Position Description
A Consumer Advisor for a national Enhanced Recovery after Surgery (ERAS)
Collaborative programme for elective patients requiring hip and knee replacements
and acute patients needing treatment of fractured neck of femur.
The Electives Team within the National Health Board (NHB) is seeking a Consumer Advisor to work
alongside them to plan and implement a national, patient centred, enhanced recovery after surgery
(ERAS) Collaborative in orthopaedics. The programme will be focussed specifically on patients having
hip and knee replacements and patients with fractured neck of femur. The consumer advisor will be a
member of the Expert Faculty whose role it is to define the technical content AND Change Package
for the ERAS Collaborative.
Background
Electives are medical or surgical services which will improve quality of life for someone suffering from
a significant medical condition, but that can be delayed because they don’t require immediate medical
care. Services such as disability support, maternity, mental health, primary health or public health
programmes are excluded from Electives.
Currently District Health Boards (DHBs) are required to have no patients waiting longer than five
months to access First Specialist Assessment (FSA) or treatment. Waiting times are being reduced so
that patient care and clinical outcomes are improved. By December 2014 DHBs are required to
reduce waiting times to no longer than four months for FSA or treatment.
A multi-disciplinary orthopaedic Expert Reference Group (ERG) was convened to advise the Electives
Team on how DHBs can improve the quality of patient care and clinical outcomes and achieve
sustainable reductions in waiting times. Using the group’s collective expertise and experience, an
analysis was undertaken of DHB orthopaedic service delivery. This included identifying critical issues
from a service provider perspective and using information from national data collections.
Following this analysis the ERG recommended a national Enhanced Recovery after Surgery (ERAS)
programme for knee and hip arthroplasty and fractured neck of femur. Additionally the group
recommended a focus on improved clinical governance in orthopaedics.
Rationale for Consumer advisor position
The Health and Disability Commissioner Act 1994, requires health care providers to promote and
protect the rights of consumers of health and disability services. The Institute of Medicine (IOM) has
identified six dimensions of health care quality including safety, effectiveness, patient-centeredness,
timeliness, efficiency, and equity. Internationally research has been conducted that evidences
engaging consumers in the planning and development of healthcare services results in improved
quality and safety of health services, and individual health care. The Electives team acknowledges
this and will include a consumer representative in the development and implementation of this
programme.
Patient and family centered care
Patient and family centered care (PFCC) respects the individuality, values, ethnicity, social
endowments, and information needs of individual patients. The primary design idea is to put each
patient in control of his or her own care. The aim is customization of care, according to individual
needs, desires, and circumstances.
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It also implies transparency, with a high level of accountability of the care system to the patient.
Because of its focus on participation and collaboration, patient and family centered care means
working with patients and families rather than doing to and for them.
In patient and family centred care, patients define who their family members are, and how they will be
involved in care and decision making. Partnerships with families are essential because for the
patient, the families are the constant – the link across different settings.
This approach is congruent with ERAS, a patient centred method of optimising surgical outcomes by
improving both patient experience and clinical outcomes.
The Role
This position requires a consumer who has some experience of hip / knee replacement, or fractured
neck of femur treatment, either through their own experience or through a close family member who
they have provided direct support to. It is expected that the consumer advisor will have established
networks through association with relevant consumer groups and communities. These networks will
ensure that the consumer advisor brings a range of relevant and current perspectives to the table.
Key consumer advisor responsibilities
1. Provide timely advice and contributions to the Expert Faculty to ensure the consumer is
placed at the centre in the planning and implementation of a national Orthopaedic ERAS
programme
2. Provide advice to the Expert Faculty on determining patient centred measures for the
programme
3. Provide advice to DHBs / orthopaedic teams participating in the programme on how they can
ensure the consumer is placed in the centre in planning and implementation of their ERAS
programme
Skill requirements, experience and personal attributes
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Well-developed communication skills
Knowledge of the health and disability sector
Good analytical skills
Ability to work in a group and confidence to interact positively with health professionals and
others
An understanding, experience and commitment to promoting the consumer voice in health
care planning and delivery
Experience and ability to work at a strategic and national level
Links with consumer and /or Maori or Pacific Island communities preferable
Time commitment
This is an eighteen month contract commencing in August 2013 and finishing in December 2014
when the formal part of the Collaborative is finished.
The consumer advisor will be expected to participate in the following activities, attend:
 An introductory meeting with the collaborative planning team in Wellington
 Expert Faculty meetings ( a maximum of two days in Auckland)
 Learning Sessions (LS) (expected to be three days in either Auckland or Wellington)
 The end of Collaborative Conference (expected to be one day in either Auckland or
Wellington)
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Approximately five meetings with the Collaborative planning team in Wellington.
o (in the planning stage (x2 meetings)
o after each Learning Set (x3 meetings)
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o To participate in a Collaborative evaluation meeting (x1),
o To participate in the preparation of the end of Collaborative Conference (x1)
In total, a maximum of 14 days.
Remuneration
Participation on this programme will be reimbursed at the rate of $320.00 per day +GST; travel and
accommodation costs will also be covered.
For more information on this position, or to be considered for an interview, please send your
curriculum vitae to:
Simon Duff
Team Leader
Service Improvement Team
Electives
Performance, Accountability, Monitoring and Funding
Ministry of Health
Simon_Duff@moh.govt.nz
DDI: 04 4962263
PO Box 5013
Wellington
Applications will close on July 19th.
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Appendix A
The New Zealand Electives system
New Zealand’s public health system is funded by the taxpayer. There are limits to how much free
treatment can be provided. Demand for Electives is increasing for a number of reasons including the
ageing of our population and new technology making more types of procedures available.
In 2000 the Electives health strategy1 was released in a document titled Reduced Waiting Times for
Public Hospital Elective Services. This strategy remains in place today. Under this strategy the system
has been improved in the following ways:

We acknowledge there are not enough resources to meet everybody’s needs right away, so
the resources available must be given out in a way that is fair to all.

All patients have the right to know what will happen to them regarding their treatment, and
when it will happen.

All patient referrals should be assessed within 10 days of receipt by the DHB, and the patient
and referrer advised within that period whether an FSA will be available.

If a patient is accepted for an FSA, the FSA should occur within five months. The specialist
may not need to see the patient in person.

If the specialist decides further specialist treatment is required, the patient will receive a
priority score according to their level of need and ability to benefit from the treatment
compared to other people.

If the patient’s priority score is high enough, given available resources, treatment should be
provided within five months of confirmation it is available.

By December 2014, waiting times will be reduced to four months for FSA / treatment.
The traditional admission to hospital for one or more nights is changing, which means more patients
can now be treated. Modern, safe treatment practices mean some people’s needs may now be met
by day-surgery, less invasive surgery, or by non-surgical techniques.
Electives programme principles
The Electives programme runs under the National Health Board within the Ministry of Health. The
Electives programme principles are committed to:
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providing services that matter to people and will make a difference
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developing policies that are fair, in the best interests of New Zealanders and the health sector

developing effective partnerships to deliver the best possible services now and in the future

communicating clearly so everybody is well-informed

monitoring performance and encouraging good practice

looking for new ideas and better ways of doing things
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Reduced Waiting Times for Public Hospital Elective Services
GOVERNMENT STRATEGY - MARCH 2000
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
Providing the best advice to the Minister of Health.
Electives will be provided in a way which:
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meets the population’s health needs to a reasonable level
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provides the best possible health gain to individuals and to New Zealand as a whole
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gives priority to patients who need treatment most and who will benefit most
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respects people’s privacy, individuality and dignity and their wishes to be well-informed and
fairly treated
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is regularly evaluated and improved
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is well-integrated with other health services.
Electives programme objectives
From 2011 the Electives programme has prioritised the following objectives:

Increase available services by improving capacity, productivity and efficiency

Work towards everyone having equal access to elective surgery no matter where they live
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Improve the way patients are prioritised to ensure fairness, value for money and that those
who access services are those with the greatest need and ability to benefit.
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Improve the management of patients (patient flow) to reduce waiting times

Support new and innovative ways of providing Electives, such as adopting alternative
pathways and models of care
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Support clinical networks, such as the National Cardiac Surgery Clinical Network, to improve
delivery of services.
Further information about elective services can be obtained from the Electives page on the Ministry
of Health website.
http://www.health.govt.nz/our-work/hospitals-and-specialist-care/electiveservices?mega=Our%20work&title=Elective%20services
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