Emergency department ‘just about at capacity’
GPS unable to take pressure off emergency department
Whanganui Hospital’s emergency department is under pressure with more people than usual wanting to be seen.
A Whanganui District Health Board spokesman said the emergency department (ED) is unusually busy for the time of year, reflecting “the general pressures on the health system”.
It’s a problem facing a number of hospitals around New Zealand, including those in Rotorua, Taupo¯, Waikato, Hawke’s Bay, Palmerston North, Dunedin and Whangarei.
The Association of Salaried Medical Specialists (ASMS) said earlier this month the costs and waiting times to see a GP are “helpi ng push emergency departments to breaking point”.
“Hospitals are seeing winter numbers but without the typical winter illnesses like flu, and the usual pre-christmas slump just isn’t happening,” ASMS executive director Sarah Dalton said.
“They should have closed off their winter beds by now but in places like Rotorua, they’re being kept open. In some hospitals there has even been talk of cutting elective beds to manage the situation, which is not an okay solution.
“Emergency medicine specialists are at their wits’ end, saying they just can’t do any more with the resources they have.”
ASMS said its members reported that the costs of primary care and prescriptions, along with a shortage of GPS, are fuelling the problems, particularly in poorer communities.
“We are hearing that people who are unwell are putting off seeing a GP or getting a prescription filled due to the costs and their condition then deteriorates to the point where they are acutely ill and need emergency t r eatment,” Dalton said.
At Whanganui Hospital, the increased number of people presenting at the ED meant it was “just about at capacity”, the Whanganui DHB spokesman said.
“There are a number of contributing factors, and availability of GP appointments is one of those factors impacting the increase in presentations to ED,” he said.
“ED staff have indicated that some patients have been unable to see a GP and so have arrived at hospital in a deteriorated state.”
The General Practice Owners Association of Aotearoa New Zealand (Genpro), the national representative body for contracted providers running general practice and urgent care centres across New Zealand, has called for changes to the general practice funding framework to help ease the pressure on hospital emergency departments.
“There is widespread agreement that the funding framework f or general practi c e needs updating. In fact, a Governmentcommissioned review by an expert Primary Care Working Group on General Practice Sustainability made 19 recommendations to address this in 2015,” Genpro chairman Dr Tim Malloy said.
“Most of those recommendations remain unactioned and are long overdue.
“The ongoing chronic underfunding of general practice has a three-fold impact — it affects health outcomes for our communities and patients, it increases pressure on our hospitals and ED departments and it undermines the sustainability of our essential general practice providers.”
Genpro said more targeting of government funding is needed to address “significant inequities” in the current system.
“For example, an af f l uent patient enrolled with a Very LowCost Access practice (VLCA) still receives an additional government subsidy (paying a maximum fee of $19.50) whilst high-needs patients may be unable to even afford the capped $19.50 fee and thus turn to ED for their health needs.”
The Whanganui DHB said it was important to “work collectively to find solutions to reduce the pressure across the health system”.
Some alternatives people could consider are:
● Where they go for health literacy advice. Health literacy is the capacity to find, interpret and use information and health services to make effective decisions for health and wellbeing.
● Whether a phone or video consultation (telehealth) is an option.
● Prescription options.
“The emergency department is there for emergencies and lifethreatening concerns only. For any immediate response required, people should call 111.
“It is important that people in our community go to the right health provider as this helps them and enables the system to respond better to their needs.”
If people feel unwell, they should seek health advice via Healthline (0800 611 116), their GP or a pharmacy, the spokesman said.
Out of hours and urgent care assistance can be obtained from Whanganui Accident & Medical (WAM) which is open from 8am to 9pm.
The community-based assessment centre at Whanganui Hospital is open Monday to Friday, 8am to 3.30pm.
No appointment is needed and the service is free.