Royal Adelaide Hospital declares ‘major incident alert’ as it struggles with patient surge

The Premier has blamed a “major incident alert” declared at the RAH on a patient “surge”. Non-urgent elective surgery is being rescheduled as staff struggle to cope.

Non-urgent elective surgery is being rescheduled after a “major incident alert” was declared at the Royal Adelaide Hospital.

The Ambulance Employees Association has released what it says is an internal SA Health memo that states the RAH’s Acute and Urgent Care services, which includes the emergency department and general medicine, were swamped with 225 inpatients on Monday morning.

It is understood these services usually cater for about 180 patients.

It is the second time in recent weeks a “major incident alert” has been declared at a hospital.

Flinders Medical Centre issued the code in May after it was swamped with patients.

Such a declaration triggers urgent action within hospitals to ease overcrowding.

Premier Steven Marshall defended the state government’s handling of the crowded hospitals on Tuesday, saying SA was in a “surge situation” – like every other state.

“It’s clear we need to significantly upgrade our capacity here in SA and that’s what we’ve been doing since we came to government,” he said.

“We are in a surge situation at the moment, this is not peculiar to SA, at the National Cabinet on Friday there was a review where all states presented with what their elevated presentation rates were … there is an increase across the country.

He said nine SA emergency departments were being upgraded and construction occurring at the same time as a “surge” was almost like “additional pain for long-term gain”.

Mr Marshall said Flinders Medical Centre would in a few weeks open a much larger emergency department.

“This is the busiest emergency department in the state, and soon will be the biggest.”

Health Minister Stephen Wade denied there was a lack of leadership at the Royal Adelaide Hospital, saying over the past week there was a 6 per cent increase in the two most urgent emergency presentations and an “unexpectedly low number of patients discharge” that led to pressure across the system.

SA Health chief executive Dr Chris McGowan on Monday issued a memo to all staff about the situation, acknowledging that there have been high levels of demand on emergency departments over the past few weeks, “especially in recent days”.

“While the increased pressure is being seen nationally, across our system we are enacting a range of initiatives to alleviate the pressure on our hospitals and our staff,” he wrote.

“This includes referring patients to My Home Hospital, Priority Care Centres and the Urgent Mental Health Care Centre, rescheduling non-urgent elective surgery, and maximising the use of peri-urban hospitals and our capacity in the private system.”

The Royal Adelaide Hospital. Picture: NCA NewsWire / Naomi Jellicoe

Dr McGowan said patients with the most urgent needs were being prioritised for treatment.

Central Adelaide Local Health Network executive director of operations Brendan Docherty also sent an email to staff, explaining that SA Health had mobilised a Network Incident Command Centre to co-ordinate, deploy resources and undertake a range of actions “to help us get emergency patients to the beds they need”.

He said those involved in the centre were meeting every two hours to review and assess progress, and determine further actions required.

“These actions will allow us to secure additional bed capacity so that we can move patients from the emergency department and avoid the delays that patients are currently experiencing at ED,” he wrote.

Mr Docherty asked clinicians to reschedule “all non-clinical, non-essential activities for the next 48 hours to allow all clinicians to focus on our patients, interventions and flow and enable our clinical managers to lean into the clinical areas to support our multidisciplinary teams”.

“This will prepare us for the week ahead,” he said.

The Ambulance Employees Association wrote on social media the internal disaster was declared at the RAH at 1pm “due to a lack of capacity”.

“Our health system remains in crisis,” it said.

South Australian Salaried Medical Officers Association chief industrial officer Bernadette Mulholland said hospitals needed more space and more beds.

“There are real concerns about being able to provide all the care in a timely manner that's required for the patients. there’s blockages everywhere,” she said.

“How you actually attend to the amount of the presentations and give them the care they deserve is very difficult when you have hospitals that don't have enough beds for the patients that are presenting.”