2013-14 statement of prioritiesdocs2.health.vic.gov.au/docs/doc... · • establishing a health...

Department of Health

2013-14 Statement of Priorities Agreement between Minister for Health and Melbourne Health

2

Contents Background 3 Policy directions 3

Part A: Strategic overview 5 Mission statement 5 Values 5 Service profile 5 Strategic planning 6 Strategic priorities 7

Part B: Performance priorities 10 Financial performance 10 Access performance 10 Service performance 11

Part C: Activity and funding 12

Part D 14

Accountability and funding requirements 15

Signature 15

Melbourne Health

Statement of Priorities 2013-14 3

Background Statements of Priorities (SoP) are key accountability agreements between Victorian public health services and the Minister for Health. The annual agreements facilitate delivery of or substantial progress towards the key shared objectives of financial viability, improved access and quality of service provision. The content and process for preparation and agreement of the annual Statement of Priorities is consistent with sections 65ZFA and 65ZFB of the Health Services Act 1988 (Vic).

Statements of Priorities are consistent with the public health services’ strategic plans and aligned to government policy directions and priorities.

A Statement of Priorities consists of four parts:

• Part A provides an overview of the service profile, strategic priorities and deliverables the health service will achieve in the year ahead.

• Part B lists the key financial, access and service performance priorities and agreed targets.

• Part C lists funding and associated activity.

• Part D forms the service agreement between each health service and the state of Victoria for the purposes of the National Health Reform Agreement (NHRA).

The mechanisms used by the Department of Health to formally monitor health service performance against the Statement of Priorities are outlined in the Victorian Health Service Performance Monitoring Framework 2013-14 Business Rules.

Policy directions The Victorian Health Priorities Framework 2012–2022 (VHPF) sets out the following 5 key outcomes the health system should strive to achieve by 2022:

• People are as healthy as they can be (optimal health status)

• People are managing their own health better

• People enjoy the best possible health care service outcomes

• Care is clinically effective and cost-effective and delivered in the most clinically effective and cost-effective service settings

• The health system is highly productive and health services are cost-effective and affordable

It also articulates seven priorities which reflect the Government’s policy ambition to build a strong health system for all Victorians. The focus is on: • developing a system that is responsive to people’s needs

• improving every Victorian’s health status and experiences

• expanding service, workforce and system capacity

• increasing the system’s financial sustainability and productivity

• implementing continuous improvements and innovation

• increasing accountability and transparency

• making better use of e-health and communications technology

These priorities are fundamental to Part A of the SoP and require address by health services.

Melbourne Health


Government commitments Victoria has long been a leader in driving efficient health services. The Government’s commitment to quality and efficiency will build an affordable health system for the long term ensuring that Victoria is well placed to address future challenges associated with a growing and ageing population, and greater rates of chronic and complex health conditions. In this context, the department will work with service partners to build a health system that is integrated and responsive to the changing needs of the community. Specific commitments made by the Government in 2013-14 relate to:

• Growing essential hospital services including capacity for critical care and elective surgery across the system

• Implementing mental health reforms, supporting mental health initiatives and growing mental health services

• Boosting alcohol and drug services, including alcohol prevention programs and specific alcohol and drug awareness campaigns

• Improving cardiovascular disease health outcomes and reducing readmission and disease progression rates through better management and support for people with chronic heart failure

• Training our future health workforce by providing additional clinical training positions for undergraduates, postgraduates and rural GP proceduralists

• Establishing a Health Innovation and Improvement Fund to support improvements in efficiency, quality, safety and patient centred care

• Implementing an infection prevention and control strategy to improve patient outcomes and reduce the cost burden of health associated infections in Victorian public health services

• Improving health outcomes for Aboriginal Victorians through the provision of culturally appropriate service options

• Increasing support for older people and younger people with a disability through the Home and Community Care (HACC) program to assist them to remain in their home

• Meeting the needs of refugees and asylum seekers through the provision of timely intervention and preventative care in primary care settings in high settlement areas of Victoria

• Improving health literacy about maternity care through the development of consumer information and piloting of a statewide parenting kit

• Increasing the availability of information for senior Victorians to support them to live independently in their own home for longer

• Boosting community health services, particularly in growth areas

• Reducing preventable disease in support of Victoria’s Healthy Together Community Strategy and via various public health initiatives

• Supporting telehealth projects that will improve co-ordination and care for patients, and support the delivery of care closer to where people live

• Supporting additional health capital projects and infrastructure improvements including the Werribee Mercy Hospital Mental Health expansion, The Waurn Ponds Community Hospital and Northern Hospital expansion

Melbourne Health


Part A: Strategic overview Mission statement Melbourne Health’s Mission is to provide world-class health care for our community. We will embrace discovery and learning, build collaborative relationships and engage our patients in their care.

Vision “Passion for Caring – Achieving the Extraordinary”

Refined vision for Melbourne Health

Melbourne Health is evolving towards a new vision to enhance the organisation as a leading academic tertiary referral service that plays a pivotal role in the Victorian health care system and is internationally recognised for the quality of our clinical services and contribution to early phase and translational research.

Strategic Goals Supporting us to achieve, guiding our direction:

• Develop our workforce

• Improve the quality and safety of our services

• Develop and encourage strategic relationships

• Foster a culture of research and innovation

• Build a sustainable organisation.

Values Underpinning our behaviour and practice, informing all that we do:

• Respect

• Caring

• Unity

• Integrity

• Discovery.

Service profile

Melbourne Health is one of Australia’s leading public healthcare providers. Our mission is to provide world-class healthcare for our community by embracing discovery and learning, building collaborative relationships, and engaging patients in their care.

Our services are delivered through The Royal Melbourne Hospital, one of Australia’s pre-eminent hospitals, NorthWestern Mental Health, the largest mental health provider in Victoria, and the internationally renowned Victorian Infectious Diseases Reference Laboratory (VIDRL).

Melbourne Health is built on a tradition of providing the best possible care for our patients, excellent teaching and training for staff and future health professionals, and a commitment to clinical research to improve outcomes for everyone in the community.

Serving a population base of more than one million Melburnians, as well as regional and rural Victorians and interstate patients, Melbourne Health is driven by its vision, ‘Passion for Caring – Achieving the Extraordinary’ and is committed to its values, underpinning all behaviour and practice.

Melbourne Health


• The Royal Melbourne Hospital (RMH) The Royal Melbourne Hospital is today one of the country’s leading hospitals. It was the first hospital in Victoria; established 165 years ago to answer the needs of a growing community.

The RMH City Campus is an acute tertiary hospital offering comprehensive general and specialist medical and surgical services including cardiac, diabetes, neuroscience and oncology as well as being one of two major adult trauma centres in Victoria and home to the Victorian Infectious Diseases Service. It is also recognised as a world-class research and teaching organisation, built on an enduring partnership with The University of Melbourne, extending for almost 150 years. The RMH Royal Park campus provides sub-acute care, including aged care, rehabilitation, ambulatory care, and residential and community services.

• NorthWestern Mental Health (NWMH) NorthWestern Mental Health is the mental health arm of Melbourne Health. It provides comprehensive hospital-based, community and specialist services to adults and aged people across northern and western Melbourne, plus comprehensive programs for young people with mental health problems through Orygen Youth Health. NWMH operates in partnership with Northern Health (Northern Hospital, Broadmeadows Health Service, Bundoora Extended Care and Craigieburn Health Service) and Western Health (Sunshine and Western Hospitals).

• Victorian Infectious Diseases Reference Laboratory (VIDRL) The Victorian Infectious Diseases Reference Laboratory (VIDRL) is Victoria’s largest public health reference laboratory with core responsibilities in virology and mycobacteriology. It provides the majority of diagnostic virology for Victoria, and undertakes specialist infectious diseases laboratory and epidemiological programs at a state, national and international level. It is Australia’s national reference laboratory for viral haemorrhagic fevers such as Ebola and Lassa Fever, and for smallpox, measles and poliovirus.

VIDRL has four WHO Collaborating Centre designations: for Influenza, for Virus Reference and Research, for Biosafety, and for Mycobacterium ulcerans; as well as WHO Regional Reference Laboratories for poliovirus, hepatitis B virus and for measles.

Strategic planning

The Melbourne Health Strategic Plan 2010–2015 is available at http://www.mh.org.au/strategic-plans/w1/i1001232/.

Melbourne Health


Strategic priorities The Victorian Government’s priorities and policy directions are outlined in the Victorian Health Priorities Framework 2012-2022.

In 2013-14, Melbourne Health will contribute to the achievement of these priorities by:

Priority Action Deliverable

Developing a system that is responsive to people’s needs

Implement formal advance care planning structure and processes that provide patients with opportunities to develop, review and have their expressed preferences for future treatment and care enacted.

Advance Care Planning KPIs achieved.

Configure and distribute services to address the health needs of the local population.

Adult Mental Health community redesign implemented and embedded.

Improving every Victorian’s health status and experiences

Improve thirty-day unplanned readmission rates.

Process for identifying and managing patients at risk of re-presentation developed.

Embed Safety First initiative across the organisation.

Key actions articulated in the Safety First Strategy implemented across the organisation (including commencement of the Clinical Area Safety Assessment program).

Use consumer feedback to improve person and family centred care and patient experience.

Implement a post-discharge patient experience survey utilising patient e-mail addresses for RMH in-patients.

Partnering with Consumers/Patient Experience Strategy developed in collaboration with Community Advisory Committee and approved by Board.

Expanding service, workforce and system capacity

Work in partnership with Parkville Precinct organisations to enhance precinct-wide governance.

Support achieved for the Parkville Research Precinct.

Parkville partnership progressed for pathology.

Develop a learning management system to integrate training and education strategies across the organisation.

Learning management system is implemented.

Further enhance Melbourne Health’s reputation as an employer of choice.

Implement a Melbourne Health Aboriginal and Torres Strait Islander employment strategy.

Melbourne Health



Work collaboratively with the department on service and capital planning to develop service and system capacity.

Opportunities for public / private partnerships across RMH campuses identified and planning progressed.

Define the future role of Melbourne Health including The Royal Melbourne Hospital to strategically position the organisation within the Victorian Health System.

Defining our Role Phase 2 completed, resulting in Road Maps including endorsed strategic directions for each service as per project plan.

Workforce plans which support future service models and strategic directions are developed.

Increasing the system’s financial sustainability and productivity

Reduce variation in health service administrative costs.

Targeted plans to address variation in administrative costs developed.

Identify opportunities for efficiency and better value service delivery.

Procurement Excellence Program delivered across the organisation resulting in $10 million improvement in efficiency.

Implementing continuous improvements and innovation

Develop and implement improvement strategies that optimise access, patient flow, system coordination and the quality and safety of hospital services.

Transforming Health initiative embedded across the organisation.

Projects established to transform priority areas, including Outpatients, Theatres and Emergency Department.

Develop a Clinical Trials Research Unit. Planning for Clinical Trials Unit commenced with Clinical Trials Research Committee established.

Work with Ambulance Victoria and the Department of Health to improve timely care for patients who arrive by ambulance.

Action plan developed and strategies implemented to reduce ambulance transfer delays.

Increasing accountability & transparency

Prepare for commencement of proposed new mental health legislation in 2014.

Changes required to support the proposed new Mental Health Act operationalised, with timelines for the Mental Health Review Tribunal met and anticipated changes to restrictive practices, including seclusion and restraint, introduced.

Increase transparency and accountability in reporting of accurate and relevant information about the organisation’s performance.

Implement a new information technology platform including delivery of a Business Intelligence Tool.

Melbourne Health



Improving utilisation of e-health and communications technology.

Trial, implement and evaluate strategies that use e-health as an enabler of better patient care.

e-Medical Record Business Case completed and approved by Board.

Melbourne Health


Part B: Performance priorities Financial performance Key performance indicator Target

Operating result

Annual operating result ($m) 1.0

WIES (1) activity performance

Percentage of WIES (public & private) performance to target 100

Cash management

Creditors < 60 days

Debtors < 60 days

Access performance Key performance indicator Target

Emergency care

Percentage of operating time on hospital bypass 3

Percentage of ambulance transfers within 40 minutes 90 NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (July – December 2013) 75 NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (January – June 2014) 81 Number of patients with a length of stay in the emergency department greater than 24 hours 0

Percentage of Triage Category 1 emergency patients seen immediately 100 Percentage of Triage Category 1 to 5 emergency patients seen within clinically recommended times 80

Elective surgery

Percentage of Urgency Category 1 elective patients treated within 30 days 100 NEST - Percentage of Urgency Category 2 elective surgery patients treated within 90 days (July – December 2013) 80 NEST - Percentage of Urgency Category 2 elective surgery patients treated within 90 days (January – June 2014) 88 NEST - Percentage of Urgency Category 3 elective surgery patients treated within 365 days (July – December 2013) 94.5 NEST - Percentage of Urgency Category 3 elective surgery patients treated within 365 days (January – June 2014) 97

Number of patients on the elective surgery waiting list (2) 2863

Number of Hospital Initiated Postponements (HiPs) per 100 scheduled admissions 8 (1) WIES is a Weighted Inlier Equivalent Separation. (2) The target shown is the number of patients on the elective surgery waiting list as at 30 June 2014. Includes only competitive elective

surgery initiatives that have been allocated at the time of signing of this agreement.

Melbourne Health


Service performance Key performance indicator Target

Elective surgery (1)

Number of patients admitted from the elective surgery waiting list – quarter 1 2116




Critical care

ICU Number of days below the agreed minimum operating capacity (2) 0

Quality and safety

Health service accreditation Full compliance

Residential aged care accreditation Full compliance

Cleaning standards Full compliance

Health care worker immunisation - influenza 75

Hospital acquired infection surveillance No outliers

Hand Hygiene (rate) 70

SAB rate per occupied bed days (3) < 2/10,000

Victorian Patient Satisfaction Monitor: (OCI) (4) (July to December 2013) 73

Consumer Participation Indicator (5) (July to December 2013) 75 Victorian Hospital Experience Measurement Instrument (6)

(January to June 2014) Full compliance

People Matter Survey Full compliance

Mental Health

28 day readmission rate 14

Post-discharge follow up rate 75

Seclusion rate per occupied bed days < 15/1,000

(1) Includes only competitive elective surgery initiatives that have been allocated at the time of signing of this agreement. (2) The agreed minimum operating capacity is 21 ICU equivalents (3) SAB is staphylococcus aureus bacteraemia. (4) The target for the Victorian Patient Satisfaction Monitor is the Overall Care Index (OCI) which comprises six categories. (5) The Consumer Participation Indicator is a category of the Victorian Patient Satisfaction Monitor. (6) The Victorian Health Experience Measurement Instrument (VHEMI) will succeed the VPSM as the instrument for measuring

patient experience.

Melbourne Health


Part C: Activity and funding Funding type Activity Budget ($'000) Acute Admitted WIES Public 56,926 $241,534 WIES Private 12,117 $39,124 WIES (Public and Private) 69,043 $280,658

WIES DVA 573 $2,489 WIES TAC 4,584 $17,456

WIES TOTAL 74,200 $300,602

Acute non-admitted Emergency Services $30,278

Specialist Clinics $50,380

Subacute & Nonacute Admitted Rehab Public 12,276 $5,794 Rehab Private 4,936 $2,167 Rehab DVA 87 $50 GEM Public 38,077 $17,972 Subacute admitted other $676

GEM Private 5,651 $2,481 GEM DVA 1,204 $687 Palliative Care Public 4,159 $1,963 Palliative Care Private 685 $301 Palliative Care DVA 67 $38 Transition Care - Beddays 10,585 $1,535 Transition Care - Homeday 12,410 $621 Subacute & Nonacute Other Other specified funding $4,529

Subacute non-admitted Victorian Artificial Limb Program $1,897

Health Independence Program $21,826

Health Independence Program - DVA $200

Aged Care Aged Care Assessment Service $2,792

Residential Aged Care 34,713 $3,835 HACC $91

Mental Health and Drug Services Mental Health Inpatient 90,264 $57,047 Mental Health Ambulatory 191,400 $70,729 Mental Health Residential 66,478 $5,255 Mental Health Service System Capacity $5,541

Mental Health Sub Acute 43,830 $17,021 Mental Health Other $272

Drug Services $352

Melbourne Health


Primary Health Community Health / Primary Care Programs 1 $0 Community Health Other $8,620

Other Other specified funding $18,848

Total Funding $634,399

Melbourne Health


Part D In 2012-13, the Commonwealth Government reduced funding to Victorian health services by $107 million. The Commonwealth Government decision to return funding of $107 million to Victorian hospitals and health services in 2012-13 was a one-off Commonwealth payment, leaving an ongoing Commonwealth shortfall in promised funding of $368 million over the next three years. In 2013-14, the impact is $99.5 million less than promised.

Period: 1 July 2013– 30 June 2014

Estimated

National Weighted Activity Units

Total Funding

Provisional Commonwealth

Percentage

Activity Based Funding 113,787 479,006,128 34.47% Other Funding 109,080,236 Total 588,086,364

If the Commonwealth government returns funding of $99.5 million this financial year, Melbourne Health budget will increase by $7.68 million. Note:

• Provisional Commonwealth Contribution Percentage is subject to change following state-wide adjustments (i.e. cross border patient flows).

• Activity loadings are included in the Estimated National Weighted Activity Units (i.e. Paediatric, Indigenous, Remoteness, Intensive Care Unit, Private Patient Service Adjustment, and Private Patient Accommodation Adjustment).

Melbourne Health


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