2012 2013 A YEAR IN REVIEW Our Hospitals contents 1

Introduction Nepean Hospital 35-36 Message from the Chair 02 Nepean Clinical School 36

Chief Executive’s Year in Review 03 Aboriginal Health 37 Cancer Care 38 Our Local Health District Drug and Alcohol 39 Organisational Structure 04 Mental Health 40 2012/13 Highlights 05 Multicultural Health 41 Directorates 06 Oral Health 42 Allied Health 06 Population Health 43 Clinical Governance 07 Health Promotion 43 Finance, Business and Information 08 HIV and Related Programs 43-44 Media and Communications 09 Public Health Unit 44 Medical Workforce 10 Primary Care and Community Health 45 Nursing and Midwifery 12 Sexual Health 46 Operations 13 Our People Planning, Strategy and Epidemiology 14 Staff 47 Workforce, People and Culture 15 Equal Employment Opportunity 47-48 Our Board 16-21 Work Health and Safety 48 Board Sub-Committees 22-23 Volunteers, Auxiliaries and Support Groups 49-50 Vision and Values 24-25 Quality and Safety 51-52 Our Community eQATE 51 Population 26 Safety Office Service 51 Geography and Boundaries 27 Infection Control 52 A Year of Activity 28 Quality Awards 52 Consumer Consultation 29 Our Educational Development 53 Our Partners 29 Essentials of Care 53 Nepean-Blue Mountains Medicare Local 30 Reward and Recognition Program 54 Our Health Services Research 55-58 Blue Mountains and Springwood Hospitals 31-32 Our Information Hawkesbury District Health Service 32 Financial Statements 59-62 Lithgow Hospital and Government Information (Public Access) Act 63 Portland Tabulam Health Centre 33-34 Privacy Management 67-68 Notre Dame Rural Clinical School 33

Nepean Blue Mountains Local Health District 2012-2013 Year in Review 2 INTRODUCTION INTRODUCTION 3

Chief Executive’s an increase in demand and District has made marked

Message from the Chair Year In Review improvements in KPIs in both

access to General Practice emergency performance and Since the inception of the Local Health District model care after hours, chronic It is with pleasure that I present the 2012/13 Nepean elective surgery, as well as in 2011, Nepean Blue Mountains Local Health District disease management, the Blue Mountains Local Health District Year in Review achieving hand hygiene rates (NBMLHD) has come ahead in leaps and bounds. establishment of a ‘HealthOne’, which highlights just some of the initiatives that have above the national benchmark. The 2011/12 year saw a number of redevelopment eHealth and health promotion been introduced to improve services to our community, These achievements are milestones achieved as well as the implementation initiatives. Key strategic collaborative programs with the Medicare Local and evidence of our commitment of staff-led initiatives aimed at improving the patient positions were also established consumer groups, new capital works developments and to enhancing the patient experience; and, while we continue to work on these to enable staff to work across innovative and staff-led projects aimed at providing experience. areas, the 2012/13 financial year has seen a renewed both settings to address key world-best care. Building on the establishment of our shared Consumer focus on fostering and improving community issues of communication Recognising our staff as our greatest assets, we have Engagement strategy with our Medicare Local partners engagement to help us in our aim to deliver world-class and integration, improve also introduced a ‘Reward and Recognition’ Program to we now have reports for each of our four Local healthcare. comprehensive data access formally acknowledge staff who exemplify the District’s Government Areas which identify our consumers’ to ensure a complete understanding of the health Nepean Blue Mountains Local Health District, in Values. There has been an outstanding response to priorities. This will allow us to plan and work together to landscape and workforce planning strategies across the partnership with the Nepean-Blue Mountains Medicare this Program with 20% of staff having been nominated address these priority needs. District. By working together with the Medicare Local, across the Customer Service, Teamwork, Improved Local, conducted eight consumer forums in 2012/13. The Local Health District has also made a number of our Local Health District is able to deliver higher quality Performance, Innovation, Leadership and Management, During the consumer engagement forums, which groundbreaking research and program advances with health services and address local health needs. and Community Spirit (Volunteers) categories. covered topical issues such as transport and parking, significant implications: the Nepean Hospital Neonatal The Local Health District Board has also experienced the availability of health services, aged care, carer Our second annual Quality Awards recognised the Intensive Care Unit pioneered a world-class treatment a number of exciting changes over the 2012/13 year, support and mental health services, members of the achievements of our staff in the Patients as Partners, using probiotics for the prevention of a common yet including the addition of new Board members Colin community were able to provide feedback and voice Integrated Health Care, Local Solutions, Healthy deadly bowel condition in premature babies with a Lenton appointed in March 2013 and Jill McCarthy their thoughts or concerns about health service delivery Living, Building Partnerships, Collaborative Team 100% success rate; the Nepean Cancer Care Centre appointed in August 2013 . For more information about across the District. A Consumer Advisory Committee, and Achievement in Reducing Healthcare Associated founded an Australia-first combination radiotherapy the members of the NBMLHD Board, or the various whose members will represent each of the four Local Infections categories. This year we introduced the Chief treatment for lung and spinal cancer patients with functions and purposes of the sub-committees that Government Areas of Lithgow, the Hawkesbury, the Blue Executive’s Medical Research Award for Innovation and successful results; and the work of Nepean Hospital’s govern the NBMLHD Board, see page 22. Mountains and Nepean, will report directly to the Boards Chairman’s Award for Safety and Quality categories. Heart Failure Service was recognised with an of both organisations in 2013/14 to address feedback Finally, I would like to extend a huge thank you to our The judges had the difficult task of identifying winners ‘exemplary’ classification by The Health Roundtable. from the 2012/13 forums. staff and volunteers across the District for your consistent from a number of outstanding nominees. Three of As a result, Nepean Hospital has moved into the top Further to this, the Local Health District and the dedication to improving health outcomes for our these winners went on to become finalists in the NSW four hospitals in NSW for length of stay on The Health Medicare Local hosted a joint Board annual planning patients. Thank you for your selflessness, energy and Health Awards with the Nepean Hospital Psychiatric Roundtable. generosity. Emergency Care Centre team claiming the Minister for meeting to determine and agree on areas of joint I am incredibly proud of what our Local Health District Mental Health Award for Excellence in the Provision of priority and measurements of improvement. Identified Associate Professor Patrick Cregan has achieved over the past year and I look forward to an Mental Health Services. shared priorities included aged care, mental health, Chair, NBMLHD Board exciting year ahead. The Nepean Centre for Oral Health significantly Kay Hyman reduced waiting times for adults and children despite Chief Executive, NBMLHD

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 4 OUR LOCAL HEALTH DISTRICT OUR LOCAL HEALTH DISTRICT 5

Organisational Structure 2012/13 Highlights

Nepean Blue Mountains Local Health District had some • The Nepean Centre for Robotic Surgery significant achievements and successes over the course opened at Nepean Hospital, which includes of the last year. the State’s first public surgical robot. This NBMLHD BOARD state-of-the-art machine allows surgeons to Key achievements for 2012/13: provide treatment for prostate cancer and perform other complex surgeries through • Nepean Blue Mountains Local Health keyhole incisions and with pinpoint accuracy. CHIEF EXECUTIVE District hospitals showed significant overall DIRECTOR PLANNING, NBMLHD DIRECTOR MEDIA AND STRATEGY AND COMMUNICATIONS improvements in meeting targets for the • The Nepean Hospital Psychiatric Emergency EPIDEMIOLOGY • Media percentage of patients leaving Emergency Care Centre Team received the NSW Health • Planning • Community Departments within four hours (NEAT - Innovation Award for their patient-focussed • Epidemiology. Communications • Events National Emergency Access Target). Nepean project, ‘PECC Inspirations’. • Graphic Design Blue Mountains Local Health District has been • Photography • Nepean Cancer Care Centre pioneered supported by the Ministry’s Whole of Hospital • Video Production. an Australia-first radiotherapy treatment project to achieve this improved result. (stereotactic body radiotherapy combined DIRECTOR ALLIED DIRECTOR NURSING DIRECTOR CLINICAL DIRECTOR WORKFORCE DIRECTOR FINANCE DIRECTOR DIRECTOR • Wait times for elective surgery revealed an with volumetric modulated arc therapy) HEALTH AND MIDWIFERY GOVERNANCE PEOPLE AND CULTURE BUSINESS AND OPERATIONS MEDICAL WORKFORCE INFORMATION overall and steady improvement across the for lung and spinal-cancer patients with Local Health District. successful results. • Allied Health Services • Nursing Services Man- • Patient Safety • Workforce Planning • Financial Operations • Population Health • Medical staff leadership • Leadership for Allied agement • Clinical Risk • Staff Health • Strategic Revenue • Multicultural Health • Strategic medical • The Nepean Centre for Oral Health reduced • NBMLHD introduced the Reward and Health Professionals & • Leadership for Nurses & Management • Human Resources -- Salary Packaging • Aboriginal Health workforce development Assistants Midwives • Incident Management & • Learning & Development (hosted) • HIV and Related • Medical and dental the general adult waiting list from 10,185 Recognition Program to increase staff • Clinical Practice • Nursing & Midwifery Investigation (Corporate) • Strategic Performance Programs workforce policy in June 2012 to 7,116 in July 2013 and child engagement in response to YourSay survey Development Workforce Development • Clinical Audit • Workforce Policy • Contracts & Procurement • Asset Management • Credentialling of medical • Workforce • Clinical Practice • Complaint Management • Risk Management • Transport & Fleet Man- • Clinical Redesign and dental staff waiting lists from 2,450 in June 2012 to results. The Reward and Recognition Program • Governance • Patient-Centred Care • Clinical Quality • Recruitment & Staffing agement • Renal Services • Recruitment services 1,800 in July 2013 and delivered a significant aims to recognise and reward staff and - Senior Medical and • Short Term Equipment • Disaster Management Improvement Services. • Information Manage- • Oral Health increase in the number of occasions of service. volunteers who exceed what is expected of Service • Clinical Education & • Policy Development ment and Organisational • Imaging Dental appointments Training • Quality Improvement Performance (IMOP) • Drug & Alcohol • Medical Administrator them in their appointed role. This Program • Hand hygiene rates are above national • Research & Education Initiatives • Business Intelligence • Facilities: to Blue Mountains, has helped to foster enthusiasm and promote • Transport Management. • Clinical Innovation, Development Solutions -- Nepean Springwood and Lithgow benchmark across Nepean Blue Mountains Design & Development. (BIDS) -- Lithgow Portland Hospitals. excellence in health service delivery among Local Health District. • Information Technology -- Blue Mountains all staff and in 2012-2013, 20 per cent of staff Services (hosted). -- Springwood Nepean Hospital Neonatal Intensive Care Unit • Primary Care & • were nominated for an award. Community Health pioneered an Australia-first treatment for the • Networks: • New facilities were commissioned for Oral prevention of a common yet deadly bowel -- Mental Health Health and Incentre Haemodialysis at Nepean -- Oncology. condition among premature babies with a 100 Hospital, and Community Health facilities at per cent success rate. Penrith and St Marys have been refurbished and upgraded.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 6 OUR LOCAL HEALTH DISTRICT our local health district 7

Directorates Clinical Governance Allied Health The role of the Clinical Governance Directorate is to promote and support patient safety and quality of services. The Clinical Governance Directorate includes the Clinical Governance Unit, the Safety Office Service and the Research The Allied Health Directorate is responsible Office and works collaboratively with staff to analyse, maintain and improve patient safety and quality systems for the development, effectiveness, across the District. Clinical Governance provides support for effective identification, investigation, management, efficiency and continuous improvement monitoring and reporting of clinical safety risks and adverse patient events. Clinical Governance also oversees of Allied Health services and staff across incident reporting, complaints handling systems and concerns and complaints regarding clinicians. The Clinical the Local Health District. The Directorate Governance team works collaboratively with and supports clinical staff to ensure rigorous review and audit of provides professional governance patient outcomes with effective uptake of safety initiatives. Clinical Governance provides support and facilitation for and accountability for Allied Health quality improvement activities and accreditation to improve services for patients, families and the community. professionals and functions as the principal reference point for advice on strategic Key achievements for 2012/13: policy and direction issues pertaining to Allied Health. • Clinical Governance hosted the Nepean Blue Mountains Local Health District Quality Key achievements for 2012/13: Awards to celebrate quality and safety initiatives across the District. Eight projects • Introduced a new graduate program that • Successfully implemented high-cost drugs from the Quality Awards were submitted supports the transition of newly qualified Medicare online claiming which provides for the 2013 NSW Health Innovation Awards Allied Health professionals into the workplace a more accurate and up-to-date financial with two projects selected as finalists through structured education, professional reconciliation. in the ‘Healthy Living’ and ‘Excellence in networks and rotations through a variety of • Recruitment of an Antimicrobial Stewardship the Provision of Mental Health Services’ clinical and service settings across the District. Pharmacist for the District whose role is to categories. • Created a Short Term Equipment Service and champion and coordinate the activities of the • Three projects from the Nepean Blue established a new hub for the Service on the District’s Antimicrobial Stewardship Program. Mountains Local Health District Quality Lemongrove Campus. Awards were selected as finalists in the • Ongoing development of Allied Health 2012 NSW Health Awards with the ‘PECC Assistant Workforce in new settings such as Inspirations’ project not only winning their Community Health. category but also taking out the Minister for • Forged a successful partnership with the Mental Health Award. Health Education and Training Institute on • Nepean Blue Mountains Local Health several projects, including clinical supervision District compliance rate for hand hygiene training. was 88% (national hand hygiene audit - • Commenced a District Allied Health training November 2012 to March 2013), well above and education series for Psychology and the 70% benchmark. For more information Physiotherapy. about infection control, see page 52.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 8 OUR LOCAL HEALTH DISTRICT OUR LOCAL HEALTH DISTRICT 9

Finance, Business and Information Media and Communications Key achievements for 2012/13: • Achieved local, national and international The role of the Finance, Business and Information • Strategic Performance and Transport and Fleet The Media and Communications Directorate media coverage for positive media stories; Directorate is to provide services that support the Management teams implemented a vehicle coordinates community engagement strategies, plans established regular columns in local overall planning, allocation, reporting and control of replacement review process to ensure the and leads the promotion of health services, manages publications including the Penrith Press, financial and information management resources to efficient and effective utilisation of our fleet. and monitors media exposure and produces effective the Nepean-Blue Mountains Medicare Local enable Nepean Blue Mountains Local Health District to The team has also continued the rollout of and engaging staff communications. newsletter and the Penrith Valley Chamber of fulfil its statutory functions, to operate within its annual the ‘Smartpool’ vehicle booking system which The Media and Communications team work Commerce newsletter to promote the services allocated budget and to meet information compliance provides improved reporting and vehicle collaboratively to improve community relations by and achievements of the Local Health District and reporting requirements. efficiency data. strengthening existing and developing new strong and advertise important health messages. The Directorate is responsible for budget monitoring • An Information Management and partnerships with media and the community to • Generated proactive media coverage and reporting, revenue performance, cash and creditor Organisational Performance Unit team improve understanding of health services and issues amounting to over 4,300 media clippings management, debt management, management of structure was developed and implementation among the local population. in 2012/13. These clippings came from contracts and procurement activities and processes, of the structure commenced. The structure The Directorate is committed to promoting and an extensive variety of local, national and data management; ensuring effective development, has been designed to provide support in encouraging attitudes and practices that generate international media outlets. collection, storage, access, use, audit and disposal of information and data management, records a positive reputation for the Local Health District in business information and records to support business management, casemix, Activity Based Funding the local community and among people who work in • Coordinated and assisted with a number of processes and clinical care, and providing casemix, and performance analysis. healthcare. The Directorate’s Multimedia team support openings, launches, construction milestones, service achievements and ceremonies across Activity Based Funding and performance analysis • The Financial Operations team completed our clinical care, staff education, patient education, research the District, including the Nepean Centre for and reporting. The Directorate is also responsible for Annual Financial Statements for the 2012/13 and corporate communication through graphic art Oral Health, the Nepean Centre for Robotic developing and providing digital innovation solutions financial year and oversighted a number of and design consultation, photography and video Surgery, the Ronald McDonald Family Room, to support strategic goals through web, application, process improvements. production. dashboard and business information development and headspace Penrith, the inaugural Nepean Blue the provision of salary packaging and fleet management • Revenue staff continued the implementation of Mountains Local Health District Annual Public services. the Local Health District Revenue Strategy and Meeting and the new Nepean Multi-Storey implemented our new revenue billing system. Car Park. Key achievements for 2012/13: • The Contracts and Procurement team • Established a video portal on the NBMLHD completed the development of our leasing • The Business Intelligence Development internet page and a YouTube channel to register which enables our services to review Solutions team worked collaboratively with showcase the District through videos. their costs and to plan for future equipment the Clinical Governance Unit to develop the • The Multimedia team created 25 major video replacements all in alignment with future ‘electronic Quality Audit Tool Exchange’ (eQATE) productions, provided technical support for clinical planning. system based on the Australian Council four major conferences and undertaken 120 • One important success includes the rollout of a of Healthcare Standards EQUIP National graphic design and 56 photographic jobs. new Treasury Rigorous Program Management Standards and National Safety and Quality system that enables the Local Health District Health Service Standards. to better demonstrate its efficiencies and methods for reducing unnecessary costs and increasing revenue.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 10 OUR LOCAL HEALTH DISTRICT 11

Medical Workforce The Medical Workforce Directorate has primary responsibility for recruitment of medical staff in accordance with NSW Ministry of Health and Local Health District By Laws. The Directorate is responsible for the development and implementation of policy related to medical staff recruitment and supports Clinical Operations in the management of medical staff as appropriate. Medical Workforce works closely with the Clinical Governance Unit in the management of complaints or concerns regarding clinicians and the introduction of new technologies and procedures.

Key achievements for 2012/13: • Developed a new process for the alignment of Visiting Medical Officer contract hours to hours worked. This has allowed for the alignment of medical costs and activities with Activity Based Funding and budget. • Developed medical establishment for junior and senior medical staff across the District to allow for more robust management of medical resources with budget and activity targets. • Developed policy, procedure, committee structure and governance processes for the implementation of new procedures and technologies within the District in consultation with the Clinical Governance Unit and Operations Directorate.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 12 OUR LOCAL HEALTH DISTRICT OUR LOCAL HEALTH DISTRICT 13

Nursing and Midwifery • Clinical placement database ‘Clinconnect’ Operations Key achievements for 2012/13: was fully implemented and a permanent full • Robotic surgery commenced at Nepean The Nursing and Midwifery Directorate develops time Clinconnect Support Officer employed The responsibilities of the Directorate of Operations are Hospital in October 2012 as a minimally and implements a framework for continuous quality, to coordinate student compliance checking to plan, establish, manage, develop, monitor and report invasive alternative to radical prostatectomy practice and service improvement whilst safeguarding processes. on all aspects of service delivery and performance high standards of care and encouraging excellence in provided by Nepean Blue Mountains Local Health and cystectomy. A total of 44 patients clinical care. This is achieved through strong clinical • 86 staff trained in ‘DETECT Junior’ – a training District. underwent robotic surgery during 2012/13 governance and support for effective patient flow as strategy for clinicians who work with children. and a reduction of almost one bed day on There are responsibilities also to support the well as appropriate utilisation of hospital care settings The Directorate established a more robust average per patient was seen as a result of this integration of clinical service delivery across all and the development of ambulatory and community DETECT reporting system to determine real new technology. training achievements and remaining gaps. networks and other directorates. This ensures ongoing based health services. • By 30 June 2013 there were no patients 374 Nepean Hospital staff, 131 Blue Mountains development of appropriate models of care, service overdue for surgery across Nepean Blue The Directorate also ensures workforce planning and District Anzac Memorial Hospital/Springwood integration in relation to needs of identified high-risk Mountains Local Health District. In addition, effective strategies are in place that attract, recruit, Hospital staff and 68 Lithgow Hospital staff populations and in response to new policy or service Lithgow Hospital, Blue Mountains District develop and retain quality nursing and midwifery staff have been trained. initiatives. to provide excellent patient care to the community. Anzac Memorial Hospital and Nepean Hospital • This was the first year that NBMLHD facilitated all met the National Elective Surgery Targets The Directorate provides effective leadership to all the Practice Development School with 22 (NEST) for Category 1 and 2 patients. nursing and midwifery professions across the Local participants completing the five-day school. • Reduced wait times for patients being Health District whilst ensuring the development The aim is that this group will continue to admitted to, or discharged from, the Nepean and implementation of the clinical scope of practice come together to reflect on practice and Hospital Emergency Department. When including appropriate standards and professional continue to develop skills that can be used in compared to the previous financial year, an development strategies for both nurses and midwives. their working environment. improvement of almost 10% has been seen at Key achievements for 2012/13: • The ‘TOP 5’ pilot program actively engages Nepean Hospital for the number of patients • An LHD Clinical Training Advisory Group was the carer of a person with dementia to discharged from the department or admitted established to develop a clinical supervision provide five key strategies for health staff to a ward within a four-hour period. which can assist in reducing anxiety for the framework for nurses and midwives, training • The Mental Health Service won two District patient. Through ‘TOP 5’, Nepean Hospital staff 14 new clinical supervisors. Quality Awards for the ‘Wellness Through achieved: • A new online medication administration Work’ program and the ‘Assertive Community training and assessment program for nurses A 25% decrease in average length of stay Treatment Team’. A direct outcome of the and midwives was accessed by 342 nurses and for dementia patients on aged care wards Assertive Community Treatment Team for midwives and completed by 127. A reduction in falls rates in the pilot wards the selected patient cohort was a reduction from 3,022 to 569 bed days and a reduction in • A project with the University of Western between 25%-37% admissions from 75 to 32. Sydney and the University of Sydney A 59% drop in patients requiring one-on- to develop multidisciplinary advanced one care on Ward 3B facilitation and supervision skills trained 59 82% of staff and 63% of carers reported facilitators across medical, nursing, midwifery the program had beneficial effects for and allied health and recruited eight new patients. nursing facilitators.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 14 OUR LOCAL HEALTH DISTRICT OUR LOCAL HEALTH DISTRICT 15

Planning, Strategy and for the District for the 10-year period to 2022. Workforce, People and Culture The Plan includes a wealth of information Epidemiology regarding the District, its population, services Workforce, People and Culture is responsible for providing high-level advice, strategy and assistance The Planning, Strategy and Epidemiology Directorate delivered, service activity levels, service flows in all areas of human resources, industrial relations, leads and facilitates the development of strategic as well as major service developments. recruitment and selection, workforce structure service developments and planning processes across • Developed the Nepean Blue Mountains Local systems and transactions, performance development, Nepean Blue Mountains Local Health District. The Health District Asset Strategic Plan 2013- organisational development, workforce development functions of the Strategy, Planning and Epidemiology 2023. The Asset Strategic Plan outlines the planning, strategic research and projects, operational Directorate include: major capital developments required by the risk management (including management and Leading and facilitating health and related services District for the 10-year period to 2023. The liability), work health and safety, fire safety, workers’ planning and the development of strategic Asset Strategic Plan closely aligns with the compensation and equal employment opportunity. directions for the Local Health District Healthcare Services Plan. This includes application, evaluation and development of Human Resources policy and programs for the Local Leading processes to identify the service and facility • Developed and led the Nepean Blue Health District. development priorities for the Local Health District, Mountains Local Health District Business and supporting their development Planning process for 2013/2014. This process The aim of Workforce, People and Culture is to empower culminated in the release of the Business Plan the LHD workforce to achieve service demands and Providing robust and accessible epidemiological for the Local Health District for 2013/14 which transform the workplace culture by placing staff at the information outlines the vision, organisational goals and forefront of the organisation’s future success. Actively facilitating collaborations with partner key strategies for implementation. Business agencies to support the delivery of high quality Plans were also prepared for each of the major Key achievements for 2012/13: health services from Local Health District facilities. facilities, service streams and Directorates • Developed ‘Road Map for Change’ - a custom- • Developed an effective recruitment across the District. The Business Plans closely Key achievements for 2012/13: designed organisational leadership program advertising schedule which provides a align with the District’s Strategic Plan. developed to address the perennial evolving systematic process to assist the Local Health • Published the inaugural Nepean Blue • Established the Clinical Services Strategic needs of the LHD and empower the workforce District to provide a consistent advertising Mountains Local Health District Strategic Committee, a sub-committee of the Nepean to meet service demands and establish future approach to customers. Plan 2012 to 2017. This inaugural Strategic commercial viability. The purpose of the Blue Mountains Local Health District Board. • Facilitated training and education to enhance Plan outlines the District’s vision, values, program is to address the critical components The role of this Committee is to ensure a management capacity and capability organisational goals and key strategic of effective people management practices and strategic approach is applied to significant to effectively handle workplace issues directions to meet challenges over the five- develop a foundational structure of support and major clinical service developments and further develop understanding of year period to 2017. Drivers of healthcare to enable the achievement of cultural change across the Local Health District. workplace culture and how each individual service delivery, achievements and a reporting and improved team performance. can contribute positively to their team framework are also outlined. • The recent appointment to the Aboriginal environment. This was undertaken through • Developed the inaugural Nepean Blue Workforce Officer has seen an increase in positive workplace culture, effective Mountains Local Health District Healthcare numbers of identified staff (from 35 to 42) communication, crucial conversations and Services Plan 2012 to 2022. This critical through engagement and encouragement. investigative services training. Healthcare Services Plan articulates and prioritises the key clinical service directions

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Our Board Clarke Scott Clarke Scott is the CEO of the National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) and has more than 20 years experience as an Aboriginal Liaison Officer, Board Chair, Patrick Cregan working in the Blue Mountains, Lithgow and Penrith regions. Associate Professor Patrick Cregan is the Chair of the Nepean Blue Mountains Local Health District A Wiradjuri man and Penrith resident, Clarke has had a key role in translating and applying Board and is a specialist surgeon with a major interest in endocrine and endoscopic surgery based Aboriginal and Torres Strait Islander health policy into community contexts and his vision for at Nepean Hospital. effective Aboriginal health is the formation of successful relationships and ongoing community consultation. Clarke has had a key role in a number of innovative local community initiatives, consulting closely with He has served on a number of committees and boards including the NSW Cancer Institute, NSW Aboriginal communities, health services and GPs including the Blue Mountains Aboriginal and Torres Strait Islander Cancer Council, the Royal Australian College of Surgeons NSW State Committee, Wentworth Area Health Coalition and Aboriginal Men’s and Boys’ Cultural Mentoring Camp and Teaching and Learning Circles – the Health Service, NSW Health Clinical Council, the Australasian Medical Simulation Society and the later winning a NSW Health Award for Innovation. listed Medical Technology and Research Company, Medicvision. Patrick was formerly the Chair of the NSW Surgical Services Taskforce from its inception until two years ago. Clarke has a passion for addressing issues impacting quality and sustainable local health services for the Aboriginal community. He is a champion of health equality that aims to close the health and life expectancy gap between Patrick has lived and worked in the lower Blue Mountains and Penrith area for 30 years and has been actively Aboriginal and Torres Strait Islanders and non-Indigenous Australians. involved in the development of health services throughout that period. Colin Lenton Andrew Keegan One of the District’s newest Board Members, Colin Lenton, comes from a diverse and dynamic Andrew Keegan is Adjunct Associate Professor at Sydney Medical School Nepean and has been a professional background - having worked in both accounting and hospitality. consultant gastroenterologist/hepatologist with a private practice in Penrith since 1988. He is also After spending his formative years proudly attending local public schools in the Sutherland Shire, a visiting consultant gastroenterologist/hepatologist at Nepean Hospital. Colin began his professional life in Sydney chartered accountancy firms, studying accounting part- Andrew graduated from the University of Sydney with a Bachelor of Science (Medical) in 1978, a time on the side. He also worked as a Director of the Family First Credit Union where professional Bachelor of Medicine and Bachelor of Surgery in 1980 and PhD in 1994. His PhD was on alcohol- development in the mutual sector occupied him during the first six years. related liver disease. The early 1990’s saw Colin’s professional focus shift to the hospitality industry. Initially Colin served as a hotel owner/ He is a past President of the Australian Medical Association (NSW) and has been a director of a variety of manager and he now works as the current owner/operator of popular tourist attraction Blue Mountains Manor government and non-government, not-for-profit organisations. Andrew has also consulted to government and House alongside his wife of 34 years, Annette. commercial organisations in the healthcare sector. The Blue Mountains local also maintains a keen - yet broad - interest in Boards and Committees having held places He is a Fellow of the Australasian College of Physicians, the American Gastroenterological Association and the on everything from Blue Mountains Tourism to the Blue Mountains Youth Accommodation Support Service. In recent Australian Medical Association. years, Colin has also been invited to Chair and assist in the formation of an educational facility in the city for which On a more personal note, Andrew has lived in the Hawkesbury area with his family since the mid 1990s. His daughter he already consults as a process analyst. has followed in his footsteps and is currently a haematology registrar. Community contribution - in addition to the busy pair’s already extensive inventory of extracurricular activities - has On the sporting front, Andrew has a keen interest in rugby and has been a member of the management committee also always been an integral part of Colin and Annette’s lives. Beginning with P&C’s, they include the establishment of Sydney University’s Rugby Club for more than five years. of a public childcare centre, community association, historical society and pacific micro-banking training and forum in which they have held various positions over the years and continue to do so. Colin and Annette have three children who have all graduated from Charles Sturt University and are currently successfully employed in their chosen fields.

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Gary Smith James Branley Gary Smith has lived and worked in the Nepean/Blue Mountains area for over 30 years, forging James Branley has worked in the public health system since 1987. He is currently the head of the a career in the management of health care facilities and the provision of health services, Medical Division at Nepean Hospital. James is a microbiologist and infectious diseases physician predominately in the General Practice arena. who also heads up the Department of Microbiology and Infectious Diseases at the hospital. He is actively involved in teaching and supporting medical students, post graduate specialist trainees, Gary is a past National and State President of the Australian Association of Practice Managers and infection control nurses. James has for many years assisted Blue Mountains District Anzac (AAPM) and is currently on the National Board and NSW State Committee. He is considered the Memorial Hospital as a general physician. ‘guru’ of practice management in Australia by his peers and is a life member of the AAPM. James holds the rank of Wing Commander with the RAAF specialist reserve. He has been awarded the Australian Gary takes a keen interest and involvement in health reform across Australia and provides advice to the Active Service Medal – for service in East Timor and the Humanitarian Overseas Service Medal for disaster relief after Commonwealth Government on the management of health reform as a member of various working and task the 2004 tsunami. He has a keen interest in supporting developing countries in our region, particularly Papua New groups. Gary is currently a clinical lead with the National eHealth Transition Authority advising them on the roll-out Guinea and Vietnam. James has a strong respect for Aboriginal culture and spirituality and has great knowledge of of the Commonwealth Government’s eHealth agenda in Australia. local Aboriginal history. He also holds Board positions with UNE Partnerships (a commercial arm of University of New England delivering James lives in the Blue Mountains with his family and is interested in rural pursuits particularly food production in education and training), Australian General Practice Accreditation Ltd (the provision of accreditation to General the district. In his spare time he enjoys a rugby league (Panthers) game or two, gardening, cooking and is interested Practice in Australia) and is Chair of Quality Innovation Performance (the provision of quality accreditation programs in Lithgow’s industrial history. consistent with international standards to all sectors of business both in Australia and internationally). He is also a Director of General Workforce Tasmania (the rural workforce agency for Tasmania). As a Board member James advocates for a patient centred approach and has a long term vision for improving local patient care through achieving greater equality with inner city hospitals and better integration with primary care Gary is also an international surveyor for the International Society for Quality in Health Care and travels the world and rural/remote pathology support. assessing Accrediting Organisations, Standards and Surveyor training programs, mainly in the hospital sector.

Gregory Allchin Jennifer Reath Professor Jennifer Reath is the Foundation Chair of the Department of General Practice at the Greg describes himself as a recycled Board member being previously a member of the Wentworth University of Western Sydney. Professor Reath has been a GP in western Sydney for over 20 years, Area Health Service Board in the late 1980’s and 1990’s. working mostly at the Aboriginal Medical Service Western Sydney (formerly Daruk AMS), providing Greg is a director of several family businesses with interests in real estate, property development vocational education in the area of Aboriginal and Torres Strait Islander health. She is currently the and the hospitality industry. He was instrumental in the development of the Nepean Private Deputy Chair of the RACGP National Aboriginal and Torres Strait Islander Health Faculty. Hospital in Barber Ave and the Hospital Specialist Clinic in Derby Street, Kingswood. Professor Reath also works closely with the Patan Academy of Health Sciences (PAHS) in Greg has a special interest in women and children’s health and was the inaugural Chairman of the Kathmandu and is on the PAHS International Advisory Board. The School aims to recruit poor rural students and Australian Women and Children Research Foundation (OZWAC). He also has an interest in mental illness and the enable them to train as doctors through the provision of scholarships and, once qualified, these doctors then return disability sector and is currently a board member of the Australian Foundation for Disability (AFFORD). Greg is also to live and work in their rural communities. Professor Reath, along with some of her GP colleagues, support PAHS the Chairman of the Penrith Business Alliance – Health and Education Precinct Development Committee and is very through www.nepalhealthscholarships.org.au passionate about growing and enhancing the health and education sector in the Penrith region. When it comes to rest and relaxation, Professor Reath says she enjoys heading out for bush walks in the Blue Greg brings a wealth of knowledge to the board in the areas of business and developing partnerships between Mountains where she has lived for the past 20 years, but a recent addition to the family also keeps her busy. “My the private and public sector. He is also a good community advocate growing up and still residing in the Penrith/ greatest current distraction and joy is my granddaughter, Maggie,” Professor Reath added. Hawkesbury area. Greg is married with three grown up daughters and two grandchildren. His hobbies include Professor Reath aims to connect the Local Health District with primary healthcare providers and to work across both photography, target shooting, fly fishing and the breeding and showing of Western Horses. sectors to improve health outcomes in Sydney’s west.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 20 OUR LOCAL HEALTH DISTRICT OUR LOCAL HEALTH DISTRICT 21

Jill McCarthy Michael Peek Nepean Hospital Perioperative Nurse Manager Jill McCarthy is the newest District Board Member. Professor Michael Peek has worked in the public health system for over 25 years and is Associate Dean and Head of School at Sydney Medical School Nepean, one of the seven clinical schools Jill has been employed as a Registered Nurse in the Operating Suite at Nepean Hospital since of the University of Sydney. The University of Sydney and Nepean Hospital have worked in March 1987 and took on the role of Perioperative Nurse Manager in November 2008. Having lived partnership since 1990 when Nepean Hospital became a teaching hospital of the University. in the local area for 27 years, Jill has an ‘ear to the ground’ for local consumer issues and a keen desire to advocate for healthcare consumers across the District. The Local Health District continues to benefit from this partnership through research and education from University of Sydney academics while University of Sydney students benefit from “Over the course of the past 27 years, I have seen and been part of many changes throughout the the hands-on training experience provided at Nepean Hospital. organisation. Nepean Hospital’s footprint has grown considerably and I have had the privilege of watching it evolve from a tiny district hospital into the impressive teaching hospital it is today,” Jill explained. “The University of Sydney works well with the Nepean Blue Mountains Local Health District to develop and deliver ongoing state-of-the-art clinical care through education, research and clinical service,” Professor Michael Peek said. Jill also had the opportunity to be actively involved in the recent planning and building of East Block as part of the Nepean Hospital campus redevelopment. Michael is an obstetrician who specialises in maternal fetal medicine who treats women with medical disorders in pregnancy and fetal problems. Michael leads an active research and education group in these areas. “I was recently afforded the opportunity to be actively involved in the planning stages and subsequent building of East Block; the six state-of-the-art operating rooms, including one hybrid imaging room, and a twenty-six bed post- Under Professor Peek’s guidance, Sydney Medical School Nepean has grown to now educate over 200 medical anaesthesia care unit, which was an incredible experience for me,” Jill said. “Seeing it come to life and benefit our students each year, a large increase in research outputs and has gained new infrastructure. patients every day is very rewarding.” Jill lives locally with her husband and two children. He lives in Windsor with his wife and four children and is involved in local sport and community research foundations. Joseph Grassi Within two years of graduating and practicing as a solicitor in Sydney’s CBD, Joe Grassi joined Tanya Gadiel Penrith legal firm, Lamrocks, Solicitors & Attorneys in 1979 and within just twelve months he was Tanya Gadiel is the CEO of Community Services at Parramatta Mission, an organisation invited to become a partner of that firm. that provides accommodation and food services for people who are homeless or at risk of Penrith has been home to Joe, his wife Lois and three children since his move from Petersham homelessness across western Sydney. in 1986. Working in the law has constantly inspired his lifelong interest in improving community In this role Tanya is responsible for the leadership of the Community Services team whose affairs and a desire to see the area prosper. His many roles have included being a member of the operations include a domestic violence refuge, men’s crisis accommodation, a youth refuge, as former Sydney West Area Health Service Research and Ethics Committee as well as being a member of the AustLaw well as a kitchen that serves 40,000 meals per year. Her passion is for being pro-active in addressing executive committee and a Director of Syd-West Personnel Pty. Ltd. human suffering and the unmet needs of the most vulnerable in our community. In 2000, Joe completed a Master of Laws degree at the University of Western Sydney to enhance his legal Prior to this, Tanya was elected to NSW Parliament in 2003 serving as the Member for Parramatta, until she retired knowledge. When Lamrocks incorporated in 2006, Joe became a director and headed the company’s Property, from the role in 2011. During this time she held the position of Deputy Speaker, Parliamentary Secretary for Police Commercial and Revenue Law Division. He has been an Accredited Specialist in Property Law since 1995, a Notary and Parliamentary Secretary assisting the Premier on Veterans Affairs. She was also a member of the Parliamentary Public since 2004 and he has served as a member of the Property Law Committee of the Law Society of New South Committee on the Health Care Complaints Commission. Wales for a number of years. Joe is a member of the Law Society of New South Wales and a Fellow of the Australian and New Zealand College of Notaries. In 2008, Joe resigned from Lamrocks and established his own legal firm, Tanya is a strong community advocate with a keen interest in the public healthcare system. She is committed to Joseph Grassi + Associates. In addition to running his own practice, in 2012, Joe took on another legal practice and workplace culture and organisational change that enables excellence in service delivery, and is on the NBMLHD became Solicitor Director of Peter Winters & Co, Solicitors. Workforce Organisational Development Committee. Joe continues to be involved in the community as Vice President of the Penrith Valley Chamber of Commerce and Tanya grew up in regional New South Wales and obtained a Bachelor of Arts/ Bachelor of Laws degree from the Industry Inc. and Chairman of the United Way Penrith Community Fund. University of New England Armidale, and has two daughters. In her spare time she enjoys travelling and scuba diving.

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Board Sub Committees Medical and Dental Appointments Work Health and Safety Committee Advisory Committee The Work Health and Safety Development Committee The Medical and Dental Appointments Advisory monitor, review and make recommendations to the Audit and Risk Management Finance and Performance Board in relation to the District’s health and safety Committee (MDAAC) is a Committee established Committee Committee systems compliance and governance, including under the District Bylaws to provide advice to the the LHD’s risk management systems to ensure that The Audit and Risk Management Committee aims The Finance and Performance Committee aims to Chief Executive regarding new Senior Medical and incidents, hazards and risks are identified and reported; to provide independent assistance and advice to monitor the expenses and revenues to budgets of Dental Staff appointments. In addition, the Credentials the action taken in response to such matters; the the Board and Chief Executive by overseeing and Nepean Blue Mountains Local Health District. The Subcommittee of the MDAAC considers and advises the adequacy, monitoring and update of these systems; monitoring Nepean Blue Mountains Local Health Finance and Performance Committee also reviews Chief Executive on the granting of Clinical Privileges to Work Health and Safety and risk management KPIs in District’s governance, risk and control frameworks and exposure to finance risks and the extent to which individual senior medical and dental staff. performance agreements and annual performance its external accountability requirements. they are being effectively managed. The Finance and reviews with the Chief Executive; the allocation of Performance Committee monitors approved Capital Research and Education Committee appropriate resources for the management of Work program and reviews letters to management from the Health and Safety issues; and reporting of Work Health The Research and Education Governance Committee Clinical Services Strategic Auditor-General, Minister for Health and NSW Health and Safety and Risk Management data and information aims to create an environment in which staff are Committee relating to significant financial matters. to the Board. encouraged to become self-directed learners, creative The Clinical Services Strategic Committee aims to problem-solvers, including research and skilled, ensure a strategic approach is applied to significant Workplace Culture and Health Care Quality Committee competent and effective team members, who can adapt and major clinical service developments across the positively to meet rapidly changing patient care and Organisational Development Nepean Blue Mountains Local Health District. The The Health Care Quality Committee is the peak safety service delivery needs. Committee functions of the Committee include overseeing the and quality committee that monitors the quality The Workplace Culture and Organisational strategic development of significant and major clinical and safety of health care and services provided by Development Committee aims to enable the service developments across NBMLHD, determining Nepean Blue Mountains Local Health District to ensure development of an organisational culture that supports continuous improvement in the quality of health priorities and coordinating and monitoring their the aims and objectives of the Nepean Blue Mountains care and service provision. The Health Care Quality implementation. The role of the Committee also Local Health District consistent with the Workplace includes the management of risks associated with Committee advises the Nepean Blue Mountains Local Culture Framework and CORE values (Collaboration, adjustments to strategic priorities and ensuring the use Health District Board of any issues of concern in relation Openness, Respect and Empowerment) of the Ministry of Ministry of Health/ NSW Treasury planning processes to the quality and safety of health care and services of Health. with appropriate representation on project governance provided within the Local Health District. structures.

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Vision and Values CORE Values decisions are based on clear information about what works best, side effects and where and when treatment Collaboration is available. Acknowledging that for empowerment Nepean Blue Mountains Local Health District to work, there must be trust on all sides and at all Accepting that everyone from the Minister to the will drive innovation and excellence in health levels, from the Minister, the Department, hospital patient, from the ward orderly to the Director-General, service delivery that provides safe, equitable, administrators and care providers – doctors, nurses, from the most skilful surgeon, the most inspiring high quality, accessible, timely and efficient allied health professionals, tradespeople, contractors, researcher, the most caring nurse to the most dedicated services that are responsive to the needs of carers and volunteers. record keeper, from the Hospital General Manager to patients and the community. the flat-out paramedic, from the public to the private SAFE Values sector, that we are all part of one team in one health CORE: Organisational Goals for NBMLHD system. Safety The NSW Health values of CORE and the Nepean Blue Openness Committed to providing superior performance in a Collaboration Mountains Local Health District values of SAFE underpin proactive framework and building a strong employee all planning processes and health service delivery. Ensuring that facts are on the table and allowed to culture where safety is everyone’s responsibility. penness O speak for themselves, no matter how embarrassing or The three organisational goals of the Nepean Blue uncomfortable they may sometimes be. Our processes Respect Mountains Local Health District are: Agility and responsiveness must be transparent. People have a right to know how Innovative healthcare provision needs to be agile Empowerment and why decisions are made, and who is making them. • Improving population health (inequalities and responsive to the views and concerns of the We also need to be upfront about what it costs to and localities) community, supported by information about the SAFE: deliver world-best health care. • Enhancing the patient experience (clinical characteristics of the population, research and emerging healthcare practices. Safety quality, access and safety) Respect • Living within our means (service and Agility Insisting that everyone engaged in providing health Fairness and Equity financial performance). care has a valued role; that there is no single source of airness We are committed to the provision of fair and equal F wisdom and that listening is as important as talking. It should be noted that no one goal is more important access to healthcare for all of our community, including xcellence Acknowledging that everyone can make a contribution E than another and all three must be practised the development and delivery of programs to redress and should be given the opportunity to contribute, simultaneously. inequalities in minority and other disadvantaged especially to a process of continuous improvement. See next page for definitions population groups including refugees, Aboriginal and Within a respectful health care system, we are able to Torres Strait Islanders and Culturally and Linguistically give real meaning to the concept of accountability to Diverse families. our patients. Excellence Empowerment Striving to be at the forefront of healthcare innovation Enabling patients to take as much control as they involves pursuing excellence in everything we do. desire of decisions with regard to their own health care in collaboration with care providers. Ensuring that

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 26 OUR COMMUNITY OUR COMMUNITY 27

Population Geography and Boundaries The hospitals in Nepean Blue Mountains Local Health District are Nepean Hospital, Blue Mountains District Anzac Memorial Hospital, Springwood Hospital, Lithgow Hospital and Portland Tabulam Health Centre (as shown in The estimated residential population of NBMLHD in 2011 was 336,920 residents. In 2011, NBMLHD had a younger Figure 4). Hawkesbury Hospital (for public patients) is operated under contract with Hawkesbury District Health population with 7.1% of the NBMLHD population aged under 5 years and 7.7% aged over 70 years compared with Service, as part of Catholic Health Care. Community Health Centres are located throughout the locality. The Nepean NSW (6.6% and 10.3%, respectively). Blue Mountains Local Health District consists of both urban and semi-rural areas, covering almost 9,179 square Aboriginal residents comprised 2.7% of the NBMLHD population compared with 2.5% of the NSW population. kilometres. NBMLHD Aboriginal population had a younger population with lower proportions of residents aged over 70 years than the NBMLHD non-Aboriginal population. Overseas born residents made up 22% of the NBMLHD population compared with 31.4% of the NSW population. The percentage of overseas born NBMLHD residents who do not speak English well or at all (4.4%) was lower than for NSW (12%). In the 2011 Census, NBMLHD had lower levels of disadvantage than NSW, with more families with income greater than $600 per week, dwellings with motor vehicles and employed in the labour force. NBMLHD, however, had lower levels of education and professionals in the workforce than NSW.

Demographics of NBMLHD population, 2011 Census Area Population (i) Births Aged<5 Aged>70 Median age Aboriginal Born SEFA of years years (ii) overseas Disadvantage Penrith 178,466 2,880 7.6% 6.2% 33.8yrs 3.0% 25.7% 996 Blue Mountains 75,941 882 6.2% 10.4% 41.8yrs 1.7% 22% 1039 Hawkesbury 62,353 884 6.8% 7.6% 36.2yrs 2.6% 17.8% 1020 Lithgow 20,161 256 6.3% 12.1% 42.1yrs 4.5% 15.2% 924 NBMLHD 336,920 4,902 7.1% 7.7% n/a 2.7% 22% n/a NSW 6,917,660 99,054 6.6% 10.3% 38yrs 2.5% 31.4% n/a

Source: 2011 Census, ABS data used with permission from the Australian Bureau of Statistics (http://www.abs.gov.au/). Note: (i) Based on usual residence. (ii) Aboriginal persons comprised of Aboriginal, Torres Strait Islanders and both Aboriginal and Torres Strait Islanders.

Hospitals and Community Health Centres in Nepean Blue Mountains Local Health District

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A Year of Activity in Nepean Blue Mountains Local Health District Consumer Consultation Our Partners Consumer feedback enables us to improve our services Nepean Blue Mountains Local Health District has a in order to provide the highest quality care to our number of partners such as city councils, community patients. Nepean-Blue Mountains Local Health District, and non-government organisations, education 109,528 Research Activity in partnership with the Nepean Blue Mountains providers and other health providers who broadly assist presentations 76 ethic approvals Medicare Local, conducted eight consumer forums in the District in the delivery of locally focused healthcare. to emergency 2012/13. The forums provided feedback on a variety of 122 peer reviewed For example, some of these partners include: departments health and medical services, including: publications • TAFE NSW - Western Sydney Institute • Transport and parking • University of Notre Dame • Availability of health services • University of Sydney • Aged care • University of Technology Sydney • Carer support • University of Western Sydney 69,383 • Mental health. admissions 4,064 Non Government Organisations: to hospital A year’s deliveries Consumer working groups for each Local Government activity in in NBMLHD Area will be formed in 2013/14 to address feedback • Substance.Org NBMLHD hospitals from the consumer forums. • Richmond PRA • Hawkesbury Community Transport • Family Planning NSW • Blue Mountains Women’s Health & Resource Centre • Barnardos • Aboriginal Medical Services 19,643 1,247,348m • Penrith Women’s Health Centre elective and community and 10,609 outpatient occasions of • GREAT Community Transport emergency surgical service • Catholic Care Social Services procedures • Blue Mountains Palliative Support Services • We Help Ourselves (WHOS) • Salvation Army

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Blue Mountains and Springwood Hospitals Blue Mountains District Anzac Memorial Hospital

Staphylococcus aureus infections at Blue Mountains District Anzac Memorial Hospital. Hand hygiene rates are also at 87.4%, well above the national benchmark of 70%. Nepean-Blue Mountains Medicare Local • Close links with the community, including The Nepean-Blue Mountains Medicare Local has reached highly involved fundraising groups and levels of excellence working in partnership with Nepean Blue volunteers. Mountains Local Health District. This partnership is testament • Blue Mountains District Anzac Memorial to the commitment, at a Board and Executive level, toward Blue Mountains District Anzac Memorial Hospital Hospital staff claimed three Nepean Blue delivering quality health services and addressing local health provides a range of general inpatient services Mountains Local Health District Quality needs. including emergency, general medicine and surgery, Awards, including ‘Healthy Living’ for the Commitment at a strategic level has facilitated joint initiatives such as: close observation unit, obstetrics and gynaecology, Blue Mountains District Anzac Memorial Hospital/Springwood Hospital Reconciliation • A consumer engagement strategy that focuses on the establishment of a governance structure paediatrics, and geriatrics, rehabilitation and palliative Committee; ‘Collaborative Team’ for the Child where the Consumer Advisory Committee, whose members will represent each of the four Local care services, on-site pathology, medical imaging and and Adolescent Development Unit and ‘Highly Government areas of Lithgow, the Hawkesbury, the Blue Mountains and Nepean, reports directly pharmacy, as well as a wide range of allied health Commended’ for the Blue Mountains DETECT to the Boards of both organisations. services such as occupational therapy, physiotherapy, speech pathology, nutrition and dietetics and social Program team. • A joint Board annual planning meeting to determine and agree on areas of joint priority work. Outpatient clinics and services at the hospital A Reconciliation Day Community Forum was and measurements of improvement. This commitment and partnership is strengthened and • include hydrotherapy, physiotherapy, dental, antenatal, held to share information about services supported by each of the Chief Executives of the organisations reporting to each others’ Boards. psychiatry, drug and alcohol and sexual health. available in the community and in the Work on shared priorities includes aged care, mental health including ‘Partners in Recovery’ and hospital. There were over 50 attendees from ‘headspace’, access to General Practice care after hours, chronic disease management including Key achievements for 2012/13: community organisations who have a focus ‘Connecting Care’, the establishment of a ‘HealthOne’, eHealth and health promotion initiatives. • Excellent elective surgery waiting times, with on Aboriginal Health services. The forum • Establishing key strategic positions that work across both settings to address key issues of ‘Triple Zero’ maintained. concluded with a question and answer communication and integration, comprehensive data access to understand fully the health • Achieved National Emergency Access session and was deemed a huge success by landscape and workforce planning strategies across the District. Targets of greater than 70% of Emergency community and hospital participants. Department patients discharged or admitted • A Reconciliation Day renaming of the from Emergency within four hours. Maternity Ward to its original name, ‘Koorana’. • High patient satisfaction with services with • Redeveloped the bathrooms in the 101 appreciations received. Rehabilitation Ward and the kitchen and • The most recent monthly Staphylococcus bathroom areas in staff accommodation. aureus infection report revealed zero.

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Springwood Hospital Hawkesbury District Health Service Lithgow Hospital and Portland Tabulam Health Centre A successful public-private partnership with the NSW • The Lithgow Ambulatory Chemotherapy Government, Hawkesbury District Health Service Lithgow Hospital Service (LACS) has had 518 presentations provides public and private healthcare services in during the 2012/13 financial year. This Sydney’s north-west. Hawkesbury District Health satellite service provides local residents with Service is a 125-bed facility in Windsor, offering 24-hour local chemotherapy treatment and related emergency care, medical, surgical, maternity, neonatal, therapies. This has been achieved by training paediatric, palliative, intensive and coronary inpatient two Registered Nurses from Lithgow Hospital care, as well as diagnostic services and a wide range of to administer chemotherapy and supportive community and Allied Health services. therapies at LACS. Since its inception in Springwood Hospital provides a range of services for Key achievements for 2012/13: August 2011, the service has grown to two low-risk medical and surgical patients including geriatric, • Zero overdue waiting lists achieved for 30, 90 days per week with an increased range of rehabilitation and palliative care patients. Allied Health drugs being administered. There are plans to and 365 day categories. Lithgow Integrated Health Service is a multi-facility services are available to both inpatients and outpatients. train more nurses to accommodate growth. campus comprising Lithgow Hospital, Lithgow The Hospital’s primary catchment is the Blue Mountains • Surgeons, operating theatre staff, surgical Community Health Centre, a small private hospital Local Government Area in which it is located, although support and administration teams provided and a residential aged-care facility. Lithgow Hospital Notre Dame Rural Clinical School surgical patients come from a broader catchment. exceptional care during a sustained period of was commissioned in 1999 and provides 24-hour high demand. The Notre Dame Lithgow Rural Clinical School, based emergency service, paediatrics, maternity, a satellite Key achievements for 2012/13: at Lithgow Hospital, is one of seven clinical schools • Pre-Admission Clinic Expansion: A chemotherapy service, low-risk surgery and general Excellent elective surgery waiting times, with of the University of Notre Dame Australia. The school • collaborative clinical program delivered by medicine, with on-call medical services. Inpatient ‘Triple Zero’ maintained. hosts about 40 students each year with six permanent medical officers, nurses, a discharge planner, services are delivered under a Visiting Medical Officer/ students for the entire academic year and four students High patient satisfaction with services with 101 occupational therapists and physiotherapists General Practitioner model of care with the capacity to • who rotate from Sydney each month. These students appreciations received. offers pre-booked surgical patients support, manage lower complexity patients who do not require are immersed in all aspects of hospital and community clinical assessment and education prior to sub-specialty care. • The most recent monthly Staphylococcus admission, and assessment of their home medicine and given the opportunity to explore the aureus infection report revealed zero environment in preparation for discharge. Key achievements for 2012/13: multifaceted dimensions of rural medicine including Staphylococcus aureus infections at daily ward rounds, General Practice attachments, Reduced the physiotherapy wait list for post- Springwood Hospital. Hand hygiene rates • Companion Observer Program: A volunteer • palliative care, surgery, anaesthetics and maternity care. surgical clients to zero, as well as markedly were also at 90.8%, well above the national support program aimed at improving the reducing the wait lists for musculoskeletal Construction commenced on the $4.8 million clinical benchmark of 70%. physical, psychological and nutritional wellbeing of patients in hospital. The outpatients and aquatic PT clients. This is school building in early 2012 and the building opened • Close links with the community, including Companion Observer Program has specially due to Allied Health Therapy Assistants now on 22 March 2013. It now boasts staff and admin offices, a highly involved Auxiliary that raises funds trained Hawkesbury Hospital Auxiliary working in expanded clinical roles across common study areas, consulting rooms, research for the hospital with ‘Friends of Springwood volunteers sitting and interacting with Physiotherapy, Occupational Therapy and spaces, training spaces, a 110-seat lecture theatre, four Hospital’ who advocate for the hospital on the patients, especially frail patients, who may Speech Pathology; performing all routine bedrooms with ensuite accommodation and a shared community’s behalf. be alone and whose wellbeing would be mobilisations on the wards and carrying kitchen/dining/living area. Each year the School hosts a rural medicine conference in March and a trauma • The Blue Mountains/Springwood Hospital improved by having a companion present. client loads in hydrotherapy, paediatrics and conference in August. Reconciliation Committee received a NBMLHD outpatient rehabilitation. Quality Award in the ‘Healthy Living’ category.

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Portland Tabulam Health Centre Nepean Hospital indicator throughout 2012/13 despite substantial increases in both ambulance presentations and general presentations to the ED throughout the year. Nepean continues to perform as one of the best performing A1 hospitals in NSW in this area. • Successful implementation of robotic surgery for urology patients, improving patient safety and efficiency of urological surgery. • Acute Geriatrics continued to develop a range Nepean Hospital is a major tertiary referral hospital of strategies to facilitate admissions within Opened in December 2006, Portland Tabulam Health Centre is a multipurpose facility that combined the services for the Nepean Blue Mountains Local Health District four hours through the ED to enable their from Portland Hospital and the Tabulam Cottages Aged Care Hostel on the one site. Portland Tabulam Health Centre and, beyond that, provides high-level inpatient and achievement of NEAT KPIs. now provides four subacute care beds, low-level residential aged care with bedding in place for 22 residents, a co- outpatient services for people of all ages. Inpatient • Established the Renal Ambulatory Clinic, located GP practice and a comprehensive range of community and primary care services. The primary care services services generally have the capacity to manage high providing improved access to day treatment include Chronic and Complex community care, Women’s and Children’s Health. complexity patients who require specialist care. and outpatient services for renal patients in Services provided include emergency, critical care, the state-of-the-art InCentre Renal Unit at Key achievements for 2012/13: acute medicine, planned and emergency surgery, Nepean Hospital. • Maintained a high standard of care throughout the year. maternity, neonatal, paediatric medicine and minor Review and restructure of ward allocation by surgery, mental health, aged care and rehabilitation • • Provided a new sunroom for residents to relax in and enjoy. specialty, enabling clinical specialties to be services, drug and alcohol, and a broad range of home-based. This home-based model of care • Provided quality entertainment for residents throughout the year. specialist outpatient clinics and services. realigns patient specialties and includes the Key achievements for 2012/13: ability to surge beds on specialty wards to meet service requirements. • Substantial improvement in National Emergency Access Target (NEAT) performance • Introduced a Post-operative and Emergency with the implementation of new strategies to Transition Environment (PETE) for surgical improve performance in both the discharge of patients identified for discharge. These patients from the Emergency Department (ED) patients are transitioned to the PETE for and the admission of patients to the ED. completion of care prior to discharge. PETE also provides an environment that facilitates • Significantly improved triage performance timely access to acute inpatient beds for indicators throughout 2012/13 patients admitted via the ED as well as notwithstanding substantial increases in elective surgical patients. The PETE model has presentations to ED throughout the year. enabled surgical specialties to improve their Nepean continues to be one of the best efficiency of patient flow. performing A1 hospitals in NSW in this area. • Implemented the ‘Birthrate Plus’ staffing • Maintenance of significantly improved model at Nepean Hospital to provide a Ambulance Transfer of Care performance

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maternity services nursing profile based on a • The Nepean Occupational Therapy Aboriginal Health Key achievements for 2012/13: NSW Ministry of Health-supported framework. Department participated in ‘HOME’ - a • The re-establishment of the Aboriginal Health A robust Maternity Services recruitment multi-site National Health and Medical The Nepean Blue Mountains Local Health District Unit in Nepean Blue Mountains Local Health strategy, in consultation with the Local Research Centre funded trial which aims to Aboriginal Health Unit has been established to operate District with three staff members relocated Health District, was developed to fill existing examine the effects of occupational therapy as the key driver in addressing the health needs and from Western Sydney Local Health District and vacancies and is currently underway. discharge planning practices for older people issues of the Aboriginal population across the District. three new staff members recruited. transitioning from hospital to home. To date The Aboriginal Health Unit works in partnership • Participated in the Ministry of Health ‘Whole the trial is progressing well. with the Aboriginal community, other Nepean • The ‘Mootang Tarimi’ Outreach Screening of Hospital Program’ (WoHP), providing Blue Mountains Local Health District services and Service has recruited new staff and is collaboration between health services, the departments, the Nepean-Blue Mountains Medicare continuing to provide services across Ministry of Health and other agencies to Local, the Aboriginal Medical Service Western Sydney Nepean Blue Mountains and Western Sydney align local effort with available support. The Nepean Clinical School and other non-government organisations to strive for Local Health Districts. Screening has been program aims to simplify care pathways for The Nepean Clinical School, based at Nepean Hospital, the delivery of clinical services and population health conducted at 13 locations across Western the patient journey to ensure timely, safe and is one of the eight Clinical Schools of the University activities within a holistic health paradigm. Sydney and the Nepean and Blue Mountains efficient care. of Sydney. Since becoming a teaching hospital of the areas, and 84 clients were screened between University of Sydney In 1990, Nepean Hospital has • Commissioned the state-of-the-art Intensive June and August 2013. experienced continued growth in its teaching and Care Education Training Centre (ICET) which research. • The NAIDOC Week health tent at Jamison provides world-best training for students Park on July 2012 attracted record numbers through simulated learning. The School presently supports around 50 students in of participants, providing health education, each of the four years of the course. With its relatively • Implemented ‘Intensys’ - a clinical information opportunistic screening and immunisation to high patient load in comparison to the student system that serves as the electronic medical attendees. population, Nepean Clinical School is able to provide record for patient management in the invaluable learning opportunities for attending medical • The Aboriginal Health Unit, along with Intensive Care Unit (ICU). students and research opportunities for Australian Western Sydney Local Health District’s • Commissioned two additional ICU beds and International students in biomedical, clinical and Health Promotion team and Muru Mittigar through additional enhancement funding. epidemiological research across all disciplines. Cultural Resources Centre are continuing • Speech Pathology and Physiotherapy, in a pilot Healthy Workers’ program. This is a collaborative research project comprising 30 partnership with the ICU, implemented The new Clinical School Building opened in May employees in total. Focus testing, as well as Agency for Clinical Innovation 2012 and provides first-class educational facilities information from the focus groups, will inform recommendations for tracheostomy care for students and staff. The new clinic areas operate the activities that will run over the next 12 to improve management of tracheostomy alongside NBMLHD and provide additional, high months. patients after transfer to the ward quality outpatient services to the local community from Intensive Care. A multidisciplinary in an educational setting. Future plans will see the tracheostomy review team has been School as pivotal for further education and research established to facilitate better nursing projects including applications for specialist training education about ward tracheostomy positions. The clinics will be linked via telemedicine to management, improve communication all major hospitals between Nepean and Dubbo thus between consulting services, improve safety providing opportunities for services to the District’s of tracheostomy removal, facilitate medical rural neighbours within a framework of education and consultation and develop service’s key research. performance indicators. Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 38 OUR HEALTH SERVICES OUR HEALTH SERVICES 39

Cancer Care Key achievements for 2012/13: Drug and Alcohol • The Drug and Alcohol Health Promotion team provided drug and alcohol information to over • Nepean Cancer Care Centre staff participated In 2012-13, staff at Nepean Cancer Care Centre saw over The Drug and Alcohol Service provides care in the 920 people in the community regarding the in Dry July, raising over $130,000 in 2012- 2,600 new patients. There were over 46,500 occasions management of alcohol and drug problems for health effects of substance misuse and how to 2013. Together with previous years’ donations, of service for consultations and treatments and with individuals, families and community organisations access treatment services. 12 chemotherapy chairs, two special procedure rooms the team was able to use this money to open a across NBMLHD. The District’s priorities are to provide • Implemented a social marketing campaign in and state-of-the-art radiotherapy equipment, staff patient garden, provide new patient amenities equitable services to all members of the community Lithgow - ‘Think consequences...don’t supply have delivered close to 20,000 chemotherapy and for areas of the hospital and refurbish a ‘quiet including marginalised groups, and to provide access alcohol to under 18s’ which helped educate radiotherapy treatments. room’ for the family members of palliative care to all levels of service from population-based strategies parents about the adverse social and health patients. designed to prevent substance abuse in the first The Nepean Cancer Care Centre falls under the consequences associated with underage • The Radiation Oncology team commissioned instance; to outpatient individual and group programs Sydney West Cancer Network - a network of senior drinking. The messages were aired on 2LT two new radiotherapy machines equipped and inpatient detoxification services to help those with clinicians across two Local Health Districts offering radio and evaluations indicated that 40% of with cutting-edge technology - using these severe dependence issues. expertise needed to treat patients with cancer (with people surveyed heard the campaign up to 10 new machines, medical physicists at the the exceptions of paediatric medical oncology and The Service provides inpatient and outpatient times and 85% could recall the key messages. orthopaedic surgery for primary bone tumours). Centre have developed a new, state-of-the- detoxification treatment, opioid treatment services, • Created a service level agreement with art treatment technique for lung and spinal hepatitis C screening and treatment, alcohol clinic, Clinical Departments at Nepean Hospital include headspace Penrith (through Uniting Care cancer patients which is already proving specialist psychology services, community counselling, clinical haematology, familial cancer, medical oncology, Mental Health) to enhance access to services highly effective. Magistrates Early Referral Into Treatment Program, palliative care, psycho-oncology, radiation oncology and enable continuity of care for young • The Nepean Cancer Care Centre Allied Health Adult Drug Court, adolescent services, drug use in and cancer-specific allied health services. In adjunct people in the areas of mental health, drug and team claimed a highly commended certificate pregnancy services, consultation liaison and population to these departments, the Nepean teams have strong alcohol and primary care. health services. surgical oncology representation within the following at the NBMLHD 2013 Quality Awards in the • Placed high priority on improving access and tumour groups: lung, melanoma and skin cancers, ‘Collaborative Team’ category. The same Key achievements for 2012/13: initiated a Drug and Alcohol Drop-In Clinic at sarcoma, urology, lower GIT, gynae-oncology and head team was also successful in gaining grants Penrith Community Health Centre resulting in and neck cancer. from the Cancer Institute to continue with a • Provided services to 3,346 patients and quality improvement project that explores provided 104,383 occasions of service, a 150% increase in occasions of service. opportunities to improve the health of head representing a 1.6% increase in occasions of • Commenced an outpatient substance and neck cancer patients and to better service from previous year. abuse relapse prevention group at Penrith performance reporting for pharmacy. • 38% of patients attending the Gateway Community Health Centre which provided • The Nepean Cancer Care Centre Opioid Treatment Clinic received influenza increased accessibility for single parents and Chemotherapy Nursing Team continues to vaccinations in a project targeting a families during school hours. provide support for nursing colleagues at vulnerable, high-risk population. • Strengthened Drug and Alcohol consumer Lithgow Hospital, thereby enabling a local • Implemented clinical redesign processes for representation and forged strong links with treatment service for residents of Lithgow. the inpatient detoxification unit, achieving the Medicare Local Consumer Engagement increased occupancy, reduction in waiting Committee to support consumers. time, a 50% reduction in aggressive incidents, • Youth Drug and Alcohol staff participated in 96% of discharges reviewed and 100% of projects aimed at increasing young people’s patients were assessed within five days knowledge of the effects of binge drinking, of first contact and commenced inpatient including a ‘Curiousworks’ film and the educational group programs. ‘iDrinksmart’ initiative.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 40 OUR HEALTH SERVICES OUR HEALTH SERVICES 41

Mental Health • An Assertive Community Treatment Team was Multicultural Health • Developed a Refugee Health Implementation established in the Nepean area, changing the Plan to improve health, access and service Nepean Blue Mountains Local Health District Mental role and responsibilities of an existing team. There are 49,302 people who speak a language other delivery for refugee and humanitarian Health services comprise inpatient and community The intensive support and care provided than English residing across Nepean Blue Mountains entrants settling in the District. An official based services covering a spectrum of acute inpatient has enabled consumers to manage their Local Health District, accounting for 14.6% of the launch of the plan was held on World Refugee care to recovery across the lifespan. These services are mental health problems in the community, population. In 2012-13 this number has grown with the Day (20 June 2013) and attended by local delivered from facilities across the Local Health District, significantly reducing presentations to the settlement of refugees and humanitarian entrants who refugee communities, non-government including inpatient units at Nepean Hospital (Pialla) and Emergency Department, length of stay have fled situations of war, violence, persecution and organisations, local press and health staff. A Blue Mountains District Anzac Memorial Hospital. when they are admitted and readmissions to abuse of human rights. refugee health forum for service providers to Key achievements for 2012/13: hospital. This initiative won the NBMLHD 2013 The role of Multicultural Health is to improve the discuss service delivery issues is identified as a Quality Award in the ‘Patients As Partners’ capacity of the Local Health District to identify and priority activity. • Conducted a service-wide review of models of category and is a finalist in the NSW Health meet the specific cultural, religious and linguistic needs care and implemented new models of care at • Developed a partnership with the Medicare Innovation Awards 2013. of its diverse population and address health inequities; Pialla and the Blue Mountains Mental Health Local and Arthritis NSW to develop a pilot provide strategic direction, consultancy, workforce Unit. The service is aligning with recovery • Two consumer representatives conducted a ‘Moving On’ program with CALD communities development, project development and liaison with based principles and contemporary practice 10-week ‘Well-Ways’ Program for consumers across the District. The program is a generic respect to healthcare for Culturally and Linguistically in mental healthcare; in the inpatient units, of mental health services. Staff have received chronic disease self-management program Diverse communities in the Local Health District;work this includes an integrated primary nursing positive feedback from participants. and is designed for anyone with any kind in partnership with other government and non- of long-term health condition. Bilingual lay approach, with patients being assigned a • The Psychiatric Emergency Care Centre won government agencies to build the capacity of Culturally leaders and bilingual health professionals primary nurse and a designated team. the Minister for Mental Health Award for and Linguistically Diverse (CALD) communities and were recruited, trained and accredited by • Commenced the newly funded Assertive ‘Excellence in the Provision of Mental Health individuals by identifying and addressing their health Arthritis NSW to run a seven-week program Child and Adolescent Mental Health Team Services’ in the 2012 NSW Health Awards. needs and encouraging them to actively participating with the Greek and Maltese communities. to improve coordination among service • Commenced construction on the $44.2million in their own healthcare. • A newly appointed Senior Cross Cultural providers involved in the emergency and Nepean Centre for Mental Health. acute mental healthcare of children and Key achievements for 2012/13: Development Officer started work on improving the capacity of the District to adolescents. Early results are showing positive • Established a Multicultural Access Committee effectively identify the specific needs of the outcomes for children, adolescents and their which provides a governance structure to multicultural population. families. oversee the development and implementation • headspace Penrith opened in May 2013, led of a local plan for improving health outcomes • Celebrated key events such as Multicultural by Uniting Care Mental Health with Nepean for the CALD population across the District. Health Week, Harmony Day and Refugee Blue Mountains Local Health District Mental A key objective is to develop a structure for Week. Health Service and Drug and Alcohol Service Multicultural Health to be embedded within as consortium partners. The Mental Health core business to ensure that research, policy, Service has co-located two teams on the planning, clinical governance, frontline headspace Penrith site and contributed to the health service provision and the community design and furnishing of the building. engagement strategies of the LHD take into account the needs of this population.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 42 OUR HEALTH SERVICES OUR HEALTH SERVICES 43

Oral Health Key achievements for 2012/13: Population Health encouraging seven to 13 year-old children and their families to adopt a long lasting and • Reduced child waiting lists from 2,450 in June Oral Health services are provided at several clinics and Health Promotion healthy approach to life. centres across Nepean Blue Mountains Local Health 2012 to 1,800 in July 2013. Health Promotion is responsible for a range of programs Tobacco Control: District. The Nepean Centre for Oral Health, located • Reduced general adult waiting lists from six that include multidisciplinary partnerships aimed at on the Nepean Hospital campus, is the third largest years in July 2012 to less than three years in • The quit smoking message has been delivered building individual, community and organisational dental centre in NSW and provides a wide range of July 2013. at a wide range of events across the Local clinical services. This Centre is also a teaching facility capacity to improve and sustain health. The unit Health District. Approximately 130 smoking • Occasions of service increased by 141% from for the University of Sydney. Similarly, dental clinics develops, implements and evaluates community based cessation brief interventions have been 28,856 in 2011/12 to 40,708 in 2012/13. at Katoomba, Hawkesbury, Springwood and Lithgow programs that improve and maintain population health carried out at the following events: NAIDOC provide dental care for patients across the District. • Weighted occasions of service increased by and reduce inequalities in health outcomes. Health Week, Ironfest at Lithgow, Mondo youth event 140% from 112,730 in 2011/12 to 158,099 in Promotion focuses on national and NSW programs and World No Tobacco Day. 2012/13. targeting healthy weight, tobacco control and falls injury prevention. • Worked with Penrith City Council to develop • Achieved 122% of 2012/13 weighted signage for 11 local disadvantaged schools. occasions of services target. Key achievements for 2012/13: The signage focuses on preventing exposure • The dental clinic at Blue Mountains Hospital Healthy Weight: to second-hand smoke. continued to provide a dedicated dental • 83 local primary schools are now participating • Systems have been put in place and 30 staff service for the Aboriginal population living in in the ‘Live Life Well@School’ Program which trained to implement ‘Quit for New Life’, the Blue Mountains and Lithgow in 2012/13, increases whole of school healthy eating a program targeting Aboriginal pregnant with over 180 patients attending the service. and physical activity practices, and 105 women and their households to quit smoking. • Postgraduate dental students from the local primary schools are taking part in the Falls Prevention: University of Sydney Graduate Diploma of Oral ‘Crunch and Sip’ Program which provides • A range of falls prevention activities held Surgery attended to 217 patients at Nepean students with an extra break during school over the 2012/2013 period included: eight Centre for Oral Health performing a range of time for fruit, vegetables and water. There ‘Stepping On’ Programs delivered (reaching minor oral surgeries over 2012/13. have been three workshops run in the local 105 participants in total); four ‘Staying area with 58 participants and 34 schools • From January 2013 to June 2013, the Active and Healthy’ presentations represented during 2012/2013. NBMLHD Oral Health Service provided the delivered (reaching 114 seniors in total) and equivalent of 578 days of clinical placement • 140 early childhood services have participated promotion of April Falls Day in the Nepean for undergraduate dental students from the in ‘Munch and Move’ workshops learning Hospital Foyer, including flyers on patients’ University of Sydney. about promoting health and wellbeing for meal trays in hospitals across the District children aged zero to five years and their (reaching 845 patients). families. There have been four workshops run in the local area with 88 participants HIV and Related Programs from 42 early childhood services represented The goal of Publicly Funded Sexual Health Services throughout the year. (PFSHS) in NSW is to reduce the impact of HIV and • Nine ‘Go4Fun’ programs were run across the Sexually Transmitted Infections (STIs) on the health and District with 76 participants enrolled during wellbeing of individuals, priority population groups the past 12 months. ‘Go4Fun’ is a free healthy and the wider community. NBMLHD HIV and Related lifestyle program that supports children Programs Services are guided by the NSW Strategic to become fitter, healthier and happier by Plans for HIV and Sexually Transmitted Infections (STIs). Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 44 OUR HEALTH SERVICES OUR HEALTH SERVICES 45

In December 2012 a new HIV strategy was released with Public Health Unit Primary Care and Community • The ‘Strong Fathers, Strong Families’ program bold targets for the reduction of transmission of HIV works with the Aboriginal community across in NSW. HIV and Related Programs were charged with The role of the Public Health Unit is to identify Health the Blue Mountains and Lithgow and in 2013 and prevent or minimise public health risks to the several areas to help achieve these targets including Primary Care and Community Health provides a range this included activities such as Men’s and Boys’ community: these risks may be from infectious or promoting HIV testing and making it easier to have a of community based services that target prevention, camps and conferences, and the distribution communicable diseases, or from exposure to harmful HIV test and promoting treatment uptake and making early intervention, clinical care coordination, of information packs for new fathers. chemicals or radiation. The Public Health Unit also has a access to treatment easy. maintenance and rehabilitative support services across role in the enforcement of public health legislation. • World Breastfeeding Week was celebrated Key achievements for 2012/13: the District. Services are provided at Community Health at Springwood Community Health Centre • The African HIV Positive Women’s Group The Public Health Unit consists of three teams: Centres, Early Childhood Centres and in client’s homes. with locals, Child and Family Health staff and Infectious Diseases, Immunisation and Environmental continues to meet monthly, with women from Primary Care and Community Health has three clinical Member for the Blue Mountains, Roza Sage, in Health. Public Health staff work closely with GPs, all over NSW attending. From June 2013, in streams: attendance. response to community demand, combined community health workers and hospital-based • Child and Family Health focuses on disease • A review of Speech Pathology services for meetings with African HIV positive men and clinicians, pathology laboratories, schools and childcare prevention, health promotion, early detection, paediatric patients was undertaken to look partners of African HIV positive women are centres, local councils, aged care facilities, Medicare intervention and treatment of health at ways to improve access and outcomes for being held, followed by a specific men only Locals and with other government agencies to protect problems in a multidisciplinary context with a clients. support group. The groups provide peer the health of the public. focus on the vulnerable and disadvantaged. support, advice and information about HIV Key achievements for 2012/13: • A review of Aged Day Services to look at support services. • Chronic and Complex Care focuses on program delivery and outcomes for clients was • 2074 staff, patients and visitors received the • ‘Deadly Liver Mob’, an Aboriginal, peer-driven people who have multiple risk factors for undertaken. influenza vaccine compared to just 1866 last intervention program to reduce hepatitis C chronic disease. Care is coordinated, planned year. Additional influenza vaccine clinics were • Integrated Violence Prevention and commenced in April 2013 and operates across and managed utilising a multidisciplinary provided for the first time to homeless and Response Service (IVPRS) Lithgow facilitated the Needle and Syringe Program for Nepean approach and includes enhanced importance disadvantaged people in North Richmond. partnerships to ensure a clear referral pathway Blue Mountains and Western Sydney Local on self-management capacity. and interagency agreement with Lithgow • Commencement of Aboriginal Immunisation Health Districts. ‘Deadly Liver Mob’ targets • Integrated Violence Prevention and Response Community Services, in addition to developing Officer Liaison Program resulting in an Aboriginal people who inject drugs and their Services (IVPRS) provides a coordinated and a more collaborative framework of practice increase in vaccination coverage of Aboriginal networks, offering hepatitis C education consistent approach to violence prevention across Child and Family Health, Drug and children in NBMLHD and a strengthening of and screening as well as full sexual health with clinical responses for sexual assault and Alcohol Services, Mental Health and IVPRS. screening. 240 people have taken part in the ties between the Public Health Unit and local child protection. IVPRS also provides policy • Worked in conjunction with the Medicare program to date. Aboriginal communities. and strategic leadership for domestic violence Local, Mountains Outreach and other partners • A partnership between NBMLHD, WSLHD and • Coordinated effective control activities during and victims of crime. on shared initiatives such as ‘Cool Kids’ and TAFE NSW-Western Sydney Institute (WSI) measles outbreaks in late 2012, resulting in no ‘Parenting Young’. ‘Cool Kids’ is a program has identified viral Hepatitis as a three-year Key achievements for 2012/13: secondary transmission within the LHD. targeting eight to 12-year-olds with anxiety. priority. To date, 40 welfare students have • Planning for the construction of a new • Addition of the HPV vaccine for boys in school ‘Parenting Young’ is a program that supports been trained in the viral Hepatitis and six premises for Lemongrove Community Health immunisation programs with a good uptake. and promotes the wellbeing of young parents student-led health promotion activities across Centre progressed, as is a refinement of up to the age of 24 and their children. WSI Campuses have been held. • Successful implementation of smoke-free models of care for the new building. environment targeted compliance and • Planning for partial refurbishment and education campaign in April and May 2013 in expansion of Cranebrook Community Health conjunction with Health Promotion staff. 43 Centre to accommodate ‘HealthOne’ services. sites visited and 41 compliance notices issued.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 46 OUR HEALTH SERVICES OUR PEOPLE 47

Sexual Health Key achievements for 2012/13: Staff Nepean Blue Mountains Local Health District Sexual • Opened the ‘Men Out West’ Sexual Health Nepean Blue Mountains Local Health District employs approximately 5,000 individuals, almost 3,800 Full Time Health Services are guided by the NSW Strategic Plans for clinic, which is run by male members of Equivalent (FTE) staff, who work across a wide variety of medical and non-medical fields. Approximately 76% of the HIV and Sexually Transmitted Infections (STIs). staff to cater to men in the Nepean and Local Health District’s staff are women, almost 80% live within or adjoining the district boundaries, and the District Blue Mountains regions. The new clinic has employs a varied and multicultural workforce that has grown markedly in size since the District’s establishment in In December 2012 a new HIV strategy was released improved the rates of gay and homosexually 2011. with bold targets for the reduction of transmission of active men and Aboriginal men accessing HIV in NSW. Sexual Health were charged with several Sexual Health services. Combined local % of all % of professiona All other Total areas to help achieve these targets including providing residency (head staff group living locally postcodes treatment, care and support services and improving the • Started the ‘Rapid HIV Test’ trial which enables numbers) health and wellbeing of people living with HIV. gay and homosexually active men to have a simple finger-prick test for HIV and receive Nursing staff 2,088 41.5 88.2% 280 2,368 47% Priority populations include people living with HIV and their results within 10 minutes. This has Medical staff 221 4.5 29.6% 526 747 14.8% AIDS, gay and homosexually active men, Aboriginal encouraged more men to present for HIV Other clinical staff 243 4.8 74.8% 82 325 6.5% people, people who inject drugs, people from Culturally testing. Allied health staff 393 7.8 69.4% 173 566 11.3% and Linguistically Diverse backgrounds, sex workers, Administrative staff 774 15.4 91.2% 75 849 16.9% An Aboriginal Sexual Health worker has people living with hepatitis C and young people. • Miscellaneous staff 150 3 84.7% 27 177 3.5% commenced working onsite at the Men Out TOTAL 3,869 1,163 5,032 100% West clinic which has been invaluable in improving uptake to testing for HIV and STIs, treatment and maintaining the health and wellbeing of Aboriginal people living with Equal Employment Opportunity HIV. Trends in the representation of Equal Employment Opportunity groups: • Moved to a complete electronic medical % of total staff record for clients which has enabled direct EEO Group Benchmark 2009 2010 2011 2012 2013 access to client notes from all clinic sites Women 50% N/A N/A 78.0% 77.0% 76.6% as well as real-time access to pathology Aboriginal people and Torres strait Islanders 2.6% N/A N/A 0.9% 1.2% 1.4% results. This has reduced paper handling, People whose first language is not English 19.0% N/A N/A 17.1% 17.5% 17.7% improved continuity of care, improved People with a disability N/A N/A N/A 3.8% 3.1% 2.8% statistic collection for NSW and federal health People with a disability requiring work 1.3% (2012) N/A N/A 0.5% 0.4% 0.3% reporting and improved staff accountability related adjustments 1.5% (2013) for patient care.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 48 OUR PEOPLE OUR PEOPLE 49

Equal Employment Opportunity continued Volunteers, Auxiliaries and equipment, a humidicrib and stretchers for the Emergency Department. Support Groups • The Springwood Hospital Auxiliary has raised Trends in the distribution of Equal Employment Opportunity groups: in excess of $30,000 which has gone towards Distribution index Blue Mountains and Springwood purchasing electric high-low beds and a EEO Group Benchmark or target 2009 2010 2011 2012 2013 Hospitals shower/bed bath. Women 100 N/A N/A 87 88 88 • Blue Mountains District Anzac Memorial Aboriginal people and Torres strait Islanders 100 N/A N/A 82 84 75 • The Katoomba/Leura/Wentworth Falls Hospital Hospital has 18 ‘Pink Ladies’ who volunteer People whose first language is not English 100 N/A N/A 112 110 111 Auxiliaries have raised in excess of $110,000, their time to visit patients, distribute reading People with a disability 100 N/A N/A 102 104 102 which has purchased day-only recliner chairs, a material and perform other duties. People with a disability requiring work 100 N/A N/A N/A N/A N/A neonatal warming system and a physiotherapy related adjustments • The Katoomba/Leura/Wentworth Falls Auxiliary treadmill. has 30 members who organise the annual fete, Nepean Hospital garage sale, concert and quilt show each year

and run the Auxiliary shop, which has raised in Nepean Hospital Volunteers The Nepean Hospital Volunteers Association provides excess of $20,000 in the last 12 months. invaluable unpaid support to Nepean Hospital, Work Health and Safety • The Leura Gardens Festival Committee run the contributing their time and effort to various projects The Risk Management Unit manages all lines of insurable risk across the Local Health District. Areas of responsibility very popular annual Leura Gardens Festival including but not limited to: with money raised donated to Blue Mountains include Liability, Workers Compensation and Rehabilitation, Manual Handling, Work Health and Safety, Enterprise Risk Volunteers Guide Desk – Guiding visitors and District Anzac Memorial Hospital. • Management, Staff Health and Fire services. outpatients to clinics, wards and departments. • The Rotary Garden and the garden in the Key achievements for 2012/13: Volunteers Gift Shop – Providing an Mental Health Unit at Blue Mountains District • inexpensive shopping outlet for patients, • The Nepean Blue Mountains Local Health District Bariatric Committee had its first meeting in October 2012 Anzac Memorial Hospital are both maintained visitors and staff. The Gift Shop recently and work commenced on improving management of bariatric patients. The other focus of the Manual by volunteers. Handling Program throughout the 2012/13 Financial Year was extending the program in patient care areas celebrated their 10th year at Nepean Hospital. • Springwood Hospital Auxiliary has that were not part of the initial roll-out including imaging, sonography, dialysis and some allied health units. Raising money to purchase clinical and facility approximately 30 members who organise • products. • Change in the workers compensation claims review process where department managers now participate via various fundraising events, including the teleconference in their staffs claims review with the Fund Manager. annual fete, golf day, trivia night, book fair • Administrative Support – Assisting in and catering. The Auxiliary donates funds to collating administrative items such as Patient buy various pieces of equipment including Information Packs, photocopying, and beds and mattresses. Springwood Hospital laminating. also receives fundraising assistance from other Nepean Hospital Archive Volunteers groups and individuals. The Nepean Hospital Archive Volunteers are dedicated Key achievements for 2012/13: to preserving the history of the hospital and are often called upon to provide historical information and create • The Leura Gardens Festival Committee has visual displays about the evolution of Nepean Hospital. raised in excess of $90,000 which has gone towards purchasing Rehabilitation Ward

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 50 OUR PEOPLE OUR PEOPLE 51

Penrith Hospital Auxiliary having to tie up the resources of the retrieval Quality and Safety Safety Office Service The Penrith Hospital Auxiliary holds stalls with many staff and five IV pumps to enable the safe Safety is the foundation on which quality is built. gifts and handmade products such as cakes, pastries and delivery of IV medication to patients, valued at Quality and safety is the cornerstone of all practise Without a culture of safety within the organisation, quilts to raise money for Nepean Hospital. $1,875 each. throughout Nepean Blue Mountains Local Health District. In line with the National Safety and Quality attempts to enhance quality would not result in • The United Hospital Auxiliary has raised Health Service Standards, the District has renewed the effective change or service enhancement. To ensure Nepean Blue Mountains Cardiac Support $27,714 for Nepean Hospital which has governance framework to drive the implementation of that we address safety across areas of Nepean Blue Group gone towards purchasing a $4,339 ‘Vitalcom’ safety and quality systems and to improve the quality Mountains Local Health District, a dedicated safety The Nepean Blue Mountains Cardiac Support Group wandering resident alarm which notifies staff of healthcare across the District. The provision of program has been introduced. The Safety Office donate their money and time to improve cardiac services electronically if patients have managed to timely information is key to the Organisation’s ability Service started as a pilot program at Nepean Hospital at Nepean Hospital and have purchased many items for move out of their allocated area; five IV pumps to respond to areas of need and to ensure there is in 2012 and has since been implemented across the District. to enable the safe delivery of IV medication to continuous improvement. the District with great results. Safety projects have patients, valued at $1,875 each; two syringe Palliative Care Volunteers included care and management of cannulas, bariatric pumps for the safe delivery of insulin for The Palliative Care Volunteers provide support and patients, creating a smoke-free environment and diabetic patients, valued at $1,500 each and eQATE companionship to inpatients and their relatives, which Patient Experience Trackers with many more initiatives an $11,000 ECG machine for Women’s and extends to the community where some visit clients in Through the development of the Nepean Blue designed to improve safety for patients, staff and Children’s Health. their homes and offer respite for carers. Mountains Local Health District electronic Quality Audit visitors. The Safety Office Service is consumer focussed, Lithgow Hospital and Portland Exchange (eQATE), managers from all over the District driven by information and organised to prevent or Nepean Therapy Dog Club will have access to information that will guide and assist minimise harm for staff, patients, carers and visitors. Nepean Therapy Dog Club allows patients to spend Tabulam Health Centre in the development of quality systems. time with specially trained dogs and their handlers. The Lithgow Hospital Auxiliary run the coffee shop and This provides companionship and emotional support to deliver newspapers and flowers to patients. Portland patients. Tabulam volunteer services include the Hospital Auxiliary, Tabulam Committee, hospital trolley, bingo Nepean Neonatal Intensive Care Unit Parents calling, resident advocate and entertainment. Support (NNICUPS) NNICUPS was established in 1992 to support parents Key achievements for 2012/13: and babies in the Neonatal Intensive Care Unit of • The Lithgow Hospital Auxiliary was one of five Nepean Hospital. NNICUPS raises funds for important finalists out of 150 nominees in the recent medical equipment as well as providing one-on- ‘Women Out West’ awards. one support for parents with a baby in the Neonatal • The Lithgow Hospital Auxiliary raised over Intensive Care Unit. NNICUPS also assisted in the $62,500 for the Hospital with the funds going establishment of the Ronald McDonald Family Room. towards trolleys for patient support staff Key achievements for 2012/13: ($7,939), a ‘Malmet’ equipment dishwasher ($17,818), ‘Commode’ chair ($1,400) and scales • The Nepean Hospital Volunteers have raised ($1,400) for the Emergency Department, $29,423 which has gone towards purchasing an ECG for the Inpatients Ward ($12,150), a $20,050 Helipad Retrieval Trolley, allowing exercise equipment and scales for the the direct transfer of patients from helicopters Physio Department ($11,994) and trolleys for to the hospital wards and theatres without paediatric and adult procedures ($10,050).

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 52 OUR PEOPLE OUR PEOPLE 53

Infection Control Quality Awards Our Educational Development to support the development and ongoing evaluation of nursing and midwifery practice and patient care Better hand hygiene by healthcare staff helps to reduce The Quality Awards program Through establishing partnerships with the Health underpinned by the principles of transformational the spread of infection in hospitals. Avoiding infections aims to recognise the Education Training Institute and the NSW Health practice development. This approach to practice is one way to help patients recover and go home more outstanding achievements Registered Training Organisation, Education and requires that all stakeholders - patients, carers, staff quickly. of staff who contribute to Development aims to empower the workforce to meet and families - have opportunities to participate and quality improvement in Hand hygiene is the use of alcohol-based hand rub or service demands and transform workplace culture are included in decisions about effective care using healthcare services across soap and water to clean hands properly. There are five to build sustainable performance. The functions of approaches that respect individual and collective the Local Health District. key times when a healthcare worker caring for a patient key facets within Education and Development are as values. It provides an opportunity should clean their hands. These five times, identified by follows: for staff to showcase Key achievements for 2012/13: the National Hand Hygiene Initiative, are: • Learning and Development creates the outcomes of quality leadership capabilities through initiatives • The 2012/2013 year saw a significant rise in • Before touching a patient improvement projects such as the Clinical Leadership Program, the number of Essentials of Care projects and share their successful • Before a procedure Customer Contact Certificate IV, Diploma of undertaken with 12 projects in current initiatives with colleagues • After a procedure or body fluid exposure Management and Certificate IV Front Line development and 28 departments currently across the District. It also provides an important Management Courses. engaged in the program. • After touching a patient opportunity for staff projects and initiatives to be • Organisational Development grows local • Four projects were submitted to the Nepean • After touching a patient’s surroundings recognised by the Board, Executive and the wider community. leadership talent through programs Blue Mountains Local Health District Nepean Blue Mountains Local Health District such as the Organisational Development Quality Awards, with two receiving highly The Nepean Blue Mountains Local Health District 2013 compliance rate for hand hygiene was 82.5% (National Program. More than 600 managers and staff commended awards. Hand Hygiene Audit - November 2012 to March 2013), Quality Awards celebrates quality and safety initiatives participated in the Program in 2012/13. • One Essentials of Care project is in the data above the NSW average of 79.6% and National average across the District. There were 24 team entries • Training and Education facilitated courses collection phase of research and four others of 76.9% for the same period. demonstrating a clear and focussed commitment by the Local Health District to ongoing and evolving to enhance management capacity and are currently writing submissions for ethics improvement. 2013 saw the addition of the Chief capability to effectively handle workplace approval - this is the first time that this group Executive’s Award for Research and the Chairman’s issues and further develop understanding of of nurses have had the opportunity to engage Award for Safety and Quality. Two projects from the workplace culture and how each individual in research. Nepean Blue Mountains Local Health District Quality can contribute positively to their team • Another team of 18 nurses created a short film Awards were selected as finalists in the 2013 NSW environment. This was undertaken through which demonstrated the use of Essentials of Health Innovation Awards. positive workplace culture, effective Care to implement a new clinical handover communication, crucial conversations and In 2012 three entries submitted from the Nepean Blue policy. This film was presented at the NSW investigative services training. Mountains Quality Awards to the 2012 NSW Health Nursing and Midwifery Office Essentials of Innovation Awards in October 2012 were finalists, with Care Showcase in May 2013 and as a result the District winning the Minister for Mental Health Essentials of Care of the film, the LHD has been inundated with requests from other Local Health Districts on Award for the ‘PECC inspirations’ project. The Nursing and Midwifery Directorate champions how to change clinical handover practice. transformational Practice Development to develop effective workplace cultures and engage with clinicians • For information about EOC nursing research, to provide evidence-based, person-centred care. As an see page 56-57. example, the Essentials of Care Program is a framework

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 54 OUR PEOPLE OUR PEOPLE 55

Reward and Recognition Program Research Telehealth use from the patient’s perspective and developing a Telehealth implementation A Local Health District Employee and Volunteer Reward and Recognition Program was established in late 2012 to Effective healthcare requires good clinical care, Handbook to educate other health districts provide formal recognition of the outstanding work and dedication of its employees and volunteers. education and research. Research continues to grow about how to implement Telehealth. within our Local Health District with significant increases The program provides patients and visitors the opportunity to formally acknowledge experiences with Local Health • Continued financial support from the in publications, research grants and numbers of medical, District staff and volunteers that they believe are outstanding and gives staff and volunteers the opportunity to community through our local research nursing and allied health students taking part in nominate their peers in appreciation of their exceptional work. Nominations can be made in any of the following foundations: the Nepean Medical Research research. six categories: Customer Service, Teamwork, Improved Performance, Innovation, Leadership and Management and Foundation (NMRF) and the Australian Community Spirit (volunteers). Women’s and Children’s Research Foundation All staff and volunteers nominated receive a letter of congratulations from the Chief Executive with selected finalists Medical Research (OZWAC). See Research Fundraising Groups on in each category being invited to an award ceremony with the Chief Executive, Board Members and other key page 56 for more information. Key achievements and supports that have led management representatives. to an increase in publications and research in Since the program was launched in late 2012 there have been a total of 188 nominations made recognising the Medical Research outputs for 2012/13 2012/13: achievements of 1,312 staff and volunteers. included: • The Annual Nepean Scientific Day brings The program was established as an initiative to improve workplace culture and employee engagement following the • Received over $1.25 million of NHMRC together researchers, medical staff and results of the 2011 YourSay results. and other nationally competitive grants students to share current research findings and $298,986 of local research grants from and scientific breakthroughs. The day also Nepean Medical Research Foundation and the provides a great opportunity for the local Australian Women’s and Children’s Research community to hear about the latest research Foundation and medical developments happening in their local hospital. Throughout the day there are • 30 postgraduate research students in 2012 and presentations from senior research staff and 35 postgraduate research students in 2013 junior researchers, along with distinguished • 20 visiting scholars in 2012 and 17 visiting guests and speakers. scholars in 2013 • The Nepean Telehealth Technology Centre • Nepean Hospital researchers received a is a multidisciplinary partnership between number of awards at national and international Nepean Hospital, Sydney Medical School conferences Nepean and the Institute of Biomedical • 122 peer-reviewed research publications Engineering and Technology (iBMET) to grow in 2012 and 66 peer-reviewed research Telehealth ideas into clinical trials and, finally, publications in 2013 into tangible initiatives for the benefit of patients and clinicians alike. 2012/13 research • 76 ethics approvals in 2012 and 69 ethics projects include a study of the psychology of approvals in 2013.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 56 OUR PEOPLE OUR PEOPLE 57

Nursing Research Nursing Research continued • 27 refereed publications • 12 conference presentations Key achievements and supports that have led to the increase in publications and research: • 10 ethics approvals • Developed the Centre for Nursing Research and Practise Development. Research outputs for 2012/2013 included: • Nine workshops conducted to develop • Secondment of the Clinical Nurse Consultant to the Nursing Research Unit to develop and implement • Received $15,000 from Nurse Strategy Reserve the skills of Registered Nurses across the research skills. Initiative Funding for career pathways of clinicians District. The workshops included: writing • Working more collaboratively with the Essentials of Care (EOC) Nurse Manager and development of literature reviews, presenting research at research protocols with clinicians involved in EOC program. Also see page 53. • Awarded a $19,000 University of Western a conference, writing grants, preparing an Sydney grant to investigate affected ethics application, writing a research proposal, women’s experiences of female genital how to write a publication and ‘Endnote’ mutilation training to manage citations when writing • Awarded a $9,000 Migrant Health grant to publications. Two workshops to determine research the experiences of nurses working in research priorities for paediatric nurses were Migrant Health also conducted. • Received $10,000 in Cancer Institute Essentials of Care outputs for 2012/2013 grants for the ‘Educating Patients Entering included: Chemotherapy for the First Time’ study • Four Essentials of Care research projects • Eight postgraduate research students undertaken • One visiting scholar: Professor Roger Watson • Three Essentials of Care research projects from Hull University in the United Kingdom received Nurse Strategy Reserve Funding.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 58 OUR PEOPLE OUR INFORMATION 59

Research Fundraising Groups Financial Statements • Australian Women and Children’s Research Foundation (OZWAC) OZWAC is a medical research foundation that draws upon community support to raise funds and community awareness of important women’s and children’s health issues. The Foundation, since its inception, has supported research at Nepean and Westmead Hospitals and other research centres across the State. Certification of the Parent/Consolidated Financial Statements for the • Nepean Medical Research Foundation (NMRF) year ended 30 June 2013 The NMRF has been established to assist and support medical research being done by the Sydney University Clinical School at Nepean Hospital. Activities of the Foundation are controlled by a Council consisting of Pursuant to Section 45F of the Public Finance and Audit Act 1983, we state that to the best of our knowledge: representatives of the University, Nepean Hospital and the local communities. The Foundation’s task is to encourage large enterprises, local business, community groups and individuals in the Penrith, St Marys, Blue 1) The financial statements of the Nepean Blue Mountains Local Health District for the year ended 30 June Mountains, and Hawkesbury areas to support important, locally based medical research. 2013 have been prepared in accordance with: The aims of the NMRF are: a) Australian Accounting Standards (which include Australian Accounting Interpretations) b) the requirements of the Public Finance and Audit Act 1983, the Public Finance and Audit Regulations To conduct research projects on causes and treatment of diseases affecting the population that is served 2010 and the Treasurer's Directions; by Nepean Hospital and the greater community at large

To improve patient care and community health through new methods of treating and preventing c) the Financial Reporting Code for NSW General Government Sector Entities. diseases

To expand research activities being conducted at Nepean Hospital which will result in more local jobs 2) The financial statements exhibit a true and fair view of the financial position and the financial and in the advancement of the Nepean campus. performance of the Nepean Blue Mountains Local Health District; and

Together the two groups raised $298,986 in 2012/13. 3) There are no circumstances which would render any particulars in the accounts to be misleading or inaccurate.

Kay Hyman, Chief Executive Angela Edwards, Director, Finance

19 September 2013 19 September 2013

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 60 OUR INFORMATION OUR INFORMATION 61

Nepean Blue Mountains Local Health District Nepean Blue Mountains Local Health District Statement of Comprehensive Income as at June 2013 Statement of Financial Position as at June 2013 PARENT CONSOLIDATION PARENT CONSOLIDATION

Actual Budget Actual Actual Budget Actual Actual Budget Actual Actual Budget Actual

Unaudited Unaudited Unaudited Unaudited

2013 2013 2012 2013 2013 2012 2013 2013 2012 2013 2013 2012

$000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000

Expenses excluding losses ASSETS

Operating Expenses Current Assets

------Employee Related 362,256 354,293 340,185 27,304 5,326 26,644 Cash and Cash Equivalents 27,304 5,326 26,644

353,087 344,388 321,878 Personnel Services ------18,384 11,805 13,242 Receivables 18,384 11,805 13,242

25,507 23,802 22,498 Visiting Medical Officers 25,507 23,802 22,498 3,836 3,325 3,325 Inventories 3,836 3,325 3,325

189,555 202,293 192,980 Other Operating Expenses 189,555 202,293 192,980 49,524 20,456 43,211 Total Current Assets 49,524 20,456 43,211

22,235 23,556 18,165 Depreciation and Amortisation 22,235 23,556 18,165 Non-Current Assets

3,599 3,025 347 Grants and Subsidies 3,599 3,025 347 724 793 793 Receivables 724 793 793

1,009 1,129 1,076 Finance Costs 1,009 1,129 1,076 Property, Plant and Equipment

3,140 4,699 3,165 Payments to Affiliated Health Organisations 3,140 4,699 3,165 473,584 472,970 445,446 -Land and buildings 473,584 472,970 445,446

598,132 602,892 560,109 Total Expenses excluding losses 607,301 612,797 578,416 31,978 30,088 31,802 -Plant and Equipment 31,978 30,088 31,802

Revenue 3,136 3,109 3,326 -Infrastructure Systems 3,136 3,109 3,326

516,759 506,652 477,225 NSW Ministry of Health Recurrent Allocations 516,759 506,652 477,225 508,698 506,167 480,574 Total Property, Plant and Equipment 508,698 506,167 480,574

46,391 45,313 46,065 NSW Ministry of Health Capital Allocations 46,391 45,313 46,065 122 ------Intangible Assets 122 ------

------Acceptance by the Crown Entity of Employee Benefits 9,169 9,905 18,307 509,544 506,960 481,367 Total Non-Current Assets 509,544 506,960 481,367

57,734 65,228 46,844 Sale of Goods and Services 57,734 65,228 46,844 559,068 527,416 524,578 Total Assets 559,068 527,416 524,578

1,017 1,819 737 Investment revenue 1,017 1,819 737 LIABILITIES

7,006 6,589 6,558 Grants and Contributions 7,006 6,589 6,558 Current Liabilities

1,714 1,528 3,567 Other Revenue 1,714 1,528 3,567 41,798 52,868 44,193 Payables 41,798 52,868 44,193

630,621 627,129 580,996 Total Revenue 639,790 637,034 599,303 2,801 ----- 2,435 Borrowings 2,801 ----- 2,435

197 (225) (270) Gain/Loss on Disposal 197 (225) (270) 51,975 52,079 51,562 Provisions 51,975 52,079 51,562

770 (300) (8,213) Othe Gains/(Losses) 770 (300) (8,213) ----- 764 764 Other ----- 764 764

33,456 23,712 12,404 Net Result 33,456 23,712 12,404 96,574 105,711 98,954 Total Current Liabilities 96,574 105,711 98,954

Other Comprehensive Income Non-Current Liabilites

Items that will not be reclassified to net result 5,866 8,068 8,398 Borrowings 5,866 8,068 8,398

Net Increase/(Decrease) in Property, Plant & 289 (13) 284 Provisions 289 (13) 284

------141 Equipment Asset Revaluation Surplus ------141 6,155 8,055 8,682 Total Non-Current Liabilities 6,155 8,055 8,682

------141 Total Other Comprehensive Income for the year ------141 102,729 113,766 107,636 Total Liabilities 102,729 113,766 107,636

33,456 23,712 12,545 TOTAL COMPREHENSIVE INCOME 33,456 23,712 12,545 456,339 413,650 416,942 Net Assets 456,339 413,650 416,942

EQUITY

141 141 141 Reserves 141 141 141

456,198 413,509 416,801 Accumulated Funds 456,198 413,509 416,801

456,339 413,650 416,942 Total Equity 456,339 413,650 416,942 Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 62 OUR INFORMATION 63

• Immunisation strategy Nepean Blue Mountains Local Health District Government Information • Employment and career information and Statement of Cash Flows for the year ended 30 June 2013 (Public Access) Act positions being recruited to PARENT CONSOLIDATION Under the Government Information (Public Access) Act Media releases and alerts and statements Actual Budget Actual Actual Budget Actual 2009 (GIPA Act), there is a presumption in favour of the • issued to the Media Unaudited Unaudited disclosure of Government information unless there is an 2013 2013 2012 2013 2013 2012 overriding public interest against disclosure. • Videos of services $000 $000 $000 $000 $000 $000 Nepean Blue Mountains Local Health District • Topic news items for the public CASH FLOWS FROM OPERATING ACTIVITIES undertakes reviews of its information on a regular Payments During 2012/13, Nepean Blue Mountains Local Health basis, including information requested via informal ------Employee Related (358,132) (349,964) (312,512) District received six new formal access applications access and formal access channels. Liaison also occurs (7,536) (8,520) (3,965) Grants and Subsidies (7,536) (8,520) (3,965) under the GIPA Act. Five applications were decided, with Executive Directorates and their respective (869) ----- (917) Finance Costs (869) ----- (917) including two applications carried forward from portfolios regarding identification of information that (601,777) (618,584) (542,846) Other (243,645) (268,620) (230,334) 2011/12. Three applications received during the can be released proactively. Review of the Nepean (610,182) (627,104) (547,728) Total Payments (610,182) (627,104) (547,728) reporting period were undecided as at 30 June 2013 Blue Mountains Local Health District disclosure log Receipts and have been carried forward to the next reporting and websites of other agencies to see the type of 516,759 506,652 477,225 NSW Ministry of Health Recurrent Allocations 516,759 506,652 477,225 period 2013/14. information they release proactively, is also undertaken. 46,391 45,310 46,065 NSW Ministry of Health Capital Allocations 46,391 45,310 46,065 During the reporting period, Nepean Blue Mountains The most accessible way for the public to access such 4,980 4,980 ----- Reimbursements from the Crown Entity 4,980 4,980 ----- Local Health District did not refuse any formal access information is via the Nepean Blue Mountains Local 56,097 64,214 36,520 Sale of Goods and Services 56,097 64,214 36,520 applications because the information requested Health District internet website, and this website is 1,017 1,099 737 Interest Received 1,017 1,099 737 was information referred to in Schedule 1 to the continually developed to make information readily 7,466 7,774 5,510 Grants and Contributions 7,466 7,774 5,510 GIPA Act (information for which there is a conclusive available to the public. During 2012-13 the following 25,833 29,023 29,991 Other 25,833 29,023 29,991 presumption of overriding public interest against information has been released proactively on the 658,543 659,052 596,048 Total Receipts 658,543 659,052 596,048 disclosure). NET CASH FLOWS FROM OPERATING website: The following tables (A-H) outline statistical information 48,361 31,948 48,320 ACTIVITIES 48,361 31,948 48,320 • Information on Nepean Hospital car parking about access applications – Clause 7(d) and Schedule 2. CASH FLOWS FROM INVESTING • NBMLHD Board information ACTIVITIES In summary, of the five applications decided in 2012/13, Proceeds from the Sale of Land and Buildings • NBMLHD Service Agreement 2012/13 three decisions were made to grant access to the ------42 Plant and Equipment and Infrastructure Systems ------42 • Public health information for General information in full and one decision was made to grant Purchases of Land and Buildings, Plant and Practitioners/Immunisation Providers and for access to the information in part. One decision was (45,396) (49,373) (44,473) Equipment Infrastructure Systems and Intangibles (45,396) (49,373) (44,473) Community Members made where the information was not held. (45,396) (49,373) (44,431) NET CASH FLOWS FROM INVESTING ACTIVITIES (45,396) (49,373) (44,431)

CASH FLOWS FROM FINANCING ACTIVITIES

(2,305) (3,893) (3,080) Repayment of Borrowings and Advances (2,305) (3,893) (3,080)

(2,305) (3,893) (3,080) NET CASH FLOWS FROM FINANCING ACTIVITIES (2,305) (3,893) (3,080)

660 (21,318) 809 NET INCREASE/(DECREASE) IN CASH 660 (21,318) 809

26,644 26,644 25,214 Opening Cash and Cash Equivalents 26,644 26,644 25,214

------621 Cash Transferred In/(Out) as a result of Administrative ------621

Restructuring

27,304 5,326 26,644 CLOSING CASH AND CASH EQUIVALENTS 27,304 5,326 26,644 Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 64 OUR INFORMATION OUR INFORMATION 65

Table A: Number of applications by type of applicant and outcome* Table C: Invalid applications Access Access Access Information Information Refuse to Refuse to Application Reason for invalidity Number of applications granted granted refused not held already deal with confirm/deny withdrawn Application does not comply with formal requirements (section 41 of the Act) 0 in full in part in full available application whether Application is for excluded information of the agency (section 43 of the Act) 0 information Application contravenes restraint order (section 110 of the Act) 0 held Total number of invalid applications recieved 0 Media 1 0 0 0 0 0 0 0 Invalid applications that subsequently became valid applications 0 Members of 0 0 0 0 0 0 0 0 Parliament Private sector 0 0 0 1 0 0 0 0 Table D: Conclusive presumption of overriding public interest against disclosure: Not for profit matters listed in Schedule 1 of the Act organisations or 0 0 0 0 0 0 0 0 Number of consideration used* community groups Overiding secrecy laws 0 Cabinet information 0 Members of the Executive Council information 0 public (application 0 0 0 0 0 0 0 0 Contempt 0 by legal Legal profession priviledge 0 representative Excluded information 0 Members of the 2 1 0 0 0 0 0 0 Documents affecting law enforcement and public safety 0 public (other) Transport safety 0 *More than one decision can be made in respect of a particular access application. If so, a recording must be made Adoption 0 in relation to each such decision. This also applies to Table B. Care and protection of children 0 Ministerial code of conduct 0 Aboriginal and environmental heritage 0 Table B: Number of applications by type of applicantion and outcome* *More than one public interest consideration may apply in relation to a particular access application and, if so, each Access Access Access Information Information Refuse to Refuse to Application granted granted refused not held already deal with confirm/deny withdrawn such consideration is to be recorded (but only once per application). This also applies in relation to Table E. in full in part in full available application whether information held Table E: Other public interest against disclosure: Personal information 1 1 0 0 0 0 0 0 matters listed in Table 14 of the Act applications* Number of occasions when application not successful Access applications Responsible and effective government 1 (other than personal Law enforcement and security 0 2 0 0 1 0 0 0 0 information Individual rights, judicial processes and natural justice 1 applications Business interests of agencies and other persons 0 Access applications Environment, culture, economy and general matters 0 Security provisions 0 that are partly Excempt documents under interstate Freedom of information legislation 0 personal information 0 0 0 1 0 0 0 0 applications and partly other *A personal information application is an access application for personal information (as defined in clause 4 of Schedule 4 to the Act) about the applicant ( the applicant being an individual). The total number of decisions in Table B should be the same as Table A.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 66 OUR INFORMATION OUR INFORMATION 67

Table F: Timeless Privacy Management Number of applications Decided within the statutory timeframe (20 days plus any extensions) 4 Nepean Blue Mountains Local Health District meets its privacy obligations through appropriate governance and the Decided after 35 days (by agreement with the applicant) 1 provision of privacy information, training and support to staff through: Not decided within time (deemed refusal) 0 Total 5 • A privacy Intranet website which provides staff with access to: NSW privacy legislation NSW Health privacy policies (Privacy Manual and Privacy Management Plan and Privacy Internal Review Guidelines) Table G: Number of applications reviewed under Part 5 of the Act (by type of review and outcome) Decision Decision Total Privacy training program Internal review 0 0 0 FAQs Review by information Commisioner* 0 0 0 Internal review following recommendation under section 93 of the Act 0 0 0 Links to external resources including the Privacy and Information Commission. Review by ADT 0 0 0 • Provision of privacy awareness at new staff orientation Total 0 0 0 • Provision of privacy training, available as either as an on-line as annual mandatory training or face to face *The information Commissioner does not have the authority yo vary decisions, but can make recommendation to • Provision of legislation, policy and compliance support/advice to health service staff by the LHD Privacy the original decision-maker. The data in this case indicates that a recommendation to vary or uphold the original Contact Officer decision has been made. • Access to a privacy information brochure for staff • Access to privacy Information posters and patient information brochures, a copy of which is issued to all patients/clients attending a Nepean Blue Mountains facility. Table H: Applications for review under Part 5 of the Act (by type of applicant) Privacy information is provided to consumers through an Information Privacy Internet site at http://www.nbmlhd. Number of applications for review Application by access applicants 0 health.nsw.gov.au/Right-to-Information/Information-Privacy/Privacy-Information- Applications by persons to whom information the subject of access application 0 relates (see section 54 of the Act)

Nepean Blue Mountains Local Health District 2012-2013 Year in Review Together, achieving better health 68

Internal Review • Application for internal review was received on 20 November 2012, alleging a breach of The Privacy and Personal Information Protection Act HPP 7 access to personal health information 1998 provides a formalised structure for managing principle. The internal review confirmed a privacy complaints relating to this Act and to the Health breach of this HPP as the requested health Records and Information Privacy Act 2002. information had not been provided to During 2012/13, Nepean Blue Mountains Local the applicant “without excessive delay”. Health District received nine new information privacy Relevant staff were counselled about the complaints via the process of statutory Internal privacy breach and processes for access to Review. Actions have been undertaken by NBMLHD as information. An apology was provided to the appropriate resulting from these complaints, including applicant. review of policies, practices and staff training. • Application for internal review was received • Application for internal review was received on 29 November 2012, alleging a breach of on 18 July 2012, alleging a breach of Health HPP’s 5 and 10, security and use principles. Privacy Principle (HPP) 11 disclosure principle. The internal review concluded that there had The internal review concluded that there was not been a breach of these HPPs. insufficient evidence to confirm a breach of • Application for internal review was HPP 11. received on 6 December 2012, alleging • Application for internal review was received breaches of HPP’s 7 and 11 access and on 17 August 2012. Not enough information disclosure principles. The internal review was provided to enable the compliant to be concluded there had not been a breach investigated and further information was of HPP11 but confirmed a breach of HPP7. requested from the applicant. This was not Recommendations were made to improve forthcoming and the file was closed. processes for access to information and an apology was extended to the applicant. • Application for internal review was received on 3 September 2012, alleging a breach • An application for internal review was of HPP’s 9 and 11, accuracy and disclosure received on 8 February 2013, alleging a breach NEPEAN BLUE MOUNTAINS LOCAL HEALTH DISTRICT principles. The internal review concluded that of HPP 11 disclosure principle. The internal PO BOX 63 there was insufficient evidence to confirm a review concluded there had not been a PENRITH NSW 2751 breach of these HPPs had occurred. breach of this HPP. PH: (02) 4734 2120 • Application for internal review was received • An application for internal review was FAX: (02) 4734 3734 on 17 November 2012, alleging breaches of received on 24 April 2013, alleging a breach of Copyright Nepean Blue Mountains Local Health District. This work is copyright. It may be produced in whole or in part HPP’s 2 and 10 relevance, excessiveness and HPP 11 disclosure principle. The investigation for study or training purposes subject to the inclusion of acknowledgement of the source and no commercial usage accuracy and use principles. The internal into this matter was still being finalised at the or sale. Reproduction for purposes other than those indicated requires permission from Nepean Blue Mountains Local review confirmed a breach of these HPP’s close of the reporting period. Health District. had occurred. Processes are being reviewed to ensure privacy compliance in this area. An apology was provided to the applicant.

Nepean Blue Mountains Local Health District 2012-2013 Year in Review 2012 2013 a year in review