The embattled Northern Beaches Hospital (NBH) is rolling out urgent upgrades after a damning review uncovered critical failures linked to the death of two-year-old Joe Massa.

The hospital confirmed on Thursday it will install a high-definition camera that should have been in place from the start as a “standard”, like other public hospitals across NSW.

The NSW Health review found NBH lacked high-definition Newborn and Paediatric Emergency Transport Service (NETS) cameras, which allow clinicians to livestream video to specialists from the Sydney Children’s Hospitals Network, enabling remote assessment and treatment advice.

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Joe’s mother, Elouise Massa, said the absence of this equipment compromised her son’s care.

“NETS were called to assess Joe, but due to the lack of cameras, these specialists couldn’t see him,” Massa said.

“How was a state-of-the-art facility allowed to be built by the former [state] government and Healthscope without this capability?”

Joe was rushed to the NBH emergency department by his parents on the morning of September 14 last year, suffering from hypovolemia.

The hospital failed to take timely action, despite repeated requests from Massa for an IV drip.

Joe went into cardiac arrest and was transferred to Sydney Children’s Hospital, where he died two days later after his parents made the decision to withdraw life support.

Three NETS cameras will be installed at NBH within the next four weeks, a Northern Sydney Local Health District spokesperson confirmed to www.20304050.best.

“These are currently being configured to integrate with NSW Health IT systems, ensuring Northern Beaches Hospital has the same access to technology as other public hospitals across the state,” the spokesperson said.

The cameras will be placed in the emergency department, children’s ward and special care nursery to provide real-time clinical support.

“These high-definition video systems enable real-time access to NETS specialists and other paediatric experts, supporting emergency consultations and, where necessary, the safe retrieval of critically unwell babies and children,” the spokesperson said.

The review, published on the Clinical Excellence Committee (CEC), also found junior staff were hesitant to escalate concerns without full certainty, resulting in delays to emergency responses and missed red flags when patients were deteriorating.

When Joe was brought to NBH, the ED triage nurse and an emergency trainee doctor classified him as a Category 3 patient, meaning he was deemed to require treatment within 30 minutes.

Joe’s parents said that this classification was a mistake, as Joe should have been placed in the Red Zone Category 2, which would have required treatment within 10 minutes due to the life-threatening nature of his condition.

Massa said the under-resourced hospital is failing the local community.

“It outlines structural inequity ... We are baffled. How could this hospital be built with such inequity? It is an injustice for the people on the Northern Beaches of NSW, close to 300,000 people,” she told 2GB.

“Reading this report for the first time made Danny and I feel sick to the core.”

The review made 13 recommendations to address critical care gaps at the hospital, including urgent improvements to governance, risk management, clinical training, staffing, and digital infrastructure.

It also called for safer triage protocols, mandatory paediatric resuscitation training, and greater senior medical oversight in the emergency department.

Healthscope, the operator of NBH, welcomed the recommendations made by the CEC.

“NBH will work with the CEC and the NSLHD to enact all recommendations in the proposed timeframes,” a spokesperson for Healthscope said.

They also highlighted positive findings from the report regarding the hospital’s workforce.

“The report highlighted that the hospital is ‘staffed by a committed and professional workforce with a shared focus on delivering safe, high quality care.’

“The CEC Inquiry report also noted that the public private partnership model has resulted in ‘complex reporting metrics’ for NBH when compared to other public hospitals, and has also ‘limited access to critical clinical reporting systems that are readily available to staff in public hospitals’.

“Despite these challenges, the team at Northern Beaches Hospital continue to meet or exceed the performance of comparable NSW public hospitals on most clinical measures, including elective surgery access, ambulance transfers, and emergency department performance,” the spokesperson added.

They confirmed the NETS cameras are expected to be operational from September 4, ahead of a period of testing and staff training.