Northern Beaches Hospital

23-Nov-2018

 

We last updated you on the Northern Beaches Hospital (NBH) in October regarding Healthscope’s chaotic, unreasonable and unfair approach in issuing contracts to our staff specialists migrating to the Hospital.

Well, this last week has been another monumental week for the new NBH, and its medical staff in particular.

The doctors at NBH have been nothing short of heroic to ensure patient safety in the face of significant logistical, staffing and other operational challenges.

Doctors-in-Training (DiT) ASMOF members, frustrated by management inaction, came to the union for help, providing detailed information regarding their serious concerns which had gone unanswered and unaddressed.

The problems identified include:

  • acute medical staff shortages
  • lack of organised relief arrangements
  • inequitable patient loads
  • excessive and unsafe hours being worked - often unpaid
  • nursing staff shortage and nurses with wrong skill mix in certain areas
  • no medical/clinical systems
  • lack of systems and forms necessary for some critical care (e.g. no separate forms for insulin administration exist; no emergency management plan for hypoglycaemia to allow nurses to administer urgent medication; no forms for heparin infusion; no stroke calls; no tiered escalation of deteriorating patients as required by Cec guidelines.
  • inadequate supervision of DiTs treating purely private patients places an unreasonable medico-legal burden on them
  • lack of essential supplies
  • lack of protected teaching time and limited access to study leave
  • inadequate internal communication systems (e.g. phones supplied do not receive signal in parts of the hospital)
  • resus trolleys not being stocked
  • oxygen not available where necessary
  • supplies of other consumables not available
  • no on-site blood bank
  • pathology system resulted in delays for urgent tests.
  • unsuitable accommodation arrangements for DiTs such as access to on-call rooms when DiTs are fatigued. There was not even a lounge in the JMO common room (as per HETI guidelines) for DiTs to relax for a few minutes. 

Another issue relating to the uncertainty around indemnity cover provided by TMF &/or Northern Beaches Hospital management has now been resolved by NSW Health in a letter dated 21/11/18 which statesthat TMF coverage accrues to seconded State-employed staff for all salaried work arising from that secondment.

These are not “teething problems” or “hiccups” as described by the Premier and Minister for Health. The issues demonstrate a gross misunderstanding of what is necessary to run a major public teaching hospital with nearly 500 beds and arguably a failure to implement proper systems and processes.

These concerns lead to, what the Sydney Morning Herald described as “an extraordinary letter ” from ASMOF to the Secretary of NSW Health on Friday 16 November describing the many issues besetting the new Northern Beaches Hospital.

To the Ministry’s great credit, the A/Secretary Dr Nigel Lyons contacted the ASMOF President, Dr Tony Sara on the Saturday to discuss the letter. Dr Lyons convened an urgent, peak level meeting with ASMOF, The Ministry of Health, HealthScope, NSLHD and AMA for the following Monday morning. 

This was at the same time as the official opening of the NBH and required several key personnel who would have been expected to attend the grand opening to attend this more pressing meeting.

The parties to the Monday meeting at the Ministry resulted in a joint statement with four key principles:  

  1. Healthscope, ASMOF, AMA, NSLHD & the Ministry to meet weekly to discuss emerging issues;
  2. Healthscope is to ensure that JMO workload distribution is appropriate to the number of patients;
  3. The working group is to be the primary channel of engagement and to have consistent messaging to the community and staff;
  4. Healthscope is to create more efficient internal engagement channels to allow issues to be raised and addressed, anonymously where appropriate.

That peak level working party is to meet again on Monday 26 November.

The ASMOF President and ASMOF Industrial Staff met with a large number of DiTs at NBH on Wednesday 21 November and further detailed information of current issues was provided to the union.

DiTs indicated that they distinguished between “teething issues” which they expected and were prepared to work through, and systemic issues which presented real challenges, which should have been foreseen and eliminated with proper planning before opening and only the dedication of the DiTs to their patients, profession and colleagues allowed them to work around those challenges and to implement their own ad-hoc systems to ensure patient safety at some not insignificant cost to their own well-being.

Senior ASMOF personnel including President Dr Tony Sara and Executive Director Andrew Holland will continue their advocacy on behalf of all ASMOF members employed at NBH. ASMOF Industrial Staff will be meeting with JMOs at Northern Beaches Hospital again on Tuesday 27 November and will continue to advocate on their behalf. We will also be holding a special end of year forum for all ASMOF members, and junior and senior doctors who may wish to join ASMOF, in early December.

If you have any questions or concern about the Northern Beaches Hospital then please email us at allocation@asmof.org.au