Comment
Maffra Ambulance Branch
AS most Victorians are aware, Victoria is grappling with a health crisis of ambulance response times, paramedic health and safety and hospital ramping.
Ambulance response times have ballooned from 15 minutes to an average of 20min in Gippsland. This is well behind Melbourne response times, proving health outcomes are worse in rural Victoria.
Paramedic health and safety in East Gippsland is at risk every night due to unsafe and outdated rosters. A small number of ambulance branches, including Maffra and Paynesville, still work rosters that are both unsafe and unhealthy.
A paramedic recently crashed and rolled an ambulance after working an ‘on-call’ version of an Ambulance Victoria roster.
Hospital ramping is when emergency departments get filled to capacity and are unable to move patients through the hospital system. This leads to ambulances with unwell patients stuck on ambulance stretchers in the ambulance bay – creating a bottleneck and ‘ramping’.
The solution is multi-factorial, but if there are ambulance resources ramped at Gippsland hospitals, then there are not enough ambulances to respond to the community.
ABC Gippsland reported on an incident on August 16, when hospital ramping at Bairnsdale Regional Health Service and Central Gippsland Health in Sale decreased ambulance availability to critical levels. This is not a new issue and happens frequently. It does, however, highlight the healthcare inequalities facing rural Victorians.
On that particular night, with local crews ramped at BRHS and CGH, ambulance crews from Traralgon were responding to cases in Bairnsdale, depleting resourcing in the Latrobe Valley and leaving most of East Gippsland from Rosedale through to Mallacoota without an ambulance during the evening from 5pm until midnight. This highlights the need for extra resources, particularly through the afternoons until midnight.
East Gippsland paramedics have been working feverishly to address ambulance availability and ambulance response times in East Gippsland. The workload, on average, has increased by 30 per cent over the past five years, yet many rosters and resources have not changed in East Gippsland.
The Maffra branch has proposed a solution for the Victorian government and AV to help with the ambulance and healthcare crisis in East Gippsland. They have been working hard, providing evidence and consulting with AV in an effort to combine the Heyfield and Maffra branches to form a blended roster – this would give the region an extra qualified afternoon shift to ease the strain.
The cost of this upgrade is well worth the investment. It would provide extra resources to relieve the pressure and improve response times in Gippsland, provide extra resources to move patients from rural hospitals to specialist care in Melbourne, and provide a safer roster to protect the public and paramedics from the dangers of fatigue, allowing them to make it home after serving the Gippsland community. It would also double the paramedic coverage working out of the Heyfield AV branch.
The Maffra ambulance branch currently work a fatiguing and unsustainable 10/14 roster (two x 10-hour dayshifts followed two x 14-hour nightshifts). AV have been moving away from this roster to a blended 10/10/12/14 pattern (two 10-hour dayshifts, one 12-hour afternoon shift and one 14-hour nightshift). Almost every other branch in Gippsland works a blended roster and the majority of paramedics enjoy this shift pattern.
Maffra are happy to work a 14-hour nightshift, but with the 30 per cent increase in workload and enormous distances they cover at night, it is not sustainable to continue with the two consecutive 14-hour nightshifts, with only 10 hours break in-between.
There have been multiple reports from Maffra crews of fatigue and near misses in AV’s health and safety reporting system.
Maffra’s catchment at night covers Heyfield, Denison, Cowwarr, Toongabbie, Newry, Coongulla, Glenmaggie, Munro, Stockdale, Stratford, Dargo, Licola, Tinamba, Boisdale, and Briagolong. Because of the lack of resources overnight, their catchment also expands to Bairnsdale, Traralgon, Loch Sport, and other towns along the Ninety Mile beach. Upgrading Maffra to a blended roster makes covering these towns safer for the Maffra crews, their patients, and the public.
Interesting to note is that 53 per cent of cases in Maffra are sourced from outlying ambulance crews. This is because the Maffra ambulance is already on another case, or they have been relocated for the shift to cover another area. A blended roster, with an added afternoon shift, allows Maffra to continue to serve East Gippsland, as well as improving coverage of their own hometown, improving healthcare and equality.
The Maffra branch is not asking for special treatment, just to do the same blended roster afforded to the majority of ambulance branches in rural Gippsland. It is a win-win for the Victorian government, Ambulance Victoria, Gippsland hospitals and the Gippsland public.
There are a limited number of ambulance resources overnight (AV reduces to a 1/4 of the daytime resources overnight which is consistent with demand) but there is a spike in workload in the afternoons until midnight. A Maffra afternoon shift can ease the strain by working with regional hospitals to move patients requiring inter-hospital transfer, which will assist with reducing hospital ramping.
A blended roster for Maffra affords AV an enormous amount of flexibility to meet ambulance demand in Gippsland and support paramedics on flexible work arrangements (FWA’s). These arrangements are in place for paramedics that have added family responsibilities. Once again, a win-win situation all stakeholders.
The job of a paramedic is rewarding and fulfilling as we attend to our communities when needed. It also takes a toll on our health however, working rosters that include working two consecutive, gruelling 14-hour nightshifts.
The Gippsland public deserve better. There is a large and diverse community that reside in Gippsland that are unaware that they have worse health outcomes by living in rural Victoria.
East Gippsland’s resourcing issues have fallen on deaf ears due to the lack of government funding and the unwillingness of Ambulance Victoria to adequately resource East Gippsland’s ambulance branches.
Please support us so we can support you.
Jack Jensen ALS paramedic, Maffra team manager
Anna Musgrave ALS paramedic, Maffra health and safety representative
Glenn Lazzaro MICA Paramedic, Sale health and safety representative
Jo O’Doherty Maffra ALS paramedic
Zac Harrington Maffra ALS paramedic
Kelsey Sharrock Maffra ALS paramedic
Bethany Adams Maffra ALS paramedic
Amy Mitchell Maffra ALS paramedic
Tiarn Krizman Maffra ALS paramedic