He acknowledged that the speed of any changes might depend on relationships of clinicians within the particular specialties involved, with areas where relationships were "not as mature" taking a bit longer.
In some services it would be challenging.
This financial year, the services identified for national service improvement are cardiac surgery, paediatric oncology and major trauma.
Speaking generally about service changes, Mr Chuah said in situations where there were differences, such as in the case of neurosurgery services in the South, it was important to keep conversation going and to continue to care for patients while that was happening.
In the past five or 10 years, the sector had realised competition did not result in sustainability or viability of any service and there were greater moves towards collaboration.
The role of clinical leadership and engagement in that needed to be emphasised.
The board's role in areas identified for national improvement was to keep clinicians talking so they could find solutions.
It was not up to the board to set arbitrary deadlines, he said. Part of the board's brief was to help clinicians establish national networks and that is what it would be doing in the case of major trauma.
Clinicians had told the board there were 2000 major traumas a year in New Zealand and that they wanted to collect consistent information around them, setting up a national registry which would gather all the data from individual district health boards.
Through reviewing that information, advice could then be given to boards on how to improve and co-ordinate care for such patients.
In the past, it had been difficult to get all boards to support a clinical network of this type so the trauma specialists had come to the board -"it is exactly one of those things we are set up to do, so we are pleased to support them".
It has been reported that there have been a number of attempts to establish an effective national network during the last 15 years.
Mr Chuah said a good example of how a national trauma service might work was the national service which covered burns.
There were four regional burns units, at Middlemore (where the National Burn Centre is situated), Waikato, Hutt and Christchurch hospitals, each dealing with an agreed level of patient care.
If the burns experience was anything to go by, it could take a couple of years to establish the national trauma network, Mr Chuah said.
• Former Dunedin Hospital registrar Dr James Falconer, whose 2000-04 study of southern trauma deaths appeared recently in the New Zealand Medical Journal, was among those calling for the development of a national trauma database to standardise assessment and care co-ordination.
