Extra payments to GPs so they can see more patients could be a solution to relieving extreme strain on hospitals' emergency departments, says Dr Vanessa Thornton who is the clinical director for hospital services at Middlemore Hospital.
Middlemore Hospital has seen four times the number of flu patients so far this winter compared with 2019, Dr Vanessa Thornton says. Photo: LDR
Auckland's Middlemore Hospital remains under extreme pressure, as an urgent investigation continues into the death of a patient who left its ED due to long waiting times.
The hospital said the patient left the ED early last Wednesday morning, only to return a few hours later after a life threatening emergency and died in intensive care.
Winter illness and Covid-19 have increased demand for the hospital's services amid staffing shortages.
The government yesterday denied that the health system was in crisis, but admitted it was under strain.
Dr Thornton said the last three to four weeks have been very busy with the increase in flu cases and other winter illnesses.
So far this winter there have been four times the presentations of people with flu compared with 2019 - with the onset of the Covid-19 pandemic, flu dropped right away because the borders were closed, she told Morning Report.
In general she said people with flu should consult Healthline or their GP and only a minority of cases who became very unwell needed to seek hospital treatment.
As far as wait times in the Emergency Department were concerned, patients who had suffered heart attacks and strokes were being seen immediately but other people faced wait times of varying lengths, Dr Thornton said.
"Our staff are under extreme pressure at the moment with this increase in presentations and have been working extremely hard to cope with the demand as the system is under enormous pressure."
Extra payments to GPs within Counties Manukau area was trialled last weekend and will go ahead again over the Matariki long weekend.
"We're in the process of reviewing that to enable people to have access to primary care..."
"[Our staff] have been working extremely hard to cope with the demand" - Middlemore Hospital clinical director for hospital services Dr Vanessa Thornton
With GPs under pressure, only those medical centres that believe their staff could cope were taking part but she believed it was a useful extra tool to help the hospital cope with the winter crunch.
"We see this as another way to assist with this high peak of winter ills."
Dr Thornton did not believe the health system was in crisis but instead was under a lot of pressure with a higher peak in illnesses than had been predicted.
She said the hospital followed the collective agreements that applied to staff and tried to protect their wellbeing - both for their welfare and to avoid overworked staff making mistakes.
Figures revealed last week showed only 54 percent of all DHB staff had received their flu vaccinations and Dr Thornton said the hospital was now seeing an increase in the number of staff members being vaccinated.
Dr Vanessa Thornton does not believe the health system is in crisis but instead is under high strain. Photo: 123RF
Extra payments welcomed by stretched GPs
Auckland GPs are juggling high patient demand with longer hours and the risk of becoming burnt out.
Clinics in East and South Auckland offered free appointments over the weekend and are set to do so again this coming long weekend.
Counties Manukau District Health Board is paying the clinics up to $350-per-patient to help ease pressure on Middlemore Hospital's emergency department.
Karl Cole from Papatoetoe Family Doctors, part of the Papatoetoe Health Hub, said his clinic will extend its hours this weekend so more patients can be seen.
Dr Cole said it was a challenging decision but the payments from the district health board help although doctors can only work so much.
He told First Up the scheme was an acknowledgement of the extra hours that GPs have been doing over the last six months.
"It helps compensate for working extra hours but there's a point where you have to start thinking about safety. Personally if I start working beyond 60 hours regularly it really becomes hard to carry on."
It was well-known that Counties Manukau had only 8 percent of the country's GPs but 11.2 percent of the population with high needs, so it was not only EDs that were stretched, Dr Cole said.
"It's a challenge to extend our hours when we're already working so much but this certainly helps us."
"There's a point where you have to start thinking about safety" - Dr Karl Cole from Papatoetoe Family Doctors
Dr Cole said Professor Des Gorman had done some interesting research which was presented to the recent GP conference showing that if people could not get in to see their local GP or practice of choice they instead went to a hospital's ED.
Last week 87 percent of people who went to Middlemore Hospital with flu-like symptoms were not admitted so should have been seen by their GP, he said.
He said the practice which had recently moved to a new purpose-built facility had attracted some excellent staff but generally there were a lot of staffing shortages within the health system.
He was optimistic about the restructure of the health system due to start next month which he believed would better cope with many current failings such as the level of chronic disease in older people.