GP After-hours

History
Current System
Can I just ring you?


HISTORY back to contents
For many years there was a "town roster" with each GP taking turns to be on-call for all the patients of those on the roster. This was extremely stressful for the on-call GP and was not particularly satisfactory for major emergencies, particularly after the loss of surgical services in Hawera Hospital. Smaller groups of GPs then established their own rosters and an A&E was set up at Hawera Hospital, which improved things for major emergencies but created conflicts and loss of continuity of care for patients. Many accidents that should be seen in General Practice were turning up so the A&E name was changed to ED (Emergency Department).
When the ED contract came up for renewal, a tender by the majority of GPs was at the time rejected by Taranaki Health in favour of one by White Cross. This arrangement initially appeared to continue the conflict and a separate GP after-hour single site was planned until it became clear that combining the Emergency service and the GP After-hours service at one site in co-operation would provide a more efficient and "seamless" emergency/after-hours service for South Taranaki with much of the medical "workforce" provided by GPs.
The decision to charge for GP type consultations (Triage groups 4 & 5) and surcharge accidents in these categories, enabled this amalgamation to succeed, while serious emergencies (Triage groups 1-3) remained free (funded under a TDHB contract).

Subsequently the contract to provide emergency services was taken over by SouthCare Emergency, the operating arm of the South Taranaki Medical Trust and all the GPs (not just those in the Trust) continued an after-hours arrangement with SouthCare.
However, this arrangement proved unsustainable, with the TDHB contract plus all the income from charging the non-emergency 4 & 5 groups not covering the medical staffing costs for meeting the emergency service. From the 2009 a new system was put in place with only emergencies seen and only by TDHB staff.

CURRENT SYSTEM back to contents
Emergencies: Patients of this (and other South Taranaki practices) are asked to attend the Emergency Department (ED) of the Hawera Hospital (on the North side, using the road access between the hospital and the Ngati Ruanui Healthcare building) ONLY for emergencies and truely urgent problems after-hours and weekends. Non-urgent after-hours problems should NOT be seen at the ED as this will make it harder for urgent problems to be seen and staff generally do not have General Practice qualifications, they are trained for emergencies.

However, as the TDHB / TWOT no longer provides after-hours funding to our practice, do not feel guilty for using the ED for urgent after-hours problems. Please note that if you do attend the ED for a minor problem, you will have to wait quite a long time after being assessed (triaged) and then you may find that only essential treatment will be given (don't expect repeats of prescriptions or second opinions). You may alternatively be "redirected" to the "South Taranaki Rural Health" practice which does receive considerable funding for seeing "ED Redirected" or even "Walk In" patients unable to access their usual GP. However, if you choose to enroll with "The Practice" (or any other practice), you will be permanently deregistered from our practice.

If you are not sure where you should attend, you may ring 0800 Healthline (0800 611 116) and a trained nurse will advise you.

Please NO NOT abuse the Emergency Service or the staff (who try their best but are only responsible for emergencies).
If you do misuse or abuse ED, we all risk losing this valuable service and our practice will not support you.

URGENT NON-EMERGENCIES (Taranaki GP after-hours services): back to contents
When you need urgent primary care that is not an emergency and the hospital based "The Practice" is closed, there is still access to GP after-hours services up to 8pm (at Medicross) every day in New Plymouth where a GP can see you and then communicate with us on the outcome (with your permission) so you may consider using this service if the problem isn't that urgent that it needs to be seen at ED or justifies disturbing me after-hours.
If you do wish to obtain after-hours GP services in New Plymouth, you may attend:

URGENT NON-EMERGENCIES (Telehealth): back to contents
When you need urgent primary care that is not an emergency after hours, another alternative is to use a Telehealth service. Ka Ora Telecare is an afterhours telehealth service providing medical advice (free consultation with a nurse or kaiāwhina) with referral to a doctor (where a fee applies) if needed for rural communities.

This service runs after-hours on weekdays and 24 hours a day on weekends and public holidays and is available to "people located in a rural location that need to use the service temporarily". All of Taranaki outside the New Plymouth district is Rural 1, 2 or 3 and all of South Taranaki is Rural 2 or 3 (R3 being east of Ararata or Meremere). Priority is given to Rural 2 & 3 and non-enrolled (all of our practice) can book an appointment directly, but our practice cannot directly refer as we are not in a PHO and do not share notes with other services electonically.

To book directly either use the free 0800 2 KA ORA (0800 252675) or go online to kaora.co.nz. Make sure you have available:

  • All your medication (they will not be able to access your GP practice notes);

  • Your NHI if possible (on any prescription, hospital or specialist report you have a copy of);

  • Info about the GP - inform them that while not enrolled in a PHO you are registered with Dr Keith Blayney -
    Postal address: PO Box 447, Hawera 4640
    EDI is "keithbly" (so I can be informed of the consultation and treatment);

  • Your Community Services Card (if you have one);

  • And of course your credit card (or online banking facility).

WHY CAN'T I JUST RING MY GP? back to contents
You can, if you believe the problem cannot wait until our practice re-opens but isn't an emergency needing ED. However the high "burnout" rate among rural GPs, not to mention the high divorce rate, primarily relates to excessive "on-call" expectations by their communities. As it is I am already on 24/7 for palliative cases and as a Medical Referee, we ask our patients to avoid "convenience calls" (in which case you should consider the A&M back-up in New Plymouth). Please respect that, as excessive inapropriate demand will risk the loss of this GP altogether.

If required I can be contacted on 0274445135.

Maternity patients should first ring their LMC or the Maternity Unit at the hospital [(06) 278 9911], not me.
   

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