ICU head shuts down Act’s criticism over intensive-care bed numbers

Intensive Care Resource New Zealand believes the Act’s claims of poor improvement in ICU bed numbers do not account for the years of training ICU staff typically require.

Health Minister Andrew Little has defended the increase of 18 beds since the $100 million funding for the ICU program was announced in December and believes the target of 85 beds will be achieved by mid-2024.

Act Health spokeswoman Brooke Van Werden still believes not enough progress has been made since funding was announced, but will not provide a benchmark for what she believes is enough progress.

The Bills Party’s criticism stemmed from information it requested from Little’s office on the number of beds in resource wards, resource intensive ICUs and highly dependent wards for the period from 24 August 2021 to 29 July 2022.

At a time when Little announced that the funding primarily involved increasing ICU bed capacity, there were 293 well-resourced wards and ICU/HDU beds available that day.

On July 29, there were 296 beds.

Van Werden claims that in the eight months since Little made the announcement, this has proven to be “almost no progress”.

Dr Craig Carr, New Zealand president of the Australian and New Zealand Intensive Care Association, said Van Velden’s comments misrepresented what he thought were actually encouraging figures.

Carr even admitted that he expected the figure of 296 to be lower given the impact of Covid-19 and winter illness.

Carr describes how the training of staff – especially from overseas – can last for years to make someone sufficiently qualified to work as an intensive care nurse.

He mentioned some nurses who had recently moved to New Zealand after working in Singapore.

They will need four to eight weeks of induction, four months of close supervision and a competency review, and may still need to complete critical care courses they completed part-time while on the job, Carr said.

He said if hospitals tried to hire staff without proper procedures, it would be “a disaster” and could jeopardize patient safety.

Another related aspect is that Covid-19 and winter illness limit the number of resource beds available on any given day.

5 to 6 nurses are required to properly staff ICU beds.

Today, 49 ICU staff across the country have left their jobs due to illness or exposure to Covid-19. That could reduce today’s capacity by about 30 beds, Carr estimates.

“We always like more resources, but we appreciate what we have,” Carr said.

He cited progress being made at Auckland Hospital, which has opened six ICU beds in the past six months. At Rotorua Hospitals, he said, good nurse recruitment had made up for the high morbidity gap.

“People may not see the difference [the funding is] Made…but it already makes a difference. “

When the Herald told van Velden of Carr’s explanation, she still believed that more capacity should be added to the system since Little was announced.

When asked about the number of ICU beds she considers acceptable, van Velden did not provide an answer.

She said her specific concerns about ICU capacity did not come from those in the ICU community, but from the public.

In an interview, Little acknowledged last year’s criticism of a shortage of ICU beds was justified, but defended progress in adding 18 extra beds since December.

While 23 beds are planned for now, Little is optimistic that the country will reach its target of 85 new beds by July 1, 2024.

“The advice I’ve been given is that we’re on track to achieve that, but that does assume we meet our hiring expectations over the next 18 months.”

Little believes Act and van Velden’s stance did not take into account the volatility of the nurse workforce “more than ever”.