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Significant shortage of senior doctors at Counties Manukau

Significant shortage of senior doctors at struggling Counties Manukau DHB, survey finds

A survey of Counties Manukau District Health Board reveals a significant shortfall of senior hospital specialists, more than two and a half times larger than the number of vacancies officially recorded.

Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS), says the results of the ASMS survey are very concerning and stand in stark contrast to reports the DHB is considering voluntary redundancies (http://www.radionz.co.nz/news/national/340369/counties-manukau-dhb-offers-voluntary-redundancies and http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11927279).

“We have an extraordinary situation where senior hospital doctors – and no doubt other clinical staff at the DHB – are working shorthanded and struggling to cope, yet the DHB’s management is looking at drastic measures to deal with the ongoing budget constraints the Government has repeatedly failed to address,” he says.

The survey of clinical leaders at Counties Manukau DHB was carried out by the ASMS with a view to assessing how many SMO full-time equivalents are needed to provide a safe and quality service for patients, including patients in need of treatment but unable to access it.

Data produced by the Organisation of Economic Cooperation and Development (OECD) show New Zealand has one of the lowest number of specialists per head of population out of 32 countries.

Main findings from the Counties Manukau DHB survey:
• Of the 30 heads of departments (HoDs) contacted for participation in this survey, 17 responded (57%), representing approximately 58% (247.2 FTEs) of the SMO FTE workforce at CMDHB.
• 16 HoDs (94%) assessed they had inadequate FTE SMOs for their services at the time of the survey. The remaining respondent was uncertain.
• Overall, the HoDs estimated they needed 44.7 more FTEs – or 18% of the current SMO staffing allocation – to provide safe, quality and timely health care at the time of the survey.
• Despite the estimated 44.7 FTE staffing shortfall, there were only 16.8 FTE vacancies at the time of the survey. The survey revealed a shortage of specialists more than two and a half times larger than the number of vacancies officially recorded.
• From the 17 HoD responses, 36% indicated their SMO staff are ‘never’ or ‘rarely’ able to access the recommended level of non-clinical time (30% of hours worked) to undertake duties such as quality assurance, supervision and mentoring, and education and training, as well as their own ongoing professional development.
• 71% of HoDs felt their SMO staff had insufficient time to undertake their training and education duties.
• On average, 59% felt there was inadequate internal SMO back-up cover for short-term sick leave, annual leave, continuing medical education leave or for covering training and mentoring duties while staff were away.
• 59% of respondents felt their staff had inadequate time to spend with patients and their families to provide good quality patient centred care.
“The Government needs to step up urgently and prevent patients, their families and hospital staff further bearing the brunt of inadequate resourcing of the public health system,” says Mr Powell.

The full survey results are detailed in an ASMS Research Brief available online at https://www.asms.org.nz/wp-content/uploads/2017/10/Counties-Manukau-DHB-staffing-survey-research-brief_168687.2.pdf. The CMDHB staffing survey is the fifth in the series to date. Similar surveys have been carried out in Nelson Marlborough, Capital & Coast, Hawke’s Bay and MidCentral DHBs, and reports of these are also available on the ASMS website at https://www.asms.org.nz/publications/researchbrief/.

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