Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
We know.
Speaker 2 (00:00):
The mother of a Darwin dancer has told the ABC
that she waited for more than six hours for an
ambulance to arrive after her daughter dislocated her knee at
a dance competition on Saturday. Now, twenty year old Monique
Dries fell to the ground and started screaming in pain
about eight fifteen pm, and was told by emergency call
(00:21):
operators to stay put until paramedics arrived. Her mother tried
to take her to hospital herself using a luggage trolley,
which was all the venue had on hand, but couldn't
due to the position of her knee. Now, paramedics did
eventually arrive, but that was at two point thirty in
the morning, but the family had to wait another forty
five minutes in the ambulance due to ramping at the hospital.
(00:44):
Now joining us on the line is Saint John Ambulance
Director of Ambulance Services, Andrew Thomas. Good morning, Andy, Good
morning Katie, and welcome back, thanks mate. Now, Andy, what
what was the go on the weekend? Was it an
ex aptionally busy night on Saturday for Saint John?
Speaker 1 (01:04):
Look, Katie, well, I mean we know that on Saturday
nights traditionally we see an increase in our workload, and
our workload trending and mapping, we know is our busiest
times kick off from around about two or three o'clock
in the afternoon and go through to around about one
to two o'clock in the morning, and that's when we
see our peak workload. We are really you know, we've apologized,
(01:28):
We've reached out to Moniquan and mum Rebecca to express
our obviously our concerns and obviously acknowledge the delay and
the response that they got. And obviously we know that
obviously it's extremely distressing for her and the family and
everyone that was there that you know those delays.
Speaker 2 (01:48):
Well, and yeah, and like I get that, you guys,
you know, it's a situation where you're having to triage.
I mean on that night, was there, like we're there
a number of incidents, what was so what was sort
of happening behind the scenes that might mean that she
had to wait for that long for what many would
would say is quite a serious issue.
Speaker 1 (02:09):
Yeah, So look over around that sort of you know,
six to seven hour period when that case came in,
we had eighteen Priority one cases, which is our highest
level of case, which is our lights and sirens response
and an average turnaround on an ambulance crew for those
is around about one and a half hours by the
time we get there, respond, treat, take them through to
(02:32):
hospital and then obviously you know, hand over to the hospital,
tidy up and then be able to respond again. We
also had another fourteen cases, both priority to seven Priority
two cases which are not lights and sirens but are
still urgent, and then also another seven lower acuity cases
(02:53):
in that period of time. So you know, we're looking
at around about you know, thirty two thirty three cases
over that period of time time and on that night
we had four emergency ambulances across the Darwin region. Oh yeah,
we know, and we've said before we are underresourced. Our
staff do an amazing job that we have the best
staff who continue to go out there and deliver really
(03:17):
high quality care and what to acknowledge and be thankful
obviously too to the family who have acknowledged the really
good care of the paramedes provided where they actually got there.
Speaker 2 (03:27):
And this is the thing I guess Andy, is you know,
in my experience, most people are really you know, like
they're very satisfied with the service and with the care
that they receive from our paramedics and from Saint John.
But the issue seems to be I mean, when you
take into account what you've just told me, thirty two
cases in that period of time for emergency ambulances, I
(03:48):
think you said on the road, how on earth do
you deal with that volume of cases?
Speaker 1 (03:55):
Yeah, look, we are you know, we've been talking for
a long time. We need more resources, we need ways
of managing that demand as well. So we're you know,
we are in discussions obviously for the contract going forward,
and we're looking at the opportunities to obviously increase resourcing
and then look at ways of also managing some of
(04:15):
that demand. And you know, so some of that some
of those opportunities we're looking for is to put more
clinicians in comms to be able to really assess those
cases and give more advice and be able to work
out the priorities that are needed to get the right
patient to the right crew at the right time. But
also we just need more resources at times, particularly in
(04:36):
that afternoon, evening and nighttime period. We know our workload
continues to increase. We've seen yet again another eleven percent
increase in call volume in the last year coming into
triple zero with over one hundred thousand triple zero calls
entered in the last last financial year. Our workload continues
(04:56):
to increase, including and what we're seeing this year is
that the higher acuity cases, those lights of Sirens jobs
are the ones that we've seen the greatest increase in
the last twenty four hours. And we know that, you know,
with those, those cases obviously put a lot of stress
on our service because we want to try and get
there and they're obviously very difficult to deal with in
(05:17):
terms of that takes out a lot of time about
to do that and then obviously the time to be
able to get from through the hospital and hand over.
Speaker 2 (05:24):
And look, we talk a lot about alcohol issues in
the Northern Territory. What kind of you know, what what
kind of impact does that alcohol issue? Some of the
incidents that are alcohol related have then on our crews
and on Saint John being able to get out to
other incidents and to get out to everything.
Speaker 1 (05:44):
Look, I mean, we see alcohol related incidents, but I
think you know, it's not that that. What we end
up seeing is the end point of it. And so
the significant road trauma, the significant traumas related from you know,
either violence and theression or domestic violence. We see the
sort of the poor health states and comorbidities within our
(06:07):
population that leads to really sick and unwell patients that
obviously require our attention. And as I said, predominantly a
lot of that tends to be in the latter part
of the day and into the night when a lot
of the other services aren't around, and we know that
that then flows into the hospital.
Speaker 2 (06:26):
So you spoke then as well about that high demand
and trying to manage that high demand. I mean, does
this just come down is it a funding or a
resourcing issue or is it both? And really what does St.
John need as you talk about the renewal of that
ambulance contract.
Speaker 1 (06:44):
Yeah, look, I mean obviously the factors that obviously really
impact into those response times is obviously the community demand,
ambulance crew and vehicle availability, the hospital capacity, patient flow
through the emergency department. But I think you know, really,
we know that across all the locations in our springs
Catherine uh and in Darwin, the resources we have quite
(07:09):
often are outstripped by the demand that I'm from that's
coming from the community. And so we really need to
look to make sure that we have the right amount
of resourcing in the right time when the result when
the demand is needed. And you know, clearly we are
under resourced in major city like Darwin's.
Speaker 2 (07:25):
So I guess we're getting though, does that come down
to needing more funding to be able to get more
staff or not being able to fill those positions.
Speaker 1 (07:35):
Look at the moment, this is where where these are
what we're currently are contracted to provide. And we've been
talking and that's the discussions of having this government is
we need more resources. We need to make sure that
the resources are targeted where they are and how we
can better use it to manage that demand. And you know,
so we are looking obviously, you know, we've been speaking
about needing more ambulance crews to meet the increase that
(07:59):
we've seeing over the you know, the last four to
five years, we've seen continual increase in our workload, you know,
up around about seven to eight percent across each year.
We're seeing that growth. And what we are seeing, as
I said in last year, is that the patience that
we're going to a sicker and obviously that obviously enties
some of our vehicles up or we need to send
a second vehicle to support to provide the appropriate treatment.
Speaker 2 (08:22):
Now, just in terms of them that ambulance ramping in
hospital bay is what needs to happen to address this.
By the sounds of things, you know, there's an enormous
demand on our emergency ward and so you know, if
they're not able to bring somebody in who's in and
in a you know, in an ambulance, or they're out
the front, they're waiting for a bed or waiting for
(08:42):
some availability, I'm assuming.
Speaker 1 (08:45):
Yeah, Look, we know that that ability for us to
transfer a care or ramping as it's often returned to,
is an issue unfortunately we see in Darwin, but it
is a significant issue across all states. Anyone who's come
from any of the other states where as well and
truly aware that you know, it causes major problems with
the health system right across Australia. You know, it is
(09:06):
a whole of health issue. It's not just you know,
we do some really great work and our teams work
really well with the hospital teams to where we can
move those patients through the hospital. Have done some really
great work to try and assis stuff to get those
crews back out to respond to cases. But you know,
as I said, similarly, we spoke around the resourcing that
(09:28):
we have. Unfortunately, at times, you know, the flow and
the demand coming in just doesn't fit the size of
the pipe that is trying to get through, and we
do see that backlog and obviously that then has an
impact and you know, we are seeing you know, at
times over three months periods, you know, loss of around
two thousand hours where our crews aren't able to respond
(09:49):
you know, in extended time at the hospital, and.
Speaker 2 (09:52):
Around two thousand hours over what period.
Speaker 1 (09:54):
Of time over three months.
Speaker 2 (09:57):
Three months spent ramping at the hospital.
Speaker 1 (10:01):
And as I said that, you know, we we you know,
we do really great work and this is not you know,
we work really well with health and we understand the
pressures there under but it does obviously then flow into
situations when we have unfortunately what happened on the Saturday
night where we have a person who is in pain,
and unfortunately, while we would like to have got there,
(10:22):
we were seeing receiving calls that were triarched at a
higher level and that means that those delays come result
at times in delays and responses to patients.
Speaker 2 (10:33):
Absolutely absolutely, And look, Andy, I know that a lot
of people listening this morning will have had interactions with
Saint John. I know myself. You know, the Saint John
crew do a phenomenal job, there's no doubt about that,
as do our overburdened health stuff. So this is not
a criticism of stuff in any way. But I think
for a lot of us what we're hearing. And I
(10:53):
took calls before I went on leave as well from
a couple of parents who'd been in contact, who also
had kids, you know, waiting at the basketball courts, waiting
at other sports for an ambulance to arrive under similar
situations to what we've seen reported this week by the ABC,
you know. So I think that people, you know, they're
happy with the service that they get once they have
(11:14):
Saint John there or once they are at the hospital.
But the concern is that they're seriously worried about people
waiting for those extended periods of time. So I suppose
what I'm trying to get to the bottom of, not
just with you, but also with health and then obviously
with the government, is how do we try to work
through these so that Territorians can be rest assured that
(11:35):
they're not going to be waiting for six hours.
Speaker 1 (11:38):
Yeah. Look absolutely, And as I said, we've done a
lot of work into modeling with future protected growth and
what the service delivery model that is needed for those
types of situations moving forward, so that we can we
want to make sure that we have the right amount
of resources and in in the right time of the
(11:58):
day to be able to get to patients within the
appropriate time. And we know that obviously healthcare is a
big important issue for Territorians, and we know that you
know that accessibility that when you are sitting there and
you're waiting for an ambulance, it feels like ours, when
you know, minutes feel like ours, and we want to
make sure that you know we want to reduce that
(12:20):
stress and have ambulances turning up in a timely manner
to be able to treat people and take them to
hospital and have processes in place that you know, when
we take the phone calls that we can actually then
deliver that response.
Speaker 2 (12:33):
Well, Andy, I really appreciate your time this morning, Saint John,
Director of Ambulance Services, Andrew Thomas, thank you very much
for having a chat with us. Much appreciated, No problem,
Katie thank you very thank you, thanks very much,
We know.
Speaker 2 (00:00):
The mother of a Darwin dancer has told the ABC
that she waited for more than six hours for an
ambulance to arrive after her daughter dislocated her knee at
a dance competition on Saturday. Now, twenty year old Monique
Dries fell to the ground and started screaming in pain
about eight fifteen pm, and was told by emergency call
(00:21):
operators to stay put until paramedics arrived. Her mother tried
to take her to hospital herself using a luggage trolley,
which was all the venue had on hand, but couldn't
due to the position of her knee. Now, paramedics did
eventually arrive, but that was at two point thirty in
the morning, but the family had to wait another forty
five minutes in the ambulance due to ramping at the hospital.
(00:44):
Now joining us on the line is Saint John Ambulance
Director of Ambulance Services, Andrew Thomas. Good morning, Andy, Good
morning Katie, and welcome back, thanks mate. Now, Andy, what
what was the go on the weekend? Was it an
ex aptionally busy night on Saturday for Saint John?
Speaker 1 (01:04):
Look, Katie, well, I mean we know that on Saturday
nights traditionally we see an increase in our workload, and
our workload trending and mapping, we know is our busiest
times kick off from around about two or three o'clock
in the afternoon and go through to around about one
to two o'clock in the morning, and that's when we
see our peak workload. We are really you know, we've apologized,
(01:28):
We've reached out to Moniquan and mum Rebecca to express
our obviously our concerns and obviously acknowledge the delay and
the response that they got. And obviously we know that
obviously it's extremely distressing for her and the family and
everyone that was there that you know those delays.
Speaker 2 (01:48):
Well, and yeah, and like I get that, you guys,
you know, it's a situation where you're having to triage.
I mean on that night, was there, like we're there
a number of incidents, what was so what was sort
of happening behind the scenes that might mean that she
had to wait for that long for what many would
would say is quite a serious issue.
Speaker 1 (02:09):
Yeah, So look over around that sort of you know,
six to seven hour period when that case came in,
we had eighteen Priority one cases, which is our highest
level of case, which is our lights and sirens response
and an average turnaround on an ambulance crew for those
is around about one and a half hours by the
time we get there, respond, treat, take them through to
(02:32):
hospital and then obviously you know, hand over to the hospital,
tidy up and then be able to respond again. We
also had another fourteen cases, both priority to seven Priority
two cases which are not lights and sirens but are
still urgent, and then also another seven lower acuity cases
(02:53):
in that period of time. So you know, we're looking
at around about you know, thirty two thirty three cases
over that period of time time and on that night
we had four emergency ambulances across the Darwin region. Oh yeah,
we know, and we've said before we are underresourced. Our
staff do an amazing job that we have the best
staff who continue to go out there and deliver really
(03:17):
high quality care and what to acknowledge and be thankful
obviously too to the family who have acknowledged the really
good care of the paramedes provided where they actually got there.
Speaker 2 (03:27):
And this is the thing I guess Andy, is you know,
in my experience, most people are really you know, like
they're very satisfied with the service and with the care
that they receive from our paramedics and from Saint John.
But the issue seems to be I mean, when you
take into account what you've just told me, thirty two
cases in that period of time for emergency ambulances, I
(03:48):
think you said on the road, how on earth do
you deal with that volume of cases?
Speaker 1 (03:55):
Yeah, look, we are you know, we've been talking for
a long time. We need more resources, we need ways
of managing that demand as well. So we're you know,
we are in discussions obviously for the contract going forward,
and we're looking at the opportunities to obviously increase resourcing
and then look at ways of also managing some of
(04:15):
that demand. And you know, so some of that some
of those opportunities we're looking for is to put more
clinicians in comms to be able to really assess those
cases and give more advice and be able to work
out the priorities that are needed to get the right
patient to the right crew at the right time. But
also we just need more resources at times, particularly in
(04:36):
that afternoon, evening and nighttime period. We know our workload
continues to increase. We've seen yet again another eleven percent
increase in call volume in the last year coming into
triple zero with over one hundred thousand triple zero calls
entered in the last last financial year. Our workload continues
(04:56):
to increase, including and what we're seeing this year is
that the higher acuity cases, those lights of Sirens jobs
are the ones that we've seen the greatest increase in
the last twenty four hours. And we know that, you know,
with those, those cases obviously put a lot of stress
on our service because we want to try and get
there and they're obviously very difficult to deal with in
(05:17):
terms of that takes out a lot of time about
to do that and then obviously the time to be
able to get from through the hospital and hand over.
Speaker 2 (05:24):
And look, we talk a lot about alcohol issues in
the Northern Territory. What kind of you know, what what
kind of impact does that alcohol issue? Some of the
incidents that are alcohol related have then on our crews
and on Saint John being able to get out to
other incidents and to get out to everything.
Speaker 1 (05:44):
Look, I mean, we see alcohol related incidents, but I
think you know, it's not that that. What we end
up seeing is the end point of it. And so
the significant road trauma, the significant traumas related from you know,
either violence and theression or domestic violence. We see the
sort of the poor health states and comorbidities within our
(06:07):
population that leads to really sick and unwell patients that
obviously require our attention. And as I said, predominantly a
lot of that tends to be in the latter part
of the day and into the night when a lot
of the other services aren't around, and we know that
that then flows into the hospital.
Speaker 2 (06:26):
So you spoke then as well about that high demand
and trying to manage that high demand. I mean, does
this just come down is it a funding or a
resourcing issue or is it both? And really what does St.
John need as you talk about the renewal of that
ambulance contract.
Speaker 1 (06:44):
Yeah, look, I mean obviously the factors that obviously really
impact into those response times is obviously the community demand,
ambulance crew and vehicle availability, the hospital capacity, patient flow
through the emergency department. But I think you know, really,
we know that across all the locations in our springs
Catherine uh and in Darwin, the resources we have quite
(07:09):
often are outstripped by the demand that I'm from that's
coming from the community. And so we really need to
look to make sure that we have the right amount
of resourcing in the right time when the result when
the demand is needed. And you know, clearly we are
under resourced in major city like Darwin's.
Speaker 2 (07:25):
So I guess we're getting though, does that come down
to needing more funding to be able to get more
staff or not being able to fill those positions.
Speaker 1 (07:35):
Look at the moment, this is where where these are
what we're currently are contracted to provide. And we've been
talking and that's the discussions of having this government is
we need more resources. We need to make sure that
the resources are targeted where they are and how we
can better use it to manage that demand. And you know,
so we are looking obviously, you know, we've been speaking
about needing more ambulance crews to meet the increase that
(07:59):
we've seeing over the you know, the last four to
five years, we've seen continual increase in our workload, you know,
up around about seven to eight percent across each year.
We're seeing that growth. And what we are seeing, as
I said in last year, is that the patience that
we're going to a sicker and obviously that obviously enties
some of our vehicles up or we need to send
a second vehicle to support to provide the appropriate treatment.
Speaker 2 (08:22):
Now, just in terms of them that ambulance ramping in
hospital bay is what needs to happen to address this.
By the sounds of things, you know, there's an enormous
demand on our emergency ward and so you know, if
they're not able to bring somebody in who's in and
in a you know, in an ambulance, or they're out
the front, they're waiting for a bed or waiting for
(08:42):
some availability, I'm assuming.
Speaker 1 (08:45):
Yeah, Look, we know that that ability for us to
transfer a care or ramping as it's often returned to,
is an issue unfortunately we see in Darwin, but it
is a significant issue across all states. Anyone who's come
from any of the other states where as well and
truly aware that you know, it causes major problems with
the health system right across Australia. You know, it is
(09:06):
a whole of health issue. It's not just you know,
we do some really great work and our teams work
really well with the hospital teams to where we can
move those patients through the hospital. Have done some really
great work to try and assis stuff to get those
crews back out to respond to cases. But you know,
as I said, similarly, we spoke around the resourcing that
(09:28):
we have. Unfortunately, at times, you know, the flow and
the demand coming in just doesn't fit the size of
the pipe that is trying to get through, and we
do see that backlog and obviously that then has an
impact and you know, we are seeing you know, at
times over three months periods, you know, loss of around
two thousand hours where our crews aren't able to respond
(09:49):
you know, in extended time at the hospital, and.
Speaker 2 (09:52):
Around two thousand hours over what period.
Speaker 1 (09:54):
Of time over three months.
Speaker 2 (09:57):
Three months spent ramping at the hospital.
Speaker 1 (10:01):
And as I said that, you know, we we you know,
we do really great work and this is not you know,
we work really well with health and we understand the
pressures there under but it does obviously then flow into
situations when we have unfortunately what happened on the Saturday
night where we have a person who is in pain,
and unfortunately, while we would like to have got there,
(10:22):
we were seeing receiving calls that were triarched at a
higher level and that means that those delays come result
at times in delays and responses to patients.
Speaker 2 (10:33):
Absolutely absolutely, And look, Andy, I know that a lot
of people listening this morning will have had interactions with
Saint John. I know myself. You know, the Saint John
crew do a phenomenal job, there's no doubt about that,
as do our overburdened health stuff. So this is not
a criticism of stuff in any way. But I think
for a lot of us what we're hearing. And I
(10:53):
took calls before I went on leave as well from
a couple of parents who'd been in contact, who also
had kids, you know, waiting at the basketball courts, waiting
at other sports for an ambulance to arrive under similar
situations to what we've seen reported this week by the ABC,
you know. So I think that people, you know, they're
happy with the service that they get once they have
(11:14):
Saint John there or once they are at the hospital.
But the concern is that they're seriously worried about people
waiting for those extended periods of time. So I suppose
what I'm trying to get to the bottom of, not
just with you, but also with health and then obviously
with the government, is how do we try to work
through these so that Territorians can be rest assured that
(11:35):
they're not going to be waiting for six hours.
Speaker 1 (11:38):
Yeah. Look absolutely, And as I said, we've done a
lot of work into modeling with future protected growth and
what the service delivery model that is needed for those
types of situations moving forward, so that we can we
want to make sure that we have the right amount
of resources and in in the right time of the
(11:58):
day to be able to get to patients within the
appropriate time. And we know that obviously healthcare is a
big important issue for Territorians, and we know that you
know that accessibility that when you are sitting there and
you're waiting for an ambulance, it feels like ours, when
you know, minutes feel like ours, and we want to
make sure that you know we want to reduce that
(12:20):
stress and have ambulances turning up in a timely manner
to be able to treat people and take them to
hospital and have processes in place that you know, when
we take the phone calls that we can actually then
deliver that response.
Speaker 2 (12:33):
Well, Andy, I really appreciate your time this morning, Saint John,
Director of Ambulance Services, Andrew Thomas, thank you very much
for having a chat with us. Much appreciated, No problem,
Katie thank you very thank you, thanks very much,
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