weddin shire council draft · weddin wellness plan 2018-2022 2 of 52 weddin shire council document...

Weddin Wellness Plan 2018-2022 1 of 52 Weddin Shire Council

WEDDIN SHIRE COUNCIL

DRAFT V9 April 2018 [email protected]

Weddin Wellness Plan –Embracing Community Health Support

2018-2022


DOCUMENT INFORMATION

Document Summary Information Version 8.0 Version Release Date 27-3-18 Document Security Council

Document History Version Amendment Amendment Date Amended by 1.0 Original 22-1-18 Sykes [email protected]

2.0 Reviewed LC 5.0 Reworked 7-2-18 Sykes 7.0 Review after stakeholder

discussion 25-3-18 Simpson


Table of Contents FIGURES............................................................................................................................................. 3

WEDDIN SHIRE COUNCIL .................................................................................................................... 5

EXECUTIVE SUMMARY ....................................................................................................................... 5

INTRODUCTION .................................................................................................................................. 6

THE PLANNING CONTEXT ................................................................................................................... 6

THE WEDDIN SHIRE ............................................................................................................................ 6

WHAT THE DATA TELLS US ................................................................................................................. 7

HEALTH NEEDS OF THE COMMUNITY ............................................................................................... 10

ABORIGINAL POPULATION .................................................................................................................... 11

HEALTH, PSYCHOLOGICAL DISTRESS AND SUICIDE RATE .................................................................. 12

AGED CARE NEEDS OF THE POPULATION ......................................................................................... 14

WHAT THE COMMUNITY SAYS THE NEEDS ARE ............................................................................... 15

EXISTING SERVICES ........................................................................................................................... 20

GRENFELL MULTIPURPOSE CENTRE (MPS) .............................................................................................. 20

GENERAL PRACTITIONERS ..................................................................................................................... 20

GRENFELL HEALTH (HUB) .................................................................................................................... 20

AGED CARE SERVICES .......................................................................................................................... 21

THE CHANGING SERVICE ENVIRONMENT ......................................................................................... 22

NATIONAL SUICIDE PREVENTION TRIAL .................................................................................................... 22

NATIONAL DISABILITY INSURANCE SCHEME (NDIS) .................................................................................... 22

GRENFELL INTEGRATED CARE PROJECT – CHRONIC ILLNESS .......................................................................... 23

WESTERN NSW INTEGRATED CARE STRATEGY – WESTERN NSW LOCAL HEALTH DISTRICT ................................. 23

WEDDIN WELLNESS PLAN ................................................................................................................. 24

HOW TO ACHIEVE IMPLEMENTATION OF THE HEALTH PLAN .......................................................................... 24

WEDDIN WELLNESS PLAN ACTION PLAN .......................................................................................... 26

STRATEGIC PLAN .............................................................................................................................. 31

HEALTH & AGED CARE SERVICES SO#2/DP#1,5,16/LEDS#2 .............................................................. 32

KEEPING PEOPLE HEALTHY SO#2/DP#1,3,5/LEDS#2 ......................................................................... 35

INTEGRATED AND COORDINATED HEALTH SERVICES SO#2,3/DP#1,5/LEDS#2 ................................ 38

SOCIAL AND EMOTIONAL WELLBEING ............................................................................................. 42

APPENDIX 1 – GOVERNANCE ............................................................................................................ 45

APPENDIX 2 - CONSULTATION CONTACTS ........................................................................................ 52

Figures Figure 1 Weddin Population to NSW Population ABS 2016 ............................................................... 8 Figure 2 Time Series Ages under 29yrs ............................................................................................... 8 Figure 3 Median Finances $s 2016 ABS Census ................................................................................. 8 Figure 4 Number of people who require assistance Weddin ABS 2016 ............................................... 9


Figure 5 Number of Volunteers Weddin ABS 2016 ............................................................................. 9 Figure 6 SEIFA Index Comparative Table (Source SBS 2011) .......................................................... 10 Figure 7 Weddin LGA Avoidable Admissions for 4 targeted Diagnostic Related Groups (DGRs), Total

Demand (number of separations) ............................................................................................... 11 Figure 8 Suicide Rates in Western NSW PHN .................................................................................. 13 Figure 9 Health & Mortality in the Western PHN Region .................................................................. 14 Figure 10 Weddin LGA Aged Care Service Requirements to 2021.................................................... 15 Figure 11 Top Needs as judged by Weddin Digital Panel .................................................................. 16 Figure 12 Importance of council services 2017.................................................................................. 17 Figure 13 Aged Care problems .......................................................................................................... 18 Figure 14 Health delivery problems .................................................................................................. 18 Figure 15 Main Street Grenfell .......................................................................................................... 19 Figure 16 Weddin tourism product .................................................................................................... 19 Figure 17 Main Street Grenfell .......................................................................................................... 19 Figure 18 Short falls in civic infrastructure........................................................................................ 20 Figure 19 Wellness Planning Framework Graphic ............................................................................. 51


WEDDIN SHIRE COUNCIL 2018 – 2022 Weddin Wellness Plan, Embracing Community Health Prepared by Stephen Sykes LM Sykes Peer Review

Executive Summary The Weddin Wellness Plan responds to Council’s concern for the health of the community and an increasing aging population, increasing numbers presenting with chronic disease, NSW’s highest suicide rate, a significant number of people requiring assistance or with a disability. Weddin Shire Council is determined to ensure that community amenity across all areas is the best it can be in order to attract and retain quality skills to support business and industry. The implementation of the Weddin Wellness Plan requires the coordinated support and oversight of a multi-agency governance structure. Otherwise the risk is that these health and wellness projects and strategies, which all require partnerships and coordination, are implemented in silos and work at odds with each other, placing increased demands on limited resources. Delivering efficient services require effective management and co-ordination. In looking at the specific governance requirements for these projects it would appear that none of the governance committees would be able to take on the broad scope of the Wellness Plan and all the projects and strategies within it. The preferred and likely most effective approach is for Council to take an initial facilitating role to ensure a sound foundation is established for the future. To oversee the initial implementation of the Plan it is proposed that Weddin establish the Weddin Wellness Planning Network comprised of all the key projects and stakeholders. It would meet as required, possibly every quarter, and be the formal avenue for shared communication, information and engagement. The Networks specific role would include:

• Revise, update and confirm Weddin Wellness Plan • Scope existing services • Identify opportunities and build partnerships around initiatives • Ensure communication between Grenfell Health, Suicide Prevention Trial Project, Grenfell

Integrated Care Project • Monitor progress on the implementation of the Weddin Wellness Plan

It is also proposed that Council engage and provide support and oversee a Partnership Agent for an initial period of 12 months (part time) to work with key stakeholders in the development of partnerships particularly in the area of:

• Developing options / promote the skeleton Business Case for residential care / hostel accommodation to possible providers

• Supporting the implementation of the National Disability Insurance Scheme (NDIS) • Attracting service providers to Weddin to ensure the community has access to services

through the NDIS • Establish the Weddin Planning Network • Facilitate communication and coordinated services through working with the Local

Health District’s Multi-Purpose Centre (MPS) and the Grenfell Integrated Care Project; the Suicide Prevention Trial Project and Grenfell Health.


Introduction Weddin 2026: Weddin Shire Council’s (WSC) 2017-2026 Community Strategic Plan (CSP) sets out the Weddin Shire community’s aspirations and provides the blueprint for sustaining Weddin into the future. It builds on the work achieved through the 2013-2023 Community Strategic Plan (the base CSP) available on Council’s website http://www.weddin.nsw.gov.au/Media/WeddinShireCouncil/Council/Adopted_Community_Strategic_Plan_2013-2023.pdf The Plan is reviewed every four years enabling Council in partnership with the community to reflect achievements; confirm or revise the preferred future, the strategic outcomes and provide a long-term focus for decision making and resource allocation. The initial community consultation processes established for the base CSP have been extended enabling a Council and community partnership approach to planning and implementation. As well as rolling community satisfaction surveys and focus groups Council has established an innovative participation model, The Digital Community Panel1 (the Panel) which enables the gathering and analysis of community views through a targeted set of questions administered through the online survey portal Survey Monkey. The Weddin Shire Council has also developed the Local Economic Development Strategy 2016 (LEDS) and the Weddin Strategic Tourism Plan 2016 (WSTP).

The Planning Context The Weddin Wellness Plan intrinsically comes from Weddin 2026: Weddin Shire Council’s (WSC) 2017-2026 Community Strategic Plan and is reflective of the Council and community’s key directions and priorities. Similarly, it builds on Council’s Local Economic Development Strategy (LEDS) which identifies health and aged services as one of the five key cluster areas. There are many factors that influence a person or a community’s health such as income, education, employment, housing, social inclusion or exclusion etc. Health cannot be seen in isolation but impacts on and is impacted by, many other factors. As such, this plan is called the Weddin Wellness Plan and relates to other key cluster areas of the Local Economic Development Strategy such as community amenity and tourism. In order to achieve the best outcomes for the community by maximising opportunities for partnerships and accessing funding opportunities, the Weddin Wellness Plan is also in line with the Federal, State and Regional policy directions and priorities. Of particular significance are the needs analysis and planning undertaken by the Western NSW Primary Health Network (PHN) and the Western NSW Local Health District (LHD).

The Weddin Shire The Weddin Shire is centred around, and derives its name from, the majestic Weddin Mountains. The name Weddin has its origins in the Wiradjuri word ‘weedin’ which means a place to sit, stay or remain, relating to the mountains’ status as a place where Indigenous youths underwent a period of 1 The Digital Community Panel has been derived from a large group of 700 participants in community surveys. It is a stratified self-selected group totally 127 members identified within the Weddin community. More detail can be found in the WSC Digital Panel Survey Report 2017.


ceremonial isolation during the course of their initiation. The mountain range rises some 400 metres above the surrounding landscape and is of great significance both to the Wiradjuri people and residents of the local Shire. The Weddin Mountains National Park is the biggest tourist attraction with in-excess of 25,000 visitors annually. Geographically, the Shire is at the crossroads of the major thoroughfares from Sydney to Adelaide and Brisbane to Melbourne. The main town of Grenfell is 364km or 5 hours by road from Sydney and within 2.5 hours drive of the major centres of Dubbo, Orange, Bathurst, Canberra and Wagga Wagga. The Weddin Local Government Area (LGA) also includes the villages of Caragabal, Quandialla, Greenethorpe and Bimbi.

Figure 1 Regional Map

Weddin adjoins the LGAs of Cowra, Bland and Forbes in Western NSW Local Health District (LHD) and Young which is in Murrumbidgee LHD. The Shire covers over 3,400 square km which is more than double the land area of greater urban Sydney. 94% is devoted to dry-land agriculture, 3% national parks and 3% state forests. Ample land is also zoned ready for new industry, as well as residential housing and hobby-farms. The recent 2017 Valuer Generals Report for NSW reported that the total land value for the Central West region increased over the 12-month period to 1 July 2017 by 14.8%

from $13.9 billion to $15.9 billion. Overall, residential land values increased moderately by 7.3%, although they increased strongly in the Weddin local government area by 16.9% due to high demand for a limited supply in the town of Grenfell. Commercial land values in the Central West region showed a moderate increase of 7.0%, however Weddin commercial land values decreased moderately (-8.4%) because limited demand led to properties being on the market for an extended period. Industrial land values generally remained steady across the region. However, the Weddin local government area experienced a strong increase of 16.0% due to the growth in the rural sector.

What the data tells us Weddin Shire has a population of 3,700 people. The Weddin population is ageing with Error! Reference source not found. showing a stark difference in age cohorts compared with the NSW age distribution, with those over 50 in Weddin being much higher in number and those between 20-44 yrs much lower.


Figure 1 Weddin Population to NSW Population ABS 2016

In the younger age bracket 2 shows that over time this has not changed a great deal with the same numbers moving through the age brackets. It is of concern that in 2016 the under 4 age range shows a decline.

Figure 2 Time Series Ages under 29yrs

Error! Reference source not found. 3 shows that while there remains a significant financial disparity across some sectors of the community with retirees relying on declining superannuation returns, the overall financial position is strong and well ahead of inflation.

Figure 3 Median Finances $s 2016 ABS Census

0

2

4

6

8

10

0-4

years

5-9

years

10-14

years

15-19

years

20-24

years

25-29

years

30-34

years

35-39

years

40-44

years

45-49

years

50-54

years

55-59

years

60-64

years

65-69

years

70-74

years

75-79

years

80-84

years

85

years

and

over

Weddin / NSW % pop by age 2016

Weddin % -- NSW % --

0 50 100 150 200 250 300

Age (years):

0-4 years

5-9 years

10-14 years

15-19 years

20-24 years

25-29 years

Weddin Time Series Ages under 29yrs

2016 2011 2006

384

879724

492

1,193904

0

500

1,000

1,500

Median total

personal income

($/weekly)

Median total family

income ($/weekly)

Median total

household income

($/weekly)

Weddin Series Median Finances $s

2006 2011 2016


The number of people requiring personal assistance is a significant indicator of the mobility and health needs of the community. Figure 5 shows that there has been an increase of 70 people requiring supported assistance in 10 years and this is escalating. Of a total population of 3,700 people in 2016, some 960 people, over 25%, of all ages, volunteer, as can be seen in Figure 5 indicating a strong sense of community as well as reflecting considerable need. The Weddin Shire Disability Inclusion Plan 2018-2021 provides some data from Australian Bureau of Statistics (ABS) Census data. Information about disability in Weddin Shire is based on 2011 ABS modelling that states 24.3% of the population, or 901 people have a disability living in Weddin Shire.

• In Weddin Shire there were 488 carers providing unpaid assistance to a person with a disability, long term illness or old age in 2011.

• According to the ABS, 80 people were receiving a Carer Payment benefit in 2014, an increase of 21 people from 2011. This payment is made to people who personally provide constant care, in the home, to someone with a severe disability, medical condition, or who is frail aged.

• 222 people were receiving a Disability Support Pension in 2014. The Disability Support Pension is provided to people who have a physical, intellectual or psychiatric condition that stops them from working or people who are permanently blind.

Figure 4 Number of people who require assistance Weddin ABS 2016

Figure 5 Number of Volunteers Weddin ABS 2016

Weddin continues to retain stable population numbers based on the ABS data over the last three censuses. However, into the future NSW Department of Planning figures project decline in all population categories, by as much as 30% by 2031 (except in the over 70s), if the underlying conditions remain unaddressed. The population of those over 70 years in Weddin will increase by 27% by 2031.

216

257

287

2006

2011

2016

0 50 100 150 200 250 300 350

Weddin LGA Need for Assistance Series ABS

0 50 100 150 200 250

15-19 years

20-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65-74 years

75-84 years

85 years and over

Weddin Volunteers by Age ABS 2016


The unemployment rate was below the State average in 2011 by 1% however personal income per annum was 67% of the State average at $35,858 for Weddin compared to the New South Wales average of $53,917. There has been a decline in Mean superannuation income from $26,500 in 2009 to $22,843 in 2015. Some 30% of the Weddin population also receive some form of pension or support payment while only 7% is reported for New South Wales.2 The population decline of all groups under 70 years heralds an ageing, financially under-resourced (declining superannuation income) population underscoring a deterioration of economic capacity in some sectors. The 2016 ABS census data reports similar trends to 2011, now 960 (up 60 from 2011) of the working age population participates in unpaid voluntary work and of this, in 2016, 287 (up 30 from 2011) provide supported care for people with a disability. The Following comparative table examines the relative advantage and disadvantage on the ABS Socio-Economic Indexes for Areas (SEIFA) which enable comparisons of the social and economic conditions across Australia. Mosman local government area in Sydney NSW, is recognised as advantaged and is provided as a way of indicating relativity. Surrounding Shires of Bland, Cabonne and regional cities of Bathurst and Orange have higher advantage and disadvantage scores and therefore are less disadvantaged than Weddin Shire. The table indicates that on a range of issues, Weddin Shire Council is at a similar level of social disadvantage to its neighbours with the exception of employment and education where there is a clearly higher level of skills and potential.

Figure 6 SEIFA Index Comparative Table (Source SBS 2011)

Health Needs of the Community In 2014 the Western NSW Local Health District produced the Grenfell Multipurpose Service, Service Statement. Of significance is the analysis of the community health needs based on the 2011 Census data. The NSW Chief Health Officers report through the Socio-Economic Indexes for Areas (SEIFA) identifies conditions which contribute to hospitalisations through the smoothed Standardised Separation Ratio (sSSR), indicating a “relative risk” compared to the NSW average which is 100. Compared to the State average Weddin LGA has:

2 (ABS Socio Economic Indexes for Area, 2011, released 18 July 2013)

0

2

4

6

8

10

12

Bathurst

Regional

(A)

Bland (A) Blayney (A) Cabonne

(A)

Cowra (A) Forbes (A) Mosman

(A)

Orange (C) Weddin (A)Hilltops (A)

Index of Relative Socio-economic Disadvantage Decile

Index of Relative Socio-economic Advantage and Disadvantage Decile

Index of Economic Resources Decile

Index of Education and Occupation Decile


• Higher rate for high body mass attributed hospitalisations – 135.7 • Higher rates for smoking attributable hospitalisations – 104.8 • Higher rates for alcohol attributable hospitalisations – 114.5 • Higher rates for ambulatory care sensitive conditions hospitalisations – 107.8 • No significant higher or lower rate for falls related injury hospitalisations – 92

This indicates a need to focus on prevention and health promotion strategies to prevent avoidable hospital admissions.

Figure 7 Weddin LGA Avoidable Admissions for 4 targeted Diagnostic Related Groups (DGRs), Total Demand (number of separations)

Target DRG Description 2010/11 2011/12 2012/13 E65B Chronic Obstructive Airways Disease W/O Catastrophic CC 8 20 25 E62C Respiratory Infections/Inflammations W/O CC 9 16 14 J64B Cellulitis W/O Catastrophic or Severe CC 8 10 6 F63B Venous Thrombosis W/O Catastrophic or Severe CC 4 3 0 Grand Total 29 49 45

Source: FlowInfo V13 excludes Renal Dialysis, Chemotherapy and Unqualified Neonates Error! Reference source not found.indicates that chronic disease management presents a challenge for health care providers in Weddin, both the primary health care providers and the Grenfell MPS. Interventions aimed at managing and preventing chronic disease will provide a real opportunity to improve the health and wellbeing of the Weddin community. Of the four targeted Diagnostic Related Groups for avoidable admissions, respiratory conditions account for the majority of separations. This is commensurate with the reported smoking rates.3 The Western NSW Local Health District is implementing the Grenfell Integrated Care Project in 2018 with a focus on chronic illness. The project aims to support high quality primary care including the commencement of ambulatory care services through integrated models of chronic and complex care tailored to the needs of the Grenfell people. Clinicians will identify at risk patients who will benefit from intervention and better coordinated clinical care. It will be focused on embedding integrated shared care systems, processes and pathways for patients who are identified using a risk stratification tool. It aims to enhance multi-organisational team based care that works to keep people healthy at home and reduce hospital presentations. Data from the Western NSW Local Health District indicates that 87 per 100 residents of the Weddin LGA have at least one chronic disease risk factor (smoking, harmfull alcohol use, physical inactivity, obesity) compared to 78 per 100 in NSW.4 Aboriginal Population In the 2011Census 1.5% of the Weddin population or 72 people identified as Aboriginal, with the median age being 37 years. Although the proportion of the population is small, it must be considered in the context of what is known about health risks for Aboriginal people in NSW:

• Socio-economic disadvantage – greater risk of exposure to behavioural and environmental health factors

• Generaly have poorer health than the rest of the population • Higher infant mortality, lower life expectancy • Higher rates of chronic disease risk factors, higher prevalence and earlier onset of chronic

illnesses (in particular respiratory illness, diabetes and renal disease)

3 Grenfell MPS Service Statement, Western NSW Local Health District, November 2014 4 Grenfell Integrated Care Project Management Plan, Western NSW Integrated Care Strategy, 2018


• Higher rates of hospitalisation and deaths from injury and assaults and higher rates of sexually transmitted diseases.

In comparison to non-Aboriginal people, Aboriginal people are more than:

• Three times as likely to die as a result of diabetes • One and a half times more likely to die from injury and poisoning

Aboriginal people are admitted to hospital 1.7 times the rate of non-Aboriginal people with renal dialysis accounting for the largest number of hospitalisations. Hospitalisations for Aboriginal people in NSW are 200% higher for diabetes, 70% higher for cardiovascular disease, 100% higher for respiratory disease and 60% higher for injury and poisoning. Reported rates of current smoking for Aboriginal adults across all age groups are about double that of the general population and reported rates of risk drinking are about 1.4 times that of the general population across all age groups.5

Health, Psychological Distress and Suicide Rate The Western NSW Primary Health Network (PHN) has recently released The Integrated Mental Health Atlas of Western NSW which states that the majority of LGAs in the Western NSW PHN region (Western NSW Local Health District and Far West Local Health District) have significantly higher rates of suicide compared to the state average of 9.4 per 100,000 with the highest suicide rate being across the LGA of Weddin (30.9 per 100,000), with Lachlan (29.1 per 100,000) and Cobar (26.7 per 100,000). Broken Hill (9.4 per 100,000), Dubbo (6.0 per 100,000), Bathurst (8.1 per 100,000) and Parkes (8.4 per 100,000) are the only LGAs to meet or fall below the state average.6 (See Figure 9). It is of concern that Weddin Shire has the highest suicide rate in the PHN region indicating the need for an all of community response. It is also pleasing to note that Weddin will be part of the National Suicide Prevention Trial, funded through the Western NSW Primary Health Network. The Suicide Prevention Trial will see a part-time project officer employed by Western Plains Regional Development and located in Grenfell.

5 NSW Health, The Health of the people of NSW – Report of the Chief Health Officer. Summary Report, 2010 6 The Integrated Mental Health Atlas of Western NSW – Version for public comments. 2017, The Menzies Centre for Health Policy, University of Sydney and ConNetica. Page 37, 38


Figure 8 Suicide Rates in Western NSW PHN

The Integrated Mental Health Atlas of Western NSW also provides data regarding Fair/Poor Health and Psychological Distress. (See Figure 10). At 16.2Weddin rated higher than the State average of 14.3 in regards to Fair/Poor Health. In regard to Psychological Distress Weddin rated 8.9, which is the best LGA score in the PHN region. The Psychological Distress measurement is the proportion of adults with very high levels of psychological distress as measured by the Kessler Psychological Distress Scale—10 items (K10). The K10 is a scale of non-specific psychological distress based on 10 questions about negative emotional states in the 4 weeks before being interviewed. 7 It is unclear why Weddin rates well in comparison with the rest of the PHN region in regard to psychological distress but worst in terms of suicide rate. It may be that there are people who are quite isolated who do not connect with programs or services and would not be part of the K10 Sample.

7 The Integrated Mental Health Atlas of Western NSW – Version for public comments. 2017, The Menzies Centre for Health Policy, University of Sydney and ConNetica. Page 36

WESTERN NSW PHN CATCHMENT

THE INTEGRATED MENTAL HEALTH ATLAS OF WESTERN NSW 41 of 137

FIGURE 22 SUICIDE RATE FOR THE WNSW PHN REGION


Figure 9 Health & Mortality in the Western PHN Region

Aged Care Needs of the Population The Local Health District’s Grenfell MPS Service Statement provides valuable data and analysis of the emerging aged care needs of the Weddin population. This work is acknowledged and reproduced below.8 An estimation of the requirements for residential and community aged care places for Weddin LGA to 2021 is based on the Commonwealth benchmark of 44 high care places per 1,000 population 70 years and older, 44 low care places per 1,000 population 70 years and over and 25 Home Care Packages (HCPs) per 1,000 population 70 years and older. These benchmarks are not entirely accurate when used for small LGAs as additional aged care beds may be located in neighbouring LGAs.

8 Grenfell MPS Service Statement, Western NSW Local Health District, November 2014

WESTERN NSW PHN CATCHMENT

THE INTEGRATED MENTAL HEALTH ATLAS OF WESTERN NSW 37 of 137

The indicators of health status for the WNSW PHN region’s population which have been examined, are presented in Table 9. Figure 20 through Figure 22 illustrate the health status, psychological distress and suicide rate by LGA in geographic maps.

TABLE 9 HEALTH AND MORTALITY IN THE WNSW PHN REGION

LGA Fair/poor health

*

(ASR per 100)

Psychological Distress*

(ASR per 100)

Suicide†

(n)

Suicide Rate†

(ASR per 100,000)

Balranald 15.3ñ 11.0ò NP NP

Bathurst 16.4ñ 12.3ñ 15 8.1ò

Blayney 17.9ñ 12.3ñ NP NP

Bogan 14.1ò 12.8ñ NP NP

Bourke NP NP NP NP

Brewarrina NP NP NP NP

Broken Hill 19.3ñ 13.6ñ 8 9.4

Cabonne 15.2ñ 10.5ò 8 13.2ñ

Central Darling 19.3ñ 13.6ñ NP NP

Cobar 14.1ò 12.8ñ 6 26.7ñ

Coonamble 14.1ò 12.7ñ NP NP

Cowra 15.4ñ 13.0ñ 8 13.9ñ

Dubbo 15.2ñ 12.9ñ 11 6.0ò

Forbes 17.6ñ 10.5ò NP NP

Gilgandra 13.3 10.0ò NP NP

Lachlan (a) 17.7ñ 10.5ò 6 29.1ñ

Mid-Western 16.3ñ 10.8ò 13 12.1ñ

Narromine 13.3 10.0ò 5 16.9ñ

Oberon 17.6ñ 11.6ñ NP NP

Orange 16.3ñ 12.6ñ 17 9.5ñ

Parkes 15.7ñ 10.9ò 5 8.4ò

Walgett NP NP 7 21.2ñ

Warren 14.1ò 12.6ñ NP NP

Warrumbungle 13.7ò 10.1ò 6 14.6ñ

Weddin 16.2ñ 8.9ò 6 30.9ñ

Wellington 16.0ñ 11.0ò NP NP

Wentworth 15.3ñ 11.0ò 5 15.1ñ

Unincorp. NSW NP NP NP NP

WNSW PHN 16.0 11.9 142 10.5

NSW 14.3 11.0 3,193 9.4

Australia 14.8 11.7 11,874 11.2

Sourced from: *2011-13 (PHIDU, 2016); †2009-2013 (PHIDU, 2016)


The Aboriginal population aged 50-69 years has been included and projections are calculated on projected population growth rates. There are limitations in this modelling as the actual population change may be less than that indicated.

Figure 10 Weddin LGA Aged Care Service Requirements to 2021

2011 Census data

2016 Population Projected

2021 Population Projected

Aboriginal Population ³ 50 years but <70 years (PUR)

15 26 29

Population ³ 70 years (ERP) 619 688 757 Total Target Population 634 714 786 Residential High Care Places (estimate)

28 31 36

Residential Low Care Places (estimate)

28 31 36

HCPs (estimate) 16 18 20 Source: ABS, 2011 Census of Population and Housing Source: Centre for Epidemiology and Evidence. Health Statistics New South Wales. Sydney: NSW Ministry of Health. Available at: www.healthstats.nsw.gov.au. Accessed 25/02/14. The current (2014) allocation of high care residential places at Grenfell MPS (26) is commensurate with that required under the Commonwealth formula. The 2014 allocation of low care residential places (8) is less than that required under the formula, with an additional 20 places required. The formula also indicates a current (2014) requirement for 16 HCPs. In 2021, the need for additional residential places in addition to the current allocations is projected to be eight (8) high care residential and twenty eight (28) low care places. This however assumes that the population will continue to change at the same rate as projected. Residents of Weddin will require access to 20 HCPs. What the Community Says the Needs Are Weddin Shire Council is committed to engaging the community in all planning processes. The development of Grenfell Health (Hub) project follows extensive community consultation on the 10-year Delivery Plan. A subsequent community survey conducted in 2014 consistently rated ‘reliable and sustainable health services’ as the top priority for the community. A follow-up survey on economic activity in Weddin Shire in 2016 further found that at 84% ‘residents’ health services’ was the highest ranking need in sustaining the community’s future and economic prosperity (sample size: n=178). 9 A further community survey was undertaken in December 2017, designed to assess the community’s perception of the importance of the standard services provided to the community; the projects that they rate most highly for future consideration; and their assessment of a number of ‘problems’ and possible ‘interventions’. Council has established a Digital Community Panel (DCP) of some 220 residents broadly representative of the community age range and location. The Panel is used to undertake consultation on a range of issues from time to time. Surveys are sent to all members of the Panel. The response rate varies from around 50 to 190 people depending on the length of the surveys. The respondent age ranges are then matched to the Australian Bureau of Census (ABS) population age distribution to test the representative nature of the Panel for each survey.

9 Weddin Health Hub – Business Case January, 2017


The survey conducted in 2017 involved a two-step process with the first providing a preliminary consultative questionnaire to a small group (Consultative Group) of both selected and random members of Weddin Shire Council’s DCP. This preliminary questionnaire was constructed by sourcing information from three previous community surveys and a range of community focus group meetings held over 2 years. Following a review of all the previous plans and consultations a number of ‘problem’ areas were identified and for each problem one possible ‘intervention’ was suggested. The Consultative Group of 30 was asked to suggest other ‘interventions’. These suggestions were then framed into 24 questions with a series of options within each for possible interventions. The Survey was extensive, taking respondents 35mins to complete, with 55 community members completing the survey. Each question also asked respondents to suggest other ‘interventions’ that might address ‘problems’. The survey was qualitative in nature. The issues were expressed as problems and the interventions as questions and respondents were asked to indicate their agreement from disagree to strongly agree (a Likert scale). The analysis provides a weighted average which represents the cumulative response including agreement and disagreement. The higher the weighted average the greater the level of agreement with the intervention. Figure 14 shows the Medical / Health Centre continues to rank as the highest priority following similar results (2014, 2015, and 2016) now that the pool has been rebuilt. The Grenfell Health (Hub) is now funded and slated for construction in 2018. The next priority across a number of questions was transformation of Main Street. Sealed roads were the next followed by sporting facilities.

Figure 11 Top Needs as judged by Weddin Digital Panel

Figure 13 shows the importance of the Council service showing the rank of satisfaction. This indicates that Health services are rated the most important with the lowest level of satisfaction and kerb and gutters the least important with the better level of service.

0 5 10 15 20 25 30 35

Cemeteries

Sewer

Public Toilets

Parks & Gardens

Rural Road Shoulders

Sporting Facilities

Community Services e.g. health, home care

Top 3 Community needs


Figure 12 Importance of council services 2017

Exceeding Expectations (Lower Importance & Higher

Satisfaction) • Grenfell Internet Centre • Sporting Facilities

• Swimming Pool

Meeting Priorities (Higher Importance & Higher

Satisfaction) • Public Toilets

• Waste Collection and Disposal

• Bridges

• Library

• Sealed Roads in Town

• Cemeteries

• Sewer

• Other Community Services

• Parks and Gardens

Less Important (Lower Importance & Lower

Satisfaction) • Animal Control

• Kerb & Guttering

• Caravan Park

• Footpaths and Cycleways

• Town and Village Footpaths

• Environmental Health

• Rural Sealed Roads

Areas of Concern (Higher Importance & Lower

Satisfaction) • Rural Road Shoulders

• Unsealed Roads

• Ageing community

• Health services / medical

• Main Street

Aged care is seen as a significant issue in the community and has ranked as important in the last 3 surveys. Error! Reference source not found. supports the importance of a diverse health role for the new Grenfell Health facility. The community is clearly keen to see an integrated response to the needs of ageing.


Figure 13 Aged Care problems

Figure 15 indicates strong acceptance that digital service delivery is paramount to future needs of an ageing community. Access to the NBN in Grenfell and across the Weddin Shire is limited by technical issues at the exchange and need to be redressed urgently to meet emerging health delivery options. Interestingly there is a real appetite in the community for the use of digital technologies.

Figure 14 Health delivery problems

Figure 16 Indicates community views on approaches to improving business outcomes in Main Street. This will inform applications made for funding support for Main Street transformation as well as continued skill development for local business. Figure 17, 18, 19 are included in the Wellness Plan as they present opportunities for community projects that build connectedness, impacting on both individual and community health and wellbeing.

Medical Centre has diverse health services

Aged care development support

Improve the assessment process for care

Improve the existing home care services

Extend the MPS Facility

Develop more respite facilities

Develop aged care facilities for couples care

Semi independent facility

Improvement existing private residential facility

Dedicated hospice rooms at the Grenfell MPS

Increase community transport

Focus on Preventative measures for aged

3.6 3.8 4 4.2 4.4 4.6 4.8

Weddin - Rank Aged care issues(weighted average 2017 survey)

Digital

diagnosis by

access to

specialists

Service

providers

visit Grenfell

Health

Co-ordianted

preventative

health care

Digital linked

hospital to

Gerenfell

Health Hub

Video link for

remote

consulation

at hospital

Digital

consultations

access

practioners

Aged persons

internet

training

3.2

3.4

3.6

3.8

4

4.2

4.4

Health delivery optionsweighted average


Figure 15 Main Street Grenfell

Figure 16 Weddin tourism product

Figure 17 Main Street Grenfell

Property owners maintenace on Main Street

Main Street Beautification

Market as liveable and affordable

Marketing advice and training to shop owners

Street trees and shade in Main Street

Hero Sculptures

0 0.5 1 1.5 2 2.5 3 3.5 4 4.5

Drive Business Changeweighted average 2017 survey

Promote country rock concerts

Develop native animal sanctuary

Have country music weekends

George St upgrade to capitalise on history and…

Railway station tourism

Weddin Mountains an Icon - adventure toursim

Beautify the Main Street so that it tells a story to…

0 1 2 3 4 5

Weddin tourism product development (weighted average)

Improve

disabled

access

Keep heritage

feel

Seating and

Active spaces

Protect the

verandah

posts

Grenfell story

- Art and

sculpture

Widen the

footpaths

Modern and

exciting

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Main Street Issues GrenfellWeighted average


Figure 18 Short falls in civic infrastructure

Existing Services Existing services were identified in The Grenfell Multipurpose Service Statement, November 2014. This will no longer be entirely accurate and some further work scoping of current services is needed. The key services are: Grenfell Multipurpose Centre (MPS) 41 bed facility with seven acute/subacute beds, 26 high care residential aged care places, eight low care residential aged care places, a respite care subsidy, two community places (level 4) and six community places (level 2) funded by the Commonwealth. It provides emergency services, acute and subacute inpatient services, residential aged services and primary and community services. It is managed and operated by Western NSW Local Health District (LHD). The Nurse Manager reports to the Health Service Manager of Cowra Health Service, who in turn reports to the Director Operations through the General Manager, Southern Sector. Other providers deliver services out of Grenfell MPS e.g. Sureway Employment and Training and a private podiatrist one day a fortnight. There is an on call General Practitioner (GP); Twice a week radiography service; Pathology services 7 days a week with a courier service to Cowra Health Service with weekly Pathology collection clinics out of community health - Pathology West. Pharmacy services are supplied by Cowra Health Service via courier services and Sterilisation services are provided from Orange Health Service General Practitioners Local medical support includes two general practitioners located in private surgeries. One general practitioner has visiting and admitting rights to the facility. There is a 12-hour general practitioner on-call roster at the MPS. Grenfell Health (Hub) Funding has now been secured for the development of Grenfell Health (Hub). It will bring together general and specialist medical practitioners, a dentist, nurses, a physiotherapist, podiatrist, visiting medical specialists and other healthcare professionals to deliver integrated healthcare tailored to the

Encourage Main Street redevelopment by owners…

Install secure self cleaning toilet near Main Street…

Beautify Main Street by program of flower planting

Revitalise community cultural spaces

Engage professional designers in developing…

Look at adaptive reuse of existing TAFE building

Investigate different ways to engage younger…

0 0.5 1 1.5 2 2.5 3 3.5 4 4.5

Shortfalls in civic infrastructureweighted average


needs of the local community. Aged Care Services Home and Community Care (HACC) - Ageing, Disability and Home Care (ADHC) is part of the Department of Family and Community Services, providing services assisting and supporting the frail, aged or disabled to live independently in their own homes. The Grenfell HACC Multi Service Outlet is under the auspice of the Weddin Shire Council. Programs include community and health related transport, food service, carers’ respite, neighbour aid (which incorporate Telelink), a handy person service and social support. Cowra Home Modifications Service provides a home modification service to enable aged care clients and clients with disabilities to remain in the community, subject to assessment by an Occupational Therapist (OT). Community Options provides case management for clients requiring support to maintain independent living. Meals on Wheels - coordinated by Home Care Services, auspiced to Grenfell MPS. One of the local hotels provides nutritional meals to frail, aged people with disabilities and carers within the Grenfell area. The service is available seven days a week with frozen meals also available for collection from the HAC Centre. Weddin Neighbour Aid and Social Support - provides support which enables people to maintain their independence and quality of life, while living at home. ComPacks- is a case-managed package of care for up to six weeks after discharge from hospital, for people who need two or more community services in place to enable them to return home safely. The concept is to case manage community support jointly with a multidisciplinary hospital team, commencing prior to discharge and continuing for a short time after discharge. Other Community Services include: • Grenfell and District Senior Citizens Welfare Committee • Lions Club • Rotary • Men’s Shed Residential Aged Care Facilities • In addition to the residential aged care beds located in Grenfell MPS, Weddin Shire residents also

access aged care facilities in surrounding towns. • As at October 2014 there were 15 Grenfell residents residing in the following facilities:

• Weroona Nursing Home, Cowra (three) • Moyne Nursing Home, Canowindra (four) • Mater Misericordia Nursing Home, Forbes) (two) • Jemalong Nursing Home, Forbes (one) • Bilyara Hostel, Cowra (one) • Mercy Place Mount St Joseph’s, Young (two) • Southern Cross Young Apartments, (two)

Aged Care Assessment Program (ACAP) – is funded by the Commonwealth to help people and their carers determine the type of care that will best meet their needs when they are no longer able to manage at home without assistance. ACAP provides information on suitable care options and can help arrange access or referral to appropriate residential or community care services such as HACC services. An ACAP assessment and approval is required before people can access residential or community aged care places. The Grenfell MPS is the only provider in the LGA of Weddin.


The Changing Service Environment National Suicide Prevention Trial Funded through the Western NSW Primary Health Network, the Suicide Prevention Trial will see a part-time project officer located in Grenfell in 2018, employed by Western Plains Regional Development. The main aim is to promote the integration of suicide prevention planning, service design and delivery across relevant health and human services, emergency services, schools and community settings. The Suicide Prevention Trial is based on research undertaken by the Black Dog Institute in 2016 which is outlined in a document produced for the Primary Health Networks. 10 It identifies nine evidence based strategies for suicide prevention:

1) After care and crisis care - a coordinated approach to improving the care of people after a

suicide attempt. 2) Psychosocial and pharmacotherapy treatments – improving the care of at-risk individuals 3) GP capacity building and support 4) Frontline staff and gatekeeper training – increasing mental health literacy to assess, manage

and provide resources to at risk individuals 5) Identifying gatekeepers 6) Schools Programs – to increase help-seeking and mental health literacy 7) Community Campaigns – increase mental health literacy in the general population 8) Media guidelines 9) Means restriction

A multi-agency whole of community approach is required for suicide prevention involving commonwealth and state government departments for example family and community services, police, justice, education, non-government organisations and local councils. The Suicide Prevention Trial requires the establishment of a Local Working Committee with high priority population groups represented. National Disability Insurance Scheme (NDIS) The NDIS is an Australia-wide scheme to support people with permanent and significant disability which replaces the current disability support scheme. The intention is to fund long-term high-quality care and support for people with significant disabilities, better link the community and people with disabilities, provide information to people, help break down stereotypes, and ensure quality assurance and best practice among service providers. It will give people with disability choice and control over the supports they receive. People are eligible for the NDIS if they are under 65; an Australian citizen or resident or permanent visa holder and meet the disability or early intervention requirements. The role of the NSW Government will change after the NDIS has been fully rolled out. From July 2018, the NSW government will not provide any residual specialist disability supports or basic community services. The whole of the NSW specialist disability budget funding will be transferred to the NDIS by July 2018.11

10 An Evidence-based Systems Approach to Suicide Prevention: Guidance on Planning, Commissioning and Monitoring, Commonwealth of Australia 2016 11 ndis.nsw.gov.au


The NDIS funds Supported Independent Living Services (SIL) and Specialist Disability Accommodation (SDA) or the old group homes. People apply through the NDIS and then choose their service providers directly. There is a small amount of funding available (2 hrs per week) for support coordinators to assist an individual to access services. The experience to date is that the NDIS attracts service providers and that non-government organisations are partnering or amalgamating, creating much bigger service provider organisations. Some concern has been raised in regard to small regional and remote communities where the service providers may not exist, especially considering there is very little funding available for agencies to travel to provide services. This could, however, be an opportunity for Weddin Shire. Options could include:

• Support carers to work together and form a cooperative to attract a service provider or perhaps even pay carers to deliver services. This could build local employment.

• Work to attract a service provider to Weddin. Incentives could include office accommodation. Service Providers currently working in the Western NSW Local Health District include: Live Better, Marathon Health, Benevolent Society, Social Futures, Wellways.

• Weddin Shire Council could register as an NDIS Service Provider. • Council project officer/Partnership agent based in the Grenfell Health (hub) facility funded

through managing the NDIS with a view to transferring to the private sector when a service provider can be found or developed.

To take advantage of the opportunities the NDIS presents, Weddin Council needs to have a facilitator role and a piloting or initiator role at least until service providers are able to be accessed by the community. Building a partnership with a Service Provider who, for example currently visits Cowra or Forbes or Young may enable them to expand their services into the Weddin Shire. They could recruit staff locally who then also benefit from the backing of the organisations training development and support. Grenfell Integrated Care Project – Chronic Illness Western NSW Integrated Care Strategy – Western NSW Local Health District This project which has some funding attached until June 2018, will identify at risk patients who will benefit from intervention and better coordinated clinical care. It will focus on embedding integrated shared care systems, processes and pathways for patients who are identified using a risk stratification tool. It will link multiple care providers across the acute, primary, community and social sectors in Grenfell. It will be supported through integrated governance, clinical leadership groups, shared care planning activities and additional GP led Care Coordination roles, through the Main Street Medical Services Grenfell.12

12 Western NSW Integrated Care Strategy, Grenfell Integrated Care Management Plan, Western NSW Local Health District


Weddin Wellness Plan The Weddin Wellness Plan – Embracing Community Health Support 2018-2022 provides the strategies and actions Council and our partners and community will undertake to meet the health and wellbeing needs of the Weddin community into the future. It relates to and references the objectives and strategies outlined in the Community Strategic Plan and the Economic Development Plan. It is intrinsically connected to the Weddin Health Hub – Business Case January, 2017, recognising that “the sustainability of the agricultural sector, the support of the digital economy and the provision of services to an ageing population are interdependent with comprehensive and integrated health services”.13 It will feed into the overarching A Better Community Strategy (ABCs) which articulates the actions to be undertaken to meet the Shires target outcomes. The Weddin Wellness Plan works to address the health and wellbeing needs of the Weddin Community based on what the data tells us in terms of population demographics and level of comparative advantage/disadvantage and projections into the future. Of particular importance, is what the needs are, based on what the community tells us. Councils community engagement process provides a sophisticated and reliable method of hearing what is important to the community. Council engagement of people with disabilities has led to the Disability Inclusion Plan which will complement the strategies of the Wellness Plan. With an ageing population, health and aged care services are of critical importance. With one of the major health issues being chronic disease it is essential to ensure a coordinated and integrated health system that can address the needs of people with chronic disease but also work to reduce the risk in others through health promotion and preventative initiatives. It will never be possible for there to be every type of health service available in every community, especially small regional ones, so it is vital that we work to break down the silos between services; work in a coordinated, planned and informed way so that we are able to advocate for services, develop partnerships and take a leading role in new technologies. The high suicide rate in Weddin is a sad reminder that health is influenced by many other factors on a personal, family, community, environmental and systems level. Councils six strategic objectives in the Community Strategic Plan (outlined below) all work to develop a healthy resilient and connected community. As such, all the projects and initiatives that come from the Strategic Plan are opportunities to engage the community, particularly those most isolated or vulnerable, and build community connectedness.

1. Strong, diverse and resilient local economy; 2. Healthy, safe and educated community; 3. Democratic and engaged community; 4. Culturally rich, vibrant and inclusive community; 5. Care for natural, agricultural and built environments; and, 6. Well-maintained and improving Shire assets and services.

How to achieve implementation of the Health Plan As with any planning document, resources and in particular human resources need to be identified to enable implementation. This is challenging in small regional communities where Council staff and elected representative capacity is stretched and where enthusiastic and committed community members are involved across a whole range of initiatives. For this reason, the Weddin Wellness Plan

13 Weddin Health Hub – Business Case January, 2017 page 14.


identifies the need for Council to engage a Partnership Agent for 12 months to facilitate the partnerships which will be crucial to the successful implementation of the Weddin Wellness Plan. There are now a number of health-related projects taking place in Weddin and managed by different agencies, which require community/stakeholder involvement through stakeholder committees or working parties. For example, Grenfell Health (Hub); the Suicide Prevention Trial Project and the Grenfell Integrated Care Project. Western NSW Local Health District also has an established Weddin Area Health Council. Rather than establish another Committee structure to oversee the implementation of the Weddin Wellness Plan an alternative approach which would work to build cooperation and avoid all these initiatives working in silos, is to bring everyone together as a Network. The Weddin Wellness Planning Network could meet quarterly, review project developments and progression on the Weddin Wellness Plan. (See further discussion on Governance in Appendix 1). Draft Proposal:

1. Council to engage and provide support and oversee a Partnership Agent for an initial period of 12 months to work with key stakeholders in the development of partnerships particularly in the area of:

• Developing options / Business Case for residential care / hostel accommodation • Supporting the implementation of the NDIS • Attracting service providers to Weddin to ensure the community has access to services

through the NDIS • Establish the Weddin Planning Network • Facilitate communication and coordinated services through working with the Local

Health District’s Multi-Purpose Centre (MPS) and the Grenfell Integrated Care Project; the Suicide Prevention Trial Project and Grenfell Health.

2. Establish the Weddin Wellness Planning Network. Meeting quarterly with specific aims for

example: • Revise, update and confirm Weddin Wellness Plan • Scope existing services • Identify opportunities and build partnerships around initiatives • Ensure communication between Grenfell Health, Suicide Prevention Trial Project, Grenfell

Integrated Care Project • Monitor progress on the implementation of the Weddin Wellness Plan

Membership should include:

• Weddin Council Staff • Council Elected Representative • Grenfell Integrated Care Project • Suicide Prevention Trial Project • Grenfell Health • Government / non-government service providers • Other stakeholders

26 Weddin Wellness Plan 2018 – 2022, Weddin Shire Council

Weddin Wellness Plan Action Plan Health and Aged Care Services Strategy Tasks Responsibility / Role 1.1 Research models (with relevant partners) of cooperative investment in aged care facilities.

Seek advice from appropriate government & industry agencies. DSC/ED Advocacy

Promote business opportunity to potential investors. ED/EA Advocacy

1.2 Encourage redevelopment of appropriate infrastructure (e.g. old TAFE site) for aged care facilities.

Promote re-development & investment opportunities. DCS/ED Advocacy

1.3 Engage appropriate partners in health and education to explore opportunities to develop Cooperative Research Centre (CRC) for regional & remote e-health delivery and training.

Research CRC process and linkage with University sector (CSU; UC or other) and health sector (NSW Health).

DSC/ED/EA Advocacy

Explore support and development models used by Rural Doctors Network and similar

DSC/ED/EA Advocacy

1.4 Encourage Health and training bodies to develop training and skills development in health care provision for a diverse and sustainable labour market.

Build relationship with TAFE & assist re-location to main street and the introduction of the CLC

DCS/ED Advocacy

Assist with identification of labour force training needs. ED/EA Advocacy

Keeping People Healthy

Strategy Task Responsibility /Role

2.1 Work with local, national and state Health agencies to identify existing developments in the government and non-government health sector that may provide opportunities for the Weddin community in

Support the Western NSW Integrated Care Project (partnership between Western NSW LHD, Western Primary Health Network (PHN) and Bila Muuji Aboriginal Health) in their implementation of the Grenfell Integrated Care Chronic Disease Project.

DCS/PA

Facilitation


regard to chronic disease management and prevention.

Participate in the Grenfell Integrated Care Project Committee to ensure collaboration between the Grenfell Integrated Care Project and Grenfell Health (Hub).

DCS/PA

Facilitation

Identify government and non-government health service providers and programs that cover the Weddin LGA

PA/WPN Facilitation

2.2 Engage a Partnership Agent to facilitate relationships and communication with partner organisations and projects.

Facilitate discussion with key stakeholders including the Aboriginal community.

DCS/PA Facilitation

Work in partnership to develop options for residential care hostel accommodation

DCS/PA Facilitation

Work in partnership with agencies and families and carers to develop strategies to attract service providers to Weddin to ensure the community has access to services through the NDIS

DCS/PA Facilitation

2.3 Explore partnership opportunities for health promotion, prevention and early intervention programs to reduce risk of chronic disease.

Work with partners to identify existing programs and services related to risk factors such as smoking, alcohol and exercise.

PA/WPN

Facilitation

Integrated and Coordinated Health Services

Strategy Task Responsibility/Role

3.1 Support the establishment of the multi-agency Wellness Planning Network to actively progress the implementation of the Wellness Plan

Work with key stakeholders to facilitate the initial Wellness Planning Network meeting with an agenda focussed on the Weddin Wellness Plan and Scoping existing services

DCS/PA Facilitation

Engage partners in the development of Terms of Reference for the Wellness Planning Network including membership, representation, roles and responsibilities, operational

DCS/PA/WPN

Facilitation


management and support, governance, reporting and accountability

Ensure engagement with the community and reporting on the progress of Wellness Plan is incorporated into Council’s communication processes.

DCS/PA

Delivery

Ensure effective communication between services and health projects such as Grenfell Integrated Care Project, Grenfell Health, Suicide Prevention Trial, MPS and Weddin Area Health Council, through strategies such as cross representation on committees and shared minutes.

PA/WPN Facilitation

3.2 Finalise contract with Grenfell Health provider

Finalise contract agreement including key accountabilities; Grenfell Health Steering Committee; monitoring and reporting.

DCS

Delivery

Establish Governance Structure to include relevant partners DCS Delivery

3.3 Encourage health and other relevant agencies to facilitate coordination of specialist clinics and programs across services

Work with health agencies to identify existing specialists and programs coming to Weddin LGA

DCS/PA/WPN

Facilitation

Work with relevant partners to identify unmet needs and gaps in community access to health services

DCS/PA/WPN

Facilitation

Work with relevant partners to develop a plan for the establishment of a coordinated approach to specialist clinics and programs

DCS/PA/WPN

Facilitation

3.4 Advocate for expansion of telehealth models of care to support improved integration of care and access to specialist services

Facilitate skills development opportunities (LEDS 5.2) DCS/ED Facilitation

Work with Grenfell Health (Hub) to develop a program for training and capacity building in digital business as a catalyst for introducing EHealth opportunities (LEDS 5.2.1)

DCS/ED Facilitation


Explore opportunities to develop Cooperative Research Centre (CRC) for regional & remote e-health delivery and training. (LEDS 5.4)

DCS/ED

Advocacy

3.5 Review outcomes of the Wellness Plan and develop an ongoing sustainability strategy for facilitating coordination and partnerships

Ensure resources, systems and learnings from the LHD Integrated Care Chronic Illness Project are transferrable to Grenfell Health (Hub).

DCS/PA Facilitation

Support the Wellness Planning Network to review the Wellness Plan and the work of the Wellness Planning Network with a view to making any changes needed to facilitate ongoing partnerships and integrated and coordination services.

DCS/PA/WPN

Facilitation

Social and Emotional Wellbeing

Strategy Task Responsibility/ Role

4.1 Develop strategy to engage the community, including people with disabilities in the design and development of Main Street Project

Research funding opportunities for community engagement in art and design project as part of Main Street Project

DCS/ED/WPN/PA Facilitation

Seek support from Arts OutWest in the development of Main Street project and other arts and cultural initiatives that assist to build community connectedness

DCS/ED/WPN/EA Advocacy

4.2 Investigate opportunities to build community connectedness and reduce isolation of the farming community

Contact the Rural Adversity Mental Health Program (RAMHP), Centre for Rural and Remote Mental Health and LHD partnership program to discuss opportunities for support

DCS/ED/WPN

Advocacy

4.3 Explore opportunities to build community capacity in regard to

Contact RAMHP to access educational resources and programs such as Books on Prescription; Mental Health First Aid or other similar strategies

DCS/ED/WPN Advocacy


mental health and drug and alcohol issues

Support the implementation of the National Suicide Prevention Trial - project officer employed by Western Plains Regional Development located in Grenfell in 2018.

DCS/EA/WPN/PA

Facilitation


Strategic Plan The Weddin Wellness Plan has four key themes or cluster areas: 1. Health and Aged Care Services; 2. Keeping People Healthy; 3. Integrated and Co-ordinated Health Services; 4. Social and Emotional Wellbeing. The World Health Organisation (WHO) defined health in its broader sense as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. 14 In this context, the Weddin Wellness Plan has a connection to all six strategic objectives of the Community Strategic Plan. However, objective #2 HEALTHY, SAFE AND EDUCATED COMMUNITY is the objective most directly relevant to this plan. It has a number of strategies which are referenced in this document. The Local Economic Development Strategy identifies the five key themes or areas of action that inform and drive the economy of the Weddin Shire: Agriculture, Health & Aged Services, Community Amenity, Tourism and Digital Disruption. The Weddin Wellness Plan articulates the Health and Aged Services objectives, strategies and actions as they appear in the Local Economic Development Strategy in order to ensure consistency in planning, implementation and review across Council’s planning documents. As with any planning document, resources and in particular human resources need to be identified to enable implementation. This is challenging in small regional communities where Council staff and elected representative capacity is stretched and where enthusiastic and committed community members are involved across a whole range of initiatives. Establishing appropriate and effective governance arrangements is critical as there is now a need for community/stakeholder oversight or involvement with Grenfell Health; the suicide prevention trial project, the Grenfell Integrated Care Project and the implementation of the Wellness Plan. See Appendix 1 Governance. The Wellness Plan also identifies the need for a ‘Partnership Agent’ to support the facilitation of partnerships and service coordination required. Key:

14 Constitution of the World Health Organisation, 1946

Director Corporate Services (DCS) Partnership Agent (PA) LEDS # -Local Economic Development Strategy reference

Economic Development Officer (ED)

SO # - Strategic Objective reference

WPN – Wellness Planning Network

External Agent (EA)

DP # - Development Plan reference


Health & Aged Care Services S O # 2 / D P # 1 , 5 , 1 6 / L E D S # 2

The population of Weddin is ageing and this fact, combined with the importance of maintaining primary care services, puts Health and Aged Care Services as a significant element in attracting new residents and maintaining the current community.

Success measures:

Grenfell Health (Hub) operating successfully

Objective

1 Encourage the provision of quality medical facilities. (CSP 2.1) Key Community Impact

Economic Social Environmental Governance

✓✓ ✓ ✓

Stra

tegi

es

1.1 Work with appropriate partners to research models of cooperative investment in aged care facilities.

1.2 Encourage redevelopment of appropriate infrastructure for aged care facilities by developing a Health Plan for the Weddin Community (Wellness Plan) to inform facility and program funding applications.

1.3 Explore opportunities to develop Cooperative Research Centre (CRC) for remote health delivery over the long term.

1.4 Encourage training and skills development in health care provision for a diverse and sustainable labour market, utilising the TAFE Connected Learning Centre in Grenfell (CLC).


Action Plan and Timeline – Strategy 1 Comment on progress

1.1 Research models (with relevant partners) of cooperative investment in aged care facilities.

Resp

onsi

bilit

y

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

1.1.1 Seek advice from appropriate government & industry agencies.

DCS/ED Funding Networks

1.1.2 Promote business opportunity to potential investors. ED/EA Staff time

1.2 Encourage redevelopment of appropriate infrastructure (e.g. old TAFE site) for aged care facilities.

Resp

onsi

bilit

y

Budg

et

Targ

et

Targ

et

Targ

et

Task

s 1.2.1 Promote re-development & investment opportunities. DCS/ED Funding

1.3 Engage appropriate partners in health and education to explore opportunities to develop Cooperative Research Centre (CRC) for regional & remote e-health delivery and training. Re

spon

sibili

ty Bu

dget

Targ

et

Targ

et

Targ

et

Task

s 1.3.1 Research CRC process and linkage with University sector

(CSU; UC or other) and health sector (NSW Health). DCS/ED/EA

CRC Grants Program


1.3.2 Explore support and development models used by Rural Doctors Network and similar

1.4 Encourage Health and training bodies to develop training and skills development in health care provision for a diverse and sustainable labour market. Re

spon

sibi

lity

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

1.4.1 Build relationship with TAFE & assist re-location to main street and the introduction of the CLC

DCS/ED Staff time and TAFE

1.4.2 Assist with identification of labour force training needs. ED/EA Staff time Industry Skills Fund


Keeping People Healthy S O # 2 / D P # 1 , 3 , 5 / L E D S # 2

Chronic disease management is a major issue for health care providers in Weddin. Interventions aimed at managing and preventing chronic disease will provide a real opportunity to improve the health and wellbeing of the Weddin community.

Success measures:

Admissions data; Implementation of the Grenfell Integrated Care Project – Chronic Illness

Objective

2 Encourage whole of community approach to healthy living and reducing risks in regard to chronic illness. Key Community Impact


✓✓ ✓✓ ✓

Stra

tegi

es 2.1 Work with local, national and state Health agencies to identify existing developments in the government and non-

government health sector that may provide opportunities for the Weddin community in regard to chronic disease management and prevention.



2.3 Explore opportunities with Health agencies for health promotion, prevention and early intervention programs to reduce risk of chronic disease.


2.1 Work with health agencies to explore existing developments in the government and non-government health sector that may provide opportunities for the Weddin community in regard to chronic disease management and prevention. Re

spon

sibili

ty

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

2.1.1 Support the Western NSW Integrated Care Project (partnership between Western NSW LHD, Western Primary Health Network (PHN) and Bila Muuji Aboriginal Health) in their implementation of the Grenfell Integrated Care Chronic Disease Project.

DCS PA

Staff time 2018/19

2.1.2 Participate in the Grenfell Integrated Care Project Committee to ensure collaboration between the Grenfell Integrated Care Project and Grenfell Health (Hub).

DCS PA

Staff time 2018/19

2.1.3 Identify government and non-government health service providers and programs that cover the Weddin LGA

PA WPN

Staff time 2018/19


Resp

onsi

bilit

y

Budg

et

Targ

et

Targ

et

Targ

et


Task

s

2.2.1 Facilitate discussion with key stakeholders including the Aboriginal community.

DCS PA

Staff time 2018/19

2.2.2 Work in partnership to develop options for residential care hostel accommodation

DCS PA

Staff Time 2018 2019

2.2.3 Work in partnership with agencies and families and carers to develop strategies to attract service providers to Weddin to ensure the community has access to services through the NDIS

DCS PA

Staff Time 2018 2019

2.3 Explore partnership opportunities for health promotion, prevention and early intervention programs to reduce risk of chronic disease. Re

spon

sibi

lity

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

2.3.1 Work with partners to identify existing programs and services related to risk factors such as smoking, alcohol and exercise.

PA WPN

Staff time 2018/19


Integrated and Coordinated Health Services S O # 2 , 3 / D P # 1 , 5 / L E D S # 2

Integrated care is about all health providers such as GPs, nurses, specialists, allied health providers, mental health, drug and alcohol workers being better connected to be able to responds to all of a persons’ needs in partnership with the person and their family and carers. This is particularly important in small communities with limited access to services.

Success measures:

Wellness Planning Network Established

Objective

3 Encourage the development of integrated and coordinated health services Key Community Impact


✓✓ ✓ ✓ ✓

Stra

tegi

es



3.3 Work with relevant partners to facilitate coordination of specialist clinics and programs across services


3.4 Advocate for expansion of telehealth models of care to support improved integration of care and access to specialist services

3.5 Review outcomes of the Wellness Plan and develop an ongoing sustainability strategy for facilitating coordination and partnerships



Resp

onsib

ility

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

3.1.1 Work with key stakeholders to facilitate the initial Wellness Planning Network meeting with an agenda focussed on:

• Weddin Wellness Plan

• Scoping existing services

DCS PA

Staff time 2018

3.1.2 Engage partners in the development of Terms of Reference for the Wellness Planning Network including membership, representation, roles and responsibilities, operational management and support, governance, reporting and accountability

DCS PA WPN

Staff Time 2018

3.1.3 Ensure engagement with the community and reporting on the progress of Wellness Plan is incorporated into Council’s communication processes.

DCS PA

Staff Time 2018/19


3.1.4 Ensure effective communication between services and health projects such as Grenfell Integrated Care Project, Grenfell Health, Suicide Prevention Trial, MPS and Weddin Area Health Council, through strategies such as cross representation on committees and shared minutes.

PA WPN

Staff Time

2018


Resp

onsi

bilit

y

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

3.2.1 Finalise contract agreement including key accountabilities; Grenfell Health Steering Committee; monitoring and reporting.

DCS

Staff Time 2019

3.2.2 Establish Governance Structure to include relevant partners

DCS Staff Time

2019

3.3 Encourage health and other relevant agencies to facilitate coordination of specialist clinics and programs across services Re

spon

sibi

lity

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

3.3.1 Work with health agencies to identify existing specialists and programs coming to Weddin LGA

DCS PA WPN

2018

3.3.2 Work with relevant partners to identify unmet needs and gaps in community access to health services

DCS PA WPN

2018/19

3.3.3 Work with relevant partners to develop a plan for the establishment of a coordinated approach to specialist clinics and programs

DCS PA WPN

2018/19


3.4 Advocate for expansion of telehealth models of care to support improved integration of care and access to specialist services Re

spon

sibi

lity

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

3.4.1 Facilitate skills development opportunities (LEDS 5.2) DCS/ED Funding 2019

3.4.2 Work with Grenfell Health (Hub) to develop a program for training and capacity building in digital business as a catalyst for introducing EHealth opportunities (LEDS 5.2.1)

DCS/ED Funding 2019

3.4.3 Explore opportunities to develop Cooperative Research Centre (CRC) for regional & remote e-health delivery and training. (LEDS 5.4)

DCS/ED Funding CRC fund

2019

3.5 Review outcomes of the Wellness Plan and develop an ongoing sustainability strategy for facilitating coordination and partnerships Re

spon

sibi

lity

Budg

et

Targ

et

Targ

et

Targ

et

Task

s

3.5.1 Ensure resources, systems and learnings from the LHD Integrated Care Chronic Illness Project are transferrable to Grenfell Health (Hub).

DCS PA

Funding 2018

2019

3.5.2 Support the Wellness Planning Network to review the Wellness Plan and the work of the Wellness Planning Network with a view to making any changes needed to facilitate ongoing partnerships and integrated and coordination services.

DCS PA WPN

Funding 2018

2019


Social and Emotional Wellbeing

Aboriginal Communities often refer to Social and Emotional Wellbeing as they consider health to be holistic with physical health being affected by the social, emotional and cultural wellbeing of both individuals and the broader community. This also links with the World Health Organisation’s Social Determinants of Health: the conditions in which people are born, grow, work, live, and age and the broader societal impacts which all affect their health. Weddin LGA has the highest suicide rate of all LGA’s in Western NSW Primary Health Nertwork region, that is, both Western NSW Local Health District and Far West Local Health District. It is critical to take an holistic approach to health and focus on connectedness and wellbeing and not just illness.

Success measures:

Community satisfaction

Objective 4

4 Support a holistic approach to health with a priority of engaging the community and in particular vulnerable groups with all key community plans and initiatives. Key Community Impact


✓✓ ✓ ✓

Stra

tegi

es

4.1 Develop strategy to engage the community in the design and development of Main Street Project


4.3 Explore opportunities to build community capacity in regard to mental health and drug and alcohol issues



4.1 Develop strategy to engage the community, including people with disabilities in the design and development of Main Street Project Re

spon

sibi

lity

Budg

et

Targ

et

Targ

et

Targ

et

Targ

et

Task

s

4.1.1 Research funding opportunities for community engagement in art and design project as part of Main Street Project

DCS/ED WPN PA

2019

4.1.2 Seek support from Arts OutWest in the development of Main Street project and other arts and cultural initiatives that assist to build community connectedness

DCS/ED WPN PA

Staff time 2018/19


Resp

onsi

bilit

y

Budg

et

Targ

et

Targ

et

Targ

et

Targ

et

Task

s

4.2.1 Contact the Rural Adversity Mental Health Program (RAMHP), Centre for Rural and Remote Mental Health and LHD partnership program to discuss opportunities for support15

DCS/ED WPN

Funding 2018

4.3 Explore opportunities to build community capacity in regard to mental health and drug and alcohol issues

Resp

onsi

bilit

y

Budg

et

Targ

et

Targ

et

Targ

et

Targ

et

15 ([email protected] 0427 460 430)


Task

s

4.3.1 Contact RAMHP to access educational resources and programs such as Books on Prescription; Mental Health First Aid or other similar strategies

DCS/ED WPN

Funding 2018

4.3.2 Support the implementation of the National Suicide Prevention Trial - project officer employed by Western Plains Regional Development located in Grenfell in 2018.

ED/EA WPN PA

Staff time 2018 2019


Appendix 1 – Governance In small regional and rural community’s it is usually the same proactive community minded people who are involved in everything. This can be a risk for new initiatives which often have specific key performance indicators and governance requirements particularly around engaging communities and target groups. Weddin Shire is committed to positioning itself to take advantage of opportunities to ensure sustainability into the future as the community ages. This includes practical infrastructure and maintenance projects such as those outlined in Councils Operational Plan; redevelopment of Main Street and working with partners to develop supported accommodation and aged care models. It also includes facilitating and supporting a contemporary approach to health and community services: an integrated and coordinated model. At its most basic level this means understanding what the needs are; what services are required; what services are available, with all agencies working together to address gaps. Agencies need to meet the governance requirements of their own organisational structures and funding requirements but there also needs to be a structure that enables all the agencies to work together to achieve the health and wellness outcomes for the Weddin Community. Existing currently in Weddin Shire is the Local Health District (LHD) Weddin Area Health Council. The LHD are also establishing a Grenfell Local Integrated Care Project Team to support the Grenfell Chronic Illness Integrated Care Project. Weddin Council will be establishing a Steering Committee for Grenfell Health (Hub) and Western Plains Regional Development need to establish a Local Working Party for the PHN funded Suicide Prevention Trial Project. The Specific Governance requirements for each of these projects are outlined below. The implementation of the Weddin Wellness Plan requires the coordinated support and oversight of a multi-agency governance structure. Otherwise the risk is that these health and wellness projects and strategies, which all require partnerships and coordination, are implemented in silos and work at odds with each other, placing increased demands on limited human resources. In looking at the specific governance requirements for these projects it would appear that none of the governance committees would be able to take on the broad scope of the Wellness Plan and all the projects and strategies within it. Although the Local Health District may be able to support some partnership development and coordination through the Integrated Care Chronic Illness Project. The governance options are:

1. Establish a separate Wellness Plan Steering Committee This is not ideal given the number of committees that are already being established and probably require similar membership.

2. Weddin Shire Council uses existing Council committee structures to establish the Wellness Plan Steering Committee which would oversee the Wellness Plan


It is critical that the community and key stakeholder agencies have ownership of this overarching Wellness Plan.

3. Weddin Shire Council takes on a facilitating role in establishing and supporting the Weddin Wellness Planning Network. This is the preferred approach with the Network being comprised of all the key projects and stakeholders. It would meet as required, possibly every quarter, and be the formal avenue for shared communication, information and engagement. It is proposed that Weddin Council contract or employ a Partnership Agent for 12 months to facilitate and support the integrated and coordinated approach required for the implementation of the Weddin Wellness Plan.


Weddin Health and Wellness Governance Requirements

1. Grenfell Health (Hub) Construction and operation of a new Health Hub building which provides interdisciplinary healthcare services to the residents of the Weddin Shire and adjacent villages and rural communities. Key Deliverables include:

• well-integrated multidisciplinary patient-centred care particularly for those with or at risk of chronic disease • integrated models of clinical governance and shared care protocols as well as a strong focus on supporting patient self-management and

preventative health • effective use of information technology including e-Health service provision and an electronic clinical information system to make patients' medical

records available (with patient consent) to all practitioners (including allied health professionals) at the Weddin Health Hub, the local pharmacy and to external providers as appropriate

• Workforce development through education and training strategies Governance Reporting to Comments Grenfell Health (Hub) Steering Committee Director, Environmental Services, Weddin Shire

Council To be established

Stakeholder / Membership

• The community of Weddin in Central West NSW and neighbouring shire residents; • Joint Organisation of Councils (Weddin Shire Council) – formerly Regional Organisation of Councils; • Weddin Shire Council; • The medical profession; • Western NSW Local Health District (WLHD); • Primary Health Network (PHN); • Contract Project Manager (Weddin Shire); • Project Reporting Group; • Building Better Regions Fund (BBRF)

2. Weddin Wellness Plan


The Weddin Wellness Plan covers the broad range of health and wellbeing issues for the Weddin Community and identifies strategies to address them. It is a whole of community plan incorporating Weddin Shire Council projects and strategies as well as those being implemented by other service providers or agencies and those requiring a partnership approach. Weddin Shire Council’s responsibilities are identified as either an advocacy role, a facilitation role or a delivery role. Governance Reporting to Comments Engagement and communication with stakeholders through the establishment of the Weddin Wellness Network

Weddin Shire Council No yet established. To be facilitated by Weddin Shire Council as a communication and engagement link to promote partnerships and coordinated services.

Stakeholder /Membership • Weddin Shire Council • Key stakeholders and service providers • Grenfell Health (Hub) • Grenfell Integrated Care Project • Suicide Prevention Trial Project • Weddin Area Health Council • Centre for Rural and Remote Mental Health (RAMHP Project)

3. Grenfell Integrated Care Project

The Local Health District’s Grenfell Integrated Care Project will support high quality primary care including the commencement of ambulatory care services which will deliver effective integrated models of chronic and complex care tailored to the needs of the Grenfell people. Through the Grenfell Integrated Care project clinicians will identify at risk patients who will benefit from intervention and better coordinated clinical care. It will be focused on embedding integrated shared care systems, processes and pathways for patients who are identified using a risk stratification tool. It will:

• Develop a comprehensive integrated service model for people flagged as high risk with a focus on delivering high quality interventions and better coordinated clinical care in the acute sector

• Enhance multi-organisational team based care that aims to keep people healthy at home and reduce hospital presentations Governance Reporting to Comments Grenfell Integrated Care Project Team Julie Cooper, Executive Director Integrated Care,

Western NSW Integrated Care Strategy, Western NSW LHD

In the process of being established. Propose that Weddin Shire Council be represented on this Project Team given the synergy between this Chronic Care Project and The Weddin Councils Grenfell Health (Hub).

Stakeholder / Membership


• Victoria Lovecchio, Grenfell Integrated Care Project Leader • Pauline Rowston, General Manager, Cowra/Grenfell Health Service • Liezel Van Eeden, Community Health Manager, Cowra/Grenfell Health Service • Dr Patrick Akhiwu, GP VMO, Main Street Medical Services Grenfell • Pauline Tregenza, Practic e Nurse, Main Street Medical Services Grenfell • Lynne Peterson, CNS, Grenfell Health Service • Karen Hancock, Nurse Manager, Grenfell Heath Service • Diane Donohue, Weddin Area Health Council • Jen Napier, Community Nurse, Grenfell Health Service • Ann Brenner, Community Pharmacist, Grenfell

4. Suicide Prevention Trial Project

This project is part of the National Suicide Prevention Trial funded through the Western NSW Primary Health Network. A part-timer Project Officer will be employed by Western Plains Regional Development based in Condobolin to:

• Promote the integration of suicide prevention planning, service design and delivery across relevant health and human services, emergency services, schools and community settings;

• Facilitate the establishment of a local working committee and ensure that high priority population groups are represented; • Build the knowledge, confidence and capacity of services and community representatives to work together to plan and deliver high quality, evidence

based suicide prevention, crisis intervention and post-vention services in response to local needs. Governance Reporting to Comments Grenfell Local Working Committee

• Identify local strategies eg training, awareness raising, media etc)

Anne Coffee, Executive Officer, Western Plains Regional Development Regional Reference Group – delegated to approve proposals of the Local Working Group

In the process of being established

Stakeholder / Membership • Rebecca Shepherd, Western Plains Regional Development, Project Coordinator Condobolin and Grenfell Suicide Prevention Trial • Grenfell Project Project Officer • Key local service providers • Community gatekeepers • People with lived experience • At risk populations such as Indigenous people, young people, males, particularly those aged 25-54 years in the mining and agricdultural industries

5. Weddin Area Health Council


Weddin Area Health Council is an established Western NSW Local Health District community health committee. As with all LGD Health Councils it is affiliated with the LHD Local Health Service. The role includes:

• Bringing local health needs to the attention of the Health Service; • Participating in the planning and evaluation of health services; • Promoting and improving the health of the local community in partnership with others; • Developing and strengthening their networks across the community.

Governance Reporting to Comments

Weddin Area Health Council Western NSW Local Health District Stakeholder / Membership As vacancies arise on the Health Council, a recruitment and selection process occurs. This includes calling for nominations from the community to be on the Health Council and appointing successful applicants. Health Councillors are appointed for an initial term of 2 years after which they have the option to re-nominate for another term.


Figure 19 Wellness Planning Framework Graphic

We

lln

ess

Pla

nn

ing

Ne

two

rk Grenfell Health (Hub) Weddin Shire Council

Grenfell Integrated Care Project

Western NSW LHD

Suicide Prevention TrialWestern Plains

Regional Development

Weddin Area Health Council

Western NSW LHD

Other key stakeholders eg RAMHP


Appendix 2 - Consultation Contacts

weddin shire council draft · weddin wellness plan 2018-2022 2 of 52 weddin shire council document...

Documents