What we are doing now - Hospital Demand Management Plan

COVID-19 response

We have implemented

In South Australia, a range of measures have been implemented on the advice of our medical and public health experts, to protect the health and wellbeing of all South Australians and prevent the spread of COVID-19 in our community.

Detailed planning has been undertaken to ensure adequate capacity and resourcing across our health system as part of our COVID-19 response.

The response is tailored to our local conditions and may change over time as the situation in our state changes.

Dedicated COVID-19 clinics remain in operation, with further mobile, pop-up and essential worker drive-through testing sites opening as required. The provision of dedicated testing locations, particularly those located at hospital sites, assist in reducing Emergency Department (ED) presentations, in particular respiratory presentations.

We are implementing

The COVID-19 vaccine is being rolled out in phases across South Australia to ensure priority groups can access the vaccine. We are establishing vaccination clinics and sites across all regional, rural, and metropolitan areas, including a vaccination hub and community clinics. The South Australian COVID-19 vaccination rollout (PDF 168KB) will be complex and different from how vaccination programs are normally administered, ensuring the vaccine is available for every South Australian.

Elective surgery

We are implementing

To ensure that beds are available for patients requiring acute or urgent care during times of peak demand, some patients scheduled for same day or overnight elective surgery may have their procedure temporarily postponed and rescheduled for a later date.

We are continuing to work on initiatives to ensure provision of timely access to care, and LHNs are continuing to partner with approved private providers to treat eligible and overdue elective surgery patients to support the recovery of the South Australian Public Health System.

Managing surges in demand

We are implementing

We are continuing to implement strategies to assist in managing surges in demand. Initiatives include:

  • SA Ambulance Service and Central Adelaide Local Health Network (CALHN) have partnered to commence a second phase of the Mental Health Co-Responder program to support consumers in the community where suitable, rather than transport them to an ED. In the first 12 months (as at 31 January 2021), crews assessed and treated 343 people, with the majority receiving home or community-based care. The program is now in its second phase, providing services in the South and Central regions over seven days per week.
  • The Clinical Telephone Assessment (CTA) (also known as secondary triage) was introduced on 29 June 2020 and ensures patients receive the very best care and are able to access the most appropriate pathway for their needs. The initiative will also free up capacity to ensure ambulances are available to respond to emergencies and ease pressure on EDs.

Southern Health Expansion Plan

We are implementing

Capital works have commenced at Flinders Medical Centre (FMC) ED, as part of the implementation of the Southern Health Expansion Plan, and will be completed in July 2021. The increase in ED beds will boost access to health services across the southern region. The Southern Health Expansion Plan will increase clinical capability of Noarlunga Hospital, increase the size of the FMC ED, and co-locate dementia specialist services at the Repat Hospital Precinct.

The Plan includes:

  • Increasing FMC ED capacity by up to 30 more spaces and separating paediatrics and adult, with increased paediatric capacity, resuscitation and time critical spaces
  • Creating state-of-the-art 12-bed facility at the Repat for patients with dementia and complex care needs
  • Enhancing acute capacity in Noarlunga Hospital and increasing medical cover in the ED.

Lyell McEwin Hospital Redevelopment

We are implementing

The Lyell McEwin Hospital (LMH) redevelopment, scheduled for completion in 2022, will increase the LMH ED capacity by 14 treatment spaces. This will include dedicated paediatric assessment and treatment spaces, additional resuscitation and triage areas, and a dedicated ambulance arrival area for patient transfers.

The redevelopment will also include a new 8-bed Mental Health Short Stay Unit providing a more suitable care environment for mental health patients requiring short stay assessment, as well as improving patient flow through the ED.

My Home Hospital

We have implemented

The My Home Hospital program is the next step in delivering more appropriate patient care throughout the health system, which will help free up hospital beds and enhance the experience of patients who can be better managed in a home setting.

Currently, only 1.3 per cent of health services delivered by all acute hospitals are at home, and the My Home Hospital program will aim to increase this number to almost five per cent.

Since January 2021, My Home Hospital has seen over 150 patients with conditions including cellulitis, kidney infections and pneumonia. Patients have been referred via public hospitals, general practitioners, residential care facilities, and the SA Ambulance Service.

My Home Hospital will expand its clinical scope to be able to care for a greater number of conditions. From 1 July 2021, My Home Hospital will also expand to Barossa Hill Fleurieu Local Health Network so more South Australians can access this service.

Priority Care Centres

We have implemented

We have opened four Priority Care Centres across metropolitan Adelaide following a successful pilot program to ease pressure on our hospital Emergency Departments (EDs). As of 14 March 2021, a total of 11,257 patients have attended the Priority Care Centres since first opening in August 2019.

Our SA Ambulance Service and our hospital ED staff offer this option to patients who could be cared for and treated in the community in a Priority Care Centre, rather than waiting at an ED, resulting in the patient receiving the care they need sooner. Children under 13 years old taken to the Women’s and Children’s Hospital ED with less serious needs can also be treated at the Priority Care Centres.

Additional access pathways to a Priority Care Centre have also been established to enable general practitioners, SAPOL and other Local Health Network (LHN) services to utilise this service option as an alternative to sending people to an ED.

Mental Health

We have implemented

In response to COVID-19, SA Health in collaboration with Ramsey had up to 20 beds available at the Adelaide Clinic for patients in the metropolitan area. The beds were open from March through to June 2020 to assist with anticipated higher demand in the acute system.

In addition, further capacity (clinical, telehealth and/or service provision) was provided to a range mental health services to respond to increased demand during the COVID-19 pandemic, including Adults and Older Persons, Child and Adolescent Mental Health Services (CAMHS), Drug and Alcohol Services SA (DASSA) and non-government services.

The Urgent Mental Health Care Centre (UMHCC) opened in the Adelaide CBD on 3 March 2021 offering an alternative for people who might otherwise present to an ED. The centre provides on-the-spot treatment, advice, and support to people in crisis from a clinical team including nursing, allied health, and medical staff, along with mental health peer workers. The service is operated by NEAMI National, with input from partners RI International, and operates on a crisis response model developed with input from key partners and stakeholders. The UMHCC is open from midday to midnight, 7 days a week.

We are also implementing:

  • Direct mental health admission pathways, and rural and remote rapid review processes for hospital transfers, in CALHN.
  • A new acute mental health model of care to improve flow of consumers through acute care at RAH and community based care.
  • A statewide Borderline Personality Disorder Collaborative has been established.
  • A new specialised 18 bed Neurobehavioural Unit (NBU) has opened at the reactivated Repat site.
  • Funding has been provided to support in reach to aged care facilities to help support older people with mental health issues in their home.
  • Planning has commenced for a Statewide Paediatric Eating Disorder Service and a Residential Eating Disorder Service.

Transferring patients to free up beds

We have implemented

By transferring metropolitan inpatients to peri-urban hospitals, patients can receive ongoing care in an appropriate setting at times of peak demand, and help free up beds for acute and urgent care in metropolitan Adelaide.

Metropolitan inpatients transferred to Angaston and Tanunda Hospitals for a long-stay admission have access to Care Pods, which have been developed by the Barossa Hills Fleurieu Local Health Network. This creates capacity in the metropolitan hospitals for more acute patients, and has brought local community members closer to home for the remainder of their in-patient care. The Care Pods provide an environment conducive to restorative care and wellbeing. The multidisciplinary team work collaboratively with the patient and their family to achieve goals and discharge to home or long-term care.

NDIS Patients Transitioning from Hospital to Home

We have implemented

As part of a project to assist in transferring long stay patients in acute beds to alternative non-acute care options. SA Health continues to work with the National Disability Insurance Agency (NDIA) and the Department for Human Services on safely discharging National Disability Insurance Scheme (NDIS) patients to home and community care and improving the timeliness of NDIS supports being available.

A new Transition to Home: Step Down program has been established in partnership with the Department for Human Services with an additional 48 beds being available for NDIS eligible patients while awaiting their longer term supports being put in place.

As at 19 March 2021, 555 patients have been discharged from hospital through these projects. These 555 patients had a combined stay of 51,832 days since being medically cleared for discharge.

Private partnerships

We have implemented

The Patient Services Panel enables public hospitals to access services at private facilities. This more streamlined coordination of services supports increased capacity for elective surgery in our public hospitals.

SA Health’s list of 20 approved private providers include day and overnight hospitals that primarily assist with providing hospital services, such as elective surgery and rehabilitation, but also support during emergencies or major incidents.

Opening more beds

We have implemented

We’ve opened more hospital beds over the last two years throughout the hospital networks, including:

  • 50 beds on the Repat site.
  • 12 beds at the Noarlunga Hospital Medical Short Stay Unit.
  • 8 bed Emergency Extended Care Unit (EECU) at Modbury Hospital.
  • 10 new forensic mental health beds at Glenside.
  • 10 new Psychiatric Intensive Care Unit (PICU) beds at the Royal Adelaide Hospital.
  • 10 new ED treatment spaces at Murray Bridge Soldiers’ Memorial Hospital.
  • 12 beds have now opened Specialised Advanced Dementia Unit at the reactivated Repat site for patients living with complex dementia.

Hospital discharges

We have implemented

Statewide hospital Criteria-Led Discharge (CLD) has been implemented to help patients return to their home as soon as possible, and reduce the pressure on our hospitals and EDs. We are continuing to promote utilisation of CLD to improve patient flow.

SA Ambulance Service (SAAS)

We have implemented

  • SAAS has undertaken a Scheduled Transport Development Program to improve the efficiency of the Patient Transport Service. This work, collaborating with the metropolitan LHNs, supports patient flow by assisting with timely discharges and assists in creating capacity within our hospitals.
  • SAAS has established Hospital Ambulance Liaison Officers (HALO) in each metropolitan LHN. These officers coordinate the SAAS support of patient flow, hospital discharges, and SAAS/LHN improvement projects. They provide timely liaison between the hospital and ambulance operations.
  • The SAAS Emergency Operations Centre has Health Network Coordinators (HNCs) who assist in the coordination of ambulance distribution among our hospitals. They actively manage any delays and support the sharing of capacity across the state’s health system.
  • Extended Care Paramedics provide the highest paramedic level clinical treatment, advice and support to assist people to remain in the community rather than attend hospital. ECPs focus in areas such as residential care, palliative care, community referral and support of out of hospital care programs. Within SAAS, they also provide clinical advice to ensure safe and effective ambulance care and referral across the state.
  • Two intern groups (approximately 35 FTE) recruited for the June and September 2020 intakes commenced in April 2020. Bringing these two internship groups forward has assisted with COVID-19 related surges in demand and winter workload due to new recruits being ready to work on-road during winter who would have otherwise received training in June and September.
  • The rapid engagement of extra resources in country South Australia which encourage existing SAAS volunteers to be engaged on casual contracts to fill roster shortfall and enlist State Emergency Service (SES) volunteers to act as Ambulance Assist officers to support Ambulance Officers.

Direct admissions to EDs

We have implemented

An increased number of direct admissions means that more patients are being admitted directly to a ward and by-passing hospital EDs, which means less waiting for patients and reduced pressure on our EDs.

Flu vaccination

We have implemented

Free flu vaccinations are available for everyone aged 65 years and over, pregnant women, all children aged six months to less than five years of age, all Aboriginal and Torres Strait Islander people aged six months and over, the homeless, and people from five years of age with medical conditions that predispose them to complications from the flu.