Reduced wait focus for service

Planning for the new Dunedin hospital’s ophthalmology service is still ongoing, as the health system tries to ensure a service which had formally fallen foul of the health and disability commissioner will operate effectively from its new home.

Te Whatu Ora Health New Zealand (HNZ) Southern group director of operations Hamish Brown said the organisation was looking at ways to reduce wait times at the eye clinic planned for the new Dunedin hospital, and had boosted the size of the waiting area.

This follows concerns from a patient who did not wish to be named that the facility at the current hospital was not meeting requirements.

"The seating area often spills down the access passageway and in some areas patients are being tested within sight of those seated in the waiting area.

The patient said unless the eye clinic at the new hospital was larger than the current clinic, it would not be fit for purpose on opening — let alone fit to meet demand ten or twenty years into the future.

Asked if the clinic was set to shrink, Mr Brown said the current hospital’s ophthalmology clinic occupied 654sqm of clinical space.

"The new Dunedin hospital will have a purpose-built ophthalmology area in the outpatient building.

"The service will occupy approximately 700sqm — this space is flexible to accommodate demand from the ophthalmology department and other Outpatient services."

About 150 people were seen each day at the current clinic, which HNZ Southern recognised was busy.

During planning for the new hospital, the organisation carried out a detailed analysis based on real patient numbers and waiting times over the course of a typical week, he said.

"This resulted in an increased size for the waiting area associated with the eye clinic."

The analysis also found ways to streamline the patient journey and reduce the amount of time people needed to wait to be seen at clinic appointments, he said.

"We are working through what this model of care will look like but can assure patients that providing high-quality care while valuing patient’s time remains at the forefront of our planning."

The Filleul Surgical Centre opened in April this year, freeing up space in operating theatres by offering day eye surgeries outside the hospital, Mr Brown said.

"The facility is used by both our ophthalmology department and also local ophthalmologists for private surgery.

"This will continue once the new Dunedin hospital is opened."

The performance of the Southern District Health Board — now HNZ Southern — ophthalmology service was the subject of a scathing health and disability commissioner report in 2018.

Waiting lists had blown out and people’s sight had been permanently damaged, the report said.

There had been an insufficient response by senior management to growing demands for ophthalmology services over many years.

By late 2019, wait lists were down and the service had made "enormous improvement".

However by early 2022, ophthalmology was again nearing a crisis point as wait lists climbed and locum clinics were planned.

At the time Dunedin clinicians were taking about 130 appointments a day, and demand was set to increase as the population aged and diabetes-related vision issues became more common.