Free GP visits not the answer to pressured Middlemore emergency department, review finds
Ricky Wilson / Stuff
A scheme offering free GP visits has been set up to help cope with the overwhelming number of patients at South Auckland’s Middlemore Hospital. (File photo)
There is ‘limited evidence of direct benefits’ from a program of free GP visits which aimed to relieve pressure on an overcrowded emergency department, a review has found.
Counties Manukau Health announced the free medical visits on weekends at participating clinics on June 17, just days after a woman died after being discharged from Middlemore Hospital due to long waiting times.
She showed up with a severe headache, but was told it would probably be hours before she was seen and gone. She had a cerebral hemorrhage a few hours later.
A record number of patients – about 400 a day – had arrived at the emergency room in the weeks before his death.
* Middlemore ED was ‘abnormally busy’ when patient left and later died, review says
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* Health Minister Te Whatu Ora delivers mixed messages on inquest into patient death
* An impostor doctor in Middlemore was surprised by a colleague, according to documents
A review of the program, published this week, said the lack of data collected during the 10-day program meant no firm conclusions could be drawn about a decline in emergency room patients.
Forty-two GP clinics participated in the program, which cost $1,258,250.
The review recommended against rolling out the same program again “due to the high cost and limited evidence of direct benefit for emergency volumes.”
“Should it be necessary to conduct a similar initiative in the future, it would be important to develop a clear and structured evaluation plan before the initiative and to ensure that it has the necessary resources to enable a proper data entry and analysis. »
The report also says that a number of primary health care providers were interested in participating in the program but were unable to do so due to “capacity issues”.
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When the program was announced, the medical director of the Royal New Zealand College of General Practitioners, Dr Bryan Betty, said there was a limit to the amount of extra work doctors could take on.
He said it was not surprising that the review highlighted the same issues.
“Te Whatu Ora needs to look at how we can address these capacity issues in general practice.”
He said primary health care providers could help reduce pressure on emergency departments, but they needed to be properly resourced and workforce shortages needed to be addressed for such programs work.
Betty said there has been an ongoing shortage of doctors in South Auckland for some time.
South Auckland GP and Chairman of the Pasifika GP Network, Dr Api Talemaitoga, has raised concerns.
He said the scheme was a reaction to events that preceded it and that lack of coordination meant many primary healthcare providers were unaware of the free GP visits.
Talemaitoga said he has no doubt that poor program coordination also played a role in the lack of data being collected.
“I think we can learn from this experience.”
In a statement, Health Minister Andrew Little said the program was a concrete decision made in real time.
“While the report may say there is not enough data to link the reduction in emergency department presentations to free GP clinics, there was nevertheless a reduction, which was needed.”