Our commitment to the health care and social assistance sector
On this page
- Factors contributing to the risk of injury and illness
- Focus areas
- Consultation and collaboration
- Our actions: 2023-2025
- Measures of success
The health care and social assistance sector is the largest and fastest growing sector, accounting for over 600,000 workers in NSW. It includes:
- hospitals
- residential care services
- other social assistance services (including disability services)
- medical services
- child care services
- pathology and diagnostic imaging services
- allied health services
- other health care services.
The sector is made up of a diverse workforce of dedicated individuals who provide vital care and services to the people of NSW. Due to the nature of the work, and the need to provide care, workers in the sector are at an increased risk of injuries and illnesses.
The sector accounts for the highest number of workers compensation claims compared to all other industries in NSW. In 2022, there were over 17,000 claims accounting for 836,652 days off work*. This is at a time where nurses, doctors, clinicians, cleaners, cooks and laundry workers, carers, aides, and educators are in high demand and not able to provide vital care and support services.
Our vision is for safer work, safer care. When work is designed to be healthy and safe, hazards are eliminated, harms are minimised, and workers can provide better and safer care for the people of NSW.
SafeWork NSW will work with industry to raise awareness, build capability, improve compliance, and drive industry wide change to create healthy and safe workplaces across the sector that ensures safer work leads to safer care.
*‘days off work’ figure current as at 18/09/2023 and measured in whole calendar days (including holidays and weekend days) that the worker has been off due to the injury/illness.
Factors contributing to the risk of injury and illness
It’s important to consider the unique factors that contribute to increased injuries and illnesses in this sector:
- Industry growth – increased demand for care and services and an ageing population.
- Competing regulatory requirements – businesses are required to comply with multiple legislation therefore making it challenging and complex to meet work health and safety (WHS) obligations.
- Culture of underreporting and acceptance of risk – despite recent work, underreporting and attitudes that hazards (both physical and psychosocial) are ‘part of the job’ are still commonly held views.
- At risk workers – a diverse workforce, who may not be aware of their WHS rights and responsibilities, including culturally and linguistically diverse workers (CALD), migrant workers, Aboriginal and Torres Strait Islander workers, young workers, labour hire workers, inexperienced workers.
- Regional or remote work – limited access to vital services and opportunities to attract, recruit and retain staff may add pressures on the system.
- Gig economy – employment relationships are changing. Workers are increasingly engaged through online platform providers, or directly through clients, on a task or short term basis.
- Home-based care – the increase in home-based care makes controlling the changing work environment (which is often isolated) complex.
Focus areas
Priority areas have been identified through data, evidence, and consultation with stakeholders.
A systems thinking approach
Systems thinking is a way of thinking about the workplace that enables us to better understand and improve outcomes in complex systems. It allows us to understand the dynamic interactions between workers, technologies, managers, and other elements of the system and how they create adverse events. Systems thinking considers factors within the broader organisational, social, and political system, such as decisions made at government, regulatory and organisational levels play a role in incident causation.
Leadership and culture
Safety starts with leaders. To be effective, leaders should visibly demonstrate their commitment to work health and safety. Strong leadership and a firm commitment to continuously improve, backed by effective consultation and action, are the foundations of a strong safety culture.
Human factors
Human Factors is a holistic systems approach focused on understanding the relationship between human behaviour and their environments. It provides a framework to understand how the environmental, organisational and job factors, and individual characteristics, can influence health and safety outcomes. Emerging evidence has recognised the links between physical and psychological factors in the workplace, therefore taking a systems approach will assist with the prevention and reduction of musculoskeletal disorders – which is still the number one injury for workers in the health care and social assistance sector.
Equipment and environment
The design and management of buildings, including external parties or others that control buildings (such as leased facilities), the work environment and nature of the workplace (i.e. home and community based care) have an impact on worker safety. This includes the procurement, handling and maintenance of equipment and the safe design of the work environment.
Psychosocial hazards
Workplace violence and aggression
Workplace violence and aggression is increasing and is more common in service-related industries such as the health care and social assistance sector. The need to provide care doesn’t stop, however the prevention and management of workplace violence and aggression should be prioritised to ensure worker safety.
Fatigue and burnout
There are many factors contributing to fatigue and burnout including the ongoing impacts of Covid-19, staff shortages and an increase in demand for care and services. In a recent survey* workers identified fatigue and burnout as one of the top risks factors that contribute to workplace injuries and illnesses.
Bullying and harassment
Bullying and harassment is one of the top causes of psychological injury in the health care and social assistance sector and to effectively address this, a strong culture of safety leadership and consultation is required. There are a number of factors that may contribute to bullying and harassment for example poor leadership and organisational culture, unsafe systems of work and high job demands.
*The Health Care and Social Assistance Work Health and Safety Sector Plan Evaluation 2022.
Exposure to harmful substances
As a regulatory priority we will ensure information is available that supports businesses and workers in addressing exposure to harmful substances including hazardous chemicals such as formaldehyde, asthmagens and cytotoxic drugs.
Consultation and collaboration
The Australian Work Health and Safety Strategy 2023-2033 identifies the health care and social assistance sector as a priority industry and also acknowledges that musculoskeletal disorders (MSDs) still account for the majority (87%) of serious workers compensation claims. In NSW, the health care and social assistance sector is the largest contributor of serious MSD workers compensation claims which will be addressed through this Action Plan as well as other SafeWork NSW programs of work.
This action plan will deliver on the SafeWork NSW Regulatory Priorities in relation to the health care and social assistance sector including:
- psychological safety (including the psychological health and safety strategy)
- gig economy – disability services sector
- exposure to harmful substances
- respect at work
To deliver our actions we will consult and collaborate with partners and stakeholders including:
- Centre for Work Health and Safety
- icare
- State Insurance Regulatory Authority (SIRA)
- unions and workers
- health and safety representatives
- academics and researchers
- associations
- employers and employer organisations
- regulators.
Our actions: 2023-2025
We collaborated with key stakeholders to ensure our priorities align with the most urgent needs of the sector.
We will address the priorities through the use of data intelligence, advice and education, national coordination and compliance and enforcement.
This plan allows us to be agile while addressing the current priorities. If in time, other priorities are identified we have the ability to be flexible to meet the needs of the sector.
Outcome
Raise awareness of work health and safety obligations with workers and employers.
Action
- Develop a communications campaign which raises awareness of the need to prioritise worker safety to provide better care in hospitals.
- Host a summit: The ‘designing work to be healthy and safe’ Summit will explore the impacts of fatigue and burnout and develop recommendations on how to address the issues.
- Develop guidance on the WHS duties and obligations for those providing care and services in the NDIS. This includes NDIS participants, sole traders, platform services, service providers and plan managers.
- Update guidance material on restricted carcinogens and increase knowledge of authorisation and notification requirements to use cyclophosphamide.
Outcome
Build work health and safety knowledge and capability.
Action
- Develop work health and safety information in relation to safely providing care and services in the home and community.
- Produce and share regular work health and safety monitoring reports for the health care and social assistance sector.
- Develop sector specific information for managers and leaders on due diligence and work health and safety duties and obligations.
- Develop case studies on workplace violence incident management and post incident management specific to hospitals, residential care, and disability care settings.
Outcome
Drive industry wide change to create safe and healthy workplaces.
Action
- Establish industry action groups for residential care, hospital and disability support services. Industry action groups will include employee and employer representatives and academics. Through collaboration they will help to develop and promote WHS messaging and initiatives.
- Continue the Action Against Violence in NSW Hospitals Working Group (PDF, 63.73 KB), drive the work plan activities and review annually.
- Host regulator roundtables in the disability services sector and the residential aged care sector to:
- understand the multiple legislative requirements for businesses
- implications of the rise of the gig economy
- work towards a coordinated regulatory approach.
- Contribute to the review of the Residential Aged Care Accommodation Framework.
Outcome
Regulatory action to drive WHS compliance through targeted programs.
Action
- Build regulator capability on the complexities of the health care and social assistance sector.
- Undertake targeted regulatory engagement with leaders focusing on WHS duties and obligations.
- Undertake targeted regulatory engagement focusing on patient handling and musculoskeletal disorders.
- Undertake a follow up compliance visit program in relation to psychosocial hazards in the disability sector.
- Undertake a follow up compliance visit program in relation to violence in NSW hospitals.
Measures of success
It's important to capture and report on the achievements of this action plan. Alongside the outcomes outlined above, we will aim to reach the following targets by 2025:
- 150,000 workers in the sector are engaged through Action Plan activities
- 80% of workplaces have sustained WHS compliance improvements after 6 months
Method
- Action Plan: Reach of resources, events, website views, communication campaigns
- Action plan compliance programs
Targets based on The Australian WHS Survey data from (baseline* to December 2025):
- Increase workers’ empowerment to participate in WHS prevention from 49% to 75%
- Increase workplaces WHS commitment and practices from 44% to 70%
- Increase workplaces that have adequate systems in place from 52% to 75%
Contribute to targets in the Australian Work Health and Safety (WHS) Strategy 2023 – 2033#
- Reduce the frequency rate of serious claims resulting in one or more weeks off work by 20%
- Reduce the frequency rate of claims resulting in permanent impairment by 15%
- Reduce the overall incidence of work-related injury or illness among workers to below 3.5%
*NSW only, April 2023. For more information about the survey visit the Centre for Work Health and Safety.
#This Action Plan is from 2023-2025 therefore will measure against the Australian Work Health and Safety (WHS) Strategy 2023–2033 up to 2025.