What we are doing now - Hospital Demand Management Plan

COVID-19 response

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.

My Home Hospital

We are implementing

The My Home Hospital (PDF 140KB) 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.

In its first year of operation, the conditions that will be eligible include those with respiratory infections or inflammations, kidney infections, and urinary tract infections.

This type of service has especially shown its worth during the COVID-19 response with around 163 COVID-19 patients treated under the current Hospital-in-the-Home (HITH) programs - receiving care at home rather than being admitted to a public hospital.

Southern Health Expansion Plan

We are implementing

The Southern Health Expansion Plan has been brought forward as part of South Australia’s COVID-19 response and completion of Stage 1 is planned in October 2020. The Plan will boost access to health services across the southern region by increasing clinical capability of Noarlunga Hospital, increasing the size of the Flinders Medical Centre (FMC) Emergency Department, and co-locating dementia specialist services at the Repat Hospital Precinct.

The Plan includes:

  • increasing emergency treatment by 24 more spaces at FMC 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 Emergency Department.

Flu vaccination

The public awareness campaign Stop the Flu Before it Stops You was launched in April to educate the community about the risks associated with flu, how easily it spreads, and practical measures to reduce the spread.

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

Priority Care Centres

We are implementing

We have opened Priority Care Centres across metropolitan Adelaide following a successful pilot program to ease pressure on our hospital Emergency Departments (EDs). As of 23 August 2020, a total of 3,520 patients have attended the Priority Care Centres.

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 now be treated at the Priority Care Centres.

The Priority Care Centre’s are also providing COVID-19 testing on site for patients.

Additional access pathways to access services at 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

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.

SA Health is continuing to work closely with the private sector to establish an urgent mental health care centre in close proximity to the Royal Adelaide Hospital, as a statewide alternative for mental health patients who would otherwise present to its Emergency Department. The successful tender was announced as Neami National and agreement with RI International providing additional support and training, with a particular focus supporting suicide prevention models - in particular the zero suicide approach. Neami National is commencing the co-design phase of the project with key stakeholders and partners.

We are also implementing:

  • Direct mental health admission pathways, and rural and remote rapid review processes for hospital transfers, in CALHN.
  • 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.
  • Building work has been completed on a specialised 18 bed Neurobehavioural Unit (NBU) at the reactivated Repat site, with planning underway for the opening of the service.
  • A 12 bed Specialised Advanced Dementia Unit has now opened at the reactivated Repat site for patients living with complex dementia.
  • SA Ambulance Service and Central Adelaide Local Health Network (CALHN) have partnered to commence a second phase of the Mental Health Co-Responder program. This program brings paramedics and mental health clinicians together to support consumers in the community where suitable, rather than transport them to an ED.
  • Planning has commenced for a Statewide Paediatric Eating Disorder Service.

Transferring patients to free up beds

We are implementing

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.

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.

LHNs continue to partner with approved private providers to treat eligible and overdue elective surgery patients. Since elective surgery restrictions were lifted on 13 May 2020, the Patient Services Panel private providers continue to collaborate to support the recovery of the South Australian public health system. Overdue patients on the list have reduced from 2,700 to 1,700 since restrictions lifted.

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 11  September 2020, 412 patients have been discharged from hospital through these projects. These 412 patients had a combined stay of 44,586 days since being medically cleared for discharge.

Private partnerships

We have implemented

In July 2019, a new Patient Services Panel was established, which allows public hospitals to access services at private facilities. This more streamlined coordination of services will result in reduced waiting times for elective procedures and increased capacity in our public hospitals.

A second open market tender process was recently held for the Panel, with four new providers being added to SA Health’s list of approved private providers, bringing the total number to 17 (as at 1 July 2020). The 17 private providers include day and overnight hospitals which will 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.
  • 5 bed Short Stay Mental Health Unit at Lyell McEwin Hospital.

Mobile Radiology Service

We have implemented

South Australia Medical Imaging (SAMI) has rolled out a mobile radiology service, bringing x-ray equipment direct to nursing home residents. This mobile imaging service trial will support older patients in the southern suburbs who would otherwise require transport to a nearby hospital for an x-ray.

Hospital discharges

We have implemented

We’ve introduced a new Statewide Hospital Criteria-Led Discharge plan to help patients return to their home as soon as possible, and reduce the pressure on our hospitals and EDs.

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.
  • 29 June 2020 saw the introduction of the Clinical Telephone Assessment (CTA) model (also known as secondary triage) to ensure that 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 emergency departments.
  • Bringing forward two intern groups (approximately 35 FTE) recruited for the June and September 2020 intakes to commence 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.