Queensland Health

My health, Queensland’s future: Advancing health 2026

compassion • inclusion • excellence • empowerment • sustainability

sustainability • compassion • inclusion • excellence • empowerment My health, Queensland’s future: Advancing health 2026 Published by the State of Queensland (Queensland Health), May 2016

This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of the licence, visit creativecommons.org/licenses/by/3.0/ au/legalcode © State of Queensland (Queensland Health) 2016 Disclaimer: You are free to copy, communicate and adapt the work, as long as you The content presented in this publication is distributed attribute the State of Queensland (Queensland Health). by the Queensland Government as an information source only. The State of Queensland makes no For more information contact: statements, representations or warranties about the [email protected] accuracy, completeness or reliability of any information contained in this publication. The State of Queensland disclaims all responsibility and all liability (including An electronic version of this document is available at: without limitation for liability in negligence) for all www.health.qld.gov.au/system-governance/strategic-direction/plans/ expenses, losses, damages and costs you might incur vision-strategy/ as a result of the information being inaccurate or incomplete in any way, and for any reason reliance was placed on such information. QH702 05/16 Message from the Minister

On many key measures, Queensland’s health Today’s healthcare is being transformed by system ranks among the best in the world. innovation. By 2026, healthcare will look However, like healthcare systems everywhere, it very different than it does today. My health, is facing significant challenges. Queensland’s future: Advancing health 2026 will further drive investment in new ideas, research Our population is ageing. A growing number of and technology. Queenslanders live with chronic disease. Better clinical interventions and new technologies We will capitalise on the potential of health offer the prospect of improved health outcomes. technology and models of care which will But health costs are rising and we need to be improve service access and aid our workforce. smarter about how we deliver healthcare into New communication technologies will help put the future. people in control of their decisions, benefiting consumers, families and communities. While I acknowledge these challenges, I have confidence they can be tackled through Making Queenslanders among the healthiest technological advances as well as harnessing people in the world is an aspirational vision. It the skill of the entire health system. can only be achieved by inspiring individuals, and making space for us to work collaboratively Vital to this effort is the knowledge, skill and to achieve our common goals. enthusiasm of the entire health workforce. Success in achieving the vision relies on the health workforce having the freedom to be The Hon. Cameron Dick MP innovative in a supportive environment. Minister for Health and Minister for Ambulance Services

3 Introduction

Australia’s health system ranks among the experience of many Aboriginal people and Torres best in the world. In a recent comparison of Strait Islander people, as it is for many people Organisation for Economic Co-operation and who live in rural and remote areas. Development (OECD) countries, Australia was found to have one of the best performing Australia’s health system is complex. It is health systems - achieving above average life funded and administered by several levels expectancy with lower than average health of government and complemented by private expenditure. health arrangements. Its reach is universal and its delivery mechanisms include both The health system relies on highly skilled staff to government and non-government organisations make clinical and management decisions. Every and the private sector. day, these decisions not only affect the health outcomes of individuals, but also impact the Advancing health 2026 was developed to guide health of the community and the sustainability Queensland government investment into health of the entire health system. over the longer term and to reorient our system to be flexible and innovative in taking advantage Like all contemporary health systems, of new technologies, while improving health Queensland is facing significant challenges. outcomes for the population at large. For us, challenges include our ageing population, increasing chronic disease rates, This plan will make real the vision statement changing consumer expectations, and finite which emerged from the consultation process resources. Better clinical interventions and new —‘By 2026 Queenslanders will be among the technologies will also present challenges, but healthiest people in the world’. offer the potential to improve health outcomes In 2016, we have a sense of the challenges and transform healthcare as we know it. facing the healthcare system, but with rapid Good health outcomes, however, are not shared changes in technology and treatment options it equally across population groups. People who is difficult to clearly predict the nature of those are socio-economically disadvantaged have challenges in 10 years time. We need a roadmap poorer health and wellbeing outcomes and lower to this future. Advancing health 2026 gives both health status than the rest of the population. a focus and a process to identify and harness Such health inequality is also the lived the advances which are critical to the future wellbeing of the population of this state.

4 Diagram 1 illustrates Queensland’s system of health and wellbeing. It highlights the shared approach to public health across jurisdictions and the multiple roles and overlapping responsibilities of funders and providers. Consumers’ use of health services is shaped by current funding models which provide subsidised access to general practice, hospital care and medications.

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6 Development of Advancing health 2026

Advancing health 2026 was developed to The ‘aspirations for 2026’ throughout this respond to the challenges and opportunities we document summarise key themes from the face in Queensland. The solutions lie in working workshop. To prepare for the workshop, together across our national health system, participants were given detailed information within our own state, our own communities and about the current health system context, with individuals and families. summarised in the diagram titled ‘Health in Queensland: A snapshot’. Advancing health 2026 came together with participation from health consumers and Diagrams 2, 3 and 4 illustrate the key themes clinical and non-clinical representatives of the discussed during the workshop. public health system, private and non-profit health providers, universities, professional organisations, unions and other key stakeholder groups, as well as several Queensland government departments. All of these groups attended a workshop held in February 2016.

7 Three health consumers set the scene for the our society now and into the future gave an workshop by detailing their experiences of insight into life in 2026. The megatrends were: the health system and their personal visions demographic shifts; digitisation; globalisation for how they would like the system to serve of the marketplace; environmental issues; consumers in 2026. As well, a presentation urbanisation and individual empowerment. on ‘global megatrends’ that are shaping

Opening

Diagram 2: Workshop scene setting – global megatrends and consumer perspectives

8 Next, participants worked in small groups to the most support formed the basis of the produce example visions for the Queensland vision in this document, which is: ‘By 2026 health system to 2026. The vision statements Queenslanders will be among the healthiest were voted on, and the statement that gained people in the world’.

Visions

Diagram 3: Vision options developed during the workshop

9 Finally, participants worked in groups to develop and communities; integrity, quality and safety; descriptions of what success in achieving the inclusiveness; integration; and innovation and vision would look like in 2026. This was applied research. to the categories of: empowering individuals

How will we know when we get there?

Diagram 4: What will healthcare in 2026 in Queensland look like?

The Vision—My health, Queensland’s future: Advancing health 2026

The following diagram sets out the 2026 vision The strategic agenda in the diagram comprises for Queensland’s health system, as well as 12 focus areas supported by 16 headline directions, strategic agenda and foundation measures of success, to be monitored to track principles, in response to the challenges progress over time. Queensland’s health system faces, and the opportunities the system can embrace.

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11 3. Inclusion - we will respond to the needs of all Principles— Queenslanders and ensure that, regardless of circumstances, we deliver the most our foundations appropriate care and service with the aim of achieving better health for all. The five principles underpin this vision, directions and strategic agenda. They state 4. Excellence - we will deliver appropriate, the values that should guide decision making timely, high quality and evidence-based and how health system partners work together. care, supported by innovation, research and These principles will guide service delivery in the application of best practice to improve the public health system, and we encourage outcomes. our health system partners to consider the principles in their work also. 5. Empowerment - we recognise that our healthcare system is stronger when 1. Sustainability - we will ensure available consumers are at the heart of everything we resources are used efficiently and effectively do, and they can make informed decisions. for current and future generations.

2. Compassion - we will apply the highest ethical standards, recognising the worth and dignity of the whole person and respecting and valuing our patients, consumers, families, carers and health workers.

12 Queensland Health

DIRECTION 1

PROMOTING WELLBEING

Improving the health of Queenslanders, through concerted action to promote healthy behaviours, prevent illness and injury and address the social determinants of health.

Improving our health and wellbeing not only “Health is everyone’s business.” improves our quality of life, it can have societal Harry Pitt – a representative of the Torres benefits such as better productivity, happier families, reduced health inequalities, and Strait Islander community reduced demand on health and social services.

Wellbeing is a complex combination of a Queensland has made progress, such as person’s physical, mental and emotional health increases in life expectancy and physical and their social and economic circumstances. activity; an overall decline in smoking rates; and It is how you feel about yourself and your life immunisation rates above the national average. and is strongly linked to happiness and life However, there are still a number of challenges satisfaction. that we must address, including the impact of the increasing proportion of people who are Many factors can improve a person’s wellbeing, overweight or obese, the challenges regarding including regular exercise, a nutritious diet, mental health, and the health inequalities that sufficient sleep, healthy self-esteem, an exist in many communities in Queensland. optimistic outlook, realistic and achievable goals, a sense of purpose and meaning, a sense of belonging, and a network of close friends.

13 Focus area 1.2 Promoting wellbeing: Aspirations for 2026 Healthy communities • A healthy choice is an easy choice. Good health in communities is an indication • A wellness model for healthcare, rather than of a fair and just society. Poor health within an illness focus. communities, or among specific population • We need to incentivise a healthy lifestyle. groups, requires many, long term strategies to reduce social and economic disadvantage. As well as action within the health system, other portfolios such as education, employment, In order to drive change and promote wellbeing housing and transport have key roles to play of Queenslanders, three areas of focus have to improve people’s daily living conditions and been identified: Health as everyone’s business, the distribution of resources in the community. Healthy communities and Healthy choices. Community development approaches and building community ownership are also Focus area 1.1 essential to overcoming health inequities. Health as everyone’s business Data shows that adults in disadvantaged areas are nearly 80 per cent more likely to report Beyond individual characteristics and poor health. Obesity, smoking and physical behaviours, health and wellbeing is determined inactivity all contribute to poorer health and are by social and economic factors that can more prevalent in lower socio-economic areas favour health or be harmful to it. These of Queensland. Reducing these risk factors include education, employment and working can result in better quality of life, increased conditions, housing and access to and use of wellbeing and satisfaction with health in these health services. For example, urban design communities. influences health and wellbeing by encouraging safe and active lifestyles, better connections, Health and wellbeing outcomes are poorer for and a sense of belonging. Access to affordable, Aboriginal and Torres Strait Islander people, healthy food helps the community to make good those who live in rural communities, people from food choices. culturally and linguistically diverse communities and people who are economically and socially Employers can benefit from investing in health disadvantaged. Life expectancy for Indigenous promotion policies and activities for their people is around 10 years less than that of the workforce, with research showing a $2.30 return general population. Residents of higher-income on investment for every $1 invested in creating areas have on average, four additional years of a healthy workforce1. For instance, although healthy life than those living in disadvantaged federal, state and local governments have a role parts of Queensland. to play in immunisations, as does the primary health sector, employers can also increase Giving all Queenslanders equal opportunities to immunisation rates through clinics as part of a experience good health and wellbeing demands wellness program. strategies that cross sectors and governments, engage communities and businesses, and Every level of government, every government empower individuals and families. agency, every employer, every community and every individual has an important role in contributing to our health and wellbeing.

1 Source: Journal of Occupational and Environmental Medicine, 2002; 44:776-80.

14 Focus area 1.3 getting enough rest, eating a good diet, regular exercise, maintaining a close network of friends Healthy choices and making time for the things you enjoy.

While our health is somewhat determined by The health system has a role in supporting our own actions, various environmental and Queenslanders to make healthy lifestyle social factors can help us to enjoy better health choices. This is not only good for individual and wellbeing throughout our lives. Smoke-free wellbeing, but is also a key foundation to public places across Queensland help to reduce Queensland’s social fabric and economic exposure to harmful tobacco smoke and reduce prosperity. the social acceptability of smoking, helping to encourage smokers to quit. Queensland state schools are among the leaders in the promotion of healthy eating through their implementation Headline Measures of Success of Smart Choices, the Healthy Food and Drink The Queensland government will measure Supply Strategy for Queensland Schools. Similar progress in promoting wellbeing through strategies have been shown to reduce the several success measures that the health amount of sugar consumed at a population level. system will work towards. These success Currently, 2.5 million Queenslanders are measures, listed below, will be monitored overweight or obese. Obesity is fuelling the over time. prevalence of chronic conditions such as stroke, By 2026 we will: hypertension and type 2 diabetes. Reducing childhood obesity is essential to prevent the • Reduce childhood obesity by 10 per cent. onset of many chronic conditions. • Reduce the rate of suicide deaths in Queensland by 50 per cent. Mental health conditions are also a leading cause of disability in Queensland. In 2007, • Increase life expectancy for Indigenous approximately one in two Queenslanders males by 4.8 years and females by 5.1 years. aged 18–65 years reported a mental health • Increase levels of physical activity for disorder at some time in their life. Improving health benefit by 20 per cent. our mental wellbeing is something that we all can do by finding the right work-life balance,

In the future I think we can utilise technology better. Technology improvements could include making the internet available for patient use via WiFi hotspots within hospitals. Having internet access will help the younger people I see with Cystic Fibrosis who spend years of their lives in and out of hospital to communicate with each other through cyber support programs as they are forbidden to do this face to face due to current cross infection protocols. The mental state of patients when they feel isolated is utmost to a successful recovery and we all know from personal experience that support groups lead to improved health outcomes for most patients. Douglas Porter – health consumer, Sunshine Coast

15 Queensland Health

DIRECTION 2

DELIVERING HEALTHCARE

The core business of the health system and improving equitable access to quality and safe healthcare in its different forms and settings.

patient care, through better systems, processes “People think we can’t influence and teamwork. Changes will also come with a the health system. But we can.” younger workforce. By 2026 it is estimated that nearly half of the Queensland Health nursing Wynn Te Kani – health consumer, Brisbane workforce and three quarters of our medical staff will be Generation Y and Z. Generation Z will be Healthcare service delivery in 2026 will be the first generation never to have experienced very different from today. New diseases the pre-internet world. will emerge, new treatments and ways of A strong consumer voice means better delivering healthcare will be developed, new healthcare and better health outcomes. As technologies will change care delivery systems consumers become more health literate their and consumers will have greater access to relationship with health professionals is information about their health and treatment stronger. Consumers should consistently be options. The continuing quality and safety of influential at all levels of the health system – healthcare delivery must underpin any change to contributing ideas about practice, providing the system. feedback on quality, and participating in design Changes to healthcare delivery will be driven of new care models, monitoring and evaluation. by the health workforce. Clinicians are in the best position to see how to improve direct

16 Queensland’s 16 Hospital and Health Services Delivering healthcare: Aspirations for 2026 (HHS) are pursuing consumer engagement strategies, sharing good practice and • Consumers as partners, not passengers. continuously improving their approaches. These • Patients increasingly treated in their own efforts are mirrored in other parts of the health homes instead of hospital. system – Primary Health Networks, general practice and private hospitals, as well as the • Data is routinely used to benefit both many community-based organisations. Health consumers and providers and improve Consumers Queensland plays an important health outcomes. role across the state showcasing how to build a culture of consumer and health service partnership that delivers tangible benefits. In order to continue to deliver care effectively, three areas of focus have been identified: Consumer voice, Empowering our workforce and Focus area 2.2 Continuous improvement culture and clinical Empowering our workforce practice. Our capacity to provide quality care and ensure Focus area 2.1 patient safety into the future is dependent upon the availability of a skilled workforce, working Consumer voice in a culture that values safety, ethical conduct, autonomy and accountability. Workplaces that Consumers’ thirst for knowledge will mean that empower staff have higher productivity and they will be more a driver of their healthcare, morale. than a passenger. Today 1 in 20 Google searches involve a quest for health information. New The management of workforce shortages, and communication technologies bring health the distribution of the health workforce to areas information into the home, raising health literacy of need, remains a key challenge and requires levels and driving personal responsibility for Queensland’s health system to explore new health and greater degrees of self-management. and innovative ways of delivering services. For Information and knowledge are power. Evidence example, using different kinds of workers or shows that when information and performance new technologies can improve Queenslanders’ data are presented in a user-friendly format, access to the services they need. this increases consumer literacy and empowers people to make more informed care choices. The shift to preventative and primary care also means changes in roles, skill requirements, The active involvement of consumers and workplaces for the health workforce. New individually and collectively through technology is driving consumer expectations networks and peak bodies is now standard and enabling different service models, while in Queensland’s health system. Consumer also affecting workforce capability and skill perspectives on all aspects of the health requirements. Many of these changes demand system offer a different and invaluable view. greater interdisciplinary collaboration and This is formally recognised in Standard 2 of team work, and more emphasis on workforce the National Safety and Quality Health Service innovation, flexibility and responsiveness. Staff Standards, which involves consumers in the need modern, adaptable technology to support organisational and strategic processes that them to make the right decisions, to reduce guide the planning, design and evaluation of duplication and waste and to interact with health services. consumers in ways that are responsive to their needs.

17 The focus of all workforce reform efforts across Part of continuous improvement is the health system should be on improving communicating system performance to the access and outcomes for consumers. To this public. Evidence shows the publication of end, Queensland Health is developing a 10-year comparative reporting of clinical performance Health Workforce Strategy which will be available data at hospital and service level influences later in 2016. clinical practice and improves overall performance of the health system. Focus area 2.3 Continuous improvement culture and clinical practice Headline Measures of Success The Queensland government will measure Queensland’s health system provides the progress in delivering healthcare through full spectrum of services for both public several success measures that the health and private patients. Hospitals provide non- system will work towards. These success admitted patient services such as emergency measures, listed below, will be monitored department and outpatient clinics, and services over time. for inpatients such as maternity, mental health, medical and surgical services. Essential services By 2026 Queensland will: such as pathology, pharmacy and allied health support both admitted and non-admitted care • Have consumers participate at all levels of services. the health system.

In the community, care, advice and treatment • Deliver a 10 year Health Workforce Strategy. occurs in many settings including at home. • Attain the lowest rate in Australia of General practice, pharmacies, child health, unplanned readmission rates for selected aged care, and allied health services such as procedures. physiotherapy, and others all form the primary health system. Complementing this is the • Publish information on service delivery and Queensland Ambulance Service (QAS), providing patient outcomes. emergency and non-emergency pre-hospital care and transport services. • Ensure Queenslanders receive clinical care within an appropriate time regardless of Research shows that the biggest single driver of location. quality in healthcare is culture – where everyone working in the health system is striving to do their very best for patients. That means team work and collaboration within services and across settings; it means investment in leadership and training in a range of areas; and it means focussing on the holistic needs of each health consumer. Fostering such a culture is likely to increase employee satisfaction as staff members see the improved health outcomes and patient safety that result from a focus on collaboration and continuous improvement.

18 Queensland Health

DIRECTION 3

CONNECTING HEALTHCARE

Making the health system work better for consumers, their families and communities by tackling the funding, policy and delivery barriers.

occurs within health services and across health “I dream of a seamless settings, especially between primary and acute interface for consumers, where care. These arrangements create inefficiencies there is no wrong door.” and can compromise good healthcare. Collaborations between parts of the health Helen Mees – health consumer, Ipswich system such as Hospital and Health Services and Primary Health Networks are an important Because Queensland’s health system is funded building block, and many initiatives are in train. from multiple sources and delivered through There is no shortage of ideas from consumers different providers, it is geared more towards and providers – both in the public and private episodes of care, not continuity of care. For health system – about what would work better many consumers this works well, but for people at the frontline. However, large scale changes with complex and chronic conditions, it could will hinge on national reform, requiring the work better. Consumers talk about fragmented Australian Government to work with States and care, providers talk about silos, and funders Territories, and also with the private health talk about duplication. Poorly coordinated care insurance and healthcare sector.

19 At the regional level, Primary Health Networks, Connecting healthcare: Aspirations for 2026 Hospital and Health Services and other partners are working together to better plan, • A system where we have a single source deliver and connect health services, with a patient record. focus on reducing potentially preventable • A sustainable funding model involving hospitalisations through connected programs. federal, state and local governments’ North Queensland, Western Queensland and contributions. Darling Downs and West Moreton Primary Health Networks, all auspiced by local Hospital and • A whole of government approach to Health Services, are leading the development of health where each Department’s/agency’s more connected and coordinated care in these decisions reinforce the achievement of rural and remote areas. better health outcomes. At the frontline, an additional 400 Nurse Navigators across the public health system will In order to effectively connect care, particularly deliver real benefits for consumers and staff by for consumers with chronic conditions, three helping to coordinate admission to hospital and focus areas have been identified: Simplifying discharge from acute care, with the community and connecting, Funding reform and Being a care back up that is needed. good partner. Staff and networks have ideas that they know can work. A new $35 million Integrated Care Focus area 3.1 Innovation Fund is designed to help fuel better Simplifying and connecting practices at all levels of the health system, with whoever and whatever it takes to better prevent The Australian Government notes that patients and detect health issues; to share care between with complex and chronic disease account for hospitals and GPs, between generalists and 10 per cent of the population but for 45 per cent specialists; and to tackle the funding and of Medicare expenditure. There are no easy organisational structures that get in the way. solutions, but being able to share information and data electronically between the consumer and provider, and between providers, is one of Nurse navigators the requirements for connecting healthcare. Nurse navigators work with patients with eHealth reforms will drive connections through complex health conditions. They will: sharing of patient information across healthcare boundaries. This will change the way consumers • monitor high needs patients, identify and health professionals interact. It could actions required to manage their mean that patients with complex and chronic healthcare and direct patients to the right conditions won’t have to remember details in service, at the right time and in the right their medical record, nor carry diagnostic test place. results with them. Electronic health records, • provide an end-to-end care coordination and easy access to full information will enable service along a patient’s entire healthcare consumers and providers to be more confident journey. about clinical care decisions. • educate and help patients to better At the state public health system level, the understand their health conditions and Queensland eHealth Investment Strategy enable them to self-manage or participate establishes the foundations of a digital health in decisions about their healthcare. In system that will secure access and sharing of some cases, this may even reduce the medical records for every public patient, and need for hospital admission. which complements a national eHealth system.

20 The Princess Alexandra Hospital Digital Hospital Program

• The Princess Alexandra Hospital Digital • With 100 per cent of inpatient records now Hospital Program has transformed paper digital, the Princess Alexandra Hospital is medical records and forms to an integrated recognised as Australia’s first large scale digital systems to support patient care, digital hospital, thanks to the hard work of to become a Digital Hospital. A Digital staff and the digital hospital project team. Hospital has an electronic medical record, • While historic patient information will remain integrated digital systems, and a paper-light in closed paper charts, all new information environment; for example, reduced use of on patients and their treatment will be paper charts and forms. documented electronically and available • The Princess Alexandra Hospital Digital on health professional screens across the Hospital Program is a program of hospital and at the bedside. transformative changes that will be delivered • This will allow clinicians to implement more in phases to provide technology, tools efficient, effective treatment. It will free up and real-time information to empower and more time for staff to spend with patients. It encourage the best people in healthcare into will reduce inefficiencies and wastage, and will new opportunities for innovation. support world class clinical care and research.

Focus area 3.2 Funding reform Other health goods Diagram 5 illustrates the complexity & services Administration of our funding and delivery and research arrangements, with the Australian Government, States and Territories, Medical services Public private health insurance, private (referred) hospital Other services providers and individuals all recurrent contributing to our healthcare. % Other health 21.3 Hospitals practitioners Share of expenditure 40.4 %

Hospitals Medical services Primary (non-referred) health care Primary health care 38.2 %

Private Other recurrent hospitals

Medications Responsibility for services Community Dental & public health Combined private sector and public sector services —all levels of government

State and territory governments

Private providers

Funding Diagram 5: Health services—funding and responsibility (Source: AIHW Australia’s Health 2014) Australian Government funding share Note: The inner segments indicate the relative size of expenditure in each of the 3 main sectors of the health system (‘hospitals’, ‘primary State/territory government funding share healthcare’, and ‘other recurrent’). The middle ring indicates the relative

Private funding share expenditure on each service in the sector (shown by the size of each segment) and who is responsible for delivering the service (shown by the colour code). The outer ring indicates the relative size of the funding (shown by the size of each segment) and the funding source for the difference services (shown by the colour code).

21 If Queensland is to have a sustainable, quality will accelerate over the next few years, driven health system in 2026 then funding levels not only by evidence and technology, but also by need to reflect population growth, the age the need to work together and work smarter in structure of the population, and changes in the interests of better health outcomes. the rate of disease and costs of technology. Funding also needs to take account of higher Queensland’s health system is well placed to healthcare costs incurred by rural and remote support many whole-of-government strategies Queensland communities, and the inequality where frontline health services and specialist of health outcomes experienced by Indigenous programs add weight to these important Queenslanders, people from culturally and initiatives. linguistically diverse communities and • Child health nurses help identify and support people who are economically and socially vulnerable children and families at risk disadvantaged. of abuse and neglect; and mental health As part of this, health services need to be professionals provide therapeutic services flexible and adopt better business systems and to young people in out-of-home care. School- clinical models to reduce costs and increase based youth health nurses work across the patient throughput and service access. However, State. efficiencies will only go so far; funding levels at • Queensland Health’s commitments under the least need to be maintained. Queensland Government’s Domestic Violence It is important that all levels of government Strategy, Not Now, Not Ever; Putting an end to honour their commitments to funding the Domestic and Family Violence in Queensland healthcare system over the long term. This will include equipping health professionals to provide more certainty in the planning and identify domestic and family violence early. delivery of healthcare. New resources and training will be developed by the Department of Health and distributed Over and above funding levels, new funding to private and public health professionals, models that are sustainable and provide as well as specialist nursing and medical aligned incentives are needed. For example, colleges. the treatment of chronic disease is an area that warrants active and joint consideration. There • The National Disability Insurance Scheme are opportunities for Queensland to work with (NDIS), due to commence from July 2016, but the Australian Government to agree on better with an early launch site in North Queensland, ways to deliver care. Initiatives such as jointly provides the opportunity to drive stronger funded care plans, coordinated planning and partnerships between the health and commissioning of services between primary and disability sectors. acute care organisations have merit. • A new refugee health policy and framework Funding and financing reform is integral to a will respond to the expected increase in sustainable health system in Queensland and refugees in Queensland and ensure frontline the Queensland government is committed to staff can respond to this group’s particular achieving this. health needs. • The Department of Health in consultation with Focus area 3.3 community partners has developed the draft Queensland Sexual Health Strategy 2016–2021 Being a good partner that encompasses sexual and reproductive health. Once finalised, the Strategy will be Delivering effective healthcare requires formal complemented by a HIV Action Plan, a Viral and informal partnerships between the public Hepatitis Action Plan and a North Queensland hospital system, governments, non-government Aboriginal and Torres Strait Islander Sexually organisations, the private sector and the newly Transmissible Infections (STI) Action Plan, established Primary Health Networks. New providing a comprehensive package to connected care and chronic disease programs improve the sexual health of Queenslanders.

22 Partnerships for an innovative Headline Measures of Success healthcare future The Queensland government will measure progress in connecting healthcare through The Queensland Government Advance several success measures that the health Queensland program aims to create the system will work towards. These success knowledge-based jobs and industries of measures, listed below, will be monitored the future here in Queensland. Part of the over time. program is a commitment to partnering with innovative companies and research By 2026 we will: institutions to accelerate healthcare innovation. For example: • Increase availability of electronic health data to consumers. • The Advance Queensland Innovation Partnerships program enables universities • Reduce the rate of potentially preventable and research institutions to partner hospital admissions e.g. for chronic disease with industry to apply for Government patients. funding of up to $1.5 million to accelerate • Implement new funding models for better translational research. connected healthcare and improved health • The Queensland Government is outcomes. collaborating with Johnson & Johnson Innovation to run the Johnson & Johnson Innovation Quick Fire Challenge, which will award prize money to help fund healthcare research with high potential for commercialisation. • The University of Queensland has partnered with US-based Emory University’s Institute for Drug Development. The Queensland Emory Drug Discovery Initiative (QEDDI) will capitalise on both universities’ success in translational research to jointly develop new drugs for conditions such as cancer, diabetes, infectious disease and inflammatory conditions such as arthritis.

What do I hope for in the next 10 years? I hope to see an open, transparent process for moving easily between primary care and specialist care, between public hospitals and private hospitals, between health and other government departments as well as non-government organisations. Where the focus is on what’s best for the consumer, rather than whose cost centre is this coming from. Helen Mees – health consumer, Ipswich

23 Queensland Health

DIRECTION 4

PURSUING INNOVATION

Developing and capitalising on evidence and models that work, promoting research and translating it into better practice and care.

Our world is being positively disrupted by new “Why do I need to go research, technologies and digital innovations to a hospital to talk to that have transformed large parts of the economy and society. Over the next five years someone; I already connect it is expected that digital innovations will be responsible for creating five new jobs for every with people on the other two that disappear.

side of the world and use Queensland’s health system is not immune mobile apps to manage my to this disruption. Today’s healthcare is being transformed by innovations which will accelerate health.” over the next decade. New approaches to prevention and clinical care are essential if we Jessica Elise – health consumer, are to meet our health challenges and grasp the Brisbane opportunities presented by new technologies.

24 The hospitals and the health facilities of the Pursuing innovation: Aspirations for 2026 future will look very different. Digital hospitals are at the cutting edge and are changing the • Enabling decision making by health delivery of healthcare. They can improve professionals and health consumers patient safety and quality of care, as well as through better and more available data and free up frontline staff to provide more direct information. patient care. • Innovation and research will be demand driven by the consumer, workforce and Future hospitals and community health facilities external industries to the health system. will also need to be more flexible in design and less capital intensive. New health facilities will • Innovation will translate seamlessly into be modular, multi-purpose and adaptable to health service delivery and operations. changing clinical practice and community need. Information technology will also drive new types of ‘smart infrastructure’ such as expanded In order to ensure that Queensland’s health community health centres that operate as a one system is innovative in its pursuit of improving stop shop for healthcare; new mobile services health outcomes, three focus areas have been (both diagnostic and treatment); and new ways identified: Smart technology and infrastructure, of delivering rehabilitation and sub-acute care. Research and new ideas into practice and A status quo approach to infrastructure design Personalised health. and delivery is not an option.

Digital disruption such as “The Internet of Focus area 4.1 Healthy Things” is offering consumers and Smart technology and clinicians new ways to connect wearable devices, wearable sensors and smartphones to infrastructure electronic health records, to deliver “anywhere healthcare” that can be personalised to There continues to be significant capital the patient. This form of healthcare will investment in built infrastructure and revolutionise the way services are accessed information and communications technology and delivered, fundamentally transforming the (ICT) across the health system. As the use relationships between clinicians, patients, their of technology to enable service delivery families and the broader community. increases, infrastructure needs will change. We have entered the age of the digital consumer, characterised by a strong shift in control over Focus area 4.2 product and service information. The consumer, Research and new ideas into together with consumer technology, is now the major disruptor in determining how services are practice delivered. Queensland recognises the importance of Future service models must empower patients research to improve health and wellbeing. In and their families to take greater responsibility order to continue to improve health outcomes, for their healthcare, through access to new overcome existing health challenges and technologies such as apps, at home or portable deal with emerging challenges, we need new diagnostics, smart or implantable drug delivery treatments, drugs, methods, equipment and mechanisms, digital therapeutics and genome models of care. sequencing. This transformation will drive investment decisions in smart ICT and smart Clinicians and researchers working in our health infrastructure. system are vital to our efforts to find new and different ways to deliver services. They need to be given the tools and skills to identify and embed new evidence-based practices into day to day care, leading to better outcomes for patients and the health system.

25 We have a tremendous opportunity with our As our economy transitions at the end of the partners in universities, the research sector mining boom our health industries are uniquely and across the health and care sectors to use placed to capitalise on the export of services to 'big data' and predictive analytics to shift our Asian markets. As a system we need to develop approach to healthcare from “break-fix” to the next generation of entrepreneurs who can “predict-prevent”. We also have the opportunity take what they have learned in Queensland to to embrace patient-led research and care via the rest of the world. We also need to nurture online communities. For example, in the United the big ideas by creating an environment where Kingdom, PatientsLikeMe is an online community they can be developed and trialled right here in where patients are “data donors”, a simple way Queensland. This can’t be done by government for patients to share their data with researchers. alone. It will require collaborative leadership and a dedication to constant innovation. Finding new and innovative ways of delivering healthcare will ensure that our health system meets the needs of Queenslanders and is Focus area 4.3 sustainable. We can continue to work smarter by Personalised health using the results of practice based research to develop new models of care. Such improvements Personalised healthcare involves tailoring must be embedded as clinical policy and practice treatments to take into account the individual across the health system. differences in people’s genes, environments and lifestyles.

Investing in the future Within standardised pathways, personalised The health system in Queensland continues to invest treatment options will be vital for some medical in innovation and skills development. Examples conditions, such as cancer. Consistently curing include: cancer will only be possible by tailoring treatment strategies to the genetic makeup of each • Attracting co-investment in developing innovations individual’s tumour, and getting this right, first – the research partnership between Brisbane’s time, every time. Development of such targeted Critical Care Research Group (CCRG) based at The treatments will take time, but Queensland can Prince Charles Hospital (TPCH) and the Centre for contribute through undertaking basic and applied Translational Research in Biomedical Sciences in research and by working to implement improved Taiwan to develop advanced treatments for heart approaches developed elsewhere. and lung disease. • Providing leading teaching, education and training through world-class facilities such as the Clinical Headline Measures of Success Skills Development Service at the Royal Brisbane The Queensland government will measure and Women’s Hospital. progress in pursuing innovation through several • Supporting clinicians to undertake research, and to success measures that the health system will commercialise research outcomes. work towards. These success measures, listed • Use of innovative hospital and health facility below, will be monitored over time. building design – such as Lady Cilento Children’s By 2026 we will: Hospital and modular building design of Moura • Have the majority of clinical activities Hospital. supported by a digital platform. • Have 20 per cent of National Health and Queensland’s health system is built on the back Medical Research Council (NHMRC) grants of world class people. We have access to the awarded to Queensland researchers and world class clinical leaders, hospital managers, the State will have NHMRC Advanced Health health planners, designers and builders and Research and Translation Centres. research and biotechnology developers. There is • Increase the proportion of outpatient a need throughout Asia and the rest of the world care delivered by Queensland Health via for these skills. The export of services will be the Telehealth models of care. next frontier in the development of Queensland. • Have a strong innovation and research culture across the health system.

26 MAKING OUR VISION A REALITY

Advancing health 2026 serves as a framework The Minister for Health and Minister for for current plans and future priorities for health Ambulance Services will establish and in Queensland. These involve all partners chair a committee to provide oversight of working collaboratively to improve the broader Advancing health 2026 and our progress. This health system. Implementing the directions committee will identify future opportunities for and strategic agenda will involve reshaping collaborative action, monitor performance and investment over time to ensure we are on track publicly report on progress against the headline to achieving our vision. measures of success.

Making this vision a reality requires methodical We will work with our partners in the health planning, sustained effort, regular review, and system and other sectors to align our efforts, a willingness to adopt different and even bold monitor progress and improve performance. We approaches. will empower the health workforce to enable them to contribute to realising our vision. We The directions, strategic agenda and headline will also continue to work with consumers measures of success will be reflected in the and consumer organisations such as Health service agreements that the Department of Consumers Queensland to develop and refine Health has with each of the 16 Hospital and initiatives as part of Advancing health 2026. Health Services in Queensland. The headline Collectively we can help all Queenslanders to be measures of success will also be incorporated among the healthiest people in the world. in the Department of Health’s performance management framework, to ensure that the public health system realises the vision.

My vision for the health system is a system that is adaptive and responsive to local community needs. That the system is respectful of all cultures, values diversity and strives for equality. For this to happen, I believe that there’s a need to build on the relationships we have with each other, with consumers and particularly with our most vulnerable groups (such as Indigenous people with disabilities), and build partnerships with primary healthcare providers, Aboriginal health service providers as well as community, social and education service providers. That Aboriginal and Torres Strait Islander people are encouraged to influence decision making and be a part of governance across all levels of the health service. Stephanie King – health consumer, Mt Isa

27 sustainability • compassion • inclusion • excellence • empowerment