Despite comments from the Northern Territory (NT) Chief Minister that the current situation is manageable, ACEM President Dr John Bonning said data showed increased pressures resulting in a deterioration in regard to patients being seen and admitted to hospital on time.
“This places patients at greater risk and increases the pressure on ED staff,” said Dr Bonning.
The data also shows that overall ED presentations have increased by some 30% since the Palmerston Regional Hospital opened in August 2018, and that in the NT people present to EDs at more than twice the rate per 1,000 head of population when compared to the rest of Australia.
While bed numbers might be comparable to other jurisdictions, in reality the system is under much greater pressure due to ED presentation and admission rates that are more than double the national average.
Based on the most recent Australian Institute of Health and Welfare data for 2018-19, Royal Darwin Hospital is in the bottom 10% of all major hospitals for patient admission times, with only 30% of ED patients being admitted within four hours (the national access target).
An average of around two patients per day (623 patients in total) were waiting more than 24 hours for admission at Royal Darwin Hospital, a 20% increase from 2018 levels and a number which is clearly unacceptable. Once the acute aspects of care have been attended to in the ED it is important that patients needing admission are moved to ward beds so the ED can continue to manage the ongoing influx of patients.
“While politicians like to blame ‘GP type patients’ who present to the ED, GP patients have minor conditions and do not need admission to hospital. The cause of overcrowding and long waits in Darwin’s hospitals is overwhelmingly a lack of beds for significantly ill/injured admitted patients,” said Dr Bonning.
“More inpatient beds are the solution; it is not simply a question of managing the fluctuations. More patients are needing admission and we need more beds.
“Situations such as ‘double bunking’, where two patients have to be put in the one cubicle, or patients being left in corridors or other inappropriate spaces are a near daily occurrence. The current situation represents an unacceptable risk to public health and is manifestly unfair to our patients.
“While staff are performing admirably under incredibly difficult circumstances, the reality is that the shortfall in beds means they are struggling to keep up with demand.
“In order to provide the health system that the community deserves, 100 additional inpatient beds are needed as a matter of priority.”
Background
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au