The latest Bureau of Health Information report released yesterday shows the impact of the peak in Omicron COVID-19 cases on hospitals in Northern NSW and the significant impact the February 28 flood had on Lismore Base Hospital staff and the services provided.

The summary from Northern NSW Local Health District (NNSWLHD) shows patients continued to receive high-quality care during the peak of the Omicron outbreak from January to March 2022 despite it being one of the most challenging quarters, thanks to the incredible efforts of the health staff.

However, research the details of the Bureau of Health reports and you can clearly see Lismore Base Hospital (LBH) has issues caused by the global pandemic and the state's largest natural disaster with key indicators below the average for the North Coast and NSW as you will read below.

LBH emergency department case numbers are the highest in the NNSWLHD with Tweed Hospital, while the response times are one of the lowest compared to the eight other hospitals in the Local Health District (LHD), including Lismore, Tweed, Murwillumbah, Ballina, Grafton, Casino, Byron and Maclean.

The question is why is LBH underperforming? What are the real issues affecting LBH that are leading to declining statistics? We will get to the answers but first the statistics.

The January to March 2022 quarter was very challenging for NNSWLHD, as it responded to high numbers of COVID-19 cases in the community together with staff furloughing, changed border restrictions and testing requirements.

During this quarter, the region also experienced its worst-ever flood emergency, which resulted in the loss of lives, significant damage to property, and access to health services being disrupted for staff and patients.

Across the District, there were 51,843 emergency department attendances during the January to March 2022 quarter. At Lismore Base Hospital this number was 9,500 attendances which was down 1079 from 2021 (10,579).

Nevertheless, more than seven in 10 patients (74.1 per cent) started treatment on time during the quarter, above the NSW state average of 70.5 per cent, while Lismore Base Hospital recorded 64%.

The majority of patients (78.6 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, in line with the state average (also 78.6 per cent) while Lismore Base Hospital again recorded 64%.

More than seven in 10 patients (73 per cent) left the ED within four hours. This is higher than the NSW average (62.3 per cent) with Lismore Base Hospital lower, recording 56%.

NNSWLHD Chief Executive Wayne Jones said the quarter had been particularly challenging for staff right across the District.

“The high COVID-19 case numbers in the community over New Year and into January resulted in complex presentations and admissions to our hospitals, and significant numbers of staff were unavailable due to being exposed to or contracting the virus, whether in the community or at work,” Mr Jones said.

“Our staff did an incredible job of adapting to the fast-changing and complex environment of managing COVID cases, providing testing facilities for our community, and continuing to provide excellent health care during one of the most challenging periods of the pandemic.

“Without the expertise and dedication of our colleagues, we could not have responded so well as a District, and I want to thank each and every staff member for their efforts.

“With the devastating floods in February and March, our region experienced significant disruption, and staff worked exceptionally hard to continue to deliver health services throughout this difficult period. They have gone above and beyond in their roles, and I cannot praise them highly enough.”

Dr Chris Ingall is the Clinical Heads of Department for LBH. Dr Ingall explained the reasons why LBH was underperforming.

"The primary issue is bed block," Dr Ingal told the Lismore App, "This is where we cannot move someone from ED (emergency department) into a ward because of the lack of available beds."

"The February 28 floods have caused many people to be homeless or living in conditions that are not healthy options to return to. As an example, if someone presents with pneumonia and they come from a house that is draughty with no walls, we need to keep them in hospital for longer to ensure they are close to full health rather than put them back into an environment that could very well bring them back in a matter of days."

Dr Ingall mentioned that LBH has the highest acuity for a B2 hospital in the state so for a large hospital we have more very sick people than most. He also added that a more robust discharge system following operations would free up more beds.

"Allied Health could provide a dedicated discharge planner that looks after wound care."

LBH has been renovating wards in the old part of the hospital, recently a 30-bed ward was reopened with another to be reopened in the future. More beds and a newly upgraded geriatric evaluation and management (GEM) care unit needs more nurse funding. The State Government has just announced an extra 10,148 new jobs for hospitals and health services across NSW so staffing is not the issue, housing, however, is a big problem.

"We can attract needed nursing staff to Lismore, like ICU nurses, but they have nowhere to live, " Dr Ingall said, "As we know there is a housing shortage in Lismore and the Northern Rivers so some new staff are having to live in Pottsville or Kingscliff then have a long commute each day."

As we know, housing is an issue that will not be solved in the short term.

In summary, while the statistics indicate a poor performance by LBH administrators and staff, that is not the case. Dr Ingall said there could be more efficiencies within the system like improving the role Allied Health plays to help with the solution but the real problem is bed block caused by the housing crisis.

Freeing up hospital beds means a clearer ED leading to an improvement in statistics when they are released each quarter.

 INDIVIDUAL HOSPITAL RESULTS

BALLINA DISTRICT HOSPITAL had 4,593 ED attendances during the quarter. The majority of patients (67.9 per cent) started their treatment on time. More than seven in 10 patients (76.2 per cent) left the ED within four hours. Further, eight in 10 patients (80 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark.

BYRON CENTRAL HOSPITAL had 5,598 ED attendances, and 87.4 per cent of patients started their treatment on time, above the average for hospitals of a similar size in NSW (80.2 percent). More than eight in 10 patients (81.7 per cent) left the ED within four hours, in line with comparable hospitals in NSW (81 per cent). Nearly all patients (92.7 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, also in line with the average for hospitals of a similar size (92 per cent).

CASINO & DISTRICT MEMORIAL HOSPITAL had 3,400 ED attendances in the quarter. The vast majority of patients (82.9 per cent) left the ED within four hours, slightly above the average for hospitals of a similar size in NSW (81 percent).

GRAFTON BASE HOSPITAL had 6,041 ED attendances during this quarter. The majority of patients (70.1 per cent) started their treatment on time, in line with the average for hospitals of a similar size in NSW (70.3 per cent). More than eight in 10 patients (86.9 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, which is higher than the average for comparable hospitals in NSW (85 per cent).

LISMORE BASE HOSPITAL had 9,500 ED attendances during the quarter. The majority of patients (64.2 per cent) started treatment on time, slightly below the peer group average of 69.2 per cent.

MACLEAN DISTRICT HOSPITAL had 3,556 ED attendances during the quarter. More than eight in 10 patients (86.3 per cent) started their treatment on time, above the average for hospitals of a similar size in NSW (80.2 percent). Nearly all patients (91.4 per cent) left the ED within four hours, which is well above the average for comparable hospitals in NSW (81 per cent).

MURWILLUMBAH DISTRICT HOSPITAL had 4,288 ED attendances during the quarter. The vast majority of patients (85.9 per cent) started their treatment on time, which is above the average for hospitals of a similar size in NSW (70.3 per cent). More than eight in 10 patients (84.8 per cent) left the ED within four hours, also higher than the average for comparable hospitals in NSW (65.8 per cent).

THE TWEED HOSPITAL had 12,647 ED attendances during the quarter. The majority of patients (73.9 per cent) started their treatment on time, above the average for hospitals of a similar size in NSW (69.2 per cent).