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Speaker 1: Well.

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Speaker 2: A tweet put out by the Ambulance Employees Association yesterday

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Speaker 2: reads or today actually last night, that was yesterday. I

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Speaker 2: beg your pardon. Last night, Wednesday night, there were fifty

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Speaker 2: four ambulances ramped across Adelaide, seventeen ramped at Flinders alone,

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Speaker 2: some for over seven hours. Despite this risk to our community,

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Speaker 2: essay Health is set to end the state wide Code

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Speaker 2: Yellow today despite our calls for it to continue. We've

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Speaker 2: asked Essay Health for a statement on that and Director

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Speaker 2: Lawrence is unable to speak. But we do have a

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Speaker 2: statement from Robin Lawrence and it says our statewide Code Yellow,

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Speaker 2: which commence thirty one May, ends today sixteen August. This

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Speaker 2: escalation process and collaborative approach we adopted through Code Yellow

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Speaker 2: will continue, as will initiatives a better manage patient flow

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Speaker 2: across our system, including purchasing care in the private sector,

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Speaker 2: hiring more staff and opening more beds as quickly as possible.

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Speaker 2: We're also advocating for long stay patients who no longer

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Speaker 2: need acute care but are unable to be discharged due

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Speaker 2: to the lack of Commonwealth Aged Care services and NDIS support.

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Speaker 2: Clinicians continue to triage patients presenting at our sites appropriately,

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Speaker 2: those needing the most urgent care are always treated first.

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Speaker 2: So the Ambulance Association, though wants Code yellow, which is

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Speaker 2: the ban on elective surgery, is internal emergency management of

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Speaker 2: the hospitals to continue. Leah Watkin, secretary of the Ambulance

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Speaker 2: Employees Association, on the line, Leah, good morning, Thanks for

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Speaker 2: your time. Why do you think it's important Code yellow

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Speaker 2: remains in place.

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Speaker 3: I think the need for the Code yellow still exists

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Speaker 3: and that it should be extended because we clearly still

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Speaker 3: have a statewide pressure on our hospitals and that we

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Speaker 3: need a coordinated statewide approach to measures to mitigating that

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Speaker 3: to reduce the risks the patients on the ramp, INDs

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Speaker 3: and in the community. That's why I think it's so important.

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Speaker 3: Measures that they have done have not alleviated that risk.

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Speaker 3: That there are some i don't know, better workflows or

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Speaker 3: whatever they want to call them in place, but whatever

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Speaker 3: they have done is still not making enough of a

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Speaker 3: difference that the risk to patients is reduced. The risk

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Speaker 3: of patients is higher than when the Code yellow was

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Speaker 3: originally caught, and that is evidenced by the Ambulance Service

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Speaker 3: being in OPST that white Wednesday night and twenty three

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Speaker 3: emergency cases uncovered and at that time fifty or so

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Speaker 3: ambulances on the ramp. They couldn't be released to respond

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Speaker 3: to them. Nothing is more of a demonstration that there

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Speaker 3: is no patient flow at that point than exactly that scenario.

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Speaker 1: And it's the.

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Speaker 3: Patients in the community that are ultimately the most risks

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Speaker 3: in that scenario.

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Speaker 2: Okay, by releasing the code yellow, do you think things

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Speaker 2: will then get worse.

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Speaker 3: I don't think they'll get worse, but I don't think

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Speaker 3: they'll be getting any better. And the whole point of

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Speaker 3: the statewide Code yellow is that minds are turned to

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Speaker 3: additional initiatives, additional looking for additional facilities or beds that could.

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Speaker 1: Be brought online, any measures that can be implemented under

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Speaker 1: a state wide Code yellow because you have the authority

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Speaker 1: to be giving directives.

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Speaker 2: Okay, when you say risk to patients will continue, is

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Speaker 2: just what we've seen in the past. I mean, you

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Speaker 2: said the other day when we spoke on Tuesday or Wednesday,

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Speaker 2: that people have died as a result of ramping. Is

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Speaker 2: that what you're concerned about.

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Speaker 3: Absolutely so. On the same day on August the second,

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Speaker 3: when we heard about the worst month of ramping ever

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Speaker 3: for July, which was over five five hundred hours, was

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Speaker 3: the same day that Robin Lawrence announced that the codeyellow

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Speaker 3: was going to be stood down today. And we have

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Speaker 3: since found out it's been confirmed by the ambulance service

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Speaker 3: that last month a patient died waiting more than five

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Speaker 3: hours for an ambulance. And we now have this situation

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Speaker 3: Wednesday night where the ambulance, the EDS and the ambulance

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Speaker 3: service it just brought to a standstill. That demand is

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Speaker 3: so high there is no through put through the hospitals.

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Speaker 3: There's nothing less to squeeze out of this situation. Meanwhile,

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Speaker 3: there's twenty three uncovered emergencies in the community, and these

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Speaker 3: are people that have been triaged by our call takers

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Speaker 3: in the ambulance call center as being at life threatening risk.

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Speaker 3: These are patients with chest paying, shortness of breath, uncontrolled bleeding,

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Speaker 3: car accidents that are just out there waiting in the

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Speaker 3: community with no ambulance to send. While there's sixty four

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Speaker 3: ambulances stuck.

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Speaker 2: On the ramp, how long have they been waiting those

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Speaker 2: twenty three It was.

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Speaker 1: A moving feast.

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Speaker 3: So what I'm aware of is that there were for

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Speaker 3: a long period of time. For Wednesday afternoon and evening,

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Speaker 3: there were always Priority twos waiting, but the number fluctuated

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Speaker 3: until at about eight pm it peaked at around twenty three,

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Speaker 3: and so as one ambulance would be freed up and

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Speaker 3: send to a job, another Priory two would come in

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Speaker 3: and so it just sort of stumbled along like that

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Speaker 3: for just hours. So I don't actually haven't heard of

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Speaker 3: any of what the wait times were for some of

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Speaker 3: these Priority twos, but we saw for last month that

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Speaker 3: the ambulance response times, particularly for PRITI twos, has deteriorated significantly,

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Speaker 3: so where it was that around seventy percent is now

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Speaker 3: back down near about fifty percent, which means at least

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Speaker 3: half of people that have been triaged as being at

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Speaker 3: life threateny risk are not being an ambulance on time.

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Speaker 2: I take what you say about the system won't necessarily

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Speaker 2: improve with the code yellow lifted, but it can't be

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Speaker 2: in place forever and a day, can it either. What

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Speaker 2: would be the answer there for the hospital system for

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Speaker 2: the health department.

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Speaker 3: Well, I think the code yellow needs to be extended

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Speaker 3: and they need to be looking at what other directives

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Speaker 3: they need to make to free up hospital capacity so

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Speaker 3: that we can actually get patients from ED intwards and

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Speaker 3: from the waiting room and ambulances into the ED and

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Speaker 3: therefore freeing up abulances to get to the community. So there,

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Speaker 3: I'm just we need to be pulling out all stops

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Speaker 3: at this point.

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Speaker 2: It's amazing that we've put on so many paramedics over

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Speaker 2: the last couple of years, particularly, and we still have

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Speaker 2: this problem where there's not enough ambulances.

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Speaker 3: Exactly, And we always knew that the extra ambos that

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Speaker 3: we were calling for was never to resolve ramping. That

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Speaker 3: is a hospital and health service issue. The extra ambos

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Speaker 3: were to help with response times and they've certainly done that.

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Speaker 3: The response times up until a few months ago were

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Speaker 3: the best that they've been in about three years, so

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Speaker 3: they have certainly improved significantly over the last few years.

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Speaker 3: But unfortunately after last months we've seen this deterioration again

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Speaker 3: because of the impact that ramping has.

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Speaker 2: The person who died after five hours was that not

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Speaker 2: apparent to staff in the hospital. Did paramedics not make

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Speaker 2: them aware this person was critically ill and needed to

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Speaker 2: be inside getting full medical attention more than can possibly

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Speaker 2: be provided from the back of an ambulance.

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Speaker 3: Well, this was a person that died in I believe

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Speaker 3: a residential care facility, so they were not in an

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Speaker 3: ambulance at the time. They were in the community. An

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Speaker 3: ambulance had been called, but one could not be sent

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Speaker 3: because they were unavailable.

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Speaker 2: So they died waiting for an ambulance.

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Speaker 3: Yes. Wow, And that's our concern that we're starting to

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Speaker 3: see these conditions again that we did, you know a

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Speaker 3: few years ago where there was a cluster of about

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Speaker 3: five patients that had passed away after a significant delay

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Speaker 3: and add to their ambulance response for an emergency case.

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Speaker 3: And again we're seeing delays to emergency cases and they're

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Speaker 3: the most.

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Speaker 2: Urgents, are the most at risk, and that's why you're

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Speaker 2: saying the Code ELLO needs to continue.

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Speaker 3: Yeah. Absolutely.

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Speaker 2: I appreciate your time this morning. Thank you, Thank you, Lea.

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Speaker 2: What can Secretary Ambulance Employees Association, Let's talk to the

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Speaker 2: nursing and mid We're Free Federation Associate Professor Elizabeth the Bars,

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Speaker 2: Good morning.

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Speaker 4: Good morning to you and to all your listeners.

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Speaker 2: How do you see the code yellow playing out? Is

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Speaker 2: it a good move by ASA Health to lift it?

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Speaker 4: Well, look, I wouldn't say that. What we do say

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Speaker 4: is that we absolutely support the concern that the Ambulance

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Speaker 4: Association has in relation to the system being in crisis,

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Speaker 4: because it is in crisis. And we support absolutely the

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Speaker 4: continuation of focus, which is the point of having a

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Speaker 4: code yellow.

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Speaker 2: But you're there, Elizabeth. I think we've lost you. We'll

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Speaker 2: try and get you back. Elizabeth de bars from the

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Speaker 2: nursing with each federation. So, as you heard from Leah Watkins,

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Speaker 2: code yellow needs to be in place. Have we got

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Speaker 2: it back? I think we have. Let's go back to Elizabeth.

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Speaker 2: You're there.

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Speaker 4: Oh, I'm so sorry about that. Look, we support absolutely

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Speaker 4: the continuation of focus, which is the point of course

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Speaker 4: of a code yellow, but we're agnostic about what it's

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Speaker 4: called or not. I mean, the point is which Leah

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Speaker 4: was making well, is this is a serious problem. It's

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Speaker 4: actually a long term problem. The band aids that are

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Speaker 4: in place are inadequate. We need the long term solutions

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Speaker 4: as well. We've been calling for additional beds, who've been

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Speaker 4: calling for additional workforce for a long time. We've been

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Speaker 4: vindicated in those calls, but the problem is bringing on

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Speaker 4: those additional beds and the workforce required to support those

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Speaker 4: beds is now a long term proposition because those calls

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Speaker 4: were not heated early enough. We need more supports to

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Speaker 4: keep people out of hospital, so better primary healthcare system. Again,

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Speaker 4: we've been vindicated. We've got movement on that front from

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Speaker 4: the federal government putting onto place moose practices and the like.

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Speaker 4: We've been calling for people to have better community supports,

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Speaker 4: particularly in the area of mental health. There's some indication

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Speaker 4: of people listening to that, and certainly we have been

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Speaker 4: vindicated on our call for more beds. There are lots

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Speaker 4: of initiatives going on. Even the more beds. You know,

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Speaker 4: there's been a commitment to three hundred more beds in

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Speaker 4: the system, but it's not enough at the moment. I

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Speaker 4: mean the amount of beds are bringing online in the

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Speaker 4: short term. I mean, we do have some smatterings. We've

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Speaker 4: got twenty eight beds about to be released at Lyle Mac.

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Speaker 4: We've recently had some more beds been retained with the

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Speaker 4: opening of additional beds at Queenlizabeth Hospital and the retention

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Speaker 4: of beds at Hampstead, which has meant forty to fifty

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Speaker 4: additional beds in the system. We know that there's a

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Speaker 4: new bed, a ward out at Finder's Medical Center. But

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Speaker 4: really this is a drop in the ocean because there

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Speaker 4: have been years of neglect by successive governments in this area.

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Speaker 4: So sadly, this is exactly what we've forewarned against. The

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Speaker 4: problem we now have is that there is such pressure

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Speaker 4: and awful time for the patients but also the clinicians

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Speaker 4: who feel desperately unable to provide the care to the

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Speaker 4: community that they need. And we take absolutely no enjoyment

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Speaker 4: out of saying we told you so, But this is

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Speaker 4: this is exactly what we said would happen. This is

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Speaker 4: exactly what's happening. Finally people are listening, Finally people are acting,

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Speaker 4: but it's not going to fix the situation in the

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Speaker 4: short term. There are very very serious problems right now.

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Speaker 4: We've got to support the workforce we have and build

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Speaker 4: a workforce for their future and get those beds online

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Speaker 4: as a matter of urgency to all the other wrap around.

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Speaker 2: Nurses will feel the effect of lifting the Code yellow emergency, though,

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Speaker 2: won't they That they must all must be having a

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Speaker 2: collective shut up given everything you've said, the burnout factor,

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Speaker 2: the extra load on them, is that going to be

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Speaker 2: a factor Look, we are of.

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Speaker 4: The understanding and what we've been advocating is whatever you

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Speaker 4: call it, we've got to keep that focus on. We

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Speaker 4: do know that already that there's a number of local

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Speaker 4: health networks who are continuing on their focus on this.

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Speaker 4: They may or may not be calling it a code yellow,

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Speaker 4: but they absolutely are keeping that focus on. That is

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Speaker 4: what we support. We don't, you know, we're a bit

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Speaker 4: agnostic about what they call it. I think the point

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Speaker 4: is that they are putting things that measures in place.

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Speaker 4: They are trying to partner as a band aid solution

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Speaker 4: with private enterprise. We support that as a as a

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Speaker 4: temporary measure. But the reality is that those additional beds

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Speaker 4: that have been promised by this government, and the additional

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Speaker 4: workforce that has been promised, and the proper planning associated

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Speaker 4: with that, that has to happen, and it has to

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Speaker 4: happen as quickly and urgently as possible. The reality is

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Speaker 4: people are sufferings and that's completely unacceptable.

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Speaker 2: Also, are people on elective waiting lists, aren't they? Though?

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Speaker 2: So yeah, on it goes. Thank you for your time,

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Speaker 2: it's a pleasure.

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Speaker 3: Thank you.

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Speaker 2: Associate Professor Elizabeth Debars from the Nursing and Midwiffery Foundation.

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Speaker 2: If you wish to comment eight double two to three

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Speaker 2: double O Double O Federation, I should say not Foundation

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Speaker 2: for the Nursing