Elective surgery recovery the focus as BHI report released

Hunter New England Local Health District’s (HNELHD) performance remained strong in the latest Healthcare Quarterly report out today from the Bureau of Health Information (BHI).

District Chief Executive Michael DiRienzo said the April to June quarter was at the height of COVID-19 restrictions affecting many parts of the State, including HNELHD.

“This quarter fell within the first wave of the pandemic and gives us a snapshot of how the virus impacted healthcare and how the community used our services in this time,” Mr DiRienzo said. 

“Overall, the results are as expected – a fall in emergency presentations and visits to our hospitals and a rise in people waiting for surgery as the Federal Government paused non-urgent surgery to respond to the pandemic. 

“Our focus now is on rescheduling semi-urgent and non-urgent elective surgeries that had to be postponed and ensuring those with long term, chronic conditions are getting treatment.”

Overall, emergency department attendances across the District decreased significantly by 17.3 per cent, or 18,495 less presentations, to 88,407 for the quarter.

The number of patients starting emergency care on time increased to 82.1 percent, an increase of 8.6 percentage points, in line with the fall in ED attendances across most Triage categories and a 6.2 per cent decrease in ambulance arrivals, to 1,462 for the quarter compared to the same period last year. 

There were 17,546 emergency department presentations at John Hunter Hospital during the April – June 2020 quarter, 3,938 less presentations than in 2019. The number of patients starting treatment on time increased to 86.2 per cent from 71.5 per cent in 2019, or 2,579 more patients.

The hospital also improved its Transfer of Care result, with 96.6 percent of 5,343 patients transferred from ambulances to the emergency department within 30 minutes, given the significant 9.1 per cent decrease in ambulance arrivals at the hospital this quarter.

Tamworth Hospital’s emergency department attendances fell by 21.9 per cent, or 2,340 less presentations, to 8,364 for the quarter. The number of patients starting emergency care on time increased to 78.6 per cent, an increase of 9.5 percentage points.

Hospitals across the District experienced similar large drops in presentations including Maitland Hospital with a decrease of 20.3 percent or 2,631 less patients, Manning Hospital with a decrease of 17.8 per cent or 1,456 less patients, Armidale Hospital with a decrease of 22.3 per cent or 930 less patients, Inverell Hospital with a decrease of 20.8 per cent or 488 less patients and Moree Hospital with a decrease of 23.9 percent or 613 less patients. 

Elective surgery 

The Federal Government decision to pause non-urgent surgeries has impacted the number of patients who were on the District’s waiting list and ready for their elective surgery or procedure.  

Hospitals across the District worked hard to ensure 100 percent of all 1,670 urgent elective surgeries were performed on time.

“Our focus is now on ensuring patients who had their surgery postponed have their procedure rescheduled and performed as soon as possible,” Mr DiRienzo said.

“A staged reintroduction of non-urgent surgeries will ensure equipment, supplies and treatment spaces remain available for all patients, including any COVID-19 cases,” Mr DiRienzo said.

“Patients waiting for elective surgery will retain their place on the hospital’s waitlist.”

Seclusion and restraint

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 April to June 2020 quarter. Armidale also recorded no periods of physical restraint and Morisset recorded less than five.

Manning Hospital cared for 95 patients during this quarter and recorded less than five periods of seclusion and less than five events of physical restraint.

John Hunter Hospital cared for 84 patients and recorded less than five periods of seclusion and 68 periods of physical restraint.

Maitland Hospital cared for 198 patients and implemented 19 periods of seclusion. Tamworth Hospital cared for 227 patients during the quarter, and implemented 13 seclusions.

Both Maitland and Tamworth met the benchmark of seclusion not exceeding four hours. The two hospitals were among 16 across the state that recorded more than 5.1 events per 1000 bed days.

The NSW Government is investing $800 million additional funding into the health system 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 in response to COVID-19.

The NSW Government has also committed up to $388 million in 2020-21 to fast-track elective surgeries for patients whose surgery has been delayed by COVID-19. This funding will support collaboration with private providers so public patients have faster access to surgeries and allow public hospitals to also increase surgery capacity.

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.
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