Medical directors are insisting they're as prepared as they can be for the nurses' strike tomorrow as facilitation talks between nurses and DHBs failed.
Last-ditch talks between nurses and their employers have concluded in Wellington.
There's been no comment from either side but RNZ understands the facilitation talks ended a short time ago.
One chief medical officer estimates 6000 to 8000 elective surgery procedures nationwide will need to be deferred.
The New Zealand Nurses Organisation (NZNO) rejected the latest district health board pay offer yesterday, saying more money was needed to avert the strike.
The Employment Relations Authority has ordered them back into talks which are due to continue today.
Finance Minister Grant Robertson told Morning Report that the government is not putting any more money on the table at the moment.
"Clearly we have to be preparing for the worst, that the strike does go ahead on Thursday," he said.
Mr Robertson said the offer put forward by the government doubled what it inherited from the previous government, which didn't reflect the value of the nurses.
"We can't solve every single problem in one year, we believe this is a good offer, we've committed to a long term relationship with nurses to improve their working conditions and we've put in place what we think is representative of what we can do in this first year."
He said it's about balancing priorities.
"People are frustrated, I understand that."
As negotiations have unfolded, so too have plans for life-preserving services during the 24-hour industrial action, scheduled to start at 7am tomorrow.
Wellington's Capital and Coast DHB's chief medical officer John Tait estimated 6000-8000 elective procedures nationwide will need to be deferred.
It would pose major challenges for the country's 20 DHBs but medical directors have insisted they're as prepared as they can be, he said.
Sue Hayward, chief nursing and midwifery officer at Waikato District Health Board, said an agreed number of nurses would work during the strike - a measure taken with the support of the NZNO.
"The contingency plan has an aim to ensure we have the right number of nurses with the right skills and knowledge to activate life preserving services with all of our patients within the seven hospitals that we have oversight of."
If any of the nurses fell ill, the hospital had staff to backfill those who were sick, she said.
Director of child health at Starship, Dr Mike Shepherd, said Auckland District Health Board was as well prepared as it could be.
"We've been contingency planning now for a couple of weeks because of the need to reduce the number of patients in the hospital and to make sure we're able to provide safe services over the strike period.
"We don't have the exact number of patients that have been deferred at this stage but it's certainly in the hundreds that have had either outpatient clinic appointments postponed or procedures and operations postponed."
The hospital had a near-complete life preserving services roster, and was confident it could keep patients safe, he said.
Dr Vanessa Thornton, chief medical officer at Counties Manakau DHB, said acute services would be prioritised during the strike.
"Obviously the elective side of the services will be cancelled because we won't be able to provide that service. Winter is a busy time for us and so we have prepared our life-preserving services around our current occupancy and acuity."
Bay of Plenty DHB chief medical officer Hugh Lees said they had a reasonable idea of the number of emergency patients they would normally get, though couldn't be certain.
"We will need to see on the day but at the same time I think we've done a lot of good planning for it and as long as the numbers are within what we expect on a Thursday at this time of year we should be able to manage."
Dr Thornton said while the hospitals were prepared, the day itself would prove difficult.
"I think it's going to be a very stressful day for staff in the hospital but, as I say, we do have contingency and arrangements made to hopefully achieve care for patients across the hospital."
DHBs national contingency planner Anne Aitcheson told Morning Report anytime staff leave their place of work to take industrial action there's a high level of disruption and this is a very large number of staff that are taking action tomorrow.
"We are working very hard to try and reduce the demand in the hospitals so elected surgical procedures have been deferred for the last three days and we've cancelled all out-patient appointments tomorrow so that we can free up other staff to provide support to patients," she said.
Ms Aitcheson said there are plans in place to ensure there is appropriate handover of patient care when the clock rolls around to 7am tomorrow morning.
If there is no one else who can pick up a particular patient's care when the strike begins at 7am, NZNO has agreed the staff member needs to stay working as a life-preserving action.