Annual report reveals troubling state of child and youth health system

There has been a growth on the number of Severity Assessment Code Incidents at Perth Children’s Hospital highlighting a health system under extraordinary pressure.
The latest Child and Adolescent Health Service Annual Report has highlighted there were 26 confirmed SAC1 incidents^ last financial year, an increase on the year before (25 incidents) and 16 incidents in 2018-19.
“It’s shocking to see the 61% increase in these incidents over the last two years, which clearly illustrates a health system and health workers under extraordinary pressure,” Ms Mettam said.
“Unfortunately, this significant increase is reflected in poor patient outcomes, with the number of incidents resulting in death in a near doubling from 3 to 5 under the McGowan Labor Governments watch over the two-year period.
“Lives should be saved in our hospitals but instead consistent under resourcing is leading to poor patient outcomes and in extreme cases even death.
“The significant issues of understaffing are highlighted in the tragic death of Aishwarya Ashwath who had to wait 2 hours in the Emergency department at Perth Children’s Hospital in April and is regrettably one of these 6 deaths that should never have occurred.
The annual report also provides new figures which reveal that almost a quarter of children and youths with mental health issues were readmitted to specialised mental health hospital services within 28 days of being discharged in 2020-21.
The figure (23.3%) is almost double the 12 per cent target outlined in the Child and Adolescent Health Service annual report released yesterday.
Shadow Health Minister Libby Mettam said while the number had dropped slightly from last year due to Telehealth consults, it was particularly concerning given the spike in the number of children presenting at EDs with mental health issues.
“Figures uncovered during Budget Estimates show that between 2017 and 2020 there was a 25 per cent increase in children who attended an emergency department for a mental health reason*,” Ms Mettam said.
“During that time, there was also a 31 per cent increase in the number of children who were admitted and a 36 per cent increase in the number of children referred to mental health treatment.
“To now see that almost a quarter of those children and youths who were treated at a hospital readmitted within a month is disconcerting.
“We know that the extent of some mental health conditions, such as eating disorders, are at record highs and there simply aren’t enough dedicated beds at Perth Children’s Hospital to deal with the increased mental health presentations.
“There is an urgent need for investment in this area now, not years down the track.”
Ms Mettam said the annual report also highlighted serious downfalls in triage response times and elective surgery wait times for children presenting at EDs.
While category 1 and 2 triage response times have been on target, category 3 and 4 have fallen well short with less than half (46%) of category 3 patients seen within the target time frame.
Only 53% of category 4 triage patients were seen in the recommended time frame.
“It’s one thing for adults to wait for long periods of time to be seen but when you have sick children waiting sometimes for hours to receive care, it is distressing for both them and their parents,” Ms Mettam said.
“We know the outcomes for extended waiting times can be tragic, we can do better and must do better.”
Elective surgery wait list times were also well behind with 29% of category 2 surgeries over boundary and 21% of category 3 over boundary, without any COVID in the community.
“There really is no excuse for the long delays in elective surgery wait times other than the government’s own incompetence after years of underfunding the system.”
^ A SAC 1 event is defined as a “clinical incident that has or could have caused serious harm or death; and which is attributed to health care provision (or lack thereof) rather than a patients underlying condition or illness.”
Examples of clinical incidents in the report included failing to use the patient sticker or proper identification, leading to surgery being performed on the wrong patient, patients being sewn up with foreign objects inside following an operation and patients being given the wrong medication.
Healthcare associated infections are identified as the category of SAC 1 incidents, causing unnecessary pain for patients and prolonging patient stay.