Queensland-wide senior medical officers audit underway

An investigation into Mackay Hospital and Health Service (HHS) has prompted a statewide audit of HHS processes for recruiting, managing and monitoring senior medical officers (SMOs). The announcement by Queensland Health follows the release of the final report of the investigation into the recruitment, credentialing and scope of clinical practice of Mackay HHS’s senior medical staff, during 2023 and 2024.

It was following a clinical review prompted by concerns around clinical scope and supervision requirements for non-specialist senior medical staff that Queensland Health Director-General Dr David Rosengren had commissioned the Mackay investigation in January this year, under Part 9 of the Hospital and Health Boards Act 2011.

All but one of the 37 SMOs were found in the report to be adequately compliant with the applicable processes and practices relating to SMO recruitment, selection and credentialing, and defining the scope of clinical practice of SMOs — the investigators identifying opportunities to improve training resources for recruitment panel chairs. Recruitment and selection processes, and supervisory records, relating to one SMO did raise serious concerns.

Despite the lack of documentation, it was reported to investigators that this staff member was determined to have been adequately supervised. An action plan has been developed by Mackay HHS to implement all recommendations, with quarterly updates on progress — starting October — to be provided.

Eleven recommendations were made in the report. These included strengthening processes for assessing, documenting, and monitoring SMOs; updating SMO recruitment procedures; training recruitment panel chairs; and updating the Mackay HHS Credentialing Procedure and Credentialing Best Practice Guideline to ensure both meet Queensland Health requirements.

“The report shows that, in the main, Mackay HHS’s processes for managing its SMOs are adequate from a compliance perspective,” Queensland Health Director-General Dr David Rosengren said. “Significant concerns were raised in relation to the recruitment, scope of practice and supervision of one SMO. This highlights the need to strengthen processes relating to the recruitment, scope of practice, and supervision of SMOs.

“I commend Mackay HHS for acting swiftly to address these issues, before, during and following the investigation,” Rosengren added, having asked the state’s 16 HHSs to, for non-specialist senior medical staff, ensure a robust process is in place to assess, document, monitor and manage supervision activities — Rosengren also requesting an audit be undertaken on current supervision of these staff.

“This is an opportunity to apply scrutiny to processes across the entire state, not just in one HHS, to prevent similar issues from arising,” Rosengren said. “As such, I have asked all HHSs to audit their own processes for supervision of SMOs to make sure they are robust and compliant with appropriate guidelines.”

More information on the Mackay HHS investigation is available here, via the Queensland Health website.

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