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The Clinical Services Plan Update 2008

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The Clinical Services Plan Update 2008 0<OCR<TOJ=@OO@MC@<GOC 0<OCR<TOJ=@OO@MC@<GOC TASMANIA’S HEALTH PLAN Clinical Services Plan: Update Incorporating changes to ownership of the Mersey Community Hospital MAY 2008 For more information on Tasmania’s Health Plan visit www.health.tas.gov.au Department of Health and Human Services Table of Contents Foreword 3 Executive summary 4 Introduction 8 Implementation commitments 9 Tasmania’s community and its health status 15 Tasmania’s population 15 The socio-economic and health status of Tasmanians 19 Implications for Tasmania’s health care system 21 Tasmania’s public acute hospital system 22 Introduction 22 The Royal Hobart Hospital 22 The Launceston General Hospital 23 The North West Regional Hospital (Burnie) and the Mersey Community Hospital 23 Principles for Tasmania’s health services 27 Progress since publication of the Clinical Services Plan 28 Inpatient activity 28 Emergency activity 28 Community-based services 29 Clinical Services Plan initiatives 29 Aligning the Department’s structure with service delivery objectives 30 The service capability framework 32 Principles 32 Cooperative service development and support 33 Statewide services – governance, funding and accountability 33 Applying the service capability framework to existing services 36 Specific service issues 41 Autologous bone marrow transplantation 41 Adult medical retrieval 41 Bariatric surgery 41 Cardiac electrophysiology 42 Hyperbaric medicine 42 Medical imaging 42 Pathology 42 Rehabilitation 43 Vascular surgery 44 Clinical Services Plan: Update 1 Integrated care centres 46 Commitment to develop purpose-built facilities for integrated care 46 Integrated care – a definition 46 The need for integrated care 46 Types of integration of health care 47 Efficiency and accessibility of hospital services 50 Introduction 50 Benchmarking Tasmania’s resources 50 Using resources efficiently – benchmarking length of stay 51 Using resources efficiently – potentially avoidable hospital admissions 52 Regional utilisation rates 53 Regional self-sufficiency 54 Equity of regional investment 55 Access to emergency department services 59 Predicting future demand 60 Meeting the needs of the community – the future service system 64 Introduction 64 Planning sub-catchments for the North West region 65 A single hospital for the North West region 65 Planning for an integrated service system in the North West region 66 Planning assumptions for the North and North West regions 69 Planned acute hospital activity, 2016–17 72 Planning outcomes for the North West Regional Hospital (Burnie) 75 Planning outcomes for the Mersey Community Hospital 76 Planning outcomes for the Launceston General Hospital 77 Planning outcomes for the Royal Hobart Hospital 78 Enablers of a sustainable service system 81 Clinical networks 81 Workforce 83 Stakeholder engagement and distributed governance 83 Glossary of abbreviations 85 Glossary of terms 86 2 Clinical Services Plan: Update Foreword Last year, when I released Tasmania’s Health Plan and the documents that underpin it – the Clinical Services Plan and the Primary Health Services Plan – I said that it was time to ‘take the politics out’ of health care. I argued that it was time to make patients, along with the quality, safety and sustainability of the care they receive, our focus. Four short months later another chapter in the shared history of politics and health was written with former Prime Minister John Howard’s intervention at the Mersey campus of the North West Regional Hospital. Ownership of the Mersey Community Hospital was transferred from the Tasmanian Government to the Australian Government on 23 November 2007. Given its intended role in the coordination of hospital services in Tasmania, the Mersey’s change of ownership made it necessary to update the Clinical Services Plan. The update that follows is not only the result of that work, but it also provides an opportunity to do much more than dwell on the change of ownership. Indeed, it provides a chance to show that work is progressing on the implementation of Tasmania’s Health Plan with the majority of projects associated with it well underway. It also allows new and updated information to be included to ensure the development of Tasmania’s public acute hospitals and related services is based on the most accurate data projections available. This update incorporates specific goals and timeframes for implementation, and includes a number of recent initiatives being pursued by the new Australian Government. These initiatives will significantly improve the availability of acute health services to our community and need to be taken into account as we plan the growth and development of Tasmania’s public acute hospitals. While the Tasmanian Government believes the 2007 Clinical Services Plan represents the best approach to meeting the health needs of all Tasmanians, this update re-endorses the principles of access, quality, safety and sustainability that underpinned the Plan. It also sets out an approach to working constructively with the Mersey Community Hospital to ensure the services it provides in the future are integrated as much as possible with other public health care services on the North West Coast. I am confident that this Clinical Services Plan update, as part of Tasmania’s Health Plan, provides a sound basis for the future of health care in this State. I look forward to its continued implementation and improvements in our health services in coming years. Lara Giddings Minister for Health and Human Services Clinical Services Plan: Update 3 Executive summary Tasmania’s Health Plan, published in May 2007, incorporated a Primary Health Services Plan and a Clinical Services Plan which defined the future configuration of Tasmania’s public acute hospital services. Since that time, a number of changes have occurred, including but not limited to the purchase of the Mersey Community Hospital by the Australian Government. The Tasmanian Government believes that the changes proposed in the 2007 Clinical Services Plan represent the most appropriate approach to meeting the health needs of the community, particularly in the North West region of Tasmania. Nevertheless, the changes that have occurred since the 2007 Clinical Services Plan was published require it to be updated. This Clinical Services Plan update reviews progress since the Clinical Services Plan was published, addresses the impact of a number of Commonwealth and State initiatives and incorporates data modelling based on the most recent service utilisation and demographic data available. Planning has continued on the redevelopment of the Royal Hobart Hospital (RHH) and on the development of an Integrated Care Centre (including a renal dialysis unit) in Launceston. Funding commitments have been made for a number of new services including a fifth linear accelerator for the State, two magnetic resonance imaging units (one at the Launceston General Hospital, the purchase of which has been approved, and one in the North West region) and a positron emission tomography (PET) scanner at the RHH. A review of bone marrow transplantation services has been concluded and the results are being implemented, and a number of other service reviews are progressing in accordance with commitments made in the 2007 Clinical Services Plan. The Department of Health and Human Services (the Department) has been restructured to enable it to meet the needs of the community more effectively and efficiently. The higher prevalence of chronic disease and poorer health of Tasmanians compared to other Australians are confirmed in recent data. The public acute hospital system continued to provide a high level of service to the community in 2006–07 with growth in both inpatient and emergency department presentations. In this Clinical Services Plan update, the Tasmanian Government endorses the key principles established for Tasmania’s health services in the 2007 Clinical Services Plan. Service accessibility is a key goal, providing services can be delivered safely, effectively and at acceptable cost locally. Where services are not sustainable locally, they will be coordinated to optimise access for all Tasmanians, regardless of where they live. With a population of less than 500,000 people, some services (e.g. cardiac surgery) can only be provided on a statewide basis from one site in Tasmania. Other services are provided as regional referral services by the Launceston General Hospital (LGH) to communities in the North West region. The 2007 Clinical Services Plan principles for regional referral and statewide services are endorsed and clarified. The LGH is recognised as the major referral hospital for the North West region. The requirement for the RHH and the LGH to be funded for the provision of necessary outreach services and to demonstrate accountability to the stakeholders in the outreach region for the quality and accessibility of those services is affirmed. A number of specific service commitments are made in this Clinical Service Plan update. A decision about the introduction of cardiac electrophysiology services will be made by June 2010. The need to invest in rehabilitation services is recognised widely and the Department will publish an implementation plan for rehabilitation services by February 2009. Specific arrangements will be made to ensure that vascular surgery services are accessible to residents across the State while maintaining a sustainable statewide service. 4 Clinical Services Plan: Update The commitment in the 2007 Clinical Services Plan to develop
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