WITH its list of concerns getting longer, the Bathurst Health Services Action Group feels it has no other option but to take its fears higher up the chain.
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The group says it has lost confidence in the Western NSW Local Health District to provide acceptable levels of service in Bathrust and it hopes to speak to the Minister for Health about immediate priorities.
It has also outlined some of its service concerns and suggestions for the future.
Orthopaedic plans might hurt, not help
THE Bathurst Health Services Action Group and the Western NSW Local Health District (WNSWLHD) hold opposing views on the value of a proposed emergency orthopaedic service in Bathurst.
The health district has proposed that the Bathurst and Orange health services work collaboratively to provide planned and emergency orthopaedic services.
Acting chief executive Mark Spittal said it will increase the number of operations performed in Bathurst.
"The proposal will see significantly more emergency orthopaedic surgery performed in Bathurst than previously," he said.
"If the proposal is adopted it will be implemented by mid-2020. This lead time is required to prepare for the changes in activity."
However, the action group feels that, after speaking to staff, Bathurst will be worse off under the proposal.
The group understands that orthopaedic surgeons from Bathurst will need to be on call in Orange for one week out of every seven.
Spokesman Warren Aubin said it not only puts strain on surgeons and their families, but elective operating will be shut down in Bathurst over the week a surgeon is in Orange.
"The proposal will not improve services to the Bathurst community when they are needed most," he said.
"It will compromise elective waiting lists and services delivered by the Bathurst Private Hospital.
"Alternative delivery models exist and cannot be dismissed."
The group, which includes local medical practitioners, said Bathurst needs a continuous orthopaedic service.
"We're pushing for a 24-hour emergency service. If we can get that, it means that another orthopaedic surgeon could be put on in Bathurst," Mr Aubin said.
"If we get another one and a 24-seven service, then it means more beds, you need more registrar doctors, more physiotherapists - it actually grows the hospital and gives it that extra scope and support, and then other specialists say 'That support is there, I can go there, that's great'.
"It just entices others to come."
He added that the 24-seven service is what staff say will enable both Bathurst and Orange health services to "provide equivalent care to that received in all other similar rural centres".
Nurses lacking vital support, group says
THE Western NSW Local Health District (WNSWLHD) has denied claims that graduate nurses aren't receiving adequate educational support in Bathurst.
According to the Bathurst Health Services Action Group, there aren't enough nurse educators at the Bathurst hospital to provide on-the-job support to nurses just starting their careers.
"Any recently graduated new employee needs proper mentoring and support to accomplish their work effectively, enjoy their time at work and develop their career. This is not happening," spokesman Warren Aubin said.
"Nurse educators need to be sufficient in number and have the time available to perform that role and build up the reputation of the hospital from a place to avoid, to an employer of choice."
Further to this, Mr Aubin claimed the hospital is failing to attract sufficient graduate nurses.
The health district's acting chief executive, Mark Spittal, says this isn't the case.
He noted that the NSW Government is investing $2.8 billion in an extra 8300 frontline staff for NSW hospitals, and that as a result 390 new staff are expected to be employed in the district.
"Bathurst is very successful in attracting nurse graduates to the hospital, and they are well supported by nurse educators, both from the Bathurst Health Service and from the district's Organisational Development Unit," Mr Spittal said.
"Bathurst Hospital has a strong contingent of nurse educators in and out of business hours. They meet regularly with the new graduate nurses and also participate in study days."
The action group, which has members who work in medicine locally, also expressed concern that five senior surgical nurses had resigned this year.
Mr Spittal also quashed this claim.
"There are currently no nurse vacancies on the surgical ward. However, sometimes nurses, including those in the surgical wards, move to different roles within the hospital," he said.
A further concern of the action group is the number of beds available to patients, specifically on the medical ward.
The group says this ward contains 31 beds, but is only funded for 20.
"This fails to provide adequate service to the Bathurst community, who are regularly turned away for treatment or sent to Orange," Mr Aubin said.
In response, Mr Spittal said the notion of having a static number of 'funded beds' was out of date.
"Current practice is to fund beds according to activity, allowing for greater flexibility, better use of resources and better patient care," he said.
"In fact, capacity was increased this year to accommodate for additional demand due to an unprecedented flu season. This has been challenging, and the success in managing that demand is a tribute to our staff at Bathurst."
The health district is developing a Clinical Services Plan for Bathurst and through this is doing a comprehensive analysis of what services will be required over the next decade.
Collaborative approach is the way forward
MORE collaboration between the public and private sectors could be the key to improving health services for the Bathurst community.
Through its analysis of services, the community action group feels that working more closely with the private hospital would take the pressure off Bathurst Health Service.
To do this, spokesman Warren Aubin said the group suggests common procedures be performed in one centre for both public and private patients in Bathurst.
It would be up to the public and private hospitals to determine which procedures each one handles, but by working together they could provide a better model of care for rural elective surgery.
"That way each place becomes specialised in that service provision, bed numbers are increased, but more importantly, efficiency and improved outcomes can be achieved," Mr Aubin said.
"It can be done cost effectively for both [private and public sectors]."
The group acknowledges that this idea would need government support and has suggested it be trialled.
"It could be set up as a trial and outcomes measured, but if successful, could be a model rolled out in all rural areas in order to offer rural patients the same level of care available to those in the cities," Mr Aubin said.
When asked about the Western NSW Local Health District's thoughts on the proposal of collaboration, acting chief executive Mark Spittal said, "assessments of such opportunities will always be based on what the community and patients need, with the interests of patients at the forefront".