8 May 2023

Hospitals discharging some very ill disabled people too early, care provider says

8:34 am on 8 May 2023
Counties Manukau Health says it has enacted special escalation plans, including cancelling elective surgery, to deal with a surge in patients visiting Middlemore Hospital's emergency department.

In separate incidents, two severely disabled people were sent home from Tauranga and Wairarapa hospitals in April while they were still seriously ill. Photo: 123RF

Two severely disabled people in residential care were sent home from hospital still seriously ill, with one readmitted within 24 hours, later dying in hospital.

Disability advocates and families fear vulnerable people are falling through the gaps in the health system because no-one wants to pick up the tab for their care.

The woman with multiple disabilities was taken to Tauranga Hospital's emergency department on 6 April because she was having trouble breathing.

New Zealand Health Group chief operating officer Veronica Manion said despite the pleas of her caregivers, she was sent back at 4.30am on 7 April by ambulance.

"She was readmitted within that 24-hour period. She subsequently passed away in hospital."

Two weeks later, a client from another facility was discharged from Wairarapa Hospital on 19 April even though the on-call nurse had strongly advised against it.

"He arrived at 9pm with an IV luer still in and his evening medications hadn't been given and he's an insulin-dependent diabetic," Manion said.

His blood sugars were low and the provider's nurse had to seek advice from the hospital about the right dose to give him, she said.

The New Zealand Health Group had done internal reviews of both cases and was considering making complaints to Te Whatu Ora, Manion said.

Unfortunately, they were not isolated cases, with emergency departments "over-flowing" everywhere, she said.

"I feel that because of their disability - and they're not always able to speak up for themselves - they're not always being made a priority.

"They're being discharged far too early and they're coming home very unwell."

She suspected in some cases hospital staff assumed residential care providers were better equipped to look after people.

"But in many cases they're not nurses, they're caregivers."

In a statement, Wairarapa Hospital's acute services manager, Gemma Askew, said no complaint has been received from a patient or a residential care provider regarding a premature discharge from the emergency department.

She admitted however that the ED and wider hospital occupancy had been under strain.

"The demands on isolation spaces due to Covid-19 positive inpatients and challenges to timely discharge can have an impact on hospital flow that can result in higher ED occupancy."

Te Whatu Ora in Hauora a Toi Bay of Plenty Tauranga Hospital coordinator Julie Williams said due to patient confidentiality, it was unable to comment on individual cases.

However, at the date and time given, Tauranga Hospital had low occupancy and beds were available if required.

"As a general comment, patients who are brought to hospital via ambulance will first be assessed in the Emergency Department. A decision and plan will then be made for that patient's further management, based on clinical need, and this may or may not require a hospital admission."

Get the RNZ app

for ad-free news and current affairs