Te Nikau Hospital in Greymouth is being tested to capacity as Covid-19 continues to rage through the region.
West Coast District Health Board operations manager Philip Wheble said those presenting at the hospital had "quite complex" needs.
"We're having some challenges around our inpatient activity, around capacity at Te Nikau," he told the board's advisory committee meeting.
Te Nikau was generally about 91 percent full, meaning there was not a lot of room to make more beds available for incoming patients overnight.
The 91 percent capacity figure essentially meant there were three spare beds at peak time, Wheble said.
Rest homes were also under pressure.
"We do have some issues with access to aged residential care. That is being resolved now."
Covid-19 had made for "a challenging time... [but] the teams have done a remarkable job."
Wheble noted the GP shortage in Reefton, which would be without a doctor throughout winter. An "enormous effort" was planned to find a locum.
Currently the DHB was using GP staff from its other practices to conduct a once a week clinic in Reefton, combined with nurse and telehealth appointments.
Telehealth waiting times for Reefton patients needing to consult a doctor were currently four days.
Reefton is 80km away from the nearest GP surgeries at both Greymouth and Westport.
Wheble said the reopening of Ziman House rest home at the Reefton Hospital had been postponed until August, "at this stage."
Advisory group chairman Peter Neame asked if the board had done anything yet about instituting some regional training given the national nursing shortage impacting on the board's capacity to operate facilities, such as at Reefton.
"If you don't have some sort of regional training, you are going to be seriously short," Neame said.
Wheble said work was beginning to bring back some West Coast-based training for enrolled nurses and aged residential care support staff "with a capped training programme."
However general registered nurse training was more of a problem as it was mainly polytechnic or university-based.
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