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Emergency surgery shutdown set to begin at Modbury

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People who arrive at Modbury Hospital needing emergency surgery will be sent to another hospital starting next week, InDaily can reveal.

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Medical unions have told InDaily emergency surgery will no longer be offered to patients that turn up at Modbury Hospital’s emergency room starting mid-next week.

SA Health would not confirm the date of the change, only saying that the final stage of hospital “service reconfigurations” in the northern Adelaide area, under the Transforming Health program, would be complete by the end of the month (Saturday next week).

Under the new policy, Modbury Hospital patients needing emergency surgery will be taken about 14 kilometres north by ambulance to the Lyell McEwin Hospital – with the most serious cases transferred about the same distance south, to the Royal Adelaide Hospital.

The plan has surgeons worried patients could be exposed to serious harm if emergency surgery is delayed by a transfer to another hospital.

SA Chair of the Royal Australasian College of Surgeons Dr Sonja Latzel told InDaily that two or three patients had arrived at Modbury Hospital in recent months with complications of childbirth, where serious harm may have been caused if they had had to wait for transfer to another hospital.

“Patients do attend in shock and those patients can be a serious risk from any sort of delay in transfer,” said Latzel.

“The average time currently for most inter-hospital transfers is four to six hours.

“Hopefully patients will [know to] go elsewhere.

“But patients don’t always understand how sick they are.”

However, Ambulance Employees Association state secretary Phil Palmer said he was cautiously optimistic about the policy change.

Palmer told InDaily the dedicated ambulance that transfers patients between the Modbury and Lyell McEwin hospitals 24/7 has the capacity to transfer more patients than it currently does.

He said the most seriously ill patients could be transferred relatively quickly.

“The ambulance service is confident that this ambulance can cope with the change,” Palmer said.

“It’s not being utilised as well as it can [and] the kinds of patients that have been moved so far have been quite stable.

“We are all being assured by the areas CEOs of the health network [that patients will be safe].”

But Palmer said the AEA had “yet to be convinced that the downgrading of any emergency department is the right move”.

Modbury Hospital is to become a “centre of excellence” in elective day surgery under the changes, SA Health says.

Only patients suffering complications from elective surgeries at Modbury will have access to emergency surgery there.

Latzel said SA Health had agreed to a six-month trial retaining the capacity for emergency surgery, but only for elective surgery patients, under the new policy.

She said SA Health may decide to eliminate the hospital’s capacity for emergency surgery altogether if not enough demand for the service is demonstrated during the trial.

SA Health would not comment on the trial, but Dr Elaine Pretorius of the Northern Adelaide Local Health Network told InDaily the policy change would see Modbury Hospital “become a centre of excellence for same day and 23 hour surgery, and the major rehabilitation hub for the north and north east”.

“NALHN has engaged extensively with staff, consumers and unions on the changes to ensure we deliver high quality and safe services to residents in the north and north-east,” she said.

“Feedback from staff resulted in a number of changes to the proposals, including an on-call theatre team available after-hours at Modbury.”

In 2015, InDaily revealed that doctors at the Modbury and Lyell McEwin hospitals had united against the proposal to “downgrade” the Modbury Hospital emergency department.

Under the changes, the Lyell McEwin Hospital will have more surgical beds to cater for the complex emergency surgery patients and the Modbury Hospital will undergo $32 million infrastructure upgrades.

Pretorius said “phase one” of the northern area “service reconfigurations successfully took place as planned one month ago” and the “final phase” was expected to occur this month.

A central element of the Transforming Health program is the consolidation of more complex healthcare, such as emergency surgery – and the resources and staff to deliver it – in larger hospitals, such as the Lyell McEwin.

This means that patients wanting the “best care, first time, every time” – as the Transforming Health motto goes – will have to know which hospital to arrive at to avoid ambulance transfer to another hospital.

Palmer said about 70 per cent of patients that turn up to South Australian hospitals each year do so by car, taxi or on foot – rather than in an ambulance.

“The public do need to be educated,” he said, to ensure they turn up at the right hospital.

Palmer said the union was in an “information-gathering” stage regarding the Transforming Health reforms and “we won’t agree to anything that puts the public at risk”.

He said the AEA was prepared to campaign against any reforms that compromise patient care, should evidence emerge that they do.

This time last week, InDaily revealed a landmark survey of South Australian doctors, showing the majority of the 530 respondents were opposed to the Transforming Health reforms, despite the State Government’s repeated assertions to the contrary.

In response, Health Minister Jack Snelling likened the Transforming Health process to the Adelaide Oval rebuild, which initially attracted entrenched skepticism but has been roundly celebrated since its opening in 2014, and dismissed the survey as “not exactly what you’d call a scientific survey”.

Earlier this year, a survey of about half of South Australia’s surgeons revealed more than 80 per cent had concerns about patients’ access to surgery and 84 per cent did not support the Transforming Health implementation process.

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