Tairāwhiti after-hours care tender delayed, ED faces daytime pressure

Tairāwhiti has remained without after hours care throughout the holidays so far, but one primary care provider says the focus is on relieving daytime ED pressure. Photo / NZME

The tender process for a new after-hours care service in Tairāwhiti remains unfinalised weeks into the summer holiday period.

Local primary healthcare providers say data showed Gisborne Hospital’s emergency department was not experiencing any more pressure after hours than usual since the region lost after-hours services, but one provider is working on a solution to relieve the separate pressure experienced by ED during daytime hours.

There has been no after-hours primary healthcare service operating in Tairāwhiti since the start of September after Three Rivers Medical Centre closed its after-hours care service due to inadequate funding, increased patient demand and an inability to retain and recruit staff.

Submissions on a tender for an after-hours primary care service in Tairāwhiti opened on the GETS government website on October 15.

A Health New Zealand Te Whatu Ora spokeswoman said the Tairāwhiti After Hours service tender process had not yet been finalised as of Wednesday this week.

The spokeswoman said Health New Zealand would provide an update to stakeholders and media as soon as it was able to.

Pinnacle clinical director Jo Scott-Jones. Photo / Mark Hamilton- Pinnacle

Pinnacle clinical director Jo Scott-Jones said he understood Health NZ initially intended to finalise the tender by mid-December last year.

“[It was] part of the reason why people didn’t put in applications because that was unrealistic,” Scott-Jones said.

He said the key issue identified by Te Whatu Ora in Gisborne’s emergency department before the holidays was not to do with a lack of after-hours care services but rather with the care of “low-acuity” (less severe) patients during daytime hours, particularly children.

Both Scott-Jones and Three Rivers Medical Centre part-owner Dr Fergus Aitcheson earlier told the Gisborne Herald data showed no measurable increase in ED presentations after hours and at weekends since the primary healthcare clinics stopped providing the service in Tairāwhiti.

Pinnacle had proposed what it calls an “ED redirect service” to address the issue of high numbers of low-acuity patients putting pressure on ED from 9am to 5pm.

“If patients who are enrolled with a general practice in town turn up at ED and the ED triage nurse says this person doesn’t need to be seen in ED, then they can be redirected back to their enrolled practice,” Scott-Jones said.

“We hope that will go some way to addressing the actual problem that ED has identified [which is] being overwhelmed during the day.”

Scott-Jones said the service had not been implemented before Christmas due to the timeframes involved, but they intended to put it into action later in January.

“The practices are aware of it and they have been engaged in the planning for it.”

What does the proposed tender for after-hours care in Tairāwhiti look like?

An overview of the after-hours tender from Health New Zealand Te Whatu Ora specified it was looking to contract a provider to deliver a “Nurse-Led, GP supported service” for the weekends and public holidays, with a minimum of four hours of face-to-face operation a day for the Gisborne Tairāwhiti population accessing primary healthcare.

According to the overview, the stated purpose of the tender was to relieve the pressure on emergency departments, facilitate seamless integration with existing healthcare services, ensure a sustainable financial model to maximise resource utilisation and support the delivery of the broader outcomes.

Initially set to close on November 8, the tender deadline was extended to November 14.