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Dunedin Hospital emergency department doctors arriving to work in the morning say they are routinely seeing patients who have waited all night and have not been seen yet.

A provisional improvement notice (Pin) has been placed on the emergency department, an action which requires the Southern District Health Board to begin addressing urgent health and safety issues within eight days of it being lodged.

The Pin was lodged by department health and safety representative Anne Daniels, an emergency department nurse.

Yesterday doctors endorsed the Pin, and senior emergency department clinicians said the department was the busiest they had ever seen.

The Ministry of Health sets a target for all DHBs that 95% of patients are seen within six hours, a target which they almost all struggle to meet.

On one day last week, Dunedin Hospital’s figure slumped to 47%, a figure understood to be a record low for the department.

‘‘We are being told that it’s taking up to eight hours for patients to be seen and some staff are arriving at work to find patients who have been waiting all night to see a doctor,’’ Association of Salaried Medical Specialists executive director Sarah Dalton said.

‘‘They are having to apologise to every single patient, which is frustrating for everyone and not the way they want to be treating people.’’

The SDHB has made many attempts over recent years to improve the flow of patients out of emergency and then through the hospital.

In recent times the level of patient acuity — how ill they are — has become more serious and complex, adding to emergency waiting times.

The department is viewed by clinicians as too small and too understaffed.

‘‘There is no real solution in sight,’’ Ms Dalton said.

‘‘The new hospital will provide double the ED size but it won’t be ready for years, and a new medical assessment ward which will take pressure off the ED won’t be available until next August.

‘‘Doctors are pleased that the nurses have issued the Pin notice because it means management now has a legal obligation to respond and hopefully come up with both urgent and workable solutions.’’

SDHB specialist services executive director Patrick Ng said all DHBs were suffering from staff shortages due to illness and recruiting issues, and noted other regions had Pins served on them.

Management shared staff concerns about the ED and were working on a response.

‘‘While there are likely to be challenges recruiting into all vacant positions an area we hope to make a meaningful difference in is to deploy additional staff to help in the triaging and management of patients prior to them receiving emergency department care,’’ Mr Ng said.

‘‘As part of our Pin response we are considering opportunities to prioritise staffing to assist in this area.’’

The arrival of a new CT scanner would also help, but is expected September arrival date had now been delayed by a month.

In the medium term, the medical assessment unit was scheduled to open in October next year, and services were now being moved out of that area to allow building to begin, he said.

mike.houlahan@odt.co.nz