Tens of thousands more patients are leaving NSW emergency departments before getting treatment compared to before the pandemic, new data shows.
Analysis of the latest data from the NSW Bureau of Health Information showed that more than 67,000 patients left emergency departments (ED) without, or before, completing treatment in the last quarter of 2024.
That’s 12,000 more people who left without treatment than in 2019, an increase of a third.
Patients needing urgent care leaving the ED
While the largest proportion of people who left were in the semi-urgent category, which would include things like a sprained ankle or an earache, a third were in the urgent category.
This group includes people with things like moderate blood loss or dehydration, where the goal is to see 75 per cent of them within 30 minutes.
Rachael Gill, acting chair of the NSW faculty of the Australasian College of Emergency Medicine, said the finding was “deeply concerning”.
“It’s a bit of a canary in the coal mine situation where the access block is felt most acutely in the emergency department, but it’s actually a symptom of a significant burden of increasing disease severity and complexity and inability for the system to be responsive to that burden,” she said.
Australian Medical Association NSW president Kathryn Austin was alarmed that urgent cases were leaving the ED.
“They’re the people who usually have significant conditions that come back in a more significant way, with a triage category one or two,” she said.
“That means they’re increasingly unwell, putting more and more strain on the systems to be seen urgently.”
About 60 per cent of people categorised as urgent are seen within 30 minutes, and the only time the goal of 75 per cent has been achieved in the last 10 years was at the start of the pandemic in 2020.
Dr Austin said frontline doctors and nurses had seen this become a bigger problem in recent years.
“We’re just seeing increased complexity, increased acuity in our patients, and having to ask our workforce to do more and more with less and less,” she said.
Non-urgent cases should be seen by ‘alternative services’, minister says
Patients were most likely to leave the ED before their treatment was completed, or without being treated, on a Monday, and between 8-10pm at night, and when aged 15-29.
Health Minister Ryan Park said EDs needed to be kept for the most urgent cases, with semi-urgent and non-urgent cases treated in the community, using services like helpline Healthdirect.
“These are the sort of people that we need to get out of our EDs and into these alternative services because they are often people who express concerns about the length of time they have taken to have treatment and that is because they are not in that emergency classification,” he said.
He pointed to new data showing improvements in ramping, where ambulances have to wait outside hospitals to transfer patients to the ED.
Blacktown Hospital had a 23 percentage point increase in the number of patients transferred from paramedics to the ED within 30 minutes in the fourth quarter of 2024, compared with the same time in 2023.
The improvement in ramping by this measure across the state went from 80 to 83 per cent.
Patients waiting for elective surgery at post-pandemic levels
The quarterly data also showed a jump in the number of people waiting for elective surgery in the last quarter of 2024 — up 13 per cent, or 11,000 patients, since the same time in 2023.
More than 100,000 people are waiting for elective surgery, almost as high as the 10-year, pandemic peak in the second quarter of 2020, where 101,000 patients were waiting for elective surgery.
The number of patients waiting longer than clinically recommended tripled from 2,100 to 6,800 in the last quarter of 2024, compared to the same time in 2023.
Mr Park said the December holiday period, along with industrial disputes, had impacted elective surgery waiting lists.
Dr Austin said NSW doctors and nurses were the lowest paid in Australia.
“We’re being told we don’t have enough access to theatres simply because we don’t have the workforce,” she said.
“There has not been an investment in this workforce that’s been sustained.”
