Tasmania's EDs taking the hit for health system failure, report finds

Health system failure as older patients present at Tasmanian emergency departments, report finds In short: The Australasian College for Emergency Medicine says successive governments have failed to plan for an aging population. A national report has found that pressure is accumulating in hospital emergency departments. What's next? The federal and Tasmanian health ministers have blamed each other for the failure. The Australasian College of Emergency Medicine (ACEM) has warned that Australia's health system is not equipped for the growing number of older patients presenting in emergency departments. The national State of Emergency report, released this morning, said the health system, from primary care, residential aged care, home support, to hospital services, was ailing from insufficient planning. It claimed successive federal, state and territory governments had not done enough to prepare for the volume or complexity of care as Australia's population aged. The report said emergency departments (EDs) were often being left to fill gaps, leading to ambulance ramping, overcrowding, corridor care and access issues. Older people represented close to a quarter of the nation's nearly nine-million presentations. The rate was highest in regional, rural and remote areas. Patients left on trolleys or chairs ACEM Tasmania branch chair Juan Ascencio-Lane said he did not have to predict what would happen in the state without intervention. "We don't need to look forward — we are in this crisis right now," he said. "When you boil it down, what's at stake is people's lives." Tasmania has Australia's highest proportion of people aged 65 and over. Older people are significantly more likely to be classified in higher urgency categories, arrive by ambulance and be admitted to hospital. The report found that between 2018-19 and 2023-24, the number of older attendees at Tasmanian EDs increased by 19 per cent, compared with 2 per cent in younger people, and 17 per cent nationally. ACEM recommends that 90 per cent of patients requiring hospital admission access a bed within eight hours, but that occurred only 40 per cent of the time in older patients locally and 54 per cent nationally. The report said extended wait times meant the elderly were often left "frail and in pain", without adequate rest, nutrition and dignity, and vulnerable to deterioration. "These patients are often left on a trolley or on a chair in a bright, noisy emergency department where staff are really pushed to the limits to care not just for them, but for the acute new patients," Dr Ascencio-Lane said. He said the toll on staff was "enormous". "We want to provide high-level care, particularly for these older people," he said. "This is causing a huge amount of stress and burnout, with nurses and doctors in particular, who are looking for alternatives within their employment." Urgent action needed The report projected a 411-per-cent increase in ED arrivals of people aged 85 and over by 2050. ACEM has made a series of recommendations and implored governments to take urgent action. They include strengthening alternative acute care pathways via programs integrating hospitals, aged care, community services, and Aboriginal health organisations, as well as more telehealth support for residential aged care. It also recommended more funding hospitals to deliver more services in the community. The not-for-profit group, which trains emergency physicians, also recommended improving patient flow by increasing inpatient beds, and ongoing training for rural EDs to treat patients locally. It is also calling for at least 10,000 additional aged care beds by 2028, 24/7 access to a registered nurse, and incentives to take on residents with complex conditions, dementia or behavioural symptoms. Federal, state blame-game The federal government is responsible for primary and aged care, with states and territories in charge of hospitals. State Health Minister Bridget Archer said Tasmanians should not have to rely on hospitals for care, but often had nowhere else to go. "These Tasmanians are not statistics," she said in a statement. "They are Tasmanians who deserve dignity, compassion, and a proper place to recover, and this growing national crisis demands an immediate response from the Federal Labor Government." Federal Minister for Health and Ageing Mark Butler said the government had eased hospital pressure through increased funding, more aged care beds, expanded bulk billing and Urgent Care Clinics. "There are real pressures facing the aged care system right now, and we continue to work with states and territories in good faith," he said. "It is time for state governments to deliver on their promises to give Australians access to health services, when and where they need them." [Image text:] EMERGENCY MAX HEIGHT 3MTRS