Experts say reducing number of trauma centres long 'overdue'

According to the Australasian College of Emergency Medicine (ACEM) any move which reduces the number of major trauma centres in New South Wales hospitals is long overdue.

A report released last week on acute care services has found the NSW hospital system is in crisis and in need of major reform and recommends the closure of a number of major trauma centres.

The Garling report says the number of major trauma centres should be halved to just four across the state and emergency departments closed in many hospitals and also suggests that only seriously ill patients should be seen by specialist emergency doctors.

Dr Sally McCarthy, the ACEM president however says this may not take pressure off emergency departments as GP clinics that currently exist across Australia in many hospitals do not ease the load as almost a third of these patients have already been referred to hospital by GPs.

Dr McCarthy says patients often present with what they or their doctor thinks is a certain condition, but after further assessment by the team in emergency it often appears that they have a more serious condition.

The latest "snapshot" of Australia's 90 major emergency departments, by the ACEM has found that more than 40% of patients receiving care in emergency departments (EDs) are waiting for ward beds, and 77% of those have been in the ED for more than eight hours.

The ACEM says emergency staff spend one-third of their work caring for patients whose emergency treatment is over who are lying on a trolley waiting too long for a hospital bed - this not only prolongs their treatment but also increases their chances of a poor outcome.

Around 2800 people are admitted to hospital through emergency departments every day and access block occurs when patients who need hospital admission clog up Emergency Departments because an inpatient bed is unavailable and that delay often exceeds eight hours.

Experts say if it were not for access block, there would be almost no wait in emergency departments.

Emergency doctors are also being urged to increase their visibility and become more vocal in the community in order to improve public health and change health policy and the ACEM says failure to do this may result in development of important relevant policy without their input.