Self–referrals by patients is a major concern at Brits Hospital

Brits District Hospital has been critically monitoring its compliance with the National Core Standards to fast track its improvement in the effectiveness and quality of the hospital’s health system as a whole. In that regard, the Brits Hospital has identified some specific areas that pose as a challenge towards the improvement of health care services for all the patients and the public at large.

One of the identified challenges to this point is ‘self-referrals’ by patients across the Madibeng Local Municipality. This challenge has rendered the Hospital unable to achieve its 100% compliance with the National Core Standards that meet the principles of Batho Pele.

“Majority of these self-referrals are non-emergency cases that were attended to in Casualty specifically between 16h00 and 6h00 the next day, the Chief Executive Officer (CEO) of Brits Hospital, Mr Themba Mhlanga explains.”

According to the CEO, on 9 January 2013 between 16h00 and 6h00 the next day, there were approximately 59 people that were attended to by the Brits Hospital Health Professionals whose conditions were not serious or should not have come to the hospital that night.

These self-referrals cases on that particular day contributed to amongst others – congestion, delay of ambulances for serious conditions such as assault, illegal abortion bleeding, traumatic amputations, long waiting time, high medical officer turnover and moreover excessive negative reports.

“Many of the complaints were have received are from those people whom their conditions were not serious; they would say our health workers were rude and uncaring. These are the people that would run to the media and allege that our Health workers turned them away,” CEO emphasises. 

“We have made efforts to reach out to the communities informing them that ours isn’t a complete hospital and as a makeshift it has merely 36 beds,” Mhlanga continues.

According to Mhlanga, people would bring conditions such as arthritis, anaemia, RVD, CA cervix, Gastro, Genital warts, back pain, syphilis, abscess and general body pains.

“You would even find a situation of someone at 23h00 comes to the hospital for dog bites. You ask yourself what he was doing at that time of the night. It’s possible that on the very same night somebody else could have reported a case of house breaking,” Mhlanga raised a concern. 

He said the dog bite case was a resident from Letlhabile. That patient by-passed Letlhabile Community Clinic, which offered a 24 hours services and moreover it has doctors. He said that this kind of referral was obstructing the hospital to deliver quality health care. It could have been caused by a number of reasons such as a health user choice of hospital over clinic, straight referral to hospital by Emergency Medical Services (EMS), no bypass fee and referrals by nurses instead of doctors.

In the same vein, Mhlanga reported some of the serious cases that were attended to at the hospital such as sexual assault and attempted suicide. These cases and sexual crime in particular are on the rise.

“In January alone, the hospital treated twenty-nine (29) patients who were raped and more than seventy patients who had attempted suicide,” Mr Mhlanga explained.

In addressing these self-referrals challenges, the management of Brits District Hospital has forged links with its key partners to inform and educate the public. Amongst the stakeholders were Board members of Brits Hospital, the members of local media, South African Police Services (SAPS), EMS, Community clinics and private hospitals and clinics.

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