1. Elective Services Productivity and Workforce Development Programme Overview Electives Forum 17 November 2010 Clare Perry Manager, Electives

2. Transformational change in ways of working to improve elective surgical productivity Cabinet allocated $70 million over the next four years Workforce and process redesign improvements to support the 20 new elective surgical theatres Support the Government’s aim of 190,000 elective surgical discharges by 2025/26

3. Increasing Elective Surgical Discharges YearNumber of elective surgical discharges 2009/2010 138,376 2010/2011 140,000 2025/2026 190,000 12 DHBs require greater than 25% increase by 2026

4. Programme Components Improve the productivity of the current workforces Introduce new types of workforce over the medium term Train the additional workforce required in the longer term

5. Funding for Improving Productivity $ millions Initiative2010/112011/122012/132013/14Total Improve productivity 7.8214.957.13029.90 New workforce roles 0.502.001.00 4.50 Training1.683.0511.8719.0035.60 Total10.0020.00 70.00

6. Improving Productivity $29.9M is to be used to support ‘radical and comprehensive’ changes in service delivery models: Action research including actual implementation of redesigned processes National implementation of already proven processes Nationally coordinated projects with champion or demonstration sites

7. Supporting the introduction of new workforce roles as part of moving to a sustainable, diversified and fit for purpose health workforce developing a sensible basis for role substitution and scope extensions demonstration sites underway for Physician Assistants, RN First Surgical Assistants setting up demonstration sites for Operating Department Practitioners (ODPs), non-specialist endoscopists

8. Training Additional Workforce $35.60M for additional training to be contracted by Clinical Training Agency: HWNZ will work with lead clinicians, clinical networks and DHBs to build a better understanding of what will be required over time

9. Process to date Business cases requested Business cases evaluated by NHB and external clinicians Recommendations made to Steering Group Proposals endorsed by sector Steering Group Letter sent to DHB Chief Executives

10. Status update Proposals under negotiation: All ‘The Productive Operating Theatre Programme’ implementation proposals (8) All pre admission redesign proposals (including nurse led) (11) A range of other proposals (10) NOTE: Other proposals may be considered if funding allows

11. Suggestions for strengthening proposals Pin point exactly what the elective surgical productivity problems are in your DHB / Region Use literature and other evidence to support your proposal to fix the problem Submit proposals for comprehensive, transformational change. Be Bold. Develop quantitative measures relating to elective discharges Clarify exactly how the money will be spent Show how findings will be shared and implemented in other areas

12. Next Steps Contractual negotiations (November - December) Sign off of contracts (December) Request for proposals for 2011/2012 (March approx) Notification of success

13. Thank you