New Maitland Hospital understaffed as pressure builds on emergency department, ambulance bays and outpatients, Hunter Health Services Union organiser says

Hunter New England Health insists the current demand on the $470m Maitland Hospital has not changed since the hospital's relocation in January, but staff say the increasing pressure is clear to see.

Staff, patients and community members have told the Newcastle Herald - both on and off the record - that since the catchment area of the new Maitland Hospital had increased, the pressure on the facility has grown.

"The catchment area has increased for the new Maitland hospital, but staffing hasn't," Tracey Gaddelin, the region's Health Services Union organiser, said. "Hospitals often go through bed block, and ambulances will be diverted when that happens - so that part isn't unusual.

"But the amount of times the ambulances are being blocked at Maitland Hospital compared to previous years is unusual. It is nothing to see up to six ambulances outside the ED waiting to offload, which takes them out of circulation. It is a new problem. The old hospital you'd see two or three ambulances, but not for very long, and not like it has been at the moment."

Ms Gaddelin said she had received reports from HSU members that outpatients were waiting in excess of two hours for their appointments, and up to four. Administration staff had been working 12-hour shifts to cover positions.

"Although the service hasn't increased, activity has," she said. "It comes down to staffing to be able to see those patients in a timely manner - and they just don't have the staff."

Ms Gaddelin said some areas at Maitland Hospital were at "surge capacity" - meaning extra beds were being used for patients when there was high demand. She said that it has a flow-on effect as more staff - such as cleaners, wardspeople, nurses and admission administration staff - were required.

"There are two wards there at the moment that have a capacity of 22, and they are at 28 beds each," she said. "That doesn't sound like a lot but when you look at the hours that go into that one bed on productivity, it is a much larger workload. Maitland Hospital is understaffed."

Ms Gaddelin said in one week alone - within the first three weeks of the hospital opening - seven administration staff resigned.

"I think the public is definitely disappointed," she said. "They have heard for many years they are getting this brand new facility that will provide a critical service to the community. What they got was a great building but the services are severely lacking.

"The common reply from the health district is that there is the same level of activity - that there has been no increase in the services, therefore there has been no increase required in the staffing.

"It works on funding. They match the services to the budget, instead of matching the budget to the services required. Lip service isn't going to solve it. Our members need a safe workload and to be able to come to work happy to do their job. At the moment, they are coming to work everyday exhausted.

"The freakishly busy days are becoming the norm, unfortunately. Talking to members in the emergency department... they are overworked, stressed, and crying out for extra help.

"They need proper staffing to support the doctors and nurses looking after the patients."

Chris Kastelan, president of the NSW Australian Paramedics Association, said since the changeover, ramping has "never been worse" at the hospital.

"Anecdotally, they are telling me it's up to 40 minutes to be triaged, and then three-to-four hours in ramping - and they have never seen it as slow to move through into the emergency department," he said. "My connections are telling me that any issues with the old hospital have carried forward to the new hospital and are exacerbated by some internal staffing issues."

Mr Kastelan said the ambulance service used a technology called "the matrix".

"That is a system where we transport a patient to hospital, we put in our computer the disposition of the patient - whether it's a cardiac issue, stroke, trauma, COVID patient - and through that, more patients are now being directed to Maitland that may have been directed to the Calvary Mater in the past," he said.

"Ultimately, this slows the system down because more presentations are now going to Maitland that may have previously gone to the Mater. I don't think the Mater is much different at this point, I've seen some horrible photos around ambulance ramping and bed block there too in the past few weeks."

He said it was another example of why they were calling for another 1500 paramedics across the state to be recruited.

"You can spend $470 million on a new hospital, and that's great," he said. "But the people are the glue that holds the local area health services, and businesses like NSW Ambulance, together.

"If you're not investing in your people, it doesn't matter how much money you spend on a building.

"It will suffer the same problems."

A Hunter New England Health spokesperson said the hospital had been designed to accommodate the needs of the growing Lower Hunter region.

"Patients who present to the emergency department (ED), either via ambulance or in-person, are prioritised to ensure those with the most urgent conditions are treated first. This means that some patients whose cases are less urgent, may wait longer than others," the spokesperson said.

"Since opening in January, the hospital has not experienced a consistent increase in presentations despite known changes to ambulance boundary lines. However, just like any other hospital, there are times when the emergency department has seen an unusual increase in activity and these fluctuations are difficult to predict.

"Our district has processes in place to minimise waiting times and ensure patients are safe and comfortable while they wait. This includes opening surge beds, rostering an additional nurse in the waiting room to manage patients and a patient experience officer who provides useful information, including updates to wait times.

"We also work in close collaboration with NSW Ambulance to divert patients around the network where appropriate, to ensure they're treated as soon as possible. We'd like to thank the community for its patience as our staff orientate themselves and we adjust our processes to the new facility.

"We'd also like to thank our staff for their ongoing dedication during the pandemic. Like other hospitals and businesses, we have seen some staff furloughed as a result of COVID-19, however, we make every effort to fill any unexpected absences to ensure we continue providing quality care.

"We encourage anyone requiring urgent care to continue to present to Maitland Hospital's emergency department where they will receive the care they need."

The spokesperson said the new hospital opened as a "service level transfer", meaning it opened with the same level of services and staffing as at the old campus.

"The facility itself has significantly more beds and treatment spaces, which will come online in future as needed," she said.

The Bureau of Health Quarterly report (Oct to Dec 2021) - compiled before the hospital moved - showed that in that quarter, 93.4 per cent of ambulance patients were offloaded in the ED within 30 minutes, "making Maitland Hospital one of the best-performing tertiary hospitals in the state."

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