Part 8: District health boards' after-hours services

8.1
In this Part, we provide a description of each DHB's after-hours services and a map of each DHB district showing the locations of after-hours services in a typical week. We have colour-coded the maps to show where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive during a representative week.

8.2
The maps and commentary are arranged alphabetically by the name of each DHB.

Caution using the maps

8.3
It is important that readers do not rely on a map to identify the specific after-hours services available to them. They should seek this information from other sources, such as their DHB, Healthline, or the providers of daytime services in their area.

8.4
The information shown on the maps does not include the hours that an after-hours service is open. The information was valid during 2009, but may have changed since then. In some instances, we have also used representative rather than actual information. For example, where rosters change regularly or vary a lot during a week, we included what appeared to be the most common arrangements.

Interpreting the maps

8.5
The individual DHB maps have been created using the geographical information system methodology described in Appendix 1. These maps assume that people drive to the nearest after-hours service – regardless of whether that service is within their DHB district.²⁵

8.6
Each DHB map shows the locations and types of providers of after-hours services, based on DHBs' plans. Figure 11 shows the different types of provider and the symbols used. Because some providers are very close to each other geographically, their symbols on the maps may be superimposed. This may show as overlapping, or, for some providers, only one symbol will show even though two or more providers are described.

Figure 11
Symbols used for after-hours service providers

8.7
On each map, we have used colour to identify three types of localities in terms of the availability of after-hours services within 60 minutes' drive:

• red is used to show where an after-hours service was never available within 60 minutes' drive in a typical week;
• orange is used to show where an after-hours service was sometimes available within 60 minutes' drive in a typical week; and
• light green is used to show where an after-hours service was always available within 60 minutes' drive in a typical week.

8.8
There are some areas on the maps that, despite being shown as not having services available within 60 minutes' drive, appear relatively close to after-hours facilities. These areas have either very low or no populations, or poor or no access to public roads.

8.9
A darker shade of green has been used to show forests and national parks. Ocean and lakes are in blue. We have also shown the main roads and DHB boundaries.

Auckland District Health Board

Description of the after-hours services

8.10
Auckland City Hospital in Grafton and an accident and medical centre in Remuera were open 24 hours a day, seven days a week.

8.11
A further six accident and medical centres (in Onehunga, Orakei, Otahuhu, Ponsonby, St Lukes, and Three Kings) were open seven days a week from between 7.30am and 8am in the morning until between 8pm and 10pm at night.

8.12
Four general practices (in Sandringham, Onehunga, Otahuhu, and Panmure) were open on Saturday mornings. There was also a home visiting service that was available 24 hours a day, seven days a week.

8.13
On Waiheke Island, a general practice and an accident and medical centre shared an on-call roster.

8.14
On Great Barrier Island, a general practice provided an on-call service after hours.

Availability of after-hours services within 60 minutes' drive

8.15
Auckland DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.16
Figure 12 sets out the percentage of Auckland DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Auckland DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Auckland DHB district.

8.17
Figure 13 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Auckland DHB's population – regardless of whether the service was within the Auckland DHB district.

Figure 12
Statistics for the availability of after-hours services for Auckland District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	404,670
% of DHB population always with after-hours services available within 60 minutes' drive	99.9%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	485

Figure 13
After-hours service coverage for Auckland District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Bay of Plenty District Health Board

Description of the after-hours services

8.18
After-hours services in the Western Bay of Plenty were available at Tauranga Hospital's emergency department, which was open 24 hours a day, seven days a week, and from an accident and medical centre open until 9pm, seven days a week. Two general practices in Tauranga provided some after-hours services.

8.19
A general practice at Waihi Beach shared a roster for after-hours services with a nearby general practice in the Waikato DHB area. The shared roster was a mix of on-call work and clinics.

8.20
In the Eastern Bay of Plenty, after-hours services were available at Whakatane Hospital's emergency department, which was open 24 hours a day, seven days a week.

8.21
In Whakatane, there was an accident and medical centre open until 6pm in the evenings and from 9am to 12pm on weekends. Six general practices (four in Whakatane, and one each in Taneatua and Ohope) also shared an on-call roster from 5pm to 6pm weeknights and from 10pm to 11.30pm on weekends.

8.22
After-hours services were available in Murupara, Te Kaha, and Opotiki. There were two general practices in Kawerau that provided clinics in the morning on weekends.

Availability of after-hours services within 60 minutes' drive

8.23
Bay of Plenty DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.24
Figure 14 sets out the percentage of Bay of Plenty DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Bay of Plenty DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Bay of Plenty DHB district.

8.25
Figure 15 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Bay of Plenty DHB's population – regardless of whether the service was within the Bay of Plenty DHB district.

Figure 14
Statistics for the availability of after-hours services for Bay of Plenty District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	195,024
% of DHB population always with after-hours services available within 60 minutes' drive	99.9%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	224

Figure 15
After-hours service coverage for Bay of Plenty District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Canterbury District Health Board

Description of the after-hours services

8.26
The main provider of after-hours services in Christchurch was an accident and medical centre on the corner of Bealey Avenue and Colombo Street. The centre was open 24 hours a day, seven days a week. The DHB told us that most general practices in or near Christchurch provide after-hours services through this accident and medical centre and contribute GPs to its after-hours roster. Accident and medical centres in Riccarton and near Moorhouse Avenue were open for extended hours, including on weekends, and after these hours provided an on-call service. The DHB told us that a small number of other Christchurch practices provide their own after-hours on-call service for their enrolled patients.

8.27
In Christchurch, hospital-level emergency care is provided 24 hours a day, seven days a week by the emergency department at Christchurch Hospital. The DHB has identified that some patients may use the emergency department for after-hours services even if this is not the most appropriate option.

8.28
In Banks Peninsula, two general practices (in Diamond Harbour and Akaroa) provided after-hours services separately in the evening, overnight, and on weekends, on an on-call basis.

8.29
In Kaiapoi, three general practices provided on-call services until 8pm, seven days a week, on a shared-roster basis.

8.30
In the Selwyn district, four general practices provided services until 8pm on a shared-roster basis. After 8pm, services were provided by an urban after-hours provider. Another general practice, in Darfield, was open for limited hours on the weekends.

8.31
In Rangiora, six general practices shared a roster to provide limited clinic services on Saturdays and on-call services at other times.

8.32
In Oxford, one general practice provided after-hours services in the evening, overnight, and on weekends, on an on-call basis.

8.33
In Ashburton, five general practices shared a roster to provide clinic services for limited hours during the day on Saturdays and Sundays. The emergency department at Ashburton Hospital provided primary care at other times after hours.

8.34
A general practice in Methven and another in Rakaia provided on-call after-hours services in the evening, overnight, and on weekends, on a shared-roster basis.

8.35
A general practice in Rotherham and another in Hanmer Springs provided on-call after-hours services in the evening, overnight, and on weekends, on a shared-roster basis.

8.36
A general practice in Amberley and another in Waikari provided on-call after-hours services in the evening, overnight, and on weekends, on a shared-roster basis. The Cheviot practice joined the roster for weekends.

8.37
In Kaikoura, one general practice provided a clinic for two hours a day on Saturdays and Sundays, and provided on-call services in the evening, overnight, and otherwise during the day on weekends.

Availability of after-hours services within 60 minutes' drive

8.38
Canterbury DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.39
Figure 16 sets out the percentage of Canterbury DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Canterbury DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Canterbury DHB district.

8.40
Figure 17 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Canterbury DHB's population – regardless of whether the service was within the Canterbury DHB district.

Figure 16
Statistics for the availability of after-hours services for Canterbury District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	466,365
% of DHB population always with after-hours services available within 60 minutes' drive	99.9%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	306

Figure 17
After-hours service coverage for Canterbury District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Capital and Coast District Health Board

Description of the after-hours services

8.41
In Wellington, the hospital emergency department was open 24 hours a day, seven days a week. The nearby accident and medical centre was open until 11pm, seven days a week. Two general practices were open until 11pm on weekdays. Six other general practices provided after-hours services on Saturday mornings.

8.42
In Porirua, an accident and medical centre within Kenepuru Hospital was open 24 hours a day, seven days a week. One general practice was open on Tuesday nights.

8.43
In the Kapiti district, an accident and medical centre was open until 10pm, seven days a week, and a general practice was open on Saturdays. There was also a mobile service provided by Wellington Free Ambulance and Kapiti Emergency Medical Service.

Availability of after-hours services within 60 minutes' drive

8.44
Capital and Coast DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.45
Figure 18 sets out the percentage of Capital and Coast DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Capital and Coast DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Capital and Coast DHB district.

8.46
Figure 19 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Capital and Coast DHB's population – regardless of whether the service was within the Capital and Coast DHB district.

Figure 18
Statistics for the availability of after-hours services for Capital and Coast District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	266,688
% of DHB population always with after-hours services available within 60 minutes' drive	100%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	0

Figure 19
After-hours service coverage for Capital and Coast District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Counties Manukau District Health Board

Description of the after-hours services

8.47
Middlemore Hospital's emergency department and an accident and medical centre in Howick were both open 24 hours a day, seven days a week.

8.48
Seven accident and medical centres (in Otara, Papakura, Takanini, Pukekohe, Chapel Downs, Dannemora, and Manukau City) were open seven days a week, closing at various times between 8pm and 11pm on weeknights and between 5pm and 11pm on weekends.

8.49
General practices in Waiuku and Mangere were open until 7pm or 8pm on weeknights and ran clinics on Saturdays and Sundays.

Availability of after-hours services within 60 minutes' drive

8.50
Counties Manukau DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.51
Figure 20 sets out the percentage of Counties Manukau DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Counties Manukau DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Counties Manukau DHB district.

8.52
Figure 21 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Counties Manukau DHB's population – regardless of whether the service was within the Counties Manukau DHB district.

Figure 20
Statistics for the availability of after-hours services for Counties Manukau District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	433,053
% of DHB population always with after-hours services available within 60 minutes' drive	99.4%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	73

Figure 21
After-hours service coverage for Counties Manukau District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Hawke's Bay District Health Board

Description of the after-hours services

8.53
The DHB told us that in the central Hawke's Bay district, four general practices (at Waipukurau) provided 24-hours-a-day after-hours care from Monday to Thursday, and that two-hourly GP clinics were run by rostered GPs on Saturdays and Sundays. Outside of these hours, patients were referred to either the accident and medical centre in Hastings or to Hawke's Bay Hospital if the accident and medical centre was not open.

8.54
In Hastings, the accident and medical centre was open until 8pm on weeknights and from 8am to 8pm on weekends. A general practice provided after-hours services until 7pm several nights a week. Another general practice was open until 7pm on weeknights and from 9am to 6pm on weekends. From 8pm to 8am every night, after-hours services were provided by Hawke's Bay Hospital's emergency department.

8.55
In Napier, an accident and medical clinic provided 24-hour urgent accident and medical services. This was an on-call service after 9pm.

8.56
In Wairoa, three permanent GPs and three locums shared an on-call roster for after-hours services. The on-call GP also covered Wairoa Hospital's emergency department after hours. Patients could also visit or phone a nurse in the Wairoa Hospital emergency department.

8.57
In the Chatham Islands, the GP was on-call after hours. A registered nurse provided 24-hour advice, both by phone and face to face at the clinic.

Availability of after-hours services within 60 minutes' drive

8.58
Hawke's Bay DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.59
Figure 22 sets out the percentage of Hawke's Bay DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Hawke's Bay DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Hawke's Bay DHB district.

8.60
Figure 23 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Hawke's Bay DHB's population – regardless of whether the service was within the Hawke's Bay DHB district.

Figure 22
Statistics for the availability of after-hours services for Hawke's Bay District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	148,293
% of DHB population always with after-hours services available within 60 minutes' drive	99.6%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	547

Figure 23
After-hours service coverage for Hawke's Bay District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Hutt Valley District Health Board

Description of the after-hours services

8.61
After-hours services were available at an accident and medical centre. This operated from 5.30pm to 8am weekdays and 24 hours a day on weekends.

8.62
Two general practices were open or on call until 10pm or 11pm on weeknights and from 8am to 9am until 6pm on weekends. Another general practice was open until 8pm on weeknights.

8.63
After-hours services were also available at Hutt Hospital's emergency department, although this was not formally part of the DHB's after-hours arrangements.

Availability of after-hours services within 60 minutes' drive

8.64
Hutt Valley DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.65
Figure 24 sets out the percentage of Hutt Valley DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Hutt Valley DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Hutt Valley DHB district.

8.66
Figure 25 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Hutt Valley DHB's population – regardless of whether the service was within the Hutt Valley DHB district.

Figure 24
Statistics for the availability of after-hours services for Hutt Valley District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	136,050
% of DHB population always with after-hours services available within 60 minutes' drive	100%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	0

Figure 25
After-hours service coverage for Hutt Valley District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Lakes District Health Board

Description of the after-hours services

8.67
In Taupo, three general practices took turns providing after-hours services between 5pm and 10pm on weekdays and from 8am to 10pm on weekends. Taupo Hospital's emergency department was open 24 hours a day, seven days a week.

8.68
Patients in Turangi needed to travel to Taupo to visit after-hours services, except for some Saturday mornings when a clinic operated in Turangi.

8.69
Patients in Mangakino could access services in Tokoroa, which is within the Waikato DHB district.

8.70
In the Rotorua area, after-hours services were available from an accident and medical centre from 8am to 10pm, seven days a week, with an on-call service available overnight, and from Rotorua Hospital 24 hours a day, seven days a week.

Availability of after-hours services within 60 minutes' drive

8.71
Lakes DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.72
Figure 26 sets out the percentage of Lakes DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Lakes DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Lakes DHB district.

8.73
Figure 27 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Lakes DHB's population – regardless of whether the service was within the Lakes DHB district.

Figure 26
Statistics for the availability of after-hours services for Lakes District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	98,421
% of DHB population always with after-hours services available within 60 minutes' drive	100%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	0

Figure 27
After-hours service coverage for Lakes District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

MidCentral District Health Board

Description of the after-hours services

8.74
In Palmerston North, after-hours services were available from:

• an accident and medical centre open from 8am to 10pm, seven days a week;
• an accident and medical centre open until 7pm on weeknights and from 9am to 6pm on weekends; and
• Palmerston North Hospital's emergency department.

8.75
In the Tararua district, three general practices shared a roster to provide after-hours services at Dannevirke Community Hospital until 9pm on weeknights, to be on call from 9pm to 11pm on weeknights, and to provide clinics on Saturday mornings.

8.76
Four general practices in Feilding shared a roster to provide Saturday morning clinics.

8.77
Eight general practices (six in Levin, one in Shannon, and one in Foxton) shared an on-call roster until 8pm, seven nights a week.

8.78
A general practice in Otaki provided after-hours services until 11pm.

Availability of after-hours services within 60 minutes' drive

8.79
MidCentral DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.80
Figure 28 sets out the percentage of MidCentral DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the MidCentral DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the MidCentral DHB district.

8.81
Figure 29 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for MidCentral DHB's population – regardless of whether the service was within the MidCentral DHB district.

Figure 28
Statistics for the availability of after-hours services for MidCentral District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	158,808
% of DHB population always with after-hours services available within 60 minutes' drive	99.2%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	538

8.82
MidCentral DHB relied on some services outside its district to meet the expectation for geographic availability of after-hours services to 95% of its population within 60 minutes' drive. When these services were excluded from our modelling, 93.2% of MidCentral DHB's population could reach after-hours services within the district. This was mainly because, after 11pm, patients in Otaki had to travel outside the district to reach an after-hours service within 60 minutes. After that time, the closest services were in the neighbouring Capital and Coast DHB district.

Figure 29
After-hours service coverage for MidCentral District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Nelson Marlborough District Health Board

Description of the after-hours services

8.83
One general practice in Takaka and three general practices in Motueka provided after-hours services on an on-call basis.

8.84
In Murchison, nurses provided after-hours services from Murchison Community Hospital. They could phone a general practice for medical back-up.

8.85
In Nelson, a general practice provided after-hours services until 10pm on weekdays and from 8am to 10pm on weekends. After-hours services were also available at Nelson Hospital's emergency department.

8.86
In Blenheim, an after-hours service was open until 10pm on weeknights and from 8am to 10pm on weekends. This service was located within the hospital grounds. After-hours services were also available at Wairau Hospital's emergency department.

Availability of after-hours services within 60 minutes' drive

8.87
Nelson Marlborough DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.88
Figure 30 sets out the percentage of Nelson Marlborough DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Nelson Marlborough DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Nelson Marlborough DHB district.

8.89
Figure 31 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Nelson Marlborough DHB's population – regardless of whether the service was within the Nelson Marlborough DHB district.

Figure 30
Statistics for the availability of after-hours services for Nelson Marlborough District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	130,080
% of DHB population always with after-hours services available within 60 minutes' drive	99.0%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	1283

Figure 31
After-hours service coverage for Nelson Marlborough District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Northland District Health Board

Description of the after-hours services

8.90
In the northern part of the district, after-hours services were provided on site at Kaitaia Hospital, from a general practice in Kaeo, and from a general practice in Te Kao with an on-call service.

8.91
In the central part of the district, after-hours services were available from:

• a hospital in Rawene;
• two general practices in Kerikeri and one in Kaikohe that held Saturday morning clinics;
• a group of general practitioners providing an after-hours service based at Bay of Islands Hospital;
• a general practice in Russell; and
• five practices (at Paihia, Kawakawa, and Moerewa) that shared a roster to provide Saturday morning clinics.

8.92
In Whangarei, an accident and medical centre provided after-hours services until 10pm on weekdays and from 8am to 10pm on weekends. A general practice in Hikurangi provided after-hours services. After-hours services were also available at Whangarei Hospital's emergency department.

8.93
In the southern part of the district, a general practice located near Dargaville Hospital provided after-hours services. General practices in Ruakaka and Waipu shared a roster for Saturday morning clinics.

Availability of after-hours services within 60 minutes' drive

8.94
Northland DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.95
Figure 32 sets out the percentage of Northland DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Northland DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Northland DHB district.

8.96
Figure 33 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Northland DHB's population – regardless of whether the service was within the Northland DHB district.

Figure 32
Statistics for the availability of after-hours services for Northland District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	148,437
% of DHB population always with after-hours services available within 60 minutes' drive	99.6%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	525

Figure 33
After-hours service coverage for Northland District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Otago District Health Board

Description of the after-hours services

8.97
In Dunedin:

• an accident and medical centre was open until 11.30pm on weeknights and from 8am to 11.30pm on weekends;
• a general practice was open until 8pm on weeknights and held clinics on weekends; and
• Dunedin Hospital's emergency department provided after-hours services overnight.

8.98
In Mosgiel, after-hours services were available from a general practice during the week between 5pm and 11.30pm.

8.99
In Palmerston, an on-call after-hours service was available from a general practice.

8.100
In the Clutha area:

• two general practices each provided on-call services during the week and shared a weekend roster for after-hours services;
• one general practice provided on-call services overnight on weeknights and 24 hours a day on weekends; and
• Clutha Health First, a community-owned integrated hospital and health centre, provided after-hours services by GPs until 9pm and by medical officers from 9pm to 9am, seven days a week.

8.101
In Central Otago:

• a general practice in Roxburgh provided an on-call service overnight and on weekends;
• three general practices in Alexandra shared an on-call roster on weeknights and weekends;
• two general practices in Cromwell provided overnight and weekend services through a mix of on-call services and clinics; and
• one general practice in Ranfurly provided some on-call services.

8.102
In Oamaru, five general practices shared an on-call roster on weeknights and weekends. Waitaki District Health Services, a rural hospital in Oamaru, also provided after-hours services overnight and on weekends.

8.103
In Kurow, a general practice provided some after-hours services.

8.104
In Wanaka, two general practices provided after-hours services.

Availability of after-hours services within 60 minutes' drive

8.105
Otago DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.106
Figure 34 sets out the percentage of Otago DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Otago DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Otago DHB district.

8.107
Figure 35 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Otago DHB's population – regardless of whether the service was within the Otago DHB district.

Figure 34
Statistics for the availability of after-hours services for Otago District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	179,481
% of DHB population always with after-hours services available within 60 minutes' drive	99.0%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	80

Figure 35
After-hours service coverage for Otago District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

South Canterbury District Health Board

Description of the after-hours services

8.108
At the time of our audit fieldwork, after-hours services in Timaru were provided by an accident and medical centre and at Timaru Hospital's emergency department.

8.109
Five general practices in Geraldine and Temuka shared an on-call roster for after-hours services between 5pm and 8am five days a week. They shared a roster for 24-hours-a-day after-hours services on weekends.

8.110
At Pleasant Point, the local GP provided after-hours services when available, otherwise patients were directed to use the Timaru accident and medical centre.

8.111
In Waimate, two general practices provided after-hours services through a shared on-call roster.

8.112
A general practice in Fairlie and another in Twizel provided after-hours services on an on-call basis.

Availability of after-hours services within 60 minutes' drive

8.113
South Canterbury DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.114
Figure 36 sets out the percentage of South Canterbury DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the South Canterbury DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the South Canterbury DHB district.

8.115
Figure 37 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for South Canterbury DHB's population – regardless of whether the service was within the South Canterbury DHB district.

Figure 36
Statistics for the availability of after-hours services for South Canterbury District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	53,955
% of DHB population always with after-hours services available within 60 minutes' drive	99.6%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	93

Figure 37
After-hours service coverage for South Canterbury District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Southland District Health Board

Description of the after-hours services

8.116
In Invercargill, after-hours services were available at an accident and medical centre until 10pm on weeknights and from 8am to 10pm on weekends. After 10pm, patients were directed to Invercargill Hospital's emergency department.

8.117
In Queenstown, after-hours services were available from:

• a general practice until 8pm on weeknights and from 8am to 8pm on weekends;
• a general practice in Frankton with an on-call service; and
• the Lakes District Hospital's emergency department, which was open 24 hours a day, seven days a week.

8.118
In Te Anau, a general practice provided an on-call after-hours service.

8.119
In Gore, local GPs at the Gore After-Hours Medical Clinic in Gore Hospital provided after-hours services.

8.120
A GP in Lumsden was on call on weeknights, and was part of the roster to provide care in Gore on weekends. The GP told us that he receives reasonable roster funding to help with this work.

8.121
The general practices in Tuatapere, Riverton, and Otautau provided after-hours services through a shared on-call roster.

8.122
Rural nurses on Stewart Island and in Tokanui provided after-hours services to patients in their local area. Southland DHB noted that some patients in the Catlins were closer to, and were enrolled in, general practices in Balclutha, where after-hours services were available.

Availability of after-hours services within 60 minutes' drive

8.123
Southland DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.124
Figure 38 sets out the percentage of Southland DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Southland DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Southland DHB district.

8.125
Figure 39 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Southland DHB's population – regardless of whether the service was within the Southland DHB district.

Figure 38
Statistics for the availability of after-hours services for Southland District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	106,767
% of DHB population always with after-hours services available within 60 minutes' drive	99.2%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	305

Figure 39
After-hours service coverage for Southland District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Tairawhiti District Health Board

Description of the after-hours services

8.126
In Gisborne:

• five general practices shared a roster to provide after-hours services until 10pm on weeknights and from 8am to 10pm on weekends;
• two general practices shared a roster until 10pm on weeknights and provided on-call services from 8am to 10pm on weekends;
• one general practice provided on-call services until 8pm on weeknights and was open from 9am to 6pm on weekends; and
• Gisborne Hospital's emergency department provided after-hours services overnight.

8.127
On the East Cape, an on-call GP roster operated at Te Puia Springs.

Availability of after-hours services within 60 minutes' drive

8.128
Tairawhiti DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.129
Figure 40 sets out the percentage of Tairawhiti DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Tairawhiti DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Tairawhiti DHB district.

8.130
Figure 41 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Tairawhiti DHB's population – regardless of whether the service was within the Tairawhiti DHB district.

Figure 40 Statistics for the availability of after-hours services for Tairawhiti District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	44,433
% of DHB population always with after-hours services available within 60 minutes' drive	98.2%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	783

Figure 41
After-hours service coverage for Tairawhiti District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Taranaki District Health Board

Description of the after-hours services

8.131
In New Plymouth, after-hours services were provided by:

• one accident and medical centre open until 8pm on weeknights, from 8am to 8pm on weekends, and on call overnight;
• one accident and medical centre open until 8.30pm on weeknights and from 8.30am to 8.30pm on weekends;
• a general practice open until 8pm on weeknights, and open for clinics on Saturday mornings; and
• Taranaki Base Hospital's emergency department.

8.132
In Hawera, one general practice was open until 8pm from Monday to Thursday, and another general practice was on call overnight and on weekends. Hawera Hospital's emergency department was also open 24 hours a day, seven days a week.

8.133
General practices in Inglewood, Oakura, Opunake, and Eltham provided after-hours services on an on-call basis.

8.134
Three general practices in Stratford shared a roster to provide extended services until 7pm on weeknights and clinics on Saturday mornings.

Availability of after-hours services within 60 minutes' drive

8.135
Taranaki DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.136
Figure 42 sets out the percentage of Taranaki DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Taranaki DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Taranaki DHB district.

8.137
Figure 43 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Taranaki DHB's population – regardless of whether the service was within the Taranaki DHB district.

Figure 42
Statistics for the availability of after-hours services for Taranaki District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	104,355
% of DHB population always with after-hours services available within 60 minutes' drive	99.7%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	244

Figure 43
After-hours service coverage for Taranaki District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Waikato District Health Board

Description of the after-hours services

8.138
In Hamilton, after-hours services were available from:

• four accident and medical centres – one open 24 hours a day, seven days a week; one open from 8am to 10pm, seven days a week; and two open from 8am to 8pm, seven days a week; and
• Waikato Hospital's emergency department, which was open 24 hours a day, seven days a week.

8.139
In the Thames-Coromandel district, after-hours services were available from:

• Thames Hospital's emergency department, which was open 24 hours a day, seven days a week;
• two general practices in Whitianga and one in Tairua, which shared a roster for after-hours services; and
• general practices in Whangamata, Colville, and Coromandel.²⁶

8.140
Four general practices in Tokoroa and one in Putaruru shared a roster until 8pm on weeknights and from 9.30am to 12pm and from 6pm to 8pm on Saturdays and Sundays. Tokoroa Hospital's emergency department was also open 24 hours a day, seven days a week.

8.141
After-hours services in the rest of the district included:

• a general practice in Te Kuiti and Te Kuiti Hospital;
• Taumarunui Hospital's emergency department; and
• general practices in Kawhia and Matamata.

Availability of after-hours services within 60 minutes' drive

8.142
Waikato DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.143
Figure 44 sets out the percentage of Waikato DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Waikato DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Waikato DHB district.

8.144
Figure 45 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Waikato DHB's population – regardless of whether the service was within the Waikato DHB district.

Figure 44
Statistics for the availability of after-hours services for Waikato District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	339,204
% of DHB population always with after-hours services available within 60 minutes' drive	99.7%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	664

Figure 45
After-hours service coverage for Waikato District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Wairarapa District Health Board

Description of the after-hours services

8.145
In the Wairarapa, after-hours services were available from:

• six general practices that shared a roster to provide after-hours services;
• another general practice;²⁷
• two rural nurses; and
• Wairarapa Hospital's emergency department in Masterton.

Availability of after-hours services within 60 minutes' drive

8.146
Wairarapa DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.147
Figure 46 sets out the percentage of Wairarapa DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Wairarapa DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Wairarapa DHB district.

8.148
Figure 47 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Wairarapa DHB's population – regardless of whether the service was within the Wairarapa DHB district.

Figure 46 Statistics for the availability of after-hours services for Wairarapa District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	38,607
% of DHB population always with after-hours services available within 60 minutes' drive	99.1%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	81

Figure 47
After-hours service coverage for Wairarapa District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Waitemata District Health Board

Description of the after-hours services

8.149
On the North Shore, after-hours services were available from:

• an accident and medical centre and a general practice in Albany that were each open until 8pm on weeknights and from 8am to 8pm on weekends;
• an accident and medical centre in Milford that was open 24 hours a day, seven days a week;
• an accident and medical centre in Browns Bay that was open until 10pm on weeknights and from 8am to 10pm on weekends;
• two general practices with Saturday morning clinics; and
• North Shore Hospital's emergency care centre, which was open 24 hours a day, seven days a week.

Correction

The first bullet point in paragraph 8.150 should read: a general practice and medical centre in Massey that was open until 8pm on weeknights and from 9am to 6pm on weekends and public holidays (except Christmas Day). Please note that the correct information relating to the Massey service was used in all our computations and analysis so this single transcribing error has not compromised the accuracy of other parts of this report.

8.150
In the Waitakere district, after-hours services were available from:

• a general practice in Massey that was open until 8pm on weeknights and on Saturday mornings;
• two general practices in New Lynn (one was open until 8pm on weeknights and from 9am to 3pm on weekends; the other had clinics on Saturday and Sunday mornings);
• four general practices in Henderson (three were open for various hours on weeknights, two had clinics on Saturday mornings, and one had clinics on Saturday and Sunday mornings);
• an accident and medical centre in Henderson that was open 24 hours a day, seven days a week;
• a general practice in Titirangi that provided an on-call after-hours service at weekends; and
• Waitakere Hospital's emergency care centre, which was open from 8am to 10pm, seven days a week.

8.151
In the Rodney district, after-hours services were available from:

• an accident and medical centre in Wellsford that was open until 8pm on weeknights and from 8am to 8pm on weekends, with on-call services available overnight;
• an accident and medical centre in Whangaparaoa that was open until 8pm on weeknights and from 8am to 8pm on weekends;
• a general practice in Helensville that was open until 7.30pm or 8pm on weeknights and on Saturday mornings; and
• two general practices in Kumeu, another practice in Waimauku, and another in Huapai that had clinics on Saturday mornings.

Availability of after-hours services within 60 minutes' drive

8.152
Waitemata DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.153
Figure 48 sets out the percentage of Waitemata DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Waitemata DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Waitemata DHB district.

8.154
Figure 49 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Waitemata DHB's population – regardless of whether the service was within the Waitemata DHB district.

Figure 48
Statistics for the availability of after-hours services for Waitemata District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	481,852
% of DHB population always with after-hours services available within 60 minutes' drive	99.9%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	81

Figure 49
After-hours service coverage for Waitemata District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

West Coast District Health Board

Description of the after-hours services

8.155
In the Grey district, three general practices in Greymouth shared an on-call roster to provide after-hours services until 8pm on weeknights and from 8am to 8pm on weekends. Outside of these hours, Grey Base Hospital's emergency department provided after-hours services. The Grey district was also served by a rural nurse clinic in Moana.

8.156
In the Buller district, a general practice in Westport provided on-call after-hours services and weekend clinics. From 8pm to 8am, Buller Health, an integrated health unit housing West Coast DHB services for Westport and Northern Buller, provided after-hours services. The Buller district was also served by two rural nurse clinics, one in Hector and one in Karamea. These services were usually, but not always, available – depending on roster arrangements.

8.157
In Reefton, patients could visit a nurse at Reefton Health Services (also known as Reefton Hospital) after-hours. The nurse could refer patients to a general practice with an on-call after-hours service.

8.158
In Westland, a general practice in Hokitika provided 24-hour, on-call after-hours services. Rural nurse clinics in Harihari, Whataroa, Franz Josef, Fox Glacier, and Haast also provided after-hours services.

Availability of after-hours services within 60 minutes' drive

8.159
West Coast DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.160
Figure 50 sets out the percentage of West Coast DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the West Coast DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the West Coast DHB district.

8.161
Figure 51 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for West Coast DHB's population – regardless of whether the service was within the West Coast DHB district.

Figure 50
Statistics for the availability of after-hours services for West Coast District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	31,371
% of DHB population always with after-hours services available within 60 minutes' drive	97.9%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	35

Figure 51
After-hours service coverage for West Coast District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

Whanganui District Health Board

Description of the after-hours services

8.162
In Whanganui, an accident and medical centre was open until 9pm on weeknights and from 8am to 9pm on weekends. It had an on-call GP available overnight. Alternatively, patients could also visit Whanganui Hospital's emergency department.

8.163
A general practice provided after-hours services in Taihape.

8.164
There were several roster arrangements to provide on-call services:

• between the military hospital and a general practice in Waiouru;
• between general practices in Raetihi and Ohakune; and
• between general practices in Marton and Bulls.

Availability of after-hours services within 60 minutes' drive

8.165
Whanganui DHB's after-hours plans met the Government's expectation for geographic availability of after-hours services.

8.166
Figure 52 sets out the percentage of Whanganui DHB's population that always had an after-hours service available within 60 minutes' drive and the number of people in the Whanganui DHB district who never had after-hours services available within 60 minutes' drive – regardless of whether the service was within the Whanganui DHB district.

8.167
Figure 53 shows where after-hours services were always available, were sometimes available, or were never available within 60 minutes' drive for Whanganui DHB's population – regardless of whether the service was within the Whanganui DHB district.

Figure 52
Statistics for the availability of after-hours services for Whanganui District Health Board's population (in a typical week, and regardless of whether the service was within the DHB's district)

DHB population at the 2006 Census	62,190
% of DHB population always with after-hours services available within 60 minutes' drive	99.9%
Number of people after-hours services were never available to within 60 minutes' drive – that is, the number of people living in the red areas on the map	53

Figure 53
After-hours service coverage for Whanganui District Health Board (in a typical week, and regardless of whether the service was within the DHB's district)

25: We have a detailed technical document outlining the information sources, assumptions, and analytical methodology used to prepare these maps. Readers interested in obtaining a copy can email their request to reports@oag.govt.nz.

26: There is also a general practice in Waihi that shares an on-call after-hours roster with the neighbouring Waihi Beach general practice, which is in the Bay of Plenty DHB's district.

27: Wairarapa DHB told us that, since our audit fieldwork, the seven general practices now participate in the same roster.

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