Qld politics: ED incentives backed by medical experts, says minister

Health Minister Tim Nicholls says a controversial move to link emergency department KPIs to funding incentives is backed by doctors.

Health and Ambulance Services Minister Tim Nicholls with paramedics in Brisbane on Tuesday. Picture: Liam Kidston

Health Minister Tim Nicholls says a controversial move to link emergency department KPIs to funding incentives is backed by doctors, confirming hospitals are at risk of losing cash if they do not transfer patients to wards on time.

It comes after The Courier-Mail revealed a directive was issued to each of the 16 health services stating that hospitals would lose activity-based patient funding for every patient that stayed in an ED for more than 24 hours.

Mr Nicholls staunchly defended the policy change on Tuesday, saying it was supported by 2022 research by the Australian College for Emergency Medicine and would save lives by incentivising hospitals to reduce ambulance ramping.

“This directive that was issued ... not by me, but by the director-general (David Rosengren) as a clinician, as an emergency doctor himself, who has worked at the Royal (Brisbane and Women’s Hospital) and at the Gold Coast,” he said.

“(It) has been discussed with all the hospital and health services and their clinical medical directors before it was signed off.

“I've spoken to the emergency doctors again in the hospitals, and I’ve asked them about the 24-hour movement, and they say (they) support it wholeheartedly.

“Evidence from around the world, evidence from the Australian College of Emergency Medicine, they support it.”

Hospitals will receive a “reconciliation” for the activity-based funding every 12 months, described by Mr Nicholls as “not a hard-and-fast variable, but an incentive”.

“We want to make sure that is driven from the very highest levels, so the people who run the hospitals, the administrators, we want them to understand that this is an very important issue, because it drives that client and consumer safety,” he said.

But the Australian Medical Association Queensland has warned that linking funding to KPIs will increase pressure on overwhelmed emergency departments.

AMAQ president Dr Nick Yim said the policy penalised clinicians who had no control over bed block.

“Patients get stuck in our EDs because there are no beds available in our hospitals,” he said.

“ED doctors tell us they often assess a patient within 45 minutes for admission, but it can take up to 97 hours for the patient to finally get a bed on the hospital ward.”

Mr Nicholls has been tasked with bringing ramping rates below 30 per cent before 2028 or risk losing his ministerial portfolio.

According to latest available Queensland Health data, 40.2 per cent of Queenslanders were ramped outside EDs, unable to be transferred within the recommended 30-minute window.

In May, there were at least 387 unavailable beds contributing to bedblock across the state, largely due to the inability to discharge long-stay patients.

ACEM Queensland faculty chair Dr Shantha Raghwan said the college supported time-based KPIs, but emergency departments experiencing prolonged bed block needed to be supported.

“ACEM particularly supports measures aimed at reducing the length of time patients spend in emergency departments (EDs) by encouraging whole-of-hospital ownership of the issue, as the drivers of access block largely lie outside of the ED,” she said.

Shadow treasurer and former health minister Shannon Fentiman said the tying of funding to KPIs could lead to clinicians prematurely discharging patients.

Originally published as Qld politics: ED incentives backed by medical experts, says minister