Staff shortages, overcrowding and poor access to GPs are being blamed for a plea by Middlemore Hospital for non-urgent patients to avoid its emergency department, a nurses college says.
Middlemore Hospital says its emergency department is only for people with life-threatening emergencies. Photo: LDR
While the pressure-cooker situation at the South Auckland hospital is a major concern, the College of Emergency Nurses NZ chair Sandy Richardson said it's part of a bigger, nationwide problem. The group is part of the New Zealand Nurses Organisation (NZNO) union.
In a statement released on Monday the clinical director of Middlemore Hospital's emergency department (ED), Dr Vanessa Thornton, asked for the Counties Manukau community's assistance as the hospital's department was under pressure.
"We want to ensure we provide the best care for all our patients and to do this effectively we need the community to seek the right care for their condition and understand that they don't have to go to our emergency department to get the appropriate treatment," she said.
"Most times a GP or family doctor can provide medical advice and prescriptions, and help to manage long-term conditions. In taking these steps people will be supporting our ED staff by enabling them to focus their time and resources on patients who have life-threatening emergencies."
Richardson said she had seen first hand the same problems in other hospitals around the country due to overcrowding, a lack of staff and patients with poor access to primary healthcare.
"DHBs need to think about how people access healthcare," she said. "By not dealing with the big issues these issues end up landing in emergency departments for the staff there to solve.
"It's becoming a major issue and it needs to be addressed because it's a risk to patients and staff," she said. "Patients are being left in situations where they aren't being seen because of overcrowding."
Counties Manukau Health said it funded eight after hours' clinics in the region, and urged patients to "seek the right care for their condition early".
Richardson however claimed patients were often being treated in corridors because of the lack of bed space, and said triaging people away from hospital emergency departments through the use of vouchers and apps was not a real solution either.
"That's just shifting the care onto the primary care sector which is also underfunded and doesn't have the capacity."
Overnight service axed after 20 years
It follows news this week that eastern and South Auckland's only private 24-hour medical clinic is scrapping its overnight service after more than 20 years due to fears for staff and patient safety.
East Care Accident and Medical in Botany initiated its overnight service - between 11pm and 7am - 24 years ago, because of the "significant" need for overnight care in the community.
Last month the Association of Salaried Medical Specialists (ASMS) said one of the reasons so many people were approaching the likes of the Middlemore Hospital's Emergency Department for non-urgent treatment was because of the lack of affordable after-hours primary healthcare services.
ASMS executive director Sarah Dalton said the costs of primary care and prescriptions, along with a shortage of GPs, were fuelling the problem, particularly in poorer communities.
In September it was revealed Middlemore Hospital's emergency department was giving non-urgent patients up to 500 free vouchers a month to encourage them to go to private accident and emergency (A&E) clinics instead for treatment.
Dalton said in response to this week's statement from Counties Manukau Health that she appreciated the hard work of the staff.
"I know Counties Manukau Health has some planning under way to address the physical capacity of its Emergency Department and is trying to get budget approval for more junior doctors, but these things all take time," she said. "But at the end of the day it comes down to the pressure of numbers and capacity."
There's a pressure on umbers and capacity at Middlemore Hospital, the College of Emergency Nurses NZ chair Sandy Richardson says. Photo: LDR
In a statement yesterday a Counties Manukau Health spokesperson said it funded eight after hours clinics in the region, including Local Doctors Ōtara, Counties Medical Papakura, Urgent Care Franklin, and East Care Botany - which are funded until 11pm.
"This funding enables these clinics to provide free or low-cost care for children under 14 years old, adults over 65, and Community Service Card or High User Health Card holders.
"We need the community to seek the right care for their condition early. That means calling or visiting their local doctor, contacting Healthline on 0800 611 116, or seeking medical help at afterhours services earlier in the evening.
"In doing so our ED can focus its resources on patients who have injuries that threaten life and limb. Even at our busiest, ED staff will ensure anyone presenting at the hospital gets the right care as soon as possible."
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