Service Models

Service models have been developed in the following areas to support improved national or regional access, quality and outcomes.

Extra Corporeal Membrane Oxygenation (ECMO)

The Ministry has worked with a sector advisory group to develop a service model for the provision of Extra Corporeal Membrane Oxygenation (ECMO).

ECMO refers to the use of a portable modified heart-lung bypass machine to support patients whose hearts and/or lungs are failing. As such ECMO is a complex resource and infrastructure-intensive modality. It is used to support organ function in a range of clinical conditions characterised by severe lung and/or circulatory failure, including support for lung transplant recipients with primary graft dysfunction in the first few days after lung transplant and after heart transplant to support heart function. 

This service model has been developed as use of ECMO is increasing. The goal is to provide a framework for service provision that will improve clarity, quality, and outcomes for people requiring this highly specialised treatment.

The attached Service Model outlines the current state, and the ECMO Service Model.

Service Model for Extra Corporeal Membrane Oxygenation (ECMO)(7.57.11)

Implementation of the Service Model will be progressed during 2018.

Perinatal Pathology Services

The Ministry has undertaken a review of the service delivery model for Perinatal Pathology Services, with a view to implementation of a sustainable national service. The attached Service Model outlines the current state, and the proposed model for a National Perinatal Pathology Service.

Service Model for National Perinatal Pathology Services

Vascular Services

In 2015 a Project Advisory Group was convened by the Ministry of Health, with the support of DHB General Managers Planning & Funding and Chief Operating Officers.  The Advisory Group has developed a nationwide tier two Vascular Services Service Specification, and a Model of Care for Vascular Services that describes minimum requirements for a DHB intending to deliver vascular services, to ensure an integrated and safe service for patients. 

Model of Care for Vascular Services

new Tier Two Service Specification for Vascular Services

The Ministry of Health will be working with providers to implement recommended changes through an agreed Implementation Action Plan.

Service Specifications

National Services are services that it is determined should be nationally planned and/or funding centrally by the Ministry of Health.  National Services have been designated as such in three tranches. 

A historical tranche of services were established and funded centrally prior to the endorsement of the National Services programme in 2010. These include the following services, links to the service specifications are also below where available.

• Solid Organ Transplant services (docx, 90.25 KB) 
• Paediatric Rheumatology

Services endorsed in 2011 and implemented in 2012 include the following.

• Paediatric and Congenital Cardiac Services
• Paediatric and Adult Metabolic Services
• Perinatal Pathology Services (Updated 2019)
• Clinical Genetics

Services endorsed in 2012 and implemented in 2014 include the following.

• Hyperbaric Medicine - Hyperbaric services
• Renal Transplant - National Renal Transplant Service - Ministry of Health website
• Intestinal Failure - National Intestinal Failure Service - Healthpoint website

National Service Improvement Programmes

National Service Improvement Programmes are for services that require action from the centre to lift DHB performance, but where the additional step of Ministry purchasing is not required. The focus is on centrally co-ordinated performance improvement activities.  The following National Service Improvement Programmes are in place.

Spinal Cord Impairment 

ACC is the lead agency for implementation of the Spinal Cord Action Plan, supported by the Ministry of Health.

Spinal Cord Impairment Action Plan 2014-2019 - Ministry of Health website

Major Trauma  

ACC is the lead agency for the Major Trauma National Clinical Network, supported by the Ministry of Health.

Further information about the Major Trauma work programme -  Major Trauma Clinical Network website

Complex Epilepsy

Technical Advisory Group Complex Epilepsy National Service Improvement Project - Terms of Reference (docx, 428.87)