5 August 2021 

Some highlights:  President's message | Aotearoa NZ A ASM | Pharmacist prescribing | End-of-Life Choice Act updates | NZSA photo competition | New health and disability standards | In the media - Dr Tony Diprose | Environmental news | Visiting Lectureships | New issue NZSA magazine | WFSA Congress

We are preparing a submission in response to the Ministry of Health's proposed amendments to the schedule of specified prescription medicines for designated pharmacist prescribers. The Ministry is recommending the addition of 198 prescription medicines and 25 controlled drugs to the schedule. View the proposed additions to the medicines list here, which includes anaesthesia drugs. The NZSA has strong concerns about these proposals in the interests of patient safety and believes these anaesthesia drugs need to be prescribed by a trained medical practitioner.  Please provide feedback to Daphne Atkinson comms@anaesthesia.nz by 8 August as submissions are due Mon 9 August.

Ministry of Health implementation and information
The Ministry of Health’s work to implement the End of Life Choice Act 2019 (the Act) and establish an assisted dying service in New Zealand from 7 November 2021 is well advanced. The current focus is to develop and finalise the care pathway, or the steps in the assisted dying service that an eligible person and a practitioner will follow; and also developing the details of the funding mechanism for the service. These details are being informed by health and disability sector partners, Māori health equity and community voices and stakeholders.

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 for health professionals also. View here.

Statutory body established for NZ's assisted dying service
The statutory body for the assisted dying service, the Support and Consultation for End of Life in New Zealand (SCENZ) group, has been formed. Appointments to SCENZ have been made by the Director-General of Health, Dr Ashley Bloomfield. SCENZ's responsibilities include maintaining the list of health practitioners and psychiatrists involved in providing assisted dying services; and providing contact details for replacement, or independent medical practitioners as part of the service. SCENZ will have oversight of the standards and work closely with the secretariat of the assisted dying service at MOH once the assisted dying service becomes legally available from 7 November 2021. MOH media release here

Ministry of Health learning modules
The first learning module about the Act and assisted dying aims to provide all 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. Further training modules are being developed for health professionals, including on the care pathway.

The NZSA has a webpage with collated EOLC Act information, news updates and resources. Bookmark to stay up-to-date here. You can also sign up for regular MOH updates.

The Ngā Paerewa Health and Disability Services Standard (HDSS) outlines the steps health and disability service providers must take to ensure they are providing safe, quality services. The updated Standard comes into effect on 28 February 2022.

Over 650 different providers across the health and disability system must demonstrate compliance with the Standard, including DHBs, aged care, and hospices. It sets out what people can expect from the services they receive, and is one of the tools to continuously improve New Zealand's health services. 

NZSA CEO Michele Thomas is attending a two-day event this week to learn more about the standards. We will provide updates to members about the changes and what it will mean for your everyday practice.  

NZSA advocacy priorities and submissions can be read on our website advocacy page. Recent submissions include:

- The Government's review of PHARMAC and how it performs against its current objectives. Our feedback included the need for improved timeliness and transparency of decision-making. 
- The Ministry of Health's proposed funding mechanisms for health professionals who will be providing services for end-of-life care outside of the DHB setting. Our key point was that it is not clear whether it is a fixed fee or time based and clarity is required. We suggested that time based funding is more appropriate. The funding will be through a section 88 notice, although a pricing schedule is yet to be developed.

Anaesthetist Dr Tony Diprose, a member of the NZSA Global Health Committee, is in Fiji assisting with non-life threatening surgeries, working with Fijian colleagues amid the country's COVID-19 crisis. Dr Diprose was interviewed on TV One's Breakfast this morning.  "In a way I’m kind of doing my day job, but in a very different setting and with a very different bunch of people and unfortunately with a lot of patients who have Covid as well…" Interview here

- Ora Taiao (the NZ Climate and Health Council), of which NZSA is as member, recommends a new article which explores the health sector's role as a significant driver of environmental pollution. The article looks at surgical and anaesthetic services, which are among the most resource-intensive components of the health system. ‘Operating in a Climate Crisis: A State-of-the-Science Review of Life Cycle Assessment within Surgical and Anesthetic Care' can be read here.

- In Ora Taio's latest newsletter a tip for health professionals to consider - when scheduling your next patient consultation or conference, look at whether ‘Zoom or SKYPE might be appropriate. It won’t work for everyone but cutting travel cost and emissions when possible is good practice.

- In our last E-Zine we highlighted the Sustainable Health Sector Network conference. Most of the talks from this conference are now available here. 

- The latest article from the NZSA's Environmental and Sustainability Network, written by Dr Paul Currant, explores the possibility of carbon neutral anaesthesia. Read it in the latest NZSA magazine, which will be delivered to members soon. 

The President's blog was published in our last E-Zine, and focused on the significant and impending changes to our health and disability system. In case you missed it, we encourage you to read Dr Sheila Hart's comprehensive update here.

Less than a month away! Dr Nick Lightfoot and Dr Rob Burrell will inform and entertain you with the inaugural new-look Visiting Lectureship Series (2 Sept @ 6pm) in a webinar format. More details on speaker topics and registration here

New Zealand Anaesthesia - the magazine of the NZSA - will be delivered to your letter boxes or inboxes in the coming week. Highlights include an article from NZSA member Dr Paul Currant on whether carbon neutral anaesthesia can become a reality; a profile of our new CEO Michele Thomas; a trainee column on personal wellbeing; and an update on the COVID crisis in Fiji and what NZSA is doing to assist.

We have refreshed our magazine design as it's been five years since we rebranded. We hope you like the new look, and we welcome your feedback and story ideas. Contact Daphne Atkinson comms@anaesthesia.nz

As COVID continues to disrupt our lives, the College of Intensive Care Medicine of Australia and New Zealand is sharing an article on the importance of self-care.

"Given that the pandemic is likely to be prolonged in its effects on the healthcare system, it is even more important to pay attention to self-care and not ignore or defer one’s own needs. To do so is ultimately a disservice not only to oneself, but also to the patient." This article has some great reminders on the fundamentals of self-care and support available. Read here

Dr Russell Rarity, ANZTADC committee member, will give a webAIRS presentation on Saturday 30 Oct, 2021 at the Aotearoa New Zealand Anaesthesia ASM: Advisory Notices for Anaesthetists – Alerts issued by webAIRS based on case reports during Session 11, from 1330 –1400. View the full program of the Aotearoa New Zealand Anaesthesia ASM, which will be a hybrid meeting with both on-site and virtual registration options. 

The NZSA will be sending out a member survey soon on webAIRS to gauge awareness and use of this online reporting tool, as well as the value members place on webAIRS. 

A new report, Bula Sautu – A window on quality 2021: Pacific health in the year of COVID-19, paints a stark picture of the healthcare challenges faced by Pacific peoples in New Zealand. The report calls for urgent systemic changes to address health inequities. The report has been developed through a partnership between the Health Quality and Safety Commission and Drs Corina Grey, Api Talemaitoga, and Debbie Ryan. It includes contributions from Pacific health and community leaders, clinicians and health workers.

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

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 WFSA Congress www.WCA2021.org