Christchurch Hospital facing 'tough' winter as more patients than beds forecast

Stuff
Emergency departments across the country have had the busiest two months ever. (First published March 24, 2021)

Christchurch Hospital planners are scrambling to ensure there are enough hospital beds for an expected influx of patients this winter.

The measures include shortening length of hospital stays and postponing elective surgeries, which will increase risk for vulnerable patients and put pressure on an already stretched primary care and hospital workforce.

GPs and senior doctors warn they are reaching breaking point and urgently need more resources to deal with the forecast influx of patients. Staff shortages further threaten to bring the system to its knees, they say.

Canterbury District Health Board (CDHB) modelling forecasts there will be more patients than resourced beds for about 19 weeks this year, mostly during winter.

Christchurch Hospital is gearing up for a “tough” winter with an expected influx of patients.
ALDEN WILLIAMS/Stuff
Christchurch Hospital is gearing up for a “tough” winter with an expected influx of patients.

CDHB production planning lead Richard Hamilton said this winter would be “tough” but he was confident the system would cope. He was more worried about next winter with higher levels of flu infections expected as borders reopen.

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CDHB production planning lead Richard Hamilton says forecasts for next winter are concerning.
DAVID WALKER/STUFF/Stuff
CDHB production planning lead Richard Hamilton says forecasts for next winter are concerning.

Planners were “playing in the margins” with an already stretched system, he said.

“When you are tight during winter you have to discharge sooner than you would like to. But we manage that risk and monitor that risk.”

Staff working overtime, elective surgeries getting cancelled and patients staying longer in ED were “last resort” measures, he said.

Christchurch Hospital has about 600 resourced beds, which means there is enough funding to staff them appropriately. It has 38 beds which are not resourced, meaning there is no money to staff them.

This winter there will be enough physical beds to meet demand, but not enough resources to staff them, forecasts show. Next winter, patients will overwhelm hospital capacity, with demand exceeding the physical number of beds, Hamilton said.

The complex modelling is based on data included the number of planned elective surgeries, size and age of population and historical trends.

This rising number of patients was due to the hospital still catching up on a backlog of elective surgeries from last year’s lockdown, an increase in people going to the emergency department with acute injuries, a growing, ageing population and staff shortages, Hamilton said.

Figures published by Technical Advisory Services show there were 450 nursing and 75 senior doctors’ vacancies in February.

Association of Salaried Medical Specialists (ASMS) executive director Sarah Dalton said the forecasts were “distressing” for patients and staff, yet predictable.

Executive director of the Association of Salaried Medical Specialists, Sarah Dalton, says senior doctors are worn out.
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Executive director of the Association of Salaried Medical Specialists, Sarah Dalton, says senior doctors are worn out.

The bar to meet the criteria for hospital admission was already very high, she said.

“Clinicians are already working as smart as they possibly can.”

Senior doctors were worn out. ASMS recent surveys showed one in two senior doctors experienced burnout, she said.

Shortages of nurses, senior doctors and GPs compounded the pressure and could not be “fixed overnight”.

Some people, including the elderly, those with mental health conditions and the homeless, could not be discharged safely from hospital if they did not have a family looking after them in the community, she said.

Christchurch Primary Health Organisation chair Angus Chambers said the system was “close to breaking point”. It had managed to keep going “in spite of severe resource limitations” by shifting patients from hospital care to the community.

Patients were at times discharged too early and GPs had to treat patients with increasingly complex social and health needs.

Covid had added another layer of stress, costs and uncertainty for GPs, he said.

“GPs are very good at stepping up, but it’s a bit unreasonable to be asking more of us when there is no extra resources,” Chambers said.