In Good Health, by Dr Kevin Snee, CEO, HBDHB

Happy New Year to all BayBuzz readers!

I have just enjoyed my first Christmas in New Zealand, and whilst it was very different to one in the UK, it was very pleasurable.

Now, with three months as chief executive of Hawke’s Bay District Health Board under my belt, I have had a chance to look at how the organisation works and where its strengths and weaknesses lie.

I am looking forward to the coming years and the opportunity to be able to deliver a sustainable health service that will take Hawke’s Bay forward. However the reality is that the DHB has to address a number of difficult issues.

My role as CEO is to ensure that local health services are of the best quality for the people of Hawke’s Bay within the funding provided.

To deliver constantly improving quality of service will be challenging for a number of reasons:

1. There will be less money about as a consequence of the recession – this will be the case for many years ahead.
2. There is a need to achieve significant improvements in organisational systems, processes and structure across the sector to ensure that we are more efficient and effective.
3. We are starting behind where we need to be as consequence of the well publicised problems that have occurred in the Hawke’s Bay health sector in recent years.

This is no time, however, for harping on about the past or complaining that we don’t have enough money. It is my intention to put Hawke’s Bay in the headlines for all the right reasons.

In order to do this my focus for the next two years will be on:

• Removing the deficit;
• Meeting government expectations;
• Delivering quality services that meet the specific needs of the Hawke’s Bay community – within the funding that is available.

This will mean ensuring that our services are not simply sustainable, but are continuously improving – this will mean doing more for less. It is my view that there are significant efficiencies possible in Hawke’s Bay.

I have identified the importance of addressing the six national health targets introduced by Government last year. These are shorter stays in the Emergency Department, improved access to elective surgery, shorter waits for cancer treatment, increased immunisation rates, better help for smokers to quit, and better diabetes and cardiovascular services.

Shorter stays in the Emergency Department specifically aims to have 95% of people admitted discharged or transferred from an emergency department within six hours.

In the Emergency Department (ED) our first quarter target was 73 percent, placing us 16 out of the 21 DHBs. Since mid-November we have seen a steady improvement, and for January our figure was 90%.

This is an important target because, if delivered, it will mean that patients attending ED with serious problems will have their pain and uncertainty dealt with quickly. It is also an important indicator of how the whole hospital manages the treatment of patients attending and being admitted with urgent problems. The community can play its part here in only attending the ED department if it is a true emergency. This could reduce attendances at the department by up to one third and allow the staff to concentrate on those patients that really need their specialist skills.

There is no question that smoking is a significant contributing factor to ill health, and it affects the poor and disadvantaged more than any other group. Advice and information or support from a health professional increases the chance of successfully quitting. For this reason, we intend to help smokers quit by ensuring 80% of hospitalised smokers are provided with advice to help them quit. Our performance is improving and, whilst it was 23% for the first quarter and showed little improvement in the second, in January it was over 40% and on an upward trend.

We have some excellent smoking cessation services in Hawke’s Bay. Now we need to make them work and help smokers to quit.

In relation to our waiting times target for cancer treatment, we are meeting in full the required access time for radiotherapy treatment. However we should not stop at that. There are many other aspects to the detection and treatment of cancer that we will need to look at to improve services.

We are our exceeding our immunisation rate target and, when we are compared to other DHBs with similar populations, our performance is recognised as the best in New Zealand. This is an important target because it means that our children are being given the right start, free from diseases that can cause significant harm and even death.  Importantly also, these conditions have in the past disproportionately affected more deprived populations.

There is much to do to improve our productivity in relation to elective surgery. We currently lag behind other parts of New Zealand and many developed countries and lifting our performance will be a key focus over the coming year.

The final target relates to improving services for people with diabetes and cardiovascular diseases. Both conditions are major contributors to death and disability in Hawke’s Bay. Improvements in treatment and care will have a significant impact on the health of the Hawke’s Bay population and will help the local service cope better with an aging population.

We welcome these targets. They make us accountable to the community and to government for demonstrably improving health services. My sense is that this has been lacking in the past.

I look forward to talking more about the improvements we have made in these areas in the future. I am also determined that we will not only improve our performance but that we will also balance the books. For too long, it seems to me, there has been too great a focus on strategy development and not enough on taking action.

It is important that the community is kept up-to-date with where we are heading and informed of our progress. Our successes are also yours – by doing better it means we are making better use of our resources and becoming more financially sustainable.

The future is in our hands. Improving health services in Hawke’s Bay requires us to have the ideas, the will and the capability to succeed, and it is my job to ensure that all three are in place.

I look forward to updating the community on a regular basis.