Latest news with #CountiesManukau
Otago Daily Times
28-05-2025
- Sport
- Otago Daily Times
Title-winning NZ U-20 coach steps down after just a month
Milton Haig, pictured during his time in charge of Tokyo Suntory Sungoliath in Japan, in 2022. New Zealand Under-20 head coach Milton Haig has stepped down just a month into the role, citing a difference in approach to the rest of his coaching staff. The former Southland player recently led the side to the Under-20 Rugby Championship title in South Africa, but said his decision was based on what he believed was best for the team. "I do not feel I'm fully aligned with the coaching group around things like playing style, so have made the difficult decision to step aside to give the team its best chance of reaching its full potential," he said. Haig was appointed last month and was due to take the side through to the World Championship in Italy in June and July. He has a lengthy coaching pedigree having previously coached Counties Manukau in the NPC, the national Georgia team, Bay of Plenty and Suntory Sungoliatah in Japan. Haig headed a four strong coaching group of Jarrad Hoeata, Alex Robertson and Craig Dunlea who were all appointed by New Zealand Rugby. "Milton's a quality coach and person has done a great job laying the foundations for the team over the past two months. His record over time is evidence of his coaching ability and it was great to see the team perform so well in South Africa," NZR high performance player development manager Matt Sexton said. "We respect his decision to step away and admire his courage in putting the team before himself." Haig said winning in South Africa was a highlight for the team and himself. "Helping the players succeed was my primary motivation for taking the role and I believe they have the skills and drive to be successful at the World Championships in Italy," he said. Haig said he would continue in his role as a World Rugby high-performance consultant.
RNZ News
27-05-2025
- General
- RNZ News
Rugby: Milton Haig steps down after just a month as NZ Under-20 coach
Milton Haig when he was coach of the Counties-Manukau NPC team. Photo: Photosport New Zealand Under-20 head coach Milton Haig has stepped down just a month into the role, citing a difference in approach to the rest of his coaching staff. Haig recently led the side to the Under-20 Rugby Championship title in South Africa, but said his decision was based on what he believed was best for the team. "I do not feel I'm fully aligned with the coaching group around things like playing style, so have made the difficult decision to step aside to give the team its best chance of reaching its full potential," he said. Haig has a lengthy coaching pedigree having previously coached Counties Manukau in the NPC, the national Georgia team, Southland, Bay of Plenty and Suntory Sungoliatah in Japan. Haig headed a four strong coaching group of Jarrad Hoeata, Alex Robertson and Craig Dunlea who were all appointed by New Zealand Rugby. "Milton's a quality coach and person has done a great job laying the foundations for the team over the past two months. His record over time is evidence of his coaching ability and it was great to see the team perform so well in South Africa," NZR high performance player development manager Matt Sexton said. "We respect his decision to step away and admire his courage in putting the team before himself." Haig said winning in South Africa was a highlight for the team and himself. "Helping the players succeed was my primary motivation for taking the role and I believe they have the skills and drive to be successful at the World Championships in Italy," he said. Haig said he would continue in his role as a World Rugby high-performance consultant.
NZ Herald
25-05-2025
- Health
- NZ Herald
More than 1500 patients treated in corridors at Middlemore ED in a month amid staff shortages
The 'quality alert' review, obtained under the Official Information Act (OIA), details 43 separate incidents where patients were harmed because of poor quality and delayed care amid ED overcrowding and staff shortages in the middle of winter. Reported ED overcrowding incidents does not show the old ladies who wet themselves in the corridors Middlemore ED staff member 'Our patients are being done an injustice and we're not talking about it – not at the level it needs to be talked about. It's not visible to our leaders, and as you will be very aware, it's certainly not visible to our politicians,' the staff member continued. Clinicians came up with a business case to boost resources before this winter – but funding has not yet been forthcoming. Another ED staff member said patients being treated in corridors and other 'non-clinical spaces' was having a 'significant effect on the morbidity and mortality' of those they're supposed to be helping. 'It [reported ED overcrowding incidents] does not show the old ladies who wet themselves in the corridors because there is nowhere else to go. It does not show the patients who had a poor experience of death when we could have shown them kindness and dignity when they took their final breath,' the staff member said. The overcrowding between July 1 and August 5 last year was 'predicted and likely to occur again', the report warned. The deficiencies identified included: 1,536 patients received care in an inappropriate clinical space like a corridor. Patients also received sub-optimal care in ambulance waiting areas, on plastic chairs in the waiting room, on the floor, and in their cars. There were 1230 'excess bed days' which is the number of days patients languished in the ED before being admitted to a ward. Only one in every 10 walk-in ED patients suffering a heart attack received appropriate medical intervention within the 90-minute KPI. However, nine out of 10 coming by ambulance were seen within recommended time frames. 1,043 patients including 660 adults and 383 children 'did not wait' in the ED because of overcrowding and long wait times. The report said occupancy rates are increasing by 2-3% every year at Middlemore. The ED has 151 beds but there were at least 12 days last winter where more than 400 patients arrived in a single day. While Counties has low presentation rates given its overall population, more than 50% of patients who do arrive at the ED are of high acuity with 'severe illness or medical conditions,' the report said. 'Very challenging for staff' Counties Manukau group director of operations Dr Vanessa Thornton was unable to say if this winter would be any different in terms of pressure on staff and patient load. 'There's no doubt at times we will have patients in corridors,' she told the Herald. Asked whether she understood why staff would say 'the ship is sinking', she said she did. 'I do sympathise with that because on some days it can be very challenging for staff, and it feels like they're not getting the support that they need at the time.' Thornton, who holds a management position but also works in the ED as an emergency physician, said treating people in corridors was 'not a perfect clinical space' but was the only option when the ED was overrun. She accepted patients were occasionally put at risk during busy periods. 'We don't want patients in corridors. I don't want patients in corridors. No one does. Part of the process of doing this review was to have a look at it and see what we would need to implement to prevent that,' she said. 'Medical error' amid staff shortages The Herald has analysed the 43 patient safety incidents reported during the 36-day period reviewed. The report said 'several' of the incidents are being investigated as 'severity assessment code' one or two, meaning they're the most serious adverse events which resulted in death or permanent loss of function. In all cases, the ED was over capacity or in 'code-red' and in at least 18 of the incidents the department was short-staffed. 'Multiple corridor patients, back-to-back resus patients and unexpected deaths,' one staff member noted next to one of the incidents. During another incident staff noted they were 'short staffed by two doctors, five registered nurses and three healthcare assistants.' 'Poor quality care' was noted as being relevant to all incidents, and in at least four incidents, iatrogenic harm was a contributing factor to patient harm meaning mistakes were made by staff during treatment or medical intervention. Thornton said getting extra staff to plug gaps was difficult. 'If a quarter of the staff are sick on a day, it's hard to replace [them]. It is challenging and it does put pressure on the staff,' she said. She said the purpose of conducting the review was to improve the system. 'Hoping' for extra funding Efforts by clinicians to get extra funding to assist this winter have so far been unsuccessful. Even before winter last year, a $3.6m proposal to boost staff numbers at Middlemore's ED failed because there was 'no mechanism to secure funding', according to the report. Thornton said the budget process is still under way and 'we're hoping' to get some money for that project which was referred to in the report as a new 'fast track' model of care. 'We have obviously asked for more money acutely across the whole region because there's demand everywhere,' she said. Thornton said some improvements had been made to alleviate pressure, including establishing a new permanent 22-bed ward as an overflow for patients waiting in ED. She said extra nurses from other departments, like intensive care, had been identified to help if required, and regional 'load sharing' of ambulances would see patients diverted to other hospitals if Middlemore was unable to cope. The report and its findings were endorsed by Counties Manukau health leaders including Thornton. However, clinicians also recommended Health New Zealand Te Whatu Ora (HNZ) national bosses and the Health Minister be notified of the risks. The Herald understands the review did find its way to HNZ's national lead for quality and patient safety, Sarah Jackson, and the agency's chief medical officer, Dame Helen Stokes-Lampard. The Herald asked why no feedback on such serious issues had been provided by national clinical leaders. A spokeswoman for HNZ said 'there was a delay in acknowledging the report' at a national level but this didn't prevent Middlemore Hospital from working on improvements. The Herald's OIA result suggested such escalation would not necessarily result in funding being approved. 'Funding allocation is progressed through dedicated channels and processes in HNZ rather than quality status reports sent to clinical leadership.' Health Minister Simeon Brown did not answer direct questions about the report or the concerns of staff, nor did he say whether he was sent the report when it was written. He blamed the previous Labour administration for 'unacceptably long' ED wait times and said the Government reinstating health targets had seen an improvement in ED wait times. 'Much more work is needed to fix this challenge, and that is why we will continue to focus Health New Zealand on putting patients first and reducing wait times,' he said. He also said funding for 24-hour urgent care services in Counties Manukau would also reduce pressure on Middlemore's ED.
RNZ News
18-05-2025
- Health
- RNZ News
Budget 2025: New funding for after-hours care 'not going to go very far' - GP and urgent care doctor
New health funding has been welcomed, but there are still concerns over the lack of a trained workforce. File photo. Photo: Photo /123RF General practice doctors are grateful for the government's new funding for after-hours urgent health care , but there are major concerns about how it will be staffed. The GPs say the funding acknowledges urgent care has been under pressure, but the funding is "reasonably light" for what the government is trying to achieve. The government has committed to greater accessibility to urgent and after-hours healthcare in the regions, with several new 24-hour services planned around the country. New funding of $164 million has been allocated over the next four years, with 24-hour urgent care clinics "identified" for Counties Manukau, Whangārei, Palmerston North, Tauranga and Dunedin. The funding boost also covers "new and extended" daytime services for other centres, including Lower Hutt, Invercargill and Timaru. In a pre-Budget announcement on Sunday, Health Minister Simeon Brown said the funding boost would mean 98 percent of New Zealanders would have access to in-person urgent care within an hour's drive. "Strengthening urgent and after-hours care is an important part of our government's plan to ensure all New Zealanders have access to timely, quality healthcare," Brown said. There are currently 48 urgent care clinics across New Zealand, most of which are jointly funded by Health New Zealand and ACC. On top of that are many other after-hours services that provide similar levels of care, but are not considered to be urgent care clinics. Dr Angus Chambers is the chair of GenPro - an organisation that represents the people who own general practices and urgent care centres. He said it was "definitely positive" to have some investment in the after hour urgent care space. "It's clearly a critical area for patient care and and it's under quite a lot of stress, so it's definitely good to see some thoughts into trying to support it." His two main concerns were around the amount of funding and the lack of a trained workforce available to staff the clinics. "The funding seems reasonably light for what they're trying to achieve." He said when the allocated funding is divided between the hundreds of services across the country, the "money's not going to go very far". Chambers also compared it to funding for telehealth services, saying the "complexity of providing an in person after hours service is so much greater". After-hours involved doctors, nurses, a receptionist and facilities, he said. "It's just a little bit hard to see how they've come up with a figure." The other issue he said was going to be "staffing the services" because "the general practice workforce has never been weaker than it is at the moment". He said some of the money will need to be used to make these roles more attractive and keep people working in New Zealand. Chambers said there were a lot of GPs working around the country at "far lower than market rates" to keep those services going, "because they're part of a community". "They see the need for some meaningful work, but we shouldn't have to expect GPs to work with altruism." Overall, Chambers said the "fix" for decreasing demand on hospitals, emergency departments and the after-hours problem was "high functioning general practice care" so that people can get appointments in a timely manner. "If we could manage chronic disease so it doesn't deteriorate, that is what will lead to far less demand." Chambers said involving people who provide these services in decision-making would result in better outcomes. "I think would get greater efficiency and greater effectiveness by trusting the people who actually deliver this work, rather than bureaucrats who are very well meaning, but have really very little idea how to deliver these kind of health services which are very complex and require a lot of experience to get right." Brown told Morning Report the government's investments in primary care will ensure new urgent care clinics are adequately staffed with doctors. "That's why we've announced another range of investments into primary care earlier this year." Funding had been allocated to train 50 more GPs a year, 100 overseas doctors already in NZ, and for 120 nurse practitioners per year, he said. "[The government] is putting a lot of effort not just into extending services or supporting services but also that workforce piece which we know is critically important." He confirmed existing providers would be central to the new services. "Generally they'll be working with current providers and looking to extend hours rather than building new clinics. For instance in Counties Manukau, where it's been identified the need for a new 24/7 provider, there's already a number of providers who provide after-hours care, Health NZ will go through a procurement process to identify a partner there to provide the overnight service in Counties Manukau," he said. Dr Luke Bradford is the medical director at the Royal New Zealand College of General Practitioners. The college looks after the education and standards, advocacy and policy work for the country's general practitioners, and has about 6500 members. Bradford cautiously welcomed the announcement, saying it acknowledged urgent care had been under pressure and an unsustainable model. "It's a vital part in the delivery of the healthcare system, so to acknowledge that it needs increased support was really important." Bradford said the core issues for urgent care come from the financial viability of the model. He wants to make sure the funding supports the model. Bradford said he understood the actual cost to see a patient was about $170 per person. Chambers added the cost to attend an after-hours clinic can range from $0-$260, which was highest he had heard. It varied based on age, ACC status and whether someone had a Community Services Card. "Without funding going in, it's user pays," Bradford said, "there's no way the fees being charged were covering that." Bradford said the other big issue was staff. Clinics are usually staffed - in large part - by GPs working "after hours and on top of their normal work," he said. Rural "on-call hours" and those in the smaller centres often were not paid so you were getting "tired GPs, GPs being underpaid to do it, and therefore you were struggling to staff them." He hoped that would level out due to this funding. As to whether what the government has proposed was possible, Bradford said the "devil's in the detail". He explained the 24/7 clinics were unlikely to be staffed by doctors overnight because there was not enough doctors. "I suspect that it'll be a combination of nurses and paramedics with telehealth support." But he did believe if conditions improved for clinicians working in urgent care, and if the clinics themselves were financially viable, "then a good service can be set up." The majority of the funding would have to go toward staffing, because "you have to pay a premium to the staff who are going to be working overnight". Staff safety was also a priority so people were not alone in buildings through the night, he said. He was also unsure how extra nurses would be attracted to the roles, given the current pay disparity between primary care nurses and their hospital counterparts. The New Zealand Nurses Organisation was also worried about staffing. Primary Health Care Nurses College chair Tracey Morgan said: "Our biggest concern is where will the staff come from. "We welcome the focus on primary and community care but it ignores the main issue. "The pressure on urgent care can't be fixed without solving the chronic under-staffing issues the sector faces." She said until the government gave primary and community health care nurses pay parity with their Te Whatu Ora counterparts, "the sector will continue to lose nurses and health care workers to better paid jobs in hospitals and to better paid jobs overseas". Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
18-05-2025
- Health
- RNZ News
New funding for after-hours care 'not going to go very far' - GP and urgent care doctor
New health funding has been welcomed, but there are still concerns over the lack of a trained workforce. File photo. Photo: Photo /123RF General practice doctors are grateful for the government's new funding for after-hours urgent health care , but there are major concerns about how it will be staffed. The GPs say the funding acknowledges urgent care has been under pressure, but the funding is "reasonably light" for what the government is trying to achieve. The government has committed to greater accessibility to urgent and after-hours healthcare in the regions, with several new 24-hour services planned around the country. New funding of $164 million has been allocated over the next four years, with 24-hour urgent care clinics "identified" for Counties Manukau, Whangārei, Palmerston North, Tauranga and Dunedin. The funding boost also covers "new and extended" daytime services for other centres, including Lower Hutt, Invercargill and Timaru. In a pre-Budget announcement on Sunday, Health Minister Simeon Brown said the funding boost would mean 98 percent of New Zealanders would have access to in-person urgent care within an hour's drive. "Strengthening urgent and after-hours care is an important part of our government's plan to ensure all New Zealanders have access to timely, quality healthcare," Brown said. There are currently 48 urgent care clinics across New Zealand, most of which are jointly funded by Health New Zealand and ACC. On top of that are many other after-hours services that provide similar levels of care, but are not considered to be urgent care clinics. Dr Angus Chambers is the chair of GenPro - an organisation that represents the people who own general practices and urgent care centres. He said it was "definitely positive" to have some investment in the after hour urgent care space. "It's clearly a critical area for patient care and and it's under quite a lot of stress, so it's definitely good to see some thoughts into trying to support it." His two main concerns were around the amount of funding and the lack of a trained workforce available to staff the clinics. "The funding seems reasonably light for what they're trying to achieve." He said when the allocated funding is divided between the hundreds of services across the country, the "money's not going to go very far". Chambers also compared it to funding for telehealth services, saying the "complexity of providing an in person after hours service is so much greater". After-hours involved doctors, nurses, a receptionist and facilities, he said. "It's just a little bit hard to see how they've come up with a figure." The other issue he said was going to be "staffing the services" because "the general practice workforce has never been weaker than it is at the moment". He said some of the money will need to be used to make these roles more attractive and keep people working in New Zealand. Chambers said there were a lot of GPs working around the country at "far lower than market rates" to keep those services going, "because they're part of a community". "They see the need for some meaningful work, but we shouldn't have to expect GPs to work with altruism." Overall, Chambers said the "fix" for decreasing demand on hospitals, emergency departments and the after-hours problem was "high functioning general practice care" so that people can get appointments in a timely manner. "If we could manage chronic disease so it doesn't deteriorate, that is what will lead to far less demand." Chambers said involving people who provide these services in decision-making would result in better outcomes. "I think would get greater efficiency and greater effectiveness by trusting the people who actually deliver this work, rather than bureaucrats who are very well meaning, but have really very little idea how to deliver these kind of health services which are very complex and require a lot of experience to get right." Dr Luke Bradford is the medical director at the Royal New Zealand College of General Practitioners. The college looks after the education and standards, advocacy and policy work for the country's general practitioners, and has about 6500 members. Bradford cautiously welcomed the announcement, saying it acknowledged urgent care had been under pressure and an unsustainable model. "It's a vital part in the delivery of the healthcare system, so to acknowledge that it needs increased support was really important." Bradford said the core issues for urgent care come from the financial viability of the model. He wants to make sure the funding supports the model. Bradford said he understood the actual cost to see a patient was about $170 per person. Chambers added the cost to attend an after-hours clinic can range from $0-$260, which was highest he had heard. It varied based on age, ACC status and whether someone had a Community Services Card. "Without funding going in, it's user pays," Bradford said, "there's no way the fees being charged were covering that." Bradford said the other big issue was staff. Clinics are usually staffed - in large part - by GPs working "after hours and on top of their normal work," he said. Rural "on-call hours" and those in the smaller centres often were not paid so you were getting "tired GPs, GPs being underpaid to do it, and therefore you were struggling to staff them." He hoped that would level out due to this funding. As to whether what the government has proposed was possible, Bradford said the "devil's in the detail". He explained the 24/7 clinics were unlikely to be staffed by doctors overnight because there was not enough doctors. "I suspect that it'll be a combination of nurses and paramedics with telehealth support." But he did believe if conditions improved for clinicians working in urgent care, and if the clinics themselves were financially viable, "then a good service can be set up." The majority of the funding would have to go toward staffing, because "you have to pay a premium to the staff who are going to be working overnight". Staff safety was also a priority so people were not alone in buildings through the night, he said. He was also unsure how extra nurses would be attracted to the roles, given the current pay disparity between primary care nurses and their hospital counterparts. The New Zealand Nurses Organisation was also worried about staffing. Primary Health Care Nurses College chair Tracey Morgan said: "Our biggest concern is where will the staff come from. "We welcome the focus on primary and community care but it ignores the main issue. "The pressure on urgent care can't be fixed without solving the chronic under-staffing issues the sector faces." She said until the government gave primary and community health care nurses pay parity with their Te Whatu Ora counterparts, "the sector will continue to lose nurses and health care workers to better paid jobs in hospitals and to better paid jobs overseas". Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
