Cairns University Hospital Redevelopment Project

Briefing Note Summary

• Investment in expanded health facilities, services and staff at Cairns Hospital is critical to meeting the health needs of TNQ in the medium and long term.

• Transitioning to a university hospital will allow Cairns Hospital to achieve its vision to grow its capabilities to ultimately provide the community and staff with more complex clinical services closer to home. This will be based on cutting-edge research, clinical trials and expanded education to support the current and future health needs of our community.

• An ongoing commitment is needed from Federal and State Governments to support the development of Cairns Hospital in two phases:

º Phase 1 is the Cairns Hospital Capacity Expansion Project by 2026 and the Cairns Health and Innovation Centre, for which further funding is needed.

º Phase 2 is a new acute services building on an expanded Cairns Hospital footprint. Planning and initial funding are required now to enable Cairns Hospital to meet projected growth in demand for health services.

The two phases have broad partner support and seek to build on successive government investments. CHHHS, supported by the Northern Queensland Primary Healthcare Network, James Cook University and other tertiary institutions, is seeking to improve the ability of Cairns to build its own medical, nursing, and allied health workforce, to expand its clinical services and to translate research into practice to improve health outcomes for TNQ communities.

The Issue

The Cairns and Hinterland Hospital and Health Service’s (CHHHS) operations extend across Tropical North Queensland (TNQ) to some of the most remote communities in the state, with a population increasingly experiencing complex, chronic conditions above national averages. Expanded health services, clinical research, and education are critical to meeting the health needs of TNQ’s growing population.

Cairns Hospital faces a number of sustainability challenges. These include:

• Short- and long-term infrastructure capacity – Cairns Hospital is now at capacity across all bed types and there is no hospital bypass option. By 2036/37, this gap is predicted to be more than 360 beds. Capacity is a critical risk and immediate planning is needed for a new acute clinical services building to ensure sustainable health service delivery for the medium term.

• Site constraints and resilience – Cairns Hospital is the smallest block of developable land for comparable hospitals, and the waterfront location creates service continuity risk (via flooding and storm surge).

• Workforce and Innovation – CHHHS needs to increase its locally grown health workforce to enable it to deliver expanded services closer to home. Attraction and retention of skilled clinicians and researchers will be vital to achieving the necessary innovation and associated research.

Transitioning Cairns Hospital to a university hospital will allow it to deliver world-class, high-quality care to address the critical current and future health challenges facing TNQ. This will result in more complex medical and surgical services, with more skilled and highly trained clinicians.

Cairns University Hospital will also enable enhanced education and research, meaning more TNQ locals can complete their entire health education and training in the Cairns region. It will also facilitate research in areas that are relevant to our region and embed the research outcomes into better health services.

The many elements that combine to become Cairns University Hospital will have the added benefit of attracting and retaining staff and clinical expertise.

Complementing the vision to transition to a university hospital, the Federal Government has committed $13.2m for 20 Commonwealth Supported Places for local students to study their medical degree at James Cook University (JCU) in Cairns. This enables JCU to offer the full 6-year program in Cairns to expand the junior medical workforce. Additionally, a further 80 CSPs have been committed for rural and remote students to be allocated nationally via competitive process. JCU is now seeking allocation of 40 of the 80 CSPs.

The Queensland Government has committed funding to help address short-term capacity challenges through temporary relocation of subacute services offsite from Cairns Hospital and a commitment to develop a new surgical centre.

To deliver on the vision of Cairns University Hospital, CHHHS needs to progress phase 1 (increased bed capacity at Cairns Hospital and CHIC) and commence planning for phase 2 (new acute clinical services building) – with both phases in close proximity to Cairns Hospital.

Background

The Cairns and Hinterland Hospital and Health Service (CHHHS) needs to support a growing population whose demand for healthcare services consistently outstrips population growth. The CHHHS annual report for 2020-2021 highlighted that Cairns Hospital supports an estimated resident population of 289,000, including the regular provision of acute medical services for residents of the Cape and Torres region, an area larger than Victoria(1) Combined with estimated population growth of 2.13% (compound annual growth rate) per annum and an ageing population, it is estimated that by 2032 an additional 67,000 people will reside in the catchment area with more than one in five residents aged over 60 – a third more than the national average(2).

Cairns Hospital continues to see increased demand on its Emergency Department. In 2021 there were more than 86,000 presentations to the Cairns Hospital Emergency Department (a 10,000 increase on the previous year), averaging 236 patients per day. In 2022 there was further increased pressure on the Emergency Department with a recordbreaking 314 patient presentations on May 4, its busiest day ever on record and a 10% jump on the previous record set in February 2021(3). Increasingly, there is demand for specialist services and elective surgery, placing additional pressure on Cairns Hospital.

In the 2022-23 State Budget, funding was committed for accelerated capital works to help address the most urgent bed pressures at Cairns Hospital. These include the relocation of subacute care offsite (45 beds) to help address existing bed capacity issues at Cairns Hospital. Additionally, there is $250m planned for a new surgical centre and additional bed capacity to be built by 2026 to help repurpose some existing areas of Cairns Hospital for acute care.

Next Steps

To successfully transition Cairns Hospital to Cairns University Hospital, an expansion of bed capacity and selected specialty services is required over coming years, potentially including endoscopy, paediatrics, and other medical and surgical specialties. This will also include new expanded clinical and professorial roles. This will be delivered through strong partnerships, the right infrastructure, and expanded provision of safe and sustainable clinical services for Tropical North Queensland.

• Complete planning of the $250m Cairns Surgical Centre (part of phase 1) by the end of 2022 and progress construction of the centre on a five-year timeline to increase surgical capacity and refurbish parts of Cairns Hospital for additional acute care beds, delivering an additional 96 beds by 2026 to help address short term capacity needs.

• Secure a funding commitment for the detailed planning and construction of the Cairns Health and Innovation Centre

(part of Phase 1) on land adjacent to James Cook University’s site in North Cairns, which will accelerate innovation and enable the much-needed workforce of the future. The CHIC will be a critical step towards realising Cairns University Hospital.

• Secure a commitment for the mediumterm sustainability of Cairns Hospital, including the land purchase, planning and construction of a new acute clinical services building near Cairns Hospital with construction to occur between 2027 to 2032 to expand the hospital footprint and address environmental resilience risks.

• Establish a planning commitment for a broader Health and Wellbeing Precinct within a 2000m radius of Cairns Hospital. The Health and Wellbeing Precinct will bring together a range of both private and public health services, closely located to the sporting precinct of Cairns and enabling co-location of health and wellbeing services for the benefit of the community.

Our Recommendation

• That the Federal Government allocates 40 of the additional 80 Commonwealth Supported Places for JCU Bachelor of Medicine, Bachelor of Surgery in Cairns.

• That the State Government commits to capital funding for the detailed design and construction of the Cairns Health and Innovation Centre.

• That construction of the $250m Cairns Surgical Centre is progressed on a five-year timeline (part of phase 1).

• That funding is committed now to acquire land to support the new acute clinical services building (phase 2).

• That the State Government starts planning now for the new acute clinical service building to enable Cairns Hospital to meet medium-term health service demands (phase 2).

• That planning for the Health and Wellbeing Precinct is progressed (within 2000 metres of Cairns Hospital).

Sources

1. State of Queensland (Cairns and Hinterland Hospital and Health Service) Annual Report 2021-2022.

2. State of Queensland (Cairns and Hinterland Hospital and Health Service) Annual Report 2020-2021.

3. https://www.tropicnow.com.au/2022/may/4/cairns-hospitalemergency-department-records-its-busiest-day-in-history