7 July 2021 

Some highlights:  President's blog | NZSA-NZNC Joint meeting | End-of-Life Choice Act news | Aotearoa NZ ASM | ADHB first to introduce NRFiT in NZ hospitals | Sustainability awards Drs Rob Burrell and Matt Jenks | New look Visiting Lectureships | Inpatient pain meeting | In the media - Prof Alan Merry and Dr Wayne Morriss

The annual joint meeting of the NZSA and ANZCA NZNC was held on 2 July in Wellington. It was wonderful to meet in person and have the opportunity to discuss a range of issues, especially as last year's meeting had been cancelled due to COVID restrictions. At a time of impending change in our health sector it was timely to welcome four guest speakers to provide updates on the Health and Disability Review and the End-of-Life Choice Act implementation. Below are some brief summaries of these talks and we recommend you read our President's latest blog for a more comprehensive update.

Our speakers from the Health and Disability Review Transition Unit described the new model as "centrally planned and regionally managed, a distributed system with local strong operations" and said that a core goal is to reduce disparities and inconsistent care throughout the country. The new entity Health NZ will commission health services and drive models of care and service delivery. The new Māori Health Authority will not be a separate system but tightly interwoven into Health NZ. There would be strong support for innovation in primary care where many Māori kaupapa providers operate. They outlined the timeline for changes with interim boards and CEOs due to be in place for the new entities in September and formally in place by next July. Attendees raised issues including the need for appropriate funding to implement reforms, the necessity of having an aligned IT infrastructure, and the need for improvements in data collection and accessibility. Read the latest updates from the transition unit here.

Speakers from the Ministry of Health outlined the eligibility criteria and process for accessing the assisted dying service, due to be in place from 7 November. Their key advice is for all doctors to undertake the training module to understand their rights and obligations under the Act (whether they choose to participate or conscientiously object). Information about this module is included in the following E-Zine news item. Attendees expressed concern about the short time frame until the Act goes live and said greater clarity is needed on the process and what is expected of medical practitioners. MOH advised that more resources, and additional information, will be out shortly. 

NZSA EOLC Act member survey
Thank you to all our members who responded to our End-of-Life Choice Act survey - we had a high response rate and appreciated the time you took to send us your considered views. What came through strongly is that members believe that the NZSA has a twofold role to play: information dissemination to support members (whether they choose to be involved or not in the EOLC Act implementation i.e. conscientious objection) and advocacy to have input into the MOH framework being developed. The results of the survey will be emailed directly to members later this week, who will be able to access more information on the members only section of our website. 

Ministry of Health information
MOH is leading the work program to implement the Act and to introduce an assisted dying service in New Zealand from 7 November 2021. The MOH website has information for health professionals to outline their rights and responsibilities under the Act (whether involved in assisted dying, wishing to conscientiously object, and/or needing guidance on how to talk with patients who may raise the issue).
There is an information booklet, which has been produced for health professionals also. View here.

Ministry of Health learning module
The first learning module about the Act and assisted dying aims to provide health professionals with a working knowledge of their roles and responsibilities under the Act, including conscientious objection. MOH strongly encourages all health professionals to complete this module as it may help if a patient asks about assisted dying.

We are collating EOLC Act information and resources on a newly created webpage, and will continue to update it as new resources are released.
View here

We held our stakeholder function last Friday (and earlier in the year than usual to introduce new NZSA CEO Michele Thomas to our stakeholders). In her speech NZSA President Dr Sheila Hart described our stakeholder relationships as enduring and vital as we work towards common goals.  "We appreciate your goodwill and generosity in supporting each other and working together." Dr Hart also acknowledged NZSA members who volunteer their time to support the NZSA's work.  "We have a growing number who are engaging with us in a range of ways, especially as members of our sub-specialty anaesthesia networks, as well as our sub-committees and of course, our Executive Committee."

We look forward to sharing photos from our stakeholder event in the next issue of our magazine.

The 2021 Sustainable Healthcare and Climate Health Conference Aotearoa held last month featured talks on mitigation and adaptation strategies, innovation and research. Well done to the organisers (Ora Taiao: NZ Health and Climate Council, the Sustainable Health Sector National Network, University of Otago Wellington and Global Green and Healthy Hospitals). Some key messages:

- Climate change is an environmental and health problem - they are inextricably linked
- Improving public health through preventative health measures will lower healthcare emissions by reducing the need for healthcare
- NZ now has legislation and frameworks to measure and audit carbon emissions taking a system wide approach
- Health professionals must speak up, create change and communicate climate change messages to healthcare colleagues and the public.

Find out more about Ora Taiao (NZSA is a member organisation), including how you can join as an individual.

Congratulations to NZSA members Dr Rob Burrell (Middlemore Hospital) and Dr Matt Jenks (Dunedin Hospital), recipients of the inaugural Climate Health Champions Aotearoa Award, presented at the Sustainable Healthcare and Climate Health Aotearoa Conference.

"It's wonderful to see Rob and Matt acknowledged for their tremendous contribution - not only the measures they've implemented in their DHBs but their willingness to share their knowledge and help other colleagues throughout the country. We are really fortunate to have them on the NZSA's Environmental and Sustainability Network helping to inform our advocacy and education work on sustainability," says NZSA President Dr Sheila Hart. 

The awards celebrate those who have gone above and beyond their day-to-day work to support, advocate for, or implement positive environmental change to protect the health of New Zealanders from climate change. 

The Government's review of PHARMAC focuses on how well PHARMAC performs against its current objectives and how its performance against these could be improved. A range of factors are being considered, including timeliness and transparency of decision-making, and equity in terms of access to medicines and devices for Māori and Pacific peoples. More information about the review is on the PHARMAC website. 

The NZSA will be providing input into the consultation and welcomes member input and comments to help inform its submission. Please email Daphne Atkinson at comms@anaesthesia.nz by 14 July.

Dr Nick Lightfoot and Dr Rob Burrell will inform and entertain you with the inaugural new-look Visiting Lectureship Series (2 September at 6pm) in a webinar format. The series was set up originally to share presentations with smaller regional hospitals. However, now that so many of us are webinar and Zoom savvy, courtesy of the year of COVID-19, the Aotearoa New Zealand Anaesthesia Education Committee (ANZAEC) has decided to give the whole country the opportunity to see our top researchers and presenters. 

• Research. Is it worth it? Dr Lightfoot
• Sustainable anaesthesia. Is it worth it? Dr Burrell

More details and registration here

The NZSA is proud to support the Inpatient Pain Network meeting on 26 November at the University of Otago, Wellington Hospital. Registrations are now open!

The meeting aims to provide: targeted education for regional pain services, networking opportunities, and a place to celebrate our joint efforts providing pain management in New Zealand. More information and registration details here. 
Learn more about this network on our website. 

Professor Alan Merry shared his wisdom and insights on improving patient safety through systemic improvements, which ensure accountability without being punitive. He would like to see improved focus on why things go wrong in the medical system, and the appropriate legal response when they do. Radio NZ interview with Kim Hill here.

Dr Wayne Morriss, member of the NZSA Global Health Committee and President-Elect of the WFSA, is in Fiji with the Australian Medical Assistance Team, to help with the Covid-19 response. Interviewed on TV 3's Newshub he said: "Suva certainly feels like a community under siege, I think people are very worried about the virus and they're worried about getting sick." Dr Morriss was also interviewed on Radio NZ.

The NZSA and the Australian Society of Anaesthetists have issued a joint statement in response to the 1 February coup d'état in Myanmar, calling for effective political action and economic sanctions to help the people of Mynamar reclaim their democratic freedoms. The statement includes an expression of support for medical colleagues. Read the statement here. 

The NZSA wellbeing page has a range of resources, including the Long Lives Healthy Workplaces, a toolkit for Anaesthesia Departments. This was originally developed in Australia and thanks to the great work of Dr Jo Sinclair there is a tailored version for New Zealand. Access here.

We are keen to keep adding resources to this page and welcome your suggestions - articles, webinars, booklets - please let us know by emailing comms@anaesthesia.nz

The current WebAIRS database has over 9000 reports, and 18% of the reports include an incident involving medication.  An analysis of the WebAIRS medication incident reports has been accepted for publication in the journal Anesthesia and Intensive Care and will available online and in print later in the year. We encourage anaesthetists to report an incident to webAIRS, to assist in improving quality patient care at a local and national level.  Please login or register: webAIRS website

Professor Alan Merry, one of the ANZTADC’s founding members, was interviewed last month on Radio NZ discussing the topic making our medical system safer and his latest book, ‘Medication Safety during Anaesthesia and the Perioperative Period’ co-written with Dr Joyce Wahr. Listen here

Experience the latest science in anaesthesiology and perioperative medicine, interact with global experts and advance your knowledge and career (1-5 Sept 2021).

100+ scientific sessions – live and on-demand, 400+ international speakers, 1800+ posters, workshops, and Meet-the-Experts. Review and watch sessions for three months post-conference. Without travel and accommodation expenses, WFSA aims to welcome the largest global community of anaesthesia and perioperative care providers ever assembled for a congress www.WCA2021.org