Critically ill patients needing treatment within ten minutes have instead waited almost one hour for their treatment to start at one of Sydney's major hospital emergency departments.
Across the state, one in four people presenting emergency departments waited too long to be treated, according to the latest Bureau of Health Information's Quarterly Report.
Nepean Hospital had the worst emergency department delays between January and March this year, with more than 45 per cent – almost 9000 patients – waiting longer than the clinically recommended time frames for their treatment to start.
Roughly 60 per cent of "emergency" cases – patients with imminently life-threatening conditions including very severe pain, serious chest pains, and severe breathing problems – waited longer than the target 10 minutes for treatment.
One in 10 of these "emergency" patients - the second-highest triage category - waited 53 minutes or longer, over five times the recommended time frame.
Just under 60 per cent of "urgent" cases did not start treatment within the recommended 30-minute timeframe. At least one in 10 waited for more than an hour, according to the report released Wednesday.
These patients have potentially life-threatening conditions such a heavily bleeding wound or major fractures.
Dr Nhi Nguyen, chair of Nepean Hospital’s medical staff council, said the results were “a reflection of a system on the brink”.
“There was a lack of acute beds to assess patients as well as a lack of hospital beds, which meant we ended up having patients with nowhere to go,” Dr Nguyen said.
Almost half of patients (45.7 per cent) at the major tertiary hospital did not leave the ED within the four-hour target window.
Nepean's treatment time result plummeted 11.1 percentage points compared to the same quarter in 2017, while the number of presentations rose 4 per cent.
In March the state government committed $450 million to stage two of a major redevelopment for the beleaguered hospital, on top of $575 million for stage one, which included plans for a new emergency department.
The new emergency department is not expected to be completed until 2021.
Dr Nguyen was hopeful that interim measures put in place in April would help the hospital weather the influx of patients over winter.
The measures included additional assessment beds, a dedicated paediatric area, additional ED staff including more doctors, and new strategies to discharge appropriate patients by 9am to free up beds.
“We are well placed now for the anticipated increase in activity into the next quarter,” Dr Nguyen said.
“Whether this will sustain us until the redevelopment, I’m not sure.”
Kay Hyman, Nepean Blue Mountains Local Health District chief executive, said semi-urgent and non-urgent presentations had declined but people were still presenting to emergency departments with conditions that could be treated at a GP, pharmacy or medical centre.
“Our emergency departments are always here to help, but with the busy winter season upon us we ask people to consider other services such as their GP for non-urgent care,” she said.
NSW emergency departments recorded 714,101 presentations from January to March.
Across the state, roughly one in four ED patients waited too long for treatment to start, amid a 1.6 per cent rise in presentations on the same quarter in 2017. The median time spent in a NSW ED was two hours and 42 minutes- up 2 minutes on the same quarter last year.
The proportion of patients transferred from ambulance to NSW EDs rose to 92 per cent and roughly three-quarters of patients (74.4 per cent) spent four hours or less in the ED.
Emergency department staff are increasingly treating sicker patients.
Overall, T1 resuscitation cases – the most serious triage category, almost always treated within two minutes – rose 6.5 per cent on the same quarter last year. T2 "emergency" cases rose 6.9 per cent and "urgent" cases rose 3.4 per cent, while the proportion of non-urgent cases dropped 3.3 per cent.
Emergency departments in western Sydney – generally some of the state’s most over-stretched – recorded marked improvements.
Westmead Hospital posted an impressive 26.5 percentage point jump in the proportion of patients starting treatment on time, though one in three patients were still waiting longer than clinically recommended.
Blacktown Hospital, which recorded wait times as dire as Nepean Hospital last year, recorded a 12.3 percentage point rise in ED patients treated on time (65.3 per cent), despite a 9.3 per cent increase in presentations.
"We see tremendous growth at Blacktown Hospital and impressive improvements [on this measure]," BHI chief executive Diane Watson said.
"There are clearly opportunities for other hospitals to learn [from their strategies]," she said.
This story originally appeared on the Sydney Morning Herald.
