Internal emergency at two major Adelaide hospitals amid bed blockages

Internal emergencies have been declared at two major hospitals as more than half their EDs’ capacity are taken up with patients waiting for beds.

Health officials have declared an internal emergency at the Royal Adelaide Hospital and Queen Elizabeth Hospital as their emergency departments are clogged with people who have been treated but are waiting on beds.

The order was given on Monday night but at 10am on Tuesday, the RAH still had 37 such cases in its 69-capacity emergency department, including seven people who had been waiting more than 24 hours for a bed, and five waiting 12-24 hours.

At the QEH, there were 15 people waiting for a bed in its 29-capacity ED, including five waiting 12-24 hours.

With more than half their official capacity taken up by people warehoused while waiting for a bed, the “major incident” declaration aimed to clear the way for new patients and in turn stop ambulance ramping.

Non-urgent elective surgery has been rescheduled to free up beds and the “major incident” status is expected to drag on into Wednesday.

An internal memo to all staff says the Central Adelaide Local Health Network, which covers both hospitals, has initiated the “major incident” alert as a result of major pressure across the network.

“To help manage the increasing complexity and acuity of our patients presenting and to ensure we are operating in a safe environment, we have initiated a network incident command centre to co-ordinate, deploy resources and undertake a range of other actions and tactics that will help us to get emergency patients to the beds they need,” the memo states.

“The network incident command centre is meeting every two hours to review and assess progress and determine further actions that are required.”

While such incidents were once rare, the RAH declared one just last month, while Flinders Medical Centre had one in May after it was swamped with patients.

The memo from executive director of operations Brendan Docherty lays out a range of actions including rescheduling “all non-clinical non-essential activities for the next 48 hours to allow all clinicians to focus on our patients, interventions and flow.”

INTERNAL DISASTER declared across the Royal Adelaide & Queen Elizabeth Hospitals due significant overcrowding.

Our healthcare system is in crisis and in desperate need of greater capacity.

When will the Marshall Govt safely fund our hospitals and ambulance service.#saparlipic.twitter.com/7mQjcxUpJ0

— Ambulance Employees Association (SA) (@aeasa1981) July 13, 2021

The Ambulance Employees Association said it was more evidence of a “healthcare system in crisis and in desperate need of greater capacity”.

The union’s industrial officer, Leah Watkins, said members were dealing with “incredibly long response times to emergency cases, including a six-month-old baby who, vomiting and short of breath, waited 45 minutes for an ambulance to arrive (at Reynella)”.

She said on Monday night there were up to 15 emergency cases where no ambulance was available due to being ramped or on other jobs.

The SA Salaried Medical Officers Association noted there were many more patients waiting for beds across the system, such as 28 at Flinders Medical Centre, including one waiting more than 24 hours.

100 patients waiting in the Emergency Departments for a bed in our hospitals across Adelaide. Hospital resources, health planning and budgets insufficient. @SAHealth@marshall_stevenpic.twitter.com/ygkshvhjZm

— SASMOA (@sasmoa4doctors) July 13, 2021

Opposition health spokesman Chris Picton said it was a major escalation in the ramping and overcrowding crisis “that has been putting patients at risk all year”.

“We now not just have one hospital at code yellow – we shockingly have two major hospitals simultaneously at code yellow or internal disaster levels,” Mr Picton said.

“This comes just weeks after Steven Marshall said his state budget would fix ramping ‘almost immediately’.

“Over 120 nursing positions have been made redundant and the government continues to prioritise its plan for a $662m basketball stadium.

“Over 100 patients were left languishing in our hospital emergency departments this morning, eight of whom have been stuck for over 24 hours left waiting for a bed.

“The Marshall Liberal government’s cuts to our health system have left our hospitals in crisis. Shockingly, Steven Marshall’s response is to inflict even more cuts with more than 160 jobs set to go at Central Adelaide Local Health Network alone.

“We don’t need more cuts. We need a government which will invest in our health system so we can address the hospital overcrowding and ambulance ramping crisis.”

Asked about the ED crisis at Tuesday’s Covid presser, Premier Steven Marshall said: “Obviously we are in the middle of a very significant surge in terms of presentations at emergency departments but also the acuity of those cases and the treatment times.”

“Look, we want to do everything we can to increase the capacity of our health network in South Australia. We’ve got more than $1 billion of work currently in place under way to expand our capacity in this state. We want to make sure that we can get back to having the very best system in the entire country – we’re allocating the money to do that.”

Asked about the plight of the baby who waited 45 minutes for an ambulance, Mr Marshall said the delay would have been “heartbreaking and very frustrating for the family”.

“That’s why we’re working extraordinary hard at the moment to expand our emergency department capacity right across the state with another 140 beds to come online. What we inherited from the previous government was not fit for purpose.”

“I note that in the last couple of weeks we’ve opened an additional nine beds down at the Flinders Medical Centre. That will be up to 30 additional beds at the FMC by the end of this month. So there is work under way at the moment, plenty more work to do.”

He said that since coming to government, another 250 ambulance officers had been added to the system.

The Central Adelaide Local Health Network released a statement saying:

“Due to an increase in the number of high acuity presentations in recent days, yesterday afternoon we initiated a major incident alert across our network. We’ve undertaken a number of actions to help improve bed availability across our network, including rescheduling non-urgent elective surgery.

“Rescheduling elective surgery is always a last resort and is done to ensure the safety and wellbeing of our patients. We will work to rearrange all surgeries over the coming days.

“As always, we must prioritise our patients with the most urgent needs and we apologise to anyone who has been affected by the measures currently in place.

“We will stand down the major incident alert as soon as our position has improved, which we expect to be within the next 24 hours.”