Health professionals in Canterbury are warning that while health services in the region are managing, they are stretched and under intense pressure.
The earthquake on 22 February 2011 left Canterbury District Health Board with 7500 damaged rooms, 106 fewer beds in Christchurch Hospital and more than $100 million worth of damage.
It says more damage is being revealed by ongoing building inspections and services are having to to be relocated.
The board has split general medical services across two hospital sites to help it cope with building damage.
It has also instituted programmes to manage patients at home, where possible, to help take pressure off Christchurch Hospital.
DHB chief executive David Meates says that will need to continue, and not just for the next few months or even the next 12 months.
He says that, in order to sustain the range of services, ongoing radical changes of service delivery and alternative means of providing services will be required.
However the DHB is still delivering operations according to Government targets, which it puts down to hard work by staff.