Mistakes in Perth hospitals contributed to 85 deaths last year as emergency departments failed to meet targets

Poor clinical decision-making or mistakes in Perth hospitals contributed to the loss of 85 lives in the past year, new data has revealed. Annual reports from the Child and Adolescent Health Service, North Metropolitan Health Service, East Metropolitan Health Service and South Metropolitan Health Service have laid bare an ailing health system, as they also revealed EDs were failing dismally at meeting prescribed targets for patient treatment. There were 318 reported incidents in 2023-24 ranked at severity assessment code 1, or SAC1. SAC1 is the top code used to rank major incidents that can be attributed to the provision, or lack thereof, of health care, rather than a patient’s condition. The Child and Adolescent Health Service, which includes Perth Children’s Hospital, has reviewed or is still reviewing 12 SAC1 incidents — five of which resulted in death and another four in serious harm. It means two in five of those incidents led to the death of a child in the past year. And it’s just one less death than the 2022-23 year, but a doubling of incidents resulting in serious harm. Its ED performance also worsened, with 30.7 per cent of patients triaged priority three seen within the recommended 30-minute time frame — down from 32.4 per cent in 2022-23. NMHS reported 22 SAC1 deaths, down from 24 the year prior, while 64 incidents led to serious harm — an increase of 25 per cent. The northern service takes in Sir Charles Gairdner Hospital, King Edward Memorial Hospital, Osborne Park Hospital, Graylands Hospital and Joondalup Health Campus, with EDs at SCGH, KEMH and JHC. Out of the 187,200 presentations at NMHS EDs, 27 per cent of those triaged category three were attended to on time — well below the 75 per cent target and the fifth consecutive year it has been below target. Across EMHS, which includes Royal Perth Hospital, St John of God Midland Public Hospital, Bentley Health Service, Armadale Health Service and Kalamunda Hospital, there were 20 SAC1 deaths — three more than 2022-23 — and a further 52 instances of serious harm. EMHS emergency departments had 217,500 people through its doors and feared even worse than NMHS departments with just 18.8 per cent of its category three patients seen within the recommended time. At SMHS, there were 38 deaths out of 119 investigations that were complete or in progress — equivalent to about one in three. Seventy-one of those incidents — more than half — resulted in serious harm across SMHS hospitals, including Fiona Stanley Hospital, Fremantle Hospital, Rockingham General Hospital, Peel Health Campus and Murray District Hospital. Its emergency departments at FSH, RGH and PHC had 221,100 presentations, recording some of the poorest response times for category three attendances at each of its hospitals. Fiona Stanley Hospital recorded the worst response rate with only 14.5 per cent of patients attended to within 30 minutes or less — falling even further below the 75 per cent target from a dismal 16.9 per cent in 2022-23. And more than half of triage two patients at FSH with “imminently life-threatening” presentations were not seen within the recommended time frame of 10 minutes or less, despite the target being set at 80 per cent or more. Peel Health Campus also failed to meet its triage two and three targets, seeing 65.6 per cent of triage two and 17.6 per cent of triage three patients on time. Rockingham General Hospital also fell below target, with 72.3 per cent of triage two and 18.4 per cent of triage three patients seen on time. Each report, tabled in parliament as part of its annual reporting, noted a number of SAC1 incidents were still under review. At NMHS, 24 reviews were still “in progress”, while 23 were outstanding at SMHS and seven at CAHS. The reports highlighted that all SAC1 clinical incidents were “subject to a rigorous clinical incident investigation”.