2013-14 Statement of Priorities
Agreement between Secretary for Health and Central Gippsland Health Service.
Department of Health Central Gippsland Health Service
Contents Background 3 Policy directions 3
Part A: Strategic overview 5 Mission statement 5 Service profile 6 Strategic planning 6 Strategic priorities 7
Part B: Performance priorities 11 Financial performance 11 Access performance 11 Service performance 12
Part C: Activity and funding 13
Part D 14
Accountability and funding requirements 15
Signature 15
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Background The Statement of Priorities (SoP) is the formal funding and monitoring agreement between Victorian sub-regional and local health services and the Secretary for Health, and is in accordance with section 26 of the Health Services Act 1988 (Vic). The annual agreement facilitates delivery of or substantial progress towards the key shared objectives of financial viability, improved access and quality of service provision. Statements of Priorities should be consistent with the health service’s strategic plans and aligned to government policy directions and priorities. A Statement of Priorities consists of four parts: • Part A provides an overview of the service profile, strategic priorities and deliverables the health service will achieve in the year ahead. • Part B lists the key financial, access and service performance priorities and agreed targets. • Part C lists funding and associated activity. • Part D forms the service agreement between each health service and the state of Victoria for the purpose of the National Health Reform Agreement (NHRA). The mechanisms used by the Department of Health to formally monitor health service performance against the Statement of Priorities are outlined in the Victorian Health Service Performance Monitoring Framework 2013-14 Business Rules. Policy directions The Victorian Health Priorities Framework 2012–2022 (VHPF) sets out the following 5 key outcomes the health system should strive to achieve by 2022: • People are as healthy as they can be (optimal health status) • People are managing their own health better • People enjoy the best possible health care service outcomes • Care is clinically effective and cost-effective and delivered in the most clinically effective and cost- effective service settings • The health system is highly productive and health services are cost-effective and afforda ble
It also articulates seven priorities which reflect the Government’s policy ambition to build a strong health system for all Victorians. The focus is on: developing a system that is responsive to people’s needs • improving every Victorian’s health status and experiences • expanding service, workforce and system capacity • increasing the system’s financial sustainability and productivity • implementing continuous improvements and innovation • increasing accountability and transparency • making better use of e-health and communications technology
These priorities are fundamental to Part A of the SoP and require address by health services.
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Government commitments Victoria has long been a leader in driving efficient health services. The Government’s commitment to quality and efficiency will build an affordable health system for the long term ensuring that Victoria is well placed to address future challenges associated with a growing and ageing population, and greater rates of chronic and complex health conditions.
In this context, the department will work with service partners to build a health system that is integrated and responsive to the changing needs of the community.
Specific commitments made by the Government in 2013-14 relate to:
• Growing essential hospital services including capacity for critical care and elective surgery across the system • Implementing mental health reforms, supporting mental health initiatives and growing mental health services • Boosting alcohol and drug services, including alcohol prevention programs and specific alcohol and drug awareness campaigns • Improving cardiovascular disease health outcomes and reducing readmission and disease progression rates through better management and support for people with chronic heart failure • Training our future health workforce by providing additional clinical training positions for undergraduates, postgraduates and rural GP proceduralists • Establishing a Health Innovation and Improvement Fund to support improvements in efficiency, quality, safety and patient centred care • Implementing an infection prevention and control strategy to improve patient outcomes and reduce the cost burden of health associated infections in Victorian public health services • Improving health outcomes for Aboriginal Victorians through the provision of culturally appropriate service options • Increasing support for older people and younger people with a disability through the Home and Community Care (HACC) program to assist them to remain in their home • Meeting the needs of refugees and asylum seekers through the provision of timely intervention and preventative care in primary care settings in high settlement areas of Victoria • Improving health literacy about maternity care through the development of consumer information and piloting of a statewide parenting kit • Increasing the availability of information for senior Victorians to support them to live independently in their own home for longer • Boosting community health services, particularly in growth areas • Reducing preventable disease in support of Victoria’s Healthy Together Community Strategy and via various public health initiatives • Supporting tele-health projects that will improve co-ordination and care for patients, and support the delivery of care closer to where people live • Supporting additional health capital projects and infrastructure improvements including the Werribee Mercy Hospital Mental Health expansion, The Waurn Ponds Community Hospital and Northern Hospital expansion
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Part A: Strategic overview
Mission statement
OUR MISSION Our mission is to provide health and community services that will best meet the current and future needs of our community.
OUR VISION Is of a safe and healthy community where everyone feels they are valued, supported and have the opportunity to participate. Social issues have been addressed through the joint efforts of community and supporting agencies.
OUR VALUES In achieving our goals and objectives we will develop an organisational culture that supports:
Social Justice - equity of outcome. To do this we will: • focus on achieving equality of outcome for individuals and groups; • understand the impact of poverty and disadvantage on behaviour and health status; • support affirmative action for the disadvantaged and marginalised amongst us; • ensure our fees policy takes into account ability to pay; • support harm minimisation and targeted community support programs; and • be compassionate, tolerant and embrace diversity.
Honesty, transparency and integrity. To do this we will: • set and model standards of behaviour consistent with the Victorian public sector code of conduct; • embrace open disclosure and provide meaningful and clear information to our stakeholders and; • support ethical leadership development at all levels of the organisation.
Quality – excellence with the client at the centre. To do this we will: • embed a quality culture of continuous improvement across the organisation such that our clients’ experience with CGHS is characterised by the following: o seamless: coordinated, integrated and timely provision of person-centred care; o capable individuals and teams working within structures and processes that support quality outcomes and continuous improvement; o facilities and equipment that enable the provision of efficient, effective and sustainable service delivery and; o a workforce that places a very high value on excellent customer service and client/patient advocacy.
Caring – support, compassion and tolerance. To do this we will: • be welcoming, caring, supportive, share knowledge freely and support learning in every setting, relating to our community with tolerance and compassion; • assist our community to understand their rights and responsibilities and to have access to genuine complaints resolution processes; • support our community to identify the need for and make decisions relating to the development, delivery and evaluation of services; • work within an inter-sectoral and collaborative framework to maximise benefits for our community; • appreciate the positive impact on organisational and community capacity that comes from diversity.
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People – respect and support. In doing so we will: • strive to provide an environment that assists our staff to: o achieve their personal goals and objectives; o live ethically within their personal value system and; o enthusiastically support CGHS to achieve our strategic and service delivery goals and objectives. • develop a workplace where people are enabled to: o be efficient and effective; o put forward ideas and participate in decision making; o be creative and innovative; and o develop their learning and career in a manner consistent with their strengths and interests. • foster very high levels of staff capability and satisfaction.
Service profile Central Gippsland Health Service (CGHS) is a sub-regional health service. CGHS works within the Victorian Health Priorities Framework, 2012-2022 with a focus on implementing, at a local and area- wide level, the priorities and actions contained in the Rural and Regional Health Plan. Within the Gippsland region, there is one regional health service, Latrobe Regional Hospital, which is the key specialist service resource for the region and the three sub-regional health services.
CGHS is the major provider of health and aged care services in the Wellington Shire. We serve an immediate population of approximately 42,000 in Central Gippsland, and reach a wider community in East Gippsland and parts of South Gippsland in terms of more specialised services such as perinatal services, critical care and surgery.
CGHS is unusual being both a sub-regional and an integrated health service, providing a broad range of primary, secondary and tertiary services, including a near comprehensive range of HACC services, through to adult intensive, coronary care and level 2 neonatal care.
Acute services include a full-time emergency department, critical care unit, neonatal critical care unit, operating theatres, day procedure unit, and oncology and dialysis services, in addition to general medical and surgical services. Bed based subacute services include rehabilitation, GEM and TCP.
The health service has acute campuses at Sale, Maffra and Heyfield. Community and home support services are provided throughout the Shire of Wellington (with the exception of Yarram and District) with centres in Maffra, Sale, Heyfield, Rosedale and Loch Sport. Residential aged care services are provided at Sale, Maffra and Heyfield.
The current focus of the health service is to use our integration and break down the traditional program barriers and service delivery silos that have flourished. We aim to develop a highly efficient system that responds to people’s needs by placing them at the centre of a service delivery system focused on supporting them to achieve their goals and aspirations, consistent with the principles embedded in the “active service model’ . To achieve these ends a transformational, innovative, whole of organisation, “ redesigning” project has been ongoing for over 3 years and has recently been supported by the establishment of a combined patient service and centralised intake area.
In 2012-13 CGHS released a comprehensive 10 year Health Plan as a consultation document. The CGHS Health Plan 2012-2022 represents a detailed response to the the Victorian Health Priorities Framework, 2012-2022, Rural and Regional Health Plan. The Plan describes how we will support an area-based planning approach to develop a system that is responsive to people’s needs.
Strategic planning Central Gippsland’s 2012-2022 health service strategic plan, health plan and associated technical paper can be accessed at http://www.gha2.net.au/CGHS/Content/Documents/CGHS-Health-Plan-20
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Strategic priorities The Victorian Government’s priorities and policy directions are outlined in the Victorian Health Priorities Framework 2012-2022 . In 2013-14 Central Gippsland Health Service will contribute to the achievement of these priorities by:
Priority Action Deliverable Developing a system • Implement formal advance • Advanced care planning that is responsive to care planning structures and procedures developed and people’s needs processes that provide implemented. patients with opportunities to
develop review and have their expressed preferences for future treatment and care
enacted. • Contribute to area-based • Implemented 2 additional planning initiatives that multi-site patient pathways consider health care across that incorporate transfer the care continuum. between sites, for people from Central and East Gippsland requiring higher level care at Latrobe Regional Hospital. • Configure and distribute • All recommendations from services to address the health the CGHS 2012-2022 Health needs of the local population. Plan incorporated into relevant CGHS service plans
and their implementation tracked through Inter-plan (integrated Planning System).
• In partnership with other local • Significant progress towards providers apply existing a subregional capability service capability frameworks framework for Central and to maximise the use of East Gippsland. available resources across the catchment.
Improving every • Improve thirty-day unplanned • Regular care co-ordination Victorian’s health readmission rates. evaluation will include status and identification of patient
experiences readmission trends. Collaborate with key partners • Demonstrated participation of such as Medicare Local, CGHS senior executive, community health services including the CEO, in the and other providers to support development of the Wellington local implementation of the Shire Council Health and Victorian Health and Wellbeing Plan. Wellbeing Plan 2011–2015.
• Identify service users who are • Identify and commence marginalised or vulnerable to implementation of strategies to poor health, and develop reduce the percentage of interventions that improve Aboriginal people leaving the their outcomes relative to Emergency Department at other groups, for example, their own risk or prior to Aboriginal people, people treatment. affected by mental illness,
people at risk of elder abuse, refugees and asylum seekers.
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Priority Action Deliverable • Improve health literacy and • Health literacy program support informed choice by developed in conjunction with responding to the health CGHS Community Liaison information needs of service Group and CGHS Chronic users. Disease and Disability Network.
Expanding service, • Optimise workforce • Complete HACC Workforce workforce and system productivity through Redesign Project with a focus capacity identification and on targeted capability implementation of development for our home and workforce models that community care workforce to enhance individual and enable these workers to: team capacity and support o provide a range of health flexibility. promotion, health support, and therapy for people in their homes;
o have available to them a
number of pathways to career development including pathways to
vocational qualifications in allied health and nursing and thereby providing further pathways to higher VET and university studies.
• Increase of the utilisation of our allied health assistant workforce in the community care settings. • Implement the • Partnering for Performance Credentialing and Scope of framework integrated into Practice policy and CGHS capability development ‘Partnering for program [Integrated, Online Performance ’ framework Performance Evaluation for senior clinicians. System (PES)]. • Develop and implement a • CGHS workforce workforce immunisation immunisation policy is updated policy that builds capacity and aligns with national and aligns with national guidelines and includes guidelines, including employment screening and reference to employment staff immunisations screening and staff assessment. immunisation assessment. • Contribute to the provision • Fourth dental chair operational of additional dental services to achieve targets, milestones and objectives of the National Partnership on Treating More Public Dental Patients.
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Priority Action Deliverable Increasing the • Reduce variation in health • Complete and document system’s financial service administrative benchmarking project relating sustainability and costs. to senior management productivity structure and costs.
• Progressed benchmarking
project in health service corporate and administrative costs.
• Identify opportunities for • Significant Progress of efficiency and better value Efficient Ward and Efficient service delivery. Theatre Projects • Identify opportunities for • Participate in implementation efficiency and better value of system improvements, service delivery. partnerships and collaboration within the region.
Implementing • Develop and implement • Improvements from continuous improvement strategies centralised intake and the improvements and that optimise access, establishment of care co- innovation patient flow, system ordination across all care coordination and the settings have been embedded quality and safety of through documented hospital services. procedures and processes. • Code Green: Emergency Department, Escalation • response procedure developed and implemented. • • Develop and implement • Theatre productivity improved strategies that support by 10 per cent compared to service innovation and co- average for 2012/13. design. • Support change and • Outputs from the “Embedding innovation in practice Continuous Improvement where it is proven to Project” include: deliver more effective and efficient health care. o Continuous improvement whiteboards being used in all departments o Establishment of a business intelligence unit o A minimum of 4 “redesigning” or CQI/lean projects in progress.
Increasing • Prepare for the National • Develop and Implement Action accountability and Safety and Quality Health Plans to achieve National transparency Service Standards, as Safety and Quality Health applicable. Service Standards Accreditation.
• Increase transparency and • Fully implement integrated accountability in reporting planning system including of accurate and relevant score card reporting of a information about the comprehensive “accountability organisation’s performance (KPI) framework.
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Priority Action Deliverable
• With the support of • Fully engage in the VHA Government, develop Board Evaluation and board capability to ensure Development Program. all board members are well equipped to effectively discharge their responsibilities and deliver against the outcomes articulated in the VHPF.
Improving utilisation of • Maximise the use of health • Fully implement iPM e-health and ICT infrastructure. Community Module across all communications community services and
technology. campuses.
• Replace local ICT • Trial, implement and infrastructure with access to evaluate strategies that Gippsland Health Alliance use e-health as an enabler infrastructure and thereby of better patient care. increase capability and reduce operating costs and risk. • Complete trial of tele-health link from the critical care unit
to specialist metropolitan units and extension to other clinical units within CGHS.
• Work with partners to • Provide electronic delivery of better connect service patient discharge information providers and deliver and service delivery plans to appropriate and timely GP and specialist medical services to rural and practices. regional Victorians.
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Part B: Performance priorities Financial performance
Key performance indicator Target Operating result Annual operating result ($m) $0.25m
WIES (1) activity performance Percentage of WIES (public and private) performance to target 100 Cash management Creditors < 60 days
Debtors < 60 days
Access performance
Key performance indicator Target Emergency care Percentage of ambulance transfers within 40 minutes 90 NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (July – December 2013) 75 NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (January – June 2014) 81 Number of patients with a length of stay in the emergency department greater than 24 hours 0 Percentage of Triage Category 1 emergency patients seen immediately 100 Percentage of Triage Category 1 to 5 emergency patients seen within clinically recommended times 80
(1) WIES is a Weighted Inlier Equivalent Separation.
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Service performance
Key performance indicator Target Quality and safety
Health service accreditation Full compliance Residential aged care accreditation Full compliance Cleaning standards Full compliance Submission of data to VICNISS (1) Full compliance
Health care worker immunisation - influenza 75 Hand Hygiene (rate) 70 Victorian Patient Satisfaction Monitor: (OCI) (2) (July to December 2013) 73 Consumer Participation Indicator (3) (July to December 2013) 75 Victorian Hospital Experience Measurement Instrument (4 ) (January to June 2014) Full compliance People Matter Survey Full compliance Maternity Percentage of women offered prearranged postnatal care 100
(1) VICNISS is the Victorian Hospital Acquired Infection Surveillance System. (2) The target for the Victorian Patient Satisfaction Monitor is the Overall Care Index (OCI) which comprises six categories. (3) The Consumer Participation Indicator is a category of the Victorian Patient Satisfaction Monitor. (4) The Victorian Health Experience Measurement Instrument (VHEMI) will succeed the VPSM as the instrument for measuring patient experience.
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Part C: Activity and funding
Funding type Activity Budget ($'000) Acute Admitted WIES Public 6,628 $30,456 WIES Private 793 $2,769 WIES (Public and Private) 7,421 $33,225
WIES DVA 224 $1,052 WIES TAC 23 $87
WIES TOTAL 7,668 $34,364
Acute non -admitted Emergency Services $3,897 Specialist Clinics $4,255 Subacute and Nonacute Admitted Rehab Public 971 $458 GEM Public 2,860 $1,350 GEM DVA 265 $151 Palliative Care Public 931 $439 Palliative Care DVA 32 $18 Subacute and Nonacute Other Other specified funding $923 Subacute non -admitted Palliative Care Other Non-admitted $415 Health Independence Program $1,177 Health Independence Program - DVA $7 Aged Care Residential Aged Care 28,928 $2,239 HACC 81,092 $3,616 Aged Care Other $43 Primary Health Community Health / Primary Care Programs 7,300 $677 Community Health Other $154 Other Other specified funding $1,641
Total Funding $55,825
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Part D
In 2012-13, the Commonwealth Government reduced funding to Victorian health services by $107 million.
The Commonwealth Government decision to return funding of $107 million to Victorian hospitals and health services in 2012-13 was a one-off Commonwealth payment, leaving an ongoing Commonwealth shortfall in promised funding of $368 million over the next three years. In 2013-14, the impact is $99.5 million less than promised.
Period: 1 July 2013– 30 June 2014
Estimated Provisional Total National Weighted Commonwealth Funding Activity Units Percentage Activity Based Funding 10,997 44,111,407 34.48per cent Other Funding 1,255,196
Total 45,366,603
If the Commonwealth government returns funding of $99.5 million this financial year, Central Gippsland Health Service budget will increase by $0.59 million.
Note: • Provisional Commonwealth Contribution Percentage is subject to change following state-wide adjustments (i.e. cross border patient flows). • Activity loadings are included in the Estimated National Weighted Activity Units (i.e. Paediatric, Indigenous, Remoteness, Intensive Care Unit, Private Patient Service Adjustment, and Private Patient Accommodation Adjustment).
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Central Gippsland Health Service
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