Vital performance maintained during unprecedented times in health

Despite a global pandemic and devastating bushfires, Hunter New England Local Health District performed very well during the January to March quarter, according to the latest Bureau of Health Information (BHI) quarterly report.

Mr Michael DiRienzo, Chief Executive, Hunter New England Local Health District, said despite the significant disruptions to day-to-day services, our dedicated staff have worked hard to ensure patients have continued to receive high-quality care.

“This quarter was bookended by some of the worst bushfires in NSW’s history and the elective surgery postponements enforced to help the nation respond to the COVID-19 pandemic,” Mr DiRienzo said.

“I’m proud of all our staff who have gone above and beyond to keep patient care running at such a high standard during these unprecedented times in health.”

Overall, emergency department attendances across the District increased slightly by 0.6 per cent, or 680 more presentations, to 107,552 for the quarter.

The number of patients starting emergency care on time remained steady at 74.3 percent, a decrease of just 0.1 percent, despite an increase in ED attendances for resuscitation (triage category 1) of 16.7 per cent and a 3.8 per cent increase in ambulance arrivals.

The percentage of 21,425 emergency department patients treated on time at John Hunter Hospital improved, from 71.6 percent in 2019 to 77.9 percent in 2020, or 199 more patients.

The hospital also improved its Transfer of Care result, with 90.4 percent of 5,893 patients transferred from ambulances to the emergency department within 30 minutes, despite a 3 per cent increase in ambulance arrivals at the hospital.

Hospitals across the entire District also worked hard to ensure 98.5 percent of all 6,708 surgeries were performed on time, a drop of just 0.1 percent compared to the same period in 2019.

“Of the District’s 15 hospitals captured in the report, eight ranked perfectly for performing elective surgeries on time, which is fantastic to see,” Mr DiRienzo said.

The best performing hospitals include Singleton, Cessnock, Calvary Mater Newcastle, Gunnedah, Inverell, Moree, Muswellbrook and Narrabri hospitals, where 100 per cent of elective surgeries were performed on time. This performance across all categories exceeds the state average and waiting times for all elective surgeries are well within the recommended timeframes.

John Hunter Hospital reduced the number of patients waiting for surgery by 5.5 per cent compared to the same time last year. The good result was achieved despite a 4.9 percent reduction in non-urgent surgeries and 10.4 percent drop in semi-urgent surgeries performed at the hospital this quarter.

The hospital also improved the number of surgeries performed on time, with 97.7 percent of 2,085 surgeries performed on time compared to 96.7 percent during the same period in 2019. Importantly, 100 percent of 646 urgent surgeries were performed on time, with a median waiting time of eight days.

“I’m pleased we were able to maintain strong results for our patients,” Mr DiRienzo said. “Our focus is now on ensuring patients who had their surgery postponed during the first wave of the COVID-19 response have their procedure rescheduled and performed as soon as possible.”

All District hospitals are gradually reintroducing elective surgery with the staged reintroduction of some category two and category three elective surgery procedures.

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 National Cabinet decision, ensuring they will be booked in to public or private hospitals as soon as possible.

NSW Health will host a roundtable with public and private health sectors and clinicians within the next month to determine if there are any additional measures the health system could employ to ensure elective surgeries and any other procedures occur as quickly and appropriately as possible.

Surgery lists are being closely monitored, and any patient whose condition changes or deteriorates should speak to their treating clinician. Clinicians determine the surgical priority of their patients.

“A staged reintroduction will allow our hospitals to balance the needs of our patients, and the safety of our staff and the greater community, and ensures adequate equipment, supplies and treatment spaces remain available for all patients, including those requiring COVID-19 treatment if required,” Mr DiRienzo said. “Patients waiting for elective surgery will retain their place on the hospital’s waitlist.”

Many of the District’s rural hospitals and health services also had a particularly busy quarter, with an influx of patients attending their local health service for COVID-19 testing and advice.

“Our rural and regional hospitals have played a key role in testing and tracking COVID-19 cases,” Mr DiRienzo said. “They have shouldered a large workload in the past few months, and many have set up screening clinics to assist in our response.”

In Moree, emergency department presentations increased by 27. 2 percent compared to the same period in 2019, seeing an additional 243 (162 per cent) Triage 5 non-urgent patients and 291 (32 percent) semi-urgent patients.

A number of other rural service also experienced significant increases in emergency department presentations, including Gunnedah (370 more to 2,459, 17.7 per cent), Inverell (198 more to 2,408, 9 per cent), Muswellbrook (198 more to 2,408, 7.2 per cent) and Tamworth (516 more to 11,106, 4.9 per cent).

“These service are to be congratulated,” Mr DiRienzo said. “They have worked very hard to provide vital assistance to their communities during the first wave of the pandemic.”

Mr DiRienzo said the addition of Patient Experience Officers, funded by a $8.6 million boost to the NSW Government Patient Experience Program, will help to further support clinical staff at John Hunter, Manning, Moree, Cessnock, Maitland, Calvary Mater, Tamworth, Armidale, and Belmont hospitals.

“These new staff will aim to create a positive, compassionate influence in our hospitals, by welcoming patients and their families into our hospitals, ensuring they receive the information they need from the minute they arrive in our care,” Mr DiRienzo said.

District hospitals with acute mental health units also tracked well against performance indicators for mental health seclusion and restraint. Seclusion and restraint are only used as a last measure to maintain the safety of the patient, other patients, staff and visitors.

Armidale and Morisset hospitals implemented no periods of seclusion or restraint in the January to March 2020 quarter, while Manning and John Hunter hospitals recorded less than five periods of seclusion each, and the number of patients restrained at both hospitals was not reported due to the small number.

Maitland Hospital cared for 195 patients and implemented 18 periods of seclusion, averaging 2 hours and 46 minutes. Tamworth Hospital cared for 244 patients during the quarter, and implemented 14 seclusions, averaging 2 hours and 45 minutes each.

Both Maitland and Tamworth met the benchmark of seclusion to not exceed four hours. The average duration of seclusion at Maitland and Tamworth was also below the state average of six hours and 21 minutes.

The 2019-20 budget for HNELHD is $2.4 billion, this is an increase of $72 million on the previous financial year’s annualised budget.

HNELHD will also benefit from the NSW Government’s $2.8 billion commitment to recruit a record 8,300 frontline health staff over the next term, including 5,000 additional nurses and midwives.

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.

 
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