ACEM asserts that supporting the Australian healthcare system to cope with current demand, as well as planning for the future needs of Australians, requires a whole-of-system reform approach and significant investment in key areas of concern that are federal responsibility, such as aged care and the NDIS.
The AIHW report shows that, despite declines during the early months of the COVID-19 pandemic, presentations to public hospital emergency departments, in every state and territory in Australia, have continued to rise, at an average of 3.2% a year, or 200,000 more people – without equal increases in resources, such as more staff and hospital beds.
Unacceptably, too many Australians are facing distressingly long, and potentially dangerous waits, for the next stage of their care, after presenting to emergency departments at their time of most need.
Average length of stay (LOS) – the amount of time it takes a patient to leave the ED after assessment and initial treatment, either back home, to an inpatient bed or to community-based care – has increased, with Australians waiting to be admitted suffering the longest delays. People who require acute hospital inpatient treatment are now waiting an average of 41 minutes longer to leave the ED than they did five years ago.
The College calls upon the parties contesting the 2022 Australian Federal Election to commit to investing in key areas of concern that are federal responsibility, such as aged care and the NDIS to keep Australians safe and healthy – now, and into the future.
ACEM President Dr Clare Skinner said, “None of the report came as a surprise to any of us – we see it and feel it, in real life every day. But these increases aren’t just numbers. They represent real people who urgently needed emergency care and had to wait longer for that care than ever before.”
“The numbers also don’t tell the full story. There are more people presenting to ED, but their problems are also more complex – people are arriving sicker and requiring more care, more social supports, and are more likely to need a bed in the hospital. And we just don’t have enough staff, and we don’t have enough free beds.”
“This creates bottlenecks in the ED because people who need treatment in hospital get stuck in the ED, then there are no beds in ED for assessment of new patients who require care. This problem has a term you may have heard – access block, one of the root causes of most of the issues in the Australian healthcare system.”
“Access block is also a major cause of ambulance ramping, as patients needing to be assessed and treated in the ED can’t get into the ED as it is too full – because of the other patients who can’t leave the ED. They get stuck in the ambulance bay, or along a corridor, and then the ambulances can’t leave to collect other people needing acute care. This is dangerous and will continue to lead to worse patient outcomes, including death, if it not fixed.”
“None of this is normal. Overcrowded emergency departments are not acceptable. It is dangerous to patients and to staff – who do their very best with resources provided to them by hospitals and governments – and it doesn’t have to be this way. We can fix these problems with more staff, more inpatient beds, and better resourced and coordinated community care for chronic disease, aged care and mental health.”
“Australia, this is your healthcare system that you expect to be there for you and your family when you need it the most. An increase of 3.2% represents well over 200,000 extra people needing acute care year on year, so it is only going to get worse. Tell your leaders you can’t wait – your health is on the line.”