South Australia - April 2021
2021 is moving quickly by, and our examinations are generally going along smoothly. At the time of writing this, Greater Brisbane is in lockdown, which shows us that COVID-19 and subsequent restrictions are still causing disruptions to many aspects of life. The RACP has interstate/international contingency plans if candidate travel is disrupted.
For members interested, the following positions have current Expressions of Interest coming due in the next month:
This year, the South Australian Regional Committee is working on the Trainee Research Awards presentations and the South Australian Annual Scientific Meeting (ASM). For trainees and supervisors, especially those in paediatrics and the Faculties, we sincerely hope that you can enter your research into this worthy competition. We are hopeful of attracting brilliant speakers for the ASM to entice more attendance.
Lastly, as the Chairperson of the South Australian Regional Committee, I am proud to recommend to all members that we support public health physicians. Now more than ever, I think we have all come to realise the vital work that our Public Health colleagues do every day.
Dr Rabin Bhandari A.Mus.A, B.Med, FAFRM
South Australian Regional Committee Chair
The turning of the page to 2021, and the initial roll-out of the COVID-19 vaccines has generated a renewed sense of optimism within the community after the challenges of the last year. However, many of our trainees are still working towards completion of their examination requirements that were deferred from 2020. We were very grateful that some RACP Divisional Clinical Examination long case candidates were able to be held remotely from home during the November Parafield Cluster, and most candidates are nearing completion of their short cases.
A key focus for the South Australian Trainees’ Committee in 2021 will be on supporting trainees who are still facing the impact of COVID-19 on their examinations and assessment to meet their requirements. This will include through the ongoing provision of examination panels and the Basic Trainee Lecture series, and through continued advocacy for flexibility for trainees.
A lot has been said in recent weeks about the treatment of female staff members in Canberra, and this has generated a discussion more broadly about workplace culture. The RACP has published policies pertaining to flexible training options and fairness in selection into training. The South Australian Trainees’ Committee continues to be passionate about supporting trainees who may face issues in these domains. The issue continues to be discussed at the national level at the College Trainees' Committee, and we would welcome any feedback or involvement from trainees who wish to be involved.
We were delighted to meet lots of new trainees at the recent Basic Training Orientation for paediatrics and adult medicine. New paediatrics trainees from Women’s and Children’s Hospital and Flinders Medical Centres are Early Adopter Trainees for the RACP New Basic Training Program. We look forward to hearing your feedback regarding how the roll-out is progressing. Although our events remain virtual for the time being, it has been wonderful to continue to foster a sense of community in this new format.
Finally, we would like to wish our fabulous Member Support Officer Lana best wishes for her upcoming maternity leave and thank her whole-heartedly for all of her guidance and contributions for the South Australian Trainees’ Committee.
If you would like to provide feedback about any training issues, please contact the RACP South Australian Office or any of our committee members. We encourage anyone wanting to get more involved in advocacy for their peers to consider joining the committee or attending our meetings as an observer.
Alyssa and James
Dr Alyssa Fitzpatrick and Dr James Johnston
South Australian Trainees’ Committee Co-Chairs
Thank you to everyone who participated in the 2020 consultation on the proposed common learning, teaching and assessment (LTA) programs for Advanced Training (AT). Your feedback was used to refine the programs and ensure they are robust and appropriate. The common LTA programs for Advanced Training have now been finalised.
The common LTA programs will establish a baseline for learning, teaching and assessment across all AT programs. As each specialty undertakes their program-specific curricula reviews, they will build on the common LTA programs to meet the needs of their specialty.
This year, in collaboration with Curriculum Advisory Group, we will continue to support the first six specialty groups to undertake the development process:
- Cardiology (Adult Medicine)
- Cardiology (Paediatrics & Child Health)
- Gastroenterology
- Geriatric Medicine
- Nephrology
- General Rehabilitation Medicine.
Find out more
It’s not long until RACP Congress commences, and for those wanting to attend, whether virtually or face-to-face in Adelaide on Saturday, 1 May or at one of our other cities, time is running out to secure your ticket. Online access to the RACP Congress 2021 sessions will be available only to those who register so do not miss the opportunity to hear from expert voices across a range of topics.
If you are purchasing a face-to-face ticket, you can also live stream the entire RACP Congress 2021 program wherever you may be so register now to ensure you can access the opening sessions in Brisbane.
For those attending in Adelaide, help us congratulate the SA and NT 2020 Trainee Research Award Recipients at their presentation.
When you register for RACP Congress 2021, you will also have access to sessions such as:
- Remote retinal scanning: Transforming early detection outcomes
- Genetic discovery and translation in neuromuscular diseases
- Our digital health future, today
- Advancing Women in Healthcare
- Artificial intelligence: Ready or not here it comes
- Building a solution space for Indigenous health at the RACP: Transformations, challenges and opportunities
Find out more
Before I came to work in Central Australia, I'd hardly heard of, or knew anything about Human T-cell Leukaemia Virus, despite being an infectious diseases doctor. While working in Central Australia, I developed significant interest in this intriguing virus in addition to my usual passion, antimicrobial stewardship, in the rural and remote setting.
Human T-cell Leukaemia Virus Type 1 (HTLV-1) is an enveloped, single stranded ribonucleic acid, human delta retrovirus. It was first identified in 1980, a few years prior to the discovery of Human Immunodeficiency Virus (HIV). Interestingly, HIV was previously named HTLV-3 before the exposure of its unique characteristics. Despite the earlier discovery of HTLV-1, it was completely outshined by HIV in the past four decades. HIV caused a global pandemic in the 1980s and an enormous amount of resources were thrown at it to bring it under control.
To date, the repertoire of antiretroviral medications for HIV is expansive and yet there is not a single antiretroviral medication that is effective against HTLV-1. Worldwide, at least five to 10 million people are infected with HTLV-1, predominantly in areas of high endemicity in southern Japan, the Caribbean basin, parts of South America and inter-tropical Africa.
An endemic focus is also present in Central Australia, where infection with the Australo-Melanesian HTLV-1 subtype C (HTLV-1c) is highly prevalent. In Australia, HTLV-1 was first described in the Kimberley region, Western Australia. Remarkably higher prevalence of HTLV 1 reported in remote communities in Central Australia (15 to 72 per cent) and Western Australia (up to 16.4 per cent), with lower prevalence in Top End Northern Territory (0.6 to 2.2 per cent) and Far North Queensland (1.3 per cent), and zero cases detected in two studies from Victoria. Blood donor screening data showed a very low national prevalence of 0.0035 per cent. In Central Australia, the prevalence is highest in the communities situated in the southern and western regions of Central Australia. The Indigenous people are disproportionally affected compared to the non-Indigenous people.
Once a person is infected with HTLV-1, like HIV, it causes lifelong infection. The routes of transmission of HTLV-1 are similar to HIV. HTLV-1 is transmitted by cell contact with infected lymphocytes, exposure to which may occur by ingesting breast milk, through condomless sexual intercourse, blood transfusions, organ transplantation and intravenous drug use. However, unlike untreated HIV infection, which inevitably caused Acquired Immunodeficiency Syndrome (AIDS) after a period of infection, HTLV-1 infection only results in serious health consequences in a minority of those infected.
HTLV-1 is thought to be the most oncogenic virus known and is the causative agent of a rapidly progressive haematological malignancy, adult T-cell leukaemia/lymphoma (ATL). Two inflammatory diseases, HTLV-1 associated myelopathy (HAM) and HTLV-1 associated uveitis (HAU), are also acknowledged to be caused by HTLV-1 infection. HTLV-1 has long been considered to have a particular tropism for the lung, a condition that has been variously termed HTLV-1 associated broncho-pneumonopathy (HAB), HTLV-1 associated bronchioloalveolar disorder (HABA) and HTLV-1 associated pulmonary disease (HAPD).
Dr Lloyd Einsiedel, an infectious diseases physician at Alice Springs Hospital, conducted an extensive body of research on HTLV-1 infections in Central Australia over the past decade. In the past two years, I had the honour of joining Dr Einsiedel in exploring more about the virus via my clinical work as an infectious diseases and general physician in Alice Springs. In Central Australia, we encountered a disproportionately greater number of HAPD cases comparing with other HTLV-1 associated complications (such as HAM and ATL) in our clinical practice.
The prevalence of bronchiectasis in Central Australia is among the highest reported in the world, and a large proportion of the patients with bronchiectasis are infected with HTLV-1, and with a high HTLV-1 proviral load. Recently, we have published a review article on HAPD in BMC Retrovirology Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection. The key objectives of this paper were to provide a narrative review of all relevant literatures related to HAPD and propose a set of clinical criteria for HAPD diagnosis. Having a clinical definition for HAPD is essential to design clinical trials to develop therapeutic options for patients with HAPD.
In conclusion, HTLV-1 has been plaguing Central Australia for centuries. A robust public health intervention is urgently needed to curb the spread of HTLV-1 in Central Australia and more resources should be invested to assist with the improvement of our understanding of this virus.
References can be provided upon request to the author via emailing the RACP SA/NT Regional Office
Dr. Fabian Chiong, Infectious Diseases and General Physician, Alice Springs Hospital
Pictured: Professor Toshiki Watanabe (third from the left) from the University of Tokyo, who is also the President of the International Retrovirology Association and his team visiting Alice Springs, November 2018. Dr Lloyd Einsiedel (third from the right) and Dr Fabian Chiong (first from the right).
This year, for the first time, South Australian Basic Training Orientations were separated into adult medicine and paediatric medicine. For many, it was their first introduction to the College and the opportunity to hear from their South Australian Trainees' Committee representatives. Both adult medicine and paediatrics Basic Trainees received a RACP wellbeing pack to welcome them to the College and provided some valuable resources. We wish them a successful start to their training journey.
South Australian Basic Training Orientations
Paediatric medicine: Held on 8 February 2021
Dr James Johnston, Paediatric Medicine Co-Chair of the RACP South Australian Trainees' Committee, was the MC for the evening. He warmly welcomed new trainees to the RACP Training Program. Dr Roger Sexton from Doctors Health SA spoke about maintaining your health as a doctor and provided tips to ensure a healthy work/life balance.
Directors of Physician Education (DPEs) Dr David Baulderstone, Women’s and Children’s Hospital and Dr Brian Coppin, Flinders Medical Centre, welcomed new Basic Trainees, encouraged their commitment to training, and provided an overview of their expectations.
Lana Rohde, the RACP SA/NT Member Support Officer gave an overview of the College’s requirements for the Basic Training program. Lana explained where trainees can access support, further training resources from the College website, and gave answers to our frequently asked questions.
New paediatrics trainees from Women’s and Children’s Hospital and Flinders Medical Centres are Early Adopter Trainees for the RACP New Basic Training Program. The new Basic Training Program is a hybrid of time and competency-based training. It was an opportunity to hear about the assessment tools, registration system, as well as ask their DPEs specific training questions.
The final presentation for the night was by Dr Daina Rudaks, who presented on behalf of the South Australian Trainees' Committee. Dr Rudaks discussed approaches to training, and what to do and not to do. The South Australian Trainees' Committee also provided an extensive list of learning resources they found useful with their studies.
The evening concluded with a Q&A opportunity with past Basic Trainees and members of the South Australian Trainees' Committee: Dr James Johnson, Dr Daina Rudaks, Dr Alice Rogers and DPEs: Dr David Baulderstone and Dr Brian Coppin.
Adult medicine: Held on 24 February 2021
Adult Medicine Basic Trainees were welcomed to the College by the RACP South Australian Trainees' Committee Adult Medicine Co-Chair, Dr Alyssa Fitzpatrick. Dr Roger Sexton again presented his health and wellbeing tips to our new trainees and encouraged them to not only look out for themselves but their colleagues too.
Members had the opportunity to hear from DPEs Dr Krishnan Varikara from Lyell McEwin Hospital, Dr Jessica Hafner from The Queen Elizabeth, Dr Suchi Grover from Flinders Medical Centre, and Dr Mark Morton from Modbury Hospital. They welcomed new Basic Trainees to the Network and shared their personal advice for succeeding in Basic Training.
RACP Member Support Officer, Lana Rohde, presented an overview of the College’s requirements for the Basic Training program. Lana explained where trainees can access support and further resources from the College website throughout their training.
Dr Alyssa Fitzpatrick presented the final presentation of the evening on behalf of the South Australian Trainees' Committee. To conclude the evening, Dr Syed Ali and Dr Tania Salehi shared their experiences while answering questions from Basic Trainees.
Hi, I’m Lana Rohde, your local RACP Member Support Officer. I will be leaving in April for maternity leave and will be replaced by Jake Sawyer until my return in April 2022. I recently had the pleasure of presenting to many new Basic Trainees at virtual orientation events for Paediatric and Adult Internal Medicine Trainees (more details in the above article).
Some other events for trainees to look forward to include:
- Basic Training Exam Preparation Panel: Details to be announced soon
- Basic Training Lecture Series: Details to be announced soon
Supervisor Professional Development Program (SPDP) is a training program for final year Advanced Trainees and Fellows who supervise trainees in RACP-accredited positions. With the extended deadline, RACP supervisors now have until the end of 2022 to complete all three SPDP workshop to become RACP approved supervisors.
Supervisors must complete:
- one SPDP workshop by the end of 2021 (an extension of 12 months)
- all remaining workshops by the end of 2022.
You will be a RACP-approved supervisor (previously 'accredited supervisor') when you've completed all three workshops, which you can complete in any order. SPDP is considered a 'Category Two: Reviewing Performance' activity in the 2021 MyCPD Framework. MyCPD participants will earn three CPD credits per hour. Further information and how to enrol in SPDP workshops can be found on the SPDP workshop registration webpage. If you can’t find a workshop to suit your availability, please reach out to your SA/NT Regional Office, and we’ll attempt to assist.
From January to March, 15 virtual SPDP workshops were made available to SA supervisors. This wouldn’t have been possible without our facilitators who give so generously of their time. I would like to extend a big thank you to facilitators, Professor Martin Veysey, Dr Michael Noel, Dr Peter Gale, Dr Carole Khaw, Dr Danielle Ni Chroinin, Dr David Holden and Dr Suganya Vignakaran who have supported these events with enthusiasm. SPDP workshops are offered regularly. If you would like to be notified when we have new workshop scheduled, please let us know.
As your College contact, please contact us with any questions you have. You can continue to reach Jake on the same details, Phone: (08) 8465 0971 or email.
We look forward to (virtually) seeing you at upcoming events.
Lana Rohde and Jake Sawyer,
Outgoing and incoming SA/NT Member Support Officers
Dr Sunday Pam, a paediatrician based at Rockhampton Hospital, received a call from Rockhampton Zoo for the treatment of an unlikely patient. Below is Dr Pam’s account of treating the chimpanzee patient, Gandali.
I received a call on 1 December 2020 – it was the head of an allied health department, with an explanation that their request was ‘weird’. I was silent. “Are you still there? Pop your seat belt on” he said. “I have been asked by the Zoo Manager to get you to see a 10-month-old infant chimpanzee following possible severe injuries from a fall.” I could not laugh, cry, or even speak. My silence betrayed me. He continued, “Human doctors generally see them instead of veterinarians because they are closer to humans.” Reference was made to a local human subspecialist who sees the adult chimps. In this case, the local vets had been consulted and declined.
My mind went to ‘what about registration regulations?’ I was reassured that this was not an issue for the above reasons. I was asked for my number to give to the lovely zoo manager, a few minutes later she called. I was again reassured and now I was getting interested, but cautiously. I was invited to name my fee and to decide how I would be paid. I quickly declined and told her that it would be my contribution to the local zoo.
Having heard the story and the behaviour of the animal, I suspected an intracranial bleed and recommended a quick CT. This would need to be under general anaesthetic. The vets, doctor and nurse were willing to give the general anaesthetic but not take decisions on the health of Gandali.
At 7 pm, my recipe-style cooking was interrupted to head to the radiology outfit in town for the celebrity CT. On arrival, I had difficulty touching the animal due to fear of zoonoses. The pictures will show me standing far away from Gandali. My physical examination with gloved hands, was similar to what I would do for a child with the same history. It was based on symmetry to rule out lateralising signs. There were none, however, there were bruises on the head, ear, and arm on the same side. This reinforced my suspicion and confirmed my request for the CT.
The CT was preceded by celebrity pictures with the sick animal. Finally, Gandali was under general anaesthetic and the CT completed without further ado. The CT showed as normal, later confirmed by the radiologist. Again, my reading of the image was purely on principles of symmetry and appearance in the human child. I cleared my chimpanzee patient of severe intracranial bleed. Gandali returned to the zoo that night.
By the next morning, I had become a celebrity Chimp Paediatrician, that I had never trained for, with only the very basic principles of medicine delivered by me.
Dr Sunday Pam FRACP
Image one (pictured at beginning of article): Dr Sunday Pam and Primate Keeper Blair Chamma and Gandli, Image two: Chimp Gandali in MRI, Image three: Chimp MRI, Image four: Chimp Gandali sedated.
The north of Australia has experienced unprecedented heat events in the past decade. Over the foreseeable future, these events are predicted to get more frequent and more extreme. The impact this new heat will have on health and wellbeing for people living in tropical locations around the world is predicted to be severe. It is often considered that these individual adverse health impacts will occur because of the direct impact of heat on human biology, however, the impact of climate change in these environmentally and socially vulnerable regions is much more complex than that.
For those of us who live and work in the Northern Territory, it is common to hear colleagues lamenting the concerns they have over the impact of climate change in a region that already suffers extreme heat. Most of us in the Northern Territory know colleagues who have left, and more speak of leaving, because they cannot envisage living in a future Northern Territory that is even hotter than it is now.
We have recently conducted a survey of all doctors in the Northern Territory, based upon a standardised workforce retention survey and modified to include the impact of climate change, to determine what this is having on workforce retention. The overwhelming majority believed that climate was a real threat (96 per cent), with 85 per cent concerned that these new extremes of heat were already either harming or risking harm to their patients. Of most concern was that 34 per cent were either considering or in the process of moving away from the Northern Territory to cooler locations because of their concerns about the impact that global warming would have on the Northern Territory.
The impacts that climate change is having on health come not just from the direct effect of heat, but also on complex human migration. Places like the Northern Territory are probably already experiencing destabilisation of workforce that is hard to measure, and even harder to measure in terms of real human health outcomes. Urgent policy attention needs to focus on health workforce and climate change.
By Dr. Simon Quilty, Specialist General and Acute Care Physician, Alice Springs Hospital
Please click on the above images to see them in full size. We would like to acknowledge Pandora Hope and the Bureau of Meteorology for providing these images mapping the extreme summers of 2018/2019 and 2019/2020.
Congratulations to the Fellows from South Australia who have been awarded RACP Foundation Research Awards for 2021.
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Award
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Recipient
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Institution
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Project
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Margorie Hooper Scholarship
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Dr Anthony Khoo
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National Hospital for Neurology and Neurosurgery, Queen Square / King's College London
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Neurology and neurophysiology Fellowship / Doctor of Medicine (Research)
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RACP Fellows Research Entry Scholarship
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Dr Mohammad Ehsan Khan
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Flinders University
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Design and evaluation of a clinical decision support system using artificial intelligence in the assessment of patients presenting with suspected acute coronary syndrome to the emergency department
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The Servier 'Barry Young' Research Establishment Fellowship in Oncology
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Dr Craig Wallington-Beddoe
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Flinders University
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Triggering a new cell death mechanism termed ferroptosis in aggressive B-cell malignancies
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Barbara Cameron Australian Rheumatology Association (ARA) Research Establishment Fellowship
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Associate Professor Mihir Wechalekar
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Flinders University / Flinders Medical Centre
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Improving outcomes in rheumatoid arthritis (RA): Investigating mechanisms of biologic disease-modifying drug response, or lack thereof, by an integrated genomic and biological marker approach
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Cottrell Research Establishment Fellowship
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Dr Christopher Xin Jie Wong
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University of Adelaide / Royal Adelaide Hospital
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Effect of iron repletion in symptomatic patients with atrial fibrillation
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The Foundation would like to express its appreciation to the Grants Advisory Committee as well as other Fellows whose generous contribution of time and expertise have made the review process for these awards possible.
Applications for the 2022 funding round will open on Monday, 3 May 2021. Upwards of 50 awards up to a total value of $2.5M are available across the different categories:
Applications for the following other award categories will open Tuesday, 1 June 2021:
Most awards are open to Fellows and trainees across Australia and New Zealand. Please refer to the RACP Foundation website for information on specific eligibility requirements for each award.
AChPM Award for Outstanding Contribution to the Discipline of Palliative Medicine
Nominate a Fellow for their outstanding contribution to Palliative Medicine. The award includes a cash prize of $500 and a certificate formally presented at the ANZSPM Conference in September 2021. Please see the website for further details. Nominations close 30 June 2021.
AChSHM Jan Edwards Prize
The Jan Edwards Prize is awarded for the best research-based abstract oral presentation by a registered AChSHM trainee. The prize includes $500 and a certificate. For further details and to apply please visit the website. Applications close 31 May 2021.
If you’re a South Australian registered health practitioner who has the authority to prescribe or dispense Schedule 8 medicines, you will soon be able to get real-time information about your patients’ prescription and dispensing history for monitored drugs via ScriptCheckSA.
All relevant AHPRA registered health practitioners have recently been invited to register for an account that will enable access to ScriptCheckSA. If you have not yet received an email invitation you can access the secure registration portal.
Free online training and resources to assist health practitioners to understand and interpret the information in ScriptCheckSA are now available. This training has been tailored for the specific needs of prescribers and you can access the five online training modules now.
More information about how to register for the online training modules, and to access the support resources is on the ScriptCheckSA website. ScriptCheckSA was released at the end of March 2021. If you have any questions about ScriptCheckSA registration or training, please email SA Health.
Real Time Prescription Monitoring Project Team, SA Health
Hood Sweeney: Lock in income protection insurance before terms tighten in 2021
The benefit structure for income protection insurance policies is slated to be tightened further by mid-2021 as insurers seek to stem the billions of dollars the industry loses each year. Hood Sweeney has written an interesting article to help you learn more about the impact of the changes.
Find out more
Online course: Physician wellbeing in challenging times
Physicians often fail to put on their own oxygen masks when dealing with the challenges and stresses that come with practising during a pandemic. This online course explores in-depth how to better support your own wellbeing, as well as the wellbeing of your staff and colleagues through compassionate leadership. The course covers concepts, strategies, and tools to help you mitigate the impact, set healthy boundaries, prevent burnout, and build support networks during a crisis.
Enrol now
Fellows and trainees of all specialties are invited to enrol in this new Qstream course, which has a mid-May start. The course is designed to provide practical strategies to help you enhance your teaching skills and effectively balance teaching with a busy workload.
You'll access in-depth case studies with questions that are sent directly to your inbox at spaced intervals over a three-week period. Each question takes just ten minutes to complete, and participants are encouraged to discuss the case studies and share opinions with others through secure, online discussion forums.
The course is designed to enhance your knowledge in adult learning, provide practical strategies to incorporate effective teaching skills into day-to-day settings, and encourage self-reflection and peer discussion.
Enrol now
We’re hosting more online events than ever before, so have introduced a condensed monthly events digest. The first one was sent to you on 7 April, but you can also read it online.
This monthly communication will be sent to you on the first Wednesday of each month, to provide you with an opportunity to virtually attend events from all over Australia and Aotearoa New Zealand. We hope this makes your life that little bit easier and we look forward to seeing you at our next event.
Read the April events digest
This is the third and final part of the series on gendered medicine. We step back and look at the way that health care and research are funded. It’s been said that the health needs of women are undervalued by our existing fee-for-service model, down to individual item numbers in the Medicare Benefits Schedule. There’s also evidence that diseases predominantly experienced by female patients receive less research investment. Is this blatant sexism or a symptom of structural imbalance, and what do we do about it?
Guest
Dr Zoe Wainer BMBS, PhD, MPH (Director of Clinical Governance, BUPA)
Listen now
Expressions of Interest are still open for Fellows in the Adult Medicine and Paediatric & Child Health Divisions to join our team of accreditors. As an accreditor, you play a vital role in ensuring the delivery of high-quality workplace training. Your contribution to accreditation can also count towards your annual CPD credits.
Please submit an Expression of Interest (EOI) form by Wednesday, 30 June to accreditation@racp.edu.au.
What are the opening hours of the SA/NT Regional Office?
Monday to Friday, 9am to 5pm. This is unchanged as staff work from home due to COVID-19 measures.
Where is the SA/NT Regional Office located?
The SA/NT Regional Office is currently closed to members and staff are currently working from home. However, the address is: Suite 7, Level 2, 257 Melbourne Street, North Adelaide SA 5006
What is the contact number for the SA/NT Regional Office?
You can reach our office on (08) 8465 0970 or Member Services on 1300 697 227.
Where can I park at the SA/NT Regional Office?
Two-hour street parking is available in Melbourne Street and all-day parking opposite the Old Lion Hotel (fees apply). A reminder that the office is currently closed.
How do I book a meeting?
Although the office is currently closed due to COVID-19, we can assist you with booking virtual meetings. Please email us or call 08 8465 0970.