Thursday, 11 March 2021

NSW Parliamentary Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales public hearings begin on 19 March in Sydney, with one hearing scheduled for the NSW North Coast at Lismore on 16 June 2021

 

A NSW Parliamentary Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales was established in September 2020.



Public hearings begin on 19 March in Sydney, with one hearing scheduled for the NSW North Coast at Lismore on 16 June 2021.



Submission excerpts as examples of what the Inquiry has heard thus far



Increase in work load adding pressure to perform unreasonable duties on your shift, resulting in working past your finishing time to complete patient notes and not getting paid to stay back, missed morning teas and lunch breaks due to patient work loads, overtime due to staff calling in sick and staff leaving the service due to burn out and not getting replaced, bullying from senior management is rife, medication errors due to over worked and high stress levels all caused by management, staff are being put on performance management programs due to, not being able to perform duties on shift, due to patient work loads, morale is at its lowest, nurses victimised for complaining or putting in an imms, lack of recruitment and the process being very complex and sometimes taking over 3 months to recruit a single nurse, our patients deserve much better from the health system which is broken and putting nurses registration at risk, with no support from management” [Name Suppressed, Submission No.2 out of 703 submissions received by Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales]



In November 2016 my mum had a fall and broke her pelvis. She was taken to Maitland Public hospital . She had suffered brain surgery and radiation treatment earlier in the year. She was 84. On the first day of her admission to hospital a resident doctor shocked both my father and myself telling us she would probably die not from the broken pelvis but from being in hospital. My dad and myself visited her every day for the next 8 weeks. She was sent to a neighbouring hospital at Kurri Kurri 3 times and returned twice with infections and delirious and we were never actually told why she was deteriorating so much. She would be very agitated saying she was not attended to when she wanted to go to the toilet. Then she was told she needed to try to walk and was using a walker, then all of a sudden that was taken away and a nurse said she was never supposed to start rehab yet. So much confusion and no one still explained to us exactly what would happen to her. No communications or accurate ones anyway.



And then it was Christmas we were going to try to get her home just for a couple of hours but on Christmas Eve she apparently had a stroke and was transferred close to a nurses station for observation her confusion level was beyond belief. On the day after Boxing Day I got a call from my dad very upset saying they were transferring mum back to Kurri hospital for rehab. I was very angry with this decision and went straight to Maitland hospital mum was screaming pleading not to be taken back there as she had already been there twice and sent back very sick both times. I argued with the nurse that it should not happen but she said there was no choice as it was about numbers. we were allowed to go in the ambulance with mum and she was crying all the way, even the ambulance drivers seemed upset. When we arrived at Kurri hospital we were met by a nurse who made a comment that surely someone else could have been transferred today.



Mum died two days later she was broken by this stage and made a comment to me that when you get to a certain age they don’t care about you any more. I said it wasn’t true at the time but ponder that question every day. Mum was a wonderful Wife, Mother, grandmother , great grandmother, sister and friend to many I miss her every day. My daughter sent a letter to Maitland Hospital and we did receive an apology for her treatment after an investigation.



Too late.”

[Name Supplied, Submission No.7 out of 703 submissions received by Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales]



The Tweed Hospital is a Peer Group B hospital that currently has 255 beds and Level 5 emergency department.



Currently at Tweed Hospital, Nursing Hours Per Patient Day wards (Medical and Surgical) are funded at 5.5 hrs instead of the 6.0 hrs that Peer Group A hospitals receive.



At Tweed the Surgical and Medical Wards are no different to any other wards of a city hospitals. The same type of patients with the same level of acuity, but at Tweed Heads every patient receives 0.5 hrs less care due to their postcode.



Our Hospital routinely has between 95%-104% occupancy and 5.5 NHPPD has a huge impact on delivering safe patient care and nursing workload.



Staffing retention is also an issue here at Tweed Heads due to our proximity to the Queensland Border, nurses no longer must put up with the horrendous workload, risks to their registration or their ability to deliver safe patient care. Many nurses have left the NSW system preferring to work in Queensland at the University Hospital 20 minutes up the highway:



They have Ratios 1:4

Education Allowance of $1800 per year

100% Salary Sacrifice

Higher pay rate by $3,000 per year

Higher penalty rates on Night Duty”

[Name Supplied, Submission No. 178 out of 703 submissions received by Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales]



In March 2012 the LHD announced it would develop a Clinical Services Plan for Coraki and surrounds to assess the health needs of the area and make recommendations on how those needs could best be met. That Plan was completed, with community input, in August 2012. It recommended the adoption of a 'HealthOne Model of Care' - bringing together Commonwealth- funded general practice and state-funded primary and community health services in the one facility. After considerable lobbying by the Reference Group the NSW Government allocated $4 million for the construction of the HealthOne in 2016 and the facility was opened in May 2017.



According to various publications by NSW Health the key features of the HealthOne model that distinguishes it from other primary and community health services are integrated care provided by co-located general practice and community health services; organised multidisciplinary team care; care across a spectrum of needs from prevention to continuing care; and client and community involvement. In Coraki we now have an impressive new HealthOne which has consulting rooms for two GPs and houses a variety of community health practitioners. Regrettably, since its opening it has not been possible to attract a single GP to the purpose-built facilities. We feel we have a HealthOne without a heart.



We are aware the lack of a GP is not unique to Coraki and that it is shared by many rural and regional communities across NSW. We are hoping this inquiry will shine a light on this problem and spur governments, both State and Commonwealth, to come up with solutions.



In Coraki's case a possible solution might be to expand the HealthOne into a Multi-Purpose Service. There is a 49-bed aged care facility adjacent to the HealthOne (operated by Baptist Care) and the future expansion of the HealthOne was allowed for in its planning and design. The Reference Group notes that a recent Commonwealth Government Report (Review of the Multi-Purpose Services Program - 2019), which was done in consultation with state and territory governments, found that the MPS is a sound model for delivering integrated health and aged care services in rural and remote communities and made recommendations, which have in large part been accepted by the Commonwealth Government, to strengthen and expand the MPS program. An MPS in Coraki, with its expanded range of health services and clients, would enhance the attractiveness of Coraki for prospective GPs.



Finally, we wish to draw the Committee's attention to the lack of an ambulance in Coraki. While ambulances are available from Casino, Evans Head and Lismore, the extra half hour they take to reach Coraki can be critical….” [Name Supplied, Submission No. 179 out of 703 submissions received by Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales]


 

To support our submission we would like to highlight anecdotal evidence of an issue that is raised time and time again – The need for increased funding for public health professionals working across the cancer care coordination/ social work areas to be more available to patients.



We have heard of many case studies from patients across the Northern Rivers and Far North Coast, ranging from private and public treatment centres about such barriers to better health outcomes.



One case study – a gentleman with Basal Cell Carcinoma of the outer nose, lost most of the features of his nose after surgery. This patient continued about his daily life with social anxiety, unable to go back to a normal daily life. Until one day, quite simply he was asked by a fellow patient to the reasons why he had not considered a prosthetic nose free of charge through a charitable support scheme. His heartbreaking response “I never had knowledge of such option, or service available to someone like me with limited financial means”. Please conceive, if only this patient had been linked to an appropriate cancer care coordinator or social worker, his burden could have been lifted much sooner and thus contributing to better outcomes. How many more patients are currently in the same position?



Another case study we would like to highlight is of a female who had undergone lumpectomy just over the border in Queensland. A breast cancer nurse who happened to be on shift advised - as this patient was living in New South Wales and not Queensland, she was not eligible to any support services. Therefore she was advised to go home to Byron Hospital and request community social work support. Once at Byron Bay Hospital, she was told that the hospital was only issued with two community social worker services per week, and that as it was now Thursday, they had already been handed out for the week. This patient was left alone at home, without support and in pain, not even able to slice a tomato for a salad. She was not even given a phone number to contact. With so many questions and with no one to turn to, she was left overwhelmed, scared and unsupported.



Had there been a dedicated cancer care coordinator available to both patients as highlighted in our case studies, they would have received the appropriate care deserved and thus better health outcomes.



We passionately could continue highlighting similar case studies as of the two above, however we hope these testimonies clearly demonstrate the priority need for increased funding for socio/emotional support during and after treatment.” [Name Supplied, Submission No. 184 out of 703 submissions received by Inquiry Into Health Outcomes And Access To Health And Hospital Services In Rural, Regional And Remote New South Wales]


All written submission made to the Inquiry can be found at 

https://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-details.aspx?pk=2615#tab-submissions


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