ED visits soaring amid GP shortages

A nationwide shortage of GPs is beginning to take its toll on state health systems, with fresh data revealing emergency departments are bearing the brunt of general practice funding shortfalls.
 
Released on Wednesday, the latest Bureau of Health Information results shed a light on the importance of funding primary care in New South Wales, finding emergency department (ED) visits are soaring at the same time as residents struggle to see a GP.
 
It found that in 2022–23, ED presentation rates for all patients were 1% higher than the year before, relative to population size, and between 2017–23, they grew by 3.4%.
 
In 2022–23, the number of Medicare-subsidised GP attendances fell by 13%, however, the report notes this fall was especially dramatic due to COVID-19.
 
NSW and ACT Chair Dr Rebekah Hoffman told newsGP the data is further proof that every dollar spent in general practice saves money in tertiary care.
 
‘That’s because GPs are experts in improving your health, improving your wellbeing, and we’d much rather be keeping people out of hospital than treating them once they’re in hospital,’ she said.
 
‘That does mean spending more money in primary care and in the primary care system, but we know that long-term, that saves money.
 
‘This is exactly what we’re telling everyone and now we have more evidence of the same and so it’s even more incentive to value what GPs do.’
 
The data comes at a time when patients delaying or not seeing a GP has doubled in the last year, according to the Australian Bureau of Statistics, with out-of-pocket costs a barrier for 7% of people.
 
NSW Health Minister Ryan Park said the data has raised concerns that people are putting off care and ‘deteriorating to a point where they become very unwell’.
 
‘While access to primary care and GPs is a federal responsibility, the NSW Government is playing our part by investing in pathways to care outside of the hospital, while improving patient flow within the hospital.
 
‘But we cannot do this on our own, and we are continuing to see our state health system shoulder the burden of the crisis in primary care.’
 
More than seven million NSW locals see a GP each year and three quarters of people have at least one long-term condition.
 
The report also found an upward trend in the number of triage 1, 2 and 3 presentations, with all three reaching record highs.
 
Dr Hoffman has seen this trend firsthand with her own patients and said GPs are key to taking preventive action, by prescribing appropriate medication and helping patients avoid a trip to the ED.
 
‘Sometimes you think your only option is to go to emergency, and that’s definitely not the case, there’s always other options, and we’d love to see GPs being thought of,’ she said.
 
‘GPs are so excellent at identifying if someone’s child needs urgent care, and if you need to go to the ED, that’s absolutely where you’re going to be sent, but it’s not always where you need to be.’
 
The report’s release came on the same day as a cohort of RACGP doctors visited the NSW Parliament to call for a significant boost to the state’s health investment.
 
The visit to Parliament saw the GPs sit down with their local politicians face-to-face, calling for funding for incentive payments for general practice registrars to do their training in NSW, and to improve health communication to better support continuity of care and keep people out of hospital. 
 
Dr Hoffman said the event received a positive response from the politicians, many of whom understood the value of their constituents having a regular GP.
 
‘We were really able to talk to them about how important it is to train more GPs, how we’ve really successfully moved back into training the next group of registrars, how general practice is no longer in crisis,’ she said.
 
‘We’re really working towards improving access, improving GP numbers, and talking about some specific incentives around general practice training that we’d really love to see happen.’
 
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emergency department GP workforce GPs @ Parliament health data New South Wales