Hospitals in crisis as taskforce searches for solutions

A panel of experts are set to begin examining how to radically reshape models of care in NSW hospitals as emergency departments come under unsustainable pressure.

A NSW Emergency Department Taskforce will be exploring how new care models such as treating people virtually could take pressure off emergency department staff. Picture: NewsWire / Monique Harmer

A panel of experts is set to begin examining how to radically reshape models of care in the ­nation’s largest public hospital system as emergency departments come under unsustainable pressure amid a breakdown in primary care and chronic bed block in the wards.

An Emergency Department Taskforce convened by the NSW government will hold its first meeting on Thursday as attendances hit record highs, ambu­lances are regularly unable to offload patients, and sick people are frequently unable to be admitted to a bed.

Comprising key clinical experts, the taskforce will be exploring how new care models such as treating people virtually could take pressure off ED staff and allow earlier discharge of those in wards to prevent people being stuck in corridors while awaiting admittance to a bed.

They will also explore strategies to reduce avoidable ED attendances, adapt workforce models and improve patient flow through the hospital to improve timely access to treatment in EDs.

The taskforce is co-chaired by clinical director, Emergency Care Institute, Agency for Clinical Innovation, Trevor Chan and NSW Health deputy secretary, system sustainability and performance, Matthew Daly.

“We’ll be looking at how ambulances are processed when they arrive, the best way for them to be spread across the system to make sure the time for care is as reduced as possible,” Dr Chan said.

“We’ll be looking at … where best care can be delivered to each patient … the other supports being developed such as urgent care centres, other avenues that can provide care.”

Dr Chan said a key focus would be virtual care models so that some emergency patients could be looked after at home via telehealth, and some patients could be discharged from hospital wards earlier, using digital care models for ongoing monitoring and treatment.

The taskforce gets under way after latest quarterly figures revealed patients spent longer in NSW emergency departments in the mid-year last year than any three-month period on record, with the median wait time out to three hours and 36 minutes.

The breakdown in bulk billing and accessible primary care is a key driver of the worsening trends in ED, together with rising incidence of chronic disease.

As many as 7 per cent of ­patients who need to see a GP around the country are avoiding making an appointment because they can’t afford to pay gap fees, which have risen to an average of $42, according to the Productivity Commission.

The NSW government is building a network of urgent care centres to try to ease the crisis, alongside the federal government’s 58 clinics nationally. So far NSW has built 25 urgent care clinics. They are also supporting pharmacist prescribing.

“Our hospitals and EDs are under continuing pressure and the NSW government is committed to doing everything possible to improve the experience of care for patients and better support our dedicated frontline health staff,” NSW Health Minister Ryan Park said.

“This taskforce is one part of the NSW government’s comprehensive strategy to address ED wait times. We are tackling issues we have right now … but also looking to the future so we can continue to innovate and adapt to meet the growing health needs of our communities.

“This taskforce will look at opportunities to streamline and deliver treatment in more strategic ways, so the people of NSW receive the best possible care.”

The ED taskforce comes after a similar taskforce slashed overdue surgeries in NSW from 14,000 to 2100 in nine months through expanding procedures eligible for same-day surgery.