‘Disgraceful’: Code yellow to end amid record ramping – but surgeries stay scrapped

SA Health will end its internal code yellow emergency this month – but documents show its measures will continue, under new names.

SA Health’s code yellow internal emergency officially ends on August 16 – but documents show its measures will continue, under new names.

These include “seasonal” elective surgery, paving the way for open ended cancellations of non-urgent elective surgery when hospitals get busy, and plans to allow ambulance arrivals to leapfrog more urgent patients stuck in waiting rooms in order to cut ramping.

The sudden dumping of the code yellow, announced as record ramping of 5539 hours in July was revealed — has infuriated the Ambulance Employees Association (AEA) and alarmed frontline emergency department clinicians.

It was declared on May 30 with measures including cancellation of some elective surgery to free up ward beds in order to move treated patients out of chronically full EDs and cut ramping.

AEA state secretary Leah Watkins said the decision must be reversed.

“The decision by SA Health chief executive Robyn Lawrence to stand down the code yellow on August 16 is disgraceful” Ms Watkins said.

Ambulance Employees Association state secretary Leah Watkins. Picture: NCA NewsWire / Naomi Jellicoe

“To call the code yellow a success while ramping hours have reached worst levels on record is simply unbelievable, and is disrespectful to patients languishing in the community, waiting for an ambulance.

“The health system is in crisis and the department believes this is the time to revert to business-as-usual — this decision must be immediately reversed.”

A memo by Dr Lawrence to staff says the code yellow resulted in improvements, despite July’s record ramping, and measures taken under it will continue even though the official declaration will finish.

These include “seasonal plans for elective surgery,” opening the door for non-urgent surgery to be pushed back when hospitals are busy.

SA Health chief executive Dr Robyn Lawrence Picture: Kelly Barnes

The memo also says a code yellow initiative to remain in place is: “A requirement for senior ED decision-makers to consider external community risk when there are extended Transfer of Care (ramping) delays.”

Worried doctors say this translates to mean they are supposed to somehow consider the theoretical welfare of the entire state instead of the actual patients in front of them, as they are trained to do.

Doctors previously have complained about less urgent ambulance arrivals being given priority so ambulances can be released to attend other urgent calls in the community, however Dr Lawrence says “expert clinicians will always make the decisions on who is seen first.”

She released a statement to The Advertiser saying: “We have experienced a period of unprecedented demand over the past few months. Clinicians and support staff have worked tirelessly to ensure South Australians receive the best access to quality care – carrying out 15 per cent more elective surgeries in July compared to the same time last year.

“We know there are seasonal peaks in acute demand, and we plan our elective surgeries accordingly. This has given us further insight into how we can match bed availability, staff leave and the need for additional measures when we are expected to be operating at capacity.

“In our Emergency Departments, our expert clinicians will always make the decisions on who is seen first, regardless of how they attended a hospital. We rely on our medically trained staff to assess patients and triage them accordingly, as they are in the best position to do so, and no directive contravenes that approach.”