Damning HETI report reveals Northern Beaches Hospital wasn’t ready to open

A damning government report — carried out weeks after the opening of the Northern Beaches Hospital — has revealed a litany of concerns about the inadequate planning and preparation for the $600m health facility.

A damning government report found that there was inadequate planning for the opening of the Northern Beaches Hospital. Picture: (AAP IMAGE)

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A damning government report found that there was inadequate planning and preparation for the opening of the $600m Northern Beaches Hospital.

A litany of concerns has been revealed for the first time in a NSW Health government body report, written in December 2018, six weeks after the hospital opened.

The concerns by Health Education & Training Institute (HETI), which accredits hospitals to supervise and train junior doctors, has been made public seven months later, after a legal request by a doctor’s union following fears that patients’ safety was at risk.

Dr Martin Mackertich’s December report revealed that one of the problems at the hospital included an unreliable paging system. Picture: Adam Yip / Manly Daily

The report identified there was inadequate planning and preparation on opening; inadequate staffing, especially after hours; and a lack of policies for safe practice, something the Manly Daily revealed in February.

It contradicts repeated comments from Health Minister Brad Hazzard that the hospital was just suffering “teething problems”.

Former patient Eddie Rivers, 79, of Dee Why, said he was admitted six days after opening and his treatment and care was not satisfactory.

“I had a couple of blood transfusions and the machine’s alarm went off but no-one came, even when I pressed the buzzer,” he said.

In the end he had to alert a nurse by calling the hospital switchboard.

Former Northern Beaches Hospital patient Eddie Rivers. Picture: (AAP Image / Julian Andrews).

He said he was glad the problems were now officially recognised and hoped that the hospital had learnt from the report.

Dr Tony Sara, from the Australian Salaried Medical Officers Federation, said the “scathing and damning report” had justified its concerns at the time

He said that the efforts of junior doctors was what had kept patients safe.

The findings

The report by HETI in December highlighted issues relating to junior doctors. HETI followed up in January to check progress and found the following:

●Staffing: There was a good response to inadequate junior doctor staffing levels, with recruitment continuing.

●After hours: A lack of after hours staff on medical and surgical wards have been addressed, although in February they were predominantly locums and the quality was variable.

●Responsibilities: Staff uncertainty around team structures and responsibilities of staff have been “completely reviewed”.

●Abnormal tests: Improvements have been made over the issue of staff not being immediately informed of abnormal diagnostic test results, with a decrease in the number of reported instances.

●Handovers: Issues over proper handovers at the end of shifts have been addressed.

●Medical Director: Concerns over the vacant role of Medical Director was addressed with the appointment of an interim Dr Simon Woods.

●Trust: The communication and trust between management and junior doctors increased, but there was still room for an improvement.

●Rostering: Rostering improved in January, but there was still ongoing system issues.

●Paging system: Issues with the paging system were addressed.

●Policies: There were still ongoing issues with policies and protocols in January.

The December report written by Dr Martin Mackertich concluded that the situation was unsustainable and that it was only working because of the significant commitment of junior doctors “to continue providing a service under adverse conditions”.

He added that technology issues were also a concern as well as an unreliable paging system — which has since been replaced.

An increase in staff numbers was one of the issues that needed addressing, according to the December report. Picture: Julie Cross.

The report issued 11 immediate issues that needed attention including increasing staff, getting a better system in place to ensure doctors are alerted to abnormal diagnostic test results to “avoid the increased likelihood that results will be missed” and getting a senior NSW Health manager to come into the private hospital and turn the situation around.

A further site visit by HETI in January found there had been significant progress and that junior doctors were happier, but there were still concerns at the registrar level and that the hospital was still relying too heavily on temporary fill-in doctors.

In the January report Dr Mackertich also said he was concerned that a new cohort of junior doctors starting on February 4 posed a “significant risk for the site”.

A litany of concerns has been revealed for the first time in a NSW Health government body report. Picture: Adam Yip / Manly Daily

However, he added that Healthscope had agreed to provide an additional senior career medical officer familiar with the hospital to act as a support for new doctors.

The report’s release comnes after an incident which saw a cancer patient have the wrong part of his bowel removed, believed to have happened after an alleged error in the pathology report.

A parliamentary inquiry into the running of the hospital will start next month.

In a Healthscope statement it said the hospital had boosted training and support for junior doctors over the past six months, increasing staffing levels, implementing improved team structures, streamlining systems and procedures, and expediting initiatives to provide greater communication.

The hospital said it had provided a “comprehensive response” followed HETI’s first visit.

NBH Interim Medical Director, Dr Simon Woods.

The statement said that one month later a second site visit confirmed significant improvements and progress by NBH toward resolving the issues with the HETI report stating: “The survey team recognised the substantial amount of progress to improve the working environment for the junior medical officers at NBH.”

“Since the second HETI site visit and report in January 2019, NBH has continued to work with our (junior doctros) to optimise their experience here,” the satement said.

NBH Interim Medical Director, Dr Simon Woods, added: “NBH secured Provisional Accreditation from HETI prior to the hospital’s opening.

“This accreditation has been maintained since. We are continuing to work towards the next milestone of securing full accreditation in September.”

NBH said it was committed to regular consultation with the Australian Salaried Medical Officers Federation of NSW (ASMOF), with the next meeting occurring at the end of this month.