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Southern District Health Board allied services staff are stressed, fatigued and have a significant lack of trust in DHB leadership and management, a damning report says.
The confidential draft of an independent review of the sector commissioned by the SDHB has been released to the Otago Daily Times under the Official Information Act.
The three-person panel found that allied health - made up of professionals such as physiotherapists, dietitians, social workers and clinical psychologists - was under-resourced, lacked administrative support and had recruitment and retention issues.
In responding to the report, the SDHB has agreed to increase staffing levels.
"Allied health staff within the scope of this review have reported adverse impacts on their physical and mental health, which they have attributed almost universally to under-resourcing and the significant number of vacancies across all professions," the report said.
"Despite some recent progress, this remains of significant concern and needs further attention and targeted strategies to address."
The SDHB had a notable shortage of allied health clinicians and administration staff, compared with other workforces nationally and when benchmarked against selected DHBs.
"SDHB has the lowest full-time-equivalents [FTEs] per 100,000 population for speech language therapists, dietitians and social workers working in physical health services," the report said.
It was also under-resourced in occupational therapy and physiotherapy.
"There are ongoing recruitment and retention challenges, particularly for [senior] skilled clinical roles and for [the] small, high-risk professions of audiology, dietetics and speech language therapy," the report said.
"The DHB has suffered reputational damage over the treatment of allied health, and this is a specific factor in some recruitment problems [particularly for staff in rotational positions and senior positions]."
It was not all doom and gloom, however, the reviewers saying staff displayed a "high level of energy" when discussing potential changes and were committed to achieving better outcomes, and there was a clear leadership opportunity to get the best from those staff.
"There is a strong evidence base for allied health professionals to add considerable value for SDHB patients who require rehabilitation, and in the management of many long-term conditions."
Public Service Association local organiser Julie Morton said the report's findings came as little surprise.
"We want to see a full plan of what they are going to do," Mrs Morton said.
"We knew in late 2017 that we were understaffed across a whole lot of allied health positions, and while the DHB has made some efforts to try and fill some of those positions, we are still not back up to a full contingent."
Medicine, nursing and allied health needed to be given equal footing and appropriate resourcing, otherwise the health system would not work properly, she said.
"They are wanting to increase theatre time, and that's fine, but there has been no reference at all to what happens afterwards. If you put more patients through, they will need more people to help with rehabilitation afterwards."
SDHB chief executive Chris Fleming said the organisation had taken the report's findings on board, and had agreed to an urgent investment in about 16 full-time-equivalent staff.
"When I first arrived at the DHB it was obvious that, for some reason, allied health had been systemically relatively underinvested [in] compared to our other workforces," Mr Fleming said.
"Over the past three years, we have progressively made more investment year on year to try and rectify that difference."
Halfway through last year, the SDHB commissioned the report to find out what deficiencies remained to be resolved, he said.
"One of the comments that alarmed me was that a number of years ago we stopped collecting allied health data, which seems fairly inexplicable to me because one of the challenges that the reviewers identified was that without collecting the data it is pretty hard to see the true picture and the real pressure that workforce is facing."
Allied health needed to be properly resourced, otherwise clinical and nursing services also came under stress, Mr Fleming said.
"I would like to increase it by probably another 50 [positions] but it is easy to say that and harder to get to that point, but our commitment is to changing the dynamic and the culture."
Historically, the SDHB might have lost sight of allied health but it wanted to put that right by showing an absolute commitment to work through all the recommendations in the report, Mr Fleming said.