www.sesiahs.health.nsw.gov.au
Transcription
www.sesiahs.health.nsw.gov.au
www.sesiahs.health.nsw.gov.au A N N U A L R E P O R T 2006/2007 Sydney/Sydney Eye Hospital SOUTH EASTERN SYDNEY ILLAWARRA AREA HEALTH SERVICE St George Hospital St Vincent’s Hospital War Memorial *Randwick Hospitals Campus Calvary Healthcare Sutherland Sutherland Hospital Gower Wilson Hospital Garrawarra Centre Lord Howe Island Coledale Hospital Bulli Hospital Wollongong Wollongong Hospital Port Kembla Hospital Shellharbour Kiama Shellharbour Hospital Kiama Hospital David Berry Hospital Shoalhaven Hospital Shoalhaven Milton Ulladulla Hospital N *Randwick Hospitals Campus Prince of Wales Hospital Royal Hospital for Women Sydney Children’s Hospital, Randwick ADDRESS South Eastern Sydney Illawarra Area Health Service Level 4, Lawson House, Wollongong Hospital Loftus St Wollongong NSW 2500 Mail to: LMB 8808, SCMC NSW 2521 CONTACT Telephone I (02) 4253 4888 Facsimile I (02) 4253 4878 Email I [email protected] Web I www.sesiahs.nsw.gov.au BUSINESS HOURS Administration office open from 8.30am - 5.00pm Monday to Friday Published by: South Eastern Sydney Illawarra Area Health Service Editoral Team: Ian McManus I Marilyn Johnson Financial Team: Kim McConnochie I Fran Hickey Design Team: Garry McArthur I Joel de los Santos Contents Map and contact details inside cover n Letter to the Minister 1 Foreword from the Chief Executive 2 Section 1 - Profile, purpose and goals Organisation chart Purpose and goals Summary of the Seven Strategic Directions 3 4 5 6 Section 2 - Performance Performance indicators Corporate Governance Statement Key milestones for the Strategic Plan 7 7 17 20 Section 3 - Health services SESIH facility activity levels SESIH facility beds and bed equivalents Hospital services Other health services 21 22 22 23 45 Section 4 - Health support services Corporate Services 61 61 Section 5 - Our people Workforce development Executive reports Staff profile Equal Employment Opportunity Occupational Health and Safety Teaching and training initiatives Research Official overseas travel 67 67 68 77 77 78 80 81 82 Section 6 - Our community Area Health Advisory Council Fundraising and sponsorship Links with Non-Government Organisations Our Volunteers 93 93 94 98 100 Section 7 - Freedom of information Freedom of information applications 103 103 Section 8 - Financial report Financial overview Financial statements 105 105 108 Index 160 Letter to Minister Letter to the Minister Letter to the Minister The Hon. Reba Meagher MP Minister for Health Parliament House Macquarie Street Sydney NSW 2000 Dear Minister I have pleasure in presenting the South Eastern Sydney Illawarra Area Health Service Annual Report 2006 - 07. The Report complies with the requirements for annual reporting under the Accounts and Audit Determination for public health organisations and the 2006 - 07 Directions for Health Service Annual Reporting. Yours sincerely Professor Debora Picone AM Chief Executive Better Services – Healthier People 1 Healthy People – Now and in the Future Foreword from the Chief Executive T Royal Hospital for Women has enabled these hospitals to add several new clinical applications to services available, while doubling patient capacity for MRIs. his year’s Annual Report for South Eastern Sydney Illawarra Health (SESIH) reflects the emergence of a much stronger and more cohesive organisation. Sydney Hospital now boasts the nation’s largest - and leading - specialist Hand Unit and, following the launch of Wollongong Hospital’s first Integrated Breast Cancer Treatment Service, women in the Illawarra now have access to an integrated breast cancer service with state-of-the-art mammography equipment. Cancer patients needing radiation therapy have also benefited from a new linear accelerator installed at the Prince of Wales Hospital, and upgraded medical imaging diagnostic technology at St George Hospital. The SESIH Clinical Services Strategic Plan has delivered an integrated health system for our Area - a large and diverse part of NSW - by creating strong networks via Area-wide services, clinical streams, and hospital networks. The appointment of three Network General Managers was an important step in consolidating the organisation, and in guiding the alignment of our facilities within the new Area structure. Already, the networks have assisted in the implementation of shared on-call rosters, individual clinician appointments and training rotations. To assist our Network General Managers, we have recruited highly experienced clinicians to head the Area’s new clinical streams. Their aim is to ensure that patient care is consistent across our hospital sites and health care centres. In creating our new structure we have achieved the capability to provide services across our communities more effectively and efficiently, while maintaining centres of excellence for our highly specialised services. A major program of capital works supporting these organisational and structural developments has included the opening of a $5 million Cardiac Catheterisation Laboratory at Sutherland Hospital and a $2 million upgrade of medical imaging services in the Illawarra, including the provision of an on-site CT-Scanner at Shellharbour Hospital. A $5.2 million purpose-built aged-care unit was opened at the Prince of Wales Hospital to improve acute care for older patients, and the opening of a MRI Suite at the Randwick Hospital’s campus to support the Prince of Wales Hospital, Sydney Children’s Hospital and the The Sydney Cord and Marrow Transplant facility opened at Sydney Children’s Hospital is playing a vital role in making umbilical cord blood available to patients, and pursuing research to extend the medical applications of cord blood. Primary and community care in the Central Network received a major boost with the opening of a new $5 million Community Health Centre and a Cannabis Clinic at Sutherland Hospital in February this year. As well, we are currently constructing a new purposedesigned renal service for patients in the Sutherland Shire. With the NSW Government providing the largest funding boost on record for facilities and initiatives to deliver leading mental health care, we have more than $15 million in new capital works now underway for mental health services across the Area. Six of our emergency departments have been strengthened with the establishment of eight new nurse practitioner positions, aimed at providing faster, more efficient care to patients with less complex conditions. Strategies like the Clinical Access Redesign Program are also making an Better Services – Healthier People 2 impact in our emergency departments, and during 2006 - 07 the Area achieved marked improvement in performance against all emergency department indicators, despite significant increases in activity. As well, the Clinically Prioritise Treat model was implemented to improve access and equity for elective surgical patients. The new Area structure is also providing more opportunities for consumer participation in a wide range of issues that affect our patients and their loved ones. The Area Health Advisory Council (AHAC) is working to ensure that clinicians, patients and the community are effectively engaged and consulted in the planning and development of our health services. At the recommendation of the AHAC, we now have a new model for consumer participation with nine consumer advisory committees, and a mental health community consultative committee. My gratitude goes to the DirectorGeneral of NSW Health, NSW Health staff, and to both Health Ministers and their staff for the ongoing support and encouragement given to our Area Health Service. I know I leave South Eastern Sydney Illawarra in very capable hands - not only those of my Executive team who have assisted me over the years, but also the highly committed and skilled staff who will carry forward the excellent programs, strategies and initiatives we have created. Their efforts continue to inspire and uplift me, and I look forward to hearing more about their excellent work, in my new role as Director-General of NSW Health. Professor Debora Picone Chief Executive AM South Eastern Sydney Illawarra Area Health Service Healthy People – Now and in the Future 1 Profile, purpose and goals Geography and setting Socio-economic profile SESIH covers approximately 6,331 square kilometres, stretching from Sydney Harbour in the North, down through Sydney’s eastern and southern suburbs, to as far south as Durras on the South Coast. By 2011, the SESIH catchment population is expected to reach 1.24 million. On average, SESIH residents are healthier than previous generations and their NSW counterparts. None of the LGAs that comprise SESIH has a mortality rate higher than the NSW average. Those within SESIH most affected by the burden of death and disease are indigenous, rural, and the socio-economically disadvantaged. The two LGAs with the highest rate of socio-economic disadvantage are the Shellharbour and Botany LGAs. In addition to the highly urbanised areas of Sydney, southern Sydney, Wollongong, Shellharbour and Port Kembla, SESIH includes the rural areas of the Kiama, Berry, Shoalhaven and Milton Ulladulla regions. Heavy industry is concentrated in and around Port Botany, Wollongong and Port Kembla. Major causes of ill-health and morbidity The Area covers 13 Local Government Areas: ◗ Botany ◗ Shoalhaven ◗ Hurstville ◗ City of Sydney (shared with Sydney ◗ Kiama South West Area Health Service) ◗ Kogarah ◗ Sutherland ◗ Randwick ◗ Waverley ◗ Rockdale ◗ Wollongong ◗ Shellharbour ◗ Woollahra In recent years, there have been significant increases among SESIH resident and patient populations in the areas of: ◗ Chronic conditions including obesity, diabetes and dementia, and to a lesser extent, mental illness, musculoskeletal conditions and cardiovascular disease. ◗ Hospitalisation rates for mental illness and injuries (eg falls among the elderly). ◗ Increasing numbers of people requiring renal dialysis. Population characteristics ◗ The Area’s estimated resident population is 1.16 million, or 17 percent of the total population of NSW. The population is increasing, with the highest growth rate recorded in the Sydney LGA. ◗ Each day, the Area’s north is affected by approximately 750,000 people travelling to the Sydney CBD, while the Area’s south is influenced by the number of holidaymakers who visit the South Coast each year. ◗ Approximately 13,000 people (approx one percent) are Aboriginal or Torres Strait Islanders of which 45 percent reside in the Wollongong and Shoalhaven LGAs. ◗ Some 300,000 residents were born overseas and 18 percent speak a language other than English at home. Botany and Rockdale LGAs have the highest proportion of non-English speaking people (approx 35 per cent), compared with the Kiama and Shoalhaven LGAs which have less than five percent. ◗ Of SESIH’s population, 10 percent are aged 70 years and older. Children under five years old make up approximately six percent of the population, with Shellharbour LGA having the highest proportion of children under five. Better Services – Healthier People 3 Healthy People – Now and in the Future Profile, purpose and goals 1 SECTION Organisation chart Director, Internal Audit Ms Norelle Maffullo Executive Clinical Director Director, Office of the Chief Executive Chief Executive Professor Debora Picone Professor Denis King Ms Nel Buttenshaw Director, Corporate Communications Ms Alison Errey Director, Clinical Governance Professor Susan Hanson Director, Clinical Operations Mr Matthew Daly Director, Financial & Corporate Services Director, Population Health, Planning & Performance Director, Workforce Development Mr John Roach Ms Elizabeth Koff (until 16 February 2007) Better Services – Healthier People 4 Dr Siun Gallagher Healthy People – Now and in the Future Director, Nursing & Midwifery Services Ms Kim Olesen Profile, purpose and goals Purpose and goals Objectives SESIH continues to focus its efforts on delivering high quality health services that are responsive to the needs of health consumers and the community and will ensure that services can adapt to meet future challenges. Work together with our clinicians, communities and other levels of government to: ◗ Our vision, ‘Healthy People - Now and in the Future’ reflects this focus and is supported by the four goals common to the NSW Health system below. The seven strategic directions for SESIH - and NSW Health underpin our vision and goals, as do our mission and objectives. ◗ ◗ Our goals are: ◗ To keep people healthy. ◗ To provide the health care that people need. ◗ To deliver high quality services. ◗ To manage health services well. ◗ ◗ Protect, promote and maintain the health of, and reduce health inequities between, our diverse communities. Enhance the safety, access, appropriateness and effectiveness of our services, while ensuring that the distribution of high quality services and clinicians match population need. Be accountable and responsible to, and esteemed by, our resident, patient and referral communities, while demonstrating ethical and sound clinical and corporate practices and outcomes. Value and respect our workforce, while promoting research and teaching within a culture of learning and innovation. Make smart choices for investment, while staying alert to new risks and opportunities. Vision I Healthy People – Now and in the Future Mission I Better Services – Healthier People Better Services – Healthier People 5 Healthy People – Now and in the Future 4 Summary of the Seven Strategic Directions 1 Make prevention everybody’s business The familiar saying that ‘prevention is better than cure’ is supported by clinical evidence. But putting prevention into practice is not easy and benefits are not always immediately apparent. Reducing risk factors such as smoking, obesity, risky alcohol use and stress requires strong will and sustained action by individuals, families, communities and governments. Similar effort is needed to increase protective factors such as good nutrition, physical activity, healthy environments and supportive relationships. The health and well-being of local communities depends on much more than health services, but access to quality health care makes a significant difference. Current arrangements for funding, organisation and delivery of human services involve three levels of government and a broad range of other agencies. Inevitably these complex arrangements lead to gaps in services and duplication. It will be vital to work collaboratively within and beyond the health system to better link and co-ordinate services and bridge the gaps. 5 better experiences for 2 Create people using health services 6 Build a sustainable health workforce Delivery of quality health services depends on having adequate numbers of skilled staff working where they are needed. Addressing the current shortfall in the supply of health professionals is one of our key priorities for the future. A shortage of staff or uneven distribution of staff will limit consumer access to the health care needed. Strengthen primary health and continuing care in the community Primary health services include general practice, community health centres and community nursing services, youth health services, pharmacies, allied health services, Aboriginal health and multicultural services. They are provided in both public and private settings and by specific non-government organisations. For most people they may be the first point of contact with the health system. They are also the services people tend to use most. Better Services – Healthier People Make smart choices about the costs and benefits of health services As the costs of health care continue to rise, consuming a growing share of Government and consumer resources, greater rigour, broader community participation, stronger accountability and a solid evidence base are required to decide how available funds should be spent. Creating better experiences for people using public health services is a matter of making sure that services continue to be high quality, appropriate, safe, available when and where needed, and co-ordinated to meet each individual’s needs, including those from Aboriginal or other culturally and linguistically diverse backgrounds. 3 Build regional and other partnerships for health 7 Be ready for new risks and opportunities The NSW health system is a large, complex organisation that must continually adapt in a dynamic environment to meet the changing health needs of the community. The system’s capacity to be ready to respond strategically to all situations, both predicted and unexpected, cannot be taken for granted. 6 Healthy People – Now and in the Future 2 2 Performance 2 SECTION Performance NRG @ OOSH (out of school hours care for children aged 5-12 years) was extended to the Illawarra and Shoalhaven with the Area’s Health Promotion Service providing programs, menu reviews and workshops to 25 services and small grants to nine services. Indicators for Strategic Direction 1 a Target met r Action required INDICATOR Baseline P Monitoring required 2006-07 Target 2006-07 Result A plan supporting the NSW Health breastfeeding policy is being implemented by the SESIH Lactation Group. The plan will ensure consistent breastfeeding information is provided across the Area, and fosters collaboration between services and supports workforce development. Chronic disease risk factors (16+ years) ▼ ▼ a a Alcohol (risk drinking behaviour % ) Smoking (daily or occasionally % ) Overweight or obese (% ) 38 21 44 Potentially avoidable mortality Persons aged <75 years (age adjusted rate per 100,000 population) 147 ▼ 133 a Immunisation against Influenza 65 years and over (% ) 77 80 78 P Children fully immunised at 1 year (%) 91 >90 91 a 34 18 49 Fall injuries Hospitalisations for people aged 65 years and over (age adjusted hospital separation rate per 100,000 population) (excluding day stays) Males Females 2,135 2,904 1,932 2,812 r Ongoing support was provided for the NSW Health Fresh Tastes strategy to increase the availability of healthy food in school canteens. In 2006 - 07, 82 schools participated in network meetings, received individual advice about healthy menus and fundraising ideas and a quarterly newsletter was distributed to 150 schools. Tobacco Tobacco continues to cause more Australian deaths each year than any other preventable risk factor. In 2006 - 07, the Area’s Health Promotion Tobacco Program supported the NSW Health Tobacco Action Plan 2005 - 09 priorities, with activities at a local level to reduce tobacco related harm. r r Strategic Direction 1 These included: ◗ Continued strong media coverage of the risks posed by environmental tobacco smoke (ETS) in the Chinese media. Both World No Tobacco Day and the Car and Home: Smoke Free Zone initiatives received considerable coverage in newspapers, satellite TV and local radio. ◗ A pilot project encouraged Chinese-speaking GPs to routinely provide smoking cessation advice and provide free nicotine replacement therapy as appropriate to Chinese-speaking patients. ◗ Development of a Quit Smoking program for Arabicspeaking women in Cringila, in the Wollongong region. Make prevention everybody’s business Healthy weight Childhood is a key period for influencing healthenhancing lifestyle behaviours. In 2006 - 07, the Healthy Weight Program continued to support children and families to establish healthy eating and physical activity behaviours and reduce the potential for developing chronic disease later in life. The Live Life Well @ School partnership project, with the NSW Department of Education and Training and the Catholic Education Office, has progressed from planning to implementation. Identified schools in the Illawarra, Kiama and Shoalhaven will receive financial support to make changes in the school environment. Falls Prevention The Area Falls Injury Prevention Plan 2007 - 2012, covering community, acute and sub-acute care and residential care for aged settings was completed. The Healthy Eating and Active Play @ Playgroup initiative enhances the abilities of supported playgroups to support vulnerable families with children 0 - 5 years old through the provision of resources and staff training. Better Services – Healthier People The Area Falls Prevention Co-ordinator, appointed in January 2007, conducted presentations on falls risk 7 Healthy People – Now and in the Future ◗ factors and prevention strategies for use at both a hospital and hospital network level. Education sessions on falls risk factors and their management were also provided to nurses working in residential care (Shoalhaven Division) and GPs (St George Division). NSW Health-funded pedometer and cardiac rehabilitation research project. Indicator Fall injuries - Hospitalisations for people aged 65 years and over (age adjusted hospital separation rate per 100,000 population) (excluding day stays): Male and Female The Acute/Sub-Acute Falls Prevention Working Party was established to support and monitor unit level implementation of the Australian Council for Safety and Quality in Health Care (ASQC) Guidelines. Major factors impacting performance ◗ An Area-wide Falls Reduction Forum held in September 2006 showcased both programs in place and being developed to facilitate a reduction in fall injury for the SESIH population. The Area Falls Prevention Co-ordinator was appointed in January 2007 to facilitate implementation of NSW Health policy on preventing falls in older people. Projects being undertaken to meet targets Indicator ◗ Chronic disease risk factors (16+ years): Overweight or obese (%) Major factors impacting performance ◗ ◗ This indicator is based on adult data. However, the NSW Health priority for health promotion is childhood overweight and obesity, therefore SESIH’s programs focus on children and are largely based on work with schools. ◗ Projects being undertaken to meet targets ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ Live Life Well @ School, an intensive project newly established within five schools in the Illawarra and Shoalhaven to address physical activity and nutrition. Healthy Eating and Active Play @ Playgroup, funded through Families NSW in the Northern Network. NRG @ OOSH (out of hours school care for children aged 5-12 years) in the Illawarra and Shoalhaven. SESIH Lactation Group, implementing a plan to support the NSW Breastfeeding Policy. Training resources and support for childcare service advisors and staff at long day care childcare centres. Support for NSW Health’s ‘Fresh Tastes’ Strategy to increase the availability of healthy food in school canteens. NSW Health’s healthykids and Go for 2 and 5 fruit and vegetable campaign messages incorporated into projects and activities of the Health Promotion Service. Gentle exercise and strength training classes for older people (reaching approximately 1,300 people per week). Better Services – Healthier People ◗ ◗ ◗ ◗ 8 Developed six year Area Falls Injury Prevention Plan 2007 - 2012 for older people to implement NSW Health policy. Established Area Falls Injury Prevention Steering Committee and three supporting working parties for community, acute and sub-acute and residential care for aged settings. Gentle exercise and strength training classes continue to be the main focus for the provision of physical activity opportunities for community-living older people (reach is 1,300 per week). The SESIH physical activity directory was updated and is available to staff on the SESIH intranet. Hard copies will be provided to community and allied health. In partnership with the St George Migrant Resource Centre, 18 multicultural day care staff from nine language groups trained to deliver Tai Chi for arthritis to their clients. Presentations on falls risk factors and prevention strategies for use at hospital and network level and nursing staff in acute and sub-acute care, residential care and for community and GPs. Health Promotion Falls Prevention Team supporting the Better Balance program at the University of Wollongong (UOW) - linking older people at risk of falls to exercise physiologists for individual or group programs. Wollongong Hospital Emergency project is identifying and referring older patients over 70 years with falls risk to three southern hospital network falls clinics and the UOW Better Balance program. The Prince of Wales Hospital is conducting a research project to analyse causes of falls related incidents over a six month period and action taken at ward level. Healthy People – Now and in the Future Performance Indicators for Strategic Direction 2 a Target met r Action required INDICATOR Baseline Strategic Direction 2 P Monitoring required 2006-07 Target Create better experiences for people using health services 2006-07 Result In 2006 - 07, SESIH achieved marked improvement in performance against all emergency department indicators despite significant increases in activity. The introduction of new emergency models of care and the establishment of nurse practitioner positions in SESIH emergency departments has assisted in achieving this improvement. Emergency Department triage times Cases treated within benchmark times (%) a a (%) (%) (%) (%) (%) 100 78 57 59 82 100 80 75 70 70 100 91 72 74 87 Off-stretcher time Transfer of care to the ED <30 minutes from ambulance arrival (%) 72 90 75 r 70 71 80 80 79 79 P P 130 0 1 P 0 0 3 P Ambulatory contacts Acute overnight inpatient separations 284,808 330,713 291,025 r 4,815 5,500 4,871 r Planned surgery Cancellations on day of surgery (%) N/A <5 4.6 a Emergency Department Hospital inpatient 76 92 ▲ ▲ 77 92 a a Unplanned/unexpected readmissions within 28 days of separation – all admissions (%) 7.3 ▼ 6.7 a Wrong patient, site, procedures (no.) 7 ▼ 10 r Falls in hospitals (rate per 1,000 bed days) 3.4 ▼ 3.6 Triage 1 within 2 Triage 2 within 10 Triage 3 within 30 Triage 4 within 60 Triage 5 within 120 minutes minutes minutes minutes minutes P a a The Area Health Service achieved optimisation of elective patient flow across all facilities and waiting times for elective surgical patients. The average number of ready for care days for category one patients fell from 21.6 days in June 2006 to 14.8 days in June 2007, and the average time for category three patients fell from 265.9 to 184 days for the same period. Emergency admission performance Patients transferred to an inpatient bed within 8 hours of treatment (%) Overall Mental Health Clinicians and clinical managers in radiology worked with hospital staff to re-engineer radiology processes to reduce the number of sentinel events related to patient identification. Waiting times Booked medical and surgical patients: Urgency Category 1 Waiting >30 days All Urgency Categories >12 months (long waits) The Area, through the Clinical Redesign Unit, has participated in the statewide survey of patient experience. Mental Health (no.) Consumer satisfaction Proportion (%) of sampled population rating their healthcare as “excellent”, “very good”, or “good” The Area is looking to establish a range of initiatives to further improve performance against emergency department performance indicators including the establishment of medical assessment and planning units, after-hours GP clinics, and the Third Door concept for the management of elderly patients. Implementation of the recommendations from the Older Persons and Chronic Care Clinical Redesign Project and the review of primary and community health services will introduce a range of initiatives aimed at the better management of patients in the community, and at preventing avoidable admissions to inpatient services. P Better Services – Healthier People SESIH will expand the clinically prioritise and treat model across all surgical specialties to improve access and equity for elective surgical patients, and realign surgical services to meet demand and the objectives of the Clinical Services Strategic Plan. 9 Healthy People – Now and in the Future ◗ The focus on application of open disclosure principles and transparency of investigation of complaints and adverse events will be reinforced via planned Clinical Governance Unit-led education programs and support tools. This includes web-based information for SESIH consumers. ◗ ◗ Indicator Off stretcher time <30 minutes (%) Major factors impacting performance Actions being taken to meet target The main factors which impact on overall performance are the increase in the total number of ED attendances, and the increase in ambulance attendances. ◗ Projects being undertaken to meet targets ◗ ◗ ◗ ◗ Pilot project with NSW Ambulance Service investigating alternatives to ED presentation. Establishment of alternative models for the management of medical patients. With the continuing growth in age and population, the number of ED attendances arriving by ambulance is continuing to increase as evidenced over the past number of years (8 percent between 2004 - 05 and 2005 - 06, and 13 percent between 2005 - 06 and 2006 - 07. The Area’s off-stretcher performance has improved greatly, from 65 percent in 2004 - 05, 72 percent in 2005 - 06 to 75 percent in 2006 - 07. With more innovative strategies/programs in place, the Area is expected to continue to improve its off-stretcher performance: 78 percent in 2007 - 08 (4.3 percent increase from 2006 - 07). If improvement continues, it is expected that the Area will meet the 90 percent target by 2011-12. ◗ ◗ Mental Health - Acute overnight inpatient separations Actions being taken to meet target ◗ ◗ ◗ Mental Health - Ambulatory contacts Major factors impacting performance ◗ As per changes to performance reporting for ambulatory activity, increased focus is being placed on collection of community care hours rather than contacts as this is considered to be more meaningful data for mental health services. Performance reports are now provided by NSW Health (INFORMH) for this indicator rather than ambulatory contacts. Services therefore continue to implement strategies to improve collection of ambulatory contacts; however the primary focus remains on improving collection of community care hours. The Mental Health Information Development Program team continues to provide regular performance reports against this performance indicator. The service is working with senior and middle management to improve performance, as well as providing support and training to clinicians. Indicator Indicator ◗ Performance target is based on funded FTE, including service enhancements. Delayed recruitment of FTE will impact on performance against this target. Increased focus on collection of outcome measures and Community Care Hours has impacted on performance against this indicator. Services relying on batch entry of data have significant challenges in ensuring timely entry of data due to limited administrative resources. Strategies to maximise data entry processes and direct clinician entry remain a priority. Mental Health Clinical Service Redesign Activity. Assertive Care Progression Model of Care Initiatives. Targeted Long Length of Stay Care Complex Multi Agency Plans, per venue, per individual. St Vincent’s Mental Health Service reported a significant decline in contacts during the transition period (of several months) for source systems from SCI-MHOAT to CHIME. Several services, though improving performance against target, remained on average, below the expected target. Better Services – Healthier People 10 Healthy People – Now and in the Future Performance 9 Indicator Indicators for Strategic Direction 3 a Target met Wrong patient, site, procedures P Monitoring required r Action required Major factors impacting performance ◗ ◗ ◗ INDICATOR Some variations may arise in response to changes in reporting requirements and practices. Notifications may be increasing in the short term, and strategies are being implemented to mitigate incidents. The baseline for the target calculation was set prior to the implementation of the Incident Information Management System (IIMS) in May 2005, and subsequent increased reporting of clinical incidents. Increased awareness, anecdotally, of reporting incorrect patient and incorrect procedure incidents in radiology, radiation oncology and nuclear medicine. Baseline 2006-07 Target 2006-07 Result Avoidable hospital separations (age adjusted rate per 100,000 population) Vaccine preventable conditions (including measles, pertussis and influenza) Acute conditions (including dental, ENT, kidney infections) Chronic conditions (including angina, diabetes complications and COPD) 53 ▼ 47 a 904 ▼ 927 r 1,042 ▼ 997 a Aboriginal persons (no.) Non-Aboriginal persons (no.) 3,139 1,961 ▼ ▼ 3,324 1,915 a Mental Health acute adult readmission within 28 days to same facility (%) 11 <10 12 P Suspected suicides of patients in hospital, on leave, or within 7 days of contact with a mental health service (number) 04/05:16 05/06:20 ▼ 13 a 10 6.1 P P 13 r TOTAL Projects being undertaken to meet targets ◗ ◗ ◗ ◗ Quality improvement projects have commenced in the Central and Southern Hospital Networks. Audit of the Area’s right patient, right site, right procedure policy. In operating theatre suites, strategies include reinforcement and refining of patient identification and correct implant verification procedures, particularly during time out; process redesign to reduce the instances where mothers and babies are separated following caesarean section; review of processes for storing and accessing implants in theatres. In radiology, radiation oncology and nuclear medicine, service strategies include staff education in relation to NSW Health policies, review and reinforcement of consent procedures for interventional radiology procedures, clearer identification of different types of central lines in procedural list systems, and liaison with patient identification working parties. Low birth weight babies weighing less than 2,500g (%) Aboriginal babies (no.) Non-Aboriginal babies (no.) 9.4 5.7 Postnatal home visits Families receiving a Families NSW visit within 2 weeks of births (%) 9 ▼ >65 Strategic Direction 3 Strengthen primary health and other continuing care in the community A framework for the management of avoidable admissions has been established focussing on the use of ambulatory care settings and home based services to provide care to patients outside the acute care services. Criteria for identifying these patients and referring them directly to non-inpatient services and clinical guidelines for the management of patients in the ambulatory or community setting, have been established. Better Services – Healthier People r 11 Healthy People – Now and in the Future ◗ The Older Persons and Chronic Care Clinical Redesign Program has established an implementation plan which includes strategies for preventing avoidable admissions for older people and those with complex care needs. The slight increase in readmission rate from 2005 - 06 to 2006 - 07 is believed to be associated with the establishment of the Psychiatric Emergency Care Centres (PECCs) at St George and St Vincent’s Hospitals, and a subsequent change in the threshold for admissions to mental heath services. Indicator Postnatal home visits - Families receiving a Families NSW visit within two weeks of the birth (%) Major factors impacting performance ◗ SESIH will establish processes to look at decreasing hospital admissions and emergency department attendances for frequent attendees, establishing alternative models of care and support to enhance the management of these patients in community and ambulatory care services. ◗ SESIH will appoint an Area Director of Primary and Community Health to oversee the implementation of the recommendations of the Older Persons and Chronic Care Redesign Project. This will see a new model of care introduced for the management of these patients which will be aimed at providing seamless services across the continuum of care and supporting the management of these patients in the community. ◗ Indicator ◗ The data that is used to provide the performance figures are 12 months behind, and the Area has made improvements throughout the 2006 - 07 period. The availability of Early Bird groups and breastfeeding groups across many parts of SESIH has allowed families to access services soon after discharge, and then not see the need for a follow-on or home visit. This has increased the rate of decline for home visiting. The data excludes families who are offered a universal home visit, but who decline in favour of attending a clinic. Projects being undertaken to meet targets ◗ Avoidable hospital separations (age adjusted rate per 100,000 population) acute conditions and Aboriginal persons ◗ Major factors impacting performance ◗ ◗ The Area has continued to provide weekly chronic care Aboriginal health clinics at La Perouse, where a significant Aboriginal community resides. Diabetes and vascular care clinics are also held monthly. Review to determine how other Area Health Services are calculating the decline rates for home visiting and how that is being recorded and reported. Ensuring the offer of a home visit is provided in a non-biased manner and that this is reflected in work practices. To ensure adequate resources/equipment are available so the Child and Family Service has a home visit as a priority rather than clinic-based services. Establishment of protocols for clinical management. Consistency of management across the three hospital networks. Projects being undertaken to meet target: ◗ ◗ ◗ A framework for the management of avoidable hospital admissions has been established, focusing on the use of ambulatory care setting and home-based services to provide care to patients outside acute care services. Agreed Area-wide strategies have been signed off and incremental targets set. A monitoring and variance reporting schedule has been established. Better Services – Healthier People 12 Healthy People – Now and in the Future Performance Otitis Media Indicators for Strategic Direction 4 a Target met r Action required INDICATOR Otitis Media Screening Aboriginal children aged 0-6 years screened (%) P Monitoring required Baseline 2006-07 Target 2006-07 Result 68 85 86 SESIH has two Otitis Media Co-ordinators: one located in the Southern Network, and one based in Central and Northern Networks. These positions were established as part of the NSW Health Otitis Media Strategic Plan for Aboriginal Children (2000). a The role of the Otitis Media Co-ordinators is to facilitate co-ordination and implementation of the Strategic Plan, ensure the implementation of the Two Ways Together Otitis Media Screening Plan (2004 - 08), and to establish and develop partnerships with Aboriginal stakeholders and key agencies. Strategic Direction 4 Build regional and other partnerships for health Consumer participation There was a significant improvement in Otitis media screening rates in SESIH in 2006 - 07, with 86 percent of children in the target population being screened. This was a marked improvement on the rate of 68 percent in 2005 - 06. Since the introduction of Area Health Advisory Councils (AHACs) in 2005, the South Eastern Sydney Illawarra AHAC has been undertaking its responsibility to advise the Chief Executive on issues such as consumer and carer participation, health service planning and budgets, and workforce development. Indicators for Strategic Direction 5 a Target met The primary focus of the AHAC to date has been to ensure that a model for consumer participation, suitable for consumers, carers and the organisation, is implemented throughout the Area Health Service. INDICATOR Net cost of service – General Fund (General) variance against budget (%) Creditors > Benchmark as at the end of the year ($’000) Following an extensive process undertaken by the AHAC and the Area’s Consumer Participation Unit, the consumer participation structure chosen is consistent with the Area’s organisational and clinical management structures, and recognises the significant role that consumers have in the development and delivery of health services. Major and minor works – Variance against Budget Paper 4 total capital allocation (%) Baseline P Monitoring required 0.15 2006-07 Target $0 2006-07 Result -0.01 a $0 $0 $0 a 45.7 0 -5.1 a Strategic Direction 5 Make smart choices about the cost and benefits of health services Indicator The revised structure, which provides for the establishment of nine new Consumer Advisory Committees (CACs) across the Area, was chosen following consultation with existing consumer groups and Hospital Executives, and after an examination of a number of different models of consumer participation currently operating in other Area Health Services. Better Services – Healthier People r Action required Sound resource and financial management Objectives Use finite resources wisely During 2006 - 07 SESIH continued to allocate enhanced funding to provide improved clinical services across the Area Health Service. An additional $1 million provided for the added cost of high-cost and complex cancer drugs/treatment at Sydney Children’s Hospital, $1 million 13 Healthy People – Now and in the Future to establish four professorial chairs at Wollongong Hospital and $0.5 million additional funding for increased orthopaedic surgery at Sutherland Hospital. SESIH achieved all of its financial benchmarks for the year and completed a number of significant capital works within the available funding. In 2006 - 07 an additional 134 transitional aged care places were created across SESIH and the SAFTE pilot at St George Hospital was recognised as an efficient model of care for the elderly group which it targeted. This program has been approved to continue in 2007 - 08. The shift in funding to the southern section of SESIH was also evident with orthopaedic services being provided effectively at Shoalhaven District Memorial Hospital and the start of construction of new mental health facilities at Shellharbour and Wollongong Hospitals. Increase accountability of funding decisions Managerial budget performance and reporting processes were strengthened with the application of an Area-wide financial system PowerBudget that allows managers to review, at their desktops, their budget accountabilities. This ongoing monitoring of budgetary performance and the provision of appropriate clinical care within agreed benchmarks is a priority for managers and staff. Improve Information and Clinical Technology Systems This last year saw a major part of the activities focused on the amalgamation of systems from the former Illawarra, and the South Eastern Sydney Area Health services with the continuing rollout of the iSOFT iPM Patient Administration System (PAS) and its integration with other clinical systems including pathology, radiology, pharmacy and billing applications. This project was a massive undertaking by SESIH and now has more than 8,000 users benefiting. SESIH achieved its financial benchmarks of an on-budget NCoS result and achieved capital expenditure against its revised yearly targets. SESIH is implementing episode funding pricing signals into hospitals to ensure that services can be maintained against peer reference costs. The major future focus is the implementation of the State-wide Electronic Medical Records (eMR) System across SESIH. The eMR will provide common clinical systems across NSW Health for theatres, emergency departments, wards and outpatient clinics, and will allow patient records to be kept electronically so that each time a patient visits a hospital, the doctor can have electronic access to that patient’s medical history, results of past and current tests, and even radiology reports. Improve efficiency The amalgamation of the SESIH Corporate Services allowed for savings to be identified, and provided over $12 million to be redirected to improve clinical front line services. Additional nurses and doctors were funded to meet increased levels of surgical and medical demand. The improvement in corporate service delivery continues with desktop financial and employee information being available for managers to review and manage their staffing levels and budgets effectively. As part of this project, communication upgrades are being made in the northern and southern sectors to ensure data flows quickly and reliably. Mobile and wireless computers will also be a feature in the emergency departments and ICUs to ensure that the eMR is able to be viewed at the patient’s bedside. Logistic services for the supply of clinical goods across the Area was strengthened and improved by consolidating to one Area warehouse facility. Shift the balance of investment Demand for services within hospitals is ever increasing, as the population grows and the age of the population increases. Internationally and within Australia these trends require changes in the way services are delivered with community-based models of care being developed. Better Services – Healthier People 14 Healthy People – Now and in the Future Performance Indicators for Strategic Direction 6 a Target met r Action required Baseline 2006-07 Target 2006-07 Result Staff turnover permanent staff separation rate (%) 15.9 6 N/A Workplace injuries (%) 6.1 5.3 N/A Sick leave – annual average per FTE (hour) (quarters 1 and 2 only) 30.4 29.4 31.3 INDICATOR Strategic Direction 7 P Monitoring required Be ready for new risks and opportunities The Area Health Service has established a New Interventions Committee to assess the clinical appropriateness of new interventions, products and services. Together with the Area Clinical Council, this provides a forum for SESIH to take advantage of new opportunities and to ensure that this is done in a controlled and open environment. r A quality framework has been established for Medical Imaging in the Central and Southern Hospital Networks as a process of managing quality and embedding NSW Health’s Correct Site, Correct Procedure, Correct Patient policy directive. Strategic Direction 6 Build a sustainable health work force Indicator Sick leave – annual average per FTE (hours) SESIH has enhanced and realigned resources provided to critical response (disaster management) services across the Area, and the Area risk review now includes emergency management to manage the recovery of critical infrastructure resources. Major factors impacting performance ◗ ◗ ◗ Limited reporting tools available to monitor sick leave by professional and network groupings. Consistency and varied ongoing management of sick leave across the hospital networks. Early winter season with flow-on of increased sick leave. In 2006 - 07, the Area recruited a Counter Disaster Development Co-ordinator to support the development of an Area training strategy for critical response management. Actions being taken to meet target ◗ ◗ ◗ Clinical Streams are required to report against agreed clinical indicators to facilitate Area-wide benchmarking and performance management and to facilitate service changes to support equity of outcomes. Enhance reporting to allow for data reporting by professional and network groupings. Review and re-enforcement of SESIH Sick Leave Policy. Monthly review of sick leave data at Executive and Network level and reduction strategies identified to meet target. Continuing refinement of clinical processes associated with the community mental health teams should improve the capacity of these teams to provide appropriate alternatives to readmission in some cases. Incident and complaint reporting support identification of clinical risks and ‘near miss’ incidents. For example, advice in relation to inappropriate storage of concentrated IV potassium replacement therapies at a particular site resulted in an Area-wide working party to develop guidelines for safe practice in relation to potassium replacement. Better Services – Healthier People 15 Healthy People – Now and in the Future Build a sustainable health workforce Strategic Direction Build a sustainable health workforce Director Workforce Development, Tony Farley ◗ Reduce staff turnover in line with industry best practice ◗ ◗ ◗ ◗ Planned initiatives for 2007 - 08 Highlights for 2006 - 07 KPIs Reduce the incidence of workplace injuries ◗ ◗ ◗ Enhanced employee related reporting deployed Develop turnover reporting Reduction of staff turnover Reduction in frequency of injury claims Reduction in workplace injuries (categories with the most frequent notifications) by 2.7% 49% reduction of compensable claims by fund year ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ Reduce the number of paid sick leave hours taken per year by full time employees by 5% each year until 2009 ◗ ◗ ◗ Enhance reporting developed. Data reporting by professional and network groups Provision of turnover reports to Executive and Networks Review of sick leave policy ◗ ◗ ◗ ◗ ◗ Increase the proportion and distribution of clinical staff in order to meet the demand for services ◗ ◗ ◗ Strategies identified in Draft Workforce Plan to increase the proportion and distribution of clinical staff Introduction of Network Visiting Medical Officer appointments Implementation of the Clinical Stream structure across Health Service ◗ ◗ Increase the proportion and distribution of Aboriginal staff in order to meet the demand for services ◗ ◗ ◗ Development of the new Aboriginal Employment Strategy (AES) for SESIH 2007-2010 Development of the National Aboriginal Health Worker (AHW) Competencies Development of the Aboriginal Workforce Survey ◗ Better Services – Healthier People 16 Healthy People – Now and in the Future Benchmarking with other Area Health Services Deliver enhanced turnover reporting Maintain staff turnover reduction Benchmarking with other Area Health Services Enhance incident identification/ notification reporting Maintain/reduce compensable claims Deliver enhanced reporting by professional and network groupings Provision of enhanced reports to Executive and Networks Deliver reviewed sick leave policy and reenforcement of sick leave policy Finalise and implement the Area Workforce Plan Finalise all Network Visiting Medical Officer appointments Finalise implementation of the Clinical Stream structure across Health Service Implementation of AES with support by the Aboriginal Employment Steering Committee (Chaired by Manager Workforce Services) focusing on the four key objectives: 1. Recruitment 2. Retention and career development 3. Developing nonAboriginal Stakeholder Capabilities 4. Working in partnership with external Aboriginal and non-Aboriginal stakeholders Developing and implementing recognition of prior learning (RPL) assessment process in line with the AQF. The RPL process will enable AHWs to have their skills and knowledge assessed against the competency standards prior to undertaking nationally recognised training (at the appropriate qualification level) Implement Workforce Survey to all Areas within SESIH to capture the correct data for Aboriginal workforce. The survey will focus on: 1. Demographics 2. Education and training 3. Workforce Performance Performance SESIH clinical governance structures have incorporated: Corporate Governance ◗ The Chief Executive of SESIH carries out the functions, responsibilities and obligations in accordance with the Health Services Act, 1997 and is committed to better practices as outlined in the Guide on Corporate Governance Compendium, issued by NSW Health. ◗ ◗ The Chief Executive has practices in place to ensure the primary governing responsibilities of the South Eastern Sydney and Illawarra Area Health Service are fulfilled in respect to: ◗ ◗ ◗ ◗ ◗ ◗ ◗ SESIH successfully implemented the NSW Patient Safety and Clinical Quality Program requirements in 2005 - 06 and continues to utilise the framework provided by this statewide program to maintain effective clinical governance across the Area. Setting strategic direction Ensuring compliance with statutory requirements Monitoring performance of the Health Service Monitoring the quality of health services Industrial relations/workforce development Monitoring clinical, consumer and community participation, and Ensuring ethical practice. Managing clinical incidents and complaints Systems are in place at facility, network and Area Health Service levels to monitor and manage the reporting of clinical incidents and complaints, utilising the Incident Information and Management System (IIMS). During 2006 - 07, a total of 17,134 incidents were notified across SESIH using IIMS. This represents an average of 1,428 incident notifications per month. The IIMS incident notifications are responded to at all levels in the organisation, from front-line clinical managers through to senior managers. Key improvement areas consistent with the national and international data relating to clinical risk, have been identified through analysis of IIMS data (for example inpatient falls, medication errors, hospital acquired infections, transfer of care). SESIH has worked with the Clinical Excellence Commission, NSW Health Quality and Safety Branch and other Area Health Services to develop strategies in response to these identified clinical risk areas. Clinical Governance and Quality Clinical governance, in its broadest sense, provides a framework through which all clinicians and health service managers share accountability for patient safety and clinical quality. Elements of effective clinical governance include: ◗ ◗ ◗ Ensuring the availability of explicit standards and performance expectations through performance and operational systems. Corporate and individual responsibility for assessing, achieving and maintaining a high level of competence to ensure the safe and effective delivery of health care. Ensuring that patient safety and clinical quality are focal areas for health service management and are identified as key priority areas for executive performance management. Strong and effective partnerships SESIH contributes to a range of statewide initiatives to improve patient safety and clinical quality. In 2006 - 07, this involved participation in working groups convened by the Clinical Excellence Commission or NSW Health Quality and Safety Branch that addressed patient safety risks in the areas of incorrect procedures in radiology, medication safety, management of the deteriorating patient falls prevention program and hospital acquired infection prevention. Close collaboration with other Area Health Services has enabled sharing of effective initiatives. Within SESIH, clinicians and managers are responsible for the quality of health care delivered within our facilities. Clinicians have a responsibility for the quality and safety of the care they provide, and for contributing to the Area Health Service’s broader clinical governance functions, a role endorsed by the NSW Medical Board in its Code of Professional Conduct (July 2005). Better Services – Healthier People Strong and effective partnerships between clinicians and managers. Clear lines of accountability for clinical care communicated across the organisation. Effective mechanisms for feedback and sharing lessons learned. 17 Healthy People – Now and in the Future Establishing clear lines of accountability Blood Watch Blood Watch is a statewide transfusion medicine improvement program with the primary goal of improving the safety and quality of fresh blood product transfusion in NSW public hospitals. In line with the implementation of the Clinical Services Plan (2005) SESIH has appointed senior medical clinicians to the positions of Clinical Stream Directors. These senior clinical leaders form the Area Health Service’s Clinical Council and are involved in key decisions involving clinical service planning, delivery and evaluation. A key component of their role is ensuring patient safety and improving clinical quality. The Clinical Governance Unit works with the Clinical Stream Directors to ensure appropriate and effective auditing of clinical care, to improve the quality of clinical data needed to support clinical management and decision-making. SESIH has established a Blood and Blood Products Committee, which is responsible for the six key areas of the Blood Watch program, including appropriateness of therapy; reporting of adverse transfusion related events; accurate costing and ongoing education and training. Implementation of the NIMC SESIH successfully implemented the National Inpatient Medication Chart across all its facilities in 2006 - 07 achieving 100 percent compliance with the implementation target. Working with patients and families SESIH is committed to the principles of open disclosure and has incorporated the principles into incident and complaints management policies and procedures across the Area Health Service. Openness and transparency in communication with patients and families following a complaint or adverse event builds trust and is the ethical thing to do. Training for all staff in the process of open disclosure has commenced. Implementing clinical practice improvement initiatives In 2006 - 07, SESIH implemented a number of statewide practice improvement initiatives. These included: Falls Injury Prevention SESIH has targeted strategies to reduce the incidence of falls in the community, in residential care and in acute and sub-acute inpatient facilities. A Falls Injury Prevention Plan 2007 - 2012 has been developed and is being implemented across all facilities, and in partnership with general practitioners, residential aged care facilities and community based organisations across the Area Health Service. Better Services – Healthier People 18 Healthy People – Now and in the Future Performance Progress in developing health service five year Strategic Plans, Health Care Service Plans, including Key Milestones for implementation National Commonwealth policy drivers including Council of Australian Governments (COAG) State Network Area Stream Driving State Policy State Plan Health Futures Planning Related strategies, eg. Illawarra Regional Strategy State Health Plan SESIH Strategic Plan: Towards 2010 SESIH Clinical Services Strategic Plan Network Health Services Plan ◗ NHN ◗ CHN ◗ SHN Area Enabling Plans ◗ Workforce ◗ Asset ◗ IM&T ◗ Risk Management ◗ Research & Teaching Better Services – Healthier People 19 Healthy People – Now and in the Future Clinical Stream Plans Key Milestones for implementation Future directions The key strategies that will guide the Area in achieving its outcomes in these priority areas include: The SESIH Clinical Services Strategic Plan 2006 - 09 (CSSP) is utilised as the basis for further planning by the hospital networks and all clinical streams. To date, all three hospital networks have progressed network plans with anticipated completion by the end of December 2007. ◗ In 2006 - 07 this strategy led to the creation of the three hospital networks (Northern, Central and Southern) aligned with 12 specialty-based clinical streams. The networks have assisted in the implementation of shared on-call rosters, individual clinician appointments and training rotations. It is expected that these processes will be extended in the coming year. The Area Enabling Plans encompass: risk management; asset; information management and technology; research and teaching and workforce. With the release of the Area’s CSSP, planning in these areas commenced in 2007. Planning in the Clinical Streams has been led by the Area Clinical Stream Directors in partnership with the Hospital Network Managers and the Area Executive, using the CSSP as the framework and starting point. The planning has engaged key staff across the whole Area with stream directors expected to report on progress at the end of each financial year. ◗ The key priorities for SESIH include addressing: Clinical specialties Mental Health Cancer Aged Care Heart and Circulation Neurology Renal Dialysis Trauma ◗ Obesity Smoking Biopreparedness Equity ◗ ◗ ◗ ◗ Build external partnerships. Many health improvements are achieved, not because of health service intervention but because of social or welfare support. By linking with other government departments such as housing, community services, childcare services and local government, SESIH has fostered further development of the Families NSW initiative as well as Housing for Mental Health, ensuring a whole of government approach. Population Health ◗ ◗ ◗ Enhance access and care with co-ordinated patient journeys. Developments include the establishment of the Rural Health Directorate in the Shoalhaven to address issues unique to rural communities as well as the commencement of a major initiative to investigate the needs, services and gaps in the provision of services to older people and those with a chronic illness. These projects focus on the enhancement of co-ordination of care to improve the patient experience and reduce service duplication and wastage. Key priorities and directions ◗ ◗ ◗ ◗ ◗ ◗ ◗ Clinician-led Area-wide departments to create integrated services delivered from Sydney Harbour to North Durras. 3 ◗ Aboriginal Health Shoalhaven / Shellharbour / Inner City people Wollongong Hospital Transport Significant headway has been achieved in the development of an Area Workforce Plan, an Asset Strategic Plan and Operating Theatre Utilisation Review. The completion of these plans is anticipated in 2007 - 08. Improved Capacity ◗ Ambulatory Care ◗ Elective Surgery ◗ Emergency Departments Better Services – Healthier People Develop new strategies that build upon the Area Clinical Services Strategic Plan. 20 Healthy People – Now and in the Future South Eastern Sydney and Illawarra Area Health Service 3 Health Services 3 SECTION Health Services Health facilities PRINCIPAL REFERRAL FACILITIES SUB ACUTE FACILITIES MAJOR DISTRICT FACILITIES Prince of Wales Hospital and Community Health Services Barker Street Randwick NSW 2031 T. 02 9382 2222 F. 02 9382 2033 Calvary Health Care Sydney 91-101 Rocky Point Road Kogarah NSW 2217 T. 02 9553 3111 F. 02 9587 1421 Shellharbour Hospital Madigan Boulevard Shellharbour NSW 2529 T. 02 4295 2500 F. 02 4295 2497 Coledale District Hospital Lawrence Hargrave Drive Coledale NSW 2515 T. 02 4267 2266 F. 02 4267 3628 Shoalhaven District Memorial Hospital Shoalhaven Street Nowra NSW 2541 T. 02 4421 3111 F. 02 4421 4967 The St George Hospital and Community Health Services Gray Street Kogarah NSW 2217 T. 02 9113 1111 F. 02 9113 3960 St Vincent's Hospital Victoria Street Darlinghurst NSW 2010 T. 02 8382 1111 F. 02 8382 2494 Wollongong Hospital Loftus Street Wollongong NSW 2500 T. 02 4222 5000 F. 02 4253 4600 SPECIALISED REFERRAL FACILITIES Royal Hospital for Women Barker Street Randwick NSW 2031 T. 02 9382 6111 F. 02 9382 6513 Sydney Children's Hospital and Community Child Health Services High Street Randwick NSW 2031 T. 02 9382 1111 F. 02 9382 1451 David Berry Hospital Tannery Road Berry NSW 2535 T. 02 4464 1001 F. 02 4464 1716 Garrawarra Centre Princes Highway Waterfall NSW 2233 T. 02 9548 4700 F. 02 9520 7133 Kiama Hospital and Community Health Service Bonaire Street Kiama NSW 2533 T. 02 4233 1033 F. 02 4233 1005 Port Kembla Hospital Cowper Street Port Kembla NSW 2505 T. 02 4223 8000 F. 02 4223 8025 War Memorial Hospital, Waverley 125 Birrell Street Waverley NSW 2024 T. 02 9369 0100 F. 02 9387 7018 Sydney Hospital and Sydney Eye Hospital Macquarie Street Sydney NSW 2000 T. 02 9382 7111 F. 02 9382 7320 Better Services – Healthier People 21 The Sutherland Hospital and Community Health Services 430 The Kingsway Caringbah NSW 2229 T. 02 9540 7111 F. 02 9540 7197 DISTRICT FACILITIES Bulli District Hospital Hospital Road Bulli NSW 2516 T. 02 4284 4344 F. 02 4283 0688 Gower Wilson Memorial Hospital Lagoon Road Lord Howe Island NSW 2898 T. 02 6563 2000 F. 02 6563 2240 Milton Ulladulla Hospital Princes Highway Ulladulla 2539 T. 02 4455 1333 F. 02 4253 4630 Eastern Sydney Scarba Service and Early Intervention Program 24a Ocean Street Bondi NSW 2026 T. 02 9365 7999 F. 02 9365 7937 Healthy People – Now and in the Future SESIH facility activity levels Separation FACILITY paration Planned as % of total separation Same day as % of total separation Expenses Overnight Non-admitted Emergency Expenses Department (accrual (accrual basis acute bed patient attendances basis $000) $000) days services Daily Acute Acute average of bed bed days days inpatients Bulli District Hospital 3,845 2,112 2,453 52.20 5,800 15,839 16,807 8,043 Calvary Healthcare, Sydney 4,044 2,711 2,634 83.40 22 N/A 71,716 N/A N/A Coledale Hospital 324 40 N/A 26.20 8,136 5,800 4,291 N/A 6,559 David Berry Hospital 503 264 12 23.0 N/A N/A 2,194 N/A 5,885 80 10 6,733 121 673 3,634 Gower Wilson Hospital 21 0 0.10 12 16,083 Kiama Hospital 225 15 0 16.00 2,365 7,250 3,257 N/A Milton Ulladulla Hospital 2,756 319 887 22.30 53,979 2,353 45,454 12,015 8,586 Port Kembla Hospital 1,174 571 21 61.00 161,650 43,899 94,980 N/A 29,530 Prince of Wales Hospital 41,512 22,632 21,506 523.30 186,617 145,740 871,061 44,609 351,952 Royal Hospital for Women 14,799 2,576 3,527 148.30 42,307 50,561 101,054 N/A 68,370 N/A N/A N/A RHW closed Nov. 2005 N/A N/A N/A 1.00 2 365 Sacred Heart Hospice 1,019 1 27 56.6 128,386 N/A 34,164 N/A N/A Shellharbour Hospital 15,328 5,303 7,905 148.50 N/A 291 55,209 22,819 34,918 Shoalhaven Hospital 20,199 8,608 10,087 162.90 52,965 143,643 156,420 31,846 78,245 St George Hospital 54,077 26,433 24,381 546.90 80,122 162,259 870,904 53,707 296,311 St Vincent's Hospital 38,641 17,806 22,353 351.70 24,624 106,033 465,341 40,156 N/A The Sutherland Hospital 18,206 4,260 3,229 268.50 54,084 76,897 533,899 34,389 126,742 Sydney Children's Hospital 14,270 7,266 6,422 117.50 18,288 35,873 236,719 34,034 129,023 Sydney/Sydney Eye Hospital 10,425 4,282 5,326 67.50 365 19,301 417,626 37,051 67,251 War Memorial Hospital 550 30 4 32.50 166,701 80 46,062 N/A N/A Wollongong Hospital 41,431 15,744 19,000 443.80 294 45,061 322,417 47,782 231,580 Others TOTAL 358,126 283,349 120,973 986,787 3153.20 28,806 4,714,434 861,255 639,414 366,572 2,094,756 SESIH facility beds and bed equivalents AREA HEALTH SERVICE Dedicated overnight unit Dedicated same-day unit Other unit Total bed equivalents General Hospital unit Bulli District Hospital 50 6 0 55 55 Calvary Healthcare, Sydney 88 7 0 95 95 Coledale Hospital 24 0 0 24 24 David Berry Hospital 26 0 0 26 26 Garrawarra Centre 120 0 0 120 0 Gower Wilson Hospital 3 0 0 3 3 Kiama Hospital 120 0 0 20 20 Kiama Hospital Nursing Home 0 0 0 0 28 28 0 Milton Ulladulla Hospital 28 0 0 Port Kembla Hospital 68 0 0 68 68 Prince of Wales Hospital 473 47 0 520 520 Royal Hospital for Women 192 8 0 200 200 Sacred Heart Hospice 72 0 0 72 72 Shellharbour Hospital 143 10 0 153 153 Shoalhaven Hospital 151 34 0 185 185 St George Hospital 533 52 0 585 585 St Vincent's Hospital 293 35 0 327 327 The Sutherland Hospital 281 13 0 294 294 Sydney Children's Hospital 130 11 0 141 141 Sydney/Sydney Eye Hospital 70 7 0 77 77 War Memorial Hospital 35 0 0 35 35 Wollongong Hospital 414 41 0 454 454 SESIH 3,214 270 0 3,484 3,484 Nursing Home units 22 Total 120 120 *Beds in Emergency Departments, Delivery Suites, Operating Theatres and Recovery Rooms are excluded. Better Services – Healthier People Community Bed Residential equivalents Healthy People – Now and in the Future 150 3,634 P R I N C I PA L R E F E R R A L FA C I L I T I E S Prince of Wales Hospital and Community Health Services ◗ The hospital and community health service received four year accreditation from ACHS and achieved an above benchmark OH&S Numerical Profile score of 84 percent. ◗ The Aged Care refurbishment of a 58-bed inpatient unit with acute care and rehabilitation services was completed. ◗ In Cancer Services, a new linear accelerator was purchased to replace the old machine and an existing simulator was replaced with a CT scanner for improved oncology planning. ◗ The professorial suite was built for the newlyappointed Professor of Medicine. Prince of Wales Hospital (POWH) and Community Health Services are based on the Randwick Hospitals Campus along with Sydney Children’s Hospital, the Royal Hospital for Women and the Prince of Wales Private Hospital. It is part of the Northern Hospital Network of South Eastern Sydney Illawarra Health. A tertiary referral and teaching hospital, POWH has close relationships with The University of NSW (UNSW), The Black Dog Institute and the Prince of Wales Medical Research Institute. Other services housed within the Randwick Campus include the South Eastern Area Laboratory Service, the Kiloh and Euroa Mental Health Centres and the Eastern Heart Clinic. Key issues and events ◗ The integration of the hospital into the Northern Hospitals Network was commenced with the appointment of a Network General Manager and the establishment of Clinical Programs across the Prince of Wales and Sydney/Sydney Eye Hospitals. ◗ In 2006, the POWH Foundation held its first major fundraising event, Hollywood Nights, supported by ambassador Sam Neill and friends and many generous sponsors. More than $150,000 was raised. Areas of excellence include oncology, cardiac, renal transplant, neuroscience, subspecialty medicine and surgery, HIV/AIDS, aged care, emergency and intensive care, community health, and rehabilitation. Statewide referral services include HIV/AIDS, Lithotripsy, Spinal Medicine, Hyperbaric Medicine, Neurovascular Surgery and Interventional NeuroRadiology. Summary of business activity ◗ POWH admitted 41,787 patients in 2006 - 07, a three percent increase on the previous year. ◗ The Emergency Department treated 44,608 patients. ◗ 870,414 occasions of service were delivered to outpatients. ◗ A total of 43 percent of admissions were emergency or unplanned activity. ◗ There were around 2,500 full-time equivalent staff and the hospital has 577 beds. Future directions ◗ To continue to improve demand management and patient access, particularly with the opportunities of networked services with Sydney/Sydney Eye Hospitals and its role in General Medicine, non-complex elective surgery and statewide specialty services for Ophthalmology and Hand Surgery. ◗ To implement the Area Clinical Services Strategic Plan with the ongoing development of Area lead services for neurovascular services, spinal cord injury, complex epilepsy, renal transplants, and specialised cancer surgery ie, sarcoma and pancreatic-biliary cancers. ◗ To continue to focus on quality and patient safety, in particular fall reductions, adverse drug reactions, incorrect procedures or sites, health care associated infections and overall improved incident and complaint management. ◗ To replace the Hyperbaric Chamber, maintaining the service as the only public chamber in NSW. ◗ To continue to develop the research value of the campus working closely with key research partners. Major goals and outcomes ◗ Fewer emergency patients waited more than eight hours for a ward bed (from 28 to 21 percent of patients - target 20 percent), despite an eight percent growth in ED presentations. ◗ Triage times improved for category 3 and 4 patients waiting in the Emergency Department. ◗ No patients who were ready for care waited more than 12 months for their elective surgery. ◗ No urgent patients (category 1) waited more than 30 days for their elective surgery. Better Services – Healthier People 23 Healthy People – Now and in the Future P R I N C I PA L R E F E R R A L FA C I L I T I E S Wollongong Hospital Summary of business activity ◗ There were 42,557 admissions to the hospital this year. ◗ The average length of stay for the hospital was 3.8 days, compared with 5.7 days in 2005 - 06. ◗ The average occupancy of the facility was 103.7 percent. ◗ Medical outpatient services contributed to the 322,419 total non-admitted patient occasions of service. ◗ Staff (average actual) Full time equivalent (FTE) was 1,566 in 2006 - 07. Wollongong Hospital is the major or principal referral hospital within the Southern Hospitals Network. The hospital has 468 beds and provides Level 5/6 services in surgery, medicine, maternal and neo-natal care, paediatrics, intensive care, emergency and cancer care. The hospital has a catchment area of approximately 350,000 people. It is the major tertiary referral service for the Network which extends from Helensburgh in the north to North Durras in the south. Major goals and outcomes ◗ Wollongong Hospital achieved an OHSRWS Numerical Profile audit score of 72 percent compared to 68 percent in 2005 - 06. ◗ Construction commenced on an Older Persons Mental Health Unit at Wollongong Hospital, due for completion November 2007. ◗ Continue to improve all ED targets. ◗ Expansion of Cancer Care Service with recruitment of Palliative Care Consultant and Clinical Nurse Consultant at Wollongong Hospital. ◗ Review commenced for the establishment of an Emergency Medical Unit (EMU) ◗ Restructure of Patient Flow Unit to include an Emergency Department Navigator to improve patient access and flow. ◗ Recruitment of Cardiology CNC and implementation of Chest Pain Evaluation Area beds. ◗ Single point of contact for breast cancer patients from diagnosis to treatment. ◗ Additional Paediatric Surgeon appointed to increase paediatric surgical activity. Key issues and events ◗ Wollongong Hospital is preparing for ACHS Accreditation survey in September 2007. ◗ Wollongong Hospital submitted four Quality Projects and two Joint Quality Projects in the 2006 NSW Health Awards. Future directions ◗ SHN Falls Forum held in October 2007 with participants from across the Area attending. ◗ Renovation of medical ward B7. ◗ Construction of Psychiatric Emergency Care Centre (PECC). ◗ Planning underway for construction of Medical Assessment and Planning Unit (MAU). ◗ Development of paediatric day ambulatory care unit. Better Services – Healthier People 24 Healthy People – Now and in the Future P R I N C I PA L R E F E R R A L FA C I L I T I E S St Vincent’s Hospital St Vincent’s Hospital was established 150 years ago by the Sisters of Charity. It operated on the philosophy of providing health care to all those in need, on a nondenominational basis; a philosophy that continues to guide the Hospital’s work today. ◗ Owned and operated by the Sisters of Charity, St Vincent’s Hospital is part of St Vincent’s and Mater Health Sydney (SV&MHS), which is the NSW arm of the Sisters of Charity Health Service. St Vincent’s Hospital is the recognised establishment of the affiliated health organisation operating within the South Eastern Sydney and Illawarra Area Health Service (SESIH). It operates under a Memorandum of Understanding between the Board of SV&MHS, SESIH and the NSW Minister for Health. St Vincent’s Hospital reports to SESIH for performance but not governance. ◗ ◗ Through a formal agreement, St Vincent’s Hospital manages Sacred Heart Hospice, also an Affiliated Health Organisation under the NSW Health Service Act. Summary of business activity ◗ St Vincent’s Hospital provides acute care services to both inpatients and outpatients. ◗ Specialty areas include; heart and lung transplantation, bone marrow transplantation, cardiology, cancer, HIV/AIDs care, respiratory medicine, mental health, and alcohol and drug services. ◗ The hospital also provides a comprehensive range of community health services, including mental health, drug and alcohol, diabetes, dementia care and generalist community health care. ◗ ◗ ◗ Major goals and outcomes ◗ The past year saw increased clinical activity. Increasing numbers of presentations to the Emergency Department placed pressure on access block, bed numbers and surgery times, however the introduction of new strategies helped to effectively manage demand. ◗ Under SESIH’s Clinical Services Plan, St Vincent’s has been identified as continuing its role as a major teaching hospital and tertiary referral centre for adults and provider of selected statewide services. Under the Plan, the hospital will network certain services within the Area Health Service, such as renal transplantation, hand surgery and secondary level ENT surgery, while it will work towards a single cardiac surgery centre for SESIH. ◗ In October 2006, the hospital was awarded a further two years of accreditation from the Australian Council on Healthcare Standards. ◗ In the first half of 2007, the SV&MHS Board and Executive of St Vincent’s Hospital welcomed an independent funding Better Services – Healthier People ◗ review by Mr Bob Sendt, former NSW Auditor-General. The final report findings were given in May and the hospital, SESIH and NSW Health have been constructively working together regarding the best implementation of the recommendations. The review confirmed that St Vincent’s is a well-managed hospital, and made some constructive recommendations for improvements, and acknowledged increased activity over recent years. After many years of planning and fundraising, the hospital commenced a magnetic imaging resonance (MRI) service in April 2007, purchased with funds raised by the Sirens Group and other supporters. A PET/CT scanner was installed in Nuclear Medicine in early 2007, one of only four centres in Sydney to provide this type of service. A significant achievement was the planning and preparation of the re-development of the O’Brien building to house an integrated mental health, drug and alcohol and community health services facility. Project application approval was achieved in May 2007 and early works construction will commence late 2007. The Caritas site, which currently houses mental health services, was sold to help fund the project, which is also supported by government funding. Planning is also underway for a Garvan St Vincent’s Campus Cancer Centre incorporating cancer treatment and research. Implementation of robust electronic clinical information systems throughout the hospital will enhance and improve communication, patient outcomes and overall clinical care. Staff are committed to continuing the Mission of the Sisters of Charity. Many outreach programs are undertaken to provide care to people less fortunate. This year, as well as the hospital’s ongoing commitment to patients from the Solomon Islands, health care support has continued for the Asylum Seekers Centre in Surry Hills and planning is underway with Rotary Australia to support a health care clinic in East Timor. Celebrations to mark the Hospital’s Sesquicentenary and 150 years of the Sisters of Charity health ministry in Australia were held throughout 2007 beginning with a Liturgy in January. Other celebrations included an open day for the local community, historical display and mass. Sacred Heart ◗ Established by the Sisters of Charity in 1890, Sacred Heart Hospice is a 72 bed facility treating more than 800 palliative care and rehabilitation patients every year. ◗ A memorandum of understanding between the Hospice, SESIH and the NSW Minister for Health defines the role and funding of the Hospice within the NSW public health system. ◗ A major achievement for Sacred Heart Palliative Care was the establishment of an Academic Unit in Palliative Care. More than $3 million in funding was secured from a consortium of partners. 25 P R I N C I PA L R E F E R R A L FA C I L I T I E S St George Hospital and Community Health Services ◗ Enhancement of Cancer Care services at SGH continued with the replacement of one of the linear accelerators. ◗ Dr Yong Li was awarded a Cancer Institute NSW Early Career Development Fellowship of $543,189 for research using proteomic approaches to identify novel biomarkers in tear and serum to improve diagnosis and monitor progression in prostate cancer. ◗ Implementation of a fully integrated midwifery service across the St George and Sutherland Hospitals. ◗ The first group of 19 students graduated from stages one and two of the two-year Nursing Studies Program for Year 11 and 12 HSC students. St George Hospital and Community Health Service (SGH) is an accredited teaching hospital of the University of NSW. The hospital offers a comprehensive range of inpatient and community-based health services to more than 250,000 residents within southern Sydney. SGH is designated as a major trauma service for NSW. Summary of business activity ◗ Emergency Department (ED) access increased from 67 percent to 75 percent alongside an increase of 9 percent in patient presentations. The average length of stay for admitted patients in the ED decreased from 9.2 hrs to 7.4 hrs. ◗ Aged care episodes increased by 2 percent and rehabilitation episodes almost doubled. ◗ Increases in unplanned activity occurred in Psychiatry, Cardiothoracic Surgery, Respiratory Medicine, ENT, Oncology and Gastroenterology. ◗ The Long-Wait Strategy was implemented in 2005. This led to a reduction in the number of patients waiting for surgery more than 12 months from 435 in July 2005, to zero in June 2006. There were no patients waiting more than 12 months at the end of June 2007. ◗ The inpatient transfers to St George Hospital from other acute hospitals increased by 15 percent of which 41 percent was attributable to hospitals outside SESIH. ◗ The number of births increased by 94 from 2,382 in 2005 - 06 to 2,476 in 2006 - 07, an increase of 3.9 percent. Key issues and events ◗ A SGH midwife was named Johnson & Johnson ‘Midwife of the Year’ for NSW. This is the second year a midwife from the hospital has won this award. ◗ The Gastroenterology Department at St George Hospital secured two competitive NH&MRC Project grants with funding totalling $916,000 over the next three years. ◗ The Dean of Faculty of Medicine’s Research Initiative was awarded to Professor Beng Chong and others for the establishment of a centre of clinical excellence in thrombosis and bleeding disorders. ◗ Numerical profile result achieved - 70 percent. Future directions ◗ St George Hospital received $1.3 million for the implementation of a new “smart theatre” system to provide surgeons with enhanced image clarity and the ability to turn the operating theatre into a virtual classroom. ◗ Stage 5 of the SGH redevelopment has progressed with the first planning phase for construction of a new building to house an ambulatory care centre, medical suites and office space underway. ◗ Further development of the hospital as one of the designated trauma centres in NSW. ◗ Increased focus on meeting the needs of older persons and people with chronic diseases. ◗ The Central Hospital Network will undertake EQuIP Accreditation in 2007 - 08. Major goals and outcomes ◗ Implementation of the Central Hospital Network management structure commenced with recruitment to a number of key positions. ◗ St George Hospital’s Orthopaedic Research Institute received international recognition for their groundbreaking study into the healing of injured intervertebral discs using the Bone Morphogenic Protein-7 (BMP-7) molecule. ◗ Completion of the redevelopment of the Sterile Services Department following a $2 million enhancement. ◗ The Clinical Practice Improvement Unit won the Baxter NSW Health award for the ‘Reformation Project’, which involved a review and audit of all clinical forms. Better Services – Healthier People 26 Healthy People – Now and in the Future S P E C I A L I S E D R E F E R R A L FA C I L I T I E S Royal Hospital for Women Key issues and events ◗ Appointment of Professor William Walters AM as Executive Clinical Director and Dr Paul Garvey as Director of Clinical Services. In addition, the appointment of Dr Alec Welsh to the Chair of Maternal Fetal Medicine, associated with the University of NSW. ◗ In June 2007 the hospital hosted the NSW Health Department Forum on Caesarean Section, which was attended by more than 100 delegates from metropolitan and rural NSW. The Royal Hospital for Women (RHW) is the oldest women’s hospital in Australia and the only specialist women’s hospital in NSW. For more than a century the Royal Hospital for Women has provided care to women and critically ill babies from within South Eastern Sydney Illawarra Health Service and NSW. The services provided at this specialised referral hospital include breast care, gynaecology, gynaecological oncology, maternity, maternal fetal medicine, menopause, natural therapies research, newborn intensive care and reproductive medicine. Future directions ◗ Appointment of the Director of Obstetrics and Maternal Fetal Medicine. ◗ With the appointment of the Chair of Maternal Fetal Medicine there will be further developments in clinical service, education and research in this area. ◗ Replacement of some gynaecology surgical services from inpatient to outpatient activity. Summary of business activity ◗ Additional funding announced for a Level 3 cot from the State Government to further enhance neonatal services. ◗ Birth rates increased with estimated total births of 4,400 this year. Outpatient attendances increased by 10 percent overall, Gynaecology and Gynaecology Oncology activity remained steady. ◗ The demand for the MotherSafe service continued to grow significantly, this year it received more than 15,000 calls from women and health care practitioners. ◗ The ‘Problems in Early Pregnancy’ clinic was relocated and services extended. Major goals and outcomes ◗ The Wertheim Prize, an international Gynaecological Oncology Award was awarded to Professor Neville Hacker, the Director of the Gynaecological Oncology Department. ◗ Introduction of placental vascular laser occlusion in twin-to-twin transfusion syndrome, where one twin receives blood from the other twin, leading to potentially fatal complications for both unless the circulations are separated by laser occlusion of communicating blood vessels. ◗ Funding was provided to open the Malabar Community Midwifery Service, which has strong links to the Aboriginal Maternal and Infant Health Service run at the hospital. In addition, Midwifery Group Practice at Mascot was established. Better Services – Healthier People 27 Healthy People – Now and in the Future S P E C I A L I S E D R E F E R R A L FA C I L I T I E S Sydney Children’s Hospital and Community Child Health Services Major goals and outcomes ◗ Received the maximum four-year period of ACHS accreditation without any limitations. ◗ Successfully halved Ear Nose and Throat (ENT) outpatient waiting times from more than 12 months to six months or less. This was achieved through improved assessment of written referrals from clinicians as well as referring patients with district level problems from out of the catchment area back to their local community. These strategies will now be explored in other clinical services. ◗ SCH was formalised as lead agent for child and adolescent health in South Eastern Sydney Illawarra Health, with the appointment of Professor Les White to the position of Director of Child and Adolescent Clinical Stream. ◗ The Pain and Palliative Care Services combined to function as a single unit. ◗ New initiatives in Aboriginal health were established including: • an Aboriginal cord blood program with Royal Darwin Hospital, • the inaugural Aboriginal Child Health Forum run by Greater Eastern and Southern NSW Child Health Network, • new community based Aboriginal services. The Sydney Children’s Hospital (SCH) and Community Child Health Services has multi-level roles. These include serving the local community as a lead paediatric agency for South Eastern Sydney Illawarra Health and the Greater Eastern and Southern NSW Children Health Network (GESCHN), and at a state and national level in contributing to the direction of child health services. The hospital is an internationally recognised centre of excellence for child health with a full range of specialist services treating children from all over NSW and Australia with many conditions including cancer, trauma, HIV/AIDS, congenital abnormalities, heart disease and respiratory disorders. Summary of business activity ◗ In 2006 - 07, the overall hospital inpatient activity increased by 2.7 percent to a new peak total of 14,555. Non-admitted occasions of service for the year totalled 318,589, representing an overall increment of 10.2 percent. ◗ The Emergency Department’s busiest winter months peaked at 30 percent higher activity than last year. Despite this, SCH was the only metropolitan hospital to meet all emergency department benchmarks in NSW for the April-June period. ◗ While the cumulative full year impact in the Emergency Department is up by a more modest 7.4 percent to 34,026 presentations, this, in the context of annual trends over several years, signals important challenges for service delivery and planning processes. ◗ Bed occupancy rates averaged 92 percent for the year. The rate of 96.6 percent in December suggested that inpatient activity levels were higher than expected during the seasonal downturn. ◗ As of June 2007 there were no patients on the waiting list who have waited more than 12 months for admission, and no patients waiting longer than one month in the most urgent waiting list category. Better Services – Healthier People Key issues and events ◗ The Sydney Cord and Marrow Transplant Facility was officially opened by Governor-General of the Commonwealth of Australia, His Excellency Major General Michael Jeffery, AC, CVO, MC. ◗ A Virtual Tour for children going to theatre was launched on the SCH website. ◗ SCH celebrated the 10th anniversary of Clown Doctors in Australia. Future directions ◗ In 2007 - 08, SCH aims to address space restraints with the commencement of a new clinical services building. 28 Healthy People – Now and in the Future S P E C I A L I S E D R E F E R R A L FA C I L I T I E S Sydney Hospital and Sydney Eye Hospital Incorporating ADAHPT, Kirketon Road Centre, The Langton Centre, Lions NSW Eye Bank and Sydney Sexual Health Service. 29 Key issues and events ◗ The integration of the hospital into the Northern Hospitals Network was commenced with the appointment of a network General Manager and the establishment of Clinical Programs across the Prince of Wales and Sydney/Sydney Eye Hospitals. ◗ In April 2007, the Kirketon Road Centre (located in Kings Cross) celebrated 20 years of operation. The centre is involved in the prevention, treatment and care of HIV/AIDS and other sexually transmitted infections among at risk populations. Sydney Hospital and Sydney Eye Hospital (SH/SEH) in Macquarie Street Sydney, and is the oldest hospital in Australia. It incorporates the Kirketon Road Centre (KRC), Langton Centre and the Sydney Sexual Health Centre as well as the AIDS Dementia and HIV Psychiatry Team. SH/SEH has a close relationship with the University of Sydney and the University of NSW. Areas of excellence include ophthalmology, hand surgery, sexual health, HIV/AIDS and drug and alcohol. Future directions ◗ To fully establish the operations of the Clinical Programs across the POWH and S/SEH campuses for the Northern Network. ◗ To implement the Area Clinical Services Strategic Plan ie, enhance the General Medicine role of the hospital, increase capacity for the delivery of non-complex elective surgery and provide statewide specialty services in Ophthalmology and Hand Surgery. ◗ To continue to focus on quality and patient safety, in particular fall reductions, adverse drug reactions, incorrect procedures or sites, health care associated infections and overall improved incident and complaint management. ◗ To build the OH&S capacity of the hospital. ◗ To complete the Technical Sterilising Service Unit refurbishment early in 2008. ◗ To continue to develop the teaching and research partnerships of the Campus. Summary of business activity ◗ SH/SEH admitted 10,425 patients in 2006 - 07, a six percent increase on the previous year. ◗ The Emergency Department treated 18,429 patients. ◗ The Eye Emergency Department saw 18,619 attendances. ◗ Outpatients provided 417,520 occasions of service. ◗ There were around 500 full-time equivalent staff and 94 beds. Major goals and outcomes ◗ The hospital consistently achieved performance targets for improving patient access from Emergency Department to the wards and emergency triage times, while managing a four percent growth in patient activity. ◗ No patients who were ready for care waited more than 12 months for their elective surgery. ◗ No urgent patients (category 1) waited more than 30 days for their elective surgery. ◗ An ACHS Periodical Review was completed in April 2007 and the hospital received an excellent report with three recommendations that are achievable. ◗ The refurbishment of the Hand Outpatient Clinic and Therapy was completed. ◗ Construction of the Microsurgery Skill Laboratory commenced for the training of eye and hand staff. Better Services – Healthier People 29 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S Calvary Health Care Sydney Calvary Health Care Sydney (CHCS) is an Affiliated Health Organisation listed in Schedule 3 of the Health Services Act. CHCS is a service of the Little Company of Mary Health Care (LCMHC). ◗ ◗ ◗ It is one of 17 similar hospitals and aged and community services in Australia. LCMHC is Australia’s biggest palliative care provider. CHCS provides palliative care services to St George and Sutherland areas, and rehabilitation and geriatric services to the St George district. Major goals and outcomes ◗ With the continuing emphasis on patient services in the community setting, a $10.33 million redevelopment is planned for Ambulatory Care Services. ◗ The Transitional Aged Care Program was implemented and provides rehabilitation services to 26 patients in their homes. Without this support these patients would have required residential aged care placement. ◗ CHCS participated in the Clinical Redesign process for the Central Sector and have implemented the findings of the review to improve discharge planning and access to rehabilitation beds at CHCS for patients from acute hospitals. ◗ The NSW Artificial Limb Service continued to implement Quality Improvement projects to enhance services to amputees across the state. An example of this is the introduction of the Early Management Program which will see prostheses made by prosthetists for the first time during the acute postoperative phase of amputee rehabilitation. Summary of business activity Palliative Care Services ◗ Occupied bed days increased by 3.38 percent in the 43 palliative care beds ◗ A Community Palliative Service aimed at maintaining patients at home or in the inpatient nursing home provided 2,196 non-admitted occasions of service per month. ◗ Rural outreach is provided by specialised medical practitioners visiting the Central Coast. Telehealth supports this service. ◗ A Bereavement Counselling Service supported bereaved families and community members on 2,183 occasions of service. ◗ A Chronic Pain Clinic for outpatients provided 4,781 occasions of service. ◗ The Holistic Healing Centre provided 18,113 complementary therapies to the public. Key issues and events ◗ Continued ACHS accreditation. The organisation-wide assessment in November 2006 awarded the hospital four years accreditation. ◗ The hydrotherapy pool construction is planned to expand and enhance rehabilitation services. Calvary Rehabilitation and Geriatric Services (CRAGS) ◗ The number of funded beds increased during the year and there were 14,072 occupied bed days in 2006 - 07. An increase of 5.1 percent due to reduced length of stay (by 10.6 percent) resulting from the commencement of a day program. ◗ A Veterans Home Care Program operated for the Central Sector and provided assessments for services in the home. ◗ A nursing homes service to residents, funded by the Chronic Care Program, provided medical care for patients allowing them to remain in familiar surroundings and avoid transfer to hospital. ◗ A Driver Rehabilitation and Assessment Service was self-funded. ◗ Appliance services including managing the Artificial Limb Service for NSW, Program for Appliances for Disabled People (PADP) for the St George area, and paediatric PADP for the Northern and Central Sectors. Better Services – Healthier People The Repatriation Appliance Scheme and an Equipment Lending Pool operated from CRAGS. Day Respite Services were provided for adult patients with brain injury and for dementia clients. Podiatry Services were provided at the hospital and to people with a disability in the community. Non-admitted patient occasions of services increased by 5.1 percent. Future directions ◗ CHCS will continue its palliative care, rehabilitation and geriatric streams and work with the Area’s acute hospitals to improve patient access and relieve bed pressure in these facilities. ◗ A Day Rehabilitation Unit to accommodate an additional ten patients daily will be developed to facilitate early discharge. ◗ CHCS plans to build a Dementia Day Care Service on-site and extend the existing program. ◗ Transfer of NSW Artificial Limb Service, Home Oxygen Program and the Program of Appliances for Disabled Persons (PADP) to NSW Health Support in 2008. 30 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S Coledale District Hospital Summary of business activity ◗ There were 298 admissions to the hospital this year. ◗ The average length of stay for the hospital was 31.7 days, compared with 26.5 days in 2005 - 06. ◗ The average occupancy of the facility was 97.06 percent. ◗ Medical outpatient services contributed to the 3,874 total non-admitted patient occasions of service. ◗ Staff (average actual) full time equivalent (FTE) was 72 in 2006 - 07. Coledale Hospital provides inpatient rehabilitation services with 20 beds, as well as a Transitional Aged Care Unit, comprising 14 beds. Coledale decreased bed numbers from 38 to 34 beds in November 2006 following the closure of the nursing home beds. A range of multidisciplinary rehabilitation services are provided to people requiring rehabilitation from medical and surgical conditions. The 18 bed West Wing was a Commonwealth-funded, fully accredited, high-level residential care facility until it ceased in November 2006 when the Nursing Home licences were transferred to the Church of Christ, Nowra. Major goals and outcomes ◗ Coledale Hospital achieved an OHSRWS Numerical Profile audit score of 97 percent, compared to 90 percent in 2005 - 06. ◗ Move to full operation of the Transitional Acute Care Unit from April 2007. From April 2007 Coledale Hospital provided 14 places on the Transitional Aged Care Program (TACP) which is a jointly funded, collaborative program between NSW Health and the Australian Government that seeks to improve the transition of older people from hospital back to the community or to residential aged care. Key issues and events ◗ Improved security surveillance of site. ◗ Shorten average length of stay to NSW Health benchmark through re-admission avoidance and supportive discharge. ◗ Open Coledale inpatient places and promote service model and eligibility criteria to local GPs. The program is goal-oriented, time-limited and targets older people at the conclusion of an acute or subacute hospital episode who require more time and support in a non-hospital environment in order to complete their healing process, optimise their functional capacity and access their longer term care arrangements. Future directions ◗ Purchase replacement airconditioning equipment. Coledale Hospital also provides the Illawarra community with outpatient services. The rehabilitation physicians conduct specialised outpatient services from the site. A community Occupational Therapy service is also provided. Better Services – Healthier People 31 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S David Berry Hospital Key issues and events ◗ David Berry is preparing for ACHS Accreditation survey in September/October 2007. ◗ Installation of an appropriate security mesh/screen on the verandah of Karinya to improve safety and patient comfort. David Berry Hospital provides rehabilitation and palliative care services to the residents of the Shoalhaven. The Aged Care Assessment Team for the Shoalhaven and community palliative care services are also based at David Berry Hospital. Inpatient rehabilitation services are provided from the Rehabilitation Ward (17 beds) and inpatient palliative care services are provided from the Karinya Palliative Care Unit (nine beds). Future directions ◗ Continued improvement in access to the Palliative Care Specialist Service with the addition of a Palliative Care Registrar in January 2008. ◗ Focus on continued improvements in patient care with implementation of clinical supervision sessions for nursing staff. ◗ Ongoing maintenance program including repair of Karinya roof and replacement of internal ceilings and removal of roofing materials. ◗ Preparation underway for 2009 Hospital Centenary celebrations with support of local community. Summary of business activity ◗ There were 418 admissions to the hospital this year. ◗ The average length of stay for the hospital was 20.2 days, compared with 17 days in 2005 - 06. ◗ A total of 447 clients were seen by the Aged Care Assessment Team with an average wait time of 16.5 days. ◗ The average occupancy of the facility was 87.9 percent compared to 83.7 percent in 2005 - 06. ◗ Medical outpatient services contributed to the 2,196 total non-admitted patient occasions of service. ◗ Staff (average actual) Full time equivalent (FTE) was 61 in 2006 - 07. Major goals and outcomes ◗ David Berry Hospital achieved an OHSRWS Numerical Profile audit score of 97 percent compared to 92 percent in 2005 - 06. ◗ Appointment of a Palliative Care Staff Specialist. ◗ Development and implementation of Practice. ◗ Development Plan for Palliative Care Services. Better Services – Healthier People 32 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S Garrawarra Centre 29 Summary of business activity ◗ There were 52 admissions and 54 discharges. ◗ Bed occupancy for the 2006 - 07 year was 99.61 percent. ◗ FTE for 2005 - 06 is 184 compared to 185 in 2005 - 06. Garrawarra Centre is a purpose-built, dementiaspecific, residential aged-care facility, managed within the Central Hospital Network. The centre provides high-level, holistic care for dementia sufferers who exhibit challenging behaviours and require a safe and secure environment to be cared for and live in. Major goals and outcomes ◗ Self–directed learning packages based on policies, accreditation standards and best practice were developed for all staff, clinical and non-clinical. ◗ Installation of eight large umbrellas in cottage courtyards to provide sun protection for residents. ◗ Staff Education developed a program called CSI (Clinical Scene Investigation) that has been nominated for “Idea of the Year” through the Aged Care Channel. ◗ Completion of the water tower project. ◗ Refurbishment of the Garrawarra Function Centre. Garrawarra has a capacity of 120 beds with resident accommodation comprising four cottages, each housing 30 residents. Key issues and events ◗ The Aged Care Standards & Accreditation Agency accredited the Garrawarra Centre until May 2008. ◗ Three fire-fighting water tanks and two domestic water tanks were installed during 2006 - 07. ◗ New exercise garden being established with a golf putting green, walking path and a bus stop. Future directions ◗ Renovation of the cottages with a focus on appropriate interior design for dementia residents. ◗ Strengthening of links with the Central Network and provision of learning and networking opportunities for clinical staff. Better Services – Healthier People 33 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S Kiama Hospital and Community Health Service Summary of business activity ◗ There were 230 admissions to the hospital this year. ◗ The average length of stay for the hospital was 25.9 days, compared with 25.5 days in 2005 - 06. ◗ The average occupancy of the facility was 99.7 percent. ◗ Medical outpatient services contributed to the 2,695 total non-admitted patient occasions of service. ◗ Staff (average actual) full time equivalent (FTE) was 36 in 2006 - 07. Kiama Hospital and Community Health Service is an integrated health care model providing inpatient and outpatient services to the local community. The hospital has 20 beds, which are a combination of slow stream medical and nursing home respite beds. Major goals and outcomes ◗ Kiama Hospital achieved an OHSRWS Numerical Profile audit score of 83 percent compared to 85 percent in 2005 - 06. ◗ Improvement in fire safety in a number of areas within the hospital. Key issues and events ◗ Kiama Hospital is preparing for ACHS Accreditation survey in September/October 2007. Future directions ◗ Upgrade several areas to improve environmental conditions and safety for patients. Better Services – Healthier People 34 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S Port Kembla District Hospital Summary of business activity ◗ There were 1,168 inpatient admissions this year. ◗ The average length of stay was 19.2 days, compared with 25 days in 2005 - 06. ◗ The average occupancy of the facility was 91.8 percent. ◗ Medical outpatient services contributed to the 90,214 total non-admitted patient occasions of service. ◗ Staff (average actual) full time equivalent (FTE) was 260 in 2006 - 07. Port Kembla District Hospital is a multi-service facility of the Southern Hospitals Network. Services consist of rehabilitation, aged care services, palliative care and drug and alcohol services. These are provided on an inpatient, outpatient and community basis. Port Kembla Hospital provides a comprehensive range of rehabilitation services at Level 5/6 (excluding acute spinal rehabilitation) as well as palliative care. Inpatient rehabilitation services are provided from 42 beds. There are 15 palliative care beds provided on the first floor of the hospital. Orana Withdrawal Management Unit is a 10 bed inpatient alcohol withdrawal unit. Major goals and outcomes ◗ Port Kembla Hospital achieved an OHSRWS Numerical Profile audit score of 91 percent compared to 86 percent in 2005 - 06. The hospital also offers outpatient rehabilitation and allied health services, is the centre for the Aged Care Assessment Team and Placement Service, and the Community Rehabilitation Service. Key issues and events ◗ Port Kembla is preparing for ACHS Accreditation survey in September 2007. Also located on site is a childcare service (Hillview), Area Food Services, Dental, Community Mental Health, Interpreter Service and the First Step Program. Future directions ◗ Electricity and water upgrades to infrastructure. ◗ Repair of main roof to prevent water damage to wards. ◗ Relocation of the Illawarra Brain Injury Service (IBIS) on to the site in 2008. Better Services – Healthier People 35 Healthy People – Now and in the Future S U B A C U T E FA C I L I T I E S War Memorial Hospital, Waverley Summary of business activity ◗ The Rehabilitation Unit’s bed occupancy remained high in 2006 - 07 (92.94 percent) ◗ Referrals to and attendance at the outpatients clinics increased in comparison to previous years. ◗ Expenditure and income budgets were achieved. The War Memorial Hospital Board continued to supplement the capital and replacement projects significantly. War Memorial Hospital (WMH), Waverley is an affiliated public hospital under the governance of the Uniting Church in Australia (NSW) Synod. The WMH Board is now appointed by and reports to UnitingCare NSW.ACT – Sydney Region. The primary role of the hospital is aged rehabilitation and assessment services. It provides rehabilitation and non inpatient rehabilitation and podiatry services; dementia and frail aged day care services; an Aged Care Assessment Team as well as specialist clinics and health promotion activities. Services include dialysis, hydrotherapy, partner (spouse) accommodation [Elizabeth Hunter Lodge] and strong clinical links with both St Vincent’s Hospital and Prince of Wales Hospital. The War Memorial Hospital also accommodates the Health and Ageing Professorial Research Unit. The hospital is affiliated with the University of New South Wales. It supports students from this entity and other colleges and professional institutions in their training and pursuit of qualifications and careers. Major goals and outcomes ◗ Achieved 72 percent in the OH&S Numeric Profile. ◗ Ongoing review of referral patterns for the rehabilitation unit and outpatient services to ensure appropriate patients were being referred. ◗ Ongoing review, implementation and upgrade of information technology services. ◗ Ongoing review of manual handling, risk management activities and related policies. ◗ Ongoing development and review of key performance indicators and benchmarking targets using EQuIP, SNAP and local data systems. Key issues and events ◗ Ongoing planning by UnitingCare NSW.ACT. Sydney Region and War Memorial Hospital to develop an aged care campus. ◗ Completed planning for refurbishment of the Morgan Building. This will provide single access to all inpatient and outpatient services to one location. This will commence late 2007. ◗ Numerous health promotion programs were provided including: • Health education for stroke, Parkinson’s disease and rehabilitation patients. • Diabetes, speech, orthotic, continence and seating clinics to educate patients and their carers about the latest procedures and equipment available. ◗ The CEO retired after 26 years. This position was combined with the DON position and was successfully appointed in November 2006 as Site Manager/DON. Future directions ◗ Continue to explore opportunities to expand appropriate outpatient and ambulatory care services for War Memorial Hospital. ◗ Continued development of the aged care campus concept. Better Services – Healthier People 36 Healthy People – Now and in the Future M A J O R D I S T R I C T FA C I L I T I E S Shellharbour Hospital Summary of business activity ◗ There were 15,326 admissions this year. ◗ The average length of stay for the hospital was 3.5 days, compared with 4.8 days in 2005 - 06. ◗ The average occupancy of the facility was 98.8 percent. ◗ Medical outpatient services contributed to the 55.209 total non-admitted patient occasions of service. ◗ Staff (average actual) full time equivalent (FTE) was 273 in 2006 - 2007. Shellharbour Hospital provides district hospital services in emergency, surgical, medical, maternity postnatal and mental health. In addition, a satellite dialysis unit is provided for residents for the Shellharbour and Kiama region. The hospital has a lead role in gynaecology and laparoscopic surgery within the Southern Hospital Network. Shellharbour Hospital provides a range of services to meet the needs of the local communities and fulfils a role as a support hospital in the Southern Hospitals Network by accepting the transfer of patients from Wollongong Hospital who do not have complex care needs. Major goals and outcomes ◗ Shellharbour Hospital achieved an OHSRWS Numerical Profile audit score of 89 percent which was the same result in 2005 - 06. ◗ Construction commenced on the 20 bed secure nonacute Mental Health Inpatient Unit. ◗ Planning is well underway for the construction of the Mental Health Adolescent Mental Health Day Unit, due for completion in late 2008. Shellharbour also provides a range of outpatient services to the community including cardiac, renal, paediatric, diabetes and allied health services. Shellharbour Hospital also has a significant mental health role in the provision of acute mental health beds and non-acute care unit. Key issues and events ◗ Shellharbour is preparing for ACHS Accreditation survey in September 2007. Future directions ◗ Implement Cardiac Pathways project to enhance care of patients who present with chest pain. ◗ Improve medication safety for patients through an education program for staff and patients. ◗ Continue upgrade to the hospital environment to improve safety. Better Services – Healthier People 37 Healthy People – Now and in the Future M A J O R D I S T R I C T FA C I L I T I E S Shoalhaven District Memorial Hospital Summary of business activity ◗ There were 19,885 admissions this year. ◗ The average length of stay was 2.9 days, compared with 4.8 days in 2005 - 06. ◗ The average occupancy of the facility was 90.3 percent. ◗ Medical outpatient services contributed to the 156,420 total non-admitted patient occasions of service. ◗ Staff (average actual) full time equivalent (FTE) was 553.0 in 2006 - 07. Shoalhaven District Memorial Hospital provides services predominantly to residents of the Shoalhaven Local Government area in association with David Berry and Milton Ulladulla Hospitals. Shoalhaven District Memorial Hospital provides a range of services including emergency, surgical, elective orthopaedic and plastic surgery, medical, intensive care, obstetric, gynaecology, paediatric, neonatal care, rehabilitation and aged care. Major goals and outcomes ◗ Shoalhaven District Memorial Hospital achieved an OHSRWS Numerical Profile audit score of 84 percent compared to 53 percent in 2005 - 06. ◗ Implement the Shoalhaven After Hours GP Clinic to provide assistance and relief to the Emergency Department, pending certain access levels being attained. ◗ Recruitment of a Clinical Nurse Consultant for the Emergency Department and funding for the provision of specialised equipment to operate a stroke service out of Shoalhaven Hospital. ◗ Improvement in provision of orthopaedic services within the Shoalhaven. Outreach renal dialysis services are provided from Wollongong Hospital, and outreach oncology services are also provided at Shoalhaven, with strong links to the Illawarra Cancer Care Services and Illawarra Renal Services. Key issues and events ◗ Shoalhaven District Memorial Hospital is preparing for ACHS Accreditation survey in September 2007. Future directions ◗ Improve car parking by increasing capacity and upgrade of access to facilities. ◗ Full implementation of the stroke service. Better Services – Healthier People 38 Healthy People – Now and in the Future M A J O R D I S T R I C T FA C I L I T I E S The Sutherland Hospital and Community Health Service ◗ ◗ The Sutherland Hospital and Community Health Services is an associated teaching hospital of The University of NSW. The hospital offers extensive inpatient and community-based services to residents of the Sutherland Shire. ◗ ◗ Summary of business activity ◗ Emergency Department (ED) access increased from 76.3 percent to 87.5 percent alongside an increase of 11 percent in patient presentations. The average length of stay for admitted patients in ED decreased from 7 hrs to 5.9 hrs. ◗ A multi-disciplinary team worked to reduce the number of patients waiting for surgery more than 12 months from 122 at 30 June 2005 to zero at 30 June 2006, in line with NSW Health requirements. This figure has been maintained at 30 June 2007. ◗ Elective orthopaedic activity increased by 35 percent (+273 separations) in comparison to 2005 - 06 due to the elective joint surgery which was transferred from St George Hospital. Total elective procedures increased by 18.6 percent. ◗ The number of births increased from 1,037 in 2005 - 06 to 1,052 in 2006 - 07 an increase of 1.4 percent. ◗ Key issues and events ◗ Creation and recruitment to the Central Network Nursing Co-Director positions. ◗ Key staffing positions were recruited to: Director of Emergency and Department Director of Anaesthetics. ◗ Numerical profile result achieved - 93%. Future directions ◗ A purpose-built Satellite Renal Dialysis Unit is currently under construction with completion anticipated in January 2008. ◗ A 20-bed non-acute Mental Health Unit is under construction and due for completion in late 2008. ◗ Reconfiguration of the Killara Acute Ward is being planned to create a 17-bed Aged Care Acute Unit and a 10-bed Dementia Unit. ◗ The establishment of a 15-bed Geriatric Assessment Unit. ◗ The Central Hospital Network will undertake ACHS Accreditation in 2007 - 08. ◗ Development of a 112-bed private nursing home on the grounds of the Sutherland Hospital site. Major goals and outcomes ◗ Capital works projects continued with the commissioning of the $5 million Caringbah Community Health Centre. ◗ The Cannabis Clinic received a $1.1 million enhancement from the NSW Government guaranteeing its operation over the next four years. It currently provides counselling to 166 clients per annum. ◗ The Paediatric area and the Mental Health interview room in the ED were refurbished. ◗ The Fast Track model of care was successfully implemented in the ED. ◗ A new full-time Obstetrician Gynaecologist Staff Specialist was appointed. This position will provide supervision and on-going training to Junior Medical staff and clinical support for the ED. ◗ The maternity service was re-designed across the Central Hospital Network with Sutherland Hospital becoming a centre of excellence in low to moderate risk maternity care. Better Services – Healthier People Successful implementation of the Jonah Ward project. Clinical trials in the Oncology Clinic were introduced allowing easier access for Sutherland Shire patients to participate. A Clinical Psychologist was appointed to Cancer Services. A Falls Prevention Program was implemented across the organisation. A Pressure Relieving Program was implemented across the organisation. 39 Healthy People – Now and in the Future D I S T R I C T FA C I L I T I E S Bulli District Hospital Summary of business activity ◗ Bulli Hospital had a total of 3,826 admissions to the hospital this year compared to 4,241 in 2005 - 06. ◗ The average length of stay for the hospital was five days, compared with 9.9 days in 2005 - 06. ◗ The average occupancy of the facility was 97.8 percent. ◗ Outpatient services increased to 16,606 total nonadmitted patient occasions of service, up from 15,984 in 2005 - 06. ◗ Staff (average actual) full time equivalent (FTE) was 121 in 2006 - 07. Bulli Hospital is a 62 bed district hospital providing geriatric, medical, surgical and Level 1 emergency department services for the local community. Bulli Hospital provides the lead role in ophthalmology and ENT surgical services for the Network and continues to experience high demand for medical and geriatric services. Bulli has demonstrated significant reduction in surgical waiting lists. Major goals and outcomes ◗ Bulli Hospital achieved an OHSRWS Numerical Profile audit score of 75 percent, a significant improvement on 59 percent in 2005 - 06. ◗ The acute geriatric service at Bulli Hospital is a multidisciplinary team of clinicians dedicated to improving the care of older patients. ◗ The Emergency Department continued to provide a Level 1 service, 24 hours per day. ◗ A day-only Geriatric Outpatient Therapy Unit was established at the Hospital and provides a comprehensive and co-ordinated team approach to ongoing physical and social therapy with strong links to patients’ GPs. Key issues and events ◗ Bulli Hospital is preparing for the ACHS Accreditation survey in October 2007. Future directions ◗ Bulli Hospital continues to focus on improvements to patient care and service delivery including the development of leadership and management systems that reflect clinical and corporate governance. Better Services – Healthier People 40 Healthy People – Now and in the Future D I S T R I C T FA C I L I T I E S Gower Wilson Memorial Hospital Major goals and outcomes ◗ Implementation of computer network systems with remote links to AHS intranet, internet, which allow access to policies, recent clinical information and promotion of paperless communication system. ◗ Implementation of IIMS and staff training in reporting mechanisms for incidents, complaints and adverse events. ◗ Development and streamlining of regular staff meetings, OH&S practices including work place inspections, communication and reporting. ◗ Pharmaceutical Benefits Scheme on-line claiming and staff training for community pharmacy process. ◗ Individualised care plans for community clients. ◗ The adaptation of the community to a primary health care model rather than a medical model of care. ◗ The creation and promotion of a culture of ongoing quality improvement, including QI register and reporting. ◗ Successful community consultation with senior AHS management personnel. ◗ Implementation of a patient call system through remote system door chimes. Gower Wilson Memorial Hospital is a multi-purpose service based on Lord Howe Island which provides primary, aged, community and acute care services. Summary of business activity Primary Care ◗ Health promotion (eg. healthy eating/lifestyle, QUIT or Sunsmart programs, education/prevention programs on national health priority areas) ◗ Healthy Ageing program ◗ Antenatal/postnatal groups ◗ Children’s health ◗ Women’s health ◗ Men’s health ◗ Speech therapy ◗ Podiatry ◗ Physiotherapy ◗ Palliative care ◗ Family counselling ◗ Drug and Alcohol counselling ◗ General practice (ie. care provided by a general practitioner) ◗ Dental Care. Key issues and events ◗ Limited nursing resources affecting ability to provide respite care within Gower Wilson Memorial Hospital. ◗ Community pharmacy - SIGMA. ◗ Ongoing consultation with Lord Howe Island Board and community to ensure future directions of health care service meet needs of the island. Aged and Community Care ◗ One Community Aged Care Package ◗ Nil episodes of Respite Care for reporting period. Community Care ◗ Home and community care type services ◗ Respite care ◗ Community nursing (not included above) ◗ Community transport Future directions ◗ Aged care customer focus. ◗ Recruitment strategies to promote, attract and maintain a nursing casual pool. ◗ Handing over community pharmacy management to local General Practitioner to govern. ◗ Ongoing work to engage the Lord Howe Community in the improvement of health services on the island. ◗ Radio page systems (UHF), to be used on the island for duress calls. Such systems could be programmed with a preset button activation that would send a signal and immediately notify the police officer. Acute care ◗ Accident and emergency ◗ Medical ◗ Surgical ◗ Retrieval (Ambulance Service on island operated by GP and Nursing Staff) Better Services – Healthier People 41 Healthy People – Now and in the Future D I S T R I C T FA C I L I T I E S Milton Ulladalla Hospital Summary of business activity ◗ Milton Ulladulla Hospital experiences a large seasonal activity increase in summer, due to the region’s popularity as a tourist destination. ◗ There were 2,756 admissions to the hospital this year, a reduction on last year’s admissions of 2,907. ◗ The average length of stay for the hospital was three days. ◗ The average occupancy of the facility was 82.8 percent. ◗ Medical outpatient services contributed to the 41,202 total non-admitted patient occasions of service. ◗ Staff (average actual) full time equivalent (FTE) was 60 in 2006 - 07. Milton Ulladulla Hospital is a 25 bed, rural acute facility. Its main focus is to provide acute services to the local community by providing general medicine, minor surgical, low risk obstetric, emergency, ambulatory care and day centre services. An outreach oncology service operates on a regular basis. The hospital is staffed by Visiting Medical Officer General Practitioners. Major goals and outcomes ◗ Milton Ulladulla Hospital achieved an OHSRWS Numerical Profile audit score of 85 percent compared to 58 percent in 2005 - 2006. Key issues and events ◗ Milton Ulladulla Hospital is preparing for ACHS Accreditation survey in September 2007. Future directions ◗ Building refurbishment and clearing of site to start construction of Cancer Support building on site. Better Services – Healthier People 42 Healthy People – Now and in the Future Eastern Sydney Scarba Program Summary of business activity ◗ Scarba works with children 0-12 years, their families, Department of Community Services (DoCS) and other agencies to facilitate the development of positive parent-child relationships, to help children work through the effects of abuse and neglect, develop resilience and to implement strategies to provide ongoing support for these families. Scarba works with families where abuse, which is considered to be moderate to high, to children has occurred. This involves conducting groups and working with children and families individually, to identify and meet needs, develop strengths and nurture resilient children. Major goals and outcomes ◗ Consolidated a strength-based working model to build resilience in families and children 0-12 years including improving children’s academic achievements, strengthen the connection between children and carers, and advocate to improve systemic and co-ordinated responses to children. ◗ Linking children and parents to community organisations such as sporting associations and educational support. ◗ Improved parenting skills and awareness of their parental responsibilities. ◗ Continued interagency co-operation with DoCS via worker exchange program and quarterly managers meetings. Key issues and events ◗ Supported a playgroup for vulnerable and at risk toddlers and their parents in conjunction with EIP. ◗ Commenced an additional supported playgroup based on ‘Circle of Security’ framework. ◗ Parenting and self-care groups offered to parents and carers. ◗ Children’s groups provided to explore art, gardening and theatre, with an aim to increase children’s selfesteem, connections and sense of achievement. ◗ Provided eight parenting workshops to clients of the Scarba service and broader community to assist developing skills in how to manage bullying, first aid, safety in the home and child cardiac pulmonary resuscitation (CPR). Future directions ◗ Continue to run home-based therapeutic interventions and family support work to vulnerable and at risk children and families. ◗ Continue the supported playgroup, jointly with EIP, for vulnerable and at risk toddlers and their parents. ◗ Undertake a detailed evaluation of the Scarba program and the supported playgroups. ◗ Continue to provide ongoing parenting workshops. Better Services – Healthier People 43 Healthy People – Now and in the Future Early Intervention Program ◗ The Early Intervention Program (EIP), established by the Benevolent Society in 1988, has worked for almost 20 years with high risk families throughout the antenatal period, and the first three years of the child’s life. The parents referred to our service have generally experienced traumatic histories and come into parenting with limited emotional resources. Managed with support of grants and funds from private sources to: ◗ Run four terms of a mother’s art therapy group. ◗ Undertake an initiative to specifically engage the most marginalised women in the antenatal phase. ◗ Offer a men’s antenatal group, co-facilitated by a male worker from the mental health service. Referrals come from the community, but predominantly from the Royal Hospital for Women (RHW), and the program has become an integral part of the perinatal mental health care initiative at the RHW. Major goals and outcomes ◗ The EIP dedicates approximately half of its resources to individually visiting families at home, and also offers a range of integrated centre based groups. These include antenatal therapeutic support groups, infant massage (privately funded), and a mother-baby therapeutic group. Summary of business activity ◗ Maintained a high standard and quality of work with our individual families, working in the home as well as linking these families, where appropriate, into EIP or alternative community groups and resources. ◗ Provided consultation to services both within and outside the Benevolent Society and presented at a number of forums throughout the last 12 months. These include; the internationally recognised Marcee Society Conference (QLD), the Adolescent Service at Prince of Wales Hospital, the Parent Infant Foundation, the Institute of Psychiatry. ◗ Along with Eastern Sydney Scarba Services (ESSS), EIP has implemented an extensive evaluation process for all new clients. ◗ Facilitated, in conjunction with ESSS, a supported playgroup, which provides an opportunity for families to explore their attachment with their babies/children through the medium of play, and discussion. ◗ Successfully obtained Families NSW funding to facilitate a Circle of Security therapeutic group - an internationally recognised initiative for working effectively with high risk families. Better Services – Healthier People Group programs receive ongoing evaluation to establish their effectiveness. Some important results from this evaluation has indicated that an increase in reflective capacity is evident. This evaluation continues. Future directions ◗ Continue with high quality intervention for high risk, traumatised new parents, ◗ Continue to offer innovative group programs. ◗ Continue to administer and refine evaluation processes. ◗ Present work at the World Infant Mental Conference in Yokohama, Japan in 2008. ◗ Present to other professional forums where appropriate. 44 Healthy People – Now and in the Future Health services Other Health Services Major goals and outcomes Community Health Improve health and reduce health inequity ◗ Summary of business activity ◗ Community Health provides a range of communitybased prevention, early intervention, assessment and treatment services to maintain the health of individuals and communities. Major goals and outcomes ◗ Continued to provide a wide range of health maintenance, continuing care and hospital alternative services from more than 100 community health centres across the Area and in workplaces, schools and homes. ◗ Key issues and events ◗ As part of the Network management restructure Community Health Services are managed within each of the hospital networks. ◗ A review of all primary and community health services across the Area was undertaken in late 2006 - 07. Key Issues and events ◗ Develop resources to support the Aboriginal Population Health Scholarship and recruit new students to the program Future directions ◗ The implementation of the recommendations of the Older Persons and Chronic Care Clinical Redesign Project will present a significant challenge to primary and community health services across the Area in 2007 - 08. ◗ Details of individual primary and community health service’s achievements and future directions are included in the facility reports. ◗ An Area Director of Primary and Community Health will be appointed early in the new financial year to oversee implementation of the recommendations of this review. Improve effectiveness and integration ◗ Completed the Division of Population Health Strategic Directions Statement 2006 - 2010. This document will guide the organisational development of the Division by creating a framework for achieving health improvement for the SESIH community and through developing a shared vision for population health. ◗ An organisational culture project was conducted to help develop an effective and integrated Division of Population Health. This involved a literature review, manager interviews, a staff survey and workshops. As a result, conducting staff performance appraisals has become a priority, communication and information exchange is being strengthened and a cross-divisional infrastructure has been established. Division of Population Health Summary of business activity Population Health services and programs aim to improve the health status of the population. The focus is on health promotion, disease and injury prevention and health protection, with an emphasis on reducing health inequities between population groups. Future directions ◗ Strengthen epidemiological capacity of the Division. ◗ Continue to implement strategic directions and build on recommendations of the organisational culture and equity projects. The Division of Population Health comprises: HIV/AIDS and Related Programs, Multicultural Health, Public Health, Health Promotion, Women’s Health and Community Partnerships. The division also has responsibility for the Area Falls Prevention Policy co-ordination and General Practice liaison. Better Services – Healthier People A mid-term formative evaluation of the Aboriginal Population Health Scholarship Program was conducted and a series of recommendations made to improve the program. The program assists Aboriginal students financially and professionally through the undergraduate degree in Population Health at the University of Wollongong, while also providing work experience placements with a different Population Health service each semester. A Divisional Equity project was conducted to investigate the ways in which equity can be better integrated within the Division of Population Health. Recommendations included the establishment of a cross-divisional practitioners’ special interest group, development of an equity profile and a stronger focus on Aboriginal Health. 45 Healthy People – Now and in the Future 47 ◗ ◗ Strengthen the Division’s focus on, and support for, programs to improve Aboriginal health. Multicultural Health Service ◗ Summary of business activity The Multicultural Health Service (MHS) focuses on supporting health services to provide accessible and culturally appropriate services and programs across the continuum of care. Key functions include: implementation and monitoring of our Ethnic Affairs Priority Statement, diversity health in the workplace, community programs and supporting research to inform the development of culturally appropriate models of care. ◗ ◗ The Area Multicultural Health Service is complemented by hospital-based diversity health co-ordinators, health care interpreters and community-based multicultural health workers. It is also well-served by a number of designated multicultural health positions within SESIH services and clinical streams, including mental health, HIV/AIDS, women’s health, aged and extended care and health promotion. ◗ ◗ Major goals and outcomes ◗ Capacity building activities ◗ Expanded cultural diversity learning and development programs to enhance the capacity of managers and clinicians to effectively address issues of cultural diversity in health care using the Diversity Health Kit produced at Prince of Wales Hospital. The Diversity Health Leadership Program has been adapted to other sites in SESIH. ◗ Developed and implemented an Area-wide collaborative care model for refugees using GPs, health staff and settlement services. Refugees receive a comprehensive health assessment on arrival, full immunisation within 12 months of settlement and ongoing co-ordinated health care. ◗ Delivered culturally appropriate End of Life Care sessions across SESIH. Sessions include presentations from palliative care and representatives of relevant religions. ◗ Provided English classes – one hour per week onsite, for all employees speaking English as a second language. ◗ Continued to educate staff and community on diversity health issues to increase cultural awareness and ability to respond effectively. Better Services – Healthier People ◗ ◗ ◗ ◗ 46 Completed evaluation of multilingual information and health care interpreter services at the Royal Hospital for Women to improve co-ordination and efficiency of development and dissemination of resources and use of interpreters. Held 12 information sessions with a total of 64 newlyarrived refugees in Illawarra, outlining the Australian health system. A play called Fear and Shame was written to promote positive messages about mental health in the Macedonian community. An excerpt was performed at the Diversity Health Conference at St George Hospital. Developed 10 culturally diverse stories for the Heart Handbook for patients and the Cardiac Storyboard Handbook for clinicians at the Prince of Wales Hospital. The project aims to increase understanding of the patient experience and fosters dialogue between patients and staff. A Chinese Mental Health Program at St George Hospital and St Vincent’s Hospital examined attitudes and beliefs of people from mainland China regarding mental illness and mental health services. Researched the need for Holocaust awareness training for Sacred Heart Hospice with a view to producing a resource for Area Health Services. A pilot study was conducted to reduce the fears of families needing to place relatives in residential care. The pilot, Partners in Residential Care, demonstrated practical ways in which relatives and staff can cooperate to provide high quality, culturally appropriate care. Continued the Building Healthier Men - Multicultural Men’s Health Project. This shed-based project targets men who may suffer from mental health problems, are isolated, lack support networks and are poorly prepared for a life after traditional work. Culturally and Linguistically Diverse (CALD) Mother’s Art, Health and Wellness Project. This project targeted women with new babies and engaged with them through the medium of art in discussions around health and mothering issues. Some 80 women participated and a major arts exhibition resulted. Developed a snapshot of bilingual staff employed by the former South Eastern Area Health services, from 2004 - 06, to assist in decision-making around the best use of bilingual staff. Continued research projects, including culturally appropriate care for children, clinical care for refugee children, pain assessment for CALD patients and medication management for CALD elderly people. Healthy People – Now and in the Future Health services legislation; and education and advocacy among members of the public, health professionals and partner organisations including local government, divisions of general practice, area health service staff and other government agencies. Key issues and events ◗ Consolidated integration of multicultural health services across the Area taking into consideration the recommendations of the review of the Multicultural Health Service. ◗ Provided enhancement grants aimed at assisting staff to develop projects addressing EAPS standards and enable consolidation of work undertaken under previous grants. ◗ Organised a 2006 Diversity Health Conference, for 170 delegates across the Area Health Service attending a conference in the St George area to raise awareness on the challenges of providing appropriate health care to CALD communities. The Public Health Unit is comprised of the operational teams including Environmental Health, Infectious Diseases and Immunisation, Epidemiology and Research, and Cancer Control which are in turn supported by the administrative team. Staff are located at two sites, the Randwick Hospitals campus and the University of Wollongong campus. Major goals and outcomes Future directions ◗ Ensure performance against the Area’s Employee Assistance Program (EAPs) is on target with goals identified for health services. ◗ Develop a strategic plan for SESIH Multicultural Health. ◗ Develop a service plan to support health needs of refugees. ◗ Review of the Multicultural Health Research Plan (2002). ◗ Develop a service agreement with the two Health Care Interpreter Service providers covering SESIH. ◗ Develop an Area policy on the governance of the role of bilingual staff in the use of their language other than English skills in the workplace. ◗ Extend the Diversity Health Co-ordinators positions to the Southern Hospital Network. ◗ Develop the content for MHS intranet and internet pages, and launch in 2008. ◗ Implement recommendations of the Diversity Health Enhancement Grants Review. Infectious Diseases and Immunisation ◗ Co-ordinated and completed the public health investigation into a cluster of cases of acute hepatitis C among patients of one eastern suburbs general practice. ◗ Managed infectious diseases and environmental health investigations into the outbreaks of Legionnaires’ Disease associated with Circular Quay and with the St George district. ◗ Prepared the public health component of the SESIH Influenza Pandemic Plan and contribution to pandemic influenza policy development at state and national levels. ◗ Multidisciplinary investigation of an outbreak of locally acquired Ross River Virus infections among residents of Sydney’s southern suburbs. ◗ Provided key infectious diseases surveillance and epidemiology support to the Sexually Transmissible Diseases in Gay Men Action (STIGMA) group. ◗ Continued co-ordination of the NSW cruise ship health surveillance and environmental inspection program. ◗ Established and managed the high school-based Human Papilloma Virus (HPV) vaccination program. ◗ Continued management of the Year 7 high school program for vaccination against hepatitis B and chickenpox. ◗ Provided public health support to Illawarra primary care and secondary clinical services caring for newlyarrived refugees. Public Health Unit Summary of business activity The primary role of the Public Health Unit is one of health protection - to identify, prevent and minimise public health risks to the community, whether infectious, chemical or radiological, arising from other humans, from animals, or from the inanimate environment. This is undertaken through a series of intersecting measures: surveillance of health, disease, risk factors and behaviours; primary prevention at an individual level; enforcement of public health and tobacco control Better Services – Healthier People 47 Healthy People – Now and in the Future Environmental Health ◗ ◗ ◗ ◗ ◗ ◗ Future directions ◗ Increase emphasis on compliance with the latest provisions of the Smoke Free Environment Act which came into force in July 2007 and requires all enclosed premises to be totally smoke free. ◗ Public Health aspects of compliance with the smokefree workplace policy in SESIH facilities, in particular the legislated banning of smoking in all enclosed areas. ◗ Respond to the challenge of substantial increases in infectious syphilis in gay men. ◗ Need to mount the high school HPV vaccination program in years 7-10. ◗ Address growing demand for surveillance and public health response capacity due to an increasing range of infectious diseases, and outbreaks, of public health concern. ◗ Mount a comprehensive and co-ordinated public health response to the APEC Leaders' Week within an emergency management framework. ◗ Work closely with local government to increase its role and responsibility in relation to prevention of legionella infection from contaminated cooling towers. ◗ Further development of pandemic influenza planning and the need to determine sources of a workforce for public health response in the event of a pandemic. Investigated and responded to mercury contamination of the portable water supply in a sustainable system in a Sydney office building. Intensive monitoring of compliance with tobacco legislation, in particular Sales to Minors and Tobacco Advertising provisions of the Public Health Act and the Smoke Free Environment Act. Participated with Botany Bay City Council and other government departments to successfully establish a response to Botany groundwater contamination. Participated in a multi-agency response to hydrocarbon contamination of land at Millers Point from past use as a gasworks, and successful remediation plan. Successfully conducted environmental health surveys, including: • Unflued gas heaters in 41 Catholic primary schools. • Rainwater tanks in private premises providing drinking water to members of the public. • Skin penetration premises. Initiated and collaborated on immunisation research projects, including: • St George Hospital paediatric ward immunisation study. • Evaluation of the hepatitis B high school vaccination program. • Sydney Children’s Hospital study of opportunistic immunisation in the Emergency Department. Women’s Health and Community Partnerships Unit Key issues and events ◗ Public health preparedness and prevention for the APEC forum including the environmental health surveillance of key buildings in close collaboration with the Council of the City of Sydney. ◗ Achieved a superior level of immunisation uptake (92.4%) among children aged 12-14 months residing in the Area. ◗ Best poster award at the National Communicable Diseases Control Conference for a poster describing an outbreak of food poisoning caused by Clostridium perfringens. ◗ Publication in peer-review journals of a range of articles including: Preparing for the inevitable – an influenza pandemic; Epidemic infectious syphilis in inner Sydney – strengthening enhanced surveillance; Investing in capacity to meet the challenge of an influenza pandemic; Risk factors and seroprevalence of markers for hepatitis A, B and C in persons subject to homelessness in inner Sydney. Better Services – Healthier People Summary of business activity Programs within Area Women’s Health and Community Partnerships during 2006 - 07 collaborated with a wide range of health services, community organisations and non-government organisations. The aim being to improve the health and well-being of women, young people and people subject to homelessness. The unit continued to provide leadership and co-ordination for implementing health policy and programs that address inequities in health outcomes in relation to these groups. The Area Women’s Health (AWH) program areas include Early Parenting, Violence and Abuse Prevention, Health Equity and Community Initiatives and Well Women’s Health. The Youth Health Program developed initiatives to increase the capacity of SESIH to respond to the health needs of young people and improve their access to services. The Homelessness Health Program supported, monitored and advocated for the implementation of the SESIH Homelessness Health Strategic Plan 2004 - 09. 48 Healthy People – Now and in the Future Health services 50 ◗ Major goals and outcomes ◗ Active participation in statewide initiatives including shaping the NSW Women’s Health Strategic Plan and supporting the first NSW Women‘s Health Summit held in March. ◗ Continued consolidation of the Women’s Health team resulted in the transfer of Southern Hospital Network staff under a single strategic and operational management structure. ◗ Developed a vision statement in line with the State Health Plan and local strategic directions; Healthier Women: Healthier Communities. ◗ ◗ ◗ ◗ A training needs assessment of Early Parenting Educators informed the updating of session content. Established language specific playgroups at Arncliffe and Daceyville. Participated in the production of an antenatal DVD titled Your Health/Your Pregnancy. Completed Father Links Project Stage 1, evaluating male-led discussion groups within antenatal preparation for parenthood and commenced Father Links Project Stage two that seeks to work with Aboriginal fathers at La Perouse. Completed Young Parents Project Report. Health Equity and Community Initiatives Program Violence and Abuse (Adults) Prevention Program ◗ ◗ ◗ ◗ ◗ The Bilingual Community Education Program provided seven programs to 69 women. The programs were delivered in Spanish, Chinese and Macedonian and covered a range of topics relating to physical and mental health and well-being, migration, parenting and ageing. Botany Women’s Committee established a bank account and independently began to hold functions for residents. Committee members have worked on a garden beautification project and intend to enter the garden in the Botany Spring Garden Competition. More than 500 plants were donated by the Botanical Gardens to this project. The Botany Community Development Project Consultation Report was finalised and presented at the National Health Promotion Conference in Adelaide. An Arabic Quit Smoking Program for women was held and a report written and released. All participants made their homes and cars smoke free. The Women’s Hands Project, a community development activity within east Nowra, commenced and a steering group has been established. ◗ ◗ ◗ ◗ Well Women’s Health Program ◗ Early Parenting Program ◗ ◗ ◗ Some seven competency-based training programs for 96 educators were provided across SESIH. Training programs included group skills and Earlybird Program facilitation. The Earlybird Program Facilitators Training DVD was completed and distributed across NSW. This work was presented at two national conferences. In partnership with University of Technology of Sydney (UTS), the program provided group skills training and support to midwives participating in the Centering Pregnancy trial. Better Services – Healthier People South Eastern Sydney and Illawarra Area Health Service The SESIH Domestic Violence Policy Implementation Group continued to provide leadership across the Area and now has representation from the Southern Hospital Network. The November 2006 Domestic Violence Screening Snapshot revealed 100 percent participation of mandated services and a 74 percent client screening rate. A total of six percent of women identified as experiencing domestic violence. Completed and distributed the Services for Perpetrators of Domestic Violence pamphlet. Provided 15 training sessions on domestic violence and routine screening to 245 health staff. Facilitated three sites in St George Hospital (Alcohol and Other Drugs, and Antenatal) for a research project on the impact of routine screening for domestic violence, undertaken by University of New South Wales (UNSW). ◗ 49 Under the Well Women’s Health Program, 821 women attended the well women’s clinics, and 725 pap tests were taken across the hospital networks. Of these, 127 women (15 percent) had not been screened for four years or more and 43 (5 percent) had never been screened. A total of 146 women (18 percent) were referred to other health service providers as a result of their clinic visits with a further 51 women (6 percent) referred to their local GP as a result of their Pap Test report and recommendations requiring further management by their GP. A total of 633 women attended 58 presentations and groups within the community on topics related to preventative health screening, sexual and reproductive health. Healthy People – Now and in the Future 51 ◗ ◗ ◗ A total of 150 nursing staff attended training/education updates on topics related to well women’s health. The program collaborated with the College of Nursing to support women’s health nurse training. ◗ Future directions ◗ Collaborate with maternity and early childhood health nurses to build their capacity to address health inequities. ◗ Building partnerships for health is the primary focus of the Botany and East Nowra Community. ◗ Consolidate community development strategies within the Botany community development project. ◗ Continue to monitor cervical cancer screening rates and respond to under-screened groups. ◗ Improve data relating to people subject to homelessness accessing health services. ◗ Map youth health and service needs and evaluation of the UZ youth health project. ◗ Develop a well women’s clinic as part of Malabar Midwifery Link Service to enhance Aboriginal women’s access to sexual and reproductive health care. Homelessness Health ◗ ◗ ◗ ◗ Assisted clients of five inner city homelessness NGOs to gain improved access to flu vaccine. Represented SESIH on the NSW Partnership Against Homelessness interagency forums and contribution to the development of partnership initiatives. Promoted the Area’s Special Needs Dental Service, which increased access to services for homeless people. Participated in NSW Audit Office’s consultation on services for the homeless. Youth Health ◗ ◗ ◗ Co-ordinated the Better Futures Regional Working Group initiative: Youth Participation Workshop at Prince of Wales Campus (24 attendees). Represented SESIH on whole-of-government initiatives, including the Better Futures Regional Strategy. In partnership with community agencies delivered innovative youth health programs including the Up Zone Youth Clinic and the Kings Cross Youth at Risk Project to provide improved services for young people. Health Promotion Service Summary of business activity The Health Promotion Service strives to improve health and reduce health inequity among communities of South Eastern Sydney, Illawarra, Kiama and Shoalhaven. Underlying social, economic, physical and behavioural determinants of health are addressed through both population level and targeted approaches. Programs include: healthy weight, falls injury prevention amongst older adults, tobacco, and health equity and community initiatives. Key issues and events ◗ More than 500 women attended the inaugural NSW Women’s Health Summit held at Sydney Town Hall in March. ◗ The Macedonian women’s advisory committee hosted an information and awareness evening on breast and cervical screening for Macedonian women in the St George district. The information evening, attended by 47 women focused on the importance of regular screening for women of all ages. ◗ The Malabar Midwifery Link Service was opened at Malabar. The Aboriginal component of the service has enabled the delivery of an outreach midwifery, child health and paediatric clinic at the new La Perouse Community Health Centre ◗ A successful Healthy Ageing Expo was held in Cronulla. Better Services – Healthier People Co-ordinated an outdoor film event in Youth Week as part of the Kings Cross Youth at Risk Project Co-ordinated a youth participation workshop for SESIH staff. Major goals and outcomes Healthy weight ◗ Live Life Well @ School, a partnership project with the NSW Department of Education and Training and the Catholic Education Office, is working intensively with five schools in the Illawarra, Kiama and Shoalhaven on physical activity and nutrition. ◗ Continue to implement Healthy Eating and Active Play @ Playgroup which enhances the abilities of supported playgroups to support vulnerable families with children 0 - 5 years old by the provision of resources and staff training. 50 Healthy People – Now and in the Future Health services ◗ ◗ ◗ ◗ ◗ ◗ Childcare service advisors and staff at long day childcare services received training, quarterly newsletters and individual assistance with menu reviews. NRG @ OOSH (out of school hours care for children aged 5-12 years) extended to the Illawarra, Kiama and Shoalhaven with the Health Promotion Service providing program, menu reviews and workshops to 25 services and small grants to nine services. As an active member of the SESIH Lactation Group, Health Promotion supported implementation of the NSW Breastfeeding Policy. This year, Health Promotion worked with the Area Women's Health and Community Partnerships Unit, Families NSW and Child and Family Health services to produce and distribute a training DVD/video which encourages peer support for new parents, to child and family health nurses across NSW. Supported the NSW Health Fresh Tastes strategy to increase the availability of healthy food in school canteens. This year, 82 schools participated in network meetings, received individual advice about healthy menus and fundraising ideas. A quarterly newsletter was distributed to 150 schools. NSW Health healthykids and 'Go for 2 and 5' fruit and vegetable campaign messages were incorporated into projects and activities, including a childhood obesity forum; transition to school information sessions; and an electronic wellness program with 67 community health staff encouraged to review their healthy eating, physical activity and energy balance. ◗ ◗ ◗ ◗ Tobacco control ◗ Training was provided to childcare workers about environmental tobacco, and referral options provided. ◗ A pilot project encouraged Chinese-speaking GPs to routinely provide smoking cessation advice and provide free nicotine replacement therapy as appropriate to Chinese-speaking patients. Evaluation will determine the suitability of this project for further expansion. ◗ Participation in the Multilingual Quitline Service Advisory Committee has assisted in ensuring the service is appropriate to the needs of the Chinesespeaking community. ◗ Identified the need to target the Arabic-speaking community and determined suitable strategies to adopt. Falls injury prevention amongst older adults ◗ Worked closely with the Area Falls Prevention Co-ordinator to implement strategies for the community component of the Area Falls Prevention Plan. ◗ Gentle exercise and strength training classes continued to be the main focus for the provision of physical activity opportunities for community-living older people across the Area. In the St George and Sutherland areas, support was given to a community organisation known as SHARE to deliver 26 ongoing exercise classes for 364 older people each week. The annual Make a Move mass media recruitment strategy resulted in more than 240 enquiries with almost 20 percent enrolling in an ongoing class. In the southern region nearly 900 older people attended the 68 classes offered each week through Heartmoves. Four classes targeted culturally and linguistically diverse communities. Better Services – Healthier People Provided professional development and class enrolment strategies to support Heartmoves fitness leaders. Eight leaders were supported to complete the National Heart Foundation re-accreditation training. A partnership with the St George Migrant Resource Centre resulted in 18 multicultural day care staff from nine language groups being trained to deliver 'Tai Chi for Arthritis' to their clients. Simple gentle exercise equipment was also provided. The physical activity directory was updated and made available to staff via the Area’s intranet. Users can search by suburb or preferred activity. Facilitated links to other services and communitybased exercise programs as part of the Better Balance research project with the University of Wollongong. Better Balance seeks to ensure older people at risk of falls are referred by GPs to exercise physiologists for individual support, education and training. Conducted a variety of falls prevention and physical activity presentations to about 250 people across the Area. Equity and communities ◗ Commenced place-based projects with local communities from the south-west Wollongong/Dapto and Maroubra areas. The projects involved providing communities and service providers with a training workshop to enable them to take photographs of their local environment as seen through their eyes. Two exhibitions reflecting issues raised by groups of women and youth took place in the Illawarra region. 51 Healthy People – Now and in the Future ◗ ◗ HIV/AIDS and Related Programs Unit Two pilot programs were conducted with Maori and Tongan communities to improve the health outcomes of children through improved parenting skills, as part of a collaborative project with the Department of Education and Training, Families NSW, Area Women's Health and Community Partnerships Unit and Pacific Community non-government organisations. Health Promotion continued to be an active member of Food Fairness Illawarra, a coalition formed to address food security in the region. Food Fairness Illawarra developed a practical, plain English resource to promote updated food donation legislation that encourages businesses to donate excess food. Other activities include a market basket survey to map food outlets in southern Wollongong suburbs, support for the Warrawong Community Kitchen and the development of a Traditional Food Directory for newly-arrived refugees. Summary of business activity ◗ The HIV/AIDS and Related Programs (HARP) Unit is responsible for Area-wide strategic oversight and program management for local and statewide sexual health and HIV/AIDS services and programs and hepatitis C health promotion and prevention services funded by the Australian Government and NSW Health’s AIDS Program. ◗ The Unit provides an Area-wide health promotion service and is the program manager for AIDS funded non-government organisations auspiced by SESIH and provides line management for two statewide services: the NSW Workforce Development Program in Hepatitis, HIV and Sexual Health (WDP), and the AIDS Dementia and HIV Psychiatry Service (ADAHPS). Major goals and outcomes Key issues and events ◗ Preliminary results for the Illawarra and Shoalhaven NSW Health funded pedometer and cardiac rehabilitation research project indicated that pedometer-based intervention increased the short-and medium-term physical activity levels of people with heart disease who had also attended a cardiac rehabilitation program. ◗ Continued to provide co-ordination and support to the Aboriginal Population Health Scholarship program. ◗ Now in its seventh year, SHIP (School Health Incentive Program) continued to grow. This year, 42 schools received small grants to implement projects addressing breakfast programs and resilience and physical activity, amongst other health issues. ◗ Provided funding and support to Healthy Cities Illawarra whose work contributes to healthy environments in the Illawarra community. Program Management ◗ Improved the quality and consistency of data collection to meet the requirements of the NSW HIV/AIDS and Sexual Health Minimum Data Set (MDS). ◗ Provided up-to-date HARP data fact sheets and financial information to inform planning and service development for the HARP sector. ◗ Developed infrastructure within the HARP sector to support the development and implementation of Area planning processes in response to NSW Strategies in HIV/AIDS, STIs and Hepatitis C and Aboriginal Implementation Plan 2006 - 09 including the HARP Planning and Performance Steering Committee, Clinic Services Committee and committees in the Northern, Central and Southern Hospital Networks to coordinate the implementation of strategies with Aboriginal communities. ◗ Established the HARP Partnership between the AIDS Council of NSW, Bobby Goldsmith Foundation, People Living with HIV/AIDS (PLWHA), (NSW) and Sydney South West Area Health Service (SSWAHS) to coordinate the implementation of the SESIH HIV/AIDS and Sexually Transmitted Infections (STIs) Plan. ◗ Undertook extensive consultation with HIV/AIDS and sexual health services, non-government organisations and community agencies in the development of the SESIH HIV/AIDS and Sexually Transmissible Infections Prevention, Treatment, Care and Support Implementation Plan 2007 - 2010 and Hepatitis C Implementation Plan. Future directions ◗ Continue to implement the five-year plans for each program area. ◗ Develop a Health Promotion Workforce Development Plan. Better Services – Healthier People 52 Healthy People – Now and in the Future Health services Area Falls Prevention Program for older people Health Promotion and Blood Borne Prevention Programs ◗ Established a program for raising awareness about HIV and sexual health among culturally and linguistically diverse communities (CALD) in the Illawarra, in partnership with Healthy Cities and other stakeholders. ◗ Conducted the Hoops 4 Health program using sport as a fun and interactive way to talk with young Aboriginal people about health, looking after themselves and hepatitis C. ◗ Implemented STI testing campaigns for gay men, including men from CALD backgrounds. ◗ Ran a series of teacher training workshops on using the Talking Sexual Health package. ◗ Worked in partnership with non-government and community agencies to run health promotion programs among people living with HIV/AIDS. ◗ Undertook a series of outreach activities promoting sexual health among TAFE and university students. ◗ Contributed to the development of an innovative project which seeks to identify risk factors for young people most at risk of taking up injecting, and supplied tools to current injectors on how to discourage others’ initiation to injecting. ◗ Promoted access to treatment for hepatitis C among people using Needle and Syringe Programs and Alcohol and Other Drug Services through the St George Hepatitis C Clinic Project. ◗ Worked in partnership with Needle and Syringe Program staff to increase access to resources for people who inject drugs through the Pharmacy Fitpak Project. Summary of activity The Area Falls Prevention Co-ordinator is responsible for facilitating the implementation of the NSW Health policy on preventing falls in older people across SESIH. Major goals and outcomes ◗ Developed the Area Falls Injury Prevention Plan 2007 - 2012. The plan covers community, acute and sub-acute care and residential care for aged settings. ◗ Conducted presentations on resources, falls risk factors and prevention strategies for use at hospital and network level. ◗ Conducted education sessions on falls risk factors and their management for nurses working in residential care (Shoalhaven Division) and general practitioners (St George Division). Key issues and events ◗ Area Falls Prevention Co-ordinator appointed in January 2007. ◗ Established Area Falls Injury Prevention Steering Committee and three supporting working parties for co-ordinating implementation in community, acute and sub-acute care and residential care. Future directions ◗ Continue to support implementation of the SESIH Falls Injury Prevention Plan 2006 - 2012. ◗ Develop standardised hospital falls prevention policy. ◗ Implement standardised falls risk assessment tool across SESIH. ◗ Support facilities to prepare documentation for EQuiP’s fall criteria. ◗ Expand strength and balance physical activity programs for older people, particularly tai chi. Key issues and events ◗ Conducted a range of activities across the Area in association with National Hepatitis C Awareness Week to raise the awareness of the importance of effective self-management practices for people with hepatitis C. ◗ Co-ordinated local activities contributing to 2006 NSW World AIDS Day. ◗ Implemented a range of strategies targeting young people during Sexual Health Week 2006. ◗ Involvement with NAIDOC Week activities across the Area in partnership with the Kirketon Road Centre, Sydney Sexual Health Centre and the AIDS Council of NSW. ◗ Increased the health promotion capacity of the HARP Unit, particularly in the area of Aboriginal sexual health. Better Services – Healthier People Oral Health Services Summary of business activity The Oral Health Service provides routine and specialised dental treatment to holders of Health Care Cards, pensioners and all children up to 18 years of age, including an after-hours emergency dental service. All hospital inpatients and persons with drug and alcohol, mental health and homelessness issues may also access care. 53 Healthy People – Now and in the Future encompassing teaching, research and treatment in conjunction with the University of Sydney Faculty of Dentistry, the Australian Dental Association, and the two Teaching Hospitals. Oral health screening, promotion, prevention, and early intervention initiatives are also undertaken in a range of settings, such as playgroups, kindergartens, pre-schools, primary schools, group homes, hostels, community health centres, nursing homes and intensive English schools. Mental Health Services Major goals and outcomes ◗ Successful recruitment strategies resulted in employment of additional dental officers and one dental therapist. ◗ Expansion of child dental services in Nowra and an additional dental clinic built. ◗ Significant improvement in waiting times for removable prosthodontic services in the Illawarra was achieved. Waiting times were reduced by an average of four years. ◗ The Information System for Oral Health (ISOH) is now available in all dental clinics in SESIH. ISOH is the statewide information system for managing all aspects of a patient’s treatment such as appointments, treatment provided, previous and future courses of care, and fee for service treatment offered to the patient. Summary of business activity ◗ Further development of Clinical Networks in the Northern, Central and Southern Mental Health Networks occurred with common organisational structures in the final stages of establishment. ◗ The continuing development and networking of services within targeted areas, Child and Adolescent services, non-acute and rehabilitation services and emergency mental health care, has resulted in significant enhancements to service delivery. ◗ Planning commenced for the establishment of purpose built Child and Adolescent Inpatient Beds, and an Area Clinical Co-ordinator for Child and Adolescent Services was appointed. ◗ The construction of three non-acute mental health units and the establishment of two Psychiatric Emergency Care Centre (PECC) services at Prince of Wales and Wollongong hospitals progressed. ◗ Construction of a 15-bed Specialist Older Persons Mental Health Unit at Wollongong Hospital commenced as did recruitment of an associated community mental health team. ◗ A number of key Mental Health Program Policies have been developed and implemented, strengthening the clinical governance processes of the Mental Health Program. Priority for development of such policies has been given to areas of identified clinical risk. ◗ Significant work undertaken in relation to preparation for the accreditation Survey by the Australian Council on Healthcare Standards, scheduled for May 2008. This is the first time that Mental Health Services will seek accreditation as a single unified program rather than as individual services affiliated with local hospitals. ◗ An Area-wide approach to Mental Health Learning and Development has been implemented, with a central registration process and maintenance of education attendance records for all mental health staff. ◗ Implementation of action plans in relation to specific population groups or service specialties developed in 2005 - 06 continued. These plans focus on increasing the capacity of the service to respond to service Key issues and events ◗ Oral Health Planning Day for all staff was held at Jamberoo Function Centre, Jamberoo Valley in December 2006. The planning day was an opportunity for staff, stakeholders and consumers to develop appropriate goals and strategies to address anticipated future trends. Sessions also undertaken to address areas of concern identified by staff. ◗ Oral Health staff have worked hard at investigating appropriate staffing levels for the Illawarra and Shoalhaven regions. As a result, a number of recruitment strategies were developed, which resulted in unfilled dental officer, dental therapist and dental assistant positions being filled. Future direction ◗ Expand the Special Needs Dental Service model into the Illawarra region. ◗ Implement the Early Childhood Oral Health (ECOH) program, targeting siblings and relatives of infants with significant oral disease. ◗ Establish the Shoalhaven Centre for Oral Health in conjunction with the Population Health, Planning and Performance Directorate. The Shoalhaven Centre of Oral Health will be a multi-purpose oral health facility, Better Services – Healthier People 54 Healthy People – Now and in the Future Health services 54 ◗ Key issues and events ◗ The Area Mental Health program is entering a period of significant development with funding for two additional non-acute mental health units having been approved, and establishment of these services is currently in planning. ◗ Planning is occurring for the establishment of a purpose-built Child and Adolescent Mental Health Unit in the Northern Network, with a small number of inpatient beds also identified for the Southern Network. ◗ A Clinical Co-ordinator Child and Adolescent Mental Health Services was appointed to provide a key leadership role in the further development and coordination of Child and Adolescent Mental Health Services. ◗ Preparation commenced for the 2008 Accreditation review by the Australian Council for Health Care Standards. This will be the first review as a single Mental Health Program, requiring significant preparations. ◗ Implementation of the comprehensive Strategic Workforce Plan for Mental Health, to address the six priority areas: Visible and transparent management; Performance management at all levels, Recruitment and retention strategies that attract and retain staff and provide for workforce distribution; on the job learning; relevant and effective work practices that support changing health service provision and staff needs; and an environment and culture that promotes staff well-being. demands within these areas. These areas include Older Person’s Mental Health Services, Rehabilitation, Carer and Family Support and Consumer Participation. An Aboriginal Mental Health Action plan was completed in 2006 - 07 and an Area Co-ordinator Aboriginal Mental Health has been appointed to support the implementation of this plan. Major goals and outcomes ◗ Mental Health Services continued collection of Outcome Measures for Mental Health clients, with improvement noted from 2005 - 06 results. ◗ Construction commenced on a 20-bed non-acute unit at Shellharbour Hospital and a specialist Inpatient Unit for Older Persons at Wollongong Hospital and establishment of an associated community mental health team. ◗ Establishment of a Psychiatric Emergency Care Centre (PECC) at Prince of Wales Hospital commenced. ◗ The Aboriginal Mental Health Strategic Plan was finalised and supports improved service provision to this population. An Area-wide Aboriginal Mental Health Co-ordinator was appointed to support the implementation of this plan. ◗ The Mental Health Services participated in the implementation of the NSW-wide MH-COPES (Mental Health Consumer Perceptions and Experiences of Services) survey, which will provide feedback which can be used locally for consultation with consumers and improvements to services. ◗ Implementation of Patient Flow initiatives of the mental health program and SESIH continued to report positive performance regarding access to Mental Health Services from the emergency departments in the Area. Better Services – Healthier People South Eastern Sydney and Illawarra Area Health Service Future direction ◗ Focus will continue on ensuring effective use of Housing and Supported Accommodation Initiative (HASI) places for people with mental illness living in community housing, strengthening approaches for emergency mental health care and maximum use of PECC resources where available. ◗ Continued focus on specialist services for older people, rehabilitation and children and adolescents. ◗ Review and development of non-acute and rehabilitation programs within the Area, in line with the completed Rehabilitation Strategic Plan. ◗ The Mental Health Services will continue to progress implementation of strategies to meet the targets identified in the NSW Health Area Mental Health Report Card and Mental Health Performance Agreement. 55 Healthy People – Now and in the Future 55 Area Drug and Alcohol South East Sydney and Illawarra Medical Imaging (SESAIMI) Summary of business activity The program provides a range of specialist treatment services across the Area including inpatient and outpatient detoxification, individual counselling, group therapy, opioid pharmacotherapy, consultation and liaison to general hospitals, telephone consultancy and support services, court diversion programs and a Drugs In Pregnancy service. Summary of business activity Work continued towards the amalgamation of the ten medical imaging departments across the Area into one operating business unit - South Eastern Sydney and Illawarra Medical Imaging (SESAIMI) - to occur on 1 July, 2007. The service performed 390,549 radiological examinations in 2006 - 07 and it is projected that the service will perform approximately 400,000 examinations in 2007 - 08. Medical Resonance Image (MRI) services are available at the Randwick Hospitals and Wollongong Hospital. The Randwick Hospitals Campus is the centre of excellence for interventional neurovascular radiology (INR) and the service has available two modern 64 slice CT scanners located at St George and Wollongong Hospitals. Prevention and early intervention services focusing on issues such as drink driving, tobacco related morbidity and infectious disease transmission are also provided. In 2006 - 07 the program provided in excess of 38,000 treatment episodes. Major goals and outcomes ◗ All activity and financial targets were met. ◗ Establishment of comprehensive case management plans for all opioid pharmacotherapy patients. ◗ Expansion of the Magistrates Early Referral Into Treatment Program to Waverley Local Court. ◗ All new patients received a comprehensive assessment within five days of first contact. Major goals and outcomes ◗ Consolidation of the Area Medical Imaging business unit. ◗ Completion of the installation of Picture Archiving and Communications Systems (PACS) to the remaining SESAIMI sites. ◗ Roll-out of the Radiology Information System (RIS) to all radiology departments in the Central and Northern Hospital Networks. ◗ Equity in the delivery of tertiary level diagnostic services to facilities in SESIH, in particular the acquisition of onsite MRI services at St George and Sutherland Hospitals. ◗ Ongoing attraction and retention of specialist medical and paramedical personnel. ◗ Attained accreditation through the Royal Australian and New Zealand College of Radiologists (RANZCR) and the National Accreditation Testing Association (NATA). Key issues and events ◗ An Area Director of Drug and Alcohol Services was appointed. ◗ Recruitment for other senior management positions commenced. ◗ A specialist Cannabis Clinic was established in the Central Network. Future direction ◗ All management positions to be filled by the end of 2007. ◗ Implementation of the recommendations of the external review into the clinical and governance structures of the service. Better Services – Healthier People Key issues and events ◗ Successfully implement both the PACS and RIS computer systems to all SESAIMI sites. ◗ Complied with and reported key performance indicators to NSW Health. ◗ Accessed and provided of all radiology examinations within SESAIMI. ◗ Acquired facilities and equipment commensurate with the role delineation of the hospitals that SESAIMI services. 56 Healthy People – Now and in the Future Health services ◗ ◗ ◗ ◗ ◗ ◗ Reported on and improved the level of customer satisfaction within SESAIMI. Achieved full staffing within SESAIMI. Managed and reduced the level of workplace injury. Promoted radiology as an area of quality research and developed strategic alliance with universities and industry to promote research. Delivered in-house MRI services at St George and Sutherland Hospitals. ◗ Future directions ◗ Successfully implement PACS to deliver the state’s first filmless radiology service from Randwick in the north to Milton Ulladulla in the south. ◗ Commence a 24/7 radiology registrar coverage to all SESAIMI sites. ◗ Develop strategic alliance with major universities offering undergraduate and post-graduate training opportunities. ◗ Achieve 100 percent self-sufficiency in the provision of in-house radiology services. ◗ Increase the awareness and benefits of hospital-based radiology services to external medical referrers. ◗ Acquire new tertiary level radiology equipment commensurate with the role delineation of the servicing hospital. ◗ Recruit and maintain specialist personnel required to deliver tertiary level radiology services to all SESIH hospital sites. Key issues and events ◗ Professor Colin Chesterman AOM and Professor Sydney Bell AM received Queens Birthday honours for their contributions to their profession and to our community through their lifetimes of work. ◗ Full availability of the Anatomical Pathology at Wollongong Hospital and Haematology at St George and Sutherland Hospitals has high acceptance from clinicians. Integration of clinical and laboratory haematology at St George and Sutherland Hospitals means this well-proven model is now standard across all SEALS sites. ◗ In Wollongong, anatomical pathologists from private sector providers Southern.IML Pathology were engaged to work on-site to help SEALS staff provide anatomical pathology services to the Southern Hospital Network. ◗ Identified new opportunities for training anatomical pathology registrars in the Illawarra which may contribute to future sustainability. ◗ Finalised several senior management positions in a new structure within SEALS which will provide a solid base from which to engage with NSW Health’s decision to proceed with a statewide restructure of pathology services. South Eastern Area Laboratory Service (SEALS) Summary of business activity In 2006 - 07 SEALS continued to provide a comprehensive range of diagnostic testing, processing 1.2 million pathology requests at its seven laboratories, amounting to a six percent increase compared to 2005 - 06. Of the requests, 41 percent were processed by SEALS North, 34 percent by SEALS Central, and 25 percent by SEALS South. Major goals and outcomes ◗ Progressed the amalgamation of the pathology business units under a single structure, under the business name of SEALS. This positions the pathology service to engage with NSW Health’s statewide reorganisation of public pathology services. SEALS will become one of four Pathology clusters. ◗ Addressed a serious shortage of specialist pathologists in two laboratories. Resolving this has been a major priority and services were fully restored. Better Services – Healthier People Planned for the replacement and standardisation of SEALS Blood Transfusion Laboratory Information Systems, with the Cerner Pathnet Millennium Blood Bank module to be implemented. This project forms part of the Area’s broader electronic medical record (eMR) project, to be completed in 2007 - 08. The eMR Project is a significant call on SEALS resources with the need for staff involvement in several of the planning, design and testing initiatives and particularly around Orders and Results Reporting. Following a successful project in collaboration with the NSW Cancer Institute in 2005 - 06 to replace paper-based notification of cancer diagnoses to the NSW Cancer Registry with electronic messaging, SEALS is now working with NSW Health on electronic notification of notifiable diseases. In addition to greater efficiency, this approach is expected to improve reliability and timeliness of notification, enhancing public health surveillance and response capacity. 57 Healthy People – Now and in the Future ◗ Nursing and Midwifery Services Continued to meet the challenge of maintaining superior laboratory medicine services in an environment where technological capability and growth in demand inexorably rise, while competition for limited funds intensifies. Summary of business activity (acute and community based) ◗ The commitment, innovation and professionalism demonstrated by SESIH Nursing and Midwifery Service on a daily basis, is fundamental in the provision of quality healthcare and improved health outcomes for local communities. Activities include: ◗ Ensuring a future workforce through active participation in school-based initiatives. ◗ Streamlining processes to enable improved capacity to support undergraduate clinical placements. ◗ Targeted marketing strategies and website development have seen SESIH stand out as the employer of choice for those considering nursing in NSW. ◗ Attracting and retaining a diverse workforce has been achieved through supporting initiatives such as orientation, induction, preceptorship and mentorship for new nurses and midwives and those in career transition. ◗ Professional and career development is accessible to all levels of nurses and midwives, with more than 350 nursing clinical education and training initiatives on offer, as well as post-registration and short nursing courses for nurses within the Area and across NSW. ◗ A comprehensive approach to role redesign has seen sustainable improvements, including enrolled nurse scrub role in operating theatres being adopted across SESIH and taken up in other Area Health Services. ◗ A culture of critical inquiry and innovation has seen SESIH lead the way in introducing new models of care such as three tiers of nursing, midwifery-led care and nurse practitioner roles. ◗ Promoting and supporting excellence in teaching and training has enabled nurses and midwives across SESIH to evaluate practice, engage in research and publish their findings. Future direction ◗ Continue to complete the amalgamation of services. ◗ Information technology rationalisation and capability will be a critical priority for SEALS. ◗ Develop strategies to mitigate the impact of a national pathology workforce shortage while continuing to work with the governments and professional bodies on state and national initiatives. ◗ Continue to retain the capacity to support and serve the community with a focus on quality of service delivery and cost-efficiency. Major goals and outcomes ◗ More than 300 new graduate nurses commenced in SESIH this year. This coincides with an improved satisfaction with the program. ◗ Developed an attractive clinical career framework with the establishment of 14 Nurse Practitioner positions across SESIH services and providing access to a Nurse Practitioner Orientation Program. ◗ Supported managers to develop and maintain high level of skills in introducing a Nursing and Midwifery Services Executive Program. Better Services – Healthier People 58 Healthy People – Now and in the Future Health services ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ Developed and implemented leadership development initiatives such as the Clinical Excellence Commission’s statewide Clinical Leadership Program (30 participants each year) and the SESIH/University of Wollongong Effective Leadership Program (60 participants each year). Fostered frontline clinical leadership by sponsoring and leading patient safety initiatives such as Clean Hands Campaign and Nurse Seen Times Project. Adopted an Area-wide approach to using the Learning Management System (LMS) for standardising and improving transportability of nursing and midwifery clinical education. Strong representation on the Electronic Medical Record Clinical Advisory groups and working parties. Regular reports on performance provided by Area Nurse Manager, with 20 percent benchmark for ‘nurse seen time’ logged in EDIS, achieved for triage categories 2 - 5. A pilot site for NSW Health, Nursing and Midwifery Office initiative to introduce enrolled nurses into critical care units. Participated in Renal Services Network Models of Care Project, three project teams exploring skill mix and models of care. Successful implementation of a model of care for children requiring long-term ventilation utilising enrolled nurses as primary carers. Centering Pregnancy - evaluation of program in progress. ◗ Future directions ◗ Gower Wilson Memorial Hospital community nursing to adapt the existing medical model of care to a primary health care model. ◗ Area Professor of Midwifery to introduce interactive learning packages to SESIH, from UK research grant in conjunction with Guys and St Thomas’ and Kings College hospitals. ◗ Actively participate as a member of the NSW Health, Nursing and Midwifery Office, Models of Care Reference Group, building sustainability of workplace innovation and widely disseminating outcome. ◗ Support a series of educational initiatives that aim to raise awareness and build capacity of nurses and midwives to engage in practice development initiatives. ◗ Establish an institute to strengthen collaboration between nursing and midwifery professors and clinical chairs. ◗ Continue to support clinical leadership initiatives, and evaluate the impact. ◗ Seek out opportunities to foster and maintain partnerships with external agencies, including universities, TAFE, Registered Teaching Organisations, and other Area Health Services. ◗ Continue to market and promote nursing and midwifery to various target audiences. Key issues and events ◗ August 2006, REACH launch - an International research collaborative between The Royal Hospitals in Belfast, The Children’s Hospital at Westmead, Northern Sydney Central Coast Area Health Service and South Eastern Sydney Illawarra Area Health Service. ◗ November 2006, hosted SESIH Nursing and Midwifery ‘In FOCUS’ conference. ◗ November 2006, The Hon. John Hatzistergos attended the graduation of the first cohort of Year 12 students completing HSC nursing subject at St George Hospital. The program is a 2007 Baxter Health award nominee. ◗ December 2006, Malabar Community Midwifery Link Service opened. ◗ April 2007, community consultation conducted on Lord Howe Island. ◗ May 2007, co-hosted International Nurses Day Conference - ‘Success Through Collaboration’ with the University of Wollongong. Better Services – Healthier People South Eastern Sydney and Illawarra Area Health Service Key stakeholder in the development of the ‘Operations at Sydney International Airport Borders During an Influenza Pandemic’ - annex to the NSW Human Influenza Pandemic Plan. June 2007, Royal Hospital for Women hosted a statewide forum on Caesarean Section: planning an intervention that aims to reduce the rate of repeat caesarean section. 59 Healthy People – Now and in the Future Better Services – Healthier People 60 Healthy People – Now and in the Future South Eastern Sydney and Illawarra Area Health Service 4 Health support services Key issues and events ◗ Completed Phase 5 re-development at Prince of Wales Hospital. ◗ Introduced an Area-wide one-patient menu. ◗ Re-accreditation of all Southern Network Food Service facilities and the Sutherland Hospital Food Service in the Central Network. Accreditation attained for St George, Prince of Wales and Sydney/Sydney Eye Hospital’s Food Service facilities. ◗ Rationalised and improved retail services across the Southern Network. ◗ Developed and implemented an OHS Plan for SESIH Food Service. Corporate services Shared Services Overview NSW Health has embarked on a program to transfer certain support services to a new entity named HealthSupport. This program will provide economic benefits by centralising group procurement, with these benefits directed into the provision of clinical services. Control of the Illawarra Linen Service was transferred to HealthSupport in 2006. Food Services, Procurement and Logistics, and transactional based Finance and Workforce Services are undergoing preliminary investigations with expected transition to HealthSupport occurring between June 2008 and December 2008. Future direction ◗ Phase two and three re-development of the kitchen at Wollongong Hospital. ◗ Phase six re-development of Prince of Wales Hospital kitchen. ◗ Redevelopment of kitchen facilities at Shoalhaven Hospital, incorporating the two retail units into one viable business unit. ◗ Upgrading of food storage facilities at the Central Production Unit at Port Kembla. ◗ Develop and expand high-protein frozen products for health service use and public purchases. ◗ Upgrade the Food Service heavy vehicle fleet. ◗ Implement the Healthy Eating Policy in Area retail outlets, as well as upgrading outlets to improve service delivery and cost-effectiveness. Food Services Summary of business activity The amalgamated SESIH Food Service Business Unit produced more than 3.31 million patient meals during the year. The Central Production Unit (CPU) at Port Kembla prepares meals for the Greater Southern Area Health Service, as well as providing some products to the Northern Sydney Central Coast and Greater Western Area Health Services, and frozen meals to the general public. Services are now provided to the Northern Network from to Sydney/Sydney Eye and Prince of Wales Hospitals, and to the Southern Network’s Milton Ulladulla Hospital. Procurement and Logistics Major goals and outcomes ◗ Rolled out one Food Safety Plan across the Food Service with accreditation for all SESIH Food Service sites. ◗ Introduced one costing model and standardised business practices for the Area. ◗ Developed a product range particularly for special diets, including gluten-free, nut allergen and salt-free meal packs. ◗ Improved the management of worker’s compensation cases to achieve reduced premiums. ◗ Implemented one database across the Area and converted facility systems to a Microsoft Windows environment. ◗ Standardised OHS policies and practices across the SESIH Food Service. Better Services – Healthier People Summary of business activity The major goal and function is to maintain an efficient purchasing and supply support service to patient care facilities. Major goals and outcomes ◗ Closure of the Balgownie Warehouse and the smooth transition of all purchasing and stores functions to the Material Resources Department (MRD) in the Central Network. ◗ Customer feedback indicated satisfaction with the service provided. Key issues and events ◗ Developed a Distribution Centre in the Southern Network. 61 Healthy People – Now and in the Future Health support services 4 SECTION ◗ ◗ ◗ ◗ ◗ ◗ Continued to provide a cost-effective service and negotiated of a number of supply agreements to reduce costs and improve clinical outcomes. Developed Area-wide standardised business processes for procurement and logistics. Increased roll-out of online requisitioning. Major goals and outcomes ◗ Amalgamation restructures to Area Finance saw the establishment of three expertise centres for the provision of SESIH’s accounting operations, patient billing, financial and budget management services. ◗ The standardisation of accounting policies, procedures and systems was further enhanced in 2006 - 07 by the implementation of a new budgeting and financial reporting application, known as PowerBudget. This application offers a more efficient mechanism for developing and deploying budgets. It also provides a desktop reporting tool for all budget holders across SESIH facilitating a more efficient and detailed budget review process. Future direction ◗ Seek further opportunities for E-technologies to reduce the operating costs of the supply chains. ◗ Work with HealthSupport to meet future goals. ◗ Introduce, in conjunction with HealthSupport/Health Procurement, a catalogue of health-related items, linked to Oracle. Financial Services Summary of business activity ◗ The Financial Services Division provides a range of accounting services and financial management information to ensure that the Health Service’s financial performance is effectively monitored, managed and reported. ◗ The corporate function of the Division is to provide the Health Service with reliable financial controls and to provide the Executive and staff of the Area with accounting and financial reports including business analysis, performance measurement and management support to assist them in their decision making process. ◗ The Financial Services Division assists the Executive with its corporate governance responsibilities by providing advice and direction on financial, accounting and assets management matters. Key issues and events ◗ Implementation of PowerBudget system for all registered users across SESIH. ◗ Completion of staff training across SESIH for PowerFTE module. ◗ Planning and relocation of staff / services to Newcastle Service Centre. Future direction ◗ In order to achieve greater control and monitoring of staffing levels across SESIH, the PowerBudget system provides SESIH with a Staff Establishment Profiling module, known as Power FTE which will be rolled out to facilities in early 2007 - 08. A new VMO (Visiting Medical Officers) budget management feature will also be available to PowerBudget users in 2008. ◗ SESIH is scheduled to join the NSW Health / HealthSupport Service Centre, located in Newcastle, in December 2008. This will result in core financial transactional based activities such as accounts payable, banking services, accounts receivable and payroll services being relocated. The Division delivers the following services: ◗ Accounts Payable ◗ Patient Billing Services ◗ Accounts Receivable ◗ Maintenance of General Ledger ◗ Assets Recording & Reporting ◗ Trust Fund Administration ◗ Treasury Functions ◗ Taxation ◗ Budget Allocations ◗ Financial Modelling and Analysis ◗ Maintenance and Development of Accounting Policies and Procedures ◗ Management of Electronic Financial Databases Better Services – Healthier People Monthly Financial Performance Reporting Compliance with Statutory Requirements Preparation of Annual Statutory Financial Statements Asset Management Summary of business activity ◗ Area-wide master planning continued to match assets with service delivery needs. Special emphasis was placed on the development of a draft urban planning view of Area facilities, in preparation of a full Asset Strategic Plan for SESIH being completed. 62 Healthy People – Now and in the Future Health support services ◗ ◗ Following the restructure of Asset Management, and in line with the Area amalgamation process, a continued review of SESIH was undertaken, recognising NSW Health’s Shared Corporate Services reform program. A significant component was the initiation of a review of the engineering and maintenance services. It is planned to finalise and implement a new structure for this service late in 2007. Key issues and events ◗ Asset strategic planning, as part of a statewide initiative continued, including the preparation of condition assessment reports for all of the Area’s key sites. Major goals and outcomes ◗ Finalised refurbishment of Rees Ward (rehabilitation) at Port Kembla Hospital. ◗ Initiated water and electrical supply projects at Port Kembla Hospital. ◗ Commenced planning and design of a brain injuries unit for Port Kembla Hospital. ◗ Several mental health projects commenced. These included non-acute mental health units at Shellharbour Hospital and Sutherland Hospital and a mental health inpatient unit for older people at Wollongong Hospital. ◗ Commenced planning for a non-acute mental health unit at St George Hospital. ◗ A new Community Health Centre at Sutherland Hospital was finalised and commissioned in January 2007. ◗ Tenders called for a satellite dialysis unit at Sutherland Hospital. ◗ Renovation of the St George Hospital Sterilising Department was finalised. ◗ A professorial unit in the Edmund Blacket Building at the Prince of Wales Hospital was finalised by the University of NSW. ◗ Completed an extension to the Hyperbaric Unit at the Prince of Wales Hospital. A project to replace the hyperbaric chamber in the unit was initiated, with the recruitment of a project manager and consultants for the project. ◗ Completed renovations on the aged care ward at the Prince of Wales Hospital. ◗ A further stage in the renovation of the POWH kitchen was finalised. ◗ Construction of an intraocular laboratory and a hand unit at Sydney/Sydney Eye Hospital commenced. ◗ Planning for a collaborative research laboratory at Sydney/Sydney Eye Hospital commenced. ◗ Progress was made on two community funded cancer services projects - the Cancer Care Outpatients facility at Milton-Ulladulla Hospital, and new facilities for the Prostate Cancer Institute at St George Hospital, which is expected to enter the construction stage early 2008. Better Services – Healthier People South Eastern Sydney and Illawarra Area Health Service The Amity Group, a private health care provider, advanced the planning and design for a proposed nursing home at Sutherland Hospital. This included community consultation and negotiations with Sutherland Shire Council. Future direction ◗ Finalise many of the projects initiated. ◗ Area-wide asset strategic planning, including the identification of key initiatives for the next five years. ◗ Restructure the provision of asset management and maintenance services will continue within the context of NSW Health’s Shared Corporate Services and health infrastructure initiatives. Information Management and Technology Services Overview The Information Services Division (ISD) is an Area-wide service that is the principal provider of information management and technology (IM&T) services for SESIH and has the primary function of supporting the Area’s IM&T infrastructure. Summary of business activity Incorporating Clinical and Corporate Services ◗ ◗ ◗ 63 Major focus on the amalgamation of systems from the former SESAHS and SESIH with the continuing rollout of iSOFT iPM Patient Administration System (PAS) and its integration with other clinical systems including pathology, radiology, pharmacy and billing applications. This project was a massive undertaking for the Area as it now has over 8,000 users. Implemented one email system Area-wide. Users can now log on from anywhere in the Area and access their emails. Health professionals can also access their personal Microsoft Office folders from anywhere in the network. Other systems merged include: the Oracle Information System, ISOH Dental system, the Health Information Exchange (HIE data Warehouse), CHIME (Community Health) and HOSBIL (Patient Billing). Healthy People – Now and in the Future ◗ ◗ ◗ Major goals and outcomes The major achievements accomplished with the support of clinical and business users are: ◗ Completed implementation of the Area-wide implementation iSOFT iPM Patient Administration System. ◗ Completion of Oracle Financial Management using a new hosting model from Health Technology. ◗ Implemented the Jonah Emergency Department patient tracking system into a number of hospitals. ◗ Standardised MS Outlook across the Area, providing transparent access to email, the intranet and MS Office folders across the network. ◗ Merged databases for the amalgamated Area for ISOH (Dental), Renal, Obstetrical (ObstetriX), Patient Billing and Health Information Exchange (HIE Data Warehouse). ◗ Completed the implementation of the Operating Room Management Information System (ORMIS) Upgrade Project - upgrading the four databases that were running on different versions of the product on different servers, to the one merged system. ◗ Completed the implementation of megabit capacity between Wollongong and St George Hospitals to provide improved bandwidth and deliver a variety of information services between hospitals Area-wide including real-time audio video, high-speed Webbased applications and image diagnostics. ◗ Implementation of latest Storage Area Network (SAN) technology in the Illawarra to assist with improving user response and access to data from all the Computer Central Servers by providing greater disk capacity with more flexibility and faster access, including the implementation of faster fiber technology disk drives. ◗ Implemented the Virtual Private Network (VPN) in the Northern Sector, which allows access to SESIH intranet via the internet for clinicians and support staff providing them with higher bandwidth access than the previous dial-up services in a secure and managed environment. VPN access has been available for some time in the Southern Sector. ◗ Upgraded the filtering software for Spam. ◗ Consolidated health IT professionals. The rationalisation of these skills has provided an improved central body of competencies that are now available Area-wide. ◗ Participated in the planning and development of many clinical, corporate and infrastructure projects to support the advances in medicine and technology Restructuring of ISD staff in line with the Shared Services Model. All positions in ISD were re-advertised, requiring staff to apply for these positions. As part of the development of services to Health Technology (HT), over the past year ISD transitioned the Area’s Help Desk to HT which is being established as a state-wide Service Desk (SWSD). Issues logged via the SWSD are prioritised and escalated to the next tier support staff. SESIH also transferred the hosting of its Oracle Financial Management System to HT, and the hosting and IT support services for that application are provided from HT’s Data Centre, Newcastle, while business support for the application is provided from SESIH. Additional services provided by ISD include: ◗ Support and operation of approximately 160 applications. ISD supports: ◗ 30,000 SESIH internet visits per month. ◗ 65,000 intranet visits per week. ◗ 1,200 web pages. ◗ 100,000 files that include the web pages and documents on the intranet. ◗ 1 million email messages per week. ◗ 550 VPN users logging in remotely. ◗ Ongoing support of the Area's increasing infrastructure for both the wide and local area networks (WAN and LAN) including approximately 16,000 desktops, laptops and PDAs, 4,500 printers, 320 Windows servers, 20 VMS servers and 18 Unix servers, all linked through a WAN from Sydney CBD to Milton-Ulladulla. ◗ Procurement of hardware, software and associated vendor services. ◗ Business value-added services such as project management/co-ordination, business process reengineering, change management, benefit realisation and communication management. ◗ Strategic planning to assist Area and facility management in determining IM&T solutions to support their business needs and technical expertise to facilitate IM&T projects. ◗ Information management such as data modelling, development of solutions for data storage, access, security, privacy etc. ◗ Participation in the EQuIP processes. Better Services – Healthier People 64 Healthy People – Now and in the Future Health support services which have driven, and continue to drive, the level of complexity of both the infrastructure and applications including: Radiology Information System (RIS); Electronic Medical Record (eMR) System; CheckList (a tool that enables the allocation of resources, planning capacity and the analysis of waiting lists), and EiCAT (an infection surveillance and staff health database); Medical Oncology (implementation of the Varian software that supports the scheduling of patients, billing and the creation of treatment protocols; and the Executive Dashboard. Corporate Communications Summary of business activity Throughout the year, Corporate Communications staff work closely with members of the Area Executive and with staff at all levels across SESIH. Staff attached to the directorate work across the three hospital networks and are physically based at Wollongong Hospital, St George Hospital, and the Randwick Hospitals campus. Due to the unique communications requirements of Sydney Children’s Hospital, two public affairs staff are based at that hospital. Key issues and events ◗ Information Management and Technology Services faced the challenge of dealing with increased demand for services in a climate of competing demand for resources available, and a worldwide shortage of IT professionals. ◗ Accommodating the changes that have arisen as a result of transferring the Area’s Help Desk Services to Health Technology’s Statewide Service Desk. ◗ Consolidated and upgraded infrastructure technology to provide the building block for future IM&T projects. ◗ Increased maintenance needed on our systems as a result of changes in data standards that requires extra data mapping and building of interfaces, whenever new systems are introduced, and interfaces to current systems. ◗ Ongoing review of ISD through the proposed shared corporate services initiative planned by the NSW Health and Health Technology. ◗ Balancing new project proposals with available resources, and using NSW Health’s definitions of “Core” applications (highest priority), followed by “Common” and lastly, “Diverse” (projects which relate to only one hospital) to rank and classify projects. Functions provided by the directorate include issues management, media liaison, internal communication, web publishing, global email distribution, graphic design, print publishing, and events management. Major goals and outcomes ◗ Maintained a 24/7 on-call media liaison service for the Area and its facilities, involving onsite presence as required, and support to Area staff and NSW Health. ◗ Attained high level, positive media coverage of Area activities to optimise quantity and quality of news coverage. ◗ Supported official openings, launches and events across the Area. ◗ Produced a fortnightly on-line newsletter for SESIH staff from the Chief Executive. ◗ Effectively managed publications and corporate image guidelines across the Area. ◗ Maintained designated Area sections of the corporate intranet. ◗ Managed the dissemination of information to SESIH staff via global email messages. ◗ Designed and produced brochures and other printed information for electronic and hard copy publication to support front line services. ◗ Produced the 2005 - 06 SESIH Annual Report. ◗ Coordinated all display advertising across the Area in line with NSW Health Advertising Guidelines. ◗ Produced monthly on-line newsletters for the staff of the Central and Southern Hospital Networks. Future directions Implement the electronic medical record (eMR) across the Area. This will involve: ◗ Upgrade the communication links between the northern and southern hospitals in preparation for the greater bandwidth requirements needed for transmission of the eMR documents. ◗ Implement the General Electric Radiology Information System (RIS) in the Central and Northern networks and the Hermes Nuclear Medicine Archiving system, which will also be integrated through the RIS to the eMR. ◗ Upgrade the Area’s Unique Patient Identifier (UPI) software and change the operating system environment that hosts this application and upgrade the current iPM PAS system. Better Services – Healthier People Key issues and events ◗ The structure of the directorate was reviewed and realigned in response to changing needs of Area services. 65 Healthy People – Now and in the Future ◗ ◗ Key issues and events ◗ Control self-assessment techniques were developed and applied to audit reviews as an efficient means of securing broader audit coverage. ◗ Maintained representation on the NSW Health Audit Working Party which meets at least twice yearly. ◗ Implemented training opportunities as part of the Unit’s performance development program. Worked with ISD to streamline global email distribution and improve editorial standards. Implementation of guidelines for all design and print requests to ensure quality and consistency of publications. Future directions ◗ Further re-structure of the directorate to improve strategic alignment of resources to meet media issues management and media monitoring needs of the Area and the Executive. ◗ Maintain high-level media and issues-management support for the Area Executive and staff. ◗ Implement performance management of all directorate staff. Future directions ◗ Commence strategic audit planning in 2007 - 08. ◗ Respond, via the NSW Health Audit Working Party, to the transition of selected services to Health Support Shared Corporate Services in 2007 - 08. Internal Audit Summary of business activity The Internal Audit Unit is directly responsible to the Chief Executive for independent appraisal of the adequacy and effectiveness of the organisation’s systems of internal control, risk management and governance. The service also has the capacity to review operations or programs to ascertain if results are consistent with established or appropriate objectives, and goals and if the operations or programs are being carried out as planned. Internal Audit also provides advice and training to strengthen the corruption resistance of the organisation and, at the Chief Executive’s request, will co-ordinate or conduct special investigations. Major goals and outcomes ◗ The Audit and Risk Management Committee has continued to meet every two months. ◗ Quality activities such as the evaluation of the Audit and Risk Management Committee along with development of charters, performance development systems and planning for a quality assurance review have commenced. ◗ Maintained corruption prevention activities. ◗ Continued to engage in audit planning and follow-up processes. ◗ Completed substantial planned audit assignments for SESIH as well as review of four Second and Third Schedule facilities, 16 special assignments and provided ad-hoc requests for advice by line managers on 211 occasions. Better Services – Healthier People South Eastern Sydney and Illawarra Area Health Service 66 Healthy People – Now and in the Future 5 5 Our people 5 SECTION Our people Strategic Profile of the Workforce guidance; individual mediations, multi-party mediation; group facilitation; conflict coaching; training programs and referral to other services such as EAP and Human Resources. In addition, an international conference entitled ‘Towards Harmony in the Health Workplace’ was held in partnership with Change Champions (external providers) at which a paper and a workshop were presented on the Internal Mediation Program. Workforce Development Summary of business activity ◗ The Workforce Development Directorate is comprised of: Workforce Performance, Workforce Services, Workforce Planning and Innovation and the Organisational Learning Units. ◗ Workforce Development activities focus on the planning, delivery and monitoring of high quality strategic, consultative, operational and transactional services across the Health Service. ◗ The Workforce Development Directorate drives the planning of workforce support structures, processes and systems; identifies and responds to individual workforce needs; and plans for the future. ◗ A major focus of the Workforce Services Branch during 2006 - 07 was the provision of support to managers and staff during the final stages of the former Areas and implementation of the new Clinical Stream structure. Extensive consultation with staff and industrial associations occurred on a regular basis to finalise the new structure. ◗ At a facility, hospital and network level, the Workforce Services Branch continued to provide a broad range of services including: change management; recruitment and selection; staff reward and retention; performance management; grievance and dispute resolution; award interpretation; staff advisory services; and contribution to overall facility management. In addition, through provision of an Area service, Workforce Services staff participated in a range of service improvements and standardisation initiatives. ◗ The Employee Assistance Program (EAP) counselling and consultancy services continued to be well utilised by employees and managers across all facilities and occupational groups. In this period 1,237 new clients (employees and some close family members) accessed the counselling services at four campus locations and at the offices of the two external EAP organisations, with a total of 4,273 counselling sessions provided. There were more than 252 workplace consultations and 102 group sessions conducted, which included support following workplace trauma, in-services/ training programs and information/promotional briefings. ◗ The Internal Mediation Program continued to operate successfully. During 2006 - 07 there were 22 workplace conflicts referred to the program. A range of services were offered including: assessment and recommendations; management support and Better Services – Healthier People Major goals and outcomes ◗ Standardisation of Workforce Services policies and forms across the Area. All Human Resources related policies and forms were standardised and are available on the intranet. ◗ Implemented the amalgamation processes. ◗ Developed and implemented procedures for control of recruitment. ◗ Implemented the electronic recruitment management tool (Ezijobs) across all networks. ◗ Implemented, and paid on time, all Award increases. ◗ Upgraded Workforce Development’s intranet site, reflecting the networked service structure. ◗ Refined Workforce Reports to accommodate financial aspects and initiatives, and clinical to administration ratios. ◗ Implemented workforce elements of the ‘Powerbudget’ program to support the achievement of staff establishment controls and performance monitoring and accountability. ◗ Significant development, consultation and research toward the introduction of the Area Workforce Plan. ◗ Attended the Industrial Relations Commission, Government Related Employees Appeals Tribunal, Anti Discrimination Board and other jurisdictions to assist in the resolution of claims submitted by individuals and industrial associations. ◗ Salary Packaging processes and marketing plans developed and implementation commenced. Currently more than 9,000 employees salary package, an increase of 11.5 percent over the previous year. ◗ Developed and implemented strategies to improve recruitment, retention and distribution of the medical workforce in all networks, with particular emphasis on the Southern Network. ◗ Commenced planning for the implementation of an Area-wide ‘Staff Screening and Vaccination Plan’. ◗ Planned for the implementation of an Area-wide ‘Smoke Free Workplace’ Plan. ◗ Reviewed Area Human Resources Services to ensure support of Networks and Area services. 67 Healthy People – Now and in the Future ◗ Executive reports Improved internal processes for the management of the medical workforce across SESIH. Collaborated with NSW Health to oversee the implementation of new procedures for recruitment of various Junior Medical Officer categories. Name: Professor Debora Picone Title: Chief Executive Key responsibilities The Chief Executive is responsible for the performance of SESIH as measured across a range of accountabilities which comprise: ◗ High priority issues ◗ Innovation and continuous improvement ◗ People management ◗ Corporate contribution ◗ Generic accountabilities Key issues and events ◗ Mr Tony Farley was appointed to the position of Director Workforce Development. Future directions ◗ Support the improvement of medical officer training and sustainable governance models for training. ◗ Increase the take-up rate of employees participating in Salary Packaging. ◗ Continue to improve Workforce Performance reports and managers’ capacity to use these to support the organisation’s focus on managing workforce numbers and productivity. ◗ Increase managerial mentoring and training. ◗ Promote innovative approaches to addressing workforce shortages including role redesign and new roles where appropriate. ◗ Continue to develop and implement strategies to improve recruitment, retention and distribution of the medical workforce in all Networks. ◗ Develop and implement FTE control system in collaboration wih the Chief Finance Officer’s unit (Powerbudget). ◗ Develop and implement an Area-wide Emergency Workforce Plan, Staff Screening and Vaccination Plan and a Smoke Free Workplace Plan. ◗ Develop and implement a recruitment control system for the Area (EziJobs). ◗ Continue to review the Area Human Resources Service to ensure maximum support for the achievement of Network and Area goals. ◗ Strengthen working relationships between IMET and SESIH to assist the development of networks and workforce distribution. ◗ Support a review of optimal staffing numbers to align this with clinical needs. ◗ Review functions of the Organisation Learning Unit to Area-wide mandatory training capabilities and develop a framework and policy for mandatory learning across SESIH. ◗ Improve Area workforce data collection, quality and reporting, and standardise across the Area. ◗ Improve processes for the management of the medical workforce across SESIH and collaborate with NSW Health to oversee the implementation of new procedures for recruitment of various JMO categories. Better Services – Healthier People AM Corporate Governance SESIH continued to maintain substantial compliance with the NSW Health’s Corporate Governance and Accountability Compendium during 2006 - 07. Major achievements include: ◗ The implementation of the Hospital Network structure. ◗ Alignment of the Area committee structure with corporate governance responsibilities and the production of the Area Corporate Governance Manual in compliance with NSW Health Corporate Governance and Accountability Compendium. ◗ The establishment of the network Clinical Practice Improvement Units across the three hospital networks to systematise corporate governance. ◗ The Randwick Hospitals’ Campus (including POWH, SCH and RHW) achieved three year accreditation with the Australian Council of Health Care Standards, (ACHS) and Sydney Hospital successfully undertook its periodic review in 2006 - 07. Significant achievements reported against NSW Health Strategic Directions 1. Make prevention everybody’s business. Healthy Weight ◗ In line with the NSW Health priority for health promotion of childhood overweight and obesity, SESIH programs focussed on children and were largely based around working with schools. 68 Healthy People – Now and in the Future Our people Falls Prevention ◗ An Area Falls Prevention Coordinator was appointed and an Area Falls Injury prevention Plan 2007 - 2012 was completed. The Acute/Sub-Acute Falls Prevention Working Party was established to support and monitor unit level implementation of Australian Safety and Quality Council (ASQC) Guidelines. 4. Build regional and other partnerships for health. ◗ ◗ 2. Create better experiences for people using health services. ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ The Area achieved marked improvement in performance against all emergency department indicators despite significant increases in activity. Elective patient flow across all facilities and waiting times for elective surgical patients was optimised. Clinicians and clinical managers in radiology worked with hospital staff to re-engineer radiology processes to reduce the number of sentinel events related to patient identification. Through the Clinical Redesign Unit the Area participated in the Statewide survey of patient experience. A pilot project with NSW Ambulance Service investigated alternatives to ED presentation. Establishment of alternative models for the management of medical patients. The Area’s off-stretcher time improved from 72 percent in 2005 - 06, to 75 percent in 2006 - 07. Implementation of emergency models of care and the ED Jonah system. The Mental Health Program was aligned across the clinical and hospital networks to manage demand through innovative models, early intervention and community care. 5. Make smart choices about the costs and benefits of health services. ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ Older Persons and Chronic Care Redesign Project developed. Review of Primary, Ambulatory and Community Health Services across SESIH. New structure implemented for Aboriginal Health. Achieved target of 0 to 6 years Aboriginal children screened for Otitis Media. Aboriginal Health promotion programs were focussed on vaccine preventable conditions, acute conditions and chronic conditions. Better Services – Healthier People SESIH continued to allocate enhanced funding to provide improved clinical services across the Area. Managerial budget performance and reporting processes were strengthened with the application of PowerBudget. The ongoing monitoring of budgetary performance and the provision of appropriate clinical care within agreed benchmarks was a priority. SESIH achieved financial benchmarks of an on-budget NCoS result, and achieved capital expenditure against its revised yearly targets. Amalgamation of SESIH Corporate Services allowed for savings to be identified, and provided over $12 million to be redirected to improve clinical front line services. Additional nurses and doctors were funded to meet increased levels of surgical and medical demand. I&CT activity focussed on the amalgamation of Information Technology (IT) and Clinical Technology (CT) systems from the former Illawarra and South Eastern Sydney Areas. 6. Build a sustainable health workforce. 3. Strengthen primary health and continuing care in the community. ◗ The SESIH Area Health Advisory Council (AHAC) advised the Chief Executive on issues such as consumer and carer participation, health service planning and budgets, and workforce development. The consumer participation structure is consistent with the Area’s organisational and clinical management structures, and allowed for the establishment of nine new Consumer Advisory Committees (CACs) across the Area. ◗ ◗ 69 Monitoring and reporting of staff turnover improved to reduce staff turnover in line with industry best practice. Workplace injuries and compensation claims reduced. Sick leave monitoring and reporting system developed. Strategies identified in Draft Workforce Plan to increase the proportion and distribution of clinical staff. Introduction of Network Visiting Medical Officer appointments. Development of Aboriginal Employment Strategy 2007 - 2010 and the National Aboriginal Health Worker Awards to increase the proportion and distribution of Aboriginal staff to meet the demand for services. Healthy People – Now and in the Future ◗ The hospital network structures were fully established, providing clear lines of accountability for corporate and clinical governance across SESIH. ◗ Establishment of the Clinical Council, brought Clinical Stream Directors and Network General Managers together, overseeing the implementation of the Area’s Clinical Services Plan and ensuring that clinical services are managed efficiently and equitably, and that quality service provision is maintained. ◗ Implementation of a range of new emergency models of care across SESIH facilities to improve the flow of patients through emergency departments into inpatient facilities, where required. This resulted in significant improvement against all emergency department performance targets, with achievement of access and triage benchmarks by April 2007, ensuring more timely access to services for the community with gains in: • Off stretcher times • Emergency department access and mental health access through emergency departments • Triage performance ◗ Development of elective surgical patient management plans consistent with the Area’s strategic goals and the objectives of the Clinical Services Plan. ◗ Maintenance of long wait surgical targets and overdue urgent elective surgical targets throughout the year, improving access to operating theatres for patients requiring elective surgery. ◗ Development of a range of Area-wide consistent clinical policies and procedures to ensure appropriate clinical care and patient outcomes. ◗ Establishment of a cold joint centre at Sutherland Hospital to improve access to orthopaedic surgery for patients in the Central Hospital Network and decreasing the per unit cost of procedures. ◗ Established medical imaging and nuclear medicine as Area-wide business units. ◗ The appointment of the Area Director of Allied Health and a review and restructure of Allied Health Services across SESIH, integrating these services within each of the hospital networks. ◗ Reviewed and developed recommendations for primary and community health services across the Area Health Service. ◗ Review of renal and renal transplant services across SESIH and the appointment of an Area Director of Renal Medicine. 7. Be ready for new risks and opportunities. ◗ ◗ ◗ ◗ ◗ New Interventions Committee established to assess the clinical appropriateness of new interventions, products and services. A quality framework established for Medical Imaging for the Central and Southern Hospital Networks as a process of managing quality and embedding the NSW Health Correct Site, Correct Procedure, Correct Patient policy directive. Resources provided to critical response (disaster management) services enhanced and realigned across SESIH. A Counter Disaster Development Coordinator was recruited to support development of an Area training strategy for critical response management. Incident and complaint reporting were geared to support identification of clinical risks and ‘near miss’ incidents. Name: Matthew Daly Title: Director, Clinical Operations Key responsibilities ◗ Responsible for the efficient and effective operation of the Area’s clinical services including planning, development, management, monitoring and reporting across all aspects of clinical service provision. ◗ Oversees the clinical services provided in each of the three hospital networks which deliver within a defined geographical area and across the 13 clinical streams which span service delivery across SESIH. ◗ Establishes performance criteria for clinical services, monitoring performance against these criteria and working with stream and network executive teams to optimise quality and equity of access and outcomes. ◗ Responsible for the implementation of redesign and improvement systems and processes to enhance access to clinical services and improve their efficiency and effectiveness. ◗ Implements systems and processes to ensure operational and financial accountability through clinician and management partnerships. ◗ The Director, Clinical Operations is the point of organisational accountability for all aspects of clinical service provision in SESIH. Significant achievements ◗ All appointments to clinical stream positions were filled and the clinical streams now co-ordinate, monitor and evaluate the provision of clinical services across the Area Health Service. Better Services – Healthier People 70 Healthy People – Now and in the Future Our people ◗ A Chair of Maternal Foetal Medicine was established with UNSW. ◗ Establishment of an Area-wide Critical Care Bed Management Policy to improve intensive care and high dependency patient flow. ◗ Review of heart failure and cardiac rehabilitation services to identify common key performance indicators and service delivery models. ◗ Critical response simulation exercises at Wollongong and St Vincent’s Hospitals to enhance counter disaster preparedness. ◗ Finalisation of the Visiting Medical Officer appointments and Visiting Dental Officer appointment in the Southern Hospital Network. ◗ Establishment of the Area Research Committee, with the Southern Hospital Network Health Research and Ethics Committee (HREC) successful in its application as a NSW Health Lead HREC. ◗ A review of blood and blood product utilisation was undertaken with the establishment of a policy for utilisation based on best clinical practice overseen by the newly established Blood and Blood Products Committee. ◗ Construction of a 15-bed Specialist Older Persons Mental Health Unit at Wollongong Hospital commenced, also recruitment for staff of the associated community mental health team. ◗ The Aboriginal Mental Health Strategic Plan was finalised and an Aboriginal mental Health Coordinator appointed to support implementation of the plan. ◗ Patient flow initiatives achieved positive performance regarding access to Mental Health Services from emergency departments. ◗ Implementation of the Strategic Workforce Plan for Mental Health to address the seven priority areas: • Visible and transparent management • Performance management at all levels • Recruitment and retention strategies that attract and retain staff and provide for workforce distribution • On the job learning • Relevant and effective work practices that support changing health service provision and staff needs • Creating an environment and culture that promotes staff well being. Pathology - South Eastern Area Laboratory Services (SEALS) ◗ Amalgamation of the pathology business units under a single structure and under the business name of SEALS progressed. ◗ A serious shortage of specialist pathologists in two laboratories was addressed satisfactorily and services fully restored. ◗ Planning undertaken for the replacement and standardisation of SEALS Blood Transfusion Laboratory Information Systems with the Cerner Pathnet Millennium Blood Bank module. ◗ SEALS commenced working with NSW Health on electronic notification of notifiable diseases. ◗ SEALS continued to meet the challenge of maintaining superior laboratory medicine services in an environment where technological capability and growth in demand inexorably rise. Drug and Alcohol Services ◗ Appointment of an Area Director of Drug and Alcohol Services and recruitment commenced for senior management positions. ◗ A specialist Cannabis Clinic was established in the Central Network. ◗ Expansion of the Magistrates Early Referral Into Treatment Program to Waverly Local Court. Mental Health Services ◗ The clinical structures for Mental Health Services each of the SESIH networks were further developed. ◗ Continuing development and networking of services within targeted areas of Child & Adolescent Services; non-acute and rehabilitation services; and emergency mental heath care resulted in significant enhancements to service delivery. ◗ Planning commenced for establishment for purpose built child and adolescent inpatient beds, and an Area Clinical Coordinator for Child and Adolescent Services was appointed. ◗ The construction of three non-acute mental health units and two Psychiatric Emergency Care (PECC) services at POWH and Wollongong Hospital progressed. Better Services – Healthier People Medical Imaging ◗ Amalgamation of the ten medical imaging departments across the Area into one operating business unit called South Eastern Sydney and Illawarra Medical Imaging (SESAIMI), progressed to occur on 1 July 2007. 71 Healthy People – Now and in the Future ◗ The Area Medical Imaging Business Unit was consolidated. ◗ Installation of Picture Archiving and Communications Systems (PACS) to remaining SESAIMI sites was completed. ◗ The Radiology Information System (RIS) was rolled out to all radiology departments in the Central and Northern Hospital Networks. ◗ Achieved equity in the delivery of tertiary level diagnostic services to facilities in SESIH, in particular the acquisition of onsite MRI services at St George and Sutherland hospitals. ◗ Attainment of accreditation through the Royal Australian and New Zealand College of Radiologists (RANZCR) and the National Accreditation Testing association (NATA). Name: Professor Susan Hanson Title: Director, Clinical Governance Key responsibilities ◗ Management and monitoring of Area-wide systems for Incident investigation and management. ◗ Management and monitoring of Area-wide systems for complaint management. ◗ Analysis and reporting of clinical incidents, adverse events and patient safety clinical risks. ◗ Implementation of statewide Clinical Practice Improvement initiatives. ◗ Ensure systems are in place for managing complaints and concerns about a clinician. Significant achievements ◗ Improvement of clinical incident notification across SESIH. ◗ Enhanced quality of the processes relating to investigation and management of serious SAC 1 incidents and reporting, including the incorporation of open disclosure processes. ◗ Enhanced quality of complaint management processes across the Area. ◗ Implementation of an Area-wide structure of Hospital Network Clinical Practice Improvement Units to manage patient safety and clinical quality. Oral Health Services ◗ Successful recruitment strategies resulted in employment of additional dental officers and one dental therapist. ◗ Expansion of child dental services in Nowra and an additional dental clinic built. ◗ Significant improvement in waiting times for removable prosthodontic services in the Illawarra was achieved. ◗ The Information System for Oral Health (ISOH) was made available to all SESIH dental clinics. ISOH is the state-wide information system for managing and recording all aspects of a patient’s treatment Better Services – Healthier People 72 Healthy People – Now and in the Future Our people ◗ Successfully completed the roll-out of the iSoft Patient Administration System (PAS) across all tertiarycontrolled facilities in the Area Health Service. ◗ Established the management/implementation team and commenced extensive communication and consultation process with clinicians in readiness for the roll-out of a total Electronic Medical Record (eMR) Clinical System (Cerner), across the Area Health Service. ◗ Oversaw the delivery of the Area’s capital works program which saw a number of significant projects undertaken including: • Commenced planning and design for brain injuries unit for Port Kembla hospital. • New mental health projects commenced including: non-acute mental health units at Sutherland and Shellharbour hospitals; a mental health inpatient unit for older people at Wollongong Hospital; and planning for a mental health unit for older people at Wollongong Hospital. • New community health centre at Sutherland Hospital was completed and opened. • Tenders were called for a satellite dialysis unit at Sutherland Hospital. • Renovation of the St George Hospital sterilising department was finalised. • Professorial Unit at the Prince of Wales Hospital (POWH) was finalised by the University of NSW. • Extension to the POWH Hyperbaric Unit was completed and the project to replace the unit was initiated. • Construction of an Intraocular Laboratory and a Hand Unit at Sydney/Sydney Eye Hospital (S/SEH) was commenced. • Planning for a collaborative research laboratory at S/SEH was commenced. • Progress made on two community funded cancer services projects: the Milton Ulladulla Hospital Cancer Care Outpatients Unit; and new facilities for the Prostate Cancer Institute at St George Hospital. • Community consultation and negotiations with Sutherland Shire Council undertaken for a proposed nursing home at Sutherland Hospital by private health care provider, The Amity Group. Name: John Roach Title: Director, Financial and Corporate Services Key responsibilities ◗ Develops and implements systems to ensure effective management of the Area’s budget. ◗ Provides the Chief Executive and NSW Health with timely, comprehensive and accurate financial reports. ◗ Ensures the Area Health Service’s compliance with government and NSW Health policies in respect of financial management and reporting. ◗ Develops financial strategies for the management of the Area’s budget and co-ordinates their implementation. ◗ Develops and implements systems for the accurate recording and effective management of the Area’s assets. ◗ Oversees the development and delivery of the Area’s Information Management and Technology Strategy. ◗ Establishes and maintains an effective management framework for the development and delivery of administrative and corporate support services within SESIH, including procurement, transport, asset maintenance and Area business units. ◗ Co-ordinates and leads SESIH’s participation in the statewide Shared Services Reform Program. ◗ Develops and implements effective strategies in respect of Corporate Risk Management. Significant achievements ◗ Achieved targeted financial benchmarks for the Area’s Net Cost of Services result and creditor management. ◗ Implemented an Area-wide Financial Executive and Cost Centre Manager’s Desktop Reporting System that allows drill down reporting of budget, actual costs and staffing establishments. ◗ Successful participation in Shared Corporate Service strategy with completion of transfer of the Area’s Linen Service to HealthSupport. ◗ Effectively managed the transfer of SESIH IT Help Desk Services to a statewide operation, managed and owned by HealthTechnology. ◗ Continued to ensure the timely negotiation and evaluation of legal, commercial and contractual agreements across the amalgamated Area. ◗ Undertook an extensive review of the maintenance and engineering operations across the Area, and completed union and staff consultations. Better Services – Healthier People 73 Healthy People – Now and in the Future ◗ Reviewed non-emergency health transport services across the Area to facilitate the implementation of the Transport for Health policy. ◗ Supported the completion of facility planning initiatives for mental health capital developments in the Southern and Central Hospital Networks, including the Specialist Mental Health Service for Older People at Wollongong Hospital. ◗ Developed a range of standard and interactive performance reports available to Area Health Service staff via the Area Intranet site. These reports provide up-to-date data on the Area’s performance against agreed targets relating to access, predictable surgery, and the NSW Health Dashboard measures. ◗ Completed the Review of Aboriginal Health Services across SESIH, to support the achievement of the Area’s strategic priorities in relation to improved outcomes for Aboriginal people in South Eastern Sydney, the Illawarra and Shoalhaven. ◗ Established, in collaboration with the Royal Hospital for Women and Area Nursing and Midwifery Services, the Malabar Midwifery Link Service, providing safe, culturally appropriate care to mothers and babies from socially disadvantaged groups who are at risk of poor perinatal outcomes and social isolation. ◗ Commenced outreach clinics at the La Perouse Aboriginal Community Health Centre. Clinics focus on early intervention and the management of chronic conditions affecting Aboriginal and Torres Strait Islander people. ◗ Worked with the Area Health Advisory Council to implement a new structure for consumer participation across the Area, including recruitment of consumer representatives to nine local Consumer Advisory Committees throughout the Area. ◗ Developed and implemented a strategic review of primary and community-based services that focus on Older Persons and Chronic Care via the Clinical Redesign Program, and initiated the Surgical Redesign Project. ◗ Improved performance in two-yearly participation rate for women in the target age group (50-69 years) undergoing breast screening. Name: Elizabeth Koff Title: Director, Population Health, Planning and Performance Key responsibilities ◗ Leads and directs the development, implementation, monitoring and evaluation of a strategic approach to population health, planning and performance across SESIH. ◗ Enhances the Area’s capacity to effectively meet the needs of its residents, now and into the future. ◗ Manages Population Health and Health Protection (including Public Health), Planning and Service Development, Performance Management, Aboriginal Health, Consumer Participation, Clinical Redesign and BreastScreen Services across the Area. Significant achievements ◗ Completed the Division of Population Health Strategic Directions Statement 2006 - 2010, which guides the organisational development of the Division by creating a framework for achieving health improvement for the SESIH community. ◗ Developed the Area Falls Injury Prevention Plan 2007 - 2012, covering community, acute and sub-acute care, and residential care for aged settings. ◗ Established the high school-based Human Papilloma Virus (HPV) vaccination program for girls in Years 10-12, to prevent cervical cancer arising from chronic infection with HPV. ◗ Prepared the public health component of the SESIH Influenza Pandemic Plan and contributed to pandemic influenza policy development at state and national levels. ◗ Completed mid-term formative evaluation of the Aboriginal Population Health Scholarship Program, which provides financial and professional support to cadets, including work experience placements within the Population Health service. ◗ Developed and implemented an Area-wide collaborative care model for refugees using GPs, health staff and settlement services, which provides a comprehensive health assessment on arrival, full immunisation within 12 months of settlement and ongoing co-ordinated health care. ◗ Completed the SESIH ‘Strategy on a Page’ Framework, which aligns the strategic objectives, key performance measures and strategic initiatives for SESIH. ◗ Completed the SESIH Health Service Strategic Plan Towards 2010. Better Services – Healthier People 74 Healthy People – Now and in the Future Our people Name: Tony Farley Title: Director, Workforce Development Name: Kim Olesen Title: Director, Nursing and Midwifery Services Key responsibilities ◗ Provide strategic advice to the Chief Executive on all matters concerning workforce planning, workforce development strategy, human resources strategy, organisational change and organisational learning. ◗ Direct the efficient and effective provision of occupational health safety and rehabilitation, human resource and employee/industrial relations advisory and other services to the organisation. ◗ Provide executive leadership on all workforce matters, including recruitment and retention, education and training, workforce assessment and planning and leadership and learning. ◗ Improve Area workforce data collection, quality and reporting, and standardise across SESIH. ◗ Continue workforce planning for the medical workforce, including approaches to assess workforce requirements, especially in relation to distribution of junior medical staff to support workforce planning. ◗ Improve management of industrial issues and consultation. Key responsibilities ◗ Maintain quality professional practice and ensure appropriate nursing and midwifery clinical, educational and managerial systems are in place to support and facilitate best practice models in partnership with other health professional groups. ◗ Develop and monitor the implementation of, and review, local and statewide nursing initiatives for the Chief Executive, to ensure the nursing workforce was aligned with the service delivery requirements of SESIH. ◗ Provide strategic advice to the Chief Executive on all matters relating to the nursing and midwifery workforce to enable decisions to be made on creating and maintaining an appropriately resourced, qualified and competent nursing workforce for the Area Health Service. ◗ Provide nursing leadership in the Area Health Service by building and maintaining relationships with facility Directors of Nursing to achieve a collaborative, coordinated and professional approach to nursing and midwifery issues. Significant achievements ◗ Responded effectively to current and impending workforce shortages, particularly in relation to the supply, distribution and quality of hospital doctors. ◗ Planned and implemented strategic improvements to the HRIS and Payroll functions to prepare for new technology and Payroll amalgamation. ◗ Upgraded Workforce Performance reporting to accentuate the organisation’s focus on managing workforce numbers and productivity and enhance the organisation’s ability to monitor its financial performance. ◗ Implemented new indicators of Workforce performance. ◗ Provided leadership and advice on the matter of selecting a staff establishment control system that will improve control of workforce numbers and distribution. ◗ Embedded the Workforce Development portfolio within the organisation. ◗ Full compliance with NSW Health’s system recruitment processes for junior medical staff and a major contribution to the statewide upgrade of recruitment programs. ◗ Progressed the streamlining of recruitment processes through roll-out of Ezijobs online recruitment. ◗ Developed and implemented the Full-Time Equivalent (FTE) control system (a collaborative project with the CFO unit) - Powerbudget. Better Services – Healthier People Significant achievements ◗ Introduction of a professional development program for the Nursing Executive of SESIH. ◗ Continued focus on the development of the Nurse Practitioner role and the establishment of a further 14 Nurse Practitioner positions within SESIH. ◗ A Higher School Certificate Nursing Subject Program conducted at St George Hospital became a nominee in the 2007 Baxter Awards. ◗ Nursing and Midwifery in Focus Conference held in November 2006. The focus of the day was on innovation and practice development initiatives in four priority areas: Capacity Building; Quality and Safety; Models of Care and Professional Practice Development. ◗ Developed and implemented leadership development initiatives such as the Clinical Excellence Commission statewide Clinical Leadership Program and the SESIH/University of Wollongong Effective Leadership Program. 75 Healthy People – Now and in the Future Name: Beth Kotze Title: Director, Mental Health Services Conjoint Associate Professor UNSW Name: Alison Errey Title: Director, Corporate Communications Key responsibilities ◗ Manage and implement internal and external communication strategies, including print and electronic communications. ◗ Manage corporate image and branding. ◗ Manage web content and on-line communication strategies. ◗ Media liaison management including the provision of timely and accurate advice and responses to the media and community. ◗ Promote health messages to the wider community. ◗ Promote health strategies through media and strategic communications. ◗ Manage health service involvement in commercial productions, including film and advertising. ◗ Develop policies to support effective communication within the organisation and disseminate health information to the community. Key responsibilities ◗ Implementation of the Mental Health Clinical Service plan including implementation of key MH strategic plans across the age groups and across populations. ◗ Implementation of the Mental Health Workforce Strategy. ◗ Effective application of the Area’s MH funding enhancements. ◗ Establish effective collaborative relationships with key stakeholders in the Area’s Drug and Alcohol Services. ◗ Ensure achievement of allocated budget and implementation of budget strategies and targets for MH - monitoring and reporting of MH Program expenditure to meet National, State and Area priorities. ◗ Ensure high quality Mental Health Services. ◗ Service development, strategic planing and performance monitoring and reporting for Mental Health Services. Significant achievements ◗ Implemented a strategy and associated procedures for more effective utilisation of on-line communications through an areawide global email structure and fortnightly, on-line newsletters from the Chief Executive and individual monthly electronic publications from Network General Managers. ◗ Attained high-level, positive media coverage of Area activities with the issuing of almost 800 media releases, hosting of 61 visits (an average of more than one a week) and the effective management of 2390 media enquiries. ◗ Implemented new procedures for publication and design management including the release of the SESIH Corporate Image Guidelines and area-wide approval procedure for logo usage and approval. ◗ Developed and implemented a revenue and governance structure supporting the use of SESIH facilities for non-media filming and photography. ◗ Establishment of network-based media liaison staff to provide on-site and on-call media liaison assistance 24/7. Significant achievements ◗ Commencement of capital development of a specialist older persons mental health inpatient unit in Wollongong and recruitment to positions within the newly established older persons community mental health service. ◗ Commencement of construction of a purpose built non-acute mental health inpatient unit in Shellharbour. ◗ Funding secured for two additional non-acute mental health units in St George and Sutherland, and Psychiatric Emergency Care Units at Prince of Wales and Wollongong Hospitals. ◗ Contribution at State Level to Mental Health Service development through Chairing of the Chronic and Continuing Care, Rehabilitation and Recovery Working Party and further roll-out of the Statewide Working with Families program. ◗ Maintenance of access rates for mental health patients presenting to Emergency Departments. Better Services – Healthier People 76 Healthy People – Now and in the Future Our people Equal Employment Opportunity Staff profile SESIH values the diversity of its employees and is committed to employment practices that ensure fairness and equity. Salaried full time equivalent staff employed as at June 2007 June 07 Medical 1,389 Nursing 6,287 Allied Health 1,400 Other prof. and para-professionals 440 Oral Health Practitioners and Therapists 80 Corporate Services 605 Scientific and technical clinical support staff 1,049 Hotel Services 1,122 Maintenance and Trades 133 Hospital Support Workers 1,768 Other 43 TOTAL 14,314 SESIH actively supports and reports (via the Premier’s Department) to the office of the Director of Equal Opportunity in Public Employment and collects Equal Employment Opportunity (EEO) information from its staff. This information helps to determine if EEO policies are making SESIH an equitable place to work, while also allowing improved employment access for equal employment opportunity groups. Achievements and planned outcomes SESIH has improved employment access for equal employment opportunity groups, through the following initiatives: ◗ Continued support of the Spokeswomen’s Program. ◗ Offering disabled apprenticeships in SESIH. ◗ Continued to work on strategies and initiatives that provide equal employment opportunities for EEO groups within its boundaries. Clinical Excellence Commission (Statutory Authority) Medical 2 Nursing Corporate Services Planned outcomes ◗ Identify specific positions within SESIH that would be suitable for people with disabilities. ◗ Develop Aboriginal Employment Strategies to increase attraction and retention of Aboriginal people. ◗ Increased development opportunities for CALD women through the Spokeswomen’s Program. 21 Allied Health TOTAL CEC 23 Third Schedule Facilities Sacred Heart Hospice St Vincent's Hospital (includes Hospice) 2,282 Calvary Hospital 248 Waverley War Memorial Hospital 118 Waverley Nursing Home - ( no longer operational) TOTAL THIRD SCHEDULE FACILITIES 2,648 GRAND TOTAL CONTROLLED AND NON-CONTROLLED ENTITIES 16,986 Better Services – Healthier People 77 Healthy People – Now and in the Future Staff numbers by level as at 30 June 2007 Aboriginal people and Torres Strait Islanders People from racial, ethnoreligious minority groups People whose language first spoken as a child was not English People with a disability Employment basis Total Staff Respondents Permanent Full-time 9,074 67% 29% 71% 0.80% 14% 14% 1% Permanent Part-time 4,916 66% 11% 89% 0.50% 10% 10% 1% Temporary Full-time 2,020 64% 35% 65% 0.40% 20% 20% 1% Temporary Part-time 549 73% 17% 83% 0.40% 11% 11% 1% Contract-Sessional 256 27% 51% 47% 13% 9% 1% Casual 3,228 51% 29% 71% 0.50% 9% 10% 1% TOTAL 20,043 64% 25% 75% 0.60% 13% 13% 1% Percentage of staff head count by level as of 30 June 2007 Level Women Men Subgroup as estimated % of total staff in each employment category Subgroup as % of total staff in each category Total Staff No. Respondents Men Aboriginal people and Torres Strait Islanders Women People whose language first People from spoken as a racial, ethnoreligious minority child was not English groups People with a disability People with a disability requiring work-related adjustment < $33,910 285 160 52 233 2 27 33 1 0 $33,910 - $44,537 4,633 3,095 1,201 3,432 46 554 720 67 17 $44,537 - $49,791 1,445 993 247 1,198 9 172 195 11 1 $49,791 - $63,006 4,450 2,989 638 3,812 26 538 514 55 12 469 434 54 16 $63,007 - $81,478 3,463 2,479 705 2,758 18 $81,478 - $101,849 1,539 1,086 593 946 3 300 280 9 3 > $101,849 (non SES) 810 508 493 317 2 134 103 8 4 > $101,849 (SES) 0 0 0 0 0 0 0 0 0 TOTAL 16,625 11,280 3,929 12,696 106 2,194 2,279 205 53 OHS and workers compensation statistics issues in real time, help formulate policy, identify the need to develop or review safe work procedures, focus education and training, and provide current details of specific incidents. Incident Information Management System (IIMS) is the electronic database system used by SESIH for recording OHS incidents. The benefit of IIMS over previous facilitybased systems is that it allows the standardisation of incident categories so that meaningful comparisons can be made between different populations of interest. The data provides information on the occurrence and trending of incidents across SESIH that can be used to review OHS Better Services – Healthier People The table following shows the OHS incident categories with the most frequent notifications that occurred across SESIH for the July 2006 - June 2007 period. 78 Healthy People – Now and in the Future Our people The surplus result for SESIH has decreased from $10,080,229 for the 2006 - 07 fund year to $8,474,194 for 2007 - 08 fund year. Number of notifications Category of OH&S notification Manual handling 558 Workplace violence (verbal and physical) 418 Slip, trip and falls 462 SESIAHS This is mainly due to an increase in wages from $1,228,274,670 for 2006 - 07 to $1,318,591,337 for 2007 - 08. Effective claims and injury management practices as well as an overall improvement in claims experience shows a positive reflection in the deposit premium for 2007 - 08. Details of injuries and prosecutions under Occupational Health and Safety Act 2000 In 2006 - 07 the ‘experience’ premium was $20,617,488 and in 2007 - 08 it is $17,022,536. SESIH has been charged this financial year for an alleged breach of Section 8(1) of the OHS Act 2000 for failing to ensure the safety of its employees. A plea of not guilty has been entered. Workers Compensation 2006 - 07 Comparative Performance Analysis as at 31 March, 2007 A verdict was due to be handed down in August 2007, however no decision has been made as yet. Workers compensation and injury management Capped reported Deposit Deposit Surplus/ incurred cost ($) premium ($) premium ($) shortfall ($) excl GST Incl GST excl GST 18,112,935 19,924,229 8,474,194 2005 2006 6,344,368 4,762,429 Fund year Total no. claims 2005-06 2006-07 Freq/100 Incurred FTE FTE costs ($) Cost per FTE ($) 1,156 16,421 7.0 6,383,000 445 774 16,903 5.0 2,936,000 191 ◗ There has been a decrease in the total number of claims. ◗ The frequency of claims per 100 employees has dropped, as has the average cost of claims per employee. Figures provided by NSW Treasury Managed Fund as at 30 June 2007. Number of claims for 2006-07 by accident type - 30 June 2007 Total cost incurred ($) Days lost Number of claims Total cost incurred ($) Being hit by an object $319,503 704 106 $3,014.18 Biological factors $20,296 43 25 $811.84 Body stressing $2,062,488 4,858 469 $4,397.63 Chemicals or other substances $54,389 128 21 $2,589.95 Heat, radiation and electricity $9,802 27 10 $980.18 Hitting an object $104,541 193 61 $1,713.78 Mental Stress $386,282 369 55 $7,023.31 Other $97,193 175 38 $2,557.72 Accident type Slip or fall $1,149,380 2,122 211 $5,447.30 Sound and pressure $19,548 0 1 $19,547.51 Vehicle accident $210,264 502 78 $2,695.70 TOTAL $4,433,686 9,122 1,075 $4,124.36 * Excludes casual employees. Better Services – Healthier People 79 Healthy People – Now and in the Future ◗ Fostering a learning culture by ensuring new nurses and midwives and those in career transition have access to appropriate orientation, induction, preceptorship, mentorship and clinical supervision. ◗ Co-ordination of more than 4,000 undergraduate and postgraduate Health and Behavioural Sciences students requiring clinical placement and clinical supervision. ◗ Co-ordination of the Certificate IV Trainee Enrolled Nurse Program, Certificate III Assistants in Nursing Program and HSC Nursing Studies program. ◗ Contribution to more than 30 research and 100 clinical practice improvement, clinical redesign and practice development activities, and ◗ Sponsorship, co-ordination and implementation of clinical leadership programs for nursing, midwifery, allied health and ambulance officers. Teaching and training initiatives Overview of business activity SESIH has maintained its commitment to providing quality education and training for all staff. The Area Organisational Learning Unit provides education and training programs to the Health Service. Local staff development and education units located in the hospitals and facilities (along with unit-based educators), continue to provide high quality, innovative and supportive education and training initiatives. All facilities contributed to the ongoing delivery of orientation, induction and mandatory training to enable staff to meet their legislated or other organisational obligations. Major goals and outcomes ◗ Organisational Learning Governance committee established. The role of this committee is to assist in setting the strategic direction for learning within SESIH and to ensure learning resources are allocated appropriately to achieve organisational objectives. ◗ A co-ordinated and strategic approach to orientation and mandatory education is being implemented across SESIH. ◗ SESIH Mandatory Training Framework established. ◗ SESIH Learning and Development Leave policy developed and issued. ◗ SESIH Performance Development policy developed and issued. Associated training developed and rolled out to site-based facilitators. ◗ Learning Management System rolled out across most SESIH sites. ◗ Work is continuing to streamline training and education programs across SESIH in order to reduce duplication in course design, promote transportability of learning across SESIH sites and enable consistent Area reporting of training completion. ◗ Changes to the way the Area uses the governmentfunded Existing Worker Traineeship scheme means employees now have more flexibility to choose a qualification directly related to their work responsibilities. Currently there are 10 qualifications being accessed including: the Certificate IV in Frontline Management and Certificate IIIs in Sterilisation, Occupational Therapy Assistance, Dental Assistance and Cleaning Services. The Learning Management System (LMS) recorded 59,961 attendances at training sessions during the reporting period. This figure, whilst a useful indicator of activity, does not include all attendances at training as the LMS does not currently capture all this data. SESIH has also continued to provide high quality training to staff through specialist services and units. Programs included: ◗ Training and education related to identifying and responding to children and young people at risk of harm provided through the Child Protection Unit and Area educators. ◗ Routine screening and responding to domestic violence through the Women’s Health Unit. ◗ Programs designed to support the provision of culturally appropriate and sensitive care provided through the Area’s Multicultural Health Unit and skilled facility education staff. ◗ Delivery of OHS related training programs provided through the Organisational Learning Unit, Workforce Safety & Injury Management Service and facility-based OHS staff. SESIH Nursing and Midwifery Services’ ongoing commitment to quality clinical teaching and training curriculum is demonstrated by their governance of clinical education and practice development initiatives, including: ◗ Audit completed on the 350 clinical education and training initiatives to ensure quality, consistency and transferability of learning outcomes. Better Services – Healthier People 80 Healthy People – Now and in the Future Our people Key issues and events ◗ e-Learning Seminar hosted by SESIH succeeded in bringing Health Service Educators from across the state together to share ideas and resources for on-line learning initiatives. ◗ SESIH is co-ordinating a statewide discussion to reach consensus on what constitutes mandatory training for all staff, and to clarify the role of education and training services across all Area Health Services. During 2006 - 07, SESIH actively pursued the development of platforms to provide the infrastructure to support current research activities as well as providing for developments to meet future needs. The involvement of the Area Health Service in agreements to establish the New South Medical Research Institutes and the Illawarra Institute for Health and Medical Research was a significant landmark in these endeavours. A Heads of Agreement, signed in 2006, to establish the New South Medical Research Institutes involving SESIH, University of New South Wales, Children’s Cancer Institute of Australia, Black Dog Institute and Prince of Wales Medical Research Institute provides a framework within which formal collaborations and partnerships can be developed. The vision for the New South Medical Research Institutes is to be a focal point for health and medical research and for the translation of those research outcomes into health and commercial benefits for the nation. Future directions ◗ A shift in focus for the Organisational Learning Unit from delivering learning programs to liaising with content experts to ensure standardisation of quality programs throughout the Area. ◗ Maximisation of expertise within the Organisational Learning Unit as specialists in designing outcomefocused adult education learning and development options. ◗ Support for Area initiatives that enhance capacity for staff to undertake nationally recognised training. ◗ Identification of new delivery methods to support delivery of timely and relevant learning programs across the Area, including use of blended learning programs that utilise e-Learning technologies. This Agreement recognises that whilst individual organisations offer unique research opportunities and investments in healthcare outcomes, through collaboration, each adds synergy in creating an environment and critical mass for sustainable research, and a focus for innovation into the future. Research Members of this consortium already have established national and international leadership in a number of research areas, with cancer and neurosciences being identified as key research strengths. The May 2006 announcement of funding for capital works will expand the capacity to accommodate research teams, and importantly, will provide the opportunity to co-locate research teams to enable further development and consolidation of research activities. In 2006 - 07, SESIH staff continued to undertake a diverse range of research activities directed towards improving healthcare outcomes achieved through advances in knowledge and skills to assist in the prevention and treatment of illness and disease. Activities undertaken ranged from laboratory-based investigations of clinical problems, to evaluation of the efficacy of treatment modalities, epidemiological studies, clinical trials of new therapies, and evaluation of healthcare delivery systems. SESIH and the University of Wollongong (UoW) entered into an agreement to establish the Illawarra Institute for Health and Medical Research in mid 2006. Their aim is to create a centre of excellence which will focus on clinical research practice, community health research and education, health service delivery, populations-based interventions and preventative health care. Often these activities involved multidisciplinary teams working at a number of locations across the Area. In some instances, studies were undertaken in collaboration with colleagues from affiliated organisations, notably the University of New South Wales, the University of Wollongong, and affiliated research institutes. Research activities have been supported through external funds obtained either from competitive, peer-review funding agencies, such as NHMRC, or external commercial contracts, foundations or philanthropic organisations. Better Services – Healthier People Recognising the role of research in underpinning improved skills and health outcomes in clinical practice, this agreement was an important initiative to support the development of the UoW Graduate School of Medicine, which opened in 2007, and builds on the existing strong relationship between the Area Health Service and a number of University departments including the Faculty of Health and Behavioural Sciences, and the Centre for Health Services Development. 81 Healthy People – Now and in the Future ◗ B Fonseca, Paediatrics, STG. Meeting. NZ. General ◗ B Fonseca, Paediatrics, STG. APLS Course. Waikato, NZ. General ◗ M Golding, ED, TSH. European Emergency Medicine. Italy. General ◗ P Gottlieb, A and D, STG. Digestive Disease Week. Washington, USA. SP&T ◗ P Graham, Cancer Care, STG. 2006 RANZCA. Singapore. SP&T ◗ M Hersch, Neurology, STG. XXVIII International Conference. Edinburgh, UK. SP&T ◗ J Holt, Renal, STG. ISSHP Conference. Lisbon, Portugal. SP&T ◗ T Jacques, ICU, STG. Symposium @ Kings College. London, UK. SP&T ◗ M Joseph, Aged, STG. **. NZ. General ◗ E Karantanis, Obstetrics, STG. ICS 3rd Annual Meeting. Netherlands. General ◗ E Karantanis, Obstetrics, STG. ICS Meeting. NZ. General ◗ P Kocney, Infectious, STG. ICAAC. Chicago, USA. General ◗ B Kotze, Mental Health, Area Mental Health. 19th ENCP Congress and 36th EABCT. Paris, France. General ◗ S Krilis, Immunology, STG. EAOH. Vienna, Austria. SP&T ◗ U Krishnan, Paediatrics, STG. Annual Meeting - Paeds. Barcelona, Spain. General ◗ M Lassare, Rheumatology, STG. ACR Conference. Washington, USA. SP&T ◗ M Lassare, Rheumatology, STG. EULAR 2007 Scientific meeting. Barcelona, Spain. SP&T ◗ S Lindstrom, Respiratory, STG. ANZSRS 2007. Auckland, NZ. SP&T ◗ S Lindstrom, Respiratory, STG. TSANZ Meeting. Auckland, NZ. SP&T ◗ M Links, Oncology, STG. AA for CR. Los Angeles, USA. SP&T ◗ J McCrohan, Cardiology, STG. SCMR 2007. Rome, Italy. SP&T ◗ J McCrohan, Cardiology, STG. RANZCR - Speaker. Christchurch, NZ. SP&T ◗ A McDonald. Anaesthetics. STG, Association of Anaesthetics, Munich. Germany, General ◗ G Mifsud. ED. STG, BADM Conference, London, UK, General ◗ G Mifsud. ED. STG, Joint Courses - EATES and ETS. Graz, Austria. General ◗ G Mifsud, ED, STG. 3rd World Conference on Ultrasound. Paris, France. General ◗ G Mifsud, ED, STG. 1st Congress on Disaster and Emergency Med. Amsterdam, Netherlands. General Official overseas travel Area ◗ K Olesen, Area Nursing, JCVU. Copenhagen, Denmark. SP&T Central Hospital Network ◗ S Baldwin, Aged Care, STG. **. NZ, General. ◗ P Boers, Neurology, STG. Joint World Congress, Stockholm, Sweden. SP&T ◗ G Bowring, Rehabilitation, STG. ACRM ASNR Conference. Boston, USA. General ◗ M Brown, Renal, STG. ESA&ANZSN Annual Conference. London, UK. General ◗ M Brown, Renal, STG. NASSHP Conference, Los Angeles, USA. SP&T ◗ J Bucci, Oncology, STG. 12th International Meeting. Rome, Italy. SP&T ◗ C Carmody, Sexual Health, STG. Summer School 2007. Oxford, UK. General ◗ T Chan, ED, STG. ACEM + CENZ Combined. Wellington, NZ. General ◗ E Clarke, Respiratory, STG. 27th Union World Conference. Paris, France. SP&T ◗ E Clarke, Respiratory, STG. 2nd Ripid International. London, UK. SP&T ◗ E Clarke, Respiratory, STG. Rare Pulmonary Diseases and Orphaned Drugs in Respiratory Medicine Diffuse Lung Diseases. Milan, Italy. SP&T ◗ K Clarke, Psychiatry, Area Mental Health. Beyond the Crossroads. Birmingham, UK. General ◗ I Cook, Gastroenterology, STG. Dysphagia Research Society. Vancouver, Canada. General ◗ G Davis, Women's/Children's, STG. NASSHP, San Diego, USA. General ◗ J Davis, Palliative Care, STG. **, Kuala Lumpur, Malaysia. General ◗ T Diamond, Endocrinology, STG. 4th Congress APSSAM. Denpasar, Indonesia. SP&T ◗ J Bothe, Surgery, Div. Critical Care and Surgery. STG. Knowledge Utilisation and Implementation in Health Service. Minneapolis, USA. SP&T ◗ M Dreux, Anaesthetics, STG. Euroanaesthesia 2007. Munich, Germany. General ◗ P Dunn, Social Work, STG. Cancer Institute International Sabbatical. USA and England. Sponsors ◗ J Edmonds, Rheumatology, STG. ACR/ARHP Scientific Meeting. Washington, USA. General Better Services – Healthier People 82 Healthy People – Now and in the Future South Eastern Sydney and Illawarra Area Health Service Our people ◗ L Mills, Nursing Services, STG. JCVU, Copenhagen, Denmark. SP&T ◗ L Morfis, Geriatric, STG. ASGM Conference. NZ. General ◗ J Moses, Respiratory, STG. American Thoracic Society. San Francisco, USA. SP&T ◗ D Murrell, Dermatology, STG. SID. Los Angeles, USA. SP&T ◗ D Murrell, Dermatology, STG. EADV, Vienna, Austria, SP&T ◗ D Murrell, Dermatology, STG. AAD Conference. Washington, USA. SP&T ◗ J Myburgh, ICU, STG. ESICH Congress. Berlin, Germany. SP&T ◗ J Myburgh, ICU, STG. Dingle 2007 Conference. Ireland. SP&T ◗ J Myburgh, ICU, STG. PROCESS Study Meeting. Paris, France. SP&T ◗ T Nau, ED, STG. RACS ASC 2007. Christchurch, NZ. General ◗ T Nau, ED, STG. 8th EFFORT Congress. Florence, Italy. General ◗ M Novy, Retrieval, STG. London Hospital Helicopter Service. London, UK. General ◗ M O'Leary, ICU, STG. 6th Summer Conference ICU. Toronto, Canada. SP&T ◗ M O'Leary, ICU, STG. ISICEM 21st International. Brussels, Belgium. SP&T ◗ P Paton, Anaesthetics, STG. Annual Congress 2007. Dublin, Ireland. General ◗ A Pethebridge, Psychiatry, STG. Annual Meeting - RCP. Glasgow, UK. General ◗ G Skowronski, D&A, STG. ESICM Conference. Berlin, Germany. SP&T ◗ S Tan, Rehab, STG. Fall Conference. Hawaii, USA. General ◗ S Tivey, Anaesthetics, STG. University of Virginia. Virginia, USA. General ◗ S Wright, Cardiology, STG. CT Coronary Angiography. New York, USA. SP&T ◗ K Yates, Paediatrics, STG. APPES 4th Scientific Meeting. Thailand. General Better Services – Healthier People Northern Hospital Network ◗ L Andrews, Oncology, POW. Intl. Society for Gastrointestinal hereditary Tumours. Yokohama, Japan. SP&T ◗ T Barnes, Albion Street Centre, POW. Indonesian HIV/AIDS Project. Jakarta-Makassar, Indonesia. SP&T ◗ T Barnes, Albion Street Centre, POW. HIV NRT Conference and Bamra Project Visit. Bangkok, Thailand. SP&T ◗ T Barnes, Albion Street Centre, ACS. HIV/AIDS Indonesia Project. Jakarta-Makassar, Indonesia. SP&T ◗ T Barnes, Albion Street Centre, POW. Indonesia HIV/AIDS Project. Jakarta-Makassar, Indonesia. SP&T ◗ A Bartlett, Outpatents, RHW. ADIPS, Christchurch, NZ. General ◗ N Bates, Snr Project Co-ordinator, POW. HIV/AIDS Indonesia Project. Jakarta-Makassar, Indonesia. SP&T ◗ N Bates, Snr Project Co-ordinator, POW. AusAid ISMPP. Port Moresby, Papua New G. SP&T ◗ N Bates, Snr Project Co-ordinator, POW. Indonesian HIV/AIDS Project and Tachin Project. Jakarta, Indonesia. SP&T ◗ N Bates, Albion Street Centre, ASC. HIV/AIDS Indonesia Project. Jakarta, Indonesia. SP&T ◗ N Bates, Albion Street Centre, ASC. AusAID HIV/AIDS Indonesian Project. Jakarta, Indonesia. SP&T ◗ N Bates, Albion Street Centre, ASC. PNG-Consultancy Project Evaluation. Port Moresby, PNG. Sponsorship ◗ N Bates, Albion Street Centre, ASC. PNG HIV/STI AusAID Project. Port Moresby, PNG. SP&T ◗ M Beaudoin, Cardiac Anaesthetics, POW. Anaesthesia Conference. New York, USA. General ◗ K Bedley, Clinical Psychologist, POW. Health Care Worker Safety Project. Jakarta, Indonesia. SP&T ◗ J Beeby, Medical Imaging, POW. Conference. Rome, Italy. SP&T ◗ J Bell, D&A, POW. National Addiction Centre. London, UK. General ◗ J Bell, D&A, POW. Conference. USA . General ◗ M Bennett, Diving and Hyperbaric, POW. UHMS ASM. Hawaii, USA. SP&T ◗ M Berger, Medical Imaging, POW. Radiology in Ireland. Ireland. SP&T ◗ E Bergin, Nurse Educator, POW. Enhancing Practice 6: Innovation, Creativity, Patient Care and Professionalism. Edinburgh, UK. Self Funded ◗ V Binns, Community and Ambulatory Care, POW. World Physical Therapy 2007. Vancouver, Canada. SP&T 83 Healthy People – Now and in the Future ◗ M Bishay, Anaesthesia, POW. Greek/Aust Int Legal and Medical. Greece. General ◗ E Bland, Neuro-Oncology Co-ordinator, CNC, SCH. COG Nursing Workshop. Dallas, USA. SP&T ◗ K Bolton, Diabetes Centre, POW. AusAid Pacific Island Project - Diabetes. Vanuatu. Sponsors ◗ K Booth, Physiotherapist, RHW. International Continence Society 36th Annual meeting. Christchurch, NZ and USA. SP&T ◗ M Boyle, ICU, POW. European Society of Intensive Care Medicine, 19th Annual Congress. Barcelona, Spain. SP&T ◗ M Bragg, Emergency, POW. Conference. NZ. General ◗ M Bragg, Emergency, POW. Society of Neuromuscular Sciences. Japan. General ◗ B Brigham, Medical Oncology, POW. Conference. Turkey. SP&T ◗ T Broe, Ageing Research Centre, POW. Movement Disorder Society. Turkey. General ◗ A Brown, Orthotics, SCH, POW. 13th World Congress of the Intl Society for Prosthetics and Orthotics. Vancouver, Canada. No Cost ◗ C Burns, Paediatric Asthma Education, Child and Family, SCH. TSANZ 2007 Annual Scientific Meeting. Auckland, NZ. General ◗ G Caplan, Geriatric Medicine, POW. American Geriatric Society, USA. General ◗ G Caplan, Geriatric Medicine, POW. Australian Society for Geriatric Medicine. NZ. General ◗ B Carrigg, Allied Health, SCH. Douglas and Lola Scholarship Study Tour - Autism USA. (Various) USA. SP&T ◗ S Carroll, Radiation Oncology, POW. **. Germany. SP&T ◗ S Carroll, Radiation Oncology, POW. TROG. NZ. SP&T ◗ S Carroll, Radiation Oncology, POW. Paediatric Radiation Oncology. Barcelona, Spain. SP&T ◗ S Carroll, Radiation Oncology, POW. Primary Therapy of Early Breast Cancer. Switzerland. SP&T ◗ B Chan, Emergency, POW. ER Medicine. Alaska, USA. General ◗ B Chan, Emergency, POW. North American Congress of Clinical Toxicology. San Francisco, USA. General ◗ B Chan, Emergency, POW. **. San Francisco, USA. General ◗ K Chan, Radiation Oncology, POW. ISRS 2007. San Francisco, USA. SP&T ◗ J Close, Geriatrics, POW. British Geriatric Society Meeting. UK. General Better Services – Healthier People ◗ J Close, Geriatric Medicine, POW. Australia & New Zealand Society of Geriatric Medicine. NZ. General ◗ J Close, Geriatric Medicine, POW. **. NZ. General ◗ S Colagiuri, Endocrinology, POW. **. UK. SP&T ◗ S Colagiuri, Endocrinology, POW. Endo Diabetes and Metabolism. India. SP&T ◗ J Colebatch, Neurology, POW. Japan Equilibrium Society. Japan. SP&T ◗ R Collins, Snr Amputee Physiotherapist, POW. World Congress of the International Society for Prosthetics and Orthotics. Vancouver, Canada. SP&T ◗ K Coote, Albion Street Centre, ASC. Training Course Training of Health Care Workers in HIV AIDS Clinical Care Counselling and Tra. Shanghai, China. SP&T ◗ M Crawford, Anaesthesia, POW. Operation ServiceOpen heart surgery, Port Moresby Hospital. PNG. Personal ◗ D Cupitt, Medications, RHW. 20th International Conference of the Organisation of Teratology Information Specialist. Pittsburgh, USA. SP&T ◗ S Daniells, Nutrition and Dietetics, POW. European Society of Parenteral and Enteral Nutrition. Prague, Czech Republic. Sponsorship ◗ G Davidson, Anaesthesia, POW. **. Paris, France. General ◗ D Dimitru, Clinical Information, POW. TROG. Rotorua, NZ. SP&T ◗ L Dowdell, Medical Imaging, POW. Crisp Medical Imaging Nurses Conference. Christchurch, NZ. Personal ◗ E Durna, PUD, Reproductive Unit, RHW. 22nd Annual Meeting of the Europeans Society of Human Reproduction Embryology. Prague, Czech Republic. SP&T ◗ C Ealing, Albion Street Centre, ASC. Bamras Collaboration/HIVNAT/TACHIN Project. Bangkok, Thailand. SP&T ◗ S Engel, Rehab and Spinal, POW. Int Nordic Spinal. Iceland and UK. General ◗ E Evans, Medical Genetics, SCH. To collect data (in the form of parent interviews and development assessments) for the Mowat-Wi. Various cities in the US. SP&T ◗ M Ewing, Snr Project Co-ordinator, POW. HIV/AIDS Indonesia Project. Jakarta-Makassar, Indonesia. SP&T ◗ L Farrell, Senior Physiotherapist, Physiotherapy, SCH. Visit to National Clinical FES Centre. Salisbury and Queen Mary's Gait Laboratory, Rockhampton. UK. SP&T ◗ D Finucci, Emergency, POW. BAEM Spring Conf 2007. UK. General 84 Healthy People – Now and in the Future Our people 88 ◗ A Flax, Ophthalmology, POW. Hawaiian Eye Meeting. Hawaii, USA. General ◗ J Foster, Diabetes Transplant Unit, POW. 2007 Joint Conference CTS-IPITA-IXA. Minnepeapolis, USA. SP&T ◗ G Frank, Podiatrist, Diabetes Centre, POW. AusAid Pacific Island Project - Diabetes. Vanuatu. Sponsors ◗ P Frank, Corneal Transplant, S/SE. Cornea and Eye Bank Meeting. Auckland, NZ. SP&T ◗ M Friendlander, Medical Oncology, POW. **. USA. SP&T ◗ V Furner, Albion Street Centre, ASC. **. Shanghai, China. SP&T ◗ R Galway, A/Nurse Educator, SCH. Australasian Nurse Educators Conference. Wellington , NZ. SP&T ◗ S Gatt, Anaesthesia and ICU, POW. AACA 2006. Singapore. SP&T ◗ S Gatt, Anaesthesia, POW. AEEAN and SOAP. Canada. General ◗ S Gatt, Anaesthesia, POW. **. Ireland. General ◗ A Ghanbari, Respiratory Medicine, POW. ANZSRS, ASM 2007. Auckland, NZ. SP&T ◗ D Giles, Neurosciences, POW. Epilepsy Drug Trial Brivaracetam . Kuala Lumpur, Malaysia. Sponsored ◗ J Gold, Albion Street Centre, POW. TACHIN HIV/AIDS Nutritional Project. Bangkok, Thailand. SP&T ◗ J Gold, Albion Street Centre, ASC. WHO Project Meeting. Berlin, Germany/Geneva. SP&T ◗ D Goldstein, Medical Oncology, POW. **. Bangkok, Thailand. nil ◗ D Goldstein, Medical Oncology, POW. 2007 ASCO Ann Mtg. USA. SP&T ◗ D Goldstein, Medical Oncology, POW. Euro Study Pancreatic Cancer. Italy. SP&T ◗ D Goldstein, Medical Oncology, POW. QMT Investigator Mtg. Thailand. SP&T ◗ E Goodison-Farnsworth, Rehabilitation, SCH. Intl Children's Continence Society. Antalya, Turkey. Self Funded ◗ I Goodwin, A/Nurse Educator, SCH. Australasian Nurse Educators Conf. Wellington, NZ. SP&T ◗ J Goulder, IT Manager, POW. World Food Program Workshop. Bangkok, Thailand. SP&T ◗ D Gracey, Nephrology, POW. **. Boston, USA. General ◗ D Gracey, Nephrology, POW. Dialysis Nephrology Transplant Workshop. NZ. General ◗ D Gracey, Nephrology, POW. **. San Diego, USA. General ◗ D Gracey, Nephrology, POW. Transplant Congress, USA. General Better Services – Healthier People ◗ A Graudins, Emergency, POW. Emer Med Acute Care Series. USA. General ◗ S Greig, Albion Street Centre, ASC. Meeting South Pacific Chief Nursing Officers Alliances. Apia, Samoa. SP&T ◗ S Greig, Speech Pathology, SCH. Cranio Facial Society of Great Britain. Dublin, Ireland. SP&T ◗ M Grogan, Radiation Oncology, POW. RANZCR 2006 Annual Meeting. Singapore. SP&T ◗ G Groves, Endocrinology, SCH. Australian Diabetes Educators Assoc Annual Scientific Meeting. Christchurch, NZ. SP&T ◗ W Haindl, Nuclear Medicine, POW. NYU Clinical Imaging Essentials. USA and Switzerland. SP&T ◗ W Haindl, Nuclear Medicine, POW. Mane, USA. SP&T ◗ W Haindl, Nuclear Medicine, POW, European Thyroid Congress. Naples, Italy. SP&T ◗ W Haindl, Nuclear Medicine, POW. Brain PET 07. Japan. SP&T ◗ W Haindl, Nuclear Medicine, POW. PET Imaging Site visitation. New York, USA. SP&T ◗ J Heads, Lactation RHW, RHW. Interdisciplinary Breastfeeding Practice - Integration through Innovation. Philadelphia, USA. Sponsors ◗ SM, Heng, Radiation Oncology, POW. ESTRO Teaching Course: Dose Calculation and Verification for External Beam Therapy. Budapest, Hungary. Sponsorship ◗ CC Hew, Medical Imaging, POW. Radiology Annual Meeting. Florida, USA. SP&T ◗ C Hiew, Medical Imaging, POW. European Society of Paediatric Radiology. Spain. SP&T ◗ CC Hiew, Medical Imaging, POW. RSNA 2005. ** . General ◗ C Hiew, Medical imaging, POW. 50th Annual Meeting. USA. SP&T ◗ R Hill, Albion Street Centre, POW. AusAid Indonesia HIV/AIDS Project. Jakarta-Makerssar, Indonesia. SP&T ◗ R Hill, Albion Street Centre, POW. WHO - PNG Consultancy. Port Moresby, PNG. SP&T ◗ R Hill, Clinical Consultant, POW. HIV/AIDS Indonesia Project. Jakarta, Makassar, Indonesia. SP&T ◗ R Hill, Albion Street Centre, POW. Indonesian HIV/AIDS Project, Jakarta Makassar Indonesia. SP&T ◗ R Hill, Albion Street Centre, POW. WHO Workshop Delivery. Port Moresby, PNG. SP&T ◗ R Hill, Clinical Nurse Consultant, POW. Indonesia HIV/AIDS Project. Jakarta, Makassar, Indonesia. SP&T ◗ C Hook, Radiation Oncology, POW. Paediatric Radiation Oncology Society Congress. Barcelona, Spain. SP&T 85 Healthy People – Now and in the Future 89 ◗ F Levy, Mental Health, POW. International Society for Research in Child and Adolescent Psychopathology. London, UK. SP&T ◗ R Lim, Medical Imaging, POW. **. Canada. SP&T ◗ KB Lindrea, Newborn Care, RHW. 6th Intl Neonatal Nursing Conference. Delhi, India. Personal ◗ E Loughman, Anaesthesia, POW. Evidence Based mgmt of acute pain. NZ. General ◗ E Loughman, Anaesthesia, POW. Paed Critical Care. Switzerland and Holland. General ◗ J Mackie, Nephrology, POW. Australian & NZ Dialysis and Transplant Workshop. Queenstown, NZ. General ◗ B Maged, Anaesthesia, POW. Aust Int Leg and Med. Crete, Greece. General ◗ S McCarthy, Emergency, POW. **. UK. General ◗ RD McDonald, Chronic Respiratory, SCH. 20TH Annual North American Cystic Fibrosis Conf. Denver, USA. SP&T ◗ RD McDonald, Non-Procedural Directorate. SCH. Australia and NZ Cystic Fibrosis Nurses Conference. Auckland, NZ. Self Funded ◗ D McKenzie, Respiratory Medicine, POW. Conference. Munich, Germany. SP&T ◗ M McShane, Endocrinology, POW. Prenatal Screening Fundamentals and Innovations. Providence Rhode Island, USA., SP&T ◗ P Melling, Albion Street Centre, ASC. Project Activity HCWS Project. Jakarta, Indonesia. Other ◗ P Melling, Clinical Consultant, POW. Safehands Project/AusAid. Jakarta, Indonesia. Other ◗ P Melling, Infection Control, POW. Indonesia HIV/AIDS Project. Makassar, Jakarta, Indonesia. SP&T ◗ P Melling, Albion Street Centre, POW. Indonesia HIV/AIDS Prevention and Care Project. Jakarta, Indonesia. SP&T ◗ P Melling, Infection Control, POW. Healthcare Worker Safety Project. Jakarta - Indonesia. SP&T ◗ P Melling, Albion Street Centre, POW. AUSAID. Indonesia HIV/AIDS Project, Jakarta - Indonesia. SP&T ◗ P Middleton, Emergency, POW. Conference. Barcelona, Spain. General ◗ D Miners, Patient Flow, NN. HRT PT Streaming and Volume Prediction. Auckland, NZ. General ◗ M Montebello, Langton Centre, POW. WFSBP 2007 Conf. Chile. SP&T ◗ K Morgan, Anaesthesia, POW. Conference. NZ. General ◗ D Moses, Radiology, POW. **. Berlin. SP&T ◗ J Murray, Epilepsy Research Co-ordinator, Neurosciences, POW. UCB Pharma Investigator Meeting. Kuala Lumpur, Malaysia. Sponsors ◗ C Hook, Radiation Oncology, POW. ESTRO - Annual Meeting. Leipzig, Germany. SP&T ◗ L Houtzager, Albion Street Centre, ASC. Indonesian HIV/AIDS Conference. Jakarta Makassar Surabaya. SP&T ◗ L Houtzager, Albion Street Centre, ASC. AusAID Nutritional Thai Project - Tachin. Bangkok, Thailand. SP&T ◗ L Houtzager, Albion Street Centre, ASC. Tachin Thai Nutritional Project. Bangkok, Thailand. SP&T ◗ L Houtzager, Albion Street Centre, ASC. Nutritional Tachin Project. Bangkok, Thailand. SP&T ◗ L Houtzager, Albion Street Centre, POW. Indonesia HIV/AIDS Project. Makassar, Jakarta, Indonesia. SP&T ◗ L Houtzager, Albion Street Centre, POW. Indonesian HIV/AIDS Project AusAid. Jakarta-Makerssar, Indonesia. SP&T ◗ L Houtzager, Dietician, POW. World Food Program Workshop. Bangkok, Thailand. SP&T ◗ L Houtzager, Albion Street Centre, POW. Tachin Project. Bangkok, Thailand. SP&T ◗ L Houtzager, Albion Street Centre, POW. HIV/AIDS Indonesia Project. Jakarta, Makassar, Indonesia. SP&T ◗ S Jarvis, Physiotherapist, RHW. International Continence Society 36th Annual Meeting. Christchurch, NZ. SP&T ◗ D Jelley, Registered Nurse, Anaphylaxis Education, Immunology, SCH. ASCIA Annual Scientific Meeting. Queenstown, NZ. General ◗ K Johnson, Clinical Perfusion, POW. Perfusion Downunder. Queenstown, NZ. SP&T ◗ L Jones, Rehabilitation Medicine, POW. Innovation in Rehab. NZ. General ◗ S Karunaratne, Radiology, POW. MRM. Turkey. SP&T ◗ S Karunaratne, Medical Imaging, POW. ESSR. Turkey. SP&T ◗ P Katrak, Rehab/Spinal, POW. Seoul, Korea. General ◗ A Khatri, Oncology Research, POW. AACR Centennial Annual mtg 2007. Los Angeles, USA. SP&T ◗ KE Khor, Anaesthesia, POW. Cong of the Euro Fed of IASP. Istanbul, Turkey. General ◗ B Kwan, Respiratory Medicine, POW. Thoracic Society of Australia and NZ ASM 2007. Auckland, NZ. SP&T ◗ A Lancaster, Cerebral Palsy Service, SCH. Annual Meeting of American Academy of Cerebral Palsy and Developmental Medicine. Boston, USA. SP&T ◗ B Lee, Spinal and Rehab, POW. NORDIC Spinal Cord Societies. Iceland and Denmark. General ◗ J Lehm, Diving and Hyperbaric, POW. Undersea and Hyperbaric Med Soc ASM. USA. SP&T Better Services – Healthier People 86 Healthy People – Now and in the Future Our people ◗ J Murray, Clinical Trial, POW. 1) EPY 369 Investigator Seminar 2) Asian Oceanic Epilepsy Conference. Kuala Lumpur, Malaysia. Sponsors ◗ N Murray, Respiratory Medicine, POW. TSANZ. NZ. General ◗ R Musson, Albion Street Centre, ASC. HIV/AIDS Indonesia Project. Jakarta - Indonesia. SP&T ◗ R Musson, Project Co-ordinator, ASC. TACHIN Project. Bangkok, Thailand. SP&T ◗ R Musson, Albion Street Centre, ASC. HIV/AIDS Indonesia Project. Jakarta, Makassar, Indonesia. SP&T ◗ R Musson, Albion Street Centre, ASC. TACHIN Project. Bangkok, Thailand. Other ◗ K Nadew, Paediatric HIV Service, SCH. Intl Symposium on Children HIV/AIDS and 2006 Intl AIDS Conference. Toronto, Canada. Personal ◗ C Ng, Registrar, Radiation Oncology, POW. Faculty of Radiation Oncology Singapore Meeting. Singapore. SP&T ◗ K Nicholl, Oncology Social Work, POW. 8th World Congress of Psycho Oncology. Venice, Italy. SP&T ◗ J O'Brien, Albion Street Centre, POW. HIV/AIDS Indonesia Project. Jakarta - Indonesia. SP&T ◗ M O'Donnell, Kiloh Centre, POW. Conference. Canada. SP&T ◗ M O'Donnell, Mental Health, POW. Conference. USA. General ◗ A Parasyn, Surgery, POW. CS Annual Scientific Congress. NZ. General ◗ A Parasyn, Surgery, POW. RACS Annual Scientific Congress. NZ. General ◗ G Paretz, Medical Imaging, POW. **. USA. SP&T ◗ J Pereira, Medical Imaging, POW. **. Berlin. SP&T ◗ G Peretz, Medical Imaging, POW. Conference. NZ. SP&T ◗ G Peretz, Medical Imaging, POW. RANZCR. NZ. SP&T ◗ G Peretz, Medical Imaging, POW. Soc of Paediatric Radiology. USA. SP&T ◗ G Peretz, Medical Imaging, POW. Conference. USA. N/A ◗ R Philips, Medical Imaging, POW. Conference. Chicago, USA. SP&T ◗ R Philips, Radiology, POW. UKRC. UK. SP&T ◗ EN Por, Endocrinology, POW. Investigator Meeting for ORIGIN Study. Hong Kong. Sponsors ◗ EN Por, Endocrinology, POW. Investigators Meeting for ADVANCE Study. Vienna, Hungary. Sponsors ◗ J Post, Infectious Dis, POW. 17th European Cong of Clin Microbiology. Germany. General ◗ T Price, Albion Street Centre, ASC. **, Shangai-China. SP&T Better Services – Healthier People ◗ B Pussell, Nephrology/Medicine, POW. Conference. USA. General ◗ B Pussell, Nephrology/Medicine, POW. World Congress of Nephrology. Rio de Janeiro/Japan. General ◗ B Pussell, Nephrology, POW. Uni of Cambridge and Euro Dialysis and Transplant conf. UK and Spain. General ◗ B Pussell, Nephrology/Medicine, POW. ANZSN DNT Workshop. NZ. General ◗ H Ramaswamykanive, ICU, POW. Trauma, Shock, Inflammation and Sepsis, Munich, Germany, Personal ◗ S Reginiano. Anaesthesia. POW, European Society of Anaesthesiology. Munich, Germany. General ◗ M Rose, Research Management, Clinical Services, POW. 1) Intl Workshop on Harmonisation 2) AALAS Annual Conference. Salt Lake City, USA. Self Funded ◗ M Rose, Research Management, Clinical Services, POW. 6th World Congress on Alternatives and Animals in the Life Sciences. Tokyo, Japan. Personal ◗ M Rossleigh, Nuclear Medicine, POW. 13th Internal Symposium of Radionuclides in Nephrourology. Turkey. SP&T ◗ M Rossleigh, Nuclear Medicine, POW. Conference. Greece. SP&T ◗ M Rossleigh, Nuclear Medicine, POW. Conference. USA. SP&T ◗ I Rotenko, Emergency, POW. Emergency Med and Acute Care. Hawaii, USA. General ◗ S Ruhle, Radiation Oncology, POW. Quality Assurance for Siemans Linear Accelerators. Singapore. General ◗ P Russell, Professor/Director Oncology Research, POW. Innovative Minds In Prostrate Cancer Today. Atlanta, USA. Other ◗ P Russell, Prof/Director Oncology Research, POW. Innovations in Prostrate Cancer. San Francisco, USA. SP&T ◗ P Russell, Oncology Research, Institute of Oncology, POW. XIV Annual Congress of ESGT. Athens, Greece. SP&T ◗ M Ryan, Nursing-Oncology, RHW. 11th Biennial IGCS Meeting. Santa Monica, USA. SP&T ◗ S Ryan, Infectious Diseases, POW. 9th Intl Symposium on modern Concepts in Endocarditis and Cardiovascular Infections. Heidelberg, Germany. Personal ◗ S Sadler, Albion Street Centre, ACS. TACHIN Project. Bangkok, Thailand. SP&T ◗ S Sadler, Albion Street Centre, ASC. TACHIN Project. Bangkok, Thailand. SP&T 87 Healthy People – Now and in the Future ◗ F Spencer, Senior Physiotherapist, SCH. Study Tour. Douglas and Lola Douglas Scholarship. UK, Norway, Sweden, Belgium. SP&T ◗ R Stacey, Clinical Perfusion, POW. Perfusion Downunder. Queenstown. NZ, SP&T ◗ M Stoodley. Neurosurgery. POW, NI, NZ, General ◗ KA Thomas. Corneal Transplant. S/SE. Cornea and Eye Bank Meeting. Auckland, NZ. SP&T ◗ K Tiller, Medical Oncology, POW. Intl Psycho-Oncology Society Conference. Venice, Italy. SP&T ◗ M Tomkins, Albion Street Centre, POW. The 3rd Indonesian Intl Symposium of Infection. Jakarta, Indonesia. SP&T ◗ T Tran, Radiation Oncology, POW. GEC-ESTRO-ISIORT Joint Meeting and Pre Meeting Workshop. Montpellier, France. SP&T ◗ B Tuch, Endocrinology, POW. Conference. France. General ◗ B Tuch, Endocrinology, POW. Int Diabetes Fed Conf. South Africa. General ◗ C Turton, Albion Street Centre, ASC. HIV/AIDS XINSIANG Project. Urumqi. China, Sponsors ◗ C Turton. Albion Street Centre. ASC, Delivery of Workshop for the Burnet Institute. Yangon, Myanmar, Other ◗ C Turton, Albion Street Centre, POW. World Health Org. HIV/AIDS Strategy Meeting. Suva, Fiji. SP&T ◗ C Turton, Albion Street Centre, POW. WPRO-WHO HIV/AIDS Consulting Regional Meeting. Suva, Fiji. Sponsors ◗ J Turton, Neurosurgery, POW. Intl Conference on Recent Advance in Neurotraumatology. Tiajin, China. SP&T ◗ M Van Rooijen, Medical Imaging, POW. Conference. New York, USA. General ◗ L Vandervliet, Nutrition and Dietetics, SCH. ISPAD, Intl Society for Paed. and Adol. Diabetes - Incl Health Prof. Science School. Cambridge, UK. Sponsors ◗ N Vernon, Endocrinology, POW. Pacific Island Project. Vanuatu. Sponsors ◗ P Versace, Ophthalmology, POW. Conference. Greece/USA. General ◗ M Watts, Registrar, Infect Diseases, POW. American Society of Tropical Med. and Hygiene. Annual Meeting. Atlanta, USA, Personal ◗ B Way, Emergency, POW. Conference. USA. General ◗ B Way, Emergency, POW. Conference. UK and USA. General ◗ S Sadler, Albion Street Centre, ASC. Nutritional Tachin Project. Bangkok, Thailand. SP&T ◗ S Sadler, Albion Street Centre, ASC. World Food Program Meetings. Vienna, Rome and Phnom Pen. Project ◗ S Sadler, Albion Street Centre, POW. Tachin HIV/AIDS Project. Bangkok, Thailand. SP&T ◗ S Sadler, Albion Street Centre, POW. World Food Program Workshop. Bangkok, Thailand. SP&T ◗ S Sadler, Albion Street Centre, POW. Tachin, HIV/AIDS Nutritional Project. Bangkok, Thailand. SP&T ◗ S Sadler, Albion Street Centre, POW. AusAidTachin Project. Bangkok, Thailand. SP&T ◗ E Salvador, Medical Imaging, POW. 22nd CRISP Conference. Christchurch, NZ. Personal ◗ D Sandeman, Anaesthetics, POW. World Congress of Paediatric Critical Care. Geneva, Switzerland. General ◗ D Sandeman, Anaesthetics, POW. Conference. Istanbul, Turkey. General ◗ M Schneider, Radiation Oncology, POW. ISRS 2007. San Francisco, USA. SP&T ◗ K Schweigert, Psychologist, Tumbatin Clinic, SCH. Joint Aust.-Kunming Training Program on Child Development. Kunming, Yunnan Province, China. SP&T ◗ J Sheather, Albion Street Centre, ASC. HIV Training Course. Shangai-China. SP&T ◗ J Sheriff, Health and Ageing Research, WMH. Intl Conference on healthy Ageing 2006. Taipei, Taiwan. Self Funded ◗ J Shiels, NCC, POW. 6th Intl Neonatal Nursing Conference. Delhi, India. Personal ◗ K Sidhu, Diabetes Transplant Unit, POW. 4th Annual Meeting of ISSCR. Toronto, Canada. SP&T ◗ R Smee, Radiation Oncology, POW. ** USA. SP&T ◗ R Smee, Radiation Oncology, POW. Innovative Approaches in Hon Oncology. Barcelona, Spain. SP&T ◗ R Smee, Radiation Oncology, POW. Australia & New Zealand Head & Neck Society. NZ. SP&T ◗ R Smee, Radiation Oncology, POW. RANZR. Singapore. SP&T ◗ R Smee, Radiation Oncology, POW. Meeting. USA. SP&T ◗ D Smith, Albion Street Centre, ASC. AusAID Xinjiang HAPAC Project. Urumqui, China . SP&T ◗ E Somerville, Neurology, POW. Asian-Oceania Epilepsy Congress. Kuala Lumpur, Malaysia. General ◗ E Somerville, Neurology, POW. Asian Epilepsy Academy Workshop. Indonesia. General Better Services – Healthier People 88 Healthy People – Now and in the Future Our people 92 ◗ E Wegner, Nuclear Medicine, POW. 8th International Conference of Nuclear Cardiology. Prague. SP&T ◗ E Wegner, Nuclear Medicine, POW. Conference. Hawaii, USA. SP&T ◗ E Wegner, Nuclear Medicine, POW. ** Korea/Italy/London. SP&T ◗ J Wenderoth, Medical Imaging, POW. ISMRM. Berlin, Germany. SP&T ◗ J Wenderoth, Medical Imaging, POW. Oxford Advanced Aneurysm Symp. Oxford, UK. Self Funded ◗ P White, Medical Physicist, POW. ISRS 2007. San Francisco, USA. SP&T ◗ N Wickham, CPU, SCH. 11TH Ispcan European Conf on Child Abuse and Neglect. Lisbon, Portugal. SP&T ◗ J Williams, HandN/CNS Research Manager, POW. ISRS 2007. San Francisco, USA. SP&T ◗ A Wilson, Albion Street Centre, ASC. PNG HIV/STI AusAID Project. Port Moresby, PNG. SP&T ◗ D Wolfers, Anaesthesia and Hyperbaric Medicine, POW. Operation Service- Open Heart Surgery. Port Moresby, PNG. SP&T ◗ D Wolfers, Anaesthesia and Hyperbaric Medicine, POW. Anaesthesia for Developing Countries. Oxford, UK. SP&T ◗ W Wong, Radiation Oncology, POW. RANZCR. Singapore. SP&T ◗ W Wong, Radiation Oncology, POW, Brachytherapy in Gynaecological Malignancies. Austria. SP&T ◗ A Wright, Nurse Educator, RHW. 6th Intl Neonatal Nursing Conference. Delhi, India. Personal ◗ SJ Yap, Anaesthetics, POW. American Society of Anaestheologist Meetings. Chicago, USA. General ◗ G Youssef, Cardiology, POW. European Society of Cardiology World Congress. Barcelona, Spain. SP&T ◗ L Zhao, Haematology Research, POW. 4th Asian Pacific Congress on Thrombosis and Hemostasis, Suzhou. China, SP&T ◗ M Zhu. Snr Hospital Scientist. S/SE. Cornea and Eye Bank Meeting. Auckland, NZ. SP&T Southern Hospital Network ◗ SI Abey. Staff Specialist. TWH, Digestive Diseases Week 2007. USA. SP&T ◗ N Al-Khateeb, Staff Specialist, PKDH. Workshop on lumber spine injection. UK. General ◗ PWT Allin, Staff Specialist, SDMH. International Forum on Quality and Safety in Health Care. Spain. General ◗ EA Almond, Staff Specialist, SHH. Association of Medical Education in Europe. Italy. General ◗ OM Arvela, Staff Specialist, TWH. EANM 2006. Greece. SP&T Better Services – Healthier People 89 ◗ GD Barclay, Staff Specialist, PKDH. 6th Annual Kaleidoscope Conference. Ireland. General ◗ AJ Bezzina, Staff Specialist, TWH. European Society Of Intensive Care Medicine Annual Congress and European Society of Emergency Medicine. Spain. General ◗ M Boers, Staff Specialist, PKDH. Wellness Program Workshop and Cutting Edge National Addiction Conference. NZ. General ◗ W Braun, Surgery, TWH. Centennial Meeting of the SIU. Paris, France. Self Funded ◗ KM Brown, Staff Specialist, PKDH. 2007 International Vulvovaginal PG course. Canada. General ◗ KM Brown, Staff Specialist, PKDH. 22nd IUSTI - Europe Conference on Sexually Transmitted Infections. France. General ◗ KD Cartwright, Staff Specialist, TWH. American Society of Haematology. USA. SP&T ◗ KD Cartwright, Staff Specialist, TWH. 9th International Symposium on Myelodysplastic Syndrome. Italy. SP&T ◗ RVK Cherukuri, Staff Specialist, TWH. RACS Annual Congress. NZ. General ◗ RVK Cherukuri, Staff Specialist, TWH. 2007 AANS Annual Meeting. USA. General ◗ WY Chia, Staff Specialist, TWH. European Society for Paediatric Urology Annual Congress 2007. Belgium. General ◗ YH Chieng, Staff Specialist, TWH. APASL2007. Japan. SP&T ◗ JN Christley, Staff Specialist, SDMH. 4th World Congress of the International Society of Physical and Rehabilitation Medicine. Korea. General ◗ KJ Coleman, Staff Specialist, TWH. IUGA. Greece. SP&T ◗ KJ Coleman, Staff Specialist, TWH. British Congress O&G 2007. UK. SP&T ◗ AE Collins, Staff Specialist, Kiama. Update Course Elderly Medicine. UK. General ◗ D Cummings, Physiotherapy, SHH. Dr Vodder Manual Lymph Drainage Level 11/111. Walchsee, Austria. Self Funed ◗ RC Davenport, Staff Specialist, DBH. NeuPSIG. Germany. General ◗ IR Davidson, Staff Specialist, PKDH. ISIS Radiofrequency Workshop. USA. General ◗ WS Davis, Staff Specialist, TWH. SMFM Meeting. USA. SP&T ◗ M Dubossarsky, Staff Specialist, PKDH. Australasian Sports Medicine. NZ. General ◗ BS Elison, Staff Specialist, TWH. British Nuclear Medicine Society. UK. SP&T Healthy People – Now and in the Future ◗ BS Elison, Staff Specialist, TWH. SNM Conference. USA. SP&T ◗ CH Fox, Staff Specialist, TWH. Faculty of Radiation Oncology 2006 Annual Scientific Meeting. Singapore. SP&T ◗ CH Fox, Staff Specialist, TWH. San Francisco Radiation Oncology. USA. SP&T ◗ AL Glasgow, Staff Specialist, TWH. St Gallen Primary therapy of early breast cancer 2007. Switzerland. SP&T ◗ AL Glasgow, Staff Specialist, TWH. European Society of Medical Oncology 31st Annual Meeting. Turkey. SP&T ◗ A Grillas, Staff Specialist, TWH. American College of Gastroenterology Annual Scientific Meeting and Postgrad Course. USA. SP&T ◗ GJ Hart, Staff Specialist, BDH. TSANZ. NZ. SP&T ◗ GJ Hart, Staff Specialist, BDH. American Thoracic Society. USA. SP&T ◗ D Hill, Staff Specialist, TWH. Royal College of Radiologists Spring Meeting. UK. SP&T ◗ T Hobbs, Oncology Clinical Trials, TWH. TROG 19th Annual Meeting. Rotorua, NZ. SP&T ◗ F Hunt, Radiotherapy/IAHS/ Wollongong, TWH. TROG 19th Annual Meeting. Rotorua, NZ. SP&T ◗ A Jenssen, Staff Specialist, PKDH. ISPO 2007. Canada. General ◗ RN Juste, Staff Specialist, SDMH. 19th European Society of Intensive Care Medicine Congress and Royal College of Anaesthetists P. Spain. UK. General ◗ W Kealy-Bateman, Staff Specialist, SDMH. 7th Int. Con. of Int. Soc for Adol Psychiatry and Psychology. Canada. General ◗ JL Kohlhagen, Staff Specialist, TWH. American Society of Nephrology Annual Scientific Meeting. USA. General ◗ I Korbel, Staff Specialist, TWH. Site Visits at Wentworth House. UK. General ◗ I Korbel, Staff Specialist, TWH. 19th ECNP Congress 2006 / EABCT Annual Congress. France. General ◗ I Korbel, Staff Specialist, TWH. 8th World Congress of Psycho-Oncology. Italy. General ◗ I Korbel, Staff Specialist, TWH. World Congress of Psycho-Oncology. Italy. General ◗ I Korbel, Staff Specialist, TWH. VIII Annual Meeting of the International Society of Addiction Medicine. Portugal. General ◗ I Korbel, Staff Specialist, TWH. 12th Oxford Workshop in Teaching Evidence Based Practice. UK. General ◗ I Korbel, Staff Specialist, TWH. Beyond The Crossroads. UK. General Better Services – Healthier People ◗ M Lonergan, Staff Specialist, TWH. Dialysis Nephrology and Transplant Workshop. NZ. SP&T ◗ E Lucas, NI, TWH. Expedition Investigators Meeting. Vienna, Austria. Sponsorship ◗ JM Mann, Staff Specialist, PKDH. 46th annual scientific meeting of the international spinal cord society/ossur vi. Iceland. General ◗ JM Mann, Staff Specialist, PKDH. 67th annual assembly American academy of physical medicine and rehabilitation. USA. General ◗ SC Marsden, Staff Specialist, DBH. 16th International Congress on Care of Terminally Ill. Canada. General ◗ J Matthews, Diabetes, SDMH. Aust. Diabetes Educators Annual Scientific Meeting. Christchurch, NZ. General ◗ J Matthews, Diabetes, SDMH. Aust. Diabetes Educators Annual Scientific Meeting. NI . General ◗ JA McDonald, Staff Specialist, TWH. Digestive Disease Week. USA. SP&T ◗ DJ McMahon, Staff Specialist, TWH. Royal College of Psychiatrists Annual Conference. UK. General ◗ AA Miller, Staff Specialist, TWH. Computer-based Medical Systems. Slovenia. SP&T ◗ AA Miller, Staff Specialist, TWH. HC2007: Challenging Boundaries. UK. SP&T ◗ AA Miller, Staff Specialist, TWH. American Society Therapeutic Radiology and Onc. and Tutorial. USA. SP&T ◗ RG Moses, Staff Specialist, TWH. American Diabetes Association. USA. General ◗ R Moses, Diabetes, TWH. Expedition Investigators Meeting. Vienna, Austria. Sponsorship ◗ RG Moses, Staff Specialist, TWH. Australian Diabetes Society. NZ. General ◗ RG Moses, Staff Specialist, TWH. 6th International Insulin Resistance. Tanzania, Africa. General ◗ GR Murray, Staff Specialist, CDH. 6th Mediterranean Congress of PRM and 14th Cochrane Colloquium. Portugal. General ◗ R Murthy, Staff Specialist, TWH. HIMSS AsiaPac07. Singapore. General ◗ EH Nasser, Staff Specialist, TWH. American Society Therapeutic Radiology and Oncology 48th Annual Meeting. USA. SP&T ◗ TH Nguyen-Dang, Staff Specialist, SHH. China Interventional Therapeutics CIT 2007. China. SP&T ◗ TH Nguyen-Dang, Staff Specialist, SHH. Tokyo Percutaneous Cardiovascular Intervention. Japan. SP&T ◗ A Norrie, Endocrinology, SDMH. ADEA Annual Conference. Christchurch, NZ. SP&T 90 Healthy People – Now and in the Future Our people ◗ F Owen, Cancer service, TWH. 4th Mayo Clinic State of the Art Symposium on Hematologic Malignancies. Wellington, NZ. SP&T ◗ J Potter, Staff Specialist, TWH. Hong Kong Geriatric Medicine Society meeting. Hong Kong, China. SP&T ◗ J Potter, Staff Specialist, TWH. Geriatric Medicine Annual Scientific Meeting. NZ. SP&T ◗ CJ Poulos, Staff Specialist, PKDH. Study tour. Canada. General ◗ WAB Pratt, Staff Specialist, SDMH. 46th Annual ICAAC. USA. General ◗ JP Quinlan, Staff Specialist, CDH. AAPMR 2006 annual assembly. USA. General ◗ KS Rachakonda, Staff Specialist, TWH. ESICM 19th Annual Congress. Spain. SP&T ◗ A Reid, NI, TWH. Prepend/Impendia Investigator Training. Singapore. Sponsorship ◗ C Sanderson, Staff Specialist, PKDH. European Association of Palliative Care. Hungary. General ◗ P Saysana, Staff Specialist, TWH. Stanford symposium on emergency medicine 2007. USA. General ◗ PB Smith, Staff Specialist, TWH. 2006 ASICS Conference of Science and Emergency Medicine in Sport. Fiji. General ◗ H Tangen, CNC, TWH. ADS and ADEA Annual Scientific Meeting. Christchurch, NZ. General ◗ H Tangen, CNR, SDMH. ADS and ADEA Annual Scientific Meeting. ** General ◗ A Taylor, Staff Specialist, SDMH. Annual Scientific Meeting 2006. NZ. General ◗ A Taylor, Staff Specialist, SDMH. British International Congress of Obstetrics and Gynaecology. UK. General ◗ A Webb, Diabetes, TWH. SYR 322 OPI-004 Investigator Meeting. Rome, Italy. Other ◗ C Wen, Staff Specialist, TWH. Annual Meeting of American Society of Nephrology. USA. SP&T ◗ C Wen, Staff Specialist, TWH. World Congress of Nephrology. Brazil. SP&T ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ SEALS ◗ T Brighton, Haematology – North. 4th Asian-Pacific Congress on Thrombosis and Haemostasis. Suzhou, China. SP&T ◗ T Brighton, Haematology - North. Einstein VTE Phase III SMCC Excie Meeting. Barcelona, Spain. External ◗ M Buckley, Genetics - Randwick. OECD Meeting on QA in Molecular Genetics. Paris, France. SP&T ◗ M Buckley, Genetics - Randwick. UPPMD Meeting on Better Services – Healthier People ◗ ◗ ◗ 91 Co-ordination of International Databases. Amsterdam, Netherlands. SP&T M Buckley, Genetics - Randwick. European Society for Immunodeficiencies. Budapest, Hungary. SP&T P Bullpitt, Anatomical Pathology - North. 2006 ASCP Annual Meeting. Las Vegas, USA. SP&T K Cartwright, Haematology - South. ASCO. Chicago, USA. SP&T K Cartwright, Haematology - South. ASH. Orlando, USA. SP&T K Cartwright, Haematology - South. 9th International Symposium on Myelodysplastic Syndrome. Florence, Italy . SP&T C Chesterman, Haematology - North. Assistance for National Children's Hospital . Hanoi, Vietnam. SP&T C Cheung, Haematology - North. American Society of Haematology . Orlando, Florida. USA. SP&T C Dr Baleriola, Microbiology. 17th ECC MID/25th ICC2007. Munich, Germany. SP&T SJ Ho, Haematology - Central. 9th International Symposium on Myelodysplastic Syndromes. Florence, Italy. SP&T A Isaacs, Haematology Registrar. Mayo Clinic Symposium - Haematology Malignancies. Wellington, NZ. SP&T P Kitching, Anatomical Pathology - North. 26th International Congress of the IAP. Montreal, Canada. SP&T SH Lee, Haematology - Central. International Society for Laboratory Haematology. Miami, Florida, USA. SP&T SH Lee, Haematology - Central. Aperio Technologies Pathology Visions 2006. San Diego, USA SP&T R Lindeman, Haematology - North. 12th Congress of the European Haematology Association. Vienna, Austria. SP&T R Lindeman, Haematology - North. 29th International Congress of the International Society of Blood Transfusion. Cape Town, South Africa. SP&T S MacCallum, Haematology - North. 12th Congress of the European Haematology Association. Vienna, Austria. SP&T S MacCallum, Haematology - North. 48th ASH Annual Meeting. Orlando, Florida, USA. SP&T G McBride, Anatomical Pathology - South. Post Grad Course Diagnostic Breast Pathology. Austria. SP&T G McBride, Anatomical Pathology - South. ASCP Pathology Update. Canada. SP&T Healthy People – Now and in the Future ◗ G McBride, Anatomical Pathology - South. IAP 2006. Canada. SP&T ◗ G McBride, Anatomical Pathology - South. ASCP Workshop. USA. SP&T ◗ G McBride, Anatomical Pathology - South. AACC Lab 200X Conference. USA. SP&T ◗ S McKenzie, Anatomical Pathology - South. USCAP Annual Meeting. USA. SP&T ◗ E Millar, Anatomical Pathology - Central. 5th Asia Pacific International Academy of Pathology Congress. Singapore. SP&T ◗ J Moshides, Clinical Chemistry. 2007 AACC Annual Meeting. San Diego, USA. SP&T ◗ D Naidoo, Clinical Chemistry - North/Central. International Society for Free Radical Research 13th Biennial Conference. Davos, Switzerland. SP&T ◗ D Naidoo, Clinical Chemistry - North/Central. 39th Annual Oak Ridge Conference - Harnessing New Technology for Clinical Diagnostics. St Louis, USA. SP&T ◗ D Naidoo, Clinical Chemistry - North/Central. Professional Practice in Clinical Chemistry Course - A Review and Update. Washington DC, USA. SP&T ◗ D Naidoo, Clinical Chemistry - North/Central. 20th Symposium of the Protein Society. San Diego, USA. SP&T ◗ G O'Sullivan, Haematology - Central. 12th Congress of the EHA. Vienna, Austria. SP&T ◗ G O'Sullivan, Haematology - Central. Mayo Clinic Symposium on Haematologic Malignancies. Wellington, NZ. SP&T ◗ P Presgrave, Haematology - South. EBMT. Lyon, France. SP&T ◗ S Ramanathan, Haematology - Central. ESH - EBMT Training Course on Blood. Marrow Transplant. Alicante, Spain. SP&T ◗ B Rawlinson, Virology - Randwick. Presentations 11th International CMV 2007 Workshop. Toulouse, France. SP&T ◗ B Rawlinson, Virology - Randwick. Talk and Lab Visit Virology Dept, University of Cambridge. Cambridge, UK. SP&T ◗ B Rawlinson, Virology - Randwick. Congenital CMV and visit to congenital CMV patients, University of Bologna. Rome, Italy . SP&T ◗ D Reeves, Anatomical Pathology - North. 16th International Congress of Cytology. Vancouver, Canada. SP&T Better Services – Healthier People ◗ D Reeves, Anatomical Pathology - North. International Academy of Pathology Centennial Congress 2006. Montreal, Canada. SP&T ◗ U Samaraweera, Anatomical Pathology - North. 4th Annual Study Day of the British Association of Gynaecological Pathologists. London, UK. SP&T ◗ J Saveriumuttu, Haematology - South. British Society for Haematology 47th Annual meeting. Bournemouth, UK. SP&T ◗ P Taylor, Microbiology - North/Central. Laboratory Networking. Dubai, UAE. SP&T ◗ P Taylor, Microbiology - North/Central. Real Time PCR for the Clinical Microbiology Laboratory - Mayo Clinic. Rochester, USA . SP&T ◗ P Taylor, Microbiology - North/Central. 37th World Congress on Lung Health. Paris, France. SP&T ◗ C Theocharous, Anatomical Pathology - Central. Surgical Pathology of Soft Tissue, Head and Neck Gynaecological and Lymph Node Tumours - . Hawaii, USA. SP&T ◗ K Tran, Anatomical Pathology - Central. 20th Combined Skin Pathology Course. Pittsburgh, PA, USA. SP&T ◗ G van der Vegte, Endocrinology. 5th World Congress on Ovulation Induction . Rome, Italy. SP&T ◗ P Warburton, Haematology - South. X11th International Myeloma Workshop. Kos Island, Greece. SP&T ◗ C White, Endocrinology - Randwick. ECTS - Innovation in Postmenopausal Osteoporosis: A Therapeutic Breakthrough. Copenhagen, Denmark. SP&T ◗ C White, Endocrinology - Randwick. 5th Winter Symposium - Endocrinology. Diabetes and Metabolism - from bench to bedside. Vellore, India. SP&T ◗ C White, Endocrinology - Randwick. Society for Neuromuscular Sciences. Niseko, Japan. SP&T ◗ R Wilson, Executive Unit. Cerner Conference. Orlando, Florida. General ◗ R Wilson, Executive Unit. Site Visit, Baton Rouge, Louisiana, USA. General ◗ K Wise, Microbiology - South. Antibiotics Conference. Singapore. SP&T ◗ K Wise, Microbiology - South. Infectious Diseases Conference. San Francisco, USA. SP&T ** information not recorded 92 Healthy People – Now and in the Future 6 Our community redesign, patient quality and safety, transport for health, Aboriginal health, extending care choices and the NSW State Plan. Area Health Advisory Council Role and functions Council members The role of the Area Health Advisory Council (AHAC) is to facilitate the involvement of health services providers, consumers and other members of the local community in developing SESIH policies, plans and initiatives in relation to the provision of health services. Clinical members A/Professor Bob Farnsworth OAM – Chair (Surgery) Dr Hunter Watt (Urology) Dr Maureen Lonergan (Renal) Prof Richard Henry (Paediatrics and Respiratory Medicine) resigned October 2006 Dr Jane McCrohan (Cardiology) resigned April 2007 Ms Debbie Cansdell (Registered nurse, operating theatres) The SESIH AHAC held nine meetings in various locations across the Area in 2006 - 07. The AHAC has the following functions: ◗ Advise health services providers, consumers and other community members about SESIH policies, plans and initiatives in providing health services. ◗ Seek the views of health services providers, consumers and other community members about SESIH policies, plans and initiatives in providing health services and advise the Area Chief Executive of those views. ◗ Confer with the Area Chief Executive on how best to support, encourage and facilitate community, consumer and health service provider involvement in the Area’s health services planning. ◗ Liaise with other Area Health Advisory Councils about local and statewide initiatives in providing health services. ◗ Publish reports relating to its work and activities. ◗ Other functions conferred or imposed by the regulations. Community members Mr Gerald Moore (Nowra) Mr Alwyn Thomas (Blakehurst) Mr Peter Holz (Horsley) Dr Rowan Vickers (GP, Caringbah) resigned April 2007 Ms Toni Garretty (Woonona) Ms Mary Lamb (Ulladulla) Ms Ibtisam Hammoud (Dulwich Hill) resigned May 2007 Community activity Local health participation groups Consumer participation aims to involve consumers in the planning of health services delivery. Throughout 2006 - 07, the Area implemented, under the guidance of the Area Health Advisory Council, a new program for consumer participation, while continuing to support and resource carer groups. Achievements During 2006 - 07, the AHAC: ◗ Continued to schedule its meetings across the Area Health Service, with an AHAC Access Forum held before each meeting as an opportunity to meet with local consumers/community members and local staff. ◗ Continued to develop the annual work plan with priority focus given to overseeing the implementation of a model for consumer/community participation across the Area. ◗ Other identified areas of focus included: Area Clinical Services Strategic Plan, Avian Flu preparedness, consultation process with the community regarding Shellharbour Hospital Maternity Service, carers in Health, Consumer and Carer Rights and Responsibilities Policy development, mental heath, SESIH quarterly performance reporting, clinical Better Services – Healthier People To achieve this, consumer advisory committees were established for the following hospitals and community health services: Prince of Wales and Sydney/Sydney Eye Hospitals, Royal Hospital for Women, St George Hospital, Sutherland Hospital, Garrawarra Centre, Wollongong/Coledale/Bulli and Port Kembla Hospitals, Shellharbour and Kiama Hospitals and Shoalhaven and David Berry/Milton Ulladulla Hospitals. The recruitment of consumers to these committees utilised an open and transparent process involving a comprehensive advertising campaign, group interviews and appointment, based on ensuring as far as possible, that the group was representative of its communities. 93 Healthy People – Now and in the Future Our community 6 SECTION The structure of Sydney Children’s Hospital’s Parent and Consumer Council and the Mental Health Consumer Committees did not change. Their purpose is to ensure consumers have a clear voice in ongoing issues affecting them, and to provide them with an opportunity to work with the Health Service. Fundraising and sponsorship Northern Hospital Network Prince of Wales Hospital In addition to their volunteer work, the POWH Volunteers undertake fundraising through their operation of the Garden Coffee Shop. They raise revenue towards the purchase of equipment for patient care. In addition to the $30,000 raised for the hospital, this year the volunteers also funded the construction of all-weather cover and new garden areas for the Coffee Shop courtyard. In addition, consumers and carers also contributed to numerous clinical areas throughout SESIH. The Carer Support Team continued to support and resource carer groups, NGOs and Area services to develop and implement innovative health redesign projects, to ensure carers’ needs are met. Examples include the development of a renal support group at Shoalhaven Hospital, educating carers at Garrawarra Centre to engage them in care planning and service development, provision of training for Motor Neurone Service care workers to improve carer confidence in and use of the service, supporting the pilot of a brain injury group with the Illawarra Brain Injury Service team, and undertaking numerous Carer Week activities. Prince of Wales Hospital Foundation The POWH Foundation has strong links with the community to assist the hospital to create better community awareness. The Foundation was formed for public charitable purposes to encourage, support, and assist the hospital in the fields of research, education, and specific activities and projects. Royal Hospital for Women Foundation The Foundation is the principal fundraising organisation for the Royal Hospital for Women. It plays a role in funding research, education and special needs for the hospital through generous support from the community. The Foundation also supports the hospital through the work of its volunteers. Sydney Children’s Hospital In addition to the funds transferred to the hospital by the Sydney Children’s Hospital Foundation, the hospital received $401,787 in donations from the community. Sydney Children’s Hospital Foundation The Sydney Children’s Hospital Foundation is the principal fundraising organisation for the Sydney Children’s Hospital. To view the Foundation’s activities and achievements, visit: www.sch.edu.au/help/foundation/ During the year the Foundation transferred a total $8.2 million to the Sydney Children’s Hospital. Central Hospital Network St George Hospital and Community Health Service In 2006 - 07 the hospital received $1.782 million through fundraising activities and donations. The fundraising strategies included direct mail campaigns, bequests, events and raffles. Better Services – Healthier People 94 Healthy People – Now and in the Future Our community The bi-annual direct mail campaigns raised more than $138,715 for the 2006 Winter Appeal, the 2006 Christmas Appeal, the 2007 William Tan Rehabilitation Appeal, and part of the 2007 Winter Appeal. The funds assisted with the purchase of an ultrasound machine for the Emergency Department and a video assisted bronchoscope for the Intensive Care Unit. The Opportunity Shop, along with proceeds from the Auxiliary’s regular craft stalls raised a total of $27,000, of which $25,000 was donated towards the video assisted bronchoscope for the Intensive Care Unit, and $2,000 for the William Tan Rehabilitation Appeal to upgrade and purchase equipment for the gymnasium/facility rooms in the Rehabilitation Ward. During the financial year, the hospital received a total of $187,000 in bequests, and a further $46,387 was received ‘In Memoriam’. The Lamrock Committee of St George Hospital President: Ms Toni Horsey Fundraising events held by The Lamrock Committee this year included a fashion parade, art show, trivia night, salmon drive, craft stalls, raffles and the Annual Kogarah Fair and Charity Bed Race. In this financial year, the Lamrock Committee raised in excess of $50,000 towards the William Tan Rehabilitation Appeal, with a further $12,000 towards the appeal raised thanks to the Committee’s first fundraising dinner in June. The hospital’s Community Relations Department staff again assisted community groups and organisations with major fundraising events for the benefit of the hospital. These included the 15th Annual Kogarah Fair and Charity Bed Race event held in August 2006, which raised more than $30,000 towards the Prostate Cancer Institute. Garrawarra Centre The Diversional Therapy staff at Garrawarra Centre raised $1,346 through their craft stalls and raffles to purchase resources needed for the residents’ leisure and recreation programs. The William Tan Fundraising Dinner, organised by the St George Hospital Lamrock Committee in June 2007, raised more than $12,000 towards the Rehabilitation Appeal. The monthly market days and barbecue organised by the Community Relations Department raised more than $14,000. Southern Hospital Network The Hospital Volunteers who organise the craft and bookstalls raised $5,482 towards the purchase of medical equipment, and a total $8,237 was raised through internal raffles. SHN Fundraising Unit The area covered by the Southern Hospital Network (SHN) Fundraising Unit ranges from Coledale Hospital in the north, to Milton Ulladulla Hospital in the south. In the past financial year, SHN Fundraising raised more than $300,000 through community donations, corporate donations, direct mail campaigns, fundraising groups and bequests. The Sydney Credit Union continued its sponsorship agreement with the hospital, which included sponsorship of a bed in the Annual Kogarah Fair and Charity Bed Race, sponsorship and support of the 2006 St George Hospital staff Christmas barbecue, and the annual St George Hospital Recognition Awards. A bequest of $64,000 for the Palliative Care Unit at Port Kembla Hospital was received from the estate of the late Mrs R McDonnell. Hospital Auxiliaries Allawah Auxiliary President: Ms Verna Phillips Barton and Friends Auxiliary President: Ms Christine Baker During the year, SHN Fundraising held a direct mail campaign with a target of $50,000 to purchase a new EEG for Wollongong Hospital’s Children’s Ward. The campaign successfully met its target and raised $51,272 to purchase the equipment. St George Hospital’s Allawah and Barton Auxiliaries continued their fundraising efforts for St George Hospital. The Allawah Auxiliary raised $4,200 towards a video assisted bronchoscope for the Intensive Care Unit. The Angels of Hope Community Committee was formed three years ago to raise awareness and funding for mental health projects in the Illawarra. The Barton Auxiliary continued to operate the Opportunity Shop in Derby Street, Kogarah. Better Services – Healthier People 95 Healthy People – Now and in the Future The Angels of Hope held their annual race day in February 2007. Members of the Glen Tobin Trust, another charity formed to raise funds to support local mental health services, held their Spud Tobin Charity Golf Day in October 2006. The combined funds raised by the Angels of Hope Race Day and the Glen Tobin Charity Golf Day reached more than $100,000 for mental health services. Wollongong Hospital Friends of Wollongong Hospital President: Barbara Harrison In addition to providing toiletries and sleepwear for patients in need, the Friends of Wollongong Hospital raised funds through its raffles and gift shop sales towards the purchase of equipment. This included a $7,074 sphygmometer for physiotherapy, a $3,225 ECG monitor; a $3,710 observation monitor for the surgical ward; a $2,201 vaccine refrigerator for respiratory medicine; a $24,995 BiPAP vision ventilator and a $10,900 bed mover for the emergency department; and Yellow Fin positioning equipment for the operating theatres costing $9,520. About Faces Photography, with sponsorship from the City Cost Credit Union, produced a 2007 Calendar featuring the children of the Illawarra. Proceeds from sales of the calendars supported the purchase of new equipment for Wollongong Hospital’s Neonatal Unit and Paediatric Emergency Area. Port Kembla Hospital President: Anne Lewis Port Kembla Hospital Auxiliary continued its fundraising towards the purchase of equipment for patient care. During the year it raised $16,000 for equipment for the refurbished Ground Floor Rehabilitation Unit, and for new, electronically-operated beds. The South Coast Pigeon Club held a Pigeon Race in support of Wollongong Hospital Children’s Services. A total of $40,000 was successfully raised towards the purchase of new cardiac monitors for the Children’s Ward. The United Hospital Auxiliaries, The Illawarra Dialysis and Transplant and Transport Association, and the Illawarra Cancer Carers have also raised funds during the 2006 - 07 financial year for the Area. Shellharbour Hospital President: Lyn Thompson Members of Shellharbour Auxiliary have a goal to replace older beds in the hospital wards through their fundraising. During the year they raised $15,852 to purchase six new electronically-operated beds, and a further $8,000 was raised to purchase bariatric commodes; a respiratory humidifier for the Special Care Unit; a laryngoscope for the Emergency Department; and ultrasound equipment for the Physiotherapy Unit. United Hospital Auxiliaries (UHA) Apart from Coledale Hospital, the hospitals in the Southern Network are supported by hospital auxiliaries which are “branches” of the UHA. Bulli Hospital Bulli Hospital is supported by Bulli, Corrimal and Friends of Bulli Hospital branches of the UHA. Friends of Bulli Hospital President: Joy Bragg Corrimal branch UHA President: Jean Ronald Bulli branch UHA President: Janice Puddle During the year, Corrimal branch raised $12,000 for four Hi Lo beds, Bulli branch raised $3,336 for a video processing unit, and Friends of Bulli provided $1,100 for four lifter slings. The combined auxiliaries also purchased bedside cabinets, a pulse oximeter, pedal exerciser, two walkers, and four special patient alarms. Better Services – Healthier People In August 2006, the Auxiliary assisted the hospital staff to hold an Open Day to celebrate the hospital’s 20th Anniversary. David Berry Hospital President: Helen Van Hoven During the year members of the David Berry Hospital Auxiliary raised funds from their annual book sale, ‘Christmas in July’ luncheon, fashion parades and street stalls. A total of $27,330 was raised towards the purchase of a Monark rehabilitation trainer, two neurological tables, electronically-operated beds, bariatric chairs and wheelchairs. 96 Healthy People – Now and in the Future Our community Ethnic Affairs Priority Program The auxiliary members contributed a total of 6,408 hours of voluntary service for the hospital. Achievements Shoalhaven District Memorial Hospital Shoalhaven Hospital is supported by two very hard working Auxiliaries, the Nowra and Greenwell Point branches of the UHA. The Area's Ethnic Affairs Priorities Statement (EAPS) for the financial year 2006 - 07 indicates a comprehensive level of activity and performance in the five areas of assessment designated for public sector organisations by the Community Relations Commission for a Multicultural NSW. Greenwell Point Auxiliary President: Diana Medcalf Meetings are held monthly at Greenwell Point Community Memorial Hall. Last financial year Greenwell Point Auxiliary members contributed 3822 voluntary hours of service, and raised $5,077 towards the purchase of equipment for the hospital. Planning and evaluation The principal achievements were the sustainability of facility-based and service-based EAPS and the continued employment of Diversity Health Co-ordinators in a number of the participating facilities. Nowra Auxiliary President: Pat Glasby The Auxiliary members raise funds through their management of the vending machines, stalls, raffles and garage sales. In 2006 - 07 they raised $2,997 for the hospital. A number of key strategic documents such as the Area Clinical Services Strategic Plan 2006 - 09, Division of Population Health Strategic Direction Statement 2006 - 2010 and the draft SESIH HIV/Aids and STIs Prevention and Care Plan embrace the cultural diversity of the Area and commit to access and equity principles. Significant equipment purchases through the year included: four new maternity beds, $10,000 towards a stress machine; two washing machines for Hotel Services; Yellow Fins for the operating theatres, two video machines for staff education; a digital weighing chair for the rehabilitation unit; a wheelchair for the 23hr ward; and two mobile phones with blue tooth technology. A total of $131,000 was raised by the Nowra Auxiliary, which also provided 84,686 hours of voluntary service to Shoalhaven Hospital. Program and service delivery The Diversity Health Enhancement Grants Program, which is funded and administered by the Area Multicultural Health Service, has continued to provide considerable support to initiatives within the hospitals and community health services such as research and community development projects. This year its key focus was on funding the development of six Diversity Health Leadership Kits. Staff fundraising Two events were held by the staff to raise funds for their hospital. They were the Shoalhaven Hospital Ball, where 160 people attended, and a theatre night attended by 140 people. A total of $4,600 was raised for the hospital through these events. The majority of the Area services have implemented initiatives targeting specific culturally and linguistically diverse population groups such as the Macedonian, Chinese, Greek, Thai, Indonesian and refugee communities. This is evident in the detailed EAPS report by the Area submitted annually. Milton Ulladulla Hospital Milton Ulladulla Hospital Auxiliary President: Mary Lamb The Milton Ulladulla Hospital Branch donated approximately $32,000 for new equipment, which included a new $26,000 humidicrib for the maternity area and $6,000 towards other equipment needs. Better Services – Healthier People Communication While production of multilingual resources has been ongoing, a number of facilities have examined processes used to identify the need for and production of translations with the aim of improving timelines and efficient use of resources. 97 Healthy People – Now and in the Future The amalgamation of the Health Care Interpreter Service of the former South East with Sydney South West Area was completed and a new service level agreement will be developed in the coming year. Non-Government Organisations Links with Non-Government Organisations (NGOs) During 2006 - 07, the Area administered grants to NonGovernment Organisations (NGOs) totaling more than $16 million. Staffing Although the Multicultural Health Service experienced a number of staff vacancies during the year, it was able to largely maintain its structure. In addition, a number of specific multicultural positions were maintained in Area services, such as mental health, women’s health and sexual health. Funding was provided for 98 health-related projects provided by 87 NGOs, across 13 different program areas. A summary of NGO projects funded in 2006 - 07 by program area: Cultural diversity learning and development programs in some sites targeted the capacity of managers and clinicians to effectively address issues of cultural diversity in healthcare by organising specific workshops. These were based on managing services to culturally and linguistically diverse communities. Funded services The NGOs administered by SESIH abide by the NSW Health Operational Guidelines, which indicate that all services must be accessible as stipulated in the NSW AntiDiscrimination Act. Work will commence to standardise the EAPS criteria for NGO contracts. Program Area Number of NGOs Total grant ($) Women’s Health 5 1,075,300 204,000 Carer’s Program 5 Community Transport 7 82,655 Health Promotion 5 699,600 Drug and Alcohol 23 6,461,705 AIDS 11 2,490,900 External Health 1 80,000 Community Services 14 1,700,250 Mental Health 5 975,000 Aged and Disability 12 881,800 HACC 7 1,798,425 IHSHY (Homeless Youth) 1 147,800 National Women’s Health 2 110,200 TOTAL 98 $16,707,635 SESIH values the significant contribution of communitybased health-funded NGOs in identifying health needs and providing health services in a cost effective manner to our community, in partnership with government agencies. Better Services – Healthier People 98 Healthy People – Now and in the Future Our community NGOs by Program Area Approved grant ($) $15,825 $971,800 $15,300 $77,500 $11,325 $44,250 Women's Health Centacare-Natural Fertility Services Illawarra Womens Health Centre Shoalhaven Womens Health Centre Waminda (South Coast Women’s Health & Welfare Aboriginal Corporation) YWCA-Encore Program $1,075,300 $61,800 $355,000 $191,900 CRC (Community Restorative Centre) Foley House Inc. GAMMA NSW Inc Healthy Cities Illawarra Inc Luncheon Club AIDS Support Group Inc. Youth Accommodation Association (NSW) Inc. $168,100 $298,500 External Health Australian Council on Health Care Standards $80,000 $80,000 Carers’ Program Can Revive Inc Eastern Respite & Recreation -The Creativity Centre Illawarra Retirement Trust Learning Links-Caring for Carers Group Sydney Multicultural Community Services Inc $204,000 $50,000 $24,700 $30,000 $49,300 $50,000 $1,700,250 Community Transport Holdsworth Street Community Centre (Woollahra) Inc. Illawarra Community Services Kiama Community Transport Randwick/Waverley Community Transport Group Inc. South Sydney Community Transport Inc. Sutherland Shire Community Transport Inc. Wollongong Community Transport $82,655 $16,500 $22,700 $5,540 $6,700 $10,000 $13,200 $8,015 Community Services Australian Red Cross NSW Glen Mervyn Young Women’Health project CanTeen - The Australian Organisation for Young People Childbirth Education Association of Australia Compassionate Friends NSW Inc. Enough is Enough Anti - Violence Movement Inc. Homicide Victims Support Group Inc. Interrelate -Family Life Movement of Australia (NSW) Lifeline South Coast NSW Macular Degeneration Foundation Mission Australia - Court Support Service St George Cancer Support Group Inc. St John Ambulance Australia (NSW) St Vincent de Paul Society - Matthew Talbot Hostel Wayside Chapel - Crisis Centre Health Promotion AIDS Council of NSW Inc.- Gay & Lesbian Anti-Violence Combined Pensioner & Superannuants Association of NSW Healthy Cities Illawarra Inc. Illawarra Aboriginal Medical Service Nutrition Australia (NSW Division) Inc. $699,600 $130,700 $137,100 $350,400 $25,000 $56,400 $975,000 $56,200 $165,400 $386,400 $156,200 Drug and Alcohol Baptist Community Services - Darcy House Project Drug & Alcohol Multicultural Education Centre Haymarket Foundation Ltd. Kedesh Rehabilitation Services Mission Australia- Drug & Alcohol Intervention Program Odyssey House McGrath Foundation Phoebe House Inc Salvation Army (NSW) - William Booth House (Post Detox Rehab) Salvation Army (NSW) - Bridge Nursing Hostel (24 hour Detox) Salvation Army (NSW) - Oasis Youth Support Network Salvation Army (NSW) - Alf Dawkins Detox Unit Salvation Army (NSW) - Catherine Booth House St George Youth Services Inc.READY Project Station Ltd Ted Noffs Foundation Inc. Waminda (South Coast Women’s Health & Welfare Aboriginal Corporation) Waverley Action for Youth Services - Kids at Risk project Waverley Drug & Alcohol Centre Wayside Chapel - Shepherd of the Streets We Help Ourselves (WHOS) Inc-MTAR Program We Help Ourselves (WHOS) Inc-OSTAR Program Wollongong Crisis Centre Women's Alcohol & Drug Action Committee (Jarrah House) $6,461,705 $21,600 $85,850 $122,400 $420,870 $122,100 $245,000 $584,550 Mental Health A.R.A.F.M.I. Illawarra After Care Association - Eastern Suburbs Support Service Independent Community Living Association Inc. Psychiatric Rehabilitation Association - The Outlook Psychiatric Rehabilitation Association Aged and Disability Association of Genetic Support of Australasia Inc. Australian Tinnitus Association (NSW) Ltd. Cancer Patients' Assistance Society of NSW Carers NSW Inc. Council on the Ageing (NSW) Inc. Headway Illawarra Inc. Little Bay Coast Centre for Seniors Inc. Multiple Sclerosis Limited (NSW/VIC) Neurofibromatosis Association of Australia Inc. Nurses on Wheels Inc. Palliative Care Association of NSW Inc. Uniting Care Ageing Blue Nursing Service $881,800 $70,300 $51,000 $113,600 $3,900 $44,200 $41,100 $36,300 $306,500 $15,500 $119,300 $70,200 $9,900 HACC Anglicare Chesalon Aged Services-Sutherland Podiatry Kiama Municipal Council Home Nursing Service Kingsgrove Community Aid Nurses on Wheels Inc. Southern Cross Community Healthcare Pty Ltd - Sutherland Spinal Cord Injuries Australia Uniting Care Ageing Blue Nursing $1,798,425 $209,134 $97,105 $48,423 $1,186,132 $69,347 $135,064 $53,220 IHSHY (Homeless Youth) Southern Youth and Family Services Association Inc. $147,800 $147,800 AIDS AIDS Council of NSW Inc.- Positive Living Centre Bobby Goldsmith Foundation Inc. Supported Accommodation Bobby Goldsmith Foundation Inc. - Administration Grant Bobby Goldsmith Foundation Inc. - Client Services Bobby Goldsmith Foundation Inc. - Financial Counsellor $2,490,900 $276,400 National Women's Health Southern Youth and Family Services Assoc. Inc. Illawarra Aboriginal Medical Service $110,200 $47,200 $63,000 TOTAL (number of projects – 98) $16,707,635 $371,855 $692,600 $360,000 $708,100 $25,185 $88,000 $98,100 $232,200 $72,100 $108,500 $102,200 $124,100 $138,385 $236,750 $418,455 $1,082,805 $223,450 $206,250 $590,350 $58,450 Better Services – Healthier People 99 Healthy People – Now and in the Future $236,100 $15,600 $61,500 $44,500 $54,800 $527,500 $36,400 $47,300 $278,500 $47,350 $9,500 $40,000 $201,200 $100,000 $210,800 Our Volunteers Volunteers are an integral part of the Sydney Children’s Hospital and can be found in all areas of the Hospital. The following volunteer programs are currently in place: Volunteers and Chaplaincy ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗ Ward volunteers Ward grannies Administrative support Theatre scrubs volunteers Meet and greet at the enquiries counter Star Café volunteers School Explorer volunteers Hospital School volunteers Australian College of Natural Therapies - neck and shoulder massages for parents and staff ◗ Patient camp volunteers Northern Hospital Network Chaplaincy services to Sydney Children’s Hospital, the Royal Hospital for Women and the Prince of Wales Hospital, are provided by the Chaplaincy Co-ordinator for the POWH and Randwick Hospitals campus. During the year, chaplaincy to the Randwick hospitals campus was strengthened through the diversity and commitment of the pastoral care team. The chaplains and volunteers from a range of faith traditions demonstrated high levels of motivation and skill. The increase in volunteer numbers contributed to an ongoing commitment to training in effective pastoral care. In March 2007, the Sydney Children’s Hospital Volunteer Advisory Committee was established. Current points of discussion include production of a volunteer training video, reviewing the volunteer handbook, and how hospital policies (eg. infection control guidelines) may impact on volunteer duties. Research conducted on the Randwick campus confirmed that the faith traditions of patients are important to them, and that the majority want visits from chaplains while in hospital. The chaplaincy also provided valuable input for hospital policy development. Central Hospital Network Prince of Wales Hospital Volunteers The volunteers who support POWH are self-managed by an elected executive committee which oversees several sub-committees. Last year, a total of 209 volunteers were registered as working at POWH and in the community: assisting with Respite Care at Annabel House; at the Albion Street Centre Ankali Program; Palliative Care with home visits; the Fitness Program in the Eastern Suburbs; and with the ReViVe Aged Care Program in the recently completed aged care precinct at POWH. These volunteers recorded 50,000 hours of service within the hospital, and 5,000 hours in the community. Garrawarra Centre In addition to the Friends of Garrawarra Centre, there are five volunteers who assist with the activities program for the residents including hairdressing, music, bus outings, social interaction, and crafts. The centre also receives visits from a Community Visitors Scheme volunteer. Garrawarra Centre has church services provided for the residents by Anglican, Catholic, Baptist and Uniting Church chaplains. Chaplaincy services to meet the spiritual needs of patients at St George and Sutherland Hospitals and Garrawarra Centre are provided by the Chaplaincy Coordinator. The service was boosted by volunteer chaplains trained during the year. Within the hospital, the volunteers carry out duties which include working in the Garden Coffee Shop, acting as hospital guides, and providing administrative support. The volunteers also provide the patient trolley and the mobile library services seven days a week, and manage the Wig Library for cancer patients. Southern Hospital Network Hospital Chaplaincy Service Network The spiritual needs of patients in the hospitals from Coledale to Milton are catered for by the 70 members of the Healthcare Chaplains’ Association. They are approved volunteers who have undergone training, offered locally twice a year, and who commit to weekly patient visits on an interdenominational basis. During May/June the volunteers contributed significantly to the working party established to upgrade all signage throughout the Randwick hospitals campus. Sydney Children’s Hospital Sydney Children’s Hospital has more than 140 current volunteers, who contribute 400 hours of work per week. Better Services – Healthier People 100 Healthy People – Now and in the Future Our community Each hospital has its own team of chaplains, headed by a co-ordinator, who tailors their ministry to the needs of that hospital. The chaplaincy teams meet monthly, and region-wide gatherings are held for continuing education, including an annual residential conference each September. To assist the work of the IDTA, during the year the City Coast Credit Union Foundation provided $25,000 towards the running of the patient transport service for those renal patients without means of transport. Friends of Wollongong Hospital The Friends of Wollongong Hospital is a branch of the United Hospital Auxiliaries (UHA). During the year, the Friends contributed a total 24,916 hours of voluntary service. In addition to staffing the hospitality desk at the hospital’s Crown Street entrance, the Friends provided a range of services to patients which included washing, and maintaining flowers and the mobile library. They also provided voluntary administrative support to the renal unit, maternity ward, birthing centre, emergency department, and chest clinic. Illawarra Cancer Carers Illawarra Cancer Carers are a wholly volunteer organisation. Their activities include caring for patients’ non-medical needs in the Illawarra Cancer Care Centre and Wollongong Hospital Oncology Ward, and providing drivers to take patients to and from their appointments for treatment. In October 2006 the Carers held a celebration to mark their having raised more than $1 million to help cancer patients in the Illawarra since they began fundraising in 1994. During the year they raised $5,581 from their cork collection fundraiser. The Carers’ major fundraiser ‘Banquet at the Beach’ held in June raised $129,000 towards new equipment for refurbishment of the Cancer Care Centre Oncology Department and for equipment for cancer research at the University of Wollongong. Their major donations for equipment during the year included: $7,500 for a Dragon Boat for the Breast Cancer Support Group; $39,600 for infusion pumps; and $1,662 to support the Field of Women event. Port Kembla Hospital Palliative Care Volunteers The hospital’s Volunteer Co-ordinator works with the 45 volunteers who provide services such as home cooking for morning teas, newspapers and reading materials as well as meeting other needs of the patients in the Palliative Care Unit. Illawarra Dialysis and Transplant Association (IDTA) IDTA is small group of volunteers who are renal dialysis patients, their carers and friends. They raise funds to assist the Illawarra Renal Dialysis Unit at Wollongong Hospital to purchase specialised equipment for patients of the unit and to provide transport for outpatients who need regular dialysis. Better Services – Healthier People 101 Healthy People – Now and in the Future Better Services – Healthier People 102 Healthy People – Now and in the Future 7 Freedom of information 7 SECTION Freedom of information During the 2006 - 07 financial year South Eastern Sydney and Illawarra Area Health Service received 118 new requests for information under the Freedom of Information Act 1989, compared with 319 for the 2005 - 06 financial year. Overall, the number of FOI applications decreased by 63 percent. The decease in FOI applications is attributed to medical records being released under the Health Records and Information Privacy Act 2002 (HRIPA) which came into force in September 2004. Two applications for an internal review were received within the reporting period. Five applications required consultations with parties outside SESIH and two applications were reviewed by the Administrative Decisions Tribunal. No Ministerial certificates were issued within the reporting period. FOI fees received in the 2006 - 07 financial year amounted to $4,149. SESIH completed 129 FOI applications during the 2006 - 07 financial year with three carried forward to the next reporting period. Freedom of information applications APPLICATIONS PERSONAL 2004-05 2005-06 NON-PERSONAL 2006-07 2004-05 2005-06 2006-07 25 Received 672 294 93 6 26 Brought forward 21 15 14 0 0 0 Completed 659 295 106 6 26 23 Carried forward 34 14 1 0 0 2 OUTCOMES Granted in full 663 266 85 5 18 19 Granted in part 2 5 12 1 5 0 Refused 4 13 5 0 1 2 Deferred 0 0 0 0 0 0 Application withdrawn 24 11 4 0 2 2 GROUNDS FOR RESTRICTIONS Applicants wrongly directed 1 6 1 1 1 0 Deposit not paid 0 12 0 0 1 0 Document exempt 1 11 14 0 2 2 available 0 0 2 0 2 0 Released to medical 0 0 1 0 0 0 Material otherwise PROCESSING TIME 0-21 days 509 238 91 4 19 20 22-35 days 53 44 13 2 5 2 >35 days 20 13 2 0 2 1 Better Services – Healthier People 103 Healthy People – Now and in the Future Financial report 8 Financial overview Financial Summary Expenses The audited financial statements presented for the South Eastern Sydney and Illawarra Area Health Service are for the period 1 July 2006 to 30 June 2007. The Net Cost of Services budget was $1.609 billion, against which the audited actuals of $1.592 billion represent a favourable budget variation of $17 million or 1.08 percent. 2005-06 Actuals $000 2006-07 Actuals $000 2006-07 Budget $000 Employee Related 1,172,469 1,158,762 1,111,255 Visiting Medical Officers 60,577 57,775 58,528 Other Operating Expenses 469,280 454,688 436,598 Depreciation and Amortisation 62,097 61,814 62,378 Grants and Subsidies 40,530 37,393 21,492 Finance Costs 1,167 316 847 Payments to Affiliated Health Organisations 288,636 287,735 291,037 TOTAL EXPENSES 2,094,756 2,058,483 1,982,133 Sale of Goods and Services 438,488 418,343 376,547 Investment Income 14,652 5,921 10,500 Grants and Contributions 38,823 19,365 31,727 Other Revenue 11,449 8,821 11,670 TOTAL REVENUES 503,412 452,450 430,444 The reported variation can be largely attributed to increased contributions above initial budget estimates from protected special purpose and trust fund arrangements. In achieving this result the South Eastern Sydney and Illawarra Area Health Service is satisfied that it has operated within the level of government cash payments, and has restricted operating costs to the budget available. It has also ensured that no general creditors exist at balance date in excess of levels agreed with NSW Health. Revenues Gain/(Loss) on Disposal 1,052 (600) 679 Other Gains/ (Losses) (1,568) (2,644) (1,413) NET COST OF SERVICES 1,591,860 1,609,277 1,553,781 As at 30 June 2007, the Area Health Service had no over 45 days General Recurrent Trade Creditors. The year’s Creditors Benchmark (42 days) was also nil at balance date. SESIH total general creditors profile monthly average was 44.4 days for the 12 months ending 30 June 2007. Budget increases/ (decreases) 2006 - 07 Budget increases/decreases Awards 56,572 CPI Escalation 9,403 3rd stage beds 8,205 Transitional Aged Care beds 6,193 High Cost drugs 6,100 General growth 1,500 General growth – Sydney Children’s Hospital 1,000 Corporate Service and other operational efficiencies (10,295) Mental Health – Community Initiatives 2,151 Inter Area Patient Flows (non cash movement) (40,250) AIDS Project Funding 3,332 Superannuation 5,586 Other 5,999 TOTAL 55,496 Better Services – Healthier People The variations in 2006 - 07 stem from budget adjustments and other movements as shown. 105 Healthy People – Now and in the Future Financial report 8 SECTION Program Reporting 2005-06 2006-07 Expenses $000 Revenue $000 NCOS variance (%) Expenses $000 Revenue $000 NCOS variance (%) Primary and Community 118,035 5,683 112,405 124,722 6,660 118,062 Aboriginal Health 2,990 424 2,566 3,157 499 2,624 Outpatient Services 267,231 15,549 251,682 283,018 18,436 264,003 Emergency Care Services 152,561 17,312 135,249 161,239 20,340 141,036 Overnight Acute 882,818 278,392 604,426 940,371 326,428 614,031 Same Day Acute 108,361 35,918 72,443 114,540 42,039 72,501 Mental Health Services 135,033 3,328 131,705 118,346 3,937 114,409 Rehab and Extended Care 169,440 38,714 130,726 179,645 45,653 133,992 Population Health 23,252 8,310 14,942 24,514 9,831 14,683 Teaching and Research 122,412 24,975 97,637 145,204 29,307 115,897 TOTAL 1,982,133 428,352 1,553,781 2,094,756 502,896 1,591,860 PROGRAM Program reporting Directions in funding The South Eastern Sydney and Illawarra Area Health Service reporting of programs is consistent with the ten programs of health care delivery utilised across NSW Health and satisfies the methodology for apportionment advised by NSW Health. As a result of the establishment of the new Area Health Service on January 2005, it has become necessary for each Area Health Service to prepare its financial statements using the Australian Equivalents to International Financial Standards (AEIFRS). Program increases of more than 10% together with all program reductions are explained as follows: In addition to the need to adopt AEIFRS, the Area Health Service has needed to respond to several other significant challenges: ◗ the amalgamation of accounting and financial systems. ◗ the restructuring of corporate and business support services (initially addressing linen, food and IT systems) designed to generate funds to source further front line services. ◗ the improvement of procurement practices consistent with the NSW Government’s Shared Corporate Services Reform Strategy. ◗ the implementation of revenue best practice initiatives as advised by NSW Health in relation to the retention of own source revenues. ◗ a new standard chart of accounts was rolled out across all sites. ◗ the implementation of Power Budget, an application that offers a more efficient mechanism for developing and deploying budgets, forecasts and associated financial analysis utilising a turnkey business intelligence software platform. Mental Health Services - the net cost of services decreased by $17.3 million (13.1%). This was mainly due to the one-off expense in respect of the St Vincent’s Hospital Caritas Mental Health facility in 2005 - 06. Population Health - the net cost of services decreased by $0.3 million (1.9%). This was mainly due to an increase of $1.5 million in revenue, which exceeded the increase in expenditure of $1.3 million. Teaching & Research - net cost of services increased by $18.2 million (18.7%). This was mainly due to a greater commitment by the Area in staff education programs, enhancement, award and growth funding that was partly committed to this program, and a refinement in the cost allocation process for this program. Better Services – Healthier People 106 Healthy People – Now and in the Future Financial report The 2007 - 08 budget – about the forthcoming year • $5.5 million for non-acute mental health units at Sutherland, St George and Shellharbour Hospitals. • $3.2 million to improve mental health facilities at Illawarra Older Person’s Unit at Wollongong. • Funding to progress the development and construction of a Psychiatric Emergency Care Centre at Wollongong. • $3.3 million ($7.6 million over 3 years) to replace the hyperbaric chamber at Prince of Wales Hospital used for treating decompression illness and advanced wound management. • $1.4 million for digital operating theatres at St George Hospital. • $400,000 to upgrade and enhance a range of medical imaging and patient monitoring equipment at Sydney Children’s Hospital. South Eastern Sydney and Illawarra Area Health Service received its 2007 - 08 allocation on 30th June 2007. ◗ ◗ ◗ SESIH initial cash budget for 2007 - 08 is $1.71 billion which is an increase of $86.3 million, or a 5.3 percent increase over last year’s initial funding. Major health service enhancements for the 2007 - 08 Budget include: • An additional 50 beds and community-based bed equivalents within the Area, including extra inpatient beds at Wollongong Hospital. • A new after hours GP Clinic at Shoalhaven Hospital. • Improved mental health services for the South Eastern Sydney Illawarra areas. • $625,000 to expand the award-winning mental health Housing Accommodation Support Initiative (HASI). • $250,000 for Aboriginal child sexual assault services. • $200,000 for improved child and adolescent mental health services. • $100,000 for eating disorder services based at Prince of Wales Hospital. • $434,000 to support a four-bed stroke unit at Shoalhaven Hospital. • $300,000 for the expansion of renal services at Shoalhaven Hospital. • $1.26 million for additional orthopaedic services at Shoalhaven Hospital. • An additional $3.3 million to reduce elective surgery waiting times throughout the Health Service. Major capital projects for SESIH that are provided for in the 2007 - 08 Budget include: • $2.5 million for child and adolescent mental health inpatient units at Sydney Children’s Hospital and Shellharbour Hospital. • $1.1 million for improvements to the Child and Adolescent Mental Health Day Unit at Shellharbour Hospital. Better Services – Healthier People 107 Healthy People – Now and in the Future South Eastern Sydney and Illawarra Area Health Service Operating Statement for the year ended 30 June 2007 PARENT Actual 2007 $000 Budget 2007 $000 CONSOLIDATION Actual 2006 $000 Notes Expenses excluding losses Operating Expenses Employee Related Personnel Services Visiting Medical Officers Other Operating Expenses Depreciation and Amortisation Grants and Subsidies Finance Costs Payments to Affiliated Health Organisations 0 1,172,469 60,577 469,280 62,097 40,530 1,167 288,636 0 1,158,762 57,775 454,688 61,814 37,393 316 287,735 787,143 324,112 58,528 436,596 62,378 21,492 847 291,037 2,094,756 2,058,483 1,982,133 438,488 14,652 58,080 11,449 418,343 5,921 19,365 8,821 376,547 10,500 38,261 11,670 Retained Revenue Sale of Goods and Services Investment Income Grants and Contributions Other Revenue 522,669 452,450 436,978 Total Retained Revenue 1,052 (1,568) (600) (2,644) (679) (1,413) 1,572,603 1,609,277 1,547,247 1,511,611 1,511,611 1,460,583 10,775 17,169 22,691 (4,624) 0 0 0 22,075 15,865 1,517,762 1,550,855 1,499,139 (54,841) (58,422) (48,108) 3 4 5 2(i), 6 7 8 9 Total Expenses excluding losses 10 11 12 13 Actual 2007 $000 Budget 2007 $000 Actual 2006 $000 1,172,469 0 60,577 469,280 62,097 40,530 1,167 288,636 1,158,762 0 57,775 454,688 61,814 37,393 316 287,735 1,111,255 0 58,528 436,596 62,378 21,492 847 291,037 2,094,756 2,058,483 1,982,133 438,488 14,652 38,823 11,449 418,343 5,921 19,365 8,821 376,547 10,500 31,727 11,670 503,412 452,450 430,444 Gain/(Loss) on Disposal Other gains/(losses) 14 15 1,052 (1,568) (600) (2,644) (679) (1,413) Net Cost of Services 36 1,591,860 1,609,277 1,553,781 2(d) 1,511,611 1,511,611 1,460,583 2(d) 10,775 17,169 22,691 (4,624) 0 0 19,257 22,075 22,399 1,537,019 1,550,855 1,505,673 (54,841) (58,422) (48,108) Government Contributions NSW Health Department Recurrent Allocations NSW Health Department Capital Allocations (Asset Sale Proceeds transferred to the NSW Health Department) Acceptance by the Crown Entity of employee benefits Total Government Contributions RESULT FOR THE YEAR The accompanying notes form part of these Financial Statements 2(a)(ii) South Eastern Sydney and Illawarra Area Health Service Statement of Recognised Income and Expenditure for the year ended 30 June 2007 PARENT CONSOLIDATION Actual 2007 $000 Budget 2007 $000 Actual 2006 $000 (618) 0 0 618 0 0 (3,764) 0 0 (3,764) 0 0 (48,108) Result for the Year (54,841) (58,422) (48,108) (48,108) TOTAL INCOME AND EXPENSE RECOGNISED FOR THE YEAR (58,605) (58,422) (48,108) 0 0 9,311 Actual 2007 $000 Budget 2007 $000 Actual 2006 $000 Notes (618) 0 0 Net increase/(decrease) in Property, Plant and Equipment Revaluation Reserve 618 0 Available for Sale Financial Assets 0 Financial asset revaluation reserve (3,764) 0 0 Asset transfer to Health Support (3,764) 0 0 TOTAL INCOME AND EXPENSE RECOGNISED DIRECTLY IN EQUITY (54,841) (58,422) (58,605) (58,422) 31 EFFECT OF CHANGES IN ACCOUNTING POLICY AND CORRECTIONS OF ERRORS 9,311 Rights to Receive Fixed Asset 0 0 0 0 (43,988) Accumulated Funds 0 0 (43,988) 0 0 (27,084) Reserves 0 0 (27,084) 0 0 TOTAL EFFECT OF CHANGES IN ACCOUNTING POLICY (61,761) AND CORRECTIONS OF ERRORS 0 0 (61,761) The accompanying notes form part of these Financial Statements 31 South Eastern Sydney and Illawarra Area Health Service Balance Sheet as at 30 June 2007 PARENT Actual 2007 $000 Budget 2007 $000 CONSOLIDATION Actual 2006 $000 Notes Actual 2007 $000 Budget 2007 $000 Actual 2006 $000 18 19 20 21 13,323 51,842 18,899 82,398 166,462 15,522 52,771 18,829 75,403 162,525 22,747 46,376 18,899 75,403 163,425 25 486 7,719 7,719 166,948 170,244 171,144 19 801 739 554 22 22 22 1,177,529 88,019 165,551 1,431,099 1,157,118 114,346 165,738 1,437,202 1,206,548 96,705 171,726 1,474,979 24 12,331 1,551 10,780 ASSETS 22,747 46,376 18,899 75,403 163,425 Current Assets Cash and Cash Equivalents Receivables Inventories Financial Assets at Fair Value 13,323 51,842 18,899 82,398 166,462 15,522 52,771 18,829 75,403 162,525 486 7,719 166,948 170,244 801 739 1,177,529 88,019 165,551 1,431,099 1,157,118 114,346 165,738 1,437,202 12,331 1,551 1,444,231 1,439,492 1,486,313 Total Non-Current Assets 1,444,231 1,439,492 1,486,313 1,611,179 1,609,736 1,657,457 Total Assets 1,611,179 1,609,736 1,657,457 129,834 7,420 338,686 2,270 128,775 (1,364) 161,164 9,144 130,783 4,565 316,309 8,946 478,210 297,719 460,603 5,719 19,260 19,021 14,376 197,106 25,928 11,890 17,123 20,267 44,000 237,410 49,280 522,210 535,129 509,883 1,088,969 1,074,607 1,147,574 31 31 244,208 844,638 1,088,846 220,217 854,390 1,074,607 243,590 903,243 1,146,833 25 123 0 741 1,088,969 1,074,607 1,147,574 7,719 Non Current Assets Held for Sale 171,144 Total Current Assets Non-Current Assets 554 Receivables Property, Plant and Equipment 1,206,548 - Land and Buildings 96,705 - Plant and Equipment 171,726 - Infrastructure Systems 1,474,979 Total Property, Plant and Equipment 10,780 Other LIABILITIES Current Liabilities Payables Borrowings Provisions Other 129,834 7,420 338,686 2,270 128,775 (1,364) 161,164 9,144 130,783 4,565 316,309 8,946 478,210 297,719 460,603 Total Current Liabilities 5,719 19,260 19,021 14,376 197,106 25,928 Non-Current Liabilities 11,890 Borrowings 17,123 Provisions 20,267 Other 44,000 237,410 49,280 Total Non-Current Liabilities 522,210 535,129 1,088,969 1,074,607 244,208 844,638 1,088,846 220,217 854,390 1,074,607 123 0 1,088,969 1,074,607 27 28 29 30 28 29 30 509,883 Total Liabilities 1,147,574 Net Assets EQUITY 243,590 Reserves 903,243 Accumulated Funds 1,146,833 Amounts recognised in equity relating to assets 741 held for sale 1,147,574 Total Equity The accompanying notes form part of these Financial Statements South Eastern Sydney and Illawarra Area Health Service Cash Flow Statement for the year ended 30 June 2007 PARENT Actual 2007 $000 CONSOLIDATION Budget 2007 $000 Actual 2006 $000 Notes CASH FLOWS FROM OPERATING ACTIVITIES Payments Employee Related Grants and Subsidies Finance Costs Other Actual 2007 $000 Budget 2007 $000 Actual 2006 $000 (1,119,685) (44,748) (1,167) (915,222) (1,110,146) (41,611) (316) (740,151) (1,075,645) (21,492) (847) (781,969) (2,080,822) (1,892,224) (1,879,953) (1,119,685) (44,748) (1,167) (915,222) (1,110,146) (41,611) (316) (740,151) (752,155) (21,492) (847) (1,105,459) (2,080,822) (1,892,224) (1,879,953) Total Payments 553,242 14,652 10,926 371,856 5,921 7,270 Receipts 316,104 Sale of Goods and Services 11,359 Interest Received 107,585 Other 553,242 14,652 10,926 371,856 5,921 7,270 316,104 11,359 107,585 578,820 385,047 435,048 Total Receipts 578,820 385,047 435,048 1,511,611 10,775 1,511,611 17,169 1,511,611 10,775 1,511,611 17,169 1,460,583 22,691 (4,624) 0 (4,624) 0 0 1,517,762 1,528,780 1,517,762 1,528,780 1,483,274 15,760 21,603 15,760 21,603 38,369 Cash Flows From Government 1,460,583 NSW Health Department Recurrent Allocations 22,691 NSW Health Department Capital Allocations Asset Sale Proceeds transferred to the 0 NSW Health Department 1,483,274 Net Cash Flows from Government 38,369 NET CASH FLOWS FROM OPERATING ACTIVITIES 1,200 1,200 (16,073) (6,995) (32,245) 0 CASH FLOWS FROM INVESTING ACTIVITIES Proceeds from Sale of Land and Buildings, Plant and Equipment 1,567 and Infrastructure Systems Purchases of Land and Buildings, Plant and Equipment (34,570) and Infrastructure Systems (7,176) Purchases of Investments (21,868) (31,045) (40,179) NET CASH FLOWS FROM INVESTING ACTIVITIES 2,023 (5,339) 2,023 194 (3,316) 2,217 (9,424) 22,747 (7,225) 22,747 5,107 NET INCREASE / (DECREASE) IN CASH 17,640 Opening Cash and Cash Equivalents 13,323 15,522 22,747 CLOSING CASH AND CASH EQUIVALENTS 36 CASH FLOWS FROM FINANCING ACTIVITIES 8,100 Proceeds from Borrowings and Advances (1,183) Repayment of Borrowings and Advances 6,917 NET CASH FLOWS FROM FINANCING ACTIVITIES The accompanying notes form part of these Financial Statements 18 1,200 1,200 1,567 (16,073) (6,995) (32,245) 0 (34,570) (7,176) (21,868) (31,045) (40,179) 2,023 (5,339) 2,023 194 8,100 (1,183) (3,316) 2,217 6,917 (9,424) 22,747 (7,225) 22,747 5,107 17,640 13,323 15,522 22,747 South Eastern Sydney and Illawarra Area Health Service Program Statement of Expenses and Revenues for the Year Ended 30 June 2007 SERVICE'S EXPENSES AND REVENUES Program Program Program Program Program Program Program Program Program Program 1.1 * 1.2 * 1.3 * 2.1 * 2.2 * 2.3 * 3.1 * 4.1 * 5.1 * 6.1 * Non Attributable Total 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2006 2007 2,006 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 76,278 72,566 1,985 1,889 151,970 144,574 96,602 91,900 521,952 492,396 3,956 3,822 102 99 7,882 7,615 5,009 4,840 25,185 23,527 656 613 50,176 46,873 36,216 33,832 Depreciation and Amortisation 4,055 4,073 106 106 8,078 8,115 5,136 5,159 27,515 Grants and Subsidies 1,616 1,403 43 37 3,220 2,796 2,046 1,777 10,967 517 376 68 49 73 53 113,370 105,279 8,247 7,658 11,267 33,463 Expenses excluding losses Operating Expenses Employee Related Visiting Medical Officers Other Operating Expenses Finance Costs Payments to Affiliated Health Organisations Total Expenses excluding losses 76 55 1 1 152 110 96 70 13,556 12,589 264 245 61,540 57,148 16,134 14,983 124,722 118,035 3,157 2,990 283,018 267,231 161,239 152,561 67,166 63,897 73,474 69,898 89,594 85,234 16,820 16,002 76,628 72,899 ---- ---- 25,935 3,483 3,365 3,810 3,681 4,646 4,489 873 843 3,973 3,839 ---- ---- 60,577 58,528 239,207 221,668 30,582 28,569 24,259 22,662 32,145 30,029 5,554 5,188 25,300 23,635 ---- ---- 469,280 436,596 27,640 3,571 3,587 3,906 3,924 4,762 4,784 894 898 4,074 4,092 ---- ---- 62,097 62,378 9,524 1,423 1,236 1,557 1,352 1,898 1,648 356 309 17,404 1,410 ---- ---- 40,530 21,492 90 65 17 12 77 56 ---- ---- 1,167 847 46,510 43,191 0 0 17,748 16,481 ---- ---- 288,636 291,037 940,371 882,818 114,540 108,361 118,346 135,033 179,645 169,440 24,514 23,252 145,204 122,412 0 0 26,843 1,172,469 1,111,255 2,094,756 1,982,133 Revenue Sale of Goods and Services 5,043 4,331 381 327 13,931 11,963 18,973 16,293 38,626 33,170 2,982 2,561 36,767 31,573 7,445 6,393 22,196 19,061 ---- ---- 438,488 Investment Income 370 265 28 20 1,020 731 285 204 7,761 5,563 772 553 218 156 2,028 1,453 546 391 1,624 1,164 ---- ---- 14,652 10,500 Grants and Contributions 979 800 73 60 2,702 2,208 754 616 20,567 16,808 2,046 1,672 579 473 5,373 4,391 1,444 1,180 4,306 3,519 ---- ---- 38,823 31,727 6,139 6,255 621 633 166 169 1,557 1,587 416 424 1,239 1,263 ---- ---- 11,449 11,670 326,611 279,501 42,065 36,028 3,945 3,359 45,725 39,004 9,851 8,388 29,365 25,007 0 0 503,412 430,444 (361) 56 (36) 15 (10) 146 (94) 39 (25) 116 (75) ---- ---- 1,052 (679) (830) (748) 614,031 604,426 (82) 72,501 (74) (23) (21) (218) (196) 72,443 114,409 131,705 133,992 130,726 (59) 14,683 (53) (174) 14,942 115,897 (157) 97,637 ---0 ---0 (1,568) (1,413) 1,591,860 1,553,781 1,537,019 1,505,673 1,537,019 1,505,673 Other Revenue 282 287 18 21 777 792 234 239 Total Revenue 6,674 5,683 500 428 18,430 15,694 20,246 17,352 26 (17) 2 (1) 73 (47) 20 (13) (40) (36) 118,062 112,405 (3) 2,658 Gain / (Loss) on Disposal Other Gains / (Losses) Net Cost of Services Government Contributions ---- ---- ---- (3) (109) (98) (30) (27) 2,566 264,624 251,682 141,003 135,249 ---- ---- ---- ---- RESULT FOR THE YEAR * The name and purpose of each program is summarised in Note 17. The program statement uses statistical data to allocate the current period's financial information to each program. ---- 292,144 250,875 559 ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- (54,841) 376,547 (48,108) South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 1. The South Eastern Sydney and Illawarra Area Health Service Reporting Entity The South Eastern Sydney and Illawarra Area Health Service was established under the provisions of the Health Services Act with effect from 1 January 2005. The South Eastern Sydney and Illawarra Area Health Service, as a reporting entity, comprises all the operating activities of the Hospital facilities and the Community Health Centres under its control. It also encompasses the Special Purposes and Trust Funds which, while containing assets which are restricted for specified uses by the grantor or the donor, are nevertheless controlled by the Health Service. The South Eastern Sydney and Illawarra Area Health Service is a not for profit entity. With effect from 17 March 2006 fundamental changes to the employment arrangements of Health Services were made through amendment to the Public Sector Employment and Management Act 2002 and other Acts including the Health Services Act 1997. The status of the previous employees of Health Services changed from that date. They are now employees of the Government of New South Wales in the service of the Crown rather than employees of the South Eastern Sydney and Illawarra Area Health Service. Employees of the Government are employed in Divisions of the Government Service. In accordance with Accounting Standards these Divisions are regarded as special purpose entities that must be consolidated with the financial report of the related Health Service. This is because the Divisions were established to provide personnel services to enable a Health Service to exercise its functions. As a consequence the values in the annual financial statements presented herein consist of the South Eastern Sydney and Illawarra Area Health Service (as the parent entity), the financial report of the special purpose entity Division and the consolidated financial report of the economic entity. Notes have been extended to capture both the parent and consolidated values with notes 3, 4, 12, 27, 29 and 36 being especially relevant. In the process of preparing the consolidated financial statements for the economic entity consisting of the controlling and controlled entities, all inter-entity transactions and balances have been eliminated. The South Eastern Sydney and Illawarra Area Health Service reporting entity is consolidated as part of the NSW Total State Sector Accounts. These financial statements have been authorised for issue by the Chief Executive on 30th October 2007. 2. Summary of Significant Accounting Policies The South Eastern Sydney and Illawarra Area Health Service's financial statements are a general purpose financial report which has been prepared in accordance with applicable Australian Accounting Standards (which include Australian equivalents to International Financial Reporting Standards (AEIFRS)), the requirements of the Health Services Act 1997 and its regulations including observation of the Accounts and Audit Determination for Area Health Services and Public Hospitals. Property, plant and equipment, investment property, assets held for trading and available for sale are measured at fair value. Other financial statement items are prepared in accordance with the historical cost convention. All amounts are rounded to the nearest one thousand dollars and are expressed in Australian currency. Judgments, key assumptions and estimations made by management are disclosed in the relevant notes to the financial statements. The financial statements and notes comply with Australian Accounting Standards which include AEIFRS. Comparative figures are, where appropriate, reclassified to give a meaningful comparison with the current year. AASB-2007.04, Amendments to Australians Accounting Standards arising from ED151 and other amendments, has application for accounting periods commencing on or after 1 July 2007. The standard is not being early adopted in 2006/07 and the new options available in the standard will not be applied. AASB123, Borrowing Costs, has application in reporting years beginning on or after 1 January 2009. The Standard, which requires capitalisation of Borrowing Costs has not been adopted in 2006/07 nor is adoption expected prior to 2009/10. AASB101, Presentation of Financial Statements, has reduced the disclosure requirements for various reporting entitles, However, in not for profit entities such as Health Services there is no change required. AASB7 Financial Instruments: Disclosures, locates all disclosure requirements for financial instruments within the one standard. The Standard has application for annual reporting periods beginning on or after 1 January 2007. The Standard will not be early adopted and has no differential impact. Other significant accounting policies used in the preparation of these financial statements are as follows: South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 a) Employee Benefits and Other Provisions i) Salaries & Wages, Current Annual Leave, Sick Leave and On Costs (including non-monetary benefits) At the consolidated level of reporting liabilities for salaries and wages (including non monetary benefits), annual leave and paid sick leave that fall wholly within 12 months of the reporting date are recognised and measured in respect of employees' services up to the reporting date at undiscounted amounts based on the amounts expected to be paid when the liabilities are settled. All Annual Leave employee benefits are reported as "Current" as there is an unconditional right to payment. Current liabilities are then further classified as "Short Term" or "Long Term" based on past trends and known resignations and retirements. Anticipated payments to be made in the next twelve months are reported as "Short Term". On costs of 21.7% are applied to the value of leave payable at 30 June 2007 inclusive of the 4% award increase payable from 1 July 2007, such on costs being consistent with actuarial assessments. Unused non-vesting sick leave does not give rise to a liability as it is not considered probable that sick leave taken in the future will be greater than the benefits accrued in the future. The outstanding amounts of workers' compensation insurance premiums and fringe benefits which are consequential to employment, are recognised as liabilities and expenses where the employee benefits to which they relate have been recognised. ii) Long Service Leave and Superannuation Benefits At the consolidated level of reporting Long Service Leave employee leave entitlements are dissected as "Current" if there is an unconditional right to payment and "Non Current" if the entitlements are conditional. Current entitlements are further dissected between "Short Term" and "Long Term" on the basis of anticipated payments for the next twelve months. This in turn is based on past trends and known resignations and retirements. Long Service Leave provisions are measured on a short hand basis at an escalated rate of 8.1% inclusive of the 4% payable from 1 July 2007 for all employees with five or more years of service. Actuarial assessment has found that this measurement technique produces results not materially different from the estimate determined by using the present value basis of measurement. The South Eastern Sydney and Illawarra Area Health Service's liability for the closed superannuation pool schemes (State Authorities Superannuation Scheme and State Superannuation Scheme) is assumed by the Crown Entity. The South Eastern Sydney and Illawarra Area Health Service accounts for the liability as having been extinguished resulting in the amount assumed being shown as part of the non-monetary revenue item described as "Acceptance by the Crown Entity of Employee Benefits". Any liability attached to Superannuation Guarantee Charge cover is reported in Note 27, "Payables". The superannuation expense for the financial year is determined by using the formulae specified by the NSW Health Department. The expense for certain superannuation schemes (i.e. Basic Benefit and First State Super) is calculated as a percentage of the employees' salary. For other superannuation schemes (i.e. State Superannuation Scheme and State Authorities Superannuation Scheme), the expense is calculated as a multiple of the employees' superannuation contributions. Consequential to the legislative changes of 17 March 2006 no salary costs or provisions have been recognised by the South Eastern Sydney and Illawarra Area Health Service beyond that date. iii) Other Provisions Other provisions exist when: the South Eastern Sydney and Illawarra Area Health Service has a present legal or constructive obligation as a result of a past event; it is probable that an outflow of resources will be required to settle the obligation; and a reliable estimate can be made of the amount of the obligation. These provisions are recognised when it is probable that a future sacrifice of economic benefits will be required and the amount can be measured reliably. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 b) Insurance The South Eastern Sydney and Illawarra Area Health Service's insurance activities are conducted through the NSW Treasury Managed Fund Scheme of self insurance for Government Agencies. The expense (premium) is determined by the Fund Manager based on past experience. c) Finance Costs Finance costs are recognised as expenses in the period in which they are incurred. d) Income Recognition Income is measured at the fair value of the consideration or contribution received or receivable. Additional comments regarding the accounting policies for the recognition of revenue are discussed below. Sale of Goods and Services Revenue from the sale of goods and services comprises revenue from the provision of products or services, i.e. user charges. User charges are recognised as revenue when the service is provided or by reference to the stage of completion. Patient Fees Patient Fees are derived from chargeable inpatients and non-inpatients on the basis of rates specified by the NSW Health Department from time to time. Investment Income Interest revenue is recognised using the effective interest method as set out in AASB139, "Financial Instruments: Recognition and Measurement". Rental revenue is recognised in accordance with AASB117 "Leases" on a straight line basis over the lease term. Dividend revenue is recognised in accordance with AASB118 when the South Eastern Sydney and Illawarra Area Health Service's right to receive payment is established. Debt Forgiveness Debts are accounted for as extinguished when and only when settlement occurs through repayment or replacement by another liability. Use of Hospital Facilities Specialist doctors with rights of private practice are subject to an infrastructure charge for the use of hospital facilities at rates determined by the NSW Health Department. Charges consist of two components: a monthly charge raised by the South Eastern Sydney and Illawarra Area Health Service * based on a percentage of receipts generated the residue of the Private Practice Trust Fund at the end of each financial year, such sum * being credited for South Eastern Sydney and Illawarra Area Health Service use in the advancement of the South Eastern Sydney and Illawarra Area Health Service or individuals within it. Use of Outside Facilities The South Eastern Sydney and Illawarra Area Health Service uses a number of facilities owned and maintained by the local authorities in the area to deliver community South Eastern Sydney and Illawarra Area Health Services for which no charges are raised by the authorities. The cost method of accounting is used for the initial recording of all such services with cost being determined as the fair value of the services given which is then duly recognised as both revenue and matching expense. Grants and Contributions Grants and Contributions are generally recognised as revenues when the South Eastern Sydney and Illawarra Area Health Service obtains control over the assets comprising the contributions. Control over contributions is normally obtained upon the receipt of cash. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 NSW Health Department Allocations Payments are made by the NSW Health Department on the basis of the allocation for the South Eastern Sydney and Illawarra Area Health Service as adjusted for approved supplementations mostly for salary agreements, patient flows between Area Health Services and approved enhancement projects. This allocation is included in the Operating Statement before arriving at the "Result for the Year" on the basis that the allocation is earned in return for the South Eastern Sydney and Illawarra Area Health Services provided on behalf of the Department. Allocations are normally recognised upon the receipt of Cash. General operating expenses/revenues of Calvary Health Care Sydney, Eastern Sydney Scarba and Early Intervention Program, Sacred Heart Hospice, St Vincent's Hospital and War Memorial Hospital (Waverley) have only been included in the Operating Statement prepared to the extent of the cash payments made to the Health Organisations concerned. The South Eastern Sydney and Illawarra Area Health Service is not deemed to own or control the various assets/liabilities of the aforementioned Health Organisations and such amounts have been excluded from the Balance Sheet. Any exceptions are specifically listed in the notes that follow. e) Goods & Services Tax (GST) Revenues, expenses and assets are recognised net of the amount of GST, except: the amount of GST incurred by the South Eastern Sydney and Illawarra Area Health Service * as a purchaser that is not recoverable from the Australian Taxation Office is recognised as part of the cost of acquisition of an asset or as part of an item of expense; * f) receivables and payables are stated with the amount of GST included. Inter Area and Interstate Patient Flows Inter Area Patient Flows Health Services recognise patient flows from acute inpatients (other than Mental Health Services), emergency and rehabilitation and extended care. Patient flows have been calculated using benchmarks for the cost of services for each of the categories identified and deducting estimated revenue, based on the payment category of the patient. The adjustments have no effect on equity values as the movement in Net Cost of Services is matched by a corresponding adjustment to the value of the NSW Health Recurrent Allocation. Inter State Patient Flows Health Services recognise the outflow of acute inpatients from the area in which they are resident to other States and Territories within Australia. The Health Services also recognise the value of inflows for acute inpatient treatment provided to residents from other States and Territories. The expense and revenue values reported within the financial statements have been based on 2005/06 activity data using standard cost weighted separation values to reflect estimated costs in 2006/07 for acute weighted inpatient separations. Where treatment is obtained outside the home health service, the State/Territory providing the service is reimbursed by the benefiting Area. The reporting adopted for both inter area and interstate patient flows aims to provide a greater accuracy of the cost of service provision to the Area's resident population and disclose the extent to which service is provided to non residents. The composition of patient flow expense/revenue is disclosed in Notes 5 and 10. g) Acquisition of Assets The cost method of accounting is used for the initial recording of all acquisitions of assets controlled by the South Eastern Sydney and Illawarra Area Health Service. Cost is the amount of cash or cash equivalents paid or the fair value of the other consideration given to acquire the asset at the time of its acquisition or construction or, where applicable, the amount attributed to that asset when initially recognised in accordance with the specific requirements of other Australian Accounting Standards. Assets acquired at no cost, or for nominal consideration, are initially recognised as assets and revenues at their fair value at the date of acquisition except for assets transferred as a result of an administrative restructure. Fair value means the amount for which an asset could be exchanged between knowledgeable, willing parties in an arm's length transaction. Where settlement of any part of cash consideration is deferred beyond normal credit terms, its cost is the cash price equivalent, i.e. the deferred payment amount is effectively discounted at an assetspecific rate. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 Land and Buildings which are owned by the Health Administration Corporation or the State and administered by the South Eastern Sydney and Illawarra Area Health Service are deemed to be controlled by the South Eastern Sydney and Illawarra Area Health Service and are reflected as such in the financial statements. h) Plant & Equipment and Infrastructure Systems Individual items of property, plant & equipment are capitalised where their cost is $10,000 or above. Prior to 1 July 2006 assets were recognised based on a value of $5,000 or above. “Infrastructure Systems” means assets that comprise public facilities and which provide essential services and enhance the productive capacity of the economy including roads, bridges, water infrastructure and distribution works, sewerage treatment plants, seawalls and water reticulation systems. i) Depreciation Depreciation is provided for on a straight line basis for all depreciable assets so as to write off the depreciable amount of each asset as it is consumed over its useful life to the South Eastern Sydney and Illawarra Area Health Service. Land is not a depreciable asset. Details of depreciation rates initially applied for major asset categories are as follows: Buildings 2.5% Electro Medical Equipment - Costing less than $200,000 10.0% - Costing more than or equal to $200,000 12.5% Computer Equipment 20.0% Infrastructure Systems 2.5% Office Equipment 10.0% Plant and Machinery 10.0% Linen 20.0% Furniture, Fittings and Furnishings 5.0% Depreciation rates are subsequently varied where changes occur in the assessment of the remaining useful life of the assets reported. j) Revaluation of Non Current Assets Physical non-current assets are valued in accordance with the NSW Health Department's "Valuation of Physical Non-Current Assets at Fair Value". This policy adopts fair value in accordance with AASB116, "Property, Plant & Equipment" and AASB140, "Investment Property". Property, plant and equipment is measured on an existing use basis, where there are no feasible alternative uses in the existing natural, legal, financial and socio-political environment. However, in the limited circumstances where there are feasible alternative uses, assets are valued at their highest and best use. Fair value of property, plant and equipment is determined based on the best available market evidence, including current market selling prices for the same or similar assets. Where there is no available market evidence the asset's fair value is measured at its market buying price, the best indicator of which is depreciated replacement cost. The South Eastern Sydney and Illawarra Area Health Service revalues Land and Buildings and Infrastructure at minimum every three years by independent valuation and with sufficient regularity to ensure that the carrying amount of each asset does not differ materially from its fair value at reporting date. The last revaluation for assets assumed by the Area as at 1 January 2005 was completed on 1 April 2005 and was based on an independent assessment. Non-specialised assets with short useful lives are measured at depreciated historical cost, as a surrogate for fair value. When revaluing non-current assets by reference to current prices for assets newer than those being revalued (adjusted to reflect the present condition of the assets), the gross amount and the related accumulated depreciation are separately restated. For other assets, any balances of accumulated depreciation existing at the revaluation date in respect of those assets are credited to the asset accounts to which they relate. The net asset accounts are then increased or decreased by the revaluation increments or decrements. 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 Result for the Year, the increment is recognised immediately as revenue in the Result for the Year. Revaluation decrements are recognised immediately as expenses in the Result for the Year, 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. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 k) As a not-for-profit entity, revaluation increments and decrements are offset against one another within a class of non-current assets, but not otherwise. Where an asset that has previously been revalued is disposed of, any balance remaining in the asset revaluation reserve in respect of that asset is transferred to accumulated funds. Impairment of Property, Plant and Equipment As a not-for-profit entity with no cash generating units, the South Eastern Sydney and Illawarra Area Health Service is effectively exempt from AASB 136 Impairment of Assets and impairment testing. This is because AASB136 modifies the recoverable amount test to the higher of fair value less costs to sell and depreciated replacement cost. This means that, for an asset already measured at fair value, impairment can only arise if selling costs are regarded as material. Selling costs are regarded as immaterial. l) Assets Not Able to be Reliably Measured South Eastern Sydney and Illawarra Area Health Service may at times hold certain assets that are not recognised in the Balance Sheet because the South Eastern Sydney and Illawarra Area Health Service is unable to measure reliably the value for the assets. South Eastern Sydney and Illawarra Area Health Service has not identified any assets that are not able to be reliably measured. m) Restoration Costs The estimated cost of dismantling and removing an asset and restoring the site is included in the cost of an asset, to the extent it is recognised as a liability. n) Non Current Assets (or disposal groups) Held for Sale The South Eastern Sydney and Illawarra Area Health Service has certain non-current assets (or disposal groups) classified as held for sale, where their carrying amount will be recovered principally through a sale transaction, not through continuing use. Non-current assets (or disposal groups) held for sale are recognised at the lower of carrying amount and fair value less costs to sell. These assets are not depreciated while they are classified as held for sale. o) Investment Properties Investment property is held to earn rentals or for capital appreciation, or both. However, for not-forprofit entities, property held to meet service delivery objectives rather than to earn rental or for capital appreciation does not meet the definition of investment property and is accounted for under AASB 116 Property, Plant and Equipment. The South Eastern Sydney and Illawarra Area Health Service does not have any property that meets the definition of Investment Property. p) Intangible Assets The South Eastern Sydney and Illawarra Area Health Service recognises intangible assets only if it is probable that future economic benefits will flow to the South Eastern Sydney and Illawarra Area Health Service and the cost of the asset can be measured reliably. Intangible assets are measured initially at cost. Where an asset is acquired at no or nominal cost, the cost is its fair value as at the date of acquisition. All research costs are expensed. Development costs are only capitalised when certain criteria are met. The useful lives of intangible assets are assessed to be finite. Intangible assets are subsequently measured at fair value only if there is an active market. As there is no active market for the South Eastern Sydney and Illawarra Area Health Service's intangible assets, the assets are carried at cost less any accumulated amortisation. The South Eastern Sydney and Illawarra Area Health Service's intangible assets are amortised using the straight line method based on the useful life of the asset. In general, intangible assets are tested for impairment where an indicator of impairment exists. However, as a not-for-profit entity the South Eastern Sydney and Illawarra Area Health Service is effectively exempted from impairment testing (see Note 2[k]). q) Maintenance The costs of maintenance are charged as expenses are incurred, except where they relate to the replacement of a component of an asset in which case the costs are capitalised and depreciated. r) Leased Assets s) A distinction is made between finance leases which effectively transfer from the lessor to the lessee substantially all the risks and benefits incidental to ownership of the leased assets, and operating leases under which the lessor effectively retains all such risks and benefits. Where a non-current asset is acquired by means of a finance lease, the asset is recognised at its fair value at the commencement of the lease term. The corresponding liability is established at the same amount. Lease payments are allocated between the principal component and the interest expense. Operating lease payments are charged to the Operating Statement in the periods in which they are incurred. Inventories South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 Inventories are stated at cost. Costs are assigned to individual items of stock mainly on the basis of weighted average costs. Obsolete items are disposed of in accordance with instructions issued by the NSW Health Department. t) Other Financial Assets Financial assets are initially recognised at fair value plus, in the case of financial assets not at fair value through profit or loss, transaction costs. The Health Service subsequently measures financial assets classified as held for trading at fair value through profit or loss. Gains or losses on these assets are recognised in the Operating Statement. Assets intended to be held to maturity are subsequently measured at amortised cost using the effective interest method. Gains or losses on impairment or disposal of these assets are recognised in the Operating Statement. Any residual investments that do not fall into any other category are accounted for as available for sale financial assets and measured at fair value directly in equity until disposed or impaired. All financial assets (except those measured at fair value through profit or loss) are subject to annual review for impairment. Purchases or sales of financial assets under contract that require delivery of the asset within the timeframe established by convention or regulation are recognised on the trade date i.e. the date the Health Service commits itself to purchase or sell the assets. u) Equity Transfers The transfer of net assets between agencies as a result of an administrative restructure, transfers of programs/functions and parts thereof between NSW public sector agencies is designated as a contribution by owners and is recognised as an adjustment to "Accumulated Funds". Transfers arising from an administrative restructure between Health Services/government departments are recognised at the amount at which the asset was recognised by the transferor Health Service/Government Department immediately prior to the restructure. In most instances this will approximate fair value. All other equity transfers are recognised at fair value. The Statement of Recognised Income and Expenditure reflects the Net Assets or change in equity in accordance with AASB 101 Clause 97. v) Financial Instruments Financial instruments give rise to positions that are a financial asset of either South Eastern Sydney and Illawarra Area Health Service or its counter party and a financial liability (or equity instrument) of the other party. For South Eastern Sydney and Illawarra Area Health Service these include cash at bank, receivables, other financial assets, payables and interest bearing liabilities. In accordance with Australian Accounting Standard AASB139, "Financial Instruments: Recognition and Measurement" disclosure of the carrying amounts for each of the AASB139 categories of financial instruments is disclosed in Note 41. The specific accounting policy in respect of each class of such financial instrument is stated hereunder. Classes of instruments recorded and their terms and conditions measured in accordance with AASB139 are as follows: Cash Accounting Policies - Cash is carried at nominal values reconcilable to monies on hand and independent bank statements. Terms and Conditions - Monies on deposit attract an effective interest rate of approximately 5.0% as compared to 5.5% in the previous year. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 Loans and Receivables Loans and receivables are recognised initially at fair value, usually based on the transaction cost or face value. Subsequent measurement is at amortised cost using the effective interest method, less an allowance for any impairment of receivables. Short-term receivables with no stated interest rate are measured at the original invoice amount where the effect of discounting is immaterial. An allowance for impairment of receivables is established when there is objective evidence that the entity will not be able to collect all amounts due. The amount of the allowance is the difference between the asset’s carrying amount and the present value of estimated future cash flows, discounted at the effective interest rate. Bad debts are written off as incurred. Terms and Conditions - Accounts are generally issued on 30-day terms. Low or zero interest loans are recorded at fair value on inception and amortised cost thereafter. In 2006/07 this involved the restatement of loan values as at 1 July 2006 for all loans negotiated prior to that date. Designation of Financial Assets - TCorp Hour-Glass Investment The Hour Glass Investment facilities are unit trust investment funds managed by NSW Treasury Corporation. The South Eastern Sydney and Illawarra Area Health Service has been issued with a number of units in managed investments based on the amount of the deposit and the unit value for the day. Investments in the TCorp-Hour Glass Investment facilities were designated at ‘fair value through profit or loss' as at 30 June 2007, in accordance with AASB 139. The Hour-Glass Investment facilities were designated at ‘fair value through profit or loss’ using the second leg of the fair value option i.e. these financial assets are managed and their performance is evaluated on a fair value basis, in accordance with a documented risk management strategy, and information about those assets is provided internally on that basis to the South Eastern Sydney and Illawarra Area Health Service’s key management personnel. Terms and Conditions – Treasury Corporation Hour Glass Investment Deposits attracted interest rates of 4.9% to 8.38% in the year ended 30 June 2007. This compares with interest rates of 9.3% to 10.1% in the previous year. Trade and Other Payables Accounting Policies -– These amounts represent liabilities for goods and services provided to the Health Service and other amounts, including interest. Payables are recognised initially at fair value, usually based on the transaction cost or face value. Subsequent measurement is at amortised cost using the effective interest method. Short-term payables with no stated interest rate are measured at the original invoice amount where the effect of discounting is immaterial. Payables are recognised for amounts to be paid in the future for goods and services received, whether or not billed to the South Eastern Sydney and Illawarra Area Health Service. Terms and Conditions - Trade liabilities are settled within any terms specified. If no terms are specified, payment is made by the end of the month following the month in which the invoice is received. Borrowings Accounting Policies - Bank Overdrafts are carried at the principal amount. Other loans are classified as non trading liabilities and measured at amortised cost. Interest is charged as an expense as it accrues. Finance Lease Liability is accounted for in accordance with AASB117, "Leases". Terms and Conditions - Bank Overdraft interest is charged at the bank's benchmark rate. Interest bearing loans are payable at quarterly intervals with interest charged between 6.45% and 7.45%. w) Borrowings Non interest bearing loans within NSW Health are initially measured at fair value and amortised thereafter. All other loans are valued at amortised cost. x) Trust Funds The South Eastern Sydney and Illawarra Area Health Service receives monies in a trustee capacity for various trusts as set out in Note 33. As the South Eastern Sydney and Illawarra Area Health Service performs only a custodial role in respect of these monies, and because the monies cannot be used for the achievement of the South Eastern Sydney and Illawarra Area Health Service's own objectives, they are not brought to account in the financial statements. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 y) Budgeted Amounts The budgeted amounts are drawn from the budgets agreed with the NSW Health Department at the beginning of the financial reporting period and with any adjustments for the effects of additional supplementation provided. z) Emerging Asset The South Eastern Sydney and Illawarra Area Health Services' emerging interest in the St George, Sydney and Randwick Campus Hospitals car parks has been valued in accordance with the Department of Health's policy for Accounting for Privately Financed Projects. This policy required the South Eastern Sydney and Illawarra Area Health Service to initially determine the estimated written down replacement cost by reference to the project's historical cost escalated by a construction index and the system's estimated working life. The estimated written down replacement cost was then allocated on a systematic basis over the concession period of 25 years using the annuity method and the 10 year Government Bond rate of 6.27% for St George Hospital, 9.21% for Sydney Hospital and 5.58% for Randwick Campus Hospitals at commencement of the concession period. The adoption of this policy paper represents a change in accounting policy and the financial impact thereof is disclosed in note 24. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 3. 2007 $000 2006 $000 845,944 56,572 19,257 75,801 29,227 90,231 38,570 0 16,831 36 802,345 52,212 22,399 68,256 23,188 90,616 28,218 807 22,889 325 1,172,469 1,111,255 661 2,213 Employee Related Employee related expenses comprise the following: 0 0 0 0 0 0 0 0 0 0 588,317 36,984 15,865 48,347 16,425 64,190 0 572 16,213 230 Salaries and Wages Awards Superannuation [see note 2(a)] - defined benefit plans Superannuation [see note 2(a)] - defined contributions Long Service Leave [see note 2(a)] Annual Leave [see note 2(a)] Sick Leave and Other Leave Redundancies Workers Compensation Insurance Fringe Benefits Tax 0 787,143 Total 0 1,567 The following additional information is provided: Employee Related Expenses capitalised - Plant and Equipment Note 1 addresses the changes in employment status effective from 17 March 2006 4. Personnel Services Personnel Services comprise the purchase of the following: 845,944 56,572 19,257 75,801 29,227 90,231 38,570 0 16,831 36 222,259 15,228 6,534 19,909 6,763 26,426 19,987 235 6,676 95 Salaries and Wages Awards Superannuation [see note 2(a)] - defined benefit plans Superannuation [see note 2(a)] - defined contributions Long Service Leave [see note 2(a)] Annual Leave [see note 2(a)] Sick Leave and Other Leave Redundancies Workers Compensation Insurance Fringe Benefits Tax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,172,469 324,112 Total 0 0 0 0 10,778 22,687 91,168 12,409 10,498 36,097 5,585 11,339 1,281 84,432 3,336 9,547 21,688 85,332 13,294 9,995 35,088 3,921 5,348 1,266 73,500 2,819 10,599 11,621 11,661 2,204 1,403 83,972 4,932 6,576 1,698 3,184 22,885 3,496 9,965 5,474 15,207 5,906 16,070 2,721 2,760 70,947 4,090 6,055 1,649 2,369 36,655 5,347 826 4,196 469,280 436,596 The following additional information is provided: 661 646 Personnel Services Expenses capitalised - Plant and Equipment Note 1 addresses the changes in employment status effective from 17 March 2006 5. 10,778 22,687 91,168 12,409 10,498 36,097 5,585 11,339 1,281 84,432 3,336 9,547 21,688 85,332 13,294 9,995 35,088 3,921 5,348 1,266 73,500 2,819 10,599 11,621 11,661 2,204 1,403 83,972 4,932 6,576 1,698 3,184 22,885 3,496 9,965 5,474 15,207 5,906 16,070 2,721 2,760 70,947 4,090 6,055 1,649 2,369 36,655 5,347 826 4,196 469,280 436,596 Other Operating Expenses Blood and Blood Products Domestic Supplies and Services Drug Supplies Food Supplies Fuel, Light and Power General Expenses (See (b) below) Hospital Ambulance Transport Costs Information Management Expenses Insurance Inter Area Patient Outflows, NSW (see (d) below) Interstate Patient Outflows (see (e) below) Maintenance (See (c) below) Maintenance Contracts New/Replacement Equipment under $10,000 Repairs Maintenance/Non Contract Other Medical and Surgical Supplies Postal and Telephone Costs Printing and Stationery Rates and Charges Rental Special Service Departments Staff Related Costs Sundry Operating Expenses (See (a) below) Travel Related Costs Total South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 5. 2007 $000 2006 $000 Other Operating Expenses (continued) 170 9,795 826 0 (a) Sundry Operating Expenses comprise: Aircraft Expenses (Ambulance) Contract for Patient Services 170 9,795 826 0 9,965 826 Total 9,965 826 1,437 1,446 855 1,725 2,783 175 1,647 312 5 556 1,489 735 2,649 5,141 10,778 3 215 401 384 244 5,697 1,437 1,446 855 1,725 991 114 961 268 0 1,178 739 449 4,769 2,196 12,421 7 250 287 160 385 7,333 (b) General Expenses include:Advertising Books, Magazines and Journals Consultancies - Operating Activities - Capital Works Courier and Freight Auditor's Remuneration - Audit of financial reports Auditor's Remuneration - Other Services Data Recording and Storage Legal Services Membership/Professional Fees Motor Vehicle Expenses Motor Vehicle Operating Lease Expense - minimum lease payments Other Operating Lease Expense - minimum lease payments Payroll Services Quality Assurance/Accreditation Translator Services Security Services Licence Fees Other 2,783 175 1,647 312 5 556 1,489 735 2,649 5,141 10,778 3 215 401 384 244 5,697 991 114 961 268 0 1,178 739 449 4,769 2,196 12,421 7 250 287 160 385 7,333 36,097 35,088 Total 36,097 35,088 37,488 42,664 37,488 42,664 6,157 6,708 6,157 6,708 43,645 49,372 43,645 49,372 (c) Reconciliation Total Maintenance Maintenance expense - contracted labour and other (non employee related), included in Note 5 Employee related/Personnel Services maintenance expense included in Notes 3 and 4 Total maintenance expenses included in Notes 3, 4 and 5 (d) Expenses for Inter Area Patient Flows, NSW on an Area basis are as follows:- 58,900 6,610 8,401 1,670 872 1,570 437 5,972 49,432 6,611 7,898 977 947 1,594 389 5,652 Sydney South West Sydney West Northern Sydney Central Coast Hunter New England North Coast Greater Southern Greater Western Children's Hospital Westmead 58,900 6,610 8,401 1,670 872 1,570 437 5,972 49,432 6,611 7,898 977 947 1,594 389 5,652 84,432 73,500 Total 84,432 73,500 (e) Expenses for Interstate Patient Flows are as follows:1,036 88 1,130 131 46 739 166 27 60 2,036 (350) 78 882 86 Australian Capital Territory Northern Territory Queensland South Australia Tasmania Victoria Western Australia 1,036 88 1,130 131 46 739 166 27 60 2,036 (350) 78 882 86 3,336 2,819 Total 3,336 2,819 South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 2007 $000 2006 $000 6. Depreciation and Amortisation 39,022 16,909 6,166 40,848 15,302 6,228 Depreciation - Buildings Depreciation - Plant and Equipment Depreciation - Infrastructure Systems 39,022 16,909 6,166 40,848 15,302 6,228 62,097 62,378 Total 62,097 62,378 7. Grants and Subsidies 14,736 2,203 16,260 7,331 14,244 1,647 480 5,121 Non Government Voluntary Organisations Grants to Community Aged Care Packages Research Organisations Other 14,736 2,203 16,260 7,331 14,244 1,647 480 5,121 40,530 21,492 Total 40,530 21,492 8. Finance Costs 1,167 847 Interest on Bank Overdrafts and Loans 1,167 847 1,167 847 Total 1,167 847 23,492 1,060 14,034 241,191 8,859 22,250 1,082 13,541 222,373 8,539 288,636 267,785 0 23,252 0 23,252 288,636 291,037 9. 23,492 1,060 14,034 241,191 8,859 22,250 1,082 13,541 222,373 8,539 288,636 267,785 0 23,252 0 23,252 288,636 291,037 Payments to Affiliated Health Organisations (a) Recurrent Sourced Calvary Hospital Eastern Sydney Scarba Centre Sacred Heart Hospice St Vincent's Hospital War Memorial Hospital Waverley (b) Capital Sourced St Vincent's Hospital Total South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 2007 $000 2006 $000 6,608 31 1,725 6,240 0 1,394 8,364 7,634 112,133 1,721 34,581 9,678 4,268 2,950 836 37 2,768 23 344 244,719 379 291 56 476 3,147 73 7,933 0 988 2,723 102,736 1,864 27,245 6,548 1,763 1,646 932 4,557 831 20 299 193,537 1,796 1,116 54 935 4,032 110 11,419 2,734 1,043 3,696 430,124 368,913 438,488 376,547 118,734 21,430 33,478 19,836 17,994 22,426 10,821 86,003 17,952 29,168 16,835 14,756 18,044 10,779 244,719 193,537 3,020 393 1,439 1,213 323 1,224 321 4,506 618 2,600 1,359 243 2,252 (159) 7,933 11,419 Interest Lease and Rental Income 11,105 3,547 7,645 2,855 Total 14,652 10,500 10. Sale of Goods and Services (a) Sale of Goods comprise the following:6,608 31 1,725 6,240 0 1,394 8,364 7,634 Sale of Prosthesis Other - Equipment Sales Pharmacy Sales (b) Rendering of Services comprise the following:112,133 1,721 34,581 9,678 4,268 2,950 836 37 2,768 23 344 244,719 379 291 56 476 3,147 73 7,933 0 988 2,723 102,736 1,864 27,245 6,548 1,763 1,646 932 4,557 831 20 299 193,537 1,796 1,116 54 935 4,032 110 11,419 2,734 1,043 3,696 430,124 368,913 438,488 376,547 Patient Fees [see note 2(d)] Staff-Meals and Accommodation Infrastructure Fees - Monthly Facility Charge [see note 2(d)] - Annual Charge Cafeteria/Kiosk Car Parking Child Care Fees Clinical Services (excluding Clinical Drug Trials) Commercial Activities Enteral Nutrition Income Fees for Medical Records Inter Area Patient Inflows, NSW Linen Service Revenues - Other Health Services Linen Service Revenues - Non Health Services Meals on Wheels Salary Packaging Fee Services Provided to Non NSW Health Organisations PADP Patient Co-payments Patient Inflows from Interstate Non Staff Meals Food Service Revenues - Other Health Services Other Total (c) Revenues from Inter Area Patient Flows, NSW on an Area basis are as follows: 118,734 21,430 33,478 19,836 17,994 22,426 10,821 86,003 17,952 29,168 16,835 14,756 18,044 10,779 244,719 193,537 Sydney South West Sydney West Northern Sydney Central Coast Hunter New England North Coast Greater Southern Greater Western (d) Revenues from Patient Inflows from Interstate are as follows:3,020 393 1,439 1,213 323 1,224 321 4,506 618 2,600 1,359 243 2,252 (159) 7,933 11,419 Australian Capital Territory Northern Territory Queensland South Australia Tasmania Victoria Western Australia 11. Investment Income 11,105 3,547 7,645 2,855 14,652 10,500 South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT CONSOLIDATION 2007 $000 2006 $000 6,690 5,916 861 1,184 3,395 1,689 19,257 1,624 198 17,266 3,025 9,116 1,514 289 2,975 900 6,534 13,908 0 0 58,080 38,261 2007 $000 2006 $000 Clinical Drug Trials Industry Contributions/Donations Commonwealth Government grants Commonwealth Teaching Hospital grants Mammography grants NSW Government grants Personnel Services - Superannuation Defined Benefits Research grants University Commission grants Other grants 6,690 5,916 861 1,184 3,395 1,689 0 1,624 198 17,266 3,025 9,116 1,514 289 2,975 900 0 13,908 0 0 Total 38,823 31,727 531 357 109 120 156 6,444 1,551 2,181 528 514 1 88 6 8,000 1,469 1,064 11,449 11,670 12. Grants and Contributions 13. Other Revenue Other Revenue comprises the following:531 357 109 120 156 6,444 1,551 2,181 528 514 1 88 6 8,000 1,469 1,064 11,449 11,670 Commissions Conference and Training Fees Discounts Sale of Merchandise, Old Wares and Books Sponsorship Income Treasury Managed Fund Hindsight Adjustment Rights to Receive Fixed Assets Other Total 14. Gain/(Loss) on Disposal 9,444 8,000 12,929 10,683 Property Plant and Equipment Less Accumulated Depreciation 9,444 8,000 12,929 10,683 1,444 1,200 2,246 1,567 1,444 1,200 2,246 1,567 (244) (679) Written Down Value Less Proceeds from Disposal Gain/(Loss) on Disposal of Property Plant and Equipment (244) (679) 7,719 9,015 0 0 1,296 0 1,052 (679) Assets Held for Sale Less Proceeds from Disposal Gain/(Loss) on Disposal of Assets Held for Sale 7,719 9,015 0 0 1,296 0 Total Gain/(Loss) on Disposal 1,052 (679) 15. Other Gains/(Losses) (1,568) (1,413) Impairment of Receivables (1,568) (1,413) (1,568) (1,413) Total (1,568) (1,413) Purchase of Health Promotion Education and Assets Research Total PARENT AND CONSOLIDATION 16. Conditions on Contributions $000 $000 $000 Contributions recognised as revenues during the current reporting period for which expenditure in the manner specified had not occurred as at balance date. 73 31,259 31,332 Contributions recognised in amalgamated balance as at 30 June 2006 which were not expended in the current reporting period. 403 72,508 72,911 Total amount of unexpended contributions as at balance date. 476 103,767 104,243 Comment on restricted assets appears in Note 26. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 17. Programs/Activities of the Health Service Program 1.1 - Primary and Community Based Services Objective: To improve, maintain or restore health through health promotion, early intervention, assessment, therapy and treatment services for clients in a home or community setting. Program 1.2 - Aboriginal Health Services Objective: To raise the health status of Aborigines and to promote a healthy life style. Program 1.3 - Outpatient Services Objective: To improve, maintain or restore health through diagnosis, therapy, education and treatment services for ambulant patients in a hospital setting. Program 2.1 - Emergency Services Objective: To reduce the risk of premature death and disability for people suffering injury or acute illness by providing timely emergency diagnostic, treatment and transport services. Program 2.2 - Overnight Acute Inpatient Services Objective: To restore or improve health and manage risks of illness, injury and childbirth through diagnosis and treatment for people intended to be admitted to hospital on an overnight basis. Program 2.3 - Same Day Acute Inpatient Services Objective: To restore or improve health and manage risks of illness, injury and childbirth through diagnosis and treatment for people intended to be admitted to hospital and discharged on the same day. Program 3.1 - Mental Health Services Objective: To improve the health, well being and social functioning of people with disabling mental disorders and to reduce the incidence of suicide, mental health problems and mental disorders in the community. Program 4.1 - Rehabilitation and Extended Care Services Objective: To improve or maintain the well being and independent functioning of people with disabilities or chronic conditions, the frail aged and the terminally ill. Program 5.1 - Population Health Services Objective: To promote health and reduce the incidence of preventable disease and disability by improving access to opportunities and prerequisites for good health. Program 6.1 - Teaching and Research Objective: To develop the skills and knowledge of the health workforce to support patient care and population health. To extend knowledge through scientific enquiry and applied research aimed at improving the health and well being of the people of New South Wales. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT CONSOLIDATION 2007 $000 2006 $000 94 13,218 11 0 85 6,063 2,293 14,306 13,323 22,747 18. 2007 $000 2006 $000 94 13,218 11 0 85 6,063 2,293 14,306 13,323 22,747 Current Assets - Cash and Cash Equivalents Cash on Hand Cash at Bank Cash at Bank Capital Short Term Deposits Cash assets recognised in the Balance Sheet are reconciled to cash at the end of the financial year as shown in the Cash Flow Statement as follows: 13,323 22,747 Cash and cash equivalents (per Balance Sheet) 13,323 22,747 13,323 22,747 Closing Cash and Cash Equivalents (per Cash Flow Statement) 13,323 22,747 14,710 5,760 1,759 11,125 4,465 2,320 1,811 3,172 4,442 14,404 12,355 398 10,326 5,608 0 112 330 249 49,564 43,782 3,188 3,656 19. Current/Non Current Receivables 14,710 5,760 1,759 11,125 4,465 2,320 1,811 3,172 4,442 14,404 12,355 398 10,326 5,608 0 112 330 249 Current (a) Sale of Goods and Services Sale of Goods and Services - Patient Fees Sale of Goods and Services - Other Debtors Non Operating Debtors GST Debtors Expense Recoupment Leave Mobility NSW Health Department Intrahealth Other Debtors 49,564 43,782 Sub Total 3,188 3,656 46,376 5,466 40,126 6,250 Sub Total Prepayments 46,376 5,466 40,126 6,250 51,842 46,376 Total 51,842 46,376 1,210 0 739 0 1,210 739 Less Allowance for impairment 1,210 0 739 0 Non Current (a) Sale of Goods and Services Patient Fees Other Debtors 1,210 739 Sub Total 653 185 Less Allowance for impairment 653 185 557 244 554 0 Sub Total Prepayments 557 244 554 0 801 554 Total 801 554 1,492 76 1,458 85 1,492 76 1,458 85 (b) Impairment of Receivables during the year - Current and Non Current Receivables: - Patient Fees - Other 1,568 1,543 Total 1,568 1,543 1,684 4,646 9,590 1,556 4,085 9,502 (c) Sale of Goods and Services Receivables include: Patient Fees - Compensable Patient Fees - Ineligible Patient Fees - Other 1,684 4,646 9,590 1,556 4,085 9,502 15,920 15,143 15,920 15,143 Total South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 20. 2007 $000 2006 $000 Inventories 5,682 10,078 225 0 2,914 5,679 11,667 94 216 1,243 Current - at cost Drugs Medical and Surgical Supplies Food and Hotel Supplies Engineering Supplies Other including Goods in Transit 5,682 10,078 225 0 2,914 5,679 11,667 94 216 1,243 18,899 18,899 Total 18,899 18,899 21. Current/Non Current Assets - Financial Assets at Fair Value 82,398 75,403 Current Treasury Corporation - Hour Glass Investment 82,398 75,403 82,398 75,403 Total 82,398 75,403 22. 1,770,133 1,760,187 592,604 553,639 1,177,529 1,206,548 234,079 237,823 146,060 141,118 88,019 96,705 246,640 246,648 81,089 74,922 165,551 171,726 1,431,099 1,474,979 Property, Plant and Equipment Land and Buildings At Fair Value Less Accumulated depreciation and impairment Net Carrying Amount Plant and Equipment At Fair Value Less Accumulated depreciation and impairment Net Carrying Amount Infrastructure Systems At Fair Value Less Accumulated depreciation and impairment Net Carrying Amount Total Property, Plant and Equipment At Net Carrying Amount 1,770,133 1,760,187 592,604 553,639 1,177,529 1,206,548 234,079 237,823 146,060 141,118 88,019 96,705 246,640 246,648 81,089 74,922 165,551 171,726 1,431,099 1,474,979 South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 23. Property, Plant and Equipment - Reconciliations 2007 Carrying amount at start of year Additions Adjustments Recognition of Assets Held for Sale Disposals Administrative restructures - transfers in/(out) Depreciation expense Reclassifications Carrying amount at end of year 2006 Carrying amount at start of year Additions Adjustments Recognition of Assets Held for Sale Disposals Administrative restructures - transfers in/(out) Depreciation expense Reclassifications Carrying amount at end of year Buildings Work in Progress Plant and Equipment Infrastructure Systems Total $000 $000 $000 $000 $000 $000 193,185 30 1,007,790 0 0 (61) (57) (1,280) (39,022) 12,656 980,026 (425) (380) (420) 0 0 191,990 5,573 11,675 0 0 0 0 0 (11,735) 5,513 96,705 12,216 0 (1,008) (2,064) (16,909) (921) 88,019 171,726 0 (9) 0 0 0 (6,166) 0 165,551 1,474,979 23,921 (9) (486) (1,445) (3,764) (62,097) 0 1,431,099 Land Buildings Work in Progress Plant and Equipment Infrastructure Systems Total $000 $000 $000 $000 $000 $000 193,185 0 0 1,090,319 2,543 (52,347) 3,148 9,400 1,148 81,002 33,251 0 177,966 0 (12) 0 0 0 (2,246) 0 0 0 193,185 (40,848) 8,123 1,007,790 0 (8,123) 5,573 (15,302) 0 96,705 (6,228) 0 171,726 1,545,620 45,194 (51,211) 0 (2,246) 0 (62,378) 0 1,474,979 (i) Land and Buildings include land owned by the Health Administration Corporation and administered by the South Eastern Sydney and Illawarra Area Health Service [see note 2(g)]. (ii) Land and Buildings were valued by the State Valuation Office on 1 April 2005 [see note 2(j)]. Those involved with the valuation are not employees of the South Eastern Sydney and Illawarra Area Health Service. CONSOLIDATION PARENT 2007 $000 Land 2006 $000 24. 2007 $000 2006 $000 Non Current Assets - Other 12,331 10,780 Non Current Emerging Rights to Assets (refer Note 2(z)) 12,331 10,780 12,331 10,780 Total 12,331 10,780 25. Non Current Assets held for sale 486 7,719 Assets held for sale Land and Buildings 486 7,719 486 7,719 Total 486 7,719 Amounts recognised in equity relating to assets held for sale 123 741 Available for sale financial asset revaluation increments/decrements 123 741 123 741 Total 123 741 The South Eastern Sydney and Illawarra Area Health Service has identified a property at 9 St George Rd Bexley as being available for sale in 2007/08 as it is surplus to requirements. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT CONSOLIDATION 26. Restricted Assets The South Eastern Sydney and Illawarra Area Health Service's financial statements include the following assets which are restricted by externally imposed conditions, eg. donor requirements. The assets are only available for application in accordance with the terms of the donor restrictions. 2007 $000 2006 $000 2007 $000 2006 $000 56,810 49,071 Specific Purposes 56,810 49,071 19,823 27,610 19,727 Research Grants 19,823 19,727 23,963 Private Practice Funds 27,610 104,243 23,963 92,761 Total 104,243 92,761 28,249 1,273 3,519 1,168 9,517 0 77,596 24,743 2,235 1,500 811 2,510 0 70,381 2,412 1,923 936 249 2,992 14,184 707 8,819 884 4,009 129,834 130,783 Category 27. 0 0 3,519 1,168 9,517 29,522 77,596 0 0 1,500 811 2,510 26,978 70,381 2,412 1,923 936 249 2,992 14,184 707 8,819 884 4,009 129,834 130,783 Payables Current Accrued Salaries and Wages Payroll Deductions GST FBT PAYG Accrued Liability - Purchase of Personnel Services Trade Creditors Other Creditors - Capital Works - Capital Acquisitions - Intra Health Liability - Contracted Patient Services - Other Total 28. Current/Non Current Borrowings 7,420 4,565 Current Other Loans and Deposits 7,420 4,565 7,420 4,565 Total 7,420 4,565 5,719 11,890 Non Current Other Loans and Deposits 5,719 11,890 5,719 11,890 Total 5,719 11,890 7,420 5,663 56 4,565 11,875 15 13,139 16,455 Other loans still to be exringuished represent monies to be repaid to the NSW Health Department. Final Repayment is scheduled for 2013/2014. Repayment of Borrowings (excluding Finance Leases) 7,420 5,663 56 4,565 11,875 15 Not later than one year Between one and five years Later than five years 13,139 16,455 Total Borrowings at face value (excluding Finance Leases) South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 29. 2007 $000 2006 $000 Provisions 0 0 0 0 338,686 0 0 0 0 316,309 Current Employee benefits and related on-costs Employee Annual Leave - Short Term Benefit Employee Annual Leave - Long Term Benefit Employee Long Service Leave - Short Term Benefit Employee Long Service Leave - Long Term Benefit Provision for Personnel Services Liability 74,917 88,292 17,351 158,126 0 88,775 62,617 16,455 148,462 0 338,686 316,309 Total Current Provisions 338,686 316,309 0 19,260 0 17,123 Non Current Employee benefits and related on-costs Employee Long Service Leave - Conditional Provision for Personnel Services Liability 19,260 0 17,123 0 19,260 17,123 Total Non Current Provisions 19,260 17,123 0 0 0 387,468 0 0 0 360,410 338,686 19,260 29,522 0 316,309 17,123 26,978 0 387,468 360,410 387,468 360,410 1,087 0 1,183 7,763 0 1,183 2,270 8,946 19,021 0 20,267 0 19,021 20,267 Aggregate Employee Benefits and Related On-costs Provisions - current Provisions - non-current Accrued Salaries and Wages and on costs (Note 27) Accrued Liability - Purchase of Personnel Services (Note 27) 30. 1,087 0 1,183 7,763 0 1,183 2,270 8,946 19,021 0 20,267 0 19,021 20,267 Other Liabilities Current Income in Advance Non-Interest DOH Loans Other Non Current Income in Advance Non-Interest DOH Loans In July 1995, $5.5m was received as income in advance from IPG under the terms of contract to operate a car park facility at the Sydney Hospital Campus for 25 years. In July 1997, $5m was received as income in advance from HCOA under the terms of contract to provide and operate a private hospital at the Randwick Hospital Campus for 40 years. In July 1998, $18.5m was received as income in advance from IPG under the terms of contract to operate a car park facility at the Randwick Hospital Campus for 25 years. In June 1999, $4.54m was received as income in advance from IPG under the terms of contract to operate a car park facility at the St George Hospital Campus for 25 years. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 31. Equity Balance at the beginning of the financial reporting period Correction of errors Rights to Receive Fixed Assets Annual leave on cost Car parks Restated Opening Balance Accumulated Funds 2007 2006 $000 $000 Asset Revaluation Reserve 2007 2006 $000 $000 Available for Sale Reserves 2007 2006 $000 $000 Total Equity 2007 2006 $000 $000 903,243 986,028 243,590 270,674 741 741 1,147,574 0 903,243 9,311 (19,873) (24,115) 951,351 0 243,590 (27,084) 243,590 0 741 0 741 0 1,147,574 1,257,443 0 9,311 (19,873) (51,199) 1,195,682 (3,764) 0 0 0 0 0 (3,764) 0 899,479 951,351 243,590 243,590 741 741 1,143,810 1,195,682 Result for the year Correction of error for annual leave on cost Transfer to Result for Year on disposal of available for sale financial assets (54,841) (45,963) (2,145) 0 0 0 0 (54,841) (45,963) (2,145) 0 0 0 0 (618) 0 (618) 0 Total (54,841) (48,108) 0 0 (618) 0 (55,459) (48,108) Asset revaluation reserve balances transferred to accumulated funds on disposal of asset 0 0 618 0 0 0 618 0 Total 0 0 618 0 0 0 618 0 844,638 903,243 244,208 243,590 123 741 1,088,969 1,147,574 Changes in equity - transactions with owners as owners Increase/(Decrease) in Net Assets from Administrative Restructure Total Changes in equity - other than transactions with owners as owners Transfers within equity Balance at the end of the financial reporting period The asset revaluation reserve is used to record increments and decrements on the revaluation of non current assets. This accords with the South Eastern Sydney And Illawarra Area Health Service's policy on the "Revaluation of Physical Non Current Assets" and "Investments", as discussed in Note 2(j). South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 2007 $000 2006 32. Commitments for Expenditure 2007 $000 $000 (a) Capital Commitments Aggregate capital expenditure contracted for at balance date but not provided for in the accounts: 2006 $000 25,997 28,584 21,273 30,219 Not later than one year Later than one year and not later than five years 25,997 28,584 21,273 30,219 54,581 51,492 Total Capital Expenditure Commitments (including GST) 54,581 51,492 Of the commitments reported at 30 June 2007 it is expected that $12.473m will be met from locally generated monies. (b) Other Expenditure Commitments Aggregate other expenditure contracted for at balance date but not provided for in the accounts: 19,968 39,123 14,683 25,976 Not later than one year Later than one year and not later than five years 19,968 39,123 14,683 25,976 59,091 40,659 Total Other Expenditure Commitments (including GST) 59,091 40,659 (c) Operating Lease Commitments Commitments in relation to non-cancellable operating leases are payable as follows: 12,562 15,752 619 8,748 14,674 105 Not later than one year Later than one year and not later than five years Later than five years 12,562 15,752 619 8,748 14,674 105 28,933 23,527 Total Operating Lease Commitments (including GST) 28,933 23,527 The operating lease commitments above are for motor vehicles, information technology, equipment including personal computers, medical equipment and other equipment. 33. Trust Funds The Health Service holds trust fund monies of $6.091 million which are used for the safe keeping of patients' monies, deposits on hired items of equipment and Private Practice Trusts. These monies are excluded from the financial statements as the Health Service cannot use them for the achievement of its objectives. The following is a summary of the transactions in the trust account. Patient Trust 2007 $000 Cash Balance at the beginning of the financial reporting period. Receipts Expenditure Cash Balance at the end of the financial reporting period. Refundable Deposits Private Practice Trust Funds 2006 $000 2007 $000 2006 $000 2007 $000 2006 $000 Total 2007 $000 2006 $000 460 460 246 209 9,266 8,783 9,972 9,452 1,117 1,027 62 57 53,022 41,784 54,201 42,868 (1,103) (1,027) (93) (20) (56,886) (41,301) (58,082) (42,348) 474 460 215 246 5,402 9,266 6,091 9,972 South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 34. Contingent Liabilities a) Claims on Managed Fund Since 1 July 1989, the South Eastern Sydney and Illawarra Area Health Service has been a member of the NSW Treasury Managed Fund. The Fund will pay to or on behalf of the South Eastern Sydney and Illawarra Area Health Service all sums which it shall become legally liable to pay by way of compensation or legal liability if sued except for employment related, discrimination and harassment claims that do not have statewide implications. The costs relating to such exceptions are to be absorbed by the South Eastern Sydney and Illawarra Area Health Service. As such, since 1 July 1989, apart from the exceptions noted above no contingent liabilities exist in respect of liability claims against the South Eastern Sydney and Illawarra Area Health Service. A Solvency Fund (now called Pre-Managed Fund Reserve was established to deal with the insurance matters incurred before 1 July 1989 that were above the limit of insurance held or for matters that were incurred prior to 1 July 1989 that would have become verdicts against the State. That Solvency Fund will likewise respond to all claims against the South Eastern Sydney and Illawarra Area Health Service. b) Workers Compensation Hindsight Adjustment Treasury Managed Fund normally calculates hindsight premiums each year. However, in regard to workers compensation the final hindsight adjustment for the 2000/01 fund year and an interim adjustment for the 2002/03 fund year were not calculated until 2006/07. As a result, the 2001/02 final and 2003/04 interim hindsight calculations will be paid in 2007/08. c) Affiliated Health Organisations Based on the definition of control in Australian Accounting Standard AASB127, Affiliated Health Organisations listed in Schedule 3 of the Health Services Act, 1997 are only recognised in the Department's consolidated Financial Statements to the extent of cash payments made. However, it is accepted that a contingent liability exists which may be realised in the event of cessation of health service activities by any Affiliated Health Organisation. In this event the determination of assets and liabilities would be dependent on any contractual relationship which may exist or be formulated between the administering bodies of the organisation and the Department. 35 Charitable Fundraising Activities Fundraising Activities The South Eastern Sydney and Illawarra Area Health Service conducts direct fundraising in all hospitals under its control All revenue and expenses have been recognised in the financial statements of the South Eastern Sydney and Illawarra Area Health Service. Fundraising activities are dissected as follows: INCOME DIRECT RAISED $000 EXPENDITURE* $000 INDIRECT + EXPENDITURE $000 PROCEEDS $000 Appeals (In House) 292 41 6 245 Fetes 211 70 0 141 19 5 1 13 Functions 198 110 0 88 Total 720 226 7 487 100% 31% 1% 68% Raffles Percentage of Income NET * Direct Expenditure includes printing, postage, raffle prizes, consulting fees, etc. + Indirect Expenditure includes overheads such as office staff administrative costs, cost apportionment of light, power and other overheads. The net proceeds were used for the following purposes: Purchase of Equipment Held in Special Purpose & Trust Fund Pending Purchase $000 487 0 The provision of the Charitable Fundraising Act 1991 and the regulations under that Act have been complied with and internal controls exercised by the South Eastern Sydney and Illawarra Area Health Service are considered appropriate and effective in accounting for all the income received in all material respects. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT 2007 $000 CONSOLIDATION 2006 $000 2007 $000 2006 $000 36. Reconciliation Of Net Cash Flows from Operating Activities To Net Cost Of Services 15,760 (62,097) 0 0 391 (24,514) 5,085 (2,089) 3,257 1,011 (0) 7,922 (3,206) 4,155 (516) (1,511,611) (10,775) 4,624 38,369 (62,378) 130 (15,865) 1,179 (21,485) 4,219 (3,067) 3,245 1,784 1,259 438 5,035 (16,157) (679) (1,460,583) (22,691) 0 Net Cash Inflows from Operating Activities Depreciation Provision for Doubtful Debts Acceptance by the Crown Entity of Employee Superannuation Benefits Donated Assets (Increase)/ Decrease in Provisions (Increase) / Decrease in Goods and Services Debtors (Increase) / Decrease in Debtors Expense Recovery (Increase) / Decrease in Other Debtors Increase / (Decrease) in Prepayments and Other Assets Increase / (Decrease) in Inventory Increase / (Decrease) in Income in Advance (Increase) / Decrease in Salary Accruals (Increase)/ Decrease in Creditors Net Gain/ (Loss) on Sale of Property, Plant and Equipment (NSW Health Department Recurrent Allocations) (NSW Health Department Capital Allocations) (Asset Sale Proceeds transferred to the NSW Health Department) 15,760 (62,097) 0 (19,257) 391 (24,514) 5,085 (2,089) 3,257 1,011 0 7,922 (3,206) 4,155 (516) (1,511,611) (10,775) 4,624 38,369 (62,378) 130 (22,399) 1,179 (21,485) 4,219 (3,067) 3,245 1,784 1,259 438 5,035 (16,157) (679) (1,460,583) (22,691) 0 (1,572,603) (1,547,247) Net Cost of Services (1,591,860) (1,553,781) 391 1,178 391 1,178 37. Non Cash Financing and Investing Activities 391 1,178 391 1,178 Assets Received by Donation 38. 2006/07 Voluntary Services It is considered impracticable to quantify the monetary value of voluntary services provided to South Eastern Sydney and Illawarra Area Health Service. Services provided include: . Chaplaincies and Pastoral Care - Patient & Family Support . Pink Ladies/Hospital Auxiliaries - Patient Services, Fund Raising Practical Support to Patients and Relatives . Patient Support Groups Counselling, Health Education, Transport, . Community Organisations Home Help & Patient Activities PARENT AND CONSOLIDATION 39. Unclaimed Moneys Unclaimed salaries and wages are paid to the credit of the Department of Industrial Relations and Employment in accordance with the provisions of the Industrial Arbitration Act, 1940, as amended. All money and personal effects of patients which are left in the custody of South Eastern Sydney and Illawarra Area Health Service by any patient who is discharged or dies in the hospital and which are not claimed by the person lawfully entitled thereto within a period of twelve months are recognised as the property of South Eastern Sydney and Illawarra Area Health Service. All such money and the proceeds of the realisation of any personal effects are lodged to the credit of the Samaritan Fund which is used specifically for the benefit of necessitous patients or necessitous outgoing patients. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 40. Budget Review Net Cost of Services The actual Net Cost of Services was lower than budget by $17.417m. This was primarily due to favouabilities in special projects and patient fees, and the favourable workers compensation hindsight adjustment. Result for the Year The result for the year from ordinary activities was lower than budget by $3.581m. This was mainly due to the factors outlined in the Net Cost of Services plus lower than expected income for capital projects and lower than expected recovery of the Area's superannuation liability. Assets and Liabilities The variance from budget is due to the reclassification of provisions from non current to current. Cash Flows Operating Activities Cash flows from operating activities were $5.843m lower than budget. This was mainly due to unbudgeted asset sale transfers to NSW Health. Investing Activities Cash outflows from investing activities were $9.177m lower than budget. This was mainly due to delays in several capital projects. Financing Activities Cash outflows from financing activities were $5.533m lower than budget. This was mainly due to repayment of loans exceeding budget. Movements in the level of the NSW Health Department Recurrent Allocation that have occurred since the time of the initial allocation in July 2006 are as follows: $000 Initial Allocation Award Increases Service Enhancements AIDS Project Funding Adjustments for Superannuation High Cost Drugs Funding Inter Area Patient Flows Interstate Patient Flows Childrens Cancer Grant Mental Health Enhancement Funding Cash Advance Clinical Streaming Clinical Service Redesign Program Risk Shared Procurement Savings NSW Artificial Limb Service Illawarra Mobile Outreach Service Funding for HACC Program Cerebral Aneurysm Services ICT Leases Predictable Surgery Program Additional Surgery Funding Cross Border Flows Managed Funds Adjustment Oral Health Strategies Blood & Blood Products Grad Radiation Therapists in PDY Compacks Program Funding Paediatric ICU Beds Nursing Strategies National Human Papillomavirus Vaccination Nurse Qualification Allowance NSW Childrens Home Ventilation Program Aged Care Funding Multiple Resistant Organisms Palliative Care Positions PADP Funding Workforce Development 1,541,864 56,572 754 3,332 5,586 6,100 (160,287) (360) 16,500 1,148 12,394 1,500 1,670 5,421 1,558 650 1,611 1,750 1,836 2,400 500 815 1,530 780 670 194 1,425 650 2,942 357 (2,205) 449 347 277 207 454 220 Balance as per Operating Statement 1,511,611 South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 41. Financial Instruments a) Interest Rate Risk Interest rate risk, is the risk that the value of the financial instrument will fluctuate due to changes in market interest rates. South Eastern Sydney and Illawarra Area Health Service's exposure to interest rate risks and the effective interest rates of financial assets and liabilities, both recognised and unrecognised, at the (consolidated) Balance Sheet date are as follows: Financial Instruments Fixed interest rate maturing in: 1 year or less Over 1 to 5 years Floating interest rate Non-interest bearing More than 5 years Total carrying amount Weighted average effective as per the Balance Sheet interest rate * 2007 $000 2006 $000 2007 $000 2006 $000 2007 $000 2006 $000 2007 $000 2006 $000 2007 $000 2006 $000 2007 $000 2006 $000 2007 % 2006 % Cash Receivables Other Loans and Deposits-Treasury Corp 13,229 0 82,398 22,662 0 75,403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 46,933 0 85 40,680 0 13,323 46,933 82,398 22,747 40,680 75,403 5.04 0.00 6.64 5.45 0.00 10.05 Total Financial Assets 95,627 98,065 0 0 0 0 0 0 47,027 40,765 142,654 138,830 Borrowings Payables Other 0 0 0 0 0 0 7,420 0 0 4,565 0 0 5,663 0 0 11,875 0 0 56 0 0 15 0 0 0 129,834 21,291 0 130,783 29,213 13,139 129,834 21,291 16,455 130,783 29,213 6.95 0.00 0.00 6.95 0.00 0.00 Total Financial Liabilities 0 0 7,420 4,565 5,663 11,875 56 15 151,125 159,996 164,264 176,451 Financial Assets Financial Liabilities * Weighted average effective interest rate was computed on a semi-annual basis. It is not applicable for non-interest bearing financial instruments. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 41. Financial Instruments b) Credit Risk Credit risk is the risk of financial loss arising from another party to a contract/ or financial position failing to discharge a financial obligation thereunder. The South Eastern Sydney and Illawarra Area Health Service's maximum exposure to credit risk is represented by the carrying amounts of the financial assets included in the consolidated Balance Sheet. Credit Risk by classification of counterparty. Governments 2007 $000 2006 $000 Banks 2007 $000 2006 $000 Patients 2007 $000 2006 $000 Other 2007 $000 2006 $000 Total 2007 $000 2006 $000 Financial Assets Cash Receivables Other Loans and Deposits 0 4,149 82,398 0 17,949 75,403 13,323 0 0 22,747 0 0 0 15,920 0 0 15,143 0 0 26,864 0 0 7,588 0 13,323 46,933 82,398 22,747 40,680 75,403 Total Financial Assets 86,547 93,352 13,323 22,747 15,920 15,143 26,864 7,588 142,654 138,830 The only significant concentration of credit risk arises in respect of patients ineligible for free treatment under the Medicare provisions. Receivables from these entities totalled $4.646m ($4.085m in 2006) at balance date. c) Derivative Financial Instruments The South Eastern Sydney and Illawarra AreaHealth Service holds no Derivative Financial Instruments. South Eastern Sydney and Illawarra Area Health Service Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 PARENT AND CONSOLIDATION 42. Prior Period Errors a) Annual Leave On Cost In 2006/07 the Department of Health determined the need to make allowance for on costs which need to be paid on the settlement of annual leave liability. This resulted in the application of an on cost of 21.7% as reported in Note 2(a). The provisions of AASB119, Employee Benefits and Treasury’s Financial Reporting Code for Budget Dependent General Government Sector Agencies, as pre existing in prior years, recognised the need to include such on costs and therefore the on costs now recognised have been brought to account as “Prior Period Errors”. The amount corrected against the Opening Balance at 1 July 2005 was $19.873M, with the 2005/06 Result being increased by $2.145M. In the Parent financial statements the $2.145M has been apportioned between Employee Related Expense ($1.523M) for the period up to 17 March 2006 and Personnel Services ($0.622M) for the period 17 March 2006 to 30 June 2006. b) Car Parks The Randwick Hospital Campus and Sydney Hospital Campus car parks were incorrectly included in the financial statements of the South Eastern Sydney and Illawarra Area Health Service for the year ended 30 June 2006. As these car parks are regarded as finance leases, consistent with AASB117, they have been eliminated from equity, with such elimination recognised in the "Statement of Recognised Income and Expenditure" as a correction of error. The amount corrected against Accumulated Funds at 1 July 2005 was $24.115M in respect to Buildings, and $27.084M in respect to Buildings Revaluation Reserve. c) Emerging Assets Refer to note 2. z). The amount corrected for the emerging asset against the Accumulated Funds at 1 July 2005 was $9.311M, with the 2005/06 result being increased by $1.469M. 43. After Balance Date Events No after balance date event has come to the attention of management. End of Audited Financial Statements Additional Unaudited Information Accounts Payable Ageing Analysis at 30 June 2007 Accrued Salaries Payroll Deductions Creditors Creditors Capital Works Creditors RMR > $5,000 Taxation Total Gross Creditors Less than 30 days 30 to 60 days 60 to 90 days Over 90 days Total for 2007 $000 $000 $000 $000 $000 28,249 1,273 62,545 1,849 929 14,204 109,049 0 0 10,882 60 355 0 11,297 0 0 1,849 6 52 0 1,907 0 0 6,497 497 587 0 7,581 28,249 1,273 81,773 2,412 1,923 14,204 129,834 The South Eastern Sydney and Illawarra Area Health Service continuously monitors the ageing of accounts payable. No interest has been paid on late payments. Income Statement of South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity for the Year Ended 30 June 2007 2007 $000 2006 $000 1,172,469 324,112 19,257 6,534 1,191,726 330,646 845,944 222,259 Awards 56,572 15,228 Defined Benefit Superannuation 19,257 6,534 Defined Contributions Superannuation 75,801 19,909 Long Service Leave 29,227 6,763 Annual Leave 90,231 26,426 Sick Leave and Other Leave 38,570 19,987 0 235 16,831 6,676 Fringe Benefits Tax 36 95 Grants & Subsidies 19,257 6,534 1,191,726 330,646 0 0 Income Personnel Services Acceptance by the Crown Entity of Employee Benefits Total Income Expenses Salaries and Wages Redundancies Workers Compensation Insurance Total Expenses Result For The Year The comparatives for 2006 cover the period 17 March 2006 to 30 June 2006 only. Note 1(c) refers. The accompanying notes form part of these Financial Statements. Balance Sheet of South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity as at 30 June 2007 Notes 2007 $000 2006 $000 368,208 343,287 368,208 343,287 19,260 17,123 19,260 17,123 387,468 360,410 29,522 338,686 26,978 316,309 368,208 343,287 19,260 17,123 19,260 17,123 387,468 360,410 0 0 Accumulated funds 0 0 Total Equity 0 0 ASSETS Current Assets Receivables 2 Total Current Assets Non-Current Assets Receivables 2 Total Non-Current Assets Total Assets LIABILITIES Current Liabilities Payables Provisions 3 4 Total Current Liabilities Non-Current Liabilities Provisions Total Non-Current Liabilities Total Liabilities Net Assets 4 EQUITY The accompanying notes form part of these Financial Statements Statement of Recognised Income and Expense of South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity for the Year Ended 30 June 2007 2007 $000 2006 $000 Opening Equity 0 0 Result for the Year 0 0 Closing Equity 0 0 Cash Flow Statement of South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity for the Year Ended 30 June 2007 2007 $000 2006 $000 Net Cash Flows from Operating Activities 0 0 Net Cash Flows from Investing Activities 0 0 Net Cash Flows from Financing Activities 0 0 Net Increase/(Decrease) in Cash 0 0 Closing Cash and Cash Equivalents 0 0 The South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity The accompanying notes form part of these Financial Statements. South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES a) The South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity The South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity "the Entity" , is a Division of the Government Service, established pursuant to Part 2 of Schedule 1 to the Public Sector Employment and Management Act 2002 and amendment of the Health Services Act 1997. It is a not-for-profit entity as profit is not its principal objective. It is consolidated as part of the NSW Total State Sector Accounts. It is domiciled in Australia and its principal office is at Wollongong, New South Wales. The Entity's objective is to provide personnel services to the South Eastern Sydney and Illawarra Area Health Service. The Entity commenced operations on 17 March 2006 when it assumed responsibility for the employees and employeerelated liabilities of the South Eastern Sydney and Illawarra Area Health Service. The assumed liabilities were recognised on 17 March 2006 with an offsetting receivable representing the related funding due from the former employer. The financial report was authorised for issue by the Chief Executive Officer on 30th October 2007. The report will not be amended and reissued as it has been audited. b) Basis of preparation This is a general purpose financial report prepared in accordance with the requirements of Australian Accounting Standards, the requirements of the Health Services Act 1997 and its regulations including observation of the Accounts and Audit Determination for Area Health Services and Public Hospitals. Generally, the historical cost basis of accounting has been adopted and the financial report does not take into account changing money values or current valuations. The accrual basis of accounting has been adopted in the preparation of the financial report, except for cash flow information. Management's judgements, key assumptions and estimates are disclosed in the relevant notes to the financial report. All amounts are rounded to the nearest one thousand dollars and are expressed in Australian currency. c) Comparative Information Comparative information reflects the creation of the Special Purpose Service Entity with effect from 17 March 2006 and covers the period 17 March 2006 to 30 June 2006. d) Income Income is measured at the fair value of the consideration received or receivable. Revenue from the rendering of personnel services is recognised when the service is provided and only to the extent that the associated recoverable expenses are recognised. e) Receivables A receivable is recognised when it is probable that the future cash inflows associated with it will be realised and it has a value that can be measured reliably. It is derecognised when the contractual or other rights to future cash flows from it expire or are transferred. A receivable is measured initially at fair value and subsequently at amortised cost using the effective interest rate method, less any allowance for impairment. A short-term receivable with no stated interest rate is measured at the original invoice amount where the effect of discounting is immaterial. An invoiced receivable is due for settlement within thirty days of invoicing. If there is objective evidence at year end that a receivable may not be collectable, its carrying amount is reduced by means of an allowance for impairment and the resulting loss is recognised in the income statement. Receivables are monitored during the year and bad debts are written off against the allowance when they are determined to be irrecoverable. Any other loss or gain arising when a receivable is derecognised is also recognised in the income statement. f) Payables Payables include accrued wages, salaries, and related on costs (such as payroll deduction liability, payroll tax, fringe benefits tax and workers' compensation insurance) where there is certainty as to the amount and timing of settlement. A payable is recognised when a present obligation arises under a contract or otherwise. It is derecognised when the obligation expires or is discharged, cancelled or substituted. A short-term payable with no stated interest rate is measured at historical cost if the effect of discounting is immaterial. South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 g) Employee benefit provisions and expenses i) Salaries and Wages, current Annual Leave, Sick Leave and On-Costs (including non-monetary benefits) Liabilities for salaries and wages (including non-monetary benefits), annual leave and paid sick leave that fall wholly within 12 months of the reporting date are recognised and measured in respect of employees' services up to the reporting date at undiscounted amounts based on the amounts expected to be paid when the liabilities are settled. All Annual Leave employee benefits are reported as "Current" as there is an unconditional right to payment. Current liabilities are then further classified as "Short Term" and "Long Term" based on past trends and known resignations and retirements. Anticipated payments to be made in the next 12 months are reported as "Short Term". Unused non-vesting sick leave does not give rise to a liability, as it is not considered probable that sick leave taken in the future will be greater than the benefits accrued in the future. The outstanding amounts of payroll tax, workers' compensation insurance premiums and fringe benefits tax, which are consequential to employment, are recognised as liabilities and expenses where the employee benefits to which they relate have been recognised. ii) Long Service Leave and Superannuation Benefits Long Service Leave employee leave entitlements are dissected as "Current" if there is an unconditional right to payment and "Non-Current" if the entitlements are conditional. Current entitlements are further dissected between "Short Term" and "Long Term" on the basis of anticipated payments for the next 12 months. This in turn is based on past trends and known resignations and retirements. Long Service Leave provisions are measured on a short hand basis at an escalated rate of 8.1% inclusive of the 4% payable from 1 July 2007 for all employees with five or more years of service. Actuarial assessment has found that this measurement technique produces results not materially different from the estimate determined by using the present value basis of measurement. The Entity's liability for the closed superannuation pool schemes (State Authorities Superannuation Scheme and State Superannuation Scheme) is assumed by the Crown Entity. The Entity accounts for the liability as having been extinguished resulting in the amount assumed being shown as part of the non-monetary revenue item described as "Acceptance by the Crown Entity of Employee benefits". Any liability attached to Superannuation Guarantee Charge cover is reported in Note 3, "Payables". The superannuation expense for the financial year is determined by using the formulae specified in the NSW Health Department Directions. The expense for certain superannuation schemes (i.e. Basic Benefit and Superannuation Guarantee Charge) is calculated as a percentage of the employees' salary. For other superannuation schemes (i.e. State Superannuation Scheme and State Authorities Superannuation Scheme), the expense is calculated as a multiple of the employees' superannuation contributions. Consequential to the legislative changes of 17 March 2006 no salary costs or provisions are recognised by the Health Service beyond that date. h) Financial Instruments Financial instruments given rise to positions that are a financial asset of either the Entity or its counter party and a financial liability (or equity instrument) of the other party. For the Entity, these include cash at bank, receivables, other financial assets, payables and borrowings. In accordance with Australian Accounting Standard AASB 139, "Financial Instruments: Recognition and Measurements" disclosure of the carrying amounts for each of AASB 139 categories of financial instruments is disclosed in Note 5. The specific accounting policy in respect of each class of such financial instrument is stated hereunder. Classes of instruments recorded and their terms and conditions measured in accordance with AASB 139 are as follows: Receivables Accounting Policies - Receivables are recognised at initially fair value, usually based on the transaction cost or face value. Subsequent measures are at amortised cost using the effective interest method, less an allowance for any impairment of receivables. Short term receivables with no stated interest are measured at the original invoice amount where the effect of discounting is immaterial. An allowance for impairment of receivables is established when there is objective evidence that the entity will not be able to collect all amounts due. The amount of the allowance is the difference between the asset's carrying amount and the present value of estimated future cash flows, discounted at the effective interest rate. Bad debts are written off as incurred. Terms and conditions - Accounts are generally issued on 30 day terms. South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 Payables Accounting Policies - These amounts represent liabilities for goods and services provided to the Health Service and other amounts, including interest. Payables are recognised initially at fair value, usually based on the transaction cost or face value. Subsequent measurement is at amortised cost using the effective interest method. Short term payables with no stated interest rate are measured at the original invoice amount where the effect of discounting is immaterial. Payables are recognised for amounts to be paid in the future for goods and services received, whether or not billed to the Health Service. Terms and Conditions - Trade liabilities are settled within terms specified. If no terms are specified, payment is made at the end of the month following the month in which the invoice is received. South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 2007 $000 2006 $000 368,208 343,287 19,260 17,123 387,468 360,410 Accrued Salaries and Wages on-costs 29,522 26,978 Total Payables 29,522 26,978 Employee Annual Leave - Short Term Benefit 74,917 88,775 Employee Annual Leave - Long Term Benefit 88,292 62,617 Employee Long Service Leave - Short Term Benefit 17,351 16,455 Employee Long Service Leave - Long Term Benefit 158,126 148,462 Total Current Provisions 338,686 316,309 Employee Long Service Leave - Conditional 19,260 17,123 Total Non-Current Provisions 19,260 17,123 338,686 316,309 Provision - Non-Current 19,260 17,123 Accrued Salaries and Wages on-costs 29,522 26,978 387,468 360,410 2. RECEIVABLES Current Accrued Income - Personnel Services Provided Non-Current Accrued Income - Personnel Services Provided Total Receivables 3. PAYABLES Current 4. PROVISIONS Current Employee benefits and related on-costs Non-Current Employee benefits and related on-costs Aggregate Employee Benefits and Related on-costs Provision - Current Total South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 5. FINANCIAL INSTRUMENTS a) Interest Rate Risk Interest rate risk is the risk that the value of the financial instrument will fluctuate due to changes in market interest rates. The Entity's exposure to interest rate risks and the effective interest rates of financial assets and liabilities, both recognised and unrecognised, at the Balance Sheet date are as follows: Non-Interest Bearing Financial Instruments 2007 $000 Total carrying amount as per the Balance Sheet 2006 $000 2007 $000 Weighted average effective interest rate* 2006 $000 2007 $000 2006 $000 Financial Assets Receivables 387,468 360,410 387,468 360,410 Total Financial Assets 387,468 360,410 387,468 360,410 Financial Liabilities Payables 29,522 26,978 29,522 26,978 Total Financial Liabilities 29,522 26,978 29,522 26,978 * The weighted average effective interest rate was computed on a semi-annual basis. It is not applicable for non-interest bearing financial instruments. b) Credit Risk Credit risk is the risk of financial loss arising from another party to a contract, or financial position, failing to discharge a financial obligation thereunder. The Entity's maximum exposure to credit risk is represented by the carrying amounts of the financial assets included in the Balance Sheet. Credit Risk by classification of counterparty Governments 2007 2006 $000 $000 Banks 2007 2006 $000 $000 Patients 2007 2006 $000 $000 Other 2007 2006 $000 $000 2007 $000 Total 2006 $000 Financial Assets Receivables 387,468 360,410 0 0 0 0 0 0 387,468 360,410 Total Financial Assets 387,468 360,410 0 0 0 0 0 0 387,468 360,410 c) Net Fair Value Financial Instruments are carried at cost. The resultant values are reported in the Balance Sheet and are deemed to constitute net fair value. d) Derivative Financial Instruments The Entity holds no Derivative Financial Instruments. South Eastern Sydney and Illawarra Area Health Service Special Purpose Service Entity Notes to and forming part of the Financial Statements for the Year Ended 30 June 2007 6. Prior Period Errors In 2006/07 the Department of Health determined the need to make allowance for on costs which need to be paid on the settlement of annual leave liability. This resulted in the application of an on cost of 21.7% as reported in Note 2(h) . The provisions of AASB119, Employee Benefits and Treasury’s Financial Reporting Code for Budget Dependent General Government Sector Agencies, as pre existing in 2005/06, recognised the need to include such on costs and therefore the on costs now recognised have been brought to account as “Prior Period Errors”. However expense and revenue adjustments are fully offsetting and the adjustment had no effect on Equity. 7. After Balance Date Events No after balance date event has come to the attention of management. End of Audited Financial Statements 8 Index SECTION Index Aboriginal Health 69 Non Government Organisation Projects Area Health Advisory Council (AHAC) 93 Nursing and Midwifery Services 58 Bulli Hospital 40 Occupational Health and Safety 78 Calvary Health Care Sydney 30 Official Overseas Travel 82 Chief Executive’s Foreword 2 Oral Health Service 53 20 Organisation Chart 4 Coledale Hospital 31 Performance Indicators 7 Community Health Services 45 Population Health 45 Consumer Participation 13 Port Kembla Hospital 35 Corporate Communications 65 Prince of Wales Hospital and Corporate Governance 17 Community Health Services 23 David Berry Hospital 32 Public Health 47 Clinical Services Strategic Plan Donations Purpose and Goals 157 98 5 56 Research 81 Environmental Health 48 Royal Hospital for Women 27 Early Intervention Program 44 St George Hospital and Eastern Sydney Scarba Service 43 Community Health Services Environmental Health 48 St Vincent’s Hospital 25 37 38 Drug and Alcohol Program 26 Equal Employment Opportunity 77 Shellharbour Hospital Ethnic Affairs Priority Program 97 Shoalhaven District Memorial Hospital Executive Reports 68 South East Sydney and Illawarra Falls Prevention 51 Medical Imaging (SESAIMI) 56 South Eastern Area Laboratory Service (SEALS) 57 77 Financial Overview 105 Financial Services 62 Staff Profile Food Services 61 Strategic Directions Freedom of Information 6 Sutherland Hospital and 103 Fundraising and Sponsorship 94 Community Health Services Garrawarra Centre 33 Sydney Children’s Hospital and Gower Wilson Memorial Hospital 41 Community Health Services Health Promotion Programs 50 Sydney Hospital and Sydney Eye Hospital 29 Health Services 21 Teaching and Training 80 Health Support Services 61 Vision and Mission HIV/AIDS Program 52 Volunteers Information Management Services 63 War Memorial Hospital Waverly 36 Kiama Hospital and Community Health Service 34 Wollongong Hospital 24 Mental Health Services 54 Women’s Health 48 Milton Ulladulla Hospital 42 Worker’s Compensation 78 Multicultural Health Service 46 Workforce Development 67 Better Services – Healthier People 160 Healthy People – Now and in the Future 39 28 5 100