Annual Report 2008/09 - West Wimmera Health Service
Transcription
Annual Report 2008/09 - West Wimmera Health Service
At the Heart of Our Communities WEST WIMMERA HEALTH SERVICE ANNUAL REPORT 2008–2009 BELOW: Nhill Hospital OUR VISION OUR VALUES To establish a health service without peer through the pursuit of excellence and by opening the doors to innovation and technology. Strong Leadership and Management OUR MISSION Safety will always be our prime focus. We value our organisation and will encourage exceptional professional skills and promote collaborative teamwork to drive better outcomes for our consumers. A Safe Environment A Culture of Continuing Improvement West Wimmera Health Service is committed to the delivery of health, welfare and disability services which are compassionate, responsive, accessible and accountable to individual and community needs, which result in quality outcomes for the people of the West and South Wimmera, and Southern Mallee. The delivery of superior care to our consumers motivates a culture of quality improvement in all that we do. Effective Management of the Environment Our Service is managed in ways which recognise environmental imperatives. Responsive Partnerships with Our Consumers We maintain a productive relationship with our communities and stakeholders through open communication, honest reporting and a willingness to embrace constructive suggestions. About this Report This Report is a clear and honest summary of our performance in every aspect of our business and is a key document in communicating with our communities and other stakeholders about every aspect of our undertakings. It details the communities we serve and the health programs and services we deliver. It also outlines the goals we set, and the strategies we planned for achieving them, our financial outcome for 2008/2009, the Governance system of the Service and the Executive staff responsible for management of the Service. To maintain our high standard of clear and open reporting this Report was prepared in accordance with the directions of the Victorian Government, the Victorian Minister for Finance, the guidelines of the Australasian Reporting Awards Inc. and also recommendations received in response to entering the 2008 Annual and Quality of Care Reports in the PricewaterhouseCoopers Transparency Awards. The Report will be distributed, in September, to the Victorian Parliament and the Department of Human Services for their approval to publish and then released to the community and other stakeholders at West Wimmera Health Service Annual General Meeting to be held in the Nhill Community Centre on Friday 27th November 2009 at 8.00pm where Dr Peter Morley MB, BS, DIP ENG, MPH, Medical Director – International Burmungrad International Hospital, Bangkok, Thailand – will be the Guest Speaker. We have included a Glossary of Terms & Abbreviations and an Index on page 86 to assist readers to navigate this Report. This Report and our Quality of Care Report can be accessed on our Website and the internal Intranet. www.wwhs.net.au Hard copies are available at each of our sites or by request via email or mail. [email protected] The Resource Centre West Wimmera Health Service P.O. Box 231 Nhill Victoria 3418 AUSTRALIA © Copyright West Wimmera Health Service September 2009 CONTENTS Our Year > Highlights, Events & Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 President’s Report > 2008 – 2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Our Organisation > The Pride of the Western Wimmera . . . . . . . . . . . . . . . . . . . . .4 Our Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Looking Forward > Steps Towards Reaching Our Vision . . . . . . . . . . . . . . . . . . . . .6 Chief Executive Officer > An Insight into Our Service 2008 – 2009 . . . . . . . .8 The Year In Review > Chief Executive Officer’s Perspective . . . . . . . . . . . . . . . .10 Industrial Relations and Human Resources > Well Managed. . . . . . . . . . . . . . . . .16 Management Of Risk > Not a Risky Business?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Education > Developing Our Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Employees > The Heart and Soul of Our Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 WWHS Staff 2008–2009. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Our Year > A Statistical Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 Community and Fundraising > We Depend on You! . . . . . . . . . . . . . . . . . . . . . . . . . . .24 Corporate Governance > Directives and Obligations . . . . . . . . . . . . . . . . . . . . . . . .28 Organisational Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Board Of Governance > Member Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Leadership And Management > Our Executive Team . . . . . . . . . . . . . . . . . . . . . . . .32 Acute Care Services > We Can Care for You. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Medical Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 Residential Care > For Our Senior Citizens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Community And Allied Health > Our Care Reaching Out . . . . . . . . . . . . . . . . . . . . .46 Cooinda > Disability and Business Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 Corporate and Quality Services > Support that is Essential. . . . . . . . . . . . . . . . .52 Accreditation – An External Measure of Quality. . . . . . . . . . . . . . . . . . . . . . . .55 Environment and Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56 Legislation > Critical to Our Performance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 Finance and Administration > Sustainable and Accountable . . . . . . . . . . . . . . . .58 Financial Performance > Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 Auditor General’s Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 Certification and Financial Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 Compliance Disclosure Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85 Glossary of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86 1 ANNUAL REPORT 2008/2009 OUR YEAR HIGHLIGHTS, EVENTS & CHALLENGES HIGHLIGHTS OF THE PAST YEAR CHALLENGES FOR THE COMING YEAR > The Honourable Daniel Andrews MP, Minister for Health > Implement recommendations from the Community Needs visited the Nhill Hospital on 27th March > > > > > > ACHS EQuIP four year accreditation status retained ACHS Diagnostic Imaging Accreditation achieved and ‘Mira’ Complex Australasian Annual Report Gold Reporting Award 2007-08 > Development of a Strategic Plan 2009-2012 > Introduction and implementation of ‘iSoft’ Patient Annual & Quality of Care Report entered in PricewaterhouseCoopers Transparency Awards > Replacement and upgrade Fire Detection system and HACC Accreditation attained Report Highly Commended > Community Needs Analysis & Service Profile Project completed Dialysis service doubled to four chairs Commencement of Dental Therapy Service Achieved a full suite of Allied Health Practitioners Medical services at Goroke Community Health Centre extended > Upgraded motor vehicle fleet to more efficient and environmentally friendly composition > > > > > Recruit & retain skilled staff > Completion of remaining building stages of the Nhill Hospital Aged Care Accreditation maintained > Department of Human Services Awards – 2007 Quality of Care > > > > Analysis & Service Profile Project Opening of Oliver’s Kiosk at Nhill Hospital Foot Care Clinic introduced Diabetes Insulin Pump Clinic increased $130,000 Philanthropic contribution from Perpetual Trustees, The Percy Baxter Charitable Trust > Department of Human Services ‘Close Watch’ Financial Reporting Monitoring ceased > Appointment of Clinical Operations Manager and Manager of Allied & Community Health > WWHS Health & Fitness Centre opened > $651,204 for Equipment and Infrastructure & Essential Services from DHS Management System Nurse Call system at Kaniva Hospital > > > > Redevelopment of Goroke Community Health Centre Finalise business plan for relocation of Kaniva Hostel Secure funding for Medical Clinics at Nhill and Rainbow Commencement of Dental Clinics at Rainbow, Kaniva and Goroke > Strengthening partnerships with regional and sub-regional hospitals and Health Services Performance in Brief for the Year Ended 30 June 2008 Acute Services Patients Treated Occupancy Cost Per Acute Inpatient 2008/09 2007/08 Variance 1,879 1,902 -1.2% 71.88% 73.65% -1.8% $4,547 $ 4,400 +3.3% Residential Aged Care Services Nursing Home (High Care) Percentage Occupancy Hostel (Low Care) Percentage Occupancy Cost Per Aged Care Day 98.86% 92.49% $245 98.94% 90.48% $241 -0.1% +2.0% +1.7% Allied & Community Health Services Occasions of Service 66,633 66,004 +1.0% 546 536 +1.8% Fundraising **Funds Raised Total Cost of Fundraising 254,105 1,206,337 10,000 15,000 -78.9% -33.3% Finance Finance Total Operating Surplus 599,000 450,000 33.1% Total Net Surplus 425,000 1,473,000 -71.1% Employees Total Employees Notes: *Total employees for financial year. **2007/08 boosted by steady donations for the Nhill Hospital Redevelopment. 2 WEST WIMMERA HEALTH SERVICE PRESIDENT’S REPORT 2008 – 2009 This is my second term in office as President of West Wimmera Health Service and when I consider the achievements of the Service during this period, I do so with a great sense of pride in the quality of leadership, the dedication and skill of staff and the altruism of community volunteers. The Board of Governance has continued to strengthen its role in effecting sound and responsible governance of West Wimmera Health Service throughout the reporting period. We have experienced another successful year of operation with many of the positive outcomes illustrated throughout this report. In particular, I am gratified to confirm very strong performances in the areas of clinical services and financial management. The Board welcomed Mr Harvey Champness from Kaniva as a Board Member at the March 2009 Board Meeting after his appointment by the Governor in Council from 3 March 2009. My fellow Board of Governance members bring together a diverse range of complementary expertise and experience, to ensure that the many aspects required in governing a health care organisation as complex as ours can be successfully undertaken. I would like to thank each and every Board Member for their valuable contribution and commitment to the Service. West Wimmera Health Service has continued to work closely with the Department of Human Services to enhance funding opportunities and the level of service delivery we provide. Hosting the Minister for Health, the Honourable Mr Daniel Andrews MP, on his visit to the Service in March 2009 was a personal highlight in my year’s presidency. His visit was a signal honour for our Service and I am pleased to report that the Minister was considerably impressed with the standard of the Nhill Hospital. It was a pleasure to host the Minister for the afternoon of his visit. Board Members thank the Executive Team and all staff for their continued exceptional contribution to the Service. Working with a strong ethos of teamwork throughout the organisation results in the end-goal of our service – the highest quality and effectiveness of care provided to our patients, residents and clients. Excellent accreditation outcomes confirm and recognise these high levels of service provision. We are at the advent of the next three year Strategic Plan – 2009-10 – 2012-13. This plan will implement recommendations from the Community Needs and Service Profile Project Report and heralds an exciting time of development for our service. We will, in the coming year, continue in our endeavours to provide the very highest levels and widest range of available healthcare for our communities. We regard it as a privilege to serve the people of West Wimmera. In accordance with the Financial Management Act 1994, I am pleased to present the Report of Operations for West Wimmera Health Service for the year ending 30 June 2009. Without doubt it is reassuring to note that his ‘bedside manner’ with our Chief Executive Officer, a patient at the time, was first rate. To Mr John Smith, Chief Executive Officer, I again extend my sincere thanks for an excellent outcome in the year 2008-09. John, your dedication and loyalty to the Service, your exemplary work ethic and forward vision have once again proved to be pivotal factors in ensuring the continually improving quality of healthcare that is delivered in all our facilities. Mr Ron A. Ismay President Nhill 24 August 2009 PAGE RIGHT: Ron A. Ismay – President, West Wimmera Health Service ANNUAL REPORT 2008/2009 3 4 WEST WIMMERA HEALTH SERVICE OUR ORGANISATION THE PRIDE OF THE WESTERN WIMMERA NSW Rainbow SOUTH AUSTRALIA Where Can You Find Us? Jeparit Kaniva Nhill Goroke Natimuk Horsham VICTORIA Ararat Ballarat Melbourne In the Grampians Region of the Department of Human Services, the Local Government areas of the Shires of Hindmarsh, West Wimmera, a portion of the Rural City of Horsham and Yarriambiack Shires in the South and West Wimmera, and Southern Mallee in rural and remote North Western Victoria. Our catchment area of approximately 17,000 square kilometres is bound by the Wyperfeld and Little Desert National Parks, home to rare species of Australian flora and fauna. Mount Arapiles, a world renowned rock climbing mecca borders our Natimuk Aged Care Centre – spectacular tourist attractions. Nhill, Rainbow, Jeparit, Kaniva, Goroke and Natimuk are the communities where we have a significant presence. wwhs facilities wwhs catchment West Wimmera Health Service, a public health service incorporated under the Health Services Act 1988, was created on the 21st August, 1995, and now is a vital element in the sustainability of the rural communities it serves. In an environment with an ageing population, continuing drought and relatively low socioeconomic conditions the health care available from this Service is central to the physical, mental and social well being of our community. We are an integrated health service offering an exceptional choice of health care ranging from Acute Surgical Specialties, Allied Health, Community Health and Health Promotion, Disability Services, Supported Employment Options, Community Aged Care Options, to Hostels and Nursing Homes. Our Community Profile Our communities and the agricultural industry have strong links with grains, sheep and legumes being the primary products. On the other hand several national and international industries are located in Nhill - a boost for the economy and employment options. Through the harsh times our communities have relied on West Wimmera Health Service as never before. Access to the diverse choice of quality health and welfare services in the community is a blessing appreciated by all. Six very diverse communities – What was their link? Resourcefulness and a determination without equal to maintain health services in these small rural communities was the foundation in 1995 for the progressive mergers of seven services in six communities, including the first Disability Service and first Community Health Centre in Victoria to come under the umbrella of a Public Hospital. As always, dollars were the change makers, with never enough to support service provision, building repairs and renewal of our hospitals and aged care facilities, the challenge to retain staff, attract General Practitioners and the need to keep up with the rising standards of care, buildings and services. The projected benefits of joining forces far outweighed the inner parochial feelings of wanting ‘each hospital to stay the same’. > Communities overwhelmingly voted to merge and become West Wimmera Health Service. The process occurred over five years and the results speak for themselves. > Brand new Hospitals, Nursing Homes and Hostels stand at Nhill, Kaniva, Natimuk, Rainbow & Jeparit, together with the significant redevelopment at Cooinda, our Disability Service. > Services thought to be a ‘pipe dream’ are now a reality. > Continued Accreditation status provides proof that West Wimmera Health Service’s broad range of care has been given the ‘tick of approval’ by independent external assessors. Our Future – What will it be? The recommendations from the Community Needs Analysis and Service Profile Project will be instrumental in setting the care provided by the Service for the next decade ensuring our Health Service will remain the centre for exceptional care in the Grampians region. 5 ANNUAL REPORT 2008/2009 OUR ORGANISATION > OUR SERVICES Aged Care Residential Hostels & Nursing Homes Community & Home Based Aged Care Clinical Services Acute Services Admission and Discharge Clinic Dental Diagnostic Dental Prosthetic Dialysis Domiciliary Midwifery Ear Nose and Throat Surgery Gastroenterology General and Specialist Medical Care General and Specialist Surgery Laparoscopic Surgery Maternity Shared Care Clinic Medical Services Nursing Traineeships Obstetrics and Gynaecology Ophthalmic Surgery Oral Surgery Orthopaedic Surgery Palliative Care Pathology Pharmacy Post Acute Care Primary Care Casualty Psychiatry Reconstructive Surgery Regional Discharge Planning Strategy Allied and Community Support Services Aged Care Assessment Services Ante/Post Natal Classes Asthma Education and Counselling Cancer Council of Victoria - Cancer Awareness Cardiac Rehabilitation Carer Support Community Health Nursing Continence Education Diabetes Education Dietetics District Nursing Drought Centre Drug and Alcohol Exercise Groups Exercise Physiology Farm Safety Education Fitness Assessments Guys & Gals School Program Gym/Weights Program Hairdressing Health & Fitness Centre Health Education and Promotion Hearing Screening Home and Community Care Hospital in the Home Hospital to Home Kindergarten Screenings - Podiatry, Speech Pathology Living with Cancer Program Lowan Rural Health Network Massage Therapy Maternal and Child Health Meals on Wheels Myotherapy National Diabetes Services Nutrition Education Occupational Therapy Optometry Orthodontic Referral Pap Smear Tests Physiotherapy Planned Activity Groups – (Day Centres) Podiatry Puberty ‘Biz’ Sexuality Education to Grade 6 Children and Parents Radiology ‘Secret Men’s Business’ – group for older men Social Work – Welfare and Counselling Service Speech Pathology Work Experience Disability Services Advocacy Assistant Training Australians Working Together Community Access Employment Program Food Preparation and Sales Future for Young Adults Living Skills Supported Employment Therapy Programs Vocational Training Regional Services To: Allambi Elderly Peoples Home, Dimboola Avonlea Hostel Nhill Dunmunkle Health Service Edenhope Hospital Goroke P-12 College Hopetoun Hospital BELOW: Jeparit Hospital Jeparit Primary School Kaniva College Kindergartens - Nhill, Jeparit, Kaniva, Rainbow, Goroke Lutheran Primary School, Nhill Natimuk Primary School Nhill College Rainbow College Rainbow Primary School Rural Northwest Health St Patrick’s Primary School, Nhill Woomelang Bush Nursing Centre Service Support Education Engineering and Maintenance Health Information Management Hotel Services Library and Resource Services Traineeships Volunteers Work Experience Work Placements Community Programs: Hospital To Home (H2H) H2H is a service available for patients who have a short term need which cannot be met through regular community service provision. This program supports patients in the transition from hospital to home. Patients must live in municipalities associated with West Wimmera Health Service. Hospital in the Home (HITH) HITH is the provision of hospital care in the comfort of the person’s own home. Patients are regarded as hospital inpatients and remain under the care of their treating doctor in the hospital. National Respite for Carers (NRCP) Provides ‘time out’ for carers of people with dementia. This program offers carers the opportunity to maintain their own interests, while fulfilling the demanding role of carer. Nursing Homes - Hostels Accommodation Community Aged Care Packages (CACPs) Nhill These packages offer comprehensive assistance to the elderly to support them in their homes, thus delaying entry into a hostel or nursing home for as long as possible. The carer is also able to manage for longer with the support provided. ‘Iona’ Digby Harris Home, for 26 frail aged, dementia and psychogeriatric residents. Kaniva Archie Gray Nursing Home, Nursing Home for 11 residents. Kaniva Cottages, 10 two bedroom units for low care Hostel residents. Jeparit Nursing Home for 10 residents. Hostel for 5 residents. Rainbow Bowhaven Hostel for 10 residents. Weeah Nursing Home for 10 frail aged residents. Natimuk Natimuk Nursing Home, for 20 residents. ‘Allan W Lockwood’ Special Care Hostel dedicated care for 11 residents with dementia. Trescowthick House Hostel for 10 frail aged residents. Post Acute Care (PAC) Provides community-based services such as community nursing and personal care. Home and Community Care Program (HACC) This program provides care in home and community settings to frail older adults, younger people with disabilities, and their carers, promoting independence to these groups thus avoiding premature or inappropriate admission to long term residential aged care. 6 WEST WIMMERA HEALTH SERVICE LOOKING FORWARD STEPS TOWARDS REACHING OUR VISION Delivering Needs Based Health Care Strategy Achievements Future Actions > Undertake a Community Needs Analysis & Service Profile Project > > Extensive stakeholder consultations held Comprehensive Project Report finalised and adopted by the Board, June 2009 > Implement recommendations from the Project Report > Establish options for expansion of Clinical Services > > Increased dialysis service from 2 to 4 chairs Dental Therapist commenced in February 2009, providing specialised public dental care for children and young adults Allied Health Staffing levels increased with all departments now fully staffed and total complement of services provided to all sites > Re-introduce Dental Services to Rainbow, Kaniva & Goroke Conduct feasibility study regarding introduction of Ultrasound Introduce Chemotherapy care Introduce post acute and step down convalescence services in conjunction with sub-regional and regional hospitals Meetings held with regional and sub-regional health services on a regular basis Brokerage of Allied Health Practitioners to other regional health services Strengthened clinical liaisons with Medical Practitioners > Formalise coordination strategies for patient transfer from sub-regional and regional services for post acute and convalescence care Commenced Oliver’s Kiosk in March 2009 with exceptional patronage Purchase of a Catering Vehicle > Investigate expansion of catering service Conducted Clinical Risk Framework Internal Audit Established coordinated network with Victorian Managed Insurance Authority to address Risk Management planning and process > Adoption of the Victorian Government Clinical Risk Governance Framework Review overall Risk Management Framework with focus of best practice risk management processes Strengthen relationship with VMIA relating to Risk Management administration Education program for Board regarding Directors Duties > > Seek and develop opportunities for greater regional alliances > > > > Strengthening Leadership and Management > Increase the viability of Oliver’s Café through increased expansion of sales and marketing > Refinement of Risk Management Framework > > > > > > > > > > Optimum Human Resources Management Safe Practices & Environment Achieve improved internal communication through organisational and committee structures > > > > Reduction in number of management committees Increased meeting attendance rates Finalisation of clinical executive structure Seamless communication between all levels of management > > Evaluate effectiveness of committee structure Policies dealing with communication strategies to be reviewed > Formalise and enhance strategies for attraction, support and retention of visiting medical practitioners > > Appointment of General Practitioner Anaesthetist Appointment of Obstetrician and Gynaecologist > Seek recognition of overseas trained General Practitioner Surgeon and General Practitioner Obstetrician qualifications for Visiting Medical Practitioners > Strengthen the defined organisational structure > > Organisation structure reviewed, revised and enhanced Succession Plan formalised > > Ongoing review of organisation structure Address Succession Plan appropriateness > Introduce Human Resources Self Service (HRSS) portal > HRSS portal introduced > Broaden use of HRSS system to include rostering and leave management > Appoint a Human Resource Manager > Human Resource Manager position advertised > Finalise appointment to Human Resource Manager position > Adopt ‘best practice’ for all clinical safety and environmental procedures > > No sentinel events recorded Policies and procedures regularly reviewed > Clinical Quality & Safety Committee to review and introduce ‘best practice’ principles as appropriate > Comply with Occupational Health & Safety Act > Dedicated Occupational Health & Safety Committee introduced that meets monthly Accredited OH&S training provided to Health & Safety representatives > Encourage staff to undertake OH&S training courses Achieve optimal waste disposal recycling and environmental management > > Rain water collection increased at all sites General waste disposal sorted and graded to address recycling opportunities > Pursue all options to improve waste disposal and recycling systems Establish an ongoing environmental strategy and protocol > > > 7 ANNUAL REPORT 2008/2009 Sound Financial Management Strategy Achievements Future Actions > Maintenance of a robust financial management strategy > Increased residential aged care subsidies received following review of resident documentation Work place efficiencies achieved Improved monitoring and adherence to departmental budgets > > Close monitoring of capital expenditure budget Achieve an operating surplus annually > Continue a capital fundraising program > Distribution from Philanthropic Trusts, Benefactors, Donations and Bequests totalled $187,548.00 > Intensify access to Private Benefactors, Commercial Enterprise, Philanthropic Foundations and Bequests > Maximise Aged Care Revenue > Increased subsidies derived from Aged Care Funding Instrument (ACFI) Highest Bed Occupancy levels for region > > Continued monitoring of ACFI levels Maximise occupancy rates at all levels Installation of IT servers providing increased capacity and improved security Introduction of HRSS New West Wimmera Health Service website launched and operational > Consider the introduction of a Knowledge Management System New Information Technology Strategic Plan to be developed Education delivered for iSoft Patient Management system Computer replacement program progressed Clinical Mobile Video System introduced > Redevelopment works commenced at Rainbow and Kaniva Applications submitted to Commonwealth seeking funding for Nhill and Rainbow Medical Clinics > Successful application to Perpetual Trustees for $130,000 > > > > Effective Information Management > Develop and implement an Information Communications Technology Strategy > Develop information technology links to improve access, efficiency and effectiveness of preparation, storage and retrieval of records > Redevelop Dental Clinics at Rainbow, Kaniva and Goroke Provide stand alone Medical Clinics at Nhill and Rainbow > Complete Stage 3 & 4 of ‘New’ Nhill Hospital and Mira complex > > Assess the need for residential services at Goroke > > > Project Control Group established at Goroke Community consultations conducted Consultant Architect commissioned to undertake feasibility study > Finalise options for redevelopment of Goroke Community Health Centre > Review redevelopment/refurbishment needs across the Services > Consultant Architect appointed to undertake a feasibility study to address the sentiments of the Strategy > Pursue Consultant’s feasibility study report and determine action to be taken > Maintain constructive relationships with our community and other stakeholders > Community Consultation Forums conducted at each township Community Advisory Committees provide regular feedback to Board of Governance Informative website developed and operational Contract retained with Media, Marketing and Public Relations Consultant Increased media coverage of Service delivery and activities > Continue to conduct open forums at each township on an annual basis Work closely with and utilise the services of Media Consultant to further promote the worth of WWHS > Asset Management > > > Relationships with the Community and Other Stakeholders > > > > > > > > > > > > > > > Installation and introduction of iSoft Patient Management system Introduction of ‘Oracle’ Financial Management system Gain greater clinical benefit from Clinical Mobile Video Unit Commission new Dental Clinics at Rainbow and Kaniva Obtain funding for Nhill and Rainbow Medical Clinics Complete ‘Mira’ Allied and Community Health Centre refurbishment – Stage 3 Commence redevelopment of Kitchen and Administration area of ‘New’ Nhill Hospital Stage 4 8 WEST WIMMERA HEALTH SERVICE CHIEF EXECUTIVE OFFICER AN INSIGHT INTO OUR SERVICE 2008 – 2009 In the coming year we have set ourselves the task to further strengthen all aspects of the organisation so that we can continue to achieve exemplary levels of excellence in the provision of healthcare. Unlike recent years 2008-09 was not a year when our focus centred on new building or major expansions of service. Rather, it was a time to closely examine and consolidate our wide ranging healthcare imperatives and business activities to ensure optimum efficiencies and realise emerging potential. The financial constraints caused by redevelopment programs during the period 2002-2005 are now behind us and we have worked extremely hard to achieve the current healthy financial position in an acknowledged difficult economic climate. The operating surplus of $599K is the consequence of refining business efficiencies while continuing to increase service delivery in many clinical areas. The true test was in being awarded accreditation by the Australian Council of Healthcare Standards in November 2008 for four years. This judgement showcased our Service and highlighted performance improvements and excellence of the quality of care we provide. Success in financial and clinical sectors can be difficult to maintain and this year West Wimmera Health Service excelled in both areas. Ensuring highly skilled staff were recruited and retained was certainly a prime concern and it is pleasing to report we conclude the year with an excellent array of clinical professionals in our workforce; this is a gratifying achievement! The calibre of such professionals is at an all time high and provides a strong platform from which to develop further innovative programs, particularly in the areas of community health and health promotion. The implementation of a ‘Back to Basics’ nursing education program mandates nursing staff members be educated on amendments to policies, new equipment and best practice documentation and competencies. This systematic approach to clinical education ensures each and every nurse at West Wimmera is well equipped to deliver all aspects of their professional roles. Increased Director of Nursing and Unit Manager involvement on Committees has had an obvious benefit with enhanced integration between strategic policy and operational roles. The final Report supports retaining all current West Wimmera Health Service clinical services and identifies areas where service growth should occur. This Report presents exciting opportunities to increase the scale and scope of health care we may offer in the future and harness new and emerging technologies to enable this to occur. The Report underlines the need and importance of continuing to press forward and intensify commitment to continual improvement. Our year of strengthening the organisation has resulted in a prime strategic manner to implement all the recommendations of the Community Needs Analysis and Service Profile Project. We now await endorsement and adoption of the Report by the Department of Human Services. There is no doubt this is the beginning of an important and exciting decade! On a personal note I have continued my association with the ACHS as a Councillor and Board Member, the AHHA as a Councillor, and serve on the Board of the VHIA. This provides West Wimmera Health Service with a voice in leading strategic and important healthcare sector authorities – privileges I gratefully value. Once again we have produced an Annual Report which comprehensively outlines who we are and how we work as an organisation. We firmly believe that the excellence in our communication with communities, staff and the broad health industry is an integral part of service provision. An explanation of every component of our operations is provided to give an understanding of how we can assist you as an individual and our collaborative population health approach for all the communities is a responsibility we must constantly remember and actively initiate. We have emerged as a potential new leader in rural health care where our emergence as a primary care innovator has commenced the journey. This transformation has been earned through continued hard work, dedication and commitment of our Board Members and Staff, with every single role contributing to our success. I look forward to the challenges and inevitably rewards that the Community Needs Analysis and Service Profile Project recommendations will bring and trust that working together with all stakeholders West Wimmera Health Service will continue to shine. The Community Needs Analysis and Service Profile Project study has been unparalleled in comparison with anything West Wimmera Health Service has embarked upon since its inception. The Project incorporated community forums, stakeholder consultations, data collection, departmental interviews and a departmental policy review to consider and address the adequacy and range of the current clinical services provided and to develop a 10 year Clinical Service Plan. Undertaken by external Consultants, the Project was managed by an Advisory Committee comprising West Wimmera Health Service Executives, Department of Human Service Representatives and a Community Representative. Mr John N. Smith PSM Chief Executive Officer PAGE RIGHT: John N. Smith PSM – CEO, West Wimmera Health Service ANNUAL REPORT 2008/2009 9 10 WEST WIMMERA HEALTH SERVICE THE YEAR IN REVIEW CHIEF EXECUTIVE OFFICER’S PERSPECTIVE In this reporting period we have concentrated on long term growth and sustainability to guarantee that the healthcare actually needed by our stakeholders will be available to them for the next decade. The challenges we will face along the way will provide outstanding opportunities for West Wimmera Health Service to adapt to the changes required to achieve ‘a Health Service without peer’. 11 ANNUAL REPORT 2008/2009 Minister For Health Visits Financial Performance One of the highlights of our year was the visit by the Minister for Health Mr Daniel Andrews on Friday 27th March 2009. It is with pride our successful financial management strategies over consecutive years were recognised by the Department of Human Services with the ceasing of Close Watch Financial Monitoring Program at the end of the 2007-08 financial year. Minister Andrews visited the Nhill Hospital to announce a $32,669 funding boost for cardiac monitoring equipment and operating theatre trolleys through the Department of Human Services Targeted Equipment Program. It was a pleasure to showcase our facility to Minister Andrews and he was glowing in his praise for the Hospital and staff. Risk Management Risk Management continues to be at the forefront of business at the Service. Our Risk Register captures all identified risks, and relevant reports are presented to the Board and Operational Committees for review and action. Internal Auditors, ‘Deloittes’ play an important role in verification of appropriate risk controls through the Internal Audit process. More than ever the Internal Auditors review items outside the traditional financial systems, and in 2009 reviews have included Clinical Governance and Occupational Health and Safety. Our diverse risk systems ensure that West Wimmera Health Service can manage risk in a proactive manner across all facets of the organisation. For further information on Risk Management refer to page 17. Annual General Meeting The Annual General Meeting was held on Friday 28th November 2008 at the Nhill Sports Centre. An excellent audience of approximately 250 people gathered to learn about the progress and achievements of the Service and staff. The Guest Speaker, Mr. Khoa Do, Young Australian of the Year 2005, was a captivating speaker with an important message for the audience. Reports indicated that the audience was indeed impressed and inspired with Khoa’s presentation. PAGE LEFT: Anaesthetist, Dr Kim Fielke preparing anaesthetic prior to surgery The Department uses Close Watch to monitor Health Services considered to be at high risk for financial performance. Our Service had been on ‘Close Watch’ for three years as a result of cash flow difficulties and the resulting deficit during the intensive building program incorporating Natimuk and Rainbow facilities. During the 2008-09 financial year we have reported mandated financial data to the Department of Human Services. Annual Report 2008 Gold Award West Wimmera Health Service received a Gold Award for its 2008 Annual Report. This is an outstanding result for the organisation and places our reporting standards at the highest level across Australasia. The Annual Report is our flagship publication each year, outlining the high level of services we provide. It is confirmation that the Service meets the criteria of producing factual, open and honest reporting, promoting a better public awareness of our activities. Quality Of Care Report 2006-07 High Commendation West Wimmera Health Service was presented with a ‘High Commendation’ award for the Quality of Care Report 2006-07 at the Victorian Public Healthcare Awards in the Small Rural Hospitals section. The recognition of the high standard of this publication was greatly appreciated as we continue to strive for excellence through the reporting media. We await the result for the 20072008 Quality of Care Report due in September 2009. Dr Kim Fielke – General Practitioner Anaesthetist Dr Kim Fielke has been credentialed as a Visiting Medical Practitioner and has commenced providing Anaesthetist services at the Nhill Hospital. Dr Fielke is an experienced General Practitioner Anaesthetist based at Western District Health Service, Hamilton. We are privileged to have gained this service to complement our comprehensive range of Visiting Medical Practitioners. Executive Structure Revised The Executive Structure relating to Clinical Divisions was reviewed, and it was deemed that one Executive Director for Clinical Services would be the most effective structure. Previously three Executive Directors covered the Clinical Divisions. The roles of Executive Director of Aged Care, Executive Director of Acute Care and Executive Director of Community and Disability are effectively combined into the new position of Executive Director of Clinical Services. The Senior Management structure of the Clinical Division was also revised to encompass new appointments to assist the Executive Director of Clinical Services. The new positions of Manager of Allied and Community Health and Clinical Operations Manager reporting directly to the Executive Director of Clinical Services were created. The changes in structure have been extremely beneficial with a more direct approach to specific aspects of Clinical and associated care. Capital & Equipment Grants 2008-09 Funding Purpose Annual Provision for Minor Works Aged Care Annual Provision Jeparit Hospital Water Tanks Kaniva Hospital Nurse Call System Natimuk Air Conditioning Kaniva Hospital Hot Water Units Fire Safety Grant Cardiac Monitoring System Total Amount 15,000 30,000 14,500 62,000 95,000 28,726 120,000 32,460 $397,686.00 12 WEST WIMMERA HEALTH SERVICE THE YEAR IN REVIEW > CHIEF EXECUTIVE OFFICER’S PERSPECTIVE Strategic Plan 2006/07 – 2008/09 HealthSMART Information Technology Program The current Strategic Plan 2006-07 to 2008-09 expired at the end of June. The implementation of HealthSMART ‘iSoft’ patient management software system has occurred this year. Environmental impact and fuel efficiency were major considerations when selecting the new vehicles throughout the reporting period. The iSoft Patient and Client Management software will replace IBA, the outdated acute patient management system currently in use. Expenses for the fleet are a significant cost. Investing in fuel efficient vehicles was a benefit to the environment and also had a positive financial impact. ‘iSoft’ will provide a comprehensive patient management and administration system inclusive of inpatients, primary health and administration data relating to aged care. Oliver’s ‘Kiosk’ Training has been provided for all key users and we eagerly await the introduction of the system in August 2009. Operated by the supported employees and staff of Oliver’s Café under the auspice of Cooinda Disability Business Services, Oliver’s Kiosk offers light meals and beverages to visitors and staff of the Nhill Hospital. ‘Moving Ahead’, a Progress Report on the implementation of the Strategic Plan to 30th September 2008 was presented to the community at the November 2008 Annual General Meeting. This public reporting was a first for the Service outlining progress towards implementing and achieving the strategic objectives of the Board of Governance. The strategic accomplishments over the period were substantial and the Service looks forward to implementing a new Strategic Plan to maintain the momentum of our planned progress. ABOVE: At the Nhill Hospital, Shirley Avery helps Braden Taylor as he chooses his lunch from Oliver’s Kiosk, while his mother Lyn watches. Barista, Graeme Ruse is busy at the very popular coffee machine. PAGE RIGHT: Exercise Physiologist, Tracey Bell (left) guides community member Sharon Bone (right) with her fitness program. New Motor Vehicle Fleet Oliver’s Kiosk at the Nhill Hospital was officially opened on Tuesday 31 March 2009. Support of the Kiosk has been astounding and customers are extremely complimentary about the quality of the food and friendly service. It has enhanced working opportunities for our supported employees and has added to the ambience of the Hospital. 13 ANNUAL REPORT 2008/2009 WWHS Health and Fitness Centre West Wimmera Health Service commenced management of the Nhill Gymnasium on the 1st January 2009 – now known as the Health and Fitness Centre. Qualified staff provide advice relating to the use of equipment and develop specialised individual fitness programs. A wonderful opportunity to impact on the health and well being of the community. 14 WEST WIMMERA HEALTH SERVICE THE YEAR IN REVIEW > CHIEF EXECUTIVE OFFICER’S PERSPECTIVE Dental Therapist Tristar Medical Group The commencement of a Dental Therapist at the Nhill Dental Clinic in February was in accordance with our goal to expand Dental Services. Tristar Medical Group continues to provide West Wimmera Health Service with a full complement of Visiting Medical General Practitioners. Under a brokerage arrangement with Wimmera Health Care Group, the Therapist provides dental services every week to children aged 0 – 18 years enhancing dental services available to children in our communities. Our working relationship has continued to strengthen with ‘Tristar’ and we are extremely thankful for its continued commitment to the communities for which we care. An excellent outcome! Community Participation and Engagement Brokerage of Allied Health Services Community Needs Analysis & Service Profile Project The recruitment drive for Allied Health Professionals has been so successful that West Wimmera Health Service is in the fortunate position to assist neighbouring Health Services and Aged Care Residential Facilities with the provision of Allied Health Practitioners on a fee for service basis. The developing network of Allied Health brokerage for speech pathology, podiatry, occupational therapy and dietetics enables the wider Wimmera region to benefit from the highly skilled Allied Health Practitioners we employ. During 2008-09 West Wimmera Health Service embarked upon a Community Needs Analysis and Service Profile Project. The purpose of the Project was to review current service provision and demand for services throughout the Service catchment. A Service Plan for a ten year period was devised to lead the Service to meet the needs of our patients, residents and clients. Consultants were appointed to conduct the Project and an Advisory Committee formed comprising a Board Member, Executive staff, Department of Human Services Central and Regional Office Representatives and a Community Representative. The project included consultation with all major stakeholders including staff. Community forums were conducted at all our catchment townships. In May 2009 the Advisory Committee approved the Final Report which outlined recommendations for future service delivery, its contents then being adopted by the Board. The Report concluded that all current service provision was essential with, additional services recommended. We now await the Department of Human Services final approval of the Report so we can commence implementing the Service Plan which will enhance our ability to deliver the healthcare needs of our catchment population. ABOVE: Dental Therapist Christine Petersen discussing dental hygiene with Jayrell Sellens. 15 ANNUAL REPORT 2008/2009 Menu Revised The development of a new menu was undertaken by WWHS throughout 2008. During the trial process considerable feedback about the new menu was received. One area of concern was the particular ‘titles’ of menu selections and for residents in particular, the modern title was difficult in some circumstances to identify the ingredients. Catering staff organised a focus group to discuss this aspect, and as a consequence meal titles were altered to more accurately reflect the content of the selected dish. New titles are based on identifying the key ingredients which further assist meal choice for preference, allergies and flavours. The feedback was extremely valuable and the clear and simplified meal titles ensure patients and residents are now fully informed. Some Highlights from Our Vast Compliments … Community Advisory Committees All communities of our Service have active Community Advisory Committees in place. Reporting to the Board, Community Advisory Committees provide a direct line of communication from community members and consumers. A successful recruiting campaign for additional Community Advisory Committee members during the year bolstered numbers. Community Advisory Committees play an important role in informing the Board about community concerns and perceptions of the Service, as well as highlighting the excellent achievements the Service has made. Conversely, members of the Advisory Committees are crucial to our communication strategy and assist in informing the broader community about what is happening within the Service. ABOVE: Audrey Gregory, resident of Archie Gray Nursing Home, Kaniva, and Div 1 Nurse Helen Ryan enjoy a chat without disturbing Ruby the Cat. Equity Trustees Not For Profit CEO of the Year Award I was honoured to be one of five finalists for the 2008 Equity Trustees ‘CEO of the Year Award’ presented at a ceremony at the Arts Centre in Melbourne on Thursday 30th October 2008. It was humbling to be recognised in a National Award with top class Chief Executive Officers from many excellent ‘Not for Profit’ organisations. Being nominated is a credit to West Wimmera Health Service and showcases the excellent work we do. Commendations & Advice Feedback either in the form of compliments or complaints is a vital component in delivering quality services. When consumers express their gratitude with a compliment, staff involved can be praised by their peers and their exceptional work acknowledged. Equally a complaint or constructive feedback assists us to identify areas of service that may require modification or, staff who may require further education to ensure high standards of healthcare delivery continues. ‘I cannot think of praise high enough in words for these people, - highly professional, caring, compassionate, thorough, serving, diligent, peaceful – I am really overwhelmed by the excellence of your staff.’ ‘Our heartfelt thanks to you all for your care, kindness and patience shown to our mother’ ‘We certainly picked the right hospital, you come highly recommended!’ Conclusion We will continue to steer West Wimmera Health Service on a direct course to achieve our Vision and Mission to practise impeccable governance, manage our finances prudently and recruit highly skilled, qualified and compassionate staff. These remain our enduring goals. 16 WEST WIMMERA HEALTH SERVICE INDUSTRIAL RELATIONS AND HUMAN RESOURCES WELL MANAGED The fundamental role of Industrial Relations and Human Resource Management is to successfully guide and support the workforce in a collaborative manner and in so doing increase productivity, position satisfaction and retain a highly skilled and knowledgeable workforce. A major and necessary attribute of the these functions is to provide advice to the Chief Executive Officer on key aspects associated with essential good governance. To ensure compliance with changes to workforce legislation and the Federal Government’s new ‘Fair Work Australia’ Policy, which will come into force on 1st July 2009, regular random audits have been conducted on employment and payroll practices. Evidence reveals the Service is meeting its legal obligations. The Australian Industrial Commission handed down its decision in relation to the Allied Health Professionals claim which resulted in a significant pay increase awarded to this group of employees. Unfortunately the decision did nothing tangible to assist Small Rural Health Services attract and retain keenly sought after Allied Health Professionals. Predictions surrounding a robust round of Enterprise Bargaining for non nursing and support staff did not eventuate largely due to the State Government changing its wages policy with the Union having to react quickly to ‘lock in’ a more generous outcome. The engagement of staff in change management practices has resulted in a number of innovative and sustainable changes across the service in the way we deliver Cleaning and Catering services. These changes have resulted in better outcomes for all concerned. During the year a Human Resource Governance Plan was developed which will be adapted to address the Service Strategic Plan. I am proud to emphasise we lost no time due to industrial disputes and our relationship with our staff is excellent. Benchmarking with other Rural Health Services continues to become a high priority in order to be recognised as an employer of choice to ensure ‘best practice’ ideals are observed. People Matter Survey 2008 The Service participates on a voluntary basis in the People Matter Survey conducted by the State Services Authority. This survey measures staff satisfaction and organisational compliance in relation to Public Sector Values and Employment Principles. The values measured are responsiveness, integrity, impartiality, accountability, respect, leadership and human rights. The purpose of the People Matter Survey is to track improvements in staff satisfaction over time and West Wimmera has recorded significant improvements over a very short period. People Matter Survey Merit Choosing people for the right reasons Reasonable avenues of redress Resolving issues fairly Equal employment opportunity Providing a fair go for all Fair and reasonable treatment Respecting and balancing people’s needs WWHS WWHS 2008 2006 84% 64% Like Orgs 2008 83% 77 % 51% 77% 94 % 87 % 94% 79% 63% 81% When comparing 2006 with the 2008 figures it is pleasing to note that the increase in staff satisfaction ranges from 7% to 26% over 39 indicators in the values section of the survey. Importantly we record the Human Resources Governance Plan has placed a high priority on continuous improvement with Executive Directors required to report to the Chief Executive Officer improvements gained across the Service. Training programs addressing Bullying and Harassment in the Workplace were well attended and we will concentrate in the coming year on employee assessment and professional development training to eradicate exposure to such undesirable behaviour. As we struggle in this economic period of financial instability and new employment laws, it will be important to build on the successes of the past and meet the challenges of the future which these unpredictable times may bring. ABOVE: John N. Smith PSM – CEO with Executive Director of Finance and Administration Ritchie Dodds who deputises in the CEO’s absence. PAGE RIGHT: Darren Welsh, Manager Quality & Safety, with Personal Care Worker Donna Watson, discussing mandatory education requirements. 17 ANNUAL REPORT 2008/2009 MANAGEMENT OF RISK NOT A RISKY BUSINESS? Risks are carefully reviewed by Executive Directors. Actions to minimise or eliminate risk are formulated and put into practise. Results are reported to the Performance Review Committee and the Board monthly. Through these processes the Service has been able to ensure there are no Very High or Extreme risks currently recorded within the Service. Risks are revealed through the Incident Reports. Incidents are documented and reported through a computerised incident reporting database (RiskMan), utilised by staff in all locations. The Risk Register is progressively refined to concentrate on organisation wide risks and to closely integrate it with the Incident Reporting system. Attestation The following attestation bears out the commitment of this Service to appropriate management of our risks. West Wimmera Health Service has adopted a proactive approach in managing its risks which includes all facilities and all types of service provision and activities. The Risk Management Framework includes procedures and practices to support the Risk Management Policy. This framework is designed to protect and enhance Service resources and support the achievement of Service objectives. The Framework emphasises that risk management is integral to the management process and is based on the following principles: > It is the responsibility of all executives, managers and employees, integrated into all Service activities and systems, and based on the Australia/ New Zealand Standard for Risk Management (AS/NZS 4360:2004). > Risk management is a part of everyday work practice for the staff of West Wimmera Health Service. > Risks may present in the clinical, non clinical, community and volunteering areas of our organisation. As a health care organisation, it is our responsibility to identify risks step by step, measure their impact and manage them. Risks take many forms; they can be associated with the long distances our allied health staff travel to attend patients in outlying areas, our maintenance staff working in confined spaces or our nurses administering medications to patients. Risk is managed from the Board through to the floor level of our operations. The Audit Committee provides the over-arching leadership and has the responsibility for risk governance. Attestation on Compliance with Australian/New Zealand Risk Management Standard 4360:2004 I, John Norman Smith certify that West Wimmera Health Service has risk management processes in place consistent with the Australian/New Zealand Risk Management Standard AS/ NZS 436:0 2004 and an internal control system is in place that enables the executives to understand, manage and satisfactorily control risk exposures. The Audit Committee verifies this assurance and that the risk profile of West Wimmera Health Service has been critically reviewed within the last 12 months. The Board and its Committees monitor and examine the risks of the organisation to ensure patients, staff, community and resources, human and material are protected. A Risk Register is maintained and is readily accessible to staff through the Service Intranet. They are encouraged to notify risks, contribute to the solutions and actions that minimise risks. Incidents are also rated according to severity, from immaterial to extreme, and placed in the Risk Register. John N. Smith PSM Chief Executive Officer Nhill 10 September 2009 18 WEST WIMMERA HEALTH SERVICE EDUCATION DEVELOPING OUR FUTURE To effectively care for our diverse communities it is crucial all staff have the necessary skills to meet the complex demands placed upon them in a safe, efficient, reliable and effective manner. Our ‘Virtual’ Future – Online Learning Our key to achieving this outcome is to establish and maintain a highly educated workforce, with the ability to respond to the changing needs of consumers. The e3 Learning opportunity is facilitated by the Department of Human Services with education modules developed jointly between the Grampians and Loddon Mallee Regions of the Department. There is no fee associated with its use and a Certificate is issued to the participant upon successful completion of each e3 Learning course. Education – Within Our Service This year, 315 internal education sessions occurred focusing on clinical care and skills, addressing practical aspects such as fire safety, technology and management, with 2,410 attendees – averaging 5 education sessions per staff member. The big change in education has been the move to online computer based learning, known as e3 Learning, a move enthusiastically embraced by staff. Modules addressing Medication Management and Fire and Emergency Training are expected to be available in December 2009. The Clinicians Health Channel, also facilitated by the Department, is another online opportunity for education, research and reputable clinical information. E3 Learning 2009 External education has been well addressed, with 156 sessions attended by 309 staff. Opportunities have included conferences, workshops and short courses providing up-to-date knowledge. We are committed to encouraging and supporting staff in pursuit of further education by making Bursaries available for Tertiary Study, paying Travel and Accommodation expenses for external Seminars, and providing paid leave for courses of study and attendance at conferences. Education Addressing Patient Safety 15 E3 Learning Participants by month Education Further Afield 12 9 6 3 The delivery of safe patient care is an undoubted imperative. To achieve this goal staff are required to undertake annual training in a number of key programs. Compliance with Mandatory Education Education Element Bullying and Sexual Harassment Chemical Handling Fire and Emergency Training Food Handling Incident Reporting Infection Control Manual Handling No Lift Privacy and Confidentiality Resuscitation: Basic CPR Resuscitation: Basic Life Support 2008/09 2007/08 2006/07 2005/06 2004/05 97% 98% 98% 70% 24% 99% 97% 95% 98% 100% 99% 86% 98% 50% 92% 99% 98% 97% 96% 95% 98% 95% 95% 97% 93% 95% 99% 97% 97% 95% 97% 94% 94% 92% 78% 81% 93% 70% 90% 68% 29% 36% 81% 66% 77% 96% 94% 98% 89% 70% 96% 90% 99% 92% 88% 0 Jan Mar Apr May Jun Total Videoconference Usage by Numbers and Duration 500 400 300 200 100 0 A high percentage of staff met the mandatory education requirements - an indication that education is more readily accessible and sought. Feb Commentary: Our staff have contiunued to embrace online (computer) learning since its official launch in January 2009. Over 190 individual education sessions have been completed. 85 different staff have used this new system and we expect this number to gradually increase in the next 12 months as staff become more aware of its availability. Each workplace has a number of computers available for staff to use. The education is also available for use from home via the internet. A Certificate of Achievement is awarded upon completion of the course and in addition this information is recorded in their personnel file. Hours Our goal is to reach 100% compliance, an outcome which must be achieved. Basic Life Support Manual Handling Elder Abuse Office Ergonomics IV Cannulation 2007/08 Total Durations (hours) Number of Conferences 2008/09 19 ANNUAL REPORT 2008/2009 Videoconferencing Educational opportunities are expanding with the increased use of videoconferencing at all sites, removing the tyranny of distance. Videoconferencing uses audio and video communication to bring people together for meeting and education purposes. This can be as simple as a discussion between two people or involve several sites with more than one person at each site. Videoconferencing can also be used to share documents and computer presentations. Counsellor Sybil Braybrook consults with clients via the Clinical Videoconferencing unit, Medilink. Face to face education is able to be undertaken where participants are great distances apart. Clinical staff meet weekly in this way to plan patient care through multi-disciplinary meetings. 20 WEST WIMMERA HEALTH SERVICE EMPLOYEES THE HEART AND SOUL OF OUR SERVICE In this era of high demand in the public and private sectors for workers in critical areas such as health care, information technology, engineering and accounting and the necessity to retain skilled workers we have applied a twofold approach to workforce planning using aggressive recruitment and innovative retention strategies to maintain experienced and highly motivated employees. Directors of Nursing & Unit Managers assemble prior to their monthly meeting. (L-R) Megan Webster, DON Jeparit, Angela Walker DON Natimuk, Lesley Hawker DON Kaniva, Christine Dufty Unit Manager Nhill Acute, Carol Paech DON Rainbow, Katrina Fraser Unit Manager Goroke. Absent: Dianne McDonald Unit Manager Iona Nhill Long & Loyal Service – Staff Service Awards 2009 Certificates and Badges will be presented at the Annual General Meeting to staff who have served this Service with loyalty and commitment over an extended period. We recognise their value to our Service and our patients. 35 Years of Service Pauline Colbert 30 Years of Service Roger Batchelor Denise Jensz 25 Years of Service Janet Fisher John Martion 20 Years of Service Shirley Ashfield Kaye Borgelt Pamela Clark Caroline Fischer Lorretta Fuller Dianne Green Rodney Greenaway Kerri Lynch Lisa Newcombe Lee-Ann Pumpa Megan Smith 15 Years of Service Karen Alexander Lisa Braybrook Gillian Burgess Pamela Burgess Richard Lane Julie Leddin Cheryl Lowe Sharyn Morrison Sharelle Newcombe Deborah Schilling Fiona Weir Desiree Williams 10 Years of Service Kelvin Asplin Rebecca Bastin Pauline Breen Toni Casey Shirley Crick Michelle Dickinson Mary Graetz Janet Heenan Brenda M Jackson Brian Jones Sally Kruger Douglas Matheson Kevin Merton Janet Shurdington Hilma Summerhayes Glenis Tink Elizabeth Witmitz Maureen Wright 21 ANNUAL REPORT 2008/2009 WWHS STAFF 2008–2009 Chief Executive Officer John Smith Executive Director Finance & Administration Ritchie Dodds Executive Director Clinical Services Janet Fisher Executive Director Corporate & Quality Services Kaye Borgelt Executive Director Medical Services Dr Ian Graham Executive Director Industrial Relations & Human Resource Management Leslie Butler Operations Manager Melanie Albrecht Executive Assistant Katrina Pilgrim Roy Abbott Lucy Adamson Elaine Aitken Jillian Albrecht Clifford Alexander Ian Alexander Karen Alexander Raelene Alexander Judy Allen Gary Allison Wendy Altmann Glenda Aristides Patricia Arnold Shirley Ashfield Kelvin Asplin Angela Atta Marlene Austin Shirley Avery Leah Bailey Zoe Ballentine Merrilyn Bamford May Barber Michelle Barber Kaye Baron Ian Barry Sharon Bartholomew Karen Barton Rebecca Bastin Roger Batchelor Heather Batson Narrelle Batson Sean Bayzand Clint Beattie Kellie Beattie Susanne Beattie Tracey Bell Julie Bloomfield Rhys Boehm Cindy Bone Mathew Bone David Brasier Lisa Braybrook Sybil Braybrook Anthony Breavington Pauline Breen Samantha Briggs Shelley Brown Amanda Brownsea Donna Burns Helen Burns Glenda Bush Jayne Campbell Helen Cannell Mark Carracher Taryn Carter Toni Casey Deborah Chaston Patricia Chequer Erol Chilton Peter Chilton Anne Christian Janine Clark Pamela Clark Robyn Clark Janice Clugston Pamela Coates Pauline Colbert Alexi Conboy Kellie Conboy Alison Connell Charles Cook Helene Cook Helisa Cook Jennifer Cook Kerryn Cook Sharyn Cook Jacqueline Cooper Sarah Coughlan Annie Coustley Judith Coutts Malcolm Coutts Kerry Coyne Marianne Cramer Shirley Crick Anthony Croke Carolyn Croke Maria Cuciniello Deborah Cunningham Janine Dahlenburg Tani Dahlenburg Jisha David Robert Davies Christine Dawson Sandra Decker Andrea Deckert Christine Deckert Kelvin Deckert Susanne Dedio Kellie Dickerson Michelle Dickinson Aimee Disher Shenae Dixon Kim Dodson Christine Dufty Jennifer Dufty Sherrie Dumesny Julie Dunford Lynette Dunford Timothy Dunmill Kerryn Dyer Danielle Eastick Michelle Eldridge Melissa Elliott Geraldine Ellis Sheryl Ellis Kaye Emmett Kevin Emmett Wendy Essex Allison Etherton Vicki Etherton Kerry Exell Christina Farinha Kaylene Featherstone Carmel Feder Penelope Finch Anne-Marie Fischer Caroline Fischer Janine Fischer Chantelle Fisher Loretta Fisher Erin Fisher Wendy Flavel Geoffrey Fletcher Jane Ford Katrina Fraser Margaret Frew Tyrone Friebel Lorretta Fuller Deborah Funcke Shirley Galpin Sharon Garwood Carol Gebert Darren Gebert Kylie Gebert Lipy George Gwenda Gilpin Leanne Glasgow Tanya Golder Kent Goldsworthy Tennille Gould Teresa Gould Stacey Grace Mary Graetz Leonie Graham Melinda Graham Ashley Grant Beverley Grant Lawrence Grayling Dianne Green Allan Greenaway Helen Greig Jennifer Greig Sarah Greig Beverly Hage Krystal Hall Yvonne Hall Anne Hamilton Cynthia Harberger Janine Harberger Judith Harrington Belinda Hartigan Lesley Hawker Christina Hayden Yingying He Christopher Hedt Janet Heenan Amanda Heinrich Marie Heinrich Trisha-Anne Heinrich Michael Henderson Samantha Hendy Craig Henley Merrin Hennessy Debra Hill Sandra Hinch Casey Hiscock Terri-Ann Hogart Jodie Holmes Shirley Honeyman Charmaine Hovey Beverley Howarth Elaine Humphrey Karen Hunter Kathleen Hutson Janice Hutton-Croser Sarai Innes Brenda Joy Jackson Brenda Mary Jackson Diane Jackson Jessica Jackson Phillip Jackson Helan Jacob Tracey Jarred Margaret Jarvis Swarnamalie Jayakody-Arachige Denise Jensz Nakita Jewell Janis John Cheryl Johnson Deborah Johnston Bianca Jones Brian Jones Kevin Jones Norman Jones Sonia Jones Valmai Jones Yvonne Jones Tesmy Jose Deborah Kakoschke Martha Karagiannis Judith Keller Marilyn Keller Rowena Keller Veronica Keller Kim Kendrick Karen Kennedy Kathryn Kennedy Catherine Kent Amanda King Mary King Sherin King Kayleen Kingwill Linda Knight Fiona Krelle Margaret Krelle Sally Kruger Elsamma Kuriakose Gladys Kyle Elizabeth Lacey Richard Lane Lynne Launer Kristine Laverty Julie Leddin Barbara Leffler Ingvar Lidman Katrina Lloyd Sally Lockwood Jessica Lovel Bree Amber Lowe Bree Camille Lowe Cheryl Lowe Darren Lyall Patricia Lyall Kerri Lynch Lynne Lynch Megan Mackenzie Patricia Mackenzie Dianne Maddern Lyn Maddern Marion Major Sharon Marais Brooke Marra Julie Marra Katie Martin Fay Martion John Martion Harsha Mary-Antony Melissa Mason Douglas Matheson Robyn Matheson Leah Matthews Seona Maybery Gaile Mayne Scott McCallum Andrea McCartney Dale McCartney Joanne McCartney Mathew McCartney Nichole McCartney Helen McClure Maree McClure Pauline McCracken Tanya McCracken Dianne McDonald Jennifer McDonald Merlyn McFarlane Bianca McGennisken Michelle McGennisken Stephanie McIntosh Catherine McKenzie Lynne McKenzie Sheryl McKenzie Julie McLean Lynette McLean Bonnie McLeod Peter McNelly Jane McPhee Casey Mellington Lisa Mellington Ann Merrett Maree Merrett Michelle Merrett Tracey Merrett Erin Merton Kevin Merton Neville Michael Pamela Michael CaraJane Millar Lisa Miller Sandra Millward-Coyne Rachel Milte Breanna Moar Cassandra Moar Trudi Moar Samantha Moloney Erin Moorhead Tracey Morphett Sharyn Morrison Sandra Muller Chloe Mulraney Samara Munn Jacqueline Nash Lisa Newcombe Sharelle Newcombe Candice Newton Courtney Newton Pamela Newton Erika Niemann Carole Nitschke Megan Nossack Kylie Oakley Leanne O’Connor Linda O’Heaney Polly O’Heaney Luke Oldaker Brenda O’Leary Jayne Oliver Carol Paech Rhianna Paech Reginald Parsons Catherine Patching Nerida Patterson Peter Pearce Elizabeth Pfeiffer Beverly Phillips Heather Pinyon Bobbie Pitt Christie Pitt Karen Pitt Loata Pitt Sandra Pollock Rebecca Powell-Hodges Courtney Preston Rhonda Preston Pamela Price Rosemary Pritchett Lee-Anne Pumpa Kelly Purcell Donna Purchase Nicola Quy Patricia Rabone Jaylath Ralalage Denise Ralph Jennifer Rentsch Joylene Rich Claire Riches Graeme Ridgwell Judith Ridgwell Christine Ridgwell Joshua Rintoule Allira Roberts Brenda Robinson Kaye Robinson Lesley Robinson Natalie Robinson Wendy Robson Lara Rogers Joylene Rohde Tanya Roll Valerie Roll Rosemarie Rose Helen Ross Teresa Ross Anna Rowe Denise Rowe Rosemary Rudd Graeme Ruse Helen Ryan Laurence Ryan Lynette Ryan Melissa Ryan Tania Ryan Patricia Sagasser Sharyn Salt Debra Sanders Sharon Sanderson Richard Sartori Patricia Saul Kathryn Saxton Judith Schier Deborah Schilling Sarah Schnaars Nicole Schneider Robert Schneider Shirley Schorback Rebecca Schultz Denise Schulz Wendy Schulze Debra Schumann Nicole Schumann Susan Scobie Ellen Scott Theresa Scott Diane Seeney Michelle Sheahan Karen Sherlock Kerryn Shrive Janet Shurdington Karen Shurdington Belinda Silinger Joyce Sipthorpe Wendy Sleep Susan Sluggett Dean Smith Flores Smith Janet Smith Judith Smith Keryn Smith Leanne Smith Stephanie Smith Philip Soumya Shirley Sproule Sreekanth Sreekumar Christine Stanford Casey Stasinowsky Amanda Stephan Yvonne Stephan Jacqueline Stevenson Elaine Stewart Denise Stimson Debra Stonehouse Hilma Summerhayes Susan Szejnoga Darren Taylor Sindi Taylor Sue Taylor Val Terry Ann Thomas Vicki Thomas Judith Thomson Penelope Thurlow Karen Tilley Glenis Tink Kristy Tink Jessie Toose Maritess Toquero Margaret Trenery Julie Tyerman Bronwyn Usher Adele Vincent Melanie Wagg Robyn Wagg Angela Walker Susan Walker Helen Wallis Krystal Wallis Leanne Wallis Rosalie Wallis Stacey Wallis-Rabone Donna Watson Julie Watson Karen Webb Lindy Webb Valerie Webb Elaine Webster Kerrie Webster Megan Webster Hannah Wedding Christopher Weir Fiona Weir Kristen Weir Katrina Welch Mary Welch Annmaree Wells Darren Welsh Linda White Cheryl Williams Desiree Williams Wendy Wills Elinor Wilson Nicol Wilson Elizabeth Witmitz Lauren Witmitz Norelle Witmitz Julie Woolcock Julie Worsley Elisa Wotherspoon Maureen Wright Martin Yau Mary Zadow Rhonda Zivkovic Christine Zubrinich 22 WEST WIMMERA HEALTH SERVICE OUR YEAR A STATISTICAL SUMMARY Allied and Community Health – Non Admitted Patient Occasions of Service Acute & Sub-Acute – 2 Year Comparison 2008/09 1,879 10,757 8,601 1,614 542 71.9% 4.68 0 615 334 60 0.8318 1,379.84 183.16 0.76 18.03 1,003.19 374.05 Patients Treated Occupied Bed Days (Total) Acute Bed Days Nursing Home Type Bed Days GEM Bed Days Percentage Occupancy (Acute) Acute Average Length of Stay (Days) Births Procedures DVA NHT Bed Days DVA GEM Bed Days Average DRG Weight Non DVA WIES DVA WIES TAC WIES Renal WIES Public WIES Private WIES 2007/08 1,902 11,052 8,366 1,669 1,017 73.7% 4.58 0 638 447 143 0.8036 1,384 144.70 4.21 14.69 1,026.49 344.88 Total Total 2008/09 862 2,245 1,429 836 3,941 4,415 3,053 514 2,003 95 1,643 3,601 1,763 2,052 2007/08 779 2,778 963 1,222 3,649 4,162 2,647 1,029 1,840 N/A 1,316 3,752 1,587 1,841 Decrease in occupied bed days is a direct result of community health promotion and preventative care activities. Pending appointment of a Geriatrician will increase the efficiency and utilisation of the GEM Program. Total Occasions of Service Transport Meals on Wheels Meals to Day Centre Meals to Senior Citizens 28,452 5,217 13,487 4,948 295 27,565 5,094 14,738 4,921 270 Residential Aged Care – 2 Year Comparison Total External Services 23,947 25,023 7,796 5,824 614 7,428 5,414 574 Total HACC 14,234 13,416 Total All Services 66,633 66,004 HACC Funded Activity Hours District Nursing Day Centre Community Health 5,305 31,979 417 5,485 29,764 380 Total 37,701 35,629 Nursing Home Bed Days Hostel Bed Days Nursing Home Discharges Hostel Discharges Percentage Occupancy Nursing Home Percentage Occupancy Hostel 2008/09 27784 15529 34 34 98.9% 92.5% 2007/08 27,883 15,234 36 24 98.94% 90.48% 2006/07 27,735 14,819 36 38 99.00% 87.10% Occupancy rates in the Nursing Homes were excellent and similar to levels achieved last year. Hostel occupancy rates improved 2% on the previous year. NB: Jeparit Hostel bed days in previous years have been counted into Nursing Home Bed days due to the facility having one RACS number. Bed days for Jeparit Hostel have now been counted into Hostel days, with figures altered from previous years accordingly. Jeparit Hostel bed days: 2006/07 - 1792; 2007/08 - 1856; 2008/09 - 1825 Attestation on Data Accuracy I, John Norman Smith certify that West Wimmera Health Service has put in place appropriate internal controls and processes to ensure that the Department of Human Services is provided with data that reflects actual performance. West Wimmera Health Service has critically reviewed these controls and processes during the year. John N. Smith PSM Chief Executive Officer 25 August 2009 Occasions of Service Diabetes Education Dietetics Massage Therapy Exercise Physiology Occupational Therapy Podiatry Physiotherapy Speech Pathology Counselling / Welfare Shared Care Midwifery Clinic Dental Primary Care Casualty (Emergency+Other) Visiting Surgeons Radiology HACC Funded Occasions of Service District Nursing Day Centre Community Health Total increase in services is the result of an increased emphasis on preventative and health promotion programs combined with the appointment of additional primary and community health care practitioners 23 ANNUAL REPORT 2008/2009 Patients Transferred From and Within West Wimmera Health Service Acute Admissions by Postcode Transfer Destination Number % Wimmera Health Care Group Ballarat Health Services Kaniva Hospital St. John of God Ballarat Western District Health Service Jeparit Hospital Nhill Hospital Rainbow Hospital Royal Adelaide Hospital Royal Melbourne Hospital Northern Hospital Epping Wakefield Private Hospital Adelaide Total 77 3 8 5 2 8 4 6 1 2 1 1 118 65.3% 2.5% 6.8% 4.2% 1.7% 6.8% 3.4% 5.1% 0.8% 1.7% 0.8% 0.8% 100% 118 (6.28%) patients were transferred from WWHS acute hospitals to other hospitals, slightly less than in the previous year when 6.94% of patients were transferred. 65% of patients were transferred to Wimmera Healthcare Group, the nearest Base Hospital with both Intensive Care and Coronary Care beds. West Wimmera Health Service Total Occupied Bed Days Number of Days Program Acute Inpatient GEM NHT Nursing Home Hostel Total 2008/09 8,601 542 1,614 27784 15529 2007/08 8366 1017 1669 27,883 15,234 54,070 54,169 Residential Aged Care Bed Days by Facility Suburb Number % Nhill Kaniva Rainbow Jeparit Horsham South Australia Goroke Dimboola Ararat Warracknabeal Serviceton Others Total 992 221 198 139 65 54 50 45 17 16 15 67 1879 52.8% 11.8% 10.5% 7.4% 3.5% 2.9% 2.7% 2.4% 0.9% 0.9% 0.8% 3.6% 100% Site Total Bed Days Iona Digby Harris Home Kaniva Nursing Home Kaniva Hostel Jeparit & District Nursing Home Jeparit Hostel Rainbow Nursing Home Rainbow Hostel Natimuk Nursing Home Allan W. Lockwood Special Care Hostel Trescowthick House Hostel 85% or 1600 admissions were from communities where we have a physical presence with more postcodes represented this year indicating a wider area of demand for our acute services. 9321 3933 2595 3604 1825 3649 3645 7277 3914 3550 Occupancy levels for our residential aged care facilities remained buoyant throughout the year with all locations achieving levels satisfactorily close to their annual targets. With the exception of Kaniva Hostel, each facility recorded occupancy levels above 97% with Jeparit Hostel, Rainbow Hostel and Rainbow Nursing home all attaining the maximum possible outcome. WWHS – Income by Program Acute Care Residential Aged Care Ambulatory Care Primary Health Business Units Capital Income Donations & Bequests Other Total 2008/09 11,634 9,495 1,800 2,184 258 758 254 1,308 2007/08 10,791 9,345 1,805 2,022 270 1,030 1,206 1,691 27,691 28,160 WWHS – Expenditure by Category 2008/09 2007/08 Category Employee Entitlements Fee for Service Corporate Other Fuel, Light and Power Supplies Depreciation $000’s 18,671 869 1,843 1,967 560 2,224 1,132 $000’s 18,412 868 1,915 1,711 727 1,882 1,172 Total 27,266 26,687 60,000 50,000 40,000 30,000 20,000 2008/09 TOTAL Hostel Nursing Home NHT GEM 0 Acute Inpatient 10,000 2007/08 In 2008/09 the majority of care provided within our organisation was in residential aged care, both nursing home and hostel. The number of bed days across each different program remained similar to that of the previous year. Program % Acute Care Residential Aged Care Ambulatory Care Primary Health Business Units Capital Type Income Donations & Bequests Other 39 33 6 7 1 4 4 6 Acute Care income received predominantly from the Department of Human Services continued to represent the largest single income category increasing from 38% of total income last year to 41% in 2008/2009. Combined with Residential Aged Care income (primarily sourced from the Australian Government) these two items comprise some three quarters of total Service income. Category % Employee Entitlements Fee for Service Corporate Other Fuel, Light and Power Supplies Depreciation 70 3 7 6 3 7 4 The bulk of our expenditure was again made up of Employee Entitlements at 69%, unchanged from last year highlighting the importance of ongoing strong and effective human resource management. Supplies and Consumables and Corporate costs formed most of the remaining expenditure. 24 WEST WIMMERA HEALTH SERVICE COMMUNITY AND FUNDRAISING WE DEPEND ON YOU! Fundraising is an ongoing commitment to raise funds to support the continual upgrading of facilities and equipment for our Service. The generosity shown by donors in such hard times has been overwhelming and we are extremely grateful for the magnificent support we have received from our Communities, Benefactors, Sponsors, Businesses, Individuals, Bequests and Philanthropic Trusts. Fundraising for the Capital Appeal has been continuing steadily throughout 2008/09, with the total appeal funds to date totalling $2.044 million. Golf Day Fundraiser In October 2008 the Service hosted the inaugural 4 Person Ambrose Event at the Nhill Golf Club. The day was well attended with 10 teams competing in the event undeterred by the hot windy conditions. The lucky winners were awarded prizes kindly donated by a number of local businesses. The day raised $2,270.00. Festive Theme Day The annual Christmas Festive Theme Day incorporated all sites with a number of schools and businesses participating. St Patrick’s School children dressed in festive clothing and collected donations as they entertained ‘Iona’ Residents with Christmas Carols. A fun day was had by all raising $582.00 for the Nhill Hospital Redevelopment. Art Show Fundraiser 2009 began with the planning of an exciting new event inspired by local artist Naomi Zanker. Naomi hosted her first solo exhibition ‘Floral Fusion’ at Radmac Gallery in Ballarat with a percentage of sales of paintings and raffle tickets donated to the Appeal. The Exhibition was a huge success with the Service receiving $1,955.00. An excellent outcome and contribution – thank you. Murray To Moyne Cycle Relay 2009 This year the Murray to Moyne Team did it tough with a head wind and rainy conditions. They did however excel and managed to ride 520 km in 17 hrs 40 mins. The team had a wonderful support crew as well as many local sponsors. Their efforts raised $600.00 for our Service. Biggest Morning Tea ‘Iona’s’ Biggest Morning Tea organised by the Activities Co-ordinator was enjoyed by residents, family, community members and staff. A gold coin donation raised $240.00 for cancer research. Sale of Chocolates And Books This activity continues to be an ongoing fundraising effort, contributing $4050.00 to our funds throughout the reporting period. Valuable Volunteers The Service has in excess of 40 dedicated community volunteers who commit their time and expertise to all areas of our organisation. Volunteers actively participate in providing patient transport, garden landscaping, music and entertainment, craft activities, meal delivery, pet therapy, walking school bus, exercise activities and shopping support. The Service is blessed to have a large base of volunteers who are instrumental in assisting with the provision of our various services. It is impossible to personally thank every volunteer but their individual contributions, commitment and dedication to the Service is greatly appreciated. Public Recognition Volunteers associated with the Nhill Drought Resource Centre, were proud to be nominated as finalists in the Pride of Australia Medal Victorian Section in recognition of the extraordinary commitment to their community. The finalists were Mrs Sue Krelle, Ms Shona Hoffrichter, Mrs Helen Schwarz and Mr Carl Krelle. This is a wonderful achievement for our volunteers to be recognised at such a high level! Congratulations. Ladies Auxiliaries A special mention must be made of the Ladies Auxiliaries across our facilities who are a tireless band raising funds for special items of equipment and who support the Service in many ways. Ladies Auxiliaries and Friends & Relatives Groups support Cooinda, Nhill Hospital, Kaniva Hospital, Jeparit Hospital, Rainbow Hospital, Goroke Residential and Aged Care Facilities, and have financed important equipment for our Service including large screen televisions, activity books, resident mobile lounge chairs, plants and garden materials, crockery, sporting uniforms, medical equipment and recreational structures. Thank you sincerely for your continuing wonderful work! Kate Kennedy, Capital Campaign Coordinator preparing for the next fundraising initiative. ANNUAL REPORT 2008/2009 25 26 WEST WIMMERA HEALTH SERVICE COMMUNITY AND FUNDRAISING > WE DEPEND ON YOU! ECG Fundraising Div 2 Nurse Judy Ridgwell has been a tremendous driving force behind a number of fundraising activities with the express purpose of raising funds for a much needed new Electrocardiograph machine. Many staff and community members supported raffles, a Melbourne Cup Day event and a walkathon which was a huge undertaking, walking from Netherby to Nhill – 32 kilometres. These efforts have contributed $6,671.55 towards the new electrocardiograph unit for Nhill Hospital. What a magnificent commitment. Div 2 Nurse Judy Ridgwell campaigned vigorously to raise funds for the purchase of a new ECG Machine for the Service. Nhill Hospital patient Keith Dickinson is pictured with Judy reaping the benefits of the new purchase. 27 ANNUAL REPORT 2008/2009 Volunteers Trevor Atwell Graham Belgrave Jacqueline Belgrave Barry Brown Barbara Champness Geoff Davis Tracey Deckert Sharon Dixon Heather Dufty Marie Goode Rosa Goode Wyn Hamlyn Kevin Hedt Beverley Hobbs Shona Hoffrichter John Hunter Joan Ingham Rochelle James Richard Jones Gary Judd Phyllis Keller Janette Kirk Carl Krelle Susan Krelle Judith Lawson Darryl Lewis Mariel Macalinao Kenneth Mackenzie Norman Mansfield Brian McGennisken Katrina Morgan Sam Morris Eunice Morris † Allen Norman Brenda Norman Luke O’Connor John Pumpa James Rochelle Gary Robinson Julia Schoneville Helen Schwarz Maureen Skinner Helen Slattery Kenneth Sleep Sini Sreekanth Elsa Williams Candice Wilson Volunteer Groups Donations and Bequests Apex CFA Community Advisory Committees CWA Ladies Auxiliaries Lions Clubs Probus Residential Care Friends & Relatives Rotary Clubs RSL Clubs SES Donor Collier Custodian Co. Estate of R C Eastick Natimuk Friends & Relatives William Angliss Charitable Trust Estate of Sarah Stott Chocolate sales Anonymous Raffles Mr N Gould Jeparit Hospital Ladies Auxiliary WWHS Golf Day Friends All Riding Together Jeparit Hospital Social Club Mr L D Creek Estate of Mr K Allen Mr & Mrs A R Taylor Greta Group Pty Ltd Drought Resource Centre Murray to Moyne The Salvation Army West Wimmera Darts Assocation Mrs N Zanker Mr & Mrs M Schilling Mr & Mrs J M Davey Nhill College Cooinda Ladies Auxiliary Christmas Red Ribbon Day Mrs Flora Taylor Mr & Mrs G Cooper Mr & Mrs P Ralph Mr & Mrs S Walter Book Sales Nhill Day Centre Frock & Frolic About Town Winiam Hall Farmers Arms Hotel Britten Floor Coverings Campbell Silos Ahrens Sherwell Mr & Mrs C J Magrath Rural Energy Jim’s Butchery Little Desert Lodge Dulkeith Computer Solutions Union Hotel Nhill St Peter’s Lutheran School Elgas Nhill Kindergarten Mr R Dodds Mr & Mrs P Cramer Total 50,000 25,000 6,503 5,000 4,160 4,050 3,903 3,122 3,000 2,775 2,270 2,200 2,000 2,000 2,000 2,000 2,000 1,907 1,155 1,000 1,000 1,000 1,000 1,000 861 614 582 500 500 500 500 447 418 364 328 300 300 250 250 250 250 250 250 250 250 220 200 200 200 200 200 Donations – Value Undisclosed Estate of George Mitchell Driscoll, McIllree & Dickinson Mr & Mrs K Binns Mr & Mrs B L Dorrington Mr & Mrs G T Kerber – – – – – Donations Under $200 Total Total Cost of Fundraising 5,439 254,105 10,000 Grand Total 244,105 28 WEST WIMMERA HEALTH SERVICE CORPORATE GOVERNANCE DIRECTIVES AND OBLIGATIONS Major Committees Audit Committee Accepts the responsibility of overseeing review processes including the performance and independence of the internal auditor and the Auditor General’s agent, internal controls for financial processes, the risk management framework, monitoring compliance with laws and regulations and the Service’s Code of Conduct and Code of Financial Practice. Executive Committee Exercises the Board’s powers between Board meetings and manages the Chief Executive Officer’s employment and performance. Finance Committee West Wimmera Health Service was incorporated as a Public Hospital on 21st August 1995 under the Services Act 1988 (VIC). Corporate Governance is the framework of rules, systems and processes within which an organisation is controlled and operates. The Board of Governance has the responsibility to govern and delegates to the Chief Executive Officer its management and operation. Currently the Service has nine Board of Governance Members. When a vacancy arises positions for Members are advertised and applications are forwarded to the Minister for Health for endorsement. The Governor in Council officially appoints Board of Governance Members on the recommendation of the Minister. The appointment cycle is three years at which time Members can apply for reappointment. The Board of Governance has two important policy documents which set our corporate governance framework of the Service. They are: ‘By-Laws’ approved by the Department of Human Services which outline the obligations of the Board to govern the Health Service. The By-Laws incorporate clear direction to the Board regarding its governance obligation in regard to Meetings of the Board, Appointment of the Chief Executive Officer, Quality Assurance, Mandatory Committees, Annual Report, Annual Meeting, Auditors, Investment And Disposal and Winding up of Assets. ‘Rules of Procedure’ adopted by the Board, detail the operational framework and processes through which all governance matters are observed. The ‘Rules of Procedure’ address the leadership role of the Board, Codes of Ethics and Acceptable Standards, Delegation of Authority, Committee Structure, Appointment of Visiting Medical Practitioners and other General Governance Standards. West Wimmera Health Service has implemented a robust governance framework which includes Financial, Business and Strategic Planning. Pecuniary, Conflict & Declaration of Interests Pecuniary Interests involve actual, potential or perceived financial gain or loss. A Conflict of Interest is conflict between public duties and private interests which may be actual, potential or perceived. The declaration of any known conflict of interest by Board Members is a fundamental element in guaranteeing the highest level of integrity and public trust. There were no instances in any Board or Executive Meetings where it was necessary for a member to declare a Conflict or a Pecuniary Interest. Monitors and oversees the financial performance by reviewing strategic performance targets, operational and capital expenditure and budgeting. Clinical Appointments, Credentialing and Review Committee Has a duty of care to ensure all health professionals practising within the organisation are appropriately qualified and competent to perform their designated duties within their defined scope of practice. Credentialing protocols for all Clinical Practitioners are applied. Performance Review Committee Is responsible for establishing and monitoring policy and quality frameworks by ensuring appropriate organisational structures, processes and resources are in place to manage and improve the safety of care, services and service delivery. It also addresses compliance with legislation, regulations and Australian Standards. Community Advisory Committees Advocate a consumer perspective on behalf of each community and advise the Board on strategic issues and initiatives, simultaneously promoting a consumer and community point of view. Management Committees Provide an important reporting and advisory role to Board Committees. These Committees are: Clinical Quality & Safety, Corporate Support, Safety & Environment, and Occupational Health & Safety. ABOVE: Independent Audit Committee Members – John Magrath (L) with Chairman John Hobday (R) 29 ANNUAL REPORT 2008/2009 ORGANISATIONAL STRUCTURE Board of Governance Consultants Chief Executive Officer Manager Disability Services Dental Services Executive Director Corporate & Quality Services Executive Director Medical Services Executive Director Clinical Services/ DON Nhill Operations Manager Executive Assistant Executive Director Industrial Relations Human Resource Mgt. Executive Director Finance & Administration Accreditation Catering Education Engineering General Services Health Information Services Manager Allied & Community Health Clinical Operations Manager OH & S Quality Risk Management Safety Security Diabetes Education Dietetics Goroke CHC Health Promotion Home & Community Care Lowan Rural Health Maternal & Child Health Occupational Therapy Physiotherapy Social Work Speech Therapy Acute Care – Nhill, Kaniva, Jeparit, Rainbow Aged Care – Nhill, Kaniva, Jeparit, Natimuk, Rainbow Central Sterilising Infection Control Operating Theatre Pharmacy Radiography Accounting Services Accounts Payable Accounts Receivable Information Technology Payroll Procurement Reception Services Resource Centre 30 WEST WIMMERA HEALTH SERVICE BOARD OF GOVERNANCE MEMBER PROFILES Ronald A. Ismay Lester C. Maybery Harvey Champness Leonie G. Clarke John A. Hicks Ronald S. Rosewall Desmond J. White Janice M. Sudholz Rodney L. Stanford Ronald A. Ismay Lester C. Maybery Harvey Champness BA, Dip Ed President / Business Proprietor Vice President / Primary Producer Term of Appointment: 01.03.07 – 30.06.09 Term of Appointment: 01.03.07 – 30.06.09 Ron has significant financial and business management experience and is dedicated to maintaining quality health services in rural areas. With his vast knowledge of rural communities Lester is committed to ensuring viable cost effective health services to the people of West Wimmera. Accredited Lay Preacher -Uniting Church, Waterwatch Community Monitoring Officer, Wimmera Catchment Management Authority WWHS Committees: Executive, Audit, Finance, Performance Review, Clinical Appointments, Credentialing & Review, Rainbow Community Advisory WWHS Committees: Executive, Finance, Chair – Performance Review, Chair – Natimuk Community Advisory Board Meeting Attendance: 100% Board Meeting Attendance: 100% Term of Appointment: 03.03.09 – 30.06.11 A recent appointment to the Board, Harvey has a background in education. Through his role as a Lay Preacher he has gained vast knowledge of community issues and has a particular interest in aged care and accessibility to quality healthcare. WWHS Committees: Kaniva Community Advisory Board Meeting Attendance: 100% 31 ANNUAL REPORT 2008/2009 Leonie G. Clarke Ronald S. Rosewall BA SocSci Janice M. Sudholz Education Support - Librarian Retired Home Duties/Farmer Term of Appointment: 01.11.08 – 30.06.2011 Term of Appointment: 01.11.08 – 30.06.10 Term of Appointment: 01.03.07 – 30.06.09 Leonie was appointed by the Governor in Council as a Justice of the Peace in September 2008 . Her vision is the long term viability of West Wimmera Health Service to deliver sustainable healthcare to our communities. Ron is a member of the National Disability Service Committee and serves on the Board of Victoria Advocacy League for Individuals with a Disability. He brings a depth of knowledge and understanding of the provision of health, welfare and disability services to the Board. Janice has broad governance experience and is keen to review and implement recommendations from the Community Needs Analysis and Service Profile Project Report. WWHS Committees: Executive, Performance Review, Clinical Appointments Credentialing and Review, Chair – Rainbow Community Advisory Board Meeting Attendance: 78% John A. Hicks MBA BE Chief Executive Officer, Hindmarsh Shire Council Term of Appointment: 01.03.07 – 30.06.09 As CEO of Hindmarsh Shire Council John has significant expertise in financial management and community issues. He is committed to responsible administration of health and aged care. WWHS Committees: Audit, Finance, Nhill Community Advisory. Board Meeting Attendance: 67% WWHS Committees: Executive, Performance Review, Clinical Appointments Credentialing & Review, Chair – Jeparit Community Advisory, Chair – Cooinda Community Advisory Board Meeting Attendance: 89% Rodney L. Stanford Social Worker Term of Appointment: 01.11.08 – 30.06.10 Rodney has experience in the governance of community care and has a wide perspective of community issues. His focus is to meet the specific healthcare needs of remote rural communities. WWHS Committees: Audit, Finance, Chair – Kaniva Community Advisory WWHS Committees: Executive, Finance and Natimuk Community Advisory. Board Meeting Attendance: 78% Desmond J. White Dip Agr Sci, Post Grad Dip Ag, Adv Cert Works Man, Dip Eng Tech, Adv Dip Eng Tech Civil Engineer Term of Appointment: 01.07.08 – 30.06.11 Des possesses astute management skills and is committed to the provision of access to sustainable health services for rural and remote communities. WWHS Committees: Audit, Chair – Goroke Community Advisory Board Meeting Attendance: 67% Board Meeting Attendance: 67% RESPONSIBLE OFFICERS FOR OUR SERVICE (as at 30th June 2009) Commonwealth State The Hon Nicola Roxon MP Minister for Health and Ageing The Hon Daniel Andrews MP Minister for Health The Hon Justine Elliot MP Minister for Ageing The Hon Lisa Neville MLA Minister for Mental Health, Community Services and Senior Victorians The Hon Jenny Macklin MP Minister for Families, Housing, Community Services and Indigenous Affairs The Hon Bill Shorten MP Parliamentary Secretary for Disability and Children’s Services The Hon John Forrest MP Member for Mallee The Hon David Koch MLC Member for Western Victoria Region The Hon Jaala Pulford MLC Member for Western Victoria Region The Hon Gayle Tierney MLC Member for Western Victoria Region The Hon Tim Holding MLA Minister for Finance, Workcover and Transport Accident Commission, Tourism and Major Events, and Water The Hon John Vogels MLC Member for Western Victoria Region Mr Hugh Delahunty MP Member for Lowan, Shadow Minister for Sport & Recreation, Youth Affairs and Veterans’ Affairs Ms Fran Thorn Secretary, Department of Human Services The Hon Gavin Jennings MLC Minister for Environment and Climate Change and Innovation The Hon Peter Kavanagh MLC Member for Western Victoria Region Department Of Human Services Dr Chris Brook Executive Director, Rural and Regional Health and Aged Care Services Ms Maree Guyatt Director, Rural and Regional Health Services Ms Brenda Boland Regional Director, Grampians Region 32 WEST WIMMERA HEALTH SERVICE LEADERSHIP AND MANAGEMENT OUR EXECUTIVE TEAM The Executive team under the leadership of the Chief Executive Officer is accountable to the Board for executing the statutory responsibilities of the Service, its targets and obligations set by the Department of Human Services and the Commonwealth Department of Health and Ageing. The focal point of the Chief Executive Officer through his Executive Team is to support the Board of Governance with the education and personal development of all staff to establish a high achieving workforce. Mr John Smith PSM MHA, Grad Dip HSM, AFACHSE, CHE, FAHSFMA, AFAHRI, AFAIM, FAICD Chief Executive Officer John commenced his appointment in 1995 after serving as the Chief Executive Officer of the Nhill Hospital. His experience and expertise is a sound basis for managing the effective and efficient use of business assets, human resources and the execution and administration of all decisions and policies of the Board. His wealth of knowledge, business acuity and determination are the basis of his strength of management. John is a Board Member and National Councillor of the Australian Council on Healthcare Standards, a National Councillor of the Australian Healthcare & Hospitals Association, and a Board Member for the Victorian Hospitals Industrial Association. ABOVE: Executive Team L-R – Katrina Pilgrim, Kaye Borgelt, Leslie Butler, John Smith PSM, Ritchie Dodds, Janet Fisher, Melanie Albrecht . Absent: Dr Ian Graham (see page 41) For his contribution and dedication to the Nhill community and the Nhill Hospital in particular, John was awarded a Public Service Medal in the Australia Day Honours 1991. 33 ANNUAL REPORT 2008/2009 Ritchie Dodds Kaye Borgelt Leslie Butler B Com (Acc) CA FFin MBA (HRM) Assoc Dip Med Rec Admin, Grad Cert Mgt Org Change, HIMAA Accredited Coder B.Lab Stud, Assoc Dip Lab Stud, RN Div 2 Executive Director Finance and Administration Ritchie was appointed in April 2006 and is responsible for Finance, Payroll, Information Technology, Supply, and Administration. Previously Ritchie gained considerable experience as the Operations Manager, Personal Assistant to the Chief Executive Officer and Finance Accountant. He gained a Bachelor of Commerce degree (Accounting major) at the University of Melbourne, is a Chartered Accountant and completed a Graduate Diploma in Applied Finance & Investment and a Master of Business Administration majoring in Human Resource Management. Ritchie deputises for the Chief Executive Officer. Executive Director Corporate & Quality Services Kaye is responsible for co-ordinating and facilitating quality and safety throughout the organisation, promoting a robust risk management framework and a culture of continuous improvement. She is responsible for Occupational Health and Safety, Organisational Security and non-clinical and support services, including engineering, catering and general services, education and health information services. Kaye has a background in Health Information Management. She was appointed in 2004 and prior to that was Director of Health Information Services. Dr Ian Graham RN RCNA Grad Dip Bus Management MB,BS (Melb.); M. Health Planning (NSW); FRACMA; Cert. Essential Skills in Medical Education (AMEE). Executive Director Clinical Services Executive Director Medical Services Jan was appointed in January 2009. Her responsibilities include management of Medical, Surgical and Primary Care Casualty Services, Central Sterilising, Radiology, Pharmacy, and Maternal and Child Health. Dr Graham is the Executive Director of Medical Services. He chairs the Clinical Quality and Safety Committee and Medical Staff Association meetings. Janet Fisher She is also responsible for the management of Residential Aged Care, Allied and Community Health, Day Centres and Goroke Community Health Centre. A Registered Nurse Division 1, Jan has an Advanced Diploma of Business Management, and was previously Executive Director of Aged Care and Community and Allied Health. Ian liaises with clinicians and senior management regarding patient safety, clinical practice, credentialing, scope of clinical practice and patient care matters. Dr Graham is the part-time Medical Director of the Postgraduate Medical Council of Victoria (PMCV) and practises as a consultant in health management, leadership and education. Executive Director Industrial Relations and Human Resource Management Responsible for the strategic direction of Human Resources and Industrial Relations Management, Les promotes development and training in management techniques. Les advises the Chief Executive Officer on Industrial Relations and Human Resource Management and supports the Executive team, advises on WorkCover claims, conducts workplace mediations and attends industrial forums as the Health Service representative. Melanie Albrecht LLB, BIS, Grad. Cert. HSM, AFCHSE Operations Manager Melanie was appointed Operations Manager in April 2006 and is responsible for the executive management of Disability Services, Dental Services, Aged Care Administration, Compliments and Complaints, Contracts and assisting the Chief Executive Officer with special projects. Melanie’s knowledge of health and business is growing as she continues her Master of both Health and Business Administration. Katrina Pilgrim Cert IV Bus Management Executive Assistant to CEO Katrina commenced employment at Nhill Hospital April 1986. She was appointed Executive Assistant to the CEO in September 2004 and has over 20 years of secretarial experience. She is the Minute Secretary to the Board of Governance, Committees and Management Committees and assists with major function organisation. 34 WEST WIMMERA HEALTH SERVICE ACUTE CARE SERVICES WE CAN CARE FOR YOU When illness strikes the place to be is home or as near as you can be. We are dedicated to caring for you; we are your home away from home where Orthopaedics, Ophthalmology, ENT, Gynaecology, Oral and General Surgery and superior Medical Services are at your fingertips. Care with compassion is our maxim. We think care, we actually do care and our care is genuine... Dialysis Unit Nurse Tania Ryan RN Div 2 with Lorraine Semmler who attends the Dialysis Unit at Nhill Hospital three days each week 35 ANNUAL REPORT 2008/2009 Goals Strategies Achievements Future To deliver safe and effective needs-based healthcare by providing timely and effective emergency and elective services and promoting improved health outcomes. Attract and retain qualified and skilled clinicians – medical, nursing and allied health professionals. 1,879 patients treated. Recruit additional Division 1 Nurses. To reintroduce ‘low risk’ maternity services. Introduce and expand clinical services to conform with the Strategic Plan. Provide modern and safe medical equipment, and embrace new technologies. 615 elective procedures performed. Dialysis Unit expanded – 305 patients treated. Professional relationships with Visiting Medical Practitioners broadened. Introduction of patient consultation via Videoconferencing allowing patients to participate in specialist consultations without having to travel long distances. X-ray reporting efficiently refined. Six graduate nurses employed. Quality Emergency and Elective Care Acute care services are at Nhill, Rainbow, Jeparit and Kaniva, with all sites having 24 hour Primary Care Casualty departments for emergency presentations. 45% of all patients admitted were classified as emergency admissions, requiring immediate attention. Most of these patients were treated effectively by our Visiting Medical Practitioners and were discharged to their home. However, occasionally patients require a higher level of care (intensive, coronary care or specialist referral). These patients are transferred to the nearest appropriate health service, or to a regional, metropolitan or interstate hospital. In 2008/09 1,021 patients were treated as elective admissions and were admitted for a planned stay. These patients included dialysis admissions and those for elective surgery. WWHS offers a range of specialist elective surgery providing patients with the opportunity to have procedures undertaken in their local environment, where family and friends can readily visit without travelling long distances. Elective surgery available includes Ear, Nose and Throat, Orthopaedic, Dental, Ophthalmology, Gynaecology and General Surgery. Electrocardiogram Reporting (ECG) Dr van den Broek, a Specialist Physician reports on all ECGs. He interprets and diagnoses ECGs (measurement of the electrical activity of the heart), providing specialist advice to our Visiting Medical Practitioners to initiate prompt and relevant clinical care for patients with acute cardiac conditions. These ECG reports are received within 24 hours. Urgent reports are dealt with almost immediately – this is outstanding professional support for the Visiting Medical Practitioners. Introduce Chemotherapy treatment. Formalise the relationship with Rural Ambulance Victoria to assist in Primary Care Casualty. As highlighted in the Community Needs Analysis and Service Profile Report we must strengthen and formalise partnerships with larger regional, metropolitan and interstate health services to broker efficient service provision and to ensure seamless patient transfers between organisations. We must continue to respond to community needs by seeking the opportunity to provide identified clinical needs. Medical Imaging - Reporting Times Improved Our alliance with Western Medical Imaging has been a positive step with a remarkable turnaround in reporting times of urgent and non urgent x-rays. Urgent reports are now received within one hour of the x-ray – providing Visiting Medical Practitioners with accurate diagnoses and supporting the commencement of necessary and timely treatment. 36 WEST WIMMERA HEALTH SERVICE ACUTE CARE SERVICES > WE CAN CARE FOR YOU Excellent Graduate Nurse Program Graduate Division 1 Nurses gain experience in medical, surgical, aged, community and ambulatory care, emergency and critical care. Mentorship and direction is provided during the first 12 months of clinical practice for newly graduated Division 1 nurses, providing a solid background for future career exposures. New Initiative After a period of consolidation at the Nhill Hospital, Graduate Nurses now have the opportunity to gain experience as the Nurse in Charge at our more remote sites. Strict parameters ensure adequate support and guidance is provided to the Graduate. This initiative is an excellent professional and clinical learning experience. Feedback from Managers and Graduates has been extremely positive. Pharmacy Admission And Discharge: In November 2008 ‘Medprof’, a computer program for Pharmacists to produce a Medication Profile for patients on discharge was installed. Patients receive information about their medications assisting them to understand the importance of safe and effective administration of their medications. The Admission and Discharge Program has two main functions: Pre-Admission Clinic and Discharge Planning. We have surveyed patients discharged since January 2009 to determine the level of benefit ‘Medprof’ has provided with the results revealing that patients have appreciated the Medication Profile particularly in preventing duplication of medications. Elective surgery patients attend for a pre-admission interview prior to their admission to hospital. The aim of the interview is to educate, assess and inform the patient regarding expected outcomes of their surgical procedure, pre and post operative requirements, preparation for lifestyle and support services required following discharge, such as Home Help or Meals On Wheels. ABOVE: Pharmacist, Martin Yau preparing patient medications. PAGE RIGHT: Dr. Shoaib Munawar (left), Tristar Medical Group, consults with patient Graham Stephan. 37 ANNUAL REPORT 2008/2009 Haemodialysis (Dialysis) Equipment Purchases Dialysis is vital to sustain life for those with renal disease or diminished renal function. It helps to balance fluid, minerals and chemical levels in the blood with patients required to receive treatment 3 days per week. Department of Human Services Targeted Equipment Program funding has provided a new Cardiac Monitor for Kaniva Hospital and Patient Trolleys in consulting areas of the Nhill Hospital. An increased demand has witnessed an increase in unit capacity from 2 to 4 chairs. Previously patients had to travel to other regional facilities to access this service. A reduction in travel time of at least six hours per week for these patients has occurred. Education for staff and patients has been an important facet in increasing our capacity. Additional training for Division 1 and 2 Nurses supported by a Department of Human Services grant ensures specifically trained Nurses are available at all times. Training of additional nursing staff is planned. Infection Control An effective Infection Control Strategy is central to providing safe quality care. This Service has stringent strategies and controls in place to maintain our virtually infection free status. Clinical Waste Waste produced by medical procedures such as dressings, surgery and dialysis must be disposed of at specialist waste centres. We questioned if the amount of clinical waste reflected how busy we were. We graphed the amount of waste in kilograms against the number of occupied bed days and discovered that there was a direct correlation. It is reassuring to be able to quantify that increases are due to increased business within the health service, rather than poor procedures. In 2009-2010 audits will be undertaken to ensure that items are discarded via the correct waste disposal system. Gastroenteritis Ongoing episodes of gastroenteritis occurred in our catchment area with many patients admitted to hospital with a diagnosis of Gastroenteritis, the commonly highly contagious Norovirus (Norwalk Virus). There were no outbreaks of hospital acquired gastroenteritis which is testament to the exceptional nursing care and infection control procedures applied across our Service. 38 WEST WIMMERA HEALTH SERVICE ACUTE CARE SERVICES > WE CAN CARE FOR YOU Hand Hygiene Swine Flu (H1N1) Occupational Exposures Hand Hygiene encompasses hand washing and the use of Alcohol Based Handrubs. Supported by Department of Human Services Statewide Quality Branch, the Victorian Hand Hygiene Program combines education and auditing of Hand Hygiene practices in Victorian Public Hospitals. The Swine Influenza pandemic created considerable concern within the community during Winter 2009. The pandemic to date is a mild form of influenza that is very infectious. Much literature and information has been supplied by the Department of Human Services and we were very aware of the situation. West Wimmera Health Service has collaborated with the Hindmarsh Shire to prepare a Pandemic Plan which, combined with our Business Continuity Plan, has us well organised to cope with the challenges associated with a major pandemic outbreak. Occupational Exposures and Needlestick injuries are occupational hazards staff attempt to avoid. Acute areas of the Health Service have a greater level of use of needles and intravenous devices which increase the risk of a ‘sharps’ injury and while all possible attempts to prevent these injuries are made occasionally accidents do occur. Strict reporting and treatment procedures are in place to address such a problem should it arise. Staff Health We endeavour to protect our staff by providing free vaccinations to resist illnesses such as Influenza and Hepatitis B. ABOVE: Young patient Katey Zivkovic playing cards with her mother Rhonda as Div 1 Nurse Helan Jacob records Katey’s discharge plans. Rhonda recently Graduated from the University of Ballarat as an RN Div 2 Nurse. Four needle stick injuries occurred in 2008-2009, all in the Nhill Hospital. Staff Education Compliance Mandatory Infection Control education is in place for staff from all Departments. Staff must have an understanding of Infection Control principles in regard to hand hygiene, special cleaning, isolation and protective clothing and special requirements of patients to ensure minimal infections are experienced and cross infection prevented. 39 ANNUAL REPORT 2008/2009 ACUTE CARE SERVICES > STATISTICS Major Elective Surgical Procedures Dental Statistics by Procedure Procedure Exams X-rays OPGs Scale & Clean Fillings Extractions Root Canal Treatments Crowns Dentures Total Major Procedures No. Performed Hip Knee Gynaecology Cholecystectomy Hernia IOL (Cataract) Eyes other Dental ENT General other Total 25 33 35 12 19 107 8 60 40 8 347 Admitted Patient Activity No. Performed 722 825 63 268 1,115 680 38 15 58 3,784 Public and private dental patients are treated and waiting lists remain at the State waiting list average, with the exception of Prosthetics which is a considerably shorter wait time. Staff Flu Vaccinations 60 Rainbow Goroke Kaniva Jeparit Nhil 0 Hand Hygiene Audit Total 774 1105 1879 858 1021 1879 1879 8601 2156 1879 Total Bed Days Same Day – patients admitted and discharged on the same day. Multi Day – patients in hospital for longer than one night. Emergency – patients whose admission was not planned – usually admitted via the Doctors Surgery or Primary Care Casualty. Elective – patients whose admission has been planned – elective surgery; dialysis Total Number of Staff Immunisations Nhill Jeparit Kaniva Rainbow Goroke Natimuk Total Percentage The Nhill Hospital continues to provide the surgery required by an ageing population. Orthopaedic replacement of hip and knee joints occurs on two days per month. Each month 5-6 joint replacements are performed relieving those people of chronic pain and loss of mobility. Each month the eye surgeon conducts cataract surgery for an average of 10 patients. Most patients have cataracts in both eyes and so have two operations a month apart. Removing the cloudy lens enables clear vision for many years. The Gynaecological and General surgeons perform a range of surgery to investigate, treat or repair as needed. This involves many minor procedures but also others such as hernia repairs, hysterectomies, removal of varicose veins and removal of gallbladder (Cholecystectomy) 90 30 Total Cases Minor Procedures Vaccinations 2007/08 320 313 633 2008/09 2007/08 Major Procedures 800 700 600 500 400 300 200 100 0 2008/09 347 266 613 SubAcute 0 45 45 0 45 45 0 Number of Staff tested Nhill Jeparit Kaniva Rainbow Goroke Natimuk 120 Type of procedure Major Procedures Minor Procedures Total Cases Acute 774 1060 1834 858 976 1834 1563.76 Hep B 2009 Month Stats Annual Report 150 Operating Suite Activity Separations Same Day Multi Day Total Separations Emergency Elective Total Separations Total WIES 100 90 80 70 60 50 40 30 20 10 0 Audit 1 Audit 2 Audit 3 Victoria Average 2007/08 2008/09 Hand Hygiene practices of staff are audited three times each year. In 2008/09 we achieved a compliance rating of 76.4% compared to the State average of 71%. We will continue to promote hand hygiene education to improve compliance levels in this vital infection control area. TOTAL 67 9 23 40 3 51 192 TOTAL 18 1 7 7 – 15 48 Hepatitis B Surface Antibody Screening Hepatitis B is a viral disease spread by blood and body fluids. A screening program to assess staff immunity to Hepatitis B is now in place. Blood is taken to assess the level of protective antibodies that are gained after undertaking the three injection course of Hepatitis B immunisation. 40 WEST WIMMERA HEALTH SERVICE ACUTE CARE SERVICES > WE CAN CARE FOR YOU Dental Services Conclusion The Nhill Hospital Dental Clinic expanded its services with the appointment of a Dental Therapist who visits weekly providing dental treatment for children under the age of 18, effectively replacing the traditional ‘School Dental Service’. Our aim will always be to provide the best care possible for our patients. This popular service is meeting a very important need in the community treating 121 youngsters since the commencement of the program in February 2009. The Nhill Dental Clinic is fortunate to also retain the expertise of Dr Damien Goh who provides public and private general dental services, and Oral Surgeon Dr Anamaly Ayasamy who conducts monthly consultations and surgical services. During the year Dental Clinics at Kaniva and Rainbow have been refurbished through funding from the Department of Health and Ageing and we are now proceeding to engage dentists for these clinics. We must recruit staff who will continue to develop professionally, to ensure care is based on sound clinical evidence, and good personal qualities are evident. A nationally recognised issue emerging in nursing, perhaps as a consequence of differing trends in Nurse Education, is making time for the ‘little things’ in daily care regimes. Taking the time to sit and talk to a patient, offering a cup of tea or comforting a distressed relative appear to be at risk of becoming the exception rather than the norm! We will always provide exceptional care with compassion and dignity. ABOVE: Dr Richard Clarnette, Visiting Orthopaedic Surgeon consulting with patient Catherine George. 41 ANNUAL REPORT 2008/2009 MEDICAL SERVICES Medical & Clinical Visiting Consultants West Wimmera Health Service continues to provide excellent clinical services to the communities of Nhill, Rainbow, Jeparit, Natimuk, Kaniva, Goroke and surrounding districts. Executive Director Medical Services Dr. Ian Graham MB BS MHP AMEE FRACMA General Surgeons Mr. S. R. Clifforth MB BS FRACS Mr. D. Bird MB BS FRACS Mr. P. H. Tung MB BS FRACS Dr Ian Graham, Executive Director Medical Services Dr Irfan Hakeem has taken over the Kaniva practice rapidly establishing a reputation for his caring, thorough and skilled approach to rural general practice. Drs Khaled El-Sheikh, Rizwan Lotia, Sumeet Dhillon, Shoaib Munawar and Katrina Morgan provide clinical services in Nhill while Dr Nouman Qadir operates the Jeparit and Rainbow practices. During the past twelve months, Medical Association meetings have been integrated with the Clinical Quality and Safety Committee agendas. The combined meetings provide a valuable forum where medical and other clinical professionals are able to discuss clinical issues, quality improvement, peer review and professional development activities. Dr Malcolm Anderson has continued to provide anaesthetic services, although he now lives and works in Ballarat. Dr Rob Ray, Specialist Anaesthetist, also regularly visits Nhill to provide anaesthetics. Visiting surgeons undertake General, Orthopaedic, ENT (Ear Nose and Throat) and Ophthalmic Surgery at Nhill Hospital. The Medical Association continues to be actively involved in the West Vic Division of General Practice Clinical Risk Management Program. Cases at West Wimmera and other hospitals throughout the region are selected for detailed review by a panel of experienced medical practitioners. The Service has continued to develop and extend its processes for the credentialing (review of qualifications) and definition of scope of clinical practice for its Medical Practitioners and other clinical staff. These processes ensure that Practitioners practising at West Wimmera Health Service are appropriately qualified and only undertake clinical work within their scope of training and experience. The Service is committed to developing a deeply embedded culture of credentialing and delineation of scope of practice going far beyond the completion of application forms, paperwork and checklists. It means that all staff (doctors, nurses, allied health professionals, executive and other staff) are aware of the requirements for credentialing and definition of scope of practice and are confident to raise issues, challenge decisions and ensure the highest standard of care is delivered. The recommendations from these reviews are considered by the Medical Association and Clinical Quality and Safety Committee for review and action. All Visiting Medical Practitioners undertake continuing medical education, attending seminars, tutorials, conferences and workshops relevant to their practice. Congratulations Drs Sumeet Dhillon and Shoaib Munawar have successfully completed their Fellowship examinations with the Royal Australian College of General Practitioners. This is an outstanding achievement and all associated with West Wimmera Health Service offer their congratulations to Sumeet and Shoaib. The communities of West Wimmera thank our General Practitioners and Visiting Specialist Medical Practitioners for their ongoing support and the quality clinical services they provide. Orthopaedic Surgeon Dr. R. Clarnette MB BS FRACS Consultant Ophthalmic Physician and Surgeon Dr. M. A. Chehade MB BS FRANZCO Ear, Nose And Throat Practitioners Ms A. Cass MB BS FRACS Mr. L. Ryan MB BS FRACS FRCS DLO Consultant Obstetrician and Gynaecologist Dr. I. Jones MB BS FRANZCOG Visiting Oral Surgeon Dr. A. Ayasamy BDS FDSR CPS FICD Specialist Anaesthetist Dr. R. Ray MB BS FANZCA General Practitioner Anaesthetists Dr. M. J. Anderson MB BS FRACGP DA FACRRM Dr. K.A Fielke MB BS DA FACRRM Consulting Psychiatrist Dr. R. Proctor MB BS BSc DPM Dental Surgeon Dr. D. Goh BDent BBSc Dental Therapist Ms C. Petersen Dip Dent Ther General Practitioners Dr. K. El-Sheikh MB BS FRACGP FACCRM DPM CASA Pilot Medical Officer Dr. R. Lotia MB BS BSc Dr. S. Dhillon MB BS FRACGP Dr. S. Munawar MB BS BSc FCPS FRACGP Dr. K. Morgan MB BS DRANZCOG DCH(SA) FRACGP Dr. M. N. Qadir MB BS FRACGP Dr. I. Hakeem MBChB Consulting Pharmacist Mrs. A. Teed PHC MPS FSHP MACPP Staff Pharmacist Mr. M. Yau BPharm MPS Consulting Radiology Service Western Medical Imaging Visiting Optometrists Ross Both & Associates 42 WEST WIMMERA HEALTH SERVICE RESIDENTIAL CARE FOR OUR SENIOR CITIZENS We believe that entering residential aged care is not the beginning of the end but rather the next phase in the life journey. Our desire is to deliver compassionate, client-centred, individualised aged care services which meet and surpass accreditation stipulations and demonstrate the way we care for every resident each and every day, in nurturing meaningful lives, within a framework of care, with respect, compassion and dignity. Goals Strategies Achievements Future To deliver a compassionate, individualised and homely residential care experience. To foster education in changing aged care philosophies and practices. A trained Diversional Therapist supports Activity Co-ordinators to evaluate programs and ensure activities are resident focused. Prepare for accreditation Surveys in August 2009. To constantly apply best practice care models. To successfully comply with Accreditation Standards. To gather accurate information from Residents and Families. Respecting Patient Choices Program allows residents the opportunity to make informed decisions regarding ‘end of life’ care. Introduction of electronic ‘iCare’ record at all Homes and Hostels. Guaranteed resident access to Allied Health professionals. All Homes and Hostels 100 per cent compliant with Accreditation Standards. Continue to improve aged care volunteer programs. Recruit addtitional Registered Nurses Division 1. Achieve 100% occupancy in aged care facilities. Accurately assess residents to maximise financial availability. 43 ANNUAL REPORT 2008/2009 Percentage Occupancy Residential Aged Care Percentage Occupancy by Site 80 60 40 20 0 Facility Iona Digby Harris Home Archie Gray Nursing Home Unit Jeparit & District Nursing Home Jeparit Hostel Rainbow Nursing Home Natimuk Nursing Home Kaniva Hostel Rainbow Hostel Lockwood Hostel Trescowthick House Hostel Percentage occupancies at individual residential aged care facilities except for Kaniva Hostel were all above 95%. Because of its unique physical layout Kaniva Hostel can only accept residents with very low care needs. For this reason percentage occupancy at this location is always lower than for other facilities. Physiotherapist Sreekanth Sreekumar assists Allan Lockwood, a resident of Trescowthick House Hostel, Natimuk. PAGE LEFT: Natimuk’s Trescowthick House Hostel Resident, Anne Phelps enjoys the sunshine with Div 2 Nurse Anne Hamilton. Living in residential care means living with new people and accepting others, doing everyday things residents can no longer do for themselves. When entering our residences we ensure resident personal privacy and dignity is maintained, and we respect their rights as citizens. Family and friends are encouraged to visit and residents can come and go as their health and physical capacity allows. This is their home and that is respected. Residents also maintain control over the personal aspects of their life, their financial affairs and possessions. Our communities have access to excellent, comfortable and safe Residential Aged Care, with dedicated, highly trained staff attending to them. Residents are Our Number One Priority The transition from living at home to moving into Residential Care sometimes has a dramatic impact on the new resident and their family. We strive to make this important change as smooth as possible. Our approach is to tailor our services to meet the specific requirements of each resident which is accomplished in a way that minimises the disruption of the move, supports individual independence and promotes increased enjoyment and a sociable lifestyle. Our planning for individual residents includes ongoing consultation with them, their relatives and the Resident-Relative and Friends Group to continually improve their care. Regular communication between the Service, Residents and their Families is a vital link. The ‘Resident Information Booklet’ detailing all facets of living in Residential Care has been reviewed recently with a new chapter providing information specific to each individual Hostel and Nursing Home. The Booklet is also produced in ‘large print’ for the sight impaired. Positive Continuous Improvement Comments and ideas received from residents, families and visitors assist us to constantly improve our care standards. A Register is provided for residents and visitors to record their thoughts, ideas, compliments and complaints - often the catalyst which leads to improved lifestyle and services for residents. If choices and preferences are known they are respected! 44 WEST WIMMERA HEALTH SERVICE RESIDENTIAL CARE > FOR OUR SENIOR CITIZENS Community Aged Care Packages are individually planned and coordinated assisting older people to remain safely at home and connected to the community. 45 ANNUAL REPORT 2008/2009 Highly Trained Staff Grants For Resident Safety High level staff training ensures we meet the physical, social and emotional needs of residents. $25,000 was received from the Department of Human Services to purchase five floor line beds and five wound care mattresses, crucial for residents identified as ‘at risk’ of falling and to reduce the possibility of skin tears and pressure areas. We provide a range of opportunities for professional development reinforcing our sound reputation for expert resident care. Continual exposure to new techniques and practices is essential in maintaining standards. This year skill updates and training were centred on Electronic Care Planning and Assessment, Behaviour Management and new practices relating to Dementia Care. Electronic Care Planning An electronic care planning and documentation system, ‘iCare’, was introduced providing an integrated and user-friendly health care record containing current health information of each resident located in one place. iCare has made handwritten resident records a task of the past and has improved adherence to complex government regulations. Access To Health Professionals Residents have access to specialist therapies provided by Allied Health professionals, including physiotherapy, speech pathology, podiatry and dietetics, who visit weekly and are available via Videoconference or telephone if consultation is required between visits. Medical Practitioners are available 24 hours a day for all Residents. Protecting Our Residents The Charter of Residents Rights and Responsibilities - Aged Care Act 1997 (the Act) explicitly states that people living in aged care homes have the right to be treated with dignity and respect, and to live without exploitation, abuse or neglect. Mandatory reporting to local Police and Department of Health and Ageing (DoHA) of any incident of elder abuse, clear policies and procedures are in place defining the immediate actions required. Resident wellbeing is paramount. PAGE LEFT: Community Aged Care Package recipient Lorna Redford returns home from a medical appointment with her Personal Care Worker, Marion Major. We are indeed grateful for this support. Accreditation All of our Residential premises are fully accredited verifying they are providing quality care and services according to Standards set by the Australian Government and monitored by the Aged Care Standards and Accreditation Agency. This is comforting to those who elect to access our Service. Our Belief It is clear we must continue to attract enthusiastic staff with a genuine passion for aged care who desire to improve life for our residents. Aged care is a ‘specialty’ requiring a passion and commitment to care for people with highly complex needs. The Aged Care Nurse must nurture a relationship with residents. It is long term care, it is being part of an extended family and it is being able to provide that little bit extra which makes the difference. Care for our residents will continue to be passionate, dedicated and delivered with respect. Community Aged Care – Help To Remain At Home Community Aged Care Packages Community Aged Care Packages (CACPs) are funded by DoHA to cater for the complex care needs of older people. Packages are designed to meet the physical wellbeing, cultural, social, spiritual and emotional needs of individuals. We deliver 15 Packages across Hindmarsh and West Wimmera Shires and the Rural City of Horsham. Currently there is a waiting list of 55 people and we await the outcome of an application to the Department of Health and Ageing for more packages to address this demand. The National Respite For Carers Program (NRCP) This Program supports the Carers of the frail elderly, dementia sufferers, people with challenging behaviours, younger persons with disabilities and those with a terminal illness. The Program assists people to remain at home for as long as possible, supporting the maintenance of caring relationships between carers and the care recipients. Services, including Home Care, Personal Care, Social Support and some travel assistance are provided to 31 clients across our region. Planned Activity Groups (PAG) Planned Activity Groups are located in our 6 communities providing programs and activities to support frail older people, people with disabilities and their carers. The groups provide balanced programs enhancing independence and providing opportunities for socialisation, intellectual stimulation, physical activity, as well as emotional and psychological support. The recognition for increased social supports for Men in Nhill and Kaniva has resulted in increasing the number of days to cater for men seeking involvement and enjoyment of socialisation and the interesting opportunities these Groups provide – a credit to our dedicated and enthusiastic staff. Conclusion Resident focus is more than words in our Residential Care facilities – it is the way we do business. We will ensure that all facilities have robust processes to meet and exceed accreditation requirements, while retaining the resident as the centre of all initiatives. We will also build on volunteer programs within Residential Care – further linking our facilities with the communities we serve. 46 WEST WIMMERA HEALTH SERVICE COMMUNITY AND ALLIED HEALTH OUR CARE REACHING OUT For the first time in many years we have recruited a full complement of Allied Health staff – a significant milestone. Community and Allied Health Professionals encompass Community Nursing, Counselling, Diabetes Education, Dietetics, Occupational Therapy, Physiotherapy, Podiatry, Speech Pathology, Social and Welfare who work together to provide an holistic approach to the management of health. 47 ANNUAL REPORT 2008/2009 Goals Strategies Achievements Future Provision of care in accordance with evidence based practice principles. Documentation in medical file entries to meet legal and statutory requirements. All clinicians are providing care in accordance with evidence based practice as indicated by results of internal audits. A collaborative approach to the development and implementation of the Health Promotion Plan for the years 2009-2012 will be utilised. Employ passionate clinicians with expertise in their speciality area . Strengthen our reputation as leaders of Allied and Community Health care. Regular clinical and documentation audits to ensure clinicians are working within their scope of practice and in accordance with evidence based principles. Staff to participate in internal and external credentialing processes. Professional development will be supported to increase the knowledge base of clinicians. All Allied and Community Health staff will be members of their respective Professional Associations. Partnerships have been formed with external health and local government agencies to ensure a coordinated approach to service provision. Allied Health clinicians have presented to national and international forums. Research and innovative workforce programs will be pursued. West Wimmera Health Service - Health & Fitness Centre opened in January 2009. In excess of $100,000 received from the Department of Human Services (DHS) for Innovative Research Grants. A Time Of Change Chronic Disease Mangement Service delivery is offered for all ages in a variety of clinical settings: acute, rehabilitation, community, and in the home. Referrals are accepted from health care professionals, doctors, nurses, carers or self referral. It is crucial that quality care is delivered within the realms of evidence based practice. In order to ensure our community receives the best and appropriate care, all staff are completing external or internal credentialing processes which ensure they are abreast of current practice and future developments of care. We are moving proactively from systems based on the acute model of care and implementing pathways that address the Burden of Disease in accordance with a social model of health. Staff travel to all campuses weekly and deliver services to neighbouring Health Services and Residential Aged Care facilities, namely Rural Northwest Health, Edenhope District and Memorial Hospital, Woomelang Bush Nursing Centre, Allambi Elderly Peoples Home Dimboola and Dunmunkle Health Service. Community and Allied Health services at the Goroke Community Health Centre will increase. The social model of health recognises the effect of social, economic, cultural and political factors and conditions on health and wellbeing. It is a conceptual framework for improving health outcomes, aimed at preventing and reducing illness and addressing inequalities and disadvantages that exist within communities. WWHS Health And Fitness Centre – Nhill Gymnasium Since January 2009 we have managed the Nhill Gymnasium which now operates as West Wimmera Health Service Health and Fitness Centre. Membership numbers have increased and our Physiotherapists, Exercise Physiologist and Fitness Instructors have commenced well supported health and fitness programs. Exercise is an important factor in preventing and controlling disease, therefore reinforcing the importance of the programs offered at the Health & Fitness Centre. PAGE LEFT: Speech Pathologist, Yingying He assessing Iona Digby Harris Nursing Home resident, Sylvie Donnell. 48 WEST WIMMERA HEALTH SERVICE COMMUNITY AND ALLIED HEALTH > OUR CARE REACHING OUT Healthy Workplace Challenge Innovative Submissions Research and Presentations Lowan Community Health Nurses organised a Healthy Workplace Challenge incorporating physical activity and healthy eating over 6 weeks. Despite major competition, our team was successful in attracting funding for several projects proving that we have the expertise and capacity to share our knowledge with our Rural, Regional and Metropolitan counterparts. Creating a dynamic and exciting research culture has assisted in attracting expert clinicians to our Service and forging partnerships with researchers from major metropolitan and regional centres such as Latrobe Regional Hospital, Latrobe Community Health Centre, The University of Melbourne, PeterMac Cancer Centre and The Murdoch Children’s Institute. Sixty participants undertook the challenge with a combined weight loss of 63 kgs, loss of waist measurement, increased physical activity as well as feelings of well being, increased energy levels and staff morale, and decreased blood pressure levels. In April 2009 another Challenge was instigated, with funding received from the ABC Rural Fund, and was opened up to local businesses. Twenty businesses completed the challenge, with 275 participants and a total weight loss of 301.9 kgs. Early Intervention – Let’s Make Tracks We embarked on the development and implementation of an early intervention program ‘Let’s Make Tracks’. A multidisciplinary team including Counselling, Dietetics, Occupational Therapy, Podiatry, and Speech Pathology screened all kindergarten children across the Hindmarsh, West Wimmera and Yarriambiack Shires. Early intervention programs are valuable, as a child’s development in the first few years of life is crucial in setting the foundation for lifelong learning, behaviour and health outcomes. Chronic Disease Management Pathway Workforce Innovations Grants of $110,000 from DHS were received to provide an effective and efficient health service for clients with a chronic disease, a proactive model of care that is capable of addressing health problems and increasing wellness. We will move from systems based on the acute model of care and develop community care pathways in the areas of Diabetes, Mental Health and Cancer Care Management. Foot Care Clinic We were also funded to complete a toolkit and DVD to provide nursing staff with education on basic foot care for residents in our Nursing Homes and Hostels. This will ensure a timely service for our residents and enables the Podiatrist to concentrate on more complex foot care. Dysphagia and High Risk Nutritional Assessment Toolkit Funding was provided to develop and implement an Assessment Form and DVD to assist in timely assessment and management of patients and residents who have difficulty swallowing, or are not consuming enough solids or fluids thus risking dehydration and malnutrition. We are currently involved in a large scale clinical trial to investigate the effects of water aspiration in patients who have been prescribed thickened fluids, by considering immunological response and bacterial colonisation - a new area of research. Our Speech Pathologists were invited to present work at the New York Speech Pathology Convention and the Speech Pathology Australia Conference in May 2009. Future Direction Decreasing the Burden of Disease through health promotion and effective chronic disease management will continue to be a priority of the Allied and Community Health team. Our collaborative approach with other clinicians and service providers will ensure that clients in our communities have access to best practice models of care that are effective and accessible. 49 ANNUAL REPORT 2008/2009 PAGE LEFT: District Nurse, Kaye Robinson Div 2 visits Dorothy Chenoweth in her home to monitor her blood pressure. BELOW: Sarah White and baby son Riley listen intently to Maternal and Child Health Nurse Mandy Stephan as daughter Baillee watches on. 50 WEST WIMMERA HEALTH SERVICE COOINDA DISABILITY AND BUSINESS SERVICE Goals Strategies Achievements Future To advance the quality of life for people with a disability. Provision of activities which enhance motor skills and increase cognitive abilities. Sensory Room established at Cooinda. Achieve compliance with Department of Human Services (DHS) Disability Accreditation. To facilitate opportunities for clients in the community. To increase client access to lifestyles, by encouraging others to respect, promote and safeguard their rights. To provide employment opportunities. Encourage community integration through public outings and activities. Provide programs which develop self-esteem, promote confidence and respect. Commence healthy lifestyle programs which promote healthy diet and exercise regimes. Intensify work based training and skill development. Workplace integration achieved at West Wimmera. Oliver’s Kiosk opened at Nhill Hospital. Success at Tristate Games with all athletes receiving medals. Our partnership with Luv-A-Duck continues. Clients participate in fitness sessions at WWHS Health and Fitness Centre. Master new State Individualised Support Payments System. Review operations utilising services of a sector lead agency. Facilitate community engagement by utilising increased volunteers. Overcome challenges of business viability. 51 ANNUAL REPORT 2008/2009 PAGE LEFT: Cooinda Client, Roger Batchelor enjoys watering the veggies with ‘worm juice’, a fertiliser produced by the centre. Exciting Year in Disability Services Cooinda Disability Service encompassing Oliver’s Café, Oliver’s Kiosk, Snappy Seconds, Cooinda Duck Farm (partnership with Luv-a-Duck) and State Funded Day Programs provide innovative programs for clients. 2008/2009 has been an exciting year with program changes and new opportunities. Oliver’s Café continues to gain increasing market share and is firmly entrenched as ‘the place to eat’ in Nhill. Excellent meals and timely service has contributed to increased clientele. ‘Oliver’s Kiosk’ was opened in March 2009 by Mr Jock McLean – Contract Manager, Department of Families, Housing, Community Services and Indigenous Affairs. The Kiosk offers a tempting variety of light meals and excellent coffee for patients, visitors and staff, simultaneously creating employment opportunities for Supported Employees. Snappy Seconds, pre-loved and collectables in Nhill now opens on Saturday mornings, made possible by the efforts of our wonderful team of volunteers adding another dimension to this enterprise. BELOW: Amy Brown has taken another step in her career development and now assists with the weekly sorting and distribution of laundry to residents at Iona, Nhill. A task undertaken with precision and a cheerful smile. The collection of cardboard and newspaper has ceased, triggered by the high cost of compliance with new OH&S regulations, the decline in the global price of cardboard and high fuel costs. Innovation and Enthusiasm Paper shredding, fire brick making and worm farms are new programs being developed. Paper is shredded to produce fire bricks and we are experimenting to produce smaller firelighters. A venture into worm farming to produce liquid fertiliser is proving to be a great success which will introduce a commercial presence. The new Sensory Room is important for the Diversional Therapy Program and offers mood music with soothing and stimulating visual effects resulting in a calming environment. The garden program provides pleasure and a sense of achievement. Plots have been extended with produce sold through a local craft shop. Clients assist at a Herb Farm, harvesting Peppermint and preparing it for drying. Cooinda operates a large Breeder Shed for Luv-a-Duck with eggs collected and delivered daily to the Hatchery where they are processed and then distributed to grower farms. Luv-a-Duck management continues to applaud the quality of the Supported Employees and praises their handling of the ducks, with outstanding egg numbers delivered in the second year of involvement. Three Supported Employees are studying for the Certificate in Poultry Management and will sit their final examinations in August 2009. The new programs have been very successful providing clients choice and the opportunity to develop new skills making Cooinda ‘The Happy Place’, the meaning of its name. The Future DHS is making changes to the funding regime for Disability Services which will challenge Service Providers such as Cooinda. We are confident Disability and Business Services will continue to provide a caring and supportive environment for our clients with their future endeavours, and ‘Cooinda’ will be no exception. 52 WEST WIMMERA HEALTH SERVICE CORPORATE AND QUALITY SERVICES SUPPORT THAT IS ESSENTIAL Although not directly related to hands on patient care the support services of the Corporate & Quality Division – Engineering and Maintenance, Catering and General Services, Education and Health Information Services are vital to our ability to function. 53 ANNUAL REPORT 2008/2009 Our Goal Strategies Achievements Future To provide timely, efficient and effective support services. Provide a comprehensive preventative maintenance program. Continued redevelopment of ‘Mira’ Primary and Community Health Centre. Complete Nhill Hospital redevelopment. Undertake building renovation projects to enhance the physical infrastructure of the Service . Redevelopment of Helen Macpherson Smith Day Procedure Unit to accommodate a 4 chair Dialysis Unit. Provide tasty and nutritious freshly cooked meals for patients and staff. Gazebo built at Natimuk for sheltered outdoor activities. Provide a clean and hygienic environment minimising the risk of infection. Provide a comprehensive education program. Provide health information in a secure manner. Provide a safe and secure working environment. General Service – Clean, Hygienic and Safe Environment The necessity to maintain a clean environment minimising the risk of infection is at the forefront of our actions. With the rapid spread of H1N1 (Swine) Flu in May and June 2009 the community also became conscious of the need for a clean and hygienic environment. A thorough and comprehensive cleaning program is in place at all sites. Regular audits are undertaken by staff and independent external auditors to ensure we meet or exceed Department of Human Services (DHS) standards. The 2009 external audit outcome revealed outstanding results. Our patients believe the hospitals within WWHS are clean. When asked to rate cleanliness between 0 (poor) and 5 (excellent) we have performed above the State average. Victorian Patient Satisfaction Monitoring December 2008 The cleanliness of the toilets and showers The cleanliness of the room where you spent the most time WWHS 4.51 State-wide 4.05 4.53 4.14 315 staff education sessions with a total of 2410 attendees. Provision of 191,406 fresh cooked meals across all sites. External cleaning audit results 11% above the State benchmark. Security review undertaken – result 98% compliant. External Cleaning Audits Implement recommendations arising from the security review . Replacement of air conditioning systems at Natimuk Hostels. Integrate the Kaniva nurse call system with fire detection systems. Establish secondary storage compound. Complete ‘No Smoking’ policy. The Dollars for Continual Improvement A number of grant submissions made to DHS were successful for which we are grateful and include. 100 95 > The replacement of evaporative air 90 85 80 2009 How we know standards are reached Modification of Oliver’s Kiosk. Expand incident reporting to gather more detailed analytical data. WWHS 2008 2007 2006 State Benchmark conditioning system at Trescowthick House Hostel and Allan W. Lockwood Special Care Hostel at Natimuk with a new refrigerated system prior to the 2009/10 summer season, to ensure residents remain comfortable and safe during all weather conditions. > The installation of an additional hot Engineering & Maintenance Services water system at Kaniva Hospital and Nursing Home will increase the safety and comfort of patients and residents. Our highly skilled team undertakes most repairs and maintenance and a large amount of our redevelopment projects, without having to outsource tradespersons - a considerable saving and importantly has ensured a high standard of quality workmanship. The Engineering staff have undertaken projects including the redevelopment of ‘Mira’, Primary and Community Health facility, installation of a Gazebo for dementia specific residents at Natimuk, modification of Oliver’s Kiosk at Nhill Hospital and relocation of the dialysis unit. How fortunate we are to have such skilled tradesmen. PAGE LEFT: Joanne McCartney, General Services Supervisor, conducts a cleaning audit using the Palm Pilot software program. 54 WEST WIMMERA HEALTH SERVICE CORPORATE AND QUALITY SERVICES SUPPORT THAT IS ESSENTIAL BELOW: Wearing protective ear and face shields, Ian Barry guides timber on the saw bench, and Matthew McCartney works on the grinder in the maintenance workshop. Safety and Security A security review was conducted to ensure security measures in place met with Australian Standards. 98% compliance with mandatory security criteria resulted. An excellent outcome, it is the highest score of any hospital surveyed by the consultant in the previous four years. Recommendations were made to improve our security systems and an Action Plan, including a priority rating, has been developed to facilitate the implementation which includes the introduction of Closed Circuit Television cameras to provide documentary evidence of security issues as they occur, which will significantly improve security across our organisation. Health Information Services Every patient treated at WWHS has a Medical Record containing medical and administrative information. The Record provides a comprehensive history of previous medical treatment which assists health professionals to plan future or emergency care should this arise. Catering – Nutritious and Tasty Meal Options A major imperative for our Catering Departments has been to establish a new menu. During the 15 week trial some recipes proved successful and others not so. However changes to recipes and menu choices did occur. A number of complaints were received from Aged Care residents that meals were ‘too healthy’ and missed the opportunity to indulge in occasional ‘fast food’ items. Given the need to promote the importance of patient and resident choice, ‘special meals’ have now been reintroduced, an initiative which has met with resounding acclaim. Prior to final approval, the menu is now being reviewed by Dietitians, Speech Pathologists and Catering Staff Challenges Fire Alarms at Kaniva During the final six months of the reporting period the number of false fire alarm calls increased at Kaniva Hospital and Nursing Home. The calls were causing great concern for our Service and the Country Fire Authority (CFA). The volunteer Kaniva Brigade has been extremely patient and understandably became increasingly frustrated by unnecessary call outs. The false alarms were caused by ageing fire detectors and wiring. We worked closely with the CFA and DHS seeking funding to install a fire detection system, integrated with the nurse call and paging systems. A vital improvement, with funding being provided for this purpose. Power Surge at Rainbow and Jeparit Hospitals Rainbow and Jeparit Hospitals experienced a power surge in April 2009 which caused a number of electrical systems to fail at the Rainbow Hospital. As a result a number of electrical applications and appliances, including electronic beds, water heating and chilling systems and air conditioners required replacement. Service personnel and contractors worked around the clock to ensure residents and patients safety was not compromised during this traumatic period. These systems have now been returned to working order with associated costs subject to an insurance claim. Information, particularly administrative and diagnostic information including pathology and X-ray results, are held electronically, with other information relating to treatment while in hospital or in an outpatient or emergency care situation in paper format. Your Privacy Assured We are forever vigilant to ensure people are confident that their information remains confidential and will only be available for those purposes for which consent is given. To this end, staff must regularly participate in privacy and confidentiality education. At the end of this reporting period, 98% of our staff were compliant with the mandatory privacy and confidentiality training – a reassuring outcome. Looking Forward to Next Year and Beyond We will embrace new technologies to increase efficiencies in all departments including ‘state-of-the-art’ catering equipment with the planned redevelopment of the Nhill Hospital catering unit, introduce CCTV video monitoring for improved security purposes and implement the electronic iSoft Patient Management system. 55 ANNUAL REPORT 2008/2009 CORPORATE AND QUALITY SERVICES ACCREDITATION – AN EXTERNAL MEASURE OF QUALITY We are committed to providing quality care across our entire range of services. We submit the quality of our care for assessment by participating in external accreditation processes, with independent surveyors reviewing services against ‘best practice’ and national standards. Australian Council of Healthcare Standards (EQuIP) ACHS > Organisational wide survey was conducted in November 2008 with Full accreditation status received – four years. Reviews WWHS organisation within a 4 year cycle – including acute inpatients, residential aged care, primary health, disability and support services > ‘Extensive Achievement’ status awarded for ‘Infection Control’ and ‘Community Consultation’ Standards. High praise indeed. > ‘Moderate Achievement’ status achieved for 41 Criteria, including all ‘Mandatory Criteria’. Home and Community Care (HACC) ACHS > Addressing District Nursing & Planned Activity Groups It is pleasing to report all forms of accreditation undertaken have resulted in positive outcomes, reinforcing the excellence of care delivered by West Wimmera Health Service. Aged Care Standards and Accreditation Agency (ACCA) Review of individual residential aged care sites every 3 years in accordance with Commonwealth legislation Disability Services Accreditation > > 19 recommendations resulted which are now being addressed. > A Self-assessment, focusing on Clinical Functions will be submitted to the Council in October 2009. > ACHS is a pre-eminent organisation recognised nationally for the quality of its accreditation programs. Assessment in November 2008 reviewed District Nursing Service against the National Standards of the ACHS. > High Standard was recorded for all 25 standards, with a rating of 20/20. > A perfect example of our continuous improvement ideals. Survey undertaken at Archie Gray Nursing Home Unit, Kaniva, in February 2009 resulted in three year accreditation status being achieved with compliance in all 44 criteria. > Weeah Lodge Nursing Home, Rainbow. > > Bowhaven Hostel, Rainbow. > Allan W. Lockwood Special Care Hostel, Natimuk. > Trescowthick House Hostel, Natimuk. > Accreditation kits have been submitted to ACCA in preparation for surveys to take place at 8 of our Nursing Homes and Hostels, scheduled for August and September 2009. > An Action Plan is in place to address all recommendations from July 2008 review. > A further review is due to take place in July 2009. Unannounced site visits were conducted at each of the following residential aged care facilities with total compliance resulting. > ‘Iona’ Digby Harris Home, Nhill. > Archie Gray Nursing Home Unit, Kaniva. > Arthur Vivian Close Hostel, Kaniva . > Tullyvea Nursing Home & Hostel, Jeparit. > Annual review audit was undertaken in July 2008 with one area of minor non-conformance identified relating to a formal Audit program. Relevant to Cooinda Disability Service Diagnostic Imaging (X-Ray) ACHS > Residential Aged Care Nursing Home, Natimuk. > A follow up review in January 2009 revealed the Audit program was re-presented with the non-conformance cleared. > From July 2009 the Department of Health & Ageing require all Diagnostic Imaging practices to be accredited in order to be eligible to receive Medicare benefits. > Self assessment and desktop audits were undertaken by ACHS assessing our Service against national standards. > Full Stage 1 accreditation status was achieved which is valid from May 2009 to June 2010. Related to X-Ray services at Nhill, Jeparit & Kaniva Department of Health & Ageing > > Community Aged Care Packages (CACP) Full accreditation status by Department of Health & Ageing maintained. The five recommendations received for CACP have been addressed. > Self-assessment toolkit submitted in preparation for full survey in August 2009. > Six recommendations received for NRCP, five of which have been complied with. One recommendation relating to carer needs remains ongoing. National Respite for Carers Program (NRCP) 56 WEST WIMMERA HEALTH SERVICE CORPORATE AND QUALITY SERVICES > ENVIRONMENT AND SUSTAINABILITY Enduring a decade of sustained drought conditions in the West and Southern Wimmera and Southern Mallee has provided us with a tangible illustration of resulting catastrophic outcomes that can occur if we do not protect the environment and promote its long term sustainability. We have contributed to this cause through the following initiatives: Landfill Waste To improve collection, recycling and disposal of waste material a trial using ‘Rubbish Skips’ has been introduced at Kaniva and Nhill Hospitals. The ‘skips’ cope with waste too large for domestic bins used previously. Efficiencies gained have translated into estimated cost savings of 53%, improved control of vermin and a reduction in inappropriate disposal of waste, therefore reducing waste consigned to landfill. Efforts have also been intensified to maximise recycling opportunities and minimise landfill waste through the segregation of paper, cans, bottles and plastic. Paper A trial of paper brick making as a business activity at Cooinda using shredded paper has commenced. The paper bricks will be sold for domestic use. Where possible we purchase items manufactured according to environment sustainability standards. For example the photocopy paper we use is purchased from a mill accredited under ISO 14001 for its Environmental Management System. 85% of the water used in making the paper is recycled. Macerators Macerators, an environmentally friendly method of human waste disposal, provide substantial savings to the environment and the Service when compared with the flush method: > 85% saving in electricity; > 75% reduction in cold water usage; > 100% reduction in hot water consumption; > Consumables used in the macerators are manufactured from recycled paper. Application has been made to the Department of Human Services for funding to install macerators at Jeparit and Kaniva Hospitals, our two remaining sites waiting to maximise the benefits of this efficiency initiative. Rain Water Storage at Jeparit – a First Four tanks purchased for Jeparit Hospital, with funding of $14,500 received from the Department of Human Services, provided the opportunity to collect and store rainwater. The Hospital is now selfsufficient in terms of access to rain water. Previously, water had been purchased and transported to the Hospital at considerable cost. Insulating For Efficiency Insulation was installed in the ceilings of the two Natimuk Hostels providing instant relief from extreme heat as well as lowering energy consumption levels. External blinds were fitted to several window areas at Rainbow Hospital thus reducing external heat during summer, and reducing the burden on air-conditioning systems. Vehicle Replacement Selection criteria for replacement of vehicles in our fleet now includes air pollution and greenhouse rating with vehicles purchased in 2008/09 averaging an efficiency rating of 3.5–4 out of a possible 5 stars and a greenhouse rating of between 7–7.5 out of 10, an improvement on previous vehicles which averaged a greenhouse rating of 6 out of 10. The Future The review of energy use planned for 2008/09 to explore methods of maximising efficiency and minimising costs thus maintaining a pleasant and comfortable environment, will now proceed in 2009/10. We will introduce innovation in all recycling and energy conserving practices to protect the environment and achieve sustainability wherever and whenever we can! ABOVE: At the Jeparit Hospital, plumber Reg Parsons continues work on the installation of rain water tanks which were provided through a DHS funding grant. 57 ANNUAL REPORT 2008/2009 LEGISLATION CRITICAL TO OUR PERFORMANCE West Wimmera Health Service has a fundamental obligation to establish a sound system which ensures compliance with legislative requirements specific to the healthcare industry. Compliance is a central element of the legal obligation of the Service. Statement on Compliance with the Building and Maintenance Provisions of the Building Act 1993 The Building Code of Australia specifies buildings must be classified according to their function. The Code, incorporating the Building Regulations 2006, define building and safety requirements, including fire safety and entry and egress depending on the use of the building. The Essential Safety Measures Report is prepared annually in accordance with requirements of the Building Regulations 2006 and confirms the safety of buildings, including fire safety, entry and exits and disabled access. The Board receives reports testifying to such compliance. A comprehensive Preventative Maintenance Program is in place at all sites to ensure physical infrastructure remains in a safe condition. Freedom of Information Act 1982 Through the Freedom of information Act clients and patients are able to gain access to information relating to their care. In exceptional circumstances requests for access to information may be denied if safety and privacy of an individual is deemed to be in jeopardy. Three applications were made under Freedom of Information, all of which were granted. The applications related to requests for medical record information. Nine requests for information, outside the Freedom of Information guidelines, were also processed. Five of these requests were from treating practitioners, with the remaining requests from police and solicitors. The Chief Executive Officer is the designated Freedom of Information Officer. Occupational Health & Safety Act 2004 Providing a safe working environment is paramount. The Occupational Health & Safety Act 2004 details employer and employee responsibilities. Two visits from WorkSafe Victoria Officers occurred, with officers being satisfied with health and safety processes in place. On one occasion an employee injured in the workplace required hospitalisation which was reported to WorkSafe Victoria. A resulting visit by WorkSafe officers confirmed that changes made to procedures had minimised the risk of such an incident recurring. Consultancies Consultancies to WWHS In excess of $100,000 Less than $100,000 No. Value $ 0 0 11 137,895 Summary of Application and Operation of Whistleblower Act The Whistleblowers Protection Act 2001 is to encourage and simplify the process of making of disclosures of improper conduct by public officers and public bodies, to provide protection for persons who make those disclosures and to provide for these disclosed matters to be properly investigated and dealt with. The value of transparency and accountability in administrative and management practices is accepted, and support disclosures which reveal corrupt conduct, substantial mismanagement of public resources, or conduct involving a substantial risk to public health and safety or the environment. The Service’s Whistleblower Policy outlines the process of making a disclosure which is available on the Service Intranet. The Operations Manager is the Disclosure Officer. No disclosures or notifications of disclosure under this Act were received. Information Information about any facet of WWHS may be requested by contacting the CEO by mail or telephone. Police Checks It is a legislative requirement that all staff and volunteers have a current Victorian Police Check. No one is employed or accepted as a volunteer at this Service without a valid Police Check. Compliance with this regulation is monitored monthly, with staff notified when their Police Check nears expiry. The organisation is 100 per cent compliant with this requirement. Publications Publications produced by West Wimmera Health Service are readily available from the Service, on the website – www.wwhs.net.au ,or by contacting the Service by telephone, mail or email [email protected]. Publications include Annual Reports, Quality of Care Reports, Strategic Plan, The Residential Aged Care Booklet, a brochure outlining the activities and services at Cooinda, and Information brochures related to specific health conditions and post operative care. Fees State and Commonwealth Governments set fees to be applied for most services offered. The schedule of fees is available from the Service where Policies and Procedures are in place outlining systems and processes for payment and collection of fees and charges. National Competition Policy Competitive neutrality ensures the significant business activities of publicly owned entities compete fairly in the market. As this policy only applies to significant businesses of a for-profit nature, no disclosure by the Service is required. Victorian Industry Participation Policy (VIPP) This policy was introduced in 2003 to increase opportunities for local business and supply chain partners to participate in government related business. The Service did not tender any works above the designated $1m threshold, therefore no reporting requirements apply. 58 WEST WIMMERA HEALTH SERVICE FINANCE AND ADMINISTRATION SUSTAINABLE AND ACCOUNTABLE Goals Strategies Achievements Future To be an industry leader in financial reporting and control. Maintain a cohesive and well trained finance team. To maximise the level of financial resources available for operating and future capital and equipment renewal. Provide financial management education and assistance to managers. Fourth consecutive year of achieving an operating surplus. Ensure the successful implementation of a new financial management information system scheduled to occur in March 2010. To be recognised as a reliable and responsive provider of financial and administrative services and able to identify and successfully deal with emerging financial challenges in a timely manner. Achieve an operating surplus for the 2009-2010 financial year. Installation of the PayGlobal Human Resource Self Service (HRSS) module which allows employees to check online pay related details including their mandatory education status and leave applications. Maximise use of HRSS to improve the effectiveness and efficiency of the Payroll Department. 59 ANNUAL REPORT 2008/2009 The Finance and Administration Division has completed another trouble free financial year due in no small part to the continued commitment of staff to best practice ,and to gaining and applying new skills and knowledge at every opportunity. Procurement The proper functioning of our Stores and Supply Department is critical to clinical staff delivering the best possible care to patients, clients and residents. The effective and efficient management of all stages of the procurement process is a vital part of this process. The following chart shows the value of medical and surgical inventory as a percentage of the annual cost of medical and surgical goods purchased. The fall in this metric indicates a significant increase in the efficiency of the supply and storage of medical and surgical goods. A trainee storeman has quickly become a reliable assistant to the Purchasing Officer. Medical & Surgical Stock as a Percentage of Total Goods and Services Costs Percentage WWHS Workforce Composition > Ensure open competition in recruitment, selection, transfer and promotion > Base employment decisions on merit > Treat employees fairly and reasonably > Provide employees with a reasonable avenue of redress against unfair or unreasonable treatment > Avoid discriminating between employees on the basis of gender, age, impairment, industrial activity, marital status and religious or political belief > We do not tolerate bullying and harassment in any form. Workcover A safe and secure environment and a healthy workforce are vital components of a successful health service. There were no serious staff injuries, diseases or workplace deaths during the year. 2009 2008 Employees Full Time Part Time Casual 134 296 116 121 296 119 Grand Total 546 536 Equivalent Full Time by Category Nursing 160 Administration 31 Medical & Allied Health 25 Professionals General Services 53 Maintenance 18 Disability 10 160 32 23 52 18 14 Grand Total 297 299 Employees by Gender Female - EFT Female - Number Male - EFT Male - Number 252 446 44 70 251 447 48 71 We acknowledge our WorkCover insurance agent, Cambridge Integrated Service which continues to provide timely assistance in the management of injured workers. Finance 20 Continued increases in the level of compliance reporting to a variety of stakeholders have been met by improved use of the PowerBudget financial management and reporting software. 15 10 5 0 Through the application of Service policies and compliance with legislation we are able to: 2005 2006 2007 2008 2009 Employment The Finance Team works together to ensure accounting and finance processes are executed in a prompt and effective manner. Our commitment to remaining an ‘employer of choice’ is underpinned by our ongoing compliance with the obligations and requirements of the following legislation: A trainee has commenced in our Finance and Payroll Departments adding strength and diversity to these services. > The Victorian Public Authorities (Equal The Pay Office Manager and Clerk ensure employees are paid on time and in accordance with all contractual and industrial agreements. Employment Opportunity) Act 1990 > The Victorian Equal Opportunity Act 1995 > The Victorian Public Sector Management and Employment Act 1998 > The Commonwealth Disability Discrimination Act 1992 > The Commonwealth Racial Discrimination Act 1975 > The Victorian Public Administration Act 2004 Payroll Upgrades to the PayGlobal personnel management software including the installation of the Human Resource Self Service (HRSS) module is expected to materially reduce non-staff related administrative costs associated with paying over 500 people. PAGE LEFT: Purchasing Officer, Luke Oldaker (right) and trainee storeman Clint Beattie (left) with the first of the morning deliveries 60 WEST WIMMERA HEALTH SERVICE FINANCE AND ADMINISTRATION > SUSTAINABLE AND ACCOUNTABLE Information & Communication Technology (ICT) ICT affects all areas of our business and is integral to maintaining the efficiency and effectiveness with which our services are delivered. However proper management of this potentially costly area is vital. Our IT Strategic Plan is pivotal to this outcome. The Service is now a member of the Grampians Regional Health Alliance (GRHA), a joint venture of Grampians region health services established to manage the acquisition and installation of major region-wide IT systems including ‘iSoft’ (Patient and Client Management System) and Oracle (Financial Management Information System). GRHA is funded directly by the Victorian Government to provide cohesive and costeffective management of the new system. GRHA also maintains the ICT connections within the Service and external to it. In August 2009 a new Patient Management System will be implemented as part of a statewide standardised information technology system. It will occur in conjunction with other public health services in the Grampians region. iSoft includes patient admissions and discharges, bookings for the Operating Theatre, referrals to Specialists and Allied Health staff, bed allocation and diagnosis and procedure coding. The importance of ICT has grown as evidenced by the use we now make of videoconferencing. This technology has greatly reduced the amount of travelling required for internal and external meetings, meaning material savings in time and money. We acknowledge the prompt and professional assistance received from our principal ICT services provider, Dulkeith Computer Solutions. Preparation for the implementation has occurred, with training for staff now taking place to ensure the system is used to its maximum potential when we ‘go live’. The implementation of the new system will improve efficiency by ensuring maximum bed allocation and use. The successful implementation of our Residential Aged Care clinical notes and care planning software, ‘iCare’, demonstrated that remoteness of a health service in no way detracts from technological outcomes. ABOVE: Josh Rintoule, Trainee Administration Clerk (front), Cassy Moar, Assistant Accountant (centre), and Richard Lane, Accounts Payable Officer (at rear) during training for the new PayGlobal Human Resource Self Service (HRSS) payroll system. 61 ANNUAL REPORT 2008/2009 FINANCIAL PERFORMANCE OVERVIEW The strong financial performance reported by the Service in recent financial years has continued through 2008-2009 with another impressive operating result achieved and relatively high levels of cash and investments held at year end. The ongoing efforts by management and staff to maximise revenue streams, while at the same time keeping costs under control, has contributed significantly to this outcome. The financial support of the Department of Human Services and our many generous benefactors is noted and greatly appreciated. Profit & Loss Financial Year Ending 30 June 2009 2008 2007 2006 2005 $’000s 26,733 (18,339) (1,201) (2,224) (4,370) 599 (174) 425 $’000s 25,961 (18,119) (1,161) (1,882) (4,349) 450 1,023 1,473 $’000s 24,743 (17,797) (927) (1,795) (4,076) 148 391 539 $’000s 23,970 (17,164) (956) (1,722) (4,077) 51 2,443 2,494 $’000s 22,815 (16,362) (796) (1,457) (4,219) (19) 3,657 3,638 2009 2008 2007 2006 2005 Current Assets Non-Current Assets Current Liabilities Non-Current Liabilities Net Assets (Equity) $’000s 8,228 52,378 (8,580) (522) 51,504 $’000s 8,255 42,894 (9,317) (433) 41,399 $’000s 4,329 43,963 (7,927) (659) 39,706 $’000s 3,530 44,083 (7,910) (536) 39,167 $’000s 4,254 40,474 (8,165) (390) 36,173 Net Operating Surplus Sources of Operating Income The net operating surplus (income minus expenses before capital items) was $599,000 compared to the surplus of $450,000 recorded in 2007-2008. This year’s result significantly bettered the original budget of surplus $195,000. In 2008-09 approximately 59% (20072008: 58%) of the Service’s total operating revenue was provided by the Department of Human Services ($15.7m) which equates to an increase of 6.0% from the previous year. Cash and Investments The remainder of operating revenue which includes receipts from the Australian Government for residential Aged Care ($5.266m) totalled $11.09m representing a 1% decrease compared with the previous financial year. The primary cause of this reduction was the planned cessation of the $550k grant previously received from the Australian Government to cover the financial effects upon the Service of recent changes to Fringe Benefi ts Tax Legislation. Balance Sheet Financial Year Ending 30 June At 30 June 2009 the Service held some $3.9m in cash and investments which does not include monies held in relation to Aged Care Accommodation Bonds, and is after deducting those amounts which have been earmarked for a specific purpose. This amount is well in excess of the budget forecast of $2.6m. It is often said an organisation’s greatest asset is its employees, which in absolute expenditure terms is true of West Wimmera Health Service. This year employee related costs were $19.54m representing some 75% of total operating expenditure, and a 1.3% increase on 2007-2008. Summary of Significant Changes to Financial Position During the Year Summary of Financial Results Revenue Employee Related Expenditure Non-Salary Labour Costs Supplies & Consumables Other Expenses Net Result before Capital & Specific Items Net Capital Items & Specific Items (includes depreciation) Net Result for the Year Funding Expenditure The following table lists those balance sheet items which have changed significantly over the 2008-2009 financial year: Summary of Significant Financial Changes Property, Plant & Equipment - Asset Property, Plant & Equipment Revaluation Reserve - Equity 2009 2008 $’000 52,350 $’000 42,844 10,050 370 In accordance with the requirements of the Department of Treasury and Finance, the Service had all Land and Buildings revalued by the Victorian Valuer General as at 30 June 2009. This resulted in a net gain on revaluation of $9.68m hence the significant increase in the value of the Service’s Property, Plant & Equipment asset category. As such revaluations must be recorded directly in the Balance Sheet this had the effect of increasing the Service’s Property, Plant & Equipment Revaluation Reserve by the same amount. 62 WEST WIMMERA HEALTH SERVICE FINANCIAL PERFORMANCE > OVERVIEW Current Ratio 0.89 At 30 June 2009 the Service’s Current Ratio (Current Assets divided by Current Liabilities) was 1.47. This means that for every dollar of current liabilities payable by the Service, it holds $1.47 cents worth of current assets. This ratio is used to indicate the Service’s capacity to pay its debts ‘when they fall due’. As can be seen in the following chart, the Service’s Current Ratio has shown strong gains in the past two years following the completion of the redevelopment of the Nhill Hospital. Debt to Equity Ratio – (Gearing) 0.18 Current Asset Ratio Comparison This ratio is used to indicate the level to which the Service relies on externally sourced funding and shows that it only requires a small level of such funding. 2.0 1.5 Ratio Financial Ratios 1.0 Conclusion 0.5 The strong financial results reveal that West Wimmera Health Service has the capacity to successfully adapt to the changing fi nancial environment in which it operates. 0.0 ‘97 ‘99 ‘01 ‘03 ‘05 ‘07 ‘09 Year ended June 30 The Service’s current ratio has ended the past five years at its highest result during such time. This outcome indicates that the Service is well able to fund its short term financial obligations and that it is in a good financial position going into the 2009-2010 financial year. Quick Asset Ratio 0.99 ABOVE: Receptionist Kerryn Cook has a busy morning with patient appointments for Radiology and Visiting Surgeons. The Service’s Quick Asset Ratio is similar to the Current Ratio, however it only includes those current assets and current liabilities which are of a very short-term nature and therefore is used to gauge the Service’s short-term solvency. This result means that the Service has 99 cents worth of liquid current assets (20072008: 93 cents) for every one dollar of short-term current liabilities. Despite the financially challenging environment faced by the Service over the past decade coupled with major redevelopment works which it undertook during such time, the Service nevertheless finds itself in a sound financial state from which it can look with confidence to continuing to meet the many and changing healthcare needs of the people we serve. ANNUAL REPORT 2008/2009 63 64 WEST WIMMERA HEALTH SERVICE WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 65 West Wimmera Health Service Board member’s, accountable officer’s and chief finance & accounting officer’s declaration We certify that the attached financial report for West Wimmera Health Service has been prepared in accordance with Standing Direction 4.2 of the Financial Management Act 1994, applicable Financial Reporting Directions, Australian Accounting Standards, Australian Accounting Interpretations and other mandatory professional reporting requirements. We further state that, in our opinion, the information set out in the Operating Statement, Balance Sheet, Statement of Changes in Equity, Cash Flow Statement and notes forming part of the financial report, presents fairly the financial transactions during the year ended 30 June 2009 and financial position of West Wimmera Health Service at 30 June 2009. We are not aware of any circumstance which would render any particulars included in the financial report to be misleading or inaccurate. We authorise the attached financial report for issue on this day. R A Ismay J N Smith R R Dodds Board Member’s President Accountable Officer Chief Finance & Accounting Officer Nhill 24 August 2009 Nhill 24 August 2009 Nhill 24 August 2009 Operating Statement For the Year Ended 30 June 2009 Revenue from Operating Activities Revenue from Non-operating Activities Employee Benefits Non Salary Labour Costs Supplies & Consumables Other Expenses From Continuing Operations Share of Net Result of Associates & Joint Ventures Accounted for using the Equity Method Net Result Before Capital & Specific Items Capital Purpose Income Depreciation and Amortisation Finance Costs NET RESULT FOR THE YEAR Balance Sheet as at 30 June 2009 Note 2 2 3 3 3 3 2009 $’000 26,228 477 (18,339) (1,201) (2,224) (4,370) 2008 $’000 25,500 461 (18,119) (1,161) (1,882) (4,349) 11 28 - 2 4 5 599 958 (1,132) 425 450 2,199 (1,172) (4) 1,473 This Statement should be read in conjunction with the accompanying notes. 2009 $’000 2008 $’000 6 7 8 9 10 5,350 569 2,012 265 32 8,228 5,132 655 2,209 252 7 8,255 7 - 50 11 12 28 52,350 52,378 60,606 42,844 42,894 51,149 13 1,438 1,436 14 15 4,519 2,623 8,580 4,888 2,993 9,317 Note Current Assets Cash and Cash Equivalents Receivables Other Financial Assets Inventories Other Current Assets Total Current Assets Non-Current Assets Receivables Investments Accounted for using the Equity Method Property, Plant & Equipment Total Non-Current Assets TOTAL ASSETS Current Liabilities Payables Employee Benefits and Related On-Costs Provisions Other Liabilities Total Current Liabilities Non-Current Liabilities Employee Benefits and Related On-Costs Provisions Total Non-Current Liabilities TOTAL LIABILITIES NET ASSETS EQUITY Property, Plant & Equipment Revaluation Reserve Restricted Specific Purpose Reserve Contributed Capital Accumulated Surpluses/(Deficits) TOTAL EQUITY Contingent Liabilities Commitments for Expenditure 14 16a 16a 16b 16c 16d 20 19 522 433 522 9,102 51,504 433 9,750 41,399 10,050 427 25,924 15,103 51,504 370 427 25,924 14,678 41,399 This Statement should be read in conjunction with the accompanying notes. 66 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 Cash Flow Statement For the Year Ended 30 June 2009 Note CASH FLOWS FROM OPERATING ACTIVITIES Operating Grants from Government Patient and Resident Fees Received Donations and Bequests Received GST Received from/(paid to) ATO Interest Received Other Receipts Employee Benefits Paid Non Salary Labour Costs Payments for Supplies & Consumables Finance Costs Cash Generated from Operations Capital Grants from Government Capital Donations and Bequests Received Non-Government Capital Income NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES 17 CASH FLOWS FROM INVESTING ACTIVITIES Payments for Non-Financial Assets Payments for Facility Redevelopments Proceeds from sale of Non-Financial Assets NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES CASH FLOWS FROM FINANCING ACTIVITIES Proceeds from Borrowings Repayment of Borrowings Transactions with the State in its capacity as owner NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES NET INCREASE/(DECREASE) IN CASH HELD CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD CASH AND CASH EQUIVALENTS AT END OF PERIOD 6 Notes to the Financial Statements 30 June 2009 2009 $’000 2008 $’000 16,784 8,673 27 544 463 733 (18,846) (870) (7,291) 217 17,309 8,962 37 (255) 391 512 (18,288) (868) (6,201) (4) 1,595 398 227 333 705 1,169 325 1,175 3,794 (1,242) 285 (420) (154) - (957) (574) 229 (229) 378 (378) - 220 - 220 218 3,440 5,132 1,692 5,350 5,132 This Statement should be read in conjunction with the accompanying notes Statement of Changes in Equity For the Year Ended 30 June 2009 Note Total equity at beginning of financial year Gain/(loss) on Asset Revaluation NET INCOME RECOGNISED DIRECTLY IN EQUITY Net result for the year TOTAL RECOGNISED INCOME AND EXPENSE FOR THE YEAR Transactions with the State in its capacity as owner Total Equity at the end of the financial year 16a 16b NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 2009 $’000 41,399 9,680 2008 $’000 39,706 - 9,680 425 1,473 10,105 1,473 - 220 51,504 41,399 This Statement should be read in conjunction with the accompanying notes Table of Contents Note 1 2 2a 2b 2c 3 3a 3b 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22a 22b 23 24 Statement of Significant Accounting Policies Revenue Analysis of Revenue by Source Patient and Resident Fees Net Gain/(Loss) on Disposal Non-Current Assets Expenses Analysis of Expenses by Source Analysis of Expenses by Internal and Restricted Specific Purpose Funds for Services Supported by Hospital and Community Initiatives Depreciation and Amortisation Finance Costs Cash and Cash Equivalents Receivables Other Financial Assets Inventories Other Assets Investments Accounted for Using the Equity Method Property, Plant & Equipment Payables Employee Benefits and Related On-Costs Provisions Other Liabilities Equity Reconciliation of Net Result for the Year to Net Cash Inflow/(Outflow) from Operating Activities Financial Instruments Commitments for Expenditure Contingent Liabilities Segment Reporting Responsible Person Disclosures Executive Officer Disclosures Events occurring after the Balance Sheet Date Auditor Remuneration Page 67 70 71 72 72 73 74 74 75 75 75 75 75 75 75 76 76, 77 77 77 78 78 78 79 82 82 83, 84 84 84 84 84 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 1: Statement of Significant Accounting Policies (a) Statement of compliance The financial report is a general purpose financial report which has been prepared on an accrual basis in accordance with the Financial Management Act 1994 and applicable Australian Accounting Standards (AASs) and Australian Accounting Interpretations. AASs includes Australian equivalents to International Financial Reporting Standards. The Service is a not-for profit entity and therefore applies the additional Aus paragraphs applicable to “not-for-profit” entities under the AAS’s. (b) Basis of preparation The financial report is prepared in accordance with the historical cost convention, except for the revaluation of certain non-financial assets and financial instruments, as noted. Cost is based on the fair values of the consideration given in exchange for assets. In the application of AASs management is required to make judgments, estimates and assumptions about carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and various other factors that are believed to be reasonable under the circumstances, the results of which form the basis of making the judgments. Actual results may differ from these estimates. The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period or in the period of the revision, and future periods if the revision affects both current and future periods. Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transactions or other events is reported. The accounting policies set out below have been applied in preparing the financial report for the year ended 30 June 2009, and the comparative information presented in these financial statements for the year ended 30 June 2008. (c) Reporting Entity The financial report includes all the controlled activities of West Wimmera Health Service. (d) Rounding Of Amounts All amounts shown in the financial report are expressed to the nearest $1,000 unless otherwise stated. (e) Cash and Cash Equivalents Cash and cash equivalents comprise cash on hand and cash at bank, deposits at call and highly liquid investments with an original maturity of 3 months or less, which are readily convertible to known amounts of cash and are subject to insignificant risk of changes in value. (f) Receivables Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. Collectability of debts is reviewed on an ongoing basis, and debts which are known to be uncollectible are written off. A provision for doubtful debts is raised where doubt as to collection exists. Bad debts are written off when identified. Receivables are recognised initially at fair value and subsequently measured at amortised cost using the effective interest rate method, less any accumulated impairment. (g) Inventories Inventories include goods and other property held either for sale or for distribution at no or nominal cost in the ordinary course of business operations. It includes land held for sale and excludes depreciable assets. Inventories held for distribution are measured at cost, adjusted for any loss of service potential. All other inventories are measured at the lower of cost and net realisable value. Bases used in assessing loss of service potential for inventories held for distribution include current replacement cost and technical or functional obsolescence. Technical obsolescence occurs when an item still functions for some or all of the tasks it was originally acquired to do, but no longer matches existing technologies. Functional obsolescence occurs when an item no longer functions the way it did when it was first acquired. (h) Other Financial Assets Other financial assets are recognised and derecognised on trade date where purchase or sale of an investment is under a contract whose terms require delivery of the investment within the timeframe established by the market concerned, and are initially measured at fair value, net of transaction costs. The Service classifies its other financial assets between current and non-current assets based on the purpose for which the assets were acquired. Management determines the classification of its other financial assets at initial recognition. West Wimmera Health Service assesses at each balance sheet date whether a financial asset or group of financial assets is impaired. (i) Property, Plant and Equipment Land and Buildings are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and impairment. Plant, Equipment and Vehicles are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and impairment. (j) Revaluations of Non-current Physical Assets Non-current physical assets measured at fair value are revalued in accordance with FRD 103D. This revaluation process normally occurs every five years, based upon the asset’s Government Purpose Classification, but may occur more frequently if fair value assessments indicate material changes in values. Revaluation increments or decrements arise from differences between an asset’s carrying value and fair value. Revaluation increments are credited directly to the asset revaluation reserve, except that, to the extent that an increment reverses a revaluation decrement in respect of that class of asset previously recognised as an expense in the net result, the increment is recognised as income in the net result. Revaluation decrements are recognised immediately as expenses in the net result, except that, to the extent that a credit balance exists in the asset revaluation reserve in respect of the same class of assets, they are debited directly to the asset revaluation reserve. WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 67 Revaluation increases and revaluation decreases relating to individual assets within an asset class are offset against one another within that class but are not offset in respect of assets in different classes. Revaluation reserves are not transferred to accumulated funds on derecognition of the relevant asset. In accordance with FRD 103D West Wimmera Health Service’s non-current physical assets were subjected to a detailed valuation in the current financial year. (k) Depreciation and Amortisation Assets with a cost in excess of $1,000 are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost or valuation over their estimated useful lives using the straight-line method. Estimates of the remaining useful lives and depreciation method for all assets are reviewed at least annually. This depreciation charge is not funded by the Department of Human Services. The following table indicates the expected useful lives of non current assets on which the depreciation charges are based. Buildings Plant & Equipment Medical Equipment Vehicles 2009 2008 30 to 40 Years 8 to 10 Years 7 to 9 Years 5 to 8 Years 30 to 40 Years 8 to 10 Years 7 to 9 Years 5 to 8 Years (l) Net Gain/(Loss) on Non-Financial Assets Net gain/(loss) on non-financial assets includes realised and unrealised gains and losses from revaluations, impairments and disposals of all physical assets and intangible assets. Disposal of Non-Financial Assets Any gain or loss on the sale of non-financial assets is recognised at the date that control of the asset is passed to the buyer and is determined after deducting from the proceeds the carrying value of the asset at that time. Impairment of Non-Financial Assets Non-Financial Assets are assessed annually for indications of impairment. If there is an indication of impairment, the assets concerned are tested as to whether their carrying value exceeds their possible recoverable amount. Where an asset’s carrying value exceeds its recoverable amount, the difference is written-off as an expense except to the extent that the write-down can be debited to an asset revaluation reserve amount applicable to that class of asset. It is deemed that, in the event of the loss of an asset, the future economic benefits arising from the use of the asset will be replaced unless a specific decision to the contrary has been made. The recoverable amount for most assets is measured at the higher of depreciated replacement cost and fair value less costs to sell. Recoverable amount for assets held primarily to generate net cash inflows is measured at the higher of the present value of future cash flows expected to be obtained from the asset and fair value less costs to sell. (m) Net Gain/(Loss) on Financial Instruments Net gain/(loss) on financial instruments includes realised and unrealised gains and losses from revaluations of financial instruments that are designated at fair value through profit or loss or held-for-trading, impairment and reversal of impairment for financial instruments at amortised cost, and disposals of financial assets. Impairment of Financial Assets Bad and doubtful debts are assessed on a regular basis. Those bad debts considered as written off are classified as an expense. Financial Assets have been assessed for impairment in accordance with Australian Accounting Standards. Where a financial asset’s fair value at balance date has reduced by 20 per cent or more than its cost price; or where its fair value has been less than its cost price for a period of 12 or more months, the financial instrument is treated as impaired. (n) Payables These amounts consist predominantly of liabilities for goods and services. Payables are initially recognised at fair value, then subsequently carried at amortised cost and represent liabilities for goods and services provided to the Service prior to the end of the financial year that are unpaid, and arise when the health service becomes obliged to make future payments in respect of the purchase of these goods and services. The normal credit terms are usually Net 30 days. (o) Provisions Provisions are recognised when the entity has a present obligation, the future sacrifice of economic benefits is probable, and the amount of the provision can be measured reliably. The amount recognised as a provision is the best estimate of the consideration required to settle the present obligation at reporting date, taking into account the risks and uncertainties surrounding the obligation. Where a provision is measured using the cash flows estimated to settle the present obligation, its carrying amount is the present value of those cash flows. (p) Functional and Presentation Currency The presentation currency of West Wimmera Health Service is the Australian dollar, which has also been identified as the functional currency of the entity. (q) Goods and Services Tax Income, expenses and assets are recognised net of the amount of associated GST, unless the GST incurred is not recoverable from the Australian Taxation Office (ATO). In this case it is recognised as part of the cost of acquisition of the asset or as part of the expense. Receivables and payables are stated inclusive of the amount of GST receivable or payable. The net amount of GST recoverable from, or payable to, the ATO is included with other receivables or payables in the balance sheet. Cash flows are presented on a gross basis. The GST components of cash flows arising from investing or financing activities which are recoverable from, or payable to the ATO, are presented as operating cash flow. Commitments and contingent liabilities are presented on a gross basis. 68 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 (r) Employee Benefits Wages and Salaries, Annual Leave and Accrued Days Off Liabilities for wages and salaries, including non-monetary benefits, annual leave and accrued days off expected to be settled within 12 months of the reporting date are recognised in the provision for employee benefits in respect of employees’ services up to the reporting date, classified as current liabilities and measured at nominal values. Those liabilities that the entity does not expect to be settled within 12 months are recognised in the provision for employee benefits as current liabilities, measured at present value of the amounts expected to be paid when the liabilities are settled using the remuneration rate expected to apply at the time of settlement. Long Service Leave Current Liability – unconditional LSL (representing 10 or more years of continuous service) is disclosed as a current liability even where the Service does not expect to settle the liability within 12 months because it will not have the unconditional right to defer the settlement of the entitlement should an employee take leave within 12 months. The components of this current LSL liability are measured at: present value – component that the Service does not expect to settle within 12 months; and nominal value – component that the Service expects to settle within 12 months. Non-Current Liability – conditional LSL (representing less than 10 years of continuous service) is disclosed as a non-current liability. There is an unconditional right to defer the settlement of the entitlement until the employee has completed the requisite years of service. Conditional LSL is required to be measured at present value. Consideration is given to expected future wage and salary levels, experience of employee departures and periods of service. Expected future payments are discounted using interest rates of Commonwealth Government guaranteed securities in Australia. Superannuation – Defined contribution plans Contributions to defined contribution superannuation plans are expensed when incurred. – Defined benefit plans The amount charged to the Operating Statement in respect of defined benefit superannuation plans represents the contributions made by the entity to the superannuation plans in respect of the services of current entity staff. Superannuation contributions are made to the plans based on the relevant rules of each plan. Employees of the Service are entitled to receive superannuation benefits and the Service contributes to both defined benefit and defined contribution plans. The defined benefit plans provide benefits based on years of service and final average salary. The name and details of the major employee superannuation funds and contributions made by the Service are as follows: Fund Defined benefit plans: Health Super Superannuation Fund Other Defined contribution plans: Health Super Superannuation Fund Other Total Contributions Paid or Payable for the year 2009 $’000 2008 $’000 45 11 58 6 1,372 60 1,488 1,351 51 1,466 The Service does not recognise any unfunded defined benefit liability in respect of the superannuation plans because the entity has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due. The Department of Treasury and Finance administers and discloses the State’s defined benefit liabilities in its financial report. NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Termination Benefits Liabilities for termination benefits are recognised when a detailed plan for the termination has been developed and a valid expectation has been raised with those employees affected that the terminations will be carried out. The liabilities for termination benefits are recognised in other creditors unless the amount or timing of the payments is uncertain, in which case they are recognised as a provision. On-Costs Employee benefits on-costs (workers’ compensation, superannuation, annual leave and LSL accrued while on LSL taken in service) are recognised separately from provisions for employee benefits. (s) Finance Costs Finance costs are recognised as expenses in the period in which they are incurred and refer to interest on the Service’s bank overdraft. (t) Residential Aged Care Service The Residential Aged Care Service segment’s operations are an integral part of the Service and shares its resources. An apportionment of land and buildings has been made based on bed numbers. The results of the two operations have been segregated based on actual revenue earned and expenditure incurred by each operation in note 2b to the financial statement. Residential Aged Care Services is substantially funded from Commonwealth bed-day subsidies. (u) Joint Ventures Interests in jointly controlled assets are accounted for by recognising in the Service’s financial statements, its share of net assets and any revenue and expenses of such joint ventures. Details of the joint venture are set out in note 11. (v) Intersegment Transactions Transactions between segments within the Service have been eliminated to reflect the extent of the Service’s operations as a group. (w) Leases Leases of property, plant and equipment are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership to the lessee. All other leases are classified as operating leases. Operating lease payments are recognised as an expense in the operating statement on a straight line basis over the lease term. (x) Income Recognition Income is recognised in accordance with AASB 118 Revenue and is recognised as to the extent it is earned. Unearned income at reporting date is reported as income received in advance. Amounts disclosed as revenue are, where applicable, net of returns, allowances and duties and taxes. Government Grants Grants are recognised as income when the entity gains control of the underlying assets in accordance with AASB 1004 Contributions. For reciprocal grants, the Service is deemed to have assumed control when the performance has occurred under the grant. For non-reciprocal grants, the Service is deemed to have assumed control when the grant is received or receivable. Conditional grants may be reciprocal or non-reciprocal depending on the terms of the grant. Indirect Contributions – Insurance is recognised as revenue following advice from the Department of Human Services. – Long Service Leave (LSL) – Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the Metropolitan Health and Aged Care Services Division Hospital Circular 34/2008. Patient and Resident Fees Patient fees are recognised as revenue at the time invoices are raised. Donations and Bequests Donations and bequests are recognised as revenue when received. If donations are for a special purpose, they may be appropriated to a reserve, such as the specific restricted purpose reserve. Interest Revenue Interest revenue is recognised on a time proportionate basis. (y) Services Supported By Health Services Agreement and Services Supported By Hospital and Community Initiatives Activities classified as Services Supported by Health Services Agreement (HSA) are substantially funded by the Department of Human Services and include Residential Aged Care Services (RACS) and are also funded from other sources such as the Commonwealth, patients and residents, while Services Supported by Hospital and Community Initiatives (Non HSA) are funded by the Health Service’s own activities or local initiatives and/or the Commonwealth. (z) Change in Accounting Policies In accordance with Victorian Government Financial Reporting Direction 103D ‘Non-Current Physical Assets’, West Wimmera Health Service measures plant and equipment, and medical equipment assets at fair value from 1 July 2008. Previously these assets were measured at cost. This change in accounting policy is required to ensure that Victoria’s Whole of Government financial report, into which the Service’s results are consolidated, complies with the requirements of AASB1049 Whole of Government and General Government Sector Financial Reporting. As this change is the initial application of a policy to revalue assets in accordance with AASB116 Property, Plant and Equipment the change is treated as a revaluation in the current year. (aa) Comparative Information Where necessary the previous year’s figures have been reclassified to facilitate comparisons. (ab) Property, Plant & Equipment Revaluation Reserve The asset revaluation reserve is used to record increments and decrements on the revaluation of non-current assets. (ac) Specific Restricted Purpose Reserve A specific restricted purpose reserve is established where the entity has possession or title to the funds but has no discretion to amend or vary the restriction and/or condition underlying the funds received. (ad) Contributed Capital Consistent with Australian Accounting Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities and FRD 119 Contributions by Owners, appropriations for additions to the net asset base have been designated as contributed capital. Other transfers that are in the nature of contributions or distributions that have been designated as contributed capital are also treated as contributed capital. (ae) Net Result Before Capital & Specific Items The subtotal entitled ‘Net result Before Capital & Specific Items’ is included in the Operating Statement to enhance the understanding of the financial performance of West Wimmera Health Service. This subtotal reports the result excluding items such as capital grants, assets received or provided free of charge, depreciation, and items of an unusual nature and amount such as specific revenues and expenses. The exclusion of these items is made to enhance matching of income and expenses so as to facilitate the comparability and consistency of results between years and Victorian Public Health Services. The Net result Before Capital & Specific Items is used by the management of the Service, the Department of Human Services and the Victorian Government to measure the ongoing result of Health Services in operating hospital services. Capital and specific items, which are excluded from this sub-total, comprise: • Capital purpose income, which comprises all tied grants, donations and bequests received for the purpose of acquiring non-current assets, such as capital works, plant and equipment or intangible assets. Consequently the recognition of revenue as capital purpose income is based on the intention of the provider of the revenue at the time the revenue is provided. • Depreciation and amortisation, as described in note 1 (k). NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 (af) Category Groups West Wimmera Health Service has used the following category groups for reporting purposes for the current and previous financial years. Admitted Patient Services (Admitted Patients) comprises all recurrent health revenue/expenditure on admitted patient services, where services are delivered in public hospitals, or free standing day hospital facilities, or alcohol and drug treatment units or hospitals specialising in dental services, hearing and ophthalmic aids. Outpatient Services (Outpatients) comprises all recurrent health revenue/expenditure on public hospital type outpatient services, where services are delivered in public hospital outpatient clinics, or free standing day hospital facilities, or rehabilitation facilities, or alcohol and drug treatment units, or outpatient clinics specialising in ophthalmic aids or palliative care. Aged Care comprises revenue/expenditure form Home and Community Care (HACC) programs, allied Health, Aged Care Assessment and support services. Primary Health comprises revenue/expenditure for Community Health Services including health promotion and counselling, physiotherapy, speech therapy, podiatry and occupational therapy. Off Campus, Ambulatory Services (Ambulatory) comprises all recurrent health revenue/expenditure on public hospital type services including palliative care facilities and rehabilitation facilities, as well as services provided under the following agreements: Services that are provided or received by hospitals (or area health services) but are delivered/received outside a hospital campus, services which have moved from a hospital to a community setting since June 1998, services which fall within the agreed scope of inclusions under the new system, which have been delivered within hospital’s i.e. in rural/remote areas. Residential Aged Care including Mental Health (RAC incl. Mental Health) referred to in the past as psychogeriatric residential services, comprises those Commonwealthlicensed residential aged care services in receipt of supplementary funding from DHS under the mental health program. It excludes all other residential services funded under the mental health program, such as mental healthfunded community care units (CCUs) and secure extended care units (SECs). Other Services excluded from Australian Health Care Agreement (AHCA) (Other) comprises revenue/expenditure for services not separately classified above, including: Public health services including Laboratory testing, Blood Borne Viruses / Sexually Transmitted Infections clinical services, Kooris liaison officers, immunisation and screening services, Drugs services including drug withdrawal, counselling and the needle and syringe program, Dental Health services including general and specialist dental care, school dental services and clinical education, Disability services including aids and equipment and flexible support packages to people with a disability, Community Care programs including sexual assault support, early parenting services, parenting assessment and skills development, and various support services. Health and Community Initiatives also falls in this category group. (ag) New Accounting Standards and Interpretations Certain new accounting standards and interpretations have been published that are not mandatory for the 30 June 2009 reporting period. As at 30 June 2009, the following standards and interpretations had been issued but were not mandatory for financial years ending 30 June 2009. West Wimmera Health Service has not and does not intend to adopt these standards early. WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 Applicable for reporting periods beginning on or ending on Impact on Entities Annual Statements 69 Standard / Interpretation Summary AASB 8 Operating Segments. Supersedes AASB 114 Segment Reporting. An accompanying amending standard, also introduced consequential amendments into other Standards. Beginning 1 January 2009 Not applicable Beginning 1 January 2009 Impact expected to be not significant. AASB 2007-6 Amendments to Australian Accounting Standards arising from AASB 123 [AASB 1, AASB 101, AASB 107, AASB 111, AASB 116 & AASB 138 and Interpretations 1 & 12] An accompanying amending standard, also introduced consequential amendments into other Standards. Beginning 1 January 2009 All Australian government jurisdictions are currently still actively pursuing an exemption for government from capitalising borrowing costs. AASB 2008-3 Amendments to AAS arising from AASB 3 & AASB 127 [AASB 1, 2, 4, 5, 7, 101, 107, 112, 114, 116, 121, 128, 131, 132, 133, 134, 136, 137, 138 & 139 and Interpretation 9 & 107] This Standard gives effect to consequential changes arising from revised AASB 3 and amended AASB 127. The Prefaces to those Standards summarise the main requirements of those Standards. Summary Beginning 1 January 2009 Impact expected to be insignificant. Applicable for reporting periods beginning on or ending on Impact on Entities Annual Statements Beginning 1 January 2009 Impact is being evaluated. Beginning 1 January 2009 Impact expected to be insignificant. Beginning 1 January 2009 Impact expected to be insignificant. Beginning 1 January 2009 Impact is being evaluated. Beginning 1 January 2009 Impact expected to be insignificant Beginning 1 January 2009 Impact expected to be insignificant Beginning 1 January 2009 Impact expected to be insignificant AASB 2007-3 Amendments to Australian Accounting Standards arising from AASB 8 [AASB 5, AASB 6, AASB 102, AASB 107, AASB 119, AASB 127, AASB 134, AASB 136, AASB 1023 and AASB 1038] Standard / Interpretation AASB 2008-5 Amendments to AASs arising from the Annual Improvements Project [AASBs 5, 7, 101, 102, 107, 108, 110, 116, 118, 119, 120, 123, 127, 128, 129, 131, 132, 134, 136, 138, 140, 141, 1023 & 1308] AASB 2008-6 Further Amendments to Australian Accounting Standards arising from the Annual Improvements project [AASB 1 & AASB 5] AASB 2008-7 Amendments to AAS Cost of an Investment in a Subsidiary, Jointly Controlled Entity or Associate [AASB 1, AASB 118, AASB 121, AASB 127 & AASB 136] AASB 2008-8 Amendments to Australian Accounting Standards – Eligible Hedged Items [AASB 139] AASB 2008-9 Amendments to AASB 1049 for Consistency with AASB 101 AASB 2009-1 Amendments to Australian Accounting Standards – Borrowing Costs of Not-for-Profit Public Sector Entities [AASB 1, AASB 111 & AASB 123] AASB 2009-2 Amendments to Australian Accounting Standards – Improving Disclosures about Financial Instruments [AASB 4, AASB 7, AASB 1023 & AASB 1038] A suite of amendments to existing standards following issuance of IASB Standard Improvements to IFRSs in May 2008. Some amendments result in accounting changes for presentation, recognition and measurement purposes. The amendments require all the assets and liabilities of a for-sale subsidiary’s to be classified as held for sale and clarify the disclosures required when the subsidiary is part of a disposal group that meets the definition of a discontinued operation. Changes mainly relate to treatment of dividends from subsidiaries or controlled entities The amendments to AASB 139 clarify how the principles that determine whether a hedged risk or portion of cash flows is eligible for designation as a hedged item, should be applied in particular situations. Amendments to AASB 1049 for consistency with AASB 101 (September 2007) version. Amendments to Australian Accounting Standards to allow borrowing costs of Not-for Profit Public Sector Entities to be expensed Amendments to AASB 7 to enhance disclosures about fair value measurements and liquidity risk. Editorial amendments to AASB 4, AASB 1023 and AASB 1038 resulting from the amendments to AASB 7 70 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 2: Revenue Revenue from Operating Activities Government Grants - Department of Human Services - Dental Health Services Victoria - State Government - Other - Department of Education - Commonwealth Government - Residential Aged Care Subsidy - Other Total Government Grants Indirect Contributions by Department of Human Services - Insurance - Long Service Leave Total Indirect Contributions by Department of Human Services Patient and Resident Fees - Patient and Resident Fees (refer note 2b) - Residential Aged Care (refer note 2b) Total Patient & Resident Fees Business Units & Specific Purpose Funds - Dental Services - Meals on Wheels - Diagnostic Imaging Total Business Units & Specific Purpose Funds Donations & Bequests Other Revenue from Operating Activities Sub-Total Revenue from Operating Activities Revenue from Non-Operating Activities Interest Property Income Sub-Total Revenue from Non-Operating Activities Revenue from Capital Purpose Income State Government Capital Grants - Targeted Capital Works and Equipment - Equipment and Infrastructure Maintenance Residential Accommodation Payments (refer note 2b) Net Gain/(Loss) on Disposal of Non-Financial Assets (refer note 2c) Donations & Bequests Sub-Total Revenue from Capital Purpose Income Share of Net Result of Joint Ventures Accounted for using the Equity Model (refer note 11) Total Revenue (refer to note 2a) HSA 2009 $’000 HSA 2008 $’000 Non HSA 2009 $’000 Non HSA 2008 $’000 Total 2009 $’000 Total 2008 $’000 15,403 203 14,650 183 - - 15,403 203 14,650 183 169 12 - - 169 12 5,266 874 21,915 5,242 1,151 21,238 - - 5,266 874 21,915 5,242 1,151 21,238 301 (50) 251 302 (233) 69 - - 301 (50) 251 302 (233) 69 1,917 1,688 3,605 2,068 1,625 3,693 - - 1,917 1,688 3,605 2,068 1,625 3,693 172 25,943 193 25,193 30 98 130 258 27 285 34 119 117 270 37 307 30 98 130 258 27 172 26,228 34 119 117 270 37 193 25,500 - - 385 92 477 391 70 461 385 92 477 391 70 461 366 – 366 631 – 631 32 336 (3) 227 592 75 305 19 1,169 1,568 32 366 336 (3) 227 958 75 631 305 19 1,169 2,199 28 26,337 25,824 1,354 2,336 28 27,691 28,160 Indirect contributions by Department of Human Services: Department of Human Services makes certain payments on behalf of the Health Service. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses. WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 71 Note 2a: Analysis of Revenue by Source (based on the consolidated view of note 2) Revenue from Services Supported by Health Services Agreement Government Grants Indirect contributions by Department of Human Services - Insurance - Long Service Leave Patient & Resident Fees (refer note 2b) Donations & Bequests (non capital) Other Revenue from Operating Activities Interest Capital Purpose Income (refer note 2) Share of Net Result of Joint Ventures Accounted for using the Equity Model (refer note 11) Sub-Total Revenue from Services Supported by Health Services Agreement Revenue from Services Supported by Hospital and Community Initiatives Dental Services Meals on Wheels Diagnostic Imaging Capital Income Donations & Bequests Interest Property Income Sub-Total Revenue from Services Supported by Hospital and Community Initiatives Total Revenue Ambulatory 2009 $’000 RAC incl. Mental Health 2009 $’000 Aged Care 2009 $’000 Primary Health 2009 $’000 Other 2009 $’000 Total 2009 $’000 2 1,586 7,731 - 2,012 392 21,915 301 (16) 1,108 14 - 33 - 214 - (10) 1,688 20 - (2) 68 - (8) 130 50 - (14) 364 88 366 301 (50) 3,605 172 366 - - - - - - 28 28 11,599 35 1,800 9,429 66 2,184 1,224 26,337 - - - - - - 30 98 130 365 254 385 92 30 98 130 365 254 385 92 - - - - - - 1,354 1,354 11,599 35 1,800 9,429 66 2,184 2,578 27,691 Admitted Patients 2009 $’000 Outpatients 2009 $’000 10,192 Indirect contributions by Department of Human Services: The Department of Human Services makes payments on behalf of the Service for its annual insurance premium. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses. Note 2a: Analysis of Revenue by Source (based on the consolidated view of note 2) Revenue from Services Supported by Health Services Agreement Government Grants Indirect contributions by Department of Human Services - Insurance - Long Service Leave Patient & Resident Fees (refer note 2b) Donations & Bequests (non capital) Other Revenue from Operating Activities Interest & Dividends Capital Purpose Income (refer note 2) Sub-Total Revenue from Services Supported by Health Services Agreement Revenue from Services Supported by Hospital and Community Initiatives Dental Services Meals on Wheels Diagnostic Imaging Capital Income Donations & Bequests Interest Property Income Sub-Total Revenue from Services Supported by Hospital and Community Initiatives Total Revenue Admitted Patients 2008 $’000 Outpatients 2008 $’000 9,318 2 Ambulatory 2008 $’000 RAC incl. Mental Health 2008 $’000 Aged Care 2008 $’000 Primary Health 2008 $’000 Other 2008 $’000 Total 2008 $’000 1,523 7,687 - 1,920 788 21,238 (7) 3 - (36) 88 50 - (68) 402 108 631 302 (232) 3,693 192 631 302 (76) 1,208 14 - 23 - 282 - (45) 1,687 20 - 10,766 25 1,805 9,349 (4) 2,022 1,861 25,824 - - - - - - 34 119 117 399 1,206 391 70 34 119 117 399 1,206 391 70 - - - - - - 2,336 2,336 10,766 25 1,805 9,349 (4) 2,022 4,197 28,160 Indirect contributions by Department of Human Services: The Department of Human Services makes payments on behalf of the Service for its annual insurance premium. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses. 72 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 Note 2b: Patient and Resident Fees Note 2c: Net Gain/(Loss) on Disposal of Non-Financial Assets 2009 $’000 Patient and Resident Fees Raised Recurrent: Acute – Inpatients – Outpatients – Other Residential Aged Care – Generic – Mental Health – Residential Accommodation Payments Total Recurrent Capital Purpose: Residential Accommodation Payments Total Capital NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 2008 $’000 1,105 20 792 1,184 16 868 1,609 79 3,605 1,531 79 15 3,693 336 336 305 305 Proceeds from Disposals of Non-Current Assets Plant and Equipment Medical Equipment Motor Vehicles Total Proceeds from Disposal of Non-Current Assets Less: Written Down Value of Non-Current Assets Sold Plant and Equipment Medical Equipment Motor Vehicles Total Written Down Value of Non-Current Assets Sold Net gains/(losses) on Disposal of Non-Current Assets 2009 $’000 2008 $’000 282 6 20 110 282 136 285 6 111 - 285 117 (3) 19 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 73 Note 3: Expenses Employee Benefits Salaries & Wages WorkCover Premium Departure Packages Long Service Leave Superannuation Total Employee Benefits Non Salary Labour Costs Fees for Visiting Medical Officers Agency Costs - Nursing Total Non Salary Labour Costs Supplies & Consumables Drug Supplies Medical, Surgical Supplies and Prosthesis Food Supplies Total Supplies & Consumables Other Expenses from Continuing Operations Domestic Services & Supplies Fuel, Light, Power and Water Insurance costs funded by DHS Motor Vehicle Expenses Repairs & Maintenance Maintenance Contracts Patient Transport Bad & Doubtful Debts Lease Expenses Other Administrative Expenses Audit Fees - VAGO - Audit of Financial Statements - Other Total Other Expenses from Continuing Operations Depreciation & Amortisation Finance Costs Total Total Expenses HSA 2009 $’000 HSA 2008 $’000 Non HSA 2009 $’000 Non HSA 2008 $’000 Total 2009 $’000 Total 2008 $’000 15,951 224 321 1,455 17,951 15,765 291 56 204 1,434 17,750 342 5 8 33 388 325 6 1 5 32 369 16,293 229 329 1,488 18,339 16,090 297 57 209 1,466 18,119 626 332 958 655 293 948 243 243 213 213 869 332 1,201 868 293 1,161 144 1,123 744 2,011 146 862 661 1,669 70 143 213 53 160 213 144 1,193 887 2,224 146 915 821 1,882 519 537 306 214 351 188 88 4 107 1,827 503 705 327 227 270 212 141 3 155 1,624 8 23 12 4 20 22 82 8 21 12 6 12 13 2 68 527 560 318 218 371 210 88 4 107 1,909 511 726 339 233 282 225 143 3 155 1,692 24 34 4,199 1,132 1,132 26,251 20 20 4,207 1,172 4 1,176 25,750 171 1,015 142 937 24 34 4,370 1,132 1,132 27,266 20 20 4,349 1,172 4 1,176 26,687 74 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 3a: Analysis of Expenses by Source (based on the consolidated view) Services Supported by Health Services Agreement Employee Benefits Non Salary Labour Costs Supplies & Consumables Other Expenses from Continuing Operations Depreciation & Amortisation (refer note 4) Sub-Total Expenses from Services Supported by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefits Non Salary Labour Costs Supplies & Consumables Other Expenses from Continuing Operations Sub-Total Expense from Services Supported by Hospital and Community Initiatives Total Expenses Ambulatory RAC incl. Mental Health Aged Care Primary Health Other Total 2009 $’000 2009 $’000 2009 $’000 2009 $’000 2009 $’000 2009 $’000 2009 $’000 5,536 837 1,244 1,359 407 17 17 10 2 1,612 2 77 314 91 8,016 119 452 1,453 455 444 16 169 28 1,541 88 459 95 785 117 435 54 17,951 958 2,011 4,199 1,132 9,383 46 2,096 10,495 657 2,183 1,391 26,251 - - - - - - 388 243 213 171 388 243 213 171 Admitted Patients Outpatients 2009 $’000 - - - - - - 1,015 1,015 9,383 46 2,096 10,495 657 2,183 2,406 27,266 Aged Care Primary Health Note 3a: Analysis of Expenses by Source (based on the consolidated view) Services Supported by Health Services Agreement Employee Benefits Non Salary Labour Costs Supplies & Consumables Other Expenses from Continuing Operations Depreciation & Amortisation (refer note 4) Finance Costs (refer note 5) Sub-Total Expenses from Services Supported by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefits Non Salary Labour Costs Supplies & Consumables Other Expenses from Continuing Operations Sub-Total Expense from Services Supported by Hospital and Community Initiatives Total Expenses Admitted Patients Outpatients Ambulatory RAC incl. Mental Health Other Total 2008 $’000 2008 $’000 2008 $’000 2008 $’000 2008 $’000 2008 $’000 2008 $’000 2008 $’000 5,722 816 977 1,466 413 - 92 19 20 6 - 1,254 59 252 72 - 7,841 132 438 1,565 458 - 544 18 143 32 - 1,628 90 510 102 - 669 68 251 89 4 17,750 948 1,669 4,207 1,172 4 9,394 137 1,637 10,434 737 2,330 1,081 25,750 - - - - - - 369 213 213 142 369 213 213 142 - - - - - - 937 937 9,394 137 1,637 10,434 737 2,330 2,018 26,687 Note 3b: Analysis of Expenses by Internal and Restricted Specific Purpose Funds for Services Supported by Hospital and Community Initiatives Dental Diagnostic Imaging Meals on Wheels TOTAL 2009 $’000 580 253 182 1,015 2008 $’000 484 252 201 937 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 8: Other Financial Assets Note 4: Depreciation and Amortisation Depreciation Buildings Plant & Equipment Medical Equipment Computers & Communication Furniture & Fittings Motor Vehicles Total Depreciation 2009 $’000 2008 $’000 622 117 213 21 54 105 1,132 619 149 212 23 82 87 1,172 Note 5: Finance Costs Interest on Overdraft TOTAL 2009 $’000 - 2008 $’000 4 4 Note 6: Cash and Cash Equivalents For the purposes of the Cash Flow Statement, cash assets includes cash on hand and in banks, and short-term deposits which are readily convertible to cash on hand, and are subject to an insignificant risk of change in value, net of outstanding bank overdrafts. Cash on Hand Cash at Bank Deposits at Call TOTAL Represented by: Cash for Health Service Operations (as per Cash Flow Statement) TOTAL 75 2009 $’000 4 314 5,032 5,350 2008 $’000 4 578 4,550 5,132 5,350 5,350 5,132 5,132 Operating Fund CURRENT Term Deposits Aust. Dollar Term Deposits TOTAL Represented by: Monies Held in Trust Patient Monies Accommodation Bonds (Refundable Entrance Fees) Licences to Occupy TOTAL Totals 2009 $’000 2008 $’000 2009 $’000 2008 $’000 2,012 2,012 2,209 2,209 2,012 2,012 2,209 2,209 - 1 - 1 1,769 243 2,012 1,881 327 2,209 1,769 243 2,012 1,881 327 2,209 (b) Ageing analysis of other financial assets Please refer to note 18(b) for the ageing analysis of other financial assets (c) Nature and extent of risk arising from other financial assets Please refer to note 18(b) for the nature and extent of credit risk arising from other financial assets Note 9: Inventories Pharmaceuticals - at cost Catering Supplies - at cost Housekeeping Supplies - at cost Medical and Surgical Lines - at cost Engineering Stores - at cost Administration Stores - at cost TOTAL INVENTORIES 2009 $’000 59 26 17 104 28 31 265 2008 $’000 57 26 14 103 33 19 252 2009 $’000 2008 $’000 32 32 7 7 Note 10: Other Assets Note 7: Receivables 2009 $’000 2008 $’000 181 328 - 308 299 15 (5) 504 (15) 607 TOTAL CURRENT RECEIVABLES 65 65 569 48 48 655 NON CURRENT Statutory Accrued Revenue - DHS TOTAL NON-CURRENT RECEIVABLES TOTAL RECEIVABLES 569 50 50 705 2009 $’000 15 (3) (7) 5 2008 $’000 15 (3) 3 15 CURRENT Contractual Trade Debtors Patient Fees Accrued Revenue - DHSV Less Allowance for Doubtful Debts Patient Fees Statutory GST Receivable (a) Movement in the Allowance for doubtful debts Balance at beginning of year Amounts written off during the year Amounts recovered during the year Balance at end of year (b) Ageing analysis of receivables Please refer to note 18(b) for the ageing analysis of receivables (c) Nature and extent of risk arising from receivables Please refer to note 18(b) for the nature and extent of credit risk arising from receivables Current Prepayments TOTAL 76 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 11: Investments Accounted for Using the Equity Method Interest in Jointly Controlled Entities TOTAL 2009 $’000 2008 $’000 28 28 Ownership Interest Name of Entity Jointly Controlled Entities Grampians Regional Health Alliance Share of Current Assets Share of Non-Current Assets Share of Current Liabilities Share of Total Revenue Share of Net Result Country of Incorporation Principal Activity Provision of Information Systems Australia 2009 $’000 241 51 41 354 28 2008 $’000 - Note 12: Property, Plant & Equipment 2009 $’000 2008 $’000 703 703 836 836 49,330 49,330 25,176 1,162 24,014 - 16,323 503 15,820 49,330 39,834 Plant and Equipment Plant and Equipment at fair value Less Acc’d Depreciation Total Plant and Equipment 1,249 1,041 208 2,840 2,314 526 Medical Equipment Medical Equipment at fair value Less Acc’d Depreciation Total Medical Equipment 3,360 2,401 959 2,989 2,134 855 875 829 46 883 835 48 1,114 397 717 748 540 208 1,575 1,188 387 52,350 2,246 1,709 537 42,844 Land Land at fair value Total Land Buildings Buildings at fair value Less Acc’d Depreciation Buildings at cost Less Acc’d Depreciation Total Buildings Computers & Communication Computers & Communication at fair value Less Acc’d Depreciation Total Computers & Communication Motor Vehicles Motor Vehicles at fair value Less Acc’d Depreciation Total Motor Vehicles Furniture & Fittings Furniture & Fittings at fair value Less Acc’d Depreciation TOTAL Published Fair Value 2009 % 2008 % 2009 $’000 2008 $’000 7.77 0 28 – WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 77 Note 12: Property, Plant & Equipment (Continued) Reconciliations of the carrying amounts of each class of asset for the Service at the beginning and end of the previous and current financial year are set out below. Balance at 1 July 2007 Additions Disposals Depreciation and Amortisation (note 4) Balance at 1 July 2008 Additions Disposals Revaluation increments/(decrements) Net Transfers between classes Depreciation and Amortisation (note 4) Balance at 30 June 2009 Land Buildings Plant & Equipment Medical Equipment Computers, Communctns Furniture & Fittings Motor Vehicles Total $’000 836 836 (133) 703 $’000 40,299 154 (619) 39,834 5 9,812 301 (622) 49,330 $’000 621 68 (14) (149) 526 75 (276) (117) 208 $’000 931 136 (212) 855 222 95 (213) 959 $’000 53 18 (23) 48 19 (21) 46 $’000 486 133 (82) 537 24 $’000 217 189 (111) (87) 208 899 (285) (105) 717 $’000 43,443 698 (125) (1,172) 42,844 1,244 (285) 9,679 (1,132) 52,350 (120) (54) 387 Land and buildings carried at valuation An independent valuation of the Health Service’s property, plant and equipment was performed by the Valuer-General Victoria to determine the fair value of the land and buildings. The valuation, which conforms to Australian Valuation Standards, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arms’ length transaction. The valuation was based on independent assessments. The effective date of the valuation is 30 June 2009. Note 13: Payables CURRENT Contractual Trade Creditors Accrued Expenses TOTAL PAYABLES 2009 $’000 2008 $’000 1,083 355 1,438 1,156 280 1,436 (a) Maturity analysis of payables Please refer to Note 18c for the ageing analysis of payables (b) Nature and extent of risk arising from payables Please refer to note 18c for the nature and extent of risks arising from payables Note 14: Employee Benefits and Related On-Costs Provisions Current Provisions Employee Benefits - Unconditional and expected to be settled within 12 months - Unconditional and expected to be settled after 12 months Total Current Provisions Non-Current Provisions Employee Benefits Total Non-Current Provisions Current Employee Benefits Unconditional LSL entitlement Annual leave entitlements Accrued Wages and Salaries Accrued Days Off Non-Current Employee Benefits Conditional long service leave entitlements (present value) Total Employee Benefits Movement in Long Service Leave: Balance at start of year Provision made during the year - Revaluations - Expense recognising employee service Settlement made during the year Balance at end of year 2009 $’000 2008 $’000 2,580 1,939 4,519 2,981 1,907 4,888 522 522 433 433 1,939 2,055 411 114 1,907 1,989 935 57 522 5,041 433 5,320 2,339 2,524 3 327 (208) 2,461 209 (394) 2,339 78 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 Note 16: Equity Note 15: Other Liabilities 2009 $’000 CURRENT Income in Advance - DVA WIES Recall - Lowan Regional Health Program - Other Monies Held in Trust* - Patient Monies Held in Trust* - Accommodation Bonds (Refundable Entrance Fees)* - Licences to Occupy Total Current * Total Monies Held in Trust Represented by the following assets: Other Financial Assets (refer to Note 8) Land and Buildings TOTAL NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 2008 $’000 6 121 58 - 1 2,374 243 2,623 2,486 327 2,993 2,012 605 2,617 2,209 605 2,814 (a) Reserves Property, Plant & Equipment Revaluation Reserve 1 Balance at the beginning of the reporting period Revaluation Increment/(Decrements) - Land - Buildings Balance at the end of the reporting period* * Represented by: - Land - Buildings 2009 $’000 2008 $’000 370 370 (133) 9,813 10,050 370 237 9,813 10,050 370 370 (1) The property, plant & equipment asset revaluation reserve arises on the revaluation of property, plant & equipment. 2009 $’000 2008 $’000 427 427 10,477 427 427 797 25,924 25,704 25,924 220 25,924 (c) Accumulated Surpluses/(Deficits) Balance at the beginning of the reporting period Net Result for the Year Balance at the end of the reporting period 14,678 425 15,103 13,205 1,473 14,678 (d) Total Equity at end of financial year 51,504 41,399 Restricted Specific Purpose Reserve Balance at the beginning of the reporting period Balance at the end of the reporting period Total Reserves (b) Contributed Capital Balance at the beginning of the reporting period Capital contribution received from Victorian Government as compensation for cessation of GST payments Balance at the end of the reporting period Note 17: Reconciliation of Net Result for the Year to Net Cash Inflow/(Outflow) from Operating Activities Net Result for the Year Depreciation & Amortisation DHS GST Funding Change in Inventories Net (Gain)/Loss from Sale of Motor Vehicles Share of Joint Venture Net Result Change in Operating Assets & Liabilities (Increase)/Decrease in Receivables (Increase)/Decrease in Prepayments Increase/(Decrease) in Payables Increase/(Decrease) in Other Liabilities Increase/(Decrease) in Employee Benefits NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES 2009 $’000 425 2008 $’000 1,473 1,132 (13) 3 28 1,172 220 10 (19) - 127 (25) (71) (197) (234) 274 167 245 179 73 1,175 3,794 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 79 Note 18: Financial Instruments Note 18: Financial Instruments (continued) (a) Financial Risk Management Objectives and Policies West Wimmera Health Service’s principal financial instruments comprise of: - Cash Assets - Term Deposits - Receivables (excluding statutory receivables) - Payables (excluding statutory payables) - Residential Aged Care Accommodation Bonds Details of the significant accounting policies and methods adopted, including the criteria for recognition, the basis of measurement and the basis on which income and expenses are recognised, with respect to each class of financial asset, financial liability and equity instrument are disclosed in note 1 to the financial statements. The main purpose in holding financial instruments is to prudentially manage the Service’s financial risks within government policy parameters. (c) Liquidity Risk The following table discloses the contractual maturity analysis for West Wimmera Health Service’s financial liabilities. For interest rates applicable to each class of liability refer to individual notes to the financial statements. Maturity analysis of financial liabilities as at 30 June Maturity Dates Categorisation of financial instruments Financial Assets Cash and Cash Equivalents Loans and Receivables Total Financial Assets (i) Financial Liabilities At amortised cost Total Financial Liabilities (ii) Carrying Amount Carrying Amount 2009 $’000 2008 $’000 7,362 509 7,871 7,341 657 7,998 4,061 4,061 4,429 4,429 (i) The total amount of financial assets disclosed here excludes statutory receivables (i.e. GST input tax credit recoverable) (ii) The total amount of financial liabilities disclosed here excludes statutory payables (i.e. Taxes payable) Note 18: Financial Instruments (continued) (b) Credit Risk The Service’s exposure to credit risk by ageing periods is set out in the following table. For interest rates applicable to each class of asset refer to individual notes to the financial statements. Ageing analysis of financial asset as at 30 June 2009 Financial Assets Cash and Cash Equivalents Receivables - Trade debtors - Patient fees receivable Other financial assets - Monies in Trust Deposits Total Financial Assets 2008 Financial Assets Cash and Cash Equivalents Receivables - Trade debtors - Patient fees receivable - DHS LSL receivable Other financial assets - Accrued revenue - Monies in Trust Deposits Total Financial Assets Consol’d Carrying Amount Not Past Due & Not Impaired Past Due But Not Impaired Less than 1 Month 1-3 Months $’000 $’000 $’000 $’000 5,350 5,350 - - 181 328 114 223 50 16 17 89 2,012 7,871 2,012 7,699 66 106 5,132 5,132 - - 303 289 50 176 118 50 8 60 - 119 111 - 15 2,209 7,998 15 2,209 7,700 68 230 2009 Financial Liabilities Payables Other Financial Liabilities - Accommodation Bonds - Licences to Occupy - Other Total Financial Liabilities 2008 Financial Liabilities Payables Other Financial Liabilities - Accommodation Bonds - Licences to Occupy - Other Total Financial Liabilities Carrying Amount Contractual Cash Flows 1 to 3 Months 3 Months to 1 Year $’000 $’000 $’000 $’000 1,438 1,438 1,438 - 2,374 243 6 4,061 2,374 243 6 4,061 1,438 2,374 243 6 2,623 1,436 1,436 1,436 - 2,486 327 180 4,429 2,486 327 180 4,429 - 2,486 327 180 2,993 1,436 80 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 18: Financial Instruments (continued) (d) Market Risk Market risk is defined as the degree to which the fair value or future cash flows of a financial instrument will fluctuate because of changes in market prices. Generally, market risk comprises three types of risk: currency risk, interest rate risk and other price risk. Currency Risk The Service is exposed to insignificant foreign currency risk through its payables relating to purchases of supplies and consumables from overseas. This is because of a limited amount of purchases denominated in foreign currencies and a short timeframe between commitment and settlement. Interest Rate Risk Exposure to interest rate risk might arise primarily through the Service’s interest bearing liabilities. Minimisation of this risk is achieved mainly by utilising fixed rate or non-interest bearing financial instruments. For financial liabilities, the Service mainly utilises financial liabilities with relatively even maturity profiles. Other Price Risk The Service is not materially exposed to price risk. Interest Rate Exposure of Financial Assets and Liabilities as at 30 June 2009 Financial Assets Cash and Cash Equivalents Receivables - Trade debtors - Other receivables Other financial assets - Monies in Trust Deposits Carrying Amount $’000 Fixed Interest Rate $’000 Non-Interest Bearing $’000 5.43 5,350 5,350 - 181 328 - 181 328 2,012 7,871 2,012 7,362 509 1,438 - 1,438 2,374 243 6 4,061 - 2,374 243 6 4,061 5,132 5,132 - 303 289 - 303 289 2,209 7,933 2,209 7,341 592 4.98 Financial Liabilities Payables Other Financial Liabilities - Accommodation Bonds - Licences to Occupy - Other 2008 Financial Assets Cash and Cash Equivalents Receivables - Trade debtors - Other receivables Other financial assets - Monies in Trust Deposits Financial Liabilities Payables Other Financial Liabilities - Accommodation Bonds - Licences to Occupy - Other Interest Rate Exposure Weighted Average Effective Interest Rate (%) 8.08 6.83 1,436 2,486 327 180 4,429 1,436 - 2,486 327 180 4,429 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 81 Note 18: Financial Instruments (continued) (d) Market Risk (cont) Sensitivity Disclosure Analysis Taking into account past performance, future expectations, economic forecasts, and management’s knowledge and experience of the financial markets, the Service believes the following movements are ‘reasonably possible’ over the next 12 months (Base rates are sourced from the Reserve Bank of Australia) - A shift of +1% and -1% in market interest rates (AUD) from year-end rates of 6%; - A parallel shift of +1% and -1% in the inflation rate from year-end rates of 2% The following table discloses the impact on net operating result and equity for each category of financial instrument held by the Service at year end as presented to key management personnel, if changes in the relevant risk occur. Interest Rate Risk 2009 Financial Assets Cash and Cash Equivalents Receivables - Trade debtors - Other receivables Other financial assets - Term Deposit Financial Liabilities Payables Other Financial Liabilities - Accommodation Bonds - Licences to Occupy - Other 2008 Financial Assets Cash and Cash Equivalents Receivables - Trade debtors - Other receivables Other financial assets - Term Deposit Financial Liabilities Payables Other Financial Liabilities - Accommodation Bonds - Licences to Occupy - Other -1% +1% Carrying Amount $’000 Profit $’000 Equity $’000 Profit $’000 Equity $’000 5,350 (54) (54) 54 54 181 328 - - - - 2,012 (20) (20) 20 20 1,438 - - - - 2,374 243 6 - - - - (74) (74) 74 74 5,132 (51) (51) 51 51 303 289 - - - - 2,209 (22) (22) 22 22 1,436 - - - - 2,486 327 180 - - - - (73) (73) 73 73 82 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 Note 19: Commitments for Expenditure Capital Expenditure Commitments Payable: Land and Buildings Plant and Equipment Total Capital Commitments Land and Buildings Later than 1 year and not later than 5 years Total Plant and Equipment Not later than one year Total TOTAL Lease Commitments Commitments in relation to leases contracted for at the reporting date: Xerox Photocopier Agreement Motor Vehicles - Lowan Regional Health Motor Vehicles - Capital Finance IP Telephone Rental Total Lease Commitments Operating Leases Cancellable Not later than one year Later than 1 year and not later than 5 years TOTAL Total Commitments for expenditure (inclusive of GST) less GST recoverable from the Australian Tax Office Total commitments for expenditure (exclusive of GST) 2009 $’000 2008 $’000 - 300 588 888 - 300 300 - 588 588 - 888 105 43 148 146 68 124 45 383 59 89 148 235 148 383 148 (13) 1,271 (116) 135 1,155 Note 20: Contingent Liabilities Details of estimates of maximum amounts of contingent liabilities are as follows: Contingent Liabilities Quantifiable Caveat over property - Kaniva Cottages Total Quantifiable Contingent Liabilities 2009 $’000 2008 $’000 200 200 200 200 The West Wimmera Shire Council holds a caveat of $200,000 over the title of the Kaniva Cottages. Should the Cottages be sold for any other purpose than to provide Aged Care accommodation at any future time or be wound up, the Council retains the right to recoup $200,000 from the Service. NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 REVENUE External Segment Revenue Total Revenue EXPENSES External Segment Expenses Total Expenses Net Result from ordinary activities Interest Expense Interest Income Share of Net Result of Associates & Joint Ventures using Equity Method Net Result for Year OTHER INFORMATION Segment Assets Total Assets Segment Liabilities Total Liabilities Investments in associates and joint venture partnership Acquisition of property, plant and equipment Depreciation & amortisation expense Note 21: Segment Reporting (502) (485) - - 19,655 19,655 (1,943) (1,943) 23,289 23,289 (1,814) (1,814) 268 2,934 2,680 - - - 221 23,250 23,250 (5,370) (5,370) 2,934 2,680 (473) 285 (1,061) - (1,061) (10,619) (10,619) (8,369) (8,369) (8,544) (8,544) 9,558 9,558 2009 $’000 11,303 11,303 2008 $’000 RACS 11,224 11,224 2009 $’000 Acute Care (490) 268 - 19,622 19,622 (5,752) (5,752) (1,146) - (1,146) (10,389) (10,389) 9,243 9,243 2008 $’000 (27) 13 - 1,127 1,127 (183) (183) (34) - (34) (469) (469) 435 435 2009 $’000 (28) 13 - 951 951 (196) (196) (5) - (5) (459) (459) 454 454 2008 $’000 Aged Care Other (16) 89 - 355 355 (52) (52) 293 - 293 (276) (276) 569 569 2009 $’000 (17) 4 - 300 300 (56) (56) 152 - 152 (270) (270) 422 422 2008 $’000 Business Units (32) 59 - 2,407 2,407 (102) (102) (371) - (371) (1,036) (1,036) 665 665 2009 $’000 (33) 28 - 2,031 2,031 (109) (109) (384) - (384) (1,014) (1,014) 630 630 2008 $’000 Internally Managed Units (79) 159 - 8,248 8,248 (1,227) (1,227) (345) - (345) (3,949) (3,949) 3,604 3,604 2009 $’000 (82) 95 - 6,961 6,961 (1,314) (1,314) (478) - (478) (3,861) (3,861) 3,383 3,383 2008 $’000 Primary Health (19) 418 28 1,930 1,930 (355) (355) 28 (736) 385 (1,149) (2,372) (2,372) 1,223 1,223 2009 $’000 (20) 22 - 1,629 1,629 (380) (380) 399 (4) 391 12 (2,322) (2,322) 2,334 2,334 2008 $’000 Other Programs (1,132) 1,244 28 60,606 60,606 (9,102) (9,102) 28 425 385 12 (27,266) (27,266) 27,278 27,278 27,769 27,769 2008 $’000 (1,172) 698 - 51,149 51,149 (9,750) (9,750) 1,473 (4) 391 1,086 (26,683) (26,683) Consol’d 2009 $’000 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 83 84 WEST WIMMERA HEALTH SERVICE > ANNUAL REPORT 2008/2009 NOTES TO THE FINANCIAL STATEMENTS JUNE 30 2009 Note 21: Segment Reporting (continued) Note 22b: Executive Officer Disclosures The major products/services from which the above segments derive revenue are: Executive Officers’ Remuneration The numbers of executive officers, other than Ministers and Accountable Officers, and their total remuneration during the reporting period are shown in the first two columns in the table below in their relevant income bands. The base remuneration of executive officers is shown in the third and fourth columns. Base remuneration is exclusive of bonus payments, long-service leave payments, redundancy payments and retirement benefits. Segment Acute Care Residential Aged Care Service Aged Care - Other Business Units Internally Managed Units Primary Health Other Programs Services Acute Inpatient Care Residential Aged Care Community Aged Care Packages, Dementia Respite Dental, Radiography, Medical & Meals on Wheels Disability Services Allied & Community Health Other Geographical Segment Geographical SegmentWest Wimmera Health Service operates predominantly in the West Wimmera region. More than 90% of revenue, net surplus from ordinary activities and segment assets relate to operations in this area. 2008 No. 2 1 1 4 $497,482 2009 No. 1 1 1 3 $387,957 2008 No. 2 1 1 4 $473,482 There were no significant events after the reporting date (30 June 2009). In accordance with the Ministerial Directions issued by the Minister for Finance under the Financial Management Act 1994, the following disclosures are made regarding responsible persons for the reporting period. Period 01/07/2008 - 30/06/2009 Board of Governance R Ismay R Rosewall L Clarke J Hicks L Maybery J Sudholz R Stanford D White H Champness 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 01/07/2008 - 30/06/2009 03/03/2009 - 30/06/2009 Accountable Officers J Smith - Chief Executive Officer 01/07/2008 - 30/06/2009 Remuneration of Responsible Persons The number of Responsible Persons are shown in their relevant income bands; Income Band $0 - $9,999 $210,000 - $219,999 $220,000 - $229,999 Total Numbers Total remuneration received or due and receivable by Responsible Persons from the reporting entity amounted to: Amounts relating to Responsible Ministers are reported in the financial statements of the Department of Premier and Cabinet Other Transactions of Responsible Persons and their Related Parties Mrs E M Stewart has provided nursing services to the Service on normal award terms and conditions T Ismay & Company of which Mr R Ismay is a director has provided hardware supplies and services to the Service on normal commercial terms and conditions Mrs L M Graham has provided secretarial services to the Service on normal award terms and conditions $110,000 - $119,999 $120,000 - $129,999 $130,000 - $139,999 $140,000 – $149,999 Total Total Remuneration 2009 No. 1 2 3 $393,957 Base Remuneration Note 23: Events Occurring after the Balance Sheet Date Note 22a: Responsible Persons Disclosures Responsible Minister: The Honourable Daniel Andrews, MLA, Minister for Health Total Remuneration 2009 No. 10 1 11 2008 No. 12 1 13 $229,080 $217,121 $’000 $’000 - 105 2 1 45 42 Note 24: Remuneration of Auditors Audit fees paid or payable to the Victorian AuditorGeneral’s Office for audit of the (Agency’s) current financial report Total Paid and Payable 2009 $’000 2008 $’000 24 24 20 20 85 ANNUAL REPORT 2008/2009 COMPLIANCE DISCLOSURE INDEX The Annual Report of West Wimmera Health Service is prepared in accordance with all relevant Victorian Legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements. Legislation Requirement Page No. Charter and purpose FRD 22B FRD 22B FRD 22B Manner of establishment and the relevant Ministers Objectives, functions, powers and duties Nature and range of services provided 4, 28, 30, 31 6, 7, 28 5 Management and Structure FRD 22B Organisational structure 29 Financial and Other Information FRD 10 FRD 11 FRD 21A FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 22B FRD 25 SD 4.2(j) SD 4.5.5 Disclosure index Disclosure of ex-gratia payments Responsible person and executive officer disclosures Application and operation of Freedom of Information Act 1982 Application and operation of Whistleblowers Protection Act 2001 Compliance with building and maintenance provisions of Building Act 1993 Details of consultancies over $100,000 Details of consultancies under $100,000 Major changes or factors affecting performance Occupational Health and Safety Act 2004 Operational and budgetary objectives and performance against objectives Significant changes in financial position during the year Statement of availability of other information Statement of merit and equity Statement on National Competition Policy Subsequent events Summary of the financial results for the year Workforce Data Disclosures Victorian Industry Participation Policy disclosures Report of Operations, Responsible Body Declaration Attestation on Compliance with Australian/New Zealand Risk Management Standard 85 NIL 65 57 57 57 57 57 62 57 6, 7 61 57 59 57 84 61 59 57 2 17 Ministerial Directions Report of Operations Financial Statements Financial statements required under Part 7 of the FMA SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements SD 4.2(b) Operating Statement SD 4.2(b) Balance Sheet SD 4.2(b) Statement of Changes in Equity SD 4.2(b) Cash Flow Statement SD 4.2(c) Accountable officer’s declaration SD 4.2(c) Compliance with Ministerial Directions SD 4.2(d) Rounding of amounts 67 65 65 66 66 65 65 67 Legislation Freedom of Information Act 1982 Whistleblowers Protection Act 2001 Victorian Industry Participation Policy Act 2003 Building Act 1993 Financial Management Act 1994 57 57 57 57 IFC 86 WEST WIMMERA HEALTH SERVICE GLOSSARY OF TERMS ACFI Aged Care Funding Instrument ACHS Australian Council on Healthcare Standards Australian Standards National Standards developed by the Standards Association of Australia/New Zealand Best Practice Measuring results against the best performance of other groups CACPs Community Aged Care Packages provide services in the home Carers Carers of patients/clients who are not part of the Service Care Team Catchment Geographical area for which West Wimmera Health Service is responsible to provide services CEO Chief Executive Officer Close Watch The program used by the Department to monitor health services considered to be at a higher than normal financial risk of being able to trade in a sustainable manner Desk Top Audit A paper-based assessment of an organisation’s progress in a particular program DHS The Department of Human Services, Victoria DoHA Commonwealth Department of Health & Ageing DON Director of Nursing DVA Department of Veterans’ Affairs ECG Electrocardiograph EQuIP Accreditation Evaluation Quality Improvement Program FaHCSIA Commonwealth Department of Families, Housing, Community Services and Indigenous Affairs FOI Freedom of Information FTE Full Time Equivalent – used in relation to the number of staff employed GEM Bed Geriatric Evaluation and Management Beds allocated to older patients requiring professional management of an illness or complex medical condition GRHA Grampians Regional Health Alliance HACC –Home and Community Care Funding for services and programs which are provided in the home or the community ICT Information & Communication Technology Inpatient A person who is admitted to an acute bed M&CH Maternal & Child Health Medical Record Compilation of patient medical treatment and history Mission Statement See Inside Front Cover Multi-disciplinary A group comprised of more than one discipline, a mix of health professionals Occupied Bed Days The total number of patients in hospital in a given time OH&S Occupational Health & Safety Outcome The result of a service provided Outpatient A patient/client who is not admitted to a bed Patient/Client/Consumer A person for whom this Service accepts the responsibility of care PCP Primary Care Partnership QOC Quality of Care Report Separation/Discharge The process whereby care is completed and the patient leaves the organisation Standard Level of performance to be achieved Statutory or Legislative Requirement A requirement laid down by an Act of Parliament Sub-Acute Subacute care is a comprehensive, cost-effective inpatient level of care for patients who have had an acute event resulting from injury, illness or exacerbation of a disease process. TAC Transport Accident Commission The Board The Board of Governance The Department The Department of Human Services, Victoria The Service West Wimmera Health Service Values The principles and beliefs that guide West Wimmera Health Service WIES Weighted Inlier Equivalent Separations WWHS West Wimmera Health Service INDEX Accreditation . . . . . . . . . . . . . . . . .1, 4, 8, 55 ACFI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Admission and Discharge. . . . . . . . . . . . 36 Aged Care . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Air Conditioning . . . . . . . . . . . . . . . . . . . . . 53 Allied Health . . . . . . . . . . . . . . . . 14,16,46,49 Annual General Meeting . . . . . . . . . .IFC, 11 Attestations: Accountable Officer . . . . . . . . . . . . . . 65 Data Accuracy . . . . . . . . . . . . . . . . . . . . .22 Responsible Body . . . . . . . . . . . . . . . . . . 2 Risk Management . . . . . . . . . . . . . . . . . 17 Audit Committee . . . . . . . . . . . . . . . . . . . . .28 Auditors . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC Australasian Reporting Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC, 1, 11 Australian Council on Healthcare Standards. . . . . . . . . 1, 8, 55 Bequests . . . . . . . . . . . . . . . . . . . . . . . . 23, 27 Board of Governance . . . . . . . 2, 28, 30, 31 Building Code of Australia . . . . . . . . . . . .57 Bullying . . . . . . . . . . . . . . . . . . . . . . . . . 16, 57 Burden of Disease . . . . . . . . . . . . . . . . . . .47 By Laws . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Capital & Equipment Grants . . . 11, 37, 53 Capital Fundraising . . . . . . 7, 24,25,26,27 Catering . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Chemotherapy . . . . . . . . . . . . . . . . . . . . . . . . 6 Chief Executive Officer . . . . 2, 8, 15,16, 32 Chronic Disease . . . . . . . . . . . . . . . . . . 47,48 Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Clinical Governance . . . . . . . . . . . . . . . . . . . 6 Clinical Risk . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Clinical Videoconferencing . . . . . . . . . . . . 7 Clinicians Health Channel. . . . . . . . . . . . . 18 Close Watch . . . . . . . . . . . . . . . . . . . . . . 1, 11 Closed Circuit Television (CCTV) . . . . . 54 Committees . . . . . . . . . . . . . . . . . . . . . . . . .28 Community Advisory Committees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7, 15, 28 Community Aged Care Packages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5, 44, 45 Community Needs Analysis & Service Profile Project . . . . 1, 6, 8, 14 Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Compliance Disclosure . . . . . . . . . . . . . . 85 Compliments . . . . . . . . . . . . . . . . . . . . . . . . 15 Confidentiality . . . . . . . . . . . . . . . . . . . . . . 54 Conflict of Interest . . . . . . . . . . . . . . . . . . .28 Cooinda . . . . . . . . . . . . . . . . . . . . . . . . . 50, 51 Corporate Governance . . . . . . . . . . . . . . .28 Credentialing . . . . . . . . . . . . . . . . . . . . 41, 47 Dental Services . . . . . . . . . . . . . . . .6, 39, 40 Dental Therapist . . . . . . . . . . . . 1, 6, 14, 40 Diagnostic Imaging Services . . . . . . 35, 55 Dialysis. . . . . . . . . . . . . . . . . . . . . . .1, 5, 6, 37 Disability Services . . . . . . . . . . . . . . . 50, 51 Donations . . . . . . . . . . . . . . . . . . . . . . . 23, 27 Dysphagia . . . . . . . . . . . . . . . . . . . . . . . . . . 48 E3 Learning . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Early intervention . . . . . . . . . . . . . . . . . . . 48 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Education,Mandatory . . . . . . . . . . . . 18, 38 Electrocardiogram . . . . . . . . . . . . . . . 27, 35 Electronic Patient Drug Information System . . . . . . . . . . . . . . 36 Emergency Services . . . . . . . . . . . . . . . . 35 Environment . . . . . . . . . . . . . . . . . . . . . . 6, 56 Equity Trustees . . . . . . . . . . . . . . . . . . . . . . 15 Executive Directors . . . . . . 2, 3, 16, 32, 33 Executive Structure . . . . . . . . . . . . . . . 6, 11 External cleaning audits . . . . . . . . . . . . . 53 Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 Finance Committee . . . . . . . . . . . . . . . . . .28 Finance . . . . . . . . . . . . . . . . . . . . . . . . . . 7, 60 Financial Management Act 1994 . . . . . . . 2 Financial Management . . . . . . . . . . . . .7, 11 Financial Ratios . . . . . . . . . . . . . . . . . . . . . .62 Foot Care Clinic . . . . . . . . . . . . . . . . . . . . . 48 Freedom of Information . . . . . . . . . . . . . .57 Fundraising . . . . . . . . . . . . . . . 24, 25, 26, 27 Garden Program and Activities . . . . . . . .51 Gastroenteritis . . . . . . . . . . . . . . . . . . . . . . .37 General Practitioner Anaesthetist . . . 6,11 Goroke . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5, 7 Graduate Nurse Program . . . . . . . . . . . . 36 Health Promotion . . . . . . . . . . . . . . . . . . . 48 Health Services Act 1988 . . . . . . . . . . 4, 28 Healthy Workplace Challenge . . . . . . . . 48 Hepatitis B. . . . . . . . . . . . . . . . . . . . . . . 38, 39 Highlights of the Year . . . . . . . . . . . . . . . . . 1 Home & Community Care . . . . . . . . . . . . . . 5 HRSS . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7, 58 Human Resource Management . . . . . . . 16 Human Resources. . . . . . . . . . . . . . . . . 6, 16 ICT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7, 60 Industrial Relations . . . . . . . . . . . . . . . . . . 16 Infection Control . . . . . . . . . . . . . . . . . . . . .37 iSoft Electronic Patient Management System . . . . . . . . 7, 12, 54 Jeparit . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5 Kaniva. . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5, 7 Ladies Auxiliaries . . . . . . . . . . . . . . . . . . . . 24 Landfill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Macerators . . . . . . . . . . . . . . . . . . . . . . . . . 56 Maternal & Child Health . . . . . . . . . . . . . .49 Medical Imaging . . . . . . . . . . . . . . . . . . . . 35 Medical Practitioners . . . . . . . . . . . . . . . . 41 Medical Records . . . . . . . . . . . . . . . . . . . . 54 Medical Staff Association . . . . . . . . . . . . 41 Medication . . . . . . . . . . . . . . . . . . . . . . . . . 36 Medprof . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Menu Review . . . . . . . . . . . . . . . . . . . . 15, 54 Merit & Equity . . . . . . . . . . . . . . . . . . . . . . .59 Minister for Health . . . . . . . . . . . 1, 2, 11, 31 Mission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC Natimuk . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5 National Respite for Carers . . . . . . . . 5, 45 Nhill Drought Resource Centre . . . . . . . . 24 Nhill Hospital . . . . . . . . . . . . . . . . . 1, 4, 5, 11 Occupational Health & Safety . . . . . . 6, 57 Olivers Café . . . . . . . . . . . . . . . . . . . . . . . . 51 Oliver’s Kiosk . . . . . . . . . . . . . . . .1, 6, 12, 51 Operating Suite . . . . . . . . . . . . . . . . . . . . . .39 Organisation Structure . . . . . . . . . . . . 6, 29 Payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Pecuniary Interest . . . . . . . . . . . . . . . . . . 28 People Matter Survey . . . . . . . . . . . . . . . . 16 Performance in Brief . . . . . . . . . . . . . . . . . . 1 Performance Review . . . . . . . . . . . . . 17, 28 Perpetual Trustees . . . . . . . . . . . . . . . . . . . . 7 Pharmacy Services . . . . . . . . . . . . . . . . . 36 Planned Activity Groups (PAG) . . . . . . . 45 Police Checks. . . . . . . . . . . . . . . . . . . . . . . .57 Pre-admission Clinic . . . . . . . . . . . . . . . . 36 Procurement. . . . . . . . . . . . . . . . . . . . . . . . .59 Publications . . . . . . . . . . . . . . . . . . . . . . . . .57 Quality of Care Report . . . . . . . . . . . . . 1, 11 Rain Water Storage . . . . . . . . . . . . . . . 6, 56 Rainbow . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5, 7 Recycling . . . . . . . . . . . . . . . . . . . . . . . . . 6, 56 Residential Care . . . . . . . . . . . . . . . . . 42, 43 Residents’ Rights . . . . . . . . . . . . . . . . . . . 45 Responsible Officers . . . . . . . . . . . . . . . . .31 Risk Management . . . . . . . . . . . . . . 6, 11, 17 Rules of Procedure . . . . . . . . . . . . . . . . . . .28 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . 18, 54 Security Review . . . . . . . . . . . . . . . . . . . . 54 Sensory Room . . . . . . . . . . . . . . . . . . . . . . .51 Staff . . . . . . . . . . . . . . . . . . . . . . 8, 18, 20, 21 Statistics . . . . . . . . . . . . . . . . . . . . . . . . 22, 39 Strategic Plan . . . . . . . . . . . . . . . . . . 1, 2, 12 Supported Employees . . . . . . . . . . . . . . . .51 Swine Flu (HINI) . . . . . . . . . . . . . . . . . . 38, 53 Targeted Equipment Program . . . . . 11, 37 Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Tristar Medical Group . . . . . . . . . . . . . . . . 14 Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 VAGO Report . . . . . . . . . . . . . . . . . . . . . 63, 64 Vehicle Fleet . . . . . . . . . . . . . . . . . . . 1, 12, 56 Videoconferencing . . . . . . . . . . . . . . . 18, 19 Visiting Surgeons . . . . . . . . . . . . . . . . . . . . 41 Volunteers . . . . . . . . . . . . . . . . . . . . . . . 24, 27 Waste Management . . . . . . . . . . . . . . . 6, 36 Whistle Blower Act . . . . . . . . . . . . . . . . . . .57 Workcover . . . . . . . . . . . . . . . . . . . . . . . . . . .59 Workforce Composition . . . . . . . . . . . . . .59 Workforce Innovation Grants . . . . . . . . 48 WWHS Health & Fitness Centre . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1, 13, 47 WWHS Strategic Plan . . . . . . . . . . . . . . . . . 1 tell us… what you think Please circle the answer which most closely reflects your opinion. Q1 a) b) c) d) Are you a: Consumer Representative of Government WWHS Staff Medical Practitioner Q2 e) Health Industry Employee f) Financial Supporter g) Other (please specify) What did you think about the Report? (please circle a number) Poor Excellent 1 2 3 4 5 6 7 8 Q3 What did you like about the Report? 9 10 ___________________________________________________________________ ___________________________________________________________________ Q4 How can we improve the Report? ___________________________________________________________________ ___________________________________________________________________ Q5 Are there any other topics which you would like to see in next year’s Annual Report? ___________________________________________________________________ ___________________________________________________________________ Thank you for your time in completing this questionnaire. You can return it by post or leave it at any of our facilities. John N. Smith, PSM, Chief Executive Offi cer WWHS. help us… to make the services we provide for six communities become better and better YES, I am interested in supporting West Wimmera Health Service and would like further information about the following: Becoming a Volunteer Joining an Auxiliary Giving financial support through a bequest or donation If you wish to discuss supporting our Service in this way please contact the Chief Executive Offi cer who will explain in detail how arrangements can be made. Alternatively, please complete the form below and return it to us. Name _____________________________________________________________________ Address ___________________________________________________________________ __________________________________________________________________________ Telephone _______________________ Facsimile _________________________________ Mobile _________________________ Email _____________________________________ John N. Smith, PSM, Chief Executive Offi cer West Wimmera Health Service PO Box 231, Nhill, Victoria 3418 Telephone 03 5391 4222 Facsimile 03 5391 4228 Email [email protected] PO Box 231 NHILL VIC 3418 West Wimmera Health Service Reply Paid 231 NHILL VIC 3418 BELOW: Gardener, Matt Bone maintaining the grounds of Nhill Hospital THANK YOU Sponsors We acknowledge the generous sponsorship which supports the production of this report. Tattersall’s ‘Tattersall’s are proud to support the initiative of West Wimmera Health Service and their commitment to regional Victoria.’ Tattersall’s George Adams Foundation The Weekly Advertiser Ace Radio 2 Stawell Rd Horsham Victoria 3400 PO Box 606, Horsham Victoria 3402 Telephone (03) 5382 1351 Wimmera Messengers Luv-A-Duck Australia’s Favourite Duck Telephone 1800 649 000 www.luvaduck.com 85 Nelson St Nhill Victoria 3418 Telephone (03) 5391 3456 Acknowledgements WW107 / MOTIV Design & Production Motiv Design Co-ordination DMR Associates Pty Ltd, Nhill Photography Robert Geh Lawyers DLA Phillips Fox, Russell Kennedy Pty Ltd, Stewart & Lipshut Auditors Victorian Auditor General’s Office Internal Auditor Deloitte Growth Solutions Pty Ltd Architects Brown Falconer Banker Commonwealth Bank This publication is printed on ENVI – 100% Carbon Neutral Paper Please use, re-use & recycle. About this Report West Wimmera Health Service is a complex organisation. We are care givers, we are business managers, we are forward planners, we are employers, we are stimulators of the local economy. It is an extensive list of activities and responsibilities and every single endeavour represented is directed towards people – people of the diverse communities in North West Victoria. NHILL 43-51 Nelson Street Nhill Victoria 3418 T (03) 5391 4222 F (03) 5391 4228 KANIVA 7 Farmers Street Kaniva Victoria 3419 T (03) 5392 7000 F (03) 5392 2203 COOINDA Queen Street Nhill Victoria 3418 T (03) 5391 1095 F (03) 5391 1229 NATIMUK 6 Schurmann Street Natimuk Victoria 3409 T (03) 5363 4400 F (03) 5387 1303 GOROKE Natimuk Road Goroke Victoria 3412 T (03) 5363 2200 F (03) 5386 1268 RAINBOW 2 Swinbourne Avenue Rainbow Victoria 3424 T (03) 5396 3300 F (03) 5395 1411 JEPARIT 2 Charles Street Jeparit Victoria 3423 T (03) 5396 5500 F (03) 5397 2392 EMAIL [email protected] www.wwhs.net.au