Record number of emergency presentations putting NSW health system under pressure

The NSW hospital system is struggling to cope with a record 665,000 patients swamping emergency departments in the last quarter of 2015.

As a result of the increased pressure on the health system the waiting time for non-urgent surgery was nine days longer than the same period the previous year, according to the NSW Bureau of Health Information [BHI].

The NSW hospital system is struggling to cope with a record number of patients.
The NSW hospital system is struggling to cope with a record number of patients. Photo: Edwina Pickles

Further, the three-year improvement in patients leaving the emergency department within four hours appears to have flatlined, with some hospitals struggling to treat half of their patients in that time.

Nepean Hospital, which is the worst performing in the state, treats only 53 per cent of patients within four hours and nearly one in five wait longer than a year for elective surgery.

Retired surgeon Patrick Cregan, until recently the chair of the Nepean Blue Mountains Local Health District, said the hospital was unable to get through its waiting list because there were insufficient beds for its expanding patient base.

The emergency department, which was designed to see 50,000 patients a year, admitted 66,700 patients last financial year, and the figure was growing annually by 5.4 per cent, fed by an ageing population and overseas immigration.

“When you get that sort of load coming through the emergency department, those patients get queued up and they essentially get first crack at the beds and therefore there’s no physical beds to put other patients into,” Associate Professor Cregan said.

“The population is ageing faster than the state average because a lot of Baby Boomers came and bought houses and now they’re getting older.”

Across NSW, patients waited on average two hours and 41 minutes in the emergency department – three minutes longer than the previous year – and 74 per cent of them were seen within the target time of four hours.

The median waiting time for elective surgery was 223 days, compared to 214 days the previous year, and about 5 per cent of people listed for non-urgent surgery such as cataracts or knee replacements – about 1000 patients – waited for more than a year.

Most elective surgery procedures were performed within their recommended time frames, and 100 per cent of urgent surgery cases were performed within 30 days.

Meanwhile, 91 percent of people were transferred from an ambulance to hospital within 30 minutes, which was the first time that NSW has hit its target.

BHI chief executive Jean-Frederic Levesque said Royal North Shore, St George and Blacktown hospitals had experienced significant increases in the number of patients coming through emergency rooms.

“This puts more pressure on staff in terms of being able to provide timely treatment and ensuring that patients are able to spend less than four hours in the waiting room,” Dr Levesque said.

A NSW Health spokesman said a new “peak activity team” had worked with the ambulance service and hospitals to ensure patients were transferred quickly.

But the longer time that patients were waiting for emergency care and elective surgery was due to the increased number of presentations.

Local health districts had various strategies to ensure surgery was performed on time, including concentrating planned surgical procedures in high volume, short stay units and sharing the demand for theatre time between hospitals and specialties, the spokesman said.

NSW Health Minister Jillian Skinner said presentations had remained at high levels because of the lasting impact of a severe influenza season over winter.

“Our hospitals continue to deliver high-quality and timely care, with 74 per cent of patients leaving emergency departments within four hours – a vast improvement from the result of 60 per cent at the end of 2010,” she said.