Over the past month, Hawke\u2019s Bay\u2019s ED in Hastings has seen an average of 157 patients daily. Over the past 12 months the baseline average has been about 150 presentations per day.<\/p>\n
\u201cMost of our patients spend their entire journey in the ED waiting room, which is not a clinical space, so the quality of care is reduced,\u201d Revell said.<\/p>\n
She said up to 60 people could be in the waiting room at times, and some patients could be assessed, treated, admitted or discharged without reaching a proper cubicle.<\/p>\n
\u201cSometimes [they are] really not getting the privacy and not having the dignity that they should be getting of their assessment,\u201d Revell said. <\/p>\n
\u201cSome things can get missed because sometimes the doctor or the nurse might not ask the personal questions, because they know that they are being overheard by the whole waiting room, and that can be significant for that patient.\u201d<\/p>\n
She said staff were doing their best, but patient flow was being slowed by a shortage of beds across the hospital and a lack of community care options for patients who no longer needed an acute hospital bed but were not safe to go home.<\/p>\n
Revell said Hawke\u2019s Bay Hospital needed more capacity, more staffed beds, better community care and more support outside hospital to stop ED becoming the place where wider system problems ended up.<\/p>\n
\u201cIt all manifests in ED,\u201d she said.<\/p>\n
\u201cPeople say it\u2019s going to take a tragedy before somebody does anything. <\/p>\n
\u201cWe\u2019ve had tragedies, and it still doesn\u2019t seem to be that anybody makes a meaningful change.\u201d<\/p>\n
Revell said winter initiatives were welcome, but years of underinvestment, combined with changing priorities whenever governments changed, had made it difficult to achieve lasting improvements. <\/p>\n
Health NZ Group director of operations for Hawke\u2019s Bay David Warrington said while winter always brought more respiratory illnesses, Hawke\u2019s Bay had a \u201creally good winter plan\u201d in place.<\/p>\n
The winter boost initiatives included introducing six surgical assessment beds, adding a doctor specialising in older people in ED, increasing weekend phlebotomy, physiotherapy and occupational therapy services, appointing a cardiology chest pain clinical nurse specialist to ED, providing three extra transition-to-home beds for older people who are well enough to leave hospital but still need some support before going home.<\/p>\n
Health NZ had also opened the Rapid Inpatient Capacity Expansion Unit to increase bed capacity by 22 beds.<\/p>\n
Revell said extra beds would help but would have little impact while the hospital remained full.<\/p>\n
\u201cIt is a bit of a drop in the ocean,\u201d she said.<\/p>\n
\u201cWhen the hospital\u2019s at 105% capacity, then you can\u2019t move. Flow doesn\u2019t occur really, especially if there\u2019s nowhere to discharge them to.\u201d<\/p>\n
Health Minister Simeon Brown acknowledged \u201cthere\u2019s more work to do\u201d and said the Government had introduced shorter-stays-in-emergency-departments targets and winter support.<\/p>\n
\u201cWe are seeing, after years of decline, every single one of our health targets showing improvement,\u201d he said.<\/p>\n
Hawke\u2019s Bay Hospital is among four regional hospitals sharing in the Government\u2019s $680 million Budget 2026<\/a> health infrastructure package.<\/p>\n Brown said the funding would allow design work and early works on the wider redevelopment to progress, with details of the Hawke\u2019s Bay upgrade to be announced \u201cshortly\u201d.<\/p>\n \u201cWe want to get that work right,\u201d he said.<\/p>\n Napier Urgent Care<\/p>\n The pressure on Hawke\u2019s Bay\u2019s health system earlier in the year affected Napier\u2019s overnight urgent care service.<\/p>\n