Clinical ServiceAbout Our Services
The Division of Medicine provides a clinical service in Internal Medicine to the people of KwaZulu-Natal. All our clinical services are underpinned by the dual purposes of academic medicine and of health-care provision, with a harmonisation of the imperatives to teach, to perform research and to provide care to our patients.
Broadly speaking, these servies may be categorised as:
Tertiary and Quaternary Services
These are highly specialised services provided by our subspecialist departments, as follows:
- Gastroenterology and Hepatology
- Infectious Diseases
- Pulmonology & Critical Care
Details of the actual services offered are listed on the appropriate departmental pages on this site. Most of these services are centralised at the Inkosi Albert Luthuli Central Hospital in Cato Manor, which is situated about 5 km away from the Medical School. This modern, state-of-the-art, hospital is dedicated to the provision of these highly specialised services. The departments of dermatology, geriatrics and infectious diseases continue to be based at King Edward VIII Hospital alongside the Medical School.
Tertiary services are also provided in the Pietermaritzburg region, 80 km from Durban, where they are centralised within Grey’s Hospital.
These comprise our undifferentiated, specialist services in Internal Medicine, which are the primary responsibility of the Department of General Medicine. A service is provided throughout the province, and is centred on the following hospitals:
- King Edward VIII Hospital
- Addington Hospital
- RK Khan Hospital
- Mahatma Gandhi Memorial Hospital
- Clairwood Hospital (our convalescent unit)
- Edendale Hospital
- Ngwelezana Hospital
We plan to develop the current limited academic secondary and tertiary services based at the Ngwelezana Hospital in Empangeni, and to develop such services at Port Shepstone Provincial Hospital in the south. This will extend such services to all regions of the Province.
Among the projects currently understudy are the establishment of multidsciplinary services spanning several departments, specialties and professions such as rehabilitation services, Comprehensive HIV care, solid organ transplantation services beyond renal transplantation and neuropsychiatric services.
Harmonisation of Services
In practice, too rigid a differentiation between the secondary and tertiary levels of care can act as a barrier to the efficient and effective care of the individual patient. A priority of the Division therefore is to facilitate a seamless service spanning all three levels of care (tertiary, secondary and primary, or district level, care) by developing appropriate protocols and referral mechanisms, by situating specific services wherever they function most efficiently, and by deploying our staff across more than one level of care. All our consultants and registrars, for instance, operate across the entire academic platform in Durban, providing subspecialist care within their own area of expertise as well as a consultant service in General Medicine at King Edward VIII and other regional hospitals.
Ultimately it is our aim to ensure that our specialist and subspecialist services are freely available to all the people of KwaZulu-Natal, and not just to those in the major metropolitan areas of Durban and Pietermaritzburg. Currently our services may be accessed to everyone via referral mechanisms from their local health facilities to our hospitals and clinics. Increasingly however we are expanding our services to offer outreach consultation services to regional and district hospitals closer to where people live in the non-metropolitan areas, with regular visits by our specialists to these hospitals for consultation with patients, coupled with in-service training to expand the knowledge and skills of the local health practitioners. At tertiary level, this is particularly well-developed in Cardiology and Dermatology. At secondary level, the Pietermaritzburg region centred on Greys and Edendale Hospitals offers a successful outreach service.
Some of our staff operate limited private practices to fee-paying patients and those covered by medical aid schemes.