Urgent Care Down Under: Australia's New Approach to Improve EMS

The Australian government is designing measures to tackle the pressing problems plaguing the national EMS sector. These challenges include ambulance ramping, hospital bed shortages, and a critical shortage of skilled staff.

While Australia boasts one of the world's best paramedic training systems, with most paramedics holding university degrees and professional registrations, recent years have seen a worrying trend of paramedic shortages. Many are lured by higher salaries and better working conditions in the US and other Western nations.

Contributing to this exodus are serious problems within the Australian EMS system, often leading to excessive workloads for paramedics. A prime example of this is the recent complaints from South Australian paramedics about their intensive 96-hour on-call rosters. Such demanding schedules endanger workers, impacting recruitment and retention, especially in regional areas.

As Susanne Tegen, chief executive of the National Rural Health Alliance, highlighted in an ABC News interview, the demands on paramedics are further compounded by broader workforce shortages across the healthcare system. She believes intensive rosters play a role in discouraging new staff from joining the profession in regional Australia.

Despite calls for national standardization, ambulance services across Australia operate under diverse rostering systems. The COVID-19 pandemic further exacerbated existing cracks in the system, leading to long ambulance queues at hospitals and prompting the hiring of thousands of paramedics to address rising patient handover times. These exacerbated shortages

However, the pandemic also exposed the limitations of this reactive approach. While the COVID-19 situation has stabilized, ambulance ramping and call delays remain a significant issue, with some reports linking them to 33 deaths over 18 months. The lack of action risks further deterioration.

Recent data from the Australian Institute of Health and Welfare (AIHW) underscores the gravity of the situation. Patients are staying longer in emergency departments and waiting longer to be seen. The average emergency department stay has increased by an hour since 2016-17.

Furthermore, an earlier report by the Australian Medical Association revealed that the time it takes to transfer patients from ambulances to emergency care is steadily increasing across the country, indicating systemic problems. Most Australian states and territories have target times of 30-40 minutes for transferring 90% of patients, but none consistently achieve this.

To address the growing pressure on the EMS sector, the Australian government and several major states are taking action. One key initiative is the establishment of up to 50 new urgent care centers nationwide. These centers, modeled after similar successful programs in New Zealand, will provide alternative care for non-life-threatening conditions, easing the burden on emergency departments and allowing hospitals to focus on critical cases.

The planned centers, requiring an investment of AUD$135 million over four years, will typically operate from GP surgeries and community health centers, offering services like treating sprains, broken bones, wounds, and minor burns. While these centers represent a positive step, additional measures are crucial for long-term stability.

The Australian Paramedics Association has called for increased funding for specialists and community care, alongside a 1500-strong boost in paramedic staffing and improved wages. Major states like South Australia and New South Wales are already taking concrete steps, committing to significant paramedic recruitment and fleet expansion.

Finally, the federal government has pledged AUD$ 1.2 billion to upgrade existing hospitals and build new ones, including emergency departments in key locations. These investments, coupled with ongoing efforts to address staffing shortages and improve operational efficiency, offer hope for a more resilient and effective EMS system in Australia.