‘Heads in the sand’: Ballarat paramedics say ramping continues to plague emergency department

Paramedics at one of the state’s busiest regional hospitals say patients are still spending hours waiting for beds despite new standards as Victoria’s health service buckles under pressure.

Ballarat paramedics say new standards meant to improve health care are not being consistently met, with ambulance patients having to wait hours for a hospital bed.

It comes as ambulances were warned on Monday night that Ballarat Base Hospital was especially busy and had long waiting times.

“Ballarat hospital bed blocked and long delays expected overnight,” the warning read.

“Please consider alternative destinations where appropriate.”

Fewer than 5 per cent of the state’s ambulances were available overnight Monday amid a code orange, which is a precautionary measure indicating increased ambulance demand or reduced ambulance fleet availability.

In July last year, exhausted Ballarat paramedics said they were forced to sit with critically ill patients in crowded corridors, sometimes for half a shift, because of Victoria’s battered health system.

Those problems persist, especially as winter brings more people to the ED with respiratory illnesses such as the flu to Covid.

Recently introduced state government standards say no ambulance patient transfer should take longer than two hours, describing anything longer as a “never event”.

But some paramedics have recently waited up to seven hours on night shifts for their patients to be properly transferred into the hospital; even more remain ramped – forced to wait for a bed inside – for longer than two hours.

Ballarat Base Hospital’s emergency department.

Victorian Ambulance Union secretary Danny Hill said long wait times were a “daily occurrence”.

“We welcome those new guidelines and welcome them coming into effect,” he said.

“The problem is that they really are just guidelines and not a fully enforceable directive on the hospitals that they must prioritise ambulance offload.

“Looking at some of the ramping we’ve seen this week, you would hope that there’s some quite strong conversations happening with hospital CEOs in relation to ramping because it’s been out of control

“We’ve had about 100 crews around the state ramped at hospitals unavailable to respond to patients in the community, including at Ballarat, where we had waits of over four hours [on Monday night].”

An experienced Grampians paramedic says ambulances are still spending too long ramped at Ballarat Base Hospital.

An experienced Grampians paramedic said that as the region’s population increased dramatically in past decades, ramping gradually became an accepted state of affairs.

“Newer staff just think that’s normal now,” he said.

“Everyone just seems to have their heads in the sand.

“Some of the students spend half the day sitting in the corridors when they want to be working – it’s not what they signed up for.”

He added that dedicated staff meant to help with patient handover at the ED were often unavailable.

Mondays are particularly burdensome, he said, as more beds tend to be taken up by the weekend’s patients and there are fewer hospital staff rostered on on Saturdays or Sundays to help with discharging them.

“Everyone at the coalface is aware that upstairs they don’t have a doctor in to discharge them from the hospital over the weekend,” the paramedic said.

“So then on a Monday you come in and the whole system’s backed up.

“It’s a simple thing that could be done.”

Paramedics are also held up responding to non-emergencies, putting more strain on the system.

“If paramedics are free to respond to genuine emergencies, then we’ve probably got the right amount [of paramedics] for the state,” Mr Hill said.

“The problem is they’re being spread across so much additional work plugging gaps in other parts of the health system that we just don’t have the resources available to be able to handle that.”

If nothing changes, he said “massive recruitment” would be needed to keep pace with the workload.

A paramedic returns a stretcher to an ambulance at Ballarat.

A Grampians Health spokeswoman said increased pressure was being felt across the state’s hospitals.

“Grampians Health manages periods of high demand across the year, and while wait times may be adversely impacted during these times — no patient is ever turned away,” she said.

“We continue to work in close partnership with Ambulance Victoria as part of our standard daily operations to ensure co-ordinated and timely care.

“As a public hospital, we remain committed to providing care to all who need it.

“All patients presenting to our ED (via ambulance or through the front door) are triaged carefully and those who are most unwell will be seen to first.”

To avoid overloading the ED, people in Ballarat with urgent but non-life-threatening conditions can visit Ballarat’s urgent care clinic at 1010 Sturt St.

A state government spokeswoman also encouraged considering nurse-on-call or the Victorian Virtual Emergency Department.