The letter sent by 20 DHBs a year ago had multiple warnings. First, the health system is buckling, with some sites in code red. Directly from the letter: "You will be aware that our hospitals are also experiencing very high levels of occupancy at present, and some sites are even in code red, where they are deemed to be at extreme levels. This is obviously an unsustainable situation and places even more pressure on our existing workforce. We are very concerned about this situation and for the potential for further deterioration if there are no changes to assist with at least securing the existing workforce from 20 DHBs." 