South Australia has recorded its worst month for ambulance ramping on record, as an independent review of the state’s public health system warns performance has deteriorated in several key areas.
Patients spent a combined 5,891 hours ramped outside South Australian public hospitals during August, surpassing the previous record of 5,866 hours set in July 2025.
The figures were released on Thursday as a separate review by the SA Health Performance Council was tabled in State Parliament, examining the performance of South Australia’s health system between 2022 and 2026.
The independent review described ambulance ramping during the period as “chronic” and concluded that, across too many areas, the performance of South Australia’s public health system had “deteriorated”.
Ambulance transfers fall well below previous levels
One of the report’s findings highlighted the significant decline in the proportion of ambulance patients being transferred into hospital care within the expected 30-minute timeframe.
During 2024–25, fewer than half of metropolitan ambulance patients were transferred from paramedics to emergency department staff within 30 minutes of arriving at hospital.
A decade earlier, in 2014–15, more than 92 per cent of patients were transferred within that timeframe.
The Health Performance Council said it was unrealistic to expect ambulance ramping to be completely eliminated, instead recommending a more sustainable benchmark.
It suggested ramping could reasonably be considered “under control” if it returned to pre-COVID levels of fewer than 2,000 hours per month.
August’s figure is almost three times that level.
Pressure across the hospital system
The State Government says South Australia’s hospitals are dealing with substantially greater demand than they were a decade ago.
In its response to the review, the government said emergency department presentations had increased by more than 50 per cent over the past decade, including growth of almost 12 per cent between 2022 and 2025.
Health Minister Blair Boyer acknowledged August had been an extremely difficult month for ambulance transfer delays.
The government has also pointed to patients who are medically ready to leave hospital but are unable to access appropriate residential aged-care placements as a major contributor to the shortage of available hospital beds.
According to Mr Boyer, 483 hospital beds were occupied during August by patients waiting for residential aged care, compared with 60 patients in October 2022.
Mr Boyer is expected to raise the issue of aged-care capacity with the federal government when health ministers meet on Friday.
Ambulance union calls for solutions
The Ambulance Employees Association says the latest figures demonstrate that ramping remains at crisis levels.
Association general secretary Paul Ekkelboom acknowledged that aged-care shortages were contributing to pressure within hospitals but said governments still needed to find solutions to the broader problem.
The union has previously warned that prolonged ramping reduces the number of ambulance crews available to respond to emergencies across Adelaide, with crews unable to return to the road while waiting to transfer patients into hospital care.
The August result represents a dramatic increase compared with historical ramping levels. The Ambulance Employees Association said South Australia recorded just 328 ramping hours in 2017, compared with 5,891 hours last month.
Health system remains under pressure
The latest figures come despite significant investment in additional ambulance resources and hospital capacity in recent years.
The State Government says ambulance response times have improved and progress has been made in expanding capacity, improving patient flow and strengthening the health workforce.
However, the Health Performance Council review has called for broader changes across SA Health, including stronger system-wide planning, accountability and coordination between different parts of the health system.
With ramping now at its highest monthly level on record, pressure is again building on both the State and Federal governments to address hospital capacity, aged-care access and patient flow across South Australia’s health system.