Acute patients could go to Nelson

01:45, Feb 14 2013

A review of general surgical and orthopaedic services at Blenheim's Wairau Hospital could result in serious after-hours emergency department cases being transferred to Nelson Hospital.

Blenheim has on-call specialist surgeons to cover all hours, but under an option of care mooted in a Nelson Marlborough District Health Board discussion paper, they would provide acute services at Wairau Hospital only between 8am and 4pm from Monday to Friday.

Acute on-call care would be done by surgeons in Nelson between 4pm and 8am on weekdays, and at weekends.

The paper proposes that when a patient is assessed at the Wairau emergency department, the case would be discussed with surgical specialists in Nelson.

The patient would either be discharged with a follow-up for elective treatment, or transferred to Nelson Hospital for acute treatment.

The paper, given to the Marlborough Express this week, was sent to health board staff last month as part of a review of services at Wairau Hospital.


Another option already reported by the Express suggests managing all acute general surgery and acute orthopaedics at Nelson, reducing Wairau Hospital to elective surgery only.

The document shows that about half of all acute general surgical and orthopaedic cases are admitted to Wairau Hospital after hours.

General surgery at Wairau Hospital had an average of 713 acute admissions a year, with 358 happening between 4pm and 8am. Orthopaedics had an average of 301 acute admissions each year, with 165 arriving after hours.

The figures were based on data collected over three years.

Board secretary Mike Cummins said yesterday the discussion paper presented staff with a range of options to provide feedback on.

This stage of the review was about gathering information, he said. "Until we have that feedback, people are only speculating as to what will happen."

There was no preconceived or preferred option, he said.

Another option, at the "other end of the spectrum", was to make Wairau Hospital a fully independent, stand-alone service for both acute and elective general and orthopaedic services, he said.

"Our focus is on a sustainable and feasible service that provides high-quality care for patients. That may require further investment from us.

"This is not just about a reduction in service. We have to explore all avenues, and that is not to say Nelson is immune to change."

The options paper was not suggesting a change in emergency department services, Mr Cummins said.

"There will always be a need for the emergency department," he said. "The emergency department is our front door - it's where people go. Some people are treated and discharged, some require further treatment.

"Already there are people transferred out of Wairau and Nelson for specialist, tertiary treatment."

Staff have until February 28 to give the board feedback on the discussion paper. This will be used to write a proposed model of care to go to the executive leadership team and the board next month.

Formal consultation on the proposed model will be done in April.

The Marlborough Express