Lack of funding, burnout contributes to urgent care clinic halting overnight service

Dr John Bonning and East Care.
Dr John Bonning and East Care. Photo credit: RNZ Insight/Karen Brown, GoogleMaps

A busy Auckland urgent care clinic is stopping its overnight service, at the same time as Middlemore Hospital tells people to use urgent care to take the stress off its emergency department.

East Care has been running an overnight service in Botany for 24 years but says it can no longer afford to stay open past 11pm.

Chief executive Gordon Armstrong said it was the busiest overnight GP clinic in Auckland, seeing a third of all night time patients in the past quarter.

But it got no funding from Counties Manukau District Health Board for the service and couldn't afford to keep running it, he said.

He met with the clinic's doctors last week.

"They graphically described to us the burnout they were experiencing, the high volumes of patients they were seeing and they talked to us about what we could all identify as a spiralling clinical risk," he said.

The closure comes as the DHB sent out a media release to say Middlemore's emergency department was "reaching capacity".

It urged patients to go to urgent GP clinics for after hours care if it was not a genuine emergency.

College of Emergency Medicine president John Bonning said the closure of East Care was bound to make things worse for Middlemore.

"Some of these [overnight] clinics see 20, 30, 40 patients... and particularly at weekends it gets incredibly busy and on holidays. So, yes, that will have an impact," he said.

The DHB did not immediately give details of the capacity problems.

But figures show a November spike in patients being cared for in corridors without monitoring equipment.

Bonning said the problem with overwhelmed emergency departments was a national one - with several departments severely affected.

It was partly because hospitals were so full, patients who needed to be admitted to a ward could not be moved out of the emergency department, creating a bottleneck, he said.

That created longer wait times and was putting patients at risk of deteriorating health or death, he said.

Armstrong said the DHB had stopped funding overnight care in 2018, despite relying on its service.

The clinic tried to "suck it up" to keep providing the important service to the community but after rising patient numbers and increased stress on its doctors it could no longer maintain good quality service, he said.

RNZ