Where do patients go?

Beds closed, nurse cuts …

Surprise bed blitz by North Coast AHS sparks nurse fury.

Nurses are furious over surprise plans by the North Coast AHS (NCAHS) to slash 86 beds and nurses every shift in hospitals across the North Coast region.

Managers at hospitals across NCAHS region were stunned to receive a memo from NCAHS chief executive Chris Crawford telling them to close beds – particularly in the face of gruelling workloads and bed occupancy levels of between 95-104%.

NSWNA Assistant General Secretary Judith Kiejda says the NCAHS has not provided additional community services to accommodate patients who will not be able to get a hospital bed.

‘With occupancy levels between 95-104%, which is already way over the accepted 85% benchmark for safety, where do these patients go?

‘Nurses and the NSWNA strongly support alternative models of care for people who shouldn’t be hospitalised. But these models of care need to be in place before the NCAHS goes slashing nurses and beds. These services need to be developed through consultation with clinical staff and they have to be properly resourced,’ said Judith.

The NCAHS plan would involve converting eight beds at Lismore Hospital and six beds at each of the following hospitals into so-called ‘surge’ beds, which would not be routinely staffed with nurses:

  • Ballina District Hospital
  • Bellinger River District Hospital
  • Casino & District Memorial Hospital
  • Coffs Harbour Health Campus
  • Grafton Base Hospital
  • Kempsey District Hospital
  • Macksville & District Hospital
  • Maclean District Hospital
  • Mullumbimby Hospital
  • Murwillumbah District Hospital
  • Port Macquarie Base Hospital
  • Tweed Hospital
  • Wauchope District Hospital.

This is a cut of 86 beds across the NCAHS.

The plan would also involve reducing nurse numbers at each facility by at least one nurse per shift every day.

For smaller facilities with 20 beds, the loss of six beds represents almost 30% of beds.

CEO Crawford said beds would be freed up as ‘surge’ beds to only be used during periods of particularly ‘high peaks in demand’ and they would be staffed ‘as required by staff rostered on an ad hoc basis’.

He warned facility managers: ‘Should there be excessive use of the surge beds and/or additional pressure on the Emergency Department, these will be indicators that your management of the new arrangements is not satisfactory (unless exceptional circumstances can be demonstrated).’

He argued this was part of broader plan to reduce the hospitalisation of people with mild or chronic conditions who could be treated more appropriately in other ways. Some how more community care services would be rolled out, taking less acute patients out of hospital. They would receive community care at home or at special clinics adjunct to hospital emergency departments.

The Crawford memo omitted to provide detail of when and how the NCAHS plan would be rolled out, and where the resources would be coming from.

NSWNA branches immediately called extraordinary meetings and passed resolutions calling for a detailed plan about how NCAHS would implement the plan.

‘Nurses are up in arms about the failure of NCAHS to consult with nurses and the union,’ said Shauna.

‘North Coast health services are already under strain due to high population growth. Crawford’s plan will significantly reduce the number of available acute hospital beds in the region,’ said Judith.

‘Reducing the number of hospital beds and nurses will increase pressure and asking community health services to do more without additional resources is impossible.

‘If they want surge beds, then they should be in addition to current beds, not a substitute for current beds,’ said Judith.

It’s all about cutting costs, said Shauna Boyle.

‘The NCAHS failed to consult with nurses, other clinicians or the wider community about a plan that will significantly impact on nurses and our community. This uncertainty has put us all under a lot of strain.

‘Mullumbimby Hospital is funded for 16 beds. A cut of six beds means a cut of more than 30%. We’re already operating with 20 beds occupied – way beyond the number we are funded for. Nurses in the hospital are flat out; community nurses are flat out. Where will the patients go who currently occupy these beds?’ asked Shauna.

‘The reality is there are not the community nurses or resources to take on these additional patients. We need more resources and more community nurses,’ she said.

Stop Press

After a meeting with NSWNA General Secretary Brett Holmes on 25 February, NCAHS CEO Chris Crawford agreed to meet with nurses and other hospital staff on the wards to discuss the bed closure plans. Bed closures and staff cuts remain on hold until these discussions have occurred.