Wait times blew out for ambulances in NSW for patients with life-threatening conditions such as cardiac arrest during the Covid pandemic, a report published on Wednesday shows.
The Australian Paramedics Association described the findings of the Bureau of Health Information (BHI) report as “alarming”, but said the pandemic was not entirely to blame for the worsening response times.
The report shows the median response time for patients with life-threatening conditions, known as “P1A” cases, was 8.8 minutes in the October-December quarter of 2021. The benchmark is 10 minutes.
In early September, the number of P1A responses per week peaked at 792, with the percentage of patients reached within 10 minutes sinking to 51.8% around the same time. Covid-19 cases added significant pressure to the workload of paramedics, the report shows.
“Hospitalisations for people with Covid-19 during the Delta wave started from late June and increased gradually until late July,” the report found.
“From August, these numbers increased sharply, with a peak of 1,266 patients with Covid-19 in hospital recorded on 20 September. Of those patients, 19% received care in intensive care units and 9% were ventilated.”
There were 33,780 ambulance responses to P1A cases in 2021, up 7,001 (26.1%) compared with 2019 when data was last reported. The percentage of these cases reached within 10 minutes was 63%, compared with 71.4% in 2019.
The number of high-priority patients with serious but not immediately life-threatening conditions, known as “P1” patients, increased in metropolitan areas as Covid-19 cases rose during Delta and Omicron waves, the data shows.
There were 605,462 emergency P1 responses in 2021, with 46.6% reached within the benchmark time of 15 minutes, compared with 58.3% in 2019. The percentage of P1 cases reached within 15 minutes decreased sharply from the beginning of the Delta wave to a low of 34.2% in the week ending 11 September.
“The emergence of the Omicron variant in late November resulted in another rise in weekly P1 responses – peaking at 12,589 in the week ending 18 December,” the report found. “Following a recovery, the percentage of P1 cases reached within 15 minutes decreased sharply again in December to a low of 37.2%.”
The president of the Australian Paramedics Association NSW, Chris Kastelan, said the data reflected a five-year low for NSW Ambulance and some of the worst-ever response times recorded. In a statement, the union said “residents should be alarmed over worsening response times”.
“NSW Ambulance is very clearly underperforming and, even more concerningly, we’re falling further behind with every quarter,” Kastelan said. But he said the pandemic was not wholly to blame.
“Patients in NSW are waiting longer and longer for an ambulance, and it isn’t a temporary blip because of Covid – today’s figures map squarely onto a consistent downward trend over five years,” he said.
“There’s no excuse for inaction in the face of these results. In an emergency situation, every minute counts. But in NSW, median response times have increased by three minutes in the past four years alone.
“The government needs to step up, listen to frontline workers, and invest in better outcomes. We urgently need another 1,500 paramedics just to bring staffing ratios in line with other states.”
The union is demanding better pay plus an investment in specialist paramedics who can treat patients at home, to reduce strain on the healthcare system.
The chief executive of the BHI, Dr Diane Watson, said health services were responding to constant change caused by rises and falls in the number of Covid-19 cases. Increases in demand for emergency ambulance responses in September and December 2021 were in metropolitan areas, while rural and regional demand was stable throughout the year, Watson said.
Meanwhile, the data shows efforts by NSW hospitals to increase elective surgery capacity in the first half of 2021 brought the waiting list down to pre-pandemic levels by June, before the Delta wave and subsequent suspension of non-urgent surgery in Sydney hospitals caused it to increase again in metropolitan local health districts.
“In rural and regional local health districts, the waiting list decreased steadily throughout 2021,” Watson said.
“Overall, while the waiting list reached a high for 2021 of 95,102 at the end of October, it was still below the record 101,024 in June 2020.”
At the end of 2021, there were 10,770 patients on the waiting list who had waited longer than recommended, with 9,309 of those in metropolitan local health districts.
