NSLHD News 30 January 2024


Main story RNSH oncologist named Australian of the year Professor Georgina Long AO was named a joint winner of the award. Page 7 Short blurb Read more on Page x

Bad knees might cause broken hearts Page 11

Outstanding stroke treatment Page 4


Message from the chief executive

Adjunct Professor Anthony M. Schembri AM

As we step into the new year, I extend a warm welcome to all our new starters and offer my best wishes for the year ahead to each and every one of you. I also want to express my sincere thanks to those who worked over the holiday periods ensuring we continued to provide high- quality healthcare to our community. Your commitment to our patients and the smooth operation of our healthcare system during the holiday season is very much appreciated. Looking ahead we have a full and exciting year of initiatives and priorities I would like to share just some of them with you. Firstly, our Ryde Hospital redevelopment is progressing at pace and in an exciting development, works are being fast-tracked and we expect to deliver the new hospital to our staff and patients and community nearly two years earlier than originally planned. Due to the complexity of the project, this will mean the potential for some disruption and I want to thank all our colleagues, consumers and partner organisations for their time and attention on the Ryde redevelopment. Another focus for us continues to be our work in planetary health and working towards our goals for net zero emissions. Thank you to everyone who has provided their feedback on our revised planetary health framework which will be launched shortly. Our new clinical service plan will also be launched in the coming months following final rounds of consumer, patient and staff consultation. Much work has gone into our new clinical service plan and I look forward to its launch and implementation. I also look forward to the work of the district’s Artificial Intelligence Council which is being established to ensure our district is using this incredibly exciting, but challenging technology in a safe, effective

and ethical way.

I am also excited to see our contribution to the rollout of the Single Digital Patient Record which will see a next-generation integrated electronic medical record, laboratory information management system and patient administration system for our clinicians that is scheduled to be delivered in the next few years. Our ambitions to grow our research and academic partnerships will also be a key focus for us this year especially as we work towards realising our ambition for clinical trials expansion and ensuring trials as therapy are core to our health service delivery. I want to acknowledge all the great work underway to develop our capability and capacity for clinical trials and once again acknowledge Kay Van Norton and Greg Poche for their inspirational gift of $20 million. Our Diversity, Inclusion and Belonging program continues to go from strength to strength and we will have some exciting initiatives to share with you in the year ahead about our work to ensure our health service is one where everyone feels welcomed and safe. As we embark on the year ahead let us remember the impact, we all make in the lives of our patients, clients and their carers. Each member of our team contributes uniquely to the compassionate care we deliver, and together, we create a safe healing environment that goes beyond just the clinical expertise. Thank you for all that you do for our patients and clients and thank you for all that you do for each other. Here is to a successful and fulfilling year ahead.

Adjunct Professor Anthony M. Schembri AM Chief Executive Northern Sydney Local Health District



NSW Deputy Secretary Deb Willcox, Heidi Roland Kenn, Jessica Ly, Lisa Woodland

NSLHD and Cancer Institute win 2023 Multicultural Health Communication Award. NSLHD recently received the 2023 NSW Multicultural Health Communication “Transforming the patient experience” Award for their project: Nourishing Our CALD Head and Neck and Gastrointestinal Cancer Patients, North Sydney Local Health District. This project was proudly funded by the Cancer Institute. Using a co-design approach with consumers and volunteer groups, the team developed culturally and language appropriate diet, nutrition, and speech-related resources for head and neck, oesophageal, and upper-GI cancer patients. The project exemplifies the power of strong partnerships in driving tangible change. Cancer Innovation and Strategy Manager, Heidi Roland Kenn, and Multicultural Health Service Manager, Cathy Butler, supported speech, diet and nursing staff to develop comprehensive materials to support cancer patients across NSW. The team translated materials into Mandarin, Cantonese, and Korean, recognising the importance of tailoring resources to diverse communities. All materials are available on the NSLHD Cancer Centre webpage. “We applied for a Cancer Institute grant two years ago when cancer nurse coordinators indicated we had a gap in our resources which needed to be accessible and culturally appropriate. It was a huge piece of work and fantastic for the team to be recognised,” said Heidi. Looking ahead, Heidi highlighted the ongoing commitment to expanding these efforts to more communities in the future. “We have more work to do with other communities and we want to involve more in future. It’s an excellent example of multi-institutional teamwork, persistence and involving the right people. We have really created something beautiful,” she said.



The students with RNSH staff outside the emergency department

Support class from Chatswood High visits RNSH A support class from Chatswood High School recently visited Royal North Shore Hospital

The hospital therapy dog Vinnie also visited the students. Before they met with some NSW Ambulance staff members and were able to experience sitting on an ambulance stretcher and entered the vehicle which helped to alleviate any fears. They were also taken on a tour to see what happens behind the scenes of the hospital. They visited the linen store, kitchen and loading dock. The last stop was the Ambulatory Care Centre (ACC) which houses all of the hospital’s outpatient clinics. The students also received t-shirts to take home from the NSLHD Aboriginal and Torres Strait Islander Health Service. RNSH ED Clinical Nurse Consultant Alison Partyka said the staff were grateful to have the students come and visit. “The RNSH staff had a lovely morning, and we felt the students did too,” she said. “We hope to have made a difference in the lives of these wonderful young people.” the emergency department, radiology, interventional neuroradiology, ICU, neurology,” she said. “We also have good executive support.” Sheila said as the service sees a lot of patients, staff in various departments have developed good skills. Aside from impressive clinical care indicators, the audit also found that 100 per cent of patients in RNSH received education about changing lifestyles, taking medication for high blood pressure and cholesterol, and various treatments that can help prevent another stroke. Sheila said the unit followed existing protocols and guidelines and was always working hard to make sure they were responding well to patients. “We’re all so happy with the results of the audit,” she said. The Stroke Foundation audit has been used to benchmark and provide feedback to clinicians and stroke care services in Australia since 2007.

as part of a valuable Life Skills Program. The class was made up of 11 students from years 10-12 who participate in a Life Skills Program. The program provides options for students with a disability. The curriculum is project-based learning encompassing a range of the topics and children are encouraged to be independent and acquire skills they need after leaving school. The topic for the students this term was based on learning about their health and the visit aimed to help alleviate any fears or preconceived ideas the students may have had about a hospital. During their visit the students toured the emergency department and met with a range of nursing and medical staff. The students wrote questions at school prior to their arrival for clinicians at the hospital to answer during their visit. Outstanding stroke treatment A 2023 national audit by the Stroke Foundation has found Royal North Shore Hospital’s stroke service is a beacon of excellence when compared to peer hospitals across the country. RNSH surpassed national standards and excelled across nearly all benchmarks. For example, an impressive 86 per cent of stroke patients received clot-busting therapy within the critical “golden hour” upon arrival at the hospital. This remarkable figure stands in contrast to the national average of 29 per cent and exceeds the national benchmark of 66 per cent. The findings were one of many underscoring RNSH’s commitment to providing swift and effective stroke care. RNSH Stroke Clinical Nurse Consultant Sheila Jala attributes the success of the service to the dedicated staff. “We have committed clinicians in the hospital, and everybody collaborates—



Professor Margaret Schnitzler recognised for leadership When Professor Margaret Schnitzler started her medical career 40 years ago, she couldn’t

of talented female registrars who start their careers at the district to become senior leaders is a priority for Margaret who has recently been appointed as the first female Professor of Surgery at the University of Sydney. Approximately 50 per cent of new medical graduates each year are female, but many don’t go on to hold senior positions within their chosen medical fields, for reasons Margert and her colleagues are trying to change. “You should do what you like. No one knows what is ahead in life,’’ she said. “I always encourage people to pursue their passion and look at the possibilities not the obstacles that could crop up. There is so much more flexibility in the workplace now.”

have imagined she would go on to be considered by others as a “trailblazer.” While carving out a successful career herself, she is surprised and disappointed that today, there is still an under representation of women in senior medical leadership positions despite the wealth of talented women in medicine. As chair of the NSLHD Advancing Women in Medical Leadership working group, Margaret is working with other senior leaders to change the status quo and celebrate women in medical leadership. Margaret was recently awarded the Royal Australian and New Zealand College of Surgeons NSW State Committee 2023 Women in Leadership Medal for Leadership

in the field of surgery, and in promoting and achieving equality. She said progress in increasing women in senior positions is slow. “When we look at gender balance in senior medical staff (in the district), we now have two years of data. There hasn’t been a significant increase in the proportion of female staff in that time – less than 1.5% per cent,” she said. “In surgery, there is 84 per cent men and 16 per cent women.” When Margaret became a surgical trainee in 1987, she was only the second general surgery registrar Royal North Shore Hospital. She went on to become the first female general surgeon appointed to the staff in Northern Sydney Local Health District and holds the title of being the first female colorectal surgeon in Australia. “To me, I have just been doing my own business. I have never considered myself a trailblazer,” Margaret said. Tapping into the pool

Professor Margaret Schnitzler



NSLHD Clinical Director of Nuclear Medicine Professor Paul Roach

Australia day honour for clinical director NSLHD Clinical Director of Nuclear Medicine Professor Paul Roach has been named a member of the Order of Australia (AM) for his significant service to nuclear medicine and medical research. Paul has been the Head of Nuclear Medicine and Positron Emission Tomography at Royal North Shore Hospital for more than 20 years - a service which is now regarded as one of Australia’s leading nuclear medicine centres. During this time, Paul has made a significant contribution to imaging, cancer diagnosis and management. He has juggled clinical and research responsibilities in addition to government and advocacy roles. He is a Clinical Professor at the University of Sydney and has published over 120 peer- reviewed papers. Paul welcomed the Australia Day award saying it was a great honour. “I am proud of what has been achieved over the years, not only at Royal North Shore Hospital, but also for the specialty of nuclear medicine at a national level,” he said. “Nuclear medicine is expanding significantly in Australia, particularly for patients with cancer, and it is satisfying to know that I have played a part in helping to facilitate that. “I have been fortunate to work with a great team at Royal North Shore Hospital as well as with many collaborators and other eminent medical professionals and colleagues both nationally and internationally.”

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Professor Georgina Long AO and her colleague, Professor Richard Scolyer AO

NSLHD clinicians acknowledged for COVID-19 response Northern Sydney Local Health District staff were recognised in this year’s Australia Day Honours for their contribution to the health’s response to COVID-19. Four staff received a Public Service Medal (PSM) in the COVID-19 honours which is a dedicated category of the Australia Day Honours to recognise health workers across the country for their incredible efforts in caring for the community during the pandemic. The NSLHD recipients were: Diane Elfleet, Royal North Shore Hospital Rachel Marlow, Ryde Hospital Initiated by his colleague Georgina, the idea was to apply the knowledge gained from melanoma research to assist her colleague. Richard became the inaugural recipient of pre- surgery combination immunotherapy for brain cancer. This marks an incredible breakthrough in brain cancer treatment. Upon receiving the joint accolade, Georgina said the duo was honoured to receive the recognition and credited the supporting team for the honour. “Our thoughts are always with those families where our breakthrough treatments came too late,” she said. “With immunotherapy, we stimulate the immune system in a very specific way so that the immune system can see the enemy, that is the cancer, and kill it,” said Georgina upon receiving her award. They have both also been at the forefront of public education on sun-smart behaviour and skin cancer prevention. Their collaborative efforts extend beyond melanoma, more recently, they adapted this successful treatment to address brain cancer, prompted by Richard’s diagnosis of incurable grade four brain cancer in June 2023. This is a world-first treatment for brain cancer based on their melanoma breakthroughs. Australian of the Year Honours for RNSH Professor Georgina Long RNSH medical oncologist Professor Georgina Long AO and her colleague, Professor Richard Scolyer AO from NSW Health Pathology and Sydney Local Health District, were jointly named the 2024 Australians of the Year. In a rare dual-win, this recognition was bestowed upon them for their significant contributions to melanoma research. The co-directors of the Melanoma Institute of Australia have played a pivotal role in advancing the treatment of advanced melanoma through their work in immunotherapy. Less than a decade ago, advanced melanoma had a fatal prognosis. However, Georgina and Richard’s immunotherapy approach, which activates the patient’s immune system, has shifted the narrative, making the disease curable for over 50 per cent of patients and saving thousands of lives.

Emma Tan, Allied Health Directorate, NSLHD Wenche Kverneland (formerly Hornsby Hospital)

A special congratulations to fellow NSW Health colleagues who also received a public service medal, Wendy Hoey (Chief Executive of Justice Health); Jacqui Cross (Chief Nursing and Midwifery Officer, NSW Health); Graeme Loy ( Chief Executive Western Sydney Local Health District) and Lorna McNamara ( Executive Director of PARVAN, NSW Health)



Physiotherapist Jason Levy

Virtual physiotherapy treatment When Rhonda’s bad fall led her to the emergency department at Royal North Shore Hospital, she underwent a full hip replacement and spent six days recovering. On the afternoon of her discharge, she received an SMS telling her she had her first virtual physiotherapy appointment at 10 a.m. the next day.

environment.” Jason added that virtual physiotherapy also allows the service to reach people who have issues getting to a clinic. He is used to people being confused about him being a “hands-off” physiotherapist. “When I say to people, I’m a virtual physiotherapist, they are like, ‘How does that work?’” Across the board, NSLHD clinics are increasingly using virtual care to look after patients in their homes —whether it be on the phone or via video. Patients like Rhonda report a raft of positive experiences with virtual care. A 2022/2023 district-wide survey found an approval rating of over 95 per cent. Respondents report a range of benefits, including convenience (73%), saving time (63%) and ease of own surroundings (47%). The district is aiming to have one in three non-admitted patients treated virtually.

Rhonda said she was happy to be treated at home. “I didn’t want to go to a hospital again,” she said. She had six online sessions via her mobile phone with Jason Levy, a physiotherapist with the Northern Sydney Local Healthcare District’s Virtual Care Service (NS VCS), which supports people needing urgent and acute care at home. During her treatment period, Rhonda was sent exercises each week, and Jason would check if she was doing them correctly. Jason said seeing a patient in their home — even if it is via a screen — gives him a holistic perspective. “You can see them in their best

SPREAD THE GOOD NEWS Share your news and achievements. Contact the Media and Communications team on 9463 1722 or email NSLHD-media@health.nsw.gov.au to submit your news.



Doctor and javelin star 2024 is a big year for Mackenzie Little. She is starting her first year as a full-time doctor at Royal North Shore Hospital and will also be competing in the women’s javelin at the Paris 2024 Summer Olympics. Currently ranked second in the world in her sport, the unassuming new doctor downplays her remarkable achievements. “I am certainly not unique in juggling a lot of things,” she said. Juggling medical studies and training, Mackenzie made her mark in 2021 at the Tokyo Olympics, secured silver at the 2022 Commonwealth Games in Birmingham, and claimed bronze at the 2023 World Championships in Budapest.

a desk. I’m just excited to run around and get the job done.” Mackenzie is aware of the challenges ahead in her first year as a doctor and anticipates a “balancing act”. “I think it will be a really difficult year,” she said. “Some might try to guess what my priorities are, but I’ve always wanted to medicine, and that’s going to be my career long-term.” “We hope to have made a difference in the lives of these wonderful young people.”

Her schedule at times has been gruelling. Last year, she flew to Europe five times to compete, with four of those for weekend competitions. “I’d leave late Thursday night, go to Europe, compete on the Saturday and fly back in Monday morning, and then go straight on the train to the hospital.” The star athlete fell into javelin by accident. She started out competing in the under sixes Little Athletics and became a hurdler like her mother. But one day in year seven at Pymble Ladies College, when hurdles were called off due to rain, she joined javelin training. The coach invited her back. “I gave it a go because the opportunity was there and I was naturally able to throw it,” said Mackenzie. But alongside her love of sport, as the daughter of doctors, she said she has always been science oriented. “I really like working with people and certainly couldn’t sit at

Mackenzie Little has a big year ahead



NSHLD Welcomes Newest Intake of Intern Doctors The Northern Sydney Local Health District (NSHLD) is pleased to announce the arrival of 90 new intern doctors, marking the

commencement of their medical careers. Last week, the interns participated in orientation, including a morning tea where they got to know each other and addressed some questions. These interns will undergo a supervised year of practice, rotating through metropolitan, regional, and rural hospitals. They will receive on-the-job education, training, and vocational support, spanning two years to become independent practitioners. Noteworthy among the interns is Nikhil Autar, a nominee for Young Australian of the Year in New South Wales, adding intern Doctor to his list of achievements. “Medicine called to me through the lens of science, a path I started on. What captivated me was not just the health aspect, but the joy of helping people.” Intern, Otto Gulliver. “This opportunity is exciting; I was drawn to this role as I want to establish and create some change. We are lucky that we have a supportive health district,” Intern Sheridan Beaumont. The NSHLD looks forward to the contributions of these interns as they begin their medical frailty in the ageing Australian population, the outdoor gym, which is supervised by physiotherapists, is transforming rehabilitation programs and enhancing community well- being. Emphasising the crucial role of targeted exercise programs, including strengthening and balance activities, the initiative aims to prevent falls and reduce frailty-related health risks. The goal is for patients to gain confidence and motivation, continuing their exercise routines upon program completion. Lorna, an 86-year-old with severe arthritis, has been using the gym and improved her balance. “I really enjoy coming to the Fresh Air Fitness Classes in the Outdoor Seniors Gym. They are fun but challenging, and I love being outdoors.” She said. Physiotherapist Tina Shimeld has observed positive changes in participants, citing Lorna’s infectious joy. “Lorna has been a very enthusiastic and energetic participant in the outdoor classes. Her positivity and joy are infectious,” she said.

Chief Executive Anthony Schembri welcomed some of the intern doctors at RNSH

Mona vale hospital unveils outdoor gym Mona Vale Hospital’s Outdoor Seniors Gym is offering a breath of fresh air to the community. Addressing the heightened risk of falls and

“She absolutely beams when she is outdoors and conquers challenging exercise tasks. She is very appreciative of the changes she has seen in her everyday life after attending the Fresh Air Fitness Classes.” The construction of the Outdoor Seniors Gym was made possible through a grant from the NSLHD and NORTH Foundation Grants Program.

Community members embracing the gym



Professor Chris Little and Dr Cindy Shu

Bad knees might cause broken hearts Exciting research is set to get underway

that there might be a biological connection where the joint disease might actually be causing heart disease. “Our team found that if we induced osteoarthritis in one knee of a mouse that was otherwise fit, young and healthy, within 16 weeks that mouse had evidence of heart disease.” The new research project funded through the NHMRC will now investigate which specific factors are contributing to the development of heart disease. “If we can define what factors are the most important, we may be able to help develop a new diagnostic tool for heart disease and potentially stop osteoarthritis contributing to cardiovascular disease,” Professor Little said. “Our research could lead to both a diagnostic test as well as a therapeutic target. It could change the health advice around risk factors for heart disease. “Our grant success highlights the breadth of expertise we have at the Kolling and the impact of collaboration, where we have researchers specialising in different fields coming together to identify new avenues to research. “It’s certainly one of the great things about working in the Kolling.”

investigating a ground-breaking approach to reduce osteoarthritis associated heart disease. Kolling Institute researcher Professor Chris Little will lead the project after receiving a highly competitive National Health and Medical Research Council Ideas grant of close to a million dollars. Chris Little and Dr Cindy Shu from the Raymond Purves Bone and Joint Research Lab will collaborate on the novel study with Kolling heart disease researcher Dr Anastasia Mihailidou and Professor Anthony Ashton from the Lankenau Institute for Medical Research in the USA. Chris has welcomed the significant funding, saying it followed years of specialised work in this field. “We’re very excited about this research and we’re hopeful it may make a big difference,” he said. “We have known about the link between osteoarthritis and heart disease for many years, with those experiencing osteoarthritis twice as likely to develop heart disease as those without the painful joint condition. “We had thought the conditions were linked because they shared the same risk factors like age, obesity and a lack of exercise, but our recent research has showed for the first time,



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