POLL: JHH emergency department disgrace

JOHN Hunter Hospital’s emergency department is cash-starved and chronically under-resourced, with fewer staff than a Sydney hospital that treats fewer patients, a Newcastle Herald investigation has revealed.

Last financial year John Hunter’s emergency department treated 3641 more patients, almost an extra 10 a day, when compared to Liverpool Hospital.

This was done with 20 fewer full-time equivalent nurses and three, or almost 40per cent, fewer full-time equivalent advanced trainee doctors.

Despite the difference in patient numbers, both hospitals have the same number of emergency physicians or specialists.

Proof of the ‘‘long-suspected imbalance’’ has been labelled a ‘‘disgrace’’ by staff working in John Hunter’s emergency department, who fear mistakes are being made because they are being  pushed ‘‘way beyond reasonable limits’’.

‘‘Nurses and doctors are working under undue stress and perhaps making decisions that if they had enough time may have been different,’’ a staff member said.

‘‘In the wards the nursing union says there should be a one-to-four ratio of patients to staff, in the emergency department nurses can manage up to eight patients.’’

Freedom of information searches (Government Information Public Access) to determine staffing levels were done by the Herald following a series of stories last year detailing patients being left to languish for hours in the overcrowded emergency department and several failures in care.

Distressed staff, who are forbidden to speak to the media, described the emergency department as ‘‘dangerous’’ and said they were run off their feet and patients and staff were suffering.

They warned that with current staffing levels, wait times for patients would continue to increase.

Hospital general manager Michael Symonds declined to speak this week about staffing levels at other hospitals, but said John Hunter had enough workers.

He said the emergency department was supported by other departments’ staff.

‘‘Staffing in any emergency department is dependent on both the demographic and number of patients, and the services each hospital provides...’’ 

‘‘We constantly monitor the emergency department’s activity and workforce levels and believe the unit is appropriately staffed,’’ Mr Symonds said.

NSW opposition health spokesman Dr Andrew McDonald said it was clear  John Hunter was overwhelmed with demand and did not have enough staff.

‘‘Liverpool emergency department is always well and truly under the hammer and their staffing levels are inadequate,’’ Dr McDonald said.

‘‘God knows how John Hunter can possibly cope when they are so far behind the benchmark. 

‘‘This sort of inequality is information the government does not want the people to know ... the Hunter has been completely dudded,’’ he said.

A spokeswoman for NSW Health said Hunter New England Health was responsible for ensuring staff levels met patient needs.

She said the department had developed workforce assessment tools to help determine the  skill mix.

The investigation revealed that John Hunter also has significantly fewer staff than Royal Perth Hospital, which is regarded as one of Australia’s best performing emergency departments and saw 4835 more patients than John Hunter in the last financial year.

According to the data, Royal Perth and John Hunter employed about the same number of full-time equivalent emergency specialists, 11 and 11.175 respectively, but Royal Perth employed an additional 20 specialists  contracted to work for set periods throughout the year.

Royal Perth also had an extra 6.4 full-time equivalent advanced trainee doctors, or an additional 79per cent, and 23 full-time equivalent nurses.

The NSW faculty chairman of the Australasian College for Emergency Medicine, Richard Paoloni, described the imbalance as a‘‘huge difference’’ and a ‘‘funding issue’’.

Dr Paoloni said there were a ‘‘whole host of things that can go wrong’’ when doctors and nurses do not have enough support.

‘‘John Hunter has the busiest emergency department in NSW and there is an expectation they should have the most staff,’’ he said.

‘‘It’s about time we took a serious look at how we resource our emergency departments as the load on them is only going to increase.’’

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