A lack of permanent emergency department specialists has led to the Launceston General Hospital being stripped of its emergency medicine training accreditation.
Subscribe now for unlimited access.
$0/
(min cost $0)
or signup to continue reading
The Australasian College for Emergency Medicine formally notified the state government on Monday of its decision to revoke accreditation – something doctors said was years in the making.
Health Department Secretary Michael Pervan said the hospital had been unable to recruit the required number of Fellows of the college to keep its accreditation.
“As this decision relates to training accreditation, it will not impact on patient services at the LGH’s emergency department, or indeed, the broader hospital,” he said.
Doctors said training accreditation was key to attracting and retaining staff.
There are 11.5 emergency medicine specialist positions at the LGH, with 4.5 permanent full-time equivalent Fellows of the college currently employed. The remaining positions are understood to be covered by locums.
A new permanent Fellow is expected to begin on Monday, and another is due to commence mid-year.
In order to receive training accreditation, the hospital needs to employ a minimum of five full-time equivalent Australian ticketed emergency medicine specialists.
“On the last college accreditation visit, it was under that so we lost accreditation,” LGH Medical Staff Association chairman Dr Scott Parkes said. “We hope we will get that back relatively quickly, because there are vacancies to be filled.
“The problem we have is the same as any other big rural/regional hospital in Australia - it’s actually hard to recruit specialists, especially in an area like emergency, where there are lots of jobs around.”
Health Minister Michael Ferguson said cabinet on Thursday approved the fast-tracking of a dedicated health recruitment, retention and workplace planning unit.
He said the unit would be established within the next month to assist with the delivery of more than 1300 new staff over six years.
It is understood bed block was named as a secondary reason for the loss of emergency medicine training accreditation, after the issue of specialist numbers.
“Bed block is a significant issue and the college says that does really impact a little bit on trainees,” Dr Parkes said.
“I think one of the problems is when you have that problem for so long, it becomes business as usual and we have to recognise that shouldn’t be business as usual.”
However, Dr Parkes said there would be no affect on healthcare at the hospital in the short-term.
“Those that are here doing advanced training … will have their training time honoured by the college.
“It’s still a very safe place to go when you’re sick.”
Australian Medical Association Tasmania president Dr Stuart Day said loss of accreditation was not something that happened “overnight”.
“It’s something that’s been on the books, with increasing levels of concern by the college over a period of years,” he said. “The longer-term impact if you can’t turn it around quickly is really significant for, particularly, a regional hospital.”
Dr Day said there were “several levels of ramping up pressure to deal with perceived deficiencies” before accreditation was lost.
“There’s an element of frustration that this is something that has been on the cards for some time and through the back channels it’s been identified as a risk and it’s come to play.
“There’s been effort put in by the clinicians on the ground to try and put that in place, but the government’s got to take some of the blame in addressing that they needed a package to attract people because this was an urgent thing, and that hasn’t happened.”
Mr Ferguson said he was “very concerned and disappointed” about accreditation being revoked.
He said Tasmania had, for many years, experienced difficulty in attracting and retaining health staff, leading to “costly reliance on locums”.
“These challenges have been compounded by a lack of strategic workforce planning. The new unit will be responsible for developing a 20 year future health workforce plan to support the roll-out of more than 300 hospital and community beds and other services across Tasmania.
“The plan will cover current and future training and recruitment, re-training and post-graduate training and recruitment processes, and will address Tasmania’s long-term health workforce needs.”
Mr Ferguson said recruiting to rural and regional hospitals was “a real challenge across the country”.
“The LGH ED is performing a great service for the community, which is unchanged by the decision of the college, but I want to see that accreditation restored.”
Australasian College for Emergency Medicine president Dr Simon Judkins said the college was in contact and working with trainees.
“In order not to disadvantage trainees currently working or those who already have a signed contract to work at Launceston General Hospital during 2018, these trainees will be allowed to complete the 2018 training year at Launceston,” he said.
Dr Judkins said accreditation was revoked because the LGH did not meet the colleges requirements.
“One of ACEM’s roles is to maintain professional standards in training, including accreditation of emergency departments for emergency medicine training.”
He said the purpose of a formal process of accreditation and re-accreditation of sites for the Fellows training program was to ensure “defined acceptable training and education standards are provided by the training site”.
“Once [the LGH] puts measures in place to resolve the issues, they can submit an application to be reassessed as an ACEM training site.”
Dr Judkins said new trainees would not be allowed to train at the LGH until a successful application was made to the college for reinstatement.
For the LGH to regain the accreditation, it would need to pass a complete re-inspection from the college.
Mr Pervan said the department recognised there were “some historical challenges to recruiting specialists in regional areas, but they are issues we will need to overcome”.
“We take great pride in being able to maintain the LGH as a teaching hospital, and therefore will be consulting closely with ACEM to ensure this issue is resolved as quickly as possible.”
He said the Tasmanian Health Service would work closely with the college to restore accreditation.