NSW emergency departments treated rising numbers of sicker patients in the depths of a record winter, but the state's hospitals have still managed to cut waiting times.
The latest Bureau of Health Information Hospital Quarterly report, published on Wednesday, also showed the wait times for elective surgeries dropped as more patients were wheeled into operating theatres within clinically recommended guidelines over the July-September period.
Some 71.5 per cent of the 652,749 patients who visited emergency departments in NSW spent four hours or less (up 1.4 percentage points), leaving 28.5 per cent waiting longer than the target time over the 2016 winter quarter.
No major Sydney hospital recorded a reduction in performance compared with the same period last year.
But wait times in emergency departments (EDs) and for surgery at some of the city's busiest major hospitals, particularly in the west, were still well below the overall NSW result, despite significant improvements across the board.
Blacktown replaced Nepean as the hospital with the longest ED wait times: 50.3 per cent of patients waited longer than four hours, followed by Nepean (47.4 per cent) and Liverpool (46.8 per cent) and Westmead Hospital (43.2 per cent).
Westmead and Campbelltown hospitals were among the most improved, lifting the volume of patients treated in four hours or less by 5 percentage points.
Statewide, nearly half a million people were admitted to NSW hospitals over the period, a record high, while the number of admissions from EDs rose 6.6 per cent.
The data showed demand for EDs was rising at three times the rate of the state's population, the Australian Medical Association NSW said.
The biggest hike in patient numbers were among the sickest, most urgent cases, with a 5 per cent rise in triage 1 presentations, a 5.4 per cent rise in triage 2 cases and a 4.7 increase in triage 3 cases, BHI chief executive Jean-Frederic Levesque said.
"Clinicians have more urgent cases in front of them. It suggests patients are coming with increasingly complex conditions," Dr Levesque said.
Yet the time patients spent waiting for treatment in EDs decreased in all triage categories compared with the same quarter last year, he said.
And amida punishing winter season for health services, the transfer time for ambulance to ED staff dropped markedly.
Nine in 10 patients were transferred within 30 minutes, the most impressive transfer result for the winter period recorded by the Bureau and a 7 percentage point increase on the same quarter a year ago.
This was during a winter quarter that was marked a rash of influenza outbreaks at aged care facilities (over 250 compared to the previous high of 120 in 2014), while ED gastroenteritis presentations were markedly higher than the winter historical average, according to NSW Health.
"It's a real credit to the system and to incredibly dedicated staff," said the Deputy Secretary of NSW Health, Associate Professor Susan Pearce.
"Winter 2015 was a pretty horrible time, but frankly no more difficult than it was this year," Associate Professor Pearce said.
This winter, NSW Health formed a peak activity team, which collaborated with major Sydney metropolitan hospitals, the ambulance service and other health services to provide "a great level of visibility about where the pressure points were and what we needed to do to try to help where we could," Associate Professor Pearce said.
"It's not just about emergency, it's about what we're doing in the back of the hospital to make sure that we have enough capacity for people to move through," she said.
Labor health spokesman Walt Secord said: "Western Sydney hospitals continue to feel the pressure of under-funding and a lack of proper resources. The families and patients at Blacktown, Nepean and Liverpool hospitals are being let down by the Baird government."
ED demand triples population growth
The NSW population has grown by about 7 per cent over the past five years but demand for emergency hospital treatment has grown by nearly 21 per cent, the president of the AMA NSW, Professor Brad Frankum, said.
"That is an extra 100,000 thousand patients coming through the doors at NSW hospital emergency departments compared to the same time five years ago," Professor Frankum said.
Professor Frankum said staff in hospitals, particularly in Sydney's west, were making a "heroic effort of limited resources in areas of extremely high health demand and population growth".
"Our hospitals are working more efficiently than ever but more resources are needed to ensure people can access quality care within a reasonable timeframe," he said.
Elective surgery
Just under 98 per cent of the 58,076 elective surgeries in NSW hospitals were performed on time over the period, up 1 percentage point on the 2015 winter quarter.
While the number of patients on wait lists grew, the number of surgeries increased (by 3 per cent). The result was shorter wait times across all urgency categories, particularly the non-urgent group, Dr Levesque said.
The Children's Hospital Westmead recorded a massive 7 percentage points in elective surgery performance, Dr Levesque said.
Even among the worst-performing hospitals by individual surgical procedure, the majority treated 100 per cent of patients within the clinically recommended timeframe.
The results were a "great improvement, given the high number of patient presentations during the season" and reflected "the tremendous work being done across the state by our dedicated hospital staff," Health Minister Jillian Skinner said.
"While there is always room for improvement, many of our hospitals have shown wonderful progress in the winter months," she said.
Mr Secord said: "Patients in western Sydney tell a very different story.
"Unfortunately, patients wait at every stage. They wait for an ambulance; they wait outside an emergency department; they wait inside an emergency department for a bed and then they are discharged too early to make way for another patient needing the bed."
