Staff shortage delays 24-hour emergency service

Demand at emergency departments is growing fast. Photo / Dean Purcell

The move to 24-hour opening at Waitakere Hospital's emergency department, where patient numbers have risen dramatically, has been delayed again.

It has been a long haul towards 24/7 opening since the department was added to the hospital in 2005.

The Waitemata District Health Board had been closing the department to walk-in patients at 6.30pm, but in 2009 issued a staged plan for 24-hour service that involved, first, accepting patients until 10pm last January.

Children were accepted around the clock from July, and adults were to get a 24-hour service from December.

However this has been deferred because of staff shortages.

Waitemata chief medical officer Dr Andrew Brant said the target was now the end of March.

The dfelay was necessary because hospital had not been able to hire enough staff - nurses and especially senior doctors.

The emergency centres at Waitakere and North Shore hospitals, like others, were very busy over the holiday period and patient numbers had grown in many places faster than population growth.

Waitakere's emergency department had a 33 per cent increase in patients last year, particularly marked in December with 57 per cent more patients than in December 2009.

To an extent this was expected because of the progressive extensions last year, but it has also been linked to difficulties in obtaining affordable, subsidised primary care.

"What is particular about Waitakere," said Dr Brant, "is that we have seen - as a different trend from North Shore Hospital - a large number of patients who would otherwise [go] to a GP. There would be conditions such as coughs and colds - and scripts and changing dressings and so forth.

"The reasons are probably related to understanding our department is for emergencies rather than GP care, and, secondly, probably the availability of GPs after hours and there may also be a cost issue.

"There are Waitemata DHB programmes particularly targeted at the Waitakere population on extending GP hours after-hours and in the weekend, and also targeting subsidies for low-income people and families," he said.

North Shore Hospital's new emergency department and associated admission and diagnostic unit are due to open this year and it is expected they will help improve Waitemata's performance on the Government's target of a six-hour maximum stay in the department for 95 per cent of patients.

Of the 20 DHBs, Waitemata came last, at 73 per cent of patients, in the latest national release of the statistics, for July to September last year.

Waikato DHB came 16th at 82 per cent of patients. Its Waikato Hospital emergency department had a 7 per cent increase in patients last year.

Waikato Hospital's department, built in the early 1970s, is about to be replaced.

The new one opens on February 8. It is twice the size and the DHB says it provides a more effective and efficient working environment.

"The staff are hanging out for the new department," said communications director Mary Anne Gill.

Counties Manukau DHB, coming fourth in the emergency health target, at 96 per cent, has about 6 per cent annual growth in emergency patient numbers.

GROWING DEMAND
Emergency department patient numbers

WAIKATO HOSPITAL

*2009...54,250
*2010...57,899
(up 7 per cent)

NORTH SHORE HOSPITAL

*2009...52,671
*2010...56,175
(up 7 per cent)

WAITAKERE HOSPITAL

*2009...25,474
*2010...33,954
(up 33 per cent)