Clinical & consumer health, Market intelligence & industry trends

Ambulance ramping in Australia: what is driving it and what is helping in 2026

Julia Lewis

Published: 16 Feb 2026

read time 4 min

Key takeaways

Ambulance ramping is now a structural feature of Australia’s health system, not a seasonal surge issue.
Persistent ramping creates material operational, workforce and reputational risk for hospitals and health services.
Exit block, delayed discharge, workforce shortages and infrastructure constraints remain the primary pressure points.
Funding increases alone have not resolved ramping because patient flow constraints persist.
Rapidly deployable clinical infrastructure is emerging as one practical way health services are relieving pressure now.

A national problem, not a surge event

Ambulance ramping is no longer confined to winter peaks or isolated jurisdictions. It has become a persistent feature of Australia’s health system, affecting metropolitan, suburban and regional hospitals alike.

The Australian Medical Association (AMA)’s Ambulance Ramping Report Card shows ramping levels in many jurisdictions remain significantly worse than they were five years ago. While reporting varies across states and territories, the overall trajectory is unmistakable.

Peter Spryszynski, Country Manager at Q-bital Healthcare Solutions, works across multiple hospital systems and jurisdictions. From that system-wide vantage point, he says ramping is now embedded across the country, with “every state continuing to battle with ambulance ramping to a degree beyond what would ordinarily be deemed acceptable”.

“Queensland reports percentages of ambulances who waited with patients beyond 30-minute yardstick to be transferred from a stretcher to the emergency department. In December 2025, 4 in 10 patients waited too long. In July it was almost 1 in every two patients.”

Spryszynski observes that comparable pressures are evident elsewhere: “Western Australia in December reported that 4,518 hours were spent on ramps. And last year that peaked at over 7000 hours a month in August. In South Australia, ambulances ramped for 52,449 hours in 2025 (that is 6 years waiting on ramps!), all but doubling the measure from 2022.”

Differing definitions, same problem

Ambulance ramping can appear inconsistent across jurisdictions because, as Spryszynski puts it, “the definitions used in different states vary”, which makes national comparisons difficult.

In most jurisdictions, ramping is measured as transfer of care time, tracking how long it takes from an ambulance arriving at hospital to clinical handover being completed and paramedics being released.

Some states apply a 30-minute benchmark, while others report total transfer times or cumulative hours spent waiting. Queensland uses a different approach again, reporting patient off stretcher time, which measures how long it takes for a patient to be moved from the ambulance stretcher into an emergency department bed.

Despite the different terminology and measurement points, Spryszynski says all definitions are capturing the same underlying constraint: emergency departments operating at or beyond capacity, with ambulances forced to wait because there is nowhere for patients to go.

Why ramping has become a systemic risk

For healthcare leaders, sustained ramping is no longer just a performance metric. It is a material operational risk that affects workforce sustainability, patient safety, emergency department capacity and public confidence in the health system.

The AMA has consistently identified exit block as a primary driver, where patients who are medically ready for discharge are unable to leave hospital due to limited access to aged care, disability accommodation or community-based supports.

Spryszynski says this failure at the back end of the system is now routine, with “recovered and well patients who are ready for discharge being held in ward beds because there are no available aged care places or NDIS-supported accommodation”.

As Spryszynski explains, that blockage creates a cascading effect through the system.

“That, in turn means patients who have been seen in the ED but who need to be admitted to hospital, have to wait in their triage bays until a bed becomes available. Those triage beds are then held up and patients turning up in ambulances need to wait for them to be freed up.”

Spryszynski also points to rising emergency department demand driven by access barriers elsewhere in the system. He notes that the “rising cost of GP visits and falling bulk billing rates means more people who need medical attention will present to the emergency department.”

“Many will opt to call an ambulance for a chest infection or a cut requiring stitches.”

These pressures are compounded by workforce shortages and infrastructure that has not kept pace with population growth or demographic change. As he puts it, there has been “insufficient investment in hospital infrastructure and labour force to match an ageing and growing population.”

Why funding alone has not fixed it

While governments have announced funding injections, the AMA has repeatedly warned that additional funding does not automatically translate into improved patient flow without structural reform and system redesign.

Spryszynski says the absence of longer term strategies, such as effective surge planning, remains a critical vulnerability.

Flu season, he notes, occurs annually, yet “it still seems to come as a surprise to many health bureaucrats that this occurs.”

What is helping now: flexible infrastructure and flow solutions

Against this backdrop, health services are increasingly looking for solutions that can be deployed quickly and work within existing constraints.

Spryszynski says flexible,rapidly deployable infrastructure can relieve pressure at multiple points in the hospital journey.

“On the ambulance ramp, small, rapidly deployable 8-bay ward facilities have been used to offload low acuity presentation patients from ambulances into this holding space.”

This reduces the burden on the emergency department, enabling effective patient care until a space is found.

At the other end of the system, Spryszynski says similar rapidly deployable facilities are increasingly being used to unblock wards: “We’re seeing more and more interest and utilisation of the same facilities but to house those patients who were taking up ward beds while they were ready to be discharged.”

Short-term fix or long-term strategy?

AMA President Dr Danielle McMullen has warned that ambulance ramping will persist unless system capacity and flow are addressed alongside funding.

“While the federal government recently locked in some welcome additional funding for public hospitals, whoever wins government must expedite a new National Health Reform Agreement.”

She cautions that without structural reform, funding alone will not relieve pressure: “The reality is that the cost of healthcare has gone up and most of the new funding will be eaten up before it is able to fund extra services.”

The leadership takeaway

Ambulance ramping is no longer an occasional surge issue. It has become a routine operating condition across Australia’s health system.

Those who plan for ramping as a structural constraint, and invest in practical flow solutions alongside workforce and discharge reform, are better placed to protect capacity, support staff and strengthen system resilience.

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