When no doctors were available after hours, Dargaville Hospital was making use of telehealth service and transferring the sickest patients to Whangārei. Photo: RNZ / Peter de Graaf
Dargaville Hospital has again been without a doctor most nights this week, a leaked staff memo reveals.
The message, sent by management at Health NZ Te Tai Tokerau, warned staff there would be no doctor or nurse practitioner on duty overnight on Wednesday or the rest of the week.
There were also "a number of gaps" in the roster for the rest of the month.
The memo set out contingency plans such as the use of telehealth - a service provided by a private business, allowing nurses to talk to an off-site doctor by phone or video call - and a lowered threshold for transferring patients to Whangārei Hospital.
Management had also arranged for an advanced paramedic to be on the ward overnight on Wednesday and Thursday to support the nurses.
Also, any patients on the ward overnight had to be assessed by a senior doctor as being stable and unlikely to need medical input during the night.
For that reason, any patients transferred to Dargaville's 12-bed general ward would need to have their transfer completed by 5.30pm.
"We are actively discussing options with the national executive team, however in the meantime we need to ensure that any patients admitted or transferred to the general ward at Dargaville Hospital are kept safe," the memo continued.
An "escalation plan" was included in case any patients who had been stable during the day deteriorated overnight.
The message ended with a thank you to Dargaville staff.
"This is clearly not a position that we would like to be in. We will continue to work together to look at safe options for care delivery for the community."
Health NZ chief clinical officer Dr Richard Sullivan told RNZ the hospital had been experiencing overnight staffing issues for some time.
"We are continuing to look at how we address these long-standing workforce challenges to ensure the needs of the local community continue to be prioritised. At this stage, we have not been successful in recruiting senior doctors. Contingency plans will remain in place to ensure patient and staff safety while we continue to recruit to these vacancies," he said.
"This is not a position we want to be in and the decisions we are taking to manage immediate operational and clinical issues are made with the focus on maintaining appropriate access to services for the community. We will continue to work with our kaimahi, communities, and unions on long-term solutions that ensure access to high-quality health services."
Sullivan urged anyone who needed hospital care to seek it as early as possible, and to make use of telehealth options such as Healthline.
In an emergency people should always call 111, he said.
The lack of doctors at Dargaville Hospital overnight prompted a rare nurses' strike on 29 August.
The nurses said they were stressed and fearful of the consequences of looking after patients when no doctors were on duty.
Earlier this week the office of Heath Minister Shane Reti said closing Dargaville Hospital was not being considered, despite the difficulties finding medical staff.
Any speculation about the ward shutting down was "utterly wrong", a spokeswoman said.
Dargaville Hospital serves a population of more than 27,000 people across Northland's Kaipara District.
Senior clinicians have told RNZ the doctor shortage at Northland's rural hospitals worsened dramatically in May, after Health NZ cut pay rates for locums - or temporary doctors - by as much as 40 percent.