Te Whatu Ora pulls inaccurate emergency department data

Te Whatu Ora has admitted some of its data on emergency department (ED) wait times is wrong, and taken the entire page of health performance metrics offline.

The concession comes as general practices struggle, putting pressure on EDs, and nurses jumping ship to bandage the higher-paid gaps in hospitals.

Doctors say this is particularly prevalent in rural and vulnerable areas.

In Northland, the incorrect data showed in November and December, more than 99 percent of people who attended an ED were seen within the target time of six hours – probably because only a few hundred each month were recorded as attending, rather than the usual 5000 or so.

“The data’s obviously wrong,” Northland-based practising GP Dr Kyle Eggleton told RNZ’s Midday Report on Thursday.

“There’s quite erroneous data that’s appeared, and it’s not just in Northland – there’s a number of other districts as well in which the data is clearly false, which is really concerning.

“If we are relying on the data for decision-making and allocation of resources, then the decision-makers are relying on very false data.”

Health Minister Dr Ayesha Verrall quoted the faulty data earlier this week when she said Northland EDs had shown improvement. Other former district health board (DHB) regions with suspect data – some showing unrealistic increases in attendance – include Wairarapa, Counties Manukau, Southern and Waitemata.

Eggleton was on the Northland DHB, which ceased to exist mid-2022. He feared lost “institutional knowledge” was potentially the cause of “errors creeping in”.

“Our responsibility as a board was to go through all of that data and look at discrepancies and ask questions of the executive around why we were seeing this data. So that was a potential opportunity to pick up on things that were erroneous.

“I don’t think the Te Whatu Ora board would have the capacity, the ability to look at individual data like this.”

Rural GP Dr Tim Malloy, chair of GenPro – the General Practice Owners Association of Aotearoa New Zealand – said the health “system as a whole is beginning to fail” and the data was “not at all” close to reality.

“Those of us who work on the coalface and have to sit in front of patients are much more aware of the realities of what’s going on out there, and having to listen to the stories that patients are telling us of delayed care, of inability to access care, and therefore presenting late or acutely and ending up in EDs in very large numbers.”

He said a big problem was the discrepancy in pay between nurses in primary care and the community, and those working in hospitals.

“We are losing nurses daily, particularly younger nurses… choosing the option of going into hospitals or Australia or other careers altogether because the discrepancy in the income that they can earn in primary care, compared to Te Whatu Ora hospitals for example, can be as much as $20,000 per annum.

“That’s just not possible to ignore, if you’re a young nurse facing the challenge of rising costs of living and perhaps mortgage interest rates rising.”

Eggleton backed this up.

“There’s been two decades of underfunding and lack of workforce development that’s occurred in primary care. Often resources tend to be shifted towards hospital-centric services and primary is often forgotten. You can see that with the discrepancy in nurse pay.”

Malloy said the current situation was “everybody’s worst nightmare”, particularly with immunisation rates falling.

Ministry of Health data shows in the final quarter of 2019, the last before Covid-19, just over 80 percent of all six-month-olds were up-to-date with their immunisations; this has since fallen to 68.8 percent.

For five-year-olds, coverage fell from 89.2 percent to 80.8 percent.

“In order for them to rise and protect us against things like measles and things which are likely to return shortly, we will need a highly skilled nursing workforce,” said Malloy.

Te Whatu Ora medical director Pete Watson earlier said the figures were “as accurate as we’ve got them at the moment”, but “clearly [are] not accurate”.