SITE DIRECTORY AND LOCATION MAPS EAST GRAMPIANS HEALTH SERVICE 2 016-17 ANNUAL REPORT

POMONAL 35km ELMHURST 25km

ARARAT WARRAK MOYSTON Ararat Rural City 15km (Part of Central Grampians)

BUANGOR

MAROONA 18km

WILLAURA TATYOON 34km

MININERA

STREATHAM Wimmera Central Grampians Central Highlands WICKLIFFE WESTMERE 54km LAKE BOLAC 49km

EAST GRAMPIANS 70 LOWE STREET WILLAURA HEALTH CARE HEALTH SERVICE Aged Care Facility Delacombe Way, Willaura 3379 P: 03 5354 1600 PO Box 155 70 Lowe Street, Ararat 3377 2016-17 P: 03 5352 9323 Girdlestone Street, Ararat 3377 PARKLAND HOUSE GARDEN VIEW COURT Delacombe Way, Willaura 3379 P: 03 5352 9300 Lowe Street, Ararat 3377 P: 03 5354 1613 F: 03 5352 5676 P: 03 5352 9324 ANNUAL E: [email protected] PATRICIA HINCHEY CENTRE www.eghs.net.au Girdlestone Street, Ararat 3377 P: 03 5352 9326 REPORT

DEMONSTRATING LEADERSHIP IN PATIENT SAFETY DEMONSTRATING LEADERSHIP IN PATIENT SAFETY OUR VISION OUR VALUE STATEMENTS To be leaders in rural health care INTEGRITY We value integrity, honesty and respect OUR MISSION in all relationships East Grampians Health Service will EXCELLENCE improve our We value excellence as the appropriate community’s health standard for all services and practices and quality of life through strong COMMUNITY partnerships and We respect the dignity and rights of by responding to our community and acknowledge their beliefs, regardless of their cultural, changing needs spiritual or socioeconomic background

WORKING TOGETHER We value equally all people who make a contribution to EGHS to achieve shared goals

LEARNING CULTURE We strive to continually learn and develop through education, training, mentoring and by teaching others

02 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY CONTENTS ESTABLISHMENT OF THE HEALTH SERVICE Our Vision, Mission & Values 02 PREMIER’S MEDIUM SIZED HEALTH SERVICE Establishment of our Health Service 03 OF THE YEAR 2016 Services and Programs 05 East Grampians Health Service is one of Victoria’s most Organisational Structure 07 innovative and progressive rural health services. This has again been recognised by the State Government who Statement of Priorities awarded East Grampians Health Service the Premier’s Strategic Priorities Part A 08 Medium Sized Health Service of the Year 2016. Performance Priorities Part B 16 East Grampians Health Service was established in 1995 Activity and Funding Part C 17 and has developed its reputation as a leader in the delivery of high quality rural health through the provision President’s Report 18 of integrated acute, residential and primary care. Responsible Bodies Declaration 22 The Annual Report, read in conjunction with our Quality Chief Executive’s Report 24 Account Report Community Matters provides our community with comprehensive information to help them Divisional Reports review our service performance. Clinical Services 32 East Grampians Health Service delivers quality health care Community Services 38 that meets the needs of the community living in Ararat, Development & Improvement 44 Willaura, and throughout the local government area of Executive Services 50 Ararat Rural City. The Board, in partnership with all tiers of Government, review community expectations through Financial Services 56 its Strategic Plan. Good governance is led by the Board Medical Services 58 and implemented by the Executive Team and staff who Support Services 60 are committed to delivering patient centred care within fiscal restraints. Working together the Board and Executive Corporate Governance Team continue to deliver appropriate and financially Responsible Officers 64 effective programs to the community. The Board 65 The Annual Report will review the year’s progress Executive Team 66 towards meeting the vision and mission of East Grampians Senior Staff 67 Health Service. Medical Staff 68 East Grampians Health Service’s Annual Report and Legislative Compliance 69 its Quality Account Report Community Matters will be presented for adoption at the Annual General Meeting to Disclosure Index 72 be held at 6.00 pm on Tuesday 28 November 2017 at the Additional Information 72 Willaura Hall. Glossary 73 Following our Annual General Meeting the Annual Report and our Quality Account Report Community Matters will be Financial Report 74 available on our website www.eghs.net.au Site Directory and Contact Details Back Cover TRADITIONAL OWNERS ACKNOWLEDGEMENTS East Grampians Health Service acknowledges the traditional owners, both past and present, of the Editor: Fiona Watson Jardwadjali and Djab Wurrung people. Design & Layout: Digital Outlaw Photography: Fiona Watson, Jodie Holwell Printing: FRP Printing And thanks to the community and staff members who COVER IMAGE: Grampians Medical Training Intern have contributed to this report Dr Blessed Gwatiwa and Dr Prasad Fonseka

2016-17 ANNUAL REPORT 03 HEALTH SERVICE OF THE YEAR

East Grampians Health Service was awarded one of the top honours in the Victorian Public Healthcare Awards by being named the Premier’s Medium Sized Health Service of the Year in 2016.

L-R Katherine Cooper, Dr Debra Schulz, Tanya Haslett, Matthew Wood, Maree Fraser, Peter Armstrong

04 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SERVICES AND PROGRAMS

As a medium sized rural health service, East Grampians Health Service delivers a comprehensive range of programs and services to the community that are accessed through inpatient, residential, home and community based services. Our health service is located at Ararat and Willaura but also delivers programs throughout the Local Government Area of Ararat Rural City. We have demonstrated our ongoing commitment to providing safe, quality care to our community and have been recognised for the second year in a row as the Premier’s Medium Sized Health Service of the Year.

CLINICAL COMMUNITY SERVICES MEDICAL SERVICES PYRENEES HOUSE • Chemotherapy • Ante Natal • Credentialing EDUCATION CENTRE • Inpatient Unit • Ark Toy and Activity Centre • General Medicine • Education and Training • Infection Control • Breast Health • General Surgery • Diploma of Nursing • Obstetrics including • Cardiac Rehabilitation - Ear Nose & Throat • Function Centre Midwifery, Domiciliary • Chronic Disease - Gynaecology • Graduate Nurse Program Midwifery Management - Ophthalmology • Undergraduate/ • Palliative Care • Community Nursing - Orthopaedics Postgraduate Clinical • Pharmacy Programs (District Nursing, - Urology Education • Urgent Care Hospital Admission - Dental GRAMPIANS HEALTH Risk Program, Regional • Medical Interns PERIOPERATIVE SERVICES Assessment Service, ALLIANCE MEMBERS • Supervision of • Central Sterilising Unit Hospital in the Home, East Grampians Health Medical Interns Service (EGHS) • Day Procedure Unit Palliative Care, Wound and Ballan District Health & Care • Haemodialysis Stomal Therapy, Post Acute DEVELOPMENT Care) (BDHC) • Operating Suite & IMPROVEMENT • Continence Support Ballarat Health Services (BHS) • Surgical Preadmission Unit • Accreditation • Dental services including • Education and Beaufort & Skipton Health AGED CARE outreach to schools and Professional Development Service (B&SHS) • 70 Lowe Street kindergartens • Information & East Wimmera Health Service • Garden View Court • Diabetes Education Communication (EWHS) • Lifestyle Team • Dietetics Technology Hepburn Health Service (HHS) • Parkland House • Exercise Physiology • Occupational Health Maryborough District Health Service (MDHS) • Willaura Day Centre • Home Care Packages & Safety Stawell Regional Health (SRH) • Willaura Health Care • Occupational Therapy • Organisational • Patricia Hinchey Centre – Development MEDICAL IMAGING planned activity groups • Quality & Risk • General X-Ray • Physiotherapy • Research • Image Intensifier • Podiatry SUPPORT SERVICES • Multi-Slice CT Scanner • Pulmonary Rehabilitation • Accommodation • OPG • Social Work - staff & students (Panoramic Dental X-ray) • Speech Pathology • Building Projects • Ultrasound (including • Women’s Health Clinic (PAP • Catering (Internal/external 3D/4D obstetrics, Testing) vascular, musculo-skeletal, functions & Café Pyrenees/ interventional) FINANCE SERVICES Meals on Wheels/Delivered Meals • Budget & Finance • Environmental EXECUTIVE SERVICES • General Accounting (Cleaning/Linen/Waste) • Business Support • Patient Billing • Fire & Emergency • Community Liaison • Payroll • Maintenance • Compliments and • Reception Concerns (Preventative Maintenance/ • Supply/Stores • Human Resources Contracts & Agreements/Fleet) • Security

Please refer to the site directory and map on the back cover for addresses and phone numbers.

2016-17 ANNUAL REPORT 05 YOUR HEALTH SERVICE

The Health Service’s 11,183 people live within A diverse workforce catchment area covers the catchment area from over 4,230 sq kms (ref. Ararat Rural City) 14 di erent countries

116 babies born 4,231 Urgent Care 12,845 Community Nursing in 2016-2017 presentations occasions of service

5,395 total 2,187 operations 5,109 Dental treatments admissions conducted (2,282 people seen)

14,497 Community Health 28,474 Aged Care Number of sta occasions of service bed days upskilled 50

06 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY ORGANISATIONAL STRUCTURE

Board President Matthew Wood

Executive Assistant Chief Executive to CEO Nick Bush

Director of Director Development Director of Human Resources Clinical Services and Improvement Community Services

Acute Services Risk Allied Health Perioperative Services Quality Community Nursing Community Liaison Aged Care Services Organisational Development Dental Medical Imaging Information and Health Promotion Health Information Communication Technology Hospital Admission Infection Control Education Risk Program (HARP) Pathology Occupational Health Hospital in the Home Board Members and Safety Aged Care Post Acute Care Assessment Service Patricia Hinchey Centre Matthew Wood Heather Fleming Russell Barker Bill Braithwaite Director Director of Director Fiona Cochrane of Finance Support Services Medical Services Don Cole Nancy Panter Corporate Services Catering Services Visiting Medical O‡cers Annie Rivett Budget & Reporting Environmental Services Interns Finance Maintenance Supervisor of Payroll Car Fleet Intern Training Procurement/Stores Contractors EGHS Credentialing Board Sub-Committees Construction

Audit & Risk Clinical Consultative Clinical Governance Community Consultative Grampians Health Alliance Capital Development

2016-17 ANNUAL REPORT 07 STATEMENT OF PRIORITIES - Part A: Strategic Priorities

DOMAIN ACTION DELIVERABLES OUTCOMES

Quality and Safety Implement systems and Implement the Care Plan for the A multidisciplinary committee processes to recognise and Dying Person - Victoria clinical has been established to increase support person-centred end of tool, for patients aged over 65 participation in Advance Care life care in all settings, with a years. Planning. As a result 95% of aged focus on providing support for care residents and 10% of all acute people who choose to die at admissions have an Advance Care home. Plan.

Advance care planning is Include in morbidity and The Director of Medical Services included as a parameter in mortality audits a review of reviews the evidence from Advance an assessment of outcomes actions, where an advanced Care Plans in relation to all morbidity including: mortality and care plan was in place, to and mortality cases. As a result morbidity review reports, patient verify the plan was adhered to recommendations from the reviews experience and routine data and action any improvement are referred to the Responsive Care collection. opportunities identified. Working Group.

Progress implementation of Implement a whole of An organisational approach to family a whole-of-hospital model for organisation response to violence has been undertaken responding to family violence. family violence utilising the using the Family Violence Tool Kit. Strengthening Hospitals Our Health Service participates in Response to Family Violence a regional approach to addressing tool kit, with an initial focus family violence. Training has been on the urgent care centre, provided to key area staff, policies maternity services and and procedures developed and community and home visiting a coordinator assigned to the services. management of the Family Violence portfolio.

Develop a regional As leader of the Regional Following the success of the first two leadership culture that fosters Grampians Medical Training Regional Grampians Medical Training multidisciplinary and multi- Program consortium, recruit five programs, the number of medical organisational collaboration post graduate year 1 interns to interns has increased from five to to promote learning and the commence their training in 2017. eight for 2017. provision of safe, quality care Develop a pathway for interns across rural and regional in the Grampians Medical Agreements have been reached in Victoria. Training Program to move from the planning for Postgraduate Year 2 post graduate year 1 to post and 3, for possible implementation in graduate year 2 and 3 within 2018 or 2019. the rural setting.

Establish a foetal surveillance Embed the foetal surveillance The Health Service has implemented competency policy and competency procedures for systems and processes that monitor associated procedures for all all staff providing maternity Midwives and General Practitioner staff providing maternity care care that includes the minimum Obstetricians for foetal surveillance that includes the minimum training requirements, safe competency. These processes training requirements, safe staffing arrangements and are based on authorised bodies’ staffing arrangements and ongoing compliance monitoring guidelines and best practice. ongoing compliance monitoring arrangements in accordance arrangements. with best practice. The Health Service is working towards all maternity staff achieving Ensure all maternity staff have a minimum Level 2 competency a minimum level 2 practitioner in Foetal Surveillance Education. competency based on the Additional training programs will be Foetal Surveillance Education provided to staff during 2017-18 to Program. continue to drive improvements in this area.

08 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY PRIORITY ACTION DELIVERABLE OUTCOME

Quality and Safety Use patient feedback, including Use consumer feedback to In consultation with the “Partnering the Victorian Healthcare drive patient and family centred with Consumers” committee, an (continued) Experience Survey to drive care through the development Action Plan has been developed improved health outcomes and of a partnering with consumer and implemented. The Action Plan experiences through a strong action plan. Evaluation of the includes consumer feedback and focus on person and family action plan to be reported to continually seeks input from all key centred care in the planning, the Board in June 2017. stakeholders. The Board received delivery and evaluation of evidence of the plan through the services, and the development Board agenda in June. of new models for putting patients first.

Develop a whole of hospital Assess current practice The use of restraint practice has approach to reduce the use in accordance with the been reviewed against organisational of restrictive practices for organisational restraint policy policy and meets all criteria. The patients, including seclusion and implement strategies to review confirmed that in all areas of and restraint. reduce the use of restrictive the health service, least restrictive practices across all relevant practice is followed. areas of the health service.

Access and Ensure the development and Ensure all processes are There is only one Specialist Clinic at implementation of a plan in aligned with the Specialist the Health Service and its processes Timelines specialist clinics to: (1) optimise Clinics in Victorian Public are aligned to the Victorian Public referral management processes Hospitals Access Policy and Hospital Access policy. and improve patient flow implement any improvement through to ensure patients are strategies required. The one Specialist Clinic at the Health seen in turn and within time; Service has no waiting list. and (2) ensure patient data is Validate the specialist clinics recorded in a timely, accurate waiting lists for all patients manner and is working toward against the Victorian Integrated meeting the requirements of Non-admitted Health waiting list the Victorian Integrated Non- time data. Admitted dataset.

Identify opportunities and Review patients admitted with The Health Service has implemented implement pathways to aid ambulatory care sensitive a review of the Ambulatory Care prevention and increase care conditions such as anaemia, Sensitive Conditions through its outside hospital walls by pyelonephritis and cellulitis, and Clinical Activity Review & Planning optimising appropriate use identify strategies to optimise Committee. In particular the review of existing programs (i.e. the appropriate use of existing has covered the following conditions, Health Independence Program programs in order to prevent anaemia, pyelonephritis and cellulitis. or telemedicine). hospital admissions. As a result, strategies have been implemented to help reduce the number of admissions. These have included a multidisciplinary focus including consultation with General Practitioners. It appears that these strategies will help reduce admissions.

Develop and implement Implement a sustainable model East Grampians Health Service a strategy to ensure the and reporting framework for the Community Services has registered preparedness of the provision of services funded with the National Disability Insurance organisation for the National through National Disability Agency to provide therapeutic Disability and Insurance Scheme and Insurance Scheme, support and group based activities and Home and Community Care Commonwealth Home Support to National Disability Insurance program transition and reform, Program and Victorian Home Scheme participants, members of the with particular consideration and Community Care. community eligible for Commonwealth to service access, service Home Support Programs and Home expectations, workforce and and Community Care for Younger financial management. Persons. In line with the organisational registration with the National Disability Insurance Agency, our systems and processes have met the requirements of the scheme.

2016-17 ANNUAL REPORT 09 STATEMENT OF PRIORITIES - Part A: Continued

PRIORITY ACTION DELIVERABLE OUTCOME

Supporting Support shared population Continue to develop effective The Health Service is participating health and wellbeing planning partnerships with local in a review of Ararat Rural City’s Healthy at a local level - aligning with agencies, Ararat Rural City Municipal Health and Wellbeing Populations the Local Government Municipal Council, Western Victoria Plan, in the development of regional Public Health and Wellbeing Primary Health Network and health promotion priorities as well as plan and working with other schools to support shared representation and participation in local agencies and Primary population health and wellbeing Grampians Pyrenees Primary Care Health Networks. initiatives. Partnership executive and associated projects. The Health Service is partnering with Stawell Regional Health in the implementation of Western Victoria Primary Health Network Chronic Conditions Models of Care.

Focus on primary prevention, Implement a strategy that An East Grampians Health Service including suicide prevention promotes schools registering funded Dietitian (project officer) activities, and aim to impact on with the School Achievement is facilitating schools’ progress in large numbers of people in the Program to have a health Healthy Together Achievement places where they spend their priority focus by the end of June Program. A total of 12 schools are time adopting a place based, 2017. participating in the program. whole of population approach to tackle the multiple risk factors of poor health.

Develop and implement In consultation with key The Health Service has consulted strategies that encourage stakeholders, investigate areas with key stakeholders to investigate cultural diversity such as of cultural need and include areas of cultural need. The outcomes partnering with culturally diverse actions in the consumer action of this review have been included communities, reflecting the plan and implement required in the “Partnering with Consumers” diversity of your community in changes. Action Plan. At the conclusion of the organisational governance, the financial year 95% of actions and having culturally sensitive, in relation to Aboriginal and Torres safe and inclusive practices. Strait Island activities have been implemented.

In collaboration with key A Diversity Action Plan has stakeholders, evaluate been developed with input from the implementation of the the Community Consultative action plan and report to the Sub-committee of the Board. Community Consultative Board Implementation is currently taking Sub Committee in April 2017. place.

Improve the health outcomes By 31 December By December 2017 the Clinical of Aboriginal and Torres Strait 2016 implement the Governance Coordinator will have Islander people by establishing recommendations identified completed the implementation of culturally safe practices which in the Strengthening Cultural recommendations from the Cultural recognise and respect their Security Audit, designed Security Audit. cultural identities and safely to identify opportunities meets their needs, expectations to enhance the cultural and rights. appropriateness of the physical environment.

Provide cultural awareness Key staff in the Health Service training for staff by June 2016. who interact with members of the Aboriginal and Torres Strait Island community have received cultural awareness training. Further training for other members of staff will take place in August 2017. Department orientation now includes incorporating cultural awareness training.

10 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY PRIORITY ACTION DELIVERABLE OUTCOME

Supporting Drive improvements to Victoria’s Work collaboratively with the The Health Service facilitates regular mental health system through Area Mental Health Service to meetings with mental health services Healthy focus and engagement in strengthen referral pathways staff from Ballarat Health Services’ Populations activity delivering on the 10 to enhance access to mental Ararat Psychiatric Services, located Year Plan for Mental Health and health services. at the Ararat campus through the (continued) active input into consultations Corrections Ambulance Prison on the Design, Service and Police Psychiatry Committee. This infrastructure Plan for Victoria’s collaboration ensures referrals of new Clinical mental health system. clients and care of existing clients are strengthened.

Using the Government’s Review the Rainbow eQuality The Health Service actively supports Rainbow eQuality Guide, Guide to identify opportunities diversity in the workplace. A identify and adopt ‘actions for to be more inclusive and review of the eQuality guide was inclusive practices’ and be responsive to the health conducted and policies have been more responsive to the health and wellbeing of lesbian, updated, where necessary, to reflect and wellbeing of lesbian, gay, bisexual, transgender diversity. A Social Worker has been gay, bisexual, transgender and intersex individuals and assigned the portfolio to ensure and intersex individuals and communities. Incorporate ongoing diversity requirements are communities. identified actions into the health documented in the Diversity Action service Cultural Diversity Action Plan. Plan for implementation.

Contribute to the development Actively contribute to The Health Service contributes to and implementation of Local the development and development and implementation of Region Action Plans under the implementation of Local Regional Action Plans and continues series of statewide design, Regional Action Plans and work to negotiate with Ballarat Health service and infrastructure plans in partnership with other health Services and other regional services being progressively released providers to ensure the plan to ensure clinical services are from 2016–17. Development meets both regional and local delivered appropriately. of Local Region Action Plans service needs. will require partnerships and The Health Service also has a active collaboration across partnership with Royal Women’s regions to ensure plans meet Hospital, Melbourne for Maternity both regional and local service Services. needs, as articulated in the statewide design, service and infrastructure plans.

Ensure that an anti-bullying Review the anti-bullying In 2016 the Health Service undertook and harassment policy exists and harassment policy and an extensive review of its policies by and includes the identification procedures to ensure they an external consultant. The review of appropriate behaviour, include the identification demonstrated the Organisation’s internal and external support of appropriate behaviour, commitment to the ongoing wellbeing mechanisms for staff and a internal and external support of our staff. It addressed issues clear process for reporting, mechanisms for staff and a raised by the Victorian Auditor investigation, feedback, clear process for reporting, General’s Office, the Department consequence and appeal and investigation, feedback, of Health and Human Services and the policy specifies a regular consequence and appeal recommendations from the 2016 review schedule. mechanism. People Matter Survey, even though our Health Service achieved the highest score of 12 comparative health services in 21 out of the 22 headline benchmarks. Following the review education sessions for staff at all levels commenced. This includes providing practical support for managers and supervisors in dealing with difficult behaviours.

2016-17 ANNUAL REPORT 11 STATEMENT OF PRIORITIES - Part A: Continued

PRIORITY ACTION DELIVERABLE OUTCOME

Supporting Board and senior management Review the organisational Throughout the year policies and ensure that an organisational policy with consideration to procedures have been reviewed and Healthy wide occupational health the recommendations from implemented with education provided Populations and safety risk management the Victorian Auditor General for managers quarterly throughout approach is in place which Office report on Bullying and 2017. Supervision and monitoring (continued) includes: (1) A focus on Harassment in the Health of managers is occurring following prevention and the strategies Sector. the policy review of performance used to manage risks, management. including the regular review of these controls; (2) Strategies Report on the outcomes of the The Culture Plan is reviewed quarterly to improve reporting of culture plan objectives to the and presented to both the Audit and occupational health and safety Audit & Risk and Occupational Risk and the Occupational Health and incidents, risks and controls, Health and Safety committees Safety committees. Contemporary with a particular focus on quarterly. and acceptable workplace cultural prevention of occupational guidelines have been established violence and bullying and with the Chief Executive delivering harassment, throughout all a set of expectations in line with our levels of the organisation, Organisational Values at Mandatory including to the board; and (3) and Orientation sessions. Mechanisms for consulting with, debriefing and communicating with all staff regarding outcomes Deliver an education program Bullying and Harassment education of investigations and controls that supports all staff in the is provided to all new staff at following occupational violence prevention of bullying and Orientation and for all existing staff at and bullying and harassment harassment. Mandatory Education sessions incidents.

Implement and monitor Develop a service wide A workforce plan has been workforce plans that: improve workforce plan which covers the developed for the service covering industrial relations; promote a industrial relations framework, all key aspects. Our Internal Audit learning culture; align with the future workforce integration, Company, HBL Man Judd reviewed Best Practice Clinical Learning education and training, the plan. An Action Plan based on Environment Framework; succession planning, diversity the audit recommendations and promote effective succession and inclusion. The plan will developed by the Audit & Risk planning; increase employment be monitored throughout the Sub-committee of the Board has opportunities for Aboriginal reporting period and revised by been implemented with all actions and Torres Strait Islander June 2017. addressed by December 2017. people; ensure the workforce is appropriately qualified and Identify workforce risks and Workforce has been identified as one skilled; and support the delivery include on the risk register of our Health Service’s major strategic of high-quality and safe person and monitor risk mitigation risks and would influence outcomes centred care. strategies. of achieving our Organisational strategic objectives. The Board reviews updates monthly and the Audit & Risk Committee reviews on a quarterly basis.

Create a workforce culture that: Review with staff the Policies and Procedures have been (1) includes staff in decision communication and reporting reviewed and training of Senior making; (2) promotes and structure for the raising of Managers has been completed supports open communication, concerns about respectful with quarterly updates delivered in raising concerns and respectful behaviour; provide education 2017. Training to Associate Nurse behaviour across all levels and support to staff in dealing Unit Managers and Supervisors of the organisation; and (3) with difficult staff behaviour; commenced in November 2016. includes consumers and the monitor performance indicators community. related to policies dealing Adherence to policy is strictly with poor behaviour including monitored by the Chief Executive and bullying and harassment and the Human resources Manager. report against identified key performance indicators to the board of management quarterly.

12 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY PRIORITY ACTION DELIVERABLE OUTCOME

Supporting Ensure that the Victorian Child Develop clear policies and To reflect legislation and guidelines, Safe Standards are embedded procedures that outline the Health Service liaises with Ballarat Healthy in everyday thinking and responsibilities and reporting Health Services to confirm that its Populations practice to better protect frameworks to meet the Child policies and procedures meet all children from abuse, which Safe Standards. legal requirements. A portfolio with a (continued) includes the implementation coordinator has been created for the of: strategies to embed an ongoing management of child safety. organisational culture of child The coordinator provides education safety; a child safe policy or to staff at the mandatory education statement of commitment sessions. A Child Safety Forum is to child safety; a code of planned for the second quarter of conduct that establishes clear 2017/2018. expectations for appropriate behaviour with children; Introduce annual mandatory Child Safety Standard Education is screening, supervision, training staff education to ensure staff being provided through the staff and other human resources are aware of and understand mandatory education program. practices that reduce the risk their responsibilities regarding of child abuse; processes for the Child Safe Standards. A Social Worker is leading the responding to and reporting implementation of education to suspected abuse of children; staff around child safety and family strategies to identify and reduce violence and is coordinating our or remove the risk of abuse organisational policies and processes and strategies to promote the with support from Ballarat Health participation and empowerment Services. of children.

Implement policies and Review access pathways to Comprehensive processes are in procedures to ensure patient vaccination and immunisation place for identifying and vaccinating facing staff have access to programs for clinical staff; staff. In 2016 our Organisation vaccination programs and are vaccination rates will be achieved a target of 84% against appropriately vaccinated and/ monitored and reported to the the Department of Health and or immunised to protect staff board on a quarterly basis. Human Service’s target of 75% for flu and prevent the transmission of Participation improvement vaccinations. infection to susceptible patients strategies will be implemented or people in their care. as required. The Infection Control Coordinator monitors the immunisation status of nursing and allied health students prior to placement and works with students to identify and manage immunisation.

2016-17 ANNUAL REPORT 13 STATEMENT OF PRIORITIES - Part A: Continued

PRIORITY ACTION DELIVERABLE OUTCOME

Financial Further enhance cash Reduce debtor days by The Director of Finance introduced management strategies to appropriately resourcing and a program to identify and reduce Sustainability improve cash sustainability and refining follow up procedures. debtor days. Accounts Receivable meet financial obligations as has been focussing on a ‘no more they are due. than 60 days’ rule. This has led to a substantial reduction of historical old debts. The current debtor days is now 43.

Complete quarterly cash The Director of Finance provides forecasting for both operating quarterly forecasting which is and capital areas, with priority presented to the Board and the reviews of capital outlays. Executive Team. The forecasting includes more in-depth information and analysis, with summarised information contained within cashflow reporting. Cashflow forecasting was completed for year-end projections as well as major capital outlays.

Actively contribute to the Implement a range of East Grampians Health Service has implementation of the Victorian environmental strategies commenced replacement of old Government’s policy to be including: lighting globes with Light Emitting net zero carbon by 2050 • Audit current lighting to Diode (LED) globes to reduce costs, and improve environmental identify energy efficient power and emissions. The Willaura sustainability by identifying and lighting opportunities and campus replacement was completed implementing projects, including replace lights with LED where in 2017 with Ararat campus expected workforce education, to reduce appropriate to be completed within the next four material environmental impacts years. with particular consideration • Assess heating hot water of procurement and waste and domestic hot water The Environmental Management management, and publicly throughout the Health Committee oversees recycling reporting environmental Service throughout the Organisation and is performance data, including • Implement a recycling reported on at: - measureable targets related to education program to reduce • Orientation reduction of clinical, sharps and rates of contamination in • Articles in the newsletter landfill waste, water and energy commingled waste • Staff briefings use and improved recycling. • Re audit peri-operative There has been a reduction in clinical waste for co-mingled waste. improvement An audit identified that the Ararat • Audit other clinical areas for campus hot water system is out- correct disposal of clinical dated, inefficient and uses a lot of waste gas. A new system will deliver a 60% • Replace Styrofoam efficiency. Notification was received containers from the Department of Health and • Provide staff education on Human Services advising that we recyclable items to reduce were successful in obtaining funding clinical and landfill waste, for a hot water boiler replacement through published articles in project. the health service newsletter A clinical waste re-audit was undertaken in October 2016 to compare the results from the previous year’s audit. The report conducted by Daniels (Making Health Care Safer – Waste Management Audit Review – Oct 2016) identified an improvement in clinical waste.

14 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY OUR GOAL To deliver safe, quality care with respect and appropriate knowledge to patients, residents and clients choosing to use our services.

Image: Lauren Miller and Aaron Meizys

2016-17 ANNUAL REPORT 15 PERFORMANCE PRIORITIES - Part B and C

Part B: Performance Priorities

KEY PERFORMANCE INDICATOR TARGET 2016-17 ACTUAL

ACCREDITATION

Compliance with NSQHS Standards accreditation Full compliance Achieved

Compliance with the Commonwealth’s Aged Care Accreditation Standards Full compliance Not Achieved*

*During the second quartile our aged care facilities required improvement activities following a support visit from the Australian Aged Care Quality Agency. The issues were rectified with full compliance achieved within the quarter.

INFECTION PREVENTION AND CONTROL

Overall compliance with standards Full compliance Achieved

Very high risk (Category A) 90 points 99

High risk (Category B) 85 points 96

Moderate risk (Category C) 85 points 95

Submission of infection surveillance data to VICNISS Full compliance Achieved

Compliance with the Hand Hygiene Australia program 80% 89%

Percentage of healthcare workers immunised for influenza 75% 85%

PATIENT EXPERIENCE

Victorian Healthcare Experience Survey - data submission Full compliance Achieved

Victorian Healthcare Experience Survey – patient experience Quarter 1 95% positive experience 99%

Victorian Healthcare Experience Survey – patient experience Quarter 2 95% positive experience 100%

Victorian Healthcare Experience Survey – patient experience Quarter 3 95% positive experience 99%

Victorian Healthcare Experience Survey – discharge care Quarter 1 75% very positive experience 86%

Victorian Healthcare Experience Survey – discharge care Quarter 2 75% very positive experience 90%

Victorian Healthcare Experience Survey – discharge care Quarter 3 75% very positive experience 94%

MATERNITY AND NEWBORN

Percentage of women with prearranged postnatal home care 100% 100%

Rate of singleton term infants without birth anomalies with APGAR score <7 to 5 minutes ≤1.6% 1.6%

Rate of severe foetal growth restriction in singleton pregnancy undelivered by 40 weeks ≤28.6% 0.0%

GOVERNANCE AND LEADERSHIP

People Matter Survey 80% 97% - percentage of staff with a positive response to safety culture questions

16 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY KEY PERFORMANCE INDICATOR TARGET 2016-17 ACTUAL

ACCREDITATION

FINANCE

Operating result ($m) 0.02 0.01

Trade creditors 60 days 35 days

Patient fee debtors 60 days 42 days

Public & private WIES performance to target 100% 97.6%

Adjusted current asset ratio 0.7 0.84

Days of available cash 14 days 21 days

ASSET MANAGEMENT

Asset management plan Full compliance Achieved

Part C: Activity and Funding

2016-17 ACTIVITY FUNDING TYPE ACHIEVEMENT

ACUTE ADMITTED

WIES DVA 64

WIES Public 2,243

WIES Private 489

ACUTE NON-ADMITTED

Home Enteral Nutrition 51

AGED CARE

Residential Aged Care 28,474

HACC 12,845

SUBACUTE & NON-ACUTE ADMITTED

Subacute WIES - Maintenance Public 43

Subacute WIES - Palliative Care Public 7

Subacute WIES - Palliative Care Private 3

Subacute WIES - DVA 0

SUBACUTE NON-ADMITTED

Health Independence Program 895

PRIMARY HEALTH

Community Health / Primary Care Programs 14,497

OTHER

Health Workforce 11 graduates

2016-17 ANNUAL REPORT 17 PRESIDENT’S REPORT

OUR GOAL To work with all stakeholders to deliver high quality health services to our community that align with government policies to reflect the needs of our diverse community.

Image: Terry Weeks and Matthew Wood

18 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL The Board is extremely proud of the skills of staff who work collaboratively and creatively to deliver on our commitment of improving our community’s health and quality of life. Staff are justifiably proud of their work, their hospital and the community in which they live. It is clear we have a workforce where the Board has invested comprehensively in them and the community is rewarded by their quality care.

This has again been recognised by the State Government as East Grampians Health Service has been named the Premier’s Medium Sized Health Service of the year for 2016. This is a fantastic achievement that reflects on the leadership of the Organisation with Chief Executive Nick Bush central to rolling out the strategic initiatives of the Board. East Grampians Health Service is innovative and has created a vision and strategies for a healthier future for our community.

Achieved We know how vital it is that patients accessing care at our Health Service feel confident that they are listened East Grampians Health Service named Premier’s to, respected and that treatment is delivered by qualified Medium Sized Health Service of the year for 2016. staff in a safe environment.

This year the Board, with the support of the Chief We have been invited to participate in a very timely Executive, has focussed on strengthening clinical research project by Alison Brown a PhD Candidate governance through responding to and enhancing the from the Centre for Health Policy at the Melbourne safety and quality of delivery of health care. One of the School of Population and Global Health, Melbourne most important documents to be released by the State University. The project will explore how Boards and Senior Government has been Better, Safer Care: delivering a Executives work together to govern the quality of care world-leading healthcare system written in response to through multiple case studies at health services across Targeting Zero, the review of hospital safety and quality Australia. We look forward to the publication of the project assurance in Victoria by Dr Stephen Duckett. and implementing its findings. Our Values continue to guide our actions as we consider the wellbeing of our community who will always be at the centre of every decision taken. Achieved In line with our Strategic Plan, new education policies CLINICAL SERVICES and reporting guidelines have been introduced to reflect With the introduction of a second theatre it has been Targeting Zero. These changes will ensure that our imperative that the Health Service has in place strategies community continues to receive quality, safe health care. to ensure a sustainable workforce now and into the future. East Grampians Health Service is not alone in experiencing workforce shortages, but we have While the Board is confident that the care delivered by addressed this challenge by introducing education East Grampians Health Service stands up to the highest programs that encourage our community to consider scrutiny, we are aware that our responsibilities towards our training and ultimately working for their health service. community can always be enhanced and that the Board’s We are acknowledged for our organisational culture that ongoing education is as important as that of the staff who promotes ongoing education with programs specifically deliver exemplary care. designed to assist people returning to work. We understand the importance of life balance, especially As a Board we continually monitor and review where there are young families to consider. We all need programs and services to reflect the demographics time for rest and play – after work. of our community. The current Strategic Plan comes to an end in 2018 and while we refer to it and update The Board acknowledges that there are ways in which the it regularly, a new one will be developed next year. workforce experience can be improved and has engaged We will be seeking community input and it is timely senior staff members Brenda Green and Ros Bloomfield to that Vice President Heather Fleming is chair of the review our current nursing workforce structure. The Board newly established Community Consultative Committee, looks forward to the review and implementing change, providing an important link between the Board, its where necessary, to develop the overall experience consumers, auxiliaries and volunteer base. of working for our Health Service. A recent initiative, organised by Allied Health staff, is an organisational network, to welcome new staff. We believe that will certainly assist with recruitment and retention of staff.

2016-17 ANNUAL REPORT 19 Achieved This year there has been an in-depth focus on clinical governance and its importance to the overall quality care The establishment of the Young Professionals Network for patients, residents and clients. I commend clinical staff to provide support and a welcoming environment for for the way in which they have accepted responsibility staff new to Ararat and the Health Service to ensure that those they care for receive the very best appropriate treatment. Seeking the views and experiences of those we care for helps our understanding and shapes Achieved our awareness of where we can improve. The Board 28 students enrolled in the Diploma of Nursing, was delighted with the results of the Victorian Healthcare delivered at our Education Centre Pyrenees House, Experience Survey, a survey sent to all acute care and with new partner Australian Catholic University. community health patients after discharge or treatment. However, I know our staff and they will continue to strive for quality outcomes for those for whom they care.

Achieved For the 2nd quarter of 2016-17, 100% of patients who responded to the Victorian Healthcare Experience Survey rated their overall experience as good or very good. In all other quarters the response was 99%.

COMMUNITY SERVICES Achieved The announcement by the Premier of Victoria the Hon Community Services registered and transitioned to the Daniel Andrews that our Health Service will receive National Disability Insurance Agency and commenced funding to extend our Community Health Centre and providing services to eligible participants refurbish Community Nursing was great news for the Introduction of Regional Assessment Service whole community. EGHS@Home: the launch of a new and innovative This funding will ensure that we can extend the service of aged care services and acute home Community Health Centre and Community Nursing service models building to now include the Ararat Rural City’s Maternal and Child Health Service and Home and Community Care Review and revision of outreach Dental Services to Services. Services will be streamlined and will certainly increase services to younger people at school improve the wellbeing of the community. Introduction of Commonwealth Home Support Program I want to acknowledge the work undertaken by our colleagues at Ararat Rural City Council, Mayor Paul Hooper and former Chief Executive Officer Andrew Evans, along with the Director of Community Services, Achieved Dr Debra Schulz in the successful submission to the The Health Service to receive $4.120million from Victorian Government. This is a great outcome for the the Regional Health Infrastructure Fund whole community. It is sound clinical and financial practice to work in partnership with other health care providers within our community. Together we can share our knowledge and can design strategies to shape the future health needs of our community. During the year a number of Aged Care reforms have been introduced and multidisciplinary teams within Community Services have collaborated with external partners in their implementation. I would like to acknowledge the work undertaken by carers in the community. Their role is one of dedication, providing many hours of support for those they love to remain independent for as long as practical. It can be a challenging time and we have developed a range of publications, with input from consumers, to help carers Premier Daniel Andrews and Matthew Wood navigate the range of services available to support them in their role.

20 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY The opening of our refurbished second theatre has Achieved been as a result of the support of the Ararat Branch Over a 15-year period the Victoria Police Blue Ribbon of the Victoria Police Blue Ribbon Foundation. Foundation Ararat Branch has raised close to $1 million The Jason Bond Perioperative Suite comprises of for our Health Service two operating theatres, a six bed day procedure unit, sterilising service, surgical Pre-Admission $63,000 to fit out the Urgent Care Centre department and six chair dialysis unit. $150,000 to build the Helipad $136,000 for image intensifier for the Medical Imaging Department $50,000 for a microscope for the Perioperative Unit $150,000 for a General x-ray and portable x-ray machine $150,000 towards the purchase of a CT Scanner $150,000 to redevelop the Jason Bond Perioperative Unit Danielle, Michael, Lyndee and Bradley Bond and Matthew Wood Image courtesy of The Ararat Advertiser

I would again like to acknowledge members of the Ararat Branch of the Victoria Police Blue Ribbon Foundation for its commitment. What started off as a living memorial to Sergeant John McNally, killed on the Ararat goldfields in 1856, has developed into a worthy appeal that has, over a 15-year period, included the funding of building a helicopter pad, upgrading Urgent Care Centre, purchasing an image intensifier, microscope, imaging equipment, CT Scanner and the redevelopment of the Jason Bond Perioperative Unit.

EXECUTIVE SERVICES • Ararat Branch of the Victoria Police Blue Ribbon Foundation The Board has the responsibility of shaping the future of the Health Service. It achieves this through engaging • Ararat Breast Cancer Support Group (on behalf of the in honest discussions with all tiers of government, Buangor Community Sports Centre Committee) working with key stakeholders and, importantly, enjoying • East Grampians Health Service Building for the Future a close working relationship with the Executive Team. Foundation Trustees It’s vital that members of the Board are familiar with • East Grampians Health Service Auxiliary their responsibilities that include establishing policies, • East Grampians Health Service Aged Care Auxiliary influencing strategic direction and, critically, understand the role of governance. This is a significant responsibility, • East Grampians Health Service Charity Golf Day one that each member takes very seriously and works • Cranks and Defibrillators Murray to Moyne Cycle Relay diligently to succeed. • Women, Wisdom and Wellbeing Dinner • The Willaura Health Care Outdoor Market Achieved • The Willaura Auxiliary Board members have undertaken specific • The Ark Toy & Activity Centre Auxiliary Board education, which includes a clinical • The Patricia Hinchey Centre Auxiliary governance component As a Board we value the contribution of our community After almost 20 years working as Manager Executive and have been encouraged at the willingness of members Services, Glenys Andrew retired during the year. She has to participate as consumer representatives on sub- been a great asset to the Organisation, guiding the Board, committees of the Board. providing a calming and wise influence during sensitive negotiations. We thank her sincerely for her integrity and professionalism and wish her well in retirement. Achieved As with so many other organisations and service clubs Consumer representation on restructured Clinical in our district, volunteers and auxiliaries play a vital Governance Committee role in helping us achieve our aims. I know without the commitment of so many people it would be much Community Consultative Committee providing harder for us to accomplish such great outcomes for more meaningful input into discussions about future our community. I want to acknowledge the following strategic planning foundations, volunteer and auxiliary groups that have made a significant contribution to support us in so many ways:

2016-17 ANNUAL REPORT 21 MEDICAL SERVICES At last year’s Annual General Meeting the Board was delighted to recognise Dr Derek Pope for his The need for an appropriately trained workforce extends 30 years’ service to the Ararat community. Dr Pope’s right across our Organisation, from nursing and allied work has been invaluable as General Practitioner, health workers, to doctors. We are now into our third Anaesthetist and Obstetrician. His range of year of the Grampians Medical Training Intern Program expertise has enabled operations to be carried out and, in partnership with St John of God Ballarat Hospital, locally and women to have their babies in Ararat. Maryborough District Health Service and three GP clinics Importantly, he has mentored the next generation including Ararat Medical Centre, Nightingale Clinic and of Doctors, providing a broad experience and Clarendon Medical Centre both in Maryborough, our Health understanding of working in rural health. Service delivers an excellent training program.

Achieved All previous interns fully employed in chosen locations Increase in the number of interns from five to eight Inclusion of Ararat Medical Centre, hosting one of the rotations

After 20 years of exemplary service, Orthopaedic surgeon Mr John Patrikios retired from operating at East Grampians Health Service on 30 June 2017. Mr Patrikios provided an important fortnightly service operating and consulting on a large range of orthopaedic surgical procedures. He was a master of his craft with staff enjoying his professional approach, vast knowledge and his cool head. We thank him sincerely for his dedication and commitment to our community. Dr Eric Kennelly and Dr Derek Pope

FINANCIAL SERVICES DEVELOPMENT AND IMPROVEMENT At the Annual General Meeting, held in November 2016, Our Health Service is audited through the accreditation it was pleasing to report that the Health Service had a process with our organisational approach to corporate healthy operating surplus. This was achieved through the and clinical governance, education and training, quality Board and all members of staff planning and evaluating and risk management under the spotlight. Clinical budgets and investigating efficiencies of program delivery. governance can best be described as a system for improving the standard of safety and quality in clinical We are living through some very challenging times, when practice and this is something we take very seriously. cyber fraud has had an impact on some health services. It is pleasing to report that the Health Service is fully I’m pleased to report that, through strict adherence to compliant. Full list of Accreditation on page 45. Delegations of Authority, our Health Service has not experienced any such fraud. Targeting Zero, the review of hospital safety Achieved and quality assurance in Victoria, written for the Review of financial policies to ensure no one person Victorian Government by Dr Stephen Duckett, signs off on payments was a wake-up call to all health services. Installation of software with the ability to automatically shut down email server Our Board has complete confidence in the Executive Team and staff at East Grampians Health Service to deliver quality, safe health care. However, the Board’s role is to The Board continues to invest in the future of our continually challenge and monitor the Executive Team Health Service through new programs, recruitment of to ensure this is maintained. The diligence of staff and appropriate staff, ongoing education and a highly effective education and training are implemented to reflect the maintenance and infrastructure program. This is judiciously vigilance required to maintain a safe, quality environment. budgeted for and the return on this investment to our community is a sustainable, qualified workforce caring for people in well-maintained facilities. Achieved We are extremely grateful that the Victorian Government Review of all governance policies, in particular clinical has chosen to provide funding for our Organisation governance so that, in partnership with Ararat Rural City, we can Engagement of independent clinical experts to review develop a seamless community health service throughout clinical activities the district.

22 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Jessica Baird and David Hosking Louise Westrup and Andrew Laidlaw Rebbekkah Seeary and David Hosking

Through the ongoing support of a number of tertiary I would like to commend Linden Marland for her initiative institutions, living in our rural setting does not in the development of regular sustainability reports that disadvantage people choosing to make a career in the inform the Organisation on various waste minimisation health industry. I would like to acknowledge the support of projects and results. We have a corporate responsibility to the following universities: our community to reduce the amount of waste. • Australian Catholic University I want to thank the members of the Board. When we accepted a position on the Board we each had to • Deakin University consider the implications and the impact it would make • La Trobe University Bendigo on our lives. We too have to balance work, family life – and some leisure time. When we attend Board meetings • Federation University and Board sub-committee meetings I am always grateful • Charles Sturt University that each member comes fully briefed, but never afraid to ask questions for clarification. This is how an effective • Melbourne University Board should operate: trust and openness, respect and The cost of study can be prohibitive so we are pleased a keen sense of the world at large. We are an effective to be able to award scholarships to students who are Board. I have great confidence that working with the Chief pursuing a particular course that will assist in the wellbeing Executive and his team, the Board will continue to deliver of the community as well as their personal development. a Health Service ready for the future. On behalf of the Board I wish to acknowledge: In conclusion, I am announcing this coming year will be • The Angela Laidlaw Clinical Scholarship: Louise my last as President and as a Board Director. My term will Westrup to complete Graduate Certificate in Nursing expire on 30 June 2018 and I have decided to step down. (Specialisation Dialysis) This will allow succession planning and board renewal, which is in the best interests of our Health Service. I • Building for the Future Foundation: awarded to would like to thank the Board for its support over the past Rebbekkah Seeary to continue Advanced Diploma six years (the last three years as President), and again of Dental Prosthetics; Jessica Baird to commence a acknowledge the leadership of Chief Executive Nick Bush, Bachelor of Nursing the Executive Team and all the staff at East Grampians • Freemasons Victoria: Narelle Briggs to undertake a Health Service. It’s been an honour working with you all. Bachelor of Nursing The introduction of a Graduate Nurse Program for Enrolled Nurses will create enhanced career pathways to RESPONSIBLE BODIES DECLARATION encourage ongoing commitment to our workforce. Responsible Bodies Declaration as at 30 June 2017 SUPPORT SERVICES In accordance with the Financial Management Act 1994, I am pleased to present the Report of Perception is an important aspect of healthcare delivery. Operations for East Grampians Health Service for While the Board acknowledges that the majority of the year ending 30 June 2017. buildings are, to put it bluntly, old, the maintenance of them is excellent. The quality of care from support services reflects on the overall pride each person takes in their role, from the upkeep of buildings to the cleaning of wards and theatres.

Matthew Wood Achieved Board President East Grampians Health Service Training of staff to undertake internal and external cleaning audits 24.8.2017

2016-17 ANNUAL REPORT 23 CHIEF EXECUTIVE’S REPORT

OUR GOAL To work with members of our community to improve their health and wellbeing experience, through innovation, research, good clinical governance, commitment and that leads to our community receiving high quality care.

Image: Nick Bush and Robin Griffiths

24 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL In every aspect of service delivery our staff have put into practice the Values they helped develop to shape our Organisation. Writing in the 2016 Annual Report I said that, as an Organisation, we had to continue to strive for excellence and improve what we do, not to reflect on our past achievements.

It’s with a great sense of pride that I can report that staff took up that challenge as our Health Service has again been named the Premier’s Medium Sized Health Service of the year for 2016. I have such admiration for our staff who took up the challenge to keep on learning, to analyse and evaluate everything they do to deliver exemplary quality safe health care.

Achieved I work with the Board on strategic planning but my responsibility is towards the day-to-day operational East Grampians Health Service named Premier’s performance of our Organisation. I want to thank Medium Sized Health Service of the year for 2016 – for Matthew Wood, President of the Board for the trust he the second year in a row, through: and the Board place in me and to the members of the Organisational Values continuing to be integrated into Executive Team – I thank them sincerely for their support, the planning and delivery of high quality care commitment and ability to guide staff to achieve great results for the health of our community. In planning for the Creating positive experiences for our patients, future health needs of our community we gain important, residents and clients relevant information by accessing publications from other Continuing to embrace learning and teaching as a health service providers and Government departments. core requirement of working at East Grampians Health For example population growth and trends: Ararat Rural Service City; Burden of Disease: Adolescent Community Profile, Victorian Department of Education and Grampians Opportunities for learning and education for staff have Pyrenees Primary Care Partnership. And, of course, increased substantially over the last few years through one of the most influential reports to be published this our multi award winning Learning, Education, Training year is Better, Safer Care: delivering a world-leading and Sustainability program that aims to increase healthcare system written in response to Targeting Zero, clinical workforce capability and counteract workforce the review of hospital safety and quality assurance in shortages Victoria by Dr Stephen Duckett. Delivering quality, safe Progress on the Montessori Model of Care enhancing patient-centred care has always been our focus and this independence and improved self-esteem document highlights that as an Executive Team we must remain vigilant in observing, evaluating and addressing all Leading the way in successfully implementing healthy concerns throughout our Organisation and community. I eating and drinking strategies for our staff have every confidence in our processes, procedures and Collaborating with Ararat Rural City to improve the policies and that specific staff education has underlined health and wellbeing of the whole community the importance of good clinical governance. In writing the report this year I want the emphasis to be With the Executive Team and their staff, we have reflected on the continuum of care that we deliver across all areas on past performance and studied ways in which we can of the health service. Each area works collaboratively ensure that our Organisation’s clinical governance is to deliver quality, safe care for our community. This second to none. cooperative approach is what is important to our patients, residents, clients and visitors: a clean ward is as We have certainly learnt from the experiences important as safe care, nutritious food, qualified staff and our financial responsibility. The receptionist who greets of other health services the importance visitors, the volunteer who supports patients and staff, the of honesty and openness and integrity in medical staff, pathologist, dietitian and diagnostic staff. decision-making and the need to question and Each has a profound impact on how we deliver our health be questioned, reflect, refine and question care to our community. The results from the Victorian Healthcare Experience Survey indicate that our team again our policies and procedures that reflect approach certainly meets with our community’s approval. our delivery of safe, quality care. It’s both a pleasure and a privilege to work for East Grampians Health Service. I am proud to represent over Of the 333 organisational policies, 108 were reviewed 350 people who daily choose to work to improve the lives this year. Of the 236 Clinical Practice Guidelines 52 were of their colleagues and the community. reviewed and 388 forms reviewed.

2016-17 ANNUAL REPORT 25 CLINICAL SERVICES A new partnership with the Australian Catholic University will deliver nursing education to our local community here The introduction of the Montessori Model of Care at 70 in Ararat. This year we are also offering a Graduate Nurse Lowe Street in 2015 has had a significant improvement Program to Enrolled Nurses. This initiative will provide on our residents’ wellbeing. Staff have embraced the support and mentoring to encourage Enrolled Nurses concept of the program with the overwhelming feedback to consider further study to enhance their future career indicating that residents’ lives have been enriched, prospects. providing a sense of purpose to their daily living. This is such a positive outcome for residents and, interestingly, The conscientious way in which staff go about their daily for our staff who indicated that it was both hard work and tasks has certainly had a positive impact on the outcome rewarding as the benefits to residents was visible. of the Victorian Healthcare Experience Survey. It is heartening to see that all levels of staff put the care and wellbeing of patients, residents and clients as their primary goal. This has been reflected in the excellent results of A component of the implementation of the this statewide survey that indicate our Health Service Montessori Model of Care was the commissioning has performed significantly higher than similar sized of artwork for 70 Lowe Street. Ararat artist organisations. Janette Lucas created an eye-catching mural depicting farm animals, buildings and people, complementing the life-like farm statues in the For over 15 years the Ararat Branch of the adjacent garden. Residents have clearly enjoyed Victoria Police Blue Ribbon Foundation has the scene, as many are off the land. The mural been supporting East Grampians Health was carefully planned and is located on an internal Service with nearly $1million raised. This is garden wall, encouraging residents to enjoy a familiar setting in which to share stories of their an extraordinary achievement and one that past experiences of rural living. has enabled us to build, purchase and redevelop aspects of our Health Service. With a donation of $150,000 we were able to complete the Perioperative Unit named in honour of Jason Bond a young local man commencing his training for the Victoria Police, who died four weeks into his training in a motor vehicle collision.

With the completion of the unit we can now conduct over 2,000 elective and emergency surgical procedures and 1,700 dialysis treatments each year. We now operate two theatres several days a week enabling us to admit 25 patients who, in a single day are prepared for theatre, operated on, recovered and discharged. We are increasing help to Ballarat Health Services to reduce their waiting list by operating on patients at Ararat. Janette Lucas and Tanya Haslett

As with many other health services we have experienced Achieved workforce shortages, which, unless addressed, could Completion of the Jason Bond Perioperative Unit, have an adverse impact on service delivery both now creating a more efficient patient journey and improving and into the future. I am so grateful to staff who have work flow within the unit worked significant hours to keep our service operational. However, we know this is not sustainable and will continue Montessori Model of Care in 70 Lowe Street continues to introduce initiatives that will equip our Health Service to improve wellbeing of residents’ lives and levels of to meet the challenges of workforce shortages. I, along staff engagement with the Board, look forward to the review of our nursing Victorian Healthcare Experience Survey – great results workforce structure and will implement its findings as soon for our Health Service as practicable. Workforce shortages being addressed

26 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY COMMUNITY SERVICES Community Services incorporates a vast array of Each program is providing awareness and education disciplines whose clinicians interact with patients, that enables community members to have a better residents, clients and carers across the Health Service as understanding of their own health issues in order to well as community members of all ages. It is a complex take greater responsibility for improving their own network integrating community service programs with health outcomes. others in the region and Ararat Rural City. The success of the service is the way in which all staff take More people are choosing to live at home for time to listen to the community to find out how they want as long as is practicable. For those members to be helped and what will help them help themselves. We of the community choosing this option, and have found that by listening and responding we are able requiring encouragement to enjoy social to provide real options for supporting the community’s independence. The key has been a flexible approach activities, the Patricia Hinchey Centre is a that focuses on a person’s lifestyle, expectations and remarkable asset. Quietly going about their achievable outcomes. Significant health benefits have business, staff provide support for people who been achieved. continue to live independently but require daily living help.

Achieved The centre provides a comprehensive range of services and activities to enjoy on a daily basis. The activities Providing a continuum of care, developed around the are chosen by members at their monthly “Friends of needs of clients the Centre” meetings – a name they chose themselves. Healthy Together Victoria Achievement Program, During the year over 50 external activities take place and, working with and supporting schools to achieve their combined with daily activities, members can enjoy over goals 150 different events annually. Big Ararat Health Study with the University Staff have been working with clients during the of New South Wales introduction of the National Disability Insurance Scheme. During the transition staff are working with clients to Activ8 Program with Ararat Rural City implement their plan. It’s important that clients are Life! Chronic Disease Prevention program supported and that their care plans continue to reflect their lifestyle, their goals and their expectations. I Dental outreach to 11 schools in the district am confident that this is being achieved through the Patricia Hinchey Centre clients involved in commitment of all staff working in Community Services. planning activities

The successful funding application from the Regional Health Infrastructure Fund of $4,120,000 to extend the Community Health Centre and Community Nursing buildings recognises the successful partnerships we have with Ararat Rural City to improve the health and wellbeing of the whole community.

Angela Hunt, Mayor Cr Paul Hooper, Premier Daniel Andrews, Chief Executive Nick Bush, Minister for Health Jill Hennessy, President of the Board Matthew Wood, Colleen White, Jane Bourman and Dr Debra Schulz

2016-17 ANNUAL REPORT 27 EXECUTIVE SERVICES Our staff are our greatest asset and when they come Achieved to work we want them to feel fulfilled and valued. Excellent result from the 2016 People Matter Survey The People Matter Survey provides staff with the having the higher score of our comparator group of 12 opportunity to have their say and for us to analyse health services in 21 of our 22 headline benchmarks results and develop an action plan that can address significant issues. The 2016 results indicated that our Commissioning of artwork by Aboriginal artist Health Service had the highest score of 12 comparative Heidi Chatfield health services in 21 out of the 22 headline benchmarks. Outstanding contribution by volunteers, auxiliaries and An excellent result that demonstrates our continued community groups commitment to shared Values.

I would like to take the opportunity to thank and Aboriginal heritage plays an important acknowledge Glenys Andrew, who retired at role in our community and to better the end of 2016 as Manager Executive Services. Glenys was a real asset as I settled into the understand and support our Aboriginal position of Chief Executive. Her organisational community we have been working on an knowledge, her wise counsel and, importantly action plan to strengthen Aboriginal and her sense of humour, were a great help to me Torres Strait Island cultural security. and she continued to be supportive through the five years we worked together. I wish her well for We believe that we can better meet the needs her retirement. of our Aboriginal community by improving the quality and effectiveness of their care by reducing the inequalities in healthcare access. (Further information on page 49). It was a very special day when we unveiled Spiritual Healing an artwork by Indigenous artist Heidi Chatfield. Heidi is a Djab Wurrung descendent and her painting has been hung in our main reception to create a culturally welcoming environment to Aboriginal and Torres Strait Islander people to our Health Service. Nick Bush, Glenys Andrew and Matthew Wood

Following staff feedback we have changed the card provider for salary packaging. The new provider delivers a range of solutions that are more convenient and practical as well as meeting changes to Federal Reserve Bank legislation.

Our supporters, whether they are volunteers, auxiliary members, donors or from local service clubs are the most amazing people, they work tirelessly so that our patients, residents and clients can enjoy an enriching life.

I join with President Matthew Wood to acknowledge their outstanding contribution to our Health Service. They have given hundreds of hours of their time and raised many thousands of dollars.

Heidi Chatfield and Matthew Wood

28 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY MEDICAL SERVICES The Grampians Pyrenees Primary Care Partnership Ararat We were pleased to welcome rural clinicians Rural City’s Health & Wellbeing Snapshot February 2017 from across the Grampians Region who attended provides useful information to guide the development of Maternity and Newborn Emergencies education collaborative services and programs for our community. program. The program is a joint initiative between Our district has a higher percentage of people identifying the Royal Women’s and Royal Children’s Hospital, with a chronic disease, in particular cancer, arthritis and providing valuable training for Victoria’s rural obesity. These diseases all have an impact on our care maternity workforce. The program focussed delivery and Medical Services works closely with Clinical on multi-disciplinary teams to improve the Services and Community Services. effectiveness in managing maternity and newborn emergencies, to enhance the delivery of safe care An excellent relationship developed with the Ararat and quality outcomes. Medical Centre and the Nightingale Clinic and Clarendon Medical Centre, both in Maryborough, is providing a comprehensive rural medical experience for junior doctors engaged in the Grampians Medical Training Program. I want to thank our Director of Medical Services, Dr Eric Kennelly for his insight and commitment to ensure that the next generation of Doctors have a real understanding of the challenges and benefits of working in a rural environment. I would also like to acknowledge Sarah Woodburn who is the Junior Medical Officer Manager as well as Manager of Development and Improvement. She works with all providers of the training program to introduce the junior doctors to a broad experience of medical practice that would not be available in a metropolitan setting.

Achieved Increase in number of interns in the Grampians Medical Training Program from five to eight

100% participation from the midwifery workforce in Kristy McEvoy and Carol Leo training, highlighting their commitment to current best practice outcomes

FINANCIAL SERVICES Our Delegation of Authority was updated in 2017 and, During the year the Department of Health and Human because of experiences in other regions Finance staff are Services gave us an additional 144 WIES for the theatre diligent in the management of budgets and expenditure. services provided largely on Ballarat people. Finance plays an extremely important role in the running This year we have also committed significant funds for of our Organisation. I want to acknowledge the Director initial and ongoing education. Our Organisation is known of Finance Tony Roberts. He has a keen eye and, with the for its learning culture, one of our five Value Statements. support of our Board Treasurer, Russell Barker invests and Investing in our staff is one of the most important uses our money wisely. The Board and Executive Team all commitments we can make. have a role in understanding financial management both on a micro and macro level but are encouraged to look forward to see opportunities for future growth. Achieved This year our Health Service received additional funding Policies developed to ensure safeguard from cyber for 62 WIES from the Department of Health and Human malpractice Services, which will enable us to provide more surgical services to our community. We will be able to undertake Additional DHHS funding approximately 100 more operations annually enabling Significant funds allocated for education more of our local patients to receive treatment sooner and locally.

2016-17 ANNUAL REPORT 29 DEVELOPMENT AND IMPROVEMENT The dedication of staff to implement the improvements The research project is aimed at members of required by the Nationally recognised Standards the community over 35 years and the results has been outstanding. This year we had a whole of organisation accreditation as well as accreditation for the will provide a valuable snapshot of the health Patricia Hinchey Centre and Garden View Court Hostel. of the community in that age group. It is often Independent assessors commented on the culture and at about the age of 35 – 40 that people start pride in work undertaken by staff. 70 Lowe Street had a to think about their health and wellbeing. successful assessment and is now fully accredited. Data collected will inform clinicians and help Although the Development and Improvement team drive participants make changes to their lifestyle. the accreditation process, it really is through the efforts of the whole Organisation that we achieve great results; I am The scholarship and bursary programs have assisted staff only too aware of the additional workload for many staff members in both their personal and professional lives. and I acknowledge their input to achieve this result. This is Our Health Service has gained an excellent reputation for a great outcome for our residents and community. encouraging and supporting staff who have demonstrated It has certainly been a challenge that some Universities a commitment to ongoing education that will benefit our are no longer willing to provide training opportunities in community. Our Learning Culture Value establishes an rural locations. This could have had a major impact on important philosophy and our staff understand that their the provision of nurse training for our future workforce. commitment will be matched by our ability to support them Therefore we were delighted to forge a new partnership in further study. with Australian Catholic University and commenced the Diploma of Nursing in February, with an intake of 28 students. This will truly advantage our local community, Achieved providing opportunities for higher quality training that will also help us alleviate our workforce shortages. Over the past five years over 80% of graduate nurses have been retained by our Health Service We really are very excited to be involved in a research collaborative partnership between the University of Participation in the Big Ararat Health Study New South Wales Rural Clinical School and our Health Scholarships and bursaries offered to four Service. The Big Ararat Health Study is one of the largest members of staff health surveys conducted in rural Australia. The baseline survey will enable researchers to learn about the health 49 staff currently upskilling to formal qualifications conditions, lifestyle, wellbeing, behaviour and attitudes of participants.

A Graduate Nurse Program for Registered Nurses has been offered here for over 20 years. For the first time this year we welcomed Enrolled Nurses into the program. All Nurses completed their training at a range of universities and TAFE providers and the Nurses will undertake nursing and midwifery care based on their training qualifications. Real career pathways are provided by offering this opportunity.

L-R Kristy McEvoy, Natasha Smith, Kara Smith, Stephanie Beasy, Jazmin Sabo, Aaron Palanas, Lucky Rubenecia, Clare Sorati, Caitlin Munday, Chantelle Hutcheon and Sally-Ann Duncan

30 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORT SERVICES Cleanliness is indeed extremely important throughout our The pilot proved to be successful and clinical pathways Health Service. With an increase in antimicrobial resistant have been established to include referral, admission and organisms an ever-increasing challenge during surgery, discharge in and out of the health service. it is reassuring to report that due to the vigilance of our Redevelopment of part of our acute ward was undertaken cleaning staff both external and internal audits demonstrate so prisoners can undergo short stay procedures and excellent compliance. (Detailed report page 61). surgical procedures requiring overnight stays in secure facilities. It is envisaged that long term our acute ward We have been recognised by the Minister will be able to accommodate prisoners for more complex for Health for our innovation, not only in the surgery requiring longer stay. quality care we deliver but also the way in which we demonstrate real concern for the wellbeing of staff. Achieved

In conjunction with Ararat Rural City’s Municipal Public Excellent results in external and internal cleaning audits Health and Wellbeing Plan we are working towards being Health Service acknowledged for its innovation in recognised as a healthy eating workplace for the Healthy workplace nutrition Together Victoria Achievement Program. Cafe Pyrenees is a welcome location for staff, visitors and students to Commencement on Regional Access Pilot enjoy nutritious food. We were the first Health Service 22 environmental services staff from throughout the within the Grampians Region to cease selling sugar-laden region attended a training session drinks and we note, with a certain amount of pride, that other health services have also acted responsibly and followed our example. Sharing knowledge between health professionals benefits consumers and staff alike. Infection Control Coordinator Linden Marland was invited by the Department of Health and Human Services to share the way in which she LOOKING TOWARDS OUR FUTURE developed a standalone sustainability report in order to The Annual Report reflects on the past year where, make information more accessible to a wider audience. with the support of the State Government, our The report has certainly led to an increased awareness of supporters and staff, we have achieved some our organisational responsibility to waste, recycling and excellent outcomes for our community. energy consumption and has enabled us to target areas where we can make real improvements. I said last year that while we had been awarded the Premier’s Medium Sized Health Service of This year a Cleaning Standards Auditor’s Certificate the Year for 2015, we had to continue to enjoy training course was also opened up to other health the challenge of working towards a healthier services in the region. This is another excellent example of community. And we did. And we were rewarded cooperation between health services. by once again being named the Premier’s Medium Sized Health Service of the Year for 2016. As with other health services built in the last century, our buildings have to be regularly maintained to ensure they meet all current building regulations. I believe that the success of improving The maintenance team are exceptional in the way they health and wellbeing for our community continue tasks to meet all legislative requirements, as well will be achieved by continuing to as landscaping gardens for the enjoyment of residents, collaborate with other health services, patients and staff. universities and local government in tightening financial times. Last year in partnership with Justice Health, we launched a pilot program Regional Access Pilot (RAP) to improve prisoner access to elective surgical services at East Grampians Health Service, being only the second Victorian public Nick Bush health service to perform elective operations Chief Executive on prisoners. East Grampians Health Service 24.8.2017

2016-17 ANNUAL REPORT 31 DIVISIONAL REPORT CLINICAL SERVICES

OUR GOAL To deliver safe, quality care with respect and appropriate knowledge to patients, residents and clients choosing to use our services.

Image: Eve McCarron

32 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL We will continue to reflect on our Values, to be innovative, maintain the high standards required for accreditation and encourage and support ongoing education of all our employees. All staff are encouraged and offered the opportunity to increase their skill levels, in order for us to offer our patients a high level of care and treatment.

Clinical Services supports our community across the life span. During this time each person will be cared for by an extraordinary team of multidisciplinary clinicians and staff who have made a commitment to work in this vibrant rural community. As has been exampled in the Chief Executive’s report, and will be reiterated throughout these Divisional Reports, in providing a continuum of care to our consumers, Clinical Services works with and across the whole Organisation to deliver quality, safe care. Many programs and services are not age specific and dovetail into services delivered by Community Services or are serviced by Information Technology, Education, Human Resources, Infection Control, Medical Imaging and Medical Services. And, of course, Support Services plays an extremely important role in providing quality food and ensuring that our wards, theatres and residential facilities meet the highest standard of cleanliness.

CLINICAL Thanks to a longstanding partnership with the Ararat The Urgent Care Centre has continued to increase in Branch of the Victoria Police Blue Ribbon Foundation, workload and complexity of presentations with additional we have renovated and refurbished our Perioperative staff employed as a response. A number of staff are Unit to have two fully functioning theatres, enabling day qualified Advanced Practice Nurses, having upskilled as surgical procedures to increase by 21.1% since 2014. In Rural, Isolated Practice Endorsed Registered Nurse, which alignment with our mission statement, we are committed enables them to treat some diagnosis that a General to improving the health of our community and this year Practitioner (GP) would normally be required to attend. saw us provide 57% of our surgical day procedures to This benefits both our community and the local GPs who residents in the Ararat and surrounding area. are on-call after hours. Receiving additional WIES funding enabled us to provide We acknowledge our medical colleagues from the Ararat more surgical services to residents within the wider Medical Centre who have, over the years, undertaken Grampians area. We worked with Ballarat Health Services additional training to provide a comprehensive Obstetric assisting them to reduce their waiting lists, resulting in 37% service. Our Registrar Doctors are now undertaking similar of people that have come in for surgery this year residing training to ensure we will continue our seven-day a week around the Ballarat area, enabling patients from the wider service into the future. Grampians region to be having their surgeries within a clinically appropriate timeframe. There are 11 Midwives and one student Midwife here in Ararat who perform a range of duties, With the ensuing increase in theatre usage this has, of course, had an impact on our workforce planning working alongside expectant mothers to strategies. This has been addressed by increasing ensure a safe delivery of baby, with follow up training opportunities for Enrolled and Registered Nurses, care as needed. Graduate Nurse programs and, for the first time we have opened this up to Enrolled Nurses. The Midwifery service continues to grow and the ongoing partnership with Ballarat Health Services and Royal Women’s Hospital is certainly benefitting our Midwifery staff who have access to education to maintain and Achieved increase their skills base as well as informing our own Renovation and refurbishment of the Inpatient Unit and Policies and Procedures. The commitment of staff for Urgent Care Centre ongoing education ensures that our maternity patients have access to the highest quality, safe care and Feedback from patients and staff indicate appreciation treatment throughout their obstetric journey. of improved layout, welcoming atmosphere and contemporary appearance

2016-17 ANNUAL REPORT 33 International Midwives’ Day in May is always a Receiving a diagnosis of cancer can be great time to celebrate as mums, babies and overwhelming. Our patients are very appreciative Midwives get together for a walk around Alexandra that they do not need to travel to regional Lake followed by morning tea at Pyrenees House. centres to receive the most appropriate care and Midwives really enjoy meeting up with mums and treatment but are able to access it locally in our babies that they have cared for. Oncology Unit. Under the guidance of Oncologist Dr Craig Carden, all treatment is delivered by our Achieved qualified Chemotherapy nurses. Our Oncology Unit is a member of Grampians Integrated Cancer Placement at Royal Women’s Hospital for Service (GICS) whose aim is to improve cancer Midwife and Lactation Consultant Marg Driscoll, care systems and services in the Grampians where she observed the breastfeeding Region. This enables staff from our Oncology assessment service and special care nursery Unit to participate in the sharing of services, The placement increased her knowledge and education and contributing to research projects exposure to a busy midwifery department and new initiatives.

Tammi Plunkett, Amanda Webb, Dr Craig Carden, Gary Jenkins and Kathy Fitzpatrick

Achieved Introduction of My Cancer Care Record, a folder that will assist patients in recording their cancer journey and to store useful information they Kerry Sturmfels, Clare Sorati, Kirsty McEvoy and Tracey Walters received during their cancer treatment

With an increase in theatre capacity and Achieved capability, the Perioperative Unit has Follow up phone calls after same day surgery are now expanded its workforce to include a new audited role of theatre technician. A patient is selected daily at random to answer a more comprehensive set of questions about admission Two staff have successfully completed courses to work in this role that will deal specifically with In the last financial year 176 patients were selected: direct patient positioning for surgery and usage 172 responded positively, with only four having minor concerns which were addressed with changes of equipment required for each procedure. in practice and procedures implemented where necessary

Number of compliments received in perioperative 330

Number of concerns – 14, all of which were resolved satisfactorily

34 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY The Regional Access Pilot program has been AGED CARE developed by the Department of Justice and We are an ageing population, and elderly people Regulation, following a report in 2011 by the deserve the very best safe healthcare. Our four Ombudsman that indicated prisoners were residential facilities maintain the highest standards of reluctant to attend a maximum security prison care employing committed staff who are prepared to take on additional education and training to promote an for healthcare and were choosing not to even greater adherence to quality and safety within their receive secondary or tertiary treatment. work environment.

As the Grampians Region was deemed organisationally ready from a corrections and health services perspective our Health Service was invited to participate in the The introduction of the Montessori Model of pilot program. A Memorandum of Understanding was Care to 70 Lowe Street in 2015 has enabled our developed between our Health Service and the Hopkins residents to enjoy a better quality of life, with Correctional Facility with clinical pathways established meaning and purpose. Some residents have that included referral, admission and discharge in and out been given roles that suit their abilities and have of the Health Service. Work commenced to redevelop been rewarded with compliments and a sense of part of the IPU and prisoners can now undergo short personal pride. A buffet breakfast is served seven stay procedures and minor surgery as well as surgical days a week, with the smell of freshly cooked food procedures requiring overnight stays. It is envisaged that enticing residents to eat more healthily. long term, IPU will be able to accommodate prisoners for more complex surgery. In June this year the Ararat Advertiser reported that family violence rates increased in Ararat, Stawell and the surrounding districts. In the past five years the Crime Statistics Agency figures revealed a 51% increase in family violence reports. While the increase may be due to increased awareness, ongoing violence continues to increase. Peter Armstrong. Director of Clinical Services continues as Child Safety Officer overseeing our Organisation’s compliance with the Victorian Child Safe Standards including our Commitment to Safety Standard. Policies developed last year are compliant and Nina Cannata we have increased our education and training for front line staff with family violence awareness a component at annual mandatory staff training. A safe environment Involving residents in many aspects of the development for children has to be the base line from which care and of their care, choosing fabrics, naming the reflection room, support is developed. which functions as a quiet room as well as a space for Violence also can have a significant impact on our staff, church services, has increased their sense of wellbeing. in particular those members working in urgent care, The Ararat Men’s Shed has been a great advocate of maternity services and community services. Posters have our male residents, inviting them to the Shed twice a been placed in reception, wards and other public areas week and supporting them to make items that are then to inform the public that as an Organisation we will not used around 70 Lowe Street. This level of community tolerate verbal or physical violence against our staff and commitment really enhances our residents’ lives. will always take action. The Montessori Model of Care gives our residents the opportunity to use their five Achieved senses to activate and stimulate their 8 key staff attended DV-alert Domestic Violence minds. Research has shown that this helps Response Training people diagnosed with dementia to remain independent for as long as possible. Cluckingham Palace, the chook shed built last year, has been a great success for residents used to tending farm animals at home.

2016-17 ANNUAL REPORT 35 An interactive garden has been added this Willaura Healthcare and Parkland House are an important year that includes an ornamental farmyard and aspect of the local Willaura community offering high and low care residential support. Families, volunteers and mural. The vegetable garden is accessible for visitors are integral to the overall philosophy of providing a all abilities, with raised beds to enable residents homelike environment to our residents. Christine McArthur in wheelchairs or using walking frames to was appointed as manager for Willaura Healthcare and participate in gardening. has come with a fresh approach and an exciting vision for the future of this facility. Renovations at Parkland House will be completed by the end of the financial year and residents took an active involvement in choosing colours Visual cues have also been introduced and, along that have been coordinated with décor and furnishings. with meaningful activities, have been shown to reduce anger, frustration and anxiety and increase A successful unannounced visit from the Australian residents’ sense of security and confidence. Aged Care Quality Agency demonstrates that Willaura Healthcare residents continue to receive a high standard of care and that staff are proud to welcome such visits. Garden View Court is a low care residential facility located within the Ararat complex and onsite to all the clinical amenities provided by the Health Service. This year enrolled nurses were employed to work alongside the manager and the personal care workers to ensure that Garden View Court continues to provide high quality care. Garden View Court achieved full three year accreditation following review by the Australian Aged Care Quality Agency. Activities are an important function of daily living for our residents and on the retirement of Lifestyle Coordinator Lorraine Koenen, the new coordinator met with residents to discuss a new program of events and activities, incorporating the best of the old favourites.

Volunteers and auxiliaries are essential to the wellbeing of our residents through the Bernadette Cincotta, resident Norma, Ingrid Henry, residents Heather many hours of time supporting lifestyle and Betty, Dr Wendy Penney coordinators or fundraising activities. These members of the community are often our ears and eyes and certainly are ambassadors Achieved for our Health Service.

Bathroom and toilet doors painted yellow to help Medical Imaging provides a dedicated diagnostic residents associate the toilet with a yellow door service for the community, with Sonographers and Toilet seats painted blue. A white seat blended Radiographers specifically skilled and experienced to with the floor perform medical imagining. Clear signage to direct residents to dining areas. In conjunction with Bendigo Radiology, the Health Service purchased and installed a CT contrast pressure Each corridor has a name and each wing is an avenue injector to replace the existing ageing one. The new Number of volunteers remains consistent, with 154 contrast injector enables a more accurate study for currently registered diagnosis of pathologies such as pulmonary embolus with less contrast use. Research project by Federation University indicates that staff have embraced the Montessori Model of Care as, from their experience, it has made a significant difference to the residents for whom they care

36 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY In October 2016 our Sonographers started Achieved diagnostic ultrasound scanning at the Hopkins Medical Imaging examinations increased from 12,205 Correctional Medical Centre. This reduces up to 12,964 – it should be noted that for the year the number of times prisoners need to leave 2011-2012 there was a total of 9,577 examinations. The the centre to attend appointments at the increase has been achieved due to consistent staffing, training an additional Sonographer and the addition of Health Service. a second ultrasound machine

With two ultrasound machines and two Sonographers, CT examinations increased from 1,724 up to 1,754 waiting times have been reduced, with appointments Ultrasound increased from 4,338 to 4,720 usually available within one or two days, and urgent cases seen on the same day. Echocardiography remained stable at 376 this year, four lower than last year

Image: Amy Leeke

2016-17 ANNUAL REPORT 37 DIVISIONAL REPORT COMMUNITY SERVICES

OUR GOAL To partner with our community to improve health and wellbeing.

Image: Jenny Kouch, Bernice Brown, Dr Dominic Barlow

38 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL Partnerships with consumers and other agencies are key to improving health outcomes. Our programs are delivered across the care continuum from prevention through to complex and chronic care. Services are provided across the life stages to meet individual and community needs. Care planning, in partnership with the consumer is a core component of our services.

Community Services covers a wide range of programs Achieved including oral health, women’s health, community nursing, Consultation and collaboration with: allied health, chronic disease management and health promotion. Our staff travel around the region to provide Consumers of services services at home, in the community and in a number of healthcare facilities. Ararat Rural City Council Continuous improvement is important and achieved through ongoing review of program outcomes. This Members of the Grampians Pyrenees ensures we are accountable for the provision of high Primary Care Partnership quality and effective services to meet the diverse needs of our community. Consulting with consumers is an important Western Victoria Primary Health Network aspect in the development of our services to ensure services continue to meet community needs. Health Services across the Grampians Region

Collaboration with our colleagues from other rural and regional health services informs our decision making so we can continue to provide a quality service across the continuum of care.

CHRONIC DISEASE MANAGEMENT Chronic diseases like diabetes, heart disease, pulmonary The rates of other chronic diseases indicated: disease and musculoskeletal disorders are becoming Ararat State average increasingly more common in our community. Many of our Cancer 8.7% 7.4% community members experience life with chronic disease. Chronic disease impacts the quality of life for the person Heart Disease 6.9% 8.9% affected and their family. Chronic disease affects the Osteoporosis 4.6% 2.5% wellbeing of our community. Arthritis 20.6% 16.1% Type 2 Diabetes 4.6% 5.3% Our catchment has been identified as experiencing higher levels of chronic disease compared to the rest Dental health of Victoria. Ararat Rural City’s Health and Wellbeing • Fair or Poor 2.9% 2.6% Snapshot, February 2017, indicates 59% of respondents were pre-obese or obese, compared to the State average • Children 6-8 2.9% 2.6% of 50%. • Teens 13-17 5.1% 3.1%

Population health data helps us to develop programs and target services to achieve improved health outcomes.

A collaborative research partnership with the University of New South Wales Rural Clinical School is key to addressing some of our local issues. The Big Ararat Health Study aims to develop a comprehensive population-based research database and biobank that will assist the local community in understanding associations between general health and chronic disease. The study aims to reach 50% of the Ararat population, 35 years and over.

Dr Debra Schulz, Dr Alex Gavino and Angela Hunt

2016-17 ANNUAL REPORT 39 This is one of the largest health surveys conducted in rural Australia and the baseline Achieved survey will enable researchers to learn about Increased staff to support schools in the health conditions, lifestyle, wellbeing, behaviour Achievement Program and individual and attitudes of participants. school progress towards milestones in the Achievement Program This is a really exciting project and will have lasting Deakin University Dietetics students have benefits for our community. Lead researcher Dr Alex completed projects to improve consumer Gavino, working alongside staff at East Grampians Health experiences including: Service, said that the focus of the research will be on both cardiovascular and metabolic disease. Participants • Vegetarian and gluten free menu review at completed a baseline survey with an optional series of East Grampians Health Service health assessments with any identified health risks • Healthy eating action plan for staff passed onto both the patient and General Practitioner for • Completed a needs assessment for cooking follow-up and management. program in Ararat region which builds knowledge and skills for healthy food preparation Achieved 240 taking part in Big Ararat Health Study Participants have access to new and emerging technologies

Cardiac and Pulmonary Rehabilitation programs are evidence-based and provide benefit to people with a heart or lung disease. Participants are encouraged to make lifestyle changes to reduce further risks of health problems. The programs are multidisciplinary and incorporate a supervised physical activity program and Increased use of social media has enabled the promotion development of self-management strategies. of services and health messages both internally and to the Access to latest equipment provides health benefits for wider community. clients. The IPro 2 is a continuous glucose monitoring The introduction of the Spinal Assessment Clinic – system introduced by the Diabetes Educators in June Regional Outreach Clinic, run in partnership with Ballarat 2016. Diabetic clients from both residential aged care Health Services, has enabled clients to be assessed and the community have used the iPro2 to monitor their and treated locally. An Advanced Musculoskeletal diabetes. The iPro2 assists clients to better manage their Physiotherapist from Ballarat Health Services provides diabetes. The iPro2 provides a pictorial education tool the clinic. This has reduced waiting times and travelling which demonstrates to clients the impact of exercise and for clients and given our Physiotherapists an excellent various forms of carbohydrates on glycaemic control. opportunity to learn from an advanced clinician.

Our Dietitians have been working in Achieved partnership with other health providers Partnership with Ballarat Health Services on including the Grampians Food Alliance, Ararat introduction of Spinal Assessment Clinic – Regional Rural City Council and Grampians Pyrenees Outreach Clinic Primary Care Partnership and, of course Five Advanced Musculoskeletal clinics held in Ararat collaborating with schools to create a healthier school environment. Podiatry works across the care continuum providing services to residential aged care, the inpatient unit and Dietetics is providing a facilitation role to support progress rural outreach clinics at Willaura, Lake Bolac and Elmhurst. in the Achievement Program with 13 schools throughout All clinics are well supported by local residents. Podiatry the local government area. Developed by the Department also services external contracts at Hopkins Correctional of Health and Human Services, the Achievement Program Centre, Langi Kal Kal Prison and Budja Budja Aboriginal is a simple, evidence-based framework to support whole- Cooperative in Halls Gap. organisation health and wellbeing approaches for early Future initiatives for Community Services include a childhood services, schools and workplaces. partnership with Stawell Regional Health to provide services for a new Chronic Conditions model of care.

40 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY ORAL HEALTH PROMOTION FAMILY VIOLENCE AND CHILD SAFETY The oral health of our community has been identified Our catchment area has the third highest incidents in as a significant factor in the Burden of Disease of the State for family violence, which includes elder abuse. our community. Across the Organisation we have strengthened our response to family violence, child safety and elder abuse. Developing a model which increases access to dental In particular our Social Worker has been working with front services has been a priority for our dental clinicians. line staff in recognising, responding and referring real and Visits to kindergartens and primary schools across our perceived cases of family violence. (Detailed report can catchment area have increased and expanded over the be found on page 35 of Clinical Services.) 12 months. Interactive group activities introduce young children to good oral health. Improvements to our Dental Outreach program have enabled us to visit more schools Elder Abuse is an insidious exploitation of with fifth year Dental students from La Trobe University, vulnerable people who are often afraid to Bendigo, participating in the provision of education and speak out. Elder Abuse Guidelines have assisting with examinations. been developed that are distributed to staff at Mandatory Education sessions. Social Work provides support to staff at 70 Lowe Street, Achieved Garden View Court and the Patricia Hinchey Visits to three kindergartens Centre, responding to allegations and suspicion Dental Outreach program screened 610 children out of of Elder Abuse. a possible 839 at no cost to the families Policies referring to legal documentation for Residential Screenings conducted at 11 primary schools in the Aged Care have been reviewed to ensure they are Ararat Rural City Council compliant with Commitment to Safety Standard.

Collaborating with other agencies, and in line with DHSV’s Strategic Plan, East Grampians Health Service has been moving from a primarily treatment focus to more activities CHILDREN AND FAMILIES HEALTH with a prevention focus. The Grampians Food Alliance, Women and children’s health is a multifaceted of which the Health Service is a member, works across area, with many components offered across the the Grampians Pyrenees Region to promote and improve continuum of care. At East Grampians Health access to fresh and nutritious local food. Our involvement Service our focus is on: is important as we complement the work of schools, food producers, community gardens, the community and Ararat • Developing oral health promotion Rural City as we all have an interest to improve the health • Enhancing the maternity journey of our community, starting with young children. • Strengthening the hospital response to Specialist dental clinics for Aboriginal and Torres Strait family violence and introducing the child Islander people are held at Budja Budja Aboriginal safety standards Cooperative and at the Community Health Centre dental clinic. • Developing women’s health services Dental screenings were completed at; Golden Gate Lodge a Supported Residential Service, Eventide Nursing Home Stawell, 70 Lowe Street, Garden View Court Ararat and Willaura.

Achieved Dental clinic treated 2282 patients 1076 children and 1961 eligible adults treated Total of 5109 visits Erin, baby Alfie, Willow, Lolah, Joel and Tanner Freeland

2016-17 ANNUAL REPORT 41 PATRICIA HINCHEY CENTRE The Patricia Hinchey Centre provides planned activities for approximately 25 clients daily, with an The Ark Toy and Activity Centre President Kaye Chamings with Georgie, Celia Tucker with James and Johnny, Amanda McCorkell with Sam, Di Pickering, Daphne Lewis and average of 580 client visits a month. The clients Philippa Brown with Isabella participate in discussions on their group activities and special outings. A calendar of events is developed by staff and clients and includes many WOMEN’S HEALTH activities that appeal to clients while stimulating Physiotherapy is an integral component of women’s a range of senses. Events are held both within health, from childbirth through to the later stages of the Patricia Hinchey Centre and across regional life. We have been extremely fortunate that the East Victoria. Grampians Health Service Auxiliary has donated a real time ultrasound, which will help in the diagnosis and Achieved management of continence and pelvic floor dysfunction. Monthly meetings with “Friends of the Centre”, The Ark Toy & Activity Centre was established in 1982 to the name chosen by the clients provide toys for children with special needs. In 35 years it has gone from strength to strength providing support to Clients participated in over 50 activities in Ararat people with special needs, their families and carers. This and across regional Victoria includes people who have physical and development disabilities, chronic illness and other long term injuries The Patricia Hinchey Auxiliary and volunteers are and illnesses that may impact on the person’s ability to an important aspect of the daily activities of the participate in everyday play and social opportunities. centre. The money raised by the auxiliary benefits The Centre is supported by an amazing auxiliary and the clients, paying for outings and other activities. volunteers who annually raise thousands of dollars to Of the 21 volunteers, at least two are at the centre purchase special equipment and toys. every day supporting the lifestyle coordinator in the activities. TRANSITION TO CARE The majority of elderly people will be able to live at home, with the support of families and community care. For those who choose to remain at home East Grampians Health Service provides a comprehensive package of care options. These include: • Home Care Packages • Planned Activities through the Patricia Hinchey Centre • Support to carers

Jacinta Harman, Janiesse Hewlett, Linda Hewitt, Jane Stoneman and Rachael Murray

42 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY VALE OUR FUTURE WORKFORCE Isabel Costello is fondly remembered by clients and staff Creating a dynamic environment that is inviting and at the Patricia Hinchey Centre, where she was a volunteer supportive encourages students on placements within for many years. Isabel, known as Izzie, by those with Community Services to consider locating to a rural health whom she worked, trained as a nurse in Ararat where she service on completion of study. worked before taking up the post of Charge Nurse at the This year many students have completed placements Patricia Hinchey Centre. Following her retirement Izzie with East Grampians Health Service including: worked as a volunteer at 70 Lowe Street and the Patricia Hinchey Centre, entertaining the residents and clients with • 3rd and 4th year Podiatry students from Western her wonderful piano playing. She will be greatly missed. Sydney University, La Trobe University Bendigo and Bundoora campuses. Preference is given to rural HOME CARE PACKAGES Victorian students to reinforce our philosophy of a future “home grown” workforce. Home Care Packages are designed to assist elderly • 5th year Dental students from people live at home and access the support they need La Trobe University Bendigo to remain at home. This is the first year that the Health Service has offered Home Care Packages. EGHS@Home • 3rd Year Social Work, Deakin University provides a comprehensive range of services including • 1st Year Master Social Work, Deakin University personal care, gardening and other services important to remaining at home. • Nursing, physiotherapy, occupational therapy and speech pathology – La Trobe University, Federation University Australia, Australian Catholic University COMMONWEALTH HOME SUPPORT PROGRAM • Year 11 students from Ararat College – annual education This coordinated service for frail elderly people living PARTY (Preventing Alcohol and Risk Related Trauma) at home provides assistance for daily living tasks. A day with students gaining a better understanding of the multidisciplinary approach allows for flexible delivery of consequences of travelling under the influence of drugs services to match an individual’s needs. and alcohol. The students spent time in Urgent Care and then visited Physiotherapy, Occupational Therapy and SUPPORT TO CARERS Speech Pathology to speak with staff about the lengthy and difficult road to recovery after trauma. This is an Caring for a person with a physical or cognitive disability ongoing partnership between the school and the Health can be daunting and exhausting. We understand how Service with the Health Service being thanked for making important the role of carers is and the support required a great contribution in educating local young people. to enable them to continue. The Commonwealth Home Support Program provides opportunities to assist carers have a break from their duties by offering planned respite services. The Carers Recognition Act 2012 underpins RETIREMENT OF DEDICATED our responsibility towards carers and our Social Workers VOLUNTEER provide advocacy and support in regard to resources and services available to carers. Joy Ambrose had been visiting Patricia Hinchey Centre since 2002 for the Thursday Reading With the introduction of the National Disability Insurance Group before retiring in October last year. Joy’s Scheme we are busy supporting clients who were stories were always entertaining, sometimes previously funded through Home and Community Care. educational but always eagerly anticipated by clients. At her farewell, prior to moving to Western SUPPORT TO RESIDENTIAL CARE Australia, Joy was presented with flowers and thanks from Chief Executive Nick Bush. Finding the right residential aged care facility is a significant event. It can be difficult and confusing as well as an emotional time. Our team provides assistance for all members of families involved in the decision for a loved one to consider residential aged care. There are a number of socio-legal matters to consider including Enduring Powers of Attorney, Advance Care Plans and support with adjusting to moving away from home. These initial meetings are important to encourage a positive sense of wellbeing and for the family to feel confident that our staff understand as much about the person choosing residential aged care and that in return they understand the level of support that will be provided.

Sarah Harrison, Joy Ambrose and Jacinta Harman

2016-17 ANNUAL REPORT 43 DIVISIONAL REPORT DEVELOPMENT & IMPROVEMENT

OUR GOAL To support the Organisation by delivering, implementing and monitoring systems and processes that provide the framework for good clinical governance reflecting Government and community expectations.

Image: L-R, Amanda Harrison, Jane Smith, Janice Darbyshire and Carol Leo

44 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL Our Organisation has developed a reputation as an innovative and progressive health service, where the quality of service delivery is fundamental to our Values, which underpin our work practices, our commitment and our personal beliefs.

In an organisation such as ours, auditing and accreditation are mechanisms by which we identify and manage risks. Risks span the Organisation and if realised can impact on our goal of providing safe quality health care, no matter whether they be financial, reputational, environmental or clinical risks. To ensure our risks are managed well our policies and procedures are referenced to legislation, Standards or guidelines as appropriate. This will protect our consumers, staff and governing body.

CREDENTIALING ACCREDITATION AND INTERNAL AUDITING Working with the Directors of Medical Services, Accreditation and internal auditing are the processes by Clinical Services and Community Services which external surveyors carry out a thorough inspection we ensure that all clinicians’ registrations are of our Organisation’s clinical systems and their supporting current and that their scope of practice reflects business systems to ensure our consumers, including the degree of competency and qualifications residents, patients, clients, staff, volunteers, visitors and required of them to undertake medical, nursing contractors are protected. The process is meticulous and or allied health procedures. Registration is one that we embrace as we are confident that we have in reviewed annually. place sound systems and processes to ensure our clinical This is one of the most important aspects governance, compliance and quality care are based around of delivery of safe, quality health care for regular monitoring and capturing important data that informs our patients, residents and clients. The our decision making. knowledge that clinicians have the appropriate Successful accreditation and auditing informs our community qualifications to care for them and that their that we meet a set of Standards expected for the delivery care is delivered in an environment that is safe of safe quality care. Vigilance, evaluation, questioning, and secure. self-assessment and audits all form part of our process to Daily we collect different types of data that is ensure we are ready for any review or inspection. used to assess our quality and safety activity. This is presented quarterly to the Clinical Achieved Governance Committee, a sub-committee National Safety and Quality Health Service Standards of the Board that includes participation from accreditation: full compliance community representatives and key clinicians. Trends are analysed against set clinical Department of Health and Human Services Standards: full indicators including maternity, falls, medication compliance errors and infection rates. These are reported Australian Aged Care Quality Agency: full compliance to the Board for discussion as necessary. National Association of Testing Authorities: full compliance

Jacinta Harman, Victor Barwick and Dr Debra Schulz Amanda Cranstoun and Dr Pieter Pretorious

2016-17 ANNUAL REPORT 45 PROMOTING A CULTURE OF LEARNING During the year: As staff support the Organisation so too does the • 94 % employees completed mandatory education: Health Service support staff to achieve professional 98% permanent employees, 73% casual employees and personal goals. The Learning, Education, Training • 50 employees upskilling to formal qualifications ranging and Sustainability (LETS) program, developed in 2012 to from Certificate III to Master’s level on Australian increase clinical and non-clinical workforce capacity and Qualifications framework capability to meet the health needs of our community, continues to be an outstanding example of providing • Increasing number of applications for career progression opportunities to upskill staff. • Provision of high quality clinical education to In our Organisation, each staff member is as important undergraduate students from 15 health disciplines and as another. Over the past four years expanding the Certificate III in Individual Support students educational model to train non-clinical staff has proved • Provision of free accommodation, Health Service highly successful with non-clinical staff members orientation and supervisors with clinical supervision embracing the educational opportunities offered to them. skills training

CAREER PROGRESSION STATISTICS

AUSTRALIAN NO EMPLOYEES NO EMPLOYEES NO EMPLOYEES NO EMPLOYEES QUALIFICATIONS QUALIFIED QUALIFIED UPSKILLING UPSKILLING FRAMEWORK 2016/2017 2015/2016 2016/2017 2015/2016

Certificate III 1 1 2 4

Certificate IV 3 - 9 7

Diploma 2 6 6 6

Advanced Diploma - - 1 1

Bachelor 2 2 15 6

Graduate Certificate 3 2 6 6

Graduate Diploma 1 1 4 5

Master’s - - 1 4

Other - - 1 4

TOTAL 18 12 50 44

The Maternity and Neonatal Emergency program is a joint initiative between the Royal Women’s Hospital and the Royal Children’s Hospital to provide training for Victoria’s rural workforce.

Our Health Service was delighted to host the program that provides training for multi-disciplinary teams to improve their effectiveness in managing maternity and newborn emergencies. This enhances the delivery of safe care and quality outcomes. Our midwifery workforce is committed to keeping up-to-date with current best practice outcomes and have attended important ongoing education during the year. Baby Rome Begelhole and Marg Driscoll

46 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Achieved DEVELOPING POSTGRADUATE TRAINING Certificate III in Individual Support (Personal Care FOR MEDICAL INTERNS Worker) – training delivered by Western District The third intake of Doctors for the Grampians Medical Employment Access (WDEA) in Pyrenees House Training Intern program has increased from five to eight. and clinical placements provided in aged care settings This is an excellent collaborative program, as has been for students described by the President (page 22). As lead health Diploma of Nursing - accredited Enrolled Nurse service, but collaborating closely with our colleagues training program delivered in Pyrenees House in at St John of God Ballarat Hospital and Maryborough new partnership with ACUcom. Full time program (18 District Health Service, we have developed a program months) commenced February 2017 with 28 students, that offers interns a unique opportunity to develop currently 22 students enrolled. East Grampians Health significant procedural skills in rural public hospital settings. Service trainers delivering the majority of training Currently our training is for postgraduate Year 1 interns, with students attending classes four days per week. but Agreements are being negotiated for Year 2 and Trainers qualified with post graduate nursing training 3 postgraduates, for possible implementation in 2018 and Certificate IV in Training and Assessment or 2019. Provision of high quality clinical education to undergraduate students from 15 health disciplines and RESEARCH PROJECTS partnership agreements with nine Universities and four Technical and Further Education (TAFE) providers The most reliable research is evidence based, bringing together clinical expertise together with the experiences 11 graduate nurses – four Enrolled Nurses, five of a range of consumers of healthcare. In collaboration Registered Nurses and two Registered Nurses/ with tertiary institutions we are participating in a number Midwives – undertaking 12-month formal graduate of current research projects that will certainly benefit our nurse program at East Grampians Health Service. This community and help shape future service delivery. includes rotations to a range of clinical settings, study days and clinical support to develop quality clinical Achieved knowledge and skills Alison Brown PhD Candidate, Centre for Health Policy, Graduate program for Enrolled Nurses: a new initiative Melbourne School of Population and Global Health in 2017 Melbourne University: Governing the Quality of Care Graduate program for Registered Nurse/Midwife: Study a collaborative effort between EGHS and Ballarat Alex Gavino PHD candidate, University of New South Health Services Wales: The Big Ararat Health Study: the effect of biological, environmental and lifestyle factors on health, chronic conditions and wellbeing in a rural community Wendy Penney Adjunct Senior Research Fellow, Faculty Maternity and Newborn Emergency workshop of Education, Federation University, Australia: Staff – two days of training delivered at Pyrenees responses to the Implementation of the Montessori House, attended by six Medical Officers from model of care Ararat Medical Centre, four Deakin Medical students, 100% of midwives working at the Health Service, including two graduate midwives and one midwifery student, also Maternal and Child Health nurse.

Kerry Sturmfels, Nathan Lay, Dr Chee Sheng Wong Dr Alex Gavino

2016-17 ANNUAL REPORT 47 SYSTEMS UTILISED TO ASSIST WITH THE PROVISION OF QUALITY EDUCATION AND Clinical placement days - discipline TRAINING:

1. Best Practice Clinical Learning Environment Framework A performance monitoring quality framework that provides guidance to health services in partnership with their education provider partners, to create a positive education culture and ensure a quality clinical learning environment for students undertaking clinical training.

2. Placeright A secure, web-based information management system to assist clinical placement providers to plan and administer clinical placements with their education provider partners.

EGHS Number clinical placement days 2010-2016

Allied Health therapy CP days • Dietetics 113.68 • Exercise physiology 49.47 • Occupational therapy 29.47 • Physiotherapy 45.26 • Podiatry 42.11 • Social Work 96.68 • Speech Pathology 35.79

Nursing CP days • Registered Nurse 1167.76 • Midwifery 10.53 • increase clinical placement days 2012 and 2013 • Enrolled Nurse 196.84 result of HWA project, a funded program to support clinical placement Allied Health science CP days • Note – also WDEA Certificate III in Individual Support • Radiography/medical imaging 281.58 17 students = 30 Clinical Placement (CP) days, Enrolled Nurses upskill 5.7 days • Pharmacy 13.68 • Total 136 students in 2016

Since LETS commenced the total number of staff upskilling to formal qualifications has been maintained at a level of 12%. Our graduate nurse program numbers have increased by 36% this year, which emphasises that our Health Service is regarded as a vibrant learning, education and training Organisation capable of attracting and sustaining an educated and committed clinical and non-clinical workforce.

48 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY THE HEALTH AND WELLBEING OF OUR INDIGENOUS COMMUNITY PARTNERING WITH OUR CONSUMERS Although the number of community members identifying Our community is such an excellent resource for as Aboriginal and Torres Strait Islander people is not us. Members of the community are philanthropists, high, their health and wellbeing is important to us and not necessarily of money but sharing a wealth of we are committed to working with key stakeholders to knowledge, ideas and opinions. These opinions improve outcomes. are so important to help us shape our future. Community representation on our recently In collaboration with Western Victoria Primary formed Community Consultative Committee has Health Network we have been reviewing the been very encouraging and we are confident Victorian Government’s strategic direction for that this experience will inspire others to Aboriginal health: Koolin Balit. In December join sub-committees and advisory groups as 2016 the Health Service implemented representatives and advocates. recommendations identified in During the year in response to the First the Strengthening Cultural Security Audit. Impressions activity, Environmental Audits and our Disability Action Plan our Health Partnership A number of contemporary cultural initiatives have officer undertook a review inviting five consumers been undertaken that make the welcome and to participate in the examination of signage and care for Aboriginal and Torres Strait Islander people entrances across a number of locations within the more appropriate. Organisation, which were: We particularly want to acknowledge our colleagues • Front Reception/Foyer Area at Budja Budja Aboriginal Cooperative, with whom we • Lifts and Pathology/X-Ray work alongside. This collaborative approach has seen an increase in the number of Indigenous people accessing • Café Pyrenees dental care, diabetes education and podiatry during the • Urgent Care Centre past year. • Inpatient Unit SUPPORTING OUR RESIDENTS WITH All corridors and walkways leading to and from ADVANCE CARE PLANS these departments were examined with a total of three audits completed. Each audit was As an Organisation we value our residents and patients configured differently, beginning and finishing in throughout their stay in our care. End of life is a very different areas. personal time and it is important that we have in place processes to make that transition as uncomplicated as For each audit consumers were asked to provide possible. In implementing the Care Plan for the Dying feedback in relation to their first impressions, Person, the development of Advance Care Plans has before being asked specific questions. provided residents the opportunity to express their wishes for their end of life care and provides clarity for As an outcome of this review over 20 family members. In consultation with a Doctor, carer suggestions and recommendations have and family member, a trained staff member will assist in been made to address identified gaps, the development of the plan. Effective communication between all interested parties ensures that residents’ which include a number of issues related wishes are fulfilled and can, importantly, relieve potential to Occupational Health and Safety (OHS). family conflict at this stage. These findings have been presented to the Partnering with Consumers and OHS meetings, with an Action Plan developed Achieved as an outcome of the process. Clinical Governance Committee reviews quality and safety data on a quarterly basis The Health Partnership officer has also recommended that a review of the remaining 95% of aged care residents have completed an buildings and departments be undertaken. Advance Care Plan. Some residents have chosen not to complete a plan

2016-17 ANNUAL REPORT 49 DIVISIONAL REPORT EXECUTIVE SERVICES

OUR GOAL To provide a supportive, sustainable environment that encourages open and honest communication and acknowledges the commitment of our staff.

Image: Member for Lowan Emma Kealy and Nick Bush

50 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL We actively encourage the community to provide feedback via our compliments and concerns process, fully participate in the People Matter Survey and are implementing strategies to address potential future workforce sustainability issues.

As the population of the region expands, so too does its cultural diversity. The multicultural community of Ararat has certainly enriched all our lives. As an Organisation one of our most important Values is Community, whereby we guarantee to respect the dignity and rights of our community and acknowledge their beliefs, regardless of cultural, spiritual or socioeconomic background. Within our Organisation this is achieved through ensuring that as care givers we do not discriminate or criticise and as employers we use contemporary recruitment practices based on fair and equitable employment principles. We have developed a Diversity Action Plan that acknowledges our responsibility to remain inclusive and responsive to the health and wellbeing of the whole community, whatever their sexual orientation and beliefs.

WORKFORCE STATISTICS

HOSPITALS JUNE JUNE In the past year, due to the LABOUR CATEGORY CURRENT MONTH FTE* YTD FTE** expansion of services to Corrections Victoria and a second theatre, 2016 2017 2016 2017 staffing levels have increased by 5%. Workforce Management Nursing 119.24 123.52 113.42 121.10 including planning and development is, inherently, of the highest priority. Administration and Clerical 42.04 48.10 38.96 47.04 To plan strategically for the Medical Support 8.69 8.24 8.04 8.46 increase and the ageing

Hotel and Allied Services 73.56 72.39 65.88 72.67 of our population and, thereby, our services we Medical Officers 0.86 0.34 0.59 0.04 have undertaken a Nursing Workforce Sustainability Hospital Medical Officers 5.05 8.00 2.31 6.27 project, which will focus Sessional Clinicians 0.00 0.00 0.00 0.00 on leadership and culture, recruitment, retention, and Ancillary Staff (Allied Health) 18.66 19.85 15.49 20.78 productivity.

PROPOSED STRATEGIES INCLUDE: Leadership and Culture • Mentoring programs to assist in the development of managers and supervisors Recruitment • Developing an ERecruitment and recruitment marketing strategies Retention • Development of Child Care assistance strategies is already underway • Education/Training – continuing scholarship and bursary support Sophie Dyer, Charlotte Harwood, Jessica Sladdin and Tracey Drake Productivity • Provision of support and guidance through additional specialist support

2016-17 ANNUAL REPORT 51 Since its inception in 2009, the Building EGHS HIGHEST SCORING RESULTS for the Future Foundation has allocated 16 bursaries to help our staff upskill and build QUESTION TEXT % their skills to provide extended capacity to My organisation provides high quality services to the Victorian 97 the Organisation. community Responsiveness Accredited training programs include Midwifery, In my organisation, earning and sustaining a high level of public Registered and Enrolled Nursing, advanced studies 97 trust is seen as important Integrity in Physiotherapy and Dental practices. All recipients have expressed their gratitude by successfully My manager is committed to ensuring customers receive a high 96 completing their courses. There can be no better standard of service Responsiveness thanks than this. Names of recipients can be found My workgroup strives to achieve customer satisfaction on in the paragraph below. 96 Responsiveness Taking on additional responsibilities, such as education and training, is in itself a huge personal commitment. In my workgroup, work is undertaken using best practice 94 Successfully completing further study is to be approaches Responsiveness commended and the 24 staff who achieved this during My organisation encourages employees to act in ways that are the year were acknowledged at the Annual General 94 Meeting. Amanda Cranstoun, Angela Graham, Anita consistent with human rights Human rights Kennedy, Annette Evans, Ashley Leggett, Carolyn Cultural background is not a barrier to success in my organisation 93 Akesson, Charmaine Bartlett, Christine Jordan, Demi Equal employment opportunity Holcombe, Garry Tierney, Grace Boag, Hanna Shea, Jennifer Cole, Katherine Pitcher, Kimberley Buncle, My manager encourages behaviours that are consistent with the 90 Kirsten O’Connor, Naomi Schott, Peter Armstrong, Rico public sector values Leadership Hilado, Rommy Nicht, Sarah Power, Simone Webb, Toni My manager treats employees with dignity and respect Fair and Molloy, Yvette Brady. 90 reasonable treatment The People Matter Survey is an anonymous, voluntary Equal Employment Opportunity is provided in my organisation survey conducted by the Victorian Public Sector 89 Commission to all health services and other Victorian Equal employment opportunity public service departments. It consists of a core survey that assesses diversity and inclusion, employee wellbeing, change management, career intentions, EGHS LOWEST SCORING RESULTS learning and development and sexual harassment. The survey is an excellent chance for staff to express QUESTION TEXT % their concerns and for them to see that issues are People recruited to my organisation seem to have the right skills taken seriously and addressed. This year’s results 70 demonstrated that our Health Service had the highest for the job Merit score of 12 comparative health services in 21 out of the 22 headline benchmarks. An excellent result – and In my organisation, employees are recruited on the basis of merit 73 with the support of staff, we are already addressing responses from the lowest scoring results. People in my workgroup treat each other with respect 75

I am confident that I would be protected from reprisal for reporting 76 improper conduct

People in my workgroup use their time and resources efficiently 76

In my organisation, behaving impartially is seen as important 79

My work performance is assessed against clear criteria 79

Disability is not a barrier to success in my organisation 79

People in my workgroup demonstrate objectivity in 80 decision-making

In my organisation, avoiding conflict of interest is seen as 81 Back L-R: Sally-Ann Duncan and Deborah Bennett important Front L-R: Michelle Wineberg and Meg Brown

52 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Effective communication is vital in an organisation that LIFE GOVERNORS AS AT 30TH JUNE 2017 relies on important messages being clearly understood by the community and in particular residents, patients, clients and their families. The Community Liaison Officer Mrs V Albert Mrs L King issues a weekly external media release on important Mr G Anderson Mr G Laidlaw health and strategic issues as well as human-interest Mrs P Armstrong Mrs J Liddle stories. We acknowledge the support of the Ararat Dr G Bertuch OAM Mr B McCutcheon Advertiser, The Weekly Advertiser, ABC Radio and ACE Mrs J Burke Mrs J Millear Radio Network who all ensure that our community is well Mr G Millear informed about our Health Service. The ECHO is our staff Mr P Carthew monthly newsletter that contains notices, Chief Executive Mrs N Dalkin Mrs A Milvain and Board announcements as well as education, infection Mr I Daly Mrs M Murray control and human resource updates. Mr C de Fegely Mrs J Nunan Mrs P Ervin Mr A O’Neill A Community Consultative Committee, chaired by Vice Mr J Evans Mrs S Philip President Heather Fleming, has been established to Mr N Faneco Dr M Plunkett provide a link between the Board and its consumer, Mrs C Forster Mrs D Radford auxiliary and volunteer base. Representatives from Mr G Foster Mr D Reid our auxiliaries, volunteers, staff and the Board have Mr I Foster Mr R Roberts established Terms of Reference to consider the role of Mr L Gason Mrs S Shannon the 150 volunteers and auxiliary members and ways in Mr D Haddow Mr K Shea which the Health Service can assist them. The needs of Mrs S Handscombe Mrs V Tosch consumers and their potential to assist our Organisation Mrs K Harvey Mr N Tosch are also considered. Volunteer and consumer feedback Mrs W Heard Miss K Turner on a range of matters is significant and assists the Board Mrs M Heard Mr T Weeks APM OAM in its strategic planning. They bring another perspective to Mrs F Hull Mr E Wilson our Health Service’s operation, including consumer needs, Mrs J Jenkinson Mrs M Young project development, education and community input. Mr B Jones Through accessible and honest communication and seeking consumer feedback we have demonstrated that we are open to addressing all formal concerns. In this way our community can have absolute confidence in knowing VALE that their concerns are being addressed and that we too The Board wishes to acknowledge the death of Mrs Phyllis can continue to learn and change. Both compliments Armstrong, a valued member of the Red Cross, who was and concerns are submitted to the Board for its awarded a Life Governor of the Health Service in 2000 for consideration as well as being shared with the particular her many years’ active service to the community. area for review. Through this process nothing is hidden and we can be sure that as an organisation we can forestall any potential issues. Achieved 5% more staff employed this year It is important to recognise those in the Excellent results in People Matter Survey community who have, over the years, made a significant contribution to our Health Service 555 compliments, 103 concerns. All concerns satisfactorily addressed and in return they have been awarded a Life Governor of East Grampians Health Service. The Board executive now contribute to ECHO on a regular basis

Auxiliaries and service clubs play a significant role in our Organisation raising many thousands of dollars each year to help us purchase state of the art equipment for the delivery of safe quality care, funds to enable day centre clients to enjoy those extra special events and toys for the Ark Toy & Activity Centre.

Without this extraordinary level of commitment it would be more difficult to maintain our excellent standard of equipment. Isabella

2016-17 ANNUAL REPORT 53 EGHS AGED CARE AUXILIARY EGHS LADIES AUXILIARY The Aged Care Auxiliary held a Fair and Carols in The Women, Wisdom & Wellbeing Dinner attracted December. 270 women, all ready to enjoy the circus themed night of entertainment and fun. Approximately This festive event attracted a good crowd $25,000 was raised which will go towards the of hearty singers, with over $3,029 purchase of a Real Time Ultrasound and pelvic model for the Physiotherapy Department’s raised. Other fund raising efforts included continence program. A highlight of the year was a film night, which raised $1,678 and recognition of members’ commitment to our Health $500 from the Community Assist and Service by the Member for Wannon the Hon Dan Rotary District Assembly. Tehan when he hosted an afternoon tea at the Ararat Town Hall. All monies raised went towards purchasing 120 guests were invited to the annual luncheon equipment for the two aged care facilities at the Willaura Hall where well-known horticulturist and media personality Rob Pelletier from Heritage Fruit Trees near Beaufort entertained the ladies at “From The Orchard’. With over $2,800 raised, five Roho cushions were purchased for the Dialysis unit.

Jane Richardson, Cathy Billings, Libby McCormick, Lynne Wilson and Margie Kilpatrick and Rob Pelletier Ingrid Henry

M2M CRANKS AND DEFIBRILLATORS This extraordinary group of men and women raised $27,900 this year. They set themselves an ambitious target of $25,000 – and did even better! The money raised will go towards a new bus for the Patricia Hinchey Centre. Fundraising events were held throughout the year and generous donations were provided by friends, family, colleagues, community members as well as sponsorship from Ararat businesses.

This is another example of what can be achieved through collaboration, generosity and a willingness to succeed.

L-R: Gary Brumby, Graeme Foster, Charlie Reid, Carolynne Smith, Ken McCready, Erin Hinchliffe, Jacinta Harman, Brenda Green, Michael McKerron, Marg Driscoll, Nikki Berg, Alan Young, Carly Croton, Peter Armstrong, Lisa Haddow

54 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY WILLAURA HEALTHCARE AUXILIARY $16,000 was raised over the past 12 months to purchase a barbecue, a chair/bed and electrical equipment for the family room, 12 dining chairs for the day centre, a hi-low bed, gift trolley supplies, $2000 towards day centre activities, signs for the Willaura Outdoor Market, visit from travelling zoo for residents, calendars, birdbaths and garden plants and contribution towards a new rollerdoor on the storeroom.

WILLAURA HEALTHCARE OUTDOOR MARKET On another beautiful autumn day, the local community gathered at the eagerly anticipated annual event: The Willaura Healthcare Outdoor Market.

PATRICIA HINCHEY CENTRE AUXILIARY CHARITY GOLF DAY Markets are becoming very popular, and the Patricia 66 golfers participated in another excellent, if wet, Hinchey Centre market is no exception. More than $2,000 charity golf day. $2,600 was raised which this was raised at its annual market with auxiliary members and year has been donated to the Dental department clients busy baking a range of delicious cakes and biscuits to purchase endodontic instrumentation and as well as their famous sauces and relishes. Funds raised obturation equipment. This will help save and go towards supporting outings to enrich the lives of clients retain patients’ natural teeth. and the purchase of equipment and lifestyle activities.

ARARAT BREAST CANCER SUPPORT GROUP The Health Service was delighted to acknowledge the support from the Ararat Breast Cancer Support Group by unveiling a plaque to them in the Oncology Department. The money raised comes from donations from a number of community groups within the district including the Buangor Community Sports Centre who this year raised $3,200 and Grease Monkeys, Seniors Club, TOWN Club, Ararat Ladies’ Bike Group, Deb’s Diner, Y’s Menettes and the Ararat Woodies. The support group purchases specific items to ensure that we are able to continue to provide high quality care to cancer patients across the region.

Neil Brehaut Ararat Rockers also donated $800 to the Oncology Department, proceeds from their annual rock and roll ball.

ARK TOY & ACTIVITY CENTRE AUXILIARY The Centre is a lending service for children and families with special needs, senior citizens, mothers and babies’ groups.

The $2,000 raised from the centre’s annual film day will be used to purchase a wide range of toys and equipment that provide enjoyment, stimulation and support to the needs of members. Lorraine Keith, Kaye Fox, Robyn Vowels, Dr Craig Carden, Bev Walker, Nick Bush, Gwen Haddow and Lynne Wilson.

2016-17 ANNUAL REPORT 55 DIVISIONAL REPORT FINANCIAL SERVICES

OUR GOAL To provide sound fiscal advice and develop processes by which the Board and the Executive can deliver, within the Health Service’s financial limitations, a strategic direction that aligns with the Government’s financial priorities to ensure that our Health Service retains its robust position within the community.

Image: Nikki Berg, Teresa Townsend and Clare Dousset

56 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL The commitment of all staff to identify efficiencies while still delivering quality safe care has had a significant impact on meeting our budget responsibilities. .

FINANCIAL OBJECTIVES AND PERFORMANCE Capacity building and collaboration in service delivery. Government grants provide a significant In what proved to be a significantly tighter financial year, source of funding for East Grampians Health Service continued to deliver more capital investment, health care services to the community and the region in 2017. which is complimented by community fundraising and donations, plus the creation of operating This year’s operating surplus of $6,000 came on the back surpluses. of significantly increased theatre activity that delivered greater access to services for people within our region.

Total Operating revenue from all sources totalled $35.43M for the Health Service and our Total Operating Expenditure was $35.37M. The Health Service ensures that it can meet its financial obligations by maintaining an adequate current asset East Grampians Health Service is committed to maintaining ratio. At 30 June 2017, the and developing its buildings and equipment so that users of consolidated quick asset ratio the service and clinicians alike have access to contemporary, was 1.13 and had combined purpose-built facilities. This year saw $1.52M invested in net available cash holdings of updating our assets and the commitment to an additional $3.888M. $4.5M of capital works to be completed in the next year.

Comparative Financial Results for the Past Five Financial years (consolidated)

2017 2016 2015 2014 2013 FOR THE PAST FIVE FINANCIAL YEARS $000 $000 $000 $000 $000

Total Revenue 37,787 35,631 32,423 32,156 30,881

Total Expenses 38,752 36,719 34,122 33,729 31,880

Other Operating flows included in the Net result (2) (185) NA NA NA

Net Result for the Year (967) (1,273) (1,699) (1,573) (999)

Operating Result 6 679 63 89 63

Total Assets 49,731 51,122 49,813 51,629 45,632

Total Liabilities 10,119 11,370 8,715 8,832 9,982

Net Assets 38,796 39,752 41,099 42,797 35,650

Total Equity 38,796 39,752 41,099 42,797 35,650

The Operating result is the result for which the hospital is monitored in its Statement of Priorities, also referred to as the Net result before capital and specific items.

2016-17 ANNUAL REPORT 57 DIVISIONAL REPORT MEDICAL SERVICES

OUR GOAL To deliver to the community the most comprehensive medical care by appropriately qualified doctors and to support the training of medical interns.

Image: Jane Smith and Rachael Pennycad

58 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL Rural medical centres and health services that participate in the rotational training and education of medical interns.

OUR MEDICAL COLLEAGUES CREDENTIALING Our Health Service continues to enjoy a close working There has probably never been a more important time to relationship with the Doctors of Ararat Medical Centre assess and evaluate all policies and procedures relating (AMC) and Tristar. We rely heavily on our local Doctors to to credentialing, privileging and scope of practice. care for patients in hospital, the Urgent Care Centre and our Aged Care facilities, as well as providing our Obstetric Along with Targeting Zero, the review of and Anaesthetic services. hospital safety and quality assurance in Victoria by Dr Stephen Duckett another useful document has been the Department of Health’s Achieved Credentialing and Defining the Scope of Ararat Medical Centre recipient of Royal Australian Clinical Practice for Medical Practitioners – a College of General Practitioners 2016 General Practice policy handbook. of the Year. The award recognises the practice’s approach to patient health and wellbeing, exemplary Members of our community warrant assurance that service and quality of care provided to patients, health medical staff are appropriately qualified. Credentialing promotion initiatives and the practice’s involvement in is a formal recognition that a medical practitioner is both general practice teaching. As an Organisation we can qualified and competent to deliver care. Privileging, or attest to AMC’s commitment to assisting in the training scope of practice, outlines the clinical services medical of the next generation of rural Doctors. Congratulations. practitioners and Visiting Medical Officers can provide. Annually medical staff, and indeed all health practitioners, have to renew their registration and this is then sited We continue to enjoy an excellent relationship with Visiting by the Director of Medical Services and the other Specialists, many of whom travel regularly from Ballarat to appropriate Directors. provide a range of specialty services. This makes access The Clinical Governance sub-committee of the Board to such services so much easier for our community. oversees the credentialing process, which has well We thank Orthopaedic Surgeon Mr John Patrikios for his defined principles to ensure our community will always be many years service to the Ararat community and extend assured of quality, safe health care. In order to maintain our best wishes for him in the next phase of his career. our community’s confidence there is an expectation that medical practitioners will annually undertake professional development. We support all health practitioners in these GRAMPIANS MEDICAL TRAINING PROGRAM endeavours. As a Health Service our responsibility is Our continuing involvement with Maryborough District to ensure that we provide well maintained, high quality Health Service and St John of God Ballarat Hospital, equipment and facilities in which our medical practitioners has allowed us to expand the Grampians Medical can work. Training Program, which prepares junior Doctors to enter We understand only too well the significance of providing subsequent specialist training. safe and high quality health care. As our region expands This year we welcomed our third intake of medical interns there will be greater community expectations on health who are participating in the Program. Based in Ararat the services and our clinical governance systems will be ready eight interns also experience working in rural and regional to meet these demands. health services at St John of God Ballarat Hospital and Maryborough District Health Service as well as Nightingale PARTNERSHIPS Clinic and Clarendon Medical Centre both in Maryborough and, for the first time this year, Ararat Medical Centre. The We look forward to developing further our relationship training program has given interns greater access and with Ballarat Health Services as well as other health understanding to a broader range of opportunities that services and hospitals across western Victoria. This they rarely get in metro hospitals. We sincerely hope that will further enhance the range of services available the welcome and positive experience the interns have across the region and develop a region-wide approach received will encourage them to consider working for rural to governance issues. We also have an established health services. relationship with Maryborough District Health Service and St John of God Ballarat Hospital in the placement of Doctors during their participation in the Grampians Medical Training Program.

2016-17 ANNUAL REPORT 59 DIVISIONAL REPORT SUPPORT SERVICES

OUR GOAL To maintain standards above Government and community expectations in cleaning and maintenance of buildings, to continue to monitor our environmental footprint and to encourage healthy eating through the provision of well-planned nutritious catering options.

Image: Ashley Leggett

60 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SUPPORTING OUR GOAL A team of staff who are committed to achieving high standards in their level of service delivery throughout the Organisation. They enjoy the interaction with people they meet and the challenge of problem solving to create better outcomes for residents, patients and clients as well as staff.

Of all the departments Support Services is the one that works across the whole Organisation. Other departments depend upon its attention to detail in cleaning, catering, the ability to monitor and maintain ageing buildings and its vision to create and meet an environmentally sustainable workplace. Support Services staff have found it most rewarding to be involved in the implementation of the Montessori Model of Care at 70 Lowe Street. Last year the maintenance team created “stable” doors for residents, providing security to their bedrooms but also the ability to open a “window” to the comings and goings of a wider community. We also created an outdoor living experience in the garden introducing pathways, a bus shelter and mail box. This year catering and support staff have been involved in the daily buffet breakfast, which has been really well received. Our staff are integral to forming meaningful relationships between residents and staff, creating interest and maintaining life stories.

The vigilance of cleaning staff has again been rewarded this year, with excellent results from the external cleaning audit, with commendations from the external auditors.

Achieved FUNCTIONAL RISK REQUIRED COMPLIANCE Overall the standard of cleaning services CATEGORY SCORE provided is of a very high standard Very High Risk 99% 90% Cleaning takes a multidisciplinary approach, to ensure that all elements including patient care equipment are attended to High Risk 99% 85% Congratulations by the auditors to the team on a Moderate Risk 98.6% (99%) 85% terrific result. To achieve such a high standard is no easy task. Overall Hospital 98.6% (99%) 85% Score

INTERNAL AUDIT PROCESS COMPLIANT

The audits are being completed as per teh schedule with rectification of failed elements ✓

As an Organisation we are very aware of the Burden of Disease, in particular the impact of overweight and obesity as a risk factor for chronic conditions. Last year we were leaders amongst health services within our region by ceasing to sell sugar-laden soft drinks. The only drinks available at Café Pyrenees, or through vending machines are water, coffee and tea. We have continued with this philosophy and provide a variety of healthy options for external clients, the Education and Conference Centre Roth Soth and of course at our popular Pyrenees House.

2016-17 ANNUAL REPORT 61 In collaboration with a dietitian, our chef provides a range of healthy menus for our patients, residents and clients that reflect the cultural diversity of our community. On a regular basis the meals are assessed to ensure we continue to meet their expectations.

Melissa O’Loughlan

The Health Service is participating in a pilot OTHER MAINTENANCE WORK INCLUDED: program with Hopkins Correctional Centre, Ararat located 8 kilometres out of Ararat. • Refurbishment of Dorevitch Pathology To facilitate prisoners receiving inpatient (reception/waiting area) care, refurbishment work has been carried • Additional swipe card access out in Urgent Care and the Inpatient Unit in • Painting throughout ground floor and Inpatient Unit order to accommodate overnight stays in • Carpet tile replacement throughout ground floor and secure facilities. Inpatient Unit • Community Nursing Service office fit out • Building Management System (heating/cooling) • Refurbishment of old Pharmacy for offices • Refurbishment of heritage building for offices/meeting room • Landscaping of grounds and gardens

Willaura • Refurbishment of Parkland House • Landscaping of grounds and gardens • Maintenance and painting

62 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY As with other departments we support our staff in ongoing education, whether they are just starting out as an apprentice or are undertaking further training to enhance their skills that improve the environment and quality of care throughout the Organisation.

Achieved Apprenticeship Anthony McKenna, 2nd year Certificate III in Hospitality – Commercial Cookery Upskilling Ashley Leggett – Certificate IV in Building and Construction

Dayle Smith – Certificate IV in Training and Anthony McKenna and Michael Kelly Assessment

We have again been providing employment opportunities Control Coordinator Linden Marland has worked for clients from disability service agencies, who gain hard on educating and encouraging staff to embrace both life skills and work experience in cleaning, catering, environmental management and sustainability as a basis maintenance and Café Pyrenees. Our staff too benefit for day-to-day work practices. from this interaction and it has been a rewarding Initiatives in place include: experience for everyone involved. This year we have been working on a school-based apprenticeship course • Solar hot water at 70 Lowe Street in cookery with Marian College. This is an introductory and Willaura Healthcare course with students coming to the Health Service to learn • Rainwater collection used for gardens and the fundamentals of cooking. washing fleet cars • LED lights replacing old globes, as they fail Achieved • All lights in Dialysis are automatically switched off at 6pm. This feature will be installed in all future 13 clients from Western District Employment Agency renovations/constructions (WDEA) employed during the year • Automatic computer “sleep mode” when not in use 1 student enrolled in school-based apprenticeship • Reusing furniture and construction materials course where possible • Reducing photocopy paper by using swipe We work closely with Ararat Rural City on HACC funded cards to print programs installing aids for people living in the community • In the process of cessation of paper-based to assist in their rehabilitation. We anticipate that with the time-sheets introduction of Home Care Packages our maintenance teams will continue to work with service providers in • Recycling installing aids to assist clients in their own homes. And staff are being encouraged to improve energy A degree of trust has to be entered into when our consumption through: maintenance team works for clients on Home Care • Turning off unnecessary lights in toilets, Packages. Staff all have mandatory police checks when storerooms and offices first employed at the Health Service so clients can feel confident with our maintenance team who come to • Turning off lights at the end of the day install aids, make alterations and undertake general • Reporting leaking taps or toilets to maintenance maintenance including garden work. The feedback we • Car-pooling fleet cars where possible. receive from clients is that they enjoy these visits. An external review undertaken this year of clinical waste A Commonwealth Department of Energy and Efficiency indicated a reduction in theatre waste, thereby reducing Climate Change report indicated that of ten large costs. However, the local recycler does not undertake commercial building types assessed, hospitals were specialist recycling. We are currently investigating ways in the second most energy-intensive building types, which this reduced waste can be recycled so that it does with universities as the most intensive. Infection not have to go to landfill.

2016-17 ANNUAL REPORT 63 CORPORATE GOVERNANCE

Responsible Ministers BOARD COMMITTEES and Officers for the As at 30 June 2017 • Audit and Risk reporting period President: Matthew Wood • Capital Development 1 July 2016 – 30 June 2016 Vice President: Heather Fleming • Clinical Consultative • Clinical Governance STATE Treasurer: Russell Barker • Community Consultative • Hon Jill Hennessy MLA Board Members: Bill Braithwaite Minister for Health and Minister • Grampians Health Alliance Fiona Cochrane for Ambulance Services • Grampians Region Building Member for Altona Don Cole Board Capacity Advisory • Hon Martin Foley MLA Nancy Panter Minister for Mental Health Annie Rivett AUDIT & RISK COMMITTEE Member for Albert Park • Louise Staley MLA Chief Executive PURPOSE: To oversee and Member for Ripon Nick Bush advise the Board on matters of accountability and internal Bankers DEPARTMENT OF HEALTH control affecting the operations Commonwealth Bank of Australia & HUMAN SERVICES of East Grampians Health • Kym Peake Solicitors Service. Secretary Health Legal Board Membership: Auditors GRAMPIANS REGION • Nancy Panter Coffey Hunt Chartered / WEST DIVISION HEALTH Accountants • Russell Barker • Jenny Tunbridge Community Membership Manager, Performance, Internal Auditors Quality and Governance HLB Mann Judd • Lucy Tribe • Ken Weldin • Jay Petty

BOARD The Board comprises dynamic members of our community who have demonstrated a commitment to good corporate and clinical governance, strategic planning and business acumen all of which will benefit our Health Service. They are appointed by the Governor-in Council on the advice of the Minister for Health, usually for a period of three years, with the option of applying for reappointment. The powers and functions of the Board are regulated by the Health Services Act 1988 and the By-Laws made in accordance with the Act. Members of the Board receive no remuneration, but can be reimbursed for expenses incurred when undertaking Board member duties.

64 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY OUR BOARD

PRESIDENT BOARD DIRECTOR Matthew Wood Fiona Cochrane BPharm Manager of Risk, Emergency Services Pharmacist and Local Laws, Ararat Rural City Council Board Member since 01.07.14 Board Member since 01.07.11 Term of Appointment Term of Appointment 01.07.14 – 30.06.17 01.07.15 – 30.06.18 Committee Membership Committee Membership Clinical Governance Building for the Future Foundation Audit & Risk Grampians Health Alliance Grampians Region Building Board Capacity Advisory BOARD DIRECTOR Don Cole BEng, MBA VICE PRESIDENT Director of Assets, Finances and Corporate Services, Ararat Rural Heather Fleming BEd(Sec) City Council Farmer Board Member since 01.07.13 Board Member since 01.07.08 Term of Appointment Term of Appointment 01.07.16 – 30.06.19 01.07.16 – 30.06.19 Committee Membership Committee Membership Clinical Consultative Community Consultative Building for the Future Foundation

BOARD DIRECTOR TREASURER Nancy Panter BA Russell Barker BBus(Acc), MIT Owner SubRosa Winery Business Manager, Marian College and Marketing Consultant Board Member since 01.07.13 Board Member since 01.07.14 Term of Appointment Term of Appointment 01.07.15 – 30.06.18 01.07.14 – 30.06.17 Committee Membership Committee Membership Audit & Risk Audit & Risk Capital Development Community Consultative

BOARD DIRECTOR BOARD DIRECTOR Bill Braithwaite DiP CE MBA Annie Rivett RN, DiP E MBA Owner/Director Bratf Olives Manager Central Allocations Unit, Board Member since 01.07.13 Ballarat Health Services Term of Appointment Board Member since 01.07.15 01.07.15 – 30.06.18 Term of Appointment Committee Membership 01.07.15 – 30.06.17 Capital Development Committee Membership Clinical Consultative Clinical Governance

2016-17 ANNUAL REPORT 65 EXECUTIVE TEAM

CHIEF EXECUTIVE: Nick Bush MHA, Grad Dip HSc(Admin), Grad Cert Crit Care, Dip HSc(Nsg), GAICD Appointed: 2011 The Chief Executive takes responsibility to lead an effective workforce that delivers appropriate health care within the parameters of government policy, financial responsibility and demographic sensitivity. The Chief Executive works with the community to explore ways in which our Health Service continues to deliver services and programs to the diverse rural community of Western Victoria. The Chief Executive also has line management for Business Support including Compliments and Concerns, Human Resources and Community Liaison.

DIRECTOR MEDICAL SERVICES: DIRECTOR DEVELOPMENT Eric Kennelly & IMPROVEMENT: Mario Santilli BSc, MBBS, DipRACOG, AFRACMA MBA, RPN, GradCertBusMan, GradDipPsychNsg Appointed: 2011 The Director of Medical Services (DMS) Appointed: 2010 has a medical leadership role within The Director of Development & the Health Service, is responsible for Improvement has responsibility to integrate credentialing and privileging of all Visiting Risk Management across the Organisation, Medical Officers to define their scope to ensure that all Standards for of practice and is also responsible for Accreditation are met by providing safe and aspects of the Health Services’ Medico quality care. The Director also investigates legal work. He liaises closely with his ways in which the Health Service can reflect colleagues from other Grampians Region Government priorities strategically. The health services to ensure that clinical Director oversees research, information practice throughout the region reflects technology, education and management of current best practice in rural health care. interns. The Director works closely with staff The DMS contributes to the quality service to enhance their knowledge of quality, risk provision. processes and systems.

DIRECTOR OF FINANCE: DIRECTOR SUPPORT Tony Roberts SERVICES: Stuart Kerr BCom, Grad Dip ICAA PIHHC, Dip Bus Appointed: 2015 Appointed: 2007 The Director of Finance provides The Director Support Services is strategic financial advice and manages responsible for Catering, Café Pyrenees/ the Health Service’s finances within Functions, Environmental/Cleaning agreed parameters. He has financial and and Linen Services, Fire & Emergency/ operational responsibility for Budget and Security, Maintenance (including Finance, General Accounting, Payroll, Preventative Maintenance Programs, Inpatient and Sundry Billing, Reception Building Maintenance, Project works and and Supply. The Director of Finance Compliance Reporting), Management supports the development of finance of Contractors Agreements and Fleet management skills and expertise with Management. departmental heads.

DIRECTOR OF COMMUNITY DIRECTOR OF CLINICAL SERVICES: Debra Schulz SERVICES: Peter Armstrong PhysioD MGeron GradDipBus RN, RPN, BNsg, GradDipPsychNsg, BAppSci(Physio) MBA, Cert IV T&A Appointed: 2015 Appointed: 2013 The Director of Community Services is The Director of Clinical Services is responsible for the services provided responsible for the management of through the Community Health Centre, the Acute Inpatient Unit, Urgent Care Community Nursing and Patricia Centre, Oncology Services, Perioperative Hinchey Centre. Services, which includes Day Procedure, Pre Admission and Dialysis, Medical Imaging, Aged Care, Willaura Health Care, Pathology Services, and Infection Control.

66 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY SENIOR STAFF (as at 30 June 2017)

EXECUTIVE SERVICES SUPPORT SERVICES Chief Executive (Freedom of Information Principal Officer) Director Nick Bush MHA, Grad Dip H Science (Admin) Grad Cert Stuart Kerr PIHHC, DipBus Crit Care, Dip of H Sc (Nursing), GAICD Executive Chef/Co-ordinator Executive Assistant to Chief Executive Michael Kelly Cert III in Commercial Cookery, DipBus, (Complaints Officer) Cert IV in Workplace Training and Assessment Jo Summers AdvDipMgmt Maintenance Human Resources Manager Ann Grierson AdvDipMgmt Ros BloomfieldCert IV in Employment Services Environmental Services, Fire & Emergency Co-ordinator Community Liaison Officer Dayle Smith Jodie Holwell CLINICAL SERVICES FINANCIAL SERVICES Director Director Peter Armstrong RN, RPN, BNsg, GradDipPsychNsg, Tony Roberts BCom, Grad Dip ICAA MBA (Child Safety Officer)

Chief Medical Imaging Technologist DEVELOPMENT AND IMPROVEMENT Craig Newson BAppSci Medical Imaging, Director GradDipAppSciMedical Ultrasound Mario Santilli RPN, Grad Cert Bus Man, Grad Dip Psych Nsg, MBA Manager Acute Services Lorine Paterson RN, DipBus Manager Development & Improvement Sarah Woodburn B AppSc (Pod), Grad Dip HSci (Ex.Rehab), Manager Perioperative Services Grad Cert Mgmt, MBM Jane Smith RN, BN, GradDipNsg(Periop), Cert Infection Control and Sterilisation Manager Education Heather Phillips RN, Dip Applied Science – Nursing, Manager Health Information Critical Care Certificate, Cert IV in Training and Nicki Blackie BMRA Assessment Manager 70 Lowe Street Information Technology Consultant Tanya Haslett RN, ACFI Assessor Ian Seaman DipLG Manager Garden View Court Maree Fraser RN, AdvDipMan(Human Resources) COMMUNITY SERVICES Director Manager Willaura Healthcare Dr Debra Schulz PhysioD MGeron GradDipBus Christine McArthur RN, CNA BAppSci(Physio) Pharmacist Manager Community Nursing - including District Olga Karia BPharm(Hons)(Russia), PostGradCertClin Nursing and Palliative Care Pharm(UK), MSHP, MPS Jane Bourman RN, GradCertHealth Infection Control Co-ordinator Manager Patricia Hinchey Day Centre Linden Marland B Nsg, RN, Cert Steril & Inf Cont Jacinta Harman EN End, DipBusMan

Senior Dentist Dominic Barlow B Dental Services

Chief Physiotherapist Christine Perry BAppSc (Physio), GradCertMgmt

2016-17 ANNUAL REPORT 67 MEDICAL STAFF (as at 30 June 2017)

DIRECTOR OF CARDIOLOGIST OPHTHALMIC SURGEON MEDICAL SERVICES Dr Christopher Hengel Dr David Francis MBBS, FRANZCO MBBS, FRACP Dr Eric Kennelly BSc MB BS Dr David McKnight DipRACOG, AFRACMA Dr Rodney Reddy MB ChB, FRACP MBBS, FRANZCO Dr Trent Roydhouse VISITING MEDICAL STAFF EAR, NOSE & MBBS, FRANZCO Dr Swemtha Bandaru (Registrar) THROAT SURGEON Dr Michael Toohey Dr David Breed MBBS Mr Niall McConchie MBBS, FRACS MBBS, FRANZCO Dr Michael Connellan MBBS, DRANZCOG, FRACGP, FACRRM GENERAL SURGEONS ORTHOPAEDIC SURGEON Dr Allison Choong MBBS Dr Ruth Bollard Mr John Patrikios MBBS, MS, FRACS MBChB, FRCS, FRACS Dr Mark Deary MBBS, (Zimbabwe) Mr Scott Mason MBBS, FRACS Dr Michael Condous MBBS, FRACS Dr Prasad Fonseka MBBS (Sri Lanka) Dr Thomas Fisher PALLIATIVE CARE Dr Adam Ghazal MBBS (Syria) MBBS (Melb) FRACS Dr Penny Cotton MBBS, FACHPM Dr Amanda Gibbons Mr Abrar Maqbool MBBS, FRACS Dr Greg Mewett MBBS, DRCOG, Dr Megan Helper Mr Ahmed Naqeeb MBBS, FRACS FRACGP, FACHPM Dr Allan Huynh (Registrar) MBBS Dr Kontoku Shimokawa MBBS, Dr Edgardo Lou MD (Philippines) FRACS RADIOLOGISTS Dr Luhong Min (Registrar) MBBS Dr Damien Cleeve MBBS, FRANZCR GYNAECOLOGIST Dr Derek Pope MBBS, DRANZCOG, Dr John Eng MBBS, FRANZCR FACRRM Dr Michael Bardsley MBBS, Dr Robert Jarvis MBBS, FRANZCR DRANZCOG, FRACGP, FRANZCOG Dr Pieter Pretorius MBChB (Pretoria) Dr Sarah Skinner MBBS FRANZCR M.Med (Family Medicine) FRACGP Dr Michael Carter MBBS, FRANZCOG Dr Jill Wilkie MBBS RCR Dr Emily Price MBBS Dr Katrina Guerin Dr Julius Tamangani Dr Novreen Rasool MBBS MBBS, DRANZCOG MBChB (Hons), MSc, FRCR Dr Kylie Rix Dr Carolyn Wilde UROLOGISTS Dr Carolyn Sebastian (Registrar) MBBS, FRANZCOG MBBS Dr Lydia Johns Putra MBBS, FRACS Dr Eric Van Opstal MBBS, DGM, NEPHROLOGY D.Pall Med FRACGP, DRANZCOG, Dr John Richmond MBBS, FRACP VISITING DENTAL STAFF FACRRM Dr Charles Reid BDSc (Liverpool) Dr Chee Sheng Wong MBBS, ONCOLOGIST & Dr Yea Lee Shu BDS DRANZCOG (Advanced), FRACGP HAEMATOLOGIST Ms Kaylene Jackson Dr Craig Carden MBBS, FRACP ANAESTHETIST (Dental Therapist) Dr Neil Provis-Vincent MBBS, BMedSci.(Hons), FACRRM

68 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY LEGISLATIVE COMPLIANCE

EAST GRAMPIANS HEALTH SERVICE COMPLIES WITH BOTH STATUTORY AND FINANCIAL DISCLOSURES UNDER ALL RELEVANT ACTS AND LEGISLATION.

ATTESTATION FOR COMPLIANCE WITH BUILDING ACT 1993 THE MINISTERIAL STANDING DIRECTION The Health Service continues to comply with the Building 3.7.1– RISK MANAGEMENT FRAMEWORK Act 1993 and Standards for Publicly Owned Buildings AND PROCESSES November 1994, as under FRD22F (Section 6.17b) I, Nick Bush certify that East Grampians Health Service Members of the Capital Development Committee are has complied with Ministerial Direction 3.7.1 – Risk responsible for providing high-level management Management Framework and Processes. The East oversight of large Capital projects that fall outside the Grampians Health Service Audit Committee has delegation of the Chief Executive. The committee provides verified this. direction and support to project managers and related staff to support the successful delivery of East Grampians Health Service Capital Projects. All Contractors engaged on works for the Health Service are required to show evidence of current registration and Nick Bush other relevant documentation such as insurances and Accountable Officer public liability. This is controlled through an electronic East Grampians Health Service data base program called iAsset for the control of Contract Management. 24.8.2017 The following works and maintenance were undertaken during the year to ensure that the Health Service conforms with the relevant Standards. ATTESTATION ON COMPLIANCE WITH Building Works 3 HEALTH PURCHASING VICTORIA (HPV) HEALTH PURCHASING POLICIES IS Building certified for approval 2 REQUIRED Works in construction and subject of 1 I, Nick Bush certify that East Grampians Health Service has mandatory inspection put in place appropriate internal controls and processes to Occupancy Permits issued 2 ensure that it has complied with all requirements set out in the HPV Health Purchasing Policies including mandatory Maintenance HPV collective agreements as required by the Health Services Act 1988 (Vic) and has critically reviewed these Notices issued for rectification of substandard Nil controls and processes during the year. buildings requiring urgent attention Involving major expenditure and urgent attention Nil Building Condition Assessment Yes Essential Services Maintenance Yes

Nick Bush Accountable Officer East Grampians Health Service 24.8.2017

2016-17 ANNUAL REPORT 69 LEGISLATIVE COMPLIANCE (continued)

CARERS RECOGNITION ACT 2012 EX-GRATIA PAYMENTS The Health Service values carers and actively promotes There were no Ex-Gratia Expenses this year. recognition of this vital role both in the community and the Health Service. Policies have been developed to ensure FEES employees understand their obligations in relation to this Act, and carry out their duties to reflect the care relationship Most fees charged by the Health Service are regulated by the principles in developing, providing or evaluating support and Commonwealth Government and the Victorian Government’s assistance for persons in care relationship. Department of Health. There were no changes to fees or charges during the year. CAR PARKING FINANCIAL MANAGEMENT ACT 1994 (FMA) East Grampians Health Service is not required to comply with the Department of Health and Human Services hospital In accordance with the Direction of the Minister for Finance Circular on car parking fees as it does not operate any fee (Part 9.1.3 iv) information requirements have been prepared paying car park space. Additional car parking space, facing and are available to the relevant Minister, Members of Lowe Street, was opened up in the last financial year. Parliament and the public on request to the Chief Executive. The Board of East Grampians Health Service is confident that it has complied with its obligations as established in the FMA. COMPETITIVE NEUTRALITY All competitive neutrality requirements comply with the FREEDOM OF INFORMATION National Competition Policy and have been made in East Grampians Health Service is an agency subject to accordance with Government costing policies for public the Freedom of Information Act 1982. As required under hospitals. The Act, East Grampians Health Service has nominated the Chief Executive, Nick Bush, as the Principal Officer and CONSULTANCIES Health Information Manager, Nicki Blackie as the Officer. The Details of consultancies (under $10,000) legislated application fee for the 2016/17 financial year was $27.90 per application, and the processing fee included a In 2016-17, there were no consultancies where the total fees search fee of $20 and a photocopying fee of 20 cents per payable to the consultants were less than $10,000. A4 page. All reports requested from the Director of Medical Services, Eric Kennelly, incurred a fee of $100. Exemptions Details of consultancies (valued at $10,000 or greater) applied that related to privacy of patients and third parties. In 2016-17, there were no consultancies where the total fees In 2016/17 East Grampians Health Service received 32 payable to the consultants were $10,000 or greater. requests, 31 of which were processed and granted in full.

DATAVIC ACCESS POLICY REQUESTS East Grampians Health Service complies with the DataVic Access Policy, issued by the Victorian Government in 2012 2016/17 2015/16 2014/15 2013/14 and supplies data to the Department of Health and Human 32 46 48 52 Services as applicable.

DISCLOSURE OF ICT EXPENDITURE The total ICT expenditure incurred during 2016/17 is $1,850 with the details shown below.

Business-As- Non-Business Operational Capital Usual As Usual expenditure expenditure (BAU) ICT (Non-BAU) ICT (excluding (excluding expenditure expenditure GST) GST) ($ ‘000) ($ ‘000) ($ ‘000) ($ ‘000)

$737 $1,113 $755 $358

70 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY INFORMATION PRIVACY ACT 2000 OCCUPATIONAL VIOLENCE STATISTICS AND HEALTH RECORDS ACT 2001 1. Workcover accepted claims with an occupational violence cause per 100 FTE = 0 Privacy Legislation commenced July 1 2002 and comprises 2. Number of accepted Workcover claims with lost time injury with an occupational violence cause • Health Records Act 2001 per 1,000,000 hours worked = 0. • Information Privacy Act 2000 3. Number of occupational violence incidents reported = 30 Information Privacy Act 2001 covers the privacy principles of: 4. Number of occupational violence incidents • The collection of health information reported per 100 FTE = 10.86 • Use and disclosure of health information 5. Percentage of occupational violence incidents • Data quality resulting in a staff injury, illness or condition = 6% • Data security and retention of information • Openness PROTECTED DISCLOSURE ACT 2012 • Access to health information Allegations of improper conduct by employees or the Board of the Health Service is very serious. Allegations can include Policies ensure strict adherence to the Act and that the corrupt conduct, substantial mismanagement of public personal health information of patients, residents and clients resources or conduct involving substantial risk to public remains confidential and secure. The information will only be health or safety. used by non-service staff with the consent of the consumer and is accessible by the consumer under Freedom of The Protected Disclosure Act 2012 is designed to protect Information guidelines. people who disclose information about serious wrongdoings within the Victorian Public Sector and to provide a framework Patients, families, residents and clients are informed of their for the investigation of these matters. rights regarding their health information on first contact with the Health Service. Disclosures of improper conduct by East Grampians Health Service or its employees may be made to: The Chief Executive Officer is the designated Privacy Officer The Protected Disclosure Co-ordinator and manages all enquiries relating to these two Acts. Nick Bush 63 written requests were received in 2016/17. [email protected] or OCCUPATIONAL HEALTH AND SAFETY 2004 The Ombudsman Victoria The Occupational Health and Safety Act 2004 and Level 22, 459 Collins Street, Melbourne, 3000 its Schedules of 2007 guide the Health Service in its Tel: 9613 6222 Toll free: 1800 806 314 occupational health and safety responsibilities. Designated work groups operate with trained representatives who In 2017/17 there were no disclosures or notifications of consult on matters relating to OH&S. The OH&S committee disclosure relevant to the Protected Disclosure Act received. develops strategic thinking in relation to the safety and welfare of workers. Lead and lag indicators are established REGISTRATION and quarterly reported to the Board. These indicators include the participation of staff in training; the number of All clinical practitioners engaged by the Health Service incidents and the types of incidents and how they have been maintained their registered status throughout the year. managed; the numbers of days lost to injury; the cost of injury and measurement of the Health Service’s performance SAFE PATIENT CARE ACT 2015 against industry Standards. The Health Service participates This Act was introduced to enshrine in law the minimum in WorkCover inspections and there were no Provisional number of Nurses and Midwives to care for patients. At East Improvement Notice was issued in 2016/17. Grampians Health Service this Act has ensured we have the Initiatives undertaken during the last financial flexibility to engage Nurses and Midwives at appropriate year include: staffing levels in line with the number of patients in our care. The Health Service has no matters to report in relation to its 1) Increase in the number of staff completing Management obligations under Section 40 of this Act. of Clinical Aggression training – now a mandatory training requirement for all employees VICTORIAN INDUSTRY 2) Improved CCTV installed (higher resolution) PARTICIPATION POLICY 3) Increase in the number of swipe card access to provide East Grampians Health Service complies with the better security to critical areas with the ability to provide requirements of the Victorian Industry Participation Policy lockdown, as needed. Act 2003 and wherever practicable and fiscally responsible will make every endeavour to purchase locally. There were no reportable disclosures during the last financial year. The Health Service has a robust policy to encourage the training and employment of members of the local community.

2016-17 ANNUAL REPORT 71 DISCLOSURE INDEX

The Annual Report of East Grampians Health Service is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements.

Legislation Requirement Page Legislation Requirement Page Report of Operations - FRD Guidance Legislation Charter and Purpose Freedom of Information Act 1982 70 FRD 22H Manner of establishment and the relevant Ministers 03 Protected Disclosure Act 2012 71 FRD 22H Purpose, functions, powers and duties 05 Carers Recognition Act 2012 70 FRD 22H Key initiatives and key achievements 08-14 Building Act 1993 71 FRD 22H Nature and range of services provided 05 Financial Management Act 1994 69 Victorian Industry Participation Policy Act 2003 70 Management and Structure Safe Patient Care Act 2015 71 FRD 22H Organisational structure

Financial and Other Information Additional information available on request FRD 10A Disclosure index 72 Consistent with FRD 22H (Section 5.19) East Grampians Health Service FRD 11A Disclosure of ex gratia expenses 70 confirms that subject to the provisions of the Freedom of Information Act, FRD 21C Responsible person and executive officer disclosures 23, FR the following information is retained by the Accountable Officer: FRD 22H Application and operation of the 71 a) Declarations of pecuniary interests have been duly completed by all Protected Disclosure Act 2012 relevant officers; FRD 22H Application and operation of the 70 b) Details of shares held by senior officers as nominee or held beneficially; Carers Recognition Act 2012 c) Details of publications produced by the entity about itself, and how these FRD 22H Application and operation of 70 can be obtained; Freedom of Information Act 1982 d) Details of changes in prices, fees, charges, rates and levies charged by FRD 22H Compliance with building and maintenance provisions 69 the Health Service; of Building Act 1993 e) Details of any major external reviews carried out on the Health Service; FRD 22H Details of consultancies over $10,000 70 FRD 22H Details of consultancies under $10,000 70 f) Details of major research and development activities undertaken by the Health Service that are not otherwise covered either in the Report of FRD 22H Employment and conduct principles Operations or in a document that contains the financial statements and FRD 22H Information and Communication Technology Expenditure 70 Report of Operations; FRD 22H Major changes or factors affecting performance 08-14 g) Details of overseas visits undertaken including a summary of the FRD 22H Occupational Health and Safety 12, 71 objectives and outcomes of each visit; FRD 22H Operational and budgetary objectives 16 h) Details of major promotional, public relations and marketing activities and performance against objectives undertaken by the Health Service to develop community awareness of the FRD 22H Summary of the entity’s environmental performance 14 Health Service and its services; FRD 22H Significant changes in financial position during the year 57 i) Details of assessments and measures undertaken to improve the FRD 22H Statement on National Competition Policy 70 occupational health and safety of employees; FRD 22H Subsequent events FR j) General statement on industrial relations within the Health Service and FRD 22H Summary of the financial results for the year 57 details of time lost through industrial accidents and disputes, which is not FRD 22H Additional information available on request 72 otherwise detailed in the Report of Operations; FRD 22H Workforce Data Disclosures including a statement on 51 k) A list of major committees sponsored by the Health Service, the purposes the application of employment and conduct principles of each committee and the extent to which those purposes have been FRD 25C Victorian Industry Participation Policy disclosures 71 achieved; FRD 110A Cash flow Statements FR l) Details of all consultancies and contractors including consultants/ FRD 112D Defined Benefit Superannuation Obligations FR contractors engaged, services provided, and expenditure committed for SD 5.2.3 Declaration in report of operations 23 each engagement. SD 3.7.1 Risk management framework and processes 12, 22

Other requirements under Standing Directions 5.2 SD 5.2.2 Declaration in financial statements FR SD 5.2.1(a) Compliance with Australian accounting standards FR and other authoritative pronouncements SD 5.2.1(a) Compliance with Ministerial Directions 70, FR

72 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY GLOSSARY

AACQA DRG PAG Australian Aged Care Quality Agency Diagnostic Related Groupings. Casemix Planned Activity Groups Funding is based upon throughput with ACAS each patient receiving a DRG based upon PALLIATIVE CARE Aged Care Assessment System Care for patients with a life limiting illness the complexity of the medical condition and their families ACFI EAP Aged Care Funding Instrument Employment Assistance Program PCP Primary Care Partnership ACHS EGHS Australian Council on Healthcare East Grampians Health Service PATIENT CENTRED CARE Standards Care designed specifically for the E-HEALTH individual ACCREDITATION The transfer of health resources and Official certification of approval. healthcare by electronic means RAC Refundable Accommodation Contribution Australian Standards EQUIP National Standards developed by the Accreditation Evaluation Quality RAD Standards Association of Australia/New Refundable Accommodation Deposit Improvement Program Zealand RTW FOI Return to Work Best Practice Freedom of Information Best Practice is a technique that leads STRATEGIC PLANNING to a desired result through experience, GP Commitment to set future plans research, review, reassessment and General Practitioner refinement performance of other groups STAKEHOLDERS HACC Customers (including patients, residents CACS&AA Home and Community Care funding for and clients), volunteers, all tiers of Commonwealth Aged Care Standards services and programs which are provided government, contractors, media and staff and Accreditation Agency in the home or the community. Three key initiatives have been implemented THE BOARD CARERS in order to refocus HACC services to a The Board of Governance East Grampians Carers of patient/clients more capacity-building, person centred Health Service CATCHMENT AREA approach Geographical area for which East THE DEPARTMENT ICT Victorian Department of Health and Grampians Health Service is responsible Information and Communications Human Services to provide services Technology THE ORGANISATION CLINICAL GOVERNANCE ICARE East Grampians Health Service The basis on which the Organisation Software program designed for use in is accountable to its stakeholders to aged care VCAL continually improve the quality of its Victorian Certificate of Applied Learning is service. This is achieved by creating INPATIENT a hands on option for students wishing to a culture of learning where staff are A person who is admitted to complete a senior secondary qualification provided with opportunities for education an acute bed to maximise their potential to deliver this VALUES quality service. Clinical excellence will be LED The principles and beliefs that guide Light Emitting Diode encouraged and will prosper East GrampiansHealth Service LPG CSSD VHIA Liquid Petroleum Gas Central Sterilising Supply Department. Victorian Hospitals Industrial Association NDIS CT SCANNER VICNISS Computed Tomography Scanner. National Disability Insurance Scheme Victorian Hospital Acquired Infection Surveillance System DHHS OHS The Department of Health and Human Occupational Health & Safety VMO Services Victoria. Visiting Medical Officer OUTCOME DIAS The result of a service provided WIES Diagnostic Imaging Accreditation Scheme Weighted Inlier Equivalent Separation. OUTPATIENT Every patient on discharge is allocated a A patient/client who is not admitted DRG which reflects the primary reason for to a bed the patient’s episode of care. The DRG has an assigned resource weight, which is related to the complexity of the patient’s medical condition on which the WIES is calculated

2016-17 ANNUAL REPORT 73 FINANCIAL REPORT

CONTENTS

Certification FR ii Victorian Auditor-General’s Report FR iii

Disclosure Index FRD 22H Relevant Ministers FR 39 FRD 21C Executive Officers Disclosures FR 40 FRD 21C Responsible Persons Disclosures FR 39 FRD 22H Subsequent Events FR 41

Financial Statements under Part 7A FMA Statement of changes in equity FR 4 Operating Statement FR 1 Balance Sheet FR 2 FRD110A Cash Flow Statement FR 3 FRD 112D Defined Benefits Superannuation Obligations FR 13

Other requirements under Standing Directions 5.2 SD 5.2.2 Declaration in financial statements FR ii SD 5.2.1(a) Compliance with Australian Accounting Standards FR 5 and other mandatory professional reporting Requirements SD 5.2.1(a) Compliance with Ministerial Directive 70 / FR ii

Financial Statements Income Statement FR 1 Balance Sheet FR 2 Statement of Recognised and Income And Expense FR 1 Cash Flow Statement FR 3 Notes to the financial statements FR 5 Accountable Officer, Chief Financial Officer FR ii and Responsible Body declaration sign off Rounding of Amounts FR 6 Responsible Bodies Declaration FR 39

FRi DEMONSTRATING LEADERSHIP IN PATIENT SAFETY 2016-17 FINANCIAL REPORT FRii

Independent Auditor’s Report

To the Board of East Grampians Health Service

Opinion I have audited the consolidated financial report of East Grampians Health Service (the health service) and its controlled entity (together the consolidated entity), which comprises the:

 consolidated entity and health service balance sheets as at 30 June 2017  consolidated entity and health service comprehensive operating statements for the year then ended  consolidated entity and health service statements of changes in equity for the year then ended  consolidated entity and health service cash flow statements for the year then ended  notes to the financial statements, including a summary of significant accounting policies  board member's, accountable officer's and chief finance & accounting officer's declaration. In my opinion, the financial report presents fairly, in all material respects, the financial positions of the consolidated entity and the health service as at 30 June 2017 and their financial performance and cash flows for the year then ended in accordance with the financial reporting requirements of Part 7 of the Financial Management Act 1994 and applicable Australian Accounting Standards.

Basis for I have conducted my audit in accordance with the Audit Act 1994 which incorporates the Australian Opinion Auditing Standards. My responsibilities under that Act and those standards are further described in the Auditor’s Responsibilities for the Audit of the Financial Report section of my report. My independence is established by the Constitution Act 1975. My staff and I are independent of the health service and the consolidated entity in accordance with the ethical requirements of the Accounting Professional and Ethical Standards Board’s APES 110 Code of Ethics for Professional Accountants (the Code) that are relevant to my audit of the financial report in Australia. My staff and I have also fulfilled our other ethical responsibilities in accordance with the Code. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

Board’s The Board of the health service is responsible for the preparation and fair presentation of the responsibilities financial report in accordance with Australian Accounting Standards and the Financial Management for the Act 1994, and for such internal control as the Board determines is necessary to enable the financial preparation and fair presentation of a financial report that is free from material misstatement, report whether due to fraud or error. In preparing the financial report, the Board is responsible for assessing the health service and the consolidated entity’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless it is inappropriate to do so.

FRiii DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Auditor’s As required by the Audit Act 1994, my responsibility is to express an opinion on the financial report responsibilities based on the audit. My objectives for the audit are to obtain reasonable assurance about whether for the audit the financial report as a whole is free from material misstatement, whether due to fraud or error, of the financial and to issue an auditor’s report that includes my opinion. Reasonable assurance is a high level of report assurance, but is not a guarantee that an audit conducted in accordance with the Australian Auditing Standards will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of this financial report. As part of an audit in accordance with the Australian Auditing Standards, I exercise professional judgement and maintain professional scepticism throughout the audit. I also:

 identify and assess the risks of material misstatement of the financial report, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.  obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the health service and the consolidated entity’s internal control  evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Board  conclude on the appropriateness of the Board's use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the health service and the consolidated entity’s ability to continue as a going concern. If I conclude that a material uncertainty exists, I am required to draw attention in my auditor’s report to the related disclosures in the financial report or, if such disclosures are inadequate, to modify my opinion. My conclusions are based on the audit evidence obtained up to the date of my auditor’s report. However, future events or conditions may cause the health service and the consolidated entity to cease to continue as a going concern.  evaluate the overall presentation, structure and content of the financial report, including the disclosures, and whether the financial report represents the underlying transactions and events in a manner that achieves fair presentation  obtain sufficient appropriate audit evidence regarding the financial information of the entities or business activities within the health service and consolidated entity to express an opinion on the financial report. I remain responsible for the direction, supervision and performance of the audit of the health service and the consolidated entity. I remain solely responsible for my audit opinion. I communicate with the Board regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that I identify during my audit.

MELBOURNE Ron Mak 25 August 2017 as delegate for the Auditor-General of Victoria

2

2016-17 FINANCIAL REPORT FRiv East Grampians Health Service Annual Report 2016/2017 EastEast Grampians Grampians Health Health Service Service ComprehensiveComprehensive Operating Operating Statement Statement ForFor the the Year Year Ended Ended 30 June 30 2017 June 2017

Parent Parent Consolidated Consolidated Note Entity Entity Entity Entity 2017 2016 2017 2016 $'000 $'000 $'000 $'000

Revenue from Operating Activities 2.1 35,161 33,671 35,201 33,698 Revenue from Non-operating Activities 2.1 178 436 232 482 Employee Expenses 3.1 (23,533) (20,962) (23,533) (20,962) Non Salary Labour Costs 3.1 (4,606) (3,085) (4,606) (3,085) Supplies & Consumables 3.1 (3,723) (7,172) (3,723) (7,172) Other Expenses 3.1 (3,471) (2,209) (3,512) (2,227)

Net Result Before Capital & Specific Items 6 679 59 734

Capital Purpose Income 2.1 2,354 1,451 2,354 1,451 Depreciation 4.4 (2,881) (2,709) (2,881) (2,709) Expenditure using Capital Purpose Income 3.1 (497) (564) (497) (564) Net Result after capital and specific items (1,018) (1,143) (965) (1,088)

Other economic flows included in net result Net fair gains/(losses) on non-financial assets 7.2 - 17 - 17 Revaluation of Long Service Leave (2) (202) (2) (202) Total other economic flows included in net result (2) (185) (2) (185) Net result from continuing operations (1,020) (1,328) (967) (1,273)

Other comprehensive income Items that may be reclassified subsequently to net result Net fair gains/(losses) on Available for Sale Financial Investments - - 11 12 Revaluation of investment property - (86) - (86) Total other comprehensive income - (86) 11 (74)

COMPREHENSIVE RESULT FOR THE YEAR (1,020) (1,414) (956) (1,347)

This Statement should be read in conjunction with the accompanying notes.

FR 1

FR1 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY East Grampians Health Service Annual Report 2016/2017 EastEast Grampians Grampians Health Health Service Service BalanceBalance Sheet Sheet ForAs theat Year30 June Ended 2017 30 June 2017

Parent Parent Consolidated Consolidated Note Entity Entity Entity Entity 2017 2016 2017 2016 $'000 $'000 $'000 $'000 Current Assets Cash and Cash Equivalents 6.1 6,840 6,714 7,886 7,681 Receivables 5.1 1,693 1,885 1,699 1,909 Investments and other Financial Assets 4.1 - - 314 303 Inventories 5.2 57 58 57 58 Other Current Assets 5.4 154 174 154 174 Total Current Assets 8,744 8,831 10,110 10,125

Non-Current Assets Receivables 5.1 1,060 1,080 1,060 1,080 Property, Plant & Equipment 4.3 37,261 38,898 37,261 38,898 Investment Properties 4.5 1,300 1,019 1,300 1,019 Total Non-Current Assets 39,621 40,997 39,621 40,997

TOTAL ASSETS 48,365 49,828 49,731 51,122

Current Liabilities Payables 5.5 1,129 1,842 1,140 1,845 Provisions 3.3 4,981 4,786 4,981 4,786 Other Liabilities 5.3 3,998 3,961 3,998 3,961 Total Current Liabilities 10,108 10,589 10,119 10,592

Non-Current Liabilities Provisions 3.3 816 778 816 778 Total Non-Current Liabilities 816 778 816 778

TOTAL LIABILITIES 10,924 11,367 10,935 11,370

NET ASSETS 37,441 38,461 38,796 39,752

EQUITY Property, Plant & Equipment Revaluation Surplus 8.1(a) 22,456 22,370 22,456 22,370 Financial Asset Available for Sale Revaluation Surplus 8.1(a) - - 23 12 General Purpose Surplus 8.1(a) 142 140 142 140 Restricted Specific Purpose Surplus 8.1(a) 1,464 420 1,464 432 Contributed Capital 8.1(b) 19,896 19,896 19,896 19,896 Accumulated Surpluses/(Deficits) 8.1(c) (6,518) (4,366) (5,186) (3,099) TOTAL EQUITY 37,441 38,461 38,796 39,752

Contingent Assets and Contingent Liabilities 7.3 Commitments 6.2

This Statement should be read in conjunction with the accompanying notes.

FR 2

2016-17 FINANCIAL REPORT FR2 East Grampians Health Service Annual Report 2016/2017 EastEast Grampians Grampians Health Health Service Service CashCash Flow Flow Statement Statement ForFor the the Year Year Ended Ended 30 June 30 2017 June 2017

Note Parent Parent Consolidated Consolidated Entity Entity Entity Entity 2017 2016 2017 2016 $'000 $'000 $'000 $'000 CASH FLOWS FROM OPERATING ACTIVITIES Operating Grants from Government 28,814 26,012 28,822 26,012 Patient and Resident Fees Received 4,498 4,385 4,498 4,385 GST Received from/(paid to) ATO 1,076 882 1,076 882 Interest Received 192 101 251 109 Other Receipts 2,593 3,191 2,593 3,191 Employee Expenses Paid (23,301) (20,405) (23,301) (20,405) Non Salary Labour Costs (5,067) (3,616) (5,067) (3,616) Payments for Supplies & Consumables (4,994) (6,214) (4,998) (6,227) Other Payments (4,617) (3,799) (4,654) (3,823) Cash Generated from Operations (806) 537 (780) 508

Capital Grants from Government 1,727 765 1,727 765 Capital Donations and Bequests Received - 202 - 202 Other Capital Receipts 627 487 627 487

NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES 8.2 1,548 1,991 1,574 1,962

CASH FLOWS FROM INVESTING ACTIVITIES Payments for Non-Financial Assets (1,525) (1,873) (1,514) (1,861) Proceeds from sale of Non-Financial Assets 111 75 111 75 Purchase of Investments - - (11) (291)

NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES (1,414) (1,798) (1,414) (2,077)

NET INCREASE/(DECREASE) IN CASH HELD 134 193 160 (115)

CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD 2,858 2,665 3,728 3,843

CASH AND CASH EQUIVALENTS AT END OF PERIOD 6.1 2,992 2,858 3,888 3,728

This Statement should be read in conjunction with the accompanying notes.

FR 3

FR3 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY East Grampians Health Service East Grampians Health Service Annual Report 2016/2017 StatementEast Grampians of ChangesHealth Service in Equity ForStatement the Year ofEnded Changes 30 June in Equity 2017 For the Year Ended 30 June 2017

Consolidated Entity Property, Plant Financial Asset General Restricted Contributions Accumulated Total & Equipment Available for Purpose Specific by Owners Surpluses/ Revaluation Sale Surplus Purpose (Deficits) Surplus Revaluation Surplus Surplus

Note $'000 $'000 $'000 $'000 $'000 $'000 $'000 Balance at 30 June 2015 22,456 - 141 491 19,896 (1,886) 41,099

Net result for the year - - - - - (1,273) (1,273) Other comprehensive income for the year 8.1 (86) 12 - - - - (74) Transfer to / (from) accumulated surplus 8.1 - - (1) (59) - 60 -

Balance at 30 June 2016 22,370 12 140 432 19,896 (3,099) 39,752

Net result for the year - - - - - (967) (967) Other comprehensive income for the year - 11 - - - - 11 Transfer to / (from) accumulated surplus 8.1 86 - 2 1,032 - (1,120) -

Balance at 30 June 2017 22,456 23 142 1,464 19,896 (5,186) 38,796

Parent Entity Property, Plant Financial Asset General Restricted Contributions Accumulated Total & Equipment Available for Purpose Specific by Owners Surpluses/ Revaluation Sale Surplus Purpose (Deficits) Surplus Revaluation Surplus Surplus

Note $'000 $'000 $'000 $'000 $'000 $'000 Balance at 1 July 2015 22,456 - 141 491 19,896 (3,110) 39,874

Net result for the year - - - - - (1,328) (1,328) Other comprehensive income for the year 8.1 (86) - - - - - (86) Transfer to / (from) accumulated surplus 8.1 - - (1) (71) - 72 -

Balance at 30 June 2016 22,370 - 140 420 19,896 (4,366) 38,461

Net result for the year - - - - - (1,020) (1,020) Other comprehensive income for the year 8.1 ------Transfer to / (from) accumulated surplus 8.1 86 - 2 1,044 - (1,132) -

Balance at 30 June 2017 22,456 - 142 1,464 19,896 (6,519) 37,441

This Statement should be read in conjunction with the accompanying notes.

FR 4

2016-17 FINANCIAL REPORT FR4 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 1: Summary of significant accounting policies

These annual financial statements represent the audited general purpose financial statements for East Grampians Health Service for the year ended 30 June 2017. The purpose of the report is to provide users with information about East Grampians Health Service's stewardship of resources entrusted to it.

(a) Statement of Compliance

These financial statements are general purpose financial statements which have been prepared in accordance with the Financial Management Act 1994 and applicable Australian Accounting Standards (AASs), which include interpretations issued by the Australian Accounting Standards Board (AASB). They are presented in a manner consistent with the requirements of AASB 101 Presentation of Financial Statements.

The financial statements also comply with relevant Financial Reporting Directions (FRDs) issued by the Department of Treasury and Finance, and relevant Standing Directions (SDs) authorised by the Minister for Finance.

East Grampians Health Service is a not-for profit entity and therefore applies the additional Aus paragraphs applicable to "not-for-profit" entities under the AASs.

The annual financial statements were authorised for issue by the Board of East Grampians Health Service on 24th August 2017.

(b) Reporting Entity

The financial statements include all the controlled activities of East Grampians Health Service. Its principal address is: Girdlestone Street, Ararat, Victoria 3377.

A description of the nature of East Grampians Health Service’s operations and its principal activities is included in the report of operations, which does not form part of these financial statements.

Objectives and funding

East Grampians Health Service's overall objective is to improve our communities health and quality of life through strong partnerships and by responding to changing needs, as well as improve the quality of life to Victorians.

East Grampians Health Service is predominantly funded by accrual based grant funding for the provision of outputs.

(c) Basis of accounting preparation and measurement Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transactions or other events is reported.

The accounting policies set out below have been applied in preparing the financial statements for the year ended 30 June 2017, and the comparative information presented in these financial statements for the year ended 30 June 2016.

The going concern basis was used to prepare the financial statements.

These financial statements are presented in Australian dollars, the functional and presentation currency of East Grampians Health Service. The financial statements, except for cash flow information, have been prepared using the accrual basis of accounting. Under the accrual basis, items are recognised as assets, liabilities, equity, income or expenses when they satisfy the definitions and recognition criteria for those items, that is they are recognised in the reporting period to which they relate, regardless of when cash is received or paid.

The financial statements are prepared in accordance with the historical cost convention, except for:

- non current physical assets, which subsequent to acquisition, are measured at a revalued amount being their fair value at the date of the revaluation less any subsequent accumulated depreciation and subsequent losses. Revaluations are made and are reassessed when new indices are published by the Valuer General to ensure that the carrying amounts do not materially differ from their fair values;

- available-for-sale investments which are measured at fair value with movements reflected in equity until the asset is derecognised (i.e. other comprehensive income – items that may be reclassified subsequent to net result). - The fair value of assets other than land is generally based on their depreciated replacement value.

FR 5 FR5 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 1: Summary of significant accounting policies

udgements estimates and assumptions are reuired to be made about the carrying amounts of assets and liabilities that are not readily apparent from other sources. he estimates and associated assumptions are based on professional udgements derived from historical eperience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates. (d) Principles of Consolidation n accordance ith AAS onsolidated inancial Statements the consolidated financial statements of East Grampians Health Service include all reporting entities controlled by East Grampians Health Service as at une and the consolidated financial statements eclude bodies of East Grampians Health Service that are not controlled by East Grampians Health Service and therefore are not consolidated. ontrol eists hen East Grampians Health Service has the poer to govern the financial and operating policies of an entity so as to obtain benefits from its activities. n assessing control potential voting rights that presently are eercisable are taen into account. he consolidated financial statements include the audited financial statements of the controlled entities listed in note ..

he parent entity is not shon seperately in he notes here control of an entity is obtained during the financial period its results are included in the comprehensive operating statement from the date on hich control commenced. here control ceases during a financial period the entity’s results are included for that part of the period in which control existed. Where entities adopt dissimilar accounting policies and their effect is considered material adustments are made to ensure consistent policies are adopted in these financial statements.

odies consolidated into East Grampians Health Service reporting entity include

East Grampians Health uilding or he uture oundation

Intersegment Transactions

ransactions beteen segments ithin East Grampians Health Service have been eliminated to reflect the etent of the East Grampians Health Service’s operations as a group.

(e) Rounding

All amounts shon in the financial statements are epressed to the nearest unless otherise stated. inor discrepancies in tables beteen totals and sum of components are due to rounding.

FR 6 2016-17 FINANCIAL REPORT FR6 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Basis of presentation

These financial statements are presented in Australian dollars and the historical cost convention is used unless a different measurement basis is specifically disclosed in the note associated with the item measured on a different basis.

The accrual basis of accounting has been applied in the preparation of these financial statements whereby assets, liabilities, equity, income and expenses are recognised in the reporting period to which they relate, regardless of when cash is received or paid.

Consistent with the requirements of AASB 1004 Contributions (that is contributed capital and its repayment) are treated as equity transactions and, therefore, do not form part of the income and expenses of the hospital.

Additions to net assets which have been designated as contributions by owners are recognised as contributed capital. Other transfers that are in the nature of contributions to or distributions by owners have also been designated as contributions by owners.

Transfers of net assets arising from administrative restructurings are treated as distributions to or contribution by owners. Transfer of net liabilities arising from administrative restructurings are treated as distribution to owners.

Judgements, estimates and assumptions are required to be made about financial information being presented. The significant judgements made in the preparation of these financial statements are disclosed in the notes where amounts affected by those judgements are disclosed. Estimates and associated assumptions are based on professional judgements derived from historical experience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates.

FR7 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 7 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note: 2 Funding delivery of our services

The hospital’s overall objective is to deliver programs and services that support and enhance the wellbeing of all Victorians.

To enable the hospital to fulfil its objective it receives income based on parliamentary appropriations. The hospital also receives income from the supply of services. Structure . nalysis of revenue by source

Note 2.1: Analysis of Revenue by Source

Non- RAC incl. Admitted Admitted Primary Mental Patients Services Aged Care Health Health Other Total 2017 2017 2017 2017 2017 2017 2017 $'000 $'000 $'000 $'000 $'000 $'000 $'000

overnment rant ndirect contributions by epartment of ealth and uman Services - - - - atient Resident ees - ommercial ctivities - - - - - Share of ointly ontrolled Revenue (ote .) - - - - - ther Revenue from perating ctivities Total Revenue from Operating Activities 17,368 1,314 1,233 3,393 9,012 2,881 35,201

nterest - - - - Total Revenue from Non-Operating Activities - - - - 120 112 232

apital urpose ncome (ecluding interest) - - - - - Share of ointly ontrolled apital Revenue (ote .) - - - - - Total Capital Purpose Income - - - - - 2,354 2,354

Total Revenue 17,368 1,314 1,233 3,393 9,132 5,347 37,787

Non- RAC incl. Admitted Admitted Primary Mental Patients Services Aged Care Health Health Other Total

2016 2016 2016 2016 2016 2016 2016 $'000 $'000 $'000 $'000 $'000 $'000 $'000

overnment rant ndirect contributions by epartment of ealth and uman Services - - - - atient Resident ees - ommercial ctivities - - - - - ther Revenue from perating ctivities Total Revenue from Operating Activities 16,513 1,248 1,153 3,288 8,929 2,567 33,698

nterest - - - - Share of ointly ontrolled Revenue (ote .) - - - - - Total Revenue from Non-Operating Activities - - - - 94 388 482

apital urpose ncome (ecluding interest) - - - - - Share of ointly ontrolled apital Revenue (ote .) - - - - - Total Capital Purpose Income - - - - - 1,451 1,451

Total Revenue 16,513 1,248 1,153 3,288 9,023 4,423 35,631

The epartment of ealth and uman Services maes certain payments on behalf of the ealth Service. These amounts have been brought to account in determining the operating result for the year by recording them as indirect revenue and epenses.

ncome is recognised in accordance with S Revenue and is recognised as to the etent that it is probable that the economic benefits will flow to ast rampians ealth Service and the income can be reliably measured at fair value. nearned income at reporting date is reported as income received in advance.

mounts disclosed as revenue are where applicable net of returns allowances and duties and taes.

Government Grants and other transfers of income (other than contributions by owners) n accordance with S ontributions government grants and other transfers of income (other than contributions by owners) are recognised as income when ast rampians ealth Service gains control of the underlying assets irrespective of whether conditions are imposed on ast rampians ealth Services use of the contributions. ontributions are deferred as income in advance when ast rampians ealth Service has a present obligation to repay them and the present obligation can be reliably measured.

Indirect Contributions from the Department of Health and Human Services - nsurance is recognised as revenue following advice from the epartment of ealth and uman Services.

- Long Service Leave (LSL) – Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the etropolitan ealth and ged are Services ivision ospital ircular (updated fpr -).

2016-17 FINANCIAL REPORTFR 8 FR8 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17

East Grampians Health Service Annual Report 2016/2017

Patient and Resident Fees atient fees are recognised as revenue at the time invoices are raised.

Revenue from commercial activities Revenue from commercial activities is recognised at the time invoices are raised.

Donations and Other Bequests onations and beuests are recognised as revenue when received. f donations are for a special purpose they may be appropriated to a surplus such as the restricted specific purpose surplus.

Interest Revenue

nterest revenue is recognised on a time proportionate basis that taes in account the effective yield of the financial asset which allocates interest over the relevant period.

Category Groups

ast rampians ealth Service has used the following category groups for reporting purposes for the current and previous financial years.

Admitted Patient Services (Admitted Patients) comprises all acute and subacute admitted patient services where services are delivered in public hospitals.

Non Admitted Services comprises acute and subacute non admitted services where services are delivered in public hospital clinics and provide models of integrated community care which significantly reduces the demand for hospital beds and supports the transition from hospital to home in a safe and timely manner.

Aged Care comprises a range of in home specialist geriatric residential care and community based programs and support services such as ome and ommunity are () that are targeted to older people people with a disability and their carers.

Primary, Community and Dental Health (Primary Health) comprises a range of home based community based community primary health and dental services including health promotion and counselling physiotherapy speech therapy podiatry and occupational therapy and a range of dental health services

Residential Aged Care including Mental Health (RAC incl. Mental Health) referred to in the past as psychogeriatric residential services comprises those ommonwealth-licensed residential aged care services in receipt of supplementary funding from the department under the mental health program. t ecludes all other residential services funded under the mental health program such as mental health funded community care units and secure etended care units.

Other Services not reported elsewhere - (Other) comprises services not separately classified above including ublic ealth Services including laboratory testing blood borne viruses seually transmitted infections clinical services ooris liaison officers immunisation and screening services drugs services including drug withdrawal counselling and the needle and syringe program isability services including aids and euipment and fleible support pacages to people with a disability ommunity are programs including seual assault support early parenting services parenting assessment and sills development and various support services. ealth and ommunity nitiatives also falls in this category group.

FR9 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 9 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17

East Grampians Health Service Annual Report 2016/2017

Note 3: The Cost of delivering services

This section provides an account of the epenses incurred by the hospital in delivering services and outputs. n Section the funds that enable the provision of services were disclosed and in this note the cost associated with provision of services are recorded. Structure . nalysis of epenses by source . nalysis of epense and revenue by internally managed and restricted specific purpose funds . rovisions . Superannuation

Note 3.1: Analysis of Expenses by Source

RAC incl. Admitted Non- Primary Mental Patients Admitted Aged Care Health Health Other Total 2017 2017 2017 2017 2017 2017 2017 $'000 $'000 $'000 $'000 $'000 $'000 $'000

mployee penses on Salary Labour osts - Supplies onsumables ther penses Share of ointly ontrolled penses (note .) - - - - - Total Expenditure from Operating Activities 19,911 559 817 3,825 8,423 1,843 35,374

penditure for apital urposes - - - - -

epreciation (refer note .) Share of ointly ontrolled apital penses (note .) - - - - -

Total other expenses 1,622 46 67 312 686 647 3,378

Total Expenses 21,533 605 884 4,137 9,109 2,490 38,752

RAC incl. Admitted Non- Primary Mental Patients Admitted Aged Care Health Health Other Total 2016 2016 2016 2016 2016 2016 2016 $'000 $'000 $'000 $'000 $'000 $'000 $'000

mployee penses on Salary Labour osts - - - Supplies onsumables ther penses Share of ointly ontrolled penses (note .) - - - - - Total Expenditure from Operating Activities 17,909 543 780 4,469 7,237 2,712 33,446

penditure for apital urposes - - - - -

epreciation (refer note .) Share of ointly ontrolled penses (note .) - - - - -

Total other expenses 1,442 44 63 360 583 782 3,273 Total Expenses 19,351 587 843 4,829 7,820 3,494 36,719

penses are recognised as they are incurred and reported in the financial year to which they relate.

Cost of Goods Sold

osts of goods sold are recognised when the sale of an item occurs by transferring the cost or value of the items from inventories.

Employee expenses

- mployee epenses include - ages and salaries - Leave entitlements - Termination payments and - Superannuation epenses which are reported differently depending upon whether employees are members of defined benefit or defined contribution plans.

Other operating expenses

ther operating epenses generally represent the day-to-day running costs incurred in normal operations and include

Supplies and consumables Supplies and services costs which are recognised as an epense in the reporting period in which they are incurred. The carrying amounts of any inventories held for distribution are epensed when distributed.

Bad and doubtful debts Refer to ote . nvestments and other financial assets.

2016-17 FINANCIAL REPORT FR10

FR 10 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17

East Grampians Health Service Annual Report 2016/2017

Other economic flows are changes in the volume or value of assets or liabilities that do not result from transactions.

Net gain/(loss) on disposal of non-financial assets et gain(loss) on non-financial assets and liabilities includes realised and unrealised gains and losses as follows

Revaluation gains/(losses) of non-financial physical assets Refer to ote . roperty plant and euipment.

Revaluations of financial instrument at fair value Refer to ote . inancial instruments

Other gains/ (losses) from other economic flows ther gains (losses) include a. the revaluation of the present value of the long service leave liability due to changes in the bond interest rates and b. transfer of amounts from the reserves to accumulated surplus or net result due to disposal or derecognition or reclassification. Derecognition of financial liabilities financial liability is derecognised when the obligation under the liability is discharged cancelled or epires. hen an eisting financial liability is replaced by another from the same lender on substantially different terms or the terms of an eisting liability are substantially modified such an echange or modification is treated as a derecognition of the original liability and the recognition of a new liability. The difference in the respective carrying amounts is recognised as an epense in the consolidated comprehensive operating statement. Note 3.2: Analysis of expense and revenue by internally managed and restricted specific purpose funds for services supported by hospital and community initiatives

Expense Revenue

Consol'd Consol'd Consol'd Consol'd 2017 2016 2016 2016 $'000 $'000 $'000 $'000 iagnostic maging atering onference Other Activities undraising and ommunity Support TOTAL 1,776 1,682 1,859 1,807

FR11 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 11 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 3.3: Employee benefits in the balance sheet

Consol'd Consol'd 2017 2016 $'000 $'000 Current Provisions mployee enefits (i) nnual leave - nconditional and epected to be settled wholly within months (ii) - nconditional and epected to be settled wholly after months (iii) ccrued days off - nconditional and epected to be settled wholly within months (ii) ccrued salaries and wages - nconditional and epected to be settled wholly within months (ii) Long service leave - nconditional and epected to be settled wholly within months (ii) - nconditional and epected to be settled wholly after months (iii) rovisions related to mployee enefit n-osts - nconditional and epected to be settled within months (ii) - nconditional and epected to be settled wholly after months (iii) Total Current Provisions 4,981 4,786

Non-Current Provisions mployee enefits (i) rovisions related to mployee enefit n-osts Total Non-Current Provisions 816 778

Total Provisions 5,797 5,564

(a) Employee Benefits and Related On-Costs

Current Employee Benefits and related on-costs nconditional LSL ntitlement nnual Leave ntitlements ccrued ages and Salaries ccrued ays ff Non-Current Employee Benefits and related on-costs onditional Long Service Leave ntitlements (iii)

Total Employee Benefits and Related On-Costs 5,797 5,564

otes (i) rovisions for employee benefits consist of amounts for annual leave and long service leave accrued by employees not including on-costs. (ii) The amounts disclosed are nominal values (iii) The amounts disclosed are discounted to present values (b) Movements in provisions

Movement in Long Service Leave: Balance at start of year 3,091 2,879 rovision made during the year - Revaluations - pense recognising mployee Service Settlement made during the year () () Balance at end of year 3,208 3,091

Provisions

rovisions are recognised when ast rampians ealth Service has a present obligation the future sacrifice of economic benefits is probable and the amount of the provision can be measured reliably.

The amount recognised as a liability is the best estimate of the consideration reuired to settle the present obligation at reporting date taing into account the riss and uncertainties surrounding the obligation. here a provision is measured using the cash flows estimated to settle the present obligation its carrying amount is the present value of those cash flows using a discount rate that reflects the time value of money and riss specific to the provision. hen some or all of the economic benefits reuired to settle a provision are epected to be received from a third party the receivable is recognised as an asset if it is virtually certain that recovery will be received and the amount of the receivable can be measured reliably. Employee Benefits

This provision arises for benefits accruing to employees in respect of wages and salaries annual leave and long service leave for services rendered to the reporting date. Wages and Salaries, Annual Leave and Accrued Days Off

Liabilities for wages and salaries including non-monetary benefits and annual leave are all recognised in the provision for employee benefits as ‘current liabilities’, because the health service does not have an unconditional right to defer settlements of these liabilities. epending on the epectation of the timing of settlement liabilities for wages and salaries annual leave and sic leave are measured- Undiscounted at value – if the health service expects to wholly settle within 12 months; or - Present value – if the health service does not expect to wholly settle within 12 months.

FR 12

2016-17 FINANCIAL REPORT FR12 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 3.3: Employee benefits in the balance sheet (cont) Long Service Leave

he liability for long service leave is recognised in the provision for employee benefits.

Unconditional is disclosed in the notes to the financial statements as a current liability, even where the health service does not expect to settle the liability within 12 months because it will not have the unconditional right to defer the settlement of the entitlement should an employee tae leave within 12 months. n unconditional right arises after a ualifying period.

he components of this current liability are measured at Undiscounted value – if the health service expects to wholly settle within 12 months; or Present value – if the health service does not expect to wholly settle within 12 months. onditional is disclosed as a non-current liability. here is an unconditional right to defer the settlement of the entitlement until the employee has completed the reuisite years of service. his non-current liability is measured at present value. ny gain or loss followed revaluation of the present value of non-current liability is recognised as a transaction, except to the extent that a gain or loss arises due to changes in bond interest rates for which it is then recognised as an other economic flow.

On-costs related to employee expense

Provisions for on-costs, such as worers compensation and superannuation are recognised together with provisions for employee benefits. Note 3.4: Superannuation Paid ontribution ontribution for the ear utstanding at

Consol'd Consol'd Consol'd Consol'd 2017 2016 2017 2016 $'000 $'000 $'000 $'000 Defined benefit plans: irst tate uperannuation und 12 12 - -

Defined contribution plans: irst tate uperannuation und 1,1 1,22 - - uperannuation und 2 - - Total 1,11 1,1 - -

mployees of ast rampians ealth ervice are entitled to receive superannuation benefits and ast rampians ealth ervice contributes to both the defined benefit and defined contribution plans. he defined benefit plans provide benefits based on years of service and final average salary.

he ealth ervice does not recognise any defined benefit liability in respect of the plans because the entity has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due. The Department of Treasury & Finance discloses the State’s defined benefits liabilities in its disclosure for administered items.

owever superannuation contributions paid or payable for the reporting period are included as part of employee benefits in the comprehensive operating statement of the ealth ervice. he name, details and amounts expense in relation to the maor employee superannuation funds and contributions made by the ealth ervices are as follows

Defined contribution plans

n relation to defined contribution i.e. accumulation superannuation plans, the associated expense is simply the employer contributions that are paid or payable in respect of employees who are members of these plans during the reporting period. ontributions to defined contribution superannuation plans are expensed when incurred.

Defined benefit plans

he amount charged to the comprehensive operating statement in respect of defined benefit superannuation plans represents the contributions made by the ealth ervice to the superannuation plans in respect of the services of current ealth ervice staff during the reporting period. uperannuation contributions are made to the plans based on the relevant rules of each plan, and are based upon actuarial advice. mployees of the ast rampiansealth ervice are entitled to receive superannuation benefits and the ast rampiansealth ervice contributes to both the defined benefit and defined contribution plans. he defined benefit plans provide benefits based on years of service and final average salary. he name and details of the maor employee superannuation funds and contributions made by the ast rampians ealth ervice are disclosed above.

FR13 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 13 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 4: Key Assets to support service delivery

The hospital controls infrastructure and other investments that are utilised in fulfillin its obectives and conductin its activities. They represent the ey resources that have been entrusted to the hospital to be utilised for delivery of those outputs.

Structure .1 nvestments and other financial assets .2 nvestments accounted for usin the euity method . Property plant & euipment . Depreciation and amortisation . nvestment properties

Note 4.1: Investments and Other Financial Assets

Capital Fund Consol'd 2017 2016 2017 2016 $'000 $'000 $'000 $'000 CURRENT Equities and Managed Investment Schemes ustralian isted uity Securities 1 1 Total Current 314 303 314 303

TOTAL 314 303 314 303

Represented by: Foundation nvestments 1 1 TOTAL 314 303 314 303

(a) Ageing analysis of investments and other financial assets Please refer to note .1 for the aein analysis of investments and other financial assets

(b) Nature and extent of risk arising from investments and other financial assets Please refer to note .1 for the nature and extent of credit ris arisin from investments and other financial assets

Investments and Other Financial Assets

Hospital investments must be in accordance in Standing Direction 4.5.6 – Treasury Risk Management. Investments are recognised and dereconised on trade date where purchase or sale of an investment is under a contract whose terms reuire delivery of the investment within the timeframe established by the maret concerned and are initially measured at fair value net of transaction costs.

nvestments are classified in the followin cateories

Financial assets at fair value throuh profit or loss;

eldtomaturity;

oans and receivables; and

vailableforsale financial assets. ast rampians ealth Service classifies its other financial assets between current and noncurrent assets based on the purpose for which the assets were acuired. anaement determines the classification of its other financial assets at initial reconition.

ast rampians ealth Service assesses at each balance sheet date whether a financial asset or roup of financial assets is impaired.

ll financial assets except those measured at fair value throuh profit or loss are subect to annual review for impairment. Derecognition of financial assets

financial asset or where applicable a part of a financial asset or part of a roup of similar financial assets is dereconised when

the rihts to receive cash flows from the asset have expired; or ast rampians ealth Service retains the riht to receive cash flows from the asset but has assumed an obliation to pay them in full without material delay to a third party under a ‘pass through’ arrangement; or

ast rampians ealth Service has transferred its rihts to receive cash flows from the asset and either a has transferred substantially all the riss and rewards of the asset; or b has neither transferred nor retained substantially all the riss and rewards of the asset but has transferred control of the asset.

here ast rampians ealth Service has neither transferred nor retained substantially all the riss and rewards or transferred control, the asset is recognised to the extent of East Grampians Health Service’s continuing involvement in the asset. Impairment of Financial Assets

t the end of each reportin period ast rampians ealth Service assesses whether there is obective evidence that a financial asset or roup of financial asset is impaired. ll financial instrument assets except those measured at fair value throuh profit or loss are subect to annual review for impairment.

eceivables are assessed for bad and doubtful debts on a reular basis. ad debts considered as written off and allowances for doubtful receivables are expensed.

The amount of the allowance is the difference between the financial asset’s carrying amount and the present value of estimated future cash flows discounted at the effective interest rate.

Doubtful debts eceivables are assessed for bad and doubtful debts on a reular basis. Those bad debts considered as written off by mutual consent are classified as a transaction expense. ad debts not written off by mutual consent and the allowance for doubtful debts are classified as other economic flows in the net result.

2016-17 FINANCIAL REPORTFR 14 FR14 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017 Note 4.2: Jointly Controlled Operations and Assets

Ownership Interest Name of Entity Principal Activity 2017 2016 % % Grampians Region Health IT lliance IT Systems .4 6.4

East Grampians Health Services interest in assets and liabilities employed in the above ointly controlled operations and assets is detailed below. The amounts are included in the financial statements under their respective asset and liability categories

2017 2016 $'000 $'000

Current Assets ash and ash Euivalents 4 Receivables ther urrent ssets Total Current Assets 265 248

Non Current Assets roperty, lant and Euipment 65 66 Total Non Current Assets 265 166

Total Assets 530 414

Current Liabilities ayables 4 54 Total Current Liabilities 41 54

Total Liabilities 41 54

East Grampians Health Services interest in revenues and expenses resulting from ointly controlled operations and assets is detailed below

2017 2016 $'000 $'000

Revenues perating receipts 54 apital receipts Total Revenue 528 585

Expenses Information Technology and dministrative Expenses 4 apital expenses Total Expenses 411 362

Net result 117 223

Contingent Liabilities and Capital Commitments s at une the Grampians Region Health IT lliance has not reported any contingent liabilities. The financial results included for GRH are unaudited at the time of signing the financial statements.

Investments in joint operations In respect of any interest in oint operations, East Grampians Health Service recognises in the financial statements • its assets, including its share of any assets held jointly; • any liabilities including its share of liabilities that it had incurred; • its revenue from the sale of its share of the output from the joint operation; • its share of the revenue from the sale of the output by the operation; and • its expenses, including its share of any expenses incurred jointly.

FR15 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 15 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017 Note 4.3: Property, Plant & Equipment

(a) Gross carrying amount and accumulated depreciation

Consol'd Consol'd 2017 2016 $'000 $'000

Land ron and at air alue , , and mprovements at air alue ess ccumulated epreciation Total Land 1,658 1,674

Buildings uildings nder onstruction at cost , ,

uildings at air alue , , ess ccumulated epreciation , ,

uildings at ost ess ccd epreciation Total Buildings 32,281 33,651

Plant and Equipment lant and uipment at air alue , , ess ccumulated epreciation , , Total Plant and Equipment 1,445 1,566

Medical Equipment edical uipment at air alue , , ess ccumulated epreciation , , Total Medical Equipment 1,612 1,841

Jointly Controlled Property, Plant & Equipment ointly ontrolled roperty, lant uipment at air alue ess ccumulated epreciation Total Jointly Controlled Property, Plant & Equipment 265 166

TOTAL 37,261 38,898

2016-17 FINANCIAL REPORT FR16

FR 16 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 4.3: Property, Plant & Equipment (Continued)

(b) Reconciliations of the carrying amounts of each class of asset

econciliations of the carrying amounts of each class of asset for the consolidated entity at the beginning and end of the previous and current financial year is set out belo.

Land & Jointly Improvements Buildings Plant & Medical Controlled Total Equipment Equipment PP&E $'000 $'000 $'000 $'000 $'000 $'000

Balance at 1 July 2015 1,709 34,686 1,386 1,858 76 39,715 dditions , isposals ovement in ointly ontrolled roperty, lant uipment note . epreciation note . , , Balance at 1 July 2016 1,674 33,651 1,566 1,841 166 38,898 dditions , isposals ovement in ointly ontrolled roperty, lant uipment note . epreciation note . , , Balance at 30 June 2017 1,658 32,281 1,445 1,612 265 37,261

Land and buildings carried at valuation n independent valuation of the ealth ervices land and buildings as performed by the aluereneral ictoria to determine the fair value of the land and buildings. he valuation, hich conforms to ustralian aluation tandards, as determined by reference to the amounts for hich assets could be exchanged beteen noledgeable illing parties in an arms length transaction. he valuation as based on independent assessments. he effective date of the valuation is une .

FR17 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 17 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 4.3: Property, Plant & Equipment (Continued)

(c) Fair value measurement hierarchy for assets

Fair value measurement at end of Fair value measurement at end of Carrying Carrying reporting period using: reporting period using: amount as at amount as at 30 June 2017 Level 1 (1) Level 2 (1) Level 3 (1) 30 June 2016 Level 1 (1) Level 2 (1) Level 3 (1)

Land at fair value pecialised land , , , , Total land at fair value 1,658 - - 1,658 1,674 - - 1,674

Buildings at fair value pecialised buildings , , , , Total building at fair value 32,281 - - 32,281 33,651 - - 33,651

Plant and equipment at fair value lant euipment and vehicles at fair value ehicles lant and euipment , , Total plant, equipment and vehicles at fair value 1,445 - - 1,445 1,566 - - 1,566

Medical equipment at fair value pecialised medical euipment , , , , Total medical equipment at fair value 1,612 - - 1,612 1,841 - - 1,841

Jointly controlled property, plant & equipment at fair value pecialised euipment Total jointly controlled property, plant & equipment at fair value 265 - - 265 166 - - 166

TOTAL 37,261 - - 37,261 38,898 - - 38,898

ote i lassified in accordance ith the fair value hierarchy, ii ehicles are categorised to evel assets if the depreciated replacement cost is used in estimating the fair value. oever, entities should consult ith an independent valuer in determining hether a maret approach is appropriate for vehicles ith an active resale maret available. f yes, a evel categorisation for such vehicles ould be appropriate.

here have been no transfers beteen levels during the period.

he estimates and underlying assumptions are revieed on an ongoing basis. evisions to accounting estimates are recognised in the period in hich the estimate is revised if the revision affects only that period or in the period of the revision, and future periods if the revision affects both current and future periods. udgements and assumptions made by management in the application of s that have significant effects on the financial statements and estimates, ith a ris of material adjustments in the subseuent reporting period, relate to the fair value of land, buildings, infrastructure, plant and euipment refer to note .; superannuation expense refer to ote .; and actuarial assumptions for employee benefit provisions based on liely tenure of existing staff, patterns of leave claims, future salary movements and future discount rates refer to note ..

onsistent ith air alue easurement, ast rampians ealth ervice determines the policies and procedures for both recurring fair value measurements such as property, plant and euipment, investment properties and financial instruments, and for nonrecurring fair value measurements such as nonfinancial physical assets held for sale, in accordance ith the reuirements of and the relevant s.

or the purpose of fair value disclosures, ast rampians ealth ervice has determined classes of assets and liabilities on the basis of the nature, characteristics and riss of the asset or liability and the level of the fair value hierarchy as explained above.

n addition, ast rampians ealth ervice determines hether transfers have occurred beteen levels in the hierarchy by reassessing categorisation based on the loest level input that is significant to the fair value measurement as a hole at the end of each reporting period.

The Valuer-General Victoria (VGV) is East Grampians Health Service’s independent valuation agency.

ast rampians ealth ervice, in conjunction ith monitors the changes in the fair value of each asset and liability through relevant data sources to determine hether revaluation is reuired.

2016-17 FINANCIAL REPORT FR18

FR 18 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Fair value measurement air value is the price that ould e received to sell an asset or paid to transer a liaility in an orderly transaction eteen maret participants at the measurement date. The air value measurement is ased on the olloing assumptions • that the transaction to sell the asset or transfer the liability takes place either in the principal market (or the most advantageous market, in the asence o the principal maret) either o hich must e accessile to the Health Service at the measurement date • that the Health Service uses the same valuation assumptions that market participants would use when pricing the asset or liability, assuming that maret participants act in their economic est interest. The fair value measurement of a non-financial asset takes into account a market participant’s ability to generate economic benefits by using the asset in its highest and est use or y selling it to another maret participant that ould use the asset in its highest and est use.

Consideration of highest and best use (HBU) for non-financial physical assets udgements aout highest and est use must tae into account the characteristics o the assets concerned including restrictions on the use and disposal o assets arising from the asset’s physical nature and any applicable legislative/contractual arrangements. n considering the H or non-inancial physical assets valuers are proaly est placed to determine highest and est use (H) in consultation ith Health Services. Health Services and their valuers thereore need to have a shared understanding o the circumstances o the assets. Health Service has to form its own view about a valuer’s determination, as it is ultimately responsible for what is presented in its audited financial statements. n accordance ith paragraph S . Health Services can assume the current use o a non-inancial physical asset is its H unless maret or other actors suggest that a dierent use y maret participants ould maimise the value o the asset. Thereore an assessment o the H ill e reuired hen the indicators are triggered ithin a reporting period hich suggest the maret participants ould have perceived an alternative use o an asset that can generate maimum value. nce identiied Health Services are reuired to engage ith VGV or other independent valuers or ormal H assessment. These indicators as a minimum include Eternal actors • Changed acts, regulations, local law or such instrument which affects or may affect the use or development of the asset; • Changes in planning scheme, including zones, reservations, overlays that would affect or remove the restrictions imposed on the asset’s use from its past use • Evidence that suggest the current use of an asset is no longer core to requirements to deliver a Health Service’s service obligation; • Evidence that suggests that the asset might be sold or demolished at reaching the late stage of an asset’s life cycle. n addition Health Services need to assess the H as part o the -year revie o air value o non-inancial physical assets. This is consistent ith the current reuirements on on-inancial physical assets and nvestment properties. Valuation hierarchy Health Services need to use valuation techniues that are appropriate or the circumstances and here there is suicient data availale to measure air value maimising the use o relevant oservale inputs and minimising the use o unoservale inputs. ll assets and liailities or hich air value is measured or disclosed in the inancial statements are categorised ithin the air value hierarchy. t is ased on the loest level input that is signiicant to the air value measurement as a hole • Level 1 – Quoted (unadjusted) market prices in active markets for identical assets or liabilities; • Level 2 – Valuation techniques for which the lowest level input that is significant to the fair value measurement is directly or indirectly observable; • Level 3 – Valuation techniques for which the lowest level input that is significant to the fair value measurement is unobservable.

FR19 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 19 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17

East Grampians Health Service Annual Report 2016/2017

Note 4.3: Property, Plant & Equipment (Continued)

(d) Reconciliation of Level 3 fair value

Jointly 30-Jun-17 Land Buildings Plant & Medical Controlled Total Equipment Equipment PP&E $'000 $'000 $'000 $'000 $'000 $'000

Opening Balance 1,674 33,651 1,566 1,841 166 38,898 urchases (sales) 1 1 23 1 1,243 Subtotal 1,691 34,352 1,803 2,030 265 40,141 ains or losses recognised in net result - epreciation (3) (2,1) (3) (1) - (2,881) Subtotal (34) (2,071) (358) (418) - (2,881)

Closing Balance 1,658 32,281 1,445 1,612 265 37,261

Jointly 30-Jun-16 Land Buildings Plant & Medical Controlled Total Equipment Equipment PP&E $'000 $'000 $'000 $'000 $'000 $'000

Opening Balance 1,709 34,686 1,386 1,858 76 39,715 urchases (sales) - 3 3 31 1,891 Subtotal 1,709 35,569 1,989 2,173 166 41,606

ains or losses recognised in net result - epreciation (3) (1,1) (23) (332) - (2,709) Subtotal (36) (1,918) (423) (332) - (2,709)

Closing Balance 1,674 33,651 1,566 1,841 166 38,898

There have been no transfers between levels during the period.

Identifying unobservable inputs (level 3) fair value measurements Level 3 fair value inputs are unobservable valuation inputs for an asset or liability. These inputs require significant judgement and assumptions in deriving fair value for both financial and non-financial assets. nobservable inputs shall be used to measure fair value to the etent that relevant observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at the measurement date. However, the fair value measurement objective remains the same, i.e., an eit price at the measurement date from the perspective of a market participant that holds the asset or owes the liability. Therefore, unobservable inputs shall reflect the assumptions that market participants would use when pricing the asset or liability, including assumptions about risk. ssumptions about risk include the inherent risk in a particular valuation technique used to measure fair value (such as a pricing risk model) and the risk inherent in the inputs to the valuation technique. measurement that does not include an adjustment for risk would not represent a fair value measurement if market participants would include one when pricing the asset or liability i.e., it might be necessary to include a risk adjustment when there is significant measurement uncertainty. or eample, when there has been a significant decrease in the volume or level of activity when compared with normal market activity for the asset or liability or similar assets or liabilities, and the Health Service has determined that the transaction price or quoted price does not represent fair value. Health Service shall develop unobservable inputs using the best information available in the circumstances, which might include the Health Service’s own data. In developing unobservable inputs, a Health Service may begin with its own data, but it shall adjust this data if reasonably available information indicates that other market participants would use different data or there is something particular to the Health Service that is not available to other market participants. Health Service need not undertake ehaustive efforts to obtain information about other market participant assumptions. However, a Health Service shall take into account all information about market participant assumptions that is reasonably available. nobservable inputs developed in the manner described above are considered market participant assumptions and meet the object of a fair value measurement.

Specialised land and specialised buildings The market approach is used for specialised land and specialised buildings although is adjusted for the community service obligation (CS) to reflect the specialised nature of the assets being valued. Specialised assets contain significant, unobservable adjustments; therefore these assets are classified as Level 3 under the market based direct comparison approach. The CSO adjustment is a reflection of the valuer’s assessment of the impact of restrictions associated with an asset to the extent that is also equally applicable to market participants. This approach is in light of the highest and best use consideration required for fair value measurement, and takes into account the use of the asset that is physically possible, legally permissible and financially feasible. s adjustments of CS are considered as significant unobservable inputs, specialised land would be classified as Level 3 assets.

or the health services, the depreciated replacement cost method is used for the majority of specialised buildings, adjusting for the associated depreciation. s depreciation adjustments are considered as significant and unobservable inputs in nature, specialised buildings are classified as Level 3 for fair value measurements. An independent valuation of the Health Service’s specialised land and specialised buildings was performed by the Valuer-General Victoria. The valuation was performed using the market approach adjusted for CS. The effective date of the valuation is 3 une 21.

Vehicles The Health Service acquires new vehicles and at times disposes of them before completion of their economic life. The process of acquisition, use and disposal in the market is managed by the Health Service who set relevant depreciation rates during use to reflect the consumption of the vehicles. s a result, the fair value of vehicles does not differ materially from the carrying value (depreciated cost). Plant and equipment lant and equipment is held at carrying value (depreciated cost). hen plant and equipment is specialised in use, such that it is rarely sold other than as part of a going concern, the depreciated replacement cost is used to estimate the fair value. nless there is market evidence that current replacement costs are significantly different from the original acquisition cost, it is considered unlikely that depreciated replacement cost will be materially different from the eisting carrying value.

There were no changes in valuation techniques throughout the period to 3 une 21. or all assets measured at fair value, the current use is considered the highest and best use.

FR 20 2016-17 FINANCIAL REPORT FR20 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 4.3.: Property, Plant & Equipment (Continued)

(e) Description of significant unobservable inputs to Level 3 valuations:

Sensitivity of fair value measurement to changes in Significant significant unobservable 2016 Range 2017 Range unobservable Valuation technique inputs (weighted average) (weighted average) inputs Specialised land

A significant increase or decrease in the CSO Community Service adjustment would result Obligation CSO in a significantly lower aret approach adjustment - - higher fair value

Specialised buildings

A significant increase or decrease in direct cost per suare meter adjustment would result epreciated irect cost per suare - ,m - ,m in a significantly higher replacement cost metre , , or lower fair value

A significant increase or decrease in the estimated useful life of the asset would result in seful life of specialised a significantly higher or buildings - years years - years years lower valuation.

Plant and equipment at fair value

A significant increase or decrease in cost per unit would result in a epreciated significantly higher or replacement cost Cost per unit - , , - , , lower fair value

A significant increase or decrease in the estimated useful life of the asset would result in a significantly higher or seful life of - years years - years years lower valuation.

Vehicles at fair value

A significant increase or ,-, per ,-, per decrease in cost per unit unit unit would result in a epreciated , per unit , per unit significantly higher or replacement cost Cost per unit lower fair value

A significant increase or seful life of vehicles - years years - years years decrease in the

Medical equipment at fair value Increase decrease in gross replacement cost would result in a epreciated significantly higher replacement cost Cost per unit - , , - , , lower fair value

Increase decrease in useful life would result in seful life of medical a significantly higher euipment - years years - years years lower fair value

Property, Plant and Equipment

All non-current physical assets are measured initially at cost and subseuently revalued at fair value less accumulated depreciation and impairment loss. here an asset is acuired for no or nominal cost, the cost is its fair value at the date of acuisition. Assets transferred as part of a mergermachinery of government are transferred at their carrying amount.

ore details about the valuation techniues and inputs used in determining the fair value of non-financial physical assets are discussed in ote . roperty, plant and euipment.

Crown Land is measured at fair value with regard to the property’s highest and best use after due consideration is made for any legal or physical restrictions imposed on the asset, public announcements or commitments made in relation to the intended use of the asset. Theoretical opportunities that may be available in relation to the assets are not taen into account until it is virtually certain that any restrictions will no longer apply. Therefore, unless otherwise disclosed, the current use of these non-financial physical assets will be their highest and best uses.

FR21 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 21 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Land and Buildings are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and impairment.

Plant, Equipment and Vehicles are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and impairment. epreciated historical cost is generally a reasonable proxy for fair value because of the short lives of the assets concerned.

Revaluations of Non-current Physical Assets

oncurrent physical assets are measured at fair value and are revalued in accordance with R Non-current physical assets. his revaluation process normally occurs at least every five years, based upon the asset’s Government Purpose Classification, but may occur more frequently if fair value assessments indicate material changes in values. ndependent valuers are used to conduct these scheduled revaluations and any interim revaluations are determined in accordance with the requirements of the Rs. Revaluation increments or decrements arise from differences between an asset’s carrying value and fair value.

Revaluation increments are recognised in ‘other comprehensive income’ and are credited directly in equity to the asset revaluation surplus, except that, to the extent that an increment reverses a revaluation decrement in respect of that same class of asset previously recognised as an expense in net result, the increment is recognised as income in the net result.

Revaluation decrements are recognised in ‘other comprehensive income’ to the extent that a credit balance exists in the asset revaluation surplus in respect of the same class of property, plant and equipment.

Revaluation increases and revaluation decreases relating to individual assets within an asset class are offset against one another within that class but are not offset in respect of assets in different classes.

Revaluation surplus are normally not transferred to accumulated funds on derecognition of the relevant asset.

n accordance with R , ast Grampians ealth ervices noncurrent physical assets were assessed to determine whether revaluation of the noncurrent physical assets was required.

2016-17 FINANCIAL REPORT FR22

FR 22 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 4.4: Depreciation

Consol'd Consol'd 2017 2016 $'000 $'000 Depreciation and mprovements uildings , , Plant quipment edical quipment Total Depreciation 2,881 2,709

Depreciation

ll infrastructure assets, buildings, plant and equipment and other nonfinancial physical assets that have finite useful lives are depreciated i.e. excludes land assets held for sale, and investment properties. epreciation begins when the asset is available for use, which is when it is in the location and condition necessary for it to be capable of operating in a manner intended by management.

epreciation is generally calculated on a straight line basis, at a rate that allocates the asset value, less any estimated residual value over its estimated useful life. stimates of the remaining useful lives and depreciation method for all assets are reviewed at least annually, and adustments made where appropriate. his depreciation charge is not funded by the epartment of ealth and uman ervices. ssets with a cost in excess of , are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost or valuation over their estimated useful lives.

he following table indicates the expected useful lives of non current assets on which the depreciation charges are based.

uildings tructure hell uilding abric to years to years ite ngineering ervices and Central Plant to years to years Central Plant it ut to years to years run Reticulated uilding ystems to years to years Plant quipment to years to years edical quipment to years to years Computers and Communication to years to years urniture and itting to years to years otor ehicles to years to years

s part of the buildings valuation, building values were separated into components and each component assessed for its useful life which is represented above.

ntangible produced assets with finite lives are depreciated as an expense from transactions on a systematic basis over the assets useful life.

FR23 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 23 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 4.5: Investment Properties

(a) Movements in carrying value for investment properties as at 30 June 2017

Consol'd Consol'd 2017 2016 $'000 $'000

Balance at Beginning of Period , , et Gainoss from air alue dustments Balance at End of Period 1,300 1,019

(b) Fair value measurement hierarchy for investment properties as at 30 June 2017

Fair value measurement at end of Carrying reporting period using: amount as at 30 June 2017 Level 1 (1) Level 2 (1) Level 3 (1)

nvestment properties , ,

1,300 - 1,300 -

Fair value measurement at end of Carrying reporting period using: amount as at 30 June 2016 Level 1 (1) Level 2 (1) Level 3 (1)

nvestment properties , ,

1,019 - 1,019 -

here have been no transfers between levels during the period. here were no changes in valuation techniques throughout the period to une . or investment properties measured at fair value, the current use of the asset is considered the highest and best use. The fair value of the Health Service’s investment properties at 30 June 2017 have been arrived on the basis of an independent valuation carried out by independent valuers name of aluer. dd brief experience of valuer. he valuation was determined by reference to maret evidence of transaction process for similar properties with no significant unobservable adustments, in the same location and condition and subect to similar lease and other contracts. The fair value of East Grampians Health Service’s investment properties at 30 June 2017 have been arrived on the basis of an independent valuation carried out as at une . he valuation was determined by reference to maret evidence of transaction process for similar properties with no significant unobservable adustments, in the same location and condition and subect to similar lease and other contracts.

nvestment properties represent properties held to earn rentals or for capital appreciation or both. nvestment properties exclude properties held to meet service delivery obectives of the health services.

nvestment properties are initially recognised at cost. Costs incurred subsequent to initial acquisition are capitalised when it is probable that future economic benefits in excess of the originally assessed performance of the asset will flow to the ealth ervice.

ubsequent to initial recognition at cost, investment properties are revalued to fair value, determined annually by independent valuers. air values are determined based on a maret comparable approach that reflects recent transaction prices for similar properties. nvestment properties are neither depreciated nor tested for impairment.

Rental revenue from leasing of investment properties is recognised in the comprehensive operating statement in the periods in which it is receivable on a straight line basis over the lease term.

2016-17 FINANCIAL REPORT FR24

FR 24 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 5: Other assets and liabilities

This section sets out those assets and liabilities that arose from the hospitals operations Structure 1 eceivables 2 nventories 3 ther liabilities repaments and other assets aables

Note 5.1: Receivables

Consol'd Consol'd Entity Entity 2017 2016 $'000 $'000 CURRENT Contractual nter Hospital ebtors 77 2 Trade ebtors 01 13 HHS Grant eceivable 17 Jointl ontrolled eceivables note 2 31 atient ees 27 ccrued nvestment ncome 7 3 ccrued evenue ther 30 2 ess lloance for oubtful ebts atient ees 1 12 1,648 1,702 Statutory GST eceivable 1 207

TOTAL CURRENT RECEIVABLES 1,699 1,909

NON CURRENT Statutory on Service eave epartment of Health epartment of Health and Human Services 100 100 1,060 1,080 TOTAL NON-CURRENT RECEIVABLES 1,060 1,080

TOTAL RECEIVABLES 2,759 2,989

(a) Movement in the Allowance for doubtful debts Consol'd Consol'd Entity Entity 2017 2016 $'000 $'000 alance at beinnin of ear 12 1 mounts ritten off durin the ear 10

ncreasedecrease in alloance reconised in net result 107 Balance at end of year 15 126

(b) Ageing analysis of receivables lease refer to note 71 for the aein analsis of contractual receivables (c) Nature and extent of risk arising from receivables lease refer to note 71 for the nature and etent of credit ris arisin from contractual receivables

eceivables consist of

ontractual receivables hich includes mainl debtors in relation to oods and services and accrued investment income and Statutor receivables hich includes predominantl amounts oin from the ictorian Government and GST input ta credits recoverable

eceivables that are contractual are classified as financial instruments and cateorised as loans and receivables Statutor receivables are reconised and measured similarl to contractual receivables ecept for impairment but are not classified as financial instruments because the do not arise from a contract

eceivables are reconised initiall at fair value and subseuentl measured at amortised cost usin the effective interest method less an accumulated impairment

Trade debtors are carried at nominal amounts due and are due for settlement ithin 30 das from the date of reconition ollectabilit of debts is revieed on an onoin basis and debts hich are non to be uncollectible are ritten off provision for doubtful debts is reconised hen there is obective evidence that the debts ma not be collected and bad debts are ritten off hen identified

FR25 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 25 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 5.2: Inventories

Consol'd Consol'd 2017 2016 $'000 $'000 Pharmaceuticals t cost 11 10 Medical and Surgical Lines t cost TOTAL INVENTORIES 57 58

nventories include oods and other propert held either for sale consumption or for distribution at no or nominal cost in the ordinar course of business operations t ecludes depreciable assets

nventories held for distribution are measured at cost adusted for an loss of service potential ll other inventories includin land held for sale are measured at the loer of cost and net realisable value nventories acuired for no cost or nominal considerations are measured at current replacement cost at the date of acuisition ost for all other inventor is measured on the basis of eihted averae cost

Note 5.3: Other Liabilities

Consol'd Consol'd 2017 2016 $'000 $'000

CURRENT atient onies Held in Trust 100 2 ccommodation onds efundable Entrance ees 3 32 ther onies Held in Trust 0 7 ther Total Current 3,998 3,961 Total Other Liabilities 3,998 3,961

* Total Monies Held in Trust Represented by the following assets: ash ssets refer to note 1 3 33 TOTAL 3,998 3,953

Note 5.4: Prepayments and Other Assets

Consol'd Consol'd 2017 2016 $'000 $'000

repaments 10 1 ental ropert onds 12 Jointl ontrolled ther ssets note 2 2 12 CURRENT 154 174 TOTAL 154 174

ther nonfinancial assets include prepaments hich represent paments in advance of receipt of oods or services or that part of ependiture made in one accountin period coverin a term etendin beond that period

2016-17 FINANCIAL REPORT FR26

FR 26 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 5.5: Payables

Consol'd Consol'd 2017 2016 $'000 $'000

CURRENT Contractual Trade reditors 0 110 ccrued Epenses 32 01 GH aables note 2 1 808 1,845 Statutory epartment of Health Human Services 332 332 -

TOTAL CURRENT 1,140 1,845

TOTAL 1,140 1,845

(a) Maturity analysis of payables lease refer to note 71 for the aein analsis of contractual paables

(b) Nature and extent of risk arising from payables lease refer to note 71 for the nature and etent of riss arisin from contractual paables

aables consist of

ontractual paables hich consist predominantl of accounts paable representin liabilities for oods and services provided to East Grampians Health Service prior to the end of the financial ear that are unpaid and arise hen East Grampians Health Service becomes oblied to mae future paments in respect of the purchase of those oods and services The normal credit terms for accounts paable are usuall ett 30 das

Statutor paables such as oods and services ta and frine benefits ta paables

ontractual paables are classified as financial instruments and are initiall reconised at fair value and then subseuentl carried at amortised cost Statutor paables are reconised and measured similarl to contractual paables but are not classified as financial instruments and not included in the cateor of financial liabilities at amortised cost because the do not arise from a contract

FR27 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 27 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017 Note 6: How we finance our operations

This section provides information on the sources of finance utilised b the hospital durin its operations alon ith interest epenses the cost of borroins and other information related to financin activities of the hospital

This section includes disclosures of balances that are financial instruments such as borroins and cash balances ote 71 provides additional specific financial instrument disclosures

Structure 1 ash and cash euivalents 2 ommitments for ependiture Note 6.1: Cash and Cash Equivalents

or the purposes of the cash flo statement cash assets includes cash on hand and in bans and shortterm deposits hich are readil convertible to cash on hand and are subect to an insinificant ris of chane in value net of outstandin ban overdrafts

Consol'd Consol'd Entity Entity 2017 2016 $'000 $'000

ash on Hand 3 3 ash at an 3 12 Short Term one aret 71 733 ash at an GH note 2 232 17 TOTAL 7,886 7,681

Represented by: ash for Health Service perations as per ash lo Statement 3 372 ash for onies Held in Trust ash on Hand 1 1 ash at an 70 Short Term one aret 37 3202 Total Cash and Cash Equivalents 7,886 7,681

ash and cash euivalents reconised on the balance sheet comprise cash on hand and cash at ban deposits at call and hihl liuid investments ith an oriinal maturit of three months or less hich are held for the purpose of meetin short term cash commitments rather than for investment purposes hich are readil convertible to non amounts of cash ith an insinificant ris of chanes in value or cash flo statement presentation purposes cash and cash euivalents include ban overdrafts hich are included as liabilities on the balance sheet

Note 6.2: Commitments for expenditure ommitments for future ependiture include operatin and capital commitments arisin from contracts These commitments are disclosed b a of a note at their nominal value and are inclusive of the GST paable n addition here it is considered appropriate and provides additional relevant information to users the net present values of sinificant individual proects are sated These future ependitures cease to be disclosed as commitments once the related liabilities are reconised on the balance sheet

East Grampians Health Service notes no commitments for ependiture arisin from contractual commitments at 30 June 2017

2016-17 FINANCIAL REPORT FR28

FR 28 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 7:Risks, contingencies & valuation uncertainties

The hospital is eposed to ris from its activities and outside factors n addition it is often necessar to mae udements and estimates associated ith reconition and measurement of items in the financial statements This section sets out financial instrument specific information includin eposures to financial riss as ell as those items that are continent in nature or reuire a hiher level of udement to be applied hich for the hospital is related mainl to fair value determination

Structure

71 inancial instruments 72 et ain loss on disposal of nonfinancial assets 73 ontinent assets and continent liabilities 7 air value determination

Note 7.1: Financial Instruments

Financial Risk Management Objectives and Policies

East Grampians Health Services principal financial instruments are comprise of ash ssets Term eposits eceivables ecludin statutor receivables aables ecludin statutor paables ccommodation onds

etails of the sinificant accountin policies and methods adopted includin the criteria for reconition the basis of measurement and the basis on hich income and epenses are reconised ith respect to each class of financial asset financial liabilit and euit instrument are disclosed in note 1 to the financial statements

The main purpose in holdin financial instruments is to prudentiall manae East Grampians Health Services financial riss ithin the overnment polic parameters

Contractual Contractual financial financial assets/liabil assets/liabil ities ities held- Contractual Contractual Contractual designated for-trading financial financial financial at fair value at fair value assets - assets - liabilities at through through loans and available for amortised profit/loss profit/loss receivables sale cost Total 2017 $'000 $'000 $'000 $'000 $'000 $'000 Contractual Financial Assets ash and cash euivalents 7 7 eceivables Trade ebtors 13 13 ther eceivables 20 20 ther inancial ssets Shares in ther Entities 31 31 Total Financial Assets (i) - - 9,534 314 - 9,848

Financial Liabilities aables 0 0 ther inancial iabilities ccomodation bonds 3 3 ther 10 10 Total Financial Liabilities (ii) - - - - 4,806 4,806

Contractual Contractual financial financial assets/liabil assets/liabil ities ities held- Contractual Contractual Contractual designated for-trading financial financial financial at fair value at fair value assets - assets - liabilities at through through loans and available for amortised profit/loss profit/loss receivables sale cost Total 2016 $'000 $'000 $'000 $'000 $'000 $'000 Contractual Financial Assets ash and cash euivalents 71 71 eceivables Trade ebtors 127 127 ther eceivables 23 23 ther inancial ssets Shares in isted Entities 303 303 Total Financial Assets (i) - - 9,383 303 - 9,686

Financial Liabilities aables 1 1 ther inancial iabilities ccomodation bonds 32 32 ther 13 13 Total Financial Liabilities (ii) - - - - 5,806 5,806

i The total amount of financial assets disclosed here ecludes statutor receivables ie GST input ta credit recoverable ii The total amount of financial liabilities disclosed here ecludes statutor paables ie Taes paable

(b) Net holding gain/(loss) on financial instruments by category

Total interest Net holding income / Fee income Impairment gain/(loss) (expense) / (expense) loss Total $'000 $'000 $'000 $'000 $'000 2017 Financial Assets ash and ash Euivalents i 21 21 vailable for Sale i 13 13 Total Financial Assets - 219 13 - 232 Financial Liabilities

2016 Financial Assets ash and ash Euivalents i 12 12 Total Financial Assets - 128 - - 128

FR 29

FR29 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 7.1: Financial Instruments (continued)

(c) Credit Risk redit ris arises from the contractual financial assets of the Health Service hich comprise cash and deposits and nonstatutor receivables financial assets. The Health Service’s exposure to credit risk arises from the potential default of a counter party on their contractual obliations resultin in financial loss to the Health Service redit ris is measured at fair value and is monitored on a reular basis Credit risk associated with the Health Service’s contractual financial assets is minimal because the main debtor is the Victorian Government. For debtors other than the Government, it is the Health Service’s policy to only deal with entities with high credit ratings of a minimum Triple ratin and to obtain sufficient collateral or credit enhancements here appropriate

n addition the Health Service does not enae in hedin for its contractual financial assets and mainl obtains contractual financial assets that are on fixed interest, except for cash assets, which are mainly cash at bank. As with the policy for debtors, the Health Service’s polic is to onl deal ith bans ith hih credit ratins

rovision of impairment for contractual financial assets is reconised hen there is obective evidence that the Health Service ill not be able to collect a receivable bective evidence includes financial difficulties of the debtor default paments debts hich are more than 0 das overdue and chanes in debtor credit ratins

Ecept as otherise detailed in the folloin table the carrin amount of contractual financial assets recorded in the financial statements net of any allowances for losses, represents East Grampians Health Service’s maximum exposure to credit risk without taking account of the value of an collateral obtained

Credit quality of contractual financial assets that are neither past due nor impaired

Financial Other Total institutions (min BBB rating)

$'000 $'000 $'000

2017 Financial Assets ash and ash Euivalents 7 7 eceivables Trade ebtors 13 13 ther eceivables 20 20 Total Financial Assets 7,886 1,648 9,534

2016

Financial Assets ash and ash Euivalents 71 71 eceivables Trade ebtors 127 127 ther eceivables 23 23 Total Financial Assets 7,681 1,702 9,383

Ageing analysis of Financial Asset as at 30 June

Consolidated Not Past Due Past Due But Not Impaired Impaired Carrying and Not Less than 1-3 Months 3 months - 1-5 Years Financial Amount Impaired 1 Month 1 Year Assets $'000 $'000 $'000 $'000 $'000 $'000 $'000

2017 Financial Assets ash and ash Euivalents 7 7 eceivables Trade ebtors 13 133 1 2 ther eceivables 20 200 22 1 7 1 ther inancial ssets Shares in ther Entities 31 31 Total Financial Assets 9,848 9,763 31 30 9 - 15

2016

Financial Assets ash and ash Euivalents 71 71 eceivables Trade ebtors 127 10 12 ther eceivables 23 22 1 1 2 12 ther inancial ssets Shares in ther Entities 303 303 Total Financial Assets 9,686 9,267 64 62 168 - 126

Contractual financial assets that are either past due or impaired There are no material financial assets which are individually determined to be impaired. Currently the East Grampians Health Service does not hold any collateral as security nor credit enhancements relating to any of its financial assets.

There are no financial assets that have had their terms renegotiated so as to prevent them from being past due or impaired, and they are stated at the carrying amounts as indicated. The ageing analysis table above discloses the ageing only of contractual financial assets that are past due but not impaired.

FR 30 2016-17 FINANCIAL REPORT FR30 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 7.1: Financial Instruments (continued)

(d) Liquidity Risk

iuidity risk is the risk that the Health Service would be unable to meet its financial obligations as and when they fall due. The Health Services operates under the Governments fair payments policy of settling financial obligations within days and in the event of a dispute, making payments within days from the date of resolution.

East Grampians Health Service’s maximum exposure to liquidity risk is the carrying amounts of financial liabilities as disclosed on the face of the balance sheet. The health service manages liuidity risk as follows Term deposits and cash held at financial institutions are managed with variable maturity dates and take into consideration cash flow reuirements of the health service form month to month.

The following table discloses the contractual maturity analysis for East Grampians Health Services financial liabilities. For interest rates applicable to each class of liability refer to individual notes to the financial statements.

Maturity analysis of Financial Liabilities as at 30 June

Maturity Dates Carrying Contractual Less than 1-3 Months 3 months - 1-5 Years Amount Cash Flows 1 Month 1 Year $'000 $'000 $'000 $'000 $'000 $'000

2017 Financial Liabilities ayables ther Financial iabilities Accommodation onds , , , ther Total Financial Liabilities 4,806 4,806 948 - 3,858 -

2016 Financial Liabilities ayables , , , ther Financial iabilities Accommodation onds , , , ther Total Financial Liabilities 5,806 5,806 5,806 - - -

FR31 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 31 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017 Note 7.1: Financial Instruments (continued)

(e) Market Risk

East Grampians Health Services exposures to market risk are primarily through interest rate risk ith only insignificant exposure to foreign currency and other price risks bectives policies and processes used to manage each of these risks are disclosed in the paragraph belo

Currency Risk

East Grampians Health Service is exposed to insignificant foreign currency risk through its payables relating to purchases of supplies and consumables from overseas his is because of a limited amount of purchases denominated in foreign currencies and a short timeframe beteen commitment and settlement

Interest Rate Risk

Exposure to interest rate risk might arise primarily through the Health Services interest bearing liabilities inimisation of risk is achieved by mainly undertaking fixed rate or noninterest bearing financial instruments or financial liabilities the health service mainly undertake financial liabilities ith relatively even maturity profiles ash flo interest rate risk is the risk that the future cash flos of a financial instrument ill fluctuate because of changes in market interest rates he Health Service has minimal exposure to cashflo interest rate risks through its cash and deposits term deposits that are at a floating rate

Other Price Risk

East Grampians Health Service has not identified any other price risks

Interest Rate Exposure of Financial Assets and Liabilities as at 30 June

Weighted Carrying Interest Rate Exposure Average Amount Fixed Variable Non- Effective Interest Interest Interest Interest Rate Rate Bearing Rate (%) $'000 $'000 $'000 $'000

2017 Financial Assets ash and ash Equivalents eceivables rade ebtors ther eceivables ther inancial ssets Shares in ther Entities 9,848 4,903 2,980 1,965 Financial Liabilities ayables ther inancial iabilities ccommodation onds ther 4,806 - - 4,806

2016 Financial Assets ash and ash Equivalents eceivables rade ebtors ther eceivables ther inancial ssets Shares in ther Entities 9,686 4,903 2,775 2,008 Financial Liabilities ayables ther inancial iabilities ccommodation onds ther 5,806 - - 5,806 FR 32

2016-17 FINANCIAL REPORT FR32 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 7.1: Financial Instruments (continued)

(e) Market Risk (continued)

Sensitivity Disclosure Analysis aking into account past performance future expectations economic forecasts and managements knoledge and experience of the financial markets East Grampians Health Service believes the folloing movements are reasonably possible over the next months ase rates are sourced from the eserve ank of ustralia

shift of and in market interest rates from yearend rates of

parallel shift of and in inflation rate from yearend rates of

he folloing table discloses the impact on net operating result and equity for each category of financial instrument held by East Grampians Health Service at year end as presented to key management personnel if changes in the relevant risk occur

Carrying Interest Rate Risk Other Price Risk Amount -1% +1% -1% +1% Profit Equity Profit Equity Profit Equity Profit Equity $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000

2017 Financial Assets ash and ash Equivalents eceivables rade ebtors ther eceivables ther inancial ssets Shares in ther Entities Financial Liabilities ayables ther inancial iabilities ccommodation onds ther (79) (79) 79 79 (3) (3) 3 3

2016 Financial Assets ash and ash Equivalents eceivables rade ebtors ther eceivables ther inancial ssets Shares in ther Entities Financial Liabilities ayables ther inancial iabilities ccommodation onds ther (77) (77) 77 77 - (3) - 3

FR33 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 33 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 7.1: Financial Instruments (continued)

(f) Fair Value

he fair values and net fair values of financial instrument assets and liabilities are determined as follos

• Level 1 - the fair value of financial instrument with standard terms and conditions and traded in active liquid markets are determined ith reference to quoted market prices • Level 2 - the fair value is determined using inputs other than quoted prices that are observable for the financial asset or liability either directly or indirectly and • Level 3 - the fair value is determined in accordance with generally accepted pricing models based on discounted cash flo analysis using unobservable market inputs

East Grampians Health Services considers that the carrying amount of financial instrument assets and liabilities recorded in the financial statements to be a fair approximation of their fair values because of the shortterm nature of the financial instruments and the expectation that they ill be paid in full he folloing table shos that the fair values of the contractual financial assets and liabilities are the same as the carrying amounts

Comparison between carrying amount and fair value

Consolidated Fair value Consolidated Fair value Carrying Carrying Amount Amount

2017 2017 2016 2016 $'000 $'000 $'000 $'000 Financial Assets ash and ash Equivalents eceivables rade ebtors ther eceivables ther inancial ssets Shares in ther Entities Total Financial Assets 9,848 9,848 9,686 9,686

Financial Liabilities ayables ther inancial iabilities ccommodation onds ther Total Financial Liabilities 4,806 4,806 5,806 5,806

i he carrying amount must exclude types of statutory financial assets and liabilities ie GS input tax credit and GS payable

Financial assets measured at fair value

Carrying Fair value measurement at end of reporting Amount as at period using: 30 June Level 1* Level 2* Level 3 2017 $'000 $'000 $'000 $'000 Financial assets at fair value through profit or loss vailable for sale securities isted securities Total Financial Assets 314 314 - -

2016 Financial assets at fair value through profit or loss vailable for sale securities isted securities Total Financial Assets 303 303 - -

Financial instruments arise out of contractual agreements that give rise to a financial asset of one entity and a financial liability or equity instrument of another entity. Due to the nature of East Grampians Health Services activities, certain financial assets and financial liabilities arise under statute rather than a contract. Such financial assets and financial liabilities do not meet the definition of financial instruments in AASB 132 Financial Instruments: Presentation. For example, statutory receivables arising from taxes, fines and penalties do not meet the definition of financial instruments as they do not arise under contract.

Where relevant, for note disclosure purposes, a distinction is made between those financial assets and financial liabilities that meet the definition of financial instruments in accordance with AASB 132 and those that do not.

The following refers to financial instruments unless otherwise stated.

2016-17 FINANCIAL REPORT FR34

FR 34 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Categories of non-derivative financial instruments

Reclassification of financial instruments at fair value through profit or loss Financial instrument assets that meet the definition of loans and receivables may be reclassified out of the fair value through profit and loss category into the loans and receivables category, where they would have met the definition of loans and receivables had they not been required to be classified as fair value through profit and loss. In these cases, the financial instrument assets may be reclassified out of the fair value through profit and loss category, if there is the intention and ability to hold them for the foreseeable future or until maturity.

NOTE 7.1: FINANCIAL INSTRUMENTS (Continued) Loans and receivables Loans and receivables are financial instrument assets with fixed and determinable payments that are not quoted on an active market. These assets are initially recognised at fair value plus any directly attributable transaction costs. Subsequent to initial measurement, loans and receivables are measured at amortised cost using the effective interest method, less any impairment.

Loans and receivables category includes cash and deposits (refer to Note 6.1), term deposits with maturity greater than three months, trade receivables, loans and other receivables, but not statutory receivables.

Held-to-maturity investments If the Health Service has the positive intent and ability to hold nominated investments to maturity, then such financial assets may be classified as held-to-maturity. Held-to-maturity financial assets are recognised initially at fair value plus any directly attributable transaction costs. Subsequent to initial recognition held-to-maturity financial assets are measured at amortised cost using the effective interest rate method, less any impairment losses.

The Health Service makes limited use of this classification because any sale or reclassification of more than an insignificant amount of held-to-maturity investments not close to their maturity, would result in the whole category being classified as available-for-sale. The Health Service would also be prevented from classifying investment securities as held-to-maturity for the current and the following financial years.

The held-to-maturity category includes certain term deposits and debt securities for which the Health Service concerned intends to hold to maturity.

Reclassification of available-for-sale financial assets Available-for sale financial instrument assets that meet the definition of loans and receivables may be classified into the loans and receivables category if there is the intention and ability to hold them for the foreseeable future or until maturity.

Financial Liabilities at amortised cost Financial instrument liabilities are initially recognised on the date they are originated. They are initially measured at fair value plus any directly attributable transaction costs. Subsequent to initial recognition, these financial instruments are measured at amortised cost with any difference between the initial recognised amount and the redemption value being recognised in profit and loss over the period of the interest-bearing liability, using the effective interest rate method.

Financial instrument liabilities measured at amortised cost include all of the Health Service's contractual payables, deposits held and advances received, and interest-bearing arrangements other than those designated at fair value through profit or loss.

FR35 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 35 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 7.2: Net Gain/(Loss) on Disposal of Non- Financial Assets

Consolidated Consolidated Entity Entity 2017 2016 $'000 $'000

Proceeds from Disposals of Non-Current Assets otor ehicles 111 Total Proceeds from Disposal of Non-Current Assets 111 75

Less: Written Down Value of Non-Current Assets Sold otor ehicles 111 Total Written Down Value of Non-Current Assets Sold 111 58

Net gains/(losses) on Disposal of Non-Current Assets - 17

Note 7.3: Contingent Assets and Contingent ontingent assets and contingent liabilities are not recognised in the balance sheet but are disclosed by way of note and if quantifiable are measured at nominal value ontingent assets and contingent liabilities are presented inclusive of receivable or payable respectively s at 3 une 21 ast rampians ealth ervice has no nowledge of any contingent assets or liabilities il for 3 une 21

Note 7.4 Fair value determination

Likely Significant Examples of types of Expected fair valuation inputs (Level Asset class assets value level approach 3 only)

n areas where there is an active maret - vacant land - land not subect to restrictions as to use or aret on-specialised land sale Level 2 approach Land subect to restrictions as to use andor sale

Land in areas where there is not an active aret pecialised land maret Level 3 approach adustments or generalcommercial buildings that are ust aret on-specialised buildings built Level 2 approach

pecialised buildings with limited alternative uses andor substantial epreciated ost per customisation eg replacement square metre prisons hospitals and cost pecialised buildings i schools Level 3 approach seful life

pecialised items with epreciated ost per limited alternative uses replacement square metre andor substantial cost lant and equipment i customisation Level 3 approach seful life f there is an active resale maret aret ehicles available Level 2 approach

epreciated ost per replacement square metre f there is no active cost resale maret available Level 3 approach seful life

i ewly built acquired assets could be categorised as Level 2 assets as depreciation would not be a significant unobservable input based on the 1 materiality threshold

FR 36

2016-17 FINANCIAL REPORT FR36 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 8: Other disclosures

his section includes additional material disclosures required by accounting standards or otherwise for the understanding of this financial report

Structure

1 quity 2 econciliation of net result for the year to net cash inflowoutflow from operating activities 3 perating segments esponsible persons disclosures ecutive officer disclosures elated parties emuneration of auditors -gratia epenses vents occurring after the balance sheet date 1 ontrolled entities 11 s issued that are not yet effective 12 lternative presentation of comprehensive operating statement

Note 8.1: Equity

Consol'd Consol'd 2017 2016 $'000 $'000

(a) Surpluses

Property, Plant & Equipment Revaluation Surplus alance at the beginning of the reporting period 223 22 evaluation ncrementecrements - Land Balance at the end of the reporting period* 22,456 22,370

epresented by - Land 212 22 - uildings 1 1 22,456 22,370 Financial Assets Available-for-Sale Revaluation Surplus alance at the beginning of the reporting period 12 - aluation gainloss recognised 11 12 alance at end of the reporting period 23 12 General Purpose Surplus alance at the beginning of the reporting period 1 11 ransfer to eneral eserve 2 1 alance at the end of the reporting period 142 140

Restricted Specific Purpose Surplus alance at the beginning of the reporting period 32 1

ransfer to and from estricted pecific urpose eserve 132 alance at the end of the reporting period 1,464 432

Total Reserves 24,085 22,954

(b) Contributed Capital alance at the beginning of the reporting period 1 1 alance at the end of the reporting period 19,896 19,896

(c) Accumulated Surpluses/(Deficits) alance at the beginning of the reporting period 3 1 et esult for the ear 123 ransfers tofrom - eneral urpose urplus 2 1 - estricted pecific urpose urplus 132 - inancial ssets available for ale eval urplus - alance at the end of the reporting period (5,186) (3,099)

Total Equity at end of financial year 38,796 39,752

Contributed Capital

onsistent with ustralian ccounting nterpretation 13 ontributions by wners ade to holly-wned ublic ector ntities and 11 ontributions by wners appropriations for additions to the net asset base have been designated as contributed capital ther transfers that are in the nature of contributions or distributions that have been designated as contributed capital are also treated as contributed capital

Property, Plant & Equipment Revaluation Surplus

he asset revaluation surplus is used to record increments and decrements on the revaluation of non- current physical assets

Financial Assets Available for Sale Revaluation Surplus he financial asset available for sale revaluation surplus is used to record increments and decrements on the revaluation of financial assets

General Reserves

general purpose reserve is established where ast rampians ealth ervice has placed a restriction andor condition on the use of particular funds received

Specific Restricted Purpose Reserve

specific restricted purpose reserve is established where ast rampians ealth ervice has possession or title to the funds but has no discretion to amend or vary the restriction andor condition underlying the funds received

FR 37 FR37 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017 Note 8.2: Reconciliation of Net Result for the Year to Net Cash Inflow/(Outflow) from

Consol'd Consol'd 2017 2016 $'000 $'000 Net Result for the Year 123

epreciation mortisation 21 2 hange in rovision for oubtful eceivables 111 111 hange in nventories 1 et ainLoss from ale of lant and quipment - 1 hange in perating ssets Liabilities ncreaseecrease in eceivables 31 11 ncreaseecrease in ther ssets 1 ncreaseecrease in repayments ncreaseecrease in ayables 1232 ncreaseecrease in rovisions 23 ncreaseecrease in ther Liabilities 3 NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES 1,575 1,962

2016-17 FINANCIAL REPORT FR38

FR 38 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 8.3: Operating Segments RAC Acute Other Consol'd 2017 2016 2017 2016 2017 2016 2017 2016 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 REVENUE

ternal egment evenue 12 2 13 113 111 1 3 32

Total Revenue 9,012 8,929 17,368 16,513 11,175 10,078 37,555 35,520 EXPENSES ternal egment penses 1 2 2133 131 113 3 321 Total Expenses (9,109) (7,820) (21,533) (19,351) (8,113) (9,750) (38,754) (36,921)

Net Result from ordinary activities (97) 1,109 (4,165) (2,838) 3,062 328 (1,199) (1,401)

nterest ncome 12 - - 112 3 232 12 hare of et esult of oint entures using quity ethod ------Net Result for Year 23 1,203 (4,165) (2,838) 3,174 362 (967) (1,273)

OTHER INFORMATION egment ssets 223 2 2133 223 1 3 31 1122 Total Assets 20,236 20,965 21,339 22,043 8,156 8,384 49,731 51,122

egment Liabilities 3 1 12 13 1 13 113 Total Liabilities 7,434 7,577 1,708 1,928 1,793 1,865 10,935 11,370

cquisition of roperty lant and quipment 33 11 21 21 123 1 epreciation mortisation pense 1 1 131 3 21 2

he maor productsservices from which the above segments derive revenue are

Business Segments Services

esidential ged are ervices igh and Low Level ged are cute ealth cute edical urgical ervices thers -rimary ealth hysiotherapy odiatry ietetics peech athology ccupational herapy ental -istrict ursing -adiology ervices -atering ervices -ay entre -onsulting ooms -undraising

Geographical Segment ast rampians ealth ervice operates predominantly in the rampians region in ictoria 1 of revenue net surplus from ordinary activities and segment assets relate to operations in the rampians region ictoria

Note 8.4: Responsible Persons Disclosures

n accordance with the inisterial irections issued by the inister for inance under the Financial Management Act 1994 the following disclosures are made regarding responsible persons for the reporting period Period Responsible Minister: he onourable ill ennessy inister for ealth inister for mbulance 121 - 321 heervices onourable artin oley inister for ousing isability and geing inister for ental ealth 121 - 321

Governing Boards r ood 121 - 321 rs leming 121 - 321 r arer 121 - 321 r ole 121 - 321 r raithwaite 121 - 321 s anter 121 - 321 rs ochrane 121 - 321 Mrs A Rivett 121 - 321 Accountable Officers r ush 121 - 321

Remuneration of Responsible Persons

Remuneration received or receivable by responsible persons was in the range: $220k – $228k ($210 – $217k in 2015-16).

mounts relating to responsible ministers are reported in the financial statements of the epartment of remier and abinet

FR39 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 39 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 8.5: Executive Officer Disclosures

Executive Officers' Remuneration

Remuneration of executives Total remuneration 2017 2016(i) $'000 $'000 Short-term employee benefits $ 625 Post-employment benefits $ 93 Other long-term benefits -$ 15 Termination benefits $ - Share-based payments $ - Total Remuneration (ii) $ 703 Total number of executives (iii) 5 5 Total annualised employee equivalent (AEE) (iv) 5 5

(i) No comparatives have been reported because remuneration in the prior year was determined in line with the basis and definition under FRD 21B. Remuneration previously excluded non-monetary benefits and comprised any money, received or receivable from a related party transaction. Refer to prior year's financial statements for executive remuneration for the 2015-16 reporting period.

(ii) Remuneration represents the expenses incurred by the entity in the current reporting periodfor the employee, in accordance with AASB 119 Employee Benefits (iii) The total number of executive officers includes persons who meet the definition of Key Management Personnel (KMP) of the entity under AASB 124 Related Party Disclosures and are also reported within the related parties note disclosure (Note 8.7) (iv) Annualised employee equivalent is based on the time fraction worked over the reporting period.

Note 8.7: Related parties

he hospital is a wholly owned and controlled entity o the tate o ictoria. Related parties o the hospital include: • all key management personnel and their close family members; • all cabinet ministers and their close family members; and • all hospitals and public sector entities that are controlled and consolidated into the whole of state consolidated financial statements.

All related party transactions have been entered into on an arm’s length basis. ey management personnel () o the hospital include the ortolio inisters and abinet inisters and as determined by the hospital (see notes 8. and 8.5). he compensation detailed below ecludes the salaries and beneits the Portfolio Ministers receive. The Minister’s remuneration and allowances is set by the Parliamentary Salaries and Superannuation Act 1968, and is reported within the Department of Parliamentary Services’ Financial Report.

2017 Compensation ($'000) Short-term employee benefits $ 846 Post-employment benefits $ 127 Other long-term benefits -$ 43 Termination benefits $ - Share-based payments $ - Total $ 930

Transactions with key management personnel and other related parties iven the breadth and depth o tate government activities related parties transact with the ictorian public sector in a manner consistent with other members o the public e.g. stamp duty and other government ees and charges. urther employment o processes within the ictorian public sector occur on terms and conditions consistent with the ublic dministration ct 200 and odes o onduct and tandards issued by the ictorian ublic ector ommission. rocurement processes occur on terms and conditions consistent with the ictorian overnment rocurement oard reuirements. utside o normal citien type transactions with the department there were no related party transactions that involved key management personnel and their close amily members. o provision has been reuired nor any epense recognised or impairment o receivables rom related parties.

Significant transactions with government related entities ast rampians ealth ervice received unding rom the epartment o ealth and uman ervices o $22.7 million (2016: $20.2 million )

2016-17 FINANCIAL REPORT FR40

FR 40 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017 Note 8.7: Remuneration of auditors

2017 2016 $'000 $'000

Victorian Auditor-General's Office Audit or review of financial statement 1 1

Other Providers nternal Audit reviews

Note 8.8: Ex-gratia expenses

2017 2016 $'000 $'000 ast rampians ealth Service is recognising the following e gratia epenses in the operating result for the year

Redundancy amounts paid to staff 1 Total ex-gratia expenses - 31

Note 8.9: Events Occurring after the Balance Sheet Date

o significant events occurred after the reporting date.

Note 8.10: Controlled Entities

Name of entity Country of Equity incorporation Holding

ast rampians ealth uilding for the Future Australia 1 Foundation

FR41 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 41 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17 East Grampians Health Service Annual Report 2016/2017

Note 8.11: AASBs issued that are not yet effective ertain new Australian accounting standards have been published that are not mandatory for the une 1 reporting period. DTF assesses the impact of all these new standards and advises ast rampians ealth Service of their applicability and early adoption where applicable. As at une 1, the following standards and interpretations had been issued by the AAS but were not yet effective. They become effective for the first financial statements for reporting periods commencing after the stated operative dates as detailed in the table below. ast rampians ealth Service has not and does not intend to adopt these standards early.

Standard / Summary Applicable for Impact on financial Interpretation annual reporting statements periods beginning or ending on AAS 9 Financial The key changes include the 1 an 18 The assessment has nstruments simplified reuirements for identified that the the classification and amendments are likely to measurement of financial result in earlier recognition assets, a new hedging of impairment losses and at accounting model and a more regular intervals. revised impairment loss hile there will be no model to recognise significant impact arising impairment losses earlier, as from AAS 9, there will be opposed to the current a change to the way approach that recognises financial instruments are impairment only when disclosed. incurred. AAS 1 The reuirements for 1an18 The assessment has Amendments to classifying and measuring identified that the financial Australian financial liabilities were impact of available for sale Accounting added to AAS 9. The AFS assets will now be Standards arising eisting reuirements for reported through other from AAS 9 the classification of financial comprehensive income December 1 liabilities and the ability to and no longer use the fair value option recycled to the profit and have been retained. loss. owever, where the fair hanges in own credit risk value option is used for in respect of liabilities financial liabilities the designated at fair value change in fair value is through profit and loss will accounted for as follows now be presented within • The change in fair value other comprehensive attributable to changes in income . credit risk is presented in edge accounting will be other comprehensive income more closely aligned with ; and common risk management • Other fair value changes practices making it easier are presented in profit and to have an effective hedge. loss. f this approach creates For entities with significant or enlarges an accounting lending activities, an mismatch in the profit or overhaul of related systems loss, the effect of the and processes may be changes in credit risk are needed. also presented in profit or loss.

AAS 1 Revenue The core principle of AAS 1 an 18 The changes in revenue from ontracts 1 reuires an entity to recognition reuirements in with ustomers recognise revenue when the AAS 1 may result in entity satisfies a changes to the timing and performance obligation by amount of revenue transferring a promised recorded in the financial good or service to a statements. The Standard customer. will also reuire additional disclosures on service revenue and contract modifications.

2016-17 FINANCIAL REPORT FR42 FR 42 Notes to and Forming Part of the Financial Statements East Grampians Health Service Annual Report 2016-17

East Grampians Health Service Annual Report 2016/2017

This tanar efers the an This aening stanar enents t anatr effective ate f ill efer the alicatin ustralian fr ntfrrfit eri f fr nt ccunting entities fr anuar frrfit entities t the Standards – t anuar rerting eri eferral f fr tfr rfit ntities

This stanar relaces an The assessent has nce f tfr ntriutins an inicate that revenue rfit ntities estalishes revenue fr caital grants that are recgnitin rinciles fr rvie uner an transactins here the enfrceale agreeent that cnsieratin t acuire an have sufficientl secific asset is significantl less ligatins ill n e than fair value t enale t eferre an recgnise as ntfrrfit entit t erfrance ligatins further its ectives are satisfie s a result the tiing recgnitin f revenue ill change

This tanar efers the an This aening stanar enents t anatr effective ate f ill efer the alicatin ustralian fr anuar eri f t the ccunting t anuar rerting eri in Standards – accrance ith the ffective ate f transitin reuireents eases The e changes intruce an The assessent has inclue the inicate that as st recgnitin f st erating leases ill ce erating leases hich are n alance sheet current nt recgnise n recgnitin f lease assets alance sheet an lease liailities ill cause net et t increase ereciatin f lease assets an interest n lease liailities ill e recgnise in the ince stateent ith arginal iact n the erating surlus The aunts f cash ai fr the rincial rtin f the lease liailit ill e resente ithin financing activities an the aunts ai fr the interest rtin ill e resente ithin erating activities in the cash fl stateent change fr lessrs

FR43 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY

FR 43 Notes to and Forming Part of the Financial Statements East Grampians Health Service East Grampians Health Service Annual Report 2016-17 Annual Report 2016/2017

Note 8.12: Alternate Presentation of Comprehensive operating statement

2017 2016 $'000 $'000 ntrst Sas ds and srs rants tr n

Total revenue 35,433 34,163

nss ratn tr ratn nss

Total expenses 38,255 36,357 Net result from transactions - Net operating balance (2,822) (2,194) t an ss n sa nnnana assts tr ans sss r tr n s ta tr n s ndd n nt rst 1,857 921

Net result (965) (1,273)

2016-17 FINANCIAL REPORTFR 44FR44 NOTES

122 DEMONSTRATING LEADERSHIP IN PATIENT SAFETY NOTES

2016-17 FINANCIAL REPORT 123 SITE DIRECTORY AND LOCATION MAPS EAST GRAMPIANS HEALTH SERVICE 2 016-17 ANNUAL REPORT

POMONAL 35km ELMHURST 25km

ARARAT WARRAK MOYSTON Ararat Rural City 15km (Part of Central Grampians)

BUANGOR

MAROONA 18km

WILLAURA TATYOON 34km

MININERA

STREATHAM Wimmera Central Grampians Central Highlands WICKLIFFE WESTMERE 54km LAKE BOLAC 49km

EAST GRAMPIANS 70 LOWE STREET WILLAURA HEALTH CARE HEALTH SERVICE Aged Care Facility Delacombe Way, Willaura 3379 P: 03 5354 1600 PO Box 155 70 Lowe Street, Ararat 3377 2016-17 P: 03 5352 9323 Girdlestone Street, Ararat 3377 PARKLAND HOUSE GARDEN VIEW COURT Delacombe Way, Willaura 3379 P: 03 5352 9300 Lowe Street, Ararat 3377 P: 03 5354 1613 F: 03 5352 5676 P: 03 5352 9324 ANNUAL E: [email protected] PATRICIA HINCHEY CENTRE www.eghs.net.au Girdlestone Street, Ararat 3377 P: 03 5352 9326 REPORT

DEMONSTRATING LEADERSHIP IN PATIENT SAFETY DEMONSTRATING LEADERSHIP IN PATIENT SAFETY