Christchurch ED’s worst winter sparks fears code red will become the norm

Friday, 7 November 2025

Christchurch’s emergency department (ED) is spending almost a third of its days in “code red”, and doctors fear it could become the new normal without urgent fixes to the health system.

Figures released under the Official Information Act (OIA) show the ED was in code red – or critical overload – on 29 of the 92 days to the end of September. It was operating above 100% of resourced capacity on 172 days, or nearly two-thirds of the year. Resourced capacity means the number of beds that are properly staffed and equipped.

It comes after a local ED doctor said patients were dying in waiting rooms, corridors and even the car park as the hospital struggled under “critical” overload – the gap between patient demand and staff’s ability to cope.

ED doctor Dominic Fleischer said the situation had improved slightly since winter’s peak, but he expected numbers to rise again over summer, and next winter could be worse.

“We are the busiest ED in all of New Zealand and possibly Australia. We need better access to community services and more resourced beds to flow into.”

According to Health New Zealand, Christchurch ED had one of its busiest days last year with 437 patients. In September this year, the daily average was 410 presentations, peaking at 460. The team saw an average of 385 patients a day in August 2024.

Fleischer said the backlog was exacerbated by both patients who could be seen by GPs and full inpatient wards.

“People languish in ED waiting for many hours to days for a bed in hospital. ED is the meat in the sandwich. There are no beds in rest homes so people stay in hospital longer… It’s complex.”

He said staffing shortages, not bed numbers, were the biggest issue.

“Resourcing capacity is the key metric… I’ve seen one nurse to more than 20 patients.”

Australasian College for Emergency Medicine deputy chairperson Michael Connelly wrote to Health NZ in September, saying pressure on EDs was being amplified by insufficient inpatient beds, inadequate staffing and poor IT systems.

“We recommended a range of solutions … [including] increasing inpatient capacity, investing in the health workforce …. and improving co-ordination between hospitals and community care.”

Health NZ said in its OIA response that it was taking steps to ease pressure, including faster admissions and alternative care pathways for less urgent cases. In September, Christchurch’s ED had 12,098 arrivals – the highest number in the country – but more than 81% were admitted, discharged or transferred within six hours thanks to the hard-working staff, Health NZ government services head Sasha Wood said.

The Government recently reconfirmed its $100 million investment to fast-track hospital infrastructure improvements, including for specific EDs, and announced rapid-build projects that would provide 140 new beds at Middlemore, Waikato, Wellington and Nelson hospitals.

Association of Salaried Medical Specialists executive director Sarah Dalton said GP access was limited due to cost barriers and full enrolments, while people with respiratory illnesses like influenza and Covid were still turning up at ED.

“Christchurch Hospital has got this big upgrade, so you may have some better workspaces, but you don’t necessarily have staffing levels that are required to keep that hospital functioning at maximum efficiency.

“This is really political … hospitals not being funded because [the Government is] still on a big austerity drive to get back to a zero budget, which is bananas.”

Dalton said senior doctors were “really worried” about continuously going in and out of critical overload and operating with unsafe staffing levels.

Hamish Brown, Health New Zealand’s group director of operations for Canterbury, said while the Christchurch ED is “always busy”, since September there has been a slight reduction in the number of patients, with the average number dipping below 400, to 393, over the last week.

“We have experienced critical overload only a couple of times since September and our focus remains on maintaining patient safety, as well as improving flow and wait times.

“We continue to work closely across the hospital to support our ED staff and are implementing multiple strategies to improve patient care and hospital flow, including new FTE (full-time equivalent staff) out of the minister's short stay ED funding.”

Health Minister Simeon Brown said that despite EDs having just had their busiest ever winter, the majority of patients, including in Christchurch, are still admitted, discharged or transferred with the Government’s six-hour target.

Between April and June 73.9% of patients nationally were seen within that timeframe, and in Canterbury it was 79.8%, up from 71.8% in the same period last year.

“While progress has been made, there is more work to do to reach the goal of 95% of patients meeting the target by 2030, and strengthening our workforce is a key part of that effort.

“To support this, I recently announced that Health New Zealand is funding an additional $20m for ED staffing across the country. This investment will enable faster care for patients and relieve pressure on hospitals such as Christchurch.”

Meanwhile, a nationwide “Hīkoi for our Health” petition signed by at least 60,000 people and measuring 200m is calling for urgent action.

Patient Voice Aotearoa chairperson Malcolm Mulholland said the health workforce was struggling mentally, physically and emotionally.

“The failure to [address the issues] has resulted in poorer health outcomes for so many of our people. What saddens me is that so many people have horror stories of how the system has let them down in their time of need.”