No Australian state or territory meeting ramping targets, AMA report finds

In the last two years there have been increased reports of ambulance ramping outside hospitals, people needing to be driven to the ED due to no available ambulances, and people dying waiting for an ambulance. The AMA’s Ambulance Ramping Report Card echoes these reports, with data from all states and territories revealing that ambulance ramping has been steadily increasing year on year.

This report card is the first time a national snapshot of ambulance ramping has been published by the AMA, and despite the different reporting mechanisms and targets in each jurisdiction, it paints a terrifying picture for all Australians.

“The Report Card does not deliver good news - with no jurisdiction able to meet its own targets of getting patients out of ambulances and into the care of ED staff in time,” AMA President, Dr Omar Khorshid said.

“Ambulance ramping outside hospitals – sometimes for hours – means not only are patients not receiving timely care, but paramedics can’t respond to new emergencies. This is what we see when our public hospitals are in logjam.

“No matter who we are, or where we live, when it’s an emergency we all call for an ambulance to take us to our public hospital. But increasingly they can’t come and are instead waiting outside an overloaded hospital,” Dr Khorshid said.

The report showed South Australia has a target of 90 per cent of patients being transferred to the ED within 30 minutes, but in 2020-21 only 54.1 per cent of patients were transferred within the target timeframe.

Other states with the same target include Western Australia where 62.7 per cent of patients were transferred within 30 minutes in the December 2020 reporting period. Significantly, ambulances spent more than double the number of hours ramped outside WA hospitals in 2021 than in 2020 (52,439.9 hours in 2021 compared to 25,902.1 hours in 2020). The number of ramped hours has also been increasing there since 2017, with a five-fold increase in ramped hours from 2017 (9,819.1) compared to 2020.

Queensland only managed to transfer 65.2 per cent of patients within 30 minutes in 2020-21, and the target has not been met in seven years. While 84.8 per cent of patients in NSW were transferred within 30 minutes in 2020-21, NSW performance has been gradually deteriorating each year.

“Behind the statistics are heart-breaking stories. People in Bundaberg, Queensland are waiting seven hours to transfer from an ambulance to a hospital bed, and in WA, St John’s ambulance has warned of delays for 000 callers with a quarter of their ambulances ramped outside hospitals, while being inundated with 40 calls for help an hour, Dr Khorshid said.

The report showed Victoria transferred 72.7 per cent of patients within 40 minutes, falling short of its 90 per cent target, and the ACT with the same performance target only transferred 62.3 per cent. Tasmania has a target to deliver 100 per cent of patients in 30 minutes, and it reported only 79.6 per cent were transferred in this timeframe in 2020-21.

The NT reports average transfer times, rather than a per cent transferred within a target timeframe, aiming to transfer all patients within 25 minutes. In 2020-21 the average transfer time was 30.6 minutes for all NT hospitals, and 35.2 minutes for the Royal Darwin Hospital, which is responsible for nearly half of all ambulance transfers in the NT.

Dr Khorshid said the report provided further evidence of the public hospital crisis being a national issue, requiring a national response.

“I want to be clear, we’re not saying ambulance ramping is the fault of our incredible paramedics and ambulance staff or our overstretched Emergency Department workers. This is a hospital logjam issue pure and simple, caused by a lack of public hospital capacity.

“To build capacity, we need funding. To do that, the next Prime Minister will need to show leadership and commit to a new 50-50 funding agreement that scraps the 6.5 per cent cap, which we are calling for as part of the AMA’s Clear the Hospital Logjam campaign.

“Our paramedics and ambulance staff deserve better than spending hours ramped outside hospitals, as do their patients – it’s time the major parties use the last week of the campaign to commit to lifting our hospitals out of crisis,” Dr Khorshid said.

AMA Ramping Report Card main findings:

*Performance for Western Australia is for the December 2020 monthly reporting period.