Public hospitals and ambulance services in NSW experienced a very busy period, as revealed in the latest data report.
The Bureau of Health Information (BHI) this week released its Healthcare Quarterly report covering April-June.
There were more than 754,000 presentations to emergency departments - an increase of 8.2 per cent compared with the same quarter in 2018. The timeliness of care provided in these departments was down across key measures at state level.
About 71.8 per cent of patients were treated within clinically recommended time frames, down 4.8 percentage points.
Seven in 10 patients spent four hours or less in emergency, down 3.4 percentage points.
Almost nine in 10 patients who arrived by ambulance had their care transferred to emergency department staff within 30 minutes, down 4.0 percentage points.
"Emergency departments were once again busier than they were in the same quarter a year ago, with more presentations overall and more patients arriving by ambulance," BHI Chief Executive Diane Watson said.
"A typical patient in NSW will have waited longer for their treatment to start and spent more time overall in the emergency department. However, there is considerable variation in performance when you look at the results for individual hospitals."
The period was also a busy one for NSW Ambulance, with almost 310,000 responses - up 9.7 per cent.
"Despite a 12 per cent increase in the number of ambulance responses to life-threatening cases, the median response time remained stable at 7.5 minutes, which is a very positive result. However, response times did slip slightly for less urgent cases," Dr Watson said.
This is the first issue of the report that includes quarterly reporting of seclusion and restraint for the 46 NSW public hospitals with one or more specialised acute mental health inpatient units.
Most episodes of care in these units did not have a seclusion or physical restraint event - three per cent of episodes had at least one seclusion event and 4.4 per cent of episodes had at least one physical restraint event.
There were 649 seclusion events and 920 physical restraint events - up 12 and 109 respectively compared with the same quarter last year.
"BHI's quarterly reporting on seclusion and restraint is an important and positive development as it increases the transparency of these practices in NSW public hospitals for the community," Dr Watson said.
APA (NSW) has warned that surging demand for ambulances is not being met by a corresponding increase in operational resource levels, putting pressure on NSW Ambulance paramedics and support staff.
Paramedics responded to nearly 310,000 calls for assistance in the quarter, with demand snowballing.
APA (NSW) President Chris Kastelan says all performance indicators and response times were headed into the red.
"We are very concerned that this increased demand is leading to poorer outcomes for the community, with slower response times and more pressure on already under-resourced, over-worked, and under-paid paramedics," HE said.
"We are stretched and near breaking point already, with fatigued staff suffering PTSD and burn out in an organisation that appears to be reactive rather than proactive on staff health and well-being.
"Paramedics are already being forced to work 12 to 15 hour days without a break, with managers telling them they can't have a lunch break because there is too much work.
"Delivering appropriate community care requires a timely ambulance response, but with increasing workloads and paramedic numbers that fail to match growing demand this is becoming increasingly difficult.
"While staffing enhancements announced by Health Minister Brad Hazzard in 2017 were a welcome step, the reality shown by this latest data is that those extra paramedics are nothing more than a stop-gap holding up an already crippled and under resourced organisation.
"Many of these new paramedics are being used to reform rosters rather than increase minimum operating levels. This is not a viable operating model for a first-world ambulance organisation."