Dr Teresa Anderson AM - Chief Executive - Sydney Local Health District
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Prepared by
Dr Teresa Anderson AM
Chief Executive
John O’Connor
A/ Executive Director of Finance
Overview
Wrap up of 2017/18 Budget Principles
2018/19 Budget Allocation from
2017/18 Achievements MoH
Overview of 2018/19 Service Agreement Hospital & Service Budgets
Next steps
2018/19 Service Level Agreement
Strategies and Priorities
Service Level Agreement
Key Performance Indicators
Wrap up of 2017/18
GENERAL FUND FOR YEAR TO 30 JUNE 2018
Actual $M Budget $M $ VAR % VAR STATUS
TOTAL EXPENDITURE $1,721.58M $1,729.50M $7.92M (F) 0.46% (PERFORMING)
(UNDER
TOTAL REVENUE $1,664.23M $1,670.86M $6.63M (UF) -0.67%
PERFORMING)
NCoS before Doubtful
$57.35M $58.64M $1.29M (F) 2.19% (PERFORMING)
Debts
(UNDER
Doubtful Debts $7.53M $3.05M $4.48M (UF) -146.88%
PERFORMING)
(UNDER
Total NCoS $64.88M $61.69M $3.19M (UF) -5.17%
PERFORMING)
Note: Total Revenue excludes one-off items provided by MoH at the
end of the financial year
2
Wrap up of 2017/18
SPECIAL PURPOSE & TRUST FUND FOR YEAR TO 30 JUNE 2018
Actual $M Budget $M $ VAR % VAR STATUS
TOTAL EXPENDITURE $36.429M $25.102M $11.33M (UF) -45.12% (UNDER PERFORMING)
TOTAL REVENUE $44.425M $38.318M $6.108M (F) 15.93% (PERFORMING)
(UNDER
TOTAL NCoS $7.997M $13.216M $5.219M (UF) -39.49%
PERFORMING)
Note: Additional SP&T expenditure was used to invest in infrastructure and equipment (medical and ICT) across the
District
3
Wrap up of 2017/18
Facility level financial performance 30 June 2018:
HOSPITAL / SERVICE 2017/18 % 2016/17 %
NCoS NCoS
($M) ($M)
RPA $8.358M (U) -1.41% $7.222M (U) -1.33%
CONCORD $3.562M (U) -1.19% $4.640M (U) -1.60%
CANTERBURY $4.043M (U) -3.82% $3.037M (U) -3.09%
BALMAIN $0.988M (U) -2.97% $0.037M (F) 0.12%
IRO $0.823M (U) -4.50% $0.101M (F) 0.54%
SYDNEY DENTAL $0.010M (U) -0.02% $4.575M (F) 10.09%
MENTAL HEALTH $0.632M (U) -0.57% $0.154M (F) 0.15%
THOMAS WALKER $0.482M (U) -7.88% $0.004M (F) 0.07%
COMMUNITY HEALTH $0.239M (F) 0.66% $1.440M (F) 4.13%
POPULATION HEALTH $0.617M (F) 5.33% $0.408M (U) -4.05%
REPORTING ENTITY (including Direct
$14.736 (F) 1.22% $9,178 (F) 0.84%
Research & Capital Works)
4
Wrap up of 2017/18
FTE Growth in 2017/18:
AWARD TYPE 1 July 2017 30 June 2018 Increase % Increase
MEDICAL 1,287 1,335 48 3.74%
NURSING 4,016 4,164 148 3.69%
ALLIED HEALTH 838 888 50 5.95%
PROFESSIONAL, TECHNICAL & ORAL HEALTH 753 763 10 1.32%
CORPORATE SERVICES, HOSPITAL SUPPORT
2,162 2,227 65 3.01%
& HOTEL SERVICES
MAINTENANCE, TRADES & OTHER 122 124 2 1.64%
TOTAL 9,178 9,501 323 3.52%
5
Wrap up of 2017/18 NWAU Activity delivered in 2017/18: ACTIVITY TYPE Actual Target Variance % Variance ACUTE 159,919 157,553 2,365 1.50% EMERGENCY DEPARTMENT 22,553 22,616 (63) -0.28% NON-ADMITTED 43,318 43,375 (56) -0.13% SUB-ACUTE 11,310 11,137 173 1.55% MENTAL HEALTH 28,808 28,219 589 2.09% DENTAL 10,518 8,234 2,284 27.74% TOTAL 276,426 271,134 5,292 1.95% 6
2017/18 Challenges These results and the following achievements were delivered in spite of a number of significant challenges during the year including: Significant demand for services, particularly during the winter period Pressures on ICU services The need for increased investment in facility infrastructure
2017/18 Achievements
PROJECT EXPENDITURE
RPA MULTI-STOREY CAR PARK (COMPLETED) $29.316M
BIOBANK PROJECT AT PROF MARIE BASHIR CENTRE (COMPLETED) $10.922M
RPA GYNAEOLOGY CAMERA STACK/TOWERS (COMPLETED) $0.284M
K2 FETAL MONITORING SYSTEM (COMPLETED) $0.624M
EMERGENCY DEPARTMENTS SECURITY AND DURESS ALARMS UPGRADE (COMPLETED) $7.298M
RPA IRO BUILDING LEVEL 6 REFURBISHMENT (COMPLETED) $0.735M
EEGP SLHD – EFFICIENCY UPGRADES AT CROYDON & MARRICKVILLE HEALTH CENTRES
$0.177M
(COMPLETED)
EEGP SLHD – BALMAIN AND SYDNEY DENTAL HOSPITAL (NEAR COMPLETION) $0.615M
RPA ENERGY EFFICIENCY GOVERNMENT PROGRAM (EEGP) (WORK COMMENCED)
$6.992M
SLHD AGED CARE/REHAB. NETWORK - WORK COMMENCED (NEAR COMPLETION)
$6.400M
8
2017/18 Achievements
WORK IN PROGRESS PROJECTS EXPENDITURE
CONCORD HOSPITAL OPERATING THEATRE RENOVATION (WORK COMPLETED
THEATRES 7&8) $2.736M
CONCORD HOSPITAL X-RAY MACHINES (PROJECT UNDERWAY)
$1.507M
CONCORD HOSPITAL MAMMOGRAPHY UNIT REPLACEMENT (PROJECT UNDERWAY)
$0.750M
CANTERBURY HOSPITAL TSSU EQUIPMENT REPLACEMENT (PROJECT UNDERWAY)
$0.800M
CANTERBURY HOSPITAL X-RAY EQUIPMENT (PROJECT UNDERWAY)
$0.435M
CANTERBURY HOSPITAL CHILLED WATER SYSTEM (PROJECT UNDERWAY) $0.620M
RPA STANDBY GENERATOR UPGRADE (PROJECT UNDERWAY) $0.654M
CONCORD HOSPITAL LIFTS MODERNISATION (PROJECT UNDERWAY) $2.000M
RPA FIRE DETECTION SYSTEM (PROJECT UNDERWAY) $0.600M
92017/18 Achievements
164,598 people attended emergency departments across SLHD (an
increase of 2.7%)
42,606 operations were performed in our hospitals (an increase of 1.04%)
171,698 admissions and discharges across our hospitals (an increase
1.4%)
6,702 babies born at RPA and Canterbury
Exceeded the SLHD NWAU target of 273,802 (1.4% YTD May exact
figure being finalised due to coding)
3,833 additional NWAU at a cost of $4,588 = $17,585,804 in additional
activity from contingency.
102017/18 Achievements
Maintained Performance at level 0 for the full year – 90 months in a row
Came in on budget (Net Cost of Service) Maintained Performance at level
0 for the full year – 90 months in a row
Came in on budget (Net Cost of Service- excluding doubtful debts)
Maintained surgical performance at 0,0,0
Significantly improved performance on most KPIs
Balmain, RPA and Community Health all achieved successful
accreditation with the Equip National standards
112017/18 Achievements
Organisation achievements
New District Strategic Plan and Research Strategic Plan completed
New Aboriginal Health Strategic Plan, cultural gardens throughout District
Outpatient Transformation Program – commencing at Canterbury Hospital
Ongoing enhancement of STARS to enable real time monitoring of services, business
processes, activity and outcomes.
Multiple signature events to engage our staff and our community– Innovation Week,
AGM, Yaralla Festival, Rivendell Flower Show, cultural events including Sorry Day,
NAIDOC Week, Close the Gap, Think Tanks and Planning forums, EquityFest, Sydney
Urban Health and
Wellbeing Forum,
commemorative
services.2017/18 Achievements
Patient achievements
A top performer in the State - timely care, transfer, flow, elective surgery wait
times and ETP + on budget.
Patient and Family Centred Care program continues – Launch of Partners in
Care Policy and Pilot at Balmain Hospital with a view to rolling out across the
District by December 2018
Canterbury Hospital launched the Cemplicity Survey tool to gain better
knowledge of the patient experience
Patient surveys show high levels of satisfaction
Clinical Governance: maintained high quality and safety standards with systems
and processes audited based on national standards.
Continued implementation of Essentials of Care, Heart of Health,
Productive ward, Canterbury Cares and Intentional Rounding.
132017/18 Achievements
Community achievements
Continued to strengthen community engagement through
consumer advisory committees, community consultation and
engagement in planning and service delivery
Developed SydneyConnect – new digital communication
platform for news and events of Sydney Local Health District
www.slhd.nsw.gov.au/sydneyconnect
Enhanced social media for community engagement, new
Community and Events Facebook and Instagram
Further opportunities to engage community in health services
delivery through Yaralla Festival, Carols at Yaralla, Fair Day
Stall (won best stall), inaugural March Arts events, inaugural
Rivendell Flower Show fundraiser, commemorative events
including Dawn Service to mark Centenary of ANZAC
142017/18 Achievements
Community achievements
Ongoing investment in community-based healthcare eg. Sustained
Home Visiting, community mental health, Sydney District Nursing
Mental Health launched Eurella House
Enhancement of Integrated Care programs eg. CCChip, Healthy
Homes and Neighbourhoods, Criteria–led Discharge, peer support
workers, HeatheNet, NDIS, Residential Aged Care Outreach
International interest in Healthy Homes and Neighbourhoods –
preliminary data shows reduction in ED presentations among
enrolled clients
NGO engagement continues through Healthy Strong
Communities, EquityFest, RPA HealthOne East consultations and
through funding NGOs
Continued Implementation of healthy children’s initiatives,
15 Go4Fun, Munch and Move, Live Life Well @ School.2017/18 Achievements
Staff achievements
Continued implementation of the Workforce Strategic Plan
People Matter 2017 survey results - achieved the highest
culture index and highest engagement score in NSW
Successfully implemented HealthRoster - an Information Technology system for
rostering staff.
Inaugural Women’s Leadership Breakfast held to acknowledge inspiring women
throughout the District. Women make up 72% of the Sydney Local Health District
workforce (in line with Premier’s Priorities).
Aboriginal Workforce development (1.7%) strategies have been very actively pursued
through AINs (nursing, Admin Assistants program). Respecting the Difference
completed by 9,000 staff.
162017/18 Achievements
Staff achievements
Health Promotion initiatives implemented to improve health of our workforce including:
‘Making healthy choices easier’ campaign as part of the Healthy Food and Drinks
Framework, Get Healthy at Work, Free Health Checks for staff.
172017/18 Achievements
Staff achievements
Officially opened new RPA Staff Car Park
182017/18 Achievements
Staff achievements
The Pitch Innovation Series reached major milestone in June with $1m invested in
the ideas of our staff
Performance Development and Review, Employee recognition programs, EAP
services, BPTOK.
Significantly reduced excessive annual leave balances
192017/18 Achievements
Education achievements
Expansion of education programs in CEWD and continued development of
CEWD as a leading delivery site of the NSW Health RTO.
Third annual Education and Training Forum at CEWD with more than 130
delegates
Enhancement of Clinical Placement capacity
Strong collaboration with University of Sydney and other tertiary partners
Opening of the David Storey Surgical Skills and Simulation Centre at the IAS at
RPA
202017/18 Achievements
Research achievements
Launched Research Strategic Plan
Held the sixth Annual Sydney Innovation and Research
Symposium – expanded program to ‘Innovation Week’ – 9
events hosted including: ‘Research Day’ with the Big
Idea, Clinical Trials Showcase and Research Education
Series, the Symposium and the Sydney Robotics Summit
- more than 2500 Delegates and 150 presenters
212017/18 Achievements
Research achievements
Strengthening of Sydney Research – Appointment of
Executive Director, hosted second ‘Big Idea’ with
$45,000 awarded to help commercialise research.
Launched the STRIVE Research Impact and
Commercialisation Series.
Sydney Research Awards and the first Sydney Local
Health District Clinical Trials Awards.
550 clinical trials underway across five hospitals, giving
our patients access to the latest in drug treatments.
Major world breakthroughs in Gene Therapy leading to
cures for Haemophilia and Thalassaemia.
222017/18 Achievements
Research achievements
Officially opened the NSW Health Statewide Biobank, a partnership of
OHMR, NSW Health Pathology, Health Infrastructure and SLHD.
Ongoing development of Sydney Health Partners, one of the first Advanced
Health and Research Translation Centres in Australia designated by
NHMRC - awarded $2.2m funding announced at 2017 Sydney Innovation
and Research Symposium.
Signed historic Partnership Agreement and IP Agreement with the
University of Sydney affirming the commitment of both institutions to
excellence in the pursuit of research, education, community engagement
and health delivery.
232017/18 Achievements
Research achievements
Launched Australian first eating disorders research institute “InsideOut Institute”
in partnership with the University of Sydney.
Established Institute of Musculoskeletal Health in partnership with the University
of Sydney.
Ongoing development of the RPA Institute of Academic Surgery and RPA
Surgical and Robotics Training Institute (only centre of its kind in Southern
Hemisphere) – more than 120 clinicians trained last year.
Further development of the Charles Perkins Centre RPA Clinic.
Ongoing development of the SLHD Clinical Research Centre and ICT Health
Informatics Unit.
Strengthened Population Health, Community Health, Nursing
and Allied Health research (annual research forums and
24
ongoing research).2017/18 Achievements
Service achievements
Announcement: $341m redevelopment of Concord
Hospital (Stage 1) – held planning and Community
Consultation Sessions.
Masterplanning for the development of Canterbury
Hospital.
Continued preparation for RPA HealthOne East,
Green Square in collaboration with community,
local providers, NGOs, four universities and staff.2017/18 Achievements
Service achievements
Opening of the Emergency Short Stay Unit at Concord Hospital
Completion of the Balmain capital works program
Sydney Dental Hospital refurbishments including 17 specialist dental surgeries in
Periodontics and Prosthodontics and the Prosthodontic Laboratory
New concierge service at Sydney Dental Hospital2017/18 Achievements
Service achievements
Digital transformation – The CARI Project: Move the delivery of the eMR service to the
eHealth Government Data Centre – in partnership with eHealth and SWSLHD.
Digital transformation - @health email migration: Over 10,000 SLHD emails (22,000
across SLHD and SSWAHS) converted to the statewide email service providing a single
lifelong health email address for all health employees.
Digital transformation RPA: roll-out of eMeds, SurgiNet and hTrak in JL Theatres, eMR2,
VitalsLink, Oncology and Haematology Information Management System (OHMIS)
introducing digital documentation and electronic prescribing within Cancer Services
Digital transformation Concord: eMeds in Intensive Care, OHMIS for oncology and
haematology.
Digital transformation Canterbury: eMR enhancements, eMR2 in outpatient departments,
clinical barcoding.
Digital transformation Balmain: eMR2, first NSW Hospital to
implement VitalsLink across an entire hospital.2017/18 Achievements
Service achievements
Digital transformation: PABX KGV – over 700 new phones
installed.
Digital transformation: BYOD program.
Strengthened discharge planning through Criteria-Led
Discharge, Whole of Health, PathWays, electronic discharge.
REACH: Concord Emergency Department implemented Reach in December –
first application of the program in Emergency in NSW.
HealthPathways Sydney became first Australian region to publish 600 locally
relevant pathways. Published 84 new pathways and referral pages, reviewed
147 existing pathways.
Launched SLHD/PRISM Electronic GP referral portal trial enabling patient
referral to supported SLHD Ambulatory care services.
282017/18 Achievements
Service achievements
Launch of the new RPA Comprehensive Stroke Service
including new ambulant services for stroke and
neurovascular care.
New ECRNOW service for acute stroke - multidisciplinary
hyperacute 24/7 state-wide endovascular clot retrieval
service supporting metro and regional hospitals across
the state. 35% increase in admissions.
New multi-disciplinary memory and cognition clinic at RPA – more than 270
patients in the first 12 months.
The COMBAT-MS Study – world first program targeting both thinking skills
and general psychological wellbeing in multiple sclerosis.
Recruiting for IMPROVE-MS the largest longitudinal
29 MS Study ever conducted in Australia integrating2017/18 Achievements
Service achievements
Commencement of the state’s second peritonectomy service at RPA – between April 2017
and June 2018 - 59 patients have had the procedure.
Best performing metropolitan Local Health District in initiating Hepatitis C treatment to
residents.
Appointment of Director of TB Services for SLHD.
Enhancement of Pulmonary Hypertension Service with the appointment of a dedicated
CNC to the multidisciplinary team.
Integrated Care Program for Aboriginal patients with chronic disease. Strong relationships
with the AMS are reinforcing patient health plans and improving health outcomes.
Chronic Care program - building innovative partnerships between the patient, health and
social services including NGOs, primary care and FACS to ensure
30 patients receive holistic care addressing health issues and2017/18 Achievements
Service achievements
Enhanced Healthy Lifestyle Services to prevent chronic disease in Sydney Local Health
District
Diabetes - Successful implementation of insulin eMeds processes across SLHD input
facilities – now being adapted statewide
SLHD ComPacks assisted 1397 inpatients with a 6-week post discharge package of care,
finishing on 100% of 2017/18 package and financial targets
89% of people living with a disability in SLHD who were assisted by the SLHD NDIS
Transition Team were deemed eligible for the Scheme
96% of SLHD Community Care Support Program clients (excluding clients receiving
nursing) were successfully transitioned to NDIS or alternative care before the 30 June 2018
deadline
RACF Outreach - Successful development and implementation of the ‘right care, right place,
right time’ - enhanced model of care and multidisciplinary team supported by a geriatrician2017/18 Achievements
Service achievements
New/upgraded service developments such as Peritonectomy, INR, Health
Interpreter Service, HiTH, Xtend, Chronic Care, obesity clinics, hybrid labs, robotic
surgery, genomics, imaging
Continued to work with Chris O’Brien Lifehouse to provide selected cancer service
for public patients under a service agreement
Achievement of rates of Organ Donation at world best practice level. 77 liver
transplants performed at RPA + 30 performed by the RPA team at the Children’s
Hospital and 121 kidney transplants performed in 2017/18.
Celebrated 50 years kidney transplants at RPA
Completion of 679 pelvic exenterations (June 2018) and 75 exenterations in 2018
with the best 5 year survival of any centre in the world
Established specialised clinic for thrombosis and haematological
32 disorders of pregnancy – Institute of Haematology2017/18 Achievements
Population Health
Healthy Beginnings has been integrated into four sustained home
visiting services, collaborated with four LHDs, NGOs and
international organisations to implement the program.
CHAT study (Communicating healthy beginnings by phone) close to completion.
Healthy Beginnings app has been published.
Public Health
Meningococcal Vaccination provided to 9613 Year 11 and 12 students and 5108
Year 10 and 11 students in 2017 and first part of 2018
$48,000 won through The Pitch to develop ‘Flucare’ web based application to
improve the quality and efficiency of notification of influenza
33 outbreaks in aged care facilities to PHU.2017/18 Achievements
Allied Health
District implementation of best practice for Stroke Patients with aphasia at all
stages of the stroke journey from acute to rehabilitation and home.
“Memory Books” for relatives and carers of dying patients (RPA)
CHESTY multi-centre trial measuring incidence of respiratory complications and
sepsis following surgery (Concord)
342017/18 Achievements
Community Health
International interest in Healthy Homes
and Neighbourhoods integrated care
program.
Redesign Child and Family Health
Nursing care model, including expansion
of Sustained Home Visiting Service
Continued focus on Growing Healthy
Families Healthy Children in Sydney
Local Health District – Talking and
Listening check ups offered to 4992
children at early childhood centres and
family friendly locations across District
352017/18 Achievements
First comprehensive domestic violence counselling service for the District – the
new Community Domestic Violence Team provides a free, confidential, trauma-
informed clinical service to women to support recovery
Achieved ambitious HIV testing targets – increasing the number of Sexual
Health Clinic patients by 155%. Enrolled over 900 high-risk patients into the
NSW Pre Exposure Prophylaxis trial.
Expanded specialist palliative care support to weekends and public holidays
Introduced first Nurse Practitioner role in Sydney District Nursing (mental
health/HIV)
Celebration - 40 years of the NSW Health Care Interpreter Service and
publication of history of the service. SHCIS Call Centre received 71,544
incoming calls in 2017/18 - a 6% increase in calls
362017/18 Achievements
Clinical Governance and Risk
Completion of the audit of 215 Cancer patients as
directed by Ministry on time with no clinical issues
identified.
Continue to be the best performer for TMF (claims
performance and deposit contribution).
Winter preparation awareness – vaccination days for staff
and pop up immunisation clinic at Redfern with more than
200 people in our community receiving free flu shots
Implemented the Advance Care Planning program with
the launch of a suite of standardised tools and resources,
including a staff forum and the provision of education to
37 key staff2017/18 Achievements
Nursing and Midwifery
Inaugural SLHD Transition to Professional Practice Programs and MidSTART
open day held at CEWD with more than 500 students attending
Medical Services
Additional support for JMOs including website resources, notice boards,
podcasts, BPT OK program, enhanced EAP involvement especially for
debriefing, review of rostering practices, streamlining recruitment to replace
staff who leave and working with senior staff to ensure JMOs take ADOs.
Establishment of the monthly CE/DiT Steering Committees
382017/18 Achievements
Awards
Prime Minister’s Award: Employ-my-ability, Workforce Services
Premier’s Award: Employ-my-ability, Workforce Services
Premier’s Award: Dr Andrea Issler-Fisher - Improving Service Levels in
Hospitals and Anthea Kerr Award
NSW Health Finalist: Supporting our people - Employ-my-ability, Workforce
Services
NSW Health Finalist: Excellence in the provision of Mental Health Services -
Living Well Living Longer, Clinical Services Integration and Mental Health
Angela Manson - NSW Human Rights Award winner
Alice Kang – Canada Bay Citizen of the Year2017/18 Achievements
Awards
Australia Day Awards: Associate Professor Peter Haertsch AM, Professor Fiona
Blyth AM and Professor David Handelsman AO
Queens Birthday Honours List: Dr Teresa Anderson AM, Professor Andrew
McLachlan AM, Clinical Associate Professor Michael Cooper OAM, Association
Professor Paul McKenzie OAM.
Pride of Concord Medal - Professor Lewis Chan
RPA Research Medal - Professor Anthony Keech
NSW Health Nursing and Midwifery Awards: Claudia Pollauszach for
Excellence in Nursing and Amal Helou for the Judith Meppem Lifetime
Achievement Award
Sydney Gay and Lesbian Mardi Gras People’s Choice stall
award – SLHD Fair DayOverview of the Service
AgreementThe objectives of the LHD Service Agreement
To articulate responsibilities and accountabilities across all NSW Health entities for the
delivery of the priorities of the NSW Government and NSW Health.
To establish with Districts and Networks a performance management and accountability
system for the delivery of high quality, effective health care services that promote, protect
and maintain the health of the community, and provide care and treatment to sick and
injured people, taking into account the particular needs of their diverse communities.
To develop effective partnerships with Aboriginal Community Controlled Health Services
and ensure the health needs of Aboriginal people are considered in all health plans and
programs developed by Districts and Networks.
To promote accountability to Government and the community for service delivery and
funding.
42National Agreement –
Hospital funding and health reform
The Council of Australian Governments (COAG) has reaffirmed that providing
universal health care for all Australians is a shared priority and agreed a Heads of
Agreement for public hospitals funding from 1 July 2017 to 30 June 2020.
The Agreement preserves important parts of the existing system, including activity
based funding and the national efficient price.
There is a focus on actions to improve patient safety and the quality of services, and
reduce unnecessary hospitalisations.
The Commonwealth will continue its focus on reforms in primary care that are
designed to improve patient outcomes and reduce avoidable hospital admissions.
http://www.coag.gov.au/agreements
43Governance
Each Health Service and Support Organisation must ensure that all applicable duties,
obligations and accountabilities are understood and complied with, and that services
are provided in a manner consistent with all NSW Health policies, procedures plans,
circulars, inter-agency agreements, Ministerial directives and other instruments, and
statutory obligations.
Districts and Networks are to ensure:
- Timely implementation of Coroner’s findings and recommendations, as well as
recommendations of Root Cause Analyses.
- Active participation in state-wide reviews.
44Clinical Governance
NSW public health services are accredited against the National Safety and Quality
Health Service Standards.
See https://www.safetyandquality.gov.au/our-work/assessment-to-the-nsqhs-
standards/nsqhs-standards-second-edition/
The Australian Safety and Quality Framework for Health Care provides a set of
guiding principles that can assist Health Services with their clinical governance
obligations.
See http://www.safetyandquality.gov.au/wp-content/uploads/2012/04/Australian-
SandQ-Framework1.pdf
The NSW Patient Safety and Clinical Quality Program provides an important
framework for improvements to clinical quality.
See http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2005_608.pdf
45Corporate Governance
Each Health Service and Support Organisation must ensure services are delivered in
a manner consistent with the NSW Health Corporate Governance and Accountability
Compendium (the Compendium) seven corporate governance standards.
See http://www.health.nsw.gov.au/policies/manuals/pages/corporate-governance-
compendium.aspx
In particular, where applicable, they are to: provide required reports in accordance
with the timeframes advised by the Ministry; review and update Manual of Delegations
(PD2012_059) to ensure currency; ensure NSW Auditor-General’s, the Public
Accounts Committee and the NSW Ombudsman’s recommendations where accepted
by NSW Health are actioned in a timely and effective manner, and that repeat audit
issues are avoided.
46Safety and Quality Accounts
Standard 1, Clinical Governance, of the National Safety and Quality Health Service
Standards describes the clinical governance, and safety and quality systems that are
required to maintain and improve the reliability, safety and quality of health care, and
improve health outcomes for patients. Standard 1 ensures that everyone – from
frontline clinicians to managers and members of governing bodies, such as boards –
are accountable to patients and the community for assuring the delivery of health
services that are safe, effective, integrated, high quality and continuously improving.
Districts and Networks complete Safety and Quality Accounts to document
achievements, and affirm an ongoing commitment to improving and integrating safety
and quality into their functions. The Account provides information about the safety and
quality of care delivered by the Organisation, including key state-wide mandatory and
locally selected high priority measures, patient safety priorities, service improvements
and integration initiatives. The Account must also demonstrate how the Organisation
meets Standard 1.
47Safety and Quality Accounts
Consistent with the National Agreement, Districts and Networks must continue to
focus on reducing the incidence of Hospital Acquired Complications. Through the
Purchasing Framework, NSW Health has incentivised Districts and Networks to locally
invest in quality improvement initiatives to specifically target these complications. It is
expected that the Safety and Quality account articulates the incentivised initiative/s,
and provides details on the approach and outcomes.
48Performance Framework
Service Agreements are central components of the NSW Health Performance Framework,
which documents how the Ministry monitors and assesses the performance of public
sector health services to achieve the expected service levels, financial performance,
governance and other requirements.
The performance of a Health Service is assessed in terms of whether the organisation is
meeting the strategic objectives for NSW Health and Government, the Premier’s priorities,
the availability and implementation of governance structures and processes, performance
against targets and whether there has been a significant critical incident or sentinel event.
The Framework also sets out the performance improvement approaches, responses to
performance concerns and management processes that support achievement of these
outcomes in accordance with NSW Health and Government policy and priorities.
Performance concerns will be raised with the Organisation for focused discussion at
performance review meetings in line with the NSW Health Performance Framework
available at:
http://www.health.nsw.gov.au/Performance/Pages/frameworks.aspxService Agreement Schedules A. Strategies and Priorities B. Services and Networks C. Budget D. Purchased Volumes E. Performance against Strategies and Objectives 50
Schedule A: Strategies and Priorities
NSW Health Strategies and Priorities are to be reflected in the strategic, operational and
business plans of the Ministry and NSW Health Services and Support Organisations.
Delivery of the Strategies and Priorities is the mutual responsibility of all entities.
- NSW: Making it Happen outlines NSW Health’s State Priorities, including 12 Premier’s
Priorities that together define the NSW Government’s vision for a stronger, healthier
and safer NSW. As delivery of both Premier’s and State priorities is the responsibility of
all NSW Government Agencies, all entities work together to ensure successful delivery,
in both lead and partnering agency capacities.
- Election Commitments: NSW Health is responsible for the delivery of 102 election
commitments over the period to March 2019. The Ministry of Health will lead the
delivery of these commitments with support from Health Services and Support
Organisations – see also
http://nswtreasury.prod.acquia-sites.com/sites/default/files/pdf/2015-
2016_Budget_Papers_-_Election_Commitments_2015-19.pdf
51Schedule A: Strategies and Priorities
Minister’s Priority: NSW Health will strive for engagement, empathy and excellence to
promote a positive and compassionate culture that is shared by managers, front-line
clinical and support staff alike.
This culture will ensure the delivery of safe, appropriate, high quality care for our patients
and communities.
To do this, Health Services are to continue to effectively engage with the community, and
ensure that managers at all levels are visible and working collaboratively with staff,
patients and carers within their organisation, service or unit.
These requirements will form a critical element of the Safety and Quality Account.
52Schedule A: Strategies and Priorities
NSW State Health Plan: Towards 2021 provides a strategic framework which brings
together NSW Health’s existing plans, programs and policies and sets priorities across the
system for the delivery of the right care, in the right place, at the right time. See
http://www.health.nsw.gov.au/statehealthplan/Publications/NSW-state-health-plan-towards-
2021.pdf
NSW Health Strategic Priorities 2018-19 builds on and complements the NSW State
Health Plan: Towards 2021 and aligns with the NSW State and Premier’s Priorities. The
approach outlined in the plan frames the Ministry’s role as system manager for NSW Health,
strengthens system governance and establishes a strategic planning framework that:
Embeds a new cross-functional approach to strategic planning and delivery in the Ministry
including tighter direction and leadership;
Allows a flexibility about how we go about achieving this in order to encourage innovation
and continuous improvement; and
Applies tight ownership around the deliverables which will enable
transparency in monitoring results.Sydney LHD local priorities
Maintenance of overall performance of SLHD: SLHD will continue to achieve
Performance Level 0 in accordance with the NSW Ministry of Health Performance
Framework throughout 2018/19.
Surgical Performance: the District will continue to be leaders in relation to surgery and
ensure all patients are admitted within the clinically appropriate timeframe for their surgery.
Quality and Safety: SLHD will continue to focus on and improve performance on all key
safety and quality measures.
Capital Works: the following major capital works projects are a priority for SLHD in
2018/19:
- Fulfilment of the SLHD Asset Strategic Plan, including the redevelopment of RPA,
Canterbury Hospital and Stage 2 of Concord Hospital Redevelopment
- Commencement of main works for Stage 1 Concord Hospital Redevelopment
- Expansion of RPA Emergency Department to increase the
56 number of resuscitation beds from 3 to 8Sydney LHD local priorities
Planning: the following plans will be developed/launched in 2018/19:
- RPA Strategic and Clinical Services Plans
- Concord Hospital Strategic Plan
- Canterbury Hospital Strategic and Master Plans
- Balmain Hospital Strategic Plan
- SLHD Diabetes Strategy
- SLHD Health Advancement Plan
- SLHD Cardiothoracic Service Plan
- SLHD Genomics Development Strategy
- Inter-sectoral Inner West Youth Health and Wellbeing Plan
57Sydney LHD local priorities
Information and Communications Technology: Continue to improve and enhance our
services, including:
- Completion of the implementation of eMR2 across all facilities
- Completion of the roll out of eMeds across all facilitates
- Implementation of PowerChart Maternity, PowerChart Cardiovascular and PowerChart
Oncology and Haematology
Leading Better Value Care: committed to the further development, implementation and
evaluation of the Leading Better Value Care initiatives.
Investing in the Early Years: Continue to redesign child and family health services to better
meet the needs of families with children 0-5 years, in particular those families requiring
additional support. New service modalities will be explored, including telehealth and targeted
outreach. Resources will continue to be reallocated to ensure sufficient capacity to provide
two-year sustained health home visiting to those families requiring additional support. The
most complex families will be offered care coordination for all family members, with health
and social care needs in scope.
58Sydney LHD local priorities
Research: Continue leading collaborative research partnerships and research through
both Sydney Research and Sydney Health Partners. SLHD will also continue conducting
and implementing research through the Translational Research Grants Scheme and
continue to implement the Research Ethics and Governance Information System
(REGIS).
Enhancement of the Surgical and Robotic Training Institute: RPA provides basic
and advanced level robotic training to surgeons from NSW, Australia and overseas in an
industry partnership with Intuitive Surgical and Device Technologies. The purpose-built
facility commenced delivering training in March 2017 and SLHD will continue to build the
profile of the Institute with industry partners and the broader surgical community.
Enhancement of the Peritonectomy Program: The Peritonectomy Program delivered
the projected activity in 2017/18 and will be enhanced in 2018/19 in line with MoH
funding activity. The Model of Care is multidisciplinary in approach and the program will
continue to develop within a translational research framework.
59Sydney LHD local priorities
Neuro-Intervention (NI) Services: As the neuro-interventional workforce is small across
Australia, SLHD is committed to the continued growth and fostering of an increasing NI
workforce at RPA.
Stroke Service: RPA plans to continue increasing both inpatient and outpatient services
including TIA, stroke and neurovascular treatments, within this includes a preoperative
assessment following stroke, specific stroke consults within the inpatient population and
a specific young stroke clinic. All clinics are multidisciplinary in nature including
neurology, neurosurgery, interventional neuroradiology and nursing. All incorporating a
comprehensive stroke service model. RPA aims to increase the capacity to treat patients
with stroke, vascular disease, aneurysms, and other complex neurological and vascular
conditions in an efficient, cost effective and clinically advanced manner.
Establishment of Cardiology Service at Canterbury Hospital: SLHD is committed to
the establishment of a Cardiology service at Canterbury Hospital, including: cardiac
clinics, enhanced ECHO service and the implementation of strategies associated with
the ACI Leading Better Value Care CHF initiative.
60Sydney LHD local priorities
Establishment of Endocrine Service at Canterbury Hospital: Committed to the
establishment of an Endocrine Service at Canterbury Hospital, including diabetes clinics
that will better serve our disadvantaged community, as well as implement strategies
associated with the ACI Leading Better Value Care management of inpatient diabetes
initiative.
National Centre for Veterans’ Healthcare: Committed to the further development of a
Model of Care and the establishment of a pilot NCVH service at CRGH.
Continued implementation of the Outpatient Transformation Project: the project
aims to revolutionise the District’s outpatient services by improving patients’ and families
interactions with services and will be further rollout in 2018/19.
61Key Performance Indicators
(KPIs)
6263
64
65
Strategic Deliverables
Leading Better Value Care
The Leading Better Value Care Program creates shared priorities across the NSW health
system to improve health outcomes, improve the experience of care for patients, carers and
clinicians and provide efficient and effective care. The main components of this approach
include the following:
- The Ministry of Health will continue as system administrator, purchaser and manager and
will articulate the priorities for NSW Health. Performance against delivery of the priorities will
be monitored in line with the NSW Health Performance Framework.
- Districts and Networks will continue to provide services established through LBVC in 2017-
18 and determine local approaches to deliver new LBVC initiatives in 2018-19.
- The Pillars, as required, will continue to support Districts and Networks in a flexible manner
that can be customised to meet local needs and will support measurement as required.
- Districts and Networks will participate with Pillars in evaluation, monitoring and regular
reporting on the progress of the LBVC initiatives as specified in the
Monitoring and Evaluation Plans.Strategic Deliverables
In 2018/19, Districts and Networks will:
- Continue to provide clinical services in the most appropriate care setting for patients in LBVC
Tranche One (T1) initiatives of Osteoporotic Refracture Prevention (ORP), Osteoarthritis Chronic
Care Program (OACCP), Renal Supportive Care and High Risk Foot Services through designated
HERO clinics.
- Implement the LBVC solutions for Chronic Heart Failure, Chronic Obstructive Pulmonary Disease
(COPD) and Diabetes.
- Continue to undertake and report on the agreed solutions to reduce falls in hospital.
- Participate in monitoring, evaluation and other studies (e.g. costing) of LBVC initiatives formative
evaluations will occur throughout 2018-19 in consultation with the Districts and other stakeholders.
- Undertake regular reviews of activity associated with all T1 initiatives.
- Work with the Ministry of Health and lead Pillar agencies to participate in data gathering and other
activities to support the development and implementation of LBVC Tranche 2 (T2) initiatives for:
Bronchiolitis, Hip Fracture, Cancer care (optimal care pathways for colorectal cancer;
hypofractionation), Wound Management.Strategic Deliverables
- Work with the Ministry of Health and lead Pillar agencies to participate in data gathering and
other activities to support the development and implementation of LBVC Tranche 2 (T2)
initiatives for:
Bronchiolitis
Hip Fracture
Cancer care (optimal care pathways for colorectal cancer; hypofractionation)
Wound Management.
6869
5270
71
2018-19 National Health
Funding Body Service Agreement
Period: 1 July 2018 – 30 June 2019
72Capital Program 73
Budget principles
As with previous years, the District is holding a contingency of $40M (to meet additional
patient demands, unforeseen equipment replacement or other unexpected District costs)
The District has established an allocation of $13.5M for enhancements which have been
finalised with the Executive and Clinical Directors
Lifehouse budget allocated as per their agreement with the NSW Ministry of Health
To derive the contingency:
– NWAU price adjusted for contribution to contingency
– Block funding adjusted for contribution to contingency
Facility budgets built using available ABF & Block Funding principles:
– ABF funding pool developed using discounted 2019FY prices
– Block funding allocated (e.g. Dental, AIDS, NGO grants)
– Alignment of Entity budgets to 2018 FY actual and
budget2018/19 Budget from MoH
SLHD Total Expenditure Budget for 2018-19 is:
$1.772BILLION
GENERAL FUND SP&T
$1.746B $0.025B
MoH presents budget escalation on prior year annualised budget – a 4.9%
increase for SLHD
752018/19 Budget from MoH
SLHD Total Revenue budget for 2018-19 is:
$1.735BILLION
Govt Contribution SP&T Own Source
$1.447B $0.038B $0.250B
Own Source Revenue represents a 3.82% increase on 2017/18 actual resultActivity NWAU Prices 2018/19
NWAU prices:
– State Price = $4,713
– MoH determined SLHD Price = $4,521
– Mental Health Non Admitted = $4,636
772018/19 NWAU Activity
SLHD NWAU activity targets
Facility / Service 2018-19 NWAU18
RPA 130,225
Concord Hospital 67,068
Canterbury 27,965
Balmain 7,073
IRO 7,177
Lifehouse 8,684
Mental Health 24,992
782018/19 Budgets
Expenditure Revenue NCoS
Facility / Service
$M $M $M
RPA $680.630M $120.518M $560.112M
Concord Hospital $363.539M $60.967M $302.572M
Canterbury $116.528M $11.227M $105.301M
Balmain $49.714M $18.652M $31.062M
IRO $26.822M $4.175M $22.647M
Lifehouse $41.292M - $41.292M
Mental Health $113.716M $7.831M $105.885M
Thomas Walker $6.261M $0.007M $6.254M
Primary and Community Health $38.209M $6.168M $32.041M
Population Health $12.959M $0.867M $12.092M
Dental $47.318M $2.073M $45.245M
Tresillian $12.101M - $12.101M
792018-19 Service Agreement
Service Agreement for 2018-19 detailing activity and funding was issued to the Chief
Executive on 19 June 2018
The signed Service Agreement was returned to the Secretary, NSW Health on 31 July 2018
The signed Service Agreement is displayed in a prominent and easily accessible location on
the Sydney Local Health District website
Service and facility-level budgets (including staffing and activity levels) were published on the
District website following Board deliberations (31 July 2018)
A summary of each facility and District-wide service total expense budget (all programs) is
available in a prominent location on the SLHD internet site (31 July 2018)
The value of roadmapping (Productivity, Expenses and Revenue) goals required to achieve
on budget performance in 2018/19 confirmed on 31 July 2018. Roadmaps must be loaded by
the 30 September 2018.
Budgets and forecasts loaded into the Statewide Management
Reporting Tool (SMRT) reporting system (31 July 2018).Next steps
Continue strong governance over financial performance:
– Monthly distribution of modified monthly finance reports.
– CE & DoF performance meetings with GMs and Clinical Directors.
– Continued monthly performance reporting to FRAP.
– Monitoring of Productivity, Expenses and Revenue Roadmaps.
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