Wagga Base Hospital wait times for surgery explodes, one in five wait too long in emergency department

The latest Bureau of Health Information (BHI) Healthcare quarterly report shows more patients presented at WWBH from January to March 2023 that the same period in 2022.

While non-urgent patients declined from 1364 to 973, patients triaged as emergency (T1) increased by 33.4 per cent from 864 to 1153.

Patients being treated on time were relative stable across all ED triage categories, and above average when compared with similar hospitals.

Murrumbidgee Local Health District (MLHD) chief executive Jill Ludford thanked staff for their hard work throughout the period of high activity.

"Our emergency departments continued to provide care within timeframes well above the state average, and our ambulance transfer of care times are once again among the best in the state for this quarter," Ms Ludford said.

"We continue to work closely with our colleagues at NSW Ambulance to ensure patients are transferred from ambulance to emergency department as swiftly as possible.

"I want to thank our highly skilled and dedicated workforce. These results are a testament to their hard work."

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While Wagga Base treated more patients on time than many in its peer group, more than one in five patients were not receiving treatment within clinically recommended time frames.

BHI's data shows almost half - 56.6 per cent - of patients spent four hours or longer at the hospital, with some waiting over 12 hours.

The hospital has a perfect scorecard for urgent planned surgeries, with 100 per cent performed on time.

While the number of patients seen within clinically recommended time frames has improved since last year, they are still significantly lower than pre-COVID averages.

The fact Wagga's numbers are better than comparable hospitals points to systemic issues within the health system extending wait times, not specific fault on the part of MLHD.

MLHD's executive director of medical services, professor Len Bruce, said Wagga's emergency department was fifth-best in the state, but there was still room for improvement.

"We clearly want to treat patients within clinically recommended time frames," Dr Bruce said.

"That's why there's such a focus on getting surgical cases done - the staff are working extremely hard.

"Even though our transfer of care metrics are very good, the benchmark for us is 90 [per cent] ... so we're definitely not happy to rest on our laurels."

Wait times have also exploded for all non-urgent elective surgeries. Patients are now waiting on average 78 days for semi-urgent surgeries, and non-urgent cases are waiting 548 days on average.

Slightly over half - 54 per cent - of surgeries were performed within the clinically recommended time frame.

Despite an increase in the number of surgeries performed, wait lists continue to grow.

More than 3790 patients were waiting for surgery at the end of the first quarter of 2023. The majority of these were considered non-urgent cases - procedures like colonoscopy, endometrial surgeries, and spinal fusion.

Semi-urgent cases - those needed to resolve chronic pain, dysfunction, or disability - rose by 50.4 per cent to 555.

Dr Bruce said MLHD are already in the process of clearing the surgery backlog - something they have already made progress on.

"One of the problems is you have data that's already three months old," he said.

"At the end of March, we had 671 overdue cases, and at the moment there are 607.

"The problem for us is the bulk of these cases are joint replacements and ENT [ear, nose and throat], so we're doing a lot of work with the private sector, and pretty much looking to double the number of ENT lists we do."

Ms Ludford acknowledged there was still a backlog of surgeries that needed to be addressed from the COVID period.

"As part of the surgical recovery plan we may offer patients the opportunity to receive their surgery sooner at one of our district hospitals," she said.

"I thank the community for their patience during this challenging time and assure everyone our district is continuing to work hard to carry out those procedures that were postponed during the COVID waves as soon as possible."

WWBH saw a 9.5 per cent increase in the total number of bed days, from 28,705 to 31,430.

Acute and non-acute patients saw a half day reduction in the average length of time in hospital, but mental health patients saw a 5.9 day increase, staying 19.2 days on average.

Total patients presenting for mental health reasons doubled compared to the same period last year, rising to 5409.

The escalating numbers of mental health presentations may also be a COVID hangover. With counselling services increasingly out of reach for many people in regional Australia. The long-term consequence of this is untreated mental illness, more likely to result in acute episodes.

Similar trends have been seen in non-urgent presentations to emergency in light of difficulty booking and affording a general practitioner visit.

One of the ongoing challenges for MLHD and all rural hospitals is staffing.

Dr Bruce acknowledged the role WWBH's hard working staff had played in improving local health over the last few quarters, as well as the role shortages played in providing better clinical care.

He said MLHD were constantly looking for new staff, and undertaking initiatives to attract people to WWBH.

"The LHD has just completed an international recruitment drive, which is going to be very good for Wagga," he said.

"We've taken on a large number of grad nurses, which is obviously the future."

He said he expects metrics will continue to improve in the next few quarters.

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