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Waikato DHB survey indicative of national crisis

22 July 2019

Waikato DHB survey indicative of national crisis; health minister guilty of dereliction of duty

One of the country’s largest district health boards has a severe shortage of hospital specialists, says the senior doctors’ union, the Association of Salaried Medical Specialists (ASMS).

Executive Director Ian Powell says a survey of departmental heads at Waikato District Health Board reveals the DHB needs another 48.6 full-time equivalent (27.6%) specialists – but at the time of the survey it was advertising just 25.5 FTE vacancies.

Mr Powell says the Waikato DHB Resource Review released to staff by the DHB’s newly-appointed Commissioner Dr Karen Poutasi claimed the DHB employs too many specialists. The review’s shoddy analysis is contradicted by the assessment of its own clinical leaders. It is also contradicted by official population data (see background note below).

This is factually inaccurate and ought to be corrected, or the Commissioner risks exacerbating the “unproductive tension” between management and staff described elsewhere in the report, Mr Powell says.

“This survey confirms they’re working significantly shorthanded in Waikato, which puts pressure on the specialists already on the wards who are grappling with high levels of patient need,” says Mr Powell.

“We’re seeing similar results at other DHBs and it’s indicative of a national crisis in the senior medical workforce.”

The ASMS survey of departmental heads was carried out in May and June this year, part of an ongoing series of surveys at eight selected DHBs. The aim is to assess, in the view of clinical leaders, how many SMO FTEs are needed to provide a safe and quality service for patients, including patients in need of treatment but unable to access it.

“The identified shortfall at Waikato DHB is the largest of the eight DHBs surveyed so far. The average shortage in these DHBs is 22%, making Waikato the worst of a national disgrace.”

ASMS distributed the survey to 30 HoDs at the DHB and received responses from 15, representing about 45% (176.3 FTEs) of the senior medical workforce at Waikato DHB.

Main findings:

13 HoDs (87% of respondents) indicated they had inadequate FTE SMOs for their services at the time of the survey.
They estimated they needed 48.6 more FTEs (27.6% of the current SMO staffing allocations in their departments).
40% indicated their SMO staff were ‘never’ or ‘rarely’ able to access the recommended level of non-clinical time (30% of hours worked). Meanwhile, 47% said non-clinical time was accessible ‘sometimes’ and 13% said ‘often’.
73% felt SMO staff had insufficient time to undertake training and education duties.
61% believed there was inadequate internal SMO backup cover for short-term sick leave, annual leave, CME leave, or for covering training and mentoring duties while staff were away.
80% considered there was inadequate access to locums or additional staff to cover for long-term leave.
Asked if the current staffing level was sufficient for full use of appropriate leave taking, as well as non-clinical time and training responsibilities, 80% said ‘no’.
The full results are available on the ASMS website at https://www.asms.org.nz/wp-content/uploads/2019/07/Waikato-DHB-staffing-survey_172221.2.pdf.

Mr Powell says the survey findings are yet more evidence of a workforce under pressure and the Government needs to take action instead of ignoring the problem.

“These shortages affect patients, specialists and the next generation of senior doctors, due to the lack of adequate time for training, supervision and mentoring.

“Health Minister David Clark is guilty of dereliction of duty by continuing to turn a blind eye to this crisis” he says.


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