Waiting Times Down at Emergency Departments

Waiting times at Waikato District Health Board’s Emergency Departments continue to decrease as staff work to achieve the government’s six-hour target.

Quarter three results released today rank the DHB at 16th, with 81 per cent – up from 79 per cent the previous quarter – of patients assessed, treated and admitted or discharged within six hours.

The Shorter Stays in Emergency Departments target is six hours for 95 per cent of patients.

Health Waikato chief operating officer Jan Adams is pleased to see ongoing improvement at a time when presentations to the departments are at an all time high.

“We are a large organisation and we see a large number of patients.

“Waikato Hospital staff, in particular, are coping with a huge, unpredictable increase of patients, some of whom are very complex cases.

“This obviously makes achieving the target that bit harder but I congratulate all the areas for their ongoing focus. We can and will continue to improve,” she said.

Waikato DHB’s figures for the ED target include Thames and Waikato hospitals.

Individually, Thames Hospital was 91.83 per cent on 3642 attendances while Waikato Hospital had 80.7 per cent of its 14,104 patients admitted, treated or discharged within six hours.

Both hospitals experienced an increase of patients in the third quarter, but Waikato jumped up by 566 patients since the second quarter, 902 more than the period last year.

Chief executive Craig Climo said last month’s result was 85 percent, showing the DHB continues to make good solid progress.

Waikato Hospital ED nurse manager Jenni Yeates said March was a record month for the department with 4999 patients.

“Previously our busiest month was August with 4842 patients and that’s in the middle of winter.

“We’re getting more unwell patients coming in with an increasing amount of complexity for each case and that means more staff resources and time is required,” she said.

Mrs Yeates said the department is working with the rest of the hospital to create sustainable change.

“Our processes are improving and we have seen a huge drop in the average wait time for patients as a result.”

The department now has 50 per cent of patients gone within four hours, down from six hours, and 95 per cent are gone within eight hours, down from 10.

Results from Waikato DHB’s other hospitals, although not included in the national results, also rated well against the target:

WHO: Pneumococcal Vaccine Should Be on Schedules

Wyeth New Zealand today welcomed the World Health Organization’s (WHO) decision to support the inclusion of pneumococcal conjugate vaccine (PCV) in national immunisation programs worldwide.

Invasive Pneumococcal Disease (IPD) is an important cause of meningitis in children under 2 years. It is a significant concern to children’s health, estimated by WHO to result in more than 1 million deaths each year in young children around the world.

Currently the pneumococcal vaccine is not listed on the National Immunisation Schedule in New Zealand and therefore not free to all infants, as is the case in many other developed countries including Australia.

Dr Michael Lee, Medical Director for Wyeth Australia & New Zealand – makers of the pneumococcal vaccine “Prevenar”, said the WHO recommendation was a resounding endorsement of the vaccine’s value in helping to protect New Zealand kids from this debilitating disease.

The New Zealand Government is currently considering whether to list Prevenar on the schedule.

“This latest recommendation from the WHO provides further evidence of the vaccine’s value in helping to protect New Zealand kids from this debilitating disease,” Dr Lee said.

About Pneumococcal Disease

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae, and may manifest as a number of illnesses, including meningitis (infection of the lining of the brain), bacteraemia (blood infection), pneumonia (lung infection) and otitis media (middle ear infection).

Pneumococcal disease affects both children and adults and, according to the U.S. Department of Health and Human Services, is a leading cause of death and illness worldwide. WHO estimates that pneumococcal disease results in up to 1 million deaths each year in young children worldwide.

Further, according to WHO, pneumococcal disease is the number one vaccine-preventable cause of death in children less than five years of age worldwide.

About Prevenar (Pneumococcal conjugated vaccine, 7 valent)

Prevenar is indicated for the active immunization of infants and children from 6 weeks to 9 years of age against 7 major strains of the pneumococcal bacteria. The usual vaccination course is 3 doses around 2 months apart, followed by a booster, if started around 2 months of age. As with all vaccines, 100% protection cannot be guaranteed. Your child should not receive Prevenar if he or she has ever had an allergic reaction to pneumococcal or diphtheria vaccines, latex, or any other ingredients of the vaccine.

Vaccination should be delayed if your child has a fever or infection requiring a visit to the doctor. The following side effects could occur at the injection site: pain, discomfort, tenderness, a rash, redness, swelling, or a lump. Other side effects that may occur include fever, irritability, drowsiness, restless sleep, decreased appetite, vomiting and diarrhoea. Rare side effects include allergic reaction (such as rash, swelling, difficulty breathing), and seizures.

A full copy of the Prevenar Consumer Medicine Information can be found at http://www.medsafe.govt.nz/Consumers/cmi/p/prevenar.htm.

Please discuss with your doctor if Prevenar will be right for your child.

Prevenar is an unfunded prescription medicine, and doctor fees and pharmacy charges may apply.

World Mental Health Day needed every day

As World Mental Health Day approaches The Royal Australian and New Zealand College of Psychiatrists is calling for governments to focus on the significant mental health needs of the community.

The Royal Australian and New Zealand College of Psychiatrists has today released a statement Improving mental health in Australia and New Zealand to coincide with the upcoming World Mental Health Day on 10 October 2010.

“One in five people will experience a mental illness at some stage in their lives and mental illness continues to be a major health and social issue,” said Dr Maria Tomasic, President of The Royal Australian and New Zealand College of Psychiatrists.

“The Royal Australian and New Zealand College of Psychiatrists believes that with appropriate commitment and investment it is possible to improve the mental health of the community,” said Dr Tomasic.

“Current funding for mental health is inadequate. Funding for mental health should be reflective of the burden of disease attributable to mental health to ensure adequate service delivery,” said Dr Tomasic.

“Mental health services must be accessible across the lifespan and be equitably implemented across all ages, patient groups, settings and for those from disadvantaged groups,” said Dr Tomasic.

“Prevention and early intervention programs across all age groups are essential to reduce the burden of mental illness across the community,” said Dr Tomasic.

“An increased mental health workforce is needed to improve care. Successful mental health services require a whole of community and whole of government approach and mental health care must focus on those experiencing mental health issues, prioritise recovery and reduce the stigma associated with mental illness,” said Dr Tomasic.

“A substantial increase in mental health research funding is required to lead to fundamental new knowledge, care and treatment options,” said Dr Tomasic.

“World Mental Health Day acknowledges the prevalence of mental illness in the community, the importance of addressing the needs of those with mental illness and their families and carers, and seeks to reduce stigma about mental illness,” said Dr Tomasic.

Protemix IP Purchased by Co-founder of Research

PhilERA, a company owned by Margaret Cooper, has completed the purchase of intellectual property assets formerly owned by Protemix Corporation Limited.

The assets have been acquired in an open bidding process upon the liquidation of Protemix.

In the early 1990s, Garth and Margaret Cooper founded and supported for more than a decade, a research and development programme that aims to provide new medicines for treatment of diabetes and its complications, in particular cardiovascular disease. Diabetic cardiovascular disease is one of the leading causes of death and disability globally, for which effective medicines are largely lacking.

Protemix’s development programme was recognised by the United States Food & Drug Administration through the award of Investigational New Drug (IND) status and a rare Fast-Track Award for its lead compound, a new first-in-class medicine for treatment of heart failure in diabetes. The company undertook a number of successful fundraisings including a significant investment from the Novartis Venture Fund in April 2007.

Garth Cooper resigned from his executive roles and directorship of Protemix in 2006, at a time the company was controlled by associates of Bill Birnie.

PhilERA will feed the important IP rights to a not-for-profit model as part of a renewed focus to realise the health benefits envisaged at the time the research programme was founded.

Xenotransplant trial in diabetes w/o immunisation

Australian-listed company to run world’s first xenotransplantation trial in diabetes without immunosupression

A product made from natural neonatal pig islet cells encased in capsules is to offer new hope to people with type 1 (insulin-dependent) diabetes.

In a world first, Australian-listed company, Living Cell Technologies (LCT), is poised to start a Phase I/IIa trial for patients with type 1 diabetes using its porcine pancreatic cell product, DiabeCell

Alcohol Outlet Density Related To Binge Drinking

University of Otago researchers have discovered an association between the number of liquor outlets within easy walking distance of home (1km) and the level of binge drinking and alcohol related harm reported in the community. The results of the study, which is the first of its kind in New Zealand, have just been published in the Journal of Epidemiology and Community Health.

The researchers found that people with more off-licences close to their home were more likely to be binge drinkers. Off-licences are places where you buy take-away alcohol, including supermarkets, liquor stores and convenience stores.

As well as this, for each type of outlet (bars/pubs, clubs, restaurants and off-licences), there was a clear association between the number of outlets and the level of harm due to drinking reported by people living within 1km. The types of harm surveyed included effects on performance at work, on relationships, on physical health and finances.

This study used a national survey to assess individual alcohol drinking patterns, and self-reported harm from alcohol. The participants’ addresses were then mapped and compared with location of alcohol outlets. The researchers pinpointed the location of all pubs, bars, clubs, restaurants and off-licences in New Zealand and counted the number of each type within 1 km of each participant’s home.

“With each extra off-licence alcohol outlet within 1 km, the odds of binge drinking increased by about 4%,” says study lead author, Professor Jennie Connor of the Department of Preventive and Social Medicine.

Although a 4% increase doesn’t sound like much, Professor Connor points out that compared with five off-licences in an area, having 15 means 48% more binge drinking and a 26% increase in alcohol related harm.

“This is an important finding considering that national alcohol policies are currently under review. We need to rethink the ease of obtaining liquor licenses and how many alcohol outlets are appropriate,” says Professor Connor.

Dr Marion Poore, Medical Officer of Health in Dunedin, agrees:

“Turning around New Zealand’s heavy drinking culture is a whole of community issue. Citizens should ask new Councils to act now, by developing local alcohol plans that limit the number and location of outlets. The challenge for Local Government is how to balance the overall wellbeing of the community with the perceived economic benefit from an increasing number of outlets.”

The researchers say that while this study cannot prove that increased outlet density causes these problems, it does demonstrate that the link seen in international research is also found in New Zealand. Other characteristics of the people and neighbourhoods have been taken into account, making it less likely that the findings have an alternative explanation.

“It is very likely that outlet density is making a contribution to harm, and it is an area where better policy could improve health and a range of social problems,” concludes Professor Connor.

Smokers quit after new smokefree law

Study published today in Tobacco Control

The law banning smoking in bars and restaurants has encouraged smokers to quit, according to a new study.

The research, just published in the international journal Tobacco Control, found that calls to the national Quitline increased by 44 percent after the new smokefree law came into force last December.

Lead researcher Dr Nick Wilson, from the University of Otago, says the study found that nearly 4000 people called the Quitline in December 2004 and January 2005 compared to about 2800 callers in the same two month period 12 months before.

Distribution of subsidised nicotine replacement therapy through the Quitline also nearly doubled after bars and restaurants went smokefree, Dr Wilson says.

“This research supports all the overseas evidence that smoking bans encourage smokers to quit.”

He says the main aim of the new law is to prevent deaths and illness caused by second-hand smoke so the increased interest in quitting is an additional bonus.

The Quit Group’s Research Manager Michele Grigg says the research is particularly interesting because there was very little advertising about the Quitline when the legislation came into force. However Ms Grigg believes the widespread media publicity about the new laws could have encouraged people to quit.

“We do get an increase in calls after news stories about smoking. Publicity about the links between smoking and blindness generated calls.”

The same new issue of the journal Tobacco Control also published a study on the success of different mass media campaigns in getting Maori smokers to call the Quitline

Health Insurance To Fund $1 Billion In Healthcare

The Health Funds Association (HFANZ) predicts continued growth in claims paid will see health insurance funding a billion dollars worth of health care each year by the end of 2012.

HFANZ executive director Roger Styles made the claim today in releasing industry figures for the March 2010 quarter, saying recent and projected growth highlighted the important contribution health insurance was making to health funding in New Zealand.

Both premium income and claims costs rose for the March year, he said. Premium income was up 4.9 percent on the March 2009 year to $879 million, while claims costs for the year were up on the March 2009 year by 9.3 percent at $779 million.

Despite premium and claims growth, the level of health insurance coverage eased slightly in the March quarter with a drop of 2700 lives covered. Mr Styles said the drop took numbers back to where they were in June 2008.

He noted a concern with the slight drop in coverage for the 270,000 people aged 55-69, the first drop for this age group the industry had recorded since 2003.

“This age group had been growing at over 2 percent a year as the baby boomers edge closer to retirement. The future contribution of health insurance to total health spending depends a good deal on how many people in this age group retain health cover in retirement,” he said.
“Affordability has been a major concern, especially as higher claims costs have driven up premiums for older New Zealanders.

“Consequently, the response, seen by the industry, has been customers moving from comprehensive to elective surgical cover, and choosing more excess options enabling premium reductions. Further progress now depends largely on the policy environment, with mounting support for some form of targeted rebate to bolster coverage for those aged over 65,” Mr Styles said.

Pandemic Influenza H1N1 2009 (swine flu) – Update

Overall, national influenza H1N1 activity in the community now appears to be falling. However, there is still regional variation, with some areas experiencing high or increasing influenza activity. In the past week, for instance, there has been a continued increase in presentations of influenza-like illness to primary care in Canterbury.

The number of calls to Healthline is still higher than normal, though the number of calls requiring assessment of influenza-like illness seems to be decreasing.

As at midday Thursday, there have been 631 hospitalisations of laboratory-confirmed cases of pandemic influenza H1N1, including 14 people with confirmed H1N1 currently in intensive care. So far this year, a total of 102 people with confirmed H1N1 have been admitted to intensive care. These figures do not include influenza-like illness among people admitted to hospital without a positive H1N1 laboratory test result.

It’s still important to seek medical advice early, particularly for people with underlying medical conditions or who are severely overweight or pregnant as they are at greater risk of a more severe illness. If you have flu-like symptoms, phoning your GP first before you go in can help them manage your care and prevent spread to others. For health advice, call Healthline on 0800 611 116. Stay home if you are unwell.

Protecting yourself and others

For some people, influenza can be a very serious illness. The main measures to protect yourself and others are:

Ministry of Health consulting with staff

The Ministry of Health today released a proposal for consultation with staff about the structure of the Ministry of Health

The proposed structure is designed to support the changes to the health system that began in October last year.

The proposal also recommends a structure to reduce the number of full time positions within the Ministry to 1390 by the end of this financial year and 1290 by July 2011 – the Ministry currently has around 1420 full time equivalent staff. This proposal would see a reduction of approximately 35 positions this financial year.

While the proposal would change some roles and disestablish a number of positions, exact numbers will not be known until all Ministry staff have had the opportunity to provide feedback and the structure is finalised around mid to late May.

The priority for the Ministry now is managing the consultation process and supporting staff who are potentially affected by the proposed changes.

This is a proposal released to staff for consultation and it is inappropriate to make further comment at this point.