NSLHD News January 31 2022

Get the latest news from across Northern Sydney Local Health District.

NEWS NORTHERN SYDNEY LOCAL HEALTH DISTRICT NSLHD

Main story Short blurb proce sing tests around the clock T e NSW Health Pathology team at Royal North Shore Hospital worked incredibly hard to deliver PCR results to the thousands of people who lined up for a test over Christmas and New Year. Read more on Page 5 Read more on Page x

young australian of the year and australia day honours Page 6-7

covid vaccination program kicks off for young kids Page 4

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All of us had hoped we would enter the New Year with COVID-19 behind us, but much like the start of 2021, the pandemic has persisted and it has been an incredibly busy and unpredictable time for our staff. We know many of you were not able to have the well-earned and long overdue break you and your families were looking forward to over the festive season. Many of you were working incredibly hard in our COVID-19 testing clinics, caring for COVID-19 positive patients in our hospitals and virtually, and working in our vaccination hubs to protect members of our community against severe disease. Some of you also had to endure the frustrations of being furloughed. On behalf of the Board, we would like to say a huge thank you to all our wonderful staff across the district who have been working tirelessly and with great selflessness, professionalism, dedication and commitment. The community knows how much it owes you, it fully appreciates how it has benefitted from your perseverance and goodwill. Our health system has been under immense pressure and while the modelling suggests some reasons for cautious optimism, the situation with Omicron remains a very real concern. As we have done throughout this pandemic, we must remain vigilant. The well-established practices of up-to-date booster shots and good hand hygiene, physical distancing and the appropriate use of personal protective equipment are your best defence to keeping you all safe. The district and hospital executive teams and senior clinicians have continued to harness cohesive teamwork and expertise to ensure we are best placed and well- resourced to get us through this challenging period. Protecting the wellbeing of staff and delivering high-quality care to our patients remains the number one priority. Our people are our greatest strength, especially in these challenging times. Working in the health system shows a person’s strong sense of service and humanity. With the current challenges, we

hope the goals of working together, caring for each other and knowing you are making a real difference to the lives of so many in our community will help you to push through. We would like to give a warm welcome to two new members who have joined the Northern Sydney Local Health District Board this year, Nadia Levin and Chris Greatrex. Both Nadia and Chris bring with them a wealth of experience. Nadia is the CEO and Managing Director at Research Australia. She champions transformative change in health driven by health and medical research. Chris leads and grows businesses in the technology sector. We look forward to working with Nadia and Chris and the other Board members throughout 2022 as we continue to develop our services, drive further successes for the district and launch the 2022-2027 NSLHD Strategic Plan. Sadly, we say farewell to Keith Skinner who is retiring from the Board after five years of service. Keith has made a valuable contribution and will be missed. We would like to thank Keith for his wisdom and expertise and the contribution he has made especially in the areas of finance, audit and risk. On behalf of the Board we wish Keith the very best in his future endeavours. Again, to each and every one of you, a huge thank you. When the pandemic is over, you will be able to look back on these times and know you have achieved something of real historical significance, both individually and collectively, that will be remembered for decades to come, or like the Spanish flu, for centuries to come. Trevor Danos AM Board Chair Northern Sydney Local Health District Professor Mary Chiarella AM Deputy Board Chair Northern Sydney Local Health District

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Chief Executive Deb Willcox with Virtual Hospital staff Deborah Cage and Julie Aspinall

virtual hospital caring for community Weeks before patients with COVID-19 began to fill hospital beds, Northern Sydney Local Health District’s

Acting general manager Jessica Drysdale (who has since taken up a new role) said every day the team of nurses and doctors were making up to 200 welfare calls to patients who were managing COVID-19 in their homes. “We have over 40,000 active cases in the local health district. Some are moderate to severe cases, others are low risk and able to self- manage at home,” she said. The sheer number of patients it now cares for was unimaginable last year, but the staff at the hospital have been able to scale up their operations and find new

ways to care for the rise. Jessica said an external company assists with some of the welfare checks and a new ambulance pathway has been established, helping people to stay at home rather than come via ambulance to emergency department, if they don’t need to. “The staff have had to adjust to so many changes. Some of those changes have happened at short notice and over New Year’s Day, Christmas Day and Boxing Day,” she said. “We are really praying we are at the peak and it will taper off.”

Virtual Hospital was caring for hundreds of people in the community as the Omicron outbreak took hold. Rapidly, the team had thousands of patients under its care, some with severe illness while others were able to self-manage at home. The rise in cases came at a time when the already exhausted team was looking forward to a break, like many healthcare workers, who had been at the forefront of the Delta outbreak last year.

covid-19 vaccination program kicks off for young kids Children as young as five are rolling up their sleeves and putting on a brave face to get vaccinated against their children to be protected when they start school. Eight-year-old Eva (pictured on the front cover) bravely

Brown said staff worked over the Christmas and holiday season to keep up with the

vaccination program. “The five to 11 year old

coronavirus at Hornsby. About 130 children a day are coming to the Hornsby Vaccination Centre to get the jab to help protect them against serious illness from COVID-19. The centre started vaccinating children aged between five and 11 years old on January 10, and has seen bookings fill into the middle of February with demand high from parents wanting

had her vaccination and while it hurt a little, she encouraged her friends not to be scared. “It hurt a little… like a pinch,” she said. Nurses have been handing out stickers and lollipops to the children who have joined their older siblings and parents being vaccinated against the virus. Nurse Unit Manager Alison

bookings opened on the 10th (Jan) and we have been fully booked since,” she said. “Some of the nurses haven’t worked with (vaccinating) kids before but they are really enjoying it.” To book your child in for a vaccination or to book your booster, visit https://covid- vaccine.healthdirect.gov.au/ booking/

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Staff from the COVID-19 testing clinic at RNSH

festive season sees nslhd testing clinics ramp up Christmas and New Year

to the occasion,” she said. “Everyone worked extra hours just to get through the line, and that was after we had to tell people they couldn’t join the queue even though the clinic was still open – we just couldn’t get to everyone. “We also had to cater for vulnerable people in the community who couldn’t get to a clinic for a test – which ramped up a lot, especially with nursing homes and disability homes.” Karen joined the COVID-19 response team in July 2020 from her role as a nurse unit manager in the emergency department at Royal North Shore Hospital. “It has been so different from what I normally do in ED,” she said. “The biggest challenge is managing the fluctuating staff needs and levels

depending on the demand and needs of the community” The introduction of rapid antigen tests (RAT) earlier this year has taken some of the pressure off staff with a triage screening model of care now in place. “We can now screen patients according to NSW Health guidelines and decide what particular test would be most appropriate for them – whether that be a PCR or RAT,” Karen said. While the last few months haven’t been easy, Karen said it was a collective effort to come out the other side stronger. “We have such amazing staff – the administration staff, the cleaners and nurses,” she said. “It has made me really proud to be a part of such a wonderfully diverse and dedicated team.”

saw huge queues, extensive waiting times and extended clinic hours for our staff at COVID-19 swabbing clinics across the district. From November to December last year the number of people coming forward for PCR tests more than tripled. Almost 78,000 tests were undertaken across the five Northern Sydney Local Health District testing clinics during December, compared to just over 23,200 the month before. Workforce COVID-19 Response Team Nurse Manager Karen Steenbergen said it was an incredibly busy time for staff trying to swab as many people as possible – with staff at Royal North Shore even swabbing until midnight one night. “Staff were shaken but not stirred – they really pulled together and absolutely rose

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medical graduate interns join nslhd Northern Sydney Local Health District has welcomed

105 new medical graduate interns who joined the ranks of more than 1,000 new interns into the NSW Health system this year. The medical graduates, who have recently completed their medical degree, will now embark on a supervised year of practice and begin their journey to become medical practitioners. The new doctors have started their orientation and will be entering a training program that will also be networked with other hospitals throughout the state where they will be provided on-the- job education, training and vocational support. They will rotate between metropolitan, regional and rural hospitals to ensure the diversity of their experience and join different units in each hospital, including surgery and emergency medicine.

Some of the new interns starting at RNSH with CE Deb Willcox and Clinical Associate Professor John Vassiliadis

Some of the interns from Royal North Shore Hospital were welcomed last week by NSW Premier Dominic Perrottet, NSW Health Minister Brad Hazzard and Chief Health Officer Dr Kerry Chant. Northern Sydney Local Health District Chief Executive, Deb Willcox said it was so great to see the

next generation of medical professionals. “It was so wonderful meeting these bright enthusiastic interns who are so eager to learn and contribute to the public health system,” she said. “I wish them all the very best for a long and rewarding career providing high-quality care to our community.”

RNSH Pathology Team - Processing Tests Around the Clock The NSW Health Pathology team at Royal North Shore Hospital have been working around the clock to deliver PCR test results to the thousands of people who lined up for a test over Christmas and New Year due to the Omicron COVID-19 wave. staff members missing out on leave to fulfil the PCR testing demands. Diseases said that on top of processing thousands of tests, the pathology team also worked hard to prioritise inpatients, outpatients and result”, he said. Dr Bernie Hudson, Director of Microbiology and Infectious

“The team would often show up to work and see the ever- growing long line of people waiting to get tested and feel the pressure to process the tests as quickly as possible,” he said. “It’s the second year in a row the team couldn’t go on leave and celebrate the festive season. “There was enormous pressure on everyone to get through the tests.” Despite this, Alex and his team maintained an uplifting spirit about the team’s approach to testing. “The team never forget that although the sample is issued a lab number to track it through the system, they always know there’s a name behind it who requires a

staff to ensure the health system remained stable. This made it a challenging task to promptly provide results to the general population with many people needing a negative PCR test result to enter certain states. Only so many slots were available to be processed in one go, which caused unavoidable delays. “Unfortunately there were problems because people were needing a PCR test to get into states like Queensland, which ultimately put a lot of strain on the system, especially in our LHD,” he said.

The microbiology laboratory processed close to 82,500 COVID-19 PCR samples from 1 December 2021 until 20 January 2022. This was 25 per cent more samples than a comparable period during the height of the Delta outbreak. The recent outbreak caps off the tumultuous couple of years the RNSH pathology team has gone through due to COVID-19. Senior Hospital Scientist and Team Leader of Molecular Biology Alex Carrera, said the strain put on the team has led to many

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australia day honours The recipients of the 2022 Australia Day Honours were announced on 26 January, and a number of NSLHD staff have been recognised for the top honours. Chief Executive Deb Willcox said being awarded an Australia Day Honour is a real tribute to hard work, dedication and commitment to making a real difference in our community. “The awards recognise outstanding service and contribution to the community,” she said. “A huge congratulations to all of the recipients who we are proud to say are part of Northern Sydney Local Health District.” Clinical Professor Catherine Birman OAM

Clinical Professor Catherine Birman has received an OAM (Order of Australia Medal) for her service to medicine through otolaryngology. Catherine is a VMO at Hornsby Hospital and is Head of the ENT Department. She is a pioneer in the field of cochlear implants, and is the Medical Director for the Cochlear Implant Program at the Sydney Cochlear Implant Centre. She has performed well over 1500 cochlear implant procedures.

Susan Day OAM Susan Day has received an OAM for her service to the community through a range of organisations. When she isn’t working as the NSLHD Stroke Coordinator, she works for local scouts, soccer clubs and schools. Susan is also on the RNSH Arts and Heritage Committee and has been instrumental in developing and coordinating the annual Christmas music festival. She has been a huge advocate for positive change to reduce the impact of waste at RNSH. Professor Helge Rasmussen OAM

Professor Helge Rasmussen has received an OAM for his outstanding service to medicine as a cardiologist. Helge has had a distinguished career as a cardiologist at Royal North Shore Hospital and North Shore Private. He has served as a professor and teacher at the University of Sydney and has had an internationally-respected research career spanning four decades at RNSH and Northwestern University, Chicago, USA. He is also the Head of the Cardiac Membrane Biology Laboratory at the Kolling Institute.

Associate Professor Dr Geoffrey Herkes AM Dr Geoffrey Herkes has been awarded an AM (Member of the Order) for his significant service to medicine as a neurologist, to medical research, and to professional associations. Geoffrey is a senior staff specialist at RNSH and is a director of research at Adventist HealthCare. His work in the medical field has also included chairing multiple committees for the Therapeutic Goods Administration.

Clinical Associate Professor Saxon Smith AM Clinical Associate Professor Saxon Smith has received an AM for his significant service to medicine as a dermatologist and researcher, and to professional societies. Saxon is a former NSLHD Board member and is a staff specialist dermatologist at RNSH.

Associate Professor Graeme Morgan AM Dr Graeme Morgan has received an AM for his significant service to medicine through radiation oncology practice and research. Graeme’s work in the field has spanned more than four decades and has included serving as a director and staff specialist in radiation oncology, including at RNSH. He has also had leading positions at the Royal Australian and New Zealand College of Radiologists and the Department of Health.

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Dr Daniel Nour at an event in Canberra

young australian of the year goes to rnsh doctor Royal North Shore Hospital doctor Daniel Nour has been named Young Australian of the Year for 2022. detecting conditions that may have otherwise gone unnoticed.

deep kindness and leadership is incredibly inspiring,” she said. “A huge congratulations Daniel – we are all so proud of you and cannot wait to see what the future holds for you and Street Side Medics.” Earlier this year Daniel gave the Australia Day address - the youngest speaker to ever deliver the national address. You can watch it here: https:// bit.ly/35mopep To find out more or volunteer with Street Side Medics, visit https://www.streetsidemedics. com.au/

In accepting his award Daniel said: “As Australians, it’s our responsibility to advocate for those who seem to have lost their voice and to rise up to the occasion, even when we question our own ability to do so.” Deb said this is a true testament to Daniel’s strong commitment to making a real difference to the lives of so many Australians experiencing homelessness. “His strong social conscience,

In 2020 Daniel founded Street Side Medics – a not-for-profit, GP-led mobile medical service for people across NSW experiencing homelessness. The free service operates from a van fitted with the necessary equipment to provide primary healthcare services to homeless communities across multiple locations. Chief Executive Deb Willcox said Daniel is so deserving of this award for his work delivering medical support to people experiencing homelessness. Over the last two years Street Side Medics has grown to a team of 250 volunteers across four clinics in New South Wales. The service aims to alleviate the barriers limiting access to healthcare by treating people with neglected medical needs and

Dr Daniel Nour delivering the Australia Day address

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Some of the PHITH team members caring for infants, children and young people with COVID-19

PAEDIATRIC HOSPITAL IN THE HOME MANAGING COVID-19 The Paediatric Hospital in the Home (PHITH) teams at Royal North Shore and Hornsby hospitals have had a very busy couple of years. The teams have been dealing a set of challenges for the teams. Like many healthcare workers, team members spent the festive season caring for those in the community with the virus. To ensure they were able to take

the ever-changing rules in regards to testing and isolation,” she said. Another looming challenge is the predicted increase of COVID-19 cases as schools return from holidays. Carola said the PHITH teams will continue to take a flexible approach to deal with the higher number of patients. “The teams have demonstrated great flexibility and have readily adapted to changing care needs of families in our community,” she said. “Our teams remain determined to continue serving the community and remain optimistic about the road ahead. “It is privilege to be a part of a great team who works collaboratively and cohesively to provide a service with such excellent continuity and quality of care to families in our community.”

with the large numbers of COVID-19 positive children in the community. Up until the end of January, a total of 404 infants, children and young people were cared for between the two teams. Royal North Shore Hospital’s Head of Department of Paediatrics, Dr Carola Wittekind said the care involves a large volume of daily calls for medical and welfare checks whilst the patients are isolating after testing positive for COVID-19. “Admissions to PHITH followed COVID-19 outbreaks in our LHD over the past almost two years and also reflect changes to admission

some time off to recharge, the team worked together to rotate and ensure they all had a break. ”All core members of the PHITH teams have been able to take leave and recharge while senior nursing colleagues from the ward stepped into their role and gained valuable experience working with greater autonomy while supported by senior medical staff,” Carola said. On top of managing the sheer volume of patients, there are also challenges around communicating to the families of the younger patients. “There has been some difficulties contacting some families and communicating

criteria based on ACI guidelines,” she said.

Whilst the service has been essential, it has come with

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rnsh nurse tells her story of fighting for a future Behind nurse Shabnam

Ighani’s smile lies a story of a determined woman who not only escaped an emotionally abusive marriage, but who crossed international borders and escaped prison with her two young sons to live a better life in Australia. After overcoming her own adversities, now the mother- of-two works at Royal North Shore Hospital’s in the renal/ urology and vascular ward to bubbly personality masks the depression and sadness that once filled her life after years of persecution in her native Iran, trapped in an unhappy marriage. Living in Iran in 1979 during the revolution, Shabnam found herself an outsider as the new Islamic government persecuted her family for being of Baha’i faith. A relatively new religion founded in the 19th century in Iran, the Baha’i faith believe in unity of all people. As the Iranian revolution took hold, Shabnam and other save the lives of others. Shabnam’s bright and Baha’i followers were locked out of studying at university, found family and friends shunned them, and they faced persecution for their religion. Aged in her late 20s, with her sons aged four and nine in tow, she made the harrowing attempt to cross the Turkish border thorough the mountains with the help of smugglers, only to be captured by authorities and imprisoned in Iran. Undeterred, Shabnam made the journey again with her sons after being released from prison – and she hasn’t looked back.

Shabnam Ighani

Detailing her escape from Iran, Shabnam has penned a memoir Fighting for Future: Trapped behind the Border which shows the incredible determination the mother had to make a better life in Australia. “I knew no one other than my brother who was already living here in Australia. I had nowhere to live, I didn’t speak English and I didn’t know what I was going to do,” she said. “It has taken me 20 years to write this book and tell my story. It was very hard to start to write my story.” Living on her own in Sydney in 1997, raising two young boys, Shabnam enrolled to be a nurse while also studying English. She is now a clinical

nurse specialist at RNSH and her past has been hidden from many of her colleagues, until now. Suffering from depression for many years, Shabnam formulated 10 self-help rules which she still lives by now to help her get through the tough times. “I want other people to know that it is okay to feel depressed. You shouldn’t feel ashamed and you are not alone,” she said. “It (domestic violence) is nothing to feel ashamed of and I want people to know it’s not their fault.” To find a copy of Shabnam’s book, visit her website www. shabnamighani.com

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NSLHD LAUNCHES NEW CONCUSSION CLINIC It has been the hot-button issue across a number of sports for a number of years, and now Royal North Shore Hospital is launching a first of its kind clinic for concussion. The clinic will operate

weekly for young adults and paediatric patients and will aim to educate and rehabilitate patients who have been diagnosed with concussion in one of Northern Sydney Local Health District’s emergency departments but still have ongoing symptoms 10 days on from the initial injury. Concussion Clinical Nurse Specialist at RNSH Vicki Evans (Roach) AM said the new clinic would aim to not just improve symptoms, but also help patients understand concussion and prevent longer term complications. “It is really important to understand the potential ramifications that could occur if a concussion is not taken seriously,” she said. “Symptoms of a concussion should resolve within seven to ten days, but this multidisciplinary clinic will see patients who are still experiencing symptoms after 10 days.” The multidisciplinary clinic, composed of adult and paediatric neurologists, clinical nurse specialist and a neuropsychologist, will take a holistic approach, reviewing patients’ cognitive function, psychological wellbeing and associated post-concussive symptoms. Depending on the outcome they may recommend various lifestyle modifications and suggest appropriate referral pathways to ensure optimal recovery and an efficient return to productivity. One of those patients that

(Left to right): Neuropsychologist Vince Oxenham, Clinical Nurse Specialist Vicki Evans (Roach) AM, Paediatric Neurologist Dr Gary Browne, Neurologist Dr Miriam Priglinger-Coorey

could have benefited from such an initiative, is Jack Winchester, 18, a state and national water polo player who suffered four concussions within a year, the last one in March 2021. “Water polo is such a big part of my life, so having to take nearly a year off playing due to multiple concussions was really tough and took a big toll on my mental health,” Jack said. “After my first concussion I didn’t take the time to recover properly. Following my second concussion, I saw a concussion physio and that’s when I learnt how important it is to listen and follow the concussion protocol otherwise it can delay your recovery.” Vicki said feedback from concussed patients and their parents and carers before the clinic, was a lack of understanding and certainty as to when it was safe to resume regular activities like return to school and sport. “It was important for them to understand the mood disorders that often accompany lingering concussions and which are sometimes downplayed or not well recognised when managing patients with this type of head injury,” she said. “Sitting out one game is much better than missing the

whole season. “We are not the ‘fun police’ – we want people to play sport, but respect the rules and sportsmanship of the game, use helmets and mouth guards, strengthen your neck muscles, warm up before the game, practice drills, report the injury, and look out for your mates too. “Don’t ignore or hide it – getting a second concussion on top of one that has not been resolved will make things worse, which is why we established this clinic: to ensure people get the advice they need and cut through all the conflicting information they may receive. “It’s also important to remember concussions can happen anywhere – not just in sport.” The clinic will treat school- aged children under 16 as part of a paediatric clinic who obtain their concussion through any method, while an under 25’s clinic will operate for those who have a sports-related concussion. The patient must have been seen in one of the NSLHD’s emergency departments and diagnosed with concussion. If symptoms persevere for greater than 10 days from initial injury, a general practitioner will be able to refer the patient to the concussion clinic.

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NSW Health email is moving to the cloud Over the coming weeks you will hear a lot about ‘the cloud’ or ‘moving to the cloud’ as eHealth NSW begins an enhancement of NSW Health ICT systems. In its simplest terms, ‘moving to the cloud’ is another move to cloud-based systems,” he said. “It is far superior technology and most importantly it’s highly secure, providing added protection for confidential information sent over our networks. “Microsoft is an industry leader in cloud-based

way of saying ‘moving off- campus.’ In a cloud-based system, data is hosted and managed off site in high security data centres and accessed via an internet connection. From early February eHealth NSW will move NSLHD staff email to Microsoft’s cloud- based email platform, called Microsoft Exchange. This is part of a wider NSW Health initiative to enhance and improve our critical health system infrastructure. Michael Bogiatzis, Program Director at eHealth NSW said cloud-based systems are the future of computing. “The industry is tipped to grow significantly this decade as more and more businesses, government agencies and individuals Professor Mary Chiarella AM who has been appointed to the Australian Health Ethics Committee (AHEC). The committee is part of the National Health and Medical Research Council (NHMRC) - the peak medical ethics body in the country and advises on ethical issues in health and on the development of health

solutions and moving email to the cloud on computers and devices will help staff work and collaborate more securely, wherever they are.” Once the emails have been successfully migrated to the cloud, staff will see no visible difference to their email. They will still be able to send and receive email in the same way, the look and feel will remain the same and they will continue have normal access to their calendar. The email migration will happen automatically on desktop computers and staff will not need to do anything. However, staff using emails on mobile or tablet devices, will need to self-migrate committee draws on expertise in philosophy, the ethics of medical research, public health and social science research, clinical medical practice and nursing, disability, law, religion and health consumer issues. NSLHD Board Chair Trevor Danos AM said: “This is a huge honour and I know Mary will make a valuable contribution in this role.”

these devices using step- by-step instructions which eHealth will send by email before the migration occurs. Northern Sydney Local Health District’s migration begins on Wednesday 2 February 2022.

For further information please email EHNSW- EmailToCloud@health.nsw. gov.au NSLHD deputy chair JOINS AUSTRALIAN HEALTH ETHICS COMMITTEE Congratulations to NSLHD Board Deputy Chair

Professor Mary Chiarella AM

research guidelines. Membership of this

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AGGRESSION IS NEVER OK

We are here to help you. Let’s work together to help stop the spread of COVID-19.

For the latest information on COVID-19 visit nsw.gov.au/covid-19

© NSW Health July 2021. SHPN (SHEOC) 210681

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