Middlemore said an average of 366 people were going through its ED each day, a 9 per cent increase compared to this time last year. Photo / RNZ
Middlemore said an average of 366 people were going through its ED each day, a 9 per cent increase compared to this time last year. Photo / RNZ
Shorter waiting times at emergency departments are now one of the Government’s top priorities. One ED’s struggle at the beginning of winter underlines how difficult this target will be.
Middlemore Hospital’s emergency department (ED) is under intense strain, partly because of staff shortages and winter illnesses.
The nurses’ union said the huge pressures on the ED presentations this month meant long queues for a hospital bed, unsafe staffing levels and some patients being kept in corridors.
Vanessa Thornton, Te Whatu Ora group director operations for Counties Manukau, said the Middlemore ED had been “very busy” over the last couple of weeks.
An average of 366 patients had gone through the department daily in the previous week - about 30 patients more per day than the same time last year.
“All patients who present to our ED are triaged and we always prioritise care so that those who need it urgently are seen quicker than those with less serious illnesses,” she said in a statement.
“This means that some people with less serious conditions or injuries may need to wait for treatment.”
It is understood that on Monday morning, up to 90 patients were waiting for a bed in the 900-bed hospital in South Auckland.
Some patients reportedly had to be treated in ambulances - known as “ramping” - because they could not be treated within the hospital.
Middlemore did not confirm these details, but said that no ambulances had to be diverted to other hospitals over this period.
NZ Nurses’ Organisation (NZNO) delegate Mohini Lal said colleagues in ED reported that on Monday morning there were 62 patients in the waiting room and another eight patients waiting in corridors.
“It is really, really hectic,” she said. “[Nurses] are fighting to get patients seen, get them out to the wards, the resource is just not there at the moment.”
Each ED nurse was handling about eight patients each. The union has previously said the maximum safe level of patients was four per ED nurse.
“That is not even taking into account the high turnover,” Lal said.
“So in that case, they will take 15 to 20 patients each [in a shift].”
Lal said there were a number of factors putting pressure on the hospital, including staffing shortages, a Covid outbreak in one of the wards, and a strike by junior doctors.
A lack of bed capacity also meant patients did not flow through the system quickly, meaning ED became jammed up.
A rise in respiratory conditions is also believed to be partly responsible for the pressure on the health system.
“We are starting to see an increase in respiratory illnesses,” General Practice New Zealand chairman and Porirua GP Bryan Betty said last week.
“Those flus and colds you often see in winter are certainly starting to pick up as the weather gets colder.”
GPs were also reporting cases of RSV (Respiratory Syncytial Virus) and adenovirus.
Dr Bryan Betty said GPs were noticing a rise in winter illnesses. Photo / Supplied
Middlemore posted on its Facebook page last Friday that the ED was “extremely busy” and people should only attend “if you are in a life or limb-threatening situation”.
It comes after the National-led Government announced shorter ED waiting times would be one of its five national health targets.
The latest available data, from the October-December period, showed about 65 per cent of patients at Middlemore ED were admitted, transferred or discharged within the targeted time of six hours.
That was well below the national target of 95 per cent. Just one of 20 regions, Tairāwhiti, was achieving that target. In MidCentral, the rate was 35 per cent.
Thornton said the vast majority of people who presented to ED did so appropriately but there were instances where other treatment or care options may be more appropriate for patients.
“We encourage anyone who is unwell but doesn’t need emergency care to seek advice from Healthline, their GP, pharmacy, or local health provider.”
However, all parts of the health system are reporting capacity problems. GP clinics, community care, and urgent care clinics all say they are struggling to cope with growing demand for their services, mainly driven by an ageing, growing population with more complicated illnesses.
Last winter, Te Whatu Ora trialled several measures during winter to relieve pressures on hospitals and GPs. Some of those measures, including increased use of telehealth and allowing pharmacists to treat minor conditions, are being rolled out more broadly or considered for expansion.
Read more on the Herald’s coverage of emergency departments:
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.
