Ever y day.

Annual Report 2009 Contents Royal District Nursing Service Limited ABN 49 052 188 717

1 Welcome

2 2009 at a glance

Staff Achievement Awards

3 Report from the Chairman & CEO

5 RDNS. Everyday.

16 Financial Summary

17 Our Executive Team

18 Thank you! –Our generous donors

20 Facts & Figures

23 Our Directors

25 Corporate Governance Statement

Thank you To our clienTs and sTaff To the clients and staff of RDNS who have so graciously participated in this Annual Report, we extend our heartfelt thanks and appreciation. Thank you for allowing us into your homes and lives, for providing insight and understanding, and for so generously sharing your stories.

PaTrons’ council Dr Sally Cockburn Lady April Hamer OAM Darvell Hutchinson AM The Honourable Jeffrey Kennett AC The Honourable Joan Kirner AM Simon Molesworth AM QC Lady Primrose Potter AC DLJ Sir Gilbert Simpson KNZM QSM

Home and Community Care (HACC) services provided by Royal District Nursing Service are jointly funded by the Victorian and Australian Governments. Welcome to the Royal District Nursing Service Annual Report 2009

RDNS. Ever y day.

Royal District Nursing Service – Annual Report 2009 | 1 2009 at a glance

Clients visited 33,213 Visits made 1,718,540* Hours of care 581,503 Cars 598 Distance travelled 8.9 million km Staff 1,400

* Visits include direct care and client related contacts Staff Achievement Awards

The Staff Achievement Awards The ouTsTanding clinical The leadershiP award is a peer-nominated, annual awards ouTcome award Awarded to a staff member who has shown scheme which recognises RDNS staff Awarded to a direct care staff member who remarkable leadership, whether that leadership members for their accomplishments. has displayed extraordinary commitment to a is of people, programs, projects or specialities. The awards identify excellence in client particular client and their condition in a way that Winner: Maureen Wilkinson and customer service, innovation and has seen that client achieve a significant and Customer Service Centre creative thinking. positive clinical outcome.

Winner: Sarah Boothby RDNS Yarra The sTar Performer award Awarded to a staff member who has displayed The Beyond The call of duTy award outstanding service in their field and has Awarded to a staff member who has either demonstrated integrity, professionalism, ability shown repeated displays of working beyond to draw respect from colleagues and clients/ the normal requirements of their daily role or has customers alike and has shown an on-going and been responsible for an extraordinary, individual genuine commitment to RDNS and the community act of going ‘beyond the call of duty’ in the course we serve. of their work. Winners: Winners: Mandy Shannon RDNS Diamond Valley Sharon McNeil Marketing & Planning Terry Gliddon RDNS Institute Michael Vermeulen Information Services

2 | Royal District Nursing Service – Annual Report 2009 Report from the Chairman & CEO

It is our pleasure to bring to you the Annual Report, covering a year of achievement and a year of challenges. Much has happened within Royal District Nursing Service; much has happened or been mooted in healthcare at Commonwealth government level; we have had to deal with the impact of the global financial crisis and we have been busy pursuing exciting strategic directions.

The Board of Directors has determined, in to undertake worker health checks under and Quality Improvement Program Survey of conjunction with senior management, a path a newly-established government initiative, RDNS, including assessment against HACC of growth and diversification for RDNS which which encourages employers to promote the National Service Standards). has already seen us set up services and offices importance of health checks such as blood Our Customer Service Centre (CSC), which in Hobart, in conjunction with the Tasmanian pressure, cholesterol and blood glucose is now in its second year of full operation, Department of Health and Human Services, checks to their staff. and in Wellington and Auckland in New Zealand. is drawing great interest from many across We are strongly committed to growing the health industry, both in Victoria and Our new New Zealand subsidiary has secured RDNS to expand our services beyond historic beyond. We set out some years ago to a contract with the Auckland District Health boundaries, and work continues to increase establish a centre which, whilst technically Board, so that Royal District Nursing Service both our revenue base and geographic advanced, would offer meaningful support New Zealand now employs over 100 staff coverage. Our plan requires this to be done and improved levels of personalised service to caring for some 500 clients. We see this as quickly and without the assumption of undue our clients, stakeholders and staff. This is now an important step in establishing a substantial risk. We look forward to reporting the results being achieved, with industry best practice RDNS presence in New Zealand, employing of our efforts next year. performance levels being routinely delivered New Zealand staff and sharing our clinical and, importantly, the capability to adapt to the We underwent a full Australian Council on expertise in community care. Implementation changing face of health and community-based Healthcare Standards (ACHS) accreditation of RDNS services in Auckland presented care. In Tasmania and New Zealand, we have survey in the second half of 2008 and received many challenges and opportunities and it is effectively mirrored aspects of the technology many notable and affirming comments from a credit to all involved that this has been such which sits behind our Melbourne CSC, enabling a success, with much positive feedback about the surveyors, including: us to enter new health markets and deliver the quality of our services and the skills of our ‘A leader in home nursing services… new services. New Zealand staff. RDNS is leading the way with The financial position of RDNS remains sound. In parallel, we are looking to extend the depth innovative care.’ Our balance sheet is strong, with a very good and breadth of our services in Australia and equity position and no debt. However, we we have been successful in gaining funding ‘RDNS is recognised as a leader have had to endure a downturn in the value from the Commonwealth government for in domiciliary care.’ of our investments and a reduction in the Community Aged Care Packages (CACPS) (Report of the September 2008 Australian earnings coming from our investments. Further, and Extended Aged Care at Home Packages Council on Healthcare Standards the capacity of many donors has also been (EACH and EACH-D) of care. We have been Organisation-Wide Accreditation Evaluation restrained in the wake of the financial downturn. granted provider status by WorkSafe Victoria

Royal District Nursing Service – Annual Report 2009 | 3 Government funding and other sources of funds These were tragic times which touched many All three had provided tireless service and have enabled us to keep the service operating across the RDNS community, both personally support to RDNS as directors and long-time at a high level. and professionally, but which also saw our supporters and all three were recognised with nursing and support staff provide selfless and the presentation of a commemorative Life The next five years will most likely see unfailing support at a time of great community Membership certificate. Longevity of service many changes in the way that major sources need – a recurring theme throughout our long and dedicated support to RDNS is something of our current funding streams from government and proud history. which we also celebrate each year at our staff are organised and provided; and in the way that Long Service Awards, and we are exceedingly purchasers of services from RDNS, together Secondly, as the H1N1 virus began to threaten fortunate to work alongside such dedicated with clients and their carers, will expect our communities, many RDNS staff gave up and hard-working staff. services to be offered and delivered. This their time to assist with the co-ordination of the presents us with both challenges and important Department of Human Services’ response to To our various supporters, advocates, opportunities and, as noted earlier, we have the epidemic. friends and beneficiaries of RDNS care, we set in train a number of directions this year thank you sincerely for your continuing trust Our governance arrangements have been to ensure that these opportunities are actively and support. We hope that you enjoy reading reviewed, with the adoption of a new and successfully pursued. By year’s end, the this Annual Report and that it provides you constitution to reflect contemporary not-for- Board had adopted a series of key strategic with clear insights into the role of Royal District profit company practice. The RDNS Board directions and management was developing Nursing Service and, importantly, the working of Directors has undertaken a number of specific plans to achieve those directions. life of our staff. We are conscious that our own reviews of its processes, with changes being stewardship of this wonderful organisation is During the year the Health and Hospitals made to committee structures, practices and but transient and we have a strong sense of Reform Commission delivered its report that roles. Across management, we are looking to the importance of ensuring that the services – contains a number of recommendations having ensure that we have the capacity and structure the care – which Royal District Nursing Service implications for primary care delivery and home to effectively address the many opportunities, staff have been delivering for almost 125 years care health services. The Commonwealth in ways which support our staff to deliver the continues to be delivered in ways which meet government has also made suggestions best care possible. the needs of both those who support us and that it might assume total control of the At Board Director level, the year has seen the those who receive our care. aged care system in Australia. This could departure of Pamela Burgess, Chris Carlile and have long-ranging implications for service Philip Mayers as RDNS Directors. Between delivery in Victoria and, in turn, RDNS could them, they had given almost 25 years of service be directly impacted. No doubt, in the next as RDNS Directors, taking various Board roles year we will gain a greater understanding of and contributing strongly to the development the Government’s intentions and priorities as Paul Montgomery Dan Romanis of our future plans and we thank them for their implementation of the reform agenda proceeds. Chairman Chief Executive Officer loyal and dedicated support. Peter Brindley We are very alert to possible changes whilst was welcomed as a new RDNS Director at remaining focused on caring for our clients. our Annual General Meeting in November. RDNS’ position as an important leading With a wealth of experience in a number of roles community provider was demonstrated on both in Australia and overseas, we are grateful two significant occasions during the year. for Peter’s ready willingness to bring new First, over 250 of our staff volunteered to perspectives to the work of the organisation. assist with the initial Department of Human In May we celebrated the appointment of three Services’ relief work following the devastating new RDNS Life Members, with presentations bushfires which our communities experienced to David Mann, Val Seeger and John Walker. early in 2009.

4 | Royal District Nursing Service – Annual Report 2009 RDNS. Every day.

The rain is falling. It is springtime and despite the light showers and low temperature, the birds are content; they chirp and play under the canopies of tree branches in early bloom. Across Melbourne, the dawn is rousing people from their overnight slumber: there is the familiar clink of breakfast bowls; the pouring of coffee; the steam from hot showers that usher in the start of a new day. It is Thursday, and while the people of Melbourne prepare themselves in myriad ways for the coming day, hundreds of individuals are already immersed in the responsibilities that their working day entails.

They are the nurses and staff of Royal District Nursing Service and today, with a seemingly endless list of people to visit and care for, is a day like any other. Twenty-fours a day, every day of the year, it is like this.

As communities rise and sleep; as alarms pierce the early morning stillness; as peace descends in the dead of night; the staff of RDNS wind their way through our streets caring for people who could be our friends, colleagues, neighbours, family.

This is their story. This is a day in their life.

Royal District Nursing Service – Annual Report 2009 | 5 early morning

7. 2 7 am After several deft key strokes, the mobile computer beeps into life and district nurse Alison responds to its call. Her computer willingly provides the information she is looking for. As the drizzle falls outside, Alison surveys the list of clients she is scheduled to see – 13 in total. At first glance it seems that much of the care she will provide share common elements. To an extent this is true, but as one steps out of the warmth of the RDNS site and into the brisk new day, it soon becomes clear that what lies ahead are 13 very different stories.

8.15 am 8.39 am A lean and wily cat greets Alison as she pushes through the creaky Dawn is feeling a little puffed. She has just done the ironing and, wire door. Her client Peter is sitting in front of his heater. He greets as Alison enters her neat and well-kept home, she laments she hasn’t her with a familiar refrain and points out his new fish tank. Alison warmly had a shower yet. Alison reassures her and she quickly relaxes in her smiles her approval and it is then quickly down to business. Diabetes comfortable dressing-gown. Dawn explains she is feeling a little drained is Peter’s main issue, and along with that a number of other ailments. from her recent trip into town to see the Melbourne Boys’ Choir, as Alison Self- management is important: Alison observes as Peter takes his prepares her various tablets. On the fridge sits the distinct RDNS magnet, own blood sugar readings, before injecting himself with insulin. As he pronouncing the number to call if Dawn was to require unscheduled does so, Alison assembles his various medications, ensuring notes are assistance from her nurses. Like Peter’s visit, the process is swift but filled as she goes. It is a quick visit: the chat is quite minimal but Alison calculated; Alison ensures that Dawn takes the medication that helps contents herself that Peter’s treatment is as it should be. Twice a day he keep her at home, where she is happiest and close to her family. “See you is visited by RDNS; someone will be back in the evening. tomorrow Dawn, have a good day,” waves Alison as she leaves. Across the road, small children are starting to be dropped off to a childcare facility. It is not yet 9.00am.

6 | Royal District Nursing Service – Annual Report 2009 mid-morning

10.02 am

It’s just after 10 and Alison has swiftly visited another client before arriving at Ada’s house. Ada squints slightly as she ushers Alison into the kitchen, joking about the ‘immaculate degeneration’ that affects her eyesight. But it is for a nasty leg ulcer that Alison is visiting today. Three times a week for almost three months Ada has been visited by RDNS to attend to the angry sore that begun with a knock to her lower leg. Alison carefully removes the bandages and delicately tends the almost healed wound. She looks pleased with the progress and happily confirms with Ada that she will need only two visits a week for a few more weeks before the wound is completely healed. Ada looks equally pleased as Alison relaces the compression stocking that helps prevent her leg from swelling.

10.26 am “Come in if you’re good looking!” is the lively call through the kitchen window. Alison responds to the cheeky invitation from Jean with a broad grin, and enters via the back door of her home. Jean has dementia but she is able to remain at home thanks to the support of her family and also that of RDNS. Jean has already been visited this morning by one of RDNS’ Community Care Aides to help shower her: it is now time for her to take her medications and attend to her eye drops. Jean is in fine spirits and, amidst the swift but detailed process of checking medication charts and assembling her tablets, the conversation flows warmly. Her home shows the evidence of her condition: hand-written notes on walls and appliances reminding her of what to do but, as she talks and enthuses about her upcoming meal at the Dingley pub, there is a strong impression of happiness and contentment. Alison completes her visit and bids Jean farewell. The Dingley pub beckons, but so do Alison’s other clients.

Royal District Nursing Service – Annual Report 2009 | 7 1 0 . 4 8 am It is mid-morning and the rain has ceased, at least for the time being. In a quiet street Alison approaches what many might call a ‘renovator’s dream’. The house is old and well-loved and in need of some TLC. But then, so is its inhabitant Mickey. It takes a minute or so for the door to open after Alison knocks; Mickey moves slowly, almost a shuffle, but when she does pull the door back she is happy to see Alison. Her main condition is a sensitive one – mental illness – not always readily understood and one that requires careful monitoring and medical attention. That is what RDNS does for Mickey and, as Alison steps into the hallway, Mickey happily partakes in the twice daily ritual of puffers and tablets and pills. Mickey is purposeful and dignified in her speech; her voice is eloquent, almost melodic. She shares pictures from the past with Alison as she quaffs her pills and coffee and reminds Alison of the two times that nurses from RDNS literally saved her life, once from heat stroke and once from leaking gas. Alison smiles and completes the medication chart that sits just a metre inside Mickey’s hallway, as this is where all treatment must be given: it is Mickey’s wish.

11. 3 3 am The morning is almost over and Alison has swiftly seen another client. She now knocks upon the door of Shirley, who greets her with a trusting smile and welcoming gesture. A quick glance of her quiet unit shows that football has been a major part of her life. The walls of her family room are adorned by pictures of her famous footballer husband, a member of Fitzroy’s ‘Team of the Century’. At the kitchen table she talks about her grandson with pride, a current member of an AFL club. But amidst the animated chat is sadness that her husband of 64 years has recently had to move to a supported residence. She has found the adjustment difficult and, as Alison takes her blood pressure and prepares the injection that will keep her anaemia at bay, she talks about how a trip to Queensland might lift her spirits. Alison encourages her that she can help prepare her medications so that she can make the trip. Shirley’s mood seems to lift at the prospect as she rises from the kitchen table to see Alison out. It is almost noon.

8 | Royal District Nursing Service – Annual Report 2009 afternoon

Alison knocks on the weathered frame of Stephen’s front door. The house is old and in a poor state of repair. Inside, the walls are stained yellow from years of living and the carpet has shrunk away from the skirting boards, protesting decades of foot traffic. A bubbly 12.12 pm woman answers the door and heartily invites Alison in, recognising her immediately. It is Stephen’s mother. She ushers Alison down the hallway and into the main room, which is crammed with items and objects and knick-knacks from almost every era. From a darkened bedroom emerges Stephen and takes his place in his chair. He is coughing hard and Alison comments immediately, as she prepares his many medications. Like a number of Alison’s clients, it is mental illness that is Stephen’s main affliction. Alison hands him his daily tablets but she is clearly concerned by his hacking cough. She persuades him to make an appointment with his doctor and looks happier as a result. Before she leaves she checks the state of his feet, which have had problems; those too seem to be on the improve. It is less than a 20 minute visit but the impact on Stephen’s life, and his mother’s, is profound.

1.47 pm Two more visits have been made to clients with various medical needs and now Alison arrives at Marjorie’s door. The rain is heavier again as Alison lets herself in; “Who is it? Is that you Alison?” is the gruff shout from the kitchen. Alison is met by Marjorie, with wild silver hair and a defiant glint in her eye. The small home is full of stately but well-worn furniture and on the wall sits a single picture of a beautiful young woman and her five year old son. On closer inspection, it is apparent that the woman is Marjorie; the boy is her son Patrick. Alison sits herself at the kitchen table and gets Marjorie to work: first a series of puffers for her chest; then a procession of tablets. She checks her feet, as she sometimes needs to organise podiatry on Marjorie’s behalf. The front door opens and Patrick enters from the drizzle; the young face from the picture on the wall still evident in this tall man. He lives with Marjorie and greets Alison warmly. Alison is efficient but ever precise in her actions. Her skilled eyes and ears, honed from years of nursing, are alert to changes in her clients’ situations, but today she is content all is as it should be. She leaves for her next visit, as mother and son farewell her until next time.

Royal District Nursing Service – Annual Report 2009 | 9 2.26 pm It’s mid-afternoon and Alison attends her last visit. Gladys answers the door of her warm and tidy apartment: “Oh, it’s the district nurse,” she says, seemingly surprised. But then, dementia has that effect, and Alison is quick to put her at ease before settling them both at the small kitchen table. It is a very quiet affair, the quietest visit of the day. There is gentle small talk about Gladys’ family and an imminent appointment at the hairdresser. Alison fills in the medication chart, supplying Gladys with her tablets as she goes, which she dispenses from the locked-box which is kept in her home. Red and angular, it is the safe that houses medications that assists Gladys and so many of Alison’s clients to stay in their own homes.

2.48 pm As children enter the last few minutes of their school day, Alison is heading back to the RDNS site. Here she will complete her paperwork, send faxes and referrals to doctors, pharmacies and others, all on behalf of her clients, before making her way back to the sanctuary of her own home.

3.52 pm Alison has completed her tasks, but by RDNS standards, the day is still young. As office workers across Melbourne stir their last cups of tea for the afternoon, nurse Max is checking the list of clients he is scheduled to see this evening. In typical Melbourne fashion, the rain has given up and a golden afternoon sun accompanies Max as he sets out on a shift which will take him well into the dark evening hours.

10 | Royal District Nursing Service – Annual Report 2009 late afternoon

4.27pm Ian doesn’t mind a chat and the relationship he has with Max is clearly affable and trusting. Max enters his home with a smile and quickly goes to work, opening the distinctive locked-box and assembling a variety of pills. “It’s for my epilepsy,” explains Ian with a disgruntled nod, obligingly swallowing each tablet without the aid of a glass of water. “You get used to it,” he says with a wry smile. Ian shows Max a letter from the hospital; it concerns an appointment that he feels Max should know about. Max reads the letter and makes a note on his mobile computer, assuring Ian that he will work around the hospital appointment to ensure Ian gets his regular RDNS visits that day. Ian looks more relaxed, as Max deftly administers eye-drops: “You take one medicine for one problem and it creates another!” Ian remarks with annoyance at his dry eyes. It’s quick but it’s effective and Max is soon back on the road.

4.53 pm 5.02 pm Val is a gentle soul; shy and almost bashful, though she As he leaves Val’s home, Max receives a obviously likes Max and ushers him through her front door. call from RDNS’ Customer Service Centre– She lives here with her brother, who helps care for her as a client has cancelled a visit that evening. she manages her mental illness. Twice a day an RDNS nurse He thinks quickly on his feet and decides visits her, so crucial is the need for her to take her medicines how to best modify his schedule. with timely regularity. “I gotta keep on my medication, don’t I Max? I gotta keep on them Max,” Val enthuses, as Max arranges her colourful tablets. Max enquires about her day; it has been one of cleaning and she seems satisfied. “How 5.13 pm was the wedding you went to, Max?” she asks of his recent social event with genuine zeal. Max shares the highlights The sun is low in the sky and Max is about to enter another client’s house. with Val, all the while carefully completing her medication It’s a quick procedure: an enema for a client with no family or other supports. chart and updating her records. His manner is relaxed and “Someone has to do it,” Max says quite matter-of-factly with a half-grin. friendly but his application to the task at hand is meticulous “And it helps keep him at home.” As he exits the house he receives another and concentrated. A balancing act. A skill. A blessing for call from the Customer Service Centre – the cancelled visit is back on. people like Val. More shuffling of the schedule.

Royal District Nursing Service – Annual Report 2009 | 11 evening 5.33 pm Max arrives at a supported residence for adults with Down’s Syndrome. He enters as if one of the family and is greeted with a hearty “Hi Max!” from some of the residents. He is seeing Susan today. She has diabetes and his assistance is vital so that she properly manages her condition and can live in this comfortable facility she calls home. As he completes his visit, the phone rings - again. It’s the CSC. The visit is cancelled – again. The son of a client had been a little confused about the medicines he was to give his mother. He has now sorted it out. No need to come tonight.

6.07 pm It’s almost dusk and as dinners are prepared throughout the suburbs, the work of Max and his colleagues continues. Peter’s cat has enjoyed a fine day frolicking in the garden and has retired in the front of the fire as Max takes Peter through the routine he performed with Alison at the start of the day. Once again, the task is precise and professional. Max checks Peter has enough of all his medications and is satisfied with his blood-sugar readings. He moves into the fading rays of daylight with plenty of work still to do.

6.31 pm Peggy answers her door and Max is greeted by the smell of toasted sandwiches. The chilly wind clutches at him as he makes his way into the warm house. Peggy is unusually quiet, Max observes, as he prepares her medications. Some are for dementia, some are for her diabetes, but he senses something is not quite right. Max checks her blood sugar and the mystery is solved. Her blood sugar is very low and Max is concerned to raise it immediately. He locates some jelly beans and Peggy quickly eats them. He then sits with her as she nibbles her toasted sandwich. It takes some time, but Max is concerned not to leave her. As he waits for the food to take effect, he administers her medications and completes her client notes, making a point to suggest that Peggy has a chat with her doctor about a couple of recent low readings. Ten minutes later another blood reading is taken – 5.2. Max is satisfied and Peggy is already brighter. The sky however is not: the last of the sun’s rays have disappeared until morning.

12 | Royal District Nursing Service – Annual Report 2009 7.13 pm Ida looks concerned as Max enters her small and sparsely furnished flat. At 83, she has seen a lot of life, and she has little need or desire for anxiety or stress. A visit from someone earlier in the day has left her feeling tense. As she talks with Max, she seems to gain comfort, knowing that in him she has someone she can trust. And trust him she does: to provide her with her medicines and administer the eye-drops that keep her glaucoma at bay. Max reminds her that she is in control and can still make her own decisions, with assistance from her family, if she feels pressured by her earlier visitor. She thanks him with clear appreciation as he steps into the increasingly cool evening.

7.4 9 pm Mickey shuffles to the door in her familiar RSPCA pyjamas. “I support the RSPCA,” she reminds Max before handing him a copy of “100 Birds to See Before You Die”. It is a quirky punctuation in an otherwise serious business: making sure Mickey takes her tablets and inhalers and puffers before the evening lengthens too much. Mickey shows the same trust in Max as she did in Alison earlier in the day, although, like this morning, all care is carried out just inside her front door. This is Mickey’s home, and she decides how things happen. Max completes her medication chart and client notes with precision before wishing Mickey a good night. The warm glow of her porch light pierces the otherwise darkened street and Max heads off into the shadows.

Royal District Nursing Service – Annual Report 2009 | 13 8.11 pm Freda has contended with her fair share of physical difficulties in her life. A problem with her bones has meant a raft of complications, including hip replacements. They have helped, but they haven’t solved her underlying problem and at 88 years old, it is now a matter of managing her pain. She sits in bed, a plasma TV in front of her, as Max enters her room. She is matter of fact about her pain and Max is determined to help her manage it. The aim is to get her through the night with as little discomfort as possible. Max notices some of her medications need replenishing and completes the appropriate paperwork before handing her painkillers. The night can be long and unforgiving and Freda’s doctor ensures via Max and his RDNS colleagues that she receives exactly the right combination of medicines. There are other things to attend to: Max ensures she is comfortable in bed and her feet are correctly placed in a support frame. There is a wheat bag to prepare for added pain relief and a night-time drink to sustain her. The world outside is quiet and Max completes his task with calm assuredness. For Max, it is all part of his evening’s work; for Freda it is an essential conclusion to her day. 8.51pm Max re-enters the dimly lit street and completes some client notes on his mobile computer. There is one more client to see. He loves 9.03 pm this work, he says, and in the evening there is a tranquillity which he enjoys as he undertakes his tasks. Soon he will be back at RDNS, The night is still, apart from a light breeze that rustles the lightly perfumed completing outstanding client notes and making sure people like trees. Across the city people settle into their regular night-time activities: Freda have their medication orders faxed off in order to alert the reading, watching television, cleaning up after a long day. The RDNS site pharmacist first thing the following day. Max smiles under the street is different at this time of day: there is no bustle of nurses preparing to lights: it’s all part of a day’s…a night’s…work. undertake morning visits; no heightened chatter or the mechanical drone of computers, printers and faxes. Instead, the office area is quiet, gently lit and calm. Sitting in front of their mobile computers are nurse Jackie and Community Care Aide Lorna. It is the night shift, and ahead of the duo are many hours of client visits. The nature of what they do is slightly different from their daytime colleagues, but just as vital. They travel as a pair – mainly for security – but it is clear that as most of Melbourne sleeps, they benefit from having each other’s company. There are clients across a few suburbs to see tonight, and a range of care to be provided.

9.53 pm It’s already been a long day for June Evelyn. After a nasty fall and a period in hospital she has returned to her warm and cherished home. She is still very sore and bruised, but well enough to be discharged. But this is her first night back at home, and without any other support, she is grateful for the arrival of her night visitors, Jackie and Lorna. June Evelyn’s mobility is limited and she walks slowly with a frame: there are medicines to take and she requires help with medicated creams and with preparing herself for bed. An artist all of her life, her many works of literature, drawing and painting adorn her home and provide a fitting background for the methodical work of Jackie and Lorna. Despite her recent trauma, there is a knowing look in her eye, as if she has learnt at least some of life’s secrets over her 82 year journey. Her movements, and that of her visitors, are measured and watchful, but she is eventually ready to retire to her own bed after an enforced period of absence. It is a simple pleasure that she cherishes and she acknowledges the role Jackie and Lorna have played in helping make it possible once again.

14 | Royal District Nursing Service – Annual Report 2009 10.48 pm The wind has lifted and the temperature has dropped again as Jackie and Lorna make their way up the drive of two sisters with schizophrenia. Long-term clients of RDNS, they are ‘a 12.03 am couple of characters’ Lorna explains, but this night, the welcome is extended to their trusted Midnight has come and gone: it is a new day. caregivers only, not to cameras. The care is swift, well-rehearsed and absolutely necessary But Norma is wide awake as the RDNS pair if the two are to remain together and in their own home. ‘Medication management’ is the pull up outside the quaint house she shares official term; the careful administration of a combination of drugs that bring relative normality with her husband Gordon. They have been to these two sisters and countless others in RDNS’ care. married 62 years and the journey of their love affair is written large on the walls of their home. 11.21 pm From the early days of blooming romance, to the raising of children, through to the more Midnight is just around the corner, and with the darkness of night comes the pain of modest adventures of these later years, incurable disease. The next visit is to a newly admitted client, Rosie: the treatment is photos speak loudly of a life fully lived and a palliative care. Jackie and Lorna are seeing her to ease her pain and to help make the last love that runs deep. Norma smiles broadly as stage of her journey as peaceful as possible. It is challenging and confronting: houses she ushers Jackie and Lorna in from the cool throughout the same street radiate the warm glow of lamps and night-lights and televisions, air, but there is sadness in her eyes as well. but in this home a harsh reality is proclaiming its cruel truth. But it is still home to Rosie, Gordon is gravely ill; these are the last stages and this is where she has chosen to complete her life. There is dignity here, and respect of untreatable disease but it is at home that and courage. he will endure until the last. The spite of his condition will not part them in these last days, although it has tried its best. Norma cared for him by herself at first, but it was too much for even this robust 86-year-old, and now she happily, gratefully, relies on Jackie, Lorna and their colleagues. “I just couldn’t cope without them,” says Norma, looking wistfully towards the bedroom in which her husband is resting more peacefully now that Jackie and Lorna have finished their task.

the small hours 12.38 am The night wind is bracing and haughty as it greets Jackie and Lorna once again. They enter the warm sanctuary of their car and refer to their client list, housed reliably on their mobile computer. Despite the relative silence that will accompany them throughout the night, there is still much to be done over the coming hours: clients with complex care needs and pain to be managed; others who need to be manually turned in their beds to provide comfort and alleviate pressure. At around 7.30am Jackie and Lorna will complete their duties, just as Alison and Max before them, and the 24 hour cycle of care will be complete. Until, as the birds rise from their slumber at the first hint of dawn, and as much of Melbourne follows shortly afterwards, the next band of RDNS nurses and support staff begin the sequence all over again.

Royal District Nursing Service – Annual Report 2009 | 15 Financial Summary

INCOME STATEMENT RDNS 2009 RDNS 2008 FOR ThE yEAR ENDED 30 JuNE 2009 $ $

Revenue from continuing operations 95,522,645 89,979,817 Net gain / (loss) on disposal of property, plant and equipment (86,004) 359,199

Total revenue 95,436,641 90,339,016

Total expenses 95,796,521 88,505,326 Surplus from continuing operations (359,880) 1,833,690

BA L A N C E ShEET RDNS 2009 RDNS 2008 AS AT 30 JuNE 2009 $ $

Total current assets 13,166,058 9,540,908 Total non-current assets 19,889,678 22,101,503

Total assets 33,055,736 31,642,411

Total current liabilities 21,654,295 19,983,931 Total non-current liabilities 2,813,103 2,348,927

Total liabilities 24,467,398 22,332,858 Net assets 8,588,338 9,309,553

Reserves 2,896,192 3,295,260

Accumulated surplus 5,692,146 6,014,293 Total equity 8,588,338 9,309,553

16 | Royal District Nursing Service – Annual Report 2009 Our Executive Team

Clockwise from front left: david aBerdeen dan romanis General Manager, Human Resources Chief Executive Officer

evan gordon sTelvio vido General Manager, Marketing and Planning Executive General Manager, Strategic and Support Services mark smiTh General Manager, External Relations fiona hearn General Manager/Director of Nursing, dr lisa donohue North and West Regions General Manager, RDNS Helen Macpherson Smith Institute of Community Health anThony Boffa General Manager, Finance and Assets ian cash General Manager, Information Services marTin wischer General Manager/Director of Nursing, rosemary hogan South and East Regions Executive General Manager, Client Services

Royal District Nursing Service – Annual Report 2009 | 17 Every gift is important. As we strive to keep pace with the Thank you! demand for our services, your support is more important than ever.

We would like to thank the individuals, If you can help RDNS please send your gift today or call RDNS on philanthropic trusts and organisations listed (03) 9536 5222 to donate. You can also make a secure online below for their wonderful support during the past donation at www.rdns.com.au year. We also sincerely thank the many donors whose names we have been unable to list.

Major donors – $15,000 and over Karingal Bowling Club Mr Alan Cohn Professor Bruce West Mrs Angela Kayser Mr & Mrs Keith & Jean Comben Mrs Judith Williams Miss E M Kelly Mrs R E Costello Mr David Wischer Jack Brockhoff Foundation Helen Macpherson Smith Trust Mrs Vivienne Key Mr John Covell Mr Stuart Young City of Melbourne Mrs Betsy King Mr Brian Cox Dame Elisabeth Murdoch City of Yarra Leighton Holdings Limited Mr Peter Davenport AC DBE Corporate sponsors Ian Rollo Currie Estate Mrs Laura Lewis Ms Esma Dicker Mrs Merna Olver Foundation Estate of Florence Clara Lawrence Mrs Noel Dobbins Commander Estate of William Maxwell Flora & Frank Leith Charitable Trust Ms Jean Ford RACV Marian & E H Flack Trust Potter Lioness Club of Deer Park Ms Anne Gaides & Dr Chris Callahan Telstra Estate of Mrs Ella Mavis Ford Tattersall’s George Adams Lioness Club of Dromana Mr L B George Estate of the Late Foundation Lions Club of Rye Inc Mr Adrian Godfrey In kind donations Glen W Griffiths Mrs A I Longworth Mrs Dorothea Gordon Telstra Clarendon Lawyers H & L Hecht Trust Mr Brian Lowe Mrs Jean Hadges Victorian Health Promotion Miss Nannette Lowth Mr Paul Heland Freehills Mrs Margaret Henderson Foundation Mrs Barbara Lyon Henry & Robert D’Esterre Taylor’s iGroup Australia Clive Johnson Trust Estate of Ian Alfred Walker Mrs Pat Mahoney Charitable Fund Print Bound Rednoise Pam & Alfred E G Lavey Trust Estate of Thomas W Whitelaw Mrs Ann Marsh Mrs Lilian Herlihy Mrs Mary Hilton Women of the University Fund Leading Solutions J O & J R Wicking Trust Mr Craig Mayo Mr James McKenzie Mr John Hopkins All of the many volunteers who have Lord Mayor’s Charitable Fund ID-ME Pty Ltd assisted with RDNS Christmas Mr John McPhee MBE ADM cards. Mrs Daisy Merrett Mr David Johnston Morris Family Trust Mr L A F Jones Mrs Valda Jones Constant Companions Sylvia Caddy Charitable Trust Mr Nicholas Mules Ms Mary Keily $10,000 – $14,999 Community Enterprise Foundation Estate of Ian Michael Nowack Mrs Rosemary Adams Mrs Dianne Kleinhenz Mrs Helen Cook Miss M O’Sullevan Mrs Lorraine A’Hearn ANZ Charitable Purposes Victoria: Mr Herman Kortenhorst Sir John Minogue Bequest, VCF Dr Nancy Cowling Mr Michael Paris Mr Douglas Alkemade Mr John Lander General Fund Estate of Elaine M Cox Mr Alexander Parker Mrs Julie Ancora Mr Joseph Lashbrook Berwick Opportunity Shop Inc Mr J Curtain Mr Graham Pearce Mr Grahame Anderson Mr & Mrs Jim & Alison Leslie Collier Charitable Fund Mrs Paula Curtis Pen Computer Systems Pty Ltd Mr Edward Appleyard Mr Alan Matheson Kimberley Foundation D’Accord (Vic) Pty Ltd Pierce Armstrong Foundation Mrs Hilda Arblaster Mr D T McGregor James N Kirby Foundation Ms Gael Danaher Public Relations Institute of Australia Mrs Nola Armstrong Mr & Mrs John Melville Herbert & Dorothy Lancaster Mrs Diana De Kessler Mr Gary Richardson Mrs Doreen Ashley-Brown Charitable Trust Mr Arthur Morgan Ms Margaret Dean Ritchies Supermarket Mrs Nancy Azzalini Mr Alexander Stewart Mrs Pauline Morrison Department of Planning & Mr Ian Robertson BEM Miss Judith Bach Joe White Bequest Northern Masonic Widows Community Development Rotary Club of Footscray Mrs Edna Bainbridge Association Estate of Susan Prentice Douglas Rotary Club of Pascoe Vale Inc Mr Frank Baines Mr Geoff O’Callaghan $1,000 – $9,999 Mr Stephen Earp Rotary Club of Rosebud Inc Mrs Colleen Baker Mr Thomas Peck Ms Elizabeth Eastgate Mr Greg Shalit & Ms Miriam Faine Mr Peter Ball Ms Janet Adams Miss Isabella Poloni Estate of Stanley Egan Miss Jane Sheridan Dr William Bamford Mrs A E Allison Ms Maria Priwitzer Eltham Rural Group St Michael’s Global Concerns Mr Les Banner Mr Max Anderson Committee Miss Margaret Raw Estate of Leslie Alfred Fisher Mrs Catherine Barnard Mrs Rita Andre Mr & Mrs D & B Sutherland Mr Alan Ray Mr Con Foscolos Mrs Eunice Barr Andrews Foundation TalkPoint Pty Ltd Mr Frederick Renouf Mr Paul Foster Miss Joan Batson William Angliss (Vic) Charitable Fund Ms Carolyn Tatchell Mrs Lorna Robinson Mr Glenn Fouse Miss Olwen Bawden Anti-Cancer Council of Vic Mrs Nancy Telford Mr Jack Rogers Freemasons Public Charitable Mr Christopher Berry Mrs Nola Armstrong Foundation Ms Katrina Tull Mr Paul Simon Ms Maree Bird Mr Tim Armstrong Mr & Mrs Syd & Thelma Greedy Mr Ian Tyler Mr Rex Sims Mrs Lorraine Birtwistle Miss Valerie Awburn Mrs E M Groat Mr & Mrs John & Marie Warnock Mr Hugh Smart Mr Ross Blair Banyule Watsonia RSL Trust Grosby Family Trust Mr Alfred Wheatland Mrs Betty Smith Mrs Sigrid Bode Mr Ross Barker Ms Sally-Anne Hains Gary White Foundation Mr Keith Smith Mr Bruce Boell Mrs Brenda Baxter Miss Dorothy Higgins Women of the University Fund Mr Henry L Speagle OAM Mrs Margot Bone Mr Noel Belcher Hobart District Nursing Service Mrs Ethel St John Mrs Sheila Boulton Besen Family Foundation Ms Patricia Holmes Ms Georgie Stubbs $500 – $999 Dr & Mrs Clive & Anne Bowman Mr Robert Butler iGroup Australia Pty Ltd Theresa Salmon Charitable Trust Mr Reg Brewer Miss Georgina Caldwell Ms Andra Jackson Mrs Betty Abraham Mrs Susan Tyzzer Mrs Pamela Brown Mr Edwin Cameron Ms Julie Jackson Mrs Kathleen Allen Mr Gerard Veitch Mrs Hilda Bruce Mrs Dorothy Carlton Mr Lionel Johnson Miss Margaret Bain Ms Catherine Ward Mrs Marjorie Bryant George Castan Family Ms Marian Jones Ms Christine Butcher Mr William Waterfield Charitable Trust Mr Paul Burness Mr Cyril Kaighin Catholic Ladies College Eltham Mrs Elizabeth Weller Mrs Nora Cayley Mrs Mary Cain

18 | Royal District Nursing Service – Annual Report 2009 Mrs Grace Cairns Mr Kim Gladigau Mrs Madge Leigh Mrs Kathleen Rouse Ms Sarah Walker Mr John Cairns Dr Reuben Glass & Mrs Hilde Lesheim Mr Alister Rowe Mr Graham Wall Mrs Alison Calwell Mrs Ann Cebon-Glass Mrs Ettyann Levy Mr John Rowe Mr Gary Wallin Ms Margaret Campbell Mr Adrian Godfrey Mr Ronald Linsdell Mrs Kathleen Rushby Ms Jacqueline Walling Mrs Susan Cannon Mrs Patricia Goodman Mrs Constance Lister Mrs Rose Sadler Mrs Jennifer Watson Ms Joanna Capozzi Mrs Marjorie Gough Mr Thomas Logan Mr Bernie Sagebrecht Mr Bryan Wearne Mr Peter Carpenter Mrs Sandra Gough Mrs Pamela Logg Mr Edwin Salisbury Mr Ian Weaver Ms Anne Carroll Mrs Sharon Graham Mrs Ruth Lord Dr Robert Salter Miss Patricia Webster Mrs Nora Cayley Miss Yvonne Gray Mr Tony Love Mr Jack Sanders Mr Ronald White Mrs Trix Chambers Mr & Mrs Michael & Rosalie Green Dr Zena Lowe Mrs Pamela Sands Mr Reginald Whiting Mr John Charitos Mr Fred Greenslade Mrs Ailsa Luke Mrs Irene Schwab Mrs Judith Wight Mrs Molly Cheah Mr Geoffrey Griffiths Mr Brian Mander Mrs Mona Scott Mrs Peggy Wigney Mr Norman Chesterfield Mr Donald Grove Mr Reginald Mannix Mrs Pauline Searle Mrs Jennifer Williams Mrs Margaret Christensen Mrs Rae Hamilton Mrs Margot Marshall Ms Elizabeth Sevior Mr Norris Williams Mrs Iona Christianson Ms Peg Hampton Ms Catherine Martin Mrs Joyce Sharp Mr George Willis Ms Jean Christie Mr Peter Hardiman Mr Alan Matheson Mr John M Shaw Mrs Doreen Wilson Mr Leslie Claringbull Mrs Gwenda Harding Mrs Julie Matthews Mr Kevin Sheather Mrs Patricia Winnett Mrs Ann Clarke Mr Tom Harle Ms Margaret May Mr Khik H Sie Mr David Wischer Mr Jack Clifton Mrs Barbara Harradine Ms Joanne McCoy Mrs Dulcie Simmons Ms Valentina Wolzak Mrs Patricia Colgan Mrs Serena Harrison Mr John McCredie Mr Robert Simpson Mrs Natalie Yeoward Mr John Cooke Mr Daryll Hart Mrs Mary McGowan Mr Rodney Simpson Mr Martin Zeeuwe Mr Brian Cox Mrs Dorothy Hart Mr James McKenzie Mr Ken Simpson Ms Valentina Wolzak Mr Dennis Creasy Mrs Valerie Harvey Ms Janet McLean Mrs Pamela Sinclair Mrs Joyce Crosby Mrs Esme Haworth Mr & Mrs David McLiesh Mrs Dianne Skehan Lifetime Companions Mr Ron Cruickshank Mrs Dorte Henriksen Mr Noel McMinn Mr Howard Skitt Dr Philippa Currie Mrs Helen Hewitt Mrs Lucy McRae Mr Mohammad Slamet Miss Judith Bach Mrs Maire Dale Mrs Dorothy Hibbs Mrs Robyn McWilliam Mr Bernard Smallacombe Mrs Irene Berry Mrs Sheila Daniels Mrs Jane Hill Ms Margaret Miller Mr Dennis Smith Miss Bea Boardman Mrs Joy Davenport Mr Geoffrey Hilliard Mrs Margot Minogue Mrs Doreen Smith Mr Rodney Bright Ms Gayle Davey Mrs Joan Holley Ms Jan Moller Mrs Esna Smith Mrs Barbara Burrows Mrs Margery Davies Ms Patricia Holmes Mr Maurice Monigatti Mrs Janette Smith Miss Ruth Doig Mr Lyle Davis Mrs Claire Holt Mr A L Moore Mr Keith Smith Mr Stephen Earp Mrs Mary Davis Ms Alex Home Miss Margaret Morrissey Mrs Margaret Smith Mrs Catherine Erdos Mr John Dawson Mrs Lorraine Hook Mr & Mrs Gil & Betty Muling Mrs Marilyn Smith Mr William Finighan Mr & Mrs Robert & Judith De Bruyn Mrs Ruth Hopkins Mr Bevan Mullett Mrs Valda Smith Ms Anne Gaides & Dr Chris Callahan Mrs Elaine Dempsey Mrs Jennifer Hornidge Ms Lorraine Murphy Mrs & Mr Wendy & Ian Smith Miss Heidi Gasser Mrs Betty Denton Mr Donald Hosking Mrs Lorna Nazier Mr William Smith Miss Gwendoline Gillard Mrs Gloria Di Tomasso Mrs Esma Houghton Mr Peter Newton Mr Henry L Speagle OAM Ms Margaret Gladstone Mrs Janet Dickins Mrs Noelle Howell Miss Ruth Nicholls Ms June Speed Mrs Gillian Hannan Ms Norma Dickson Mrs Patricia Hoyle Mr Geoff O’Callaghan Mrs Shirley Stanley Mrs Helen Harbeck Mr Richard Ditterich Mr Robert Hudson Ms Anne O’Connor Mrs Helen Steiner Mr Ray Harbert Mr Blair Dixon Mrs Della Hutchinson Mrs Debra O’Farrell Mrs May Stephen Dr Margaret Henderson Mrs Mary Doak Mrs Maureen Irving Ms Lesley Ogden Mr Henry Stevens Mrs Patricia Holdenson Mr John Dollimore Mrs Margaret Jacobs Mr Edward Oldham Ms Kiera Stevens Mr & Mrs Terence & Janet Keefe Mrs Sarah Donnan Mrs Ellen Jansz Mr Norman O’Leary Mr Alexander Stewart Mrs Betsy King Ms Helen Donnellan Ms Robin Jeffs Ms Janine O’Neill Mrs Benita Stribley Mrs Judith Knight Mr & Mrs Richard Dooley Mrs Diane Jenkins Mrs Nance O’Ryan Mr Rudi Stryk Mr John Lander Mrs Diane Dott Mrs Marjorie Job Mr Kevin O’Sullivan Ms Georgie Stubbs Mrs Patricia Lawson Ms Carolyn Downes Mrs Karen Joel Mrs Susan Parisian Mr Anthony Sullivan Mr Donald Linden Miss Patricia Doyle Mrs Marjorie Johnson Mr Alexander Parker Mr Ian Suren Mr Brian Lowe Ms Mary Duckworth Miss Lorraine Jones Mrs Joan Parrett Miss Phyllis Tanti Miss Nannette Lowth Ms Anne Duffield Mr Arthur Joslyn Mrs Janet Paterson Ms Carolyn Tatchell Mr Anthony Lux Mr John Dunn Mr Ronald Jukes Mr Don Peckham Mrs Gwendoline Taylor Mrs Ruby Marshall Mrs Tulay Durur Ms Margaret Jungwirth Mrs Joyce Penman Mrs Judy Tham-Gazzard Mr Philip Mayers Mr Con Duyvestyn Ms Margaret Junor Mrs Patricia Petch Mrs Beryl Thomas Ms Inge Meldgaard Mr Gary Dyason Mrs Anneli Kaendler Mr Vincent T Powell Mrs Virginia Thompson Miss Edna Olson Miss Nancy Elliott Ms Ann Kang Mrs Edna Preston Mr William Thompson Mrs Kathleen Pook Mrs Betty Fabry Mrs Veronica Kastelan Mr Maurice Pritchard Miss Ruby Thomson Mr Emmanuel Psaila Mrs Stella Faidy Mr Don Katugampala Mr Thomas Pritchard Mrs Irene Tilley Ms Pamela Purton Mrs Jane Farr Mrs Angela Kayser Mr Emmanuel Psaila Mr Thomas Tillig Mrs P J Randall Mr Tony Ferguson Mrs Marjorie Kean Mrs Sandra Quinlan Mrs Esther Tims Mr Stuart Robinson Mrs Ruth Firkin Mrs Elaine Keenan Mr John Radford Mrs Elizabeth Tobias Mrs Audrey Smith Mrs Norma Firth Mrs Rose Keley Mrs Carol Ramsbotham Mrs Judith Tuck Mr Brian Smith Mr & Mrs H & P Ford Mr Patrick Kelly Mr Graeme Randall Mr & Mrs Can & Sema Tuncer Mr Henry L Speagle OAM Ms Sara Fotheringham Mrs Peggy Kemp Mrs Sheila Randell Mr Henry Turnbull Mr Harold Swanton Ms Anne Gaides & Dr Chris Callahan Ms Susan Kemp Mrs Maria Raper Miss Jean Urie Mr Ferdinand Ten-Tye Mrs Joan Gale Mrs Isobel Kerr Mrs Joyce Raverty Mr Hugh Vallance Mr Ian Walker Mr Brian Garde Mr & Mrs Alan & Charon Khor Mrs Diane Redman-Heath Ms Marie Vassallo Mr William Gates Mr Richard Knight Ms Judith Rees Mrs Elsie Veal In memory Miss Daphne Gendle Mrs Margaret Kovacic Ms Yvonne Renard Mr Gerard Veitch Mrs Lore Germain Mrs Irene Kowala Mrs Pamela Richardson Mr Michael Vermeulen Donations of $1,000 or more were made to honour the following: Rev Joan Gilchrist Mr John Lander Mrs Cheryl Rintoull Mrs May Vernon Mr Peter Fong Mrs Joyce Gilchrist Mrs Joan Langford Mrs Lorna Robinson Mr Ronald Vidmer Mr Raymond Lyon Mrs Joyce Gillespie Mr David Last Mr Chris Rogers Mrs Joy Vincent Mr Charles Weller Mr & Mrs Norman & Gladys Gillies Mr & Mrs Robert & Alma Laycock Mr Dan Romanis Mr Ronald Wadey Mrs Jean Lee Mrs Moira Wischer

Royal District Nursing Service – Annual Report 2009 | 19 You can help

We need your help to care for the sick and elderly in our community. Being a charity, RDNS relies on the gifts of supporters to help meet the ever-increasing demand for our services.

If you can help, simply fill out this form and send it, along with your donation, to the address below.

Yes! I would like to help Name

Address

Postcode

Telephone (H) (W)

Email

Enclosed is my donation of: $25 $50 $75 $100 Other $

Enclosed is my cheque/money order payable to Royal District Nursing Service

Or please charge my:

Visa Mastercard Amex

Card No.

Name on card

Signature

Expiry date

You can make a credit card donation over the phone by calling (03) 9536 5222 or securely online at www.rdns.com.au

All donations of $2 or more to RDNS are tax deductable.

Please send me further information on how to include RDNS in my Will

I would like information on making a regular monthly donation to RDNS

Return your completed form to: Royal District Nursing Service 31 Alma Rd, St Kilda, Victoria, 3182

Telephone (03) 9536 5222 Facsimile (03) 9536 5333 Email [email protected]

www.rdns.com.au Facts & Figures 2008–09

Explanation of tables and graphs

Visits and client-related contacts Admissions by source of referral Visits by care type Comprises face-to-face visits with clients The greatest proportion of referrals to RDNS The core focus of RDNS is clearly demonstrated as well as a count of ‘client-related contacts’, continues to come from public hospitals where to be the provision of support and maintenance which are activities undertaken on behalf RDNS Liaison nurses are pivotal in coordinating services to clients in their homes. of a specific client though not in their discharge planning. presence. (For example, a visit to a client’s Top ten classification by occurence GP, attendence at a case conference or time The table graphically demonstrates the diversity spent communicating with other service of conditions RDNS clients present with. providers involved in a client’s care).

E p I S O D E S O F C A R E A N D V I S I T S B y R D N S S u p p ORT SITE C L I E N T A D M I S S I O N B y S O u R C E O F R E F E R R A L

Region Support Site Episodes % Visits* % Source Admissions %

Eastern Box Hill 2,374 6.3 97, 282 5.7 Acute hospital / public 11,462 40.1 Camberwell 1,397 3.7 62,129 3.6

Knox & Lilydale 2,892 7.6 141,985 8.3 Local doctor 2,800 9.8

Eastern total 6,663 17.6 301,396 17.6 Acute hospital / private 1,751 6.1 Northern Diamond Valley 2,672 7.1 100,295 5.8

Heidelberg 1,841 4.9 62,734 3.7 Relatives, friends, neighbours 1,862 6.5

Moreland & Gisborne 2,701 7.1 99,743 5.8 Self-referral 1,351 4.7 Yarra 1,303 3.4 56,267 3.3

Northern total 8,517 22.5 319,039 18.6 Extended care rehabilitation facilities 433 1.5

Southern Berwick & Cranbourne 1,995 5.3 64,564 3.8 Palliative care / hospice 1,502 5.2 Caulfield 1,765 4.7 99,517 5.8

Frankston 1,819 4.8 82,529 4.8 Other community health service 1,219 4.3

Moorabbin 1,857 4.9 142,504 8.3 Other community service non-health 224 0.8 Rosebud 2,064 5.4 74,584 4.3

Springvale 1,923 5.1 65,164 3.8 Aged care assessment team 674 2.4

Southern total 11,423 30.2 528,862 30.8 Nursing home / hostel / other residence 136 0.5 Western Altona 3,080 8.1 102,787 6.0

Essendon & Lionsville 1,915 5.1 79,476 4.4 Respite care – except palliative 24 0.1

Sunshine 3,921 10.4 111,950 6.5 Mental health / psychiatric service 7 0.0 Western total 8,916 23.6 294,213 16.9

RALLY Healthcare total 58 <1 2,304 0.1 Other 5,168 18.1

Homeless Persons Program (HPP) total 2,261 6.0 35,804 2.1 TOTAL 28,613 100 Customer Service Centre (CSC) total 190,025 11.1

Liaison total 12 <1 46,897 2.7

TOTAL 37,850 100 1,718,540 100

Note: Percentages (%) have been rounded up to 1 decimal point. * Visits include direct care and client related contacts.

20 | Royal District Nursing Service – Annual Report 2009 Number of clients treated for the year 2008 – 09: 33,213

Top ten ICD-9-CM* classification of diseases and injuries: number of occurrences and percentage 2008– 09

Classification of diseases and injuries Conditions at RDNS within the Main ICD-9-CM within ICD-9-CM (Primary Diagnosis) categories Occurrences %

Symptoms, signs and ill-defined conditions Urinary incontinence (7%) ** 6,731 16

Post-operative care 6,636 16

Diseases of the skin and subcutaneous tissue Leg ulcers and cellulitis (11%) ** 5,808 14

Injury and poisoning Wounds (7%) ** 4,105 10

Neoplasms Malignant neoplasm (7%) ** 3,130 8

Mental disorders Dementia (2%) ** 2,931 7

Endocrine, nutritional, metabolic diseases and immunity disorders Diabetes (6%) ** 2,912 7

Diseases of the circulatory system Venous ulcers (1%) ** 2,401 6

Diseases of the nervous system and sense organs Multiple Sclerosis, Alzheimer’s, Parkinson’s diseases (2%) ** 1,912 5

Genitourinary system Urinary retention (1%) 1,068 3

Other 3,889 9

TOTAL 41,523 100

* International Classification of Diseases (9th Revision) Clinical Modification. ** Each ICD-9-CM classification consists of a number of conditions. This figure represents the frequency of the conditions’ occurrence within the ICD-9-CM classification.

V I S I T h o u R S B y C A R E T y p e 2 0 0 8 – 0 9

Support and Acute / maintenance Post acute Palliative Other TOTAL

Visit at home 428,993 25,536 24,982 58,228 537,739

Visit at school / work 3,114 111 93 10,804 14,122

Visit to hospital (liaison) 664 330 52 15,176 16,222

Visit to hospital (not liaison) 553 2 32 1,807 2,394

Client attended centre 2,009 164 4 6,259 8,436

Bereavement visit 80 4 253 60 397

Other 89 0 0 2,104 2,193

TOTAL 435,502 26,147 25,416 94,438 581,503

Note: Visit hours exclude client-related contact hours.

Royal District Nursing Service – Annual Report 2009 | 21 Facts & Figures (continued)

CuLTuRAL DIVERSITy O F C L I E N T pOpuLATION 2008–09 % of clients born in non-English speaking countries

REGIONS

Western 45 55

Southern 28 72

Northern 44 56

Eastern 28 72

% 0 10 20 30 40 50 60 70 80 90 100

Non-English speaking countries English speaking countries

addiTional informaTion aBouT culTural diversiTy of clienT PoPulaTion

• RDNS clients originate from 146 countries • RDNS clients speak 105 languages • 34% of total RDNS clients are born in non-English speaking countries • 0.6% of total RDNS clients are Aboriginal and/or Torres Strait Islander

Staff • RDNS staff speak 48 languages • 15% RDNS staff speak a language other than English

Language Services • 38% increase in the use of on-site interpreters • 16% increase in the use of the RDNS Language Line (an automated telephone interpreter system for clients and carers)

22 | Royal District Nursing Service – Annual Report 2009 Our Directors

L–R: Michael Roberts, Professor Leon Piterman, Jillian Pappas, Noel Armstrong, Desmond Benjamin, Dr Michael Murray, Paul Montgomery, Marion Lau, Jan Begg, Peter Brindley noel armsTrong retirement in May 2006. During that Manager, Jan brings a sound Desmond has had extensive FpRIA time, Noel worked on the integration understanding of organisational experience as a Director, Chief 68 of the Freemasons business with change initiatives to RDNS - from Executive, Non-Executive Director, RDNS Director since 2006; the Epworth Group and was strategic planning to harvesting Chairman and Board consultant Deputy Chairman since 2009 partly responsible for the overall benefits from successful across a broad spectrum of both administration of the three hospital implementation. public and private companies. Member of RDNS Board campuses at Richmond, Box Hill Jan’s recent experience includes His honorary work has included Committee: Audit and Risk, and Brighton. Remuneration and Nominations corporate governance of major past President of the Company Whilst working at Epworth, Noel projects at ANZ Banking Group, Directors Association, Save the Noel’s expertise in strategic successfully established a company project setup and business case Children, Toorak and South Yarra communication is supported by to assess and analyse the customer development for the Victorian Rotary Clubs and Life Education. over 35 years experience in the performance of call centres of major Public Service and pharmaceutical Desmond was also a past Zone industry. Prior to moving into corporations throughout Australia. research and development project Chairman of the Salvation Army Red corporate and public affairs in 1972, Noel is also a past member of the management. Shield Appeal and a past Treasurer Noel had worked for newspapers Board of Management of Alexandra She has also consulted to major of the Toorak Red Cross. and radio; and produced television District Hospital. government and corporate business news and current affairs programs. Apart from his responsibilities within Australia, New Zealand, UK at RDNS, Desmond is currently In 1978, Noel established Jan Begg and USA and is active in developing a shareholder and Director of a a Victorian-based strategic BSc (hons), MBA scholarship funding for the privately owned home garden communications consultancy 52 Melbourne Business School. and agricultural chemical supplier which he sold to Hill and Knowlton RDNS Director since 2004 in 1989. He continued to work as Apart from her role at RDNS, Jan is and a Non-Executive Director of a General Manager, Victoria, before Member of RDNS Board also Managing Director of Azulin Pty privately owned retail lifestyle chain becoming Chief Executive of the Committee: Finance (Chair) Ltd and a Member of the Australian and consultancy. Institute of Company Directors. company’s Australian operations. Jan has extensive experience at PeTer Brindley He was later appointed Executive senior executive level in the areas desmond BenJamin Bachelor of Commerce (Economics Chairman of Hill and Knowlton of strategic consulting, project FGAA FAICD & Finance), Grad Dip of Business Australia and New Zealand and management, sales and marketing, 67 (Accounting), CpA Executive Vice President of the change management, software 43 company in the Asia Pacific Region. development and business unit RDNS Director since 2001 management. RDNS Director since 2009 In 1996, Noel become the Director Member of RDNS Board Member of RDNS Board of Corporate Affairs at Epworth As an experienced consultant, Committee: Audit and Risk Committee: Assets, Finance Hospital and worked there until his Company Director and Executive

Royal District Nursing Service – Annual Report 2009 | 23 Peter is a senior manager with She was awarded an Order of He has extensive professional the F.H. Faulding Prize for research a breadth of experience across Australia in 1996 for her services networks in aged care including in General Practice in 1987, the various business disciplines to older Australians, as well as National Evaluation of the Innovative Silver Jubilee Teaching Prize in in both local and international to the Chinese community. In Care (Rehabilitation) Services 1992 and the Hong Kong College environments. recent years, she received the Steering Committee; Continence of General Practitioners Award for Centenary Medal for her services Management Advisory Committee; best research project in 1994. He With a strong background in to multiculturalism and for her work Care of Older Australians clinical has over 90 publications in refereed finance, strategy, sales and as Chair of the Victorian Ethnic reference group Australian Centre journals and co-authored the text operations Peter has worked in Communities Council. for Evidence Based Aged Care “General Practice Psychiatry”. key strategic planning and finance (La Trobe University); Australian roles of major organisations such Other roles held by Marion include In June 2006, he was made a Association of Gerontology (Vic as Dulux New Zealand, Orica Executive member – Ethnic Member of the Order of Australia Branch); Continence Foundation New Zealand and ICI Australia, Communities’ Council of Victoria; (AM) for service to family medicine of Australia (National); Lynden as well as in general management President Elect 2009/2010 – Rotary through distance education Aged Care Association Board of roles in both mature and start-up Club of Elsternwick; Director for doctors in remote areas, to Governance; Australian Society businesses. – Doutta Galla Aged Services; research and student training, and for Geriatric Medicine and the Committee of Management – Small to international education. Peter has held various directorships International Continence Society. Business Mentoring Service; and specific legal entity, statutory Apart from his roles at RDNS, Member – Communications Apart from his roles at RDNS, compliance and public relations Leon is also Professor of General Alliance Consumer Council and Michael is also Director of responsibilities during his career. Practice - Monash University; Head Charter Member - Rotary Club of Geriatric Medicine - St Vincent’s; He is currently working with the of School - Primary Health Care and Elsternwick. Fellow - Australian Association of RACV as General Manager, RACV Deputy Dean - Faculty of Medicine Gerontology (FAAG) and Adjunct Home Services. Nursing and Health Sciences. He Associate Professor - Australian Paul Montgomery is also a member of the Board of BA, LLB (ANU) Centre for Evidence Based Aged Marion Lau OAM JP Examiners of the Australian Medical 60 Care (ACEBAC). RN Div 1; RM; Certificate in Council and sits on numerous RDNS Director since 2005; Gynaecology, Diploma in Nursing university, professional and Jillian Pappas Administration; Bachelor in Health Chairman since 2009 government expert committees. BEc (Monash) Services Administration (BHA) Member of RDNS Board 61 66 Committee: Assets, Remuneration Michael Roberts RDNS Director since 2000 RDNS Director since 1996 and Nominations (Chair) Registered Nurse, Grad Dip Member of RDNS Board Bus Admin Member of RDNS Board With a track record as one of Committee: Assets, Finance, 53 Committee: Clinical Governance Australia’s most respected law firm Remuneration and Nominations RDNS Director since 2005 Marion has excelled as an aged leaders, Paul specialises in strategy Member of RDNS Board care consultant, registered nurse and leadership development and Jillian has experience in research Committee: Assets, Audit and Risk and midwife and is also a mentor recognises the importance of and analysis in economics, (Chair) and business coach to the health its implementation from a client copywriting, accountancy and perspective. fundraising. industry and small business. Michael has more than 27 years experience in healthcare as a Her vast experience includes Paul was a Partner of Freehills In addition to her responsibilities nurse, clinical service manager, Matron/Manager - Avenue Hospital, Melbourne for 28 years and at RDNS, Jillian is also a Company and consultant. He worked in senior Windsor, Administrator and Advisor Managing Partner for 12 years. Director, President of Merton management and clinical roles at for the Commonwealth Department He is now an active director of Hall Foundation and a member St Vincent’s Hospital Melbourne of Health & Aged Care; Justice of several private companies that have of Council of Melbourne Girls and other hospitals. the Peace; Director - Management activities in a number of industries. Grammar. Consultants and Technology Apart from his responsibilities Apart from his roles at RDNS, Services; Member - Ministerial at RDNS, Paul is also Director – Professor Michael is also a Director of Small Business Advisory Council; Mental Illness Fellowship, Victoria. Leon Piterman AM Iridium Consulting – a Melbourne President - Chinese Health MBBS, MMed, MEdSt, MRCP(UK), based healthcare consultancy. Foundation; President - Chinese Dr Michael Murray FRCP (Edin) FRACGP He specialises in problem solving, Community Society of Victoria and 61 MBBS, FRACP, MPH change management, service Past Chair - Ethnic Communities’ 49 RDNS Director since 2006 redesign and planning. Iridium’s Council of Victoria. clients include health departments, RDNS Director since 2004 Member of RDNS Board professional bodies, hospitals, Marion was the first woman to Committee: Clinical Governance Member of RDNS Board community services, aged care be elected as Chair of the Ethnic Committee: Clinical Governance Leon has extensive expertise services and mental health Communities Council of Victoria – (Chair) in medical education, medical services. He is also active in the Victorian Peak Body for Ethnic research and clinical audit. several community service fields. Specific Organisations, as well as Michael brings a broad range of the first woman President of the management, clinical and clinical He has published widely on clinical Chinese Community Society of teaching experience to RDNS. and educational issues related to Victoria. general practice and was awarded

24 | Royal District Nursing Service – Annual Report 2009 Corporate Governance Statement

On 31 March 2003 the Australian Stock Exchange released the ASX Corporate Governance Council’s Principles of Good Governance and Best Practice Recommendations (‘ASX Principles’). Those ASX Principles require major publicly listed companies to disclose in their annual reports whether their corporate governance practices follow the ASX Principles on an ‘if not, why not’ basis.

RDNS is not a publicly listed company and is not subject to the ASX Principles – indeed some of them are not applicable to the not-for-profit sector. For over ten years the Board of Directors of Royal District Nursing Service has worked, as a key priority, on the development and adoption of processes and practices which are aimed at achieving best practice in good governance in the not-for-profit sector. So, whilst not technically required to comply with the ASX Principles, RDNS Directors have determined to use them as the basis for continuing to revise and update their own practices.

The RDNS Board Charter, originally developed in 1996/97, sets out the basis by which the RDNS Board fulfils its role and the Charter Statement (1999) provides further guidance on the way by which the Board/management/staff interface operates.

In summary, the Board is a strong advocate of good corporate governance and seeks to ensure that all officers and employees of the company fulfil their obligations and their responsibilities to all stakeholders. ERC 090891

Royal District Nursing Service – Annual Report 2009 | 25 Contact us Telephone Fax

Clients/general public 1300 33 44 55 1300 657 265

Health professionals 1300 687 7464 1300 657 265 (1300 NURSING)

RALLY Healthcare 1300 633 933 1300 791 162

RDNS Head Office 31 Alma Road, St Kilda, VIC, 3182 (03) 9536 5222 (03) 9536 5333

www.rdns.com.au