Northern NSW Local Health District (NNSWLHD) emergency departments (EDs) had fewer attendances and improved their performance from April to June 2020 as the state battled the unprecedented COVID-19 pandemic.
According to the latest Bureau of Health Information quarterly report there was a 21.1 per cent decrease in ED attendances across the District, a trend that was reflected across the state.
There were 41,673 total emergency presentations compared with 52,794 in the same period last year, a reduction of more than 11,000 people.
The largest reductions were in the semi-urgent (T4) and non-urgent (T5) categories, which were down by 25.2 per cent and 25.7 per cent respectively.
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 per cent of patients starting treatment on time, a 6.6 percentage point increase on the same quarter in 2019. 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.
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 per cent, while urgent and semi-urgent surgeries decreased by 17 per cent and 16.3 per cent 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.
“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.
INDIVIDUAL HOSPITALS
Ballina District Hospital ED had 3,670 emergency presentations, down 19.8 per cent on the same quarter last year. The percentage of patients who started their treatment on time improved by 10 percentage points to 82.8 per cent and the median time to leave the ED improved by 16 minutes to one hour and 40 minutes.
Byron Central Hospital ED had a 24.6 per cent decrease in emergency presentations, with a total of 3,935, while 86 per cent of patients started their treatment on time.
Casino and District Memorial Hospital ED had a 25.3 per cent drop in emergency presentations, with 2,550 in total. Of these, 78.1 per cent of patients started their treatment on time, a 9.4 percentage point increase.
Grafton Base Hospital ED had 5,185 emergency presentations, a 22.6 per cent drop compared with the same period last year. The median time to treatment improved across all triage categories and 80.2 per cent of patients started their treatment on time, a 3.2 percentage point increase.
Lismore Base Hospital ED had 8,547 presentations to emergency during the quarter, a 12.8 per cent decrease on the same quarter in 2019. Arrivals by ambulance remained stable at 2,313, down just 0.6 per cent.
The median time to treatment improved across all triage categories, and 82.2 per cent of patients started treatment on time – a 13.3 percentage point increase.
Maclean District Hospital ED had a 28.3 per cent drop in emergency presentations, with a total of 2,375. The median time to treatment improved across all triage categories, and 77.2 per cent of patients started treatment on time.
Murwillumbah District Hospital had a 22.4 per cent decrease in emergency presentations, with 3,380 people attending the ED. Of these, 93.2 per cent started treatment on time, an 8.9 percentage point improvement.
The Tweed Hospital had 10,157 ED attendances in the April to June quarter, a 22.4 per cent decrease, or 2,924 fewer people.
Of these, 88.8 per cent started their treatment on time, an 8.6 percentage point increase.
MENTAL HEALTH
Northern NSW LHD is committed to reducing and where possible, eliminating seclusion and restraint, and providing the best possible mental health care in the least restrictive environment.
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.