In the lead up to what promises to be the biggest tourist season for over two years, the two nurse practitioners at Pambula Hospital's Assessment and Treatment Centre are being moved to South East Regional Hospital's (SERH) emergency department.
Southern NSW Local Health District (SNSWLHD) maintains there will be no change to the service levels offered at Pambula Hospital, but the news of the move has left locals concerned about treatment levels, particularly during the busy holiday season.
SNSWLHD said functions that only nurse practitioners or doctors could undertake, such as writing prescriptions or referrals, could be done remotely and that nurses would be able to suture wounds.
ACM has been told there has been difficulty in getting full coverage from local doctors in SERH's emergency department and it was not proving an attractive proposition for locums.
SNSWLHD has not commented on these claims.
Large hospitals such as SERH are subject to assessment on their services (key performance indicators) which are made publicly available. Pambula's ATC is not subject to the same public scrutiny, leading to questions the move may be part of a strategy to improve reported statistics.
President of Save Our Hospital Inc (SOHI) Sharon Tapscott said she was concerned removal of nurse practitioners from Pambula would leave the southern part of the shire, and as far as Mallacoota, exposed, and would place extra pressure on SERH.
"SOHI currently has a watching brief but I will be hugely disappointed if we are to lose two nurse practitioners. We were supposed to have two teams so they could rotate between SERH and Pambula. This will have a huge impact on SERH," Ms Tapscott said.
She has personal experience of the pressure on beds at SERH and the effect that has on the ED.
"I am aware of two incidents where there was considerable delay, with patients left waiting in ED before being admitted," Ms Tapscott said.
"In one case there was a wait of 12 hours and in another case a bed had to be brought down to ED so that a patient, waiting to be admitted, could be taken off the trolley. The patient then stayed in the bed in ED overnight before being moved to a ward."
There could be further pressure on beds at SERH if patients at Pambula have to be moved.
SNSWLHD would not comment on discussions around inpatients at Pambula Hospital and how they might be affected during the holiday period when local doctors, who visit the ward, would not be available.
It's understood that without the availability of doctors, patients - Pambula can accommodate around 14 - would need to be moved.
Ms Tapscott said she had contacted state and federal members with questions around the future of services at Pambula Hospital.
The ATC model of care was introduced in 2016 but got off to a very bumpy start with patients being turned away and unable to be treated. The situation saw SNSWLHD apologise to a patient and review the service.
In late 2018 the nurse practitioner model was announced and the following year became permanent.
"Following the successful introduction of the nurse practitioner model, the district will continue to have a nurse practitioner at Pambula ATC, with the service open seven days a week," SNSWLHD said in July 2019.
There was recognition too of the benefits in having the higher volume of category 4 and 5 patients seen close to where they were staying during holiday times, and not filling SERH's ED.