The hospital’s present ICU is outdated, and in 2014 its training accreditation was withdrawn by the College of Intensive Care Medicine of Australia and New Zealand.
Four years on, intensive care specialists still cannot train at Dunedin Hospital, although the Southern District Health Board says it plans to request reaccreditation when the ICU rebuild is complete and commissioned.
Work began on the first stage of the project last June, and the SDHB expects 12 new beds will come into use on the fifth floor of Dunedin Hospital’s ward block in the second half of this year.
The second stage of the 22-bed unit, which combines ICU and the existing high-dependency unit (HDU) and was originally scheduled to be open at the end of this year, will be completed in the first half of 2019.
"The unexpected discovery of asbestos in the site and proactive measures to protect staff and patients from construction noise by relocating a sixth-floor ward have slowed progress," SDHB chief executive Chris Fleming said.
"This illustrates the challenges of working in an operational hospital, and why it was the right decision to build a brand-new hospital instead of attempting to refurbish the existing one."
A separate project for a new gastroenterology unit is on schedule and will open in June this year, and in line with the timetable to roll out the national bowel screening programme.
The redeveloped ICU is a stop-gap measure until the new Dunedin Hospital is built - a project not likely to be completed until between 2022 and 2025.
Initially budgeted to cost $11 million, it was revealed last year the cost of the new ICU had risen to $14.8 million, the tight market in Dunedin for building work being cited as a factor in the increase.
Resident Doctors Association national secretary Deborah Powell said delays getting the ICU back up to a training standard made Dunedin a less attractive place for junior doctors.
"If you are doing basic training, OK, but in terms of training for the entire pathway through to vocation and registration, Dunedin is just not making the grade, which is sad," she said.
"On the one hand, you can understand it because they have an awful building which provides all sorts of barriers, but on the other they don’t seem to be putting the infrastructure which supports training too high up the priority list."
The College of Intensive Care Medicine examines each training hospital when it reapplies for accreditation to ensure it still meets required standards.
If it fails, the college supplies a report stating why, but has no further involvement with the hospital until it reapplies for accreditation.
"It is a fairly straightforward process for any hospital [to be reaccredited] if they have the will to change things," college national chairman Jonathan Casement said.
The college provided guidelines for ICUs to meet minimum standards for training, information which was available for those designing a new unit for the hospital rebuild, he said.
A unit also had to have certain staffing levels to be an accredited training facility.
Mr Fleming said while work in Dunedin’s present ICU could not count towards CICM’s formal training programme, the department still offered training opportunities.
"We still are able to continue to provide training and experience in the care of critically unwell patients to a mixture of medical, surgical, rural, and emergency medicine trainee doctors and also to overseas anaesthetic and intensive care doctors seeking education and experience in a busy general intensive care unit," he said.
"We also continue to enjoy a reputation for providing excellent aero-medical retrieval training and experience in the transfer of critically unwell patients."
There were no other issues over training accreditation elsewhere in the hospital, and training and education would remain a function of both the old and new Dunedin hospitals, he said.
"The new hospital will be built to contemporary quality standards to meet relevant accreditation requirements.
"This will include a professional development unit responsible for education and training, as is the case in the current hospital."
