Health bosses are worried patients will not turn up to emergency departments when they need to, as long waits and overcrowding continues.

Emergency departments in most main centre hospitals were still working at winter levels.

There has been some high-profile incidents of people leaving before they have been treated or even triaged and then getting sicker - or dying.

General practitioners spoken to by RNZ say it's hard to judge how many patients are choosing not to go to EDs when they really should, but it's likely happening in small numbers.

Te Whatu Ora medical lead Pete Watson says he worries about people not turning up, but he feels hospitals have been clear that those who need care urgently will get it from them.

"So a lot of our messaging to the community is please 'make sure you come if you need help'. Our hospitals are there, they're there 24/7 and if people are sick, they will be triaged and if they need to be seen, they'll be seen first," says Watson.

But that message has gone hand-in-hand with one telling people to stay away from ED if they are not acutely unwell.

A GP at Etu Pasifika in Auckland, Maryann Heather, says striking a balance and making a decision is difficult for people, especially when they are feeling really sick.

"Everyone who feels unwell, they feel that it is urgent ... so until you go, you don't know," says Heather.

"Then the deterrent is, people hear that message and they don't want to go, and so they're sitting on heart attacks and strokes at other things at home."

She has a patient who went to Middlemore at 6pm one day last week and didn't leave until 7am the next day.

Stories like that get around, she says.

"Our coconut wireless is pretty good. People talk, people see stuff, they talk in the community, they talk at church, they talk at home... they know what is going on."

Dr Maryann Heather says making a decision can be difficult for people when they're feeling really sick. Photo: Pasifika Medical Association Group.

The clinical director of Etu Pasifika in Christchurch, Monica Nua-George, says she knows of a handful of patients who have left early from the hospital ED in the past few months.

In all cases, the hospital have followed up to let the clinic know and the patients are able to be treated in the community, she says.

Both doctors say they tried to have a clear plan in place for patients who may deteriorate about when to go to the ED.

Porirua GP Bryan Betty says people should seek advice where possible - from their GP or Healthline - on whether their case is an emergency. Photo: RNZ / Karen Brown.

Porirua GP Bryan Betty says people should seek advice where possible - from their GP or Healthline.

But if they can't get it, or are unsure, they should err on the side of caution and call an ambulance.

Te Whatu Ora chair Rob Campbell visited Middlemore Hospital's ED at the weekend.

The staff were busy but took the time to tell him about the pressures they were under, including staff shortages and pay rates, he says.

The board wanted to advocate for them, he says.

-Rowan Quinn/RNZ.