Severe bottlenecks at Ngwelezana Tertiary Hospital have forced the distressing transfer of some patients to lower-level facilities while others wait for beds for up to five days.

This ongoing challenge was highlighted in a recent circular as the hospital continues to grapple with a high influx of patients – often exceeding its 554-bed availability.

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Ngwelezana is the only tertiary hospital serving the King Cetshwayo, Zululand and uMkhanyakude districts, with calls for more such facilities in the region.

The communique, signed by the hospital CEO Dr BS Madlala, said a decision was taken to move all district-level care patients to Catherine Booth, eShowe and Mbongolwane hospitals.

The hospital has been ‘down-stepping’ or ‘de-canting’ stable patients to free-up specialist beds for patients in critical need, as the hospital serves as an apex referral centre for specialised services such as orthopaedics, burns and cardiology.

‘Bed blocking’ challenges

The KZN Department of Health (DoH) said it is addressing this ‘bed blocking’ challenge to ensure patients needing life-saving care are not denied access.

“This occurs when patients who are medically stable and no longer require the intensive, specialised care available at a tertiary hospital, remain in beds that are critically needed for emergency referrals from district and regional hospitals,” said KZN DoH spokesperson Ntokozo Maphisa.

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He said the consequence of bed blocking includes surgical delays, with patients requiring emergency or urgent surgery waiting up to five days or more.

“The lack of available beds at Ngwelezana creates gridlock across the entire referral chain, delaying ambulance services and causing congestion in emergency centres,” said Maphisa.

He did, however, allay fears that patients are being turned away without critical care.

“Ngwelezana Hospital’s doors remain open and all emergency cases are attended to immediately,” he said.

Patient admission management critical

KZN Health Portfolio Committee chairperson Dr Imran Keeka has called for calm, but re-emphasised that Ngwelezana is not a walk-in hospital.

“There is a great burden on Ngwelezana Hospital because the Zululand District itself does not have what is called a regional hospital,” said Dr Keeka.

He said the DoH plans to ease this burden by upgrading Vryheid Hospital to provide regional services, easing the referral burden on Ngwelezana.

However, Ngwelezana needs to ensure cases that don’t require hospital admission are referred to lower-level hospitals.

“The entire accident burden of the N2, all the complicated injuries that take place, are immediately referred via the district hospitals in King Cetshwayo to Ngwelezana,” said Dr Keeka.

“So hospital management needs to ensure they have a proper referral system in place, and not just everybody walks in.”

He said a triage system was needed at the casualty and outpatients to ensure those not needing speciality services go elsewhere.

“This is exactly what they are trying to do now, which is the reason the circular was issued.”

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