Christchurch Hospital reduced the number of ICU beds from 36 to 24 at the start of the year. Photo: RNZ / Nate McKinnon
Christchurch cardiac patients awaiting lifesaving operations are among those having their surgery delayed, sometimes several times, due to a lack of intensive care unit beds.
At the start of the year, Health NZ reduced the number of ICU beds at Christchurch Hospital from 36 to 24, closing one of three available pods of beds.
Medical unions say this is leading to delays in essential surgeries, because no ICU beds are available for patients to use after complex surgery.
RNZ is aware of one patient who has had their surgery delayed seven times, due to a shortage of ICU beds.
Resident Doctors' Association national secretary Deborah Powell said the decision to shut a third of Christchurch's ICU beds made no sense, as the ICU was extremely busy.
Christchurch Hospital takes referrals of more difficult cases from regional centres and the ICU provides for patients who need 24-hour care after a complex operation.
Dr Powell said the biggest impact was on surgical patients, particularly cardiac patients.
"If you are having heart bypass surgery, for instance, you need to be in the ICU after that surgery to be monitored for at least 24 hours," she said. "If there are no beds, you can't have the surgery and we are aware that patients are being delayed in their heart surgery, sometimes up to weeks, as a result of this decision."
She said the delays also added to the stress for the patients.
"If you are waiting for heart surgery, stress is one of the things we try to avoid and, of course, having your surgery postponed because there is no ICU bed is likely to increase your stress levels. It is very counter-productive to those patients, not only the delay, but the stress they experience as part of those delays."
New Zealand Nurses Organisation delegate Gayl Marryatt said there were cases where a person was within an hour of surgery when they are told it had been delayed due to a shortage of ICU beds.
"Obviously, we feel for the patients, because we are not getting them the surgery they need. To tell a patient, day after day, 'Sorry, you are cancelled again... sorry, you are cancelled again', it's a huge strain on the ward staff."
Dr Powell said patients waiting for surgery were often still taking up a bed in another part of the hospital.
"Any idea this is saving money is just ludicrous," she said. "It has just shifted the money to another part of the hospital and to a bad outcome for patients, quite frankly."
Letita Harding - chief executive of Heart of Aotearoa Kia Manawanui Trust, which advocates for better cardiac care for patients - said there was increasing demand on ICU beds all over the country and Christchurch should be increasing its beds, not decreasing them.
"This is a tremendous roadblock for these patients who are requiring this cardiothoracic surgery and, ultimately, that would would result in higher complications or even death in some cases. This bed-blocking is a real tipping point and we need to address it across the country."
She wanted to see dedicated beds for cardiac patents in ICU units to ensure operations didn't have to be postponed.
Health NZ Canterbury group operations director Hamish Brown said Christchurch Hospital typically operated at 24 beds, but had flexibility and staffing to increase to 28, as required.
"We have had to defer a small number of elective surgeries recently, due to a high demand for ICU beds and high occupancy across the Christchurch campus," he said. "Some surgeries were outsourced and the remaining cases are being rescheduled for surgery as soon as possible.
"We acknowledge this is disappointing for people who have been waiting for surgery, and patients can be assured that surgeries and procedures are only deferred where absolutely necessary, and only if it is clinically safe to do so."
Brown said the decision to defer or delay care was not taken lightly, and all decisions were made with patient safety and wellbeing as the highest priority.
Health Minister Simeon Brown said it was an operational matter for Health New Zealand.
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