Fiona Stanley Hospital deputy director of clinical services John Anderson declares crisis in ED

An executive at one of WA’s biggest public hospitals has admitted what the State Government won’t — doctors have faced an unprecedented “crisis” this week. The West Australian has obtained an email sent by Fiona Stanley Hospital deputy director of clinical services John Anderson to senior staff on Wednesday. In the leaked email, Mr Anderson alerted the leadership team to “yet another day” of FSH’s emergency department declaring a “code yellow”. Code yellows — issued when EDs are so busy they need to alert other wards to discharge medically suitable patients to free-up beds — were declared on Monday, Tuesday and Wednesday. Yesterday, “bed state black” was declared at the hospital’s intensive care unit, meaning the department couldn’t accept any more patients and they needed to go elsewhere for treatment. Dr Anderson reminded staff of “mandated actions” designed to identify patients “for potential transfer or discharge as soon as possible”. “The current capacity and access pressures are unprecedented — combinations of ED presentations and admission loads across all services over extended periods ... with an inability to clear patients for admission to beds that are currently occupied,” he wrote. The advice was to “see only unstable patients first”, “then see the patients who are likely discharges” and “then the other patients”. “Wherever possible as soon as the decision to discharge a patient is made, they should be sat out on the ward or transferred to transit lounge so that the clearing process can take place,” Dr Anderson continued. “It is self-evident that when running the hospital at high occupancy we must discharge patients before we can admit new patients. Please be mindful that staffing issues are seriously impacting — particularly nursing — and that co-operation with transfers is the aim. “Thank you for your attention and the extraordinary efforts that are being made to help us get through this crisis.” Health Minister Roger Cook and Premier Mark McGowan have refused to describe the surge in demand in the State’s EDs as a “crisis”, but this week announced an indefinite delay for non-urgent surgeries. Mr Cook said in the first three months of this year, category one presentations to EDs was four per cent higher than in the same period in 2019, with category twos 10 per cent higher. “Something is going on in our EDs and something is going on in our hospitals. People right across the country are trying to come to grips with what this change of presentations looks like and what the implications are. This has been felt in EDs right across the country,” he said. The South Metropolitan Health Service said it was not prepared to comment on leaked emails.