Health New Zealand releases report into Equity Adjustor Tools

An independent review panel has released their report into two waitlist prioritisation tools initiated by Health New Zealand’s Te Toku Tumai Auckland, and Southern Region.

Both tools included a range of parameters including clinical speciality, days already waited, socioeconomic deprivation, geographic area and ethnic group.

The tools were implemented as part of a range of initiatives to manage planned care during and following the COVID-19 pandemic. The evaluation of the tools began in August 2023 and was carried out by an expert panel independently chaired by Professor Rod Jackson.

The review found that the benefits of the specific tools were inconclusive.

The evaluation noted that the tools could have been strengthened with better quality data, and alignment with best practice algorithm development.

The review panel has made six recommendations. In short form, these were:

• action on demonstrated health inequities is legally and ethically justifiable;

• a consistent planned care action plan must be developed and mandated;

• the action plan must address unacceptable variation in receipt of planned care;

• development and implementation must consider the right team and approach;

• until then (and subject to conditions), the current tools should continue; and

• co-benefits of equity interventions should be recognised and measured.

Health NZ agrees with all of these except the recommendation that the tools should continue to be used while evolved. Health NZ considers a fundamental relook is required, not a simple evolution of the tools that the evaluation found were not robust.

The Southern region ceased using their tool in November 2023. Te Toku Tumai Auckland will stop using their tool and will revert to pre-existing waitlist management systems. Northland have already stopped using this tool.

We will commence a new process to robustly look at waitlist prioritisation for Health NZ overall.

Should any new tool(s) or processes be developed, this will be done in line with the findings of the evaluation and would be rigorously assessed.

No decision to adopt a new tool or process has been taken at this time. We will take the time we need to undertake robust assessment work on whether a new tool should be put in place.