Whanganui Hospital's emergency department is experiencing "significant" demand - but it's not at capacity, as some around New Zealand are.
Whanganui District Health Board chief executive Russell Simpson said while it hadn't reached those levels locally, up to 1900 people were going through the department (ED) each month.
"We aren't too dissimilar to a number of emergency departments in the country, where demand is quite significant at the moment," Simpson said.
"There are a lot more numbers coming through than we've seen previously, and whether that correlates with population growth, I'm not sure."
Staffing was based on demand, Simpson said, and Whanganui Hospital had a "very good ability to flex" if demand became high.
"We can pull staff from our resource unit into the emergency department during periods of high demand.
"It is important to reinforce to the public that the emergency department at the hospital is for emergencies, such as injuries that affect life or limb. We are not here to provide ongoing care, or address health concerns that should be seen by your family doctor or general practice."
Emergency room attendances had fluctuated between 1700 and 1900 per month since July, Simpson said.
"Attendance numbers aren't always a reflection of how busy we actually are. A person who is acutely unwell requires more resources than someone who's not.
"If you are feeling unwell or have a minor injury, please visit your GP first.
"I accept some people have difficulty getting in to see their family doctor, and if that's the case the Whanganui Accident and Medical (WAM) located at the hospital is open seven days a week, 8am to 9pm."
There was a charge at WAM because it was a primary care facility, Simpson said, and the emergency department was under the public health system.
"Keeping the emergency department free for emergencies will help people be seen faster, and allow our staff to provide the best care for patients.
"If you are in ED and are waiting for a long time, it is often because other people require more urgent care.
"The Whanganui DHB and the Whanganui Regional Health Network are currently working together to see if we can offer alternative services for our community to access, which does not require people to come to hospital."
WAM is run by the Regional Health Network, whose chief executive Judith MacDonald said collectively the ED and WAM had around 50,000 people per year through their doors.
"The area of focus that we're interested in at the moment is about those who are turning up to access general practice-type services because they can't get into primary care, they're not enrolled or have other issues," MacDonald said.
"We want people to turn up at the right door, because if you want something quite minor and you turn up at WAM you have to pay an urgent care fee for that.
"That isn't subsidised like general practice, so people with lower incomes may needlessly be spending more than they need to.
"People know that at the hospital front door there are two service providers, and they might have to wait a long time but at least someone will serve their need. The question is, is it the right place for it?"
Some members of the public could be "served in a better way", and there were inequalities for Māori that WRHN wasn't comfortable with, MacDonald said.
"There are also people presenting for readmissions, or late presentations at ED that therefore have a poor outcome.
"If we had seen them earlier we could have put them into active treatment or been able to create another pathway.
"There's lots of work to do but we're all trying to do it together."
MacDonald said a possible solution for better healthcare access was setting up another general practice in Whanganui to accommodate those who weren't enrolled.
"We need to support our people to self-manage as well. That's really important, so they have a level of education and are able to navigate our health system well.
"They have to feel confident about representing their needs with professionals."