Page 4535 - Week 13 - Tuesday, 26 November 2019
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increased visibility of bed capacity across the system, including at Calvary Public Hospital Bruce, and supports a proactive approach to increasing the movement of patients. This includes reporting twice a day on bed capacity, including all inpatient units and the identification of patients suitable to be cared for in other settings. This enables creation of capacity for high dependency unit beds in particular.
Another initiative has been the establishment of a five-bed subacute pod in the adult mental health rehabilitation unit, which went live on 6 August this year and will run until the end of 2019 and support the ligature minimisation works occurring at the adult mental health unit, whilst concurrently demonstrating whether there is a need for additional subacute beds. This pod enables patients with barriers to discharge, such as housing availability or awaiting NDIS approval, to be cared for in a less restrictive environment than the adult mental health unit, with access to a broader range of day programs. These people are also able to continue to access the day programs post discharge, further supporting keeping them well in the community.
Canberra Health Services has employed a dedicated consultant psychiatrist in the emergency department, where traditionally the emergency department interface has been managed by a registrar with support from consultants from the consultation liaison service and the adult mental health unit. A dedicated consultant has been allocated full time during weekday business hours to the emergency department to enable timely assessment and planning for people presenting with mental illness. This has enabled better relationships with the emergency department consultants.
There has also been the establishment of a cross-directorate forum with the Justice and Community Safety Directorate, including emergency services, to identify and progress issues impacting across various services, with an aim to streamline processes which impact both emergency services and the emergency department at Canberra Hospital. Working with emergency services provides the opportunity to review the current processes for transfer to the emergency department under an emergency action. In 2018-19 there were 1,171 people with a mental illness transported to Canberra Hospital emergency department on emergency detention by authorised ambulance paramedic; and, of these 1,171 people, only 156—or 14.6 per cent—were assessed as requiring a three-day emergency detention.
In the 2019-20 budget the government provided funding to design an ACT model based on the PACER model from Birmingham in the UK. This model supports a joint response from police, ambulance and mental health clinicians to incidents where mental state is thought to be a factor. The three services provide officers to work together in vehicles that are available to respond to emergency calls, allowing early assessment of mental state and ensuring that people are only transferred to the emergency department where there is a determined need following this initial assessment. A pilot vehicle will be operational in December this year.
There has also been consideration of alternative approaches to court-ordered section 309 assessments, in collaboration with the Chief Psychiatrist. These alternative approaches will be investigated, including the feasibility of undertaking these assessments at the courts, rather than transferring all people under section 309 of the Crimes Act to Canberra Hospital emergency department for assessment.
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