Chief Psychiatrist Dr John Brayley revealed in his annual report last year that his office had undertaken a detailed investigation into ramping at the Royal Adelaide Hospital, Lyell McEwin Hospital and Flinders Medical Centre.
His investigators visited the hospitals’ emergency departments and interviewed frontline staff, representatives from the SA Ambulance Service and mental health care providers.
Brayley has made a series of recommendations to help fix the escalating problem of patients left parked in ambulances outside emergency departments, which paramedics say is putting lives at risk.
SA Health has told InDaily Brayley’s investigation report will be published soon, but has declined to answer any questions about what it found or recommended.
The Ambulance Employees Association and State Opposition are calling on the State Government to immediately release the “damning” report.
In his annual report tabled in State Parliament last September, Brayley stated “the report has just been finalised at the time of writing”.
Six months later, details are still under wraps, in the midst of a bitter dispute between the State Government and Ambulance Employees Association about how to fix the problem.
The government has offered to employ 50 extra ambulance officers to help ease pressures but wants paramedics to reduce their shift lengths and take their breaks at the closest station rather than their home base.
But the union says hundreds more paramedics are needed and argues that workers shouldn’t be forced to give up rights that help them protect the community.
Brayley’s investigation into ramping was one of only four investigations conducted by his office last year.
In his annual report, Brayley said the investigation was undertaken in response to concerns expressed by the SA Ambulance Service about “increasing problems” of mental health patients being forced to endure ramping.
“The investigators visited the Emergency Departments of the Royal Adelaide Hospital (RAH), Lyell McEwin Hospital (LMH) and Flinders Medical Centre (FMC),” Brayley said.
“They interviewed representatives from SAAS, and from SA Emergency Departments and Mental Health services.
“The investigators also examined data collected about delayed transfer of care and reviewed several policy documents from SA Health and the Australasian College of Emergency Medicine.”
Brayley said the investigation provided “comprehensive reporting” and analysis and findings of:
- The frequency and duration of delayed TOC (transfer of care)/external triaging/ramping of people with a mental illness across the system and at different hospitals
- Handover of patient care processes in place at different sites
- Determining the effect delays in transfer of care have on consumers, family and staff
- Compliance with the Mental Health Act (MHA) 2009, and relevant policies during periods of delayed transfer of care
He said the investigation made a number of immediate, urgent, short-term and longer-term recommendations.
They would “assist in the prevention of delays in the TOC or if ramping occurs, strategies to mitigate the effects of these delays, including actions that could be taken by SAAS and receiving hospitals”.
“Whilst not all recommendations will apply to every emergency department, the report does provide a broad approach that will have relevance for all Local Health Networks,” he said.
Brayley said “a draft copy was circulated to LHNs, and the report has just been finalised at the time of writing”.
“The Investigation report will be distributed to Local Health Networks,” he said.
Ambulance Employees Association industrial officer Leah Watkins called on the Government to “immediately” release the report.
“Anecdotes tell us that the Chief Psychiatrist’s report is likely to be damning on the state of the health system and in particular as it pertains to mental health patients – we hear that from our members,” Watkins told InDaily.
“We are deeply concerned and we believe the public should be deeply concerned that the government is putting more effort into hiding any information that poses a risk to its reputation, than it is in ensuring an accessible health system for the community.”
Opposition health spokesperson Chris Picton accused the government of “sitting on this report for six months” and also called for its immediate release.
“We know there’s a huge impact upon people with mental health problems in our hospital ambulance system at the moment,” he said.
“There are reports of people being stuck in emergency departments for up to five days and significant ramping happening at all of our major hospitals.
“It seems a pretty clear attempt from the government to try to hide the extent of the problem by keeping this report secret when it may well shed more light on what doctors, nurses and paramedics have been speaking out about.”
Picton said the public had a right to know what the Chief Psychiatrist had recommended to fix the problem.
“We know the Chief Psychiatrist said it was finalised when he tabled that annual report,” he said.
“That was last year. There’s no excuse for why it hasn’t been released. There’s no excuse for why doctors, nurses and paramedics can’t see what the extent of that is and, importantly, patients and community members can understand how bad things have got and what is being proposed and recommended to address these issues.
“Saying that they’re going to release it at some point down the track only now that they’re getting media questions about it, looks like an attempt to deflect attention from this issue when they should have been proactive and released it when they received it last year.”
Health Minister Stephen Wade said “the report will not be hidden”.
“It will be released soon,” he said.
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