Victorian Heart Hospital Economic Impact Assessment

Final Report

29/05/2017

Note: This pack should be read in conjunction with the accompanying methodology pack

Document 7 This project seeks to articulate the economic value of the VHH to Victoria

Monash University, in conjunction with Monash Health and the Department of Health and Human Services (DHHS) are working to develop the Victorian Heart Hospital (VHH). The VHH scheduled to commence operations in 2021 will be a world class hospital, research and education facility dedicated to specialised clinical care of heart related conditions, located on the Clayton campus and be the first of its kind in Australia. The project partners have launched a project to develop a narrative on the VHH’s value to Victoria and the community, to be used in potential public communications for the VHH.

Objectives of this project:

• Develop a narrative for VHH’s economic impact to the Victorian economy • Establish and calculate available metrics to quantify VHH’s economic impact • Articulate VHH’s value as a series of ‘supporting statements’ to be used in public communications where appropriate

This project seeks to articulate the VHH’s economic impact for Victoria through a series of key messages to communicate to the community the value of the VHH to Victoria

1 Document 7 The VHH will be a valuable part of the Victorian economy, and a key driver of industry and research activity Report Contents

PAGE: 7 PAGE: 11 The VHH will deliver significant The VHH will deliver improved economic benefits to Victoria outcomes and experiences for cardiac patients

. The VHH is expected to contribute nearly $400m in 2026 . The VHH will improve the health outcomes for cardiac (calendar year) directly to the Victorian economy patients

. The VHH will be a major employer in the South East of . The VHH will decrease the fragmentation of the State Melbourne cardiac care system and improve patient experience

. The VHH will attract significant research funding

PAGE: 15 PAGE: 20 VHH will grow specialist education, research and Construction of the VHH will innovation in Victoria generate significant economic benefits for . The VHH will undertake world leading clinical research and Victoria inform global best practice . The project will cost over $571m, with the hospital . The VHH will be a leading provider of cardiac specific expected to open in 2021 training for students and professionals . The construction of the VHH will directly create more than . The VHH will develop new medtech and pharmaceutical 1,700 local jobs products for the prevention and treatment of CVD

2 Document 7 The Victorian Heart Hospital will be the first of its kind in Australia

The Victorian Heart Hospital (VHH) will be Australia’s first dedicated, integrated specialist Project cardiovascular hospital that will improve the lives of individuals at risk of, or diagnosed with, cardiovascular disease (CVD). The VHH will integrate clinical care, research, training and education to Overview improve patient experiences and outcomes, accelerate cardiac research and advance and upskill the current and future medical workforce.

Key project facts

• The VHH will be located on the Monash University Clayton campus adjacent to Blackburn Road, which presents a number of key benefits: • Enhanced access to Monash University academic staff with closely linked research and education activities • Access to world-class infrastructure in the immediate surrounding area • The purpose-built VHH will include: • A Cardiac Emergency Department • Cardiac catheterisation laboratories • Specialist cardiac surgical and imaging facilities • Cardiovascular tele-health services Partners and roles • The VHH, once fully operational will have 204 beds • The VHH will have the capacity to: • Undertake 2,000 cardiac surgical procedure p.a. • Undertake 13,500 cardiac catheterisation laboratory procedures p.a. Policy and capital Clinical and translational Training, education • Undertake 108,000 consultations p.a. delivery partner research partner and research partner

Source: The Victorian Hear Hospital Full Business Case, DHHS, December 2016

3 Document 7 VHH will complement existing business and research activity in the Monash Cluster

Monash National Employment and Innovation Cluster Key attributes of the Monash Cluster

• The Monash Cluster has a critical mass of leading education, health and research facilities • Key metrics of the cluster, include: VHH site • Employs 82,000 people • Home to over 12,000 businesses • Represents 3.4% of jobs in Victoria • It includes business, commercial, industrial and employment areas within Clayton, Clayton South, Huntingdale, Monash University, Mulgrave, Notting Hill and Springvale • Prominent Monash Cluster occupants include: • Australia’s largest university, Monash University • Monash Medical Centre • Monash Children’s Hospital • the Australian Synchrotron • CSIRO’s largest site in Victoria • the Melbourne Centre for Nanofabrication • Monash Enterprise Centre

The VHH will leverage the facilities and capabilities that exist within the Cluster, foster great economic activity

Source: Plan Melbourne 2017-2050, Victorian Planning Authority; Monash Economic Value Assessment: Articulating the economic value of the Clayton Cluster, SPP March 2017

4 Document 7 VHH delivers benefits in four broad areas

Ongoing impacts

The cardiovascular care at the VHH VHH will deliver will improve patient outcomes, through co-location of leading improved outcomes cardiovascular care, research and and experience for training. The VHH will improve the The VHH project will have a cardiac patients experience of patients being treated major economic impact on VHH will deliver for cardiovascular disease. Victoria. The economic impact of significant economic the hospital is achieved through benefits to Victoria employment, procurement, research and teaching activity VHH will grow specialist The VHH partnership and situation at Monash University Clayton will education, research support the development of world and innovation in class research, training and Victoria education programs within the VHH.

Construction impacts

Construction of the VHH will generate The VHH will be a major infrastructure project for the Monash Cluster. The capital investment in the significant economic construction of the hospital will result in the creation of thousands of direct and indirect jobs. benefits for Victoria

5 Document 7 This project has used specific methodologies and a number of assumptions to calculate the impact of VHH to Victoria

Methodology for the calculation of the economic impact of the Methodology for articulating hospital, includes: additional metrics, includes any of • Clinical (Monash Health) • Collation of existing metrics from internal Clinical salary expenditure business cases for Monash University, impact • Clinical procurement Monash Health and the Department of • Retail sales Health and Human Services • Medical tourism • Leveraged previous ratios and • Research (Monash proportions for metrics to calculate the VHH’s Research University) salary future value of components of economic impact on impact expenditure and jobs impact GDP • Research procurement • Extraction of metrics from the new model • Research tenants rental of care income • Teaching income • Estimation of metrics by relevant internal Teaching • Professional development stakeholders, informed by previous impact income experience • Economic impact of international students

Key assumptions for this project:

• All metrics (unless otherwise stated) show the impact of the entire hospital, not the marginal benefit compared with existing operations, with all metrics considered at a Victorian scale only • The metrics will only show the direct impacts of the hospital rather than any indirect impacts. The assumption is that the project is fully funded and construction as outlined in the DHHS business case by 2021 • All metrics (unless otherwise stated) are for year 5 of operation, expressed in 2026 dollar terms, with VHH assumed to be fully operational by 2026 across both clinical care, research and teaching areas of the hospital • It is assumed that the VHH will service at least 80% of the catchment area, increased from the current 60% of public patients

6 Document 7 VHH will deliver significant economic benefits to Victoria

Document 7 The VHH will generate almost $400m in economic activity for Victoria in 2026 Components of the VHH’s economic impact:

Clinical Procurement $178m

Clinical Payroll

$102m ~$398m

Teaching Research $53m $59m Retail sales ($4.25m)

$19m $40m $13m Medical tourism ($2.75m) $21m $18m Education Tourism Research Payroll Professional Development Research Procurement Teaching Prestige tenants ($900k) The partnership with Monash University and location at its Clayton campus provides a direct economic impact of $110m+ through research and teaching on the economy

Source: Various data sources from Monash University and MonashHeart, Monash Health; SPP workbook ref (000,302)

8 Document 7 The VHH will be a major employer in the Monash Cluster

$142m spent on salary $178m spent on clinical 850+ employees expenditure procurement

Number of clinical and research employees at Salary for VHH clinical and research staff Procurement spend for the VHH VHH

The VHH will become a major employer in Staff salaries will result in the VHH directly The VHH will procure $178m worth of goods the Monash Cluster, by directly employing contributing $142m to the Victorian and services in 2026 to support the delivery over 850 people across the research and economy of world leading cardiac care clinical care areas

Source: Various data sources from Monash University and MonashHeart, Monash Health; SPP workbook ref (000,300,301)

9 Document 7 The VHH will attract international visitors and students to Victoria

~$18.6m injected into Victoria ~$2.75m spent by medical “tourists”

International education economic impact Medical tourism economic impact The VHH will support places in award and professional development The VHH is expected to become a destination for cardiac medical courses for international students. Their attendance and participation “tourists” due to the reputation and expertise of the hospital. This in courses at the VHH will contribute to the Victorian economy through income to Victoria excludes any medical costs associated with their their daily expenditure while studying. The teaching and professional treatment at the VHH, this number assumes their holidaying development programs delivered by the VHH will generate $18.6m in expenditure while in Victoria tourism expenditure by students while they are studying at the VHH

International education and medical tourisms contribute to the Victorian economy through their expenditure while traveling to Victoria. This figure includes all expenses related to their trip including flights, package tour expenditure, food and beverages, accommodation, leisure activities and conventions while in Australia*.

* - Tourism Research Australia Regional Expenditure Source: Various data sources from Monash University and MonashHeart, Monash Health; SPP workbook ref (000)

10 Document 7 VHH will deliver improved outcomes and experiences for cardiac patients

Document 7 VHH will significantly improve the patient experience

Less than 3 hours wait time for any Wait times reduced by up to 18 weeks 10% reduction in hospital length of stay inpatient test

Outpatient wait times at the VHH Reduction in length of stay Wait times for non-urgent procedures It is expected that wait times for outpatients at All cardiac inpatients on working days will The VHH will reduce cardiac patients average VHH will be reduced from 3 - 20 weeks to 1 - 2 access diagnostic services within 3 hours from hospital length of stay by 10% weeks the time of request during working hours

108,000 consultations capacity annually 2,000 transfers eliminated annually

Consultation capacity annually Hospital transfers will be reduced

The VHH eliminates the need for inter-hospital The VHH will have the capacity for 108,000 transfers between Monash Health locations consultations annually in the new facilities

21,000 bed moves eliminated annually >98% positive patient satisfaction HIMSS Stage 6 accreditation

Number of bed moves eliminated at VHH Patient satisfaction of good to excellent Accreditation level for the VHH IT system The VHH will implement a state of the art IT The VHH's universal inpatient cardiac bed The superior service and facilities at VHH is system to improve patient care and will achieve practice will reduce the number of bed moves expected to result in 98% of patients rating a HIMSS Stage 6 accreditation supporting its per patient by 3 per stay their hospital satisfaction as good to excellent commitment to safe patient care Source: Data supplied by MonashHeart, Monash Health; SPP workbook ref (000,100) 12 Document 7 Telehealth services will improve the care of CVD patients in rural and regional locations The VHH will deliver an extensive telehealth program for patients across regional Victoria, Project interstate and overseas. All consulting rooms in the VHH will be equipped with telehealth video Overview conferencing facilities that will connect specialists with patients, removing the need for patients to travel to their specialist appointments

Connecting remote patients to VHH partners Relevant patients: Relevant partners: • Pre-procedure and pre- • Local GPs, who provide surgery referrals to VHH • Post procedure specialists consultations • Regional hospitals, who • Ongoing care provide tests for patients • Medicare and DHHS

Benefits to patients Telehealth at the VHH will change the way that • Removal of travel time required for appointments remote patients access specialist cardiac care. Telehealth will support rural and non-local patients to • Reduced time away from work or caring for Changes to access new technologies, clinical trials and devices dependants. Virtual waiting rooms will allow patients that would previously be impracticable for these rural health to continue daily tasks while waiting for their patients, with telehealth enabling many of the pre consultation care and post procedure appointments to be conducted via • Increased access to services and specialities that are video conferencing. Telehealth will enable remote offered at the VHH patients to access leading specialists from a convenient location in a secure manner. • Reduced cost of travel

Source: Consultation with Anne Mennen, MonashHeart, Monash Health, May 2017; SPP analysis

13 Document 7 The VHH will deliver a premium patient experience

The VHH has a strong focus on delivering a strengthened patient experience at the VHH. Improving the Project patient experience enhances the reputation of the hospital and supports patients to achieve better Overview health outcomes. The VHH will implement systems, initiatives and programs to ensure that patients have the best experience possible prior to, during and after their experience at the VHH.

Example VHH initiatives:

Electronic Medical Records VHH patient app Premium patient facilities (EMR) • Improved patient safety • Tailored care and lifestyle information provided • Improved patient facilities, implementing directly to patients via the app state-of-the-art design features • Timely referrals • Integrated appointment booking capability • Access to adoption of technology • Access to comprehensive patient Wayfinding technology embedded to help direct information • Positive staff culture patients to appointments

Benefits: • Instantaneous discharge records • Extensive range of services • Push notifications provide patients with key provided to a patient’s GP information regarding the hospital • Universal bed would minimised number of bed moves during patient’s stay at the • Platform for patient feedback, electronic forms VHH and research capability

Source: Consultation with Anne Mennen, MonashHeart, Monash Health, May 2017; SPP analysis

14 Document 7 VHH will grow specialist education, research and innovation in Victoria

Document 7 The VHH will be a central player in the global advancement of cardiac research

~220 research scientists and clinicians $58m research and grant income in 2026

Research scientists and clinicians associated with the VHH Income for research at the VHH in 2026

The VHH will become Australia's leading cardiac research centre, supporting The VHH will attract significant financial funding to conduct research from around 156 research scientists and 64 clinician scientists in 2026. public, private and philanthropic organisations. This expected to include $39m of public funding, $10m from private organisations and an additional $9m from donations in 2026*

The research undertaken within the VHH will support the development of new devices, procedures and treatments for CVD A Deloitte Access Economics study into the return on investment on patient as well as support the development of the medical technology research funding found that every $1 invested into the NHMRC- and pharmaceutical industry in Victoria. It is expected that the funded health and medical research workforce for cardiovascular research at the VHH will be an accelerator attracting entrepreneurs to disease returned a benefits - costs ratio of $9.80. create innovative products and companies from the research activity in the hospital.

* - A proportion of private funding is accounted for in the public funding budget due to the industry contributions required for CRC funding Source: Various data sources from Monash University and MonashHeart, Monash Health; SPP workbook ref (000)

16 Document 7 The VHH will support the development of the future cardiac care workforce

~7400 learning days in 30 sub-specialty ~590 students in 2026 2026 fellowships in 2026

Students taught at the VHH in 2026 Professional development course days taught in Sub-speciality fellowships at the VHH in 2026 2026 The VHH will teach undergraduate The VHH will offer an extensive 30 sub-specialty clinical fellowships and postgraduate students across professional development program, will be offered at the VHH in 2026 to medicine, nursing and allied health which will include: further develop professionals that courses. In 2026 this is expected to support cardiac care in Australia include: Around ~7400 professional development teaching days In addition to cardiac fellows, the VHH ~310 undergraduate students will support the introduction of Professional development courses will fellowships in: ~260 postgraduate students include: extended, specialist, advanced and basic courses • Emergency medicine ~20 PhD students • Intensive cardiac care medicine • Anaesthetics

Source: Various data sources from Monash University and MonashHeart, Monash Health; SPP workbook ref (000, 200)

17 Document 7 The VHH will support the expansion of current clinical trial programs across all stages of product development

Project The VHH will be a world leading medical technology development hub and clinical trial location, Overview with specialties to deliver all the clinical trial stages for devices and pharmaceutical development.

The med-tech innovation product development pipeline:

Concept Pre- First-in- Identification of Bench Clinical Product Integration into design & Prototype clinical human clinical need testing trial launch clinical practice visualisation testing testing

Future range of focus at the VHH

The vision for the VHH is for the hospital to play a leading role, across the entire clinical trial pipeline, in the development of devices and pharmaceuticals for the treatment of CVD. This initiative is expected to be in collaboration with local and international start up companies and with leading multinational companies with an interest in CVD.

• Development of a full cardiac clinical trial pipeline for Victoria • Support for start-ups and innovative researchers to develop their Benefits of products and thrive within an innovation ecosystem at the VHH and clinical trial the Monash Cluster program to • Help attract venture capital investment into new cardiac devices Victoria • Provide a training hub for innovative medtech device specialists • Co-location with Monash University supporting medtech researchers and engineers to respond to identified clinical needs Source: Consultation with James Cameron, MonashHeart, Monash Health, May 2017; SPP analysis 18 Document 7 Clinical trial capability will foster industry collaboration

The clinical trial ecosystem will support the That provide social and delivery of novel healthcare solutions to To deliver outcomes… economic benefit for Victoria patients globally, from Victoria…

Medtech start ups Increased number of start-ups Accelerated product development and research spin- associated with CVD outs Attraction of leading multinationals to Victoria Growth of start-ups

Increase in the number of buy outs by large multinationals of Australian start-ups Commercialisation of research Local VHH Clinical Increased venture capital funding industry Trial Hub for clinical trials by start ups Improved health outcomes Expedited product development process due to VHH research capabilities New international investment and Support for the development of jobs Medtech and pharmaceutical industry Multinational in Victoria medtech Attraction of leading clinicians to the Victoria is recognised as an companies VHH due to a leading program for innovator in CVD treatment product development

Improved access to cutting edge Expansion of Victorian medtech Source: Consultations with Monash University and MonashHeart, technology for patients and pharmaceutical industry Monash Health; May 2017; SPP analysis

19 Document 7 Construction of the VHH will generate significant economic benefits for Victoria

Document 7 The construction phase of the VHH will support the creation of local jobs

$571m capital spend on the 1,700+ construction jobs construction of the VHH created to build the VHH

Cost of construction for the VHH Construction jobs created by the VHH

The construction of the VHH is expected to commence in late The construction of the VHH will be a major infrastructure project 2018 following the completion of the design phase and early for Victoria. It is expected for every $1m spent on the construction works. It is expected that the construction phase of construction of hospitals supports 3 construction jobs the VHH will take nearly 3 years to complete and will allow the throughout the project. hospital to open in 2021

Source: DHHS Business Case; Consultation with Tony Michele, DHHS, April 2017; SPP analysis

21 Document 7 Acknowledgements & next steps

Document 7 SPP would like to thank the follow people for contributing to this report

Consultees: Disclaimer

• Sarah Newton, Deputy Dean, External Relations, Medicine, Nursing • This project was prepared by SPP in and Health Sciences, Monash University May 2017. It sought to articulate the future economic impact of the • Megan Astle, Group Manager, External Relations (Projects), Victorian Heart Hospital through a Medicine, Nursing and Health Sciences, Monash University series of key messages. This should be read alongside the supplement pack • Anne Mennen, Director of Development, Victorian Heart Hospital, which details the approach to MonashHeart, Monash Health calculating the included messages and • James Cameron, Director Monash Cardiovascular Research Centre, metrics. Associate Director, MonashHeart, Monash Health • Monash University and Monash • Tony Michele, Project Director, Infrastructure Planning and Delivery Health were the primary sources for Branch, Department of Health and Human Services data used throughout this report

• Andrew Coates (indirectly), Director of Monash Warwick Alliance • Data to inform impact metrics were and Academic Vice-President, Monash and Warwick Universities provided by Monash University and / or Monash Health • Ben Vivekanandan (indirectly), Director, Government Relations, External Relations, Development and Alumni, Office of the • Metrics are reflective of the current President and Vice Chancellor, Monash University VHH plans as at May 2017

23 Document 7 Appendix A: Summary of Gross Domestic Product calculation

Document 7 The calculation for VHH’s impact on GDP combined three elements

ITEM: ASSUMPTION:

Clinical (Monash That the staff expenditure represents salary and on costs for staff at Monash Health. It is Health) salary assumed that the Monash Health salary expenditure is an indicative cost profile that can expenditure apply to VHH’s clinical staff to indicate expected salary expenditure Clinical That procurement includes all aspects of procurement for the clinical components of the Clinical procurement VHH impact Retail sales That the retail area in the VHH returns a similar rate as the baseline business used by Monash Health to give an indicative impact of retail sales Medical tourism That medical tourists to the VHH spend additional time (14 days) in Melbourne around their hospitalisation, where they spend money in the local market with their carer as well

Research (Monash That the research salary includes 156 research staff members plus an additional ~100 University) salary professional staff members to support research activities (based on ARMI ratio) and that the expenditure blended average salary of ARMI is an indicative salary for VHH researchers VHH’s Research impact on Research That after removing MU salary expenditure from grant income the remaining value impact GDP procurement represents the value of research procurement at the VHH Prestige tenants That the blended m2 rate for similar rental spaces owned by Monash University at the Alfred rental income is an indicative rate to calculate the rental income from prestige tenants at the VHH

Teaching income That Monash University can provide and fill all the places modelled for undergraduate and postgraduate course and receive the ratio of domestic and international students in 2026 Professional That MU can provide and fill all professional development days expected for 2026 and Teaching development income receives the expected income impact Economic impact of That international students for award and non award courses have a certain level of international expenditure into the tourism economy while they are studying at the VHH and that their students length of stay in Victoria is as stated in the modelling

25 Document 7 Document 9 Document 9 Not Relevant Document 9 Not Relevant Document 12 33(1) Document 12 33(1) Investment Logic Mapping

Context

The Victorian Government’s Investment Planning and Evaluation guidelines (the “Guidelines”) (published by Department of Treasury and Finance) outline key requirements to obtain funding approval (and then implement) major capital projects. The Guidelines are comprised of the Investment Lifecycle Framework (an overview is attached separately) and High Value High Risk (“HVHR”) guidelines, which are supported by the Investment Management Standard (“IMS”). The Investment Logic Map process is part of the IMS. It provides the overall rationale for the project and an ongoing point of reference for project direction.

The HVHR guidelines mandate a high level of scrutiny and monitoring of projects with a capital cost of $100m or more, which have been evaluated as high risk or which Government has otherwise identified warrant extra rigour.

A business case, prepared in accordance with the Guidelines, forms the core of any funding submission to be considered in the State’s annual budget process.

ILM Workshop process

The IMS suggests the following line of enquiry in developing an ILM:

What is the What benefits What is the What is the preferred need to be preferred problem? strategic delivered? solution? response?

Answers to these questions are generally developed in a workshop, with a one-page ILM being the key output. Some example ILMs are attached separately, as reference for the following commentary.

What is the problem? The problem statements are initially developed as part of the ILM process. There are up to four problem statements developed for the initiative. Four key questions should be addressed in terms of defining the problem. These are:

 Is the problem clearly defined in terms of cause and effect?  Is there sufficient evidence to confirm both the cause and effect?  Does the problem need to be addressed now?  Does the defined problem capture its full extent / scope?

Prior to the workshop, participants may like to consider the likely problems or issues that exist and how these may be evidenced throughout the business case.

What benefits need to be delivered? There are up to four benefits statements developed for the initiative. The benefit statements should be made up of an overarching statement that provides line-of-sight to the outcomes the organisation is seeking and is (ultimately) supported by two high-quality KPIs. These KPIs should be outcome rather than output or activity focused.

Document 12

Four key questions should be addressed in terms of defining the benefits:

 Have the benefits been adequately defined in the context of the problem?  Are they of high value?  Are the KPIs smart and provide strong evidence the benefits have been delivered?  Have key dependencies been considered?

Prior to the workshop, participants may like to consider the likely benefits that are realisable in overcoming the identified problems.

What is the preferred strategic response? The strategic response is the third column of the ILM. It should set out each strategic intervention identified as a preferred response to an identified problem(s).

Strategic interventions can be considered in the context of:  changing the demand – stop, slow, divert or increase it;  improving productivity – improve its productivity or effectiveness; and  changing supply – treat it, fix it.

At a high level each business case should address the series of strategies that were considered to address the problem. Questions asked are:  Have a reasonable spread of strategies been considered?  Is there evidence to demonstrate strategies are feasible?  Were options evaluated fairly?  Is the preferred strategic option the most effective way to address the problem and deliver benefits?

Prior to the workshop, participants may like to consider a series of combination of interventions and connect them to the relevant benefits to which they relate. A minimum of four and a maximum of eight strategic interventions should be considered.

What is the preferred solution? The items in the Changes and Assets columns form the solution. Changes are the things that must be done by the business if the expected benefits are to be delivered. Changes provide the detail of how the strategic response will be put into effect. Assets are any physical items that must be acquired to enable the identified changes to occur. Examples of these are hospitals (or other buildings), pipelines, plants or computer systems. A change must align with at least one strategic intervention.

In defining the project solution, the following four questions are asked:

 Have a reasonable spread of project options been considered?  Is recommended solution the best value for money way to deliver the benefits?  Is the solution specified clearly and fully?  Can the solution really be delivered?

Prior to the workshop, participants may like to consider several Changes and Assets that could result from the strategic interventions considered.

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Investment Lifecycle Framework The investment lifecycle framework guides Victorian Government investments, ensuring that the State receives maximum benefit from the investment of public money.

This simple framework depicts the lifecycle of an investment which may take place 1 2 3 4 5 over many years Conceptualise Prove Procure Implement Realise Establish a clear need, define Explore project options and Finalise procurement plan, Implement solution and Measure the success of the likely benefits and explore estimate costs to validate value specify requirements, engage transition to normal investment strategic interventions for money and viability the market and award business contract Confirm the need Recommend an investment Award a contract Deliver the solution Deliver the benefits

The framework is High value/high risk Investments Technical Guidelines scalable, with the Investments which meet one or more of Each stage of the Framework is set out in Procurement guideline effort required the following are determined to be high a detailed guideline. For more technical dependent on value/high risk (HVHR) and will face a components of the lifecycle, DTF has ICT guideline: Business case the value and/or greater level of scrutiny and monitoring developed a number of technical ICT guideline: Procure and deliver throughout the investment lifecycle: guidelines including: complexity of the Sustainability guideline investment a TEI of $100m plus; or Economic evaluation guideline Investment business plan guideline Score ‘High Risk’ on the Gateway Project budget guideline RFT communication guideline Project Profile Model; or Project risk guideline Consultation guideline Government identifies that the investment warrants extra rigour. Governance guideline www.lifecycleguidance.dtf.vic.gov.au

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Investment Lifecycle Framework The processes and requirements of the investment lifecycle framework can be scaled to suit the needs of a wide range of investment programs

1 2 3 4 5

Conceptualise Prove Procure Implement Realise Establish a clear need, define Explore project options and Finalise procurement plan, Implement solution and Measure the success of likely benefits and explore estimate costs to validate specify requirements, engage transition to normal business the investment strategic interventions value for money and viability the market and award contract Confirm the need Recommend an investment Award a contract Deliver a solution Deliver the benefits

Strategic assessment Full business case Project status reports Project wrap-up report Preliminary business case Investment business plan Expression of interest Investment evaluation report (HVHR investments)* Request for tender Contract Outputs Outputs Outputs Outputs Outputs Project status reports

Investment lifecycle overview Prove guideline Procure guideline Implement guideline Realise guideline Conceptualise guideline Investment business plan guideline Guidelines Guidelines Guidelines Guidelines Guidelines

Project profile model Project profile model Procurement tool Benefits realisation tool IMS tools IMS tools Investment decision-maker’s Investment decision-maker’s Tools Tools Tools Tools Tools checklist (stage 1) checklist (stage 2)

Gate 1 Gate 2 Gate 3 Gate 5 Gate 6 Concept and feasibility Full business case Readiness for market Readiness for service Benefits realisation Gate 4 Gateway Gateway Gateway Tender decision Gateway Gateway

Government filtering Government funding Government approval Government monitoring Government evaluation

*High value/high risk (HVHR) investments include some further specific requirements. To find out more about HVHR investments, read the Overview, at www.lifecycleguidance.dtf.vic.gov.au Document 12 DEPARTMENT OF HEALTH (Fictional)

Improving access to health services in rural Victoria Health workforce enhancement program

INVESTMENT LOGIC MAP Initiative PROBLEM BENEFIT STRATEGIC SOLUTION RESPONSE CHANGES ASSETS

Improved health Shortage of health outcomes for regional professionals is Victorians Reduce the cost burden for patients Develop grants and limiting the health subsidy program for 50% to access services in care available to KPI 1: Access to medical patients requiring metropolitan areas treatment in city growing regional health services 15% communities 60% KPI 2:Increased use of medical services

Use information technologies to Develop telemedicine allow local program in areas of Upgrade to IT practitioners and high demand and infrastructure consultants to shortage deliver services 35% More engaged and capable workforce Broaden range of 30% training and Develop career path- KPI 1: Reduction in skill professional way that integrates Upgrade to off-campus shortages in health development for training in primary care training facilities & medical procedures sector students and local KPI 2:Increase in range professionals 20% courses available Expand Continuing Professional Development activities & provide support

Provide an incentive program for graduates & current professional Sustainable regional to undertake training Loss of local health communities profession students Provide incentives 20% and support to local pursuing better KPI 1: Attraction of medical Develop recognition and remuneration professionals to study opportunities graduates to rural strategy that rewards is impacting growth practice undertake training retention KPI 2:Retention of in rural medicine of regional and rural 30% communities 40% professionals within rural practice

Investor: Version no: Facilitator: Initial Workshop:

Accredited Facilitator: Yes / No Last modified by: 12 Template version: 5.0 DEPARTMENT FOR THE ARTS (Fictional)

Increasing access to the performing arts for regional and rural Victoria Small theatre companies initiative

INVESTMENT LOGIC MAP Initiative PROBLEM BENEFIT STRATEGIC SOLUTION RESPONSE CHANGES ASSETS

Increased Victoria’s reputation as competition from a leader in performing other States is Increase support arts is maintained 30% and incentives for Target artists and reducing performing KPI 1: Increase in the production and companies and offer artists and productions touring touring of sponsorship and marketing support KPI 2:Increase in commissioned companies touring works 20% regional Victoria commissioned works from regional artists Re-engineer show 40% development and touring schedule & profile new works

Broaden the marketing mix to Prepare and implement target new and non- market development traditional and promotion strategy Reduction in small Cultural life of audiences 25% community-based communities is Expand the theatre companies enriched programming profile using major regional 50% to new cultural and education programs venues has KPI 1: Increase in audience numbers restricted the range KPI 2:Increase in of arts programs program diversity offered 35% Improve the flexibility of venue spaces and improve Work with local councils and venue Upgrade to target their suitability and managers to develop venues appeal to small new design plans niche audiences 35%

Immature business More sustainable arts organisations experience within Improve the skills 20% of regionally based the independent arts KPI 1: Growth in regional independent artists Develop arts incubator programs in regions to Lease meeting and to attract new sector is impeding performing arts market support skill training facilities growth within KPI 2:Increase in audiences and sell development their productions regional areas regional touring by independent companies 20% 25% and artists

Investor: Version no Facilitator: Initial Workshop::

Accredited Facilitator: Yes / No Last modified by: 12 Template version: 5.0 Document 14 33(1) Document 14D 33(1) Document 14D Document 16 33(1) Document 17 33(1) Document 17 Document 19A 33(1) Document 20 33(1) Document 20 Document 20G 33(1) Document 22 33(1) Document 22 33(1) Document 23 33(1) Document 24 33(1) Document 30 33(1) Document 30 33(1) Veda Advantage Information Services and Solutions Ltd ABN 26 000 602 862

Service Request ID: 150928-W5429-03MCZ Client Charge Back No: Report date: 28 Sep 2015 Business Name Current Extract

VEDA ADVANTAGE INFORMATION SERVICES AND SOLUTIONS LTD 28/09/2015 A.C.N. 000 602 862 REQUEST ID: 150928-W5429-03M80

*** BUSINESS NAME EXTRACT (CURRENT INFORMATION ONLY) ***

Veda File No : 831369041

Extracted from Business Names Register on 28 September 2015 14:59

Business Name : Victorian Heart Hospital State Registration No: Not Applicable State Name : Not Applicable Jurisdiction : ASIC Date Registered : 19-Aug-2015 Next Renewal Date : 19-Aug-2018 Date Cancelled : Not Applicable Registration Status : Registered as of 19-Aug-2015

Principal Place of Business Address (Current): Address : 89 Bridge Rd Richmond VIC 3121 Start Date : 19-Aug-2015

Service of Notice Address (Current): Address : 89 Bridge Rd Richmond VIC 3121 Start Date : 19-Aug-2015

Adverse Information: (Includes Defaults, Mercantile enquiries, Judgements and Writs) Adverse information present on Veda file : NO

Business Name Holder Details: ======

Organisation Name : EPWORTH FOUNDATION Organisation ACN : None Organisation ABN : 97420694950 Type : UNINCORPORATED BODY Start Date : 19-Aug-2015

Name : Lye, Tess ABN : None Type : INDIVIDUAL REPRESENTATIVE OF EPWORTH FOUNDATION Start Date : 19-Aug-2015

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Document 30

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Attention:

Department of Health and Human Services 50 Lonsdale Street MELBOURNE VIC 3000

Dear

Re: Return Brief and Preliminary Fee Proposal Victorian Heart Hospital (VHH) VHH Model of Care VHH Functional Brief

1.0 Introduction

We refer to your request for a return brief as per our meeting of 13 April 2016 and the enclosed written request.

STH, represented by will co-ordinate both internal resources and external consultants (Jill Howard to undertake the work). This proposal is submitted as a return brief with preliminary fees and program which will be subject to further discussion with the Department of Health and Human Services (DHHS) to finalise those items. In addition we understand further discussion will need to be undertaken to confirm program, process and fee proposal.

2.0 Context

The Victorian Heart Hospital (VHH) Project is the first purpose built specialist heart hospital capital investment initiated by Government, and presents a once in a lifetime opportunity to create a patient focused, integrated cardiovascular centre that will improve the lives of those in Victoria’s growing and ageing population at risk of or diagnosed with cardiovascular disease.

The VHH to be located on the Monash University site is not occurring in isolation, the VHH is a partnership between Monash Health, Monash University, other Health and Research providers and the Victorian Government and builds on the achievements of MonashHeart, the specialist cardiology service provider of Monash Health and currently the largest provider of cardiac care in Victoria.

Document 80 33(1) Victorian Heart Hospital STH Architects

The Project also is to be undertaken within an environment of reform to the public cardiac system across the state as outlined in the ‘draft’ Victorian cardiac service plan 2015. The service plan builds on and continues the evolution of the cardiac system of care outlined in Heart Health: improved services and better outcomes for Victorians (‘Heart Health’)1 released by the department in 2014.

The draft Victorian Cardiac Service Plan ‘addresses the need for statewide service planning which can be used to determine the role of individual health services and agencies’.2

The focus of the draft service plan concentrates on three priority themes:  Better patient access, experience and outcomes  A coordinated cardiac system of care  Effective and innovative cardiac services The draft service plan proposes a major change from the current service configuration ‘by creating a limited number of specialist cardiac services or consortia to build clinical leadership, coordinate care, drive improvement in research and expand innovative models of care to benefit all Victorians. The VHH will be established as the specialist centre for the southern and eastern areas, noting the ongoing role of The Alfred in transplantation services’.3

New and innovative models of cardiac care that are patient-centred and service orientated including use of new technology, research, education and training will be developed to enhance both patient experience and seamless patient flow.

3.0 Scope of Service

The Department of Health and Human Services has requested Silver Thomas Hanley (STH) Principal Consultants for the VHH Masterplan and Feasibility Study to submit a return brief identifying preliminary resource requirements and project outline required to achieve the following project objectives:

 STH to develop a framework, methodology and project program in order to achieve the following outcomes:

o work with VHH project planning team to facilitate the development and compilation of the VHH Strategic Service Delivery Model which encompasses a whole of system (integrated) redesign of cardiac services incorporating Monash Health, (Monash Heart) Monash University, other health partners and service providers, State Government and

o work with VHH project planning team to facilitate the development and compilation of the Models of Care that are focused on the operational, education, research and teaching elements of the service streams that are to be provided to the community; creating an environment that encourages and promotes new and innovative evidence based methods of delivering cardiac care; encourages and supports staff to adopt new organizational values and systems of work that will lead to an optimally patient centred and outcome focused approach to care.

1 Department of Health 2014. Heart Health; improved services and better outcomes for Victorians, State Government of Victoria, Melbourne. 2 Draft Victorian cardiac service plan: The future of Victorian cardiac services‐ 2015: Victorian Government – Department of Health. 3 Draft Victorian cardiac service plan: The future of Victorian cardiac services – 2015: Victorian Government‐ Department of Health.

2 Document 80 Victorian Heart Hospital STH Architects

o Facilitate and compile a Functional Brief which will describe how the facility will function and will also inform the design requirements for a capital project. The AustHFG and Monash University Guidelines will provide the context for the development of the Functional Brief. The newly developed Models of Care will inform the Functional Brief and will incorporate the guiding principles of a 21st century heart hospital inspired by new innovations in cardiovascular health care delivery, education and training through a facility that:

. embraces national and international design to encourage research and innovative practice, education and training; and . supports a design and culture that speaks universally to a seamless, supportive, user-focused, personally empowering care model of ‘recovering from, adapting to and successfully living with’ rather than the more traditional, and somewhat segmented, acute and post-acute care model.4 . supports ultra-modern, technically advanced, highly safe and cost efficient service delivery. . meets the requirements and objectives of the major stakeholders and the State Government.

4.0 Project Personnel

The proposed personnel to undertake this project are as follows:

Architect To be advised

Administrative Assistant – Data To be advised Input

Graphic Designer / Support To be advised

Note: Detailed responsibilities for each of the project personnel when detailed scope process and program is agreed.

5.0 Governance

The Project will require defined governance structures including a Communication and Risk Strategy. These need to be developed with the major stakeholders in consultation with the State (DHHS).

 Project Governance - Steering Committee and membership  Clinical/Research Governance  Organizational Governance

4 ‘At the heart of care and innovation’.Victorian Heart Hospital – An initiative of MonashHeart, Monash Health ,Monash University and the Victorian Government ‐

3 Document 80 33(1) Victorian Heart Hospital STH Architects

 The project will require a number of committees and working groups (broad range of stakeholders) each working group will require senior Planning Leads i.e. Clinical/Research Service Director paired with a senior executive member and/or nominated person who will lead the broad range of stakeholders in developing the following:

o ‘Strategic Service Delivery Model’ which will describe an organization wide Model of Care i.e. VHH may operate as the ‘hub’ for the Integrated Cardiac Service supporting ‘spoke’ cardiac services located at other Monash Health Hospitals and community sites as well as have a specialist ‘statewide’ focus and service, and partnerships and linkages involving research, education, and training with various institutions. The Strategic framework provides an overview of how a clinical or non-clinical service will be provided across a health service and detail the capability and characteristics of the service to be provided, and the role that each site/setting in the health service plays in providing the clinical or non- clinical service. o The Strategic Service Delivery Model will also include the VHH Project Vision, Goals and Objectives, Project Guiding Principles, Philosophy and Principles of Care, Partnerships and Linkages, elements instrumental to the development of Models of Care, Demographic Profiles, Cultural and Linguistic diversity, Catchment areas, Service Activity (current and projected), Workforce impacts, Consumer and Community Consultation o ‘Models of Care’- The development of integrated work stream models of care link the operational detail of how a service is delivered at a site, and how this service integrates with other health care providers within a network. The Model of Care links the operational detail of how a service is delivered at each site to the higher-level principles of service delivery across the health service (documented in the ‘Strategic Service delivery Model document)’. o Functional Brief – many of the working groups involved in the MOC development will also be involved in the development and review of the Functional Brief. All working groups/streams will be supported by STH clinical planner, and architectural expertise as required.

6.0 Program

Based on the initial review of your enclosed briefing document we anticipate a program as follows:

Report 1 Victorian Heart Hospital Model of Care – 3 months/13 weeks (June, July, August 2016)

Report 2 Victorian Heart Hospital Functional Brief – 3 months/13 weeks (September, October, November 2016)

7.0 Preliminary Fee Proposal

Our preliminary fee is based on staffing required over the 6-month program.

4 Document 80 Victorian Heart Hospital STH Architects

Name Title Total Weeks Cost Involvement* (Excl GST)

4 $32,000

23 $138,000

TBC Administrative 23 $46,000 ($50/hr) Assistant – Data Input

TBC Graphic 4 $9,600 ($60/hr) Designer/Support

TBC Architect 4 $18,400 ($115/hr)

1 $9,000

TOTAL $253,000

*Based on 40 hours per week.

The above table represents a preliminary calculation of total resourcing and cost and will require detailed discussion with DHHS, MH and MU to inform the final calculation based on detailed program and resourcing hours.

Yours sincerely SILVER THOMAS HANLEY (AUS) PTY LTD

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15 April 2016

Attention:

Department of Health and Human Services 50 Lonsdale Street MELBOURNE VIC 3000

Dear

Re: Return Brief and Preliminary Fee Proposal Victorian Heart Hospital (VHH) VHH Model of Care VHH Functional Brief

1.0 Introduction

We refer to your request for a return brief as per our meeting of 13 April 2016 and the enclosed written request.

2.0 Context

Document 81 33(1) Victorian Heart Hospital STH Architects

The draft Victorian Cardiac Service Plan ‘addresses the need for statewide service planning which can be used to determine the role of individual health services and agencies’.2

3.0 Scope of Service

 STH to develop a framework, methodology and project program in order to achieve the following outcomes:

2 Document 81 Victorian Heart Hospital STH Architects

4.0 Project Personnel

The proposed personnel to undertake this project are as follows:

Architect To be advised

Administrative Assistant – Data To be advised Input

Graphic Designer / Support To be advised

Note: Detailed responsibilities for each of the project personnel when detailed scope process and program is agreed.

5.0 Governance

The Project will require defined governance structures including a Communication and Risk Strategy. These need to be developed with the major stakeholders in consultation with the State (DHHS).

 Project Governance - Steering Committee and membership  Clinical/Research Governance  Organizational Governance

4 ‘At the heart of care and innovation’.Victorian Heart Hospital – An initiative of MonashHeart, Monash Health ,Monash University and the Victorian Government ‐

3 Document 81 33(1) Victorian Heart Hospital STH Architects

6.0 Program

Based on the initial review of your enclosed briefing document we anticipate a program as follows:

Report 1 Victorian Heart Hospital Model of Care – 3 months/13 weeks (June, July, August 2016)

Report 2 Victorian Heart Hospital Functional Brief – 3 months/13 weeks (September, October, November 2016)

7.0 Preliminary Fee Proposal

Our preliminary fee is based on staffing required over the 6-month program.

4 Document 81 Victorian Heart Hospital STH Architects

Name Title Total Weeks Cost Involvement* (Excl GST)

4 $32,000

23 $138,000

TBC Administrative 23 $46,000 ($50/hr) Assistant – Data Input

TBC Graphic 4 $9,600 ($60/hr) Designer/Support

TBC Architect 4 $18,400 ($115/hr)

1 $9,000

TOTAL $253,000

*Based on 40 hours per week.

Yours sincerely SILVER THOMAS HANLEY (AUS) PTY LTD

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