2014 Annual Report
Grand Pacific Health trading as Illawarra-Shoalhaven Medicare Local 1 | 2014 Annual Report 2014 Annual Report | 2
Grand Pacific Health (trading as Illawarra-Shoalhaven Medicare Local) was established in 2011 as a not-for-profit company, with the focus on facilitating, integrating and coordinating primary health care in the Illawarra Shoalhaven region. Grand Pacific Health aims to improve health outcomes for the Illawarra Shoalhaven community by addressing gaps in primary health care knowledge and services. We do this by supporting GPs, practice nurses, practice staff and allied health providers to meet CONTENTS workforce needs and professional development priorities. Report from the Chair ……..……..……..……..……..……..……..…….. 3 Our priority is to meet local health needs and facilitate better access to services, focusing on chronic disease management and care, mental health, aged care and Aboriginal health care. Report from the CEO ……..……..……..……..……..……..……..……..… 4 We establish partnerships and collaborate with key stakeholders including the Illawarra Shoalhaven Local Health District, University of Board of Directors ……..……..……..……..……..……..……..……..…… 5 Wollongong, specialist providers and community service organisations to deliver these primary health outcomes for the region. Integration……..……..……..……..……..……..……..……..……..…….. 7 Grand Pacific Health also provides frontline services to meet unmet needs in our capacity as Illawarra-Shoalhaven Medicare Local, Capacity building ……..……..……..……..……..……..……..…….. 14 headspace Wollongong, headspace Nowra, Shell Cove Family Health, Shoalhaven Wellness Centre, and in the future, the Grand Pacific Health Centre – Nowra. Evidence based ……..……..……..……..……..……..……..……..…… 16 Health promotion ……..……..……..……..……..……..……..…….. 18 Access and equity ……..……..……..……..……..……..……..…….. 20 Organisational capability ……..……..……..……..……..……..…….. 23 Financials……..……..……..……..……..……..……..……..……..……. 25
Grand Pacific Health (trading as Illawarra-Shoalhaven Medicare Local) gratefully acknowledges the financial and other support from the Australian Government Department of Health. 3 | 2014 Annual Report 2014 Annual Report | 4
REPORT FROM THE CHAIR REPORT FROM THE CEO
It is a great privilege to present my second Annual Report for the company as Chair of the I was delighted to take up the position of Chief Executive Officerlate last year and Board of Grand Pacific Health Ltd. am proud to see Grand Pacific Health (GPH) growing in both relevance and influence within the region. I have enjoyed travelling around the district, meeting stakeholders and The Board was pleased to welcome our new Chief Executive Officer (CEO), Dianne learning about the health needs and issues of the region, as well as the programs and Kitcher, who commenced in September 2013. Dianne has brought a wealth of leadership services available. knowledge and capability, including experience as the CEO of the Central West Community College and Chief Operating Officer at Victor Chang Cardiac Research One of our main objectives over the last 12 months has been the development of Institute. Dianne and the new Executive team have quickly got up to speed and have partnerships with key organisations. We have forged strong relationships with the responded effectively to implement new and improved ways of keeping people well and Illawarra Shoalhaven Local Health District, University of Wollongong, and Radio Doctors out of hospital, working in partnership with local providers to build innovative programs Illawarra, all of which are providing us with tangible benefits in a range of areas. We have and services that best suit the needs of the region. also entered into formal consortium arrangements with a network of non-government organisations as part of Partners in Recovery. This is on top of many other focused The last 12 months has seen rapid growth for Grand Pacific Health (trading as Illawarra- agreements with a wide range of partners. Our commitment to partnership agreements Shoalhaven Medicare Local) in terms of our capacity, activity and outcomes. It has also will continue to grow throughout 2014/15. seen a number of exciting developments with partnerships and integration of service delivery. Another major project taking shape is the building of the new GP Superclinic, also known as the Grand Pacific Health Centre – Nowra, which is now well under way and will be The Illawarrra Shoalhaven Local Health District (ISLHD) and Grand Pacific Health completed early in 2015. It will be a great resource added to the health precinct located partnered in a ‘HealthPathways’ style project in the Shoalhaven, which brought together on the local hospital grounds for the Nowra and broader Shoalhaven community. hospital clinicians and general practitioners (GPs). The success of this project and hard work from our organsation has resulted in a contract to progress HealthPathways. We look forward to the positive impact it has on the At the same time as we plan and implement new initiatives, we are committed to reviewing existing programs and ensuring that they patient’s journey and the GPs ease of referral across the whole region. operate as effectively and efficiently as possible. We initiated reviews of the ATAPS (Access to Allied Psychological Services) program in 2013/14 and this has resulted in improved targeting of those who are most disadvantaged in our community. The Board is also proud of responding to a unique local need for the rural part of our region, and was delighted to form a partnership with Parkinson’s NSW to support a neurological nurse. This reflects a strong desire by the Board to keep our focus on local needs Stakeholder relationship management, particularly with GPs was identified as a strategic priority for Grand Pacific Health in 2013/14. throughout our region. Much of the organisation’s practice support work has involved working closely with GPs and their practice staff to build capacity through a program of continuing professional development, networking opportunities and providing access to reliable information, In early 2014, the Board was pleased to appoint a new Director, Jodi Keast, following the retirement of Jennie George AO. Jodi was advice and resources. a standout applicant. She is currently a senior manager in a local community-based not-for-profit organisation and specialises in evaluating and improving governance in organisations, financial and stakeholder management, strategic and business planning, risk and We have strengthened our capability and capacity through significant enhancements to our organisational structure. A new structure business continuity management. was introduced in late 2013 to better reflect and support the major activities and functions of the organisation, not only current activities but position us for a sustainable future. As a result, four new general managers were welcomed to the organisation including Ron de Membership of the organisation has also grown and diversified, with an increase in allied health members. Our practice support services Jongh (Corporate Services), Linda Livingstone (Service Integration and Facilitation), Dianne Knight (Service Delivery) and Andrew Gow and initiatives such as eHealth, data management, workforce education and networking, continue to grow. As we move towards the (Population Health and Planning), who have brought with them an impressive array of skills, abilities and experiences and have hit the new model of Primary Health Networks (PHNs), we hope representatives from these networks will provide a strong local connection for ground running. a clinical council and community advisory committee, which will ensure a local focus is preserved. Our commitment to quality has also continued with the organisation accredited with the Medicare Locals Accreditation Scheme in April There is no doubt that 2015 will hold new challenges for us, as that is the nature of this sector. We are however confident that the 2014. In fact, the auditors were very complimentary regarding our strong governance and polices, as well as the examples and evidence significant time we have invested in planning over the past year has prepared us well for the future. of work occurring on the ground, including our ICT and knowledge management, HR, clinical work, practice support, and analysis and I want to thank all directors who have worked hard and have given me great encouragement as Chair. I would also like to take this planning. This was a significant achievement for our organisation and recognition of the great work that we do! opportunity to acknowledge our two retiring Board members – Chris Symons and Dr Declan Mulvaney. Both have made an invaluable None of this would have been possible without the significant contribution and support from all Grand Pacific Health employees. I would contribution to the Board. like to thank and acknowledge the hard work of all staff across the organisation. I would also like to acknowledge the great support I I would like to also acknowledge their contribution to the Governance and Policy Committee as well as Kate Manderson, as Chair of have received from all the Board members, in particular the Chair, Dr Vicki McCartney. that committee. Their work to review policy documents leading to our successful Medicare Local accreditation was invaluable to the Next year our sector will be subject to extensive changes as Medicare Locals are replaced by Primary Health Networks. There will Grand Pacific Health team. certainly be some interesting, as well as challenging, opportunities ahead. Change can be difficult, however we are excited that primary I look forward to working with the Board, management team and all staff across our organisation over the next 12 months. health and the important role it plays in a viable and affordable health system, is strongly emphasised in this new direction. I can assure you that Grand Pacific Health team is working hard to ensure the organisation is well placed to transition to the new organisation and will continue to lead and support the primary health care sector beyond 2015.
DR VICKI MCCARTNEY CHAIR, BOARD OF DIRECTORS GRAND PACIFIC HEALTH DIANNE KITCHER CHIEF EXECUTIVE OFFICER GRAND PACIFIC HEALTH 5 | 2014 Annual Report 2014 Annual Report | 6
BOARD OF DIRECTORS
DR VICKI MCCARTNEY DAVID FULLER DR KATE MANDERSON DR DECLAN MULVANEY CHAIR, BOARD OF DIRECTORS DEPUTY CHAIR, BOARD OF BOARD MEMBER BOARD MEMBER DIRECTORS MB, BS Univ. Sydney, DCH London, B Med. Sc., MBBS (Hons), MPH, BM B.Ch., BAO, MRCGP (UK), Dip Paeds UNSW, Senior Clinical B.Ed. M.A., MAICD, MIAM D.Adv.Med., FRACGP, FACAsM FRACGP Lecturer GSM UOW David Fuller is the CEO of WEA A board member since 2011, Dr Kate A director for two years, Dr Declan Vicki has been in general practice in Illawarra, a community owned not-for- Manderson has been a GP in the Mulvaney has been living and working the Nowra area since 1986, following profit organisation that runs several Shoalhaven since starting her registrar as a GP in the Shoalhaven region for experience as a paediatric registrar different education operations including training with the Navy in 2001, and is over eight years after moving from the at Sydney Kids Hospital and resident a Community College, Registered now a Fellow of the College of GPs, UK with his family. He graduated as a medical officer at Royal Alexandra Hospital for Children. Training Organisation and a non-traditional Independent Senior senior lecturer with the University of Wollongong Graduate podiatrist in 1986 and after returning to Queens University in Since 1998, Vicki has been the principal medical practitioner Secondary Learning Centre. He was formerly Director of School of Medicine, and a senior aviation medical officer in the Belfast, completed his medical degree in 1995, progressing to of a general practice in Nowra where she focuses on chronic Strategic Projects and Director of Innovation Campus at the Navy Reserve. a general practice Royal College membership in 2001. disease management, antenatal care, mental health care, University of Wollongong, and has over 35 years’ experience on major development initiatives. David brings considerable project Kate has been involved in health service governance in both During his time as a practice principal in the UK, Declan paediatric care, aged care and preventative care for the military and civilian fields, since 2005 as a senior medical was a member of the Local Medical Committee for South diverse needs of her patients. Vicki is also a passionate and governance experience as a member and deputy chair of officer for the Navy and as a former board member of the Staffordshire. He was an assessor for the Quality Outcomes teacher of students from the Graduate School of Medicine at the Grand Pacific Health board. Shoalhaven Division of General Practice since 2006. Program for his local Primary Care Trust and was a board University of Wollongong where she is a senior clinical lecturer. David is a member of the Advisory Committee, Asian Science member of the trust. She is also a supervisor to registrars in training. Park Association, a member of the Advisory Board of the Vicki was the deputy chair of Shoalhaven Division of General Wollongong Science Centre and Planetarium and is immediate Practice and became a director of Grand Pacific Health past president of the Australia and New Zealand Regional Science Association International Inc. and Technology Park in October 2011. She has been chair of the board since JOHN PETTY ROSLYN ROLLESTON November 2012. Australia and New Zealand. BOARD MEMBER BOARD MEMBER
B Comm (Hons), M Bus, FCPA FCA RN, ICNI, BHSc, Cert IV TAE John brings a wealth of governance Ros is a registered nurse from Nowra DR BRETT THOMSON JODI KEAST experience gained over many years where she has lived since 1987. Ros BOARD MEMBER BOARD MEMBER to the board and holds a number of worked at Shoalhaven Hospital for directorship positions. He is a member 14 years before moving into primary MBBS (Hons), FACRRM, FARGP, BComm, CPA, MBA, GAICD, Cert IV of the Compliance Audit & Risk health care in 2001. Since then she has FRACGP, DRANZCOG (Adv), MAICD Training & Assessment Management Committee of Australian worked as the Enhanced Primary Care Dr Brett Thomson, Clinical Associate Jodi Keast grew up in Kiama and General Practice Network Ltd, and a member of the Transition Project Officer for the Shoalhaven Division of General Practice, Professor at the University of returned in 2005 after working in Taskforce for National Medicare Local Network. an RN at HMAS Albatross Medical Centre and spent four years Wollongong, is a GP based in Milton. chartered accounting firms in Sydney, as a general practice nurse. A consultant to leading G100 businesses, facilitator, coach He moved to Milton about 12 years followed by seventeen years as an and mentor, John is also a tenured lecturer at University of Ros is currently working as an immunisation nurse for ago from the Northern Territory where executive manager in the federal Technology Sydney. From 2002 - 2006 John was Australia’s Shoalhaven City Council, has her own Primary Health Care he had worked as a GP and hospital administrator. Brett has public service in Canberra. She is currently a senior manager representative on the International Federation of Accountants’ Education business and is studying a Masters of Nursing at the extensive experience as a GP, GP supervisor and teacher and in a local community-based not-for-profit organisation and a Professional Accountants in Business Committee and University of Wollongong. Ros is committed to the promotion he currently manages and supervises a procedural practice management consultant. is a four-time winner of IFAC Articles of Merit award for of patient-centred care and collaborative team work. Ros is a including obstetrics, emergency and hospital inpatients. Jodi specialises in evaluating and improving governance distinguished contribution to the accounting profession. member of the Australian College of Nursing Community and Brett’s governance experience includes immediate past chair in organisations, financial and stakeholder management, Primary Health Care Advisory Committee. She is also a member of Grand Pacific Health, seven years on the board of Coast strategic and business planning, risk and business continuity of the Australian Primary Health Care Nurses Association City Country GP Training and the immediate past chair of the management. Education and Professional Development Advisory Committee. Shoalhaven Division of General Practice. He is a member Passionate about philanthropy and her community, Jodi has of several committees including the Local Health District’s held board positions in a number of community organisations, Shoalhaven Clinical Council and University of Wollongong’s is the regional Volunteer Manager for Primary Ethics and Phase 3 committee. He is also a member of the Australian volunteers for Lifeline. Medical Association (AMA) NSW Council of General Practice. MR CHRIS SYMONS BOARD MEMBER BA Psych, MAPS Registered Psychologist Chris Symons has worked as a psychologist in the Shoalhaven area for the past 30 years in schools and community health. He is now in an independent practice at the Coolooli Counselling and Therapy Centre, which he manages. He has previously served on the boards of Marriage and Family Counselling and Lifeline. Chris worked closely with the Shoalhaven Division of General Practice setting up the first ATAPS program. Chris has a strong commitment to his professional association, the Australian Psychological Society, having served as its branch chair on the state executive. 7 | 2014 Annual Report 2014 Annual Report | 8
INTEGRATION PROVIDING SUPPORT AND RESOURCES FOR OLDER PEOPLE In 2013/14 an Aged Care Taskforce was set up by Grand Pacific Health to develop a regional approach to care for older people and Improving the patient journey and developing integrated identify improvements for both access to, and quality of primary health care provided in the Illawarra and Shoalhaven. and coordinated services Significant progress has been made with the Taskforce, building on the strength of existing networks and initiatives, particularly with the Illawarra Shoalhaven Local Health District (ISLHD), University of Wollongong, Alzheimer’s Australia and local aged care providers such INCREASING ACCESS TO AFTER HOURS SERVICES as Warrigal Care, Uniting Care, IRT, Anglicare, Multicultural Aged Care Illawarra, and Hammond Care. Ensuring improved access to after hours primary health care services for all residents, regardless of where they live within the region, Some highlights include: has been a key focus for our organisation in 2013/14. • the coordination of two Advanced Care Clinical Skills workshops in partnership with the School of Nursing, Midwifery and Indigenous This year, Grand Pacific Health successfully implemented the recommendations outlined in the report: ‘Health Profile and Needs Health at the Simulation Centre at the University of Wollongong Assessment Report, Planning After Hours Primary Care in the Illawarra-Shoalhaven Medicare Local’, and distributed more than $2.6 • promotion of resources developed by Alzheimer’s Australia that enable greater awareness of the types of issues and tools that can be million in ‘Towards After Hours’ incentives. This included $1.3 million to local medical practices as part of the After Hours Practice used to help individuals, families and carers plan around health issues experienced in older age Incentive Program and a further $1.3 million distributed through the After Hours Local Partnership Grants Program. • promotion to GPs of a range of alternatives that the ISLHD can provide for residents of aged care facilities who need medical care in A total of 37 applications were received from general practices, residential aged care facilities and pharmacies as part of the Local the after hours period Partnership Grants Program. Applications included requests for additional hours for practice nurse and administrative staff in the after hours period, an education program to enable pharmacies to be an after hours health care destination, and training for residential aged • provision of funding to local residential aged care facilities to develop the skills and resources of staff to improve management of care care staff on how to better assess the need for their residents to access GPs after hours. during the after hours period. Collaboration regarding aged care initiatives will continue with a particular focus on further development of advanced care clinical skills within the primary health care workforce and the further development of clinical pathways for older people.
RADIO DOCTORS EXPANDS SERVICE In a major win for residents of the Illawarra, Grand Pacific Health trading as Illawarra- + 40,000 Shoalhaven Medicare Local has successfully negotiated for Wollongong Radio Doctors to expand their services into the Kiama Local Government Area and the northern Wollongong region for a trial period of 12 months. Radio Doctor Illawarra (formerly known as Wollongong Radio Doctor) is currently the only medical deputising service (MDS) in the Illawarra. Under the arrangement, more than 40,000 additional residents will be able to access the MDS from 1 September 2014, taking the total number to 270,000 residents or 60 per cent of the Illawarra Shoalhaven population. This trial will also provide an opportunity for both organisations to assess whether More than 40,000 additional residents expanding the MDS across a larger region is the best solution to increasing after will be able to access this vital after hours services within the Illawarra Shoalhaven area. hours home doctor service. 9 | 2014 Annual Report 2014 Annual Report | 10
IMPROVING INTEGRATION OF SERVICES WITH THE LOCAL HEALTH DISTRICT GROWING eHEALTH INITIATIVE Grand Pacific Health has developed a significant partnership with the Illawarra Shoalhaven Local Health District (ISLHD), with the two organisations working together to overcome barriers between primary and secondary care, physical and mental health, and ensure the The rollout and implementation of the Personally Controlled Electronic Health right health and social care services are provided at the right time, in the right place. Record (PCEHR) has continued apace over the last 12 months. This initiative provides consumers and their healthcare professional with access to a In order to effectively engage with the ISLHD, interaction takes place at three different levels of their organisation through the executive 5,000+ comprehensive summary of their important health information online. management team; the operational management team; and with frontline staff. In fact, Grand Pacific Health has established an agreement to develop joint leadership and governance of service integration initiatives around clinical pathways, and to participate in In 2013/14, more than 210 consumer registration sessions were held in the ISLHD’s community partnership council. general practices and eHealth staff attended 17 community events across the region. At an operational level, the two organisations have committed to an 18 month project to build the foundations for accurate, timely and high-quality electronic communication between the ISLHD and GPs. Consumer feedback has been positive, with many having already heard about the system and readily signing up. In fact, registrations have grown For frontline staff, the organisation works closely with ISLHD staff to implement service delivery through our Connecting Care and rapidly over the past year. Nationally more than 1.5 million people have Partners in Recovery programs. registered for their PCEHR, with more than 5,000 consumers in the Illawarra More than 5,000 consumers in the Illawarra At each level there are agreed terms of reference and outcomes which are established at the beginning of the program or project and Shoalhaven signing up. Shoalhaven have registered for PCEHR these are regularly reviewed. Despite funding for the program concluding in June 2014, Grand Pacific Health will continue to play a critical role in linking health professionals, practices and patients through the use of the eHealth initiative.
USE OF TECHNOLOGY TO IMPROVE THE PATIENT JOURNEY headspace Connect was an exciting trial rolled out by Grand Pacific Health in 2013/14, taking advantage of the National Broadband Network (NBN) to improve access to mental health services for young people in the Kiama municipality. headspace Connect enabled young people between 12 and 25 to access the services of headspace Wollongong including a clinical psychologist, counsellor, youth worker and vocational worker, free of charge and without any waiting periods. Services were delivered securely and confidentially at home or at several youth friendly locations or ‘touch points’ in Kiama via pre-installed secure video conferencing. The trial wrapped up in June 2014 and the response from the community, stakeholders and, most importantly, the young people was overwhelmingly positive. Key partners of the program include the Department of Communication, NSW Ministry of Health, headspace National, headspace Wollongong, the Australian Health Services Research Institute (AHSRI) at the University of Wollongong, Kiama High School, North Kiama Neighbourhood Centre and Kiama Council.
LAUNCHING NEW MOBILE APPLICATION Throughout 2013/14, Grand Pacific Health has been busy working on an exciting new mobile application (app) which will enable better integration and coordination of primary health services for both consumers and providers. The app will provide a search directory of health professionals and will enable appointments to be made by consumers. It will also offer service providers with integrated appointment scheduling using clinical software packages. Some of the other key functions include recording favourites (regularly used service providers), viewing contact details including location maps, and dialing from within the app. The app was made available from Apple and Android stores in October 2014. 11 | 2014 Annual Report 2014 Annual Report | 12
INCREASING CONSUMER ENGAGEMENT Youth participation is an important aspect of the headspace model. Both headspace Nowra and headspace Wollongong have a Youth Reference Group (YRG) which consists of volunteers aged 16-25 years who are passionate about promoting mental health and general well-being amongst young people in the region. Membership consists of both consumers and non-consumers of headspace services. This year, members of the YRGs have had a voice in service planning and implementing local headspace services and service activities. They have also had the opportunity to develop and foster leadership, media, communication and advocacy skills. Perhaps most importantly, the YRGs have supported young people to lead projects that promote health and well-being to their peers. Having young people involved in creating and presenting help-seeking messages aims to reduce some of the barriers to accessing services. GROWING THE CONNECTING CARE IN COMMUNITY PROGRAM A partnership agreement was signed with the Illawarra Shoalhaven Local Health District in July 2013, leading to better identification of patients, improved coordination of care and more timely referrals for people with chronic disease in the area. ESTABLISHING PARTNERS IN RECOVERY Known as Connecting Care in the Community, the program aims to improve the quality of life for people living with chronic disease, creating an integrated health care journey for patients and encouraging them to become more actively involved in their health care via In June 2013, Grand Pacific Health exchanged a contract with theDepartment of Health for the delivery of the Partners in Recovery chronic disease self-management strategies, and reduce the number of unplanned hospital admissions. (PIR) program throughout the region. Over the 12 months to June 2014, the Connecting Care program delivered more than 4,000 occasions of service in the Illawarra PIR is a national program that aims to support people with enduring mental illness and complex needs, and their carers and families. Shoalhaven region, and enrolled nearly 360 new patients into the program. This represents a 20 per cent increase in the number of new The program works with multiple sectors, services and supports that people may come into contact with (and could benefit from) to enrolments from the previous year. The Connecting Care team also contribute to a number of health promotion and health screening provide a more collaborative, coordinated and integrated approach to care. events throughout the year. Over the last year, Grand Pacific Health as the lead agency partnered with a number of organisations to form the Illawarra Shoalhaven Partners in Recovery (ISPIR) Consortium. The Consortium is responsible for contributing to the governance of ISPIR, including strategic INTEGRATING MENTAL HEALTH SERVICES directions and outcomes, and consists of representatives from: 2013/14 has seen an increased emphasis on partnerships with other organisations • Aftercare • Neami National • Supported Accommodation and in the delivery of mental health programs. In particular, partnerships with non- Homelessness Services Shoalhaven health organisations, which are often key in reaching people who are not currently • Care Connect • Richmond PRA “Working with Big Fat Illawarra (SAHSSI) accessing psychological treatment/s. • Illawarra Aboriginal Medical Service • Schizophrenia Fellowship of New South • Watershed A partnership with Big Fat Smile has been further enhanced, with a focus on Wales Smile we have created a • Illawarra Shoalhaven Local Health providing a comfortable non-clinical setting for mothers, along with practical District childcare so they could attend to their treatment. comfortable non-clinical The Suicide Prevention program continues to involve a strong working relationship A Consumer and Carer Forum and Stakeholder Council have also been set up. with the public Child and Adolescent Mental Health Service (CAMHS) to ensure Grand Pacific Health has subcontracted five organisations to deliver the ISPIR Support young people do not ‘fall between the cracks’ that may exist between service setting, with practical Facilitation services including NEAMI, Richmond PRA, Schizophrenia Fellowship of NSW, thresholds. This partnership therefore facilitates the smooth transition of care and, Care Connect and Wollongong Women’s Refuge. 5HIHUUDOV when appropriate, shared care for young people at risk of suicide or self-harm. childcare, for mothers.” The program started accepting referrals for the Shoalhaven area in March 2014 and in the Illawarra in May 2014. By June 30 2014, ISPIR had received 84 referrals - 20 were registered as active participants, of which 20 per cent were Aboriginal or Torres Strait Islander. 13 | 2014 Annual Report 2014 Annual Report | 14
COORDINATING CARE AND CAPACITY BUILDING SERVICES FOR ABORIGINAL AND TORRES STRAIT Supporting clinicians and service providers to ISLANDER PEOPLE improve patient care Aboriginal and Torres Strait Islander people DELIVERING INNOVATIVE PRACTICE SUPPORT experience a burden of chronic disease two- and-a-half times that of other Australians. Grand Pacific Health continues to build the capacity of frontline services to provide Early intervention and the management of quality, evidence-based care by supporting clinicians and service providers with risk factors are key to reducing this statistic. continuing professional development, networking opportunities and access to reliable information, advice and resources. The Care Coordination and Supplementary Service (CCSS) program aims to reduce The organisation provides individual assistance to practices with accreditation, chronic disease risk factors, foster early immunisation, MBS items for chronic disease management, recalls and reminder 2&&$6,2162)6(59,&( detection and promote better management systems, data cleansing, workforce support, information on Grand Pacific Health '(/,9(5('72*(1(5$/35$&7,&(67+,6<($5 of chronic health conditions in primary services, human resources, industrial relations, and work, health and safety. A total health centres. The program, delivered by of 2,996 occasions of service were delivered to general practices, with all practices the Journey to Health team, is available to receiving assistance by either phone, email or an on-site visit. Aboriginal and Torres Strait Islander people Grand Pacific Health’s extensive direct support to general practices and GPs is complemented by communication strategies which living in the Illawarra Shoalhaven region include a weekly e-bulletin (PS Weekly), bi-monthly (Nurses Voice) and quarterly publications (Allied Health Bulletin). The Grand Pacific with one or more of the five priority chronic Health website contains valuable information, templates and links for practices. disease including chronic heart disease, cancer, diabetes, chronic respiratory The Nursing in General Practice program continued throughout 2013/14, with a particular focus on leadership, peer support and disease and chronic renal disease. continuing professional development. A nurse reference group was established to provide input into the program. Networking meetings continued across the region, providing nurses with information on local services and referral pathways, clinical information, and an Throughout 2013/14, more than 250 clients opportunity for peer support. from across the region benefited from the program through care, equipment and Grand Pacific Health has also provided assistance to new practice nurses with orientation and supported the review of nurse clinical support to prevent returns to hospital. competency standards conducted by the UoW School of Nursing, Midwifery and Indigenous Health by arranging a focus group. Clients were also able to undertake urgent Engagement with the allied health sector continued throughout 2013/14 with the goal of facilitating referral pathways with general medical tests and see allied health or practice. ‘Link Up’ meetings in the Shoalhaven brought a range of allied health disciplines together, including practice managers, specialists in appropriate timeframes. In practice nurses as well as Grand Pacific Health staff. fact, more than 4,860 occasions of care coordination and more than 800 occasions of supplementary support were provided this year. CONTINUING TO SUPPORT A HIGHLY ENGAGED GP WORKFORCE Grand Pacific Health continues to achieve high levels of GP engagement. In 2013/14, GPs attended more than 50 per cent of education events, this included 17 events which were GP-specific. The Southern Sector GP group continued to thrive and Grand Pacific Health provided support to the Shoalhaven Medical Association for their bi-annual conferences. In addition, more than 110 occasions of service were delivered directly to individual GPs for the six months to 30 June.
SUPPORTING PROFESSIONAL DEVELOPMENT OF PRIMARY HEALTH WORKFORCE In 2013/14, Grand Pacific Health delivered a total of 96 continuing professional development (CPD) events to GPs, practice managers, practice nurses and allied 250+ 96 health professionals, with a total attendance of 1,812. More than 84 per cent of CONTINUING PROFESSIONAL PEOPLE BENEFIT DEVELOPMENT EVENTS practices had staff attend at least one education event, with 68 per cent (204) of practice nurses, 7 per cent (76) of allied health professionals and 65 per cent (70) of practice managers attending at least one education event. Education events were held in Wollongong, Kiama, Bomaderry and Milton/Ulladulla, and focused on providing knowledge and applied skills in evidence-based care, as well as education in sexual health, chronic disease and antenatal shared care. The education program also provides business information such as human resources and industrial relations, to assist practice principals and practice managers. 15 | 2014 Annual Report 2014 Annual Report | 16
MAINTAINING AND IMPROVING CHILD EVIDENCE BASED IMMUNISATION RATES The region’s immunisation coverage rate has been maintained Identifying the health needs of local areas and developing focused and above the target of 90 per cent fully immunised for another responsive services year, achieving a coverage rate of 93.8 per cent as at 30 June 2014. Grand Pacific Health continues to contribute to PROVIDING POPULATION HEALTH DATA TO SERVICE PROVIDERS AND CONSUMERS this consistently high rate of coverage with more than 380 occasions of service to GPs and general practices to advise on Population Health Profile the schedule, undertake cold chain monitoring to promote safe In August 2013, Grand Pacific Health released its inaugural Population Health Profile – a unique document that provides quality vaccine storage and implement recall systems. information and data on the local health needs of our community and identifies where there are gaps in local health care and social A highlight of 2013/14 has been collaboration with the Public services. Health Unit. to identify children overdue for vaccination and The report is highly regraded within the local community with increasing interest from a brand range of stakeholders, partner provide reports to their usual practice for follow-up action. The organisations and residents. preliminary evaluation shows the project has had a positive effect, with more than 44 per cent of practices which received It has also been acknowledged as the primary source of information used by local councils, the Illawarra Shoalhaven Local Health the not fully immunised lists (NFI) responding to the reports and District, Healthy Cities Illawarra and several other major organisations for their strategic planning. The Profile has also been cited in recalling a total of 39.6 per cent of NFI children. several academic research papers, formed the basis of many new research initiatives including regional specific general practice based research that is currently being conducted within the Illawarra Shoalhaven and has been presented at regional planning and research seminars. ,0081,6$7,21&29(5$*( Health Collaborations In 2013/14, Grand Pacific Health undertook extensive stakeholder and community consultation as part of the Health Collaborations IMPROVING ICT SUPPORT TO PRACTICES Project. This project was the second phase of the inaugural comprehensive Population Health Needs Assessment which provided quality information and data on the local health needs of our community and identified where there were gaps in local health care and Grand Pacific Health continues to deliver extensive support social services. to the primary care sector with their information and The Health Collaborations Project was a reiterative process aimed to inform evidence-based population health planning and communication technology (ICT) needs. In 2013/14, Grand implementation that included regular stakeholder and community consultation, evaluation, and knowledge dissemination to both Pacific Health provided more than 850 occasions of service stakeholders and the community. to a broad range of customers including general practices, medical consultants, allied health professionals and other not- The project was rolled out in October 2013 using a three-pronged approach aimed at gathering holistic qualitative evidence of the for-profit health organisations. community, healthcare provider and stakeholder-perceived needs for the region. This included dissemination of a community survey, healthcare provider survey and five regionally-specific population health stakeholder consultation forums. The majority of activities focused on implementing, upgrading and maintaining the ICT systems to support clinical and There was a high level of participation in the project with a total of 1,700 respondents completing either the community and/or provider practice management systems. Assistance was also provided surveys, along with 106 attendees to the consultation forums. to practices in relation to ICT and security aspects of The findings de-identify the holistic community and primary health care service needs of the Illawarra Shoalhaven region and will be accreditation as well as site audits to help inform practices utilised by Grand Pacific Health to construct a list of priorities for action, implementation and evaluation aimed to improve the health and on some of their options to resolve issues, improve efficiency, well being of all residents of the region. security and reliability. A detailed report on the project will be available in late 2014. Grand Pacific Health has also provided assistance with a wide range of electronic healthcare initiatives including the rollout and implementation of the Personally Controlled Electronic Health Record (PCEHR), secure messaging, electronic prescription transfers and telehealth. In the last year, Grand Health Collaborations Project Report | 16 Health Collaborations Project Report | 24 Pacific Health supported 98 general practices and 62 allied Health Collaborations Project Report | 28
PERCEPTIONS OF SERVICE ACCESS: health organisations through their eHealth journey. This resulted • 77.8% (1122) of respondents reported on their perceptions of barriers in accessing the right healthcare. The results revealed: - 44.7% of respondents were identified as facing no barriers to accessing the right healthcare QUALITATIVE PERCEPTIONS OF HEALTH NEEDS AND SERVICE GAPS: Facing no barriers to accessing the right healthcare, % Providing after hours services, % • 44.0% (113) of respondents qualitatively identified the barriers for clients in accessing the right healthcare services in the Illawarra- in more than 70 per cent of general practices in the region 33.8 Shoalhaven region and offered solutions for the most vital factors for improving healthcare service delivery to clients in the region. The - the major barriers to accessing the 27.8 22.2 major barriers identified by respondents were: 56.3 right healthcare as needed were - poor service knowledge and awareness - respondents reported gaps in the dissemination of service location and existence, eligibility reported to be: of access and availability which was reported to be detrimental to both consumer access as well as provider referral having access to the PCEHR system, and more than 4,000 39.2 - cost – identified by 35.4% of - financial barriers - unaffordability of services such as high costs of specialist services and out-of-pocket costs for private billing 38.7 46.4 respondents 16.4 general practices and allied health services was the major financ - opening hours of the service discontinuation of program/service funding was also reported within financial barriers provider – identified by 23.9% of - lack of services - this included the inadequacy of services primarilyial forbarrier specialist identified. services Lack and of generalgovernment services funding, that inadequacyincluded GPs, and/or clinical documents uploaded into the system. respondents mental health services and other community support services was reported. Specifically for the Shoalhaven LGA (including Jervis Bay KIAMA - distance to services – identified Territory), a lack of after-hours GP services and the general lack of services due to the geographical isolation of certain pockets of the SHELLHARBOUR Anytime on Sundays or SHOALHA by 17.9% of respondents LGA and the distance from major centres like Sydney was identified as contributing to lack of services VEN WOLLONGONG After 12pm on Public Holidays - transport issues - the lack of public transport as well as poor fr - transport – identified by 5.5% of After 6pm on Saturday - the geographical isolation of areas within the Shoalhaven LGA (including Jervis Bay Territory) was reflectiverespondents in the high proportion of Before 8am on weekdays - long waiting lists and/or waiting times - the inability to obtain GP equency and coverage of existing transport services was reported respondents identifying distance and transport as major barriers for them in accessing healthcare services weekdays reported - language barriers were majorly reported in the Wollongong LGA and the Shellharbour LGA, indicative of the needs of the linguistically and/or specialist appointments as and when required was widely diverse populations within these LGAs. Service access barriers by LGA, frequency of identification
Major barriers to accessing the right healthcare, % - 38% of providers did not provide after-hours services any day of the week and only 10.6% provided some after-hours services all seven days of the week Financial barriers - lack of staffing and poor financial viability were ranked as the greatest and second greatest barriers respectively for providers to deliver after-hours services Transport issues respondents also identified certain support/incentives that they identified as vital for them to provide/extend/continue after-hours - Poor service knowledge & awar KIAMA services wherein: SHOALHAVEN eness SHELLHARBOUR (Including Jervis Bay) - financial benefits were the most identified support/incentive by respondentsified support which whichincorporated included suggestionsthemes such such as governmentas increased Lack of services remuneration, and increments to government funding and/or incentives Long waiting lists and/or waiting times WOLLONGONG - infrastructural and policy level support was the second most ident support for recruitment of ancillary staff (such as additional practice staff, security guards, administrative staff) and policy amendments at organisational levels such as job sharing arrangements, provision of time-in-lieu, and additional recruitment Poor service knowledge & awar 27 specific to the after-hours service delivery within provider organisations thatmodel are wascurrently the third delivering most expressed the services support/incentive only within 39.2 39.3 33 eness 21.8 26.5 24.9 Financial barriers 23.3 16.1 normal business hours 11.8 28.3 10.6 Cost 3.41 2.9 7.9 Opening hours of 5 0.6 - demonstrated evidence of demand that would support a viable business Lack of services 4.9 3.4 1.3 the service pr Distance 0.6 ovider 212.2 by respondents. Transport 011.8 Disability 1.7 Transport issues Language • 79.5% (1147) of respondents identified Culture Long waiting lists and/or waiting times the degree to which cost of healthcare Health Collaborations services was perceived/experienced by Cost reported as a barrier at high degrees them as a barrier to accessing care, out Financial barriers ^, % of which: Transport issues - 58.2% reported high ranges varying Project Report - 2014 from ‘sometimes’ to ‘often’ to ‘always’ 50 59.9 Poor service knowledge & awar 64.9 - eness figures were the highest for the 55.7 Lack of services Shoalhaven LGA (including Jervis Bay Long waiting lists and/or waiting times Territory) withGrand 64.9% Pacific ofHealth respondents trading as reporting toIllawarra-Shoalhaven perceive/experience Medicare cost Local as a barrier to accessing healthcare at Poor service knowledge & awar high degrees KIAMA eness SHELLHARBOUR Financial barriers SHOALHA ^ responses include ‘Always’, ‘Often’ and ‘Sometimes’ VEN WOLLONGONG Lack of services Transport issues Long waiting lists and/or waiting times 17 | 2014 Annual Report 2014 Annual Report | 18
Population health research HEALTH PROMOTION One of the key priorities identified in the inaugural Grand Pacific Health Population Health Profile: 2013¹ was the high prevalence of chronic disease in the Illawarra Shoalhaven Developing skills and environments region. In order to understand the impact at a more detailed level, Grand Pacific Health for good health along with researchers from the University of Wollongong, conducted the Sentinel Practices Data Sourcing (SPDS) study using a general practice-based sentinel site IMPROVING PRIMARY HEALTH OUTCOMES surveillance system to monitor chronic disease prevalence and its associated risk factors in the region. FOR ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE The pilot study was conducted at Shell Cove Family Health in 2012/13 and after gaining successful feasibility results, the research team rolled out the study to the broader The Closing the Gap program provides funding for preventative Illawarra Shoalhaven region. This involved the recruitment of 17 local general practices, health interventions, more coordinated and patient-focused practice staff training to perform data cleansing, collection of de-identified data and data primary health care and an expanded Aboriginal and Torres Strait analysis. Islander (ATSI) health workforce. It also recognises that chronic diseases and associated risk factors are responsible for about Results revealed higher than national average estimates for the age-adjusted prevalence two-thirds of the life expectancy gap between Indigenous and of chronic diseases such as obesity/overweight (65.9 per cent compared to 63.4 per non-Indigenous Australians. cent), hypertension (11.9 per cent compared to 10.4 per cent) and anxiety disorders (5 per cent compared to 3.8 per cent) for residents of the Illawarra Shoalhaven. However, a Almost 11,000 people identified as Aboriginal or Torres Strait lower than national average age-adjusted prevalence of asthma (8 per cent compared to Islander in the Illawarra Shoalhaven catchment area in the 2011 10.2 per cent) and depression (8.4 per cent compared to 9.7 per cent) was also identified. census, representing three per cent of the overall population. This is higher than both the NSW and Australian averages, both The study and its outcomes have been one of the biggest research initiatives for Grand of which are estimated to be 2.5 per cent of people who identify Pacific Health and is the first of its kind in regional primary health care in NSW. as Aboriginal or Torres Strait Islander. The study was presented at the 2014 Primary Health Care Research Conference and published in international health journal, Bio Med Central: With dedicated care coordinators and outreach workers, known www.biomedcentral.com/1471-2458/14/557. as the Journey to Health team, Grand Pacific Health provides ¹ Ghosh A et al. (2013), Illawarra-Shoalhaven Medicare Local - Population Health Profile: 2013. Grand Pacific Health Ltd. support to primary health care providers to deliver culturally sensitive services, strengthen uptake of Aboriginal and Torres Strait Islander people in health check-ups and health care services, and foster community collaboration and support between mainstream primary care and Indigenous health sectors. Throughout the year, the Journey to Health team took part in a number The Journey to Health of health promotion activities including the team aims to increase Otitis Media Screening Project, ‘One Deadly Step’ program, ‘Gather the uptake of Aboriginal for a Yarn – Men’s Health’ Project, ‘Tour and Torres Strait da Country’, the Illawarra Aboriginal Islander people in health Men’s Physical Health and Training Program (IAMPHAT), Illawarra check-ups and health Koori Women’s Group, ‘Live Longer Be care services. Stronger’, Aunty Jeans Health Program and Mini-Olympics. 19 | 2014 Annual Report 2014 Annual Report | 20
ACCESS AND EQUITY Implementing primary health care initiatives and programs IMPROVING DIETETICS OUTREACH SERVICE TO PATIENTS Grand Pacific Health aims to improve access to a range of primary and allied health care services and activities for rural and remote communities by designing health promotion and preventative health activities specific to the needs of the community. In the Illawarra Shoalhaven region, Grand Pacific Health structured a program to improve the management of diabetes and related diseases in rural communities, and most at risk populations by increasing access to these communities in allied health interventions. Dietetic services are delivered through outreach clinics within general practices, and other sites for clients diagnosed with either type 1 or type 2 diabetes. Clinicians also provided a range of health promotion interventions ranging from group nutrition education sessions, cooking demonstrations, health screening at community events, as well as a range of other activities including health advocacy and resource development. Over the 12 months to June 2014, our dietitians provided 918 occasions of service at health facilities (predominantly through GP clinics) for patients with type 2 diabetes. The outreach services covered 30 GP clinics, spanning a geographical area from Berry in the north to Bawley Point in the south. Of the 76 patients attending the outreach clinics each month, on average more than 35 per cent were new to the service and had been referred by a GP into the program. In addition, our dietitians delivered more than 20 group education sessions to 180 participants on topics ranging from healthy eating to pediatric nutrition, and diabetes management, and participated in a range of community based health promotion events, predominantly targeting Aboriginal and Torres Strait Islander groups and children. An additional service implemented in 2013/14 was the ‘Healthy Lifestyle for Kids’ program, aimed at children aged 6 to 24 years who are at risk of developing chronic lifestyle related disease in later life. The program teaches children and their parents about healthy eating, physical activity, provides management plans for fussy eaters, and other life skills. Our dietitians also provided 120 occasions of service to clients presenting with a range of conditions including failure to thrive (malnutrition), overweight and obesity, and complex needs such as autism spectrum disorder or other psychosocial and health challenges. DELIVERING MALNUTRITION AND FALLS PREVENTION INITIATIVES Grand Pacific Health continues to work towards increased access to allied health services for residents in residential aged care facilities (RACFs). In 2013/14, malnutrition screening was undertaken by Grand Pacific Health dietitians at RACFs across the region to identify residents at risk of malnutrition or who are already malnourished. The program was deemed highly successful with more than 1,400 occasions of service delivered in the 12 months to June 2014 and overall rates of malnutrition dropped significantly in seven of the 10 facilities collecting data. In fact, INTRODUCING INNOVATIVE HEALTH PROMOTION PROGRAMS IN RURAL AREAS four of the 10 facilities had a baseline level of malnutrition higher than 20 per cent of In an exciting new initiative, Grand Pacific Health and the Illawarra Shoalhaven Local Health District teamed up with Shoalhaven all residents. All four of these facilities had a significant reduction in their recorded City Council to help people make the most of their local outdoor gyms. malnutrition rates, while one facility experienced a 63 per cent reduction in the number of residents classified as ‘malnourished’. During Senior’s Week (16 – 23 March 2014), an exercise physiologist and other health and fitness staff demonstrated the use of outdoor gym equipment at four local parks in Shoalhaven Heads, Sanctuary Point, Sussex Inlet and Mollymook. Grand Pacific Health exercise physiologists (EPs) also conducted falls risk assessments with individual residents and worked with facility staff to identify those at greatest risk Research into the use of outdoor gyms by seniors (55 years and over) suggests they meet the need for cheap and accessible of having a fall. Through both group and individual interventions, the EPs focused on fitness equipment, although large proportions of the community either fear using the equipment because of arthritis or injury, developing core strength, balance and coordination with the goal of reducing the impact embarrassment or are disinterested in getting more physical activity, while those who used the gyms tended to be people who were of falls-related injury among the facilities. already active¹. Benefits of using an outdoor gym typically include increased feelings of wellbeing, fitness, confidence and social interaction². Outdoor activities also introduce exposure to sunshine, which is important for vitamin D, but must be managed for skin Over the course of the year, Grand Pacific Health provided EP services in 12 RACFs cancer risk. across the Illawarra Shoalhaven region, with a total of 354 group sessions delivered to more than 2,900 participants. While each piece of equipment has instructions on to how to use it, the demonstrations were aimed at helping seniors to feel more confident. Participants also received a ‘how to’ guide to take home. In addition to the group sessions, 180 individual exercise physiology sessions were implemented in the region targeting clients identified as at high risk of having a fall. The program was a great success with more than 35 participants taking part in the program – 24 of which had never used The program was highly successful with reported improvements in the risk factor for equipment previously. some residents, as well as improvements in the residents’ ability to move from a sit to stand position. The groups also provided a valuable opportunity for social engagement among the residents and had benefits in terms of depression, anxiety and mental health 1 Mitchell R & Popham F (2008). Effect of exposure to natural environment on health inequalities: an observational population study. The Lancet, 372:1655-1660. outcomes. 2 Bates G, McCoy E, Murphy R, Kornyk N & Suckley D. Evaluating the provision of outdoor gym equipment, Liverpool John Moores University, 2013 Available at http://www.cph.org.uk/wp-content/uploads/2013/10/Evaluating-the-provision-of-outdoor-gym-equipment-revised.pdf 21 | 2014 Annual Report 2014 Annual Report | 22
DELIVERING QUALITY SERVICES AT WELLNESS INCREASING ACTIVITY AT HEADSPACE CENTRES NOWRA AND WOLLONGONG Grand Pacific Health supports two Wellness Centres – one in Bomaderry and Mental disorders remain the single biggest health issue facing the other as part of the Shell Cove Family Health facility. Both centres aim to young people today. Grand Pacific Health’s headspace hubs in provide the highest quality allied health services including exercise physiology and Wollongong and Nowra continue to reduce the disparity between dietetics services to clients of local GPs. Shell Cove Family Health also provides the many young people who would benefit from support and early psychology and a diabetes education service. intervention, and those that actually reach the health professional and primary care they need. Over the 12 months to June 2014, the Shoalhaven Wellness Centre provided more than 1,400 occasions of service to patients presenting with chronic disease headspace Wollongong and Nowra deliberately structure services /2&$/ management plans, Department of Veterans Affairs, WorkCover or through private to challenge some of the barriers that have in the past delayed referral. Just over half (55 per cent) of these presentations were for exercise or prevented young people receiving the professional health they <281* physiology services. In addition to the one-on-one client appointments, the need. It is therefore encouraging that in 2013/14, 45 per cent of dietitians and EPs delivered 148 group education sessions through the year, the young people accessing Grand Pacific Health’s headspace 3(23/( reaching nearly 600 participants through local schools, Disability Trust and hubs were accessing mental health support for the first time. Department of Veteran’s Affairs. The support available in both Nowra and Wollongong continues to The Wellness Centre at Shell Cove Family Health provided 1,816 occasions evolve and respond to community needs with both sites home to of service through the dietitians, EPs and psychologists located at the facility. multidisciplinary teams including psychologists, youth counsellors, The psychology appointments made up more than half of these individual GPs, social workers, mental health nurses and dietitians. Our two headspace sites interacted with more than 1,720 local appointments (52 per cent), followed by dietetics (27 per cent) and EP (21 per Expanded partnerships with Illawarra Shoalhaven Local Health young people in the last 12 months and delivered more than cent) appointments. In addition to the one-on-one client appointments, the EPs District Drug and Alcohol Services, Access Community Group and 8,250 occasions of service directly to young people. delivered 319 group education programs throughout the year reaching 1,326 Relationships Australia ensure that a young person’s vocational participants. support needs, substance use or family context can be integrated into the care planning and delivered in one accessible point for young people. ENHANCING MENTAL HEALTH SERVICES headspace continues to work closely with health professionals throughout the region, with GPs being the second most frequent referral source of young people attending headspace. The importance of ongoing mental health literacy among family, peers and community Mental health programs have undergone significant reforms over the past 12 settings remains crucial with 55 per cent of young people reporting that it was their family or a friend who most influenced them to months, largely prompted by changes to the Access to Allied Psychological attend. Services (ATAPS) funding contract with the Commonwealth Department of Health. The reforms have focused on ensuring the programs are more effectively targeting headspace Wollongong and Nowra have also undertaken help seeking and health promotion activities. Schools remain the primary specific population groups who are in need of psychological treatments, but are not setting to roll out these programs and workshops have been delivered in 18 secondary schools across the region, reaching thousands currently accessing them. of young people. One exciting new program established is the Kids Count program which began 6(66,216'(/,9(5(' in October 2013 and expanded significantly through to March 2014. The program focuses on improving access to psychological treatments for children aged 0-5 years, and provides support for the whole family. The Suicide Prevention program also expanded to headspace Nowra in March 2014, enabling young people in the Shoalhaven to access the service. Grand Pacific Health staff have also been very active in collaborating with other servicesincluding public mental health services and education staff to provide information and education to parents about how best to support young people at risk of suicide or self-harm. In addition, the Aboriginal and Torres Strait Islander Mental Health program established a partnership with the Illawarra Aboriginal Medical Service (IAMS) to provide psychological services from both Wollongong and Dapto. Both clients ,1',9,'8$/6 *52836 and staff have been very appreciative of this program and referrals are steadily increasing. 94 per cent of these sessions were for The perinatal mental health program experienced a surge in referrals since January individuals, 6 per cent for groups or with 2014 with an increase in interest from women seeking support, especially antenatal families. support. Grand Pacific Health is currently scoping options to expand this program into the Shoalhaven. Overall, more than 7,050 sessions were delivered across Grand Pacific Health’s broad range of mental health programs with 81 per cent of referrals coming from GPs, five per cent from midwives, 10 per cent from directors of early childhood services and four per cent from other sources. 23 | 2014 Annual Report 2014 Annual Report | 24
ORGANISATIONAL CAPABILITY DEVELOPING OUR WORKFORCE FOR THE FUTURE Enhancing our capability and positioning Grand Pacific Health for the future During 2013/14, Grand Pacific Health refined our ENHANCING SERVICES AT SHELL COVE organisational structure to improve the capability, support and leadership required to meet the strategic objectives. Now in its fourth year of operations, Shell Cove Family Health continues to deliver a The engagement of a new CEO and senior managers in multidisciplinary and integrated primary care service for the local community. the areas of corporate services, service delivery, service In late 2013, Shell Cove Family Health welcomed Dr Carl Simpson from the United integration and facilitation and population health and Kingdom (UK). Dr Simpson has been practicing medicine since 1980, having trained at planning provided the leadership and expertise required the Liverpool Medical School in the UK. In February, the centre also welcomed Dr Mark to position Grand Pacific Health for the future. The new Burgess to the team. Dr Burgess is a University of Wollongong (UOW) graduate, having structure reflects the important role our organisation completed his junior medical officer training at the Illawarra ShoalhavenLocal Health plays in stakeholder engagement, particularly in terms District. of engaging with the local GP workforce, to improve the patient journey. Shell Cove Family Health also providies a learning forum for GP Registrars and medical students from UOW’s Graduate School of Medicine. Throughout 2013/14, Across the four arms of the business, well qualified and six Prevocational General Practice Placement Program (PGPPP) interns were able to skilled people have been engaged to deliver services in line experience teaching and training within the integrated health model by participating with funding agreements and based on local priorities. As at in sessions with general practice, nursing, dietetics, exercise physiology, pathology, 30 June 2014, we employed 130 staff, which equated to 95 physiotherapy and podiatry. full time equivalent (FTE) employees. In addition, 33 sub- contractors were engaged to deliver health services under The centre also had two phase three medical students who were involved in teaching or parallel consulting sessions with each of the a number of funding streams and based on identified need. GPs in the practice. This provided students with an opportunity to experience different consulting and teaching techniques. Approximately 48 per cent of the Grand Pacific Health BUILDING THE GRAND PACIFIC HEALTH CENTRE – NOWRA workforce is engaged to deliver health services directly to members of the Illawarra and Shoalhaven communities, The first soil was turned on the site of the new Grand Pacific Health (GPH) Centre – Nowra in April 2014, marking the commencement of including to youth aged 12-25 years via headspace construction of the state-of-the-art primary health facility. Wollongong and headspace Nowra. Health professionals are also employed to deliver services in the key priority The Centre will host a range of high-quality, comprehensive and integrated primary care services which are aimed at addressing the areas of Aboriginal health, chronic disease, older people, health care needs and priorities of the local community. mental health and health promotion/wellness. Located between Shoalhaven District Memorial Hospital and the Cancer Care Centre, the Centre is an exciting addition to the health Grand Pacific Health continues to offer attractive working precinct in Nowra and will bring together general practitioners, practice nurses, allied health professionals, visiting medical specialists conditions including offering flexible work arrangements. and other health care providers in one single location. An after hours GP service will also be available from the centre. Nearly half of our workforce is employed on a part- Regular meetings with local GPs and other time basis. Grand Pacific Health has been successful in health care providers will take place recruiting and retaining excellent staff and contractors. A to ensure that the Centre works with, greater focus on professional development during 2013/14 contributes to, and enhances the existing has provided staff and contractors with opportunities to health infrastructure. In fact, the model develop new skills required to progress the organisation’s for after hours care will be developed in objectives or apply to their work with clients and the consultation with local GPs. community. Grand Pacific Health is also committed As an organisation now employing more than 100 staff, we to working with the Illawarra Shoalhaven reported gender equality indicators under the Workplace Local Health District to establish the best Gender Equality Act 2012. arrangement to improve service delivery A copy of the 2014 report is available at and ease the pressure on the emergency http://bit.ly/Grand Pacific Health_WGEA department. The Centre is expected to be completed in the first half of 2015 and is supported by financial assistance from the Australian Government under the GP Super Clinics Program. This initiative aims to build a stronger primary health care system that is more efficient, lowers rates of avoidable hospital admissions, reduces health inequalities and improves health outcomes. 25 | 2014 Annual Report 2014 Annual Report | 26
FINANCIALS
STATEMENT OF PROFIT OR LOSS AND OTHER STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED COMPREHENSIVE INCOME FOR THE YEAR ENDED 30 JUNE 2014 30 JUNE 2014 (CONT.)
2014 2013 2014 2013 $ $ $ $
Operating grants 14,251,996 8,376,366 Assets Capital grants 800,404 72,749 Sale of goods 238,530 113,314 Current assets Rendering of services 2,544,102 2,157,906 Cash and cash equivalents 12,438,658 9,936,752 Donations and gifts 18,686 4,070 Trade and other receivables 309,014 5,472,197 Net gain on disposal of fixed assets - 8,695 Total current assets 12,747,672 15,408,949 Other income 233,392 295,573 Non-current assets Revenue and other income 18,087,110 11,028,673 Property, plant and equipment 4,367,068 3,512,986 Total non-current assets Employee expenses 9,048,353 7,492,526 4,367,068 3,512,986 Clinical service delivery 4,261,849 477,833 Total assets Contracted clinical services 190,657 117,400 17,114,740 18,921,935 Occupancy expenses 772,484 722,973 Liabilities Depreciation and amortisation 259,061 234,222 Management and administration 1,797,364 1,313,854 Current liabilities Other 465,441 465,448 Trade and other payables 11,385,461 14,287,868 Expenditure 16,795,209 10,824,256 Provisions 623,316 886,426 Total current liabilities 12,008,777 15,174,294 Net surplus for the year 1,291,201* 204,417 Non-current liabilities Other comprehensive income - - Provisions 269,317 202,896 Total comprehensive income for the year 1,291,901 204,417 Total non-current liabilities 269,317 202,896
* Includes capital grants received of $800,404 (2013 $72,749) Total liabilities 12,278,094 15,377,190
Net assets 4,836,646 3,544,745
Funds General funds 4,713,825 3,430,878 Donations reserve 122,821 113,867 Total funds 4,836,646 3,544,745 Suite 3, Level 1 1/54 Meroo Road 336 Keira St Bomaderry Wollongong NSW 2541 NSW 2500 t 4220 7600 t 4448 2200
www.gph.org.au
Grand Pacific Health (trading as Illawarra-Shoalhaven Medicare Local) gratefully acknowledges the financial and other support from the Australian Government Department of Health.