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New RAH will fail to cover nearly 40,000 patient appointments

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The head of SA Health has conceded the $2.3 billion new Royal Adelaide Hospital’s outpatient facilities are inadequate to meet expected demand, as the department scrambles to figure out how to cater for a shortfall of almost 40,000 patient appointments a year.

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SA Health CEO Vickie Kaminski told ABC Radio Adelaide this morning the new hospital would be unable to cater for a staggering 375,000 outpatient appointments every year.

However, an SA Health spokesperson told InDaily shortly afterwards that Kaminski had misspoke: 375,000 was the total number of outpatients to be seen annually, not the shortage.

But the department confirmed it was consulting with clinicians on how to cater for about 10 per cent of expected outpatient appointments – 37,500 of them – that will now have to occur elsewhere.

In a letter addressed to Kaminski, quoted in The Advertiser over the weekend, 14 heads of departments at the current Royal Adelaide Hospital described outpatient facilities at the $2.3 billion new hospital as “woefully inadequate and not fit for purpose”.

Speaking on radio today, she conceded: “We have an outpatient department that was designed for fewer patients [than] we’re actually going to see there”.

She said SA Health was considering how to cater for the appointments.

“There’s no reason why we couldn’t do outpatients in the evening – and lots of outpatients would appreciate that,” she said.

“But remember when you do your design and planning it’s 10 years ago – you’re predicting what you think the demand will be.”

She appeared to suggest some of the department heads who wrote to her were to blame for the planning failure, as they had been involved in the design of the outpatients unit in 2008.

“So some of them are signatories to [that planning, but] not all of them,” she said.

“These 14 [clinicians] represent 20 per cent of all the department heads and the rest are reasonably happy.”

She said there were “about 375,000 attendances that aren’t going to fit” in the new RAH’s outpatient service.

“They’re not all individual patients, it could be one patient having several visits.

“Yeah, it’s a lot … but it’s probably about 20 per cent of the total attendances.”

But SA Health said that both of those figures were wrong.

Instead: “The RAH currently sees a total of around 375,000 occasions of service for outpatients – around 90 per cent of these will relocate to the new RAH.”

“Where appropriate, some less acute outpatient clinics will relocate to alternative settings, including the Queen Elizabeth Hospital.

“We’re continuing to talk to clinicians to determine the best location for these services to provide the best outcomes for patients.”

Kaminski said the design of outpatient facilities at the new RAH was similar to those in the old RAH, except that there were fewer rooms in the new hospital’s outpatient unit.

“If you look at our current RAH we have 12 square metre consulting rooms and 20 square metre examining rooms; that’s the same as we’ve got in the new RAH, we just don’t have the same number of them when you add up all the spaces that people have,” she said.

“We’re looking at the QEH for example and saying they’re going to have some capacity.

“What we’ve committed to the group of doctors that we met with two weeks ago … [was that] we’ll sit down with them and plan out what they need in terms of another opportunity for outpatients perhaps in a GP clinic.

“That was something we were looking at in the CBD [but] we don’t have that available.”

SA President of the Australian Medical Association, associate professor William Tam, told InDaily:”We have been concerned about RAH Outpatients for quite some time and SA Health has been on notice about the problems – [yet] not enough has happened to properly address the issues that doctors have been trying to have heard and recognised, in some cases for years.”

The fact that 14 department heads at the RAH have taken the major step of sending a joint letter to the CEO of SA Health is a giant red flag on what has been a long-running issue.

“These are people who have great loyalty to the hospital and their concerns must be given great weight.”

InDaily contacted the South Australian Salaried Medical Officers’ Association for comment.

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