Northern Beaches Hospital VMO Update

Quite a few changes have happened at Northern Beaches Hospital (NBH) since the last issue of The NSW Doctor. In particular:

• NBH has an interim CEO in Mr Stephen Gameren;
• Healthscope Australia Chief Medical Officer Dr Victoria Atkinson is on the ground at Frenchs Forest to provide much needed medical leadership; and
• Senior Medical Staff have created an NBH Medical Staff Council (MSC) to complement the Medical Advisory Committee. (At the time of writing the second MSC meeting was about to take place.)

AMA (NSW) have noted a marked change in the engagement between Healthscope and stakeholders. Rolling weekly meetings have been taking place with representatives from Healthscope, AMA (NSW), ASMOF (NSW), Northern Sydney LHD, and the Ministry of Health. During the meetings, we discussed matters such as safety concerns, junior and senior medical workforce numbers, excessive workloads, night staffing, IT and communications issues, and the availability of policies and procedures. AMA (NSW) has attended a number of meetings with Junior Medical Staff to provide further context as to what is working at NBH and, more importantly, what needs to be fixed.

Recruitment is underway for a large number of JMO and Accredited Trainee positions, with some already accepting contracts for February 2019. This will provide welcome relief to all staff members who have worked tirelessly over the first few months ensuring optimal care for all patients in ED, theatres, wards and clinics. Junior doctors have, to date, reported that there has been no opportunity for education and training due to staffing levels, and the influx of additional staff should see to remedy this. AMA (NSW) is watching recruitment numbers closely and seeks feedback from members in real time.

Following continued lobbying by Physician VMOs, the ward-based model for General Medicine has been replaced with the desired team-based model, which has much more evenly distributed the workloads.

At the time of writing, AMA (NSW) was scheduled to host a Physician Dinner giving NBH Physician VMOs the opportunity to meet with AMA (NSW) President Dr Kean-Seng Lim and other Board members. The dinner is an opportunity for us to gain a clear picture of a patient’s journey through the hospital, from ED to the wards, and a better understanding of areas to improve.

We encourage expressions of interest from other craft groups who may wish for us to hold a similar event for them.

A number of Public Patient clinics are now up and running, and AMA (NSW) is engaging with Healthscope to ensure that the payment method will not leave VMOs exposed to any ‘double dipping’ issues with Medicare. We encourage surgeons and other proceduralists performing consults in their private rooms to inform AMA (NSW) of how the arrangements are working.

Information sessions are scheduled to have taken place with the Healthscope CIO to ensure that any questions and concerns regarding the Electronic Medical Record and the Incident Management Systems have been addressed. Junior doctors reported problems with the communications devices issued and, hopefully, these will have been addressed by the time this edition is printed.

An external review of the operating theatres as supported by members of the Department of Anaesthesia is also scheduled to take place.

The Hospital received a fair amount of negative press in November and December 2018, in particular regarding safety concerns raised by doctors.

We can appreciate the overwhelming frustration borne from the perceived foreseeability of some of these issues. It is, however, important to note AMA (NSW)’s position that any safety or other concerns should be raised through the appropriate channels, whether that be through the IIMS notification system or via a head of department, hospital administrator, or MSC Chair. Should such channels fail to lead to a satisfactory outcome, AMA (NSW) would be comfortable to discuss additional pathways of escalation to appropriate audiences.

At the time of writing, AMA (NSW) is still working to resolve outstanding issues raised by members, including, but not limited to:

• Non-receipt of countersigned VMO contracts;
• Inability to submit monthly payment claims;
• Difficulties in transferring medical records from other NSLHD facilities;
• Inadequate consulting rooms and office accommodation for some specialties; and
• Delays in receiving imaging and other test results.

We trust that these outstanding issues will also be resolved in due course, and welcome feedback from both NBH VMOs and those following the story from other facilities who would like to ask any questions or offer their advice and support.