Wollongong patients are stuck in the emergency department longer than almost anywhere else in NSW, with those seeking treatment at the region's major hospital facing another quarter of record wait times.
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New Bureau of Health Information data showed Wollongong Hospital recorded its longest median wait times for people waiting to leave the ED, usurping the record set in the previous quarter.
From October to December, the median time from arrival to leaving was just under five hours for all patients, including those who gave up and left without treatment.
Patients who required a bed in hospital waited far longer, with a median waiting time of 11 hours and 23 minutes.
And one in ten of these admitted patients had to wait at least 27 hours and 23 minutes before leaving the ED.
The quarterly data also showed the hospital recorded its lowest ever percentage of people (38.6%) who left the ED within the state's four-hour benchmark.
Across NSW, only Maitland, Westmead and Blacktown hospitals recorded worse results against these benchmarks.
At Shellharbour ED, results were better with just over half the patients leaving the within four-hours; the average wait time was over an hour less than in Wollongong, at three hours and 53 minutes.
The slow flow through Wollongong ED also impacted ambulance arrivals, with paramedics in Wollongong waiting an average of 22 minutes for their patients be transferred to hospital care.
While this was a significant improvement on the 31 minute median wait recorded in July to September, it remains well above the 15 minute average in NSW and the 17 minutes average in comparable hospitals.
In Shellharbour, the wait for patients to be transferred from paramedics to the ED was 19 minutes.
In better news for Wollongong, there was an improvement in the proportion of ED patients starting their treatment on time, with 63.5 per cent of patients treated on time, compared to 59.9 per cent at similar hospitals.
At Shellharbour hospital, only 55 per cent of ED patients had treatment started on time.
The health district's boss of clinical operations Margaret Martin said emergency departments had improved in a number of areas, despite continuing pressure from COVID-19, hospital admissions and staff furloughing.
"We are working to sustain this upward trend through a number of initiatives aimed at providing high-quality and timely care, not just in our EDs but throughout the patient's entire hospital journey," she said.
She also noted there were 341 resuscitation presentations during the quarter, which was the highest level recorded in the district since BHI began reporting in 2010.
Ms Martin said hospital performance was still being impacted by a high number of patients who cannot be discharged as they need an aged care placement to become available.
"This impacts the capacity of our hospitals to admit new patients in a timely manner," she said.
"The district continues to work closely with local RACF providers, the Federal Government and NSW Government to develop sustainable solutions to the current challenges and enable timely and appropriate residential placement for our community."
Which parts of the region wait longest for an ambulance?
The BHI data also looks at ambulance response times, revealing that people living in the Dapto and Port Kembla area have some of the longest waits for ambulances outside Sydney.
There, response times were above the state average, with patients waiting a median of 16 minutes for emergency calls and 27 minutes for urgent calls. One in 10 emergency patients in the Dapto - Port Kembla statistical area waited 35 minutes, while a tenth of urgent patients waited more that an hour and 42 minutes.
In Wollongong, the median emergency response time was 14 minutes - better than the state average - and in Shellharbour - Kiama it was also 16 minutes.
The median time for urgent responses was 25 minutes in Wollongong and 26 minutes in Kiama - Shellharbour.
All of these times were an improvement on the previous quarter, but overall much higher than the long term average response times.
The data also showed there are about 6500 people across the Illawarra on the elective surgery waiting list, which is on par with pre-COVID levels. Elective surgery waiting times are also stabilising.
Ms Martin said 3275 elective surgeries were performed across the health district from October to December, with almost all urgent elective surgery (99.7 per cent) was performed on time.
"The District is working to provide non-urgent elective procedures as soon as possible, both within our hospitals and through our ongoing arrangements with local private hospital partners," she said.
"We continue to prioritise those patients impacted by previous suspensions of semi-urgent and non-urgent surgery due to COVID-19.
"As always, any patients who feel their condition has deteriorated while waiting for their procedure are encouraged to contact their treating doctor for a clinical review and they can be placed in a higher urgency category if required."