Health care down the drain

To the Editor: Sydney’s St Vincent’s Hospital, like many other hospitals, experiences a high occupancy rate which sometimes exceeds 100%, because of continual presentations to the emergency department (ED). NSW Health has recently encouraged new models of community acute/post-acute care (CAPAC) which allow patients to be managed in their homes, thus easing ED overcrowding and avoiding unnecessary presentations.1 However, those presenting most frequently to the ED at St Vincent’s Hospital are homeless. In response, this hospital has sent an outreach team consisting of a medical registrar and a community nurse to the streets of Sydney to deliver a “Backpack” CAPAC service (Figure).