Elective surgery at RAH, QEH postponed amid demand surge
Elective surgery at the Royal Adelaide Hospital and Queen Elizabeth Hospital has been postponed as the health system grapples with a surge of demand at their EDs.
SA News
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Twenty-one elective surgery cases were postponed on Tuesday after 61 cases on Monday, following a surge in demand left hospital clinicians struggling to cope.
SA Health officials postponed 13 cases at the Queen Elizabeth Hospital and eight at the Royal Adelaide Hospital.
They say demand has now eased and no more cases are expected to be delayed this week but Opposition health spokesman Chris Picton said the system is “buckling under pressure” of cutbacks.
Urgent category one cases are still proceeding and the postponed cases which cover conditions ranging from back pain to plastic surgery will be “re-prioritised.”
SA Health officials say cancelling elective surgery is a last resort and they have apologised to the patients affected.
Officials say there is no single factor for the surge in demand over the weekend and into Monday which saw EDs clogged, dozens of people waiting extended periods for a ward bed after treatment, ambulances ramping and paramedics working extended shifts without a break.
They say the conditions which caused people to call an ambulance or arrive at an ED covered a wide range, including respiratory, back, mental health and heart issues.
However, unlike other years where demand spiked flu was not the culprit.
Flu cases are at their lowest numbers for this time of year in six years thanks to COVID-driven hygiene and social distancing measures. Flu numbers stood at 1553 confirmed cases for the year to August 22, compared to 23,107 at the same time last year which went on to record 27,097 cases.
There were no flu cases in the week to August 22.
While demand on EDs has eased, there were still 80 people waiting for a ward bed after being treated as at 8.30am on Tuesday, including two waiting more than 24 hours for a bed.
Premier Steven Marshall said: “You will always have fluctuations in demand, surges in demand.”
However, Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars blamed weekend staffing levels for clogging EDs, in turn leading to ramping.
“We have been advocating for over two years for there to be senior nurses and doctors available on the weekends to help facilitate required complex care as well as the discharging of patients,” she said.
“Week after week we see a build-up of people waiting for discharge over the weekend which creates an overflow of people stuck in emergency departments waiting for beds on Monday.
“Surely Minister Wade appreciates that medical issues don’t simply occur Monday to Friday and as such our hospitals can’t continually run with inadequate staffing over the weekend. It places an unfair burden on staff and ultimately puts patients at unacceptable risk.’
Ms Dabars noted that over the last six months more than 100 voluntary separation packages have been offered to nurses across metropolitan hospitals.
“It beggars belief that amid a pandemic SA Health thought it was appropriate to reduce the number of nurses available when the state of our emergency departments clearly indicates that our hospitals are woefully under resourced,” she said.
“We were assured by senior hospital staff that the VSPs would not impact on the availability of patient care and safe staffing arrangements; clearly they were wrong.”
Union links patient’s death to surge in demand
The ambulance union says a man’s death at the weekend may be linked to a lack of resources, after a huge surge in demand at the weekend.
Ambulance Employees Association state secretary Phil Palmer described the weekend as “a shocker” with staff working extended shifts without breaks that he warned put the safety of patients and staff at risk.
“This is the 12th OpStat Red in the last couple of months, each time because SAAS have been caught out with not enough ambos to meet demand,” Mr Palmer said.
He cited a social media post from a union member which states: “Roughly 75 per cent of the metro crews did their entire 12-hour shift without a single break. A person died today because we took 18 minutes to get an ambulance to them and even then it was only a single responder. Would they have died anyway if we’d been there in five minutes or even hit our own KPIs? Who knows.”
The union says the patient was attended by a solo responder who began CPR while waiting for help from an ambulance crew.
“We cannot say for sure whether the patient would have survived if attended earlier, but we can say unequivocally that whatever chance he may have had was denied by the lack of ambulances,” Mr Palmer said.
The male patient, 75, was alert and talking while his wife, a former nurse, stayed on the triple-0 call due to him complaining of dizziness and shortness of breath, and his priority status was upgraded when his condition deteriorated and a two-man ambulance was sent to join the first solo responder.
SAAS chief executive David Place said the incident has been reviewed and no further investigation will take place, but as in standard procedure the case will be referred to the Coroner. “SAAS did not take 18 minutes to respond to a cardiac arrest,” he said.
“While Saturday was an exceptionally busy day with workload far above predictions, the safety of our patients is our priority. It is, of course, challenging for both our paramedics and our communities when surges occur.
“We continue to focus on reforming our service and supporting the health system to reduce ramping. Ensuring we operate efficiently is critical to releasing resources and we have a number of changes planned in the coming months.”
Mr Marshall noted the SAAS workforce has increased 20 per cent in the past year with an extra 130 officers.
However, Opposition health spokesman Chris Picton said: “The Marshall Liberal Government’s savage cuts to our health system have left our ambos chronically understaffed and under-resourced and subject to ramping.
“How many more times does the Marshall Liberal Government need to be warned before they take action and invest in our ambulance service?”