Fears of backtrack over emergency dept staff

A senior Dunedin Hospital emergency department specialist says Southern District Health Board management appear to have backtracked on recruiting an extra 4.5 senior medical officers for the department.

However, yesterday board chairman Joe Butterfield said the extra staffing proposal was still a work in progress, and no decisions had been made.

In the public-excluded session of its July meeting, the board approved the ED observation unit business case, which included $1.779 million extra for ED staffing in the first year, and $1.695 million in the second year. However, it was subject to budgetary constraints.

Mr Butterfield was unable to clarify whether those figures solely related to the possible extra SMOs.

Dr John Chambers, also an Association of Salaried Medical Specialists union representative, believed the board approved the additional top staff, but management stopped it, seemingly because of lack of funds.

Word of the significant extra SMOs was welcomed by senior staff, who prepared rosters factoring in the additional resource.

After preparing the rosters the doctors were advised the extra staff were no longer a top priority.

"It seems to be back to the drawing board.

"My colleagues spent quite a few months developing rosters to make the best use of the increase in staff to improve our staffing at the weekends in particular."

There seemed to be a disconnection between the board's expectations, and what management subsequently decided, he said.

Dunedin would not have had trouble attracting the specialists, who had been expected to take up the posts this year.

"We have capable young specialists who would love to come and work in Dunedin."

Instead, the department was to get an additional 0.6 SMO, a position that might not be easy to fill as it was not full-time.

"Young doctors want a full-time position."

The department had 7.6 SMOs; it should have 12 to 13, according to professional guidelines, Dr Chambers said.

The recent appointment of two senior registrars was positive, and they could fill in as senior medical officers, although only with supervision. However, the pair worked half of their hours in anaesthetics.

It was disappointing for doctors keenly following recommendations made by the National Health Board and other parties for hospital improvements, for which there seemed to be no money.

It was hoped the specialists would be in place in time for the new observation ward, which is to open in the middle of the year.

Chief operating officer (Otago) Vivian Blake said the proposal approved in the middle of last year had not specified the extra staff, and was part of a wider business case for the ED observation unit.

"We haven't got any additional money to put to additional staffing."

Instead, rosters were being rearranged to make better use of existing staff.

"At the moment, we have a mismatch of [specialist] rosters to [patient] attendances."

Doctors at Southland Hospital had also requested an increase in ED staff, and the DHB was taking a district-wide approach to the problem.

The Otago and Southland chief medical officers, Richard Bunton and Dr David Tulloch, were arranging meetings with ED doctors in both Invercargill and Dunedin.

In an email obtained by the Otago Daily Times, Mrs Blake advised a colleague there was no money "coming our way via the NHB for this or anything else".

"The first thing to consider is whether this request for additional FTE is the highest organisational priority ... If it is agreed that ED is the highest priority, I suggest you look at whether there is a vacant [senior medical officer] in the system that can be realigned."

eileen.goodwin@odt.co.nz