A hospital in Sydney’s inner west has been given 12 months to clean up its act after the body responsible for accrediting its radiology training program found senior specialists were so swamped with work they were unable to train junior staff – some of whom were so exhausted they had been involved in car accidents after long shifts.
In a damning audit of radiology training at Concord Hospital, the Royal Australian and New Zealand College of Radiologists (RANZCR) downgraded the hospital’s training program to a D-grade – the lowest level on its scale – and gave the department until December to act upon its 13 recommendations.
A damning report by the college training radiologists is another blow to the radiology department at Concord Hospital, which is still working through a backlog of thousands of unreported scans. Credit: James Brickwood
“The training accreditation at Concord Repatriation General Hospital is now conditional upon all issues being addressed over the next 12 months,” the report said. “Failure to make adequate progress may result in the loss of accreditation.”
Losing the accreditation would mean the department – which also provides radiology services at Canterbury Hospital – would not be able to accept trainees, a major blow considering 12 of the department’s 21 full-time equivalent radiologists are trainees.
The ratio of 12 accredited trainees to nine supervisors is within the college’s guidelines. However, the report noted recent departures of senior clinical staff and a backlog of 30,000 unreported scans has led to “very little or no” face-to-face training and “significant and dangerous” delays in senior radiologists signing off on work done by trainees.
The high volume and complexity of scans had led to major burnout in the department, the report said. It also questioned the safety of 12-hour rostered shifts on weekends, saying the audit found “many reports of exhaustion and several motor vehicle accidents” following trainee shifts.
Sydney Local Health District did not respond to detailed questions about the downgrade. In a statement, a spokeswoman said Concord Hospital was outsourcing after-hours reporting to ease pressure on staff, and attempting to recruit local and international staff to fill vacancies despite a “national shortage of radiologists”.
The college’s 13 requirements include hiring at least seven more radiologists to ease the training and workload on current staff, clearing the backlog of unreported scans, and reviewing after-hours workloads.
The first of the college’s recommendations is to conduct an independent cultural review of the department to investigate allegations of a breakdown in communication and toxic relations between management and staff.
Those allegations are already being investigated by mediators from conflict management firm ProActive ReSolutions, which was appointed by NSW Health in July after senior medical staff at Concord revolted against the hospital’s chief executive – forcing an intervention from Health Minister Ryan Park.
Senior doctors were particularly concerned about the radiology department, where staffing issues had led to a backlog of more than 30,000 unreported X-rays and scans.
Outsourcing work to contractors has helped cut the backlog after it ballooned to more than 50,000 at one stage last year.
In a meeting last month, mediator John McDonald told senior doctors a lack of transparency and communication from previous management had left “a legacy of distress and hurt with people” inside the radiology department, but commended more recent efforts from the hospital’s leadership to meet with the department on a weekly basis.
Neither the college nor Park responded to requests for comment. In a statement, a government spokesman said the current mediation process should be allowed to run its course.
“The Minister continues to urge all relevant parties to participate in the process in good faith,” the statement said.
Westmead Hospital was stripped of its training accreditation in 2021 after the college downgraded it to a level D site in 2019, while the Central Coast Cancer Centre at Gosford Hospital had its accreditation withdrawn midway through last year.
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