The change means patients for practices which have split from the Urgent Doctors, in Filleul St, will no longer be treated there and will be sent back to their own medical centres.
The practices affected, which no longer provide assistance to the Urgent Doctors, are Mornington Health Centre, Mosgiel Health Centre, Outram Medical Centre, Dunedin City GP and Dunedin Community Health Centre.
The exception is for accidents that require X-rays.
The move has prompted concern that if patients are not properly made aware of the change they could turn up sick to the Urgent Doctors only to be turned away.
Urgent Doctors general manager Adam O’Byrne said the decision was made due to increasing pressure on the after-hours system.
"If we reach capacity, we’ll be closing our queue off early just to reduce the burnout and increase patient safety and clinician safety.
"We’re always in constant dialogue just to understand how many patients we’re seeing are [non-guild members] because this is not a new issue and we always try to redirect these patients back to their own services."
Dunedin City GP owner Dr Adrian Hindes said he understood the rationale behind the decision, but worried many patients were unaware of the arrangement.
His main concern was "one of transition", as many sick patients would attend the Urgent Doctors in the first instance, only to be turned away and redirected towards the after hours provided by their respective practices.
"It probably should have happened earlier. I think what’s historically happened is when people think of after-hours care, they think Urgent Doctors.
"I think it’s absolutely fair and reasonable that we have our own after hours as do the other practices and we see those patients.
"But I think it’s kind of hard to get the message out there that after-hours care is not a one-stop shop."
The changes would affect about 30,000 people throughout the city, Dr Hindes said.
Previously, non-guild members could pay up to an extra $50 on top of the $120 consultation fee when seeing Urgent Doctors.
"Obviously, there’s a proportion of people that are really struggling out there and that will be really difficult for them.
"But what Urgent Doctors have done at times is they’ve said ‘well, are you aware that your practice has got your own after hours?’.
"Often our patients aren’t aware and then they’ll make contact and we’ll see them."
His practice had previously contributed to the Urgent Doctors’ roster, but "to continue we would have had to do one shift a week, which was unsustainable".
In a letter to non-guild members, Mr O’Byrne said the practice had also been enduring significant pressures on its own systems.
"Our daytime load has, therefore, increased significantly.
"Our daytime staff often cannot get through the patient load before they finish at 6pm."
This had a spillover effect for the evening clinicians because there might be a long queue waiting at 6pm when they arrived, he said.
"One of the issues we have been tackling is to keep our evening work manageable for our guild members who take part in the after-hours work roster.
"The late shifts, after 6pm, are the most onerous and often our clinicians do not get home until well after 10pm and sometimes nearing 1am."
Earlier this month, WellSouth, a Health New Zealand Te Whatu Ora-funded primary care network for Otago and Southland, announced it had bought a 50% stake in Dunedin After Hours Doctors Ltd, which operates the Dunedin Urgent Doctors and Accident Centre.
Had WellSouth not come into the picture, the centre would have had to make changes which would have inevitably lessened its services, Mr O’Byrne said.
