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Health - Hospital Performance and Staffing

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Monday, 6 September 2021

Tags: Royal Hobart Hospital, Health, State Budget

Dr WOODRUFF - Okay, thanks. In July, the Royal Hobart Hospital recorded its worst result on record for patients seen on time. Only 36 per cent of people were getting care within clinically-recommended timeframes. That overall figure included only 42 per cent of patients with imminently life-threatening conditions. It also included only 24 per cent of patients with potentially life-threatening conditions, or who were in severe discomfort, being seen on time. That's more than three times below the national benchmark of 75 per cent. All of these performance indicators have been going backwards at the Royal Hobart Hospital faster than at the state's other hospitals. Why is that the case?

Mr ROCKLIFF - I recognise the recent ED data and the Health Dashboard for the Royal Hobart Hospital is, indeed, concerning. However, I want to assure Tasmanians that we are working to improve outcomes for people who present at the ED. We are seeing high-levels of complexity at the Royal Hobart Hospital. In July this year the Royal Hobart Hospital's Emergency Department saw its highest percentage of patients in categories 1 3 this year. Patients in these categories present to an ED with immediate life-threatening conditions, or symptoms such as chest pains, wounds, or severe pain and are more likely to need hospital admission. This increase in complexity leads to an increased number of patients requiring admission to hospital which can make it challenging for staff to be able to see people within the recommended times.

I've said previously that requires collaboration, and sharing of information, which is why I'm now releasing data on the performance of our hospitals on a monthly basis. We are working with our health staff to improve access in patient flow, as we've spoken about before, including implementing services such as Hospital in the Home, which assists people to get home as soon as it is appropriate to do so. We are also investing in strategies to keep people well, and out of hospital, such as the secondary triage which as of 16 August had referred approximately 600 triple zero calls to our alternate care provider. We've also provided permanent funding for the community rapid response service, which I mentioned this morning. Applications for the GP after hours support initiative are now open, providing support for primary health providers such as GPs to offer extended hours or an urgent care service where people can attend, where appropriate. Today we've also announced the acceleration of emergency department beds - 25 beds - by the end of 2022, to alleviate the areas you've highlighted and improve the data you referred to.

Dr WOODRUFF - Minister, I can't disagree with Ms Morgan-Wicks' comments that it's more than just about providing beds. Beds are clearly an issue. However, I know that clinicians, nursing and other staff in emergency departments are asking why your government has resisted increasing staffing numbers those departments? You talked about hospital flow investment and the challenges for staff to meet people within the required timetable. Why has there not been the increase in staff commensurate with the increase in people coming into emergency?

Mr ROCKLIFF - I wouldn't say we're not keen on increasing the staff numbers.

Dr WOODRUFF - I didn't say that. It's been reported to us that there has not been a commensurate investment in increasing staffing numbers to balance the number of people coming through the door.

Mr ROCKLIFF - I'll go through some of the figures for emergency department staffing full time equivalents. At the Royal Hobart Hospital, the three yearly figures are: in 2018 19 we had 219.3 FTE; in 2019 20 we had 235.5 FTE; this last financial year it's increased to 254.2 FTE. That's an example of increasing staff numbers. The Royal Hobart Hospital has been a focus, but I hear what people are saying. We've spoken about increase in demand and more complex presentations.

Dr WOODRUFF - It's a matter of record that the ANMF had to take the government to the Industrial Commission to get the LGH properly staffed with nurses. This government has taken the approach to understaff emergency departments. Are you going to change that approach?

Mr ROCKLIFF - Yes. I will hand over to Ms Morgan Wicks for comments.

Ms MORGAN-WICKS - That industrial issue related to a dispute on benchmarking analysis and numbers. Nursing staff at the LGH emergency department had been increased but the ANMF put a position about that number. We've previously commented on that.

Mr ROCKLIFF - We recognise the concern. We have committed to bringing forward the 25 beds and we'll have more staff to support those beds.