Better Sooner More Convenient Primary Care - New Zealand Doctor

to easily access by telephone). Otherwise the patient is referred for an FSA and may have the
investigation done prior to, or after, their FSA.
There is potentially spare capacity which does allow for increasing direct access for those
conditions where:
CT is the appropriate first line investigation,
GPs are often able to provide the management indicated by the CT scan diagnosis
without needing an FSA
guidelines can be implemented that will manage demand.
CTs currently seen by both general practitioners and the radiology department as being
appropriate for direct access are:
CT head for head injury
CT scan for painless haematuria
CT urogram for renal colic
CT colonography instead of barium enemas.
As the Health Pathways are adapted for West Coast, it may be that other kinds of CT scan are
identified for development of direct access pathways.
Remote access
If patients are coming from remote rural areas, such as Fox Glacier, and are likely to need a
FSA along with their radiological investigation, where possible the Central Booking Unit
organises for both to happen on the same visit to Greymouth.
There are difficulties for low socio-economic families in rural areas with the cost of transport
to Greymouth for radiological procedures and the difficulty accessing travel assistance.
Radiology in Integrated Family Health Centres (IFHC)
The equipment and resources required for radiology services are expensive. Currently at 5000
community ordered radiology investigations a year, this equates to approximately 1700 per year
per IFHC, approximately 7 investigations per day per centre. While it would be desirable to
have plain radiology and portable ultrasound in each IFHC, and this is achievable in Buller, in
Hokitika/Westland (thirty minutes from Greymouth) this would not be cost effective. In
Greymouth while it would be convenient to have the radiology department within the IFHC, use
is greater by the hospital and having two radiology centres would not be cost effective;
therefore the radiology department should remain close to ED, and medical and surgical wards.
Proximity of the IFHC to the hospital could advantage those 7 patients a day who need
radiology, but only if their investigation was able to be provided at the same visit.
Business case appendices V12 AC 25Feb2010 Page 73