The $86 million Southern Health Expansion Project which expanded the Flinders Medical Centre’s emergency department to fix ambulance ramping has failed, an independent report shows.
The report by ED physician Mark Monaghan described the Southern Health Expansion Project (SHEP) as “poorly conceived and implemented”.
The report commissioned by Southern Adelaide Local Health Network (SALHN) was provided to the Malinauskas Labor Government this week and released today.
The report comes as the latest SA Ambulance Service data reveals ramping across the metro area increased by 78% from February to March 2022, in the final weeks of the Liberal Government. The data shows that ramping declined in January and February due to the cancellation of elective surgery over that period but escalated again after surgery resumed at the end of February.
SA Health data shows that in March 2018 the total number of hours it took for patients to be transferred from ambulance to an ED was 750 hours. But in March 2022, that number has risen to 2712 hours.
Dr Monaghan makes 19 recommendations to improve the operation of the ED, and SALHN Board has supported all recommendations. He also praises ED staff at FMC saying: “The ED staff that I met were universally dedicated to their department and patient care.”
The Malinauskas Labor Government will work with SALHN through SA Health to address the findings and support actions to improve the functioning of the ED.
Labor at the election pledged it would work to help fix the ramping crisis, with 300 extra beds across the health system, and extra doctors and nurses. Labor committed $49 million for an extra 24 beds at FMC that will help to fix bed block and improve patient flow from the ED – and help to fix the ramping crisis.
The former Government’s SHEP initiative centred around an expansion of FMC’s Emergency Department to allow more patients into the ED. The redeveloped ED was opened in July last year.
Dr Monaghan said in his report: “There was a view that an ED expansion would solve performance issues, including ramping. This was never going to happen in the absence of inpatient reform”.
“Due to the nature of the process, the models of care were developed to fit the expansion and not the other way round as should always be recommended. The senior ED staff articulated that they clearly expressed their view at the time that this would worsen performance and these concerns were ignored.
“FMC ED is not functioning at a level that I would consider excellent or efficient. There are multiple areas of concern.
“I have observed an ED workforce chronically traumatised by the processes and dynamics that surround them, further exacerbated by the recent SHEP initiatives.”
A second report prepared by consultants EY and analysing the impact of SHEP says SHEP’s goal of eliminating ramping was not achieved:
“Despite the increase in capacity at FMC ED, the ambulance ramping has not decreased, as expected.
“Ambulance ramping has deteriorated throughout 2021, with no discernable impact from the SHEP changes.
“Ramping post-SHEP is higher than before despite significant decrease in the number of days ED breaches 150% capacity.”
The Monaghan report can be found here.
Quotes
Attributable to Health & Wellbeing Minister Chris Picton
These reports tell us that the Liberals’ $86 million plan to fix ramping was never going to work.
The Liberals’ plan was to expand the ED at Flinders Medical Centre – but closed other beds in the hospital that this makes clear made the situation worse.
Unfortunately, it is FMC staff, ambos, and patients that are bearing the brunt of that poor planning under the previous Government.
The Malinauskas Government is already working with the Southern Adelaide Local Health Network on the findings and the recommendations from this report. And we have also committed to funding extra beds at FMC and other hospitals that will help to reduce bed block, improve flow through the hospital – and ultimately help to fix the ramping crisis.
I want to thank all the hard-working staff at FMC, who are managing a busy ED and the burden of the COVID pandemic.
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