ANNUAL REPORT 2017–2018
CONTENTS
REPORT FROM THE BOARD CHAIR AND CHIEF EXECUTIVE...... 7
BOARD OF DIRECTORS...... 17
PETER MAC SERVICES...... 20
ATTESTATIONS...... 22
OTHER INFORMATION AND DISCLOSURES...... 24
SUMMARY OF FINANCIAL RESULTS...... 28
EMPLOYMENT AND CONDUCT PRINCIPLES...... 30
ADDITIONAL INFORMATION AVAILABLE ON REQUEST...... 33
OBJECTIVES, FUNCTIONS, POWERS AND DUTIES...... 34
2017-2018 STATEMENT OF PRIORITIES...... 35
DISCLOSURE INDEX...... 46
BOARD MEMBER’S, ACCOUNTABLE OFFICER’S AND CHIEF FINANCE AND ACCOUNTING OFFICER’S DECLARATION...... 48
FINANCIAL STATEMENTS...... 51
APPENDIX...... 130 BREAKING NEW GROUND. CHANGING LIVES.
“We are a cancer centre unsurpassed in the world, where humanity, caring service and relentless research share equal value. Nothing but the best is good enough in the treatment of cancer.” — Peter MacCallum
4. Vision and Values
VISION VALUES To provide the best in cancer Excellence – ensuring that clinical care, accelerating discovery and practice is evidence-based and translating to cures. patient-centred and is provided by qualified and experienced staff who Peter Mac is a proud, mission- are accountable and appropriately driven organisation that leads on a credentialed. global scale. Our founder, Sir Peter MacCallum said: Innovation – fostered by supporting research and a learning culture. “We are a cancer centre unsurpassed in the world, where humanity, caring Compassion – adhering to the service and relentless research share strongest ethical standards to equal value. ensure a culture of openness, mutual respect and trust is at our core. Nothing but the best is good enough in the treatment of cancer.” Although he made that statement nearly 70 years ago, as a guiding principle it is as clear, simple and relevant today as when Sir Peter first said it.
Peter MacCallum Cancer Centre Annual Report 2017-18 5. Achievements
300,000 600 $380M
cancer research articles published in hospital treatments prestigious journals budget
225 41 5
active clinical research sites across trials laboratories Victoria
160,000+ $80M
specialist clinic research budget appointments
We treated 36,500+ research revenue from all sources reached patients, $80 MILLION 4% an increase in 2 years of more than 2016-17. 34%
9.4% INCREASE in surgical patients treated from the previous year
6. REPORT FROM THE BOARD CHAIR AND CHIEF EXECUTIVE.
The year 2017-18 has been Last year, our 2,398 clinicians, outstanding for Peter MacCallum nurses, researchers, scientists, Cancer Centre. administrators and volunteers – delivered services from our home in We are, very proudly, Australia’s the Victorian Comprehensive Cancer only public hospital solely dedicated Centre (VCCC) building in Parkville to cancer treatment, research and and at our sites in Bendigo, Box education. Hill, Moorabbin and Sunshine, and Peter Mac delivers high quality care throughout the broader community. and treatment for individual patients, Guided by our Strategic Directions and improves the health and 2015-2019, we are closer than ever wellbeing for all Victorians affected to achieving our goal to be one of the by cancer. We achieve this through a top ten cancer hospitals in the world. comprehensive, globally-recognised cancer research program, our During 2017-18, we made significant network of international and national progress against our four Strategic partners, as well as world-class Directions, supported by a series of training of current and future health four Strategic Enablers. professionals.
The Hon. Maxine Morand Ms Dale Fisher Chair, Board of Directors Chief Executive
Peter MacCallum Cancer Centre Annual Report 2017-18 7. Report from the Board Chair and Chief Executive
STRATEGIC DIRECTION: Provide the world’s best cancer care
In 2017-18, Peter Mac cared for Our eight-bed short stay (23 more cancer patients than any other hour) unit for patients, who need Australian hospital. monitoring post-surgery but do not require an overnight bed, has According to the Victorian Healthcare successfully freed up in patient Experience Survey (VHES), beds, improving bed utilisation and perceptions of our care are very increasing flow through surgery. positive – 99% of adult Inpatients and As a result we treated an additional 98% of adult specialist clinic patients 469 surgical patients during the year, rated their overall experience as a 9.4% increase in surgical patients ‘very good’ or ‘good’. Our performance treated from the previous year. on a range of other key indicators remained above the We pride ourselves on caring for our We are frequently the benchmarked peer patients, not only during their stays average. with us, but after they return to their first site in Australia lives. We do this in a myriad of ways: Treatment for our to recruit patients for patients begins • the introduction of a nurse-led international first-in- with research. survivorship clinic in breast Clinical trials are cancer means that patients, human clinical trials. the foundation for the first time, are given upon which clinical a survivorship care plan at medicine is practised and patient discharge, which is then followed outcomes are realised. up in a shared care model with their GP. This initiative increases There are 225 clinical trials active at GP capacity and saves time in our Peter Mac at any one time. We are busy clinics by ensuring patients frequently the first site in Australia who need support get it directly. to recruit patients for international first-in-human clinical trials. Trials • the introduction of telehealth commonly involve new cancer consultations in 2017. Through therapeutics but also examine new telehealth, patients can have an approaches to surgery, radiation appointment with their Peter therapy, supportive care, pain control Mac specialist by video from and better ways of detecting the their home, with their local GP or spread of tumours. from their local health service. Our telehealth consultations During the year, we increased expanded last year and were clinical trial access by flexing-up conducted by 50 clinicians from four additional beds in the Parkville around Victoria for approximately Cancer Clinical Trials Unit. This 55 patients per month. means we can provide increased, more intense monitoring for clinical trial patients with trained nurses, while also freeing up inpatient beds.
8. Report from the Board Chair and Chief Executive
STRATEGIC DIRECTION: Accelerate discovery and translational research
Underpinned by internationally In the last two years, we have recognised clinical and laboratory established three global industry research staff and world’s best collaborations with pharmaceutical facilities, Peter Mac leads the way companies, Roche-Genentech, in the translation of research in the Bristol-Myers Squibb and Glaxo- prevention, diagnosis, treatment and Smith-Kline, to support lab-based care of cancer patients. and translational research in cancer immunotherapy. In addition to Peter Mac has 580+ full time providing more than $10 million in researchers funded from peer- additional funding for Peter Mac- review, industry and philanthropic led translational studies, these sources. In 2017-18, research international networks include world revenue from all sources reached renowned academic institutions $80 million, an increase of 34% in (Memorial Sloan Kettering, Institute just two years. Of this funding, we Gustave Roussey, Netherlands received $26.4 million from the Cancer Institute) that now formally National Health Medical Research align us with the very best like- Council organisations on the global stage. Peter Mac leads the (NHMRC). Recently, Peter Mac was invited Peter Mac way in translation of to join a selected number of continues a elite organisations in becoming research in the prevention, strategy of a Milner Therapeutics Institute promoting diagnosis, treatment and Affiliated Organisation. The Milner and investing Therapeutics Institute is part of the care of cancer patients. in the highly University of Cambridge. Its mission educated and is to accelerate academic research specialised discipline of clinician towards medical advancement by researchers. We employ the largest connecting the research potential number of PhD students – who of the University of Cambridge and are clinicians – in Australia and its affiliated organisations with the we intend to further bolster these drug development expertise and numbers. Clinician researchers are resources of the pharmaceutical key to driving translational research. industry. Many of our labs that carry out These international partners offer discovery-based fundamental a range of potential benefits to and translational research are led Peter Mac, including attracting by qualified medical specialists, talent, building capability, furthering particularly medical oncologists. training and education, establishing This is an important distinction and new research collaborations and differentiator for Peter Mac, clearly encouraging new investment. demonstrating that our workforce places an inherent value on bridging Our researchers continue to the gap between research and care. develop ground-breaking tests and Pioneering clinician researchers treatments in several different blood from around the world are keen to cancers, melanoma and skin cancer, work at Peter Mac for this reason. lung cancer and cancers that affect women: breast, ovarian and uterine.
Peter MacCallum Cancer Centre Annual Report 2017-18 9. Report from the Board Chair and Chief Executive
Many of the new drug treatments are LuPSMA therapy in men with targeted to specifically kill cancer advanced prostate cancer. A cells, and other novel approaches compilation of scans of eight that activate a patient’s immune Peter Mac patients, created by system. Many of these have been Professor Michael Hofman and advanced to clinical trials. Some his research team, has been examples include: declared “Image of the Year” by the Society of Nuclear Medicine and Venetoclax. During the year we Molecular Imaging. The image – that announced a breakthrough drug, demonstrates the dramatic before making a shift in the treatment and after effect of LuPSMA therapy of a range of blood cancers. This – was part of Peter Mac-sponsored breakthrough includes two new Phase II, single-arm study. clinical trials of chemotherapy-free combinations that demonstrated Cemiplimab drug trial. Previously dramatic benefits for patients with incurable skin cancers responded hard-to-treat diseases. Venetoclax to the new anti-PD1 therapy drug is based on scientific discoveries in almost 50% of patients on a made at the Walter and Eliza Hall Peter Mac clinical trial. Results Institute of Medical Research and of the Cemiplimab drug trial, led collaborations with Peter Mac by Professor Danny Rischin, have researchers and clinicians. The trials, shown 29 out of 59 patients with led by Professor John Seymour and advanced cutaneous squamous Associate Professor Constantine cell carcinoma had their cancers Tam, used Venetoclax in combination significantly reduced. with another targeted drug, and In recognition of our research resulted in remarkably high rates of eminence, Professor Joe Trapani clinical response, even in patients and Professor David Bowtell were who had exhausted every other elected Fellows of the Australian available treatment option. Academy of Science for 2018. Both Stereotactic ablative body are past Executive Directors of radiotherapy (SABR). A Peter Cancer Research at Peter Mac. The Mac clinical trial, led by Associate Australian Academy of Science is Professor Shankar Siva, using a fellowship of the nation’s most a highly advanced, single-dose distinguished scientists, elected radiotherapy treatment has halted by their peers for outstanding the spread of prostate cancer in contribution to science and some men, while also delaying scientific research. the need for conventional lifelong hormone therapy.
Our researchers continue to develop ground breaking tests and treatments.
10. Report from the Board Chair and Chief Executive
STRATEGIC DIRECTION: Focus on prevention and wellbeing Our ‘Population Health Strategy in cancer support programs and Framework’ is our blueprint for improving health literacy across collaborative work to develop, design the community, particularly for and deliver health initiatives for all disadvantaged groups. Victorians. An example is our work with young During 2017-18, after six years’ cancer patients. Our ONTrac at work with a multidisciplinary team Peter Mac Victorian Adolescent and of experts, we launched iPrevent® Young Adult Cancer Service is a – a tailored, web-based, decision multidisciplinary team that ensures support tool for breast cancer risk all aspects of a patient’s health and assessment and management. wellbeing are given attention both during treatment and in the years iPrevent gathers information about beyond. lifestyle, medical and family history and estimates breast cancer risk for Our Wellbeing Centre is a dedicated both the next 10 years and the rest of space for patients and carers to a person’s life. A personalised report relax and seek practical, emotional can then be printed and taken to a and social support during their time doctor for further discussion. with us. A sanctuary for our patients, their families and carers, the An international prospective patient-controlled space encourages validation study using data from relaxation and emotional and over 16,000 women confirmed physical wellbeing. the accuracy of the risk estimates provided by iPrevent. And an It provides a space for meetings Australian pilot study of women and and seminars for patients, their clinicians demonstrated that iPrevent families and carers, and co-ordinates has high usability and acceptability, a range of activities such as pet and suggesting that it improved music therapy. knowledge without increasing With a commitment to inclusion, we anxiety. work hard to promote accessibility The treatment of cancer can for all Victorians, including the include a range of drug therapies. economically or geographically During the year, implementation disadvantaged, Aboriginal and of the allergy de-labelling clinic Torres Strait Islanders, people commenced testing of patients with disability, and those from who state that they are allergic to Culturally and Linguistically Diverse specific antibiotics. The clinic has backgrounds (CALD) and Lesbian, identified that 90% of patients who Gay, Bisexual, Transgender and are labelled with an antibiotic allergy Intersex (LGBTI) backgrounds. are actually allergy-free. This has led Our public commitment to same to a significant reduction in the use sex marriage culminated in the first of broad spectrum antibiotics and is same sex marriage certificate issued welcome news for patients. in Victoria to a couple, Cas and Our commitment to empowering the Heather, who were married at Peter community to make better health Mac on 18 December 2017. choices drives our investment Cas and Heather’s wedding fulfilled
Peter MacCallum Cancer Centre Annual Report 2017-18 11. Report from the Board Chair and Chief Executive
During 2017-18, we their wish to be STRATEGIC ENABLER: married as soon Collaborative continued to build as possible due on our international to Cas’ declining partnerships and health. A waiting networks network, consolidating period was waived our global reputation and all goods and Peter Mac has a network spanning services were Victoria, Australia and the globe and multiplying benefit donated. Guests with partners across all aspects of to our cancer patients included the our vital work. These relationships improve the quality of our cancer back at home. Premier the Hon. Daniel Andrews, services and increase the reach, and Health impact, community awareness and Minister the Hon. Jill Hennessy and sustainability of our work for the Minister for Equality, the Hon. Martin benefit of cancer patients all over the Foley. world. During 2017-18, we continued to STRATEGIC DIRECTION: build on our international network, Develop new business consolidating our global reputation and multiplying benefits to our models and commercial cancer patients back at home. ventures Ongoing international relationships Peter Mac is pursuing a are thriving. Our Sister Institute diverse range of business and Agreement with MD Anderson commercialisation opportunities to Cancer Centre in Texas, USA provide a solid financial foundation continued to facilitate knowledge that enables future growth, exchanges around specific areas of innovation and adaption. expertise, increased participation in the global academic program In 2017-18 Peter Mac has enabling new collaborations with established new partnerships other international cancer centres with industry that has resulted in and supported joint research the translation of research into projects. commercial outcomes. In 2016, we signed a collaborative 2017-18 was the first full operating agreement with the Harvard- year for our clinical cancer genomics affiliated Dana-Farber Cancer unit 'Nexomics'. This unique model Institute in Boston to advance supports the implementation of novel research and improve diagnosis tests and technologies with the view towards better treatments and to enable commercialisation, rapidly potential cures. In 2017-18 we transferring new findings to clinical continued a joint research program applications leading to improved and a shared work program for quality of life for patients. senior clinicians. Our researcher Dr Elaine Sanij visited Dana-Farber to work with the world’s leaders in DNA repair therapies in ovarian cancer, helping our own trial of CX-5461 at Peter Mac and advancing Australian research in the area.
12. Report from the Board Chair and Chief Executive
Under our agreement with China’s 2017-18 Peter Mac provided immune Fudan University Shanghai Cancer monitoring for all of the paediatric Centre, we created further capability immunotherapy trials performed building and the rapid exchange of across the 12 partner institutions. clinical and scientific knowledge, Our work will lead to potential with five radiation oncologists funding opportunities and expansion visiting Peter Mac in 2017. of translational research capacity. On behalf of AusTrade, Chief Within Victoria, we continue to Executive Dale Fisher was the partner with leading healthcare and health lead in the Australian Life cancer specialist treatment, research Sciences delegation to Philadelphia and community organisations: and Houston during June 2018, • the Parkville Clinical Services showcasing Australia’s capability Operating Model drives improved in health and medical research, coordination of patient care, biotechnology and digital health. and offers expanded patient The delegation had a specific services. Under the model, focus on clinical trials and building Peter Mac is responsible for international relationships, which providing day chemotherapy strongly aligns with Peter Mac’s and medical oncology for the strategic directions. New connections entire Parkville precinct. were made and existing relationships • other services – including strengthened in the fields of new palliative care and haematology collaborations and clinical trials. – are now provided jointly Peter Mac’s Dr Dominic Wall and by Peter Mac and the Royal Associate Professor Jayesh Desai Melbourne Hospital. joined Dale on the mission. • we have signed a MoU with Swinburne University to work Back in Australia, Peter Mac works on a program of collaborative with health services and research projects, including a connection institutions, prevention and wellbeing with their astrophysicists and organisations, primary care partners, computing experts to help conferences and congresses. us look at complex research By collaborating with other research problems. Their unique expertise institutes such as Queensland and practical skills in studying Institute of Medical Research, the atmosphere are adding new Diamantina Institute, Children’s perspectives on our interest in 3D Cancer Institute Australia (Sydney), images and multi fluorescents, Centre for Cancer Biology/SAHMRI flow cytometry clustering (cell (Adelaide) and the Garvan Institute of counting, sorting, biomarker Medical Research (Sydney), exchange detection) and data mining in of knowledge, collaborative projects areas such as genomic mutations. and talent are brought to Victoria. An example is our work on the Zero Childhood Cancer program – the most significant childhood cancer research initiative ever undertaken in Australia. It brings together all major national clinical and research groups working in childhood cancer. In
Peter MacCallum Cancer Centre Annual Report 2017-18 13. Report from the Board Chair and Chief Executive
STRATEGIC ENABLER: Victorian Comprehensive Cancer Specialised cancer Centre Alliance. During 2017-18, more than 200 PhD students education and training undertook placements at Peter Mac. We significantly strengthened Peter Mac has the largest cohort in our educational strategy over many years of nurses undertaking the last 12 months by reshaping the Graduate Certificate in Nursing our organisational structure and Practice (Cancer and Palliative Care). operating model to maximise During 2017-18, students were being educational opportunities and supported by an internal scholarship resources. This included: medical program. As the Centre of Excellence staff, junior doctors, advanced for this University of Melbourne trainees, post fellowship trainees, program, our nurse educators teach nurses, allied health and pastoral and provide academic and subject care staff. coordination.
Peter Mac is training the STRATEGIC ENABLER: future cancer workforce. The best cancer workforce Clinical and research, allied health, This very important repositioning administrative and support staff reflects the multidisciplinary nature across all Peter Mac sites are of modern cancer care; mostly now offered access to professional delivered within tumour streams. development opportunities. Not only These are primarily focussed do we support them to meet their on caring for the patient with a career aspirations, underpinning particular illness. The opportunity is our corporate goal of employing to cross the pathways of traditional the best workforce, we also help by educational models to reflect reinforcing the culture, behaviours modern multidisciplinary care and attitudes required to deliver involving individuals from multiple our vision. professional backgrounds. During 2017-18, we implemented As we continue to establish a new leadership development ourselves as a leader in innovative, program (Leadership at all Levels) comprehensive and specialised which aims to improve leadership cancer education and training, the capability through individual leadership and support we provide performance appraisal, 360-degree the next generation of cancer feedback, mentoring, forums, clinicians and researchers is vital. coaching and leadership circles. Of equal value is the leadership In 2017, 80 staff participated in and support we provide to the next the 360 degree feedback program generation of cancer clinicians and including a debriefing session with a researchers. psychologist. As an example, with support from A major focus during the year was University of Melbourne, Peter to develop a strategy of promoting Mac designed the Comprehensive and investing in the highly educated Cancer PhD program to provide a and specialised discipline of training and support framework clinician researchers and increasing for the academic and professional our numbers of post-graduate development of students undertaking researchers. Peter Mac has the cancer-related research within the largest number of PhD students who
14. Report from the Board Chair and Chief Executive
are clinicians in Australia. In 2018, STRATEGIC ENABLER: we employed 120 post-grad research Advanced technology students, including 42 clinicians. This represents growth of 30% over the and infrastructure past three years. Robotic surgery has become an Our targeted recruitment campaign exciting new treatment option in for nurses Change a life, change urological, gynaecological and your own recruited 109 nurses. This general surgical procedures. Peter impressive result also allows us to Mac now has the most advanced focus on building talented teams, surgical robot in Australia. The skilling up our workforce, and to dual console da Vinci© Xi with an conduct longer-term career planning integrated motion operating table and succession planning. was installed in August 2017, representing the next frontier Peter Mac and The Royal Melbourne for minimally invasive surgery. Hospital commenced a nursing The Surgical Oncology da Vinci© haematology rotational pilot program Xi robot was funded exclusively that provides the opportunity for by public donations, including nurses from each haematology unit significant contributions from to spend three months working several philanthropic individuals, in the other hospital's unit. This in particular Bevelly Mitchell who model provides an opportunity for contributed the principal gift to make staff to care for patients across a this purchase possible. variety of disease streams within haematology as well as maintaining The Connecting Care program and expanding their knowledge and will transform patient care and skillset. research in Parkville by creating one powerful electronic clinical and Our People and Culture board research system for all Parkville subcommittee was established health services. With $124 million in 2018 and refreshed our people funding announced in the Victorian strategy. For the first time, gender Budget 2018/19, Connecting Care is equity was prioritised to identify a partnership with Melbourne Health, issues and strategies to improve The Women’s and Royal Children’s gender equity. For example, we Hospital. Work has commenced and conducted a pilot initiative – Return is due for completion in 2020. It will 1 to Work Grants in Aid – which see the delivery of a comprehensive recognises the particular challenges electronic medical record system for facing researchers attempting to the precinct. successfully integrate young families and their careers, and provides Peter Mac is working with the small grants to aid their career Melbourne Metro Rail Authority development. and its partner the Cross Yarra Partnership on the new Parkville Railway Station. The Metro Tunnel will connect the Parkville precinct to the city by train for the first time, making it quicker and easier for Victorians to access our main campus.
1 This was created by the "Gender Equity Committee".
Peter MacCallum Cancer Centre Annual Report 2017-18 15. Report from the Board Chair and Chief Executive
In the reporting period, Peter Mac Thank you to our clinicians, nurses continued to be a proud, mission- and allied health professionals; driven organisation that leads on a our researchers, scientists and lab global scale. Our founder, Sir Peter staff; the professionals who support MacCallum said: the business of Peter Mac and our tireless volunteers and Auxiliary. "We are a cancer centre unsurpassed in the world, where humanity, caring All of our staff come to work each service and relentless research day with one aim in mind – to give share equal value. Nothing but the people affected by cancer hope best is good enough in the treatment for the future. Peter Mac’s people of cancer." deserve the heartfelt appreciation of us all. Although he made that statement nearly 70 years ago, as a guiding Our network of partners and principle it is as clear, simple and collaborators, funders and donors relevant today as when Sir Peter first remain vital to our services. said it. And our community of patients, We would like to thank the Victorian families and carers remain at the government, the Premier and Health centre of everything that we do. Minister for their invaluable support during 2017-18. The Board welcomes new Directors: Ms Deirdre Blythe and Associate Professor Kate Cherry.
Ms Dale Fisher The Hon. Maxine Morand Chief Executive Chair, Board of Directors
16. BOARD OF DIRECTORS.
Peter MacCallum Cancer Centre’s BOARD DIRECTORS Board consists of nine Directors appointed by the Victorian The Hon. Maxine Morand, Chair Government. The Board provides Mr Desmond Pearson AO overall governance and strategic Ms Deirdre Blythe direction to Peter Mac Cancer Centre. Mr Ian Dunn AM Directors are appointed for a term of up to three years and may be re- Professor Jane Gunn appointed to serve for a maximum Associate Professor Kate Cherry nine years. The Board welcomed Associate Professor Leslie Reti AM Deirdre Blythe and Kate Cherry, Ms Louise Davidson who commenced their board terms during 2017-18. Mr Matt O’Keefe
RESPONSIBLE BODIES AUDIT AND RISK DECLARATION MANAGEMENT COMMITTEE MEMBERS In accordance with the Financial Management Act 1994, I am pleased Chair to present the report of operations Mr Desmond Pearson for Peter MacCallum Cancer Institute (Peter MaCallum Cancer Centre) for Members the year ending 30 June 2018. Ms Deirdre Blythe Mr Ian Dunn AM Ms Louise Davidson
ACCOUNTABLE The Hon. Maxine Morand OFFICER Chair, Board of Directors Melbourne Chief Executive Officer 17 August 2018 Ms Dale Fisher
Peter MacCallum Cancer Centre Annual Report 2017-18 17. Organisation Chart: 30 June 2018
BOARD RESEARCH PROFESSIONAL ACCOUNTABILITY
EXECUTIVE DIRECTOR CANCER RESEARCH CHIEF EXECUTIVE
Ricky Johnstone Dale Fisher
Cancer Experience Research Clinical Research Laboratory Research Translational Research Technology Transfer Office Ethics Office of Cancer Research
CHIEF NURSING OFFICER CHIEF MEDICAL OFFICER CHIEF FINANCIAL OFFICER
Jac Mathieson David Speakman Martin Shore
NURSING PROFESSIONAL MEDICAL PROFESSIONAL Accounts Payable ACCOUNTABILITY ACCOUNTABILITY Commercial Finance Financial Accounting Allied Health Australian Cancer Survivorship Centre Payroll Cancer Imaging Clinical Tumour Streams Private Billing and Revenue Education and Training (Parkville) Procurement and Support Nursing Workforce Consultative Medical Services Services Specialist Nurses Health Information Services Medical Heads of Units OnTRAC Psychosocial Oncology Prevention and Wellbeing
18. GENERAL COUNSEL & CORPORATE SECRETARY Elizabeth Kennedy
BOARD SECRETARY Robyn Sparre
EXECUTIVE DIRECTOR CLINICAL GOVERNANCE EXECUTIVE DIRECTOR CHIEF OPERATING OFFICER AND STRATEGIC PROJECTS STRATEGY & PLANNING
Nicole Tweddle Siegi Schmidmaier Lisa Dunlop
CLINICAL SERVICES Communications Facilities and PPP Pathology Metro Rail Project • Nexomics Quality and Safety Ambulatory Services Cell Therapies • Day Therapies • Specialist Clinics • Familial Cancer Centre Inpatient Services • Access • Inpatient Wards • Short Stay Unit • Perioperative Services • Peter Mac @ home Improvement Team IM&ICT Operational Planning and Performance Parkville Cancer Clinical Trials Unit People and Culture Radiation Oncology Business Management
Peter MacCallum Cancer Centre Annual Report 2017-18 19. PETER MAC SERVICES.
Peter Mac is Australia’s only public CLINICAL health service entirely dedicated to the treatment of people affected Allied Health by cancer. The powers, functions Anaesthesia and duties of Peter Mac are as Ambulatory Services prescribed by the Act. Peter Mac Cancer Imaging is world renowned as Australia’s Clinical Operations largest centre for cancer research, Clinical Services treatment and care and has played Clinical Tumour Streams a leading role in understanding the • Breast causes of cancer and improving • Upper Gastrointestinal how the disease is prevented, • Lower Gastrointestinal diagnosed, managed and treated, • Genitourinary to the benefit of Victorians and • Gynae-oncology Australians for 69 years. Peter • Haematology Mac comprises campuses at • Head and neck the Victorian Comprehensive • Lung Cancer Centre Building, Parkville, • Melanoma and skin with sites in Bendigo, Box Hill, • Neuro-oncology Moorabbin and Sunshine, which • Paediatric offer radiation therapy services. • Sarcoma • Cancer of unknown origin Dental Haematology Health Information Services Infection Prevention Inpatient Services Internal Medicine Medical Oncology Nursing Education & Training ONTrac @ Peter Mac Palliative Care Pathology Perioperative Nurse Coordinators Pharmacy Psychosocial Oncology Program Radiation Oncology Stomal Therapy Surgical Oncology
20. Peter Mac Services
CORPORATE SUPPORT Commercialisation Australian Cancer Communications Survivorship Centre Executive Office Core Facilities Finance Peter MacCallum Cancer Foundation Information Management & Information Communication Cell Therapies Technology Procurement & Support Services RESEARCH Operational Planning & Performance Blood Cell Therapies Patient Accommodation Cancer Based Cell Therapy People & Culture Cancer Experiences & Quality & Safety Nursing Research Centre for Biostatistics Volunteers and Clinical Trials Prevention and Wellbeing Office of Cancer Research Parkville Cancer Clinical Trials Unit Pathology Clinical Trials
Peter MacCallum Cancer Centre Annual Report 2017-18 21. ATTESTATIONS.
DATA INTEGRITY CONFLICT OF INTEREST I, Dale Fisher, certify that Peter I, Dale Fisher, certify that Peter MacCallum Cancer Centre has MacCallum Cancer Centre has put in worked to strengthen internal place appropriate internal controls controls and processes to and processes to ensure that it has ensure that data reported to the complied with the requirements of Department of Health and Human hospital circular 07/2017 Compliance Services reasonably reflects actual reporting in health portfolio entities performance. Peter MacCallum (Revised) and has implemented a Cancer Centre has critically ‘conflict of interest’ policy consistent reviewed these controls and with the minimum accountabilities processes during the 2017/2018 required by the Victorian Public year and has not identified any Sector Commission (VPSC). material inconsistencies that would Declaration of private interest forms significantly impact the accuracy and have been completed by all executive completeness of the performance staff within Peter MacCallum Cancer data. Centre and members of the Board, and all declared conflicts have been addressed and are being managed. Conflict of interest is a standard agenda item for declaration and documenting at each executive and Ms Dale Fisher Board meeting. Chief Executive and Accountable Officer 17 August 2018
Ms Dale Fisher Chief Executive and Accountable Officer 17 August 2018
22. Attestations
COMPLIANCE WITH FINANCIAL HEALTH PURCHASING MANAGEMENT VICTORIA (HPV) HEALTH COMPLIANCE PURCHASING POLICIES ATTESTATION I, Dale Fisher, certify that Peter I, Maxine Morand, on behalf of MacCallum Cancer Centre has the Responsible Body, certify that put in place appropriate internal Peter MacCallum Cancer Centre controls and processes to ensure has complied with the applicable that it has materially complied Standing Directions of the Minister with all requirements set out in the for Finance under the Financial HPV Health Purchasing Policies Management Act 1994 and including mandatory HPV collective Instructions. agreements as required by the Health Services Act 1988 (Vic) and has critically reviewed these controls and processes during the year. Minor instances of non-compliance arose The Hon. Maxine Morand out of the Peter MacCallum Cancer Chair, Board of Directors Centre’s contract for the provision 17 August 2018 of the procurement supply chain services with Melbourne Health.
Ms Dale Fisher Chief Executive and Accountable Officer 17 August 2018
Peter MacCallum Cancer Centre Annual Report 2017-18 23. OTHER INFORMATION AND DISCLOSURES.
CONSULTANCIES INFORMATION In 2017-18 there were 11 consultancies where the fee payable to the consultants totalled $10,000 or greater. The total expenditure incurred during 2017-18 in relation to these consultancies is $369,000 (excl. GST) including:
Total Future Total fee expenditure commitment approved approved approved (excl. GST) (excl. GST) (excl. GST) Consultant Purpose of consultancy Start Date End Date $000 $000 $000 Corporate and Clinical C. Meldrum 01/07/ 2017 30/06/2018 16 16 - Governance reviews Strategic Recruitment Davidson Pty Ltd 01/07/ 2017 30/06/2018 16 16 - Services Deloitte Strategic Advice - Consulting 01/07/ 2017 30/06/2018 50 50 - Education Pty Ltd Corporate and Clinical Ernst & Young 01/07/ 2017 30/06/2018 18 18 - Governance reviews Hardy Group Strategic Recruitment International Pty 01/07/ 2017 30/06/2018 62 62 - Services Ltd Jost & Co Strategic Advice – HR 01/07/ 2017 30/06/2018 54 54 - Commercialisation KPMG 01/07/ 2017 30/06/2018 26 26 - Advice L. Betts Corporate and Clinical 01/07/ 2017 30/06/2018 40 40 - Consulting Governance reviews Corporate and Clinical Oban Consulting 01/07/ 2017 30/06/2018 15 15 - Governance reviews Paxton Consulting Strategic Advice - 01/07/ 2017 30/06/2018 60 60 - Pty Ltd Finance The Centre for Corporate and Clinical Blood Diseases 01/07/ 2017 30/06/2018 12 12 - Governance reviews Pty Ltd
Consultancies in 2017-18 costing less than $10,000 Using the definition set out in FRD 22H, the total spend on consultancies costing less than $10,000 in 2017- 18 was $61,000 (excl. GST) across 8 consultants.
24. Other information and disclosures
INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) EXPENDITURE The ICT expenditure incurred during 2017-18 totalled $15,269,000 (excl. GST) with the details shown on the next page.
Business as usual (BAU) ICT expenditure Non-business as usual (Non-BAU) ICT expenditure
Total = Operational expenditure and capital Operational expenditure Capital expenditure (excl. Total (excl. GST) expenditure (excl. GST) (excl. GST) GST) $000s $000s $000s $000s 13,949 1,320 136 1,184
CAR PARKING FEES environment. Honeywell’s approach towards creating, promoting and Peter MacCallum Cancer Centre maintaining an environmentally complies with the DHHS hospital sensitive and sustainable service circular on car parking fees and delivery approach is detailed in the details of car parking fees and Environmental Management Plan. concession benefits can be viewed at: https://www.petermac.org/sites/ In 2017-18, Honeywell set objectives default/files/page/downloads/Peter_ and targets to improve the building’s Mac_Fact_Sheet-Car_Parking_2016. environmental impacts, ensured pdf operational control procedures were implemented and monitored and recorded the environmental system ENVIRONMENTAL implemented. Targets, utilities PERFORMANCE consumption and environmental Peter Mac is committed to operating audit results were reported monthly. in an environmentally responsible manner. This includes building EX GRATIA PAYMENTS a strong and sustainable future, A total of $34,327 was paid without continually aiming to improve admission of liability ex gratia to environmental performance by settle two (2) claims during the year. achieving best practice outcomes, complying with relevant federal and state legislation, and reducing NATIONAL COMPETITION the organisation’s environmental POLICY footprint. Peter Mac complies with the VCCC building manager, Honeywell, Victorian government’s competitive operates an environmental neutrality policy and complies with management system which is the National Competition Policy in certified to the AS/NZS/ISO 14001 relevant business activities. Standard and is in accordance with all applicable laws relating to the
Peter MacCallum Cancer Centre Annual Report 2017-18 25. Other information and disclosures
VICTORIAN INDUSTRY PROTECTED DISCLOSURE PARTICIPATION POLICY ACT 2012 ACT 2003 Peter MacCallum Cancer Centre has The Victorian Industry Participation a procedure for receiving complaints Policy Act 2003 requires Peter and notifications of public sector Mac to consider competitive local corruption and misconduct. A person suppliers, including small to who detects or has reasonable medium enterprises, when awarding grounds for suspecting improper contracts valued at $3 million or conduct (which includes corrupt more in metropolitan Melbourne conduct) is encouraged to raise any or for statewise activities. This is concerns with the designated Peter factored into any tender evaluation Mac Disclosure Officer. conducted by Peter Mac. There were Alternatively, under s51 of the no relevant contracts awarded or Independent Broad-Based Anti- commenced in 2017-18. Corruption Commission Act 2011 a person may also make a report FREEDOM OF directly to the Broad-Based Anti- INFORMATION ACT 1982 Corruption Commission (IBAC) about the existence of conduct they believe The Freedom of Information Act to be corrupt. There have been no 1982 (Vic) (FOI) provides the public disclosures reported to IBAC in the with a right to apply for access year ending 30 June 2018. to documents in accordance with this Act. Procedures for requesting information from records held by Peter Mac are outlined in the Freedom of Information brochure, available from Peter Mac or from DHHS, the Department of Justice, Public Records Office or the State Library. Requests for access to information in documentary form in the custody of Peter Mac should be made to Teresa Trotta, Freedom of Information Officer, Health Information Service, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Victoria, 8006. During 2017-18 Peter Mac received 79 FOI requests. Of these requests 76 were for medical record documents, 55 were for legal requests, 21 were for patient or next of kin requests and three were made by politicians. Peter Mac provides a report on these requests to the Department of Justice.
26. Other information and disclosures
CARERS RECOGNITION BUILDING ACT 1993 ACT 2012 The Minister for Finance has issued As a care support organisation, instructions in accordance with the Peter Mac: Building Act 1993 – No.126/1993, such that all public entities are • Takes all practicable measures required to ensure that all buildings to ensure that its employees under their control are safe and and agents have an awareness fit for occupation, comply with and understanding of the statutory requirements, buildings care relationship principles are maintained to a standard in • Takes all practicable measures which they remain safe and fit for to ensure that persons who are occupancy, and to report annually in care relationships and who on measures taken to ensure are receiving services in relation compliance with the Building to the care relationship from Act 1993. Peter Mac, have an awareness It is Peter Mac’s practice to obtain and understanding of the building permits for new projects care relationship principles and, where required, Certificates of • Takes all practicable measures Occupancy or Certificates of Final to ensure that Peter Mac and its Inspection when these projects are employees and agents reflect completed. the care relationship principles in developing, providing or Registered building practitioners evaluating support and assistance have been involved with all new for persons in care relationships. building works projects and were There are no disclosures required supervised by the Project Manager, to be made under the Carers Support Services. In order to Recognition Act 2012. maintain buildings in a safe and serviceable condition, routine inspections were undertaken. Where required, Peter Mac proceeded to implement the highest priority recommendations arising out of these inspections through planned rectification and maintenance works.
SAFE PATIENT CARE ACT 2015 Peter Mac has no matters to report in relation to its obligations under Section 40 of the Safe Patient Care Act 2015.
Peter MacCallum Cancer Centre Annual Report 2017-18 27. SUMMARY OF FINANCIAL RESULTS.
For the year ending 30 June 2018, Peter Mac (parent entity) recorded a net deficit of $1,135,000 after taking into account the impact of capital, depreciation and net results from its operations. The Victorian Government provides separately for depreciation costs via capital payments in response to submissions by health services. Excluding capital and specific items, Peter Mac recorded a small operating surplus of $10,000, compared to the budgeted break even target for 2017-18, and an operating surplus of $7,890,000 in the previous year.
FIVE YEAR FINANCIAL SUMMARY 1 Peter Mac 2017-18 2016-17 2015-16 2014-15 2013-14 (Parent entity) $000s $000s $000s $000s $000s
Total revenue 622,263 520,718 387,267 406,629 425,833
Total expenses (622,299) (572,703) (407,878) (334,969) (329,239)
Other Economic Flows Included in (1,099) 2,155 609 - - Net result Net result from the financial year (including capital and (1,135) (49,830) (20,002) 71,660 96,594 specific items)
Operating Result1 10 7,890 7,783 7,475 (1,998)
Total assets 1,619,020 1,652,014 1,686,977 540,480 409,059
Total liabilities 1,259,986 1,276,385 1,320,512 138,649 101,411
Net assets 359,034 375,629 366,465 401,831 307,648
Total equity 359,034 375,629 366,465 401,831 307,648
1. The operating result is the result for which Peter Mac is monitored in its Statement of Priorities also referred to as the Net Result before Capital and Specific Items.
28. Summary of Financial Results
Significant changes in the balance sheet (parent entity only) Net assets have decreased $16.6 million over the financial year, primarily due to a reduction in assets, offset by a smaller reduction in liabilities. Total assets have decreased by $33.0 million mainly due to depreciation and amortisation of assets associated with the VCCC building. Total liabilities have decreased $16.4 million due to a reduction in borrowings related to the PPP finance lease associated with the VCCC building offset by an increase in the liability for the interest rate swap that DHHS took out against potential interest rate movements in the PPP finance lease payments. Operational and budgetary objectives for 2017-18 The primary operational and budgetary objectives for the year were to meet the access, activity and financial targets agreed between Peter Mac and the Minister for Health as set out in the 2017-18 Statement of Priorities. Subsequent events Refer to Note 8.13: Events occurring after the balance sheet date.
Peter MacCallum Cancer Centre Annual Report 2017-18 29. EMPLOYMENT AND CONDUCT PRINCIPLES.
EMPLOYMENT AND VALUING A HEALTHY CONDUCT PRINCIPLES WORKFORCE Peter Mac’s culture reflects our The health of our workforce remains organisational values of excellence, a priority for Peter Mac. Our new innovation and compassion, and wellbeing strategy aims to provide is underpinned by our passion to a safe work environment for deliver the best in cancer care, staff and to promote and support treatment and research. all aspects of their health and wellbeing. This strategy covers This year, we ensured our emotional and spiritual health employment practices aligned and wellness, physical health and with the Victorian Public Sector wellness, financial health, leadership Employment Standards and behaviours and supporting cancer continued to demonstrate health and wellness. achievements in relation to our attraction and recruitment practices. We are committed to incident and injury prevention, ensuring staff Our orientation program continues have the right skills and capability to ensure staff begin their career to perform their roles safely and at Peter Mac with a patient centric effectively. understanding. The program highlights the role individual staff Our proactive approach includes: can have in leading change and • An accessible and trained group of improving the patient experience. health and safety representatives It includes presentations from our who actively participate in the patient ambassadors, whose stories identification and management help to ground our knowledge in the of the work environment reality of the cancer journey. • A manual handling program, Throughout the year, we continued shared throughout Peter to work with staff to deliver new Mac by a group of non-lift workforce models, programs and trainers, to educate staff in initiatives to increase engagement safe handling practices and build capability. This process has • Workplace assessments at an created capacity within our service, organisational and individual without compromising our high level to ensure the identification standard of care. of sound ergonomic practices, focused on eliminating or reducing muscle fatigue and injury
30. Employment and Conduct Principles
• Personal, professional development and wellbeing education programs featuring workshops on stress awareness and building resilience, courageous conversations, managing challenging behaviours, customer service, understanding change and transition and reflective practice • A benefits program which provides discounts and a range of physical, financial and mental health options to staff in line with our wellbeing strategy.
WORK FORCE STATISTICS
June Current Month FTE June YTD FTE
Labour Category 2017-18 2016-17 2017-18 2016-17
Nursing Services 508.92 445.92 469.85 412.92
Administration & Clerical 457.97 439.85 455.36 434.52
Medical Support Services 863.89 792.18 832.09 758.79
Hotel & Allied Services 63.98 64.95 64.78 71.83
Medical Officers 83.01 84.34 82.67 74.26
Hospital Medical Officers 100.81 110.73 109.70 102.26
Sessional Clinicians 56.12 58.09 57.04 53.18
Ancillary Support 63.42 59.74 60.56 47.88
Grand Total 2,198.12 2,055.8 2,132.05 1,955.64
Peter MacCallum Cancer Centre Annual Report 2017-18 31. Employment and Conduct Principles
PREVENTION AND MANAGEMENT OF OCCUPATIONAL VIOLENCE The prevention and management of occupational violence and aggression remains a major focus for Peter Mac in 2017-18 and as such, a new action plan has been developed to combat this significant risk area.
Occupational violence statistics 2017-18
Workcover accepted claims with an occupational violence cause per 100 FTE 0.05
Number of accepted Workcover claims with lost time injury with an occupational violence 0.26 cause per 1,000,000 hours worked.
Number of occupational violence incidents reported 47
Number of occupational violence incidents reported per 100 FTE 2.23
Percentage of occupational violence incidents resulting in a staff injury, illness or condition 2.13%
The following definitions apply: Occupational violence – any incident where an employee is abused, threatened or assaulted in circumstances arising out of, or in the course of their employment. Incident – an event or circumstance that could have resulted in, or did result in, harm to an employee. Code Grey reporting is not included. Accepted Workcover claims – accepted Workcover claims that were lodged in 2017-18. Lost time – is defined as greater than one day. Injury, illness or condition – This includes all reported harm as a result of the incident, regardless of whether the employee required time off work or submitted a claim.
OCCUPATIONAL HEALTH AND SAFETY INCIDENT TYPES Staff reporting of incidents has increased over the year, however Peter Mac remains at 32% better than the industry benchmark for WorkCover-related incidents.
Injury 2017 -18 2016-17 2015-16 Fall 21 18 26 Near miss 44 48 25 Occupational Violence 47 9 12 Sprain/strain, including back injuries 44 30 50 Splash/Spray 48 56 25 Other (incl. lacerations) 114 96 84 Total injuries 318 248 210
32. ADDITIONAL INFORMATION AVAILABLE ON REQUEST.
In compliance with the requirements g. Details of overseas visits of FRD 22G Standing Directions in undertaken including a the Report of Operations, details in summary of the objectives respect of the items listed below and outcomes of each visit. have been retained by Peter Mac, h. Details of major promotional, and are available to the relevant public relations and marketing Ministers, Members of Parliament activities undertaken and the public on request (subject by Peter Mac to develop to freedom of information community awareness of requirements, if applicable): Peter Mac and its services. a. A statement of pecuniary i. Details of assessments and interest has been completed. measures undertaken to improve the occupational health b. Details of shares held by senior officers as nominee and safety of employees. or held beneficially. j. General statement on industrial relations within Peter Mac and c. Details of publications produced by DHHS about the details of time lost through activities of Peter Mac and industrial accidents and disputes, where they can be obtained. which is not otherwise detailed in the Report of Operations. d. Details of changes in prices, fees, charges, rates and levies k. A list of major committees charged by Peter Mac. sponsored by Peter Mac, the purposes of each committee e. Details of any major external and the extent to which the reviews carried out on Peter Mac. purposes have been achieved. f. Details of major research l. Details of all consultancies and development activities and contractors including undertaken by Peter Mac that consultants/contractors are not otherwise covered either engaged, services provided, in the Report of Operations or and expenditure committed in a document that contains for each engagement. the financial statements and Report of Operations.
Peter MacCallum Cancer Centre Annual Report 2017-18 33. OBJECTIVES, FUNCTIONS, POWERS AND DUTIES.
Peter MacCallum Cancer Institute is aim to meet community needs a public health service incorporated effectively and efficiently. under the Health Services Act 1998 e. Integrate care as needed (Vic) (the Act), and uses as its trading across service boundaries in name, Peter MacCallum Cancer Centre order to achieve continuity of (Peter Mac). Peter Mac, through its care and promote the most Board of Directors, reports to the appropriate level of care to Victorian Minister for Health, the Hon. meet the needs of individuals. Jill Hennessy MP. f. Ensure that we aim for The powers, functions and duties of improvements in individual health Peter Mac are as prescribed by the Act. outcomes and population health status by allocating resources The core objective of Peter Mac is according to best practice to provide public health services health care approaches. in accordance with the National g. Ensure that we strive to Healthcare Agreement principles. continuously improve quality The National Healthcare Agreement and foster innovation. stipulates that states and territories h. Support a broad range of high- will provide health and emergency quality health research to services through the public hospital contribute to new knowledge system, based on the following and take advantage of Medicare principles: knowledge gained elsewhere. a. Eligible persons are to be given the i. Operate in a business-like choice to receive, free of charge manner which maximises as public patients, health and efficiency, effectiveness and cost- emergency services of a kind or effectiveness and ensures the kinds that are currently, or were financial viability of Peter Mac. historically provided by hospitals. j. Ensure that mechanisms are b. Access to such services by public available to inform consumers and patients free of charge is to be on protect their rights and facilitate the basis of clinical need and within consultation with the community. a clinically appropriate period. k. Operate a public health service as c. Arrangements are to be in authorised by or under the Act. place to ensure equitable l. Carry out any other activities that access to such services for all may be conveniently carried out in eligible persons, regardless of connection with the operation of a their geographic location. public health service or calculated d. Provide high quality health to make more efficient any of services to the community which Peter Mac’s assets or activities.
34. 2017 -2018 Statement of Priorities
2017-2018 STATEMENT OF PRIORITIES.
PART A: END OF YEAR REPORT
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
Better Health Reduce statewide Establish an Equity and Complete A system geared risks Diversity Committee, • Committee has been formally to prevention which will initially focus constituted and Terms of Build healthy as much as on gender equity in the Reference in place. neighbourhoods treatment workplace, and will then • The Gender Equity Strategy Help people to include age, disability and is under development. Everyone stay healthy cultural equity. understands their own health and Target health gaps Develop an action plan Complete risks that focusses on the • A disability and cultural safety outcomes of the recently Illness is detected audit has been completed and completed Aboriginal and managed an action plan put in place Cultural Safety audit. The early • An Aboriginal Health Strategic activities will focus on: Framework has been developed Healthy • Providing a welcoming • The possum skin cloak project neighbourhoods and culturally safe was completed. This project was and communities physical environment initiated as an outcome of the encourage • Addressing the Aboriginal Cultural Safety audit healthy lifestyles information and • Established a Parkville precinct education needs of Aboriginal and Torres Straight our staff to provide Islander (ATSI) working group them with support • Peter Mac’s Director of Prevention in ensuring cultural and Wellbeing has achieved safe services representation on the following • Research on what the key ATSI health committees: cancer care needs of ›› DHHS “Improving cancer Aboriginal people are outcomes for ATSI communities” • Implementing our Advisory Committee Aboriginal employment ›› DHHS “Improving identification action plan of ATSI people accessing cancer • Re-establishing our care”- Advisory Committee Aboriginal Health ›› DHHS “Optimal Care Pathway Advisory Committee for ATSI people with cancer” - Steering Committee
Peter MacCallum Cancer Centre Annual Report 2017-18 35. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
Part Complete • An Aboriginal Cultural Safety action plan is under development. • Peter Mac is collaborating with the Menzies School of Health Research to identify the experience of ATSI people access in cancer care.
Finalise the Breast Complete Screening Prevention iPrevent® A tailored, web-based, decision Tool and make it publicly support tool for breast cancer risk available to other assessment and management has institutions been published and made available to consumers and community providers via our website www.petermac.org/iPrevent. Since the launch of iPrevent in January, there have been over 5,000 people who have undertaken a breast cancer risk assessment
Establish a telehealth Complete program to enable rural • 2017, Peter Mac established a and remote patients and telehealth program, supported their local clinicians to by funding from the DHHS access relevant Peter • During the year, Peter Mac’s telehealth Mac experts via video consultations expanded, conducted from their own homes by 50 clinicians from around and communities. Victoria, treating 108 patients Initial focus to include • In 2018, new focus areas include haematology, late effects, pre-chemotherapy/Immunotherapy and palliative care. treatment reviews, Wimmera district to join Bendigo and Mildura, as key telehealth provider hubs • In February 2018, Peter Mac hosted an inaugural tele- oncology education program
36. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
Better Access Plan and invest Establish an eight Complete bed Short Stay Unit to Care is always Unlock innovation • Established an eight bed short there when increase throughput and stay (23 hour) unit for patients who people need it Provide easier efficient management need monitoring post-surgery access of inpatient beds for More access to • Performance against surgical surgical patients, throughput targets has improved care in the home Ensure fair and those requiring and community access significantly, finishing the year with cardiac monitoring or an elective surgery waiting list of People are assessment 540 against a revised target of 570 connected to the full range of care and support they Implement new models Part complete need of care to deliver • Authorisation is pending for several chemotherapy and treatment protocols to switch from IV There is equal immunotherapy in the administration to short subcutaneous access to care community setting. This injections making it more practical will include consultation to give in the community and partnerships with the • Identified potential patient Department of Health and cohorts suitable to convert to Human Services, Primary new protocol have been Health Network, and • Developed a patient self-administration home care providers education and administration program and identified non-hazardous therapies to pilot this program
Implement a patient (and Part complete referrer) friendly referral • Following extensive consumer and management process for referrer consultation, an ideal future Radiation Oncology so all state process has been developed patients can receive an • A full review of the patient registration appointment within one system and staff roles has been day of first contact completed. A new team has been established with training program in place. Subsequent to the training program a new ‘referrer hotline’ and support system that will meet all Victorian Integrated Non-Admitted Health business rules for patient and referrer notification will be implemented in Sept 2018
Peter MacCallum Cancer Centre Annual Report 2017-18 37. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
Quantify current unmet Complete demand for inpatient • Established a business case palliative care beds at • A specialist cancer palliative care bed Peter Mac and develop an unit at Peter Mac has been developed. approach in partnership The proposal will expand the current with the Department Parkville Integrated Palliative Care of Health and Human Service. The proposal has been Services to better meet endorsed by the Peter Mac Board this demand • The proposal: ›› Aligns with the Victorian Government End of Life and Palliative Care Framework and particularly the priority to strengthen specialist palliative care ›› Strengthens the Parkville Integrated Palliative Care Service ›› Responds to real demand for specialist palliative care beds. The palliative care beds will free up acute beds that can be used for cancer patients requiring acute care (so an increase of around 5 acute beds per day)
Define Peter Mac’s role Complete in the provision of high • Peter Mac has been recognised as complexity/high cost a specialist and majority provider of surgical procedures such Pelvic Exenteration services for Victoria as pelvic exenteration and hyperthermic intraperitoneal chemotherapy to ensure appropriate access can be maintained and supported
38. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
In partnership with Complete (Business Case and Planning) Melbourne Health and • In the 2018/19 State Budget, $124 The Royal Women’s million was awarded for the joint Hospital, commence Connecting Care EMR program planning and detailed between Peter Mac, the Royal Women’s design of the Foundation Hospital and Melbourne Health Electronic Medical • In May 2018, Epic was announced as Record. This will include Electronic Medical Record (EMR) vendor electronic orders and • Planning and detailed design Results functionality for for the Foundation Electronic Peter Mac Medical Record is underway • Project initiation activities including clinician engagement, communications, benefits realisation, scheduling and recruitment are in progress
Better Care Better Care As an academic Complete Target zero led, research based Put quality first • An external review of Parkville avoidable harm organisation, partner Cancer Clinical Trials Unit (PCCTU) Join up care with the Victorian Healthcare that was undertaken in Sept 2017. As a Comprehensive Cancer result of this review, processes were focusses on Partner with Centre to improve access streamlined to increase access two outcomes patients to clinical trials hundred open trials are underway Patients and Strengthen the • The VCCC Strategic Research Plan carers are active workforce being supported by a $20 million partners in care grant from the Victorian government Embed evidence Care fits together for clinical trials. The objectives around people’s Ensure equal include improving access, increasing needs care participation, ensuring equity for patients and Investigators. Nine programs areas have been identified including: tele-trials, investigator initiated trials, efficiencies, workforce, metrics, awareness. Peter Mac staff are deeply involved in the VCCC programs as Chairs or lead Members of respective steering committees. The PCCTU is also the VCCC Clinical Trial Lead
Peter MacCallum Cancer Centre Annual Report 2017-18 39. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
Through our People and Complete Culture Committee: • Strengthening Health Services • Finalise consultation Response to Family Violence and implement year (SHRFV) program implementation one of the Preventing has commenced Occupational Violence • SHRFV Advisory Committee and Aggression Plan establish, Terms of References • Implement the endorsed. The following initiatives Strengthening have been implemented: Health Services ›› Family violence policies and Response to Family procedures developed and endorsed Violence program ›› Family violence leave has been put in place and a number of staff have utilised this leave ›› An intranet site for family violence has been developed ›› A mandatory training program for all staff • A face-to-face occupational violence training program commenced in March 2018 and will continue for all staff who have contact with patients and visitors • The occupational violence working group has worked with Pro Com to design an online training program and will be available for all staff who have contact with patients and visitors to complete on an ongoing annual basis
40. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
Better Care Mandatory Developing electronic Part complete actions against dashboards to monitor • Peter Mac has commissioned new the ‘Target zero and report quality and business intelligence infrastructure, avoidable harm’ safety data (against that includes electronic performance goal: Develop and targets) across our dashboards, data warehousing implement a plan clinical areas. These and quality and safety reporting. to educate staff dashboards will provide The new infrastructure will go about obligations managers with a real- live in the second half of 2018 to report patient time performance tool safety concerns that can be used to inform discussions and education with staff to optimise their service
Mandatory Partner with patients Part complete actions against to put quality first by • Inpatient bed access has vastly the ‘Target addressing priorities improved over the last with a series of zero avoidable arising from the improvement initiatives in discharge harm’ goal: outcomes of the Victorian planning and demand management. In partnership Healthcare Experience A discharge summary taskforce with consumers, Survey: has recently been commissioned identify 3 priority • Discharge planning to improve discharge planning improvement - the proportion of • A customer service education areas using patients who will program for frontline support staff Victorian receive a copy of their has been implemented and resulted Healthcare discharge summary in a 20% drop in patient complaints Experience on leaving the hospital related to staff behaviour Survey data and will increase • All patient information material is establish an developed with consumers using improvement • Politeness and co-design methodology with content plan for each. courtesy of staff – a tested against health literacy criteria These should be customer service reviewed every training program • The Australian Cancer Survivorship six months to will be implemented Centre - A Richard Pratt legacy reflect new areas across the hospital, (ACSC) at Peter Mac has launched a for improvement targeting areas new language resources for CALD in patient with the highest cancer survivors. The new resources experience complaints rate first include “On the Road to Recovery” – • Patient information a suite of booklets and fact sheets – review adequacy of focused on the time after cancer patient information, treatment and specifically designed including languages for people from CALD backgrounds available and appropriateness to meet the needs of our diverse community
Peter MacCallum Cancer Centre Annual Report 2017-18 41. 2017 -2018 Statement of Priorities
Strategies set by Deliverable - Goals the DHHS Peter Mac Actions End of Year Report Back
• A languages drop-down menu has also been added to the Peter Mac website to provide an obvious entry point to the new information in languages including Arabic, Chinese, Greek, Hindi, Italian, Turkish, Tagalog, Vietnamese and also easy English • Second Ears – a tool for patients to record consultations has been developed. Second Ears has promoted patient participation by improving their recall and understanding of medical information. Second Ears was introduced after comprehensive testing with patients, families, clinicians and administrators • Peter Mac embarked on a new partnership with RMIT University to explore how creativity, design and innovation can improve the experience of patients and cancer information. Peter Mac hosted two design studios, identifying six project concepts to progress to phase 2. Three to six projects will be selected for implementation and investment/grant application in the second half of 2018
42. 2017 -2018 Statement of Priorities
PART B: PERFORMANCE PRIORITIES HIGH QUALITY AND SAFE CARE1 Accreditation 2017-18 Target 2017-18 Result Accreditation against the National Safety and Quality Full Compliance Full accreditation Health Service Standards
Infection Prevention and Control 2017-18 Target 2017-18 Result
Compliance with the Hand Hygiene Australia Program 80% 83.5%
Percentage of healthcare workers immunised for 75% 82.5% influenza
Patient Experience 2017-18 Target 2017-18 Result
Q1 Full compliance1 Victorian Healthcare Experience Survey – percentage of 95% positive experience Q2 Full compliance1 positive patient experience responses Q3 94% Q1 Full compliance1 Victorian Healthcare Experience Survey – percentage of 75% very positive Q2 Full compliance1 very positive responses to questions on discharge care experience Q3 86% Q1 Full compliance1 Victorian Healthcare Experience Survey – patients 70% Q2 Full compliance1 perception of cleanliness Q3 77%
2
345 • Healthcare Associated Infections 2017-18 Target 2017-18 Result
Number of patients with surgical site infection No outliers 82
Rate of patients with SAB4 per occupied bed day < 1/10,000 < 0.81/10,000
Adverse Events 2017-18 Target 2017-18 Result
Number of sentinel events Nil Achieved
Mortality – number of deaths in low mortality DRGs5 Nil NA3
1 Less than 42 responses were received for the period due to the relative size of the health service. 2 This data is extrapolated based on a detailed audit of surgical cases conducted by Peter Mac for a 3 month period. 3 This indicator was withdrawn during 2017-18 and is currently under review by the Victorian Agency for Health Information 4 SAB is Staphylococcus aureus bacteraemia 5 DRG is Diagnosis Related Group
Peter MacCallum Cancer Centre Annual Report 2017-18 43. 2017 -2018 Statement of Priorities
TIMELY ACCESS TO CARE
Elective Surgery 2017-18 Target 2017-18 Actual Percentage of urgency category 1 elective surgery 100% 100.0% patients admitted within 30 days Percentage of urgency category 1, 2 and 3 elective surgery patients admitted within clinically recommended 94% 89.7% time Percentage of patients on the waiting list who have 5% or 15% proportional waited longer than clinically recommended time for their improvement from prior 9.4% respective triage category year Number of patients on the elective surgery waiting list* 600 511 Number of hospital initiated postponements per 100 ≤ 8 /100 8.2 scheduled elective surgery admissions Number of patients admitted from the elective surgery 3,100 3,147 waiting list
Specialist Clinics 2017-18 Target 2017-18 Actual Percentage of urgent patients referred by a GP or external specialist who attended a first appointment 100% 83.1% within 30 days Percentage of routine patients referred by GP or external specialist who attended a first appointment within 365 90% 96.2% days
STRONG GOVERNANCE, LEADERSHIP AND CULTURE
Key performance indicator 2017-18 Actual
People matter survey – percentage of staff with a positive response to the question, 88% “I would recommend a friend or relative to be treated as a patient here”
EFFECTIVE FINANCIAL MANAGEMENT
Key performance indicator 2017-18 Target 2017-18 Actual Operating result ($million) $0.0M $0.0M Average number of days to paying trade creditors 60 days 44 days Average number of days to receiving patient fee debtors 60 days 38 days Public and Private WIES2 activity performance to target 100% 100.7% 0.7 or 3% improvement Adjusted current asset ratio from health service base 1.66 target Number of days of available cash 14 days 12.2 days
2 WIES is a Weighted Inlier Equivalent Separation 44. 2017 -2018 Statement of Priorities
PART C: ACTIVITY AND FUNDING
2017-18 2016-17 Acute Admitted Actual Activity Actual Activity
WIES Public 15,635 14,328
WIES Private 6,961 6,390
WIES DVA 125 148
2017-18 2016-17 Acute Non-Admitted Actual Activity Actual Activity
Home Enteral Nutrition 1,242 1,267
Radiotherapy WAUs Public 294,868 279,803
Radiotherapy WAUs DVA 3,706 3,082
Specialist Clinics - Public 85,104 NA
2017-18 2016-17 Other Actual Activity Actual Activity
Health Workforce 65 115
Peter MacCallum Cancer Centre Annual Report 2017-18 45. DISCLOSURE INDEX.
The annual report of Peter MacCallum Cancer Centre is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of Peter MacCallum Cancer Centre’s compliance with statutory disclosure requirements. Legislation Requirement Page Reference Charter and purpose FRD 22H Manner of establishment and the relevant Ministers 34 FRD 22H Purpose, functions, powers and duties 34 FRD 22H Initiatives and key achievements 35 FRD 22H Nature and range of services provided 20
Management and structure FRD 22H Organisational structure 18
Financial and other information FRD 10A Disclosure index 46 FRD 11A Disclosure of ex gratia expenses 25 FRD 21C Responsible person and executive officer disclosures 17, 116 FRD 22H Application and operation of Protected Disclosure 2012 26 FRD 22H Application and operation of Carers Recognition Act 2012 27 FRD 22H Application and operation of Freedom of Information Act 1982 26 FRD 22H Compliance with building and maintenance provisions of Building Act 1993 27 FRD 22H Details of consultancies over $10,000 24 FRD 22H Details of consultancies under $10,000 24 FRD 22H Employment and conduct principles 30 FRD 22H Information and Communication Technology Expenditure 25 FRD 22H Major changes or factors affecting performance 7, 28 FRD 22H Occupational violence 32 FRD 22H Operational and budgetary objectives and performance against objectives 29
46. Disclosure Index
Legislation Requirement Page Reference FRD 22H Summary of the entity’s environmental performance 25 FRD 22H Significant changes in financial position during the year 29 FRD 22H Statement on National Competition Policy 25 FRD 22H Subsequent events 29, 128 FRD 22H Summary of the financial results for the year 28 FRD 22H Additional information available on request 33 FRD 22H Workforce Data Disclosures including a statement on the application of employment and conduct principles 30 FRD 25C Victorian Industry Participation Policy disclosures 26 FRD 29B Workforce Data disclosures 31 FRD 103F Non-Financial Physical Assets 86 FRD 110A Cash flow Statements 60 FRD 112D Defined Benefit Superannuation Obligations 74 SD 5.2.3 Declaration in report of operations 17 SD 3.7.1 Risk management framework and processes 23 SD5.1.2.2 Financial Management Compliance Attestation 23
Other requirements under Standing Directions 5.2 SD 5.2.2 Declaration in financial statements 48 SD 5.2.1(a) Compliance with Australian accounting standards and other authoritative pronouncements 48, 62 SD 5.2.1(a) Compliance with Ministerial Directions 62
Legislation Freedom of Information Act 1982 26 Protected Disclosure Act 2012 26 Carers Recognition Act 2012 27 Victorian Industry Participation Policy Act 2003 26 Building Act 1993 27 Financial Management Act 1994 17, 62 Safe Patient Care Act 2015 27
Peter MacCallum Cancer Centre Annual Report 2017-18 47. BOARD MEMBER’S, ACCOUNTABLE OFFICER’S AND CHIEF FINANCE AND ACCOUNTING OFFICER’S DECLARATION
The attached financial statements for Peter MacCallum Cancer Centre and the Consolidated Entity have been prepared in accordance with Direction 5.2 of the Standing Directions of the Standing Directions of the Minister of Finance under the Financial Management Act 1994, applicable Financial Reporting Directions, Australian Accounting Standards including Interpretations, and other mandatory professional reporting requirements. We further state that, in our opinion, the information set out in the comprehensive operating statement, balance sheet, statement of changes in equity, cash flow statement and accompanying notes, presents fairly the financial transactions during the year ended 30 June 2018 and the financial position of Peter MacCallum Cancer Centre and the Consolidated Entity at 30 June 2018. At the time of signing, we are not aware of any circumstance which would render any particulars included in the financial statements to be misleading or inaccurate. We authorise the attached financial statements for issue on 17 August 2018.
The Hon. Maxine Morand Dale Fisher Martin Shore Chair, Board of Directors Chief Executive and Chief Finance Officer and Melbourne Accountable Officer Accounting Officer Melbourne 17 August 2018 Melbourne 17 August 2018 17 August 2018
48.
FINANCIAL STATEMENTS.
Peter MacCallum Cancer Centre Annual Report 2017-18 51.
Independent Auditor’s Report To the Board of Peter MacCallum Cancer Centre