Wellington ED ‘over capacity’ — NZNO
NZNO members who work in Wellington ED have repeatedly raised concerns about continued overcrowding since mid-2024 — with some patients waiting as long as 65 hours in ED.
In an April letter to Te Whatu Ora central region deputy chief executive Robyn Shearer, NZNO requested managers meet with nursing staff as soon as possible about “continuing over-capacity”. Much of the problem was a lack of inpatient beds for ED’s medical or mental health patients.
A promised overcrowding plan had not been provided, and even when ED was full, no hospital spaces were made available for patients, the letter said.
“When ED is over-capacity, the hospital seems to continue to do surgery and business as usual, despite the risk to the organisation and our NZNO members.”
The hospital was slow to recruit and the loss of an 18-bed temporary medical ward had had a “serious flow-on effect” for ED patients.
Shearer replied in June, saying the hospital was “actively recruiting” to vacancies including six new senior nurse FTE approved. ED was a priority when nurses needed to be called in from other parts of the hospital.
When ED was full, she said elective surgery was deferred so other areas of the hospital could be used.
As for a 65-hour waiting time?
“We agree this is a concern for those few patients who end up with a longer stay in the ED observation unit than we would like. We work hard to get patients out of the EDOU within a 24-hour maximum.”
Minister of Health Simeon Brown and Minister of Finance Nicola Willis visited Wellington Regional Hospital last month, after announcing it would be getting a $100 million chunk of a new $1 billion health infrastructure fund announced in Budget 2025.
That would allow its already-underway new ED to be built by 2029 with 87-beds/treatment spaces — 34 more than the current 53. It would also fund new medical and surgical assessments units with an extra 16 beds; another 36 inpatient beds; four intensive care beds; and 36 new outpatient spaces — all scheduled for completion in 2027 with construction beginning next year.
‘We are trying to deliver a service that meets the standards of emergency nursing, and are facing extremely challenging situations where we’re over capacity and nursing patients in unconventional spaces.’
In total, there will be another 126 beds/treatment spaces than currently exist, said Brown, with extra inpatient beds “easing admission bottlenecks” in ED.
New ED ‘must be staffed’
On a Wednesday morning in late May when the ministers visited, there were about six or seven ED patients waiting on beds in corridors, but staff tell Kaitiaki there are usually many more — up to 27 some days.
“It’s not reflective of how we work every day — and after they left, all the patients arrived!” said one nurse, who asked not to be named.
Current recommendations were for 135 full-time-equivalent (FTE) nurses to be on the roster, an ED staff member said. Instead, there were just under 100 — leaving it 36 FTE short.
On top of that, for safe staffing levels — according to safe staffing tool CCDM (care capacity demand management) but not yet approved by hospital management — recommended another 30 or so FTE nurses for the ED roster, ED staff said.
That meant the total nursing shortfall in ED was 66 FTE, staff told Kaitiaki.
“Front-of-whare [project name] approval is fantastic but that’s five years away. Will we still have to work in the current space in the current conditions, with the current staffing for the next five years?” asked one.
Caring for critically-unwell patients in corridors was not safe for either patients or staff — particularly when the ED was working below recommended safe staffing levels, the nurse said.
‘I think the new build will be great, so long as the rest of the hospital sort out their business, otherwise we will be shifting the overcapacity problem to a new area.’
“We are trying to deliver a service that meets the standards of emergency nursing, and are facing extremely challenging situations where we’re over capacity and nursing patients in unconventional spaces.”
Another problem was moving ED patients onto wards, if they were full.
“I think the new build will be great, so long as the rest of the hospital sort out their business, otherwise we will be shifting the overcapacity problem to a new area,” one nurse said.
Wellington ED ‘the worst’
Brown told media at the visit that Wellington ED was the worst-performing in the country, with an outdated layout that contributed to long wait times. His office later provided confirmation that just 49 per cent of Wellington ED patients were seen within six hours — bottom of the table.
Some wait more than 60 hours, staff have told Kaitiaki.
Brown said the planned upgrades would address that, improving patient flow between ED and the wards and supporting modern models of care, as well as creating a better working environment for staff.
Asked by Kaitiaki if he would also staff up ED to help it better meet its six-hour targets — which may now become legally binding — Brown said that $16.68 billion funding (announced in Budget 2024, over six years to 2030) would “ensure Health New Zealand can invest in frontline resources”.
“We’re not just investing in the infrastructure, we’re investing in the people required so they can give the quality and timely care people needed.”
Te Whatu Ora director of operations Capital, Coast & Hutt Valley Jamie Duncan said the ED was “constantly responding to fluctuations in patient demand and acuity” and staffing needs changed accordingly.
The ED was currently recruiting to ED nursing vacancies for “faster review and treatment of patients”, Duncan said.
“We are committed to delivering a new ED in 2029 that meets the needs of our community for timely quality health care, and we are focused on ensuring we have the workforce in place to support that model of care.”
Emergency doctors have also spoken out about the lengthy wait times, Association of Salaried Medical Specialist member Thomas Carter telling The Post they risked the chance of death, longer stays and hospital-acquired infections. “We cannot continue to cause harm,” he said late last year, after leaked figures revealed more than 400 patients waited 48 hours or more in EDs. More than half were in the central region, including Wellington.
Wellington ED: At a glance
Work on Wellington’s ED began in 2023, after $100 million was allocated in the 2022 Budget by the Labour-led Government. In 2023, $10 million of that was released by then-health minister Ayesha Verrall for Te Whatu Ora to develop a business case, planning consents and designs for a new ED with an extra 35 beds.
Another $30 million was released in December 2024 for preparatory building work for the ED — which will be located alongside the main entrance; along with the remaining $60 million, a spokesperson for Brown confirmed.
At a media event at the hospital on May 28, Brown and Minister of Finance Nicola Willis announced the Government would contribute a further $100 million-plus to allow the new ED to be built by 2029; along with a new adjoining medical assessment and planning unit (MAPU), surgical assessment and planning unit (SAPU), transit lounge and behavioural assessment unit.
Another 36 inpatient beds, four intensive care beds and 36 new outpatient spaces were also announced, all scheduled for completion in 2027.
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