Urgency for Wakari upgrade

There are few high points in the Sapere Research Group's report into the state of mental health, addiction and intellectual disability facilities at Wakari Hospital aired in this newspaper last week.

Researchers found nearly all facilities were dated and not fit for purpose, posing safety risks to patients and staff and hindering appropriate quality care of patients.

Poor facilities contribute to longer recovery rates, longer stays in hospital, more incidents involving staff and patient injuries, increased seclusion rates and more staff sick leave, and increase the likelihood patients will need to be readmitted. The parlous state of most of the facilities illustrates both the under-funding for capital works in district health boards and that these sorts of health services have been the poor relation in our health system for too long. The Southern District Health Board will not be alone in having to address the issue of buildings like these which are long past their use-by date and out of step with modern healthcare practice. The Sapere report, completed in January, and not yet officially made public, says four of the six inpatient units need "varying degrees of attention in the immediate to near future'' and three of the four outpatient units also need upgrading.

As well as being poorly designed, many of the buildings have structural issues such as leaky roofs.

The difficulty the sector faces in recruiting and retaining staff is unlikely to be helped by working conditions where staff feel that the facilities are detracting from the care they want to be able to provide and, in some circumstances, seem downright dangerous. Staff were generally positive about two refurbishments completed in 2011 - that for the dual diagnosis mental health and intellectual disability inpatient unit, 10b, at Helensburgh Cottage, and 9c, the acute inpatient unit. With the acute unit, staff felt patient and staff satisfaction had risen and the number of patient injuries had fallen.

Given the increased emphasis on primary mental health care, it was encouraging to read that the South Community Health unit, based in Helensburgh House, was fit for purpose, apart from some structural issues, and that it allows for the delivery of safe contemporary care.

The issues highlighted in the Sapere report have not arisen overnight and will be no surprise to staff and many of the patients they work with. It is to be hoped there will be some urgency in dealing with them, now greater importance is being placed on mental health and addiction services in the wake of the Government's recent inquiry into the state of these.

Sapere suggests the DHB develop a business case for making the facilities fit for purpose, giving two options for this. One would look at the various wards individually, giving attention first to those most in need of upgrading. The other would consider the future of the Wakari site as a whole. The researchers point out that the first option would be faster but could miss systemic issues. A combination of the two may be needed.

It was good to hear Health Minister David Clark has strongly hinted money could be available for renovation or replacement of unsuitable buildings if the district health board puts forward a compelling case.

The board's commissioners were briefed about the Sapere report in May and a follow-up report is being drafted, so let us hope this is being given the urgency it deserves.

The fact that this confidential report has become public should give this some extra impetus. Not that anybody would want a break-neck pace which risks half-cocked changes, but now the issues have been spelled out, the new board will have no excuse not to keep the pressure on.


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