Health care and social assistance

Overview

Healthcare and Social Assistance has been identified as a priority harm industry in the Australian Work Health and Safety Strategy due to its high rate of work-related injury and illness.

The healthcare and social assistance industry is the largest sector in South Australia, employing more than 162,700 workers – or 18 percent of the state’s workforce.

It provides essential services across the following four areas:

Residential care services – primarily aged care residential services

Hospitals – both public and private

Social assistance services – childcare

Medical and other health care services – ambulances, pathology, dental, medical services.

The South Australian Health care and social assistance workforce is predominately female (77 percent) with the average age of workers 42.6 years.

The issues facing the industry in South Australia are similar to those nationally. They include significant workforce shortages, particularly among doctors, nurses and allied health professionals. This is driven by burnout, an ageing workforce and an increased demand for services.

In response, there is an increased focus on changing care models, improving job satisfaction, and leveraging technology such as telehealth and AI to improve patient care and reduce administrative burden.

Fifty organisations with the highest claims in the industry accounted for about 80 per cent of all workers’ compensation claims in the sector between 2016-17 and 2023-24. A sub-industry breakdown indicates:

Residential care services: 18 organisations had more than 100 claims
Social assistance services: 10 organisations had more than 100 claims
Hospitals: a significant proportion of claims are attributed to hospitals.

Other social assistance services also have the highest prevalence of psychosocial risks within the Return to Work South Australia (RTWSA) scheme. Common issues include assaults on workers, poor risk management, fatigue, and lack of support due to limited field staff and supervision.

Claims data

The healthcare and social assistance industry had the highest number of workers’ compensation claims of any industry in South Australia - 25,560 – between 2016-17 and 2023-24. The high rate is often due to manual handling tasks, exposure to infectious diseases and high-stress environments. Mental health concerns, including burnout, are also increasing.

Hospitals and aged care facilities received the most claims.

Hazard	Injuries
Body stressing	Causes: muscular stress while handling objectives while lifting, carrying or putting down objects. Injuries: traumatic joint/ligament and muscle/tendon injuries, musculoskeletal and connective tissue diseases, nervous system and sense organ diseases.
Falls, trips and slips	Causes: falls on same level and falls from heights. Injuries: traumatic joint/ligament and muscle/tendon injuries, musculoskeletal and connective tissue diseases, fractures, wounds, lacerations, amputations and internal organ damage.
Hit by moving objects	Causes: assault, being hit accidentally, hit by falling object. Injuries: traumatic joint/ligament and muscle/tendon injuries, wounds, lacerations, amputations, internal organ damage, fractures, musculoskeletal and connective tissue disease.
Mental health	Causes: work pressure, workplace harassment and bullying, exposure to workplace violence, exposure to traumatic events. Conditions: anxiety/stress disorders, adverse reactions to stressors, post-traumatic stress disorders, anxiety/depression combined disorders.

Occupations

The following occupations are at highest risk of injury in the healthcare and social assistance industry:

Personal carers and assistants – 26.7 percent of claims received, with aged and disabled carers, and personal care assistants being most affected.
Health and welfare support workers – 18.5 percent of claims received.
Midwifery and nursing – 11.1 percent of claims received.

Other social assistance is the fastest-growing sub-industry, which has expanded from 277 registered employers across Australia in 2019 to 1,230 by the end of June 2024. This sub-industry includes workers engaged in providing a wide variety of social support services directly to their clients such as disabilities assistance, adult day care, welfare counselling, aged care assistance and youth welfare.

In 2024, remunerations in the sub-industry reached $1.4 billion, three times the size in 2019.

Compliance campaign

The 2025-26 compliance campaign will focus on audits to address psychosocial hazards in the healthcare and social assistance industry, particularly the ‘other social assistance’ sub-industry.

The campaign will have a proactive focus to encourage healthy workplace culture, improve training quality and HR capability, and support field supervision and worker wellbeing.

Common reasons for psychosocial risk in ‘other social assistance’ include:

High prevalence of clients with challenging behaviours – assaults on workers are common.
Poor risk management by employers – hazards are not being managed.
Fatigue is common when dealing with clients with challenging behaviours.
Workers tend to be older.
Many workers who have injuries are female.
Employers operate with limited or no field staff and supervision so workers can lack support.
Many workers have lived experience and will put their own health at risk for a client.
Employers struggle to get and retain suitable staff.
Workers may work in isolation. Client’s home may not be properly set up for care.
Staff training can be online tick and flicks and not relate to the duties they undertake.
HR skills and practices lacking to deal proactively with healthy workplace culture and climate programs, and with staff interpersonal issues and personality issues.