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Rural Directions––For a Stronger Healthier Victoria Update of Rural Directions for a Better State of Health

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Rural Directions––For a Stronger Healthier Victoria Update of Rural Directions for a Better State of Health Rural directions––for a stronger healthier Victoria Update of Rural directions for a better state of health Rural directions––for a stronger healthier Victoria Update of Rural directions for a better state of health ii Rural directions––for a stronger healthier Victoria If you would like to receive this publication in an accessible format, please phone 03 9096 2007 using the National Relay Service 13 36 77 if required, or email <[email protected]>. This document is also available in PDF format on the internet at <www.health.vic.gov.au/ruralhealth>. Published by Victorian Government Department of Health, Melbourne, Victoria. © Copyright State of Victoria, Department of Health, 2009 This publication is copyright. No part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968. Authorised by the State Government of Victoria, 50 Lonsdale Street, Melbourne. Printed on sustainable paper by Energi Print Pty Ltd, 2–4 Emily Street, Murrumbeena 3163. (0220909) October 2009 Rural directions––for a stronger healthier Victoria iii Contents Foreword v Vision and principles vii Executive summary 1 Introduction 5 Policy context 6 Changing demographics of rural Victoria 7 Forecast demand for health services 10 Rural directions––for a stronger healthier Victoria 13 Direction 1: Improving the health of rural Victorians 15 Aboriginal health 16 Alcohol and drug services 17 Aged care 18 Cancer services 19 Cardiac services 19 Critical care 20 Emergency care 20 Environmental health 21 Health promotion 22 Hospital Admission Risk Program 23 Maternity services 23 Mental health 24 Neonatal services 25 Oral health 25 Paediatric services 26 Palliative care 26 Primary health care 27 Procedural services 28 Renal dialysis 30 Stroke services 30 Sub-acute services 31 Vulnerable children 31 Direction 2: Supporting a contemporary health system 33 Regional health services 35 Sub-regional health services 39 Local health services 43 Emergency ambulance and patient transport services 48 Direction 3: Strengthening and sustaining rural health services 51 Continuing service enhancement 52 Growing workforce capacity 56 Improving governance and performance 59 Appendix 1: Minimum emergency care 65 Appendix 2: Regional profiles 66 iv Rural directions––for a stronger healthier Victoria Abbreviations ABS Australian Bureau of Statistics AHNP Aboriginal Health National Partnership AIHW Australian Institute of Health and Welfare AMWAC Australian Medical Workforce Advisory Committee ARV Adult Retrieval Victoria BNC bush nursing centre BNH bush nursing hospital COAG Council of Australian Governments CPHI Centres for Promoting Health Independence CT computerised tomography GEM geriatric evaluation and management GP general practitioner HARP Hospital Admission Risk Program HARP–BCOP Hospital Admission Risk Program––Better Care for Older People HIP guidelines Health independence programs guidelines HITH Hospital in the Home ICT information and communications technology IMG international medical graduate IT information technology LGA local government area MNCN Maternity and Newborn Clinical Network MPS multipurpose service NEPT non-emergency patient transport PCN Victorian Paediatric Clinical Network PCP Primary Care Partnership RICS rural integrated cancer services RMI Rural Maternity Initiative SACS sub-acute ambulatory care services SCN special care nursery SEIFA Socio-Economic Indexes for Areas SFF Sustainable Farm Families SRHS Small Rural Health Services VMO visiting medical officer VPTAS Victorian Patient Transport Assistance Scheme Rural directions––for a stronger healthier Victoria v Foreword When we think of health care, we think of much more than just hospitals. Health promotion, illness prevention, management and active treatment of illness and injury, through to care of the aged and end-of-life care are all active components of the coordinated and connected health system we have in rural Victoria. We have seen much innovation and change in the years since Rural directions for a better state of health was released in 2005. Rural health services have embraced the opportunities to provide better comprehensive care for their communities. The cooperation and coordination between services demonstrates what can be achieved when we work together to support high-quality health care in local communities. Good health care and an increasing focus on illness prevention is a high priority for both the Commonwealth and Victorian Government. The challenges of managing growing demand on the health system as a result of the ageing population and increasing complexity of clients provides us with opportunities to examine how the system can do better. In many ways rural health services lead the way in integrated care, with innovation evident throughout the state. The Government is strongly committed to continuing to improve the health of Victorians. Victoria is well positioned to capitalise and lead the way in the national reform agenda currently being discussed and debated by all governments. As an example, tackling cancer has already been identified as one of our top priorities, with the objective of improving access for all Victorians to the best possible care, informed by world-class research. We know we will only achieve measurable change when improvement in access and outcomes is evident in rural Victoria. Rural health services face a changing world, with impacts of climate change, workforce pressures and population trends presenting both challenges and opportunities. The government will continue to support health services to manage these challenges and ensure communities remain strong and resilient, with an exciting future ahead as health care provision continues to evolve. I am pleased to present Rural directions––for a stronger healthier Victoria, which continues to articulate the government’s vision for a high-quality and sustainable rural health system for the next five years and beyond. The Hon. Daniel Andrews MP Minister for Health Rural directions––for a stronger healthier Victoria vii Vision Principles To enhance and protect the health Rural health policy directions recognise health care needs are and wellbeing of Victorians living changing and that the system must continue to evolve to better meet in rural and regional areas by those needs. The guiding principles aim to maximise access, quality providing a sustainable rural health and continuity of care, service flexibility, opportunities for service system that is connected, person substitution and diversion as well as optimal use of all resources. focused and provides the right The principles of rural health system planning, development and support in the right place. provision are: • A comprehensive health system is about the full continuum of health––from health promotion, illness prevention and management, active treatment of illness or injury, care for the aged and end-of-life care. • The health system will be person and family centred, with consideration of a person’s needs as these change over time, rather than centred on agencies or programs. • People will have appropriate access to services and contemporary models of care that are both effective and safe. • People will be supported to manage and protect their own health. • Victorians living in rural areas should expect to have the majority of their care needs met by services in their own region. • A comprehensive service system has services working flexibly and in coordinated partnerships, to benefit communities. • Health care will be provided in the most appropriate and least complex setting. • Services should be planned and coordinated within geographical areas to address needs of a broader population. • High-volume, low-complexity services will be provided as close to home as possible, without compromising the quality of care. • Low-volume, high-complexity services will be concentrated in key locations to ensure service quality and sustainability. • Changing models and alternative options for care will increase the need for flexibility in both workforce and physical infrastructure. • Innovation and planning contribute to an improved, sustainable workforce and service system. viii Rural directions––for a stronger healthier Victoria Rural directions––for a stronger healthier Victoria 1 Executive summary The Victorian Government’s vision for the ongoing support and development of the health system in rural Victoria was outlined in Rural directions for a better state of health,1 released in November 2005. This recognised that a comprehensive health system will provide the right care in the best place to meet community needs. It also recognised that the health system cannot be static but must constantly evolve as service models and options for care progress and change. Rural directions confirmed that the future of health services in Victoria was assured. What was needed was to ensure we have a strong, responsive and sustainable health system, which is able to keep pace with social, economic and service changes and continue to meet contemporary community needs. Rural directions provided an opportunity for all those working with or for rural health services to see how change needed to be supported to continue to meet the challenges faced by the system and how, working together, these can be managed. Rural directions then provided three strategic directions, each containing a number of specific projects, for rural health services to develop and enhance their roles in the system of care across Victoria. Since 2005 work
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