Audit finds Dannevirke hospital not safe for patients

An urgent Health New Zealand audit has found Dannevirke Community Hospital is "not capable at the moment of providing a safe and sustainable inpatient service" because it does not have enough clinicians to staff a safe roster. The agency has frozen new admissions while it sends in extra staff and gives the hospital's operator 30 days to fix the problem.

The finding follows weeks of concern. Local doctors had already been raising worries about referring patients to the hospital because of safety risks, and a string of resignations there prompted Health NZ to carry out the audit this week. Health NZ central region director Geoff Gwyn told RNZ's Checkpoint those concerns were correct.

It matters because Dannevirke and the wider Tararua district now have a smaller and shakier rural health system just as a second local service, Pahiatua Medical Centre, has also had to be propped up after staff resignations there. For a rural community, any gap in hospital or GP cover is not an abstract policy question, it is about where people can safely get care.

The record

Health NZ audited Dannevirke hospital in June and found no critical concerns, though it flagged 23 issues rated low to medium. Gwyn said the situation "deteriorated" since then, and this week's follow-up audit found the hospital lacked sufficient clinicians to run a roster he considered safe for admitted patients.

In response, Health NZ has frozen new admissions to the hospital and sent five of its own clinicians to work there while staffing is rebuilt. Palmerston North Hospital is now taking the patients Dannevirke would otherwise admit. Tararua Health Group, which owns the hospital along with several medical centres in the district, has been given 30 days to fix the roster and recruit more clinical staff. Gwyn said the intervention carries "significant contractual obligations" for the provider that he could not detail because they were commercially sensitive, and that no decision had yet been made on the contract itself.

Tararua Health Group is owned by OmniHealth, a network of about 17 practices around the country.

At the same time, Health NZ audited Pahiatua Medical Centre, where six staff resigned last week amid concerns about extreme workload and patient safety. Almost 5000 patients rely on that service. The primary health organisation, or PHO, has placed a general practitioner and a practice manager there for three months, with nurse practitioner support arriving later this week. Gwyn said overdue patient recalls had been reviewed, prioritised and actioned.

What doesn't add up

The gap between the two audits is the clearest unanswered question. In June, inspectors found no critical issues at Dannevirke hospital, only lower-level concerns. Three months later the same hospital is judged incapable of safe inpatient care. The article does not explain what changed in that window beyond the resignations themselves, so the underlying cause of the sudden deterioration, whether it was staffing, workload, management or something else, is not addressed.

It is also unclear what would actually trigger a change to Tararua Health Group's contract. Gwyn says no decision has been made, but also says he does not have "a high level of confidence" in the services currently provided. What has to happen in the next 30 days, short of full safe rostering, for Health NZ to decide the contract itself is at risk? The commercial sensitivity cited around those contractual implications means the public is being asked to trust the process without seeing the criteria.

Neither audit result spells out, in numbers, how many patients were or could have been affected by the Dannevirke admissions freeze, unlike the Pahiatua figure of almost 5000 patients, which is given precisely. And while Gwyn says he is "hoping" the resigned Pahiatua staff will return once they see the changes made, that outcome is not yet confirmed either way.

The other side

Health NZ's response to both situations is set out in some detail. At Dannevirke, it has sent five of its own clinicians to bolster staffing and is "working with them this week" to restore a sustainable roster, while diverting admissions to Palmerston North in the meantime. It has also given Tararua Health Group a defined 30 day window to fix the roster and recruit permanent staff, rather than acting immediately on the contract.

At Pahiatua, Gwyn pointed to concrete steps already taken: a full time GP and practice manager placed for three months, a GP with full daily bookings, incoming nurse practitioner support and all overdue recalls actioned. He said he had confidence in the level of care given those additions.

RNZ reported that Tararua Health Group had been contacted for comment. No response from the provider is included in the article.

What happens next

The immediate deadline is 30 days, the window Health NZ has set for Tararua Health Group to rebuild its roster and recruit enough clinicians to satisfy the agency that inpatient care at Dannevirke is safe and sustainable. Gwyn was explicit that no decision on the underlying contract has been made yet, and that the outcome depends on what the provider can demonstrate in that time.

At Pahiatua, the completed audit findings were due to be shared with staff on Wednesday. Whether the six staff who resigned choose to return will depend on how those findings are received and whether the temporary GP, practice manager and nurse practitioner support translate into a sustainable workload.

For now, Dannevirke's admissions freeze and Palmerston North's stand-in role remain in place, with the coming weeks set to determine whether local inpatient care resumes or whether Health NZ's confidence in the current operator continues to slide.