26 Aug 2015

People calling ambulances for sore throats

2:02 pm on 26 August 2015

The cost of going to the doctor, and difficulties navigating the health system have meant more people in the Nelson region are calling an ambulance for minor ailments.

St John Nelson shift manager Kris Gagliardi.

St John Nelson shift manager Kris Gagliardi. Photo: RNZ / Tracy Neal

The St John service in Nelson-Tasman has teamed up with Nelson Marlborough District Health Board to help guide non-emergency patients into the right care, via a new referral pathway which connects patients with the right services.

The DHB said, in a recent report, that in the last five years, about 80 percent of calls to the ambulance service in the Nelson region had been for moderate to minor conditions.

St John Nelson shift manager Kris Gagliardi said they ranged from cuts and bruises, sore throats and chest infections, to people needing social support.

"As a health system, sometimes we can be quite reactive - we're very good at treating established disease but where we can achieve the best result is in preventing disease from occurring in the first place.

"This pathway is about the ambulance sitting at the top of the cliff and not at the bottom, and helping our community health partners prevent illness," Mr Gagliardi said.

Under the scheme, paramedics assess patients to find out whether they are safe to stay at home but need further care. The region's community care coordination service then connects the patient with the right services.

Mr Gagliardi said the calls came from across the board, from people genuinely struggling to get help. While they were often not emergencies they could sometimes mask bigger underlying problems, he said.

"For example, someone calls us for a shortness of breath but we notice they're not connected with a GP, they're over 45 years - perhaps they're from a high-risk ethnic group, so we refer them for a cardiovascular risk assessment to reduce the risk of them having a heart attack.

"It's often unrelated to the reason they're calling, but it's still really important they're referred," Mr Gagliardi said.

He said 52 referrals had been made since the scheme was set up early last month.

Mr Gagliardi said that meant 28 percent of people attended to by St John in that time had received health care they otherwise might not have had, including those in an increasingly culturally diverse population.

"Maori people are disadvantaged in almost every area of health care, and in access to health services, so the special thing about this is we can refer patients directly to a Maori health provider. We're enabling culturally appropriate care for the first time."

Nelson GPs spokesman Graham Loveridge said cost was another reason why some people were not getting the health support they needed.

"The word has consistently come from DHBs to try and keep people away from the emergency department unless they have emergencies. Cost remains a barrier for people seeking health care, particularly after hours. Where people are confused about what they should do, then it's often St John that's been a first port of call.

"They are between a rock and a hard place because they're accessible, they're on-call 24 hours a day, seven days a week so I'm sure that's why they're feeling the pinch, but it's a matter of re-education so people are phoning when it's appropriate," Dr Loveridge said.

The health board's strategy funding and alliance support manager Andrew Lesperance said they were right behind the scheme.

He said they were also keen to prevent potentially worse health problems for people further down the line.

"We're looking at an ageing and vulnerable population across our district and anything we can do to connect them to a broader range of health services, has to be good for everyone."

Mr Lesperance accepted it was become increasingly hard for some to find their way around the health system, which was why they were missing out.

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