Northside Hospital Briefing to Community Groups
6 June 2023
Summary of Northside Hospital Briefing meeting – 19 May 2023
Presenter: Cathie O’Neill, Canberra Health Services (CHS)
Facilitator: Kate Gorman, HCCA
Notes from Cathie’s Presentation:
Cathie O’Neill (CHS) and her team are leading the transition from Calvary to CHS, with respect to service continuity and how the transition impacts on consumers and staff. Liz Lopa (ACTHD) and her team are leading the infrastructure work for the new northside hospital (to be built on the Bruce site).
Key messages from this presentation are summarised as follows.
The aging infrastructure at Calvary Public Hospital Bruce cannot support delivery of contemporary health care and is maintenance intensive. The Bruce site has been assessed as the best location for a new northside hospital in the ACT.
The ACT Government will invest $1 billion to build the new hospital. Investment into public health infrastructure must be made on ACT Government-owned land. The current Calvary services contract (the Calvary Network Agreement) is tied to Little Company of Mary’s lease of the Bruce site. ACT Government acquisition of the land would end the Calvary Network Agreement.
The acquisition will include the land within the ring road on the site (Mary Potter Circuit) – as well as some land outside of it. It will only affect public services, not land where private services are located.
The new hospital is likely to offer double the number of beds as the current Calvary Public Hospital.
Transition arrangements aim to provide ongoing certainty of services and access to health care for consumers, as well as certainty of employment for staff. When the proposed merger happens, almost all Calvary staff will be able to continue working as CHS employees at the Bruce site if they wish to do so.
While the change of provider model is expected to provide supplementary benefits in terms of service efficiencies and integration, this was not the primary intent of the acquisition, which was to select the most suitable ACT site for a new large hospital investment.
The legislation which will enable the acquisition of the Bruce site will be debated and voted on 31 May 2023. If passed, the team will enter into the prescribed transition process. The transition team is already liaising with Calvary on transition issues and details. Minimal change will occur in the short term. Staff will continue work as usual unless they opt not to transition their employment. (The legislation has passed since this presentation.)
Once the immediate ‘administrative’ transition is completed, thinking will commence about how to best deliver services over two hospital sites.
Existing unique offerings from Calvary including centres of expertise/excellence will be supported, retained, and enhanced.
The Calvary Network Agreement will be in place until 3 July 2023.
The administrative transition isn’t contingent on just terms being agreed by 3 July. The transition can begin while negotiations occur in parallel. The ACT Government recognises that it may take time to resolve all issues.
Calvary staff have been feeling uncertainty and a range of emotions. The transition team is committed to providing full support and answering all staff questions and concerns. They have been running sessions for staff to ask questions. They already feel this has created more positivity around the change, particularly once staff have had some questions answered. The website is being updated almost daily at the moment to continue to answer FAQs.
In recognition of the administrative burden and disruption, $200 will be paid to every staff member to assist with the administrative changes required from them.
All staff will transition under the same employment conditions they currently enjoy or better. All flex balances will be honoured. No application or interview will be required, however all staff who wish to continue will need to accept a new offer of employment.
Staff can choose to transition early – particularly to make the process easier if they have complex circumstances and to allow the transition team to practice their process before the main cohort are transitioned. A form is currently available for people to register their interest to transition early.
Calvary is still governed under the network agreement until the transition date of 3 July. Calvary has committed to providing full service up until the transition.
The team is aware they will be transitioning during the difficult winter respiratory virus season – which may result in some staffing pressure.
After 3 July, CHS is not anticipating any significant changes to management structures or services for 12 months. The same referral processes, teams, and structures will remain in place. No disruption to services is expected. Consumers and GPs should expect services as planned unless contacted to advise otherwise.
If the legislation is passed, the public hospital will move into the transition phase, becoming a one provider model. This will be followed by the new northside hospital beginning construction in the coming years.
Once the administrative transition is completed, planning for the new hospital will ramp up, including revising the Canberra Hospital Master Plan to reflect new opportunities presented by the provision of services on the Bruce site. This work will include substantial consultation and opportunities for consumer input.
Q & A
The following is a summary of participant questions and answers.
Q – Which services will be provided on the Bruce site in the future – will there be cardiac surgery?
A – The distribution of types of health services has yet to be worked through, so this question cannot be fully answered yet. The acquisition of the Bruce site will begin a piece of work to consider the optimal location of service delivery across all Canberra Health Service sites. It is likely that some services will only be provided at one site. Complex and specialised services like cardiac surgery are likely to be provided at the Woden campus, due to the investment on that site of other critical services.
Q – While old Calvary Hospital is being demolished, where will people be treated as inpatients/outpatients?
A – The intention is that the new hospital will be located to the front of the block, where there is limited existing development. The new facility will be able to be constructed without substantial initial demolition. We will have the ability to use the old buildings while building the new one – the buildings that will need to be demolished won’t impact inpatient services. Any demolition needed will be staged over time to minimise service and access disruption.
Q – Are there performance issues that will be improved after this transition, and if so, what?
A – There will be benefits realised outside of infrastructure development. We will continue to strive to improve performance, as Calvary does, but the scope and nature of the benefits will become evident as planning continues. The decision to develop the new hospital on this site has been made based on land acquisition. None of this is an indication of any dissatisfaction with Calvary’s services today.
Q – We understand there is a $77m pay out to Calvary involved in this transition. Where does the money for this come from? What are the impacts to the health budget? What does that mean for services provided by NGOs, and the health sector in general?
A – Funding for the special payment will not come from the ‘health envelope’ in the budget but from fixed provision funding. ‘Just terms’ will be negotiated between Calvary and government. No specific figure is available yet. Funding comes from ‘central provisions’, not from the health budget.
Q – Will more services, particularly in paediatrics, be available locally (after this merger?) – ADACAS sees and supports a lot of families having to go to Sydney because services aren’t available here – how can we reduce that need and have services fit for everyone here?
A – The new northside hospital will provide some opportunities for paediatric services to be strengthened, especially around emergency and short stay. However some services will never be able to be provided here in the Territory as we don’t have high enough case numbers. Canberra Hospital would retain the acute paediatric services, but emergency and outpatient services may be expanded. Work is currently being done on the Child and Adolescent Services Plan for the ACT. A draft will be available for consultation soon.
Q – Will an Adolescent sub-specialty also be included at CHS?
A – No decisions on this yet. The team is looking at what services can be removed from acute hospital sites and delivered in community settings.
Q – Is Clare Holland House also part of the transition to CHS – which might be important with the introduction of voluntary assisted dying in the ACT (expected in late 2023)?
A – Clare Holland House (palliative care) is subject to separate negotiations and is not part of this merger. However, its staff are employed by Calvary Public, which presents complexity that needs to be resolved in the short term. VAD has not played a role in this decision.
Q – Compliance with National Standards – how will campuses be accredited – is it intended that the Calvary public hospital will now be accredited as part of a group accreditation or continue to have separate accreditation?
A – Clinical Governance team is working through issues around this. Negotiating with Australian Commission on Safety and Quality in Health Care to achieve consistency. Calvary Public Hospital is moving to short notice accreditation inspections in advance of Canberra Hospital. The team is looking to delay Calvary’s transition to this so both are consistent. Calvary was accredited 18 months ago.
Q – Will referrals from Calvary Public to other entities remain valid?
A – There should be no change beyond the provider number of the referrer. Over time CHS will work to coordinate single outpatient waiting list including surgical wait lists.
Q – Are there preliminary plans or ideas about how planning will impact or improve mental health services?
A – Clinical services planning and projections see significant expansion of mental health capacity, both inpatient and community. How these services are aligned across services is an ongoing consideration. Mental Health is certainly one of the growth areas. Clinical service planning and projection for northside sees increase in capacity for inpatient and community based – next phase is about how that’s structured – for example replication on both sites; whether some sub-specialties are at one site and some at others.
Q – There are some cultural and morale issues at CHS. How will the transition impact staff who have left CHS because of this? Will we lose necessary specialists in the transition?
A – Culture is improving at CHS – they are achieving the best cultural scores they have ever achieved. Some staff have negative experiences at Calvary also. Culture is often team dependent. This process is a merger. Existing management structures will remain in place. The ‘values landscape’ is consistent between the providers, and values driven policy should be compatible. The transition team will work closely with individuals who feel challenged by the change. They have already done sessions with 200 staff to talk through their concerns.
Q – Will the sexual health centre have a presence at northside campus?
A – Yes, it likely will.
Q – Will this impact the commissioning process that is going on?
A – This project should not have an impact on commissioning.
Q – Will there be a birth centre in new hospital?
A – It is intended that there will be a stand-alone birth centre. The new hospital will not be operational until 2030, so the existing birth centre will be ageing by then and due for renewal.
Q – Are there any guarantees that graduates from the Canberra medical school will help build Canberra medical workforce?
A – Building the workforce is an ongoing priority and the team is doing everything they can to feed the pool of medical workers. The new hospital will provide further opportunities for workforce growth. It is very clear that health workforce will continue to grow and grow. We will be doing everything we can to feed that pipeline. Workforce plan has been published a couple of weeks ago, and northside will give further opportunities for workforce growth.
Q – Nationally there is a shortage of dialectical behaviour therapy services, and a shortage of trained practitioners and training providers. This therapy has a positive impact on mental health conditions and the more acute and complex end of mental health spectrum. Could there be future consideration to establishing DBT as a specialisation at northside?
A – The mental health workforce is stretched locally and nationally. Cathie will take this suggestion to mental health team.
Q – Data from Australian Institute of Health and Welfare shows there are wards the ACT doesn’t have that other states and territories do – AIDS, Burns, Spinal, etc. Some services have a very limited presence (compared to Tas and NT for example). Will any of these services will be implemented or expanded in the new hospital?
A – This question would be best answered by the information put out in clinical services plan. We can arrange a talk from Jacinta George about where services are headed re: specialisation.
Q – Will the hospital have a new name?
A – Yes, there will be a new name from 3 July – we need a working title to do the transfer of ownership, there will then be full consultation for naming the new build hospital, but there is no time to do so before establishing a working title name for the transition.
- There is a need for accessible community information – making information really accessible in easy English and Auslan – about what services remain available on Calvary campus including access (transport etc). For example, are emergency, outpatient services, parking etc. still open. Need to be clear that nothing has changed, service still available. Organisations are already fielding questions about changes.
- Consumers with illicit substance issues have had to be treated outside Calvary, then transferred to CHS. Opioid addiction treatment (methadone) not available at Calvary. This project offers potential to implement a program at Bruce site to ensure drug and alcohol treatment is provided effectively and efficiently. Transition needs to work for the marginalised. Opportunity here to work with CAHMA just down the road.
- 85% of patients said they are satisfied with care received at Canberra Hospital and would recommend to family and friends.
- I hope the new hospital will be a Safewards
Questions on notice:
- Is a new hydrotherapy pool being considered for the new build? Options are currently quite limited but extremely useful to a section of community (including those with long covid).
For questions relating to the transition visit www.canberrahealthservices.act.gov.au/northside-hospital, email [email protected], or call the Transition Team Hotline on (02) 5124 0400 (8:30am to 4:30pm Monday to Friday, 10am to 4pm Saturday and Sunday).
Please also email HCCA so we are aware of the issues raised.