A direction from WBHHS to transfer out more critical patients has raised concerns

A bleak picture of an ICU in crisis has been painted in extraordinary leaked letters sent between a senior doctor, Wide Bay Hospital and Health chiefs and the union.

A letter from Wide Bay Hospital and Health Service CEO Debbie Carroll said that the intensive care unit at the hospital had been assessed as a level 4 service, but a response from the Together Union said the hospital had been operating as a level 5 hospital for eight years.

Letters leaked amid escalating concerns about Hervey Bay’s under-pressure hospital claim patients will die if new directions from the health service are followed.

In one letter, sent to a senior doctor and sighted by the Fraser Coast Chronicle, Wide Bay Hospital and Health Service CEO Debbie Carroll stresses the Hervey Bay Intensive Unit is assessed as Level 4 and provides a number of directions staff must follow to ensure it operates as such – including the transfer out of patients whose needs are beyond the ‘clinical capabilities’ of the local team.

A response from Together Union Lead Organiser Allison Finley-Bissett however claims that in reality the Hervey Bay ICU had been wrongly categorised by the health service as Level 4 when it had been experiencing Level 5 activity for the past eight years

She said the union believed this was an exercise in ensuring Hervey Bay Hospital was not upgraded - a concern which has repeatedly been flagged as plans progress for a new hospital in Bundaberg.

“We believe this is so Bundy could be upgraded as an ICU to a Level 5, so that hospital could be a Level 5,” the letter reads

The union letter goes on to say that if staff were to follow the directions outlined in Ms Carroll’s letter, it would mean 70% of patients would have to be transferred elsewhere.

“The ICU doctors are terribly distressed by this,” Ms Finley-Bissett said.

“The knock on impact will be considerable.

“The surgeons are telling me more complex surgeries will need to go elsewhere.

“Doctors will end up wasting time trying to find beds elsewhere … transfers can waste a doctor’s entire day.”

Ms Finley-Bissett said the decision to transfer patients requiring above a level 4 service should have been made in consultation with the union, especially given the risk to patients, the impact on patients and the diversion of resources away from other medical evacuations.

“My members have indicated a high degree of distress at this direction,” she wrote.

“It is their very strong view that patients will die unnecessarily.”

A protest was held at both Hervey Bay Hospital and Maryborough Hospital earlier this month, flagging these concerns along with staff and bed numbers and the fact that an entire floor of the upgraded emergency department remained out of bounds.

In the letter sent to the senior doctor, Ms Carroll says “clinicians have professional and patient safety obligations in providing clinical services within their designated Scope of Clinical Practice and in alignment with the determined Clinical Service Capability Framework level of their area of practice”.

The letter goes on to discuss the actions that should be taken should “patient care requirements exceed the capability of the facility”.

Hervey Bay Hospital.

“The health service is keen to support clinicians working to care for all patients within the CSCF,” she wrote.

“However it is noted that at times this cannot happen and we appreciate the skills of our staff to cater for the emergent needs of the Fraser Coast community when this needs to occur.

“The policies and procedures highlighted in this letter support clinicians to ensure safe emergency management of our patients’ needs as well as the transfer process when needed.”

In the letter, Ms Carroll also says the procedures and processes are in place to ensure patient safety and mitigate potential risks.

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“I take this opportunity to reaffirm the requirement for compliance with these processes for managing a patient outside the clinical capability level and the established escalation pathways available to assist.”

Ms Finley-Bissett claimed the decision would also impact socially, emotionally and financially on patients.

Together Union organiser Allison Finley-Bissett with other protesters outside Hervey Bay Hospital.

If the patient were to die or be discharged while at another hospital service, they or their families would wear the cost, she said.

The Chronicle went to Ms Carroll about the union’s concerns, including the alleged risk to patients and move to favour Level 5 services at Bundaberg.

In a statement she said “the Wide Bay Hospital and Health Service thanks its Hervey Bay Hospital Intensive Care Unit staff for their ongoing commitment to providing the best possible care for our patients”.

“We acknowledge the workload demands on the Hervey Bay Hospital ICU and we are committed to continuing to support the unit as it safely treats patients,” the statement read

“We can reassure the Fraser Coast community that they will continue to be provided safe and high quality intensive care services, as they have in the past.

“The Hervey Bay Hospital ICU remains open and continues to operate as a Level 4 service, managing moderate complex inpatients and ambulatory care services.

“It has not previously been assessed as a Level 5 service.”