Survey shows the Hawke's Bay DHB workplace culture could be better.


District health boards are continuing to fall woefully short when it comes to providing a workplace culture that encourages clinical leadership in health decision-making," says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

"A survey of our members highlights yet again the fact that the people running New Zealand’s public hospitals need to be doing a lot more to actively involve senior doctors and dentists in decisions that will, ultimately, affect patient care. We surveyed members on clinical engagement 18 months ago, and it appears as if nothing much has changed."

In the 2015 survey, ASMS asked its DHB-employed members a number of questions related to distributive clinical leadership. The most recent findings are still being analysed but already indicate that DHBs have made little progress in terms of their commitment to clinical leadership: http://www.asms.org.nz/wp-content/uploads/2015/07/DHBs-need-to-improve-commitment-to-distributive-clinical-leadership_163958.2.pdf

"That also seems to be the case when it comes to our members’ responses to another survey question about the culture within DHBs," says Mr Powell. "A few DHBs are doing all right when it comes to clinical engagement (although not as well as we’d like), but many of them are doing poorly."

For the 2015 survey, 1182 of our DHB employed members responded; a response rate of 31.6%. Overall, this sample size is adequate at the 95% confidence level with +/- 2.5% margin of error. Disaggregated to individual DHBs, however, the response rates vary considerably and as a consequence, some DHB responses have limited statistical validity. Nevertheless, as always, the results are illuminating and align with members’ own reported experiences.

Some initial observations include:

Compared with the 2013 survey, the average responses are slightly more negative and no more positive in 2015 (54 to 59% answering ‘no and 28 to 27% answering ‘yes’), suggesting little has improved in terms of DHB culture towards distributive clinical leadership.

Members in the Southern and Hutt Valley DHBs responded the most negatively to this question. Hawke’s Bay and Canterbury’s responses were the most positive but still less than 60% of all respondents answered ‘yes’.

Lakes DHB’s responses suggest a declining performance in this regard. In the 2013 survey, they had 63% answering yes with only 14% in 2015. This drop of 35% was statistically significant (p=0.003).

"Health bosses have an obligation to create a culture within hospitals that actively fosters clinical leadership and draws on the expertise that is available," says Ian Powell.

"Public health professionals, including doctors, are highly motivated and wish to ensure the best possible treatment and care is available for their patients. It’s up to their bosses to create a culture that values their expertise. Anything else results in a negative, isolated working environment which will undermine the ability of hospital specialists to fully contribute."

Influenza rate in Hawke's Bay has doubled.


There is a significant increase of influenza like illness in the Hawke’s Bay community, and doctors are urging people, especially pregnant women and those with a chronic illness to make sure they have had the influenza vaccine.

The weekly rate of influenza like illness reported last week by general practice has nearly doubled compared to the previous week.

Taradale GP, and Chief Medical Officer primary care for the district health board, Mark Peterson said there had been a big increase in respiratory illness in the community. "If anyone who had a chronic respiratory condition and hadn’t had the influenza vaccine - now was the time to do it." The vaccine is available free for many people with chronic illnesses until the end of July, he said.

Hawke’s Bay Hospital was also busy Chief Medical Officer John Gommans said. Shortness of breath and chest infections were the lead causes of hospital presentations and admissions over the past week, particularly in the elderly.

Dr Gommans said anyone who was sick should see their family doctor before they were so sick they needed hospital care. "We have seen a big increase in flu-like illness over the past couple of weeks particularly amongst the elderly, and getting to see a doctor early can make a big difference in preventing serious illness."

Influenza is highly contagious and people with flu can spread it to others up to two metres away, and many people can spread it even before they have developed symptoms. Pregnant women are also more at risk and the vaccine is funded in New Zealand for pregnant women and is highly effective in preventing influenza and its complications in women and for a short time after birth, her baby.

Dr Gommans said making sure you had the influenza vaccine and seeing your family doctor early if you were sick, were two of the best ways to prevent becoming seriously ill.

If you feel unwell you can help reduce the spread of the virus by:

- Staying at home if you are unwell.

- Covering your cough or sneeze using disposable tissues.

- Regularly washing your hands thoroughly with soap and hot water, and then dry your hands with a clean dry towel or paper towel.

- Contact your GP or local medical centre to get the influenza vaccine.

- Further information on general hygiene and influenza can be found at: 0800 Immune (0800 466 863) or Healthline on 0800 611 116.

Napier Inflatable World closes its doors over safety issues.



Napier's Inflatable World has been forced to close it's doors after a 10 year old boy fell down a hole and fractured his skull while playing at the indoor inflatable park.

On July the 7th Zaybein Wathey had been playing on an inflatable piece of equipment when he fell down a hole  and landed head first on exposed concrete.

Hastings woman Nevenka Pervan saw the boy fall and when she noticed he was having a seizure she rushed to help.

Ms Pervan held Zaybein until the paramedics arrived and he was then flown to Starship Hospital where he remains in a serious condition.

Zaybein's mother Haley Wathey said she was glad the indoor playground was closed until safety standards could be improved but was disappointed that Napier Inflatable World had only made contact with her after the story was given to the media.

A 10 year old boy suffered terrible injuries at a Napier indoor playground.


The future of Napier's Inflatable World could be in doubt after a 10 year old boy allegedly fractured his skill while playing on a bouncy castle.

It is believed the boy fell down a hole at the indoor playground and landed head first on concrete.

Emergency services rushed to the scene and the boy was then flown to Auckland Starship Hospital after he started having seizures.

The boys mother, who is still in Starship Hospital with her son, said she had received no apology from the company.

The Upper Hutt family had been visiting Napier when the accident happened and mum Hayley Wathey took to Facebook after the incident to thank the woman pictured holding her son.

Ms Wathey said the woman stayed by her son's side throughout the entire incident as they waited for an ambulance to arrive.

Worksafe NZ say they were aware of the incident and were making inquiries as to whether they should launch and investigation. 



Napier boy battles on after being found hanging from a window.


A nine year old Taradale Primary School student may have suffered significant brain damage after he was found hanging from a toilet window on May the 26th. 

Aryan Banerjee wasn't breathing when he was discovered hanging by his shirt from a window at the primary school and paramedics rushed to resuscitate him.

He was taken to Starship Hospital in a critical condition and was transferred to Hawke's Bay hospital last month. 

Over the past few weeks Aryan has been able to open his eyes but the full extent of his injuries are not yet known.

Aryan has now been moved back to Starship Hospital after his heart rate became elevated and he began to develop twitches. 


Hawke's Bay DHB committed to clinical leadership


"Hospital specialists are very disappointed at the lack of progress district health boards have made on distributive clinical leadership in recent years," says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

"Our latest survey of members shows there has been almost zilch movement since the last survey on this which we carried out in late 2013. That survey sent DHBs a clear message that they needed to lift their game - and these latest findings tell us they haven’t."

Mr Powell says ASMS asked its DHB-employed members about their DHBs’ commitment to clinical engagement, also known as distributive clinical leadership. Survey questions looked at the DHB’s overall commitment to clinical engagement, how supportive the DHB’s culture was, and the extent of the chief executive’s and senior management team’s commitment.

A total of 1182 members responded to the survey; a response rate of 32%. The findings are still being analysed but Mr Powell says they are already providing valuable insights, especially when compared with members’ own reported experiences of clinical engagement within their DHBs.

Key findings from a question about DHB commitment to distributive clinical leadership include:

Canterbury DHB was - again - ranked highest on DHB commitment to distributive clinical leadership, although there were indications of some decline.

In only three DHBs did at least 50% of members answer with a ‘yes’ to the question - Canterbury, Northland and Hawke’s Bay (the latter two improving since the previous survey).

Previously highly-rated Lakes DHB has dropped to the middle of the DHB pack.

Waikato DHB has noticeably declined.

Hutt Valley and Southern DHBs have both performed abysmally remaining at the bottom of the pack.

"What DHBs are still failing to understand in any meaningful way is that clinical engagement and leadership offers them so many benefits," says Mr Powell.

"Hospital specialists specialise in complexity and are natural problem solvers. If our health bosses actively supported them to be in the engine room of decision-making this would lead to significantly improved quality of patient care and financial performance.

"Health bosses who don’t support comprehensive leadership by hospital specialists are guilty of wasting a tremendous resource and condemning their DHBs to being struggling performers."

The ASMS has published a plain language advisory for members about distributive clinical leadership, available from the ASMS website at http://www.asms.org.nz/wp-content/uploads/2015/07/ASMS-Advice-Making-Distributive-Clinical-Leadership-Work_163930.pdf

Hawke's Bay man is airlifted to hospital after fleeing his burning vehicle.


This morning, Lowe Corporation Rescue Helicopter crew responded to a 38 year old male who had rolled his motor vehicle into a ditch sometime during the evening at Elsthorpe. 

The man managed to extract himself from the vehicle after it had caught fire and he had to walk 5km to a house to raise the alarm.  

He sustained injuries and was airlifted by rescue helicopter to Hawke’s Bay Regional Hospital for further treatment. 

Timber by EMSIEN-3 LTD