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Despite winter coming every year, it seems that we are always impacted by the same problems: the hospitals fill up with the elderly and those affected by the flu and RSV; elective surgery forges ahead despite this; our ICUs fill and critically unwell patients occupy our resus bays for hours; we see our emergency departments (EDs) full, ambulances ramped and patients suffering.

It also seems there was a distinct lack of planning this year, with budget cuts experienced across many systems and many locations. On top of this, patient risks have never been clearer, with the horrible media reports of a patient who went in to arrest after spending more than an hour ramped in an ambulance outside an ED in South Australia. Sadly, not an isolated case.
 
The links between overcrowding, bed block and patient mortality are clear and the current situation should not be accepted as the ‘new normal’. Data to be released soon from Professor Drew Richardson will show that overcrowding and access block numbers are worsening, and Dr Peter Jones will be showing us the strong links with mortality in a soon-to-be-released study.
 
With this data, and with feedback from you, we will be repositioning our access targets to focus on admissions. The pressure has to continue and the advocacy must remain strong for the sake of patients and our ED staff. We will be working very closely with other Colleges, the Australian Medical Association and other health bodies to get agreement on these goals. As we know, we can’t do this without all players on board.
 
On another matter, I recently had the chance to visit Papua New Guinea to see first-hand the great work the ACEM Global Emergency Care staff and our Fellows are doing. The international development work is incredible, and I would encourage all of you to learn more about what emergency physicians, with ACEM support, are doing in the South Pacific and Asia. It is inspiring, and you’ll see some of the stories in the latest edition of Your ED magazine, which has just been released. If you have the opportunity, get involved; there are many ways to help.
  
In a few weeks, the ACEM Board will have its first meeting with our new Board members, and our first Board meeting in New Zealand. Sadly, and somewhat ironically, I won’t be able to get there as I have a family event the night before… and we all need to get that balance right (I know; pot, kettle). On the upside, our incoming President, Dr John Bonning, will take the Chair role at a Board meeting which is sending a strong message of change.
 
As I move out of the big chair and into Immediate Past President mode, the big piece of College work that I will continue to be involved with is emergency medicine workforce. This is complex and involves multiple levels of engagement at federal, state/territory and hospital levels and, of course, with all of you.
 
We will be developing strategies and structures to ensure that we can provide emergency medicine care to all communities in Australia and New Zealand; as you know, the largest deficits are in regional and rural areas. We have the FACEM numbers coming through, but we need to ensure that we are getting the supply and demand balance right. More on that to come soon.
 
Stay well, stay engaged and, as always, let me know how ACEM can help.

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