The Ministry of Health is not satisfied with Southern District Health Board assumptions that many Queenstown residents are using the Lakes District Hospital emergency department for GP services.
The ministry, asked for advice from the board on the suitability of the proposal to have patients seen by a general practitioner before they accessed the emergency department, has called for more information on several issues.
The Wakatipu Models of Care document said 73% of all those arriving at the ED in Frankton lived in the Queenstown area, which suggested many residents were using the hospital instead of going to their GP.
The ministry said more analysis of patient presentations was needed.
If appropriate, the board could also investigate the reasons why people were attending the ED instead of a general practice.
The ministry wants to know how denial of emergency department care will be avoided to patients at the hospital under the proposal.
It also asks whether patients would have any input into the decision about access to the ED or would be able to challenge it.
The ministry said it would like to discuss how the potential conflict between the business interests of general practice and the interests of the patient would be managed.
This conflict involved the economic incentive for GPs to refer patients into the general practice and the patient's need to be referred to the most clinically appropriate area.
The ministry said it was also interested to know what involvement the after-hours accident and medical service in Queenstown had had in the development of the board proposal and whether it would be involved in the proposed new service.
The ministry, referring to a recent guidance paper on emergency departments and how they connect with community health care, said there were three main requirements for returning or referring a patient to community care.
These were that ED care should not be denied against the patient's wishes, the assessing clinician had to be satisfied the referral was best for the patient and not be under pressure to refer, and the patient must be able to be seen in the community in a time suitable to their condition.
The advice from the ministry, which is included in agenda papers for the Southern District Health Board's meeting this week, will be considered by the working party clinically reviewing the healthcare options for the Wakatipu district.
In his report chief executive Brian Rousseau advised that Prof John Campbell would chair the review group and Valerie Meyer, the former general manager of South Island Shared Service Agency Ltd, would be the project manager.
The group was set up following some clinicians' opposition to the proposal to refurbish the hospital and turn it into an integrated family healthcare centre and concern about their lack of input.
It is expected to come up with a proposal by November 30 which is clinically and financially sustainable. elspeth.mclean@odt.co.nz
