Waikato Hospital is in danger of losing some of its funding because it cannot meet a Ministry of Health target aimed at cutting waiting times in hospital emergency departments.
Waikato District Health Board has been ranked second to last out of the country's 20 DHBs in meeting the target, which specifies that 95 per cent of patients be admitted, discharged, or transferred from an emergency department within six hours.
The latest performance results show the DHB has slipped from 89 per cent to 84, above only Capital and Coast DHB on 74 per cent.
Only six boards attained the target in the first quarter, led by West Coast with 100 per cent.
The Waikato board's chief executive, Craig Climo, says it has until the end of June next year to consistently achieve the target otherwise it could lose money.
In a report to the board to be discussed at its meeting on Wednesday, Mr Climo said the situation was serious because the board's overall ministry performance monitoring status was at risk.
"The potential for a downgrade based on a languishing acute six-hour target has been signalled by the ministry," Mr Climo said.
A downgrade would result in in loss of revenue through funding being paid in arrears rather than in advance and through monthly instead of six-monthly payments.
It's not clear exactly how much funding the DHB could lose, but in a blog to staff and a concentrated campaign Mr Climo has called for their help.
"We don't want to lose funding or suffer reputational damage, and I ask the people who can assist in achieving the target to do so.
"If we don't hit the bullseye on this target we face serious consequences and penalties."
In an urgent memo to all staff this month as part of the six-hour target acute care campaign, Mr Climo outlined a 60-day plan to get Waikato back on track.
It included a weekly meeting of managers and clinicians to drive improved performance, weekly progress updates for staff, and a "wait-loss" discussion sheet being introduced so managers and staff can write down suggestions and tips.
The Ministry's "target champion" for shorter emergency department stays, Mike Ardagh, said the Wakato figure was disappointing.
The poor performance had prompted Minister of Health Tony Ryall to speak to board chairman Graeme Milne.
The board is about to hit the peak stage of its $430 million Waikato and Thames hospital campus upgrade, which is expected to push up costs.
At its meeting on Wednesday the board will be asked to approve a $7 million information and communication technology budget for the yet to built $130 million Meade Clinical Centre.