Neither NSW Health, the CEO of eHealth NSW, minister Ryan Park, nor health secretary Susan Pearce appear willing to hold the SDPRIA to account for a nightmare plan. Is a vote of no confidence coming?
Some time between 5am and 5.30am tomorrow, Sydney time, the final go/no-go decision will be made about the rollout of Epic’s single digital patient record across the Hunter New England Local Health District.
Back in June 2024, Maddocks – the law firm which advised NSW Health on one of the largest technology procurement projects ever undertaken by the state – called the deal a “$2 billion ‘once in a generation’ project”.
As HSD has been reporting that project has been careering towards its most significant milestone so far, swirling in staff complaints, LHD worries, and the prospect of real patient harms if things go pear-shaped.
If the decision tomorrow morning is “go” – and that is most likely outcome given the reported presence of a pack of Grey Suits from Epic who have flown in from the US especially – at 6am someone will push the big green button and, if the worst fears of staff on the ground are realised, unleash hell.
Yesterday, HSD reported that HSU members who work for the SDPRIA held a stop-work meeting to put a series of demands to Dr Teresa Anderson, CEO of the SDPRIA, and her senior executive team.
They didn’t do that for fun. Workers are stressed, exhausted, working overtime for no pay, and have told us clearly that the workplace culture at the SDPRIA is toxic. Staff members are falling ill and are doing the classic thing that happens in healthcare.
They are bending over backwards to get the Epic systems working properly in time for doctors and other frontline staff on the ground in the HNELHD’s hospitals to use it smoothly and calmly. And they’re doing it at the expense of their own wellbeing, back pocket, and work/life balance.
Who’s in charge?
Apart from Dr Anderson, nobody seems to want to claim that responsibility.
NSW Health, the health minister Ryan Park, eHealth NSW, its CEO Richard Taggart, the secretary of health, Susan Pearce – nobody wants to talk to HSD about the SDPR or the SDPRIA. We have been shouting hoarsely into a vacuum.
Yesterday the SDPRIA sent us a, frankly, pathetic two-paragraph response to what are very serious claims from its own staff. Here it is:
“We recognise the implementation of a program as large and complex as the SDPR is challenging and we thank our dedicated staff for their collaboration, preparation and hard work to ensure a successful transition to the SDPR.
“The wellbeing of our staff remains our priority, and we are continuing to work on strategies to support them during this busy time. We are also committed to continuing to work with the Health Services Union to address any concerns raised by its members.”
The Health Services Union also remains steadfastly silent on the outcomes of yesterday’s stop-work meeting and any future industrial action. That leads one to wonder if the union has been told to keep its lip buttoned if it wants to remain in negotiation with Dr Anderson and her executives.
Happy to be corrected on that, any time, by the way, HSU.
Dr Alexander Whitfield, a delegate with the Australian Salaried Medical Officers Federation, which represents doctors working in the state’s public hospitals, told HSD this morning that the SDPRIA was essentially a law unto itself.
“The SDPRIA seems to be doing its own thing,” he said. “They are working independent of the LHD system and their communications with staff has been quite poor.”
Understatement.
Also in today’s edition:
- Who will rip the Cohealth band-aid off?
- How eReferrals, Advice & Guidance and eScripts support connected care
- Why fears over private health insurance rebate changes for older Australians are overstated
- MediRecords and Consultmed strike interoperability deal
- Tasmanian Health burned $47m on failed HR system
- Don’t waste petrol if telehealth is an option
- Maternal deaths increasingly tied to mental health and obesity
What if it goes wrong?
In an ideal world, nothing will go wrong tomorrow or in the subsequent weeks. Hoorah. The SDPRIA will suddenly start telling us how great it all is.
In a less than perfect world, HNELHD staff will have problems and the roll-back systems and helplines implemented by the SDPRIA staff will be there to catch the problems. Patients will, with any luck, not notice.
In the scenario many at the SDPRIA are most worried about, frontline staff in the HNELHD hospitals have been inadequately trained, and haven’t had enough time or support to get their heads around the complexities of this rollout.
HSD reported on that, too. A letter to us from an HNELHD worker said: “the amount, and most importantly the quality, of online training has been extremely poor” and “many staff have been forced to use their own time, including days off, to review material and attempt to prepare themselves for SDPR implementation”.
The bottom line is, one SPDRIA staff member said to me yesterday:
“Let’s hope no one dies on Wednesday.”
Despite all the clinical systems that have been put in place, there is still the opportunity for medication errors and other patient-facing mishaps.
“User error is our main concern,” said one SDPRIA source. “If users aren’t trained sufficiently then user error will increase and there’s your risk to patients.”
This plane has literally been built in mid-air.
Another risk is with part-time and casual staff who have not been in the mix for the full suite of training – such as it has been. When they rock up tomorrow and start pushing buttons, stand back.
Go-live dates have been changed from the end of March to 20May – which staff were told about on 15 May, we understand – and then to 27 May, a decision made on 18 May.
The amount of chaos those changes wrought upon SDPRIA staff rostering, alone, is almost incalculable.
Related
No confidence
Whether that big-green-button-pushing someone is Dr Anderson or not, her fingerprints will be all over tomorrow morning’s rollout.
HSD’s understanding is that hope for change in the staff wellbeing space and better management processes is approaching nil. There are rumblings that some union members among the SDPRIA staff are close to calling for a no-confidence vote against Dr Anderson.
To be clear, Dr Anderson has form. I’m not telling tales out of school in recounting the history of her time as CEO of Sydney Local Health District.
On 29 June 2023, the Concord Repatriation General Hospital Medical Staff Council held a vote of no confidence in Dr Anderson. That motion passed by 109 votes to 73.
That vote was in response to accusations by Concord staff of widespread under-resourcing, a culture of fear silencing hospital staff members, and mandatory training established simply to achieve “minimum standards”.
Sound familiar?
During the NSW Special Commission of Inquiry into Healthcare Funding, Dr Anderson defended her management style, saying several meetings had been held with hospital staff to attempt to identify and resolve the issues, but these efforts stalled as communication on the part of the medical staff council became “more and more adversarial and directive”.
HSD reported at that time that, under questioning, Dr Anderson admitted she had not raised with members of the senior executive involved in the conversations whether their approach to engaging with the medical staff council may have contributed to exacerbating tensions between both parties.
Staff at the SDPRIA who have spoken to us in detail about the culture at the Authority, will also recognise that.
Chances are things will go better than we fear tomorrow. And if that’s true, it will be down to the people on the ground at the SDPRIA and the HNELHD, and will be despite its senior management.