Third of ED presentations more suited to pharmacy or GP


Splinters, sunburn, acne and hiccups are all examples of non-urgent presentations to Emergency in Queensland late last year… but a pharmacy trial is set to help

More than a third of Queensland’s emergency presentations in October to December 2020 could have been treated by a GP or pharmacist, new data shows.

The state’s hospital performance data for the quarter shows that there were 587,301 ED presentations, and that all 4,234 Category 1 patients – the most urgent cases – were seen by a clinician within two minutes of arriving.

While the median wait time for all ED patients to be seen was 14 minutes and 77% of all cases were seen within clinically recommended times, Minister for Health and Ambulance Services Yvette D’Ath noted that 30-40% of monthly presentations were classified as non-urgent complaints.

“In December alone, almost 76,000 presentations could have been treated elsewhere,” she said.

“Most are legitimate health concerns however they are not matters for emergency department staff whose primary role is to save lives.

“They are being asked to treat splinters, blisters, sunburn and even acne and hiccups. People are turning up asking for medical certificates, prescription refills and immunisations.

“No patient will be refused care at any of our hospitals however EDs are for seriously ill and injured patients. Less urgent presentations place unnecessary pressure on the system and, potentially, put the lives of others at risk.”

Professor Trent Twomey, president of the Queensland branch of the Pharmacy Guild, told the AJP that the Queensland Government is “already working hard to reduce non-urgent presentations to hospitals and has committed to an Australian first trial of pharmacists prescribing to their full scope of practice in North Queensland”.

“This trial aims to reduce non-urgent presentations and unnecessary hospitalisations,” he said.

“Throughout the coronavirus (COVID-19) pandemic we’ve seen an increase in community pharmacies being utilised as one-stop primary healthcare hubs.

“Looking through the Queensland Government list of non-urgent presentations to Emergency Departments, a majority of these presentations could be avoided in the future through a visit to a community pharmacy, if pharmacists were able to practice to their full scope.”

Professor Twomey said that with 97% of people living within 2.5km of their local community pharmacy, and 65% in regional areas, community pharmacists and pharmacy assistants are in a unique position to be the first port of call for patients and to alleviate the pressure off of our hospitals.

“Community pharmacists’ full scope of practice is broadening and includes immunisations and travel vaccinations, laboratory tests and point-of-care testing, medication and disease management services,” he told the AJP.

He also highlighted the recently launched free online tool (getmycovidvax.com.au) to provide information to the community as to when they may be able to access their COVID-19 vaccinations, given that community pharmacists will be involved in the rollout from phase 2A.

Professor Twomey also highlighted the work already being done to allow pharmacists to help with urinary tract infections.

“Community pharmacists are already helping to prevent up to 20,000 potentially preventable hospitalisations in Queensland due to urinary tract and kidney infections,” he said.

“The Queensland Government is supporting hospitalisation reductions through the Urinary Tract Infection (UTI) Pharmacy Pilot, which ensures that the one in two women who may be experiencing a UTI can be seen and treated immediately by participating community pharmacists to avoid further complications.”

Examples of non-urgent ED presentations in 2020-21 YTD

#

Attention to surgical dressings and sutures

8,195

Splinter

2,525

Medical certificate

1,704

Repeat prescription

1,654

Nail disorders/ingrown nail

559

Fractured, loose or impacted teeth

377

Muscle cramps and spasms

358

Sunburn

180

Contraceptive management

81

Blisters

59

Psoriasis

52

Immunisations

46

Acne

29

Insect bite

29

Hiccups          

20

Source: Queensland Health

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