Makeshift wards threaten patient health, say doctors

PATIENTS are being left overnight on trolleys in rooms intended for waits of several hours at the crowded Royal North Shore Hospital, a senior doctor says.

Dr Greg Purcell, an anaesthetist at Royal North Shore Hospital for 30 years, said the patients were staying in ''inappropriate rooms for inappropriate periods'', heightening their risk of inadequate care and spreading infections.

Dr Purcell and other senior doctors interviewed by the Herald blamed the situation on a budgetary method to clear overcrowded wards.

Two rooms - the emergency department's medical assessment unit (intended to hold patients for up to six hours) and the transit lounge (intended as a pick-up area for discharged patients) - had been operating as ''pseudo wards'', they said.

It has been alleged acute patients were regularly left on trolleys or chairs in the transit lounge for up to 12 hours and in some extreme cases overnight when the hospital has been full, Dr Purcell said.

The emergency department's medical assessment unit is a cramped room with four beds, two chairs and one toilet down the corridor.

''It is as far removed from patient- and family-centred care as imaginable and comprehensively abandons any commitment to patient safety, dignity or confidentiality,'' Dr Purcell said.

The general manager of Royal North Shore Hospital, Sue Shilbury, denied that patients were kept for more than six hours in the medical assessment unit. She added that ''any infectious patient in [a medical assessment unit] is isolated in a single room''.

A spokesperson for NSW Health said public hospitals were not routinely ''using short-stay units, medical assessment units, transit lounges/discharge lounges for prolonged periods of time''.

But the Herald can confirm that three major NSW hospitals are misusing such units: Royal North Shore, Dubbo Base Hospital and St Vincent's.

Dr Tony Nocera, an emergency physician at Dubbo Base Hospital, said due to its overcrowded emergency department, the hospital had been leaving hospital in-patients in its emergency medical unit for several days and longer. The hospital's acting general manager, Debbie Bickerton, said this only happened during ''periods of high activity'', but Dr Nocera said it happened almost every week.

The Herald revealed a week ago that St Vincent's Hospital was misusing a corridor of beds called the medical and surgical transit unit, which was only intended for stays of less than 24 hours. The hospital has been keeping patients in the corridor for up to six days.

A St Vincent's spokesman has since told the Herald the hospital is trying to ''fast-track'' a move to a more appropriate facility.

The Health Minister, Jillian Skinner, said: ''If any patient has a concern about the care they have received in a short-stay unit, they should raise it with hospital management and it will be investigated''.

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