Health officials have outlined the dire state of Wellington Hospital’s overcrowded emergency department (ED), revealing a third of patients are being treated in corridors.
The information was revealed in a detailed business case for the refurbishment of the ED, published by Health New Zealand, which said the ED was “clinically and culturally unsafe”.
The refurbishment project is being funded as part of Budget 2025, with the hospital to get a new ED and 126 additional beds. It is expected to be delivered by 2029.
Wellington’s ED is one of the country’s worst performers when it comes to shortening wait times, with less than half of cases presenting to the ED being admitted, transferred or discharged within six hours or less.
The department’s challenges meant one in 10 patients were leaving and not waiting to see a clinician and one third were treated in the corridor instead of a cubicle.
“This results in a poor healthcare environment and poor health outcomes for patients. This is unsafe and increases the risk of patients deteriorating in the department,” the business case said.
This also led to an increase in medical errors and a 10% increase in patient mortality. Lack of access to a call bell, emergency suction or oxygen, and isolation capabilities for potentially contagious patients were all issues resulting from corridor treatment.
Patients not waiting for care was also a problem as these patients might later call an ambulance and come to hospital in a worsened condition.
There has been a 35% increase of people not waiting for treatment since 2019.
Māori, Pacific and disabled people were disproportionately affected by “did not wait” events.
ED occupancy is currently at or above 90% of capacity every second day by 8am, or six out of seven days if measured at 4pm or midnight. It was also operating at 100% capacity or higher for three quarters of the year.
“This is not a failure of the ED or the people who work in it; this is a system capacity issue,” the business case said.
The staff were delivering the best care they could while “working in trying circumstances”.
Increasing staff turnover was partly due to “the moral injury inflicted by the reality of providing care to patients in corridors where they cannot provide optimal care and compromises patient dignity”.
The business case also found the spaces were cramped, inadequately designed, fragmented, and inefficient.
It described the current ED as containing “disjointed clinical spaces, physically separated from one another”. The layout isolates patients and staff and means the ED is unable to flex staff and resources across different spaces to respond to changes in demand.
While safe to occupy, it is also at medium to high risk of seismic failure, putting people at risk during and after a major seismic event.
If the investment in the refurbishment weren’t to proceed, the ED would be unable to meet the health needs of the region, the document said.
Cabinet approved the most expensive of three options for the upgrade, but the cost of the project has been withheld. The Cabinet paper noted while it was the priciest, it gave the best value for money, and “critically, provides an additional 36 in-patient beds”.
Melissa Nightingale is a Wellington-based reporter who covers crime, justice and news in the capital. She joined the Herald in 2016 and has worked as a journalist for 10 years.