GP Shortages Fuel Pressure on NSW Emergency Departments Amid Growing Healthcare Demand

The latest Bureau of Health Information (BHI) Health Quarterly report highlights the mounting strain on New South Wales’ health system, with emergency department (ED) attendances continuing to rise in response to diminishing access to general practitioners (GPs). Between April and June 2024, there were 795,817 attendances at NSW EDs, a 3.3% increase from the same period last year, demonstrating the growing demand for critical care services.

The report also underscores a signifcant drop in GP attendance across the state, with a decrease from 754,709 to 653,802 GP visits per 100,000 people between June 2022 and June 2023. This sharp decline represents the most substantial reduction in GP appointments in over a decade, a worrying trend exacerbated by the Federal Department of Health & Aged Care’s data showing a decrease in NSW’s GP workforce, down from 9,700 in 2019 to 9,485 in 2023.

NSW Health Minister Ryan Park expressed concern over the worsening situation, noting that many individuals are delaying necessary care, particularly for chronic conditions, which can result in health deterioration and the need for emergency treatment. The BHI report confrms that ED presentations from the sickest patients— categories 1, 2, and 3—have surged to record levels, far outpacing population growth.

“A growing number of patients are resorting to EDs simply because they cannot afford to see a GP or are unable to secure an appointment within a reasonable time frame,” said Park. He emphasized the link between inadequate access to primary care and increased ED visits, stating that many of those seeking emergency care could have been treated by GPs if access were more readily available.

Compounding the issue, many admitted patients awaiting aged care or National Disability Insurance Scheme (NDIS) placements are contributing to bottlenecks in hospitals. According to the report, nearly 800 patients exceeded their discharge dates, accumulating over 41,000 additional bed days across NSW hospitals.

To address these challenges, the NSW Government has introduced several initiatives aimed at alleviating the pressure on EDs by expanding access to alternative care pathways and improving patient fow. These include:

• $100 million for urgent care services and $171.4 million for three new virtual care services aimed at diverting thousands of patients away from EDs.

• Expanding pharmacists’ roles to provide consultations for low-complexity conditions, easing the burden on GPs.

• $70 million for short stay units, $31.4 million for hospital-in-home programs, and $53.9 million for deploying 86 patient fow offcers across the state’s hospitals.

Minister Park also pointed to the NSW Government’s $189 million Bulk-Billing Support Initiative, which aims to improve access to GPs and increase bulk-billing rates, a critical step in addressing the ongoing primary care crisis.

The state has also established an Emergency Department Taskforce to review statewide ED performance and develop strategies for improving care delivery across NSW hospitals.

While acknowledging that primary care access remains a federal responsibility, Park emphasized that the NSW Government is doing its part by implementing these measures. He called on the federal government to continue working to reverse the impacts of the Medicare rebate freeze, which has further restricted access to GPs.

“We are incredibly grateful for the hard work of our hospital staff, who face unprecedented pressure. Our focus on creating alternative care pathways has already helped nearly a quarter of a million people avoid long waits in EDs, but we still need federal support to address the underlying issues in primary care,” Park said.

For non-emergency health concerns, residents are encouraged to call HealthDirect on 1800 022 222 to receive free advice from registered nurses, who can guide them to appropriate care services.

Heroin Overdoses Linked to Drugs Thought to Be Cocaine

NSW Health has issued an urgent warning following four recent heroin overdoses in New South Wales, two of which were fatal. These incidents involved individuals using substances they believed to be cocaine.

Dr. Hester Wilson, NSW Health’s Chief Addiction Medicine Specialist, cautioned that the danger of heroin overdose can arise from even a single dose of what users believe to be cocaine. Two people have died, and two others were hospitalized after using the suspected cocaine.

“A heroin overdose could quickly result from a single line,” Dr. Wilson warned. “Opioids such as heroin can cause severe effects, including pinpoint pupils, drowsiness, loss of consciousness, slowed breathing or snoring, and skin turning blue or grey. These are life-threatening symptoms.”

Risks of Unknown Drug Composition

Dr. Wilson emphasized that one of the major risks of illicit drugs is that the contents and strength are often unknown and inconsistent. Heroin and other opioids can sometimes be found in substances sold as cocaine, methamphetamine, or MDMA (ecstasy).

“You cannot always distinguish between these drugs by appearance,” she added. The Importance of

Naloxone

People who use substances like cocaine, methamphetamine, MDMA, or opioids are urged to carry naloxone, a life-saving medication that can reverse the effects of opioid overdoses. Naloxone is available as a nasal spray or injection, and it is free and accessible without a prescription in NSW. If someone shows any unexpected symptoms after using drugs, call Triple Zero (000) immediately and administer naloxone if available. Naloxone can be obtained discreetly by contacting NUAA at (02) 8354 7343, or ordered through their online shop.

Key Resources:

• NSW Poisons Information Centre: 13

11 26 (available 24/7)

• Alcohol and Drug Information Service: 1800 250 015 (for confdential and anonymous support, available 24/7)

• Public drug warnings: Visit NSW

Health’s drug warnings page.

Remember, seeking medical help for yourself or others will not result in legal trouble—take action immediately if you or someone else feels unwell.

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