Fewer people attended Lismore Base Hospital’s Emergency Department (ED) throughout the Covid-19 pandemic from April to June, according to a new Bureau of Health Information quarterly report. 

With 8,547 presentations to ED, it was a 12.8% decrease compared to the same quarter in 2019. However, arrivals by ambulance remained stable at 2,313, down 0.6%.

At the same time, the hospital’s performance improved, with 82.2% of patients starting treatment on time. The median time to leave the ED remained stable at two hours and one minute, lower than the state average of two hours and 27 minutes.  

The decrease in hospital ED attendances was reflected across the Northern NSW Local Health District (NNSWLHD) – as well as across the whole State. The largest reductions were in the semi-urgent (T4) and non-urgent (T5) categories, which were down by 25.2% and 25.7% respectively. 

Covid restrictions

NNSWLHD Chief Executive Wayne Jones said the drop in presentations coincided with increased restrictions on community gatherings and activities, as well as people practising social distancing and better hand hygiene in response to the pandemic.  

“Over the past six months we have had to significantly change our behaviour, and there’s no doubt that has impacted on the numbers of people we’re seeing through our hospitals,” Mr Jones said.  

“The restrictions meant Northern NSW residents were moving less frequently around the community, socialising less, and not participating in regular activities like competitive sport.  

“We also know there has been a significant reduction in flu-like illness this year, with people adopting the public health advice around good respiratory and hand hygiene.”  

Emergency department performance improved, with 84.3% of patients starting treatment on time, a 6.6 percentage point increase on the same quarter in 2019. 

Elective surgery performance

Due to COVID-19, there were major changes to elective surgery following the Federal Government’s direction to cease non-urgent elective surgery on 25 March and to recommence incrementally from 27 April.

Despite the major disruptions, the LHD performed 2,215 surgeries. Non-urgent surgeries were down 73.3%, while urgent and semi-urgent surgeries decreased by 17% and 16.3% respectively.  

“Our surgical teams worked extremely hard, both in actioning the initial reduction in surgery, and then gradually recommencing the delivery of non-urgent surgery in a COVID-safe environment,” Mr Jones said. 

Changing situation

“They have done incredibly well to respond to the changing situation, adapting quickly to ensure our community can continue to receive the care they need.” 

The NSW Government has announced up to an extra $388 million will be invested to fast-track elective surgeries which were delayed as a result of the Federal Government’s decision, ensuring patients will be booked in to public or private hospitals as soon as possible. 

The NSW Government has committed $800 million extra funding over two years on top of the 2019-20 Health Budget of $26.7 billion to help boost ICU capacity and purchase additional services and medical equipment, to help respond to COVID-19. 

The 2019- 20 budget for Northern NSW Local Health District was $875 million, this is an increase of $37 million on the previous financial year’s annualised budget. 

Mental health

During the April to June quarter, there were 443 acute mental health episodes of care across the specialised mental health units, with 224 at Lismore and 219 at Tweed. 

The rate of seclusion at Lismore was 10 per 1,000 bed days and at Tweed it was 5 per 1,000 bed days. The NSW average rate is 7.3 per 1,000 bed days. 

The rate of physical restraint at Lismore was 4.3 per 1,000 bed days and at Tweed it was 8.6. The NSW average rate is 9.6 per 1,000 bed days. 

Mr Jones said NNSWLHD is committed to reducing and where possible, eliminating seclusion and restraint, and providing the best possible mental health care in the least restrictive environment.