An open letter has been sent to the NSW Premier and the Health Minister calling for urgent action to address what clinicians have described as ‘chronic understaffing’ and ‘access block’ inside Westmead Hospital’s emergency department (ED).

Signed by over 200 emergency department nurses, registrars, senior medical officers, administration, orderlies and security guards, the open letter highlights a range of issues which have resulted in unsafe conditions for patients and staff.

The NSW Nurses and Midwives’ Association (NSWNMA) said widespread concerns were raised with Western Sydney Local Health District (WSLHD) over two years ago, yet little had been done to fix them.

Yesterday afternoon, medical, nursing and allied health staff met with WSLHD Chief Executive Graeme Loy, who has now referred the concerns raised by staff to a working group at the local level.

NSWNMA Westmead Hospital Branch Secretary, Timothy Blofield, agreed ongoing issues inside the ED had been compounded by a junior-heavy workforce and responding to the pandemic.

“Our ED nurses have been battling these issues on a daily basis and it has been relentless for everyone in the department,” said Mr Blofield.

“These working conditions have taken a massive toll on the wellbeing, mental health and morale of all the ED staff, with increased amounts of sick leave, overtime and sadly, even resignations.

“A surge in COVID-19 presentations thanks to the recent Delta outbreak has been an extra burden, with increased risks and safety concerns piling on to an already overwhelmed department.”

NSWNMA General Secretary, Brett Holmes, said it was unacceptable the ED of Western Sydney’s largest tertiary referral hospital was consistently one of the poorest performers.

“While our members will try to work with local management on this, they are concerned the working groups will not deliver the changes that are needed within a suitable time frame. The Health Minister needs to step in and provide assurances that the Local Health District will get the additional funding needed to match the growing demand being placed on this facility,” said Mr Holmes.

“Expert advice is also required to develop effective strategies that will address the access block and relieve congestion that builds regularly in the ED. They need some longer-term strategies implemented, rather than band-aid solutions.

“Management taking the time to meet with staff yesterday afternoon to discuss solutions is a step in the right direction, but it will mean little if there are no actions taken soon as it is imperative that changes are put in place to fix the dire situation at Westmead Hospital.”

The open letter also outlines several ED staffing improvements to boost safe patient care, including:

• a minimum of 1 nurse to a maximum of 3 patients; and 1:1 nursing care in resuscitation bays
• increased ED medical staffing across all shifts (morning, afternoon and evening)
• additional Mental Health Clinical Nurse Consultant and Psychiatry Registrar 24/7
• 1.4 full-time equivalent (FTE) Clinical Nurse Educators per 30 nursing staff
• 1.0 FTE Nurse Educator; and 1.0 FTE permanent Equipment Officer
• a minimum of 90% registered nurses to be skilled in emergency nursing

The NSWNMA said it was continuing to support members who had described the situation as ‘at breaking point’ and urged the NSW government to prioritise the health and wellbeing of all staff trying to provide safe care to their ED patients.