Building the business case in New South Wales

NSW Health paid $414m in workers' compensation contributions that year, plus a $51.4m charge for poor claims performance (NSW Health financial statements).

The policy window is open too. A statewide Health Safety Taskforce formed in July 2026 is looking at "workforce capability" and specialised training. NSW Health's own violence prevention and training policies are under review, and SafeWork NSW's codes of practice for health care became enforceable on 1 July 2026.

What are the numbers in NSW?

Violence-related claims at NSW Health rose from 373 to 578 in three years, and nearly every district's contribution rose in 2024-25.

2021-22

373

2022-23

427

2023-24

482

2024-25

578 (+55% on 2021-22)

Source: icare answers to a NSW parliamentary inquiry (August 2025), reported in the NSWNMA Occupational Violence Report 2026. 2025-26 figures are due with the NSW Health annual report in late 2026.

Source: each district's audited 2024-25 financial statements, "workers' compensation insurance" line (NSW Health financial statements). Listed alphabetically. Per FTE is our calculation, using June 2025 FTE. Western Sydney's 2024-25 statement couldn't be read; its 2023-24 figure is on the open data page, with the CSV.

What sits behind the claims:

• 88% of NSW nurses, midwives and carers experienced or witnessed violence in six months of 2025. After an incident, 28.4% used their own personal leave and only 6.5% claimed workers' compensation, so most of the absence never becomes a claim (NSWNMA, 2026).
• Only about a quarter of nurses report every incident (NSWNMA, 2026).
• Average seclusion lasted 7 hours 7 minutes in January to June 2026, down 1 hour 45 minutes on a year earlier but still well above NSW's target of under 4 hours. The figures exclude Hunter New England hospitals, which were moving to a new patient record system (BHI, January–June 2026).
• At John Hunter Hospital, the security workforce reports more than 1,000 code blacks a year, and one patient injured three security officers in July 2026 (Dungog Chronicle).

What are NSW regulators and government saying?

The NSW Health Safety Taskforce (July 2026) brings NSW Health, the HSU, NSWNMA and ASMOF together with Sydney, Western Sydney and Western NSW LHDs. Its focus includes security systems, "workforce capability", consistent approaches across facilities, and staff wellbeing and retention, and "specialised training is being explored" for security staff (NSW Government). It meets monthly and hasn't published findings yet.

SafeWork NSW is inspecting hospitals. Its Hospital Industry Action Group has 23 inspectors on a hospital compliance operation (NSW Government, September 2025), and in October 2026 it began its largest-ever psychosocial compliance operation (SafeWork NSW). WHS codes of practice, including the health care and social assistance code, have been legally enforceable since 1 July 2026.

The regulator's precedent is training. After three nurses were stabbed at Royal Prince Alfred Hospital in 2019, the remedy SafeWork NSW accepted was an enforceable undertaking worth more than $3m. It included a 24/7 behavioural support team and a graduate diploma in managing acute behavioural disturbance (SafeWork NSW).

NSW Health's own policies are under review. Both the zero-tolerance policy (PD2015_001) and the violence prevention and management training framework (PD2017_043) are listed as under review (NSW Health). PD2017_043 already says training "is only one of the control measures required".

The 2026-27 NSW Budget has no dedicated line for occupational violence or security, so the money has to come from within LHD budgets or other sources (see Part 3 of this guide).

Which arguments land in NSW?

In NSW, lead with cost: the premium rises have already landed on every LHD's books.

1. Avoided cost. Your LHD's contribution rose in 2024-25, probably by 12% to 44%, and icare added $51.4m system-wide for poor claims performance. Contributions follow claims history, so fewer claims lower future premiums.
2. Compliance. The health care code is now enforceable, SafeWork is inspecting hospitals and running its largest psychosocial operation, and its precedent remedy was training. Training records give you evidence of compliance.
3. Workforce. Most violence-related absence goes on personal leave, not workers' compensation. Ask HR for sick leave in your high-risk units alongside claims.
4. The Taskforce window. It's exploring specialised training and workforce capability now. A service with a funded, evaluated program will help shape what becomes standard.
5. Security and clinical together. NSW security officers are mostly employed by the LHD. Joint training of clinical and security staff fits the Taskforce's focus and the 2019 Anderson review's recommendation for team-based responses.

Where can the money come from in NSW?

NSW has the country's clearest nurse-led fund, plus LHD budgets under pressure from rising premiums. The 2026-27 Budget has no OV line, so the money comes from these routes.

Where do I find my own figures?

Your district's contribution is public; the rest sits in your incident, BHI and HR data.

• Workers' compensation: the "workers' compensation insurance" line in your LHD's audited financial statements (Note 2), and your icare claims reports.
• Incidents: ims+ reports for violence and aggression and code blacks, by unit.
• Seclusion and restraint: BHI's six-monthly seclusion and restraint supplement, by hospital.
• Sick leave and backfill: HR data for high-risk units, including agency and overtime spend.