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1

ANNUAL REPORT2012–13

ACT Government Health Directorate

11 Moore Street, Canberra City ACT 2601 GPO Box 825 Canberra ACT 2601

General enquiries: 132 281 Annual report contact: 02 6205 0837 Fax: 02 6207 5775

Web: www.health.act.gov.au Email: [email protected]

ISBN: 978 0 642 60607 2

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© Australian Capital Territory, Canberra, September 2013

Thisworkiscopyright.ApartfromanyuseaspermittedundertheCopyright Act 1968,nopartmaybereproducedbyanyprocesswithoutwrittenpermissionfromtheTerritoryRecordsOffice,CommunityandInfrastructureServices,TerritoryandMunicipalServices,ACTGovernment,GPOBox158,CanberraCityACT2601.

EnquiriesaboutthispublicationshouldbedirectedtoACTGovernmentHealthDirectorate,CommunicationsandMarketingUnit,GPOBox825CanberraCityACT2601oremail:[email protected]

www.health.act.gov.au | www.act.gov.au

Enquiries:Canberra13ACT1or132281|PublicationNo13/0966

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www.health.act.gov.au

www.act.gov.au

III

ContentsTransmittalCertificate VI

Aidstoaccess VII

Abbreviationsandacronyms VII

Glossaryoftechnicalterms X

Othersourcesofinformation XI

Complianceindex XII

Section A —Performance and financial management reporting 1

PerformanceSummary 4

A.1TheOrganisation 6

A.2&A.3Overviewandhighlights2012–13 8

A.4Outlookfor2013–14 10

A.5Managementdiscussionandanalysis 11

A.6Financialreport 23

A.7Statementofperformance 94

A.8Strategicindicators 107

A.9Analysisofagencyperformance 115

StrategyandCorporateoverview 115

CanberraHospitalandHealthServicesoverview 117

Output1.1Acuteservices 119

DivisionofCriticalCare 131

DivisionofMedicine 133

DivisionofPathology 138

DivisionofSurgeryandOralHealth 141

DivisionofWomen,YouthandChildren 143

Calvary Heath Care ACT 148

Output1.2Mentalhealth,justicehealthandalcoholanddrugservices 152

Output1.3Publichealthservices 156

Output1.4Cancerservices 160

Output1.5Rehabilitation,agedandcommunitycare 163

Output1.6Earlyinterventionandprevention 167

QualityandSafetyUnit 171

A.10Triplebottomlinereport 175

IV ACT Government Health Directorate AnnualReport2012–13

Section B—Consultation and scrutiny reporting 177

B.1Communityengagement 178

B.2Internalandexternalscrutiny 195

B.3LegislativeAssemblycommitteeinquiriesandreports 202

B.4Legislationreport 218

Section C—Legislative and policy-based reporting 221

C.1Riskmanagementandinternalaudit 222

C.2Fraudprevention 223

C.3Publicinterestdisclosure 224

C.4Freedomofinformation 225

C.5Internalaccountability 228

Seniorexecutiveandresponsibilities 228

Seniorexecutiveandorganisationalchanges 228

Seniormanagementcommittees,rolesandmembership 229

ACTLocalHospitalNetworkCouncil 235

Corporateandoperationalplans(andassociatedreportingandreview) 235

C.6Humanresourceperformance 247

C.7Staffingprofile 249

C.8Learninganddevelopment 252

C.9Workplacehealthandsafety 261

C.10Workplacerelations 263

C.11HumanRightsAct2004 265

C.12StrategicBushfireManagementPlan 266

C.13Strategicassetmanagement 267

C.14Capitalworks 269

C.15Governmentcontracting 274

C.16Communitygrants,assistanceandsponsorship 283

C.17Territoryrecords 287

C.18CommissionerfortheEnvironment 289

C.19Ecologicallysustainabledevelopment 291

C.20Climatechangeandgreenhousegasreductionpoliciesandprograms 297

C.21AboriginalandTorresStraitIslanderreporting 298

V

C.22ACTMulticulturalStrategy2010–2013 301

C.23ACTStrategicPlanforPositiveAging2010–2014 303

C.24ACTWomen’sPlan 305

C.25ModelLitigantGuidelines 309

C.26Noticesofnon-compliance 310

Annexed reports 313

ACTLocalHospitalNetworkDirectorateFinancialandPerformanceStatements2012–13 314

ChiefPsychiatrist 354

HumanResearchEthicsCommittee 357

MentalHealthACTOfficialVisitors 358

RadiationCouncil 361

VeterinarySurgeonsBoard 364

Index 368

VI ACT Government Health Directorate Annual Report 2012–13

Transmittal Certificate

VII

Aids to accessThetableofcontentsandalphabeticalindexappearrespectivelyatthebeginningandendofthereport.

Abbreviations and acronymsAACB AustralianAssociationofClinicalBiochemists

ABF Activity-basedfunding

ABS AustralianBureauofStatistics

ACAT AgedCareAssessmentTeam ACTCivilandAdministrativeTribunal

ACHS AustralianCouncilonHealthcareStandards

ACP Advancedcareplanning

ACTES ACT Equipment Scheme

ACTGS ACT Government Solicitor

ACTPS ACT Public Service

ACTPAS ACTPatientAdministrationSystem

ACU AustralianCatholicUniversity

AGAR AustralianGrouponAntimicrobialResistance

AHA AlliedHealthAssistant

AIDS AcquiredImmuneDeficiencySyndrome

AIHW AustralianInstituteofHealthandWelfare

AMAP AboriginalMidwiferyAccessProgram

AMC AlexanderMaconochieCentre

AMHU AdultMentalHealthUnit

ANU AustralianNationalUniversity

APTSRH Antenatalcare,pre-pregnancyandteenagesexualandreproductivehealth

ARM AdmittingRegistrarforMedicine

ARPANSA AustralianRadiationProtectionandNuclearSafetyAgency

ASSAD AustralianSecondarySchoolAlcoholandDrugsurvey

ATODA Alcohol,TobaccoandOtherDrugAssociationACT

AVA AustralianVeterinaryAssociation

AVBC AustralasianVeterinaryBoardsCouncil

AWA AustralianWorkplaceAgreement

AWOL AbsenceWithoutLeave

BCHC Belconnen Community Health Centre

BFHI Baby-FriendlyHealthInitiative

BHRC BrianHennessyRehabilitationCentre

CAA CouncilofAmbulanceAuthorities

CALD CulturallyandLinguisticallyDiverse

CAHMA CanberraAllianceforHarmMinimisation

CAMHS ChildandAdolescentMentalHealthService

CARECareandResponseEscalation

CallandRespondEarly

CaTCH Program ContinuityattheCanberraHospital

CCCS CommunityCareCommonStandards

CCL CardiacCatheterLaboratory

CDM ChronicDiseaseManagement

CDMR ChronicDiseaseManagementRegister

CEO ChiefExecutiveOfficer

CHF Chronicheartfailure

CHO ChiefHealthOfficer

CFACT Clinical Forensics ACT

CFET ConsumerFeedbackandEngagementTeam

CFMS ClinicalForensicMedicalServices

CFR CommunityFundingRound

CHF Chronicheartfailure

CHC ACT Calvary Health Care ACT

CH&HS CanberraHospital&HealthServices

CHWC CentenaryHospitalforWomenandChildren

CIT CanberraInstituteofTechnology

CMP CanberraMidwiferyProgram

CO2e Equivalentcarbondioxide

COAG CouncilofAustralianGovernments

COPD ChronicObstructivePulmonaryDisease

CPCHS CommunityPaediatricandChild Health Service

CPD ContinuingProfessionalDevelopment

CPOE ComputerisedPhysicianOrderEntry

CPSU CommunityandPublicSectorUnion

CRCS CapitalRegionCancerService

CSS CommonwealthSuperannuationScheme

CSTD Closedsystemtransferdevices

CT ComputerisedTomography

CTSC ClinicalTrialsSubcommittee

DA Developmentapplication

DDG DeputyDirector-General

DG Director-General

DHP DentalHealthProgram

DMFT Decayed,missingorfilledteeth

VIII ACT Government Health Directorate AnnualReport2012–13

DVA DepartmentofVeterans’Affairs

ECCHO EffectiveCommunicationinClinicalHandover

ECT Electro-convulsivetherapy

ED EmergencyDepartment

EDIS EmergencyDepartmentInformationSystem

EDSU ExtendedDaySurgeryUnit

EEG Electro-encephalogram

EH Environmental Health team

EISGP EducationInfrastructureSupport Grant Payment

EMM Electronicmedicationmanagement

EN EnrolledNurse

ESA ACTEmergencyServicesAgency

FAMSAC ForensicandMedicalSexualAssaultCare

FMA FinancialManagementAct1996

FOI FreedomofInformation

FTE Full-timeequivalent

GAAP GenerallyAcceptedAccountingPrinciples

GHICS GetHealthyInformationandCoachingService®

GM Geneticallymodified

GP Generalpractitioner/generalpractice

GPADS GPAgedDayService

GPO GovernmentPaymentsforOutputs/ GeneralPostOffice

GPWWG GPWorkforceWorkingGroup

GST GoodsandServicesTax

HAAS Healthcare Access at School

HACC HomeandCommunityCare

HCCA HealthCareConsumers’AssociationoftheACT

HCI HealthyCommunitiesInitiative

HCV HepatitisCvirus

HIP HealthInfrastructureProgram

HITH Hospital in the Home

HIV HumanImmunodeficiencyVirus

HPS HealthProtectionService

HRC ACTHumanRightsCommission

HSU HealthServicesUnion

HPV Human papillomavirus

HREC HumanResearchEthicsCommittee

HWA HealthWorkforceAustralia

IBLCE InternationalBoardofLactationConsultantExaminers

ICU Intensive care unit

IM&IT Informationmanagementand informationtechnology

IMPACT IntegratedMulti-agenciesforParentsandChildrenTogether

ipatCH Paediatrcishighdependencyunit

IRCTN IntegratedRegionalClinicalTrainingNetwork

ISS ISS Health Services

JACSD JusticeandCommunityServicesDirectorate

LHN Localhospitalnetwork

LSTS LoanSchemeforTertiaryStudy

MACH MaternalandChildHealth

MAPU MedicalAssessmentandPlanningUnit

MET MedicalEmergencyTeam

MEWS ModifiedEarlyWarningScore

MHAGIC MentalHealthAssessmentGenerationandInformationCollection

MHCPI MentalHealthCommunityPolicingInitiative

MOU Memorandumofunderstanding

NATA NationalAssociationofTestingAuthorities

NEAT NationalEmergencyAccessTarget

NEST NationalElectiveSurgeryTarget

NETS NewbornEmergencyTransportService

NEWS NeonatalEarlyWarningScore

NGO Non-governmentorganisation

NHMRC NationalHealth&MedicalResearchCouncil

NHRA NationalHealthReformAgreement

NICU NeonatalIntensiveCareUnit

NIMC NationalInpatientMedicationChart

NIP NationalImmunisationProgram

NPAPH NationalPartnershipAgreementonPreventiveHealth

NPDI NationalPerinatalDepressionInitiative

NRVR nationalrecognitionofveterinaryregistration

NSFATSIH NationalStrategicFrameworkforAboriginalandTorresStraitIslanderHealth

NSQHSS NationalSafetyandQualityHealth ServiceStandards

OCHO OfficeoftheChiefHealthOfficer

OCYFS OfficeofChild,YouthandFamilyServices

OH&S Occupationalhealthandsafety

OMATSIA OfficeofAboriginalandTorresStraitIslanderAffairs

OPG Orthopantomograph

OPMHIU OlderPersonsMentalHealthInpatientUnit

ORE Occupationalriskexposure

OSCAR OnlineSystemforComprehensive ActivityReporting

PANDSI Pre-andAnte-NatalDepressionSupportandInformationService

PART Predict,AssessandRespondtoChallenging/AggressiveBehaviour

PatCH PaediatricsattheCanberraHospital

PBS PharmaceuticalBenefitsScheme

IX

STI Sexuallytransmissibleinfection

TAMS TerritoryandMunicipalServicesDirectorate

TCH (the)CanberraHospital

TIA Transientischaemicattack

TIS TranslatingandInterpretingService

TRIM TotalRecordsInformationManagement

TTCP TransitionalTherapyandCareProgram

UNSW UniversityofNewSouthWales

VMO Visitingmedicalofficer

VTE Venous thromboembolism

WHA Women’sHealthAustralasia

WHO WorldHealthOrganization

WHS Women’sHealthService

WiC Walk-inCentre

WHOS We Help Ourselves

WIL WorkplaceIntegratedLearning

WYC Women,Youth&ChildrenDivision

YPN YoungProfessionals’Network

PCEHR PersonallyControlledElectronicHealthRecord

PCHR PersonalChildHealthRecord

PET PositronEmissionTomography

PH&CDS PrimaryHealthandChronicDisease StrategyCommittee

PHD PopulationHealthDivision

PIN Provisionalimprovementnotice

PMHCS PerinatalMentalHealthConsultationService

PND Perinataldepression

P&O ProstheticsandOrthotics

PPEI Promotion,preventionandearlyintervention

PPID Positivepatientidentification

PPM privatelypractisingmidwife

PRRAC PalliativeRadiotherapyRapidAccessClinic

PRSC PractitionerRegulationSubcommittee

PSS

PublicSectorSuperannuationScheme

PharmaceuticalServiceSection

PeopleStrategyandServices

PSSAP PublicSectorSuperannuationSchemeAccumulationPlan

PSSB PeopleStrategyandServicesBranch

PSU PsychiatricServicesUnit

PTO Psychiatrictreatmentorder

QSU QualityandSafetyUnit

RACC Rehabilitation,AgedandCommunityCare

RADAR RapidAssessmentoftheDeteriorating andAt-Risk

RCD Residualcurrentdevice

RCPA RoyalCollegeofPathologistsofAustralasia

RED Respect,Equity,Diversity

RILU RehabilitationIndependentLivingUnit

ROGS ReviewofGovernmentService

RPC Respectingpatientchoices

RRC RapidResponseCommittee

SEA SpecialEmploymentArrangement

SHAHRDACTMinisterialAdvisoryCouncilon SexualHealth,HIV/AIDS,HepatitisCandRelatedDiseases

SHFPACT SexualHealthandFamilyPlanningACT

SHOUT SelfHelpOrganisationsUnitedTogether

SLE SimulatedLearningEnvironment

SOG StrategicOversightGroup

SOP Standardoperatingprocedure

SPIEWG ACTSuicidePreventionImplementationandEvaluationWorkingGroup

SRG SurveyResourceGroup

SRRM Seclusionandrestraintreviewmeetings

SRSStereotacticradiosurgery

SocialResearchSubcommittee

X ACT Government Health Directorate AnnualReport2012–13

Glossary of technical termsAccess Improvement Program

Amajorchangeprograminitiatedinearly2005aimedatredesigningthewayweprovidehealthservicesbyfocusingonpatientjourneysthroughourhealthsystem.

Acute careAnepisodeofacutecareforanadmittedpatientisoneinwhichtheprincipalclinicalintentistoprovideshort-termhospitaladmissionfocusedonthetreatmentofemergencyconditionsortheconductofanelectiveprocedure.

Ambulatory care Careprovidedinanon-inpatientsettingsuchasoutpatients,home-basedcare,office-basedcareorcommunityhealthcentre-basedcare.

Benchmarking

Theprocessofassessingtheperformanceofanorganisationofentitywithinanorganisation bycomparingittotheperformanceofasimilarentity,anationalaverage,orthebestperformingentitywithinthesamefieldinordertoassessperformanceanddetermineopportunitiesforimprovement.

Community-basedorganisations

Not-for-profitorganisationswithinthecommunitythathavespecialistskills inthemanagementofcertainhealthissues.Theseorganisationsprovideservicessuchashealthservicesfordisadvantagedyoungpeople,drugandalcoholrehabilitation,AboriginalandTorresStraitIslanderhealthservicesandsupportedaccommodationforpeoplewithmentalillness.

CostweightAcostweightisaformofmeasurementfortheuseofhealthservicesthatprovidesanindicationoftherelativeresourceuse.Itprovidesanindicationastothecomplexityofanadmissionoranoccasionofservice.

Decant Torehousepeoplewhiletheirbuildingsarebeingrefurbishedorrebuilt.

HepatitisC Hepatitisisinflammationoftheliver.HepatitisCisaviralformthatistransferredby blood-to-bloodcontact.

Lengthofstay Thenumberofdays(orpartthereof)thateachadmittedpatientstaysinhospital.Patientswhoareadmittedanddischargedonthesamedayhavealengthofstayofoneday.

Patient-centredcare Refocusingthedeliveryofhealthcarearoundtheneedsofthepatientratherthanotherstakeholderssuchasproviders.

Patientjourney Apatient’sexperienceoftravellingormovingthroughthehealthsystematpre-hospitaltohospitalandtocommunitycare.

Primary healthcare service

PrimaryhealthcareservicesarethosewhichfocusonfirstcontacthealthservicesprovidedpredominantlybyGPs,butalsobypracticenurses,primary/communityhealthcarenurses,earlychildhoodnursesandcommunitypharmacists,alliedhealthprofessionalsandotherhealthworkerssuchasmulticulturalhealthworkersandIndigenoushealthworkers,healtheducation/promotionandcommunitydevelopmentworkers.

Public health officers

Publichealthofficersprovidearangeofservicestothecommunity,includingcommunicablediseasecontrol,pharmaceuticalservices,environmentalhealthandscientificservices,andhavecertainpowersenshrinedinlegislation.

Occasionofservice Ameasureofservicesprovidedtopatients—usuallyusedintheoutpatientorcommunity healthsetting.

Sub-acuteIntermediatecareprovidedbetweenacutecareandcommunity-basedcare.Sub-acutecareincludesservicessuchasrehabilitationthatcanbeprovidedinalessinvasiveenvironmentthananacutehospitalenvironment.

Tertiaryservices Tertiaryservicesaregenerallythoseprovidedinacomplex,highlyspecialised hospitalenvironment.

XI

Other sources of informationACTHealthpublicationsareavailableatACTgovernmentcommunitylibraries,theHealthDirectoratelibrarylocatedattheCanberraHospital,Garran,andfromCommunityHealthCentres.

InformationcanalsobeaccessedthroughtheHealthDirectoratewebsiteatwww.health.act.gov.au, Canberra Connect’swebsiteatwww.canberraconnect.act.gov.au ortheACTGovernmentwebsiteatwww.act.gov.au.

InformationcanalsobeobtainedbycontactingtheHealthDirectoratethroughthefollowingcontactpoints:

ACTGovernmentHealthDirectorate11 Moore Street, Canberra City ACT 2601GPO Box 825 Canberra ACT 2601

General inquiries: 132 281Annualreportcontact: (02)62050837Fax: (02)62075775Web: www.health.act.gov.auEmail: [email protected]

AdditionalpublicationsrelatingtohealthstatusandhealthservicesintheACTare: ACT Chief Health Officer’s Report 2012 ACT Human Rights Commission Annual Report 2012–13 Australian hospital statistics 2011–12, AustralianInstituteofHealthandWelfare Australia’s health 2012,AustralianInstituteofHealthandWelfare


www.canberraconnect.act.gov.au

www.act.gov.au



XII ACT Government Health Directorate AnnualReport2012–13

Compliance Index

TransmittalCertificate VI

Aidstoaccess VII

Abbreviationsandacronyms VII

Glossaryoftechnicalterms X

Othersourcesofinformation XI

Complianceindex XII

Section A —Performance and financial management reporting 1

PerformanceSummary 4

A.1Theorganisation 6

A.2&A.3Overviewandhighlights2012–13 8

A.4Outlookfor2013–14 10

A.5Managementdiscussionandanalysis 11

A.6Financialreport 23

A.7Statementofperformance 94

A.8Strategicindicators 107

A.9Analysisofagencyperformance 115

A.10Triplebottomlinereport 175

Section B—Consultation and scrutiny reporting 177

B.1Communityengagement 178

B.2Internalandexternalscrutiny 195

B.3LegislativeAssemblycommitteeinquiriesandreports 202

B.4Legislationreport 218

Section C—Legislative and policy-based reporting 221

C.1Riskmanagementandinternalaudit 222

C.2Fraudprevention 223

C.3Publicinterestdisclosure 224

C.4Freedomofinformation 225

C.5Internalaccountability 228

C.6Humanresourceperformance 247

C.7Staffingprofile 249

C.8Learninganddevelopment 252

C.9Workplacehealthandsafety 261

C.10Workplacerelations 263

C.11HumanRightsAct2004 265

XIII

C.12StrategicBushfireManagementPlan 266

C.13Strategicassetmanagement 267

C.14Capitalworks 269

C.15Governmentcontracting 274

C.16Communitygrants,assistanceandsponsorship 283

C.17Territoryrecords 287

C.18CommissionerfortheEnvironment 289

C.19Ecologicallysustainabledevelopment 291

C.20Climatechangeandgreenhousegasreductionpoliciesandprograms 297

C.21AboriginalandTorresStraitIslanderreporting 298

C.22ACTMulticulturalStrategy2010–2013 301

C.23ACTStrategicPlanforPositiveAging2010–2014 303

C.24ACTWomen’sPlan 305

C.25ModelLitigantGuidelines 309

C.26Noticesofnon-compliance 310

Annexed reports 313

ACTLocalHospitalNetworkDirectorateFinancialandPerformanceStatements2012–13 314

CareCoordinator N/A*

ChiefPsychiatrist 354

HumanResearchEthicsCommittee 357

MedicalRadiationScientistsBoard N/A**

MentalHealthACTOfficialVisitors 358

RadiationCouncil 361

VeterinarySurgeonsBoard 364

*Asinpreviousyears,theCareCoordinatorannualreporthasbeenpublishedaspartofthePublic Advocate of the ACT Annual Report 2012–13,byarrangementwiththeChiefMinisterandTreasuryDirectorate.

**AnationalMedicalRadiationScientistsBoardwasestablishedfortheentireyearof2012–13.Therefore,anACT-basedboardannualreportisnolongerproduced.

XIV ACT Government Health Directorate AnnualReport2012–13

Section A Performanceandfinancialreporting1

2 ACT Government Health Directorate AnnualReport2012–13

Director-GeneralDr Peggy Brown

Organisational chart

Allied Health Advisor

Karen Murphy

Deputy Director-General

Strategy & CorporateSteven Goggs

Chief Health Officer Population Health

Dr Paul Kelly

Executive Director Quality & Safety UnitElizabeth Trickett

Senior Manager Executive

CoordinationJackie Andersen

Manager

Canberra Hospital

Foundation

Moira Lye

Manager Canberra Hospital

FoundationElizabeth Harris

A/g

Director DonateLife ACT

Dr Frank Van Haren

Chief NurseVeronica Croome

Principal Medical Advisor

Prof Frank Bowden

Research OfficeAssoc Prof

Matthew Cook

Executive Director Service & Capital

PlanningGrant Carey-Ide

Executive Director People, Strategy

& ServicesJudi Childs

Executive Director Policy & Government

RelationsRoss O’Donoughue

Executive Director Business &

InfrastructureRosemary Kennedy

Executive Director Performance & Innovation

Phil Ghirardello

Minister for HealthKaty Gallagher

Professional Leadership, Research & Education

GP AdvisorDr Helen Toyne

Chief Information Officer, E-Health

& Clinical RecordsJudy Redmond


Operational Support

Executive Director Nursing & MidwiferyVeronica Croome

A/g

Executive Director Medical Services

Prof Frank BowdenA/g

Director Acute Support ServicesJune Gunning

A/g

Deputy Director-General

Canberra Hospital & Health ServicesIan Thompson

Internal Audit & Risk ManagerSarwan Kumar

Senior Manager Communications

& MarketingAlexandra Kellar

A/g

Executive Director Division of Mental

Health, Justice Health and Alcohol

& Drug ServicesKatrina Bracher

Executive Director Division of PathologyDr Peter Collignon

Executive Director Division of Medicine

Rosemary O’Donnell

Executive Director Rehabilitation, Aged & Community CareLinda Kohlhagen

Executive Director Division of Women’s

Youth & ChildrenElizabeth Chatham

Executive Director Division of

Critical CareJeanett Maccullagh

A/g

Executive Director Division of

Capital Region Cancer ServiceDenise Lamb

Executive Director Division of Surgery,

Oral Health & Imaging

Barbara Reid

Chief Finance Officer Financial

ManagementRon Foster


Performance Summary

28

18

1

We are fully

accredited for the

next four years M

arke

d

Achi

evem

ents

Exte

nsiv

e

Achi

evem

ents

Out

stan

ding

Ac

hiev

emen

t

100%ofcategory one emergencypatientsseen immediately

Samplesanalysedbythe ACT Government AnalyticalLaboratory

Births in ACT Public Hospitals

100%urgent and semi-urgent

cancertreatmentsprovidedontime


ACT

Publ

ic H

ospi

tals

outpatientservices

electivesurgeryprocedures

presentationstoemergency

surgical operations performed

totalpresentations to the Walk-in Centre

consumerrepresentationon Mental Healthcommittees

coveragefortheprimaryimmunisationschedule

immunisation

breastscreensundertaken


A.1 The organisation

Vision and valuesACTHealth’svisionis‘YourHealth—OurPriority.’

Our values are:

• Care

• Excellence

• Collaboration

• Integrity.

Ourvision,andthesevaluesdevelopedbyACTHealthstaff,representwhatwebelieveisimportantandworthwhile.Ourvaluesunderpinthewayweworkandhowwetreatothers.

The ACT Health Directorate Corporate Plan 2012–17guidesACTHealthbusinessunitsinachievingtheoverarchingorganisationalvisioninlinewithitscorporatevalues.

Theplanbuildsonexistingandnewplansunderdevelopment,whileprovidinganorganisationalframeworkagainstwhichtoprioritiseoureffortsoverthenextfiveyears.

Weaimtodeliverbetterservicetoourgovernmenttomeettheneedsofcommunity,andtoourcommunityonbehalfofourgovernment.

ObjectivesThe ACT Health Directorate Corporate Plan 2012–17hasfourkeyareasoffocus,whichinformallbusinessplansandperformanceagreementswithintheorganisation.

ACTHealthpartnerswiththecommunityandconsumersforbetterhealthoutcomesby:

• deliveringpatientandfamilycentredcare

• strengtheningpartnerships

• promotinggoodhealthandwellbeing

• improvingaccesstoappropriatehealthcare,and

• havingrobustsafetyandqualitysystems.

Weaimforsustainabilityandimprovedefficiencyintheuseofresources,bydesigningsustainableservicestodeliveroutcomesefficiently,andembeddingacultureofresearchandinnovation.

ACTHealthcontinuestostrengthenclinicalgovernanceofitsprocesses,andstrivestobeaccountabletoboththegovernmentandthecommunity.

ACTHealthaimstosupportourpeopleandstrengthenteams,byhelpingstafftoreachtheirpotential;promotingalearningcultureandprovidinghigh-levelleadership.


Organisational structureTheorganisationalchartonpages2and3providesanoverviewofthestructureoftheHealthDirectorateon30June2013.

ACTHealth’sDirector-Generalguidestheorganisationindeliveringitsvision.ACTHealth’stwomajordivisionsareledbyDeputyDirectors-GeneralwhoreporttotheDirector-General.

CanberraHospitalandHealthServices(CH&HS)employsthemajorityofstaffworkingwithintheHealthDirectorate,andprovidesacute,sub-acute,primaryandcommunity-basedhealthservicestothepopulationoftheACTandsurroundingregion.TheLittleCompanyofMaryalsoprovidespublichospitalservicesthroughCalvaryPublicHospitalunderacontractualagreementwithACTHealth.

StrategyandCorporateemploysasmallernumberofstaffwhoprovideinfrastructure,policyguidance,fundingandstrategicplanningsupporttoclinicalserviceareas,whileplanningforACTHealth’sfutureworkforceandhealthserviceneeds.

OtheroperationalareasalsoreportdirectlytotheDirector-Generalandprovidearangeofcorporatesupportandorganisation-wideservices,suchasqualityandsafetyoversightandsoundfinancialmanagement.

ACTHealth’sPopulationHealthDivisionprovidesarangeofpublicandenvironmentalhealthservices,healthprotectionandhealthpromotionservices,undertheguidanceoftheACTChiefHealthOfficer.

ACT Health, other agencies and external stakeholdersACTHealthworkscloselywithotherACTGovernmentagenciessuchastheACTGovernment’sCommunityServicesDirectorate,JusticeandCommunitySafetyDirectorate,ChiefMinisterandTreasuryDirectorate,andemergencyservicesproviderssuchastheACTAmbulanceServiceandtheAustralianFederalPolice.

Formalisedconsultativearrangementsexistwitharangeofagencies,suchastheHealthCareConsumers’Association(ACT),ACTMedicareLocalandmentalhealth,alcoholanddrug,andothercommunityserviceproviders.

Thetertiaryandtrainingsectorsremainkeypartnersintheplanning,developmentanddeliveryofhealthcareservices.PartnershiparrangementswithTheAustralianNationalUniversityMedicalSchool,UniversityofCanberra,AustralianCatholicUniversityandCanberraInstituteofTechnologyarewellestablishedandservetoassurethefuturesupplyofskilledhealthprofessionals.


A.2 and A.3 Overview and highlights 2012–13

ACTHealthfacedachallengingyearin2012–13,butrosetothechallengeandperformedwellagainstitskeystrategicobjectives.

In2012–13,ACTHealthexceededitstargetforthenumberofpeopleremovedfromtheelectivesurgerywaitinglist—thehighestonrecordfortheACT—andcontinuestoreducetheamountofpatientswaitinglongerthanclinicallyrecommendedtimeframes.

ACTPublichospitalsmettheneedforcancertreatmentservicesinallthreemajortriagecategories:urgent,semi-urgentandnon-urgent.

TheACTGovernment’sinvestmentinthepublichealthsystembetteredthenationalrateofgovernmentinvestmentin2012–13.

TheACTalsofaredwellinthemanagementofchronicdisease,withratesoflifeexpectancyatbirthformenandwomenintheACTexceedingthenationalaverage.ACTresidentshavethehighestlifeexpectancyofany Australianjurisdiction.

However,thehigherproportionoftheACTpopulationdiagnosedwithsomeformofcirculatorydiseasewhencomparedwiththenationalaverageistangibleevidencethattheACTpopulationisageingfasterthanthatofotherjurisdictions,withthemedianageoftheACTpopulationincreasing6.4yearssince1985to34.5yearsin2011.

Moreover,improvedearlyinterventionhasincreaseddetectionofdiabetesintheACT.Expertsestimatethatonlyhalfofthosewithdiabetesareactuallyawareoftheircondition.

TheACTmetthenationalresponsetimeframeforin-hospitalassessmentsbytheAgedCareAssessmentTeam,indicatingtheteam’sresponsivenessinassessingtheneedsofclients.

Ourmentalhealthserviceswereparticularlyeffectiveatminimisingtheneedforseclusion,reflectedinasignificantreductionintheuseofseclusionduringinpatientmentalhealthepisodes.

Moreover,mentalhealthconsumersandcarerswererepresentedonallMentalHealthcommittees,whichmonitorthedeliveryandplanningofourmentalhealthservices.

Wealsoachievedourtargetoflessthat10percentofmentalhealthclientsreturningtohospitalwithin28daysofdischargefromanACTpublicmentalhealthunit,whichisveryheartening.

Weperformedwellinminimisingtheincidenceofvaccine-preventablediseasesamongtheACT’spopulation ofAboriginalandTorresStraitIslanderpeople,withanoverallimmunisationrateof88percentforchildrenagedbetween12and63months,againstatargetof90percent,therebylesseningthedisparitywith non-IndigenousAustralians.

ThehighqualityofservicethatCanberransreceiveatourACTpublichospitalswasreflectedinthequalityoftheatreandpost-operativecare,theeffectivetreatmentofpeoplewhoreceivehospital-basedcarebyourhospital-basedandcommunityservices,andthelownumberofpeopleadmittedtohospitalwhoacquiredabacteraemialinfection(bacteriaintheblood)duringtheirstay.

TheACTexceededthenationalaverageforitsparticipationrateintheCervicalScreeningProgram.

ACTpublichospitalemergencydepartmentscontinuedtotreatpatientsrequiringurgenttreatmentwithinnationaltimeframes,whiledealingwithincreaseddemand.

BreastscreenACThasanumberofinitiativesunderwaytoraiseawarenessofitsscreeningservice,particularlywithinthetargetgroupofwomenaged50to69,tolifttheproportionofwomeninthetargetagegroupwho havebreastscreens.

TheACThadthelowestjurisdictionalrateforthemeannumberofteethwithdentaldecay,missingorfilledteethamongchildrenatages6and12,showingtheeffectivenessofourprevention,earlyinterventionandtreatmentservices.Moreover,ACTHealthmetitstargetpercentageforthenumberofdentalemergencyclientsseenwithin24hours.


Wedidn’tachieveourlong-termtargetforreducingtherateofbrokenhips(fracturedneckoffemur)inolderpersons.However,onlysmallnumbersofpatientsareincludedinthecalculations,andsmallchangescanresultinsignificantfluctuationsintheresult.

TheACThasseenacontinueddeclineintherateof12–17-year-oldswhosmokeregularly,whichissignificantlylowerthanthenationalrate.

ThisyearwealsocompletedtheACTHealthWorkforcePlan2013–2018andtheACTHealthAboriginalWorkforceActionPlan2013–2018andimplementedHealthWorkforceAustralia(HWA)initiativestosupportnationalhealthworkforcereforms.

AnindependentevaluationreportconfirmedtheWalk-InCentre(WiC)modelforthetreatmentofpeoplewithminorillnessorinjuriestobeasafeandeffectivemeansofprovidingprimaryhealthcareservices,whilehighlightingthatitimprovedaccesstofree,extendedhoursprimaryhealthcareservices.

In2012–13,weopenedStageOneofthenewCentenaryHospitalforWomenandChildren—oneoftheHealthInfrastructureProgram’smajornewcapitalworks,whichfeaturesstate-of-the-artequipmentandfacilities.TheGungahlinCommunityHealthCentrealsoopened,providingarangeofservicestothoseinthenorthofCanberra.

TheRadiationOncologyDepartmentcommencedoperationofafourthlinearaccelerator,whichwastimelyinlightofincreaseddemandforradiotherapytreatmentservices.

WeimprovedourProstheticsandOrthoticsServicebyimplementingatriageclinictobettermanagetheneedsofclients,resultinginasignificantfallinthenon-urgentwaitingtime.

ACTHealth,throughtheAustralianCouncilonHealthcareStandards,metallreaccreditationcriteria—with28markedachievements,18extensiveachievementsandoneoutstandingachievement—toretainitsfullaccreditationstatusforanotherfouryears.

Projectionssuggestthatlifeexpectancywillcontinuetoincreaseoverthecomingyears,withcancer,mentaldisordersandcardiovasculardiseasetheleadingcontributorstothetotalburdenofdisease,contributingnearlyhalfofthetotaldiseaseburden.

AnumberofstaffchangesatCanberraHospitalandHealthServicesoccurredduringtheyear.MrLeeMartin,DeputyDirector-General,resignedtoreturntotheUnitedKingdom,asdidMsSusanAitkenhead,ExecutiveDirectorofNursingandMidwifery.DrJoBurnand,ExecutiveDirectorofMedicalServices,alsoresigned.Wethankthemfortheircontributionsandwishthemwellfortheirfuturecareers.

ACTHealthalsomournedthelossofthreeseniormedicalstaffin2012.DrDamianMcMahon,ProfessorMarjanKlijakovicandDrToniMedcalf(Peadon)allpassedaway,cuttingshortlivesthatwerededicatedtodeliveringbetterhealthtotheACTcommunity.

http://www.health.act.gov.au/c/health%3Fa%3Ddlpubpoldoc%26document%3D2830


A.4 Outlook for 2013–14

The2013–14reportingperiodpromisestobeanotheryearoftremendousgrowthforACTHealth,asitdeliverskeypiecesofinfrastructureundertheHealthInfrastructureProgramandfurtherconsolidatesitsresponsetotheNationalHealthReformAgenda,includingtheNationalElectiveSurgeryTargetandNationalEmergencyAccessTarget.

TheACTGovernmentcontinuestoinvestheavilyinhealthtomeetbothpresentandfuturechallenges.HealthcontinuestobeoneoftheACTGovernment’sbiggestareasofspending,withannualinvestmentof$1.3billiontotransformourhealthsystem.

Inthecomingyear,wearecommittedtofurtherimprovementstoelectivesurgeryservices,furtherreductionsinwaitingtimes,expansionoftheEmergencyDepartmentandIntensiveCareUnitatCanberraHospital,andrapidassessmentservicesatCalvary.

WewillcompletetheplanningandcommenceforwarddesignofthenewUniversityofCanberraPublicHospital.

MorebedswillbeopenedatCanberraHospital,CalvaryPublicHospitalandtheCentenaryHospitalforWomenandChildren,andtherewillbeincreasedstaffingattheCanberraHospitalEmergencyDepartment.

ACTHealthwilldeliveranadditional31inpatientbedsacrossCanberraandCalvaryPublicHospitals,aswellassixHospitalintheHomeplaces.

AdditionalstaffingandresourcesatCanberraHospitalwillhelpusbettermanagepatientmovementthrough andoutoftheemergencydepartment,andwewillalsoestablishaneight-bedrapidassessmentunitatCalvaryPublicHospital.

WewillalsoestablishanObesityManagementServicetoimprovethehealthofpatientswithsevereobesitythroughcoordinatedinterventionandpreventionservices.

Amobiledentalclinicwillhelppeoplewhocannotaccessadentistsurgery,andwewillexpandoutreachservicesforcancersufferers.

Wewillincreasementalhealthservicesprovidedthroughnon-governmentorganisationsandcommunityhealthprograms,andexpandourcommunityhealthcentresandnurse-ledwalk-incentres.

ServiceswillberelocatedtothenewBelconnenCommunityHealthCentreinCanberra’snorth,andanexpandedandrefurbishedTuggeranongCommunityHealthCentrewillreopeninCanberra’ssouth.

Finally,inthefirsthalfofthe2013–14financialyear,wewillofficiallyopenStage2oftheCentenaryHospitalforWomenandChildren,andtheCanberraRegionCancerCentre.

ThesearetwoofthemostsignificantpiecesofhealthinfrastructuretohaveeverbeendeliveredintheACT,andareanimportantlegacyforCanberraandthesurroundingregionofthiscentenaryyear.


A.5 Management discussion and analysis

Management discussion and analysis for the Health Directorate for the financial year ended 30 June 2013

General overview

Operations and principal activitiesTheHealthDirectorateaimstoachievegoodhealthforallresidentsoftheTerritorybyplanningandprovidingqualitycommunitybasedhealthservicesandhospitalandextendedcareservices,managingpublichealthrisks,andpromotinghealthandearlycareinterventions.

TheHealthDirectorate’sobjectivesaregroupedaroundthefollowingsevenkeyperformanceareas:

• consumer experience

• sustainability

• hospitalandrelatedcare

• prevention

• socialinclusionandindigenoushealth

• communitybasedhealth,and

• agedcare.

Changes in administrative structureTheDirectoratedidnotgainorloseanyfunctionsinthe2012–13financialyear.

Therewashowever,achangetofundingarrangements.TheACTisasignatorytotheNationalHealthReformAgreement,whichchangedthewayhospitalsarefundednationally.Asaconsequence,theACTGovernmentcreatedanewLocalHospitalNetwork(LHN)Directorateforreceivingfundingforbothactivity-basedservicesandblock-fundedservicesfromanationalpooloffundsthatwascontributedtobyCommonwealth,StatesandTerritories.ThechangedfundingarrangementmeantthattheHealthDirectorateisnolongerfundedbytheGovernmentdirectlyforhospitalservices.

TheACTLocalHospitalNetworkDirectoratepurchaseshospitalservicesfromthefollowingACTpublichospitals:

• the Canberra Hospital

• Calvary Public Hospital

• ClareHollandHouse,and

• QueenElizabethIIFamilyCentre.

Risk managementTheDirectorate’smanagementhasidentifiedthefollowingpotentialrisksthatmayinfluencethefuturefinancialpositionoftheDirectorate:

• abnormalratesofstaffseparation

• thecostofmedicalmalpracticeindemnity

• abilitytoattractandretainhealthprofessionals

• risingcostsofpharmaceuticals,medicalandsurgicalsupplies

• demandsonreplacingsystemsandequipment,and

• growthindemandforservices.


The Government andtheDirectoratehaverespondedtotheserisksinanumberofways,including:

• implementationofstrategiesfortheretentionandrecruitmentofdoctors,nurses,midwivesandallied healthprofessionals

• strengtheningourpatientsafetyandclinicalpracticereviewframework

• establishingtheMedicalSchoolincooperationwiththeAustralianNationalUniversity

• enhancementofprocurementprocessestomaximisebenefitsfromcontracting

• asignificantinvestmentininfrastructurereplacementandgrowth

• asignificantinvestmentinclinicalsystemsandrecordingsystems,and

• theGovernmentintroducedgrowthfundingintotheHealthBudgetin2006–07.Thiswasbasedonactivityprojectedthroughclinicalservicesplanning.

Theaboverisksaremonitoredregularlythroughouttheyear.

Financial performanceThefollowingfinancialinformationisbasedonauditedfinancialstatementsfor2011–12and2012–13,andtheforwardestimatescontainedinthe2013–14BudgetPaperNumber4.

Total net cost of services

Actual 2011–12

$m

Budget 2012–13

$m

Actual 2012–13

$m

Forward Estimate 2013–14

$m


$m


$m

Total Expenses 1,177.8 1,063.3 1,083.8 1,109.7 1,174.0 1,252.7

TotalOwnSourceRevenue 255.9 666.8 679.9 840.7 890.3 950.8

Net Cost of Services 921.9 396.5 403.9 269.0 283.7 301.9

Comparison to budgetTheDirectorate’snetcostofservicesfor2012–13of$403.9millionwas$7.4millionor1.9percenthigherthanthe2012–13budget.Thisreflectsacombinationoffactorsthatresultedinhigherthanbudgetedexpenses($20.5million).Themainvariationsare:• depreciationandamortisation($17.1million)—duetoaccelerateddepreciationfortheoldWomenand

Children’sHospital,TuggeranongCommunityHealthCentre,Level5Building1attheCanberraHospitalandtheoldPsychiatricServicesUnitasaresultofextensiverefurbishmentworks

• grantsandpurchasedservices($6.0million)—duetohigherpaymentstoCalvaryPublicHospitalforcostpressuresandemergencydepartmentrefurbishmentworks,and

• salaryandsuperannuationexpenses($6.4million)—duetothedifferencebetweenthelongserviceleavediscountrateof92percentusedinbudgetcalculationsandtheactualrateof101.3percent,andaslowerthananticipateddeclineinthenumberofemployeesleavingthehighercostCSS,PSSandPSSAPsuperannuationschemes.

Thehigherthanbudgetedexpenseswereoffsetbylowerthanbudgetedexpensesfor:• costofgoodssold($4.9million)—asaresultofACTprivatehospitalspurchasingsomemedicalandsurgical

suppliesdirectlyfromsuppliers,and

• otherexpenses($4.1million)—duetothisexpensecategoryincludingthebudgetforbloodproductsandtheactualexpensebeingreportedinthesuppliesandservicesexpensecategory.

Theseexpenseswereoffsetbyacombinationofhigherthanbudgetedownsourcerevenue($13.0million). Themainvariationsforhigherthanbudgetedrevenueare:• non-ACTGovernmentusercharges($12.4million)—followingacquittalofprioryearcrossborderactivity• otherrevenue($2.7million)—forgrantsreceivedfromHealthWorkforceAustraliaandprioryear

reimbursementssuchasworkers’compensation,and

• gains($0.9million)—mainlyfromincreasedgeneraldonations.

Thehigherthanbudgetedownsourcerevenuewasoffsetbylowerthanbudgetedrevenuefor:

• ACTGovernmentusercharges($3.2million)—mainlyduetoreducedfundingfromtheACTLocalHospitalNetworkDirectorateinlinewithareductionintheCommonwealthspecificpurposefundingbasedonpopulationadjustments.


Comparison to 2011–12 actual expensesTotalnetcostofserviceswas$518.0millionor56.2percentlowerthanthe2011–12actualcost.Thisisduetodecreasedexpenses($94.0million),mainlycomprisinglower:

• grantsandpurchasedservices($164.6million)—fromCalvaryPublicHospitalpaymentsthatarenowbeingpaidthroughtheACTLocalHospitalNetworkDirectorate.

Thiswasoffsetbyincreasedexpensesfor:

• salaryandsuperannuationexpenses($34.8million)—asaresultofalargerworkforceandpayincreasesinlinewithenterpriseagreements

• depreciationandamortisation($24.1million)—duetoaccelerateddepreciationfortheoldWomenandChildren’sHospital,theTuggeranongCommunityHealthCentre,Level5Building1attheCanberraHospitalandtheoldPsychiatricServicesUnithavingextensiverefurbishmentsworksandtheCommissioningofthenewGungahlinCommunityHealthCentreandtheCentenaryHospitalforWomenandChildren,and

• suppliesandservices($15.9million)—fromincreasedcomputercostsforadditionalICTprojectstaff,increasesinfloorspacefortheHealthDirectoratewhichresultsinhighercleaning/utilitiescosts,theintroductionofthecarbontaxlevy,runningcostsassociatedwithanewpatienttransportvehicle,includingwagesforaParamedicteam,andanincreaseinthedemandforhigh-costbloodproducts.

Increasedownsourcerevenue($423.9million)alsocontributedtothelowernetcostofservices.Themaincontributorstothisreductionare:

• ACTGovernmentusercharges($542.7million)—asaresultofthechangestohowpaymentsarereceivedfromtheACTandCommonwealthGovernmentsandthishasadirectcorrelationwiththereducedGovernmentPaymentforOutputs,whichis$540.0millionlowerthanin2011–12,and

• gains($1.2million)—fromincreasedgeneraldonationsandtheprofitfromsaleofalargernumberofmotorvehicles.

Thesewereoffsetbyreduced:

• non-ACTGovernmentusercharges($115.9million)—fromachangeinfundingarrangementsforinterstateresidents,and

• otherrevenue($4.1million)—asaresultofreceivingalargeone-offgrantfromHealthWorkforceAustraliain2011–12forthepurchaseofstudentaccommodationpropertiesandtrainingequipment.

Future trends

0.0 200.0 400.0 600.0 800.0

1,000.0 1,200.0 1,400.0

Actual 2011-12

Budget 2012-13

Actual 2012-13

Forward Estimate 2013-14



$m

Total Expenses Total Own Source Revenue Net Cost of Services

Figure 1: Net cost of servicesThereasonfornetcostofservicesdecreasingin2013–14isthatthisyearisthefirstwholeyearthatthechangeinfundingfromGovernmentappropriationtoownsourcerevenueasaresultofimplementingtheNationalHealthReformAgreementfrom2012–13isinoperation.Netcostofservicesisthenplannedtoincreaseslightlyoverthefollowingyears.


Total expenditure

Components of expenditureFigure2belowindicatesthecomponentsoftheDirectorate’sexpensesfor2012–13,withthelargestcomponentsofexpensebeingemployeeexpenses(excludingsuperannuation),whichrepresents51.3percentor $556.5million,suppliesandserviceswhichrepresents27.8percentor$301.3millionandgrantsandpurchasedservices,whichrepresents7.7percentor$82.9million.

Employee Expenses 51.3%

CostofGoodsSold 1.0%

SuppliersandServices 27.8%

BorrowingCosts 0.01%

Other Expenses 0.6%

PurchasedServices 7.7%

DepreciationandAmortisation

4.9%

SuperannuationExpenses 6.7%

Figure 2: Components of expenditure

Comparison to budgetTotalexpensesof$1,083.8millionwere$20.5millionor1.9percent,higherthantheoriginal2012–13budgetof$1,063.3million.

Thisincreasewaspredominantlyduetohigher:

• depreciationandamortisation($17.1million)—duetoaccelerateddepreciationfortheoldWomenandChildren’sHospital,TuggeranongCommunityHealthCentre,Level5Building1attheCanberraHospital,andtheoldPsychiatricServicesUnitasaresultofsignificantrefurbishmentworks

• grantsandpurchasedservices($6.0million)—mainlyduetohigherpaymentstoCalvaryPublicHospitalassociatedwithcostpressuresandrefurbishmentoftheemergencydepartmentatCalvaryPublicHospital

• employeeexpenses(excludingsuperannuation)($3.2million)—mainlyduetothedifferencebetweenthelongserviceleavediscountrateof92percentusedinbudgetcalculationsandtheactualrateof101.3percent,and

• superannuation($3.2million)—mainlyduetoanincreasingworkforceandaslowerdeclineinthenumberofemployeesleavingthehighercostCSS,PSSandPSSAPschemesthanhadbeenanticipated.


Thishigherexpenditurewaspartiallyoffsetbylower:

• costofgoodssold($4.9million)—duetolowerthananticipatedsuppliesboughtthroughtheDirectoratebyprivatehospitals,whoarenowpurchasingsomeitemsdirectlyfromsuppliers,and

• otherexpenses($4.1million)—mainlyrelatingtobloodproducts,whichisbudgetedagainstotherexpensesbutwiththeactualsbeingreflectedagainstsuppliesandservices,whicharepartiallyoffsetbyhighermiscellaneousexpenses,higherlegalsettlementsandhigherimpairmentlosses.

Comparison to 2011–12 actual expensesTotalexpenseswere($94.0million)or8.0percentlowerthanthe2011–12actualresult.Thedecreasereflectsacombinationoffactors:

• lowergrantsandpurchasedservices($164.6million)—duetopaymentsmadetoCalvaryPublicHospitalnowbeingpaidbytheACTLocalHospitalNetworkDirectorate.

Thelowerexpenseswerepartiallyoffsetbyhigher:

• employeeexpenses(excludingsuperannuation)($28.6million)—duetoagreaterincreaseintheoverallworkforcetocovergrowthinservicesincriticalcare,acutecare,womenandchildren’shospital,adultmentalhealth,agedcareandrehabilitationandcancerandpayincreasesinlinewithassociatedenterpriseagreements

• depreciationandamortisation($24.1million)—mainlyresultingfromaccelerateddepreciationfortheoldWomenandChildren’sHospital,TuggeranongCommunityHealthCentre,Level5Building1attheCanberraHospital,andtheoldPsychiatricServicesUnitduetoextensiverefurbishmentworks.ThecommissioningoftheGungahlinCommunityHealthCentreandthenewCentenaryHospitalforWomenandChildrenalsoincreaseddepreciationcosts

• suppliesandservices($15.9million)—thevariationsbeinglargelyduetoincreased:

– computerexpenses—whichisacombinationofpriceescalation,increaseinstaffnumbers,andsupportcostsforprojectsthatbecameoperationalin2013.TheseprojectsincludeaDigitalWirelessNetwork atTCHCampus,DigitalIntensiveCareUnitCISSystem,E-Referral&DischargeSummaryandClinicalSystemsProject

– domesticservices/food/utilities—asaresultofcleaningcontractpriceincreases,increasesinfloorspacefornewfacilitiesandthecarbontaxlevy

– runningcostsfromthepurchaseofanewpatienttransportvehicle,includingwagesforparamedics,anddemandforhighcostbloodproducts

• superannuation($6.2million)—asaresultofalargerworkforce,increaseinnotionalsuperannuationrates,andaslowerdeclineinthenumberofemployeesleavingthehighercostCSS,PSSandPSSAPschemesthanhadbeenanticipated.

Future trendsExpensesarebudgetedtoincreasesteadilyacrosstheforwardyearstoaccountforpriceescalationandgrowth inservices.


Total own source revenue

Components of own source revenueFigure3belowindicatesthatforthefinancialyearended30June2013,theDirectoratereceived80.3percentofitstotalownsourcerevenueof$543.6millionfromACTGovernmentusercharges.

Figure 3: Components of own source revenue

Comparison to budgetOwnsourcerevenuefortheyearending30June2013was$677.5million,whichwas$12.2millionor1.8percenthigherthanthe2012–13budgetof$665.3million.

Thisfavourablevarianceisduetohigher:

• usercharges—non-ACTGovernment($12.4million)—duetotheaccrualofcrossborderrevenuerelatedtoprioryears’activityforresidentsofNewSouthWales

• otherrevenue($2.7million)—mainlyrelatingtoHealthWorkforceAustraliagrantsandadditionalprioryearexpenditurereimbursementforworkers’compensationclaims,and

• gains($0.9million)—duetoincreasedgeneraldonationsandprofitfromthesaleofmotorvehicles.

Thehigherrevenuewasoffsetbylowerthanbudgeted:

• ACTGovernmentusercharges($3.2million)–mainlyduetoreducedfundingfromtheACTLocalHospitalNetworkDirectorateinlinewithareductionintheCommonwealthspecificpurposefundsbasedonpopulationadjustments.

Comparison to 2011–12 actual incomeOwnsourcerevenuewas$423.9millionor165.7percenthigherthanthe2011–12actualresultof$254.7million.

Theresultreflectsanincreasein:

• ACTGovernmentusercharges($542.7million)—duetoachangeinthewaypaymentsarereceivedfromtheACTandCommonwealthGovernments,andhasadirectcorrelationwithGovernmentPaymentsforOutputs,whichis$540.0millionlowerthantheactual2011–12result,and

UserCharges–ACT Government

80.3%

UserCharges–Non-ACT

Government 16.7%

OtherRevenue 2.9%

ResourcesReceivedFreeofCharge0.1%

Interest&Distributions 0.0%


• gains($1.2million)—duetoincreasedgeneraldonationsandprofitfromthesaleofmotorvehicles,whichduetothecyclicnatureofmotorvehicleleasesmorecarswereduetobesoldin2012–13.

Thiswaspartiallyoffsetbyareductionin:

• non-ACTGovernmentusercharges($115.9million)—mainlyduetothechangedfundingarrangementsforthetreatmentofinterstatepatientsinACThospitalsfollowingtheimplementationoftheNationalHealthReformAgreement(theserevenuesarenowcollectedthroughtheACTLocalHospitalNetworkDirectorate),and

• otherrevenue($4.1million)—duetothereceipt,in2011–12,ofalargeone-offgrantfromHealthWorkforceAustraliafortrainingandeducationofthehealthworkforceintheACTandsurroundingregions,includingpurchaseofstudentaccommodationandtrainingequipment.

Future trendsTotalownsourcerevenueisexpectedtoincreaseby$160.9millionin2013–14,mainlyduetothefirstfullyearofchangedfundingarrangementsfollowingtheimplementationoftheNationalHealthReformAgreement,underwhichthefundingforhospitalservices,whichwaspreviouslypaidasGovernmentPaymentforOutputs,willnowbepaidasuserchargesbythenewACTLocalHospitalNetworkDirectorate.Itwillthentrendupwardssteadilyacrossthetwoforwardyears.

Financial position

Total assets

Components of total assetsFigure4belowindicatesthat,forthefinancialyearended30June2013,theDirectorateheld63.8 percentofitsassetsinproperty,plantandequipment.

Other Assets 0.2%

Property, Plant andEquipment

63.8%

IntangibleAssets 1.0%

CapitalWorksinProgress 21.8%

CashandCashEquivalents

0.9%

Receivables 11.4%

Investments 0.3% Inventories

0.7%

AssetsHeldforSale 0.0%

Figure 4: Total assets as at 30 June 2013


Comparison to budgetThetotalassetpositionasat30June2013is$1,110.9million,$74.6millionlowerthanthe2012–13budgetof$1,185.5million.

Thevariancereflectsthetimingassociatedwiththeacquisitionandcompletionofvariousassetsoverthe2012–13financialyearincluding:

• intangibles($22.2million)—mainlyduetodelayswithICTprojectssuchase-HealthandIdentityAccessManagement

• capitalworksinprogress($59.7million)—duetothedeferralofcapitalworksprojectsfrom2012–13intofutureyearsasaresultofprolongedleasenegotiationsfordecantspace,procurementdelaysduetostructuralandmanufacturingissues,andoperationalcommissioningdelays,and

• property,plantandequipment($77.4million)—mainlyduetodelayswithcommissioningoftheBelconnenCommunityHealthCentreandaccelerateddepreciationforbuildingsundergoingextensiverefurbishmentwork.

Thiswaspartiallyoffsetbyhigher:

• receivables($76.5million)—duelargelytopaymentsowingfromtheACTLocalHospitalNetworkDirectorate,whichreliesonpaymentsfromtheNewSouthWalesMinistryofHealthtothenpaytheHealthDirectorate,and

• cashandcashequivalents($8.0million)—mainlyduetofundingforICTcapitalprojectsandgrantsreceivedfromHealthWorkforceAustralia.

Comparison to 2011–12 actualTheDirectorate’stotalassetpositionis$114.7millionhigherthanthe2011–12actualresultof$996.2million,largelyduetoincreasesin:

• property,plantandequipmentincludingassetsheldforsale($80.2million)—mainlyduetocompletednewbuildingcapitalworksprojects,includingtheCentenaryHospitalforWomenandChildren,theGungahlinCommunityHealthCentreandtheCancerPatientAccommodationproperty

• receivables($68.6million)—duelargelytocrossborderrevenuenotyetreceivedfromtheNewSouthWalesMinistryofHealth,and

• capitalworksinprogress($23.4million)—asaresultofworksprogressingonthenewfacilities,includingtheCommunityHealthCentresinBelconnen,TuggeranongandGungahlin,theCanberraRegionCancerCentre,theCentenaryHospitalforWomenandChildren,forClinicalServicesRedevelopment,theCanberraHospitalEmergencyDepartmentIntensiveCareUnit,e-Health,DigitalMammography,IdentityAccessManagementandvariouscapitalupgrades.

Theaboveincreaseswerepartiallyoffsetbyareductionin:

• cashandcashequivalents($59.8million)—duetoanincreaseinreceivablesassociatedwiththetimingofcrossborderpaymentsbytheNewSouthWalesMinistryofHealth.


Total liabilities

Components of total liabilitiesFigure5belowindicatesthatthemajorityoftheDirectorate’sliabilitiesrelatetoemployeebenefits66.3 per cent andpayables30.2percent.

EmployeeBenefits 66.3%

FinanceLeases 2.2%

Payables 30.2%

OtherLiabilities 1.3%

Figure 5: Total liabilities as at 30 June 2013

Comparison to budgetTheDirectorate’sliabilitiesfortheyearended30June2013,of$291.0million,were$43.7millionhigherthanthe2012–13budgetof$247.3million.

Thiswaslargelyduetohigher:

• payables($31.2million)—mainlyduetoinvoicesforcapitalworksprojectsbeingreceivedlateinJune,and

• employeebenefits($15.5million)—mainlyduetothelongserviceleavediscountratechangingfrom92percentto101.3percentshortlyaftertheoriginalbudgetwasset.

Thiswasoffsetbylower:

• otherliabilities($3.2million)—otherliabilitiesmainlyrelatestorevenuereceivedinadvance.Mostofthegrantsanddonationsreceivedduringtheyearwerebroughttoaccountasrevenueearnedeventhoughconditionsattachedtothosewerenotyetfulfilled.Thevarianceisduetobudgetassumptionsnotbeinginlinewiththetypeofactualrevenuereceived.


Comparison to 2011–12 actualTotalliabilitieswere$24.5millionhigherthantheactualresultsasat30June2012of$266.5million.

Thiswasduetoincreasesin:

• employeebenefits($13.7million)—mainlyduetotheimpactofcollectiveagreementpayrisesandanincreaseinstaffnumbersforgrowthinservicesandthegrowthinliabilityduetoleaveconsumptionnotinlinewithleaveearned

• payables($7.8million)—duetoreceiptofinvoicesforcontractualcapitalworkstobepaidtoSharedServicesProcurementbeingreceivedlateinJune2013

• otherliabilities($1.6million)—mainlyduetopaymentinadvanceforservicesprovidedtotheDepartmentofVeterans’Affairs,and

• financeleases($1.4million)—duetothecyclicnatureofthemotorvehicles,whicharegenerallyonathreeyearlease.In2012–13theHealthDirectorateacquired185newmotorvehicleleasesanddisposedof164oldmotorvehiclefinanceleases.

Territorial statement of revenue and expensesTheactivitieswhosefundsflowthroughtheDirectorate’sTerritorialaccountsare:

• thereceiptofregulatorylicencefees,and

• thereceiptandon-passingofmoniesforcapitalworksatCalvaryPublicHospital.

Total incomeFigure6belowindicatesthat59.5percentofTerritorialincomeisregulatorylicencefees,withthebalancebeingthereceipt,foron-passing,ofmoniesforcapitalworksatCalvaryPublicHospital(expensesonbehalfoftheTerritory).

RegulatoryLicenceFees 59.5%

PaymentsforExpensesonBehalfof

the Territory 40.5%

Figure 6: Sources of Territorial revenue TotalTerritorialincomefortheyearending30June2013was$1.8million,whichwas$0.4millionhigherthanthebudgetfigureof$1.4million.Thevariancewasduetohigherregulatorylicencefeesrevenue($0.4million).

TotalTerritorialincomefor2012–13,of$1.8millionwasconsistentwiththe2011–12incomeof$1.8million.


Total expensesFigure7belowindicatesthat40.6percentofexpensesincurredonbehalfoftheTerritoryrelatetotheon-passingofmoniesforcapitalworkstoCalvaryPublicHospital,withtheother59.4percentbeingthetransfer,toGovernment,ofregulatorylicencefees.

GrantsandPurchasedServices 40.6%

TransfertoACTGovernment

59.4%

Figure 7: Sources of Territorial expensesTotalexpenseswere$1.8million,whichwas$0.4millionhigherthanthebudgetof$1.4millionduetohigherregulatorylicencefeesreceived.

Totalexpenseswere$0.3millionhigherthanforthesameperiodlastyearof$1.5million.

Other disclosures

Audit qualification/matters of emphasis InSeptember2013,theAuditor-GeneralcompletedthefinancialauditoftheDirectorateandprovidedanopinion.TheAuditor-General’sopinionoftheDirectorate’sfinancialstatementsconcludedthatthestatementswerepreparedinaccordancewiththeFinancial Management Act 1996 andfairlyrepresentedthefinancialperformanceoftheDirectoratefortheyearended30June2013.


Attachment A—Comparison of net cost of services to budget 2012–13

Original BudgetPlus AAO Transfers Total Funding Less Actual

Variance to be Explained

Description $’000 $’000 $’000 $’000 $’000 %

Expenses

EmployeeandSuperannuation 622,396 – 622,396 628,781 –6,385 –1.03

SuppliesandServices 301,234 – 301,234 301,333 –99 –0.03

DepreciationandAmortisation 35,882 – 35,882 53,014 –17,132 –47.75

PurchasedServices 76,920 – 76,920 82,888 –5,968 –7.76

Other Expenses 11,461 – 11,461 7,299 4,162 36.32

CostofGoodsSold 15,394 – 15,394 10,475 4,919 31.96

Total Expenses 1,063,287 – 1,063,287 1,083,790 –20,503 –1.93

Own Source Revenue

UserCharges 647,533 – 647,533 656,783 –9,250 –1.43

Interest 278 – 278 250 28 9.96

ResourcesFreeofCharge 758 – 758 1,010 –252 –33.30

Gains 1,524 – 1,524 2,377 –853 –56.00

OtherRevenue 16,746 – 16,746 19,425 –2,679 –16.00

Total Own Source Revenue 666,839 – 666,839 679,845 –13,007 –1.95

Total Net Cost of Services 396,448 – 396,448 403,945 –7,497 –1.89

Section A Performance and financial reporting 23

A.6 Financial Report

24 ACT Government Health Directorate Annual Report 2012–13

Section A Performance and financial reporting 25


Health Directorate Controlled Financial Statements For the Year Ended 30 June 2013

Health Directorate Operating Statement For the Year Ended 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Actual 2012

$’000IncomeRevenue

GovernmentPaymentforOutputs 4 364,256 365,860 904,281

UserCharges–ACTGovernment 5 543,569 546,730 825

UserCharges–Non-ACTGovernment 5 113,214 100,803 229,102

Interest 6 106 278 97

DistributionfromInvestmentswiththeTerritoryBankingAccount 7 144 – 157

ResourcesReceivedFreeofCharge 8 1,010 758 954

OtherRevenue 9 19,425 16,746 23,542

Total Revenue 1,041,724 1,031,175 1,158,958

Gains

Gains on Investments 10 21 – –

Other Gains 11 2,356 1,524 1,185

Total Gains 2,377 1,524 1,185

Total Income 1,044,101 1,032,699 1,160,143

Expenses Employee Expenses 12 556,505 553,280 527,932

SuperannuationExpenses 13 72,276 69,116 66,067

SuppliesandServices 14 301,333 301,234 285,428

DepreciationandAmortisation 15 53,014 35,882 28,929

GrantsandPurchasedServices 16 82,888 76,920 247,512

BorrowingCosts 17 375 401 415

CostofGoodsSold 18 10,475 15,394 13,359

Other Expenses 19 6,924 11,060 8,120

Total Expenses 1,083,790 1,063,287 1,177,762

Operating (Deficit) (39,689) (30,588) (17,619)

Other Comprehensive (Deficit)

Itemsthatwillnotbereclassifiedsubsequentlytoprofitorloss

(Decrease)intheAssetRevaluationSurplus 37 – – (994)

Total Comprehensive (Deficit) (39,689) (30,588) (18,613)

TheaboveOperatingStatementshouldbereadinconjunctionwiththeaccompanyingnotes.TheDirectorateonlyhasoneoutputclassandassuchtheaboveOperatingStatementisalsotheDirectorate’sOperatingStatementfortheHealthandCommunityCareOutputClass.Aseparatedisaggregateddisclosurenotehasthereforenotbeenincluded intheseFinancialStatements.


Health Directorate Balance Sheet As at 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Actual 2012

$’000

Current Assets

CashandCashEquivalents 23 9,562 1,522 69,379

Receivables 24 126,339 47,572 57,730

Inventories 25 8,113 8,066 7,553

AssetsHeldforSale 26 34 127 169

Other Assets 31 2,675 2,516 2,515

Total Current Assets 146,723 59,803 137,347

Non-Current Assets

Receivables 24 – 2,235 –

Investments 27 3,011 3,000 2,990

Property,PlantandEquipment 28 707,919 785,281 627,749

IntangibleAssets 29 11,636 33,872 9,870

CapitalWorksinProgress 30 241,636 301,294 218,235

Total Non-Current Assets 964,202 1,125,682 858,844

Total Assets 1,110,925 1,185,485 996,190

Current Liabilities

Payables 32 87,773 56,597 79,960

FinanceLeases 33 2,315 3,099 3,288

EmployeeBenefits 34 180,522 159,114 164,307

OtherLiabilities 36 2,224 5,462 656

Total Current Liabilities 272,834 224,272 248,211

Non-Current Liabilities

FinanceLeases 33 4,162 3,099 1,802

EmployeeBenefits 34 12,457 18,392 14,984

Other Provisions 35 1,503 1,503 1,503

Total Non-Current Liabilities 18,122 22,994 18,289

Total Liabilities 290,956 247,266 266,500

Net Assets 819,969 938,219 729,690

Equity

AccumulatedFunds 675,962 793,218 585,683

AssetRevaluationSurplus 37 144,007 145,001 144,007

Total Equity 819,969 938,219 729,690

TheaboveBalanceSheetshouldbereadinconjunctionwiththeaccompanyingnotes.TheDirectorateonlyhasoneoutputclassandassuchtheaboveBalanceSheetisalsotheDirectorate’sBalanceSheetfortheHealthandCommunityCareOutputClass.AseparatedisaggregateddisclosurenotehasthereforenotbeenincludedintheseFinancialStatements.


Health Directorate Statement of Changes in Equity For the Year Ended 30 June 2013

Note No.

Accumulated Funds Actual

2013 $’000

Asset Revaluation

Surplus Actual

2013 $’000

Total Equity Actual

2013 $’000

Original Budget

2013 $’000

BalanceattheBeginningofthe ReportingPeriod 585,683 144,007 729,690 730,925

Comprehensive Income

Operating(Deficit) (39,689) – (39,689) (30,588)

Increase/(Decrease)intheAsset Revaluation Surplus

37 – – – –

Total Comprehensive (Deficit) (39,689) – (39,689) (30,588)

Transactions Involving Owners Affecting Accumulated Funds

CapitalInjections 129,968 – 129,968 237,882

Total Transactions Involving Owners Affecting Accumulated Funds 129,968 – 129,968 237,882

Balance at the End of the Reporting Period 675,962 144,007 819,969 938,219

TheaboveStatementofChangesinEquityshouldbereadinconjunctionwiththeaccompanyingnotes.

Note No.


2012 $’000

Asset Revaluation

Surplus Actual 2012

$’000

Total Equity Actual

2012 $’000

BalanceattheBeginningoftheReportingPeriod 440,499 145,001 585,500


Operating(Deficit) (17,619) – (17,619)

(Decrease)intheAssetRevaluationSurplus 37 – (994) (994)

Total Comprehensive (Deficit) (17,619) (994) (18,613)


CapitalInjections 162,803 – 162,803

Total Transactions Involving Owners Affecting Accumulated Funds 162,803 – 162,803

Balance at the End of the Reporting Period 585,683 144,007 729,690



Health Directorate Cash Flow Statement For the Year ended 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Actual 2012

$’000

Cash Flows from Operating Activities

Receipts

GovernmentPaymentforOutputs 364,256 365,860 904,170

UserCharges–ACTGovernment 483,564 – 822

UserCharges–Non-ACTGovernment 112,659 647,487 215,328

InterestReceived 106 278 97

DistributionfromInvestmentswiththeTerritoryBankingAccount 145 – 151

GoodsandServicesTaxInputTaxCredits

fromtheAustralianTaxationOffice48,063 – 59,616

GoodsandServicesTaxCollectedfromCustomers 5,952 – 5,028

Other 19,183 104,670 19,882

Total Receipts from Operating Activities 1,033,928 1,118,295 1,205,094

Payments

Employee 542,570 551,238 497,483

Superannuation 72,068 69,116 65,740

SuppliesandServices 296,813 296,432 254,897

GrantsandPurchasedServices 80,159 76,920 243,608

GoodsandServicesTaxPaidtoSuppliers 53,131 – 63,973

BorrowingCosts 375 401 415

Other 30,344 112,660 25,789

Total Payments from Operating Activities 1,075,460 1,106,767 1,151,905

Net Cash (Outflows)/Inflows from Operating Activities 41 (41,532) 11,528 53,189

Cash Flows from Investing Activities

Receipts

ProceedsfromSaleofProperty,PlantandEquipment 2,438 – 1,397

Total Receipts from Investing Activities 2,438 – 1,397

Payments

PurchaseofProperty,PlantandEquipment 128,584 247,996 64,548

PaymentsforCapitalWorks 18,200 – 111,634

Total Payments from Investing Activities 146,784 247,996 176,182

Net Cash (Outflows) from Investing Activities (144,346) (247,996) (174,785)


Health Directorate Cash Flow Statement For the Year ended 30 June 2013 (Continued)

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Actual 2012

$’000

Cash Flows from Financing Activities

Receipts

CapitalInjections 129,968 237,882 162,803

Total Receipts from Financing Activities 129,968 237,882 162,803

Payments

RepaymentofFinanceLeases 3,907 1,452 2,426

Total Payments from Financing Activities 3,907 1,452 2,426

Net Cash Inflows from Financing Activities 126,061 236,430 160,377

Net (Decrease)/Increase in Cash and Cash Equivalents (59,817) (38) 38,781

CashandCashEquivalentsattheBeginningofthe ReportingPeriod 69,379 1,560 30,598

Cash and Cash Equivalents at the End of the Reporting Period 41 9,562 1,522 69,379

TheaboveCashFlowStatementshouldbereadinconjunctionwiththeaccompanyingnotes.


Health Directorate Controlled Statement of Appropriation For the Year Ended 30 June 2013

Original Budget

2013 $’000

Total Appropriated

2013 $’000

Appropriation Drawn

2013 $’000

Appropriation Drawn

2012 $’000

Controlled

GovernmentPaymentforOutputs 365,860 377,387 364,256 904,170

CapitalInjections 237,882 255,318 129,968 162,803

Total Controlled Appropriation 603,742 632,705 494,224 1,066,973

TheaboveControlledStatementofAppropriationshouldbereadinconjunctionwiththeaccompanyingnotes.

Column Heading ExplanationsThe Original BudgetcolumnshowstheamountsthatappearintheCashFlowStatementintheBudgetPapers. ThisamountalsoappearsintheCashFlowStatement.

The Total Appropriated columnisinclusiveofallappropriationvariationsoccurringaftertheOriginalBudget.

The Appropriation DrawnisthetotalamountofappropriationreceivedbytheDirectorateduringtheyear. ThisamountappearsintheCashFlowStatement.

Variances between ‘Original Budget’ and ‘Total Appropriated’

Government Payment for OutputsThedifferencebetweentheOriginalBudgetandTotalAppropriatedtotheDirectorateisduetothere-appropriationin2012–13ofunspentCommonwealthGovernmentfundingfrom2011–12andincreasedCommonwealthGovernmentfundingforprogramsincludingEssentialVaccines,LongStayOlderPatientsandPreventableHealth.

Capital InjectionsThedifferencebetweentheOriginalBudgetandTotalAppropriatedin2012–13isduetotheSection16bcapitalinjectionreconciliationinstrumentof$17.436mfrom2011–12.TheSection16binstrumentisusedtomovethebalanceofcapitalinjectionfromtheendofoneyearintothefollowingfinancialyear.

Variances between ‘Total Appropriated’ and ‘Appropriated Drawn’

Government Payment for OutputsThedifferencebetweentheTotalAppropriatedandAppropriatedDrawnisduetothemovementoffundingfrom2012–13into2013–14mainlyduetodelaysintheNationalHealthReformandPreventableHealthprograms.Thedeferralsinpartrelatetodelaysinrefurbishmentworkbeforefacilitiescouldbecomeoperational.

Capital InjectionsThedifferencebetweentheTotalAppropriatedandAppropriationDrawnin2012–13isduetothedeferralofcapitalworksprojectsfrom2012–13to2013–14and2014–15.Themainreasonsforthedeferralofcapitalworksprojectsfrom2012–13intofutureyearswasprolongedleasenegotiationsforvacantspacetobeusedastemporaryaccommodation,procurementdelaysduetostructuralandmanufacturingissues,developmentapplicationapprovaldelays,delaysinappointmentofprincipalconsultants,andoperationalcommissioningdelays.


Health Directorate Controlled Note IndexNote 1 ObjectivesoftheHealthDirectorate

Note 2 SummaryofSignificantAccountingPolicies

Note 3 ChangeinAccountingPolicyandAccountingEstimates,andCorrectionofaPriorPeriodError

Income Notes

Note 4 GovernmentPaymentforOutputs

Note 5 UserCharges

Note 6 Interest

Note 7 DistributionfromInvestmentswiththeTerritoryBankingAccount

Note 8 ResourcesReceivedFreeofCharge

Note 9 OtherRevenue

Note 10 Gains on Investments

Note 11 Other Gains

Expense Notes

Note 12 Employee Expenses

Note 13 SuperannuationExpenses

Note 14 SuppliesandServices

Note 15 DepreciationandAmortisation

Note 16 GrantsandPurchasedServices

Note 17 BorrowingCosts

Note 18 CostofGoodsSold

Note 19 Other Expenses

Note 20 Waivers,ImpairmentLossesandWrite-Offs

Note 21 Auditor’sRemuneration

Note 22 ActofGracePayments

Asset Notes

Note 23 CashandCashEquivalents

Note 24 Receivables

Note 25 Inventories

Note 26 AssetsHeldforSale

Note 27 Investments

Note 28 Property,PlantandEquipment

Note 29 IntangibleAssets

Note 30 CapitalWorksinProgress

Note 31 Other Assets

Liabilities Notes

Note 32 Payables

Note 33 FinanceLeases

Note 34 EmployeeBenefits

Note 35 Other Provisions

Note 36 OtherLiabilities

Equity Note

Note 37 Equity

Other Notes

Note 38 Financial Instruments

Note 39 Commitments

Note 40 ContingentLiabilities

Note 41 CashFlowReconciliation

Note 42 EventsOccurringAfterBalanceDate

Note 43 ThirdPartyMonies


Health Directorate Notes to and Forming Part of the Financial Statements For the Year Ended 30 June 2013

Note 1. Objectives of the Health Directorate

Operations and Principal ActivitiesTheHealthDirectorate(theDirectorate)aimstoachievegoodhealthforallresidentsoftheTerritorybyplanningforandprovidingqualitycommunitybasedhealthservices,hospitalandextendedcareservices,managingpublichealthrisksandpromotinghealthandearlycareinterventions.(TheACTLocalHospitalNetworkDirectoratebecameresponsibleforpurchasingpublichospitalservicesfromJuly2012.)

TheDirectorate’sobjectivesaregroupedaroundthefollowingsevenkeyperformanceareas:• consumerexperience;• sustainability;• hospitalandrelatedcare;• prevention;• socialinclusionandindigenoushealth;• communitybasedhealth;and

• agedcare.

Note 2. Summary of Significant Accounting Policies

(a) Basis of AccountingThe Financial Management Act 1996(FMA)requiresthepreparationofannualfinancialstatementsforACTGovernmentAgencies.

TheFMAandtheFinancial Management Guidelines issuedundertheAct,requirestheDirectorate’sfinancialstatementstoinclude:i. anOperatingStatementfortheyear;ii. aBalanceSheetattheendoftheyear;iii. aStatementofChangesinEquityfortheyear;iv. aCashFlowStatementfortheyear;v. aStatementofAppropriationfortheyear;vi. anOperatingStatementforeachclassofoutputfortheyear;vii.asummaryofthesignificantaccountingpoliciesadoptedfortheyear;andviii.suchotherstatementsasarenecessarytofairlyreflectthefinancialoperationsoftheDirectorateduringthe

yearanditsfinancialpositionattheendoftheyear.

Thesegeneral-purposefinancialstatementshavebeenpreparedtocomplywith‘GenerallyAcceptedAccountingPrinciples’(GAAP)asrequiredbytheFMA.Thefinancialstatementshavebeenpreparedinaccordancewith:

i. AustralianAccountingStandards;and

ii. ACTAccountingandDisclosurePolicies.

Thefinancialstatementshavebeenpreparedusingtheaccrualbasisofaccounting,whichrecognisestheeffectsoftransactionsandeventswhentheyoccur.Thefinancialstatementshavealsobeenpreparedaccordingtothehistoricalcostconvention,exceptforassetswhichwerevaluedinaccordancewiththe(re)/valuationpoliciesapplicabletotheDirectorateduringthereportingperiod.

Asat30June2013,theDirectorate’scurrentassetsareinsufficienttomeetitscurrentliabilities,butthisisnotconsideredaliquidityriskasitsoperationsarefundedthroughappropriationfromtheACTGovernmentona cash-needsbasis.ThisisconsistentwiththeWhole-of-GovernmentcashmanagementregimewhichrequiresexcesscashbalancestobeheldcentrallyratherthanwithinindividualDirectoratebankaccounts.

ThesefinancialstatementsarepresentedinAustraliandollars,whichistheDirectorate’sfunctionalcurrency.

TheDirectorateisanindividualreportingentity.



Note 2. Summary of Significant Accounting Policies (Continued)

(b) Controlled and Territorial ItemsTheDirectorateproducesControlledandTerritorialfinancialstatements.TheControlledfinancialstatementsincludeincome,expenses,assetsandliabilitiesoverwhichtheDirectoratehascontrol.TheTerritorialfinancialstatementsincludeincome,expenses,assetsandliabilitiesthattheDirectorateadministersonbehalfofthe ACTGovernment,butdoesnotcontrol.

ThepurposeofthedistinctionbetweenControlledandTerritorialistoenableanassessmentoftheDirectorate’sperformanceagainstthedecisionsithasmadeinrelationtotheresourcesitcontrols,whilemaintainingaccountabilityforallresourcesunderitsresponsibility.

ThebasisofaccountingdescribedinNote2(a)aboveappliestobothControlledandTerritorialfinancialstatementsexceptwherespecifiedotherwise.

(c) The Reporting PeriodThesefinancialstatementsstatethefinancialperformance,changesinequityandcashflowsoftheDirectoratefortheyearending30June2013togetherwiththefinancialpositionoftheDirectorateasat30June2013.

(d) Comparative Figures

Budget FiguresTofacilitateacomparisonwithBudgetPapers,asrequiredbytheFinancial Management Act 1996,budgetinformationfor2012–2013hasbeenpresentedinthefinancialstatements.BudgetnumbersinthefinancialstatementsaretheoriginalbudgetnumbersthatappearintheBudgetPapers.

Prior Year ComparativesComparativeinformationhasbeendisclosedinrespectofthepreviousperiodforamountsreportedinthefinancialstatements,exceptwhereanAustralianAccountingStandarddoesnotrequirecomparativeinformationtobedisclosed.

Wherethepresentationorclassificationofitemsinthefinancialstatementsisamended,thecomparativeamountshavebeenreclassifiedwherepractical.Whereareclassificationhasoccurred,thenature,amountandreasonforthereclassificationisprovided.

(e) RoundingAllamountsinthefinancialstatementshavebeenroundedtothenearestthousanddollars($’000).Useofthe“-”symbolrepresentszeroamountsoramountsroundedupordowntozero.




(f) Revenue RecognitionRevenueisrecognisedatthefairvalueoftheconsiderationreceivedorreceivableintheOperatingStatement. AllrevenueisrecognisedtotheextentthatitisprobablethattheeconomicbenefitswillflowtotheDirectorateandtherevenuecanbereliablymeasured.Inaddition,thefollowingspecificrecognitioncriteriamustalsobemetbeforerevenueisrecognised:

Cross Border (Interstate) Health RevenueRevenueforcrossborder(interstate)healthservicesisrecognisedwhenthenumberofpatientsandcomplexitiesofthetreatmentsprovidedcanbemeasuredreliablyandthecontractpriceforsuchservicesareagreedwiththeStatesandNorthernTerritory.ActualpatientnumbersandservicesaresettledfollowinganacquittalprocessundertakeninsubsequentyearsandvariationstotherevenuerecognisedisaccountedforintheyearofsettlementwiththeStatesandNorthernTerritory.

Service RevenueRevenuefromtherenderingofservicesisrecognisedwhenthestageofcompletionofthetransactionatthereportingdatecanbemeasuredreliablyandthecostsofrenderingthoseservicescanbemeasuredreliably.

Inventory SalesRevenuefrominventorysalesisrecognisedasrevenuewhenthesignificantrisksandrewardsofownershipofthegoodshastransferredtothebuyer,theDirectorateretainsneithercontinuingmanagerialinvolvementnoreffectivecontroloverthegoodssoldandthecostsincurredinrespectofthetransactioncanbemeasuredreliably.

Amounts Received for Highly Specialised DrugsRevenuefromthesupplyofhighlyspecialiseddrugsisrecognisedasrevenuewhenthedrugshavebeensuppliedtothepatients.

Inpatient FeesForthehospitaltreatmentofchargeablepatients,inpatientfeesarerecognisedasrevenuewhentheserviceshavebeenprovided.

RevenuerelatedtohospitalservicesprovidedtotheDepartmentofVeterans’AffairspatientsisrecognisedwhenthenumberofpatientsandcomplexitiesofthetreatmentsprovidedcanbemeasuredreliablyandthecontractpriceforsuchservicesareagreedwiththeDepartmentofVeterans’Affairs.ActualpatientnumbersandservicesaresettledfollowinganacquittalprocessundertakeninsubsequentyearsandvariationstotherevenuerecognisedisaccountedforintheyearofsettlementwiththeDepartmentofVeterans’Affairs.

Facilities FeesFacilitiesfeesaregeneratedfromtheprovisionoffacilitiestoenablespecialistsandseniorspecialiststoexerciserightsofprivatepracticeinthetreatmentofchargeablepatientsataHealthDirectoratefacility.Theyarerecognisedasrevenuewhentheamountofrevenuecanbemeasuredreliably.

DistributionDistributionrevenueisreceivedfrominvestmentswiththeTerritoryBankingAccount.ThisisrecognisedonanaccrualbasisusingdatasuppliedbytheTerritoryBankingAccount.




(f) Revenue Recognition (Continued)

GrantsGrantsarenon-reciprocalinnatureandarerecognisedasrevenueintheyearinwhichtheDirectorateobtainscontroloverthem.

Wheregrantsarereciprocalinnature,therevenueisrecognisedoverthetermofthefundingarrangements.

InterestInterestrevenueisrecognisedusingtheeffectiveinterestmethod.

(g) Revenue Received in AdvanceRevenuereceivedinadvancerelatingtocontributions,grantsanddonationsarerecognisedonlywherethereisapresentobligationtorepayagrant,contributionsanddonationsbecausespecificconditionsattachedtothegrant,contributionsanddonationshavenotbeenmetbytheDirectorate.

(h) Resources Received and Provided Free of ChargeResourcesreceivedfreeofchargearerecordedasarevenueandexpenseintheOperatingStatementatfairvalue.Therevenueisseparatelydisclosedunderresourcesreceivedfreeofcharge,withtheexpensebeingrecordedinthelineitemtowhichitrelates.GoodsandservicesreceivedfreeofchargefromACTGovernmentagenciesarerecordedasresourcesreceivedfreeofcharge,whereasgoodsandservicesreceivedfreeofchargefromentitiesexternaltotheACTGovernmentarerecordedasdonations.ServicesthatarereceivedfreeofchargeareonlyrecordedintheOperatingStatementiftheycanbereliablymeasuredandwouldhavebeenpurchasedifnotprovidedtotheDirectoratefreeofcharge.

Resourcesprovidedfreeofchargearerecordedattheirfairvalueintheexpenselineitemstowhichtheyrelate.

(i) Repairs and MaintenanceTheDirectorateundertakesmajorcyclicalmaintenanceonitsassets.Wherethemaintenanceleadstoanupgradeoftheasset,andincreasestheservicepotentialoftheexistingasset,thecostiscapitalised.Maintenanceexpenseswhichdonotincreasetheservicepotentialoftheassetareexpensed.

( j) Borrowing CostsBorrowingcostsareexpensedintheperiodinwhichtheyareincurred.

(k) Waivers of DebtDebtsthatarewaivedduringtheyearunderSection131oftheFinancial Management Act 1996areexpensedduringtheyearinwhichtherighttopaymentwaswaived.FurtherdetailsofwaiversaredisclosedatNote20:Waivers,ImpairmentLossesandWrite-offs.




(l) Current and Non-Current ItemsAssetsandliabilitiesareclassifiedascurrentornon-currentintheBalanceSheetandintherelevantnotes.Assetsareclassifiedascurrentwheretheyareexpectedtoberealisedwithin12monthsafterthereportingdate.Liabilitiesareclassifiedascurrentwhentheyareduetobesettledwithin12monthsafterthereportingdateorwhentheDirectoratedoesnothaveanunconditionalrighttodefersettlementoftheliabilityforatleast12monthsafterthereportingdate.

Assetsorliabilitieswhichdonotfallwithinthecurrentclassificationareclassifiedasnon-current.

(m) Impairment of AssetsTheDirectorateassesses,ateachreportingdate,whetherthereisanyindicationthatanassetmaybeimpaired.Assetsarealsoreviewedforimpairmentwhenevereventsorchangesincircumstancesindicatethatthecarryingamountmaynotberecoverable.However,intangibleassetsthatarenotyetavailableforusearetestedannuallyforimpairmentregardlessofwhetherthereisanindicationofimpairment,ormorefrequentlyifeventsorcircumstancesindicatetheymightbeimpaired.

Anyresultingimpairmentlosses,forland,buildings,andleaseholdimprovements,arerecognisedasadecreaseintheAssetRevaluationSurplusrelatingtotheseclassesofassets.WheretheimpairmentlossisgreaterthanthebalanceintheAssetRevaluationSurplusfortherelevantclassofasset,thedifferenceisexpensedintheOperatingStatement.ImpairmentlossesforplantandequipmentandintangibleassetsareexpensedintheOperatingStatement,asplantandequipmentandintangiblesarecarriedatcost.Also,thecarryingamountoftheassetisreducedtoitsrecoverableamount.

Animpairmentlossistheamountbywhichthecarryingamountofanassetexceedsitsrecoverableamount.Therecoverableamountisthehigheroftheasset’s‘fairvaluelesscosttosell’andits‘valueinuse’.Anasset’s‘valueinuse’isitsdepreciatedreplacementcost,wheretheassetwouldbereplacediftheDirectorateweredeprivedofit.

Non-financialassetsthathavepreviouslybeenimpairedarereviewedforpossiblereversalofimpairmentateachreportingdate.

(n) Cash and Cash EquivalentsForthepurposesoftheCashFlowStatementandtheBalanceSheet,cashincludescashatbankandcashonhand.Cashequivalentsareshort-term,highlyliquidinvestmentsthatarereadilyconvertibletoknownamountsofcashandwhicharesubjecttoaninsignificantriskofchangesinvalue.BankoverdraftsareincludedincashandcashequivalentsintheCashFlowStatementbutnotinthecashandcashequivalentslineontheBalanceSheet.




(o) ReceivablesAccountsreceivable(includingtradereceivablesandothertradereceivables)areinitiallyrecognisedatfairvalueandaresubsequentlymeasuredatamortisedcost,withanyadjustmentstothecarryingamountbeingrecordedintheOperatingStatement.

Tradereceivablesariseinthenormalcourseofsellinggoodsandservicestootheragenciesandtothepublic.Tradereceivablesarepayablewithin30daysaftertheissueofaninvoiceorthegoods/serviceshavebeenprovidedunderacontractualarrangement.Insomecases,theDirectoratehasenteredintocontractualarrangementswithsomecustomersallowingittochargeinterestatcommercialrateswherepaymentisnotreceivedwithin90daysaftertheamountfallsdue,untilthewholeofthedebtispaid.

Othertradereceivablesariseoutsidethenormalcourseofsellinggoodsandservicestootheragenciesandtothepublic.Othertradereceivablesarepayablewithin30daysaftertheissueofaninvoiceorthegoods/serviceshavebeenprovidedunderacontractualarrangement.Ifpaymenthasnotbeenreceivedwithin90daysaftertheamountfallsdue,underthetermsandconditionsofthearrangementwiththedebtor,theDirectorateisabletochargeinterestatcommercialratesuntilthewholeamountofthedebtispaid.

TheallowanceforimpairmentlossesrepresentstheamountoftradereceivablesandothertradereceivablestheDirectorateestimateswillnotberepaid.Theallowanceforimpairmentlossesisbasedonobjectiveevidenceandareviewofoverduebalances.TheDirectorateconsidersthefollowingisobjectiveevidenceofimpairment:

• becomingawareoffinancialdifficultiesofdebtors;

• defaultpayments;or

• debtsmorethan90daysoverdue.

Theamountoftheallowanceisthedifferencebetweentheassetscarryingamountandthepresentvalueoftheestimatedfuturecashflows,discountedattheoriginaleffectiveinterestrate.Cashflowsrelatingtoshort-termreceivablesarenotdiscountediftheeffectofdiscountingisimmaterial.TheamountoftheallowanceisrecognisedintheOperatingStatement.TheallowanceforimpairmentlossesarewrittenbackagainstthereceivablesaccountwhentheDirectorateceasesactiontocollectthedebtasitconsidersthatitwillcostmoretorecoverthedebtthanthedebtisworth.

Receivablesthathavebeenrenegotiatedbecausetheyarepastdueorimpairedareaccountedforbasedontherenegotiatedterms.

(p) InvestmentsTheDirectorateholdsonelong-terminvestment.ItisheldwiththeTerritoryBankingAccountinaunittrustcalledtheFixedInterestPortfolio.InvestmentsaremeasuredatfairvaluewithanyadjustmentstothecarryingamountrecordedintheOperatingStatement.Fairvalueisbasedonanunderlyingpoolofinvestmentswhichhavequotedmarketpricesasatthereportingdate.

(q) InventoriesInventoriesarestatedatthelowerofcostandnetrealisablevalue.Costcomprisesthepurchasepriceofinventoriesaswellastransport,handlingandothercostsdirectlyattributabletotheacquisitionofinventories.Tradediscounts,rebatesandsimilaritemsaredeductedindeterminingthecostsofpurchase.Thecostofinventoriesisassignedusingthecostweightedaveragemethod.

Netrealisablevalueisdeterminedusingtheestimatedsalesproceedslesscostsincurredinmarketing,sellinganddistributiontocustomers.




(r) Assets Held for SaleAssetsheldforsaleareassetsthatareavailableforimmediatesaleintheirpresentcondition,andtheirsaleishighlyprobable.

Assetsheldforsalearemeasuredatthelowerofthecarryingamountandfairvaluelesscoststosell.Animpairmentlossisrecognisedforanyinitialorsubsequentwritedownoftheassettofairvaluelesscosttosell.Assetsheldforsalearenotdepreciated.

(s) Acquisition and Recognition of Property, Plant and Equipment

Property,plantandequipmentareinitiallyrecordedatcost.Costincludesthepurchaseprice,directlyattributablecostsandtheestimatedcostofdismantlingandremovingtheitem(where,uponacquisition,thereisapresentobligationtoremovetheitem).

Whereproperty,plantandequipmentareacquiredatnocost,orminimalcost,costisitsfairvalueasatthedateofacquisition.Howeverproperty,plantandequipmentacquiredatnocostorminimalcostaspartofaRestructuringofAdministrativeArrangementsismeasuredatthetransferor’sbookvalue.

Wherepaymentforproperty,plantandequipmentisdeferredbeyondnormalcreditterms,thedifferencebetweenitscashpriceequivalentandthetotalpaymentismeasuredasinterestovertheperiodofcredit. Thediscountrateusedtocalculatethecashpriceequivalentisanassetspecificrate.

Property,plantandequipmentwithaminimumvalueof$5,000arecapitalised.

(t) Measurement of Property, Plant and Equipment after Initial Recognition

Property,plantandequipmentarevaluedusingthecostorrevaluationmodelofvaluation.Land,buildingsandleaseholdimprovementsaremeasuredatfairvalue.

Fairvalueistheamountforwhichanassetcouldbeexchangedbetweenknowledgeablewillingpartiesinanarm’slengthtransaction.Fairvalueismeasuredusingmarketbasedevidenceavailableforthatasset(orasimilarasset),asthisisthebestevidenceofanasset’sfairvalue.Wherethemarketpriceforanassetcannotbeobtainedbecausetheassetisspecialisedandisrarelysold,depreciatedreplacementcostisusedasfairvalue.

Land,buildingsandleaseholdimprovementsarerevaluedevery3years.However,ifatanytimemanagementconsidersthatthecarryingamountofanassetmateriallydiffersfromitsfairvalue,thentheassetwillberevaluedregardlessofwhenthelastvaluationtookplace.Anyaccumulateddepreciationrelatingtobuildingsandleaseholdimprovementsatthedateofrevaluationiswritten-backagainstthegrosscarryingamountoftheassetandthenetamountisrestatedtotherevaluedamountoftheasset.

TheDirectoratemeasuresitsplantandequipmentatcost.




(u) Intangible AssetsTheDirectorate’sIntangibleAssetsarecomprisedofinternallydevelopedandexternallyacquiredsoftwareforinternaluse.Externallyacquiredsoftwareisrecognisedandcapitalisedwhen:

a. itisprobablethattheexpectedfutureeconomicbenefitsthatareattributabletothesoftwarewillflowtotheDirectorate;

b. thecostofthesoftwarecanbemeasuredreliably;and

c. theacquisitioncostisequaltoorexceeds$50,000.

Internallygeneratedsoftwareisrecognisedwhenitmeetsthegeneralrecognitioncriteriaoutlinedaboveandwhereitalsomeetsthespecificrecognitioncriteriarelatingtointernallydevelopedintangibleassets.

Capitalisedsoftwarehasafiniteusefullife.Softwareisamortisedonastraight-linebasisoveritsusefullife,overaperiodnotexceeding5years.

IntangibleAssetsaremeasuredatcost.

(v) Depreciation and Amortisation of Non-Current Assets Non-currentassetswithalimitedusefullifearesystematicallydepreciated/amortisedovertheirusefullivesinamannerthatreflectstheconsumptionoftheirservicepotential.Theusefullifecommenceswhenanassetisreadyforuse.Whenanassetisrevalued,itisdepreciated/amortisedoveritsnewlyassessedremainingusefullife.Amortisationisusedinrelationtointangibleassetswhiledepreciationisappliedtophysicalassetssuchasbuildingsandplantandequipment.

Landhasanunlimitedusefullifeandisthereforenotdepreciated.

Leaseholdimprovementsandmotorvehiclesunderafinanceleasearedepreciatedovertheestimatedusefullifeofeachassetimprovement,ortheunexpiredperiodoftherelevantlease,whicheverisshorter.

Alldepreciationiscalculatedafterfirstdeductinganyresidualvalueswhichremainforeachasset.

Depreciation/amortisationfornon-currentassetsisdeterminedasfollows.

Class of Asset Depreciation/Amortisation Method Useful Life (Years)

Buildings StraightLine 40-80

LeaseholdImprovements StraightLine 2-10

PlantandEquipment StraightLine 2-20

ExternallyPurchasedIntangibles StraightLine 2-5

InternallyGeneratedIntangibles StraightLine 2-5

Landimprovementsareincludedwithbuildings.

Theusefullivesofallmajorassetsheldarereassessedonanannualbasis.




(w) PayablesPayablesareafinancialliabilityandaremeasuredatthefairvalueoftheconsiderationreceivedwheninitiallyrecognisedandatamortisedcostsubsequenttoinitialrecognition,withanyadjustmentstothecarryingamountbeingrecordedintheOperatingStatement.Allamountsarenormallysettledwithin30daysaftertheinvoicedate.

PayablesincludeTradePayables,AccruedExpensesandOtherPayables.

TradePayablesrepresenttheamountsowingforgoodsandservicesreceivedpriortotheendofthereportingperiodandunpaidattheendofthereportingperiodandrelatingtothenormaloperationsoftheDirectorate.

AccruedExpensesrepresentgoodsandservicesprovidedbyotherpartiesduringtheperiodthatareunpaidattheendofthereportingperiodandwhereaninvoicehasnotbeenreceivedbyperiodend.

OtherPayablesarethoseunpaidinvoicesthatdonotdirectlyrelatetothenormaloperationsoftheDirectorate.

(x) LeasesTheDirectoratehasenteredintofinanceleasesandoperatingleases.

Finance LeasesFinanceleaseseffectivelytransfertotheDirectoratesubstantiallyalltherisksandrewardsincidentaltoownershipoftheassetsunderafinancelease.Thetitlemayormaynoteventuallybetransferred.Financeleasesareinitiallyrecognisedasanassetandaliabilityatthelowerofthefairvalueoftheassetandthepresentvalueoftheminimumleasepaymentseachbeingdeterminedattheinceptionofthelease.Thediscountrateusedtocalculatethepresentvalueoftheminimumleasepaymentsistheinterestrateimplicitinthelease.Assetsunderafinanceleasearedepreciatedovertheshorteroftheasset’susefullifeorleaseterm.Assetsunderafinanceleasearedepreciatedonastraight-linebasis.Eachleasepaymentisallocatedbetweeninterestexpenseandreductionoftheleaseliability.Leaseliabilitiesareclassifiedascurrentandnon-current.

Operating LeasesOperatingleasesdonoteffectivelytransfertotheDirectoratesubstantiallyalltherisksandrewardsincidentaltoownershipoftheassetunderanoperatinglease.OperatingleasepaymentsarerecordedasanexpenseintheOperatingStatementonastraight-linebasisoverthetermofthelease.




(y) Employee BenefitsEmployeebenefitsincludewagesandsalaries,annualleave,longserviceleaveandapplicableon-costs.On-costsincludeannualleave,longserviceleave,superannuationandothercoststhatareincurredwhenemployeestakeannualandlongserviceleave.Thesebenefitsaccrueasaresultofservicesprovidedbyemployeesuptothereportingdatethatremainunpaid.Theyarerecordedasaliabilityandasanexpense.

Wages and SalariesAccruedwagesandsalariesaremeasuredattheamountthatremainsunpaidtoemployeesattheendofthereportingperiod.

Annual and Long Service LeaveAnnualleaveandlongserviceleavethatfallduewhollywithinthenext12monthsismeasuredbasedontheestimatedamountofremunerationpayablewhentheleaveistaken.

Annualandlongserviceleaveincludingapplicableon-coststhatdonotfallduewithinthenext12monthsaremeasuredatthepresentvalueofestimatedfuturepaymentstobemadeinrespectofservicesprovidedbyemployeesuptothereportingdate.Considerationisgiventothefuturewageandsalarylevels,experienceofemployeedeparturesandperiodsofservice.Ateachreportingperiod,thepresentvalueoffuturepaymentsareestimatedusingmarketyieldsonCommonwealthGovernmentbondswithtermstomaturitythatmatch,ascloselyaspossible,theestimatedfuturecashflows.In2012–13,therateusedtoestimatethepresentvalueofthesefuturepaymentsis101.3%(106.6%in2011–12).

Thelongserviceleaveliabilityisestimatedwithreferencetotheminimumperiodofqualifyingservice.Foremployeeswithlessthantherequiredminimumperiodof7yearsqualifyingservice,theprobabilitythatemployeeswillreachtherequiredminimumperiodhasbeentakenintoaccountinestimatingtheprovisionforlongserviceleaveandtheapplicableon-costs.

Theprovisionforannualleaveandlongserviceleaveincludesestimatedon-costs.Astheseon-costsonlybecomepayableiftheemployeetakesannualandlongserviceleavewhilein-service,theprobabilitythatemployeeswilltakeannualandlongserviceleavewhilein-servicehasbeentakenintoaccountinestimatingtheliabilityforon-costs.

AnnualleaveandlongserviceleaveliabilitiesareclassifiedascurrentliabilitiesintheBalanceSheetwheretherearenounconditionalrightstodeferthesettlementoftheliabilityforatleast12months.However,wherethereisanunconditionalrighttodefersettlementoftheliabilityforatleast12months,annualleaveandlongserviceleavehavebeenclassifiedasanon-currentliabilityintheBalanceSheet.




(z) SuperannuationTheDirectoratereceivesfundingforsuperannuationpaymentsaspartoftheGovernmentPaymentforOutputs.TheDirectoratethenmakespaymentsonafortnightlybasistotheTerritoryBankingAccount,tocovertheDirectorate’ssuperannuationliabilityfortheCommonwealthSuperannuationScheme(CSS)andthePublicSectorSuperannuationScheme(PSS).ThispaymentcoverstheCSS/PSSemployercontribution,butdoesnotincludetheproductivitycomponent.TheproductivitycomponentispaiddirectlytoComsuperbytheDirectorate.TheCSSandPSSaredefinedbenefitsuperannuationplansmeaningthatthedefinedbenefitsreceivedbyemployeesarebasedontheemployee’syearsofserviceandaveragefinalsalary.

SuperannuationpaymentshavealsobeenmadedirectlytosuperannuationfundsforthosemembersofthePublicSectorwhoarepartofsuperannuationaccumulationschemes.ThisincludesthePublicSectorSuperannuationSchemeAccumulationPlan(PSSAP)andschemesofemployeechoice.

Superannuationemployercontributionpayments,fortheCSSandPSS,arecalculated,bytakingthesalarylevelatanemployee’sanniversarydateandmultiplyingitbytheactuariallyassessednominalCSSorPSSemployercontributionrateforeachemployee.Theproductivitycomponentpaymentsarecalculatedbytakingthesalarylevel,atanemployee’sanniversarydate,andmultiplyingitbytheemployercontributionrate(approximately3%)foreachemployee.SuperannuationpaymentsforthePSSAParecalculatedbytakingthesalarylevel,atanemployee’sanniversarydate,andmultiplyingitbytheappropriateemployercontributionrate.Superannuationpaymentsforfundofchoicearrangementsarecalculatedbytakinganemployee’ssalaryeachpayandmultiplyingitbytheappropriateemployercontributionrate.

AsuperannuationliabilityisnotrecognisedintheBalanceSheetastheSuperannuationProvisionAccountrecognisesthetotalTerritorysuperannuationliabilityfortheCSSandPSS,andComsuperandtheexternalschemesrecognisethesuperannuationliabilityforthePSSAPandotherschemesrespectively.

TheACTGovernmentisliableforthereimbursementoftheemergingcostsofbenefitspaideachyeartomembersoftheCSSandPSSinrespectoftheACTGovernmentserviceprovidedafter1July1989.ThesereimbursementpaymentsaremadefromtheSuperannuationProvisionAccount.

(aa) Equity Contributed by the ACT GovernmentContributionsmadebytheACTGovernment,throughitsroleasowneroftheDirectorate,aretreatedascontributionsofequity.

IncreasesordecreasesinnetassetsasaresultofAdministrativeRestructuresarealsorecognisedinequity.

(ab) InsuranceMajorrisksareinsuredthroughtheACTInsuranceAuthority.Theexcesspayable,underthisarrangement,variesdependingoneachclassofinsuranceheld.

(ac) Third Party MoniesTheDirectorateholdsthirdpartymoniesinatrusteecapacityfortheACTMedicalRadiationScientistsBoard,theACTVeterinarySurgeonsBoard,theHealthDirectorateHumanResearchEthicsCommitteeandforresidentsofitsMentalHealthfacilities.TheDirectoratealsoholdsthirdpartymoniesinanadministrativecapacitywhichisprincipallyderivedfrompatientstreatedbysalariedspecialists.

Accordingly,thirdpartytransactionsareexcludedfromtheDirectorate’sfinancialstatements.DetailsofthirdpartymoniesareshownatNote43:ThirdPartyMonies.




(ad) Significant Accounting Judgements and EstimatesIntheprocessofapplyingtheaccountingpolicieslistedinthisnote,theDirectoratehasmadethefollowingjudgementsandestimatesthathavethemostsignificantimpactontheamountsrecordedinthefinancialstatements:

a. Fair Value of Assets:theDirectoratehasmadeasignificantjudgementregardingthefairvalueofitsassets.LandandLeaseholdImprovementshavebeenrecordedatmarketvalueofsimilarpropertiesasdeterminedbyanindependentvaluer.Buildingshavebeenrecordedatfairvaluebasedonadepreciatedreplacementcostasdeterminedbyanindependentvaluer.Thisvaluationisdeterminedbyreferencetothenewcostofthebuildingslessdepreciationfortheirphysical,functionalandeconomicobsolescence.

b. Employee Benefits: significantjudgementshavebeenappliedinestimatingtheliabilityforemployeebenefits.Theestimatedliabilityforemployeebenefitsrequiresaconsiderationofthefuturewagesandsalarylevels,experienceofemployeedeparturesandperiodsofservice.Theestimatealsoincludesanassessmentoftheprobabilitythatemployeeswillmeettheminimumserviceperiodrequiredtoqualifyforlongserviceleaveandthaton-costswillbecomepayable.FurtherinformationonthisestimateisprovidedinNote2(y):EmployeeBenefitsandNote3:ChangeinAccountingPolicyandAccountingEstimates,andCorrectionofaPriorPeriodError.

c. Cross Border (Interstate) Health Revenue:thecrossborderrevenueintheHealthDirectoraterelatestoactivitypriorto2012–13anditisbasedoncostweightedseparationsandanagreedprice.ActualpatientnumbersandservicesaresettledfollowinganacquittalprocessundertakeninsubsequentyearsandvariationstotherevenuerecognisedareaccountedforintheyearofsettlementwiththeStatesandNorthernTerritory.TheHealthDirectoratehasaccountedforpatientactivitythathasbeenagreedwiththeNewSouthWalesMinistryofHealth.Thereiscurrentlythreeyearsoffinalacquittalsforpatientactivitythathavenotbeenfinalisedduetoalengthyprocessofdatareview(InAugust2013the2009–10and2010–11financialyearacquittalprocesseswerefinalisedandpaidbytheNewSouthWalesMinistryofHealth).

d. Depreciation and Amortisation:theDirectoratehasmadeasignificantestimateinthelengthsofusefullivesoverwhichitsassetsaredepreciatedandamortised.Thisestimationistheperiodinwhichutilitywillbegainedfromtheuseoftheasset,basedoneitherestimatesfromofficersoftheDirectorateoranindependentvaluer.

e. Contingent Liabilities:contingentliabilitiesisanestimateprovidedbytheACTGovernmentSolicitorofthelikelyliabilityforlegalclaimagainsttheDirectorate.

f. Allowance for Impairment Losses: theDirectoratehasmadeasignificantestimateincalculatingtheallowanceforimpairmentlosses.TheallowanceisbasedonreviewsofoverduereceivablebalancesandtheamountoftheallowanceisrecognisedintheOperatingStatement.FurtherdetailsinrelationtothecalculationofthisestimateareoutlinedinNote2(o):Receivables.

g. Impairment of Assets: theDirectoratehasmadeasignificantjudgementregardingitsimpairmentofassetsbyundertakingaprocessofreviewinganylikelyimpairmentfactors.BusinessUnitsacrosstheDirectoratemadeanassessmentofanyindicationofimpairmentbyassessingagainstanimpairmentchecklist.




(ae) Impact of Accounting Standards Issued but Yet to be AppliedThefollowingnewandrevisedaccountingstandardsandinterpretationshavebeenissuedbytheAustralianAccountingStandardsBoardbutdonotapplytothecurrentreportingperiod.Thesestandardsandinterpretationsareapplicabletofuturereportingperiods.TheDirectoratedoesnotintendtoadoptthesestandardsandinterpretationsearly.Whereapplicable,theseAustralianAccountingStandardswillbeadoptedfromtheirapplicationdate.Itisestimatedthattheeffectofadoptingthebelowfinancialstatementpronouncements,whenapplicable,willhavenomaterialfinancialimpactontheDirectorate’sfinancialstatementsinfuturereportingperiods:

• AASB9FinancialInstruments(applicationdate1January2015);

• AASB13FairValueMeasurement(applicationdate1January2013);

• AASB119EmployeeBenefits(applicationdate1January2013);

• AASB1055BudgetaryReporting(applicationdate1July2014);

• AASB2010-7AmendmentstoAustralianAccountingStandardsarisingfromAASB9(December2010)[AASB1,3,4,5,7,101,102,112,118,120,121,127,128,131,132,136,137,139,1023&1038andInterpretations2,5,10,12,19&127](applicationdate1January2015);

• AASB2011-7AmendmentstoAustralianAccountingStandardsarisingfromtheConsolidationandJointArrangementsStandards[AASB1,2,3,5,7,9,2009–11,101,107,112,118,121,124,132,133,136,138,139,1023&1038andInterpretations5,9,16&17](applicationdate1January2013forfor-profitentitiesand 1January2014fornot-for-profitentities);

• AASB2011-8AmendmentstoAustralianAccountingStandardsarisingfromAASB13[AASB1,2,3,4,5,7,9,2009–11,101,107,112,118,119,120,121,128,131,132,133,134,136,138,139,140,141,1004,1023&1038andInterpretations2,4,12,13,14,17,19,131&132](applicationdate1January2013);

• AASB2011–10AmendmentstoAustralianAccountingStandardsarisingfromAASB119(September2011)[AASB1,8,101,124,134,1049&2011-8andInterpretation14]](applicationdate1January2013);

• AASB2012-2AmendmentstoAustralianAccountingStandards–Disclosures–OffsettingFinancialAssetsandFinancialLiabilities[AASB7&132](applicationdate1January2013);

• AASB2012-3AmendmentstoAustralianAccountingStandards–OffsettingFinancialAssetsandFinancialLiabilities[AASB132](applicationdate1January2014);

• AASB2012-5AmendmentstoAustralianAccountingStandardsarisingfromAnnualImprovements2009–2011Cycle[AASB1,1010,116,132&134andInterpretation2](applicationdate1January2013);

• AASB2012-6AmendmentstoAustralianAccountingStandards–MandatoryEffectiveDateAASB9andTransitionDisclosures[AASB9,2009–11,2010-7&2011-8](applicationdate1January2013);

• AASB2012–10AmendmentstoAustralianAccountingStandards–TransitionGuidanceandOtherAmendments[AASB1,5,7,8,10,11,12,13,101,102,108,112,118,119,127,128,132,133,134,137,1023,1038,1039,1049&2011-7andInterpretation12](applicationdate1January2013);and

• AASB2013-3AmendmentstoAASB136–RecoverableAmountDisclosuresforNon–FinancialAssets(applicationdate1January2014).



Note 3. Change in Accounting Policy and Accounting Estimates, and Correction of a Prior Period Error

Change in Accounting PolicyTheDirectoratehadnochangesinAccountingPolicyduringthereportingperiod.

Change in Accounting Estimates

Revision of the Estimation of Employee Benefit LiabilityAsdisclosedinNote2(y):Employeebenefits,annualleaveandlongserviceleave,includingapplicableon-costs,whichdonotfalldueinthenext12months,aremeasuredatthepresentvalueofestimatedpaymentstobemadeinrespectofservicesprovidedbyemployeesuptothereportingdate.ThepresentvalueoffuturepaymentsisestimatedusingtheGovernmentbondrate.

Lastfinancialyearthepresentvalueratewas106.6%,however,duetoachangeintheGovernmentbondratethatrateisnow101.3%.Assuchtheestimateofthelongserviceleaveliabilityhaschanged.Thischangehasresultedinadecreasetotheestimateofthelongserviceleaveliabilityandexpenseinthecurrentreportingperiodof$4,597,538.

Revision of Depreciation ChargeAsaresultoftheHealthInfrastructureProgram,someDirectoratebuildingsarebeingpartiallydemolishedandreconstructedandsomeareplannedtoundergosignificantrefurbishmentwork.Asnofutureeconomicbenefitswillbederivedfromthepartoftheassetfromthedateofdemolitionorstartofrefurbishment,thiswouldconstitutea de-recognitionofthatcomponentoftheasset.Therefore,depreciationwasacceleratedforthoseassetcomponents.ForfurtherdetailsseeNote15:DepreciationandAmortisation.

Correction of a Prior Period ErrorTheDirectoratehadnocorrectionofmaterialpriorperioderrorsduringthereportingperiod.

Note 4. Government Payment for OutputsGovernmentPaymentforOutputsisrevenuereceivedfromtheACTGovernmenttofundthecostsofdeliveringoutputs.TheACTGovernmentpaysGovernmentPaymentforOutputsappropriationonafortnightlybasis.

2013 $’000

2012 $’000

Revenue from the ACT Government

GovernmentPaymentforOutputsa 364,256 904,281

Total Government Payment for Outputs 364,256 904,281

a. ThedecreaseinGovernmentPaymentforOutputswasduetothecommencementofanewfundingarrangementundertheNationalHealthReformAgreement.UnderthenewarrangementtheDirectoratenolongerreceivesGovernmentPaymentforOutputsformostpublichospitalservices.GovernmentPaymentforOutputsforpublichospitalservicesareprovidedtotheACTLocalHospitalNetworkDirectorate.



Note 5. User ChargesUserchargerevenueisderivedbyprovidinggoodsandservicestootherACTGovernmentagenciesandtothepublic.UserchargerevenueisnotpartofACTGovernmentappropriationandispaidbytheuserofthegoodsorservices.Thisrevenueisdrivenbyconsumerdemandandiscommercialinnature.

2013 $’000

2012 $’000

User Charges – ACT Government

LocalHospitalNetworkFundinga 542,759 –

ServiceRevenue 810 825

Total User Charges – ACT Government 543,569 825

User Charges – Non-ACT Government

ServiceRevenueb 13,069 13,751

AmountsReceivedforHighlySpecialisedDrugsc 15,639 16,423

CrossBorder(Interstate)HealthRevenued 13,445 129,580

InpatientFeese 29,893 25,678

FacilitiesFeesf 23,846 22,929

Non-inpatientFees 780 766

Inventory Salesg 12,864 16,501

AccommodationandMeals 3,678 3,474

Total User Charges – Non-ACT Government 113,214 229,102

Total User Charges 656,783 229,927

a. ThisrevenueisduetothechangedfundingarrangementsfollowingtheimplementationoftheNationalHealthReformAgreementfrom 1July2012.ThisrevenuerelatestothereceiptoffundingfromtheACTLocalHospitalNetworkDirectorateforpublichospitalservicesprovidedbyCanberraHospitalandHealthServices.

b. Thedecreaseismainlyattributabletoareductioninthenumberofprivatepatientsrequiringimplantedprostheses.c. Thisismainlyduetousageofhighlyspecialiseddrugsbeinglowerthaninthepreviousyear.d. ThedecreaseisduetothechangedfundingarrangementsforthetreatmentofinterstatepatientsinACThospitalsfollowingthe

implementationofNationalHealthReformAgreement.ThisrevenueisnowcollectedbytheACTLocalHealthNetworkDirectorate.e. TheincreasemainlyrelatestorevenuereceivedforprioryearactivityforDepartmentofVeterans’Affairs(DVA)patientsfollowingthe

acquittalsof2010–11and2011–12financialyears.f. TheincreaseisattributabletothefullyearoperationofthePositronEmissionTomography(PET)/ComputerisedTomography(CT)service

whichcommencedoperationduring2012.g. Thereductionisduetoreduceddemandfromtheprivatesectorforthesupplyofmedicalandsurgicalsupplies.



Note 6. Interest2013

$’0002012

$’000

Revenue from Non-ACT Government Entities

InterestRevenue 106 97

Total Interest Revenue from Non-ACT Government Entities 106 97

Total Interest Revenue 106 97

Totalinterestrevenuefromfinancialassetsnotatfairvaluethroughprofitandloss 106 97

Note 7. Distribution from Investments with the Territory Banking Account

2013 $’000

2012 $’000

Revenue from ACT Government Entities

DistributionfromInvestmentswiththeTerritoryBankingAccount 144 157

Total Distribution from Investments with the Territory Banking Account 144 157

Note 8. Resources Received Free of ChargeResourcesreceivedfreeofchargerelatetogoodsand/orservicesbeingprovidedfreeofchargefromotheragencieswithintheACTGovernment.GoodsandservicesreceivedfreeofchargefromentitiesexternaltotheACTGovernmentareclassifiedasdonations.DonationsareshowninNote11:OtherGains.

2013 $’000

2012 $’000

Revenue from within ACT Government

LegalServices 1,010 954

Total Resources Received Free of Charge 1,010 954



Note 9. Other RevenueOtherRevenuearisesfromthecoreactivitiesoftheDirectorate.OtherRevenueisdistinctfromOtherGains,asOtherGainsaretransactionsthatarenotpartofthecoreactivitiesoftheDirectorate.

2013 $’000

2012 $’000

Revenue from Non-ACT Government Entities

Grantsa 19,425 23,542

Total Revenue from Non-ACT Government Entities 19,425 23,542

Total Other Revenue 19,425 23,542

Contribution Analysis

Contributionswhichhaveconditionsofexpenditurestillrequiredtobemet

Grants 583 546

TheDirectoratehasreceivedgrantsfromvariousentitieswhichmustbespentonspecificpurposes.

a. Thedecreaseisduetothereceipt,in2011–12,ofalargeone-offgrantfromHealthWorkforceAustraliafortrainingandeducationofthehealthworkforceinACTandsurroundingregions,includingpurchaseofstudentaccommodationandtrainingequipment.

Note 10. Gains on Investments2013

$’0002012

$’000

Revenue from ACT Government Entities

UnrealisedGainsonInvestments 21 –

Total Gains on Investments 21 –



Note 11. Other GainsOtherGainsaretransactionsthatarenotpartoftheDirectorate’scoreactivities.OtherGainsaredistinctfromOtherRevenue,asOtherRevenuearisesfromthecoreactivitiesoftheDirectorate.

2013 $’000

2012 $’000

GainsfromtheSaleofAssetsa 331 206

Donationsb 2,025 979

Total Other Gains 2,356 1,185

Contribution Analysis

Contributionswhichhaveconditionsofexpenditurestillrequiredtobemet

Donations 594 282

TheDirectoratehasreceiveddonationsfromorganisationsandthegeneralpublicwhichmustbespenton specificpurposes.

a. Thismainlyrelatestothedisposalofmotorvehiclesthatwereonafinanceleasewhichmaturedduringtheyear.Theincreaseismainlyduetoahighernumberofleasesthatmaturedthanin2012.

b. Theincreaseismainlyattributabletoincreasesinspecialpurposedonationsaswellasdonationsfromthepublic.

Note 12. Employee Expenses2013

$’0002012

$’000

WagesandSalariesa 507,914 473,758

AnnualLeaveExpensesb 14,253 11,633

LongServiceLeaveExpensesc 8,253 16,297

WorkerCompensationInsurancePremiumd 18,361 17,407

TerminationPaymentse 778 1,314

OtherEmployeeBenefitsandOn-Costsf 6,946 7,523

Total Employee Expenses 556,505 527,932

No. No.

Averagefull-timeequivalentstafflevelsduringtheyearwere: 5,415 5,296

a. TheincreaseinWagesandSalariesmainlyrelatestopayrisesundercollectiveagreementsandstaffincreasesrelatedtogrowthinservicesinCriticalCare,AcuteCare,WomenandChildren’sHospital,SurgicalServices,AdultMentalHealth,RehabilitationandCancer.

b. TheincreaseinAnnualLeavelargelyrelatestotheimpactofpayrisesandanincreaseinstaffnumbersin2013.c. ThedecreaseinLongServiceLeaveismainlyduetoareductionintherateusedtoestimatethepresentvalueofLongServiceLeave

paymentsfrom106.6%to101.3%.d. Theincreaserelatestolabourcosts,astheWorkers’CompensationInsurancePremiumisaffectedbyincreasedwagesandsalaries.e. Thedecreasereflectsalowernumberofredundanciesin2013.f. Thedecreaseismainlyduetolowerrecruitmentagencyfeesthaninpreviousyearduetochangedrecruitmentpractice.



Note 13. Superannuation Expenses2013

$’0002012

$’000

SuperannuationContributionstotheTerritoryBankingAccounta 39,024 35,961

ProductivityBenefitb 5,011 5,286

SuperannuationPaymenttoComsuper(forthePSSAP) 3,525 3,433

SuperannuationtoExternalProvidersc 24,716 21,387

Total Superannuation Expenses 72,276 66,067

a. TheincreaseisduetoanincreaseintherateforthePublicSectorSuperannuationScheme(PSS)from17.8%in2012to19.7%in2013.ThiswaspartiallyoffsetbyareductionintheratefortheCommonwealthSuperannuationScheme(CSS)from19.7%in2012to18.5%in2013.

b. ThedecreaseisduetodecliningnumberofmembersintheCSSandPSS.c. Theincreaseisduetopayrisesandthatmostnewstartersaremembersofsuperannuationschemesmanagedbyexternalproviders.

Note 14. Supplies and Services2013

$’0002012

$’000

AuditExpensesa 504 601

BloodProductsb 9,344 7,922

ClinicalExpenses/MedicalSurgicalSuppliesc 57,436 55,875

Communications 3,690 3,835

Computer Expensesd 32,007 26,871

ContractorsandConsultantse 5,535 6,061

DomesticServices,FoodandUtilitiesf 31,762 27,513

GeneralAdministrationg 17,959 15,570

HireandRentalCharges 4,065 3,918

Insuranceh 28,550 29,190

Minor Capitali 4,303 3,265

Non-ContractServicesj 8,074 7,301

OperatingLeaseRentalPayments 6,459 6,175

Pharmaceuticalsk 36,863 38,020

PrintingandStationery 2,253 2,219

PropertyandRentalExpensesl 3,009 2,548

PublicRelationsm 667 1,011

Publications 1,191 1,110

RepairsandMaintenancen 13,227 12,094

StaffDevelopmentandRecruitmento 6,277 5,773

TravelandAccommodation 1,178 1,308

Vehicle Expenses 1,554 1,638

VisitingMedicalOfficers 25,426 25,610

Total Supplies and Services 301,333 285,428



Note 14. Supplies and Services (Continued)a. Thedecreaseisduetoaone-offauditofemergencydepartmentdataconductedin2012.b. Theincreaseismainlyattributabletopriceescalationandanincreaseindemandforhighcostbloodproducts.c. Theincreaseismainlyattributabletopriceescalation.d. Theincreaseisduetoacombinationoffactors,includingpriceescalation,increaseinstaffnumbersandsupportcostsforprojectsthat

becameoperationalin2013.TheyincludeDigitalWirelessNetworkattheCanberraHospitalcampus,DigitalIntensiveCareUnitClinicalInformationSystem,E-Referral&DischargeSummaryandClinicalSystemsProject.

e. Thedecreaseismainlyattributabletoareductionintheuseofconsultantsinlinewithatargetedsavingsplan.f. Theincreaseismainlyattributabletocleaningcontractpriceincreases,increasesinfloorspaceandnewfacilitiesandthecarbontaxlevy.g. Theincreaseismainlyduetoacombinationoffactors,includingpaymentstoACTEmergencyServicesforoperatinganambulance,

increasedcostoffreight,paymenttotheAustralianNationalUniversity(ANU)forthemaintenanceofthemedicalresearchanimalhousethatwasre-locatedtotheANUcampusandpriceescalationforServiceLevelAgreementchargespaidtoSharedServices.

h. Thedecreaseintheinsurancepremiumreflectsareductionfollowinganactuarialassessmentofthefuturecostofclaims.Thekeyelementbeingadownwardrevisiontothenumberofassumedsmallclaimsettlementsforthe2012–13insuranceyear.

i. Theincreaseismainlyduetothequantityofmedicalequipmentpurchasesthatfellbelowtheassetcapitalisationthresholdof$5,000.j. Theincreaseismainlyduetohigherusageofagencynursingandagencydentalstafftocovervacancies,whichwerepartiallyoffsetbya

reductionintheuseofagencymedicalstaff.Agencystaffreferstotemporarystaffsourcedatshortnoticefromexternallabourproviders.k. Thedecreaseismainlyduetoacombinationoffactors,includingareductionintheusageofhighlyspecialised(s100)drugs,price

decreasesforsomedrugsandareductionintheusageofsomeexpensivedrugs.l. Thisincreasemainlyrelatestoincreasesintemporaryrentalaccommodationfornewmedicalstaff.m. Thedecreaseismainlyduetoareductioninuseofpromotionalmaterials.n. Thisismainlyattributabletoincreasedexpenditureonpreventativeandreactivemaintenanceofageinginfrastructureandanincrease

inbreakdownrepairsformedicalequipment.

o. Theincreasemainlyrelatestotrainingexpensesandstudyreimbursements.

Note 15. Depreciation and Amortisation2013

$’0002012

$’000

Depreciation

Buildingsa 35,854 12,034

PlantandEquipment 10,952 11,291

LeaseholdImprovementsb 1,754 1,078

Total Depreciation 48,560 24,403

Amortisation

IntangibleAssets 4,454 4,526

Total Amortisation 4,454 4,526

Total Depreciation and Amortisation 53,014 28,929

Change in Depreciation Due to De-recognition of Components of BuildingsDepreciationwasacceleratedtode-recognisepartoftheoriginalWomenandChildren’sHospitalandTuggeranongHealthCentrewhichwerepartiallydemolishedforreconstructionandTheCanberraHospitalPsychiatricUnitbuildingandTheCanberraHospitalTowerBlocklevel5whichareplannedtoundergosignificantrefurbishmentwork.Asaresultdepreciationexpensesincreasedby$22.1millioninthecurrentaccountingperiod.

a. TheincreasemainlyrelatestoacceleratingthedepreciationfortheoriginalWomenandChildren’sHospital($16.1million)andTuggeranongHealthCentre($1.4million)whichwerepartiallydemolishedforreconstructionandfortheCanberraHospitalPsychiatricUnitbuilding($1.9million)andtheCanberraHospitalTowerBlocklevel5($2.7million)whichareplannedtoundergosignificantrefurbishmentwork.Theadditionofnewbuildings,namelytheCentenaryHospitalforWomenandChildren,GungahlinCommunityHealthCentreandCancerPatientAccommodationpropertyinDuffyhavealsocontributedtothisincrease.

b. TheincreaseismainlyduetoadditionalleaseholdimprovementsatVillageCreekCentreand1MooreStreet.



Note 16. Grants and Purchased ServicesGrantsaresumsofmoneygiventoorganisationsorindividualsforaspecifiedpurposedirectedatachievinggoalsandobjectivesconsistentwithGovernmentpolicyonhealthpromotion.

PurchasedServicesareamountspaidtoobtainservicesbytheDirectoratefromotherACTGovernmentagenciesandexternalparties.Theymaybeforcapital,currentorrecurrentpurposesandtheyareusuallysubjecttotermsandconditionssetoutinacontract,agreement,orbylegislation.

Non-GovernmentOrganisationserviceprovidersprovideservicesinarangeofareasincludingHomeandCommunityCare,AlcoholandDrug,CommunityMentalHealth,Women’sHealth,AgedCareandAboriginalHealth.

PurchasedServicesfromCalvaryHospitalisfortheprovisionofhealthcarefortheNorthCanberrapopulation.

CrossBorderHealthCostsrelatestocostsincurredbyACTresidentsininterstatehospitals.

ExpendituretoOtherServiceProvidersaremainlyfortheprovisionofelectivesurgeryproceduresbyprivatehospitals.

2013 $’000

2012 $’000

Grants

Grants 2,637 2,709

Total Grants 2,637 2,709

Purchased Services

Calvary Hospitala 14,708 151,855

Non-GovernmentOrganisationsb 59,436 71,515

CrossBorderHealthCostsc 2,788 16,675

Otherd 3,319 4,758

Total Purchased Services 80,251 244,803

Total Grants and Purchased Services 82,888 247,512

a. ThedecreaseinPurchasedServicesfromCalvaryHospitalisduetothecommencementoftheNationalHealthReformAgreement.PublichospitalactivitiesthatmeetthefundingcriteriaoftheIndependentHospitalPricingAuthorityarenowpurchasedthroughtheACTLocalHospitalNetworkDirectorate.

b. Thedecreaseisduetothechangedfundingarrangementforover65yearoldsandtheHomeandCommunityCareProgramwhicharenowbeingdirectlyfundedbytheCommonwealthGovernment,offsetbyindexation,growthinmentalhealthservicesandelectivesurgeryproceduresdeliveredbythenon-governmentsector.

c. Thedecreaseisduetocrossborderhospitalservicesbeingpurchasedin2012–13bytheACTLocalHospitalNetworkDirectorateratherthantheHealthDirectorate.The2013amountisduetothefinalisationofprioryearacquittals.

d. Thedecreaseisduetoareducedlevelofelectivesurgeryprocedurespurchasedfromprivateproviders.



Note 17. Borrowing CostsBorrowingcostisforfinancechargesinrespectoffinanceleasesfortheDirectorate’sfleetofvehiclesand clinicalequipment.

2013 $’000

2012 $’000

FinanceCharges 375 415

Total Borrowing Costs 375 415

Note 18. Cost of Goods SoldCostofGoodsSoldrepresentshospitalsuppliessoldtoprivatehospitals.

2013 $’000

2012 $’000

CostofGoodsSolda 10,475 13,359

Total Cost of Goods Sold 10,475 13,359

a. Thedecreaseisduetoreduceddemandforsuppliesfromtheprivatesector.

Note 19. Other Expenses2013

$’0002012

$’000

Miscellaneous Expensesa 2,219 1,327

LegalSettlements 2,374 2,427

Waivers,ImpairmentLossesandWrite-offs(see Note 20)b 2,292 2,764

LossonSaleofAssetsc 38 136

AssetsDonatedtoThirdPartiesd – 1,466

Total Other Expenses 6,923 8,120

a. TheincreasemainlyrelatestotheexpensingoffeasibilityanddesigncostsoftheSkillsDevelopmentCentreProject.b. Thedecreasemainlyrelatestoareductionintheamountofdebtwrittenoffanddebtsassessedasimpaired.c. Thisrelatestothesaleofmotorvehiclesonfinanceleasethatmaturedduringtheyear.Thereductionreflectsabettermarketpricefor

secondhandcars.d. 2012relatestotransferofownershipofIntensiveCareUnitequipmenttoCalvaryPublicHospital.



Note 20. Waivers, Impairment Losses and Write-OffsUnderSection131ofthe Financial Management Act 1996,theTreasurermay,inwriting,waivetherighttopaymentofanamountpayabletotheTerritory.

AwaiveristherelinquishmentofalegalclaimtoadebtoverwhichtheDirectoratehascontrol.Thewrite-offofadebtistheaccountingactiontakentoremoveadebtfromthebooksbutdoesnotrelinquishthelegalrightoftheDirectoratetorecovertheamount.Thewrite-offofdebtsmayoccurforreasonsotherthanwaivers.

Thewaivers,impairmentlossesandwrite-offslistedbelowhaveoccurredduringthereportingperiodfor theDirectorate.

No.2013

$’000 No.2012

$’000

Waivers

Waiversa 1 14 - -

Total Waivers 1 14 - -

Impairment Losses

ImpairmentLossfromReceivables

TradeReceivablesb 92 395 29 640

Total Impairment Loss from Receivables 92 395 29 640

Impairment Loss from Property, Plant and Equipment

PlantandEquipmentc 156 1,121 8 613

Total Impairment Loss from Property, Plant and Equipment 156 1,121 8 613

Total Impairment Losses 248 1,516 37 1,253

Write-Offs

IrrecoverableDebtsd 1,949 762 2,045 1,511

Total Write-Offs 1,949 762 2,045 1,511

Total Waivers, Impairment Losses and Write-Offs 2,198 2,292 2,082 2,764

a. TheincreaseisduetotheTreasurer’sdecision,in2013,tograntadebtora50percentwaiverofdebtowedforhospitaltreatmentoncompassionategrounds.

b. Thisislargelyattributabletolowerlevelsofineligible(thosenotcoveredbyMedicare)andcompensablepatients’debts,thatareimpaired.c. Theincreaseismainlyattributabletomedicalandsurgicalequipmentthathasbeenassessedasnotoperatingefficiently,orisunder

repairorcannotbelocatedwithinthecampus.d. Thedecreasemainlyrelatestolowernumberofhighvaluewrite-offsin2013.



Note 21. Auditor’s RemunerationAuditor’sremunerationrepresentsfeeschargedbytheAuditor-General’sOfficeforfinancialauditservicesprovidedtotheDirectorate.

2013 $’000

2012 $’000

Audit Services

AuditFeesPaidtotheACTAuditor-General’sOffice 225 227

Total Audit Fees 225 227

NootherserviceswereprovidedbytheACTAuditor-General’sOffice.

Note 22. Act of Grace PaymentsUnderSection130oftheFinancial Management Act 1996,theTreasurermay,inwriting,authoriseActofGracePaymentsbemadebytheDirectorate.ActofGracePaymentsareamethodofprovidingequitableremediestoentitiesorindividualsthatmayhavebeenunfairlydisadvantagedbytheGovernmentbuthavenolegalclaimtothepayment.

TheHealthDirectoratemadenoActofGracePaymentsduringthereportingperiodortheprioryear.

Note 23. Cash and Cash EquivalentsTheDirectorateholdsanumberofbankaccounts.In2013,aspartoftheWhole-of-Governmentbankingarrangements,theDirectoratetransitionedbankingservicesfromtheCommonwealthBanktoWestpacBankingCorporation.Aspartofthesearrangements,theDirectoratereceivedinterestattherateof3.44%(4.87%in2012).Thesefundsareabletobewithdrawnuponrequest.

2013 $’000

2012 $’000

CashonHand 46 47

CashatBanka 9,516 69,332

Total Cash and Cash Equivalents 9,562 69,379

a. Thedecreaseincashatbankismainlyduetothe2012balancebeingunusuallyhighduetothelevelsofpayablesassociatedwithcashdrawndownfromTreasuryandthetimingofthepaymentofcapitalworksinvoices.



Note 24. Receivables2013

$’0002012

$’000

Current Receivables

TradeReceivablesa 9,519 8,705

Less:AllowanceforImpairmentLosses (1,668) (1,697)

7,851 7,008

OtherTradeReceivablesb 74,767 13,910

Less:AllowanceforImpairmentLosses (478) (538)

74,289 13,372

NetGSTReceivable 4,035 4,572

4,035 4,572

AccruedRevenuec 4,254 6,349

AccruedRevenue–CrossBorderd 35,910 26,429

40,164 32,778

Total Current Receivables 126,339 57,730

Total Non-Current Receivables – –

Total Receivables 126,339 57,730

a. Theincreasemainlyrelatestoprivatepatientsfeesandanincreaseindebtorsforconsumablessoldtoprivatehospitals.b. TheincreasemainlyrelatestoreceivablefromtheACTLocalHospitalNetworkDirectoratefortheprovisionofhospitalservicesunder

thenewfundingarrangement,anincreaseinreceivableforCalvaryHealthCareforsecondedmedicalstaffreimbursements,andforreimbursementforresidentialcareservicesbytheCommunityServicesDirectorate.

c. Thedecreasemainlyrelatestoprioryearacquittals,settledduringtheyearwiththeDepartmentofVeterans’Affairsforhospitalcareprovidedtoveterans.

d. TheincreasemainlyreflectsadjustmentsforprioryearactivitynotyetpaidbytheNewSouthWalesMinistryofHealth.



Note 24. Receivables (Continued)Ageing of Receivables

Not Overdue $’000

Past Due Less Than

30 daysf $’000

Past Due 30 to 60

daysf $’000

Past Due Greater

Than 60 daysf

$’000Total

$’000

2013

NotImpaired

Receivablese 77,647 3,503 1,486 7,793 90,429

CrossBorderg 35,910 – – – 35,910

Impaired

Receivables – – – 2,146 2,146

2012

NotImpaired

Receivables 24,811 1,269 561 4,660 31,301

CrossBorder 26,429 – – – 26,429

Impaired

Receivables – – – 2,235 2,235

Receivablesarewritten-offduringtheyearinwhichtheyareconsideredtobecomeuncollectible.

e. ‘NotOverdue’componentofReceivableslargelyconsistofaccruedrevenuesforDepartmentofVeterans’Affairspatientswhicharenotdueuntilanacquittalprocessinsubsequentyears,GoodsandServicesInputTaxreceivablefromtheAustralianTaxationOfficeandprivatepatientfeesaccruedinJune. ‘PastDue–GreaterThan60Daysaremostlythirdparty,workers’compensationorpublicliabilitytransactionswhichhavebecomethesubjectoflegalclaimsastoresponsibilityforthepayment.Substantialdelayscanthereforeoccurbeforeliabilityforsuchdebtsisdetermined.ThisalsoincludesamountsreceivablefromCalvaryHealthCareformedicalofficerssecondedfromtheCanberraHospital.

f. Theincreaseintheoverdueamountsin2013islargelyattributabletopaymentsduefromCalvaryHealthCare.g. CrossBorderreceivablesisfundingduefromtheNewSouthWalesMinistryofHealthforadmittedandnon-admittedpatientservices

providedtoresidentsofNewSouthWales.Thisiscategorisedasnotoverdueasthefundingagreementdoesnotmandateatimeframeforpaymentpriortofinalacquittalofactivitynumbersforeachperiodandthefinalacquittalsareyettooccur.InAugust2013the NewSouthWalesMinistryofHealthfinalisedandpaidinfullthe2009-10and2010-11acquittals($27.7million).



Note 24. Receivables (Continued)2013

$’0002012

$’000

Reconciliation of the Allowance for Impairment Losses

AllowanceforImpairmentLossesattheBeginningoftheReportingPeriod 2,235 1,601

AdditionalAllowanceandImpairmentLossesRecognised 395 640

ReductioninAllowance (484) –

ReductioninAllowanceResultingfromaWrite-BackagainsttheReceivables – (6)

Allowance for Impairment Losses at the End of the Reporting Period 2,146 2,235

Classification of ACT Government/Non-ACT Government Receivables

ReceivableswithACTGovernmentAgencies

NetTradeReceivables 67 42

NetOtherTradeReceivables 60,349 1,677

AccruedRevenue 16 17

NetGoodsandServicesTaxReceivable 52 –

Total Receivables with Other ACT Government Agencies 60,484 1,736

ReceivableswithNon-ACTGovernmentEntities

NetTradeReceivables 7,784 6,966

NetOtherTradeReceivables 49,850 11,695

NetGoodsandServicesTaxReceivables 3,983 4,572

AccruedRevenue 4,238 32,761

Total Receivables with Non-ACT Government Entities 65,855 55,994

Total Receivables 126,339 57,730



Note 25. InventoriesTheDirectorate’sinventoryconsistsofPharmaceuticals,MedicalandSurgicalSupplies,PathologySuppliesandgeneralconsumables.

2013 $’000

2012 $’000

Current Inventory

PurchasedItems–Cost 8,113 7,553

Total Current Inventory 8,113 7,553

Total Inventory 8,113 7,553

Note 26. Assets Held for SaleTheDirectoratehas2motorvehicleswhichhavebeenreturnedtotheFleetManagerandareexpectedtobesoldinJuly2013.Theresidualandallleasepaymentshavebeenpaid.Assuchthesevehicleshavebeenclassifiedasplantandequipmentheldforsale.

2013 $’000

2012 $’000

PlantandEquipmentheldforSalea 34 169

Total Assets Held for Sale 34 169

a. Thedecreaseisduetothelowernumberofvehiclesheldforsale(twoin2013comparedtotenin2012).

Note 27. Investments2013

$’0002012

$’000

Non-Current Investments

InvestmentswiththeTerritoryBankingAccount–FixedInterestPortfolioatFairValue 3,011 2,990

Total Non-Current Investments 3,011 2,990

Total Investments 3,011 2,990



Note 28. Property, Plant and EquipmentProperty,plantandequipmentincludesthefollowingclassesofassets–land,buildings,leaseholdimprovementsandplantandequipment.Property,plantandequipmentdoesnotincludeassetsheldforsale.

LandincludesleaseholdlandheldbytheDirectorate.

Buildingsincludehospitalbuildings,communityhealthcentresandamultistoreycarpark.

Leaseholdimprovementsrepresentcapitalexpenditureincurredinrelationtoleasedassets.TheDirectoratehasfit-outsinitsleasedbuildings.

Plantandequipmentincludesmedicalequipment,motorvehicles,mobileplant,airconditioningandheatingsystems,officeandcomputerequipment,furnitureandfittings,andothermechanicalandelectronicequipment.

2013 $’000

2012 $’000

Land and Buildings

LandatFairValue 36,827 36,820

Total Land Assets 36,827 36,820

BuildingsatFairValuea 669,366 551,154

Less:AccumulatedDepreciation (48,881) (13,027)

Total Written Down Value of Buildings 620,485 538,127

Total Land and Written Down Value of Buildings 657,312 574,947

Leasehold Improvements

LeaseholdImprovementsatFairValue 9,761 9,244


Total Written Down Value of Leasehold Improvements 6,629 7,866

Plant and Equipment

PlantandEquipmentatCost 104,271 96,314


Less:AccumulatedImpairmentLosses (1,121) (613)

Total Written Down Value of Plant and Equipment 43,978 44,936

Total Written Down Value of Property, Plant and Equipment 707,919 627,749

Assets Under a Finance Lease

Assetsunderafinanceleaseareincludedintheassetclasstowhichtheyrelateintheabovedisclosure.

Assetsunderafinanceleasearealsorequiredtobeseparatelydisclosedasoutlinedbelow.

Carrying Amount of Assets Under a Finance Lease

PlantandEquipmentUnderaFinanceLease 8,775 7,538

AccummulatedDepreciationofPlantandEquipmentunderaFinanceLease (2,130) (2,485)

Total Written Down Value of Assets Under a Finance Lease 6,645 5,053

a. TheincreasemainlyrelatestocompletednewbuildingcapitalworksprojectsincludingtheCentenaryHospitalforWomenandChildren($90.0million),theGungahlinCommunityHealthCentre($18.7million)andtheCancerPatientAccommodationproperty($1.4million).



Note 28. Property, Plant and Equipment (Continued)

Reconciliation of Property, Plant and EquipmentThefollowingtableshowsthemovementofProperty,PlantandEquipmentduring2012–13.

Land $’000

Buildings $’000


$’000

Plant and Equipment

$’000Total

$’000

CarryingAmountattheBeginningoftheReportingPeriod 36,820 538,127 7,866 44,936 627,749

Additions 7 118,213 517 13,162 131,899

AssetsClassifiedasHeldforSale – – – (34) (34)

Disposals – – – (4,561) (4,561)

Depreciation – (35,854) (1,754) (10,952) (48,560)

DepreciationWriteBackforAssetDisposals – – – 1,934 1,934

ImpairmentLossesRecognisedinthe Operating(Deficit) – – – (1,121) (1,121)

ReversalofImpairmentLossesRecognisedintheOperating(Deficit) – – – 613 613

Carrying Amount at the End of the Reporting Period 36,827 620,486 6,629 43,978 707,919

ThefollowingtableshowsthemovementofProperty,PlantandEquipmentduring2011–12.

Land $’000

Buildings $’000


$’000

Plant and Equipment

$’000Total

$’000

CarryingAmountattheBeginningoftheReportingPeriod 36,820 501,245 8,014 46,521 592,600

Additions – 49,910 930 12,378 63,218

Revaluation(Decrement) – (994) – – (994)

AssetsClassifiedasHeldforSale – – – (169) (169)

Disposals – – – (2,428) (2,428)

Depreciation – (12,034) (1,078) (11,291) (24,403)

ImpairmentLossesRecognisedintheOperating(Deficit) – – – (613) (613)

ReversalofImpairmentLossesRecognisedintheOperating(Deficit) – – – 538 538

Carrying Amount at the End of the Reporting Period 36,820 538,127 7,866 44,936 627,749

Valuation of Non-Current AssetsCertifiedpracticingregisteredvaluersAONRisksSolutionsperformedanindependentvaluationoftheDirectorate’sLand,BuildingsandLeaseholdImprovementsasat30June2011.Namesandqualificationsofthevaluers are:

1. MrHeinzLindemanAAPI–CertifiedPractisingValuer

2. MrShaneWelshASA–CertifiedPractisingValuer,Plant&Machinery

Thenextvaluationwillbeundertakenduring2013–14.



Note 29. Intangible AssetsTheDirectoratehasbothinternallygeneratedsoftwareandexternallypurchasedsoftware.Theinternallygeneratedsoftwareconsistsmainlyof‘thepatientadministrationsystemsoftware’,whiletheexternallypurchasedsoftwareconsistsmainlyofthe‘patientadmissionsystemsoftwarelicence’.

2013 $’000

2012 $’000

Computer Software

InternallyGeneratedSoftware

ComputerSoftwareatCosta 39,819 33,599

Less:AccumulatedAmortisation (28,183) (23,729)

Total Internally Generated Software 11,636 9,870

Total Computer Software 11,636 9,870

Total Intangible Assets 11,636 9,870

a. TheincreaseisduetoadditionalsoftwarepurchasesfortheIntensiveCareUnitMetavisionSystem,IntegratedPatientMealSystem,HealthServicesDirectoryandenhancementstotheACTPatientAdministrationSystem.

Reconciliation of Intangible Assets

ThefollowingtableshowsthemovementofeachclassofIntangibleAssetdistinguishingbetweeninternallygeneratedandexternallypurchasedintangiblesfromthebeginningtotheendof2012–13.

Internally Generated

Software $’000

Externally Purchased

Software $’000

Total $’000

CarryingAmountattheBeginningoftheReportingPeriod 9,870 – 9,870

Additions 6,220 – 6,220

Amortisation (4,454) – (4,454)

Carrying Amount at the End of the Reporting Period 11,636 – 11,636

ThefollowingtableshowsthemovementofeachclassofIntangibleAssetdistinguishingbetweeninternallygeneratedandexternallypurchasedintangiblesfromthebeginningtotheendof2011–12.

Internally Generated

Software $’000

Externally Purchased

Software $’000

Total $’000

CarryingAmountattheBeginningoftheReportingPeriod 12,827 – 12,827

Additions 1,545 – 1,545

Amortisation (4,526) – (4,526)

OtherCharges 24 – 24

Carrying Amount at the End of the Reporting Period 9,870 – 9,870



Note 30. Capital Works in ProgressCapitalWorksinProgressareassetsbeingconstructedoverperiodsoftimeinexcessofthepresentreportingperiod.Theseassetsoftenrequireextensiveinstallationworkorintegrationwithotherassets,andcontrastwithsimplerassetsthatarereadyforusewhenacquired,suchasmotorvehiclesandequipment.CapitalWorksinProgressarenotdepreciatedastheDirectorateisnotcurrentlyderivinganyeconomicbenefitsfromthem.

Assets,whichareunderconstruction,includehospitalbuildings,communityhealthcentresandcomputersoftware.

2013 $’000

2012 $’000

BuildingWorksinProgressa 186,265 177,252

PlantandEquipmentWorksinProgressb 915 154

ComputerSoftwareWorksinProgressc 54,398 40,641

OtherWorksinProgress 58 188

Total Capital Works in Progress 241,636 218,235

a. TheincreaseinbuildingworksinprogressismainlyforworkscarriedoutontheCommunityHealthCentresinBelconnenandTuggeranong,theCanberraRegionCancerCentre,theCentenaryHospitalforWomenandChildren,forClinicalServicesRedevelopment,theCanberraHospitalEmergencyDepartmentIntensiveCareUnit,andvariouscapitalupgradeprojects.

b. TheincreaseinplantandequipmentworksinprogressisduetothecommencementoftheImprovingCriticalCareOutreachandTrainingintheACTandSouthernNSWProject.Thisprojectistoprovideaccesstoarangeofvisualandaudiocommunicationtoolstoassistinthedecisionmakingandprovisionofmedicalcareforcriticallyillpatients.

c. Theincreaseincomputersoftwareworksinprogressismainlyforthee-HealthprojectwhichisprovidingtheinformationtechnologyandcommunicationsystemsneededtosupporttheHealthInfrastructureProgramandNationalE-HealthProgram,theIdentityAccessManagementprojectwhichisprovidingasystemthatautomatesandmanagesidentityandaccesstoinformation,andtheDigitalMammographyprojectwhichischangingthebreastscreeningsystemfromanalogue(hardcopy)todigital(softcopy).

Reconciliation of Capital Works in ProgressThefollowingtableshowsthemovementofCapitalWorksinProgressduring2012-2013.

Building Works in Progress

$’000

Plant and Equipment

Works in Progress

$’000

Computer Software Works in Progress

$’000

Other Works in Progress

$’000Total

$’000

Carrying Amount at the Beginning of the Reporting Period 177,252 154 40,641 188 218,235

Additions 128,826 887 19,911 28 149,651

CapitalWorksinProgressCompletedandTransferredtoProperty,PlantandEquipmentandIntangibleAssets

(118,715) (121) (6,154) (28) (125,018)

CapitalWorksExpensed (1,098) (5) – (130) (1,232)

Carrying Amount at the End of the Reporting Period 186,265 915 54,398 58 241,636



Note 30. Capital Works in Progress (Continued)

Reconciliation of Capital Works in ProgressThefollowingtableshowsthemovementofCapitalWorksinProgressduring2011-2012.

Building Works in Progress

$’000

Plant and Equipment

Works in Progress

$’000

Computer Software Works in Progress

$’000

Other Works in Progress

$’000Total

$’000

CarryingAmountattheBeginningoftheReportingPeriod 85,189 98 23,138 153 108,578

Additions 143,780 56 19,138 35 163,009

CapitalWorksinProgress CompletedandTransferredto Property,PlantandEquipmentand IntangibleAssets

(49,910) – (1,569) – (51,479)

CapitalWorksExpensed (1,807) – (66) – (1,873)

Carrying Amount at the End of the Reporting Period 177,252 154 40,641 188 218,235

Note 31. Other Assets2013

$’0002012

$’000

Current Other Assets

Prepayments 2,675 2,515

Total Current Other Assets 2,675 2,515

Total Other Assets 2,675 2,515



Note 32. Payables2013

$’0002012

$’000

Current Payables

TradePayablesa 17,351 11,280

Other Payables 19 62

AccruedExpenses 70,403 68,203

GST Payable – 415

Total Current Payables 87,773 79,960

Total Payables 87,773 79,960

a. TheincreaseincurrentTradePayablesfor2012–13isduetoreceiptofinvoicesforcapitalworkstobepaidtoSharedServicesProcurementlateinJune2013.

2013 $’000

2012 $’000

Payables are aged as follows:

NotOverdue 78,388 79,404

OverdueforLessthan30Daysb 8,926 482

Overduefor30to60Daysc 435 45

OverdueforMorethan60Daysc 24 29


Classification of ACT Government/Non-ACT Government Payables

PayableswithACTGovernmentEntities

TradePayables 9,449 3,966


Total Payables with ACT Government Entities 44,209 43,507

Payables with Non-ACT Government Entities

TradePayables 7,902 7,714

Other Payables 19 62


Total Payables with Non-ACT Government Entities 43,564 36,453


b. ThismainlyrelatestoSharedServicesProcurementinvoicesforprogresspaymentofcapitalworks.Thesepaymentsweredelayedtoensureadequatecashavailabilityfornon-ACTGovernmentsuppliers.

c. Thedelayismainlyduetodisputedinvoices.



Note 33. Finance LeasesTheDirectoratehas351financeleases,whichhavebeentakenupasafinanceleaseliabilityandanassetunderafinancelease.Theseleasesareformotorvehicles.Theinterestrateimplicitintheseleasesvaryfrom4.35%to7.99%andthetermsvaryfrom1yearto5years.Theseleasesallowforextensions,buthavenotermsofrenewalorpurchaseoptionsandescalationclauses.

2013 $’000

2012 $’000

Current Finance Leases

Secured

FinanceLeases 2,315 3,288

Total Current Finance Leases 2,315 3,288

Non-Current Finance Leases

Secured

FinanceLeasesa 4,162 1,802

Total Non-Current Finance Leases 4,162 1,802

Total Finance Leases 6,477 5,090

Secured LiabilityTheDirectorate’sfinanceleaseliabilityiseffectivelysecuredbecause,iftheDirectoratedefaults,theassetsunderafinancialleasereverttothelessor.

a. Theincreaseinnon-currentfinanceleasesisduetothecyclicnatureofthemotorvehicleswhicharegenerallyona3yearlease.In2012–13HealthDirectorateacquired185newmotorvehicleleasesanddisposedof164oldmotorvehiclefinanceleaseswhichresultsinalargernon-currentbalance.

2013 $’000

2012 $’000

Finance lease commitments are payable as follows:

Within one year 2,613 3,513

Laterthanoneyearbutnotlaterthanfiveyears 4,412 1,905

Minimum Lease Payments 7,025 5,418

Less:FutureFinanceLeaseCharges (548) (328)

Amount Recognised as a Liability 6,477 5,090

Add:Leaseincentiveinvolvedwithnon-cancellableoperatinglease – –

Total Present Value of Minimum Lease Payments 6,477 5,090

Thepresentvalueoftheminimumleasepaymentsareasfollows:



Total Present Value of Minimum Lease Payments 6,477 5,090

Classification on the Balance Sheet

FinanceLeases

CurrentFinanceLeases 2,315 3,288

Non-CurrentFinanceLeases 4,162 1,802

Total Finance Leases 6,477 5,090



Note 34. Employee Benefits2013

$’0002012

$’000

Current Employee Benefits

AnnualLeavea 83,716 76,428

LongServiceLeaveb 79,538 71,762

AccruedSalariesc 17,025 15,688

OtherBenefits 243 429

Total Current Employee Benefits 180,522 164,307

Non-Current Employee Benefits

LongServiceLeaved 12,457 14,984

Total Non-Current Employee Benefits 12,457 14,984

Total Employee Benefits 192,979 179,292

a. Theincreaseismainlyduetotheimpactofcollectiveagreementpayrisesandanincreaseinstaffnumbersforgrowthinservicesandthegrowthinliabilityduetoleaveconsumptionnotinlinewithleaveearned.

b. Theincreaseismainlyduetotheimpactofcollectiveagreementpayrisesandanincreaseinstaffnumbersforgrowthinservicesandthegrowthinliabilityduetoleaveconsumptionnotinlinewithleaveearned,whichwaspartiallyoffsetbytheimpactofareductionintherateusedtoestimatethepresentvalueoflongserviceleavepaymentsfrom106.6%to101.3%.

c. Theincreaseisduetoanadditionalday’spayaccruedin2013comparedto2012.d. Thereductioninnon-currentlongserviceleaveliabilitiesismainlyduetoareductionintherateusedtoestimatethepresentvalueof

longserviceleavepaymentsfrom106.6%to101.3%.

Estimate of when Leave is Payable

Estimated Amount Payable within 12 months

AnnualLeave 83,715 76,428

LongServiceLeave 6,107 7,223

AccruedSalaries 17,026 15,688

OtherBenefits 243 429

Total Employee Benefits Payable within 12 months 107,091 99,768

Estimated Amount Payable after 12 months

LongServiceLeave 85,888 79,524

Total Employee Benefits Payable after 12 months 85,888 79,524

Total Employee Benefits 192,979 179,292



Note 35. Other Provisions

Provision for Make GoodTheDirectorateenteredintoleaseagreementsforsomeofficespaceinCivicandBelconnen.ThereareclauseswithintheleaseagreementswhichrequiretheDirectorate,uponcessationofthetenancy,toreturntheofficespacetotheconditionitwasinbeforeitwasleased(thisisreferredtoas‘makegood’).Thetenanciesrunfor5years.

2013 $’000

2012 $’000

Non-Current Other Provisions

ProvisionforMakeGood 1,503 1,503

Total Other Provisions 1,503 1,503

Note 36. Other Liabilities2013

$’0002012

$’000

Current Other Liabilities

RevenueReceivedinAdvancea 2,224 656

Total Current Other Liabilities 2,224 656

Total Other Liabilities 2,224 656

a. TheincreaseismainlyduetopaymentinadvanceforservicesprovidedtotheDepartmentofVeterans’Affairs.

Note 37. Equity

Asset Revaluation SurplusTheAssetRevaluationReserveisusedtorecordtheincrementsanddecrementsinthevalueofproperty,plantandequipment.

2013 $’000

2012 $’000

Balance at the Beginning of the Reporting Period 144,007 145,001

IncrementinLandduetoRevaluation – –

DecrementinLandduetoDisposal – –

IncrementinBuildingsduetoRevaluation – –

DecrementinBuildingsduetoImpairmentLoss – –

OtherDecrements – (994)

Total (Decrease) in the Asset Revaluation Surplus – (994)

Balance at the End of the Reporting Period 144,007 144,007



Note 38. Financial InstrumentsDetailsofthesignificantpoliciesandmethodsadopted,includingthecriteriaforrecognition,thebasisofmeasurement,andthebasisonwhichincomeandexpensesarerecognised,withrespecttoeachclassoffinancialassetandfinancialliabilityaredisclosedinNote2:SummaryofSignificantAccountingPolicies.

Interest Rate RiskInterestrateriskistheriskthatthefairvalueorfuturecashflowsofafinancialinstrumentwillfluctuatebecauseofchangesinmarketinterestrates.

TheDirectoratedoesnotholdanyfinancialliabilitieswithfloatinginterestrates,theDirectorateisthereforenotexposedtomovementsininterestpayable.TheDirectorateis,however,exposedtomovementsininterestratesonamountsheldinCashatBank.

InterestrateriskforfinancialassetsismanagedbytheDirectoratebyonlyinvestinginfloatinginterestrateinvestmentsthatarelowrisk.Therehavebeennochangesinriskexposureorprocessesformanagingrisksincelastfinancialreportingperiod.

AsensitivityanalysishasnotbeenundertakenasitisconsideredthattheDirectorate’sexposuretothisriskisinsignificantandwouldhaveaninsignificantimpactonitsfinancialresults.

Credit RiskCreditriskistheriskthatonepartytoafinancialinstrumentwillfailtodischargeanobligationandcausetheotherpartytoincurafinancialloss.TheDirectorate’screditriskislimitedtotheamountofthefinancialassetsitholdsnetofanyallowanceforimpairment.TheDirectorateexpectstocollectallfinancialassetsthatarenotpastdueorimpaired.

CreditriskismanagedbytheDirectorateforcashatbankbyholdingbankbalanceswiththeACTGovernment’sbanker,WestpacBankingCorporation.In2012–13aspartoftheWhole-of-Governmentbankingarrangements,theDirectoratetransitionedbankingservicesfromtheCommonwealthBanktoWestpacBankingCorporation.BothofthesebanksholdaAA-issuercreditratingwithStandardandPoors.

CreditriskismanagedbytheDirectorateforinvestmentsbyonlyinvestingsurplusfundswiththeTerritoryBankingAccount,whichhasappropriateinvestmentcriteriafortheexternalfundmanagerengagedtomanagetheTerritory’ssurplusfunds.

TheDirectorate’sreceivablesarepredominantlyfrominsurancecompanies,ACTGovernmentandState(mainlyNewSouthWales)andtheCommonwealthGovernments.AstheCommonwealthGovernmentandNewSouthWalesGovernmenthaveaAAAcreditratingitisconsideredthatthereisaverylowriskofdefaultforthosereceivables.CreditriskforreceivableswiththeNewSouthWalesMinistryofHealth,whichareforprovisionofservicestopatientswhoresideinNewSouthWalesismanagedbyhavinganagreementinplace,providingrequiredactivitydatainatimelymannerandrequiringprovisionalpaymentsfortheseactivities.

Therehasbeennochangeincreditriskexposuresincelastreportingperiod.



Note 38. Financial Instruments (Continued)Liquidity RiskLiquidityriskistheriskthattheDirectoratewillencounterdifficultiesinmeetingobligationsassociatedwithfinancialliabilitiesthataresettledbydeliveringcashorotherfinancialassets.TheDirectorate’sfinancialobligationsrelatetothepaymentofgrantsandthepurchaseofsuppliesandservices.Grantsarepaidonaquarterlybasisandpurchasesofsuppliesandservicesarepaidwithin30daysofreceivingthegoodsorservices.

ThemainsourceofcashtopaytheseobligationsisappropriationfromtheACTGovernmentwhichispaidonafortnightlybasisduringtheyear.TheDirectoratemanagesitsliquidityriskthroughforecastingappropriationdrawdownrequirementstoenablepaymentofanticipatedobligations.Seethematurityanalysisprovidedlaterinthisnoteforfurtherdetailsofwhenfinancialassetsandliabilitiesmature.

TheDirectorate’sexposuretoliquidityriskisconsideredinsignificantbasedonexperiencefromprioryearsandthecurrentassessmentofrisk.

Price RiskPriceriskistheriskthatthefairvalueorfuturecashflowsofafinancialinstrumentwillfluctuatebecauseofchangesinmarketprices(otherthanthosearisingfrominterestrateriskorcurrencyrisk),whetherthesechangesarecausedbyfactorsspecifictotheindividualfinancialinstrumentoritsissuer,orfactorsaffectingallsimilarfinancialinstrumentstradedintothemarket.TheonlypricerisktheDirectorateisexposedtoresultsfromitsinvestmentintheFixedInterestPortfolio.TheDirectoratehasunitsintheFixedInterestPortfoliothatfluctuateinvalue.Thepricefluctuationintheunitsoftheportfolioiscausedbymovementsintheunderlyinginvestmentsoftheportfolio.Theunderlyinginvestmentsaremanagedbyanexternalfundmanagerwhoinvestsinavarietyofdifferentsecurities,includingbondsissuedbytheCommonwealthGovernment,theStateGovernmentguaranteedtreasurycorporationsandsemi-governmentauthorities,aswellasinvestment-gradecorporateissues.

TheDirectorate’sexposuretopriceriskandthemanagementofthisriskhasnotchangedsincelastreportingperiod.

AsensitivityanalysishasnotbeenundertakenforthepriceriskoftheDirectorateasithasbeendeterminedthatthepossibleimpactonprofitandlossortotalequityfromfluctuationsinpriceisimmaterial.

Fair Value of Financial Assets and LiabilitiesThecarryingamountsandfairvaluesoffinancialassetsandliabilitiesattheendofthereportingperiodare:

Carrying Amount

2013 $’000

Fair Value 2013

$’000

Carrying Amount

2012 $’000

Fair Value 2012

$’000

Financial Assets

CashandCashEquivalents 9,562 9,562 69,379 69,379

Receivables 122,304 122,304 53,158 53,158

InvestmentwiththeTerritoryBankingAccount 3,011 3,011 2,990 2,990

Total Financial Assets 134,877 134,877 125,527 125,527

Financial Liabilities

Payables 87,773 87,773 79,960 79,960

FinanceLeases 6,477 6,477 5,090 5,090

Total Financial Liabilities 94,250 94,250 85,050 85,050



Note 38. Financial Instruments (Continued)

Fair Value HierarchyTheDirectorateisrequiredtoclassifyfinancialassetsandfinancialliabilitiesintoafairvaluehierarchythatreflectsthesignificanceoftheinputsusedindeterminingtheirfairvalue.Thefairvaluehierarchyismadeupofthefollowingthreelevels:

• Level1–quotedprices(unadjusted)inactivemarketsforidenticalassetsorliabilities;

• Level2–inputsotherthanquotedpricesincludedwithinLevel1thatareobservablefortheassetorliability;eitherdirectly(i.e.prices)orindirectly(i.e.derivedfromprices);and

• Level3–inputsfortheassetorliabilitythatarenotbasedonobservablemarketdata(unobservableinputs).

Thecarryingamountoffinancialassetsmeasuredatfairvalue,aswellasthemethodsusedtoestimatethefairvaluearesummarisedinthetablebelow.Allotherfinancialassetsandliabilitiesaremeasured,subsequenttoinitialrecognition,atamortisedcostandassucharenotincludedinthetablebelow.

2013

Classification According to Fair Value Hierarchy

Level 1 $’000

Level 2 $’000

Level 3 $’000

Total $’000

Financial Assets

InvestmentwiththeTerritoryBankingAccount– FixedInterestPortfolioAccount 3,011 – 3,011

– 3,011 – 3,011

Transfer Between Categories

TherehavebeennotransfersoffinancialassetsorliabilitiesbetweenLevel1andLevel2duringthereportingperiod.

2012

Classification According to Fair Value Hierarchy

Level 1 $’000

Level 2 $’000

Level 3 $’000

Total $’000

Financial Assets

InvestmentwiththeTerritoryBankingAccount– FixedInterestPortfolioAccount – 2,990 – 2,990

– 2,990 – 2,990

Transfer Between Categories

TherehavebeennotransfersoffinancialassetsorliabilitiesbetweenLevel1andLevel2duringthereportingperiod.



Note 38. Financial Instruments (Continued)ThefollowingtablesetsouttheDirectorate’smaturityanalysisforfinancialassetsandliabilitiesaswellastheexposuretointerestrates,includingweightedaverageinterestratesbymaturityperiodasat30June2013.Allfinancialassetsandliabilitieswhichhaveafloatinginterestrateorarenon-interestbearingwillmaturein1yearorless.Allamountsappearinginthefollowingmaturityanalysisareshownonanundiscountedcashflowbasis.

Fixed Interest Maturing in:

Note No.

Weighted Average Interest

Rate

Floating Interest

Rate $’000

1 Year or Less

$’000

Over 1 to 5 Years

$’000

Over 5 Years $’000

Non-Interest Bearing

$’000Total

$’000

Financial Instruments

Financial Assets

CashandCashEquivalents 23 3.44% 9,516 – – – 46 9,562

Receivables 24 – – – – 122,304 122,304

InvestmentswiththeTerritoryBankingAccount 27 – – – – 3,011 3,011

Total Financial Assets 9,516 – – – 125,361 134,877

FinancialLiabilities

Payables 32 – – – – 87,773 87,773

FinanceLeases 33 7.99% – 2,613 4,412 – – 7,025

Total Financial Liabilities – 2,613 4,412 – 87,773 94,798

Net Financial Assets/(Liabilities) 9,516 (2,613) (4,412) – 37,588 40,079



Note 38. Financial Instruments (Continued)ThefollowingtablesetsouttheDirectorate’smaturityanalysisforfinancialassetsandliabilitiesaswellastheexposuretointerestrates,includingweightedaverageinterestratesbymaturityperiodasat30June2012.Allfinancialassetsandliabilitieswhichhaveafloatinginterestrateorarenon-interestbearingwillmaturein1yearorless.Allamountsappearinginthefollowingmaturityanalysisareshownonanundiscountedcashflowbasis.

Fixed Interest Maturing In:

Note No.


Rate

Floating Interest

Rate $’000

1 Year or Less

$’000

Over 1 to 5 Years

$’000



$’000Total

$’000


Financial Assets

CashandCashEquivalents 23 4.87% 69,332 – – – 47 69,379

Receivables 24 – – – – 53,158 53,158

InvestmentswiththeTerritoryBankingAccount 27 – – – – 2,990 2,990

Total Financial Assets 69,332 – – – 56,195 125,527


Payables 32 – – – – 79,960 79,960

FinanceLeases 33 7.18% – 3,513 1,905 – – 5,418

Total Financial Liabilities – 3,513 1,905 – 79,960 85,378

Net Financial Assets/(Liabilities) 69,332 (3,513) (1,905) – (23,765) 40,148

2013 $’000

2012 $’000

Carrying Amount of Each Specified Category of Financial Asset and Financial Liability

Financial Assets

LoansandReceivablesMeasuredatAmortisedCost 122,304 53,158

FinancialAssetsatFairValuethroughtheProfitandLossDesignated uponInitialRecognition 3,011 2,990


FinancialLiabilitiesMeasuredatAmortisedCost 94,250 85,050

Gains on Each Category of Financial Asset and Financial Liability

Gains on Financial Assets

LoansandReceivablesMeasuredatAmortisedCost – –

FinancialAssetsatFairValuethroughtheProfitandLossDesignated uponInitialRecognition 144 157

Gains on Financial Liabilities

FinancialLiabilitiesMeasuredatAmortisedCost – –



Note 39. Commitments

Capital CommitmentsCapitalcommitmentscontractedatreportingdateincludeHealthCentresinBelconnen,TuggeranongandGungahlin,theCanberraRegionCancerCentre,theCentenaryHospitalforWomenandChildren,theUniversityofCanberraPublicHospital,theEmergencyDepartmentIntensiveCareUnitExpansion,AdultSecureMentalHealthUnit,ClinicalServicesandInpatientUnitDesignandInfrastructureExpansion,Ane-HealthyFuture,CentralSterilisingService,Walk-InCentresforBelconnenandTuggeranong,andotherminornewworksconstructionprojects.Thesehavenotbeenrecognisedasliabilities.

Capital Commitments – Property, Plant and Equipment2013

$’0002012

$’000

Payable:



Total Capital Commitments – Property, Plant and Equipmenta 313,014 407,901

Total Capital Commitments 313,014 407,901

a. Thedecreaseisaresultoflesscapitalworksfundingappropriatedin2013.

Operating Lease Commitments

TheDirectoratehasseveralnon-cancellableoperatingleasesforbuildings.TheoperatingleaseagreementsgivetheDirectoratetherighttorenewtheleases.Renegotiationsoftheleasetermsoccuronrenewaloftheleases.TheDirectoratealsohasnon-cancellableoperatingleaseswithSharedServicesforITequipment.Contingentrentalpaymentshavenotbeenincludedinthecommitmentsbelow.

Non-cancellable operating lease commitments are payable as follows:2013

$’0002012

$’000



Total Operating Lease Commitments 24,804 28,425

Other Commitments

OthercommitmentscontractedatreportingdatemainlyrelatetograntstoNon-GovernmentOrganisationsthathavenotbeenrecognisedasliabilities.

Non-cancellable other commitments are payable as follows:2013

$’0002012

$’000


Laterthanoneyearbutnotlaterthanfiveyearsb 53,060 36,855

Total Other Commitments 102,557 86,150

b. TheincreaseinothercommitmentslaterthanoneyearbutnotgreaterthanfiveyearsisduetothecyclicnatureofcontractingwithNon-GovernmentOrganisationswithmostcontractsrunningforthreeyears.Approximately40percentofcontractswereenteredintoin2013extendingthecommitmentperiod.

Finance Lease CommitmentsFinanceleasecommitmentsaredisclosedinNote33:FinanceLeases.

AllamountsshowninthecommitmentnoteareinclusiveofGST.



Note 40. Contingent Liabilities

Contingent LiabilitiesTheDirectorateiscurrentlydefending123actions(2012–142actions).Theseactionshaveanestimatednetliabilityof$5,190,000(2012–$5,530,000),whichhasnotbeenprovidedforintheaccounts.TheestimatedliabilityhasbeencalculatednetoftheamountscoveredundertheDirectorate’sinsurancepolicy.ThereductionintheestimatednetliabilityisduetotheACTInsuranceAuthority’sacceptance,in2012,ofonepreviouslydeclinedhighcostinsuranceclaim.

Therewerenocontingentassetsasat30June2013.



Note 41. Cash Flow Reconciliationa. Reconciliation of Cash and Cash Equivalents at the end of the reporting period in the Cash Flow Statement to

the equivalent items in the Balance Sheet

2013 $’000

2012 $’000

CashandCashEquivalentsRecordedintheBalanceSheet 9,562 69,379

Total Cash and Cash Equivalents at the end of the reporting period as recorded in the Cash Flow Statement 9,562 69,379

b. Reconciliation of Net Cash (Outflows)/Inflows from Operating Activities to the Operating (Deficit)

2013 $’000

2012 $’000

Operating(Deficit) (39,688) (17,619)

Add/(Less) Non-Cash Items

DepreciationofProperty,PlantandEquipment 48,560 24,403

AmortisationofIntangibles 4,454 4,526

BadandDoubtfulDebts 1,171 2,151

AssetBookValueWrittenDown 509 1,871

ImpairmentLossofNon-CurrentAssets 1,121 613

Add/(Less) Items Classified as Investing or Financing

NetGainonDisposalofAssets – (75)

UnrealisedGainonInvestments (21) (10)

Cash Before Changes in Operating Assets and Liabilities 16,106 15,859

Changes in Operating Assets and Liabilities

(Increase)inReceivables (68,609) (9,127)

(Increase)/DecreaseinInventories (559) 313

(Increase)inOtherAssets (160) (101)

(Decrease)/IncreaseinPayables (3,565) 22,715

Increase in Provisions 13,686 28,136

Increase/(Decrease)inOtherLiabilities 1,569 (4,606)

Net Changes in Operating Assets and Liabilities (57,638) 37,330

Net Cash (Outflows)/Inflows from Operating Activities (41,532) 53,189

c. Non-Cash Financing and Investing Activities

UndertheWhole-of-GovernmentmotorvehicleleasingarrangementsallnewmotorvehicleleasesenteredintobytheDirectorateareunderafinanceleaseratherthanunderanoperatinglease.

2013 $’000

2012 $’000

AcquisitionofMotorVehiclesbyMeansofFinanceLeasea 3,908 1,235

a. Theincreaseinfinanceleasesisduetothecyclicnatureofthemotorvehicleleaseswhicharemostlyonathreeyearlease.In2013,185newvehicleswereacquiredcomparedto104in2012.



Note 42. Events Occurring After Balance DateTherewerenoeventsoccurringafterthebalancedate,whichwouldaffectthefinancialstatementsasat 30June2013,orinthefuturereportingperiods.

Note 43. Third Party MoniesTheDirectorateheldfundsintrustrelatingtotheactivitiesoftheACTMedicalRadiationScientistsBoard,the ACTVeterinarySurgeonsBoardandtheHealthDirectorateHumanResearchEthicsCommittee.

2013 $’000

2012 $’000

Registration Boards and Ethics Committee Trust Account

BalanceattheBeginningoftheReportingPeriod 529 438

CashReceipts 900 1,079

Cash Payments (866) (988)

Balance at the End of the Reporting Period 563 529

TheDirectorateheldfundsintrustrelatingtoresidentsofitsMentalHealthfacilities.

2013 $’000

2012 $’000

Mental Health Trust Account

BalanceattheBeginningoftheReportingPeriod 27 22

CashReceipts 108 127

Cash Payments (99) (122)

Balance at the End of the Reporting Period 36 27

TheDirectorateheldfundsrelatingtotheactivitiesofSalariedSpecialists.

2013 $’000

2012 $’000

Private Practice Hospital Account

BalanceattheBeginningoftheReportingPeriod 23,267 21,702

CashReceipts 24,973 18,954

Cash Payments (23,404) (17,389)

Balance at the End of the Reporting Period 24,836 23,267


Health Directorate Territorial Financial Statements for the year ended 30 June 2013

Health Directorate Statement of Income and Expenses on Behalf of the Territory For the Year Ended 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Actual 2012

$’000

Income

Revenue

PaymentsforExpensesonBehalfoftheTerritory 45 746 746 986

Fees 46 1,094 693 794

Total Revenue 1,840 1,439 1,780

Total Income 1,840 1,439 1,780

Expenses

GrantsandPurchasedServices 47 746 746 727

TransfertotheACTGovernment 48 1,094 693 794

Total Expenses 1,840 1,439 1,521

Operating Surplus – – 259

Total Comprehensive Surplus – – 259

TheaboveStatementofIncomeandExpensesonBehalfoftheTerritoryshouldbereadinconjunctionwiththe accompanyingnotes.



Health Directorate Statement of Assets and Liabilities on behalf of the Territory As at 30 June 2013

Note No.

Actual 2013 $’000

Original Budget

2013 $’000

Actual 2012

$’000

Current Assets

CashandCashEquivalents 49 295 294 300

Receivables 50 5 6 –

Total Current Assets 300 300 300

Total Assets 300 300 300

Non-Current Liabilities

AdvancefromtheTerritoryBankingAccount 51 300 300 300

Total Liabilities 300 300 300

Net Assets – – –

Equity

AccumulatedSurplus/(Deficits) – – –

Total Equity – – –

TheaboveStatementofAssetsandLiabilitiesonBehalfoftheTerritoryshouldbereadinconjunctionwiththe accompanyingnotes.



Health Directorate Statement of Changes in Equity on Behalf of the Territory For the Year Ended 30 June 2013

Accumulated Funds 2013

$’000

Total Equity

2013 $’000

Original Budget

2013 $’000

BalanceattheBeginningoftheReportingPeriod – – –


Operating(Deficit) – – –

Total Comprehensive Income – – –


TotalTransactionsInvolvingOwnersAffectingAccumulatedFunds – – –

Balance at the End of the Reporting Period – – –

TheaboveStatementofChangesinEquityonBehalfoftheTerritoryshouldbereadinconjunctionwiththeaccompanyingnotes.

Accumulated (Deficits)/

Funds 2012

$’000

Total Equity

2012 $’000

BalanceattheBeginningofthe ReportingPeriod (259) (259)


OperatingSurplus 259 259

Total Comprehensive Income 259 259

Balance at the End of the Reporting Period – –

TheaboveStatementofChangesinEquityonBehalfoftheTerritoryshouldbereadinconjunctionwiththeaccompanyingnotes.



Health Directorate Cash Flow Statement on Behalf of the Territory For the Year Ended 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Actual 2012

$’000


Receipts

CashfromtheACTGovernmentforExpenseson BehalfoftheTerritory 746 746 986

Fees 1,094 693 794

OtherReceipts 69 75 78

Total Receipts from Operating Activities 1,909 1,514 1,858

Payments

GrantsandPurchasedServices 746 746 727

TransferofTerritoryReceiptstotheACTGovernment 1,094 693 794

Other 74 75 73

Total Payments from Operating Activities 1,914 1,514 1,594

Net Cash (Outflows)/Inflows From Operating Activities (5) – 264

Net(Decrease)/IncreaseinCash 52 (5) – 264

CashandCashEquivalentsattheBeginningoftheReportingPeriod 300 294 36

Cash and Cash Equivalents at the End of the Reporting Period 52 295 294 300

TheaboveCashFlowStatementonBehalfoftheTerritoryshouldbereadinconjunctionwiththeaccompanyingnotes.



Health Directorate Territorial Statement of Appropriation For the Year Ended 30 June 2013

Original Budget

2013 $’000

Total Appropriated

2013 $’000

Appropriation Drawn

2013 $’000

Appropriation Drawn

2012 $’000

Territorial

ExpensesonBehalfoftheTerritory 746 746 746 986

Total Territorial Appropriation 746 746 746 986

TheaboveTerritorialStatementofAppropriationshouldbereadinconjunctionwiththeaccompanyingnotes.

Column Heading ExplanationsTheOriginalBudget columnshowstheamountsthatappearintheCashFlowStatementintheBudgetPapers.

TheamountalsoappearsintheCashFlowStatementonBehalfoftheTerritory.

TheTotalAppropriatedcolumnisinclusiveofallappropriationvariationsoccurringaftertheOriginalBudget.

TheAppropriationDrawnisthetotalamountofappropriationreceivedbytheDirectorateduringtheyear. TheamountalsoappearsintheCashFlowStatementonBehalfoftheTerritory.



Health Directorate Territorial Note IndexNote 44 SummaryofSignificantAccountingPolicies–Territorial

Income Notes

Note 45 PaymentforExpensesonbehalfoftheTerritory–Territorial

Note 46 Fees–Territorial

Expenses Notes

Note 47 GrantsandPurchasedServices–Territorial

Note 48 TransfertoGovernment–Territorial

Assets Notes

Note 49 CashandCashEquivalents–Territorial

Note 50 Receivables–Territorial

Liabilities Note

Note 51 AdvancefromTerritoryBankingAccount–Territorial

Other Notes

Note 52 CashFlowReconciliation–Territorial

Note 53 FinancialInstruments–Territorial

Note 54 Commitments–Territorial

Note 55 ContingentLiabilitiesandContingentAssets–Territorial

Note 56 EventsOccurringafterBalanceDate–Territorial



Note 44. Summary of Significant Accounting Policies – Territorial

TheDirectorate’saccountingpoliciesarecontainedinNote2:SummaryofSignificantAccountingPolicies. ThepoliciesoutlinedinNote2applytoboththeControlledandTerritorialfinancialstatements.

Note 45. Payment for Expenses on Behalf of the Territory – Territorial

Underthe Financial Management Act 1996, fundscanbeappropriatedforexpensesincurredonbehalfoftheTerritory.TheDirectoratereceivesthisappropriationtofundanumberofexpensesincurredonbehalfoftheTerritory,beingon-passingofappropriatedfundsforcapitalfundingforCalvaryPublicHospital.

(SeeNote47GrantsandPurchasedServices–Territorial)

2013 $’000

2012 $’000

PaymentforExpensesonBehalfoftheTerritorya 746 986

Total Payment for Expenses on Behalf of the Territory 746 986

a. ThisrelatestocapitalupgradesatCalvaryHospital.Thedecreasereflectsthatthepaymentin2012includedsomeofthe2011capitalupgradesfunding.

Note 46. Fees – TerritorialFeereferstothecollectionoflicencefees,includingfromfoodbusinesses,smokefreeplaces,boardinghousesandradiationequipment.

2013 $’000

2012 $’000

Fees

FeesforRegulatoryServicesa 1,094 794

Total Fees 1,094 794

a. Theincreaseismainlyduetopriceescalationincreases,growthinlicencenumbersandtheintroductionoflicencesforpharmacies.



Note 47. Grants and Purchased Services – TerritorialGrantsareamountsprovidedbytheDirectorate,toACTGovernmententitiesandnon-ACTGovernmententitiesforgeneralassistanceorforaparticularpurpose.Grantsmaybeforcapital,currentorre-currentpurposesandthenameorcategoryreflectstheuseofthegrant.Thegrantsgivenareusuallysubjecttotermsandconditionssetoutinacontract,correspondence,orbylegislation.

2013 $’000

2012 $’000

CapitalGrantstoExternalParties-CalvaryHospitala 746 727

Total Grants and Purchased Services 746 727

a. ThisrelatestopaymentsforcapitalupgradesatCalvaryHospital.

Note 48. Transfer to Government – Territorial ‘TransfertoGovernment’representsthetransferofmoney,whichtheDirectoratehascollectedonbehalfoftheTerritory,toGovernment.ThemoneycollectedbytheDirectorateonbehalfoftheTerritoryincludeslicencefeescollected.

2013 $’000

2012 $’000

TransfertotheTerritoryBankingAccount 1,094 794

Total Transfer to the ACT Government 1,094 794

Note 49. Cash and Cash Equivalents – Territorial TheDirectorateholdsoneTerritorialbankaccount.In2012–13,aspartoftheWhole-of-Governmentbankingarrangements,theDirectoratetransitionedbankingservicesfromtheCommonwealthBanktoWestpacBankingCorporation.InterestisnotearnedoncashatbankheldintheTerritorialBankAccount.

2013 $’000

2012 $’000

CashatBank 295 300

Total Cash and Cash Equivalents 295 300



Note 50. Receivables – Territorial 2013

$’0002012

$’000

Current Receivables

GoodsandServicesTaxReceivable 5 –

Less:AllowanceforDoubtfulDebts – –

Total Current Receivables 5 –

TotalNon-CurrentReceivables – –

Total Receivables 5 –

Ageing of Receivables

Not Overdue $’000

Past Due Less than

30 days $’000

Past Due 30 to 60 days

$’000

Past Due Greater than 60

days $’000

Total $’000

2013

NotImpairedReceivables 5 – – – 5

ImpairedReceivables – – – – –

2012

NotImpairedReceivables – – – – –


Classification of ACT Government/Non-ACT Government Receivables2013

$’0002012

$’000

Receivables with Non-ACT Government Entities

NetGoodsandServicesTaxReceivable 5 -

Total Receivables with Non-ACT Government Entities 5 -

Total Receivables 5 -

Note 51. Advance from Territory Banking Account – Territorial

2013 $’000

2012 $’000

AdvancefromTerritoryBankingAccount 300 300

Total Advance from Territory Banking Account 300 300

ThiscashadvanceinperpetuityisforthepurposeoffundingtheGST(GoodsandServicesTax)cashoutlayduetotimingdifferencebetweentheGSTpaymentandreceivingofrefundsfromtheAustralianTaxationOffice.CapitalupgradesfundstransferredtoCalvaryHospitalattractsGSTwhichisnotappropriated.



Note 52. Cash Flow Reconciliation – Territoriala. ReconciliationofCashattheendoftheendoftheReportingPeriodintheCashFlowStatementonBehalfof

theTerritorytotheRelatedItemsintheStatementofAssetsandLiabilitiesonBehalfoftheTerritory.

2013 $’000

2012 $’000

TotalCashDisclosedontheStatementofAssetsand LiabilitiesonBehalfoftheTerritory 295 300

Cash at the End of the Reporting Period as Recorded in the Cash Flow Statement on Behalf of the Territory 295 300

b. ReconciliationofNetCash(Outflows)/InflowsfromOperatingActivitiestotheOperatingSurplus

2013 $’000

2012 $’000

OperatingSurplus – 259

Cash Before Changes in Operating Assets and Liabilities – 259


(Increase)/DecreaseinReceivables (5) 5

Net Changes in Operating Assets and Liabilities (5) 5

Net Cash (Outflows)/Inflows from Operating Activities (5) 264

Note 53. Financial Instruments – TerritorialDetailsofthesignificantpoliciesandmethodsadopted,includingthecriteriaforrecognition,thebasisofmeasurement,andthebasisonwhichincomeandexpensesarerecognised,withrespecttoeachclassoffinancialassetandfinancialliabilityaredisclosedinNote44:SummaryofSignificantAccountingPolicies–Territorial.

Interest Rate RiskInterestrateriskistheriskthatthefairvalueorfuturecashflowsofafinancialinstrumentwillfluctuatebecauseofchangesinmarketinterestrates.

TheDirectoratehasallofitsTerritorialfinancialassetsandfinancialliabilitiesheldinnon-interestbearingarrangements.ThismeansthattheDirectorateisnotexposedtomovementsininterestrates,and,assuchdoesnothaveanyinterestraterisk.

AsensitivityanalysishasnotbeenundertakenfortheinterestrateriskoftheDirectorateasitisnotexposedtomovementsininterestrates.



Note 53. Financial Instruments – Territorial (Continued)

Credit RiskCreditriskistheriskthatonepartytoafinancialinstrumentwillfailtodischargeanobligationandcausetheotherpartytoincurafinancialloss.TheDirectorate’screditriskislimitedtotheamountofthefinancialassetsheld.

TheDirectorate’sTerritorialfinancialassetsmostlyconsistofCashandCashEquivalents.

CreditriskismanagedbytheDirectorateforcashatbankbyholdingbankbalanceswiththeACTGovernment’sbanker.In2012–13aspartoftheWhole-of-Governmentbankingarrangements,theDirectoratetransitionedbankingservicesfromtheCommonwealthBanktoWestpacBankingCorporation.Bothofthesebanksholda AA-issuercreditratingwithStandardandPoors.

Liquidity RiskLiquidityriskistheriskthattheDirectoratewillbeunabletomeetitsfinancialobligationsastheyfalldue. TheDirectorate’sonlyTerritorialfinancialobligationrelatestoanadvancereceivedfromtheTerritoryBankingAccountwherethereisnorequirementtorepaytheadvancewithinthenexttwelvemonths.TheDirectorate’sexposuretoliquidityriskisthereforeinsignificant.

Price RiskPriceriskistheriskthatthefairvalueorfuturecashflowsofafinancialinstrumentwillfluctuatebecauseofchangesinmarketprices,whetherthesechangesarecausedbyfactorsspecifictotheindividualfinancialinstrumentoritsissuer,orfactorsaffectingallsimilarfinancialinstrumentstradedinthemarket.

TheDirectorateholdsnoinvestmentsonbehalfoftheTerritorythataresubjecttopriceriskandasaresult,isnotconsideredtohaveanypricerisk.Accordingly,asensitivityanalysishasnotbeenundertaken.

Fair Value of Financial Assets and LiabilitiesThecarryingamountsandfairvaluesoffinancialassetsandliabilitiesatbalancedateare:

Carrying Amount

2013 $’000

Fair Value 2013

$’000

Carrying Amount

2012 $’000

Fair Value 2012

$’000

Financial Assets

CashandCashEquivalents 295 295 300 300

Receivables 5 5 – –

Total Financial Assets 300 300 300 300


AdvancefromTerritoryBankingAccount 300 300 300 300

Total Financial Liabilities 300 300 300 300

Net Financial (Liabilities) – – – –



Note 53. Financial Instruments – Territorial (Continued)ThefollowingtablesetsouttheDirectorate’smaturityanalysisforfinancialassetsandliabilitiesaswellastheexposuretointerestrates,includingtheweightedaverageinterestratesbymaturityperiodasat30June2013.Allfinancialassetsandliabilities,excludingAdvancefromtheTerritoryBankingAccountwhicharenon-interestbearingwillmaturein1yearorless.Allamountsappearinginthefollowingmaturityanalysisareshownonanundiscountedcashflowbasis.


Note No.


Rate

Floating Interest

Rate $’000

1 Year or Less

$’000

Over 1 to 5

Years $’000



$’000Total

$’000


Financial Assets

CashandCashEquivalents 49 – – – – 295 295

Total Financial Assets – – – – 295 295


AdvancefromTerritoryBankingAccount 51 – – – – 300 300

Total Financial Liabilities – – – – 300 300

Net Financial (Liabilities) – – – – (5) (5)

ThefollowingtablesetsouttheDirectorate’smaturityanalysisforfinancialassetsandliabilitiesaswellastheexposuretointerestrates,includingtheweightedaverageinterestratesbymaturityperiodasat30June2012. Allfinancialassetsandliabilities,excludingAdvancefromTerritoryBankingAccountwhicharenon-interestbearingwillmaturein1yearorless.Allamountsappearinginthefollowingmaturityanalysisareshownonanundiscountedcashflowbasis.


Note No.

Floating Interest

Rate $’000

1 Year or Less

$’000

Over 1 to 5 Years

$’000


Non- Interest Bearing

$’000Total

$’000


Financial Assets

CashandCashEquivalents 49 – – – – 300 300

Total Financial Assets – – – – 300 300


AdvancefromTerritory BankingAccount 51 – – – – 300 300

Total Financial Liabilities – – – – 300 300

Net Financial Assets/(Liabilities) – – – – – –



Note 53. Financial Instruments – Territorial (Continued)2013

$’0002012

$’000

Carrying Amount of Each Class of Financial Asset and Financial Liability

Financial Assets

LoansandReceivablesMeasuredatAmortisedCost 5 –


FinancialLiabilitiesMeasuredatAmortisedCost 300 300

Fair Value HierarchyTheDirectoratedoesnothaveanyfinancialassetsorfinancialliabilitiesonbehalfoftheTerritoryatfairvalue. Assuchnofairvaluehierarchydisclosureshavebeenmade.

Note 54. Commitments – Territorial

Capital CommitmentsCapitalcommitmentsatreportingdatethathavenotbeenrecognisedasliabilitiesareasfollows:

2013 $’000

2012 $’000

Capital Grant Commitments

Within one year 4,615 746

Laterthanoneyearbutnotlaterthanfiveyears – –

Total Capital Commitments 4,615 746

AllamountsshowninthecommitmentnoteareexclusiveofGoodsandServicesTax(GST).

Note 55. Contingent Liabilities and Contingent Assets – Territorial

Therewerenocontingentliabilitiesorcontingentassetsasat30June2013,(Nilat30June2012).

Therewerenoindemnitiesasat30June2013,(Nilat30June2012).

Note 56. Events Occurring After Balance Date – Territorial

Therewerenoeventsoccurringafterthebalancedate,whichwouldaffectthefinancialstatementsasat 30June2013,orinthefuturereportingperiods.


A.7 Statement of Performance


Output Class 1: Health and Community Care

Output 1.1 Acute Services

DescriptionTheCanberraHospitalprovidesacomprehensiverangeofacutecare,includinginpatient,outpatientandemergencydepartmentservices.Thekeystrategicpriorityforacuteservicesistodelivertimelyaccesstoeffectiveandsafehospitalcareservices.

Thismeansfocussingon:

• implementingworkarisingfromtheNationalHealthReformAgreementwhichtheCommonwealthGovernmenthasputintoplacethroughanumberofnationalpartnershipsandagreementswiththeaimofimprovingservicestotheAustraliancommunity;

• strategiestoimproveaccesstoemergencyservices;

• meetingthedemandforelectivesurgeryintheTerritoryandreducingthenumberofpeoplewaitinglongerthanrecommendedstandardwaitingtimes;

• strategiestomeetperformancetargetsfortheemergencydepartmentandelectiveandemergencysurgery;and

• continuingtoincreasethecapacityofacutecareservicesintheACTandsurroundingregion.

Original Target

2012–13

Actual Result

2012–13

% Variance from

Original Target Explanation of Material Variances Notes

Totalcost($000’s) 659,657 682,977 4%

Thehigherthanexpectedtotalcost relatesmostlytoaccelerateddepreciationfortheoldWomen’sandChildren’s Hospitalandtowerblocklevel5at CanberraHospital.Thesefacilitiesareundergoingsignificantredevelopment.

Government payment foroutputs (GPO)($000’s)

137,678 134,615 (2%)

Accountability Indicators Patient activity

a.Costweightedpatientseparations 63,541 66,184 4%

Thegrowthinacutecostweightedseparationsin2012–13waslargelydue toincreasedlevelsofelectivesurgeryandmaternityservices.Theincreasein maternitywasduetohighbirthratesexperiencedin2012–13.

1

Notes1. CostweightedseparationsforallCanberraHospitalepisodes,excludingthosereportedelsewhere(MentalHealth,CancerServicesand

AgedCareandRehabilitationService)andunqualifiedneonates(wellbabies,whoarecountedaspartoftheirmother’sadmission).Costweightedseparationsdifferfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureoftheactivityperformed.


Output Class 1: Health and Community Care (Continued)

Output 1.1 Acute Services (Continued)

Original Target

2012–13

Actual Result

2012–13

% Variance from


b.Non-admittedoccasionsofservice 268,434 282,192 5%

TherehasbeenahigherthanexpecteddemandforoutpatientservicesattheCanberraHospital.Growthhasoccurredinallareas,althoughitismostnotableinMedicalImagingandPathology.

2

c.Percentageofcategoryoneelectivesurgerypatientswhoreceivesurgerywithin30daysoflisting

97% 99% 2% 3

d.Numberofalliedhealth care services providedforacutecarepatientsinACTpublic hospitals

101,400 107,485 6% Therehasbeenahigherthanexpecteddemandfortheseservices. 4

e.Meanwaitingtimeforclientsonthedentalserviceswaitinglist

12 Months 12 Months – 5

f.PercentageoftheWomen’sHealthServiceIntakeOfficer’sclientswhoreceiveanintakeandassessmentservicewithin14workingdaysoftheirinitialreferral

100% 100% – 6

Notes2. Non-admittedpatientservicesprovidedattheCanberraHospital,excludingthoseservicesprovidedbyMentalHealth,CancerServices

andtheAgedCareandRehabilitationService.3. Categoryonepatientsarethoseassessedbythetreatingmedicalofficerasthehighestpriorityforelectivesurgeryrequiringsurgery

within30daysofbeinglistedontheelectivesurgerywaitinglist.Inlinewithnationaldefinitions,the30-dayrecommendedwaitingtimeforcategoryonepatientscommencesfromwhenthehospitalacceptsthepatient’s‘requestforadmission’fromthetreatingmedicalofficerandisplacedonthehospital’selectivesurgerywaitinglist.ThetimedoesnotstartfromthedateapatientisinitiallyassessedbythetreatingmedicalofficerastheDirectoratecannotcontrolthetimetakenbythetreatingmedicalofficertosubmitcompletedocumentationtothehospitaltoplacethemontheelectivesurgerywaitinglist.

4. ThenumberofalliedhealthservicestoinpatientswithintheCanberraHospital.5. Clientmeanwaitingtimeisdefinedasthemeanwaitingperiodbetweenwhenaclientisplacedontheadultdentalcentralwaitinglist

andthereceiptoftreatmentprovidedbyapublicdentist.6. Thisaccountibilityindicatorprovidesanindicationoftheavailabilityofservices.



Output 1.2 Mental Health, Justice Health and Alcohol and Drug Services

DescriptionMentalHealth,JusticeHealthandAlcoholandDrugServicesprovidearangeofservicesinhospitals,communityhealthcentres,adultandyouthcorrectionalfacilitiesandprivatehomes.Thisserviceworkswithitscommunitypartnerstoprovideintegratedandresponsivecaretoarangeofservicesincludinghospitalbasedspecialistservices,supportedaccommodationservicesandcommunitybasedserviceresponses.

ThekeystrategicprioritiesforMentalHealth,JusticeHealthandAlcoholandDrugServicesareensuringthatclients’needsaremetinatimelyfashionandthatcareisintegratedacrosshospital,community,andresidentialsupportservices.

Thismeansfocussingon:• ensuringtimelyaccesstoemergencymentalhealthcarebyreducingwaitingtimesforurgentadmissionsto

acutepsychiatricunits;

• ensuringthatpublicmentalhealthservicesintheACTprovideconsumerswithappropriateassessment,treatmentandcarethatresultinimprovedmentalhealthoutcomes;and

• providinghospitalandcommunitybasedalcoholanddrugservicesandhealthcareassessmentsforpeopledetainedincorrectivefacilities.

Original Target

2012–13

Actual Result

2012–13

% Variance from


Totalcost($000’s) 117,504 114,338 (3%)

Thevariancerelatestostaffvacanciesandadelayedopeningofaplannedolderpersonsstep-upstep-downsub-acuteservice.TheunderspendwasoffsetbyincreasedexpenditureforaccelerateddepreciationoftheoldPsychiatricServicesUnitthatwillbeconvertedtoaccommodateotherservices.

Government payment foroutputs(GPO)($000’s)

54,432 54,432 –

Accountability Indicators

a.Costweightedseparations 3,004 3,098 3% 7

b.Admittedpatientseparations 830 950 14% Thevarianceisduetoincreaseddemandfor

servicesattheAdultMentalHealthUnit(AMHU). 8

c.Adultservices (18–64years) 185,000 203,689 10% Thevarianceisattributabletocontinuedgrowth

indemandforadultservices. 9

d.Childrenandyouthservices(0–17years) 52,000 48,455 (7%) Staffvacanciesearlyinthereportingperiod

impactedonthelevelofactivity. 10

e.Olderpersons’services(65+years) 17,000 14,974 (12%) Thevarianceismainlyduetotheunavailability

ofstaff. 11

Notes7. CostweightedseparationsformentalhealthrelatetotheAdultMentalHealthUnitatCanberraHospitalandHealthServicesand

AlcoholandDrugServices.Costweightedseparationsdifferfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

8. RawseparationsfromtheAdultMentalHealthUnit.Rawseparationscountthenumberofinpatienthospitalepisodesdischargedinthereferenceperiod.

9. MentalHealthACTAdultcommunityoccasionsofservice(Agegroup18–64).10.MentalHealthACTChildrenandAdolescentscommunityoccasionsofservice(Agegroup0–17).11.MentalHealthACTolderperson’scommunityoccasionsofservice(Agegroup65+).



Output 1.2 Mental Health, Justice Health and Alcohol and Drug Services (Continued)

Original Target

2012–13

Actual Result

2012–13

% Variance from

Original Target

Explanation of Material Variances Notes

f.Olderpersons’servicesbeddays 4,928 5,174 5% Thevarianceisduetoincreaseddemand

forthisservice. 12

g.Supportedaccommodation bedoccupancyrate

95% 97% 2% 13

h.ProportionofclientscontactedbyaHealthDirectoratecommunityfacilityduringthe7dayspostdischargefromtheinpatientservices

75% 90% 20%

Follow-upcontactpostdischargewasabovetargetandthiswasduetotheworkundertakenbymentalhealthworkerswhoassistinthetransitionofpatientsfrominpatientunitsbackintothecommunity.

14

i.Percentageofclientswithoutcomemeasurescompleted

65% 58% (11%)

Thetargetwasbasedonadifferentmethodofcalculation.Byapplyingthemethodofcalculationusedinsettingthetarget,theresultwouldhavebeen65%

15

j.ProportionofoffendersanddetaineesattheAlexanderMaconochieCentrewithacompletedhealthassessmentwithin24hoursofdetention

100% 100% – 16

k.ProportionofoffendersanddetaineesinBimberiYouthDetentionCentrewithacompletedhealthassessmentwithin 24hoursofdetention

100% 93% (7%)

Atotalof7youngpeoplewerenotassessedwithin24hoursofdetention. Sixyoungpeoplewerestillassessedhoweverduetoattendingcourt breachedthe24hourtargetbyless thantwohours.Oneyoungperson refusedahealthassessment.

16

l.Percentageofcurrentclientsonopioidtreatmentwithmanagementplans

98% 99% 1% 17

Notes12.TheactualnumberofOccupiedBedDaysattheCalvaryPublicHospitalolderpersons’mentalhealthinpatientunit.13.ActualoccupancyexpressedasapercentageofthetotalsupportedaccommodationplacesprovidedbythefollowingCommunity

Serviceproviders:RichmondFellowship,Centacare,ACTMentalHealthFoundationandInanna.14.TheproportionofclientsadmittedtoamentalhealthinpatientunitandcontactedbyMentalHealthACTCommunityServicesduring

the7dayspostdischargefromthementalhealthinpatientunit(notallinpatientsarereferredtoMentalHealthACTcommunitymentalhealthbutmaybeseenbytheirgeneralpractitionerorprivatepsychiatrist).

15.PercentageofMentalHealthACTregisteredclientswithmandatoryoutcomemeasurescompletedeachthreemonthsandforeachinpatientepisode.Thepurposeofmeasuringclinicaloutcomesistoseewhetherconsumersofpublicmentalhealthservicesaregettingbetterasaresultoftheservicestheyreceive.

16.PercentageofdetaineesinductedintoBimberiandAlexanderMaconochieCentrewhoareassessedwithin24hoursofarrivalatthefacility.InrespectofBimberi,youngdetaineeswhoaredetainedforaperiodoflessthan24hourswillbeexcludedfromthisindicator.

17.Onpresentationforopioidreplacementtreatment,amanagementplanisdeveloped.Thisindicatorrepresentsthepercentageofclientswithmanagementplans.



Output 1.3 Public Health Services

DescriptionPublicHealthServicesprovideshighqualityhealthandcommunityservicestotheACTandsurroundingregion.ThekeystrategicprioritiesforPublicHealthServicesincludemonitoringthehealthoftheACTPopulation,promotinghealth,preventingdisease,improvinghealthequity,protectingthehealthofthepublic,andsupportingworkforceexcellence(PopulationHealthDivision).

Original Target

2012–13

Actual Result

2012–13

% Variance from

Original Target

Explanation of Material Variances Notes

Totalcost($000’s) 40,952 41,338 1%


37,417 37,417 –


a.Samplesanalysed 7,600 8,322 10% Thevarianceisduetoanincreaseinsamplesreceivedtotestforasbestos. 18

b.Complianceoflicensable, registrableand non licensable activitiesatthe timeofinspection

85% 76% (11%)

Thecomplianceratesrecordedprimarilyrelatetoregulatedfoodbusiness.Thenon-complianceisacontinuationofprevioustrendsinfoodsafetycompliance,whichisattributedtoroutineinspections,complaintbasedinspectionsandre-inspectionsofnoncompliantpremises.

19

c.Responsetimetoenvironmental healthhazards,communicable diseasehazardsrelatingtomeaslesandmeningococcalinfectionsandfoodpoisoningoutbreaks is less than 24 hours

100% 100% – 20

Notes18.NumberofsamplesanalysedduringtheperiodbytheACTGovernmentAnalyticalLaboratory.19.Percentageofinspectedpremisesfoundtobeincompliancewithrelevantlegislation,licence,orregistration.Thedataisdrawnfrom

recordsofinspectioncarriedoutunderprovisionsofallACTHealthadministeredlegislation.TherelevantActsare:Food Act 2001, Public Health Act 1997, Radiation Protection Act 2006andMedicines, Poisons and Therapeutic Goods Act 2008.

20.Responsetimeisdefinedastheelapsedtimebetweennotificationandcommencementofinvestigation.Thereportedpercentageisderivedfromthecombineddatasetsacrossthethreeclassesofquickresponsecategories:environmentalhealthhazards,communicablediseasecontrolhazardsandfoodpoisoningoutbreaks.



Output 1.4 Cancer Services

DescriptionCapitalRegionCancerServiceprovidesacomprehensiverangeofscreening,assessment,diagnostic,treatmentandpalliativecareservices.Servicesareprovidedininpatient,outpatientandcommunitysettings.

Thekeystrategicprioritiesforcancercareservicesareearlydetectionandtimelyaccesstodiagnosticandtreatmentservices.Theseincludeensuringthatpopulationscreeningratesforbreastcancermeettargets,waitingtimesforaccesstoessentialservicessuchasradiotherapyareconsistentwithagreedbenchmarks,andincreasingtheproportionofwomenscreenedthroughtheBreastScreenAustraliaprogramforthetargetpopulation(aged50to69years)to70percentovertime.

Original Target

2012–13

Actual Result

2012–13

% Variance from


Totalcost($000’s) 64,866 66,698 3%

Government paymentforoutputs(GPO)($000’s)

15,205 15,252 –


a.Costweightedadmittedpatientseparations

4,142 4,154 – 21


Demandremainshighforoutpatientcancerservices.SignificantgrowthhasoccuredinallareasalthoughitismostnotableinMedicalOncologyandImmunology.Theincreasedactivitywasmanagedbypermanentappointmentsduringthefinancialyearinboththeseareas.

22

Notes:21.InpatientcostweightedactivityforpatientsoftheCapitalRegionCancerServiceatCanberraHospital.Costweightedseparationsdiffer

fromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

22.Medicaloncology(includingchemotherapy),radiationoncology,immunologyandhaematologyoutpatientservicesatCanberraHospital.



Output 1.4 Cancer Services (Continued)

Original Target

2012–13

Actual Result

2012–13

% Variance from


Breast Screening

c.Totalbreastscreens 14,907 14,017 (6%)

Appointments at BreastScreen ACT are readilyavailable,howevertheserviceisexperiencingdifficultyinfillingthem.ThereareanumberofinitiativesunderwaytoencourageACTwomentoparticipateintheBreastScreenACTprogramincludingcontactinglapsedattendeesandadvisingGeneralPractitionersthatthereareappointmentsavailable.Useofelectoralrolldatafordirectinvitationforwomeninthetargetagegrouptoparticipateintheprogramiscurrentlybeingestablished.

23

d.Numberofbreastscreensforwomenaged50to69 12,552 11,385 (9%)

Appointments at BreastScreens ACT are readilyavailable,howevertheserviceisexperiencingdifficultyinfillingthem.ThereareanumberofinitiativesunderwaytoencourageACTwomenaged50–69toparticipateintheBreastScreenACTprogramincludingcontactinglapsedattendeesandadvisingGeneralPractitionersthatthereareappointmentsavailable.Useofelectoralrolldatafordirectinvitationforwomeninthistargetgrouptoparticipateintheprogramiscurrentlybeingestablished.

24

e.Percentageofwomenwhoreceiveresultsofscreenwithin28days

100% 100% – 25

f.Percentageofscreenedwhoareassessedwithin 28days

90% 94% 4%

Thewaittimetoassessmenthasimprovedsignificantly,primarilyasaresultofmodifiedworkpracticesresultingfromaredesignprojectandalsoduetoincreasedcapacity.Inaddition,areductionintimetakentoreadimagesbyradiologistshasenabledwomentoberecalledforassessmentsooner.

26

Notes:23.Totalnumberofwomenscreenedintheperiod.24.Numberofwomenagedbetween50to69yearsscreenedintheperiod.Thisagegroupisthetargetpopulationforthebreastscreenprogram.25.Thepercentageofwomenwitha‘normal’resultwhoreceivenoticeofthisoutcomewithin28daysoftheirscreeningappointment.

Consistentwithnationalmethods,theenddateisthedatetheresultsareproduced,asitisnotpossibletoascertainthedateaclientreceivesamaileddocument.

26.Thepercentageofwomenrequiringassessmentwhowait28daysorlessfromtheirbreastscreenappointmenttotheir assessmentappointment.



Output 1.5 Rehabilitation, Aged and Community Care

DescriptionTheprovisionofanintegrated,effectiveandtimelyresponsetorehabilitation,agedcareandcommunitycareservicesininpatient,outpatient,emergencydepartment,sub-acuteandcommunity-basedsettings.

ThekeystrategicprioritiesforRehabilitation,AgedandCommunityCareare:

• ensuringthatolderpersonsinhospitalwaittheleastpossibletimeforaccesstocomprehensiveassessmentbytheAgedCareAssessmentTeam.Thiswillassistintheirsafereturnhomewithappropriatesupport,oraccesstoappropriatelysupportedresidentialaccommodation;

• improvingdischargeplanningtominimisethelikelihoodofreadmissionorinadequatesupportforindependentliving,followingcompletionofhospitalcare;and

• ensuringthataccess,consistentwithclinicalneed,istimelyforcommunitybasednursingandalliedhealthservicesandthatcommunitybasedservicesareinplacetobetterprovidefortheacuteandpostacutehealthcareneedsofthecommunity.

Original Target

2012–13

Actual Result

2012–13

% Variance from


Totalcost($000’s) 101,815 100,891 (1%)


69,160 69,020 –



3,541 3,511 (1%) 27

b.Non-admittedoccasionsofservice 2,230 1,485 (33%)

ThebelowtargetresultisduetoachangewhichnowexcludesGeriatricshomevisitactivity(undertakenbytheRADARTeam),whichisnowcountedascommunityhealthserviceratherthanasanon-admittedoccasionsofservice.ThebelowtargetresultisalsoduetooneregistrarpositionbeingvacantinRehabilitationMedicineforthelargerpartofthethirdquarterof2012–13duetoanunexpectedresignation.

28

Notes27.InpatientcostweightedactivityforpatientsoftheAgedCareandRehabilitationServiceatCanberraHospital.Costweightedseparations

differfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

28.Geriatricandrehabilitationoutpatientservices.



Output 1.5 Rehabilitation, Aged and Community Care (Continued)

Original Target

2012–13

Actual Result

2012–13

% Variance from


c.Sub-acuteservice—episodesofcare 1,384 1,289 (7%)

Thevarianceisduetoalargenumberofnursinghometypepatientswaitingforanagedcareplacement,whichhasreduced theunit’scapacitytomanageadditional sub-acuteservices.Theunithasalsoexperiencedadelayintherecruitmentof anadditionalmedicalspecialistinrehabilitationmedicine.

29

d.Sub-acuteservice—occupiedbeddays 13,349 11,572 (13%)

Thevarianceisduetoalargenumberofnursinghometypepatientswaitingforanagedcareplacement,whichhasreduced theunit’scapacitytomanageadditionalsub-acuteservices.Theunithasalsoexperiencedadelayintherecruitmentofanadditionalmedicalspecialistinrehabilitationmedicine.

30

e.Numberof peopleassessed infallsclinics

420 448 7%

Thevarianceisaresultoftheincreaseduseofawarenessandpromotionalmaterials.TheseincluderepresentationattheSeniorsWeekExpo,AprilFallsmonth,engagementwiththeHealthcareConsumersGroupandACTMedicareLocal,mediaadvertisementsandmonthlynewsletters.

31

f.Numberofnursing(domiciliaryandclinicbased)occasionsofservice

80,000 83,962 5% Thevarianceisduetoincreasedcomplexityandacuityofpatients. 32

g.Numberofalliedhealthregionalservices(occasionsofservice)

22,000 21,740 (1%) 33

Notes29.Thetotalnumberofpersonsseparatedfromthesub-acuteserviceatCanberraHospital.30.Totalnumberofoccupiedbeddaysusedforpersonsseparatedfromthesub-acuteserviceatCanberraHospital.31.DatafortheFallsClinicistakenfrom‘IntegratedHealthCarePartnershipCentralRegionalTeam‘.The‘IntegratedHealthCare

PartnershipAssessors’contactshavebeenexcludedasthisrelatesto‘non-clinictime’interventionbystaffmember.32.AlloccasionsofserviceprovidedtocommunitypatientsbyContinuingCareNursesinthefollowingsettings:homevisits;ambulatory

careclinics;footcareclinics;continenceclinics;woundclinics;andstomaclinics.33.AlloccasionsofserviceprovidedtocommunitypatientsbyContinuingCareAlliedHealthProfessionalsandTechnicalOfficersfor

Physiotherapy,OccupationalTherapy,SocialWork,PodiatryandNutrition.



Output 1.6 Early Intervention and Prevention

DescriptionIncreasingthefocusoninitiativesthatprovideearlyinterventionto,orprevent,healthcareconditionsthatresultinmajoracuteorchronichealthcareburdensonthecommunity.

ThekeystrategicprioritiesforinterventionandpreventionarereducingthelevelofyouthsmokingintheACTandmaintainingimmunisationratesforchildrenabove90percent.

Original Target

2012–13

Actual Result

2012–13

% Variance from


Totalcost($000’s) 78,493 77,546 (1%)

Governmentpaymentforoutputs(GPO)($000’s) 51,968 53,520 3%


a.Immunisationcoveragefortheprimaryimmunisationschedulemeasuredat1yearofage,inaccordancewiththe Australian ChildhoodImmunisationRegister

92% 93% 1% 34

b.Proportionofclientsattending‘WellWomen’sCheck’withintheWomen’sHealthServicethatarefromculturallyandlinguisticallydiversecommunities

30% 40% 33%

Thefavourableoutcomeisduetotargetedpromotionofservicesinculturallyandlinguisticallydiversecommunitiesandservicesofferedinoutreachlocations.

35

c.Proportionofchildrenaged0–14whoareenteringsubstituteandkinshipcarewithintheACTwhoattendtotheChildatRiskHealthUnitforahealthandwellbeingscreen

80% 96% 20%ThepositivevariancereflectsimprovedreferralratesfromOfficeofChild,YouthandFamilyServices.

36

Notes34. Percentageof12montholdchildrenwhohavebeenfullyimmunisedinaccordancewiththeAustralianChildhoodImmunisationRegister.35.Thisindicatormeasuresthepercentageofwomenwhoarefromculturallyandlinguisticallydiversecommunitiesaccessinga’Well

Women’sCheck’.36.Thisindicatormeasuresthepercentageofchildrenaged0–14placedinoutofhomecare(substituteorkinshipcare)whohavereceived

ahealthandwellbeingscreen.TheHealthDirectorateisreliantonreferralsfromtheCommunityServicesDirectorateinordertoprovidetheseservices.


A.8 Strategic indicators

Health Directorate strategic indicators

Strategic objectives and indicatorsThegovernment’soverarchinghealthpolicy,Your health—our priority,identifiesthefollowingpriorities:

• timelyaccesstobettercare

• managementofchronicdisease

• improvedcarefortheelderly

• comprehensiveservicesformentalhealth

• supportingchildrenandvulnerablefamilies,and

• addressingthegapinAboriginalandTorresStraitIslanderhealthstatus.

Somestrategicindicatorswhichwerereportedin2011–12havebeendeletedfromthe2012–13setofstrategicindicators.Thestrategicindicatorsrelatingtoemergencydepartmentaccessblockweredeleted,astheyarenolongerconsistentwithnationalreportingorreportingunderthenationalhealthreforms.Thestrategicindicatorsrelatingtodischargeplanninghavealsobeendeleted,astheyarenotreflectiveofwiderdischargeplanningservices.

Strategic objective 1: Removals from waiting list for elective surgeryThisreferstothenumberofpeopleremovedfromtheACTelectivesurgerywaitinglistsmanagedbyACTpublichospitals.Thismayincludepublicpatientstreatedinprivatehospitals.

Strategic indicator 1: Number of people removed from waiting list

2012–13 target 2012–13 result

PeopleremovedfromtheACTelectivesurgerywaitinglist 11,000 11,579

Inordertoimproveaccesstoelectivesurgery,theCommonwealthandstateandterritorygovernmentshaveenteredintoapartnershiptosignificantlyincreasethenumberofelectivesurgeryoperationsprovidedinourpublichospitalseachyearandreducethenumberofpeoplewaitingmorethanclinicallyrecommendedtimesforthatsurgery.Aspartofthisprogram,theCommonwealthandtheACTgovernmentshavecommittedfundstospecificallyincreaseaccesstosurgeryfrom2009–10to2012–13.

Strategic objective 2: No waiting for access to emergency dental health services

Strategic indicator 2: Percentage of assessed emergency clients seen within 24 hoursThisprovidesanindicationoftheresponsivenessofthedentalservicetoemergencyclients.


Percentageofemergencyclientsseenwithin24hours 100% 100%


Strategic objective 3: Reaching the optimum occupancy rate for acute adult overnight hospital beds

Strategic indicator 3: The mean percentage of adult overnight acute medical and surgical beds in useThisprovidesanindicationoftheefficientuseofresourcesavailableforhospitalservices.


Percentageofadultovernightacutemedicalandsurgicalbedsinuse 85% 93%1

1. Therehasbeenanincreaseinthenumberofnon-samedaybeddays,whichhasimpactedonthebedoccupancyrate.

Strategic objective 4: Access to radiotherapy services

Strategic indicator 4: Percentage of radiotherapy patients who commence treatment within standard time framesThisprovidesanindicationoftheeffectivenessofpublichospitalsinmeetingtheneedforcancertreatmentservices.

Category 2012–13 target 2012–13 result

Urgent—treatmentstartswithin48hours 100% 100%

Semi-urgent—treatmentstartswithin4weeks 95% 100%

Non-urgent—treatmentstartswithin6weeks 95% 98%

Strategic objective 5: Government capital expenditure on healthcare infrastructure

Strategic indicator 5: Capital consumptionThisindicatorprovidesinformationongovernmentinvestmenttoimprovehealthcareinfrastructure.Informationontheleveloffundingallocatedforhealthinfrastructureasaproportionofoverallexpenditureprovidesanindicationofinvestmenttowardsdevelopingsustainableandimprovedmodelsofcare.TheaimfortheACTistobetterthenationalrate.

Government1 capital expenditure as a proportion of government2 capital consumption expenditure by healthcare facilities, 2007–08 to 2009–10 ACT rate National rate

2007–08 1.89 1.51

2008–09 2.76 1.90

2009–10 2.67 1.57

Source: HealthExpenditureAustralia2009–10(AustralianInstituteofHealthandWelfare).Excludeslocalgovernment.Expenditureonpubliclyownedhealthcarefacilities.


Strategic objective 6: Management of chronic disease

Strategic indicator 6: Maintenance of the highest life expectancy at birth in Australia

Maintenance of the highest life expectancy at birth in Australia ACT rate National rate

Females 84.8 84.2

Males 81.0 79.7

Source: ABS2012,Deaths,Australia,2011,cat.no.3302.0,ABS,Canberra.

Lifeexpectancyatbirthprovidesanindicationofthegeneralhealthofthepopulationandreflectsarangeofissuesotherthantheprovisionofhealthservices,suchaseconomicandenvironmentalfactors.TheACThasthehighestlifeexpectancyofanyjurisdictioninAustralia,andthegovernmentaimstomaintainthisresult.

Strategic objective 7: Lower than national average prevalence of circulatory disease

Strategic indicator 7: The proportion of the ACT population with some form of circulatory disease

Cardiovascular disease ACT rate National rate

ProportionoftheACTpopulationdiagnosedwithsomeform ofcardiovasculardisease 18.4% 16.9%

Source: AustralianHealthSurvey:FirstResults,2011–12,cat.no:4364.0.55.001,ABS,Canberra.

PopulationprojectionssuggestthattheACTpopulationisageingfasterthanthatofotherjurisdictions.ThemedianageoftheACTpopulation(34.5yearsin2011)hasincreased6.4yearssince1985.Whilepeopleofallagescanpresentwithchronicdisease,theageingofthepopulationanditslongerlifespanmeanthatchronicdiseaseswillplacemajordemandsonthehealthsystemforworkforceandfinancialresources.

Strategic objective 8: Lower than national average prevalence of diabetes

Strategic indicator 8: The proportion of the ACT population diagnosed with some form of diabetes

Diabetes ACT rate National rate

PrevalenceofdiabetesintheACT 3.8% 3.7%

Source: AustralianHealthSurvey:FirstResults,2011–12,cat.no:4364.0.55.001,ABS,Canberra.

Thisprovidesanindicationofthesuccessofpreventionandearlyinterventioninitiatives.Theself-reportedprevalenceofdiabetesinAustraliahasmorethandoubledoverthepast25years.Prevalenceratesmayincreaseintheshorttermasaresultofearlyinterventionanddetectioncampaigns.Thiswouldbeapositiveresult,asexpertspredictthatonlyhalfofthosewithdiabetesareawareoftheircondition.Thiscanhavesignificantimpactsontheirlong-termhealth.


Strategic objective 9: Higher than national average proportion of government recurrent health funding expenditure on public health activities

Strategic indicator 9: Proportion of government recurrent health funding expenditure on public health activitiesImprovementsinthepreventionofdiseasescanreducelonger-termimpactsonthehealthsystem,particularlyforpeoplewithchronicdiseases.TheaimfortheACTistobettertheAustralianaverage.

Estimated total government expenditure on public health activities as a proportion of total current health expenditure ACT rate National rate

2008–09 3.1% 2.7%

2009–10 2.7% 2.2%

2010–11 2.6% 2.1%

Source: HealthExpenditureAustralia2010–11(AustralianInstituteofHealthandWelfare).

Strategic objective 10: Maintaining the waiting times for in-hospital assessments by the Aged Care Assessment Team

Strategic indicator 10: The mean waiting time in working days between the request for, and provision of, assessment by the Aged Care Assessment Team (ACAT) for patients in public hospitalsThisprovidesanindicationoftheresponsivenessofACATinassessingtheneedsofclients.


Meanwaitingtimeinworkingdays 2days 2.5days1

1. TheACTAgedCareAssessmentTeam(ACAT)wasunabletomeettheindicatortargetduetoincreasedpublicandprivatehospitalreferralsandongoingissueswithunexpectedstaffunavailability.Toimproveperformanceonthisindicator,ACATisattemptingtorecruitadditionalcasualbackfillassessorstodealwiththeincreasedlevelsofreferrals.Theresultisstillwithinthenationalresponsetimeframe.

Strategic objective 11: Providing comprehensive services for mental health and reducing the usage of seclusion

Strategic indicator 11: The proportion of clients with episodes of seclusion of public mental health in the ACT who are subject to seclusion during an inpatient episodeThismeasurestheeffectivenessofpublicmentalhealthservicesintheACTovertimeinprovidingservicesthatminimisetheneedforseclusion.


ProportionofclientsofpublicmentalhealthservicesintheACTsubjecttoseclusionduringaninpatientepisode <3% 1.5%

ACTHealthisleadinganinnovativepieceofresearchintoseclusionreductionpracticesinthementalhealthinpatientunitattheCanberraHospital.Thefindingsoftheresearch,whichconcludedinApril2012,showtheimportanceofconsumerinvolvementinthegrassrootsofdecisionmaking,theimportanceoftheconsumerexperiencewhenimplementingchangeandhowunderstandingconsumers’pasttraumaticexperiencesprovidesforinformedcareandcanimproveoutcomesformentalhealthconsumers,leadingtoamorecompassionateandtherapeuticrelationshipbetweenconsumersandstaff.TheresearchwasdoneincollaborationwithconsumerrepresentativesandclinicalstaffthroughweeklySeclusionandRestraintReviewMeetings(SRRM)andhasledtoahugereductionintheuseofseclusionatthatunit.


Strategic objective 12: Maintaining consumer and carer participation on relevant mental health committees

Strategic indicator 12: The proportion of mental health ACT committees in which consumers and carers are representedThismeasureensuresthatthecommitteeswhichmonitorthedeliveryandplanningofourmentalhealthserviceshaveeffectiveinputfrommentalhealthconsumers.


Proportionofmentalhealthservicescommitteeswithconsumerandcarerrepresentation 100% 100%

Strategic objective 13: Patients return rate to an ACT public mental health inpatient unit lower than national average

Strategic indicator 13: The proportion of clients who return to hospital within 28 days of discharge from an ACT public mental health inpatient unit


Proportionofclientswhoreturntohospitalwithin28daysofdischargefromanACTpublicmentalhealthinpatientunit <10% 9.8%

Source: ReportonGovernmentServices,2013.

Strategic objective 14: Addressing gaps in Aboriginal and Torres Strait Islander health status

Strategic indicator 14: Immunisation rates—ACT Indigenous populationThisprovidesanindicationofthepublichealthservicestominimisetheincidenceofvaccinepreventablediseases,asrecordedbytheAustralianChildhoodImmunisationRegister,intheACT’sindigenouspopulation.TheACTaimstomaintaintheimmunisationcoverageratesforvulnerablegroupsand,inparticular,minimisedisparitiesbetweenIndigenousandnon-IndigenousAustralians.

Immunisation rates for vaccines in the national schedule for the ACT Indigenous population: 2012–13 target 2012–131 result

12 to 15 months ≥90% 81.5

24 to 27 months ≥90% 91.6

60 to 63 months ≥90% 91.0

All ≥90% 88.0

Source: ProductivityCommission’sReviewofGovernmentService(ROGS).1. TheverylownumbersofAboriginalandTorresStraitIslanderchildrenintheTerritorymeansthattheACTAboriginalandTorresStrait

Islandercoveragedatashouldbereadwithcaution.Giventhesmallpopulation,smallchangescanresultinsignificantratefluctuations.


Strategic objective 15: Maximising the quality of hospital servicesThefollowingthreeindicatorsareaselectionofthepatientsafetyandservicequalityindicatorsthatareusedtomonitorACTpublichospitalservices.Thetargetsprovideanindicationofthedesiredoutcomesovertime.Giventhenatureoftheindicators,smallfluctuationsduringaparticularperiodcanskewresults.DeterminingthesuccessoftheHealthDirectorateinmeetingtheseindicatorsrequiresaconsiderationofperformanceovertimeratherthanforanygivenperiod.

Strategic indicator 15.1: The proportion of people who undergo a surgical operation requiring an unplanned return to the operating theatre within a single episode of care due to complications of their primary conditionThisprovidesanindicationofthequalityoftheatreandpost-operativecare.


Canberra Hospital <1.0% 0.75%1

Calvary Public Hospital 0.5% 0.05%

1. TheCanberraHospitaltargetisbasedonsimilarratesforpeerhospitals—basedonAustralianCouncilonHealthcareStandards(ACHS).

Strategic indicator 15.2: The proportion of people separated from ACT public hospitals who are readmitted to hospital within 28 days of their separation due to complications of their condition (where the readmission was unforeseen at the time of separation)Thisprovidesanindicationoftheeffectivenessofhospital-basedandcommunityservicesintheACTinthetreatmentofpeoplewhoreceivehospital-basedcare.


Canberra Hospital <2.0% 1.30%

Calvary Public Hospital 1.0% 0.6%

Strategic indicator 15.3: The number of people admitted to hospitals per 10,000 occupied bed days who acquire a bacteraemial infection during their stayThisprovidesanindicationofthesafetyofhospital-basedservices.


Canberra Hospital < 7 per 10,000 6.7per10,000

Calvary Public Hospital < 3 per 10,000 1.3per10,000

Strategic objective 16: High participation rate in the Cervical Screening Program

Strategic indicator 16: Two-year participation rate in the Cervical Screening Program.Thetwo-yearparticipationrateprovidesanindicationoftheeffectivenessofearlyinterventionhealthmessages.TheACTaimstoexceedthenationalaverageforthisindicator.

ACT rate National rate

Two-yearparticipationrate 58.8% 57.4%

Source: CervicalScreeninginAustralia2009–10(AustralianInstituteofHealthandWelfare,May2012).


Strategic objective 17: Improved Emergency Department timeliness

Strategic indicator 17: The proportion of Emergency Department presentations that are treated within clinically appropriate timeframes


One(resuscitation,seenimmediately) 100% 100%

Two(emergency,seenwithin10mins) 80% 74%

Three(urgent,seenwithin30mins) 75% 43%

Four(semi-urgent,seenwithin60mins) 70% 46%

Five(non-urgent,seenwithin120mins) 70% 79%

Allpresentations 70% 51%

Strategic objective 18: Improved breast screen participation rate for women aged 50 to 69 years

Strategic indicator 18: The proportion of women in the target age group (50 to 69 years) who have a breast screen in the 24 months prior to each counting period


Proportionofwomenaged50to69 60% 56%1

1. BreastScreenACThasreadilyavailableappointmentsbutisexperiencingdifficultyfillingthem.Anumberofinitiativesareunderwaytoraisetheawarenessandprofileoftheservice,particularlywithinthetargetgroupofwomenaged50to69.

Strategic objective 19: Achieve lower than the Australian average in the Decayed, Missing, or Filled Teeth (DMFT) Index

Strategic indicator 19: The mean number of teeth with dental decay, missing or filled teeth at ages 6 and 12Thisgivesanindicationoftheeffectivenessofprevention,earlyinterventionandtreatmentservicesintheACT.TheaimfortheACTistobettertheAustralianaverage.

Dental health—Decay, missing or filled teeth (DMFT) ACT rate1 National rate

a DMFTIndexat6years 1.16 2.31

b DMFTIndexat12years 0.71 1.11

Source: ChildDentalHealthSurvey,2008(published:AustralianInstituteofHealthandWelfare,2012).1. Lowestofalljurisdictions.


Strategic objective 20: Reducing the risk of fractured femurs in ACT residents aged over 75 years

Strategic indicator 20: Reduction in the rate of broken hips (fractured neck of femur)Thisprovidesanindicationofthesuccessofpublicandcommunityhealthinitiativestopreventhipfractures. In2011–12,theACTrateofadmissionsinpersonsaged75yearsandoverwithafracturedneckoffemurwas 6.6per1,000ACTpopulation.Thisisslightlyhigherthanthepreviousrateof5.3in2010–11;however,thedifferenceisnotstatisticallysignificant.Thisiswithinthelong-termtargetandfollowsthegenerallydecreasingtrendsince2001–02.

2011–12 outcome Long-term target

Rateper1,000people 6.6 5.3

Thelownumbersofpatientsincludedinthiscalculationmeansthattherateofbrokenhipsinolderpersonsshouldbereadwithcaution.Giventhesmallnumbers,smallchangescanresultinsignificantratefluctuations.

Strategic objective 21: Reduction in the youth smoking rate

Strategic indicator 21: Percentage of persons aged 12 to 17 years who smoke regularlyTheresultsfromthe2008SecondarySchoolAlcoholandDrugSurvey(ASSAD)showthat6.7percentofstudentsweresmokersinthatyear.Thisdemonstratesacontinueddeclineinsmokingfrom15.3percentin2001to6.7percentin2008.Thenationalrateforsmokingin2008was7.3percent.

2011 outcome National rate Long-term target

Percentageofpersonsaged12–17whoare currentsmokers 5.8% 6.7% 5%

Source:ASSADconfidentialisedunitrecordfiles2011,ACTHealth.Australiansecondarystudents’useoftobacco,alcohol,andover-the-counterandillicitsubstancesin2011report,TheCancerCouncilVictoria,December2012.


A.9 Analysis of Agency Performance

Strategy and Corporate overviewThebrancheswithinthedirectorate’sStrategyandCorporatedivisionundertakeworkindiversearenaswhichcrossallareasofACTHealth.TheserangeacrosssupportforNationalHealthReformsandNationalPartnershipAgreements,strategiesforattractionandretentionofthehealthworkforce,anddevelopmentandmaintenanceofcriticalphysicalandtechnologicalinfrastructureforourhospitalsandhealthservices.

HighlightsforthisreportingperiodforStrategyandCorporate,whichmaynotappearelsewhereinthisreport,aresetoutbelow.

Professional leadershipPendingfinalisationofareviewofthe2011restructure,interimarrangementswereputintoplacefollowingthedepartureofpreviousincumbentsofseniorclinicalleadershippositions.ACTHealthtooktheopportunitytoamalgamatethePrincipalMedicalAdvisorrolewiththatoftheExecutiveDirector,MedicalServices,andtheChiefNurserolewiththatoftheExecutiveDirector,NursingandMidwifery.

eHealthTheeHealthandClinicalRecordsBranchadministerstheICTstrategywithinACTHealthandisresponsiblefortheimplementationofthetechnologiestosupportthe$90millionACTHealthYour health—Our priority programofworkentitled‘Health-eFutures’.InadditiontotheprojectswithinHealth-eFutures,managedunderthethreeareasofClinicalSystems,SupportSystems,andDigitalHealthInfrastructure,thebranchwasresponsibleforsuccessfulcompletionofthefirstpublichospitalconnectiontothenationalPersonallyControlledElectronicHealthHealthRecord(PCEHR)duringthereportingperiod.HealthcareconsumerswhoareadmittedtotheCanberraHospitalcannowelecttohavetheirdischargesummarysenttotheirnationaleHealthrecord.WiththeACTbeingthefirstjurisdictiontosubmitdischargesummariestothenationaleHealthrecordsystem,andACTHealthbeingthesecondhealthcareorganisationtoachievethismilestone,ACTHealthisleadingthewayforhealthcareorganisationsacrossthecountry.

Locally,therolloutoftheACTPatientAdministrationSystem(ACTPAS)totheCalvaryHospitalin2012laidthefoundationforintroductionatCalvaryofavarietyofprovenclinicalsystemsusedbyACTHealth.Theuseofcommonsystemsenhancesthenetworkingofservicesacrosstheterritoryforthebenefitofpatientsandcliniciansalike.TheConcertoClinicalPortalisoneexample.Designedtoprovideasinglepointofaccessforclinicalinformation,theportalenablesstafffromboththeCanberraHospitalandCalvaryHospitaltoviewepisodeinformation,allergies,alerts,radiologyandpathologyresults,anddischargesummariescreatedwithinit.Thiswillgreatlyimproveaccesstotimelyinformationtoassistwithclinicaldecisions.

Similarly,Metavision,theIntensiveCareClinicalInformationSystemattheCanberraHospital,enablesstafftomanageallclinicaldocumentationelectronically,integrateswiththeclinicalmodalitiesandprovidesthemwithacompleteviewofpatienthealthinformationatthepointofcare.ThisrecentlyimplementedapplicationatCalvaryHospitalnowprovidesasharedviewofcarefortheIntensiveCareStaffSpecialiststreatingthepatients.

InfrastructureInadditiontothecompletionofanumberofmajorcapitaldevelopmentprojects(seesectionC.14Capitalworks),branchesacrossthedirectoratecollaboratedtodeliveravarietyofotherprojectsforthebenefitofconsumersofourhealthservices.


Duffy HouseInOctober2011,ahouseinDuffywaspurchasedtoprovideahome-away-from-homeenvironmentforregionalcanceroutpatientsandtheircarersduringtreatmentatCanberraHospital,lessthan10kilometresaway.TheAustralianGovernmentprovided$1.8millionfortheproperty’spurchase,extensiverenovations,specialfurnitureandequipment,landscapingandfit-outofthefacility,whichwasopenedtoitsfirstresidentson6September2012.

Youth Mental Health Step-Up, Step-Down residential serviceInlate2012,ahouseinKambahwaspurchasedwithfundingsupportfromtheCouncilofAustralianGovernments(COAG)NationalPartnershipAgreementonImprovingPublicHospitalServicestoprovideaYouth(18–25-year-olds)MentalHealthStep-Up,Step-Downresidentialaccommodationservice.Theservice,whichopenedon6 March 2013,operatesunderapartnershiparrangementbetweentheACTHealthclinicalmentalhealthserviceandthecommunitymentalhealthserviceprovider,theMentalIllnessFellowshipofVictoria.Thesix-bedresidenceoffers24-hoursupportsevendaysperweekandprovidesadditionalclinicalandpsychosocialsupportforyoungpeoplewhoeitherrequiretransitionbetweenanacuteadmissiontohospitalandtheirhome,orhaveadeterioratingmentalillnessandrequiretreatmentandsupportofatypethatcannotreadilybeprovidedathomebutwhichdoesnotrequireahospitaladmission.Theservicecompletesthecontinuumofsub-acutementalhealthcarebetweenthetwoexistingstep-upstep-downservicescurrentlyoperatingforthe13–17-year-oldand26–64-year-oldagegroups.

MyMealIntheBusinessandInfrastructurebranch,theFoodServicessectionintroducedMyMeal—afullyintegratedfoodservicemanagementsystemtoimprovethequalityandefficiencyoforderinganddeliveryofmealstopatientswithintheCanberraHospital,therebyenhancingthepatient’sjourney.TheMyMealsystemunderpinsCanberraHospital’sabilitytoordersafeandnutritiousmealsanddeliverthemtotherightpatientattherighttime,aswellasassistingwiththemanagementofthe1.3 millionpatient,clientandcafeteriamealsproducedbyFoodServicesannually.

Local Health Network performanceIn2011,COAGagreedtotheNationalHealthReformAgreement (NHRA)toaddresschangingandgrowinghealthcareneeds,nationallyandfortheACT.TheagreementprovidedforsubstantialincreasesinCommonwealthfundingfortheACT. KeycomponentsofthereformsweretheestablishmentofLocalHospitalNetworks(LHNs),comprisingsmallgroupsofpublichospitalswithageographicorfunctionalconnection,andaNationalHealthFundingBodytoadministerpaymentsforhospitalservicesbetweentheCommonwealthandparticipatingstatesandterritories.

InMarch2011theACTLegislativeAssemblypassedamendmentstotheHealth Act 1993thatprovidedfortheestablishmentoftheACTLHNandaskill-basedACT LHN Council.InFebruary2013theAssemblypassedcomplementarylegislationestablishingthebankingandfinancialinfrastructurethatenablesfundstobemadepayabletotheACTbytheAdministratoroftheNationalHealthFundingPool.

TheACTLHNconsistsofanetworkedsystemofservicecontractsbetweenACT HealthandCanberraHospital,CalvaryPublicHospital,ClareHollandHouseandtheQueenElizabethIIFamilyCentre.

Throughoutthereportingperiod,ACTHealth’sPerformanceandInformationBranchandPolicyandGovernmentRelationsBranchhavecontinuedtorefinedataanalysisandreportingcapabilitytosupportthesenewarrangements,asevidencedbyquarterlyreportsprovidedtotheACTLHNCouncil.

TheACTLocalHospitalNetworkDirectoratefinancialandperformancestatementsareprovidedasanannexuretothis annualreportatpage314.


WorkforceItwasparticularlypleasingduringthereportingperiodtohavefinalisedtheACT HealthWorkforcePlan2013–18 andtheAboriginalandTorresStraitIslanderHealthWorkforceActionPlan2013–2018.

TheformerforgeslocallinkageswithnationalinitiativesbydescribinglocalworkforceissuesandactionsundertherubricofthedomainsidentifiedinHealthWorkforceAustralia’sNationalHealthWorkforceInnovationandReformStrategicFrameworkforAction2011–2015.

ThelatterrespondsdirectlytotheNational Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2011–2015andtheACT Public Service Employment Strategy for Aboriginal and Torres Strait Islander People—Building a culturally diverse workforce 2010.

RefinementandupdatingofourLearningandDevelopmentFrameworkandtheEssentialEducationPolicyhasalsostrengthenedthesupportprovidedtoourworkforce.

Canberra Hospital and Health Services overviewCanberraHospitalandHealthServices(CH&HS)providesacute,sub-acute,primaryandcommunity-basedhealthservicestotheACTandsurroundingregion.

CHHSconsistsofeightdivisions:Surgery&OralHealth,WomenYouth&Children,CriticalCare,CapitalRegionCancerService,Rehabilitation,Aged&CommunityCare,MentalHealth,JusticeHealth,Alcohol&DrugService,PathologyandMedicine.

AcomprehensiverangeofservicesaredeliveredfromtheCanberraHospitalcampus,includingacuteinpatientanddayservices,outpatientandpathologyservices.Community-basedservicesincludeearlychildhood,youthandwomen’shealth,dentalhealth,rehabilitationandcommunitycare,mentalhealthcare,andalcoholanddrugservices.Inaddition,justicehealthservicesareprovidedwithintheterritory’sdetentionfacilities.Stronglinksaremaintainedbetweenhospitalandcommunity-basedservices,asmanyofthecommunity-basedservicesareprovidedfromvariousvenuesacrosstheACT,includingcommunityhealthcentres,childandfamilycentres,schoolsandinpeople’shomes.CanberraHospitalandHealthServicesliaisescloselywithCalvaryPublicHospitaltoensureeffectivecoordinationofservicesacrosstheterritoryanddeliveryofrequiredoutputs.AnumberofCHHSdivisionsprovideserviceswithintheCalvaryPublicHospitalfacilitiesandmanyofthecommunity-basedservicesliaisecloselytoensurethataseamlessserviceisprovided.

SignificantachievementsforCHHSoverthepastyearincludethecompletionofthenewCentenaryHospitalforWomenandChildren.PatientsweremovedintothenewhospitalinAugust2012anditwasasignificantmilestonetomovepatientsfromtheoldareatothenewareawithoutincident.ThemoveincludedmovingbabiesfromwithintheNeonatalIntensiveCareUnit.Thismovewasacarefullyplannedandconsideredprocess,whichincludedcommunicationstrategiestoensurethatthesafetyofthepatientsandstaffwasupheldasthehighestpriority.

ThenewCentenaryHospitalforWomenandChildrenfeaturesstate-of-the-artequipmentandinfrastructureandisanimpressivebuilding,deliveringhigh-levelcaretowomen,childrenandadolescents.

AspartoftheNationalElectiveSurgeryTargets(NEST),theACTwasrequiredtoremove11,000peoplefromthesurgicalwaitinglist.TheCanberraHospitalcomponentofthistargetwas6,300removals.TheCanberraHospitalexceededthistargetbydelivering6,464removalsfromthelist.ThiscontributedtotheACTmeetingtheNESTtargets.AreportreleasedbytheAustralianInstituteofHealthandWelfareshowsthattheACTwastheonlyjurisdictiontomeetallthreecomponentsofthenationalelectivesurgerytargets.Inaddition,theCanberraHospitaliscurrentlyadmitting81percentofpatientsforsurgerywithinstandardwaitingtimes.Thisisa10percentimprovementonthesameperiodlastyear.

ActivitythroughouttheCanberraHospitalhasincreasedoverthepastyear,whichhasincreasedpressureonbothinpatientandoutpatientareas.TheCanberraHospitalEmergencyDepartmenthadatotalof65,815presentationsoverthe2012–13financialyear,anincreaseonthepreviousyear.Anumberofinitiativeshavebeenputinplacetohelpmanageincreasinglevelsofactivitywithintheemergencydepartmentandacrossthehospital.



Theseinclude:

• ‘frontloading’—wherebypatientscanbeassessedandtreatedbyadoctormorerapidly

• expansionoftheCanberraHospitalDischargeLounge,whichenablespatientstoleavetheinpatientwardsearlier,whichinturnopensupinpatientbedsquicker,allowingforincreasedaccess

• purchasingbedsatMonashGoodwinVillageforsub-acutepatientswithanextendedlengthofstay.Thisenablesacutebedstobemadeavailableforpatientswhoneedtobeinanacutesetting.

Managingincreaseddemandrequiresawhole-of-hospitalapproach.Thehospitalfrequentlyoperatesatcapacityandregularlydealswithincreasesinactivity.Workwillcontinueoverthenextfinancialyeartoinitiateanumberofhospital-widechangesthatwillfurtherimprovepatientflow.

CanberraHospitalandHealthServicesalsoopenedthenewGungahlinCommunityHealthCentreinSeptember2012.ThisprogressivedevelopmentprovidesarangeofservicestoresidentswholiveinornearGungahlin.Thecentreoffersaccesstocommunitynursing,alliedhealthservices,includingphysiotherapyandpodiatry,dentalsurgeriesforchildrenandyouth,andarangeofservicesforwomenandchildrenincludingawomen’shealthnurseandnutritionclinic.Thecentreincorporatesmanyenvironmentallysustainabledesignprinciples,suchasenergy-efficientlightingsystems,fresh-airventilation,air-cooledchillers(ratherthanwater-cooledones),cyclistfacilities,andstormwaterretentiontanksbeneaththesurface-levelcarpark,whichcapturewaterforirrigatingthelandscapedareas.

AnothersignificantachievementforCHHSwasourprogressinreducingthepublicdentalwaitinglist.In2012–13thefederalGovernmentallocated$345.9millionoverthreeyearstoreducethepublicdentalwaitinglistacrossAustralia.Thefundinghasincreasedworkforcecapacityandincreasedutilisationoftheprivatesectortoreducepublicdentalwaitinglists.At30June2013,therewere165peoplewaitingfornon-urgentrestorativedentalservices,comparedwith2,310clientsonthewaitinglistat30June2012.At30June2013,2,447clientswereremovedfromtherestorativewaitinglist,comparedwith1,856at30June2012.Thisisanincreaseinclientsbeingremovedof591in12months—asignificantachievement.

CanberraHospitalandHealthServicesisalsoundernewleadership,followingtheappointmentofMrIanThompsoninAugust2012.


Output 1.1 Acute Services

Output description

The Government provides public hospital services at Canberra Hospital and Calvary Public Hospital. These public hospitals provide a comprehensive range of acute care, including inpatient, outpatient, and emergency department services. The key strategic priority for acute services is to deliver timely access to effective and safe hospital care services.

This means focusing on:

• implementing work arising from the National Health Reform Agreement which the Commonwealth Government has put into place through a number of national partnerships and agreements with the aim of improving services to the Australian community;

• strategies to improve access to emergency services under the National Health Reform; meeting the increasing demand for elective surgery in the Territory and reduce the number of people waiting longer than recommended standard waiting times;

• strategies to meet performance targets for the emergency department and elective and emergency surgery; and

• continuing to increase the capacity of acute care services within the ACT and surrounding region.

Both Canberra Hospital and Calvary Public Hospital are part of the ACT Local Hospital Network. Section A9 reflects acute services delivered by the ACT Local Hospital Network.

Increasing the capacity of the ACT Public Health Services

More beds to manage increasing demand for hospital servicesTheAustralianInstituteofHealthandWelfare(AIHW)reportedthatin2011–12,ACTpublichospitalsprovided anaverageof939beds.In2012–13,anadditional47bedswereintroduced,providinganestimatedcapacityof986beds.

TheACTGovernmenthasproposedfundingforanother39inpatientbedsin2013–14,including:

• 16generalinpatientbedsatCanberraHospital

• 15generalinpatientbedsatCalvaryPublicHospital

• an8-bedRapidAssessmentandPlanningUnittobeestablishedatCalvaryPublicHospital.

Thisequatestoanextra355bedssince2001–02.

InadditiontherehasbeenaconsiderableexpansiontotheHospitalintheHomeservice,withtheadditionof15bedequivalentsin2012–13.


ACT public hospitalsBed capacity by year

670 682 683 679 714

785 851 875

907 926 939 986

1025

20

13-1

4*

2012

-13*

2011

-12

2010

-11

2009

-10

2008

-09

2007

-08

2006

-07

2005

-06

2004

-05

2003

-04

2002

-03

2001

-02

*2012–13and2013–14figuresprovidesestimatedimpactofGovernmentinvestmentinadditionalcapacity.Source:AustralianHospitalStatistics,AIHW,2012–02to2011–2012publications.

TheACTGovernmentcontinuesitscommitmenttoaddingbedcapacitytothepublichospitalsystemtomeetgrowingdemandforcareandtoreducebedoccupancytooptimumlevels.

In2012–13,theACT’spublichospitalsprovided87,969cost-weightedseparationswithinAcuteCareServices(whichincludesgeneralhospitalservicesandprivatehospitalcontractedpatientsbutexcludeshospitalservicesprovidedbyMentalHealthACT,theCapitalRegionCancerServiceandtheAgedCareandRehabilitationService).Thisrepresentsa2percentincreaseincost-weightedseparationsin2012–13comparedwith2011–12.

ACT public hospitalsInpatient Admitted Patient CWS (Round 14 National DRG 6.0X)

2012-132011-122010-11

82,287

86,390 87,969

Source:Admittedpatientcaredataset


In2012–13,ACT’spublichospitalsprovidedover277,988overnighthospitalbeddaysofcare,1percentuponthetotalof274,851in2011–12.TheAustralian Hospital Statistics Reportfor2011–12issuedbytheAIHWinApril2013showedthattheACThadachievedthenationalaverageinprovidingpublichospitalbedavailabilityforthethirdtimeinthealmost21yearsofreportingbytheAIHW.ACTHealthreached2.6publichospitalbedsper1000people—whichisonparwiththeAustraliannationalaverage.

ACT public hospitalsAvailable beds per 1,000 population ACT vs national

2.1 2.1 2.12.1 2.2 2.3 2.5 2.5 2.62.62.62.62.62.62.5 2.5 2.5 2.6 2.6 2.6 2.7 2.6

2011

-12

2010

-11

2009

-10

2008

-09

2007

-08

2006

-07

2005

-06

2004

-05

2003

-04

2002

-03

2001

-02

ACT AUS

Thebedoccupancyrateforovernightadultmedicalandsurgicalbedsin2012–13was93percent.TheAustralianGovernment’slong-termtargetistomaintainbedoccupancylevelsataround85percent,whichisconsideredthebestlevelforbestpatientoutcomesandtoachievemaximumefficiency.However,withincreasingpressureonACTpublichospitalseachyear,thetargetforthisindicatorin2013–14hasbeenrevisedto90percent.ThiswillallowforthenecessaryinfrastructureandprocessimprovementtotakeeffectwhichwillmakeformorerealistictransitionforACTpublichospitalstoachievethe85percentincomingyears.

Theadditional39bedsfundedinthe2013–14budgetshouldassistinreducingbedoccupancyratestowardsthe90percenttarget.

ACT public hospitalsBed occupancy rate

2012-132011-122010-112009-10

88%

86%89%

93%


OutpatientServicesredesignhasbeendevelopedandimplementedoverthepasttwoyears,withtheprincipalobjectivesbeingtoreviewcurrentbusinessprocesseswithintheoutpatientserviceandimplementchangestoimproveefficiency,andtosupportaccesstoservicesforconsumers.

Overrecentyears,therehavebeensignificantincreasesinthedemandfornon-admittedoutpatientservices. In2012–13,OutpatientServicesexperienceda6percentgrowthinoutpatientoccasionsofservicecomparedwith2011–12.However,since2009–10,demandfortheseserviceshasgrownby18percentatbothCanberraandCalvaryhospitals.Inresponsetothisgrowth,resourceshavebeencommittedtoimprovethefunctionandprocessesofOutpatientServices.

ACT public hospitalsNon-admitted occasions of service

2012-132011-122010-112009-10

349,179

363,445

385,915

410,785

Source:Outpatientdataset

BirthsACTpublichospitalshaveaccommodatedrecordnumbersofbirthsin2012–13,with4,854birthsatCanberraandCalvaryHospitals,an8percentincreaseonthe2011–12result.Theresultof4,854birthsin2012–13alsorepresentsa70percentgrowth(almost2,000additionalbirths)inthenumberofACTpublichospitalbirthssince2001–02.

ACT public hospitalsBirths by year

2012-132011-122010-112009-10

4, 1834,247

4,490

4,854


ThenumberofbirthsbornbyCaesareansectionhasreducedto28percentofallbirthsduring2012–13,downfromthe29percentreportedin2011–12.


ACT public hospitalsProportion of births that required a caesarean procedure

2012-132011-122010-112009-10

28%

25%

26%

29%


However,Caesareanrateshavebeensteadilyrisingsince2001—bothintheACTandnationally.TheACTrateof 26percentin2010–11waslowerthanmostrecentnationalfigurespublishedbytheAIHW,for2007–08.ACTpublichospitalscontinuetohavealowCaesareanratecomparedtobenchmarkinghospitals.Themainstrategyistomovetowardsfurtherimplementationofthe‘continuityofmaternitymodelofcare’whichhasprovenimprovedclinicaloutcomesforwoman—suchasreducedrateofCaesareans.

TheACTGovernmenthasalsoprovidedanadditional$2millionin2010–11and$1.5millionin2011–12toenhanceobstetricandgynaecologicalservicesandneonatalservices.TheContinuityattheCanberraHospital(CatCH)Programbeganin2011asasecondcontinuity-of-caremodelattheCanberraHospital.In2012–13,aCommunityMidwiferyProgram(CMP)atCalvaryPublicHospitalwillbeestablishedtofurtherenhanceobstetricservicesatCalvary.

Operations in ACT public hospitalsOverthepastthreeyears,thenumberofsurgicaloperationsperformedatACTHealthpublichospitalshasjumpedby13percent,from16,312in2009–10to18,469in2012–13.Around30 per centoftheemergencyandelectivesurgicaloperationsareperformedonpeoplefromNewSouthWales.


ACT Public HospitalsTotal surgical operations performed (elective and emergency surgery)

2012-132011-122010-112009-10

18,469

29%

16,312

17,93518,232

Source:Admittedpatientdataset

Access to elective surgeryACTpublichospitalsprovided11,579electivesurgeryproceduresin2012–13.ThisisthehighestnumberinayearofpatientsaccessingelectivesurgeryintheACT.ThisisalsothethirdconsecutiveyearthatACTHealthhasprovidedforover11,000electivesurgeryprocedures.The2012–13resultof11,579isan18percentincreaseoverthefigureof9,778in2009–10.

Thisachievementwasaidedthroughutilisingtheprivatesector,andwaspartofthestrategytomaintainthehighlevelofthroughputforelectivesurgeryintheACT—particularlyinthespecialtiesofear,noseandthroatsurgery,urologysurgeryandorthopaedicsurgery.

In2010–11,approximately171patientsaccessedelectivesurgeryunderthesearrangements.Anadditional366peopleaccessedelectivesurgeryunderthisagreementin2011–12andover2012–13afurther191patientshadelectivesurgerywhichmakesatotalof761patientssincethisinitiativewasfirstestablished.

ACT Public HospitalsNumber of elective surgery operations performed

2012-132011-122010-112009-10

11,579

9,778

11,336 11,300

Source:Electivesurgerywaitinglistdataset


Inadditiontotheworkcontractedbytheprivatesector,theACTGovernmentandSouthernNewSouthWalesLocalHealthDistricthavecommencedutilisationofQueanbeyanHospitaltoprovideelectivesurgerycapacitypurchasedbytheACT.In2012–13,atotalof69patientsaccessedelectivesurgeryatQueanbeyanHospital,coveringurologicalandgynaecologicalprocedures.

Asaresultoftheincreasedaccesstoelectivesurgery,thenumberofpeoplewaitingtoaccesselectivesurgeryhasreducedto3,943peopleonthewaitinglistat30June2013.Thisisa1percentreductioncomparedwiththesameperiodlastyear,anda26percentdecreasecomparedwith2009–10.

Theincreasedaccesstoelectivesurgeryhasalsomeantthatthenumberofpeoplewaitingbeyondtheclinicallyrecommendedtimeframesfortheirsurgeryhasseensignificantreductions,withatotalof705patientswaitingat 30June2013.Thishasresultedina21percentreductioninthenumberofoverduepatientsinjust12months,anda68percentreductiononthe2,220reportedforJune2010.Whiletheresultof705ispleasing,itisstilltoohigh. ACTHealth’scommitmenttoimprovingaccesstoelectivesurgerywillresultinthisnumberreducinginfuturereports.

TheACTGovernmentwillprovideover$12millionoverthenextfouryearstomeetthegrowingdemandforsurgicalservicesinACTpublichospitals.

Number of people waiting against standard recommended waiting times by clinical urgency

ACT Public HospitalsReducing the number of patients waiting too long for elective surgery

500

700

900

1100

1300

1500

1700

1900

2100

2300

Jul-

10

Aug

-10

Se

p-1

0

Oct

-10

N

ov-1

0

Dec

-10

Ja

n-1

1

Feb

-11

M

ar-1

1

Apr

-11

M

ay-1

1

Jun

-11

Ju

l-11

A

ug-1

1

Sep

-11

O

ct-1

1

Nov

-11

D

ec-1

1

Jan

-12

Fe

b-1

2

Mar

-12

A

pr-1

2

May

-12

Ju

n-1

2

Jul-

12

Aug

-12

Se

p-1

2

Oct

-12

N

ov-1

2

Dec

-12

Ja

n-1

3

Feb

-13

M

ar-1

3

Apr

-13

M

ay-1

3

Jun

-13

Source:ACTelectivesurgerypublisheddatasetJune2013


Median waiting time to surgery for ACT public hospitalsACTHealthreportsthemedianwaitingtimetoaccesselectivesurgery.Thisensuresthatanyimprovementordeteriorationinthewaythedirectoratemanagestheelectivesurgerywaitinglistisevident,soitcanadjustmanagementtoimproveaccessasrequired.Theresultof51daysreportedfor2012–13isavastimprovementonthe77daysreportedin2010–11,whichisevidencethatthisapproachispayingoff.

Urgency category 2009–10 2010–11 2011–12 2012–13

Categoryone 13days 15days 14days 14days

Categorytwo 106days 103days 89days 72days

Categorythree 200days 225days 198days 171days

Medianwaittimeallcategories 73days 77days 64days 51days

Access to acute servicesACTHealthiscommittedtoimprovingwaitingtimesinACTHealthemergencydepartment(ED)servicesandisworkingtowardsmeetingtheNationalEmergencyAccessTargets(NEAT).

In2012–13,ACTPublicHospitalEDssaw118,969presentations,anincreaseof580presentations,comparedto2011–12,andan18percentincreasecomparedwiththesameperiodfouryearsago.AdmissionstohospitalviatheEDhavealsogrown,with31,206admissionsreportedfor2012–13comparedtothe31,064recordedin2011–12.

ACT Public HospitalsAll presentations to the Emergency Department

2012-132011-122010-112009-10

118,969

106,799

112,213

118,389

Source:EmergencyDepartmentpublisheddatasetJune2013


Waiting times for emergency treatmentACTpublichospitalEDsdidnotmeetnationaltargetsfortimelyaccesstoemergencycareinthreeofthefivetriagecategories.Presentationswithintriagecategoriesoneandfivearecurrentlymeetingnationaltargets.

Targetswerenotreachedfortriagecategorytwo,threeorfourpresentations.WhiletherehasbeengrowthinthenumberofpresentationstotheEDs,therehasbeena12percentdecreaseinnon-urgentcategoryfivepresentations.Thisreflectsasignificantincreaseinhigheracuitypresentationsandincreasingpressureon EDresourcesandcanrestricttheabilitytoseeandtreatloweracuitypresentationsinatimelymanner.

Triage category 2012–13 Target 2012–13 Result

One(resuscitation–seenimmediately) 100% 100%

Two(emergency–seenwithin10mins) 80% 74%

Three(urgent–seenwithin30mins) 75% 43%

Four(semi–urgent–seenwithin60mins) 70% 46%

Five(non-urgent–seenwithin120mins) 70% 79%

Allpresentations 70% 51%

ACTHealthEDstaffarecurrentlyreviewingtheirprocesses,andworkingwiththeircolleaguesthroughoutthehospitals,tofindwaysofeliminatebarriersthatdelayquickaccesstoservicesandimprovepatientflowthroughtheEDs.

Recentinitiativesimplementedtoimprovetimelyaccesstoemergencyservicesinclude:

• ‘frontloading’—wherepatientscanbeassessedandtreatedbyanEDdoctormorerapidly

• theexpansionoftheCanberraHospitaldischargelounge,whichenablespatientstoleavetheinpatientwardsearlier,freeingupinpatientbedsandallowingforincreasedaccessfromtheED,and

• thepurchaseofbedsatMonashGoodwinVillageforsub-acutepatientswithanextendedlengthofstayintheacutesetting.

The2012–13budgetprovidesforanadditional$12.7millionoverthenextfouryearstomeetthegrowingdemandforemergencycare,including:

• anadditionalsixtreatmentspacesatCalvary

• capitalworksatCanberraHospitaltoexpandtheEDbysixbedsandtochangethephysicallayoutoftheED

• fourcardiacassessmentbedstoproviderapidassessmentforcareforpeoplewhopresenttotheEDwithchestpainandassociatedcardiacissues

• anadditional47inpatientbedsacrossbothpublichospitals,whichwillallowforimprovedaccesstoinpatientbedsforpatientsintheED.

TheACTGovernmenthasalsocommittedadditionalfundingfrom2013–14toprovidefor:

• expansionofCanberraHospital’sEmergencyMedicineUnit

• increasingthenumberofEDphysiciansatbothCanberraHospitalandCalvaryPublicHospital

• theestablishmentofaRapidAssessmentUnitatCalvaryPublicHospital

• anadditional170bedstotheACTpublichospitalsystem.

InMarch2013,theACTGovernmenttableditsEmergencyAccessPlanfor2013–17,whichdetailedactionstobeimplementedoverthenextfouryearstoimprovewaitingandtreatmenttimeswithinACTHealthpublichospitalEDs.TheplanrecognisesthatimprovementstoEDtimesmustincludechangestothewaythewholehospitalworksandimprovedpartnershipsbetweenhospitalsandcommunityservices.


Australia’s first Walk-in-CentreTheWalk-in-Centre(WiC),locatedonthecampusoftheCanberraHospitalatGarran,providesfreetreatmentforpeoplewithminorillnessesorinjuries.TheWiChasbeenfundedbytheACTandAustraliangovernments.

TheWiCisdesignedtohelppeoplegetfast,free,one-offtreatmentforminorillnessesandinjuries.ThepeopleofCanberraareabletoseeaspecialistnurseforadvice,assessmentandtreatmentforconditionssuchascutsandbruises,minorinfections,strains,sprains,skincomplaints,andcoughsandcolds.

In2011–12anindependentevaluationreportconfirmedtheWiCmodeltobeasafeandeffectivemeansofprovidingprimaryhealthcareservices.Thereportalsohighlightedtheimprovedaccesstofree,extendedhoursprimaryhealthcareservices.

ACTHealthcurrentlyoperatesoneWiClocatedonthecampusoftheCanberraHospital.In2012,theACTGovernmentmadeanelectioncommitmenttodoublethecurrentbudgetfortheWiCandexpandthenurse-ledWiCstothecommunitylocationinBelconnenandTuggeranong.ItisproposedthatthetwoWiCsbelocatedwithinthenewCommunityHealthCentresatBelconnenandTuggeranong.

WorkontheWiCwithintheTuggeranongHealthCentrerefurbishmentwilloccurin2014.

Walk-in CentreTotal Presentations to the WiC

2012-132011-122010-11

15,237

17,45019,142

Source:WiCpublisheddataset

PresentationstotheWiCincreasedby10percentin2012–13comparedwith2011–12.Thisincreasereflectsthevaluethattheserviceprovidestothecommunity.

TheWiCnursestreatawiderangeofconditions,withnosignificantchangesinthetop10conditionstreatedsincelastyear.ThecommoncoldremainsthemainreasonforpresentationtotheWiC.


Walk-in CentreTop 10 conditions treated at the WiC

1,844

1,130

948

563

509

406

377

362

294

288OTHER MUSCULOSKELETAL

URTI - SINUSITIS

ANKLE SPRAIN

URTI - TONSILITIS

GASTROENTERITIS - DIARRHOEA

URTI - SORE THROAT

EAR CONDITIONS - EAR WAX

WOUND DRESSING

WOUNDS AND LACERATIONS - LACERATION

URTI - COMMON COLD

Note:URTIinabovetableisupperrespiratorytractinfection.

Ifnecessary,peopleareredirectedtomoreappropriateservices,suchastheirGPortheED.Ofthe19,142presentationsin2012–13,atotalof13,665hadacompletedtreatmentepisodebythenurse.Atotalof6percentofpatientsassessedweresubsequentlyredirectedtotheirGP(comparedwith18percenttwoyearsago)and5percentweretoldtopresenttotheCanberraHospitalED(onparwith2011–12).

Walk-in CentrePatient redirections following assessment by nurse

GPED-TCHMedical ImagingCALMS

6%

2%

4%

5%

Source:WiCpublisheddatasetNote:CALMSinabovetablereflectsCanberraAfter-hoursLocumMedicalService.ED-TCHinabovetablereflectsEmergencyDepartmentandCanberraHospital.GPinabovetablereflectsgeneralpractitioner.

TheWiCdoesnotprovideongoingcareforpatientsandwillnottreatpeoplewithchronicconditionsorchildrenlessthantwoyearsofage.ThesepatientsshouldseektreatmentandadvicefromtheirGPortheED.

TheWiCisnotdesignedtoprovidetherangeofservicesthataGPcanprovide,includingcomprehensivemedicalmanagement,referraltospecialistservicesorgeneralhealthchecks.ThenurseswhoworkintheWiChaveallcompletedadditionaltrainingandthecaretheyprovideisguidedbyestablishedprotocolsthathavebeenendorsedbytheappropriateclinicalapprovalsprocesses.Avisitreportissenttothepatient’sgeneralpractitionerwithconsent.


PeopleintheACTcommunitynowhaveaccesstoawiderangeofprimaryhealthservicesincludingtheirGPs,EDs,communityhealthservices,pharmacistsandtheWiC.

TheoperationoftheWiCwasevaluatedexternallyafteritsfirstyearofoperation.ACTHealthisrespondingtoaspectsoftheWiCreviewthatwillenhanceitsefficiency,suchasstaffingprofileandhoursofoperation,aswellaseffectivenessofservicedelivery.PatientattendanceshaveincreasedconsistentlysincetheWiCopenedandconsumerfeedbackremainspositive.

National Partnership Agreement on Improving Public Hospital ServicesTheCommonwealthwilldeliveranadditional$67milliontotheACTundertheNationalPartnershipAgreementonImprovingPublicHospitalServicesforED,electivesurgeryandsub-acuteservices.Thisagreementcommencedon1January2012.

National Emergency Access Targets ThemainobjectiveofNationalEmergencyAccessTargets(NEAT)isthat90percentofallpatientspresentingtoapublichospitalEDwillbeadmitted,transferredordischargedwithinfourhours.Thetargetswillbestagedinincrementsoverthenext4yearstoachievethefinaltargetof90percent.ThefirsttargetwastobeachievedbyDecember2012,withthetargetsetat64percent.

Inthe2012calendaryear(January2012toDecember2012),ACTpublichospitalsreported57percentofallpatientshadalengthofstaylessthanfourhours.Thiswas7percentbelowthetargetof64percent.NationalreportsonjurisdictionalperformanceagainstNEATtargetsshowedthatWesternAustraliawastheonlyjurisdictiontomeettheir2012target.

InthecalendaryeartoendJune2013(January2013toJune2013),ACTpublichospitalshaveseensomeimprovementinNEATperformance,witharesultof58percent,againstatargetfortheendof2013of65percent.ACTHealthexpectsfurtherimprovementsinthefuturewith:

• increasedinvestmentininfrastructure,includinganadditional170bedsoverthenextfouryears

• physicalredesignsofED.

Atthesametime,bothpublichospitalsareundergoingcontinualredesignandprocessimprovementinitiativestoimprovethewaypatientsmoveinto,throughandoutoftheEDs.

National Elective Surgery Targets TherearethreecomponentstotheNationalElectiveSurgeryTargets(NEST).Theseareaimedatensuringtimelyaccesstosurgerywhilstreducingthenumberofpatientswaitingbeyondclinicallyrecommendedtimeframes.ThefinaltargetsforallcomponentsoftheNESTaretobemetbyDecember2016;thefirstsetoftargetswastobeachievedbyDecember2012.

Inthe2012calendaryear(January2012toDecember2012)ACTHealthwassuccessfulinmeetingallthreecomponentsoftheNEST.On27February2013,theAIHWreleaseditsfirstannualreportonjurisdictionalperformanceagainstemergencyaccessandelectivesurgerytargets.ThereportshowsthattheACTwastheonlyjurisdictiontosuccessfullymeetallthreecomponentsoftheNEST.

Part 1oftheNESTreferstotheproportionofpatientswhoaccesstheirelectivesurgeryprocedurewithinclinicallyrecommendedtimeframes.InthecalendaryeartoJune2013(January2013toJune2013),ACTpublichospitalsachievedtherequiredtargetsforcategoryoneandthreepatientsaccessingtheirsurgeryontime.Categorytwopatientsdidnotmeetthetargetreportingaresultof57percentofcategorytwopatientsaccessingsurgeryontimeagainstatargetof66percent.Recentmonthlyresultshaveseenanimprovement,andworkisongoingtoimprovethisresultforfuturemonths.


Part 2AoftheNESTisbasedontherequirementtoreducetheaverageoverduewaitingtimesforeachcategoryofpatientssothattherearenooverduepatientsbytheconclusionoftheagreement.InthecalendaryeartoendJune2013(January2013toJune2013),ACTpublichospitalswereontracktomeettherequiredtargetsforurgencycategoryone,twoandthreepatients.

Part 2BoftheNESTisrelatedtotheremovalofthetop10percentoflongestwaitingpatientsontheelectivesurgerywaitinglist.TheAustralianGovernmenthasissuedACTHealthwiththe2013cohortoflong-waitpatientstohavetheirsurgeryin2013.InthecalendaryeartoendJune2013(January2013toJune2013),ACTpublichospitalsremoved76percentofthelongestwaitingpatientsfromthelistestablishedat31December2012,andremainedontracktomeettheendof2013target.

Sub-acute care reformThesub-acutecomponentisaimedatimprovingpatienthealthoutcomes,functionalcapacityandqualityoflifebyincreasingaccesstosub-acutecareservicesincludingrehabilitation,palliativecare,sub-acutementalhealthandgeriatricevaluationandmanagement,andpsycho-geriatricservicesinbothhospitalsandthecommunity.

TheACTwasrequiredtobuildcapacityfor11sub-acutebedequivalentsbefore1July2012.DuetoalackofappropriatetenderapplicationsinrelationtotheACT’ssub-acuteprojects,theACTadded6.9bedequivalentstothesystemattheendofJune2012.

However,tofacilitatetheprocess,ACTHealthestablishedaNationalHealthReformSteeringCommittee.Thiscommitteehasworkedonalternativemodelstoattractadditionalserviceproviders,aswellascontingencyplansinrelationtothisproject.Overthe12monthsof2012–13,theplanningintogrowthforsub-acutecareserviceshaspaidoff.TheACThasnowdeliveredover22sub-acutebedequivalentsintothesystem,abovetheJune2013targetof16bedequivalents.Thereisnofinancialrewardorpenaltyassociatedwiththistarget.

Division of Critical CareTheDivisionofCriticalCarewasformedfollowingtherestructureofACTHealthinFebruary2011.Thedivisionisresponsibleforthedeliveryofacuteandcriticalcareandretrievalservices.TheseareprovidedasinpatientandoutpatientservicesattheCanberraHospital,withastrongemphasisonaccessibleandtimelycare,deliveredtoahighstandardofsafetyandquality.Thisisunderpinnedbythedivision’scommitmentstoresearchandtraining.ThedivisionincludestheRetrievalService(bothroadandair),EmergencyDepartment(ED),IntensiveCareUnit(ICU),AccessUnit,SurgicalShortStayUnit,MedicalAssessmentandPlanningUnit(MAPU),andSurgicalAssessmentandPlanningUnit.

Achievements• EDnursingintroducedaMentorMatrixin2012toensurethatallnursingstaffhavesupportforfeedback,goal

settingandrecognitionofachievements.Sinceitsimplementation,therehasbeen100%percentcompliancewithlearningandachievementplans.

• TheMedicalEducationTeamcollaboratedinacross-borderlearninginitiativetodevelopandintroduceaneducationwebsite(www.canberraemergency.com.au).ThisisavailabletoallEDnursing,medicalandalliedhealthstaffandhasquicklybecomeanexcellentcommunicationandeducationtool.

• EDNursingEducationTeamarrangedforQueanbeyanEmergencyStafftoattendtriageandresuscitationtrainingworkshopsatCanberraHospital.

• InSeptember2012,fouradditionalEDtreatmentspaceswerecreated.Theseareusedtotreatambulatorypatientswithnon-complexproblems.TheadditionalbedssupportthecapacityrequirementsfortheEDtoprovidequality,safecareandassistwithmeetingactivitytargets.

• TheOptimalCapacityEscalationPlanwasintroducedtomanagetheunpredictablenatureoftheEDclinicalvolumeandacuitythroughtheimplementationofefficientchangesinbedmanagementprocessestomaintainpatientsafety,includingtheforecastingofclinicalworkloadstoassistinpredictingfuturerequirementsforinpatientbeds.

• Atargetededucationplansawasignificantimprovementinthecomplianceratewithpoliceblood testingrequirements.

www.canberraemergency.com.au


• TheED,inconjunctionwithRehabilitation,AgedandCommunityCare,ranaDeliriumProjecttoscreenallpatientsolderthan85yearspresentingtotheED.TheprojectachievedagreaterunderstandingofthetreatmentofpatientswithadeliriumdiagnosiswithinanextremelybusyEDandhasimprovedtheworkingrelationshipbetweenthetwodepartments.

• InNovember2012,anadditionaltwohigh-dependencybedswerecommissionedintheIntensiveCareUnit.Thesehaveincreasedavailablecapacityto24beds,expandingtheabilityoftheIntensiveCareUnittooptimallyacceptandtreat12intensivecareandeighthigh-dependencypatientsatanygiventime.

• Aterritory-wideapproachtoclinicalleadershiptrainingfornursingandmedicalstaff,withmultipleleadershiptrainingopportunities,wasimplemented.

• AcascadingmentorshipstructurewasimplementedinICUtoensureallnursingstaffparticipateinregularperformanceandfeedbackdiscussions,goalsettingandrecognitionofachievements.

• TheMedicalEmergencyTeam(MET),incollaborationwiththeDeterioratingPatientTeam,wontheQualityAwardforCareandResponseEscalation(CARE)forpatientsafetyandwasanationalfinalistintheNationalLeadCliniciansGroupAwardsforExcellenceinInnovativeImplementationofClinicalGuidelinesin2013.

• AVolunteerProgramwassuccessfullyintroducedintotheICUwaitingroomtoimprovecommunication,supportforfamiliesandorientationtotheenvironment.

• OncompletionofherPhD,theClinicalDirectoroftheICU,AssociateProfessorImogenMitchell,receivedaHarknessScholarshipforHealthandPolicyPracticeatJohnsHopkinsHospitalintheUnitedStates.

• AssociateProfessorFrankVanHarenwasappointedStateMedicalDirector,DonateLife.

• MsJennyRochow,ICUNurseUnitManager,receivedtheDefenceReservesSupportCouncilEmployer SupportAward.

• TherelocationoftheDischargeLoungetolevel2ofBuilding1hasprovidedadditionalcapacity,improvedaccesstosupportservicessuchasPharmacyandmadepick-upeasierforrelativesandtransportservices.

• TheAccessUnitreceivedanAustraliaDayTeamAchievementAwardforthecommitmentandabilityofstafftostriveforexcellenceinservicedeliveryinourhealthservicesystem.

Issues and challenges• WhiletheNationalEmergencyAccessTargetsremainachallenge,seniorEDstaffcontinuetodevelopinitiatives

directedatinternaldepartmentalissues,withaviewtoachievingtriagetargetsforallcategoriesandstreamliningthedischargepathway.

• EDandICUcontinuetoexperiencechallengesassociatedwiththeincreasingnumbersofunplannedadmissionsafterhours.

• METisworkingwiththeStaffDevelopmentUnittoimplementamorecomprehensiveadvancedlifesupporttrainingprogramtomeetthelearningneedsofmultipletiersofstaffandprovideopportunitiestomeetthedemandsofconcurrentMETcalls.

Future directions• TheDivisionofCriticalCareisworkingcollaborativelywithallhospitaldivisionstodevelopanACTHealth

WinterBedStrategyforthesafetyandisolationofpatientsduringthefluseason.

• TheDivisionofCriticalCareisworkingcollaborativelywiththeDivisionofWomen,YouthandChildrentodevelopthePaediatricShortStayUnittoenablepaediatricpatientstobeadmittedmorequickly.

• SixnewbedsopenedintheMedicalAssessmentandPlanningUnit(MAPU)inSeptember2012havebeenallocatedtoprovidecapacityfortheMedicalShortStayWard(MSS).ThisinitiativeisdirectedatexpeditingtheflowofpatientswithanundifferentiatedmedicalconditionfromtheEDtoaninpatientareaforfurtherassessmentandmanagement,leadingtoimprovedpatientcareandsafety,andefficienciesofservice.

• TheDivisionofCriticalCareisworkingcollaborativelywiththeDivisionofMedicinetodeveloptheMSSmodelandundertakingongoingworktoprovidetimelyadmissionforpatients.

• TheACTGovernmenthascommittedfundstoestablishadedicatedPaediatricStreamforchildrenintheCanberraHospitalEDtoprovideanoverallincreaseintreatmentspaces.


• AlargeInfectionControlQualityImprovementProjectincollaborationwiththeInfectionControlTeamisunderwaytoreduceratesofinfectionintheICU.Amonthlyscorecard,handhygieneaudits,environmentalimprovementsandacomprehensiveeducationstrategyformpartoftheprojecttoimprovepatientoutcomesbyreducingthetransmissionofinfectionsbetweenpatients.

• Aneight-bedroomMediHostelattheCanberraHospitalisontracktobecomeoperationalin2013.TheMediHostelwillprovidehigh-quality,non-ward,hotel-styleaccommodationwithnursingsupervisiontoeligibleconsumerspriortoorfollowingtheirepisodeofacutecare.

• In2013,theAccessUnithasexpandedoperationalhourstoprovideseven-daycover,until11pm.Theextendedhourshaveenhancedservicedelivery,continuity,coordinationandmonitoringthroughacentralisedpointofcontactforallpatientflowactivity.

• TheAccessUnitAfter-HoursHospitalManagementServicewasthebeneficiaryofa2013PracticeDevelopmentScholarshipAward,whichwillprovideresourcesforareviewofitsservices.Itisenvisagedthatthereviewwillidentifyopportunitiesaimedatmakingresourceefficienciesandimplementingqualityimprovementinitiatives.

• TheUniversityofTechnologySydneyhasengagedinapartnershipprojectwithACTHealthWard7Btoundertakeastudytitled‘Effectiveclinicalhandovercommunication:improvingpatientsafety,experiencesandoutcomes’.Thisinnovativestudyprojectisdueforcompletionin2014andaimstoimprovethesafetyofclinicalhandoverpractices,therebyreducingthenumberofadverseevents.

Division of MedicineTheDivisionofMedicineprovidesawiderangeofadultmedicineservicestotheCanberracommunityininpatient,outpatientandoutreachsettings.Italsoprovideschronicdiseasemanagement,infectioncontrolandpharmacyservices.Astrongemphasisisplacedonaccessible,timelyandintegratedcaredeliveredtoahighstandardofsafetyandquality.

Thedivisionhasastrongcommitmenttoteachingandresearch.Healthstudentsfromseveraluniversitiesdopracticalplacementswithinthedivision.MostofourseniormedicalstaffalsoholdacademicappointmentsintheAustralianNationalUniversityMedicalSchool,andtherearemanyactiveresearchprogramsinoperation.Manymembersofthedivisionalsoparticipateinthedevelopmentofnationalprofessionalguidelinesandqualityinitiatives.

Manyunitsofthedivisionworkactivelywithcommunitygroups,otherservicesandtheprivatesectortoimprovethecareofpatientsacrossthewholehealthsystem.Consumerrepresentativesplayacrucialroleonourinternaladvisorycommittees.

Inthecomingyear,thedivision’sserviceswillexpandtoincludemoreinpatientbedsandanincreaseinHospitalintheHomeprovision.Wewillcontinuetodevelopinnovativewaystoprovidethecarethatpeopleneedandensureourpatientshaveaccesstoleadingedgemedicaltreatment.Overthenextyear,anemphasiswillbeplacedonthecareofacutemedicaladmissionstoCanberraHospitalandHealthServices,includingmodelsofpreventionofadmissionandthestreamliningofdischargetoappropriateservicesinthecommunitywiththefurtherdevelopmentoftheAcuteGeneralMedicineService.

Achievements

Endocrinology and Diabetes servicesIn2012–13,theACTHealthDiabetesServicemadeprogressinrestructuringandexpandingitsservicetomeetexistingneedsandtheexpectedgrowthinservicerequirementsduetoincreasingdiabetesprevalence.Therestructurewasdirectedatimprovingthequalityandefficiencyofcaretochildren,youth,pregnantwomenandadultsintheambulatoryandacutecaresettings.Therestructureincludedthefollowing:

• establishingtheACTHealthDiabetesServiceClinicalAdvisorytoprovidestrategicdirectionandclinicalgovernance

• establishingclinicalteamsineachoftheserviceareas

• increasingthefocusanddevelopmentofclinicalservicestoadolescentsandyoungadultswithdiabetes

• addressingdeficienciesinservicelevelsforpeoplewithdiabetesonthenorthsideoftheACT.


TheexpansionoftheACTHealthDiabetesServiceinvolvedtherecruitmentofthreenewpart-timeendocrinologistsandapart-timesocialworker.AttheCanberraHospital,theDiabetesServicewasenhancedbytheopeningoftwonewspecialistmedicalconsultingroomsandasecondpodiatryroom.

AnorthsideACTDiabetesServiceWorkingGroup(includingconsumerrepresentation)wasestablishedtoinformthedevelopmentofanenhancedcollaborativeapproachtodiabetespreventionandcareacrossallhealthcaresectorsforthecommunitylivingonthenorthsideoftheACT.

TheACTHealthDiabetesServicecommencedclinicalservicesattheGungahlinCommunityHealthCentreinNovember2012.Servicesforwomenarebeingstrengthenedonthenorthsidewiththeestablishmentofanewclinicforwomenwithgestationaldiabetes.

TheACTHealthDiabetesServiceincreaseditssupporttotheWinnungaAboriginalHealthServicewiththeestablishmentofanendocrinologistclinicatWinnungatosupporttheexistingnursing,nutritionandpodiatrydiabetesservice.

AServiceFundingAgreementwasestablishedwiththeACTMedicareLocalfortheDiabetesLinkProjecttoimprovethecollaborativelinksbetweentheprimarycaresectorandtheACTHealthDiabetesServiceandfosterabestpracticecareapproachforallpeoplewithdiabetesintheACT.AprojectcoordinatorfortheDiabetesLinkProjectwasidentifiedandwillcommenceinmid-2013.

Cardiology ServicesProcurementisunderwayforthepurchaseofareplacementstate-of-the-artcardiaccatheterlaboratory.Inaddition,approvalhasbeengrantedtopurchasetwoechocardiographymachinesandthetenderprocessiscurrentlyunderway.ThefirststageoftheintegratedITsystemhasjustbeenrolledout.Thisstagewillprovideanimprovedarchivingprocessandultimatelyamoresecurereportingofechocardiographyandbetteraccesstoechocardiographyresults.Thisisthefirststepinamajorupgrade.Therecruitmentprocessforacardiologistspecialisinginechocardiographyisunderwaytosupportthisgrowingservice.ThisisakeypositionthatwillassistwiththeupgradeofCanberraHospital’sechocardiographyservices.

TheCardiologyDepartmentcommencedtheChestPainEvaluationUnitinApril2013.AlargeportionofpatientsattendingtheEmergencyDepartment(ED)presentwithchestpain.PatientsthatareidentifiedasrequiringaccesstotheCardiacCatheterLaboratoryforinterventionareprocesseddirectlytotheCardiacCatheterLaboratory(CCL);however,thosenotrequiringtheCCLaretransferredoutoftheEDinamoretimelyway.ThisprocesswillallowforconcentratedmanagementandfacilitationofinvestigationofthesepatientsandthereforedecreasetimesinED.

Renal ServicesTheRenalElectronicMedicalRecordprojectisnowoperationalanditsusehassteadilyincreasedinallareasoftheservice.ThisprojecthasimprovedrenalservicedeliverybyreducingduplicationofdataentryandimprovingcommunicationbetweengeographicalsitesandintegrationwithotherHealthDirectorateapplications.HavingaholisticviewofpatientdataacrosstheRenalServiceallowsforqualityimprovementinpatientoutcomesandwillassistinfurtherclinicalresearch.TheRenalElectronicMedicalRecordwaslaunchedin2012andhasbeenrolledouttoalldialysisunitsintheACTandsouthernNewSouthWales.

ArenalnetworkcoveringtheACTandSouthernNewSouthWalesLocalHealthDistrictwasestablished.Underthisagreement,theRenalServiceisprovidinggovernancetoalldialysiscentresintheSouthernNewSouthWalesLocalHealthDistrict,includingthoseinQueanbeyan,Goulburn,MoruyaandBega.TheRenalServiceisprovidingoutreachclinicstoGoulburn,Moruya,BatemansBay,BegaandCoomaandoverseeingqualityassuranceacrossthearea.

Afurtherachievementforrenalservicesin2012–13wasthecompletionoftheself-caretrainingfacilityatGauntPlaceandtheWestonSelf-CareUnit,establishedforthosepatientswhoareunabletodialyseathome.

Chronic Disease ManagementChronicDiseaseManagement(CDM)isamultidisciplinaryteamwithintheDivisionofMedicineofCanberraHospitalandHealthServices.CDMfocusesonimprovingthemanagementofpatientswithchronicdisease,particularlychronicobstructivepulmonarydisease(COPD),chronicheartfailure(CHF),Parkinson’sDiseaseandobesity.


Achievementsfor2012–13includethefollowing:

• Duetoincreasedservicedemand,anewapproachtomanagingpatientsintheCareCoordinationServicewasimplemented,leadingtosignificantlyincreasedproductivity.

• TheChronicDiseaseManagementRegister(CDMR)wasusedtosupportresearchprojectsandgeneratemultiplepatientidentificationreports.IncollaborationwiththeACTMedicareLocal,apilotstudywasdevelopedtotestjointcareplanningbetweentheChronicCareProgramoftheCDMUandtheprimaryhealthcaresector.

• Therewasanincreaseduptakeofadvancedcareplanning(ACP)intheChronicCareProgram,witharoundhalfofcasecoordinationpatientshavinganACPbyJune2013.

Neurology servicesThenumberofadmissionstotheStrokeUnitcontinuestoriseeachyear,butthisyeartherisewasoffsetbythecreationofaTransientIschaemicAttack(TIA)clinic,whichallowedappropriateurgentneurologypatientstobeseenonanoutpatientbasis.

InadditiontotheTIAclinics,therewasanexpansionofcapacitytomeetdemandforneurologyoutpatients,withincreasedregistrarinputintoclinics.

Withtheappointmentofathirdneurophysiologytechnician,thewaitingtimeforanelectro-encephalogram(EEG)wasreducedinthepastyear,fromeightmonthstolessthanamonth.

Clinical Forensic Medical ServicesClinicalForensicMedicalServices(CFMS)istheoverarchingservicecombiningtwoservices,ForensicandMedicalSexualAssaultCare(FAMSAC),fundedunderACTHealth,andClinicalForensicsACT(CFACT),fundedunderatenderedcontractualarrangementbetweenACTHealthandtheAustralianFederalPolice(AFP).

CFMScontinuedtoexpandCFACTservices,meetingincreaseddemandinresponsetoAFPrequirements.Thisincluded:thesuccessfulintroductionofaseven-day-a-weeknursingservicetotriageandattendconsultationswithinscopeofpractice;increasedmedicalexpertreportingrequirementsfortheACTCoroner’sOffice;andcomplexreportingtopolicerequestingmedicalinformationandtoxicologyreportsinrelationtodrivingundertheinfluence.AddingtothiswasarecentlysignedagreementwithNewSouthWalesallowingCFMStoprovidemedicalforensicservicestotheNewSouthWalesPoliceintheMonaroLocalAreaCommand.

FAMSACcontinuedtoprovidecaretovictimsofsexualassaultintheACTandsurroundingNewSouthWales.FAMSACalsooffersaserviceforinjurydocumentationforvictimsofdomesticviolence.CFMSnursingstaffcommencedaservicein2013toprovideaweeklyclinicwithinthedrugandalcoholserviceforthepurposeofblood-bornevirusscreening.

Pharmacy ServicesAkeyindicatorforpharmacyisthewaitingtimefordischargeprescriptionprocessing.In2012–13theaveragewaittimefromreceiptofthemedicationordertodistributionofthemedicationorderwaslessthan45minutes.AsignificantrecognitioninalliedhealthwasattributedtothePharmacyDepartment.JessicaParkerwastherecipientofthe2012AlliedHealthAwardforExcellenceandwonthe2012AlliedHealthProfessionaloftheYearaward.

ClosedSystemTransferDevices(CSTD)werefullyimplementedinchemotherapyproduction,enhancingsafetyforstaffinthepharmacyandonthewards.

Anumberofmedicationsafetyinitiativesandcontinuousqualityimprovementactivitieswereundertaken,including:

• TheAustralianCommissiononSafetyandQualityinHealthcarerecommendedapilotofavenousthromboembolism(VTE)prophylaxissectionintheNationalInpatientMedicationChart(NIMC).ThispilotprovidedstrongsupportfortheinclusionofaVTEprophylaxissectionintheNIMC,amajorenhancementtopatientsafety.

• AdruglibrarywasintroducedtothenewB.BraunSmartInfusionPumps,whichensuresthatallintravenous drugsareadministeredinthesafestpossiblemanner.


• TheDirectorofthePharmacyDepartmentwasthejointclinicalleadfortheMedicationSafetyStandardoftheNationalSafetyandQualityHealthServiceStandardsandoversawworktomeetnationalstandardsformedicationsafety.

ThePharmacyDepartmentoftheCanberraHospitalparticipatedinanationalpharmaceuticalspendingbenchmarkingexercise.Despitebeingasmalljurisdiction,theACThasexcellentpurchasingprocesses,ensuringthatresourcesaremaximised.

Gastroenterology and hepatologyTheGastroenterologyandHepatologyUnitatCanberraHospitalprovidesservicestopatientsintheACTandsurroundingregioninallareasofgastrointestinaldiseases,withparticularfocusoninflammatoryboweldiseases,gastrointestinalcancer,chronichepatitis,chronicliverdiseaseandgastrointestinalendoscopy.Theunithaswell-developedmultidisciplinaryteams,includingconsultantmedicalstaff,seniorregistrarsandnursingstaffwithspecialexpertise.

In2012–13,theunitcommissionedathirdendoscopyroomandcommissionednewtechnology,theTransientElastography(FibroScan),toassistinthedetectionandstagingofliverdiseaseandtoreducerelianceonliverbiopsies.In2012–13,additionalmedical,nursingandadministrativestaffwereappointedonreceiptofbudgetenhancementfortheunit.

In2012–13,staffoftheunitperformed4,832endoscopyprocedures(electiveandacute),thehighestnumberofendoscopieseverrecordedandanincreaseof9.4percentfromlastyear.Therewere7,040outpatientattendances,anincreaseof9.8percentover2011–12.Theunitprovidedmanyotherservices,includinginpatientcareandday-onlyadmissions.ItalsoprovidedservicesandinformationsessionsinthecommunityandattheAlexanderMaconochieCentre.

Hospital in the HomeIn2012–13,fundingforHospitalintheHome(HITH)wasincreased.Thiswasusedtorecruitnursingstaff, includinganursededicatedtoidentifyingandassessingpotentialreferralsinatimelymanner.NewarrangementswereputinplacewherebyGPscandirectlycontacttheHITHRegistraraboutapatienttheyareseeingintheirroomsbeforesendingthemintoHITHforassessmentforadmission,withoutpatientsneedingtoattendtheEmergencyDepartment.

Respiratory and Sleep ServiceTheRespiratoryandSleepServiceisavailabletopatientsintheACTandsurroundingareasofNewSouthWales,withanoccasionalreferralfromVictoria.Itprovidescareinallareasofrespiratoryandsleepmedicine—andinparticularsupportstheTuberculosisServiceoftheACTandsurroundingNewSouthWales—includingasthma,COPD(chronicobstructivepulmonarydisease),interstitiallungdiseaseandcysticfibrosis.

TheRespiratoryandSleepServicesupportsthemanagementoflungcancerandinparticularhasspecialweeklyurgentclinicssetaside.Inaddition,theserviceconductsjointmeetingswiththoracicsurgeons,medicalstaffandradiationoncologiststofacilitatethemanagementoflungcancers.Thesemeetingsareheldweekly.

Theservicesprovidedhaveincreasedoverthepastfewyearsandwillcontinuetodoso,particularlyinrelationtoconsultationsforbothinpatients,outpatientsandbronchoscopies.

General/Acute MedicineWorkcommencedin2011–12todevelopamodelforageneral/acutemedicineserviceaspartofaredesignexercise.Fundingin2012–13wasutilisedtoimplementanacutegeneralmedicinemodelwiththeadventof theMedicalShortStay(MSS)Unit.Thisservicefacilitatesearlyidentificationandmanagementofpatientswho areidentifiedasrequiringadmissiontomedicinebedsinthehospitalfromtheEmergencyDepartment.Itisstaffedbynursingandmedicalstafftobettermanagepatientswithmultiplecomplexconditionswhopresenttothehospitalforcare.


Issues and challengesIssuesandchallengesfortheDivisionofMedicineinclude:

• furtherintegratingservicesacrosstheTerritory,suchastheStrokeUnit,RenalServicesandCardiologyServices,includingChronicDiseaseManagement

• meetingpatientdemandforendoscopy

• facilitatingpreventionofhospitaladmissionandpromotingseamlessdischarge.

Future directions

Endocrinology and Diabetes servicesServiceswillberepresentedonthenorthsidewiththeopeningoftheBelconnenCommunityHealthCentrein2013.TheDiabetesServicewillbefurtherenhancedonthenorthsidewiththeestablishmentofanewVisionScreeningProgram.

In2013–14,programstoenhanceengagementbetweenACTHealthDiabetesServiceandprimarycareserviceswillbedevelopedwithassistancefromtheACTMedicareLocal,andimprovedreferralpatterns,jointprofessionaleducationandstaffdevelopmentprogramswillbeestablished.

TheACTHealthDiabetesServicehasestablishedcollaborationwithACThealthunitsinvolvedinthecareofpatientswithacutediabetes-relatedfootcomplications.Amultidisciplinaryhigh-riskfootcollaborationclinicwillcommenceinJuly2013attheCanberraHospital.

ACTHealthisworkingtowardstheestablishmentofaPublicObesityManagementServiceandisimprovingclinicaldatacollectioninrelationtoweightandheight.In2013–14,thisservicewillworkcloselywithgeneralpractitionersandcommunityorganisations,aswellasotherspecialistservicesthatcareforthesepeople.Thesehospital-basedservicesincludeDiabetes,Cardiology,RespiratoryandChronicCareprograms.

Neurology servicesThedevelopmentofaStrokeNetwork,inclusiveofaStrokeUnit,plannedforCalvaryHealthCarewillgreatlycontributetothemanagementofthesepatientsacrosstheTerritory.

PharmacyThePharmacyBusinessPlanfor2013–14aimstobuildonpastsuccessesandaddressupcomingchallenges—namely:

• toimproveclinicalpharmacyservices,suchastheestablishmentofspecialisedpharmacistpositions,thecreationofaward-basedtechnicianserviceandanincreaseinthenumberofclinicalpharmacists

• toprovidefurthereducationforthepharmacyworkforce,suchasTAFEcertificatetrainingfortechniciansandtheinternalPeopleManagerProgramforallseniorstaff.

Gastroenterology and HepatologyWaitinglistsforbothendoscopyandoutpatientservicescontinuetogrowbuthavebeenaddressedbytherecruitmentofadditionalmedical,nursingandadministrativestaffandeffectiveleavemanagementformedicalstaff.Theplannedrefurbishmentoftheunitwillalsoenablemorepatientstobeseenin2013–14.Theunitplanstocommenceendoscopicultrasoundtoenhancethediagnosisandtreatmentofgastrointestinalcancer.


Hospital in the HomeHITHisworkingonthedevelopmentofaprotocolwiththeChronicCareProgramfortherespiratoryservicetoidentifypatientsinthecommunitywhoareacutelydeterioratingandwhomaybenefitfromapre-emptivestayinHITH,potentiallyavoidinganadmissiontohospital.Inthesecondhalfof2013,theintroductionofadedicatedpharmacisttoHITHwillassistwiththeincreasinglycomplexandnumerousmedicationsbeingutilisedbothbypatientsintheirhomesandbythosereceivingtreatmentasday-onlypatients.

General/Acute MedicineThetrainingprogramforGeneralMedicinewasaccreditedbytheRoyalAustralasianCollegeofPhysicians,and ateamofregistrars,includinganAdmittingRegistrarforMedicine(ARM),wasrecruitedtosupportthisservice.TheservicewillenhanceservicesalreadyprovidedbytheMedicalAssessmentandPlanningUnit(MAPU). Amultispecialtyconsultantteamwillbefurtherdevelopedin2013–14tobettermanagethiscohortofpatientsandfacilitateeducationofphysiciantraineesinGeneralMedicineandsubspecialties.

Division of PathologyTheDivisionofPathologyprovidesspecialistpathologyservicestothemedicalpractitionersoftheACTandsurroundingregion.Thisincludespathologytestingwhilepatientsareinhospitalandwhentheyreturntotheirhomes.

ServicesareprovidedintheacutesettingatCanberraandCalvaryhospitalsandtheNationalCapitalPrivateHospitalandinthecommunitythroughcollectioncentresacrosstheACT.Ahomecollectionserviceforpatientswhoarefrailorunwellandwhocannotattendthesecollectioncentresisalsoprovided.

AnalysisofcollectedsamplesisundertakenatthetwolaboratoriesintheACT.ThemainlaboratoryislocatedattheCanberraHospitalandabranchlaboratoryislocatedatCalvaryHospital.

Pathologyisamedicalspecialtylookingatdiseaseprocessesandtheircause.Bodytissue,bloodandotherbodilyfluidsareanalysedtoassistmedicalpractitionerstoidentifythecauseandseverityofdisease,andtomonitortreatment.TheDivisionofPathologyismadeupofarangeofclinicalspecialities:AnatomicalPathology,ChemicalPathology,Haematology,Cytogenetics,Immunology,MicrobiologyandMolecularPathology.AllareasareaccreditedwiththeNationalAssociationofTestingAuthoritiesandtheRoyalCollegeofPathologistsofAustralasia.

Pathologyisademand-drivenservicethatplaysacriticalroleinmorethan70percentofclinicaldiagnosesandmanyofthedecisionsaroundoptimaltreatmentforpatients.Duetothecriticalroleofpathologytestingindiagnosisandtreatment,theobjectiveanddirectionforpathologyareintimatelytiedtotheobjectivesandprioritiesofACTHealth’sCorporatePlan.

Achievements

Quality systemACTPathologyundergoesthree-yearlyaccreditationinspectionsbytheNationalAssociationofTestingAuthorities(NATA)andRoyalCollegeofPathologistsofAustralasia(RCPA).Thelastaccreditationassessmentin2012sawanoverallaccreditationachievementatahighlevel.AlargenumberofACTpathologyspecialistandscientificstaffhavebeeninvitedtobecomeNATAassessorsandregularlyinspectotherlaboratoriesinAustraliaandoverseas.

Themicrobiologylaboratoryparticipatesinarangeofsurveillanceprograms,includingtheAustralianGrouponAntimicrobialResistance(AGAR)andtheWorldHealthOrganization(WHO)influenzasurveillancegroup,contributingtoimportantepidemiologicalinformationlocallyandinternationally.ACTPathologyisalsoamemberofthePublicHealthLaboratoryNetwork.

Social inclusionPathologytestingnowincludesAboriginalidentificationwhenthisinformationhasbeenprovided.ThisdataisthenavailabletofeedthroughtohealthdatabasessuchasthePapsmearregister,notifiablediseasesandcancercases,andshouldenablebetterhealthpolicyplanning.


Collaboration and performancePathologyworksinclosecollaborationwithmanyareasoftheHealthDirectoratetoprovideaccesstotimelyresults,facilitatedecisionmakingandassistthemtoachievetheiroutputs.

WhilethenumberofrequestsforpathologyfromCanberraHospitalhasslightlydecreasedoverall,therehasbeenanincreaseinthenumberoftestsperrequest,resultingina2.6percentincreaseintests.

LocationNumber of requests

2011–12Number of requests

2012–13% increase in requests

Canberra Hospital 352,519 350,048 –0.7%

Calvary Hospital 94,951 100,411 5.8%

New technologyTheCytogeneticDepartmenthasimplementedmicroarrayanalysisasthefirstlineofinvestigationforthedetectionofchromosomalrearrangementsinconstitutionalandproductsofconceptionreferrals.Thistechnologyoffersahigherlevelofresolution,improvesthescopeofdetectionofchromosomeanomaliesandreplacesconventionalkaryotypingofchromosomes.TheintroductionofthisservicetoACTPathologyhascontributedtopatientcareingeneticservices.

Changes in technology• Newslidestainer:TheAnatomicalPathologyDepartmenthasintroducedanewprocessorforthestainingof

tissuesamples.Thisprocessorhasanumberoffeaturesthatimprovesafetyandquality.Thisincludesdecreasedhandlinganduseofdangerouschemicalsbystaff,andindividualprocessingofsamplestoeliminatecross-contamination.

• Front-endautomation:APVTautomatedfront-endprocessorwasinstalledthisyear.Thissystemimprovesprocessingandstorageofpatientsamplesreceivedinthelaboratory.Itdecreasestheamountofmanualhandlingofsamplesstaffarerequiredtodo,aswellasreducingpre-analyticalerrorsandtheincidenceofrepetitivestraintypeinjury.Itwillbenefitbothpatients(withimprovedquality)andstaff(withimprovedworksafepractice)andreleasestafftoconcentrateonmorecomplexscientificduties.

E-healthPathologyembraceselectronicdeliveryofpathologyresultsforbettermanagementofpatientcareandtheprovisionofcontinuityofservices.Pathologyresultsarecurrently:

• includedinthedischargesummary

• deliveredtotheICUandrenaldepartmentsystemstosupportpatientcareandotherdatabasesinclinicalareas

• deliveredelectronicallytomedicalpractitionersinthecommunity.

Education• PathologyholdsRoyalCollegeofPathologistsofAustralasiaaccreditationformedicalpostgraduatepathology

traininginallthemajorspecialisationsofpathology.

• PathologyisworkingincollaborationwiththeUniversityofCanberra,AustralianNationalUniversityandCanberraInstituteofTechnologytocontinuetodevelopandsupportthevariousscientificandtechnicalcoursesrequiredinmedicallaboratoryscience.Thisincludesbothundergraduateandpostgraduatecourses. AnumberofACTPathologyscientificstaffprepareandprovidelecturesforthesecourses.Inaddition,studentsaresupportedinthepathologylaboratorieswhileundertakingtheirprofessionalpracticerequirements.ThisinitiativeisalreadyprovidingnewgraduateswhoarebeingintroducedintotheworkforceinCanberra

• ThescientificstafffromcytogeneticscontributedtothedevelopmentoftheUniversityofCanberracoursethatisnowtheonlypostgraduatecytogeneticcoursetobeofferedinAustralia.

• ACTPathologycontinuestosupportstaffcontinuingeducationthroughattendanceatexternalconferencesofnationalassociations,includingtheAustralianAssociationofClinicalBiochemists(AACB),AustralianInstituteofMedicalScientistsandvariousindustryworkshops.


Investments in research• Pathologyisascientificdisciplinewithresearchasacornerstone.Manyofthepathologistsandscientistsare

activelyinvolvedintheirownresearchorworkcollaborativelywithothers.Thisdemonstratestheimportantroleofresearchinteaching,andPathology’sincreasinglinkandcontributiontotheAustralianNationalUniversityMedicalSchool.Membersofthedivision(scientificandmedical)continuetopublishactivelyinpeer-reviewedjournalsandparticipateinprofessionalmeetingsandworkshopsbothinAustraliaandoverseas.

• ACTPathologyhasbeeninstrumentalinastudytodeterminereferenceintervalsforahealthyAustralianpopulation.Thisstudy,AussieNormals,hasbeensupportedbythediagnosticindustrythroughtheavailabilityofconsumables.ACTPathologyscientificandclinicalstaff,insupportingthisinitiative,havebeeninvolvedinpursuingharmonisedreferenceintervalsinclinicalchemistry.Thishasresultedinanationalworkshopin2012andasatelliteconferenceinassociationwiththeAACBnationalmeeting.Publicationofthefindingswillbepresentedlaterin2013.

• TheACTHaematologyResearchTissueBankarchivestissuesamplesfrompatientswithhaematologicalandrelateddisorders.Setupin2007,ithasproventobeanimportantresourcetosupportlaboratoryresearchandhasenabledthedepartmenttoapplyforcompetitivegrants.

Issues and challengesThemajorchallengefortheDivisionofPathologyinthefutureisdealingwithincreasingdemandbycliniciansandpatientsformorerapid,specificandhigh-techtestingforpatientmanagement,particularlyinthemolecularfieldsofcancergeneanalysisandbacterialsequencing,incombinationwithmaintainingaskilledworkforceoperating24hoursaday.Thefuturewillseeasignificantincreaseintechnology,includingbothautomationandnewtechnologies,thatwillrequireaworkforcethatiswellinformedandabletoadapttochangesinlaboratorypractice.Therefore,itisimperativetomaintainlinkswithuniversitiesandothernationalbodiestofosteradynamicgroupofpathologistsandscientistswhoformthecriticallinkbetweenclinicalmedicineandlaboratorypractice.

AnotherchallengefortheDivisionofPathologyismanagingdemandonstaffandresources.Communitycollectioncentreshavebeenamajorcontributortothisincreasingdemandoverrecentyears.Tomanagethisincreaseindemand,twoofPathology’scollectioncentreshavebeenclosed.Thishasenabledresourcestoberedirectedandassistinrespondingtodemandonpublicpathologyserviceswiththeavailableworkforceandresources.ACTPathology’scorebusinessisthedeliveryofinpatientpathologyservicestoCanberraandCalvaryhospitals.

Future directions

Increased range of servicesAttherequestofACTHealthstaffspecialists,theMolecularPathologyDepartmentisintheprocessofimplementingmutationmarkerassaystoassistintheselectionofsuitabletreatmentmodalitiesforcancerpatients.Thisdiagnosticserviceislikelytobeofferedlaterin2013.Thelaboratoryoffersanalreadyexpandedrespiratorypathogentestingserviceandislookingtoexpandthisrepertoireoftestinginthefuture.

Research that promotes evidence-based practicePathologysupportsmuchoftheclinicalresearchbeingcarriedoutinthepublichospitalsystemintheACTbyundertakingtheassaysdirectlyorpreparingspecialsamplesforforwardingtoresearchinstitutesinotherstates.Thisactivityisinadditiontoworkinitiatedwithinvariousdepartmentsacrosspathology,whichisoftenofacollaborativenaturewiththeAustralianNationalUniversityandUniversityofCanberra.ACTPathologyiscurrentlysupportingandcontributingtoinexcessof40researchprojects,anditwillcontinuetosupportsuchprojectsinthefuture.


Improve patient safety and quality of carePathologyisworkingcollaborativelywithHealthITtointroduceComputerisedPhysicianOrderEntry(CPOE).CPOEisanelectronicwardorderingsystemthatwillimprovecompletionofmandatoryinformationrequiredforpathologytesting,improvelegibilityandthusaccuracyofrequestinformationandprovidedecision-makingsupportinformationtotherequestingdoctor.Havingthisup-frontinformationforrequestingdoctorsisexpectedtoleadtomoreefficientorderingofpathologytests.InconjunctionwiththeCPOE,apathologycollectionsystemprovidingpositivepatientidentification(PPID)forthecollectionofbloodsampleswillbeintroduced.TheintroductionofbothCPOEandPPIDisexpectedtoreducepre-analyticalerrorsthatoccurbeforethesampleispresentedtothelaboratoryforanalysis.Thiswillsignificantlyimprovepatientsafety.Theprocessisnecessarilylongandintensiveandwelookforwardtoimplementationin2014.

Division of Surgery and Oral HealthTheDivisionofSurgeryandOralHealthisresponsiblefordeliveringinpatientandoutpatientsurgicalandmedicalimagingservicesandpreventionandtreatmentdentalhealthprogramsforchildren,targetedyouthandadultsoftheACTcommunityandsurroundingregion.Theaimofsurgicalservicesistoprovidetimelyaccesstoelectiveandemergencysurgery,withafocusonqualitypatient-centredcare,supportedbyevidence-basedpractice.ThedivisionincludestheSurgicalBookingsandPre-AdmissionClinic,Anaesthesia,thePainManagementUnit,OperatingTheatres,thePost-AnaestheticCareUnit,theDaySurgeryUnit,theAdmissions/ExtendedDaySurgeryUnit,MedicalImaging,variousspecialtysurgicalwardareas,theOutpatientDepartment(medicalandnursingonly),theShockTraumaService,theTraumaOrthopaedicResearchUnitandtheDentalHealthProgram.

Achievements• CapitalfundingwasreceivedforthepurchaseandinstallationoftwonewCTscanners.Thefirst,astate-of-the-

artCTscanner,becameoperationalon3July2013.Thesecond,amedium-rangeCTscanner,isexpectedtobeoperationalbytheendofAugust2013.

• MedicalImagingimplementedneuro-interventionalservices—inparticular,coilingofintracranialaneurysms—whichprovideaccessforpatientswhohavepreviouslyhadtotravelinterstatefortheseservices.

• Inthepast12months,therehasbeenincreasinginterestfrominternationalradiologistsinspendingtimeatCanberraHospitaltofurtherdevelopskillsandtraining.Thesepositionsaresponsoredbytheirindividualgovernments.

• TheappointmentofaNuclearMedicineFellowassistedwiththedevelopmentofacareerpathandfutureteachingopportunities.

• DrRobertAllenreceivedanInterventionalRadiologySocietyofAustraliaGoldMedalAwardinrecognitionofhiscontributiontointerventionalradiology.DrAllenisthethirdpersontobeawardedthishonour.

• MrChrisMcLarenbecameanHonoraryLifeMemberoftheAustralianandNewZealandSocietyofNuclearMedicinein2012.MrMcLarenisonlythesecondnuclearmedicinescientisttobegrantedthishonour.

• In2012–13,thefederalgovernmentprovided$345.9millionoverthreeyearstoreducepublicdentalwaitinglistsacrossAustralia.TheACTwasthefirstjurisdictiontosigntheNationalPartnershipAgreement(NPA)inJanuary2013andwasallocated$5.5millionoverthreeyears.Thefundinghasincreasedworkforcecapacityandincreasedutilisationoftheprivatesectortoreducepublicdentalwaitinglists.At30April2013,theDentalHealthProgram(DHP)metbaselineNPAactivitytargets,attractinganadditional$300,000ofNPAfundingon1June2013.ThisbringstotalNPAfundingfor2012–13to$954,000.

• At30June2013,therewere1,659peoplewaitingfornon-urgentrestorativedentalservices,comparedto2,310clientsonthewaitinglistat30June2012.At30June2013,2,447clientswereremovedfromtherestorativewaitinglist,comparedto1,856at30June2012.Thisisanincreaseof591clientsbeingremovedin12months.

• OnedentalclinicinCivicwasrefurbished,andanadditionalclinicinCivicwasconstructed.Astudenttutorialroomandorthopantomograph(OPG)x-raymachine,toincreasethenumberofdentistrystudents,werecompleted.

• Vision-ImpairedPersonsHospitalKitswereintroducedacrossthehospitalinSeptember2012forusebypeoplewhoareblindorhavelowvision,aswellastheirfamiliesandcarers.Thekitprovidesinformationonarangeofresourcesthatenablepatientstomaintainahighlevelofindependenceandassisthospitalstafftohaveagreaterunderstandingoftheneedsofpeoplewhoareblindorhavelowvision.Thekitincludesresourcesforuseinhospital,suchassignagetoincreaseawarenessofpatients’needs,checkliststoensurepatientsarepreparedandorientatedtothewardenvironment,signedguidetechniquesforstafforcarersandinformationaboutlowvisionservicesintheACT.


• MrDanielWood,ActingAssistantDirectorofNursing,Wards,wasawardedanACTHealthAustraliaDayAward.

• Twocollegeophthalmologytraineeswerere-accreditedinSeptember2012forthreeyears.

• DrRohanEssexiscoordinatinganationalresearchprojectonretinalsurgeryoutcomesbasedinCanberra.

• ThePainManagementUnitwontheACTQualityinHealthcareAwardin2012for‘AccessandEfficiency—ImprovingCustomerAccesstoMultidisciplinaryPainManagementServices’andtheACTGovernmentHealthBetterPracticeAwardin2013for‘ImprovingConsumerAccesstoMultidisciplinaryPainManagementInterventions’.

• TheACTTraumaCommitteewasformedtopromoteintegrationandcoordinationofthetraumasystem.KeyrepresentativesfromCanberraHospitalandfromhospitalsinourregionaremembers.

• MonthlyTraumaGrandRoundswereestablishedtoimprovethehealthoutcomesoftraumapatientsbyprovidingtraumaeducationandtrainingthatarelocallyaccessible.

• TheShockTraumaServicemadeaformalcommitmenttotheAustralianTraumaQualityImprovementProgram.Theaimoftheprogramistocollaborateinimprovingcareofseriouslyinjuredpatientsthroughsharinginformation,makingjointeffortsintraumaqualityimprovementprojectsanddevelopinga‘nextgeneration’nationalclinicalqualityregistryfortrauma.

• MsRebekahOgilvie,TraumaCoordinator,wasrecognisedthisyearforherresearchinmajortraumaticinjuryinyoungpeoplewhenshewasawardedtheinauguralSkellernPhDScholarship.

• AnewDirectorofthePainManagementUnitcommencedinApril2013.

Issues and challenges• Demandforservicesincreasedbutthedivisionwasabletorespondwithadditionalactivity—forexample:

– In2012–13,therewere6,464electivesurgeryproceduresundertaken,comparedwith6,317in2011–12,whichhasexceededtheannualtargetof6,300.

– TheDentalHealthProgramremoved3,098clientsfromthecentrallistfortreatmentin2012–13,comparedwith1,727in2011–12.

• ThedecantingoftheTuggeranongDentalClinictothePhillipDentalClinictoallowfortherefurbishmentoftheTuggeranongHealthCentrepresentedanumberofchallenges,including:

– schedulingandrelocationofstaffandequipmenttoenablethecontinuationofservicedeliverytochildandyouth clients

– negotiationswiththePhillipHealthCentreforadditionalofficespacetoadministertheNationalChildOralHealth Survey

– goodcommunicationtoallaystaffconcernsandanxietyabouttherelocation

– amulti-prongedclientcommunicationstrategytoinformclientsofthechangestoservicedeliveryandaccess.

Future directions• TheinstallationofnewCTscannersprovidesopportunitiestooffernewdevelopmentsindiagnosticoptions.

• MedicalImaginghasreceivedfundingtoacquirearangeofnew,state-of-the-artequipment,includingultrasoundmachines,agammacameraandabiplaneangiographysuite.

• TheACTGovernmenthascommitted$1.6millionfrom2013–14overfouryearstofundamobiledentalvantoprovidedentalcaretoresidentialagedcarefacilities,specialschools,andpregnantandparentingstudentsattendingtheCanberraCollegeCaresProgram.Theoperationsofthemobiledentalvanareintheearlyplanningstages.

• ThenewlybuiltBelconnenHealthCentrewillopeninNovember2013with11dentalchairs—anadditionalsixchairscomparedwiththeoldBelconnenHealthCentre.ThenewlyrefurbishedTuggeranongHealthCentrewillopeninthefirsthalfof2014withfivedentalchairs.

• TheDHPcontinuestocollaboratewithalliedhealthprofessionalstointroduceorthodontictreatmentforclientswithcleftpalate.ClinicaltrainingisoccurringbetweentheCanberraHospitalCleftPalateClinicandtheDHP,andamentorshiphasbeenestablishedwithaseniororthodontistattheSydneyCleftPalateClinic.Clientsarebeingtreatedforgeneraldentalinterventions,withfullorthodonticsexpectedtocommenceforclientsreferredbytheCanberraHospitalCleftPalateCliniclaterin2013.


• Anupgradetothedentalelectronicclientinformationsystem,includingdigitalradiography,willbecompletedinOctober2013.

Formalisationofcross-bordernetworkingarrangementsaspartofthe2013NewSouthWalesTraumaServicesReviewwillstrengthendatalinkagewithNewSouthWalesreferralfacilitiesandfacilitaterepatriationforongoingcare,whichwilllinkinwithrehabilitationservicesavailableclosertohome.

Division of Women, Youth and ChildrenTheDivisionofWomen,YouthandChildrenprovidesabroadrangeofprimary,secondaryandtertiaryhealthcareservices.Theprovisionofservicesisbasedonafamily-centred,multidisciplinaryapproachtocareinpartnershipwiththeconsumerandotherserviceproviders.ServicesareprovidedattheCanberraHospital,incommunityhealthcentresandincommunity-basedsettings,includingclients’homes,schools,andchildandfamilycentres.Someservicesareprovidedwithinotheragencyfacilities.

TheDivisionofWomen,YouthandChildrenservicecomprises:

• maternityservices,includingtheContinuityattheCanberraHospital(CatCH)ProgramandtheCanberraMidwiferyProgram(CMP)

• women’shealth,includingscreening,gynaecologyandprogramstargetingviolenceagainstwomen

• neonatology,includingtheNeonatalIntensiveCareUnit,SpecialCareNursery,specialistclinics,newbornhearingscreeningandACTNewbornRetrievalService

• paediatrics,includinginpatientcare,specialistclinics,communitypaediatriciansandgenetics

• MaternalandChildHealth(MACH),includingauniversalhomevisitfollowingbirth,supportforbreastfeedingandparenting,immunisationandreferral

• servicesthatsupportchildrenandtheirfamilieswithcomplexcareneeds:

– MaternalandChildHealth(MACH)ParentingEnhancementProgram

– AsthmaNurseEducatorService

– CaringforKidsProgram(careinthehomeforchildrenwithcomplexneeds)

– ChildatRiskHealthUnit(careforchildrenaffectedbyviolenceandabuse)

– IntegratedMulti-agenciesforParentsandChildrenTogether,whichcoordinatescareforwomanwithcomplexcareneedswhoarepregnantand/orhaveyoungchildren

– childprotectiontrainingforclinicians

• school-basednursingservices,includingimmunisation,kindergartenhealthchecks,schoolyouthhealthchecksandspecialschoolnurses

• nurseaudiometry,providinghearingassessmentstochildrenandadults.

Achievements

Centenary Hospital for Women and ChildrenThenewCentenaryHospitalforWomenandChildrenisoneoftheHealthInfrastructureProgram’smajornewfacilitiesandfeaturesstate-of-the-artequipmentandinfrastructure.Theprojectincludesthemajorrefurbishmentoftheexistingmaternitybuilding.ThemoveintotheCentenaryHospitalforWomenandChildrentookplaceinAugust2012andpresentedsignificantchallenges,including:

• relocationofbabiesintheNICUandSpecialCareNurseryandwomenintheMaternityUnit

• communicationwithstaff,whichwasofutmostimportancetoalleviateanyconcernsregardingtherelocation

• amulti-prongedclientcommunicationstrategytoinformclientsofthechangestoservicedeliveryandaccess.


Community health programsCommunityhealthprogramsprovideservicesunderaprimaryhealthcareframeworkforchildren,familiesandwomeninthecommunity.Programsandservicesaredeliveredtoindividualsorgroupsacrossavarietyofsettingsinhealthcentres,childandfamilycentres,schoolsandclients’homes.

In2012–13,therewasincreaseddemandforservicesandaneedtodevelopnewmodelsforservicedeliverytotrytoaddressthisdemand.Extensiveworkwasalsodonetoprepareforthemovestotheneworrefurbishedcommunityhealthcentres.

ACT Breastfeeding Strategic FrameworkThe ACT Breastfeeding Strategic Framework 2010–2015waslaunchedon10November2010.Itsaimistoincreasethenumberofinfantsbeingexclusivelybreastfedfrombirthtosixmonthsandtoencourageongoingbreastfeedingwithcomplementaryfoodsuntilatleast12monthsofage,inlinewithNationalHealthandMedicalResearchCouncilrecommendations.Implementationoftheframeworkcontinues,withafocusonprioritygroupsandconsistencywiththenationalbreastfeedingstrategicframework.

Keyinitiativesincludethedevelopmentofresourcesforpriorityandmainstreamgroups,healthprofessionaleducation,awhole-of-governmentapproachtothe‘Breastfeeding-FriendlyWorkplace’andenhancedbreastfeedingdatacollection.AdedicatedprojectofficerledtheimplementationuntilJune2013.ThedevelopmentandimplementationoftheBreastfeedingStrategicFrameworkwasfundedbytheACTPopulationHealthDivision’sHealthyFuturebudgetandisajointinitiativeoftheHealthImprovementBranchandtheWomenYouthandChildrencommunityhealthprograms.

TheimplementationoftheframeworkhasbeenguidedsinceitsinceptionbytheBreastfeedingInitiativeSteeringCommittee.ImplementationwillnowbecoordinatedthroughtheDivisionofWomen,YouthandChildrenandPolicyandGovernmentrelations.TheDivisionofWomen,YouthandChildrenwillmanagetheservicedeliverysideofbreastfeeding,including:

• explorationofthecurrentservicedeliverymodelforbreastfeeding

• ongoingeducationofhealthprofessionalsandsupportforresourcedevelopment

• theembeddingofbreastfeedingandthestrategyintothecorebusinessofACTHealthbyestablishingasubcommittee

• ongoingBreastfeeding-FriendlyWorkplacere-accreditationforACTHealth

• thedevelopmentofanACTHealthpolicyonthepreparationofformula

• theembeddingofbreastfeedingintoallrelevanthealthandgovernmentpoliciesandframeworksduringthedevelopmentprocess.

Women’s Health ServiceTheWomen’sHealthService(WHS)hascontinuedtoimplementaninterprofessionalprimaryhealthcare(ACCESS)modelfordisadvantagedwomenwhoexperiencesignificantbarrierstohealthserviceaccess.Thecounsellors,women’shealthnurses,nursepractitionerandstaffspecialistworkcollaborativelytoprovidecomprehensivecaretotheprioritypopulationgroups.Thewomen’shealthnurseshavemaintainedtheirexpandedoutreachtobettertargetvulnerablegroups.AnevaluationframeworkfortheACCESSmodelhasbeendevelopedbyresearchersfromtheAustralianPrimaryHealthCareResearchInstitute.

Tosupporthealthprofessionalsworkingwithwomenwhohavebeensubjectedtointerpersonalviolence,atrainingpackageforgeneralpractitionershasbeendevelopedanddeliveredinconjunctionwithMedicareLocal,andpresentationsontrauma-informedcarehavebeendevelopedanddeliveredtootherhealthprofessionals.

School Youth Health Nurse ProgramTheSchoolYouthHealthNurseProgramaimstopromotepositivehealthoutcomesforyoungpeopleandtheirfamiliesthroughthedeliveryofaccessible,acceptable,appropriateandculturallyrespectfulprimaryhealthcareservicesintheschoolsetting.Italsoprovidestheopportunityforyoungpeople,theirparentsandmembersoftheschoolcommunitytoaccessahealthprofessionalintheschoolsetting.Thiscanbeformattersrelatingtohealthorwellbeingandincludesactingasacurriculumresourceforstaff.Theexternalevaluationwascompletedin2012and,basedonthepositiveresults,theprogramwasextendedin2013.


ImmunisationFrom2013,theHumanPapillomavirus(HPV)vaccinationprogram,whichhasbeenofferedtogirlsinYear7,isbeingofferedtoboys.TheSchoolHealthTeamisofferingthevaccinationtoYear7boys,withatwo-yearcatch-upcomponentforboysinyear9.TheHPVviruscancausegenitalwartsandarangeofcancers,includingcervical,penileandanalcancer.

Maternal and Child Health nursing partnership with Canberra CollegeTheMaternalandChildHealth(MACH)nursingpartnershipwithCanberraCollege(CCCares),whereMACHservicesaredeliveredtopregnantyoungwomenandyoungparentswhoarecontinuingtheireducationandbringingtheirchildtothisuniqueschoolsetting,continuestogrowanddevelop.Over100youngparentsareengagedwithMACHservicesthroughthispartnership,andanincreasednumberofsessionshavebeenprovidedbyMACHservices.Acommunitypaediatriciannowprovidesacliniconceamonth.

National Perinatal Depression InitiativeTheAustralianGovernmentDepartmentofHealthandAgeingandACTHealthhaveafive-yearagreementfortheNationalPerinatalDepressionInitiative(NPDI),from2008to2013,toimprovepreventionandearlydetectionofantenatalandpostnataldepressionandprovidebettersupportandtreatmentforexpectantandnewmotherswhoareexperiencingdepressionorareatriskofdevelopingdepression.TheinitiativeismakingconsistentprogressalignedwiththeagreedmilestonesoftheNPDI.Progressandimprovementsagainstalloutputsintheimplementationplanareontrack,withnosignificantrisksorissuesemerging.

TheNPDIprojectparticularlyfocuseson:

• routineanduniversalscreeningtoidentifywomenatriskof,orexperiencing,perinataldepression(PND)

• follow-upintegratedcarepathwaysforwomen

• aneducationandtrainingframeworkinperinatalmentalhealthformultidisciplinaryprofessionals

• communityawarenessoftheriskfactorsrelatedtoPND,anxietyandadjustmenttoparenting

• improvementofdatacollectionmethods.

Health services to children and young people with complex health issues in all ACT Government schoolsTheHealthDirectorateandtheEducationandTrainingDirectorateareworkingtogetheronaprojecttodevelopawhole-of-governmentmodeladdressingtheprovisionofhealthservicestochildrenandyoungpeoplewithcomplexhealthissuesinallACTGovernmentschools.AcommunityconsultationprocesswasconductedinNovember2012.Apreferredmodel,namedHealthcareAccessAtSchool(HAAS),waspilotedinearly2013withpositiveoutcomes.Implementationwilloccurin2013–14.

Centre for Newborn CareThenewNeonatalIntensiveCareUnit(NICU)wasbuilttoaccommodateupto34patients.SincethemovetotheCentenaryHospitalforWomenandChildreninAugust2012,occupancyintheNICUhasbeenat91percent.

Neonatal Intensive Care Unit WebcamInthe2008–09Budget,ACTHealthallocated$200,000todevelopandimplementavideostreamingserviceforparentsofinfantsattheCentreforNewbornCareNeonatalIntensiveCareUnit(NICU).

TheNICUCAMwebsiteprovidesgeneralinformationontheservicesprovidedbytheCentreforNewbornCareandcanbeaccessedbythepublic.Fromthissite,parentscanaccessthesecurepassword-protectedportaltoviewtheirownbabiesdailybetween6.00amand10.00amandbetween6.00pmand10.00pm,viaawebcaminstalledabovethebaby’scotintheCentreforNewbornCare.

ParentsmayprovidethepasswordandlogintofamilymembersinAustraliaandoverseas,whichpromotesbondingwiththenewbaby.


Atotalof10babiescanbeonthewebcamsiteatthesametime,thoughtodatesixhasbeenthemaximumnumber.Thewebsitehasreceivedover100,000hitsandhasbeenaccessedfrom80countries,asfarafieldastheUnitedKingdom,Canada,France,Italy,HungaryandIndia.In2011,theprogramwasawardedthenationaland,in2012,theInternationalOceania–PacificProjectManagementAwardinthecategoryOrganisation/ChangeManagement.

AtechnicaldesignwasdevelopedtoupdatethewebsiteandmanagethecamerasbyNICUCAMstaff.Solutionwentfortenderandthesuccessfulcompanywasofferedthecontract.

ACT Newborn Retrieval ServiceTheNewbornRetrievalService,asatelliteoftheNewbornEmergencyTransportService(NETS)NewSouthWales,hasbeenoperationalsince2008.Annually,40to50babiesareretrievedfromtheACTandNewSouthWalesandtakenasfarasfromNowratoCanberraHospitalbytheneonatalretrievalteam,whichconsistsofaneonatalnurseandmedicalofficer.Inaddition,theserviceprovidesatimely,safeandcoordinatedtransferofbabiestotheirlocalhospitals.Theretrievalteam(medicalandnursing)isbeingtrainedinpaediatriclifesupportandprovidesaneonatalandinfant(upto10monthsofage)medicalemergencyteamatCanberraHospitalintheCentreforNewbornCare.TheteamalsoprovidestreatmentandstabilisationofchildrenuptotheageoftwoyearsbeforetransfertoSydneytoaPaediatricIntensiveCareUnit.

AnupdatedmemorandumofunderstandinghasbeendevelopedtoincreaseservicedeliverytohospitalsinNewSouthWalesthatareclosertoCanberrathanSydneyandtofacilitatetime-appropriateretrievalandback-transferofconvalescingneonatestoimprovepatientflow.

Paediatric and Adolescent Health ServicesThePaediatricDepartment,inadditiontoitsgeneralpaediatricsduties,runssub-specialityservicesinpaediatricendocrinology,respiratorymedicineandnephrologyandconductsoutreachclinicsinCoomaandPambulaonamonthlybasis.Thedepartmentalsostrivestomeettheneedsofchildrenrequiringothersub-specialistservicesbyhostingvisitingspecialistsfromSydneyinpaediatriccardiology,gastroenterology,oncologyandneurology.Paediatricresearchisconductedwithinvolvementinvaccineanddrugtrials,aswellasresearchongeneticrenaldisordersandendocrineandmetabolismdisordersinchildren.AllpaediatricstaffspecialistshaveanacademicappointmentandactivelyparticipateinAustralianNationalUniversityMedicalSchoolstudentteaching.

Outpatientwaitinglistsinpaediatricshavebeenaddressedbyadministrativeimprovements,therecruitmentoftwonewpaediatricians(1.8full-timeequivalent)andimprovedpaediatricregistrarparticipationinoutpatientclinics.TheworkoftheChronicCareCoordinatornurseintheOutpatientDepartmenthasallowedforacohesive,family-andchild-centredapproachforchildrenwithchronicdisease.

ThePaediatricPalliativeCareCommitteehasimprovedpalliativecareservicesforchildrenandtheirfamiliesthroughacollaborative,multidisciplinaryandmulti-agencyapproach.ImprovedlinkswithClareHollandHousethroughamonthlyinterdisciplinarymeetingandattendanceataconjointmeetingwithNewSouthWalesPaediatricPalliativeCareServicesensureourpaediatricpalliativeservicealignswithcurrentbestpractice.

ThePaediatricDepartmenthascommencedstrategicplanningonimprovedresidentandregistrartrainingbydevelopingatrainingprogramthatwillallowAustralianNationalUniversitygraduatestoundertakeallbutsixmonthsoftheirpaediatrictrainingintheACT.RecognitionisactivelybeingsoughtfromtheRoyalAustralasianCollegeofPhysiciansforlocaltraininginseveralpaediatricsub-specialityrotations.

iPatCH (Paediatrics high dependency unit)Inthe2012–13Budget,fundingwasallocatedfortwoadditionaliPatCHbeds.ThesebedshavebeenidentifiedinWard4Bandwillbeutilisedtoprovideclosermonitoringofpatientsandahigherlevelofnursingcareforsickchildren.iPaTCHhasacceptedNETStransferofnineacutelyunwellchildrenfromsurroundinghospitalsinNewSouthWalesandCanberra.iPaTCHbedsarenotrestrictedtopatientsofthePaediatricDepartment;allspecialitiesmayadmitpaediatricpatientsintoiPatCHcareundertheguidanceofaconsultantpaediatrician.


Maternity and gynaecology servicesMaternityandgynaecologyservicesatCentenaryHospitalforWomenandChildrenprovidecaretowomenandchildrenintheACTandsurroundingregionalarea.Therewere3,342birthsin2012–13,comparedto2,974in2011–12and2,769in2010–11.Inthepastsixmonths,outpatientantenatalcareoccasionsofservicewere3,425formedicalofficersand3,848formidwifery.Outpatientgynaecologyservicesprovided1,795occasionsofservice.

Issues and challengesInrecentyears,therehavebeensignificantchangesinthemixbetweenprivateandpublicsectorbirths,andthenumberofpublicsectorbirthshasincreasedsignificantly.Between2006–07and2011–12,therewasonlya9percentincreaseinthetotalnumberofbirthsintheACT;thisislessthan2percentayear.Overthesameperiod,therewasa25percentincreaseinbirthsinthepublicsector,whileprivatehospitalsexperienceda21percentreductioninbirthratesoverthesameperiod.

ChangestotheMedicareSafetyNethavecoincidedwithasignificantdecreaseinprivatesectoractivityandasignificantincreaseinpublicsectoractivity.Thischangewassignificantin2010–11and2011–12,asmanyoftheprivatesectorbookingswerepreviouslymadeatthetimeofthesafetynetchanges.Thechangeinpatternanddownturnofprivatesectoractivityunfortunatelyoccurredtoolatetoenableanychangeinplanningfortheconstructionofthenewhospital.Theplanningofthefacilitywasbasedontheprojectionsforincreasesindemand.ThetotalnumberofACTbirthsisconsistentwiththeprojectionsthatweremade.However,thesafetynetchangeswerenotknownatthetimeandthereforetheshiftfromprivatetopublicsectorwasunexpected.

TheCentenaryHospitalforWomenandChildrenhasexperiencedpressureinrelationtooccupancy.Areviewintomaternityserviceshasbeencommissionedtolookatwaysinwhichtheterritorycanworkcollaborativelytomeetthisunprecedenteddemand.ThepurposeofthereviewistoexamineandprovideanassessmentofthemodelofcareinthenewCentenaryHospitalforWomenandChildrenMaternityUnit.ItwillalsolookatthecapacityofACTmaternityservicestomeetcurrentandfuturedemand,takingintoaccountrecentchangestoservicedemandaswellasthemodelofcare.ThereviewteamwassoughtfromWomen’sHealthAustralasia(WHA),thepeakbodyforhospitalsandhealthservicesprovidingcaretowomenandbabies.ThereviewteamhasconductedinterviewswithmembersofstaffandconsumersoftheCentenaryHospitalforWomenandChildrenandwillprovideareportbySeptember2013.Strategieshavebeenputinplacetomanagedemand,suchas:

• theopeningoffourshort-staypostnatalbedsasashort-termmeasuretomanagetheoverflowofpatients

• additionalstaff

• increasedcapacityforthecontinuityofthemidwiferyprogram.

Future directions

Centenary Hospital for Women and ChildrenMaternityandgynaecologyservicesatCentenaryHospitalforWomenandChildrenprovidecaretowomenandchildrenintheACTandsurroundingregionalareas.TheCentenaryHospitalforWomenandChildren,stage2willopenattheendofOctober2013.Atthecompletionofstage2,theinpatientandoutpatientpaediatricservicewillrelocatetolevel1.TheAntenatalandGynaecologyOutpatientService,theMaternityUnitandtheFetalMedicineUnitwilloccupylevel2.Twoassessmentrooms,fivebirthcentrebedsandthenewbirthingsuite,whichhave13labourbirthrecoverybeds,willoccupylevel3.

Community Paediatric and Child Health Service: Child Development ServiceInearly2012,adiscussionpapertitled‘TheFutureofCommunityPaediatricsintheACTRegion—Beyond2012’wassenttotheDirector-GeneralofACTHealth,DrPeggyBrown.Itwassubsequentlyendorsedforfurtherexplorationandaworkinggrouptobeformed.Thispaperhasstimulatedstakeholdersacrossgovernmentdepartmentsandnon-governmentorganisationsinvolvedintheprovisionofchildandyouthservicestoworktogethertodevelopacollaborativemodeltoimprovechilddevelopmentservicesintheACT.ThisworkwillbeincorporatedintothePaediatricServicesStrategicPlan.

TheaimofthiscollaborativeandmultidisciplinaryworkistoexaminethepotentialtotransformthepresentCommunityPaediatricandChildHealthService(CPCHS)intoabestpractice,evidence-based,multi-disciplinarychilddevelopmentcentrefortheACTandsurroundingregion.


Personal Child Health RecordInalignmentwiththeNational Framework for Universal Child and Family Health Services,ACTHealthiscommittedtotheprogressionofanationalPersonalChildHealthRecord(PCHR).ThelogicalfirststepistocomeintoalignmentwiththerecentlyupdatedNewSouthWalesPCHRinconsultationwithACTcliniciansandotherprofessionalswhoworkwithchildren.ThisapproachwasapprovedbytheACTChildYouthHealthReferenceGroupandtheACTMaternityServicesNetworkForum.Therationaleforthisincludes:

• extensiverecentconsumerconsultationbyNewSouthWalesHealthontheirPCHR

• ongoingtrialsofanelectronicversionoftheNewSouthWalesPCHR

• considerationofthoseprofessionals,cliniciansandfamilieswhoseworkingandlivingarrangementsstraddletheACT–NewSouthWalesborder

• substantialcostsavingsfromprintingthisformat.

ApprovaltoadopttheNewSouthWalesPCHRstyleandformathasbeengivenbyNewSouthWalesHealthandtheExecutiveDirectorofNewSouthWalesKidsandFamilies.AworkinggroupwillmakeminorlocalamendmentsandthenseekfinalendorsementbytheACTChildYouthHealthReferenceGroupandNewSouthWalesHealth.

Chronic KidsThepaediatricserviceislookingatthedevelopmentandimplementationofachroniccarestrategy.Thiswouldaimtoimprovetheservicedeliveredtochildrenandtheirfamiliesthroughamoreintegratedandcomprehensiveapproachtochroniccaremanagement.ThestrategywouldbebasedontheprinciplesoutlinedintheACTChronicConditionsStrategyandtheNationalChronicDiseaseStrategy.

Paediatric Services Strategic PlanThefuturedirectionforthePaediatricDepartmentistocontinuetostrivetoimprovepaediatricoutpatientservicesandwaitingtimesforfamilies,toimproveinpatientservicesandtoensurethetimelyandseamlessdischargeofchildrenwhenhospitalcareisnolongerrequired.TheserviceisworkingtoimprovetheflowofchildrenthroughtheEmergencyDepartmenttothewardandisundertakingatrialofapaediatricobservationunit(ShortStayWard)forchildrenwhorequirealongerperiodofobservationforacutetreatmentpriortoadecisiontoadmitordischargebeingmade.Theserviceisplanningtodevelopanacutepaediatricreviewclinic,whichwillgiveACTgeneralpractitionerstheabilitytoobtainanimmediatepaediatricreviewofachildtheyhaveconcernsaboutwhodoesnotrequirepresentationtotheEmergencyDepartment.SuchamodelwillassistgreatlyinmeetingtheNationalEmergencyAccessTarget(NEAT),reducetheburdenontheEmergencyDepartmentandimproveliaisonwithACTgeneralpractitioners.

Calvary Health Care ACTCalvaryHospitalprovidespublichealthandhospitalservicesintheACT.TheseservicesincludeEmergencyMedicine,CriticalCare,MedicalCare,ElectiveandEmergencySurgery,DaySurgery,AgedCareandRehabilitation,MentalHealth,andInpatientandCommunitySpecialistPalliativeCareservicesfromClareHollandHouse(theACTHospice).

CalvaryHospitalisoperatedbyCalvaryHealthCareACT(CHCACT),asubsidiaryofLittleCompanyofMaryHealthCare.CHCACThasoperatedCalvaryHospitalsinceitsinceptionin1979.

FundingfortheoperationofthepubliccomponentofCalvaryHospitalisprovidedbytheTerritory.TheenduringarrangementsbetweenCalvaryHealthCareACTandtheTerritoryaredescribedintheCalvaryNetworkAgreement.

EachyeartheTerritoryandCalvaryHealthCareACTnegotiaterequiredactivitylevelsandfundingarrangements.TheseareformalisedintheannualPerformancePlan,againstwhichCalvaryregularlyreportsitsservicetothelocalcommunityandotherpeopleinneedofpublichealthandhospitalservices.


Achievements in the reporting period• AchievingimpressiveresultsfromtheAustralianCouncilonHealthCareStandardsaccreditationsurveyof

CalvaryHealthCareACTagainsttherecentlyintroducedEquipNationalcriteria,whichincludetheNationalQualityandHealthStandards.CalvaryHospitalisthefirstpublichealthfacilityintheACTtobereviewedandtoreceiveunqualifiedaccreditationagainstEquipNationalrequirements.

• Deliveringrecordlevelsofserviceinallclinicalareasandoutpatientoccasionsofservice.

• RedesigningCommunityPalliativeCareServicesprovidedfromClareHollandHouse.TheCommunitySpecialistPalliativeCarePathwayprovidespatientswithfasterandmoreequitableaccesstopalliativecareservices,withallpatientsbeingassessedandreviewedthroughatriageprocessandthenbeinginvolvedinchoosingtheirpreferredpalliativecaretreatmentprogram.

• IntroducingthePalcarepatientmanagementsystemtoenablegreaterinvolvementandimprovedcoordinationofprimarycareprovidersintheirpatients’palliativecaretreatment.

• EmbeddingtheCalvaryPatientAccessImprovementProgram,whichisconstructedaroundrobustprocessesandcooperationbetweenclinicalareas,toprovideimprovedpatientaccessandflowandtoachieveefficiencyinelectiveandemergencyadmissionsandsurgery.

• ContinuingtobuildthepartnershipsandprocessesassociatedwiththenetworkingofhealthandhospitalservicesintheTerritory.

• Increasingthenumberofpeoplewhoreceivedelectivesurgeryproceduresandreducedsurgerywaitingtimes.

• CompletingtherefurbishmentoftheCalvaryHospitalEmergencyDepartment,whichhascreatedadditionaltreatmentspacesandfacilitatedthestreamingofpatientsinto‘likelytobeadmitted’and‘seeandtreat’streams.

• ExpandingAboriginalandTorresStraitIslanderliaisonservicesthroughtheappointmentofasecondLiaisonOfficer;theseofficershavedirectcontactwithIndigenouspatientsandfamiliesandactivelyparticipateinAboriginalandTorresStraitIslandernetworksinandaroundtheACT.

• StrengtheninglinksbetweenClareHollandHouseandtheAboriginalandTorresStraitIslandercommunitiestoensureIndigenouspeoplehaveaccesstoculturallysensitiveandappropriatepalliativeandend-of-lifecare.

• ContinuingtheprogramofimplementingtechnologywhichissharedwithotherhealthandhospitalservicesintheTerritory.Notableachievementsinthisareainclude:theroll-outoftheACTPatientAdministrationSystem(ACTPAS),creatingasingleelectronicpatientrecordacrosstheTerritory;theexpansionoffreewi-fiinmanyareasofCalvaryforbusinessandpersonaluse;andtheintroductionoftheMetaVisionClinicalInformationSystemintheCalvaryCriticalCareUnit.

• ImprovingthelevelofgovernanceofclinicalandadministrativesystemsthroughthecontinuousreviewandrefinementoftheCalvaryHospitalCommitteeStructure.

• EstablishingtheAustralianCatholicUniversityClinicalSchoolontheBrucecampus,enrichingclinicalexperienceandpracticallearningopportunitiesforACUstudentsofnursing,midwiferyandalliedhealth.

• EnhancingtheGraduateProgramforNursing,MidwiferyandAlliedHealthstaff,andbuildingtheimportanceofthisprogramasacoreelementoftherecruitmentandretentionstrategiesdocumentedinthedraftCalvaryworkforceplan.

• AdvancingnegotiationswiththeTerritoryontheplanninganddevelopmentofexpandedservicesandnewfacilitiesontheCalvaryBrucecampus.

• RefiningtheCalvaryHealthCareACTStrategicPlanningFramework,comprisinga15-YearStrategicVision, a5-YearStrategicPlanandthe2013–14LocalServicesPlan.

• Expandingandformalisingpatientandconsumerparticipationinthedesign,development,reviewandrefinementofCalvary’sservices.TheroleofpatientsandconsumerswillbeformalisedinaConsumerandCarerParticipationStrategythatwillbecompletedinthethirdquarterof2013.

• ActivelycontributingtothebroaderpublichealthandhospitalnetworksandpartnershipsintheACT,withparticularattentiontotheLocalHospitalNetworkandtheACTMedicareLocal.

• CreatingtheCalvaryHealth@HomeUnit,comprisinganexpandedHospitalintheHomeprogramandaninnovativeCalvaryMedicalOutreachService.ApilotoftheOutreachServicewillcommenceinthefourthquarterof2013.


• Implementing,inpartnershipwithCarersACT,theCarersatCalvaryprogram,whichintroducestheassistanceandsupportavailabletocarersearlyinthepatientjourney,andfacilitatesthecreationofcarerservicesandsupportforthetimelyandsafedischargeofpatientstotheirpreferredresidentialarrangement.

• Expandingtheprocessforpatientfeedback,includingtheintroductionofbedsidepatientexperiencesurveysandfollow-upphonecallstopatientsdischargedaftertreatmentforserioushealthailments.

• CommencingthedesignofCalvaryHospital’sMidwife-LedModelofCare,includinganextensivepublicconsultationprocessaroundthemodelandservice.DesignworkhasalsobeenadvancedforthecreationofabirthcentreatCalvaryHospital.

• Initiatingthedevelopmentprocessforexpandedcar-parkingcapacityattheCalvaryBrucecampus.

• EnrichingtheCalvarycommunityandtheCalvarypatientexperiencethroughtheexpandedandinnovativeengagementanddeploymentoftheCalvaryVolunteersGroup.

• RefiningtheCalvaryRefugeeMentoringprogramandofferingparticipantsmoreindividualisedworkplacementstoassistwiththeirsettlement,assimilationandcontributiontotheirnewcommunity.

• ContinuingtocollaboratewiththeCalvaryCommunityAdvisoryCouncil.

• Improvingstaffengagement.Inthemostrecentstaffsatisfactionsurvey,63percentofrespondentssaidtheybelievedCalvarywas‘atrulygreatplacetowork’.

Issues and analysisTheclearandtransparentarrangementsthatnowexistbetweenCalvaryandtheTerritoryundertheCalvaryNetworkAgreementcontinuedtoprovideaplatformforopenandproductiveclinicalandadministrativerelationshipsthataddresscontemporarycircumstancesandallowforcollaborativefutureplanninganddevelopment.Thisisofparticularimportance,astheTerritoryiscommittedtotheexpansionofpublichealthandhospitalservicesinNorthCanberraincloseproximitytothemajorpopulationgrowthareasofGungahlinandMolonglo.

Calvary’slevelsofactivityinthereportingperiodcorrespondedwiththeprojectedhealthneedsofanageingandgrowingpopulation,inthecontextofimprovingservicesanddevelopingnewtreatments.Calvaryhasmadeconsistentprogressinthisarea.Improvedpatientflowprocessesenablebetterforecastingofservicelevels; 24-hourcoverageofemergencysurgicalservicesensuresearlierappropriatetreatmentforemergencypresentations;enhanceddischargeproceduresfeaturingmultidisciplinarycollaborationarereducingpatientlengthofstay;trackingofinpatientprogressoccursinallmedicalandsurgicalwards,withtheproductionofdailypatientstatusreports;andtheuseofclinicalpathwaysisbeingexpandedfromsurgicalpatientstoincludemanymoremedicalpatients.

Theprovisionofservicesinnon-acutesettingsisalsobeingexpandedatCalvary.Morepatientsarereceivingthelaterstagesoftheirtreatmentandfollow-upcareintheOutpatientClinicenvironment;theCalvaryHospitalintheHomeprogramhasbeenexpandedandatrialofdirectexternalreferralstotheserviceisunderway;andamedicaloutreachservicewillcommenceshortly.Inaddition,anewwardareahasbeencreatedspecificallyforpatientstransitioningfromacutecaretonursinghomeaccommodation.

TheCalvaryMedicalInpatientWardshavebeenreconfiguredtocreatestandardpatientnumbersandcommonstaffinglevels.Thisprocessensuresequitableaccommodationforpatientsacrossthevariouswardsandenhancespatientandstaffsafetybyreducingtheriskoftransmissionofinfectionsandotherillnessthroughimprovedpatientisolationoptions.

EngagementwithpatientsandconsumersatCalvaryisgrowingasaresultoftheirgreaterformalinvolvementandrepresentationonclinicalandnon-clinicalcommittees.Inaddition,consumersareengagedtocommentonandcontributetoanyinformationbeingproducedforpatientsandfamilies.

Developmentanddesignworkforexpandedcar-parkingcapacityatCalvaryHospital,whichisexpectedtoassistwithpeakdemand,hascommenced.


Future directionsCalvaryHealthCareACThasidentifiedanumberofareasoffocusfortheshort,mediumandlongterm.Theseinclude:

• increasingthecapabilityofourworkforceandgrowingtheengagementoftheworkforceinthedevelopmentanddeliveryofservices—aworkforceplanwillbepublishedtodescribethestrategiestoachievethis

• ensuringourconductandservicestronglyrepresentourvaluesofhospitality,healing,stewardshipandrespect

• strivingtobemoreconsistentintheprovisionofhigh-qualitycare,distinguishedbypatientengagement

• advancingourattentiontopatientsafetywithanevenstrongerfocusonareasofpreventableharm,includinginfectioncontrol,skinintegrityandpressureulcers,fallsprevention,medicationsafety,thehandlingofbloodproducts,nutrition,andpre-procedureconsentandpreparation

• enhancingourpatientandfamilyfeedbackprocessestoensureourpatients’experiencesassistustoimproveour service

• introducingnewservicesandserviceexpansion,asnegotiatedwiththeTerritoryanddescribedintheCalvaryPerformancePlan

• continuingtoexplorewayscarecanbeprovidedearlier,morerapidlyandinthemostappropriatesetting

• exploringwaysthattechnologycanimproveourservicesandworkingcollaborativelywiththeTerritoryintheuseofsharedtechnology

• continuingtheenhancementofbudgetaryandreportingprocessestounderpinourfinancialsustainability

• consideringtheenvironmentalimpactandwhole-of-lifecostsinourprocurementprocesses

• publishingandimplementingtheCalvaryHealthCareACTReconciliationActionPlan

• ensuringthatwesupportandassistthevulnerableandneedyinourcommunity,andensuringthattheyhaveaccesstoourservices.

OurfuturedirectionsaredocumentedintheCalvaryHealthCareACTLocalServicesPlanfor2013–14.


Output 1.2 Mental Health, Justice Health and Alcohol and Drug Services

Mental Health, Justice Health and Alcohol and Drug Services provide a range of services in hospitals, community health centres, adult and youth correctional facilities and people’s homes across the territory. They work with community partners to provide integrated and responsive care with a range of services, including hospital-based specialist services, supported accommodation services and community-based service responses.

The key strategic priorities for Mental Health, Justice Health and Alcohol and Drug Services are ensuring that clients’ needs are met in a timely fashion and that care is integrated across hospital, community and residential support services.

This means focusing on:

• ensuring timely access to emergency mental health care by reducing waiting times for urgent admissions to acute psychiatric units

• ensuring that public mental health services in the ACT provide consumers with appropriate assessment, treatment and care that result in improved mental health outcomes

• providing hospital and community-based alcohol and drug services and health care assessments for people detained in corrective facilities.

MentalHealth,JusticeHealthandAlcoholandDrugServicesprovidehealthservicesdirectlyandthroughpartnershipswithcommunityorganisations.Theservicesprovidedrangefrompreventionandtreatmenttorecoveryandmaintenanceandharmminimisation.Consumerandcarerparticipationisencouragedinallaspectsofserviceplanninganddelivery.Thedivisionworksinpartnershipwithconsumers,carersandarangeofgovernmentandnon-governmentserviceproviderstoensurethebestpossibleoutcomesforclients.

Thedivisiondeliversservicesatanumberoflocations,includinghospitalinpatientandoutpatientsettings,communityhealthcentres,detentioncentresandcommunitysettingssuchaspeople’shomes.Servicesareoutlinedbelow.

Mental Health Services• ACT-WideMentalHealthServices

• ChildandAdolescentMentalHealthServices

• AdultMentalHealthServices

Justice Health Services• Primary Health

• Forensic Mental Health


Alcohol and Drug Services• OpioidMaintenanceTreatmentServices

• WithdrawalServices

• CounsellingandTreatmentServices

• DiversionServices

• ConsultationandLiaisonServices

Achievements• MentalHealthServicescontinuetomonitorandreviewallepisodesofseclusionandrestraint.In2013theEarly

SupportandInterventionTeamwillbereintroducedintheAdultMentalHealthUnittoassistintheidentificationofconsumerswhoareescalatingandtoworkoneononetode-escalate.ThisinitiativewillbeintroducedinpartnershipwithWardServicestoreduceaggressionandconsumerdistress.Atrainingpackagethatfocusesonengagementandde-escalationhasbeendevelopedcollaborativelywithWardServices.

• TheMentalHealthCommunityPolicingInitiative(MHCPI)wasdevelopedafterareviewofACTPolicingmentalhealthpracticesandproceduresin2010.ApilotwascommencedinApril2011.Thisprojectwasfundedin2011–12andisnowanongoinginitiative.InMarch2013,thepresenceofCrisisTeamcliniciansinthePoliceOperationsCentrewasextendedfromfourdaysperweektosevendaysperweek.Thecliniciansareadedicatedresourceforthepolice.Theyhaveaccesstothementalheathelectronicclinicalrecord,MHAGIC,andcanprovideinformationrelevanttoindividuals.

• AtthecommencementoftheMHCPI,therewere,onaverage,90AFP-initiatedemergencyactionsplacedonconsumerspermonth.Thishasdroppedby50percent,withanaverageoverthepastyearof45permonth.AFP,ambulanceandMHCPIrepresentativesarenowprovidingmandatoryin-servicetrainingtomental healthteams.

• InApril2012,theAdultMentalHealthUnitwascommissioned.Thisisapurpose-builtfacilitywithaninnovativemodelofcarethathasconsumerengagementatitscentre.Thefacilityhasapurpose-builtHighDependencyUnit,LowDependencyUnitandatherapywing,whichincludesgrouptherapyrooms,agymandspiritualspace.In2013,additionalalliedhealthstaffwereemployedintheAdultMentalHealthUnitintheextendedtherapyprogram,andactivitiesbecameavailableafterhoursandontheweekends.

• ThePerinatalMentalHealthConsultationServiceprovidesspecialistconsultationandtreatmentplanningforpregnantandpostnatalwomen(upto12monthspostpartum).Sinceitsinception,servicedemandhasincreasedconsiderably.Theprogramcurrentlyhasapproximately80registeredclients.Thisyearsawtheimplementationofagroupprogramtosupportwomenwithhighlevelsofstressordistress.Thisgroupisco-facilitatedwithChildandFamilyCentrestaff(Gungahlin)andhasbeenbeneficialforparticipants.

• TheChildandAdolescentMentalHealthService(CAMHS)wasreviewedin2012todeveloparevisedmodel ofcareinconsiderationofthementalhealthneedsofchildren,adolescentsandyoungadultsuptotheage of25years.TheCAMHSRe-designProjectwasinformedbyconsultationwithstaffmembers,service providers,consumersandcarerstoensurethementalhealthneedsofthisclientgroupcouldbemetusingevidence-basedpracticesinthecontextofarecoveryframework.TheCAMHSModelofCarewasendorsed bytheACTHealthRe-developmentCommitteeinMay2013.Planningforaphasedimplementationprocesshascommenced.

• AttheHumeHealthCentre,JusticeHealthServiceshaveintroduced:

– aSuboxoneWithdrawalandMaintenanceRegime.ThisisthefirsttimethatbuprenorphinehasroutinelybeenusedtomanagewithdrawalandmaintenanceinanACTcorrectionalfacility

– HepatitisCtreatments,whichareachievedthroughasharedcaremodelwithareferralpathwaytotheGastroenterologyServiceoftheCanberraHospital.Upto10patientscontinuetobecaredforunderacomplextreatmentregime.


• IntheAlcoholandDrugServices(ADS)program:

– FollowingtwopilotprogramstoimplementinfluenzavaccinationforclientsoftheOpioidTreatmentService,theprogramwasrolledoutasayearlyservicein2013.

– TheAlcoholandDrugServicesoverallprogramandtheADSDiversionteamweretherecipientsofAboriginalandTorresStraitIslanderreconciliationawards,recognisingtheworkbeingdoneacrosstheprogramtoprovideaccessandservicedeliverytopeoplefromanAboriginaland/orTorresStraitIslanderbackground.

– TheADSwontheQualityinHealthCareoverallawardinNovember2012fortheiropportunisticopioidtreatmenttrainingprogramforcommunitypharmacists,generalpractitionersandotherhealthprofessionals.

– InJanuary2013,counsellingcommencedintheAlexanderMaconochieCentre.AdedicatedcounselloremployedbyADSisworkingwithAlexanderMaconochieCentreclientswhohavecomplexalcoholandotherdrug(AOD)issuestoprovidecontinuityofcounsellingcarewhentheyaredischarged.Aseniornursealsoattendsweeklytoworkwithclientswhoareonopioidmaintenancetreatmentandwhoareclosetobeingreleasedfromthecentrebackintothecommunity.

– AODpsychotherapyandcounsellingarenowprovidedattheTuggeranong,Gunghalin,Humeandcityhealthcentres.PsychotherapyandcounsellingwillcommenceattheenhancedBelconnenhealthcentrewhenitopenslaterin2013.

• Consumerandcarerparticipationhasremainedapriority,andanumberofconsumersandcarerconsultantshavebeenemployedinthedivision.TheserolessupportaculturalshiftinMentalHealthServices,particularlyinrecoveryandconsumerempowerment.Rolesincludesystemsadvocacyforconsumers,involvementinthereviewoftheMental Health (Treatment and Care) Act 1994,implementationoftherecoverymodel,developmentandimplementationofadvanceagreements,andstafftraining.Thedivisionalsomaintainsfullrepresentationofconsumersandcarersonallrelevantgovernancecommittees.

• Thementalhealthserviceshavebeenworkingtoimplementrecoveryprinciplesandpracticesforanumberofyears.ThisworkissupportedthroughtheactionsoftheACT Mental Health Services Plan 2009–2014andtheNational Standards for Mental Health Services 2010.TheACThasalsobeeninvolvedinconsultationsontheNationalMentalHealthRecoveryFramework,tobereleasedoverthenext12months,andthisframeworkwillhelptofurtherconsolidatearecoveryorientationofservices.Trainingandeducationareofferedsothatstaffandstakeholderscandevelopanunderstandingofrecoveryandhowservicescanassistthroughtheimplementationofpracticesandprocessesthatpromoteaperson-centred,strengths-focusedandcollaborativeapproachtotheplanninganddeliveryofthedivision’sservices.

• Thedivisionimplementedasmoke-freeenvironmentinresponsetoconcernsaboutpassivesmokingraisedbyconsumers,carersandstaff.On1January2013,allareasofthedivisionbecamesmokefree.Staffcompletedtrainingdesignedtoassistconsumerswhosmokebyprovidingeducation,supportandaccesstoarangeofnicotinereplacementtherapies.Thedivisionwonthe2013HealthPromotionAwardfortheSmoke-FreeInitiativeintheOutstandingAchievementtoAddressUnhealthyBehaviourscategory.

• MentalHealthtransitionalclinicianshavebeenemployedineachofthefourAdultCommunityMentalHealthTeams.Theprimaryfunctionofthesecliniciansistosupportthetransitionof,andcoordinatecarefor,peopleexitingeitherofthetwopublicACTpsychiatricinpatientunits(theAdultMentalHealthUnitorCalvaryPsychiatryWard2N)intothecommunitysetting.

• AreviewoffourAdultCommunityMentalHealthTeamcatchmentareaboundarieswascompletedinlate2012.TheboundariesbetweentheCityandWodencatchmentareaswererealignedandfivesuburbsweremovedintotheWodencatchmentarea.Thiswillresultinbenefitsofimprovedaccesstomentalhealthservices,includingreducedwaitingtimesforappointments,reallocationofclinicalstaffandreducedresponsetimetoreferrals.

• TheAboriginalLiaisonServicewasexpandedasaresultoftherecruitmentofaseniormentalhealthnursetoworkwithWinnungaNimmityjahAboriginalHealthService.Thenurseprovidesdirectmentalhealthinterventionsandclinicalmanagementforconsumerswithmentalhealthissuesinthatcommunitywhoareseekingtreatmentandcare.


Issues and challenges• ThereviewoftheMental Health (Treatment and Care) Act 1994continues.Thereviewaimstoensurethatthe

Actremainsconsistentwithcontemporarymentalhealthpolicyandservicedelivery.WorkinggroupsareaddressingseveralareasofdetailedcontentoftheAct.TherevisedActisscheduledforconsiderationbytheACTLegislativeAssemblyinlate2013.

• Thedivisionisfacingsomechallengesinfindingstafftofillclinicalvacancies.Strategiesincludetheimplementationofhealthprofessionalofficercareerpathwaystoensureongoingdevelopment,mentoringandsustainabilityforhealthprofessionalofficersinthissector.

Future directions• AstreamlinedinductionprocesswillbeestablishedattheBimberiYouthDetentionCentre,whichwillreduce

duplicationandengagespecialistserviceswhentheyareassessedasbeingclinicallyrequired.

• StrengthenedmedicationmanagementatBimberiYouthJusticeCentrehasbegun,withtherecruitmentofendorsedenrollednurseswhosupportathrough-caremodel.

• ForensicServiceswillprovidetrainingonmentalhealthawarenessandprocessestothemagistratesoftheACTlawcourts.Preparationandorganisationforthetraininghavecommenced.Itishopedthisinitiativewillbeexpandedtootheragencies,suchastheOfficeoftheDirectorofPublicProsecutionsandLegalAidservices.ForensicServiceshasalsocontinuedtoprovidementalhealthawarenessandeducationtrainingtoBimberiyouthworkersaspartoftheirtraininginductions.

• AlcoholandDrugServicesareintheprocessofsettingupapharmacist-ledNicotineReplacementClinicforclientsoftheOpioidTreatmentService.ApilotprogramwillcommenceinAugust2013withanevaluationthatwillinformfurtherdevelopmentofthisclinic.

• Fundingfortheenhancementofalcoholanddrugoutpatientservicesisintheplanningphase,whichincludesconsiderationofapublicopioidtreatmentclinicinthenorthofCanberra.

• TheadultMentalHealthServicesModelofCareprojectistoreviewanddevelopmentalhealthservicescurrentlyprovidedtoadults(18–64years)withintheACT.Thedevelopmentofthismodelofcarewillinformtheconceptdesignofhealthinfrastructure.Themodelofcarewillbebasedonevidence-basedpracticeandcomplywithallrelevantlegislations.

• TheimplementationoftheChildandAdolescentMentalHealthServices(CAMHS)ModelofCareiscurrentlybeingplannedfordeliveryduring2013–14.


Output 1.3 Public Health Services

Public Health Services provides high quality health and community services to the ACT and surrounding region. The key strategic priorities for Public Health Services include monitoring the health of the ACT population, promoting health, preventing disease, improving health equity, protecting the health of the public, and supporting workforce excellence (Population Health Division).

PublichealthservicesintheACTarelargelyprovidedthroughthePopulationHealthDivision.ThePopulationHealthDivisionisheadedbytheChiefHealthOfficerwhoisappointedunderthePublic Health Act 1997 andreportstotheDirector-GeneralofACTHealth.TheChiefHealthOfficerisalsorequiredtoreportbienniallyonthehealthoftheACTpopulationonspecifichealth-relatedtopics,whichisdonethroughtheChief Health Officer’s Report.

ThePopulationHealthDivisionhasprimaryresponsibilityforthemanagementofpopulationhealthissueswithinACTHealth.TheDivisionundertakesthecorefunctionsofprevention,assessment,policydevelopmentandassurance,andcontributestolocalandnationalpolicy,programdeliveryandprotocolsonpopulationhealthissues.Asof1July2012,thePopulationHealthDivisionhasimplementedanewstructure:

• TheHealthImprovementBranchisresponsibleforimprovingthehealthandwellbeingoftheACTpopulationthroughpromotinghealthybehavioursandlifestyles—andprovidingongoingmonitoringandevaluationofhealthprogramsandpolicy.TheBranchincludestheACTCancerRegistry,ACTCervicalCytologyScreeningProgramandtheACTHealthPromotionGrantsProgram.

• TheHealthProtectionServicemanagesrisksandimplementsstrategiesforthepreventionof,andtimelyresponseto,publichealthincidents.Thisisachievedthrougharangeofregulatoryandpolicyactivitiesrelatingtoareassuchasfoodsafety,communicablediseasecontrol,environmentalhealth,emergencymanagement,pharmaceuticalproducts,tobaccocontrol,andanalyticalservices.

• TheOfficeoftheChiefHealthOfficer(OCHO)isresponsibleforprovidingpublichealthadvice—bothinternallyandexternallytothedivision—aswellashigh-levelprojectandpolicyworkonbehalfoftheCHO.KeypolicypriorityareasfortheOCHOincludegenetechnology;climatechange;theWhole-of-GovernmentHealthyWeightInitiative;andtheWholeofGovernmentInitiativeonInjuryPrevention.

Achievements• ThePopulationHealthDivisionfulfilleditsstatutoryandnationalreportingrequirementsfor2012–13.These

includedthecollectionofdatafor,andmaintenanceof,theACTCancerRegistryandMaternalandPerinatalDataCollection.ThePopulationHealthDivisionfulfillednationalreportingrequirementsonpublichealthexpenditure,cancerincidenceandmortality,andmaternalandperinatalstatisticsfortheACT.

• On24August2012,theMinisterforHealth,KatyGallagher,tabledthe2012 Chief Health Officer’s Report.ThereportisalegislatedrequirementunderthePublicHealthActandprofilesthehealthoftheACTpopulation,includingmortality,morbidity,health-serviceuseandsocialfactorsinfluencinghealth.

• ThePopulationHealthDivisionhasaSurveyProgramthatsupportsthemonitoringofpopulationhealthtrendsacrosstheAustralianCapitalTerritory.Surveyresultsarepublishedinanumberofreportsandhealthseriespublicationswhichareutilisedtoinformhealthpolicyandprogramdevelopment.TheSurveyProgramincludes:

– theACTGeneralHealthSurvey,atelephonecomputer-assistedtechnologyhouseholdsurveywhichcollectsinformationacrossarangeoffactorsinfluencinghealthstatusintheACT.

– theACTSecondarySchoolAlcoholandDrugSurvey,aclassroom-basedquestionnaireconductedeverythreeyears,collectinginformationonriskbehavioursofACTsecondaryschoolstudentsincludingalcohol,tobaccoandillicitdruguse

– theACTYear6PhysicalActivityandNutritionSurvey,aclassroom-basedquestionnaireconductedeverythreeyearsonchildren’sweightstatus,physicalactivityandnutrition

• The report, The Health of Aboriginal and Torres Strait Islander People in the ACT 2006–2011waspublishedinJanuary2013.ThisreportprovidesademographicoverviewofAboriginalandTorresStraitIslanderpeoplelivingintheACTandexaminesfactorsinfluencingtheirhealthprofile.


• In2012–13,thePopulationHealthDivisioncontinuedtostrengthenitsqualitysystemsinpopulationhealthdatacollectionandreporting.ThisincludedworkingtowardthedevelopmentofsystemsfortheelectronictransmissionofmaternalandperinataldataintheACT,withonenotifierdevelopingthecapacitytotransmitdataelectronicallyduringthisreportingperiod.ThePopulationHealthDivisionhasalsocontinuedtobuildlocalcapacityindatalinkagebetweenkeypopulationhealthdatacollections.

• InlateJune2013,anewnotifiablediseasesdatabasewasimplementedafteralengthydevelopmentperiod.Thenewsystemwillenablemoreefficientrecordingandmanagementofnotifiablediseases,andwillprovideaccurate,consistentinformationthatcomplieswithnationalreportingrequirements.ThedatabasewasoneofthelastremainingrecommendationstobefinalisedfromtheevaluationoftheresponsetotheH1N1Influenza2009pandemic.

• Afoodsafetyguideforbusinesseswasfinalisedandtranslatedinto11languagestoensurefoodsafetyinformationwasavailabletonon-Englishspeakers.Thefoodsafetyguideprovidescomprehensiveinformationaboutthemostcommonfoodsafetyrequirements.

• Afoodstallguidelinefortemporaryfoodstallswasdevelopedandtranslatedinto12languages.ThefoodstallguidelineisdesignedtoassistorganisersoffoodstallsatoutdooreventsintheACTtomeetallnecessaryfoodsafetyrequirements.

• The Food (Nutritional Information) Amendment Act 2011commencedoperationon1 January 2013,requiringcertainfoodbusinessestodisplaythekilojoule(kJ)contentoftheirstandarditemsonmenusandpricetags.Thebusinesseswillalsoneedtodisplaythestatement‘Theaverageadultdailyenergyintakeis8,700kJ’inonelocationoneachmenuboardandfooddisplaystand.Kilojouledisplaysmayencourageconsumerstomakehealthierfoodchoicesandpromotedietaryawareness.Theymayalsoencouragefoodbusinessestoreformulatefoodsintohealthieroptions.

• TheFoodAmendmentBill2012introducedanewrequirementforfoodsafetysupervisors.From1September2013,allregisteredfoodbusinessesarerequiredtoappointafoodsafetysupervisorresponsibleforensuringthathygieneandfoodsafetystandardsareachievedandmaintainedinfoodbusinesses.Thefoodsafetysupervisormustcompleteprescribedtraining,whichwillremaincurrentforfiveyears.TheACT Healthwebsiteprovidesfullinformationaboutfoodsafetysupervisors,includingtrainingrequirements.

• InFebruary2013,ateamof12publichealthofficersconductedfoodinspectionsduringthethree-dayNationalMulticulturalFestivalasastrategytominimisepublichealthrisksfromseriousbreachesoftheFood Act 2001.Intotal,approximately300inspectionswereconductedoverthedurationoftheevent.Duringinspectionsoffoodstalls,PublicHealthOfficersroutinelylookforissues(breaches)thatwouldgiverisetounacceptablefoodsafetyrisksincludingtemperaturecontrol,poorhand-washingfacilitiesandinsufficientfoodstorage.Anumberoffoodsafetybreacheswereidentified,includingonefoodseizureand12voluntarydisposalsofdeterioratedfooditems.

– Priortotheevent,theEnvironmentalHealth(EH)teamundertookfourcommunityconsultationforums.Twowereattendedbyprospectivestallholdersandonewasforacommunityorganisationwhichrequestedanadditionalfoodsafetytalk.Thefinalforumwasaimedatfestivalvolunteers.

– ThePharmaceuticalServiceSection(PSS)attendedanumberofcommunityconsultationforumswhileestablishingthekavaexemptionforthefestival.Oncethekavaexemptionwasinplace,aspecificforumwasheldwiththecommunitiesdirectlyinvolvedwiththeculturaluseofkava,atwhichtheexemptionwasclearlyarticulatedandexplainedtostakeholders.

• TheHealthProtectionServicerespondedtotwomajoroutbreaksofgastrointestinalillnessamongdinerswhoreportedeatingattworestaurantsintheACTovertheweekendof11and12May2013.Thefirstoutbreakhad162casesofgastrointestinalillness,with78oftheseconfirmedasSalmonellainfections.Ofthosethathavebeentested,Salmonella typhimurium 170hasbeenidentifiedasthecausativeserotype.Morethan90casesofillnesswerereportedinthesecondoutbreak.Duringtheinvestigation,HealthProtectionServicestaffinterviewedmorethan400people(bothwellandunwell)frombothoutbreaks,conductedmultipleinspectionsoftheimplicatedrestaurants,andsampledandtested109fooditemsfromonerestaurant.Interviews,inspectionsandtestingoffoodsupportedtheclinicalandepidemiologicalfindings.TheresponseinvolvedsignificantcollaborationbetweenHealthProtectionService,theCanberraandCalvaryhospitals,andlocalandinterstatelaboratories,andincludedtheutilisationoftheHealthEmergencyCoordinationCentre.Thiscollaborationandhardworkbyall,bothintheoutbreakinvestigationandinmaintainingroutinebusinessoperations,contributedtothesuccessfulinvestigationandresolutionoftheoutbreak.

• TheHealthProtectionServiceconductedaLegionellaCoolingTowerssurvey,OrientalGrocersfoodsurvey,FreshSqueezedJuicesurveyandReadytoEatfoodsurveytodeterminethebacteriologicalstatusandcompliancewiththerelevantlegislationandcodesofpractice.


• TheChiefHealthOfficerworkedcloselywiththeACTMedicareLocal,andbothCanberraandCalvaryHospitalstocoordinateanddocument2013winterpreparednessactivities.Thesubsequent2013ACTHealthSectorWinterPlanwaslaunchedatamediareleaseon16April2013.The2013ACTHealthSectorWinterPlandocumentspreparednessactivitiesbyagencyincludingstockpilingofessentialmedicinesandequipment,streamlininginfectiousdiseasetesting,improvingsurveillancearrangementsanddevelopinghealthfacilityescalationplans.

• AreviewandmajorrevisionofthePublic Health Emergency Response Plan 2007 wasundertaken.TherevisedPlanwasendorsedinearly2013.

• In2011,theHealthEmergencyManagementSubCommitteeagreedtodevelopfourappendicestotheHealthEmergencyPlan.TheHealthEmergencyPlanAppendixI:ACTBurnPlanandAppendixII:HealthEvacPlanwereendorsedbytheHealthEmergencyManagementSubCommitteeoutofsessionon30July2012.ThedraftHealthEmergencyPlanAppendixIII:HealthCBRNPlanwasendorsedwithoutchangeattheHealthEmergencyManagementSubCommitteemeetingof18June2012.ThedraftHealthEmergencyPlanAppendixIV:PartA—SummerPlan,wasalsoendorsedatthesamemeetingwithminoramendment.Thefinaldraftappendix,AppendixIV:PartB—WinterPlan,remainsaworkinprogress.TheexpectedcompletiondateisFebruary2014,followingatrialoverthe2013winter.Oncecompleted,alloftheHealthEmergencyPlanappendiceswillbeprovidedtotheSecurityandEmergencyManagementSeniorOfficialsGroup,throughtheACTHealthExecutiveCouncilforinformation.

• ThePopulationHealthDivisionledaconsultationprocesswiththeACTPacificIslandcommunityin2012regardinganACTexemptionforculturalkavause.RecommendationsweresubsequentlyprovidedtotheMinisterforHealth.AnamendmenttotheMedicines,PoisonsandTherapeuticGoodsRegulation2008wasmadeon25January2013toenableuseofkavaforculturalpurposesatdeclaredpublicevents.On29January2013,theMinisterforHealthdeclaredtheNationalMulticulturalFestivalheldinCanberraeachyeartobeanexemptpublicevent.ThesechangesfolloweddetailedconsultationwiththeACTPacificIslandcommunity.Overalltheservingofkavaatthe2013NationalMulticulturalFestivalwasregardedtobeasuccess.OfficersoftheHealthProtectionServiceattendedtheeventtoobservestallholdercompliancewiththeexemption.

• The2011–12ACTHealthAnnualReportnotedthattheMinisterhadagreedtointroduceanewlicensingschemeforcommunitypharmaciesunderthePublic Health Act 1997.ThiswassuccessfullyimplementedbytheHealthProtectionServiceover2012–13.Thenewlicensingschemecameintoeffecton1March2013withallexistingACTpharmacieslicensedbytherequireddate.

Issues and challenges• ThePopulationHealthDivisionimplementedanewtestingmethodforrecreationalwaters.Sincethe

introductionoftheMicrobiological Guidelines for the ACT Recreational Watersin2010,theHealthProtectionServicehasbeenstrivingtoimprovesampleturnaroundtimesandtheresponsivenessoftheserviceonthePublicHealthstatusofthelocallakesandrivers.Thishasreducedtestingturnaroundtimesfrom48hoursto24hoursandprovidedthecapabilitytoresamplesitespromptlyandprovidethecommunitysuretyregardingthestatusofourlocallakes.

Future directions• TheHealthImprovementBranchisdevelopinganewwebplatformforreportingonnationalandlocal

indicators,aswellasotherpopulationhealthpriorities.

• ThePopulationHealthDivisionundertookaninternalreviewofoptionstochangetherequirementsforprescribingcontrolledmedicinesundertheMedicines, Poisons and Therapeutic Goods Act 2008.Thereviewfollowedanumberofcomplaintsfromthemedicalandpharmacistcommunitiesthatthecurrentsystemimposesexcessiveregulatoryburdenandisnotachievingitspublichealthobjectives.TheHealthProtectionService(HPS)willbeimplementinganewreal-timemonitoringsystemforcontrolledmedicinesin2013–14.ThiswillinvolvetransmissionofdatafromACTpharmacieselectronicallyinrealtimeforeverycontrolledmedicinethatisdispensed.ThenewsystemwillprovidetheHPSwithavastlyimprovedtoolformonitoringthesupplyofcontrolledmedicinesintheACT.Thisiswiththeviewtominimisetheriskofharmsassociatedwiththeirmisuse,abuseanddiversion.

• TheACTGovernmentannouncedon13June2013thatcommercialsolariumswillbebannedintheACTfrom31December2014.ThebanisexpectedtohelplowertheincidenceofskincancersintheACT,andisinlinewithsimilarbansinotherjurisdictionscommencingonthesamedate.


• ACTHealthcollaboratedwiththeUniversityofCanberraontheestablishmentofanaccreditedEnvironmentalHealthcourseintheACT.Theneedforthiscollaborationwasoutlinedinthe2011Auditor-General’sReport,whichidentifiedanecessityforACTHealthtopromotethedevelopmentofanaccreditedEnvironmentalHealthcourseatalocalUniversitytoaddresstheshortageofskilledEnvironmentalHealthOfficers.ThecollaborationwiththeUniversityofCanberraseekstopromoteenvironmentalhealthcareersandhelptoaddresstheEnvironmentalHealthOfficerworkforceshortage.ThecollaborationalsohopestofacilitatecommunicationbetweenNSWregionallocalgovernment,otherenforcementagencies,tertiaryinstitutionsandACTHealth.Itwillalsoensuretheprovisionofappropriateundergraduatetrainingandnetworkopportunitiesforstudentsembarkingonacareerinenvironmentalhealth.TheEnvironmentalHealthcourseisunderstoodtocommencein2014.

• ThePopulationHealthDivisionisexpandingtheambientairmonitoringnetworkbyestablishinganAmbientAirQualityNationalEnvironmentProtectionMeasurePerformanceMonitoringStationintheBelconnenregion.Thisstationwillassistwithassessinganddevelopingpoliciesaroundambientairquality.ItisexpectedtheestablishmentofthestationatFloreywillbecompletedbyDecember2013.

• ScopinganddevelopmentworkforawebsitefeaturingairqualitydatahasbeenundertakenbythePopulationHealthDivision.TheaimistoallowthepublicaccesstoambientairqualitydataintheCanberraregion,withtheviewtohavinganAirQualityIndextoprovideanoverallratingoftheambientairquality.

• TheHPScontinuesworkondevelopingfurtherenforcementstrategiesregardingfoodregulation.Thisincludesscopingworkonafoodhygienegradingschemeforfoodbusinesses,oftencalled‘ScoresonDoors’,pendingagreementfromtheACTGovernment.Thisworkwillinvolveconsultationwithrelevantstakeholders,includingrepresentativesfromfoodindustry,communityandpublichealthgroups.TheHPSwillcontinuetoconsultwithstakeholdersconcerningfoodregulationmatters.

• TheHPSisimplementingthefoodsafetysupervisortrainingrequirement,whichwillbecomemandatoryon 1September2013.TheHPSalsocontinuestostrengthenfoodsafetyinformationbaseforfoodbusinessesandthegeneralpublicbyreviewingcurrentanddevelopingnewinformation.


Output 1.4 Cancer Services

Capital Region Cancer Service provides a comprehensive range of screening, assessment, diagnostic, treatment, and palliative care services. Services are provided in inpatient, outpatient, and community settings.

The key strategic priorities for cancer care services are early detection and timely access to diagnostic and treatment services. These include ensuring that population screening rates for breast cancer meet targets, waiting times for access to essential services such as radiotherapy are consistent with agreed benchmarks, and increasing the proportion of women screened through the BreastScreen Australia program for the target population (aged 50 to 69 years) to 70 per cent over time.

TheCapitalRegionCancerService(CRCS)Divisionisresponsiblefortheprovisionofoncology,clinicalhaematology,radiationoncology,BreastScreenandimmunologyservicestotheACTandsurroundingregion.Servicesareofferedintheformofscreening,inpatientandoutpatientservicesandcommunity-basedpsycho-socialsupportservices.ThedivisionalsomanagesandcoordinatesclinicalOutpatientadministrativesupport,HealthCentreAdministration,CommunityHealthIntakeandTranscriptionServices.

TheclinicalservicesofCRCSintegrateexistingcancerservicesacrosstheACTandsurroundingregiontoensureacontinuumofcareforconsumers,rangingfrompreventionandscreeningthroughtodiagnosis,treatment,rehabilitationandpalliativecare.Servicesareprovidedonanarea-widebasisanddeliveredatanumberoflocations,includinghospitalandcommunitysettingsandthepatient’shome.

Achievements• TheRadiationOncologydepartmentcommencedoperationofafourthlinearacceleratorinJuly2012.

Additionalstaffrecruitedtosupportthisexpansionincludedaradiationoncologist,radiationtherapistsandnursingstaff.Thisresultedinanincreaseinservicesprovided.

• Demandforradiotherapytreatmentservicesincreasedby3.4percent,with1,330coursesoftreatmentprovidedin2012–13comparedto1,286coursesin2011–12.

• CRCSprovidedcarefor1,566newradiationoncologypatientsin2012–13.Thisisa2.7percentincreaseonthe1,525newpatientsinthesameperiodlastyear.CRCSprovidedcarefor649newpatientsfrominterstate;642ofthesepatientswerefromNSW,representing41.4percentofnewpatientsprovidedwithcare.

• Brachytherapytreatmentservicesprovideahighlyfocusedtreatmentoptiontoaspecificgroupofprostatecancerpatientsandcervicalcancerpatients.Indicationsarethatdemandforprostatecancertreatmentisincreasing.However,duetothesuccessofscreeningandimmunisationprogramsforcervicalcancer,therehasbeenasignificantdecreaseindemandforcervicalcancertreatment.

• Overthepast12months,RadiationOncologyhasdevelopedthestereotacticradiosurgery(SRS)capabilityofferedwiththenewlinearacceleratortotreatbraincancers.TheSRSservicewasreleasedforclinicaloperationinJune2013,withthefirstpatientscheduledfortreatmentinearlyJuly2013.

• Theimplementationofthe‘CHARM’cancerinformationmanagementsystemhasprovidedasinglesystemforscheduling,billingandorderingcomplexchemotherapyregimesforMedicalOncology,HaematologyandImmunology.MedicalOncology,HaematologyandImmunologyhaveimplementedelectronicsigningofchemotherapyordersandcommencedtheelectronicdocumentationofpatientnotes,withtheaimofeliminatingpaperrecords.

• TheHaematologydepartmentachievedanend-of-yearresult9percentovertargetforoutpatientservicesdespitecriticalhaematologistshortagesthroughouttheyear.Thiswasachievedthroughthesignificantcommitmentofthehaematologistsinensuringthatallurgent,category1andcategory2patientsreceivedappointmentswithintherecommendedtimeframes.

• CRCSprovidedrepresentationontheCancerCouncilAustraliaOncologyEducationCommitteeandtheTherapeuticGoodsAdministrationAdvisoryCommitteeonPrescriptionMedicine.

• TheMedicalOncologyOfficeManager,MarilynCooper,wastherecipientoftheACTGovernmentHealthDirectorateAustraliaDay2013AchievementMedallion.

• ThreenewhaematologistswererecruitedtoCRCSthisyear,providingmuchneededspecialistsupporttothedepartment.TwoofthespecialistshavecommencedandthethirdisduetostartinAugust2013.


• TheimplementationofaRadiationOncologyNurseLedClinicinJanuary2013hasimprovedaccessforpatientsfollowingradiationtreatment.Theclinicprovidesadvice,treatmentandmedicalreview,asneeded,forpatientswhohavecompletedacourseofradiationtreatment.

• Thefirstperipheralbloodstemcelltransplantwassuccessfullytrialledinanoutpatientsetting,achievingareductionoffourinpatientdaysfortheoverallcare.

• Participationinradiotherapyclinicaltrialshasincreasedwiththeappointmentofaclinicaltrialsdatamanager.Participationintechnicallybasedtrialssupportscredentialingofprocessesandindependentauditofdosimetrysystemsfortheimplementationofnewradiotherapytechniques.

• AllnineconsultantsinMedicalOncologyhaveachievedacademicappointmentswiththeAustralianNationalUniversityMedicalSchoolandparticipateinteachingandresearch.MedicalOncologypublishedfourpapersin2012–13andgave16conferencepresentations.

• RadiationOncologysuccessfullyappliedforanAlliedHealthResearchSupportgranttosupporttheestablishmentofthePalliativeRadiotherapyRapidAccessClinic(PRRAC).Thisclinicwillprovidestreamlinedcareforpalliativepatientsrequiringradiotherapytreatment.Thegrantfundingistosupportsalarycostsofaradiationtherapistengagedindevelopingthecommunicationaspectsoftheproject.

• CanberraHospitalOutpatientServicescommencedtheinitialphaseofplanningfortherefurbishmentofthewaitingareasforCentralOutpatients,Ear,NoseandThroatDepartment,FractureClinic,Sleep&RespiratoryDepartmentandDiabetes/Endocrinologydepartments.Therefurbishmentplanstoincreaseseatedwaitingareasbyatleast50percent,withspecificconsiderationgiventotheneedsofbariatricpatients,wheelchairaccess,children’splayareaandimprovedsignage.

• BreastscreenACTachievedaparticipationrateof56percentforwomeninthetargetagegroupof50to69.Thisisthehighestlevelachievedinthepastfiveyears.

• BreastScreenACTunderwentatwo-daydataauditaspartoftheBreastScreenAustraliaaccreditationprocess.Forthefirsttimeallcriteriaweremet.

• CRCSdevelopedandcommencedaclinicalauditprojecttointroducearegularprogramofclinicalauditacrossallareasofCRCS.InitialbaselinedatawasreceivedfortheareasofPatientIdentification,Schedule8medicationregister,handhygieneandfallsassessment.

• TheCareoftheDyingPatientCollaborativePathwaypilotwasimplementedonwards11A,14Band10A. Thepathwayreflectsashiftfromlife-prolongingtreatmenttopalliativecare.Thisenhancescomfortandacknowledgestheneedtoactivelymakedecisionsthatpromotesensitiveandappropriatecareforthepatientinthelastpredicteddaysoflife.ItalsotakesintoaccountthewishesofthepatientandfamilyundertheirRespectingPatientChoicesandadvancedcareplanneeds.Thepilothasproducedexcellentfeedbacktodate.

• GungahlinCommunityHealthCentreopenedinSeptember2012,offeringawiderangeofhealthservices.TuggeranongHealthCentrewastemporarilyrelocatedtoanalternativesiteatGreenwayWatersSuitesinJanuary2013,facilitatingthecommencementofworktorefurbishandextendtheexistingcentre.

• 4,111cost-weightedadmittedseparationswereprovidedbyCancerServicesin2012–13againstthetargetof4,142.Thisconstitudesa2percentincreaseonthoseprovidedin2011–12.

• 65,462non-admittedoccasionsofservicewereprovidedbyCancerServicesin2012–13againstthetargetof59,260.Thisisa14percentincreaseonthoseprovidedin2011–12andreflectsthehighdemandforservices.

• Againstatargetof100percent,99.9percentofwomenreceivedtheresultsoftheirnormalbreastscreenwithin28days.

• Againstatargetof90percent,94percentofwomenscreenedwhorequiredanassessmentwereassessedwithin28daysoftheirscreeningappointment.


Issues and challenges• ContinuedgrowthandincreaseddemandforallCRCSserviceshaschallengedthephysicalspaceandresources

acrossinpatientandoutpatientservices.ThemovetothenewCanberraRegionCancerCentrewillprovideincreasedoutpatientcapacity.Newmodelsofservicearebeingdevelopedtoreflectchangestotreatmentoptionsandwillbeimplementedinreadinessforthemovetothenewcentre.

• TheHaematologydepartmentexperiencedshortagesinthehaematologistworkforce,resultinginextremelyhighworkloadsandanincreaseinthenumberoflessurgentpatientswaitingtobeseen.WiththecommencementofnewspecialistsinMarchandAprilthewaittimeisbeingreduced.

• Breastscreencontinuestohavechallengesinrecruitingwomentothescreeningprogram.Activitiescontinuetopromotetheprogramtonewwomenandlapsedattendees.

Future directions• TheCanberraRegionCancerCentreisduetoopeninthesecondhalfof2013.Thenewfacilityandimproved

modelsofcarewillenhanceservicesforpatients.

• ThePalliativeRadiotherapyRapidAccessClinic(PRRAC)modelofcarewillbeestablished.Thisisapatient-centredapproachtocarewherebyappointmentsarecoordinatedaroundpatientsandtheirrequirementsandthewaitingtimefortreatmentisreduced.ARadiationTherapistAdvancedPractitionerroletosupporttheclinicisbeingdeveloped,andtheclinicisplannedtocommenceoperationinAugust2013.

• Therewillbefurtherdevelopmentofthestereotacticradiotherapyservicetoincludetreatmentofawiderrangeofcancers.

• BreastScreenACTisduetocompletetheNationalBreastScreenprogramaccreditationprocessinNovember2013.Thedataaudithasbeencompletedandthetwo-daysitevisitisscheduledforAugust2013.

• ThedevelopmentoftheCancerTriageandRapidAssessmentmodelofcareisnearingcompletion,withtheimplementationofapilotplannedforAugust2013.ThismodelofcareaimstoprovidetimelyaccesstoinformationandassessmentforpatientsreceivingoutpatienttreatmentthroughCRCSOncologyandHaematology.Itwillfocusonassessingconcernsearly,allowingtreatmentandsupportwithintheoutpatientsettingwiththeaimofreducinganddivertingpresentationstotheemergencydepartment.

• BelconnenCommunityHealthCentreisscheduledtoopenforbusinesson11November2013.Thisisthelargestofthenewcommunityhealthcentresanditwillprovideamuchwiderrangeofservicesthanwaspreviouslyavailableincommunityhealthcentres,andthesewillincluderenaldialysis.


Output 1.5 Rehabilitation, Aged and Community Care

The provision of an integrated, effective and timely response to rehabilitation, aged care and community care services in inpatient, outpatient, emergency department, sub-acute and community-based settings.

The key strategic priorities for Rehabilitation, Aged and Community Care are:

• ensuring that older persons in hospital wait the least possible time for access to comprehensive assessment by the Aged Care Assessment Team. This will assist in their safe return home with appropriate support, or access to appropriately supported residential accommodation

• improving discharge planning to minimise the likelihood of re-admission or inadequate support for independent living, following completion of hospital care

• ensuring that access, consistent with clinical need, is timely for community-based nursing and allied health services and that community-based services are in place to better provide for the acute and post-acute health care needs of the community.

TheRehabilitation,AgedandCommunityCare(RACC)divisionintegratespublichealthsystemrehabilitation,agedandcommunityandprimarycareservicesacrosstheACT.Thedivisionaimstoimprovethequalityandaccessibilityofservicestoclients.RACCpromotesacontinuumofcarecoveringtherangeofprevention,assessment,diagnosis,treatment,support,rehabilitationandmaintenance.

RACCadoptsanarea-wideapproachtoclient-centredcare.Tothisend,RACCworkscloselywithotherstoimprovethecommunicationbetweenprimary,acute,sub-acuteandcommunityhealthcareserviceswhilefosteringprofessionaldevelopmentandpromotingbestpracticeinrehabilitation,agedandcommunitycare.

RACCservicesaredeliveredatabroadrangeofsitesthroughouttheACT,includinghospitals,communityhealthcentresandthehomesofclients.Thisincludeshealthcareandsupportforpeoplewithacute,post-acute,long-termandterminalillnesses.

Theprovisionoftheseservicesincludes:

• hospital-basedadmittedandoutpatientgeriatricandrehabilitationmedicineservices,includingortho-geriatrics,atboththeCanberraHospitalandCalvaryPublicHospital

• geriatricmedicineandrehabilitationmedicineoutpatientservicestoregionalNewSouthWales

• theRapidAssessmentoftheDeterioratingandAt-RiskAged(RADAR)Service,providingservicetoolderpeopleintheirownhomes,includingtoresidentsofagedcarefacilitiesuponreferralfromageneralpractitioner

• agedcareclientassessmentservices

• residentialagedcareliaison

• communitynursingandalliedhealthservices,suchaspodiatry,socialwork,nutritionandweightmanagement,physiotherapy,continenceservices,occupationaltherapyandself-managementofchronicconditionstrainingcourses

• theTransitionalTherapyandCareProgram(TTCP),providingalliedhealthservicestosupportclientsinthepost-hospitaldischargeperiod,eitherinaresidentialsettingorintheirownhomes.RACCprovidesthisserviceinpartnershipwithBaptistCommunityServices

• fallsinjurypreventionservices,includingfallsassessmentclinics,theSteppingOnprogramandrelatedhealthpromotionactivities

• transitionalrehabilitationattheRehabilitationIndependentLivingUnit(RILU)

• community-basedmulti-disciplinaryrehabilitationservices

• servicesprovidedbyexercisephysiologists,includingprogramsforrehabilitation,cardiacrehabilitation andhydrotherapy

• vocationalassessmentandrehabilitationservices

• driverassessmentandrehabilitationservices

• geriatricoutpatientspeechpathologyandneuropsychologyservices

• amulti-disciplinarymemoryassessmentservice


• ACT Equipment Scheme

• EquipmentLoanService

• DomiciliaryOxygenandRespiratorySupportScheme

• ACTContinenceSupportService

• ClinicalTechnologyServices

• aspecialisedwheelchairandpostureseatingservice

• prostheticsandorthoticsservices

• informationandadviceonassistivetechnologiesbytheIndependentLivingCentre(ILC).

AchievementsRACCmadeimprovementstoarangeoffacilities,systemsandprocesseswiththeaimofimprovingserviceprovisions,includingthefollowing:

• RACCProstheticsandOrthoticsimplementedatriageclinictobettermanageclientneedandwaittimes.Thissawthenon-urgentwaittimefallfrom20weeksinJune2012to13weeksinJune2013.

• TheDomiciliaryOxygenandRespiratorySupportSchemeimprovedcontractarrangementsandmanagementofclients.ThisincludedannualreviewofalloxygenclientsforthefirsttimeintheACTandtheongoingannualreviewofallrespiratoryclients.

• Followingamulti-disciplinaryreviewofhowtheSpinalCordInjuryReviewClinicwasconducted,formatchangeshaveallowedforanincreaseinthenumberofclientsabletoattend.

• PainmanagementsupportwasintroducedintheRehabilitationIndependentLivingUnit(RILU)forclientsattendingthegymfortherapysessions.Thishaspromotedgoodpainmanagement,allowingtheclientstoachievetheirgoalswithminimaldisruptiontotheirprograms.

• Implementationofmulti-disciplinarytriagemeetingsdailyhasresultedinmoretimelyprocessingandmanagementofreferralstotheRapidAssessmentoftheDeterioratingandAt-RiskAged(RADAR)service.ClientsreferredtoRADARcontinuetobeassessedwithinthetargetofoneworkingday.

• TheExercisePhysiologyDepartmentimplementedanumberofserviceimprovements,includingtherolloutandcompletionoftheBeatItPhysicalActivityandLifestyleProgramtoHealthDirectoratestaff,andtherevisionanddevelopmentofstandardisedtestingprotocolsforexercisetests.

• RACCstrengthenedexistinginitiativesandintroducedinnovationswiththeaimoffurtherreducingfallsinbothcommunityandhospitalsettings.

RACCintroducedthefollowingnewservicesin2012–13:

• Physiotherapy,nutrition,podiatryservicesandanursingambulatorycareclinicarenowprovidedatthenewGungahlinCommunityHealthCentre,whichopenedinthesecondhalfof2012.

• AdditionalworkshopspaceattheVillageCreekCentrewasrefurbishedandequippedfortheimplementationofacustommedical-gradefootwearservicewithintheClinicalTechnologyService.

RACCimprovedthecoordinationofgeriatricandrehabilitationservicesacrosscommunity,outpatient,EmergencyDepartmentandinpatientsettings:

• Thisyearsawthesuccessfultransitionanddischargeofthefirstventilator-dependenttetraplegicclientfrominpatientrehabilitationservicestothecommunity.Thiswasachievedthroughcomprehensiveclinicalmanagement,collaboration,andconsultationacrossvarioushealthareasandACTGovernmentdepartments.

• RACCNursingundertookaprojectaimedatenhancingtheexperienceofelderlyclientsintheEmergencyDepartment(ED).Theprojecttargetedclientseitherpresentingfromresidentialagedcarefacilitiesorwhowereover85years.Thefocuswasonimprovedassessment,diagnosisandtreatmentofdelirium.ThisprojectwasundertakencollaborativelywiththeED.Asaresultoftheproject,theaverageresponsetimebytheDepartmentofGeriatricMedicinetotheEDshowedanimprovementofalmost30minutes.EDstaffalsoreporttheyarenowbetterinformedaboutdeliriumanddementia.

• Avalidatedscreeningtoolformalnutritionintheelderlypopulationon11A,theAcuteCareoftheElderlywardattheCanberraHospital,wasintroduced.Thescreenhasresultedinmoreefficientreferraltoadieticianandtimelyfollow-up.


• AsuccessfulpartnershipwithGoodwinAgedCareServicesresultedinanadditionaleightbedsforCanberraHospitalclientsapprovedandwaitingforpermanentresidentialagedcareplacement.Thisreleasedeightacutebedstoassistwithaccess.

RACCundertookconsiderablelearninganddevelopmentactivities,includingthefollowing:

• Sustainingahighlevelofstudentplacementopportunitiesacrosstheservice,includingopportunitiesforstudentsfromtheUniversityofCanberra,inanumberofalliedhealthprofessions(suchasoccupationaltherapy,clinicalpsychology,podiatry,physiotherapy,nutrition,prostheticsandspeechpathology).

• Anursing-specificcoreeducationcourseonneurologicalrehabilitationwasdevelopedanddelivered.This12-modulecourseisconductedinacyclicalmanneronafortnightlybasis.Thisformatisdesignedtocaptureallnursingstaffovertime,withoutbeingdependentontheirparticularscheduledshifts.

• TheDepartmentofGeriatricMedicinehasreceivedaBestClinicalUnitforTeachingnominationfromtheANUMedicalSchoolforthepastthreeyears.

• Throughtrainingandmentoring,acareeringeriatricmedicinewaspromotedtojuniormedicalofficersandmedicalstudents.

In2012–13,RACCundertookanumberofworkforceinitiatives,includingthefollowing:

• ThesuccessfulimplementationofaPodiatryAssistantroleintheCommunityCarePodiatryServicein2011–12ledtotheestablishmentofasecondtraineeposition,commencinginApril2013.

• RecruitmentwasundertakentoaTransitionalTherapyandCareProgram(TTCP)AccessOfficerpositionattheCanberraHospital.Thepurposeofthepositionistoimproveaccessto,andoccupancyof,theTTCPandtoimprovethetransitionfromhospitalforclients.ThepositionhasbeenoperatingsinceMarch2013andearlyindicationsarethattherehavebeenimprovementsinTTCPaccess.

RACCservices,teamsandstaffmemberswerenominatedfororwonthefollowingin2012–13:

• TheACTEquipmentScheme(ACTES)EquipmentMobileRepairsandMaintenanceServicewasevaluatedandfoundtoprovideahigh-qualityservice,winninganACTQualityinHealthcareAwardintheInnovativeModelsofCarecategory.

• CommunityRehabilitationoccupationaltherapystaffwerefinalistsattheACTHealthQualityinHealthcareAwardsforGettingonwithIt—SingleHanded,agroupdesignedtolookatengagementinfunctionalactivitiesandcareoflow-functionupperlimbs.

• InJanuary2013,theRehabilitationNursePractitionerwasawardedanACTHealthAustraliaDay achievementmedallion.

• InMay2013,theRehabilitationNursePractitionerwasawardedtheinauguralNursePractitioneroftheYearawardattheACTNursingandMidwiferyExcellenceAwards.

• TheEquipmentLoanServicewasawardedanACTHealthAustraliaDayTeamachievementmedallionforitscontributiontoclientsinthecommunity.

• AttheHealthPromotionAwardsinJune2013,theCommunityCareProgramwasawardedtheACTMedicareLocalAwardforOutstandingAchievementinaPrimaryHealthCareSettingforitsHealthyCommunitiesOutreachHealthProgram.

• RACCstaffwerealsonomineesandrecipientsofawardsatthe2012–13AlliedHealthAwardsforExcellence,nominatedforAlliedHealthClinicalExcellence,AlliedHealthManagementandLeadershipExcellence,andwinningtheAwardforAlliedHealthAssistantExcellence.

RACCpublishedandpresentedkeyworkin2012–13:

• TheDepartmentofGeriatricMedicinepublishedandpresentedextensiveworkon:

– cardiovascularandneurologicaldiseasesinolderpatientswithosteoporotichipfracture

– interactionsbetweenserumadipokinesandosteocalcininolderpatientswithhipfracture

– hypertensionandhaemodynamicinstabilityandfallsintheelderly

– hipfractureinstrokesurvivors

– theimpactofmalnutritiononco-morbidities,bonemetabolismandoutcomesinolderadultswithhipfracture.

• OtherRACCpresentationsatconferencesin2012–13included:

– ‘TransitionfromCliniciantoSupervisor—HowDoWeDeveloptheHealthProfessionalSupervisorsoftheFuture?’


– ‘HowDoWeKnowStudentsHavePositiveClinicalExperiencesinourHealthService?’

– ‘MakingSelf-ReflectionaRealityinWorkplaceIntegratedLearning(WIL):PracticalStrategiesforSupervisors’

– ‘AdultHealthyWeightService’

– ‘SocialInclusionthroughaHealthCoachingApproachtoPromotingHealthyLifestylesinaDisadvantagedCommunity’—developedincollaborationwiththePopulationHealthDivisionaspartofajointAustralianandTerritoryGovernmentinitiativeundertheNationalPartnershipAgreementonPreventativeHealth

– ‘HWAAgedCareWorkforceReform—IntroductionofaDischargeSupportAlliedHealthAssistantRoleintheAgedCareSetting’

– ‘MSandDriving:AConsiderationforAllHealthProfessionals’

– ‘DiabExercise:ImprovingExercisePhysiologyServicesfortheManagementofType2’.

Issues and challenges• TheupgradeoftheAgedCareAssessmentTeam(ACAT)nationalsoftwaredatabasetoreflectchangesto

Commonwealthlegislationrequiredasignificanttimecommitment,onthepartoftheACATteam,tounderstandthechangesandimplicationsfortheserviceinreadinessforimplementationbyAugust2013.

• IncreasingdemandforACATassessmentremainsachallengetomeetingthekeyperformanceindicatorforpriority3referrals.Strategiestoimprovethisoverthenextsixmonthsincludethereviewofintakeprocessesandrecruitmentofcasualandtemporarystafftomeetdemandatpeaktimes.

• SomespecialistNewSouthWalesservicesarenolongerprovidingorthoticsservicestoACTclients,placingadditionalpressureonRACCProstheticsandOrthotics.

• Thelackofresidentialagedcarefacilitybedsinthecommunityiscontinuingtoimpactontheaveragelengthofstayandseparationsinagedcare.At30June2013,therewere46publichospitalinpatientsawaitingresidentialagedcarefacilityplacement.

• SignificantworkcontinueswiththeprospectivedecantofsomeservicesbasedontheCanberraHospitalcampusaspartoftheHealthInfrastructureProject.Thechallengesincludeprovidingexistingservicestemporarilyinarefurbishedareaandmeetingexpectedincreaseddemandsoverthenextfewyears,whiletheUniversityofCanberraPublicHospitalisbuilt.

• Geriatricstaffingremainsachallenge.Althoughthreenewconsultantstaffhavebeenrecruitedsinceearly2011,therewasaresignationinJune2013andthereisaretirementpendinginSeptember2013.Advertisingforrecruitmenttovacantpositionsandtemporarybackfilltocovermaternityleaveareimminent.In2012–13,therewerethreeAdvancedTraineesinGeriatricMedicine.

Future directions• Modelofcareprojectsarebeingfinalisedtosupporttheexpansionofcommunity-basedservicesincommunity

healthcentres.Thisincludestheprovisionofservices,equipmentandfacilitiestoenhancetheoverallexperienceofclientsandstaff.Akeyfocusistodeliverhealthservicesthatarebuiltaroundtheclient,addressingneedsatthelocallevel.Consumersandstaffarecentraltothedesignofallnewservicesandfacilities.

• Newnurse-ledwalk-incentres(WiC)willbelocatedattheBelconnenandTuggeranongCommunityHealthCentreopeningin2014.ThemodelofcareforthenewWiCswillbesimilartothatoftheCanberraHospitalWiC,whichisavailablefortheone-offtreatmentofminorillnessandinjury.Noappointmentisnecessaryandtheserviceisprovidedfreetoclients.

• AccesstoRACCnursingandalliedhealthcommunity-basedservicesinCanberra’snorthwillbeimprovedasclinicsatthenewBelconnenCommunityHealthCentreopeninlate2013.

• WorkcontinueswithusergroupsinpreparationforthebuildingoftheUniversityofCanberraPublicHospital,astand-alonesubacutefacilityonthenorthsideofCanberra.Thisexcitingprojectwillfeatureacentreofexcellenceforsubacutecare,includinginpatientandambulatorymodelsofcareforrehabilitation.

• ThereareplanstoreviewtheinputofCommunityGeriatricstohavegreaterinputintotheassessmentandfollow-upofelderlyclientspresentingtoED,especiallywithfalls,toexpeditetheirsafedischargefromEDandminimisethelikelihoodofre-presentation.

• IncollaborationwithotherACTGovernmentdirectorates,includingtheCommunityServicesDirectorate, RACCwillparticipateintherolloutofDisabilityCareAustraliaintheACT.


Output 1.6 Early intervention and prevention

Increasing the focus on initiatives that provide early intervention to, or prevent, healthcare conditions that result in major acute or chronic health care burdens on the community.

The key strategic priorities for intervention and prevention are reducing the level of youth smoking in the ACT and maintaining immunisation rates for children above 90 per cent.

ACTHealthundertakesseveralactivitiesaimedatincreasingthefocusoninitiativesthatprovideearlyinterventionto,orprevent,healthconditionsthatmayresultinmajoracuteorchronichealthcareburdensonthecommunity.

EarlyinterventionismanagedinmanywaysincludingtheHealthDirectoratescreeningprogramssuchasBreastScreen,cervicalscreening,andnewbornhearingscreening,aswellasthroughimmunisationprograms.

TheHealthDirectoratesupportsacomprehensiverangeofprogramsaimedatprimarypreventiontoreducetheonset,causesandcomplicationsofchronicdiseases.

ACTHealthprimarypreventionprogramsareaimedatbetterunderstanding,quantifyingandpreventingchronicdiseaseacrossthewiderACTpopulation.

Achievements• TheACTmaintaineditspositionasthejurisdictionwiththehighestlifeexpectancyinAustralia.Projections

suggestthatlifeexpectancyintheACTwillcontinuetoincreaseovercomingyears.By2015,lifeexpectancyatbirthintheACTisprojectedtobe83.1yearsformales(up2.4yearsfrom2007)and86.5forfemales(up2.5yearsfrom2007).Cancer,mentaldisordersandcardiovasculardiseasearetheleadingcontributorstothetotalburdenofdiseaseintheACT,contributingnearlyhalfofthetotaldiseaseburden.

• ACTHealthwillreceive$8.75millioninfacilitationpaymentsthroughtheNationalPartnershipAgreementonPreventiveHealth(NPAPH)fromJuly2010toJune2018.Thepartnershiphasbeenextendedwithintheexistingfundingenvelope,toaddafurtherthreeyears,fromJune2015untilJune2018.TheNPAPHisaimedatstimulatingactioninpreventingchronicdisease.TheNPAPHfundsthedeliveryoffivedifferentinitiatives:SocialMarketing;HealthyChildren;HealthyWorkers;HealthyCommunities;andEnablingInfrastructure.

• SocialMarketing:InDecember2012,anACT-developedcampaign,‘BeyondToday...it’suptoyou’waslaunchedtoencouragehealthylifestylesandsmokingcessationamongtheAboriginalandTorresStraitIslandercommunity.

• SocialMarketing:InMarch2013,informationwassenttoapproximately25,000ACTresidentsaged45-49yearstoadvisethemoffreehealthchecksandtheGetHealthyService.MedicareAustraliawebsitedatashowsthatthenumberofpeopleclaimingthehealthcheckMedicareBenefitsScheduleitems701,703,705,707intheACTinMarch–April2013haddoubledcomparedtothesameperiodinthepreviousyear.Twoweeksfollowingthemailout,GetHealthyACTdatashowedthattheaveragenumberofparticipantsjoiningtheservicehadalmosttripled.

• HealthyChildren:ACTHealthisreceiving$4.09millionoversevenyearsfromJuly2011,todeliverprogramsaimedatreducingtheratesofoverweightandobesityinchildrenaged0–18years.Theseinclude:

– Healthy food at school:aninitiativetotransformthehealthyfoodanddrinkcultureinACTschools,inaround75schoolsoverthenextfiveyears.Theprogramtargetschildrenfrompre-schooltoYear6.

– It’s your move:aresearchinterventionwithDeakinUniversity,targetinghighschoolstoincreasephysicalactivityandhealthyeatingandaimingtoreduceunhealthyweightgaininyoungpeopleaged12–16years.

– Ride or walk to school:aninitiativetoencourageridingandwalkingtoschoolinaminimumof60schoolsoverthenextfiveyears.

• HealthyWorkers:ACTHealthisreceiving$3.66millionoversevenyearsforthedeliveryofprogramsthatpromoteandsupporthealthylifestylesinandthroughACTworkplaces.TheHealthyWorkersprogramhasachievedthefollowingin2012–13:

– Healthier Work: TheACTHealthierWorkServicewaslaunchedinMay2012andhasconductedsitevisitstoover100ACTworkplaces.Aworkplaceincentivesgrantsprogramwasconductedin2013with27workplacessupportedtoinitiateorconsolidatestaffhealthandwellbeingprograms.


– Public sector health promotion:InpartnershipwiththeChiefMinisterandTreasury, ACT Health supportedthedevelopmentofanACTwhole-of-governmentWorkplaceHealthandWellbeingPolicy whichwasendorsedinMay2012.ItalsoimplementedacomprehensivestaffhealthandwellbeingprogramwithinACTHealthknownas‘myhealth’andfacilitatedastaffsurveyandpublicconsultation onthedevelopmentofahealthyfoodanddrinkchoicespolicyforstaff,volunteersandvisitorsto ACTHealthfacilities.

• HealthyCommunitiesInitiative(HCI):ThisinitiativereceivesfundingundertheNPAPHandaimstoreducetheprevalenceofoverweightandobesityamongadultsnotinpaidemploymentintheInnerNorthofCanberra.Achievementsin2012–13included:

– increasedcoverageofprogramssuchasHeartFoundationWalkingandHeartmoves,toincreasephysicalactivityandimprovednutritionalintake

– increasednutritioneducationbyCommunityHealthDietitians,introductionofoutreachclinicsdeliveredbyContinuingCarenursingandalliedhealthstaff,andimprovedfoodandnutritionintakethroughtheRedCrossFoodcentsprogram

– increaseinnumbersofpeopleparticipatinginactiverecreation.

• Followingasuccessfulpublicconsultationprogram,theChiefMinisterannouncedarefocusedHealthPromotionGrantsprogram.Anew‘HealthyCanberraGrants’roundwillfocusontacklingobesityacrossthepopulation,andonimprovingchildren’shealth,includingimprovingeatinghabitsthroughschoolcanteensandfoodeducation.Anew‘HealthPromotionInnovationFund’willbealsobeintroduced.Thisfundwilloffersmallervaluegrantfundingopportunitiesseveraltimesperyear.

• TheACTHealthFoodandNutritionStrategicFramework2012–18wasreleasedinSeptember2012.ThisframeworkhighlightshealthyeatingandoptimalnutritionasprioritiesfortheHealthDirectorateandcreatesgreaterrecognitionoftheimportanceofnutritioninoptimisinghealthoutcomes.

• Toeffectivelytacklerisingratesofoverweightandobesity,broadactionisrequiredbeyondthetraditionalhealthsectortomakehealthychoiceseasierinourneighbourhoods,workplacesandschools.Underthe WholeofGovernmentHealthyWeightInitiative,allDirectoratesoftheACTGovernmentareworkingtogethertodevelopandimplementactionstoincreasephysicalactivityandimprovenutritionacrosstheACTpopulation.ThedevelopmentoftheACT’sfirstwholeofgovernmentactionplanonobesitypreventionisunderway.TheWholeofGovernmentHealthyWeightInitiativewasallocated$0.3millionunderthe 2012–13ACTbudgetoverthreeyears.

• TheACTcontinuedtoachievehighchildhoodimmunisationcoverageinthegeneralpopulation.Coverageratesforchildreninallthreecohortswereconsistentlyabovethenationalaverage.In2012–13,ACTchildhoodimmunisationcoverageratesremainedabovethenationaltargetof90percentfor12-month-oldchildren.ACTHealth’stargetof92percentof1-year-oldchildrenbeingfullyimmunisedwasexceededinallquarters(93.1percent,93percent,92.5percentand92.6percent).

• InJuly2009theNationalPartnershipAgreementonEssentialVaccineswasimplemented.TheobjectiveofthisAgreementistoimprovethehealthandwellbeingofAustraliansthroughthecost-effectivedeliveryoftheNationalImmunisationProgram.TheAgreementsetsoutperformancebenchmarksthatmustbeachievedfortheACTtobeeligibleforanincentivepayment.TheperformancebenchmarksassociatedwiththeessentialvaccinesAgreementare:

1. maintainingorincreasingvaccinecoverageforIndigenousAustralians

2. maintainingorincreasingcoverageinagreedareasoflowimmunisationcoverage

3. maintainingordecreasingwastageandleakage

4. maintainingorincreasingvaccinationcoveragefor4-yearolds.

• TheACTcannotbeassessedagainstbenchmark2(maintainingorincreasingcoverageinagreedareasoflowimmunisationcoverage),astheACTdoesnothaveanyidentifiedareasoflowimmunisationcoverage.

• In2012–13theACTachievedtwoofthethreeassessablebenchmarks—maintainingordecreasingwastageandleakage(benchmark3)andmaintainingorincreasingvaccinationcoveragefor4-yearolds(benchmark4).


• TheACTdidnotmeettheperformancebenchmark1,maintainingorincreasingvaccinecoverageforIndigenousAustralians.TheACTonlyimprovedontheimmunisationratesforAboriginalandTorresStraitIslanderchildreninthe4-yearcohort.TherewasadropinimmunisationcoverageforAboriginalandTorresStraitIslanderchildrenat12–15monthsand24–27months.AsthereareverylownumbersofAboriginalandTorresStraitIslanderchildrenineachcohortthecoveragedatacanfluctuatewidely.Fortheperiod1April2011to31March2012themeanimmunisationcoverageforAboriginalandTorresStraitIslanderchildrenintheACTwas:

– 12–15months—81.5percent

– 24–27months—91.6percent

– 60–63months—91.0percent.

• Fortheperiod1April2010to31March2011,themeanimmunisationcoveragefor4-yearoldchildrenintheACTincreasedby0.9percentfromthepreviousyearandwas92.3percent.

• TheACTImmunisationStrategy2012–2016,waslaunchedon17December2012.Itaimstoexpandthefocusofimmunisationtowholeoflifeandtoreducehospitaladmissionsforvaccinepreventablediseases,particularlyinhigh-riskgroups.TheprimaryobjectivesoftheStrategyareto:

– ensuretheongoingappropriateness,quality,safetyandeffectivenessoftheACTimmunisationprogram

– maintainorimproveourcurrentimmunisationcoverage

– maintainordecreaseourcurrentlevelsofvaccine-preventablediseasesintheCanberracommunity,therebydecreasingthepressuresonprimaryhealthcaresuchasGPs,walkincentresandtertiaryhealthfacilitiessuchashospitals,especiallyemergencydepartments

– supportandmaintainthecurrenthighqualityimmunisationworkforcewitheducationandresources.

• Aspregnantwomenareathigherriskofseverediseasefrominfluenza,thevaccineisrecommendedandfundedforallpregnantwomen.Therehashistoricallybeenalowuptakeoftheinfluenzavaccinewithpregnantwomen.ToincreasetheinfluenzavaccinationratesHealthProtectionServiceliaisedwiththematernityunitsofTCH,CalvaryandJohnJames.Influenzapromotiontoparentsandeducationtostaffwasprovided.ThevaccineisnowofferedtoallwomenwhoareadmittedtotheantenatalunitsoroutpatientsoftheantenatalclinicsatTCH.PostershavealsobeenprovidedtoGeneralPractitioners,obstetricians,childcarecentresandlibraries.

• TheHumanPapillomavirus(HPV)vaccinationprogramforboyscommencedin2013andisofferedto12–13yearoldboys(Year7)viaaschoolprogramwithatwo-yearcatch-upcomponentforboysinYear9.UndertheNationalImmunisationProgram(NIP)boysinYear7areeligibletoreceivethefundedvaccine.Aspartofacatch-upprogram,boysinYear9in2013and2014arealsobeingofferedthevaccine.Thevaccineisadministeredbytheschoolhealthteam.BoysinYear10andabovewhoare15yearsofageoryoungerareabletoaccessthevaccinethroughtheirgeneralpractitioner.

• TopromotethisnewvaccinationprogramtheHealthProtectionServiceandtheDivisionofWomen,YouthandChildrenprovidedcommunicationtostakeholderswhichincluded:

– lettersandinformationtoGeneralPractitionersandgeneralpracticestaff

– articlesinthe‘ImmunisationNewsletter’

– mediareleases,educationeventsandinformationontheACTHealthwebsite.

• HPVvaccinationcourseconsistsofthreevaccinations.TheadministrationofthefirstdoseoftheHPVvaccinationprogramwascompletedbyMay2013.Atotalof5,739dosesofvaccinewereadministeredtoeligiblestudents.Preliminarydataindicatesthatthefollowingcoveragerateshavebeenachievedforthefirstdose:

– Year7girls—82.5percent

– Year7boys—79.2percent

– Year9boys—72.0percent.

• TheCervicalScreeningProgramcapturesandreportsdataovera2-yearperiodasrecommendedbytheNationalCervicalScreeningProgram.Asof30June2013,theACTparticipationrateforthetargetpopulationwas57.14percent.TheAIHWreport,Cervical Screening in Australia 2010–2011,againputstheACTinthetopthreejurisdictionsinAustraliaforparticipationincervicalscreeningandfirstoverallinAustraliaforthefive-yearparticipationrate.


• During2012–13,theCervicalScreeningProgramactivelypromotedcervicalscreeningamongcommunitygroups.ThemainmessageinthispromotionisforyoungwomentocontinuescreeningeveniftheyhavebeenvaccinatedagainstHPV.Programstaffhaveattendedseveralnotablewomen’shealthpromotionaleventsaroundtheACTtopromotescreeninginthecommunity.InadditionseveralprintmediacampaignswereimplementedtopromotescreeningamongwomenincommunitypublicationsaswellasACTGovernmentpublicationstargetingACTGovernmentstaff.Severalnewbrochuresweredesignedandproduced.

• BreastScreenACT&SENSWispartofanationalpopulationbreastscreeningprogramthatisaimedatreducingdeathsfrombreastcancerthroughearlydetection.FurtherinformationcanbefoundunderCancerServicesonpage160ofthisreport.

• NewbornHearingScreeningsareprovidedtoeverynewbornintheACTandaimtoidentifybabiesbornwithsignificanthearinglossandintroducethemtoappropriateservicesassoonaspossible.FurtherinformationcanbefoundunderDivisionofWomen,YouthandChildrenonpage143ofthisreport.School-basednursingprogramsincludeimmunisationsandkindergartenhealthchecks.TheSchoolYouthHealthNurseProgrampromotespositivehealthoutcomesforyoungpeoplebyprovidingaccesstoanurseinthehighschoolsetting.FurtherinformationcanbefoundunderDivisionofWomen,YouthandChildrenonpage143ofthisreport.

• AspartoftheCommonwealth-fundedNationalBowelCancerScreeningProject,endoscopyservicesareprovidedtopatients.FurtherinformationcanbefoundunderDivisionofMedicineonpage133ofthisreport.

• FortypercentofallWellWoman’sCheckswereprovidedtowomenfromculturallyandlinguisticallydiversebackgrounds.Thisisabovethetargetof30percent,andisthesameresultasinthe2011–12period.

• Ninety-sixpercentofeligiblechildrenaged0to14whoenteredsubstituteandkinshipcareintheACTwereseenbytheChildatRiskHealthUnit’sOut-of-HomeCareClinic.Thisisabovethetargetof80percent,andanincreaseof16percentfromthe2011–12period.

• InMay2013,theACTMinisterforHealthendorsedtheACT Chronic Conditions Strategy—Improving Care and Support 2013–2018,buildingonthepreviousstrategy. The ACT Chronic Conditions Strategy—Improving Care and Support 2013–2018setsthedirectionofcareandsupportforthoselivingwithchronicconditionsintheACTandoutlinesacollaborativeapproachtothisvitallyimportantareaofhealthcare.ImplementationandevaluationoftheStrategyisbeingoverseenbytheACTPrimaryHealthandChronicDiseaseSteeringCommittee.

Issues and challenges• TheimmunisationcoverageratesforAboriginalandTorresStraitIslanderchildrenintwoofthethreecohorts

(12–15monthsand24–27months)decreasedin2012–13.

• TheverylownumbersofAboriginalandTorresStraitIslanderchildrenintheACTmeansthatACTAboriginalandTorresStraitIslandercoveragedatashouldbereadwithcautionastheimmunisationcoverageratescanfluctuategreatly.Coverageratescanvarydramaticallybetweencohortsandbetweenreportingperiods.

• IncreasingandmaintaininghighimmunisationcoverageratesinAboriginalandTorresStraitIslanderchildrenwillcontinuetobeachallenge.TheHealthProtectionServiceisactivelypursuingdifferentstrategiestoincreaseimmunisationratesforAboriginalandTorresStraitIslanderchildrenincluding:phonecontactwithchildrenidentifiedasoverdueforimmunisations,discussionswithstakeholders,liaisingwithWinnungaNimmityjahAboriginalHealthServiceandinvestigatingimmunisationpromotionopportunitieswiththeAboriginalandTorresStraitIslandercommunity.

• WorkingcollaborativelywiththeACTMedicareLocal,ClosingtheGapunittoproduceresourcesandeducatecommunitiesontheimportanceofimmunisation.

• HealthProtectionServiceundertakesaquarterlymail-outtoparentsofchildrenwhoarerecordedintheAustralianChildhoodImmunisationRegisterasoverdueforimmunisation.Thisletteradvisesparentsorguardiansthattheirchildisoverdueforimmunisation,remindsthemoftheimportanceofvaccinationandenablesanyadministeredbutunrecordedimmunisationstobeenteredontoACIR.


Future directions• FollowingthesuccessfulimplementationoftheWholeofGovernmentHealthyWeightInitiative,theACT

GovernmentwillcommencecollaborativeactiontoreducetheburdenofinjuryontheACTpopulation.Injuryaccountsforapproximately7percentoftheburdenofdiseaseintheACT,andaddressingthisissueispivotaltoreducingtheincidenceofprematuremortality,chronicdisabilityandtheassociatedhealthsystemcosts.

• TheMinisterforHealthlaunchedFutureDirectionsforTobaccoReduction2013–2016onWorldNoTobaccoDay(31May2013).ThepurposewastoinformtheCanberracommunityofthe12initiativesproposedby ACTHealthintobaccocontrol.Theseinitiativesaimtoinvestigaterestrictingaccesstotobaccotoreducedemandandcontrolsupplyandrestrictingplacesoftobaccouse.Theareasthatwillbelookedatincludeoutdoorareasatpublicswimmingpools,children’splaygrounds,amongmanyothers,wheremeasures couldbetakentoreducesmokingandprotectnon-smokersfromtheeffectsofenvironmentaltobaccosmoke.ThetimeframesareoutlinedinFutureDirections,withworkoneachinitiativephasedoverthelife ofFutureDirections.

• In2012thePopulationHealthDivisionwassuccessfulinwinninganAustralianResearchCouncilGrantinpartnershipwiththeAustralianNationalUniversity.Thisgrantwillenablethedevelopmentofmethodsbywhichresearchinpopulationhealthcanbebetterusedbypolicy-makers.In2012–13workbeganwithdecision-makersandpolicyadvocatestoidentifybarrierstotheuptakeofresearchevidenceinpopulationhealthandtodevelopatrainingmodeltoimproveprocessesbywhichresearchersandpolicy-makersworktogether.Toolstoassistpolicy-makersuseevidencewillbedevelopedfollowingthisstudy.

Quality and Safety UnitSafetyandqualityofcarearecoreelementsintheprovisionofhealthservices.TheQualityandSafetyUnit(QSU)takesaleadroleinplanning,managingandevaluatingpatientsafetyandqualityfortheACTHealthDirectorate.TheQSUfocusesonqualityimprovement,evaluationandreview,clinicalmanagementsystemsandmeasurement,consumerengagement,clinicalperformancerelatedtopatientsafetyandquality,andriskmanagement.TheWorkplaceSafetysectionwithintheQSUhasoverarchingresponsibilityforkeepingHealthDirectoratestaffhealthyandsafe.

TheBusinessPlanfortheQSUhighlightsthreethemeswhichunderpinthefunctionsoftheunit.Thesethemesarethatcareprovidedtoconsumerswillbe:

• consumer-centred

• drivenbyinformation

• organisedforsafety.

Thesethemeshavebeencompiledusing:

• recommendationsandinformationfromreviewsandmonitoringprocessescarriedoutwithintheHealthDirectorate

• nationalandinternationalhealthimprovementmethods

• nationalpriorityandreformprocesses.

National Safety and Quality Health Service StandardsQSUiscommittedtoadvancingthenationalagendaonpatientsafetyandisworkingcloselywiththeAustralianCommissiononSafetyandQualityinHealthCaretoprogressimplementationofthe10National Safety and Quality Health Service Standards.

TheQSUalsocoordinatestheaccreditationprocessfortheorganisation.TheAccreditationandEvaluationteamiscurrentlymanagingchangesinaccreditationpracticetoensurethattheHealthDirectorateisreadyforitsassessmentagainstthe10NationalSafetyandQualityHealthServiceStandardsin2014.


AchievementsIn2012–13,theQSUcarriedoutthefollowingactivities.

Policies and procedures• Developedclearpolicydocumentsonimportantsafetyandqualityissuessuchas:

– consentandTreatmentPolicyandStandardOperatingProcedures

– respondingtotheuseofnon-prescriptionalcoholandotherdrugsinhealthsettings

– opendisclosure

– workhealthandsafety,andthesafetymanagementsystem

– dangeroussubstancemanagement.

• IssuedaRespiratoryPolicytoensureappropriaterespiratoryprotectionismaintainedforallrelevantstaff.

• SupportedandmonitoredthequalityofpolicydocumentsthroughthePolicyAdvisoryCommitteeandstafftrainingsessionsonpolicygovernanceandpolicywriting.

• CompletedtheupdatedWorkHealthandSafetyManagementSystemandrevisedWorkHealthandSafetyPolicy to:

– ensuretheHealthDirectoratemeetstheWork Health and Safety Act 2011andassociatedregulations,codesofpractice

– provideappropriateguidancetostaffinrelationtobestpracticesafetymanagement.

• DevelopedtwonewRiskManregistersforOccupationalMedicineandWorkplaceSafetyPhysiotherapymanagementandenhancedanumberofRiskManmodulestomeetchangedneedsanduserrequirements.

Accreditation• SupportedtheHealthDirectoratethroughtheAustralianCouncilonHealthcareStandards(ACHS)Organisation

WideSurveytoretainitsaccreditationstatus.TheHealthDirectoratemetallcriteriatoachieveaccreditationforanotherfouryearswith28markedachievements,18extensiveachievementsand1outstandingachievement.

• UpdatedtheSafetyandQualityFrameworktoincludethenewNational Safety and Quality Health Service Standards.Aconsultationdraftwillbeissuedinearly2013–14.

• Supportedtheestablishmentofthe10National Safety and Quality Health Service StandardsGroupstoprovidestrategicdirectionfortheimplementationofthesestandardsandmonitorprogressonkeyactivities.

• DevelopedaHealthDirectorateQualityImprovementandNational Safety and Quality Health Service Standards (NSQHSS)Educationstrategytoimproveunderstandingofchangemanagementandqualityimprovementmethodologytosupportimprovementsinqualityandsafetypractices.

Projects and programs• CompletedaprojectonbehalfoftheLocalHospitalNetwork(LHN)Counciltocollectpatientstories

particularlyrelatedtobedsidehandoveranddischargeplanning,toallowtheLHNtomakerecommendationsforimprovements.

• NegotiatedabudgetbidtoallowincreasedresourcingfortheRespectingPatientChoicesProgramtoincreasecommunityawarenessanduptakeofadvancecareplans.

• TheRespectingPatientChoicesprogramnegotiatedasuccessfulpartnershiparrangementwithMedicareLocalACTtosupportandpromoteAdvanceCarePlanningtothewiderACTcommunityandhealthprofessionals.

• FacilitatedtheACTQualityinHealthcareAwardswhichshowcasepatientsafetyandqualityinitiatives acrosstheterritory;andtheHealthDirectorateBetterPracticeAwardswhichcelebratelocalqualityimprovementactivities.


Publications• DevelopedatoolkittosupportChairsandSecretariatsofcommitteeswhohaveconsumerrepresentatives

oncommittees.

• Planningforfutureimplementationofcorestandardsforformsoutlinedin‘ANationalFrameworkforAdvancedCareDirectives’throughworkingwiththeMedicareLocalAgedCareForumsandCouncilontheAgeingACT.

• RevisedThe Dangerous Substances Manualtomeetupdatedlegislation.

• AmendedtheSafety Management Systemdocumenttoreflectthechangestoworkplacelegislation,inparticular,theresponsibilitiesofmanagers.

Staffing• MadeanappointmenttothePatientExperienceTeamLeaderposition.

Training and education• ImplementedandevaluatedtraininginbedsidehandoveraspartoftheEffectiveCommunicationinClinical

Handover(ECCHO)Project,anationalAustralianResearchCouncilFundingprojectincollaborationwiththeUniversityofTechnologySydneyandthreeotherjurisdictions.Trainingisnowbeingpilotedinanotherward.TheprojectteampresentedattheInternationalCouncilofNursesConferenceinMay2012.Held‘OpenDisclosureMasterClasses’forseniorclinicalandexecutivestaff.Theseclassesprovidetargetedskillstosupportstaffwhenopendisclosurediscussionswithpatientsandfamiliesarerequired.PartneredwiththeHealthcareConsumersAssociationACTtoprovideforumson‘Howtocomplainproperly’,consumerrepresentativetrainingandadvocacytraining.

• ParticipatedintheRuralHealthEducationFoundationDVDandtoolkittitled‘ThePatient’sChoice:QualityattheEndofLife’.

• Providededucationandtrainingtostaffonimplementingthe10National Safety and Quality Health Service Standards.

Issues and analysisTransitioningtothe10National Safety and Quality Health Service StandardsfromtheAustralianCouncilonHealthServicesStandards(ACHS)accreditationprogramisasignificantchangefortheorganisation.Implementationofthestandardsprovidesanopportunitytoembedthesestandardsintheorganisationandfurtherimprovethesafetyandqualityofourservices.


A.10 Triple Bottom Line Report INDICATOR 2011–12 Result 2012–13 Result % Change

ECO

NO

MIC

Employee Expenses

Numberofstaffemployed(headcount) 6,228 6,540 5.0%

Totalemployeeexpenditure(dollars) $593,999,000 $628,781,000 5.9%

Operating Statement

Totalexpenditure(dollars) $1,177,762,000 $1,083,790,000 –8.0%

Totalownsourcerevenue(dollars) $255,862,000 $679,845,000 165.7%

Totalnetcostofservices(dollars) $921,900,000 $403,945,000 –56.2%

Economic Viability

Totalassets(dollars) $996,190,000 $1,110,925,000 11.5%

Totalliabilities(dollars) $266,500,000 $290,956,000 9.2%

ENVIRO

NMEN

TAL*

Transport

Totalnumberoffleetvehicles 321 322 0.3%

Totaltransportfuelused(kilolitres) 365 362 –0.8%

Totaldirectgreenhouseemissionsofthefleet(tonnesofCO2e) 987 975 –1.2%

Energy Use

Totalofficeenergyuse(megajoules) 11,234,403 8,139,197 –27.6%

OfficeenergyuseperFTE(megajoules)1 23,820 7,004 –70.6%

Officeenergyusepersquaremetre(megajoules) 1,642 466 –71.6%

Greenhouse Emissions

Totalofficegreenhouseemissions–directandindirect (tonnesofCO2e)2 1,644 1,957 19.0%

TotalofficegreenhouseemissionsperFTE(tonnesofCO2e/FTE) 3.90 1.68 –56.9%

Totalofficegreenhouseemissionspersquaremetre

(tonnesofCO2e/m2) 0.27 0.11 –59.3%

Water Consumption

Totalwateruse(kilolitres)3 186,552 194,088 4.0%

OfficewateruseperFTE(kilolitres/FTE) n/a n/a n/a

Officewaterusepersquaremetre (kilolitres/m2) n/a n/a n/a

Resource Efficiency and Waste

Estimateofco-mingledofficewasteperFTE(litres)4 286.57 289.43 1.0%

Estimateofpaperrecycled(litres)5 1,477,222 1,194,348 –19.1%

Estimateofpaperused(byreams)perFTE 7.11 7.38 3.8%


INDICATOR 2011–12 Result 2012–13 Result % Change

SOCIAL

Diversity of Our Workforce

Women(FemaleFTEsasapercentageofthetotalworkforce) 76.06% 75.87% –0.2%

Peoplewithadisability(asapercentageofthetotalworkforce) 1.88% 1.93% 2.7%

AboriginalandTorresStraitIslanderpeople(asapercentageofthetotalworkforce) 0.84% 0.99% 17.9%

StaffwithEnglishasasecondlanguage(asapercentageofthetotalworkforce) 18.10% 22.11% 22.2%

Staff Health and Wellbeing

OH&SIncidentReports 1,209 1,355 12.1%

Acceptedclaimsforcompensation 89 113 27.0%

Staffreceivinginfluenzavaccinations** 2,481 3,189 28.5%

Workstationassessmentsrequested 129 304 135.7%

*SeeC.13page267.Onlyofficespaceusedinthecalculationofenergyandgreenhousegasemissions.

**Staffreceivinginfluenzavaccinations.Thisinformationispreparedbycalendaryear.

NotesTotal office energy use (megajoules) and greenhouse gas emissions

1 Thedifferencebetween2011–12and2012–13energyusehasresultedfromtheinclusionof12MooreStreetLevel1,CarruthersStreetCurtin,TCHcampusBuildings23&24,andofficespacewithinBuildings2&6andasmallspaceinBuilding12MedicalRecordsDepartment. Total office greenhouse emissions – direct and indirect (tonnes of CO2e)

2 Thedifferencebetween2011–12and2012–13greenhousegasemissionsresultedfromtheinclusionof12MooreStreetLevel1,CarruthersStreetCurtin,TCHcampusBuildings23&24,officespacewithinBuildings2&6TCHandasmallspaceinBuilding12MedicalRecordsDepartment. Total water use (kilolitres)

3 Thisamountwasincorrectlyreportedinthe2011–12AnnualreportsectionA10TripleBottomLineas183,174kilolitres,whichwasanadministrativeerror.186,552kilolitresiscorrect,asstatedinC19tableofthe2011–12reportonpage318.Thisincreaseisduetotheadditionalclinicalspace. Resource Efficiency and Waste

4 Notethefigurein2011–12wasinclusiveof18mthsdata.Theadjustedfigurefor12mthsis209.1.5 Notethefigurein2011–12wasinclusiveof18mthsdata.Theadjustedfigurefor12mthsis1,139,422.

Section B Consultationandscrutinyreporting177


B.1 Community engagement

ACTHealthrecognisesthatbuildinganeffectivehealthcaresystemrequiresgenuinecollaborationbetweenconsumers,carersandACTHealthstaff.ACTHealthiscommittedtoprovidingopportunitiesforconsumersandcarers,thosewhoaremostaffectedbyhealthcareservices,toinfluencethedevelopment,deliveryandreviewofservices.Increasingtheparticipationofconsumersandcarersinhealthcareisfundamentaltobuildingastrongpartnership.ACTHealthserviceswillbeabletoprovidehigherqualitycareasaresultofmeaningfulconsumerandcarerinvolvementinpolicydevelopmentandplanningofhealthservices.

The ACT Health Consumer and Carer Participation Framework aims to assistconsumers,carersandACTHealthstafftoworkingenuinecollaborationinorderto:

• increaseconsumerandcarerparticipationinhealthcare

• facilitatejointdecisionmakingatalllevels

• improvethedevelopment,deliveryandevaluationofACT’spublichealthservices.

Opportunitiesforconsumerparticipationwithinthehealthsystemexistatmanylevelsandatmanypointswithinthecontinuumofcareanddeliveryofservices.Theseincludebutarenotlimitedtoparticipationat:

• thelevelofindividual care, wherethereareinteractionsbetweentheconsumer,patientand/orcarerandthehealthcareproviders

• the service level, whereconsumerandcarerparticipationisfocusedoncontributingtoservicedeliveryguidelinesandprocedures

• the organisational level,wherethelevelofparticipationisfocusedonbroaderstrategicandpolicydevelopmentactivity.

ACTHealthalreadyhasinplaceanextensiverangeofestablishedpracticesandinitiativesthatdemonstrateitsongoingcommitmenttoconsumerandcarerparticipation.Examplesoftheseinclude:

• ListeningandLearning:ConsumerFeedbackPolicyandStandards

• implementationoftheAustralian Charter of Healthcare RightsandCharter on the Rights of Children and Young People in Healthcare Services in Australia

• Consumer,CarerandCommunityRepresentativeprogramandReimbursementPolicy

• relationshipswithconsumeradvocacyagenciesthroughservicefundingagreements

• RespectingPatient’sChoices

• PatientandFamilyCentredCareFramework.

ACTHealthhasactivelyengagedwiththecommunityonarangeofmatters,asindicatedinthefollowingtable:


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es

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–201

5tokeystakeho

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erorgan

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Ant

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Highlevelcon

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er

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represen

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ase

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20

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entw

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rthe

serviceatK

amba

h.Trainingisprovide

dinre

latio

ntoaccesstoth

eClinicalPortalonan

as-ne

edsba

sisan

dim

med

iatelyfo

rstaffiden

tifying

therequ

iremen

t,and

isotherwise

sche

duled.Trainingisprovide

dforthe

Men

talH

ealth

Assessm

entG

enerati

onand

Inform

ation

Collection

(M

HAG

IC)system.A

ccessisprovide

don

thecompleti

onoftrainingprovided

bySh

ared

ServicesICTHealth

.

Theothe

rtrainingan

dsupp

ortm

odelism

anaged

throug

hbu

sine

ssunitsfo

rallothe

rapp

licati

ontraining

an

dsupp

ort.Spe

cifically,emergencyde

partmen

ttrainingan

dsystem

adm

inistrati

onism

anaged

locallyby

theeachhospitalserviceand

training

isprovide

dtohospitalstaffbytheAC

THealth

staffwho

man

agethe

system

s.OtherITre

latedho

spita

lsystemsareman

aged

using

asim

ilarm

odelto

EDand

training

is

addressedasnee

dedan

dwhe

reapp

ropriatesched

uled

forg

roup

s.Anum

bero

fthe

ITre

latedho

spita

lsystem

smaysup

portspe

cialista

ndlimite

duserre

quire

men

tsto

serviceaparticularbusinessne

edor

functio

nalreq

uiremen

t.Localbusinesssupp

ortm

odelsaccommod

atetheserequ

iremen

ts.

Thereisalsoworkun

derw

ayassessing

theDataGoverna

nceacrossth

eDire

ctorate.One

key

recommen

datio

nwillbetocon

ductafu

llscaleau

dito

fallda

taassetsacrossth

eDire

ctorate.Thisprocess

willena

blevisibilityofallda

tasystemsan

dprocesses.The

Dire

ctoratewillbeab

leto

assesscurren

tdata

assetsand

develop

app

ropriatetraining

and

protocolsfo

rthe

collection

,collatio

nan

drepo

rting

ofh

ealth

system

inform

ation

.Thisprocesswillbeon

goingwith

regu

lara

uditing

ofd

atatoprovide

furthe

revide

nce

ofadd

ition

altraining

requ

iremen

ts.

System

sareinplaceto

provide

training

forstaffinallrelevant

applicati

ons.New

training

mod

ules

arebe

ingde

velope

dforthe

new

versionofEDIS.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

4.The

Com

mittee

recommen

dsth

at

theHealth

Dire

ctoratein

conjun

ction

with

Sha

redServices

ICT

ensu

re th

at a

ppro

pria

te

training

oneveryITre

lated

hospita

lsystem,w

ithaparticular

focuson

theEm

ergency

Dep

artm

entInformati

onSystem

(EDIS),isprovide

dtoallstaff

atthe

Ca

nberraHospitaland

Calvary

PublicHospital.

Agree

d.

Trainingfo

rsystemsism

anaged

byShared

ServicesICTHealth

and

trainingisprovide

dforstaffatth

ecommen

cemen

tofd

utiesand

whe

retrainingre

quire

men

tsaresub

sequ

ently

iden

tified

(iewhe

nstaff

tran

sfer

toareasre

quiringapp

licati

onuseorh

aveextend

edleavethatm

ayre

quire

are

freshe

regMaternityleave).

New

training

packagesha

vebee

nde

velope

dforthe

EDISwhichfo

cuson

thediffe

rentro

lesofpeo

ple

with

inth

eem

ergencyde

partmen

t(nu

rses,adm

inistrati

vestaff,doctors).New

systemsarealsobeing

im

plem

entedwhichwillre

quire

moreform

altraining

processesto

becompleted

byallstaffwith

inth

eem

ergencyde

partmen

t.

Compreh

ensivetraining

inth

emajorsystems(suchasth

eAC

TPatie

ntAdm

inistrati

onSystem)isprovided

forC

anbe

rraHospital,Ca

lvaryPu

blicHospitaland

com

mun

ityservicesstaff

.Trainingisprovide

dforthe

eq

uipm

entlen

ding

systemfo

rthe

serviceatK

amba

h.Trainingisprovide

dinre

latio

ntoaccesstoth

eClinicalPortalonan

as-ne

edsba

sisan

dim

med

iatelyfo

rstaffiden

tifying

therequ

iremen

t,and

isotherwise

sche

duled.Trainingisprovide

dforthe

Men

talH

ealth

Assessm

entG

enerati

onand

Inform

ation

Collection

(M

HAG

IC)system.A

ccessisprovide

don

thecompleti

onoftrainingprovided

bySh

ared

ServicesICTHealth

.

Theothe

rtrainingan

dsupp

ortm

odelism

anaged

throug

hbu

sine

ssunitsfo

rallothe

rapp

licati

ontraining

an

dsupp

ort.Spe

cifically,emergencyde

partmen

ttrainingan

dsystem

adm

inistrati

onism

anaged

locallyby

theeachhospitalserviceand

training

isprovide

dtohospitalstaffbytheAC

THealth

staffwho

man

agethe

system

s.OtherITre

latedho

spita

lsystemsareman

aged

using

asim

ilarm

odelto

EDand

training

is

addressedasnee

dedan

dwhe

reapp

ropriatesched

uled

forg

roup

s.Anum

bero

fthe

ITre

latedho

spita

lsystem

smaysup

portspe

cialista

ndlimite

duserre

quire

men

tsto

serviceaparticularbusinessne

edor

functio

nalreq

uiremen

t.Localbusinesssupp

ortm

odelsaccommod

atetheserequ

iremen

ts.

Thereisalsoworkun

derw

ayassessing

theDataGoverna

nceacrossth

eDire

ctorate.One

key

recommen

datio

nwillbetocon

ductafu

llscaleau

dito

fallda

taassetsacrossth

eDire

ctorate.Thisprocess

willena

blevisibilityofallda

tasystemsan

dprocesses.The

Dire

ctoratewillbeab

leto

assesscurren

tdata

assetsand

develop

app

ropriatetraining

and

protocolsfo

rthe

collection

,collatio

nan

drepo

rting

ofh

ealth

system

inform

ation

.Thisprocesswillbeon

goingwith

regu

lara

uditing

ofd

atatoprovide

furthe

revide

nce

ofadd

ition

altraining

requ

iremen

ts.

System

sareinplaceto

provide

training

forstaffinallrelevant

applicati

ons.New

training

mod

ules

arebe

ingde

velope

dforthe

new

versionofEDIS.

Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

5.The

Com

mittee

recommen

dsth

at

robu

stdatavalid

ation

processesbe

establishe

dforthe

Can

berra

Hospitaland

thatth

eGovernm

ent

ofth

eda

yrepo

rtto

theAC

TLegislati

veAssem

blyon

thefirst

sitting

dayof2

013on

their

implem

entatio

n.

Agree

dinpart.

Valid

ation

ofd

atainth

eHealth

Dire

ctorateoccursata

num

bero

fpointsalon

gtheconti

nuum

from

the

pointo

fdatacollection

inth

esourcesystemto

end

useofthe

dataforrep

ortin

gan

dan

alysis.The

firstti

er

ofvalidati

oninvolvesre

view

byad

ministrati

vestaffand

systemadm

inistratorsatth

etim

eofdataen

tryinto

theEm

ergencyDep

artm

entInformati

onSystem,u

suallyonada

ilybasis.A

secon

dtie

rofd

atavalid

ation

occursatthe

timewhe

nda

taisextracted

from

sou

rcesystem

san

dsentto

theHealth

Dire

ctoratefor

centralised

processing.

Thisvalidati

onprocessoccurson

am

onthlybasiswhe

rebyeachrecordextracted

from

thesourcesystemis

runthroughaserie

sofvalidati

onche

cksagainste

stab

lishe

dcrite

riainorderto

assessthecompleten

ess,

accuracyand

qua

lityofth

edata.The

sevalidati

onsen

sureth

atACT

datameetsnati

onallym

andateddata

specificatio

nsaswellasad

ditio

nalvalidati

onsde

velope

dwith

inACT

Health

based

onan

alysesofd

ata,suchas

cross-checkingdatasourceswith

dataextractsusedforrep

ortin

gpu

rposes,and

theau

ditin

gofdataextracts

backto

sou

rcesystem

stoensurethatnochan

gesaremad

etodataextracts.

Eachm

onthare

portisprodu

cedon

recordsthatfa

ilthevalid

ation

criteriaan

dthen

sen

tbacktoth

eoriginati

nghospitalforinvestigatio

natth

epo

into

fserviceto

determineiftherecordiscorrectorreq

uires

upda

tinginth

esourcesystem.R

ecordsflaggedforinvestig

ation

willkee

pre-app

earing

onconsecuti

ve

mon

thlyre

portsun

tilsuchtim

easth

eda

taiscorrected

inth

esourcesystemora

dviceisre

ceived

thatth

erecordisaccurate.

Thesevalidati

onche

cksreview

allrecordsforp

ossibleerrorsand

validity,regardlessofwhe

therth

eyhaveor

havenotm

ettimelinesstargetsorotherestab

lishe

dbe

nchm

arks.The

yalsoinclud

e,whe

repossible,

validati

onche

cksthathavebe

endevelop

edatthe

nati

onallevelforche

ckingthequ

ality

ofE

mergency

Dep

artm

entd

ataatth

epo

intw

henallStatehealth

autho

ritiessub

mittheird

atatonati

onalbod

ies.

Additio

nalche

cksthataredesigne

dtom

onito

rand

iden

tifyanysignificantcha

ngeintren

dsata

more

aggregatelevelhavealsobeenim

plem

entedinth

eHealth

Dire

ctorateatth

epo

into

fana

lysisan

drepo

rtingof

EmergencyDep

artm

entd

ata.Prio

rtotheissueswith

emergencyde

partmen

tdatain201

2,

anu

mbe

rofaud

itcheckswereinplaceto

ensuredataaccuracy.Thisinclud

edaud

itsbythestaff

who

review

eddatafollowingthecompleti

onofanem

ergencyde

partmen

trecordfora

nyinconsistenciesor

inaccuracies.Thisprocessconti

nues.H

owever,inad

ditio

ntoth

esechecks,add

ition

al,system-gen

erated

checksareund

ertakenwhichm

onito

ranycha

ngesto

datafollowingtheau

ditp

rocessaswellasad

ditio

nal

repo

rtswhichhavebe

endevelop

edto

noteanychan

gestore

sults.The

seadd

ition

alprocesseswillprovide

themecha

nism

stohighlightanycha

ngesto

datathatarenotsup

ported

byeviden

ce.

TheHealth

Dire

ctorateiscurrentlyre

view

ingprocessesford

atavalid

ation

inotherju

risdictio

nsto

ascertain

iftherearean

yareasforimprovem

entb

ased

onexpe

rien

ceselsewhe

re.

Thetim

eframespecified

bytheCo

mmittee

wasnotachievablean

dthereforeno

tagree

d.

Valid

ation

processesarealre

adyin

place.Add

ition

alaud

itchecksfo

rED

ISwillbeim

plem

entedwith

the

introd

uctio

nofth

ene

wsystemin

late201

3.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

6.The

Com

mittee

recommen

dsth

at,

consistentwith

the

recommen

datio

nofth

eAud

itor-

Gen

eral,the

rapidsign

-onsystem

be

implem

entedassoo

nas

practicab

leand

thatth

eGovernm

ento

fthe

dayre

portto

theAC

TLegislati

veAssem

blyatth

eea

rlie

st o

ppor

tuni

ty o

n its

im

plem

entatio

n.

Agree

d.

TheAC

TGovernm

entH

ealth

Dire

ctorateha

sbe

enworking

with

Sha

redServicesIC

Ttodevelop

and

triala

piloto

fthe

Rap

idSign-Ontechno

logyto

ensurethatth

ehu

man

useab

ilityfa

ctorsan

dtechnicalfeasibility

aread

dressedtom

inim

isethedisrup

tiontoclin

icalworkfl

ow.The

com

pleti

onofthispilotw

illre

sultina

recommen

datio

nan

dcostsforc

onside

ratio

nbyth

eorganisatio

ntoproceed

towidespreadim

plem

entatio

nwith

inth

eHealth

Dire

ctoratean

ditsdiverseapp

licati

ons.

ThePilotti

meframeisexpectedtobecompleted

byen

dofDecem

ber2

013with

theresulting

costm

odel

andim

plem

entatio

nplan

tobeconsidered

bytheHealth

Dire

ctorate.Thispilotw

illdrawupo

navarietyof

busine

ssand

technicalresou

rcesto

integrateanu

mbe

rofkeycom

pone

ntstoensurethatth

eRa

pidSign

-Onsolutio

niseasytousefo

rourstaff,secure,ro

bustand

reliable.

Theim

plem

entatio

nofth

eRa

pidSign

-OnTechno

logywillfo

cusinareasofh

ighe

stnee

d,suchasth

eEm

ergencyDep

artm

ent,with

aprogressivero

lloutth

atislikelyto

takeaperiodoftimebe

foreth

een

tire

organisatio

nha

sallofthe

ben

efits.Thistim

eframewillbecom

eclearfollowingthecompleti

onofthe

pilo

tstud

y.Thisislargelyasare

sultofth

eleveloftrainingan

dchan

gem

anagem

enttha

twillbene

eded

fora

successfulintegrati

onoftechn

olog

yintoexisting

clin

icalworkpracticeswith

outimpa

cting

upo

npa

tient

care.

Thepilotp

rojectisdue

tobe

completed

bytheen

dof201

3.

Theassessmen

tofthe

pilo

t willdeterminetheroll-ou

tof

thetechno

logy.

7.The

Com

mittee

recommen

dsth

at

allA

CTGovernm

entd

irectorates

andagen

ciessho

uldha

veeffe

ctive

practicesand

processesinplaceto

review

allrepo

rtsofth

eAud

itor-

Gen

eral,and

toassessthe

relevanceofth

efin

ding

san

drecommen

datio

nsto

theira

gency,

regardlessofw

hetherth

eagen

cy

wasinvolved

inaspe

cificaud

it.

Agree

d.

TheDire

ctor-Gen

eralofth

eAC

TGovernm

entH

ealth

Dire

ctoratewroteto

allAC

TGovernm

entD

irectors-

Gen

eral.D

irectoratesarere

view

ingtheirp

rocessesto

ensurethatth

isoccurs.

Completed

.The

ACT

Health

Dire

ctor-

Gen

eralwroteto

alldirectors-gene

ral

notin

gthisre

commen

datio

n.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

8.The

Com

mittee

recommen

dsth

at

allA

CTGovernm

entd

irectorates

andagen

ciessho

uldprioritiseasa

matt

erofu

rgen

cyanassessmen

t ofth

ead

equa

cyofcon

trolsover

theirrespe

ctiveITsystemsan

dap

plicati

ons.Thisshou

ldinclud

econsiderati

onofthe

con

trols

thataffe

ctth

ereliabilityofall

ITsystemsan

dap

plicati

ons

(gen

eralcon

trols)and

con

trolsthat

arespecifictoeachap

plicati

on

(app

licati

oncon

trols).

Agree

d.

On4July201

2,th

eCh

iefM

inisterw

roteto

allMinisterialcolleague

s,and

sub

sequ

ently,the

Dire

ctorGen

eral

ofth

eAC

TGovernm

entH

ealth

Dire

ctoratewroteto

allAC

TGovernm

entD

irectoratesto

drawth

eir

atten

tiontoth

isissue.Respo

nsesnotethatsystemsareinplaceacrosstheAC

Ttoensurecontrolofa

ccess

toand

useofITsystem

s.

TheGovernm

ent’snew

Com

merceand

WorksDire

ctorateha

srespon

sibilityforp

roviding

asecureICT

operati

ngenviro

nmen

twith

inwhichDire

ctoratesope

rateth

eirb

usinessap

plicati

ons.Respo

nsibilityfo

rspecificap

plicati

onsan

dtheinternalcon

trolsne

cessarytoadd

ressinde

ntifie

drisksliewith

therespectiv

eDire

ctorate.Security

advicetoDire

ctoratesisprovide

dbyth

eSSIC

TSecurityTeam.

SSIC

Tha

sinplacem

anyofth

econtrolsre

quire

dtom

aintainthesecurityofa

pplicati

ons(in

clud

ingbu

tnot

limite

dto):

•Who

leofG

overnm

entsecurity

policies,stand

ardsand

procedu

res;

•Aded

icated

security

team

with

highlevelsofskillinallfacetsofICT,P

hysical,Pe

rson

neland

Inform

ation

security,including

forensics,web

pen

etratio

nassessmen

t,security

architecture,riskassessm

entsand

securecod

ing.Readyto

assistd

irectoratesasrequ

ired;

•Adetailedsecurityaud

itprog

ramacrosstheAC

Tgo

vernmen

tsnetworksto

minim

isevulnerab

ilitie

s;•ASecurity

Awaren

esstraining

program

availablefree

ofcha

rgetoalldirectorates;

•Assistanceinth

eprovisionofsecurity

templatesand

advicetofa

cilitateDire

ctoratesassessing

risksan

dtreatm

entstrategiesforthe

irapp

licati

ons;

•Vu

lnerab

ilityassessm

entforbothinternallyand

externa

llyfa

cing

app

licati

ons;

•Serverbuildstand

ards;

•Ro

bustand

rigo

roussystemand

app

licati

oncha

ngecontrolprocesses;

•Aro

bustand

secureInternetGatew

ayand

com

mun

icati

onsne

twork;

•Goo

dph

ysicalsecurity

con

trolsarou

nddatacentres;

•Internetcon

tentfilte

ring

and

Anti

-spa

m;

•Workstatio

nen

dpo

intp

rotection

toadd

ressm

alware;

•Deviceen

cryptio

nforL

aptops;

•Havingen

crypted‘Thu

mb-drives’availableforsecuretran

sporta

ndstorageoffi

les;

•Serverbased

anti

malwareprotectio

n;•NetworkAccesscontrol;

•Ba

ckup

and

storagestrategiestailo

redtodire

ctoratene

eds.

Shared

ServicesICTSecurityassistsbusinesssystem

owne

rsto

con

ductsystemlevelriskassessmen

tsand

completesystem

levelsecurity

plansspe

cificto

eachDire

ctorateinaccorda

ncewith

Aud

itorG

eneralre

port

2/20

12,R

ecom

men

datio

n3e

.Thisassistan

ceiden

tifiesand

man

agesvulne

rabiliti

esinre

latio

ntoissuesof

confi

denti

ality,integrityand

availabilityofapp

licati

onsystems.

Completed

.The

ACT

Health

Dire

ctor-

Gen

eralwroteto

alldirectors-gene

ral

notin

gthisre

commen

datio

n.In

ad

ditio

n,security

plansarebeing

de

velope

dfora

llAC

THealth

systems

(see

recommen

datio

n3ab

ove).


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

9.The

Com

mitteere

commen

dsth

at

theGovernm

ento

fthe

daydetailto

theAC

TLegislati

veAssem

bly,atthe

earliestp

ossibleop

portun

ity,how

it

willadd

ressand

improveissues

abou

tachievemen

tsagainst

throug

hputand

triageta

rgets

asth

eyre

lateto

theEm

ergency

Dep

artm

entatthe

Canbe

rraHospital

Agree

d.

Thede

tailedplan

toadd

ressissuesinre

latio

ntoaccesstoemergencyde

partmen

tsand

improving

performan

cewasta

bled

onthelastsitti

ngdayinM

arch201

3.

Completed

.The

MinisterforHealth

tabled

theED

accessplan

inth

eAC

TLegislati

veAssem

blyinM

arch201

3.

10.The

Com

mittee

recommen

dsth

at

clearg

uide

linesbeestablishe

dconcerning

internal

commun

icati

onbetwee

nthe

AC

THealth

Dire

ctorate,th

eCa

nberraHospitaland

Calvary

PublicHospital.

Noted

.

Thereareanu

mbe

rofformalcom

mittee

mee

tingsth

atensurevisibilityan

dclarity

onissuesaffe

cting

all

facetsofthe

Health

Dire

ctoratean

dCa

lvaryPu

blicHospital.

Am

onthlyFinan

ceand

Perform

ancem

eetin

gha

sbe

enestab

lishe

dtodiscussm

attersrelatin

gtoactivity

andfin

ancialpressuresexperienced

byCa

lvaryPu

blicHospital.Adm

inistrati

veofficersfrom

Health

and

Ca

lvaryatt

endtheforumand

wereap

plicab

le,itemsdiscussedthatareofcon

cerncan

befurthe

rraisedat

regu

larN

etworkCo

mmittee

mee

tingsfo

rresoluti

on.

TheAC

THealth

Dire

ctoratean

dCa

lvaryHealth

CareAC

Thaveestab

lishe

daNetworkAg

reem

enttoclarifyth

erelatio

nshipbe

tweentheHealth

Dire

ctoratean

dCa

lvaryPu

blicHospital.Asparto

fthis,are

gularm

eetin

gbe

tweenbo

thenti

tiesoccursaswellasaform

alm

onthlym

eetin

gbe

ingestablishe

dbe

tweenbo

thpartie

sto

discussissuesre

latedtopressuresand

activity.Thisprovidesth

eba

sisforthe

relatio

nshipbe

tweenen

tities

andprovidesclearguide

linesinre

latio

ntocom

mun

icati

onbetweenpa

rties.

System

sareinplace.The

Calvary

NetworkAgree

men

tCom

mittee

providesfo

rhigh-level

commun

icati

onbetwee

nen

titiesand

theFina

ncean

dPe

rforman

ce

Committee

provide

sform

ore

detailedop

erati

onalm

attersto

bediscussed

.

11.The

Com

mittee

recommen

dsth

at

clearg

uide

linesbeestablishe

dconcerning

externa

lcommun

icati

onre

gardingmatt

ers

concerning

the

AC

THealth

Dire

ctorate,th

e

Canb

erraHospitaland

Calvary

PublicHospital.

Agree

d.

TheHealth

Dire

ctorateworkswith

ara

ngeofnati

onalorgan

isati

onsan

dcommittee

stoensurethatour

inform

ation

iscon

sisten

twith

nati

onalguide

linesand

stand

ards.Thisinclud

esre

presen

tatio

non

Co

mmittee

sestablishe

dbyth

eAustralianInstituteofH

ealth

and

Welfare,the

Nati

onalHealth

Perform

ance

Autho

rity,sub

-com

mittee

softh

eAustralianHealth

Ministers’A

dvisoryCo

unciland

mee

tingsarran

gedby

theCO

AGReformCou

ncilinre

latio

ntohealth

matt

ers.

TheHealth

Dire

ctoratewillestab

lishacommun

icati

onplantoensurethatoutcomesfrom

thesena

tiona

lmee

tingsarecom

mun

icated

moreeff

ectiv

elyacrossth

eDire

ctorate.

Clearg

uide

linesand

agency

represen

tatio

nexistforallmajor

natio

nalcom

mittee

san

dorganisatio

ns.R

espo

nsibilitie

s

areclearlyarticulated

to

relevantexecutiv

es.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

9.The

Com

mitteere

commen

dsth

at

theGovernm

ento

fthe

daydetailto

theAC

TLegislati

veAssem

bly,atthe

earliestp

ossibleop

portun

ity,how

it

willadd

ressand

improveissues

abou

tachievemen

tsagainst

throug

hputand

triageta

rgets

asth

eyre

lateto

theEm

ergency

Dep

artm

entatthe

Canbe

rraHospital

Agree

d.

Thede

tailedplan

toadd

ressissuesinre

latio

ntoaccesstoemergencyde

partmen

tsand

improving

performan

cewasta

bled

onthelastsitti

ngdayinM

arch201

3.

Completed

.The

MinisterforHealth

tabled

theED

accessplan

inth

eAC

TLegislati

veAssem

blyinM

arch201

3.

10.The

Com

mittee

recommen

dsth

at

clearg

uide

linesbeestablishe

dconcerning

internal

commun

icati

onbetwee

nthe

AC

THealth

Dire

ctorate,th

eCa

nberraHospitaland

Calvary

PublicHospital.

Noted

.

Thereareanu

mbe

rofformalcom

mittee

mee

tingsth

atensurevisibilityan

dclarity

onissuesaffe

cting

all

facetsofthe

Health

Dire

ctoratean

dCa

lvaryPu

blicHospital.

Am

onthlyFinan

ceand

Perform

ancem

eetin

gha

sbe

enestab

lishe

dtodiscussm

attersrelatin

gtoactivity

andfin

ancialpressuresexperienced

byCa

lvaryPu

blicHospital.Adm

inistrati

veofficersfrom

Health

and

Ca

lvaryatt

endtheforumand

wereap

plicab

le,itemsdiscussedthatareofcon

cerncan

befurthe

rraisedat

regu

larN

etworkCo

mmittee

mee

tingsfo

rresoluti

on.

TheAC

THealth

Dire

ctoratean

dCa

lvaryHealth

CareAC

Thaveestab

lishe

daNetworkAg

reem

enttoclarifyth

erelatio

nshipbe

tweentheHealth

Dire

ctoratean

dCa

lvaryPu

blicHospital.Asparto

fthis,are

gularm

eetin

gbe

tweenbo

thenti

tiesoccursaswellasaform

alm

onthlym

eetin

gbe

ingestablishe

dbe

tweenbo

thpartie

sto

discussissuesre

latedtopressuresand

activity.Thisprovidesth

eba

sisforthe

relatio

nshipbe

tweenen

tities

andprovidesclearguide

linesinre

latio

ntocom

mun

icati

onbetweenpa

rties.

System

sareinplace.The

Calvary

NetworkAgree

men

tCom

mittee

providesfo

rhigh-level

commun

icati

onbetwee

nen

titiesand

theFina

ncean

dPe

rforman

ce

Committee

provide

sform

ore

detailedop

erati

onalm

attersto

bediscussed

.

11.The

Com

mittee

recommen

dsth

at

clearg

uide

linesbeestablishe

dconcerning

externa

lcommun

icati

onre

gardingmatt

ers

concerning

the

AC

THealth

Dire

ctorate,th

e

Canb

erraHospitaland

Calvary

PublicHospital.

Agree

d.

TheHealth

Dire

ctorateworkswith

ara

ngeofnati

onalorgan

isati

onsan

dcommittee

stoensurethatour

inform

ation

iscon

sisten

twith

nati

onalguide

linesand

stand

ards.Thisinclud

esre

presen

tatio

non

Co

mmittee

sestablishe

dbyth


ealth

and

Welfare,the

Nati

onalHealth

Perform

ance

Autho

rity,sub

-com

mittee

softh

eAustralianHealth

Ministers’A

dvisoryCo

unciland

mee

tingsarran

gedby

theCO

AGReformCou

ncilinre

latio

ntohealth

matt

ers.

TheHealth

Dire

ctoratewillestab

lishacommun

icati

onplantoensurethatoutcomesfrom

thesena

tiona

lmee

tingsarecom

mun

icated

moreeff

ectiv

elyacrossth

eDire

ctorate.

Clearg

uide

linesand

agency

represen

tatio

nexistforallmajor

natio

nalcom

mittee

san

dorganisatio

ns.R

espo

nsibilitie

s

areclearlyarticulated

to

relevantexecutiv

es.

Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

12.The

Com

mittee

recommen

dsth

at

theGovernm

ento

fthe

daydetail

toth

eAC

TLegislati

veAssem

bly,

at th

e ea

rlie

st p

ossi

ble

oppo

rtun

ity,w

hata

ction

the

Health

Dire

ctorateha

stakento

assesswhe

theraprevailing

organisatio

nalcultureatthe

Ca

nberraHospitalcon

tributed

to

thecircum

stan

cessurrou

nding

thealteratio

nan

dmisrepo

rting

of

performan

ceinform

ation

.

Agree

d.

Asaresultoffind

ingsofd

ataalteratio

natCan

berraHospitalemergencyde

partmen

t,th

eHealth

Dire

ctoratecommission

edtw

oau

ditrep

orts,p

arto

fwhichinvolved

theassessmen

tofreasoning

beh

ind

thene

edto

tampe

rwith

thisdata.The

outcomeofth

eseassessmen

tscan

befoun

dinth

eAud

itRe

port

cond

uctedbyPWC.

Inadd

ition

,the

Health

Dire

ctoratecond

uctedthe4thinaseriesoforgan

izati

on-w

ideWorkplaceCulture

Surveysoverth

epe

riod

19March–11April20

12.Thisfollowed

surveyscon

ducted

in200

5,200

7an

d20

09,eachofwhichwasusedtoiden

tify,promotean

dtracktheou

tcom

esofkeydevelop

men

tinitia

tives

acrossth

eorganisatio

n,aswellasspecificactiv

itieswith

indivisions/branche

san

dworkareas.The

surveys

areun

dertaken

byan

inde

pend

ento

rgan

isati

on,w

hichprovide

sforb

enchmarking

againstsim

ilarservices

acrossth

ena

tion.The

surveyscoverara

ngeofissuesre

latin

gtostaffm

anagem

entincluding

respon

sesto

questio

nsinre

latio

ntotraining

and

edu

catio

n,bullyingan

dha

rassmen

t,te

amdynam

ics,staffm

anagem

ent

andlead

ership.

The20

12surveyha

darespon

sera

teof5

5%,w

ith316

1staff

com

pleti

ngth

esurvey.Thisisth

ehigh

est

respon

sera

teth

eorganisatio

nha

sachieved

and

isstatisticallysignifican

tlyabo

veaveragecom

paredwith

similaro

rgan

isati

onsna

tiona

lly.

Theoverallculturehasstead

ilyim

proved

and

isabo

veaveragecom

paredwith

governm

entp

ublichealth

carenorms.

The‘Employee

Qua

lityofW

orking

Life

’ind

ex(w

hichisextracted

from

thegene

ralstaffsurveyno

tedab

ove)

whichcon

side

rsabroad

rang

eoffa

ctors(in

clud

ingjobsatisfaction

,workplacevalue

s,te

amnorms,and

man

agem

enta

ndlead

ershipskills)h

assim

ilarlyshow

nsign

ificantim

provem

entsand

placestheHealth

Dire

ctorate15

%abo

vegovernm

entp

ublichealth

careno

rms.

Training

,rep

ortin

gan

dpe

rcep

tionsofh

owbullyingan

dha

rassmen

tcom

plaintsareman

aged

sho

wed

som

eofth

ebiggestimprovem

ents.

Thede

tailedresultsand

ana

lysisofth

e20

12W

orkplaceCultureSurveyareused

tocon

side

rthe

priority

areasoffo

cusatboththeorganisatio

nleveland

atd

ivision/bran

ch/unitlevels.

Improvingtheworkplaceenviro

nmen

tand

respon

ding

tofe

edba

ckfrom

staffisacorerespon

sibilityofth

eAC

TGovernm

enta

san

employer.

Completed

.Are

spon

seisprovide

din

thego

vernmen

t’ssub

mission

toth

eassembly.The

respon

senoted

the

workun

dertaken

toassess

organisatio

nalcultureand

systemsin

placetoadd

ressissuesra

ised

from

thatassessm

ent.

13.The

Com

mittee

recommen

ds

that,given

theHealth

Dire

ctorate’sfailu

reto

protectth

eprivacyofth

eExecuti

vewho

ad

mitted

toalte

ring

data—

prior

to a

ny c

ivil,

cri

min

al o

r ad

ministrati

veproceed

ings—

theHealth

Dire

ctorateshou

ld:

(i)issueapu

blicapo

logyto

the

individu

alcon

cerned

;and

(ii)take

approp

riatestep

stoackno

wledg

etheindividu

al’scon

tributi

onsto

theop

erati

onand

adm

inistrati

on

ofth

eCa

nberraHospital.

Noted

.

Thena

mingofth

eExecuti

vewho

adm

itted

faultforalte

ring

emergencyde

partmen

tdataatCan

berra

Hospitalw

asunfortuna

te.Itw

asnotth

eintenti

onofthe

ACT

Governm

entH

ealth

Dire

ctorate,orthe

ACT

Governm

enttoha

veth

isperson’sna

merevealed

,alth

ough

legaladviceindicatedthatth

erewasnoreason

towith

holdth

estaff

mem

ber’sna

me.

ThisExecutiv

eha

dalong

stan

ding

caree

rinHealth

includ

ingworking

asaClinicalNurseCon

sulta

nt,a

Dire

ctorofN

ursing

ofC

anbe

rraHospitalEmergencyDep

artm

ent,beforecommen

cing

asExecuti

veDire

ctor,

CriticalC

areDivision.Itisunfortuna

teth

atth

eha

rdworkan

dcommitm

ento

fthisindividu

alovera

long

pe

riod

hasbee

novershad

owed

bymorerecentevents.

Thego

vernmen

t’ssub

mission

toth

ePu

blicAccou

ntsCo

mmittee

noted

thecareerofthe

personinque

stion

.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

14.The

Com

mittee

recommen

dsth

at

theCo

mmission

erfo

rPub

lic

Adm

inistrati

on,inconsultatio

nwith

ACT

Governm

ent

directoratesand

agencies,

developawho

le-of-go

vernmen

tpo

licyforthe

man

agem

ento

fprivateinform

ation

relatin

gto

ACT

Publ

ic S

ervi

ce e

mpl

oyee

s

andrecipien

tsofA

CT

Governm

entservices.

Agree

d.

TheDire

ctor-Gen

eralhaswritten

toth

eCo

mmission

erfo

rPub

licAdm

inistrati

onand

isawaitin

garespon

se

onth

ism

atter.

TheCo

mmission

erfo

rPub

lic

Adm

inistrati

onisdevelop

ingan

ap

proa

chinre

latio

ntoth

ism

atter

(The

ACT

Health

Dire

ctor-Gen

eral

wroteto

theCo

mmission

erin

Septem

ber2

013no

tingthis

recommen

datio

n).

15.The

Com

mittee

recommen

dsth

at

theGovernm

ento

fthe

day

shou

ldinform

theAC

TLegislati

ve

Ass

embl

y, a

t the

ear

liest

pos

sibl

e op

portun

ity,ifthe

emergency

accessta

rgetsun

derthe

Nati

onal

Partne

rshipAgree

men

ton

ImprovingPu

blicHospital

Services,w

illnotbereache

dby

theCa

nberraHospitalforth

e20

12calen

dary

ear.

Agree

d.

PublicHospitalsacrosstheAC

Tha

vebee

nworking

hardtoim

provetheTerrito

ry’sperform

anceagainstth

eNati

onalEmergencyAccessTargets.The

initialinfrastructurere

quire

dtoincreaseemergencyde

partmen

tan

dinpa

tientcap

acity

willnotbecompleted

unti

l201

3,and

thereha

vebee

nde

laysinim

plem

entin

gne

w

processestoim

provepa

tientflow

s.

Inth

emeanti

me,neitherCan

berraHospitalnorth

eAC

Tasawho

lehavereache

dthe64

%ta

rget.(forthe

prop

ortio

nofpeo

plewith

anem

ergencyde

partmen

tlen

gthofstayoflessth

anfo

urhou

rs)toachieve

rewardfund

ingforthe

Nati

onalEmergencyAccessTargetin201

2.Currentindicatio

nsfrom

the

Common

wealth

Dep

artm

ento

fHealth

and

Ageingarethatth

eAC

Tisnotalone

inth

isre

sult.

Thecurren

tDep

utyDire

ctor-Gen

eral,C

anbe

rraHospitaland

Health

Servicesisre

view

ingtheprojects

unde

rwayinorderto

estab

lishacleara

ndcoo

rdinated

app

roachacrossth

een

tireho

spita

ltoredu

ceth

eba

rrierswhichcreatede

laysand

resultinsystemblockages.

Inadd

ition

,the

emergencyde

partmen

tatC

anbe

rraHospitalhasim

plem

entedsomerecentinitiati

vesthat

willassistinim

provingpe

rforman

cein201

3,includ

ing:

•‘fron

tloa

ding

’—aconcep

tthate

nablestreatm

entspa

cestobeavailabledu

ringpe

akhou

rsofthe

day

whe

repati

entscan

beassessed

and

treatedbyanED

doctorm

orerapidly;

•Th

eexpa

nsionofth

eCa

nberraHospitalD

ischargeLou

nge.Thisen

ablespa

tientstoleavetheinpa

tient

wardsearlier,freeingup

inpatie

ntbed

san

dallowingforincreased

accessfrom

theem

ergencyde

partmen

t;•Establish

ingcriterialeddischargetoprovidebett

eraccesstoinpatie

ntbedsb

yeliminatingdelays.

TheNati

onalHealth

Perform

anceAutho

rityre

leased

the20

11–1

2MyH

ospitalsre

porton14

Decem

ber

2012

.The

repo

rtsho

wed

thatbothCa

nberraHospitaland

CalvaryPub

licHospitalw

erepe

rformingator

abovethena

tiona

laverageagainstotherpee

rhospitalsinte

rmsofNEATpe

rforman

ce.

Completed

.The

assem

blywas

inform

edth

atth

eAC

Tdidno

tmee

tthe20

12NEATtarget.

16.The

Com

mitteere

commen

dsth

at

the8thAC

TLegislati

veAssem

bly

Stan

dingCom

mitteeonPu

blic

Accoun

tssho

uldgivedue

considerati

onto

con

ductingan

inqu

iryintoth

eprocessoffu

ture

deliveryofhealth

careservices

acrossth

eCa

nberraHospitaland

Ca

lvaryPu

blicHospital.

Noted

.

Thisisam

atterfo

rthe

Com

mittee

.

Thisisam

atterfo

rthe

new

Pub

lic

Accou

ntsCo

mmittee

.


Stan

ding

Com

mit

tee

on H

ealt

h, A

gein

g, C

omm

unit

y an

d So

cial

Ser

vice

sRe

port

No.

Titl

eD

ate

pres

ente

d

Ann

ualand

Finan

cialRep

orts201

1–20

12Co

mpleted

16May201

3.

Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

6.Tha

tthe

MinisterforHealth

provide

theCo

mmittee

with

ade

tailedup

dateofe

achhe

althinfrastructureproject

curren

tlyund

erwayorinplan

ning

by30

June

201

3.

TheGovernm

entrespo

nseisstillbeing

develop

edasat

30Ju

ne201

3.Th

ede

tailedup

datewasprovide

ddirectlyto

thecommittee

.

Sele

ct C

omm

itte

e on

Est

imat

es 2

012–

13Re

port

No.

Titl

eD

ate

pres

ente

d

1App

ropriatio

nBill20

12–2

013an

dApp

ropriatio

n

(Officeofthe

Legislativ

eAssem

bly)Bill201

2–20

13Co

mpleted

14Aug

ust2

012.

Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

28.The

Com

mittee

recommen

ds

that

the

ACT

Gov

ernm

ent c

onsu

lt with

Param

edicsAustralia

regardingregistratio

nof

paramed

icsasparto

fthe

Nati

onalHealth

Practitio

ners

Registratio

nSche

me.

Agree

d.

TheHealth

Dire

ctoratean

dtheAC

TAmbu

lanceServiceha

salread

yconsultedwith

Param

edicsAustraliainre

latio

ntore

gistratio

nop

tionsof

paramed

icsan

dwillcon

tinue

tocon

sultwith

them

unti

laNati

onal

decision

ism

ade.

TheAC

TParamed

icsRe

gulatio

nProjectC

onsulta

tionForumwasheld

on

24July201

2.Param

edicsAustralasiaatten

dedthisfo

rumand

provided

inpu

t.

Acop

yofth

eParamed

icsAustralasiaR

ole

Des

crip

tors

for P

aram

edic

s in

A

ustr

alia

and

New

Zea

land

wascirc

ulated

toACT

param

edic

stakeh

olde

rsinFeb

ruary20

13.

ACTHealth

isawaitin

gthefin

aldraftofthe

decisionRe

gulatoryIm

pact

Statem

enttobe

provide

dforc

irculati

onand

com

men

t.

•From

July201

2toJa

nuary20

13,n

ation

alcon

sulta

tionwasund

ertaken

tocon

side

rthe

AHMAC

con

sulta

tionpa

per‘Opti

onsforregulati

onof

paramed

ics’.

•Re

presen

tativ

esfrom

Cou

ncilofAmbu

lanceAutho

ritie

s(CAA)m

embe

rorganisatio

nsatten

dedconsultatio

nforumsineachstatean

dterrito

ry

andawritten

sub

mission

wasm

adebyCAA.

•AH

WMCrequ

estedad

vicefrom

theHWPC

ontheprop

osalto

includ

epa

ramed

icsasaprofessioninth

enatio

nalschem

e.

Thede

cision

RegulatoryIm

pactStatemen

tisstillbe

ingde

velope

dbyth

ePractiti

onerRegulati

onSub

committee(P

RSC),onbe

halfofth

eHWPC

,for

ministersto

con

side

rwhe

therre

gulatorycha

ngeisre

quire

d.

29.The

Com

mittee

recommen

ds

thatth

eAC

TGovernm

entd

etail

toth

eLegislati

veAssem

blythe

scop

ean

dtim

etab

lefo

rallthe

e-he

althinitiati

ves.

Agree

d.Th

ee-he

althprogram

ofw

orkan

dsche

dulearecurrentlybeing

upd

ated

forthe

201

3–14

fina

ncialyear.Followingcompleti

onofthisup

date,

inform

ation

forthe

201

3–14

fina

ncialyearw

illbeprovided

toth

eassembly.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

30.The

Com

mittee

recommen

ds

ACTHealth

develop

and

repo

rtto

theLegislati

veAssem

blyon

the

indicatorsitwilluseto

measure

thequ

ality

and

theou

tcom

esof

careprovide

dthroug

hthe

Canb

erraHospitalEmergency

Dep

artm

ent.

Agree

d.

TheGovernm

entw

illprovide

are

portfo

rAssem

blyconsiderati

onnoti

ng

theou

tcom

esofthe

currentprocessesund

erwayto

develop

theba

sis

foro

utcomemeasuresfore

mergencyde

partmen

tcare.Thisprocess

includ

esliaisonwith

stateand

territo

ryhealth

autho

ritie

san

darang

eof

natio

nalbod

ies(suchasth


ealth

and

Welfare

andtheNati

onalHealth

Perform

anceAutho

rity).

Therepo

rtwillnotetheworkne

eded

tofu

llydevelop

,defi

ne,collect

andrepo

rtonan

yprop

osed

measures.

TheGovernm

entw

illalsotaketh

eresultsofthisreview

toCOAG

for

considerati

oninth

eestablishm

ento

fnew

measuresforE

mergency

Dep

artm

entcarewith

inth

eNati

onalPartnershipAgree

men

ton

ImprovingPu

blicHospitalServices.

TheAC

Tislead

ingaprocesstoestab

lishne

wnati

onalemergency

depa

rtmen

toutcomemeasures.The

AustralianHealth

Ministers’

AdvisoryCo

uncilhasend

orsedaprop

osalto

estab

lishaprojectin20

13–

14to

workwith

jurisdictio

nsand

relevantnati

onalbod

iestodevelop

op

tionsfo

rAHMAC

con

side

ratio

nin201

4.Som

eworkha

sbe

en

unde

rtaken

byvariou

sbo

diesacrossAustralia.Thisprocesswillassistin

consolidati

ngeffo

rtsan

dprovidingana

tiona

llycon

sisten

tapp

roachto

EDoutcomemeasuremen

t.

31.The

Com

mittee

recommen

ds

thatth

eAC

TGovernm

ente

ngage

with

localm

idwife

represen

tativ

esto

furthe

rde

velopan

app

ropriatem

odel

fora

stand

-alone

birthcen

tre.

Notagree

d.

Theplan

nedsubacuteho

spita

lontheno

rthside

ofC

anbe

rrawillnot

haveanassociated

norastand

alon

ebirthcentreastherene

edstobe

provisionfore

scalati

onupw

ardtoanacutefacilityforthe

purpo

seof

man

agingob

stetricem

ergencies.

TheCa

nberraHospitalhasabirthcen

trean

dCa

lvaryPu

blicHospitalw

ill

alsobeprog

ressingaconti

nuity

ofm

idwife

rycaremod

elwhichwill

provideim

proved

accesstom

idwife

rycare.

Nofurthe

raction

requ

ired.

32.The

Com

mittee

recommen

dsth

at

theAC

TGovernm

entcon

tinue

stogrowth

eprop

ortio

nofhealth

fund

ingallocatedtom

ental

healthservicestowards12pe

rcentofthe

totalA

CTBud

get.

Agree

d.Th

eAC

TGovernm

entisprog

ressivelyincreasing

thepe

rcen

tageof

healthfu

ndingallocatedtom

entalhealth

services.Thisha

sinclud

eda

minim

umann

ualallo

catio

nof$1millioninm

entalhealth

growth

fund

ingineachofth

elasteightbud

gets,aswellasconstructio

nan

drunn

ingcostsofanew

Adu

ltMen

talH

ealth

Inpa

tientUnita

ndM

ental

Health

Assessm

entU

nita

tthe

Can

berraHospital.

TheAC

TGovernm

entthrou

ghth

eALP–G

reen

sParliamen

taryAgree

men

ton

Governm

enth

ascom

mitted

to$35

millionform

entalhealth

overthe

term

ofthe

eighthLegislati

veAssem

bly.Thiswillsup

portadd

ition

al

adulta

ndolderpersonsand

new

ado

lescen

tmen

talhealth

inpa

tient

beds,asecuremen

talhealth

unit,add

ition

alcom

mun

itym

entalhealth

servicesinboththepu

blicand

com

mun

itysector,youth-specificmen

tal

healthservicesan

dsuicidepreven

tion-specificfund

ing.

Duringtheterm

ofthe

eighthLegislati

veAssem

blythefullroll-ou

tofthe

Nati

onalDisab

ilityInsuranceSche

mewillcom

eintoeffe

ctinth

eAC

T.This

willaffe

ctservicescurren

tlyprovide

dthroughtheHealth

bud

get,suchas

non-clinicalsup

ported

accom

mod

ation

,outreachsupp

orta

ndvocati

onal

training.The

rewillbesignificantopp

ortunityfo

rmorepe

oplewith

serious

anden

durin

gmen

talillnesstoaccessthesewith

inth

einsurance-ba

sed

system

.The

currentm

entalhealth

fund

ingforthe

seserviceswillneedto

moveintoth

eAC

TNDISfu

ndingpo

oland

hen

ceim

pactontheap

parent

percen

tageofh

ealth

fund

ingallocatedtom

entalhealth

.

TheCo

mmon

wealth

hasalsodirectlyfu

nded

outreachan

dcentre-based

men

talhealth

servicesinth

eAC

Tthatotherwise(e.g.inNew

Zealand

)wou

ldhavebe

encou

nted

inth

eAC

Tmen

talhealth

bud

get(Person

al

Helpe

rsand

Men

tors,Pha

MS,and

Day-to-DayLivingprograms).


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

33.The

Com

mittee

recommen

dsth

at

theAC

TMinisterforHealth

repo

rtto

theLegislati

veAssem

bly

onwha

tlevelofin-pa

tient

serv

ices

the

ACT

Gov

ernm

ent

providesto

adu

ltssuff

ering

eatin

gdisorders,and

whe

re

ACTreside

ntsgo

ifth

eynee

da

high

erlevelofservice.

Agree

d.Inpa

tientservicesareprov

ided

forad

ultssuff

eringfrom

eati

ng

disordersinthe

med

icalwardsofb

oththeCa

nberraHospitaland

Ca

lvaryHospital(toena

blemed

icalsup

portfo

rtheseclients).Interm

sofm

entalh

ealthcareand

sup

port,clie

ntsaread

mitted

toW

ard2N

at

CalvaryHospital.Otherin

patie

ntservicesareprov

ided

inthe

private

sectorin

boththeACT

and

New

Sou

thW

ales.A

llservicesatthese

faciliti

esarevolun

taryadm

ission

s.

34.The

Com

mittee

recommen

dsth

eAC

TGovernm

enta

dvisethe

Legislati

veAssem

blywhichlocal

drug

and

alcoh

olserviceswillbe

redu

cedasare

sultofcutsin

Common

wealth

fund

ing,and

wha

tstrategieswillbe

implem

entedtocop

ewith

the

unmetclientnee

dcaused

by

theseredu

ction

s.

Notagree

d.

Thism

attersho

uldbe

referred

toth

eCo

mmon

wealth

Governm

ent.

Nofurthe

raction

requ

ired.

35.The

Com

mittee

recommen

ds

thatallAlexand

erM

acon

ochie

Centredetaine

eswith

Hep

atitisChavetim

elyaccessto

Hep

atitisCtreatm

ent,ifth

ey

haveth

egene

and

bod

yweigh

tthatm

akesth

emtreatablewith

thistreatm

ent.

Agree

dinprinciple.

JusticeHealth

Servicescurren

tlytreats10pe

oplefo

rHep

atitisC

infection

ata

nytime.Aspa

rtofthe

treatm

entp

rotocol,pa

tientsconsen

ttoserialtestin

gforH

epati

tisCvirus.A

dmission

togainaccessto

the

treatm

entp

rogram

includ

esanun

derstand

ingof,and

acom

mitm

entto,

completetreatm

ent;are

ason

ablebod

ymass(asob

esity

isapredictor

ofpoo

rtreatmen

trespo

nse);and

thespecificgeno

type

ofthe

person’s

virus(gen

otypes2and

3havebe

ttertreatm

ento

utcomes).

Potenti

alpati

ents‘awaitin

gassessmen

tforth

etreatm

entp

rogram

s’and

those‘awaitin

gad

mission

toth

etreatm

entp

rogram

’arem

onito

redwith

liverfu

nctio

ntestingatp

eriodsbetweensixan

d12

mon

ths.Ifth

ereisa

chan

geinseverity

ofthe

secon

darylivere

ffects,th

enre

-prio

ritisatio

noccurs,inconsultatio

nwith

thegastroen

terologyclinicatthe

Can

berra

Hospital.Th

isiscon

sisten

twith

com

mun

itystand

ards.

36.The

Com

mittee

recommen

dsth

at

ane

edleand

syringeprogram

be

trialledinth

eAlexand

er

Mac

onoc

hie

Cent

re s

o as

to

preven

tfurtherspreadofblood

bo

rnediseases.

Agree

d.

On15

thAug

ust2

012,th

eCh

iefM

inisterreleasedadraft

blood

borne

virusman

agem

entstrategyforthe

Alexand

erM

acon

ochieCe

ntrewhich

includ

esapropo

salfordetaine

esto

begivenregu

latedaccessto

sterile

injecting

equ

ipmen

tona‘one

-for-one

’excha

ngeba

siswith

themed

ical

officerh

avingrespon

sibilityforthe

equ

ipmen

texcha

nge.

Consultatio

nwith

indu

strialorgan

isati

onson

theprop

osed

mod

elfo

rim

plem

entatio

nwillcom

men

ceim

med

iatelyto

workthroug

han

yconcernsre

latedtoth

emod

eland

tosee

kagreem

entw

ithaviewto

the

exchan

gebeing

implem

entedin201

3.

Consultatio

nisong

oing

.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

37.The

Com

mittee

recommen

dsth

eAC

TGovernm

enttakegreatersteps

tota

rgetanti

-smok

ingcampa

igns

andprog

ramstolowincomean

dvulnerab

lepeo

ple.

Agree

dinprinciple.

TheHealth

Dire

ctoratewillexploreopti

onswith

initscurren

tcam

paigns

andprog

ramstota

rgetlowincomean

dvulnerab

lepeo

ple.

On31

May201

3theMinisterforHealth

laun

ched

Fut

ure

Dire

ction

s fo

r To

bacc

o Re

ducti

on 2

013–

2016

.FutureDire

ction

sinform

stheCa

nberra

commun

ityofthe

12initiati

vesprop

osed

byAC

THealth

into

bacco

control.Th

eseinitiati

vesaimto

investigatere

stricting

accesstoto

bacco

tore

ducedem

andan

dcontrolsup

ply,and

restrictplacesofto

baccouse.

Theareasthatwillbelooked

atinclude

outdo

orareasatp

ublic

swim

mingpo

olsan

dchild

ren’splaygrou

nds,amon

gman

yothe

rs,w

here

measurescouldbe

takentore

ducesmok

ingan

dprotectn

on-smokers

from

theeff

ectsofe

nviro

nmen

taltob

accosmoke.

TheAC

TGovernm

entcom

mitted

add

ition

alfu

ndinginth

e20

13–1

4bu

dgetto

ena

bleconti

nued

implem

entatio

nofth

eAC

TAbo

rigina

land

TorresStraitIslan

derTob

accoCon

trolStrategy,includ

ingde

liveryofth

eBe

yond

Tod

aycam

paign.

Beyond

Tod

ayisasocialm

arketin

gcampa

ignde

velope

dbyth

eHealth

Dire

ctoratetoencou

rageth

eup

takeofh

ealth

ylifestylebeh

avioursan

dsm

okingcessati

onamon

gAbo

rigina

land

TorresStraitIsland

er

commun

itiesinth

eAC

T.

Thede

velopm

ento

fthiscampa

ignha

sbe

eninclosecollabo

ratio

nwith

thepo

licydivision

’sAb

originaland

TorresStraitIsland

erUnita

nditisakey

compo

nentof:theAC

TGovernm

entH

ealth

Dire

ctorate’s

Abor

igin

al a

nd

Torr

es S

trai

t Isl

ande

r Tob

acco

Con

trol

Str

ateg

y 20

10–1

1 to

201

3–14

;the

AC

T Im

plem

enta

tion

Plan

for t

he C

OAG

Nati

onal

Par

tner

ship

Agr

eem

ent

on C

losi

ng th

e G

ap in

Abo

rigin

al a

nd T

orre

s St

rait

Isla

nder

Hea

lth

Out

com

es;and

theAC

TGovernm

entH

ealth

Dire

ctorate’sIm

plem

entatio

nPlan

forthe

nati

onalM

easureUpcampa

ignun

derthe

Nati

onal

Partne

rshipAg

reem

ento

nPreven

tiveHealth

.

Thecampa

ignwaslaun

ched

inDecem

ber2

012.

ACTHealth

,throu

ghaservicefu

ndingagreem

ent,con

tinue

dtoprovide

fund

ingtoW

innu

ngaNim

mity

jahAbo

rigina

lHealth

Servicefo

rdelivery

ofam

ulti-compo

nentsmok

ingcessati

onand

redu

ction

program

based

on

family,socialand

workplacenetworks.

From

1Ja

nuary20

12th

ereha

sbe

enasmoke-free

enviro

nmen

tinthe

DivisionofM

entalH

ealth

,JusticeHealth

and

Alcoh

oland

DrugServices.

Thisinclud

esinpa

tientareassuchasth

eAdu

ltMen

talH

ealth

Unit,th

eAlcoh

oland

DrugsW

ithdraw

alUnit,th

eBrianHen

nessyRe

habilitati

on

Centreand

theMen

talH

ealth

Assessm

entU

nit.The

aim

of

implem

entin

gasm

oke-free

enviro

nmen

tistoprovide

ahealth

yan

dsafe

environm

entforallem

ployee

s,pati

ents,visito

rsand

con

tractors.

TheHealth

yCo

mmun

itiesIn

itiati

veisata

rgeted

cam

paignfocusing

on

betterhealth

forlow

socioecon

omiccom

mun

ities,w

hichinclud

es

encouragingsm

oke-free

beh

aviours.W

orkisalsobe

ingun

dertaken

in

capa

citybuildingfora

llied

health

staff,suchaspod

iatrists,inshort

smok

inginterven

tionsfo

rthe

irpati

ents.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

38.The

Com

mittee

recommen

ds

that

the

ACT

Gov

ernm

ent

developamen

’shealth

plan

an

dap

prop

riateassociated

literaturetoim

provemen

’s

healthinth

eAC

T.

Agree

dinprinciple.

TheAC

TGovernm

entissupp

ortin

gmen

’shealth

issuesinline

with

a

natio

nalm

en’shealth

policystatem

enta

ndspe

cificallyinth

eAC

Tacross

thesuite

ofe

xisting

health

strategiesan

dplan

s,includ

ing:Tow

ardsa

Health

ierA

CT201

0–15

,ACT

Chron

icDiseasesStrategy200

8–11

(und

er

revision

),AC

TCo

rrectio

nsHealth

Plan20

08–1

2,M

anagingtheRiskof

Suicide20

09–1

4,and

theAC

TPrim

aryHealth

CareStrategy201

1–14

.

TheAC

TCh

ronicCo

ndition

sStrategyhasbee

nup

datedfor2

013–

18.

39.The

Com

mittee

recommen

dsth

at

theAC

TGovernm

entp

rovide

the

Legislati

veAssem

blywith

acop

yofth

erepo

rtonthereview

of

Lymph

oede

maservicesassoon

asitisavailable.

Agree

d.

Thisre

portwascom

mission

edbyCa

lvaryHealth

Careandrelatedlargelyto

theservicesprovide

datCalvary.The

Territoryisworkingwith

Calvaryand

theMed

icareLocaltode

term

inewaystoprovide

bestp

racticeservicesto

consum

ers.The

outcomeofth

isworkwillbeprovided

toth

eMinistera

nd

therepo

rtand

recommen

datio

nswillbeprovided

toth

eAssembly.

Therepo

rthasbee

nprovided

toth

ecommittee

.The

Health

Dire

ctorate

isprepa

ring

are

spon

seto

thisre

port,w

hichwillinclud

erecommen

datio

nsfo

rprogressing

thene

edto

mee

tunm

et

lymph

oede

made

man

d.

40.The

Com

mittee

recommen

dsth

eAC

T G

over

nmen

t est

ablis

h m

ore

timelyad

ministrati

onprocesses

forH

omean

dCo

mmun

ityCare

grow

thand

inde

xatio

nfund

s.

Agree

d.

30Ju

ne201

2markedtheen

dofth

ena

tiona

ljointfu

ndingprog

ramfo

rHealth

and

Com

mun

ityCare.Afterth

atdate,th

eAC

Tbe

came

respon

sibleforservicestoCan

berran

sun

der6

5yearsofage(a

nd

Abo

rigina

land

TorresStraitIsland

erpeo

pleun

der5

0years).

Adm

inistrati

onprocessesincon

junctio

nwith

theseserviceswill

conti

nuetoberefin

edoverthe

com

ingyear.

Thefulllevelofcom

mun

ityCPIhasbee

npa

idto

NGOsfund

edund

erth

eAC

THAC

CProg

ram,w

itheffe

ctfrom

1Ju

ly201

3.

Anew

Sched

uleBofth

eNPA

outlin

ingcross-billing

arran

gemen

tsfo

r20

12–1

3wasissued

on14

June

201

3.The

new

sched

ulewasend

orsed

byth

eCh

iefM

inistero

n19

June

201

3.Due

toth

elateadviceregarding

thequ

antumofg

rowthfu

ndsavailableun

derthe

NPA

,the

rewas

insufficien

ttimetoallo

catefu

ndsviaan

ope

ntend

erprocessand

ensure

thefund

swereallocatedtocom

mun

ityserviceprovide

rsbefore30

June

20

13.A

decisionwasm

adetoutiliseun

allocatedAC

THAC

Cgrow

th

fund

sfor2

012–

13ason

e-off

fund

ingin201

3–14

todevelop

and

im

plem

enta

coo

rdinated

servicere

spon

sefo

rpati

entd

ischargeta

rgeted

atth

eun

der-65

s.

Theam

ountofg

rowthfu

ndsavailablefor2

013–

14and

thetim

ingofany

fund

ingprocessarede

pend

ento

nfin

alisati

onofthe

NPA

.Negoti

ation

sbe

twee

nthestatesand

territo

riesand

theCo

mmon

wealth

willcon

tinue

todevelop

aSched

uleBtore

flectfu

ndingmovem

entswith

greater

accuracy.U

nderth

eNPA

,201

3–14

isth

efin

alyearo

fcross-billing.

41.The

Com

mittee

recommen

dsth

at

theAC

TGovernm

entd

evelop

a

long

-termstrategyforthe

provisionofstafffo

rgeriatrician

servicesinth

eAC

T.

Agree

d.Th

ereisstillasho

rtageofgeriatriciansinAustraliasuchthatithasbee

ndifficulttore

cruitsuffi

cien

tspe

cialiststafffrom

othercities.

Regu

lara

dvertisingofposition

sha

sconti

nued

,with

anew

adpe

nding

inJu

ly201

3.

Throug

htraining

and

men

toring

,acaree

ringeriatricmed

icinewillbe

prom

oted

toJM

Ostaffand

med

icalstude

nts.

TheDep

artm

ento

fGeriatricM

edicineha

sreceived

aBestC

linicalUnit

forTeachingno

minati

onfrom

ANUM

edicalSchoo

lforth

epa

stth

ree

yearsan

don

one

occasionwon

theaw

ard.

In201

3werecruitedthreeAdvan

cedTraine

esinGeriatricM

edicinean

dha

veothersinterested

for2

014.W

eareexpe

cting

thatsom

ewillm

ove

tolong

-termspe

cialistcaree

rsinth

eAC

T.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

42.The

Com

mittee

recommen

dsth

at

the

ACT

Gov

ernm

ent e

stab

lish

a plan

incon

sulta

tionwith

ACT

ION

tore

solvetheprob

lemswith

accessingtheVillageCreek

Centrebypu

blictran

sport.

Agree

dinprinciple.

Therelevantagencieswillcon

tinue

tolook

atw

aystoim

proveaccessto

VillageCreekbypu

blictran

sport.

RACC

con

tinue

dtom

eetw

ithACT

IONand

Com

mun

ityTranspo

rt

providersregardingpu

blictran

sporttoVillageCreekCen

tre.

ACTIONhasnow

sched

uled

easyaccess,w

heelchair-accessiblebusesfo

rthemajority

ofb

ustripson

Rou

te62pa

ssingthecentreonSu

mmerland

Circuit.

Commun

ityTranspo

rtcan

becontactedtoassistc

lientswith

tran

sport.

Scripti

nghasbee

nde

velope

dan

dprovided

toadm

inistrati

onstaffat

VillageCreekCen

tresoth

eycan

sched

uleap

pointm

entsaroun

dclient

tran

sportn

eeds.

TheAC

THealth

VillageCree

kCe

ntreweb

sitehasbee

nreview

edand

providesupd

ated

inform

ation

ontran

sporto

ption

s.

ACTIONhasim

proved

thesafetyofthe

Sum

merland

Crescen

tbusstop

bywiden

ingtheaccesspathan

dinstallin

gsign

agetodire

ctpasseng

ers

toth

ecentre.

Thereha

vebee

nno

dire

ctcom

plaintsreceived

byAC

THealth

relatin

gto

accessto

theVillageCreekCen

trebypub

lictran

sportsinceaW

omen

’s

SafetyAud

itwasund

ertakeninJu

ly201

2.

43.The

Com

mittee

recommen

dsth

eAC

TMinisterforHealth

upd

ate

theLegislati

veAssem

blyon

how

an

dwhe

refu

ndingfrom

the

Nati

onalPartnershipona

Common

wealth

Den

talProgram

willbetargeted

,and

wha

tchan

geswilloccurindelineatio

nofstaffro

les.

Agree

d.

Oncethede

tailisworkedthroug

hwith

theCo

mmon

wealth

are

portwill

beprovide

dtoth

eAssem

bly.

Den

talarestillprogressing

con

sulta

tionswith

theCo

mmon

wealth

regardingtheNPA

implem

entatio

nplan

.Itisen

visagedthiswillbe

finalised

beforetheen

dofth

ecalend

aryear.

44.The

Com

mittee

recommen

dsth

at

the

ACT

Gov

ernm

ent r

epor

t to

theLegislati

veAssem

blywhe

ntheissueofoutstan

ding

em

ployee

enti

tlemen

tsfo

rCa

lvaryPu

blicHospitalstaffis

resolved

,assoon

asthatoccurs.

Agree

d.Th

eHealth

Dire

ctorateha

sreferred

thism

atterto

theCh

iefM

inistera

nd

TreasuryDire

ctoratefora

dvice.Thismatt

erisstillund

ercon

side

ratio

n.

45.The

Com

mitteere

commen

ds

ACTHealth

proactivelyestablish

netw

orksand

relatio

nships

betw

eenmed

icalstaffan

dprivate

midwivesatthe

Can

berraHospital

soastoensurebirthingwom

en,in

theAC

T,can

accessMed

icare

bene

fitsforu

seofapriv

ate

midwifepre-and

post-birth.

Agree

dinprinciple.

TheHealth

Dire

ctorateisliaising

with

theon

eknow

nprivatelypractising

midwife

(PPM

)tofacilitaterelatio

nshipswith

obstetriciansand

tofo

ster

engagemen

tonhe

rmod

elofm

idwife

rycare.Professiona

lInd

emnity

Insuranceexem

ption

forP

PMsha

sno

wbee

nextend

edto

June

201

5an

dworkha

scommen

cedna

tiona

llyto

develop

collabo

rativerelatio

nships

betw

eenPP

Msan

dHealth

Services.

TheAC

TMaternityServicesNetworkmee

tsth

ree-mon

thlyto

progress

theim

plem

entatio

nofju

risdictio

nalaction

sinth

eMaternityServices

Plan

and

otherm

aternityissues,suchasfo

steringcollabo

rativ

earrang

emen

tsbetwee

nob

stetrician

san

dmidwives.

TheOfficeofthe

ChiefNursehasre

centlyallo

catedresourcesto

commen

ceth

eprelim

inaryad

ministrati

vecha

ngessowom

encan

choo

seaprivatem

idwife

rym

odelofcareatth

eCa

nberraHospital.

Th

isworkha

scommen

ced.


Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

42.The

Com

mittee

recommen

dsth

at

the

ACT

Gov

ernm

ent e

stab

lish

a plan

incon

sulta

tionwith

ACT

ION

tore

solvetheprob

lemswith

accessingtheVillageCreek

Centrebypu

blictran

sport.

Agree

dinprinciple.

Therelevantagencieswillcon

tinue

tolook

atw

aystoim

proveaccessto

VillageCreekbypu

blictran

sport.

RACC

con

tinue

dtom

eetw

ithACT

IONand

Com

mun

ityTranspo

rt

providersregardingpu

blictran

sporttoVillageCreekCen

tre.

ACTIONhasnow

sched

uled

easyaccess,w

heelchair-accessiblebusesfo

rthemajority

ofb

ustripson

Rou

te62pa

ssingthecentreonSu

mmerland

Circuit.

Commun

ityTranspo

rtcan

becontactedtoassistc

lientswith

tran

sport.

Scripti

nghasbee

nde

velope

dan

dprovided

toadm

inistrati

onstaffat

VillageCreekCen

tresoth

eycan

sched

uleap

pointm

entsaroun

dclient

tran

sportn

eeds.

TheAC

THealth

VillageCree

kCe

ntreweb

sitehasbee

nreview

edand

providesupd

ated

inform

ation

ontran

sporto

ption

s.

ACTIONhasim

proved

thesafetyofthe

Sum

merland

Crescen

tbusstop

bywiden

ingtheaccesspathan

dinstallin

gsign

agetodire

ctpasseng

ers

toth

ecentre.

Thereha

vebee

nno

dire

ctcom

plaintsreceived

byAC

THealth

relatin

gto

accessto

theVillageCreekCen

trebypub

lictran

sportsinceaW

omen

’s

SafetyAud

itwasund

ertakeninJu

ly201

2.

43.The

Com

mittee

recommen

dsth

eAC

TMinisterforHealth

upd

ate

theLegislati

veAssem

blyon

how

an

dwhe

refu

ndingfrom

the

Nati

onalPartnershipona

Common

wealth

Den

talProgram

willbetargeted

,and

wha

tchan

geswilloccurindelineatio

nofstaffro

les.

Agree

d.

Oncethede

tailisworkedthroug

hwith

theCo

mmon

wealth

are

portwill

beprovide

dtoth

eAssem

bly.

Den

talarestillprogressing

con

sulta

tionswith

theCo

mmon

wealth

regardingtheNPA

implem

entatio

nplan

.Itisen

visagedthiswillbe

finalised

beforetheen

dofth

ecalend

aryear.

44.The

Com

mittee

recommen

dsth

at

the

ACT

Gov

ernm

ent r

epor

t to

theLegislati

veAssem

blywhe

ntheissueofoutstan

ding

em

ployee

enti

tlemen

tsfo

rCa

lvaryPu

blicHospitalstaffis

resolved

,assoon

asthatoccurs.

Agree

d.Th

eHealth

Dire

ctorateha

sreferred

thism

atterto

theCh

iefM

inistera

nd

TreasuryDire

ctoratefora

dvice.Thismatt

erisstillund

ercon

side

ratio

n.

45.The

Com

mitteere

commen

ds

ACTHealth

proactivelyestablish

netw

orksand

relatio

nships

betw

eenmed

icalstaffan

dprivate

midwivesatthe

Can

berraHospital

soastoensurebirthingwom

en,in

theAC

T,can

accessMed

icare

bene

fitsforu

seofapriv

ate

midwifepre-and

post-birth.

Agree

dinprinciple.

TheHealth

Dire

ctorateisliaising

with

theon

eknow

nprivatelypractising

midwife

(PPM

)tofacilitaterelatio

nshipswith

obstetriciansand

tofo

ster

engagemen

tonhe

rmod

elofm

idwife

rycare.Professiona

lInd

emnity

Insuranceexem

ption

forP

PMsha

sno

wbee

nextend

edto

June

201

5an

dworkha

scommen

cedna

tiona

llyto

develop

collabo

rativerelatio

nships

betw

eenPP

Msan

dHealth

Services.

TheAC

TMaternityServicesNetworkmee

tsth

ree-mon

thlyto

progress

theim

plem

entatio

nofju

risdictio

nalaction

sinth

eMaternityServices

Plan

and

otherm

aternityissues,suchasfo

steringcollabo

rativ

earrang

emen

tsbetwee

nob

stetrician

san

dmidwives.

TheOfficeofthe

ChiefNursehasre

centlyallo

catedresourcesto

commen

ceth

eprelim

inaryad

ministrati

vecha

ngessowom

encan

choo

seaprivatem

idwife

rym

odelofcareatth

eCa

nberraHospital.

Th

isworkha

scommen

ced.

Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

Dir

ecto

rate

impl

emen

tati

on

151.Th

eCo

mmittee

recommen

ds

thatth

eAC

TGovernm

ent(a)

repo

rtto

theLegislati

ve

Assem

blyon

itsprop

osed

expe

nditu

reduringthe20

12–1

3fin

ancialyearforalcoh

oland

othe

rdrugservices;and

(b)

clearlystateitspropo

sed

expe

nditu

refo

ralcoh

oland

othe

rdrugservicesinth

ebu

dget

pape

rsfo

rallfutureACT

Bud

gets.

Parta)A

gree

dinprinciple,Partb

)Noted

.

Inre

latio

ntoParta

),theGovernm

entw

illprovide

detailondrug

and

alcoho

lservicesthatarefu

nded

in201

2–13

,how

everaswith

man

yhe

althservicestherewou

ldbecostslin

kedtodrugan

dalcoho

lissue

sthatareembe

dded

inservicesinclud

ingacutecare,chron

icdisease,

intensivecareand

can

cerservices.

Inre

latio

ntoPartb

),theGovernm

entw

illcon

side

rthe

detailtobe

provided

infu

turebud

getp

apersin201

3.Thisconsiderati

onwilladd

ress

theim

pactofthe

agree

dmovetoactivitybased

fund

ingon

thecurren

tou

tputstructurefo

rthe

Health

Dire

ctorate.

Thisinform

ation

wasprovide

dtoth

eSelectCom

mittee

onEstim

ates

2012

–13inJu

ly201

2.See

EstimatesQue

stion

onNoti

ceNo.E12

-124

.

Sele

ct C

omm

itte

e on

Est

imat

es 2

013–

14Re

port

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Titl

eD

ate

pres

ente

d

1Inqu

iryintoApp

ropriatio

nBill20

13–2

014an

dApp

ropriatio

n(Officeofthe

Legislativ

eAssem

bly)Bill201

2–20

13Ong

oing

at3

0June

201

3.

Reco

mm

enda

tion

Gov

ernm

ent r

espo

nse

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ecto

rate

impl

emen

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on

Notapp

licab

le.

Notapp

licab

le.

Notapp

licab

le.


B.4 Legislation report

ThefollowingisalistofalllegislationthattheACTHealthDirectoratewasresponsibleforduringthereportingperiod:

• BloodDonation(TransmittableDiseases)Act1985

• DrugsofDependenceAct1989

• EpidemiologicalStudies(Confidentiality)Act1992

• FoodAct2001

• GeneTechnologyAct2003

• GeneTechnology(GMCropMoratorium)Act2004

• Health Act 1993

• Health(NationalHealthFundingPoolandAdministration)Act2013

• HealthPractitionerRegulationNationalLaw(ACT)Act2010

• HealthProfessionalsAct2004

• HealthProfessionals(SpecialEventsExemptions)Act2000

• HealthRecords(PrivacyandAccess)Act1997

• HumanCloningandEmbryoResearchAct2004

• IntoxicatedPeople(CareandProtection)Act1994

• Medicines,PoisonsandTherapeuticGoodsAct2008

• MentalHealth(TreatmentandCare)Act1994,exceptparts8and9andsections141,142and143

• Public Health Act 1997

• RadiationProtectionAct2006

• Smoke-FreePublicPlacesAct2003

• SmokinginCarswithChildren(Prohibition)Act2011

• SupervisedInjectingPlaceTrialAct1999,exceptsections7,8and13

• Tobacco Act 1927

• TransplantationandAnatomyAct1978.

Thefollowinglegislationwasenactedduringthereportingperiod:

• Health(NationalHealthFundingPoolandAdministration)Act2013.

Thefollowinglegislationisawaitingcommencement:

• FoodAmendmentAct2012,sections7,1112and14.

Section C Legislativeandpolicy-basedreporting221


C.1 Risk management and internal audit

ACTHealth’sAuditandRiskManagementCommitteeChartergovernstheoperationoftheAuditandRiskManagementCommittee.TheAuditandRiskManagementCommitteeplaysanessentialrolebyprovidingassurancetotheDirector-GeneralonACTHealth’sgovernanceandoversightinrelationtoriskmanagement,internalsystemsandlegislativecompliance.

ACTHealth’sAuditandRiskManagementCommittee’sabilitytoconsidertheinternalcontrolenvironment,governanceandriskmanagementactivitiesobjectivelyisfacilitatedbythemixofinternalandexternalmembers,whoareandsupportedbyACTHealth’sManager,InternalAuditandRiskManagement.

ACTHealth’sAuditandRiskManagementCommitteeconsistsoffivemembers:anindependentchair,threeseniorexecutivesfromwithinACTHealthandoneexternalmember.ObserversfromACTHealthandtheACTAuditor-General’sOfficealsoattendmeetings.TheAuditandRiskManagementCommitteeheldfivemeetingsin2012–13.

Thecommittee’sattendancesaresetoutbelow:

Name of member Position Duration Meetings attended

GeoffKnuckey IndependentChair 2 years 5

Ian Thompson DeputyChair 6.5years 5

Tina Bracher Member 2 months 1

JeremyChandler External member 6 months 2

JudiChilds Member 5.5years 3

StephenGoggs Member 10 months 4

Bruce Jones External member 6.5years 3

TheInternalAuditandRiskManagementBranchofACTHealthpromotesandimprovesACTHealth’scorporategovernancebyconductingandcoordinatinginternalaudits,investigationsandmakingrecommendationsforimprovements.ACTHealth’sStrategicInternalAuditProgramfortheperiodfrom1January2012to30June2013isdesignedtoalignwithACTHealth’sstrategicprioritiesandrisks.Theprogramisreviewedregularlytoensurethatitcontinuestobeeffective.

In2012–13,10internalauditassignmentswerecompleted.Twospecialreviewswerealsocommissionedinresponsetoissuesofconcernidentifiedduringtheyear.

AuditfindingsandrecommendationsareratedinlinewithACTHealth’sIntegrated Risk Management Guidelines. Throughouttheyear,theManager,InternalAuditandRiskManagementreporteddevelopmentsinimplementingtheStrategicInternalAuditprogramandimplementationofauditrecommendationstotheAuditandRiskManagementCommittee.

TheAuditandRiskManagementCommitteeisalsokeptinformedonimplementationofrecommendationsmadebytheACTAuditor-General’sOffice,wheretheseapplytoACTHealth.

In2012–13,theACTHealthRiskManagementPolicyandGuidelineswerereviewedinlinewiththeInternationalStandardforRiskManagementAS/NZSISO31000.Thereviseddocumentsclarifythegovernancearrangementsandincludeclearresponsibilitiesandmeasurablekeyperformanceindicators.

AnExecutives’RiskManagementworkshopwasalsoheldin2012–13toreviewthedirectorate’sorganisationalrisks.ACTHealth’sExecutiveDirector’sCouncilisresponsiblefor:

• monitoringtimely,effectivemanagementoforganisationallevelrisks

• managingescalationofriskstoorganisationallevel.


C.2 Fraud prevention

ACTHealthFraudManagementFramework,PolicyandPlangovernthefraudmanagementandpreventionworkacrossACTHealth.DivisionsofACTHealthregularlyundertakefraudriskassessmentstogetherwithintegratedriskassessments.Mitigatingcontrolsareputinplacetoaddressidentifiedfraudthreatsandrisks.TheExecutiveDirectorsareresponsibleformanagingfraudriskintheirrespectivedivisions.

TheACTHealthSeniorExecutiveResponsibleforBusinessIntegrityRisksisrequiredtoprovidereportsonfraudcontrolactivitiestotheAuditandRiskManagementCommitteeatanagreedinterval.

StaffreceivefraudcontrolandpreventiontrainingduringorientationandthroughaneLearningprogram.Managersareprovidedwithfurtherfraudcontrolandpreventioninformationandtrainingduringthemanager’sorientationprogram.Thisissupportedbytargetedinformationthatisprovidedtoalertstafftoresponsibilitiesandprotocolsintendedtoimprovesystemsortomitigateidentifiedfraudthreatsandrisks.

TherewasoneallegationoffraudmadeagainstanACTHealthemployeeduring2012–13.ThisallegationwasinvestigatedbytheCommissionerforPublicAdministration.Followingapreliminaryinvestigation,itwasdeterminedthattherewasinsufficientevidencetoprogresstoaformalinvestigation.


C.3 Public interest disclosure

PublicinterestdisclosureismanagedinACTHealthinaccordancewiththePublic Interest Disclosure Act 2012.ProceduresforactioningpublicinterestdisclosuresarecarriedoutaccordingtotheChiefMinisterandTreasuryDirectorateguidelines.ACTHealth’spublicinterestdisclosurepolicyandproceduresareavailabletoallstaffandthecommunityontheHealthwebsite.TheSeniorExecutiveResponsibleforBusinessIntegrityRiskreceivesdisclosuresanddeterminestheappropriateactioninaccordancewiththeAct.

Ofthesixdisclosuresunfinalisedattheendof2011–12:

• onewasdismissedastheallegationslackedsubstancefollowingthegatheringofpreliminaryevidence

• onewassubjecttoexternalreviewaspartofanAuditor-GeneralPerformanceReview,andrecommendationsfromthatreviewweretranslatedintoanactionplan

• threewerethesubjectofexternalinvestigation,withonerevealingnoevidenceofmisconduct,andtheothertworesultinginfindingsofmisconductandproposeddisciplinaryaction

• onewasdiscontinuedfollowingstaffrelocationsandexits.

Ofthetwomatterswheretheexternalinvestigationfoundmisconductsubstantiated:

• onerelatedtobullyingandharassment,failuretoexercisereasonablecareandskill,andfailuretoabidebylawfuldirections

• theotherrelatedtofailuretoexercisereasonablecareandskillandfailuretoabidebylawfuldirections.

Ineachcasetheeventsdescribedwererestrictedtotheconductofparticularindividualsandnotconsideredtobeahighriskofsystematicrecurrence.

NodisclosuresrelatingtodisclosableconductwerereceivedbyACTHealthin2012–13.


C.4 Freedom of information

The ACT Freedom of Information Act 1989givescitizensalegallyenforceablerightofaccesstoofficialinformationinadocumentaryformheldbyACTMinistersandagencies,exceptwhereanessentialpublicinterestrequiresconfidentialitytobemaintained.ItalsorequiresinformationabouttheoperationsofACTagenciestobemadepubliclyavailable,particularlyrulesandpracticesaffectingcitizensintheirdealingswiththoseagencies.

Section 7 statementSection7oftheACT Freedom of Information Act 1989 requiresallagenciestoprepareandpublishastatementsettingoutthestructure,operationandcategoriesofdocuments.Thisissetoutbelow.

OrganisationACTHealthisresponsibletotheMinisterforHealth,whoappointstheDirector-General.Theagencyisresponsibleforpolicydevelopment,planningandtheprovisionofarangeofhealthservicestobestmeettheneedsofthecommunitywithinthepolicyframeworkandbudgetparameterssetbygovernment.

PowersACTHealthholdsawidevarietyofstatutorypowersrelatingtohealthservicesintheACT.AcomprehensivelistoflegislationunderwhichACTHealthexercisesstatutorypowerscanbefoundinSectionB.4,Legislationreport.

ACTHealthhastheauthoritytodoallthingsthatarenecessaryfortheperformanceofitsfunctions,including:

• thepurchase,saleandleaseofbuildingsandequipment

• theprovisionoffinancialassistance

• enteringintoarrangementswithpeopleorauthoritiesfortheprovisionofhealthservices.

TheChiefHealthOfficerhastheauthoritytogrant,deny,varyandrevokeapplicationsforthesupplyofprescriptiondrugsofdependenceundertheDrugs of Dependence Act 1989.TheChiefHealthOfficeralsoholdspowerstolicenseandinspecthairdressers,boardinghouses,eatinghouses,privatehospitalsandotherestablishments.

The Health Records (Privacy and Access) Act 1997 assistsconsumersofhealthservicestogainaccess totheirmedicalrecordswithouthavingtoapplyundertheFreedom of Information Act 1989.

TheHealthServicesCommissionerholdspowerundertheHuman Rights Commission Act 2005toinvestigateandconciliatecomplaintsaboutprovidersofhealthservices.ConsumerscancontacttheCommissioner’sofficebytelephoning0262052222orcallinginpersonatLevel2,12MooreStreet,CanberraCity,ACT2601.

Categories of documentsACTHealthholdsseveralbasiccategoriesofdocuments,including:

• thosethatarefreelyavailableonrequestandwithoutcharge

• thoseavailableforsale,includingthosethatarepartofapublicregister

• thosethatareexemptundertheFreedom of Information Act 1989(theAct)

• allotherkindsofdocumentsthatmaybemadeavailableundertheAct.


Documents available on requestDocumentsinthiscategoryincludepublicationsproducedbyACTHealthonvariousaspectsofitsactivities. ThesearedistributedfrompubliccountersandlibrariesthroughouttheACTandmayalsobeavailableonthe ACTGovernment’swebsiteatwww.act.gov.au,orACTHealth’swebsiteatwww.health.act.gov.au.

DocumentsofotherkindsthatmaybeavailableundertheFreedomofInformationActare:

a. generalfiles,includinginternal,interdepartmentalandpublicdocuments,minutesofmeetingsofmanagementandothercommittees,agendasandbackgroundpapers,policystatements,financialandstaffingestimates

b. diaries,rostersandworksheets

c. programandpolicyfiles

d. recordsheldonmicrofilm,computerorpaperinconnectionwithspecialiseddivisionalfunctions

e. photographs,videosandfilms

f. financialandaccountingrecords

g. detailsofcontractsandtenders

h. filesonapplicantsandclients

i. recordsofgovernment,includingthemachineryofgovernment

j. leasesanddeedsofagreement

k. databasesrelatingtopersonneladministration,assetsregisters,in-patientmorbiditystatisticsandaccountingsystems

l. mapsandplansofACTHealth’sfacilities,suchashospitalsandhealthcentres,workingplansanddrawingsforproposedbuildingsorfacilitiesunderalterationorconstructionandmapsoftheACTandsurroundingregionusedforplanninganddeliveryofservices.

ACTHealthmayholdmedicalandclientrecordswithinitsmanyfunctionalunits.TheseincludeinpatientandoutpatientrecordsattheCanberraHospitalandhealthcentres’medicalrecordsanddentalrecords.AccesstotheserecordsmaybegainedundertheHealth Records (Privacy and Access) Act 1997.

ACTHealthalsoproduces,forpublicdistribution,anumberofpamphletsandbrochuresrelatingtohealthmattersintheACTandthesurroundingregion.

ACTHealthwillmakeavailableforpurchasedocumentscoveredbysection8oftheFreedom of Information Act 1989.

Freedom of Information procedures and initial contact points ACTHealth’sFreedomofInformation(FOI)officerreceives,monitorsandcoordinatesallrequestsfordocumentsheldbythedirectorate.TheFOIofficerislocatedatLevel3,11MooreStreet,CanberraCity(phone0262051340).TheFOIofficerisavailabletomembersofthepublicfrom9.00amto4.00pmMondaytoFriday(excludingpublicholidays)forthelodgementofrequests.ElectronicrequestscanbesenttoExecutive_Co-ordination_unit@act.gov.au.CopiesofdocumentstowhichaccesshasbeengrantedundertheFOIActmaybeforwardedtotheapplicantormaybeinspectedundersupervisionduringofficehours.

Processing guidelinesAcopyofACTHealth’sFOIprocessingguidelinesisprovidedtotheFreedomofInformationDecisionMakertoassistintheirdeliberations.TheFOIofficerisabletoassistdecisionmakersinallaspectsofprocessingapplications,inaccordancewiththeAct.

www.act.gov.au




Inaccordancewiththewhole-of-governmentpolicy,thedecisionletter,scheduleofdocumentsandtherelateddocumentsaretobemadeavailableinPDFformatontheopengovernmentwebsitewithin15days.Thedecisionmakerwillidentify‘certaininformation’thatisnottobepublishedinaccordancewiththeAct.

NoapplicationfeesarechargedforFOIrequests—howeverACTHealthappliesprocessinginaccordancewiththeAttorneyGeneral(Fees)Determinationforapplicationsthatrequireinexcessof10hoursprocessingtimeand/or200pagesofdocuments.

Section 8 statementSection8oftheFreedom of Information Act 1989 requirestheprincipalofficertoprepareandmakeavailableeachyearastatement(whichmaybeintheformofanindex)specifyingthedocumentsthatareprovidedbyACTHealthforthepurposesofanenactmentorschemeadministeredbyACTHealth.Thestatementcanbemadeavailabletomembersofthepublicbycontactingtheprincipalofficer.

Section 79 statementThefollowingtablessummarisetheresultsofFOIrequestsacrossACTHealthin2012–13,andthetimetakentofinaliserequests.

Description

Initial applications lodged

Partialaccess

Accessrefused

Full release

Technicalrefusal

Withdrawn

Transferred

Notyetfinalised(asat30June2013)

38

11

4

4

6

8

0

5

Reviews lodged (under section 59 of the Freedom of Information Act 1989)

Numberupheld

Numberpartialaccess

Numberoverturned

Numbernotyetfinalised(asat30June2013)

4

1

2

1

0

ApplicationstoACTCivilandAdministrativeTribunal 0

Requeststoamendrecords 0

Time taken to finalise requests

Lessthan31days

31–45days

46–60days(thirdpartyconsultation)

61–90days

Morethan90days

13

1

3

7

1


C.5 Internal accountability

Senior executive and responsibilitiesTheorganisationalchartonpages2and3showsthestructureofACTHealthat30June2013.Thischartincludesthenamesoftheseniorexecutivesresponsibleforeachoftheorganisation’soutputareas.

ExecutivesintheACTPublicServiceareengagedundercontractforperiodsnotexceedingfiveyears.TheirremunerationisdeterminedbytheAustralianCapitalTerritoryRemunerationTribunal.

Senior executive and organisational changesACTHealthunderwentaninternalrestructureduring2010–11.Thepurposeofthisrestructurewastoimprovethedeliveryoffamily-andpatient-centredcare,achievegoodgovernanceandaccountability,andpositiontheorganisationtomeetdemandforservicesnowandintothefuture.

Priortoimplementationoftherestructure,extensiveconsultationoccurredwithstaffandstakeholders.Oneofthecommitmentscomingoutofthisconsultationwasthatanumberoffactorsanddecisionswouldbereviewedoneyearafterimplementation.

In2012,ACTHealthengagedtheNousGrouptoconductanexternalreviewofACTHealth’s2011restructure.Itspurposewastodeterminetheeffectivenessoftherestructureandhowwellitwasmeetingitsprimaryobjectives.Followingconsiderationoftheconsiderableamountoffeedbackreceivedduringthesix-weekconsultationprocessearlierin2013,adetailedresponsetoeachoftherecommendationsinthefinalNousreporthasbeendeveloped.

Thereviewacknowledgedthatthemajorityofstaffhavebeensupportiveofmanyofthestructuralchangesputinplaceoverthelasttwoyears,butopportunitieshavebeenidentifiedforfurtherrefinement.Atotalof36recommendationsweremadeinthereviewreport.ThesewillbeafocusforACTHealthinthenext12to18monthstoensurethatthestructurecontinuestobeastrongbasisforthedeliveryofourdiversehealthservices.Consultationhasbeenundertakenwithrelevantstaffandunionstodiscussthedetailsofhowchangescanbestbeimplemented.

Senior executiveACTHealthisorganisedintogroupsandoperationalareaswhichreportdirectlytotheDirector-General. Thetwogroups—CanberraHospitalandHealthServices,andStrategyandCorporate—areledbytheDeputyDirectors-Generalandaredividedintodirectclinicalservicedivisionsandstrategicandcorporatesupportbranches.CanberraHospitalandHealthServicesemploysthemajorityofstaffworkinginACTHealth.

Seniorexecutivepositionsacrosstheorganisationareasfollows:

• DrPeggyBrown Director-General(DG)

• StephenGoggs DeputyDirector-General(DDG),StrategyandCorporate

• IanThompson DeputyDirector-General(DDG),CanberraHospitalandHealthServices

• DrFrankVanHaren Director,DonateLifeACT

• DrPaulKelly ChiefHealthOfficer,PopulationHealthDivision

• ElizabethTrickett ExecutiveDirector,QualityandSafetyUnit

• RonFoster ChiefFinanceOfficer,FinancialManagementUnit

• JudyRedmond ChiefInformationOfficer,E-healthandClinicalRecordsBranch


• PhilGhirardello ExecutiveDirector,PerformanceandInnovationBranch

• RosemaryKennedy ExecutiveDirector,BusinessandInfrastructureBranch

• RossO’Donoughue ExecutiveDirector,PolicyandGovernmentRelationsBranch

• GrantCarey-Ide ExecutiveDirector,ServiceandCapitalPlanningBranch

• JudiChilds ExecutiveDirector,PeopleStrategyandServices

• VeronicaCroome ChiefNurse/ExecutiveDirector,NursingandMidwifery

• KarenMurphy AlliedHealthAdvisor

• ProfFrankBowden PrincipalMedicalAdvisor/ExecutiveDirector,MedicalServices

• DrHelenToyne GPAdvisor

• ProfPaulGatenbyAM DirectorofResearch

• BarbaraReid ExecutiveDirector,DivisionofSurgeryandOralHealth

• ElizabethChatham ExecutiveDirector,DivisionofWomen,YouthandChildren

• JeannetteMacCullagh(A/g) ExecutiveDirector,DivisionofCriticalCareandImaging

• DeniseLamb ExecutiveDirector,DivisionofCapitalRegionCancerService

• LindaKohlhagen ExecutiveDirector,DivisionofRehabilitation,AgedandCommunityCare

• KatrinaBracher ExecutiveDirector,DivisionofMentalHealth,JusticeHealthandAlcohol andDrugServices

• ProfJuliaPotter ExecutiveDirector,DivisionofPathology

• RosemaryO’Donnell ExecutiveDirector,DivisionofMedicine

• JuneGunning Director,AcuteSupportServices.

Senior management committees, roles and membershipACTHealthcommitteesareestablishedatthefollowinglevels:

• Tier1—directoratelevel

• Tier2—division/branchlevelandTier1subcommittees

• Tier3—unit/teamlevel.

InformationintheorganisationiscascadeddownfromTier1committees,andsimilarlyinformationandissuescanberaisedattheTier3levelandreportedandmanagedupthroughthehighercommitteetiers.

TheoverarchinggovernancecommitteeforACTHealthistheExecutiveCouncil.


Executive Council

ExecutiveDirectors’

Council

SafetyandQuality

Committee

WorkSafetyCommittee

Informationand

CommunicationTechnologyCommittee

RedevelopmentCommittee

WorkforceSafety

Committee

AuditandRiskManagementCommittee

Name of committee Role of committee Membership

ExecutiveCouncil

AtthecentreofACTHealth’sgovernancemodelistheExecutiveCouncil.Theroleofthecouncilisto:

•supporttheDirector-GeneraltomeetresponsibilitiesoutlinedintheHealth Act 1993 andotherrelevantlegislation

•makerecommendationsonthestrategicdirection,prioritiesandobjectivesoftheorganisationandendorseplansandactionstoachievetheobjectives

•overseefinance,performanceand human resources

•setanexampleforthecorporateculturethroughouttheorganisation.

TheExecutiveCouncilischairedbytheDirector-Generalandmeetstwicemonthly;oneofthesemeetingseachmonthisfocusedonfinanceandperformanceandothermatters,andtheothermeetingisfocusedonotherbusiness.AnumberofsubcommitteesreporttotheExecutiveCouncil,eachdealingwithdifferentareasofaccountabilityacrossACTHealth.

Director-General(Chair)

DeputyDirector-General,CanberraHospitalandHealth Services

DeputyDirector-General,StrategyandCorporate

ChiefFinanceOfficer

ChiefHealthOfficer

ExecutiveDirector,QualityandSafety

AlliedHealthAdvisor

ChiefNurse/ExecutiveDirector,NursingandMidwifery

PrincipalMedicalAdvisor/ExecutiveDirector MedicalServices

ConsumerRepresentative

AcademicRepresentative

http://www.legislation.act.gov.au/a/1993-13/default.asp



ExecutiveDirectorsCouncil

ThiscouncilprovidesanopportunityforallexecutivememberstocommunicateandcollaborativelyworkinpartnershipwithotherareasofACTHealthtodeliverpatient-focused,high-qualitycarethroughinfluencingpolicyandstrategicdirection,managingpolicygovernanceandrisk,andmaximisingoperationaleffectiveness.TheExecutiveDirectorsCouncilmeetsmonthlyandreportstotheExecutiveCouncilonstrategicoperationalmattersand riskmanagement.




Director,ExecutiveCoordination

Manager,CommunicationsandMarketing

Manager,InternalAuditandRiskManagement

ChiefFinanceOfficer

ChiefHealthOfficer

ExecutiveDirector,QualityandSafety

ChiefNurse

PrincipalMedicalAdvisor

AlliedHealthAdvisor

ChiefInformationOfficer

Director,DonateLife

ExecutiveDirector,PerformanceandInnovation

ExecutiveDirector,BusinessandInfrastructure

ExecutiveDirector,ServiceandCapitalPlanning

ExecutiveDirector,PolicyandGovernmentRelations

ExecutiveDirector,PeopleStrategyandServices

ExecutiveDirector,SurgeryandOralHealth

ExecutiveDirector,CriticalCare

ExecutiveDirector,Women,YouthandChildren

ExecutiveDirector,Medicine

ExecutiveDirector,Rehabilitation,AgedandCommunity Care

ExecutiveDirector,CapitalRegionCancerService

ExecutiveDirector,MentalHealth,JusticeHealthandAlcoholandDrugServices

ExecutiveDirector,Pathology

ExecutiveDirector,MedicalServices

ExecutiveDirector,NursingandMidwifery

SafetyandQuality Committee

Thiscommitteecomprisesexecutiveandprofessionaladviserpositionsandacademicandconsumerrepresentatives.Itsroleisto:

•setstrategicdirections,prioritiesandobjectivesinqualityandsafety

•overseeclinicalpracticeimprovement,qualityimprovement,accreditation,clinicalgovernancematters(includingsentinelevents),consumerengagementandclinicalpolicy

•monitorresearchactivityacrossACTHealth.ThecommitteeischairedbytheDirector-General,meetsmonthlyandreportstotheExecutiveCouncil.

Subcommittees:

•AccreditationSteeringGroup•HealthTechnologyandAssessmentCommittee•HealthInteragencyClinicalReviewCommittee•MedicalandDentalAppointmentsCommittee•ClinicalPrivilegesCommittee•AppropriateUseofBloodReferenceGroup.

Director-General

DeputyDirector-General,CorporateandStrategy


ExecutiveDirector,QualityandSafetyUnit


ExecutiveDirector,PerformanceandInnovationBranch

ExecutiveDirector,BusinessandInfrastructureBranch

ExecutiveDirector,ServiceandCapitalPlanningBranch

ExecutiveDirector,PolicyandGovernment RelationsBranch


ChiefNurse


PrincipalAlliedHealthAdvisor

Manager,InternalAuditandRiskManagementUnit

Consumerrepresentatives(2)



WorkHealthandSafetyCommittee

Thiscommittee:

•facilitatescooperationbetweenACTHealthandstafftoinstigate,developandcarryoutmeasuresdesignedtoensurethehealthandsafetyofstaff

•assistsinthedevelopmentofstandards,rulesandproceduresrelatingtohealthandsafetythataretobecompliedwithintheworkplace

•providesworkhealthandsafetyadviceandrecommendationsonstrategies,allocationofresourcesandlegislativearrangements

•addresseswhole-of-agencyworkhealthand safetyissuesunabletoberesolvedatdivisionorbranchlevel.


Director,WorkplaceSafety

Toachieveaquorum,atleasthalfofthemembersofthecommitteemustbestaffwhoarenotnominatedbyACTHealth.

Tworepresentativesfromeachdivision/branchTier2HealthandSafetyCommittee—onemanagerandoneHealthandSafetyRepresentative.

Subcommitteemembersattendasvisitors,asdoothers.

InformationCommunicationandTechnologyCommittee

Thiscommittee:

•overseesthedevelopmentofACTHealth IM&ICTplans,policiesandframeworks,asrequired,ensuringwhole-of-governmentissues areconsidered

•monitorslifecycleICTassetmanagementframeworks,strategiesandpoliciesconsistent withbestpractice

•monitorsIM&ICTrisks•monitors,reviewsandmanagesICTasset,serviceanddeliveryandfinancialperformanceandinfrastructureriskacrossACTHealth

•ensureswhole-of-ACTGovernmentand ACTHealthIM&ICTpoliciesandstandardsareimplementedacrosstheorganisation

•prioritisesIM&ICTinitiatives•evaluatesproposedIM&ICTinitiativesandrecommendssupportedbusinesscasesforall majorIM&ICTprojectstoExecutiveCouncil

•regularlyreviewsandreportsonthestatusofICTprojectsunderdevelopmentand,ifrequired,recommendsstrategiestorectifysignificantvariancesofthese.



Chair,ClinicalWorkingGrouporrepresentative





ExecutiveDirector,PolicyandGovernmentRelations

ChiefHealthOfficer

ChiefNurse


ExecutiveDirector,CriticalCare

ExecutiveDirector,CapitalRegionCancerService

ExecutiveDirector,Rehabilitation,AgedCareandCommunity Care


ExecutiveDirector,Womens,YouthandChildren

ExecutiveDirector,MentalHealth,JusticeHealthandAlcoholandDrugServices

ExecutiveDirector,Pathology

ExecutiveDirector,Medicine

ExecutiveDirector,SharedServicesICT orrepresentative

ChiefExecutive,CalvaryPublicHospital orrepresentative

HealthCareConsumerrepresentative

ACTMedicareLocalrepresentative



RedevelopmentCommittee

TheACTHealthRedevelopmentCommitteeisthechiefdecision-makingbodyfortheACTHealthHealthInfrastructureProgram(HIP).Itisresponsibleforprovidingadvice,monitoringprogressandmonitoringriskoftheHIP.

Director-General,ACTHealth(Chair)



ExecutiveDirector,PolicyCoordination andDevelopment,TreasuryDirectorate

ExecutiveDirector,SharedServicesProcurement

ExecutiveDirector,SharedServicesICT



ChiefFinanceOfficer


Director-General,CommerceandWorksDirectorate

ChiefInformationOfficer,ACTHealth

DeputyDirector-General,ChiefMinisterandCabinet

Directorate

ChiefExecutive,CalvaryHealthcareACT

ExecutiveDirector,HealthCareConsumers’Association

SeniorManager,HealthServicesPlanning,ServiceandCapitalPlanning

ExecutiveConstructionDirector,Serviceand CapitalPlanning

SeniorFinanceManager,ServiceandCapitalPlanning

OperationsManager,ServiceandCapitalPlanning

Director,HealthInfrastructureBranch,SharedServicesProcurement,CommerceandWorksDirectorate

Thecommitteemayinviteotherattendees,attheChair’sdiscretion.

WorkforceStrategyCommittee

Toprovidehigh-leveladvicetotheExecutiveCouncilonallmattersabouttheACTHealthworkforce.Thiscommittee:

•givesstrategiccontextanddirectionforthedevelopmentoftheworkforce,includingafocusonplanning,recruitmentandretentionstrategies,organisationaldevelopment,workplacecultureandleadershipandhumanresourcemanagement

•ensuresalignmentandintegrationofstrategiestobroaderHealthDirectorateobjectives

•providesstrategicoversightoforganisation redesignontheworkforceprofileandhealth andsafety.


ExecutiveDirector,CRCS

ExecutiveDirector,PSSB

ACTChiefNurse,StrategyandCorporate

LeadCommissioningManager



Director,WorkforcePolicyandPlanningUnit

DirectorofOperations

A/gDirectorofAcuteSupport

SeniorDataOfficer,WPPU


AlliedHealthManager

AlliedHealthAdvisor


Director,StaffDevelopmentUnit

Director,CommunityCareProgram

SeniorManager,OrganisationalDevelopmentUnit

DeputyDirector-General,CanberraHospital

ExecutiveDirector,QualityImprovement

WorkforceInitiativesCoordinator



AuditandRiskManagementCommittee

Thecommitteeconsistsoffivemembers:

•Chairperson—Thechairoftheauditcommitteeisexternalandindependentofthedirectorate

•DeputyChair—oneDeputyDirector-General,appointedforafixedperiod

•twoseniorexecutives•anexternalmemberwithanappropriatebusinessorauditbackground.

TheInternalAuditandRiskManagerisinvitedtoallmeetingsoftheARMC.ThesecretariatroleisperformedbytheInternalAuditandRiskManagementBranch.

Aswellasthesecommittees,governancemeetingsareestablishedattheTier2levelintheStrategyandCorporategroupandtheCanberraHospitalandHealthServicesgroup,aswellasinclinicaldivisionsandcorporatebranches.SeniorstafffromdivisionsandbranchesareinvolvedinthesemeetingsandkeyinformationiscascadeddownfromtheTier1levelviagroups,divisionsandbranchestounitlevelacrossthedirectorate.

Arangeofforumsprovidetheopportunityforstakeholderinput.Theseinclude:

• ACTHealthHumanResearchEthicsCommittee—ongoing

• ACTLocalHospitalNetworkCouncil(sixtimesayear)—ongoing

• ACTMedicareLocal/ACTHealthLiaisonCommittee(quarterly)

• ACTRegionIntegratedRegionalClinicalTrainingNetwork—ongoing

• AlliedHealthForum(quarterly)—ongoing

• ClinicalSenate(quarterly)—ongoing

• Director-GeneralForums(six-weekly)—ongoing

• GPLiaisonNetwork(quarterly)—ongoing

• ACTHealth/CommunityServicesDirectorateLiaisoncommittee(quarterly)—ongoing

• ACTHealth/HumanRightsCommission(annual)—ongoing.

• HealthEmergencyManagementSubcommittee(quarterly)—ongoing.

• HealthcareConsumersLiaisonCommittee(quarterly)—ongoing

• IntegratedRegionalClinicalTrainingNetwork—ongoing

• LeadershipNetwork(threetimesayear)—ongoing

• MedicalStaffCouncil(monthly)—ongoing

• NursingandMidwiferyLeadersmeeting(monthly)—ongoing

• PrivateHospitalsLiaisonCommittee(quarterly)—ongoing

• SouthernLocalHospitalNetworkHNLiaisonCommittee—ongoing

• TertiaryEducationLiaisonCommittee(quarterly)—ongoing


ACT Local Hospital Network CouncilOn27July2011,theChiefMinisterannouncedtheestablishmentoftheACTLocalHospitalNetworkCouncil.ThecouncilwasestablishedunderamendmentstotheHealth Act 1993,passedbytheLegislativeAssemblyon29March2011.ItisresponsibleforprovidingstrategicadvicetotheDirector-GeneralofACTHealthonmatterscriticaltotheACTLocalHospitalNetwork’ssuccess.Thecouncil’sspecificfunctionsaresetoutinsection14oftheAct.

EachfinancialyearthecouncilisrequiredtopresenttotheMinisterforHealthareportonthestateofthelocalhospitalnetworkandanyrecommendationsrelatingtotheimprovementofhealthservicesbythelocalhospitalnetworkthatthecouncilconsidersnecessary.

Part3AoftheActrequiresthatthecouncilconsistofnotmorethan10members,appointedbytheMinister. ThecouncilmustincludememberswhobringthenecessaryskillsandexperiencetoallowthecounciltoperformitsfunctionsundertheActandincludememberswhohaveexpertiseorexperienceinseveralareas,including,butnotlimitedto:healthmanagementexperience;expertiseinclinicalmatters;andacademic,teachingandresearchexperienceinthefieldofhealthservicesandconsumers.

TheActrequiresthecounciltomeetatleastsixtimesayear.ACTHealthprovidessecretariatsupporttothecouncil.

Clinical SenateTheroleoftheSenateistoprovideaforumforamultidisciplinarygroupofclinicians,healthexpertsandconsumerswithdiverseperspectivestosharetheircollectiveknowledgeindiscussingstrategicclinicalissues. TheClinicalSenatemakesrecommendationsandreportstotheDirector-General,ACTHealth,andtheChairof ACTMedicareLocal,whoconsiderandrespondformallyandtransparentlytoallrecommendations.

ThemembershipoftheSenatereflectstherangeofviewsthatwouldbeencounteredacrossthefullbreadthofthecommunityonsignificantclinicalstrategicissues.Membersareappointedfollowingdueconsiderationofclinicalskillsand/orknowledge,capacitytomakeacontribution,clinicalinfluence,consumerinputandmultidisciplinarycoverage.

TheSenatecomprisesupto40members,themajorityofwhomareclinicianswithdirectclinicalduties.Inadditiontoex-officiomembers,membershipconsistsofspecialistmedicalpractitioners,juniormedicalpractitioners,specialistdentalpractitioners,nursingandmidwiferyrepresentatives,academicstaff,alliedhealthprofessionalsandconsumerrepresentatives.

Meetingsareheldthreeorfourtimesayear.ACTHealthprovidessecretariatsupporttotheSenate.

Corporate and operational plans (and associated reporting and review)

Corporate Plan 2012–2017TheCorporatePlan2012–2017replacestheCorporatePlan2010–2012.Theplanarticulatesthekeyfocusareas,prioritiesforimprovement,keystrategiesforachievingthepriorities,andachievementsplannedforthelongterm(fiveyears).

TheprioritiesofACTHealthareorganisedunderfourkeyfocusareas.

Community and consumers—Partnering for better health outcomes• Deliverpatientandfamily-centredcare

• Continueandstrengthenpartnerships

• Promotegoodhealthandwellbeing

• Improve access to appropriate health care

• Haverobustsafetyandqualitysystems


Our resources—Building sustainability and improving efficiency• Designsustainableservicestodeliveroutcomesefficiently

• Strengthendecisionsupport

• Embedacultureofresearchandinnovation

Our processes—Strengthening governance• Beaccountabletogovernmentandthecommunity

• Continuetostrengthenclinicalgovernance

Our people—Supporting and strengthening the teams• Supportourstafftoreachtheirpotential

• Promotealearningculture

• Providehigh-levelleadership

In2012–13,ACTHealthcontinuedtomeasureperformanceagainsttheseareasthroughkeyperformancemeasuresidentifiedintheACTPublicHealthService’squarterlyperformancereport,ACTHealth’sstrategicandaccountabilityindicatorsetsintheACTBudgetPapersandthePublicHospitalsScorecard.ThetargetachievementsforeachyeararecontainedinACTHealth’sBusinessPlan.

Clinical Services PlanThereisrecognitionthatthedemandforhealthservicesisincreasingeveryyear.Expandinghealthtechnologies,greaterconsumerexpectationsandanincreasingandageingpopulationallcontributetothisdemandforpublichealthservices.

Followingextensiveconsultationwithourstakeholderstowardstheendof2012,theClinicalServicesPlanisnowbeingfinalised.TheplanwillprovidestrategicguidanceforthedevelopmentofpubliclyfundedhealthservicesintheACT.ThestrategiesintheplanhavebeendevelopedtopositionACTHealthtomeetfuturedemandforhealthservicesandimproveaccessforthosemostinneed.

ThereareanumberofspecifichealthservicesplanswhichcascadeandalignstrategicdirectionsfromtheClinicalServicesPlantoenablethedeliveryofanintegratedserviceandofferacontinuumofcaretopatients.Thefocusareasoftheplanareto:

• meetincreasingdemandforhealthservices

• improvethepatientjourney

• improvethehealthofvulnerablepeople

• buildandnurtureasustainablehealthsystem

• ensuretheplanninganddeliveryofhealthservicesisunderpinnedbytheACTHealthSafetyandQualityFramework.

ACT Primary Health Care Strategy 2011–2014TheHealthMinisterlaunchedtheACT Primary Health Care Strategy 2011–2014on14December2011,buildingontheprevioushealthcarestrategyandsettingthedirectionforprimaryhealthcareintothefuture.Thestrategyaimstoimproveintegrationbetweengeneralpracticeandthewiderprimaryhealthcaresectorintheprovisionofprimaryhealthcare.

ThePrimaryHealthandChronicDiseaseStrategyCommittee(PH&CDS)overseesimplementationofthestrategy. Six-monthlyreportsoutliningprogressagainsttheannualimplementationplanareprovidedtotheACTHealthExecutiveCouncilandprimaryhealthcarestakeholders.


Actionareaswhereprogressisbeingmadeinclude:

• improvingaccessandreducinginequity

• improvingcontinuityandcoordinationofcare,especiallyforpeoplewithchronicconditions

• increasingthefocusonhealthpromotion,prevention,earlyinterventionandconsumerempowerment

• improvingquality,safety,performanceandaccountability

• informationmanagement

• workforce

• infrastructure.

Successfulongoingactivitiesinclude:

• theGeneralPracticeAgedDayService(GPADS),whichprovidesaccesstoGPsforpatientswhoarehomeboundorinresidentialagedcarefacilities

• thenurseledWalk-inCentre,whichsuccessfullymeetshealthcareneedsinthecommunitywhilerelievingpressure on the public hospital system

• theGPMarketingandSupportOfficerrole,whichaimstoincreasethenumberofGPslivingandworkingintheCanberraregion,viaanonline,printandin-personcampaign.

Implementationhighlightsinclude:

• provisionofmini-healthchecksandfollow-upreviewsforthevulnerableordisadvantagedattheEarlyMorningCentreincentralCanberraandatAinslieVillage

• provisionofthreefull-timecarecoordinatorstoassistlocalAboriginalandTorresStraitIslanderpeopletomanagethehealthsysteminrelationtotheirchronicconditions

• establishmentandpromotionoftheGetHealthyinformationandcoachingservice,whichprovidestargetedmessagingandafreepersonalhealthcoach,andtheACT-wideHealthierWorkService,whichsupportsemployerstodevelophealthandwellbeinginitiativesintheirworkplaces

• provisionoftheHealthServicesDirectory,whichliststhemajorityofACTHealth’sservicesaswellasallACTGPandpharmacylocalities

• developmentandpromotionofACTHealthpoliciesandprocedurestoensurebettersharingofclinicalinformationbetweenandwithintheacuteandprimaryhealthcaresectors

• fundingfortheACTMedicareLocaltoundertaketheGPWorkforceScopingStudytoprovidejurisdictionalinformationandmappingoftheGPworkforceacrosstheACT.

ACT Chronic Disease StrategyThenewACT Chronic Conditions Strategy—Improving Care and Support 2013–2018 (www.health.act.gov.au/c/health?a=dlpubpoldoc&document=2825)willprovideoverarchingdirectionforchronicconditioncareandsupportintheACToverthenextfiveyearsandoutlinestherequirementforacoordinatedapproachacrossthegovernmentandnon-governmentsectors.Itconcentratesonimprovingcareandsupportservicesandisbasedonthecommitmentgoalsthateverypersonlivingwithachroniccondition:

• receivesappropriatescreeningandearlydetection

• receivestherightcareintherightplaceattherighttimefromtherightteam

• hasaplanwhichsupportsactiveparticipationintheircare

• isawareofrelevantsupportoptionsandhowtoaccessthem

• isprovidedwithinformationandsupporttostayhealthyand/orminimisetheriskofotherdiseases

• doesnothavetorepeattheirstoryunnecessarily.

www.health.act.gov.au/c/health



Thekeyprioritiesinthedraftstrategyareto:

• optimiseexistingservicesthroughenhancedintegration

• improve access

• bettersupportthoseinthecommunity

• improveperson-centredness

• enhancedetectionandsecondaryprevention

• enhancegovernanceandsystemenablers.

ThePrimaryHealthandChronicDiseaseSteeringCommitteeoverseesimplementationofthestrategyandprovidesoversightandcentralcoordinationofrelatedpoliciesandinitiatives.ThecommitteeischairedbythePolicyandGovernmentRelationsBranchandincludesrepresentationfromrelevantoperationalareasofACTHealth,theACTMedicareLocal,thePharmacyGuildofAustralia(ACT),theHealthCareConsumers’AssociationoftheACT,WinnungaNimmityjahAboriginalHealthService,ANUMedicalSchool,theHeartFoundationACT,andDiabetesACT,theUniversityofCanberra,theAustralianprimaryHealthCareResearchInstituteandtheCommunityServicesDirectorate.Six-monthlyreportsoutliningprogressagainsttheannualimplementationplanareprovidedtotheACTHealthExecutiveCouncilandkeystakeholders.

ACT Palliative Care Services PlanTheACTPalliativeCareStrategy2007–2011providedoverarchingdirectionforthedeliveryofpalliativecareservicesintheACTinaccordancewithPalliativeCareAustralia’sNationalPalliativeCareStandards.From2007to2011,thestrategymadeconsiderableprogressinpromotingcoordinatedpalliativecareservices.Inparticular,achievementsweremadein:

• theavailabilityofpalliativecareandbereavementinformationandeducationresourcesforcommunitymembers

• increasedliaisonbetweenpalliativecareservices,residentialagedcarefacilitiesandprimaryhealthcare

• implementationofAustralianGovernment-fundedpalliativecareprojects.

ThedevelopmentofthenewdraftACTPalliativeCareServicesPlan2013–2017includedextensivecommunityconsultationandanexaminationoflikelyfuturedemandforpalliativecare,existingworkforceneedsandfutureneeds,communityeducation,supportfornon-governmentorganisationsandidentificationofpossiblefuturemodelsofcare.

Asaresult,thedraftplanoutlinesavisionthat‘peoplewithalife-threateningillnessintheACTandtheirfamiliesandcarerswillhavetimelyaccesstoqualitypalliativecarethatisconsumerandcarerfocused,respectstheirchoicesandisappropriatetotheirneed’.ItalsooutlinessixkeygoalsforthefuturedevelopmentofACTpalliativecareservices,alongwith16associatedstrategiestoachievethem.Thesixkeygoalsareasfollows:

1. ACTHealthplaysaleadershiproleinensuringreliableaccesstoqualitypalliativecareintheACT.

2. Toensurethatpalliativecareservicesprovidecontinuityofcareandsmoothtransitionsbetweensettings.

3. TheACTcommunityiswellinformedaboutallaspectsofdeathanddyingandindividualsandfamiliesareabletomakeaninformedchoiceabouttheirtreatmentoptions.

4. Tobuildcapacityofpalliativecareservicestomeetthecurrentandprojectedpopulationdemand.

5. ToensureanappropriatelyqualitativeandsustainableworkforcetoprovidetheprojectedlevelofpalliativecareservicesintheACT.

6. Todeveloptheknowledgebasetoinformserviceandworkforcedevelopmentandqualityimprovement.

ThedraftplanisalignedwiththedraftClinicalServicesPlanandinparticularsuggeststheestablishmentofasingleACTPalliativeCareClinicalNetwork,aproposalwhichwaswellreceivedduringthepublicconsultationoftheplan.

Asthisisaservicesplan,thedocumentislongandcontainstechnicallanguagethatmaybeabarriertosomeconsumersandtime-poorclinicians.Asaresult,aone-pagesummaryandashortenedversionoftheplan,whichwillbeknownastheACTPalliativeCareServicesPlan2013–2017,havebeendeveloped.Thefulltechnicalpaperwillalsobeavailable.

TheACTPalliativeCareServicesPlanSteeringCommitteeoversawthedevelopmentofthisservicesplan.ThiscommitteeincludedrepresentativesfromACTHealth,theACTMedicareLocal,theSouthernNewSouthWalesLocalHealthDistrict,CalvaryHealthCare,PalliativeCareACTandtheHealthCareConsumers’AssociationoftheACT.

TheplanisexpectedtobeendorsedbytheMinisterinSeptember2013.


HIV/AIDS, Hepatitis C, Sexually Transmissible Infections: A Strategic Framework for the ACT 2007–2012The HIV/AIDS, Hepatitis C, Sexually Transmissible Infections—A Strategic Framework for the ACT 2007–2012 (www.health.act.gov.au/c/health?a=dlpubpoldoc&document=915)outlinesastrategicapproachtothemanagementofHIV/AIDS,hepatitisCandsexuallytransmissibleinfectionsandprovidesaframeworktoguidecooperationbetweenACTGovernmentandnon-governmentorganisations,privatepractitioners,researchers,serviceproviders,communitygroups,affectedcommunitiesandthebroaderACTcommunity.

TheACTframeworkconfirmsACTHealth’scommitmenttoguidingprinciplessuchasharmminimisationandhealthpromotion,apartnershipapproach,anevidence-basedapproach,accessandequity,socialdeterminantsofhealth,apopulationhealthapproachandhumanrights.ProgresshasbeenmadetowardstheACTframework’sgoalsof:

• reducingthetransmissionintheACTofHIV,hepatitisCvirus(HCV)andsexuallytransmissibleinfections(STIs)

• increasingaccessforACTresidentstotestingandtreatmentforHIV,HCVandSTIs

• improvingthehealthandwellbeingofACTresidentslivingwithHIV/AIDSandHCVandreducingthemorbidityassociatedwithundiagnosedanduntreatedSTIs.

TheACTMinisterialAdvisoryCouncilonSexualHealth,HIV/AIDS,HepatitisCandRelatedDiseases(SHAHRD)advisesontheimplementationoftheACTframework.ItwasagreedthattheACTframeworkbeextendedbeyond2012tocorrespondwiththedevelopmentoftheNationalStrategiesforHIV,HepatitisB,HepatitisC,SexuallyTransmissibleInfectionsandAboriginalandTorresStraitIslanderBlood-BorneVirusandSexuallyTransmissibleInfections.Thenationalstrategieswillbeunderdevelopmentin2013foranestimatedlaunchinJuly2014. ThenewACTframeworkwillalignwiththesestrategies.

ACT Children’s Plan The ACT Children’s PlanwaslaunchedinJune2010toprovideanaspirationalwhole-of-governmentandwhole-of-communityvisiontomakeCanberraagreatandsafeplaceforchildrenandtoensuretheirneedsareapriorityforthegovernmentandcommunity.TheACT Children’s Planisoperationalfrom2010to2014.

TheaimoftheACT Children’s PlanisthatCanberraisachild-andyouth-friendlycitythatsupportsallchildrenandyoungpeopletoreachtheirpotential,makeacontributionandsharethebenefitsofourcommunity.TheplanproposessixbuildingblockstomakeCanberraachild-friendlycity:

• opportunitiesforchildrentoinfluencedecisionsabouttheirlivesandtheircommunityandtoactivelyparticipateintheircommunities

• advocacy,promotionandprotectionofchildren’srights

• processestoassesstheimpactoflaw,policyandpracticeonchildren

• regularmonitoringofthestateofchildren’shealth,wellbeing,learninganddevelopment

• services,programsandenvironmentsthatsupportchildren’soptimaldevelopmentandenhanceparental,familyandcommunitycapacity

• effectivegovernancemechanismsacrossgovernmentandcommunity.

Strategies, actions and projects fully implemented at the end of June 2012A Picture of ACT’s Children and Young People 2012(www.children.act.gov.au)wasreleased.

Major goals and projects commenced in 2012–13• ACTHealthcontributedtothedevelopmentofthe2013 A Picture of ACT Children and Young People,whichwill

bethethirdreportonchildren’shealth,wellbeing,developmentandlearningindicators.

• DraftingcommencedforaStandardOperatingProcedure(SOP)onNeglectofMedicalNeedsofChildrenandYoungPeopletoimproveACTHealth’scapacitytomeettheneedsofvulnerablechildrenandtheirfamilies.

• TheACTHealthChildProtectionPolicywasreviewedandaChildProtectionPracticePaperandSOPweredrafted.


http://www.children.act.gov.au


ACT Mental Health Services Plan 2009–2014The ACT Mental Health Services Plan 2009–2014 isastrategic-leveldocumentgivingbroaddirectionforthefuturedevelopmentofpublicmentalhealthservicesintheACT.Itwasdevelopedinconsultationwithstakeholdersoveratwo-yearperiod.Theplancoverstheyears2009to2014butconveysavisionforhowmentalhealthserviceswillbedeliveredintheACTin20years’time.TheguidingvisionformentalhealthservicesintheACTisthatby2020thementalhealthneedsofthecommunitywillbemetbyacomprehensivenetworkofcomplementaryandintegratedmentalhealthservicesthat:

• enhanceknowledgeandunderstanding

• interveneandprovidesupportearlyandforaslongasisnecessary

• asfaraspossible,addressmentalhealthissuesincommunitysettings,workingwithanddevelopingnaturalsystemsofsupport.

The ACT Mental Health Services Plan 2009–2014 statesthatconsumerandcarerparticipationwillberichlywoventhroughallaspectsofserviceplanning,delivery,research,teachingandevaluation,whilepeersupportandadvocacyserviceswillbeavailableasrequiredtosupportconsumersintheirjourneyofrecovery.

Theplanalignsserviceswithfourdevelopmentalstagesthat,ratherthanpromotingservicedeliveryalongagelinesalone,willfocusondevelopmentalandlifemilestonestodeterminethemostappropriatepointofservice.

Strategic directionsTheplansetsgoalsforchangeandimprovementsinthementalhealthsector.Timelinesforimplementationhavebeenindicatedthroughoutthefive-yearlifeoftheplan.OversightoftheimplementationprocesswasallocatedtotheStrategicOversightGroup(SOG).Co-chairedbyaconsumerrepresentativeandanACTHealthrepresentative,theSOGincludesconsumer,carer,communityandprimarycarerepresentatives,withparticipationfromACTandAustralianGovernmentagencies.TheSOGreportsannuallyonimplementationoftheACT Mental Health Services Plan 2009–2014.

In2012–13,theACTGovernment,inpartnershipwiththecommunitysector,consumersandcarers,continuedtoworktowardstheguidingvisionoftheACT Mental Health Services Plan 2009–2014byfocusingonthefourprioritiesoutlinedinit:

1. reinforcingcapacityinthementalhealthsector

2. extendingthementalhealthservicesystem

3. innovatinginthementalhealthservicesystem

4. planningimplementationofchange.

Building a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014Building a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014 aimstoguidetheimplementationanddevelopmentofactivitiestopromotementalhealthandwellbeing,preventmentalillnessand,wherethisisnotpossible,interveneearlytodetectandtreatmentaldisorders. Theframeworkhasthreepriorities:

1. Promotingmentalhealthandwellbeingiseverybody’sbusiness.

2. Preventingmentalillnessisasharedresponsibility.

3. Earlyinterventionrequiresstronginter-sectoralcooperation.

OversightoftheprocessisundertakenbytheMentalHealthPromotion,PreventionandEarlyInterventionImplementationandEvaluationWorkingGroup,whichincludesconsumer,carer,community,education,primarycareanddirectoraterepresentation.


Theevaluationreport,Building a Strong Foundation: Evaluation Findings 2010–2011,wasfinalisedin2013andsummarisestheimplementationfindingsfromthesecond-yearevaluationoftheframework.EvaluationreportsareavailableontheACTHealthwebsiteatwww.health.act.gov.au/health-services/mental-health-justice-health-alcohol-drug-services/mental-health-policy/suicide-prevention/implementation-and-evaluation.Highlightsinclude:

• Twenty-fouragenciesreportedthattheyhadsuccessfullyembeddedactivitiestopromotementalhealthandwellbeingintotheirstrategicplansandstrategies.

• AreviewofinternationalandnationalsocialmarketingcampaignswascompletedinordertobetterinformfutureACTintegratedphysicalandmentalhealthandwellbeingcampaigns.

• Atotalof5,500peopleweresuccessfullytrainedinworkplacementalhealthliteracy.

• TheAlexanderMaconochieCentreintroducedextendedvisitinghoursforfamiliesandsetasidetwoprivateunitsintheVisitors’Centreforfamilyvisits.Thisistoencouragedetaineestomaintainandstrengthentheirfamilyrelationshipswhileincarcerated.

Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009–2014Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009–2014providesaservicedevelopmentframeworktoguideanintegrated,whole-of-communityapproachtosuicidepreventionacrossthelifespan.Thestrategy’smainstrategicdirectionsareto:

• reduceratesofsuicideandself-harmintheACT

• increaseresilience,copingskillsandconnectedness

• improveawarenessofandaccesstosuicidepreventiontraining,educationandinformation

• increasecollaborationandpartnershipsbetweenorganisationsprovidingsuicidepreventionandpostventionservicesintheACT.

Theevaluationreport,Managing the Risk of Suicide: Evaluation Findings 2010–2011,wasfinalisedin2013.Thisreportsummarisestheimplementationfindingsfromthesecond-yearevaluationofthestrategy.EvaluationreportsareavailableontheACTHealthwebsiteatwww.health.act.gov.au/health-services/mental-health-justice-health-alcohol-drug-services/mental-health-policy/suicide-prevention/implementation-and-evaluation.

ACTHealth,inconjunctionwiththeCentreforMentalHealthResearchattheAustralianNationalUniversity,isleadingthewayinternationallyinevaluatingtheoutcomesofimplementationandidentifyingthefactorsthataffectimplementationofbothBuilding a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014andManaging the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009–2014.

Outcomeandprocessevaluationdata,collectedfromagenciesidentifiedashavingresponsibilityforimplementingactions,iscollatedandthefindingsfromthesurveysusedtocompileanannualreporttotheLegislativeAssembly.

National Partnership Agreement Supporting National Mental Health ReformTheCouncilofAustralianGovernmentssignedaNationalPartnershipAgreementSupportingNationalMentalHealthReformin2012.Thisagreementprovides$200millioninCommonwealthfunding,alongsideinvestmentsbythestatesandterritories,toimproveoutcomesforpeoplewithsevereandpersistentmentalillness.ThetwoACTprojectsbeingfundedundertheagreementare:

1. TheAdultMentalHealthStep-up,Step-downOutreachSupport.WodenCommunityServiceshasbeenengagedtoprovideshort-termearlyinterventiontoavoidacutehospitaladmission,andpost-dischargefollow-upsupport.Fundingundertheagreementallowsforsupportforuptoanadditional60consumersperannum.

2. SupportedAccommodationOutreachtargetingpeoplewithseriousmentalillnessandrecentexperienceofinvoluntaryinstitutionalcare.StVincentdePaulhasbeenengagedtoprovidesupportedaccommodationandoutreachforanadditional18peopleannuallywhohaveseriousmentalillnessandahistoryofinvoluntaryinstitutionalcare.

www.health.act.gov.au/health-services/mental-health-justice-health-alcohol-drug-services/mental-health-policy/suicide-prevention/implementation





Roadmap for National Mental Health Reform 2012–2022TheCouncilofAustralianGovernmentsendorsedthe Roadmap for National Mental Health Reform 2012–2022 in December2012. TheroadmaprecommitstheAustralianGovernmentandstatesandterritoriestowhole-of-governmentandwhole-of-lifespanapproachestomentalhealthreformandtomaintainingmentalhealthasanongoingnationalpriority.AkeycommitmentoftheroadmapisthedevelopmentofthesuccessortotheFourthNationalMentalHealthPlan.TheACTGovernmentisamemberoftheworkinggroupchargedwiththisresponsibility.

Fourth National Mental Health PlanThe Fourth National Mental Health Plan: An Agenda for Collaborative Government Action in Mental Health 2009–2014 demonstratesacommitmenttoongoingnationalmentalhealthreformandidentifieskeyactionsto advancethevisionoftheNationalMentalHealthPolicy2008.Whileledbyhealthministers,theplantakesawhole-of-governmentapproachbyinvolvingsectorsotherthanhealth.Itprovidesabasisforgovernmentstoadvancementalhealthactivitiesinthevariousportfolioareasinamoreintegratedway,recognisingthatmanysectorscancontributetobetter outcomesforpeoplelivingwithmentalillness.

TwosignificantelementsoftheFourthNationalMentalHealthPlanhavebeenprogressedin2012–13:thedevelopmentoftheNationalMentalHealthServicesPlanningFrameworkandtheNationalMentalHealthRecoveryFramework.Whenfinalised,thesetwoframeworkswillappreciablycontributetothecultureandprovisionofmentalhealthservicesintothefuture.

A New Way—Aboriginal and Torres Strait Islander Health and Wellbeing Plan 2006–2011The ACT Aboriginal and Torres Strait Islander Health and Family Wellbeing Plan 2006–2011wasdevelopedinresponsetotherequirementoftheNationalStrategicFrameworkforAboriginalandTorresStraitIslanderHealth(NSFATSIH)foreachjurisdictiontodevelopalocalimplementationplan.Areviewoftheplanwasundertakenin2012–13bytheAboriginalandTorresStraitIslanderHealthForum,whichincludesmembershipfromACTHealth,theACTAboriginalandTorresStraitIslanderElectedBody,WinnungaNimmityjahAboriginalHealthServiceandACTMedicareLocal.Inthisprocess,manyfactorswereidentifiedasaffectingitsimplementation,mostsignificantlytheClosingtheGapIndigenousreformagenda,whichwasintroducedhalfwaythroughimplementationoftheplanin2008.

DevelopmentofanewACTAboriginalandTorresStraitIslanderHealthPlancommencedin2013.TheplanwillincorporatelearningfromthereviewofthepreviousplanandoutstandingactionitemswhichhavebeenidentifiedasongoingstrategiesrequiringimplementationbytheHealthForum.ThenewplanwillalsobeinformedbytheNationalPartnershipAgreementonClosingtheGapinIndigenousHealthOutcomesandwillseektoformlinkageswiththeothernationalhealth-relatedplansdevelopedin2013:

• NationalAboriginalandTorresStraitIslanderHealthPlan

• NationalAboriginalandTorresStraitIslanderSocialandEmotionalWellbeingPlan

• NationalAboriginalandTorresStraitIslanderSuicidePreventionStrategy

• NationalAboriginalandTorresStraitIslanderBlood-BorneVirusesandSexuallyTransmissibleInfectionsStrategy

• NationalAboriginalandTorresStraitIslanderDrugStrategy.

ThenewhealthplanaimstopromoteaholisticapproachtoAboriginalandTorresStraitIslanderhealthplanningfortheACTandsurroundingcommunity.


Health Workforce Plan 2013–18The ACT Health Workforce Plan 2013–2018wasreleasedin2012–13,aligningwithnationalhealthworkforcereform,includingtheHealthWorkforceAustralia(HWA)National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015.

Theprinciplesthatunderpintheplanincludeworkforceinitiativesdrivenbyconsumerneedsandcost-effectiveness,efficiencyandsustainability.Theplanprovidesaframeworkforactionsbyprovidingmedium-termsustainableworkforceplanningstrategiesandassociatedactionswhichsupportthecontinueddeliveryofhigh-qualityhealthservicestotheACTregioninanenvironmentofincreasingworkforcechallenges.ThefocusareasoftheplanarestronglylinkedtoACTHealthstrategiesandserviceplanswhichsupportmorespecificlocalneeds.

Theplanseekstoaddresshealthworkforceissuesthroughtheuseoffiveareasfocusareas:

1. healthworkforcereform:improvingservicedelivery

2. healthworkforcecapacity:skillsdevelopment

3. leadershipandcultureimprovementforhealthsystemsustainability

4. healthworkforceplanning

5. policy,fundingandregulation.

Theplanprovidesstrategiesundereachfocusareawhichprovidedirection,actions,accountabilitiesandmeasuresofsuccesswhichareabletobeappliedforoperationalworkforceplanninginallareasofACTHealth.

ACT Breastfeeding Strategic Framework 2010–2015The ACT Breastfeeding Strategic Framework 2010–2015(www.health.act.gov.au/c/health?a=dlpubpoldoc& document=2777)setsthecontextfortheprotection,promotionandsupportofbreastfeedingintheACT.Theframeworkisconsistentwith,andsupportstheimplementationof,theactionareasintheAustralian National Breastfeeding Strategy 2010–2015.WhileACTHealthistheleadagencytoguideimplementation,thereisawhole-of-ACTGovernmentcommitmenttothisproject,includingtheidentificationofstrategiestosupportbreastfeeding-friendlyworkplaces(BFW)acrossACTGovernmentdirectorates.

Significantachievementsin2012–13includebreastfeeding-friendlyworkplaceaccreditationforthreedirectorates,includingACTHealth,withothersconsideringaccreditation.AninclusiveDVDforyoungparentswasproducedin2012asacollaborativeinitiativebetweentheAboriginalandTorresStraitIslanderHealthUnit,GuganGulwanAboriginalYouthCorporation,CanberraCollegeCaresandyoungparentsintheACT.Therehasbeensubstantialsupportforhealthprofessionaleducation,includingsupportforcandidatessittingfortheInternationalBoardofLactationConsultantExaminers(IBLCE).Therehasalsobeenconsiderablecollaborationwithnon-governmentorganisations,includingtheAustralianBreastfeedingAssociation.

BothpublichospitalsintheACTareBaby-FriendlyHealthInitiative(BFHI)accredited.Allbreastfeedingresourcesdevelopedarewebcompatibleandmostresourcesutilise‘apps’tobeuser-friendlyforayoungtargetaudience.

EnhancedbreastfeedingdatahasbeencollectedsinceJuly2011,withcapabilitytoreportagainstthenationallyagreedindicators:‘exclusive’,‘predominant’and‘any’breastfeeding.

Adedicatedprojectofficeroversawimplementationoftheframeworkin2012–13,guidedbyamultidisciplinaryBreastfeedingInitiativeSteeringCommittee.

ACT Alcohol, Tobacco and Other Drug Strategy 2010–2014ActionsfromtheACT Alcohol, Tobacco and Other Drug Strategy 2010–2014progressedin2012–13included:

• smokingreductionandcessationprogramsfortargetpopulations:

– TheAlcohol,TobaccoandOtherDrugsAssociationACT(ATODA)receivedfundinginthe2012–13 ACTHealthPromotionGrantsProgramCommunityFundingRoundtoconducttheUnder10% project. TheprojectaimstosupporttheACTtobethefirstjurisdictioninAustraliawithasmokingprevalenceunder10 per centbyprovidingtargetedtobaccomanagementandsupporttocommunityservicesworkersandclientswithhighsmokingrateswhoexperiencedisadvantage.




– ACTHealth,incollaborationwithasmallreferencegroup,developedaBriefInterventionSmokingCessationE-learningPackage,whichhasbeenavailabletoACTHealthstaffonlinesinceDecember2012.

– ACTHealth’s‘BeyondToday … it’suptoyou’socialmarketingcampaigntopromotetobaccocessationandhealthylifestylebehavioursamongtheAboriginalandTorresStraitIslandercommunitiesofthe ACTandsurroundingregionswaslaunchedinDecember2012.

• drugtreatmentforpeopleexperiencingwithdrawal,includingthosecontinuingonopioidmaintenancetreatmentprogramsorchoosingtoceaseopioidmaintenancetreatment:

– ATODAdevelopedadiscussionpaperonexpandingaccesstoallACTalcohol,tobaccoandotherdrugresidentialtreatmentforpeoplereceivingopioidmaintenancetherapyandengagedwithkeypeoplenationallyworkinginthisarea,includingWeHelpOurselves(WHOS),aninterstateproviderofresidentialtreatmentforpeoplereceivingopioidmaintenancetherapy.

– KarralikaProgramsInc.receivedthreeyearsoffederalgovernmentfundingtoplan,implementandevaluateapilotprogramadmittingpeopleonopioidmaintenancetherapytoitsresidentialrehabilitationprogram.Implementationbeganinmid-2013.

• peer-basedmodelsofservicedelivery,supportadvocacyandcommunitydevelopment:

– TheCanberraAllianceforHarmMinimisationandAdvocacy(CAHMA),incollaborationwithATODAand ACTHealth,developedandimplementedAustralia’sfirstoverdosemanagementprogram,whichprovidesnaloxoneonprescriptiontopotentialoverdosevictims.TheprogramisbeingevaluatedbyProfessorPaulDietze(BurnetInstitute),ProfessorSimonLenton(NationalDrugResearchInstitute),Dr AnnaOlsen(KirbyInstitute,UNSW)andMrDavidMcDonald(SocialResearchandEvaluationandConsultanttoATODA).

• drugdiversionprograms:

– AnexternalevaluationofACTpoliceandcourtdrugdiversionprogramswasundertaken.TheevaluationwasconductedbytheDrugPolicyModellingProgram,NationalDrugandAlcoholResearchCentreandUniversityofNewSouthWalesandwascompletedinFebruary2013.

Sustainability StrategyACTHealthcontinuestodemonstrateitscommitmenttotheprinciplesofsustainabilitybymonitoringitsuseofresourcesandintegratingeconomic,socialandenvironmentalconsiderationsintoimplementingmeasurestominimisetheimpactofagencyactivitiesontheenvironment.In2012–13,it:

• continuedtoembedtheACTHealthSustainabilityStrategyintogovernanceprocesses

• implementedthefirstphaseoftheSustainabilityActionPlanbyincorporatingsustainabilityactionsintokeyfocusareasofACTHealthbusinessactivity.Allactionshavebeenclassifiedasshort-,medium-andlong-term. Oftheshort-termactions(1–3years),93percenthavenowbeencompleted.Thisequatesto59actions.

• developedandendorsedSustainability—EnvironmentalPrinciplesandGuidelinesforBuildingandInfrastructureProjects,adocumentdesignedtoguideandinformallfuturedevelopmentofhealthcarefacilities,includingsustainabilitychecklistsformasterplanning,buildingdesign,theconstructionphaseandtheoperationalstage

• implementedadditionalbicyclestorageforvisitorsandstaffontheCanberraHospitalcampus

• usedarestrictedOfficeMaxstationerycataloguetoensurecostminimisation,maximisingvalueformoneyandembeddingtheprinciplesofpurchasingsustainableproducts

• conductedcommunityconsultationforumsonfutureenergyoptionsfortheCanberraHospitalcampusaspartofafeasibilitystudytobestmeetthesustainabilitygoalofminimisingCO2emissionsassociatedwithfutureinfrastructuregrowth

• becameamemberoftheAustralasianHealthInfrastructureAllianceEnvironmentallySustainableDesignSubcommittee,aforumwhosemissionistosharebestpracticebetweenjurisdictions,poolresourcestodeliverinfrastructureprojects,leverageexistingstate-basedprojectsatanationallevelandimplementacommonandunifiedunderstandingofsustainabilityinhealthcare.


Quality and Safety Framework 2010–2015The Quality and Safety Framework 2010–2015 describesavisionanddirectiontoimprovesafetyandqualityinACTHealthandsetsoutthekeyactivitiesthatwillhappenthroughouttheorganisationtoimprovethesafetyandqualityofservicesprovidedtoconsumers.

Theplanincludesasetofactionsdividedintothreethemes,whichalignwiththoseoftheAustralianCommissiononSafetyandQualityinHealthCareinitsframeworkforavisionforsafeandhigh-qualityhealthcareforAustralia.Thesethemesarethatcarewillbe:

• consumer-centred

• drivenbyinformation

• organisedforsafety.

Tomeetthesethemes,theQualityandSafetyUnithasachievedthefollowing:

• partneredwiththeHealthCareConsumers’AssociationACTtoprovideforumson‘howtocomplainproperly’,consumerrepresentativetrainingandadvocacytraining

• supportedACTHealththroughtheAustralianCouncilonHealthcareStandards(ACHS)Organisation-WideSurveytoretainitsaccreditationstatus.ACTHealthmetallcriteriatoachieveaccreditationforanotherfouryears,with28markedachievements,18extensiveachievementsandoneoutstandingachievement

• implementedandevaluatedtraininginbedsidehandoveraspartoftheEffectiveCommunicationinClinicalHandover(ECCHO)project,anationalAustralianResearchCouncilfundingprojectincollaborationwiththeUniversityofTechnologySydneyandthreeotherjurisdictions.Trainingisnowbeingpilotedinanotherward.TheprojectteampresentedattheInternationalCouncilofNursesConferenceinMay2012

• supportedtheestablishmentofthe10NationalSafetyandQualityinHealthServicesStandardsGroupstoprovidestrategicdirectionfortheimplementationofthesestandardsandmonitorprogressonkeyactivities

• developedclearpolicydocumentsonimportantsafetyandqualityissuessuchas:

– consentandtreatmentpolicyandstandardoperatingprocedures

– respondingtotheuseofnon-prescriptionalcoholandotherdrugsinhealthsettings

– opendisclosure

– workhealthandsafety,andthesafetymanagementsystem

– dangeroussubstancemanagement

• heldOpenDisclosureMasterClassesforseniorclinicalandexecutivestaff.Theseclassesprovidetargetedskillstosupportstaffwhenopendisclosurediscussionswithpatientsandfamiliesarerequired

• supportedandmonitoredthequalityofpolicydocumentsthroughthePolicyAdvisoryCommitteeandstafftrainingsessionsonpolicygovernanceandpolicywriting

• providededucationandtrainingtostaffonimplementingthe10NationalSafetyandQualityHealthServiceStandards(NSQHSS)

• facilitatedtheACTQualityinHealthcareAwards,whichshowcasepatientsafetyandqualityinitiativesacrosstheterritoryandtheACTHealthBetterPracticeAwards,whichcelebratelocalqualityimprovementactivities

• developedanACTHealthQualityImprovementandNationalSafetyandQualityHealthServiceStandards(NSQHSS)educationstrategytoimproveunderstandingofchangemanagementandqualityimprovementmethodologytosupportimprovementsinqualityandsafetypractices

• workedtoupdatetheSafetyandQualityFrameworktoincludethenewNationalSafetyandQualityinHealthServicesStandards.Aconsultationdraftwillbeissuedinearly2013–14

• appointedaPatientExperienceLeader

• completedaprojectonbehalfoftheLocalHospitalNetwork(LHN)CounciltocollectpatientstoriesrelatingparticularlytobedsidehandoveranddischargeplanningtoallowtheLHNCounciltomakerecommendationsforimprovements

• developedatoolkittosupportchairsandsecretariatsofcommitteeswhohaveconsumerrepresentativesonthecommittees

• madeasuccessfulbudgetbidtoallowincreasedresourcingfortheRespectingPatientChoicesprogramtoincreasecommunityawarenessanduptakeofadvancecareplans


• heldanannualThankYoucelebrationforconsumerrepresentativesonACTHealthcommittees

• heldregularliaisonmeetingswiththeHumanRightsCommissiontodiscussprocessesandtrainingopportunitiesforstaff

• completedthedivisionalprogressreport,providingweeklyupdatesofconsumerfeedbackandstatus

• arrangedguestpresentationsatMedicareLocalAgedCareForumsandtheCouncilontheAgeingACT

• rolledouteducationandtrainingontheNationalRecommendationsforUser-AppliedLabellingofInjectableMedications,FluidsandLines

• completedatrainingstrategytofurthersupporttheimplementationofopendisclosureinACTHealth

• ACTHealthcoordinatedandmonitoredpreparationsfortheNovember2012AustralianCouncilonHealthStandardsorganisation-widesurvey

• developedandimplementedCanberraHospitalandHealthServices-wideclinicalauditsthatalignwiththeNationalSafetyandQualityHealthServiceStandards

• revisedACTHealthincidentmanagementpolicyandassociatedstandardoperatingprocedures(SOP),includingtheIncidentManagementSOP,SignificantIncidentSOPandOpenDisclosureSOP

• completedthefirstACTAuditofSurgicalMortalityAnnualReport.

Theframeworkisbeingreviewedforprogressagainsttheareasforactionandalignmentwiththe10NationalSafetyandQualityHealthServiceStandards.

General Practice and Acute Sector Interaction SurveysSeveralnewservices,communicationstrategiesandprocessrefinementshavebeenputinplacetoimprovetheinteractionbetweengeneralpracticeandACTHealth,followingtwoGPandacutesectorinteractionsurveysconductedin2009and2010.Thecombinedreportmade25recommendations,whichhavenowbeenimplementedorareongoing.Improvementshavebeenwide-rangingandhaveincluded:

• expansionoftheACTHealthGPwebsitetoincludecommonexternalresources,integrationwithoutpatientandsurgicalwaitingtimesandreferralguidelinesforoutpatientservicesacrossACTHealth

• establishmentofane-referralsystem,whichallowsclinician-to-cliniciancommunication

• improvementstothequalityandtimelinessofdischargesummaries,includingeducation,clinicalsupportanddischargesummaryawards

• development,endorsementandpromotiontoallstaffofpoliciesandstandardoperatingprocedures(SOPs) toensurebetteraccessandsharingofclinicalinformationbetweenandwithintheacuteandprimaryhealthcare sectors

• improvedcommunicationandreferralpracticesfacilitatedbyinteractionbetweentheGeneralPracticeLiaisonUnit,ehealthstaffandgeneralpractices.

FormalcommunicationchannelsbetweengeneralpracticeandACTHealthcontinuetooperatethroughtheACTHealthandACTMedicareLocalquarterlymeetings,GPLiaisonNetworkquarterlymeetingsandthe ACTGPWorkforceWorkingGroup.


C.6 Human resource performance

In2012–13,thePeopleStrategyandServicesBranchinACTHealthfocusedonembeddingthenewbranchstructuretobettersupportservicedeliveryandplanningforthefutureworkforce.Thebranchhasworkedhardtoimplementcontinuousimprovementandqualityactivities,includingamajorreviewofallpoliciesandproceduresandrefinementofbusinessprocessesinsupportofefficientandeffectiveservicedelivery.

Keystrategiesforthebrancharetoimproveemployeeengagementandperformancethrougheffectiveperformancemanagementanddevelopment;toimprovethequalityofmanagement,leadershipandorganisationalculture;andtoimplementspecificstrategiesforthecreationofnewandinnovative employmentstrategies.

Keyachievementsandmajoractivitiesin2012–13arelistedbelow.

• ThecompletionoftheACTHealthWorkforcePlan2013–2018wasasignificantmilestoneforPeopleStrategyandServices(PSS)inthereportingyear.InconjunctionwiththeAboriginalandTorresStraitIslanderHealthWorkforceActionPlan2013–2018,itestablishesastrategicframeworkforinnovationandreformintheworkforce.

• HealthWorkforceAustralia(HWA)releasedtheHealthWorkforce2025seriesofreports,whichclearlyforecasttheemergingworkforceshortagesinthedomainsofnursingandmidwifery,medicineandalliedhealthdisciplines.Theseimportantreportsmakeasubstantialcontributiontotheevidencebasedrivingsignificantnationalworkforcereformsacrossthehealthsector.ACTHealthstrategiesaredescribedinmoredetailinSectionA.9ofthisreport,under‘Healthworkforce’.

• ThestaffinthebranchhaveworkedwithcolleaguesinHealthServicePlanningtoimprovetheeffectivenessofworkforceplanningintandemwithsupportserviceplanningandinfrastructuredevelopment.

• TheACTHealthLeadershipNetworkcontinuedtocreateopportunitiestobuildcollaborativerelationshipsandpartnershipsacrossthedirectorate.Thegroupmetthreetimesduringtheyear,withspeakersandpresentationsencouragingparticipantstodeveloptheirleadershipskills,withaparticularfocusonchangeandresilience,ethicsandself-awareness.

• HWAinitiativesandprojectstosupportthedevelopmentofthefutureworkforcearecentrallycoordinatedbyanHWA-fundedteamembeddedwithinPSS.WithinthisteamaretheACTRegionIntegratedClinicalTrainingNetwork(ICTN)coordinatorandsecretariatandtheSimulatedLearningEnvironment(SLE)projectstaff.Majorachievementsin2012–13include:

– establishmentoftheACTRegionICTNwebsite

– developmentoftheweb-basedSLElendinglibrary

– commissioningofsixtwo-bedroomunitsfortheuseofinterstatestudentsonclinicaltrainingplacements,and

– increasingclinicaltrainingplacementsacrosstheregion.

• In2013,negotiationscommencedonanumberofreplacemententerpriseagreementscoveringallstaffemployedbyACTHealth.Additionally,therenegotiationoftheVisitingMedicalOfficercoreconditionswasundertaken.

• SignificantinvestmentinandcommitmenttotheRespect,EquityandDiversity(RED)frameworkcontinuedduring2012–13,withtheREDcontactofficernetworkexpandingto90officersandtrainingnowhavingbeendeliveredtoapproximately75percentofstaffintheorganisation.TheREDcontactofficernetworkprovidesanimportantsupporttostaffmemberswhomaybeexperiencingbullyingandharassment,includingtheprovisionofinformationaboutpotentialnextstepstoaddressthebehaviour.

• TheresultsoftheAustralianCouncilonHealthStandardsAccreditationsurveyheldinNovember2012wereagratifyingaffirmationthathumanresourcepracticewithinACTHealthisontrack.ItwasawardedfourExtensiveAchievementsandoneMarkedAchievementforthefivehumanresourcecriteriainthestandards.TheExecutiveteamofPSSwasawardedanACTHealthAustraliaDayAwardinrecognitionofthisoutcome.



• TheEmploymentInclusionOfficerhasdevelopedanumberofemploymentactivitiestofacilitatetheachievementoftheACTPSEmploymentStrategies.ThisofficeralsocoordinatesACTHealth’sparticipationintheACTGovernment’sAboriginalandTorresStraitIslanderTraineeshipProgramandhasdevelopedaTraineeshipProgramforPeoplewithaDisability.Todate,fourAboriginalandTorresStraitIslandertraineeshipsandseventraineeshipsforpeoplewithadisabilityhavebeenenabled.Newprogramsareplannedforimplementationinthecomingyear,alongwithanexpansionofthecurrentprograms.

– ThedevelopmentandsuccessfulpilotofthePeopleManagerProgramwasanotherhighlight.Thisprogramfocusesondevelopingandsupportingfront-linemanagersinarangeofskillareas.Theprogramwillnowberolledoutmoreextensivelyinthenewfinancialyear.

– Thecontinuedcommitmenttoongoingdevelopmentandenhancementoftheworkforcethroughacomprehensiveandrigorouslearninganddevelopmentstrategydeliveredsignificantrewardsintermsofqualificationsandtraineeships,asdescribedinsectionC.8,Learninganddevelopment.


C.7 Staffing profile

Full-time equivalents (FTE) and headcount

Female Male Total

FTEbygender 4,272.71 1,476.36 5,749.07

Headcountbygender 4,962.00 1,578.00 6,540.00

%ofworkforce(headcount) 76% 24%

Classifications

Classification group Female Male Total

AdministrativeOfficers 771 169 940

Dental 13 4 17

ExecutiveOfficers 14 8 22

GeneralServiceOfficersandequivalent 199 273 472

Health Assistants 58 6 64

HealthProfessionalOfficers 781 234 1,015

InformationTechnologyOfficers 0 2 2

LegalOfficers 0 1 1

MedicalOfficers 383 431 814

NursingStaff 2,357 269 2,626

ProfessionalOfficers 7 5 12

SeniorOfficers 249 124 373

Teacher 1 0 1

TechnicalOfficers 127 50 177

Traineesandapprentices 2 2 4

TOTAL 4,962 1,578 6,540

Employment category by gender

Employment category Female Male Total

Casual 280 96 376

Permanentfull-time 2,322 887 3,209

Permanentpart-time 1,516 132 1,648

Temporaryfull-time 645 428 1,073

Temporarypart-time 199 35 234

TOTAL 4,962 1,578 6,540


Average length of service by age group by gender

Average length of service

Pre-Baby Boomers Baby Boomers Generation X Generation Y Total

F M F M F M F M F M

0–2 4 2 177 43 427 191 745 313 1,353 549

2–4 2 3 179 40 305 121 377 106 863 270

4–6 3 2 175 61 249 98 214 43 641 204

6–8 5 0 140 41 215 65 93 17 453 123

8–10 5 2 148 41 160 61 48 9 361 113

10–12 2 1 152 38 124 32 21 3 299 74

12–14 1 1 95 27 78 18 8 0 182 46

14+years 5 5 577 139 227 55 1 0 810 199

Generation Birth years covered Generation Birth years covered

Pre-BabyBoomers prior to 1946 GenerationX 1965 to 1979 inclusive

Baby Boomers 1946 to 1964 inclusive GenerationY from1980andonwards

Total average length of service by gender

Gender Average length of service

Female 7.4

Male 6.2

Total 7.1

Age profile

Age group Female Male Total

<20 32 12 44

20–24 325 113 438

25–29 686 219 905

30–34 635 214 849

35–39 574 226 800

40–44 640 213 853

45–49 567 170 737

50–54 674 155 829

55–59 480 144 624

60–64 270 75 345

65–69 67 28 95

70+ 12 9 21


Agency profile

Branch/division FTE Headcount

CanberraHospitalandHealthServices 4,626.53 5,326

Director-GeneralReports 300.62 320

Special Purpose Account 13.56 17

StrategyandCorporate 808.36 877

Total 5,750.07 6,540

Agency profile by employment type

Branch/division Permanent Temporary Casual

CanberraHospitalandHealthServices 3,904 1,096 326

Director-GeneralReports 283 35 2

Special Purpose Account 5 9 3

StrategyandCorporate 665 167 45

Total 4,857 1,307 376

Equity and workplace diversity

Category A Category B Category C

Aboriginal and/or Torres Strait

Islander

Culturally and linguistically

diverse People with a

disability

Employees who identify in

category A, B or C* Women

Headcount 65 1,446 126 1,609 4,962

% of total staff 0.99% 22.11% 1.93% 24.60% 75.87%

*NB:Employeeswhoidentifyinmorethanoneequityanddiversitycategoryarecountedonlyonce.

Statisticsexcludeboardmembers,staffnotpaidbytheACTPublicServiceandpeopleonleavewithoutpay.StaffmemberswhohadseparatedfromtheACTPublicServicebutreceivedapaymenthavebeenincluded.


C.8 Learning and development

Learning and development outcomesAnorganisation-widesystemisinplaceforthedevelopment,implementationandregularreviewoflearninganddevelopmentinACTHealth.ThisincludestheACTHealthLearningDevelopmentFrameworkandreportingandassociatedpolicies,whichsupportalearningculturetoenhancestaffcapabilities,competencyandlegislativecompliance.TheEducationActivityRegistermonitorsexecutiveapprovalforprograms,annualevaluationandrevision.Acomprehensivecalendaroflearningopportunitiesisprovidedtostaffontheintranetandthelearningmanagementsystemandannualdatademonstratesahighdegreeofuptakeofeducationandtraining.

In2012–13achievementsincluded:

• AustralianCouncilonHealthCareStandards(ACHS)2012accreditationratingofEA(ExtensiveAchievement)forlearninganddevelopment

• revisionandimplementationoftheACTHealthLearningandDevelopmentFrameworkandassessmenttoolbasedonlearningorganisationprinciples

• significantrevisionoftheessentialeducationpolicy(mandatorytraining)andprocedures.Thispolicyalsoenunciatesrequirementsforstudents,volunteersandcontractors

• anextensiveevaluationandrevisionofclinicalprogramstocomplywiththeNationalSafetyandQualityHealthServiceStandardsand

• anincreaseincompetency-basedtrainingtocomplywiththeNationalSafetyandQualityHealthServiceStandards,includingrevisionordevelopmentofeducationandpilotingofnewassessmenttools—forexample,inlifesupportprogramsandinaseptictechnique.

ACTHealthiscommittedtoensuringthequalityofitseducationandtraining.Thisincludes:

• auditingoftheEducationActivityRegister,whichmonitorsprogramsontheACTHealthlearningmanagementsystemtoensuretheyarereviewed,updatedannually,linkedtoevidence-basedpracticeandapprovedbyanexecutivedirector.In2012–13,153programswerelistedontheEducationActivityRegister

• maintainingcompliancewiththeStandardsforNVRRegisteredTrainingOrganisations2011,withtwonationallyrecognisedprogramsofferedin2012–13

• evaluatinglearninganddevelopmentprograms—assessingoutcomesandreportingtostakeholdergroups

• providingprofessionaldevelopmentandnetworkingforstaffacrosstheorganisationengagedinwork-basedtrainingandeducationinitiatives,studentclinicalsupervision,graduatesupport,andcompetencyassessmenttosupporttheprovisionofsafe,qualityhealthcare,asshowninthetablebelow.

Program Enrolments and attendees 2012–2013

TAE40110CertificateIVinTrainingandAssessment72enrolmentsfromnursing,midwifery,alliedhealth,technicalandadministrativeroles

Clinicalsupportandsupervisionessentials 67attendees(54nursingand13alliedhealthstaff)

TrainersandEducatorsnetwork 158attendeesover5meetings

Leadership and culture programs• TheACTHealthLeadershipNetworkiscomposedofaround100employeesidentifiedbytheHealthExecutive

asleadersandpotentialleaderswhocouldmostbenefitfromthenetworkandcontributetoitsobjectives. Thethreeworkshopsheldduringthe2012calendaryearhadleadershipthemesofidentifyingandfocusingonstrengths,positiveorganisationalstories,ethicaldecisionmaking,collaboration/teamworkandcourageousleadership.InspiringandinformativeguestspeakersincludedMichaelMilton(Paralympian),JohnHill(StJamesEthicsCentre),RechelleHawkes(formerHockeyrooscaptain),AndrewKefford(DeputyDirector-General,WorkforceCapabilityandGovernanceDivision&CommissionerforPublicAdministration,ACTPublicService),andMargieWarrell(CEO,GlobalCourageInstitute),withHealthexecutiveandstaffalsocontributingstrongly.Participantswereencouragedtodeveloptheirindividualandgroupthinkingonthesetopicsaswellastocontinueformingconstructivepartnershipswitheachotherandacrosstheorganisation.


• ThePeopleManagerProgram,developedandcommencedin2012–13,aimstodevelopknowledgeandskillsinpeoplemanagement,underpinnedbyHealth’svalues.ThePMPisforcliniciansandnon-cliniciansinfrontlinesupervisorandmiddlemanagementpositionswhohavepeoplemanagementresponsibilities.Ithasreceivedexcellentevaluationsfromparticipants,whohaveappreciatedtheHealth-focusedexamplesandcontextsused.

• TheCriticalCareLeadershipProgramisaninter-professionalleadershipprogramattendedbyIntensiveCareUnitandEmergencyDepartmentclinicalstafffromtheCanberraHospitalandCalvaryHospital.In2012–13,twoprogramswereattendedby50staff.

• TheClinicalLeadershipandCommunicationSkillsDevelopmentProgramtargetsparticipantsfromgraduateprograms,nursingnightduty,clinicaldevelopmentnursesandmidwives,andupcomingnursingteamleaders.Theprogramwasdevelopedinresponsetoevaluationandneedsanalysisofthesegroups.Atotalof293staffattendedthesesessions,whichreceivedpositiveevaluations.

• Managingandpreventingbullying,harassmentanddiscriminationtrainingisavailabletoallmanagersandallstaff.Morethan4,600staffintheACTHealthworkfocehavebeentrainedsincetheprogrambegunin2011.

All-staff workshops Managers’ seminar Total number of staff trained in 2012–13

1,385 101 1,486

ThenumberofRespectEquityandDiversity(RED)contactofficersat30June2013was90.REDcontactofficersincludenurses,alliedhealthprofessionals,administrativestaffandstaffwhoworkoutsidetraditionalbusinesshours.

• ACTHealth’scombinedeffortsonREDtraining,policydevelopment,casemanagementandotherinitiativesresultedinitbeingshortlistedforanACTPSAwardforExcellenceintheRespectcategory.

Recruitment and transition to practice programsACTHealthimplementshighlysuccessfulprogramstotransitionnewnursesfromstudentlifetopractice,includingaGraduateRegisteredNurseprogram,EnrolledNurseprogram,andAlliedHealthGraduateProgram.Theprogramsprovideahighlevelofclinicalandprofessionalsupport,care,feedbackandguidanceduringthetransitionyear.Theevaluationsdemonstratedthattheprogramsmetparticipants’expectationsandthoseoftheclinicalareas.

Participants’commentsinevaluationsincludedthefollowing:

‘Learningalotaboutnursinginapracticalcapacityandbecomingresponsibleformyownlearningandmyownactions.IalsofeelthatIhavemadeapositivecontributiontootherpeople’slives,anditisnicetoknowthatmycareercandothisforpeople’.

‘beingabletoworkasanurse,learningnursingskillfromalldifferentareasofthehospitalandexperiencingdifferenttypesofnursingsuchaswardandclinic’.

‘Gainingsomanyvaluableskillswhilstbeingsupported’.

Program Number of participants Completions Retention rate (stay in ACT Health after completion)

RNGraduateprogram2012 99over3intakes 98(99%) 92(93%)

RNGraduateprogram2013 103over4intakes Programongoing Programongoing

ENGraduateprogram2012 17over2intakes 6completed 9ongoing

5employed,othersongoingbecauseofmaternityetc.

ENGraduateprogram2013 5commenced Programongoing Programongoing

TheAlliedHealthGraduateProgramwasdevelopedandpilotedin2012tosupportnewalliedhealthprofessionalstointegrateintotheworkforcewithaninterprofessionalfocus.ThefullprogramcommencedinFebruary2013,with27participants,andwillconcludeinJuly2013.

NurseandMidwivesRe-entryProgramsandOverseasQualifiedNursePrograms:There-entryprogramsrecruitandprovideeducationalsupporttonursesandmidwiveswhohavenotworkedinacutehealthcareforupto10years.TheOverseas-QualifiedNurseProgramprovideseducationandsupportforinternationallyqualifiednursestoobtainregistrationinAustraliaandthepossibilityofobtainingapositioninACTHealth.BothprogramsareaccreditedwiththeNursingandMidwiferyBoardofAustralia


2012–13 Completed Currently participating Recruited to ACT Health

Registerednursere-entry 7 3 4

Midwiferyre-entry 3 1 1

Overseasqualified 12 4 6

Essential Education programs

Safety education programs

Program Description Staff Trained

ManualHandlingEducation Arangeofprogramsprovidedforclinicalandnon-clinicalstaff,studentsandvolunteers

2,913staffface-to-face

133volunteers,271nursingandalliedhealthstudents

30medicalstudentsandinterns

2,882e-learningcompletions

Predict,AssessandRespondtoChallengingorAggressive Behaviour(PART)

Helpsstaffinhigh-riskareastorespondtochallengingclientbehavioursafelyandeffectivelyinordertoreducetheriskofharmtobothclientsandstaff

111,nurses,alliedhealth,administrationstaffandwardspersons

Chemotherapysafehandling

ProvidedforstafflookingafterpatientswhoarereceivingchemotherapytocomplywiththeClinicalWasteACT,thePoisonsandDangerousDrugsAct,theWorkplaceHealthandSafetyActandtheHazardousChemicalsandDangerousGoodsAct.

66 nurses

Child protection training ThisisprovidedatthreelevelsforstaffaccordingtotheircontactwithchildrenandyoungpeopleandisdeliveredacrossallHealthorganisationsandsections,includingbothCalvaryHealthCarehospitalsandnon-governmentagenciesthatreceivefundingfromACTHealth.ACTHealthvolunteersarealsoprovidedwithtraining.E-learningoptionsareavailableforlevel1childprotectiontrainingandthelevel2refreshertraining.

ACTHealthcontinuestopartnerwiththeCommunityServicesDirectoratetoprovideWhatAboutMe,aseriesofworkshopsforgovernmentandnon-governmentorganisationsaimedatincreasingstaffconfidenceandabilitytoworkwithvulnerablechildrenandfamilies.

Number of ACT Health staff attending child protection training 2012–13

Level of training Total number trained*

Level1(face-to-face) 278

Level2 797

Level2refresher(face-to-face) 121

Level3 454

Level3refresher 212

Level1e-learning 719

Level2e-learning 569

Total2012–13 3,150

Total2011–12 2,830

*Staffmayattendmorethanoneleveloftraining—forexample,level1andlevel3.Theparticipanttotalreflectsthefullnumberofattendeesateducationsessions.ThesefiguresincludeallstafftrainedinACTHealth(andCalvaryBruceandCalvaryJohnJames).


Life support programsLifesupportprogramsareprovidedinlinewiththerequirementsoftheNationalSafetyandQualityHealthServiceStandards(Standard9).In2012–13,alllifesupportprogramswererevisedinconsultationwithstakeholderstostrengthenalignmentwithcurrentguidelines,improveavailabilityandaccess,andincreasethenumbersofaccreditedtrainersandassessors.Programsin2012–13increasedtheuseofsimulationandscenariostohelpsolidifyknowledgeandskills.

Thetablebelowshowsthetrainingprovidedandthenumberofstaffwhoattended:

Training No. of participants

BasicLifeSupport—433programs 3,354

AdvancedLifeSupport—13programs 167

AdvancedLifeSupportRefresher—12programs 113

NeonatalLifeSupport—9programs ACTHealth—151,Calvary—45

UpdateNeonatalLifeSupport—6programs ACTHealth—80,Calvary—11

PaediatricLifeSupport—8programsfacilitatedbyAdvancedPaediatricLifeSupport(Victoria),heldinCanberra 130

PaediatricLifeSupportRefresher,CanberraHospital—4programs 12

Note:TheBasicLifeSupportprogramisnowincludedin13AdvancedLifeSupportprograms,inwhich167staffwereassessedonBasicLifeSupport.

Early Recognition of the Deteriorating Patient Program (COMPASS) Thisprogramsupportsimplementationofstandard9oftheNationalSafetyandQualityHealthServiceStandardsandisdesignedfornurses,midwives,physiotherapists,doctorsandundergraduates,andisdeliveredbytheEarlyRecognitionoftheDeterioratingPatientteam.TheCOMPASSeducationprogramisusedbyfacilitiesineverystateandterritoryinAustralia,andinternationally.TheCOMPASSprogramsofferedin2012–13aresetoutinthetablebelow.

COMPASS Program Number of sessions Number of participants

Adult 29 475

Paediatric 5 11

Maternity 5 20

Adultrefresher 48 997

Paediatricrefresher 24 116

Maternityrefresher 20 62

• AmonthlyModifiedEarlyWarningScore(MEWS)andMedicalEmergencyTeam(MET)forumisheldtodiscusscasestudies,auditsandatopicofthemonth.

• NewjuniormedicalstaffundertakeCOMPASSintheannualJanuarymedicalorientationforjuniordoctors.

Anewfamily-activatedescalationprogram,CallandRespondEarly(CARE)forpatientsafety,hasbeendeveloped.Thistrainingincludeda1.5-hourin-serviceforwardnursingstaff,andaneight-hourCAREskillsdaywasdevelopedanddeliveredinconjunctionwithOrganisationalDevelopmentforCARErespondersandseniorwardnurses.Therewere50CAREin-servicesfor458participantsandfiveCAREskillsdaysfor51participants.

TheNeonatalEarlyWarningScore(NEWS)pilottraininghascommencedforstaffinthematernityunit.Thistraining,developedbytheNEWSprojectteam,wasledanddeliveredbyneonatalandmaternityclinicalsupportnursesandclinicaldevelopmentnurses.Todatetherehavebeenseventwo-hoursessionsfor48participants.


Clinical programsACTHealthprovidesalargenumberofclinicaleducationprograms.Somekeyprogramsaredescribedbelow.

Night Duty ProgramNightDutyProgramisofferedonceortwiceamonthfor11monthsoftheyearfornursingstaffworkingnightduty.Theprogramincludesprofessionalissues,clinicaleducation,invitedguestspeakersandcompetencyassessmentforclinicaleducation.TheNightDutyProgramwasconductedon30occasionsduringtheyear,with962staffattending.

Introduction to Perioperative Nursing Program TheIntroductiontoPerioperativeNursingProgramwasfirstdevelopedtoattractandretainnursesinresponsetostaffingshortagesinthePerioperativeUnit.

• InFebruary2012,16nursescommencedtheprogram,includingeightgraduatenursesandnursesfromotherareasinCanberraHospitalandregionalNewSouthWaleshospitals.Theprogramis12monthslongandiscompletedinthefollowingFebruary,inlinewiththenewgraduateprogram.Allgraduatenurseselectedtocontinuetoworkintheperioperativearea.The2012programwasextensivelyevaluated,indicatingthatthecoursehaddeliveredorientation,providedbasicskillsandknowledge,andretainedstaffintheperioperativenursingspecialties.Feedbackfromregionalhospitalparticipantswasverypositive,andplaceswillcontinuetobeofferedtothem.

• InFebruary2013,13nurses(includingeightgraduatenurses)commencedtheprogram,includingtwoparticipantsfromregionalNewSouthWales.TheprogramwillcontinueuntilFebruary2014.

Perioperative Team Leader ProgramThePerioperativeTeamLeader(TL)ProgramwasdevelopedtoattractandeducatenursestofulfiltheroleofScrubTLafterhours.Followingevaluationtheprogramwaschangedtodeliverabroader,team-orientatedapproach,providingeducationmodulesencompassingallperioperativenursingspecialties.TheseincludeScrub,Anaesthetics,theExtendedDaySurgeryUnit(EDSU)andthePost-AnaestheticCareUnit.Perioperativelevel1registerednurseswithaminimumoftwoyearsexperience(12monthsforEDSU)orlevel2perioperativeregisterednurseswhohavenotyetworkedasateamleaderarethetargetgroupsforthisprogram.Twelvenursesattendedthefirstfourmodulesandsevennursesattendedthefinalmodule.Therevised2013programwaswellreceived.

Paediatric Foundation ProgramThePaediatricFoundationProgramisalignedwiththeNurseGraduateProgram.Theprogramallowsthenovicepaediatricnursetodevelopandconsolidatetheirskillsthroughworkshopsandlearningmodules.

In2013,thereweretwointakesandatotalofeightgraduates.InAugust2013,thefirstintakewillcompletetheprogram.ThesecondintakeisduetocompleteitinNovember2013.

Child and Adolescent Mental Health ProgramThisthree-dayprogramisruninconjunctionwiththeChildandAdolescentMentalHealthServiceandprovideshealthprofessionalswithknowledgeandmanagementskillsusedinthecareofthechildandyoungpersonwithanacutementalhealthproblem.In2012,18participantscompletedtheprogramandpaper-basedevaluationsdemonstrated100percentsatisfaction,withratingsof‘good’to‘verygood’.Thisprogramisre-scheduledforSeptember2013.

Peripheral Intravenous Cannulation ProgramTheprogramisforregisterednursesandmidwives,medicalstudentsandmedicalofficersandradiographers,andthirdyearstudentnursesintheirfinalplacementmayalsoapply.In2012–13,10workshopswereconducted,with159participants,and13percentcompletedallrequirements.Thefocusisnowonrevisingthecontenttomorecloselyalignwiththe10NationalSafetyandQualityHealthServiceStandards,ACTHealthpolicyandcurrentliterature,andonthedevelopmentofane-learningprogramforthetheorycomponenttoencourageahigherrateofcompletionofallaspectsoftheprogramrequirements.


Central Venous Access Devices WorkshopThisprogramprovidesanoverviewofACTHealthpolicyandproceduresinthecareandmanagementofcentralvenousaccessdevicesandisavailableasaworkshopande-learningpackage.In2012–13,21participantsattendedworkshopsand69staffcompletedthee-learningprogram.

Postgraduate Certificates for Nurses and MidwivesTwoPostgraduatecertificatesareofferedtonursesandmidwivesthroughtheAustralianCatholicUniversity(ACU)inpartnershipwithACTHealth.TheACUdeliversanonlinecomponentfortwounits,andaneducatorinthe StaffDevelopmentUnitteachesanapprovedcurriculumfortheremainingtwounits.Thiseducationmodelcombinestheoryandexperientiallearning.TheadvantagesforACTHealthofusingthismodelarethatpostgraduatestudyistailoredtoworkareaneed,studentscanworkandstudyatthesametime,andtherearenofeesfortheACTHealthcomponent.

• GraduateCertificateinNeonatalNursing:In2012,fourstudentscompletedtheonlinecomponentthroughtheAustralianCatholicUniversity.In2013,ninestudentswereenrolledintheACTHealthprogram,includingthefourstudentswhocompletedtheonlinesubjectsin2012.Twostudentshavecontinuedontostudyforamaster’sdegree.

• ChildandAdolescentHealthGraduateCertificate:ThecoursecurriculumwasrevisedandapprovedbytheACUin2013.In2012sixstudentswereenrolled,fivespecialisinginacutepaediatricsandoneinmaternalandchildhealth.Allstudentscompletedthecourseandfivewentontostudyforamaster’sdegree.Afurtherthreestudentsstartedinmid-semester,twospecialisinginacutepaediatricsandoneinmaternalandchildhealth. In2013,11studentsenrolled,fivespecialisinginacutepaediatricsandsixinmaternalandchildhealth.Threestudentscompletedthecourseattheendofsemester1,2013,withtwogoingontoamaster’sdegree.

E-learningSevennewe-learningprogramswereimplementedin2012–13tosupportclinicalandnon-clinicalareasandafurthersixareinfinaldevelopment.Tenprogramswerereviewedandupdatedasaresultofevaluationfeedbackandchangestolegislationorclinicalpractices.Thesedevelopmentswithe-learningaresetoutinthetablebelow.

Programs implemented 2012–13 Programs in final development and piloting

FinanceModule1(basicfinanceprocesses) B.Braun(infusionpumps)

FinancesPracticalities(practicalapplicationoffinancetools) Ketamine(administrationofpainmanagementmedication)

TobaccoIntervention RespectingPatientChoices(patientchoicesregardingcare)

OpenDisclosure PersonalSafetyandConflict

MagneticResonanceImaging(toenablelogon) PatientIDandProcedureMatching

CertificateIVinTrainingandAssessment(supplementary) IntrathecalMorphine(painmanagement)

IncidentManagement(Riskman)

E-learning updates as a direct result of evaluations

ChildProtectionLevel1 AustralianCharterofHealthcareRights

ChildProtectionLevel2Refresher MedicationPackaging

Work Health and Safety Act 2011 Ethics,FraudandIntegrity

Consent PCA Competency Test

Health Procurement AboriginalandTorresStraitIslanderAwareness


Student supportThe Secondary School Work Experience Program isafour-dayplacementofferedtoyear10,11and12studentsattendingahighschoolorcollegeintheACT.Theaimoftheprogramistogivestudentsarealisticideaofwhatitisliketoworkinhealthcareandencouragethemtochoosecareerpathsinhealth.In2012–13,Healthplaced251secondarystudents.Positivefeedbackwasreceivedfromstudents,teachersandworkplaces.

Secondarystudents’commentsincludedthefollowing:

‘Igotthechancetoseeaverybroadrangeofprofessionalswithintheward,whichwasinterestingandbeneficial. Ialsogottointeractalotwithpatientsandwasabletodomanyactivitieswiththem.’

‘IlovedthepeoplewhoIworkedwithbecausetheyweresofriendly,accommodatingandwillingtoeducateme.’

‘Whenthepatientsshowedimprovements,theexcitementexpressedbythemwasgreat.Thetherapist/patientrelationship.Thepatientswerereallyfriendly.Thepersonalityofthenursesandobservingthedailyrequirementsandabilitiesanurseisexpectedtoprovide.Thenursesaresuchbeautifulwomenandmenwhowerecontinuouslydevotedandalwayssharedsuchfriendlysmilesandwordstogether.’

The Student Placement Unitassistswiththemanagementofclinicalplacementsfornursing,midwifery,medicalandalliedhealthstudents.Itprovidesaplatformforpre-placementpreparation,includinge-learningprogramsforlegislativecompliancepriortoclinicalplacementcommencement.ThestudentplacementmanagementsystemalsoassistswiththereportingrequirementsofHealthWorkforceAustraliainrelationtostudentclinicalplacementactivity.In2012–13,therewere523alliedhealthplacements.Inthesameperiod,23,770clinicalplacementdayswereprovidedtonursingandmidwiferystudents.Clinicalplacementopportunitieswereofferedinavarietyofacuteandprimaryhealthcareareas.

The Allied Health Student Clinical Placement Mapping project commencedin2012toassessandidentifycapacityforgrowthinstudentnumbersandclinicalplacementsupto2014inalliedhealthprofessionsdeemedtobeinneedofmoreclinicalplacementsduetoincreasedstudentnumbers.ThisworkwasinitiatedtoassisttheClinicalTrainingPlacementsReferenceGroup,asubcommitteeoftheIntegratedRegionalClinicalTrainingNetwork(IRCTN).Theproject’sinitialfocushasbeenonthecollectionofinformationrelatingtocurrentandplannedclinicalplacementactivityandstudentnumbersinphysiotherapyatbothACTHealthandCalvaryHealthCareACT(public).Theprojecthasincludedtheidentificationofbarriersandenablerstoincreasingthenumberofplacementsoffered,andhighlightedtheresourcesrequiredtomaintainandenhancethequalityoftheplacementsoffered.Theprojectwillbefinalisedinlate2013.

Scholarships for allied health, nursing and midwifery

Allied healthTheOfficeoftheAlliedHealthAdvisersupportsandpromotesACTHealth’scommitmenttoongoinglearninganddevelopmentthroughtheAlliedHealthPostgraduateScholarshipScheme.Scholarshipsareawardedtosupportrecipientsintheirpursuitoffurtherlearninginclinicalpractice,educationandtraining,researchand/ormanagementandleadership.Scholarshipsareawardedannuallyoveracademic(calendar)years,withthebudgetspreadovertwofinancialyears.

The2012–13budgetcommitted$71,345tosupport25recipientscompletingtheirSemester2,2012,postgraduatestudy.However,actualpaymentforthisstudyperiodwas$50,194duetothewithdrawalofsevenrecipients.InSemester3,2012,atotalof$18,277wascommittedtosevenrecipients.However,followingtwowithdrawals,actualpaymentmadewas$15,311.Inthe2013academicyear,alliedhealthpostgraduatescholarshipswereawardedto13newapplicantsand13continuedtheirstudyfrom2012.Ofthepostgraduatecoursesbeingundertakenbythe2013recipients,fiveareatGraduateCertificatelevel,oneisatGraduateDiplomaleveland20areatMaster’slevel.Twenty-fiverecipientscommencedtheirstudyinSemester1,2013,representingacommitmentof$62,326andresultinginatotalinvestmentof$127,832inalliedhealthpostgraduatescholarshipsfor2012–13.


Nursing and midwiferyTheNursingandMidwiferyPost-RegistrationScholarshipScheme,offeredsinceNovember2000,providesfinancialassistancewithcoursetuitionfeestosupportstudiesinaclinical,education,researchandleadershipormanagementareaforenrolledandregisterednursesandmidwives,throughthefollowingscholarshipprograms:

• AboriginalandTorresStraitIslanderEnrolledNursingScholarships

• JoannaBriggsInstituteClinicalFellowshipScholarships

• AboriginalandTorresStraitIslanderEnrolledNursingScholarship

• JenniferJamesMemorialHonoursDegreeScholarship

• NursingandMidwiferyTravelScholarship.

Therehasbeena25percentgrowthinpost-registrationscholarshipsand,in2012–13,arecordnumberofregisterednurses,midwivesandenrollednursesreceivedscholarshipsupport.

ACT Health total learning and development activity

Learning and development activity for face-to-face programs and completion of e-learning programs by health division as recorded in the ACT Health learning management system, Capabiliti, from July 2012 to June 2013

Health divisionNo. of

attendances Hours SalaryE-learning

completed

OfficeoftheDirector-General 937 3,265 $147,804 656

DDGStrategyandCorporate 2,631 7,302 $296,665 1,628

DDGCanberraHospitalandHealthServices 54,847 130,578 $4,899,055 16,351

Calvary* 54 N/A N/A N/A

Special Purpose Account 100 191 $7,455 58

TOTAL 58,569 141,336 $5,350,979 18,693

*Calvaryhoursandsalarycostsarenotavailable.

ACT Health staff undertaking whole-of-government learning and development

Study assistanceIn2012—13,studyassistancewasprovidedto212employeestoallowthemtoaccesspaidleaveandcompleteexternalstudytodevelopcapabilitiesthatcanbeappliedintheworkenvironment.Inadditiontostudyleave,atotalof$41,124infinancialassistancewasprovidedtoACTHealthstaff.


ACTPS calendar of trainingIn2012–13,203ACTHealthstaffattendedtrainingfromtheACTPStrainingcalendar,atatotalcostof$73,588.29

Initiative No. of participants

ACTPSGraduateProgram 2

YoungProfessionals’Network(YPN) N/A*

FutureLeadersProgram 4

ExecutiveDevelopmentProgram 1

PSMProgram N/A*

SponsoredTrainingforFirst-timeandFrontlineManagers N/A*

*In2012–13,thePublicSectorManagementProgram,first-timeandfrontlineManagersProgramandYPNactivitieswerenotcoordinatedcentrally,sothereisnodataavailabletoreport.

Future learning and development prioritiesKeyfuturelearningprioritiesasdeterminedbyACTHealthexecutivesare:

• educationtosupportimplementationoftheNationalSafetyandQualityHealthServiceStandards

• changemanagement

• customer service

• dealingwithdifficultbehaviours

• peoplemanagement

• effectivecommunication

• partneringwiththetertiarysectorfordeliveryofthenursingrefresherandoverseasqualifiednurseprograms.


C.9 Workplace health and safety

Our priority—a safe and healthy working environment for all employeesWorkplacesafetywithinACTHealthisasharedresponsibilitybetweenmanagers,staffandtheWorkplaceSafetysection.

TheWorkplaceSafetysection:

• hasoverarchingresponsibilityforensuringthatACTHealthhasaneffectiveworkplacesafetymanagementsystemtoidentify,manageandmonitorandreportsafetyrisks

• providesaholisticearlyinterventionphysiotherapyservicetostaffwhohavesustainedamusculo-skeletalaccidentorinjuryintheworkplace

• providesoccupationalmedicineservicesacrossACTHealthtopreventthepotentialtransmissionofinfectiousdiseasetohealthcareworkers.Theseservicesincludepre-employmentscreening,avaccinationprogram(includingannualinfluenzavaccinations),animmunisationdrop-inclinic,occupationalriskexposure(ORE)andfollow-upmanagement,counsellingandadvice,cytotoxicscreening,amobileclinicforseasonalinfluenzavaccinationsandproductmonitoringonsafetydevices,surveillanceandeducation.

Inadditiontopromotingworkplacesafety,ACTHealthprovidesstaffwithhealthpromotionopportunities.Theseaimtoenhancetheeffortsalreadyachievedinkeepingdirectoratestaffhealthyandsafeandensurethisisasustainablegoal.

Measures taken during 2012–13Workplacesafetymeasuresundertakenduring2012–13aresetoutbelow.

• TheACTHealthWorkHealthSafetyManagementSystemwasamendedduringtheyeartoreflectchangestolegislationandtofocusonriskmanagement.Itincludesenhancedasbestosmanagementandremovalproceduresandanupdateofcytotoxicdrugprocedures.ThissystemwasdesignedtomeettheAustralianStandard4804andenablesACTHealthtohaveanintegratedsafetysystem.AuditingagainstAustralianStandard4801willenableACTHealthtocontinuouslyimproveitssafetymanagementsystem.

• TheACTHealthWorkplaceSafetyCommittee(thepeakorganisationalbodyforoccupationalhealthandsafetyinACTHealth)metfourtimesduringtheyear.ItischairedbytheDirector-Generalandincludesmanagementandworkplacehealthandsafetyrepresentatives.

• ThefourthyearofelectronicstaffaccidentandincidentreportinghasresultedinconsistentreportingandenabledACTHealthtoquicklyidentifyandimplementrelevantcontrols,aswellasreporttomanagementandworkplacehealthandsafetyrepresentatives.

• Safetytrainingremainsapriorityandcontinuestobeprovidedforhealthandsafetyrepresentatives,managersandnewstaff.E-learningpackagesweredevelopedforworksafetylegislation,workstationsetup,andviolenceandaggression.

• TheACTHealthCapitalAssetDevelopmentPlan,andtheresultantcapitalconstructionofnewbuildingsandtherefurbishmentofexistingbuildings,hascreatedaneedtoincreasethelevelandextentofsafetyadviceprovidedbyWorkplaceSafetystaff.

• The Dangerous Goods and Hazardous Substances Manualwasre-issuedinApril2013.ThiswassupportedbyaRespiratoryPolicy.


Target 2 — Reduce the incidence of claims resulting in one or more weeks off work by at least 30 per cent

0 2 4 6 8

10 12 14 16 18

New

5 d

ay c

laim

s pe

r 10

00 e

mpl

oyee

s

HD rate per 1000 employees ACTPS rate per 1000 employees HD Target 2 ACTPS Target 2

Base

line

(Avg

FY

09-1

2)

2020

-21

2021

-22

2018

-19

2019

-20

2016

-17

2017

-18

2014

-15

2015

-16

2012

-13

2013

-14

Health

Baseline (Avg FY 09–12)

2012 –13

2013 –14

2014 –15

2015 –16

2016 –17

2017 –18

2018 –19

2019 –20

2020 –21

2021 –22

HD#new 5dayclaims 60.0 71

HDrateper1000 employees 12.03 12.85

HDTarget2 12.03 11.67 11.30 10.94 10.58 10.22 9.86 9.50 9.14 8.78 8.42

ACTPS#new 5dayclaims 304.3 274

ACTPS rate per 1000 employees 15.66 13.87

ACTPSTarget2 15.66 15.19 14.72 14.25 13.78 13.31 12.84 12.37 11.90 11.43 10.96

Overthelast10yearsACTHealthhasconsistentlyreducedthenumberofnewclaimsthathaveexceededfivedaysincapacityper1000employees.Thisimprovementvariesonayear-to-yearbasisdependingonthenatureandcomplexityofasmallnumberofclaims.Asmalldeteriorationhasoccurredinoverallperformancebetweenthe2009–2012averageand2012–13.However,2012–13figuresarestillreflectiveofhistoricaltrends.OverallperformanceisverygoodagainsttheACTPublicServicefigures.

Target 3 — Reduce the incidence of claims for musculoskeletal disorders (MSK) resulting in one or more weeks off work by at least 30 per cent

0 2 4 6 8

10 12 14 16 18

New

5 d

ay c

laim

s pe

r 10

00 e

mpl

oyee

s

HD rate per 1000 employees ACTPS rate per 1000 employees HD Target 2 ACTPS Target 2

Base

line

(Avg

FY

09-1

2)

2020

-21

2021

-22

2018

-19

2019

-20

2016

-17

2017

-18

2014

-15

2015

-16

2012

-13

2013

-14


Health

Baseline (Avg FY 09–12)

2012 –13

2013 –14

2014 –15

2015 –16

2016 –17

2017 –18

2018 –19

2019 –20

2020 –21

2021 –22

HD#new5dayMSDclaims 31.0 36

HDMSDrateper1000 employees 6.21 6.52

HDTarget3 6.21 6.03 5.84 5.65 5.47 5.28 5.10 4.91 4.72 4.54 4.35

ACTPS#new5dayMSDclaims 154.7 114

ACTPSMSDrateper 1000 employees

7.96 5.77

ACTPSTarget3 7.96 7.72 7.48 7.24 7.00 6.76 6.53 6.29 6.05 5.81 5.57

Thereportincludesacceptedclaimsonly.DatesarebasedonthoseclaimsreceivedbyComcareineachfinancialyear.Bothreportsarebasedoninjuryordiseasewhichresultsinoneormoreweeksoffwork.

ACTHealth’sperformancehasindicatedasmalldeteriorationcomparedwiththeprecedingfouryears.ThisisreflectiveoftheincidenceofmusculoskeletalclaimsinlinewiththeriskprofileforthesetypesofinjurieswithinACTHealth.ACTHealthmanagesthisriskthroughinvestinginproactiveapproachestoensurethatlong-termtrendsdonotreflect2012–13statisticalperformance.Theoveralltrendinperformanceontheseclaimsisimprovingwiththeseearlyinterventionstrategiesandproactivecasemanagement.

Other key performance indicatorsIncidents,accidents,investigationsandnoticesin2012–13wereasfollows:

• 1355accident/incidentreportswerelodgedduringthe2012–13financialyear(notincludingnon-individualorRedevelopmentUnitcontractors).Thiscompareswith1209lodgedduring2011–12.Ofthesereports,164resultedinlosttimeofonedayormore,comparedwith153in2011–12.

• 74accidents/incidentsrelatingtoACTHealthstaffwerenotifiedtoWorkSafeACTundersection35ofthe Work Health and Safety Act 2011,comparedwith14in2011–12.InadditiontherewereanumberofinstanceswherecontractorsworkingforACTHealthreportedincidentsdirectlytoWorkSafeACT.

• Therewasoneoutstandingprovisionalimprovementnotice(PIN)issuedin2011–12(27March2012).Thenoticewasinrelationtopotentialunknowncontaminantsinlevel5,1MooreStreetaffectingstaffworkingthere.ThePINwasliftedbyWorkSafeACTon6September2012.ACTHealthhassincerelinquishedoccupancyofthisfloor.OnefurtherPINwasissuedon7December2012.ThiswasbecauseofanongoingchemicalsmellthathadbeendetectedintheACTResearchSchoolEndocrinologyandDiabeticsLaboratoryinBuilding10,level6,TCH.ThiswasliftedbytheHealthandSafetyRepresentativeon5March2013whentheodourhadbeeneliminated.

• At30June2013,therewere243electedHealthandSafetyrepresentativeswithinACTHealth.Therewere194HealthandSafetyRepresentativesduringthe2011–12period.

• Therewere304workstationassessmentscompletedbytheWorkplaceSafetyEarlyInterventionPhysiotherapyProgramduringthe2012–13financialyear.Workstationassessmentsareconductedaspartofworkers,compensationreturn-to-workplansaswellasfornon-compensatorypurposes.Thisisanincreasefromthe129completedthepreviousyear.

• Fiveimprovementnotices,failuretocomplynotices,prohibitionnoticesornoticesofnon-compliancewereissuedtoACTHealthundertheWork Health and Safety Act 2011.


C.10 Workplace relations

DetailsoftheHealthDirectorate’sSpecialEmploymentArrangements(SEAs)andAustralianWorkplaceAgreements(AWAs)aresetoutinthetablebelow.IntheHealthDirectorate,SEAsareusedtoattractandretainspecialskillsinhighdemand,includingofmedicalandhealthpractitionersandspecialisedskillsinclinicalsupportroles.

DescriptionNo. of Individual

SEAsNo. of Group

SEAs*

Total employees covered by

Group** Total

A B C (A+C)

SEAs

NumberofSEAsat30June2013 106 24 198 304

NumberofSEAsenteredintoduringperiod 14 4 216 230

NumberofSEAsterminatedduringperiod 15 3 74 89

ThenumberofSEAsprovidingforprivatelyplatedvehiclesasat30June2013 7 0 0 7

NumberofSEAsforemployeeswhohavetransferredfromAWAsduringperiod 0 0 0 0

* AgenciesshouldrecordthenumberofgroupSEAsenteredintoduringthereportingperiod** AgenciesshouldrecordthetotalnumberofindividualSEAsenteredintowithinthegroup/sduringthereportingperiod

Classification Range Remuneration as at 30 June 2013

IndividualandGroupSEAs SOC-SOAplusSITB $85024–$138208

HPO2-HPO6 $20675–$156296

SPEC-SSPEC $69807–$593109

TCMG2-TCMG3 $186210–$236812

MPSSP-MPCHF $166284–$188911

AWAs(includesAWAsceasedduring reportingperiod) SSPEC $203848–$272473

SOC $98089–$131926


C.11 Human Rights Act 2004

StaffofACTHealthcontinuetobesupportedintheiraccesstointernalandexternaltrainingopportunitiesrelatingtohumanrightsissues.TheHumanRightsCommissionprovidesregulartrainingsessionsonhumanrightsmattersforallACTHealthemployees,whicharewidelyadvertisedwithintheagency.Staffareencouragedtoattendtrainingsessions,whichareprovidedfreeofcharge.Inaddition,representativesfromtheHumanRightsCommissionattendACTHealthmanagersandstafforientationinductionmodulesandprovideinformationonthehumanrightsresponsibilitiesofstaff.ACTHealthiscommittedtobuildingahumanrightscultureinthedeliveryofhealthservicesandtoensuringthatACTHealthmanagersworkwithinahumanrightsframework.

InACTHealth,educationontheHuman Rights Act 2004hasbeenidentifiedasessentialforpolicywritersandformanager-levelstaffandabove.ThehumanrightstrainingformanagersprogramisconductedthroughouttheyearbytheStaffDevelopmentUnit.Inaddition,inconsultationwiththeACTHumanRightsCommission,ACTHealthhasnowdevelopedane-learningprogramtoallowanalternativemethodoftraining,aswellastheface-to-facesessions.Theface-to-facetraining,deliveredbyinternaltrainers,wascompletedby95staffin2012–13:27seniorofficers,20healthprofessionals,11administrationofficers,35nurses,onemedicalscientistandonemedicalofficer.Courseevaluationscompletedbyparticipantsindicatethatthetrainingincreasedparticipants’awarenessoftheirobligationsundertheAct.Inrespectofthee-learningprogram,57staffenrolledonlineand34completedthemodule.Intotal,129staffcompletedhumanrightstrainingin2012–13.

In2012–13ACTHealthdevelopedandpublishedanumberofbrochuresdealingwithhumanrightsissuesofconcerntotheorganisation.ACTHealthprinted10,000copiesoftheHealthcareRightsbrochure,30,000copiesoftheListeningandLearningConsumerFeedbackbrochure,10,000copiesoftheGuidetoPatient,Consumer,CarersandFamilybrochure,500copiesoftheMentalHealthCharterofRightsbrochureand100copiesforeachofthe12languagegroupsoftheVictimsSupportMultilanguagebrochure.

TheConsumerFeedbackandEngagementTeam(CFET)ofACTHealthvaluesthepartnershipithasdevelopedwiththeHumanRightsCommission.Thetwobodiesmeettwiceayeartodiscusshowtheycanworktogethertoachievepositiveoutcomes.ThecommissionregularlycontactsCFETtofindoutwhetheracomplaintithasreceivedhasalsobeensubmittedthroughtheACTHealthconsumerfeedbackmanagementprocess.Thisisimportantasitassiststoresolveissuesassoonaspossiblefortheconsumer.

LiaisonwiththeHumanRightsandRegulatoryPolicyUnitoftheJusticeandCommunitySafetyDirectorateisinitiatedwherestaffdevelopinglegislationareuncertainabouthumanrightsissuesandfortheroutinevettingofdraftBills.IssuesidentifiedinanyACTHealthBillsasaresultoftheLegislativeAssembly’sscrutinyprocessarealsobroughttotheattentionofrelevantstaff.In2012–13,ACTHealthprepared16Cabinetsubmissions,twoofwhichrelatedtolegislativeproposalsforwhichhumanrightscompatibilitystatementsweresought.

In2012–13ACTHealthcontinueditsmajorreviewoftheMental Health (Treatment and Care) Act 1994,whichengagesanumberofsignificanthumanrightsissues.DraftinginstructionsarebeingcompletedforthefinalamendmentBillfollowingreleaseoftwoexposuredraftbillsforpublicconsultationinAugust2012andApril2013.

RecommendationsfortheseamendmentsweremadebyaReviewAdvisoryCommitteecomprisingmorethan40stakeholdergroups,includingconsumersandcarersandACTHumanRightsCommissionrepresentatives.TheamendmentswerealsoendorsedbyaPolicyManagementTeamcomprisingmembersofthegovernmentagenciesinvolvedindevelopingthefinalamendmentBillandincludinghumanrightslawpolicyrepresentation.CompatibilitywiththeHuman Rights Act 2004willbeaddressedaspartoftheexplanatorystatementaccompanyingtheBill.

Inrespectoflitigation,oneapplicationinvolvingACTHealthwhichraisedissuesarisingundertheHumanRightsActcamebeforetheACTSupremeCourtin2012–13.Theapplicationarosefromtheadministrationofelectro-convulsivetherapywithouttheconsumer’sconsent.Theapplicationbeforethecourtclaimsgeneraldamages,aggravateddamagesandexemplarydamagesforfalseimprisonment,assaultandbattery,andabreachof section18oftheHuman Rights Act 2004.Thematterisstillbeforethecourt.


C.12 Strategic Bushfire Management Plan

During2012–13,ACTHealthdidnothaveanyfacilitieslocatedinruraloremberzonesandwasthereforenotrequiredbytheACTEmergencyServicesAgency(ESA)toprepareaBushfireOperationalPlanundertheStrategicBushfireManagementPlan.

In2010,theESAcompletedfire/emberriskassessmentstoidentifyat-riskACTGovernmentownedandoperatedfacilitiesduringhighfiredangerperiodsfortheACTElevatedFireDangerPlan.Assessmentsweremadeofgovernment-ownedorregulatedpropertieswherenormalactivitiesshouldbesuspendedwhenacatastrophicbushfiredangeralertisinplace.

OneACTHealthfacilitywasidentifiedbytheESAassessment—theproposedrehabilitationcentreknownastheNgunnawalBushHealingFarm,locatedatMiowera,inthefoothillsoftheBrindabellaranges,inthefarwestoftheACT.

Workprogressedin2012–13todevelopaBushfireOperationPlanandaBushfireActionPlanforthepropertyandfacility.ItisanticipatedthesewillbesubmittedtotheESAin2013–14.

Inaddition,aBushfireAssessmentandComplianceReportwassubmittedaspartofthedevelopmentapplicationprocessfortheproposedfacility.


C.13 Strategic asset management

Assets managedTheHealthDirectoratemanagedassetswithatotalwrittendownvalueof$707.919millionasat30June2013,including:

Builtpropertyassets $620.485million Land $36.827million Plantandequipment $43.978million Leasedplantandequipment $6.629million.

Theestimatedreplacementvalueoftheseassetswas$1,419.47million,ofwhichpropertyassetswere$1,316.78million.ThefollowingtableliststheHealthDirectorate’spropertyassets.

The Canberra Hospital (TCH) campus Area m2 Health facilities Area m2

TCHBuilding1—TowerBlock 37,560 Belconnen Health Centre 3,800

TCHBuilding2—Reception/Administration 5,950 DicksonHealthCentre 490

TCHBuilding3—Oncology/AgedCare/Rehab 17,390 GungahlinHealthCentre 2,608

TCHBuilding3—LinearAccelerator 1,650 Phillip Health Centre 3,676

TCHBuilding4—ANUMedicalSchool 4,115 TuggeranongHealthCentre 4,524

TCHBuilding5—StaffTraining/Accommodation 8,230 Bruce—ArcadiaHouse 467

TCHBuilding6—SurgicalServices/Offices 4,710 Bruce—BrianHennessyHouse 3,719

TCHBuilding7—Alcohol&Drug 1,260 HealthProtectionServices—Holder 1,600

TCHBuilding8—PainManagement 660 Monash—HealthProtection N/A

TCHBuilding9—Accommodation 740 LanyonFamilyCareCentre 194

TCHBuilding10—Pathology 10,250 NgunnawalFamilyCareCentre 215

TCHBuilding11—CentenaryHospital forWomenandChildrenStage1 14,554 Weston—IndependentLivingCentre 1,143

TCHBuilding12—Diagnostic&Treatment 18,870 Barton—ClareHollandHouse 1,600

TCHBuilding13—HelipadSouthernCarpark 7,980 Curtin—QEIIFamilyCentre 1,120

TCHBuilding14—ChildCare 627 Kambah—StepUpStepDownUnit 279

TCHBuilding15—Toberefurbished 2,020 Fadden—Karralika 534

TCHBuilding22—InformationManagement 243 IsabellaPlains—Karralika 1,400

TCHBuilding23—RedevelopmentUnitOffices 1,810 O’Connor—MentalIllnessFellowship 200

TCHBuilding24—HealthAdministrationOffices 1,332 Rivett—BurrangiriRespiteCareCentre 1,054

TCHBuilding25—AdultAcuteMentalHealth 5,436 Watson Hostel 2,431

TCHBuilding26—SouthernCarpark 53,000 Paddy’sRiver—Mirowera 206

GauntPlaceBuilding1—DialysisUnit 871 Duffy—CancerPatientAccommodation 319

GauntPlaceBuilding2—RILU 688 StudentAccommodation—Phillip(3units) 276

GauntPlaceBuildings3,4,5,6(HealthOffices) 668 StudentAccommodation—Belconnen(2units) 220

YambaDrivecarpark(PhillipBlk7,Sec1) N/A StudentAccommodation—Garran(1unit) 117

During2012–13,noassetswereremovedfromtheassetregister.Thefollowingassetswereaddedtotheregister:

GungahlinHealthCentre StudentAccommodation(2units)—PhillipandGarran StepUpStepDownUnit—Kambah

Asat30June2013,theHealthDirectoratedidnothaveanypotentiallysurplusproperties.


Assets maintenance and upgradeWorkswereundertakenatpropertiesthroughouttheHealthDirectorate’sportfolioin2012–13.Workscompletedinthereportingyearwere:

• CanberraHospital—provisionofafour-bedobservationunitintheEmergencyDepartment

• CanberraHospital—provisionofanadditional‘HospitalintheHome’bed

• CanberraHospital—relocationofthedischargeloungetoalargerandmoreconvenientsiteonLevel2,Building1

• CanberraHospital—modificationofinpatientensuitesfordisabledaccessonWard6B

• CanberraHospital—improvementstotrafficsafetyonHospitalRoad

• FloreyChildHealthClinic—air-conditioningupgrade

• KarralikaFaddenandIsabellaPlains—buildingupgrades,includingasbestosremoval,heatingunitreplacement,pergola,fencinganddrainageworks

• CityHealthCentre—soundproofingofcounsellingrooms.

• PhillipHealthCentre—replacementofair-conditioningchillersystem.

DetailsofthecapitalworksprogramareincludedinsectionC.14ofthisreport.

Property,plantandequipmentaremaintainedtoahighstandardtomeethealthrequirements.Expenditureonrepairsandmaintenance(excludingsalaries)was$11.862million,whichrepresents0.84percentofthereplacementvalue.

Building auditsNinety-sixbuildingconditionassessments,hazardousmaterialsauditsandfirereportshavebeenundertakenaspartofarollingthree-yearprogramtoassessallbuildingsmanagedbytheHealthDirectorate.Theseauditsareusedtoinformthedirectorate’songoingassetmanagementprogram.Theconditionauditsassessedthesepropertiesasbeinginnormaloraveragecondition.

Office accommodationTheagencyemploys6,540staff,ofwhom1,162occupyoffice-styleaccommodationinthesiteslistedinthetablebelow,atanaverageutilisationrateof14.6squaremetres(m2)peremployee.

Location PropertyOwned/Leased

Work points/staff on 30 June 2013

Office area (m2)

Utilisation rate m2 per employee

Civic 1MooreStreetLevel3 Leased 130 1,954 14.8

Civic 11MooreStreetLevel2&3 Leased 155 2,290 15.0

Civic 12MooreStreetLevel1* Leased n.a 447 n.a

Curtin Carruthers Street Leased 217 3,187 9.9

Garran TCHBuilding2 Owned 54 808 15.0

Garran TCHBuilding6 Owned 202 3,051 15.1

Garran TCHBuilding12MedicalRecords Owned 62 613 9.9

Garran TCHBuilding22 Leased 23 243 10.6



Holder HealthProtectionServices Owned 75 1,163 15.5

Phillip 1BowesPlace Leased 47 583 12.4

*Note:12MooreStiscurrentlybeingfittedoutforoccupancyby42staffatautilisationrateof10.6m2peremployee.

Theother5,378staffworkinnon-officeenvironmentswithintheHealthDirectorate’sacuteandnon-acutefacilities.Duetotheclinicalnatureoftheseworkplaces,theaverageareaperemployeeisnotapplicable.


C.14 Capital works

CapitalworkswithinACTHealthoccurundertheleadershipoftheServiceandCapitalPlanningBranch.

TheServiceandCapitalPlanningBranchisresponsibleforthedeliveryoftheHealthInfrastructureProgram(HIP)—asignificantinvestmentinthefuturehealthservicesfortheACTcommunityandsurroundingregion—aswellastheStrategicAccommodationandCapitalUpgradesProgram.

InSeptember2012uponthenaturalexpirationofthecontractwithThincHealthAustraliatoprovideProjectDirectorservicesfortheHIP,ACTHealthprogressedplansfortheintegrationoftheProjectDirectorroleintothegovernancefortheHIP.

TheServiceandCapitalPlanningBranchgrewsignificantlyinthelatterhalfof2012,withthedirectengagementofstaffwithindustryexperienceandexpertisetosupporttheworkoftheHIP.

TheHIP,amajorcapitalinfrastructureprogram,isbasedonacomplexmixofpopulationgrowthandageing,changingtechnologyandproviderandconsumerexpectations—allofwhichcontributetoasignificantincreaseindemandforhealthservicesintheACT.Demandforhealthservicesisprojectedtoincreaserapidlyoverthenext 10yearsandbeyondandtheHIPisaplanned,comprehensiveandstructuredresponsetothesepressures.Underpinnedbyfuturehealthservicesdemandprojections,theHIPencompassesmodelsofcareandservicedelivery,technology,workforceandinfrastructureredesignworkinconjunctionwithasignificantcapitalworksprogramovera10-yearperiod,upto2022.ThisreportingyearmarkedthefifthyearoftheHIP.

TheongoingprogramofcapitalworkstobuildingsandplanttomaintainandimprovetheexistinginfrastructuresupportingtheHealthDirectoratewastransferredfromtheBusinessandInfrastructureBranchtotheServiceandCapitalPlanningBranchon1January2013.TheCapitalUpgradesProgramisfundedannually,withprioritisationofworkbeingdeterminedbytheACTHealthExecutiveunderthefollowingcategories:

• buildingupgrades

• safety/securityupgrades

• medicalfacilityupgrades

• patientfacilityupgrades

• ambulatory care improvements

• augmentationofmedicalandadministrationoffices.

Projectscompletedin2012–13undertheHIPwereasfollows:

• Stage1oftheCentenaryHospitalforWomenandChildren(CHWC)wascompletedinAugust2012andclinicalservicescommencedon21August2012.Stage1ofthefacilityprovidespermanentaccommodationfortheNeonatalIntensiveCareUnit,SpecialCareNursery,BirthCentre,maternityandgynaecologyinpatientwardareasandadministration.RonaldMacDonaldHouseisalsoincorporatedwithinthisfacility.ItprovidesovernightaccommodationforfamiliesandcarersofchildrenwhoareinpatientswithintheCHWC.

• TheCalvaryHospitalemergencydepartmentexpansionwascompletedinDecember2012,withcapacitycreatedforanadditionalsixtreatmentspaces(fourchairareasandtwoconsultingrooms).

• TheGunghalinCommunityHealthCentrewascompletedinAugust2012,withservicedeliverycommencingon3September2012.ThefacilityprovideshealthservicesfortheGunghalinCommunityintheareasofdentalhealth,alliedhealthandcommunitynursing.

• DuffyHousewascompletedinAugust2012.Itprovidesaccommodationforinterstatecancerservicespatientsandcarers.ThefacilitywasdevelopedwithfundingsupportfromtheAustralianGovernment.


WorksinprogressundertheHIPat30June2013were:

• Staging,decantingandcontinuityofservices:theseworksarecontinuing.Thisprojectconsistsofmultiple sub-projectsthataimtorelocateoccupantsofACTHealthfacilitiestoallowbuildingworkstoprogress.

• CanberraRegionCancerCentre:thisfacilityisnearingthefinalstagesofconstruction.ThefacilityisexpectedtobecompletedinSeptember2013.ThenewfacilitywillprovideanintegratedtreatmentcentreforcancerservicesfortheCanberraregion.

• UniversityofCanberraPublicHospitalachievedanumberofmilestones,withasiteontheUniversityofCanberracampusidentifiedasthepreferredlocationforthefacility.A‘HeadsofAgreement’wassignedinSeptember2012tosupporttheagreement.Negotiationsrelatingtoacquisitionofthelandcommencedduringthereportingyear.Inaddition,adraftservicedeliveryplantoinformaconceptdesignforthefacilitywasdevelopedbasedonusergroupconsultation;sitestudieswereundertakenonthepreferredsite;areportwaspreparedonpossibleprocurementdeliverymodelstobeadopted;andanexpressionofinterestfortheprincipalconsultantwasadvertised,with18submissionsreceived.

• TuggeranongHealthCentre(refurbishmentandstage2):thisprojectinvolvestherefurbishmentandextensionofthephysicalinfrastructureoftheTuggeranongCommunityHealthCentreandtheexpansionandenhancementofservicesprovidedattheTuggeranongHealthCentre.Theextensionandrefurbishmenthavebeendesignedtomeetthefuturehealthneedsofthelocalpopulationto2021–22.

• BelconnenCommunityHealthCentre(BCHC):physicalworkscommencedinJanuary2012,withcompletionofconstructionexpectedinSeptember2013.TheBCHCwillprovideanincreasednumberoftraditionalcommunityhealthservices,suchasdental,communitynursingandcommunitymentalhealth.Itwillalsoprovideanexpandedrangeofhigherorderclinicalservicesthatwerepreviouslyprovidedonhospitalgrounds,suchasrenaldialysis,somespecialistoutpatientservicesandchronicdiseasemanagement.

• Stage2oftheCentenaryHospitalforWomenandChildrenisnearingcompletion,withhandoverto ACTHealthexpectedinlate2013.

• AdultSecureMentalHealthUnit—ForwardDesign:workisproceedingtoprepareahealthfacilitybriefbeforeproceedingtodesign.Thenewpurpose-builtfacilitywillbelocatedontheformerQuambysiteatSymonston.Itisexpectedthatdesignworkswillcommencein2014.

• TheNgunnawalBushHealingFarmprojectexperienceddelaysrelatingtoitsdevelopmentapplication(DA)process.Duringthereportingyear,themodelofcare(phase2)andthepreliminaryandfinalsketchplansforthefacilitywereendorsedbytheRedevelopmentCommittee.Constructiondocumentationhasbeencompletedforthetenderingofconstructionworks.AftercommunityconsultationandaninitialsubmissionofaDAinmid-2012,amendeddevelopmentapplicationswerelodgedforleasevariation,designandsitingofthefacilityinFebruary2013.InMay2013theleasevariationwasapprovedwithconditionsbytheEnvironmentandSustainableDevelopmentDirectorate—ACTPlanningandLandAuthority.InJune2013ACTHealthwasadvisedthatapplicationsforareviewofthisdecisionhadbeenreceivedbytheACTCivilandAdministrativeTribunal.At30June2013,theoutcomeofthedesignandsitingDAwaspending.Inadditiontothiswork,landmanagementactivitiesontheMiowerapropertyhavebeenongoing,andplanningforconstructionhasprogressed.

ThefollowingtablescontainACTHealthcapitalworksprojectinformationandthereconciliationschedule.


Capital works table—Health Directorate

Project

Proposed or Actual

completion date

Original project

value $’000

Revised project

value $’000

Prior years expend

$’000

2012–13 expend

$’000

Total expend to date

$’000

New works – Departmental

AdultSecureMentalHealthUnit(FinalisingDesign) Jun-14 2,000 2,000 N/A – –

StagingandDecanting– MovingToOurFuture Sep-14 22,300 22,300 N/A 247 247

HealthInfrastructureProgram–ProjectManagement Dec-14 19,319 19,319 N/A 4,225 4,225

EnhancedCommunityHealthCentreBackupPower Jun-14 3,540 3,540 N/A 250 250

ReplacementofCTScannerattheCanberra Hospital Aug-13 2,893 2,893 N/A – –

MajorBuildingPlantReplacementandUpgrade Jun-13 5,292 5,292 N/A 1,230 1,230

Capital Upgrades Program – Departmental

BuildingUpgradestoaddressConditionReportFindings Jun-14 580 580 N/A 379 379

Fire/Safety/Security Jun-14 352 352 N/A 313 313

MechanicalSystemsUpgrades Jun-14 580 580 N/A 563 563

FacilitiesImprovementstoPatientAccommodation Jun-14 620 620 N/A 268 268

Ambulatory Care Improvements Jun-14 680 680 N/A 41 41

AugmentationofMedicalandAdministrativeOffices Jun-14 420 420 N/A 262 262

Capital Upgrades Program – Territorial

ResidentialAccommodationRefurbishment–Calvary Jun-14 310 310 – 79 79

InstallationofaPrimary-SecondaryLoopfortheEnvironmentalCoolingSystemtomeettheneedsofaGrowingHospitalandReduceEnergyCosts

Oct-13 200 200 N/A – –

ImprovementstoPatient Safety–ExpansionofReticulatedSuctionSystem

Oct-13 50 50 N/A – –

ImprovementstoKeaneyEnvironmentalCoolingSystemwhichwillprovideredundancy

Oct-13 296 296 N/A – –

InstallationofaServiceColumnintheIntensiveCareUnittoProvideReticulatedGas,PowerandDatatoaCardiacProcedureRoom

Jun-13 80 80 N/A 39 39

Works in progress – Departmental

ClinicalServicesRedevelopment–Phase 3 Dec-14 25,700 21,800 4,283 -2,243 2,040

IntegratedCancerCareCentre–Phase 2 Sep-13 15,102 15,102 - 12,378 12,378

Staging,DecantingandContinuityofServices Dec-14 19,430 19,430 1,815 3,765 5,580

IdentityandAccessManagement Dec-13 3,100 3,100 1,186 1,358 2,544


Project

Proposed or Actual

completion date

Original project

value $’000

Revised project

value $’000

Prior years expend

$’000

2012–13 expend

$’000


$’000

CentralSterilisingService Apr-15 17,270 17,270 103 152 255

NorthSideHospitalSpecificationandDocumentation Jun-14 4,000 4,000 257 625 882

ClinicalServicesRedevelopment–Phase 2 Jun-14 15,000 8,850 4,990 2,791 7,781

TuggeranongHealthCentre–Stage2 Jun-14 14,000 14,000 0 1,424 1,424

HIPChangeManagementandCommunicationSupport Jun-14 4,117 4,117 1,968 1,054 3,022

NationalHealthReform Aug-13 15,098 10,088 2,323 6,409 8,732

IntegratedCanberraRegionCancerCentre–Phase1 Sep-13 27,900 29,652 8,233 20,997 29,230

EnhancedCommunityHealthCentre–Belconnen Sep-13 51,344 51,344 8,592 30,433 39,025

MentalHealthYoungPersonsUnit Nov-13 775 775 121 – 121

WomenandChildren’sHospital Nov-13 90,000 111,060 78,240 24,995 103,235

RefurbishmentofHealth Centre–Tuggeranong Jun-14 5,000 5,000 999 4,001 5,000

ProvisionforProject DefinitionPlanning Jun-14 63,800 59,040 49,686 5,804 55,490

AdultSecureMentalHealthInpatientUnit–ForwardDesign Jun-14 1,200 1,200 755 – 755

AboriginalTorresStraitIslanderResidentialAlcohol&OtherDrugRehabilitationFacility

Aug-15 5,883 7,933 876 290 1,166

LinearAcceleratorProcurementandReplacement Dec-12 18,700 17,250 16,488 29 16,517

AnE-HealthyFuture Mar-15 90,185 90,185 31,888 14,926 46,814

DigitalMammography Jun-13 5,715 5,715 4,805 563 5,368

NeonatalIntensiveCareUnit–VideoStreamingService Jun-13 200 200 100 8 108

Projects – Physically complete but financially incomplete – Departmental

NewMultistoreyCarParkTCH Jun-13 29,000 42,720 41,881 97 41,978

AdultMentalHealthInpatientUnit Apr-12 23,630 28,480 23,630 4,642 28,272

NewGungahlinHealthCentre Aug-12 18,000 18,000 13,880 3,546 17,426

Projects – Physically complete but financially incomplete – Territorial

FireSafetyUpgrades–Calvary Oct-12 300 300 210 14 224

Completed Projects – Physically and financially complete – Departmental

ProvisionforPhase1CSR Jun-13 57,000 26,630 26,630 - 26,630

ACTHealthSkills DevelopmentCentre Jun-13 1,300 1,010 901 109 1,010

EnhancementofCanberraHospitalFacilities(Design) Jun-13 41,000 220 79 141 220

TCHDischargeLoungeRelocation Jun-13 150 150 117 33 150

ElectiveSurgery (CommonwealthFunding) Sep-09 4,680 4,680 4,452 228 4,680


Project

Proposed or Actual

completion date

Original project

value $’000

Revised project

value $’000

Prior years expend

$’000

2012–13 expend

$’000


$’000

BuildingUpgradestoaddressConditionReportfindingsincludingWorkstoBathrooms,DisabilityAccessandRoofing

Jun-13 561 561 518 43 561

EnergySavings/Sustainability–UpgradeWorkstoBuilding Control Systems to Improve EfficiencyandInstallationof BikeStorageFacilities

Jun-13 300 300 183 117 300

Safety/SecurityUpgradestoaddressOutcomesofFire Reports,ImproveAccessControltoPlantRooms,FloorCoveringUpgradesandRemovalofHazardousMaterials

Jun-13 380 380 305 75 380

MechanicalSystemsUpgradestoPlantandEquipmentattheCanberraHospitalandvariousotherACTHealthFacilities

Jun-13 600 600 589 11 600

Patient/MedicalFacilitiesUpgradesincludingRefurbishmentofAmbulatoryCareFacilities,ProvisionofaCommunityDialysisSelfCareFacilityandUpgradestoPatientFacilities

Jun-13 670 670 379 291 670

WorkplaceImprovementswhichwillfacilitateimprovedPatientFlowsandOperationsandServicesat Canberra Hospital

Jun-13 590 590 523 67 590

MedicalFacilities Jun-13 520 520 N/A 520 520

Completed Projects – Physically and financially complete – Territorial

WorksAssociatedwiththeInstallationofaMRIEquipment Aug-12 70 70 N/A 70 70

SecurityUpgradestoImproveStaffandPatientSafety Jun-13 50 50 N/A 50 50

UpgradeofChiller Jun-13 350 350 330 20 350

Upgradesto6thFloorKitchen,TheatreStorageandXavierLevelPublicToiletsandFloorFinishes

Oct-12 285 285 110 175 285

Reconciliation schedule—capital works and capital injection

Approved Capital Works Program financing to capital injection as per cash flow statement

Original

$m

Section 16B $m

Variation $m

Deferred $m

Not drawn $m

Total $m

Capitalworks 197.651 15.651 0.000 –101.018 –7.129 105.155

ICTCapitalInjections 28.584 0.361 0.000 –9.838 1.592 20.699

Othercapitalinjections 11.647 1.424 0.000 –1.328 –7.629 4.114

TotalDepartmental 237.882 17.436 0.000 –112.184 –13.166 129.968

Total Territorial 0.746 0.000 0.000 0.000 0.000 0.746


C.15 Government contracting

Basis of requirement1. Government Procurement Act 2001

2. GovernmentProcurementRegulation2007

3. GovernmentProcurementAmendmentRegulation2009(No.1)

1. Procurement principles and processesIn2012–13,ACTHealthexercisedallprocurementactivitiesinaccordancewiththegovernmenttenderthresholdsandcompliedwithprocurementpoliciesandproceduresasstatedintheGovernment Procurement Act 2001, GovernmentProcurementRegulation2007 and GovernmentProcurementAmendmentRegulation2009(No. 1).

ToensurecompliancewithACTGovernmentprocurementlegislation,ACTHealth:

i. soughtadviceongovernmentprocurementpoliciesandproceduresfromSharedServicesProcurement

ii. notifiedSharedServicesProcurementofallprocurementsover$25,000undertakenbyACTHealth

iii. appropriatelyreferredprocurementsrequiringsingle,restrictiveoropentenderprocurementprocessestoSharedServicesProcurement,and

iv. referred,wherenecessary,allprocurementsrequiringGovernmentProcurementBoardconsiderationand/orapprovaltoSharedServicesProcurement.

Toconfirmthatcontractorsmeettheiremployeeandindustrialrelationsobligations,alltendersandcontractsdraftedbySharedServicesProcurementonbehalfofACTHealthincludeconditionsprovidedbytheACTGovernmentSolicitor’sofficetoreflecttheGovernment Procurement Act 2001, GovernmentProcurementRegulation2007 and GovernmentProcurementAmendmentRegulation2009(No.1).TheseincludefollowingtheEthicalSuppliersGuidelineandcomplyingwithgovernmentprocurementonethicalsuppliers.

Inaccordancewithprocurementlegislation,ACTHealthobservedthehigheststandardofprobityandethicalbehaviourtowardsprospectivetenderers.Suchbehaviourincluded,butwasnotlimitedto:

i. equality

ii. impartiality

iii. transparency

iv. fairdealing

Tofurthersupporttheprocurementprocesses,in2012–13ane-learningpackageprovidesproceduralguidancetoallACTHealthemployeesengagedinprocurementactivities.

2. External sources of labour and servicesIn2012–13,ACTHealthengagedarangeofexternalconsultantsandcontractorstoundertakeservicesinthefollowingareas:

i. frontlineclinicalhealthservices

ii. structuralandproceduralreviewsofcurrentbusinessmodels

iii. disputeresolutionservices,includingcomplaintinvestigationandmediationservices,and

iv. capitalworksprojects.


ToverifythatACTHealth’scontractorsmeettheiremployeeandindustrialrelationsobligations,ACTHealth:

i. engagedtheservicesofSharedServicesProcurementtomanage,whererequired,contractsonbehalfof ACTHealth,and

ii. usedSharedServicesProcurementdocumentation,includingtenderdocumentationandgovernmentcontractsthatencapsulateallrelevantindustrialrelationslegislationasadvisedbytheACTGovernmentSolicitor’soffice.

ACTHealthconstructioncontractsabove$500,000wereestablishedusingSharedServicesProcurementforprojectmanagementandcontractorpre-qualification.

AllHeadContractorsandProjectManagersengagedonACTHealthInfrastructureProgram(HIP)capitalworksprojectsvaluedabove$500,000werepre-qualifiedbytheTerritory.AllPrincipalConsultantsengagedincontractsvaluedabove$50,000werealsopre-qualifiedbytheTerritoryundertheappropriatepre-qualificationcategoryforconsultants.

ThefollowingtablescatalogueallACTHealthconsultants,contractorsandvisitingmedicalofficers(VMOs)forthereportingperiod.


Consultants

Name of Consultant Description of Contract

Cost (Exclusive

of GST)

Date Contract Let End Date

Select Tender Yes/No

Reason for Select Tender

Individualcontractswhichexceed$25,000;andsmallercontractsawardedtothesameconsultantwhich,intotal,exceed$25,000.

Consultant–Apersonwhohastheknowledgeandexpertisetoperformatask,project,orotherwhichisnotavailablewithintheHealthDirectorateandProducesareport,audit,investigation,orothertoHealthDirectorateorthirdparties.

Acute Services (Output 1.1)

Mental Health, Justice Health and Alcohol and Drug Services (Output 1.2)

Public Health Services (Output 1.3)

Australian Health Care Associates

ExternalQualityReviewsofACTbasedHomeandCommunityCare(HACC)agenciesagainstTheCommunityCareCommonStandards(CCCS)

$49,673.00 01-Jul-12 30-Jun-13 No

MedicalSoftware IndustryAssociation

ProvisionofconsultancyservicesfromMSIA–MonitoringDrugsofDependence(MODDS)

$75,000.00 02-Jul-12As per agreedmilestones

YesSoleserviceproviderwithspecialistknowledge

Cancer Services (Output 1.4)

Rehabilitation, Aged and Community Care (Output 1.5)

Early Intervention and Prevention (Output 1.6)

QuorusPtyLtd DevelopmentofaNewACTChronicDiseaseStrategy $36,045.00 03-Jan-12 31-Dec-12 Yes Expertise

infield

TheMillerGroup–SocialPolicyandManagementConsultantsPtyLtd

ConsultanttoEvaluatetheDeliveryandImpactofHealthierWork $72,114.00 17-Jul-12 31-Mar-15 No

Consultants distributed as Overheads of Outputs

Canberra Property ManagementPtyLimited

ProvisionofPublicHealthConsultationServicesforWater,AirandRelatedIssues $48,097.54 17-Jan-13 17-Jan-18 No

GreyAdvantageConsultingPtyLtd

ReviewPreventativeMaintenanceProgram,andReviewAnalysisand DateGathering

$121,480.00 20-Jun-12 20-Jun-13 No

GS1AUSTRALIALTD ConsultancyforLocationBased ServiceProject $46,661.50 19-Oct-12 19-Oct-13 No

KaizenManagementServices

ProvisionofaConsultanttoUndertakeSafetyAuditsforACTHealthtoAustralianStandards4801and4804

$33,818.18 22-Dec-10 22-Dec-13 No

MichaelReidandAssociatesPtyLtd

ReviewofthegovernancearrangementswithintheHealthDirectorate $63,823.50 21-Dec-12 30-Jun-13 Yes

ExpertiseinthereviewofHealth’sgovernancestructure

Nous Group ReviewoftheHealthDirectorate’srestructureandReviewoftheSmokefreeWorkplacePolicy

$74,750.00 04-Sep-12 11-Dec-13 Yes Expertise infield

PriceWaterhouseCoopers (PwC)

ProvisionofInternalAuditServicesandprofessionalservices/investigations $440,961.35 11-Sep-08 09-Jun-13 No

RichardPaulMarshall ActivityBasedFundingImplementationandDataIntegrityStrategyReports $47,216.36 01-Nov-12 30-Dec-13 Yes Specialistand

ExpertiseServices

TheTrusteeforTheCogentUnitTrustT/ACogentBusinessSolutions

FinancialGovernanceand ManagementConsultancy $46,888.64 28-Sep-12 28-Sep-13 No

UltrafeedbackPtyLtd Patientsatisfactionsurveys $77,365.53 30-May-12 31-May-14 No

UniversityofNew South Wales

Consultant to evaluate the Australian CapitalTerritoryDrugDiversionPrograms $86,456.12 08-Feb-12 30-Jun-12 No


Contractors

Name of Contractor Description of Contract

Cost (Exclusive of

GST)




Individualcontractswhichexceed$25,000;andsmallercontractsawardedtothesamecontractorwhich,intotal,exceed$25,000.

Contractor–ApersonwhoperformsaJob,Task,Projectonbehalfoftheorganisation,i.e.ajobthatcanbedonebyastaffmember,buttherearenoresourcestodoitinhouse.


ACTNursingServicesPtyLtd DaytoDayonCallAgencyNurses $1,903,725.42 16-Feb-11 16-Feb-14 No

Adecco Provisionofrecruitmentservices $180,660.52 31-May-10 28-Feb-13 No

Calvary Health Care ACTLimited

PrivateContractingofElectiveSurgeryin the ACT $1,288,264.30 16-May-13 25-Dec-15 No

Calvary Private Health Care CanberraLimitedT/ACalvary John James Hospital

PrivateContractingofElectiveSurgeryin the ACT $2,002,751.58 30-Sep-10 25-Dec-15 No

CanberraAfterhoursLocumMedicalService

CanberraAfterhoursLocum MedicalService $1,153,931.40 30-Jun-10 30-Jun-13 No

HaysSpecialistRecruitmentAustraliaPtyLtd Provisionofcontractstaff $236,710.80 27-May-10 26-May-13 No

IPSWorldwide Criticalincidentcounsellingservices $142,593.83 Month to month No

KLMGroupLtdACT/SouthernNSWCriticalCareTelehealthSolution-Supply,InstallationandAssociatedServices

$464,090.00 28-May-12 30-Jun-14 YesSpecialist knowledgeandexpertiseinfield

MediservePtyLtd DaytoDayonCallAgencyNurses $1,176,354.03 16-Feb-11 15-Feb-14 No

NationalHealthCallCentreNetworkLtd

ParticipationintheNationalCall CentreNetwork $1,073,984.00 01-Jul-12 30-Jun-13 No

NationalHealthcareServices ProvisionofAgencyNurses $1,059,562.37 16-Feb-10 16-Feb-14 No

PeoplebankAustraliaPtyLtd Contractorprofessionalservices $89,145.00 28-Jun-12 28-Jun-13 No

ProfessionalNursingAgency ProvisionofAgencyNurses $717,889.23 Month to month Yes Specialised

nursingservices

Resolutions(INT)PtyLtdasTrusteesfortheResolutionsTradingTrust

ProvisionofClinicalCodingServices $52,354.01 19-Oct-10 Ongoing No

RossHumanDirectionsLimited MedicalRecordsDatabaseServices $55,606.73 10-Jun-11 10-Jun-12 No

ThetrusteeforNelsonFamilyTrusttradingasJustBetterCareCanberra

ProvisionofTechnicalNursingCare $239,734.00 06-Dec-10 Ongoing YesExpertiseintechnical nursing

TheUniversityofQueensland

TranslationofFoodSafetyGuidefromUniversityofQueensland $64,755.87 22-Jun-12 22-Jun-13 No

UniversityofSouthAustralia AlliedHealthResearchServices $80,233.00 03-Jun-11 03-Jun-12 No


ACT Mental Health ConsumerNetworkInc

ACTMentalHealthConsumerNetworkInc $312,893.00 01-Jul-10 30-Jun-13 No


AustralianBreastfeedingAssociation,ACTandSthnNSW Branch

ServiceExpansiontoSupportNewandBreastfeedingMothersandtheirFamilies

$42,411.68 17-May-11 30-Jun-12 No


Name of Contractor Description of Contract

Cost (Exclusive of

GST)




ByGeorgeStudios PtyLimited

DevelopmentofaParentingEducationDVDforYoungAboriginalandTorresStraitIslanderParents

$37,094.55 20-Nov-12 20-Feb-13 Yes Expertise infield

Environmental Health Services(TAS)PtyLtd

ContractorServicesforStatutoryComplianceUnderFood Act 2001 $55,203.00 26-May-11 30-Jun-12 No

NationalMailandMarketing

ProvisionofWarehousing,Pick/PackingandDistributionServicesforHealthPromotionBranch

$35,701.60 23-Aug-10 30-Jun-13 YesSpecificandtargetedservices

SchoolofPublicHealthtradingasUniversityofSydney

EvaluationofGETHealthService $61,233.85 29-Oct-10 Ongoing No

TaylorNelsonSofresAustraliaPtyLimited

Gofor2&5®CampaignSocial MarketingResearchProject

$30,000.00 09-Mar-10 Ongoing Yes Expertiseinpublic health

XVTSolutionsPtyLtd ReplacementoftheMonitoringofDrugsofDependenceSystem(MODDS) $73,026.18 01-Feb-13 01-Feb-16 Yes

Specialist knowledgeinbusinessneeds


CancerInstitute(NSW) ProvisionofServicestoSupporttheMaintenanceoftheACTCancerRegistry $175,193.88 03-Jun-11 Ongoing No

CharmHealth ProvisionofCHARMCancerInformationManagementSystem $50,681.82 14-May-13 13-May-14 No

CharterhouseMedical Recruitmentservices $97,546.80 13-Feb-12 27-Jun-13 No

MirrabookaSystemsPtyLtd CAS lease, licence, maintenance, upgradeandreportdevelopment $30,929.51 01-Jul-12 30-Jun-13 No

Rehabilitation, Aged and Community Care (Output 1.5)

Early Intervention and Prevention (Output 1.6)

Alcohol,TobaccoandOtherDrugAssociationAustralianCapital Territory Incorporated

ACTComorbiditySmokefree PilotProject $383,844.27 01-Jun-10 Ongoing No

NationalHeartFoundation(ACTDivision)

ProvisionofChronicDiseasePreventionServices $416,224.27 15-Nov-09 30-Jun-12 No

PaxusAustraliaPtyLtd ChronicDiseaseManagementRegister $199,633.50 21-Sep-09 Ongoing No

Contractors distributed as Overheads of Outputs

Christopher Bruce Plumbingcontractor $97,336.47 Month to month Yes

Specialisedservices rendered

Control&ElectricPtyLtdBuildingManagementSystemandMandatoryTestingofFireDampersandCompartmentilisationTesting

$284,422.37 14-Jun-11 14-Jun-12 No

DreamtimePublicRelations MediaandPublicRelationsServices $59,323.00 24-Apr-12 24-Apr-13 No

GammasonicsInstituteforMedicalResearchPtyLtd

RadiationComplianceTestingofRadiationSourceswithintheACT $31,198.18 03-Aug-09 30-Jun-14 No

GriffithMassageCentre RemedialMassageforwork-relatedstrains $54,746.30 01-Jul-08 Ongoing No

LecSafeAustraliaPtyLtd TestingandTaggingServices $75,261.94 07-Jul-10 06-Jul-13 No

ProtivitiPtyLtd ProvisionofInternalAuditandRiskManagementServices $187,065.59 11-Sep-08 09-Jun-13 Yes

PreferredGovernment Provider


Visiting medical officers

Title Surname First Name SpecialityDescription of contract

Date Contract Commences

Date Contract Expires

Total Amount

Paid (exc. GST)


Dr Al-Sameraaii Ahmad Urology VMO 01-Jun-13 31-May-16 $47,603.22

Dr Albekaa Safi ENTSurgery VMO 01-Nov-07 01-Nov-14 $62,145.96

Dr Ansary Saidul(BSSWPtyLtd Respiratory&Sleep VMO 17-Dec-12 01-May-15 $137,297.62

Dr Ashman Bryan OrthopaedicSurgery VMO 01-Sep-12 31-Aug-15 $294,281.22

Dr Aubin Phil OrthopaedicSurgery VMO 02-Aug-10 02-Aug-13 $119,081.25

Dr Auzins Edwin GeneralDentistry(OMFS) VMO 02-Jul-11 01-Jul-14 $51,673.52

Dr BassettMark (MarkBassett PtyLtd)

Gastroenterology VMO 25-Nov-09 25-Nov-16 $187,230.25

Dr Bissaker Peter CardiacSurgery VMO 01-Aug-08 01-Aug-15 $411,793.68

Dr BradshawStephen (VascularPartnersPtyLtd)

VascularSurgery VMO 01-Feb-12 01-Aug-14 $308,394.54

Dr Brady Marc GeneralDentistry(OMFS) VMO 31-Oct-12 30-Oct-13 $49,390.27

Dr Bromley Jonathan Gastroenterology&Hepatology&MAPU VMO 01-Jan-11 31-Dec-14 $159,277.77

Dr Buchanan Guy Anaesthesia VMO 01-Dec-07 01-Dec-14 $34,757.16

Dr Burke Bill ThoracicMedicine VMO 02-Oct-10 02-Oct-13 $160,081.35

Dr Burns Alexander OrthopaedicSurgery VMO 01-Jun-08 01-Jun-15 $176,642.00

Dr Carney Gavin(GavinM.CarneyPtyLtd) RenalMedicine VMO 24-Aug-10 01-Nov-14 $169,537.49

Dr Chapman Peter ENTSurgery VMO 01-Oct-07 01-Oct-14 $87,157.05

Dr Chong Guan(DrGuanChongPtyLtd) GeneralSurgery VMO 02-Jul-12 01-Jul-15 $277,099.96

Dr Choy Ellis PlasticSurgery VMO 02-Apr-13 01-Apr-14 $355,399.08

Dr Close Susanne(SusieClosePtyLtd) O&G VMO 05-Oct-10 31-Jul-14 $55,231.48

Dr Crawford Anthony Paediatrics VMO 30-Nov-07 30-Nov-13 $37,552.60

Dr Crawshaw Ian Paediatrics VMO 01-Oct-07 30-Sep-14 $111,834.73

Dr Damiani Maurizio OrthopaedicSurgery VMO 06-Jul-10 06-Jul-13 $319,790.49

Dr Davies Stephen Anaesthesia VMO 01-Mar-08 01-Mar-15 $39,416.86

Dr Davis Ian GeneralSurgery VMO 01-Sep-07 01-Sep-14 $226,773.45

Dr DoraiRaj Anna Rheumatology VMO 01-Sep-07 01-Sep-14 $130,770.82

Dr Drummond Catherine Dermatology VMO 01-Nov-10 31-Oct-14 $50,142.90

Dr Edwards Joanne Paediatrics VMO 22-Aug-12 21-Aug-13 $118,318.70

Dr Ellingham John CardiacAnaesthesia VMO 29-Nov-09 29-Nov-16 $287,092.15

Dr Fahey Caroline Anaesthesia VMO 01-Sep-07 01-Sep-14 $105,062.00

Dr FarhadiehRostam(PantheaPlasticSurgeryPtyLtd)

PlasticSurgery VMO 01-Apr-13 07-Mar-18 $135,274.33

Dr Findlay Michael PlasticSurgery VMO 12-Jun-11 11-Jun-13 $45,921.69

Dr Fitzgerald Ailene GeneralSurgery VMO 31-Jul-12 30-Jul-13 $206,545.84





Total Amount

Paid (exc. GST)

Acute Services (Output 1.1) (Continued)

Dr Fletcher Victoria Anaesthesia VMO 11-Feb-08 10-Feb-15 $166,065.52

Dr Freckmann Mary-Louise ClinicalGenetics VMO 01-Jul-08 30-Jun-15 $64,749.55

Dr French James Anaesthesia VMO 02-Sep-12 01-Sep-15 $285,516.23

Dr Fuller John Neurosurgery VMO 12-Nov-10 01-Aug-13 $228,304.82

Dr Gillmore Colin Anaesthesia VMO 01-Feb-08 31-Jan-15 $71,258.61

Dr Gross Michael OrthopaedicSurgery VMO 10-Aug-12 09-Aug-13 $182,015.79

Dr Hamid Celine PaediatricSurgery VMO 08-Apr-13 09-Apr-14 $53,966.67

Dr Hardman David VascularSurgery VMO 01-Jul-08 01-Jul-15 $370,319.54

Dr Hayes Deborah Cardiology(Paediatrics) VMO 02-Mar-12 01-Mar-15 $125,104.02

Dr Hehir Andrew Anaesthesia VMO 27-Jan-08 27-Jan-15 $299,717.62

Dr Holz Paul Anaesthesia VMO 01-Jul-13 01-Mar-14 $214,720.43

Dr Hufton Ian PaediatricMedicine VMO 02-Jul-11 01-Jul-14 $26,667.61

Dr JainTarun (T.J.Imaging PtyLtd)

Radiology VMO 05-Nov-12 04-Nov-13 $56,000.00

Dr Jeans Phil GeneralSurgery VMO 12-Aug-12 11-Aug-15 $233,914.07

Dr Kaye Graham Gastroenterology VMO 07-Sep-10 30-Aug-14 $269,939.20

Dr Khoo Kenneth GeneralMedicine &Rheumatology VMO 06-Jul-11 05-Jul-14 $73,183.65

Dr Klar Brendan OrthopaedicSurgery VMO 07-Aug-12 01-Aug-15 $218,964.95

Dr Kulisiewicz Gawel OrthopaedicSurgery VMO 07-Aug-09 07-Aug-15 $296,949.87

Dr Kwan Bernard Anaesthesia VMO 01-Sep-07 01-Sep-14 $60,075.95

Dr Lah Frank Anaesthesia VMO 01-Aug-11 31-Jul-14 $191,769.15

Dr Lang Robert Anaesthesia VMO 26-Jan-13 25-Jan-16 $244,222.44

Dr Lee Elaine Anaesthesia VMO 11-Oct-12 10-Oct-15 $484,541.19

Dr Lee Tack-Tsiew ENTSurgery VMO 01-Jun-08 01-Jun-15 $72,019.24

Dr Leerdam Carolyn PaediatricMedicine VMO 01-Feb-08 01-Feb-15 $30,815.65

Dr Lim James GeneralSurgery VMO 30-Nov-10 29-Nov-13 $129,974.67

Dr Lu DonBunnag Anaesthesia VMO 05-Oct-10 01-Dec-14 $57,810.45

Dr Major Jennifer Anaesthesia VMO 02-Nov-10 02-Nov-14 $35,004.65

Dr Makeham Timothy ENTSurgery VMO 14-Feb-11 13-Feb-14 $105,870.66

Dr Malecky George PaediatricSurgery VMO 01-Nov-07 31-Oct-14 $610,877.25

Dr Malhotra Ram Neurology VMO 01-Apr-11 31-Mar-14 $36,894.73

Dr Marshall Natalie Anaesthesia VMO 01-Aug-07 31-Jul-14 $396,631.63

Dr McCredie Simon Urology VMO 01-Jul-10 01-Jul-13 $176,080.24

Dr McDonald Tim Paediatrics VMO 01-Aug-07 01-Aug-14 $274,298.95

Dr McInerney Carmel Anaesthesia VMO 01-Jul-12 01-Jun-15 $55,436.62

Dr Meares Nicola Anaesthesia VMO 31-May-13 30-May-16 $36,225.41

Dr Melhuish Nicholas CardiacAnaesthesia VMO 01-Oct-07 01-Oct-14 $255,382.08

Dr Miller Andrew Dermatology VMO 30-Nov-10 29-Nov-13 $64,448.75

Dr MorrisseyPhillip(DrP.Morrissey PtyLtd)

Anaesthesia VMO 01-Nov-10 01-Nov-13 $122,699.54





Total Amount

Paid (exc. GST)


Dr Mosse Charles GeneralSurgery VMO 05-Apr-11 30-Nov-13 $314,654.08

Dr Mulcahy Maurice Urology VMO 02-May-13 01-May-16 $154,910.37

Dr Nagy Attila Anaesthesia VMO 05-Sep-12 04-Sep-13 $25,232.35

Dr Neilson Wendell VascularSurgery VMO 01-Jul-13 30-Jun-16 $53,451.45

Dr O’Connor Simon Cardiology VMO 01-Oct-07 30-Sep-14 $293,456.90

Dr OKera Salim Ophthalmology VMO 12-Apr-10 12-Apr-17 $82,292.62

Dr Palnitkar

Girish (BrindabellaAnaesthesia PtyLtd)

Anaesthesia VMO 01-Dec-10 14-Nov-13 $172,869.04

Dr Peady Clifford Anaesthesia VMO 24-Aug-10 01-Aug-14 $245,713.57

Dr Peake Ross Anaesthesia VMO 22-Jul-10 22-Jul-13 $180,953.75

Dr Pham Tuan ENTSurgery VMO 17-Aug-12 01-Jun-13 $313,452.82

Dr Ponniah Senthan Anaesthesia VMO 24-Jan-11 23-Jan-14 $147,677.68

Dr Powell Suzanna PaediatricMedicine VMO 01-Jun-08 31-May-15 $60,359.93

Dr Quah YeowLeng(Valerie) Anaesthesia VMO 17-Jan-11 16-Jan-14 $95,505.95

Dr Rajapakse YasanthaRanjeeva PlasticSurgery VMO 12-Sep-12 11-Sep-13 $317,062.87

Dr Rangiah David GeneralSurgery VMO 31-Oct-11 01-Feb-15 $139,953.35

Dr Reiner David Anaesthesia VMO 01-Sep-11 31-Aug-14 $115,051.05

Dr Riddell James(J.RiddellPtyLtd)

GeneralMedicine&Gastroenterology VMO 10-Dec-09 30-Nov-14 $26,122.75

Dr Roberts Chris OrthopaedicSurgery VMO 01-Nov-07 01-Nov-14 $78,635.08

Dr Robertson Tanya GeneralPractice VMO 01-Jun-08 01-Jun-15 $146,251.20

Dr Robson Stephen O&G VMO 01-Aug-11 31-Jul-14 $107,629.73

Dr Rosier Michael PaediatricMedicine VMO 01-Aug-07 01-Aug-14 $96,346.14

Dr ScottCameron (ScottMedicalServicesPtyLtd)

OMFS VMO 31-Aug-12 30-Aug-13 $55,000.00

Dr Sjarif Adrian PlasticSurgery VMO 21-Mar-13 20-Mar-14 $49,235.01

Dr Simpson Erroll PaediatricSurgery VMO 19-Jun-12 31-Oct-14 $311,931.55

Dr Smith Joseph OrthopaedicSurgery VMO 02-Mar-13 11-Mar-14 $330,858.71

Dr Smith Paul OrthopaedicSurgery VMO 02-Feb-11 01-Feb-14 $121,054.81

Dr Smith Damian OrthopaedicSurgery VMO 01-Jul-08 01-Jul-15 $268,285.96

Dr Speldewinde Geoffrey Anaesthesia VMO 01-Nov-07 01-Nov-14 $37,329.73

Dr Stone Hilton ENTSurgery VMO 01-Feb-11 31-Jan-14 $154,565.92

Dr Stubbs Geoffrey OrthopaedicSurgery VMO 24-Jan-11 23-Jan-14 $44,250.59

Dr Subramaniam Peter CardiothoracicSurgery VMO 01-Jul-11 02-Sep-13 $804,198.53

Dr Tharion John ThoracicSurgery VMO 30-Aug-12 01-Aug-15 $411,195.65

Dr Thomson Andrew Gastroenterology VMO 01-Oct-07 01-Oct-14 $532,773.96

Dr UptonZain(CZAnaesthesia PtyLtd)

Anaesthesia VMO 10-Feb-11 09-Feb-14 $186,200.25

Dr Vrancic Sindy OrthopaedicSurgery VMO 01-Sep-09 01-Sep-16 $163,459.06





Total Amount

Paid (exc. GST)


Dr Walton Ashley Radiology VMO 21-Apr-13 22-Apr-14 $45,345.45

Dr Wilson Michael(JangaAnaesthesia PtyLtd)

Anaesthesia VMO 01-Nov-07 01-Nov-14 $77,224.35

Dr Witherspoon Robert OMFS VMO 10-Dec-12 09-Dec-13 $142,609.95

Dr Yuille Rosemary GeneralPractice(AboriginalServices) VMO 23-Aug-10 30-Sep-14 $38,437.36


Dr Bromley JenniferGeneralPractice(CorrectionsHealthProgram)

VMO 06-Feb-10 06-Feb-14 $63,762.15

Dr Eldridge James Neil

GeneralPractice(CorrectionsHealthProgram&ClinicalForensicsACT)

VMO 01-Feb-10 01-Feb-17 $172,714.58

Dr Fernando SellupperumageNoel Psychiatry VMO 28-Feb-13 27-Feb-14 $77,036.34

Dr Fitzgerald Paul Psychiatry VMO 01-Aug-07 01-Aug-14 $154,437.56

Dr George Graham Psychiatry VMO 02-Dec-12 01-Dec-15 $160,558.00

Dr HendersonAScott (A.S.Henderson PtyLtd)

Psychiatry VMO 01-Nov-07 31-Oct-14 $231,811.64

Dr Kasinathan John Psychiatry VMO 01-Jul-08 01-Jul-15 $331,984.56

Dr Liang Rachel GeneralPractitioner VMO 24-Jul-12 23-Jul-13 $133,622.07

Dr Owen Cathy Psychiatry VMO 01-Nov-07 01-Nov-14 $73,133.76

Dr Thomson Graeme

GeneralPractice(CorrectionsHealthProgram&ClinicalForensicsACT)

VMO 01-Mar-10 13-Jan-17 $218,932.56

Dr Westcombe David Psychiatry VMO 30-Nov-10 30-Nov-13 $186,414.18

Dr Wurth Peter Psychiatry VMO 01-Feb-08 31-Jan-15 $71,181.08


Dr Storey Desmond GeneralDentistry VMO 30-Nov-10 29-Nov-13 $35,719.11

Dr Tin Stephen DentalSurgery VMO 01-Sep-07 01-Sep-14 $49,659.56


DrsAppliedImaging PtyLtd

(Elizabeth Lim&NigelHunter)

Radiology–BreastScreen VMOs 01-Sep-08 01-Sep-15 $81,700.72

Dr Bell Susanne Radiology–BreastScreen VMO 11-Nov-11 10-Nov-14 $138,590.02

Dr Chen Suet Wan Radiology–BreastScreen VMO 01-Nov-11 31-Oct-14 $100,997.67

Dr Cranney Brendan Radiology–BreastScreen VMO 02-Jul-11 01-Jul-14 $33,144.76

Dr Hazan Georges Radiology–BreastScreen VMO 01-Sep-08 01-Sep-15 $285,437.46


C.16 Community grants, assistance and sponsorship

In2012–13,theHealthImprovementBranchofACTHealthprovidedgrants,assistanceandsponsorshiptovariousorganisationsassetoutinthefollowingtables.

2012–13 Community Funding RoundTheCommunityFundingRound(CFR)in2012–13fundedactivitiesrelatedtothepromotionofhealthacrosstheACTpopulation,includingthereinforcementofhealthylifestylemessages.TheCFRalsoaimedtoenhancethecapacityofindividualsandcommunitygroupstopositivelycontrolfactorsthatdeterminehealthoutcomes.OrganisationsfundedthroughtheCFRareexpectedtoadopttheprinciplesandpracticesofhealthpromotioninthedeliveryoftheirprojects.

Outcomeshavenotbeenreportedinthissection.Whiletheseprojectswerefundedin2012–13,deedsofgrantspecifythatthedeadlineforreportingonoutcomesiswithinthreemonthsoftheexpirationorterminationofthedeed.Asnoneofthesedeedshasexpiredorterminated,theoutcomesforthegrantslistedbelowarenotyetavailable.Allgrantsrecipientsarerequiredtoreportonprogress,andevaluationsareundertakenaspartoftheiragreements.

Organisation/recipient Project description/process/period of time engaged Amount

1 AGenderAgenda BeingTruetoOurselves:DevelopingandSharingPersonalStoriesofSexandGenderDiversity $67,000

2 Alcohol,TobaccoandOtherDrugAssociationACT(ATODA) Under10%Project $41,361

3 ArthritisACT LoweringtheBarriers $30,919

4 AsthmaFoundationACT AsthmaSwimProgram $50,522

5 AustralianBreastfeedingAssociationACT/SNSW

ImprovingbreastfeedingratesintargetgroupsidentifiedintheACTBreastfeedingStrategicFramework2010–2015 $24,571

6 BasketballACT NightHoopsInclusionProgram(NightBasketballHoops) $12,359

7 CanberraDanceTheatre ‘LifeisaWorkofArt’ $16,350

8Canberra Environment andSustainability ResourceCentre

FoodforThought,ecotherapyfoodgardens $30,018

9 CanberraYouthTheatre CYT’sWellbeingandInclusivityProgram $30,000

10 FootballUnited—University ofNewSouthWales

EmpoweredforHealthierCommunities—aFootballUnitedCanberraProject $37,161

11 GungahlinRegional Community Service ConnectingthePieces $57,900

12 HealthCareConsumers’Association

HealthLiteracyforAll:buildinganinclusivecommunityofsupportwithempoweredhealthconsumersandtheirfamiliesandfriendsacrossalifetime

$58,148

13 MentalHealthFoundationACT DramaticRecovery—aforumtheatreprojectwithmental health consumers $28,620

14 NarrabundahEarly ChildhoodSchool NarrabundahTuckerTime $27,100

15 Nican KnowBeforeYouGo—buildingdisabilityconfidenceandhealthoutcomesthroughempoweringsocialparticipation $22,550

16 OzHelpFoundation CommunityTune-Up(CTU) $49,265

17 ReclinkAustralia ReclinkAustraliaActiveArtsProject(RAAAP)ACT $83,642



18 RoyalLifeSavingSocietyAustralia—ACTBranch ACTHighSchoolsLifesavingPilotProgram $35,800

19 SHINEforKids Co-operativeLimited

Buildingresilienceinauniquelyvulnerablegroup: childrenofprisoners $75,400

20 StVincentdePaul Family Services Homeground $21,563

21 Taylor Primary School LifeStart $20,000

22 TheCanberraRaidersPtyLtd RaidersRecess $45,000

23 Women’sCentrefor HealthMatters

AprofessionalapproachtopeersupportforACTwomen inprisonandwomenexitingprison $48,529

23 projects $913,778

2012–13 Stay On Your Feet® Falls Prevention Funding RoundThisroundprovidedfundingforthedevelopment,implementationandevaluationoffallspreventionprograms. Itassistedcommunity-basedgroups,not-for-profitorganisations,residentialagedcarefacilitiesandrelevantgovernmentagenciestoreducetheincidenceandseverityoffallsandfalls-relatedinjuriesamongolderpeopleintheACT.


1 ArthritisFoundationoftheACT,incorporatingOsteoporosisACT IndigenousFallsPreventionOutreachProgram $26,452

2 ArthritisFoundationoftheACT,incorporatingOsteoporosisACT TravellingFallsPreventionExpo $43,578

3 Belconnen Community Service MatureStrengthandBalance $16,991

4 CouncilontheAgeing(ACT)Inc. SteadyMed—ManagingMedicinestoMinimiseFalls $34,340

5 NationalHeartFoundationofAustralia(ACTDivision)

HeartmovesandHeartFoundationWalking—Reducingfallsrisk inresidentslivinginagedcarefacilities $18,300

6 SupportAsianWomen’sFriendshipAssociationInc. StayFirmandBeActiveforCALDBackgroundsSeniors $15,786

7 TandemRespiteInc. Heartmoves@Tandem $15,000

8 YMCAofCanberra Collaborationandevaluation—strengtheningtheYMCA’sMobiliserProgram $28,940

8 projects $199,387

2013 Healthy Schools, Healthy Children Funding RoundTheHealthySchools,HealthyChildrenFundingRoundwasdeliveredincollaborationwiththeACTEducation andTrainingDirectorate.Itsaimin2013wastocreatesustainableopportunitiesforhealthy,activelifestylesthroughimprovedphysicalactivityandhealthyeating.Targetgroupsareearlychildhoodcentresandschools. Thefundingroundalsoaimedtofacilitatecommunication,collaborationandpartnershipsbetweenschoolsand theircommunities.



1 AustralianRedCross FoodFromHome $30,130

2 CanberraandSouth-EastRegionEnvironment Centre GrowTogether $37,091

3 EvattPrimarySchool Eatwell4eva(tt) $6,788

4 KidsPantryPtyLtd KidsPantryProgramofHealthyFood@SchoolGardento TableActivities $20,889

5 KingsfordSmithSchool GrowingTogether—GardentoTable $20,000

6 MalkaraSchool VegetableGarden $8,270

7 Monash School FromLittleThings,BigThingsGrow $5,130

8 Mother Teresa School GungahlinCatholicSchoolsJointInitiativeforActiveTravel to School $19,990

9 NorthAinsliePrimarySchoolP&C TheHealthyEatingHub,SensoryGardenandNo-WasteChookPen $15,000

10 NutritionAustraliaACT Food&ME—TheEarlyYears $20,000

11 PalmerstonDistrict Primary School PRIDEInternationalGardentoGourmetProject $14,488

12 PhysicalActivityFoundationLtd SchoolCommunityActiveTravelprogram (incorporatingRideorWalktoSchool) $121,705

13 TheWodenSchool GrowingaHealthyLife $15,600

14 TheodorePrimarySchool Connectingchildren,theirfamiliesandtheschoolcommunitythroughfood $3,000

15 TorrensPrimaryP-6School Fithabitz—‘CatchMeIfYouCan’Torrens,PearceandChifleypreschools $2,380

16 Torrens Primary School TorrensPrimarySchool’sHealthyFood+HealthyChoices=HealthyKidsProgram $11,504

16 projects $351,965

2012–13 Health Promotion Sponsorship Funding RoundOneofthewaystheACTHealthPromotionGrantsProgramcontributedtoimprovedhealthandwellbeinginourcommunitywasthroughtheprovisionofsponsorshiptosports,recreation,andartsandculturalorganisations. Theprioritycampaignsfor2012–13were:

• Gofor2&5® (encouragingoptimalfruitandvegetableconsumption)

• Findthirtyeveryday®(encouragingphysicalactivity)• Tapintowatereveryday(promotingwaterasthedrinkofchoice)

• SwapItDon’tStopIt(encouraginghealthybehavioursbyswappinganunhealthybehaviourforahealthieralternative)

• SmokeFreeACT(aimedatreducingtobacco-relatedharms).

Sponsorshiparrangementscanalsobeusedtofacilitateimprovedhealthpromotionpolicies,practicesandcultureswithincommunityorganisations,tohelpthemworktowardsbecomingahealth-promotingorganisation.


Organisation/recipient Amount

1 ACTCricketAssociation $10,000

2 ACTGridironInc. $20,000

3 ACTVeteransAthleticClubInc. $10,000

4 AustralianCapitalTerritoryUltimateAssociationIncorporated $10,000

5 AustralianDanceCouncil—Ausdance(ACT)Inc. $20,000

6 AustralianInstituteofAboriginalandTorresStraitIslanderStudies(AIATSIS) $20,000

7 AustralianNationalBotanicGardens $10,000

8 BarbershopHarmonyClubofCanberra $20,000

9 BasketballACT $10,000

10 BrindabellaDanceFestival $10,000

11 CanberraRaidersPtyLtd. $20,000

12 Capital Football $10,000

13 HallRugbyUnionFootballClub $10,000

14 KultureBreak $10,000

15 QL2DanceInc. $10,000

16 RoyalLifeSavingSocietyAustralia—ACTBranchInc. $20,000

17 RoyalNationalCapitalAgriculturalSociety $20,000

18 TheVillageFestivalofNewPerformanceInc. $20,000

19 Touch Football ACT $10,000

20 TuggeranongBMXClubInc. $10,000

21 YMCAofCanberraInc. $20,000

21 sponsorships $300,000

2012–13 Communication and Learning and DevelopmentTheACTHealthPromotionGrantsProgramsupportedfundedorganisationsthroughalearninganddevelopmentprogramtobuildongoingcapacityinthesectorforhealthpromotiondelivery.Examplesofactivitiesinthe2012–13programinclude:

• theprovisionofworkshopstoenhancegrant-writingskills

• theprovisionofaHealthCoachingcoursetoprovidehealthpractitionerswithastructuredsystemofevidence-basedbehaviourchangeprotocolsinthecontextofchronicconditionself-management

• theprovisionofaHealthPromotionShortCourseforhealthprofessionalstoincreaseparticipants’confidencetointegratehealthpromotionintotheirpractice

• provisionofscholarshipassistancetocommunitysectorworkerstocompleteaCertificateIIIinPopulationHealth.

TheprogramalsoprovidedsponsorshipforhealthprofessionalstoattendthePopulationHealthCongress2012.

Project description/process/period of time engaged Amount

1 HealthCoachingCourse $9,290

2 Scholarshipassistancex20CITCertificateIIIinPopulationHealth $7,464

3 GrantsApplicationWritingTraining—HCCA $900

4 GrantsApplicationWritingTraining—OurCommunityP/L $4,146

5 GrantsApplicationWritingCoaching—HCCA $1,540

6 FundingofCommunityDevelopmentNetwork(CDNet) $6,759

Total $30,099


C.17 Territory records

Records Management ProgramACTHealth’sRecordsManagementProgramwasapprovedbytheChiefExecutiveofACTHealthinJune2009.TheRecordsManagementProgramhasbeenlodgedwiththeDirectoroftheTerritoryRecordsOfficeandcontinuestobetheinstrumentunderwhichACTHealthworks.

Records management proceduresTheRecordsManagementProgramcomprisesACTHealth’spolicystatement,detailedprocedures,theBusinessClassificationSchemeandasetofdisposalschedules.InlinewiththeTerritory Records Act 2002,thedirectorate’sRecordsManagementPolicyoutlinesaRecordsManagementProgramforACTHealthanddetailshowtheagencywilladheretotherequirementsoftheAct.

ThisprocedureprovidesaframeworkforACTHealthtocreate,systematicallycapture,register,classify,use,store,disposeofandretainrecords.

During2011–12,areviewcommencedofACTHealth’sAdministrativeRecordsManagementProceduresManual2005inconsultationwiththeTerritoryRecordsOffice.TherevisedRecordsManagementProceduresandGuidelineshavenowbeenplacedontheintranetandareavailableforallstafftoview.TheRecordsManagementintranetsiteisunderreview.TheupdatedsitewillincludelinkstotheTerritoryRecordsOffice’sstandardsandguidelines.

Records disposal schedulesAlistofapprovedrecordsdisposalschedulesisoutlinedbelow.

Records disposal schedule name Effective Year and number

CommunityRelations 8 March 2012 NI2011-84

Compensation 11 March 2012 NI2012-183

EquipmentandStores 13 April 2012 NI2912-186

Establishment 11 September 2009 NI2009-437

FinancialManagement 2 September 2011 NI2011-482

FleetManagement 13 April 2012 NI2012-187

GovernmentRelations 8 March 2011 NI2011-88

IndustrialRelations 8 March 2011 NI2011-90

InformationManagement 8 March 2011 NI2011-92

LegalServices 11 September 2009 NI2099-443

OccupationalHealthandSafety 11 September 2009 NI2009-444

Personnel 8 March 2011 NI2011-97

PropertyManagement 11December2009 NI2009-625

Publication 11 September 2009 NI2009-450

StrategicManagement 11 September 2009 NI2009-453

TechnologyandTelecommunications 11 September 2009 NI2009-454

PatientServicesAdministration 8 May 2009 NI2009-210

PopulationHealthCareManagementandControl 8 May 2009 NI2009-209

http://www.legislation.act.gov.au/a/2002-18/default.asp


TrainingThroughout2012–13,thepolicyandprocedureswerepromotedtostaffthroughformalandin-the-workplacetrainingandeducationsessions,therebyensuringcomplianceacrossACTHealth.

ARecordsManagementtrainingmoduleisincludedintheManagersOrientationprogram,conductedmonthlyandcoordinatedbytheStaffDevelopmentUnit,and117managershavecompletedtheprogram(seeC.8Learninganddevelopment).

RecordsManagementstaffprovidein-classroomandon-the-jobtrainingtoclients.Ane-learningpackageandotherrecordsmanagementtrainingmaterialareatanadvancedstageofdevelopmentandarebeingevaluatedpriortofinalisation.

AnewTRIMusermanualandfactsheetsareavailabletoallstaffandthesewillbeupdatedasrequiredonthehealthHUB(ACTHealth’sintranet).

Customisedclient-specificTRIMtutorialshavebeendeveloped.Additionally,TRIMclassroom-styletrainingmaterialandasyllabushavebeenfinalisedandtrainingwillcommenceinthenearfuture.

Over2012–13,anumberofqualityimprovementinitiativeswereundertakentoevaluatethetrainingprovided.Asaresultoftheseevaluations,anumberofimprovementstothetrainingprogramhavebeenimplemented,asnoted.Thetrainingprovidedwillcontinuetobeevaluatedandadjustedasrequired.

Preservation of Aboriginal and Torres Strait Islander informationAdministrativerecordscontainingcontentaboutAboriginalandTorresStraitIslanderpeoplemainlybelongtothegeneralrecordseriesaboutHealthCommunityPrograms,HealthandWelfareIssuesandPolicy.

AllRecordsManagementstaffunderstandthesensitivitiesrelatingtorecordsaboutAboriginalandTorresStraitIslanderpeoplesandtheneedfortheserecordstobepreservedforpossiblefutureaccessandreference.

ThecurrentdisposalschedulehasidentifiedasmallselectionofrecordsforAboriginalandTorresStraitIslanderpeoplesforpermanentretention.

Public access to Territory recordsIn2012–13,HealthRecordsManagementstaffliaisedcloselywiththeTerritoryRecordsOffice’sReferenceArchivistinresponsetopublicaccessrequestsundersection26oftheTerritory Records Act 2002.Duringthisperiod,sixrequestswerereceivedforaccesstorecords.


C.18 Commissioner for the Environment

ACTHealthisresponsibleforreportingagainstthefollowingrecommendationfromtheState of the Environment Report 2007–08:

Communitywellbeingandsafetyisstrengthenedby...Encouragingcommunityhealthprograms,particularlythoseaimedatexercise,healthyeating,mentalwellbeingandminimisingtheexcessivealcoholconsumption.

The ACT Aboriginal and Torres Strait Islander Health and Family Wellbeing Plan 2006–2011wasdevelopedinresponsetotherequirementoftheNationalStrategicFrameworkforAboriginalandTorresStraitIslander Healthforeachjurisdictiontodevelopalocalimplementationplan.Areviewoftheplanwasundertakenin 2012–13bytheAboriginalandTorresStraitIslanderHealthForum,whichincludesmembershipfromACTHealth,theACTAboriginalandTorresStraitIslanderElectedBody,WinnungaNimmityjahAboriginalHealthServiceand ACTMedicareLocal.Throughthisprocess,manyfactorswereidentifiedasaffectingitsimplementation,mostsignificantlytheClosingtheGapIndigenousreformagenda,whichwasintroducedhalfwaythroughimplementationoftheplanin2008.

DevelopmentofanewACTAboriginalandTorresStraitIslanderHealthPlancommencedin2013.ThenewplanwillincorporatelearningsfromthereviewofthepreviousplanandoutstandingactionitemswhichhavebeenidentifiedasongoingstrategiesrequiringimplementationbytheHealthForum.Theseareasrelateto,butarenotlimitedto,earlyintervention,healthpromotion,serviceprovision,workforceplanning,localresearch,reportingandleadership.PleaserefertoC.21,AboriginalandTorresStraitIslanderReporting,forfurtherdetails.

Beyond Today—it’s up to you,asmokingcessationandhealthylifestylesocialmarketingstrategytargetingtheAboriginalandTorresStraitIslandercommunitiesoftheACTandsurroundingregion,waslaunchedinDecember2012.ThecampaignistheculminationofasignificantengagementprocesswiththeACTAboriginalandTorresStraitIslandercommunities.Thecampaignfeatureslocalmembersofthecommunitytellingstoriesacrossarangeofmaterials,includingposters,banners,abrochure,shortvideosandsongscreatedlocallyandperformedbylocalAboriginalandTorresStraitIslanderchildrenandyoungpeople.

ProgresscontinuesintheestablishmentoftheAboriginalandTorresStraitIslanderAlcoholandOtherDrugResidentialRehabilitationService(NgunnawalBushHealingFarm).Thisservicewillseektoimprovehealthoutcomesbyaddressingthecomplexissuesthatrelatetodrugandalcoholabuse.Theservicewillprovideculturallyappropriateprevention,education,rehabilitationandoutreachprogramsforAboriginalandTorresStraitIslanderpeoplesaged18yearsandover.Workisoccurringtofinalisethepre-tendercostestimate,constructionprogramandgovernancearrangementsfortheservice.PleaserefertoC.21,AboriginalandTorresStraitIslanderReporting,forfurtherdetails.

ACTHealthhasinitiatedanumberofmeasurestoimprovecommunityhealthinlinewiththecommissioner’ssecondrecommendationrelatingtohealthpromotionandcareservices.Theseinclude:

• thelaunchof Beyond Today—it’s up to you

• promotionoftapwaterasthedrinkofchoicetotheACTcommunity,includinglendingportable‘Tapintowatereveryday’water-dispensingunitstocommunityevents,andworkinginpartnershipwiththeACTEducationDirectoratetotrialfixedwaterunitsinschools

• theGetHealthyInformationandCoachingService®,afreeinformationandtelephone-basedhealthservicetoassistadultstoidentifyandreachtheirhealthgoals

• localsupportfortheAustralianGovernment’sSwapIt,Don’tStopItsocialmarketingcampaign,whichencouragespeopletomakesustainable,incrementalchangesintheirlifestylechoices

• fundingforawiderangeofcommunity-basedhealthpromotionactivitiesthroughtheACTHealthPromotionGrantsprogram

• KidsatPlayActivePlayandtheEatingWellEarlyChildhoodproject,whichprovidesorganisationsresponsibleforearlychildhoodserviceswithsupporttopromotehealthychildhoodhabits

• SmartStartforKidsProgram,fundedtoscreenchildrenforhealthriskfactorsandprovideaschool-basedprogramforhigher-riskchildcare


• theHealthyFoodatSchoolsproject,includingsupportforschoolstoimplementNationalHealthySchoolsCanteenGuidelinesinpartnershipwithNutritionAustralia

• theHealthyFoodatChildren’sSportsproject,inpartnershipwithSportandRecreationandlocal sportingorganisations

• theActiveTraveltoSchoolsproject

• fundingoftheHeartFoundation’sActiveLivingagenda—HeartFoundationWalkingandtheHeartmovesprogram

• ongoingimplementationoftheAustralianGovernment’sHealthyCommunitiesInitiative

• implementationofavarietyofworkplacehealthpromotionactivities,includingACTHealthSmoke-FreeWorkplacepolicy,andthedevelopmentandpilotingofanumberofresourcestosupportworkplacehealthandwellbeingprograms

• MyHealth—theHealthDirectorate’sstaffhealthandwellbeingprogram.


C.19 Ecologically sustainable development

TheACTHealthDirectorateactivelysupportswhole-of-governmentsustainabilityinitiativesandin2012–13continuedtoworkcloselywiththeEnvironmentandSustainableDevelopmentDirectoratetoembedclimatechangepolicy,energypolicyandenvironmentalsustainabilityintothedeliveryofservice.

Sustainability planningToassistwithitsplanningprocesses,ACTHealthdevelopedtheACTHealthDirectorateSustainabilityStrategy(2010),whichoutlinesthecurrentenvironmentalchallengespresentedbyincreasingdemandsonhealthcareintheACTandprovidesaroadmapforacollaborativesustainablefuture.Itencapsulatesapictureofwherethedirectoratewantstobein30years’timeandtakesintoaccountallthekeyelementscontributingtoasustainableanddynamicfuture.TheSustainabilityStrategycontainssevenfocusareas(ModelsofCare,BuildingsandInfrastructure,theDigitalHealthEnvironment,Transport,RegulatoryEnvironment,Workforce,andPartnershipsandExternalServiceDelivery).

During2012–13,ACTHealthundertookextensiveworkonfinalisingtheSustainabilityActionPlan,inlinewiththeSustainabilityStrategy.DevelopmentoftheActionPlanwassupportedbyACTHealth’sLeadershipNetwork,whichconsistsoftheagency’sfutureleaders.ThesestaffembraceddevelopmentoftheActionPlan,whichcontainsshort-,medium-andlong-termactionstobeimplementedacrossthedirectorate,with93percentoftheshort-termactions(1–3years)alreadycompleted.

Theseactionsinclude:

• significantreductioninoperatingcosts

• improvedqualityoftheinternalenvironmentforstaffandvisitors

• future-proofingofbuildingssothattheyareabletoadapttofuturerequirements

• informeddesignchoices,basedonwhole-of-lifeconsiderations

• reductionincarbonemissions.

ACTHealthcontinuestodemonstrateitscommitmenttotheprinciplesofecologicallysustainabledevelopmentby:

• closelymonitoringitsuseofresources

• integratingeconomic,socialandenvironmentalconsiderationsintodecision-making

• implementingmeasurestominimisetheimpactofagencyactivitiesontheenvironment.

ACTHealthdevelopedtheSustainability–Environmental Principles and Guidelines for Building and Infrastructure documenttoinformallcapitalprojectsandmajorrefurbishmentworksregardingsustainabledesignandfunctionalitythatalignswiththeACTGovernment’stargets.

ForthepurposeoftheAgencyResourceUseDataTableattheendofthissection,officespaceisclassifiedasitisinsectionC.13ofthisAnnualReport;thatis,fullyinclusiveofnewofficespace.TheCanberraHospitalcampusbuildings’housingofficespacehasalsobeenincludedthisyear.

Energy useTotalenergyusein2012–13increasedby5,410,420megajoules(approximately2.35percent)comparedwith2011–12,dueto:

• increasedbuildingandclinicalspaceassociatedwiththeHealthInfrastructureProgram(HIP)

• anincreaseinclinicaldemandacrossthedirectorate,bothintheacuteandnon-acuteareas.

Newspacein2012–13,whichhadanimpactonenergyusage,included:

• theCentenaryHospitalforWomenandChildrenStage1,whichopenedinSeptember2012


• theGungahlinCommunityHealthCentre,whichopenedinAugust2012

• thefullyoperationalAdultMentalHealthUnit

• additionalbedsimplementedacrosstheCanberraHospital.

Otherdevelopmentsnearingcompletionwhichwillincreaseenergyusageinthenearfutureinclude:

• Stage2oftheCentenaryHospitalforWomenandChildren

• CanberraRegionCancerCentre

• additionalCanberraHospital(TCH)bedscurrentlybeingconstructed

• thenewBelconnenEnhancedCommunityHealthCentre

• TuggeranongCommunityHealthCentreextension.

In2012–13,thefollowinginitiativestoimproveenergymanagementwereeitherimplementedorcontinued across ACT Health:

• replacementofseveralgas-firedboilersatCanberraHospital

• replacementofair-conditioningfancoilunitsthroughoutBuilding1atCanberraHospital

• ongoingupgradeofelectricaldistributionboardsacrossmanyareasofthedirectorate

• ongoinginstallationofenergy-efficient,occupancy-sensorortime-controlledlightingfornon-criticalbuildinglightingandair-conditioningsystems

• continuedreview,monitoringandtrackingoflargeplantequipment(e.g.high-energyusechillersandboilers),withprogrammingadjustmentsmade,wherepossible,bythebuildingmanagementsystemtomaintainpeakefficiency

• replacementofolder,largerelectricalequipmentinnon-acuteareaswithmoreenergy-efficientunits,e.g.panflushersandutensilwashers

• installationofboilerheatrecoveryandburnermanagementsystems.

Water consumptionACTHealth’smainuseofwaterisfortheprovisionofclinicaltreatmentandassociatedservicesforpatientsandclients.Themostsignificantconsumptionofwaterisattributableto:

• patientservices,clinicaluseassociatedwitha24-hourservice,includingbathrooms

• chilledandhotwaterservicesforair-conditioningsystemsforwards,operatingroomsandtreatmentareas

• operationswithinthekitchensandpreparationofpatientmeals

• anincreaseinbuilding-relatedactivitiesassociatedwiththeHealthInfrastructureProgram

• sterilisationofsurgicalinstruments,includingwaterusedinautoclaveunits

• renaldialysistreatments

ACTHealth’stotalwaterconsumptionincreasedfrom186,552kilolitresin2011–12to194,088kilolitresin2012–13,anincreaseof7,536kilolitresor4percent.

Thisincreaseisattributableto:

• operationalactivityassociatedwiththeuseoftheCentenaryHospitalforWomenandChildrenStage1andtheAdultMentalHealthUnit.Bothbuildingsaddadditionalbathroomsandclinicalrequirements.

• constructionrequirementsfortheCanberraRegionCancerCentreandStage2oftheCentenaryHospitalforWomenandChildren

• additionalbedsattheCanberraHospital

• increasedservicedeliveryacrossACTHealth

• operationalactivityassociatedwiththeGungahlinCommunityHealthCentre.

ThegraphbelowsummarisestotalwaterconsumptiondataforACTHealth,representedastotalkilolitresused,from2008–09whenitwas154,711kilolitresto2012–13whenitwas194,088.


ACT Health Annual Water Consumption

0

50,000

100,000

150,000

200,000

250,000

2008/2009 2009/2010 2010/2011 2011/2012 2012/2013

Theongoingimplementationandreviewofavarietyofwaterefficiencyinitiativescontinuedthrough2012–13,including:

• installationofflowrestrictorsonarangeofplumbingfixtures(e.g.showers,handbasinsandtoiletsforallnewworksandrefurbishments)

• installationofsix-starenergyratingfixturesasreplacements,wherepractical

• replacementofheatingpipeworkandassociatedworksatTCH

• boilerupgradesatTCH

• continuationofrestrictionsontheuseofpotablewaterforoutsidewateringatallHealthDirectoratefacilitiesanddeactivationofallgardensprinklersanddecommissioningoffountains

• monitoringofwatermetersforcoolingtowersusage

• useofnewly-installedtankwaterforoutdoorgardenwateringandexternalwashingoffacilities,buildings andpavements.

Greenhouse gas emissionsACTHealthsupportsandparticipatesintheAustralianGovernmentDepartmentofClimateChangebenchmarkingthroughtheOnlineSystemforComprehensiveActivityReporting(OSCAR)database.OSCARstandardisesthecalculationofgreenhousegasemissionstoproducecomparabledatasetsonenvironmentalperformance.

Improveddatagatheringimplementedduring2011–12and2012–13enabledenhancedmonitoringofgreenhousegasemissiontrendsacrossACTHealthinfutureyears.

TransportIn2012–13,theHealthDirectoratevehiclefleetincreasedinnumberbyonevehicle.Thefollowingtransportdatawasreportedfor2012–13:

• Totalfuelusereducedfrom365.2kilolitres(petrolanddieselcombined)reportedfor2011–12to362.4kilolitresfor2012–13.Thisisareductionof0.76percent.

• Totalpetrolfuelusewasreportedas228.1kilolitres;totaldieselusewas134.4kilolitres.

• Totalnumberofvehiclekilometrestravelledremainedrelativelystaticat4,046,311kilometres,comparedto4,056,252kilometresreportedfor2011–12,areductionof0.25percent.

• Vehicleutilisationdecreasedfrom12,636to12,566kilometres(0.6percent).

• Averagefleetfuelconsumptionremainedstaticat8.97litresper100kilometresrelativetothe2011–12figureof9.00litresper100kilometres.


• Totaltransportgreenhousegasemissions(allscopes)reducedfrom987tonnesCO2-eto975tonnes,areductionof1.22percent.

• Transportgreenhousegasintensityimprovedfrom0.16tonnesCO2-eperheadcountto0.15tonnesperheadcount(5.4percent).

• Totaltransportenergyusewas12,988gigajoules.

Fuel Utilisation Per Financial Year

451,397

426,067

395,739

388,867

365,093

359,228 365,249 362,472

340,000

360,000

380,000

400,000

420,000

440,000

460,000

FY05/06 FY06/07 FY07/08 FY08/09 FY09/10 FY10/11 FY11/12 FY12/13

Total Litres

• InJune2010,theHealthDirectorateenteredintoacontractwithCarpool-It.com(Australia)PtyLtd(alsoknownasMyCarpools)forthedevelopmentandhostingofacar-poolingsystemforstaff.SubsequentlytheACTGovernmentintroducedMyCarpools acrossACTGovernmentdirectoratesandsinceJune2012ACTHealthhasbeenparticipatinginthisprogram.UsageoftheACTGovernment’sMyCarpools hassteadilyincreasedsinceitsinception.

• Since2012,301usershaveregistered,with110ofthoseusersbeingstaff ofACTHealth.Therearecurrently 15car-poolinggroupsregisteredwithMyCarpools,ofwhich13aremadeupofACTHealthstaff,resultinginACTHealthhavingthelargestnumberofactivecar-poolingstaffacrosstheACTGovernment.

• ACTHealthwillacquiretwoelectricalvehiclesinthenextfinancialyear.

• NewbicyclefacilitiesatCanberraHospitalhavehelpedstafftousethismodeoftransporttowork.

Waste minimisation (NoWaste)ISSHealthServices(ISS)providesawastemanagementsolutionfortheHealthDirectorateunderthetermsoftheACTHealthDomesticandEnvironmentalServicesContract.ISSservicesareprovidedto17sites,includingtheCanberraHospital.

HealthDirectorateandISSdevelopedandimplementedaHealthWasteManagementPlan,whichwasendorsedinAugust2012.Themanagementofallwasteservicesbyoneproviderandinaccordancewiththewasteplanfacilitatesthedeliveryofauniformapproachtowastemanagementactivities.

TheHealthWasteManagementPlancomplieswiththeprinciplesoftheACTSustainableWasteStrategy2010–2015,whichbuildsonthesuccessoftheNoWasteby2010ACTGovernmentstrategyreleasedin1996andprovidesfor:

• monitoringandmeasuringofallservicesthroughinternalbenchmarkingactivities,targetsetting,wasteaudits,wastedatacollectionandreporting

• improvedsystemstorecycle,reduceandreuseasmanyresourcesaspossiblefromwastestreams,includingpaper,cardboard,glass,plastic,cans,fluorescenttubes,metal,batteries,tonercartridges,andbiodegradables.

Carpool-It.com

http://rideshareact.mycarpools.com.au/

http://rideshareact.mycarpools.com.au/


• ACTHealthisalsoasignatorytotheACTGovernmentACTSmartprogram,whichalignswithandsupportstheinitiativesoftheHealthWasteManagementPlan,specificallyinincreasingrecyclingoutputs.ACTHealthandISSareworkingcloselywithACTSmartrepresentativestoincreaserecyclingoutputsthrougheducationforstaffandtheimplementationofrecyclingsystemswithinadministrativeareas.

• ACTHealthintroducedwastestreamingstationsintothedesignofallnewbuildingscomingonlinethroughtheHealthInfrastructureProgram(HIP).

• ACTHealthcollaboratedwithAustralianNationalUniversity(ANU)MedicalSchoolstudentsontheACTGreenHospitalsProject2010–2013.OneoftheaimsoftheprojectwastoencourageandincreasecorrectstreamingofwasteatthepointofdisposalintheCanberraHospitaltheatres.Theprojectdelivereda4.6percentreductionofwasteincorrectlydisposedofintotheclinicalwastestream,thereforereducinggreenhousegasemissionsassociatedwithclinicalwastetreatmentsanddisposal.

• ACTHealthreceivedanEArating(excellentachievement)fromtheAustralianCouncilonHealthcareStandards(ACHS)forWasteandEnvironmentalManagementinrelationtoCriterion3.2.3EQUIP5oftheaccreditationprocessundertakeninNovember2012.

Agency resource use data

Indicator as at 30 June Unit 2011–12 2012–13

Line General Office Total Office Total

L1 Occupancy–stafffull-timeequivalent Numeric(FTE) 413 6,270 1,1621 6,5402

L2 Areaofficespace– netlettablearea Squaremetres(m2) 5,990 249,8773 17,4814 228,090

Stationary Energy Office Total Office Total

L3 Electricity use Kilowatthours 2,514,171 35,382,895 1,715,888 34,664,9565

L46 Renewableenergyuse(GreenPower+EDLlandfillgases) Kilowatthours 1,122,211 8,908,951 N/a 3,328,618

L5 Percentageofrenewableenergyused(L4/L3x100) Percentage 44.63 25.20 N/a 9.60

L6 Natural Gas use Megajoules 2,183,387 103,065,000 1,962,000 111,060,000

L7 Totalenergyuse Megajoules 11,234,403 230,443,422 8,139,197 235,853,842

Intensities

L8 EnergyintensityperFTE(L7/L1) Megajoules/FTE 23,820 36,753 7,004 36,063

L9 Energyintensitypersquaremetre(L7/L2) Megajoules/m2 1,642 922 466 1,034

Transport Office Total Office Total

L10 Totalnumberofvehicles Numeric N/a 321 N/a 322

L11 Totalvehiclekilometrestravelled Kilometres(km) N/a 4,056,252 N/a 4,046,311

L12 Transportfuel(Petrol) Kilolitres N/a 212 N/a 228

L13 Transportfuel(Diesel) Kilolitres N/a 152 N/a 134

L14 Transportfuel(LPG) Kilolitres – – – –

L15 Transportfuel(CNG) Kilolitres – – – –

L16 Totaltransportenergyuse Gigajoules N/a 13,162 N/a 12,988

Water Office Total Office Total

L17 Water use Kilolitres N/a 186,5527 N/a 194,0888

Intensities

L18 WateruseperFTE(L17/L1) Kilolitres/FTE N/a 29.75 N/a 29.68

L19 Water use per square metre (L17/L2) Kilolitres/m2 N/a 0.70 N/a 0.85


Agency resource use data (continued)

Indicator as at 30 June Unit 2011–12 2012–13

Line General Office Total Office Total

Resource Efficiency and Waste Office Total Office Total

L20 Reamsofpaperpurchased Reams N/a 44,603 N/a 48,2599

L21 Recycledcontentof paperpurchased Percentage N/a 7.41 N/a 4.95

L22 Estimateofgeneralwaste (basedonbinscollected) Litres N/a 25,904,736 N/a 19,805.57710

L23 Estimateofcominlgedmaterialrecycled(basedonbinscollected) Litres N/a 1,796,850 N/a 1,892,88011

L24 Estimateofpaperrecycled (basedonbinscollected) Litres N/a 1,477,222 N/a 1,194,34812

L25 Estimateoforganicmaterialrecycled(basedonbinscollected) Litres – 0% – 0%

Greenhouse Gas Emissions Office Total Office Total

L26Totalstationaryenergygreenhousegasemissions (AllScopes)

TonnesCO2-e 1,644 43,862 1,957 40,666

L27 Totaltransportgreenhousegasemissions(AllScopes) TonnesCO2-e N/a 987 N/a 975

Intensities

L28 Greenhousegasemissionsperperson(L26/L1) TonnesCO2-e/FTE 3.90 7.0 1.68 6.21

L29 Greenhousegasemissionspersquaremetre(L26/L2) TonnesCO2-e/m2 0.27 0.18 0.11 0.18

L30 Transportgreenhousegasemissionsperperson(L27/L1) TonnesCO2-e/FTE N/a 0.15 N/a 0.14

1 Variationto2011–12istheinclusionof12MooreStreetLevel1,CarruthersStreetCurtin,Buildings23&24,officespacewithinBuildings2&6TCHandBuilding12MedicalRecordsDepartment.

2 Headcount,notFTE.3 Includes4,548m2thatwasincludedtwicein2011–12.4 Variationto2011–12istheinclusionof12MooreStreetLevel1,CarruthersStreetCurtin,Buildings23&24,officespacewithin

Buildings2&6TCH,andBuilding12MedicalRecordsDepartment.5 Reductioninconsumptionasspaceoccupiedbynon-governmententitieshasbeenremoved.6 GreenPowerbeingreportedatwhole-of-governmentlevelbyTAMS.7 Thisamountwasincorrectlyreportedinthe2011–12AnnualreportsectionA.10TripleBottomLineas183,174kilolitres.Thiswasan

administrativeerrorand186,552kilolitresiscorrect,asstatedintheC.19tableofthe2011–12reportonpage318.8 Increaseinwaterconsumptionduetothefullyeareffectofanewbuildingcomingonline.9 Figurereflectsan8percentincreaseofpaperreamspurchasedassociatedwithincreasedheadcount/activitygrowthacrossallHealth.10 Note2011–12landfilllitresreflected18monthsofdata/weights.Theadjusted12-monthlandfilllitresfigureis17,717,865litres.

2012–13landfilllitresrepresentsanincreaseof2,087,712litres(12percent)whencomparedtotheadjustedfigurefrom2011–12. Thisisduetoincreasedgrowth.TCHonly.

11 2011–12comingledrecycledlitresreflected18monthsofdata/weights.Theadjusted12-monthcomingledrecycledlitresfigureis1,302,290litres.2012–13comingledrecycledlitresrepresentsanincreaseof590,590litres(45.3percent)whencomparedtotheadjustedfigurefrom2011–12.Thisisduetoimprovedrecyclingsystemsandincreasedgrowth.TCHonly.

12 2011–12paperrecycledlitresreflected18monthsofdata/weights.Theadjusted12-monthpaperrecycledlitresfigureis1,139,422litres.2012–13paper-recycledlitresrepresentsanincreaseof54,926litres(4.8percent)whencomparedtotheadjustedfigurefrom2011–12,duetoimprovededucation/signage.AcrossallHealthsites.


C.20 Climate change and greenhouse gas reduction policies and programs

TheACTHealthSustainabilityStrategywasdevelopedinresponsetotheACTGovernment’sClimate Change Strategy 2007–2025: Weathering the Change (2007),theCanberra Plan(2008)andtheClimate Change and Greenhouse Gas Reduction Act 2010.Thesedocumentsandlegislationoutlinethegovernment’scommitmenttosustainabilityanddetailthegreenhousegasemissionsreductiontargetofzeronetemissions(carbonneutrality)by2060.

Duetothenatureandscaleofitsoperations,theHealthDirectorateisamajorconsumerofenergyandwater,andgeneratesasignificantamountofwaste.

TheHealthInfrastructureProgram—amajorhospitalredevelopmentinitiative—providesanimportantopportunitytocreateecologicallysustainablehealthfacilities.Thechallengeistobuildintelligently,sothatbuildingsuseaminimumofnon-renewableenergy,produceaminimumofpollutionandwaste,andcostaminimumofenergydollars,whileincreasingthehealth,safety,andwelfareofeveryonewhoworksin,visitsorresidesinthem.Thesearethekeycomponentsofsustainabledesign.Newhealthfacilitieshaveincorporatedmanyenvironmentallysustainabledesignprinciplessuchas:

• energyefficientlightingsystems,includingLEDs

• cleanenergyoptions

• cyclistfacilitiesforsustainabletransport.

ACTHealthwillstrivetoachievehigherlevelsofenvironmentalperformanceinthefutureasweworktowardmeetingtheGovernment’sgreenhousegasemissionandwaterconsumptiontargets.

Sustainabilityinhealthcarefacilitiesneednotcompromisefunctionality,norsignificantlyincreasethecostofdesigningandoperatingbuildings.Well-designedsustainabilityinitiativescanprovidethefollowingbenefits:

• significantreductioninoperatingcosts

• improvedqualityoftheinternalenvironmentforstaffandvisitors

• futureproofingofbuildingssothattheyareabletoadapttofuturerequirements

• informeddesignchoices,basedonwhole-of-lifeconsiderations

• reductionincarbonemissions.

ACTHealth’sSustainabilityStrategy(2010)outlinesthecurrentenvironmentalchallengespresentedbytheincreasingdemandsinhealthcareintheACTandprovidesavisionforachievingasustainablefuture.

ThroughdeliveryoftheSustainabilityActionPlan,ACTHealthwillprogressivelyreduceitscarbonfootprintbyembeddingsustainabilityinallelementsofitscorebusinessthrouhthefollowingbusinessfunctions:ModelsofCare;BuildingsandInfrastructure;TheDigitalEnvironment;Transport;RegulatoryEnvironment;WorkforceandPartnershipswithExternalServices.

Todate,ACTHealthhascompleted93percentoftheshort-termactions(59short-termactionsintotal)towards asustainablefuture,including:

• developmentoftheEnvironmental Principles and Guidelines for Building and Infrastructure ProjectsundertheHealthInfrastructureProgram

• improvementofaccesstoinformationtoconsumersthroughtheACTHealthconsumerportal

• developmentofmodelsofcareinconjunctionwithconsumersandstaff,takingintoaccountevidence-baseddesign,supportiveleadershipandteams,andoptimisingpatient/staffexperiences

• establishmentofnewprocessesincommunityhealthcentresthatenablestronglinkswiththeirlocalcommunities,improvingcommunictaionflowsandinformationandadaptingservicestolocalneeds

• establishmentofsecurebicyclesheds,shower/changeroomfacilitiesintocurrentandfuturebuildstosupporthealthytransportoptions.


C.21 Aboriginal and Torres Strait Islander reporting

Early child development and growth (prenatal to age 3)ACTHealthcontinuedtofundWinnungaNimmityjahAboriginalHealthServicetodelivertheAboriginalMidwiferyAccessProgram(AMAP)toACTAboriginalandTorresStraitIslandercommunities.TheprogramisfundedaspartofElement3oftheCouncilofAustralianGovernments’NationalPartnershipAgreementonAboriginalandTorresStraitIslanderEarlyChildhoodDevelopment.

Comprehensiveantenatal,postnatalandmaternalandchildhealthsupportisprovidedtowomenandtheirfamiliesthrough:outreachclinicalandnon-clinicalassessmentsathome;referralto,andsupportinaccessing,mainstreamandspecialistservices;andtheprovisionofinformationonmainstreamservices.From1Julyto 30December2012,39womenreceivedantenatalcareand44womenreceivedpostnatalcare.Theproportionofwomensmokinginpregnancyfrom1Julyto30December2012was50percentandforthesameperiodtheproportionofwomenusingalcoholinpregnancywas10percent.From1Januaryto30June2013,44womenreceivedantenatalcareand35womenreceivedpostnatalcare,Forthesameperiodtheproportionofwomensmokinginpregnancywas45percentandtheproportionofwomenusingalcoholinpregnancywas7percent.

ACTHealthengagedwithkeystakeholdersintheAboriginalandTorresStraitIslandercommunitiesonthe ‘Beyond Today ... it’s up to you’socialmarketingcampaign,whichpromotestobaccocessationandhealthylifestylebehaviours,includingprovidinginformationontheeffectsofsmokinginpregnancyandinfamilies.

Early school engagement and performance (preschool to Year 3)ACTHealthcontinuedtofundWinnungaNimmityjahAboriginalHealthServicetodeliveraHearingHealthProgramforinfantsandchildren,whichincludedprovisionofacomprehensiveschool-basedscreeningserviceandthedevelopmentandprovisionofappropriateeducationandtreatment,includingreferralforsurgicalinterventions.From1Julyto30December2012,514infantsandchildren(aged0to14)werescreenedbyanaudiologist(somechildrenwereassessedmorethanonceduringthereportingperiod),24infantsorchildrenwereseenbyaGPforotitismediaandsevenwerereferredtootherhearingspecialistcentres,and28schoolswerevisited(includingpreschools),with171studentsreceivinghearingassessments.Between1Januaryand30June2013,246infantsandchildrenwerescreenedbytheaudiologist,33wereseenbyaGPforotitismediaandfourwerereferredtootherhearingspecialistcentres.Thirteenschoolswerevisited,with116studentsreceivinghearingassessments.

Positive childhood and transition to adulthoodACTHealthprovidesfundingtoGuganGulwanYouthAboriginalCorporationtodeliver:theYouthOutreachNetwork—StreetBeat;alcoholandotherdrugtreatmentsupportservices,aHealthyFuturepreventativehealthprogram;andaMentalHealthandSocialandEmotionalWellbeingProgram.

From1Julyto30December2012,theYouthOutreachNetwork—StreetBeatconducted27nightpatrolsand460clientsaccessedthenetwork.Between1Januaryand30June2013therewere38nightpatrols,with736clientsaccessingtheservice.Thenetworksupportsearlydiagnosis,treatmentandadviceforyoungpeopleonarangeofhealthproblemsthatrelatetoat-riskbehaviour.


ACTHealthisresponsibleforElement2oftheEarlyChildhoodDevelopmentNationalPartnershipAgreement. TheAntenatalCare,Pre-pregnancyandTeenageSexualandReproductiveHealthProjectisprogressinginlinewithagreedoutcomes.Anadvisorygroupcontinuestomeetbi-monthlytoprovideoverallgovernanceandprojectdirection.Aprojectworkinggroupmeetsasneededtoprovideinputtostrategiesandresourcedevelopment.Threekeystrategieswereintroducedtoguidetheproject,including:

• Strategy1:SupportwasprovidedforaworkforcetraininginitiativeforteenagesexualandreproductivehealththroughSexualHealthandFamilyPlanningACT.TrainingwasdeliveredtoworkersfromWinnungaNimmityjahAboriginalHealthServiceandGuganGulwanAboriginalYouthCorporation.Followingthistraining,consultationoccurredwithCanberraSexualHealthCentretosecureaprojectofficertodeliversexualhealtheducation,trainingandopportunistictestingforyoungAboriginalandTorresStraitIslanderpeople.

• Strategy2:TherewascontinuedimplementationofCoreofLife(COL),acomprehensivelifeeducationprogramwithafocusontherealitiesofpregnancy,birthandearlyparentingforAboriginalandTorresStraitIslanderyoungpeopleandtheirpeergroups.In2012–13,theprogram,whichisfacilitatedbyamidwife,wasdeliveredinschools,communityservices,healthservices,refugesandyouthdetentioncentres.Over460youngpeopleparticipated,approximately40percentofwhomidentifiedasAboriginaland/orTorresStraitIslander.ThreeCOLfacilitatortrainingworkshopswereheld,where58peopleweretrainedtodelivertheprograminpartnershipwiththemidwife,andafacilitators’networkwasestablishedtoprovideprofessionalsupport.

• Strategy3:Resourcesdevelopedtosupportstrategies1and2betweenJuly2012andJune2013include:installationofaHitNetKioskattheGuganGulwanYouthAboriginalCorporation;investigationsundertakenforanothertwokiosksforBimberiYouthJusticeCentreandtheJunctionYouthHealthService;developmentofaninclusivebreastfeedingDVDforyoungpeople;anddevelopmentofHealthinPregnancyandSexualHealthinformationbooklets.

Substance use and misuseACTHealthcontinuedtofundWinnungaNimmityjahAboriginalHealthServicetodeliverarangeofalcohol-anddrug-relatedprograms,including:DualDiagnosis;theYouthDetoxificationSupportService;theOpiateProgram;TackleSmoking;andMentalHealthLiaison.FundingisalsoprovidedforadedicatedtobaccocontrolworkertoaddresspriorityareasoftheACTAboriginalandTorresStraitIslanderTobaccoControlStrategy.

ACTHealthhasprogressedwiththedevelopmentoftheNgunnawalBushHealingFarm,aresidentialrehabilitationserviceforAboriginalandTorresStraitIslanderpeoplelivingintheACT,whichseekstoaddressthecomplexissuesrelatedtodrugandalcoholabuse.Theservicewillprovideculturallyappropriateprevention,education,rehabilitationandoutreachprogramsforAboriginalandTorresStraitIslanderpeoplesaged18yearsandover.

TheAboriginalandTorresStraitIslanderAdvisoryBoard,whosemembershipincludestheACTAboriginalandTorresStraitIslanderElectedBody,UnitedNgunnawalEldersCouncil,community-organisationsandACTdirectorates,continuedtoprovideadviceandguidethedevelopmentoftheNgunnawalBushHealingFarm.

AnAboriginalandTorresStraitIslanderAlcoholandDrugLiaisonOfficerisemployedbyACTHealth,providingsupportandeducationtoalcoholanddrugsectorservicesandotherservicestoassistinprovidingappropriatecaretoAboriginalandTorresStraitIslanderclients.

Functional and resilient families and communitiesThe ACT Aboriginal and Torres Strait Islander Health and Family Wellbeing Plan 2006–2011wasdevelopedinresponsetotherequirementintheNationalStrategicFrameworkforAboriginalandTorresStraitIslanderHealth(NSFATSIH)foreachjurisdictiontodevelopalocalimplementationplan.

Areviewoftheplanwasundertakenin2012–13bytheAboriginalandTorresStraitIslanderHealthForum,whichincludesmembershipfromACTHealth,theACTAboriginalandTorresStraitIslanderElectedBody,WinnungaNimmityjahAboriginalHealthServices,ACTMedicareLocalandtheCommonwealthDepartmentofHealthandAgeing.Throughthisprocess,factorsaffectingitsimplementationwereidentified,mostsignificantlytheClosingtheGapIndigenousReformAgenda,whichwasintroducedhalfwaythroughtheimplementationoftheplanin2008.


DevelopmentofanewACTAboriginalandTorresStraitIslanderHealthPlanhascommenced.Thiswillincorporatewhatwaslearntinthereviewofthepreviousplan,aswellasoutstandingactionitemsidentifiedasongoingstrategiesrequiringimplementationbytheHealthForum.ThenewplanwillalsobeinformedbytheNationalPartnershipAgreementonClosingtheGapinIndigenousHealthOutcomesandwillseektoformlinkageswiththeseothernationalhealth-relatedplansdevelopedin2013:

• NationalAboriginalandTorresStraitIslanderHealthPlan

• NationalAboriginalandTorresStraitIslanderSocialandEmotionalWellbeingPlan

• NationalAboriginalandTorresStraitIslanderSuicidePreventionStrategy

• NationalAboriginalandTorresStraitIslanderBlood-BorneVirusesandSexuallyTransmissibleInfectionsStrategy

• NationalAboriginalandTorresStraitIslanderDrugStrategy.

InJuly2012,ACTHealthlauncheditsthree-yearReconciliation Action Plan 2012–2015.Theplanhasarangeofactionstobringaboutchangeandcreateahealthenvironmentthatisculturallysensitive,wherestaffareawarethatclosingthegapinAboriginalandTorresStraitIslanderlifeexpectancyisanimportantpartofourorganisation’sbusiness.

ACTHealth’sReconciliationActionPlanWorkingGroupandtheAboriginalandTorresStraitIslanderHealthCoordinationGroupprovidedsupportandguidanceonthedevelopmentoftheplan.ConsultationswereundertakeninternallywithACTHealthlineareasandexternallywithAboriginalandTorresStraitIslanderstakeholders.

Effective environment health systemsInfrastructure,watersanitation,freshfoodandhousingareofaconsistentlyhighstandardintheACTwhencomparedtothoseofruralandremoteenvironments.TheACTGovernmentfundsarangeofAboriginaland TorresStraitIslanderandmainstreamprogramswhichensureaccesstoandavailabilityofappropriatehealthylivingenvironments.

Economic participation and developmentACTHealthprogressedthedevelopmentofanAboriginalandTorresStraitIslanderHealthWorkforceActionPlan2013–2018thatrespondsdirectlyto:theNational Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2011–2015;andtheACT Public Service Employment Strategy for Aboriginal and Torres Strait Islander People—Building a culturally diverse workforce 2010.TheplanisformallylinkedtoACTHealth’sWorkforce Plan 2013–2018andwasendorsedbyACTHealth’sExecutiveCouncilinJune2013.

TheAboriginalandTorresStraitIslanderHealthWorkforceSupportNetworkcontinuedtoprovidesupportandadvicetoAboriginalandTorresStraitIslanderstaffemployedinthehealthworkforceandincludedmembersfromACTHealth,ACTMedicareLocal,WinnungaNimmityjahAboriginalHealthService,GuganGulwanYouthAboriginalCorporationandCalvaryHealthCareACT.

AnEmploymentInclusionOfficercontinuedtofacilitateACTHealth’sinvolvementintheACTPublicServiceAboriginalandTorresStraitIslanderTraineeshipProgram.IntheJuly2012intakefortheprogram,ACTHealthemployedfourtrainees.AlltraineeswereassignedACTGovernmentmentors.

ACTHealthimplementedanAboriginalandTorresStraitIslanderCulturalAwarenessandSkillsDevelopmentPrograminlinewithitsEssentialEducationPolicy.Thetrainingconsistsofthreeelements:stafforientation,ane-learningmoduleandaskillsdevelopmentworkshop.

In2012–13,1,033healthstaffparticipatedinstafforientationsessionsand991staffcompletedthee-learningmoduleandquiz.Anevaluationofthepilotworkshopswascompletedtoinformthecontentanddeliveryof futureworkshops.




C.22 ACT Multicultural Strategy 2010–2013AnewMulticulturalHealthPolicyUnithasbeenestablishedandwillcommenceoperationsfrom1July2013.TheunitwillbeplacedalongsidetheAboriginalandTorresStraitIslanderHealthUnitwithinthePolicyandGovernmentRelationsBranch.TheMulticulturalHealthPolicyUnitwillprovideguidanceacrossACTHealthtoensurethatall ACTHealthservices(includingprimaryhealthcare,clinicalhealthservicesandpopulationprograms,includinghealthpromotionandprevention)aredeliveredinculturallysafeandappropriateways.Itisanticipatedthatalldivisionsandbrancheswillworkwiththeunitto:improvedatacollection;deliverculturallysafeandappropriateservicesandinformation;engageculturallyandlinguisticallydiverse(CALD)consumersinprovidingfeedbackandparticipatinginserviceplanningandevaluation;anddeveloptheculturalcompetencyofallstaff.

Focus area Progress

Languages

ACTHealthcontinuedtopromoteserviceaccessibilitytopeoplefrommulticulturalbackgroundsbypromotingaccesstointerpreterservices.Afterareviewinvolvingsignificantconsultation,theinternalMigrantHealthUnit,whichprovidedin-houseinterpretingofMandarin,CantoneseandVietnamese,ceasedoperationinDecember2012.AllinterpretingservicesarenowaccessedthroughthenationalTranslatingandInterpretingService(TIS),andarevisedstandardoperatingprocedureprovidesguidanceonaccessingthisservice.In2012–13,expenditureonTIStelephoneandon-siteinterpretingservicestotalled$410,000,withMandarin,Arabic,VietnameseandCantoneseinterpretersmostfrequentlyaccessed.

Key Performance Indicator (KPI)—That 100 per cent of ACT Government publications include accessibility block information—that is, information in alternative formats such as other languages.

OnehundredpercentofACTHealthpublications(butnotallposters,becauseofspacelimitations)include‘accessibilityblock’information.Translateddocuments,includingalternativeformatssuchaslargeprintoraudio,canberequestedbytheclient.TheOfficeofMulticulturalAffairsisinformedaccordingly.

HealthPromotionGrantswereawardedtosupporttheHealthCareConsumers’AssociationInc.forHealthLiteracyforAll,aprojecttodevelopaseriesofhealthliteracymodules,includingmodulesinane-learningformatthatincludea‘translate’functionsomaterialcanbeaccessedincommunitylanguages;andtheintroductionofamulticulturalQUITmoduleandtraininglocalbilingualpresenterstodeliverit.

TheHealthProtectionServicesfinalisedafoodsafetyguideforbusinesses,whichwastranslatedinto11languagestoensurefoodsafetyinformationwasavailabletoCALDcommunities.Theguideprovidescomprehensiveinformationaboutthemostcommonfoodsafetyrequirements.Guidelinesfortemporaryfoodstallswerealsodevelopedandtranslatedinto12languages.TheguidelinesaredesignedtoassistorganisersoffoodstallsatoutdooreventsintheACTtomeetallfoodsafetyrequirements.

Childrenandyoungpeople

HealthPromotionGrantssupportedFootballUnitedtodeliverEmpoweredforHealthierCommunities,whichprovidesregularphysicalactivityandleadershiporlifeskillstrainingforover1,000childrenandyouthfromdiverseanddisadvantagedbackgroundsintheWestBelconnenandDicksonregionsoftheACT.In2012–13,refugeechildrenandyouthwereafocusoftheproject.

Adults,olderpeopleandagedcare

HealthPromotionGrantssupportedtheAsianWomen’sFriendshipAssociationtoprovideStayFirmandBeActiveforCALDBackgroundSeniors,aprogramtoprovideseniorsandtheircarersfromCALDbackgrounds,specificallythosefromAsianbackgrounds,withinformativeandconstructiveweeklyTaiChiclasses.


Focus area Progress

Women

TheHealthDirectoratehascontinuedtoaddressthespecificneedsofwomenfrommulticulturalbackgroundsby:

•providingwomen’shealthservicesacrosstheACTtoenhanceaccessbywomenofculturallyandlinguisticallydiverse(CALD)backgrounds

•deliveringawomen’shealthtalkto195womenattheCITEnglishasaSecondLanguagecourse•developingaprojectplantoincreaseliaisonwithculturalcommunitiesinwhichfemalecircumcision ispractised

•withidentifiedfunding,commencingrecruitmenttoapart-timewomen’shealthnursepositiontoprovideholistichealthpromotiononwomen’shealth,includingtheimpactoffemalecircumcision.

Nursing,medicalandcounsellingservicesareprovidedtowomenwhoexperiencesignificantbarrierstoaccessinghealthservices,includinglanguageandculture.

KPI—Proportion of clients attending Well Women’s Checks at the Women’s Health Service from multicultural backgrounds.

In2012–13,266CALDwomen(40percentofallclients)accessedthisservice.

TheBreastScreenACTprogramhascontinuedtoaddressthespecificneedsofwomenfrommulticulturalbackgroundsbyprovidingfreebreastscreeningservicestoallwomenintheACTagedover40.BreastScreenACTrecommendsregularscreeningofthetargetgroup—womenaged50to69years—whichhasbeeneffectiveinreducingdeathsfrombreastcancerthroughearlydetection.Theprogramhasimplementedarecruitmentplan(inconsultationwithmulticulturalrepresentatives)withspecificstrategiesthataimtoincreasetheparticipationofwomeninthisgroup.WorkhasalsooccurredtodevelopandproducegeneralbreastscreeninginformationbrochuresinChinese,Vietnamese,Croatian,Greek,ItalianandSpanish.

KPI—Percentage of women with multicultural backgrounds in the BreastScreen ACT program.

In2012–13,767CALDwomen(5.5percentofallclients)accessedtheBreastScreenACTservice.

HealthPromotionGrantssupportedtheAustralianBreastfeedingAssociationACT/SNSWtoimprovebreastfeedingrates(initiationandduration)amongspecifictargetgroups,includingwomenfromCALDbackgrounds.ThisisdonebydeliveringtargetedpeersupporttrainingprogramsandbreastfeedinginformationsessionsandincreasingthenumberofestablishmentsororganisationsintheACTthatareBreast-FriendlyWorkplaceaccredited.

ACTHealthsupportedtheHealthCareConsumers’AssociationtoemployaConsumerCoordinator/MulticulturalLiaisonOfficerin2012–13tofacilitateinvolvementandperspectivefromconsumersinthedevelopmentofserviceplanningfortheHealthInfrastructureProgram.TheConsumerCoordinator/MulticulturalLiaisonOfficerfosterednetworkswithmulticulturalcommunityorganisationsanddiversecommunitiesaboutthehealthsystem,particularlyregardingtheHealthInfrastructureProgram,consumerparticipationandhealthliteracy,includingthedevelopmentofsuitableinformationresources.

Refugees,asylum seekersandhumanitarian entrants

ACTHealthcontinuedtoseektomeettheneedsofrefugees,asylumseekersandhumanitarianentrantsbyprovidingaccesstohealthandwellbeingservicessothatthistargetgroupcanmaintaintheirdignityandphysicalandmentalhealth.Itdidsoby:

•continuingtoprovideMedicare-ineligibleasylumseekerswiththesameaccessasHealthCareCardholderstopublicdentalandcommunityhealthservices

•collaboratingwiththeCommonwealthDepartmentofImmigrationandCitizenshipinaccommodatingthehousingandhealthcareneedsof50immigrationdetaineesintheACTcommunity

•continuingtopromoteawarenessoftheACTServicesAccessCardintroducedforrefugeesinOctober2011.Thecardisdesignedtoprovideaccesstoservices,withouttheneedforrefugeestore-telltheirtraumaorrefugeestory.

HealthPromotionGrantssupportedArthritisACT,incorporatingOsteoporosisACT,todeliverLoweringtheBarriers,whichinvolvedfindingrepresentativesfromarangeofdisadvantagedgroups,includingrefugees,tosharetheirlifestorieswithoneanotherinthecontextofworkshopswithonesimplehealthmessage:‘Youarethemostimportanthealthproviderforyou.’

Intercultural harmonyandreligiousacceptance

ACTHealthpromotedorconductedgeneralprogramsforstafftoenhancetheirunderstandingoftherightsoftheircolleaguesandclients.Theseinitiativesincluded:

•Respect,EquityandDiversity(RED)training,andestablishmentoftheREDcontactofficernetwork•HumanRightsActtraining•workshopsonmanagingandpreventingdiscrimination,bullyingandharassment•AustralianCharterofHealthcareRightstraining•e-learningpackagesonmanagingworkaggressionandviolence.TheHealthDirectoratehasimplementedculturalawarenesstrainingforstaff,topromoteacaringandcompetenthealthworkforce.


C.23 ACT Strategic Plan for Positive Ageing 2010–2014

Focus area Progress

Informationandcommunication

ACTHealthpromotioncommunicationcampaignsaimtoreachawidepopulation,includingseniors,toinfluencebehaviour.Manymessagesarefocusedonpreventingchronicdisease.

TherehasbeenlocalpromotionofthenationalMeasureUpandSwapIt,Don’tStopItsocialmarketingcampaigns,includingwebsitesprovidingpeoplewithinformationonhowtheycanchangetheirlifestylestobecomemoreactiveandhaveahealthydiet:www.measureup.gov.auandwww.swapit.gov.au.

The‘Beyond Today ... it’s up to you’campaignwasdevelopedtoencouragehealthylifestylesandsmokingcessationamongtheACTAboriginalandTorresStraitIslandercommunity.Messagesweredesignedtoreachtheeldersinthiscommunitytofacilitatebehaviourchange(www.health.act.gov.au/health-services/aboriginal-torres-strait-islander/information/beyond-today).

TheGetHealthyInformationandCoachingService®(GHICS)isafreeACTHealthtelephonecoachingservicestaffedbyqualifiedhealthcoachesandaimedathelpingadultstomakelifestylechangesregardinghealthyeating,physicalactivityandhowtoreachandmaintainahealthyweight.Between1July2010andongoing.18.4percentornearlyoneinfivepeopleusingtheservicewereagedover60yearsandapproximatelytwoinfive(40.1percent)wereaged50orover.

The‘FindanACThealthservice’pageincludesup-to-dateinformationaboutagedcarehealthservicesinCanberraandsurroundingregions(www.health.act.gov.au/health-services/find-a-health-service).

HeartFoundationHeartmovesisagentlephysicalactivityprogramwhichreceivesfundingthroughACTHealth.Itisdesignedtobesafeforpeoplewithstablelong-termhealthconditionssuchasheartdisease,diabetesorobesityandissuitableforanyonewhohasnotexercisedinawhile.TwoHeartmovesgroupsarebasedatCanberraSeniorCentreinTurner.

HeartFoundationWalkingreceivesfundingthroughACTHealth.TheHeartFoundationsupportsAustralianstoleadactive,healthylivesbyencouragingthemtojoinorstartHeartFoundationWalkinggroups,whicharefunandagreatwaytomeetnewpeople.Somewalkinggroupstarget,amongothers,peopleagedover50.

http://www.measureup.gov.au

http://www.swapit.gov.au

www.health.act.gov.au/health-services/aboriginal-torres-strait-islander/information/beyond

www.health.act.gov.au/health-services/aboriginal-torres-strait-islander/information/beyond

www.health.act.gov.au/health-services/find


Focus area Progress

Healthandwellbeing

FundedbytheACTGovernment,CarersACTreleasedover20MentalHealthE-bulletinsforCarersin2012–13.CarersACTalsoheldnumerousforumsforcarersonsuchtopicsas:

•thesecondexposuredraftoftheMentalHealth(TreatmentandCare)Act•endinghomelessnessbasedonthecommongroundmodel•theprevalenceanddiseaseburdenoftobaccoaddictiononpeoplelivingwithmentalhealthissuesandresearchfindingsonimplementingsmoke-freepoliciesinmentalhealthservices

•medicinesandmentalhealthcarers•navigatingthementalhealthsystem.

Inaddition,throughoutthereportingperiod,CarersACThostedamoderatedMentalHealthCarersVoiceOnlineDiscussionForum,whichcoveredmanytopicsrelevanttocarers.

Inthereportingperiod,100percentofMentalHealthServicecommitteeshadrepresentationfromconsumersandcarers.

ACTHealthiscontinuingtopreparefortheintroductionofanelectronicmedicationmanagement(EMM)solution,whichwill:supporttransparentcommunicationofmedicationhistoryacrosscaresettings;enableelectronicprescribing,managementandadministrationofmedications;andsupporthigh-qualitypatientcarethroughimprovedmedicationsafety.

Followingarequestforquotation,apreferredvendorwasselected.Contractnegotiationsareunderway.Animplementationplanningstudyandareviewofhigh-levelrequirementswillbeundertakenpriortoimplementationoftheEMMsolution.

ACTHealthiscontinuingtoworkwiththeDepartmentofHealthandAgeingandtheNationalE-HealthTransitionAuthorityinrelationtothenationalPCEHRsystem.

ACTHealthbegansubmittingdischargesummariestothenationale-healthrecordsystemon22March2013.HealthcareconsumerswhoareadmittedtotheCanberraHospitalarenowaskedtoindicatewhethertheywouldliketheirdischargesummarysenttotheirnationale-healthrecord.Consumerscanchangetheirpreferenceatanytimepriortodischarge.

ACTHealthisworkingcollaborativelywiththeDepartmentofHealthandAgeingtoenableprovisionofanassistedregistrationserviceforACTHealthconsumers.Thiswouldenablehealthcareconsumerstoquicklyandeasilyregisterforane-healthrecord.

AdischargesupportAlliedHealthAssistant(AHA)wasemployedintheacutecareoftheelderlyward(11A)tofacilitatetheimplementationofcareplansandfollow-onreferralsforelderlyclientsdischargedhomefromthehospital.Theroleofthe11AdischargesupportAHAisto:

•makecontactwiththeclientandcarer/familywhiletheyarestillinhospitalandexploretheirneeds afterdischarge

•ensurethatthearrangedservicesareimplementedandappropriate• liaisewiththeclientandcarer/familyandprovidefurtherinformationpost-discharge•workwiththeoccupationaltherapyteaminassessingtheneedandprovisionofequipmentafterdischarge.The11AdischargesupportAHAhassupportedmanyclientstoreturnhome.In2012–13,the11AdischargesupportAHAreceived179referralsandconducted731occasionsofservice.

TheRespectingPatientChoices(RPC)programworkswithcommunityagenciesandgroups,peakbodiesandothergovernmentagenciestopromoteandimprovetheuptakeofAdvanceCarePlanning(ACP)intheACT.Atotalof298advancecareplanswereprocessedthroughtheprogram.Atotalof215consumerconsultations/referralsandinformationqueries/packswereundertakenorprocessedthroughtheprogram.

Over26RPC/ACPpresentationsweregiventoACTHealth,communityandprofessionalgroups.

TheRPCprogramparticipatedintheCOTASeniorsExpoatEPIConThursday,21March2013.

TheRPCprogramstaffwereinvitedtoparticipateinaLocalHospitalNetworksponsoredEndofLifeIssuesandDecision-MakingCommunityEngagementForum,heldonthe4May2013.

TheRPCprogramhostedtwofacilitatortrainingworkshopsand14participantscompletedtheirtraining. Afacilitatorpeereducationgroupwasalsohosted,withfiveattending.


Focus area Progress

Healthandwellbeing (continued)

TheRPCsubmittedasuccessfulbudgetproposalforincreasedRPCprogramresourcestoenhanceandimprovetheuptakeofACPintheACT.

TheRPCprogramnegotiatedasuccessfulpartnershiparrangementwithMedicareLocalACTtosupportandpromoteadvancecareplanningtothewiderACTcommunityandhealthprofessionals.

Rehabilitation,AgedandCommunityCareprovideaFallsandFallsInjuryPreventionAssessmentClinic. ThisisafreeACTHealthservicetargetingpeopleovertheageof65,or55yearsforAboriginalandTorresStraitIslanders,whoareathighriskoffalling.FallsPreventionClinicsaredesignedtoprovideamulti-disciplinaryassessmentandinterventionservice.Clinicstaffworkwitholderadultstoassessindividualfallrisksandprovideacomprehensivefallsreductionplan.Theclinichealthprofessionalteamcomprisesaregisterednurse,occupationaltherapistandphysiotherapist.

Rehabilitation,AgedandCommunityCarealsoprovidesSteppingOn,aseven-weekprogramrunthreetofourtimesperyearforpeopleovertheageof70whoareactiveandwellbutfearfallingorhavepreviouslyhadafall.Theprogramfocusesonexercise,educationandpreventativestrategies.Itisalsostaffedbyamulti-disciplinaryteam,includinganoccupationaltherapist,aphysiotherapistandothereducators.

In2012–13,theFallsandFallsInjuryPreventionServicecontinuedtopromotefallsawarenessthroughinvolvementincommunityexpos,includingtheSeniorsWeekexpo,aswellasrunningamonth-longinitiativeattheCanberraHospitalandcommunityhealthcentrestolinkinwiththeNewSouthWalesAprilFallsDayinitiative.Theseactivitiespromotedtheservicethroughaccesstofallspreventionstaffandtheprovisionoffactsheetsforcommunity,clientsandstaff.

TheFallsandFallsInjuryPreventionServicehascommencedajointinitiativewiththecommunityRenalServicetoprovidetargetedfallspreventionadvicetopeoplereceivingdialysisincommunitysettings.

In2012–13,488peoplewereassessedinfallsclinics.

EightgrantsfromtheACTHealthPromotionGrantsProgramwereprovidedthroughthe2012–13StayOnYourFeetFallsPreventionFundingRound,toatotalvalueof$199,387.Grantswereawardedtoprojectstopreventfalls,managemedicinestominimisefallsandreducefallsriskinagedcarefacilities.TheseactivitiesinvolvedpartnershipswitharangeofproviderssuchastheHeartFoundationandtheYMCA.

TheACTChronicConditionsStrategy:ImprovingCareandSupport2013–2018hasthekeyprioritiesofintegratedserviceprovisionandimprovedaccessandsupportforthoselivingwithchronicconditions.OlderCanberranshavethehighestincidentofchronicdiseaseinourcommunityandwillbenefitfromtheintroductionofthestrategy.ThisstrategybuildsonthepreviousACTChronicDiseaseStrategy2008–2011,whichsawthedevelopmentofarangeofspecialistservicesforpeoplewithcomplexchronicconditions,includingtheestablishmentofadvancecareplanningclinicswithintheChronicCareProgram.

Support services

Hearingaugmentationhasbeenincorporatedintoseveralhealthfacilities.Thereareplanstoincludehearingloopsinfacilitiesyettobedesigned.

Transportandmobility

Rehabilitation,AgedandCommunityCareprovidesadriverassessmentserviceforolderpeople.Teammembersincludeageriatrician,neuropsychologist,occupationaltherapist,andafull-timedrivinginstructorforolderdrivers.In2012–13,189drivingassessmentswereconductedforclientsaged75yearsandover.


C.24 ACT Women’s Plan

Economic priority

Strategic outcomeWomenandgirlsequallyandfullyparticipateinandbenefitfromtheACTeconomy.

Priority areas• responsiveeducation,trainingandlifelonglearning

• flexibleworkplaces

• economicindependenceandopportunities

• leadershipanddecisionmaking

Indicators of progressEvidenceof:

• educationandtrainingpathwaysforwomenandgirls

• increasedopportunitiesfortheadvancementofwomenintheworkforce

• increasedeconomicleadershipanddecision-makingopportunitiesforwomenandgirls

• improvedfinancialequity.

Seventy-sixpercentofthe6540staffemployedbyACTHealtharefemale.Therangeofeducational,leadershipandotheropportunitiesofferedbythedirectorateandsetoutbelowisavailabletoallstaff.

StudyassistanceisavailabletoACTHealthstafftoaccessprogramsofstudytomeettheirtraininganddevelopmentneeds.Theprogramassistsemployeestoundertakeexternalstudyleadingtoaqualificationrelatedtotheiremploymentbyprovidingdiscretionaryaccesstopaidstudyleaveand/orfinancialassistance.

ACTHealthprovidesaccesstoflexibleworkingarrangementstosupportahealthywork–lifebalance.Thesearrangementsincludegenerousmaternityleaveprovisionsandaccesstopart-timeworkaftermaternityleave.Breastfeedingmothersaresupportedthroughpaidlactationbreaks.

TheLeadershipNetworkisacollaborativeinitiativetocapitaliseonthetalentandexperienceofACTHealthemployees.Summitworkshopsareheldthreetimesayearinadditiontoprojectgroupworkacrossdivisions,leadingtosignificantnetworkinganddevelopmentopportunities.

Thedirectorateoffersthefollowingscholarshipsforstaff:

• AlliedHealthPostgraduateScholarships• AlliedHealthUndergraduateScholarships• NursingandMidwiferyAboriginalandTorresStraitIslanderEnrolledNursingScholarships• NursingandMidwiferyPost-RegistrationScholarships• NursingandMidwiferyPostgraduateDiplomainMentalHealthScholarships• NursingandMidwiferyJenniferJamesHonoursDegreeMemorialScholarships• NursingandMidwiferyJoannaBriggsClinicalFellowshipScholarships• NursingandMidwiferyStudentClinicalPlacements• PersonalClassificationLevel2—CareerAdvancement.

TheACTHealthLoanSchemeforTertiaryStudy(LSTS)isavailableforallstafftosupportadvancedpaymentoffeesfortertiaryeducation.Thepurposeistopromoteapositivelearningorganisationenvironmentthatincreasestheknowledgeandskilllevelsofstaff.


Social priority

Strategic outcomeWomenandgirlsequallyandfullyparticipateinsustainingtheirfamiliesandcommunitiesandenjoycommunityinclusionandwellbeing.

Priority areas• safeandrespectfulrelationships

• goodhealthandwellbeing

• safeandaccessiblehousing

Indicators of progressEvidenceof:

• recognitionofwomenandgirls’contributionstothecommunity

• increasedcommunityleadershipanddecision-makingopportunitiesforwomenandgirls

• affordableandaccessiblegenderandculturallysensitiveservices

• pathwaysforwomenexperiencingdisadvantage,socialexclusionandisolation

• addressingviolenceagainstwomenandtheirchildrenandprotectionandsupportforvictims.

TheWomen’sHealthServiceprovided40percentofwellwomen’sclinicstoculturallyandlinguisticallydiversewomen,exceedingthetargetof30percent.

TheBreastScreenprogramprovidesfreebreastscreeningservicestoallwomenintheACTagedover40.WorkhasoccurredtodevelopandproducegeneralbreastscreeninginformationbrochuresinChinese,Vietnamese,Croatian,Greek,ItalianandSpanish.In2012–13,767CALDwomen(5.5percentofallclients)accessedtheACTBreastScreenservice.

ACTHealthisimplementingElement2oftheCouncilofAustralianGovernments’AboriginalandTorresStraitIslanderEarlyChildhoodDevelopmentNationalPartnershipAgreement’santenatalcare,pre-pregnancyandteenagesexualandreproductivehealthproject.ThisincludesimplementingtheCoreofLifereality-basededucationprogramforyoungpeopleonpregnancyandparentingandsupportingsexualhealthinformationandeducationactivitiesforAboriginalandTorresStraitIslanderyoungpeople.

ACTHealthfundstheWomen’sCentreforHealthMatters,whichprovidessupporttoconductresearchrelatedtowomenexperiencingdisadvantage,socialexclusionandisolation—forexample,WomenwithDisabilitiesACTandtheWomenandPrisonsGroup.

KarralikaProgramsInc.supportsadultsandtheirfamiliesthrougharangeofalcoholanddrugprograms.KarralikaoffersaccesstosubsidisedchildcareforparentsundertakingtheirprogramsfromCommunities@Work.ThearrangementwithCommunities@Workwasestablishedanumberofyearsago,whenKarralikaProgramsInc.ceasedtoprovidechildcareinternally.ACTHealthisactivelylookingatopportunitiestoimproveaccesstosubsidisedchildcareforparentsundertakingdrugtreatmentprogramsintheACT.

TheWomen’sHealthServicegivesprioritytowomenwhoexperiencesignificantbarrierstohealthserviceaccess.

TheACTHealthcareSurveyincludesasectiononresultsbygender.Thequestionscoverbeingtreatedwithrespect,respectforprivacy,respectforcultural,socialorreligiousneeds,personalsafety,andeaseofaccesstoconsumerinformation.Surveyresultsguideserviceimprovement.

CanberraHospitalandHealthServicesparticipatedinabenchmarkingstudyforinpatientsthroughBestPracticeAustraliainFebruary2013.ThetwoseparatesurveysmeasuredinformationrelatedtothenewNationalSafetyandQualityStandardsandaskedaseriesofquestionsrelatedtopatientexperience,includingpatients’greatestexpectationsandhowtheyratethoseexpectations.

ACTHealthismakingconsistentprogresstowardstheagreedmilestonesoftheNationalPerinatalDepressionInitiative(NPDI).Progressandimprovementsagainstalloutputsintheimplementationplanareontrack,withnosignificantrisksorissuesemerging.ACTNPDIactivitiescontinuetosupportmaternityservices,includingthecommunity-basedMaternalandChildHealthService,theAntenatalClinic,ContinuumofCareattheCanberraHospital,theCanberraMidwiferyProgramattheCentenaryHospitalforWomenandChildren,CanberraHospital,theCalvaryHealthCareMaternityUnit,MentalHealthServicesandrelatednon-governmentservices.


ACTHealthalsofundsthePre-andAnte-natalDepressionSupportandInformationService(PANDSI)toprovidepsychosocialsupportandinformationforwomenatriskofperinataldepression.

ThePerinatalMentalHealthConsultationService(PMHCS)isaconsultationandreferralserviceforwomenwithmoderatetoseverementalhealthpresentationsintheperinatalperiod.ThePMHCSisatertiaryservicethatprovidesspecialistopinionandtreatmentplanningforexpectantandpostnatalwomenforupto12monthspostpartum.Theserviceaimstoimproveperinatalmentalhealthbyworkingincollaborationwithexistingantenatalandpostnatalservicesandothercommunityhealthagencies.Psychiatryclinics,staffedbyamultidisciplinaryhealthprofessionalteam,providestructuredtherapiesforwomenlikelytobenefitfromatime-limitedpsychologicalapproach.

PMHCShasimplementedanOutreachAssessmentCliniclinkedtotheAntenatalClinicattheCentenaryHospitalforWomenandChildren,CanberraHospital.APMHCShealthspecialistprovidesassessmentsforreferredwomenwhoareunlikelytoengageoverthetelephoneorattendthePMHCS.Thisinitiativealsoservestostrengthentheskillsandknowledgeofmidwivesattheclinicinperinatalmentalhealthissues.

Trauma-informedcareseminarsforhealthprofessionals:TheWomen’sHealthServiceprovidesinterprofessionalandholisticmedical,nursingandcounsellingservicesforwomenaffectedbyviolence.

TheACTHealthFamilyViolencepolicywasdevelopedforimplementationin2013–14.

Environmental priority

Strategic outcomeWomenandgirlsequallyandfullyparticipateinplanningandsharingasafe,accessibleandsustainablecity.

NilresponsefromACTHealth.

Improving women’s access to health care services and information: A strategic framework 2010–2015Improving women’s access to health care services and information: A strategic framework 2010–2015informsthedirectionsforthedeliveryofhealthservicestoACTwomenupto2015.Improvingwomen’saccesstohealthcareservicesandinformationbenefitsnotonlywomenbutalsothewholecommunitythroughthediverserolesthatwomenplay.Fordisadvantagedandvulnerablewomen,improvingaccesstohealthservicesisasignificantcontributortoimprovedhealthoutcomes.TheWomen’sHealthAdvisoryGroup,whichcompriseskeycommunityandconsumermembers,overseesimplementationoftheframework.

Highlightsin2012–13aresetoutbelow.

• ACTHealthisimplementingtriplebottomlineannualreporting,including,whereappropriate,genderimpactstatements.

• ThenationalPregnancy,BirthandBabywebsiteisbeingenhancedandwillincludeACT-specificlinkstomaternityinformation.

• TheACTMaternityServicesAdvisoryNetworkisguidingtheimplementationofactioninthenationalMaternityServicesPlanandadvisingonprioritiesandimprovementstomaternitycareintheregion.

• TheCentenaryHospitalforWomenandChildrenopenedin2012.Thenewhospitalco-locatesservices,includingpaediatrics,maternityservices,theneonatalintensivecareunit,gynaecology,foetalmedicine, thebirthcentreandspecialisedoutpatientservices,inapurpose-builtthree-storeybuilding.

• Antenatalcare,pre-pregnancyandteenagesexualandreproductivehealth(APTSRH)project:theCoreofLiferealities-basedlifeeducationprogramforAboriginalandTorresStraitIslanderyouthiswellestablishedacrosstheACT.Negotiationsareunderwaytooffersexualhealthinformation,educationandclinicalservicestoyoungpeopleinthecomingyear.

• NationalPerinatalDepressionInitiative(NPDI):ACTHealthservicescontinuetoofferroutineanduniversalscreeningusingtheEdinburghPostnatalDepressionScaleforPNDatantenatalandpostnatalvisits.

• InSeptember2012,ACTHealthachievedBreastfeeding-FriendlyWorkplaceaccreditation.


C.25 Model Litigant GuidelinesTheHealthDirectorateiscommittedtoupholdingtheprinciplesoftheModelLitigantGuidelinesbyactinghonestly,fairlyandwithproprietyintheconductofallcivilclaimsandlitigation,arbitrationandotheralternativedisputeresolutionprocesses.

TheHealthDirectorateunderstandsitsroleasamodellitigantandplacessignificantemphasisonmaintainingeffectivecommunicationwithhealthcareconsumerswhohavecomplaintsabout,orhavesufferedadverseoutcomesasaresultof,treatmentinthepublichealthservice.Opencommunicationmayalsominimisetheneedforconsumerstoseekresolutionofcomplaintsorclaimsthroughformallegalavenues.

TheHealthDirectorateiscommittedtorespondingtocomplaintsaboutpublicsectorhealthservicesinatimelyandsystematicmanner.Complaintsareavaluablepartofthequalityimprovementsystem,whichaimstooptimisepatientcareandsafety,promotepositivesystemchangesandensureresolutionofthecomplainttothesatisfactionoftheconsumer,wherepossible.

Consumersareinvitedtoprovidefeedbackaboutthecaretheyreceivedatthepointofservice,orbytelephone,letter,emailorthroughtheHealthDirectorateinternetsite.TheHealthDirectoratehasanindependentConsumerFeedbackandEngagementTeam(CFET)andensuresthatallconsumerfeedbackisrespondedtoandresolved,wherepossible,inatimelymanner.TheCFETacknowledgesconsumercomplaintswithinfiveworkingdays,coordinatesinvestigationsandaimstoinformtheconsumeroftheoutcomewithin35calendardays.Iftheconsumerisnotsatisfiedwiththeresponsetotheircomplaint,theconsumerisadvisedofassistanceavailablethoughtheACTHumanRightsCommission(HRC).TheHRCprovidesanindependentmeansfordealingwithcomplaintsabouthealthservicesthroughtheHealthServicesCommissioner.

Insomeinstances,analternativemethodofdisputeresolutionsuchasconciliationisconsidered.ThisinvolvestheHRCactingasanimpartialthirdpartytohelptheconsumerandhealthstaffclarifyissuesandresolvemattersraisedinacomplaint.Sometimes,inresolvingacomplaint,afinancialsettlementmaybeconsideredandagreedtoinaformallybindingagreement,reducingtheriskofcomplaintsdevelopingintolegalclaimsandtherebyreducingclaimcostsforbothparties.

TheHealthDirectorateacknowledgesthatearlyresolutionofaclaimnotonlycanhavebenefitsfortheplaintiff’shealthandwellbeingbutalsoreducesthecostsassociatedwithlitigation.TheHealthDirectorateiscommittedtoworkingwiththeACTGovernmentSolicitor(ACTGS)toensurethatitsconductinmattersthatprogresstolitigationistimely,efficient,effectiveandinaccordancewiththeModelLitigantGuidelines.

Itisimportanttonotethat,whiletheobligationtocomplywiththeModelLitigantGuidelinesisconferredontheagency,theACTGSactsonbehalfoftheHealthDirectorateinalllitigationandprovidesadviceinaccordancewiththeobligationsapplyingundertheLaw Officers Act 2011.TheACTGShasadvisedthatitisnotawareofanybreachesoftheModelLitigantGuidelinesinHealthDirectoratemattersduring2012–13.


C.26 Notices of non–complianceIn2012–13theHealthDirectoratedidnotreceiveanynoticesofnon-complianceinrelationtotheDangerous Substances Act 2004.

Fivenoticesofnon-compliancewereissuedinrelationtotheWork Health and Safety Act 2011:

• Notice5824wasissuedon14August2012totheDirector-GeneraloftheACTHealthDirectorate.Worksafe ACThasadvisedthatitissatisfiedthatalltherequirementshavebeenmetandthatthenoticehasbeencompliedwith.Thenoticerequiredthedirectoratetoreviewandamenditsworksafetysystemstoensurethat,ifanyfurthernotifiableincidentsoccurattheCanberraHospital,theincidentsiteisnotdisturbeduntilaninspectorarrivesatthesiteoranyearliertimetheinspectordirects.Thisdoesnotpreventanyactionsprescribedbysection39(3)oftheAct.

• Notice5825wasissuedon14August2012totheDirector-GeneraloftheACTHealthDirectorate.WorksafeACThasadvisedthatitissatisfiedthatalltherequirementshavebeenmetandthatthenoticehasbeencompliedwith.Thenoticerequiredthedirectoratetoensurethattheregulatorisnotifiedimmediately,bythefastestpossiblemeans,afterbecomingawarethatanotifiableincidentoutoftheconductofthebusinessorundertakinghasoccurredattheCanberraHospital.

• Notice6072wasissuedon3May2013totheExecutiveDirector,BusinessandInfrastructureoftheACTHealthDirectorate.WorksafeACTadvisedon27June2013thatitissatisfiedthatalltherequirementshavebeenmetandthatthenoticehasbeencompliedwith.ThenoticedirectedtheHealthDirectoratetoimplementcontrolmeasuresattheCanberraHospitaltoeliminateorminimiseriskstohealthandsafetyassociatedwiththeuseofelectricalequipmentsuppliedthroughasocketoutlet.Thesemeasuresincludeinstallingappropriateresidualcurrentdevices(RCD)toswitchboardsorportableRCDcordsets/plugadaptersuntilswitchboardshavebeenupgraded.AllreasonablestepsmustalsobetakentoensurethattheRCDsusedattheworkplacearetestedregularlybyacompetentpersontoensuretheyareoperatingeffectively.

• Notice6073wasissuedon3May2013totheExecutiveDirector,BusinessandInfrastructureoftheACTHealthDirectorate.WorksafeACTadvisedon27June2013thatitissatisfiedthatalltherequirementshavebeenmetandthatthenoticehasbeencompliedwith.Thenoticerequiredthedirectoratetohaveacompetentpersonundertakeanelectricalauditofthefoodpreparationareaandbio-medicalworkshopasamatterofurgencyanddisconnect(orisolate)anyunsafeelectricalequipmentfromtheelectricalsupplyuntilitisrepairedortestedandfoundtobesafe.

• Notice6074wasissuedon3May2013totheExecutiveDirector,BusinessandInfrastructureoftheACTHealthDirectorate.WorksafeACTadvisedon27June2013thatitissatisfiedthatalltherequirementshavebeenmetandthatthenoticehasbeencompliedwith.ThenoticerequiredthedirectorateimplementcontrolmeasuresattheCanberraHospitaltoeliminateorminimiseriskstohealthandsafetyassociatedwiththeuseofelectricalequipmentsuppliedthroughasocketoutlet.ThesemeasuresincludeinstallingappropriateRCDstoswitchboardsorportableRCDcordsets/plugadaptorsuntilswitchboardshavebeenupgraded.AllreasonablestepsmustalsobetakentoensurethattheRCDsusedattheworkplacearetestedregularlybyacompetentpersontoensurethattheyareoperatingeffectively.

AnnexedReports313


ACT Local Hospital Network Directorate Financial and Performance Statements 2012–13

Management discussion and analysis for the ACT Local Hospital Network Directorate for the financial year ended 30 June 2013

General overview

PurposeTheACTLocalHospitalNetworkisanewDirectoratesetuptoreceiveanddistributefundingforpublichospitalservicesundertheNationalHealthReformAgreement.TheACTLocalHospitalNetworkreceivesActivityBasedFundingfromboththeCommonwealthandtheACTGovernmentsandBlockFundingincludingtrainingandresearch.TheACTLocalHospitalNetworkpurchasespublichospitalservicesfromfourACTpublichospitalproviders:

• CanberraHospitalandHealthServices;

• CalvaryPublicHospital;

• ClareHollandHouse;and

• QueenElizabethIIHospital.

Changes in administrative structureTheACTLocalHospitalNetworkcommencedoperationon1July2012andisadministeredbytheDirector-GeneraloftheHealthDirectorateandsupportedbyHealthDirectoratestaff.

Risk managementTheDirectorate’smanagementhasidentifiedthefollowingpotentialrisksthatmayinfluencethefuturefinancialpositionoftheDirectorate:

• EstimatedpublichospitalactivityishigherthantheactualactivitydeliveredbytheentitiesintheACTLocalHospitalNetworkthatresultsinareductiontofundingfromtheCommonwealthGovernment;and

• TheCommonwealthGovernmentrevisestheNationalHealthcareSpecificPurposePaymentfor2013–14. TheSpecificPurposePaymentfundingcanchangeduetopopulationestimatesandindexationfactors.

TheGovernmentandtheDirectoratehaverespondedtotheserisksbyincludingintheimplementationoftheNationalHealthReformAgreementtwoyearsoftransitionwiththeCommonwealthGovernmentfundingcontributionlimitedtotheSpecificPurposePaymentin2012–13and2013–14.TheCommonwealthGovernmentwillfund45percentofthegrowthinpublichospitalactivityfrom2014–15andtheACTGovernmentandtheDirectoratewillagreeontheprocessformanagingfluctuationinactivityandcostsfrom2014–15duringdevelopmentofthebudget.

IntheeventthatthereisamaterialreductiontotheCommonwealthGovernmentSpecificPurposePaymentduring2013–14,theDirectoratewillconsideralternativefundingoptionsincludingworkingwiththeChiefMinisterandTreasuryDirectorateasnecessary.

Theaboverisksaremonitoredregularlythroughouttheyear.

AnnexedReports315

Financial performanceThefollowingfinancialinformationisbasedonauditedfinancialstatementsfor2012–13,andtheforwardestimatescontainedinthe2013–14BudgetPaperNumber4.

Total net cost of services

Budget 2012–13

$m

Actual 2012–13

$m


$m


$m


$m

Total Expenses 718.7 713.8 906.3 964.6 1,036.2

TotalOwnSourceRevenue 289.6 165.0 356.3 397.7 442.0

NetCostofServices 429.1 548.8 550.0 566.9 594.2

Comparison to budgetTheDirectorate’snetcostofservicesfor2012–13of$548.8millionwas$119.7millionor27.9percenthigherthanthe2012–13budget(refertoAttachmentA).TheincreaserelatestodelaysintheenactmentoflegislationtoenabletheestablishmentoftheLocalHospitalNetwork’sNationalHealthFundingPoolbankaccount.Asaresultofthedelaysinlegislation,CommonwealthGovernmentfundingwhichwastobereceivedasOwnSourceRevenuewasinsteadpaidtotheChiefMinisterandTreasuryDirectorateandon-passedtotheACTLocalHospitalNetworkDirectorateasGovernmentPaymentforOutputs.

Comparison to 2011–12 actual expensesTheDirectoratebeganoperationsin2012–13sotherearenocomparisonsfor2011–12.

Future trends

Total Expenses Net Cost of ServicesTotal Own Source Revenue

Forward Estimate2013-14

Actual2012-13



Budget2012-13

0.0

200.0

400.0

600.0

800.0

1,000.0

1,200.0

$m

Figure 1: Net Cost of ServicesAsshownaboveinFigure1,thenetcostofservicesareexpectedtoslightlyriseeachyearthroughto2015–16.

C:\Users\CS\Central\FINANCE\2011-12\External Reporting\EOFY - Jodie\MD&A BS and P&L TM1 Slice.xlsx#'Dept - P&L'!L3


Total expenditure

Components of expenditureFigure2belowshowsthatforthefinancialyearended30June2013,theDirectoratepaid99.3percentofexpenditureasGrantsandPurchasedServices($708.9million),and0.7percentforTransferExpenses ($4.8million),spendingatotalof$713.8million.

GrantsandPurchasedServices 99.3%

Other expenses 0.7%

Figure 2: Components of Expenditure

Comparison to budgetTotalexpensesof$713.8millionwere($4.9million),or0.7percentlowerthantheoriginal2012–13budgetof$718.7million.

Thisvariationwaspredominantlydueto:

• areductioninCommonwealthGovernmentNationalHealthcarefundingof$3.1millionassociatedwithpopulationandindexationfactors,and

• achangetothemethodforCrossBorderHealthpaymentsbetweenStatesandTerritories.Underthenewarrangements,theCommonwealthGovernmentfundedcomponentofcrossborderactivityissubtractedfromtheresidentsState/Territory’sNationalHealthcareSpecificPurposePaymentandpaidtotheproviderState/Territory.

Comparison to 2011–12 actual expensesTheDirectoratebeganoperationsin2012–13sotherearenocomparisonsfor2011–12.

Future trendsExpensesarebudgetedtosteadilyincreaseuntil2015–16.

AnnexedReports317

Total revenue

Components of revenueFigure3belowindicatesthatforthefinancialyearended30June2013,theDirectoratereceived77.2percentofitstotalrevenueof$725.3millionfromGovernmentPaymentforOutputs($560.3million),11.5percentfromCrossBorderUserCharges($83.3million),withtheremaining11.3percentmadeupofGrantsfromtheCommonwealth($81.7million).

UserCharges 11.5%

GrantsfromtheCommonwealth

11.3%

Government Payment forOutputs

77.2%

Figure 3: Components of Own Source Revenue

Comparison to budgetOwnsourcerevenuefortheyearending30June2013was$165.0million,whichwas$124.6millionor43.0percentlowerthanthe2012–13budgetof$289.6million.ThereductionisduetodelaysintheenactmentoflegislationtoenabletheestablishmentoftheLocalHospitalNetwork’sNationalHealthFundingPoolbankaccount.Asaresultofthedelaysinlegislation,CommonwealthGovernmentfundingwhichwastobereceivedasownsourcerevenuewasinsteadpaidtotheChiefMinisterandTreasuryDirectorateandon-passedtotheACTLocalHospitalNetworkDirectorateasGovernmentPaymentforOutputs.Inaddition,therewasareductioninCommonwealthGovernmentNationalHealthcarefundingof$3.1millionassociatedwithpopulationandindexationfactors.

Comparison to 2011–12 actual incomeTheDirectoratebeganoperationsin2012–13sotherearenocomparisonsfor2011–12.

Future trendsTotalownsourcerevenueisexpectedtoincreasesteadilyuntil2015–16.


Financial positionThepurposeoftheDirectorateistoreceiveActivityBasedandBlockFundingfromtheNationalHealthFundingPoolcreatedundertheNationalHealthReformAgreement,andtopurchasehospitalservicesfromACTpublichospitals.TheACTLocalHospitalNetworkDirectoratewasneverintendedtohaveassetsnorliabilitiesonitsbalancesheet,thereforenobudgetwasset.

Total assets

Components of total assetsFigure4belowindicatesthat,asat30June2013,theDirectorateheld97.3percentofitsassetsinreceivables.

Receivables 97.3%

CashandCashEquivalents

2.7%

Figure 4: Total Assets as at 30 June 2013

Comparison to budgetThetotalassetpositionasat30June2013is$86.8million,whichis$86.8millionhigherthanthe2012–13budgetof$0million.

Thevariancereflectstheincreasein:

• CashandCashEquivalents($2.3million)—duetotheprovisionofacashbufferfromChiefMinisterandTreasuryDirectoratetoallowforthetimingofGoodsandServicesTax(GST)transactions;and

• Receivables($84.5million)—whichrelatestothecrossborderreceivablesfromNewSouthWalesandanAustralianTaxationOfficerefundforGST.

Comparison to 2011–12 actualTheDirectoratebeganoperationsin2012–13sotherearenocomparisonsfor2011–12.

AnnexedReports319

Total liabilities

Components of total liabilitiesFigure5belowindicatesthat100percentoftheDirectorate’sliabilitiesrelatestopayables.

Payables 100%

Figure 5: Total Liabilities as at 30 June 2013

Comparison to budgetTheDirectorate’sliabilitiesasat30June2013,of$71.8million,is$71.8millionhigherthanthe2012–13budgetof$0million.

Thisisduetohigherpayables($71.8million)whichrelatestocrossborderpaymentstotheNewSouthWalesGovernmentandtheACTHealthDirectorate.

Comparison to 2011–12 actualTheDirectoratebeganoperationsin2012–13sotherearenocomparisonsfor2011–12.

Net assetsTheDirectorate’snetassetsasat30June2013was$15.0millionhigherthanthenilpositionbudgeted.

Thisismainlyduetocrossborderrevenueof$114.1millionbeinghigherthanthebudgetof$102.6million,andcapitalinjectionof$3.5milliontocovertimingofGSTrefundsfromtheAustralianTaxationOffice.


Attachment A—Comparison of net cost of services to budget 2012–13

Original Budget

Plus AAO Transfers

Total Funding Less Actual Variance to be Explained

Description $’000 $’000 $’000 $’000 $’000 %

Expenses

PurchasedServices 696,592 – 696,592 708,909 –12,317 –1.77%

Other Expenses 17,418 – 17,418 – 17,418 100.00%

TransferExpenses 4,730 – 4,730 4,842 –112 –2.36%

Total Expenses 718,740 – 718,740 713,751 4,989 0.69%

Own Source Revenue

UserCharges 120,000 – 120,000 83,300 36,700 30.58%

GrantsfromCommonwealth 169,605 – 169,605 81,695 87,910 51.83%

OtherRevenue – – – – – –

Total Own Source Revenue 289,605 – 289,605 164,995 124,610 43.03%

Total Net Cost of Services 429,135 – 429,135 548,755 – 119,620 –27.87%

AnnexedReports321

AnnexedReports323

AnnexedReports325

ACT Local Hospital Network Directorate Controlled Financial Statements For the Year Ended 30 June 2013

ACT Local Hospital Network Directorate Operating Statement For the Year Ended 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Income

Revenue

GovernmentPaymentforOutputs 3 560,272 429,135

UserCharges–Non-ACTGovernment 4 83,300 120,000

GrantsfromtheCommonwealth 5 81,695 169,605

Total Revenue 725,267 718,740

Total Income 725,267 718,740

Expenses

GrantsandPurchasedServices 6 708,909 696,592

Other Expensesa – 17,418

TransferExpenses 7 4,842 4,730

Total Expenses 713,751 718,740

Operating Surplus 11,516 –

Total Comprehensive Income 11,516 –

TheaboveOperatingStatementshouldbereadinconjunctionwiththeaccompanyingnotes.TheDirectorateonlyhasoneoutputclassandassuchtheaboveOperatingStatementisalsotheDirectorate’sOperatingStatementfortheACTLocalHospitalNetworkOutputClass.AseparatedisaggregateddisclosurenotehasthereforenotbeenincludedintheseFinancialStatements.

TherearenoprioryearcomparativefiguresbecausetheACTLocalHospitalNetworkDirectoratecommencedoperationson 1July2012.

a. Although‘CrossBorderHealthCosts’payabletoNewSouthWaleswasbudgetedonthisline,theactualcostsof$15.5millionhavebeenreclassifiedandincludedwith‘GrantsandPurchasedServices’.


ACT Local Hospital Network Directorate Balance Sheet As at 30 June 2013

Note No.

Actual 2013

$’000

Original Budget

2013 $’000

Current Assets

CashandCashEquivalents 11 2,323 –

Receivables 12 84,477 –

Total Current Assets 86,800 –

Total Assets 86,800 –

Current Liabilities

Payables 13 71,784 –

Total Current Liabilities 71,784 –

Total Liabilities 71,784 –

Net Assets 15,016 –

Equity

AccumulatedFunds 15,016 –

Total Equity 15,016 –

TheaboveBalanceSheetshouldbereadinconjunctionwiththeaccompanyingnotes.TheDirectorateonlyhasoneoutput classandassuchtheaboveBalanceSheetisalsotheDirectorate’sBalanceSheetfortheACTLocalHospitalNetworkOutputClass.AseparatedisaggregateddisclosurenotehasthereforenotbeenincludedintheseFinancialStatements.


AnnexedReports327

ACT Local Hospital Network Directorate Statement of Changes in Equity For the Year Ended 30 June 2013


2013 $’000

Total Equity Actual

2013 $’000

Original Budget

2013 $’000

BalanceattheBeginningoftheReportingPeriod – – –


OperatingSurplus 11,516 11,516 –

Total Comprehensive Income 11,516 11,516 –


CapitalInjections 3,500 3,500 –

Total Transactions Involving Owners Affecting Accumulated Funds 3,500 3,500 –

Balance at the End of the Reporting Period 15,016 15,016 –



ACT Local Hospital Network Directorate Cash Flow Statement For the Year Ended 30 June 2013

Note No.

Actual 2013

$’000

Original Budget 2013

$’000


Receipts

GovernmentPaymentforOutputs 560,272 429,135

UserCharges – 120,000

GrantsreceivedfromCommonwealth 81,695 169,605

GoodsandServicesTaxInputTaxCreditsfromtheAustralianTaxationOffice 14,372 –

Total Receipts from Operating Activities 656,339 718,740

Payments

GrantsandPurchasedServices 637,125 696,592

GoodsandServicesTaxPaidtoSuppliers 15,549 –

Other – 17,418

PaymentstoHealthDirectorate 4,842 4,730

Total Payments from Operating Activities 657,516 718,740

Net Cash Outflows from Operating Activities 18 (1,177) –

Cash Flows from Financing Activities

Receipts

CapitalInjections 3,500 –

Total Receipts from Financing Activities 3,500 –

Net Cash Inflows from Financing Activities 3,500 –

Net Increase in Cash and Cash Equivalents 2,323 –

Cash and Cash Equivalents at the End of the Reporting Period 2,323 –

TheaboveCashFlowStatementshouldbereadinconjunctionwiththeaccompanyingnotes.


AnnexedReports329

ACT Local Hospital Network Directorate Controlled Statement of Appropriation For the Year Ended 30 June 2013

Original Budget 2013

$’000

Total Appropriated

2013 $’000

Appropriation Drawn

2013 $’000

Controlled

GovernmentPaymentforOutputs 429,135 560,272 560,272

CapitalInjections – 3,500 3,500

Total Controlled Appropriation 429,135 563,772 563,772

TheaboveControlledStatementofAppropriationshouldbereadinconjunctionwiththeaccompanyingnotes.

TherearenoprioryearcomparativefiguresbecausetheACTLocalHospitalNetworkDirectoratecommencedoperationson1July2012.

Column Heading ExplanationsThe Original BudgetcolumnshowstheamountsthatappearintheCashFlowStatementintheBudgetPapers.ThisamountalsoappearsintheCashFlowStatement.

The Total AppropriatedcolumnisinclusiveofallappropriationvariationsoccurringaftertheOriginalBudget.

The Appropriation DrawnisthetotalamountofappropriationreceivedbytheDirectorateduringtheyear.ThisamountappearsintheCashFlowStatement.

Variances between ‘Original Budget’ and ‘Total Appropriated’

Government Payment for OutputsThedifferencebetweentheOriginalBudgetandTotalAppropriatedtotheDirectorateisduetodelaysinenactinglegislation,theHealth (National Health Funding Pool and Administration) Act 2013, to establish the ACT State Pool accountundertheNationalHealthReformAgreement.ThedelaysinestablishingtheACTStatePoolAccountresultedinGrantsfromtheCommonwealthundertheNationalHealthReformAgreement(includingacomponentofcrossborderrevenue)notbeingabletobereceivedbytheDirectorate.ThisamountwaspaidtotheChiefMinisterandTreasuryDirectorateuntilMarch2013,amountingto$131.1million,whichwasthenpaidtotheDirectorateasGovernmentPaymentforOutputs.

Capital InjectionThedifferencebetweentheOriginalBudgetandTotalAppropriatedtotheDirectorateisduetotheneedforprovisionofacashbuffertodealwiththedelaybetweenoutflowsofGSTandthereceivingofinputtaxcreditsfromtheAustralianTaxationOffice.


ACT Local Hospital Network Directorate Controlled Note IndexNote 1 ObjectivesoftheACTLocalHospitalNetworkDirectorate

Note 2 SummaryofSignificantAccountingPolicies

Income Notes

Note 3 GovernmentPaymentforOutputs

Note 4 UserCharges–Non-ACTGovernment

Note 5 GrantsfromtheCommonwealth

Expense Notes

Note 6 GrantsandPurchasedServices

Note 7 TransferExpenses

Note 8 Auditor’sRemuneration

Note 9 Waivers,ImpairmentLossesandWrite-Offs

Note 10 ActofGracePayments

Asset Notes

Note 11 CashandCashEquivalents

Note 12 Receivables

Liabilities Notes

Note 13 Payables

Other Notes

Note 14 Financial Instruments

Note 15 Commitments

Note 16 ContingentLiabilitiesandContingentAssets

Note 17 EventsOccurringAfterBalanceDate

Note 18 CashFlowReconciliation

Note 19 Service Concession Assets

AnnexedReports331

ACT Local Hospital Network Directorate Notes to and Forming Part of the Financial Statements For the Year Ended 30 June 2013

Note 1. Objectives of the ACT Local Hospital Network Directorate

Operations and Principal ActivitiesIn2011theACTGovernmentbecomeasignatorytotheNationalHealthReformAgreementwhichintroducednewfinancialandgovernancearrangementsforAustralianpublichospitalservicesandnewarrangementsforprimaryhealthcareandagedcare.

On29March2011,theACTGovernmenttookthefirststeptowardimplementingtheACTLocalHospitalNetworkwhentheACTLegislativeAssemblypassedamendmentstotheHealth Act 1993.TheseamendmentsprovidedalegislativebasisfortheestablishmentoftheACTLocalHospitalNetworkDirectorate(theDirectorate)anda skill-basedACTLocalHospitalCouncil(Council).

TheDirectoratecommencedoperationon1July2012andisadministratedbytheDirector-GeneraloftheHealthDirectorateandsupportedbyHealthDirectoratestaff.

TheCouncilprovidesadvicetotheDirector-Generalontheclinicalandcorporategovernanceframeworkneededtosupportimprovementofstandardsofpatientcareandservicesunderthelocalhospitalnetworkandwaysinwhichtosupport,encourageandfacilitatecommunityandclinicianinvolvementintheplanningofservicesthatformpartoftheDirectorate.

TheCouncilalsoreportstotheMinisterforHealthonthestateofthelocalhospitalnetworkandanyrecommendationsrelatingtotheimprovementofhealthservicesprovidedbytheDirectoratethattheCouncilconsidersnecessary.

TheDirectoratereceivesActivityBasedFundingfromtheCommonwealthandACTGovernmentsandblockfundingforteaching,trainingandresearch.ItpurchasespublichospitalservicesfromfourACTpublichospitalproviders:

• CanberraHospitalandHealthServices;

• CalvaryPublicHospital;

• ClareHollandHouse;and

• QueenElizabethIIFamilyCentre.



Note 2. Summary of Significant Accounting Policies

(a) Basis of AccountingThe Financial Management Act 1996 (FMA)requiresthepreparationofannualfinancialstatementsforACTGovernmentAgencies.

TheFMAandthe Financial Management Guidelines issuedundertheAct,requirestheDirectorate’sfinancialstatementstoinclude:

i. anOperatingStatementfortheyear;

ii. aBalanceSheetattheendoftheyear;

iii. aStatementofChangesinEquityfortheyear;

iv. aCashFlowStatementfortheyear;

v. aStatementofAppropriationfortheyear;

vi. anOperatingStatementforeachclassofoutputfortheyear;

vii.asummaryofthesignificantaccountingpoliciesadoptedfortheyear;and

viii.suchotherstatementsasarenecessarytofairlyreflectthefinancialoperationsoftheDirectorateduringtheyearanditsfinancialpositionattheendoftheyear.

Thesegeneral-purposefinancialstatementshavebeenpreparedtocomplywith‘GenerallyAcceptedAccountingPrinciples’(GAAP)asrequiredbytheFMA.Thefinancialstatementshavebeenpreparedinaccordancewith:

i. AustralianAccountingStandards;and

ii. ACTAccountingandDisclosurePolicies.

Thefinancialstatementshavebeenpreparedusingtheaccrualbasisofaccounting,whichrecognisestheeffectsoftransactionsandeventswhentheyoccur.Thefinancialstatementshavealsobeenpreparedaccordingtothehistoricalcostconvention.

ThesefinancialstatementsarepresentedinAustraliandollars,whichistheDirectorate’sfunctionalcurrency.

TheDirectorateisanindividualreportingentity.

(b) Controlled and Territorial ItemsTheDirectorateproducesControlledfinancialstatements.TheControlledfinancialstatementsincludeincome,expenses,assetsandliabilitiesoverwhichtheDirectoratehascontrol.

TheDirectoratedoesnotproduceTerritorialfinancialstatementsbecauseitdoesnotadministeranyresourcesonbehalfoftheTerritory.

(c) The Reporting PeriodThesefinancialstatementsstatethefinancialperformance,changesinequityandcashflowsoftheDirectoratefortheyearending30June2013togetherwiththefinancialpositionoftheDirectorateasat30June2013.

AnnexedReports333



(d) Comparative FiguresBudget Figures

TofacilitateacomparisonwithBudgetPapers,asrequiredbytheFinancial Management Act 1996,budgetinformationfor2012-2013hasbeenpresentedinthefinancialstatements.BudgetnumbersinthefinancialstatementsaretheoriginalbudgetnumbersthatappearintheBudgetPapers.

Prior Year Comparatives

ComparativeinformationarenotprovidedbecausetheDirectoratecommencedoperationson1July2012.

(e) RoundingAllamountsinthefinancialstatementshavebeenroundedtothenearestthousanddollars($’000).Useofthe“–”symbolrepresentszeroamountsoramountsroundedupordowntozero.

(f) Revenue RecognitionRevenueisrecognisedatthefairvalueoftheconsiderationreceivedorreceivableintheOperatingStatement.AllrevenueisrecognisedtotheextentthatitisprobablethattheeconomicbenefitswillflowtotheDirectorateandtherevenuecanbereliablymeasured.Inaddition,thefollowingspecificrecognitioncriteriamustalsobemetbeforerevenueisrecognised:

Cross Border (Interstate) Health Revenue

Revenueforcrossborder(interstate)healthservicesisrecognisedwhenthenumberofpatientsandcomplexitiesoftreatmentsprovidedcanbemeasuredreliablyusingtheNationalEfficientpricethatisdeterminedbytheIndependentHospitalPricingAuthority.Actualpatientnumbersandservicesaresettledfollowinganacquittalprocessundertakeninsubsequentyearsandvariationstotherevenuerecognisedisaccountedforintheyearofsettlement.

TheNationalHealthReformAgreementspecifiesthateachjurisdictionwillmakefundingcontributionsthroughtheNationalHealthFundingPoolforservicesprovidedbyotherjurisdictionstoitsresidentseitheronanadhocbasisreflectingactualactivity,oronaregularbasisasscheduledthroughaCrossBorderagreement.

Commonwealth Grants

CommonwealthGrantsrelatetoActivityBasedFundingandBlockFundingundertheNationalHealthReforms.TheyalsoincludetheCommonwealthfundingcomponentofcrossborderhealthcostsforNewSouthWalesresidentstreatedinACTpublichospitals.

ActivityBasedFundingreferstoasystemforfundingpublichospitalservicesprovidedtoindividualpatientsusingnationalclassifications,priceweightsandnationallyefficientpriceassetbytheIndependentHospitalPricingAuthority.

BlockfundingisprovidedtosupportpublichospitalfunctionsthatarerecognisedbytheIndependentHospitalPricingAuthorityasservicesacceptabletobefundedonthisbasisandthatconformtotheIndependentHospitalPricingAuthority’snationalpricingmodel.

Commonwealthgrantsin2012–13werebasedontheformerNationalHealthcareSpecificPurposePaymentmethod.CommonwealthfundingtostatesandterritoriesbecomesuncappedandwillbeinformedbytheIndependentHospitalPricingAuthority’spricingmodelfrom2014–15.




(g) Waivers of DebtDebtsthatarewaivedduringtheyearunderSection131ofthe Financial Management Act 1996 are expenses duringtheyearinwhichtherighttopaymentwaswaived.FurtherdetailsofwaiversaredisclosedatNote9:Waivers,ImpairmentLossesandWrite-Offs.

(h) Current and Non-Current ItemsAssetsandliabilitiesareclassifiedascurrentornon-currentintheBalanceSheetandintherelevantnotes.Assetsareclassifiedascurrentwheretheyareexpectedtoberealisedwithin12monthsafterthereportingdate.Liabilitiesareclassifiedascurrentwhentheyareduetobesettledwithin12monthsafterthereportingdateorwhentheDirectoratedoesnothaveanunconditionalrighttodefersettlementoftheliabilityforatleast12monthsafterthereportingdate.

Assetsorliabilitieswhichdonotfallwithinthecurrentclassificationareclassifiedasnon-current.

(i) Cash and Cash EquivalentsForthepurposesoftheCashFlowStatementandtheBalanceSheet,cashincludescashatbankandcashonhand.Cashequivalentsareshort-term,highlyliquidinvestmentsthatarereadilyconvertibletoknownamountsofcashandwhicharesubjecttoaninsignificantriskofchangesinvalue.

( j) ReceivablesAccountsreceivableareinitiallyrecognisedatfairvalueandaresubsequentlymeasuredatamortisedcost,withanyadjustmentstothecarryingamountbeingrecordedintheOperatingStatement.

AccruedCrossBorderrevenuerelatestotheestimatednumberofNewSouthWalespatientstreatedinanACTpublichospitalforthe2012–13financialyear.UndertheNationalHealthReformAgreement,StatesandTerritoriesarerequiredtopayforCrossBorderactivityusingtheNationalEfficientPricethatisdeterminedbytheIndependentHospitalPricingAuthority.Theactuallevelofrevenuewillbesubjecttoanacquittalprocesstobecompletedinsubsequentyears.

TheallowanceforimpairmentlossesrepresentstheamountofreceivablestheDirectorateestimateswillnotberepaid.Theallowanceforimpairmentlossesisbasedonobjectiveevidenceandareviewofoverduebalances. TheDirectorateconsidersthefollowingisobjectiveevidenceofimpairment:

• becomingawareoffinancialdifficultiesofdebtors;

• defaultpayments;or

• debtsmorethan90daysoverdue.

Theamountoftheallowanceisthedifferencebetweentheassets’carryingamountandthepresentvalueoftheestimatedfuturecashflows,discountedattheoriginaleffectiveinterestrate.Cashflowsrelatingtoshort-termreceivablesarenotdiscountediftheeffectofdiscountingisimmaterial.TheamountoftheallowanceisrecognisedintheOperatingStatement.TheallowanceforimpairmentlossesarewrittenbackagainstthereceivablesaccountwhentheDirectorateceasesactiontocollectthedebtasitconsidersthatitwillcostmoretorecoverthedebtthanthedebtisworth.

Receivablesthathavebeenrenegotiatedbecausetheyarepastdueorimpairedareaccountedforbasedontherenegotiatedterms.

AnnexedReports335



(k) PayablesPayablesareafinancialliabilityandaremeasuredatthefairvalueoftheconsiderationreceivedwheninitiallyrecognisedandatamortisedcostsubsequenttoinitialrecognition,withanyadjustmentstothecarryingamountbeingrecordedintheOperatingStatement.Allamountsarenormallysettledwithin30daysaftertheinvoicedate.

(l) Employee Costs and Employee Benefits LiabilitiesTheDirectoratewasestablishedasaconsequenceoftheACTimplementingtheNationalHealthReformAgreement.TheobjectiveoftheDirectorateistoreceiveActivityBasedFundingandBlockFundingfromtheCommonwealthandACTGovernments,andtopurchasehospitalservicesfromACTpublichospitals.TheDirectoratedoesnotemployanystaff.AllstaffprovidingadministrativesupportareemployedbytheHealthDirectorate.Therefore,theDirectoratedoesnotincuranyemployeecostsanddoesnothaveanyemployeebenefitliabilities.

(m) Equity Contributed by the ACT GovernmentContributionsmadebytheACTGovernment,throughitsroleasowneroftheDirectorate,aretreatedascontributionsofequity.

IncreasesordecreasesinnetassetsasaresultofAdministrativeRestructuresarealsorecognisedinequity.

(n) Significant Accounting Judgements and EstimatesIntheprocessofapplyingtheaccountingpolicieslistedinthisnote,theDirectoratehasmadethefollowingjudgementsandestimatesthathavethemostsignificantimpactontheamountsrecordedinthefinancialstatements:

CrossBorder(Interstate)HealthReceivables:isanestimationbasedonthenumberofinterstatepatientsconvertedintoaNationalWeightedActivityUnitandpaidattheNationalEfficientPriceconsistentwiththeNationalHealthReformAgreement.Interstatepatientnumbersforthecurrentyearisanestimationbasedontheactualpatientnumbersfortheninemonthsto31March2013.Actualpatientnumbersandservicesaresettledfollowinganacquittalprocessundertakeninsubsequentyearsandvariationstotherevenuerecognisedareaccountedforintheyearofsettlement.




(o) Impact of Accounting Standards Issued but Yet to be AppliedThefollowingnewandrevisedaccountingstandardsandinterpretationshavebeenissuedbytheAustralianAccountingStandardsBoardbutdonotapplytothecurrentreportingperiod.Thesestandardsandinterpretationsareapplicabletofuturereportingperiods.TheDirectoratedoesnotintendtoadoptthesestandardsandinterpretationsearly.Whereapplicable,theseAustralianAccountingStandardswillbeadoptedfromtheirapplicationdate.Itisestimatedthattheeffectofadoptingthebelowfinancialstatementpronouncements,whenapplicable,willhavenomaterialfinancialimpactontheDirectorate’sfinancialstatementsinfuturereportingperiods:

• AASB9FinancialInstruments(applicationdate1January2015);

• AASB13FairValueMeasurement(applicationdate1January2013);

• AASB1055BudgetaryReporting(applicationdate1July2014);

• AASB2010-7AmendmentstoAustralianAccountingStandardsarisingfromAASB9(December2010)[AASB1,3,4,5,7,101,102,112,118,120,121,127,128,131,132,136,137,139,1023&1038andInterpretations2,5,10,12,19&127](applicationdate1January2015);

• AASB2011-7AmendmentstoAustralianAccountingStandardsarisingfromtheConsolidationandJointArrangementsStandards[AASB1,2,3,5,7,9,2009–11,101,107,112,118,121,124,132,133,136,138,139,1023&1038andInterpretations5,9,16&17](applicationdate1January2013forfor-profitentitiesand 1January2014fornot-for-profitentities);

• AASB2011-8AmendmentstoAustralianAccountingStandardsarisingfromAASB13[AASB1,2,3,4,5,7,9,2009–11,101,107,112,118,119,120,121,128,131,132,133,134,136,138,139,140,141,1004,1023&1038andInterpretations2,4,12,13,14,17,19,131&132](applicationdate1January2013);

• AASB2011–10AmendmentstoAustralianAccountingStandardsarisingfromAASB119(September2011)[AASB1,AASB8,AASB101,AASB124,AASB134,AASB1049&AASB2011-8andInterpretation14](applicationdate1January2013);

• AASB2012-2AmendmentstoAustralianAccountingStandards–Disclosures–OffsettingFinancialAssetsandFinancialLiabilities[AASB7&AASB132](applicationdate1January2013);

• AASB2012-3AmendmentstoAustralianAccountingStandards–OffsettingFinancialAssetsandFinancialLiabilities[AASB132](applicationdate1January2014);

• AASB2012-5AmendmentstoAustralianAccountingStandardsarisingfromAnnualImprovements2009–2011Cycle[AASB1,AASB1010,AASB116,AASB132&AASB134andInterpretation2](applicationdate1January2013);

• AASB2012-6AmendmentstoAustralianAccountingStandards–MandatoryEffectiveDateAASB9andTransitionDisclosures[AASB9,AASB2009–11,AASB2010-7&AASB2011-8](applicationdate1January2013);

• AASB2012–10AmendmentstoAustralianAccountingStandards–TransitionGuidanceandOtherAmendments[AASB1,5,7,8,10,11,12,13,101,102,108,112,118,119,127,128,132,133,134,137,1023,1038,1039,1049&2011-7andInterpretation12](applicationdate1January2013);and

• AASB2013-3AmendmentstoAASB136–RecoverableAmountDisclosuresforNon–FinancialAssets(applicationdate1January2014).

AnnexedReports337


Note 3. Government Payment for OutputsGovernmentPaymentforOutputsisrevenuereceivedfromtheACTGovernmentforthepurchaseofhospitalservicesfromACTpublichospitals.TheACTGovernmentpaysGovernmentPaymentforOutputsappropriationonafortnightlybasis.

2013 $’000

Revenue from the ACT Government

GovernmentPaymentforOutputsa 560,272

Total Government Payment for Outputs 560,272

a. GovernmentPaymentforOutputsistofundthepurchaseofhospitalservicesfrompublichospitalsintheACT.

Note 4. User Charges – Non-ACT GovernmentUserchargerevenueisderivedbyprovidingpublichospitalservicestointerstateresidents.UserchargerevenueisnotpartofACTGovernmentappropriationandispaidbystateorterritorygovernments.Thisrevenueisdrivenbydemandforhealthservicesfrominterstatepatientsandisnotforprofitinnature.

2013 $’000

User Charges – Non-ACT Government

CrossBorder (Interstate)HealthRevenuea 83,300

Total User Charges – Non-ACT Government 83,300

a. CrossBorder(Interstate)HealthRevenuerelatestorevenueearnedattheNationalEfficientPriceforthetreatmentofresidentsfrom NewSouthWalesinACTpublichospitals.

Note 5. Grants from the CommonwealthGrantsfromtheCommonwealthreflectcontributionsfromtheCommonwealthforActivityBasedFundingandBlockFunding,aswellasacontributionforpublichealthservices.

2013 $’000

Grants from the Commonwealth

Grants 81,695

Total Grants from the Commonwealth 81,695



Note 6. Grants and Purchased ServicesGrantsandPurchasedServicesreflectpublichospitalpaymentstotheCanberraHospital,CalvaryPublicHospital,ClareHollandHouseandQueenElizabethIIHospital.

2013 $’000

Purchased Services

PaymentstoServiceProviders

Canberra Hospital 537,917

Calvary Public Hospital 148,517

ClareHollandHouse 4,564

QueenElizabethIIHospital 2,410

CrossBorder(Intertstate)HealthCosts–NewSouthWales 15,501

Total Grants and Purchased Services 708,909

Note 7. Transfer ExpensesTransferExpensesrelatetotheon-passingofCommonwealthpublichealthfundingtotheHealthDirectorate.

2013 $’000

TransferExpenses 4,842

Total Transfer Expenses 4,842

Note 8. Auditor’s RemunerationAuditor’sremunerationrepresentsfeeschargedbytheAuditor-Generalforfinancialauditservicesprovidedto theDirectorate.

2013 $’000

Audit Services

AuditfeespaidtotheACTAuditor-General’sOffice 50

Total Audit Fees 50

NootherserviceswereprovidedbytheACTAuditor-General’sOffice.

Note 9. Waivers, Impairment Losses and Write-OffsUnderSection131oftheFinancial Management Act 1996,theTreasurermay,inwriting,waivetherighttopaymentofanamountpayabletotheTerritory.

AwaiveristherelinquishmentofalegalclaimtoadebtoverwhichtheDirectoratehascontrol.Thewrite-offofadebtistheaccountingactiontakentoremoveadebtfromthebooksbutdoesnotrelinquishthelegalrightoftheDirectoratetorecovertheamount.Thewrite-offofdebtsmayoccurforreasonsotherthanwaivers.

TheDirectoratehadnowaivers,impairmentlossesorwrite-offs.

AnnexedReports339


Note 10. Act of Grace PaymentsUnderSection130oftheFinancial Management Act 1996theTreasurermay,inwriting,authoriseActofGracePaymentstobemadebyaDirectorate.ActofGracePaymentsareamethodofprovidingequitableremediestoentitiesorindividualsthatmayhavebeenunfairlydisadvantagedbytheACTGovernmentbuthavenolegalclaimtothepayment.

TheDirectoratemadenoActofGracePaymentsduringthereportingperiod.

Note 11. Cash and Cash EquivalentsTheDirectorateholdsanumberofbankaccountsonwhichitdoesnotearninterest.In2012–13aspartofthewhole-of-governmentbankingarrangements,theDirectoratetransitionedbankingservicesfromtheCommonwealthBanktoWestpacBankingCorporation.Thesefundsareabletobewithdrawnuponrequest.

2013 $’000

CashatBank 2,323

Total Cash and Cash Equivalents 2,323

Note 12. Receivables2013

$’000

Current Receivables

AccruedRevenuea 83,300

83,300

NetGSTReceivables 1,177

1,177

Total Current Receivables 84,477

Total Receivables 84,477

a. AccruedrevenueconsistsofcrossborderreceivableowedfromtheNewSouthWalesMinistryofHealthforadmittedandnon-admittedpatientservicesprovidedtoresidentsofNewSouthWales.



Note 12. Receivables (Continued)

Ageing of ReceivablesNot Overdue

$’000

Past Due Less Than

30 days $’000

Past Due 30 to 60 days

$’000

Past Due Greater Than 60

days $’000

Total $’000

2013

NotImpairedReceivablesa 84,477 – – – 84,477


a. Thismainlyrelatestocrossborderreceivables,whichisfundingduefromtheNewSouthWalesMinistryofHealthforadmittedand non-admittedpatientservicesprovidedtoresidentsofNewSouthWales.Thisiscategorisedas‘notoverdue’asthefundingagreementdoesnotmandateatimeframeforpaymentpriortofinalacquittalofactivitynumbersforeachperiodandthefinalacquittalsareyettooccur.$63.1millionofthenetReceivableowing(ie$83.3millionasdisclosedaboveminus$15.5millionowedtotheNewSouthWalesGovernmentasdisclosedinNote13:Payables)totheDirectoratewasreceivedon27August2013asaninitialpayment,untilthefullyearreconciliationhasbeenfinalised.

Classification of ACT Government/Non-ACT Government Receivables2013

$’000

Receivables with Non-ACT Government Entities

NetOtherReceivables 83,300

NetGoodandServicesTaxReceivables 1,177

Total Receivables with Non-ACT Government Entities 84,477

Total Receivables 84,477

AnnexedReports341


Note 13. Payables2013

$’000

Current Payables

AccruedExpensesa 71,784

Total Current Payables 71,784

Total Payables 71,784

a. AccruedexpensesconsistsofcrossborderpayablesowedtotheHealthDirectorateandtheNewSouthWalesMinistryofHealthforadmittedandnon-admittedpatientservicesprovidedtoresidentsofNewSouthWalesintheCanberraHospitalandHealthServicesandresidentsoftheACTinNewSouthWaleshospitalsrespectively.

2013 $’000

Payables are aged as follows:

NotOverdue 71,784

OverdueforLessthan30Days –

Overduefor30to60Days –

OverdueforMorethan60Days –


Classification of ACT Government/Non-ACT Government Payables

PayableswithACTGovernmentEntities

AccruedExpensesa 56,283

Total Payables with ACT Government Entities 56,283

PayableswithNon-ACTGovernmentEntities

AccruedExpensesb 15,501

Total Payables with Non-ACT Government Entities 15,501


a. ThisiscrossborderpayablesowedtotheHealthDirectorateforadmittedandnon-admittedpatientservicesprovidedtoresidentsof NewSouthWalesintheCanberraHospitalandHealthServices.

b. ThisiscrossborderpayablesowedtotheNewSouthWalesMinistryofHealthforadmittedandnon-admittedpatientservicesprovidedtoresidentsoftheACTinNewSouthWaleshospitals.



Note 14. Financial InstrumentsDetailsofthesignificantpoliciesandmethodsadopted,includingthecriteriaforrecognition,thebasisofmeasurement,andthebasisonwhichincomeandexpensesarerecognised,withrespecttoeachclassoffinancialassetandfinancialliabilityaredisclosedinNote2:SummaryofSignificantAccountingPolicies.

Interest Rate RiskInterestrateriskistheriskthatthefairvalueorfuturecashflowsofafinancialinstrumentwillfluctuatebecauseofchangesinmarketinterestrates.TheDirectorateisconsideredtohavenoexposuretointerestraterisk,asitholdsonlycashandcashequivalentswithWestpacBankthatgeneratenointerest,andreceivablesare non-interestbearing.

AsensitivityanalysishasnotbeenundertakenfortheinterestrateriskoftheDirectorateasitisnotexposedtomovementsininterestrates.

Credit RiskCreditriskistheriskthatonepartytoafinancialinstrumentwillfailtodischargeanobligationandcausetheotherpartytoincurafinancialloss.TheDirectorate’screditriskislimitedtotheamountofthefinancialassetsheldlessanyallowanceforimpairment.

TheDirectorate’sfinancialassetsconsistofCashandCashEquivalentsandReceivables.

CashandcashequivalentsareheldwiththeWestpacBankingCorporation,ahighcredit,qualityfinancialinstitution,inaccordancewithwholeofACTGovernmentbankingarrangementsandtheDirectorateholdsnoinvestments.

TheDirectorate’sreceivablesconsistofamountsowedfromtheNewSouthWalesMinistryofHealth.AstheNewSouthWalesGovernmenthasaAAAcreditratingitisconsideredthatthereisaverylowriskofdefaultforthesereceivables.

Liquidity RiskLiquidityriskistheriskthattheDirectoratewillencounterdifficultiesinmeetingobligationsassociatedwithfinancialliabilitiesthataresettledbydeliveringcashoranotherfinancialasset.

ThemainsourceofcashtopaytheseobligationsisappropriationfromtheACTGovernmentwhichispaidonafortnightlybasisduringtheyear.TheDirectoratemanagesitsliquidityriskthroughforecastingappropriationdrawdownrequirementstoenablepaymentofanticipatedobligations.

Price RiskPriceriskistheriskthatthefairvalueorfuturecashflowsofafinancialinstrumentwillfluctuatebecauseofchangesinmarketprices,whetherthesechangesarecausedbyfactorsspecifictotheindividualfinancialinstrumentoritsissuer,orfactorsaffectingallsimilarfinancialinstrumentstradedinthemarket.

TheDirectorateholdsnofinancialinstrumentsthataresubjecttopriceriskandasaresult,isnotconsideredtohaveanypricerisk.Accordingly,asensitivityanalysishasnotbeenundertaken.

AnnexedReports343


Note 14. Financial Instruments (Continued)

Fair Value of Financial Assets and LiabilitiesThecarryingamountsandfairvaluesoffinancialassetsandliabilitiesattheendofthereportingperiodare:

Carrying Amount 2013

$’000

Fair Value 2013

$’000

Financial Assets

CashandCashEquivalents 2,323 2,323

Receivables 84,477 84,477

Total Financial Assets 86,800 86,800


Payables 71,784 71,784

Total Financial Liabilities 71,784 71,784

ThefollowingtablesetsouttheDirectorate’smaturityanalysisforfinancialassetsandliabilitiesaswellastheexposuretointerestrates,includingaverageweightedinterestratesbymaturityperiodasat30June2013.Allfinancialassetsandliabilitieswhichhaveafloatinginterestrateorarenon-interestbearingwillmaturein1yearorless.Allamountsappearinginthefollowingmaturityanalysisareshownonanundiscountedcashflowbasis.

Fixed Interest Maturing in:

Note No.

Weighted Average Interest Rate

Floating Interest

Rate $’000

1 Year or Less

$’000

Over 1 to 5

Years $’000



$’000Total

$’000


Financial Assets

CashandCashEquivalents 11 – – – – 2,323 2,323

Receivables 12 – – – – 84,477 84,477

Total Financial Assets – – – – 86,800 86,800


Payables 13 – – – – 71,784 71,784

Total Financial Liabilities – – – – 71,784 71,784

Net Financial Assets – – – – 15,016 15,016



Note 14. Financial Instruments (Continued)2013

$’000

Carrying Amount of Each Specified Category of Financial Asset and Financial Liability

Financial Assets

LoansandReceivablesMeasuredatAmortisedCost 84,477


FinancialLiabilitiesMeasuredatAmortisedCost 71,784

Fair Value HierarchyTheDirectoratedoesnothaveanyfinancialassetsorfinancialliabilitiesatfairvalue.Assuchnofairvaluehierarchydisclosureshavebeenmade.

Note 15. CommitmentsTheDirectoratehasnocommitmentsasat30June2013.

Note 16. Contingent Liabilities and Contingent Assets Therewerenocontingentliabilitiesorcontingentassetsasat30June2013.

Therewerenoindemnitiesasat30June2013.

Note 17. Events Occurring After Balance DateTherewerenoeventsoccurringafterthebalancedate,whichwouldaffectthefinancialstatementsasat 30June2013,orinthefuturereportingperiods.

AnnexedReports345


Note 18. Cash Flow Reconciliationa. Reconciliation of Cash and Cash Equivalents at the end of the reporting period in the Cash Flow Statement to

the equivalent items in the Balance Sheet

2013 $’000

TotalCashandCashEquivalentsRecordedintheBalanceSheet 2,323

Cash and Cash Equivalents at the end of the reporting period as recorded in the Cash Flow Statement 2,323

b. Reconciliation of Net Cash Outflows from Operating Activities to the Operating Surplus/(Deficit)

2013 $’000

OperatingSurplus 11,516

Cash Before Changes in Operating Assets and Liabilities 11,516


(Increase)inReceivables (84,477)

Increase in Payables 71,784

Net Changes in Operating Assets and Liabilities (12,693)

Net Cash Outflows from Operating Activities (1,177)

Note 19. Service Concession AssetsTheDirectoratehasenteredintoanagreementwithCalvaryHealthCareACTLtdfortheprovisionofhospitalandassociatedservices.TheoriginalagreementwasenteredintobytheCommonwealthon22October1971anddoesnotstipulateanyexpirydate.Thiswassubsequentlyamendedin1979toincludetheDirectorate(namedatthetimeasCapitalTerritoryHealthCommission)withanydutiesorfunctionsoftheCommonwealthbeingtransferredtotheDirectorate.TheAgreementwasforthefacilitytobeusedforapublichospital.Thiswasvaried,in1988,bytheCalvaryPrivateAgreementtoallowCalvaryHealthCareLtdtousetwofloorsofthefacilityfortreatingprivatepatients.TheCalvaryPrivateAgreementsetstheprocessandmechanismforCalvaryPrivatetoreimburseCalvaryPublicforanycostsincurredinusingpublichospitalfacilitiesfortreatingprivatepatients.Theseagreementswerereplacedon7December2011withtheCalvaryNetworkAgreement.

Undertheagreement,CalvaryHealthCareACTLtdisrequiredtoprovidehospitalservicesandmaketheseservicesavailabletoallpersonsirrespectiveoftheircircumstancesandistochargepatientsfeesonlyinaccordancewiththescaleoffeesapplicableatHealthDirectoratehospitalsforcomparableservices.Intheeventthattheagreementceases,alllandistobereturnedtotheTerritory.Thelevelofservicesthatisrequiredtobeprovidedinafinancialyear,fortheamountoffundingprovided,isstipulatedinaPerformancePlanagreedbetweentheDirectorateandCalvaryHealthCareACTLtdforeachyear.

Theamountoffundingprovidedforinthe2012–13financialyearwas$167.8millioninrecurrentfunding,recognisedintheHealthDirectorate’s($14.7million)andACTLocalHospitalNetworkDirectorate’s($153.1million)grantsandpurchasedservicesexpenditure,and$0.7millionforcapitalupgradesofassetssubjecttotheseserviceconcessionarrangements.ThisisrecognisedasTerritorialgrantsexpenditure.

Theland,hospitalbuildingsandotherassetscomprisingtheCalvaryPublicHospitalarenotrecognisedintheDirectorate’sBalanceSheet.


ACT Local Hospital Network Directorate Statement of Performance

AnnexedReports347

AnnexedReports349

Output Class 1: ACT Local Hospital Network

DescriptionTheACTLocalHospitalNetworkreceivesfundingunderNationalHealthReformAgreementandpurchasespublichospitalservicesfromCanberraHospital,CalvaryPublicHospital,ClareHollandHouseandQueenElizabethIIHospital.

Original Target

2012–13

Amended Target

2012–13

Actual Result

2012–13

% Variance from

Original/Amended

Target1 Explanation of Material Variances Notes

Totalcost($000’s) 718,740 713,751 (7%)

ThevarianceintotalcostsfollowsareductioninCommonwealthNationalHealthcareSpecificPurposePaymentfundinglinkedtopopulationandindexationadjustments.

Government paymentforoutputs(GPO)($000’s)

429,135 542,282 560,272 3%

TheincreasetotheoriginaltargetfollowstheapprovalofaSupplementaryAppropriationduetodelaysinlegislationtoenabletheoperationoftheACTStatePoolAccount.The3%increaseinGPOfromtheamendedtargetrelatestoachangetothepaymentarrangementsforCrossBorderactivitybetweenStatesandTerritories.


1.Numberofnationalweightedactivityunits

117,494 120,748 3% 2

1.1 Acute Services – Calvary Public Hospital3

a.Costweightedpatientseparations

24,844 22,002 (11%)

TheOriginalTargetfor2012–13includedtotalactivityformentalhealth,cancer,agedcareandrehabilitationservicesandClareHollandHouse(reportedatoutputs1.2,1.3,1.4and1.5respectively).Theremovalofthetargetsforoutputs1.2,1.3,1.4,1.5wouldreducethetargetfor2012–13to21,742,whichiscloselymatchedbytheresultfortheperiod.

4

b.Non-admittedoccasionsofservices

53,736 58,576 9%CalvaryHospitaloutpatientserviceshaveexperiencedsignificantgrowthinallareasin2012–13.

5

Notes1. Ifthetargethasnotbeenamendedthevarianceisfromtheoriginaltarget,otherwisethevarianceisfromtheamendedtarget.2. Nationalweightedactivityunitisthe‘currency’thatisusedtoexpressthepriceweightsforallservicesthatarefundedonanactivitybasis.3. ThesemeasuresrelatestoCalvaryPublicHospitalonly,forsimilarmeasuresrelatedtoCanberraHospital,refertotheHealthDirectorate

PerformanceReport.4. CostweightedseparationsforallhospitalepisodesatCalvaryPublicHospital,excludingthosereportedelsewhere(MentalHealth,

CancerServicesandAgedCareandRehabilitationService)andunqualifiedneonates(wellbabies,whoarecountedaspartoftheirmother’sadmission).Costweightedseparationsdifferfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

5. Non-admittedpatientservicesprovidedatCalvaryPublicHospital,excludingthoseservicesprovidedbyMentalHealth,CancerServicesandtheAgedCareandRehabilitationService.


Output Class 1: ACT Local Hospital Network (Continued)

Original Target

2012–13

Actual Result

2012–13

% Variance from


1.1 Acute Services – Calvary Public Hospital (Continued)3

c.Percentageofcategoryoneelectivesurgerypatientswhoreceivesurgerywithin30daysoflisting

97% 97% – 6

1.2 Mental Health – Calvary Public Hospital3

a.Costweightedseparations 1,424 1,256 (12%) Thevariancerelatestoadropindemandfor

servicesatCalvaryWard2N. 7

b.Admittedpatientseparations 670 493 (26%) Thevariancerelatestoadropindemandfor

servicesatCalvaryWard2N. 8

c.Percentageofclientswithoutcomemeasurescompleted

65% 88% 35%

The2012–13targetof65%wassetin-linewiththetargetfortheHealthDirectoratewhichincludescommunitybasedservices.CalvaryHospitalclientsareallinpatientsandasaresulthaveahigherrateofoutcomemeasurescompleted.

9

d.TheproportionofclientscontactedbyaHealthDirectoratecommunityfacilityduringthe7dayspostdischargefromtheinpatientservices

75% 76% 1% 10

1.3 Cancer Services – Calvary Public Hospital3

a.Costweightedadmittedpatientseparations 271 249 (8%)

Calvarymanagesarelativelysmallnumberofcostweightedinpatientseparationsthataredirectlyrelatedtocanceradmissions(totallinglessthan1%ofallseparations).Thesmallnumberscanresultinmajorfluctuationswithinandbetweenyears.

11

Notes6. Categoryonepatientsarethoseassessedbythetreatingmedicalofficerasthehighestpriorityforelectivesurgeryrequiringsurgery

within30daysofassessmentbyasurgeonatCalvaryPublicHospital.7. CostweightedseparationsformentalhealthrelatetotheWard2NandtheOlderPerson’sMentalHealthInpatientUnit(OPMHIU)at

CalvaryPublicHospital.Costweightedseparationsdifferfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.Ward2NisthementalhealthinpatientunitatCalvaryPublicHospital.

8. RawseparationsfromCalvaryPublicHospitalWard2NandOPMHIU.Rawseparationscountthenumberofinpatienthospitalepisodes.9. PercentageofinpatientclientsadmittedtoCalvaryPublicHospitalWard2NandOPMHIUwithmandatoryoutcomemeasures

completedperadmissionepisode.Thepurposeofmeasuringclinicaloutcomesistoseewhetherconsumersofpublicmentalhealthservicesaregettingbetterasaresultoftheservicestheyreceive.

10.TheproportionofmentalhealthclientsadmittedtoCalvaryPublicHospitalandcontactedbyMentalHealthCommunityServicesduringthe7dayspostdischargefromhospital.

11.InpatientcostweightedactivityforpatientsoftheCancerServicesatCalvaryPublicHospital.Costweightedseparationsdifferfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

AnnexedReports351

Output Class 1: ACT Local Hospital Network (Continued)

Original Target

2012–13

Actual Result

2012–13

% Variance from


1.3 Cancer Services – Calvary Public Hospital (Continued)3


Thevarianceisduetoincreaseddemandforserviceswithinthesecancerunits.SignificantgrowthhasoccurredinMedicalOncology.

12

1.4 Rehabilitation and Aged Care – Calvary Public Hospital3


789 745 (6%)

Thevarianceisduetolesscomplexpatientsrequiringtreatmentin2012–13.Whiletherehasbeenanincreaseinthenumberofrehabilitationpatientsin2012–13comparedto2011–12,theaveragelengthofstayforthesepatientshasdecreasedwhencomparedwiththepreviousyearduetoadecreaseinacuity.

13

b.Subacuteservice–episodesofcare 256 270 5%

Theaveragelengthofstayforrehabilitationpatientshasreducedsignificantlyoverthepastyear.Thisimprovementindischargingpeoplefromhospitaltohomeortomoreappropriateserviceshasresultedinanincreaseinthroughputfortheservices.

14

c.Subacuteservice–occupiedbeddays 9,500 6,937 (27%)

Thevarianceisduetodifficultiesintherecruitmentofspecialistgeriatricians,areductionindemandforservicesandreducedlengthofstay(onaverage)forrehabilitationpatients.

15

1.5 Clare Holland House16

a.Costweightedpatientseparations 618 618 – 17

Notes12. MedicaloncologyoutpatientservicesatCalvaryPublicHospital.13.InpatientcostweightedactivityforpatientsoftheAgedCareandRehabilitationServiceatCalvaryPublicHospital.Costweighted

separationsdifferfromreportingrawseparations,astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

14. Thetotalnumberofpersonsseparatedfromthesub-acuteservicesatCalvaryPublicHospital.15.Totalnumberofpersonsseparatedfromthesub-acuteserviceatCalvaryPublicHospital.16. ThismeasurerelatestoClareHollandHouse,forsimilarmeasuresrelatedtoCanberraHospital,refertotheHealthDirectorate

PerformanceReport.17. InpatientcostweightedactivityforpatientsoftheClareHollandHouse.Costweightedseparationsdifferfromreportingrawseparations,

astheyaccountfortherelativecomplexityofeachseparation,therebygivingamoreaccuratepictureofactivityperformed.

ACT Local Hospital Network strategic indicatorsOn29March2011,theACTGovernmenttookthefirststeptowardsimplementingtheACTLocalHospitalNetwork(ACTLHN)whentheACTLegislativeAssemblypassedamendmentstotheHealth Act 1993.TheseamendmentsprovidedalegislativebasisfortheestablishmentoftheACTLHNandaskill-basedACTLHNCouncil.

TheACTLHNconsistsofanetworkedsystemthatwillholdservicecontractswithACTHealth.TheACTLHNcomprisestheCanberraHospital,CalvaryPublicHospital,ClareHollandHouse(CHH)andtheQueenElizabethIIFamilyCentre(QEII).

UnderthereformsoutlinedintheNationalHealthReformAgreement,theACTGovernmentwillcontinuetomanagesystem-widepublichospitalserviceplanningandperformance,includingthepurchasingofpublichospitalservicesandcapitalplanning,andwillberesponsibleforthemanagementoftheperformanceoftheACTLHN.


PerformanceoftheACTLHNwillbesubjecttoanationalperformanceframework(theHealthPerformanceFramework)tobeadministeredbytheindependentNationalPerformanceAuthority.TheframeworkwillincludearangeofperformanceindicatorsthatwillbepubliclyavailableontheMyHospitalswebsiteandwilloutlinearemediationprocesstobeimplementedforunderperformingLHNs.

TheACTandtheCommonwealthhaveagreedtoanetworkedservicearrangement.ThismeanstheACTGovernmentwillnothaveasingleserviceagreementwiththeACTLHNbutwillhavefourseparateserviceagreementswitheachconstituententityoftheACTLHN.

ThefollowingstrategicindicatorsincludesomeofthemajorperformancebenchmarksimplementedbytheCommonwealthGovernmentundertherequirementsofthenationalhealthreforms.Theseinitiativesincludearangeofperformancebenchmarksandgovernancearrangementstobemetbystatesandterritories.

ACT public hospitals—Canberra Hospital and Calvary Public Hospital

Performance indicator 1: Percentage of elective surgery cases admitted on time by clinical urgency

Clinically recommended time by urgency category 2012 target 2012 result 2013 target

One(Urgent—admissionwithin30daysisdesirableforaconditionthathasthepotentialtodeterioratequicklytothepointthatitmaybecomeanemergency)

95% 98% 97%

Two(Semi-urgent—admissionwithin90daysisdesirableforaconditioncausingsomepain,dysfunctionordisabilitywhichisnotlikelytodeterioratequicklyorbecomeanemergency)

55% 57% 66%

Three(Non-urgent—admissionatsometimeinthefutureacceptableforaconditioncausingminimalornopain,dysfunctionordisability,whichisnotlikelytodeterioratequicklyandwhichdoesnothavethepotentialtobecomeanemergency).TheHealthDirectorateestablishesa365-daymaximumdesirablewaitingtimeforcategory3patients.

82% 89% 86%

Note:Targetsandresultsarebasedoncalendaryeardata.

Performance indicator 2: The proportion of Emergency Department presentations whose length of stay in the Emergency Department is four hours or less

2012 target 2012 result 2013 target

TheproportionofEmergencyDepartmentpresentationswhoeitherphysicallyleavetheEmergencyDepartmentforadmissiontohospital,arereferredfortreatmentoraredischarged,whosetotaltimeintheEmergencyDepartmentiswithinfourhours.

64% 57% 65%

Note:Targetsandresultsarebasedoncalendaryeardata.

AnnexedReports353

Clare Holland House (CHH)TheACTGovernment,throughtheHealthDirectorate,providesfundingforinpatient,outpatientandcommunity-basedspecialistpalliativecareservicesintheACT.TheseincludeClareHollandHouse,aninterdisciplinaryserviceincludinga19-bedinpatienthospice,specialistoutreachservicestopeople’shomes(Home-BasedPalliativeCare),consultancyservicestohospitals,anurseeducator,anursepractitioner,bereavementservicesandtheCalvaryCentreforPalliativeCareResearch,allmanagedbyCalvaryHealthCareACT.

Performance indicator 3: Reaching the optimum occupancy rate for Clare Holland House inpatient beds


PercentageofCCHinpatientsbedsinuse 85% 76%

Performanceindicator4:Thenumberofhome-basedpalliativecareoccasionsofserviceprovidedbyCHH


Thenumberofpeoplereceivinghome-basedpalliativecareservicesprovidedbyCHH(off-campusoccasionsofserviceprovidedbynurses) 5,250 3,433

Queen Elizabeth II Family Centre (QEII)TheACTGovernment,throughtheHealthDirectorate,alsoprovidesfundingtotheCanberraMothercraftSocietytomanagetheQueenElizabethIIFamilyCentre.Thecentreprovidesresidentialprimaryhealthcareandparentingprogramsforfamilieswithyoungchildrenwhoareexperiencingcomplexhealthandbehaviouraldifficultiesinthefirstthreeyearsofaninfant’slife.

Performance indicator 5: The total number of admissions to the Queen Elizabeth II Family Centre


Totaladmissions 1,400 1,674

Performance indicator 6: Maintain the waiting time for admission of urgent people to the Queen Elizabeth Family Centre


Proportionofadmissionsofurgentclientsequaltoorlessthan2days 100% 47%

Performance indicator 7: Reaching the optimum occupancy rate for the Queen Elizabeth II Family Centre


PercentageofQEIIinpatientsbedsinuse 85% 94%

Performance indicator 8: The proportion of patients readmitted to the Queen Elizabeth II Centre following their separation from the centre


TheproportionofpeopleseparatedfromQEIIwhoarereadmittedtoQEII <5% 0%


Chief Psychiatrist Annual Report 2012–13

The Mental Health (Treatment and Care) Act 1994wasimplementedintheAustralianCapitalTerritoryon6February1995.

Section 120AreportpreparedbytheChiefPsychiatristundertheAnnual Reports (Government Agencies) Act 2004forafinancialyearmustinclude:

a. statisticsinrelationtopeoplewhohaveamentalillnessduringtheyear

b. detailsofanyarrangementswithNewSouthWalesduringtheyearinrelationtopeoplewhohaveamentalillness.

Emergency apprehensionThefollowingtableshowsthenumberofemergencyapprehensionsin2012–13,withabreakdownofwhoinitiatedthem.

Emergency action Police officer Mental health officer Medical practitioner

Total 876 617 165 94

Emergency detentionThefollowingtableshowsthenumberofemergencydetentionnotificationsissuedin2012–13incomparisontopreviousyears.Applicationsforextensionofemergencydetention(forafurtherperiodofuptosevendays)andapplicationsformentalhealthordersandvariationsofmentalhealthordersaremadetotheACTCivilandAdministrativeTribunal.

Emergency detentions July 09–June 10 July 10–June 11 July 11–June 12 July 12–June 13

Total 505 596 614 689

Outcome of those detained

July 09–June 10 July 10–June 11 July 11–June 12 July 12–June 13

Revocationof72-hrdetentionand/or72-hrdetentionbeingallowedtolapse

302 322 389 363

Applicationsforextensionofinvoluntarydetention 204 274 225 326

Psychiatric treatment orders UndertheMental Health (Treatment and Care) Act 1994,theChiefPsychiatristisresponsibleforthetreatmentandcareofapersontowhomapsychiatrictreatmentorder(PTO)applies.ThemaximumdurationofaPTOis sixmonths.


PTOsgrantedbythetribunal 790 884 864 924

PTOsrevoked 69 119 148 127

BreachofPTO 68 59 76 82

Restrictionorders 3 3 5 16

AnnexedReports355

Other mattersThe Mental Health (Treatment and Care) Act 1994providesfortheauthorisationofinvoluntaryelectro-convulsivetherapy(ECT),includingemergencyECT.Italsohasprovisionsfortheinterstateapplicationofmentalhealthlaws,includingforthetransferofpeopletoandfromtheACT.

The Crimes Act 1900providesforthecourttoorderremovalofanindividualtotheCanberraHospitalforthepurposesofanemergencyassessmenttodeterminewhetherimmediatetreatmentandcarearerequired.


ApplicationforECTauthorised 19 17 16 13

Applicationforemergency ECTauthorised 0 2 0 1

Transfersto/fromNSW 12 4 10 8

Courtorderedremovalforassessment—s309oftheCrimes Act 1900 25 26 54 40

Key points arisingThefollowingtrendsinkeyareasofactivityrelatedtotheOfficeoftheChiefPsychiatristarenoteworthy.

In2012–13,876peoplewereapprehendedandbroughttotheCanberraHospitalforassessment.Thisisadecreaseof7percentfromthepreviousyear,whenitwas942.Thislikelyreflectstheincreasinglevelofmentalhealtheducationprovidedtothepoliceandotherstakeholders.Emergencydetentionrevocationshavedecreasedfrom389to363,a7percentdecreaseincomparisontothesamereportingperiodlastyear.Thisreflectseffortstomovetoleastrestrictivecareatanearlyopportunityifatallpossible.Notwithstandingthis,therewasagreaternumberofapplicationsforextensionoffurtherinvoluntarydetention(ofuptosevendays),indicatingthetreatingteam’seffortstocontinuetoappropriatelystabiliseanacuteepisodeofillness.Increasedstabilityduringanadmissionprovidesagreaterchanceofsuccessfulongoingmanagementwhenapersonisdischargedtothecommunity.

TheACTCivilandAdministrativeTribunal(ACAT)granted924psychiatrictreatmentorders(PTO).Thisisanincreaseof6percentfrom2011–12.Uponapplicationbyaconsultantpsychiatrist,orofitsownmotion,ACATrevoked127orders,comparedto148inthepreviousreportingperiod.Communitypsychiatryisproactiveinmanagementwithoutorderswherepossible.

Therewere14electro-convulsivetherapyapplicationsauthorised,anegligibledecreasefromthepreviousyear.TherewasonlyoneapplicationforemergencyECTmadetothetribunalandafterafullhearingandreviewthisapplicationwasabletoberevoked.Thus,forthe2012–13year,noemergencyECTneededtobeauthorisedbythetribunalundertheprovisionsinPart7oftheAct,introducedin2005.

Eightcross-borderagreementsweremadebetweentheACTandNewSouthWales.TheACTacceptedfourtransfersfromNewSouthWalesandfourtransfersweremadetoNewSouthWalesfacilities.BreachofPTOsincreasedfrom76to82.Thisamountstoanincreaseof7percentfrom2011–12.Thirty-fivepeoplewerebroughttotheMentalHealthAssessmentUnitformedicationorassessmentpurposes.Communityteamsmakeeveryefforttoanticipateandmanagecrisesearly.Often,ifthisissuccessful,abreachisnotrequired.

TheACTMagistratesCourtmade40referralsforassessmentpursuanttosection309oftheCrimes Act 1900, adecreaseof25percentfromthepreviousyear.Ofthese,24peoplerequiredadmissiontotheAdultMentalHealthUnitforassessmentpurposes,with16beingreturnedtocourtonthesameday.TheCourtLiaisonServiceisoftenabletoprovideassessmentandadvicetothecourtsatthetimeofthehearing,whichinsomecircumstancesmeansthatasection309referralisnotrequired.

ThereviewofthecurrentMental Health (Treatment and Care) Act 1994continues,andarevisedamendmentbillisexpectedtobepresentedtocabinetbeforetheendof2013.

Dr Peter Norrie

Chief Psychiatrist


Human Research Ethics Committee Annual Report 2012–13TheACTHealthHumanResearchEthicsCommittee(HREC)continuesitsworkofreviewinghumanresearchprojectstoensuretheymeettheethicalstandardssetoutintheNationalStatementonEthicalConductinHumanResearch(2007),preparedbytheNationalHealthandMedicalResearchCouncil(NHMRC),theAustralianResearchCouncilandtheAustralianVice-Chancellors’Committee.Duringthereportingperiod,HRECcontributedtotheNHMRCconsultationpapersontheMcKeonreview.

TheHRECanditssubcommitteesstrivetoprovideethicalreviewandapprovalintheshortestpossibletime,consciousofthepressuresonresearchersandtheirteams.Duringthereportingperiod,HRECimprovedonitspreviousaverageof30days.In2012,theaveragetimetakenfromsubmissiontoapprovalwas23.5days.Therewere115fulland174low-riskapplicationsin2012–13.

HREChascontinuedtopreparefortheadventofnationalprogramsofsingleethicalapprovalofmultisiteresearchand,inSeptember2012,achievedNHMRCcertificationtoactasleadHRECinthesinglereviewsystem.TheHumanResearchEthicsManager,MsAugustMarchesi,hascontinuedtorepresentHRECandtheACTHealthDirectorateontheJurisdictionalWorkingGroupthatisprogressingthesinglereviewsystem.Bytheendof2013,theACTexpectstosignthememorandumofunderstandingwithotherjurisdictionswhichwillmarkthestartofthenationalsinglereviewsystem.

TheEthicsCommitteehasintroducedanewSocialResearchSubcommittee(SRSC).Afterpreparationsin2012,membershipwasestablishedandthefirstmeetingheldinFebruary2013.SRSChasprovedtobeavaluableadditiontotheHRECprocess.Applicationsinvolvingsocialresearch,includingdatalinkageandinternet-basedprograms,areincreasing,andHRECisgratefultohavetheadviceofexpertmembersoftheSRSC.

TheClinicalTrialsSubcommittee(CTSC)andtheSurveyResourceGroup(SRG)havecontinuedtoprovideHRECwithexpertadviceonthemeritandintegrityofresearchproposals.June2013sawtheresignationofAssociateProfessorZsuzsokaKecskesasChairofSRG.AssociateProfessorKecskeswasalong-servinganddedicatedchairandIampleasedtohavethisopportunitytothankherforherinestimableworkingrowingthisgroup,asavaluedresourcetoHRECandACTHealth.

HRECmembershipincludesalawyer,femaleandmalelaypersons,aministerofreligion,apsychologist,amemberprovidingIndigenousknowledgeandexpertise,andseniorcliniciansfromCanberraHospital.Thechairmanisaformerspecialistinobstetricsandgynaecology,aformerdeanandpostgraduatedeanandanadjunctprofessorofmedicaleducation.Newmembersappointedinthepastyearhavebeenapharmacist,ahepatologistandapaediatrician.Theworkofthemembersofthemaincommitteeandvarioussubcommitteesisgreatlyvalued.

OnbehalfofHRECanditssubcommittees,Ithanktheadministrativestafffortheirtirelessworkinkeeping HRECanditsprocessesoperatingatthehigheststandards.AugustMarchesi,SarahFloodandGillianFoxhaveprovidedanotheryearofexceptionalworkinsupportingHREC.

Membership of the committeeProfessorJohnBiggs Chairman

A/ProfessorPeterHickman DeputyChair

ProfessorWalterAbhayaratna member

ProfessorGeoffFarrell member

ProfessorDougBoer member

ProfessorPaulPavli member(resignedApril2013)

A/ProfessorFrankvanHaren member

DrDiptiTalaulikar member

DrJasonMazanov member

DrLouiseMorauta member

AnnexedReports357

DrMarianCurrie member

DrTonyHuynh member

DrManojSingh member

RevDougHutchinson member

MrRayLovett member

MrRayComer member(resignedOctober2012)

MrLukeWilliamson member

MsKimberleyBaillie member

Mr John Morrissey member

MsLynTodd member

MsJulieKussy member

Number of research projectsDuring2012–13,HRECreviewed115proposals;105wereapproved.Oftheremaining10proposals,onewaswithdrawnbytheapplicant,onewasdeclinedduetoACT-specificlegislativerestrictions,andeightremaininconsultation,progressingtowardsapproval.

Meetings of the Ethics CommitteeThecommitteemet11timesfrom1July2012to30June2013.Meetingsareheldmonthly.

SubcommitteesThe Clinical Trials Subcommittee(CTSC)reviewed53proposals,ineachinstancemakingrecommendationstothemaincommittee.

The Social Research Subcommittee (SRSC),whichfirstmetinFebruary2013,reviewed18proposals,ineachinstancemakingrecommendationstothemaincommittee.

The Low Risk Subcommittee (LRSC)reviewed174proposalsandapproved157.Oftheremaining17,fivewerereferredforconsiderationbythemaincommittee,onewaswithdrawnbytheapplicantand11areinconsultation.

The Survey Resource Group (SRG)reviewed70proposalsprovidingendorsementofsurveytoolsand/orrecommendationstothemaincommitteeandLRSC.

Key points arisingThework,overathree-yearperiod,ofpreparingHRECforthenationalsinglereviewsystemhasproducedmanyreformsandinnovationsinprocessesandadministration.InOctober2012,theChairmandeliveredpresentationsonthisworktoCanberraHospitalGrandRoundsandtotheSocietyofResearchAdministratorsInternationalConferenceinOrlando,Florida.In2013,anarticleauthoredbythechairmanandmanagerwaspublishedintheJournal of Research AdministrationintheUnitedStatesofAmerica.


Mental Health ACT Official Visitors Annual Report 2012–13

IntroductionMentalHealthOfficialVisitorsareappointedbytheMinisterforHealthtovisitandinspectpsychiatric inpatientfacilitiesandmakeinquiriesastothecareandtreatmentofpatients,assetoutintheMental Health (Treatment and Care) Act 1994.Matterscoveredinclude:

• theadequacyofservicesfortheassessmentandtreatmentofpersonswithmentaldysfunctionora mental illness

• theappropriatenessofrecreation,occupation,education,trainingandrehabilitationservices

• whetherservicesareprovidedintheleastrestrictiveenvironmentpossibleandintheleastintrusive manner possible

• anycontraventionsoftheMentalHealth(TreatmentandCare)Act

• anycomplaintreceivedfromapersonreceivingtreatmentandcareformentalillnessordysfunction.

Currently,MentalHealthOfficialVisitors’rolescoverthementalhealthservicesprovidedattheBrianHennessyRehabilitationCentre(BHRC),Ward2N,theOlderPersonsMentalHealthInpatientUnit(OPMHIU)andHysonGreen(providingprivatementalservices)atCalvaryPublicHospital,aswellastheAdultMentalHealthUnit(AMHU),formerlythePsychiatricServicesUnit(PSU),atCanberraHospital.

TheOfficialVisitorsenjoyedattendingtheNewSouthWalesOfficialVisitorsConferenceinSydneyasguestsoftheNewSouthWalesserviceinAugust.Thisservedasanimportantliaisonactivity,andOfficialVisitorsbenefitedfromtheeducativefunctionoftheconferenceaswellasfromtheinformaldiscussionsabouttheOfficialVisitorrole. ThePrincipalOfficialVisitorwasreappointedduringthisperiodandoneOfficialVisitorresigned.

VisitsSinceDecember2002,theOfficialVisitorshaveoperatedamonthlypre-determinedscheduleofformal visits to eachofthefacilities.Priornoticeofthevisitisgiventothefacilitytoreinforceacooperativeasopposedtoaninspectorialapproachwithunitstaff.In2012–13,OfficialVisitorsmade60scheduledformalvisitstothefivementalhealthfacilities.

FormalvisitsbytheOfficialVisitorsweresupplementedbyfollow-upvisitsasrequired.Othervisitsweremade on requestbypatientsofthefacilitiesfollowingcontacteitherbytelephoneorthroughmessagesleftintheOfficialVisitors’suggestionboxes,whicharelocatedinthefacilities.

Adutytelephoneserviceisprovidedtothepublic.ThisrequiresamobiletelephonetobestaffedonarosterbasisbytheOfficialVisitors.AlogofthecallsismaintainedbyeachrosteredOfficialVisitorandresponsestoconcernssometimesincludeavisittothecarefacility.ContactdetailsformentalhealthservicessuchastheMentalHealthCrisisTeamareprovidedifdeemedappropriate.

StaffatthefacilitieshavebeenextremelycooperativeandopenwiththeOfficialVisitors.Inmanyinstances,staffhavegoneoutoftheirwaytoassisttheOfficialVisitorsincarryingouttheirduties.Detailedreportsareprovidedtotheteamleadersandtoseniormentalhealthstaffaftereachvisit.Thereportssummariseallmattersraisedduringthevisitsbypatientsandstaffanddiscussedwiththeteamleader.Half-yearlyreportsareprovidedtotheMinisterforHealth.

Adequacy of assessment and treatment services ACTMentalHealthanditsstaffarecommittedtoimprovingthequalityofcareatallfacilities.Thestaffatthefacilitiesendeavourtoimprovetheexperiencesoftheirpatientsandtodeveloppracticesandproceduresaimedatthelong-termbenefitofpatients.Aftermorethanayearofoperating,theAMHUatCanberraHospitalcontinuedtobefavourablycommentedonbymanyconsumers.

AnnexedReports359

TheOfficialVisitorscontinuetobeimpressedbyHysonGreenandtheOPMHIU,whichpresentasverywellequippedandwellstaffed.Botharemodern,light,spaciousanddesignedforcomfortandsafety.Forthefirsttimeinthreeyears,HysonGreenremainedopenduringtheChristmasperiod.TheOPMHIUandBHRCfacilitatetheirstaffaccompanyingpatientsintothecommunityafterdischargeandassistingintheirfollow-up.

CalvaryWard2Nprovidesawiderangeofactivitiesfortheirpatients,includingdiscussiongroups.Positivecommentsareconsistentlyreceivedfromconsumersattheunit.Staffarefavourablymentionedandgenerallythepatientscommentthattheyexperienceacalmandpleasantstay.Thenewsmokingbanshavenotposedtoomanyproblems.

Appropriateness of recreation, occupation, education, training and rehabilitation servicesEachfacilityoperatesarangeofthesetypesofprogramsandmadechangesin2012–13toimprovetherelevanceandeffectivenessoftheseactivities.Thegeneraldirectionistoenhancetheservicesprovided.

BHRC’srehabilitationandrecreationfocusisonpatientparticipationincommunityprogramsoutsidethefacility—forexample,activitiesattheBelconnenCommunityCentre.Patientsareencouragedtocommenceexternalcourses.Withinthefacility,programstailoredtoindividualpatientneedsareoffered,suchashealthycookinglessons,mediastudies,relaxationtechniquesandgardening.Computeraccessisalsoavailable.Consumermeetingshavebeenheldregularly.Thefacilityhasbeenchallengedbymanagingforensicpatients.

CalvaryWard2Nhasdailyactivitiesonweekdaysforallpatientsandwasrecentlycommendedbyanaccreditationteamforitscommunityengagement.GroupprogramsrunbyWard2NandHysonGreenareverypopularwithinpatientsandoutpatients.TheOPMHIUencouragespatientstobeasactiveandindependentaspossible,althoughactivitiesarerestrictedbytheageanddisabilitiesofconsumers.

Whether services are provided in the least restrictive environment possibleInpatientsinpsychiatricfacilitiesareadmittedonavoluntaryorinvoluntarybasis.Enforcinginvoluntarydetentioninvolvesareductionofanindividual’sfreedomwhiletreatingtheirmentalillness.Patientsafetyisaparamountconcern,asisthesafetyofthestaffinvolved.Whileallfacilitiesmustprimarilyassistpatientstoimprovetheirmentalhealth,theyfocusonenhancingtheskillspatientsneedtoreintegrateintothecommunityandaimtodiscouragedependencyoninpatientfacilitiesandreducethedurationoftheiradmissiontime.

TheAMHUcontinuedtoemphasisereducingboththefrequencyandthedurationofseclusion,andduringvisitsthisyearitwasveryevidentthattherateofseclusioninthefacilityhadbeenreduced.

Commendably,BHRChasmademanyeffortstoensureitsconsumersareintegratedwherepossibleintocommunity-basedprogramstofacilitatetheirtransitionfromthefacilityintothecommunity.

Any contraventions of the Mental Health (Treatment and Care) ActNocontraventionshavecometotheattentionoftheOfficialVisitors.

Complaints received from persons receiving treatment and care for mental illness or dysfunction Ingeneral,patientsandtheircarersprovidepositivefeedbackabouttheirexperiencesinthefacilities.Issuestakenupwithandactedonbytheunitsinclude:

• treatment issues

• maintenanceandcleanlinessissues

• smokingbans

• dischargeplans

• lackofstimulation


• gymaccess

• physicalfacilities

• accesstostafforperceivedinadequaciesintreatmentandinterpersonalrelationships

• adequacyorotherwiseoffoodprovidedforpatients

• anydevelopingtrends—forexample,inAbsenceWithoutLeave(AWOL),electro-convulsivetherapy(ECT)treatmentnumbersandseclusions.

Reports to the Minister for HealthThePrincipalOfficialVisitorprovidedthefollowingwrittenreportstotheMinisterforHealth:

• twohalf-yearlyreportsforthereportingyear.

Mental Health Official Visitors PeopleworkingasMentalHealthOfficialVisitorsduringtheperiodwere:

• SueConnor,PrincipalOfficialVisitor

• PamelaBurton,OfficialVisitor

• KayBarralet,OfficialVisitor

• ShannonPickles,OfficialVisitor.

Average length of service by gender

Average length of service (years) Female Male Total

0–2 1 1 2

2–4 0 0 0

4–6 0 0 0

6–8 1 0 1

8–12 1 0 1

Total average length of service by gender

Gender Average length of service

Female 7 years, 3 months

Male 1.5years

Total 5.5years

Sue Connor

Principal Official Visitor 14 July 2013

AnnexedReports361

Radiation Council Annual Report 2012–13

Chair’s reviewItismypleasuretopresenttheAnnualReportoftheRadiationCouncilfor2012–13.

TheRadiationCouncilhashadaproductiveyearandhascontinuedtoaddressissuesconcerninglicensing,registrationandradiationsafetyrequirementstoprovideadequateradiationprotectiontothecommunity. ThecouncilcontinuestoaddressissuesandupdateprocedurestomaintaincompliancewiththeRadiation Protection Act 2006.

Thecouncilcontinuestomonitorthedevelopmentofcodesofpractice,standardsandregulationsfromtheAustralianRadiationProtectionandNuclearSafetyAgency(ARPANSA)regardingradiationsafety.InformationreceivedfromARPANSAisconsideredindecisionsmadebythecouncil.

ThecouncilwelcomesDrAJavaid,whowasappointedfromOctober2012forathree-yearterm.WealsowelcomethereappointmentofDrSGeogheganforafurtherthreeyears.

IwishtoexpressmyappreciationtothemembersofthecouncilfortheirexpertcontributionandtothestaffoftheHealthProtectionServicefortheirongoingsupport.

Council functionsThe Radiation Protection Act 2006 www.legislation.act.gov.aucontrolsthesafeuse,storage,transportationanddisposalofradioactivematerialandirradiatingapparatus.TheRadiationCouncilisestablishedunderPart5oftheRadiation Protection Act 2006,andhasthefollowingfunctions:

• issuinglicences

• registeringregulatedradiationsources

• advisingtheMinisteronradiationprotectionissues

• exercisinganyotherfunctiongiventoitunderthe Radiation Protection Act 2006oranotherterritorylaw.

Council membership ThecompositionoftheRadiationCouncilisspecifiedintheRadiation Protection Act 2006andmustconsistof:

• onememberwhoisadoctorregisteredundertheHealth Practitioner Regulation National Law (ACT) in the specialistareaofradiology

• onememberwithexpertknowledgeofthephysicalpropertiesorbiologicaleffectsofradiation

• apersonwho,intheMinister’sopinion,hasqualificationsorexperiencerelevanttoassistingthecounciltocarryoutitsfunctions

• amemberofthepublic

Acouncilmembermustnotbeappointedforlongerthanthreeyears.

MrAAgostino Chair

Prof.LKFifield DeputyChair

DrMDespois Member

MsECroft Member

DrAJavaid Member

DrSGeoghegan Member

MrsJIBennett CommunityRepresentative

HealthProtectionServiceofACTHealth Secretariat


Council meetings 2012–13Thecouncilmeetsapproximatelyeverysixweeksandmetninetimesduringtheyear.MeetingswereheldinJuly,September,OctoberandNovemberof2012andinJanuary,February,April,MayandJuneof2013.

Regulatory standardsAnumberofstandards,codesofpractice,safetyguides,andrecommendationsareusedbythecouncilasareferencewhenconsideringmattersrelatingtoradiationprotectionpolicies,practices,conditionstobeattachedtolicences,registrationsandexemptionsfromtheapplicationoftheRadiation Protection Act 2006.ThisincludestheARPANSApublications,suchastheRadiationProtectionSeries(RPS)publications,whichareavailablefreeofchargefromwww.arpansa.gov.au.

National Directory for Radiation Protection The National Directory for Radiation Protection (theDirectory)providesthebasisforachievinguniformityofradiationprotectionpracticesandlegislationacrossallAustralianjurisdictionsforbothionisingandnon-ionisingradiation.TheDirectoryisaconstantlyevolvingdocumentthatreflectsthebestradiationprotectionpracticeofthetime.TheDirectoryisupdatedfollowingaprescribedprocess,designedtomeettheCOAG Principles and Guidelines for National Standard Setting and Regulatory Action by Ministerial Councils and Standard-setting Bodies (November 1997),andafteramendmentsareendorsedbytheAustralianHealthMinisters’Conference.

TheDirectorywasrepublishedinJuly2011toincludeAmendmentNo.5.ThisamendmentaddedtwoCodesofPracticetoSchedule11;theCodeofPracticeforRadiationProtectioninVeterinaryMedicine(RPS17)andtheCodeofPracticeforRadiationProtectionintheApplicationofIonizingRadiationbyChiropractors(RPS19).

ThecouncilisregularlybriefedondevelopmentswithregardtotheworkoftheNationalRadiationHealthCommittee(RHC)ofARPANSA.TheACThasajurisdictionalrepresentativefromACTHealthappointedtotheRHC.

Council activities

Approvals and decisions

LicencesIn2012–13thecouncilissued186newlicencestodealwitharadiationsource.Togetherwithlicencesre-issuedduringtheyear,thetotalnumberofradiationlicenceholdersintheACTwas1057.

RegistrationsIn2012–13thecouncilregistered52newradiationsources.Togetherwithsourcesre-registeredduringtheyear,thetotalnumberofregisteredradiationsourcesintheACTwas553.

Radiation incidents Thefollowingradiationincidentswerereportedtothecouncilduringtheyear:

Radiotherapy:threeincidents

• two*incidentsinvolvedmisalignmentoftreatmentarea

• oneincidentinvolvedequipmentmalfunction

Nuclearmedicine:oneincident

• oneincidentinvolvedthecontaminationwithordispersalofaradioactivematerial.

Soildensitygauges:oneincident

• one*incidentinvolveddamageto,ormalfunctioningof,aradiationapparatusorsealedsource.

AnnexedReports363

Followinginvestigation,threeofthereportedincidents(markedabovewithanasterisk—*)werereferredtoARPANSAforinclusionontheAustralianRadiationIncidentRegister.InlinewiththeACT Health Risk Management Guidelines,thethreeincidentsreferredtoARPANSAwereconsideredtobeofminorconsequence.Theremainingtwoincidentsweredeemedinsignificant.Theareasinvolvedundertookreviewsofworkingsystemsandwherenecessary,amendedprocedurestoreducethelikelihoodofsimilarincidentsoccurringinthefuture.

Enforcement and remedial actions by the councilNoinvestigationsorlegalproceedingswerecommencedin2012–13.

Contact detailsAllcorrespondenceshouldbeaddressedto:

Secretariat RadiationCouncil c/oHealthProtectionService LockedBag5005 WESTONCREEKACT2611 Phone: (02)62051700 Email: [email protected] Website: www.health.act.gov.au\radiationsafety

Tony Agostino

Chair, July 2013

www.health.act.gov.au\radiationsafety


Veterinary Surgeons Board Annual Report 2012–13

Requirement for the reportThisreportisprovidedinaccordancewiththeAnnual Reports (Government Agencies) Act 2004andtheAnnualReports(GovernmentAgencies)Notice2013(No.1).

Functions, aim and goals of the BoardTheACTVeterinarySurgeonsBoardadministersSchedule12,VeterinarySurgeons,totheHealthProfessionalsRegulation2004.TheHealth Professionals Act 2004chargestheBoardwithresponsibilityfortheregistrationofappropriatelyqualifiedpersonsasveterinarysurgeonsandveterinaryspecialists,enablingthemtopractiseveterinarysurgeryintheAustralianCapitalTerritory.TheBoard:

• ensuresthattheinterestsofthepublicandthewelfareofanimalsintheACTareprotected

• ensuresthatonlyproperlyqualifiedpersonsareregisteredasveterinarysurgeonsintheACT

• providesadvicetogovernmentagenciesandinterestgroups

• conductsinquiries,asrequired,toensureprofessionalstandardsofpracticearemet.

Membership of the BoardPresident DrKevinDoyleAM

Deputy President DrJohnAspleyDavis

Members DrSimonMorris DrRogerMeischke DrSarahWebb DrStevenRoberts

Community Representative MsEileenJergaAM

Secretariat HealthProtectionService

AllmembersservetheBoardinapersonalandhonorarycapacity.

Meetings of the BoardFrom1July2012to30June2013,theBoardmetoneightoccasions.MeetingsweregenerallyheldmonthlyatHowardFloreyCentenaryHouse,25MulleyStreet,Holder.

President’s reportIampleasedtopresenttheAnnualReportoftheVeterinarySurgeonsBoardfortheyearended30 June2013.

TheBoardpreviouslyreporteditsrelocationfromtheHealthProfessionsRegistrationBoardstotheHealthProtectionService(HPS)oftheACTGovernmentHealthDirectorate,locatedatHowardFloreyCentenaryHouseinHolder.Asaresultoftherelocation,anewdatabasewasrequired.ThiswasdevelopedtoallowabetterserviceforregisteredveterinarysurgeonsandtheBoard.Thetestingofthedatabasewascompletedin2012.

AnnexedReports365

TherelocationcreateddifficultiesfortheBoardinthatsomerecordsandcorporatememorywerelost.Inaddition,whenmanagedasoneofninehealthprofessionboardsservedbyaprofessionalsecretariat,theBoardhadaccesstoresourcesbeyonditspart-timeregistrar/executiveofficer.ThishasnotbeenpossiblewithintheHPS.Whileextraresourceshavebeenmadeavailable,theirdutieshavehadtobecarriedoutinadditiontotheirongoingtasks.Ithasbecomeclearthatapart-timeregistrar/executiveofficerisnotadequate.TheBoardagreedatitsMarch2013meetingtoappointafull-timeregistrar.EffortsarebeingmadetoensurethatthemoveoftheBoardtotheTerritoryandMunicipalServicesDirectoratewillprovideaccesstothenecessaryresources.

TheBoardreportedlastyearthatitwasclearthatchangesmustbemadetothelegislationtoupdateitandtobringitintolinewithcontemporarylegislation.Thisincludedharmonisingitwiththelegislationoftheotherjurisdictionsandprovidingfornationalrecognitionofveterinaryregistration(NRVR).TheBoardsupportsNRVRandwillcontinuetoworkonitsimplementation.

TheBoardsetshighstandardsforprofessionalcompetenceinordertoensurepublicprotection,whichincludessupportingandenforcingthemandatoryprofessionalindemnityinsurance.

TheBoardhasbeenactiveintheaffairsoftheAustralasianVeterinaryBoardsCouncil(AVBC),onwhichitisrepresentedbyDrJohnAspleyDavis.TheBoardsupportsAVBCeffortstopromotecooperationinstrategicplanningforthefutureofregisteredveterinarysurgeonsandtohelpimproveveterinaryservicesprovidedtothecommunity.ThisyeartheAVBCconferencewasheldinCairns.

DrStevenRobertswasappointedtotheBoardduringtheyearandprovidesparticularexpertiseonhorses.

MyappreciationisextendedtoallmembersoftheBoardfortheirconsiderableeffortsduringtheyearandoverthetermoftheirappointments.

AsaresultofthereviewintotheACTGovernmentandtherecommendationmadeinitsfinalreport,Governing the City State: One ACT Government—One ACT Public Service,theBoard’ssecretariattransferredtotheTerritoryandMunicipalServicesDirectorateon9July2013,followingthe2013–14registrationrenewalprocess.TheBoardthankstheHealthProtectionServiceforitssupporttotheBoard.

RegistrationAt30June2013,261veterinarysurgeonshadcurrentregistrationsintheACT.TheBoardcontinuedtoprocessapplicationsforinitialregistrationsandregistrationsundertheprovisionsoftheMutualRecognitionAct.

Number of registrants

Year 2006 2007 2008 2009 2010 2011 2012 2013

Total 246 253 260 236 272 256 245 261

ActivitiesTheBoardaddressedissuesrelatedtothefollowingtopicsduringtheyear:

• professionalstandardsmatters

• recencyofpractice

• continuingprofessionaldevelopment

• nationalrecognitionofveterinaryregistration

• policyreview

• database.


Complaints and disciplinary actionTheBoardrecognisesthatmanycomplaintsemergefrompoorcommunicationbetweenpartiesabouttheservicetobeprovidedortheservicethatisprovided.Thiscanresultinintransigencefrombothpartiesinresolvingcomplaints.

In2012–13,theBoardjointlyreviewedthecomplaintprocesswiththeHumanRightsCommissionandtheGovernmentSolicitor’sOffice.TheBoardispleasedtoreportthesuccessoftherevisedprocess.AllcomplaintsmadetotheBoardhavebeenprocessedandthevastmajorityresolved,withonlythreecomplaintsongoing.

TheBoardinvestigatedanumberofcomplaintsorprofessionalstandardsissuesthroughouttheyear.

Matters of significance

National recognition of veterinary registrationTheBoardsupportstheprocessbeingputinplacebytheAVBCandPrimaryIndustriesStandingCommitteetomovetowardsNationalRecognitionofVeterinaryRegistration(NRVR).Eachjurisdictionwillretainitsownboardandlegislationbutwillrecogniseregistrationinotherjurisdictionsasarighttopractiseineveryjurisdictionwithoutfurtherregistration.Thiswillachievemobilityofveterinarysurgeonsbetweenjurisdictionsandassistintheaimofachievingconsistencyofstandards.TheBoardhopestointroduceprocessesinthenextfinancialyearforNRVRintheACT.

Continuing veterinary professional developmentContinuingprofessionaldevelopment(CPD)iscompulsoryinalltheACThealthprofessions.TheACTisamonganumberofAustralianjurisdictionstohavecompulsoryCPDforveterinarysurgeons.Itisimportantthatallregisteredveterinarysurgeonsdemonstrateacommitmenttocontinuingprofessionaldevelopmentiftheywishtorenewtheirregistration.

Australasian Veterinary Boards CouncilTheannualgeneralmeetingoftheAustralasianVeterinaryBoardsCouncil(AVBC)washeldinCairnsinMay2013.DrJohnAspleyDavisistheBoard’srepresentativeonthecouncil.TherewasattendancebyrepresentativesandtheirregistrarsfromtheNewZealandVeterinaryCouncilandallstateandterritoryboards.Reportsweresubmittedanddiscussedonissuesconcerningregistration,uniformityoflegislation,theNationalVeterinaryExamination,NationalRecognitionofVeterinaryRegistrationandtheaccreditationofuniversityundergraduatecourses,bothinAustraliaandwiththosewhomwehaveamutualrecognitionagreement—namely,theRoyalCollegeofVeterinarySurgeonsintheUnitedKingdom.AVBCalsoacceptsgraduateswhohavequalifiedundertheremitoftheAmericanVeterinaryMedicalAssociation,whichincludesanincreasingnumberoffacultiesnotontheNorthAmericancontinent,andtheSouthAfricanVeterinaryBoard.Thistime,viaSkype,allthestatesandterritoriessignedoffonamutualrecognitionagreementwithSouthAfricawhichentitlesgraduatesofAustraliaandNewZealandtopractisetherewithoutfurtherexamination.Previously,therecognitionwasonlyinfavourofSouthAfricangraduates.

FinancesTheBoardisnotaterritoryauthorityforthepurposesoftheFinancial Management Act 1996(seetheFinancialManagement(TerritoryAuthorities)Declaration2005(No.1)).TheBoardisself-funding,withaccountmanagementundertakenbytheHealthProtectionServiceaspartofitssecretariatfunction.AsummaryoftheBoard’sfinancesisprovidedforinformation.

Carryover $139,093

Revenue $77,667

Expenditure $82,676

Carriedforward $132,084

AnnexedReports367

Liaison with Australian Veterinary Association (AVA)TheBoardmaintainsliaisonwiththeAVAtoensureafreeexchangeofviewsandinformation.TheAVAprovidescontinuingeducation,mentoringandotherformsofassistancetoveterinariansintheACT.Thisisparticularlyimportantfornewgraduates.

TheBoardtakesthisopportunitytoacknowledgethecooperationoftheAVA.

Contact detailsTheACTVeterinarySurgeonsBoardwastransferredtotheTerritoryandMunicipalServicesDirectorateon 9July2013.InformationontheBoardcanbefoundatwww.tams.act.gov.au/parks-recreation/plants_and_animals/veterinary-surgeons-board.

Dr Kevin Doyle

President

www.tams.act.gov.au/parks-recreation/plants_and_animals/veterinary

www.tams.act.gov.au/parks-recreation/plants_and_animals/veterinary


Index

AAboriginalandTorresStraitIslandercommunity

Aboriginalidentification,138alcoholanddrugrehabilitation,190–1,289,299engagementwith,149,154,182healthandwellbeing,111,156,289,298–300,307healthworkforce,117,247,248,300immunisationrates,8,111,169,170mental health services, 154, 300NgunnawalBushHealingFarm,166,270,289,299Reconciliation Action Plan, 182, 300recordspreservation,288scholarships, 259WinnungaAboriginalHealthService,134,154,298,299

AccessUnit,131–3accommodation

healthfacilities,116,267officeaccommodation,268,295foroutpatientsorcarers,116,269

accountability see internal accountabilityaccreditation,4,9,138,149,162,172,173,245,247,295ACTDiabetesServiceWorkingGroup,134ACTGovernmentagencies,7ACTGovernmentAnalyticalLaboratory,4,101ACTLocalHospitalNetworkseeLocalHospitalNetworkACTMedicareLocal,7,134,135,137,144,149,158,165,170,

172, 237, 305ACTNewbornRetrievalService,146ACTPathology,138–41ACTPolicingseepoliceforcesACTQualityinHealthcareAwards,142,165,172,245acuteservices,97–8,349–50

access to, 118, 126contractors, 277general/acutemedicine,136performance,97–8,119–51,349–50visitingmedicalofficers,279–82

addressandcontactdetails,xi,226adolescenthealthservicessee youth health servicesAdultAcuteMentalHealthInpatientUnit,201AdultMentalHealthUnit,99,153,154,201,355AdultSecureMentalHealthUnit,270agedcare,104–5,351

multiculturalstrategy,301–2performance,104–5,163–6,351residentialcareplacement,165,166strategicplan,303–5

agedcareassessments,8,110,163,164,166ageingpopulation,8,109airqualitymonitoring,159alcoholanddrugservices,99–100,152–5

forAboriginalandTorresStraitIslanderpeople,190–1,289,299communityengagement,181contractors, 277strategy,243–4visitingmedicalofficers,282

alcoholanddruguse,156,298,299AlexanderMaconochieCentre,100,136,154,181,213,241alliedhealth,163–6

clinical placements, 258communityengagement,183–4educationandtraining,149,258recruitment, 253

assetmanagement,17–18,267–8see alsofinancialperformance

asylumseekers,302AuditandRiskManagementCommittee,222,234audits,321–2

ACTAuditor-General,21,23–4,94–5,199–200internalaudit,222

AussieNormalsstudy,140AustralianCatholicUniversityClinicalSchool,7,149AustralianCouncilonHealthcareStandardsaccreditation,9,

172, 245, 295AustralianFederalPolice,135AustralianInstituteofHealthandWelfare,119,121AustralianNationalUniversity,139,140,171,241

MedicalSchool,7,11,133,140,146,161AustralianPrimaryHealthCareResearchInstitute,144AustralianResearchCouncil,171,173,245AustralianWorkplaceAgreements,264awards(recognition),132,133,146,154,161,165,172,247,

253 see also scholarships

Bbabies seechildren;children’sservices;maternityservices;paediatricservices

bacteraemialinfection,8,112bedoccupancyrateseehospitalbedsBelconnen Community Health Centre, 10, 128, 142, 162, 166, 270bicyclefacilities,244,294,297BimberiYouthJusticeCentre,155,299birth,lifeexpectancyat,8,109,167births,4,122–3,147bloodandbloodproducts,12,14,15blood-borneviruses,135,239,242,300bowelcancerscreening,170brain cancers, 160breastscreening,5,8,113,161,162,170,307breastfeeding,144,243,308brokenhips,9,114budgetseefinancialperformancebuildingaudits,268see alsocapitalworksbullyingandharassment,224,247,253burdenofdisease,9,167,171bushfiremanagementplans,266BusinessandInfrastructurebranch,116

Ccaesareanrates,122–3CalvaryHealthCareACT,148–51,353CalvaryNetworkAgreement,150CalvaryPublicHospital,7,10,12,148–51

achievements,149–50emergencydepartment,112,269localhospitalnetwork,116,314,351 see alsoLocalHospitalNetworkDirectorate

parkingfacilities,150performanceindicators,112,352servicesdelivered,117statementofperformance,349–51

Index 369

Canberra HospitalCatCHProgram,123iPaTCH, 146localhospitalnetwork,116,314,351mealmanagement,116MediHostel,133performanceindicators,112,117,352servicesdelivered,10,117–18see also acute services

CanberraHospitalandHealthServices,7,9,117–18,234,314,351CanberraHospitalEmergencyDepartment,9,10,111,117–18,

352 see alsoemergencydepartmentsCanberraHospitalOutpatientServices,161CanberraInstituteofTechnology,7,139CanberraMothercraftSociety,353CanberraRegionCancerCentre,10,162,270cancerburdenofdisease,9Cancer Council Australia, 161cancerservices,8,10,102–3,117

CalvaryPublicHospital,350–1communityengagement,190contractors, 278futuredirections,162informationmanagementsystem,160outpatientaccommodation,116performance,102–3,160–2,350–1radiationoncology,9,160,161treatment centre, 10, 162, 270treatmentsandtargets,4,161visitingmedicalofficers,282

CapitalRegionCancerService,102,117,160–2,190see also cancer services

capitalworks,32,108,269–73see also healthcare infrastructure

carpooling,294cardiologyservices,127,134cardiovasculardisease,9,109carerparticipationseeconsumerandcarerparticipationCarers ACT, 150, 304CentenaryHospitalforWomenandChildren,9,10,12,117,143–4,147,269,270,308

CentralVenousAccessDevicesWorkshop,257cervical cancer, 160CervicalScreeningProgram,8,112,169–70CHARMcancerinformationmanagementsystem,160chemotherapyprescribing,dispensingandadministrationsystem(CHARM),160

ChiefHealthOfficer,156,158,225,228ChiefPsychiatristAnnualReport2012–13,354–5ChildandAdolescentMentalHealthService,153,155childprotectiontrainingforstaff,254children

AboriginalandTorresStraitIslandercommunity,298–9births,4,122–3,147healthpromotion,167,168,284,289–90hearingscreenings,170,298multiculturalstrategy,301atrisk,106,170

children’sservices,143–8,170ACT Children’s Plan, 239immunisationseeimmunisationmental health services, 153, 155, 256neonatalcare,117,123,143,145–6,170,255,269see alsoCentenaryHospitalforWomenandChildren;paediatricservices;QueenElizabethIIFamilyCentre

chronicdiseaseburdenof,9,167,171communityengagement,179–80management,8,134–5,146,148preventionandriskreduction,167–73strategies,170,237–8,305

circulatorydisease,8,109ClareHollandHouse,116,146,148,314,351,353climatechangeandgreenhousegasreduction,297ClinicalForensicMedicalServices,135clinicalhandover,133clinicalinformationseehealthrecords;patientadministration

systemsClinical Senate, 235Clinical Services Plan, 236CommissionerfortheEnvironment,289–90committees

HumanResearchEthicsCommittee,356–7LegislativeAssemblycommittees,202–17PrimaryHealthandChronicDiseaseStrategyCommittee,

236seniormanagementcommittees,229–34

communicablediseasehazards,responseto,101communicationbetweenACTHealthandGPs,246communitycare,104–5,117,163–6,183,190see also health educationandpromotion

communityengagement,111,154,178–94communitygrants,assistanceandsponsorship,283–6community health centres, 9, 10, 12, 118, 128, 134, 142, 153,

161, 162, 164, 166, 269, 270community pharmacies, 158COMPASSprogram,255compensationclaims,175,262–3complaintshandling,309,359–60ComputerisedPhysicianOrderEntry,141conferenceattendance/presentation,139,166consultants,274–6see alsocontractingconsumerandcarerparticipation,8,111,154,286,304see

alsocommunityengagementconsumerfeedback,265,309ContinuityattheCanberraHospital(CatCH)Program,123contracting,274–82controlledmedicines,158corporate/operationalplans,6,144,149,170,235–46,266corporategovernanceseeexternalscrutiny;internalaccountability;internalscrutiny

costofservices,13,22see alsofinancialperformanceCouncilofAustralianGovernments,116,241,242,298,307,

362 see alsoNationalPartnershipAgreementscourt cases, 265criticalcareseeacuteservices;DivisionofCriticalCarecrossborderagreementsandactivity,16,18,54,135,143,146,355

Ddangeroussubstances,310deliriumdiagnosis,132,164dentalhealth,8,10,107,113,118,141–3depression,145,153,307DeputyDirectors-General,7deterioratingpatients,138,163,164,198,255diabetes,8,109,133–4,137Director-General,7disasterpreparedness,158see alsobushfiremanagementplansdisputeresolutionprocesses,309DivisionofCriticalCare,131–3DivisionofMedicine,132,133–8


DivisionofPathology,138–41DivisionofRehabilitation,AgedandCommunityCare,163,183

see alsoOutput1.5DivisionofSurgeryandOralHealth,141–3DivisionofWomen,YouthandChildren,132,143–8domesticviolencevictims,careof,135drivingassessments,305drugservicesseealcoholanddrugservicesdruguseseealcoholanddruguseDuffyhouse,116,269

Eearlyinterventionandprevention,106,109,112,167–73,

276, 278 see alsohealtheducationandpromotion;suicidepreventionstrategy

EarlyRecognitionoftheDeterioratingPatientProgram(COMPASS),255

ecologicallysustainabledevelopment,291–6educationandtraining

ACTPSprograms,260capacitybuildingforhealthpromotion,286clinicalprograms,256–7criticalcare,131–2e-learning,257,259,288environmental health, 159EssentialEducationprogram,254–5foodsupervisors,159infraudprevention,223futurepriorities,260generalmedicine,138graduateprograms,149humanrights,265learninganddevelopmentoutcomes,117,252–60mental health services, 153neonatal care, 255, 257paediatrics,146pathology,139pharmacyworkforce,137inqualityandsafety,173,245,252inrecordsmanagement,288rehabilitation,agedandcommunitycare,165see alsohealtheducationandpromotion;scholarships

e-health,115,139,185–6see alsoelectronichealthrecordselderlypersons,132,164,165,166,301–2,303–5e-learning,257,259,288electivesurgery

operationsperformed,5,123–4,142performanceindicators,352waitinglist/times,8,10,107,117,125–6,130–1,352

electronichealthrecords,115,148,149,304electronicmedicationmanagementsystems,304emergencydentalhealthservices,8,107EmergencyDepartment,131–3,148,164,199,352emergencydepartments,8

accesstargets,130,132Calvary expansion, 269demand,126–7,131,132performanceindicators,352presentationsto,5,117,352timeliness,4,8,113,127,130,148,352

emergencyplanninganddisasterpreparedness,158see also bushfiremanagementplans

emergencysurgery,123–4employees/employmentarrangementsseestaffendocrinologyservices,133–4,137endoscopyservices,136,137,170

energyuse,174,175,291–2,295enterpriseagreements,247environmentalhealthhazards,responseto,101environmentalperformance,118,291–6,297EssentialEducationPolicy,117ethicalstandards,274,356–7ExecutiveCouncil,230,236ExecutiveDirectorsCouncil,231exercisephysiology,163,164expenses,12–15,20–2,174see alsofinancialperformanceexternalscrutiny,195–201,224

Ffallsandfallsinjuryprevention,163,284,305feedbackaboutcareseeconsumerfeedbackfinancialperformance(HealthDirectorate)

auditreport,23–4financialstatements,25–93report,12–22triplebottomlinereport,174–5

financialperformance(LocalHospitalNetworkDirectorate)auditreport,321–2financialstatements,323–45report,315–20

fireriskassessment,266foodregulationandsafety,101,157,159see alsonutritionfoodservicemanagementsystemsinhospitals,116forensicservices,135,155fracturedfemurs,9,114fraudprevention,223freedomofinformation,196,225–7fuelconsumption,293–4,295fundingroundsseecommunitygrants,assistanceand

sponsorshipfuturedirections

Calvary Health Care, 151cancer services, 162criticalcare,132–3DivisionofMedicine,137–8earlyinterventionandprevention,171mentalhealth,justicehealthandalcohol/drugservices,155outlookfor2013–14,10pathology,140–1publichealthservices,158–9rehabilitation,agedandcommunitycare,166trends(expenses/revenue),13,15,17,315,316,317women’sandchildren’sservices,147–8

Ggastroenterologyandhepatologyservices,136,137generalpractice–ACTHealthcommunication,246general/acutemedicineservice,138glossary,xGoodwinAgedCareServices,118,127,165grantsseecommunitygrants,assistanceandsponsorshipgreenhouseemissions,174,175,293,294,297GuganGulwanYouthAboriginalCorporation,298,299GungahlinCommunityHealthCentre,9,12,118,134,161,164,269gynaecologyseematernityservices;women’shealth

Hhaematology,160,161,162harassment seebullyingandharassmentHealth Act 1993, 116, 230, 235, 331, 351

Index 371

HealthandCommunityCare(OutputClass1)performance,97–106

healthandwellbeingseehealthylifestyles;mentalhealthservices;workplacehealthandsafety

healtheducationandpromotion,167–71,283–6,289–90,303HealthEmergencyPlan,158HealthImprovementBranch,156,158,187–9HealthInfrastructureProgram,10,166,197,233,269–70,275,297HealthLeadershipNetwork,247healthpromotionseehealtheducationandpromotionHealthProtectionService,156–7,158,186–7healthrecords,115,148,149,200,304see alsoe-healthHealthServicesPlanningUnit,191–2health surveys, 156healthworkforce

AboriginalandTorresStraitIslander,117,247,248,300alliedhealth,165communityengagementinplanning,194developmentof,247diversity,175,248geriatricians,166haematologists,160,161,162nurses seenursingworkforceplans, 9, 117, 233, 242, 247recruitment,200,253–4shortages,247staffingprofile,249–51see alsoeducationandtraining

HealthWorkforceAustralia,9,12,117,247healthcare consumers seeconsumerandcarerparticipationhealthcareinfrastructure,10,108,115,166,233,269–73,275,297Health-eFutures,115healthylifestyles,167–8,283,289–90,298,303–4see also nutrition;physicalactivity

HealthySchools,HealthyChildrenFundingRound,284–5hearingscreenings,170,298heartdiseaseseecardiovasculardiseasehepatitisC,239hepatologyseegastroenterologyandhepatologyserviceshospitalbeds

additionalemergencyfacilities,127availability, 10, 118, 121capacity,119–20,127occupancy rates, 108, 121, 353

Hospital in the Home service, 119, 133, 136, 138, 149HumanPapillomavirusvaccinationprogram,169HumanResearchEthicsCommitteeAnnualReport2012–13,356–7humanresourceperformance,247–8see alsostaffhumanrightsissues,265Hume Health Centre, 153

Iimmunisation,5,8,106,111,145,167–70,175infectioncontrol,133influenzavaccinations,169,175InformationCommunicationandTechnologyCommittee,232informationmanagement,157,195see alsohealthrecords;patientadministrationsystems;TerritoryRecords

informationsources,xiinformationtechnology,149,157,232,304intensivecare,115,131–3

neonatal, 117, 143, 145, 269, 308internalaccountability,228–46internalaudit,200,222internalscrutiny,195–201Internethomepage,xii

interpreter services, 301iPaTCH, 146

Jjusticehealthservices,99–100,152–5,277,282

KKarralikaProgramsInc.,307kavause,157,158,186

Llakesandriversmicrobiologicalstatus,158languages,301leadership,115,132,,252–3learninganddevelopment,252–60,286see alsoeducationandtraining

legislation,116,154,155,218,265,355LegislativeAssemblycommitteeinquiriesandreports,202–17liabilities,19–20see alsofinancialperformancelifeexpectancy,8,9,109,167lifesupportprograms,255linear accelerators, 9litigation,265,309LittleCompanyofMary,7,148see also Calvary Health Care ACT;CalvaryPublicHospital

LocalHospitalNetwork,116,314,351strategicindicators,351–3see also public hospital services

LocalHospitalNetworkCouncil,116,172,235LocalHospitalNetworkDirectorate,12,116

financialperformance,315–22financialstatements,323–45OutputClass1:ACTLocalHospitalNetwork,349–53overview,314riskmanagement,314statementofperformance,346–8

Mmalnutrition,165managementdiscussionandanalysis,11–22maternityservices,143–8,243,298,299,307–8see also CentenaryHospitalforWomenandChildren

MedicalAssessmentandPlanningUnit,131–2,138medicalimaging,141–3medicaloncologysee cancer servicesMedicalRadiationScientistsBoard,xiiiMedicalShortStayUnit,132,138medicaltechnology,139,149MedicareLocalseeACTMedicareLocalmedicationmanagementsystems,304MediHostel,133mentaldisordersburdenofdisease,9MentalHealthACTOfficialVisitorsAnnualReport2012–13,358–60

MentalHealthCommunityPolicingInitiative,153mentalhealthservices,8,10,110,152–5

AboriginalandTorresStraitIslandercommunity,154,300AdultMentalHealthUnit,153,154,201,270Calvary Public Hospital, 350children,153,155,256clientreturnrate(tohospitalafterdischarge),111communityengagement,111,154,180–1CommunityPolicing,153


mental health services (cont.)consumerandcarerparticipationinrelevantcommittees,5,

8, 111, 154, 304contractors, 277legislationreview,154,155,181,265,355OfficialVisitorsAnnualReport,358–60performance,99–100,304,350perinatalmentalhealth,145,153,307–8plansandstrategies,240–2psychiatricservices,354–5seclusionofclients,8,110visitingmedicalofficers,282workforcetraining,256youth, 116, 155, 256see alsosub-acutecare

Mental Health (Treatment and Care) Act 1994, 218, 354, 355, 358nocontraventionsof,359reviewof,154,155,181,265,355

microbiologicaltestingoflakesandrivers,158midwives,123,149,184,253–4,257,259MinisterforHealth,2ModelLitigantGuidelines,309multiculturalstrategy,301–2

NNationalElectiveSurgeryTargets,10,117,130–1see also electivesurgery

NationalEmergencyAccessTargets,130,132NationalHealthFundingBody,116NationalHealthReformAgreement,10,116,351–2NationalMentalHealthPlan,242NationalPartnershipAgreements,115,116,130,132,167,241,

298, 299, 307NationalSafetyandQualityHealthServiceStandards,136,171,

245, 246, 252, 255, 260, 307NeonatalIntensiveCareUnit,117,143,145,269,308neonatalservices,117,123,143,145–6,170,255,257,269neurologyservices,135,137NewSouthWalesPolice,135NewbornRetrievalService,146NgunnawalBushHealingFarm,166,270,289,299notifiablediseasesdatabase,157Nous Group, 228NursingandMidwiferyOffice,184nursingworkforce

clinical placements, 258educationandtraining,149,257,259midwives,123,149,184,253–4,257,259recruitmentandtransitiontopractice,253–4SchoolYouthHealthNurseProgram,144

nutrition,118,156,157,168,284–5,289,290,303see also foodregulationandsafety

Oobesitymanagementandprevention,10,134,137,167–8objectives,6,11occupancy rates seehospitalbedsoccupationalhealthseeworkplacehealthandsafetyofficeaccommodation,268OfficeoftheAlliedHealthAdviser,183–4OfficeoftheChiefHealthOfficer,156OfficialVisitorsseeMentalHealthOfficialVisitorsAnnualReportoncologysee cancer servicesorganisationalstructure,2–3,7,11,228outlookseefuturedirections

outpatientservices,5,116,122,136,148,161,162,163see alsoemergencydepartments

Output1.1:AcuteServicesanalysisofperformance,119–51contractors, 277statementofperformance,97–8see also acute services

Output1.2:MentalHealth,JusticeHealthandAlcoholandDrugServicesanalysisofperformance,152–5contractors, 277performance,99–100visitingmedicalofficers,282see alsoalcoholanddrugservices;justicehealthservices;

mental health servicesOutput1.3:PublicHealthServices

analysisofperformance,156–9consultants, 276contractors,277–8performance,101visitingmedicalofficers,282see also public health services

Output1.4:CancerServicesanalysisofperformance,160–2contractors, 278performance,102–3visitingmedicalofficers,282see also cancer services

Output1.5:Rehabilitation,AgedandCommunityCareanalysisofperformance,163–6contractors, 278performance,104–5see alsoagedcare;communitycare;rehabilitationservices

Output1.6:EarlyInterventionandPreventionanalysisofperformance,167–73consultants, 276contractors, 278performance,106see alsoearlyinterventionandprevention;healtheducationandpromotion

OutputClass1:ACTLocalHospitalNetwork,349–53OutputClass1:HealthandCommunityCareperformance,97–106

outreach services, 10, 133, 134, 146, 149, 165, 168, 298, 308, 353overview,8–9oxygenandrespiratoryschemes,164,196

PPacificIslandcommunity,158,186paediatricservices,132,143–8,256see also Centenary HospitalforWomenandChildren;children’sservices

painmanagement,164palliativecare,146,148,149,161,179,238,353Parkinson’sdisease,134partnershiparrangements,6,7,117,143,145,150,152,165,

172, 178witheducationsector,7,133,171,257NationalPartnershipAgreements,115,116,130,132,167,

241, 298, 299see alsoLocalHospitalNetwork

pathologyservices,138–41patientadministrationsystems,115,141,149,200see also healthrecords

patientsafetyandservicequality,112,117,171–3PeopleManagerProgram,253PeopleStrategyandServicesBranch,193–4,247

Index 373

peoplewithadisabilitytraineeships,248performance

analysisof,115–73CanberraHospitalandHealthServicesoverview,117–18LocalHospitalNetworkDirectorate,314–20,346–53statementof,94–106strategicobjectivesandindicators,107–14,351–3StrategyandCorporateoverview,115–17summary,4–5triplebottomlinereport,174–5see also Outputs

PerformanceandInformationBranch,116perinatalmentalhealth,145,153,307–8perioperativenursingtraining,256pharmacyservices,135–6,137,158Phillip Health Centre, 142physicalactivity,156,164,167,168,284–5,301,303policeforces,initiativeswith,135,153PolicyandGovernmentRelationsBranch,116,179–82,301PopulationHealthDivision,7,156–9,186–9preventioninitiativesseeearlyinterventionandpreventionPricewaterhouseCoopers,195–8PrimaryHealthandChronicDiseaseStrategyCommittee,236primaryhealthcareservices,130,143–8

strategy,236–7Walk-inCentre,9,10,128–30

procurementconsultantsandcontractors,274–8reviewofpurchasingofmedical/surgicalsupplies,196visitingmedicalofficers,279–82

prostate cancer, 160prostheticsandorthotics,9,164,166Protiviti,195,201psychiatricservices,354–5see also mental health servicespublicdentalhealthseedentalhealthPublic Health Act 1997, 156, 158PublicHealthEmergencyResponsePlan,158see also emergencyplanninganddisasterpreparedness

publichealthservices,101,110,156–9,276,277–8,282public hospital services, 8, 10, 116

bedstatisticsseehospitalbedsdemandmanagement,117–18,126–7emergencyservicesseeemergencydepartmentslocalhospitalnetwork,116,314,351–3see alsoLocalHospitalNetworkDirectorate

patientadministrationsystems,115performance,5,112,117,350–2

publicinterestdisclosure,224publications,xi,165,173purchasingsee procurement

QQuality and Safety Framework 2010–2015,245–6QualityandSafetyUnit,171–3,192see alsopatientsafetyand

service qualityQueanbeyan Hospital, 125QueenElizabethIIFamilyCentre,116,314,351,353

RRadiationCouncilAnnualReport2012–13,361–3radiationoncologysee cancer servicesradiographyseemedicalimagingradiotherapyservices,108,161,162RapidAssessmentoftheDeterioratingandAt-RiskAged(RADAR)Service,163,164

Reconciliation Action Plan, 182, 300recordsmanagement,115,148,200,287–8see also health records;patientadministrationsystems

recreationalwaters,158recruitment,200,253–4recycling,294–5,296RedevelopmentCommittee,233RedevelopmentUnit,191refugeeservices,150,302regulatorylicencefees,20Rehabilitation,AgedandCommunityCaredivision,163,183rehabilitationservices,104–5,163–6,183,351remuneration,228,264

salary expenses, 12, 13, 51renal services, 134renewableenergyuse,295research,140,171,173,245,356–7residentialcareplacement,165,166Respect,EquityandDiversity(RED)framework,247,253RespectingPatientChoicesprogram,172,304respiratoryandsleepservices,136,138,164revenue,12–13,16–18,20,22,174see alsofinancialperformance

riskmanagement,11,222,223,266,314roleandfunctions,6RonaldMacDonaldHouse,269

SSafetyandQualityCommittee,231safetyofstaffseeworkplacehealthandsafetysafetystandardsseeNationalSafetyandQualityHealthServiceStandards

salary expenses, 12, 13, 51samplesanalysed,4,101scholarships

available/provided,193,258–9,286,306awards(recognition),132,133,142

school health services, 144, 145schoolstudentsurveys,156ScoresonDoors(foodestablishments’inspectionresults),159seclusionorrestraintofmentalhealthinpatients,110SelectCommitteeonEstimates,211–17seniorexecutivesandresponsibilities,2–3,228–9seniormanagementcommittees,229–34seniors seeagedcare;elderlypersonsServiceandCapitalPlanningBranch,190–2,269sexualassaultvictims,careof,135sexual health services, 180, 239, 299, 307, 308SharedServicesProcurement,274–5sleep seerespiratoryandsleepservicessmoking

AboriginalandTorresStraitIslandercommunity,289,298,299amongyouth,8,106,114,156reduction/preventionstrategies,154,163,171,289,299

social inclusion, 138solarium ban, 158SpecialEmploymentArrangements,264spinalcordinjury,164sponsorship seecommunitygrants,assistanceandsponsorshipstaff,51

employeeexpenses,12,13,14,15,51–2employmentarrangements,228,247–8,264healthandwellbeing,175,290humanresourcemanagement,247–8learninganddevelopmentseeeducationandtrainingnumber, 51, 174, 249


staff(cont.)recruitment,200,253–4staffingprofile,175,249–51see alsohealthworkforce;seniorexecutivesandresponsibilities

staffachievementsseeawards(recognition)staffhealthandsafetyseeworkplacehealthandsafetystakeholderforums,7,234see alsocommunityengagementstandardsofservicesee Australian Council on Healthcare Standards;NationalSafetyandQualityHealthServiceStandards;strategicobjectivesandindicators

StandingCommitteeonHealth,Ageing,CommunityandSocialServices, 211

StandingCommitteeonHealth,CommunityandSocial Services, 202

StandingCommitteeonPublicAccounts,202–10StrategicBushfireManagementPlan,266strategicobjectivesandindicators

HealthDirectorate,107–14LocalHospitalNetworkDirectorate,351–3

strategicplansseecorporate/operationalplansStrategyandCorporate,7,115–17,234Street Beat, 298stroke,135,137studentworkexperienceandplacement,258studyassistance,259see also scholarshipssub-acutecare,118,127,131,166,351substanceuse/misuse,156,298,299see alsosmokingsuicidepreventionstrategy,180,241,242,300superannuationexpenses,12,13,14,52see alsofinancialperformance

surgicaloperations,141–3complications,112demand,125electivesurgerywaitinglist/time,8,10,107,117,125–6,130–1,352

emergencysurgery,123–4numberof,5,122–4,142see alsoDivisionofSurgeryandOralHealth

surveys, 156SustainabilityStrategy,244–5,291,297

Ttechnical terms, xtechnologyseeinformationtechnology;medicaltechnologyTerritoryRecords,287–8TherapeuticGoodsAdministration,161tobacco use seesmokingtrainingseeeducationandtrainingtransientischaemicattack,135transport(vehicles),174,293–4,295triplebottomlinereport,174–5TuggeranongCommunityHealthCentre,10,12,128,142,166,270

UUniversityofCanberra,7,139,140,159,165UniversityofCanberraPublicHospital,10,166,191,270UniversityofTechnologySydney,173,245

Vvaccination,167–70,175see alsoimmunisationvalues, 6vehicles(fleetvehicles),174,293–4,295VeterinarySurgeonsBoardAnnualReport2012–13,364–7violenceandaggressionvictims,servicesfor,135,308visionandvalues,6VisionImpairedHospitalKits,141visionscreening,137visitingmedicalofficers,247,279–82volunteers, 132

Wwaitingtimes

dentalhealth,107,118forEEG,135electivesurgery,8,10,107,117,125–6,130–1,352emergencydepartments,8,148,352QueenElizabethIIFamilyCentre,353

walk-incentres,5,9,10,128–30,166wastemanagement,174,175,294–5,296waterconsumption,174,175,292–3,295websites,xi,145–6wellbeingseehealtheducationandpromotionWinnungaAboriginalHealthService,134,154,298,299winterpreparednessactivities,132,158women,249–50,306–8women’shealth,106,143–8,170

AboriginalandTorresStraitIslandercommunity,298–9,307, 308

gestationaldiabetes,134maternityservices,143–8,243,298,299,307–8multiculturalstrategy,302obstetricandgynaecologicalservices,122–3strategicplan,306–8see alsobreastscreening;CentenaryHospitalforWomenandChildren

WorkHealthandSafetyCommittee,232workerscompensationclaimsseecompensationclaimsworkforceseehealthworkforce;staffWorkforcePolicyandPlanningUnit,193–4WorkforceStrategyCommittee,233workplacehealthandsafety,172,175,197,254,261–3,290,310workplacerelations,264

Yyouthhealthservices,116,143–6,155,256,298–9,301youth health surveys, 156youthsmokingrate,8,106,114,156