The number of seriously sick people arriving for treatment at Wollongong Hospital has climbed to its highest ever peak, with new annual data showing the time spent in the emergency department also hit an all time high.
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The figures also highlight how bad aged care-related bed block is at the region's largest hospital, which has struggled to move patients out of the ED and into wards because a lack of aged care spots is keeping older patients stuck in hospital.
Data from the Australian Institute of Health and Welfare shows one in ten Wollongong patients who needed to be admitted to hospital from the ED waited just under 28 hours before they could get into a ward bed.
This was the sixth worst performance in the country on this measure in 2022-23, and well above the time spent at "peer" hospitals - of 17 hours and 44 minutes - for the top 10 per cent of patients needing to be admitted.
The average wait time for all patients at Wollongong last year was four hours and 41 minutes, while the average wait for patients who needed a hospital bed was 10 hours and 7 minutes.
These were both the highest figures on record for the hospital, and well above the state averages.
For many this will come as no surprise, as for - more than a year - the hospital and wider health district has struggled to move people through the hospital, with a serious shortage of aged care beds leaving older people who need care unable to be discharged.
'Seismic structural reforms are underway to turn things around'
The NSW Bureau of Health Information also released its figures on December 6, showing how hospitals performed between July to September this year.
The Illawarra Shoalhaven Local Health District Executive Director of Clinical Operations Margaret Martin said despite record levels of demand in EDs across the busy winter period, the data showed the work being done to improve access and flow in the region's hospitals was making a difference.
The biggest improvements was in the time it takes for patients to be transferred from paramedics to hospital staff, she said.
"Despite increased demand in EDs, we've seen some remarkable improvements in the time for transfer of care from ambulance to hospital staff, with 77.3 per cent of patients transferred in 30 minutes, an increase of 25.6 percentage points on the same quarter in 2022," Ms Martin said.
In Wollongong, this jump was even bigger with 81 per cent of patients transferred to the ED within the benchmark - a jump of 31 percentage points from the same time last year.
The health district has put a number of measures in place to help get people through the ED, including using Emergency Short Stay Assessment Units more often, developing alternate emergency department pathways for patients who don't need to be admitted and cutting the length of stay for patients who can safely continue their care at home through Hospital in the Home and virtual care.
Last month, 15 new transitional aged care beds opened at Figtree Private Hospital allowing older people who need to stay in hospital to get the care they need while they wait for a permanent place to become available.
Health minister Ryan Park, who pledged to keep a special eye on Wollongong as his local hospital in the lead up to the March election, said "seismic" reforms were happening in health, but would take time to show results.
"We won't undo 12 years of underinvestment in our health system overnight, but I can assure staff and the community that seismic structural reforms are underway to turn things around," he said.
"Patients just want to receive the care they need and deserve in a timely manner.
"I'm proud of our local healthcare workers in the Illawarra who have faced serious challenges over the past couple of years but continue to show professionalism amidst record presentations and demand on our health system."
More seriously ill patients going to Wollongong ED last year
The number of people arriving at Wollongong ED who need resuscitation or emergency level care has eclipsed previous records, while the number of emergency category presentations has more than doubled in a decade.
Ms Martin said the latest quarterly results also showed a record number of patients requiring complex treatment accros the health district.
"During the quarter, there were 354 triage 1 (resuscitation) presentations and 5,722 triage 2 (emergency) presentations, both representing a 17.2 per cent increase on the same quarter last year and the highest number of patients in these triage categories since BHI began reporting in 2010," she said,
"We also saw a 9.9 per cent increase in the number of ambulance arrivals at the District's EDs compared to the same quarter last year, with 12,254 patients arriving by ambulance."
However, it appears that measures like extended urgent care centres in the northern Illawarra, and the insistence from local health authorities that the ED is only for emergencies may be starting to work, with the number of people attending Wollongong for non-urgent care on the decline from the record high of 2021-22.
The number of non-urgent presentations at Wollongong fell to 3475 in 2022-23, down from 4283 the previous year and hitting the lowest level since 2017.
Semi urgent presentation hit their lowest level since 2017.
However, the government says the proportion of cases that could be treated in primary or aged care settings continues to be a major factor in the record demand on hospitals,
Almost half of all presentations to EDs across the state were semi-urgent like a sprained ankle or earache or non urgent, which includes small cuts or abrasions.
The NSW Government has been trying to divert these "unnecessary" presentations to hospitals, by rolling out urgent care services, empowering pharmacists to prescribe more medications, increasing the use of virtual care and allowing doctors in regional health districts to work in both GP and hospital settings.
Small improvements in latest quarter
While the annual data presents some of the worst results on record for Wollongong Hospital, there have been improvements in recent months.
The three-monthly statistics show the average patient at Wollongong is waiting four hours and 52 minutes - four minutes off the record set at the end of 2022 and three minutes less than the previous quarter - from their time of arrival to leaving the ED.
But one in 10 patients in the ED still face a wait of more than 16 hours before they leave, while admitted patients continue to spend an average of 10 hours and seven minutes.
Despite these long times spent in the ED, two thirds of patients started their treatment "on time", and Wollongong performed better than comparable hospitals on this measure.
Most emergency category patients has been seen within 11 minutes, people with urgent and semi-urgent conditions were seen within a median of 22 minutes and half of all non-urgent conditions were seen in 20 minutes.
The number of people presenting to Wollongong ED has been relatively steady for the past year, and is back to pre-pandemic levels.
At Shellharbour Hospital, the average patient spends three hours and 50 minutes in the ED, while one in ten patients are there for just over 10 hours.
On-time treatment times were worse in Shellharbour, with only 58 per cent of patients starting treatment on time.
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.
