Overview
Each year, ACEM administers the Annual Site Census, which is a comprehensive survey completed by Directors of Emergency Medicine and Directors of Emergency Medicine Training at all ACEM-accredited emergency departments (ED) across Australia and Aotearoa New Zealand. Findings from the census are used to monitor activity, staffing and resources of ACEM-accredited training sites and provide an evidence base for ACEM's policy and advocacy initiatives relating to ED workforce and function.
The 2025 site census was distributed to the 150 EDs that were accredited at the time of data collection. ED activity and case mix data were sought from 1 July 2024 to 30 June 2025, with all other data reflecting the status at the time of completing the survey.
All 150 sites (130 in Australia and 20 in Aotearoa) submitted the 2025 census. Data is reported by region (state and territory in Australia and by health region in Aotearoa), remoteness and delineation and by the range of annual presentations. ED remoteness and delineation categorises EDs using the Modified Monash Model (MMM) in Australia and the Geographic Classification for Health (GCH) in Aotearoa. In Australia, EDs in metropolitan (MMM 1) areas are separated into sub-categories which include major referral, non-major referral, specialist children’s and private. While EDs located in MMM2 are classified as regional and EDs in MMM 3-7 are combined and classified as rural and remote. In Aotearoa, all ACEM-accredited EDs are located within Urban 1 or Urban 2 areas of the GCH.
Key data is shown in the visuals on this page with more comprehensive data available in the supplementary file which can be downloaded at the bottom of the page.
ED activity and case mix
From 1 July 2024 to 30 June 2025, a total of 8,791,925 presentations were reported at ACEM-accredited EDs. The average number of annual ED presentations was 58,254 across 130 Australian EDs (comparable to the 2024 census) and 60,942 across 20 Aotearoa New Zealand EDs (7.7% increase vs. 2024 census).
The figure also shows the proportion of attendances aged <16 years and 65+ years, the proportion of patients who arrived by ambulance, and the proportion of presentations classified in the most urgent triage categories (ATS 1-3).
24-hour ED length of stay
Between 1 July 2024 and 30 June 2025, 130,134 presentations to ACEM-accredited EDs, or 1.5% of total presentations, were reported to have a length of stay greater than 24 hours. In Australia, Tasmanian EDs had the highest proportion of total ED presentations with a length of stay greater than 24 hours (3.5%), followed by EDs in South Australia (3.1%). EDs located in Central Aotearoa reported the highest proportion of presentations with a length of stay greater than 24 hours (1.9%), compared to the other health regions. By remoteness, regional EDs in Australia had the highest proportion of ED presentations with a length of stay greater than 24 hours (3% vs 2.4% in the 2024 census).
The proportion of discharged patients (0.3%) who had a length of stay greater than 24 hours was significantly lower than the proportion of inpatient admissions (5.3%), and inter-hospital transfers (7.4%) (available in supplementary data).
EM specialist and FACEM trainee staffing profiles
In 2025, the average full-time equivalent (FTE) of EM specialists across ACEM-accredited EDs was 17.6. The average FTE of FACEM trainees in training stage 1 was 3.7, compared with 7.2 FTE for those in training stages 2 – 4.
The EM specialist FTE to headcount ratio was 1 : 1.6, meaning an average of 1.6 emergency medicine specialists were required to fill every 1 FTE position. On average, accredited EDs had 0.6 FTE of FACEM trainees for every 1 FTE of EM specialists. The figure also shows the ratio of emergency medicine specialists and FACEM trainees to ED presentations and the number of EDs which met ACEM’s recommended minimum EM specialist staffing levels (G23).
EM specialist and EM trainee vacancies
The proportion of accredited EDs with funded but unfilled FTE (i.e. vacancies) of EM specialists decreased from 45.3% in 2024 to 38% in 2025. Overall, there were 101 unfilled FTE of EM specialists reported across Australia (75.3 FTE) and Aotearoa New Zealand (25.7 FTE).
On the contrary, the proportion of accredited EDs reporting EM trainee vacancies increased from 52% in 2024 to 55.3% in 2025. There was a total of 376.6 unfilled FTE of EM trainees reported across Australian and Aotearoa EDs.
EDs located in regional, rural and remote areas of Australia were more likely to report having funded but unfilled FTE for both EM specialists and EM trainees, compared with EDs in metropolitan areas. Comparable proportions of EDs located in Urban 1 and Urban 2 areas of Aotearoa reported having unfilled EM specialist or EM trainee vacancies. EDs with 40,000 – 50,000 annual presentations were most likely to report having EM specialist (50%) and EM trainee (72.7%) vacancies.
ED treatment spaces and resources
The average number of treatment spaces (beds and chairs) across ACEM-accredited EDs was 51.7, with one treatment space per 1,165 ED presentations. Almost half of the spaces were designated as acute beds (average of 23.9 per ED).
Trends in average EM workforce FTE, annual presentations, and treatment spaces over time
Recent years of Annual Site Census data have been collated to track trends in key metrics between 2021 and 2025. The figure shows the trends in average EM workforce FTE, annual presentations and treatment spaces. The ratio of EM workforce FTE and ED treatment space to the number of ED presentations are also shown in the figure.
Additional data is available in the supplementary data tables below. If you would like to request access to additional data you can do so via the data request form. For any further enquiries about ACEMs Annual Site Census please contact [email protected].