The surge in "high acuity" patients is in part a result of people deferring health care over the past 20 months because of COVID and presenting with more severe illness.

"The numbers (presenting) themselves are not huge, around 150 to 160 a day, which is by and large okay but they are really high acuity," said Ballarat Health Services executive director acute operations Ben Kelly.

"People are quite unwell so a reasonable percentage are needing to have an admission, which slows things down, and you've got to have sufficient discharges for people to be admitted to a bed."

The pressure on the ED has prompted BHS to twice in the past week issue warnings via social media about longer than average waiting times, and suggest possible alternative medical care for less urgent cases.

"It's been widely documented that people may have been deferring their health for some time because of COVID concerns and we will continue to feel the consequences of that for some time."

The BHS emergency department is still operating in zones for respiratory, non-respiratory and suspected COVID cases with staff wearing personal protective equipment, all of which also impacts ED operations.

From July to September, about two thirds of patients attending the emergency department were classed as category one, two or three patients needing timely medical care, and a third were category four or five needing less urgent treatment.

"They are the ones who wait long periods of time," Mr Kelly said. "We are not going to turn anyone away who comes to receive care, but depending on how severe the illness is there may be a long wait."

Mr Kelly said he was concerned about the number of people attending the ED but not waiting for treatment.

"You can interpret that many ways. Our concern is we don't want anyone leaving in frustration who continues to be unwell and is forced to call an ambulance or come in again ... that's far from ideal."

Delays in the ED are also impacting ambulances, who are not able to release patients in to hospital care as quickly as BHS would like.

"At the moment it's a frustrating time for all," Mr Kelly said. "We put out these social media posts to the community to be clear and transparent and make sure people are aware there is a longer wait.

Mr Kelly said the hospital was looking at all options to help ease the pressure, including BHS's hospital at home program.

"With higher acuity, people might stay longer in hospital so we are looking at innovative strategies whether there are safe ways for people to be managed at home with follow-up from the hospital.

"It's challenging for patients who see hospital, when they are sick, as the safest place to be but convalescing at home, if it's appropriate, with our clinicians actively supporting them" is another option.

Mr Kelly said he was proud of staff for working through such difficult conditions.

Patients deferring health care because of COVID concerns has also lead to fears hospitals will see a surge of new cancer diagnoses over the coming months and years.

According to the Victorian Cancer Registry's 2020 figures, cancer diagnoses in Victoria fell seven percent - or about 2420 fewer individual diagnoses - likely due to the COVID-19 pandemic.

The most common cancers that went undiagnosed in Victoria were cancers of the oral cavity (a 16 per cent decline), prostate cancer (13 per cent), melanoma (12 per cent), and bowel cancer (11 per cent). Breast cancer diagnoses in females fell during April to June but recovered slightly by the end of the year with a five per cent drop.

"People are presenting later in their illness and later stage cancer means it may have gone from being curable to non curable," Mr Kelly said.

"We are seeing more later stage disease, from delays in investigation and delays in diagnosis."

Mr Kelly said many people had delayed going to see their doctor because of COVID concerns, or had faced issues with accessing appointments, delays in investigation and delays in surgery.

Mr Kelly said the regions public and private cancer system worked hand in hand to deal with patients and was confident any increase in numbers would not cause further delays in treatment.

IN OTHER NEWS

"We are really fortunate with the quality of public and private clinical oncologists we have in our region. It's hard to know what next year will bring in this really unpredictable in COVID-19 environment."

BHS will look to grow its outpatient oncology and haematology services where demand is high.

"The message is to make sure you do go and see your GP, attend follow-up appointments and even if you think it's nothing, get it checked," he said.

Our team of local journalists work hard to provide local, up-to-date news to the Ballarat community. This is how you can continue to access our trusted content: