Hawke's Bay Hospital is set to gain jobs in a proposed restructure that will disestablish 15 roles and create 21, while in a separate proposal more doctors will be employed.

The disestablishment decision is expected to be announced by the end of this month, after feedback on the proposal was "fully considered before any final decisions are made", a spokesperson said.

The reconfiguration comes as the Association of Salaried Medical Specialists, currently negotiating a collective contract, says a survey of district health board (DHB) department heads throughout the country had revealed an "invisible" shortage of senior doctors at Hawke's Bay Hospital.

We have 142 senior doctors as at June 2016 compared to 129 in July 2014 which is a 10 per cent increase.


Association executive director Ian Powell said there was a difference between the number of vacancies a health board advertised, determined by available funding, and the number of hospital specialists needed.


He said the survey found eight of the 11 department heads who participated in the survey did not have enough full-time senior doctors.

They needed an extra 22 per cent of the current senior doctor staffing level to provide safe, quality and timely health care at the time of the survey.

Just over half of the heads believed there was not enough internal senior-doctor cover for short-term sick leave, annual leave or continuing medical education leave.

The survey revealed 73 per cent believed senior doctors did not have enough time to spend with patients and their families to provide quality patient-centred care.

"An estimated 27 per cent of senior doctors were never or rarely able to have the recommended amount of non-clinical time, which is when doctors do other activities such as supervision, quality assurance, or professional development," Mr Powell said.

"They confirm that this particular DHB does indeed have a largely invisible workforce shortage, so it is very useful for our members in Hawke's Bay - and hopefully for the DHB itself - to draw attention to that.

"The results also spell out some of the unacknowledged consequences of this shortage - less time to spend with patients, little leeway in the system to cover for sick leave and so on, and senior doctors not being given enough non-clinical time within working hours to do the other activities required as part of their jobs."

He said the association would follow up the survey's results with the DHB's senior management, and planned further surveys of heads of departments at selected DHBs.

Hawke's Bay Hospital chief medical officer Dr John Gommans said survey data had not been yet analysed "however we strongly refute any suggestion Hawke's Bay Hospital doesn't provide a safe and quality service to its patients".

"On an initial review we can see some of the data is old," he said.

"We have 142 senior doctors as at June 2016 compared to 129 in July 2014 which is a 10 per cent increase."

He said that in the past six months the district health board agreed to employ 10 more senior doctors across five departments, with proposals for two more departments to be bolstered.

"We have a constructive working relationship with our doctors and are pleased to see the pressure points highlighted in this survey are the same we are working on together. Through constructive working relationships and sound financial management we are also in a financial position which enables us to invest in additional staff.

"We are also pleased to see that many of our heads of departments believe GPs are appropriately sending patients for a first specialist assessment with a specialist, and not holding off.

"We recognise increased presentations to ED is an issue that impacts on all clinical departments, as is cover for leave that is needed at short notice. However we are working on new ways with staff to help reduce those pressures.

"The district health board is working on a clinical services plan that will be finalised within a year, which will give us a long-term clear road map of future clinical needs and how they will be addressed."