6 August 2022
Jeremy Rockliff, Premier
The Tasmanian Liberal Government is committed to reducing pressures on our health system and improving patient flow throughout our hospitals.
Yesterday, I wrote to the Federal Health Minister, Mark Butler, and Disability Minister, Bill Shorten, calling on the Federal Government to urgently address a significant issue that contributes to acute bed block in Tasmania: delayed discharge of long-stay disability and aged care patients.
The number of patients who are currently medically cleared for discharge from our hospital – but who are unable to leave due to waiting for aged care accommodation or an NDIS package – represents the equivalent of two acute wards at the Royal Hobart Hospital, or half of the Mersey Community Hospital.
While this type of bed block is not a new issue, it is particularly challenging as we navigate our way through the pandemic and the current wave which has seen a peak in COVID-related hospitalizations requiring acute care beds. In peak COVID periods, our hospitals need every spare acute bed that can be made available.
In our hospitals, we currently have 29 aged care patients medically ready for discharge. This equates to $17 million per year in cost to our health system.
Aged care patients face a number of barriers to being discharged, including reports of residential aged care facilities not accepting returning residents on weekends or in the absence of an available GP.
We also know there is a lack of clinical support in aged care facilities to support the process of discharge.
While I acknowledge the Commonwealth’s policy of increasing the number of clinical nurses to assist with this, this simply is not enough to fix the problem.
In addition to aged care patients, we also currently have 17 disability patients in our hospitals medically ready to be discharged from an acute bed, but waiting on NDIS packages to be negotiated and accepted – or the identification of supported accommodation or adjustments to their own homes to help them safely return to the community.
Again, acute beds in a public hospital are not the right place for these patients to receive continued and daily non-acute care.
The cost to our health system of only three of these patients awaiting discharge is approximately $724,000 with a combined total of 604 additional bed days.
These numbers have a large impact for a small state that is doing its best to manage significant COVID workloads.
Acute beds are not the right environment for people medically fit for discharge.
I want to be clear, these delays are at no fault of patients. In fact, every one of these patients should be back in their community, with their loved ones.
Patients should be discharged as soon as they are medically cleared from acute hospital beds, and this simply isn’t happening due to blockages out of the control of our State system.
At yesterday’s Health Minister’s meeting, Tasmania has asked the Commonwealth to consider paying for transitional care pathways as an interim measure, such as specially designated sub-acute transition wards that we establish, or by purchasing available transitional sub-acute bed space in private hospitals, while we work together to look at longer-term solutions around accommodation to speed up the safe transfer of the medically-ready to aged care and NDIS supported living arrangements.
This will not only help with the timely discharge of these patients but significantly reduce the cost to the Tasmanian health system noting the cost of an acute bed is about $815,000 per year versus $450,000 for a sub-acute bed.
We have done incredible things together during COVID, and now that we are facing rolling COVID-19 waves in the short to medium term, we need the Commonwealth to take immediate action to reduce the pressure on our already strained hospital resources.
Our proposal will free up our acute beds for those who need them and incentivize the NDIA to finalize the package approval and supported placement of NDIS participants.
We are committed to a patient-centred approach to providing the right care, in the right place, at the right time, and hospitals are not the right place for people who are clinically ready to leave.
Tasmania’s plan for step-down transition care represents a pathway forward while the Commonwealth works to improve Aged Care and NDIS processes.
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