Medical staff at Orange Health Service have told a parliamentary inquiry that "serious adverse outcomes" for patients are at risk of not being properly investigated.
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The OHS Medical Staff Council made the claim in a submission to the NSW government's current inquiry into regional hospitals.
Dr Ruth Arnold, who is a senior clinician at OHS and co-chair of the NSW Medical Staff Executive Council, said that when something goes wrong with the treatment of a patient at a NSW hospital - such as being given the wrong medication - doctors or nurses must file a report in which they grade the extent to which the error impacted the patient.
These gradings were known as the Severity Assessment Code.
According to NSW Health "serious incidents" were rated SAC1 or SAC2.
SAC3 and SAC4 incidents were those resulting in "little or no harm".
Dr Arnold said a SAC1 rating required external investigation, while a SAC2 lead to an internal investigation.
Some serious adverse outcomes have been downgraded, without information being provided to the clinicians
- OHS Medical Staff Council
She said once the nurse or doctor had graded the SAC, their report went to the Clinical Governance Unit within Western NSW Health, and the CGU ruled on whether the grading remained or was changed.
"That's what the system is there for - to make sure that there's constant improvement in health," Dr Arnold said.
"If you've got a system that isn't performing at a top level and you've got people downgrading things without discussing it with clinicians, you can appreciate that's not an ideal way to make outcomes better in the future."
The medical staff submission stated: "Some serious adverse outcomes have been downgraded, without information being provided to the clinicians as to the reasons for downgrading, and this can change whether a poor patient outcome is investigated at all".
It also said the local CGU had "lacked senior medical leadership for a number of years", and it "welcomed" the recent appointment of a senior clinician to the CGU.
The submission went on to state there had been "a lack of clarity in the grading of some clinical incidents".
A NSW Health spokesperson said "reporting and analysis of clinical incidents .... is an important part of clinical care that health professionals and managers take very seriously ... this work focuses on finding system issues that lead to service improvements".
"Incident reporting is increasing and is testament to the clinical and managerial staff in NSW Health continuously promoting the reporting of incidents, patient safety and system improvement," said the spokesperson.
Hearings will be held between March and July.
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