The ANMF dispute the new 45-minute Transfer of Care protocol

The Australian Nursing and Midwifery Federation Tasmanian Branch (ANMF) will today lodge a dispute with the Tasmanian Industrial Commission seeking a status quo order to prevent the implementation of the 45-minute transfer of care protocol on December 15 across the Tasmanian Health Service.

ANMF Branch Secretary Emily Shepherd said the Transfer of Care protocol was implemented in April 2024, by the then Health Minister Guy Barnett, as part of an election commitment to ban Ambulance Ramping.

“However, while our members have worked tirelessly alongside their ED colleagues to offload those patients arriving by ambulance within 60 minutes, this has effectively created a two-tiered health system,” Ms Shepherd said.

“Those who arrive by ambulance are given priority over those who arrive on foot.

“This has created corridor ramping, where patients who would have previously been cared for by paramedics on ambulance trolleys are now being parked in corridors and in ambulance air locks and around overcrowded emergency departments, all of which have not received one single additional resource to deal with this increased workload when they are already overflowing.”

Ms Shepherd said the ANMF supports ambulances being able to respond in a timely way to triple zero calls in the community.

“However, every patient who is offloaded into the ED within 60 minutes should be able to access timely and quality care in our EDs and across our hospitals.

“Yet this is not the case, with wait times blowing out in EDs and patients being parked in corridors.

“It is only a matter of time before an adverse event occurs and implementation of a 45-minute offload protocol will be catastrophic to patient safety.”

The ANMF, with the AMA, lodged a dispute in 2023 seeking a 60-minute Transfer of Care Protocol be implemented as a guideline so that ED clinicians could move patients into the ED according to clinical priority.

“While this was agreed by the Department of Health, the communication escalation procedure currently sees Ambulance Tasmania call upon senior Tasmanian Health Service management to offload those patients who have waited longer than 60 minutes to enter an ED bed, which gives rise to senior managers directing clinicians to offload the patient despite patients in the waiting room having waited longer.”

Ms Shepherd said when the Transfer of Care working group was re-established earlier this year, the ANMF wrote to Ambulance Tasmania as well as the Minister for Health seeking for access and flow strategies to be implemented into the terms of reference.

“This was to improve flow right across the health system, importantly to improve patient discharges to enable more timely admissions from ED and therefore reducing waiting times for all patients accessing the hospital.

“This request was denied and despite consultation on the 45-minute protocol not having yet been completed, the Health Minister has announced the protocol will be implemented on 15 December, this Monday.

“Not only do our hospitals not have the capacity to support a 45-minute transfer of care procedure without compromising patient safety, they also do not have the staffing, with the Launceston General Hospital ED alone being over 60 FTE of nursing staff short of their minimum safe staffing levels.”

Ms Shepherd said the ANMF maintains access and flow strategies are urgently needed to support our entire health system.
“Earlier this month, the ANMF called upon Government to take over Rosary Gardens, listed for closure in June 2026, which would see a reduction of 94 beds in residential aged care.

“Despite the Government highlighting that patients awaiting aged care in public hospitals are making flow difficult to achieve, no announcement has occurred.

“We also called for the implementation of medi-hotels which would accommodate those suitable patients outside of acute hospitals, where clinically appropriate, to improve access and flow and again no action has been taken.

“Improving access and flow across our health system is critical. While our hospitals are at breaking point, implementing a procedure to cause even further bottlenecks without concurrent strategies to address the poor flow will be catastrophic.”