Appendix 6: Performance indicators for scheduled services
The Ministry monitors DHBs' performance in meeting aspects of the Strategy using eight Elective Services Patient-flow Indicators, or ESPIs. Under the Strategy, all patients are meant to be treated within certain periods. In practice, the Ministry allows a certain amount of variation from the ESPI before non-compliance attracts a financial penalty. This information was correct at 15 September 2010.
| Number | Elective Services Patient-flow Indicator | What is and is not counted by this ESPI |
|---|---|---|
| ESPI 1 | DHB services that appropriately acknowledge and process all patient referrals within 10 working days. | All specialties are included. |
| ESPI 2 | Patients waiting longer than six months for their first specialist assessment. | All specialties are included. |
| ESPI 3 | Patients waiting without a commitment to treatment whose priorities are higher than the [DHB's minimum] treatment threshold. | All surgical specialties are included. Some medical specialties are included (see ESPI 5). |
| ESPI 4 | Clarity of treatment status. | Patients on residual waiting lists do not have clarity of treatment status. DHBs are not allowed to put patients on residual waiting lists. |
| ESPI 5 | Patients given a commitment to treatment but not treated within six months. | Increasingly, some DHBs are submitting data for this ESPI for some medical specialties. These are cardiology (11 DHBs), gastroenterology (6 DHBs), respiratory medicine (3 DHBs) and general medicine (3 DHBs). |
| ESPI 6 | Patients in active review who have not received a clinical assessment within the last six months. | All specialties are included. |
| ESPI 7 | Patients who have not been managed according to their assigned status and who should have received treated. | All surgical specialties are included. Some medical specialties are included (see ESPI 5). |
| ESPI 8 | The proportion of patients treated who were prioritised using nationally recognised processes or tools. | All surgical specialties are included. Some medical specialties are included (see ESPI 5). |
As a group, medical specialties are less likely to provide procedures that need scheduling in the same way that surgery is scheduled. In most instances, patients' care is managed at out-patient visits and with pharmaceuticals. The main medical specialties that offer medical procedures that require scheduling are cardiology (which carries out procedures such as angioplasty) and gastroenterology (which provides procedures such as colonoscopy and gastroscopy).
All ESPIs exclude patients who are identified with a "planned", "staged", or "surveillance" tag. These are patients who will receive a scheduled procedure, but who receive the procedure outside the six-month time limit because it is in their best interest. Examples are patients who need implants removed about a year after they were inserted to stabilise a fracture, children who need a series of operations as they grow, or patients who have temporary ostomies reversed at a specific interval.
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