When we covered what the $723.3 million hospital added in July, we said we would report its performance from here. This is the first instalment, built from the Bureau of Health Information’s quarterly emergency department data file, released on 9 September 2026 with results to the end of June.
The front door: quick, and it was before the move
BHI reports the new hospital and the old Tweed Hospital under one hospital code, so its series runs back past the May 2024 opening. Through 2023, the old hospital started between 79.0 and 83.1 per cent of its emergency patients’ treatment on time. The share fell to 76.5 per cent in January to March 2024 and 74.7 per cent in April to June 2024, the quarter the hospital moved. In the eight quarters since, it has run between 76.5 and 82.1 per cent. The 82.1 per cent for April to June 2026 is the highest since the old hospital’s 83.1 per cent in October to December 2023.
Interpret with caution (SDPR transition). Some hospitals moved into or out of this peer group from the October to December 2025 quarter, so the major hospitals line is not a fixed set of hospitals. Values in the table below; * marks a flagged value.
| Quarter | Tweed | NSW | Major hospitals |
|---|---|---|---|
| Jan-Mar 2023 | 79.0 | 67.4 | 64.6 |
| Apr-Jun 2023 | 80.5 | 65.8 | 61.1 |
| Jul-Sep 2023 | 80.3 | 67.0 | 62.4 |
| Oct-Dec 2023 | 83.1 | 68.3 | 64.2 |
| Jan-Mar 2024 | 76.5 | 66.1 | 61.7 |
| Apr-Jun 2024 | 74.7 | 63.7 | 57.3 |
| Jul-Sep 2024 | 79.0 | 61.4 | 53.8 |
| Oct-Dec 2024 | 76.5 | 65.3 | 58.2 |
| Jan-Mar 2025 | 80.8 | 67.3 | 62.0 |
| Apr-Jun 2025 | 79.5 | 66.1 | 59.8 |
| Jul-Sep 2025 | 78.7 | 64.3 | 57.9 |
| Oct-Dec 2025 | 80.8 | 66.5 | 62.5 |
| Jan-Mar 2026 | 79.5 | 68.4 | 65.6 |
| Apr-Jun 2026 | 82.1 | 68.7* | 67.2* |
Tweed has been ahead of the NSW figure in every one of the 14 quarters charted, by between 10.4 and 17.6 points. In April to June 2026 the gap was 13.4 points. The lead holds at the urgent end: 81.0 per cent of triage category 2 (emergency) patients started treatment on time at Tweed, against 56.8 per cent across NSW, and 76.8 per cent of category 3 (urgent) patients, against 65.5 per cent.
The rest of the front-door picture matches. The median time in the department, for every attendance, was 167 minutes at Tweed, 229 across NSW and 244 at the major hospitals. Of patients treated and discharged, 80.7 per cent left within four hours, against 64.0 and 60.7 per cent. Paramedics handed over 82.1 per cent of ambulance patients to ED staff within 30 minutes, a different measure that happens to share the on-time figure.
The back door: patients who needed a bed
Of the 14,653 attendances in the quarter, 2,632 ended in admission to the hospital and 86 in a transfer to another hospital. A further 1,748 were admitted to the ED short stay unit, which BHI reports separately. BHI reports the first two groups together. Their median time in the emergency department was 480 minutes, eight hours. Only 34.6 per cent left within six hours, and the slowest tenth spent 1,282 minutes or more, over 21 hours.
Tweed still beats the state and its peers on these numbers. The NSW median for admitted or transferred patients was 565 minutes, with 30.9 per cent leaving within six hours; at the major hospitals, 597 minutes and 26.3 per cent. It trails its own district. Across the Northern NSW Local Health District the median was 421 minutes and 42.6 per cent left within six hours. A district total mixes hospitals of every size, so that is a reference point, not a like-for-like comparison.
BHI’s current set of time-to-leave measures starts in January to March 2025, so these figures cannot be carried back to the opening. Across the six quarters since, Tweed’s share of admitted or transferred patients leaving within six hours has ranged from 31.0 to 38.9 per cent, and their median time from 440 to 516 minutes. January to March 2025 was the best quarter on both, January to March 2026 the worst. The April to June figures sit close to the same quarter a year earlier, 33.9 per cent and 482 minutes. BHI’s data measure how long patients waited, not why, and we draw no conclusion about cause.
| Measure | Tweed | Northern NSW LHD | Major hospitals | NSW |
|---|---|---|---|---|
| Attendances | 14,653 | 56,307 | 203,066† | 748,242† |
| Started treatment on time | 82.1% | 79.4% | 67.2%* | 68.7%* |
| Median time in ED, all attendances | 167 min | 151 min | 244 min* | 229 min* |
| Treated and discharged, left within 4 hours | 80.7% | 80.1% | 60.7%* | 64.0%* |
| Admitted or transferred, left within 6 hours | 34.6% | 42.6% | 26.3%* | 30.9%* |
| Median time in ED, admitted or transferred | 480 min | 421 min | 597 min* | 565 min* |
| 90th percentile, admitted or transferred | 1,282 min | 1,206 min | 1,453 min* | 1,532 min* |
| Spent 12 hours or less in ED | 92.4% | 94.2% | 88.3%* | 89.7%* |
| Ambulance patients handed over within 30 minutes | 82.1% | 86.4% | 80.9%* | 80.3%* |
* BHI: Interpret with caution (SDPR transition)
. † BHI:
Incomplete data (SDPR transition)
. Major hospitals is BHI’s peer group B, the group
Tweed belongs to.
Demand held steady
The department had 14,653 attendances in April to June 2026, against 14,713 a year earlier. Through 2023, before the move, the old hospital’s quarterly attendances ran from 13,692 to 14,481. Ambulance arrivals rose from 3,110 to 3,278 over the year, an increase of 5.4 per cent on our arithmetic.
Why the comparison carries a caution flag
NSW Health is moving its hospitals to the Single Digital Patient Record, which BHI’s
page says brings a person’s health information into one system, and warns of temporary
interruptions to the centralised data it reports from. BHI’s note on this quarter says Hunter New England Local Health District
transitioned to the Single Digital Patient Record (SDPR) on 27 May 2026. Centralised data from
Hunter New England were not available for the period 27 May to 30 June 2026.
BHI marks the
NSW and major hospitals results for the quarter as Interpret with caution (SDPR
transition)
and their attendance counts as incomplete. The Tweed and Northern NSW rows carry
no caution or incomplete-data flag. Tweed has led by at least 10.4 points in every quarter charted, so the gap is
unlikely to have reversed, but the size of this quarter’s gap is softer than the decimal points suggest.
Our view
This section is opinion, built on the figures above. On the measures a patient meets first, the Tweed emergency department is doing well against the state and comparable major hospitals on every one of them, and it was doing well before the new building opened. Its on-time figure dipped in the two quarters around the move, when the state figure also fell, and has since climbed back to where the old hospital was. That is a quieter result than a new hospital’s launch suggests, and a creditable one.
The number we would put in front of the district is 480 minutes. Half of the people who needed a bed, or a transfer, spent eight hours or more in an emergency department, two years after the opening of a hospital that added more than 190 beds and 16 emergency treatment spaces. Beating a state median of 565 minutes is faint praise, and Tweed trails its own district on this measure. We will add the July to September 2026 quarter when BHI publishes it, and the six-hour figure is the one we will watch first.
How we worked this out
We read BHI’s Healthcare Quarterly page for April to June 2026 and downloaded its emergency department data file on 18 October 2026, using a browser, because the BHI site refuses plain automated requests. The file’s metadata gives a publication date of 9 September 2026. We extracted every emergency department measure for the Tweed Valley Hospital (BHI code H223), the Northern NSW Local Health District, the Major hospitals peer group and NSW, from all four results sheets. H223 rows run from January to March 2010 under the one name, and BHI’s own notes for late 2021 and early 2022 refer to that code as The Tweed Hospital, so we treat the series as continuous across the move. April to June 2024 straddles the May 2024 opening. The specified-time measures (within four, six and 12 hours) and the median time in the ED for the current departure groups, including admitted or transferred, begin in January to March 2025 in this file; the older groupings end in October to December 2024, so we compare them only from January to March 2025. BHI warns that quarterly percentages and medians cannot be combined into annual figures, and we have not done so. Point gaps and the 5.4 per cent rise in ambulance arrivals are our arithmetic. We did not contact the Northern NSW Local Health District or BHI for this story.
Sources
The working. AI read the documents and drafted this story, under rules people set and answer for, working from the primary sources below. How we work.
- Bureau of Health Information, Healthcare Quarterly, April to June 2026 (released 9 September 2026, read 18 October 2026): the release date, the NSW results and the note on the Single Digital Patient Record transition.
- Bureau of Health Information, Emergency department data, January to March 2010 to April to June 2026 (spreadsheet, publication date 9 September 2026, downloaded 18 October 2026 from BHI’s downloadable data page): every figure in this story, the caution and incomplete-data flags, the Hunter New England note and the peer group reclassification note.
- NSW Government (Health Infrastructure), Tweed Valley Hospital Development (last updated 16 June 2025, read 18 October 2026): the May 2024 opening, the $723.3 million cost, the more than 190 additional beds and the 16 extra emergency treatment spaces.
- The Watershed Review, The $723 million question the Tweed Valley Hospital answered was not beds, it was travel (24 July 2026).
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