Ballarat hospital's emergency department pressure builds

New quarterly health performance statistics reveal that while the number of patients treated in the ED from April to June fell slightly compared to the previous quarter, the number of severely-ill patients needing immediate treatment increased 14 per cent over three months and is now more than 50 per cent higher than the same time last year.

The number of category two patients, who should be seen within 10 minutes, also increased to an average of 30 a day, and an average of a further 70 category three patients, requiring treatment within 30 minutes, also came through the door.

The latest Victorian Agency for Health Information quarterly performance statistics come as Grampians Health - Ballarat was forced to issue an alert about higher than usual demand in the emergency department on Friday afternoon that was expected to continue over the weekend.

"Everyone in our community - who at one time or another will need their health service - is asked to play their part in stabilising this pressure over coming weeks," the statement said.

"We're asking our community to partner with us in our collective effort to protect each other and our health services from the impacts of COVID and flu-like illnesses.

READ MORE: Letter to the Editor: A local's experience at the Ballarat Base Hospital Emergency Department

"The consequence of not wearing a mask, and not getting vaccinated is that the pressure we are seeing in our hospitals will continue to rise."

It is one of several similar warnings the hospital has issued in recent months and comes after the hospital twice declared a Code Yellow - in April and June - signalling an internal emergency allowing it to focus staffing on the most urgent areas of care and service delivery.

The combined pressure of COVID, flu, winter viruses, staff illness and "higher acuity' patients has stretched ED waiting times and prompted regular advice from the hospital about alternative avenues for healthcare if people do not require emergency treatment.

During the April to June quarter, the ED treated a third of patients within the recommended waiting time for their category of illness/injury.

That was down slightly from almost 39 per cent from January to March, and 45 per cent at the same time last year.

All category one patients received immediate treatment, and 29 per cent of category two patients were seen within 10 minutes which although lower than many hospitals is almost double the rate of Melbourne's Monash Hospital in Clayton.

Ballarat Base Hospital saw an average of almost 130 people a day, every day, from April to June.

The average waiting time between presenting at the ED and first being seen by a nurse or doctor for treatment was 51 minutes, up from 43 minutes the previous quarter and 38 minutes during the same time last year with the wait for category one to three patients averaging 44 minutes - the highest in the state.

READ MORE: How long non-urgent patients wait at Ballarat Base Hospital emergency department

Last month, Grampians Health chief operating officer - hospitals Ben Kelly said the Ballarat ED, along with all EDs across the state, was seeing consistently high demand.

"All patients who present to ED are triaged and are seen based on their level of acuity - those who are most unwell are seen first. We're seeing consistently high presentations of patients with acute (serious) illness or injury, which are more resource-intensive and can cause longer wait times for those who attend with non-urgent concerns," Mr Kelly said.

"Our ED has seen consistently high demand - we're not alone in this, and we thank our staff for doing everything they can to limit wait times for our community."

While the time it takes to transfer patients from ambulance to ED care increased to 36 minutes, from 27 minutes, it was still well below the state average and several hospitals where it takes more than 60 minutes, contributing to ambulance response delays.

More than half of patients in Ballarat were transferred from ambulance to ED within 40 minutes, down from two thirds at the same time last year.

Victorian Healthcare Association head of policy and advocacy Juan Paolo Legaspi said extreme demand for paramedics and emergency department care, driven by COVID-19 and other respiratory illnesses, caused longer waits for all types of health care including planned surgery.

"Our public health services are doing everything they can to keep up, but extreme demand appears to be the new norm in Victoria," he said.

With COVID-19 now predicted to affect large numbers of Victorians in multiple waves throughout the year, not just once a year like the flu typically does, Mr Legaspi said it was time for governments to do more to address the workforce shortage in our public health system.

This shortage, which existed before the pandemic, has worsened with furloughing due to COVID-19, and increasing rates of burnout.

"We can't just keep asking healthcare workers to "keep on going" when we know this won't be the last wave of COVID," he said.

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"There used to be seasonal peaks and troughs in the intensity of work for our healthcare workers. This data shows we are in an unprecedented era of intense demand. Our health workforce is under high pressure all the time. It's unsustainable. Unless we bring in a lot more workers to reduce this burden quickly, we're at risk of losing staff faster than we can recruit or train them."

An extra 278 patients received elective surgery during the past three months, compared to the first three months of the year with 1086 patients going under the knife and an average wait time for surgery of 27 days, up slightly from the previous quarter but fairly steady over the past 12 months.

Just over half of category two patients received their surgery within the recommended 30 days, higher than the previous quarter but still well below the 75 per cent mark reached at the same time last year.

Unlike many other hospitals, Ballarat's elective surgery waiting list was down slightly from the previous quarter across category one (needing surgery within 30 days) and category three (within 12 months) and only grew by five patients in category two (within 90 days).

It was however much higher than at the same time last year.

For those category two and three patients the wait could be agonisingly long with an average overdue wait time of 172 days for category two, and 250 days for category three patients.

Ahead of the November Victorian election, the VHA is calling for the state government to create a workforce strategy and recruitment campaign to urgently attract more health workers locally and from overseas.

As well as bolstering the domestic workforce, the VHA has called for the Commonwealth to cut red tape for international recruits.

Mr Legaspi said: "COVID-19 isn't going anywhere. If we value timely access to care in our public health system, we need more flexibility and more workers to meet new levels of demand from our community.'

Ambulance Victoria Interim chief executive Felicity Topp said data for the fourth quarter of 2021-22 showed response times impacted by soaring demand, the wide spread of the Omicron variant, sicker patients who have deferred care, and staff furloughing.

"There are no signs of demand slowing down through winter. COVID-19 continues to pose a high risk to Victorians and will do some for some time," Ms Topp said.

Ambulances were called to 97,928 Code 1 cases from April to June this year - the highest number in AV history and third consecutive record-breaking quarter.

That is 16 per cent or 13,487 more 'lights and sirens' cases compared to this time last year and 4694 more than the previous quarter.

Between April and June, 64 per cent of Code 1 cases were responded to within the state-wide average response time target of 15 minutes. The state-wide average response time to Code 1 cases was 15 minutes and 49 seconds.

Ms Topp said Ambulance Victoria was working hard to relieve pressure in the system with more paramedics on the road and more Ambulance Victoria Offload (AVOL) teams to rapidly transfer patients to hospital care.

"These teams, established as part of our pandemic response efforts to improve patient flow at the ambulance and hospital interface, are now being expanded to 14 public hospitals and a further five are in planning," Ms Topp said.

Grampians Health Ballarat advises:

If you do not need time-sensitive emergency care, or if you are unsure, while you are at home consider contacting

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