Better Sooner More Convenient Primary Care - New Zealand Doctor

Appendix Nine: Referred services
1. Aspirational statement:
Better alignment of clinical and financial decision making for referred services within an
integrated system will improve the effectiveness and efficiency of service provision both from
a clinical and financial perspective.
2 Project overview
This project begins in year one with a detailed analysis of current laboratory and
pharmaceutical expenditure so as to better understand current patterns of use and unexplained
variation. Current expenditure on both laboratory investigations (labs) and pharmaceuticals
(pharms) is below the national average. If the analysis shows potential for savings if financial
and clinical incentives were better aligned, then a number of change management activities will
be implemented.
3 Problem definition
General
Poor access and/or delays in receiving appropriate treatment can result in increased utilization
of emergency services and an increase in avoidable hospital admissions.
Currently there is poor linkage and co-ordination between the different parties involved in the
funding, commissioning, provision and monitoring of referred services.
The general increase in demand for services is placing increasing pressure on scarce health
resources. As both laboratory and pharmacy services are essentially demand-led services it
would generally be inappropriate or counterproductive to cap or otherwise limit expenditure or
funding. However it may be appropriate to establish better mechanisms and procedures to
increase the effectiveness and efficiency of referred service utilization and the prescribing of
pharmaceuticals to achieve better resource management and health outcome within an
integrated model.
Business case appendices V12 AC 25Feb2010 Page 79