Central Adelaide Local Health Network

Mrs HURN (Schubert) (14:13): My question is to the Minister for Health and Wellbeing. Has the minister heard of any concerns from clinicians within CALHN in relation to ward round directives, and if so has he taken any action to address them? With your leave, sir, and that of the house, I will explain.

Leave granted.

Mrs HURN: In a parliamentary committee last week, the directive requiring ward rounds to be completed by 10.30am was described as an absolute disgrace, with one consultant referring to it as 'completely bonkers' and an impossible task in an already decimated and fatigued workforce, with reports it was completely out of touch with the clinical provision of care to patients.

The Hon. C.J. PICTON (Kaurna—Minister for Health and Wellbeing) (14:13): Thank you very much to the shadow minister for her question. I certainly can confirm in relation to the direction that was issued by the Central Adelaide Local Health Network CEO, Ms Lesley Dwyer, and I understand signed off by the board of the Central Adelaide Local Health Network, including the chair, Mr Raymond Spencer. This has obviously been subject to dispute that has been lodged by the Salaried Medical Officers Association, as has been publicly ventilated. It has been raised in the South Australian Employment Tribunal.

This has been raised between SASMOA and the Central Adelaide Local Health Network and it is going through a process of discussion through the tribunal process. Essentially, I don't think that there is any dispute in terms of the central issue, which is that if we can have earlier discharges in the day then that helps the flow in terms of the hospital system. What we have seen over a period of time, particularly in the past few years, is that discharges in our hospital system—

Mrs Hurn interjecting:

The SPEAKER: Order! Member for Schubert, you are called to order. The minister has the call.

The Hon. C.J. PICTON: Discharges in our hospital system have been getting later and later in the day and that makes it more difficult for flow from the emergency department into the inpatient wards to occur. If those discharges happen later, it addresses the flow and ultimately addresses access block in the system, which is the key contributor to ramping occurring, which is the key contributor to ambulance delays happening.

There is a key imperative—not just at Central Adelaide Local Health Network but at all our local health networks—to try to improve that flow and to get discharges happening earlier in the system. This is not something that is unique to South Australia. Work in this regard is happening around the country and certainly work is happening at other local health networks on this as well to try to get those discharges happening earlier in the day.

The key concern here is whether or not this forms part of a direction from the CEO of that local health network and the board, or whether it is part of other work that should be happening in our local hospital network. I certainly haven't heard anybody disputing the fact that we need to try to address the blockages that are leading to discharges happening later in our hospital system, which is causing delays to happen.

There have been a number of good elements that have happened so far. I had the pleasure of visiting the discharge lounge at the Royal Adelaide Hospital a few weeks ago and meeting the nurses who work there. That has been an element that has been in place over the past few months to help discharge happening from the wards to that lounge to free up the beds, which enables flow from the emergency departments to happen earlier.

The nurses are doing a great job there; they can follow up in terms of additional information or additional pharmaceuticals that people might need before they are discharged, or other elements of the discharge process that might still need following up, or transport to the appropriate place after hospital. It means that those beds they were in in the ward can be freed up, that people can go into them and that ultimately we can free up the emergency department.

The key issue is the emergency department being stuck with people who need to be in patient beds. That causes the issue that we see on a regular basis across the system. Those sorts of initiatives are really important. We have been looking at how this has been operating in other health systems around the country as well. We have been particularly looking at what has been happening in Westmead Hospital where they have had a successful program running on this behalf as well.

While there is clearly a dispute that will go through its process—and I obviously don't want to interrupt that process that will happen through the tribunal—I think that there is significant agreement with clinicians across the board that if we can address the factors that lead to those late discharges then that helps access block across the system.