West Coast Māori medical attendance spikes with follow-up calls

6:34 pm on 9 November 2020

The number of Māori patients who fail to show up for outpatient clinics on the West Coast has dropped to a historic low as a result of what staff say is an "embarrassingly simple" intervention.

Te Nikau Hospital & Health Centre, Greymouth

Te Nikau Hospital in Greymouth Photo: RNZ / Nate McKinnon

The West Coast DHB Māori health team has been working for the past three months with Te Nikau Hospital's central booking unit on reducing the did-not-attend (DNA) rate for tangata whenua.

At times that has been as high as 18 percent of Māori patients, and the rate has rarely dropped below 10 percent.

Hauora Māori portfolio manager Marian Smith (Makaawhio) said the no-shows in October were down to a mere 1.5 percent.

"We are so stoked about this result - it's something to be really proud of for all the staff involved and it shows you can make a big difference in health equity with a fairly small intervention, if you're consistent, and diligent," Smith said.

Booking staff and the Māori health team had focused on communicating with patients to find out why they had not turned up and how they could help them get to appointments, she said.

"The most common reason was whānau and social issues ... If mum had to look after kids and couldn't get to the hospital, or there was no money for petrol that week, or no car or credit on the phone."

Transience was another factor - 17 percent of patients never received their appointment letter because they had moved, and 12 percent simply forgot.

"But the key was talking to them. Not giving up on them but following up and working out how we could make it happen, with help from a friend or a community organisation."

The project's success had inspired the team to take the same approach with other no-shows, although the DNA rate for non-Māori was much lower at about 3-4 percent, Smith said.

The clinics with the highest number of no-shows were usually ear, nose and throat; gynaecology; and paediatrics.

Next step for West Coast DHB equity targets

The Māori health team also reported progress in another equity indicator - the number of staff registering their ethnicity with the DHB.

DHBs need to know how many of their staff are Māori and Pasifika, and how many have disabilities, to meet the government's equity targets.

Hauora Māori manager Gary Coghlan said at the DHB meeting in Greymouth last week the goal was to match the percentage of those groups in the health workforce to the numbers in the community by 2030.

"We have had high numbers of staff whose ethnicity we don't know for whatever reason, and some of that is down to people thinking it's irrelevant, or not wanting to say. And if we don't know, we can't see how we are meeting the targets."

In the latest survey, those 'don't know' figures had dropped by 20 percent, one of the best results in the country, Coghlan said.

Some 6.4 percent of the West Coast health workforce was registered as Māori, compared to about 14 percent of the region's population.

The Māori health team's Kia Ora Hauora programme, which gives Māori secondary students a week working alongside health professionals, was paying dividends, he said.

"Twenty-five percent of those kids have gone on to careers in health - we have to make sure we retain them, make them welcome, show manaakitanga and connect them with other Māori staff."

DHB chair Rick Barker said that was pleasing but the board had to make more effort to grow that figure and would welcome any ideas for attracting more young Māori into health careers.

"We have until 2030 to meet the target ... we could always up the numbers by hiring more Māori cooks and cleaners, but that is not the goal. It takes time to get people through medical training; nine years is not a lot of time for that," Mr Barker said.

no metadata

Local Democracy Reporting is a public interest news service supported by RNZ, the News Publishers' Association and NZ On Air.