Secondary care

What we’re doing

We’re working with the secondary care sector to design a more effective, clinically led secondary care model – one that delivers the right care, at the right time, in a more consistent way.     

This work is the next step in our efforts to strengthen how we commission secondary care services to support better recovery outcomes for injured people and a sustainable Accident Compensation Scheme.  

We’re now in the detailed design phase, building on the conceptual design shared with the sector in late 2025. 

As part of the design process, we’re engaging with the sector at different stages and seeking feedback through short surveys, and meetings with suppliers, professional bodies, and the Musculoskeletal Secondary Care Clinical Advisory Group.   

Ensuring clients receive the right care at the right time

At the centre of the proposed new model is the introduction of the Musculoskeletal Triage and Assessment Service, which would provide a single and more consistent entry point into secondary care.  

The proposed new service aims to support earlier clinical decision-making, improve coordination across the care pathway, and make better use of available specialists. 

Under the proposed design, referrals into secondary care for musculoskeletal injuries would be triaged within the new service.  

This new triage function would determine eligibility, prioritise referrals, and direct kiritaki to the most appropriate pathway for assessment and treatment, including returning to primary care where appropriate. 

The overall aim is to ensure kiritaki receive the right care at the right time, and are supported through appropriate assessment and treatment planning.  

Updates to other secondary care contracts 

Existing contracted services remain an integral part of the secondary care system. Clinical Services will continue to play a key role but with a focused scope of supporting clients with non-musculoskeletal injuries. Other key secondary care contracts, including Elective Surgery Services and High‑Tech Imaging, will remain largely the same but there will be a stronger focus on performance. This is to make sure the services are safe, high quality, timely and financially sustainable and that they help improve outcomes for kiritaki. 

Why we’re doing this

We’re seeing wide variation in the quality of referrals into secondary care, there’s limited visibility of how much capacity providers have to pick up new patients, and decisions about assessment, imaging, treatment, and onward referral can happen at different points along the client’s journey, without a clear end-to-end view of how their recovery is tracking.  

This can make it harder to direct people to the right specialist care early, particularly when their needs are more complex. 

As a result, some clients move through the system efficiently, while others experience delays, duplication, or unnecessary steps before they reach the right assessment or treatment.  

Costs are rising, with elective surgery as a key driver, and more clients are needing weekly compensation after surgery and taking longer to recover and return to work. 

Kiritaki with simple injuries, like sprains and strains, are increasingly being referred into secondary care, when they could be effectively managed in primary care. We’re also seeing surgeries that aren’t clinically necessary or appropriate. 

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. 

For questions about the work we’re doing to strengthen how we commission secondary care services, or to share your feedback about this work, 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.