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Non-urgent ambulance pick-ups scrapped as hospitals crisis escalates

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Ambulances will attend only “urgent” cases, all non-elective surgeries will be postponed and some patients admitted directly to hospital wards – bypassing Emergency Departments – as the government today struggles to cope with the state’s clogged health system.

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The move comes amid revelations all of the state’s ambulances were treating patients – with none available for any new emergencies – at various points yesterday, while all metropolitan hospitals have been forced to “ramp” patients outside EDs today, according to the Ambulance Employees’ Association.

SA Health today responded to the crisis, with a new plan “aimed at reducing pressure on busy hospital emergency departments”.

Chief executive Vickie Kaminski said the move was “necessary to meet the high number of presentations to metropolitan emergency departments over the past week”, which has seen 8538 presentations to EDs.

“This unprecedented demand has placed considerable pressure on our EDs and the SA Ambulance Service, which is why we are implementing these important strategies,” she said in a statement.

“From today, patients who are assessed as not requiring hospital or paramedic care will be advised of alternative care options, including visiting a GP clinic or pharmacy.

“For some patients not requiring paramedic support, the Royal District Nursing Service will also be able to provide in home support.

“This will see fewer ambulances going to our hospital EDs, and ensure they’re available to respond to the most urgent cases.”

All “non-urgent” surgeries will be delayed to “flex up as many beds as possible”.

“Where appropriate some patients will be directly admitted into a bed rather than going through ED, and patients may also be relocated to peri-urban hospitals where it is safe to do so,” Kaminski said.

“I want to acknowledge those patients who may be impacted and thank them for their understanding at this time.”

SA Ambulance Service CEO Jason Killens implored South Australians, during a press conference this afternoon, not to call Triple Zero unless they were concerned it was a genuine emergency. Other patients were urged to consult Health Direct on 1800 022 222, their general practitioner or a pharmacist.

He said some patients had phoned an ambulance for conditions that do not require an ambulance – such as toothache and stubbed toes – in the past 24 hours.

“We are continuing to receive calls from patients who… do not need an emergency ambulance,” he told reporters.

Health Minister Jack Snelling said he would write to federal Health Minister Greg Hunt to request an urgent meeting to deal with the fact that patients were not accessing primary health care such as general practitioners as much as they did in previous years – which was placing huge strain on emergency departments.

“What we’re seeing at the moment is a fundamental problem (of) people not accessing GPs,” he told reporters.

“It’s a problem we’re seeing right across the country.”

He added that GPs referring patients to emergency departments for low-priority procedures like stitches, plus a failure to adequately address patients with chronic disease before they need an emergency department, have contributed to the problem.

“We can invest billions (in hospitals) but it can only go so far,” said Snelling.

SA ambulance union general secretary Phil Palmer told ABC Radio Adelaide this morning that yesterday was “a dog’s breakfast out there, total chaos” for paramedics, and a dangerous situation for patients.

“At various points we had every single ambulance tied up either on the ramp (waiting at a hospital) or on a job – so none left for emergency coverage,” Palmer said.

“If they had an emergency case come in then there would have been no-one to deal with it.”

He said there was also no ambulance coverage for large portions of the state yesterday.

“We had no crews down south, no crew at Aldinga, no crew at McLaren Vale (and) Sellicks Beach – the area where someone died from a long response time previously – was left uncovered again,” he said.

“The Ambulance Service had to cancel all low-acuity cases, all priority eights (low priority) and were leaving higher-acuity cases in hospital because they just could not move them, just did not have the resources.

“I’m reluctant now to say it’s the worst day I’ve ever seen because my members think every time I say that it gets worse.”

He said the reason for the crisis was a sheer lack of resources.

“Workload too high, too few ambulances – as we’ve been saying almost forever,” he said.

“We had managers dragged in off shift, off time off, we had members offering to come in on time-off to try and bolster the crew load.”

All metropolitan hospitals have been forced to ramp patients and have been over capacity at the most extreme “code white” level.

It comes less than two weeks after the opening of the new Royal Adelaide Hospital.

Palmer told InDaily last month that the department had failed to release funds for the recruitment or extra paramedics early enough as part of the Transforming Health hospital reforms, and that the Ambulance Service was working beyond its capacity as a result.

“We don’t have any extra ‘boots on the ground’ yet, due to (SA Health and) Treasury refusing to release funds until it was too late,” he said at the time.

“Recruiting should have started 18 months ago at least but did not start until early this year.

“It requires a 12-month long internship to make a degree-qualified graduate –road-ready, with authority to practice as a paramedic.”

Palmer said at the time that paramedics’ workload was continuing to climb, and response times were deteriorating.

“Blown-out response times are now the norm, and there have already been two deaths that had 23-minute plus responses to cases that should have been attended in eight minutes,” he said.

“(Transforming Health) has created more need for patient transfers, but no extra resources to meet increased demand.”

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