"For some patients it is better to be seen and stay in the community instead of being trucked off to ED.
"Many people don't want to go to hospital - they want options.
"They know they will be in hospital for a long time and if they live in Napier they know they will have to get back.
"A lot of the time they could just go to their GP and be home within an hour."
Patients could be monitored at health centres and taken to hospital if their condition worsened "but for most of the cases people have been seen by a GP and gone home".
Hawke's Bay District Health Board (DHB) chief medical officer Dr John Gommans said this winter "gridlock" was experienced for the first time in ED, which only had 18 beds. People were forced to wait several hours after being treated until there was a free bed in another part of the hospital.
"It cuts the amount of beds to process people by a third or a half."
In the July quarter Hawke's Bay Hospital failed its Ministry of Health target for the amount of time people spent in ED.
Health Hawke's Bay CEO Liz Stockley said some people went to hospital "because they don't know any different".
"My husband cut his head and phoned me on his way to ED. I said, don't go to ED, go to your GP. He only needed a few stitches.
"There is a lack of understanding about what general practice can do, there is also a misunderstanding about what can be done in A&M centres."
A review of urgent care in Hawke's Bay is currently underway, part of the DHB's wider Transform and Sustain programme to shift resources to more effective options.