Page 680 - Week 02 - Thursday, 20 February 2020

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Workforce, recruitment and retention of psychiatrists

Recruitment for senior medical staff has been a priority. There have been challenges with recruiting permanent staff at Adult Mental Health Unit (AMHU). However, there has been no circumstance at all in which there has only been one staff specialist working at AMHU in routine business hours. The usual staffing ratio is to have one Clinical Director, four Staff Specialists, and four Registrars with additional support from Resident Medical Officers. For most of the last twelve months two of the staff specialists have been permanently appointed staff and two locums. These locums have usually been longer term, staying over several months.

The Clinical Director, a locum, has been consistent since the start of 2019. A substantive appointment to that post has been made and the person will take up the post in February 2020.

In terms of other recruitment and retention in 2019, I can advise that one Clinical Director and one older person’s psychiatrist who commenced in August 2018 decided for personal reasons that they would not remain in Canberra. There have been no other resignations or significant reductions in working hours. We have successfully recruited two substantive Clinical Directors – one in post and one due to take up post in February 2020. We have also recruited 1 FTE general adult psychiatrist, 1.8 FTE CAMHS psychiatrists, and 1 FTE CMO (all permanent and in post). We have also appointed an interim Clinical Director for ECT who will continue for a further twelve months and who has been pivotal in providing training and support for increasing the number of people on the ECT Roster. In addition, we have recruited 1 FTE older person’s psychiatrist who is due to take up post in February/March 2020 (pending finalising RANZCP requirements as well as Certificate in Older Person’s Psychiatry).

Mental Health Care in Emergency Department

It is acknowledged that the on call demands of medical staff has increased. Data shows that there has been a 137 per cent increase since 2014-15 in the number of presentations to the ED. It is also noted that there has been a significant increase in the number of people brought into ED under the emergency provisions of the Mental Health Act 2015, with an increase in the acuity of presentations. It has been demonstrated that activity on weekends and weeknights has increased although weeknights can be variable. Anecdotally this activity is believed to be comparable to other specialities where staff are frequently in the hospital for extended hours over the weekend as well as in the evening, reviewing patients, including the facilitation of ward rounds, and managing on going care as well as facilitating discharges. We would note that the frequency of the staff specialist on-call roster for psychiatry is far less onerous than for other areas of our Division (Alcohol and Drug Services, and Justice Health Services) as well as most other specialties (e.g. surgery, medicine, oncology).

Further funding for acute and non-acute beds

Currently under development is:

Acute beds

o Adolescent Mental Health Unit (AdMHU) (six-eight beds) and Adolescent Mental Health Day Service (AMHDS)

Sub-acute beds

o Step Up Step Down (SUSD) (six beds);

o Supported Accommodation (11 beds across three houses); and

o Extend Care Unit (ECU) (10 beds - five currently operational).


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