Record numbers of patients stuck in SA emergency departments

Almost 9000 patients waited more than a day in clogged metropolitan emergency departments for a ward bed last financial year. See where the logjam is worst.

Almost 9000 patients were forced to wait more than 24 hours in metropolitan public hospital emergency departments until a ward bed became available last financial year.

Patients lost in the limbo of clogged EDs have spiralled to an average of 24 every day, waiting more than a day for a ward place — up from seven a day five years ago.

Figures obtained by the Sunday Mail show patient numbers warehoused in EDs for 24 hours or more tripled from 2655 in 2017-18 to 8843 in 2022-23.

This period included two changes of governments, the opening of the $2.4bn Royal Adelaide Hospital and the pandemic.

Patients presenting to ED with visit time equal or greater than 24 hours

Source: SA Health. Includes patients who died, did not wait to be seen, or left at their own risk before treatment was complete.

Patients stuck in EDs in turn has created record ambulance ramping as new arrivals are forced to wait with paramedics in car parks, and to soaring delays in treatment for people who take their own transport to hospital.

Ramping jumped to 3354 hours lost in car parks in July, up from 3105 in June, despite the goverrnment’s pre-election promise to “fix” ramping.

An ambulance at the Royal Adelaide Hospital. Picture: NCA NewsWire

SASMOA chief industrial officer, Bernadette Mulholland. Picture: MATT LOXTON

Some patients end up waiting several days in ED beds until a suitable bed becomes available. Many are in need of suitable mental health beds.

One glimmer of positive news was the 4124 patients stuck in EDs for more than 24 hours in January-June 2023, was a drop compared to the record 4718 patients in the previous six months. However, this was still almost double the number in the same period two years earlier.

SA Salaried Medical Officers Association chief industrial officer Bernadette Mulholland said clinicians are feeling “crushed” by a system that has needed attention for years.

“Our hospitals and health system should never have reached this crisis point, lack of workforce and bed planning over years by health administrators and successive governments placed the SA community’s health at significant risk,” she said.

“There is still enormous pressure on doctors in our hospitals to meet patient demand, and although there is a slight decline no one should be patting themselves on the back.

“It takes years to fix a broken health system. Everyone can pat themselves on the back when we have enough beds and staff in our hospitals.”

Health Minister Chris Picton welcomed the downward trend and accused the former government of “neglecting health.”

He noted the government is adding 550 more hospital beds and has employed 550 more clinicians, along with rostering more clinicians on weekends to streamline discharges and investing in alternatives to hospital.

“For the first time in a long time, the numbers of patients stuck in emergency beds waiting for a ward bed is starting to trend downwards, however there is still much more to be done,” he said.

Health Minister Chris Picton. Picture: NCA NewsWire / Brenton Edwards

“The key issue is not enough beds in hospital wards – which is why we are building hundreds more beds.

“We need more ward beds in our hospitals to move patients out of EDs and that is exactly why we are investing record funding to build more capacity right across our hospital system.”

However, Opposition health spokeswoman Ashton Hurn accused the government of downgrading health as a priority.

“Every single week there are around 170 people waiting an entire day or more to be seen in our emergency departments – it is a frightening result and the worst it’s been in five years,” she said.

“The Labor Party came to office promising to fix ramping and fix health, but this is another clear sign that health doesn’t seem to be Peter Malinauskas’ priority now he’s Premier.”

A SA Health statement notes patients presenting to EDs are prioritised based on clinical need with those requiring urgent care seen first.

“Increases in wait times align with surges in Covid hospitalisations and respiratory illness in the community, as well as rises in mental health presentations,” it says.

“A hospital is not always the most appropriate place for mental health patients and alternative sites such as the Urgent Mental Health Care Centre, the Safe Haven in Salisbury and successful programs such as Mental Health Core are helping suitable patients.”

It says there are plans to open two adult mental health centres and urges people who do not require emergency care to consider other options such as their local GP, pharmacist, after-hours GP clinic or virtual care services.

SA Health is working to fast track discharges including rostering more clinicians and staff on weekends, establishing transit lounges to move patients safely out of beds sooner and better use of home hospital programs.

Child and adult virtual ED services also are being expanded, and the RAH’s new Respiratory Rapid Access Service offers existing respiratory patients a specialist appointment, instead of needing to attend the ED.

New EDs have opened at Mount Barker Hospital and the Lyell McEwin Hospital this year.

Originally published as Record numbers of patients stuck in SA emergency departments