Intensive Care Service Model NSW Level 4 Adult Intensive Care Units

Section 1
Background
In NSW, Local Health Districts and Specialty
Health Networks (LHD/SHN) are responsible
for determining the role delineation level of
their clinical services. The role delineation
of a service describes the complexity of
clinical services provided by health facilities,
including intensive care. The NSW Health
Guide to the Role Delineation of Health
Services (2002) outlines the support services,
staffing profile and other minimum
requirements for safe service provision. 1,2
The 2002 Guide describes five levels of intensive care,
of differing levels of complexity (Levels 2-5). A revised
NSW Health Guide to the Role Delineation of Clinical
Services 3 , due for release end of 2015, includes changes
to the description of Intensive Care Services.
These changes are summarised below. While the
activity data in this document is based on the 2002
Guide description of Level 3 and 4 Intensive Care
Services, the recommendations reflect the revised
2015 Guide definitions.
Intensive Care Service
Levels – 2002 Guide
Intensive Care Service (ICS) Levels & Close Observation Unit (COU)
– 2015 revised Guide
2 COU level 3 (designated unit in a facility with no ICS)
3 COU level 4 (designated unit in a facility with and ICS) or upgrade to a level 4 ICS
4 4
5 5
6 6
There are 46 adult Intensive Care Units in NSW as defined by the 2002 Guide, outlined in the table below. 1
Level Number of units Description of service and assigned hospitals
2 nil Provide a recovery area for post-operative patients and a high dependency area for general
ward patients requiring observation over and above available in general ward area.
3 7 Medical officer on site 24 hours or available within 10 minutes.
Auburn, Bowral, Fairfield, Kempsey, Maitland, Ryde and Wyong
4 12 Provide basic multi-system life support, usually for less than 24 hours. Separate and
self-contained unit. Medical director with training and experience in intensive care.
Armidale, Bathurst, Bega, Broken Hill, Canterbury, Dubbo, Grafton, Griffith, Goulburn,
Manning (Taree), Mona Vale and Shoalhaven
5 17 Provide long term mechanical ventilation and more complex interventions such as renal
replacement therapy.
Albury, Bankstown, Blacktown, Calvary Mater Newcastle, Campbelltown, Coffs Harbour,
Gosford, Hornsby, Lismore, Manly, Orange, Port Macquarie, Sutherland, Tamworth, Tweed,
Wagga Wagga and Wollongong
6 10 Provide complex multi-system life support for indefinite period. Referral centre for intensive
care patients.
Concord, John Hunter, Liverpool, Nepean, Prince of Wales, Royal North Shore, Royal Prince
Alfred, St George, St Vincent's and Westmead
Intensive Care Service Network – Intensive Care Service Model: NSW Level 4 Adult Intensive Care Units Page 7