Clinical Matters Newsletter Nov/Dec 2024 6 Dec 2024

In this issue:

• Post Menopausal Bleeding Ultrasound request - Reminder
• Collection of Rectal Swabs
• Pathlab Pathology results
• Paralytic Shellfish Poisoning (PSP) warning for Bay of Plenty
• 2024 Pertussis Outbreak
• New eReferral for Community Health 4 Kids
• Community Referred Radiology (CRR) baseline survey for Primary Care

Post Menopausal Bleeding Ultrasound request - Reminder

An ultrasound scan improves the patient journey through the Faster Cancer Treatment pathway. Currently an estimated 25% are referred without an ultrasound.

When referring patients to the gynaecology service for post-menopausal bleeding, please remember to use the specific eReferral form which can initiate a request for ultrasound on the form.

This is an essential part of a single referral, and assumes a scan has not already been performed.

Collection of Rectal Swabs

Effective immediately, Pathlab phlebotomy staff will no longer be responsible for the collection of rectal swabs due to the procedure being outside the scope of practice for phlebotomists at Pathlab.

All patients presenting at a Pathlab collection room with a request for a rectal swab will be redirected back to their referring clinician without the sample being collected.

Please ensure this information is communicated to all requesting providers at your practice, and also clearly communicated to all patients.

We appreciate your understanding and co-operation in implementing this policy.

On behalf of Keith Walmsley, Customer Liaison, Pathlab
26 November 2024

Pathlab Pathology results

It is essential that results and follow-up actions are appropriately managed by both Primary and Secondary Care providers.

When results received in Primary Care recommend further investigations, clear accountability for initiating these tests must be established.

In a recent case, a FNA (fine needle aspiration) was deferred in favour of an USS (ultrasound) guided FNA, but the report did not clearly specify who was responsible for organising the procedure. As a result, neither the GP nor the Pathologist arranged it until the patient revisited the GP at a later date. Fortunately, the investigation was carried with favourable results once completed.

The Pathologists at Pathlab have agreed to provide clearer instructions by including statements such as, ‘The original requesting clinician to make the referral, please.'

This change aims to eliminate any future ambiguity.

Please contact the Pathlab Pathology team if you get a result that is unclear to clarify any course of action that may be needed.

Please also contact the GP Liaison team on baynav@bopdhb.govt.nz if you have ongoing concerns.

Paralytic Shellfish Poisoning (PSP) warning for Bay of Plenty

2024 Pertussis Outbreak

The Bay of Plenty region is starting to see more cases of Pertussis as part of the current epidemic which was declared on 24th November 2024.

Babies under the age of 3 months and those where the caregivers are reporting possible apnoeic episodes are amongst the highest at risk of complications and should be considered for admission.

The Paediatric oncall teams at both Tauranga and Whakatane hospitals are happy to discuss patients where pertussis is being considered as a diagnosis.

For more information about the epidemic refer to the Health NZ - Te Whatu Ora Notification and Health Pathways - https://midland.communityhealthpathways.org/13614.htm

Immunisation information can be found at https://www.immune.org.nz/diseases/pertussis.

New Community Health 4 Kids eReferral form

A new Community Health 4 Kids eReferral form goes live 27th November 2024. This referral replaces all PDF referrals for the Service.

Community Referred Radiology (CRR) baseline survey for Primary Care

On 6 June 2024, Minister Reti announced the investment of $30 million through Health New Zealand to improve community access to X-ray, CT scans and diagnostic ultrasound across New Zealand (and in a later phase, other imaging modalities). This will ensure that primary health providers can refer patients directly where clinically appropriate, rather than having to wait for a specialist assessment.

Below is a clinical survey which is being circulated to General Practitioners, Nurse Practitioners, and Allied Health Professionals to quantify baseline satisfaction with the current access to community radiology and to inform aspects of the workplan.

Please complete this two-minute survey using the link https://my.thoughtexchange.com/scroll/500259803/welcome, to inform the delivery of the Heath New Zealand Community Referred Radiology programme being rolled out over the next two years which aims to improve primary care practitioners' access to radiology.