Precisely what that may look like will become clearer in coming days and weeks. One certainty is that old, new and evolving challenges will continue to make their presence felt.

Clearly, there are difficulties and pressures already being experienced in jurisdictions contending with significant and growing COVID-19 cases, community impact and ED presentations. Our thoughts remain with colleagues grappling with these, in addition to the major challenges of providing timely acute care to our “business as usual” patients in hospital emergency departments.

As a College we have continued to emphasise the importance of governments, system leaders and all those involved in healthcare maintaining a focus on healthcare systems as a whole. Collaboration and cooperation across these systems is key as we collectively seek to address the immediate challenges, improve systems and be prepared for what predictably comes to all our EDs every day.

Certainly, circumstances are difficult. However, solutions offered must not simply shift pressure from one part of the system to another and they must genuinely result in all patients receiving the highest possible standard of care.

It is not just locations where COVID-19 is currently having a significant impact where issues must still be addressed. Wrangling at political levels, and shifting government strategies and outlooks aside, it is increasingly obvious that it is a matter of when, not if, COVID-19 reaches us all. Our systems must be prepared; to support staff on the frontline – already weary and under sustained pressure – and to ensure patients get the care they need in a timely manner.

Vaccination, and rapidly increasing uptake, is one very important part of the plan. And while it has been heartening to see vaccination rates increase relatively quickly after the well canvassed issues which plagued the early phase of the rollout – particularly in Australia – there is still more to be achieved.

This is particularly the case in those jurisdictions and communities where vaccination rates are lagging. Inequity of vaccination access and coverage poses a significant threat to ensuring the highest possible level of protection across our countries, as well as a major barrier to eventual re-opening and reunification across our nations. As we inevitably move from an elimination phase to mitigation of the effects of the virus on individuals, communities and hospitals, we must ensure that we protect vulnerable populations.

Governments must redouble efforts to address this, just as they must ensure our systems are prepared, and frontline workforces are supported, to address the inevitable increase of COVID-19 cases, as well as the systemic contributors to the access block that hard experience has taught us is so prone to persist, and intensify.

Whole of system solutions to address whole of system issues’ is our persistent refrain, as our College advocacy efforts progress on these important issues.  Access block in EDs is a symptom of the wider problem and ACEM’s hospital access targets (HAT) seek to address this.

As the pandemic has continued to present a significant number of challenges, often changing on a daily, basis, the College too has continued to adapt and modify the way it operates. Disappointingly, this has involved the cancellation of our 2021 Annual Scientific Meeting, which was initially planned to take place in Christchurch in November, but which is unable to proceed due to ongoing challenges, including those associated with travel and construction of the conference venue amid the pandemic.

While not a full replacement, the College is still planning a one-day virtual event – “2021, The Year in Review” – showcasing the work of our members, trainees and staff, and coinciding with our Annual General Meeting on Tuesday 9 November. Details of the day, including a program outline,will be provided very shortly, and I encourage you all to attend. We will continue to keep you updated with regard to all College events, and look forward to a future where in-person meetings are once again possible.

Despite the many challenges of the COVID-19 pandemic, ACEM has continued to navigate the immediate challenges, and continues to do its best to support members and trainees on the frontline. Amid this, is it also very important to maintain focus on the future.

With this in mind, the College is embarking on the development of its next Strategic Plan to cover the period 2022 to 2024. The ACEM Board has worked with senior College staff to develop an initial draft document, and is now inviting feedback to inform the next stage of the development of this important piece of work. 

Please do consider this document and take the opportunity to provide your feedback. The College is here for its members and trainees, and it is important that your views and expectations are reflected.

As I write this, my penultimate blog as President, I reflect on what we have been through since the start of 2020, and more there is still to come. Remember kindness and compassion to all, including yourselves, and remember your work is as important to your communities as it has ever been. I give my sincere thanks to you all for your interest, involvement and contributions to the life and work of our College, in addition to the contributions you make each and every day in providing care to those most in need.
Kia kaha,

Dr John Bonning
ACEM President