Nelson Hospital Review Fails To Hold Leadership To Account - ASMS Says

The review of Nelson Hospital released by Health New Zealand today is little more than a ‘plan to make a plan’ the Association of Salaried Medical Specialists says.

The review just restates well-established problems with leadership and severe understaffing at Nelson Hospital which are causing delayed care for hundreds of patients.

The Nelson Review was commissioned after Senior Medical Officers spoke to media in March about the poor working conditions. Doctors, fed up with inaction, described massive wait times for first specialist appointments, and repeated refusals from leadership to address staffing shortages across many departments.

This prompted Health New Zealand’s chief clinical officer Richard Sullivan to commission a review. He said, "I would hope we will have some answers within weeks."

"Four months later and all we have is a a plan to make a plan," ASMS executive director Sarah Dalton says."

Doctors, nurses and patients want solutions to these ongoing problems, not a bland description of known issues leadership should have addressed years ago.

"The review lacks timeframes, holds no leaders to account for these failures. Just last month Nelson Hospital was again in the news for booking "ghost clinics" in what appears to be an attempt to game the system in regard to first specialists’ appointments numbers.

"There is a worrying trend of poor management and poor leadership at Nelson Hospital which the review fails to address."ASMS is disappointed there has been little engagement with hospital staff - and no consultation as to the review’s findings and recommendations.

"We understand regional deputy chief executive Martin Keogh and National Chief Clinical Officer Dame Helen Stokes-Lampard presented the report to just a handful of senior staff and gave other staff just 24 hours’ notice to a 30-minute briefing.

"This is a wasted opportunity to make positive change," Dalton says the real finding from the review is that the issues at Nelson are present in other hospitals around the motu.

"The review uses comparative data that paints the dire picture of medical staffing gaps in similar sized hospitals across the country too. This aligns with our own findings.

We simply need more doctors," she says.

"Short staffing and increased acute patient demand, coupled with a lack of accountability from our health leaders that allow hospitals to be so poorly staffed has bred a culture of getting by instead of getting ahead."

Additional information

ASMS has been working with senior doctors and managers to conduct in job-sizing activities independent of the Nelson Hospital Review. The following are findings from these activities: - ASMS has completed 17 service reviews (job sizing) across the Nelson Marlborough district since 2024.There are nine further services still to assess. - Our findings so far - which Nelson Hospital management has accepted - show these departments are short a total of 48.7 senior medical officers. - Only 14.7 vacant SMO roles, identified in job sizing, are currently budgeted to be replaced. - Nelson and Wairau hospital district do not provide recruitment or retention allowances, or "public-only" allowances to senior medical and dental staff. This measure would help fill vacancies. - Senior doctors are routinely working beyond their contracted FTE with large amounts of unpaid overtime being gifted to the hospital to fill staffing gaps. Leadership is aware of this. - Senior doctors are not being allocated their non-clinical time (this is non-patient facing work, including teaching, planning, audit, research, and the like) due to the acute patient load and short staffing. - Nelson district has been in breach of its obligation to have formal recovery time arrangements since 2020. This measure allows senior medical staff to safely recover after working overnight calls. The district has been in breach of this SECA clause since 2020 with most departments having no formal arrangements in place. - All reviewed services are currently understaffed Services we’ve reviewed to date (job-sized): Nelson anaesthesia , Child and adolescent mental health services, Cardiology Nelson general surgery, Nelson ED, Wairau ED, endocrinology, Nelson general medicine, Wairau general medicine, Nelson pediatrics, Wairau pediatrics, respiratory, Nelson O&G, Wairau O&G, older persons’ health, vascular surgery, neurology

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