Rural hospital managers in Otago and Southland have been asked to work out how to adapt to a call for more integrated health services.
The hospitals have been advised that the status quo is not an option under the Otago and Southland district health board's proposed "Models of Care" strategy arising from Cranleigh Health's hospital capacity review.
It is hoped draft models for the various hospital areas will be completed by the end of June and it is expected each area will vary the model to suit local circumstances.
It is expected there will be consultation in the respective rural hospital areas.
The Wakatipu area consultation closed last Friday.
Rather than funding all rural inpatient beds as they do now, regardless of the occupancy rate, the boards should consider basing funding on occupancy based on the previous year and then adjusted quarterly, the Cranleigh report states.
Consideration should also be given to only funding them for patients in the three most urgent triage categories.
One of the concerns of the boards has been that too many people are turning up at hospital emergency departments for medical conditions which could be treated in general practice.
The strategy suggests that future rural services should include integrated family health centres, where multidisciplinary teams are located together and provide services including general practice, minor surgery, chronic care, health promotion, nursing and allied health services, emergency care and some social services.
Such centres would involve not just general practitioners and rural hospitals but all health service providers in an area.
It was, however. important that any integration was centred on patients' needs.
Patients would enter the system through community care, which meant that access to general practices 24 hours a day, seven days a week was central to the sustainability of future service delivery.
The hospitals in Balclutha, Gore and Ranfurly already had GPs on site, while Oamaru had the capacity for this and Dunstan (Clyde) had clear referral processes.
The new model proposed for Queenstown would include general practice on site.
