Kingston SE Robe 10 Year Local Health Service Plan
2011 – 2020
Kingston Robe Health Advisory Council Kingston SE Robe Multipurpose Service Country Health SA Local Health Network
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10 Year Local Health Service Plan
Kingston Robe MPS
2011 - 2020
Table of Contents
1. Executive Summary ...... 3 2. Catchment summary...... 5 3. Needs Analysis summary...... 8 4. Local implications of Statewide plans...... 10 5. Planning Principles...... 11 6. Service Delivery Plan...... 12 6.1 Core Services to be Sustained ...... 12 6.2 Strategies for the Future...... 15 7. Key Requirements for Supporting Services...... 18 7.1 Safety & Quality...... 18 7.2 Patient Journey ...... 19 7.3 Cultural Respect...... 20 7.4 Engaging with our community...... 21 7.5 Local Clinical Networks ...... 22 8. Resources Strategy ...... 23 8.1 Workforce...... 23 8.2 Infrastructure ...... 24 8.3 Finance ...... 24 8.4 Information Technology...... 25 8.5 Risk Analysis...... 26 9. Appendix ...... 27 9.1 Leadership Structure ...... 27 9.2 Methodology...... 27 9.3 Review Process...... 27 9.4 Glossary...... 27
Date: 29 June 2011
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1. Executive Summary
Background and context
The Kingston Robe Health Advisory Council (HAC) has taken the lead and determining role in the development of the 10 Year Health Service Plan, with the support of the management of the Kingston SE Robe Multipurpose Service (MPS) and the Country Health SA Local Health Network (CHSALHN) Planning Projects Team. The Kingston Robe Health Advisory Council has worked closely with health services in the planning and implementation of the community consultation as well as the review and consultation of the Plan.
A workshop was held in May 2009 involving the Kingston SE Robe MPS Executive and HAC members to identify the priority areas for community consultation and the process of engagement.
Between July 2009 and February 2010, the community consultation process sought feedback on the health service needs of the local population. Also during this period, a detailed profile of the catchment area and health services available was compiled.
In April 2010, the Kingston SE Robe Executive team, in partnership with Health Advisory Council members, undertook a needs analysis process to capture the strengths, weaknesses, opportunities and threats (SWOT) of existing services and future directions. The needs analysis has drawn on information obtained through the consultation process and analysis of the Health Service Profile and other relevant data.
A significant issue expressed in community feedback was the need for the Health Service to continue to provide the local community with services currently available, particularly emergency services and aged care services and to continue to develop integration of services within the Kingston SE Robe MPS.
Key components of the Plan
The key evidence which supported the strengthening of existing services as well as the development of new programs includes the right for people to access services close to home within resources, risk factors (alcohol consumption, high blood pressure, obesity, physical inactivity, and smoking), and a higher prevalence of chronic disease - arthritis, asthma, cardiovascular disease and mental illness.
The Kingston SE Robe communities exhibit the following characteristics: • Insufficient catchment population to sustain separate acute hospital, residential care, community health and home care services. • Inability to access the mix of health and aged care services appropriate to their needs, due to isolation. • Existing complementary (rather than competing) services. • Common service boundaries reflecting a common sense of community.
The Kingston SE Robe service has been a recognised Multipurpose Service site since 2008 with this model supported by existing health professionals, including general practitioners (GPs). The flexibility of this model facilitates the delivery of hospital, aged care and community health services to the wider community, incorporating the towns of Kingston, Robe and as far east as Lucindale.
Since shifting to the MPS model in 2008, the organisation is integrated with acute care, aged care and most community health services managed under a single structure. The process of integrating two previously independent organisations (Kingston Soldiers’ Memorial Hospital and local elements of South East Regional Community Health Services) has provided some challenges. There has been extensive learning from the process and there is a deep commitment to continue to develop services within the philosophy of the MPS model.
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To sustain, maintain and develop services to meet the growth and needs of the community is the primary focus of the Plan including 24/7 emergency services, acute inpatient care, aged care, community and outpatient care, palliative care, clinical support services, medical specialties services, mental health and Aboriginal health care with strong links to the local Country General Hospital in Mt Gambier.
The predominate service providers in the catchment area outside of the Kingston SE Robe MPS are the local general practices and Pangula Mannamurna for Aboriginal health care.
Recommendations
• Support provision of limited ultrasound services within capacity of local GPs. • Strengthen primary and preventative health care provided to the community. • Meet the residential nursing home and home care requirements for older people in the catchment area. • Utilise technology to secure remote specialist contribution in conjunction with expanded diagnostic investigations locally. • Explore options to redevelop the current facility to be able to provide more workable and safer working conditions for staff, patients and visitors.
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2. Catchment summary
Introduction
The township of Kingston is located approximately 300 kilometres south-east of Adelaide and approximately 160 kilometres north of Mount Gambier Country General Hospital, and Robe is located approximately 340 kilometres south-east of Adelaide and 130 kilometres north of the Mount Gambier Country General Hospital.
The Kingston Soldiers’ Memorial Hospital which supports both Robe and Kingston townships, is situated within the Kingston Regional Local Government area. The catchment area for the Hospital encompasses the Kingston and Robe Statistical Local Areas (SLA) covering approximately 4,300 square kilometres extending to Greenways and Nora Creina to the south, the lower Coorong to the north, and towards Avenue and Padthaway to the east (see map below). It is recognised that some residents living in Avenue and other areas west of Lucindale in the Naracoorte catchment access services from the Kingston Hospital.
Reference: http://www.atlas.sa.gov.au/
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Population
The estimated resident population for the Kingston/Robe catchment is 3,906 (DPLG, ERP, 2011). People from Aboriginal and Torres Strait Islander backgrounds comprise 1.1% of the Kingston/Robe catchment compared with 3.1% of the total country South Australian population. Approximately 0.9% of the population in the Kingston/Robe catchment speak a language other than English at home, compared with 3.9% of the total country South Australian population.
When compared with country South Australian averages, there is a lower proportion within the Kingston/Robe population under the age of 45 years, and a higher proportion above 45 years (particularly in the 65-84 year age group). The projected population for the catchment area is estimated to increase slightly by the year 2021. The average fertility rate for the catchment is approximately 2.2. This is above replacement level and higher than the South Australian rate (1.82). The indirect standardised death rate for the catchment ranges from 4.9 (Robe SLA) to 5.8 (Kingston SLA). This is lower than the South Australian average (6.1).
The broader Limestone Coast region (which includes Kingston, Robe, Naracoorte, Bordertown, Meningie, Penola, Millicent and Mount Gambier) received an estimated 589,000 overnight visitors and 1,758,000 day visitors in 2007.
Table 1: Kingston SE Robe catchment population
Country USE Cluster SA total No. % SA Cluster % % % Total Population 3,906 19,806 490,635 1,667,444
Males 2,009 51.4% 10,289 51.9% 50.5% 49.4% Females 1,897 48.6% 9,517 48.1% 49.5% 50.6%
0-14 years 669 17.1% 3,764 19.0% 20.4% 18.5% 15-24 years 421 10.8% 2,356 11.9% 11.4% 13.3% 25-44 years 875 22.4% 5,133 25.9% 25.1% 26.7% 45-64 years 1,149 29.4% 5,469 27.6% 27.3% 26.1% 65-84 years 704 18.0% 2,670 13.5% 13.9% 13.4% 85 years and over 88 2.3% 414 2.1% 1.8% 2.0%
ATSI* 43 1.1% 208 1.1% 3.1% 1.7% CALD* (Speaks a language 37 0.9% 823 4.2% 3.9% 12.2% other than English at home) Source: Projected population by age and sex – SLAs in South Australia, 30 June 2011, Department of Planning and Local Government *Source: 2006 ABS Census
Socioeconomic factors
The catchment region has been identified as outer regional indicating a moderate level of remoteness when compared with other South Australian locations. The catchment reflects a moderate (Robe SLA) to high (Kingston SLA) degree of socioeconomic disadvantage. This is particularly reflected in significantly lower than average median individual, family and household incomes in the Kingston SLA region when compared with South Australian averages. Limited transport options are available from Kingston to Adelaide return. A transport service operates in the area to enable people who have no access to other means of transportation to attend medical appointments.
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Based on data which monitors the trends of diseases, health related problems, risk factors and other issues across major regional areas, the South East region demonstrates higher levels of risk factors for overweight, obesity, physical inactivity, and smoking when compared with total South Australia. The prevalence of chronic disease for persons aged 16 years and over in the South East region demonstrates a higher prevalence of diabetes when compared with total South Australia.
The Limestone Coast is one of South Australia's highly productive and diverse agricultural regions with a range of products including vegetables, wine grapes, cereal grain, softwood timber, pastures and livestock. Fishing is also a major contributor to the regional economy and aquaculture an emerging industry. Unique natural attractions such as the World Heritage listed Naracoorte Caves and the Blue Lake at Mount Gambier contribute to an active tourism industry.
Agriculture, forestry and fishing make up 36% of total employment across the Kingston/Robe catchment, followed by accommodation and food services (11%) and retail trade (10%). The Upper South East region, along with other major areas of the State, has been identified for exceptional circumstances due to the prevailing drought.
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3. Needs Analysis summary
Introduction
In April 2010, the Kingston SE Robe Executive team, in partnership with Health Advisory Council members, undertook a needs analysis process to capture the strengths, weaknesses, opportunities and threats of existing services and future directions. The needs analysis has drawn on information obtained through the consultation process and analysis of the Health Service Profile and other relevant data.
Priorities identified through the needs analysis
The priority needs identified through the needs analysis for the Kingston SE Robe MPS were primarily the maintenance, sustainability and expansion of some services to meet community needs. The priority areas identified included emergency care, acute inpatient, community health and outpatients, mental health, aged care, general practitioners, palliative care and clinical support services.
The key evidence which supported the strengthening of existing services as well as the development of new programs included the right for people to access services close to home within resources, a high degree of socioeconomic disadvantage, risk factors (alcohol consumption, high blood pressure, obesity, physical inactivity, and smoking) and a higher prevalence of chronic disease (arthritis, asthma, cardiovascular disease and mental illness) in comparison South Australian averages.
Key priority areas
Emergency Services • Maintain effective 24hr access to Accident & Emergency (A&E). • Develop a business case for ultra sound equipment and support any Upper South East plans for CT scanner. • Strengthening partnerships with other agencies within cluster. • Co-locate emergency services with acute care services as far as possible.
Acute Inpatient Care • Maintain current and effective acute care service. • Explore models of care and work practice around service delivery. • Co-locate emergency services with acute care services.
Aged Care (including respite care) • Upgrade to meet fire standards. • Maintain flexibility and MPS status. • Develop plans for upgrade to infrastructure. • Support investigation into the development of a quality dementia care unit in the Upper South East.
Community Health and Outpatient Services • Implement the local service MPS plan for community health in partnership with cluster resources. • Further develop service delivery integration at local level. • Staff and community education in future service delivery models. • Enhancement of current care delivery within the community. • Expand primary health care initiatives.
Palliative Care • Increase to 24/7 service delivery model. • Community education regarding available services. • Further roll out of Respecting People’s Choices philosophy and practice. • Expand access to counselling services. 8
Medical Specialist Services • Maintain current specialist services. • Extension of specialist services at local level. • Further develop relationships with other regional service providers (e.g. Mount Gambier Hospital). • Investigate transport options. • Maintain current GP services and partnerships. • Extend service opportunities where possible (e.g. registrars). • Redesign work environment into the health service. • Continue community capacity building and participation in health planning. • Upgrade computer technology.
Mental Health • Expand current services in lower acuity services and early intervention. • Improvement in transport processes for high risk clients. • Further develop relationships with other regional service providers (e.g. Mount Gambier Hospital). • Continue further education for staff on management of patients requiring mental health services. • Promotion of available services within the community.
Clinical Support Services • Increase Clinical support services (e.g. extended telehealth facilities). • Review pharmacy services. • Investigate more point of care services. • Maintain current services. • Become proactive in the support for any information and communications technology (ICT) initiatives regarding the implementation of an electronic medical record. • Support provision of limited ultrasound services within capacity of local GPs. • Develop protocols with SA Ambulance for Robe patients transported to Robe Clinic. • Support development of protocols for remote interpretation of digital x-rays taken at Kingston.
Facilities and Buildings • Upgrade facilities to meet fire and privacy standards. • Continue to encourage community support for fundraising. • Explore the options to redevelop current A&E facility to be able to provide more workable and safe working conditions for staff, patients and visitors. • Explore the options to redevelop both acute and aged care facility to incorporate single room design to assist with better bed management of infectious patients, privacy and security for older patients.
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4. Local implications of Statewide plans
The Strategy for Planning Country Health Services in South Australia, endorsed in December 2008, builds on the vision in South Australia’s Health Care Plan 2007-2016, South Australia’s Strategic Plan, and the SA Health Aboriginal Cultural Respect Framework and sets out how to achieve an integrated country health care system so that a greater range of services are available in the country, meaning fewer country residents will need to travel to Adelaide for health care.
Identify the need for significant changes to achieve a sustainable health system that addresses the contemporary challenges facing the health system. The main factors contributing to an increasingly unsustainable health system include the ageing population, increasing prevalence of chronic diseases, disability and injury, poorer health of Aboriginal people and people of lower socioeconomic status, and increasing risks to society from communicable diseases, biological threats, natural disasters and climate change.
A number of Statewide Clinical Service Plans have been developed or are currently under development providing specific clinical direction in the planning of services. Interpreting these plans for country South Australia and specific health units is an important element of the planning process for Country Health SA. The enabling factors which are demonstrated across the statewide clinical plans include:
• Multi-disciplinary teams across and external to the public health system.
• Patient focused care.
• Care as close to home as possible.
• Teaching and research integrated in service models.
• Integrated service model across the continuum of care.
• Streamlining access to specialist consultations.
• Increasing use of tele-medicine.
• Improving Aboriginal health services.
• Focus on safety and quality.
• Recruiting and developing a workforce to meet future service models.
• Engaging closely with consumers and community.
• Developing the infrastructure to meet future service models.
• Clinical networking and leadership.
• Connect local patients with pathways to higher level care needs.
• Reduce progression to chronic disease for at risk populations.
Strategies within the Statewide Clinical Service Plans which support the achievement of local needs have been integrated through the 10 Year Health Service Plans.
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5. Planning Principles
The Strategy for Planning Country Health Services in South Australia set out important principles which have been used to guide the local planning which include:
1. Focusing on the needs of patients, carers and their families utilising a holistic care approach.
2. Ensuring sustainability of country health service provision.
3. Ensuring effective engagement with local communities and service providers.
4. Improving Aboriginal health status.
5. Contributing to equity in health outcomes.
6. Strengthening the IT infrastructure.
7. Providing a focus on safety and quality.
8. Recognising that each health service is part of a total health care system.
9. Maximising the best use of resources.
10. Adapting to changing needs.
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6. Service Delivery Plan
6.1 Core Services to be Sustained
Service Category Service Description Target Group Future Directions Emergency Services • Provide 24/7 Emergency Service utilising Kingston Robe • Maintain and strengthen 24 hour access to A&E hospital staff in conjunction with general community and services practitioners travelling visitors • Develop a business case for ultra sound • Advanced life support trained staff equipment and support any Upper South East • Shared video conference technology links with plans for CT scanner Emergency Services / Medstar • Strengthening partnerships with other agencies • Volunteer ambulance officers support pre- within cluster trauma and trauma services when required • Co-locate emergency services with acute care services • Redevelopment of current A&E facilities including low stimulus room for mental health presentations Acute Inpatient Care • Provide low level acute services including step Kingston Robe • Maintain current and effective acute care service down services from tertiary hospitals for local community and • Explore models of care and work practice around community travelling visitors service delivery • Workforce development and planning to respond to changes in service demands to stabilise workforce • Involvement with any possible ICT clinical support systems when available • Co-locate emergency services with acute care • Current nursing practice skills to retain local admissions otherwise transferred Aged Care (including respite • Provide Commonwealth funded residential Kingston Robe • Obtain increased number of available home care care) aged care places community with packages for the elderly 1 • Variety of home / aged care packages and focus on frail / aged • Develop plans for upgrade to infrastructure services • Progress towards single room accommodation • Inpatient admissions for elderly, including high • Assist with the development of a cluster wide care and respite residential aged care communication, education, training and coordination of packages of care • Increase opportunities for institutional and home based respite • Upgrade to meet fire standards • Support investigation into the development of a quality dementia care unit in the Upper South East • See section 6.2
1 Health Services Framework for Older People 2009-2016 12
Community Health & • Home based nursing and other services to Kingston Robe • Develop support groups for carers as required Outpatient Services support clients to retain independent living community and • Offer open days to educate community on services travelling visitors available • Further develop service delivery integration at local level • Expand primary health care initiatives wherever opportunities exist 2 • Develop infrastructure plans to accommodate outpatients • Explore opportunities for accessible transport for clients to other locations for consultations / expand use of telemedicine for consultations • See section 6.2 Palliative Care • Inpatient palliative care beds Kingston Robe • Increase to 24/7 service delivery model • Collaborative relationships with SERCHS and community • Community education re services Pangula Mannamurna for home based care • Further roll out of Respecting People’s Choices philosophy and practice • Expand access to counselling services • Maintain existing collaborative relationships with SERCHS and Pangula Mannamurna for home based care • Build local palliative care services in line with statewide plans, interconnecting with level 4 palliative care services in Mount Gambier Medical Specialist Services • Visiting medical specialists to Kingston/Robe Kingston Robe • Continue to support existing visiting medical • Access to medical specialists through community and specialists and expand local access to medical telemedicine or other ICT initiatives travelling visitors specialists locally • Aboriginal specific services by Pangula • Expand utilisation of ICT technology for accessing Mannamurna wherever possible remote specialist input in diagnostics, including interpretation of x-rays and other point of care tests • Introduce opportunities for local ultrasound investigations Mental Health • Local GP practice provides initial mental health Kingston Robe • Expand current services in lower acuity services assessments community and and early intervention • Access to Mental Health Team from Mount travelling visitors • Continued education for staff on management for Gambier patients requiring mental health services 3 • Ongoing promotion of available services • Improvement in transport processes for high risk clients • Further develop relationships with other regional
2 Strategy for Planning Country Health Services in South Australia 13
service providers e.g. Mount Gambier Hospital • See section 6.2 Clinical Support Services • Limited point of care testing with iCCnet Kingston Robe • Maintain and increase clinical support services • ECG machine which connects with Flinders communities and • Extended telehealth facilities Medical Centre for reporting travelling visitors • Review pharmacy services • Access to HPS pharmacy services including • Become proactive in the support for any ICT starter packs of medication availability after initiative regarding the implementation of an hours electronic medical record • Access to general imaging (x-ray) capabilities • Develop protocols with SA Ambulance for Robe patients transported to Robe Clinic • See section 6.2
3 South Australia’s Mental Health and Wellbeing Policy 14
6.2 Strategies for the Future
Service objective: To provide safe, appropriate accommodation for those requiring acute mental health care Target group: Kingston SE Robe catchment area communities and visitors Critical milestones: N/A
Outcomes Strategies Time Frames Address the needs of patients requiring mental health services • Strengthen partnerships with aged care providers within the area to determine TBD when in an acute/emergency phase of care viability of a dementia unit in the Upper South East cluster • Improve video conferencing technology at Kingston • Compliance with the South Australian Mental Health Act (2009) • Support establishment of higher acuity mental health services capacity in the South East in conjunction with other providers, especially Mount Gambier Hospital
Service objective: Exploit technology to secure remote specialist contribution in conjunction with expanded diagnostic investigations locally Target group: Kingston SE Robe catchment area communities and visitors Critical milestones: N/A
Outcomes Strategies Time Frames Minimise time delays in obtaining diagnostic results • Expand the use of point of care testing locally at Kingston and Robe TBD • Investigate opportunity for introduction of local ultrasound testing within capacity of local GPs and nurses • Upgrade x-ray technology • Ongoing professional development of nursing staff to support local diagnostic testing • Support investigation of the introduction of CT scanning capability in the Upper South East
Exploit technology for information sharing to achieve timely and • Support expansion of ICT technology to obtain remote specialist input into TBD informed interventions diagnostic analysis and intervention decisions o Transmission and interpretation of more complex x-rays o Transmission and interpretation of other point of care tests, including locally conducted ultrasound • Direct access to specialist consultations in a range of medical specialities via teleconference or similar technologies
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Service objective: Strengthen primary and preventative health care provided to the community 4 Target group: Kingston SE Robe catchment area communities Critical milestones: N/A
Outcomes Strategies Time Frames Address the needs of the community for primary health care, • Use demographic data to identify areas of need TBD preventative health care, early intervention • Specific focus on smoking cessation • Continue to identify opportunities to work collaboratively across Kingston SE Robe MPS, local GPs and SERCHS • Explore opportunities for developing alternate models of care – with particular emphasis on those that are community based • Explore opportunities to establish a 7 day per week service for community based services including contingencies
Service objective: Meet the residential and home care requirements for older people in the catchment area Target group: People that have been appropriately assessed for aged care in the Kingston SE Robe catchment area communities Critical milestones: N/A
Outcomes Strategies Time Frames Establish a sustainable number of flexible aged care and acute • Maintain MPS status to provide flexibility in providing aged care TBD care beds within the health units to cater for the ageing • Enhance the MPS model to achieve maximum flexibility population • Work closely with key partners to determine specific bed needs • Communication, education, training and coordination of packages of care across the MPS Continue to improve pathways for older clients to access • Develop internal guidelines relating to ongoing coordination and management TBD appropriate services locally of care from home to residential care • Facilitate the changes required in acute care model to enhance the acute care/community care/residential care continuum
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Service objective: Enhanced Aboriginal health care services Target group: All Aboriginal and Torres Strait Islander people accessing services Critical milestones: N/A
Outcomes Strategies Time Frames Improve health outcomes for Aboriginal and Torres Strait • Work to achieve the workforce target for the proportion of Aboriginal staff TBD Islander client groups employed by the health service • Continue to consult with South East Aboriginal Health Advisory Committee (AHAC) in relation to service delivery, access and opportunities for service growth • Increase collaboration with Pangula Mannamurna to deliver services to local communities
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7. Key Requirements for Supporting Services
7.1 Safety & Quality
Objective: Securing the confidence in our communities that high quality services are delivered across the spectrum of services provided Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Continual improvement and patient-centred • Adherence to the Aged Care Act • Contribute to a country-wide accreditation approach underpinning service delivery • Audit programs in place to ensure client satisfaction framework • Implement the Australian Charter of Health Care • Integrate acute, community health and aged care in Rights accreditation • Continue to implement strategies to improve the • Contribute to the investigation of options to install a state and national patient safety priority areas CT scanner at Naracoorte • Improve capacity to effectively care for bariatric clients • Improve capacity to care for the needs of those requiring a secure dementia unit • Contribute to improving capacity to have a Limited Treatment Centre in the South East • Monitor readmission and frequent users of the Hospital to analyse opportunities for improved care models • Contribute to a cluster-wide accreditation framework • Develop a consumer role in safety Integrated access across the health system • 24 hr access to remote specialist support • Strengthen community based support following particularly in the areas of stroke services and discharge cardiology (iCCnet) • Further expansion of statewide and Country Health • Use web based links to ensure updated references SA clinical networks are available to support staff clinical practice • Expand relationships and combine resources within Upper South East cluster • Improve the use of knowledge, information management and technology to increase quality and safety
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7.2 Patient Journey
Objective: Increase the accessibility of the health system to reduce the impact on the patient journey 5 Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Access to safe and quality care • Discharge / Patient Liaison Officer in place • Explore opportunities for access to Transitional Care Program funding near home • RIBS funding able to be accessed in response to model need • Explore nurse practitioner and other workforce models that enable increased local access to services • Increase use of telemedicine to access services locally • Support staff and medical specialists to provide local care • Manage the majority of health care needs so that only patients requiring highly specialised or complex care will need to access this in Adelaide or Mount Gambier Provide a smooth and supported • Red Cross car used as suitable • Enhance coordination across the statewide health system to ensure a journey when people do need to • SA Ambulance Service accessed for transport client orientated approach when having to travel for more specialised travel to access services when clinically indicated services • Review of mental health cases in relation to delay • Explore initiatives and develop options to support local community in transport accessing transport for heath related appointments including: o Transfers of patients requiring mental health services to a site of appropriate care (pending Limited Treatment Centre at Mount Gambier) o Establishment of a CT scanner in Upper South East if supported by the business case • Continue to focus on improvement of discharge planning and coordination • Contribute feedback / solutions to improve the Patient Assistance Transport Scheme for residents of the catchment
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7.3 Cultural Respect
Objective: Increase capacity to contribute to the priority of closing the gap in Aboriginal health life expectancy Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Kingston SE Robe MPS is culturally safe and • Build on the strength of existing Aboriginal health • Expand opportunities for Aboriginal people to be accessible initiatives available to the community employed at the health service • Established annual calendar of Aboriginal and • Implement recommendations identified in the Torres Strait Islander events Aboriginal Health Impact Statement for the local 10 • Established NAIDOC calendar of events year Health Service Plan
Targeted Aboriginal health improvement strategies • Close working relationship with Pangula • Communication with Aboriginal community Mannamurna providing information about current services • Aboriginal specific chronic disease management • Develop a sustainable cost effective patient program transport plan in partnership with local council, current private transport providers and community transport services • Build connections with Aboriginal health workers at Pangula Mannamurna
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7.4 Engaging with our community
Objective: Increase the capacity for the community to contribute to the planning, implementation and evaluation of services Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Health service needs of the community are • Support the Kingston Robe Health Advisory • Explore opportunities for ongoing and meaningful understood Council to implement their ongoing role of engaging discussion with the community and targeted with their community and local stakeholders population groups • Regular community information through local • Support the Kingston Robe Health Advisory channels in partnership with the Health Advisory Council members to continue in their roles as Council strong advocates for their community on health related issues • Ongoing follow up of patient questionnaire information and feedback • Use of communication methods including site newsletters, displays and notices
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7.5 Local Clinical Networks
Objective: Enhance relationships with other services locally, regionally and Statewide Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Formal ties with health service organisations in the • Strengthen relationships with service providers • Seek to establish formalised partnerships with local region associated with responding to emergencies external agencies to foster collaboration which • Continue to build partnership with local GPs and leads towards better outcomes and more flexibility SERCHS in health care for the catchment • Strengthen continuity between hospital and home • Investigate the opportunity for support workers based services which can provide pathways to both community • Strengthen relationships with other health services and other relevant services in the catchment • Increased use of technology for staff education and resourcing and case conferencing (e.g. online self directed cultural training) • Further develop relationships with other regional service providers particularly the Country General Hospital in Mount Gambier Formal ties with statewide and Country Health SA • Strengthen networks with metropolitan and • Expand collaborative relationships with visiting clinical networks statewide services (such as iCCnet SA cardiologist, specialists throughout the region to build service MedStar and Rural and Remote Mental Health models that meet local needs Service) to sustain visiting and remote access • Further expansion of clinical networks with tertiary service specialist centres for coordination of follow up care • Further expansion of statewide and Country Health SA clinical networks • Further develop relationships with other regional service providers particularly the Country General Hospital in Mount Gambier • Establish partnerships with other centres of excellence to share ideas and resources
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8. Resources Strategy
8.1 Workforce
Objective: Improve ability to recruit, develop and retain a skilled health workforce Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Highly skilled and qualified workforce • Continue clinical staff up skilling and development • Expand training opportunities for nursing staff, • Staff skilled in providing both high and low level particularly accident and emergency, palliative residential care services care, personal care and aged care nursing staff • Continue to integrate community and institutional nursing care roles Recruitment and retention of the workforce to • Support to retain qualified nursing staff • Explore options to strengthen the retention of all support the service profile • Recruitment of qualified nursing staff via graduate personnel in the health service nurse and cadetship programs • Plan for implications of an ageing workforce • Explore a sustainable model to recruit and retain specialist medical staff within the region Increased accessibility for Aboriginal people to be • Continue to seek all staff to undertake Aboriginal • Encourage and recruit Aboriginal people across all employed in the Health Service cultural awareness training levels of the health service
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8.2 Infrastructure
Objective: Increase the capability of the infrastructure to support planned service levels Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Infrastructure and equipment that meets standards • Strengthen existing facilities and infrastructure for • Explore the options to redevelop current Accident and supports existing and future service delivery current level of activity and Emergency facility to be able to provide more workable and safe working conditions for staff, patients and visitors • Explore options to redevelop both acute and aged care facility to incorporate single room design to assist with better bed management of infectious patients, privacy and security for older patients.
8.3 Finance
Objective: Increase the efficiency and effectiveness of resources, and balanced with the provision of services as close to home as possible Critical milestones: NA
Outcomes Existing Strategies Sustained Strategies for the Future Sustainable funding to achieve the planned service • Maintain funding to support existing services to be • Develop business cases to seek funding to profile sustained implement new services or ease demand pressures on existing services
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8.4 Information Technology
Objective: Increase access to communication and information technology systems to strengthen health care Critical milestones: N/A
Outcomes Existing Strategies Sustained Strategies for the Future Effective and efficient clinical networks to support • Maintain existing reliance on ICT to communicate • Expand the use of point of care testing locally at emergency advice and support within the service and with other CHSALHN units Kingston and Robe • Investigate opportunity for introduction of local ultrasound testing within capacity of local GPs and nurses • Upgrade x-ray technology • Ongoing professional development of nursing staff to support local diagnostic testing • Support investigation of the introduction of CT scanning capability in the Upper South East Reduced need for patients to travel away for • Support expansion of ICT technology to obtain specialised services remote specialist input into diagnostic analysis and intervention decisions o Transmission and interpretation of more complex x-rays o Transmission and interpretation of other point of care tests, including locally conducted ultrasound • Direct access to specialist consultations in a range of medical specialities via teleconference or similar technologies
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8.5 Risk Analysis
Objective: Increase ability to plan for and manage risks Critical milestones: NA
Outcomes Existing Strategies Sustained Strategies for the Future Successful implementation of the service directions • Maintain the risk register • Develop an implementation, monitoring and review identified in the 10 Year Health Service Plan • Maintain the health service accreditation strategy for the 10 Year Health Service Plan – early identification of risks • Ongoing contribution and participation in the CHSALHN risk management policy framework • Ongoing participation and contribution to other CHSALHN nominated risk management activities
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9. Appendix
9.1 Leadership Structure
Country Health SA including senior staff from the Kingston SE Robe Multipurpose Service and the Planning Projects Team have coordinated the development of the 10 Year Local Health Service Plan. The Kingston Robe Health Advisory Council has undertaken an important role in leading and analysing the community and stakeholder feedback and providing oversight of the local planning process.
9.2 Methodology
July-Aug 2009 Community, staff and stakeholder engagement strategy planned in partnership with Health Advisory Council. Sept-Nov 2009 Community, staff and stakeholder engagement strategy implemented; local plans and past consultations reviewed by Planning Projects Team. November 2009 Community, staff and stakeholder engagement report developed by the Kingston SE Robe Health Executive group. Dec 2009-Feb 2010 Findings consolidated in needs analysis – workshops with staff and stakeholders, feedback on draft needs analysis via email (nursing, senior staff, Executive group, GPs). January 2010 Final draft Preliminary Service Profile completed. April-May 2010 Draft Health Service Plan ready for CHSALHN Steering Committee, HAC and community consultation. June 2010 Community consultation on draft 10 Year Health Service Plan. June 2010 Re-draft Plan to include community feedback. HAC endorsement of Plan. 30 June 2010 Final Plan submitted to County Health SA for sign off by the Minister. ####
9.3 Review Process
To be developed during consultation for the final Plan.
9.4 Glossary
24/7 24 hour – 7 days/week A&E Accident and Emergency ABS Australian Bureau of Statistics ACHS Australian Council on Healthcare Standards CHSALHN Country Health SA Local Health Network CT Computed Tomography ECG Electrocardiography GP General Practitioner HAC Health Advisory Council ICT Information and Communications Technology
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iCCnet Integrated Cardiovascular Clinical Network of South Australia MPS Multipurpose Service NAIDOC National Aboriginal Islander Day Observance Committee SA South Australia SE South East SERCHS South East Regional Community Health Service SLA Statistical Local Area SWOT Strategy development tool which identifies strengths, weaknesses, analysis opportunities, threats Telehealth Access to clinicians by video-conference or phone
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