"I have yet to see the day that someone has been referred to our [Balclutha] hospital from the emergency department," Balclutha GP Branko Sijnja said at this week's board meeting.
Speaking after the meeting, Clutha Health First manager Ray Anton said the board could be "more aggressive" about using rural hospitals' capacity.
While accepting patients was always a clinical decision, the board did have access to the information about bed occupancy on the trust's computer system.
Patients transferred would be from the area.
There were up to 15 beds available, 13 of them provided as part of the trust's contract with the board.
At the board meeting, member Errol Millar, who lives near Ranfurly, agreed more use could be made of rural beds.
He had experienced the situation in which a relative had attended the Dunedin Hospital emergency department who needed to be referred to a bed, but staff did not seem to know that there was a hospital in Ranfurly.
The patient could have been left "sitting in ED because they couldn't find a bed in Dunedin" if it were not for an insistent relative who helped organise a referral to Ranfurly.
Speaking after the meeting, Maniototo Health Services manager Geoff Foster said there were times when beds were available.
The hospital had a total of 15 beds, seven of them long-term beds for the elderly, six acute and two maternity.
At the moment, it had two of the long-term beds available which could be used for short stay patients if necessary, as long as the patients did not need the sort of care which would require extra staffing.
The board's new patient management system, which he expected to be working from April next year, would show all available rural beds which hopefully would raise awareness. In the meantime, it was just a matter of getting on the phone and asking.
Chief executive Brian Rousseau told the board high occupancy in the hospital and surgical beds being taken by medical patients was affecting how much elective surgery or procedures the hospital could do.
Events such as the norovirus outbreak had major impacts and it was "virtually impossible" to catch up, he said.
Chief operating officer Vivian Blake said hospital staff had contacted rural hospitals during the norovirus outbreak to check if they could refer patients. However, the hospital did not have a "holistic view" of how many beds were available across all hospitals in Otago.
Getting the right balance of medical and surgical beds in Dunedin Hospital was important as having medical patients in surgical beds, or vice-versa, had the potential to detract from patient care, she said.
A surgical patient in a medical bed would not have a specialised surgical team caring for them. It also could lead to duplication of medical testing and a longer stay in hospital.
The lack of residential hospital-level beds for the elderly in rest-homes and hospitals was another factor in the high hospital occupancy, she said.
The last count showed 10 patients were waiting in a hospital bed to be discharged to a residential hospital level-bed in the community.
