Hunter New England Health has received a copy of a confidential report from the Tenterfield External Review, which investigated clinical care at Tenterfield Health Service, as a result of recent clinical incidents.

At the request of Hunter New England Health’s Acting Chief Executive, an independent external review was undertaken to ensure that the internal review process was seamless and transparent, and to provide further recommendations to the Acting Chief Executive with regard to clinical issues at the hospital.

"We remain committed to being open and transparent and have developed an action plan resulting from recommendations contained in the report, and will be discussing these with stakeholders in Tenterfield this week," Hunter New England Health’s Acting Chief Executive Dr Nigel Lyons said.

"I, along with relevant senior managers met with Tenterfield Hospital staff, Local Health Advisory Committee and United Hospital Auxiliary members on Tuesday 30 October to discuss the report.

"I would like to pay tribute to our staff and volunteers from both the Hospital Auxiliary and Local Health Advisory Committee, who have continued to provide outstanding services to the community during what has been a difficult time.

"I was pleased to see that the review recommendations from the External Review included evidence of Hunter New England Health’s proactive approach to supporting the needs of the Tenterfield Health Service and its staff, and it made reference to a number of areas where more could be done.

"In particular, the review recommends continued efforts in the areas of education and training for nursing staff, monitoring and auditing of clinical care incidents and networking between hospitals so that patients from Tenterfield who require higher levels of care are transfer from Tenterfield in appropriate timeframes," Dr Lyons said.

"We have already started to make real progress in these areas, such as introducing Telehealth technology to provide extra support staff in the Emergency Department which staff have found invaluable.

The External Review team identified areas that need further improvement, relating to the culture amongst management, clinicians and staff and identified numerous strategies to further develop those relationships in a professional and collegiate manner.

Dr Lyons said the recommendations have lead to action plan being developed to improve and strengthen the Tenterfield Health Service, making it a safer, more friendly and cooperative environment. Dr Lyons also said that as the external report contains information that identifies individuals, such as staff, clinicians and patients, it is inappropriate to publicly release the report.

Specific recommendations related to:

- Reviewing the health service’s capacity to deal with emergency maternity patients prior to their transfer to higher levels of care

- Ensuring basic pathology testing can be conducted at Tenterfield Health Service

- Improving clinical feedback to medical and nursing staff regarding patients transferred to other hospitals for specialised care

- Ensuring local management is conducted in a proactive manner to improve the culture within the workplace, and improving relationships with the community and local medical practitioners

- Reviewing management development education

- Ensuring clinical and community leadership is an important component of the role of the local manager

- Implementing clear guidelines to support nursing staff to escalate urgent clinical issues in the Emergency Department

- Ensuring medical practitioners appointed to the hospital are equipped with a high level of trauma and emergency medicine skills

- Investigating the possibility of medical practitioners operating from a group practice, with support from the Tenterfield Shire Council an the New England Division of General Practice

- Regularly conducting performance reviews of medical practitioners at Tenterfield Community Hospital

- Stronger involvement of medical practitioners and nursing staff in investigations of clinical incidents to enable improvements to system problems

- Working with the Local Health Advisory Committee to provide advice of health service strategic planning and service delivery, and

- Working with the Tenterfield Shire Council through their new Community Services Committee.

Dr Lyons said the review process has been challenging but essentially, it was a positive exercise with significant recommendations to further develop the health service at Tenterfield.

"I anticipate that this review will be the start of some very positive outcomes for the Health Service there," he said.

Dr Lyons said the investigation into the suspended clinician was a separate issue to the independent external review.

"We are working positively with the doctor to resolve the matter as swiftly as possible," Dr Lyons said.

For further information on the Recommendation and Actions, please refer to the Fact Sheets

http://www.hnehealth.nsw.gov.au/__data/assets/pdf_file/0016/40237/Fact_sheet_Actions_301007.pdf

http://intranet.hne.health.nsw.gov.au/__data/assets/pdf_file/0017/40238/Fact_sheet_Recommendations_301007.pdf