Central Coast Health: Managing the Demand of a Growing Population

Central Coast Local Health District, the NSW Health entity responsible for the public hospital and community health services for the Central Coast's 340,000 residents, manages the healthcare needs of a population that is growing faster than the health infrastructure investment can keep pace with and that is ageing at a rate that intensifies the chronic disease and aged care demand that a population with a higher-than-metropolitan median age generates. The two principal hospitals, Gosford Hospital and Wyong Hospital, provide the acute care services for the north and south of the local health district area and are supplemented by the community health centres, the mental health services, and the oral health and aged care programs that the district coordinates.

Gosford Hospital, the larger of the two acute hospitals, provides the emergency, surgical, and specialist services that are available at a level three district hospital, including the obstetrics and maternity services that the Central Coast's birth rate requires. The hospital's emergency department, one of the busiest in the NSW Health system outside of the metropolitan hospitals, manages the emergency presentations of a large coastal population that includes the significant over-65 population whose emergency presentations are more complex and more resource-intensive than the younger adult population's presentations.

The NSW Government's investment in the Gosford and Wyong hospital redevelopment, responding to the capacity shortfall that has been documented through the patient wait time and access metrics that the performance framework tracks, has funded the building and equipment upgrades that the aging hospital infrastructure required. The redevelopment's staging, managing the construction disruption to the operating hospital, has extended the delivery timeline for the capacity that the population growth and the aging demographics require now.

The primary care shortage on the Central Coast, with the GP workforce per capita lower than the state average and the bulk-billing rate declining as general practice businesses face the cost pressures that the current Medicare rebate structure does not adequately compensate, creates the pressure on the public hospital emergency departments that the avoidable presentations from people who cannot access timely GP care generate. The primary care shortage's structural causes, including the training pipeline and the practice viability economics, require solutions beyond the capacity of the local health district to address alone.

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