Glossary

To help the reader, we have simplified some of the terms that the Ministry of Health and district health boards use. Fuller definitions about scheduled services are available on the Ministry's website. Where we have replaced the Ministry's term with one of our own, we explain the difference. We do not explain the medical terms used in our report because some of the terms are in general use or information about them is widely available from reputable medical websites and other sources.

A care pathway describes what happens to patients with certain conditions or groups of symptoms from the time a patient raises a concern with a doctor to after any treatment is completed. Many pathways cross the traditional boundaries between hospital and community care. In this way, care pathways help to implement new knowledge, clinical guidelines, and protocols.

Diagnostic tests are tests (such as colonoscopies, biopsies, X-rays, and CT and MRI scans) that are recommended or needed to help establish a diagnosis, to discover the extent of a disease, or evaluate the effectiveness of treatment.

Elective services – see scheduled services.

Elective Services Patient-flow Indicators (ESPIs) are a set of eight performance indicators used to monitor some aspects of DHBs' performance in managing patients' progress through the scheduled services system. The Ministry can impose financial penalties if DHBs do not comply with the ESPIs. The ESPIs are listed in Appendix 6.

First specialist assessment (FSA) refers to a patient's first visit to a specialist for advice about a health condition after referral from a GP or other health professional. A written plan of care must be produced for a specialist's advice to be considered an FSA or virtual FSA.

General practitioners (GPs) are medical practitioners registered with the Medical Council of New Zealand who specialise in general practice. For the sake of simplicity, we use the term to represent all health professionals who may refer patients for scheduled services, such as nurse practitioners, dentists, optometrists, and others.

Home DHB is the DHB responsible for people living in a certain geographical district. The Ministry and DHBs call this the DHB of domicile.

The National Booking and Reporting System (NBRS) is a national database that contains information about patients seeking and receiving scheduled services.

Scheduled services are medical and surgical services to provide FSAs, virtual FSAs, or treatment that can be delayed because they do not need to be provided urgently. We use this term to refer to all services that are known as elective or non-urgent services. They are services that are provided more than seven days after the need for treatment is recommended. Scheduled services do not include access to diagnostic tests or services such as disability support, maternity, mental health, oncology, primary health, or public health services.

Specialists are medical practitioners registered with the Medical Council of New Zealand who specialise in a particular vocational area. They have appropriate qualifications, training, and specialist experience, and are competent to practise independently. Other health professionals may also provide scheduled services, but for the sake of simplicity we use the term specialists to refer to all the relevant professionals.

The Strategy is a document called Reduced Waiting Times for Public Hospital Elective Services: Government Strategy that was published by the Ministry in March 2000 and is available from www.moh.govt.nz.

The Treating DHB is the DHB delivering scheduled services to a patient who lives outside a certain geographical district. In this report, the Treating DHB is never the Home DHB. The Ministry uses "DHB of service" to describe the DHB that provides an FSA or treatment, which means that the DHB of service and DHB of domicile could be the same.

Treatment can include medical procedures, pharmaceuticals, surgery, and other therapies (such as physiotherapy) to relieve or treat a patient's health condition.

Unscheduled services are services for patients provided within seven days after treatment is recommended. We use this term to refer to all services that are known as emergency, urgent, and acute health services.

Virtual FSAs do not require the patient to attend an appointment with a specialist. However, the specialist may telephone the patient or speak with the GP as part of providing their advice. Doctors in training to be specialists, nurse practitioners, and GPs who are employed to decide which patients will be offered scheduled services may also provide virtual FSAs. A written plan of care must be produced for a specialist's advice to be considered an FSA or virtual FSA.