29 Nov 2022

GPs worry urgent care patients avoiding busy emergency departments

6:21 am on 29 November 2022
Emergency department sign

Te Whatu Ora's message to the community was people, needed help to please make sure they went to an emergency department. Photo: RNZ / Marika Khabazi

Health bosses are worried patients will not turn up to emergency departments when they need to, as long waits and overcrowding continues.

Emergency departments (EDs) in most main centre hospitals were still working at winter levels.

There had been some high-profile incidents of people leaving before they had been treated or even triaged and then getting sicker - or dying.

General practitioners spoken to by RNZ said it was hard to judge how many patients were choosing not to go to EDs when they really should, but it was likely happening in small numbers.

Te Whatu Ora medical lead Pete Watson said he worried about people not turning up, but he felt hospitals had been clear that those who needed care urgently would get it from them.

"So a lot of our messaging to the community is please 'make sure you come if you need help'. Our hospitals are there, they're there 24/7 and if people are sick, they will be triaged and if they need to be seen, they'll be seen first," Watson said.

But that message had gone hand in hand with one telling people to stay away from ED if they were not acutely unwell.

A GP at Etu Pasifika in Auckland, Maryann Heather, said striking a balance and making a decision was difficult for people, especially when they were feeling really sick.

"Everyone who feels unwell, they feel that it is urgent ... so until you go, you don't know," Heather said.

"Then the deterrent is, people hear that message and they don't want to go, and so they're sitting on heart attacks and strokes at other things at home."

She had a patient who went to Middlemore at 6pm one day last week and didn't leave until 7am the next day.

Stories like that got around, she said.

"Our coconut wireless is pretty good. People talk, people see stuff, they talk in the community, they talk at church, they talk at home... they know what is going on," she said.

Dr Maryann Heather

Dr Maryann Heather says making a decision can be difficult for people when they're feeling really sick. Photo: Pasifika Medical Association Group

The clinical director of Etu Pasifika in Christchurch, Monica Nua-George, said she knew of a handful of patients who had left early from the hospital ED in the past few months.

In all cases, the hospital had followed up to let the clinic know and the patients were able to be treated in the community, she said.

Both doctors said they tried to have a clear plan in place for patients who may deteriorate about when to go to the ED.

Dr Bryan Betty of Porirua Union and Community Health.

Porirua GP Bryan Betty says people should seek advice where possible - from their GP or Healthline - on whether their case is an emergency. Photo: RNZ / Karen Brown

Porirua GP Bryan Betty said people should seek advice where possible - from their GP or Healthline.

But if they could not get it, or were unsure, they should err on the side of caution and call an ambulance.

Te Whatu Ora chair Rob Campbell visited Middlemore Hospital's ED at the weekend.

The staff were busy but took the time to tell him about the pressures they were under, including staff shortages and pay rates, he said.

The board wanted to advocate for them, he said.

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