At the Heart of Our Communities
ANNUAL REPORT WEST WIMMERA HEALTH SERVICE 2008–2009 BELOW: Nhill Hospital
OUR VISION OUR VALUES
To establish a health service without peer Strong Leadership and Management through the pursuit of excellence and We value our organisation and will encourage exceptional professional skills and by opening the doors to innovation and promote collaborative teamwork to drive better outcomes for our consumers. technology. A Safe Environment OUR MISSION Safety will always be our prime focus. A Culture of Continuing Improvement West Wimmera Health Service is The delivery of superior care to our consumers motivates a culture of quality committed to the delivery of health, improvement in all that we do. welfare and disability services which are Effective Management of the Environment compassionate, responsive, accessible and accountable to individual and Our Service is managed in ways which recognise environmental imperatives. community needs, which result in quality Responsive Partnerships with Our Consumers outcomes for the people of the West and We maintain a productive relationship with our communities and stakeholders South Wimmera, and Southern Mallee. through open communication, honest reporting and a willingness to embrace constructive suggestions.
About this Report This Report is a clear and honest summary of our performance in every aspect of our business and is a CONTENTS key document in communicating with our communities and other stakeholders about every aspect of our Our Year > Highlights, Events & Challenges ...... 1 undertakings. President’s Report > 2008 – 2009 ...... 2 It details the communities we serve and the health programs and services we deliver. It also outlines Our Organisation > The Pride of the Western Wimmera ...... 4 the goals we set, and the strategies we planned for Our Services ...... 5 achieving them, our fi nancial outcome for 2008/2009, Looking Forward > Steps Towards Reaching Our Vision ...... 6 the Governance system of the Service and the Executive staff responsible for management of the Service. Chief Executive Offi cer > An Insight into Our Service 2008 – 2009 ...... 8 To maintain our high standard of clear and open The Year In Review > Chief Executive Offi cer’s Perspective ...... 10 reporting this Report was prepared in accordance with Industrial Relations and Human Resources > Well Managed...... 16 the directions of the Victorian Government, the Victorian Management Of Risk > Not a Risky Business?...... 17 Minister for Finance, the guidelines of the Australasian Reporting Awards Inc. and also recommendations Education > Developing Our Future ...... 18 received in response to entering the 2008 Annual and Employees > The Heart and Soul of Our Service ...... 20 Quality of Care Reports in the PricewaterhouseCoopers WWHS Staff 2008–2009...... 21 Transparency Awards. Our Year > A Statistical Summary ...... 22 The Report will be distributed, in September, to the Victorian Parliament and the Department of Human Community and Fundraising > We Depend on You! ...... 24 Services for their approval to publish and then released Corporate Governance > Directives and Obligations ...... 28 to the community and other stakeholders at West Wimmera Health Service Annual General Meeting to Organisational Structure...... 29 be held in the Nhill Community Centre on Friday 27th Board Of Governance > Member Profi les ...... 30 November 2009 at 8.00pm where Dr Peter Morley MB, Leadership And Management > Our Executive Team ...... 32 BS, DIP ENG, MPH, Medical Director – International Burmungrad International Hospital, Bangkok, Thailand – Acute Care Services > We Can Care for You...... 34 will be the Guest Speaker. Medical Services ...... 41 We have included a Glossary of Terms & Abbreviations Residential Care > For Our Senior Citizens...... 42 and an Index on page 86 to assist readers to navigate Community And Allied Health > Our Care Reaching Out ...... 46 this Report. Cooinda > Disability and Business Service ...... 50 This Report and our Quality of Care Report can be accessed on our Website and the internal Intranet. Corporate and Quality Services > Support that is Essential...... 52 Accreditation – An External Measure of Quality...... 55 www.wwhs.net.au Environment and Sustainability ...... 56 Hard copies are available at each of our sites or by request via email or mail. Legislation > Critical to Our Performance...... 57 Finance and Administration > Sustainable and Accountable ...... 58 [email protected] Financial Performance > Overview...... 61 The Resource Centre West Wimmera Health Service Auditor General’s Report...... 63 P.O. Box 231 Certifi cation and Financial Statements ...... 65 Nhill Victoria 3418 Compliance Disclosure Index ...... 85 AUSTRALIA Glossary of Terms ...... 86 © Copyright West Wimmera Health Service September 2009 Index ...... 86 ANNUAL REPORT 2008/2009 1
OUR YEAR HIGHLIGHTS, EVENTS & CHALLENGES
HIGHLIGHTS OF THE PAST YEAR CHALLENGES FOR THE COMING YEAR
> The Honourable Daniel Andrews MP, Minister for Health > Implement recommendations from the Community Needs visited the Nhill Hospital on 27th March Analysis & Service Profi le Project > ACHS EQuIP four year accreditation status retained > Recruit & retain skilled staff > ACHS Diagnostic Imaging Accreditation achieved > Completion of remaining building stages of the Nhill Hospital > Aged Care Accreditation maintained and ‘Mira’ Complex > HACC Accreditation attained > Development of a Strategic Plan 2009-2012 > Australasian Annual Report Gold Reporting Award 2007-08 > Introduction and implementation of ‘iSoft’ Patient Management System > Annual & Quality of Care Report entered in PricewaterhouseCoopers Transparency Awards > Replacement and upgrade Fire Detection system and Nurse Call system at Kaniva Hospital > Department of Human Services Awards – 2007 Quality of Care Report Highly Commended > Redevelopment of Goroke Community Health Centre > Community Needs Analysis & Service Profi le Project > Finalise business plan for relocation of Kaniva Hostel completed > Secure funding for Medical Clinics at Nhill and Rainbow > Dialysis service doubled to four chairs > Commencement of Dental Clinics at Rainbow, Kaniva > Commencement of Dental Therapy Service and Goroke > Achieved a full suite of Allied Health Practitioners > Strengthening partnerships with regional and sub-regional hospitals and Health Services > Medical services at Goroke Community Health Centre extended > Upgraded motor vehicle fl eet to more effi cient and environmentally friendly composition Performance in Brief for the Year Ended 30 June 2008
> Opening of Oliver’s Kiosk at Nhill Hospital Acute Services 2008/09 2007/08 Variance > Foot Care Clinic introduced Patients Treated 1,879 1,902 -1.2% > Diabetes Insulin Pump Clinic increased Occupancy 71.88% 73.65% -1.8% > $130,000 Philanthropic contribution from Perpetual Trustees, Cost Per Acute Inpatient $4,547 $ 4,400 +3.3% The Percy Baxter Charitable Trust Residential Aged Care Services > Department of Human Services ‘Close Watch’ Financial Nursing Home (High Care) Percentage Occupancy 98.86% 98.94% -0.1% Reporting Monitoring ceased Hostel (Low Care) Percentage Occupancy 92.49% 90.48% +2.0% > Appointment of Clinical Operations Manager and Manager of Cost Per Aged Care Day $245 $241 +1.7% Allied & Community Health Allied & Community Health Services > WWHS Health & Fitness Centre opened Occasions of Service 66,633 66,004 +1.0% > $651,204 for Equipment and Infrastructure & Essential Employees Services from DHS Total Employees 546 536 +1.8% Fundraising **Funds Raised 254,105 1,206,337 -78.9% Total Cost of Fundraising 10,000 15,000 -33.3% Finance Finance Total Operating Surplus 599,000 450,000 33.1% Total Net Surplus 425,000 1,473,000 -71.1%
Notes: *Total employees for fi nancial year. **2007/08 boosted by steady donations for the Nhill Hospital Redevelopment. 2 WEST WIMMERA HEALTH SERVICE
PRESIDENT’S REPORT 2008 – 2009
This is my second term in offi ce as President of West Wimmera Health Service and when I consider the achievements of the Service during this period, I do so with a great sense of pride in the quality of leadership, the dedication and skill of staff and the altruism of community volunteers. The Board of Governance has continued to strengthen its role in effecting sound and responsible governance of West Wimmera Health Service throughout the reporting period. We have experienced another successful year of operation with many of the positive outcomes illustrated throughout this report. In particular, I am gratifi ed to confi rm very strong performances in the areas of clinical services and fi nancial management.
The Board welcomed Mr Harvey Champness from Kaniva as Board Members thank the Executive Team and all staff for their a Board Member at the March 2009 Board Meeting after his continued exceptional contribution to the Service. Working appointment by the Governor in Council from 3 March 2009. with a strong ethos of teamwork throughout the organisation results in the end-goal of our service – the highest quality and My fellow Board of Governance members bring together a diverse effectiveness of care provided to our patients, residents and range of complementary expertise and experience, to ensure that clients. Excellent accreditation outcomes confi rm and recognise the many aspects required in governing a health care organisation these high levels of service provision. as complex as ours can be successfully undertaken. I would like to thank each and every Board Member for their valuable We are at the advent of the next three year Strategic Plan – contribution and commitment to the Service. 2009-10 – 2012-13. This plan will implement recommendations from the Community Needs and Service Profi le Project Report West Wimmera Health Service has continued to work closely and heralds an exciting time of development for our service. with the Department of Human Services to enhance funding opportunities and the level of service delivery we provide. We will, in the coming year, continue in our endeavours to provide the very highest levels and widest range of available healthcare Hosting the Minister for Health, the Honourable Mr Daniel for our communities. We regard it as a privilege to serve the Andrews MP, on his visit to the Service in March 2009 was people of West Wimmera. a personal highlight in my year’s presidency. His visit was a signal honour for our Service and I am pleased to report that In accordance with the Financial Management Act 1994, I am the Minister was considerably impressed with the standard of pleased to present the Report of Operations for West Wimmera the Nhill Hospital. It was a pleasure to host the Minister for the Health Service for the year ending 30 June 2009. afternoon of his visit. Without doubt it is reassuring to note that his ‘bedside manner’ with our Chief Executive Offi cer, a patient at the time, was fi rst rate. To Mr John Smith, Chief Executive Offi cer, I again extend my sincere thanks for an excellent outcome in the year 2008-09. Mr Ron A. Ismay John, your dedication and loyalty to the Service, your exemplary President work ethic and forward vision have once again proved to be Nhill pivotal factors in ensuring the continually improving quality of 24 August 2009 healthcare that is delivered in all our facilities.
PAGE RIGHT: Ron A. Ismay – President, West Wimmera Health Service ANNUAL REPORT 2008/2009 3 4 WEST WIMMERA HEALTH SERVICE
OUR ORGANISATION THE PRIDE OF THE WESTERN WIMMERA
NSW Rainbow
SOUTH AUSTRALIA Jeparit Where Can You Find Us?
Nhill In the Grampians Region of the Kaniva Department of Human Services, the Local Government areas of the Shires
Goroke Natimuk of Hindmarsh, West Wimmera, a portion Horsham of the Rural City of Horsham and VICTORIA Yarriambiack Shires in the South and West Wimmera, and Southern Mallee in rural and remote North Western Victoria. Ararat Our catchment area of approximately 17,000 square kilometres is bound by Ballarat the Wyperfeld and Little Desert National Parks, home to rare species of Australian Melbourne fl ora and fauna. Mount Arapiles, a world renowned rock climbing mecca borders our Natimuk Aged Care Centre – spectacular tourist attractions. wwhs facilities Nhill, Rainbow, Jeparit, Kaniva, Goroke wwhs catchment and Natimuk are the communities where we have a signifi cant presence.
West Wimmera Health Service, a Our Community Profi le The projected benefi ts of joining forces far outweighed the inner parochial public health service incorporated Our communities and the agricultural feelings of wanting ‘each hospital to stay under the Health Services Act industry have strong links with grains, the same’. 1988, was created on the 21st sheep and legumes being the primary August, 1995, and now is a vital products. On the other hand several > Communities overwhelmingly voted to merge and become West Wimmera element in the sustainability of national and international industries are located in Nhill - a boost for the economy Health Service. The process occurred the rural communities it serves. and employment options. over fi ve years and the results speak In an environment with an ageing for themselves. population, continuing drought Through the harsh times our communities have relied on West Wimmera Health > Brand new Hospitals, Nursing Homes and relatively low socioeconomic Service as never before. Access to the and Hostels stand at Nhill, Kaniva, conditions the health care available diverse choice of quality health and Natimuk, Rainbow & Jeparit, together from this Service is central to the welfare services in the community is a with the signifi cant redevelopment at physical, mental and social well being blessing appreciated by all. Cooinda, our Disability Service. of our community. > Services thought to be a ‘pipe dream’ Six very diverse communities – are now a reality. We are an integrated health service What was their link? > Continued Accreditation status offering an exceptional choice of health provides proof that West Wimmera care ranging from Acute Surgical Resourcefulness and a determination Health Service’s broad range of care Specialties, Allied Health, Community without equal to maintain health services has been given the ‘tick of approval’ by Health and Health Promotion, Disability in these small rural communities was the independent external assessors. Services, Supported Employment Options, foundation in 1995 for the progressive mergers of seven services in six Community Aged Care Options, to Hostels Our Future – What will it be? and Nursing Homes. communities, including the fi rst Disability Service and fi rst Community Health The recommendations from the Centre in Victoria to come under the Community Needs Analysis and Service umbrella of a Public Hospital. Profi le Project will be instrumental in As always, dollars were the change setting the care provided by the Service makers, with never enough to support for the next decade ensuring our Health service provision, building repairs and Service will remain the centre for renewal of our hospitals and aged care exceptional care in the Grampians region. facilities, the challenge to retain staff, attract General Practitioners and the need to keep up with the rising standards of care, buildings and services. ANNUAL REPORT 2008/2009 5
OUR ORGANISATION > OUR SERVICES BELOW: Jeparit Hospital
Aged Care Health & Fitness Centre Jeparit Primary School Community Programs: Residential Hostels & Nursing Homes Health Education and Promotion Kaniva College Hospital To Home (H2H) Community & Home Based Aged Care Hearing Screening Kindergartens - Nhill, Jeparit, Kaniva, H2H is a service available for patients Clinical Services Home and Community Care Rainbow, Goroke who have a short term need which Acute Services Hospital in the Home Lutheran Primary School, Nhill cannot be met through regular Admission and Discharge Clinic Hospital to Home Natimuk Primary School community service provision. This Dental Diagnostic Kindergarten Screenings Nhill College program supports patients in the Dental Prosthetic - Podiatry, Speech Pathology Rainbow College transition from hospital to home. Dialysis Living with Cancer Program Rainbow Primary School Patients must live in municipalities Domiciliary Midwifery Lowan Rural Health Network Rural Northwest Health associated with West Wimmera Health Ear Nose and Throat Surgery Massage Therapy St Patrick’s Primary School, Nhill Service. Maternal and Child Health Woomelang Bush Nursing Centre Gastroenterology Hospital in the Home (HITH) Meals on Wheels General and Specialist Medical Care HITH is the provision of hospital care in Myotherapy Service Support General and Specialist Surgery the comfort of the person’s own home. National Diabetes Services Education Laparoscopic Surgery Patients are regarded as hospital Nutrition Education Engineering and Maintenance Maternity Shared Care Clinic inpatients and remain under the care of Occupational Therapy Health Information Management Medical Services their treating doctor in the hospital. Nursing Traineeships Optometry Hotel Services National Respite for Carers (NRCP) Obstetrics and Gynaecology Orthodontic Referral Library and Resource Services Provides ‘time out’ for carers of people Ophthalmic Surgery Pap Smear Tests Traineeships with dementia. This program offers Oral Surgery Physiotherapy Volunteers carers the opportunity to maintain Orthopaedic Surgery Planned Activity Groups Work Experience their own interests, while fulfi lling the Palliative Care – (Day Centres) Work Placements demanding role of carer. Pathology Podiatry Puberty ‘Biz’ Sexuality Education Nursing Homes - Hostels - Community Aged Care Packages Pharmacy Accommodation Post Acute Care to Grade 6 Children and Parents (CACPs) Primary Care Casualty Radiology Nhill These packages offer comprehensive Psychiatry ‘Secret Men’s Business’ ‘Iona’ Digby Harris Home, assistance to the elderly to support Reconstructive Surgery – group for older men for 26 frail aged, dementia and them in their homes, thus delaying Regional Discharge Planning Strategy Social Work psychogeriatric residents. entry into a hostel or nursing home for – Welfare and Counselling Service Kaniva as long as possible. The carer is also Allied and Community Support Speech Pathology Archie Gray Nursing Home, able to manage for longer with the Services Work Experience Nursing Home for 11 residents. support provided. Aged Care Assessment Services Disability Services Kaniva Cottages, 10 two bedroom Post Acute Care (PAC) Ante/Post Natal Classes Advocacy units for low care Hostel residents. Provides community-based services Asthma Education and Counselling Assistant Training Jeparit such as community nursing and Cancer Council of Victoria Australians Working Together Nursing Home for 10 residents. personal care. - Cancer Awareness Community Access Hostel for 5 residents. Home and Community Care Program Cardiac Rehabilitation Employment Program Rainbow (HACC) Carer Support Food Preparation and Sales Bowhaven Hostel for 10 residents. This program provides care in home Community Health Nursing Future for Young Adults Weeah Nursing Home for 10 frail aged and community settings to frail Continence Education Living Skills residents. older adults, younger people with Diabetes Education Supported Employment disabilities, and their carers, promoting Natimuk Dietetics Therapy Programs independence to these groups thus Natimuk Nursing Home, District Nursing Vocational Training avoiding premature or inappropriate for 20 residents. Drought Centre admission to long term residential ‘Allan W Lockwood’ Special Care Drug and Alcohol Regional Services To: aged care. Exercise Groups Allambi Elderly Peoples Home, Hostel dedicated care for 11 residents Exercise Physiology Dimboola with dementia. Farm Safety Education Avonlea Hostel Nhill Trescowthick House Hostel for 10 frail Fitness Assessments Dunmunkle Health Service aged residents. Guys & Gals School Program Edenhope Hospital Gym/Weights Program Goroke P-12 College Hairdressing Hopetoun Hospital 6 WEST WIMMERA HEALTH SERVICE
LOOKING FORWARD STEPS TOWARDS REACHING OUR VISION
Strategy Achievements Future Actions
Delivering Needs Based > Undertake a Community Needs > Extensive stakeholder consultations held > Implement recommendations from the Health Care Analysis & Service Profi le Project > Comprehensive Project Report fi nalised and Project Report adopted by the Board, June 2009
> Establish options for expansion of > Increased dialysis service from 2 to 4 chairs > Re-introduce Dental Services to Rainbow, Clinical Services > Dental Therapist commenced in February 2009, Kaniva & Goroke providing specialised public dental care for > Conduct feasibility study regarding introduction children and young adults of Ultrasound > Allied Health Staffi ng levels increased with > Introduce Chemotherapy care all departments now fully staffed and total > Introduce post acute and step down complement of services provided to all sites convalescence services in conjunction with sub-regional and regional hospitals
> Seek and develop opportunities for > Meetings held with regional and sub-regional > Formalise coordination strategies for patient greater regional alliances health services on a regular basis transfer from sub-regional and regional > Brokerage of Allied Health Practitioners to other services for post acute and convalescence care regional health services > Strengthened clinical liaisons with Medical Practitioners
> Increase the viability of Oliver’s Café > Commenced Oliver’s Kiosk in March 2009 with > Investigate expansion of catering service through increased expansion of sales exceptional patronage and marketing > Purchase of a Catering Vehicle
Strengthening > Refi nement of Risk Management > Conducted Clinical Risk Framework Internal > Adoption of the Victorian Government Clinical Leadership and Framework Audit Risk Governance Framework Management > Established coordinated network with Victorian > Review overall Risk Management Framework Managed Insurance Authority to address Risk with focus of best practice risk management Management planning and process processes > Strengthen relationship with VMIA relating to Risk Management administration > Education program for Board regarding Directors Duties
> Achieve improved internal > Reduction in number of management > Evaluate effectiveness of committee structure communication through organisational committees > Policies dealing with communication strategies and committee structures > Increased meeting attendance rates to be reviewed > Finalisation of clinical executive structure > Seamless communication between all levels of management
Optimum Human > Formalise and enhance strategies for > Appointment of General Practitioner Anaesthetist > Seek recognition of overseas trained General Resources Management attraction, support and retention of > Appointment of Obstetrician and Gynaecologist Practitioner Surgeon and General Practitioner visiting medical practitioners Obstetrician qualifi cations for Visiting Medical Practitioners
> Strengthen the defi ned organisational > Organisation structure reviewed, revised and > Ongoing review of organisation structure structure enhanced > Address Succession Plan appropriateness > Succession Plan formalised
> Introduce Human Resources Self > HRSS portal introduced > Broaden use of HRSS system to include Service (HRSS) portal rostering and leave management
> Appoint a Human Resource Manager > Human Resource Manager position advertised > Finalise appointment to Human Resource Manager position
Safe Practices & > Adopt ‘best practice’ for all clinical > No sentinel events recorded > Clinical Quality & Safety Committee to review Environment safety and environmental procedures > Policies and procedures regularly reviewed and introduce ‘best practice’ principles as appropriate
> Comply with Occupational Health & > Dedicated Occupational Health & Safety > Encourage staff to undertake OH&S training Safety Act Committee introduced that meets monthly courses > Accredited OH&S training provided to Health & Safety representatives
> Achieve optimal waste disposal > Rain water collection increased at all sites > Pursue all options to improve waste disposal recycling and environmental > General waste disposal sorted and graded to and recycling systems management address recycling opportunities > Establish an ongoing environmental strategy and protocol ANNUAL REPORT 2008/2009 7
Strategy Achievements Future Actions
Sound Financial > Maintenance of a robust fi nancial > Increased residential aged care subsidies received > Close monitoring of capital expenditure budget Management management strategy following review of resident documentation > Achieve an operating surplus annually > Work place effi ciencies achieved > Improved monitoring and adherence to departmental budgets
> Continue a capital fundraising program > Distribution from Philanthropic Trusts, Benefactors, > Intensify access to Private Benefactors, Donations and Bequests totalled $187,548.00 Commercial Enterprise, Philanthropic Foundations and Bequests
> Maximise Aged Care Revenue > Increased subsidies derived from Aged Care > Continued monitoring of ACFI levels Funding Instrument (ACFI) > Maximise occupancy rates at all levels > Highest Bed Occupancy levels for region
Effective Information > Develop and implement an Information > Installation of IT servers providing increased > Consider the introduction of a Knowledge Management Communications Technology Strategy capacity and improved security Management System > Introduction of HRSS > New Information Technology Strategic Plan to > New West Wimmera Health Service website be developed launched and operational
> Develop information technology links > Education delivered for iSoft Patient Management > Installation and introduction of iSoft Patient to improve access, effi ciency and system Management system effectiveness of preparation, storage > Computer replacement program progressed > Introduction of ‘Oracle’ Financial Management and retrieval of records > Clinical Mobile Video System introduced system > Gain greater clinical benefi t from Clinical Mobile Video Unit
Asset Management > Redevelop Dental Clinics at Rainbow, > Redevelopment works commenced at Rainbow > Commission new Dental Clinics at Rainbow Kaniva and Goroke and Kaniva and Kaniva > Provide stand alone Medical Clinics at > Applications submitted to Commonwealth seeking > Obtain funding for Nhill and Rainbow Medical Nhill and Rainbow funding for Nhill and Rainbow Medical Clinics Clinics
> Complete Stage 3 & 4 of ‘New’ Nhill > Successful application to Perpetual Trustees for > Complete ‘Mira’ Allied and Community Health Hospital and Mira complex $130,000 Centre refurbishment – Stage 3 > Commence redevelopment of Kitchen and Administration area of ‘New’ Nhill Hospital - Stage 4
> Assess the need for residential > Project Control Group established at Goroke > Finalise options for redevelopment of Goroke services at Goroke > Community consultations conducted Community Health Centre > Consultant Architect commissioned to undertake feasibility study
> Review redevelopment/refurbishment > Consultant Architect appointed to undertake a > Pursue Consultant’s feasibility study report and needs across the Services feasibility study to address the sentiments of the determine action to be taken Strategy
Relationships with the > Maintain constructive relationships > Community Consultation Forums conducted at > Continue to conduct open forums at each Community and Other with our community and other each township township on an annual basis Stakeholders stakeholders > Community Advisory Committees provide regular > Work closely with and utilise the services of feedback to Board of Governance Media Consultant to further promote the worth > Informative website developed and operational of WWHS > Contract retained with Media, Marketing and Public Relations Consultant > Increased media coverage of Service delivery and activities 8 WEST WIMMERA HEALTH SERVICE
CHIEF EXECUTIVE OFFICER AN INSIGHT INTO OUR SERVICE 2008 – 2009
In the coming year we have set ourselves the task to The fi nal Report supports retaining all current West Wimmera further strengthen all aspects of the organisation so Health Service clinical services and identifi es areas where that we can continue to achieve exemplary levels of service growth should occur. excellence in the provision of healthcare. This Report presents exciting opportunities to increase the scale and scope of health care we may offer in the future and harness Unlike recent years 2008-09 was not a year when our new and emerging technologies to enable this to occur. focus centred on new building or major expansions of The Report underlines the need and importance of continuing service. Rather, it was a time to closely examine and to press forward and intensify commitment to continual consolidate our wide ranging healthcare imperatives improvement. and business activities to ensure optimum effi ciencies Our year of strengthening the organisation has resulted in a and realise emerging potential. prime strategic manner to implement all the recommendations of the Community Needs Analysis and Service Profi le Project. We now await endorsement and adoption of the Report by the Department of Human Services. The fi nancial constraints caused by redevelopment programs during the period 2002-2005 are now behind us and we have There is no doubt this is the beginning of an important and worked extremely hard to achieve the current healthy fi nancial exciting decade! position in an acknowledged diffi cult economic climate. On a personal note I have continued my association with the ACHS The operating surplus of $599K is the consequence of refi ning as a Councillor and Board Member, the AHHA as a Councillor, and business effi ciencies while continuing to increase service serve on the Board of the VHIA. delivery in many clinical areas. The true test was in being awarded This provides West Wimmera Health Service with a voice in accreditation by the Australian Council of Healthcare Standards leading strategic and important healthcare sector authorities – in November 2008 for four years. This judgement showcased privileges I gratefully value. our Service and highlighted performance improvements and excellence of the quality of care we provide. Once again we have produced an Annual Report which comprehensively outlines who we are and how we work as an Success in fi nancial and clinical sectors can be diffi cult to organisation. maintain and this year West Wimmera Health Service excelled in both areas. We fi rmly believe that the excellence in our communication with communities, staff and the broad health industry is an integral Ensuring highly skilled staff were recruited and retained was part of service provision. certainly a prime concern and it is pleasing to report we conclude the year with an excellent array of clinical professionals in our An explanation of every component of our operations is provided workforce; this is a gratifying achievement! to give an understanding of how we can assist you as an individual and our collaborative population health approach for all the The calibre of such professionals is at an all time high and communities is a responsibility we must constantly remember provides a strong platform from which to develop further and actively initiate. innovative programs, particularly in the areas of community health and health promotion. We have emerged as a potential new leader in rural health care where our emergence as a primary care innovator has commenced The implementation of a ‘Back to Basics’ nursing education the journey. program mandates nursing staff members be educated on amendments to policies, new equipment and best practice This transformation has been earned through continued hard documentation and competencies. work, dedication and commitment of our Board Members and Staff, with every single role contributing to our success. This systematic approach to clinical education ensures each and every nurse at West Wimmera is well equipped to deliver all I look forward to the challenges and inevitably rewards that aspects of their professional roles. the Community Needs Analysis and Service Profi le Project recommendations will bring and trust that working together Increased Director of Nursing and Unit Manager involvement with all stakeholders West Wimmera Health Service will on Committees has had an obvious benefi t with enhanced continue to shine. integration between strategic policy and operational roles. The Community Needs Analysis and Service Profi le Project study has been unparalleled in comparison with anything West Wimmera Health Service has embarked upon since its inception. The Project incorporated community forums, stakeholder consultations, data collection, departmental interviews and a departmental policy review to consider and address the adequacy Mr John N. Smith PSM and range of the current clinical services provided and to develop Chief Executive Offi cer a 10 year Clinical Service Plan. Undertaken by external Consultants, the Project was managed by an Advisory Committee comprising West Wimmera PAGE RIGHT: John N. Smith PSM – Health Service Executives, Department of Human Service CEO, West Wimmera Health Service Representatives and a Community Representative. ANNUAL REPORT 2008/2009 9 10 WEST WIMMERA HEALTH SERVICE
THE YEAR IN REVIEW CHIEF EXECUTIVE OFFICER’S PERSPECTIVE
In this reporting period we have concentrated on long term growth and sustainability to guarantee that the healthcare actually needed by our stakeholders will be available to them for the next decade. The challenges we will face along the way will provide outstanding opportunities for West Wimmera Health Service to adapt to the changes required to achieve ‘a Health Service without peer’. ANNUAL REPORT 2008/2009 11
Minister For Health Visits Financial Performance Dr Kim Fielke – General One of the highlights of our year was the It is with pride our successful fi nancial Practitioner Anaesthetist visit by the Minister for Health Mr Daniel management strategies over consecutive Dr Kim Fielke has been credentialed as Andrews on Friday 27th March 2009. years were recognised by the Department a Visiting Medical Practitioner and has Minister Andrews visited the Nhill of Human Services with the ceasing commenced providing Anaesthetist Hospital to announce a $32,669 funding of Close Watch Financial Monitoring services at the Nhill Hospital. Program at the end of the 2007-08 boost for cardiac monitoring equipment Dr Fielke is an experienced General fi nancial year. and operating theatre trolleys through the Practitioner Anaesthetist based Department of Human Services Targeted The Department uses Close Watch to at Western District Health Service, Equipment Program. monitor Health Services considered to be Hamilton. It was a pleasure to showcase our facility at high risk for fi nancial performance. We are privileged to have gained this to Minister Andrews and he was glowing in Our Service had been on ‘Close Watch’ service to complement our comprehensive his praise for the Hospital and staff. for three years as a result of cash range of Visiting Medical Practitioners. fl ow diffi culties and the resulting Risk Management defi cit during the intensive building Executive Structure Revised Risk Management continues to be at the program incorporating Natimuk and forefront of business at the Service. Rainbow facilities. The Executive Structure relating to Clinical Divisions was reviewed, and it During the 2008-09 fi nancial year we have Our Risk Register captures all identifi ed was deemed that one Executive Director reported mandated fi nancial data to the risks, and relevant reports are presented for Clinical Services would be the Department of Human Services. to the Board and Operational Committees most effective structure. Previously for review and action. Annual Report 2008 Gold Award three Executive Directors covered the Internal Auditors, ‘Deloittes’ play Clinical Divisions. West Wimmera Health Service received an important role in verifi cation of The roles of Executive Director of Aged a Gold Award for its 2008 Annual appropriate risk controls through the Care, Executive Director of Acute Care Report. This is an outstanding result Internal Audit process. More than ever the and Executive Director of Community and for the organisation and places our Internal Auditors review items outside the Disability are effectively combined into reporting standards at the highest level traditional fi nancial systems, and in 2009 the new position of Executive Director of across Australasia. reviews have included Clinical Governance Clinical Services. and Occupational Health and Safety. The Annual Report is our fl agship The Senior Management structure of publication each year, outlining the Our diverse risk systems ensure that West the Clinical Division was also revised to high level of services we provide. It is Wimmera Health Service can manage risk encompass new appointments to assist confi rmation that the Service meets the in a proactive manner across all facets of the Executive Director of Clinical Services. the organisation. criteria of producing factual, open and honest reporting, promoting a better The new positions of Manager of Allied For further information on Risk public awareness of our activities. and Community Health and Clinical Management refer to page 17. Operations Manager reporting directly to Quality Of Care Report 2006-07 the Executive Director of Clinical Services Annual General Meeting High Commendation were created. The Annual General Meeting was held on West Wimmera Health Service was The changes in structure have been Friday 28th November 2008 at the Nhill presented with a ‘High Commendation’ extremely benefi cial with a more direct Sports Centre. award for the Quality of Care Report approach to specifi c aspects of Clinical An excellent audience of approximately 2006-07 at the Victorian Public and associated care. 250 people gathered to learn about the Healthcare Awards in the Small Rural progress and achievements of the Service Hospitals section. Capital & Equipment Grants 2008-09 and staff. The recognition of the high standard of The Guest Speaker, Mr. Khoa Do, Young this publication was greatly appreciated Funding Purpose Amount Australian of the Year 2005, was a as we continue to strive for excellence Annual Provision for Minor Works 15,000 captivating speaker with an important through the reporting media. Aged Care Annual Provision 30,000 message for the audience. Reports We await the result for the 2007- Jeparit Hospital Water Tanks 14,500 indicated that the audience was indeed 2008 Quality of Care Report due in Kaniva Hospital Nurse Call System 62,000 impressed and inspired with Khoa’s September 2009. Natimuk Air Conditioning 95,000 presentation. Kaniva Hospital Hot Water Units 28,726 Fire Safety Grant 120,000 Cardiac Monitoring System 32,460 Total $397,686.00
PAGE LEFT: Anaesthetist, Dr Kim Fielke preparing anaesthetic prior to surgery 12 WEST WIMMERA HEALTH SERVICE
THE YEAR IN REVIEW > CHIEF EXECUTIVE OFFICER’S PERSPECTIVE
Strategic Plan 2006/07 – HealthSMART Information New Motor Vehicle Fleet 2008/09 Technology Program Environmental impact and fuel effi ciency The current Strategic Plan 2006-07 to The implementation of HealthSMART were major considerations when 2008-09 expired at the end of June. ‘iSoft’ patient management software selecting the new vehicles throughout the system has occurred this year. reporting period. ‘Moving Ahead’, a Progress Report on the implementation of the Strategic Plan to The iSoft Patient and Client Management Expenses for the fl eet are a signifi cant 30th September 2008 was presented to software will replace IBA, the outdated cost. Investing in fuel effi cient vehicles the community at the November 2008 acute patient management system was a benefi t to the environment and also Annual General Meeting. currently in use. had a positive fi nancial impact. This public reporting was a fi rst for the ‘iSoft’ will provide a comprehensive Oliver’s ‘Kiosk’ Service outlining progress towards patient management and administration implementing and achieving the strategic system inclusive of inpatients, primary Oliver’s Kiosk at the Nhill Hospital objectives of the Board of Governance. health and administration data relating to was offi cially opened on Tuesday 31 aged care. March 2009. The strategic accomplishments over the period were substantial and the Service Training has been provided for all Operated by the supported employees and looks forward to implementing a new key users and we eagerly await staff of Oliver’s Café under the auspice Strategic Plan to maintain the momentum the introduction of the system in of Cooinda Disability Business Services, of our planned progress. August 2009. Oliver’s Kiosk offers light meals and beverages to visitors and staff of the Nhill Hospital. Support of the Kiosk has been ABOVE: At the Nhill Hospital, Shirley Avery astounding and customers are extremely helps Braden Taylor as he chooses his lunch from complimentary about the quality of the Oliver’s Kiosk, while his mother Lyn watches. food and friendly service. Barista, Graeme Ruse is busy at the very popular coffee machine. It has enhanced working opportunities for our supported employees and has added PAGE RIGHT: Exercise Physiologist, Tracey Bell to the ambience of the Hospital. (left) guides community member Sharon Bone (right) with her fi tness program. ANNUAL REPORT 2008/2009 13
WWHS Health and Fitness Centre West Wimmera Health Service commenced management of the Nhill Gymnasium on the 1st January 2009 – now known as the Health and Fitness Centre. Qualifi ed staff provide advice relating to the use of equipment and develop specialised individual fi tness programs. A wonderful opportunity to impact on the health and well being of the community. 14 WEST WIMMERA HEALTH SERVICE
THE YEAR IN REVIEW > CHIEF EXECUTIVE OFFICER’S PERSPECTIVE
Dental Therapist Tristar Medical Group Consultants were appointed to conduct the Project and an Advisory Committee The commencement of a Dental Therapist Tristar Medical Group continues to formed comprising a Board Member, at the Nhill Dental Clinic in February was provide West Wimmera Health Service Executive staff, Department of Human in accordance with our goal to expand with a full complement of Visiting Medical Services Central and Regional Offi ce Dental Services. General Practitioners. Representatives and a Community Under a brokerage arrangement with Our working relationship has continued Representative. Wimmera Health Care Group, the to strengthen with ‘Tristar’ and we are The project included consultation with Therapist provides dental services extremely thankful for its continued all major stakeholders including staff. every week to children aged 0 – 18 years commitment to the communities for which Community forums were conducted at all enhancing dental services available to we care. our catchment townships. children in our communities. In May 2009 the Advisory Committee An excellent outcome! Community Participation and Engagement approved the Final Report which outlined recommendations for future service Brokerage of Allied Health Community Needs Analysis & Service delivery, its contents then being adopted Services Profi le Project by the Board. The recruitment drive for Allied Health During 2008-09 West Wimmera Health The Report concluded that all current Professionals has been so successful that Service embarked upon a Community service provision was essential with, West Wimmera Health Service is in the Needs Analysis and Service Profi le additional services recommended. fortunate position to assist neighbouring Project. The purpose of the Project was We now await the Department of Human Health Services and Aged Care to review current service provision and Services fi nal approval of the Report Residential Facilities with the provision demand for services throughout the so we can commence implementing the of Allied Health Practitioners on a fee for Service catchment. service basis. Service Plan which will enhance our ability A Service Plan for a ten year period was to deliver the healthcare needs of our The developing network of Allied Health devised to lead the Service to meet catchment population. brokerage for speech pathology, podiatry, the needs of our patients, residents occupational therapy and dietetics and clients. ABOVE: Dental Therapist Christine Petersen enables the wider Wimmera region to discussing dental hygiene with Jayrell Sellens. benefi t from the highly skilled Allied Health Practitioners we employ. ANNUAL REPORT 2008/2009 15
Menu Revised The development of a new menu was undertaken by WWHS throughout 2008. During the trial process considerable feedback about the new menu was received. One area of concern was the particular ‘titles’ of menu selections and for residents in particular, the modern title was diffi cult in some circumstances to identify the ingredients. Catering staff organised a focus group to discuss this aspect, and as a consequence meal titles were altered to more accurately refl ect the content of the selected dish. New titles are based on identifying the key ingredients which further assist meal choice for preference, allergies and fl avours. The feedback was extremely valuable and the clear and simplifi ed meal titles ensure patients and residents are now fully informed.
Some Highlights from Our Vast Compliments … ‘I cannot think of praise high enough in words for these people, - highly professional, caring, Community Advisory Committees Equity Trustees Not For Profi t compassionate, thorough, serving, All communities of our Service have active CEO of the Year Award diligent, peaceful – I am really Community Advisory Committees in place. I was honoured to be one of fi ve fi nalists overwhelmed by the excellence of Reporting to the Board, Community for the 2008 Equity Trustees ‘CEO of the your staff.’ Advisory Committees provide a direct Year Award’ presented at a ceremony at line of communication from community the Arts Centre in Melbourne on Thursday ‘Our heartfelt thanks to you all for members and consumers. 30th October 2008. your care, kindness and patience A successful recruiting campaign It was humbling to be recognised in a shown to our mother’ for additional Community Advisory National Award with top class Chief Executive Offi cers from many excellent Committee members during the year ‘We certainly picked the right bolstered numbers. ‘Not for Profi t’ organisations. Being nominated is a credit to West Wimmera hospital, you come highly Community Advisory Committees Health Service and showcases the play an important role in informing the recommended!’ excellent work we do. Board about community concerns and Conclusion perceptions of the Service, as well as Commendations & Advice highlighting the excellent achievements We will continue to steer West Wimmera the Service has made. Feedback either in the form of Health Service on a direct course to compliments or complaints is a vital Conversely, members of the Advisory achieve our Vision and Mission to practise component in delivering quality services. Committees are crucial to our impeccable governance, manage our When consumers express their gratitude communication strategy and assist in fi nances prudently and recruit highly with a compliment, staff involved can be informing the broader community about skilled, qualifi ed and compassionate staff. praised by their peers and their exceptional what is happening within the Service. These remain our enduring goals. work acknowledged. Equally a complaint or constructive feedback assists us to identify areas of service that may require ABOVE: Audrey Gregory, resident of Archie Gray Nursing Home, Kaniva, and Div 1 Nurse modifi cation or, staff who may require Helen Ryan enjoy a chat without disturbing further education to ensure high standards Ruby the Cat. of healthcare delivery continues. 16 WEST WIMMERA HEALTH SERVICE
INDUSTRIAL RELATIONS AND HUMAN RESOURCES WELL MANAGED
The fundamental role of Industrial Relations and Human Resource Management is to successfully guide and support the workforce in a collaborative manner and in so doing increase productivity, position satisfaction and retain a highly skilled and knowledgeable workforce.
A major and necessary attribute of the these functions is to provide advice to the Chief Executive Offi cer on key aspects associated with essential good governance. To ensure compliance with changes to workforce legislation and the Federal Government’s new ‘Fair Work Australia’ Policy, which will come into force on 1st July 2009, regular random audits have been conducted on employment and payroll practices. Evidence reveals the Service is meeting its legal obligations. The Australian Industrial Commission handed down its decision in relation to the Allied Health Professionals claim which resulted in a signifi cant pay increase awarded to this group of employees. People Matter Survey 2008 When comparing 2006 with the 2008 Unfortunately the decision did nothing fi gures it is pleasing to note that the The Service participates on a voluntary tangible to assist Small Rural Health increase in staff satisfaction ranges basis in the People Matter Survey Services attract and retain keenly sought from 7% to 26% over 39 indicators in the conducted by the State Services after Allied Health Professionals. values section of the survey. Authority. This survey measures Predictions surrounding a robust round of staff satisfaction and organisational Importantly we record the Human Enterprise Bargaining for non nursing and compliance in relation to Public Sector Resources Governance Plan has placed a support staff did not eventuate largely Values and Employment Principles. The high priority on continuous improvement due to the State Government changing values measured are responsiveness, with Executive Directors required to its wages policy with the Union having to integrity, impartiality, accountability, report to the Chief Executive Offi cer react quickly to ‘lock in’ a more generous respect, leadership and human rights. improvements gained across the Service. outcome. The purpose of the People Matter Training programs addressing Bullying The engagement of staff in change Survey is to track improvements in staff and Harassment in the Workplace were management practices has resulted in satisfaction over time and West Wimmera well attended and we will concentrate in a number of innovative and sustainable has recorded signifi cant improvements the coming year on employee assessment changes across the service in the way we over a very short period. and professional development deliver Cleaning and Catering services. training to eradicate exposure to such undesirable behaviour. These changes have resulted in better People Matter Survey outcomes for all concerned. As we struggle in this economic period of Like fi nancial instability and new employment During the year a Human Resource WWHS WWHS Orgs laws, it will be important to build on Governance Plan was developed which 2008 2006 2008 the successes of the past and meet the will be adapted to address the Service Merit 84% 64% 83% challenges of the future which these Strategic Plan. Choosing people for the unpredictable times may bring. right reasons I am proud to emphasise we lost no Reasonable avenues 77 % 51% 77% time due to industrial disputes and our of redress relationship with our staff is excellent. Resolving issues fairly ABOVE: John N. Smith PSM – CEO with Executive Equal employment 94 % 87 % 94% Benchmarking with other Rural Health Director of Finance and Administration Ritchie Services continues to become a high opportunity Dodds who deputises in the CEO’s absence. priority in order to be recognised as Providing a fair go for all PAGE RIGHT: Darren Welsh, Manager Quality an employer of choice to ensure ‘best Fair and reasonable 79% 63% 81% & Safety, with Personal Care Worker Donna practice’ ideals are observed. treatment Respecting and balancing Watson, discussing mandatory education requirements. people’s needs ANNUAL REPORT 2008/2009 17
MANAGEMENT OF RISK NOT A RISKY BUSINESS?
Risks are carefully reviewed by Executive Directors. Actions to minimise or eliminate risk are formulated and put into practise. Results are reported to the Performance Review Committee and the Board monthly. Through these processes the Service has been able to ensure there are no Very High or Extreme risks currently recorded within the Service. Risks are revealed through the Incident Reports. Incidents are documented and reported through a computerised incident reporting database (RiskMan), utilised by staff in all locations. The Risk Register is progressively refi ned to concentrate on organisation wide risks and to closely integrate it with the Incident Reporting system.
Attestation The following attestation bears out the commitment of this Service to appropriate management of our risks. Attestation on Compliance with Australian/New Zealand Risk As a health care organisation, it is our Management Standard 4360:2004 West Wimmera Health Service has responsibility to identify risks step I, John Norman Smith certify that adopted a proactive approach in by step, measure their impact and West Wimmera Health Service has managing its risks which includes manage them. risk management processes in place all facilities and all types of service Risks take many forms; they can be consistent with the Australian/New provision and activities. associated with the long distances Zealand Risk Management Standard AS/ The Risk Management Framework our allied health staff travel to NZS 436:0 2004 and an internal control includes procedures and practices to attend patients in outlying areas, our system is in place that enables the support the Risk Management Policy. maintenance staff working in confi ned executives to understand, manage and This framework is designed to protect and spaces or our nurses administering satisfactorily control risk exposures. The enhance Service resources and support medications to patients. Audit Committee verifi es this assurance the achievement of Service objectives. Risk is managed from the Board through to and that the risk profi le of West Wimmera Health Service has been critically The Framework emphasises that the fl oor level of our operations. The Audit reviewed within the last 12 months. risk management is integral to the Committee provides the over-arching management process and is based on the leadership and has the responsibility for following principles: risk governance. > It is the responsibility of all executives, The Board and its Committees monitor managers and employees, integrated and examine the risks of the organisation into all Service activities and to ensure patients, staff, community systems, and based on the Australia/ and resources, human and material New Zealand Standard for Risk are protected. Management (AS/NZS 4360:2004). A Risk Register is maintained and is John N. Smith PSM Chief Executive Offi cer > Risk management is a part of everyday readily accessible to staff through the work practice for the staff of West Service Intranet. They are encouraged to Nhill Wimmera Health Service. notify risks, contribute to the solutions 10 September 2009 > Risks may present in the clinical, and actions that minimise risks. non clinical, community and Incidents are also rated according to volunteering areas of our organisation. severity, from immaterial to extreme, and placed in the Risk Register. 18 WEST WIMMERA HEALTH SERVICE
EDUCATION DEVELOPING OUR FUTURE
To effectively care for our diverse communities it is Our ‘Virtual’ Future – Online Learning crucial all staff have the necessary skills to meet the The big change in education has been the move to online computer complex demands placed upon them in a safe, effi cient, based learning, known as e3 Learning, a move enthusiastically reliable and effective manner. embraced by staff. Our key to achieving this outcome is to establish and The e3 Learning opportunity is facilitated by the Department of Human Services with education modules developed jointly maintain a highly educated workforce, with the ability between the Grampians and Loddon Mallee Regions of the to respond to the changing needs of consumers. Department. There is no fee associated with its use and a Certifi cate is issued to the participant upon successful completion of each e3 Learning course. Modules addressing Medication Management and Fire and Education – Within Our Service Emergency Training are expected to be available in December 2009. This year, 315 internal education sessions occurred focusing on clinical care and skills, addressing practical aspects such as fi re The Clinicians Health Channel, also facilitated by the Department, safety, technology and management, with 2,410 attendees – is another online opportunity for education, research and averaging 5 education sessions per staff member. reputable clinical information.
Education Further Afi eld E3 Learning 2009 External education has been well addressed, with 156 sessions 15 attended by 309 staff. Opportunities have included conferences, workshops and short courses providing up-to-date knowledge. 12 We are committed to encouraging and supporting staff in pursuit of further education by making Bursaries available for Tertiary 9 Study, paying Travel and Accommodation expenses for external Seminars, and providing paid leave for courses of study and 6 attendance at conferences. Basic Life Support Manual Handling 3 Elder Abuse
Education Addressing Patient Safety by month E3 Learning Participants Office Ergonomics The delivery of safe patient care is an undoubted imperative. To IV Cannulation 0 achieve this goal staff are required to undertake annual training Jan Feb Mar Apr May Jun in a number of key programs. Commentary: Our staff have contiunued to embrace online (computer) learning since its offi cial Our goal is to reach 100% compliance, an outcome which must launch in January 2009. Over 190 individual education sessions have been completed. 85 be achieved. different staff have used this new system and we expect this number to gradually increase in the next 12 months as staff become more aware of its availability. Each workplace has a number of Compliance with Mandatory Education computers available for staff to use. The education is also available for use from home via the internet. A Certifi cate of Achievement is awarded upon completion of the course and in addition this information is recorded in their personnel fi le. Education Element 2008/09 2007/08 2006/07 2005/06 2004/05 Bullying and 97% 98% 98% 70% 24% Sexual Harassment Chemical Handling 99% 95% 100% 86% 50% Total Videoconference Usage by Numbers Fire and 97% 98% 99% 98% 92% and Duration Emergency Training Food Handling 99% 95% 97% 92% 68% 500 Incident Reporting 98% 95% 97% 78% 29% 400 Infection Control 97% 97% 95% 81% 36% 300 Manual Handling 96% 93% 97% 93% 81% No Lift 95% 95% 94% 70% 66% Hours 200 Privacy and 98% 99% 94% 90% 77% 100 Confi dentiality 0 Resuscitation: 96% 94% 98% 89% 70% 2007/08 2008/09 Basic CPR Total Durations (hours) Resuscitation: 96% 90% 99% 92% 88% Number of Conferences Basic Life Support A high percentage of staff met the mandatory education requirements - an indication that education is more readily accessible and sought. ANNUAL REPORT 2008/2009 19
Videoconferencing Educational opportunities are expanding with the increased use of videoconferencing at all sites, removing the tyranny of distance. Videoconferencing uses audio and video communication to bring people together for meeting and education purposes. This can be as simple as a discussion between two people or involve several sites with more than one person at each site. Videoconferencing can also be used to share documents and computer presentations. Face to face education is able to be undertaken where participants are great distances apart. Clinical staff meet weekly in this way to Counsellor Sybil Braybrook consults with clients plan patient care through multi-disciplinary meetings. via the Clinical Videoconferencing unit, Medilink. 20 WEST WIMMERA HEALTH SERVICE
Directors of Nursing & Unit Managers assemble prior to their monthly meeting. (L-R) Megan Webster, DON Jeparit, Angela Walker DON Natimuk, Lesley Hawker DON Kaniva, EMPLOYEES Christine Dufty Unit Manager Nhill Acute, Carol Paech DON Rainbow, Katrina Fraser Unit Manager Goroke. THE HEART AND SOUL OF OUR SERVICE Absent: Dianne McDonald Unit Manager Iona Nhill
In this era of high demand in the Long & Loyal Service – Staff Service Awards 2009 public and private sectors for workers in critical areas such Certifi cates and Badges will be presented at the Annual General Meeting to staff who have served this Service with loyalty as health care, information and commitment over an extended period. We recognise their value to our Service and our patients. technology, engineering and 35 Years of Service 20 Years of Service 15 Years of Service 10 Years of Service accounting and the necessity to retain skilled workers we have Pauline Colbert Shirley Ashfi eld Karen Alexander Kelvin Asplin Brian Jones Kaye Borgelt Lisa Braybrook Rebecca Bastin Sally Kruger applied a twofold approach 30 Years of Service Pamela Clark Gillian Burgess Pauline Breen Douglas Matheson to workforce planning using Roger Batchelor Caroline Fischer Pamela Burgess Toni Casey Kevin Merton aggressive recruitment and Denise Jensz Lorretta Fuller Richard Lane Shirley Crick Janet Shurdington innovative retention strategies Dianne Green Julie Leddin Michelle Dickinson Hilma Summerhayes Rodney Greenaway Cheryl Lowe Mary Graetz Glenis Tink to maintain experienced and 25 Years of Service Kerri Lynch Sharyn Morrison Janet Heenan Elizabeth Witmitz highly motivated employees. Janet Fisher Lisa Newcombe Sharelle Newcombe Brenda M Jackson Maureen Wright John Martion Lee-Ann Pumpa Deborah Schilling Megan Smith Fiona Weir Desiree Williams ANNUAL REPORT 2008/2009 21
WWHS STAFF 2008–2009
Chief Executive Anthony Breavington Christina Farinha Jessica Jackson Joanne McCartney Courtney Preston Philip Soumya Offi cer Pauline Breen Kaylene Featherstone Phillip Jackson Mathew McCartney Rhonda Preston Shirley Sproule Samantha Briggs Carmel Feder Helan Jacob Nichole McCartney Pamela Price Sreekanth Sreekumar John Smith Shelley Brown Penelope Finch Tracey Jarred Helen McClure Rosemary Pritchett Christine Stanford Executive Director Amanda Brownsea Anne-Marie Fischer Margaret Jarvis Maree McClure Lee-Anne Pumpa Casey Stasinowsky Finance & Donna Burns Caroline Fischer Swarnamalie Pauline McCracken Kelly Purcell Amanda Stephan Administration Helen Burns Janine Fischer Jayakody-Arachige Tanya McCracken Donna Purchase Yvonne Stephan Ritchie Dodds Glenda Bush Chantelle Fisher Denise Jensz Dianne McDonald Nicola Quy Jacqueline Stevenson Jayne Campbell Loretta Fisher Nakita Jewell Jennifer McDonald Patricia Rabone Elaine Stewart Executive Director Helen Cannell Erin Fisher Janis John Merlyn McFarlane Jaylath Ralalage Denise Stimson Clinical Services Mark Carracher Wendy Flavel Cheryl Johnson Bianca McGennisken Denise Ralph Debra Stonehouse Janet Fisher Taryn Carter Geoffrey Fletcher Deborah Johnston Michelle McGennisken Jennifer Rentsch Hilma Summerhayes Executive Director Toni Casey Jane Ford Bianca Jones Stephanie McIntosh Joylene Rich Susan Szejnoga Corporate & Quality Deborah Chaston Katrina Fraser Brian Jones Catherine McKenzie Claire Riches Darren Taylor Services Patricia Chequer Margaret Frew Kevin Jones Lynne McKenzie Graeme Ridgwell Sindi Taylor Erol Chilton Tyrone Friebel Norman Jones Sheryl McKenzie Judith Ridgwell Sue Taylor Kaye Borgelt Peter Chilton Lorretta Fuller Sonia Jones Julie McLean Christine Ridgwell Val Terry Executive Director Anne Christian Deborah Funcke Valmai Jones Lynette McLean Joshua Rintoule Ann Thomas Medical Services Janine Clark Shirley Galpin Yvonne Jones Bonnie McLeod Allira Roberts Vicki Thomas Pamela Clark Sharon Garwood Tesmy Jose Peter McNelly Brenda Robinson Judith Thomson Dr Ian Graham Robyn Clark Carol Gebert Deborah Kakoschke Jane McPhee Kaye Robinson Penelope Thurlow Executive Director Janice Clugston Darren Gebert Martha Karagiannis Casey Mellington Lesley Robinson Karen Tilley Industrial Relations Pamela Coates Kylie Gebert Judith Keller Lisa Mellington Natalie Robinson Glenis Tink & Human Resource Pauline Colbert Lipy George Marilyn Keller Ann Merrett Wendy Robson Kristy Tink Management Alexi Conboy Gwenda Gilpin Rowena Keller Maree Merrett Lara Rogers Jessie Toose Kellie Conboy Leanne Glasgow Veronica Keller Michelle Merrett Joylene Rohde Maritess Toquero Leslie Butler Alison Connell Tanya Golder Kim Kendrick Tracey Merrett Tanya Roll Margaret Trenery Operations Charles Cook Kent Goldsworthy Karen Kennedy Erin Merton Valerie Roll Julie Tyerman Manager Helene Cook Tennille Gould Kathryn Kennedy Kevin Merton Rosemarie Rose Bronwyn Usher Melanie Albrecht Helisa Cook Teresa Gould Catherine Kent Neville Michael Helen Ross Adele Vincent Jennifer Cook Stacey Grace Amanda King Pamela Michael Teresa Ross Melanie Wagg Executive Assistant Kerryn Cook Mary Graetz Mary King CaraJane Millar Anna Rowe Robyn Wagg Katrina Pilgrim Sharyn Cook Leonie Graham Sherin King Lisa Miller Denise Rowe Angela Walker Jacqueline Cooper Melinda Graham Kayleen Kingwill Sandra Rosemary Rudd Susan Walker Sarah Coughlan Ashley Grant Linda Knight Millward-Coyne Graeme Ruse Helen Wallis Roy Abbott Annie Coustley Beverley Grant Fiona Krelle Rachel Milte Helen Ryan Krystal Wallis Lucy Adamson Judith Coutts Lawrence Grayling Margaret Krelle Breanna Moar Laurence Ryan Leanne Wallis Elaine Aitken Malcolm Coutts Dianne Green Sally Kruger Cassandra Moar Lynette Ryan Rosalie Wallis Jillian Albrecht Kerry Coyne Allan Greenaway Elsamma Kuriakose Trudi Moar Melissa Ryan Stacey Wallis-Rabone Clifford Alexander Marianne Cramer Helen Greig Gladys Kyle Samantha Moloney Tania Ryan Donna Watson Ian Alexander Shirley Crick Jennifer Greig Elizabeth Lacey Erin Moorhead Patricia Sagasser Julie Watson Karen Alexander Anthony Croke Sarah Greig Richard Lane Tracey Morphett Sharyn Salt Karen Webb Raelene Alexander Carolyn Croke Beverly Hage Lynne Launer Sharyn Morrison Debra Sanders Lindy Webb Judy Allen Maria Cuciniello Krystal Hall Kristine Laverty Sandra Muller Sharon Sanderson Valerie Webb Gary Allison Deborah Cunningham Yvonne Hall Julie Leddin Chloe Mulraney Richard Sartori Elaine Webster Wendy Altmann Janine Dahlenburg Anne Hamilton Barbara Leffl er Samara Munn Patricia Saul Kerrie Webster Glenda Aristides Tani Dahlenburg Cynthia Harberger Ingvar Lidman Jacqueline Nash Kathryn Saxton Megan Webster Patricia Arnold Jisha David Janine Harberger Katrina Lloyd Lisa Newcombe Judith Schier Hannah Wedding Shirley Ashfi eld Robert Davies Judith Harrington Sally Lockwood Sharelle Newcombe Deborah Schilling Christopher Weir Kelvin Asplin Christine Dawson Belinda Hartigan Jessica Lovel Candice Newton Sarah Schnaars Fiona Weir Angela Atta Sandra Decker Lesley Hawker Bree Amber Lowe Courtney Newton Nicole Schneider Kristen Weir Marlene Austin Andrea Deckert Christina Hayden Bree Camille Lowe Pamela Newton Robert Schneider Katrina Welch Shirley Avery Christine Deckert Yingying He Cheryl Lowe Erika Niemann Shirley Schorback Mary Welch Leah Bailey Kelvin Deckert Christopher Hedt Darren Lyall Carole Nitschke Rebecca Schultz Annmaree Wells Zoe Ballentine Susanne Dedio Janet Heenan Patricia Lyall Megan Nossack Denise Schulz Darren Welsh Merrilyn Bamford Kellie Dickerson Amanda Heinrich Kerri Lynch Kylie Oakley Wendy Schulze Linda White May Barber Michelle Dickinson Marie Heinrich Lynne Lynch Leanne O’Connor Debra Schumann Cheryl Williams Michelle Barber Aimee Disher Trisha-Anne Heinrich Megan Mackenzie Linda O’Heaney Nicole Schumann Desiree Williams Kaye Baron Shenae Dixon Michael Henderson Patricia Mackenzie Polly O’Heaney Susan Scobie Wendy Wills Ian Barry Kim Dodson Samantha Hendy Dianne Maddern Luke Oldaker Ellen Scott Elinor Wilson Sharon Bartholomew Christine Dufty Craig Henley Lyn Maddern Brenda O’Leary Theresa Scott Nicol Wilson Karen Barton Jennifer Dufty Merrin Hennessy Marion Major Jayne Oliver Diane Seeney Elizabeth Witmitz Rebecca Bastin Sherrie Dumesny Debra Hill Sharon Marais Carol Paech Michelle Sheahan Lauren Witmitz Roger Batchelor Julie Dunford Sandra Hinch Brooke Marra Rhianna Paech Karen Sherlock Norelle Witmitz Heather Batson Lynette Dunford Casey Hiscock Julie Marra Reginald Parsons Kerryn Shrive Julie Woolcock Narrelle Batson Timothy Dunmill Terri-Ann Hogart Katie Martin Catherine Patching Janet Shurdington Julie Worsley Sean Bayzand Kerryn Dyer Jodie Holmes Fay Martion Nerida Patterson Karen Shurdington Elisa Wotherspoon Clint Beattie Danielle Eastick Shirley Honeyman John Martion Peter Pearce Belinda Silinger Maureen Wright Kellie Beattie Michelle Eldridge Charmaine Hovey Harsha Mary-Antony Elizabeth Pfeiffer Joyce Sipthorpe Martin Yau Susanne Beattie Melissa Elliott Beverley Howarth Melissa Mason Beverly Phillips Wendy Sleep Mary Zadow Tracey Bell Geraldine Ellis Elaine Humphrey Douglas Matheson Heather Pinyon Susan Sluggett Rhonda Zivkovic Julie Bloomfi eld Sheryl Ellis Karen Hunter Robyn Matheson Bobbie Pitt Dean Smith Christine Zubrinich Rhys Boehm Kaye Emmett Kathleen Hutson Leah Matthews Christie Pitt Flores Smith Cindy Bone Kevin Emmett Janice Hutton-Croser Seona Maybery Karen Pitt Janet Smith Mathew Bone Wendy Essex Sarai Innes Gaile Mayne Loata Pitt Judith Smith David Brasier Allison Etherton Brenda Joy Jackson Scott McCallum Sandra Pollock Keryn Smith Lisa Braybrook Vicki Etherton Brenda Mary Jackson Andrea McCartney Rebecca Leanne Smith Sybil Braybrook Kerry Exell Diane Jackson Dale McCartney Powell-Hodges Stephanie Smith 22 WEST WIMMERA HEALTH SERVICE
OUR YEAR A STATISTICAL SUMMARY
Acute & Sub-Acute – 2 Year Comparison Allied and Community Health – Non Admitted Patient Occasions of Service 2008/09 2007/08 Patients Treated 1,879 1,902 Total Total Occupied Bed Days (Total) 10,757 11,052 Occasions of Service 2008/09 2007/08 Acute Bed Days 8,601 8,366 Diabetes Education 862 779 Nursing Home Type Bed Days 1,614 1,669 Dietetics 2,245 2,778 GEM Bed Days 542 1,017 Massage Therapy 1,429 963 Percentage Occupancy (Acute) 71.9% 73.7% Exercise Physiology 836 1,222 Acute Average Length of Stay (Days) 4.68 4.58 Occupational Therapy 3,941 3,649 Births 0 0 Podiatry 4,415 4,162 Procedures 615 638 Physiotherapy 3,053 2,647 DVA NHT Bed Days 334 447 Speech Pathology 514 1,029 DVA GEM Bed Days 60 143 Counselling / Welfare 2,003 1,840 Average DRG Weight 0.8318 0.8036 Shared Care Midwifery Clinic 95 N/A Non DVA WIES 1,379.84 1,384 Dental 1,643 1,316 DVA WIES 183.16 144.70 Primary Care Casualty (Emergency+Other) 3,601 3,752 TAC WIES 0.76 4.21 Visiting Surgeons 1,763 1,587 Renal WIES 18.03 14.69 Radiology 2,052 1,841 Public WIES 1,003.19 1,026.49 Total Occasions of Service 28,452 27,565 Private WIES 374.05 344.88 Transport 5,217 5,094 Decrease in occupied bed days is a direct result of community health promotion and preventative care activities. Pending appointment of a Geriatrician will increase the effi ciency and utilisation of the Meals on Wheels 13,487 14,738 GEM Program. Meals to Day Centre 4,948 4,921 Meals to Senior Citizens 295 270 Residential Aged Care – 2 Year Comparison Total External Services 23,947 25,023 HACC Funded Occasions of Service 2008/09 2007/08 2006/07 District Nursing 7,796 7,428 Nursing Home Bed Days 27784 27,883 27,735 Day Centre 5,824 5,414 Hostel Bed Days 15529 15,234 14,819 Community Health 614 574 Nursing Home Discharges 34 36 36 Hostel Discharges 34 24 38 Total HACC 14,234 13,416 Percentage Occupancy Nursing Home 98.9% 98.94% 99.00% Total All Services 66,633 66,004 Percentage Occupancy Hostel 92.5% 90.48% 87.10% HACC Funded Activity Hours
Occupancy rates in the Nursing Homes were excellent and similar to levels achieved last year. Hostel District Nursing 5,305 5,485 occupancy rates improved 2% on the previous year. Day Centre 31,979 29,764 NB: Jeparit Hostel bed days in previous years have been counted into Nursing Home Bed days due to the Community Health 417 380 facility having one RACS number. Bed days for Jeparit Hostel have now been counted into Hostel days, with fi gures altered from previous years accordingly. Total 37,701 35,629 Jeparit Hostel bed days: 2006/07 - 1792; 2007/08 - 1856; 2008/09 - 1825 Total increase in services is the result of an increased emphasis on preventative and health promotion programs combined with the appointment of additional primary and community health care practitioners
Attestation on Data Accuracy I, John Norman Smith certify that West Wimmera Health Service has put in place appropriate internal controls and processes to ensure that the Department of Human Services is provided with data that refl ects actual performance. West Wimmera Health Service has critically reviewed these controls and processes during the year.
John N. Smith PSM Chief Executive Offi cer 25 August 2009 ANNUAL REPORT 2008/2009 23
Patients Transferred From and Within Acute Admissions by Postcode Residential Aged Care Bed Days West Wimmera Health Service by Facility
Suburb Number %
Transfer Destination Number % Nhill 992 52.8% Site Total Bed Days Kaniva 221 11.8% Wimmera Health Care Group 77 65.3% Rainbow 198 10.5% Iona Digby Harris Home 9321 Ballarat Health Services 3 2.5% Jeparit 139 7.4% Kaniva Nursing Home 3933 Kaniva Hospital 8 6.8% Horsham 65 3.5% Kaniva Hostel 2595 St. John of God Ballarat 5 4.2% South Australia 54 2.9% Jeparit & District Nursing Home 3604 Western District Health Service 2 1.7% Goroke 50 2.7% Jeparit Hostel 1825 Jeparit Hospital 8 6.8% Dimboola 45 2.4% Rainbow Nursing Home 3649 Nhill Hospital 4 3.4% Ararat 17 0.9% Rainbow Hostel 3645 Rainbow Hospital 6 5.1% Warracknabeal 16 0.9% Natimuk Nursing Home 7277 Royal Adelaide Hospital 1 0.8% Serviceton 15 0.8% Allan W. Lockwood Special Care Hostel 3914 Royal Melbourne Hospital 2 1.7% Others 67 3.6% Trescowthick House Hostel 3550 Northern Hospital Epping 1 0.8% Total 1879 100% Wakefield Private Hospital Adelaide 1 0.8% Total 118 100% Occupancy levels for our residential aged care facilities remained 85% or 1600 admissions were from communities where we have buoyant throughout the year with all locations achieving levels a physical presence with more postcodes represented this year satisfactorily close to their annual targets. With the exception of 118 (6.28%) patients were transferred from WWHS acute indicating a wider area of demand for our acute services. Kaniva Hostel, each facility recorded occupancy levels above 97% hospitals to other hospitals, slightly less than in the previous year with Jeparit Hostel, Rainbow Hostel and Rainbow Nursing home all when 6.94% of patients were transferred. 65% of patients were attaining the maximum possible outcome. transferred to Wimmera Healthcare Group, the nearest Base Hospital with both Intensive Care and Coronary Care beds. WWHS – Income by Program WWHS – Expenditure by Category 2008/09 2007/08 West Wimmera Health Service - Acute Care 11,634 10,791 Total Occupied Bed Days 2008/09 2007/08 Residential Aged Care 9,495 9,345 Category $000’s $000’s Ambulatory Care 1,800 1,805 Number of Days Employee Entitlements 18,671 18,412 Primary Health 2,184 2,022 Program 2008/09 2007/08 Fee for Service 869 868 Business Units 258 270 Acute Inpatient 8,601 8366 Corporate 1,843 1,915 Capital Income 758 1,030 GEM 542 1017 Other 1,967 1,711 Donations & Bequests 254 1,206 NHT 1,614 1669 Fuel, Light and Power 560 727 Other 1,308 1,691 Nursing Home 27784 27,883 Supplies 2,224 1,882 Total 27,691 28,160 Hostel 15529 15,234 Depreciation 1,132 1,172 Total 54,070 54,169 Total 27,266 26,687
60,000 50,000 40,000 30,000 20,000 10,000 0 NHT GEM
Acute Program % Hostel TOTAL Home Nursing Inpatient Acute Care 39 Category % Residential Aged Care 33 2008/09 2007/08 Ambulatory Care 6 Employee Entitlements 70 Primary Health 7 Fee for Service 3 In 2008/09 the majority of care provided within our organisation Business Units 1 Corporate 7 Capital Type Income 4 was in residential aged care, both nursing home and hostel. The Other 6 Donations & Bequests 4 Fuel, Light and Power 3 number of bed days across each different program remained Other 6 Supplies 7 similar to that of the previous year. Depreciation 4
Acute Care income received predominantly from the Department The bulk of our expenditure was again made up of Employee of Human Services continued to represent the largest single Entitlements at 69%, unchanged from last year highlighting the income category increasing from 38% of total income last year importance of ongoing strong and effective human resource to 41% in 2008/2009. Combined with Residential Aged Care management. Supplies and Consumables and Corporate costs income (primarily sourced from the Australian Government) these formed most of the remaining expenditure. two items comprise some three quarters of total Service income. 24 WEST WIMMERA HEALTH SERVICE
COMMUNITY AND FUNDRAISING WE DEPEND ON YOU!
Fundraising is an ongoing commitment to raise funds to support the continual upgrading of facilities and equipment for our Service. The generosity shown by donors in such hard times has been overwhelming and we are extremely grateful for the magnifi cent support we have received from our Communities, Benefactors, Sponsors, Businesses, Individuals, Bequests and Philanthropic Trusts.
Fundraising for the Capital Appeal has Murray To Moyne Cycle Public Recognition been continuing steadily throughout Relay 2009 Volunteers associated with the Nhill 2008/09, with the total appeal funds to Drought Resource Centre, were proud date totalling $2.044 million. This year the Murray to Moyne Team did it tough with a head wind and rainy to be nominated as fi nalists in the Pride Golf Day Fundraiser conditions. They did however excel and of Australia Medal Victorian Section managed to ride 520 km in 17 hrs 40 mins. in recognition of the extraordinary In October 2008 the Service hosted the commitment to their community. inaugural 4 Person Ambrose Event at the The team had a wonderful support crew as The fi nalists were Mrs Sue Krelle, Nhill Golf Club. well as many local sponsors. Ms Shona Hoffrichter, Mrs Helen Their efforts raised $600.00 for our The day was well attended with 10 teams Schwarz and Mr Carl Krelle. This is Service. competing in the event undeterred by the a wonderful achievement for our hot windy conditions. volunteers to be recognised at such a Biggest Morning Tea The lucky winners were awarded prizes high level! Congratulations. kindly donated by a number of local ‘Iona’s’ Biggest Morning Tea organised by businesses. The day raised $2,270.00. the Activities Co-ordinator was enjoyed Ladies Auxiliaries by residents, family, community members A special mention must be made of the and staff. Festive Theme Day Ladies Auxiliaries across our facilities The annual Christmas Festive Theme Day A gold coin donation raised $240.00 for who are a tireless band raising funds incorporated all sites with a number of cancer research. for special items of equipment and who schools and businesses participating. support the Service in many ways. Sale of Chocolates And Books St Patrick’s School children dressed in Ladies Auxiliaries and Friends & festive clothing and collected donations This activity continues to be an ongoing Relatives Groups support Cooinda, as they entertained ‘Iona’ Residents with fundraising effort, contributing $4050.00 Nhill Hospital, Kaniva Hospital, Jeparit Christmas Carols. to our funds throughout the reporting Hospital, Rainbow Hospital, Goroke period. Residential and Aged Care Facilities, A fun day was had by all raising $582.00 and have fi nanced important equipment for the Nhill Hospital Redevelopment. Valuable Volunteers for our Service including large screen televisions, activity books, resident The Service has in excess of 40 dedicated Art Show Fundraiser mobile lounge chairs, plants and garden community volunteers who commit their materials, crockery, sporting uniforms, 2009 began with the planning of an time and expertise to all areas of our medical equipment and recreational exciting new event inspired by local artist organisation. Naomi Zanker. structures. Volunteers actively participate in Thank you sincerely for your continuing Naomi hosted her fi rst solo exhibition providing patient transport, garden wonderful work! ‘Floral Fusion’ at Radmac Gallery in landscaping, music and entertainment, Ballarat with a percentage of sales of craft activities, meal delivery, pet therapy, paintings and raffl e tickets donated to the walking school bus, exercise activities and Appeal. shopping support. The Exhibition was a huge success with the The Service is blessed to have a large base Service receiving $1,955.00. of volunteers who are instrumental in An excellent outcome and contribution – assisting with the provision of our various thank you. services. It is impossible to personally thank every volunteer but their individual Kate Kennedy, Capital Campaign contributions, commitment and dedication Coordinator preparing for the to the Service is greatly appreciated. next fundraising initiative. ANNUAL REPORT 2008/2009 25 26 WEST WIMMERA HEALTH SERVICE
COMMUNITY AND FUNDRAISING > WE DEPEND ON YOU!
ECG Fundraising
Div 2 Nurse Judy Ridgwell has been a tremendous driving force behind a number of fundraising activities with the express purpose of raising funds for a much needed new Electrocardiograph machine. Many staff and community members supported raffl es, a Melbourne Cup Day event and a walkathon which was a huge undertaking, walking from Netherby to Nhill – 32 kilometres. These efforts have contributed $6,671.55 towards the new electrocardiograph unit for Nhill Hospital. What a magnifi cent commitment.
Div 2 Nurse Judy Ridgwell campaigned vigorously to raise funds for the purchase of a new ECG Machine for the Service. Nhill Hospital patient Keith Dickinson is pictured with Judy reaping the benefi ts of the new purchase. ANNUAL REPORT 2008/2009 27
Volunteers Volunteer Groups Donations and Bequests
Trevor Atwell Judith Lawson Apex Donor Total Graham Belgrave Darryl Lewis CFA Collier Custodian Co. 50,000 Jacqueline Belgrave Mariel Macalinao Community Advisory Committees Estate of R C Eastick 25,000 Barry Brown Kenneth Mackenzie CWA Natimuk Friends & Relatives 6,503 Barbara Champness Norman Mansfi eld Ladies Auxiliaries William Angliss Charitable Trust 5,000 Geoff Davis Brian McGennisken Lions Clubs Estate of Sarah Stott 4,160 Chocolate sales 4,050 Tracey Deckert Katrina Morgan Probus Anonymous 3,903 Sharon Dixon Sam Morris Residential Care Friends Raffl es 3,122 Heather Dufty Eunice Morris † & Relatives Mr N Gould 3,000 Marie Goode Allen Norman Rotary Clubs Jeparit Hospital Ladies Auxiliary 2,775 Rosa Goode Brenda Norman RSL Clubs WWHS Golf Day 2,270 Wyn Hamlyn Luke O’Connor SES Friends All Riding Together 2,200 Kevin Hedt John Pumpa Jeparit Hospital Social Club 2,000 Beverley Hobbs James Rochelle Mr L D Creek 2,000 Shona Hoffrichter Gary Robinson Estate of Mr K Allen 2,000 John Hunter Julia Schoneville Mr & Mrs A R Taylor 2,000 Greta Group Pty Ltd 2,000 Joan Ingham Helen Schwarz Drought Resource Centre 1,907 Rochelle James Maureen Skinner Murray to Moyne 1,155 Richard Jones Helen Slattery The Salvation Army 1,000 Gary Judd Kenneth Sleep West Wimmera Darts Assocation 1,000 Phyllis Keller Sini Sreekanth Mrs N Zanker 1,000 Janette Kirk Elsa Williams Mr & Mrs M Schilling 1,000 Carl Krelle Candice Wilson Mr & Mrs J M Davey 1,000 Susan Krelle Nhill College 861 Cooinda Ladies Auxiliary 614 Christmas Red Ribbon Day 582 Mrs Flora Taylor 500 Mr & Mrs G Cooper 500 Mr & Mrs P Ralph 500 Mr & Mrs S Walter 500 Book Sales 447 Nhill Day Centre 418 Frock & Frolic 364 About Town 328 Winiam Hall 300 Farmers Arms Hotel 300 Britten Floor Coverings 250 Campbell Silos 250 Ahrens Sherwell 250 Mr & Mrs C J Magrath 250 Rural Energy 250 Jim’s Butchery 250 Little Desert Lodge 250 Dulkeith Computer Solutions 250 Union Hotel Nhill 220 St Peter’s Lutheran School 200 Elgas 200 Nhill Kindergarten 200 Mr R Dodds 200 Mr & Mrs P Cramer 200 Donations – Value Undisclosed Estate of George Mitchell – Driscoll, McIllree & Dickinson – Mr & Mrs K Binns – Mr & Mrs B L Dorrington – Mr & Mrs G T Kerber – Donations Under $200 5,439 Total 254,105 Total Cost of Fundraising 10,000 Grand Total 244,105 28 WEST WIMMERA HEALTH SERVICE
CORPORATE GOVERNANCE DIRECTIVES AND OBLIGATIONS
Major Committees Audit Committee Accepts the responsibility of overseeing review processes including the performance and independence of the internal auditor and the Auditor General’s agent, internal controls for fi nancial processes, the risk management framework, monitoring compliance with laws and regulations and the Service’s Code of Conduct and Code of Financial Practice. Executive Committee Exercises the Board’s powers between Board meetings and manages the Chief Executive Offi cer’s employment and performance. Finance Committee Monitors and oversees the fi nancial performance by reviewing strategic West Wimmera Health Service Executive Offi cer, Quality Assurance, performance targets, operational and was incorporated as a Public Mandatory Committees, Annual Report, capital expenditure and budgeting. Hospital on 21st August 1995 Annual Meeting, Auditors, Investment And Disposal and Winding up of Assets. Clinical Appointments, Credentialing under the Services Act 1988 (VIC). and Review Committee ‘Rules of Procedure’ adopted by the Board, Corporate Governance is the detail the operational framework and Has a duty of care to ensure all health framework of rules, systems and processes through which all governance professionals practising within the matters are observed. organisation are appropriately qualifi ed processes within which an organisation and competent to perform their designated is controlled and operates. The ‘Rules of Procedure’ address the duties within their defi ned scope of leadership role of the Board, Codes The Board of Governance has the practice. Credentialing protocols for all of Ethics and Acceptable Standards, Clinical Practitioners are applied. responsibility to govern and delegates Delegation of Authority, Committee to the Chief Executive Offi cer its Structure, Appointment of Visiting Performance Review Committee management and operation. Medical Practitioners and other General Is responsible for establishing and Governance Standards. monitoring policy and quality frameworks Currently the Service has nine Board of West Wimmera Health Service has by ensuring appropriate organisational Governance Members. When a vacancy implemented a robust governance structures, processes and resources are in arises positions for Members are framework which includes Financial, place to manage and improve the safety of advertised and applications are forwarded Business and Strategic Planning. care, services and service delivery. It also to the Minister for Health for endorsement. addresses compliance with legislation, The Governor in Council offi cially appoints Pecuniary, Confl ict & regulations and Australian Standards. Board of Governance Members on the Declaration of Interests Community Advisory Committees recommendation of the Minister. Pecuniary Interests involve actual, Advocate a consumer perspective on The appointment cycle is three years potential or perceived fi nancial gain or loss. behalf of each community and advise the at which time Members can apply for A Confl ict of Interest is confl ict between Board on strategic issues and initiatives, reappointment. public duties and private interests which simultaneously promoting a consumer and The Board of Governance has two may be actual, potential or perceived. community point of view. important policy documents which set our The declaration of any known confl ict Management Committees corporate governance framework of the of interest by Board Members is a Service. They are: Provide an important reporting and fundamental element in guaranteeing the advisory role to Board Committees. ‘By-Laws’ approved by the Department highest level of integrity and public trust. of Human Services which outline the These Committees are: Clinical Quality There were no instances in any Board or obligations of the Board to govern the & Safety, Corporate Support, Safety & Executive Meetings where it was necessary Health Service. Environment, and Occupational Health for a member to declare a Confl ict or a & Safety. The By-Laws incorporate clear direction Pecuniary Interest. to the Board regarding its governance obligation in regard to Meetings of ABOVE: Independent Audit Committee Members the Board, Appointment of the Chief – John Magrath (L) with Chairman John Hobday (R) ANNUAL REPORT 2008/2009 29
ORGANISATIONAL STRUCTURE
Board of Governance
Consultants
Chief Executive Officer
Manager Operations Executive Dental Services Disability Services Manager Assistant
Executive Executive Director Executive Director Executive Executive Director Director Corporate Clinical Services/ Industrial Relations Director Finance Medical Services & Quality Services DON Nhill Human Resource Mgt. & Administration
Accreditation Accounting Services Catering Accounts Payable Education Accounts Receivable Manager Allied Clinical Engineering Information Technology & Community Operations General Services Payroll Health Manager Health Information Services Procurement OH & S Reception Services Quality Resource Centre Risk Management Diabetes Education Safety Acute Care Dietetics Security – Nhill, Kaniva, Goroke CHC Jeparit, Rainbow Health Promotion Aged Care Home & Community Care – Nhill, Kaniva, Jeparit, Lowan Rural Health Natimuk, Rainbow Maternal & Child Health Central Sterilising Occupational Therapy Infection Control Physiotherapy Operating Theatre Social Work Pharmacy Speech Therapy Radiography 30 WEST WIMMERA HEALTH SERVICE
BOARD OF GOVERNANCE MEMBER PROFILES
Ronald A. Ismay Lester C. Maybery Harvey Champness
Leonie G. Clarke John A. Hicks Ronald S. Rosewall
Rodney L. Stanford Janice M. Sudholz Desmond J. White
Ronald A. Ismay Lester C. Maybery Harvey Champness BA, Dip Ed President / Business Proprietor Vice President / Primary Producer Accredited Lay Preacher -Uniting Church, Waterwatch Community Term of Appointment: Term of Appointment: Monitoring Offi cer, Wimmera Catchment 01.03.07 – 30.06.09 01.03.07 – 30.06.09 Management Authority Ron has signifi cant fi nancial and business With his vast knowledge of rural Term of Appointment: management experience and is dedicated communities Lester is committed to 03.03.09 – 30.06.11 to maintaining quality health services in ensuring viable cost effective health rural areas. services to the people of West Wimmera. A recent appointment to the Board, Harvey has a background in education. WWHS Committees: WWHS Committees: Through his role as a Lay Preacher he has Executive, Audit, Finance, Performance Executive, Finance, Chair – Performance gained vast knowledge of community Review, Clinical Appointments, Review, Chair – Natimuk Community issues and has a particular interest in Credentialing & Review, Rainbow Advisory aged care and accessibility to quality Community Advisory Board Meeting Attendance: 100% healthcare. Board Meeting Attendance: 100% WWHS Committees: Kaniva Community Advisory Board Meeting Attendance: 100% ANNUAL REPORT 2008/2009 31
Leonie G. Clarke Ronald S. Rosewall BA SocSci Janice M. Sudholz Education Support - Librarian Retired Home Duties/Farmer Term of Appointment: Term of Appointment: Term of Appointment: 01.11.08 – 30.06.2011 01.11.08 – 30.06.10 01.03.07 – 30.06.09 Leonie was appointed by the Governor Ron is a member of the National Disability Janice has broad governance experience in Council as a Justice of the Peace in Service Committee and serves on the and is keen to review and implement September 2008 . Her vision is the long Board of Victoria Advocacy League for recommendations from the Community term viability of West Wimmera Health Individuals with a Disability. He brings a Needs Analysis and Service Profi le Service to deliver sustainable healthcare depth of knowledge and understanding Project Report. to our communities. of the provision of health, welfare and WWHS Committees: disability services to the Board. WWHS Committees: Executive, Finance and Natimuk Executive, Performance Review, Clinical WWHS Committees: Community Advisory. Appointments Credentialing and Review, Executive, Performance Review, Board Meeting Attendance: 78% Chair – Rainbow Community Advisory Clinical Appointments Credentialing & Review, Chair – Jeparit Community Board Meeting Attendance: 78% Advisory, Chair – Cooinda Community Desmond J. White Advisory Dip Agr Sci, Post Grad Dip Ag, Adv Cert John A. Hicks MBA BE Works Man, Dip Eng Tech, Adv Dip Eng Board Meeting Attendance: 89% Tech Chief Executive Offi cer, Hindmarsh Shire Council Rodney L. Stanford Civil Engineer Term of Appointment: Term of Appointment: Social Worker 01.03.07 – 30.06.09 01.07.08 – 30.06.11 Term of Appointment: As CEO of Hindmarsh Shire Council John Des possesses astute management skills 01.11.08 – 30.06.10 has signifi cant expertise in fi nancial and is committed to the provision of management and community issues. He is Rodney has experience in the governance access to sustainable health services for committed to responsible administration of community care and has a wide rural and remote communities. of health and aged care. perspective of community issues. His WWHS Committees: focus is to meet the specifi c healthcare WWHS Committees: Audit, Chair – Goroke Community needs of remote rural communities. Audit, Finance, Nhill Community Advisory. Advisory WWHS Committees: Board Meeting Attendance: 67% Board Meeting Attendance: 67% Audit, Finance, Chair – Kaniva Community Advisory Board Meeting Attendance: 67%
RESPONSIBLE OFFICERS FOR OUR SERVICE (as at 30th June 2009)
Commonwealth State The Hon David Koch MLC Member for Western Victoria Region The Hon Nicola Roxon MP The Hon Daniel Andrews MP Minister for Health and Ageing Minister for Health The Hon Jaala Pulford MLC Member for Western Victoria Region The Hon Justine Elliot MP The Hon Lisa Neville MLA Minister for Ageing Minister for Mental Health, Community The Hon Gayle Tierney MLC Services and Senior Victorians The Hon Jenny Macklin MP Member for Western Victoria Region Minister for Families, Housing, Community The Hon Tim Holding MLA The Hon John Vogels MLC Services and Indigenous Affairs Minister for Finance, Workcover and Member for Western Victoria Region Transport Accident Commission, Tourism The Hon Bill Shorten MP and Major Events, and Water Department Of Human Services Parliamentary Secretary for Disability and Children’s Services Mr Hugh Delahunty MP Ms Fran Thorn Member for Lowan, Shadow Minister for Secretary, Department of Human Services The Hon John Forrest MP Sport & Recreation, Youth Affairs and Member for Mallee Dr Chris Brook Veterans’ Affairs Executive Director, Rural and Regional The Hon Gavin Jennings MLC Health and Aged Care Services Minister for Environment and Climate Ms Maree Guyatt Change and Innovation Director, Rural and Regional The Hon Peter Kavanagh MLC Health Services Member for Western Victoria Region Ms Brenda Boland Regional Director, Grampians Region 32 WEST WIMMERA HEALTH SERVICE
LEADERSHIP AND MANAGEMENT OUR EXECUTIVE TEAM
The Executive team under the leadership of the Mr John Smith PSM Chief Executive Offi cer is accountable to the MHA, Grad Dip HSM, AFACHSE, CHE, FAHSFMA, AFAHRI, AFAIM, FAICD Board for executing the statutory responsibilities Chief Executive Offi cer of the Service, its targets and obligations set John commenced his appointment in 1995 after serving as the by the Department of Human Services and the Chief Executive Offi cer of the Nhill Hospital. Commonwealth Department of Health and Ageing. His experience and expertise is a sound basis for managing the The focal point of the Chief Executive Offi cer effective and effi cient use of business assets, human resources through his Executive Team is to support the Board and the execution and administration of all decisions and policies of Governance with the education and personal of the Board. development of all staff to establish a high His wealth of knowledge, business acuity and determination are achieving workforce. the basis of his strength of management. John is a Board Member and National Councillor of the Australian Council on Healthcare Standards, a National Councillor of the Australian Healthcare & Hospitals Association, and a Board Member for the Victorian Hospitals Industrial Association. For his contribution and dedication to the Nhill community and ABOVE: Executive Team the Nhill Hospital in particular, John was awarded a Public Service L-R – Katrina Pilgrim, Kaye Borgelt, Leslie Butler, Medal in the Australia Day Honours 1991. John Smith PSM, Ritchie Dodds, Janet Fisher, Melanie Albrecht . Absent: Dr Ian Graham (see page 41) ANNUAL REPORT 2008/2009 33
Ritchie Dodds Kaye Borgelt Leslie Butler B Com (Acc) CA FFin MBA (HRM) Assoc Dip Med Rec Admin, Grad Cert Mgt Org B.Lab Stud, Assoc Dip Lab Stud, RN Div 2 Change, HIMAA Accredited Coder Executive Director Executive Director Industrial Relations Finance and Administration Executive Director and Human Resource Management Corporate & Quality Services Ritchie was appointed in April 2006 Responsible for the strategic direction of and is responsible for Finance, Payroll, Kaye is responsible for co-ordinating and Human Resources and Industrial Relations Information Technology, Supply, and facilitating quality and safety throughout Management, Les promotes development Administration. the organisation, promoting a robust risk and training in management techniques. management framework and a culture of Previously Ritchie gained considerable continuous improvement. experience as the Operations Manager, Les advises the Chief Executive Offi cer on Personal Assistant to the Chief Executive She is responsible for Occupational Health Industrial Relations and Human Resource Offi cer and Finance Accountant. and Safety, Organisational Security Management and supports the Executive and non-clinical and support services, team, advises on WorkCover claims, He gained a Bachelor of Commerce degree including engineering, catering and conducts workplace mediations and (Accounting major) at the University of general services, education and health attends industrial forums as the Health Melbourne, is a Chartered Accountant and information services. Service representative. completed a Graduate Diploma in Applied Finance & Investment and a Master of Kaye has a background in Health Business Administration majoring in Information Management. She was Melanie Albrecht Human Resource Management. appointed in 2004 and prior to that was LLB, BIS, Grad. Cert. HSM, AFCHSE Director of Health Information Services. Ritchie deputises for the Chief Operations Manager Executive Offi cer. Dr Ian Graham Melanie was appointed Operations Manager in April 2006 and is responsible MB,BS (Melb.); M. Health Planning (NSW); Janet Fisher for the executive management of FRACMA; Cert. Essential Skills in Medical RN RCNA Grad Dip Bus Management Education (AMEE). Disability Services, Dental Services, Aged Care Administration, Compliments Executive Director Executive Director and Complaints, Contracts and assisting Clinical Services Medical Services the Chief Executive Offi cer with Jan was appointed in January 2009. Her Dr Graham is the Executive Director of special projects. responsibilities include management Medical Services. He chairs the Clinical Melanie’s knowledge of health and of Medical, Surgical and Primary Care Quality and Safety Committee and business is growing as she continues Casualty Services, Central Sterilising, Medical Staff Association meetings. her Master of both Health and Radiology, Pharmacy, and Maternal and Business Administration. Child Health. Ian liaises with clinicians and senior management regarding patient safety, She is also responsible for the clinical practice, credentialing, scope of Katrina Pilgrim management of Residential Aged Care, clinical practice and patient care matters. Allied and Community Health, Day Centres Cert IV Bus Management Dr Graham is the part-time Medical and Goroke Community Health Centre. Executive Assistant to CEO Director of the Postgraduate Medical A Registered Nurse Division 1, Jan Council of Victoria (PMCV) and practises Katrina commenced employment at Nhill has an Advanced Diploma of Business as a consultant in health management, Hospital April 1986. She was appointed Management, and was previously leadership and education. Executive Assistant to the CEO in Executive Director of Aged Care and September 2004 and has over 20 years of Community and Allied Health. secretarial experience. She is the Minute Secretary to the Board of Governance, Committees and Management Committees and assists with major function organisation. 34 WEST WIMMERA HEALTH SERVICE
ACUTE CARE SERVICES WE CAN CARE FOR YOU
When illness strikes the place to be is home or as near as you can be. We are dedicated to caring for you; we are your home away from home where Orthopaedics, Ophthalmology, ENT, Gynaecology, Oral and General Surgery and superior Medical Services are at your fi ngertips. Care with compassion is our maxim. We think care, we actually do care and our care is genuine...
Dialysis Unit Nurse Tania Ryan RN Div 2 with Lorraine Semmler who attends the Dialysis Unit at Nhill Hospital three days each week ANNUAL REPORT 2008/2009 35
Goals Strategies Achievements Future
To deliver safe and Attract and retain qualifi ed 1,879 patients treated. Recruit additional Division 1 effective needs-based and skilled clinicians – Nurses. 615 elective procedures healthcare by providing medical, nursing and allied performed. Introduce Chemotherapy timely and effective health professionals. treatment. emergency and elective Dialysis Unit expanded – 305 Introduce and expand clinical services and promoting patients treated. Formalise the relationship services to conform with the improved health with Rural Ambulance Strategic Plan. Professional relationships Victoria to assist in Primary outcomes. with Visiting Medical Provide modern and safe Care Casualty. To reintroduce ‘low risk’ Practitioners broadened. medical equipment, and maternity services. As highlighted in the embrace new technologies. Introduction of patient Community Needs Analysis consultation via and Service Profi le Report Videoconferencing allowing we must strengthen and patients to participate in formalise partnerships with specialist consultations larger regional, metropolitan without having to travel long and interstate health services distances. to broker effi cient service X-ray reporting effi ciently provision and to ensure refi ned. seamless patient transfers Six graduate nurses between organisations. employed. We must continue to respond to community needs by seeking the opportunity to provide identifi ed clinical needs.
Quality Emergency and WWHS offers a range of specialist Medical Imaging - Reporting Elective Care elective surgery providing patients with Times Improved the opportunity to have procedures Acute care services are at Nhill, Rainbow, undertaken in their local environment, Our alliance with Western Medical Imaging Jeparit and Kaniva, with all sites having 24 where family and friends can readily has been a positive step with a remarkable hour Primary Care Casualty departments visit without travelling long distances. turnaround in reporting times of urgent for emergency presentations. Elective surgery available includes and non urgent x-rays. 45% of all patients admitted were Ear, Nose and Throat, Orthopaedic, Urgent reports are now received classifi ed as emergency admissions, Dental, Ophthalmology, Gynaecology and within one hour of the x-ray – providing requiring immediate attention. Most of General Surgery. Visiting Medical Practitioners with these patients were treated effectively accurate diagnoses and supporting by our Visiting Medical Practitioners and Electrocardiogram Reporting the commencement of necessary and were discharged to their home. However, (ECG) timely treatment. occasionally patients require a higher Dr van den Broek, a Specialist Physician level of care (intensive, coronary care or reports on all ECGs. He interprets and specialist referral). These patients are diagnoses ECGs (measurement of the transferred to the nearest appropriate electrical activity of the heart), providing health service, or to a regional, specialist advice to our Visiting Medical metropolitan or interstate hospital. Practitioners to initiate prompt and In 2008/09 1,021 patients were treated relevant clinical care for patients with as elective admissions and were admitted acute cardiac conditions. These ECG for a planned stay. These patients reports are received within 24 hours. included dialysis admissions and those for Urgent reports are dealt with almost elective surgery. immediately – this is outstanding professional support for the Visiting Medical Practitioners. 36 WEST WIMMERA HEALTH SERVICE
ACUTE CARE SERVICES > WE CAN CARE FOR YOU
Excellent Graduate Pharmacy Admission And Discharge: Nurse Program In November 2008 ‘Medprof’, a computer The Admission and Discharge Program has Graduate Division 1 Nurses gain program for Pharmacists to produce two main functions: Pre-Admission Clinic experience in medical, surgical, aged, a Medication Profi le for patients on and Discharge Planning. discharge was installed. Patients receive community and ambulatory care, Elective surgery patients attend for a information about their medications emergency and critical care. pre-admission interview prior to their assisting them to understand the Mentorship and direction is provided admission to hospital. The aim of the importance of safe and effective during the fi rst 12 months of clinical interview is to educate, assess and inform administration of their medications. practice for newly graduated Division 1 the patient regarding expected outcomes nurses, providing a solid background for We have surveyed patients discharged of their surgical procedure, pre and post future career exposures. since January 2009 to determine the operative requirements, preparation for level of benefi t ‘Medprof’ has provided lifestyle and support services required New Initiative with the results revealing that patients following discharge, such as Home Help or After a period of consolidation at the have appreciated the Medication Profi le Meals On Wheels. Nhill Hospital, Graduate Nurses now have particularly in preventing duplication of the opportunity to gain experience as medications. the Nurse in Charge at our more remote sites. Strict parameters ensure adequate support and guidance is provided to the Graduate. This initiative is an excellent professional and clinical learning experience. Feedback from Managers and ABOVE: Pharmacist, Martin Yau preparing Graduates has been extremely positive. patient medications. PAGE RIGHT: Dr. Shoaib Munawar (left), Tristar Medical Group, consults with patient Graham Stephan. ANNUAL REPORT 2008/2009 37
Haemodialysis (Dialysis) Equipment Purchases In 2009-2010 audits will be undertaken to ensure that items are discarded via the Dialysis is vital to sustain life for those Department of Human Services Targeted correct waste disposal system. with renal disease or diminished renal Equipment Program funding has provided function. It helps to balance fl uid, minerals a new Cardiac Monitor for Kaniva Hospital Gastroenteritis and chemical levels in the blood with and Patient Trolleys in consulting areas of Ongoing episodes of gastroenteritis patients required to receive treatment 3 the Nhill Hospital. occurred in our catchment area with days per week. many patients admitted to hospital An increased demand has witnessed Infection Control with a diagnosis of Gastroenteritis, an increase in unit capacity from 2 to 4 An effective Infection Control Strategy the commonly highly contagious Norovirus chairs. Previously patients had to travel is central to providing safe quality care. (Norwalk Virus). There were no outbreaks to other regional facilities to access this This Service has stringent strategies and of hospital acquired gastroenteritis which service. A reduction in travel time of at controls in place to maintain our virtually is testament to the exceptional nursing least six hours per week for these patients infection free status. care and infection control procedures has occurred. applied across our Service. Clinical Waste Education for staff and patients has Waste produced by medical procedures been an important facet in increasing our such as dressings, surgery and dialysis capacity. Additional training for Division 1 must be disposed of at specialist waste and 2 Nurses supported by a Department centres. We questioned if the amount of Human Services grant ensures of clinical waste refl ected how busy we specifi cally trained Nurses are available were. We graphed the amount of waste in at all times. Training of additional nursing kilograms against the number of occupied staff is planned. bed days and discovered that there was a direct correlation. It is reassuring to be able to quantify that increases are due to increased business within the health service, rather than poor procedures. 38 WEST WIMMERA HEALTH SERVICE
ACUTE CARE SERVICES > WE CAN CARE FOR YOU
Hand Hygiene Swine Flu (H1N1) Occupational Exposures Hand Hygiene encompasses hand washing The Swine Infl uenza pandemic created Occupational Exposures and Needle- and the use of Alcohol Based Handrubs. considerable concern within the stick injuries are occupational hazards Supported by Department of Human community during Winter 2009. The staff attempt to avoid. Acute areas of the Services Statewide Quality Branch, pandemic to date is a mild form of Health Service have a greater level of use the Victorian Hand Hygiene Program infl uenza that is very infectious. Much of needles and intravenous devices which combines education and auditing of Hand literature and information has been increase the risk of a ‘sharps’ injury and Hygiene practices in Victorian Public supplied by the Department of Human while all possible attempts to prevent Hospitals. Services and we were very aware of the these injuries are made occasionally situation. West Wimmera Health Service accidents do occur. Strict reporting and Staff Health has collaborated with the Hindmarsh treatment procedures are in place to We endeavour to protect our staff by Shire to prepare a Pandemic Plan which, address such a problem should it arise. combined with our Business Continuity providing free vaccinations to resist Four needle stick injuries occurred in Plan, has us well organised to cope with illnesses such as Infl uenza and Hepatitis B. 2008-2009, all in the Nhill Hospital. the challenges associated with a major pandemic outbreak. Staff Education Compliance Mandatory Infection Control education is in place for staff from all Departments. Staff must have an understanding of Infection Control principles in regard to hand hygiene, special cleaning, isolation and protective clothing and special ABOVE: Young patient Katey Zivkovic playing requirements of patients to ensure cards with her mother Rhonda as Div 1 Nurse Helan Jacob records Katey’s discharge plans. minimal infections are experienced and Rhonda recently Graduated from the University cross infection prevented. of Ballarat as an RN Div 2 Nurse. ANNUAL REPORT 2008/2009 39
ACUTE CARE SERVICES > STATISTICS
Major Elective Surgical Procedures Dental Statistics by Procedure Admitted Patient Activity
Procedure No. Performed Sub- Exams 722 Separations Acute Acute Total X-rays 825 Same Day 774 0 774 OPGs 63 Multi Day 1060 45 1105 Scale & Clean 268 Total Separations 1834 45 1879 Fillings 1,115 Emergency 858 0 858 Extractions 680 Elective 976 45 1021 Root Canal Treatments 38 Total Separations 1834 45 1879 Crowns 15 Total WIES 1563.76 0 1879 Dentures 58 Total Bed Days 8601 2156 1879 Total 3,784 Same Day – patients admitted and discharged on the Public and private dental patients are treated and waiting lists same day. Multi Day – patients in hospital for longer than one night. Emergency – patients whose admission was Major Procedures No. Performed remain at the State waiting list average, with the exception of Prosthetics which is a considerably shorter wait time. not planned – usually admitted via the Doctors Surgery or Primary Care Casualty. Elective – patients whose admission Hip 25 has been planned – elective surgery; dialysis Knee 33 Gynaecology 35 Cholecystectomy 12 Hernia 19 IOL (Cataract) 107 Eyes other 8 Dental 60 Staff Flu Vaccinations Hep B 2009 Month Stats Annual Report ENT 40 General other 8 Number of Staff tested TOTAL Total 347 150 Nhill 67 120 Jeparit 9 Kaniva 23 Operating Suite Activity 90 Rainbow 40 60
Type of procedure 2008/09 2007/08 Vaccinations Goroke 3 30 Major Procedures 347 320 Natimuk 51 Minor Procedures 266 313 0 Total 192
Total Cases 613 633 Nhil Kaniva Jeparit Goroke
Rainbow Number of Staff Immunisations TOTAL 800 Nhill 18 700 600 Jeparit 1 500 Kaniva 7 400 2008/09 Rainbow 7 300 Goroke – 200 2007/08 100 Hand Hygiene Audit Natimuk 15 0 Total 48 100 Total Total Major Minor Hepatitis B Surface Antibody Screening Cases 90 80 Hepatitis B is a viral disease spread by blood and body fl uids. Procedures Procedures 70 A screening program to assess staff immunity to Hepatitis B 60 is now in place. Blood is taken to assess the level of protective Audit 1 50 antibodies that are gained after undertaking the three injection The Nhill Hospital continues to provide the surgery required by 40 Audit 2 course of Hepatitis B immunisation. Percentage an ageing population. Orthopaedic replacement of hip and knee 30 Audit 3 joints occurs on two days per month. Each month 5-6 joint 20 Victoria Average replacements are performed relieving those people of chronic 10 pain and loss of mobility. Each month the eye surgeon conducts 0 cataract surgery for an average of 10 patients. Most patients 2007/08 2008/09 have cataracts in both eyes and so have two operations a month apart. Removing the cloudy lens enables clear vision for many Hand Hygiene practices of staff are audited three times each years. The Gynaecological and General surgeons perform a year. In 2008/09 we achieved a compliance rating of 76.4% range of surgery to investigate, treat or repair as needed. This compared to the State average of 71%. We will continue involves many minor procedures but also others such as hernia to promote hand hygiene education to improve compliance repairs, hysterectomies, removal of varicose veins and removal levels in this vital infection control area. of gallbladder (Cholecystectomy) 40 WEST WIMMERA HEALTH SERVICE
ACUTE CARE SERVICES > WE CAN CARE FOR YOU
Dental Services Conclusion ABOVE: Dr Richard Clarnette, Visiting The Nhill Hospital Dental Clinic expanded Our aim will always be to provide the best Orthopaedic Surgeon consulting with patient Catherine George. its services with the appointment of care possible for our patients. a Dental Therapist who visits weekly We must recruit staff who will continue to providing dental treatment for children develop professionally, to ensure care is under the age of 18, effectively replacing based on sound clinical evidence, and good the traditional ‘School Dental Service’. personal qualities are evident. This popular service is meeting a very A nationally recognised issue emerging important need in the community treating in nursing, perhaps as a consequence of 121 youngsters since the commencement differing trends in Nurse Education, is of the program in February 2009. making time for the ‘little things’ in daily The Nhill Dental Clinic is fortunate to also care regimes. Taking the time to sit and retain the expertise of Dr Damien Goh talk to a patient, offering a cup of tea or who provides public and private general comforting a distressed relative appear dental services, and Oral Surgeon Dr to be at risk of becoming the exception Anamaly Ayasamy who conducts monthly rather than the norm! consultations and surgical services. We will always provide exceptional care During the year Dental Clinics at Kaniva with compassion and dignity. and Rainbow have been refurbished through funding from the Department of Health and Ageing and we are now proceeding to engage dentists for these clinics. ANNUAL REPORT 2008/2009 41
MEDICAL SERVICES
Medical & Clinical Visiting Consultants Executive Director Medical Services Dr. Ian Graham MB BS MHP AMEE FRACMA West Wimmera Health Service continues to provide excellent General Surgeons Mr. S. R. Clifforth MB BS FRACS clinical services to the Mr. D. Bird MB BS FRACS communities of Nhill, Rainbow, Mr. P. H. Tung MB BS FRACS Jeparit, Natimuk, Kaniva, Goroke and surrounding districts. Orthopaedic Surgeon Dr Ian Graham, Dr. R. Clarnette MB BS FRACS Executive Director Medical Services Consultant Ophthalmic Physician and Surgeon Dr Irfan Hakeem has taken over the During the past twelve months, Medical Dr. M. A. Chehade MB BS FRANZCO Kaniva practice rapidly establishing Association meetings have been Ear, Nose And Throat Practitioners a reputation for his caring, thorough integrated with the Clinical Quality Ms A. Cass MB BS FRACS and skilled approach to rural general and Safety Committee agendas. Mr. L. Ryan MB BS FRACS FRCS DLO practice. Drs Khaled El-Sheikh, Rizwan The combined meetings provide a Lotia, Sumeet Dhillon, Shoaib Munawar valuable forum where medical and Consultant Obstetrician and Katrina Morgan provide clinical other clinical professionals are able and Gynaecologist services in Nhill while Dr Nouman to discuss clinical issues, quality Dr. I. Jones MB BS FRANZCOG Qadir operates the Jeparit and improvement, peer review and Visiting Oral Surgeon Rainbow practices. professional development activities. Dr. A. Ayasamy BDS FDSR CPS FICD Dr Malcolm Anderson has continued to The Medical Association continues to Specialist Anaesthetist provide anaesthetic services, although be actively involved in the West Vic he now lives and works in Ballarat. Division of General Practice Clinical Dr. R. Ray MB BS FANZCA Dr Rob Ray, Specialist Anaesthetist, Risk Management Program. Cases at General Practitioner Anaesthetists also regularly visits Nhill to provide West Wimmera and other hospitals Dr. M. J. Anderson anaesthetics. Visiting surgeons throughout the region are selected MB BS FRACGP DA FACRRM undertake General, Orthopaedic, ENT for detailed review by a panel of Dr. K.A Fielke MB BS DA FACRRM (Ear Nose and Throat) and Ophthalmic experienced medical practitioners. Surgery at Nhill Hospital. Consulting Psychiatrist The recommendations from these Dr. R. Proctor MB BS BSc DPM The Service has continued to develop reviews are considered by the Medical and extend its processes for the Association and Clinical Quality Dental Surgeon credentialing (review of qualifi cations) and Safety Committee for review Dr. D. Goh BDent BBSc and defi nition of scope of clinical and action. Dental Therapist practice for its Medical Practitioners All Visiting Medical Practitioners Ms C. Petersen Dip Dent Ther and other clinical staff. undertake continuing medical These processes ensure that education, attending seminars, General Practitioners Practitioners practising at West tutorials, conferences and workshops Dr. K. El-Sheikh Wimmera Health Service are relevant to their practice. MB BS FRACGP FACCRM DPM CASA Pilot Medical Offi cer appropriately qualifi ed and only undertake clinical work within their Congratulations Dr. R. Lotia MB BS BSc scope of training and experience. Dr. S. Dhillon MB BS FRACGP Drs Sumeet Dhillon and Shoaib Dr. S. Munawar MB BS BSc FCPS FRACGP The Service is committed to developing Munawar have successfully completed Dr. K. Morgan a deeply embedded culture of their Fellowship examinations with MB BS DRANZCOG DCH(SA) FRACGP credentialing and delineation of the Royal Australian College of General Dr. M. N. Qadir MB BS FRACGP scope of practice going far beyond Practitioners. This is an outstanding Dr. I. Hakeem MBChB the completion of application forms, achievement and all associated with paperwork and checklists. It means that West Wimmera Health Service offer Consulting Pharmacist all staff (doctors, nurses, allied health their congratulations to Sumeet Mrs. A. Teed PHC MPS FSHP MACPP professionals, executive and other and Shoaib. Staff Pharmacist staff) are aware of the requirements The communities of West Wimmera for credentialing and defi nition of Mr. M. Yau BPharm MPS thank our General Practitioners scope of practice and are confi dent and Visiting Specialist Medical Consulting Radiology Service to raise issues, challenge decisions Practitioners for their ongoing Western Medical Imaging and ensure the highest standard of care support and the quality clinical services is delivered. Visiting Optometrists they provide. Ross Both & Associates 42 WEST WIMMERA HEALTH SERVICE
RESIDENTIAL CARE FOR OUR SENIOR CITIZENS
We believe that entering residential aged care is not the beginning of the end but rather the next phase in the life journey. Our desire is to deliver compassionate, client-centred, individualised aged care services which meet and surpass accreditation stipulations and demonstrate the way we care for every resident each and every day, in nurturing meaningful lives, within a framework of care, with respect, compassion and dignity.
Goals Strategies Achievements Future
To deliver a To foster education A trained Diversional Prepare for accreditation compassionate, in changing aged care Therapist supports Activity Surveys in August 2009. individualised and philosophies and practices. Co-ordinators to evaluate Continue to improve aged homely residential care programs and ensure To constantly apply best care volunteer programs. experience. activities are resident practice care models. focused. Recruit addtitional To successfully comply with Registered Nurses Division 1. Respecting Patient Choices Accreditation Standards. Program allows residents Achieve 100% occupancy in To gather accurate the opportunity to make aged care facilities. information from Residents informed decisions regarding Accurately assess residents and Families. ‘end of life’ care. to maximise fi nancial Introduction of electronic availability. ‘iCare’ record at all Homes and Hostels. Guaranteed resident access to Allied Health professionals. All Homes and Hostels 100 per cent compliant with Accreditation Standards. ANNUAL REPORT 2008/2009 43
Residential Aged Care Percentage Occupancy by Site
80 60 Occupancy 40 20 Percentage Percentage 0 Facility
Iona Digby Harris Home Archie Gray Nursing Home Unit Jeparit & District Nursing Home Jeparit Hostel Rainbow Nursing Home Natimuk Nursing Home Kaniva Hostel Rainbow Hostel Lockwood Hostel Trescowthick House Hostel
Percentage occupancies at individual residential aged care facilities except for Kaniva Hostel were all above 95%. Because of its unique physical layout Kaniva Hostel can only accept residents with very low care needs. For this reason percentage occupancy at this location is always lower than for other facilities.
Physiotherapist Sreekanth Sreekumar assists Allan Lockwood, a resident of Trescowthick House Hostel, Natimuk.
PAGE LEFT: Natimuk’s Trescowthick House Hostel Resident, Anne Phelps enjoys the sunshine with Div 2 Nurse Anne Hamilton.
Living in residential care means living Residents are Our Number The ‘Resident Information Booklet’ with new people and accepting others, One Priority detailing all facets of living in Residential doing everyday things residents can Care has been reviewed recently with The transition from living at home to a new chapter providing information no longer do for themselves. moving into Residential Care sometimes specifi c to each individual Hostel and has a dramatic impact on the new resident When entering our residences we Nursing Home. and their family. We strive to make this ensure resident personal privacy important change as smooth as possible. The Booklet is also produced in ‘large and dignity is maintained, and we print’ for the sight impaired. Our approach is to tailor our services to respect their rights as citizens. meet the specifi c requirements of each Positive Continuous Improvement Family and friends are encouraged to resident which is accomplished in a way Comments and ideas received from visit and residents can come and go that minimises the disruption of the residents, families and visitors assist us as their health and physical capacity move, supports individual independence to constantly improve our care standards. allows. This is their home and that and promotes increased enjoyment and a sociable lifestyle. A Register is provided for residents and is respected. visitors to record their thoughts, ideas, Our planning for individual residents Residents also maintain control over compliments and complaints - often the includes ongoing consultation with them, the personal aspects of their life, their catalyst which leads to improved lifestyle their relatives and the Resident-Relative fi nancial affairs and possessions. and services for residents. and Friends Group to continually improve Our communities have access to excellent, their care. If choices and preferences are known they comfortable and safe Residential Aged are respected! Regular communication between the Care, with dedicated, highly trained staff Service, Residents and their Families is a attending to them. vital link. 44 WEST WIMMERA HEALTH SERVICE
RESIDENTIAL CARE > FOR OUR SENIOR CITIZENS
Community Aged Care Packages are individually planned and coordinated assisting older people to remain safely at home and connected to the community. ANNUAL REPORT 2008/2009 45
Highly Trained Staff Grants For Resident Safety The National Respite For Carers Program (NRCP) High level staff training ensures we meet $25,000 was received from the the physical, social and emotional needs Department of Human Services to This Program supports the Carers of the of residents. purchase fi ve fl oor line beds and fi ve frail elderly, dementia sufferers, people wound care mattresses, crucial for with challenging behaviours, younger We provide a range of opportunities for residents identifi ed as ‘at risk’ of falling persons with disabilities and those with a professional development reinforcing and to reduce the possibility of skin tears terminal illness. our sound reputation for expert resident and pressure areas. care. Continual exposure to new The Program assists people to remain at techniques and practices is essential in We are indeed grateful for this support. home for as long as possible, supporting maintaining standards. the maintenance of caring relationships between carers and the care recipients. This year skill updates and training were Accreditation centred on Electronic Care Planning and All of our Residential premises are fully Services, including Home Care, Personal Assessment, Behaviour Management and accredited verifying they are providing Care, Social Support and some travel new practices relating to Dementia Care. quality care and services according assistance are provided to 31 clients to Standards set by the Australian across our region. Electronic Care Planning Government and monitored by the Aged Planned Activity Groups (PAG) Care Standards and Accreditation Agency. An electronic care planning and Planned Activity Groups are located in our documentation system, ‘iCare’, was This is comforting to those who elect to 6 communities providing programs and introduced providing an integrated access our Service. activities to support frail older people, and user-friendly health care record people with disabilities and their carers. containing current health information of Our Belief each resident located in one place. iCare The groups provide balanced programs It is clear we must continue to attract has made handwritten resident records enhancing independence and providing enthusiastic staff with a genuine passion a task of the past and has improved opportunities for socialisation, for aged care who desire to improve life adherence to complex government intellectual stimulation, physical for our residents. regulations. activity, as well as emotional and Aged care is a ‘specialty’ requiring a psychological support. Access To Health Professionals passion and commitment to care for The recognition for increased social people with highly complex needs. Residents have access to specialist supports for Men in Nhill and Kaniva has therapies provided by Allied Health The Aged Care Nurse must nurture a resulted in increasing the number of days professionals, including physiotherapy, relationship with residents. It is long term to cater for men seeking involvement speech pathology, podiatry and dietetics, care, it is being part of an extended family and enjoyment of socialisation and the who visit weekly and are available and it is being able to provide that little bit interesting opportunities these Groups via Videoconference or telephone if extra which makes the difference. provide – a credit to our dedicated and enthusiastic staff. consultation is required between visits. Care for our residents will continue to Medical Practitioners are available 24 be passionate, dedicated and delivered Conclusion hours a day for all Residents. with respect. Resident focus is more than words in our Protecting Our Residents Community Aged Care Residential Care facilities – it is the way we do business. The Charter of Residents Rights and – Help To Remain At Home Responsibilities - Aged Care Act 1997 Community Aged Care Packages We will ensure that all facilities have (the Act) explicitly states that people robust processes to meet and exceed Community Aged Care Packages living in aged care homes have the right accreditation requirements, while (CACPs) are funded by DoHA to cater to be treated with dignity and respect, retaining the resident as the centre of for the complex care needs of older and to live without exploitation, abuse all initiatives. people. Packages are designed to or neglect. meet the physical wellbeing, cultural, We will also build on volunteer programs Mandatory reporting to local Police social, spiritual and emotional needs within Residential Care – further linking and Department of Health and Ageing of individuals. our facilities with the communities (DoHA) of any incident of elder abuse, we serve. We deliver 15 Packages across Hindmarsh clear policies and procedures are in place and West Wimmera Shires and the Rural defi ning the immediate actions required. City of Horsham. Currently there is a Resident wellbeing is paramount. waiting list of 55 people and we await the outcome of an application to the Department of Health and Ageing for more packages to address this demand.
PAGE LEFT: Community Aged Care Package recipient Lorna Redford returns home from a medical appointment with her Personal Care Worker, Marion Major. 46 WEST WIMMERA HEALTH SERVICE
COMMUNITY AND ALLIED HEALTH OUR CARE REACHING OUT
For the fi rst time in many years we have recruited a full complement of Allied Health staff – a signifi cant milestone. Community and Allied Health Professionals encompass Community Nursing, Counselling, Diabetes Education, Dietetics, Occupational Therapy, Physiotherapy, Podiatry, Speech Pathology, Social and Welfare who work together to provide an holistic approach to the management of health. ANNUAL REPORT 2008/2009 47
Goals Strategies Achievements Future
Provision of care in Documentation in All clinicians are providing A collaborative approach accordance with evidence medical fi le entries to care in accordance with to the development and based practice principles. meet legal and statutory evidence based practice implementation of the requirements. as indicated by results of Health Promotion Plan for Employ passionate internal audits. the years 2009-2012 will clinicians with expertise Regular clinical and be utilised. in their speciality area . documentation audits Partnerships have to ensure clinicians are been formed with Community and Allied Strengthen our reputation working within their external health and local Health services at the as leaders of Allied and scope of practice and in government agencies Goroke Community Community Health care. accordance with evidence to ensure a coordinated Health Centre will based principles. approach to service increase. provision. Staff to participate in Research and innovative internal and external Allied Health clinicians workforce programs will credentialing processes. have presented be pursued. to national and Professional development international forums. will be supported to increase the knowledge West Wimmera Health base of clinicians. Service - Health & Fitness Centre opened in All Allied and Community January 2009. Health staff will be members of their In excess of $100,000 respective Professional received from the Associations. Department of Human Services (DHS) for Innovative Research Grants.
A Time Of Change Chronic Disease Mangement WWHS Health And Fitness Centre Service delivery is offered for all ages We are moving proactively from systems – Nhill Gymnasium in a variety of clinical settings: acute, based on the acute model of care and Since January 2009 we have managed the rehabilitation, community, and in the implementing pathways that address the Nhill Gymnasium which now operates as home. Referrals are accepted from health Burden of Disease in accordance with a West Wimmera Health Service Health and care professionals, doctors, nurses, social model of health. Fitness Centre. carers or self referral. It is crucial that The social model of health recognises Membership numbers have increased quality care is delivered within the realms the effect of social, economic, cultural and our Physiotherapists, Exercise of evidence based practice. In order and political factors and conditions on Physiologist and Fitness Instructors have to ensure our community receives the health and wellbeing. It is a conceptual commenced well supported health and best and appropriate care, all staff framework for improving health fi tness programs. are completing external or internal outcomes, aimed at preventing and credentialing processes which ensure they Exercise is an important factor in reducing illness and addressing are abreast of current practice and future preventing and controlling disease, inequalities and disadvantages that developments of care. therefore reinforcing the importance exist within communities. of the programs offered at the Health & Staff travel to all campuses weekly and Fitness Centre. deliver services to neighbouring Health Services and Residential Aged Care facilities, namely Rural Northwest Health, Edenhope District and Memorial Hospital, Woomelang Bush Nursing Centre, Allambi Elderly Peoples Home Dimboola and Dunmunkle Health Service. PAGE LEFT: Speech Pathologist, Yingying He assessing Iona Digby Harris Nursing Home resident, Sylvie Donnell. 48 WEST WIMMERA HEALTH SERVICE
COMMUNITY AND ALLIED HEALTH > OUR CARE REACHING OUT
Healthy Workplace Challenge Innovative Submissions Research and Presentations Lowan Community Health Nurses Despite major competition, our team Creating a dynamic and exciting research organised a Healthy Workplace Challenge was successful in attracting funding for culture has assisted in attracting expert incorporating physical activity and several projects proving that we have clinicians to our Service and forging healthy eating over 6 weeks. the expertise and capacity to share our partnerships with researchers from major knowledge with our Rural, Regional and metropolitan and regional centres such Sixty participants undertook the Metropolitan counterparts. as Latrobe Regional Hospital, Latrobe challenge with a combined weight loss Community Health Centre, The University of 63 kgs, loss of waist measurement, Chronic Disease Management Pathway of Melbourne, PeterMac Cancer Centre increased physical activity as well as Workforce Innovations Grants of and The Murdoch Children’s Institute. feelings of well being, increased energy $110,000 from DHS were received to levels and staff morale, and decreased We are currently involved in a large scale provide an effective and effi cient health blood pressure levels. clinical trial to investigate the effects service for clients with a chronic disease, of water aspiration in patients who In April 2009 another Challenge was a proactive model of care that is capable have been prescribed thickened fl uids, instigated, with funding received from of addressing health problems and by considering immunological response the ABC Rural Fund, and was opened up increasing wellness. We will move from and bacterial colonisation - a new area to local businesses. Twenty businesses systems based on the acute model of care of research. completed the challenge, with 275 and develop community care pathways in participants and a total weight loss of the areas of Diabetes, Mental Health and Our Speech Pathologists were invited 301.9 kgs. Cancer Care Management. to present work at the New York Speech Pathology Convention and the Speech Early Intervention Foot Care Clinic Pathology Australia Conference in – Let’s Make Tracks We were also funded to complete a toolkit May 2009. and DVD to provide nursing staff with We embarked on the development and education on basic foot care for residents Future Direction implementation of an early intervention in our Nursing Homes and Hostels. This program ‘Let’s Make Tracks’. A multi- Decreasing the Burden of Disease through will ensure a timely service for our disciplinary team including Counselling, health promotion and effective chronic residents and enables the Podiatrist to Dietetics, Occupational Therapy, disease management will continue to be concentrate on more complex foot care. Podiatry, and Speech Pathology a priority of the Allied and Community screened all kindergarten children across Dysphagia and High Risk Nutritional Health team. the Hindmarsh, West Wimmera and Assessment Toolkit Our collaborative approach with other Yarriambiack Shires. Early intervention Funding was provided to develop and clinicians and service providers will programs are valuable, as a child’s implement an Assessment Form and ensure that clients in our communities development in the fi rst few years of DVD to assist in timely assessment and have access to best practice models of life is crucial in setting the foundation management of patients and residents care that are effective and accessible. for lifelong learning, behaviour and who have diffi culty swallowing, or are not health outcomes. consuming enough solids or fl uids thus risking dehydration and malnutrition. ANNUAL REPORT 2008/2009 49
PAGE LEFT: District Nurse, Kaye Robinson Div 2 BELOW: Sarah White and baby son Riley listen visits Dorothy Chenoweth in her home to monitor intently to Maternal and Child Health Nurse Mandy her blood pressure. Stephan as daughter Baillee watches on. 50 WEST WIMMERA HEALTH SERVICE
COOINDA DISABILITY AND BUSINESS SERVICE
Goals Strategies Achievements Future
To advance the quality Provision of activities Sensory Room Achieve compliance with of life for people with a which enhance motor established at Cooinda. Department of Human disability. skills and increase Services (DHS) Disability Workplace integration cognitive abilities. Accreditation. To facilitate achieved at West opportunities for clients Encourage community Wimmera. Master new State in the community. integration through public Individualised Support Oliver’s Kiosk opened at outings and activities. Payments System. To increase client Nhill Hospital. access to lifestyles, by Provide programs which Review operations Success at Tristate encouraging others to develop self-esteem, utilising services of a Games with all athletes respect, promote and promote confi dence and sector lead agency. receiving medals. safeguard their rights. respect. Facilitate community Our partnership with To provide employment Commence healthy engagement by utilising Luv-A-Duck continues. opportunities. lifestyle programs which increased volunteers. promote healthy diet and Clients participate Overcome challenges of exercise regimes. in fi tness sessions business viability. at WWHS Health and Intensify work based Fitness Centre. training and skill development. ANNUAL REPORT 2008/2009 51
PAGE LEFT: Cooinda Client, Roger Batchelor enjoys BELOW: Amy Brown has taken another step in her career development and watering the veggies with ‘worm juice’, a fertiliser now assists with the weekly sorting and distribution of laundry to residents produced by the centre. at Iona, Nhill. A task undertaken with precision and a cheerful smile.
Exciting Year in Disability Services The collection of cardboard and Cooinda operates a large Breeder Shed newspaper has ceased, triggered by the for Luv-a-Duck with eggs collected and Cooinda Disability Service encompassing high cost of compliance with new OH&S delivered daily to the Hatchery where they Oliver’s Café, Oliver’s Kiosk, Snappy regulations, the decline in the global price are processed and then distributed to Seconds, Cooinda Duck Farm (partnership of cardboard and high fuel costs. grower farms. with Luv-a-Duck) and State Funded Day Luv-a-Duck management continues to Programs provide innovative programs Innovation and Enthusiasm for clients. applaud the quality of the Supported Paper shredding, fi re brick making Employees and praises their handling 2008/2009 has been an exciting and worm farms are new programs of the ducks, with outstanding egg year with program changes and new being developed. numbers delivered in the second year opportunities. of involvement. Paper is shredded to produce fi re bricks Oliver’s Café continues to gain increasing and we are experimenting to produce Three Supported Employees are studying market share and is fi rmly entrenched as smaller fi relighters. for the Certifi cate in Poultry Management ‘the place to eat’ in Nhill. Excellent meals and will sit their fi nal examinations in and timely service has contributed to A venture into worm farming to produce August 2009. increased clientele. liquid fertiliser is proving to be a great success which will introduce a The new programs have been very ‘Oliver’s Kiosk’ was opened in March commercial presence. successful providing clients choice and 2009 by Mr Jock McLean – Contract the opportunity to develop new skills Manager, Department of Families, The new Sensory Room is important for making Cooinda ‘The Happy Place’, the Housing, Community Services and the Diversional Therapy Program and meaning of its name. Indigenous Affairs. offers mood music with soothing and stimulating visual effects resulting in a The Kiosk offers a tempting variety calming environment. The Future of light meals and excellent coffee DHS is making changes to the funding for patients, visitors and staff, The garden program provides pleasure regime for Disability Services which simultaneously creating employment and a sense of achievement. Plots have will challenge Service Providers such as opportunities for Supported Employees. been extended with produce sold through Cooinda. We are confi dent Disability and a local craft shop. Clients assist at a Snappy Seconds, pre-loved and Business Services will continue to provide Herb Farm, harvesting Peppermint and collectables in Nhill now opens on a caring and supportive environment for preparing it for drying. Saturday mornings, made possible by our clients with their future endeavours, the efforts of our wonderful team of and ‘Cooinda’ will be no exception. volunteers adding another dimension to this enterprise. 52 WEST WIMMERA HEALTH SERVICE
CORPORATE AND QUALITY SERVICES SUPPORT THAT IS ESSENTIAL
Although not directly related to hands on patient care the support services of the Corporate & Quality Division – Engineering and Maintenance, Catering and General Services, Education and Health Information Services are vital to our ability to function. ANNUAL REPORT 2008/2009 53
Our Goal Strategies Achievements Future
To provide timely, Provide a comprehensive Continued redevelopment of Complete Nhill Hospital effi cient and preventative maintenance ‘Mira’ Primary and Community redevelopment. effective support program. Health Centre. Expand incident reporting services. Undertake building renovation Redevelopment of Helen to gather more detailed projects to enhance the Macpherson Smith Day Procedure analytical data. physical infrastructure of the Unit to accommodate a 4 chair Implement recommendations Service . Dialysis Unit. arising from the security Provide tasty and nutritious Gazebo built at Natimuk for review . freshly cooked meals for sheltered outdoor activities. Replacement of air patients and staff. Modifi cation of Oliver’s Kiosk. conditioning systems at Provide a clean and hygienic Natimuk Hostels. 315 staff education sessions with environment minimising the a total of 2410 attendees. Integrate the Kaniva risk of infection. nurse call system with fi re Provision of 191,406 fresh Provide a comprehensive detection systems. cooked meals across all sites. education program. Establish secondary storage External cleaning audit results Provide health information in a compound. 11% above the State benchmark. secure manner. Complete ‘No Smoking’ Security review undertaken – Provide a safe and secure policy. result 98% compliant. working environment.
General Service – Clean, Hygienic External Cleaning Audits The Dollars for Continual Improvement and Safe Environment A number of grant submissions made to The necessity to maintain a clean 100 DHS were successful for which we are grateful and include. environment minimising the risk of 95 infection is at the forefront of our actions. > The replacement of evaporative air With the rapid spread of H1N1 (Swine) Flu 90 conditioning system at Trescowthick in May and June 2009 the community also House Hostel and Allan W. Lockwood 85 became conscious of the need for a clean Special Care Hostel at Natimuk with a and hygienic environment. 80 new refrigerated system prior to the 2009 2008 2007 2006 2009/10 summer season, to ensure How we know standards are reached residents remain comfortable and safe A thorough and comprehensive cleaning WWHS State Benchmark during all weather conditions. program is in place at all sites. Regular > The installation of an additional hot audits are undertaken by staff and water system at Kaniva Hospital and independent external auditors to ensure Engineering & Maintenance Nursing Home will increase the safety we meet or exceed Department of Human Services and comfort of patients and residents. Services (DHS) standards. Our highly skilled team undertakes The 2009 external audit outcome revealed most repairs and maintenance and a outstanding results. large amount of our redevelopment projects, without having to outsource Our patients believe the hospitals tradespersons - a considerable saving and within WWHS are clean. When asked to importantly has ensured a high standard rate cleanliness between 0 (poor) and 5 of quality workmanship. (excellent) we have performed above the State average. The Engineering staff have undertaken projects including the redevelopment of ‘Mira’, Primary and Community Victorian Patient Satisfaction Monitoring Health facility, installation of a Gazebo for dementia specifi c residents at December 2008 WWHS State-wide Natimuk, modifi cation of Oliver’s Kiosk The cleanliness of the 4.51 4.05 at Nhill Hospital and relocation of the toilets and showers dialysis unit. PAGE LEFT: Joanne McCartney, General Services The cleanliness of the 4.53 4.14 Supervisor, conducts a cleaning audit using the room where you spent How fortunate we are to have such Palm Pilot software program. the most time skilled tradesmen. 54 WEST WIMMERA HEALTH SERVICE
BELOW: Wearing protective ear and face shields, Ian Barry guides timber on the saw CORPORATE AND QUALITY SERVICES bench, and Matthew McCartney works on the SUPPORT THAT IS ESSENTIAL grinder in the maintenance workshop.
Safety and Security A security review was conducted to ensure security measures in place met with Australian Standards. 98% compliance with mandatory security criteria resulted. An excellent outcome, it is the highest score of any hospital surveyed by the consultant in the previous four years. Recommendations were made to improve our security systems and an Action Plan, including a priority rating, has been developed to facilitate the implementation which includes the introduction of Closed Circuit Television cameras to provide documentary evidence of security issues as they occur, which will signifi cantly improve security across our organisation.
Health Information Services Every patient treated at WWHS has a Medical Record containing medical and administrative information. The Record provides a comprehensive history of previous medical treatment which assists health professionals to plan future or emergency care should this arise. Information, particularly administrative and diagnostic information including Catering – Nutritious and Tasty causing great concern for our Service pathology and X-ray results, are held Meal Options and the Country Fire Authority (CFA). electronically, with other information The volunteer Kaniva Brigade has been relating to treatment while in hospital A major imperative for our Catering extremely patient and understandably or in an outpatient or emergency care Departments has been to establish a became increasingly frustrated by situation in paper format. new menu. During the 15 week trial some unnecessary call outs. The false alarms recipes proved successful and others were caused by ageing fi re detectors Your Privacy Assured not so. and wiring. We are forever vigilant to ensure people However changes to recipes and menu We worked closely with the CFA and DHS are confi dent that their information choices did occur. seeking funding to install a fi re detection remains confi dential and will only be A number of complaints were received system, integrated with the nurse call and available for those purposes for which from Aged Care residents that meals were paging systems. A vital improvement, with consent is given. funding being provided for this purpose. ‘too healthy’ and missed the opportunity To this end, staff must regularly to indulge in occasional ‘fast food’ items. Power Surge at Rainbow and Jeparit participate in privacy and confi dentiality Given the need to promote the importance Hospitals education. At the end of this reporting period, 98% of our staff were compliant of patient and resident choice, ‘special Rainbow and Jeparit Hospitals with the mandatory privacy and meals’ have now been reintroduced, experienced a power surge in April 2009 confi dentiality training – a reassuring an initiative which has met with which caused a number of electrical outcome. resounding acclaim. systems to fail at the Rainbow Hospital. Prior to fi nal approval, the menu is now As a result a number of electrical Looking Forward to Next Year being reviewed by Dietitians, Speech applications and appliances, including and Beyond Pathologists and Catering Staff electronic beds, water heating and chilling systems and air conditioners required We will embrace new technologies Challenges replacement. to increase effi ciencies in all departments including ‘state-of-the-art’ Fire Alarms at Kaniva Service personnel and contractors worked catering equipment with the planned around the clock to ensure residents and During the fi nal six months of the redevelopment of the Nhill Hospital patients safety was not compromised reporting period the number of false fi re catering unit, introduce CCTV video during this traumatic period. alarm calls increased at Kaniva Hospital monitoring for improved security and Nursing Home. The calls were These systems have now been returned purposes and implement the electronic to working order with associated costs iSoft Patient Management system. subject to an insurance claim. ANNUAL REPORT 2008/2009 55
CORPORATE AND QUALITY SERVICES ACCREDITATION – AN EXTERNAL MEASURE OF QUALITY
We are committed to Australian Council of > Organisational wide survey > 19 recommendations was conducted in November resulted which are now being providing quality care Healthcare Standards (EQuIP) ACHS 2008 with Full accreditation addressed. across our entire range status received – four years. > A Self-assessment, focusing Reviews WWHS of services. We submit > ‘Extensive Achievement’ on Clinical Functions will be organisation within a 4 the quality of our status awarded for ‘Infection submitted to the Council in year cycle – including Control’ and ‘Community October 2009. care for assessment acute inpatients, Consultation’ Standards. > ACHS is a pre-eminent by participating in residential aged High praise indeed. organisation recognised external accreditation care, primary health, > ‘Moderate Achievement’ nationally for the quality of its disability and support status achieved for 41 accreditation programs. processes, with services Criteria, including all independent surveyors ‘Mandatory Criteria’. reviewing services against ‘best practice’ Home and Community > Assessment in November > High Standard was recorded Care (HACC) ACHS 2008 reviewed District for all 25 standards, with a and national standards. Nursing Service against the rating of 20/20. Addressing District National Standards of the > A perfect example of our Nursing & Planned ACHS. continuous improvement Activity Groups ideals. It is pleasing to report all forms of accreditation Aged Care Standards > Survey undertaken at > Weeah Lodge Nursing Home, undertaken have resulted and Accreditation Archie Gray Nursing Home Rainbow. in positive outcomes, Agency (ACCA) Unit, Kaniva, in February > Bowhaven Hostel, Rainbow. 2009 resulted in three year reinforcing the excellence Review of individual accreditation status being > Residential Aged Care Nursing of care delivered by West residential aged achieved with compliance in Home, Natimuk. Wimmera Health Service. care sites every 3 all 44 criteria. > Allan W. Lockwood Special years in accordance > Unannounced site visits Care Hostel, Natimuk. with Commonwealth were conducted at each of > Trescowthick House Hostel, legislation the following residential Natimuk. aged care facilities with > Accreditation kits have total compliance resulting. been submitted to ACCA in > ‘Iona’ Digby Harris Home, preparation for surveys to Nhill. take place at 8 of our Nursing > Archie Gray Nursing Home Homes and Hostels, scheduled Unit, Kaniva. for August and September 2009. > Arthur Vivian Close Hostel, Kaniva . > Tullyvea Nursing Home & Hostel, Jeparit.
Disability Services > Annual review audit was > An Action Plan is in place to Accreditation undertaken in July 2008 address all recommendations with one area of minor from July 2008 review. Relevant to Cooinda non-conformance identifi ed > A further review is due to take Disability Service relating to a formal Audit place in July 2009. program. > A follow up review in January 2009 revealed the Audit program was re-presented with the non-conformance cleared.
Diagnostic Imaging > From July 2009 the > Self assessment and desktop (X-Ray) ACHS Department of Health & audits were undertaken by Ageing require all Diagnostic ACHS assessing our Service Related to X-Ray Imaging practices to be against national standards. services at Nhill, accredited in order to be > Full Stage 1 accreditation Jeparit & Kaniva eligible to receive Medicare status was achieved which benefi ts. is valid from May 2009 to June 2010.
Department of Health > Full accreditation status > The fi ve recommendations & Ageing by Department of Health & received for CACP have been Ageing maintained. addressed. Community Aged Care > Self-assessment toolkit > Six recommendations Packages (CACP) submitted in preparation for received for NRCP, fi ve of National Respite for full survey in August 2009. which have been complied Carers Program (NRCP) with. One recommendation relating to carer needs remains ongoing. 56 WEST WIMMERA HEALTH SERVICE
CORPORATE AND QUALITY SERVICES > ENVIRONMENT AND SUSTAINABILITY
Enduring a decade of sustained Where possible we purchase items Insulating For Effi ciency manufactured according to environment drought conditions in the West and Insulation was installed in the ceilings sustainability standards. For example the Southern Wimmera and Southern of the two Natimuk Hostels providing photocopy paper we use is purchased from instant relief from extreme heat as well as Mallee has provided us with a tangible a mill accredited under ISO 14001 for its lowering energy consumption levels. illustration of resulting catastrophic Environmental Management System. outcomes that can occur if we do not External blinds were fi tted to several 85% of the water used in making the paper window areas at Rainbow Hospital protect the environment and promote is recycled. its long term sustainability. thus reducing external heat during Macerators summer, and reducing the burden on We have contributed to this cause through air-conditioning systems. the following initiatives: Macerators, an environmentally friendly method of human waste disposal, provide Vehicle Replacement Landfi ll Waste substantial savings to the environment Selection criteria for replacement and the Service when compared with the To improve collection, recycling and of vehicles in our fl eet now includes fl ush method: disposal of waste material a trial using air pollution and greenhouse rating ‘Rubbish Skips’ has been introduced at > 85% saving in electricity; with vehicles purchased in 2008/09 Kaniva and Nhill Hospitals. > 75% reduction in cold water usage; averaging an effi ciency rating of 3.5–4 out of a possible 5 stars and a greenhouse The ‘skips’ cope with waste too large for > 100% reduction in hot water rating of between 7–7.5 out of 10, domestic bins used previously. consumption; an improvement on previous vehicles Effi ciencies gained have translated into > Consumables used in the macerators which averaged a greenhouse rating of estimated cost savings of 53%, improved are manufactured from recycled paper. 6 out of 10. control of vermin and a reduction in Application has been made to the inappropriate disposal of waste, therefore Department of Human Services for The Future reducing waste consigned to landfi ll. funding to install macerators at Jeparit The review of energy use planned for Efforts have also been intensifi ed to and Kaniva Hospitals, our two remaining 2008/09 to explore methods of maximising maximise recycling opportunities and sites waiting to maximise the benefi ts of effi ciency and minimising costs thus minimise landfi ll waste through the this effi ciency initiative. maintaining a pleasant and comfortable segregation of paper, cans, bottles and environment, will now proceed in 2009/10. plastic. Rain Water Storage at Jeparit – a First We will introduce innovation in all recycling Paper and energy conserving practices to protect Four tanks purchased for Jeparit Hospital, the environment and achieve sustainability A trial of paper brick making as a business with funding of $14,500 received from wherever and whenever we can! activity at Cooinda using shredded paper the Department of Human Services, has commenced. The paper bricks will be provided the opportunity to collect and sold for domestic use. store rainwater. The Hospital is now self- suffi cient in terms of access to rain water. ABOVE: At the Jeparit Hospital, plumber Reg Previously, water had been purchased Parsons continues work on the installation of and transported to the Hospital at rain water tanks which were provided through considerable cost. a DHS funding grant. ANNUAL REPORT 2008/2009 57
LEGISLATION CRITICAL TO OUR PERFORMANCE
West Wimmera Health Service Occupational Health & Safety Police Checks has a fundamental obligation to Act 2004 It is a legislative requirement that all staff establish a sound system which Providing a safe working environment is and volunteers have a current Victorian ensures compliance with legislative paramount. The Occupational Health & Police Check. No one is employed or requirements specifi c to the Safety Act 2004 details employer and accepted as a volunteer at this Service healthcare industry. Compliance is a employee responsibilities. without a valid Police Check. central element of the legal obligation Two visits from WorkSafe Victoria Compliance with this regulation is of the Service. Offi cers occurred, with offi cers being monitored monthly, with staff notifi ed satisfi ed with health and safety processes when their Police Check nears expiry. Statement on Compliance with in place. The organisation is 100 per cent compliant the Building and Maintenance On one occasion an employee injured in with this requirement. Provisions of the Building Act the workplace required hospitalisation 1993 which was reported to WorkSafe Publications Victoria. A resulting visit by WorkSafe Publications produced by West Wimmera The Building Code of Australia specifi es offi cers confi rmed that changes made to buildings must be classifi ed according to Health Service are readily available from procedures had minimised the risk of such the Service, on the website – their function. The Code, incorporating the an incident recurring. Building Regulations 2006, defi ne building www.wwhs.net.au ,or by contacting and safety requirements, including fi re Consultancies the Service by telephone, mail or email safety and entry and egress depending on [email protected]. the use of the building. Consultancies to Publications include Annual Reports, The Essential Safety Measures Report WWHS No. Value $ Quality of Care Reports, Strategic Plan, is prepared annually in accordance with In excess of $100,000 0 0 The Residential Aged Care Booklet, a requirements of the Building Regulations Less than $100,000 11 137,895 brochure outlining the activities and 2006 and confi rms the safety of buildings, services at Cooinda, and Information including fi re safety, entry and exits and Summary of Application and brochures related to specifi c health conditions and post operative care. disabled access. Operation of Whistleblower Act The Board receives reports testifying to The Whistleblowers Protection Act 2001 Fees such compliance. is to encourage and simplify the process State and Commonwealth Governments A comprehensive Preventative of making of disclosures of improper set fees to be applied for most Maintenance Program is in place at all conduct by public offi cers and public services offered. sites to ensure physical infrastructure bodies, to provide protection for persons remains in a safe condition. who make those disclosures and to The schedule of fees is available from the provide for these disclosed matters to be Service where Policies and Procedures are Freedom of Information Act 1982 properly investigated and dealt with. in place outlining systems and processes for payment and collection of fees Through the Freedom of information Act The value of transparency and and charges. clients and patients are able to gain access accountability in administrative and to information relating to their care. management practices is accepted, and National Competition Policy support disclosures which reveal corrupt In exceptional circumstances requests conduct, substantial mismanagement of Competitive neutrality ensures the for access to information may be denied public resources, or conduct involving a signifi cant business activities of if safety and privacy of an individual is substantial risk to public health and safety publicly owned entities compete fairly deemed to be in jeopardy. or the environment. in the market. As this policy only applies Three applications were made under to signifi cant businesses of a for-profi t The Service’s Whistleblower Policy Freedom of Information, all of which nature, no disclosure by the Service outlines the process of making a were granted. The applications related to is required. disclosure which is available on the requests for medical record information. Service Intranet. Victorian Industry Participation Nine requests for information, outside the The Operations Manager is the Policy (VIPP) Freedom of Information guidelines, were Disclosure Offi cer. also processed. Five of these requests This policy was introduced in 2003 to were from treating practitioners, with No disclosures or notifi cations of increase opportunities for local business the remaining requests from police and disclosure under this Act were received. and supply chain partners to participate solicitors. in government related business. Information The Chief Executive Offi cer The Service did not tender any is the designated Freedom of Information about any facet of WWHS works above the designated $1m Information Offi cer. may be requested by contacting the CEO threshold, therefore no reporting by mail or telephone. requirements apply. 58 WEST WIMMERA HEALTH SERVICE
FINANCE AND ADMINISTRATION SUSTAINABLE AND ACCOUNTABLE
Goals Strategies Achievements Future
To be an industry leader in fi nancial Maintain a cohesive and Fourth consecutive year Ensure the successful reporting and control. well trained fi nance team. of achieving an operating implementation of a new surplus. fi nancial management To maximise the level of fi nancial Provide fi nancial information system resources available for operating management education Installation of the scheduled to occur in and future capital and equipment and assistance to PayGlobal Human March 2010. renewal. managers. Resource Self Service (HRSS) module which Maximise use of To be recognised as a reliable and allows employees to HRSS to improve the responsive provider of fi nancial and check online pay related effectiveness and administrative services and able to details including their effi ciency of the Payroll identify and successfully deal with mandatory education Department. emerging fi nancial challenges in a status and leave timely manner. applications. Achieve an operating surplus for the 2009-2010 fi nancial year. ANNUAL REPORT 2008/2009 59
The Finance and Administration Through the application of Service WWHS Workforce Composition Division has completed another policies and compliance with legislation 2009 2008 trouble free fi nancial year due we are able to: in no small part to the continued > Ensure open competition in Employees recruitment, selection, transfer and commitment of staff to best practice Full Time 134 121 promotion Part Time 296 296 ,and to gaining and applying new skills > Base employment decisions on merit Casual 116 119 and knowledge at every opportunity. > Treat employees fairly and reasonably Grand Total 546 536 Procurement > Provide employees with a reasonable avenue of redress against unfair or Equivalent Full Time by Category The proper functioning of our Stores and unreasonable treatment Nursing 160 160 Supply Department is critical to clinical Administration 31 32 staff delivering the best possible care > Avoid discriminating between Medical & Allied Health 25 23 employees on the basis of gender, age, to patients, clients and residents. The Professionals effective and effi cient management of impairment, industrial activity, marital General Services 53 52 all stages of the procurement process is a status and religious or political belief Maintenance 18 18 vital part of this process. > We do not tolerate bullying and Disability 10 14 The following chart shows the value harassment in any form. Grand Total 297 299 of medical and surgical inventory as a percentage of the annual cost of medical Workcover Employees by Gender and surgical goods purchased. The fall in A safe and secure environment and a Female - EFT 252 251 this metric indicates a signifi cant increase healthy workforce are vital components Female - Number 446 447 in the effi ciency of the supply and storage of a successful health service. There Male - EFT 44 48 of medical and surgical goods. were no serious staff injuries, diseases or Male - Number 70 71 A trainee storeman has quickly become workplace deaths during the year. a reliable assistant to the Purchasing We acknowledge our WorkCover Offi cer. insurance agent, Cambridge Integrated Service which continues to provide Medical & Surgical Stock as a Percentage timely assistance in the management of of Total Goods and Services Costs injured workers.
20 Finance Continued increases in the level of 15 compliance reporting to a variety of 10 stakeholders have been met by improved
Percentage use of the PowerBudget fi nancial 5 management and reporting software. 0 The Finance Team works together to 2005 2006 2007 2008 2009 ensure accounting and fi nance processes are executed in a prompt and effective Employment manner. Our commitment to remaining an A trainee has commenced in our Finance ‘employer of choice’ is underpinned by our and Payroll Departments adding strength ongoing compliance with the obligations and diversity to these services. and requirements of the following legislation: Payroll > The Victorian Public Authorities (Equal The Pay Offi ce Manager and Clerk Employment Opportunity) Act 1990 ensure employees are paid on time and > The Victorian Equal Opportunity in accordance with all contractual and Act 1995 industrial agreements. > The Victorian Public Sector Upgrades to the PayGlobal personnel Management and Employment management software including the Act 1998 installation of the Human Resource Self Service (HRSS) module is expected to > The Commonwealth Disability materially reduce non-staff related Discrimination Act 1992 administrative costs associated with > The Commonwealth Racial paying over 500 people. Discrimination Act 1975 PAGE LEFT: Purchasing Offi cer, Luke Oldaker > The Victorian Public Administration (right) and trainee storeman Clint Beattie (left) with the fi rst of the morning deliveries Act 2004 60 WEST WIMMERA HEALTH SERVICE
FINANCE AND ADMINISTRATION > SUSTAINABLE AND ACCOUNTABLE
Information & Communication In August 2009 a new Patient Management The importance of ICT has grown as Technology (ICT) System will be implemented as part of evidenced by the use we now make of a statewide standardised information videoconferencing. This technology has ICT affects all areas of our business and is technology system. It will occur in greatly reduced the amount of travelling integral to maintaining the effi ciency and conjunction with other public health required for internal and external effectiveness with which our services are services in the Grampians region. meetings, meaning material savings in delivered. However proper management of time and money. this potentially costly area is vital. Our IT iSoft includes patient admissions and Strategic Plan is pivotal to this outcome. discharges, bookings for the Operating We acknowledge the prompt and Theatre, referrals to Specialists and Allied professional assistance received from our The Service is now a member of the Health staff, bed allocation and diagnosis principal ICT services provider, Dulkeith Grampians Regional Health Alliance and procedure coding. Computer Solutions. (GRHA), a joint venture of Grampians region health services established to Preparation for the implementation has manage the acquisition and installation occurred, with training for staff now taking of major region-wide IT systems including place to ensure the system is used to its ‘iSoft’ (Patient and Client Management maximum potential when we ‘go live’. System) and Oracle (Financial Management The implementation of the new system will Information System). improve effi ciency by ensuring maximum GRHA is funded directly by the Victorian bed allocation and use. Government to provide cohesive and cost- The successful implementation of our effective management of the new system. Residential Aged Care clinical notes GRHA also maintains the ICT connections and care planning software, ‘iCare’, ABOVE: Josh Rintoule, Trainee Administration within the Service and external to it. demonstrated that remoteness of a Clerk (front), Cassy Moar, Assistant Accountant health service in no way detracts from (centre), and Richard Lane, Accounts Payable Offi cer (at rear) during training for the new technological outcomes. PayGlobal Human Resource Self Service (HRSS) payroll system. ANNUAL REPORT 2008/2009 61
FINANCIAL PERFORMANCE OVERVIEW
The strong fi nancial performance reported by the Service in recent fi nancial Funding Expenditure years has continued through 2008-2009 with another impressive operating It is often said an organisation’s greatest result achieved and relatively high levels of cash and investments held at asset is its employees, which in absolute year end. expenditure terms is true of West Wimmera Health Service. The ongoing efforts by management and staff to maximise revenue streams, This year employee related costs were while at the same time keeping costs under control, has contributed $19.54m representing some 75% of signifi cantly to this outcome. total operating expenditure, and a 1.3% The fi nancial support of the Department of Human Services and our many increase on 2007-2008. generous benefactors is noted and greatly appreciated. Summary of Signifi cant Changes to Financial Position Summary of Financial Results During the Year The following table lists those balance Profi t & Loss Financial Year Ending 30 June sheet items which have changed 2009 2008 2007 2006 2005 signifi cantly over the 2008-2009 fi nancial year: $’000s $’000s $’000s $’000s $’000s Revenue 26,733 25,961 24,743 23,970 22,815 Summary of Signifi cant Financial Changes Employee Related Expenditure (18,339) (18,119) (17,797) (17,164) (16,362) Non-Salary Labour Costs (1,201) (1,161) (927) (956) (796) 2009 2008 Supplies & Consumables (2,224) (1,882) (1,795) (1,722) (1,457) $’000 $’000 Other Expenses (4,370) (4,349) (4,076) (4,077) (4,219) Property, Plant & 52,350 42,844 Net Result before Capital & Specifi c Items 599 450 148 51 (19) Equipment - Asset Net Capital Items & Specifi c Items (includes depreciation) (174) 1,023 391 2,443 3,657 Property, Plant & 10,050 370 Net Result for the Year 425 1,473 539 2,494 3,638 Equipment Revaluation Reserve - Equity Balance Sheet Financial Year Ending 30 June 2009 2008 2007 2006 2005 $’000s $’000s $’000s $’000s $’000s In accordance with the requirements of Current Assets 8,228 8,255 4,329 3,530 4,254 the Department of Treasury and Finance, Non-Current Assets 52,378 42,894 43,963 44,083 40,474 the Service had all Land and Buildings Current Liabilities (8,580) (9,317) (7,927) (7,910) (8,165) revalued by the Victorian Valuer General Non-Current Liabilities (522) (433) (659) (536) (390) as at 30 June 2009. Net Assets (Equity) 51,504 41,399 39,706 39,167 36,173 This resulted in a net gain on revaluation of $9.68m hence the signifi cant increase in the value of the Service’s Property, Plant & Equipment asset category. Net Operating Surplus Sources of Operating Income As such revaluations must be recorded directly in the Balance Sheet this had The net operating surplus (income minus In 2008-09 approximately 59% (2007- the effect of increasing the Service’s expenses before capital items) was 2008: 58%) of the Service’s total Property, Plant & Equipment Revaluation $599,000 compared to the surplus of operating revenue was provided by the Reserve by the same amount. $450,000 recorded in 2007-2008. This Department of Human Services ($15.7m) year’s result signifi cantly bettered the which equates to an increase of 6.0% original budget of surplus $195,000. from the previous year. Cash and Investments The remainder of operating revenue which includes receipts from the At 30 June 2009 the Service held some Australian Government for residential $3.9m in cash and investments which Aged Care ($5.266m) totalled $11.09m does not include monies held in relation representing a 1% decrease compared to Aged Care Accommodation Bonds, with the previous fi nancial year. The and is after deducting those amounts primary cause of this reduction was which have been earmarked for a specifi c the planned cessation of the $550k purpose. This amount is well in excess of grant previously received from the the budget forecast of $2.6m. Australian Government to cover the fi nancial effects upon the Service of recent changes to Fringe Benefi ts Tax Legislation. 62 WEST WIMMERA HEALTH SERVICE
FINANCIAL PERFORMANCE > OVERVIEW
Financial Ratios Debt to Equity Ratio – (Gearing) 0.18 Current Asset Ratio Comparison Current Ratio 0.89 This ratio is used to indicate the level to At 30 June 2009 the Service’s Current 2.0 which the Service relies on externally Ratio (Current Assets divided by Current sourced funding and shows that it only 1.5 Liabilities) was 1.47. This means that for requires a small level of such funding. every dollar of current liabilities payable 1.0 by the Service, it holds $1.47 cents worth Ratio Conclusion of current assets. This ratio is used to 0.5 The strong fi nancial results reveal that indicate the Service’s capacity to pay its West Wimmera Health Service has the debts ‘when they fall due’. 0.0 ‘97 ‘99 ‘01 ‘03 ‘05 ‘07 ‘09 capacity to successfully adapt to the changing fi nancial environment in which As can be seen in the following chart, the Year ended June 30 Service’s Current Ratio has shown strong it operates. The Service’s current ratio has ended the past fi ve gains in the past two years following the years at its highest result during such time. This Despite the fi nancially challenging completion of the redevelopment of the outcome indicates that the Service is well able to environment faced by the Service Nhill Hospital. fund its short term fi nancial obligations and that it is over the past decade coupled with in a good fi nancial position going into the 2009-2010 major redevelopment works which it fi nancial year. undertook during such time, the Service nevertheless fi nds itself in a sound Quick Asset Ratio 0.99 fi nancial state from which it can look with confi dence to continuing to meet the The Service’s Quick Asset Ratio is similar many and changing healthcare needs of to the Current Ratio, however it only the people we serve. includes those current assets and current liabilities which are of a very short-term nature and therefore is used to gauge the Service’s short-term solvency. This result means that the Service has 99 cents worth of liquid current assets (2007- ABOVE: Receptionist Kerryn Cook has a busy morning with patient appointments for 2008: 93 cents) for every one dollar of Radiology and Visiting Surgeons. short-term current liabilities. ANNUAL REPORT 2008/2009 63 64 WEST WIMMERA HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 65
West Wimmera Health Service Board member’s, accountable offi cer’s and chief fi nance & accounting offi cer’s declaration We certify that the attached fi nancial report for West Wimmera Health Service has been prepared in accordance with Standing Direction 4.2 of the Financial Management Act 1994, applicable Financial Reporting Directions, Australian Accounting Standards, Australian Accounting Interpretations and other mandatory professional reporting requirements. We further state that, in our opinion, the information set out in the Operating Statement, Balance Sheet, Statement of Changes in Equity, Cash Flow Statement and notes forming part of the fi nancial report, presents fairly the fi nancial transactions during the year ended 30 June 2009 and fi nancial position of West Wimmera Health Service at 30 June 2009. We are not aware of any circumstance which would render any particulars included in the fi nancial report to be misleading or inaccurate. We authorise the attached fi nancial report for issue on this day.
R A Ismay J N Smith R R Dodds Board Member’s President Accountable Offi cer Chief Finance & Accounting Offi cer Nhill Nhill Nhill 24 August 2009 24 August 2009 24 August 2009
Operating Statement For the Year Ended 30 June 2009 Balance Sheet as at 30 June 2009
2009 2008 2009 2008 Note $’000 $’000 Note $’000 $’000 Revenue from Operating Activities 2 26,228 25,500 Current Assets Revenue from Non-operating Activities 2 477 461 Cash and Cash Equivalents 6 5,350 5,132 Employee Benefi ts 3 (18,339) (18,119) Receivables 7 569 655 Non Salary Labour Costs 3 (1,201) (1,161) Other Financial Assets 8 2,012 2,209 Supplies & Consumables 3 (2,224) (1,882) Inventories 9 265 252 Other Expenses From Continuing Operations 3 (4,370) (4,349) Other Current Assets 10 32 7 Share of Net Result of Associates & Joint Total Current Assets 8,228 8,255 Ventures Accounted for using the Equity Method 11 28 - Non-Current Assets Receivables 7 - 50 Net Result Before Capital & Specifi c Items 599 450 Investments Accounted for using the Equity Capital Purpose Income 2 958 2,199 Method 11 28 - Depreciation and Amortisation 4 (1,132) (1,172) Property, Plant & Equipment 12 52,350 42,844 Finance Costs 5 - (4) Total Non-Current Assets 52,378 42,894 NET RESULT FOR THE YEAR 425 1,473 TOTAL ASSETS 60,606 51,149
This Statement should be read in conjunction with the accompanying notes. Current Liabilities Payables 13 1,438 1,436 Employee Benefi ts and Related On-Costs Provisions 14 4,519 4,888 Other Liabilities 15 2,623 2,993 Total Current Liabilities 8,580 9,317
Non-Current Liabilities Employee Benefi ts and Related On-Costs 522 433 Provisions 14 Total Non-Current Liabilities 522 433 TOTAL LIABILITIES 9,102 9,750 NET ASSETS 51,504 41,399
EQUITY Property, Plant & Equipment Revaluation Reserve 16a 10,050 370 Restricted Specifi c Purpose Reserve 16a 427 427 Contributed Capital 16b 25,924 25,924 Accumulated Surpluses/(Defi cits) 16c 15,103 14,678 TOTAL EQUITY 16d 51,504 41,399 Contingent Liabilities 20 Commitments for Expenditure 19
This Statement should be read in conjunction with the accompanying notes. 66 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Cash Flow Statement For the Year Ended 30 June 2009 Notes to the Financial Statements 30 June 2009
2009 2008 Table of Contents Note $’000 $’000 Note Page CASH FLOWS FROM OPERATING ACTIVITIES 1 Statement of Signifi cant Accounting Policies 67 Operating Grants from Government 16,784 17,309 2 Revenue 70 Patient and Resident Fees Received 8,673 8,962 2a Analysis of Revenue by Source 71 Donations and Bequests Received 27 37 2b Patient and Resident Fees 72 GST Received from/(paid to) ATO 544 (255) 2c Net Gain/(Loss) on Disposal Non-Current Assets 72 Interest Received 463 391 3 Expenses 73 Other Receipts 733 512 3a Analysis of Expenses by Source 74 Employee Benefi ts Paid (18,846) (18,288) 3b Analysis of Expenses by Internal and Restricted Specifi c Purpose 74 Non Salary Labour Costs (870) (868) Funds for Services Supported by Hospital and Community Initiatives Payments for Supplies & Consumables (7,291) (6,201) 4 Depreciation and Amortisation 75 Finance Costs - (4) 5 Finance Costs 75 Cash Generated from Operations 217 1,595 6 Cash and Cash Equivalents 75 7 Receivables 75 Capital Grants from Government 398 705 8 Other Financial Assets 75 Capital Donations and Bequests Received 227 1,169 9 Inventories 75 Non-Government Capital Income 333 325 10 Other Assets 75 11 Investments Accounted for Using the Equity Method 76 NET CASH INFLOW/(OUTFLOW) 1,175 3,794 12 Property, Plant & Equipment 76, 77 FROM OPERATING ACTIVITIES 17 13 Payables 77 CASH FLOWS FROM INVESTING ACTIVITIES 14 Employee Benefi ts and Related On-Costs Provisions 77 Payments for Non-Financial Assets (1,242) (420) 15 Other Liabilities 78 Payments for Facility Redevelopments - (154) 16 Equity 78 Proceeds from sale of Non-Financial Assets 285 - 17 Reconciliation of Net Result for the Year to Net Cash 78 NET CASH INFLOW/(OUTFLOW) Infl ow/(Outfl ow) from Operating Activities (957) (574) FROM INVESTING ACTIVITIES 18 Financial Instruments 79 19 Commitments for Expenditure 82 CASH FLOWS FROM FINANCING ACTIVITIES 20 Contingent Liabilities 82 Proceeds from Borrowings 229 378 21 Segment Reporting 83, 84 Repayment of Borrowings (229) (378) 22a Responsible Person Disclosures 84 Transactions with the State in its capacity as 22b Executive Offi cer Disclosures 84 owner - 220 23 Events occurring after the Balance Sheet Date 84 NET CASH INFLOW/(OUTFLOW) 24 Auditor Remuneration 84 - 220 FROM FINANCING ACTIVITIES NET INCREASE/(DECREASE) IN CASH HELD 218 3,440 CASH AND CASH EQUIVALENTS AT 5,132 1,692 BEGINNING OF PERIOD CASH AND CASH EQUIVALENTS AT END OF PERIOD 6 5,350 5,132
This Statement should be read in conjunction with the accompanying notes
Statement of Changes in Equity For the Year Ended 30 June 2009
2009 2008 Note $’000 $’000 Total equity at beginning of fi nancial year 41,399 39,706 Gain/(loss) on Asset Revaluation 16a 9,680 - NET INCOME RECOGNISED DIRECTLY IN EQUITY 9,680 - Net result for the year 425 1,473 TOTAL RECOGNISED INCOME AND EXPENSE FOR THE YEAR 10,105 1,473 Transactions with the State in its capacity as - 220 owner 16b Total Equity at the end of the fi nancial year 51,504 41,399
This Statement should be read in conjunction with the accompanying notes NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 67
Note 1: Statement of Signifi cant Accounting Policies Revaluation increases and revaluation decreases relating to individual assets within an asset (a) Statement of compliance class are offset against one another within that class but are not offset in respect of assets in The fi nancial report is a general purpose fi nancial report which has been prepared on different classes. an accrual basis in accordance with the Financial Management Act 1994 and applicable Revaluation reserves are not transferred to accumulated funds on derecognition of the relevant Australian Accounting Standards (AASs) and Australian Accounting Interpretations. AASs asset. includes Australian equivalents to International Financial Reporting Standards. In accordance with FRD 103D West Wimmera Health Service’s non-current physical assets The Service is a not-for profi t entity and therefore applies the additional Aus paragraphs were subjected to a detailed valuation in the current fi nancial year. applicable to “not-for-profi t” entities under the AAS’s. (k) Depreciation and Amortisation (b) Basis of preparation Assets with a cost in excess of $1,000 are capitalised and depreciation has been provided The fi nancial report is prepared in accordance with the historical cost convention, except for on depreciable assets so as to allocate their cost or valuation over their estimated useful the revaluation of certain non-fi nancial assets and fi nancial instruments, as noted. Cost is lives using the straight-line method. Estimates of the remaining useful lives and depreciation based on the fair values of the consideration given in exchange for assets. method for all assets are reviewed at least annually. This depreciation charge is not funded by In the application of AASs management is required to make judgments, estimates and the Department of Human Services. assumptions about carrying values of assets and liabilities that are not readily apparent from The following table indicates the expected useful lives of non current assets on which the other sources. The estimates and associated assumptions are based on historical experience depreciation charges are based. and various other factors that are believed to be reasonable under the circumstances, the results of which form the basis of making the judgments. Actual results may differ from these 2009 2008 estimates. Buildings 30 to 40 Years 30 to 40 Years The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions Plant & Equipment 8 to 10 Years 8 to 10 Years to accounting estimates are recognised in the period in which the estimate is revised if the Medical Equipment 7 to 9 Years 7 to 9 Years revision affects only that period or in the period of the revision, and future periods if the Vehicles 5 to 8 Years 5 to 8 Years revision affects both current and future periods. Accounting policies are selected and applied in a manner which ensures that the resulting (l) Net Gain/(Loss) on Non-Financial Assets fi nancial information satisfi es the concepts of relevance and reliability, thereby ensuring that Net gain/(loss) on non-fi nancial assets includes realised and unrealised gains and losses from the substance of the underlying transactions or other events is reported. revaluations, impairments and disposals of all physical assets and intangible assets. The accounting policies set out below have been applied in preparing the fi nancial report for Disposal of Non-Financial Assets the year ended 30 June 2009, and the comparative information presented in these fi nancial Any gain or loss on the sale of non-fi nancial assets is recognised at the date that control of the statements for the year ended 30 June 2008. asset is passed to the buyer and is determined after deducting from the proceeds the carrying (c) Reporting Entity value of the asset at that time. The fi nancial report includes all the controlled activities of West Wimmera Health Service. Impairment of Non-Financial Assets (d) Rounding Of Amounts Non-Financial Assets are assessed annually for indications of impairment. If there is an All amounts shown in the fi nancial report are expressed to the nearest $1,000 unless indication of impairment, the assets concerned are tested as to whether their carrying value otherwise stated. exceeds their possible recoverable amount. Where an asset’s carrying value exceeds its (e) Cash and Cash Equivalents recoverable amount, the difference is written-off as an expense except to the extent that the Cash and cash equivalents comprise cash on hand and cash at bank, deposits at call and write-down can be debited to an asset revaluation reserve amount applicable to that class of highly liquid investments with an original maturity of 3 months or less, which are readily asset. convertible to known amounts of cash and are subject to insignifi cant risk of changes in value. It is deemed that, in the event of the loss of an asset, the future economic benefi ts arising (f) Receivables from the use of the asset will be replaced unless a specifi c decision to the contrary has been Trade debtors are carried at nominal amounts due and are due for settlement within 30 days made. The recoverable amount for most assets is measured at the higher of depreciated from the date of recognition. Collectability of debts is reviewed on an ongoing basis, and debts replacement cost and fair value less costs to sell. Recoverable amount for assets held primarily which are known to be uncollectible are written off. A provision for doubtful debts is raised to generate net cash infl ows is measured at the higher of the present value of future cash where doubt as to collection exists. Bad debts are written off when identifi ed. fl ows expected to be obtained from the asset and fair value less costs to sell. Receivables are recognised initially at fair value and subsequently measured at amortised cost (m) Net Gain/(Loss) on Financial Instruments using the effective interest rate method, less any accumulated impairment. Net gain/(loss) on fi nancial instruments includes realised and unrealised gains and losses from (g) Inventories revaluations of fi nancial instruments that are designated at fair value through profi t or loss or Inventories include goods and other property held either for sale or for distribution at no or held-for-trading, impairment and reversal of impairment for fi nancial instruments at amortised nominal cost in the ordinary course of business operations. It includes land held for sale and cost, and disposals of fi nancial assets. excludes depreciable assets. Impairment of Financial Assets Inventories held for distribution are measured at cost, adjusted for any loss of service potential. Bad and doubtful debts are assessed on a regular basis. Those bad debts considered as All other inventories are measured at the lower of cost and net realisable value. written off are classifi ed as an expense. Bases used in assessing loss of service potential for inventories held for distribution include Financial Assets have been assessed for impairment in accordance with Australian Accounting current replacement cost and technical or functional obsolescence. Technical obsolescence Standards. Where a fi nancial asset’s fair value at balance date has reduced by 20 per cent or occurs when an item still functions for some or all of the tasks it was originally acquired to do, more than its cost price; or where its fair value has been less than its cost price for a period of but no longer matches existing technologies. Functional obsolescence occurs when an item no 12 or more months, the fi nancial instrument is treated as impaired. longer functions the way it did when it was fi rst acquired. (n) Payables (h) Other Financial Assets These amounts consist predominantly of liabilities for goods and services. Other fi nancial assets are recognised and derecognised on trade date where purchase or sale Payables are initially recognised at fair value, then subsequently carried at amortised cost of an investment is under a contract whose terms require delivery of the investment within the and represent liabilities for goods and services provided to the Service prior to the end of the timeframe established by the market concerned, and are initially measured at fair value, net of fi nancial year that are unpaid, and arise when the health service becomes obliged to make transaction costs. future payments in respect of the purchase of these goods and services. The Service classifi es its other fi nancial assets between current and non-current assets based The normal credit terms are usually Net 30 days. on the purpose for which the assets were acquired. Management determines the classifi cation (o) Provisions of its other fi nancial assets at initial recognition. Provisions are recognised when the entity has a present obligation, the future sacrifi ce of West Wimmera Health Service assesses at each balance sheet date whether a fi nancial asset economic benefi ts is probable, and the amount of the provision can be measured reliably. or group of fi nancial assets is impaired. The amount recognised as a provision is the best estimate of the consideration required to (i) Property, Plant and Equipment settle the present obligation at reporting date, taking into account the risks and uncertainties Land and Buildings are recognised initially at cost and subsequently measured at fair value surrounding the obligation. Where a provision is measured using the cash fl ows estimated to less accumulated depreciation and impairment. settle the present obligation, its carrying amount is the present value of those cash fl ows. Plant, Equipment and Vehicles are recognised initially at cost and subsequently measured at (p) Functional and Presentation Currency fair value less accumulated depreciation and impairment. The presentation currency of West Wimmera Health Service is the Australian dollar, which has (j) Revaluations of Non-current Physical Assets also been identifi ed as the functional currency of the entity. Non-current physical assets measured at fair value are revalued in accordance with FRD (q) Goods and Services Tax 103D. This revaluation process normally occurs every fi ve years, based upon the asset’s Income, expenses and assets are recognised net of the amount of associated GST, unless the Government Purpose Classifi cation, but may occur more frequently if fair value assessments GST incurred is not recoverable from the Australian Taxation Offi ce (ATO). In this case it is indicate material changes in values. Revaluation increments or decrements arise from recognised as part of the cost of acquisition of the asset or as part of the expense. differences between an asset’s carrying value and fair value. Receivables and payables are stated inclusive of the amount of GST receivable or payable. The Revaluation increments are credited directly to the asset revaluation reserve, except that, to net amount of GST recoverable from, or payable to, the ATO is included with other receivables the extent that an increment reverses a revaluation decrement in respect of that class of asset or payables in the balance sheet. previously recognised as an expense in the net result, the increment is recognised as income Cash fl ows are presented on a gross basis. The GST components of cash fl ows arising from in the net result. investing or fi nancing activities which are recoverable from, or payable to the ATO, are Revaluation decrements are recognised immediately as expenses in the net result, except that, presented as operating cash fl ow. to the extent that a credit balance exists in the asset revaluation reserve in respect of the same Commitments and contingent liabilities are presented on a gross basis. class of assets, they are debited directly to the asset revaluation reserve. 68 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
(r) Employee Benefi ts Termination Benefi ts (y) Services Supported By Health Services Agreement Wages and Salaries, Annual Leave and Accrued Days Off Liabilities for termination benefi ts are recognised when a and Services Supported By Hospital and Liabilities for wages and salaries, including non-monetary detailed plan for the termination has been developed and Community Initiatives benefi ts, annual leave and accrued days off expected a valid expectation has been raised with those employees Activities classifi ed as Services Supported by Health to be settled within 12 months of the reporting date are affected that the terminations will be carried out. The Services Agreement (HSA) are substantially funded by the recognised in the provision for employee benefi ts in respect liabilities for termination benefi ts are recognised in other Department of Human Services and include Residential of employees’ services up to the reporting date, classifi ed as creditors unless the amount or timing of the payments is Aged Care Services (RACS) and are also funded from other current liabilities and measured at nominal values. uncertain, in which case they are recognised as a provision. sources such as the Commonwealth, patients and residents, Those liabilities that the entity does not expect to be On-Costs while Services Supported by Hospital and Community settled within 12 months are recognised in the provision for Employee benefi ts on-costs (workers’ compensation, Initiatives (Non HSA) are funded by the Health Service’s own employee benefi ts as current liabilities, measured at present superannuation, annual leave and LSL accrued while on LSL activities or local initiatives and/or the Commonwealth. value of the amounts expected to be paid when the liabilities taken in service) are recognised separately from provisions (z) Change in Accounting Policies are settled using the remuneration rate expected to apply at for employee benefi ts. In accordance with Victorian Government Financial Reporting the time of settlement. (s) Finance Costs Direction 103D ‘Non-Current Physical Assets’, West Long Service Leave Finance costs are recognised as expenses in the period in Wimmera Health Service measures plant and equipment, Current Liability – unconditional LSL (representing 10 or which they are incurred and refer to interest on the Service’s and medical equipment assets at fair value from 1 July more years of continuous service) is disclosed as a current bank overdraft. 2008. Previously these assets were measured at cost. liability even where the Service does not expect to settle (t) Residential Aged Care Service This change in accounting policy is required to ensure that the liability within 12 months because it will not have the The Residential Aged Care Service segment’s operations Victoria’s Whole of Government fi nancial report, into which unconditional right to defer the settlement of the entitlement are an integral part of the Service and shares its resources. the Service’s results are consolidated, complies with the should an employee take leave within 12 months. An apportionment of land and buildings has been made requirements of AASB1049 Whole of Government and The components of this current LSL liability are measured at: based on bed numbers. The results of the two operations General Government Sector Financial Reporting. As this present value – component that the Service does not expect have been segregated based on actual revenue earned and change is the initial application of a policy to revalue assets to settle within 12 months; and expenditure incurred by each operation in note 2b to the in accordance with AASB116 Property, Plant and Equipment nominal value – component that the Service expects to settle fi n a n c i a l s t a t e m e n t . the change is treated as a revaluation in the current year. within 12 months. Residential Aged Care Services is substantially funded from (aa) Comparative Information Non-Current Liability – conditional LSL (representing less Commonwealth bed-day subsidies. Where necessary the previous year’s fi gures have been than 10 years of continuous service) is disclosed as a (u) Joint Ventures reclassifi ed to facilitate comparisons. non-current liability. There is an unconditional right to defer Interests in jointly controlled assets are accounted for by (ab) Property, Plant & Equipment Revaluation Reserve the settlement of the entitlement until the employee has recognising in the Service’s fi nancial statements, its share The asset revaluation reserve is used to record increments completed the requisite years of service. Conditional LSL is of net assets and any revenue and expenses of such joint and decrements on the revaluation of non-current assets. required to be measured at present value. ventures. Details of the joint venture are set out in note 11. (ac) Specifi c Restricted Purpose Reserve Consideration is given to expected future wage and salary (v) Intersegment Transactions A specifi c restricted purpose reserve is established where levels, experience of employee departures and periods of Transactions between segments within the Service have the entity has possession or title to the funds but has no service. Expected future payments are discounted using been eliminated to refl ect the extent of the Service’s discretion to amend or vary the restriction and/or condition interest rates of Commonwealth Government guaranteed operations as a group. underlying the funds received. securities in Australia. (ad) Contributed Capital Superannuation (w) Leases Consistent with Australian Accounting Interpretation 1038 – Defi ned contribution plans Leases of property, plant and equipment are classifi ed as fi nance leases whenever the terms of the lease transfer Contributions by Owners Made to Wholly-Owned Public Contributions to defi ned contribution superannuation plans substantially all the risks and rewards of ownership to the Sector Entities and FRD 119 Contributions by Owners, are expensed when incurred. lessee. All other leases are classifi ed as operating leases. appropriations for additions to the net asset base have – Defi ned benefi t plans Operating lease payments are recognised as an expense been designated as contributed capital. Other transfers that The amount charged to the Operating Statement in respect in the operating statement on a straight line basis over the are in the nature of contributions or distributions that have of defi ned benefi t superannuation plans represents the lease term. been designated as contributed capital are also treated as contributions made by the entity to the superannuation contributed capital. (x) Income Recognition plans in respect of the services of current entity staff. (ae) Net Result Before Capital & Specifi c Items Superannuation contributions are made to the plans based Income is recognised in accordance with AASB 118 Revenue The subtotal entitled ‘Net result Before Capital & Specifi c on the relevant rules of each plan. and is recognised as to the extent it is earned. Unearned income at reporting date is reported as income received in Items’ is included in the Operating Statement to enhance Employees of the Service are entitled to receive the understanding of the fi nancial performance of West superannuation benefi ts and the Service contributes to both advance. Amounts disclosed as revenue are, where applicable, net of Wimmera Health Service. This subtotal reports the result defi ned benefi t and defi ned contribution plans. The defi ned excluding items such as capital grants, assets received benefi t plans provide benefi ts based on years of service and returns, allowances and duties and taxes. Government Grants or provided free of charge, depreciation, and items of an fi nal average salary. unusual nature and amount such as specifi c revenues and Grants are recognised as income when the entity gains The name and details of the major employee superannuation expenses. The exclusion of these items is made to enhance control of the underlying assets in accordance with AASB funds and contributions made by the Service are as follows: matching of income and expenses so as to facilitate the 1004 Contributions. For reciprocal grants, the Service is comparability and consistency of results between years Contributions Paid or deemed to have assumed control when the performance and Victorian Public Health Services. The Net result Before Fund Payable for the year has occurred under the grant. For non-reciprocal grants, the Capital & Specifi c Items is used by the management of Service is deemed to have assumed control when the grant is the Service, the Department of Human Services and the 2009 2008 received or receivable. Conditional grants may be reciprocal Victorian Government to measure the ongoing result of $’000 $’000 or non-reciprocal depending on the terms of the grant. Health Services in operating hospital services. Indirect Contributions Defi ned benefi t plans: Capital and specifi c items, which are excluded from this – Insurance is recognised as revenue following advice from Health Super Superannuation sub-total, comprise: the Department of Human Services. Fund 45 58 • Capital purpose income, which comprises all tied – Long Service Leave (LSL) – Revenue is recognised upon Other 11 6 grants, donations and bequests received for the purpose fi nalisation of movements in LSL liability in line with the Defi ned contribution plans: of acquiring non-current assets, such as capital works, arrangements set out in the Metropolitan Health and Aged Health Super Superannuation plant and equipment or intangible assets. Consequently the Care Services Division Hospital Circular 34/2008. Fund 1,372 1,351 recognition of revenue as capital purpose income is based Patient and Resident Fees Other 60 51 on the intention of the provider of the revenue at the time the Patient fees are recognised as revenue at the time invoices Total 1,488 1,466 revenue is provided. are raised. • Depreciation and amortisation, as described in note 1 (k). Donations and Bequests The Service does not recognise any unfunded defi ned benefi t liability in respect of the superannuation plans because Donations and bequests are recognised as revenue when the entity has no legal or constructive obligation to pay received. If donations are for a special purpose, they may future benefi ts relating to its employees; its only obligation be appropriated to a reserve, such as the specifi c restricted is to pay superannuation contributions as they fall due. purpose reserve. The Department of Treasury and Finance administers and Interest Revenue discloses the State’s defi ned benefi t liabilities in its fi nancial Interest revenue is recognised on a time proportionate basis. report. NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 69
(af) Category Groups Applicable for reporting West Wimmera Health Service has used the following periods beginning on or Impact on Entities category groups for reporting purposes for the current and Standard / Interpretation Summary ending on Annual Statements previous fi nancial years. Admitted Patient Services (Admitted Patients) comprises all AASB 8 Operating Segments. Supersedes AASB 114 Beginning 1 January 2009 Not applicable recurrent health revenue/expenditure on admitted patient Segment Reporting. services, where services are delivered in public hospitals, AASB 2007-3 Amendments An accompanying amending Beginning 1 January 2009 Impact expected to be not or free standing day hospital facilities, or alcohol and drug to Australian Accounting standard, also introduced signifi cant. treatment units or hospitals specialising in dental services, Standards arising from AASB consequential amendments hearing and ophthalmic aids. 8 [AASB 5, AASB 6, AASB into other Standards. Outpatient Services (Outpatients) comprises all recurrent 102, AASB 107, AASB 119, health revenue/expenditure on public hospital type outpatient AASB 127, AASB 134, AASB services, where services are delivered in public hospital 136, AASB 1023 and AASB outpatient clinics, or free standing day hospital facilities, 1038] or rehabilitation facilities, or alcohol and drug treatment AASB 2007-6 Amendments An accompanying amending Beginning 1 January 2009 All Australian government units, or outpatient clinics specialising in ophthalmic aids or to Australian Accounting standard, also introduced jurisdictions are currently palliative care. Standards arising from consequential amendments still actively pursuing an Aged Care comprises revenue/expenditure form Home and AASB 123 [AASB 1, AASB into other Standards. exemption for government Community Care (HACC) programs, allied Health, Aged Care 101, AASB 107, AASB 111, from capitalising borrowing Assessment and support services. AASB 116 & AASB 138 and costs. Primary Health comprises revenue/expenditure for Interpretations 1 & 12] Community Health Services including health promotion and AASB 2008-3 Amendments This Standard gives effect Beginning 1 January 2009 Impact expected to be counselling, physiotherapy, speech therapy, podiatry and to AAS arising from AASB 3 to consequential changes insignifi cant. occupational therapy. & AASB 127 [AASB 1, 2, 4, arising from revised AASB Off Campus, Ambulatory Services (Ambulatory) comprises all 5, 7, 101, 107, 112, 114, 116, 3 and amended AASB recurrent health revenue/expenditure on public hospital type 121, 128, 131, 132, 133, 127. The Prefaces to those services including palliative care facilities and rehabilitation 134, 136, 137, 138 & 139 Standards summarise the facilities, as well as services provided under the following and Interpretation 9 & 107] main requirements of those agreements: Services that are provided or received by Standards. hospitals (or area health services) but are delivered/received Standard / Interpretation Summary Applicable for reporting Impact on Entities outside a hospital campus, services which have moved from periods beginning on or Annual Statements a hospital to a community setting since June 1998, services ending on which fall within the agreed scope of inclusions under the new system, which have been delivered within hospital’s i.e. AASB 2008-5 Amendments A suite of amendments Beginning 1 January 2009 Impact is being evaluated. in rural/remote areas. to AASs arising from the to existing standards Residential Aged Care including Mental Health (RAC incl. Annual Improvements Project following issuance of IASB Mental Health) referred to in the past as psychogeriatric [AASBs 5, 7, 101, 102, 107, Standard Improvements residential services, comprises those Commonwealth- 108, 110, 116, 118, 119, 120, to IFRSs in May 2008. licensed residential aged care services in receipt of 123, 127, 128, 129, 131, Some amendments result supplementary funding from DHS under the mental health 132, 134, 136, 138, 140, in accounting changes for program. It excludes all other residential services funded 141, 1023 & 1308] presentation, recognition under the mental health program, such as mental health- and measurement purposes. funded community care units (CCUs) and secure extended AASB 2008-6 Further The amendments require Beginning 1 January 2009 Impact expected to be care units (SECs). Amendments to Australian all the assets and liabilities insignifi cant. Other Services excluded from Australian Health Care Accounting Standards of a for-sale subsidiary’s Agreement (AHCA) (Other) comprises revenue/expenditure arising from the Annual to be classifi ed as held for services not separately classifi ed above, including: Public Improvements project [AASB for sale and clarify the health services including Laboratory testing, Blood Borne 1 & AASB 5] disclosures required when Viruses / Sexually Transmitted Infections clinical services, the subsidiary is part of Kooris liaison offi cers, immunisation and screening services, a disposal group that Drugs services including drug withdrawal, counselling and meets the defi nition of a the needle and syringe program, Dental Health services discontinued operation. including general and specialist dental care, school dental AASB 2008-7 Amendments Changes mainly relate to Beginning 1 January 2009 Impact expected to be services and clinical education, Disability services including to AAS Cost of an Investment treatment of dividends from insignifi cant. aids and equipment and fl exible support packages to people in a Subsidiary, Jointly subsidiaries or controlled with a disability, Community Care programs including Controlled Entity or Associate entities sexual assault support, early parenting services, parenting [AASB 1, AASB 118, AASB assessment and skills development, and various support 121, AASB 127 & AASB 136] services. Health and Community Initiatives also falls in this AASB 2008-8 Amendments The amendments to Beginning 1 January 2009 Impact is being evaluated. category group. to Australian Accounting AASB 139 clarify how the (ag) New Accounting Standards and Interpretations Standards – Eligible Hedged principles that determine Certain new accounting standards and interpretations have Items [AASB 139] whether a hedged risk or been published that are not mandatory for the 30 June portion of cash fl ows is 2009 reporting period. As at 30 June 2009, the following eligible for designation standards and interpretations had been issued but were not as a hedged item, should mandatory for fi nancial years ending 30 June 2009. West be applied in particular Wimmera Health Service has not and does not intend to situations. adopt these standards early. AASB 2008-9 Amendments Amendments to AASB 1049 Beginning 1 January 2009 Impact expected to be to AASB 1049 for Consistency for consistency with AASB insignifi cant with AASB 101 101 (September 2007) version. AASB 2009-1 Amendments Amendments to Australian Beginning 1 January 2009 Impact expected to be to Australian Accounting Accounting Standards to insignifi cant Standards – Borrowing Costs allow borrowing costs of of Not-for-Profi t Public Sector Not-for Profi t Public Sector Entities [AASB 1, AASB 111 & Entities to be expensed AASB 123] AASB 2009-2 Amendments Amendments to AASB 7 to Beginning 1 January 2009 Impact expected to be to Australian Accounting enhance disclosures about insignifi cant Standards – Improving fair value measurements Disclosures about Financial and liquidity risk. Editorial Instruments [AASB 4, AASB amendments to AASB 4, 7, AASB 1023 & AASB 1038] AASB 1023 and AASB 1038 resulting from the amendments to AASB 7 70 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 2: Revenue
HSA HSA Non HSA Non HSA Total Total 2009 2008 2009 2008 2009 2008 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Operating Activities Government Grants - Department of Human Services 15,403 14,650 - - 15,403 14,650 - Dental Health Services Victoria 203 183 - - 203 183 - State Government - Other - Department of Education 169 12 - - 169 12 - Commonwealth Government - Residential Aged Care Subsidy 5,266 5,242 - - 5,266 5,242 - Other 874 1,151 - 874 1,151 Total Government Grants 21,915 21,238 - - 21,915 21,238 Indirect Contributions by Department of Human Services - Insurance 301 302 - - 301 302 - Long Service Leave (50) (233) - - (50) (233) Total Indirect Contributions by Department of Human Services 251 69 - - 251 69 Patient and Resident Fees - Patient and Resident Fees (refer note 2b) 1,917 2,068 - - 1,917 2,068 - Residential Aged Care (refer note 2b) 1,688 1,625 - - 1,688 1,625 Total Patient & Resident Fees 3,605 3,693 - - 3,605 3,693 Business Units & Specifi c Purpose Funds - Dental Services - - 30 34 30 34 - Meals on Wheels - - 98 119 98 119 - Diagnostic Imaging - - 130 117 130 117 Total Business Units & Specifi c Purpose Funds - - 258 270 258 270 Donations & Bequests - - 27 37 27 37 Other Revenue from Operating Activities 172 193 - - 172 193 Sub-Total Revenue from Operating Activities 25,943 25,193 285 307 26,228 25,500 Revenue from Non-Operating Activities Interest - - 385 391 385 391 Property Income - - 92 70 92 70 Sub-Total Revenue from Non-Operating Activities - - 477 461 477 461
Revenue from Capital Purpose Income State Government Capital Grants - Targeted Capital Works and Equipment - - 32 75 32 75 - Equipment and Infrastructure Maintenance 366 631 - - 366 631 Residential Accommodation Payments (refer note 2b) - - 336 305 336 305 Net Gain/(Loss) on Disposal of Non-Financial Assets (refer note 2c) - - (3) 19 (3) 19 Donations & Bequests – – 227 1,169 227 1,169 Sub-Total Revenue from Capital Purpose Income 366 631 592 1,568 958 2,199 Share of Net Result of Joint Ventures Accounted for using the Equity Model (refer note 11) 28 - - - 28 - Total Revenue (refer to note 2a) 26,337 25,824 1,354 2,336 27,691 28,160
Indirect contributions by Department of Human Services: Department of Human Services makes certain payments on behalf of the Health Service. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses. NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 71
Note 2a: Analysis of Revenue by Source (based on the consolidated view of note 2)
RAC incl. Admitted Mental Primary Patients Outpatients Ambulatory Health Aged Care Health Other Total 2009 2009 2009 2009 2009 2009 2009 2009 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Services Supported by Health Services Agreement Government Grants 10,192 2 1,586 7,731 - 2,012 392 21,915 Indirect contributions by Department of Human Services - Insurance 301 301 - Long Service Leave (16) - - (10) (2) (8) (14) (50) Patient & Resident Fees (refer note 2b) 1,108 33 214 1,688 68 130 364 3,605 Donations & Bequests (non capital) ------Other Revenue from Operating Activities 14 - - 20 - 50 88 172 Interest ------Capital Purpose Income (refer note 2) ------366 366 Share of Net Result of Joint Ventures Accounted for using the Equity Model (refer note 11) ------28 28 Sub-Total Revenue from Services Supported by 11,599 35 1,800 9,429 66 2,184 1,224 26,337 Health Services Agreement
Revenue from Services Supported by Hospital and Community Initiatives Dental Services ------30 30 Meals on Wheels ------98 98 Diagnostic Imaging ------130 130 Capital Income ------365 365 Donations & Bequests ------254 254 Interest ------385 385 Property Income ------92 92 Sub-Total Revenue from Services Supported by ------1,354 1,354 Hospital and Community Initiatives
Total Revenue 11,599 35 1,800 9,429 66 2,184 2,578 27,691
Indirect contributions by Department of Human Services: The Department of Human Services makes payments on behalf of the Service for its annual insurance premium. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.
Note 2a: Analysis of Revenue by Source (based on the consolidated view of note 2)
RAC incl. Admitted Mental Primary Patients Outpatients Ambulatory Health Aged Care Health Other Total 2008 2008 2008 2008 2008 2008 2008 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Services Supported by Health Services Agreement Government Grants 9,318 2 1,523 7,687 - 1,920 788 21,238 Indirect contributions by Department of Human Services - Insurance 302 302 - Long Service Leave (76) (45) (7) (36) (68) (232) Patient & Resident Fees (refer note 2b) 1,208 23 282 1,687 3 88 402 3,693 Donations & Bequests (non capital) ------Other Revenue from Operating Activities 14 - - 20 - 50 108 192 Interest & Dividends ------Capital Purpose Income (refer note 2) ------631 631 Sub-Total Revenue from Services Supported by 10,766 25 1,805 9,349 (4) 2,022 1,861 25,824 Health Services Agreement
Revenue from Services Supported by Hospital and Community Initiatives Dental Services ------34 34 Meals on Wheels ------119 119 Diagnostic Imaging ------117 117 Capital Income ------399 399 Donations & Bequests ------1,206 1,206 Interest ------391 391 Property Income ------70 70 Sub-Total Revenue from Services Supported by ------2,336 2,336 Hospital and Community Initiatives
Total Revenue 10,766 25 1,805 9,349 (4) 2,022 4,197 28,160
Indirect contributions by Department of Human Services: The Department of Human Services makes payments on behalf of the Service for its annual insurance premium. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses. 72 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 2b: Patient and Resident Fees Note 2c: Net Gain/(Loss) on Disposal of Non-Financial Assets
2009 2008 2009 2008 $’000 $’000 $’000 $’000 Patient and Resident Fees Raised Proceeds from Disposals of Non-Current Assets Recurrent: Plant and Equipment - 6 Acute Medical Equipment - 20 – Inpatients 1,105 1,184 Motor Vehicles 282 110 – Outpatients 20 16 Total Proceeds from Disposal 282 136 – Other 792 868 of Non-Current Assets Residential Aged Care – Generic 1,609 1,531 Less: Written Down Value – Mental Health 79 79 of Non-Current Assets Sold – Residential Accommodation Payments - 15 Plant and Equipment - 6 Total Recurrent 3,605 3,693 Medical Equipment - 111 Motor Vehicles 285 - Total Written Down Value Capital Purpose: 285 117 Residential Accommodation Payments 336 305 of Non-Current Assets Sold Total Capital 336 305 Net gains/(losses) on Disposal of Non-Current Assets (3) 19 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 73
Note 3: Expenses
HSA HSA Non HSA Non HSA Total Total 2009 2008 2009 2008 2009 2008 $’000 $’000 $’000 $’000 $’000 $’000 Employee Benefi ts Salaries & Wages 15,951 15,765 342 325 16,293 16,090 WorkCover Premium 224 291 5 6 229 297 Departure Packages - 56 - 1 - 57 Long Service Leave 321 204 8 5 329 209 Superannuation 1,455 1,434 33 32 1,488 1,466 Total Employee Benefi ts 17,951 17,750 388 369 18,339 18,119
Non Salary Labour Costs Fees for Visiting Medical Offi cers 626 655 243 213 869 868 Agency Costs - Nursing 332 293 - - 332 293 Total Non Salary Labour Costs 958 948 243 213 1,201 1,161
Supplies & Consumables Drug Supplies 144 146 - - 144 146 Medical, Surgical Supplies and Prosthesis 1,123 862 70 53 1,193 915 Food Supplies 744 661 143 160 887 821 Total Supplies & Consumables 2,011 1,669 213 213 2,224 1,882
Other Expenses from Continuing Operations Domestic Services & Supplies 519 503 8 8 527 511 Fuel, Light, Power and Water 537 705 23 21 560 726 Insurance costs funded by DHS 306 327 12 12 318 339 Motor Vehicle Expenses 214 227 4 6 218 233 Repairs & Maintenance 351 270 20 12 371 282 Maintenance Contracts 188 212 22 13 210 225 Patient Transport 88 141 - 2 88 143 Bad & Doubtful Debts 4 3 - - 4 3 Lease Expenses 107 155 - - 107 155 Other Administrative Expenses 1,827 1,624 82 68 1,909 1,692 Audit Fees - VAGO - Audit of Financial Statements 24 20 - - 24 20 - Other 34 20 - - 34 20 Total Other Expenses from Continuing Operations 4,199 4,207 171 142 4,370 4,349 Depreciation & Amortisation 1,132 1,172 - - 1,132 1,172 Finance Costs - 4 - - - 4 Total 1,132 1,176 - - 1,132 1,176 Total Expenses 26,251 25,750 1,015 937 27,266 26,687 74 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 3a: Analysis of Expenses by Source (based on the consolidated view)
RAC incl. Admitted Out- Mental Primary Patients patients Ambulatory Health Aged Care Health Other Total 2009 2009 2009 2009 2009 2009 2009 2009 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Services Supported by Health Services Agreement Employee Benefi ts 5,536 17 1,612 8,016 444 1,541 785 17,951 Non Salary Labour Costs 837 - 2 119 - - - 958 Supplies & Consumables 1,244 17 77 452 16 88 117 2,011 Other Expenses from Continuing Operations 1,359 10 314 1,453 169 459 435 4,199 Depreciation & Amortisation (refer note 4) 407 2 91 455 28 95 54 1,132 Sub-Total Expenses from Services Supported 9,383 46 2,096 10,495 657 2,183 1,391 26,251 by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefi ts ------388 388 Non Salary Labour Costs ------243 243 Supplies & Consumables ------213 213 Other Expenses from Continuing Operations ------171 171 Sub-Total Expense from Services Supported ------1,015 1,015 by Hospital and Community Initiatives Total Expenses 9,383 46 2,096 10,495 657 2,183 2,406 27,266
Note 3a: Analysis of Expenses by Source (based on the consolidated view)
RAC incl. Admitted Out- Mental Primary Patients patients Ambulatory Health Aged Care Health Other Total 2008 2008 2008 2008 2008 2008 2008 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Services Supported by Health Services Agreement Employee Benefi ts 5,722 92 1,254 7,841 544 1,628 669 17,750 Non Salary Labour Costs 816 - - 132 - - - 948 Supplies & Consumables 977 19 59 438 18 90 68 1,669 Other Expenses from Continuing Operations 1,466 20 252 1,565 143 510 251 4,207 Depreciation & Amortisation (refer note 4) 413 6 72 458 32 102 89 1,172 Finance Costs (refer note 5) ------4 4 Sub-Total Expenses from Services Supported 9,394 137 1,637 10,434 737 2,330 1,081 25,750 by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefi ts ------369 369 Non Salary Labour Costs ------213 213 Supplies & Consumables ------213 213 Other Expenses from Continuing Operations ------142 142 Sub-Total Expense from Services Supported ------937 937 by Hospital and Community Initiatives Total Expenses 9,394 137 1,637 10,434 737 2,330 2,018 26,687
Note 3b: Analysis of Expenses by Internal and Restricted Specifi c Purpose Funds for Services Supported by Hospital and Community Initiatives
2009 2008 $’000 $’000 Dental 580 484 Diagnostic Imaging 253 252 Meals on Wheels 182 201 TOTAL 1,015 937 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 75
Note 4: Depreciation and Amortisation Note 8: Other Financial Assets
2009 2008 Operating Fund Totals $’000 $’000 2009 2008 2009 2008 Depreciation $’000 $’000 $’000 $’000 Buildings 622 619 CURRENT Plant & Equipment 117 149 Term Deposits Medical Equipment 213 212 Aust. Dollar Term Deposits 2,012 2,209 2,012 2,209 Computers & Communication 21 23 TOTAL 2,012 2,209 2,012 2,209 Furniture & Fittings 54 82 Motor Vehicles 105 87 Represented by: Total Depreciation 1,132 1,172 Monies Held in Trust Patient Monies - 1 - 1 Accommodation Bonds Note 5: Finance Costs (Refundable Entrance Fees) 1,769 1,881 1,769 1,881 Licences to Occupy 243 327 243 327 2009 2008 TOTAL 2,012 2,209 2,012 2,209 $’000 $’000 Interest on Overdraft - 4 (b) Ageing analysis of other fi nancial assets TOTAL - 4 Please refer to note 18(b) for the ageing analysis of other fi nancial assets (c) Nature and extent of risk arising from other fi nancial assets Please refer to note 18(b) for the nature and extent of credit risk arising from other fi nancial assets Note 6: Cash and Cash Equivalents
For the purposes of the Cash Flow Statement, cash assets includes cash on hand and in Note 9: Inventories banks, and short-term deposits which are readily convertible to cash on hand, and are subject to an insignifi cant risk of change in value, net of outstanding bank overdrafts. 2009 2008 2009 2008 $’000 $’000 $’000 $’000 Pharmaceuticals - at cost 59 57 Cash on Hand 4 4 Catering Supplies - at cost 26 26 Cash at Bank 314 578 Housekeeping Supplies - at cost 17 14 Deposits at Call 5,032 4,550 Medical and Surgical Lines - at cost 104 103 TOTAL 5,350 5,132 Engineering Stores - at cost 28 33 Represented by: Administration Stores - at cost 31 19 Cash for Health Service Operations (as per Cash Flow TOTAL INVENTORIES 265 252 Statement) 5,350 5,132 TOTAL 5,350 5,132
Note 10: Other Assets
Note 7: Receivables 2009 2008 $’000 $’000 2009 2008 Current $’000 $’000 Prepayments 32 7 CURRENT TOTAL 32 7 Contractual Trade Debtors 181 308 Patient Fees 328 299 Accrued Revenue - DHSV - 15 Less Allowance for Doubtful Debts Patient Fees (5) (15) 504 607 Statutory GST Receivable 65 48 65 48 TOTAL CURRENT RECEIVABLES 569 655
NON CURRENT Statutory Accrued Revenue - DHS - 50 TOTAL NON-CURRENT RECEIVABLES - 50 TOTAL RECEIVABLES 569 705
(a) Movement in the Allowance for doubtful debts 2009 2008 $’000 $’000 Balance at beginning of year 15 15 Amounts written off during the year (3) (3) Amounts recovered during the year (7) 3 Balance at end of year 5 15
(b) Ageing analysis of receivables Please refer to note 18(b) for the ageing analysis of receivables (c) Nature and extent of risk arising from receivables Please refer to note 18(b) for the nature and extent of credit risk arising from receivables 76 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 11: Investments Accounted for Using the Equity Method
2009 2008 $’000 $’000 Interest in Jointly Controlled Entities 28 - TOTAL 28 -
Ownership Interest Published Fair Value Country of 2009 2008 2009 2008 Name of Entity Principal Activity Incorporation % % $’000 $’000 Jointly Controlled Entities Grampians Regional Health Alliance Provision of Information Systems Australia 7.77 0 28 –
2009 2008 $’000 $’000 Share of Current Assets 241 - Share of Non-Current Assets 51 - Share of Current Liabilities 41 - Share of Total Revenue 354 - Share of Net Result 28 -
Note 12: Property, Plant & Equipment
2009 2008 $’000 $’000 Land Land at fair value 703 836 Total Land 703 836
Buildings Buildings at fair value 49,330 25,176 Less Acc’d Depreciation - 1,162 49,330 24,014
Buildings at cost - 16,323 Less Acc’d Depreciation - 503 - 15,820
Total Buildings 49,330 39,834
Plant and Equipment Plant and Equipment at fair value 1,249 2,840 Less Acc’d Depreciation 1,041 2,314 Total Plant and Equipment 208 526
Medical Equipment Medical Equipment at fair value 3,360 2,989 Less Acc’d Depreciation 2,401 2,134 Total Medical Equipment 959 855
Computers & Communication Computers & Communication at fair value 875 883 Less Acc’d Depreciation 829 835 Total Computers & Communication 46 48
Motor Vehicles Motor Vehicles at fair value 1,114 748 Less Acc’d Depreciation 397 540 Total Motor Vehicles 717 208
Furniture & Fittings Furniture & Fittings at fair value 1,575 2,246 Less Acc’d Depreciation 1,188 1,709 387 537 TOTAL 52,350 42,844 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 77
Note 12: Property, Plant & Equipment (Continued)
Reconciliations of the carrying amounts of each class of asset for the Service at the beginning and end of the previous and current fi nancial year are set out below. Plant & Medical Computers, Furniture Motor Land Buildings Equipment Equipment Communctns & Fittings Vehicles Total $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Balance at 1 July 2007 836 40,299 621 931 53 486 217 43,443 Additions - 154 68 136 18 133 189 698 Disposals - - (14) - - - (111) (125) Depreciation and Amortisation (note 4) - (619) (149) (212) (23) (82) (87) (1,172) Balance at 1 July 2008 836 39,834 526 855 48 537 208 42,844 Additions - 5 75 222 19 24 899 1,244 Disposals - - - - - (285) (285) Revaluation increments/(decrements) (133) 9,812 - - - - 9,679 Net Transfers between classes - 301 (276) 95 - (120) - - Depreciation and Amortisation (note 4) - (622) (117) (213) (21) (54) (105) (1,132) Balance at 30 June 2009 703 49,330 208 959 46 387 717 52,350
Land and buildings carried at valuation An independent valuation of the Health Service’s property, plant and equipment was performed by the Valuer-General Victoria to determine the fair value of the land and buildings. The valuation, which conforms to Australian Valuation Standards, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arms’ length transaction. The valuation was based on independent assessments. The effective date of the valuation is 30 June 2009.
Note 13: Payables
2009 2008 $’000 $’000 CURRENT Contractual Trade Creditors 1,083 1,156 Accrued Expenses 355 280 TOTAL PAYABLES 1,438 1,436
(a) Maturity analysis of payables Please refer to Note 18c for the ageing analysis of payables (b) Nature and extent of risk arising from payables Please refer to note 18c for the nature and extent of risks arising from payables
Note 14: Employee Benefi ts and Related On-Costs Provisions
2009 2008 $’000 $’000 Current Provisions Employee Benefi ts - Unconditional and expected to be settled within 12 months 2,580 2,981 - Unconditional and expected to be settled after 12 months 1,939 1,907 Total Current Provisions 4,519 4,888
Non-Current Provisions Employee Benefi ts 522 433 Total Non-Current Provisions 522 433
Current Employee Benefi ts Unconditional LSL entitlement 1,939 1,907 Annual leave entitlements 2,055 1,989 Accrued Wages and Salaries 411 935 Accrued Days Off 114 57 Non-Current Employee Benefi ts Conditional long service leave entitlements (present value) 522 433 Total Employee Benefi ts 5,041 5,320
Movement in Long Service Leave: Balance at start of year 2,339 2,524 Provision made during the year - Revaluations 3 - - Expense recognising employee service 327 209 Settlement made during the year (208) (394) Balance at end of year 2,461 2,339 78 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 15: Other Liabilities Note 16: Equity
2009 2008 2009 2008 $’000 $’000 $’000 $’000 CURRENT (a) Reserves Income in Advance Property, Plant & Equipment Revaluation Reserve 1 - DVA WIES Recall - 121 Balance at the beginning of the reporting period 370 370 - Lowan Regional Health Program - 58 Revaluation Increment/(Decrements) - Other 6 - Land (133) - Monies Held in Trust* - Buildings 9,813 - - Patient Monies Held in Trust* - 1 Balance at the end of the reporting period* 10,050 370 - Accommodation Bonds (Refundable Entrance Fees)* 2,374 2,486 * Represented by: - Licences to Occupy 243 327 - Land 237 370 Total Current 2,623 2,993 - Buildings 9,813 - 10,050 370 * Total Monies Held in Trust Represented by the following assets: (1) The property, plant & equipment asset revaluation reserve arises on the revaluation of Other Financial Assets (refer to Note 8) 2,012 2,209 property, plant & equipment. Land and Buildings 605 605 2009 2008 TOTAL 2,617 2,814 $’000 $’000 Restricted Specifi c Purpose Reserve Balance at the beginning of the reporting period 427 427 Balance at the end of the reporting period 427 427 Total Reserves 10,477 797
(b) Contributed Capital Balance at the beginning of the reporting period 25,924 25,704 Capital contribution received from Victorian Government as compensation for cessation of GST payments - 220 Balance at the end of the reporting period 25,924 25,924
(c) Accumulated Surpluses/(Defi cits) Balance at the beginning of the reporting period 14,678 13,205 Net Result for the Year 425 1,473 Balance at the end of the reporting period 15,103 14,678
(d) Total Equity at end of fi nancial year 51,504 41,399
Note 17: Reconciliation of Net Result for the Year to Net Cash Infl ow/(Outfl ow) from Operating Activities
2009 2008 $’000 $’000 Net Result for the Year 425 1,473
Depreciation & Amortisation 1,132 1,172 DHS GST Funding - 220 Change in Inventories (13) 10 Net (Gain)/Loss from Sale of Motor Vehicles 3 (19) Share of Joint Venture Net Result 28 - Change in Operating Assets & Liabilities (Increase)/Decrease in Receivables 127 274 (Increase)/Decrease in Prepayments (25) 167 Increase/(Decrease) in Payables (71) 245 Increase/(Decrease) in Other Liabilities (197) 179 Increase/(Decrease) in Employee Benefi ts (234) 73 NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES 1,175 3,794 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 79
Note 18: Financial Instruments Note 18: Financial Instruments (continued)
(a) Financial Risk Management Objectives and Policies (c) Liquidity Risk West Wimmera Health Service’s principal fi nancial instruments comprise of: The following table discloses the contractual maturity analysis for West Wimmera Health - Cash Assets Service’s fi nancial liabilities. For interest rates applicable to each class of liability refer to - Term Deposits individual notes to the fi nancial statements. - Receivables (excluding statutory receivables) Maturity analysis of fi nancial liabilities as at 30 June - Payables (excluding statutory payables) - Residential Aged Care Accommodation Bonds Maturity Dates Details of the signifi cant accounting policies and methods adopted, including the criteria for recognition, the basis of measurement and the basis on which income and expenses Carrying Contractual 1 to 3 3 Months are recognised, with respect to each class of fi nancial asset, fi nancial liability and equity Amount Cash Flows Months to 1 Year instrument are disclosed in note 1 to the fi nancial statements. 2009 $’000 $’000 $’000 $’000 The main purpose in holding fi nancial instruments is to prudentially manage the Service’s Financial Liabilities fi nancial risks within government policy parameters. Payables 1,438 1,438 1,438 - Categorisation of fi nancial instruments Other Financial Liabilities - Accommodation Bonds 2,374 2,374 - 2,374 Carrying Carrying - Licences to Occupy 243 243 243 Amount Amount - Other 6 6 - 6 2009 2008 Total Financial Liabilities 4,061 4,061 1,438 2,623 $’000 $’000 Financial Assets 2008 Cash and Cash Equivalents 7,362 7,341 Financial Liabilities Loans and Receivables 509 657 Payables 1,436 1,436 1,436 - Total Financial Assets (i) 7,871 7,998 Other Financial Liabilities - Accommodation Bonds 2,486 2,486 - 2,486 Financial Liabilities - Licences to Occupy 327 327 327 At amortised cost 4,061 4,429 - Other 180 180 - 180 Total Financial Liabilities (ii) 4,061 4,429 Total Financial Liabilities 4,429 4,429 1,436 2,993
(i) The total amount of fi nancial assets disclosed here excludes statutory receivables (i.e. GST input tax credit recoverable) (ii) The total amount of fi nancial liabilities disclosed here excludes statutory payables (i.e. Taxes payable)
Note 18: Financial Instruments (continued)
(b) Credit Risk The Service’s exposure to credit risk by ageing periods is set out in the following table. For interest rates applicable to each class of asset refer to individual notes to the fi nancial statements. Ageing analysis of fi nancial asset as at 30 June
Not Past Past Due But Not Impaired Consol’d Due Carrying & Not Less than 1 Amount Impaired Month 1-3 Months 2009 $’000 $’000 $’000 $’000 Financial Assets Cash and Cash Equivalents 5,350 5,350 - - Receivables - Trade debtors 181 114 50 17 - Patient fees receivable 328 223 16 89 Other fi nancial assets - Monies in Trust Deposits 2,012 2,012 - - Total Financial Assets 7,871 7,699 66 106
2008 Financial Assets Cash and Cash Equivalents 5,132 5,132 - - Receivables - Trade debtors 303 176 8 119 - Patient fees receivable 289 118 60 111 - DHS LSL receivable 50 50 - - Other fi nancial assets - Accrued revenue 15 15 - - - Monies in Trust Deposits 2,209 2,209 - - Total Financial Assets 7,998 7,700 68 230 80 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 18: Financial Instruments (continued)
(d) Market Risk Market risk is defi ned as the degree to which the fair value or future cash fl ows of a fi nancial instrument will fl uctuate because of changes in market prices. Generally, market risk comprises three types of risk: currency risk, interest rate risk and other price risk. Currency Risk The Service is exposed to insignifi cant 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. Interest Rate Risk Exposure to interest rate risk might arise primarily through the Service’s interest bearing liabilities. Minimisation of this risk is achieved mainly by utilising fi xed rate or non-interest bearing fi nancial instruments. For fi nancial liabilities, the Service mainly utilises fi nancial liabilities with relatively even maturity profi les. Other Price Risk The Service is not materially exposed to price risk.
Interest Rate Exposure of Financial Assets and Liabilities as at 30 June Interest Rate Exposure Weighted Average Effective Interest Carrying Amount Fixed Interest Rate Non-Interest Bearing 2009 Rate (%) $’000 $’000 $’000 Financial Assets Cash and Cash Equivalents 5.43 5,350 5,350 - Receivables - Trade debtors 181 - 181 - Other receivables 328 - 328 Other fi nancial assets - Monies in Trust Deposits 4.98 2,012 2,012 - 7,871 7,362 509 Financial Liabilities Payables 1,438 - 1,438 Other Financial Liabilities - Accommodation Bonds 2,374 - 2,374 - Licences to Occupy 243 243 - Other 6 - 6 4,061 - 4,061 2008 Financial Assets Cash and Cash Equivalents 8.08 5,132 5,132 - Receivables - Trade debtors 303 - 303 - Other receivables 289 - 289 Other fi nancial assets - Monies in Trust Deposits 6.83 2,209 2,209 - 7,933 7,341 592 Financial Liabilities Payables 1,436 1,436 Other Financial Liabilities - Accommodation Bonds 2,486 - 2,486 - Licences to Occupy 327 327 - Other 180 - 180 4,429 - 4,429 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 81
Note 18: Financial Instruments (continued)
(d) Market Risk (cont) Sensitivity Disclosure Analysis Taking into account past performance, future expectations, economic forecasts, and management’s knowledge and experience of the fi nancial markets, the Service believes the following movements are ‘reasonably possible’ over the next 12 months (Base rates are sourced from the Reserve Bank of Australia) - A shift of +1% and -1% in market interest rates (AUD) from year-end rates of 6%; - A parallel shift of +1% and -1% in the infl ation rate from year-end rates of 2% The following table discloses the impact on net operating result and equity for each category of fi nancial instrument held by the Service at year end as presented to key management personnel, if changes in the relevant risk occur.
Interest Rate Risk
-1% +1% Carrying Amount Profi t Equity Profi t Equity 2009 $’000 $’000 $’000 $’000 $’000 Financial Assets Cash and Cash Equivalents 5,350 (54) (54) 54 54 Receivables - Trade debtors 181 - - - - - Other receivables 328 - - - - Other fi nancial assets - Term Deposit 2,012 (20) (20) 20 20 Financial Liabilities Payables 1,438 - - - - Other Financial Liabilities - Accommodation Bonds 2,374 - - - - - Licences to Occupy 243 - Other 6 - - - - (74) (74) 74 74 2008 Financial Assets Cash and Cash Equivalents 5,132 (51) (51) 51 51 Receivables - Trade debtors 303 - - - - - Other receivables 289 - - - - Other fi nancial assets - Term Deposit 2,209 (22) (22) 22 22 Financial Liabilities Payables 1,436 - - - - Other Financial Liabilities - Accommodation Bonds 2,486 - - - - - Licences to Occupy 327 - Other 180 - - - - (73) (73) 73 73 82 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 19: Commitments for Expenditure
2009 2008 $’000 $’000 Capital Expenditure Commitments Payable: Land and Buildings - 300 Plant and Equipment - 588 Total Capital Commitments - 888 Land and Buildings Later than 1 year and not later than 5 years - 300 Total - 300 Plant and Equipment Not later than one year - 588 Total - 588
TOTAL - 888
Lease Commitments Commitments in relation to leases contracted for at the reporting date: Xerox Photocopier Agreement 105 146 Motor Vehicles - Lowan Regional Health 43 68 Motor Vehicles - Capital Finance - 124 IP Telephone Rental - 45 Total Lease Commitments 148 383 Operating Leases Cancellable Not later than one year 59 235 Later than 1 year and not later than 5 years 89 148 TOTAL 148 383 Total Commitments for expenditure (inclusive of GST) 148 1,271 less GST recoverable from the Australian Tax Offi ce (13) (116) Total commitments for expenditure (exclusive of GST) 135 1,155
Note 20: Contingent Liabilities
Details of estimates of maximum amounts of contingent liabilities are as follows: 2009 2008 $’000 $’000 Contingent Liabilities Quantifi able Caveat over property - Kaniva Cottages 200 200 Total Quantifi able Contingent Liabilities 200 200
The West Wimmera Shire Council holds a caveat of $200,000 over the title of the Kaniva Cottages. Should the Cottages be sold for any other purpose than to provide Aged Care accommodation at any future time or be wound up, the Council retains the right to recoup $200,000 from the Service. NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 30 JUNE STATEMENTS FINANCIAL THE TO NOTES Note 21: Segment Reporting
Internally Acute Care RACS Aged Care Other Business Units Managed Units Primary Health Other Programs Consol’d 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 REVENUE External Segment Revenue 11,224 11,303 9,558 9,243 435 454 569 422 665 630 3,604 3,383 1,223 2,334 27,278 27,769 Total Revenue 11,224 11,303 9,558 9,243 435 454 569 422 665 630 3,604 3,383 1,223 2,334 27,278 27,769 EXPENSES External Segment Expenses (8,544) (8,369) (10,619) (10,389) (469) (459) (276) (270) (1,036) (1,014) (3,949) (3,861) (2,372) (2,322) (27,266) (26,683) Total Expenses (8,544) (8,369) (10,619) (10,389) (469) (459) (276) (270) (1,036) (1,014) (3,949) (3,861) (2,372) (2,322) (27,266) (26,683) Net Result from ordinary 2,680 2,934 (1,061) (1,146) (34) (5) 293 152 (371) (384) (345) (478) (1,149) 12 12 1,086 activities Interest Expense ------(4) - (4) Interest Income ------385 391 385 391 Share of Net Result of Associates & Joint Ventures using Equity Method ------28 - 28 - Net Result for Year 2,680 2,934 (1,061) (1,146) (34) (5) 293 152 (371) (384) (345) (478) (736) 399 425 1,473 OTHER INFORMATION Segment Assets 23,289 19,655 23,250 19,622 1,127 951 355 300 2,407 2,031 8,248 6,961 1,930 1,629 60,606 51,149 Total Assets 23,289 19,655 23,250 19,622 1,127 951 355 300 2,407 2,031 8,248 6,961 1,930 1,629 60,606 51,149 Segment Liabilities (1,814) (1,943) (5,370) (5,752) (183) (196) (52) (56) (102) (109) (1,227) (1,314) (355) (380) (9,102) (9,750) Total Liabilities (1,814) (1,943) (5,370) (5,752) (183) (196) (52) (56) (102) (109) (1,227) (1,314) (355) (380) (9,102) (9,750) Investments in associates and SERVICE HEALTH WIMMERA WEST joint venture partnership ------28 - 28 - Acquisition of property, plant and 221 268 285 268 13 13 89 4 59 28 159 95 418 22 1,244 698 equipment Depreciation & amortisation expense (485) (502) (473) (490) (27) (28) (16) (17) (32) (33) (79) (82) (19) (20) (1,132) (1,172) > ANNUAL REPORT 2008/2009 83 84 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009
Note 21: Segment Reporting (continued) Note 22b: Executive Offi cer Disclosures
The major products/services from which the above segments derive revenue are: Executive Offi cers’ Remuneration The numbers of executive offi cers, other than Ministers and Accountable Offi cers, and their Segment Services total remuneration during the reporting period are shown in the fi rst two columns in the table Acute Care Acute Inpatient Care below in their relevant income bands. The base remuneration of executive offi cers is shown in Residential Aged Care Service Residential Aged Care the third and fourth columns. Base remuneration is exclusive of bonus payments, long-service Aged Care - Other Community Aged Care Packages, Dementia leave payments, redundancy payments and retirement benefi ts. Respite Total Remuneration Base Remuneration Business Units Dental, Radiography, Medical & Meals on Wheels Internally Managed Units Disability Services 2009 2008 2009 2008 Primary Health Allied & Community Health No. No. No. No. Other Programs Other $110,000 - $119,999 1 2 1 2 $120,000 - $129,999 - 1 1 1 $130,000 - $139,999 2 - 1 - Geographical Segment $140,000 – $149,999 - 1 - 1 Geographical SegmentWest Wimmera Health Service operates predominantly in the West Total 3 4 3 4 Wimmera region. More than 90% of revenue, net surplus from ordinary activities and segment Total Remuneration $393,957 $497,482 $387,957 $473,482 assets relate to operations in this area.
Note 23: Events Occurring after the Balance Sheet Date Note 22a: Responsible Persons Disclosures There were no signifi cant events after the reporting date (30 June 2009). 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. Note 24: Remuneration of Auditors Responsible Minister: Period The Honourable Daniel Andrews, 01/07/2008 - 30/06/2009 2009 2008 MLA, Minister for Health $’000 $’000 Audit fees paid or payable to the Victorian Auditor- Board of Governance General’s Offi ce for audit of the (Agency’s) current R Ismay 01/07/2008 - 30/06/2009 fi n a n c i a l r e p o r t 24 20 R Rosewall 01/07/2008 - 30/06/2009 Total Paid and Payable 24 20 L Clarke 01/07/2008 - 30/06/2009 J Hicks 01/07/2008 - 30/06/2009 L Maybery 01/07/2008 - 30/06/2009 J Sudholz 01/07/2008 - 30/06/2009 R Stanford 01/07/2008 - 30/06/2009 D White 01/07/2008 - 30/06/2009 H Champness 03/03/2009 - 30/06/2009
Accountable Offi cers J Smith - Chief Executive Offi cer 01/07/2008 - 30/06/2009
Remuneration of Responsible Persons
The number of Responsible Persons are shown in their relevant income bands;
2009 2008 Income Band No. No. $0 - $9,999 10 12 $210,000 - $219,999 - 1 $220,000 - $229,999 1 - Total Numbers 11 13 Total remuneration received or due and receivable by Responsible Persons from the reporting entity amounted to: $229,080 $217,121 Amounts relating to Responsible Ministers are reported in the fi nancial statements of the Department of Premier and Cabinet $’000 $’000 Other Transactions of Responsible Persons and their Related Parties Mrs E M Stewart has provided nursing services to the Service on normal award terms and conditions - 105 T Ismay & Company of which Mr R Ismay is a director has provided hardware supplies and services to the Service on normal commercial terms and conditions 2 1 Mrs L M Graham has provided secretarial services to the Service on normal award terms and conditions 45 42 ANNUAL REPORT 2008/2009 85
COMPLIANCE DISCLOSURE INDEX
The Annual Report of West Wimmera Health Service is prepared in accordance with all relevant Victorian Legislation. This index has been prepared to facilitate identifi cation of the Department’s compliance with statutory disclosure requirements.
Legislation Requirement Page No.
Ministerial Directions Report of Operations Charter and purpose FRD 22B Manner of establishment and the relevant Ministers 4, 28, 30, 31 FRD 22B Objectives, functions, powers and duties 6, 7, 28 FRD 22B Nature and range of services provided 5
Management and Structure FRD 22B Organisational structure 29
Financial and Other Information FRD 10 Disclosure index 85 FRD 11 Disclosure of ex-gratia payments NIL FRD 21A Responsible person and executive offi cer disclosures 65 FRD 22B Application and operation of Freedom of Information Act 1982 57 FRD 22B Application and operation of Whistleblowers Protection Act 2001 57 FRD 22B Compliance with building and maintenance provisions of Building Act 1993 57 FRD 22B Details of consultancies over $100,000 57 FRD 22B Details of consultancies under $100,000 57 FRD 22B Major changes or factors affecting performance 62 FRD 22B Occupational Health and Safety Act 2004 57 FRD 22B Operational and budgetary objectives and performance against objectives 6, 7 FRD 22B Signifi cant changes in fi nancial position during the year 61 FRD 22B Statement of availability of other information 57 FRD 22B Statement of merit and equity 59 FRD 22B Statement on National Competition Policy 57 FRD 22B Subsequent events 84 FRD 22B Summary of the fi nancial results for the year 61 FRD 22B Workforce Data Disclosures 59 FRD 25 Victorian Industry Participation Policy disclosures 57 SD 4.2(j) Report of Operations, Responsible Body Declaration 2 SD 4.5.5 Attestation on Compliance with Australian/New Zealand Risk Management Standard 17
Financial Statements Financial statements required under Part 7 of the FMA SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements 67 SD 4.2(b) Operating Statement 65 SD 4.2(b) Balance Sheet 65 SD 4.2(b) Statement of Changes in Equity 66 SD 4.2(b) Cash Flow Statement 66 SD 4.2(c) Accountable offi cer’s declaration 65 SD 4.2(c) Compliance with Ministerial Directions 65 SD 4.2(d) Rounding of amounts 67
Legislation Freedom of Information Act 1982 57 Whistleblowers Protection Act 2001 57 Victorian Industry Participation Policy Act 2003 57 Building Act 1993 57 Financial Management Act 1994 IFC 86 WEST WIMMERA HEALTH SERVICE
GLOSSARY OF TERMS
ACFI Desk Top Audit GEM Bed Multi-disciplinary Statutory or Legislative Aged Care Funding Instrument A paper-based assessment of Geriatric Evaluation and A group comprised of more than Requirement ACHS an organisation’s progress in a Management Beds allocated one discipline, a mix of health A requirement laid down by an Act Australian Council on Healthcare particular program to older patients requiring professionals of Parliament Standards DHS professional management of Occupied Bed Days Sub-Acute Australian Standards The Department of Human an illness or complex medical The total number of patients in Subacute care is a National Standards developed Services, Victoria condition hospital in a given time comprehensive, cost-effective by the Standards Association of DoHA GRHA OH&S inpatient level of care for patients Australia/New Zealand Commonwealth Department of Grampians Regional Occupational Health & Safety who have had an acute event Best Practice Health & Ageing Health Alliance Outcome resulting from injury, illness or Measuring results against the best DON HACC The result of a service provided exacerbation of a disease process. performance of other groups Director of Nursing –Home and Community Care Outpatient TAC CACPs DVA Funding for services and A patient/client who is not Transport Accident Commission Community Aged Care Packages Department of Veterans’ Affairs programs which are provided in admitted to a bed The Board the home or the community provide services in the home ECG Patient/Client/Consumer The Board of Governance Carers Electrocardiograph ICT A person for whom this Service The Department Information & Communication Carers of patients/clients who are EQuIP Accreditation accepts the responsibility of care The Department of Human Technology not part of the Service Care Team Evaluation Quality Improvement PCP Services, Victoria Catchment Program Inpatient Primary Care Partnership The Service A person who is admitted to an Geographical area for which FaHCSIA QOC West Wimmera Health Service acute bed West Wimmera Health Service is Commonwealth Department of Quality of Care Report Values M&CH responsible to provide services Families, Housing, Community Separation/Discharge The principles and beliefs that Maternal & Child Health CEO Services and Indigenous Affairs The process whereby care is guide West Wimmera Health Chief Executive Offi cer FOI Medical Record completed and the patient leaves Service Compilation of patient medical Close Watch Freedom of Information the organisation WIES treatment and history The program used by the FTE Standard Weighted Inlier Equivalent Department to monitor health Full Time Equivalent – used in Mission Statement Level of performance to be Separations services considered to be at relation to the number of staff See Inside Front Cover achieved WWHS a higher than normal fi nancial employed West Wimmera Health Service risk of being able to trade in a sustainable manner
INDEX
Accreditation ...... 1, 4, 8, 55 Community Needs Analysis Graduate Nurse Program ...... 36 Performance in Brief ...... 1 ACFI...... 7 & Service Profi le Project . . . .1, 6, 8, 14 Health Promotion ...... 48 Performance Review ...... 17, 28 Admission and Discharge...... 36 Complaints ...... 15 Health Services Act 1988...... 4, 28 Perpetual Trustees ...... 7 Aged Care ...... 42 Compliance Disclosure ...... 85 Healthy Workplace Challenge ...... 48 Pharmacy Services ...... 36 Air Conditioning...... 53 Compliments ...... 15 Hepatitis B...... 38, 39 Planned Activity Groups (PAG)...... 45 Allied Health ...... 14,16,46,49 Confi dentiality ...... 54 Highlights of the Year ...... 1 Police Checks...... 57 Annual General Meeting ...... IFC, 11 Confl ict of Interest ...... 28 Home & Community Care ...... 5 Pre-admission Clinic ...... 36 Attestations: Cooinda ...... 50, 51 HRSS...... 6, 7, 58 Procurement...... 59 Accountable Offi cer ...... 65 Corporate Governance ...... 28 Human Resource Management ...... 16 Publications ...... 57 Data Accuracy...... 22 Credentialing ...... 41, 47 Human Resources...... 6, 16 Quality of Care Report ...... 1, 11 Responsible Body ...... 2 Dental Services ...... 6, 39, 40 ICT ...... 7, 60 Rain Water Storage ...... 6, 56 Risk Management ...... 17 Dental Therapist ...... 1, 6, 14, 40 Industrial Relations ...... 16 Rainbow...... 4, 5, 7 Audit Committee ...... 28 Diagnostic Imaging Services...... 35, 55 Infection Control ...... 37 Recycling...... 6, 56 Auditors ...... IBC Dialysis...... 1, 5, 6, 37 iSoft Electronic Patient Residential Care ...... 42, 43 Australasian Reporting Awards Disability Services ...... 50, 51 Management System ...... 7, 12, 54 Residents’ Rights ...... 45 ...... IFC, 1, 11 Donations ...... 23, 27 Jeparit ...... 4, 5 Responsible Offi cers ...... 31 Australian Council on Dysphagia ...... 48 Kaniva...... 4, 5, 7 Risk Management...... 6, 11, 17 Healthcare Standards...... 1, 8, 55 E3 Learning...... 18 Ladies Auxiliaries ...... 24 Rules of Procedure...... 28 Bequests ...... 23, 27 Early intervention ...... 48 Landfi ll...... 56 Safety...... 18, 54 Board of Governance ...... 2, 28, 30, 31 Education ...... 18 Macerators ...... 56 Security Review ...... 54 Building Code of Australia ...... 57 Education,Mandatory ...... 18, 38 Maternal & Child Health ...... 49 Sensory Room ...... 51 Bullying ...... 16, 57 Electrocardiogram ...... 27, 35 Medical Imaging ...... 35 Staff ...... 8, 18, 20, 21 Burden of Disease ...... 47 Electronic Patient Drug Medical Practitioners ...... 41 Statistics ...... 22, 39 By Laws ...... 28 Information System ...... 36 Medical Records ...... 54 Strategic Plan ...... 1, 2, 12 Capital & Equipment Grants . . . 11, 37, 53 Emergency Services ...... 35 Medical Staff Association ...... 41 Supported Employees ...... 51 Capital Fundraising ...... 7, 24,25,26,27 Environment ...... 6, 56 Medication ...... 36 Swine Flu (HINI)...... 38, 53 Catering ...... 54 Equity Trustees ...... 15 Medprof ...... 36 Targeted Equipment Program . . . . . 11, 37 Chemotherapy ...... 6 Executive Directors ...... 2, 3, 16, 32, 33 Menu Review ...... 15, 54 Training ...... 45 Chief Executive Offi cer . . . .2, 8, 15,16, 32 Executive Structure ...... 6, 11 Merit & Equity ...... 59 Tristar Medical Group ...... 14 Chronic Disease ...... 47,48 External cleaning audits...... 53 Minister for Health ...... 1, 2, 11, 31 Ultrasound...... 6 Cleaning...... 53 Fees ...... 57 Mission...... IFC VAGO Report ...... 63, 64 Clinical Governance ...... 6 Finance Committee ...... 28 Natimuk ...... 4, 5 Vehicle Fleet...... 1, 12, 56 Clinical Risk ...... 6 Finance ...... 7, 60 National Respite for Carers ...... 5, 45 Videoconferencing ...... 18, 19 Clinical Videoconferencing ...... 7 Financial Management Act 1994 ...... 2 Nhill Drought Resource Centre ...... 24 Visiting Surgeons ...... 41 Clinicians Health Channel...... 18 Financial Management ...... 7, 11 Nhill Hospital ...... 1, 4, 5, 11 Volunteers...... 24, 27 Close Watch ...... 1, 11 Financial Ratios...... 62 Occupational Health & Safety ...... 6, 57 Waste Management ...... 6, 36 Closed Circuit Television (CCTV) . . . . . 54 Foot Care Clinic ...... 48 Olivers Café ...... 51 Whistle Blower Act ...... 57 Committees ...... 28 Freedom of Information ...... 57 Oliver’s Kiosk ...... 1, 6, 12, 51 Workcover ...... 59 Community Advisory Committees ...... Fundraising...... 24, 25, 26, 27 Operating Suite ...... 39 Workforce Composition ...... 59 ...... 7, 15, 28 Garden Program and Activities...... 51 Organisation Structure ...... 6, 29 Workforce Innovation Grants ...... 48 Community Aged Care Packages Gastroenteritis...... 37 Payroll ...... 59 WWHS Health & Fitness Centre ...... 5, 44, 45 General Practitioner Anaesthetist . . . 6,11 Pecuniary Interest ...... 28 ...... 1, 13, 47 Goroke ...... 4, 5, 7 People Matter Survey ...... 16 WWHS Strategic Plan ...... 1 tell us… what you think
Please circle the answer which most closely refl ects your opinion. Q1 Are you a: a) Consumer e) Health Industry Employee b) Representative of Government f) Financial Supporter c) WWHS Staff g) Other (please specify) d) Medical Practitioner
Q2 What did you think about the Report? (please circle a number) Poor Excellent 1 2 3 4 5 6 7 8 9 10 Q3 What did you like about the Report? ______Q4 How can we improve the Report? ______Q5 Are there any other topics which you would like to see in next year’s Annual Report? ______Thank you for your time in completing this questionnaire. You can return it by post or leave it at any of our facilities. John N. Smith, PSM, Chief Executive Offi cer WWHS.
help us… to make the services we provide for six communities become better and better
YES, I am interested in supporting West Wimmera Health Service and would like further information about the following:
Becoming a Volunteer
Joining an Auxiliary
Giving fi nancial support through a bequest or donation
If you wish to discuss supporting our Service in this way please contact the Chief Executive Offi cer who will explain in detail how arrangements can be made.
Alternatively, please complete the form below and return it to us.
Name ______
Address ______
______
Telephone ______Facsimile ______
Mobile ______Email ______
John N. Smith, PSM, Chief Executive Offi cer West Wimmera Health Service PO Box 231, Nhill, Victoria 3418 Telephone 03 5391 4222 Facsimile 03 5391 4228 Email [email protected] PO Box 231 NHILL VIC 3418
West Wimmera Health Service Reply Paid 231 NHILL VIC 3418 BELOW: Gardener, Matt Bone maintaining THANK YOU the grounds of Nhill Hospital
Sponsors
We acknowledge the generous sponsorship which supports the production of this report.
Ace Radio Tattersall’s Wimmera Tattersall’s George Adams 2 Stawell Rd Luv-A-Duck Messengers Foundation Horsham ‘Tattersall’s are Victoria 3400 Australia’s Favourite 85 Nelson St proud to support the PO Box 606, Duck Nhill Victoria 3418 Telephone initiative of West Horsham Telephone (03) 5391 3456 Wimmera Health Victoria 3402 1800 649 000 Service and their The Weekly Telephone www.luvaduck.com commitment to (03) 5382 1351 regional Victoria.’ Advertiser
Acknowledgements Design & Production Motiv Design Co-ordination DMR Associates Pty Ltd, Nhill Photography Robert Geh Lawyers DLA Phillips Fox, Russell Kennedy Pty Ltd, Stewart & Lipshut Auditors Victorian Auditor General’s Offi ce Internal Auditor Deloitte Growth Solutions Pty Ltd Architects Brown Falconer Banker Commonwealth Bank
WW107 / MOTIV This publication is printed on ENVI – 100% Carbon Neutral Paper Please use, re-use & recycle. About this Report West Wimmera Health Service is a complex organisation. We are care givers, we are business managers, we are forward planners, we are employers, we are stimulators of the local economy. It is an extensive list of activities and responsibilities and every single endeavour represented is directed towards people – people of the diverse communities in North West Victoria.
NHILL KANIVA 43-51 Nelson Street 7 Farmers Street Nhill Victoria 3418 Kaniva Victoria 3419 T (03) 5391 4222 T (03) 5392 7000 F (03) 5391 4228 F (03) 5392 2203 COOINDA NATIMUK Queen Street 6 Schurmann Street Nhill Victoria 3418 Natimuk Victoria 3409 T (03) 5391 1095 T (03) 5363 4400 F (03) 5391 1229 F (03) 5387 1303 GOROKE RAINBOW Natimuk Road 2 Swinbourne Avenue Goroke Victoria 3412 Rainbow Victoria 3424 T (03) 5363 2200 T (03) 5396 3300 F (03) 5386 1268 F (03) 5395 1411 JEPARIT EMAIL 2 Charles Street [email protected] Jeparit Victoria 3423 T (03) 5396 5500 F (03) 5397 2392
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