Winter is Looming

This week has brought persistent rain, chilly temperatures and even thunder and lightning – all of which signal the approach of winter and with it, one of our busiest times of the year. So I want to update you on the planning that’s underway to ensure we manage this winter effectively without adding pressure to the system. I’ve invited our Director of Allied Health, Martin Chadwick, to share more detail about this work he’s been leading.

Many of you will be aware of Middlemore Central (MMC) which was launched last year. If not, MMC (based on level two of the AMC building) is a centre designed to give us a coordinated, sophisticated and connected approach to how we manage capacity and work in the hospital. It is based on initiatives from other sectors, including the aviation industry and Air New Zealand which uses a central point of coordination to monitor all of its planes, pilots and support services and how they link together. Healthcare has similar complexities which is where MMC comes in, to coordinate information from throughout the hospital and provide an overview. We can even refer to MMC for the current hospital temperature! According to Manager Dot McKeen, MMC brings together all of the pieces of the puzzle to enable us to see the bigger picture.

Monitoring information also allows us to identify patterns over time. Having studied data from the past three years, we can forecast that demand will peak this July and August. To prepare for this, we’ve been working with hospital services to ensure we have appropriate capacity to meet increased demand over winter, and to look at how we can effectively use the capacity we do have. Medicine, Surgery and ARHOP have been working collaboratively to make sure that patients will be seen in the right place, at the right time and in the right way. This may mean that beds are redistributed to avoid ‘outliers’ (patients belonging to one division receiving care in another division’s ward).

The divisions have also been looking at weekends as we know that a discharge variance creeps in at this time. We discharge fewer and fewer people as the weekend wears on, which often means that a backlog has built up and we end up with a ‘Dot Day’ on Monday. All divisions have been looking at what they can do to help ease this pressure and there may be some changes to the usual routine to assist with this.

Communication is going to be vital to managing the winter peak. We encourage staff to raise issues they think are impeding the quality of care provided over the winter time so that we can proactively address these. If you have any thoughts on this, please email Martin on We’ll also be sending out a weekly update with changes that may alter our forecasted demand (such as bad weather) and how we might work to address these.

This winter we’re really trying to learn from years past and prepare accordingly. We know that we need to plan for school holidays, for house officer and registrar run changes, and for sudden changes in temperature. We also know that there are things you can do individually to help, such as making sure you get your staff vaccinations for flu and pertussis (whooping cough). As you’ll be aware, there is a concern about pertussis at present and we are offering vaccinations to all staff. Please also be aware of the symptoms of pertussis, which initially include a runny nose, fever, malaise and coughing, and which can deteriorate into severe prolonged coughing. I strongly encourage you to have both vaccinations if you haven’t already. Only by taking care of yourself can you continue to take care of others, who we know are going to need our expertise and assistance more than usual in the coming months.

I think it’s fair to say that it won’t be business as usual during winter and inevitably there’ll be some tightness. But we are planning early and planning well so that we can manage the anticipated impact of the cold season without putting undue pressure on our staff.  It’s worth pointing out that all the work happening around winter planning is focused on providing quality care during a period of peak demand on the hospital in the next few months. This is in addition to 20,000 Days, our campaign to address wider hospital demand by redesigning the health system in order to keep people well and at home in the longer term. 20,000 Days launched successfully at the beginning of the month – check out the video from the launch to learn more about this campaign (please allow time for video to load).

Finally, my weight’s hovering at the moment but MiddleNOmore participants altogether have lost 142.8kg – great work! It’s hard to feel motivated when the days are getting darker and colder, which is why I was pleased this week to hear about one of our staff achieving a milestone of her own. Katie Wylie works in our Communications team and helps me with my blog. When we met earlier in the week, she was thrilled to tell me she’s just completed her first ever 5km running event after training for some time. Well done Katie! If anyone else has success stories they want to share to inspire their fellow MiddleNOmore participants, please let me know at

Stay warm,

Geraint and Martin


Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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