SDHB head's email enrages clinicians, hospital staff

Southern DHB chief executive Chris Fleming says Dunedin Hospital is doing its best amid heavy...
Southern DHB chief executive Chris Fleming. Photo: ODT files
An email from Southern District Health Board chief executive Chris Fleming to all staff which said the Dunedin Hospital "Code Black" emergency was a collective rather than individual failure was galling, doctors say.

The hospital was briefly crammed beyond capacity on March 24, with patients queuing in corridors awaiting a bed.

Mr Fleming declared a Code Black situation and an operations centre was opened. Several hours later the crisis was resolved.

The recriminations have rumbled on for much longer though: Health Minister Andrew Little singled out the Southern District Health Board for criticism for letting the hospital get into such a quandary.

In an email to all staff, which was supplied to the Otago Daily Times, Mr Fleming said he wanted to speak to staff directly about the media coverage of the Code Black incident.

"I appreciate that the media attention has created undue stress for some of you: please do not take the criticism directly on yourself," Mr Fleming wrote.

"We all (management and clinicians alike) had a role to play in the fact that the hospital got to the stage it did that day, and we all need to take respective roles in ensuring actions are taken early when these situations start to arise again in the future.

"The system failed to respond to the building pressure, and as such we must accept collective responsibility for this."

A doctor, speaking anonymously, said Mr Fleming was blaming clinicians, who had repeatedly warned a problem was looming.

"Clinicians are outraged," the doctor said.

Mr Fleming’s email went on to praise staff for their response on March 23, saying many people put in a "huge effort" to attempt to manage the situation.

"However the statement [by Mr Little] ‘very poor management, very poor patient planning’ must be seen in the light of our collective failure, both managerially and clinically, to recognise the increasing pressure and take effective steps to remediate the problems before they reached the extent we found that day," Mr Fleming’s email said.

Mr Fleming said he was confident that "as a collective organisation" everyone had stepped up their game, that everyone had learned from the Code Black experience, and that the SDHB was in a better position to manage ongoing pressure at Dunedin Hospital.

Sarah Dalton, executive director of senior doctors union the Association of Salaried Medical Specialists, said Southern doctors were frustrated by the assertion that the Code Black issue was of everyone’s making.

"At the heart of the issue, other than the not-fit-for-purpose building that everyone is trying to navigate, is short staffing, and that’s not just
medical but nursing as well.

"I can see why a group of doctors could be peeved by
that ‘we’re in this together, we’re all failing a bit’ language, it’s very galling for frontline clinicians who are doing their best."

The ASMS understood that for several weeks leading up to the Code Black incident, Dunedin Hospital emergency department had substantially failed to meet its target of 95% of patients seen within six hours.

That measure, which many DHBs regularly fail to meet, had gone as low as 59% on one day, Ms Dalton said.

"It was mostly in the 60s and 70s, so it is normal for them to fall well short of target, for a whole bunch of reasons."




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I bet what happened was the massively overpaid secretary (CEO) thought that to take the clinicians advice about the max number of patients and having to plan more beds somewhere else was to much of a threat to sticking within the budget so his bonus is safe.sack everyone who is paid by the govt more than the prime minister . this idea that we have to attract overseas talent and have to offer huge amounts is total rubbish half the CEOs are no different from you or i they just have great connections and 300,00 to500,000 dollar salary. it is bull and a ripoff

Health cannot, and should not be run as a business.
It is a public service, funded by taxpayers for their health and wellbeing.
Dump the professional management class from our health system please.

I second that!

Nothing is ever the fault of physicians. They lead blameless, poverty-stricken lives dedicated solely to the service of patients...

This is all by design, paving the way to central government administration of our health system so they can fix it all up from Wellington, very similar to the trajectory of the DCC and many other local government organisations.

I would almost hope you're right as it might suggest there is some plan for health. But I have learned that we should never attribute to ill-intent what can equally well be ascribed to incompetence. :-(

Oh! Please........! Never attribute to conspiracy that which can be adequately explained by incompetence.

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