Health NZ proposes cut to Napier’s overnight urgent care services

The Napier Health Centre's urgent care overnight services could be cut in 2025. Photo / Duncan Brown

Changes are being proposed that could result in the loss of overnight urgent care at the Napier Health Centre.

The Health NZ proposal includes a recommended “best option” of cutting in-person care from 8pm to 8am at the Wellesley Rd centre and replacing it with a “virtual overnight urgent service”.

A December briefing note about the proposal, labelled as confidential but seen by Hawke’s Bay Today, says changes could occur “by March 2025″.

Health New Zealand director of operations David Warrington told Hawke’s Bay Today he expects to share an update on the changes with the community this month.

“We are working with our partners, including Health Hawke’s Bay PHO, local healthcare providers, and community leaders, on how urgent care might be delivered differently in the future. This work includes a review of the Napier Health nurse-led overnight service,” he said.

In the meantime, current services will continue to operate, Warrington said.

Since Napier Hospital closed in 1999, urgent care in the city has been delivered by City Medical, a privately owned general practice cooperative, from 8am to 9pm, followed by a 9pm to 8am after-hours service provided by Health NZ nurses, supported by an on-call GP roster system to 3am.

However, according to the briefing note, workforce shortages have made it “increasingly difficult” to keep these services fully staffed, “resulting in the service sporadically closing early”.

The December briefing says over the past year, the Napier overnight service has seen an average of just 6.6 patients per night with most cases classified as low acuity.

“In short, we need to look at different ways to offer better services which meet the needs of the community. Clinical safety, workforce challenges and efficient use of resources are the key drivers for change,” the briefing note says.

The Virtual Overnight Urgent Service would operate as an extension of a patient’s usual practice, connecting healthcare providers such as “primary care practice, pharmacy, urgent care, and ED [Hawke’s Bay Hospital’s emergency department in Hastings]”.

Patients would be triaged to the most appropriate provider, with their health records accessible across connected practices.

“The model is shown to have high levels of problem resolution. It provides increased access to clinical care and could reduce visits for health services the next day.”

Napier Health provides urgent care, not emergency care.

The briefing note says there will be no changes to how people access emergency services in Hawke’s Bay.

“Anyone needing emergency care should call 111 or visit Hawke’s Bay Hospital’s Emergency Department as they do now.”

According to the document, the change would have “minimal impact” on the Emergency Department in Hastings.

Merger proposal

The briefing note says because of staffing issues City Medical and The Doctors Napier were looking to merge their urgent care services seven days a week.

The Doctors Napier board chairperson, Wayne Hudson confirmed discussions on the topic had occurred, but no formal agreement had been made.

The discussions were around “after-hours and weekend services with City Medical to increase medical resources and stabilise the long-term future of urgent care services for Napier City,” he said.

“For clarity, any conversations on this topic are related to weeknight after-hours and weekend services. Weekday operations at The Doctors Napier’s three sites across Napier city will not be impacted.”

The Doctors, founded in 1989 by three Napier practitioners, has operated from their Munro St premises ever since, as well as expanding into other parts of Hawke’s Bay.

Napier Mayor Kirsten Wise said representatives from Te Whatu Ora met with her in December to discuss the review.

“I gave input verbally at that meeting,” she said.

“I do believe decisions of this calibre need to include community input.”