Free GP visits not the answer for Middlemore’s under-pressure ED, review finds

By Contributor

Middlemore Hospital's emergency department. Photo / LDR / Stephen Forbes

By Local Democracy Reporter, Stephen Forbes

There is "limited evidence of any direct benefits" from a free GP visit scheme which was intended to take pressure off an overloaded emergency department, a review has found.

Counties Manukau Health announced the free weekend doctors' visits at participating clinics on June 17, just days after a woman died after leaving Middlemore Hospital because of long wait times.

She turned up with a severe headache but was reportedly told it would likely be hours before she would be seen, and left. She had a brain haemorrhage just hours later.

Record numbers of patients - about 400 a day - had been arriving at the ED in the weeks leading up to her death.

A review of the scheme, released this week, said the lack of data collected during the 10-day programme meant no definitive conclusions could be drawn on any drop in patient numbers at the ED.

Forty-two GP clinics took part in the scheme, which cost $1,258,250.

The review recommended against rolling out the same scheme again "due to the high cost and limited evidence of direct benefit to ED volumes".

"Should there be a requirement to run a similar initiative in the future, it would be important to develop a clear, structured evaluation plan in advance of the initiative and ensure this was resourced to enable adequate data capture and analysis."

The report also said a number of primary healthcare providers were interested in taking part in the scheme, but were unable to do so due to "capacity issues".

When the scheme was announced, Royal New Zealand College of General Practitioners medical director Dr Bryan Betty said there was a limit to how much extra work doctors could take on.

He said it was no surprise the review had highlighted the same issues.

"Te Whatu Ora needs to look at how we can address these capacity issues in general practice."

He said primary healthcare providers could help to take pressure off emergency departments, but they had to be resourced appropriately and workforce shortages needed to be addressed for such schemes to work.

Betty said there had been an ongoing shortage of doctors in south Auckland for some time.

South Auckland GP and chairperson of the Pasifika GP Network Dr Api Talemaitoga shared his concerns.

He said the programme was a reaction to the events leading up to it and the lack of coordination meant a lot of primary health care providers were unaware of the free GP visits.

Talemaitoga said he had no doubt the scheme's poor coordination also played a part in the lack of data collected.

"I think we can learn from this experience."

In a statement Minister of Health Minister Andrew Little said: "Although the report may say the data is not sufficient to link the reduction in ED presentations to the free GP clinics, there was, nevertheless, a reduction, which was needed."

He said the scheme was devised based on what was known at the time and was a real-world decision made in real time.

Local Democracy Reporting is Public Interest Journalism funded through NZ On Air

Local Democracy Reporting is Public Interest Journalism funded through NZ On Air