New Zealand Society of Anaesthetists (NZSA) – Level 1, Central House, 26 Brandon Street, Wellington 6011
04 494 0124 | nzsa@anaesthesia.nz

Public health system under pressure
The public health system is under-staffed and under-resourced, which is affecting access to healthcare, according to a survey of almost 6000 paramedics, nurses, mental health workers and support staff. Ian Powell, the Director of the Association for Salaried Medical Specialists (ASMS), says these findings will strike a chord with hospital specialists who, like other health care workers, are struggling with high workloads and ongoing shortages. “There’s no doubt that these things are taking a toll on their personal health, with half of all senior doctors surveyed by ASMS last year reporting high levels of burnout.” Read more on STUFF 

Consultation on recertification of vocationally registered doctors
The NZSA has developed a submission in response to the Medical Council of New Zealand’s (MCNZ) Consultation on strengthening recertification for vocationally registered doctors.

Decision to delist tramadol hydrochloride oral drops 100 mg per ml
The NZSA welcomes PHARMAC’s decision to progress the proposal to delist tramadol hydrochloride oral drops 100 mg per ml from Part II of Section H of the Pharmaceutical Schedule, and instead list a 10 mg per ml strength of tramadol hydrochloride oral solution for use in DHB hospitals. This was the subject of a consultation letter dated 4 October 2016. In summary, the effect of the decision is that:
– tramadol hydrochloride oral solution 10 mg per ml will be listed for use in DHB
hospitals from 1 January 2017.
– tramadol hydrochloride oral drops 100 mg per ml will be delisted from 30 June 2017.

Perioperative morbidity and mortality within the Hip Fracture Population: identification of a core outcome set
Ciara O’Donnell, an anaesthetic research fellow in Queens University Belfast, N Ireland has invited NZSA members to participate in a study. The University is setting up a project to define a list of core outcomes relating to the perioperative management of patients with a hip fracture. They are aiming to use the Delphi technique which involves sending an online survey to as many patients, healthcare professionals and researchers in this field as possible, to form a consensus of expert opinion. The opinions will be collated and a position paper written by a worldwide expert panel. Participants will be acknowledged in the resultant publication.

The Delphi process requires the completion of three consecutive questionnaires over the space of a couple of months.  Each questionnaire will take a few minutes to complete and the purpose of the three rounds is to give participants feedback on the worldwide responses. The purpose of doing three is to give the participant feedback regarding the response of others and to achieve consensus. Here is  additional information regarding the process.

The first of these online questionnaires is now open and responses can be submitted.  You can access the survey at this link: http://ctrc.liv.ac.uk/DelphiManager/HipFractures 

Semantic interoperability – the search for shared meaning
Dr Greig Russell is a Clinical Health Informaticist at MidCentral DHB and is completing his training medical management. He is currently the chair of the Mid-Central IT Governance group.  He writes about the latest in IT developments.

The 2016 HINZ was held in Auckland this year and was the biggest ever with DHB representatives, clinicians, Health IT vendors and a few hundred speakers both international and local. The meeting was supported by the Ministry of Health and included several streams and various clinical specialities. Both the Minister and the Director General talked about the value of health leadership.  The value of clinician led initiatives were discussed and examples provided. Read semantic-interoperability article.

Interview with anaesthetist Tony Diprose
Anaesthetist Dr Tony Diprose, who describes his overseas aid work as “adventurous and challenging,” is interviewed in Hawkes Bay Today. His aid work has taken him to the Pacific and recently the coast of West Africa.  New Zealand Anaesthesia magazine will have a feature article on Dr Diprose, who is a member of the NZSA Overseas Aid Committee, in our December issue.

Burnout rife among DHB senior doctors
Burnout is rife among senior doctors in New Zealand’s public hospitals and higher than  in comparable international studies, according to the Association of Salaried Medical Specialists, with half of all senior doctors and dentists surveyed appearing to have very high levels of burnout.

Key findings of the survey include:

  • Half (50.1%) of hospital specialists reported symptoms of burnout – ie, high levels of fatigue and exhaustion.
  • 42.1% said this was due to their work, and they cited frustrations with management, intense and unrelenting workloads, under-staffing, and onerous on-call duties.
  • 15.7% attributed their burnout to their interactions with patients.
  • Three out of five female specialists (59.4%) were likely to be experiencing burnout, compared with 43.9% of male specialists.
  • Burnout was even more prevalent among female doctors aged between 30 and 39, with 7 out of 10 (70.5%) experiencing burnout. More than half (51.1%) attributed this to their work.
  • Some medical specialties reported higher levels of burnout than others – in particular, emergency medicine, dentistry and psychiatry.

A full report of the research findings can be read here

Sole supply of propofol
Sole Supply Contracts (Hospital Supply Status) have been awarded to two suppliers for propofol:
• AFT Pharmaceuticals’  Provive brand MCT-LCT 1% inj 10 mg per ml, 20 ml vial;
• Fresenius Kabi (NZ)’s Fresofol brand 1% MCT/LCT inj 10 mg per ml, 50 ml vial and inj 10 mg per ml, 100 ml vial.

These products will be the only brands of propofol that can be used in DHB hospitals from 1 June 2016 until 30 June 2019. The 50ml and 100ml vials of Fresofol were introduced on 1 April. All other presentations of propofol currently listed were delisted from 1 June 2016. The NZSA wrote a submission to Pharmac earlier in the year expressing strong support for continued availability of Provive and Fresofol and said consistency of supply for NZ’s leading anaesthetic drug is essential.

Workforce survey
The Medical Council of New Zealand (MCNZ) has published the New Zealand Medical Workforce Survey Report for 2013-2014.  Chairman Andrew Connolly says the size of the medical workforce was 15,366 in 2014.  There were increases in the number of international medical graduates (42 percent of the medical workforce), female doctors (42.4 percent of the medical workforce) and the age of doctors (45.7 years), continuing the trend of past years. Registration data show that the number of practising doctors increased by 2.7 percent in 2014, up from 14,964.  See the media release here.

National Medication Chart Review and Design Changes
The Health Quality & Safety Commission has reviewed and made design changes to the National Medication Chart (NMC).  The review was based on feedback from clinicians since the last review in 2012. Submissions were made via the electronic change register or by direct communication with the Commission’s medication safety team. To read more