One in every 10 emergency patients needing a hospital bed in NSW is waiting longer than a day for admission as the public health system continues to fall short of its own performance targets.
Health Minister Ryan Park said the state’s hospitals could only meet the ambitious targets if the Albanese government finds a solution to move about 1100 elderly patients waiting for discharge from NSW hospitals into aged care.
“I need some additional work from the Commonwealth … to get those patients out of acute beds and into an appropriate setting: aged care or [into] NDIS support,” Park said when asked about NSW Health missing its own targets.
“Once I see that number [of patients awaiting discharge] come down, then I think we can get those targets met.”
Park’s comments set up another funding battle with his federal colleagues barely a week after NSW secured $6.5 billion of a $25 billion deal to fund hospitals for the next five years.
A Sun-Herald analysis of hospital data reveals the scale of the task ahead of Park if he wants to tackle bed block.
Half of NSW admitted patients waited at least nine hours in an emergency department before receiving a hospital bed, with one in 10 patients waiting more than 25 hours.
NSW Health adopted new hospital access targets in 2024 which set goals for how long the majority of patients should spend in an emergency department before they are either discharged, treated in the department’s short stay unit, or admitted to a hospital ward.
Eighteen months after they were introduced, NSW Health is failing to meet all four.
Under the targets, no more than 5 per cent of patients should stay longer than 12 hours in ED. Instead, the figure is more than double (11 per cent).
NSW hospital access targets:
- At least 80 per cent of discharged patients should have an ED length of stay no more than four hours
- 63.2 per cent of patients are discharged within four hours
- At least 60 per cent of patients admitted to an ED short stay unit should stay no longer than four hours
- 43.7 per cent of ED patients were treated and admitted to ED short stay within four hours
- At least 80 per cent of admitted patients should have an ED length of stay no greater than six hours
- 30 per cent of patients are treated and admitted to hospital within six hours
- At least 95 per cent of patients should have an ED length of stay no greater than 12 hours
- 89.4 per cent leave within 12 hours
Only 30 per cent of NSW patients needing a hospital bed spent fewer than six hours in the emergency department, well short of the 80 per cent target developed alongside the Australasian College of Emergency Medicine.
Dr Rachael Gill, the college’s NSW branch chair, said hospitals across the state were struggling to find beds for patients who needed them, and this was leading to worse health outcomes.
“There’s simply not enough beds to care for those patients,” Gill said.
“If they’re not receiving care [in the hospital], there are more patients in that overcrowded [ED] that aren’t going to have the same degree of attention from the ED staff.”
The College defines bed block (also known as access block) as when a patient has been assessed as requiring a hospital bed, but is forced to spend more than eight hours in an emergency department before they are admitted.
A 2020 study from New Zealand found that, in hospitals with more than one in 10 patients suffering access block, patients had a 10 per cent greater chance of death within seven days of admission.
Gill said the fact that all of Sydney’s hospitals – including two children’s hospitals – fell short of the target to admit patients within six hours suggested the problem could not only be attributed to issues with aged care.
“I don’t think there’s any one solution to … fixing the underlying factors that are contributing to the increased volume in patients and their complex care needs,” she said.
Another measure of bed block is how long the top 10 per cent of emergency patients waited for admission.
At Mount Druitt Hospital, one in 10 patients waited at least 43 hours and 49 minutes for admission – the longest in Sydney.
Westmead Hospital recorded the second-longest wait in Sydney, with one in 10 waiting at least 37 hours and 18 minutes. Only 14 per cent of patients at Westmead were admitted within six hours (the target is 80 per cent).
In a separate analysis of national hospital data by health policy analyst Martyn Goddard, 15 of the country’s 30 most bed-blocked hospitals were in NSW.
“Hospitals in NSW are under more pressure than most hospitals in other states,” Goddard said. “They haven’t understood they’ve been hit by a tsunami … the situation public hospitals have to deal with now is different from a decade ago.”
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Angus Thomson is a reporter covering health at The Sydney Morning Herald.Connect via X or email.
