Which LHDs dropped the ball on hospital safety? – updated

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New data has spotlighted the districts where patients think safety, pain management and post-discharge arrangements have declined.


Hunter New England, Illawarra Shoalhaven, Murrumbidgee, Mid North Coast and Northern NSW were among local health districts where patient feedback on the safety of care received while in hospital has notably declined over the last five years, a new report from the Bureau of Health Information has shown.

Compiling results from more than 115,000 respondents to the Adult Admitted Patient Survey between 2018 and 2023, the latest report in the Institute’s Insight Series highlighted trends in patient experience regarding the safety of hospital care at both a state and individual LHD level.

The report identified “significant decline” in patient ratings for Hunter New England LHD on four safety indicators and drivers of hospital readmission, with just 31% of respondents saying health professionals were “definitely” open about addressing issues in 2023, 7% lower than the statewide average and drastically down from 51% in 2020.

Across the HNE LHD 81% of patients said the “right amount” of information was given to them about their condition or treatment while in hospital, down from 86% in 2020 and 3% lower than the NSW average, while ratings of how well health professionals explained things declined from 82% in 2020 to 79% in 2023.

HNE’s performance also dropped on the question of errangements made for patients for services needed following their discharge from hospital, with 69% of patients saying adequate arrangements were “definitely” made in 2023, up from 66% in 2020 but down from 71% in 2020. 

In a statement issued to Health Services Daily, a spokesperson for HNE LHD said it valued the insights provided by the latest BHI report and acknowledged that there was “room for improvement” to bolster patient experience across the district.

“While the results of the survey indicate that our hospitals and staff continue to provide high-quality care and treatment, we acknowledge that some questions show there is room for improvement to enhance the overall patient experience and the communication provided to patients and their carers,” said the spokesperson.

“This BHI report spans a period when the challenges of covid were felt acutely across many of our facilities.

“Measures taken to safeguard our community, such as visitor restrictions, may have impacted patient experiences, but safety and care have always remained our top priority.

“We are committed to improving patient experiences to ensure every member of our community receives the best care possible.

“We will continue to listen to patient feedback and work together to deliver better health outcomes.”

Illawarra Shoalhaven LHD and Murrumbidgee LHD’s performances declined across three safety and risk of readmission metrics, with 27% of patients across Illawarra Shoalhaven and 33% of patients across Murrumbidgee saying health professionals were open to discussing problems experienced during their hospital admission, down from 59% and 52% respectively in 2020.

Across Illawarra Shoalhaven LHD, 71% of patients said they’d speak highly of their hospital experience to friends and family if asked in 2023, down from 79% in 2020, while 66% said health professionals had done everything they could to manage their pain while in hospital, down significantly from 82% in 2020 and 10% lower than the NSW average for 2023.

“Illawarra Shoalhaven Local Health District (ISLHD) values patient feedback as it helps guide our ongoing efforts to improve services and meet the needs of our community,” ISLHD chief executive director of clinical operations Margaret Martin told HSD in a statement.

“In 2023, adult patients across our District reported positive experiences of care with strong results around compassion, respect and kindness.

“Results include 98 per cent of patients surveyed at Shellharbour and Shoalhaven Hospitals rated the nurses who treated them as “very good” or “good”, [and] 92 per cent of patients surveyed at Wollongong Hospital rated their overall care as either ‘very good’ or ‘good’.

“The District encourages patients, their families and carers to share feedback on their experience in our hospitals and supports people to raise any concerns directly with our staff.”

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In Murrumbidgee LHD, 66% of patients indicated they would rate their hospital care as “very good” in 2023, down from 68% across NSW, while ratings of information provided regarding care management at home following hospital discharge declined from 79% in 2020 to 73% in 2022.

Responding to Health Services Daily’s request for comment, Murrumbidgee LHD said patients across the district had reported largely positive experiences of care during and after their hospital admission, with 87% saying hospital staff were “always welcoming” upon their arrival to hospital and 85% agreeing that staff had “always” treated them with respect and dignity.

“Results of patient surveys conducted by the Bureau of Health Information are used by
the District to gain a comprehensive understanding of our overall performance and
opportunities for improvement,” the statement said.

“In 2023, adult patients from the four largest hospitals across our District reported
positive experiences of care, with more than nine in 10 patients (93 per cent) rating the
care they received in hospital as “very good” (66 per cent) or “good” (27 per cent).

Mid North Coast LHD and Northern NSW LHD’s ratings also declined on two safety and readmission metrics, including patients’ experience of pain management and the clarity of explanations provided by health professionals while in hospital.

“Mid North Coast Local Health District (MNCLHD) thanks our dedicated staff for their work to keep the community safe and deliver high-quality care to patients,” a spokesperson for MNC LHD told HSD.

“MNC LHD values patient feedback as it offers insights that help us in our ongoing efforts to improve services and help staff meet the needs of our community.”

According to a statement from Northern NSW LHD, while the district’s performance had declined on a few metrics, overall its scores were consistently higher than the statewide average.

“NNSWLHD consistently rates above the NSW average for a range of patient experience measures. Patients rate the care they receive in NNSWLHD hospitals, as well as their treating nurses and doctors, very highly every year,” the statement said.

“In the most recent Adult Admitted Patient Survey for 2023, NNSWLHD recorded 21 measures which were significantly higher than the NSW average.

“In 2023, 95 per cent of patients said the care they received at NNSWLHD hospitals was ‘very good’ or ‘good’. Almost all surveyed patients (97 per cent) rated the nurses who treated them as ‘very good’ or ‘good’, with 95 per cent rating the doctors who treated them as ‘very good’ or ‘good’.

Full results from the latest BHI Insights Series report, Patients’ experiences of safe care and readmission to hospital over time, is available on the BHI’s website.

Updated at 5:13 pm to include comment from Murrumbidgee LHD.

Updated at 10:52 am to include comment from Northern NSW LHD.

Updated at 3:38pm to include comment from Illawarra Shoalhaven LHD.

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