There is a gem in the Southern Highlands that provides life-altering support for seriously ill people.
And the team behind the invaluable service has jumped through hoops over the past 18 months to ensure no patient is left unsupported.
We have now passed well over a year since Australia was forced in to lockdown for the first time in March 2020 due to the COVD-19 pandemic.
A lot has happened since then - including several more lockdowns across the country.
People have re-evaluated the things they do and how they do them - simple greetings quickly spring to mind with the ever-popular handshake no longer suitable.
Businesses and other organisations such as emergency services and medical providers have also had to re-define the processes of operation.
The team at one of the Southern Highlands most invaluable life-saving services is especially overwhelmed and proudly emotional by what has been achieved over the past 18 months.
That team, at the Southern Highlands Cancer Centre within the Southern Highlands Private Hospital in Bowral, almost completely re-invented operational processes in an instant when the first COVID lockdown began in March 2020.
It is no surprise to one man who has been a driving force of the centre for more than 20 years.
Associate Professor Stephen Della-Fiorentina said the Southern Highlands Cancer Centre had been providing multidisciplinary high quality cancer care for more than 20 years.
"Meanwhile, there is a unique partnership with South West Sydney Cancer Services, where patients without private health insurance are able to receive chemotherapy closer to home fulfilling the vision of the centre of 'Cancer Care For All'," he said.
"Patients are able to access specialists in medical and radiation oncology, haematology and palliative care, in addition to nurse care co-ordinators and allied health professionals. A clinical trials unit also allows patients to access new medications aimed to improve cancer management."
Keeping patients safe
The pandemic and associated lockdowns had the potential to compromise a variety of inpatient and outpatient services offered within the centre including chemotherapy treatment and specialist consult appointments for medical, radiation and haematology services.
However, professor Della-Fiorentina said the cancer centre team quickly adopted telehealth for up to 40 per cent of all consultations "to keep our patients safe and also minimise travel time for them."
"We have continued this practice into 2021 for suitable patients," he said.
Private practice manager Naomi Bermingham said that the centre's professional health care team worked with a unified, thorough and well co-ordinated approach to instantaneously reassess the pathway to access services and establish new protocols to ensure continuity of care was safely maintained and no patient missed.
She said the ultimate goal was to ensure that no-one relying on the centre for its lifesaving treatment would have their treatment plan interrupted.
"There was also a concern new patient diagnosis would be delayed due to patients avoiding attending general practices, pathology and diagnostic clinics due to fear of exposure to COVID," she said.
"Our local pathology centres were amazing, offering times to our vulnerable patients to avoid contact with groups of people.
"The local pharmacies also partnered with us receiving faxed copies of prescriptions and then delivering medication direct to patients homes free of charge. This was an incredible assistance to patients so they didn't have to move about the community unnecessarily."
Ms Bermingham said it was equally essential to ensure that every patient, carer and staff member was protected from the possible harm of a new and potentially deadly virus.
However, the logistics of meeting these expectations were emotionally challenging, "more than anyone could have anticipated."
As Ms Bermingham explains the hurdles continued to unfold. She proudly adds that with every challenge her team found solutions.
Furthermore, not one patient missed out on their much-needed treatment and emergency support.
And that patient list was significant and greater than the previous year.
Patient numbers increased to the centre.
During period March 2019 to 2020 the outpatient consults equalled 3853. During period March 2020 to 2021 outpatient consults 5136.
Ms Bermingham points out that this was an increase of 33.3 per cent during the COVID year.
In the period from March 2019 to 2020 inpatient admissions were 4066. During period from March 2020 to 2021 inpatient admission 4176.
This equated to a 2.7 per cent increase during the COVID year of 2020.
Newly referred patients to the four medical specialties increased from 477 in 2019/20 to 594 in 2020/21, a 25 per cent increase.
Ms Bermingham emphasised the incredible outcomes of continued service could not have been possible without the wonderful support of the community, staff, and especially patients and their carers.
"At no point did we close the centre," she said.
"This was achieved by us contacting every single patient scheduled for admission or consult to discuss new safety measures including the fact that only patients would be permitted to the centre.
"While they had previously been able to be accompanied by loved ones and carers this was no longer the case, including a cessation of volunteers and Paws for Pet therapy which provide a wonderful service of support to our patients having treatment."
Ms Bermingham said this was an especially tough call to make as patients relied on that extra support from a loved one while they were undergoing treatment.
She added that it was as heartbreaking for the staff as it was for carers who had to dropped their sick loved ones at the hospital front door rather than sitting beside them during treatment.
The telephone triage process also aimed to identify any possible risks that could be posed by those with recent links to COVID hot spots.
Ms Bermingham said the intention was not to cancel any appointments, but rather to assess what risks could present themselves and how they could be managed.
"As it turned out there were over a dozen instances where patients or family members were return overseas travellers to areas that became known as COVID epicentres over the months that followed, including New York, Milan and the Ruby Princess," she said.
"The solution, if required, involved treatment provided in a private room with clinical staff protected with full PPE."
Ms Bermingham said during every single one of the triage phone calls "our patients were so open and honest about their recent activities."
"The patients trusted us to disclose their movements, including any overseas travel and potential exposure of whom they live with," she said.
"We reassured them at all times their treatment and access to services would continue.
"We had increased infection control policies and processes in place at Southern Highlands Private to manage patients in the event they were compromised, or at risk with exposure, to ensure there were no barriers to receiving their life saving treatments.
"Through their provision of accurate information we were able to safely care for everyone, with no adverse event to our specialists, nursing staff and administration team working together to coordinate timely delivery of our services.
"Our patients were so concerned about protecting other patients and our oncology team it was an inspirational partnership."
Ms Bermingham said that the movements of professionals, such as doctors, who had previously worked between several hospitals also required a new approach.
"In the height of the pandemic those professionals were restricted to physically work from one location to avoid the potential risk of spreading infection across multiple sites," she said.
"The introduction of tele-health consultations with patients residing in all areas throughout our Local Health District helped to ensure patients were reviewed on time and our waiting rooms remained empty."
Boosting protocols through latest lockdown
Ms Bermingham said that with the community once again facing the continuing challenges of COVID with the rise of cases with the Delta variant across NSW and locally, protocols had been boosted even further.
"Since July we have further increased our infection control protocols to ensure every patient is screened prior to outpatient and inpatient attendance for a COVID negative test, this includes all our doctors travelling to assist our patients and staff living out of area to access attendance at our facility," she said.
"We are incredibly grateful to be able to achieve this. We thank our patients, their families and carers for their support to partner us to deliver a high quality, safe service and remain open.
"The Cancer Centre is currently seeing up to 400 admissions a month and our outpatient consult services remain high employing telehealth and face to face sessions where clinically required."
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