Thousands of sick people left Wollongong emergency department with little or no treatment, according to new damning health data showing how the region's health system struggled as winter flu and a new COVID wave kicked off.
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The Illawarra's main hospital performed worst in the state, compared to similar hospitals, when it came to median waiting times for patients needing to be admitted.
One in ten patients needing a bed waited more than 26 hours and 49 minutes to leave Wollongong ED, data shows.
Wollongong also had the highest number of patients who left before being treated, compared to hospitals in its peer group.
The Bureau of Health Information (BHI) Quarterly Report shows 3004 patients left the ED without treatment or before their treatment was complete between April to June, up almost 50 per cent compared to a year ago.
It was also significantly more than most other comparable hospitals, with only Liverpool Hospital coming close to having the same number leaving without treatment.
"The sheer volume of patients leaving our emergency departments before starting their care is shameful. Returning within a few days to try and access care, as they've likely deteriorated, doesn't depict a 'world class' health system, or one that's meeting the needs of NSW patients."
- Nurses union boss Shaye Candish
Statewide, there were only two hospitals - Campbelltown and Sutherland - with a slightly higher number of walkouts than Wollongong.
BHI Acting Chief Executive Hilary Rowell said the number of patients leaving before receiving or completing treatment was the highest on record in NSW.
"Our additional analysis shows that one in five patients who leave without, or before completing treatment, tend to re-present to an ED within three days," she said.
Wollongong hospital's struggle to meet demand between April to June was well-documented by the Illawarra Mercury, with patients, nurses and ED doctors speaking out about deteriorating conditions.
Among these people was Fairy Meadow mother Tylah Buckley, who spoke out in June after her five week old baby Mahli, was sent to the ED with pneumonia and a note marked "urgent" from her GP.
After a five and a half hour wait in the packed waiting room, Ms Buckley was advised that she would be better off taking Mahli home.
"I spoke to my doctors surgery who were shocked they sent Mahli away," she said.
Likewise, five-year-old Jessica Sharpe's parents rushed her to hospital with "extreme" stomach pain, but decided to leave without seeing a doctor after waiting for more than six hours.
Jessica's father Robert Sharpe told the Mercury at the time that he was alarmed by the conditions he witnessed in the ED.
"All of the staff seemed tired and exhausted," he said
"They go to work each day knowing the system isn't at breaking point, it's broken. They simply cannot provide medical services to meet the demands as enough are not available."
On June 20, an emergency department consultant raised the alarm about "dangerous" conditions facing his patients, after one person waited wait in emergency for three days, 17 hours and 24 minutes before being admitted.
They were among three patients that day who waited in the ED for more 60 hours before getting a bed, the doctor said.
"I can't remember anything else like this," the doctor said.
"These are the worst figures I've seen anywhere. I know it is getting worse and it is dangerous."
The Bureau of Health data for April to June confirms wait times were a problem in Wollongong, with the hospital recording the longest waits for those needing to be admitted from the ED compared to similar-sized hospitals in NSW .
Half of all patients needing a bed from Wollongong ED waited more than 10 hours and 34 minutes, which was 33 minutes longer than the second longest wait at St Vincent's Hospital.
The data also shows one in ten patients needing a bed waited more than 26 hours and 49 minutes, which was the second longest time among comparable hospitals.
Treatment times also increased, with nearly two-thirds of Wollongong patients classed as having a critical illness or being in very severe pain not starting their treatment on time.
Only 36 per cent of these "emergency" patients were treated within the state benchmark of ten minutes, and one in ten waited more than 42 minutes for treatment to start.
Treatment times for less serious patients were better, with about six out of ten people across all categories presenting to the ED seen on time.
However, only about two in five Wollongong patients left the ED within the state's four-hour benchmark, with the median wait time of 4 hours and 38 minutes about a quarter of an hour longer than average for comparable hospitals.
Illawarra Shoalhaven Local Health District Clinical Operations boss Margaret Martin said the latest BHI report was a "snapshot of emergency department and elective surgery activity during one of the most unique and challenging periods".
She said staff had done remarkable work at a time of high numbers of COVID-19 cases associated with the Omicron wave, coupled with the peak of the flu season.
"This presented serious challenges with respect to complex presentations and admissions to our hospitals, as well as significant staff unavailability as staff contracted or were exposed to respiratory illnesses," she said.
"Further impacting our performance during the quarter were a number of other external factors; namely reduced access for the community to GP appointments and bulkbilled services as well as a significant reduction in local residential aged care capacity, which meant ongoing pressure for our workforce, hospital services and access to acute inpatient hospital beds."
The aged care bed shortage in the Illawarra has been recognised as among the worst in the state, with more than a quarter of hospital beds available from the ED currently taken up by patients waiting for a spot in aged care.
The region accounts for about one sixth of the hospital beds across NSW which are blocked by elderly patients who are ready to be discharged.
The BHI data also shows that delays inside the ED spilled over into long waits for ambulances arriving in Wollongong.
In NSW, 72.5% of people who arrived at emergency by ambulance had their care transferred from paramedics to ED staff within 30 minutes.
However, in Wollongong, only 56.5 per cent of patients were transferred within the 30 minute benchmark.
Likewise, across the state one in 10 patients waited longer than 1 hour 11 minutes to be transferred, but in Wollongong the wait time for one in 10 patients was more than two hours.
Ms Martin said noted the Illawarra Shoalhaven district had experienced "very high demand" for its emergency department services between April and June, with 43,832 attendances at EDs from Wollongong to Milton.
She said the number of "emergency" category presentations was the highest of any quarter on record, .
"All patients are seen and triaged on arrival at the ED and, as always, the most seriously unwell patients are treated first," she said.
"During busy times, those with less urgent conditions will experience longer wait times when there are large numbers of seriously unwell patients being prioritised for emergency care."
She said the district had remained focused on strategies to improve ED performance throughout the rest of winter, when hospitals faced ongoing challenges.
It has implemented new models of care, accessing additional surge beds, and bolstering partnerships with private providers and the Commonwealth Government, she said.
Meantime, the NSW Nurses and Midwives' Association (NSWNMA) says the "walk out" figures showed a need for staffing inside emergency departments to be overhauled.
The union's General Secretary Shaye Candish said BHI results reflected the extreme pressure experienced by nursing staff.
"Our public health system has been under enormous pressure for an extended period, held together by nurses, midwives and other health staff stretching themselves beyond what is reasonable," said Ms Candish.
"The sheer volume of patients leaving our emergency departments before starting their care is shameful.
"Returning within a few days to try and access care, as they've likely deteriorated, doesn't depict a 'world class' health system, or one that's meeting the needs of NSW patients."
"We can see bed block issues and ramping outside emergency departments are also compounding the delays in ambulance response times to some of the highest priority cases."
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Kate McIlwain
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
