Bay of Plenty GP clinics are grappling with "increased levels of demand" as influenza and Covid-19 plague local health services.
Patients are waiting for up to seven days for non-urgent doctor appointments while some GP practices have closed their books for new enrolments altogether.
Tauranga and Whakatāne Hospitals have been busy for "many months," with a steady increase in people going to its emergency departments year on year.
In Rotorua, a coughing, feverish two-year-old boy "gasping for air" waited nearly 10 hours to be fully assessed in the local hospital's emergency department because of soaring demand for medical services.
Western Bay of Plenty Primary Health Organisation chief executive Lindsey Webber said high levels of influenza and Covid-19 were driving "increased levels of demand" for healthcare services locally and nationally.
As of June 28, 15 out of the 39 general practices the Western Bay of Plenty Primary Health Organisation supported were not taking enrolments for new patients.
Webber said GP shortages, workforce fatigue and a growing population affected the ability of practices to accept new patients all of the time.
"General practices may decide to close their books to new patients after taking into account workforce and capacity issues that can impact the ability to safely deliver primary care services to their enrolled populations."
Webber said most practices would have time set aside each day for urgent appointments but non-urgent appointments could require waiting up to seven days or longer, based on the capacity of individual practices.
"Patients are encouraged to plan ahead if they want a non-urgent appointment, including arranging repeat prescriptions."
Webber said the rising cost of living could also impact people's access to healthcare and "equity of health outcomes".
Patients may then choose to seek care through hospital emergency departments, where they may face long wait times for non-urgent treatment, she said.
Bay of Plenty District Health Board chief medical officer Dr Kate Grimwade said emergency departments at Tauranga and Whakatāne hospitals had been busy for "many months".
Patients were presenting at emergency departments in higher numbers in general, and had been impacted by the flu and other winter viruses, she said.
"Having not seen much winter respiratory infection over the last two years due to the measures taken to mitigate the risk of Covid, people have lost some of the immunity they usually build up through repeated exposure."
As a result, people of all ages were experiencing "more significant respiratory illness" than might be expected.
Additionally, people had a higher level of anxiety around respiratory illness due to preparing themselves for Covid-19, and may seek care differently than before the pandemic.
The board provided information that showed the percentage of people seen, managed and either discharged or admitted to the inpatient wards within a six-hour period, which had been declining over the past 12 months.
The national target definition for emergency department wait times was for 95 per cent of patients to be managed within six hours.
In the past three months, 79 per cent of people were managed within six hours. In the March to June quarter last year, it was 87 per cent.
In Rotorua, Bernice Hill-Albert took her two-year-old grandson to Rotorua Hospital's emergency department on June 18 after she discovered that morning he had a high temperature, was coughing and "gasping for air".
She waited nearly 10 hours for him to be fully assessed. During that period, he was seen by nurses, a doctor and a practitioner to ensure he was drinking fluids and his fever was going down. Yet it was not until about 8pm that he was moved into a room. They arrived at 9.45am that day.
Despite the wait, Hill-Albert said she knew "how much pressure" doctors and nurses were under and did not mind waiting all day.
She said staff were "constantly apologising" for the wait time, to which she told them there was no need to apologise as she understood the pressure they were under.
"I knew he was in a safe place so I really didn't mind how long it was going to take."
Lakes District Health Board chief operating officer Alan Wilson said its emergency departments were under "significant pressure" due to the impact of illness on staff and the types of illness patients were presenting with such as influenza and Covid-19.
Asked what a normal emergency department wait time was, Wilson said there were no normal wait times as it depended on how sick a patient was when they presented, how many other patients were waiting and staffing levels.
"We try to treat people as quickly as we can ... We see patients in order of urgency so some patients may be waiting much longer than others.
"Unless it is an emergency, we encourage patients to contact their GP or to ring Healthline before coming to ED."
Health Minister Andrew Little said yesterday that despite some hospitals being under pressure the health system "as a whole is managing".
How to protect yourself this winter:
Bay of Plenty District Health Board chief medical officer Dr Kate Grimwade advised wearing a well-fitted mask in public places, social distancing, hand sanitising and staying home when sick to avoid respiratory infection.
"Use simple measures such as taking paracetamol or cold or flu medication for symptoms, maintain fluid intake, get plenty of rest and only seek help if becoming more unwell via your GP or Healthline as your first port of call.
"If you do need emergency care, however, you should know that the ED services are there for you.
"Check in on your friends, whānau or neighbours to see if they need any help through the winter."