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Repat gone, fewer beds in Health shakeup

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Rehabilitation centres will close, “super” emergency departments will be established and fewer beds will “be needed” under the massive health shakeup announced by the State Government today.

Most of the services provided by Rehabilitation General Hospital, St Margaret’s Rehabilitation hospital and Hampstead Rehabilitation hospital will be “integrated” to major hospitals.

As previously revealed, the New Royal Adelaide Hospital, Lyell McEwin Hospital and Flinders Medical Centre will each have “super” emergency departments, with emergency departments at the Queen Elizabeth, Modbury and Noarlunga hospitals no longer to deal with life-threatening emergency situations.

The Government’s ‘transforming health’ blueprint argues that sweeping changes to the state’s hospital system will mean that “we will not need as many beds”.

Upgrades to metropolitan hospitals will cost about $250 million.

Most of that funding will come from a fund set up at last year’s Budget, containing the savings from shelving upgrades at those very hospitals.

The ambulance service will receive an extra $15 million to fund the extra travel required due to the consolidation of services.

Consolidation of hospital services also means that the Government will “very likely” have to fund an advertising campaign to explain where patients should go for particular treatments.

Admission processes at every hospital will be reviewed to adjust to the changes.

Health Minister Jack Snelling said large numbers of staff would have to change their work location.

Rehabilitation services

The paper says the Repat “will have some significant areas retained, with the surrounding space made available for uses that are compatible with the history of the site”. The chapel and the garden will be retained for use of veterans, and the prosthetics unit will also be kept. The “surrounding area will be made available for uses that are compatible with the history of the site”.

“St Margaret’s Rehabilitation Hospital is a dedicated community health asset and will have a continued health focus into the future.”

“Discussions will take place with other users of the Hampstead Rehabilitation Centre to determine the most appropriate future use of the site.”

“Palliative care services, elective surgery and outpatient services currently provided at the Repatriation General Hospital will also integrate to other locations.”

South Australia’s five metropolitan hospitals will get new or upgraded rehabilitation facilities to deal with the closure of the smaller rehab centres.

Flinders Medical Centre will get an expanded rehab facility, Modbury will become a major rehab centre for sub-acute services in the North and the New RAH will have a specialised centre for rehabilitation of people with spinal or brain injury.

Emergency services

The new Royal Adelaide Hospital (new RAH) will be the major “multi-trauma hospital” for the state.
The new RAH, Flinders Medical Centre and Lyell McEwin Hospital will be “super-sites for major emergencies”.
The Queen Elizabeth Hospital and Modbury Hospital emergency departments would continue to support
local communities, but life-threatening emergencies will bypass them directly to sites with 24/7 specialist care.
The Noarlunga Hospital will host a “walk-in emergency clinic”.

Elective surgery

Noarlunga Hospital will host a specialty single-day elective surgery service, while the Queen Elizabeth will have a specialty service for multi-day elective surgery and the New RAH will be used for highly complex, multi-day elective surgery.

The paper argues that: “Dedicated elective streams will mean fewer postponements, shorter waiting lists and better planned and managed care for patients”.

“It will also reduce emergency surgical team members being distracted by elective surevery, improving their ability to focus on emergency work.”

Mental Health

The major change proposed in the paper for mental health care is that more mental health patients will be taken straight into a mental health bed, avoiding emergency departments.

However, it is unclear how the shortage of acute beds in mental health wards will be assuaged under the new plans.

The papers says patients who are intoxicated will still need a “short stay in an emergency department if medical care and stabilisation are required”.

The paper sets out targets for emergency mental health care:

By January 2016, no mental health patient should have to wait more than 24 hours for admission into an acute hospital bed.

By July 2018, 75 per cent of mental health patients should be admitted to hospital within four hours, and 90 per cent should be admitted within eight hours.

Consultation

The Government is calling for submissions on the paper released today. Submissions will close on February 27.

The paper can be found here.

The “clinical ambassador” for the transforming health project, Professor Dorothy Keefe, told a media conference today that the system was working “against us”.

Problems with the system probably accounted for hundreds of deaths each year.

“We need to change the way we do things,” she said. “Some service that people love are going to have to change.”

She asked people to avoid “knee jerk” negative reactions to the plan.

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