Relatives of a young Wiradjuri woman who died despite presenting multiple times to Tumut Hospital are planning to lodge formal complaints against individuals involved in her care.
Lawyers for the family confirmed that healthcare complaints are still likely to be made about individuals, arising from Naomi Williams' death on New Year's Day in 2016.
Lawyer George Newhouse, who heads up the human rights legal service National Justice Project, represented the Williams during the inquest into her death and is now assisting the family to lodge healthcare complaints against the Murrumbidgee Local Health District.
"Firstly I would like to acknowledge that Sharon has asked me to respond because she really does find talking about Naomi incredibly distressing," Mr Newhouse said.
"I know that she's pleased that there's some progress, but it's slow and I know that she would like all the [coroner's] recommendations implemented sooner rather than later."
Ms Williams' mother Sharon Williams told The Daily Advertiser she wanted to see someone held accountable for the death of her daughter.
Naomi Williams was 27-years-old and six months pregnant with her first child when she died after 18 presentations in seven months to Tumut Hospital complaining of extreme physical pain, vomiting, and nausea.
On her last presentation she was discharged from the hospital after being given Panadol and then died at home.
An autopsy report later revealed her death was caused by sepsis related to the bacterium Neisseria meningitidis, a condition which can usually be treated with antibiotics.
One year has passed since the NSW deputy state coroner handed down her findings from an inquest into Ms Williams' death, during which it was acknowledged there "is a perception in the local community that the Hospital is not a safe place for Aboriginal people".
The Murrumbidgee Local Health District is working with the Williams family to implement the recommendations made by coroner Harriet Grahame to address implicit racial bias within local health services.
Mr Newhouse pointed to a recent study by researchers at the Australian National University which found three in four people hold negative views of Indigenous Australians.
"That's why it's vital for the health system to incorporate the systemic tools that the coroner recommended, in order to ensure that we do not see further deaths or injuries arising from implicit bias again in the region," he said.
The MLHD said in a statement it acknowledges the impact felt by the loss of Naomi Williams to her family and friends and the broader Aboriginal community.
"We extend our thanks to the Williams family and community for their ongoing patience and understanding with us over the past 12 months," the statement said.
"We hope the changes we are making to our policies, procedures, training and recruitment will contribute positively towards community healing and deliver a better quality of health care to all."
Following one of the coroner's recommendations, representatives from the MLHD visited the Hunter New England local health district to learn from their model and "determine strategies for culturally appropriate care".
The MLHD said it had used the NSW Aboriginal Cultural Assessment Audit tool to review hospital capability and a dashboard has been developed to monitor performance and outcomes.
Mr Newhouse said he was glad the MLHD was implementing the Newcastle Model and now had a dashboard in place to monitor performance.
"I think it would be really useful for the MLHD to report back to the community on what they're finding through the use of these anti-discrimination tools," he said.
"That would make progress more visible to community members and hold the system accountable for their progress, or lack thereof.
"Let's get some feedback to the community."
The MLHD has introduced further changes including the appointment of two Aboriginal people to its board alongside a plan to to focus on Aboriginal Health in the coming year, including building a safe and effective workplace culture.
The MLHD also said it is planning on building a paediatrics service for Aboriginal children and babies and their families.
"MLHD seeks ways to improve our connection with Aboriginal people through Healthy Enriched Aboriginal Living Mawang (Together) Group meetings and the Tumut Local Health Advisory Committee who advocate for health services in the Tumut area," the health district said.
"The MLHD Chief Executive is the health negotiator with the Riverina-Murray Regional Alliance Local Decision Making Ngunggiyalali (Accord)".
The health district has also implemented a Nurse Delegated Emergency Care (NDEC) model at Tumut.
"This model support nurses to provide timely, quality care for patients presenting to EDs with less urgent conditions. We continue to explore permanent options for an Aboriginal Health Worker to be on call after hours," the MLHD said.
The MLHD has introduced an electronic system across its services to alert, monitor and report on health indicators for Aboriginal people who present to its emergency departments.
The health district said, further training was provided to staff in Tumut on the use of electronic medical records.
"MLHD values the relationships with local people and remains committed to listen and be guided by the Williams' family and local community to make further improvements," the statement said.