A plan to merge wards at Maclean District Hospital has been “deferred” in the face of growing community opposition.
Northern NSW Local Health District says it has postponed a decision on a plan to reconfigure Maclean Hospital by merging its acute and sub-acute wards.
The proposal would have cut bed numbers by about one third and deleted two positions – nursing unit manager and ward clerk.
Widespread public protest forced the LHD to announce it would set up a community advisory group.
The group would “provide input into the ward reconfiguration proposal” and future healthcare plans, LHD chief executive, Wayne Jones, said.
“We will delay any decisions around the proposed reconfiguration of wards at the hospital until the community has had further opportunity to provide input,” he said.
“It’s clear that the Maclean community wants to be more involved with the plans for their local hospital.
“We have listened to what the community and our staff have had to say, and we acknowledge that we need to improve our consultation processes.”
The LHD is using local radio and its web page to call for expressions of interest from people interested in joining the advisory group.
The LHD appears not to have approached staff or NSWNMA branch members to be part of the group.
Nurses garner community support
Earlier, the LHD announced it would shut the Level 2 acute ward and combine it with the Level 1 sub-acute and rehabilitation ward.
It said the acute ward would remain available for “surge” capacity during peak periods.
The acute ward’s nursing unit manager and ward clerk would be “displaced” and offered jobs elsewhere in the hospital.
A meeting of the NSWNMA’s Clarence Valley branch unanimously rejected the proposal and resolved to launch a community awareness campaign including a public forum.
The hospital’s NSWNMA’s delegate, Melissa McDonough, said the branch feared that consolidating patients and staff into one ward would be difficult to manage and compromise patient safety, while staff would have to carry a greater workload.
“Our biggest concern is the mix of patients we will have to care for: acute, sub-acute, rehab and palliative care all in the one large ward,” she said.
Under the LHD’s original proposal, level 1 would contain a 10-bed rehab facility plus 23 patients in acute, sub-acute, palliative care and infectious beds sharing toilets and showers in a ratio of 1:4.4 patients.
That is more than double the toilet/shower-to-patient ratio of the present acute ward.
Maclean hospital was one of the first regional facilities to get increased nursing hours – from five to six nursing hours per patient day (NHPPD) – as a result of a state government election commitment.
Only ENs and AiNs for new positions
The NHPPD increase came into effect on 24 February but the recruitment process had not started when The Lamp went to press. Nurses were doing extra shifts to cover the additional hours.
Also, the LHD plans to recruit only enrolled nurses and assistants in nursing (AiNs) to the new positions.
NSWNMA Assistant Secretary Judith Kiejda said these new positions are being funded at RN level.
“Why would facilities put in lower classifications except to save money,” she said.
“An increase in nursing hours per patient day should not be a reason to cut the number of experienced nurses – especially when the additional hours are to be filled by less qualified nurses,” Melissa McDonough said.
“The increased use of AiNs raises questions about the safety of the skills mix among the nurses on each shift.”
Melissa said the proposed ward reconfiguration appeared to ignore the future need for expanded health services to meet population growth.
The Clarence Valley region is getting several new housing estates, as well as the Clarence Correctional Centre.
It will be Australia’s largest jail with 1700 inmates and 600 staff.
Melissa said the branch had decided to postpone a planned street march and continue to participate in consultation meetings with the LHD to ensure it prioritised safe patient care and adequate staffing.
Locals pack town meeting
About 200 Maclean residents attended a town forum organised by the hospital’s NSWNMA branch.
Participants decided to take up a petition and organise a street march against the ward merger.
NSWNMA delegate Melissa McDonough said the branch was “overwhelmed” by the public response to the forum.
“The Maclean community has a real sense of ownership of their hospital,” she said.
“The hospital auxiliary has raised a lot of money for the hospital over the years.
“For example, it paid for the hospital’s first helipad and half the cost of its replacement. The ED was refurbished from a community member’s bequest and free TV sets for patients were donated by local service clubs.”
The LHD executive rejected an invitation to address the NSWNMA-organised forum and instead hastily arranged its own community information session for the day prior.
The LHD information session failed to pacify the community and the executive later announced the merger plan would be deferred.