The Australasian College for Emergency Medicine (ACEM; the College) said that extra funding to expand hospital capacity and inpatient beds recognises the growing year-on-year demand on the health system which is driving more acutely unwell people to present to EDs.
“The main challenge facing EDs is bed block which is a whole-of-health system failure that occurs when patients cannot be safely discharged because of inadequate community support. It reduces capacity for new patients to be admitted to hospital, which results in overcrowded EDs at or above capacity, and longer waits for patients,” Aotearoa New Zealand National Branch Chair Dr Michael Connelly said.
“Upgrades for hospital infrastructure, especially for our regional hospitals, will go some way to alleviate ED pressure. However, improving patient access and flow also requires greater, sustained investment across our health sector to help keep people out of hospital.
“More funding for health services such as primary care, aged care, hospital-in-the home and mental health and addiction services to deliver timely, accessible, and appropriate care would help achieve this.”
Dr Connelly said that health inequity for Māori, who are over-represented in high-acuity ED presentations, is unacceptable and reflects longstanding systemic failure, including a lack of access to primary and community care.
“Health investment must align with Te Tiriti o Waitangi obligations. Health equity measures need to be embedded and integrated throughout the system. This includes high-quality ethnicity data and equity-focused performance measures, with clear accountability to improve Māori health outcomes,” Dr Connelly said.
“Another ongoing key priority is the need to grow and retain our emergency medicine workforce. We need to focus on addressing shortages and maldistribution, especially in regional and rural communities.”
“In the short term, streamlined recruitment and support for overseas-trained doctors will remain critical to maintain ED care. But in the long term, we need to train more emergency medicine specialists, improve retention by addressing stress and burnout, and resolve regional workforce disparities to provide equitable access to specialist emergency care across Aotearoa.”
“We encourage the Government to target funding towards workforce initiatives that are evidence-based and profession-led, such as ACEM’s rural training, blended supervision and accredited training networks.”
“Emergency department teams continue to manage increasing patient numbers and patient complexity, but despite the strain EDs are under we remain committed to safe, high-quality care for everyone who comes to the ED for help.”
“Today’s Budget is a step in the right direction but ultimately, we need sustained funding growth across our health sector that keeps up with rising demand, takes a more preventive and early intervention approach, and enables health system reform to meet the healthcare needs of our communities.”
Background:
ACEM is the peak body for emergency medicine in Australia and Aotearoa New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
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