Northern NSW Local Health District has again released its quarterly BHI (Bureau of Health Information) report for hospitals across the region.

According to a statement released by NNSWLHD, most hospitals continue to improve emergency department performance, despite record attendances and more complex admissions to emergency departments. Lismore Base Hospital, however, continues to struggle with some key metrics. 

The latest BHI Healthcare Quarterly report (October – December 2022) shows there was a record 56,393 attendances to NNSWLHD EDs, including 6,617 by patients with an imminently life-threatening condition (triage category 2) – also the highest number of patients in this category since BHI began reporting. Lismore was static with most of the increase in cases coming from The Tweed hospital.

Acting Chief Executive for Northern NSW Local Health District, Lynne Weir, said the District’s hospitals continued to perform well amid the high activity.  

“After the challenging years of the COVID-19 pandemic, we’re beginning to see small, but important upwards trajectories in the second half of 2022 across the majority of indicators of hospital performance,” Ms Weir said.  

“This includes time to treatment, the percentage of patients leaving emergency departments within four hours, the time to transfer of care from ambulance to hospital staff, and the number of patients on the elective surgery waiting list at the end of the quarter.”  

More than seven in 10 patients (72.7 per cent) started treatment on time, which is better than the NSW state average (66.4 per cent). More than eight in 10 patients (84.9 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, also above the state average (78 per cent). The majority of patients (72.6 per cent) left the ED within four hours, above the NSW average (58.4 per cent). 

Across the region, these statistics look fine but when you look at Lismore in isolation, you can see no improvement in treatment starting on time in emergency departments and for patients spending less than 4 hours in emergency.

For treatment on time, Lismore recorded 57.8% so below the state average of 66.4% and for spending under 4 hours in ED the result was 54%, again under the state average of 58.4%.

The area that did see a large improvement was in transferring patients from paramedics to ED staff within 30 minutes. This result was up 18.2% from 64.1% to 82.3%.

“We have recently introduced a Patient Flow Unit, with the aim of further improving the transfer of patients throughout our hospitals, to make sure we’re providing patients with the right care in the right place, and also making the best use of our available resources across the District,” Ms Weir said. 

So, NNSWLHD is getting patients into hospitals faster but for Lismore, the pace at which treatment starts is not improving and is consistently at the bottom of the list of NNSWLHD hospitals.

As was pointed out by Dr Chris Ingall the Clinical Heads of Department in our December 2022 story, the wards are full which is impacting getting patients out of the emergency department (ED).

"The loss of nursing homes has caused a substantial deadlock on LBH which is one reason treatment is slower in the ED, the wards are full."

"Then there is the lack of accommodation in Lismore and the Northern Rivers. We are finding it hard to recruit nurses and doctors. We are having to use locums due to staff shortages."

"We used to put the nurses at the Bounty but where do they sleep now? A lot of accommodation was smashed and is full of tradespeople helping rebuild the city."

"Everyone is working doubly hard and there are cracks developing, and efficiencies are being lost."

"The exec team are doing everything in its power to find a solution."

This is another example of the community being patient as the flood recovery takes a lot longer than anyone would like, hospitals included.

Ms Weir mentioned elective surgeries totalled 3,535 across the region, with nearly all urgent elective surgery (97.4 per cent) performed on time. 

“Additional elective surgery lists have also been scheduled at Ballina and Casino hospitals to increase the number of procedures we’re able to provide, and we are continuing our collaborative surgical care with private hospitals in the region,” Ms Weir said.  

Any patients who feel their condition has deteriorated while waiting for their procedure are encouraged to contact their treating doctor for a clinical review.  

The 2022-23 budget for Northern NSW Local Health District is more than $985 million, an increase of more than $40 million, or 4.3 per cent more, on the previous year’s budget. In addition, the NSW Government is incentivising hard-to-fill, critical roles in hospitals and health facilities with an $883 million investment targeted at recruiting and retaining staff in regional, rural and remote areas.  

INDIVIDUAL HOSPITAL RESULTS 

BALLINA DISTRICT HOSPITAL had 4,572 ED attendances during the quarter. The majority of patients (68.6 per cent) started their treatment on time. More than seven in 10 patients (76.2 per cent) left the ED within four hours. Almost nine in 10 patients (88.5 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark.  

BYRON CENTRAL HOSPITAL had 5,893 ED attendances and almost nine in 10 patients (89.7 per cent) started their treatment on time, which is better than the average for hospitals of a similar size in NSW (77.2 percent). Nearly all patients (95.5 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, which is also better than the average for comparable hospitals in NSW (93.3 per cent).  

CASINO & DISTRICT MEMORIAL HOSPITAL had 3,680 ED attendances in the quarter. The vast majority of patients (83.9 per cent) left the ED within four hours of arriving, which is better than the average for hospitals of a similar size in NSW (79.2 per cent). More than 9 in 10 patients (93 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark.  

GRAFTON BASE HOSPITAL had a record 7,210 ED attendances during this quarter. The majority of patients (65 per cent) started treatment on time, and seven in 10 patients (70.8 per cent) left the ED within four hours, above the average for comparable hospitals in NSW (60.9 per cent). More than eight in 10 patients (87.8 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, which is also better than the average for hospitals of a similar size in NSW (85 per cent). 

LISMORE BASE HOSPITAL had 10,093 ED attendances during the quarter. More than eight in 10 patients (82.3 percent) were transferred from ambulance to ED staff within the 30-minute benchmark, which is above the average for hospitals of a similar size in NSW (76.3 per cent).

MACLEAN DISTRICT HOSPITAL had 4,134 ED attendances during the quarter, the most on record. More than eight in 10 patients (83.2 per cent) started their treatment on time, which is better than the average for hospitals of a similar size in NSW (77.2 percent). Nine in 10 patients (90.5 per cent) left the ED within four hours, which is above the average for comparable hospitals in NSW (79.2 per cent). Nearly all patients (92.1 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark.  

MURWILLUMBAH DISTRICT HOSPITAL had 4,627 ED attendances during the quarter. The majority of patients (77.5 per cent) started their treatment on time, which is better than the average for hospitals of a similar size in NSW (67.4 per cent). More than eight in 10 patients (81.4 per cent) left the ED within four hours, also better than the average for comparable hospitals in NSW (60.9 per cent). Almost all patients (92.5 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark. 

THE TWEED HOSPITAL had 14,089 ED attendances during the quarter. More than seven in 10 patients (77.5 per cent) started their treatment on time, which is above the average for hospitals of a similar size in NSW (63.2 per cent). Eight in 10 patients (80.8 percent) were transferred from ambulance to ED staff within the 30-minute benchmark, which is also better than the average for hospitals of a similar size in NSW (76.3 per cent).