A shortage of emergency department doctors at Wollongong Hospital is leading to a blow-out in patient waiting times, and putting staff under stress according to an insider.
The staff member, who does not wish to be named, said that on an average night shift there were just four doctors rostered on to deal with scores of patients.
"It's been going on for years and it's getting to the point where it's becoming unsafe in terms of the number of doctors on shift," the staff member said.
"Wollongong has one of the busiest emergency departments in the state - we see around 250 patients each day.
"But there's a discrepancy with around 12 to 15 doctors rostered on during the day, yet only around four or five on overnight.
"The understaffing is leading to doctors being overworked and unable to take breaks, while nurses are struggling to juggle the people coming in and trying to prioritise and triage as best they can.
"It's time for hospital management to employ more doctors to make the workplace safer for doctors - and patients."
The latest data from the Bureau of Health Information shows pressure on Wollongong's ED is increasing. From July to September 2019, just over 18,500 patients presented to the ED - more than a 1000 more patients than the same period in 2018.
Meantime only around half (53.4 per cent) of the patients were able to leave the ED within the four-hour state benchmark in the 2019 quarter.
Illawarra Shoalhaven Local Health District Executive Director Clinical Operations Margaret Martin said additional staff were coming on board.
"Wollongong Hospital's ED rosters up to 23 doctors each day, and provides safe, high-quality care, with the most unwell patients always a priority," she said. "Six new staff are expected to start in the ED in the coming month.
"The majority of medical staff are rostered to work during the first 12 hours of the day given most patients present before 8pm."
Ms Martin said the hospital had a "robust escalation process" to manage peaks in demand, including additional senior emergency clinicians.
She said there were specific provisions in the Nurses Award for EDs to allow for flexible staffing according to the number and complexity of presentations.
"Rosters are regularly reviewed to ensure adequate staffing, including during unexpected periods of increased demand and unplanned staff leave," she said.
"The Nurses Award also provides for reasonable workload committees so that any workload concerns can be addressed to ensure a reasonable workload."
However the staff member said the situation within Wollongong ED was becoming "untenable".
"We know that the suicide rate for doctors is among the highest of any profession. At Wollongong Hospital ED, staff are doing their absolute best and they love their jobs, but they're getting burnt out."
Ms Martin said hospital management appreciated the dedication and hard work of its staff and was committed to supporting them.
"Wollongong Hospital has established a wellness committee which delivers initiatives for all staff in targeted areas such as work life balance, mindfulness, self-care and financial wellness," she said.
Last year NSW Health introduced additional work standards, she added. These included a maximum of 14 hours for rostered shifts and a minimum 10-hour break between shifts for medical officers to better manage fatigue.
As well, in 2017, the NSW Government launched its $3 million Well-being and Support Plan and an additional $1m for the Junior Medical Officer Be Well Program.
The latter included 10 initiatives to improve the health and well-being of JMOs including a dedicated support line offering specialised confidential counselling.