EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022

 
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
Eastern health 2022
The Strategic Clinical
SERVICE PLAN 2012–2022
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
This work is copyright. It may be
reproduced in whole or in part to inform
people about strategic directions for
clinical services within Eastern Health and
for study and training purposes, subject to
an inclusion of the acknowledgement of
the source. It may not be reproduced for
commercial use or sale. Reproduction for
purposes other than those above requires
written permission from Eastern Health.

For information, please contact:
Eastern Health
Quality, Planning and
Innovation Directorate
Phone: 9955 1289
Fax: 9955 1392

This document can be downloaded
from the Eastern Health web site at:
www.easternhealth.org.au

May 2013

Acknowledgments
Eastern Health 2022 has been
developed after feedback and
comments on a draft plan that was
presented to and circulated amongst
the staff of Eastern Health, healthcare
partners and the broader community.
All contributors are sincerely thanked
for their input and feedback.

In addition, the following people
are acknowledged for their work
in research, data collection, analysis
and writing of this Plan:
Karen Fox
Director, Quality Planning & Innovation
(Strategy, Planning & Risk Management),
Eastern Health

Lachlan MacBean
Director, Decision Support and Health
Information Services, Eastern Health
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
FOREWORD

It is with great pleasure that we present   increasingly, outside our hospitals.
Eastern Health 2022 – the Strategic         We have thought carefully about how
Clinical Service Plan for 2012 – 2022.      we can do things differently to provide
We have developed Eastern Health            the best possible patient outcomes
2022 consistent with our mission ‘to        and value for our health system.
provide positive health experiences for     Eastern Health 2022 outlines Eastern
people and communities in the east.         Health’s aspirations to provide health
                                            services in our communities over the
We acknowledge and thank the                next decade. Furthermore, it describes the
hundreds of people who were involved        important role that we play in achieving
in the development of Eastern Health        substantial reforms within the broader
2022 Their experience, expertise and        Victorian health system, as described
wisdom have been invaluable in the          in the Victorian Government’s Victorian
identification of innovative strategies     Health Priorities Framework 2012–22:
which will ensure that Eastern Health       Metropolitan Health Plan.
continues to serve the health needs of
people in the east over the next decade.    We are keen to begin the substantial
                                            work which is now needed to implement
At Eastern Health, we are excited           Eastern Health 2022 and look forward to
to articulate a comprehensive plan          working with our people, our healthcare
that will ensure we can deliver on          partners and the broader community in
our promise – our vision – of Great         its implementation.
Health and Wellbeing by providing
a broad range of health services to our     We commend Eastern Health 2022 to you
communities in conjunction with our         as we begin this exciting journey.
healthcare partners.
                                            Dr Joanna Flynn, AM
We are particularly proud that the          Chair, Eastern Health
initiatives mapped out in Eastern Health
2022 focus not only on the bricks and       Mr Alan Lilly
mortar of our health services but also,     Chief Executive
what we do within our hospitals and
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
CONT EN T S

1       Introduction                                                                7

2       Executive Summary                                                           9

3       Background                                                                  12

4       The External Context                                                        15

5       Policy Context                                                              17
5.1     Victorian Health Priorities Framework 2012–2022: Metropolitan Health Plan   17
5.2     Melbourne 2030 and Melbourne @ 5 million                                    18
5.3     National Health and Hospitals Network Agreement                             19
5.4     A Healthier Future for all Australians                                      19

6       Eastern Health organisational profile                                       21

7       The current Eastern Health Clinical Service Profile                         23

8       Primary and secondary catchment profile                                     25

9       Demographic population analysis                                             28
9.1     Population forecasts for Eastern Health’s primary catchment area            28
9.2     Population forecasts for Eastern Health’s secondary catchment area          29
9.3     Our ageing population                                                       30
9.4     Growth in demand for hospital admission across primary catchment area       30
9.5     Our community profile                                                       34
9.5.1   Religion, culture, ethnicity and our indigenous population                  34
9.5.2   Socio-economic status                                                       34
9.5.3   Burden of disease                                                           34
9.5.4   Disability                                                                  35
9.5.5   Travel                                                                      35
9.6     What are our patients telling us?                                           35

10      Meeting the demand for public services in the east                          37
10.1    Clinical activity – Top 10                                                  37
10.2    The Patient Care Delivery System and Streams of Care                        39
10.3    Self-sufficiency                                                            43
10.4    Patient ‘Outflows’                                                          46
10.5    Patient ‘Inflows’                                                           48

11      Prioritising clinical service areas                                         50

12      Eastern Health-wide priority initiatives                                    52
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
13     New and planned investment in our buildings                                                        67
13.1   Box Hill Hospital Redevelopment                                                                    67
                                                                                                          67
13.2   Maroondah Hospital Expansion Project (Stage 2B)                                                    67
13.3   Healesville & District Hospital Site (incorporating Yarra Valley Community Health Service)         67
13.4   Wantirna Health                                                                                    67

14     Configuration of Clinical Services by site                                                         69
14.1   Current configuration of clinical services by site                                                 69
14.2   Future configuration of clinical services by Directorate, Program and site                         70

15     What does this mean for Eastern Health’s larger sites?                                             72

16     Key enablers                                                                                       75
16.1   An Eastern Health workforce that supports the Plan                                                 75
16.2   Information and Communications Technology (ICT) as a vehicle for excellence in clinical practice   76
16.3   Research, Education and Training that supports the Plan                                            76

17     Implementation, review and next steps                                                              79

18     References                                                                                         80

19     Appendices                                                                                         82
       Appendix 1 – Government Policy Frameworks                                                          82
       Appendix 2 – Data Analysis, Assumptions and Calculations                                           91
       Appendix 3 – Glossary                                                                              92
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
S tr ateg i c p l a n 2015

                                                                         EXCELLENCE

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                                                                     Great

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                                                                   Health and
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                                                                   wellbeing

                                                                                            LE PL GREAT
                                                                                                N A TO
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STRATEGIC    1.A PROVIDER                 2. A GREAT PATIENT              3. A GREAT PLACE TO          4. A GREAT PARTNER          5. A GREAT ACHIEVER
DIRECTIONS        OF GREAT                     EXPERIENCE                       LEARN AND WORK               WITH OUR                     IN SUSTAINABILITY
                  HEALTHCARE                                                                                 COMMUNITIES

STRATEGIC    1.1	
                 Meeting or                2.1	
                                               Taking a person-             3.1	
                                                                                Ensuring flexible,        4.1	
                                                                                                              Delivering models        5.1	
                                                                                                                                           Ensuring optimal
GOALS            exceeding all                 centred approach                 highly-skilled and            of care with our             utilisation of
                 required standards            which actively                   capable workforce             community partners           resources across the
                 of service and care.          involves patients in             and volunteer                 that provide a               organisation.
                                               decision-making.                 networks.                     seamless patient
                                                                                                              journey and deliver
                                                                                                              the right service in
                                                                                                              the right place.

             1.2	
                 Delivering models         2.2	
                                               Aligning our                 3.2	
                                                                                Communicating and         4.2	
                                                                                                              Partnering with          5.2 	
                                                                                                                                            Building flexible,
                 of care and                   services and                     consulting with our           other hospitals and           sustainable
                 treatment that are            resources to meet                staff and providing           community partners            environments and
                 based on evidence.            the changing needs               feedback, reward              to provide a                  technologies.
                                               of our communities.              and recognition.              comprehensive and
                                                                                                              integrated range of
                                                                                                              services.

             1.3	
                 Monitoring,               2.3	
                                               Ensuring services            3.3	
                                                                                Identifying               4.3 	
                                                                                                               Embracing               5.3	
                                                                                                                                           Measuring the
                 repairing and                 are easy to access               leaders and                    technologies                things that matter.
                 continuously                  and navigate.                    providing learning             that enhance our
                 improving the                                                  opportunities for              partnerships.
                 quality and safety of                                          our staff.
                 clinical care.

             1.4	
                 Tailoring services        2.4	
                                               Ensuring access              3.4	
                                                                                Partnering                4.4	
                                                                                                              Being socially           5.4	
                                                                                                                                           Living within our
                 around the needs              to health services               with education                responsible and              means minimising
                 of a diverse                  for the most                     and training                  active in our                waste.
                 population.                   disadvantaged                    organisations to              community.
                                               within our                       drive research and
                                               community.                       education.

                                                                                                          Strategic Clinical Service Plan 2012–2022 | 5
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
1            IN TRODU C T ION

Good health will always be valued              ensures that Eastern Health can deliver its        Ms Claire Grieveson
by Australian society. Doctors,                services in a way that makes a substantial         Health Service Lead, Service Performance
nurses, midwives, allied health                contribution to the broader direction for          & Governance, Department of Health
professionals, clinical support staff          health services in Victoria.                       (from February 2013)
and other care givers will always
play a pivotal role in caring for people       The Plan was developed over 18 months
                                                                                                  Mr Craig Guscott
in need. However, the way we deliver           following extensive consultation within
                                               and outside Eastern Health. Figure 1a              Manager, South East Metropolitan Service
 the healthcare of tomorrow will be
                                               overleaf illustrates the various mechanisms        and Capital Planning, Department of Health
different to that of today.
                                               used by Eastern Health to develop an
The health system faces enormous               evidence-based Strategic Clinical Service          Ms Neth Hinton
challenges. Community expectations             Plan 2012–22 – Eastern Health 2022.                Executive Director, Continuing Care,
are increasing, the burden of chronic                                                             Community and Mental Health,
disease is increasing and the population       The project to develop the Plan was                Eastern Health
is growing and ageing. Public health           overseen by a Strategic Clinical Service
services will need to respond to these         Plan Steering Committee with the                   Ms Jackie Kearney
challenges. Hospitals will always have an      following members:
                                                                                                  Acting Manager, Continuing Care,
important role to play in the management       Mr Alan Lilly                                      Department of Health
of illness and injury, acute exacerbation
                                               Chief Executive, Eastern Health (Chair)
of chronic illness and surgical intervention                                                      Mr Lachlan MacBean
of disease, however, their role in the
                                               Ms Narelle Campbell                                Director, Performance Analysis and Health
continuum of health will shift. Rather than
                                               Project Manager, South East Metropolitan           Information Services, Eastern Health
being the ‘starting point’ in a patient’s
journey, the hospital admission will be        Service and Capital Planning, Department
                                               of Health (from September 2011)                    Mr Tony McNamara
but one option for health services to be
provided. Where possible and appropriate,                                                         Senior Health Service Lead, Service
services will be provided in the home          Mr Kevin Carter                                    Performance & Governance, Department
and community. An important role of            Manager, Capital Planning, Service                 of Health (to February 2013)
health services will be to ensure people       Improvement, Mental Health Drugs and
have the services and support they need        Regions Division, Department of Health             Mr David Plunkett
to remain at home – receiving care that                                                           Executive Director, Nursing, Access
is increasingly becoming their choice.         Ms Janet Compton                                   and Patient Support Services and Chief
                                               Executive Director, Acute Health,                  Nursing Officer, Eastern Health
Eastern Health 2022 (the Plan) responds to
                                               Eastern Health
these issues by considering the service,                                                          Ms Chelsea Simpson
activity and physical profile that will be
                                               Ms Zoe Ding                                        Project Manager, South East
required to ensure equity of access to                                                            Metropolitan Service and Capital
health services for people in Melbourne’s      Project Assistant, Strategic Clinical Service
                                               Plan, Eastern Health (to May 2011)                 Planning Department of Health
east by providing clinical services to our                                                        (from March 2011 to September 2011)
community at the appropriate level and
at the appropriate place.                      Dr Colin Feekery
                                                                                                  Ms Gayle Smith
                                               Executive Director, Medical Services
In May 2011, during the development            and Research and Chief Medical Officer,            Executive Director, Quality, Planning
of the Plan, the Victorian Government          Eastern Health                                     & Innovation, Eastern Health
released the Victorian Health Priorities
Framework 2012–22: Metropolitan Health         Ms Karen Fox                                       Ms Gill Smith
Plan which articulated the principles and                                                         Project Manager, South East Metropolitan
                                               Director, Quality, Planning & Innovation
priorities that will guide health service                                                         Service and Capital Planning, Department
                                               (Strategy, Planning & Risk Management),
and capital planning over the next ten                                                            of Health (to March 2011)
                                               Eastern Health (Project Manager, Eastern
years within a broader, statewide context.
                                               Health 2022)
Eastern Health 2022 is well-aligned with
this statewide framework and, importantly,

                                                                                               Strategic Clinical Service Plan 2012–2022 | 7
EASTERN HEALTH 2022 THE STRATEGIC CLINICAL SERVICE PLAN 2012-2022
1 | Int ro d uction

 Figure 1a – Consultation and evidence
 used to develop Eastern Health 2022

                                                                      Past and
                                          Forum with the            Forecast Data              40 Workshops
                                           Secretary and              Analysis            including almost 500
                                        Executive Directors                                clinical services staff
                                        of the Department                                      across Eastern
                                             of Health                                             Health

                       Externally                                                                                     Consultation
                      reviewed by                                                                                    with the Eastern
                    communications                                                                                   Health Board of
                        experts                                                                                         Directors

      Strategic Clinical
    Service Plan Steering                                                                                                           Government
      Committee input                                                                                                               Policy Review
        and reviews

                                                      E a st ern
                                                   H e a lt h 2022
                                                                                                                                       Consultation
   Discussions with                                     An evidence-Based                                                             with the Eastern
 public health services
  and hospitals in the                                  strategic clinical                                                           Health Community
                                                                                                                                          Advisory
   east and beyond
                                                       service plan 2012-22                                                              Commitee

                                                                                                                                  Multiple
                                                                                                                            incremental reviews
                 General                                                                                                     by members of the
           Practitioner Forum                                                                                                  Eastern Health
               and Survey                                                                                                  Executive Commitee
                                                                                                                           and Clinical Executive
                                                                                                                                 Commitee

                                                                                                           Consultation
                                                                                                          with the Eastern
                                Community                                                                 Health Primary
                                Consultation                                                            Care and Population
                                  Forum                                                                   Health Advisory
                                                    Forum with Eastern            Forum with                 Commitee
                                                      Health Program            Department of
                                                       Directors and            Health Program
                                                     Clinical Executive         representatives
                                                         Directors

8 | Strategic Clinical Service Plan 2012–2022
2            Exe c ut i v e sum m ary

Eastern Health is one of the largest                 and our work, we make a substantial and          the burden of chronic disease within the
public health services in Australia.                 significant contribution to the health and       community and advances being made
                                                     wellbeing of communities in Melbourne’s          through evidence-based practice.
We provide a comprehensive range of                  east and we embrace this role with
high quality acute, sub-acute, palliative            enthusiasm, skill and expertise.                 The Plan is based around nine principles
care, mental health, drug and alcohol,                                                                that articulate what Eastern Health aims
residential care and community health                The configuration of health services             to achieve through its clinical service
services to people and communities that              at Eastern Health has served the                 development in the ten years to 2022.
are diverse in culture, age, socio-economic          community and the people of Eastern              These principles are well-aligned with
status, population and healthcare needs.             Health well for many years. But times            the principles as outlined by the Victorian
Our role is to provide positive health               are changing and the services at Eastern         Government in the Metropolitan Health
experiences for people and communities               Health must also change to keep up               Plan. They are:
in Melbourne’s east. Through our efforts             with rising community expectations,

         Principles for Eastern Health 2022 –                                    Alignment with the guiding principles
         The Strategic Clinical Service Plan 2012–22                             within the Victorian Health Priorities
                                                                                 Framework 2012–22: Metropolitan Health Plan

   1     Clinical services will be provided to ensure that patients have            Universal access and a focus on those most in need
         equity of access to the full range and standard of clinical services       Equitable outcomes across the full continuum of health
         across Eastern Health

   2     Clinical services will be patient-centred                                  Person and family-centred

   3     Changes in clinical services will be based upon evidence                   Evidence-based decision-making
                                                                                    Continuous improvement and innovation.

   4     Clinical Services profile will be orientated to meet population-           Universal access and a focus on those most in need
         health demand and improve Eastern Health-wide ‘self-sufficiency’           Local and responsive governance

   5     Configuration of services will ensure that there is adequate critical      Capable and engaged workforce
         mass and appropriate clinical profiles in the interests of quality
         and safety, teaching and research

   6     Clinical services will be configured to enhance timely patient flow     	
                                                                                  Sustainable use of resources through efficiency and effectiveness

   7     Clinical services that are encountered frequently by patients will be      Person and family-centred
         located close to where patients live

   8     Services that can safely be provided in the home or in the               Responsibility for care spans the continuum
         community will be provided in the home or the community by              	
                                                                                  Sustainable use of resources through
         the most appropriate health service provider                             efficiency and effectiveness

   9     Clinical services will be configured in such a way that they             Capable and engaged workforce
         are sustainable and optimise utilisation of capacity across EH           Maximum returns on health system investments
         (financial, environmental, workforce, infrastructure, technology)
                                                                                 	
                                                                                  Sustainable use of resources through efficiency
                                                                                  and effectiveness

                                                                                                  Strategic Clinical Service Plan 2012–2022 | 9
2 | Ex e c ut i v e S um m ary

 Figure 2b – Clinical Service
 Priority Initiatives 2012-22

  Clinical Service Priority Initiatives 2012–22

 1     Re-orientate inpatient (bed-based) services to be provided      11   Establish and enhance coordinated, multi-disciplinary
       in ambulatory settings, including home, where appropriate            specialty and ambulatory clinics, providing patients
       to do so.                                                            with a ‘one-stop-service’.

 2     Maximise utilisation of all Eastern Health infrastructure and   12   Expand and promote Advance Care Planning protocols
       align future service expansion with forecast geographical            and procedures across all Eastern Health sites.
       demand for public health services in the mid-section of
       Eastern Health’s primary catchment area – specifically Yarra
       Ranges (Lilydale), Maroondah (Croydon) and Knox
       (North-East).

 3     Implement rapid assessment and early intervention               13   Invest in partnerships with general practitioners,
       models of care.                                                      community providers and Medicare Locals.

 4     Adopt and implement the Eastern Health Streams of Care as       14   Achieve Eastern Health-wide orientation of all clinical
       a basis for Eastern Health’s patient care delivery system            services and access points.
       and ensure capacity is geared to these streams appropriately.

 5     Expand Eastern Health clinical services and progress            15   Develop specific strategies for targeted groups on the
       planning for facilities to meet the current and future               elective surgical waiting list to enhance preparedness
       needs of the community and ensure a minimum 70 per                   for admission, improve communication, reduce functional
       cent self-sufficiency rate in the areas required.                    decline and enhance quality of life while they are
                                                                            waiting for admission.

 6     Establish models of care that are tailored to the               16   Orientate Eastern Health care delivery systems around the
       requirements of older people within all services.                    time of day and days of week that the community
                                                                            demonstrates it needs healthcare.

 7     Consider new models for the delivery of patient-focused         17   Develop an active research program whereby research is
       maternity and paediatric services that are                           translated into clinical practice at Eastern Health and
       safe and consistent across Eastern Health.                           clinical practice is used to inform research.

 8     Consider capacity and infrastructure options for planned,       18   Achieve the appropriate blend of generalist and sub-
       short cycle streams of care and chronic disease                      specialist clinical staff to improve self-sufficiency in
       (ambulatory) streams of care where it is not possible to             particular areas of clinical practice and ensure Eastern
       deliver these services in the home or community.                     Health provides a level of service equal to or better than
                                                                            other services in Melbourne.

 9     Explore opportunities with St Vincent’s Health and other        19   Respect and value diverse communities through tailored
       health services to ensure timely access for Eastern                  models of care.
       Health patients to tertiary services that are not within the
       Eastern Health service profile.

 10    Enable our health professionals to work to their full and       20   Align Clinical Support services with the clinical service
       extended scope of practice.                                          profile of each hospital.

10 | Strategic Clinical Service Plan 2012–2022
Eastern Health 2022 provides a
framework that guides Eastern Health’s
future decision-making. Eastern Health
2022 is fundamentally focused around
20 Clinical Service priority initiatives
which are outlined below. The priority
initiatives represent major pieces of work
that apply right across Eastern Health
Clinical Services and are primarily about
continuous improvement and driving
change that will ensure Eastern Health
can execute its strategy and achieve
tangible outcomes based upon the
principles. The priority initiatives are:
                                                According to Eastern Health clinicians,         In October 2011, Eastern Health
In addition to these 20 priority initiatives,   the most significant advances in                implemented new and streamlined
Eastern Health 2022 outlines over 400           healthcare over the next decade will            processes for Ambulatory and Community
specific and targeted improvements that         not be through advances in technology           Services. Wherever possible, patients
relate to specific clinical service groups      or breakthrough research, but rather            are cared for in their own homes which
across the organisation. These are explored     in streaming of healthcare delivery             reduces the risk of injury due to falls in
in greater detail in Part B of Eastern Health   systems to focus around the needs of the        an unfamiliar environment or acquiring
2022. These improvements represent the          patient and ensuring smooth interfaces          a hospital infection. Research shows
specific ways in which our clinical services    between services (or ‘flow’). Redesigning       that outcomes for patients cared for at
will be working to achieve the overall          the systems, processes, structure and           home are similar to those for hospitalised
strategic objectives of Eastern Health 2022.    infrastructure to make these advances           patients but without the inherent risks of
                                                possible will be critical.                      being in hospital and with a much higher
Orientating Eastern Health’s services to                                                        level of patient satisfaction. This is an
address the high level of growth in service     Healthcare provided by Eastern Health           important direction for Eastern Health as
demand in the middle sections of our            will address the biomedical aspects             it cares for an increasing number of older
primary catchment area is critical for          of care (dealing with abnormalities of          people in its catchment area.
ensuring equity of access – particularly        body function and structure and activity
for disadvantaged members of the                limitations) and the bio-psychosocial           People living in the east who are
community whose options are more                aspects of care (dealing with personal care     over 70 years of age will be the most
limited than others. At the time of writing     participation restrictions, environmental       frequent users of our service by 2022. In
this Plan, there are exciting and substantial   factors and personal factors that               2009–10, Eastern Health admitted almost
capital developments underway at                collectively influence quality of life).        30,000 people over the age of 70 years
Eastern Health – the Box Hill Hospital                                                          (excluding dialysis) and each patient
Redevelopment, the Maroondah Hospital           Historically, the predominant need              stayed, on average, over 3 days longer
Inpatient Ward Expansion Project and the        in health care has been for the                 in hospital than those aged under 70
sub-acute redevelopment at Maroondah            treatment of acute disease, but nearly          years of age. Whilst the number of patients
Hospital. Even with this terrific capital       ten percent of hospital admissions are          over 70 years of age represented 27 per
expansion, Eastern Health 2022 identifies       avoidable. (5). Most health care today          cent of all patients, they represented 45
that there will still be additional inpatient   and in the foreseeable future concerns          per cent of all inpatient ‘bed days’ or days
bed capacity required across Eastern            the management of chronic health                spent in hospital. It is imperative that
Health to manage the forecast increase in       conditions, which have intermittent             elder-friendly services and environments
activity to 2022. A high level ‘map’ of the     exacerbations. Health services that             permeate throughout the breadth and
future configuration of clinical services at    are now typically provided in hospital          depth of Eastern Health.
Eastern Health is provided in section 14.2.     will be provided by Eastern Health in
                                                the home and community. Hospital
                                                admissions at Eastern Health will
                                                increasingly becoming ‘planned’
                                                episodes of disease management.

                                                                                            Strategic Clinical Service Plan 2012–2022 | 11
3            BACKGRO UND

Eastern Health provides a                             any metropolitan health service in Victoria.                           progressive, responsive and innovative
comprehensive range of high quality                   We employ over 8300 people, deliver                                    health service, we demonstrate our
acute, sub-acute, palliative care, mental             more than 800,000 episodes of patient                                  commitment to excellence through
health, drug and alcohol, residential                 care each year and manage a budget                                     external accreditation with the Australian
care and community health services to                 approaching $760m per year. We aspire to                               Council on Healthcare Standards.
people and communities that are diverse               be GREAT in everything that we do.
in culture, age, socioeconomic status,                                                                                       The primary objective of Eastern Health
population and healthcare needs.                      We focus extensively on continuously                                   2022 is to recommend the future service
                                                      building a high quality health care system                             profile of Eastern Health Programs and
We deliver clinical services to more than             for the people we serve and through                                    Clinical Services, at site and Eastern
750,000 people through seven clinical                 which we can also attract and retain the                               Health-wide levels, to best meet the
programs from more than 29 different                  best staff. We have an active education                                needs of Eastern Health’s communities
locations. Our services are located across            and research focus and strong affiliations                             over the next ten years and improve
2800 square kilometres in the east – the              with some of Australia’s top universities                              equity of access to Eastern Health services.
largest geographical catchment area of                and educational institutions. As a

 Figure 3a – Eastern Health
 Performance Excellence Framework

                                                                        Phase 1
                                                                Performance Standards
                                                          What is the Eastern Health Standard?

                                                                                  EXCELLENCE

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                 Phase 3                                  Ann                                 ent                                                      Phase 2
      Perfomance Improvement                                 ua l P                      a gem
                                                                   lanning and Risk Ma n                                                      Performance Monitoring
              & Innovation
                                                                                                                                             What is actually happening?
     What to do when performance
    doesn’t meet the EH standard or
 there is an opportunity for innovation

12 | Strategic Clinical Service Plan 2012–2022
The scoping and development of the            planning and capital investment, Eastern
Plan was identified as a priority for         Health 2022 was developed with a ten-
the organisation in 2010–12 and goes          year horizon for the period 2012–2022.
directly to Eastern Health’s Strategic
goal of ‘aligning our services and            Figures 3a and 3b illustrate where
resources to meet the changing needs          Eastern Health 2022 fits within Eastern
of our communities’.                          Health’s overall Performance Excellence
                                              Framework and Planning Framework.
Eastern Health 2022 will inform the Eastern   Eastern Health 2022 is a major statement
Health Workforce Plan and a series of         of the ‘standards’ Eastern Health expects
Master Planning projects that will be         and significantly influences and informs
undertaken at the larger Eastern Health       Eastern Health direction.
sites. To enable a comprehensive, longer
term perspective on clinical service
planning that will inform site master

 Figure 3b – Eastern Health
 Planning Framework

     Performance against scorecard
     & Statement of Priorities (SoP)
                                                  Eastern Health 2022 –
     Incident management system                   The Strategic Clinical                             Corporate Function Plans
                                                   Service Plan 2012-22
                                                                                                         Capital Equipment
           Policy and funding
    requirements and opportunities
                                                                                                            Master Plans
        Legislative requirements
                                                                                                     Organisation Development
                                                        Strategic Plan (5 year)                         and Workforce Plan
         Benchmarking data and
        stakeholder consultations
                                                                                                    Information Communication
                                                                                                     Technology Long Term Plan
         Internal and external
    recommendations and standards
                                                                                                   Engaging with our Community
                                                        Annual Operations and                      – Consumer Participation Plan
       Risk profile and risk register                  Improvement Plan (OIP)                       – Patient Experience of Care
    3 year improvement plan review
                                                                                                 Economic Sustainability Strategies
    Annual evaluation of operations
                                                                                                             Budget Plan
   and improvement plan outcomes
                                                Annual Statement of Priorities (SoP)
          Patient experience of
         care data and feedback

                                                                                          Strategic Clinical Service Plan 2012–2022 | 13
4            T h e Ext e r na l Co nte xt

Eastern Health 2022 has been developed         Persistent health gaps                         Workforce
within the context of a number of ‘big         Inequities in health are evident in the        Finding new, innovative ways of learning
picture’ challenges that we face now           eastern metropolitan region. The outer         and working to ensure we can attract
and in the future.                             east areas of Eastern Health’s primary         and retain highly skilled, capable staff in
                                               catchment areas have high numbers of           an environment where there is a national
These challenges were identified through
                                               aboriginal people and socioeconomically        healthcare workforce shortage, our
research, consultation with our clinical
                                               disadvantaged groups which are the most        workforce is ageing and there is increased
staff and a review of clinical service
                                               severely affected and are most likely to       globalisation (and mobilisation) of the
plans and strategic plans at other health
                                               be overweight, smoke, develop chronic          health workforce. Role substitution will
services in Victoria and Australia. The
                                               illness and disability, be hospitalised for    become increasingly important and there
challenges include:
                                               avoidable conditions and die prematurely.      will be emergence of roles that haven’t
Population                                                                                    even been ‘invented’ yet.
Meeting the needs of an ageing population      Changes in the way health is delivered
in the east, where the number of those         There is a shift from hospital-based to        Environment
who are over 70 years of age is growing        more ambulatory and community-based            Climate change and environmental
more quickly than the rest of Melbourne.       health care. People are better informed,       consequences of this such as bushfire,
Forecast population changes in other           expect more access to services locally and     flood and water scarcity also impact
parts of Melbourne will also have an affect    increasingly want to participate in their      health directly and indirectly. There is
on Eastern Health which manages some           own chronic care and that of their families.   mounting evidence and support for all
aspects of demand by referring patients        The role of Emergency Departments              industries to use ‘clean’ energy, reduce
to other health services.                      has changed in line with community             energy consumption, be environmentally
                                               expectations. Rather than continuing to        sustainable and be good corporate
Distribution of demand                         operate the same way, a challenge exists       citizens.
Demand for public health services are          to redesign people’s experience with this
not distributed equally throughout the         ‘first point of call’.                         Cost Escalation
2800 square kilometres of Eastern Health’s                                                    Health care spending in Australia is
primary catchment area. The challenge is       Advancing technology                           growing in excess of the economy
to align services and resources to manage      Operating within our means in an               generally with most of this attributable
a projected increased demand for public        industry where change and technological        to population, the burden of chronic
health services – particularly in the areas    advancement is rapid, essential and            disease and technology.
of Yarra Ranges, Maroondah and Knox –          expected. There are challenges in acquiring
to improve self-sufficiency and ensure that    costly equipment and drugs to ensure that      Government policy
health services are positioned where they      Eastern Health remains a leading health        Uncertainty around the further
are needed most.                               service and complacency in this area can       establishment and level of Government
                                               quickly impact referral patterns.              involvement in national health reforms,
Changes in disease patterns                                                                   including Medicare Locals, Local
Chronic conditions such as diabetes,                                                          Healthcare Networks, National Health
heart disease, respiratory disease, obesity,                                                  Performance Authority, other initiatives of
dementia and mental illness are rising                                                        the National Health and Hospitals Reform
and now account for over two-thirds of                                                        Agenda and changes associated with the
avoidable hospitalisations. The incidence                                                     national Private Health Insurance Rebate.
of chronic disease also increases as the
population ages – a major challenge in
the eastern metropolitan region.

                                                                                          Strategic Clinical Service Plan 2012–2022 | 15
5             P oli cY Co nt ext

Eastern Health 2022 has been developed        These are also aligned with ten                    In terms of the particular focus on
to ensure consistency with the state and      guiding principles:                                communities in the east, the following
national Government policy frameworks.        1 . 	
                                                   Universal access and a focus on those         are extracts from the Metropolitan Health
                                                   most in need                                  Plan – Technical Paper (2011) relating to the
The following four government policy                                                             Inner and Outer East regions of Melbourne.
frameworks provide the primary                2. 	
                                                  Equitable outcomes across the full
reference points for the Plan, however            continuum of health
                                                                                                 I nner E as t
there are numerous other policies that        3 . 	
                                                   Person and family-centred
have also influenced Eastern Health’s                                                            “It is noted that the Inner East planning
                                              4. 	
                                                  Evidence-based decision-making                 area is well served with health services and
direction for particular clinical services.
Details of these other government                Capable and engaged workforce
                                              5.	                                               facilities. It comprises relatively advantaged
                                                                                                 areas, with good health outcomes, generally
policies are contained in Appendix 1.         6. 	
                                                  Responsibility for care spans the
                                                                                                 above Victorian levels on health indicators
                                                  continuum
                                                                                                 measured in VPHS. While well served with
                                              7. 	
                                                  Maximum returns on health system               health services, residents of the Inner East are
5.1 Victorian Health
                                                  investments                                    relatively mobile and receive 43 per cent of
Priorities Framework
                                              8 . 	
                                                   Sustainable use of resources through          their health care from areas outside the Inner
2012 – 2022: Metropolitan                                                                        East planning area. The projected population
                                                   efficiency and effectiveness
Health Plan                                                                                      growth to 2022 is the second lowest of all the
                                              9. 	
                                                  Continuous improvement and
The Victorian Health Priorities Framework                                                        planning areas.”
                                                  innovation
2012 – 2022: Metropolitan Health Plan
                                              10. 	Local and responsive governance              O u ter E as t
was released by the Department of Health
in May 2011. A companion Metropolitan         By 2022, Victoria’s health system should be:        “Self-sufficiency is relatively high despite
Health Plan – Technical Paper provides                                                           the lack of a major hospital within the
                                              A . 	
                                                   Responsive to people’s needs (People-         planning area. This may have to do with the
the essential data and analysis to inform
                                                   focused) with the following outcomes:         distance and the time it takes to travel to
implementation of these planning
priorities in metropolitan Melbourne.               	
                                                     People are as healthy as they can           large hospitals outside the planning area.
                                                     be (optimal health status).                 In percentage terms, the Outer East area
The seven priority areas for metropolitan,                                                       has the smallest growth to 2022. Given the
                                                    	
                                                     People are managing their own
rural and regional and health capital                                                            current service availability and fair health
planning into the future are:                        health better.
                                                                                                 status of residents, current facilities are likely
1. 	
    Developing a system that is                     	
                                                     People enjoy the best possible              to be suitable into the future.”
    responsive to people’s needs                     health care service outcomes.
                                                                                                 Eastern Health must consider the
2 . 	
     Improving every Victorian’s health       B . 	
                                                   Rigorously informed and informative
                                                                                                 challenges that exist to manage very
     status and experiences                        (knowledge-focused) with the
                                                                                                 high increases in forecast population and
                                                   following outcomes:
3. 	
    Expanding service, workforce and                                                             health service demand in the broader
    system capacity                                 	
                                                     Care is clinically effective and            Victorian context and design its Plan to
                                                     cost-effective and delivered in             consider this broader environmental
4. 	
    Increasing the system’s financial
                                                     the most clinically effective and           context over the ten years to 2022.
    sustainability and productivity
                                                     cost-effective service settings.
5. 	
    Implementing continuous
                                                    	The health system is highly
    improvements and innovation
                                                      productive and health services
6. 	
    Increasing accountability and                     are cost-effective and affordable.
    transparency
7. 	
    Utilising e-health and
    communications technology

                                                                                             Strategic Clinical Service Plan 2012–2022 | 17
5 | Po l i cy Context

5.2 Melbourne 2030 and
Melbourne @ 5 million
Released in 2002, Melbourne 2030
provides a long-term plan for Melbourne
and the surrounding region. Melbourne
@ 5 million provides policy initiatives that
are complementary to the directions of
Melbourne 2030 and the two documents
should be considered together.

Melbourne @ 5 million outlines the
implications of the Victoria in Future
2008 growth projections for Melbourne,
which indicate that the city’s population
is likely to reach 5 million before
2030. Actively managing this growth
and change is an important part
of Melbourne’s future liveability.

The Melbourne 2030 policy identifies a
number of “Principal Activity Centres” and
as such, outlines planning guidelines to
develop these centres into major hubs
of community services, transport, retail,
commercial and government services.
The Principal Activity Centres are major
Victorian Government initiatives being
delivered by the Victorian Department
of Sustainability and Environment and
are designed to create safe, vibrant and
accessible communities. They will help link
people to services, to opportunities and
to each other by locating activities and
development around public transport.

18 | Strategic Clinical Service Plan 2012–2022
5.3 National Health                            Elective surgery: National Access              5.4 A Healthier Future
and Hospitals Network                          Guarantee and Targets                          for all Australians
Agreement                                      Under the Agreement, the Government
                                               will improve access to elective surgery in     The Final Report of the National Health
On 13 February 2011, the Council of            public hospitals by fast-tracking elective     and Hospitals Reform Commission,
Australian Governments (COAG) agreed           surgery for patients who have waited           A Healthier Future for all Australians
to sign the National Health and Hospitals      longer than clinically-recommended times       was released in July 2009 by the
Network Agreement with the Federal             under a new National Access Guarantee          Commonwealth Government. The
Government. The objective of the               and establishing new access targets for        objective was to report on long term
Agreement is to improve health outcomes        elective surgery. States and territories       reform of the Australian Health Care
and the sustainability of the Australian       will work with patients, clinicians and        System. This report emphasises four
health system.                                 Local Hospital Networks to offer surgery       strategic reform themes:
                                               to patients, either within Local Hospitals      	
                                                                                                Taking responsibility – Individual and
The Agreement sets out the architecture        Networks, through another Local Hospital         collective action to build good health
and foundations of the National Health         Network, or at a private hospital, at the        and well-being – by people, families,
and Hospitals Network, which will deliver      state’s expense.                                 communities, health professionals,
five major structural reforms to establish                                                      employers, health funders and
the foundations of Australia’s future health   The Government will improve access to            governments
system in the areas listed below:              elective surgery in public hospitals by:
                                                                                               	
                                                                                                Connecting care – Comprehensive
1. 	
    Public hospitals and Local Hospital        	
                                                Fast-tracking elective surgery for              care for people over their lifetime
    Networks (LHNs)                             patients who have waited longer
                                                                                               	
                                                                                                Facing Inequities – Recognise and
2. 	
    Primary health care and Primary             than clinically recommended
                                                                                                tackle the causes and impacts of
    Health Care Organisations                   times under a new National Access
                                                                                                health inequities
                                                Guarantee, started in 2012
3. 	
    Financing                                                                                  	
                                                                                                Driving quality performance –
                                               	
                                                Establishing new access targets for
   Performance and Accountability
4.	                                                                                            Leadership and systems to achieve
                                                elective surgery. By December 2014,
   Framework                                                                                    best use of people, resources and
                                                95 per cent of patients waiting for
5. National governance                                                                         evolving knowledge.
                                                surgery in Category 1 or Category
                                                2 will be treated within clinically
The reform of Australia’s health and
                                                recommended times. The 95 per cent
hospital system includes:
                                                target will be extended to patients
	
 Improving our hospitals                        waiting for elective surgery in
	
 A greater focus on primary health care         Category 3 by December 2015
	
 Training more doctors, nurses and             	
                                                Providing hospitals with financial
 allied health professionals                    rewards, including $650 million
                                                to meet these new demands. The
	
 Supporting aged care
                                                funding will provide the equivalent
	
 Investing in prevention                        of 90,000 extra elective surgeries
	
 Helping those with mental illness              across Australia.
	
 Modernising our health system

                                                                                          Strategic Clinical Service Plan 2012–2022 | 19
6           East er n H e a lth
            org a ni s at i o na l profi le

Eastern Health is organised into eight       The structure was implemented in               Eastern Health 2022 identified that the
directorates which are defined by clinical   February 2010 and later modified in            full range of clinical services which are
programs and corporate functions             April 2011 and August 2012 to integrate        required over the next decade can be
that run across the health service as        ambulatory and community health                managed within Eastern Health’s existing
illustrated in Figure 6a below.              and establish a Statewide Services             organisational profile.
                                             Program respectively. The structure
                                             supports the integration of clinical
                                             programs and corporate functions                 Figure 6a – Eastern Health
                                             across all Eastern Health facilities.            Organisational Profile

 Figure 6a

 Cl inical Direc to r at e         P ro gr a m                     Larger Sites                       Corporate and Clinical
                                                                                                      Support Directorates

   Acute Health                    Emergency and General           Angliss Hospital                   Corporate Projects &
                                   Medicine                                                           Sustainability
                                                                   Box Hill Hospital
                                   Women & Children’s                                                 Finance, Procurement and
                                                                   Healesville & District Hospital    Information Services
                                   Specialty Medicine
                                                                   Maroondah Hospital                 Quality, Planning and
                                   Surgery                                                            Innovation
                                                                   Peter James Centre
   Continuing Care,                Continuing Care                                                    Human Resources, Fundraising
   Community and                                                   Wantirna Health
                                                                                                      and Community Relations
   Mental Health                   Mental Health
                                                                   Yarra Ranges Health
                                                                                                      Nursing, Access and Patient
                                   State-wide Services                                                Support Services
                                                                   Yarra Valley Community Health
                                   Ambulatory and Community                                           Medical Services and Research
                                   Services

                                                                                       Strategic Clinical Service Plan 2012–2022 | 21
7             T h e c u r r e nt Ea ste rn
              Hea lt h C li ni c al S e rvi c e P rofi le

In 2012, within the two Eastern Health
Clinical Directorates, there are eight Clinical
Programs and 42 Clinical Service Groups.

 Directo r ate             C l i ni ca l            Clinical                                                                    Clinical
                           P ro gr a m              Service Group                                                               Support

 Acute Health              Emergency and General    1.    General Medicine
                           Medicine                 2.    Emergency Services
                                                    3.    Intensive Care Services

                           Women & Children’s       4. Gynaecology
                                                    5. Maternity Services
                                                    6. Neonatology
                                                    7.	
                                                       Paediatric Services (includes Paediatric Medicine, Paediatric Surgery)

                           Specialty Medicine       8. Cardiology (includes invasive cardiology)
                                                    9. Dermatology

                                                                                                                                (Including, but not limited to Pathology, Medical Imaging, Pharmacy, Allied Health,
                                                    10. Endocrinology
                                                    11. Endoscopy services

                                                                                                                                      Anaesthetics, Biomedical Engineering, Health Information Services, etc.)
                                                    12. Gastroenterology
                                                    13. Haematology
                                                    14. Infectious Diseases
                                                    15.	
                                                        Neurology (includes Acute Stroke and Multiple Sclerosis Services)
                                                    16. Oncology, Chemotherapy and Radiotherapy
                                                    17. Renal Medicine and Dialysis
                                                    18. Respiratory Medicine
                                                    19. Rheumatology

                                                                                                                                                             Clinical Support Services
                           Surgery                  20.   Breast & Endocrine Surgery
                                                    21.   Colorectal Surgery
                                                    22.   Ear, Nose & Throat Surgery
                                                    23.   General Surgery
                                                    24.   Ophthalmology
                                                    25.   Orthopaedic Surgery
                                                    26.   Plastic Surgery
                                                    27.   Thoracic Surgery
                                                    28.   Upper Gastro-Intestinal Surgery (includes Bariatric Surgery)
                                                    29.   Urology
                                                    30.   Vascular Surgery

 Continuing care,          Mental Health            31. Adult Mental Health
 community and                                      32. Acute Aged Persons’ Mental Health
 mental health                                      33. Child and Youth Mental Health Service (CYMHS)

                           Continuing Care          34.   Geriatric evaluation and management
                                                    35.   Residential Aged Care
                                                    36.   Palliative Care
                                                    37.   Rehabilitation

                           Ambulatory & Community   38. Ambulatory Services
                           Services                 39. Transition Care Program (TCP)
                                                    40. Community Health

                           State-wide Services      41. Turning Point, Alcohol and Other Drugs
                                                    42.	
                                                        Spectrum (state wide service for people who have personality
                                                        disorders)

                                                                                            Strategic Clinical Service Plan 2012–2022 | 23
8            Pr im a ry a nd s e co nda ry
             catc hm ent p ro fi le

Eastern Health’s primary catchment            The secondary catchment area is defined              catchment, as defined here. For the
area is defined as the group of Statistical   as the group of SLAs for which Eastern               purposes of this Plan, unless otherwise
Local Areas (SLAs) for which Eastern          Health treats the second greatest number             specified, the primary and secondary
Health treats the greatest number of          of public admitted patients of any public            catchments as defined here will be
public admitted patients of any public        health service. There are slight differences         applied. Eastern Health’s primary and
health service.                               in the catchments of Eastern Health’s                secondary catchments include Melbourne
                                              Mental Health Programs. These relate                 SLAs as detailed in Figure 8a below.
                                              to the outer margins of our primary

 Figure 8a – Eastern Health’s
 primary and secondary catchments
 Source – Department of Health
 Victoria 2012

 Primary Catchment Area                            Km²                Secondary Catchment Area                               Km²

 Boroondara (C) – Camberwell N.                    17.4               Boroondara (C) – Hawthorn                              9.9

 Boroondara (C) – Camberwell S.                    18.2               Boroondara (C) – Kew                                   14.5

 Knox (C) – North-East                             40.4               Cardinia (S) – North                                   713.9

 Knox (C) – North-West                             31.2               Knox (C) – South                                       42.2

 Manningham (C) – East                             58.0               Monash (C) – Waverley East                             27.9

 Manningham (C) – West                             55.5               Monash (C) – Waverley West                             32.1

 Maroondah (C) – Croydon                           37.9               Murrindindi (S) – East                                 2,222.1

 Maroondah (C) – Ringwood                          23.5               Murrindindi (S) – West                                 1,650.6

 Whitehorse (C) – Box Hill                         21.6               Nillumbik (S) – South                                  65.8

 Whitehorse (C) – Nunawading E.                    21.4

 Whitehorse (C) – Nunawading W.                    21.2

 Yarra Ranges (S) – Central                        421.8

 Yarra Ranges (S) – North                          386.9

 Yarra Ranges – Dandenongs                         147.2

 Yarra Ranges – Lilydale                           102.8

 Yarra Ranges – Seville                            273.6

 Yarra Ranges (S) – Pt B                           1,137.5

 Total(s)                                          2,816.1                                                                   4,779.0

                                                                                               Strategic Clinical Service Plan 2012–2022 | 25
8 | Pri ma ry and secondary catchment profile

In 2008-09, 82 per cent of Eastern Health’s   communities in the east’ and confirms that    Figure 8b – Melbourne Metropolitan
admissions to hospital related to patients    it is a health service which predominantly    Primary Catchment Areas
who lived within Eastern Health’s primary     serves communities in Melbourne’s east.       Source – Department of Health
catchment area and a further ten per cent                                                   Victoria 2008
related to patients who lived within its      Figure 8b illustrates that Eastern
secondary catchment area. This supports       Health’s primary catchment area
Eastern Health’s mission ‘to provide          is geographically the largest of any
positive health experiences for people and    public health service in Melbourne.

 Figure 8b

                                                                        Eastern Health

    	
     Austin                         	
                                     Melbourne Health                   	
                                                                         Peninsula Health             	
                                                                                                       St Vincent’s Health

     Alfred Health                  	
                                     Mercy Health & Aged Care           	
                                                                         Southern Health              	
                                                                                                       Western Health

    	
     Eastern Health                 	
                                     Northern Health

26 | Strategic Clinical Service Plan 2012–2022
Eastern Health’s main facilities and the                        Eastern metropolitan area, consisting                         Figure 8c – Eastern Health’s
primary and secondary catchment areas                           of community-based mental health                              main facilities, primary and
are illustrated in figure 8c. The primary                       services, community health services and                       secondary catchment area
catchment stretches from Glen Iris                              residential care. These services are detailed                 Source – Department of
in the inner east to the outer eastern                          in the Eastern Health Sites and Services                      Health Victoria 2010
township of Matlock. In addition to                             Profile within Appendix 1.
its seven larger sites, Eastern Health
occupies over 60 locations across the

 Figure 8c

                                                                                                      dah
                                                                                                                Buxton
                                                             Melba

                                                                     Glenburn

                                                                                                       oon
                                                                                                   M ar                                              Woods Point

                                                       Kinglake                                                  Marysville
                                                                                                                                       Cambarville                 Matlock
                                                                                                    Narbethong
                                                          Steel Creek
                                                                                Chum Creek

                                                                                    Healesville &
                                                          Yarra Glen                District Hospital
                                                                                                                                  Reefton
                                     Kangaroo Ground

                      Eltham Warrandyte                 Yarra
                                                        Ranges                                                                                                     Toorongo
                     Templestowe                        Health
                                                                       Warburton                             Warburton
                                             e
                                         ors
               Eastern                 iteh                          Wandin
   Kew                               Wh Maroondah                                  Woori Wallock
                  box hill                 Hospital
                          Eastlink

                  HOSPITAL            Mountain                                               Hoddles Creek
         Glen Iris                    WANTIRNA            Olinda
                      PETer           HEALTH                                                        Powelltown
                      James
         Monash       centre                      ANGLISS               Emerald
                                                  HOSPITAL
                               Stud

           Mulgrave                    Rowville                                    Gembrook
                                                   Lysterfield

                                                               Upper Beaconsfield

                                                                                                Garfield

     Eastern Health Campuses                                            Primary Catchment                                        Secondary Catchment

     Arterial Roads                                                     Highways

                                                                                                                     Strategic Clinical Service Plan 2012–2022 | 27
9             Dem o gr a p hi c popu l ati o n a na lysi s

9.1 Population forecasts                           Figure 9.1a – Eastern Health primary
for Eastern Health’s                               catchment area forecast population
primary catchment area                             growth to 2021
                                                   Source – Department of Planning &
Figure 9.1a illustrates that the population
                                                   Community Development, Victoria in
in Eastern Health’s primary catchment area
                                                   Future (VIF) 2012
is expected to grow at a lower rate (5.8%)
than that of Victoria (15.6%) in the period
2011 – 2021.

 Figure 9.1a

 Statistical Local Area                  Population                 Forecast                Forecast               Forecast
                                         2011                       Population 2021         Population             Population
                                                                                            change 2011 to         change 2011 to
                                                                                            2021 (no.)             2021 (%)

 Boroondara (C) - Camberwell N.          47,104                     48,863                  1,759                  3.7%

 Boroondara (C) - Camberwell S.          53,993                     55,379                  1,386                  2.6%

 Knox (C) - North-East                   66,871                     70,097                  3,226                  4.8%

 Knox (C) - North-West                   47,259                     50,714                  3,455                  7.3%

 Manningham (C) - East                   16,254                     16,803                  549                    3.4%

 Manningham (C) - West                   103,185                    111,089                 7,904                  7.7%

 Maroondah (C) - Croydon                 62,516                     68,073                  5,557                  8.9%

 Maroondah (C) - Ringwood                44,793                     49,005                  4,212                  9.4%

 Whitehorse (C) - Box Hill               56,168                     61,181                  5,013                  8.9%

 Whitehorse (C) - Nunawading E.          47,528                     48,992                  1,464                  3.1%

 Whitehorse (C) - Nunawading W.          53,731                     54,855                  1,124                  2.1%

 Yarra Ranges (S) - Central              15,697                     16,086                  389                    2.5%

 Yarra Ranges (S) - Dandenongs           30,746                     32,003                  1,257                  4.1%

 Yarra Ranges (S) - Lilydale             73,527                     77,863                  4,336                  5.9%

 Yarra Ranges (S) - North                13,695                     14,713                  1,018                  7.4%

 Yarra Ranges (S) - Seville              16,319                     16,795                  476                    2.9%

 Yarra Ranges (S) - Pt B                 618                        630                     12                     1.9%

 TOTAL                                   750,005                    793,140                 43,137                 5.8%
                                         (13% of all Victoria)      (12% of all Victoria)   (5% of all Victoria)

 Victoria                                5,621,210                  6,500,653               879,443                15.6%

28 | Strategic Clinical Service Plan 2012–2022
9.2 Population forecasts                         Figure 9.2a – Eastern Health’s
for Eastern Health’s                             secondary catchment area forecast
secondary catchment area                         population growth to 2021
                                                 Source – Department of Planning &
Figure 9.2a illustrates that the population
                                                 Community Development, Victoria in
in Eastern Health’s secondary catchment
                                                 Future (VIF) 2012
area is also expected to grow at a lower rate
(6.5%) than that of Victoria (15.6%) to 2021.

 Figure 9.2a

 Statistical Local Area                    Population            Forecast             Forecast                Forecast
                                           2011                  Population 2021      Population              Population
                                                                                      change 2011 to          change 2006 to
                                                                                      2021 (no.)              2021 (%)

 Boroondara (C) - Hawthorn                         37,656                42,856                  568                    2.0%

 Boroondara (C) - Kew                              31,686                33,274                 5,200                  13.8%

 Cardinia (S) - North                              25,969                27,218                 1,588                   5.0%

 Knox (C) - South                                  42,958                44,846                 2,581                   4.3%

 Monash (C) – Waverley East                        60,717                63,298                 3,757                   5.4%

 Monash (C) – Waverley West                        69,465                73,222                 1,888                   4.4%

 Murrindindi (S) – East                             6,292                 7,236                 1,749                   6.7%

 Murrindindi (S) – West                             7,349                 9,262                  944                   15.0%

 Nillumbik (S) - South                             28,693                29,261                 1,913                  26.0%

 TOTAL                                           310,785                330,974               20,189                   6.5%

 Victoria                                       5,621,210             6,500,653              879,443                  15.6%

                                                                                      Strategic Clinical Service Plan 2012–2022 | 29
9 | De mo gr a phic popu l ation analysis

9.3 Our ageing population                          expected to experience a higher growth
                                                   in older persons than metropolitan
Australia’s ageing population affects us
                                                   Melbourne and Victoria. (2).
all. The median age of the population
has been rising for 40 years owing to a            As illustrated in Figure 9.3a below, the
long-term decrease in fertility. The leading       changes associated with the ageing
edge of the “baby boomers”, born in 1946,          population are more pronounced in
reached the age of 66 in 2012 and are              Eastern Health’s primary catchment area
either already retired or will retire soon. At     than the rest of Victoria. While the rest of
the same time, our population aged 65-84           the state will experience a fairly normal
is increasing as is the number of people           distribution in growth across all age groups,
aged 85 and over who have an increased             all of Eastern Heath’s growth will be aged
reliance on care and support services. (1).        over 50. While Eastern Health’s primary                Figure 9.3a – Current and forecast age
                                                   catchment will always have young people,               distribution, Eastern Health primary
Most areas within Eastern Health’s primary
                                                   the forecast demographic changes to 2021               catchment area and Victoria
catchment experience a higher median
                                                   will see a net decrease in the number of               Source – Department of Planning &
age than the national average. The outer
                                                   people aged less than 50 and a substantial             Community Development, Victoria in
eastern catchment, which includes
                                                   rise in the number of people over 50.                  Future (VIF) 2012
Maroondah, Yarra Ranges and Knox, is

Figure 9.3a

Age   Eastern Health Primary Catchment                                                   Victoria
Group
           Population   Population   Forecast     Forecast     Forecast     Proportion   Population   Forecast     Forecast     Forecast     Proportion
           2011         within age   population   population   population   of           2011         population   population   population   of
                        group 2011   2021         change       change       population                2021         change       change       population
                        (%)                       2011 to      2011 to      change                                 2011 to      2011 to      change
                                                  2021         2021 (%)     within age                             2021         2021 (%)     within age
                                                                            group by                                                         group by
                                                                            2021 (%)                                                         2021

 0-9          88,043        11%        85,506       -2,537          -3%          -6%      691,582      783,433       91,851         13%          10%

 10-19        95,085        12%        97,066        1,981           2%           5%      698,087      758,884       60,797           9%           7%

 20-29       103,969        13%       103,021         -948          -1%          -2%      854,373      903,465       49,092           6%           6%

 30-39        96,627        12%       104,519        7,892           8%         18%       802,865      982,541      179,676         22%          20%

 40-49       108,534        14%       101,654       -6,880          -6%        -16%       790,731      843,610       52,879           7%           6%

 50-59        99,649        12%       101,489        1,840          2%           4%       697,598      782,693       85,095         12%          10%

 60-69        78,793        10%        87,681        8,888         11%          21%       537,065      671,944      134,879         25%          15%

 70-79        46,379          6%       69,079       22,700         49%          53%       326,720      486,193      159,473         49%          18%

 >80          32,925          4%       43,125       10,200         31%          24%       222,189      287,889       65,700         30%           7%

30 | Strategic Clinical Service Plan 2012–2022
Older people generally need more health         Figure 9.3b – Eastern Health rate of
services than younger people. Figure            inpatient admission by age grouping,
9.3b illustrates that, in 2007, members         actual and forecast
of Eastern Health’s community aged 70           Source – Department of Health Inpatient
and older required almost four times            Forecast model (2010) & Australian Bureau
the number of hospital admissions as            of Statistics Census (2001, 2006 & 2011)
those aged 69 and younger. The demand
for hospital admission increases as the
population ages. Also, the overall demand       Figure 9.3b                                                0-44          45-69        70-84          85+
for Eastern Health hospital admission,
                                                2003
within every age group, increased in the        Eastern Health admitted patients (‘000)                    38.2          30.4         21.9           6.6
four years to 2007 and this trend is forecast   Primary catchment population (‘000)                        437.3         206.3        56.6           12.0
to continue up to 2022.                         Ratio (EH admissions per 1,000 residents)                  87.4          147.4        386.9          553.4

                                                2007
9.4 Growth in demand for                        Eastern Health admitted Patients (‘000)                    42.1          36.0         26.4           7.9
hospital admission across                       Primary catchment population (‘000)                        433.4         216.3        58.3           13.3
                                                Ratio (EH admissions per 1,000 residents)                  97.0          166.0        453.0          589.0
primary catchment area
The projected increase in population,           2022 (Forecast)
                                                Eastern Health admitted Patients (‘000)                    45.7          42.8         41.3           14.3
together with the marked ageing of the
                                                Primary catchment population (‘000)                        439.4         241.5        89.8           22.4
population in Eastern Health’s primary          Ratio (EH admissions per 1,000 residents)                  104.0         177.2        460.0          638.4
catchment area, means that Eastern
Health is expected to experience a
42 per cent increase in hospital admissions
between 2008-09 and 2021-22. As Figure
9.4a illustrates, this growth will primarily    Figure 9.4a – Eastern Health
relate to patients older than 70 years.         Projected Hospital Admissions by
                                                Age Group 2005-06 to 2021-22 (
                                                Excluding Dialysis)
                                                Adapted from – Department of Human
                                                Services Inpatient Forecast Model (2010)

                                                Figure 9.4a

                                                    45,000
                                                    40,000
                                                    35,000
                                                    30,000
                                                    25,000
                                                    20,000
                                                    15,000
                                                    10,000
                                                     5,000
                                                         0
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                                                     0-14               	
                                                                         15-44               	
                                                                                              45-69                     	
                                                                                                                         70-84                  	
                                                                                                                                                 85+

                                                                                                 Strategic Clinical Service Plan 2012–2022 | 31
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