An 18 month pilot of the UCC Network – which aims to provide patients with urgent, but not life-threatening, health issues with quick GP appointments rather than requiring them to visit EDs – was launched in WA last week.
“It’s encouraging to see community health resources being boosted, but we are disappointed that the initiative fails to address the issue of hospital beds for patients waiting days in EDs for admission to a ward or mental health unit in WA,” said ACEM President Dr Simon Judkins.
With state-wide ambulance ramping hours tripling from June 2018 to June 2019, and access block – where people wait in the ED for longer than eight hours for an inpatient bed – having not been below 10% since May 2018, ACEM Western Australia Faculty Chair Dr Peter Allely said much more was needed to address the lack of resourcing and lack of beds for those needing admission to hospitals.
“UCCs will not solve bed or access block in hospitals,” said Dr Allely. “It’s very demoralising for staff and their dedicated efforts to help patients who need to be admitted into a hospital ward from the ED, but are unable to access a bed.”
Dr Allely said although ACEM supports measures which improve access to a range of healthcare services, the real solution to ED congestion requires a whole-of-system approach. Patients who require inpatient beds are unlikely to have the same needs as those presenting to UCCs.
As a recent WA Auditor General’s report highlighted, people are repeatedly visiting the ED and waiting for extended periods because of the lack of mental health inpatient beds and dedicated mental health services in the community. These patients require specialist services that won’t be available at UCCs.
While it has been difficult to get official figures on dangerously long waits in EDs for mental health patients, according to ACEM’s calculations, 156 mental health patients across the state spent more than 24 hours in EDs in August 2019, with the longest wait for a mental health bed coming in at 100 hours and 9 minutes.
“The ongoing issues of overcrowding, access block and ambulance ramping at WA hospital EDs make it clear many more systemic issues still need to be urgently addressed,” said Dr Allely.
“On top of this, the lack of inpatient beds has also been the cause of severe ambulance ramping in winter this year, considered to be the worst in a decade.
“Critical overcrowding has resulted in extended periods of code yellow (indicating an internal emergency) being called in hospitals in Perth this winter.
“ACEM calls on the WA Government to provide an open and transparent plan to address these systemic issues, and would welcome the opportunity to be part of finding solutions.
“We also, once again, urge the Government to act on its previous commitment to address the issue of long-stay patients in EDs by reporting and acting on 24-hour stays, including though the public release of this data to encourage transparency and accountability.”
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au