B.1 Organisational overview

Vision, mission and values

ACT Health’s vision is ‘Your Health - Our Priority’.

Our vision and values, developed by ACT Health staff, represent what we believe is important and worthwhile. We provide services where the patient is the central focus of everything we do and this patient-centric care is delivered within a workplace culture that showcases our values of care, excellence, integrity and collaboration.

We often see people in our community when they are at their most vulnerable. The way we interact with them directly influences how they experience our care. Compliments and complaints received from our health care consumers reflect our commitment to our values as exemplified through our behaviour.

Our values are:

  • Care: Go the extra distance in delivering services to our patients, clients and consumers. Be diligent, compassionate and conscientious in providing a safe and supportive environment for everyone. Be sensitive in managing information and ensuring an individual's privacy. Be attentive to the needs of others when listening and responding to feedback from staff, clinicians and consumers.
  • Excellence: Be prepared for change and strive for continuous learning and quality improvements. Acknowledge and reward innovation in practice and outcomes. Develop and contribute to an environment where every member of the team is the right person for their job, and is empowered to perform to the highest possible standard.
  • Collaboration: Actively communicate to achieve the best results by giving time, attention and effort to others. Respect and acknowledge everyone's input, skills and experience by working together and contributing to solutions. Share knowledge and resources willingly with your colleagues.
  • Integrity: Be open, honest and trustworthy when communicating with others, and ensure correct information is provided in a timely way. Be accountable, reflective and open to feedback. Be true to yourself, your profession, consumers, colleagues and the government.

Role, functions and services

ACT Health aims to deliver better services to our:

  • Community on behalf of our Government
  • Government to meet the needs of our community.

We aim for improved efficiency in the use of resources by designing sustainable services that deliver outcomes efficiently, and embed a culture of research and innovation within the organisation.

ACT Health aims to help staff reach their potential, by providing high-level leadership and promoting a learning culture.

The ACT Health Corporate Plan provides direction to the organisation to:

  • meet increasing demand for health services
  • improve the health of vulnerable people
  • improve the patient journey
  • build and nurture a sustainable health system
  • ensure the principle of safety and quality underpin all we do.

ACT Health has strengthened the foundations of our health system by:

  • enhancing service delivery
  • redeveloping capital infrastructure through our Health Infrastructure Program.

Clients and stakeholders

ACT Health partners with the community and consumers to improve health outcomes by:

  • delivering patient and family-centred care
  • strengthening partnerships
  • promoting good health and wellbeing
  • improving access to appropriate health care
  • having robust safety and quality systems

ACT Health works closely with other ACT Government agencies, including the:

  • Community Services Directorate (CSD)
  • Justice and Community Safety Directorate (JACS)
  • Chief Minister, Treasury and Economic Development Directorate
  • ACT Ambulance Service
  • ACT Policing

ACT Health has formalised consultative arrangements with a range of agencies. These include:

  • The ACT HealthCare Consumers’ Association
  • Capital Health Networks
  • Mental health, alcohol and drug, and other community service providers.

The tertiary and training sectors are key partners in the planning, development and delivery of healthcare services.

ACT Health has formal partnership arrangements in place with:

  • The Australian National University (ANU) Medical School,
  • University of Canberra (UC)
  • Australian Catholic University (ACU)
  • Canberra Institute of Technology (CIT).

Organisational structure

The ACT Health Director-General leads the organisation in the delivery of its vision.

ACT Health’s Canberra Hospital and Health Services (CHHS) Division provides acute, subacute, primary and community-based health services to the ACT and surrounding region through its key service divisions.

The Little Company of Mary also provides public hospital services through Calvary Public Hospital, under a contractual agreement with ACT Health.

ACT Health’s Strategy and Corporate Division provides corporate and strategic support to clinical service areas by:

  • supporting national health reforms and National Partnership Agreements
  • developing strategies for attracting and retaining the health workforce
  • maintaining critical physical and technological infrastructure for public hospitals and health services

The Health Planning and Infrastructure Division manages the single largest capital works project undertaken in the history of the ACT. This includes:

  • developing whole-of-government plans (as they relate to the Health Directorate and health services), the Health Directorate Corporate Plan, territory-wide strategic plans and clinical service plans that have a territory-wide impact
  • directing and managing the directorate’s Health Infrastructure Program, including health planning, coordination, management and implementation
  • delivering strategic accommodation, the Capital Upgrades Program (CUP) and the Arts in Health Program.

ACT Health’s Population Health Division, led by the ACT Chief Health Officer/Deputy Director-General provides a range of public and environmental health services, health protection services and health promotion services, while delivering:

  • core functions of prevention, assessment, policy development and assurance
  • local and national policy, program delivery and protocols on population health issues.

The Chief Health Officer fulfils a range of statutory responsibilities and delegations as required by public health legislation.

Other operational areas report directly to the Director-General and provide a range of corporate support and organisation-wide services, such as financial management and audit and risk management.

Organisational chart

organisational chart

Environment and the planning framework

ACT Health’s vision is ‘Your Health - Our Priority’. To contribute to the broader ACT Government vision, this vision is supported by a range of strategic plans that identify objectives for the organisation.

There is recognition that the demand for health services is increasing every year.

New health technologies, higher consumer expectations an ageing population, and and a growing consumer base all contribute to this demand.

The Corporate Plan articulates:

  • key focus areas
  • priority areas for improvement
  • key strategies for achieving priorities
  • achievements planned for the long term (five years).

In 2015–16, ACT Health continued to measure its performance against these areas through:

  • key performance measures identified in the ACT Public Health Service’s quarterly performance report
  • ACT Health’s strategic and accountability indicator sets in the ACT Budget Papers.

Summary of performance

Summary of performance

ACT Health performed well against a range of strategic objectives and priorities over the reporting period.

The ACT continues to enjoy the highest life expectancy of any jurisdiction in Australia.

Life expectancy at birth is:

  • 85.2 years for females in the ACT, against a national average of 84.4 years
  • 81.4 years for males, against a national average of 80.3 years.

This indicates the general health of the population and reflects on a range of issues other than providing health services, such as economic and environmental factors.

For more information, see Strategic Objective 8: Management of Chronic Disease: Maintenance of the Highest Life Expectancy at Birth in Australia, page 79.

ACT Health assessed 100 per cent of emergency dental clients within 24 hours and saw a lower than the national result in the Decayed, Missing, or Filled Teeth (DMFT) index at ages six years and 12 years. The DMFT index at six years in the ACT was 1.03, compared to the national result of 2.13. At 12 years the ACT result was 0.70, compared to the national result of 1.05.

For more information, see:

  • Strategic Objective 2: No Waiting for Access to Emergency Dental Health Services, page 76
  • Strategic Objective 13: Achieve Lower than the Australian Average in the Decayed, Missing, or Filled Teeth (DMFT) Index, page 82.

Preliminary results show that 13,396 people were removed from the ACT elective surgery waiting list during 2015–16.

For more information, see Strategic Objective 1: Removals from Waiting List for Elective Surgery, page 75.

For radiotherapy, 100 per cent of emergency, 81 per cent of palliative and 82 per cent of radical radiotherapy patients commenced treatment within targeted time frames for 2015–16.

For more information, see Strategic Objective 3: Improving Timeliness of Access to Radiotherapy Services, page 76.

For women aged 50 to 69 years, 58 per cent had a breast screen in the 24 months prior to the counting period. This is slightly below the target of 60 per cent.

For more information, see Strategic Objective 4: Improving the Breast Screen Participation Rate for Women aged 50 to 69 years, page 77.

For the two-year Cervical Screening Program participation rate the ACT achieved a result of 57.9 per cent, on par with national average, which demonstrates the effectiveness of health promotion activities.

For more information, see Strategic Objective 12: Higher Participation Rate in the Cervical Screening Program than the National Average, page 82.

Public mental health services were effective in providing appropriate care to mental health clients, with only nine per cent of clients returning to hospital within 28 days of discharge from an ACT public acute psychiatric unit following an acute episode of care. This is one per cent below the target of 10 per cent.

For more information, see Strategic Objective 6: Maintaining Reduced Rates of Patient Return to an ACT Public Acute Psychiatric Inpatient Unit, page 78.

ACT public hospitals achieved a mean bed occupancy rate of 86 per cent in 2015–16, consistent with the 2014–15 result.

For more information, see the Strategic Objective 7: Reaching the Optimum Occupancy Rate for all Overnight Hospital Beds section, page 78.

The ACT rate of admissions in persons aged 75 years and over with a fractured neck of femur was 5.5 per 1,000 persons in the ACT population, which is slightly above the long-term target of 5.3 per 1,000.

For more information, see Strategic Objective 14: Reducing the Risk of Fractured Femurs in ACT Residents Aged Over 75 years, page 82.

The prevalence of diabetes in the ACT of 4.3 per cent, which is similar to the national rate of 4.7 per cent.

For more information, see Strategic Objective 10: Lower Prevalence of Diabetes than the National Average, page 80.

The overall ACT Aboriginal and Torres Strait Islander immunisation rate of 90 per cent indicates a high level of investment in public health services to minimise the incidence of vaccine preventable diseases among the ACT’s Aboriginal and Torres Strait Islander population.

For more information, see Strategic Objective 11: Addressing Gaps in Aboriginal and Torres Strait Islander Immunisation Status, page 81.

Results from the 2014 Australian Secondary School Alcohol and Drug Survey (ASSAD) show that 5.2 per cent of students were smokers in that year, slightly above the national average of 5.1 per cent.

For more information, see Strategic Objective 15: Reduction in the Youth Smoking Rate, page 82.

Our public hospitals continue to perform better than targets for:

  • hand hygiene rates
  • hospital-acquired infection rates
  • unplanned return to hospital within 28 days
  • unplanned return to the operating theatre.

For detailed information, see the ACT Local Hospital Network strategic objectives and indicators, page 84.

Outlook for 2016–17

2016–2017 will be a pivotal year for ACT Health, as it moves to a new level of health service delivery to better meet the needs of the Canberra community for the future.

While the service remains committed to its core values – of care, excellence, collaboration and integrity – it will explore new opportunities for innovation, efficiency and sustainability, while delivering on ongoing commitments to provide more doctors, nurses and better health services for Canberra.

To help meet these challenges, ACT Health will receive a record investment of $1.6 billion in 2016–17.

2016-17 will be another year of growth and achievement for ACT Health.

The Canberra Hospital Emergency Department is under increasing pressure as a result of an ageing population with increasingly complex conditions, low bulk billing rates and its role as the major trauma centre for the ACT and surrounding regions.

Major reform is needed to allow doctors, nurses and other hospital staff to be able to continue delivering high-quality care in a way that allows them to meet national targets for timeliness.

In 2016-17, the Health Directorate will undertake significant reform of Canberra Hospital’s Emergency Department to improve timeliness and access to emergency health care.

A three-tiered approach, focused on infrastructure, staffing and reforms, is being implemented including:

  • Infrastructure: a $23 million dollar expansion of Canberra Hospital Emergency Department is currently underway, which will increase its capacity by more than a third. This is part of the ACT Government’s $900 million Health Infrastructure Program that is changing the way health services are being delivered in the territory.
  • Staffing: recruiting more staff to deliver timely access to emergency health care.
  • Reforms: improving the current processes and work practices to allow staff to operate as efficiently and effectively as possible. For example, an Emergency Department Navigator has been appointed to improve the patient journey by overseeing access to services and supporting patient flow from triage to leaving Emergency Department.

Other strategic and operational initiatives to be pursued in 2016–17 include:

  • delivering the $5 million Acute Ischaemic Stroke Unit, the $4.6 million intensive care bed and the $5.3 million expansion of trauma services at Canberra Hospital
  • providing almost $29 million to employ a further 54 staff in the expanded Emergency Department at Canberra Hospital and $2 million for a new Emergency Department physician at Calvary Hospital
  • funding $1.3 million for an additional 300 endoscopy services
  • investing in new projects and improving health infrastructure such as the $2.4 million supported accommodation for people with mental health conditions and the $95.3 million infrastructure maintenance package
  • continuing to strengthen mental health services by providing $2.7 million for two more beds at the Adult Mental Health Unit, $3.9 million for three targeted mental health programs and the $43.4 million for the operation of the Secure Mental Health Unit
  • strengthening non‐government organisations, to deliver tailored health programs and care to their clients including $1.3 million Aboriginal and Torres Strait Islander services and $176,000 for the Early Morning Centre
  • researching, developing and delivering new and innovative techniques to improve care for patients through the establishment of a $7.3 million genomic service and $1.3 million for deep brain stimulation for people with Parkinson’s Disease
  • addressing the increased demand for drug treatment by providing $8 million to increase the capacity of front line services, including $2 million to specifically address family violence issues
  • more funding for prevention and detection services such as the $1.3 million sexual health expansion, $507,000 for forensic chemistry and $4.2 million for growth in outpatient services.

Internal accountability

Executives in the ACT Public Service are engaged under contract for periods not exceeding five years. Their remuneration is determined by the Australian Capital Territory Remuneration Tribunal.

Table 1 identifies the Senior Executives across the organisation.

Table 1: Senior Executives
Senior Executive Position
Nicole Feely Director-General
Ian Thompson Deputy Director-General, Canberra Hospital and Health Services
Dr Paul Kelly Chief Health Officer, Population Health Division
Kim Smith Deputy Director-General, Strategy and Corporate (until 12/2/16)
Paul Carmody Deputy Director-General, Health Planning and Infrastructure (until 17/5/16)
Shaun Strachan (A/g) Deputy Director-General, System Innovation Group
Ron Foster Chief Finance Officer (until 4/4/16)
Cheryl Harkins (A/g) Executive Director, Finance, Performance and Data Innovation
Brad Burch (A/g) Executive Director, Strategic Partners, Infrastructure, Business and Digital Innovation
Matt Wright (A/g) Executive Director, Access Innovation Partner
Yu-Lan Chan (A/g) Executive Director, Workforce and Culture Innovation Partner
A/Prof Frank Van Haren Director, DonateLife ACT
Liz Sharpe Director, Strategic Projects
Dr Andrew Mitchell Director, Territory-Wide Surgical Services
Warren Prentice (A/g) Chief Information Officer, ehealth and Clinical Records Branch (until 3/6/16)
Phil Ghirardello Executive Director, Performance Information Branch
Rosemary Kennedy Executive Director, Business and Infrastructure Branch
Ross O’Donoughue Executive Director, Policy and Government Relations Branch
Liesl Centenara (A/g) Executive Director, People Strategy and Services Branch
Veronica Croome ACT Chief Nurse
Dr Christina Wilkinson (A/g) Chief Medical Administrator (until 26/6/16)
Karen Murphy Chief Allied Health Officer
Prof Kirsty Douglas Director, Academic Unit of General Practice and Professor of General Practice, ANU Medical School
Dr Marianne Bookallil GP Advisor
A/Prof Deborah Browne Executive Director, HealthCARE Improvement Division
Rosemary O’Donnell Executive Director, Medicine
Katrina Bracher Executive Director, Mental Health, Justice Health and Alcohol and Drug Services
Prof Peter Collignon Executive Director, Pathology
Linda Kohlhagen Executive Director, Rehabilitation, Aged and Community Care
Barbara Reid Executive Director, Surgery and Oral Health
Elizabeth Chatham Executive Director, Women Youth and Children
Mark Dykgraaf Executive Director, Critical Care
Adrian Scott Executive Director, Clinical Support Services
Denise Lamb Executive Director, Cancer, Ambulatory and Community Health Support
David Blythe Principal Medical Adviser (from 8/2/16)
Chris Bone Chief of Clinical Operations (from 2/11/15)
John Wollard Executive Director, Health Protection Service (until 26/6/16)
Joanne Greenfield Executive Director, Health Improvement
Dr Andrew Pengilley Deputy Chief Health Officer, Office of Chief Health Officer

Senior management committees and roles

ACT Health committees are established at the following levels:

  • Tier 1: directorate level
  • Tier 2: division/branch level and Tier 1 subcommittees
  • Tier 3: unit/team level.

Information within the organisation cascades down from Tier 1 committees. Similarly, information and issues can be raised at the Tier 3 level and reported and managed up through the higher committee tiers.

Figure 1 shows the relationship between the Executive Council and other councils and committees.

Figure 1: Relationship between the Executive Council and other councils and committees

Figure 1: Relationship between the Executive Council and other councils and committees

Executive Council

The overarching governance committee for ACT Health is the Executive Council chaired by the Director-General. Its role is to:

  • support the Director-General to meet responsibilities outlined in the Health Act 1993 (http://www.legislation.act.gov.au/a/1993-13/default.asp) and other relevant legislation
  • make recommendations on the strategic direction, priorities and objectives of the organisation and endorse plans and actions to achieve the objectives
  • oversee finance, performance and human resources
  • set an example for the corporate culture throughout the organisation.

The Executive Council meets twice monthly, where:

  • one meeting focuses on finance, performance and other matters
  • one meeting focuses on other business.

A number of subcommittees report to the Executive Council, each dealing with different areas of accountability across the directorate.

Executive Directors’ Council

The Executive Directors’ Council provides an opportunity for all executive members to communicate and collaboratively work in partnership with other areas of ACT Health to deliver patient-focused, high-quality care by:

  • influencing policy and strategic direction
  • managing policy governance and risk
  • maximising operational effectiveness.

Executive Directors’ Quality and Safety Committee

The Executive Directors’ Quality and Safety Committee provides high-level advice to the Executive Council on all matters regarding quality and safety and ensures impacts on patient safety are considered in decision-making. The committee:

  • sets the strategic direction, priorities and objectives for safety and quality across the organisation
  • oversees clinical practice improvement, quality improvement, accreditation, clinical governance matters (including sentinel events), consumer engagement and clinical policy.

Work Health and Safety Committee

The Work Health and Safety Committee:

  • facilitates cooperation between ACT Health and staff to instigate, develop and carry out measures designed to ensure the health and safety of staff
  • assists in developing standards, rules and procedures relating to health and safety that are to be complied with in the workplace
  • provides work health and safety advice and recommendations on strategies, resource allocation and legislative arrangements
  • addresses whole-of-agency work health and safety issues unable to be resolved at the division or branch level.

Information Communication and Technology Committee

The Information Communication and Technology Committee:

  • oversees the development of Health Directorate information management and information and communications technology (IM&ICT) plans, policies and frameworks, as required, ensuring whole-of-government issues are considered
  • monitors lifecycle information and communications technology (ICT) asset management frameworks, strategies and policies and ensures these are consistent with best practice
  • monitors portfolio IM&ICT risks
  • monitors, reviews and manages ICT assets, services and delivery and financial performance and infrastructure risk across the Health Directorate
  • ensures whole-of-ACT Government and Health Directorate IM&ICT policies and standards are implemented across the organisation
  • prioritises IM&ICT initiatives
  • evaluates proposed IM&ICT initiatives and submits business cases for all major IM&ICT projects to the Executive Council, for endorsement
  • reviews and reports the status of ICT projects under development and, if required, recommends strategies to rectify significant variances of these.

Health Infrastructure Program Strategic Committee

The Health Infrastructure Program Strategic Committee is the chief decision-making body for the ACT Health Infrastructure Program. It is responsible for:

  • providing advice
  • monitoring progress
  • monitoring risk in the Health Infrastructure Program.

Audit and Risk Management Committee

The Audit and Risk Management Committee provides independent assurance, assistance and advice to the Director-General regarding:

  • audit
  • risk control and its framework
  • external accountabilities and responsibilities
  • appropriate internal controls.

Canberra Hospital and Health Services Overview

Canberra Hospital and Health Services (CHHS) is led by the Deputy Director-General. It provides acute, subacute, primary and community-based health services to the Australian Capital Territory (ACT) and surrounding region through its key service divisions, which are:

  • Division of Surgery, Oral Health and Imaging
  • Division of Women, Youth and Children
  • Division of Critical Care
  • Division of Cancer, Ambulatory and Community Health Support
  • Division of Rehabilitation, Aged and Community Care
  • Division of Mental Health, Justice Health, Alcohol and Drug Services
  • Division of Pathology
  • Division of Medicine
  • Division of Clinical Support Services
  • Director of Operations
  • The Office of the Chief Nurse
  • The Office of the Chief Medical Administrator
  • The Office of the Chief Allied Health Officer
  • HealthCARE Improvement Division.

Achievements

During 2015–16, CHHS undertook a range of reform activities, which were designed to improve patient flow through Canberra Hospital, particularly the Emergency Department. The major focus areas were:

  • improving our performance against the National Emergency Access Target (NEAT)
  • conducting an elective surgery blitz by implementing the Longwait Reduction Strategy
  • improving Medical Imaging services.

For more information, see section Strategic Objective 1: Removals from Waiting List for Elective Surgery, page 75.

Performance against targets

NEAT specifies that 90 per cent of all patients will leave the Emergency Department within four hours by being:

  • discharged
  • admitted to hospital or
  • transferred to another hospital for treatment.

Between 1 March and 30 June 2016, the NEAT performance at Canberra Hospital was 68.6 per cent, compared with 57.5 per cent for the same period in 2015. This was achieved despite a 9 per cent increase in the number of presentations in 2016 compared with the same period of 2015.

For the month of June 2016 (up to 30 June 2016) the result was 72.7 per cent compared with 58.2 per cent for the same period in 2015.

Waiting lists

From November 2015 to 30 June 2016, the number of patients on waiting lists for Magnetic Resonance Imaging (MRI) scans, Computed Tomography (CT) scans and ultrasounds at Canberra Hospital reduced, with the number of patients waiting for:

  • MRI scans reducing from more than 1,000 patients to approximately 300 patients
  • CT scans reducing from 550 patients to no patients
  • ultrasounds reducing from more than 1,100 patients to approximately 500 patients.
At 30 June 2016, there was no waiting list for CT scans.

CT scan patients with an outpatient’s referral were able to book an appointment to have their scan performed within 48 hours. Improved efficiencies in medical imaging services have also resulted in reduced waiting times for Emergency Department patients requiring a CT scan, with:

  • 75 per cent of these patients being seen within 45 minutes
  • 25 per cent of these patients being seen within 90 minutes.

The strategy to reduce the number of patients waiting longer than the clinically recommended times for elective surgery has resulted in over 1,000 additional patients being removed from the Elective Surgery Waiting List in 2015–16.

Advance Care Planning

The Respecting Patient Choices program continues to provide Advance Care Planning (ACP) for CHHS and the wider ACT community. This includes participants completing:

The program continues to collaborate with, and fund, the Health Care Consumers Association of the ACT to raise awareness of ACP in the community. In 2015–16, activity increased, with:

  • consumer contacts increasing by 56 per cent
  • consultations increasing by 44 per cent
  • completed documents received through the program increasing by 60 per cent.

Contact details: For more information on ACP, email rpc@act.gov.au or phone 02 6244 3344.

Surveys

Distribution of the Patient Experience inpatient survey began in March 2016. The survey collects information verbally or in writing from patients who have recently been discharged from Canberra Hospital. This information represents the patient’s perspective and will be used to:

  • identify and focus on areas where we need to improve our services
  • generate additional ideas for service improvements
  • identify service areas where we met or exceeded our patients’ expectations.

Contact details: For more information, contact the Patient Experience Survey Coordinator via email at PtExpSurveys@act.gov.au or phone 02 6174 8190.

Quality improvement

Ongoing improvement in the quality and safety of care we provide our consumers is at the heart of a high-quality healthcare service. To support this aim, the HealthCARE Improvement Division is developing a Quality Improvement platform to assist staff to integrate clinical care improvements into their daily practice. The platform currently:

  • features an Improvement Library, which is a ‘go to’ staff resource that provides feedback from clinical units across CHHS
  • provides staff with tools and techniques to support them in their ongoing improvement work
  • allows us to target improvements for the safe care of our patients.

Outlook for 2016–17

The Division of Medicine will implement the Acute Medicine Unit (AMU) model, incorporating the Medical Assessment and Planning Unit. The AMU will be a physician-led medical admissions short-stay unit. It will be structured to promote the inter-specialty and interdisciplinary care of patients who require unplanned admission to an internal medicine unit at Canberra Hospital.

New funding is being delivered as part of the 2016–17 ACT Budget to enhance the acute stroke service in the ACT. It will provide an additional four specialised clinical staff, which will provide faster assessments and more interventions for stroke treatment. This includes:

  • more timely assessments for clot breakdown treatment at Canberra Hospital and Calvary Hospital
  • adopting evidence-based care for patients who would benefit from clot retrieval using interventional radiology services at Canberra Hospital.

ACT Health has received Government approval to commence a trial of publicly funded homebirth. The trial will be conducted over three years up to a total number of 24 births per year. A framework document for the service has been written and endorsed.  Expressions of interest for the homebirth trial will be taken from 4 October 2016.

The Secure Mental Health Unit is scheduled to open in November 2016. The will form part of an integrated care pathway for those people who need care and treatment as a result of their mental illness and associated comorbidity.

In 2016–17, staffing for the Trauma Service at Canberra Hospital will increase to provide Canberrans with more timely access to effective, efficient and flexible trauma care when they need it.

Palliative Care services based at Canberra Hospital will be expanded to:

  • increase medical services for inpatients
  • provide a paediatric palliative care nurse to specifically address the needs of children and young adolescents in the ACT.

Strategy and Corporate Division Overview

The Strategy and Corporate Division:

  • supports national health reforms and National Partnership Agreements
  • develops strategies for attracting and retaining the health workforce
  • maintains critical physical and technological infrastructure for the ACT’s public hospitals and health services.

The Strategy and Corporate Division consists of seven branches:

  • Policy and Government Relations
  • Business and Infrastructure
  • People, Strategy and Services
  • Performance Information
  • eHealth and Clinical Records
  • Academic Unit of General Practice (AUGP)
  • Canberra Region Medical Education Council (CRMEC).

Strategy and Corporate Division administers ACT Health’s contract for the provision of Public Hospital services by Calvary Health Care ACT at Bruce and at Clare Holland House, and supports these close working relationships.

Calvary Health Care Bruce ACT’s report on its achievements in 2015–2016 is provided in the following annexed report:

Attachments—Annexed and subsumed public authority reports—Calvary Health Care Ltd Annual Report 2015–16, page 264.

Academic Unit of General Practice

The Academic Unit of General Practice (AUGP) is co-funded by the ACT Health Directorate and the Australian National University (ANU) Medical School. It is supported by research officers, nurses and administrative staff.

The AUGP has education, research and advocacy roles and contributes to State and national policy development through the work of the GP Advisor, Integrated Clinical Training Network and Health Workforce Australia.

The AUGP has contributed significantly to:

  • delivering the ANU Medical School Program
  • delivering junior medical officer training
  • supporting GP vocational trainees
  • supporting practicing doctors’ medical education programs.

Senior AUGP staff have pivotal roles with:

  • the ANU Medical School
  • ACT Health
  • the Department of Health
  • the Royal Australian College of General Practitioners (RACGP)
  • the Capital Health Network
  • the Australian Association of Academic Primary Care
  • the Canberra Regional Medical Education Council
  • the Confederation of Postgraduate Medical Education Councils.

The AUGP teaching and research GPs also provide clinical services in the community to ensure they are actively involved in all aspects of general practice.

The AUGP leads research using ACT Health Kindergarten Health Check data. Other research activities include those associated with:

  • integrated service development
  • clinical research
  • individual routes to health and healing
  • social determinants of medical care
  • scholarship in teaching and learning.
Key achievements

During 2015–16, AUGP’s key achievements included the following:

  • delivering ANU Medical School Program
  • supporting the Healer’s Art
  • conducting supervisor and registrar teaching
  • supporting the GP Workforce Infrastructure Program
  • funding the Peter Sharp Scholarship
  • conducting Kindergarten Health Check research
  • conducting Treating Adult Obesity in General Practice research
  • conducting Refugee Health research
  • conducting Integration in Primary Health Care research
  • conducting Vertical Integration of GP Education research
  • auditing referrals and discharges between residential aged care Facilities and hospitals
  • conducting Teach-the-Teacher workshops
  • participating in GP Grand Rounds.

Strategic partnerships have been maintained with the Research School of Population Health at the ANU, and with Capital Health Network.

Future directions

Research efforts will continue in the areas of primary care in vulnerable populations, medical education and child health.

Canberra Region Medical Education Council

The Canberra Region Medical Education Council (CRMEC) performs accreditation functions for intern training and education programs in the ACT and region for:

  • Canberra Hospital and Health Services (CHHS)
  • Calvary Health Care ACT
  • Goulburn Base Hospital
  • Bega District Hospital.

Additionally, the CRMEC oversees the development and management of medical education standards, policies, processes and functions for the ACT and Regional Prevocational Network.

Key achievements

Accreditation activities that occurred in 2015–16 included the following:

  • On 22 July 2015, the CRMEC, in conjunction with the New South Wales (NSW) Health Education and Training Unit (HETI), undertook accreditation for Bega District Hospital. The hospital was awarded a three-year accreditation with:
    • two Commendations
    • four Provisos
    • three Recommendations. 
  • On 11 and 12 November 2015, the CRMEC undertook the accreditation of Calvary Health Care ACT. Calvary Health Care ACT was awarded a three-year accreditation with:
    • two Commendations
    • five Provisos
    • six Recommendations.
  • For CHHS the CRMEC undertook accreditation of new terms, change of terms and monitoring of provisos.

Other key activities for the CRMEC in 2015–16 included the following:

  • The inaugural meeting for Directors of Training was held to discuss current issues around registrar training and pathways for junior doctors into specialty training. A report summarising training across the network was written. The report found that, overall, junior doctors are having an excellent training experience across the network.
  • The CRMEC was involved in the Review of Intern Training, which involved making multiple submissions and being represented on the Health Workforce Principal Committee (HWPC) Working Group.
  • The CRMEC was also involved in the Confederation of Postgraduate Medical Education Councils meeting and activities.
Future directions

Key activities for the CRMEC for 2016–17 include the following:

  • Reviewing supervisor capacity and quality across the region. This review will:
    • examine supervision across all levels: student, prevocational and specialty training
    • provide recommendations for support, planning and capacity.
  • Continuing to develop a CRMEC logo and website which should be in operation by May 2016.
  • In conjunction with HETI, undertaking accreditation of Goulburn Hospital in August 2016.
  • Continuing to develop partnerships. In August 2016 CRMEC is partnering with HETI in organising a two-day education forum to explore training issues across NSW and the ACT. Our partnership with South Australia Medical Education and Training continues to be strong.

Business and Infrastructure Branch

Business and Infrastructure Branch is responsible for providing a range of infrastructure and strategic support services to all ACT Health acute and non-acute sites across the ACT.

The Business and Infrastructure Branch portfolio includes the following services:

  • Business Continuity Management
  • Communications
  • Corporate Records Management
  • Domestic and Environmental Services
  • Fire and Emergency Coordination and Training
  • Fleet Management
  • Food Services
  • Main Reception / Switchboard
  • Parking
  • Procurement and Asset Management
  • Property Management and Maintenance
  • Residential Accommodation
  • Security Services
  • Sterilising Services
  • Supply Services
  • Sustainability
  • Volunteer Management.
Key achievements
Courtesy Bus

In June 2015, a Courtesy Bus service was introduced at the Canberra Hospital campus. The service is designed to assist patients, visitors and staff with mobility difficulties to navigate across the campus. The decision to run the service was based on feedback received from consumers, specifically regarding the distance from the multi-storey car park to the main hospital and the Centenary Hospital for Women and Children (CHWC).

The service has been received favourably by the community and staff, with positive feedback having been received since its implementation.

In 2016–17, ACT Health will seek further feedback on the service as part of quality improvement practices.

Food services

In the 2014–15 Annual Report, Business and Infrastructure Branch reported on the success of a Meal Service Quality Improvement Project, in a report named A Quality Improvement Journey in Service Delivery to Aged Care – The Canberra Hospital Experience. The project resulted in improved menu items and packaging, as well as greater ‘access’ to meals through the use of coloured tray mats to identify which patients require some or full assistance with their meal.

The Food Services Department at Canberra Hospital submitted the project for consideration in the 2015 Rosemary Pirie Excellence Awards. The National Board of the Institute of Hospitality and HealthCare Australia select a recipient or organisation to be awarded the national Rosemary Pirie Excellence Award in recognition of the contribution they have made toward providing excellence in Health and Aged Care Food or Hotel Services Training and Quality assurance.

The Meal Service Quality Improvement Project was awarded the Rosemary Pirie Excellence Award at the 34th Institute of Hospitality in HealthCare National Conference in October 2015.

The Meal Service Quality Improvement Project was awarded the Rosemary Pirie Excellence Award at the 34th Institute of Hospitality in HealthCare National Conference.
Sterilising Services accreditation

ACT Health Sterilising Services has been successfully accredited for ISO 9001:2008 Quality Management System (QMS) since 2006. This is a three-year re-certification cycle, which was last achieved on 30 November 2014. An annual surveillance assessment is required to maintain re-certification. The surveillance assessment was conducted on 21 August 2015 and all objectives were achieved.

Sustainability

In August 2015, the Minister for Health and Minister for the Environment,
Simon Corbell MLA, announced that ACT Health were successful in their application to the ACT Government Carbon Neutral Government Fund (CNGF).

The application will fund:

  • the installation of photovoltaic (PV) solar panels (500KW) on the roof of the Southern (multi-storey) Car Park at Canberra Hospital
  • an LED replacement program for existing hospital infrastructure.
Issues and challenges

ACT Health’s energy usage continues to grow in line with increased activity and significant additional infrastructure that has come online in the past few years. Canberra Hospital is one of the ACT Government’s largest user of electricity, consuming almost 20 per cent of the Territory’s electricity to power its critical 24-hour service.

Hospitals are high energy consumers due to:

  • their size and operation
  • the number of bathrooms and operating theatres
  • the energy requirements of the numerous pathology services, Medical Imaging services and diagnostic equipment.

All contribute to the volume of energy consumed, particularly at Canberra Hospital which is the region’s tertiary referral hospital and major trauma centre.

Installing PV solar panels on the multi-storey car park and LED lighting throughout existing buildings will assist to reduce the energy usage in the future.

Future directions

It is important that new technologies and innovative solutions be introduced and implemented to:

  • service both the current and future demands of support services
  • enhance the patient-focused service delivery across all areas of health care.

Business and Infrastructure Branch’s implementation of an automated identification system for assets, patients and staff will continue to progress. Currently, the project is standardising the identifiers used in linear barcodes and Radio-frequency Identification (RFID) formats that are used in ACT Health. In implementing this system, the branch has adopted international standards and developed a Location-based Services Framework. This work is supported through GS1 Australia.

At Canberra Hospital the standards have been implemented to identify patients and staff when collecting pathology samples. Work is continuing to implement these standards to support real-time tracking and location identification of movable and portable assets.

To further improve the Courtesy Bus service, a live GPS tracking device has been installed in the bus to provide consumers with real-time route information. The live route map will be accessible on the ACT Health website and via a Quick Response (QR) code.

Business and Infrastructure Branch will also continue to review systems and processes as part of quality improvements and to gain efficiencies.

eHealth and Clinical Records Branch

Key achievements

The eHealth and Clinical Records Branch oversaw improvements to a range of existing information and communication technology (ICT) solutions, including the following:

  • Introducing a new electronic clinical record system for the Walk-in Centres (WiCs) at Tuggeranong and Belconnen, to support clinical and administrative workflows.
  • Introducing the QFlow system at Belconnen Community Health Centre, to streamline appointment processes and healthcare consumer assistance processes.
  • Expanding the use of an improved clinical record search and registration solution, known as Active Search. This functionality leverages the patient master index to provide advanced searching tools that support fast, effective patient record searches and reduce duplicate record creation rates.
  • Continuing to rollout a rapid access technology solution which enables Canberra Hospital clinical staff to log into shared computers within 4–6 seconds.
  • Introducing a new system for the Revenue and Financial Services Unit.
  • Enhancing the ACT Health Clinical Portal, including introducing a surgical safety checklist.
  • Expanding the eRostering system for a range of community-based staff.
  • Introducing the Epiphany system, for storing echocardiograms and generating associated reports.
  • Expanding the Renal Service information system, to provide access for Renal Service staff operating in NSW regional locations.

A range of existing systems were also upgraded, including:

  • the risk and incident management system
  • systems used by the Clinical Record Service, Facilities Management, Medical Imaging, Emergency Department, Equipment Loans Service, Thoracic Unit, and the Renal Service.

In addition, e-learning packages were developed for a number of ACT Health clinical systems.

Future directions

eHealth and Clinical Records Branch is working towards implementing a range of initiatives to support staff in delivering high-quality care to our healthcare consumers. These initiatives will build on the solid eHealth foundation that has been established over the past few years. The objectives that guide these initiatives include:

  • improving availability and timeliness of information designed to support clinical decision-making at the point of care
  • facilitating better collaboration
  • supporting improved efficiencies across hospital- and community-based health services.

Population Health Division Overview

The Population Health Division has primary responsibility for managing population health issues within ACT Health. The division undertakes the core functions of prevention, assessment, policy development and assurance, and contributes to local and national policy, program delivery and protocols on population health issues.

The division consists of:

  • Health Improvement Branch (HIB)
  • Health Protection Service
  • Office of the Chief Health Officer (OCHO)
  • Health Emergency Management Unit (HEMU).

The Population Health Division is headed by the ACT Chief Health Officer who is appointed under the Public Health Act 1997 and reports to the Director-General of ACT Health. The ACT Chief Health Officer is also required to report biennially on the health of the ACT population on specific health-related topics, through the ACT Chief Health Officer’s Report.

The HIB has carriage of policy and program delivery in the areas of health promotion and preventive health. The HIB also collects, analyses and disseminates information on the health status and health-related behaviours of the ACT population. This information can be used to monitor, evaluate and guide health planning and policy.

The Health Protection Service manages risks and implements strategies for the prevention of, and timely response to, public health incidents. This is achieved through a range of regulatory and policy activities relating to areas such as:

  • food safety
  • communicable disease control
  • environmental health
  • pharmaceutical products
  • tobacco control
  • analytical services.

The OCHO is responsible for providing public health advice—both internally and externally to the division—as well as high-level project and policy work on behalf of the ACT Chief Health Officer. Key policy priority areas for the OCHO include:

  • obesity and injury prevention and reduction
  • medicinal cannabis
  • loose-fill asbestos
  • organ and tissue donation
  • gene technology
  • climate change.

The HEMU provides direction and advice to support ACT Health responses to:

  • incidents
  • emergencies
  • public health risks
  • disasters that occur locally, nationally and internationally.

Key achievements

Population Health Division has introduced several legislative changes since February 2016 to protect or improve the health of the population:

  • Smoke-Free Legislative Amendment Bill 2016: this amendment restricts the sale, promotion and use of personal vaporisers (e-cigarettes).
  • Medicines, Poisons and Therapeutic Goods Regulation 2008: this amendment allows pharmacists to administer vaccinations to adult patients without a prescription.
  • Transplantation and Anatomy Amendment Bill 2016: this amendment introduces a more efficient organ donation process.
  • Smoke-Free Public Places Amendment Bill 2016: this amendment will streamline the process for establishing new smoke-free areas.
  • Medicines, Poisons and Therapeutic Goods Regulation 2008: this amendment introduces a more streamlined and flexible process for prescribing controlled medicines.

In June 2016, Population Health Division released Healthy Canberra: the 2016 Chief Health Officer’s Report, which focused on four key areas:

  • Healthy City
  • Healthy Weight
  • Healthy Lifestyle
  • Healthy People.

This year’s report is complemented by a new HealthStats ACT website, which provides health statistics on a broad range of population health topics.

The Population Health Division continued to work closely with Chief Minister, Treasury and Economic Development Directorate (CMTEDD) to implement the Healthy Weight Initiative (HWI) and aligned programs to reduce the burden of overweight and obesity related chronic diseases and demand on the health services, including the following:

  • Introducing the Choose Healthier local business pilot project which is a pilot of five businesses that have increased their promotion and availability of healthy food and drinks, and reduced the marketing of unhealthy food and drinks, particularly towards children.
  • Releasing the ACT Health Promotion Grants Program Report which provides a snapshot of how the ACT Government’s investment in the ACT Health Promotion Grants Program has improved health outcomes across the ACT. Over 90 per cent of the ACT Health Promotion Grants Program funding was provided to programs that address issues of overweight and obesity in the ACT. 
  • Continuing to deliver programs and campaigns that improve the health and wellbeing of the ACT community, including:
  • Kids at Play
  • Good Habits for Life
  • Fresh Tastes
  • Ride or Walk to School
  • It’s Your Move.

The ACT continued to lead the country in immunisation rates for children under five years old, with rates consistently above 90 per cent in all age cohorts.

Outlook for 2016–17

The Population Health Division will undertake work to establish a Medicinal Cannabis Scheme in the ACT to give people safe and legal access to high-quality medicinal cannabis products.

In 2016–17, amendments will be made to the Medicines Poisons and Therapeutic Goods Regulation to introduce a more flexible approach when applying for ACT Chief Health Officer approval for controlled medicines.

In 2016-17, the Public Health Amendment Bill 2016 will be introduced to allow public health officers to better manage insanitary conditions resulting from hoarding and domestic squalor in the ACT.

Health Infrastructure and Planning Division Overview

During 2015–16, Health Planning and Infrastructure Division had corporate responsibility for:

  • the project direction and management of the Directorate’s Health Infrastructure Program, including coordination, management and implementation
  • strategic accommodation
  • the Capital Upgrades Program
  • the Arts in Health Program
  • the Woden Relocation Project.

Achievements

2015–16 marked the eighth year of the Health Infrastructure Program.

A range of projects within the Health Infrastructure Program have been completed, others are ongoing and a number recently commenced. Planning, designing and constructing facilities is aligned with concurrent activity relating to:

  • the workforce
  • models of care and service delivery
  • technology.

This will ensure that the built environment assists clinicians to provide the best possible care.

Section C.3 Capital works, page 228, provides a detailed description of the progress on Health Infrastructure Program works, and works undertaken as part of the Capital Upgrades Program.

Projects delivered in 2015–16 by the Health Planning and Infrastructure Division as part of the Health Infrastructure Program, or under the Capital Upgrades Program, included:

  • refurbishing the Central Outpatients Department
  • constructing a new cryogenics facility at Canberra Hospital
  • completing the Calvary Hospital Car Park
  • constructing the new modular Building 15 at Canberra Hospital.

The Arts in Health Program includes the development and implementation of briefs for art in new Health Infrastructure Program projects.

The year 2015–16 saw the completion of projects at Belconnen Community Health Centre and Paediatric Emergency, Apheresis in the Canberra Regional Cancer Centre and continued procurement of works for the Centenary Hospital for Women and Children (CHWC). The program also saw a pilot dance project in association with Ausdance ACT at the CHWC. These projects have been funded by the Canberra Hospital Foundation, including donations by Ausdance ACT and some in kind donations by artists.

Procurement of works of art for the Secure Mental Health Unit is underway and a brief for art at the University of Canberra Public Hospital is in progress.

Outlook for 2016–2017

The following Health Infrastructure Program projects are programmed to be completed in 2016–17:

  • the Emergency Department Expansion Project
  • Ngunnawal Bush Healing Farm
  • Secure Mental Health Unit
  • Calvary Hospital – Operating Theatre Upgrade and Medical Imaging Department Upgrade
  • Hospital Road upgrades to provide additional capacity to Canberra Hospital
  • installation of internal signage across Canberra Hospital campus.

The following project will continue construction throughout 2016–17:

  • University of Canberra Public Hospital.

The following Health Planning and Infrastructure projects are programmed to commence construction in 2016–17:

  • Southern Carpark Solar Panel Project
  • Electrical Main Switchboard Replacement at Canberra Hospital.

Corporate and Operations Plans

ACT Health's efforts over the reporting year have been guided by:

This section discusses the ACT Health-specific frameworks and strategies.

ACT Aboriginal and Torres Strait Islander Health Workforce Action Plan 2013–2018

The ACT Aboriginal and Torres Strait Islander Health Workforce Action Plan 2013–2018 seeks to increase the numbers of Aboriginal and Torres Strait Islander people employed in the health workforce.

Employing, recruiting and retaining Aboriginal and Torres Strait Islander people in the health workforce strengthens our ability to provide an effective, responsive and culturally safe health system, which is of mutual benefit to the community and our organisation.

ACT Health Workforce Plan 2013–2018

The ACT Health Workforce Plan 2013–2018 aligns with national health workforce reforms, including the research and evidence provided by the Health Workforce Australia (HWA) National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015. The plan provides strategies under focus areas for direction, action, accountabilities and measures of success, which are able to be applied to operational workforce planning in all areas of ACT Health.

ACT Breastfeeding Strategic Framework 2010–2015

The ACT Breastfeeding Strategic Framework 2010–2015 sets the context for protecting, promoting and supporting breastfeeding in the ACT. The framework supported the implementation of the action areas in the Australian National Breastfeeding Strategy 2010–2015.

ACT Chronic Conditions Strategy 2013–2018

The ACT Chronic Conditions Strategy 2013–2018 provides overarching direction for chronic condition care and support in the ACT and outlines the requirement for a coordinated approach across the government and non-government sector. It concentrates on improving care and support services for every person living with a chronic condition.

ACT Health Corporate Governance Statement, 2015

The ACT Health Corporate Governance Statement, 2015 provides an overview of the organisation. It is a starting point for gaining further detailed information on organisational:

  • structures
  • roles and relationships
  • policies and procedures
  • accountability mechanisms.

ACT Health Corporate Plan 2012–2017

The ACT Health Corporate Plan 2012–2017 articulates:

  • key focus areas
  • priorities for improvement
  • key strategies for achieving the priorities
  • achievements planned for the long-term (five years).

In 2015–16, ACT Health continued to measure its performance against these areas through key performance measures identified in:

The target achievements for each year are contained in ACT Health’s Business Plan.

ACT Health Quality and Clinical Governance Framework 2015–2018

The ACT Health Quality and Clinical Governance Framework 2015–2018articulates the clinical governance systems within ACT Health that support delivery of high-quality safe services. In practice, good clinical governance focuses on creating an environment in which there is transparent responsibility and accountability for maintaining standards, allowing excellence in clinical care to flourish.

ACT Health Reconciliation Action Plan 2015–18

The ACT Health Reconciliation Action Plan 2015–18 will build on the previous plan, which was created to foster a cultural change in the health environment. The new plan ensures that ACT Health will continue working towards reconciliation and to making a difference in health outcomes for Aboriginal and Torres Strait Islander peoples.

In reflecting on our cultural awareness training achievements to date, ACT Health is resolved to further our commitment to building a culturally proficient organisation. We will do this by increasing our awareness of reconciliation and encouraging conversations within ACT Health on how we can work towards creating a cultural proficient workforce that recognises that health is not just the physical wellbeing of an individual but the social, emotional and cultural wellbeing of the whole community.

ACT and Southern NSW Local Health District Cancer Services Plan 2015–2020

The ACT and Southern NSW Local Health District Cancer Services Plan 2015–2020 acknowledges the necessity for close collaboration between the ACT and Southern NSW Local Health District (SNSWLHD) health services when planning cancer services for the region’s population. The plan:

  • provides overarching strategic direction for cancer services across both the ACT and SNSWLHD
  • highlights the need to work together in order to provide person-centred care that is equitable and timely
  • recognises that the number of people needing cancer treatments in the Southern NSW (SNSW) region is expected to grow significantly, which reflects an ageing demographic, and that this is a very important part of our health service planning
  • builds on Australia’s very strong role in recognising that a fully comprehensive approach to cancer control needs to consider the role of primary and secondary prevention
  • addresses that with improvements in the science of cancer, we need clinicians who are skilled at dealing with the human dimensions of care, and that this is crucial area of workforce capability.

In addition, the plan addresses the requirement for modern cancer services to have strong linkages between disciplines such as:

  • research, an area in which Canberra Hospital has had great success
  • cancer service clinicians, e.g. Medical Oncology
  • clinical trials in new cancer therapeutics.

The role of ACT Health in developing a national-level centre of excellence in cancer services at Canberra Hospital is pivotal to delivering the plan, whereby:

  • the Canberra Hospital service functions as the main tertiary Oncology referral service for the region and provides the leadership and support required in regional areas
  • clinicians in SNSW hospitals deliver considerable cancer-related care, e.g. surgery, medical oncology day centres and palliative care.

ACT Health Sustainability Strategy 2010–2015

The ACT Health Sustainability Strategy 2010–15 is designed to meet the challenges that climate change will have on the ACT. It provides a roadmap for collaborative action between ACT Health and all stakeholders, clients and staff, including other government departments. The roadmap ensures business and clinical services (including planning for the future) are linked with the strategy and incorporate actions and achievements to deliver the objective of a sustainable health system for the future.

A renewed ACT Health Sustainability Strategy for 2016–2020 has been drafted. It embraces the roadmap as a checklist for deciding what actions to take and actively tracks progress towards the established aims and objectives. The renewed strategy will lead a plan of action that also captures strategies from and aligns timescales with the ACT Health Resource Management Plan 2016–2020.

Population Health Division Strategic Framework 2013–2016

The Population Health Division Strategic Framework 2013–2016 verifies the role of the Population Health Division in the context of other key players working in public health in the ACT. The framework identifies strategic objectives for the division to meet in improving the health of the ACT.

ACT Immunisation Strategy 2012–2016

The ACT Immunisation Strategy 2012–2016 provides a framework for improving immunisation services and coverage within the ACT. It continues the work achieved in the previous immunisation strategy by building on its achievements and identifying further focus areas for immunisation.

Future Directions for Tobacco Reduction in the ACT 2013–2016

The ACT Government’s Future Directions for Tobacco Reduction in the ACT 2013–2016 was launched on 31 May 2013, World No Tobacco Day. It focuses on two key action areas for further development:

  • restricting access to tobacco
  • restricting places of tobacco use.

ACT Health Mental Health Service Planning

ACT Health is working with the ACT Capital Health Network to develop a consistent jurisdictional approach for mental health planning for the ACT. The Capital Health Networks across Australia are tasked by the Commonwealth Government to develop regional mental health plans that are endorsed by the Local Hospital Networks.

ACT Mental Health and Wellbeing Framework 2015–25

The ACT Mental Health and Wellbeing Framework 2015–25 was endorsed as a whole-of-government framework in February 2016. The framework is a high-level strategic policy document that covers the related areas of:

  • mental health
  • mental illness
  • preventing suicide and self-harm.

The framework recognises that good mental health and wellbeing depend on a wide range of factors and that a holistic, whole-of-community approach is essential for preventing and reducing the impacts of mental illness. The framework provides a structure for coordinated whole-of-government and whole-of-community action. As the lead agency, ACT Health holds a primary responsibility for working with other government agencies to ensure the framework objectives are met.

ACT Lymphoedema Plan 2015–2018

The ACT Lymphoedema Services Plan 2015–2018 is a high-level strategic planning document that guides the delivery of public lymphoedema services to residents of the ACT and surrounding region.

The plan promotes communication and collaboration across public and private services in the ACT and surrounding region. In addition, a framework for services has been developed and a Lymphoedema Services Network has been established in order to better meet the needs of people in the ACT region and respond to increasing demand in an efficient and sustainable way.

The plan highlights a ‘Hub and Spoke’ model for service provision to enable a critical mass of specialist clinicians to provide treatment and to provide education to General Practices and staff in community and hospital settings. The Hub will be based at Calvary Hospital and the Spokes will include a northside and a southside community health centre.

ACT Palliative Care Services Plan 2013–2017

The ACT Palliative Care Services Plan 2013–2017 provides strategic direction for developing palliative care in the ACT to best meet current and projected population needs. It recognises that people in the ACT with a life-threatening illness and their families and carers need timely access to quality palliative care that is consumer- and carer-focused, respects their choices and is appropriate to their needs.

Improving Women’s Access to Health Care Services and Information: A Strategic Framework 2010–2015

The Improving Women’s Access to Health Care Services and Information: A Strategic Framework 2015–2016 has provided the overarching strategic directions, i.e. long-term objectives, for ACT Health to enable and enhance women’s access to and satisfaction with healthcare services. The target group for this framework is females aged 12 years and over.

MyHealth Strategy

In January 2015, ACT Health demonstrated its commitment to staff wellbeing, by establishing the MyHealth Manager role with recurrent annual funding The MyHealth Staff Health and Wellbeing Strategy and Action Plan 2016–2018 provides a framework to enable ACT Health to develop, implement and monitor wellbeing initiatives to December 2018. The strategy’s overall objectives fall under the categories People, Places and Culture, and the four key focus areas are:

  • Emotional Wellbeing
  • Smoke-Free Environment
  • Healthy Eating and Drinking
  • Physical Health.

Towards Culturally Appropriate and Inclusive Services - A Coordinating Framework for ACT Health 2014–18

A new Multicultural Health Policy Unit (MCHPU) was established within Policy and Government Relations and commenced on 1 July 2013. Its role is to facilitate an organisation-wide approach to multicultural health issues so that culturally and linguistically appropriate services and information are a focus not only in clinical areas but across the organisation, including in preventive health, health promotion and public health services.

After extensive consultation, the MCHPU released Towards Culturally Appropriate and Inclusive Services - A Coordinating Framework for ACT Health 2014–18 to improve responsiveness to cultural and linguistic diversity across the organisation.

For more information, see B.1 Organisational overview—2015–16 strategic priorities—Improving services and information for people from culturally and linguistically diverse backgrounds, page 68.

System Innovation Group

The System Innovation Group (SIG) is a new organisational unit headed by the Deputy Director-General, ACT Health System Innovation Group.

SIG partners with other areas of the organisation to lead innovation in the areas of:

  • access, quality and mental health
  • workforce and culture
  • strategic partners, infrastructure, business and digital
  • finance, performance and data innovation.

ACT Health established the SIG to manage the System Innovation Program (SIP), which was approved by the ACT Government in November 2015.

The SIP is ACT Health’s approach for achieving continuous improvement in ACT Health services. The approach aims to strengthen the delivery of health care by focusing on patient-centred care and enriching the patient experience.

SIP outcomes are delivered across seven key organisation-wide themes:

  • Access
  • Quality
  • Mental Health
  • Innovation and Sustainability
  • Strategic Partners
  • Infrastructure
  • Culture.

The SIP objectives include improving access to services, increasing efficiency and freeing up hospital capacity by implementing contemporary service delivery solutions and models of care.

More specifically the SIP is focusing on:

  • Improving efficiency by:
    • increasing the bed efficiency equivalent to 50 overnight beds by 2018–19
    • achieving savings totalling $97.2m between 2016–17 and 2019–20.
  • Progressively improving ACT Health’s performance against the National Emergency Access Target (NEAT), by the achieving the following targets:
    • 69 per cent of the national performance target by 30 June 2016
    • 77 per cent of the national performance target by 30 August 2016
    • 90 per cent of the national performance target by June 2017.
  • Improving our performance against the National Elective Surgery Target (NEST) by:
    • reducing the number of paediatric patients classified as ‘long wait’ to zero
    • reducing the remaining ‘long wait’ list by 90 per cent.
  • Reducing the need for category 4 and 5 presentations to attend the ED.

In addition, ACT Health has committed to becoming a leading public healthcare organisation in terms of culture, including:

  • revitalising ACT Health’s values
  • improving the methods of managing organisational change
  • continuing initiatives to address and prevent inappropriate workplace behaviour.

SIP is driven by a process of transformational change through an Integrated Program Management Office (IPMO), which is administered under SIG.

The IPMO is responsible for coordinating and reporting for ACT Health SIP.

Achievements

During 2015–16, SIG’s achievements included:

  • establishing the SIG itself and the SIP
  • establishing the IPMO
  • providing centralised coordination, support and governance to 93 projects across ACT Health
  • improving ACT Health’s performance against the NEAT to meet our 30 June 2016 target of 77 per cent
  • improving ACT Health’s performance against the NEST by conducting more than 1,300 additional ‘long wait’ elective surgery cases by June 2016
  • reviewing Medical Imaging services, which has resulted in significant improvements in outpatient waiting times for CT and MRI scans
  • developing a Strategic Asset Management Framework.

Outlook for 2016–2017

Initiatives to be pursued in 2016–17 include:

  • developing Strategic Asset Management Plans
  • developing a Performance Excellence Framework
  • implementing Activity-based Funding and Activity-based Management
  • transitioning from a consultant-led to an in-house Program Management Office capability.

2015–16 strategic priorities

Strategic and operational initiatives pursued in 2015-16 included:

  • continuing to meet the growth in the demand for services across acute care, mental health, palliative care, women’s and children’s, outpatients and community health
  • providing increased community mental health, alcohol and other drug treatment services including supportive accommodation, Crisis Assessment and Treatment Team, self-harm diversion, specialist drug treatment and support for people with psychogeriatric conditions
  • continuing work to improve health and wellbeing within the Aboriginal and Torres Strait Islander community;
  • continuing to support a reduction in the burden of chronic disease and the related increasing costs of health care through a range of programs to promote and support healthy lifestyles
  • increasing the level of elective surgery operations provided for the ACT community
  • strengthening the capacity of non-government organisations to deliver specialist drug treatment and support services.

Meeting growth in demand

Overview

In 2015–16, ACT public hospitals had increased demand for:

  • Emergency Department presentations
  • inpatient admissions
  • elective surgery
  • births.

To meet growing demand for hospital services, the 2015–16 ACT Budget provided further funding for an additional 19 beds across ACT public hospitals. The 2015–16 Budget was $1.5 billion, which a seven per cent increase on 2014–15

 

Births

In 2015–16, preliminary figures show there were a total of 5,288 births at ACT public hospitals, an increase of two per cent from 2014–15. As shown in Figure 2, the result for 2015–16 is the highest number of births within a single year for ACT Health.

In 2015–16, the number of births by caesarean section equates to 28 per cent of all births.

 
Figure 2 ACT public hospitals birthing instances vs caesarean
*Preliminary figures used for 2015–16. Source: ACT Health Admitted Patient Care Dataset
Emergency Department presentations

Figure 3 shows that in 2015–16 ACT public hospital Emergency Departments had 135,307 presentations, a four per cent increase on 2014–15.

Admissions to hospital via the Emergency Department increased by 12 per cent to 39,868 in 2015–16.

More information: For detailed information on improving Emergency Department timeliness, see B.2 Performance Analysis, ACT Local Hospital Network strategic objectives and indicators, Strategic Objective 2: Improved Emergency Department Timeliness, page X.

 
Figure 3: Presentation to the Emergency Department versus admissions for hospital via the Emergency Department
Source: ACT Health Emergency Department Published Dataset
Alcohol and Other Drug Services

In mid-2015, the ACT Government announced one-off funding of $800,000 to increase the capacity of specialist drug treatment and support services, to prevent and reduce increasing methamphetamine and other drug-related harms. The funding allowed:

  • new staff to be hired
  • services to provide treatment earlier through improved management of waiting lists.

In the recent 2016–17 Budget announcement, the ACT Government announced $6 million over four years for more drug treatment and support services.

In the recent 2016–17 Budget announcement, the ACT Government announced $6 million over four years for more drug treatment and support services.

This includes annual funding to:

  • maintain the additional capacity created in 2015–16
  • rollout the successful naloxone program for those at risk of opioid overdose, through the Canberra Alliance for Harm Minimisation and Advocacy
  • provide booster training sessions for drug treatment and support workers
  • assess alcohol and other drug education and training needs of those working in allied sectors and to customise and deliver training
  • increase the capacity of drug rehabilitation programs to provide post-treatment support in conjunction with peer treatment support workers.

Improving health and wellbeing within the Aboriginal and Torres Strait Islander community

The Ngunnawal Bush Healing Farm will provide a culturally appropriate alcohol and other drug residential rehabilitation facility for adult Aboriginal and Torres Strait Islander people in the ACT. The initial service will be an eight-bed facility with scope to increase to 16 beds, subject to future funding decisions.

Construction of the facility is expected to be completed in the second half of 2016. Development approvals and negotiations to secure a service provider are progressing.

Improving services and information for people from culturally and linguistically diverse backgrounds

The Multicultural Health Policy Unit continued to facilitate implementation of Towards Culturally Appropriate and Inclusive Services – A Co-ordinating Framework for ACT Health (2014–18), focusing on four key areas:

  • improving data collection
  • providing culturally appropriate services and information
  • engaging Culturally and Linguistically Diverse (CALD) consumers in providing feedback and participating in service planning and review
  • developing organisational cultural competence.

The Multicultural Health Policy Unit also introduced:

  • a Language Services Policy and related procedure on the use of interpreters
  • a comprehensive ACT Health Guide to Language Services.

The unit was also finalist in the safety category of the 2015 ACT Safety and Quality in Health Care Awards for increasing interpreter use in clinical services.

The Multicultural Health Policy Unit was a finalist in the 2015 ACT Safety and Quality in Health Care Awards.

The unit presented the keynote address at a Health Literacy Conference, which was held in Melbourne, in March 2016.

The unit also increased the training and learning opportunities provided to staff by:

  • further developing intranet-based resources and other resources
  • providing face-to-face and e-learning on cultural competence and working with interpreters
  • in partnership with the Centre for Culture, Ethnicity and Health (Victoria), developing the Health Literacy Development Course, which focuses on cultural diversity
  • maintaining the ACT Health Multicultural Reference Group, which has participants from key external organisations.

In May 2016, the unit received additional resources to include a focus on other groups facing similar issues of stigma, discrimination and difficultly accessing responsive health services, including:

  • lesbian, gay, bisexual, transgender and intersex (LGBTI) people
  • people living with disabilities.

Implementing programs that promote and support healthy lifestyles

ACT Aboriginal and Torres Strait Islander Health Plan

ACT Health is currently developing a new ACT Aboriginal and Torres Strait Islander Health Plan: Priorities for the Next Five Years 2016-2020 (Health Plan). In line with feedback from initial consultations held in August and December 2014, the Health Plan will:

  • respond to key areas outlined in the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 and the ACT Aboriginal and Torres Strait Islander Agreement 2015-2018
  • be consistent with the values and principles of the United Nations Declaration on the Rights of Indigenous Peoples.

The Health Plan will include identifying key priority areas for action such as:

  • mental health and social and emotional wellbeing
  • chronic disease
  • community health
  • culturally skilled workforce
  • health performance
  • quality improvement.
Tobacco control

During 2015–16, the Government continued to implement initiatives to reduce smoking rates among Aboriginal and Torres Strait Islander peoples in the ACT.

Ongoing funding was provided to Winnunga Nimmityjah Aboriginal Health Service (Winnunga) and Gugan Gulwan Youth Aboriginal Corporation (Gugan Gulwan) to continue the Tackle Smoking Program and Street Beat Youth Outreach Network. One-off funding was also provided to Winnunga and Gugan Gulwan to support additional smoking cessation activities, including:

  • developing new information materials
  • conducting group activities
  • purchasing new educational resources for tobacco workers
  • providing staff education and professional development
  • providing free Nicotine Replacement Therapy for pregnant women and their cohabitants (where costs would otherwise be associated)
  • participating in community education and events.

One-off funding was also provided to the Alcohol, Tobacco, and Other Drug Association ACT (ATODA) to:

  • write a report on reducing smoking in the ACT among Aboriginal and Torres Strait Islander women who are pregnant or who have young children
  • implement a small smoking cessation capacity building project in response to some of the recommendations contained in the report. 

A review of the previous ACT Aboriginal and Torres Strait Islander Tobacco Control Strategy has been completed and development of a revised strategy has commenced.

Increasing elective surgery levels

During 2015–16, ACT significantly reduced the number of people waiting beyond recommended timeframes for surgery. A Whole-of-Territory elective surgery plan is being developed to manage demand into the future.

More information: For detailed information on elective surgery, see:

  • B.2 Performance Analysis, Health Directorate strategic indicators, Strategic Objective 1: Removals from Waiting List for Elective Surgery, page 75
  • B.2 Performance Analysis, ACT Local Hospital Network strategic objectives and indicators, Strategic Objective 1: Percentage of Elective Surgery Cases Admitted on Time by Clinical Urgency, page 84.