This embattled hospital in the city's inner west outshone major hospitals for ED wait times, elective surgery received on time and the rate of hospital-acquired golden staph infections.
Concord Repatriation hospital outperformed all other major Sydney hospitals across the board for AIHW hospital performance metrics, an exclusive Health Services Daily investigation has found.
The result will be welcome news for the hospital, which has seen staff and Sydney LHD executives at loggerheads for years over reports of unmanageable work conditions and widespread fear of being silenced or punished for speaking out.
Some staff have claimed the controversies have left them at breaking point.
HSD compared data collected across eight major Sydney hospitals from 1 July 2022 to 30 June 2023 and found Concord hospital consistently ranked among the top performing hospitals.
This included scoring the highest for emergency department flow with 60% of patients departing ED within four hours, compared to an average of 48% across other major hospitals, and the lowest median wait time at three hours and 41 minutes.
90% of patients departed ED within 10 hours at Concord between 2022 and 2023, compared to an average of 11 hours and 50 minutes at other major hospitals, despite the hospital seeing an increase of 2516 presentations over the same period, from 40,529 in 2021-22 to 43,045 in 2022-23.
Prince of Wales Hospital scored the second highest spot for ED performance, with 54% of patients departing within four hours and 90% departing within nine hours and 37 minutes in 2022-23. This was followed by Royal Prince Alfred, St George and Royal North Shore hospitals where 53%, 52% and 50% of patients respectively left ED within four hours in 2022-23.
Concord hospital was also ranked second-best for elective surgery performance with 100% of urgent surgeries and 82% of semi-urgent and non-urgent surgeries performed on time in 2022-23, compared to 89% of urgent surgeries, 61% of semi-urgent and 65% of non-urgent surgeries received on time across all major hospitals during that same period.
The only hospital to surpass Concord was Royal Prince Alfred hospital where 100% of urgent surgeries, 98% of semi-urgent and 98% of non-urgent surgeries were performed on time in 2022-23. Liverpool hospital ranked third with 100% of urgent patients, 62% of semi-urgent and 69% of non-urgent patients receiving surgery on time in that same period.
Regarding rates of healthcare-associated Staphylococcus aureus bloodstream infections (SASBI), Concord hospital had the second lowest rate of infections with 0.54 cases per 10,000 days recorded in 2022-23, compared to an average of 0.91 cases among other major hospitals, with the number of cases reported dropping by 3 cases from 16 cases in 2021-22.
St Vincent’s hospital had the lowest SASBI rate of all major hospitals with 0.32 infections recorded per 10,000 patient days in 2022-23, a total of 11 cases, with Prince of Wales hospital coming third at 0.58 infections per 10,000 patient days despite also reporting a total of 11 cases between 2022 and 2023.
Concord’s stellar outcomes across the AIHW hospital performance metrics will be welcome news given the controversy surrounding working conditions at the hospital in recent years. There have been claims of staff suffering under unmanageable workloads and feeling pressured not to report their concerns.
The matter hit the headlines with the leaking of a letter circulated by ICU senior staff specialist Associate Clinical Professor Winston Cheung during his bid for election as Concord’s medical staff council chair in May 2022.
Tensions came to a head in mid-2023 following reports the hospital was experiencing a backlog of around 30,000 radiology scans and a workplace survey revealing more than 60% of clinicians surveyed feared for their health and safety due to their working conditions. NSW Health Minister Ryan Park forced to intervene after hospital staff held a vote of no confidence against Sydney LHD CEO Dr Teresa Anderson in July 2023.
In May this year, as reported by HSD, NSW Health secretary Susan Pearce announced Dr Anderson was leaving the Sydney LHD to lead the newly formed SDPR Implementation Authority.
This week the Concord controversy was front and centre once again when Dr Anderson appeared at the NSW Special Commission of Inquiry into healthcare funding.
She was adamant in her defence of the district’s investment in Concord hospital, the quality of services and support for staff to speak out regarding concerns during her time as head of the Sydney LHD.
Dr Anderson argued Professor Cheung’s claims regarding a culture of silencing and excessive workloads affecting staff morale and service delivery at Concord were too “black and white” and lacked necessary context, insisting the hospital and district’s senior executive teams were highly responsive to any problems that were raised by staff and no coverup or silencing took place.
Hospital performance data for all major Sydney hospitals is available below:
Royal North Shore Hospital, Northern Sydney LHD
- 84,843 patients presented to ED in 2022-23, up from 78,564 in 2021-22
- 50% of patients left ED within four hours in 22-23
- 99% of urgent patients, 64% of semi-urgent patients and 65% of non-urgent patients received surgery within clinically recommended time
- Median wait time of 14 days for urgent procedures, 71 days for semi-urgent and 289 days for non-urgent procedures
- 22 cases of healthcare-acquired SASBI in 22-23, down from 26 in 21-22
Royal Prince Alfred Hospital – Sydney LHD
- 84,461 patients presented to ED in 22-23, up from 78,821 in 21-22
- 53% of patients left ED in 4 hours in 22-23
- 100% of urgent patients, 98% of semi-urgent and 98% of non-urgent patients received surgery within recommended time in 22-23, compared to 89%, 61% and 65% “peer value”
- Median wait time for surgery was 5 days for urgent patients, 18 days for semi-urgent and 34 days for non-urgent, compared to 14 days, 71 days and 280 days “peer value”
- 46 cases of healthcare-acquired SASBI in 22-23, up from 31 in 21-22
Concord Repatriation Hospital – Sydney LHD
- 43,045 patients presenting to ED in 2022-23, up from 40,529 in 21-22
- Median wait time for 22-23 was 3 hrs 41 mins – same in 21-22
- 60% of patients left ED within four hours in 22-23
- 100% of urgent patients, 82% of semi-urgent and 82% non-urgent patients received surgery within clinically recommended time in 22-23
- Median wait time for surgery was 6 days, semi-urgent was 45 days and non-urgent was 144 days
- 13 cases of healthcare-acquired SASBI in 22-23, down from 16 in 21-22
Prince of Wales Hospital – South Eastern Sydney LHD
- 60, 331 patients presenting to ED in 2022-23, up from 57,704 in 21-22
- Median wait time for 22-23 was 3 hrs 45 mins and 21-22 was 3 hrs 26 mins
- 54% of patients left ED in 4 hours in 22-23
- 99% of urgent patients, 67% of semi-urgent and 42% of non-urgent patients were seen within clinically recommended time for elective surgery
- 11 cases of healthcare-acquired SASBI in 22-23, down from 12 in 21-22
St George Hospital – South Eastern Sydney LHD
- 81,994 patients presenting to ED in 22-23, up from 79,024 in 21-22
- Median time patients departed ED was 3 hrs 54 mins in 22-23, up from 3 hrs 27 mins in 21-22
- 52% of patients departed ED within 4 hours in 22-23
- 100% of urgent patients, 60% of semi-urgent and 50% of non-urgent patients received surgery within clinically recommended time
- 13 cases of healthcare-acquired SASBI in 22-23, down from 21 in 21-22
Liverpool Hospital – South Western Sydney LHD
- 86,591 patients presenting to ED in 22-23, up from 84,650 in 21-22
- Median time patients departed ED was 5 hrs 7 mins, up from 4 hrs 30 mins in 21-22
- 38% of patients left ED within four hours
- 100% of urgent patients, 62% of semi-urgent and 69% of non-urgent patients received surgeries within clinically recommended time in 22-23
- 32 cases of healthcare associated SASBI infection in 22-23, same as 21-22
Westmead Hospital – Western Sydney LHD
- 75,516 patients presenting to ED in 22-23, up from 71,454 in 21-22
- Median time patients departed ED was 5 hrs 28 mins, up from 4 hrs 55 mins in 21-22
- 38% of patients left ED within 4 hours in 22-23
- 100% of urgent surgeries, 68% of semi-urgent and 65% of non-urgent surgeries performed in clinically recommended times in 22-23
- 42 cases of healthcare associated SASBI infection in 22-23, down from 56 in 21-22
St Vincent’s Hospital (Darlinghurst) – St Vincent’s Health Network
- 50,990 patients presented to ED in 22-23, up from 46,663 in 21-22
- Median time patients departed ED was 4 hrs, up from 3 hrs 44 mins in 21-22
- 50% of patients left ED in 4 hours in 22-23
- 100% of urgent patients, 66% of semi-urgent and 53% of non-urgent patients were seen within recommended time in 22-23
- 11 cases of healthcare associated SASBI infection in 22-23, up from 9 in 21-22
The AIHW My Hospitals data is available for all public and private hospitals in Australia via the institute’s website here.