Lismore Base Hospital
Lismore Base Hospital Marc Stapelberg

EXCLUSIVE: Hospital now 18 months without critical doctor

IN A staffing bungle described by senior clinicians as "grossly negligent", The Northern Star can exclusively reveal Lismore Base Hospital has gone without a dedicated infectious disease doctor for the last 18 months.  

Senior clinicians have warned the arrangement is putting lives at risk, with intensive care unit doctors forced to wait up to 12 hours to receive critical advice on how to treat severely sick patients with antibiotics, over the phone.   

The bombshell revelation comes in the wake of the death of a mother from a sepsis infection at the hospital and a warning from nurses that more deaths are feared due to poor staffing.

Since July 2016, a part-time infectious diseases trained general doctor, who is currently on study leave, has given what senior clinicians have described as "pseudo" medical advice on antibiotics use, without the ability to clinically review patients.

Northern NSW Local Health District Chief Executive Wayne Jones confirmed Lismore Base Hospital has not been able to recruit a full-time infectious disease specialist to the role.

"These positions are difficult to fill, especially outside of metropolitan areas," Mr Jones said.

He said arrangements had been made with infectious disease doctors "from a number of metropolitan hospitals to provide specialist support as required".

"This support has been extremely valuable for Lismore Base Hospital, especially over the past few weeks when the local physician was not available," Mr Jones said.

However a senior clinician who asked not to be named said an informal arrangement to seek medical advice on antimicrobial use from Sydney Royal North Shore Hospital was unreliable, and withdrawn two months ago.

On December 4, hospital administration was alerted to several Lismore and Grafton doctors having "been turned away" in an "abysmal situation, when a professional reaches out for support and is denied".

In one incident, an intensive care unit doctor called for advice from another hospital at midday and did not receive that advice until 12-hours later via text.

In another incident a patient had to stay an extra night at Lismore Hospital, while doctors confirmed what dose of antibiotics the patient needed.

An outgoing pharmacist warned in a letter that Lismore Hospital was in danger of a department "collapse" because it had been 'inappropriately' using a "pseudo ID approver account" through an accredited system to process 1,939 antimicrobial requests for drugs, from July 2016 to - August 2017.

The Hospital is also "experiencing an unprecedented number of antimicrobial stock shortages ... but no (experts) are available to draw on" to deal with the problem.

A senior clinician who asked not to be named said patients' lives are being put at risk.

"We are going to compromise patient care because we are making recommendations outside of our scope and a patient could die of an infection that we haven't treated properly, because we didn't know what to treat them with," the clinician said.

In a letter to hospital administrators this month, clinicians called for the matter to be formally identified on the hospital's risk register.

An urgent review of infectious disease services at Lismore Hospital has also been sought "given the demonstrated requirement for our hospitals to have timely access to a infectious diseases service".

Mr Jones said NNSWLHD was recruiting a full-time infectious disease physician.

"We are developing long-term solutions to these workforce challenges by establishing rural training programs that allow the Local Health District to identify specialists in training who wish to work in rural NSW," Mr Jones said.

NNSWLHD has no current job listing for the role.



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