The new facility, which SA Health wants up and running by October 1, would also accept pre- and post-operation patients, pre-birth mothers who require “monitoring and close observation”, and mental health patients awaiting medication or electroconvulsive therapy who are “unable to be managed at home”.

SA Health released a tender on Monday for the facility, describing it as an “end-to-end full-service sub-acute healthcare model” requiring 24/7 nursing and security, an on-call medical officer, pharmacist, admin staffing, housekeeping and food and beverage services.

It comes after ambulance ramping reached a record 5539 hours in July, with the state government partly attributing the result to problems with patient flow through the hospital system.

Ramping outside the Royal Adelaide Hospital in May. Photo: Thomas Kelsall/InDaily

On Friday, Health Minister Chris Picton said there were 273 people in Adelaide metropolitan hospitals “medically ready for discharge” that have been unable to secure aged care or community-based support.

The SA Health tender states that a “ready-made facility” is needed to “provide support to the SA public health system while additional beds are being brought online to expand the system permanently”.

The procurement also specifies that the facility must accept less urgent category four and five patients “who require medical intervention/observation and are unable to discharge home”.

“The SA public health system is currently over capacity,” the tender states.

“There are large volumes of patients who remain in hospital to receive maintenance care while awaiting an aged care placement and other services.

“This contributes to increasing delays in the transfer of care from the Ambulance to the Emergency Department each day and a large number of patients waiting to be admitted to hospital wards from the Emergency Department.”

SA Health’s preference is for the facility to be in metropolitan Adelaide and to run for at least a year, with an option to extend for a further year.

The tender also specifies that the accommodation provided “must be comfortable and private”.

“Each room should be equipped with amenities such as a bed, toilet, shower and TV,” the tender states.

“Strong infection control principles must be applied with thorough cleaning protocols.

“Between 20 and 25 beds must be available within two months.”

Department of Health and Wellbeing chief executive Dr Robyn Lawrence said these amenities would be available “at hotels and former health and aged care facilities”.

“But we also are open to considering other alternative proposals,” she said in a statement to InDaily, adding that the procurement “does not limit the type of accommodation a provider may offer”.

Health Minister Chris Picton said the Queensland Government has successfully run a sub-acute healthcare service.

That program features a 27-bed lower acuity healthcare facility run by a private healthcare provider on one floor of a Gold Coast hotel.

Picton also said the federal government has agreed to “try to do more to address” moving aged care patients out of hospital when they no longer need to be there.

“While this work is underway and we continue to build more beds, we need to consider all options to create more capacity in our hospital system,” he said.

“Establishing a new healthcare service for low-acuity patients who don’t need to be in our hospitals will help free up hospital beds for higher acuity patients, while providing appropriate health support for those lower acuity patients.

“This could occur in a range of facilities and we look forward to seeing ideas and expressions of interest from appropriate healthcare providers.”

Dr Daniel Haustead, SA faculty deputy chair of the Australasian College for Emergency Medicine, said the new facility is “essentially a stop gap solution”.

“I think this subacute step down area is essentially a band-aid solution – it will certainly help, but it’s not the primary solution,” Haustead said.

“Obviously, the primary solution is these people need access to residential care and I think this will – I don’t whether it will be a long-term help, but at least temporarily should help the situation.

“We certainly see it as potentially a positive, at least in the immediate term.”

Haustead, who is also an emergency specialist with the Central Adelaide Local Health Network, said problems with getting patients access to in-patient hospital beds were affecting ambulance ramping.

“Our main problem and the cause of ramping is that we can’t get beds within the hospital system for patients that have essentially had their emergency department treatment completed,” he said.

“And these patients, these sort of complicated, long stay patients, essentially take up beds for long periods of time within the hospital.”

Haustead stressed that the issue is “obviously not the patient’s fault” and they often have complex care needs, meaning “they wouldn’t be suitable just to put them in Tom’s Court like we did with the healthy COVID patients”.

Council on the Ageing SA chief executive Miranda Starke said the situation with patients unable to be discharged from hospital “has continued to escalate over the past year” and state and federal governments “have not been able to resolve” it.

“No one wants to be in hospital,” she said.

“We know that there have been older South Australians that have been 10 or 11 months in hospital, bouncing in and out of residential aged care, coming back to the hospital, dying in hospital.

“That is not what they would want for their life, it’s not what their family wants for them either, so it’s certainly not an intentional thing.”

Starke welcomed SA Health’s search for a lower acuity facility but cautioned that “there’s not going to be one solution to this system problem”.

“Having an interim, accommodation option for older people to be able to access supports they need in terms of rehabilitation, re-ablement, allied health… that is welcomed,” she said.

“And certainly, a state government option is going to provide a safety net that is missing right now in the system.”