In 2024-25, we delivered important achievements and improved our services, facilities and access to care to ensure we meet the needs of our patients, staff and Northern NSW communities now and into the future.

KEY ACHIEVEMENTS

In September 2024, we launched a co-management model of care for children with ADHD with Healthy North Coast and local Aboriginal community-controlled health organisations.  The model connects our LHD's paediatricians with general practitioners in the ongoing management of ADHD medication, bringing care closer to home while significantly reducing the need for paediatric outpatient appointments.

The Australian Commission on Safety and Quality in Health Care conferred the Clinical Care Standards Excellence Award on us for our colonoscopy clinical standards. The award recognised the significant work undertaken by our teams to ensure treatment complies with the national standard.

Throughout 2024-25, we ran a series of Aboriginal Women and Children's Health Champions Yarn Up events to increase immunisation rates among the Aboriginal community. These gatherings educated participants on immunisation, breast and cervical screenings, encouraging them to be advocates within their communities and make informed health choices for themselves and their communities. By June 2025, 123 Aboriginal and Torres Strait Islander women had attended a Yarn Up.

In March 2025, we played a lead role in the emergency response to ex-Tropical Cyclone Alfred, which involved a whole-of-system approach through the cross-agency Emergency Operations Centre, ensuring all facilities remained open and patients and staff cared for. We also supported evacuation centres and public health monitoring and messaging in the recovery phase.

Ex-Tropical Cyclone Alfred was no match for the incredible, dedicated team we have the privilege of working with! Bonalbo Multi-Purpose Service Nurse Manager Kim Grey wouldn't let a little floodwater stop her from getting to work. After inspecting that the water was safe to cross, Kim was paddled into work on a kayak. Thank you to all NSW Health staff who went above and beyond to ensure continuity of care for our community.

Throughout the year, our recruitment strategies increased candidate hires by 30%, reduced advertising costs and shortened recruitment timeframes by more than 20%. This was done by centralising LHD-wide bulk recruitment, streamlining processes, increasing our presence at careers expos and enhancing and embedding our brand positioning. Also, we expanded our overseas recruitment efforts to address long-term vacancies, including hiring 18 overseas-trained doctors and 105 overseas-trained nurses. 

Discover more achievements aligned with each of our Strategic Priorities.

WORKFORCE

 

The People Matter Employee Survey in 2024 highlighted that our workforce is patient-focused, empowered and supported. A total of 80% of staff said their work group considers consumer needs when planning their work and two-thirds said they felt empowered to make decisions that positively impact our patients. Also, most of our staff said their manager encourages and values their input in the workplace.

The survey showed where we can improve. We actioned these key areas:

• communication for change management and future directions – we enhanced corporate and clinical governance structures, launched the NNSWLHD Sustainable Futures Program Roadshow and sought feedback on the NNSWLHD Strategic Plan 2025-2030
• leadership and management – we launched the New Manager Orientation Program, empowered managers with revised delegations and held NNSWLHD Leadership Summits
• staff experience, satisfaction and wellbeing – we supported staff with a TELUS Health wellbeing program, held Kindness Week celebrations, began implementing the LGBTIQ+ Health Strategy, and actioned facility and service plans.

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Recognising excellence among our staff

At our 2025 Northern NSW Quality Awards in May, we proudly honoured individuals and teams who went above and beyond to deliver personalised, sustainable and digitally enabled care. These awards allow us to shine a light on the exemplary projects and people in our District who make a significant difference to our patients, community and each other.

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Excellence in Aboriginal Healthcare

Clouded Minds

Most young people don't vape, and our program Clouded Minds helps keep it that way. Adapted from an initiative created by our friends at Mid North Coast Local Health District, Clouded Minds is a school-based program supporting students in Years 7 to 9 to make informed, confident choices about their health. This community-led initiative is helping young people stay strong, informed and proud of their choices.

 

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Excellence in Multicultural Healthcare

Women's Health Project for Multicultural Communities in NNSWLHD, a Women's Health Nurse, Priority Populations and TAFE NSW partnership.

By creating culturally safe, welcoming spaces, our women' health nurses joined TAFE NSW to empower TAFE English Language students from across the Tweed, Byron, Richmond and Clarence regions to take charge of their health and wellbeing. Through six information sessions coordinated by our Multicultural Strategies Officer, the women learned about cervical screening, cancer prevention and more, with interpreter support and multilingual resources on hand. A total of 100 women attended and 19 took the next step, booking in for follow-up appointments within six weeks.

 

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Excellence in Mental Health, Alcohol and Other Drugs Services

Suicide Prevention Peer Worker in the Emergency Department, Tweed Valley Hospital

At Tweed Valley Hospital, a new peer worker initiative added another layer of support for people visiting the Emergency Department, complementing the care already provided by our dedicated ED team. Led by our mental health clinicians, the program brings a Senior Peer Worker into the ED to offer calm, lived-experience support, helping people feel heard and connecting them with services for ongoing care. They're now working in partnership with the existing Mental Health Emergency Care Team at the hospital.

 

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Health Innovation

Technology supports radiation oncology contouring, Tweed Valley Hospital

Radiation therapy is now faster and smarter in Northern NSW thanks to new tech helping our expert teams contour organs with greater speed and consistency. What used to take up to 90 minutes can now be done in just 20 without compromising accuracy. It means our radiation therapists can spend more time on patient care, helping our patients start radiotherapy treatment sooner.

 

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Health Research

Improving the Dining Experience in Residential Aged Care, MPS Sites

What if every mealtime in aged care felt more like home? We asked ourselves that question, and the answers we found are making a difference for residents of our Multi-Purpose Services (MPS) in Kyogle, Bonalbo, Nimbin and Urbenville. By listening to residents, families and their colleagues, our MPS team has discovered ways to make mealtimes more nourishing, personal and joyful. Residents have more say in what and how they eat. Staff are better equipped to support nutrition and dignity. Ongoing collaboration with dietitians and students ensures we keep improving.

 

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Keeping People Healthy

Innovative Collaboration for Women's Health Screening

Life gets busy. It's one reason many women miss routine breast and cervical screenings. But what if you could do both in a single, supportive visit? Thanks to a collaboration launched in 2024-25 between BreastScreen NSW, Mid North Coast Local Health District and us, women can now book a combined screening at the BreastScreen NSW Lismore, Tweed Heads, Coffs Harbour and Port Macquarie locations. Results show strong uptake and glowing feedback from women who've taken part.

 

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Patient Safety First

TIA Clinic Implementation, Lismore Base Hospital

Every minute counts when it comes to strokes, and a new approach at Lismore Base Hospital is helping patients get the care they need, faster and more safely. A dedicated Transient Ischaemic Attack (TIA) Clinic is now supporting patients at risk of stroke with faster follow-up for suspected TIA cases. In its first six months, 81% of referred patients attended the clinic – nearly half were confirmed TIA cases with others diagnosed early with stroke or non-stroke conditions. Also, almost $53,900 in hospital costs were saved and patient flow and safety were improved.

 

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People and Culture

Flexible Delivery of Respecting the Difference Training

Respecting culture, building trust and creating safer spaces for Aboriginal patients, staff and communities is what our Respecting the Difference staff training is all about. Our Aboriginal Health team has boosted the number of staff who underwent the training by offering greater flexibility, accessibility and inclusivity. Staff completion jumped from 58 to 74% in just one year. More than 80% of staff have now completed this training, laying a stronger foundation for culturally safe care across our services. 

 

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Transforming Patient Experience

Day Stay Hip and Knee Replacement, Grafton Base Hospital.

Recovering from a hip or knee replacement no longer has to mean days in hospital. At Grafton Base Hospital, eligible patients are now going home the same day as their surgery thanks to a pioneering joint-replacement program that's transforming the way care is delivered.

This model is one of the first of its kind in Australia, made possible through teamwork, innovation and close collaboration with patients and their families. The program was acknowledged on a state-level as a finalist in the 2025 NSW Health Awards.

 

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Staff Member of the Year

Amanda Leigh, Lismore Base Hospital Emergency Department

Amanda, one of our Clinical Nurse Specialists, is setting a benchmark for leadership and innovation in sepsis care at Lismore Base Hospital's Emergency Department. Her role in our Sepsis Quality Improvement Program has evolved to focus on in-house data analysis, previously done externally. Amanda uses this data to drive collaborative change across disciplines.

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Volunteer of the Year

Dorothy 'Dot' Holdom, Tweed Valley Hospital

At Northern NSW Local Health District, volunteers are vital to our care teams, and Dot is a shining example. A former Tweed Shire Councillor and long-time advocate for the Tweed Valley Hospital, Dot now volunteers as a Healthcare Helper Greet and Guide and serves on several committees.

More highlights

• Lismore Base Hospital was among the first regional hospitals in NSW to commence rollout of new Safe Staffing Levels. Recruitment for 27 FTE additional nurses was completed in September to meet Safe Staffing Level requirements in the hospital's emergency department. Lismore, Grafton, Ballina and Tweed Valley hospitals are included in the statewide rollout of Safe Staffing Levels to improve patient care and support nurses.
• We launched our Manager Orientation Program to equip newly appointed leaders from across the District with the essential skills, knowledge and resources required to succeed in their roles. We launched the Connect and Care Manager Training Program, providing managers with a best-practice understanding of the basics of workers' compensation and trauma-informed care.
• The Nursing and Midwifery Research and Innovation Symposium showcased the nursing and midwifery research being undertaken across the District, contributing to improved patient outcomes. The symposium provided a platform for sharing transformative research that impacts older adults, family carers, pregnant woman and their families, children with complex care needs and healthcare policies.
• The Quarterly Leadership Forum fostered connection and collaboration, generated ideas and initiative, and promoted a safe space for learning and development of our leaders.
• A total of 39 medical interns joined our public hospitals, bolstering our medical staffing.
• More than 100 clinicians, aged care providers, community members and academics gathered in Ballina to learn how they can support older people from falling.
• An impressive lineup of educators, many of whom are recognised as Australian leaders in palliative care, presented to 68 attendees at the NNSWLHD Specialist Palliative Care Service Symposium.

 

PARTNERSHIPS

 

North Coast health partners enhance collaboration

Navigating the health system can be challenging for patients, families and even staff. That's why we have enhanced our collaboration with Mid North Coast Local Health District and Healthy North Coast.

By strengthening ties between primary care, hospital services, community health, Aboriginal Medical Services and social care services, we are tackling long-standing challenges such as service fragmentation and confusing access points. Our intent is to make the system easier to navigate, to create better patient outcomes, improve patient and staff experiences, and reduce duplication and cost.

A prime example of this collaboration in action is the development of a shared ADHD care model for children in the region.

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New partnership to drive better health outcomes for coastal regions

A great example of how we're working together is our Joint Regional Plan for Mental Health, Alcohol and Other Drugs, and Suicide Prevention. It's the culmination of work by staff across our LHD, Mid North Coast Local Health District and Healthy North Coast. The plan aims to improve access to care and make it easier for people to get the right help, at the right time.

 

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Academic Health Alliance builds a healthier Northern NSW

Our Northern NSW Academic Health Alliance held its inaugural Strategic Governance Forum at Tweed Valley Hospital in December 2024. The event drew together leaders from our LHD and partner institutions – Bond University, Southern Cross University, Griffith University and TAFE NSW – marking a milestone in advancing multidisciplinary education and research in the NSW North Coast.

The Alliance is helping us build a skilled healthcare workforce and shaping better health outcomes for our communities, with our first student cohort involving 608 medical students, 150 nursing students and 91 allied health students undertaking placements at Tweed Valley, Byron Central and Murwillumbah District hospitals.

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Murwillumbah Collaborative Care Program

Participation in the Murwillumbah Collaborative Care Program began. Facilitated by Rural Doctors Network (RDN) and supported by NSW Health, this community-centred healthcare planning program aims to ensure residents of Murwillumbah and surrounding towns have better access to the care they need, and that healthcare providers have sustainable services.

The project group includes representatives from the District, Tweed Shire Council, NSW Ambulance, Healthy North Coast, Murwillumbah Community Centre, and the Murwillumbah District Hospital Community Advisory Group. They've identified three key priorities to jointly work towards, including:

• improving the community's understanding of the range of available health services and how to access them
• making mental health services and drug and alcohol support more accessible in the primary care setting
• promoting preventative health services and the social supports that people need for good health and wellbeing.

These priorities were drawn from a community survey, which received over 460 submissions, and from extensive interviews with local health professionals. The project group aims to develop a plan to address the priorities by early 2026.

Murwillumbah is one of five locations across NSW chosen in this round of the program.

More highlights

• In a first for the NSW North Coast, women can have their breast and cervical screenings in a single visit, thanks to a partnership between our LHD, Mid North Coast Local Health District and BreastScreen NSW.
• Additional support for people living with advanced breast cancer is now available in Northern NSW, thanks to the employment of the District's first McGrath Cancer Care Nurse for Advanced Breast Cancer.
• Bulgarr Ngaru Medical Aboriginal Corporation and BreastScreen NSW North Coast teamed up to boost screening participation among Aboriginal women in the Clarence Valley. Through culturally safe group bookings, 31 women in Yamba and Maclean accessed breast screening services, with another 40 scheduled in Grafton. The initiative supported early detection and fostered connection, complete with shared meals and thoughtful BreastScreen NSW gift packs featuring the Biyani design.
• Because access to quality care shouldn't depend on where you live, our diabetes services worked with Aboriginal Medical Services (AMS) to bringing diabetes care closer to Aboriginal communities in our region.

SERVICE DELIVERY

 

Cyclone response a statewide effort

Our emergency response to Tropical Cyclone Alfred in March 2025 involved a whole-of-system approach to ensure all hospitals and MPS facilities remained open and operational, providing continued care for patients.

The Emergency Operations Centre, including cross-agency partners, was stood up with daily meetings convened to share information and make swift decisions. Support was also provided to the 20 evacuation centres in the LHD, while ongoing support was given around measles management, boil water alerts and monitoring of emergency health data, including gastrointestinal and vector-borne illnesses. Clear public health messaging was delivered in the recovery phase to further support the community.

The cyclone was no match for our dedicated team. Hundreds of hospital staff went above and beyond – including some sleeping on site and even kayaking to work – to continue to provide health care services to our patients over the emergency period.

More than 40 NSW Health staff travelled from across the state to lend a hand and help keep the District's healthcare services running.

An extraordinary display of generosity and teamwork ensured patients and staff were supported throughout the weather event.

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Virtual care and Hospital in the Home

We continue to develop our virtual care services in response to community needs. The rapid development of virtual care models underpinned by relevant technologies (including telemedicine and wearable technologies) will mean more people gain treatment within the comfort of their own home.

Additionally, virtual care has significant potential to help address the challenges in delivery of healthcare in the rural and remote areas. We have continued to grow our Hospital in the Home (HITH) services and have recently developed an innovative virtual medical model of care for Hospital in the Home, ensuring stability and consistency within the HITH workforce. We continue to partner with external virtual services to supplement service provision in many of our smaller sites.

More highlights

• We are expanding our research footprint by growing the number of clinical trials across the region. More than a dozen cancer trials were underway or launched this year, including studies on melanoma, leukaemia and breast cancer.
• Innovative delirium research conducted at NNSWLHD has been recognised by the Australian Government. The project was awarded a $1.3 million grant in the latest Partnership Projects round from the National Health and Medical Research Council. It's hoped the project drives systemic change in delirium management, enhancing patient outcomes and alleviating pressures on our healthcare system.
• Tweed Valley Hospital earned three prestigious Time is Brain awards for delivering fast life-saving clot-busting treatments to stroke patients. Presented by the NSW Telestroke Service, the awards celebrate the hospital's achievement of having the third-fastest door-to-needle time in NSW.
• A permanent BreastScreen NSW screening van rejoined the North Coast fleet ensuring women of the North and Mid North Coast communities have continued access to two mobile clinics. The van replaced a vehicle on loan after the region's mobile service was destroyed during the February 2022 floods. It provides a purpose built, specialised mammography service on wheels to support women to access life-saving screening closer to home.

 

EFFICIENCY AND SUSTAINABILITY

 

Creating a Sustainable Future Together

We continued implementing Creating a Sustainable Future Together, a three-year program aimed at embedding a whole-of-system improvement framework across all our activities. The program aims to strengthen the culture of the organisation, models of care, workforce, systems and processes, financial sustainability, and partnerships that enable the LHD to meet the needs of our community today, while ensuring the health needs of future generations are met.

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New radiation therapy cuts prostate cancer treatment times over half

An innovative new prostate cancer treatment is now available at the North Coast Cancer Institute in Lismore, offering significant reductions in treatment times for eligible patients. The stereotactic radiotherapy treatment delivers a higher dose of radiation to the target area over five treatment sessions, compared to the previous standard course which delivered a smaller dose across 20 sessions.

More highlights

• We've installed overbed cameras in Emergency Departments and Special Care Units. Enabling remote specialist reviews, they're reducing unnecessary transfers and ensuring timely, targeted care. Patients can be assessed locally, with only one transfer if needed, saving time and improving outcomes.
• Through the Remote Access Program, patients connect with NSW and Queensland specialists from any our sites, including HealthOne, community health and MPS facilities. The program runs up to four times a day, reducing travel barriers and improving access to care.
• To strengthen oversight and ensure donations are used as intended, we've established the Restricted Financial Assets Governance Expenditure Sub-Committee. The committee reviews proposals, monitors fund use and ensures alignment with donor wishes. It also helps prevent funds from sitting idle and supports timely, purposeful spending that benefits patients and services.
• To strengthen procurement, aligned procurement practices with broader strategic goals, including environmental sustainability and support for Aboriginal businesses, as outlined in the NSW Aboriginal Procurement Policy. We also introduced changes that support better compliance with NSW Health Procurement Policy and are ensuring we're making informed, value-based decisions.
• We implemented the Student Clinical Placement Supervision Model, a cost-neutral model of student supervision that enhances the clinical placement experience of nursing and midwifery students and District staff. The model provides a safe, structured and supportive learning environment that fosters professional development and high standards of patient care. It’s supported by a dedicated team of educators overseeing student placements and has received an increase in positive student evaluations across the District.

 

PATIENT EXPERIENCE

 

Patients warm to our kindness

More than 2,400 patients responded to the Bureau of Health Information (BHI) survey about their experiences while receiving care with us, recognising our staff for their ‘kind and caring’ treatment of adult patients. We were among the top LHDs in the BHI’s 2024 Adult Admitted Patient Survey.

• 93% felt their overall care as 'very good' or 'good'
• 96% rated the nurses who treated them as 'very good' or 'good'
• 95% rated the doctors who treated them as 'very good' or 'good'
• 89% said their treatment was 'kind and caring'
• 90% felt we were polite and welcoming upon their arrival at hospital
• 91% said they were treated with respect and dignity

Murwillumbah District Hospital and Casino and District Memorial Hospital were stand out performers. Both recorded among the best satisfaction levels in the state, when compared to facilities of a similar size.

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Joint replacement day stays now embedded

We embedded a new Day Stay Joint Replacement Program at Grafton Base Hospital for eligible patients undergoing hip and knee replacements, giving patients the chance to receive their operation as a day-only procedure. The program started at the hospital in 2021 and has had 53 eligible patients receive their operation utilising this model of care. Of these, 22 (42 per cent) patients were discharged on day 0, 27 (51 per cent) patients were discharged on days one and four (eight per cent) patients were discharged day two with a combined average length of stay of 0.65 days. The program was acknowledged on a state-level as a finalist in the 2025 NSW Health Awards, for Transforming the Patient Experience.

 

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Better flow means better care

Staff at Lismore Base Hospital have undertaken significant work to improve patient flow, working together to improve how we transfer care for patients from ambulances into the Emergency Department and onto the wards. The project has enjoyed significant success, achieving key targets even during periods of high demand, allowing for improved flow processes and easing the pressure on the Emergency Department.

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Tech makes radiation therapy faster, smarter

Radiation is now faster and smarter in Northern NSW thanks to new technology helping our radiation therapy teams contour organs with greater speed and consistency. New technology has significantly cut contouring time for radiation therapists from 90 to 20 minutes per patient, saving 70 minutes per case. Radiation Oncologists also experienced notable time savings. These efficiencies are projected to increase clinical capacity for Radiation Therapy Cancer Treatment by nine per cent across the District while optimising resources and workflows.

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Cancer care receives high praise from patients

People receiving cancer treatment with us provided overwhelmingly positive feedback for the care they received in the Bureau of Health Information’s (BHI) Outpatient Cancer Clinics Survey. A total of 99 per cent of our patients rated their overall care as ‘very good’ or ‘good’, and the same percentage rated our health professionals as ‘very good’ or ‘good’.

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ED care rated well by patients

Patients who attended our emergency departments (EDs) once again given our health staff, including clinicians and support staff, positive ratings. The Bureau of Health Information’s Emergency Department Patient Survey provides a snapshot of the experiences of 2,347 patients who attended NNSWLHD’s EDs from July 2023 to June 2024. During this period, more than 227,000 people attended EDs across the District.

More highlights

• We strengthened our commitment to culturally inclusive care through health education and hospital orientation programs. In Lismore, hospital tours in partnership with TAFE NSW helped newly arrived migrant and refugee women understand how to access care and navigate the health system. At Tweed Valley Hospital, tours and women’s health information sessions have helped women from diverse backgrounds, complementing their English studies at local TAFE institutes.
• We continued to embed and expand the School Dental Van Program by focusing on schools that experience higher rates of socio-economic disadvantage, with priority given to schools furthest away from a fixed clinic and less able to access oral health care services. Our dental van visited 21 schools in 2024-25, providing more than 700 children with the full scope of oral health services rather than just a screening service. Most of the children completed their care while at school, avoiding the need to travel for follow-up appointments.
• Innovation isn’t always about technology. Sometimes it’s about the simple things that make a big difference. Instead of waiting for patients to arrive on the ward, nurses from the Lismore Base Hospital inpatient team now meet patients in ED. They introduce themselves, take part in bedside handovers and then personally walk with patients to the mental health unit. This small shift has had a big impact, helping people feel safer and more supported.
• Patients at Tuckeroo Mental Health Unit at Byron Central Hospital will feel the warmth of community kindness this Christmas, thanks to a donation of 25 handmade quilts lovingly crafted by local volunteers. The patchwork quilts, stitched by craftspeople from the Mental Health Support Group, are part of the group’s longstanding commitment to supporting people throughout the Northern NSW Local Health District who are living with mental illness.
• The team at Kamala Child and Adolescent Mental Health Inpatient Unit understand that entering a mental health ward may be daunting for young people. They worked diligently to create a supportive and informative solution: a video for potential young inpatients.
• Our Disaster Recovery Team (DRT) clinicians and Rural Adversity Mental Health Program (RAMHP) Coordinators supported communities at various temporary pod villages in our area, hosting barbecues for residents.

 

ASSETS AND TECHNOLOGIES

 

Latest designs unveiled for Grafton Base Hospital Redevelopment

Grafton and surrounding communities were given a look at the latest designs for the Grafton Base Hospital Redevelopment with new artist impressions showcasing the new hospital building and improved access to the facility. The NSW Government is investing $263.8 million in the redevelopment to provide new and enhanced health services for the region.

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120 years of history and connection for Murwillumbah District Hospital

In September, we commemorated 120 years of health care at Murwillumbah District Hospital, hosting a week of history and celebration which culminated in a BBQ for staff and family members. The hospital was officially opened in May 1904.

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$1.7M to upgrade our health facilities

We received a $1.7 million funding boost to upgrade hospitals and health facilities throughout the region. The projects include a cardiac catheter lab chiller upgrade at Lismore Base Hospital and an Emergency Department Short Stay Unit upgrade at Grafton Base Hospital.

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Shaping the new SDPR with local knowledge

The Single Digital Patient Record (SDPR) project is a once-in-a-generation clinical-transformation program to unify the nine electronic medical records, 10 patient administration systems and five laboratory information management systems currently in use across NSW Health. SDPR will provide clinicians with access to patient information from a single, secure and reliable source, and improve the patient experience through better continuity of care.

SDPR representatives from the District have been appointed to Configuration Working Groups. These representatives will be playing a role in one of the biggest changes to a health system Australia has seen to date.

SDPR will cover more than 220 public hospitals, more than 150 pathology collection centres, 65 laboratories and approximately 600 community health centres across the state when fully complete in 2028. It’s scheduled to go live in our District in late 2026.

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Tweed Valley Hospital celebrated its first birthday

The $723.3 million Tweed Valley Hospital celebrated its first anniversary in May, transforming the delivery of healthcare in the region with a record number of patients treated during the year. In the 12 months to 30 April 2025, the new Tweed Valley Hospital:

• welcomed the birth of 1,082 babies
• hired an additional 330 staff, including doctors, nurses, and support personnel
• provided care to 56,406 people who presented to the Emergency Department
• admitted more than 33,751 patients for care
• performed 3,611 emergency surgeries and 6,787 planned surgeries, totalling 10,398 surgeries.