High-profile CEO says charging the Commonwealth for every day a patient stays in hospital past their discharge date is the only way to improve length-of-stay data.
Local Health Districts should charge the federal government for every day acute hospital patients exceed their date of discharge to force its hand on resolving shortfalls in aged care and NDIS placements, said a high-profile CEO todayaccording to Tracey McCosker PSM, CEO of Hunter New England LHD.
Addressing the NSW Special Commission of Inquiry into healthcare funding, Tracey McCosker, CEO of Hunter New England LHD, said as long as districts continued to subsidise care for patients unable to be discharged from hospital into the community, there was no incentive for the Commonwealth to rectify, or even acknowledge, the situation.
“Most of the time people from aged care facilities and NDIS-eligible patients are admitted [to hospital] for appropriate reasons,” she told the inquiry.
“But then there comes a time when they don’t need to be in the acute service anymore but we can’t discharge them, [and] we’re paying a premium for not having that bed available.
“They’re [also] not getting the best and most appropriate care while they’re in an acute hospital, when they should be in an aged care place or a place that’s suitable and appropriate for someone with a disability.
“While those people are taking up one of our beds, where’s the incentive for the Commonwealth to do anything about that? Because [the patient’s] got a bed and they’re safe.
“If we could get their attention by charging them for every day that [these patients] are in one of our beds, outside the scope of when they should be, perhaps we would either get [the Commonwealth’s] attention, or they would think that they could use the money that they have to pay us better to fix the problem.”
In a statement submitted prior to her appearance before the inquiry, Ms McCosker also acknowledged there were currently 44 NDIS and 83 aged care patients across HNE LHD’s acute care facilities who were unable to be transferred back into the community, many of whom were “complex patients who often need complex community care”.
According to the statement, the demand to provide care to those patients, in place of support or funding from the federal government, was having a “major impact” on hospital operations, KPI performance and budget allocation across Hunter New England.
Ms McCosker said the difficulty for the district to recruit and retain staff under the state’s health awards was another significant obstacle preventing the district from meeting its state performance benchmarks and maintain its facilities.
Some hospitals in the region are going on bypass to divert ambulances elsewhere due to a lack of ED staff.
“A number of times we’ve had someone that has been interested, who we’re trying to [recruit], they get an offer from Queensland, and … the pay difference is too much to refuse,” she said.
“It’s a story we hear over and over again. Some of the locums that we’re getting to fill vacancies are coming from Queensland, because a lot of the positions are full, because they’re offering much better pay [and] fulltime positions.
“The people who want to do locums [in Queensland] are actually coming to New South Wales and [because they] can’t get a job back in [their] own state because everybody wants the permanent jobs.
“Very often we don’t have the right number of medical staff in our EDs to process people quickly enough. We can keep the ED open, but it means that there’s constant triaging, and if you get a [resuscitation] in, then all of the resources go to the resus, and people wait longer.
“If we can’t staff the beds, we have to close the beds, and therefore we can’t accept patients. Often ambulances are told that we’re on bypass, which means that you have to pass that hospital and go to the next closest hospital that is staffed appropriately to take patients.
“It just slows down the whole processing, because we can’t get enough staff in our emergency departments.”