Secondary care

What we’re proposing

We’re engaging with the health sector to develop a clinically-led secondary care model for musculoskeletal injuries – a service that delivers a more consistent, transparent and coordinated experience, helping clients access the right care at the right time and supporting better recovery outcomes. The proposed model will improve referral quality, strengthen clinical governance, create earlier clinical review, improve visibility across the pathway, and support clients to access the right care at the right time.  

The new model will include 5 key improvements: 

1. Clinically led care networks

   
   The future system will be delivered by multidisciplinary groups of clinicians working together to provide more coordinated secondary care. This creates an opportunity for groups of clinicians, including specialists, working within strong clinical governance and leadership arrangements, bringing together capability across triage, specialist assessment, non-surgical specialist treatment and coordinated pathway management. 

2. Stronger clinical governance and accountability

   
   We’re building clear clinical leadership, decision criteria and quality assurance into the model, so that decisions are more consistent and there is clearer accountability for the quality of those decisions. 

3. Improved referral quality

   
   Clearer information requirements for referrals into secondary care will support better decisions earlier and reduce unnecessary administration. By providing clearer referral expectations and guidance, clinicians will be better equipped to connect people with the right care from the outset, improving access and reducing delays across the system. 

4. Greater visibility and transparency

   
   Data requirements will provide better visibility of referral patterns, pathway decisions, outcomes, variation and delays. This will give ACC and providers a better understanding of what’s working well, where the pressure points are, and where improvement is needed. 

5. Coordinated clinical decision-making

   
   A triage component will help direct clients to the right next step based on clinical need, urgency and pathway fit. That may be specialist assessment, non-surgical specialist input, imaging, surgery, rehabilitation support, primary care, or escalation back to ACC where cover or entitlement issues need to be resolved.

Why changes are needed

Today, a client’s experience in secondary care can vary widely, depending on where they live, who refers them, and which provider receives the referral. Referral quality is inconsistent, there’s limited visibility of provider capacity, and decisions about assessment, imaging, treatment, and onward referral are often made at different points along the client’s journey. This makes it difficult to maintain a clear view of a client’s progress to ensure they’re achieving their recovery outcomes. As a result, some clients move through the system efficiently, while others experience delays, duplication, or unnecessary steps before receiving the right assessment or treatment. 

In addition, demand for specialist assessment of musculoskeletal injuries has been rapidly increasing, putting pressure on elective surgery and other secondary care services, and the Accident Compensation Scheme. 

How to stay informed 

Over the coming months, we’ll continue to engage with the sector as we refine the model. Join us at one of our online engagement webinars to stay updated on this work.  

To share your feedback with us, or for any questions, contact us:  

Email engage.secondarycare@acc.co.nz

Past events

Click through to view the previous webinar recordings and download the presentation slides and FAQ documents.

Musculoskeletal Secondary Care Clinical Advisory Group

The Musculoskeletal Secondary Care Clinical Advisory Group provides guidance on potential solutions to improve recovery outcomes for people who have a musculoskeletal injury.