Temporary measures which were introduced to ease pressure on hospitals during the winter surge could be made permanent or rolled out nationwide after showing some promise, the Health Minister says.
Te Whatu Ora put in place 24 initiatives at the beginning of winter to relieve pressure on hospitals in their busiest period.
The Winter Preparedness Plan aimed to shift as much demand as possible from hospitals to primary care, and relieve pressures on GPs by giving pharmacists and community health providers more responsibility.
It was one of the first examples of the reformed, centralised health system in action, as pilot schemes were rapidly extended to whole regions or nationwide.
Health Minister Dr Ayesha Verrall said she was waiting on a review of the measures before she would decide if they would be continued or expanded.
But she said some had already shown promise, in particular a scheme in which pharmacists treated minor conditions like lice, scabies or fever. Around 700 pharmacies had offered consultations in selected regions, mostly for children under 14 years old.
Pharmacy Guild CEO Andrew Gaudin said pharmacists had successfully managed the extra workload and patients had welcomed the free, convenient service. They now wanted it rolled out across the country.
GPs also welcomed the scheme, while noting that it probably had a marginal impact. Pharmacies carried out a total of 68,000 consultations over winter. GPs around New Zealand see around 50,000 patients a day.
Royal NZ College of GPs chairwoman Dr Samantha Murton said of greater value was a change which allowed GPs to refer patients directly for an X-ray without needing to co-ordinate with hospitals.
“Not having to go to hospital to get an X-ray or scan and being able to afford it is just massive for patients,” she said.
The minister said another promising initiative was allowing ambulance staff to video-call a specialist or emergency department doctor to get advice on a patient.
“In many instances, we find a trip to hospital was actually unnecessary,” Verrall said. “That support enables them to manage that person safely, but away from the emergency department.
The new measures - and less disruption from Covid - had led to a fall in wait times for some surgeries, which had blown out during the pandemic. Outsourcing to the private sector also helped reduce wait times, though that was not seen by the Government as a long-term solution.
Unpublished data provided to the Herald showed the number of people waiting more than a year for elective surgery had fallen from around 50,000 at the end of last year to 9,400 in early August (excluding orthopaedic surgeries). Te Whatu Ora has a target of zero people waiting this long by the end of the year.
Fixing other issues, in particular overwhelmed emergency departments, was expected to take much longer.
“In all honesty, it’s the worst we’ve ever seen,” said Dr Kate Allan, chairwoman of the Australasian College of Emergency Medicine’s New Zealand branch.
“There is no doubt that we’ve experienced an incredibly difficult time, but if those measures hadn’t been in place, it may have been a lot worse.”
Allan said high occupancy rates within hospital wards meant patients had very long waits in EDs. That led to backlogs throughout the system, patients being held in corridors and ambulances, increased violence and aggression and poorer care.
Verrall said she understood the pressure EDs were under and had been encouraged by how they had managed the huge demands placed on them.
She said it would take three to five years to address the problems in EDs, which would require growing the workforce, further innovations to ease congestion and investing more in primary care to improve accessibility and continuity for patients.
Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics, and social issues.