2016 | ANNUAL REPORT 2015 ANNUAL REPORT

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 - 2016

Sturt Street PO Box 577 Dental Clinic Cancer Centre www.bhs.org.au Ballarat Vic 3350 Ballarat Vic 3350 Ballarat Vic 3353 Ballarat Vic 3350 Ballarat Vic 3350 Phone: 5320 4225 Phone: 5320 4000 Phone: 5320 4000 Phone: 5320 4100 Phone: 5320 3700 Sebastopol Vic 3356 02 Ascot Street South 1 http://bricc.bhs.org.au Ballarat Base Hospital Drummond Street North www.bhs.org.au Mental Health Services Ballarat Health Services Queen Elizabeth Centre Ballarat Regional Integrated www.twitter.com/BallaratHealth Corner Sturt and Drummond Streets Corner Hertford Street & Tuppen Drive Phone: Radiation Oncology – 5320 8600 Oncology Consulting Clinics – 5320 8500 www.facebook.com/BRICCWellnessCentre www.facebook.com/BallaratHealthServices 100% Recycled Paper Printed on SERVICE DIRECTORY

Allied Health Services Dental Services Diabetes Education • Dietetics • Exercise therapy Ear, Nose and Throat Surgery • Occupational therapy Emergency Medicine • Physiotherapy Endocrinology, including Diabetes Management • Podiatry Eureka Linen • Prosthetics and orthotics Falls and Balance • Psychology Gastroenterology • Social work General Medicine • Speech therapy General Surgery Geriatric Evaluation and Management Acquired Brain Injury Service Gynaecology Ballarat Regional Integrated ICU Liaison Nurse Service Cancer Centre Infection Control • Chemotherapy Day Unit Intensive Care Unit and Medical Emergency Response Team • Clinical Trials and Research Lymphoedema Management • Oncology Clinics Maxillofacial Surgery • Medical Oncology Neonatology • Radiation Oncology (BAROC) Nephrology and Renal Dialysis • Wellness Centre Neurology • Clinical Trials and Research Maternity Services

BreastScreen Mental Health Community Care Teams BHS Catering • Adult Cardiology • Aged Central Sterile Supply Department (CSSD) • Infant and Child Centre Against Sexual Assault (CASA) • Mother and Family Unit Cognitive Impairment and Dementia • Youth Management Mental Health Inpatient Care Units

Community Programs • Adult Acute Unit • Aged Acute • Ambulatory Care Services • Aged Residential • Carer Respite and Support Services • Community Care Unit • Community Rehabilitation • Mother and Family Unit (home and centre based) • Secure and Extended Care Unit • Continence Resource Centre • Domiciliary Services Operating Suite • GEM in the Home Ophthalmology • Grampians Aged Care Assessment Service Organ and Tissue Donation Service • Grampians Regional Continence Service Orthopaedic Surgery • Grampians Regional Palliative Care Team Otolaryngology • Hospital Admission Risk Program Outpatient Services • Linkages (home care packages) Paediatric Medicine • Planned Activity Groups Perioperative Day Procedure Unit • Post-Acute Care Pain Management • Restorative Care Palliative Care • Transition Care Program Pharmacy • Victorian Paediatric Rehabilitation Service Plastic Surgery • Critical Care Unit Rehabilitation (in-patient and out-patient) Diabetes Education and Treatment Residential Aged Care Diagnostic and Radiology (X-ray) Services Respite Care Safety Link • BreastScreen Stroke Management • CT Scan Stomal Therapy • ECG Statewide Aids and Equipment Program (SWEP) • EEG • MRI Thoracic Medicine • Nuclear medicine Thoracic Surgery • Ultrasound Urology Vascular Surgery Wound Management Profile of BHS 2

Ballarat Health Services is Victoria’s second largest regional health service, providing a comprehensive range Report of Operations 3 of general and specialist care across key medical and healthcare disciplines including acute care, sub-acute care, residential aged care services, community care, Organisation Chart 18 mental health, dental and rehabilitation services. Ballarat Health Services is the principal referral hospital Board of Directors 19 for the Grampians Region, which extends from Bacchus Marsh to the South Australian border. The region, covering some 48,000 square kilometres, is home to Executive Team 20 nearly 250,000 people. With a staff in excess of 4,000 employees, Ballarat Health Senior Staff 22 Services is one of the major employers in the Grampians Region. Statement of Priorities 26 Ballarat Health Services was established under the Health Services Act 1988. The incorporation came into effect on 1 January 1997 following the voluntary amalgamation of Reporting Requirements 40 the Ballarat Base Hospital, the Queen Elizabeth Centre and Grampians Psychiatric Services. Disclosure Index 43 For the period 1 July 2015 to 30 June 2016 Ballarat Health Services was accountable, through its Board of Directors, to The Honourable Jill Hennessy MLA, Minster Additional Information 44 for Health and Minister for Ambulance Services and The Honourable Martin Foley MLA, Minister for Mental Health Financials Inside back cover and Minister for Housing, Disability and Ageing. Copies of this Annual Report, the BHS Quality of Care Report and the BHS Strategic Plan 2014-2017 are available online at www.bhs.org.au

With a staff in excess of 4,000 employees, Ballarat Health Services is one of the major employers in the Grampians Region.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 3 Our Vision Excellence in health care

Our Mission To deliver quality care to the communities we serve by providing safe, accessible and integrated health services resulting in positive experiences and outcomes.

Our Values Our services and staff embrace the following:

Compassion - fair and caring to all those we come into Ballarat Health Services is contact with, even during difficult times. We treat others Victoria’s second largest regional as we would expect to be treated. health service, providing a Integrity - behaving in accordance with our comprehensive range of general professional, ethical and legislative requirements. Using and specialist care across our resources responsibly and transparently, we are honest and trustworthy. key medical and healthcare disciplines including acute care, Excellence - striving to attain the highest standards of service delivery and clinical practice. We achieve sub-acute care, residential this by acknowledging, recognising and promoting aged care services, community innovation, participating in continuous learning, care, mental health, dental and development, training and research. We come to work to make a difference. rehabilitation services. Accountability - understanding our role in providing a safe environment for staff, patients, visitors and members of the community. We take personal responsibility to maintain the necessary skills and competencies to perform our workforce roles and encourage others to do the same. If we make mistakes, we support each other to be open about them in order to learn.

Collaboration - Involving staff and services both internally and externally in decision making, sharing our knowledge and experiences to build a better health system. Together we work in partnership with our patients, their families, carers and colleagues.

4 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 REPORT OF OPERATIONs Chair and CEO’s Report Recognition On behalf of the Board of Directors and Executive Staff This year has been another extremely busy one for BHS. We Council, we would like to recognise and thank all BHS staff have again treated record patient numbers as our population for their continued dedication to the provision of quality within the region continues to grow. healthcare to the community we serve. It was a significant year in that the findings from a number of BHS enjoys a very positive and constructive relationship independent reviews into claims of bullying and harassment with the Department of Health and Human Services and the within the organisation were released. These reports uncovered Minister for Health. We extend our appreciation to officers a number of issues affecting the moral and culture of the BHS of the Department of Health and Human Services and the workforce. Minister for their support throughout 2015/2016. Though the Board has long had zero tolerance for bullying and Board and Management retirements and harassment, our processes for identifying and addressing this appointments sort of behaviour have been found to be inadequate and in some instances have failed to protect staff. During the 2015/2016 period, both the Board of Directors Chair, Andrew Faull, and Chief Executive Officer, Andrew In response to these reviews the Board of BHS has: Rowe, announced their retirements from Ballarat Health • Established a People and Culture Board Sub Committee to Services. We would like to thank both Andrews for their oversee the recommendations of the reports; significant contributions to Ballarat Health Services during their respective tenures. We also farewelled a number of our • Scheduled a capability audit of the Board and Executive; executive team, who left BHS for other roles. This year we also welcomed three new members onto the • Scheduled an organisational structure review that will start Board of Directors - Patty Kinnersly, David Miller and Juliana with Mental Health Services and Human Resources; Addison – who were appointed by the Minister for Health for a • Committed to establish a new Complaints Manager three year period from 1 July 2015. position who reports directly to the CEO; Significantly, the board appointed Dale Fraser as the organisation’s new Chief Executive Officer. Dale • Committed to enhanced training of all staff to include commenced his position on 25 July 2016 and brings with workplace behaviour and values; him comprehensive experience in the public health and • Offered a greatly enhanced Employee Assistance Program government sectors. Prior to taking on the role at BHS, Dale to all former staff who were interviewed for both reports; was CEO at Goulburn Valley Health. He was also previously and Chief Financial Officer and Director Planning and Resources at Barwon Health, and Chief Financial Officer and Executive • Committed to establishing a protected disclosure process Director Finance and Information Management at Ballarat to allow staff to identify and report inappropriate Health Services. behaviours. Though we have a long way to go, these actions affirm our commitment to take all steps possible to stamp out the cultural Responsible Bodies Declaration issues that exist within BHS and achieve a best practice In accordance with the Financial Management Act 1994, we workplace for each and every member of our workforce. are pleased to present the Report of Operations for Ballarat We are pleased to present some of the highlights from the Health Services for the year ending 30 June 2016. previous year in the following section.

Rowena Coutts Dale Fraser Chair, Board of Directors Chief Executive Officer Ballarat 19 August, 2016

BALLARAT HEALTH SERVICES Annual Report 2014 - 2015 3 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 5 MEDICAL SERVICES

The Medical Services Directorate incorporates all acute medical services at BHS including the Division of Medicine, management of all junior and senior medical staff, mortuary services, Medico Legal issues, the Ballarat Regional Integrated Cancer Centre, Research Ethics and Governance, Infection Control, medical education, medical credentialing and GP Liaison.

Ballarat Regional Integrated The Wellness Centre and associated complementary programs continue to be in great demand by patients and Cancer Centre (BRICC) a continual source of positive patient satisfaction surveys The BRICC has completed its third year of clinical operations, within BRICC. Community fundraising, The BRICC café and with oncology services experiencing unprecedented growth the BHS Foundation provide wonderful and ongoing support during this time. In 2015/16, BRICC continued to grow in for the Wellness Centre programs. A total of 18 programs are terms of new service partnerships, new oncology treatment now offered through the BRICC Wellness Centre. options for patients, oncology clinical trials choice, and New Treatment Technologies additional supportive care and wellness programs. BRICC, in partnership with BAROC (The Ballarat Austin Activity Growth Radiation Oncology Centre) and Austin Health is close to Within the Medical Oncology unit, in terms of Day Oncology completion of the planning phase for the commencement and consultations, activity has grown by a further 20 percent of a Stereotactic treatment program for Grampians region in 2015/16. This equates to an approximate doubling of radiation oncology patients. This service is expected to activity from the commencement of services in 2013. BRICC benefit patients with primary lung cancers in the first phase led Outreach Medical Oncology expanded in 2015/16, with and patients requiring treatment to the brain and other body existing services in Stawell and Horsham growing strongly sites in the second phase. This initiative is unique in regional and sustainably and a new service commencing in Hamilton Australia and one that is expected to significantly reduce at the Western District Health Service. This service will soon travel burden to metropolitan services. expand to a weekly service. Community Support and Grants The Haematology service expanded to include a new two The community continues to provide outstanding support for day a week BHS staff haematologist, the first for BHS in BRICC with donations utilised to purchase capital items and approximately 15 years. The service continues to enjoy the to develop services within BRICC. support of metro based VMO specialists. BRICC continues The BRICC was aided through the financial support of large to benefit from the strengthening of established links with corporations (special thanks to Woolworths), community metropolitan haematology services, particularly the Austin groups (VRI Cricket Club Ball) and local businesses (trivia and Northern hospitals. nights), individuals and community initiatives such as Dry Radiation Oncology service activity (provided through Austin July, the Ballarat Girls Night Out and the ‘Cricket for a Health and BAROC) increased to sustainable levels for a Cause’ tournament (Coronet City Cricket Club). The BRICC busy two linear accelerator facility. The outreach consultation café continues to provide funds to the Wellness Centre for service in Stawell continues to grow with around 25 patients program development and delivery. per month receiving post treatment review or follow-up in In 2016, BRICC was successful in obtaining service Stawell rather than in Ballarat. A further outreach expansion development grants from the Grampians Integrated Cancer to Horsham is expected during 2016/17. Service (GICS) for pilot programs to explore development Pharmacy services within BRICC continue to grow particularly of ‘Wellness on Wheels’ and acupuncture complementary with new chemotherapy treatment regimes, clinical trials therapy for Breast cancer patients. support and with the number of prescriptions increasing by Transport Network around 15 percent in 2015/16. During 2016, BRICC commenced an expanded oncology The established allied health and supportive care services patient transport service through the introduction of a second (Social Work, Dietetics, Speech Pathology, Occupational vehicle (electric car) for local transfers. Patients attending the Therapy, Psychology, Physiotherapy, Exercise Physiology and cancer accommodation now utilise this service. Allied Health Assistants) continue to provide patient support within BRICC. Planning has commenced to increase support for these programs in 2016/17.

6 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 BRICC Website In 2015/16, BRICC deployed a second iteration of its external website to provide information to patients and stakeholders The website now provides about oncology services. The website now provides a patient a patient portal to enable portal to enable online complementary therapy bookings for wellness programs. New initiatives include a monthly update online complementary on oncology services, clinical trials and initiatives within BRICC. therapy bookings for wellness BRICC Research programs. New initiatives In 2016, a significant amount of research was undertaken as include a monthly update on investigator led projects from clinical staff within BRICC. A wellness study was commenced to compare the experience oncology services, clinical trials of prostate cancer patients receiving oncology massage. The and initiatives within BRICC. BRICC allied health team presented at national conferences, highlights including an oncology malnutrition study by the Dietetics team and a regional patient distress study by the BRICC Social Work team. BAROC presently a range of new radiation oncology research at the annual ASMMIRT conference. Presentations focused on Breast Radiation setup techniques, equipment comparisons for prostate patient stabilisation and Deep Inspiration Breath Hold for breast cancer patients New Oncology clinical trials commenced within BRICC in 2015/16 with eight pharmacology trials currently accruing patients and another five in the assessment phase. Immunotherapy treatment options are rapidly increasing, now accounting for around five percent% of all procedures in day oncology. BRICC Support for Regional Cancer Service Development BRICC staff contributed strongly to a range of regional research initiatives including the GICS led Improving cancer Outcomes Project, the Ophelia Health Literacy project, Regional Chemotherapy Mapping Project and the Lung Redesign Project. BRICC has commenced strategic discussions with the Andrew Love Cancer Centre (Geelong) and Bendigo Cancer Centre with a goal of establishing a community of practice for regional cancer centres.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 7 New Telemedicine Technology Vital in Diagnosing Strokes

The Victorian Stroke Telemedicine (VST) program is assisting Under the Combined Ballarat Health Services and St John the diagnosis and treatment of acute stroke patients after of God Ballarat Hospital Human Research Ethics Committee hours at BHS. research is reviewed and authorised under certification from The VST program provides a virtual technology system which the National Health and Medical Research Committee and links rural and regional Victorian hospitals to a network of the National Mutual Acceptance of Single Ethical Review of Melbourne-based neurologists who can provide treatment Multisite Research. advice on patients when stroke specialists at regional sites There are 176 active research studies under way with 92 new are not available. applications being approved to commence at BHS in the Since becoming operational at BHS in September 2015, current period. the VST has helped diagnose more than a dozen people • 129 locally initiated research underway with 69 new presenting to the Emergency Department with stroke projects approved in current period. symptoms. • 46 led by local researchers The first person to utilize the VST earlier this year was a o 12 high risk category research patient who was brought into the Emergency Department o 34 low risk category research by ambulance after experiencing a sudden onset of visual disturbance, slurred speech and right side weakness on their • Participation in 47 international and national clinical way home from work. research trials with 23 new this period. After arriving at the Emergency Department via Ambulance Safety is closely monitored with 27 reviews conducted to Victoria, Emergency Department staff promptly contacted assess potential adverse effects of research participation. the VST program for an urgent review by the on call VST Researchers, participants and sponsors also have direct one neurologist. on one contact and support via the Research and Ethics As a result of the VST service, the patient received stroke Service. thrombolysis and was transferred to Melbourne for Research training and researcher support continues to be a Endovascular clot retrieval. priority with the success of the Annual Research Symposium The VST neurologist was able to conduct an audio-visual (which 88 people attended) and Biostatistics and Research consult with the patient by dialling into the telemedicine cart Methodology training delivered to 44 staff. located in the Emergency Department. This was performed in The BHS Research and Ethics Service also maintains conjunction with ED staff and the VST neurologist was able to a research champions email communication database provide a neurological assessment leading to diagnosis and which provides researchers and those with an interest in treatment advice for the patient. research with regular information on research participation Thankfully, the patient made a full recovery following their opportunities, training programs and grant opportunities. treatment thanks, in part, to the intervention we were able to offer utilizing the VST. BHS strives to build a sustainable research culture of integrity and collaboration so that the Grampians community continues to benefit with access to research innovations via the governance structure of BHS Research and Ethics Service.

Neurologist Dr Thomas Kraemer, Ambulance Victoria’s Grant Hocking and BHS VST Site Coordinator Casey Hair

8 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 ACUTE NURSING AND MIDWIFERY

The Acute Nursing and Midwifery Directorate encompasses Critical Care Services, Emergency Medicine, Women’s and Children’s Health Services, Acute Inpatient Services (including hospital wards, Dialysis and Medical Day Unit), Clinical Nurse Consultants and the BHS Nurse Donation Specialist.

Helipad Celebrating our nurses The Ballarat Base Hospital Helicopter Landing Site and midwives (Helipad) was officially opened on Wednesday 17 June 17 International Midwives Day and Nurses Day are celebrated 2015 by the Minister for Health and Ambulance Services around the world on 5 May and 12 May each year. Jill Hennessy. On these days we take the time to acknowledge and The ability to land Helicopter Emergency Medical Service reflect on the outstanding efforts and commitment from (HEMS) aircraft at the hospital was delivered after nearly all our nurses and midwives for their ongoing contribution a decade of encouragement from the Ballarat and District to providing excellent care across the health service and community, political campaigning, strategic planning by broader community. BHS and 18 months of construction. Previously HEMS Each day our nurses and midwives deliver quality care based transports could only be achieved by Ambulance across a diverse range of services from inpatient care, to Victoria transporting the patient from the hospital to providing care in their homes and the community setting. Ballarat Airport or a nearby sports oval. Our nursing and midwifery staff do an amazing job looking In the first twelve months of operations there were after a whole range of people every day, including the 49 helicopter movements, just over four per month. critically ill, elderly and new mothers and their babies in a dynamic, challenging and rewarding environment. This exceeded expectations of two per month, further demonstrating the need for the facility. In the 2015-16 year BHS employs approximately 1,200 EFT nursing staff in the there were 31 completed transfers out, 13 transfers in, hospital, aged care, mental health and allied health areas. three transfers that were cancelled and two test flights. BHS has received patients from a number of other hospitals, including Stawell, St Arnaud, Horsham, Ararat, Rainbow, Maryborough and the Grampians for conditions BHS employs approximately such as myocardial infarction, arrhythmias, bronchitis, severe epistaxis and fractures. 1,200 EFT nursing staff in the hospital, aged care, mental health and allied health areas.

Some of BHS’ Midwives

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 9 RESIDENTIAL AND CLINICAL GOVERNANCE SERVICES

The Residential and Clinical Governance Directorate encompasses BHS’ ten Residential Aged Care facilities located at four sites throughout Ballarat. This Directorate also includes clinical governance and risk management services, incorporating the Patient Safety and Quality Committee and the Consumer Advisory Committee. BHS operates 444 aged care beds and has more than 500 staff providing high quality care and services at ten facilities across Ballarat.

Quality, Innovation and Highly Commended - BAROC team for Implementing Excellence Awards Deep Inspiration Breath Hold After extensive planning, BAROC successfully implemented Each year at the Annual General meeting of Ballarat Health Deep Inspiration Breath Hold radiotherapy for women with Services, the annual Quality, Innovation and Excellence left-sided breast cancer in 2015. In doing so, they became Awards are presented. the first regional radiotherapy centre in Victoria to offer this In 2015 there were 37 nominations across both the clinical technology. and corporate categories. This is very encouraging and showcases the commitment Corporate Category and engagement of all our staff to improve the quality and outcomes of the care and services they provide. Winner - Emergency Department for Reducing Violence and Aggression in the ED Clinical Category Evidence suggests that improving a patient’s knowledge and understanding of their hospital journey can reduce Winner - Grampians Regional Palliative Care Team the risk of violent and aggressive behaviour in hospital. for the development of a carer package for safe Simple tools such as information, signage, brochures and administration of subcutaneous medications across the environmental design factors can be used to enhance Grampians Region patients’ knowledge, experience and expectations. This project focused on the education of carers to safely The ED team working with the Occupational Health and administer injectable medications to their loved ones Safety team, implemented these principles to improve receiving palliative care at home. The education package patient experience through signage and education. Staff included a DVD to teach, support and enhance carer have also been provided training and support to change confidence when administering injectable medications in their response to potentially aggressive and violent the home. situations in the ED. Runner-up - The Redesign and Specialist Clinics team Runner-up - Volunteer Welcome team for the Redesign of the Urology Clinic Template With the demolition of Yuille House in 2014, and major The Specialist clinics and Redesign teams identified that redevelopment continuing across the Base site until patients waited too long to be seen by a clinician on the completion of the new Drummond building in 2016, it was day of their specialist clinics appointment. Baseline data identified that visitors and patients required assistance with showed that patients were being booked into the clinic way finding. The Volunteer Services, in consultation with prior to the actual start time, the average consulting the Redesign team, recruited and trained volunteers and time was 20 minutes however appointment times were piloted a volunteer wayfinding team. The team is based booked at 15 minute intervals and all appointments were at the front entrance at Sturt Street and direct, guide and scheduled within the first 1.5 hours of the clinic. As a result escort visitors and patients around the hospital as needed. the appointment template was redesigned to overcome identified issues. Highly Commended - 3 South Team for improving accessibility to patient’s bedside documents Ward 3 South trialled and implemented new patient bedside folders to increase the accessibility of important clinical documents for the multi-disciplinary team. The charts and plans are located in one spot at the patient’s bedside.

10 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 SUB-ACUTE AND COMMUNITY

The Sub-Acute and Community Directorate incorporates all nine allied health disciplines (Dietetics, Exercise Therapy, Occupational Therapy, Physiotherapy, Podiatry, Prosthetics/Orthotics, Psychology, Social Work, and Speech Pathology). The Directorate includes sub-acute inpatient and ambulatory services including rehabilitation, aged care evaluation, palliative care and community programs. Also incorporated within this division are the State-Wide Equipment Program (SWEP), the Centre Against Sexual Assault, pharmacy and dental services CASA and WRISC sign MoU Community Programs The Ballarat Centre Against Sexual Assault (CASA) and The Community Programs Teams have had a busy year WRISC Family Violence Support signed a Memorandum of implementing some of the major reforms to the aged care Understanding which will see the two agencies working more sector, including: closely together to support victims of domestic or sexual violence. Commonwealth Home Support Program Ballarat CASA (which is a program of Ballarat Health Services) The introduction of the Commonwealth Home Support and WRISC will explore opportunities where they can Program (CHSP) is one of the changes the Australian combine resources to provide services to mutual clients. Government is making to help older people to stay The first joint project to be undertaken by the two independent in their own homes and communities for longer. organisations was a support group for women who have experienced family violence and/or sexual violence. From 1 July 2016 four existing programs will be consolidated into the CHSP, they are: • Commonwealth Home and Community Care (HACC) Program • National Respite for Carers Program (NRCP) • Day Therapy Centres (DTC) Program • Assistance with Care and Housing for the Aged (ACHA) Program. Other highlights include Our Disability Funded programs successfully participated in

Ballarat CASA Manager Shireen Gunn and WRISC Executive an accreditation audit in February 2016 conducted by the Officer Elizabeth Jewson sign the MoU Australian Council on Healthcare Standards. The programs met all required standards with no recommendations pending. My Aged Care The Annual Transition Care Program Forum was held on As part of the Federal Government’s Living Longer Living Thursday 19 November 2015 at the Museum of Australian Better aged care reform package, the My Aged Care Gateway Democracy at Eureka (M.A.D.E). The theme for the day was has been created to provide an identifiable entry point into the aged care system. ‘You Only Live Twice’, featuring guest speaker ‘Dr Karen Hitchcock’ author of the Quarterly Essay Dear Life: On caring This system when complete will provide: for the elderly. Topics covered on the day were Advance • national contact centre and website care planning, People with dementia, Decision-making • national assessment process operated through the and limitations of care and goals of care and Advance care gateway planning. The forum was a great success with around 100 • central client records people from various Health Services in attendance. • linking of services for complex clients with multiple needs • report on the quality and availability of aged care services including waiting lists. In March this year the Aged Care Assessment Services (ACAS) in Victoria transitioned over to My Aged Care and this meant a change to how the team’s assessments are recorded as well as a change to the referral pathways to ACAS.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 11 Dental Clinic Throughout the year, the clinic’s portable chair equipment has been used to treat a number of patient groups in their own It was another exciting year for the BHS Dental Clinic, with settings, including: it celebrating its first anniversary at its new premises at Phoenix College, Sebastopol, in April 2016. • New mums and bubs program through healthcare The dental clinic incorporates 10 dental chairs for centres teaching. In June 2015 the clinic opened its dental school which caters to 4th and 5th year dental students from • Residential aged care staff education sessions Latrobe University. The students have been able to offer • Healthy Eating Active Lifestyle (HEAL) program for mental comprehensive dental experiences to eligible patients. health clients In the first six months they saw 985 patients with 10,009 treatments performed. The teaching component of the new • Various programs with the Ballarat and District Aboriginal facility employed additional staff (Including ten teachers, Co-operative five assistants, one co-ordinator and a receptionist). • Kindergartens Fourteen dental students from Latrobe University commenced in June 2015, growing to 24 students in the • Smiles for Miles Program - Examination expansion second rotation in January 2016. All students are seeing offered to all children patients are under the guidance of experienced Dentist/ specialist teachers. • Supported Residential Services This year saw an expansion of the dental program with • Homeless youth program (13 years to 25 years) a focus to help more priority groups access dental care. These groups have embraced the clinic’s visits, in many • Expectant mums program (maternity outpatients) cases with an examination onsite for their patients and treatments offered on site in aged care. • The young mums program

• Disability services

• Primary school talks and exams

In the first six months they saw • Secondary schools

985 patients with 10,009 • Childcare centres . treatments performed • BHS Residential Aged Care facilities The teaching component of The Ballarat Health Services Dental Clinic helped 7,295 patients in pain this year. In total the clinic offered care to the new facility employed 9,470 patients and completed 87,433 treatments. Of those, additional staff (Including ten 1,393 patients received dentures. teachers, five assistants, one co-ordinator and a receptionist).

12 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 MENTAL HEALTH SERVICES

The BHS Mental Services Directorate provides a comprehensive range of inpatient and community mental health services to Ballarat and the Grampians region. These include Infant and Child, Perinatal, Youth, Adult, and Aged persons mental health services. Community mental health services are region-wide with offices located in Ballarat, Ararat, Stawell and Horsham. Inpatient services are provided through an Adult Acute, Aged Acute, Secure Extended Care and Community Care facilities. The service also operates a five day a week Mother and Family Unit.

It has been an exciting 12 months for the Mental Health Mother and Family Unit commences Services Directorate with notable achievements including operation • The opening of the Mother and Family Unit (MaFU) The BHS Mother and Family Unit (MaFU) commenced • Co-located Infant, Children and Youth Services building operations in November 2015. providing Mental Health Services to the 0-25 age range The five-bed unit, located at the site of the former Pleasant from our Midlands building at 701 Norman street Ballarat Homes in Pleasant Street, will give new mothers experiencing North mental health issues access to high quality mental health care • Completion of the significant Psychiatric Intensive Care locally. Area (PICA) redevelopment in the Adult Acute Unit (AAU) The unit offers specialised assessment and treatment for • Increasing the number of peer roles employed across women experiencing mental illness before and after birth, the Grampians Region in recognition of the importance while also allowing them to strengthen their relationship with and contribution this growing workforce have on their babies within a family inclusive context. achieving better patient outcomes. This includes the The model of care offers partners/support persons and continuous implementation of the Youth Advisory Group siblings the opportunity to also stay at the unit with the and Consumer Advisory Group who, along with our Koori mother and baby during treatment. Liaison Officer and Carer Consultants, have made The facility operates five days a week. significant contributions to better engagement and consumer led health provision. • Strengthening collaborative partnerships with service providers across the Grampians Region including Ballarat Community Health, Centacare and Uniting Care The BHS Mother and Family Infant, Child and Youth Mental Health Unit (MaFU) commenced services relocation operations in November 2015.. Mental Health Services relocated its child, youth and family mental health services to Ballarat North in July 2016. The move brought together all BHS perinatal, infant, child and youth mental health services to operate from the refurbished Midlands complex at 701 Norman Street. Prior to the move, the services operated from separate sites in Ascot Street and at the Queen Victoria Building in Sturt Street. One of the main benefits of the move has been improved collaboration between early intervention mental health services.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 13 FINANCE, INFORMATION AND BUSINESS DEVELOPMENT

The Finance, Information and Business Development Directorate is responsible for providing a range of financial management services to BHS including accounts payable and receivable, management accounting, patient billing, taxation, insurance and payroll. The division also incorporates Information Technology, Radiography and Diagnostic Services and Pathology Services.

Financial Performance BHS has continued to implement a range of cost saving and revenue generating activities, and has seen significant improvement in the financial performance of a number of key areas throughout the organisation. Whilst these initiatives are of significant importance with regard to long term financial sustainability, it should be noted that the 2015/16 financial year has been particularly challenging with additional unbudgeted costs being incurred in relation to workplace culture external reviews, sick leave, and other associated costs. These additional costs have contributed to BHS recording an operating deficit before Capital items of $982,000 for the 2015/16 financial year. The target was a breakeven operating result in the statement of priorities.

Key performance indicator 2016 2015 2014 2013 2012 $000 $000 $000 $000 $000

Total Revenue 415,893 388,957 372,541 346,418 329,341

Total Expenses 416,874 388,823 372,230 345,710 329,127

Net Result for the Year (before (982) 134 311 708 214 capital and specific items)

Net Result (4,468) (11,523) (10,027) 446 16,511

Retained surplus/ (39,924) (32,905) (21,372) (11,370) (11,860) (accumulated deficit)

Total assets 420,557 420,177 418,584 335,444 331,990

Total liabilities 129,871 125,208 117,954 101,019 98,011

Net assets 290,686 294,969 300,630 234,425 233,979

Total equity 290,686 294,969 300,630 234,425 233,979

14 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 HUMAN RESOURCES

The Human Resources Directorate is responsible for all aspects of human resource management including recruitment, organisational change, industrial/employee relations, equal employment opportunity, security services, occupational health and safety, library services, pastoral/spiritual care, corporate training and development, volunteers and emergency management.

Occupational Health and Safety In December an internal OHS Management System Audit was conducted by Ernst & Young as part of the Ballarat Health Services is committed to providing a safe 2015/16 internal audit plan. To address some of the key and healthy environment for staff, patients, residents, findings additional EFT has been added to the OHS visitors, volunteers and contractors. This commitment Department including an OHS Officer. Key improvements includes achieving best practice in occupational health also include OHS Committees reporting to the OHS and safety, with a strong focus on injury management and Executive Committee, monthly Safety Leadership walks, continuous improvement. risk assessments and controls at Eureka Linen and risk Acuity, workload demands and the aging demographic of assessments at Catering. the organization have all been factors in injuries, particularly The Melbourne Health Management of Clinical Aggression manual handling, which continues to be the highest injury (MOCA) training program continues to roll out across the cause. The Workers Compensation Performance Rate has organization with approximately 1,500 people trained. BHS declined due to increasing claim numbers and complexity has also lead the implementation of a regional approach of injuries. The EFT in the Injury Management team has to MOCA training across the Grampians Region. With been increased by an additional 0.5 EFT to ensure prompt support from the DHHS eight health services are now follow up. There has also been a strong focus on early implementing MOCA into their workplaces. A total of 12 intervention to ensure workers return to pre-injury duties trainers attended train the trainer programs in 2015 and the as soon as practicable. Early reporting and an increased MOCA Coordinator at BHS is also providing Master Trainer involvement in the management of injuries by managers support and expertise to other health services. has played a vital role in the early return to work of injured employees. The injury management team also actively Occupational Violence risks remain a high priority. A DHHS supports workers with non-work related injuries and illness funded project for innovation in managing occupational to ensure successful outcomes during recovery. The violence was completed. The included development of a OHS team has funded and worked closely with Exercise waiting room video, waiting room screen displaying how Physiology to roll out health and wellbeing strategies in busy ED is, patient signage and revised patient brochures. high risk areas, including Cardiovascular Suite, Residential Numerous health services have visited BHS to review and Aged Care and Catering. identify opportunities for replication. BHS has had further success with funding from DHHS to prevent occupational violence through minor capital works at the ED entrance and upgrading the PICA unit of the Mental Health Services Adult Acute Unit. Our annual occupational violence statistics are outlined in the below table.

Occupational violence statistics 2015 - 2016

1. Workcover accepted claims with an occupational violence cause per 100 FTE 0.12 2. Number of accepted Workcover claims with lost time injury with an occupational violence 0.64 cause per 1,000,000 hours worked. 3. Number of occupational violence incidents reported 851 4. Number of occupational violence incidents reported per 100 FTE 30 5. Percentage of occupational violence incidents resulting in a staff injury, illness or condition 18%

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 15 Our People

Labour Category JUNE JUNE Current Month FTE YTD FTE

2015 2016 2015 2016

Nursing 1181.4 1236.5 1204.2 1206.93

Administration and Clerical 505.8 530.68 497.0 512.12

Medical Support 259.7 270.94 248.1 266.12

Hotel and Allied Services 371.9 391.48 347.8 394.67

Medical Officers 46.4 47.58 41.9 46.22

Hospital Medical Officers 138.1 174.59 122.1 164.67

Sessional Clinicians 40.6 46.2 39.3 45.04

Ancillary Staff (Allied Health) 249.3 257.06 245.1 250.22

Total 2793.3 2955.03 2745.5 2885.99

Number of employees occupying full, part time and casual positions at 30/6/2016 is 4042.

Staff scholarships Nurse Practitioner Scholarships Each year, BHS awards scholarships to assist staff to Suzanne Bartlett, Breast Care Nurse. access an overseas or interstate professional development Sue will use the scholarship to commence her Masters of opportunity or complete further study. Advanced Nursing Practice at Melbourne University which will Congratulations are extended to the following winners of ultimately lead to her endorsement as a Nurse Practitioner. the scholarships, which were presented at the BHS AGM in Kylie Morton, Registered Nurse in the Emergency November 2015. Department. Doreen Bauer Travelling Scholarship Kylie will use the scholarship to commence her Masters of Steven Medwell, Director of Ballarat Regional Integrated Advanced Nursing Practice at Melbourne University which will Cancer Centre ultimately lead to her endorsement as a Nurse Practitioner. Steve received the scholarship to attend the American Staff Service Awards Society of Clinical Oncology Annual Meeting to be held in Long serving staff members of Ballarat Health Services were Chicago, IIIinois (USA) between 3 and 7 June 2016 and once again recognised at a series of special ceremonies in undertake visits to cancer centres. June 2016. Mental Health Travelling Scholarship In total, more than 310 staff with periods of service greater Breanna Achterbosch, Registered Psychiatric Nurse based in than ten years were acknowledged, including 78 with 25 Sovereign House Secure Extended Care Unit. years or more service to BHS and its predecessors (The Base Hospital, The Queen Elizabeth Geriatric Centre and Lakeside Breanna received the scholarship to attend the International Hospital). Society of Psychiatric Mental Health Nurses 18th Annual Conference in Minneapolis, Minnesota (USA) held between Each year we hold similar ceremonies as it is important to 10 and 16 April 2016 as well as the Mayo Clinic in Minnesota acknowledge and celebrate the contribution and loyalty of between 17 and 24 April 2016. The Mayo Clinic has our long serving staff members who have given so much to numerous mental health services including inpatient and BHS and the broader community during their years of service. community based programs. Their experience and knowledge is invaluable to BHS and we value their contribution to our operations greatly.

16 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Volunteers All our wonderful volunteers do an amazing job greeting, guiding, serving, chatting, listening, playing, singing, A strong and vibrant workforce of around 300 volunteers assisting and supporting patients and visitors to help exists at Ballarat Health Services, providing valuable make the patient experience at BHS brighter and support to many areas across the organisation. enhance the service offered by our staff. As a volunteer involving organisation, Ballarat Health Congratulations must also go to the Base Hospital Services is very fortunate to be able to attract many Welcome Team on being named 3BA’s Volunteers of the potential volunteers from the community on a regular Year in 2016. We are extremely proud of all our volunteers basis. Volunteer Services receives on average five and the valuable contribution they make to our services. expressions of interest per week and conducts two applicant interviews each week.

Up to 60 new volunteers are trained each year, with sessions being run quarterly. Expert staff from Human Resources, Psychology Department and Occupational Therapy assist with the delivery of this training and their A strong and vibrant workforce on-going support is greatly appreciated. of around 300 volunteers Once appropriately recruited and trained, volunteers exists at Ballarat Health are placed into their chosen program (of which there are about 20), and from there, they are oriented and Services, providing valuable supervised by team leaders and/or departmental staff. support to many areas across Some programs are actually led by volunteer team leaders. All these staff, paid and unpaid, work together the organisation. with the volunteers to ensure their role is valuable and fulfilling and also that they are meeting the requirements of the organisation.

BHS volunteers Maria Sidea, Tsedale Alagaw, Geoff Herreen, Jan Koolmees and James Perrie

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 17 CORPORATE SERVICES The Corporate Services Directorate encompasses capital building projects, facilities management, supply, engineering and environmental services. The Directorate is also responsible for BHS’ business units BHS Catering, Eureka Linen and Safety Link.

Capital works The committee has continued to educate of staff on environmental issues over the last year through the staff The past 12 months has been an exciting period for our newsletter and intranet when necessary. In addition to this an capital works program. Environmental Sustainability section was included in the Staff Information Handbook to increase environmental awareness Work on the Drummond Street building project has continued, in new staff. with contractors H.Troon making the building water tight and commencing on internal fit outs. Work to date has included More recently the committee has appointed an Environmental the completion of the main structural building work, with fit- Sustainability Officer to improve the capacity of the out works well under way including plastering, painting and committee to implement environmental initiatives and help electrical installation. On completion, the new building will be BHS deliver the strategic direction to ‘achieve and enhance the main entrance to the hospital. sustainability’. This position operates across all areas of BHS to create change for an environmentally sustainable Construction of the Mother and Family Unit (MAFU) at organisation. Pleasant Street was completed and the first patients treated at the new facility. The infant, child and youth mental health New energy saving equipment at teams also relocated to the renovated Midlands Complex on Eureka Linen Norman Street next to Hailey House. Eureka Linen increased its capacity this financial year The design process for the second cardiac catheter following the installation of a new batch washer, gas ironers laboratory has commenced, with works expected to and gas dryers. commence in October 2016. The new equipment allows Eureka Linen’s plant to efficiently Environmental Performance increase its capacity by around 40 tonnes per week, meaning it can now process around 110 tonnes of linen each week, Ballarat Health Services recognises protecting the health of whilst also achieving significant water, gas and power our environment is essential to the long term health of our savings. communities. To reduce the impact of the health service on the environment BHS has an Environmental Sustainability Eureka Linen provides linen services to BHS, Bendigo Health, Management Committee to promote environmentally Maryborough District Health Service, Hepburn Health, sustainable practices. Ballarat Day Procedure Centre and Ballan District Health and Care. In the last year the committee has implemented a number of environmental initiatives to reduce the carbon footprint During the year, Eureka Linen also gained the contract to of the organisation including the replacement of bottled provide laundry services to Barwon Health for five years. This water dispensing units with plumbed drinking fountains. created an additional 20 part-time positions with the ability to Implementing this initiative eliminated carbon emissions increase capacity if required. from the transport and packaging processes associated with regular deliveries of bottled drinking water.

Negotiations with the BHS waste contractor resulted in disposable coffee cups being accepted as part of our commingled recycling. This was the result of a 24-hour waste audit which identified a large proportion of disposable coffee cups in general waste. This change in waste management was then communicated to staff through internal media channels.

18 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Safety Link celebrates 35 years of Safety Link has recently introduced new products to further providing peace of mind enhance its services and support to clients. The new EVE 3+ alarm provides greater range coverage, operates on The Safety Link 24-hour personal response service has the National Broadband Network (NBN), and has built-in celebrated 35 years of supporting at-risk clients Australia- contingency to automatically function via the 3G mobile wide. network in the event of an outage.

Safety Link began in 1980, when nurses at the Queen Safety Link is one of the founding members of the Personal Elizabeth Centre in Ballarat identified the need to provide a Emergency Response Service Association (PERSA). service that allowed clients to maintain their independence in their own home. As a result, Safety Link was created to provide assistance to the frail, elderly, or those living alone by offering a simple and reliable way to keep connected to family, friends, and care-givers in times of need.

Progressing from a small, local business in 1980, Safety Link now monitors tens-of-thousands of clients nationally from its 24-hour Response Centre in Ballarat.

Through simple press-of-a-button technology, vulnerable people living on their own can summon emergency assistance when they need it.

As a division of BHS, Safety Link is committed to ensuring all clients receive the highest levels of customer service with an emphasis on a personal and caring approach. Safety Link is proud to deliver a service that allows clients to remain at home with dignity and peace-of-mind. Safety Link staff Steve Smith, Maureen Williams and Hayley Bruhn

OPERATIONAL PERFORMANCE AND IMPROVEMENT The Operational Performance and Improvement Directorate is responsible for patient access, performance, improvement and service redesign. The division includes specialist clinics and perioperative services (including operating theatres, anaesthetics, endoscopy, day procedures and preadmission and cardiovascular suite). Activity Continuing what has become a trend in recent years, it has been another extremely busy year across all areas of BHS. As demonstrated in the table below, activity across most areas of BHS increased, whilst attendance at Outpatients clinics fell slightly by 1.1 percent. Despite an increase in the number of surgeries performed this year, the waiting list has increased.

2015 - 16 2014 - 15 Change % Change WIES (funding units) 29,338 27,581 1,757 6.4% Inpatients treated 39,966 36,545 3,441 9.4% Bed days 87,926 84,015 3,911 4.7% Births 1,423 1,352 71 5.3% Theatre Cases (including endoscopies) 12,753 12,503 250 2% Emergency Attendances 53,313 51,433 1,880 3.7% Outpatient Attendances (VACS) 56,342 56,993 -651 -1.1% Elective Surgery Waiting List (ESWL) 1,073 851 222 26%

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 19 ORGANISATIONAL CHART

Chief Executive Officer

Board and CEO Services

Foundation and Fundraising

Media & Communications

Medical Operational Acute Residential Sub Mental Finance Corporate Human Services Performance Nursing & & Clinical Acute & Health Information Services Resources ++ & Midwifery Governance Community Services & Business Improvement ## Services ** Development

• Cancer • Perioperative • Emergency • Residential • Sub-Acute • Infant & Child • Finance • Asset & • Human Services- Services Department Administration Services Facility Resources • Youth • Health BRICC including: Management • Intensive Care • Nursing • Allied Health Information • Chaplains - Child & Youth • Internal - Operating Unit Education • Engineering • Allied Health Redesign • IT • Corporate Medicine Theatres • Women’s and • Nursing education Project • Supply Education & Service • Imaging and - Anaesthetics Children’s Research Development • Community • Adult Mental Breastscreen • Contracts • Medical - Day Procedure • Acute Wards • Ballarat East Programs Health and Tender • OH&S Administration Unit • Consulting Comple Services Management • Acute Nursing • Dental and • Industrial • Senior and - Endoscopy Eureka Villag Services - Community Diagnostic • Food Services Employee Junior Medical Geoffrey • State-wide -Cardiovascular Teams Ballarat Suite Relations Staff Service • Nursing Cutter Centre Equipment SE, SW, NE, NW, • Environmental administration Programs • Data • Equal • Medical - CSSD • QE Centre Ararat, Wimmera • Safety Link management Opportunity education • Nursing Talbot Place • CASA Southern Mallee • Elective and reporting • Eureka Linen Education Bill Crawford • Volunteers • Research Surgery - Acute Inpatient Lodge Services • Information • Switchboard and Ethics Management • Same Day • Emergency Technology Unit including • Queen - Secure Extended Planning and • Medico-Legal • Outpatient Alliance • Print Shop Transit Lounge Elizabeth Care Preparedness Services • Mortuary Village • Payroll • Car parking • Hospital in - Community Care • Library • Activity QE Village • Pharmacy the Home Unit - Salary Performance Hostel • Security Packaging • Pathology and Planning • Centralised PS Hobson - Perinatal Mental Allocations Nursing Health - FBT • Infection • Patient Flow Unit Hailey House compliance Control Co-ordinators • Aged Persons • Sebastopol Mental Health • Patient • Dialysis • Redesign/ Complex Services Services Facility Jack Lonsdale Operational - Community Lodge Team Planning James Thomas Court - Acute Inpatient Unit • Centralised Allocations - Aged High Unit Level Needs Nursing Home • Governance and Risk • Education Management Team Unit

Key Professional Reporting Lines Chief Nursing Officer ## Chief Medical Officer ++ Chief Allied Health Officer** Close and co-operative relationship in respect to the operation of Acute Services Shared Responsibility

20 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 BOARD OF DIRECTORS AS AT 30 JUNE 2016

Chair Deputy Chair Deputy Chair Rowena Coutts LLB BJuris Patty Kinnersly David Miller DipCmmtyStud BEd GradCertMgt DipAOD MMgt GAICD BOARD MEMBER SINCE 2013 BOARD MEMBER SINCE 2015 BOARD MEMBER SINCE 2015 Term of appointment: Term of appointment: Term of appointment: 03/12/2013 – 30/06/2016 01/07/2015 – 30/06/2018 01/07/2015 – 30/06/2018 Board meetings attended: 10 Board meetings attended: 11 Board meetings attended: 10 Audit and Risk Committee, Board Board Executive and Human Executive and Human Resources Audit and Risk Committee, Board Resources Committee, Medical Committee, Medical Credentials Executive and Human Resources Credentials and Appointments and Appointments Committee, Committee, Primary Care and Committee, Finance Committee, Credentials Appeal Tribunal Board, Population Health Advisory Committee Human Ethics, St John of God Joint Finance Committee, Primary Care Liaison Committee, Project and Population Health Advisory Control Group Committee, People and Culture Committee, St John of God Joint Liaison Committee

Juliana Addison Craig Coltman MAICD Victoria Kennedy Mark Patterson BA(Hons) MA(Communications) BPhysio CertPR DipMgt MBA BOARD MEMBER SINCE 2011 GradDipEd BOARD MEMBER SINCE 2013 BOARD MEMBER SINCE 2008 BOARD MEMBER SINCE 2015 Term of appointment: Term of appointment: 01/07/2014 – 30/06/2017 Term of appointment: Term of appointment: 30/07/2013 – 30/06/2016 01/07/2015 to 21/01/2017 01/07/2015 – 30/06/2018 Board meetings Board meetings Board meetings Board meetings attended: 10 attended: 11 attended: 10 attended: 11 Audit and Risk Committee, Board Executive and Human Human Ethics, Quality Care Community Advisory Finance Committee Resources Committee, Committee, People and Committee, Finance Community Advisory Culture Committee Committee, Quality Care Committee, Quality Care Committee, People and Committee Culture Committee

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 21 EXECUTIVE TEAM AS AT 30 JUNE 2016

Chief Executive Officer

Andrew Kinnersly BBus MBA ACHSE AHSFMA CPA Acting from 01/01/2016 The Chief Executive Officer is responsible to the Board of Directors for the efficient and effective operational management of Ballarat Health Services. Major responsibilities include the development and implementation of service and strategic planning, the promotion of quality care, optimising financial performance and implementation of human resource strategies. The Chief Executive Officer chairs the Executive Staff Council which comprises the senior executive staff of Ballarat Health Services. The CEO provides leadership through collaborative management with staff and consultation with the community.

Executive Director - Medical Services/Chief Medical Officer

Dr Jaycen Cruickshank MBBS MClinRes FACEM Acting Chief Medical Officer from 01/03/2016 The Chief Medical Officer has overall responsibility for medical services including direct service provision in the Division of Medicine, management of all senior and junior medical staff, ongoing medical education in all specialties and other professional issues. The Chief Medical Officer chairs the BRICC Governance Committee which coordinates and supervises activities in the Ballarat Regional Integrated Cancer Centre, and leads cancer services throughout the organisation. He is also responsible for research and ethics, medicolegal issues, pathology and infection control. The Chief Medical Officer ensures all medical staff have appropriate credentials and actively encourages the placement of medical students at Ballarat Health Services. In conjunction with all the clinical executives, the Chief Medical Officer has an active role developing clinical governance frameworks, embracing clinical risk management and continuous quality improvement.

Executive Director – Acute Nursing and Midwifery Leanne Shea RN DipProjMan AdvDipBusMgt Appointed April 2011 The Executive Director provides organisational and professional leadership to contribute to developing and achieving strategic goals, policies, healthcare reforms, budget and quality management of acute nursing and midwifery services at Ballarat Health Services. Major management responsibilities include business, resource management, service planning and provision, and quality improvement and compliance.

Executive Director – Residential and Clinical Governance Services Adjunct Associate Professor Sue Gervasoni RN RPN CertCritCare BN MBA AFCHSM Appointed December 2010 The Executive Director has direct operational responsibility for Residential Aged Care Services. This role supports the organisation to achieve its strategic goals through the provision of leadership and support for safe and high quality residential aged care services. Key accountabilities include the monitoring of the clinical care and outcomes for residents, management of resources, business performance and compliance with legislation and Aged Care Standards. The Executive Director also has the portfolio and organisational responsibility for clinical governance and risk management. She chairs the Patient Safety and Quality Committee, has executive responsibility for the Consumer Advisory Committee and supports the Governance and Risk Management Unit in all aspects of their service

Executive Director - Sub-Acute and Community Wendy Hubbard BAppSc(PT) MAppSc(HM) MBA Appointed March 2000 The Executive Director has responsibility for nine allied health disciplines, carries executive responsibility for the sub-acute inpatient and ambulatory services including rehabilitation, aged care evaluation and palliative care, and has responsibility for community-based programs. The Executive Director also has responsibility for the State-Wide Equipment Program (SWEP), the Centre Against Sexual Assault, pharmacy and dental services.

22 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Executive Director - Mental Health Services Tamara Irish RN RM RPN Appointed June 2010 The Executive Director is responsible for the full range of Mental Health Services provided by Ballarat Health Services within the Grampians Region. These services include Infant and Child, Perinatal, Youth, Adult, and Aged persons Mental Health Services both within the community and as inpatient services. The Executive Director has professional responsibility for all Mental Health Services staff.

Executive Director - Finance, Information and Business Development

Mick Smith BCom AHSFMA FCPA Acting from 01/01/2016 The Executive Director has responsibility for the financial management of Ballarat Health Services including accurate and timely budget reports for the Board of Directors and staff. The Executive Director also has operational responsibility for finance, information technology, radiology services, payroll, insurance and taxation systems.

Executive Director - Human Resources Trevor Olsson BBus AIMM CAHRI AFACHSM Appointed October 1999 The Executive Director Human Resources responsibilities include all aspects of strategic human resource management including recruitment, organisational change, industrial/employee relations, equal employment opportunity, security services, occupational health and safety, the library, chaplaincy services, corporate training and development, volunteer co-ordination and emergency management.

Executive Director - Corporate Services Russell Hardy CertIV (Food Tech) GradCertMgt PTC MIHHC Appointed November 2012 The Executive Director Corporate Services has responsibility for supply, engineering and environmental services as well as the business units including BHS Catering, Eureka Linen, and Safety Link. The Executive Director also has responsibility for service planning, capital building projects and equipment, accommodation and facilities management and development.

Executive Director – Operational Performance and Improvement

Mr Matthew Hadfield ProfCertHlthSysMan BSc MBCHB(Hons) FRCS(Gen Surg) Acting from 13/06/2016 The Executive Director is responsible for leading the organisation on patient access, performance, improvement and service redesign. The role works across the divisions and portfolios in acute and sub-acute services to develop and implement an organisation-wide improvement program to ensure BHS responds to current and future needs of the community. The role oversees Specialist Clinics, Perioperative Services (including operating theatres, anaesthetics, endoscopy, day procedures and preadmission and cardiovascular suite), Access Team, Redesign and Improvement.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 23 SENIOR STAFF AS AT 30 JUNE

EXECUTIVE SERVICES Physicians GP Liaison Unit A/Clinical Manager South Ballarat Adult Mental Health General (Sub-Specialty) GP Liaison Manager Acting Chief Executive Services James Hurley Jannine Rigby RN RPN Officer Kate Ward BAPsych GradDipPsych Andrew Kinnersly MBBS BMedSci PhD FRACP GradDipHealthAdmin BN MBusMgt BBus MBA ACHSE AHSFMA CPA Brett Knight MBBS FRACP James Cameron GP Liaison Consultant Clinical Manager Wimmera Director Board and Bsc(Hons) MBChB FACEM FRACP Malcolm Anderson and Southern Mallee Mental MBBS DA FACRRM CEO Services Raquel Cowan MBBS FRACP Health Services Michael Fryar RPN Katrina Hishon RN CertNurseImm David Song MBChB FRCPA FRACP BAppSc(NsgAdmin) GradDip(PsychNsg) CertBusAdmin AdvCertPaed Binara Jayasinghe AdvDipBusMgt MBBS MRCP FRACP MD CORPORATE SERVICES Shannon McCarthy Clinical Manager Ararat/ Director Foundation MBBS B.Med.Sci. FRACP Executive Director Stawell Mental Health and Fundraising Russell Hardy CertIV(FoodTech) Services Head of Cardiology GradCertMgt PTC MIHHC Geoff MillarDipTeach BA BEd Michael Fryar RPN Romulo Ernesto Oqueli Flores BAppSc(NsgAdmin) GradDip(PsychNsg) GradCertMgt GradDipEdAdmin EMFIA MD FRACP Director of Property and Infrastructure Clinical Manager Youth Media and Communications Cardiologists Gerard Kennedy Manager Romulo Ernesto Oqueli Flores Mental Health Services Daniel Anderson MD FRACP Cara McCormack Environmental Services BPsych GradDipHM DipLeadMgt BSocSc GradDipJourn Christopher Hengel MBBS FRACP Manager John van den Broek MBBS FRACP Don Colbert GradCertMgt Robert MacFadyen Clinical Manager Infant and MEDICAL SERVCES BSc MBChB MD PhD FRCP Child Mental Health Services John Zhu PhD FRACP Supply Services Manager Lisa Sambrooks RN RM Ron Hiller MAHSPO MCIPSA Chief Medical Officer Anand Sharma MRCP FRACP Jaycen Cruickshank Clinical Manager Aged MBBS MClinRes FACEM Gastroenterologists BHS Catering Manager Persons Mental Health Maree Pekin MBBS FRACP Robert Fraser CertIVWTA CertIVHosp Services – Community AdDipBusMgt RAB QSA AMS Deputy Director Mohammed Al-Ansari Kevin Harris RN RPN Medical Services MBChB FRACP Safety Link Linda Danvers MBBS DipRACOG Timothy Elliott MBBS PhD FRACP Clinical Manager Secure AdDipMgt MPH AFRACMA FRACGP General Manager Extended Care Unit Neurology Mark Czulij BCom(Mgt/Mkt) Colleen Fryar RN RPN Director Medical Thomas Kraemer MBBS FRACP Administration, Workforce Mandy Lau MBBS FRACP Eureka Linen Manager Clinical Manager Aged Planning and Engagement Ramesh Sahathevan Monica McMahon Craig Wilding BAppSc (Medical MD M.Med, FRCPI, PhD Persons Inpatient Mental Radiation) GradDipBusMgt MBA Health Services Nephrology MENTAL HEALTH Jane Lockhart Director Ballarat Regional John Richmond MBBS FRACP RPN BN RN GradCertGeron Integrated Cancer Centre Susheel Sharma MBBS FRACP SERVICES Steve Medwell Clinical Manager Community GradDipEd BAppSc MBA Endocrinologist (Paediatric) Acting Executive Director Care Unit Michael Fryar RPN Christine Rodda MBBS FRACP Brendan Thomas RPN GradDipCBT Junior Medical Workforce BAppSc(NsgAdmin) GradDip(PsychNsg) Unit Manager Neurologist (Paediatric) Clinical Manager Adult Director of Clinical Services Victoria Fara BA MPA Michael Hayman MBBS FRACP Acute Inpatient Unit Abdul Khalid MBBS FRANZCP Marice O’Brien RN RPN Manager Infection BRICC MD(Psych) CCST Prevention and Control Unit Manager Education and Sue Flockhart RN CertIVAAT Acting Head of Medical Consultant Psychiatrists Research DipPrjctMgt GradDipMgt&InfctnCntrl Oncology Rajul Tandon BN MNsg Julia Hailes MEd PhD Stephen Brown MBBS FRACP MBBS MD(Psych) FRANZCP Ram Singh MBBS MD(Psych) MSc Manager Senior Medical Medical Oncologists (IPAS) CCST FRANZCP Manager Performance & Governance Workforce and Stephen Brown MBBS FRACP Ramesh Chandra MBBS MD(Psych) Partnerships Research Office Lee Na Teo MBBS FRACP David Barton (Prof) Michelle Harper Susan Shea BSc (Psych & Psychophysiology) MBBS FRACP MBBS FRANZCP MRACMA BAppSc(Pod) PhD FAAQHC GAICD Geoff Chong Bhuamik Shah MBBS FRACP Richard Kefford MBBS CertAccTrng C&APsych FRANZCP Manager Quality and Safety Prashanth Prithviraj Medical Education Priya Allencherry Michael Mennen RPN Co-ordinator MBBS MSc MPH FRACP PhD Craig Carden MBBS FRACP MBBS MD(Psych) FRANZCP Michelle Bodey BCom BEd Vishal Boolell Anne Seneviratne MBBS MD(Psych) B. Med. Sci. MBBS FRACP MBBS MD(Psych) HUMAN RESOURCES Medical Education Officer Ranjith Nallehewa Kate Hamilton MBBS FRACP Hany Ghabrash MBBCh CABMPsych Zoe Howell BSc (Extended leave) Ravindra Mutha Executive Director MBBS MRCPsych CCT Trevor Olsson Medicine Radiation Oncologists Anoop Lalitha MBBS DPM MD(Psych) BBus AIMM CAHRI AFACHSM (BAROC) Clinical Director of Medicine Louise Gorman MBBS FRANZCR Service Managers Deputy Executive Director/ Brett Knight MBBS FRACP Simone Reeves MBBS FRANZCR Employee Relations Jonathan Tomaszewski Clinical Manager North Manager MBBS FRANZCR Ballarat Adult Mental Health Kevin Stewart Carminia Lapuz MBBS FRANZCR Services BAppSc(PT) GradDipErg Carly Johnson BSoc

24 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Workforce and Recruitment Manager, Business Alfredo Obieta MD FRACP Orthoptics Operational Services Manager Management Binara Jayasinghe Manager MBBS MRCP MD FRACP Angela Turley CertIVTAA Mick Sheehan BBus AHSFMA CA Michelle Oliver DipProjMgt BBus(HR/Marktng) Yasmin Sheikh MBBS FRACP DipBusMgt BAppSc(P&O) MLaw(EmploymentLabourrEL) MAHRI Pathology Rehabilitation Medicine Laboratory Manager Psychology Clinical Occupational Health and Richard Bignell MBBS FAFRM (RACP) Manager Michael Phyland BAppSc Safety Manager Thomas Kraemer MBBS FRACP Kylie McKenzie BA(Hons) Alisha Bedggood Susan Hodson MPsych(Clinical) MAPS CertIVHlth(Nsg) PostGradDipOHM Pathologists MBBS DipRANZCO&G FRACGP Swapna Sengupta MD FRCPA Michael McDonough MBBS Social Work Clinical Learning and Development David Clift MBBS FRCPA DipClinTox MAddSc FAChAM Manager Manager Ngoc Le MBBS FAFRM(RACP) Catherine Ludbrook BA BSW MBBS FAFRM(RACP) Megan Ali CertIVTAA BMgt(HR/ Radiography and Tom Hale Speech Pathology Clinical Marktng) GradDipPsych MAHRI Diagnostic Services Palliative Care Medicine Senior Human Resources Manager Director Radiography and Greg Mewett MBBS Acushla Thompson BAppSc(SP) Consultants PostgradDipPallMed FAChPM DRCOG GradCert(Mgt) MSPAA CPSP Maree Baker CertIVOHS DipBusHR Diagnostic Services FRACGP AdDipM(HRM) GradCertHRM CAHRI Richard van Dreven Penelope Cotton MBBS(Hons) Community Programs Megan Ralston BMgt(HR) DipAppSc(MedRadtn) GradDipAdmin BMedSci MClinEd FRACGP FAChPM MISRRT MIR Joanne Innes Chi Li MBBS FAChPM (RACP) Director Community CertIVTAA AdDipBus(Mgt&HR) MAHRI Claire Hepper MBBS FRACGP Nurse Unit Managers Programs Leah Shillito BA GradDipBusHRM Michelle Veal RN DipPrjMgt Bronwyn Bentley RN Paediatric Rehabilitation Charisse Nuske BBus(Mgt) DipAppSc(Nursing) CertCritCare/Emerg BA(Nsg) GradCert(BusAdmin) Specialist GradCert(HlthSysMgt) Toni Clarke BAppSci(Nsg) Adam Scheinberg Emergency Management MBBS MMed FRACP FAFRM Aged Care Assessment Manager BreastScreen Program Services Acting Manager Don Garlick CertIVTAA Centre Against Sexual Manager Rachel Fishlock RN AdvDipMgt CertIVFrontLead CertIVProjMgt Assault Manager CertIVFireTech AdvDipPubSaf(EMgt) Kim Kyatt BAppSci(MedRad) GradDipNsg(CritCare) MEmMgt GradCertMedRad(BreastImaging) Shireen Gunn Carer’s Programs Manager Dip T BSW AAMC AccMAASW Cheryl Hines DipWelf AdvDipBusMgt Pastoral/Spiritual Care Dental Services Coordinator SUB ACUTE AND Hospital Admission Risk Johanna Niedra COMMUNITY Dental Services Manager Program Manager Melinda Farnsworth RN BA(Nsg) GradCertGrief&Loss TPTC Jacqui Nolan Executive Director GradDip(AdvClinPracInfctnCntrl) Volunteer Services Manager Wendy Hubbard BAppSc(PT) Dentists MAppSc(HM) MBA Linkages Manager Sue Jakob CertIVTAA DipTeach(Prim) Pallavi Mishra BDS ADC MDSC Nick Grakini GradDipEd(Lit) Nidhi Tandon BDS ADC Director of Nursing DipMgt DipHRM BHlthSci(OT) Rachel Sim BDSHons Sub-Acute Services Security Manager Tiffany Chuo BHSc(Dent) MDent Planned Activity Groups Meredith Theobald RN Robert Dekleva CertIII(Sec) RPN CertRehabNsg BN Preeti Grover BDS Manager GradDipSocSc(SecMgt) GradCertNsg(MentHlth) Sandra Duong BDSHons Jan Stewart AdvDip(Mgt) BAppSci(PE) Mitchell Barker BHSc(Dent) MDent GradDip(HlthSci) Library Manager Nurse Unit Managers Jorge Sepulveda BHSc (Dent) MDent Transition Care Program, Gemma Siemensma CertIVTAA Monica Massiha BHSc (Dent) MDent BA(LIS) MAppSc(LIM) MBA AALIA Inpatient Complex Care (Jim GEM in the Home and Gay Unit-GEM) Allied Health Restorative Care Manager Karen Moran RN CertIVTAA Helen Mathews FINANCE GradCertGeron Dietetics Clinical Manager RN GradDip(AdminMgt) Gandarra Palliative Care INFORMATION Meredith Atkinson BAppSc(Nutn) Grampians Regional Unit GradDipDiet MPH MDAA AND BUSINESS Continence Service Maree Kewish RN BAppSc(Nsg) DEVELOPMENT MPrimHlthCare(PallCare) Exercise Therapy Clinical Manager Manager Shirley Whitaker RN CertContProm BN GradCertHlth:AdvContNseSpec Acting Executive Director Inpatient Rehabilitation Kerry Walsh BEd(PE) Mick Smith BCom AHSFMA FCPA Jason Wakefield RN (Acting NUM) Occupational Therapy Grampians Regional Director Information Sub-Acute Medicine Clinical Manager Palliative Care Team Manager Management Michele Pearson BAppSc(OT) Jade Odgers RN CertIVWrkPlAAT Kate Nolan BHlthInfoMgt MBA GradDip(HSM) Clinical Director of DipPrjMgt GradDip(PallCare) Sub-Acute Medicine Physiotherapy Clinical GradDip(Psych) GradDipMgt Director Remuneration GradDipFrontMan MNsg Joseph Ibrahim MBBS PhD FAFPHM Manager Services FRACP Georgie Kemp BAppSc(Physio) Post-Acute Care and Central Paul Keane AdvDipMgt AHSFMA MPhysio GradCert(HSM) Geriatric Medicine Intake Manager Manager Billing Services Mark Yates MBBS FRACP Helen Jarvis Podiatry Operational RN RM BN GradCertMgt MRCNA Jenny Palmer DipBusMgt Judith Adams MBBS FRACP Manager Philip Street MBBS FRACP Dimitri Diacogiorgis BPod Sub-Acute Ambulatory Care Manager Financial Rosemarie Shea GradCertDiabEd GradCertHealthServMgt and Domiciliary Services MBBS MClinEd FRACP GradDipWoundCare MApplSc Accounting Manager Christena Renouf Tamsin Santos BSC(Biomed) MBBS FRACP Prosthetics/Orthotics Margaret Dawson BAppSc(Pod) BAcc AHSFMA CPA GradDip(Pod) MBA DPH Michael J Brignell Clinical Manager MBBS GradDipBus FRACP FRCP Michelle Oliver DipBusMgt BAppSc(P&O)

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 25 Pharmacy Ballarat North and Anaesthetists/Intensivists Clinical Director and Head of Wendouree Bruce Christie MBBS FANZCA Paediatrics Director of Pharmacy Doug Paxton MBB FANZCA David Tickell MBBS FRACP Aaron Fitzpatrick Director of Nursing BPharm GradCertMgt MSHPA Greg Henderson MBBS FANZCA Ken Pfukwa RN BN DipBus Robert Ray MBBS FANZCA Paediatricians PostGradDipPubHlth MHM AFCHSM Deputy Director of Craig Mitchell MBBS FANZCA Louise du Plessis MBChB FRACP Mark Nethercote MBBS FRACP Pharmacy (Quality Use of Facility Managers Medicines and Dispensary Emergency Medicine Fiona Noble MBBS FRACP Services) PS Hobson Nursing Home Philippa Bolton MBChB FRACP Clinical Director of David Kong BPharm MPharm PhD Heather George Shabna Rajapaksa MA MB BChir MRCPCH MSc GCHE MSHPA MRACI RN BN CertGerontics GradDipMid Emergency Medicine Austen Erasmus Tanya Barun RN CertIVTAA BN MCom Andrew Crellin MBBS FACEM MBBCh DCH FCP FRACP Deputy Director of (Prof Accounting) CPA ASA Pharmacy (Clinical Deputy Director of Lakshman Doddamani Pharmacy Services) MBBS DNB(paediatrics) MRCPCH WB Messer Hostel Emergency Medicine FRCPCH FRACP Renee Dimond Elizabeth Sayers Pauline Chapman MBBS FACEM BPharm(Hons) MClinPharm MSHPA AdvDipMgt RN RGNC Nigel Beck MBBS FACEM Nursing Director Mark Hartnell MBBS FACEM Carolyn Robertson RN RM RESIDENTIAL Hailey House Hostel DipAppSc(Nsg) BANsg PostGradDipMid Linda Newby CertIVOH&S Emergency Physicians MClinMid CertIVTAA RN GradDipMidwifery AND CLINICAL Heather Crook MBBS FACEM GradDipRehabNsg GOVERNANCE Ali Al Joboory MBBS FACEM McGrath Breast Care Nurses SERVICES Janie Worth MBBS FACEM Sue Bartlett RN CertIVWrkplceTAS Ballarat Central and CertICU/HDU GradCertCanc&PallCare Jaycen Cruickshank MBBS FACEM Cath Healy Executive Director Sebastopol MBBS FACEM Jocelyn Howell RN BNsg MaNsgBreastcare Residential & Clinical Treena Quarin MBBS FACEM Director of Nursing Governance Services Amanda Lishman MBBS FACEM Mick Kirby RN BAppScNsg CCRN Prostate Cancer Sue Gervasoni RN RPN BN Cert GradDipBusMgt DipProjMan Spiro Tsipouras MBBS FACEM Specialist Nurse Critical Care MBA AFCHSM Amanda Wilkin MBBS FACEM Gay Corbett RN CertIVTAA DipPrjtMgt Facility Managers Kirsty Dunn MBBS FACEM BNsg GradDipEd Clinical Governance Linda Chow MBBS FACEM Services Talbot Place Nursing Home Steve Costa MBBS FACEM Clinical Midwife Consultant Mark Jones RN BN GradDipMgt Petra Niclasen MBBS FACEM – Lactation Director Governance and Andrew Underhill MBBS FACEM Judy Russell RN RM BNsg Risk Management Unit Eoin Fogarty MBBS FACEM GradCertTertEd CertIVTAA IntBoardCert Bill Crawford Lodge Nursing Lactation Consultant Keren Day RN DipProjMan Home Rajesh Sannapareddy MBBS FACEM BN GradCertHSMgt GradDipAdvNsgWmnHlth MNsg Tijamol Jacob RN BN Nurse Unit Managers Senior Medical Officers Risk Manager Jack Lonsdale Lodge (Emergency Medicine) Maternity Clinical Services Trudy Shortal Nursing Home Waad Elias MBBS Annemarie McKenzie RN RM BaNsg RN GradCertCCN BN MMgt Jenny Relouw Jahir Ahmed MBBS PostGradDipMid AdvDipBusMgt RN PostGradGer Molly Martin RN Residential Services Quality Women and Children’s Maternity Outpatient Manager James Thomas Court Hostel Health Services Services Claudio Dellore RPN RN Annette Vaarzon Morel RN Marlene Martin BAppSc(Nurse Ed & Admin) CertIVTAA BA(SocSci) BSW RN RM DipParaMed AdvDipMgt/HR PostGradDip(Nsg) Joanna Briggs GradCertAcuteCare GradCertClinMgt Clinical Director and Head of Institute Fellowship GradDipMid Obstetrics and Gynaecology Paul Davey MBBS FRANZCOG Special Care Nursery Manager Quality and Safety Susan Phin RN RM BaNsg PostGradDipMid CertNeonursing - Sub-Acute and Community ACUTE NURSING Staff Obstetricians and Cathy Caruso ROT BAppSci(OT) Gynaecologists GradDipHSci(HealthEd) AND MIDWIFERY Paediatric and Adolescent Zainab Sabri MBchB FRANZCOG Unit Iruka Kumarage MBBS MRCOG Transfusion Practice Clinical Executive Director Acute Clinton GriffithsRN BaNsg Nursing & Midwifery PostgradDipPaedNsg DipBusFrontMan Nurse Consultant Gynaecological Oncologist ProfCertHlthSymMgt Wendy McLeod Leanne Shea RN AdvDipBusMgt DipProjMan Prof Tom Jobling RN GradCert(Transfusion Practice) MBBS CGO MD FRCOG FRANZCOG Acute Inpatient Services Residential Services Nursing Director – Clinical Education and Practice Urogynaecologist Nursing Director Development Jeanette Lim MBBS FRANZCOG Angie Spencer Ballarat East RN GradDipBus(e-Bus&Mkg) Denielle Beardmore RN CertIVTAA DipPrjtMgt BN BHlthSci GradDiPEd&T Obstetricians and Director of Nursing GradDipAdClinNsgOnc/PallCare MEd Gynaecologists Nurse Unit Managers Jacqui King RN BN AdvDipBusMgt AAM Russell Dalton MBBS FRANZCOG 2 North Deepika Monga Danelle Klein RN BN Facility Managers Critical Care Services MBBS MD (O&G)DNBE FRANZCOG GradCertOrthoNsg Patrick Moloney MBBS FRANZCOG Geoffrey Cutter Centre Clinical Director of Michael Bardsley MBBS FRANZCOG 3 North Nursing Home Intensive Care Katrina Guerin Annette McFarlane RN Lynda Fraser RN BHlthSci Angus Richardson MBBS(Hons) FRANZCOG GradDipBusMgt GradDipHM MBBS FANZCA FCICM Natasha Frawley Eureka Village Hostel MA(BioEth) MBBS MRANZCOG 3 South Sherin Jose RN BN Deputy Director of Michael Carter MBBS FRANZCOG Nicole Snibson RN AdvDipMgt Intensive Care Chantelle Stubna MBBS FRANZCOG GCertDiabEd Rob Gazzard MBBS FANZCA FCICM

26 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 4 South/Day Oncology Diabetes Educators Perioperative Services Anaesthetists Stephen Hearn RN BN DipBisMgt Sandra Anstis RN Cert IVTAA Mike Bassett MBBS FANZCA GradDipAdvNsg (ICU) GradCertDiabEd Director Perioperative Deas Brouwer FANZCA 4 North Patricia Baker Services Anne Chew MBBS FANZCA RN BHlth GradCertDiabEd Matthew Hadfield Vicki Thomas RN BN CertHlthSrvMgt Bruce Christie MBBS FANZCA Amy Horvath ProfCertHealthSystemsMan BSc RN BHlthSci GradCertDiabEd MBChB(Hons) FRCS(Gen Surg) FRACS Richard Connell FANZCA Emergency Department Belinda Moore B.Anthtopology RN Rachel Cowell FANZCA Phil Catterson RM BNsg GradDipPaeds GradDipMid General Surgeons Jonathan Evans RN CertIVTAA BN CCRN MBA MBBS FANZCA(Hons) GradCertDiabEd Ruth Bollard Gail Schuler RN GradCertDiabEd MBChB MD FRACS FRCS (Gen) Sam Frost MBBS FANZCA Critical Care Unit Ben Mudford David Deutscher BSc MBBS FRACS Rob Gazzard MBBS FANZCA FJFICM Andrew Thomas RN Cert IV in A & T GradCertDiabEd MBBS FRACS Greg Henderson MBBS FANZCA RN BN CertIVTAA GCertCritCare Stuart Eaton Tom Fisher MBBS FRACS Malcolm Hogg BMBS FANZCA FFPMANZCA Medical Day Unit Andrew Lowe MBBS FRACS OPERATIONAL Greg Hughes MBBS FANZCA Sylvia Mitting RN RM DipFrontMgt Bruce Stewart MBBS FRACS Tony Keeble MBBS FANZCA PERFORMANCE AND Daniel Wong MBBS FRACS Jeyanthi Kunadhasan MDM FANZCA Dialysis IMPROVEMENT Michael Ng MBBS FRACS Craig Mitchell MBBS FANZCA Catherine Thomas Ahmed Naqeeb RN BN CertHlthSrvMgt Acting Executive Director MBChB FRACS MRCS Dan McIntyre MBBS FANZCA Matthew Hadfield Douraid Abbas MBChB FRACS Ryan McMullan MBBS FANZCA Nurse Donation Specialist ProfCertHlthSysMan BSc MBCHB(Hons) Kontoku Shimokawa MBChB FRACS John Oswald MBBS FANZCA Larna Kennedy RN BN PostGradDip FRCS(Gen Surg) Shaktivel Palanivel MD FANZCA AdvClnclNsg-CritCareStrm General and Vascular Doug Paxton MBBS FANZCA Redesign and Innovation Surgeons Ross Phillips MBBS FANZCA Clinical Support Services Manager Michael Condous Catherine Plank MBBS FANZCA Vacant MBBS FRACS (Vasc) Rob Ray MBBS FANZCA Nursing Director – Clinical Matthew Hadfield Angus Richardson MBBS FANZCA Support Services Capital Works Service ProfCertHealthSystemsMan BSc Rachna Shankar MBBS FANZCA MBChB(Hons) FRCS(Gen Surg) P.K. Peter RN RM CertHlthMgt Development Officer Michael Shaw MBBS FANZCA CertIVTAA CertIVinE&W DipF&P Sally Kruger CertIVProjMan Peter Shea MBBS FANZCA BBus(Eco) GradCertHEcom DipAppSci(Nsg) BANsg Urologists GradCertAdvNsg MHthSc MEdn CCRN Hock Tan MBBS FANZCA GradCertCritCare Lachlan Dodds MBBS FRACS PICNC Kiran Tippur David Cook MBBS FRACS MBBS FCARSCI FFPMANZCA Hospital in the Home/ Redesign and Improvement Lydia Johns-Putra MBBS FRACS Radha Vivekananthan Residential In Reach Services Development Richard McMullin MBBS FRACS MBBS FANZCA Lisa Brooks RN RM AdvDipHR Officer Robert Forsyth MBBS FRACS Mike Whitehead MBBS FANZCA AdvDipMgt BN GradDipAdvNsg MNS Lee-Anne Sargeant BA DipAud Adee-Jonathan Davidson MBBS FRACS Manager Nursing Nursing Director Jyotsna Jayarajan BMedSci Information & Systems Perioperative Services and MBBS(Hons) FRACS (Urology) Patient Flow Development Orthopaedic Surgeons John Morrison RN BHthSci Margaret O’Neill RN BN(Post Reg) David Mitchell AdvDipBus AdvDipHR AdvDipMk CertCritCare GradDipHlthMgt MBBS FRACS (Orth) FAOA MAICD Shaun English MBBS FRACS (Orth) Central Allocations Unit Nursing Director Surgical John Nelson Annie Rivett RN BAppSci GradCertMgt Access MBBS FRACS (Orth) FAOA Joy Taylor RN CertPeriopNsg GradDipMgt MRCNA John Dillon Clinical Nurse MB MD FRCS (Orth) FRACS (Orth) Consultants Scott Mason MBBS FRACS (Orth) Nurse Unit Managers Matthias Russ als Arzt FRACS Wound Management/Stomal Nurse Unit Manager Luke Spencer MBBS FRACS (Orth) Therapy/Breast Cancer Specialist Clinics Support Ear Nose & Throat Surgeons Wendy Giddings RN RM BHlthSc MBBS FRCS Marianne Crowe RN CertStomThrpy GradCertNursSci(Clinical Teaching) Paul Donoghue DipAppSciNsg BN (PostReg) GradDipAdvClinNurs(Critical Care) Mark Guirguis MBBS FRACS Niall McConchie MBBS FRACS Wound Care Team Nurse Unit Manager, Karin Annertz MBBS FSSOR (Sweden) Matt Squire RN RN RPN B Nursing, Preadmission and Day DipSocComHlthMgt Procedure Unit Ophthalmologists Donna Nair RN RN B Nursing, Lorraine Hoiles RN BN(PostReg) Michael Toohey MBBS FRANZCO Lisa O’Neil RN RPN B Nursing Trent Roydhouse Julianna Hinchey RN B Nursing Nurse Unit Manager MBBS(Hons) MRCOphth FRANZCO Grace Wilson RN B Nursing Endoscopy David Francis MBBS FRANZCO Hollie Schutz RN B Nursing Sandra Holt RN Maxillofacial Pain Management Nurse Unit Manager CSSD Graeme Fowler MDSc FDSRCPS Louise Humble RN ICU/ CCUCert GradDipAcuteCareNsg Denise Jackson RN BN(PostReg) GradDipSciMed(PainMgt) GradCertInfctnCntrl MRCNA Anaesthetics

Cognition Acting Nurse Unit Manager, Director of Anaesthetics Michelle Morvell Operating Suite Fred Rosewarne MBBS FANZCA RN RPN BN CertIVTAA Ivor Riesewyk DipPeriOpNsg BN Shannon Styles Deputy Director of RN RPN BN GradCertOrthoNsg Anaesthetics Sanjay Sharma MBBS FANZCA

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 27 STATEMENT OF PRIORITIES

PART A: STRATEGIC OVERVIEW

In 2015–16 Ballarat Health Services will contribute to the achievement of the government’s commitments by:

Domain Action Deliverables Outcomes

Patient experience Drive improved health Improve patient Progression of Care is embedded as a weekly and outcomes outcomes through a access, flow, system meeting with standardised KPIs and agenda strong focus on patient- management and items. High level patient data is analysed, centred care in the discharge planning to discussed and action plans developed. A ensure that patients planning, delivery and number of changes to processes supporting have access to the right evaluation of services, patient flow and discharge planning have been care, at the right time and the development of identified and implemented across the health and in the right place new models for putting service from Emergency to Residential Aged patients first. through the weekly ‘Progression of Care’ Care. meetings. Further expansion of the BHS Regional Bed Utilise high level data, Meeting now includes Beaufort Skipton Health patient stories and Service and Djerriwarrh Health Services. There strong leadership across are now seven health services participating the organisation to in this process which assists with the flow of inform and direct this patients across the region. work High level ‘real time’ data dashboards have been developed to support key decisions and understanding across the organisation. Review of relative stay index data, health round table and Dr Foster enable focus on key patient cohorts for bed day saving opportunities.

Recommendations from Victorian Auditor General’s Office report into ‘length of stay’ have been considered by the organisation and ‘length of stay’ incorporated into the Board of Directors key performance indicator monthly report and relevant governance groups reporting lines to support progress in this area.

Utilise the Victorian Victorian Healthcare Experience Survey data Healthcare Experience results are distributed across the organisation Survey data to inform to individual departments as appropriate and identify areas within and action plans are developed to drive the organisation that improvement. In addition, results are reported require improvement. at all levels of Ballarat Health Services as part of the Clinical Governance Framework and are a standing agenda item on the Board of Directors Quality Care Committee.

28 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Domain Action Deliverables Outcomes

Address feedback Consumer feedback is obtained in a variety of received through the ways including, Patient Experience Trackers, various governance Complaints, Compliments and Patient Stories. committees and action Individual departments are provided with outcomes accordingly. their own data to analyse and action, and consolidated data is reviewed at relevant governance committees where themes are identified. Patient stories are utilised regularly and action plans are developed following each story to ensure the organisation address’s issues raised.

Work with the Ballarat Regional Integrated Cancer Care Grampians Integrated management staff and clinicians attend Cancer Service to further regional cancer governance meetings to assist develop Regional Cancer in the development of the cancer service Care Services and network. improve results against Multi-disciplinary team information is recorded six monthly audits of the via two methods; internal case-conferencing state-wide cancer key and via regional multi-disciplinary meetings performance indicators. facilitated by Grampians Integrated Cancer Service. Ballarat Regional Integrated Cancer Care is engaged in the multi-disciplinary meeting management process and in 2016 will commence coordination of these meetings for the region. The transition expectation is improvement in the data recording, reporting process and communication of information from multi-disciplinary meetings to stakeholder health services and general practitioners. Medical oncology chemotherapy plans and radiation oncology patient treatment plans are provided to general practitioners. Cancer diagnosis reporting will be adjusted according to new notification guidelines. BRICC is engaged in the implementation of optimal care pathways through the Lead Clinicians Committee. Measures are in place to improve supportive care services through the improved practical deployment of the Supportive Care Screening Tool. A project commenced to review and map chemotherapy services, utilising the draft chemotherapy capabilities framework. Consumer engagement will continue to be enhanced through deployment of recommendations from the cancer conversations forum.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 29 STATEMENT OF PRIORITIES

PART A: STRATEGIC OVERVIEW (CONT.)

Domain Action Deliverables Outcomes

Strengthen the response By June 2016 develop The existing elder abuse protocol has been of health services to and implement a reviewed and revised to ensure it is appropriate family violence. This policy, including a staff across all service settings. includes implementing education component, Staff education sessions have commenced. interventions, processes aimed at increasing and systems to prevent, the awareness of and identify and respond appropriate response appropriately to family to suspected or actual violence at an individual incidents of elder abuse and community level. particularly in community settings

Identify service users Expand the Centre A highly experienced senior CASA counsellor who are marginalised Against Sexual Assault has the portfolio of Institutional Abuse. or vulnerable to poor (CASA) support services This responsibility includes the following; health, and develop by ensuring the skill Case management and counselling of eligible interventions that mix of staff supports clients; improve their outcomes the needs of victims of relative to other groups, institutionalised abuse. Providing a resource for information and for example, women, secondary consultation to CASA counsellors Aboriginal people, who are supporting eligible clients; people affected by Co-writing and presenting a paper at state-wide mental illness, people conferences to CASA and Social Workers across at risk of elder abuse, the field; people with disability, homeless people, Participating in regular peer supervision for other refugees and asylum state-wide CASA workers; seekers, people whose Writing submissions and Issue papers to the alcohol and other drug Royal Commission; use is damaging their health or impacting on Representing Ballarat CASA at the Royal Commission Round Table. their recovery.

Work with local BHS meets quarterly with the local Ballarat Aboriginal Co-operatives Aboriginal Community Controlled Health Service to identify enablers and where the Grampians Region Eye Health Project barriers to accessing is listed as an Agenda item. ophthalmic surgery in An Aboriginal Care Coordinator has been line with the Grampians employed to support Aboriginal people Region Aboriginal Eye accessing services at BHS. Health Project. A cultural environmental scan was undertaken By 30 June 2016 in 2015 and new initiatives introduced to ensure develop actions to that BHS is identified as a culturally safe place assist improvement for Aboriginal people. in accessing 100% of Outpatient staff have participated in ophthalmology surgery Cultural Awareness Training during 2015. for Aboriginal people in the Grampians region. Posters developed as part of the Grampians Region Aboriginal Eye Health Project have been installed in the Outpatient Clinic area. Contact has been made with the three regional Aboriginal Cooperatives and the identified local GP Clinics referring patients for ophthalmic surgery, to ensure that they are aware of newly established pathways to support Aboriginal patients requiring ophthalmic surgery. Aboriginal patients have been identified from the Outpatient waiting list requiring ophthalmology surgery. Each patient has been successfully supported to access treatment.

30 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Domain Action Deliverables Outcomes

Improve the health Develop and deliver A ‘face to face’ Cultural Education training outcomes of Aboriginal a cultural education package was developed and introduced to staff and Torres Strait program across the in 2015. Islanders by increasing organisation to increase accessibility and cultural understanding of the In addition, an ‘online’ Cultural Education responsiveness of the impact of colonisation, training tool was identified and introduced as Victorian health system. trans-generational an alternative for those who preferred this mode trauma and culture of learning over ‘face to face’ training sessions. when delivering care The online package was modified to include to Aboriginal people local knowledge and information pertaining to accessing the Health key organisations and services for Aboriginal Service with the aim of people. providing a more patient centred approach. Twelve percent of BHS employees participated in cultural awareness training in 2015.

BHS has employed an Aboriginal person to deliver cultural insight training as a component of a DHHS part funded project (Strengthening Clinical Care and Pathways – Aboriginal Care Coordinator Project). A Cultural Training calendar has been developed for 2016 and staff training commenced.

Continue to work BHS meets quarterly with the local Aboriginal in partnership with Community Controlled Health Service to identify the local Aboriginal gaps in service delivery and issues pertaining community to identify to access. High level managers from across the gaps in service delivery organisation attend these meetings to increase and issues pertaining to awareness of Aboriginal health issues and to access. support initiatives aimed at improving access and service delivery for Aboriginal people. A planning workshop was held in February 2016 with representatives from BHS and the local Aboriginal Community Controlled Health Service to develop the BHS 2016 Aboriginal Strategic Plan. In 2015 an Aboriginal Care Coordinator was employed to support Aboriginal people accessing services at BHS. Aboriginal Hospital Liaison Officers are employed in the Acute Hospital and in Mental Health Services providing advocacy and feedback. The Ballarat Aboriginal Elders group have agreed to be consumer representatives for BHS and have been engaged in several feedback processes during 2015-16.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 31 STATEMENT OF PRIORITIES

PART A: STRATEGIC OVERVIEW (CONT.)

Domain Action Deliverables Outcomes

Demonstrate an In collaboration with the The Improving Cancer Outcomes Project (a organisational Grampians Integrated Grampians Integrated Cancer Service led commitment to quality Cancer Service and project in partnership with Federation University cancer services through other relevant health and Ballarat Health Services) examined key engagement with services progress data (pathway and treatment) concerning the local Integrated implementation of colorectal cancer in the Grampians region. Cancer Service and optimal care pathways This project highlighted delays in general implementation of the for colorectal and practitioner presentation, access to colonoscopy Optimal Care Pathways prostate cancer. services and low supportive care screening rates. – Grampians Integrated Cancer Service in partnership with Ballarat Health Services continues to develop key performance indicators that better align services with the timeline benchmarks within the Optimal Care Pathways. At this time, Ballarat Regional Integrated Cancer Care is working to achieve better alignment with the prostate optimal care pathway through coordination of specialist nursing services (Prostate Cancer Nurse and the Urology Care Coordinator) – this has facilitated a coordinated approach for patients with prostate cancer. Ballarat Regional Integrated Cancer Care is currently supporting the development of a nurse led Prostate Cancer Clinic. It is hoped that this service will commence in the second half of 2016. During 2015-16 Ballarat Health Services staff have attended tumour stream summits, as arranged through Grampians Integrated Cancer Service and the Victorian Integrated Cancer Service.

Governance, leadership Demonstrate an By June 2016 implement An Employee Assistance Program has been and culture organisational a formalised and implemented (Nov 2015) and is available to commitment to outsourced Employee staff 24 hours per day, 7 days per week. This Occupational Health and Assistance Program program is being run by Converge International, Safety, including mental across Ballarat Health which is one of the largest national Employee health and wellbeing Services. Assistance Program providers. in the workplace. Ensure accessible and affordable support services are available for employees experiencing mental ill health. Work collaboratively with the Department of Health and Human Services and professional bodies to identify and address systemic issues of mental ill health amongst the medical professions.

32 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Domain Action Deliverables Outcomes

Monitor and publically Monitor incidents of The monitoring and reporting of occupational report incidents of occupational violence violence is managed by the Prevention and occupational violence. through the Prevention Management of Aggression Committee on a Work collaboratively and Management of monthly basis, which reports to the Department with the Department Aggression Committee of Human Services as required. The Board of Health and Human to develop appropriate of Directors is provided with a monthly Services to develop prevention and report, including training progress across the systems to prevent mitigation strategies. organisation. the occurrence of Report to the The Management of Clinical Aggression training occupational violence Department of Health for staff has commenced, with 71% of staff in & Human Services as high risk areas and 38% of all other staff trained directed. throughout the organisation to date. Provide ongoing Management of Clinical Aggression training for staff throughout 2015–16.

Promote a positive Promote workplace An organisation wide culture and engagement workplace culture and initiatives and strategies survey was undertaken in 2015. All directorates implement strategies through the Workforce have received feedback from the survey. Key to prevent bullying & Culture Development strategies and action plans are presently and harassment in the Committee. being developed by individual directorates workplace. Monitor and departments, which will then form an Undertake an trends of complaints of organisational wide key improvement plan. organisational wide bullying and harassment culture and engagement A Risk Profile and Treatment Plan – Workforce and identify and survey in September Morale & Culture has been developed. address organisational 2015 which will measure units exhibiting poor Following concerns raised by staff an external workplace culture and workplace culture and workplace cultural review has been undertaken engagement. morale. within the Mental Health Services directorate, by Implement an action Susan Zeits of PeaceMaker, ADR. An action plan plan to progress has been developed and the implementation of implementation of key recommendations has commenced. recommendations In addition, an ‘organisational wide’ workplace from the culture and cultural review has been undertaken with BHS engagement survey. appointing Ms Sarah Rey, Managing Partner of Justita, to conduct this review. Results of this review are pending. A new Board of Directors Sub-Committee called People and Culture has been established to progress and oversee this work. All managers and clinical directors have completed the online education module on the Prevention of Bullying & Harassment. Mandatory refresher training pertaining to Equal Employment Opportunity & Professional Conduct has commenced with good attendance from staff across the organisation and a training calendar developed. The target date for all staff completing this refresher training is November 2017

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 33 STATEMENT OF PRIORITIES

PART A: STRATEGIC OVERVIEW (CONT.)

Domain Action Deliverables Outcomes

Embed the principles of Deliver directorate wide 100% of Clinical Staff in the Mental Health the Mental Health Act training to all direct care Directorate have received education on the 2014 (Vic) into all levels staff in relation to the Mental Health Act 2014. of service and system Mental Health Act 2014. All reporting requirements have been met on design and delivery. Demonstrate compliance Electro Convulsive Therapy, Seclusion and with all reporting Restraint. obligations in respect All Governance documentation has been of Electro Convulsive updated accordingly. All reporting obligations Therapy, seclusion and and KPI’s have been met for 15/16 financial year restraint registers. to date.

Apply existing capability Enhance partnerships By the end of 2015 the Grampians Regional frameworks and clinical across the region Maternity and Newborn Reference Group was guidelines to inform through leadership of established. Quarterly meetings in 2016 have service system planning, the Grampians Regional been scheduled. The venues are alternating giving consideration Maternity and Newborn around the region. to the capability of Reference Group These meetings will be aligned to occur with neighbouring services utilising an agreed the Grampians Regional Maternal and Perinatal and how best to allocate framework for the Mortality and Morbidity Committee. available resources so as delivery of safe patient to deliver the maximum care for the maternity Grampians Regional Maternity and Newborn benefit to the local and newborn cohort. Reference Group Framework completed and community. endorsed as a foundational document for use by the reference group. The first Grampians Regional Maternal and Perinatal Mortality and Morbidity Committee was held on May 25th at BHS, with attendance from all regional health services with antenatal, birthing and postnatal care. Further meeting scheduled for August and November 2016.

Safety and quality Ensure management In collaboration with The resource kit for the management of plans are in place the Grampians Region Carbapenem Resistant Enterobacteriaceae to prevent, detect Infection Control Group (CRE) has been developed in consultation and and contain facilitate preparedness collaboration with Grampians Region Infection Carbapenem Resistant for the management of Control Group. Enterobacteriaceae Carbapenem Resistant The Emergency Department Infectious Diseases as outlined in Hospital Enterobacteriaceae Quick Reference Guide Poster (includes Triage Circular 02/15 (issued 16 through the development Triggers for CPE/CRE) has been implemented June 2015). of a resource kit which within the department. A Carbapenemase- will include personal producing Enterobacteriaceae (CPE) Information protection training Sheet for staff has been developed and for staff, policy and dispersed. procedure, flow chart for detection and A Carbapenemase-producing management and Enterobacteriaceae protocol has been emergency department developed based on the Grampians Region signage. Infection Control template. Staff education has commenced using a specific and newly created power point education presentation. The Carbapenemase-producing Enterobacteriaceae Health Service Audit tool has been completed with the Department Health Human Services input at a regional level.

34 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Domain Action Deliverables Outcomes

Implement effective Ensure ongoing An Antimicrobial Stewardship Service is in place antimicrobial communication, and the team comprises of a pharmacist and stewardship practices education and training physician. and increase awareness initiatives are in place Information/Education sessions for medical of antimicrobial and that a Physician, staff and nurses have been conducted by the resistance, its supported by pharmacy Antimicrobial Stewardship Service pharmacist implications and actions staff, is overseeing during 2015 and 2016. to combat it, through and managing the use BHS participated in Antimicrobial Awareness effective communication, of antibiotic therapies week in November 2015. This involved a education, and training. across the organisation. meet and greet session between staff and the Antimicrobial Stewardship Service team and In collaboration with a quiz for clinical staff relating to appropriate the Grampians Region use of antimicrobials. During the same week, Infection Control BHS participated in the National Antimicrobial Prescribing Survey. Group, reaffirm existing stewardship policies During 2015 BHS commenced submitting data and practices through to National Antimicrobial Utilisation Surveillance Program to enable comparison of usage data a planned education with other organisations. program to support improved antimicrobial Compliance audits have been conducted regarding antimicrobial restrictions/usage and awareness. Vancomycin drug guidelines are in development

Develop Perinatal Lead the Grampians Ballarat Health Services continues to monitor mortality and morbidly Regional Perinatal and review maternity performance indicators review processes in mortality and morbidity through monthly governance committees and alignment with Clinical group meetings. dashboard reporting. Monthly internal Ballarat Health Services Obstetrics and Gynaecology Practice Guideline for Implement systems Mortality and Morbidity committees occur. With maternity and processes to continued six monthly reporting to Board Quality assist with identifying Care Committee on BHS Perinatal Mortality. areas for improvement Awaiting formalisation of the framework for monitored through the Grampians Regional Mortality and Morbidity Ballarat Health Services which is being developed by the Royal Women’s governance structure Hospital. The first Grampians Regional Maternal and Perinatal Mortality and Morbidity Committee meeting was held on May 25th at Ballarat Health Services, with attendance from all regional health services with antenatal, birthing and postnatal care. Chaired by Professor Mark Umstead (independent obstetric expert). No recommendations came from this committee meeting. All perinatal deaths from the last 15 months were reviewed by this committee. Further meetings have been scheduled for August and November 2016. Ballarat Health Services has recently invited Professor Peter Mourik and Ms Debbie Rogers (who carried out a Perinatal review in 2012) back to undertake further review of Ballarat Health Services perinatal mortality over the last 4 years. Ballarat Health Services is now awaiting for their report and recommendations. Ballarat Health Services six monthly Perinatal Mortality report for June – December 2015 was reported at Ballarat Health Services Board Quality of Care Committee in February 2016. For this period of reporting Ballarat Health Services had one perinatal death over 22 weeks and for the 2015 year had no perinatal deaths over 32 weeks. For the period of January–June 2016 four cases of perinatal mortality were identified for audit. Two cases over 32 weeks gestation and two (twins) over 22 weeks gestation.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 35 STATEMENT OF PRIORITIES

PART A: STRATEGIC OVERVIEW (CONT.)

Domain Action Deliverables Outcomes

Financial sustainability Improve cash Improve monitoring of Creditor balances are reported to the Finance management processes financial obligations Committee at each monthly meeting. Trade to ensure that financial through analysis of Creditors as reported on the Victorian Health obligations are met as creditor reports at Board Services Performance Monitor remains they are due. and Finance Committee consistent and well below the state benchmark. meetings. Cash management has been closely monitored through the Easter period as Public Holiday costs continue to grow.

Invest in revenue Implement revenue Initiatives and actions continued through the optimisation initiatives to optimisation initiatives year including ongoing auditing of acute activity ensure maximisation of in a range of program to ensure Weighted Inlier Equivalent Separation revenue from both public areas. maximisation, Aged Care Funding Instrument and private sources. revenue generation, growth in Medicare Benefits Schedule funded services and private inpatient fees. Initiatives and actions were monitored via the BHS Finance Committee and the BHS Sustainability Committee.

Access Implement integrated Develop an Aboriginal An Aboriginal Service Directory has been care approaches Service Directory on the developed and added to the BHS Cultural across health and Ballarat Health Services Diversity webpage creating ease of access community support intranet site that can by health professionals and external services services to improve be accessed by health looking for supportive referral pathways for access and responses professionals looking Aboriginal patients. for disadvantaged for supportive referral http://bhsnet/node/4875 Victorians. pathways for Aboriginal patients and contact details of the Aboriginal Community Controlled Health Services in the Grampians Region.

Actively participate in Through consultation and collaboration a the Prisoner Health new Memorandum of Understanding is being Regional access pilot developed between Justice Health (Hopkins & project to ensure safe Langi Kal Kal) and BHS. and effective delivery The Regional Access Pilot continues with of health services in planned elective procedures (day only) under collaboration with the consideration. Location and design of secure Hopkins Correctional waiting room completed and to be discussed Centre and other with Justice Health and DHHS. health services in the Grampians region.

36 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Domain Action Deliverables Outcomes

Access Progress partnerships Further develop Cancer Cancer Care Services with other health Care Services regionally Discussions commenced regarding expansion services to ensure through partnerships of Ballarat Integrated Cancer Centre wellness patients can access with Stawell Regional services to partner oncology practices in the treatments as close to Health, Wimmera Health region. where they live when Care Group and Western Ballarat Integrated Cancer Centre outreach it is safe and effective District Health Service. services commenced in March 2016 at to so, making the most Investigate the feasibility Western Districts Health Service Hamilton. This efficient use of available of establishing a medical partnership includes coordination with Barwon resources across the oncology outreach Health and Barwon South West Regional system. service at the Western Integrated Cancer Services. District Health Service Discussions have commenced regarding the and a radiation oncology feasibility of a superficial x-ray therapy unit at outreach service in Stawell Regional Health, in partnership with BHS Stawell Regional Health. and Austin Health Investigate the feasibility Statement of Intent signed with Primary Health of providing outreach Network Western Victoria to continue to develop cardiology services to key strategies to improve primary secondary Stawell Regional Health, interface. Health pathway project commenced in Ballan District Health March 2016. and Djerriwarrh Health Cardiology Services Services. Stawell Regional Health currently have a private consultant providing cardiology clinics and at this stage no plans to expand this service. Early discussions have commenced with Western District Health Service, however no further progress in relation to Ballan District Health and Djerriwarrh Health Services.

Work collaboratively with In collaboration with Implementation of Ambulance arrivals board in Ambulance Victoria to Ambulance Victoria the Emergency Department. achieve timely transfer of review systems and Procedures are in place for the management patients. processes for incoming of Air Ambulance arrivals and retrievals. Over and outgoing air the 2015/16 year we have had 31 completed ambulance patient transfers out and 13 transfers in from regional transfers to ensure that area. There was an average of 2.8 transfers time critical patients are a month in this timeframe, compared to one managed in the most transfer per month in 2014/2015. Transfers effective way have predominately been retrieved out to Tertiary Centres in Melbourne to the Alfred, Royal Melbourne Hospital, Royal Children’s Hospital, Austin Health, Monash Medical Centre, St. Vincents Hospital Melbourne and Geelong. The Helicopter Landing Officer is a dedicated role undertaken by trained Emergency Department Technicians or other nominated Ballarat Health Services staff members to ensure that any helicopter arrivals or departures are managed immediately in a safe manner. A Helicopter Landing Officer is available at all times (24/7/365) to assist Air Ambulance Victoria personnel with safe helicopter and patient movements.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 37 STATEMENT OF PRIORITIES

PART B: PERFORMANCE PRIORITIES

SAFETY AND QUALITY PERFORMANCE

Key performance indicator Target 2015 - 16 Actual

Compliance with NSQHS Standards accreditation Full compliance Achieved

Compliance with the Commonwealth’s Aged Care Accreditation Standards Full compliance Achieved

Cleaning standards – Overall compliance with standards Full compliance Achieved

Very high risk (Category A) 90 Achieved

High risk (Category B) 85 Achieved

Moderate risk (Category C) 85 Achieved

Compliance with the Hand Hygiene Australia program 80% 82%

Percentage of healthcare workers immunised for influenza (rates achieved 75% 75% for the period 20 April 2015 to 21 August 2015)

PATIENT EXPERIENCE AND OUTCOMES PERFORMANCE

Key performance indicator Target 2015 - 16 Actual

Victorian Healthcare Experience Survey - data submission Full compliance Achieved

Victorian Healthcare Experience Survey – patient experience Quarter 1 95% positive experience 92%

Victorian Healthcare Experience Survey – patient experience Quarter 2 95% positive experience 91%

Victorian Healthcare Experience Survey – patient experience Quarter 3 95% positive experience 93.7%

Number of patients with surgical site infection No outliers Achieved

ICU central line-associated blood stream infection No outliers Achieved

SAB rate per occupied bed days < 2/10,000 0.7

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

Mental Health – Percentage of seclusion events relating to an acute 15% 11 admission - composite seclusion rate

Mental Health – Percentage of adult inpatients who are readmitted within 28 14% 10 days of discharge

Mental Health – Percentage of adult patients who have post-discharge 75% 89% follow-up within seven days

Mental Health – Rate of seclusion events relating to an adult acute ≤15/1,000 14 admission

Mental Health – Percentage of child and adolescent patients with post- 75% 71% discharge follow-up within seven days

Mental Health – Percentage of aged patients who have post-discharge 75% 91% follow-up within seven days

Mental Health – Rate of seclusion events relating to an aged acute ≤15/1,000 2 admission

38 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 GOVERNANCE, LEADERSHIP AND CULTURE PERFORMANCE

Key performance indicator Target 2015 - 16 Actual

People Matter Survey - percentage of staff with a positive response to 80% 88% safety culture questions

FINANCIAL SUSTAINABILITY PERFORMANCE

Key performance indicator Target 2015 - 16 Actual

Finance

Operating result ($m) 0.00 -0.98

Trade creditors < 60 days 30 days

Patient fee debtors < 60 days 36 days

Public & private WIES performance to target 100% 99.2%

Asset management

Asset management plan Full compliance Achieved

Adjusted current asset ratio 0.7 0.44

Days of available cash 14 days 5 days

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 39 STATEMENT OF PRIORITIES

PART B: PERFORMANCE PRIORITIES (CONT.)

ACCESS PERFORMANCE

Key performance indicator Target 2015 - 16 Actual

Emergency care

Percentage of ambulance patients transferred within 40 minutes 90% 92%

Percentage of Triage Category 1 emergency patients seen immediately 100% 100%

Percentage of Triage Category 1 to 5 emergency patients seen within 80% 66% clinically recommended times

Percentage of emergency patients with a length of stay less than four hours 81% 67%

Number of patients with a length of stay in the emergency department greater 0 1 than 24 hours

Elective surgery

Percentage of elective patients removed within clinically recommended 94% 82.2% timeframes

Percentage of Urgency Category 1 elective patients removed within 30 days 100% 100%

10% longest waiting Category 2 and 3 removals from the elective surgery 100% 100% waiting list

Number of patients on the elective surgery waiting list 830 1073

Number of hospital initiated postponements per 100 scheduled admissions ≤8 /100 5.8

Number of patients admitted from the elective surgery waiting list – annual 5,440 5,095 total

Critical care

Adult ICU number of days below the agreed minimum operating capacity 0 2 days

40 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 PART C: ACTIVITY AND FUNDING

Funding type 2015-16 Activity Achievement

Acute Admitted

WIES Public 23,494

WIES Private 5,281

WIES (Public and Private) 28,775

WIES DVA 244

WIES TAC 180

WIES TOTAL 29,199

Subacute & Non-Acute Admitted

Rehab Public 9,526

Rehab Private 3,966

Rehab DVA 339

GEM Public 11,358

GEM Private 3,796

GEM DVA 675

Palliative Care Public 2,969

Palliative Care Private 1,517

Palliative Care DVA 233

Transition Care - Beddays 10,339

Transition Care - Homeday 6,526

Subacute Non-Admitted

Health Independence Program 39,274

Aged Care

Residential Aged Care 148,717

HACC 61,335

Mental Health and Drug Services

Mental Health Inpatient - Beddays 3,925

Mental Health Inpatient – WOt - Beddays 8,053

Mental Health PDRS N/A

Mental Health Ambulatory 40,147

Mental Health Residential 6,767

Mental Health Subacute 4,272

Primary Health

Community Health / Primary Care Programs 13,134

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 41 REPORTING REQUIREMENTS AND GENERAL INFORMATION

Application of Merit and Equity

We are an equal opportunity employer and ensure open competition in recruitment, selection, transfer and promotion. Employment decisions are based on merit and without consideration gender, marital status, age, pregnancy, disability, race, religious or political beliefs or activities, or on the grounds of being a parent, childless or in a de facto relationship. Our people are treated fairly and reasonably and provided with redress against any unfair or unreasonable treatment.

Ex-gratia Payments

We did not make any ex-gratia payments during 2015-2016.

Freedom of Information Requests

Ballarat Health Services complies with the Victorian Freedom of Information Act 1982 (FOI). Since 2012 we have received the following number of requests. • 2011-2012: 464 • 2012-2013: 497 • 2013- 2014: 475 • 2014-2015: 511 • 2015-2016: 484

Building Act 1993

Ballarat Health Services complies with building standards and regulations. All buildings constructed after July 1994, have been designed to conform to the Building Act 1993 and its regulations, as well as meet other statutory regulations that relate to health and safety matters. All buildings have been issued with occupancy permits and all building practitioners engaged by Ballarat Health Services are required to produce evidence of current registration on commencing a project, as well as evidence that their registered status will be maintained throughout the year.

Consultancies

In 2015-16, there were seven consultancies where the total fees payable to the consultants was $10,000 or greater. The total expenditure incurred during 2015/16 in relation to these consultancies is $620,188.34 excl GST. Details of individual consultancies can be viewed at www.bhs.org.au/node/19 In 2015-16, there were nine consultancies where the total fees payable to the consultants was less than $10,000. The total expenditure incurred during 2015/16 in relation to these consultancies is $13,445 excl GST.

National Competition Policy

Ballarat Health Services complied with all government policies regarding competitive neutrality with respect to all tender applications.

42 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 Protected Disclosure Act

Ballarat Health Services had no disclosures notified to the IBAC under section 21(2) of the Protected Disclosure Act 2012 in the past financial year.

Contracts

We abide by the Victorian Industry Participation Policy Act 2003. In 2015 -16 there were two contracts continued by Ballarat Health Services under this Act. The contracts were: • Community Programs – Personal and domestic care to the value of $2 million. The service proposes the use of more than 85 per cent local content and has created more than 100 new jobs. • Statewide Equipment Program – Non Customised Equipment, to the value of $4 million per annum distributed via 10 suppliers awarded. On average the suppliers propose to provide goods and services and utilise around 60 per cent

local content and in total create the possibility of 40 additional EFT and the possibility of nine new apprenticeships.

Carers Recognition Act

The Carers Recognition Act 2012 promotes and values the role of people in care relationships and formally recognises the contribution that carers and people in care relationships make to the social and economic fabric of the Victorian community. Ballarat Health Services has taken all practicable measures to comply with its obligations under the Act. BHS has promoted the principles of the Act to people in care relationships who receive our services and to the wider community by distributing printed material about the Act at community events or service points. BHS has taken all practicable measures to consider the carer relationships principles set out in the Act when setting policies and providing services by reviewing our employment policies such as flexible working arrangements and leave provisions to ensure these comply with the statement of principles in the Act.

Information and Communication Technology (ICT) expenditure

The total ICT expenditure incurred during 2015-16 is $8,312,109.09 (excluding GST) with the details shown below:

Non-Business As Usual Business As Usual (BAU) Operating expenditure Capital expenditure (non-BAU) ICT ICT Expenditure (excluding GST) (excluding GST) Expenditure

3,800,973.07 4,511,136.02 231,277.38 4,279,858.64

Car Parking Fees

Ballarat Health Services complies with the DHHS hospital circular on car parking fees effective 1 February 2016 and details of car parking fees and concession benefits can be viewed at https://www.bhs.org.au/node/46.

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 43 STATUTORY REQUIREMENTS

Attestation on Data Integrity

I, Dale Fraser, certify that Ballarat Health Services has put in place appropriate internal controls and processes to ensure that reported data reasonably reflects actual performance. Ballarat Health Services has critically reviewed these controls and processes during the year.

Dale Fraser Chief Executive Officer Ballarat 16 August, 2016

Attestation for compliance with the Ministerial Standing Direction 4.5.5– Risk Management Framework and Processes

I, Dale Fraser, certify that Ballarat Health Services has complied with Ministerial Direction 4.5.5 – Risk Management Framework and Processes. The Ballarat Health Services Audit Committee has verified this.

Dale Fraser Chief Executive Officer Ballarat 15 August, 2016

44 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 DISCLOSURE INDEX

The annual report of Ballarat Health Services is prepared in accordance with all relevant Victorian legislations and pronouncements. This index has been prepared to facilitate identification of Ballarat Health Services compliance with statutory disclosure requirements. Legislation Requirement Page

Ministerial Directions Report of Operations - FRD Guidance Charter and purpose FRD 22G Manner of establishment and the relevant Ministers 1 FRD 22G Purpose, functions, powers and duties 1,2 FRD 22G Key initiatives and projects 3-17 FRD 22G Nature and range of services provided Inside front cover Management and structure FRD 22G Organisational structure 18 Financial and other information FRD 10A Disclosure index 43 FRD 22G Employment and conduct principles 40 FRD 22G Occupational health and safety policy 13 FRD 22G Summary of the financial results for the year 12 FRD 22G Significant changes in financial position during the year 12 FRD 22G Major changes or factors affecting performance 12 FRD 22G Subsequent events In finance report FRD 22G Application and operation of Freedom of Information Act 1982 40 FRD 22G Compliance with building and maintenance provisions of Building Act 1993 40 FRD 22G Statement on National Competition Policy 40 FRD 22G Application and operation of the Protected Disclosure 2012 41 FRD 22G Application and operation of the Carers Recognition Act 2012 41 FRD 22G Details of consultancies over $10 000 40 FRD 22G Details of consultancies under $10 000 40 FRD 22G Disclosure of ICT expenditure 41 FRD 22G Statement of availability of other information 44 FRD 22G Summary of entity’s environmental performance 16 FRD 25B Victorian Industry Participation Policy disclosures 41 Attestations SD 3.4.13 Attestation of Data Integrity 42 SD 4.5.5 Attestation for compliance with Ministerial Standing Direction 4.5.5 42 Occupational Violence Reporting 13 Compliance with car parking fees reporting 41 Financial Report SD 4.2(j) Responsible bodies declaration 3 Financial statements required under Part 7 of the FMA SD 4.2(a) Statement of changes in equity In finance report SD 4.2(b) Operating statement In finance report SD 4.2(b) Balance sheet In finance report SD 4.2(b) Cash flow statement In finance report Other requirements under Standing Directions 4.2 SD 4.2(c) Compliance with Australian accounting standards and other authoritative pronouncements In finance report SD 4.2(c) Compliance with Ministerial Directions In finance report SD 4.2(d) Rounding of amounts In finance report SD 4.2(c) Accountable officer’s declaration In finance report Other disclosures as required by FRDs in notes to the financial statements FRD 11A Disclosure of ex gratia expenses 40 Legislation Freedom of Information Act 1982 40 Building Act 1993 40 Protected Disclosure Act 2012 41 Carers Recognition Act 2012 41 Victorian Industry Participation Policy Act 2003 41 Financial Management Act 1994 In finance report

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 45 SERVICEADDITIONAL DIRECTORY INFORMATION AVAILABLE ON REQUEST

Allied Health Services Dental Services Diabetes Education • Dietetics • Exercise therapy Ear, Nose and Throat Surgery • Consistent Occupational with therapyFRD 22G (Section 6.19) the itemsEmergency listed below Medicine have been retained by Ballarat Health Services and • are available Physiotherapy to the relevant Ministers, MembersEndocrinology, of Parliament andincluding the public Diabetes on request Management (subject to the freedom • of information Podiatry requirements, if applicable): Eureka Linen • Prosthetics and orthotics Falls and Balance • a) Declarations Psychology of pecuniary interests have beenGastroenterology duly completed by all relevant officers • Social work General Medicine • b) Details Speech oftherapy shares held by senior officers as Generalnominee Surgeryor held beneficially; Geriatric Evaluation and Management Acquiredc) Details Brain ofInjury publications Service produced by the entityGynaecology about itself, and how these can be obtained Ballarat Regional Integrated ICU Liaison Nurse Service Cancerd) CentreDetails of changes in prices, fees, charges, ratesInfection and levies Control charged by the Health Service; • Chemotherapy Day Unit Intensive Care Unit and Medical Emergency Response Team e) Details of any major external reviews carried out on the Health Service; • Clinical Trials and Research Lymphoedema Management • Oncology Clinics Maxillofacial Surgery f) Details of major research and development activities undertaken by the Health Service that are not otherwise • Medical Oncology Neonatology • covered Radiation either Oncology in the (BAROC) Report of Operations or Nephrologyin a document and that Renal contains Dialysis the financial statements and Report of • Operations; Wellness Centre Neurology • Clinical Trials and Research Maternity Services g) Details of overseas visits undertaken including a summary of the objectives and outcomes of each visit; BreastScreen Mental Health Community Care Teams h) Details of major promotional, public relations and marketing activities undertaken by the Health Service to BHS Catering • Adult develop community awareness of the Health Service and its services; Cardiology • Aged Centrali) SterileDetails Supplyof assessments Department and (CSSD)measures undertaken• to improve Infant and the Child occupational health and safety of employees; Centre Against Sexual Assault (CASA) • Mother and Family Unit Cognitivej) General Impairment statement and onDementia industrial relations within the• Health Youth Service and details of time lost through industrial Managementaccidents and disputes, which is not otherwiseMental detailed Health in the Inpatient Report ofCare Operations; Units

Communityk) A list Programs of major committees sponsored by the Health• Service, Adult Acute the purposesUnit of each committee and the extent to which those purposes have been achieved; • Aged Acute • Ambulatory Care Services • Aged Residential • Carer Respite and Support Services l) Details of all consultancies and contractors including• consultants/contractors Community Care Unit engaged, services provided, and • Community Rehabilitation • Mother and Family Unit expenditure (home and centre committed based) for each engagement; • Secure and Extended Care Unit • Continence Resource Centre m) Details about feedback and complaints procedures. • Domiciliary Services Operating Suite • GEM in the Home Ophthalmology • Grampians Aged Care Assessment Service Organ and Tissue Donation Service • Grampians Regional Continence Service Orthopaedic Surgery • Grampians Regional Palliative Care Team Otolaryngology • Hospital Admission Risk Program Outpatient Services • Linkages (home care packages) Paediatric Medicine • Planned Activity Groups Perioperative Day Procedure Unit • Post-Acute Care Pain Management • Restorative Care Palliative Care • Transition Care Program Pharmacy • Victorian Paediatric Rehabilitation Service Plastic Surgery • Critical Care Unit Rehabilitation (in-patient and out-patient) Diabetes Education and Treatment Residential Aged Care Diagnostic and Radiology (X-ray) Services Respite Care Safety Link • BreastScreen Stroke Management • CT Scan Stomal Therapy • ECG Statewide Aids and Equipment Program (SWEP) • EEG • MRI Thoracic Medicine • Nuclear medicine Thoracic Surgery • Ultrasound Urology Vascular Surgery Wound Management

46 BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 -16 SERVICE DIRECTORY

Allied Health Services Dental Services Diabetes Education • Dietetics • Exercise therapy Ear, Nose and Throat Surgery • Occupational therapy Emergency Medicine • Physiotherapy Endocrinology, including Diabetes Management • Podiatry Eureka Linen • Prosthetics and orthotics Falls and Balance • Psychology Gastroenterology • Social work General Medicine • Speech therapy General Surgery Geriatric Evaluation and Management Acquired Brain Injury Service Gynaecology Ballarat Regional Integrated ICU Liaison Nurse Service Cancer Centre Infection Control • Chemotherapy Day Unit Intensive Care Unit and Medical Emergency Response Team • Clinical Trials and Research Lymphoedema Management • Oncology Clinics Maxillofacial Surgery • Medical Oncology Neonatology • Radiation Oncology (BAROC) Nephrology and Renal Dialysis • Wellness Centre Neurology • Clinical Trials and Research Maternity Services

BreastScreen Mental Health Community Care Teams BHS Catering • Adult Cardiology • Aged Central Sterile Supply Department (CSSD) • Infant and Child Centre Against Sexual Assault (CASA) • Mother and Family Unit Cognitive Impairment and Dementia • Youth Management Mental Health Inpatient Care Units

Community Programs • Adult Acute Unit • Aged Acute • Ambulatory Care Services • Aged Residential • Carer Respite and Support Services • Community Care Unit • Community Rehabilitation • Mother and Family Unit (home and centre based) • Secure and Extended Care Unit • Continence Resource Centre • Domiciliary Services Operating Suite • GEM in the Home Ophthalmology • Grampians Aged Care Assessment Service Organ and Tissue Donation Service • Grampians Regional Continence Service Orthopaedic Surgery • Grampians Regional Palliative Care Team Otolaryngology • Hospital Admission Risk Program Outpatient Services • Linkages (home care packages) Paediatric Medicine • Planned Activity Groups Perioperative Day Procedure Unit • Post-Acute Care Pain Management • Restorative Care Palliative Care • Transition Care Program Pharmacy • Victorian Paediatric Rehabilitation Service Plastic Surgery • Critical Care Unit Rehabilitation (in-patient and out-patient) Diabetes Education and Treatment Residential Aged Care Diagnostic and Radiology (X-ray) Services Respite Care Safety Link • BreastScreen Stroke Management • CT Scan Stomal Therapy • ECG Statewide Aids and Equipment Program (SWEP) • EEG • MRI Thoracic Medicine • Nuclear medicine Thoracic Surgery • Ultrasound Urology Vascular Surgery Wound Management 2016 | ANNUAL REPORT 2015 ANNUAL REPORT

BALLARAT HEALTH SERVICES ANNUAL REPORT 2015 - 2016

Sturt Street PO Box 577 Dental Clinic Cancer Centre www.bhs.org.au Ballarat Vic 3350 Ballarat Vic 3350 Ballarat Vic 3353 Ballarat Vic 3350 Ballarat Vic 3350 Phone: 5320 4225 Phone: 5320 4000 Phone: 5320 4000 Phone: 5320 4100 Phone: 5320 3700 Sebastopol Vic 3356 02 Ascot Street South 1 http://bricc.bhs.org.au Ballarat Base Hospital Drummond Street North www.bhs.org.au Mental Health Services Ballarat Health Services Queen Elizabeth Centre Ballarat Regional Integrated www.twitter.com/BallaratHealth Corner Sturt and Drummond Streets Corner Hertford Street & Tuppen Drive Phone: Radiation Oncology – 5320 8600 Oncology Consulting Clinics – 5320 8500 www.facebook.com/BRICCWellnessCentre www.facebook.com/BallaratHealthServices 100% Recycled Paper Printed on

Ballarat Health Services Financial Statements for the year ended 30 June 2016

BALLARAT HEALTH SERVICES COMPREHENSIVE OPERATING STATEMENT FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 Note $000 $000 Revenue from Operating Activities 2 413,911 386,988 Revenue from Non-Operating Activities 2 1,981 1,969 Employee Benefits 3 (287,989) (271,921) Supplies and Consumables 3 (70,207) (64,833) Other Expenses 3 (58,678) (52,069) Net Result before Capital and Specific Items (982) 134

Capital Purpose Income 2 24,086 18,401 Capital Purpose Expense 3 (4,458) (3,838) Depreciation 4 (25,683) (26,220) Net Result for the Year (7,037) (11,523)

Other Comprehensive Income Item that will not be reclassified to Net Results Net Fair Value Revaluation on Non-Financial Assets 16(a) 2,569 - Comprehensive Result for the Year (4,468) (11,523) This statement should be read in conjunction with the accompanying notes. Ballarat Health Services Financial Statements for the year ended 30 June 2016

BALLARAT HEALTH SERVICES BALANCE SHEET AS AT 30 JUNE 2016 2016 2015 Note $000 $000 ASSETS Current Assets Cash and Cash Equivalents 5 2,380 13,164 Prepayments 9 1,356 1,365 Inventory 8 1,614 1,680 Receivables 6 16,183 13,108 Other Financial Assets 7 17,175 25,038 Total Current Assets 38,708 54,355

Non-Current Assets Receivables 6 10,784 8,284 Other Financial Assets 7 13,003 5,603 Intangible Assets 10(a) 536 936 Property, Plant and Equipment 10 357,526 350,999 Total Non-Current Assets 381,849 365,822 Total Assets 420,557 420,177

LIABILITIES Current Liabilities Employee Benefits 12 58,669 54,296 Monies Held in Trust 14 33,270 30,177 Payables 11 24,697 30,551 Other Liabilities 15 221 51 Total Current Liabilities 116,857 115,075

Non-Current Liabilities Employee Benefits 12 13,014 10,133 Total Non-Current Liabilities 13,014 10,133 Total Liabilities 129,871 125,208 Net Assets 290,686 294,969

EQUITY Specific Purpose Reserve 16(a) 486 503 Contributed Capital 16(b) 155,997 155,814 Asset Revaluation Reserve 16(a) 174,127 171,557 Retained Earnings 16(c) (39,924) (32,905) Total Equity 16 290,686 294,969 This statement should be read in conjunction with the accompanying notes. Ballarat Health Services Financial Statements for the year ended 30 June 2016

BALLARAT HEALTH SERVICES STATEMENT OF CHANGES IN EQUITY FOR THE YEAR ENDED 30 JUNE 2016 Property, Plant Unrestricted Contributions Accumulated Total & Equipment Specific By Owners Surpluses/ Revaluation Purpose (Deficits) Surplus Surplus Note $000 $000 $000 $000 $000 BALANCE AS AT 30 JUNE 2014 171,557 493 149,952 (21,372) 300,630 Net Result for the year - - - (11,523) (11,523) Transfer to / Returned from Contributed Capital 16(b) - - 5,862 - 5,862 Transfer to accumulated surplus 16(a),(c) - 10 - (10) - BALANCE AS AT 30 JUNE 2015 171,557 503 155,814 (32,905) 294,969

Net Result for the year - - - (7,037) (7,037) Other Comprehensive Income for the year 16(a) 2,569 - - - 2,569 Transfer to / Returned from Contributed Capital 16(b) - - 183 - 183 Transfer to accumulated surplus 16(a),(c) - (17) - 17 - BALANCE AS AT 30 JUNE 2016 174,127 486 155,997 (39,924) 290,686 This statement should be read in conjunction with the accompanying notes. Ballarat Health Services Financial Statements for the year ended 30 June 2016

BALLARAT HEALTH SERVICES CASH FLOW STATEMENT FOR THE YEAR ENDED 30 JUNE 2016 2016 2015 $000 $000 Inflows/ Inflows/ Note (Outflows) (Outflows) CASH FLOWS FROM OPERATING ACTIVITIES Receipts Operating Grants from Government 341,670 321,448 Proceeds from Donations 973 419 Patient Fees 20,946 17,259 Interest & Dividends Received 2,225 2,050 Other 48,099 48,326 GST Received from/(paid to) ATO 6,828 7,797

Payments Employee Benefits (282,814) (268,922) Supplies & Consumables (77,533) (72,854) Other (65,515) (56,215) Cash Generated from Operations (5,119) (692)

Capital Grants 22,571 17,745 Repayment of Monies Held in Trust (12,108) (8,757) Proceeds from Monies Held in Trust 15,201 14,954 Capital Expense (3,825) (3,726) NET CASH INFLOWS /(OUTFLOWS) FROM OPERATING ACTIVITIES 17 16,720 19,524

CASH FLOWS FROM INVESTING ACTIVITIES Purchase of Non-Financial Assets (29,047) (33,985) Purchase of Investments (11,263) (28,604) Proceeds from Sale of Investments 12,000 27,500 Proceeds from Sale of Non-Financial Assets 2(a) 622 1,004 NET CASH INFLOWS /(OUTFLOWS) FROM INVESTING ACTIVITIES (27,688) (34,085)

CASH FLOWS FROM FINANCING ACTIVITIES Contributed Capital from Government 183 5,862 NET CASH INFLOWS /(OUTFLOWS) FROM FINANCING ACTIVITIES 183 5,862

NET INCREASE/(DECREASE) IN CASH HELD (10,785) (8,698)

Cash and Cash Equivalents at Beginning of Financial Year 13,165 21,863 CASH AND CASH EQUIVALENTS AT END OF FINANCIAL YEAR 5 2,380 13,165 This statement should be read in conjunction with the accompanying notes. Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Note 1: Summary of Significant Accounting Policies

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

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

Ballarat Health Services is a not-for-profit entity and therefore applies the additional Australian paragraphs applicable to not-for-profit health services under the AASs.

The annual financial statements were authorised for issue by the Board of Management of Ballarat Health Services on 19/08/2016.

(b) Basis of Accounting Preparation and Measurement Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substances of the underlying transactions or other events are reported.

The accounting policies set out below have been applied in preparing the financial statements for the year ended 30 June 2016 and the comparative information presented in these financial statements for the year ended 30 June 2015.

These financial statements are presented in Australian dollars, the functional and presentation currency of Ballarat Health Services.

The financial statements, except for cash flow information, have been prepared using the accrual basis of accounting. Under the accrual basis, items are recognised as assets, liabilities, equity, income or expenses when they satisfy the definition and recognition criteria for those items. They are recognised in the reporting period to which they relate, regardless of when cash is received or paid.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

The financial statements are prepared in accordance with the historical cost convention, except for the revaluation of certain non-financial assets and financial instruments as noted. Particularly, exceptions to the historical cost convention include:

 Non-current physical assets which subsequent to acquisition, are measured at a revalued amount being their fair value at the date of the revaluation less any subsequent accumulated depreciation and subsequent impairment losses. Revaluations are made and are reassessed when new indices are published by the Valuer-General Victoria (VGV) to ensure that the carrying amounts do not materially differ from their fair values  Available-for-sale investments which are measured at fair value with movements reflected in equity until the asset is derecognised  The fair value of assets other than land is generally based on their depreciated replacement value

Historical cost is based on the fair value of the consideration given in exchange for assets.

In the application of AASs, management is required to make judgements, estimates and assumptions about carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on professional judgements derived from historical experience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period; or in the period of the revision and future periods if the revision affects both current and future periods. Judgements made by management in the application AASs that have significant effects on the financial statements and estimates, with a risk of material adjustments in the subsequent reporting period, relate to:

 The fair value of land and buildings 1(l)  Superannuation expense 1(i)

Consistent with AASB 13 Fair Value Measurement, Ballarat Health Services determines the policies and procedures for both recurring fair value measurements such as property, plant and equipment, investment properties and financial instruments, and for non-recurring fair value measurements such as non-financial physical assets held for sale, in accordance with the requirements of AASB 13 and the relevant FRDs.

All assets and liabilities for which fair value is measured or disclosed in the financial statements are categorised within the fair value hierarchy, based on the lowest level input that is significant to the fair value measurement as a whole described as follows:

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

 Level 1- Quoted (unadjusted) market prices in active markets for identical assets or liabilities  Level 2- Valuation techniques for which the lowest level input that is significant to the fair value measurement is directly or indirectly observable  Level 3- Valuation techniques for which the lowest level input that is significant to the fair value measurement is unobservable

For the purpose of fair value disclosures, Ballarat Health Services has determined classes of assets and liabilities on the basis of the nature, characteristics and risks of the asset or liability and the level of the fair value hierarchy as explained above. In addition, Ballarat Health Services determines whether transfers have occurred between levels in the hierarchy by reassessing categorisation (based on the lowest level input that is significant to the fair value measurement as a whole), at the end of each reporting period.

The VGV is Ballarat Health Services independent valuation agency.

Ballarat Health Services in conjunction with the VGV, monitors the changes in the fair value of each asset and liability through relevant data sources to determine whether revaluation is required.

(c) Going Concern The going concern basis was used to prepare the financial statements.

After due consideration of the results of the operations of Ballarat Health Services for the year ended 30 June 2016 and the forecast cash flows of Ballarat Health Services for the next 12 months, the Board of Management of Ballarat Health Services have sought a letter of comfort from the Department of Health & Human Services for support in determining that the going concern basis is appropriate for the preparation of these statements. The Department of Health & Human Services has provided confirmation that it will continue to provide Ballarat Health Services adequate cash flow support to meet its current and future obligations as and when they fall due up to September 2017.

Ballarat Health Services is dependent upon the State of Victoria via the Department of Health & Human Services for the funding of a significant proportion of its operations.

(d) Reporting Entity The financial statements include all of the controlled activities of Ballarat Health Services.

Its principal address is: Drummond St North Ballarat, Victoria, 3350

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

A description of the nature of Ballarat Health Services operations and its principal activities is included in the report of operations, which does not form part of these financial statements.

(e) Rounding All amounts shown in the financial statements are expressed to the nearest thousand dollars unless stated otherwise. Minor discrepancies in the tables between totals and sum of components are due to rounding.

(f) Principles of Consolidation

Ballarat Health Services does not have any consolidated reporting entities.

Inter-Segment Transactions Transactions between segments within Ballarat Health Services have been eliminated to reflect the extent of Ballarat Health Services operations as a group.

Joint Operations Interests in the jointly controlled operations of Grampians Rural Health Alliance are not consolidated by Ballarat Health Services but are accounted for in accordance with the policy outlined in Note 1 (l) Financial Assets.

(g) Scope and Presentation of Financial Statements

Fund Accounting Ballarat Health Services operates on a fund accounting basis and maintains three funds:

1) Operating 2) Specific Purpose; and 3) Capital

Ballarat Health Services Capital and Specific Purpose Funds include unspent capital donations and receipts from fundraising activities conducted solely in respect of these funds.

Residential Aged Care Service The Residential Aged Care Service operations are an integral part of Ballarat Health Services and share its resources. An apportionment of land and buildings has been made based on floor space. The results of the two operations have been segregated based on actual revenue earned and expenditure incurred by each operation in note 21 to the financial statements.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Comprehensive Operating Statement The Comprehensive Operating Statement includes the subtotal entitled “Net Result before Capital & Specific Items” to enhance the understanding of the financial performance of Ballarat Health Services. This subtotal reports the result excluding items such as capital grants, assets received or provided free of charge, depreciation and items of an unusual nature and amount such as specific revenues and expenses. The exclusion of these items are made to enhance matching of income and expense so as to facilitate the comparability and consistency of results between years and Victorian Public Health Services. The “Net Result before Capital & Specific Items” is used by the management of Ballarat Health Services, the Department of Health & Human Services and the Victorian Government to measure the ongoing performance of Ballarat Health Services in operating hospital services.

Capital and specific items, which are excluded from this subtotal, consists of:

 Capital purpose income which comprises all tied grants, donations and bequests received for the purpose of acquiring non-current assets such as capital works, plant and equipment or intangible assets. It also includes donations of plant and equipment (refer note 1(h)). Consequently, the recognition of revenue as capital purpose income is based on the intention of the provider of the revenue at the time the revenue is provided  Impairment of financial and non-financial assets includes all impairment losses (and reversal of previous impairment losses)  Depreciation and amortisation as described in note 1(i)  Assets provided or received free of charge as described in note 1(h)  Expenditure using capital purpose income, which comprises of expenditure which either falls below the asset capitalisation threshold or does not meet asset recognition criteria. Therefore, does not result in the recognition of an asset in the balance sheet where funding for that expenditure is from capital purpose income. The asset capitalisation threshold is set at $2,000 (2015: $2,000)

Balance Sheet Assets and liabilities are categorised as either current or non-current (non-current being those assets or liabilities expected to be recovered/settled more than 12 months after the reporting period) and are disclosed in the notes where relevant.

Statement of Changes in Equity The Statement of Changes in Equity presents a reconciliation of each non-owner and owner equity opening balance at the beginning of the reporting period to the closing balance at the end of the reporting period. It also shows separately, changes due to amounts recognised in the comprehensive result and amounts recognised in other comprehensive income related to other non-owner changes in equity.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Cash Flow Statement Cash flows are classified according to whether or not they arise from operating activities, investing activities or financing activities. This classification is consistent with requirements under AASB 107 Statement of Cash Flows.

(h) Income from Transactions Income is recognised in accordance with AASB 118 Revenue and is recognised as to the extent that it is probable that the economic benefits will flow to Ballarat Health Services and the income can be reliably measured at fair value. Unearned income at reporting date is reported as income received in advance.

Amounts disclosed as revenue are where applicable, net of returns, allowances and duties and taxes.

Government Grants Grants are recognised as income when Ballarat Health Services gains control of the underlying assets in accordance with AASB 1004 Contributions. For reciprocal grants, Ballarat Health Services is deemed to have assumed control when the performance has occurred under the grant. For non-reciprocal grants, Ballarat Health Services is deemed to have assumed control when the grant is received or receivable. Conditional grants may be reciprocal or non-reciprocal depending on the terms of the grant.

Indirect Contributions from the Department of Health & Human Services  Insurance is recognised as revenue following advice from the Department of Health & Human Services  LSL Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the Metropolitan Health and Aged Care Services Division Hospital Circular 05/2013

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

Private Practice Fees Private practice fees are recognised as revenue at the time invoices are raised.

Donations and Bequests Donations and bequests are recognised as revenue when received. If donations are for a special purpose, they may be appropriated to a reserve such as the specific purpose reserve.

Dividend Revenue

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Dividend revenue is recognised when the right to receive payment is established. Dividends represent the income arising from Ballarat Health Services investment in financial assets.

Interest Revenue Interest revenue is recognised on a time proportionate basis that takes into account the effective yield of the financial asset.

Sale of Investments The gain/loss from the sale of an investment is recognised when the investment is realised.

Resources Provided and Received Free of Charge or for Nominal Consideration Resources provided or received free of charge or for nominal consideration are recognised at their fair value when the transferee obtains control over them, irrespective of whether restrictions or conditions are imposed over the use of the contributions, unless received from another health service or agency as a consequence of a restructuring of administrative arrangements. In the latter case, such transfer will be recognised at carrying value. Contributions in the form of services are only recognised when a fair value can be reliably determined and the services would have been purchased if not donated.

(i) Expense Recognition Expenses are recognised as they are incurred and reported in the financial year to which they relate. Employee Expenses Employee expenses include:  Wages and salaries  Annual leave  Sick leave  Work cover premiums  Long service leave  Superannuation expenses which are reported differently depending upon whether employees are members of defined benefit or defined contribution plans

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

Defined Benefit Superannuation Plans The amount charged to the Comprehensive Operating Statement in relation to the defined

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

benefit superannuation plans represent the contributions made by Ballarat Health Services to the superannuation plan, in respect to the services of current Ballarat Health Services staff during the reporting period.

Employees of Ballarat Health Services are entitled to receive superannuation benefits and Ballarat Health Services contributes to both the defined benefit and defined contribution plans based on the relevant rules of each plan and upon actuarial advice. The defined benefit plans provide benefits based on years of service and final average salary.

Ballarat Health Services does not recognise any unfunded defined benefit liability in respect of the superannuation plan as Ballarat Health Services has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due. The Department of Treasury and Finance administers and discloses the state’s defined benefit liabilities in its financial statements.

Depreciation All infrastructure assets, buildings, plant and equipment and other non-financial physical assets over $2,000 that have finite useful lives are depreciated (i.e. excludes land assets held for sale and investment properties). Depreciation is calculated on a straight line basis, at a rate that allocates the asset value less any estimated residual value over its estimated useful life.

Depreciation begins when the asset is available for use, which is when it is in the location and condition necessary for it to be capable of operating in a manner intended by management. Linen and Personal Alarm Call Systems (PACS), used in the Linen and Safety Link services are considered fixed assets of Ballarat Health Services and depreciated accordingly.

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

2016 2015 Buildings 1 to 60 years 2 to 60 years Kitchen and Catering Equipment 10 years 10 years Plant and Equipment 5-22 years 10 years Medical Equipment 5-10 years 5 years Furniture and Fittings 5 years 5 years Personal Alert Call Systems 5 years 5 years Linen 5 years 5 years Motor Vehicles 3 to 7 years 3 to 7 years Computers and Communications 3 years 3 years Intangibles 3 years 3 years

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Building works currently in progress are not depreciated until the completion of the building project.

Please note: the estimated useful lives, residual values and depreciation methods are reviewed at the end of each annual reporting period and adjustments made where appropriate. This depreciation charge is not funded by the Department of Health & Human Services.

Amortisation Amortisation is allocated to intangible assets with finite useful lives on a systematic (typically straight line) basis over the assets useful life. Amortisation begins when the asset is available for use, which is when it is in the location and condition necessary for it to be capable of operating in the manner intended by management. The consumption of intangible non-produced assets with finite useful lives is classified as amortisation. The amortisation period and the amortisation method for an intangible asset with a finite useful life are reviewed at least at the end of each annual reporting period. In addition, an assessment is made at each reporting date to determine whether there are indicators that the intangible asset concerned is impaired. If so, the assets concerned are tested as to whether their carrying value exceeds their recoverable amount.

Intangible assets with indefinite useful lives are not amortised. However, they are assessed for impairment annually or whenever there is an indication that the asset may be impaired.

The useful lives of intangible assets that are not being amortised are reviewed each period to determine whether events and circumstances continue to support an indefinite useful life assessment for that asset. In addition, Ballarat Health Services tests all intangible assets with indefinite useful lives for impairment by comparing the recoverable amount for each asset with its carrying amount.

Any excess of the carrying amount over the recoverable amount is recognised as an impairment loss. Intangible assets with finite useful lives are amortised over a 3-5 year period.

Other Operating Expenses Other operating expenses generally represent the day-to-day running costs incurred in normal operations and include:

Supplies and Consumables Supplies and service costs are recognised as an expense in the reporting period in which they are incurred. The carrying amounts of any inventories held for distribution are expensed when distributed.

Bad and Doubtful Debts Refer to note 1(l) - Assets

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

(j) Other Comprehensive Income Other comprehensive income measures the change in volume or value of assets or liabilities that do not result from transactions.

Revaluation Gain/ (Loss) of Non-Financial Physical Assets Refer to note 1 (l) - Assets Non-Financial Physical Assets

Net Gain/ (Loss) on Disposal of Non-Financial Assets Any gain or loss on the disposal of a non-financial asset is recognised at the date of disposal and is the difference between the proceeds and the carrying value of the asset at that time.

Net Gain/ (Loss) on Financial Instruments Net gain/ (loss) on financial instruments include:

 Realised and unrealised gains and losses from revaluation of financial instruments at fair value  Impairment and reversal of impairment for financial instruments at amortised cost; and  Disposals of financial assets and de-recognition of financial liabilities

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

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

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Available-for-Sale Financial Assets

Trade receivables, loans and other receivables are recorded at amortised cost, using the effective interest method, less impairment. Term deposits with maturity greater than 3 months are also measured at amortised cost, using the effective interest method less impairment.

The effective interest method is a method of calculating the amortised cost of a financial asset and of allocating interest income over the relevant period. The effective interest rate is the rate that exactly discounts estimated future cash receipts through the expected life of the financial asset or where appropriate, a shorter period.

Available-for-Sale Financial Assets Other financial instrument assets held by Ballarat Health Services are classified as being available- for-sale and are measured at fair value. Gains and losses arising from changes in fair value are recognised directly in equity until the investment is disposed of or is determined to be impaired, at which time the cumulative gain or loss previously recognised in equity is included in the net result for the period. Fair value is determined in the manner described in note 18.

(l) Assets

Cash and Cash Equivalents Cash and cash equivalents recognised on the balance sheet comprise of cash on hand and cash at bank, deposits at call and highly liquid investments with an original maturity of 3 months or less, which are held for the purpose of meeting short term cash commitments rather than for investment purposes and are readily convertible to known amounts of cash and subject to insignificant risk of changes in value.

Receivables Receivables consist of:

 Contractual receivables which include mainly debtors in relation to goods and services  Accrued investment income; and  Statutory receivables which include predominantly amounts owing from the Victorian Government and Goods and Services Tax (GST) input tax credits recoverable

Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. Collectability of debts is reviewed on an ongoing basis and debts which are known to be uncollectible are written off. A provision for doubtful debts is raised where doubt as to collection exists. Bad debts are written off when identified.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Investments and Other Financial Assets Investments are recognised and derecognised on trade date where purchase or sale of an investment is under a contract, whose terms require delivery of the investment within the timeframe established by the market concerned and are initially measured at fair value, net of transaction costs.

Ballarat Health Services classifies its other financial assets between current and non-current based on the purpose for which the assets were acquired. Management determines the classification of its other assets at initial recognition.

Ballarat Health Services assesses at each balance sheet date whether a financial asset or group of financial assets is impaired.

All financial assets, except those measured at fair value through the profit and loss, are subject to annual review for impairment.

Impairment of Financial Assets At the end of each reporting period, Ballarat Health Services assesses whether there is objective evidence that a financial asset or group of financial assets are impaired. Objective evidence includes financial difficulties of the debtor, default payments, debts which are more than 60 days overdue and changes in debtor credit ratings. All financial instrument assets, except those measured at fair value through the profit and loss, are subject to annual review for impairment.

Bad and doubtful debts for financial assets are assessed on a regular basis. Those bad debts considered as written off and allowances for doubtful receivables are recognised as expenses in the net result.

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

Where the fair value of an investment in an equity instrument at balance date has reduced by 20 percent or more than its cost price, or where its fair value has been less than its cost price for a period of 12 or more months, the financial asset is treated as impaired.

Net Gain/ (Loss) on Financial Instruments Net gain/ (loss) on financial instruments includes:

 Realised and unrealised gains and losses from revaluations of financial instruments that are designated at fair value through the profit and loss or held-for-trading  Impairment and reversal of impairment for financial instruments at amortised cost  Disposals of financial assets

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Revaluation of Financial Instruments at Fair Value The revaluation gain/ (loss) on financial instruments at fair value excludes dividends or interest earned on financial assets. Refer to note 1 (j) – Other Comprehensive Income

Inventories Inventories include goods and other property held either for sale, consumption or for distribution at no or nominal cost in the ordinary course of business operations.

Inventories held for distribution are measured at cost, adjusted for any loss of service potential. All other inventories are measured at the lower of cost and net realisable value.

The basis used in assessing loss of service potential for inventories held for distribution include current replacement cost and technical or functional obsolescence. Technical obsolescence occurs when an item still functions for some or all of the tasks it was originally acquired to do, but no longer matches current technologies. Functional obsolescence occurs when an item no longer functions the way it did when it was first acquired.

Cost for all other inventory is measured on the basis of weighted average cost.

Inventories acquired for no cost or nominal considerations are measured at current replacement cost at the date of acquisition. Property, Plant and Equipment All non-current physical assets are measured initially at cost and subsequently revalued at fair value less accumulated depreciation and impairment. Where an asset is acquired for no or nominal cost, the cost is its fair value at the date of acquisition.

More details about the valuation techniques and inputs used in determining the fair value of non- financial physical assets are discussed in note 10 Property, Plant and Equipment.

Crown Land Crown land is measured at fair value with regard to the property’s highest and best use after due consideration is made for any legal or constructive restrictions imposed on the asset, public announcements or commitments made in relation to the intended use of the asset. Theoretical opportunities that may be available in relation to the assets are not taken into account until it is virtually certain that any restrictions will no longer apply.

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

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

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

Revaluations of Non-Current Physical Assets Non-current physical assets are measured at fair value and are revalued in accordance with FRD 103F Non-Current Physical Assets. This revaluation process normally occurs at least every 5 years, based upon the assets Government Purpose Classification, but may occur more frequently if fair value assessments indicate material changes in values. Independent valuers are used to conduct these scheduled revaluations and any interim revaluations are determined in accordance with the requirements of the FRDs. Revaluation increments or decrements arise from differences between an asset carrying value and its fair value.

Revaluation increments are recognised in Other Comprehensive Income and are credited directly to the asset revaluation surplus, except that, to the extent that an increment reverses a revaluation decrement in respect of that same class of asset previously recognised as an expense in net result.

Revaluation decrements are recognised in Other Comprehensive Income to the extent that a credit balance exits in the asset revaluation surplus in respect of the same class of property, plant and equipment. Revaluation increases and revaluation decreases relating to individual assets within a class are offset against one another within that class but are not offset in respect of assets in different classes.

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

In accordance with FRD 103F Non-Current Physical Assets, Ballarat Health Services non-current physical assets were assessed to determine whether revaluation of the non-current physical assets was required.

Intangible Assets Intangible assets represent identifiable non-monetary assets without physical substance such as patents, trademarks and computer software and development costs.

Intangible assets are initially recognised at cost. Subsequently, intangible assets with finite useful lives are carried at cost less accumulated amortisation and accumulated impairment losses. Costs incurred subsequent to initial acquisition are capitalised when it is expected that additional future economic benefits will flow to Ballarat Health Services.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Prepayments Other non-financial assets include prepayments which represent payments in advance of receipt of goods or services or that part of expenditure made in one accounting period covering a term extending beyond that period.

Disposal of Non-Financial Assets Any gain or loss on the sale of a non-financial asset is recognised at the date that control of the asset is passed to the buyer and is determined after deducting from the proceeds the carrying value of the asset at the time. Refer to note 1(j) – Other Comprehensive Income

Investments in Joint Operations In respect of any interest in joint operations, Ballarat Health Services recognises in the financial statements:

 Its assets including its share of any assets held jointly  Any liabilities including its share of liabilities that it had incurred  Its revenue from the sale of its share of the output from the joint operation  Its share of the revenue from the sale of the of the output by the operation and  Its expenses including its share of any expenses incurred jointly

(m) Liabilities

Payables Contractual payables which consist predominantly of accounts payable representing liabilities for goods and services provided to Ballarat Health Services prior to the end of the financial year that are unpaid, and arise when Ballarat Health Services becomes obliged to make future payments in respect of the purchase of those goods and services.

Contractual payables are initially recognised at fair value and then subsequently carried at amortised cost. Statutory payables are recognised and measured similarly to contractual payables but are not classified as financial instruments and not included in the category of financial liabilities at amortised cost, because they do not arise from a contract. The normal credit terms are 30 days from the end of the month, in which the invoice was raised.

Provisions Provisions are recognised when Ballarat Health Services has a present obligation, the future sacrifice of economic benefits is probable and the amount of the provision can be measured reliably.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

The amount recognised as a liability is the best estimate of the consideration required to settle the present obligation at reporting date, taking into account the risks and uncertainties surrounding the obligation. Where a provision is measured using the cash flows estimated to settle the present obligation, its carrying amount is the present value of those cash flows, using a discount rate that reflects the time value of money and risks specific to the provision.

Resident Trust Accounts Ballarat Health Services holds deposits in trust on behalf of residents. As Ballarat Health Services has no claim on these funds they have been shown in the balance sheet as a liability.

Employee Benefits This provision arises for benefits accruing to employees in respect of wages and salaries, annual leave and LSL for services rendered to the reporting date.

Wages and Salaries, Annual Leave and Accrued Days Off Liabilities for wages and salaries including annual leave and accrued days off, which are expected to be settled within 12 months of the reporting date are recognised in the provision for employee benefits in respect of employee’s services up to the reporting date and are classified as current liabilities and measured at their nominal values.

Long Service Leave The liability for LSL is recognised in the provision for employee benefits.

Current Liability – Unconditional LSL (representing 10 or more years of continuous service) This is disclosed in the notes of the financial statements as a current liability even where Ballarat Health Services does not expect to settle the liability within 12 months as it will not have the unconditional right to defer the settlement of the entitlement should an employee take leave within 12 months.

The components of this current LSL liability are measured at:

 Present value – component that Ballarat Health Services does not expect to settle within 12 months  Nominal value – component that Ballarat Health Services expects to settle within 12 months

Non-Current Liability – Conditional LSL (representing less than 10 years of continuous service) This is disclosed as a non-current liability. There is an unconditional right to defer the settlement of the entitlement until the employee has completed the requisite years of service. Conditional LSL is required to be measured at present value.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Consideration is given for expected future wage and salary levels, experience of employee departures and periods of service. Expected future payments are discounted using interest rates of the Commonwealth Government guaranteed securities in Australia.

Termination Benefits Termination benefits are payable when employment is terminated before the normal retirement date or when an employee accepts voluntary redundancy in exchange for these benefits.

Liabilities for termination benefits are recognised when a detailed plan for the termination has been developed and a valid expectation has been raised with those employees affected that the terminations will be carried out. The liabilities for termination benefits are recognised in other creditors unless the amount or timing of the payments is uncertain, in which case they are recognised as a provision.

On-Costs Employee benefit for on-costs such as workers compensation and superannuation are recognised together with provision for employee benefits, while LSL taken in service are recognised separately.

(n) Leases Leases are classified at their inception as either operating or finance leases based on the economic substance of the agreement so as to reflect the risks and rewards incidental to ownership.

Leases of property, plant and equipment are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership to the lessee. All other leases are classified as operating leases.

Finance Leases

Entity as Lessor Ballarat Health Services does not hold any finance lease arrangements with other parties.

Operating Leases Rental income from operating leases is recognised on a straight line basis over the term of the relevant lease.

Operating lease payments including any contingent rentals are recognised as an expense in the Comprehensive Operating Statement on a straight line basis over the lease term, except where another systematic basis is more representative of the time pattern of the benefits derived from the use of the leased asset. Page 17 of 23

Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Leasehold Improvements The cost of leasehold improvements are capitalised as an asset and depreciated over the remaining term of the lease or the estimated useful life of the improvements, whichever is shorter.

(o) Equity

Contributed Capital Consistent with Australian Accounting Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities and FRD 119A Contributions by Owners, appropriations for additions to the net asset base have been designated as contributed capital. Other transfers that are in the nature of contributions or distributions that have been designated as contributed capital are also treated as contributed capital.

Property, Plant and Equipment Revaluation Surplus The asset revaluation surplus is used to record increments and decrements on the revaluation of non-current physical assets. Specific Restricted Purpose Surplus A specific restricted purpose surplus is established where Ballarat Health Services has possession or title to the funds but has no discretion to amend or vary the restriction and/or condition.

(p) Commitments Commitments for future expenditure include operating and capital commitments arising from contracts. Major project commitments are fully funded by the Department of Health & Human Services. These commitments are disclosed by way of note (refer to note 19) at their nominal value and are inclusive of the GST payable.

(q) Contingent Assets and Contingent Liabilities Contingent assets and contingent liabilities are not recognised in the balance sheet, but are disclosed by way of note 20 and if quantifiable, are measured at nominal value. Contingent assets and contingent liabilities are presented inclusive of GST receivable or payable respectively.

(r) Goods and Services Tax (GST) Income, expenses and assets are recognised net of the amount of associated GST, unless the GST incurred is not recoverable from the taxation authority. In this case it is recognised as part of the cost of acquisition of the asset or as part of the expense. Receivables and payables are stated inclusive of the amount of GST receivable or payable. The net amount of GST recoverable from the taxation authority is included with other receivables in the balance sheet.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Cash flows are presented on a gross basis. The GST components of cash flows arising from investing or financing activities which are recoverable from or payable to the taxation authority are presented as an operating cash flow.

Commitments and contingent assets and liabilities are presented on a gross basis.

(s) Category Groups Ballarat Health Services have used the following category groups for reporting purposes in the current and previous financial years:

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

Mental Health Services (Mental Health) Mental Health comprises all specialised mental health services providing a range of inpatient, community based residential, rehabilitation and ambulatory services which treat and support people with a mental illness and their families and carers. This excludes any Emergency Department Services. These services aim to identify mental illness early, and seek to reduce its impact through providing timely acute care services and appropriate longer-term accommodation and support for those living with a mental illness.

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

Emergency Department Services (EDS) EDS comprises all emergency department services.

Aged Care Aged care comprises a range of in-home, specialist geriatric, residential care and community based programs and support services, such as Home and Community Care (HACC) programs that are targeted to older people, people with a disability and their carer’s.

Residential Aged Care including Mental Health (RAC incl. Mental Health) RAC including mental health has been referred to in the past as psychogeriatric residential services and comprises those Commonwealth-licensed residential aged care services in receipt of supplementary funding from the Department of Health & Human Services, under the mental Page 19 of 23

Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

health program. It excludes all other residential services funded under the mental health program, such as mental health funded Community Care Units (CCUs) and Secure Extended Care Units (SECUs).

Other Services Not Reported Elsewhere (Other) Other services includes services not separately classified above including public health services laboratory testing, blood borne viruses/sexually transmitted infections, clinical services, Koori liaison officers, immunisation and screening services, drugs services including drug withdrawal, counselling and the needle and syringe program, disability services including aids and equipment and flexible support packages to people with a disability, community care programs including sexual assault support, early parenting services, parenting assessment and skills development, and various support services. Health and Community Initiatives also fall into this category group.

(t) AASs Issued that are not yet effective Certain new AASs and interpretations have been published that are not mandatory for the 30 June 2016 reporting period. The Department of Treasury and Finance assesses the impact of all new standards and advises Ballarat Health Services of their applicability and early adoption where suitable.

As at 30 June 2016, the following standards and interpretations had been issued by the AASB but were not yet effective. They become effective for the first financial statements for reporting periods, commencing after the stated operative dates as detailed below. Ballarat Health Services has not and does not intend to adopt these standards early.

The following standards and interpretations, currently issued by the AASB which apply to reporting periods ending after 30 June 2016 include:

AASB Compiled Standards

Standard/ Summary Applicable Impact on public sector entity Interpretation 1 for annual financial statements reporting period beginning on AASB 9 The key changes include the 1 Jan 2018 The assessment has identified Financial simplified requirements for the that the financial impact of Instruments classification and measurement of available for sale (AFS) assets will financial assets, a new hedging now be reported through other accounting model and a revised comprehensive income (OCI) and impairment loss model to no longer recycled to the profit recognise impairment losses and loss. While the preliminary earlier, as opposed to the current assessment has not identified any

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

approach that recognises material impact arising from impairment only when incurred. AASB 9, it will continue to be monitored and assessed. AASB 15 The core principle of AASB 15 1 Jan 2018 The changes in revenue Revenue from requires an entity to recognise recognition requirements in AASB Contracts with revenue when the entity satisfies a 15 may result in changes to the Customers performance obligation by timing and amount of revenue transferring a promised good or recorded in the financial service to a customer. statements. The Standard will also require additional disclosures on service revenue and contract modifications. A potential impact will be the upfront recognition of revenue from licenses that cover multiple reporting periods. Revenue that was deferred and amortised over a period may now need to be recognised immediately as a transitional adjustment against the opening returned earnings if there are no former performance obligations outstanding. AASB 2014-5 Amends the measurement of trade 1 Jan 2017, The assessment has indicated Amendments to receivables and the recognition of except that there will be no significant Australian dividends. amendments impact for the public sector. Accounting Trade receivables that do not have to AASB 9 Standards a significant financing component, (Dec 2009) arising from are to be measured at their and AASB 9 AASB 15 transaction price, at initial (Dec 2010) recognition. apply from Dividends are recognised in the 1 Jan 2018 profit and loss only when: • the entity’s right to receive payment of the dividend is established • it is probable that the economic benefits associated with the dividend will flow to the entity; and • the amount can be measured reliably AASB 2015-8 This Standard defers the 1 Jan 2018 This amending standard will defer Amendments to mandatory effective date of AASB the application period of AASB 15 Australian 15 from 1 January 2017 to 1 to the 2018-19 reporting period January 2018. Page 21 of 23

Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

Accounting in accordance with the transition Standards – requirements. Effective Date of AASB 15 AASB 16 The key changes introduced by 1 Jan 2019 The assessment has indicated Leases AASB 16 include the recognition of that as most operating leases will most operating leases (which are come on balance sheet, current not recognised) on balance recognition of lease assets and sheet. lease liabilities will cause net debt to increase. Depreciation of lease assets and interest on lease liabilities will be recognised in the income statement with marginal impact on the operating surplus. The amounts of cash paid for the principal portion of the lease liability will be presented within financing activities and the amounts paid for the interest portion will be presented within operating activities in the cash flow statement. No change for lessors. AASB 2015-6 The Amendments extend the scope 1 Jan 2016 The amending standard will result Amendments to of AASB 124 Related Party in extended disclosures on the Australian Disclosures to not-for-profit public entity's key management Accounting sector entities. A guidance has personnel (KMP), and the related Standards – been included to assist the party transactions. Extending application of the Standard by not- Related Party for-profit public sector entities. Disclosures to Not-for-Profit Public Sector Entities [AASB 10, AASB 124 & AASB 1049]

AASB Amending Standards In addition to the new standards above, the AASB has issued a list of other amending standards that are not effective for the 2015-16 reporting period (as listed below). In general, these amending standards include editorial and references changes that are expected to have insignificant impacts on public sector reporting.

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Ballarat Health Services Notes To And Forming Part Of The Financial Statements For The Year Ended 30 June 2016

 AASB 1056 Superannuation Entities  AASB 1057 Application of Australian Accounting Standards  AASB 2014-3 Amendments to Australian Accounting Standards – Accounting for Acquisitions of Interests in Joint Operations [AASB 1 & AASB 11]  AASB 2014-6 Amendments to Australian Accounting Standards – Agriculture: Bearer Plants [AASB 101, AASB 116, AASB 117, AASB 123, AASB 136, AASB 140 & AASB 141]  AASB 2015-2 Amendments to Australian Accounting Standards – Disclosure Initiative: Amendments to AASB 101 [AASB 7, AASB 101, AASB 134 & AASB 1049]  AASB 2015-9 Amendments to Australian Accounting Standards – Scope and Application Paragraphs [AASB 8, AASB 133 & AASB 1057]  AASB 2015-10 Amendments to Australian Accounting Standards – Effective Date of Amendments to AASB 10 and AASB 128  AASB 2016-2 Amendments to Australian Accounting Standards – Disclosure Initiative: Amendments to AASB 107 Notes: 1. For the current year, given the number of consequential amendments to AASB 9 Financial Instruments and AASB 15 Revenue from Contracts with Customers, the standards/interpretations have been grouped together to provide a more relevant view of the upcoming changes.

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Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

0.64 0.15 0.04 0.00 0.16 0.01 Note 2: Analysis of Revenue by Source Admitted Non EDS Mental RAC Aged Other Total Patients Admitted Health Care 2016 2016 2016 2016 2016 2016 2016 2016 $000 $000 $000 $000 $000 $000 $000 $000 2016 Revenue from Operating Activities Government Grants 179,525 12,932 16,271 29,854 41,451 7,982 54,999 343,014 Patient and Resident Fees 12,537 40 232 143 8,054 503 5 21,514 Business Units and Special Purpose Funds ------38,237 38,237 Indirect contributions by the Department of Health & Human Services 132 12 14 28 27 7 45 266 Donations and Bequests ------973 973 Grampians Rural Health Alliance ------1,027 1,027 Other Revenue from Operating Activities 5,724 127 768 399 460 76 1,326 8,880 Total Revenue from Operating Activities 197,918 13,111 17,285 30,424 49,992 8,569 96,613 413,911

Revenue from Non-Operating Activities Interest and Dividends ------1,981 1,981 Total Revenue from Non-Operating Activities ------1,981 1,981

Capital Purpose Income Capital Purpose Income (excluding interest) ------23,371 23,371 Capital Interest ------43 43 Grampians Rural Health Alliance ------672 672 Total Capital Purpose Income ------24,086 24,086 Total Revenue 197,918 13,111 17,285 30,424 49,992 8,569 122,680 439,978

The Department of Health & Human Services makes Indirect Contributions for insurance payments on behalf of Ballarat Health Services. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expense.

Note 2: Analysis of Revenue by Source Admitted Non EDS Mental RAC Aged Other Total Patients Admitted Health Care 2015 2015 2015 2015 2015 2015 2015 2015 $000 $000 $000 $000 $000 $000 $000 $000 2015 Revenue from Operating Activities Government Grants 175,866 12,764 15,962 27,721 39,213 7,963 44,309 323,798 Patient and Resident Fees 6,620 93 12 168 10,674 435 11 18,013 Business Units and Special Purpose Funds ------32,623 32,623 Indirect contributions by the Department of Health & Human Services 149 12 14 28 27 7 45 282 Donations and Bequests ------419 419 Grampians Rural Health Alliance ------958 958 Other Revenue from Operating Activities 7,140 1,181 448 834 552 44 696 10,895 Total Revenue from Operating Activities 189,775 14,050 16,436 28,751 50,466 8,449 79,061 386,988

Revenue from Non-Operating Activities Interest and Dividends ------1,969 1,969 Total Revenue from Non-Operating Activities ------1,969 1,969

Capital Purpose Income Capital Purpose Income (excluding interest) ------18,379 18,379 Capital Interest ------5 5 Grampians Rural Health Alliance ------17 17 Total Capital Purpose Income ------18,401 18,401 Total Revenue 189,775 14,050 16,436 28,751 50,466 8,449 99,431 407,358

The Department of Health - (1 July 2014-31 December 2014)and then the Department of Health and Human Services (1 January 2015 - 30 June 2015) makes Indirect Contributions for insurance payments on behalf of Ballarat Health Services. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expense.

Note 2(a): Net Gain/(Loss) on Disposal of Non-Financial Assets 2016 2015 $000 $000 Proceeds from Disposal of Non-Financial Assets Plant and Equipment 10 14 Medical Equipment 15 15 Land - 215 Motor Vehicles 597 504 Buildings - 256 Total Proceeds from Disposal of Non-Financial Assets 622 1,004

Less: Written Down Value of Non-Financial Assets Sold Plant and Equipment (181) (2) Medical Equipment (2) (11) Land - (215) Motor Vehicles (203) (287) Buildings - (519) Total Written Down Value of Non-Financial Assets Sold (386) (1,033) Net Gain/(Loss) on Disposal of Non-Financial Assets 236 (29) Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 3 : Analysis of Expenses by Source Admitted Non EDS Mental RAC Aged Other Total Patients Admitted Health Care 2016 2016 2016 2016 2016 2016 2016 2016 $000 $000 $000 $000 $000 $000 $000 $000 2016 Expenditure from Operating Activites Employee Expenses 138,782 13,986 21,215 32,051 41,687 6,614 31,228 285,563 Contract Labour Costs 1,293 45 122 102 549 235 80 2,426 Supplies and Consumables 17,952 449 32 353 757 99 1,803 21,445 Medical and Surgical Supplies 11,061 315 913 190 668 49 35,566 48,762 Insurance Costs 2,356 237 360 544 708 112 530 4,848 Purchased Services 7,842 634 22 401 339 2,261 4,338 15,837 Grampians Rural Health Alliance ------990 990 Other Expenses 17,044 2,660 506 2,719 2,604 1,233 10,238 37,003 Total Expenses from Operating Activities 196,330 18,326 23,170 36,360 47,313 10,603 84,773 416,874

Other Expenditure for Captial Purpose ------3,975 3,975 Impairment of Financial Assets ------483 483 Depreciation 8,566 2,533 506 4,199 2,563 6,213 1,101 25,683 Total Other Expenses 8,566 2,533 506 4,199 2,563 6,213 5,559 30,141 Total Expenses 204,896 20,860 23,676 40,559 49,876 16,816 90,332 447,015

Note 3 : Analysis of Expenses by Source Admitted Non EDS Mental RAC Aged Other Total Patients Admitted Health Care 2015 2015 2015 2015 2015 2015 2015 2015 $000 $000 $000 $000 $000 $000 $000 $000 2015 Expenditure from Operating Activites Employee Expenses 137,447 12,922 18,359 29,626 39,635 5,300 27,229 270,518 Contract Labour Costs 842 15 12 10 265 176 83 1,403 Supplies and Consumables 12,619 458 8 350 730 49 1,299 15,513 Medical and Surgical Supplies 10,556 347 781 186 669 23 36,758 49,320 Insurance Costs 2,392 225 320 516 690 92 474 4,708 Purchased Services 6,226 40 - 62 56 2,264 3,643 12,291 Grampians Rural Health Alliance ------935 935 Other Expenses 17,307 2,465 363 2,421 2,409 813 8,356 34,135 Total Expenses from Operating Activities 187,389 16,472 19,843 33,171 44,454 8,717 78,777 388,823

Other Expenditure for Captial Purpose ------3,726 3,726 Impairment of Financial Assets ------83 83 Depreciation 8,745 2,586 516 4,287 2,617 6,343 1,125 26,220 Net Loss from disposal of Non-Current Asset ------29 29 Total Other Expenses 8,745 2,586 516 4,287 2,617 6,343 4,963 30,058 Total Expenses 196,134 19,058 20,359 37,458 47,071 15,060 83,740 418,881

Note 3(a): Analysis of Expense and Revenue by Special Purpose Funds Expense Revenue 2016 2015 2016 2015 $000 $000 $000 $000 Business Units Safety Link 5,268 5,323 5,945 6,035 Eureka Linen 6,164 4,560 7,417 4,691 Catering 10,333 9,907 10,426 9,357 Radiology 16,583 14,064 17,488 15,051 Business Unit Total 38,348 33,854 41,276 35,134

Other Services Private Practice 1,909 1,823 2,496 2,092 Education Services 3,553 3,021 3,342 2,158 Breastscreen 1,449 1,414 1,661 1,484 Dental Teaching Clinic 1,400 94 1,286 117 Grampians Intergrated Cancer Service 1,244 1,494 1,245 1,494 Accommodation 892 533 1,151 1,025 Child and Youth Redesign 817 823 844 833 Diabetic Shop 360 334 352 345 IMS Research 350 263 291 243 Salary Packaging 110 271 1,869 1,789 Print Shop 164 190 345 383 Car Park 192 61 674 138 Hopsital Improvement 177 144 129 137 Midwifery 118 111 123 120 Other 3,150 4,634 3,482 4,156 Grampians Rural Health Alliance 990 935 1,027 958 Other Services Total 16,875 16,145 20,317 17,472 Total 55,223 49,999 61,593 52,606 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 4: Depreciation and Amortisation 2016 2015 $000 $000 Buildings 17,778 17,865 Medical Equipment 3,345 3,216 Plant and Equipment 1,705 1,609 Motor Vehicles 785 939 Personal Alarm Call Systems 365 299 Linen Stock 253 290 Computers and Communications 505 940 Furniture and Fittings 401 472 Kitchen and Catering 100 107 Intangibles 446 484 Total 25,683 26,220

Note 5: Cash and Cash Equivalents 2016 2015 $000 $000

Cash on hand and at bank 2,380 13,164 Total Cash and Cash Equivalents 2,380 13,164

Represented By Cash for Health Services Operations (as per Cash Flow Statement) 2,380 13,164 Total Cash and Cash Equivalents 2,380 13,164

Note 6: Receivables Current Non-Current Total Current Non-Current Total 2016 2016 2016 2015 2015 2015 $000 $000 $000 $000 $000 $000 Contractual Trade Debtors - Acute and Sub-Acute Inpatients 2,796 - 2,796 2,201 - 2,201 - RAC 353 - 353 380 - 380 - Eureka Linen 508 - 508 283 - 283 - Radiology 278 - 278 357 - 357 - Safety Link 387 - 387 388 - 388 - Sundry 8,845 - 8,845 6,243 - 6,243 Accrued Investment Income 143 - 143 387 - 387 Total Contractual 13,310 - 13,310 10,239 - 10,239

Statutory GST Receivable 1,618 - 1,618 644 - 644 Department of Health/Department of Health & Human Services 1,513 10,784 12,297 2,500 8,284 10,784 Total Statutory 3,131 10,784 13,915 3,144 8,284 11,428 Total 16,441 10,784 27,225 13,383 8,284 21,667

Less: Allowance for Doubtful Debts Trade Debtors 126 - 126 95 - 95 Patient Fees 132 - 132 180 - 180 Net Debtors and Accrued Revenue 16,183 10,784 26,967 13,108 8,284 21,392

Note 6(a): Movement in the Allowance for Doubtful Debts 2016 2015 $000 $000 Balance at beginning of year 275 172 Amounts written off during the year (54) (23) Amounts recovered during the year (129) (52) Increase/(decrease) in allowance recognised in the net result 166 178 Balance at end of year 258 275

Note 6(b): Ageing Analysis of Receivables Please refer to note 18 for the ageing analysis of receivables

Note 6(c): Nature and Extent of Risk Arising from Receivables Please refer to note 18 for the nature and extent of credit risk arising from receivables Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 7: Other Financial Assets Operating Operating Specific Specific Trust Trust Capital Capital Total Total Fund Fund Purpose Purpose Fund Fund Fund Fund Fund Fund 2016 2015 2016 2015 2016 2015 2016 2015 2016 2015 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 Current Shares 650 671 ------650 671 Term Deposits - - 486 503 163 10,552 2,351 945 3,000 12,000 Managed Investment Schemes (VFMC) - - - - 12,258 11,917 - - 12,258 11,917 Grampians Rural Health Alliance - - 1,267 450 - - - - 1,267 450 Total Current 650 671 1,753 953 12,421 22,469 2,351 945 17,175 25,038

Non-Current Floating Rate Notes - - - - 13,003 5,603 - - 13,003 5,603 Total Non-Current - - - - 13,003 5,603 - - 13,003 5,603 Total 650 671 1,753 953 25,424 28,072 2,351 945 30,178 30,641

Represented by: Health Service Investments 650 671 486 503 - - 2,351 945 3,486 2,119 Monies held in Trust - Accommodation Bonds - - - - 23,653 26,643 - - 23,653 26,643 - Patient Monies - - - - 833 834 - - 833 834 - State Wide Equipment Program - - - - 677 297 - - 677 297 - Grampians Intergrated Cancer Services - - - - 262 298 - - 262 298 Grampians Rural Health Alliance - - 1,267 450 - - - - 1,267 450 Total 650 671 1,753 953 25,424 28,072 2,351 945 30,177 30,641

Note 7(a): Ageing Analysis of Other Financial Assets Please refer to note 18 for the ageing analysis of other financial assets

Note 7(b): Nature and Extent of Risk Arising from Other Financial Assets Please refer to note 18 for the nature and extent of credit risk arising from other financial assets

Note 8: Inventory 2016 2015 $000 $000 General (at cost) 916 952 Pharmaceuticals (at cost) 698 728 Total 1,614 1,680

Note 9: Prepayments 2016 2015 $000 $000 Prepayments 1,356 1,365 Total 1,356 1,365 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 10: Property, Plant and Equipment Gross Cost Accumulated Written Down Written Down Valuation Dep'n Value Value 2016 2016 2016 2015 $000 $000 $000 $000 Land 21,866 - 21,866 19,297 Under Construction 29,398 - 29,398 12,637 Buildings 317,651 35,122 282,529 296,928 Plant and Equipment 26,223 17,242 8,981 8,056 Medical Equipment 40,073 31,700 8,373 9,326 Computers and Communications 7,628 6,252 1,376 638 Furniture and Fittings 3,884 3,133 751 1,001 Kitchen and Catering 2,735 2,410 325 295 Personal Alarm Call Systems 6,648 5,099 1,549 741 Linen Stock 1,428 593 835 577 Motor Vehicles 3,987 2,445 1,542 1,503 Total Fixed Assets 461,521 103,996 357,526 350,999

An independent valuation of Ballarat Health Services buildings was peformed by the VGV to determine the fair value of the buildings.The valuation, which conforms to Australian Valuation Standards, was determined to reference to the amounts to which assets could be exchanged between knowledgeable willing parties in an arm's length transaction. The valuation was based on independent assesments. The effective date of the valuation is 30 June 2014.

Ballarat Health Services obtained approval from the Department of Health & Human Services to undertake a Managerial Revaluation of Land assets in accordance with FRD103F. This Managerial Revaluation was based on Land indexation factors issued by the VGV for the financial year 01/07/2015 to 30/06/2016 .

Reconciliations of the carrying amounts of each class of assets for the entity at the beginning and end of the previous and current financial year is set out below.

Land Under Buildings Plant and Medical Computers Furniture and Kitchen and Personal Linen Stock Motor Total Construction Equipment Equipment and Fittings Catering Alarm Call Vehicles Comm'n Systems $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 2016 Carrying amount at start of year 19,297 12,637 296,928 8,056 9,326 638 1,001 295 741 577 1,503 350,999 Additions - 23,519 144 332 2,168 413 111 131 1,174 511 1,027 29,530 Revaluations 2,569 ------2,569 Net transfers between classes - (6,758) 3,235 2,386 227 830 131 - - - - 51 Disposals - - - (89) (3) - (91) (1) - - (204) (386) Depreciation expense - - (17,778) (1,705) (3,345) (505) (401) (100) (365) (253) (785) (25,237) Carrying amount at end of year 21,866 29,398 282,529 8,981 8,373 1,376 751 325 1,549 835 1,542 357,526

2015 Carrying amount at start of year 19,217 16,125 286,031 7,223 8,720 1,211 1,094 270 824 589 1,923 343,227 Additions 295 28,643 504 1,304 1,670 322 378 127 216 279 806 34,543 Revaluations ------Net transfers between classes - (32,131) 28,777 1,141 2,163 46 - 5 - - - - Disposals (215) - (518) (2) (11) - - - - - (288) (1,034) Depreciation expense - - (17,865) (1,609) (3,216) (940) (472) (107) (299) (290) (939) (25,736) Carrying amount at end of year 19,297 12,637 296,928 8,056 9,326 638 1,001 295 741 577 1,503 350,999

Note 10(a): Intangible Assets 2016 2015 $000 $000 Computer Software 4,481 3,057 Less: Accumulated Amortisation (3,945) (2,121) Total 536 936

Carrying amount at start of year 936 1,342 Additions 97 78 Revaluations - - Net transfers between Classes (51) - Disposals - - Amortisation (446) (484) Carrying amount at end of year 536 936 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 10(b): Fair Value Measurement Hierarchy for Assets at 30 June 2016

Carrying amount as at Fair value measurement at end of reporting period using: 30 June 2016 Level 1 Level 2 Level 3 Land at fair value Non-Specialised Land 11,021 - 11,021 - Specialised Land 10,845 - - 10,845 Total of Land at fair value 21,866 - 11,021 10,845

Buildings at fair value Non-Specialised Buildings 131,506 - 131,506 - Specialised Buildings 151,023 - - 151,023 Total of Buildings at fair value 282,529 - 131,506 151,023

Plant, Equipment and Vehicles at fair value - Motor Vehicles 1,542 - 1,542 - - Plant and Equipment 8,982 - 7,303 1,679 - Furniture and Fittings 751 - 751 - - Kitchen and Catering 325 - 325 - Total of Plant, Equipment and Vehicles at fair value 11,600 - 9,921 1,679

Medical Equipment at fair value 8,373 - 5,534 2,839

Computers and Communications 1,377 - 1,377 -

Personal Alarm Call Systems 1,549 - 1,549 -

Linen Stock 834 - 834 - Total 328,128 - 161,742 166,386

Note 10(b): Fair Value Measurement Hierarchy for Assets at 30 June 2015

Carrying amount as at Fair value measurement at end of reporting period using: 30 June 2015 Level 1 Level 2 Level 3 Land at fair value Non-Specialised Land 9,776 - 9,776 - Specialised Land 9,521 - - 9,521 Total of Land at fair value 19,297 - 9,776 9,521

Buildings at fair value Non-Specialised Land 134,186 - 134,186 - Specialised Land 162,742 - - 162,742 Total of Buildings at fair value 296,928 - 134,186 162,742

Plant, Equipment and Vehicles at fair value - Motor Vehicles 1,503 - 1,503 - - Plant and Equipment 8,056 - 8,056 - - Furniture and Fittings 1,001 - 1,001 - - Kitchen and Catering 295 - 295 - Total of Plant, Equipment and Vehicles at fair value 10,855 - 10,855 -

Medical Equipment at fair value 9,325 - 5,387 3,938

Computers and Communications 638 - 638 -

Personal Alarm Call Systems 741 - 741 -

Linen Stock 577 - 577 - Total 338,361 - 162,160 176,201 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 10(c): Reconciliation of Level 3 Fair Value Land Buildings Plant and Equipment Medical Equipment 2016 Opening Balance 9,521 162,742 - 3,938 Purchases (sales) - 626 1,723 - Subtotal 9,521 163,368 1,723 3,938

Gains or losses recognised in net result - Depreciation - (12,345) (45) (1,099) Subtotal - (12,345) (45) (1,099)

Items recognised in other comprehensive income - Revaluation 1,324 - - - Subtotal 1,324 - - - Closing Balance 10,845 151,023 1,678 2,839

Classified in accordance with the fair value hierarchy, see Note 1 (b) There have been no transfers between levels during the period.

Land Buildings Plant and Equipment Medical Equipment 2015 Opening Balance 9,521 176,010 - 4,081 Purchases (sales) - (827) - 995 Subtotal 9,521 175,183 - 5,076

Gains or losses recognised in net result - Depreciation - (12,441) - (1,138) Subtotal - (12,441) - (1,138) Closing Balance 9,521 162,742 - 3,938

Specialised land, buildings and other assets The market approach is also used for specialised land and specialised buildings although is adjusted for the Community Service Obligation (CSO) to reflect the specialised nature of the assets being valued. Specialised assets contain significant, unobservable adjustments; therefore these assets are classified as Level 3 under the market based direct comparison approach.

The CSO adjustment is a reflection of the valuer’s assessment of the impact of restrictions associated with an asset to the extent that is also equally applicable to market participants. This approach is in light best use consideration required for fair value measurement, and takes into account the use of the asset that is physically possible, legally permissible and financially feasible. As adjustments of CSO are considered as of the highest and significant unobservable inputs, specialised land would be classified as Level 3 assets.

For the health services, the depreciated replacement cost method is used for the majority of specialised buildings, adjusted for the associated depreciation. As depreciation adjustments are considered as significant and unobservable inputs in nature, specialised buildings are classified as Level 3 for fair value measurements.

Plant and Equipment is held at carrying value (depreciated cost). When plant and equipment is specialised in use, such that it is rarely sold other than as part of a going concern, the depreciated replacement cost to estimate the fair value. Unless there is market evidence that current replacement costs are significantly different from the original acquistion cost, it is considered unlikely that depreciated replacement costs will is used be materially different from the existing carrying value. Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 10(d): Description of Significant Unobservable Inputs to Level 3 Valuations Valuation technique Significant unobservable Range (weighted average) Sensitivity of fair value measurement to inputs changes in significant onobservable inputs

Specialised Land Queen Elizabeth Centre - Ascot Street Sth Community Service A significant increase or decrease in the CSO 908 Eyre Street 20% Market Approach (i) Obligation (CSO) adjustment would result in a significantly lower Base Hospital - Drummond Street Nth (2015: 20%) Sebastopol Complex - Morgan Street Adjustment (higher) fair value 113 Ascot Street Sth Specialised Buildings Direct cost per square $313 - $2,400/m2 ($2,300) A significant increase or decrease in direct cost metre (2015: $313 - $2,400/m2 per square metre adjustment would result in a ($2,300)) significantly higher or lower fair value

Depreciated Replacement Cost Useful life of specialised 1 - 60 years (45 years) A significant increase or decrease in the buildings 2015: 1 - 60 years (45 estimated useful life of the asset would result years) in a significantly higher or lower valuation Plant and Equipment at Fair Value

Depreciated Replacement $530,000 - $648,000 A significant increase or decrease in direct cost Cost Per Unit Cost (575,000) per square metre adjustment would result in a significantly higher or lower fair value

A significant increase or decrease in the useful Useful Life of Plant and life of the asset would result in significantly Equipment 5 - 10 Years (7 Years) higher or lower valuation

Medical Equipment at Fair Value $223,000 -$1,328,000 Increase (decrease) in gross replacement cost ($600,000) Cost Per Unit would result in a significantly higher (lower) fair (2015: $223,000 - value $1,328,000 ($600,000)) Depreciated Replacement Cost Useful Life of Medical 10-33 years (17 years) Increase (decrease) in useful life would result in Equipment (2015: 10-33 years (17 a significantly higher (lower) value years)) (i) CSO adjustments of 20% were applied to reduce the market approach value for the Health Services specialised land Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 11: Payables 2016 2015 $000 $000 Trade Creditors and Accrued Expenses 23,782 25,977 Salary Packaging Held in Trust 688 2,766 Department of Health & Human Services (i) 227 1,808 Total 24,697 30,551 (i) Terms and conditions of amounts payable to the Department of Health & Human Services vary according to the particular agreement with the Department.

Note 11(a): Maturity Analysis of Payables Please refer to note 18 for the ageing analysis of payables

Note 11(b): Nature and Extent of Risk Arising from Payables Please refer to note 18 for the nature and extent of credit risk arising from payables

Note 12: Employee Benefits 2016 2015 $000 $000 Current Provisions Employee Benefits Annual Leave - Unconditional and expected to be settled within 12 months 15,987 15,646 - Unconditional and expected to be settled after 12 months 2,640 2,617 Long Service Leave - Unconditional and expected to be settled within 12 months 4,259 3,302 - Unconditional and expected to be settled after 12 months 21,169 21,003 Other - Accrued Wages and Salaries 7,607 5,185 - Accrued Days Off 436 509

Provisions related to Employee Benefit On-Costs - Unconditional and expected to be settled within 12 months 2,540 2,369 - Unconditional and expected to be settled after 12 months 3,024 2,952 Other - Accrued Wages and Salaries 952 648 - Accrued Days Off 55 65 Total Current 58,669 54,296

Non-Current Provisions Conditional Long Service Leave 13,014 10,133 Total Non-Current 13,014 10,133 Total Provisions 71,683 64,429

Note 12(a): Employee Benefits and Related On-Costs 2016 2015 $000 $000 Current Unconditional Long Service Leave 28,664 27,344 Accrued Leave 20,956 20,546 Accrued Wages and Salaries 8,558 5,833 Accrued Days Off 491 573 Total Current 58,669 54,296

Non-Current Conditional Long Service Leave 13,014 10,133 Total Non-Current 13,014 10,133 Total Employee Benefits 71,683 64,429

Note 12(b): Movement in Provisions 2016 2015 $000 $000 Movement in Long Service Leave: Balance July 1 37,477 33,345 Provision made during the year 8,479 7,847 Settlement made during the year (4,278) (3,715) Balance June 30 41,678 37,477

Provision for Long Service Leave in accordance with AASB 101: Presentation of Financial Statements, Provision for Long Service Leave is considered a current liability in respect to employees who have met the required qualification period, and therefore Ballarat Health Services does not have an unconditional right to defer settlement of the liability for at least 12 months after the balance date. Refer Note 1(m) for details.

Note 13: Superannuation Paid Contribution Contribution Outstanding 2016 2015 2016 2015 $000 $000 $000 $000 Defined Benefit Plans (i): First State Super 1,282 1,467 102 117 Defined Contribution Plans: First State Super 13,467 13,349 1,115 1,108 Hesta 4,815 4,125 437 370 Emergency Services Scheme 415 422 33 3 Other 714 596 54 85 Total 20,693 19,959 1,742 1,683 (i) The basis for calculating the level of contributions is determined by the various actuaries of the defined benefit superannuation plans. Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 14: Monies Held in Trust 2016 2015 $000 $000 Current Monies Held in Trust - Refundable Accommodation Bonds 31,498 28,748 - Patient Monies 833 834 - Grampians Integrated Cancer Service 262 298 - State Wide Equipment Program 677 297 Total 33,270 30,177

Monies Held in Trust Represented by: Other Financial Assets 33,270 30,177 Total Monies Held in Trust 33,270 30,177

Note 15: Other Liabilities 2016 2015 $000 $000 Current Grampians Rural Health Alliance 221 51 Total Other Liabilities 221 51

Note 16: Equity

Note 16(a): Reserves 2016 2015 $000 $000 Asset Revaluation Reserve (i) Balance at the beginning of the reporting period 171,557 171,557 Revaluation Increments/(Decrements) - Land 2,569 - Balance at the end of the reporting period 174,127 171,557

Represented by: - Land 14,324 11,754 - Buildings 159,803 159,803 174,127 171,557

Specific Purpose Reserve Balance at the beginning of the reporting period 503 493 Transfer to accumulated surplus (17) 10 Balance at the end of the reporting period 486 503 Total Reserves 174,613 172,060 (i) The land and buildings assets revaluation reserve arises on the revaluation of land and buildings.

The above reserves are internally managed Special Purpose Funds, which are used to quarantine Capital Income such as Donations, Capital Grants and Interest Revenue. Once quarantined, this income is used to fund Capital Projects, Refurbishments, Equipment and Education.

Note 16(b): Contributed Capital 2016 2015 $000 $000 Balance at the beginning of the reporting period 155,814 149,952 Capital contribution received from the Victorian Government 183 5,862 Balance at the end of the reporting period 155,997 155,814

Note 16(c): Retained Earnings 2016 2015 $000 $000 Balance at the beginning of the reporting period (32,905) (21,372) Net Result for the Year (7,684) (11,503) Grampians Rural Health Alliance 648 (20) Transfer from Reserve 17 (10) Balance at the end of the reporting period (39,924) (32,905)

Note 16(d): Total Equity at the End of the Financial Year 2016 2015 $000 $000 Total Equity at the beginning of the reporting period 294,969 300,630 Total Changes in Equity Recognised in Comprehensive Operating Statement (4,283) (5,660) Total Equity at the end of the reporting period 290,686 294,969 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 17: Reconciliation of Net Result for the Year to Net Cash Inflow/(Outflow) from Operating Activities 2016 2015 Note $000 $000 Net Result for the Year (7,037) (11,523)

Non-Operating Cash Movements Net (Gain)/Loss on Sale of Fixed Assets 2(a) (236) 29 Net (Gain)/Loss on Investments 61 -

Non-Cash Movements Depreciation and Amortisation 25,683 26,220 Grampians Rural Health Alliance (647) 36 Resources/Assets Received Free of Charge (579) (634) Impairment of Investments 483 83 Provision for Doubtful Debts (17) 103

Movements in Assets and Liabilities Change in operating assets and liabilities Increase/(Decrease) in Payables (5,855) (88) Increase/(Decrease) in Employee Benefits 7,254 1,220 Increase/(Decrease) in Other Liabilities 3,093 6,182 (Increase)/Decrease in Inventory 66 (158) (Increase)/Decrease in Prepayments 9 (401) (Increase)/Decrease in Receivables (5,558) (1,545) Net Cash Inflows from Operating Activities 16,720 19,524 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 18: Financial Instruments

(a) Financial Risk Management Objectives and Policies Ballarat Health Services principal financial instruments comprise: - Cash Assets - Term Deposits - Managed Investment Schemes (VFMC) - Receivables (excluding statutory receivables) - Available-for-sale Financial Assets - Payables (excluding statutory payables) - Accommodation Bonds

Details of the significant accounting policies and methods adopted, including the criteria for recognition, the basis of measurement and the basis on which income and expenses are recognised, with respect to each class of financial asset, financial liability and equity instrument are disclosed in Note 1.

Ballarat Health Services main financial risks include credit risk, liquidity risk and interest rate risk. Ballarat Health Services manages these financial risks in accordance with its financial risk management policy.

The main purpose in holding financial instruments is to prudentially manage Ballarat Health Services financial risks within the government policy parameters.

Categorisation of Financial Instruments Carrying Carrying Amount Amount 2016 2015 $000 $000 Financial Assets Cash and cash equivalents 2,380 13,164 Receivables 13,052 9,964 Available for Sale 30,178 30,641 Total Financial Assets(i) 45,610 53,769

Financial Liabilities Payables 24,470 28,743 Accommodation Bonds 31,498 28,748 Monies Held in Trust 1,772 1,429 Other Liabilities 221 51 Total Financial Liabilities(ii) 57,961 58,971 (i) The total amount of financial assets disclosed here excludes statutory receivables (i.e. GST input tax credit recoverable) (ii) The total amount of financial liabilities disclosed here excludes statutory payables (i.e. Taxes, payables)

(b) Net Holding Gain/(Loss) on Financial Instruments by Category Carrying Carrying Amount Amount 2016 2015 $000 $000 Financial Assets Cash and Cash Equivalents(i) 1,981 1,969 Receivables (17) (103) Available for Sale(i) (440) (78) Total Financial Assets 1,524 1,788

Financial Liabilities Accommodation Bonds 176 130 Total Financial Liabilities 176 130 (i) For cash and cash equivalents, loans and receivables and available-for-sale financial assets, the net gain or loss is calculated by taking the interest revenue, plus or minus foreign exchange gains or losses arising from revaluation of the financial assets, and minus any impairment recognised in the net result. (ii) For financial assets and liabilities that are held-for-trading or designated at fair value through profit or loss, the net gain or loss is calculated by taking the movement In the fair value of the financial asset or liability. Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 18: Financial Instruments (cont)

(c) Credit Risk Credit risk arises from the contractual financial assets of Ballarat Health Services, which comprise cash and deposits, non statutory receivables and available for sale contractual financial assets. Ballarat Health Services exposure to credit risk arises from the potential default of a counter party on their contractual obligations resulting in the financial loss to Ballarat Health Services. Credit risk is measured at fair value and is monitored on a regular basis.

In addition, Ballarat Health Services does not engage in hedging for its contractual financial assets and mainly obtains contractual financial assets that are on fixed interest, except for cash assets, which are mainly cash at bank. Ballarat Health Services policy is to only deal with banks with high credit ratings.

Provision for impairment for contractual financial assets is recognised when there is objective evidence that Ballarat Health Services will not be able to collect a receivable. Objective evidence includes financial difficulties of the debtor, default payments, debts which are more than 60 days overdue, and changes in debtor credit ratings.

Except as otherwise detailed in the following table, the carrying amount of contractual financial assets recorded in the financial statements, net of any allowances for losses, represents Ballarat Health Services maximum exposure to credit risk without taking account of the value of any collateral obtained.

Credit Quality of Contractual Financial Assets That Are Neither Past Due Nor Impaired Financial Government Other Total Institutions Agencies (AA-Credit (AAA-Credit Rating) Rating) $000 $000 $000 $000 2016 Financial Assets Cash and Cash Equivalents 2,380 - - 2,380 Receivables - Trade Debtors - - 12,909 12,909 - Other Receivables (i) 143 - - 143 Other Financial Assets - Term Deposits 3,000 - - 3,000 - Managed Investment Schemes (VFMC) - 12,258 - 12,258 - Floating Rate Notes 3,600 - 9,403 13,003 - Shares in Other Entities 650 - 1,267 1,917 Total Financial Assets 9,773 12,258 23,579 45,610

2015 Financial Assets Cash and Cash Equivalents 13,164 - - 13,164 Receivables - Trade Debtors - - 9,577 9,577 - Other Receivables (i) 387 - - 387 Other Financial Assets - Term Deposits 12,000 - - 12,000 - Managed Investment Schemes (VFMC) - 11,917 - 11,917 - Floating Rate Notes 1,600 - 4,003 5,603 - Shares in Other Entities 671 - 450 1,121 Total Financial Assets 27,822 11,917 14,030 53,769 (i) The total amounts disclosed here exclude statutory amounts (eg; amounts owing from Victorian Government and GST input tax credit recoverable).

Ageing Analysis of Financial Assets as at 30 June Past Due But Not Impaired Consolidated Not Past Due and Less than 1 1-3 Months 3 Months - 1 Year 1-5 Years Impaired Carrying Amount Not Impaired Month Financial Assets

$000 $000 $000 $000 $000 $000 $000 2016 Financial Assets Cash and Cash Equivalents 2,380 2,380 - - - - - Receivables 13,052 11,880 564 556 52 - - Other Financial Assets 30,178 17,920 - - - - 12,258 Total Financial Assets 45,610 32,180 564 556 52 - 12,258

2015 Financial Assets Cash and Cash Equivalents 13,164 13,164 - - - - - Receivables 9,964 8,875 525 351 213 - - Other Financial Assets 30,641 18,724 - - - - 11,917 Total Financial Assets 53,769 40,763 525 351 213 - 11,917

There are no financial assets that have had their terms renegotiated so as to prevent them from being past due or impaired, and they are stated as the carrying amounts as indicated. The ageing analysis table above discloses the ageing only of contractual financial assets that are past due but not impaired. Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 18: Financial Instruments (cont)

(d) Liquidity Risk Liquidity risk is the risk that Ballarat Health Services would be unable to meet its financial obligations as and when they fall due. Ballarat Health Services operates under the Government's fair payments policy of settling financial obligations within 30 days and in the event of dispute, making payments within 30 days from the date of resolution. Ballarat Health Services maximum exposure to liquidity risk is the carrying amounts of financial liabilities as disclosed in the balance sheet.

Ballarat Health Services manages its financial instruments so as to minimise liquidity risk. This is achieved through a combination of daily cash flow forecasting and appropriate budget setting and monitoring.

Maturity Analysis of Financial Liabilities as at 30 June Maturity Dates Carrying Amount Nominal Amount Less than 1 Month 1-3 Months 3 Months - 1 Year $000 $000 $000 $000 $000 2016 Financial Liabilities Payables 24,470 24,470 24,470 - - Accommodation Bonds 31,498 31,498 567 1,446 26,735 Monies Held in Trust 1,772 1,772 - 939 833 Other Liabilities 221 221 - - 221 Total Financial Liabilities 57,961 57,961 25,037 2,385 27,789

2015 Financial Liabilities Payables 28,743 28,743 28,743 - - Accommodation Bonds 28,748 28,748 517 1,320 26,911 Monies Held in Trust 1,429 1,429 - 595 834 Other Liabilities 51 51 - - 51 Total Financial Liabilities 58,971 58,971 29,260 1,915 27,796

(e) Market Risk Ballarat Health Services exposures to market risk are primarily through interest rate risk with only insignificant exposure to foreign currency and other price risks. Objectives, policies and processes used to manage each of these risks are disclosed in the paragraph below.

Currency Risk Ballarat Health Services is exposed to insignificant foreign currency risk through its payables relating to purchases of supplies and consumables from overseas. This is because of a limited amount of purchases denominated in foreign currencies and a short timeframe between commitment and settlement.

Other Price Risk Ballarat Health Services is not subject to price risk.

Interest Rate Risk Minimisation of risk is achieved by mainly undertaking fixed rate or non-interest bearing financial instruments. Cash flow interest rate risk is the risk that the future cash flows of a financial instrument will fluctuate because of changes in market interest rates. Ballarat Health Services has minimal exposure to cash flow interest rate risks through its cash and deposits that are at floating rate. Ballarat Health Services manages this risk by mainly undertaking fixed rate or non-interest bearing financial instruments with relatively even maturity profiles, with only insignificant amounts of financial instruments at floating rate. Management has concluded for cash at bank as for financial assets that can be left at floating rate without necessarily exposing Ballarat Health Services to significant bad risk, management monitors interest rates on a daily basis.

Interest Rate Exposure of Financial Assets and Liabilities as at 30 June Interest Rate Exposure Weighted Average Carrying Amount Fixed Interest Rate Variable Interest Non-Interest Effective Interest Rate Bearing Rate (%) $000 $000 $000 $000 2016 Financial Assets Cash and Cash Equivalents 1.75% 2,380 - 2,380 - Receivables 0% 13,052 - - 13,052 Other Financial Assets 3.85% 30,178 3,000 27,178 - Total Financial Assets 45,610 3,000 29,558 13,052

Financial Liabilities Creditors 0% 24,470 - - 24,470 Accommodation Bonds 3.60% 31,498 31,498 - - Monies Held in Trust 0% 1,772 - - 1,772 Other Liabilities 0% 51 - - 51 Total Financial Liabilities 57,791 31,498 - 26,293

2015 Financial Assets Cash and Cash Equivalents 2.00% 13,164 - 13,164 - Receivables 0% 9,964 - - 9,964 Other Financial Assets 3.60% 30,641 12,000 18,641 - Total Financial Assets 53,769 12,000 31,805 9,964

Financial Liabilities Creditors 0% 28,743 - - 28,743 Accommodation Bonds 3.60% 28,748 28,748 - - Monies Held in Trust 0% 1,429 - - 1,429 Other Liabilities 0% 51 - - 51 Total Financial Liabilities 58,971 28,748 - 30,223 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 18: Financial Instruments (cont)

(e) Market Risk (cont) Sensitivity Disclosure Analysis Taking into account past performance, future expectations, economic forecasts and management's knowledge and experience of the financial markets, Ballarat Health Services believe the following movements are 'reasonably possible' over the next 12 months (Base rates are sourced from the Reserve Bank of Australia) - A parallel shift of +0.50% and -0.25% in interest rate from year-end rates of 1.75% The following table discloses the impact on net operating result and equity for each category of financial instrument held by Ballarat Health Services at year end as presented to key management personnel, if changes in the relevant risk occur.

Interest Rate Risk -0.25% +0.50% Carrying Amount Profit Equity Profit Equity $000 $000 $000 $000 $000 2016 Financial Assets Cash and Cash Equivalents 2,380 (6) (6) 12 12 Other Financial Assets 30,178 (75) (75) 151 151

Financial Liabilities Accommodation Bonds 31,498 79 79 (157) (157)

Interest Rate Risk -0.50% +1% Carrying Amount Profit Equity Profit Equity $000 $000 $000 $000 $000 2015 Financial Assets Cash and Cash Equivalents 13,164 (33) (33) 132 132 Other Financial Assets 30,641 (77) (77) 306 306

Financial Liabilities Accommodation Bonds 28,748 72 72 (287) (287)

(f) Fair Value The fair values and net fair values of financial instrument assets and liabilities are determined as follows: Level One - the fair value of financial instrument assets and liabilities with standard terms and conditions and traded in active liquid markets are determined with reference to quoted market prices; and Level Two - the fair value is determined using inputs other than quoted prices that are observable for the financial asset or liability, either directly or indirectly; and Level Three - the fair value of other financial instrument assets and liabilities is determined in accordance with generally accepted pricing models based on discounted cash flow analysis using unobservable market inputs.

Ballarat Health Services considers that the carrying amount of financial instrument assets and liabilities recorded in the financial statements to be a fair approximation of their fair values, because of the short-term nature of financial instruments and the expectation that they will be paid in full.

The following tables show that the fair values of most of the contractual financial assets and liabilities are the same as the carrying amounts.

Comparison between carrying amount and fair value Carrying Amount Fair Value Carrying Amount Fair Value 2016 2016 2015 2015 $000 $000 $000 $000 Financial Assets Cash and Cash Equivalents 2,380 2,380 13,164 13,164 Receivables 13,052 13,052 9,964 9,964 Available for Sale 30,178 30,178 30,641 30,641 Total Financial Assets 45,610 45,610 53,769 53,769

Financial Liabilities Payables 24,470 24,470 28,743 28,743 Accommodation Bonds 31,498 31,498 28,748 28,748 Monies Held in Trust 1,772 1,772 1,429 1,429 Other Liabilities 51 51 51 51 Total Financial Liabilities 57,791 57,791 58,971 58,971

(f) Fair Value (cont)

Financial assets measured at fair value Fair value measurement at end of reporting period using: Carrying Amount Level 1 Level 2 Level 3 as at 30 June $000 $000 $000 $000 2016 Financial Assets at fair value through Profit and Loss Available for sale financial assets 30,178 30,178 - - Total Financial Assets 30,178 30,178 - -

2015 Financial Assets at fair value through Profit and Loss Available for sale financial assets 30,641 30,641 - - Total Financial Assets 30,641 30,641 - - Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 19: Commitments 2016 2015 $000 $000 Capital Expenditure Commitments Land and Buildings 16,042 33,872 Furniture and Fittings 88 36 Medical Equipment 2,089 263 Computer 60 199 Plant and Equipment 721 733 Intangible Assets 20 164 Total Capital Expenditure Commitments 19,020 35,267

Not later than 1 year 19,020 29,467 Total Capital Expenditure Commitments Payable 19,020 35,267

Operating Expenditure Commitments Furniture and Fittings 23 26 Plant and Equipment 329 125 Computer 39 209 Medical Equipment 114 720 Other 1,086 2,158 Total Operating Expenditure Commitments 1,591 3,238

Not later than 1 year 1,584 3,225 Later than 1 year and not later than 5 years 7 13 Total Operating Expenditure Commitments Payable 1,591 3,238

Operating Leases Property 1,454 1,036 Medical Equipment 610 803 IT Equipment 314 18 Total Operating Leases 2,378 1,857

Not later than 1 year 848 602 Later than 1 year and not later than 5 years 1,530 1,255 Later than 5 years - - Total Operating Leases Payable 2,378 1,857

Total Commitments for Expenditure (inclusive of GST) 22,989 40,362 Less GST recoverable from the Australian Tax Office 2,074 3,621 Total Commitments for Expenditure (exclusive of GST) 20,915 36,741

All amounts shown in the Commitments note are nominal amounts inclusive of GST. Capital Commitments of $13,498,953.08 are fully funded by DHHS. Capital Commitments for 2014/15 $28,562,777 and were fully funded by DHHS.

Note 20: Contingent Assets and Contingent Liabilities There were no contingent assets or liabilities as at 30 June 2016 (2015 NIL) Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 21: Segment Reporting Admitted Admitted Non Non EDS EDS Mental Mental RAC RAC Aged Aged Other Other Total Total Patients Patients Admitted Admitted Health Health Care Care 2016 2015 2016 2015 2016 2015 2016 2015 2016 2015 2016 2015 2016 2015 2016 2015 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 Revenue External Segment Revenue 209,093 194,323 13,851 13,982 18,261 16,357 32,142 31,356 52,815 50,394 9,052 8,295 102,740 90,677 437,954 405,384 Total Revenue 209,093 194,323 13,851 13,982 18,261 16,357 32,142 31,356 52,815 50,394 9,052 8,295 102,740 90,677 437,954 405,384

Expenses External Segment Expenses 210,525 196,399 19,652 17,740 24,845 21,371 38,989 34,800 50,557 47,388 11,370 11,586 91,549 89,448 447,487 418,732 Total Expenses 210,525 196,399 19,652 17,740 24,845 21,371 38,989 34,800 50,557 47,388 11,370 11,586 91,549 89,448 447,487 418,732 Net Result from Ordinary Activities (1,432) (2,076) (5,801) (3,758) (6,584) (5,014) (6,847) (3,444) 2,258 3,006 (2,318) (3,291) 11,191 1,229 (9,533) (13,348)

Interest Expense ------(176) (130) - - - - (176) (130) Interest Income ------1,420 1,385 - - 604 589 2,024 1,974 Share of Net Result of 310 (9) 21 (1) 27 (1) 48 (2) 78 (2) 13 - 151 (4) 648 (19) Associates and Joint Operations Net Result for Year (1,122) (2,085) (5,780) (3,759) (6,557) (5,015) (6,799) (3,446) 3,580 4,259 (2,305) (3,291) 11,946 1,814 (7,037) (11,523)

Other Information Segment Assets 199,109 199,195 4,636 5,577 5,720 6,525 30,753 31,089 91,712 88,708 56,807 52,921 31,820 36,162 420,557 420,177 Total Assets 199,109 199,195 4,636 5,577 5,720 6,525 30,753 31,089 91,712 88,708 56,807 52,921 31,820 36,162 420,557 420,177

Segment Liabilities 46,666 45,839 3,091 3,298 4,076 3,858 7,173 7,397 44,065 41,469 2,020 1,957 22,780 21,390 129,871 125,208 Total Liabilities 46,666 45,839 3,091 3,298 4,076 3,858 7,173 7,397 44,065 41,469 2,020 1,957 22,780 21,390 129,871 125,208

Investments in Associates and Joint Operations 495 188 8 3 9 3 76 30 246 93 162 62 50 20 1,046 399 Acquisition of Property, Plant and Equipment 14,002 16,362 219 256 256 299 2,164 2,529 6,969 8,144 4,598 5,375 1,419 1,656 29,627 34,621 Depreciation and Amortisation Expense 12,138 12,392 190 194 222 226 1,876 1,916 6,041 6,168 3,987 4,070 1,229 1,254 25,683 26,220 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 22: Jointly Controlled Operations and Assets

Ballarat Health Services has an interest in a Jointly Controlled Operation. The Jointly Contolled Operation is Grampians Rural Health Alliance. Details of operations are listed as follows.

Grampians Rural Health Alliance

In June 2008, the Department of Health issued circular number 17/2008, which outlines government requirements for the operation of rural health Information and Communication Technology (ICT) alliances. The policy outlines the accepted governance model for the operation of the ICT alliances.

The policy requires public hospitals, public health services and multipurpose services which are declared or established under the Health Services Act 1988, to enter into the alliance for the region in which they operate, in accordance with a Joint Operation Agreement. Consistent with this policy, the Grampians Rural Health Alliance came into effect on 9th of December 2008.

2016 2015 $000 $000 Revenue 1,699 975 Expenses (1,051) (995) Net Result 648 (20)

Assets 1,267 450 Liabilities (221) (51) Net Assets 1,046 399 Equity 1,046 399

Ownership Interest 20.14% 20.14% Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 23: Responsible Person Related Disclosures

In accordance with the Ministerial Directions issued by the Minister for Finance under the Financial Management Act 1994 ,the following disclosures are made regarding responsible persons for the reporting period. Period Responsible Minister: The Honourable Jill Hennessy, Minister for Health, Minister for Ambulance Services 01/07/2015 30/06/2016 The Honourable Martin Foley, Minister for Housing, Disability and Ageing, Minister for Mental Health 01/07/2015 30/06/2016

Governing Board: Mr M Patterson 01/07/2015 30/06/2016 Mr A Faull 01/07/2015 09/03/2016 Mr C Coltman 01/07/2015 30/06/2016 Mrs V Kennedy 01/07/2015 30/06/2016 Mrs R Coutts 01/07/2015 30/06/2016 Ms P Kinnersly 01/07/2015 30/06/2016 Mr D Miller 01/07/2015 30/06/2016 Ms J Addison 01/07/2015 30/06/2016

Accountable Officer Mr A Rowe - Chief Executive Officer 01/07/2015 31/12/2015 Mr A Kinnersly - Acting Chief Executive Officer 01/01/2016 30/06/2016

Remuneration of Responsible Persons The number of Responsible Persons are shown in their relevant income band; 2016 2015 No. No. Income Band $20,000 - $29,999 7 4 $30,000 - $39,999 1 3 $50,000 - $59,999 - 1 $170,000 - $179,999 1 - $430,000 - $439,999 - 1 $730,000 - $739,999 1 - Total Numbers 10 9 Total remuneration received or due and receivable by Responsible Persons from the reporting entity amounted to: 1,109,619 697,692

Amounts relating to the Responsible Ministers are reported in the financial statements of the Department of Premier and Cabinet. For information regarding related party transactions of ministers, the register of members interests is publicly available from: www.parliament.vic.gov.au/publications/register of interests.

Other Transactions of Responsible Persons and their Related Parties 2016 2015 $000 $000 Mr M Patterson has an association with North Ballarat Sports Club who provided services on commercial terms and conditions The total value of transactions with this entity was; 8 5 Ballarat Health Services Notes to and forming part of the Financial Statements for the year ended 30 June 2016

Note 23: Responsible Person Related Disclosures (cont)

Executive Officers' Remuneration

The numbers of executive officers, other than Ministers and Accountable Officers and their total remuneration during the reporting period are shown in the first 2 columns in the table below in their relevant income bands. The base remuneration of executive officers is shown in the third and fourth columns, base remuneration is exclusive of bonus payments, LSL payments, redundancy payments and retirement benefits.

Total Remuneration Base Remuneration 2016 2015 2016 2015 $90,000 - $99,999 1 - 1 1 $110,000 - $119,999 - 1 - - $150,000 - $159,999 1 - 1 - $160,000 - $169,999 - - - 1 $180,000 - $189,999 - - - 4 $190,000 - $199,999 - - - 1 $200,000 - $209,999 - 2 7 1 $210,000 - $219,999 4 4 - - $220,000 - $229,999 2 1 - - $260,000 - $269,999 - - 1 - $270,000 - $279,999 - - - 1 $280,000 - $289,999 1 - - - $320,000 - $329,999 1 1 - - $370,000 - $379,999 - - - 1 $400,000 - $409,999 - 1 - - Total 10 10 10 10

Total Annualised Employee Equivalent (AEE) (i) 10 10 10 10 Total Remuneration 2,180,762 2,352,920 1,936,391 2,038,342 (i) Annualised employee equivalent is based on paid working hours of 38 ordinary hours per week over the 52 weeks for a reporting period.

All payments made to Executives are governed by the Government Sector Executive Remuneration Panel (GSERP). The changes from the previous year reflect GSERP approved pay increases, as well as the payment of accumulated long service leave for a number of Executives.

Note 24: Remuneration of Auditors 2016 2015 $000 $000 Audit or review of financial statement (VAGO) 95 82 Internal Audit 191 159 Total Remuneration of Auditors 286 241

Note 25: Events Occurring after the Balance Sheet Date On 25 July 2016, Dale Fraser commenced as Chief Executive Office of Ballarat Health Services

Note 26: Economic Dependency As a result of the financial performance and position for the year ended 30 June 2016, Ballarat Health Service has obtained a letter of support from the State Government and in particular, the Department of Health and Human Services (DHHS), confirming that the department will continue to provide Ballarat Health Services adequate cash flow to meet its current and future obligations up to September 2017. A letter was also obtained from the previous financial year. On that basis, the financial statements have been prepared on a going concern basis.