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

Affiliated Provider funding for anaesthesia consultations
Southern Cross has advised that anaesthetic and intensivist consultations will not be part of its Affiliated Provider (AP) only funding services for 2017. They say that while these are the only exceptions under their AP-only specialist consultation programme, they will continue their discussions with anaesthetists to investigate appropriate models of contracting with these two specialist groups. Pain specialists will be listed in Southern Cross’ Health Care Finder directory and members will be using this to identify AP-only providers that they should use to be reimbursed.

NZSA forum – save the date
Please save the date of Saturday 29 July 2017 for this year’s not-to-be missed NZSA Forum ‘Behind the Scenes.’ The forum’s key focus will be on the topical themes of competency, recertification and medical college accreditation – especially in light of the MCNZ’s proposed recertification changes for vocationally registered doctors. There will also be updates on other issues impacting your everyday practice such as assistants to the anaesthetist, neuromuscular blocking, health IT and ACC. We will have an excellent range of speakers from across the health sector, with plenty of time for questions.

The event will be held at the University of Otago, 23A Mein Street, Newtown, Wellington and will be a full day event (9.00am-5.00pm). There will be a heavily discounted rate for NZSA members. The programme will be available soon and registrations open in May.

Regional anaesthesia survey
An online survey has been launched to gather feedback on a new technology which may make it easier for anaesthetists to site regional anaesthesia. The survey is being conducted by the Universities of Edinburgh, Dundee and Heriot Watt University, and a clinical team at NHS Lothian. You can participate in the survey here

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 

 

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.