Ms O’CONNOR – Minister, during Monday’s discussions on health in the Lower House, there was a lot of talk about transfer of care delays and ambulance ramping. In discussing the issue of patients arriving at the hospital, and that interface with the Emergency Department and transfer of care occurring from paramedics to hospital staff, the secretary said:
The reality is that the first 14 to 15 minutes is the usual handover period. We want them transferred within 15 minutes.
That’s a view that reflects the Australian College of Emergency Medicine’s advice that for clinical safety, handover should routinely occur within 15 minutes. I just want to confirm with you as minister, for the avoidance of doubt, that the transfer of care within 15 minutes remains the government’s best practice goal for ambulance arrivals.
Mr WEBSTER – It is and that’s why we continue to report that category. It’s important that we actually do achieve that. As I said, there are clinical – the reason we use transfer of care delay as the sort of terminology is that they’re in the care of a health professional. Ideally they should be transferred, but there were, as in the answer the previous question as I was saying, it may better to actually leave them in the care of a health professional because someone’s come in the door that isn’t the care of health professional.
There are always balances between them, which is why you’ll never achieve 100 per cent, but ideally, with that’s what we need to be going for.
Mrs ARCHER – And as quickly as possible.
Ms O’CONNOR – Thank you, Mr Webster and minister. In an ABC story published on Monday, the secretary is quoted as saying:
Ambulances spent nearly 17.5 thousand fewer hours ramped in 2024-25 than the year before.
We want to confirm the data behind this statement. When you say ramped, are you using the commonly understood definition that the department, previous ministers and previous secretaries all use – that is, that ‘ramped’ or ‘transfer of care delay’ patients – are those subject to transfer of care delays greater than 15 minutes? What’s the measure?
Mr WEBSTER – I’ve just had someone nod at me. That’s how the data’s derived.
Ms O’CONNOR – Okay.
Minister, the government, in quite an interesting election announcement that preceded you, announced a ban on ambulance ramping – which I hope you agree is just not only unrealistic but ridiculous – which was slapped down by the Industrial Commission last year when it ruled that transfer time frames couldn’t be mandated. After that decision, the Premier and the former minister changed their language and instead talked about the ‘goal to end ambulance ramping’. Is ‘ending’ ambulance ramping still the government’s goal?
I know these might sound like very basic questions, but we’re just trying to get to the bottom of what the policy is, the practice, and the evidence underneath it.
Mrs ARCHER – From my point of view, we want to see patients transferred to hospital as quickly as possible. We want to minimise the transfer of care delay that occurs. These figures that I spoke to you about earlier demonstrate that having those targets is resulting in fewer transfer of care delays. That is a good outcome, but that doesn’t mean that you sort of ‘set and forget’ or you don’t do any more. I think it’s a continuous improvement situation, both in terms of transfer of care delays, ambulance response times – noting, of course, everything that we’ve already said about demand, and also recognising then that there are access and flow issues to overcome as well. We’ve also spoken about some of the issues –
CHAIR – We are getting a bit repetitive here. We spent a lot of time on this earlier.
Mrs ARCHER – Yes. I mean, I think it is part of a wider situation, but it is about minimising those transfer of care delays, getting ambulances back out on the road in the community as quickly as possible, and importantly, ensuring that patients are being able to be cared for and are being able to be attended to in the community as well.
Ms O’CONNOR – I’m sure that’s true. We understand that so far the department has laid out a plan to gradually transition to transfer of care protocols at 45 minutes and then 30 minutes. Are you then planning to go to a 15‑minute transfer protocol? What’s the plan to reach the goal we talked about in terms of routine transfers within 15 minutes, and when do you think we might get there?
Mrs ARCHER – I will ask the secretary to make some more comments, but as I said, we can see that data is improving with the transfer of care protocols. That’s what we want to see, that continuous improvement, and that has been achieved by setting that protocol, so I would say that that has been successful in that respect.
But I will ask the secretary to give some more information about phasing that approach, and recognising that – which I think Ms Lovell sort of indicated – it doesn’t act in isolation as well. You can’t just have that one part.
Ms O’CONNOR – It’s all intimately connected, yes.
Mrs ARCHER – Correct.
Mr WEBSTER – I’d note – and again, we publish this data – that the percentage that are being transferred within 15 minutes and within 30 minutes has also increased as a result of this focus on transfer of care occurring quicker. So, in terms of ‘will we be getting down to 15 minutes,’ I think at that target, we will have that in there continuing. We’re doing this in steps to make sure that the protocols meet what we’re requiring. Some time in 2027, we will continue to report the 15 and 30 minutes, but we would hope that we’re getting to the maximising 15 minutes once we’ve actually got these focus coming down.
Will we ever say our only benchmark is 15? I don’t think we will; we will still have a 30‑minute one because we will track the people in between, but it’s about getting the focus right. As I said, by focusing on transfer of care and saying, ‘we have to achieve it within 60 minutes as much as possible,’ it’s actually had a positive impact on what we’re achieving in 15 and 30 across the network. Those sorts of improvements are what we’re tracking in the background. I am hoping by getting the 30, we will be maximising the 15 to get there.
Ms O’CONNOR – I want to ask about the data around the extended transfer-of-care delays. I am not sure if this was passed on to Ms Lovell in her questioning. For 2024-25, what’s the 90th percentile figure for length of delay for ramp patients? Is it possible to provide this statewide and for each hospital?
CHAIR – Do you have that data?
Mr WEBSTER – Yes, we have got to find it.
If you bear with me, I will do 50th, 75th and 90th, which is actually what we’ve been asked in previous years.
Ms O’CONNOR – Sure.
Mr WEBSTER – At Launceston General Hospital, the 50th percentile is 29, the 75th percentile is 41.2, and the 90th is 60.4.
At the Mersey, it’s 25.4, 33.9 and 48.1.
At the North West Regional, it’s 25.9, 37.3 and 53.4.
The Royal Hobart Hospital is 36.5, 55.2 and 81.5.
Ms O’CONNOR – From that data, where do you see the greatest opportunity for improvement?
Mr WEBSTER – Obviously at the tertiary hospital, which is the Royal. They’re getting the most complex cases. They’re getting most of the higher-level trauma cases and those sorts of things, but we do need to drive performance there. I think the minister already mentioned this, but the rebuild of the ED at the Royal is essential to that. It’s also essential in the North West and Launceston, but the rebuild of the ED – a more efficient flow of the ED, where we have greater access to different types of treatment bays and those sorts of things – will assist in that. In the meantime, our focus needs to be on on getting the Royal back to similar to the other three major hospitals.
Ms O’CONNOR – Is the ED redevelopment on track and on budget at this point?
Mr WEBSTER – Yes.
Mrs ARCHER – Yes.
Ms O’CONNOR – It is? I don’t need the extra layering of detail on that, but if there’s any update –
CHAIR – I would like to move on to 2.4, now. We’ve still got to get to mental health, etcetera.
Ms O’CONNOR – Can we just confirm before we do that the ED redevelopment is actually on track and on budget?
Mrs ARCHER – So far as I understand it. I’ll ask the secretary.
Ms O’CONNOR – If there’s any delays, let us know.
Mr WEBSTER – Yes and yes. I am getting a thumbs up from my Deputy Secretary of Infrastructure.
Ms O’CONNOR – Great, that is good to know. Thank you.
