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Service ceases suddenly

Orthopaedic services cut
All orthopaedic acute surgery patients to be sent out of region

Story by Soumya Bhamidipati

Wairarapa Hospital in Masterton. PHOTO/FILE

Wairarapa Hospital has closed its acute orthopaedic service after a failure to recruit specialist surgeons to the region.

Residents presenting with acute orthopaedic needs will now need to travel to Wellington, Hutt Valley, or Palmerston North for surgery.

This was effective at 8am on Thursday.

Wairarapa District Health Board announced the immediate changes to its acute orthopaedic care service on Thursday afternoon.

In a statement, the district health board [DHB] confirmed “unplanned service challenges” had led it to close its acute orthopaedic service.

DHB chief executive Dale Oliff said the decision was an interim solution and would be reviewed regularly.

“Our community deserves and expects the right care in the right place at the right time, and as close to home as possible,” she said.

“The needs of the Wairarapa community is continually at the centre of our decision-making, but the clinical safety of staff and patients is always our number one priority.”

The Times-Age reported on Thursday the DHB’s plan to bring a New Zealand-based fixed-term non-training orthopaedic registrar to the region had been stymied by the Medical Council.

The news was described as “disappointing” in the latest DHB board paper.

“In the interim, two interviews for the ongoing surgeon vacancy have been conducted with two strong candidates,” the May report said.

“We continue to be mindful of known anticipated extended leave as well as succession planning for this service.”

There had been three permanent orthopaedic surgeons in place at the time of the report.

Oliff acknowledged the changes to the orthopaedic service had been caused by a constrained workforce.

“Wairarapa’s orthopaedic service is designed to be provided by four resident surgeons with some locum cover, rostered to provide 24/7 care. Currently, only three surgeons are rostered, one of whom has leave planned from July, which leaves the hospital short of specialists to deliver a safe service,” she said.

“Unfortunately, this means that, for a time, acute surgical care has to be provided elsewhere.”

The DHB’s recruitment efforts had been “extensive, but unsuccessful”.

“Applicants are predominantly overseas surgeons whose registrations are subject to the approval of the Medical Council. This is a complex process, and so far, the DHB has been unable to appoint any overseas applicants in this regard.”

Orthopaedic services made up about 25 per cent of Wairarapa’s surgical throughput, with more than 900 orthopaedic surgeries delivered each year. About 400 of these were acute cases.

“Our staff are working hard now to ensure our scheduled patients that are expecting local orthopaedic care are informed, to avoid any confusion about their care plan,” Oliff said.

“We know the impact of having to travel for acute care will be significant for our Wairarapa patients, and we will be doing all we can to make things as seamless as possible, including working on travel options for patients that will be going out of the region for acute orthopaedic care.”

Oliff extended her gratitude to the three DHBs which would provide services to Wairarapa patients in the meantime.

“We have long recognised the opportunities in the health sector for increased regional collaboration, and this situation illustrates the advantages for our service in having hospitals close by that can provide our patients quality care.”

Building a sustainable workforce had been one of the DHB’s eight focus areas outlined in its 10-year plan, launched in April.

DHB chairman Sir Paul Collins said the strategy was about providing the “right care, right place, at the right time”.

However, during the same month, Health Minister Andrew Little announced all 20 DHBs would be replaced by a new national body.

Wairarapa MP Kieran McAnulty said at the time that the announcement was good news for the region, which had the second smallest DHB in New Zealand, because Wairarapa residents faced barriers to accessing healthcare and often had to travel.

“We are a region that is attracting families and businesses from the larger urban centres. We want to continue doing that. Despite the best efforts of the DHB, that goal is hampered by our size and the limited healthcare services in our region.”

Orthopaedic patients’ surgical needs differ and can be best classified into three separate service areas; planned care, acute care and acute arranged care.

Planned care is where people are admitted from a waitlist, with their surgery booked ahead.

Acute care is where people are admitted directly, after a trauma injury.

Acute arranged care is where trauma has occurred requiring surgery, and the patient is admitted within seven days of initial assessment.

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