Allied health services staff in the lower South Island are overworked, under-resourced and struggling to deliver the services that are required, a "damning" report says.
The confidential draft summary follows an independent review of allied health services at the Southern District Health Board.
It found staff were stressed, fatigued and had a significant lack of trust in management.
An allied health services employee at the DHB, on the condition of anonymity, said they were worried speaking out could affect their job.
Staffing not only hit morale but impacted how they could work with patients, they said.
"It's really difficult. We can't deliver the service to the patient that we would like to deliver and that leaves patients feeling really angry and frustrated, often at us. It's quite heartbreaking not to be able to do justice to your patient and have them receive the care that they need," they said.
Some patients were on long waiting lists or missing out because there weren't enough staff, they said.
"Staff retention is definitely an issue. Southern DHB definitely has a reputation in the community for not being a wonderful employer of allied health staff so it's very difficult to get people to come into our hospital services. Allied health staff would prefer to work privately out in the community than work for the Southern DHB."
High priority recommendations made
Public Service Association local organiser Julie Morton said she wasn't surprised by the findings.
"This is just business as usual, which is we know there's a problem, we know there's not enough staff in those allied roles. There's been some attempt to fix it, but not nearly enough.
"We've now got a report that's quite damning and again, the reaction to it is very slow and not articulated and, from what I can see, not planned," Ms Morton said.
The three independent reviewers made about 70 recommendations as part of the summary - half were marked as a high priority and of those, close to a third were rated as urgent.
The urgent changes included increasing full-time staff in audiology, speech-language therapists, dietitians, social workers and physiotherapists.
The reviewers estimate around 300 bed days per month could potentially be freed up with better staffing, communication and support.
There has been two years worth of staff shortages across allied health, she said.
The DHB was recruiting for 16 roles - but the union and staff didn't know if they were new or filling vacant positions, Ms Morton said.
"Our women's and children's social workers are barely enough to cover the work that needs to be done so much so that they have to really prioritise who they see and don't see," she said.
"Then some of our most vulnerable patients from vulnerable families potentially don't get as much assistance as they need."
She said allied health services had improved since a particularly dire period in 2017 - the review found staff supported each other, cared about their patient's wellbeing and were valued by health professionals,
But Ms Morton said there was still plenty to do.
While she was pleased the Southern DHB requested a review, Ms Morton said the union and staff remained in the dark about the April summary for a long time and still didn't know what was being done to fix the issues.
"I still remain concerned about the real outcomes because until we see a plan of how they're going to address the deficits, we don't know what's going to happen."
Southern DHB chief executive Chris Fleming said, in a statement, there had been a long-standing under-investment in allied health staffing, but the DHB was working to address it.
"Allied health professionals will play a critical role in the future of our health system in Southern as we work to deliver care closer to home and support people to stay independent for longer," Mr Fleming said.
"Our next steps will be to look at how the recommendations of this review can be implemented, with input from the wider organisation. Workshops are underway to progress this."
The DHB was looking at how it could implement recommendations from the review, Mr Fleming said.
He said the DHB had engaged with the union throughout this process.
Ms Morton disagreed that the union has been informed throughout, and said it would continue to push for more staff to help cover the workload.