Workforce Survey

League Table for Adult Diabetes Specialist Physician Services in New Zealand

Compiled by NZSSD Executive 2009

Background:

The NZSSD Executive requested workforce information from each DHB towards the end of 2008. This first league table shows ranks all DHB's in terms of their Diabetes Specialist Physician services. Further information relating to other aspects of diabetes service provision will be made available in due course. All DHB's provided information. NZSSD takes no responsibility for the accuracy of the information provided, although we have attempted to verify data that appears incongruous.

It should be noted that some DHB's may provide diabetes services with a different configuration, for example, relying more heavily on diabetes nurses, and therefore requiring less diabetes specialist physician services. Recommended diabetes specialist physician services have been calculated based on information from the United Kingdom. Whether these calculations are applicable to the New Zealand workforce is unknown, however they serve as a good comparison. The NZSSD Executive believes that 1 FTE Diabetes Specialist per 125,000 population is probably appropriate for New Zealand also.

Findings:

  1. There is significant variation in the provision of diabetes specialist physician services between DHB's.
  2. The national mean is 0.44 FTE Diabetes Specialist Physicians per 125,000 population.
  3. The national mean is 0.35 FTE Diabetes Specialist Physicians per 100,000 population.
  4. The total Diabetes Specialist Physician FTE for New Zealand is 14.5
  5. No DHB has a Diabetes Specialist Physician service that is at or above that recommended by the Federation of the Royal Colleges of Physicians of the United Kingdom.
  6. New Zealand requires 19.4 more Diabetes Specialist Physician FTE's to meet recommended numbers.

Conclusion:

There is significant variability in the provision of Diabetes Specialist Services in New Zealand. This must lead to inequities in service delivery between DHB's. Provision of specialist services is markedly less than those recommended by the Federation of the Royal Colleges of Physicians of the United Kingdom.

 

Area Total Population ranking Recommended FTE Diabetes Specialist Physician [1] Actual FTE Diabetes Specialist Diabetes Specialist Physicians per 100,000 population Ranking for Specialist Service Provision
West Coast 32000 21 0.26  0.2 0.60 1
Lakes 102000 16 0.82 0.5 0.52 2
Canterbury 491000 2 3.93 2.4 0.52 3
Wairarapa 39000 20 0.31 0.2 0.50 4
Otago 185000 8 1.48 0.9 0.50 5
Auckland 439000 4 3.51 2.05 0.46 6
Midcentral 165000 9 1.32 0.7 0.45 7
Southland 110000 14 0.88 0.4 0.38 8
Nelson / Marlborough 135000 13 1.08 0.5 0.37 9
Capital and Coast 282000 6 2.26 1 0.37 10
Waikato 355000 5 2.84 1.6 0.36 11
Counties Manukau 468000 3 3.74 1.5 0.32 12
Hutt Valley 141000 12 1.13 0.45 0.31 13
Northland 154000 10 1.23 0.5 0.30 14
Waitemata 516000 1 4.13 1.3 0.27 15
Tairawhiti 45000 19 0.36 0.1 0.22 16
Hawkes Bay 153000 11 1.22 0.3 0.20 17
Bay of Plenty 204000 7 1.63 0.4 0.20 18
South Canterbury 55000 18 0.44 0.1 0.18 19
Whanganui 63000 17 0.5 0.1 0.16 20
Taranaki 107000 15 0.86 0.15 0.14 21
             
Total 4241000   33.93 14.5    
Mean         0.35  

[1] Based on data from "Federation of the Royal Colleges of Physicians of the United Kingdom. Census of consultant physicians in the UK , 2006. Data and commentary. Suffolk : Lavenham Press, 2007."

Recommendations:

1. Inform the Minister of Health of this information, particularly the inadequate and inequitable provision of diabetes specialist services in New Zealand.

2. A nationally agreed target for Diabetes Specialist Services should be established to reduce the inequity in service provision between DHB's.

3. DHB's should be instructed to meet this target within a reasonable time frame e.g. 5 years.

4. Diabetes should be recognised as an under-resourced discipline and incentives be developed for doctors to train in this discipline.