SLHD budget presentation 2015/16 - Prepared by Teresa Anderson Chief Executive Jacquie Ferguson Director of Finance - Sydney Local Health ...

SLHD budget
presentation 2015/16
                    Prepared by
               Teresa Anderson
                 Chief Executive

              Jacquie Ferguson
              Director of Finance

                      August 2016

SLHD budget
presentation 2015/16

 Excellence in Health Care

SLHD budget
           presentation 2015/16
Dr Teresa Anderson, Chief Executive
Opening and welcome

Dr Teresa Anderson and Ms Jacquie Ferguson
Budget presentation

Dr Teresa Anderson, Chief Executive
Questions

                                             1

Wrap up of 2015/16

GENERAL FUND FOR YEAR TO 30 JUNE 2016

                              $M        $ VAR     % VAR   STATUS

TOTAL EXPENDITURE       $1,566.1M   $6.10M (F)    0.38% (PERFORMING)

TOTAL REVENUE           $1,476.1M   -$5.97M (U)   -0.40% (UNDER PERFORMING)

TOTAL NCoS                $90.0M    $0.13M (F)    0.14%   (PERFORMING)

                                                                              2

Wrap up of 2015/16

SPECIAL PURPOSE AND TRUST FUND FOR YEAR TO 30 JUNE 2016

                             $M         $ VAR     % VAR    STATUS

TOTAL EXPENDITURE       $27.372M   -$1.632M (U)   -6.34%

TOTAL REVENUE           $47.569M   $9.494M (F)    24.9% (PERFORMING)

TOTAL NCoS              $20.196M   $7.862M (F)    63.7%    (PERFORMING)

                                                                          3

Wrap up of 2015/16
 FACILITY LEVEL FINANCIAL PERFORMANCE 30 June 2016:
HOSPITAL / SERVICE            2015/16        %      2014/15         %
                            NCoS ($M)             NCoS ($M)

RPA                        $9.210M (U)   -1.74%   $9.554M(U)    -1.97%

CONCORD                    $3.133M (U)   -1.10%   $4.629M (U)   -1.78%

CANTERBURY                 $1.439M (U)   -1.52%   $0.206M (U)   -0.23%

BALMAIN                    $0.110M (F)   0.36%    $0.012M (F)   0.04%

IRO                        $0.190M (F)   1.08%    $0.638M (U)   -3.74%

SYDNEY DENTAL              $0.516M (F)   1.21%    $0.009M (F)   0.02%

MENTAL HEALTH              $0.129M (U)   -0.13%   $2.360M (U)   -2.76%

THOMAS WALKER              $0.147M (U)   -3.07%   $0.005M (F)   0.12%

COMMUNITY HEALTH           $0.380M (F)   1.15%    $0.748M (U)   -2.61%

POPULATION HEALTH          $0.254M (F)   2.89%    $1.455M (F)   16.89%

                                                                         4

2015/16 Achievements
                 PROJECT                      EXPENDITURE
RPA RADIOLOGY REPLACEMENT OF CT1 AND CT2           $4.168M
SCANNERS
RPA JOHN LOWENTHAL (JL) THEATRES - DA VINCI        $3.500M
ROBOT
RPA RADIOLOGY REPLACEMENT OF                       $3.300M
ANGIOGRAPHY EQUIPMENT ROOM 1 AND 2
RPA INSTITUTE OF ACADEMIC SURGERY                  $1.508M
RPA BUILDING 63 LIFT MODERNISATION                 $0.500M

CONCORD INTERVENTIONAL HYBRID VASCULAR             $4.488M
THEATRE
CONCORD HOSPITAL – BIOLOGICAL RESEARCH             $3.000M
FACILITY
CONCORD HOSPITAL SPECT-CT CAMERA                   $1.254M
REPLACEMENT

                                                             5

2015/16 Achievements
       WORK IN PROGRESS PROJECTS   EXPENDITURE
DENTAL HOSPITAL REFURBISHMENT            $2.183M
MEDICAL RESEARCH INFRASTRUCTURE          $2.500M
INITIATIVES PHASE 1 (SLHD)
2015/16 ASSET REPLACEMENT AND            $0.494M
REFURBISHMENT PROGRAM
BED REPLACEMENT                          $1.000M

                                                   6

2015/16 Achievements
 156,152 people attended emergency departments
  across SLHD

 41,612 operations were performed in our hospitals

 165,524 admissions and discharges across our
  hospitals

 6,658 babies were born at RPA

   and Canterbury

                                                      7

2015/16 Achievements
 Maintained performance at level 0 for the full year – 66
  months in a row

 Came in on budget

 Maintained surgical performance at 0,0,0

 Significantly improved performance on most key
  performance indicators including Emergency Treatment
  Performance

 Successful accreditation of Sydney Dental Hospital and
  Oral Health Services against national standards

                                                             8

2015/16 Achievements
 Nursing Transfer of Care (TOC)
  at RPA – successfully
  established an Emergency
  Department nursing Transfer of
  Care program in partnership
  with the NSW Ambulance
  Service.

 Institute of Academic Surgery
  at RPA – officially opened the
  IAS and the RPA Transplant
  Institute building and launched
  the SLHD Surgical Robotic
  Program.

                                         9

2015/16 Achievements

 Canterbury Hospital consistently met its emergency
  department targets (including Emergency Treatment
  Performance, triage and surgical targets) throughout
  2015-16.
•   The Emergency Department
    Short Stay Unit was opened
    at Canterbury Hospital, which
    is well utilised by clinicians to
    ensure best patient care and
    flow throughout the
    emergency department.

                                                         10

2015/16 Achievements
 The Telopea ward was refurbished, which has helped to
  ensure the ward’s aged care and rehabilitation focus.
  This ward now has a purpose-built bariatric room, with a
  ceiling hoist.

 Canterbury Hospital received the 2015 NSW Health
  Harry Collins Award for reducing the incidence of
  catheter associated urinary tract infections.

                                                             11

2015/16 Achievements
 Rollout of the Electronic Medication
  Management System ‘eMeds’.
  Concord was the first public
  hospital in NSW to implement
  eMeds and received the Minister’s
  prize for Innovation at the NSW
  Health Awards 2015.

 Completion of schematic design for
  the Concord Hospital
  redevelopment.

 Construction and opening of the
  hybrid theatre as well as
  refurbishment of theatres 3 and 4.

                                         12

2015/16 Achievements
 Procurement of new MRI machine and new
  angiography machine in the Radiology Department at
  Concord.

 Concord Hospital completed a hospital-wide bed
  replacement program with electric beds delivered to all
  wards as of June 2016.

 Balmain Hospital Physiotherapy Department received
  funding as part of “The Pitch” in September 2015 for the
  purchase of a Litegait patient hoist.

                                                             13

2015/16 Achievements
 Periodic review was conducted by ACHS surveyors in
  October 2015. Balmain Hospital met all criteria in each
  of the reviewed standards, successfully closed off the
  two previous recommendations and did not receive any
  new recommendations. Balmain Hospital was awarded
  three met with merits in regards to hand hygiene.

 The Falls Safety Huddle Review Tool, a clinical initiative
  to address falls risk and incidents, was introduced
  across all wards at Balmain Hospital in December 2015.

                                                               14

2015/16 Achievements
 Sydney Dental Hospital and Oral Health Services
  successfully met the accreditation requirement under
  the ACQSHC National Standards and achieved 14 met
  with merits.

 Sydney Dental Hospital and Oral Health Services
  successfully decanted prosthodontics, periodontics and
  endodontics and completed half of the construction of
  level 4 refurbishment for these departments.

                                                           15

2015/16 Achievements
 Youth health moved into purpose-built premises in July
  2015. The stand-alone building in Abercrombie Street
  Redfern makes it more accessible to young people.

 The implementation of the Living Well Living Longer
  program continues to ensure the physical health and
  wellbeing of mental health clients.

                                                           16

2015/16 Achievements
 The Sexual Health Service commenced delivery of the
  expanded PrEP implementation in communities (EPIC)
  trial in Sydney Local Health District.

•   Implementation and rollout of the Healthy Homes and
    Neighbourhoods integrated care initiative.

•   Development and implementation of the Healthy
    Families Healthy Children harmonised model of
    sustained health home visiting.

                                                          17

2015/16 Achievements
 Implemented the CHOC eMR in April, with the ability for
  integrated medical records to be available across the
  LHD in ambulatory and inpatient settings.

 Healthy Strong Communities, which evolved from the
  Premier’s Service Delivery Reform initiative, has seen
  the Mental Health Service, in partnership with Housing,
  New Horizons and Partners in Recovery, develop maps
  of rough sleepers, boarding houses and supported
  accommodation.

 The Harm Minimisation Program commenced a project
  to increase the number of sterile injecting equipment
  distributed in line with ministry targets.

                                                            18

2015/16 Achievements
 Drug Health Services Strategic Plan 2016-2021 was
  launched on 3 March 2016.

 Drug Health Services Harm Minimisation Program won
  a position on the ACI’s Clinical Redesign Program in
  2016.
•   The Professor Marie
    Bashir Short Stay Unit is a
    collaborative initiative
    between Mental Health,
    ED and Drug Health
    Services at RPA and won
    the People’s Choice
    Award at the NSW Health
    Awards 2015.
                                                         19

2015/16 Achievements
 Continuing successful partnership with CESPHN of
  Health Pathways Sydney including the development of
  400 live localised pathways and completing 100
  practice visits.

 The continued work of the multi-agency and NGO
  partnership: Healthy Strong Communities (Service
  delivery reform in Sydney) includes three programs:
  Housing and Mental Health, Healthy Homes and
  Neighbourhoods; and RedLink officially opened on 29
  July 2015.

 The launch by Minister for Health of the multi-agency
  Child Health and Wellbeing Plan.

                                                          20

Overview of the service
      agreement

                          21

Strategic context
 Strategic Priorities

 NSW: Making it happen

 Election commitments

 Key system priorities for 2016/17

                                                   22

Performance framework
 The Service Agreement is a key component of the NSW Health
  Performance Framework. The Framework:
  – Has the over-arching objectives of improving service delivery,
    patient safety and quality;
  – Provides a single, integrated process for performance review,
    escalation and management;
  – Provides a clear and transparent outline of how the
    performance of districts and networks is assessed;
  – Outlines how responses to performance concerns are
    structured to improve performance;
  – Operates in conjunction with the purchasing framework, the
    activity based funding and small hospital operational
    specifications.

                                                                 23

2016/17 Service level
      agreement,
strategic priorities and
        themes

                           24

Strategic priorities
 The NSW Ministry of Health, pillars and state wide services are
  committed to co-ordinating and partnering with districts and
  networks to:
– Deliver NSW: Making it happen - including the Premier’s and state priorities
– Achieve the key goals, directions and strategies articulated within the NSW State
  Health Plan: Towards 2021 and the NSW Rural Health Plan: Towards 2021
– Support districts and networks to deliver optimal and efficient frontline services
– Provide leadership in NSW Health’s contribution to the Reform of the Federation
  process, review of primary health care and any resulting reforms; and
  identification of strategies to drive efficiency and sustainability in the health system
– Deliver on NSW Government election commitments

                                                                                       25

Key system priorities for 2016/17
 The key strategic priorities for NSW Health in 2016/17 are
  articulated within the plan on the next slide.

•   These priorities are to be
    reflected in the strategic and
    operational plans of the NSW
    Ministry of Health, pillars,
    support organisations, districts
    and networks comprising NSW
    Health. Delivery of the strategic
    priorities is the mutual
    responsibility of all entities.

                                                               26

27

Key focus for NSW Health in
                                  2016/17

 The roles and responsibilities for Mental Health Intensive Care
  Units (MHICU) include:
   – standardisation of referral
   – clinical handover procedures and pathways
   – the role of the primary referral centre in securing a MHICU
     bed, and the
   – standardisation of escalation processes

                                                                    28

Other priority plans and initiatives
 Implement programs and policies to achieve NSW targets, focusing
  on:
   – Reducing smoking rates (in both the Aboriginal and non-Aboriginal population)
   – Reducing smoking in pregnant women (in both the Aboriginal and non-Aboriginal
     population)
   – Reducing overweight and obesity rates in children, young people and adults
   – Reducing risk drinking
   – Closing the gap in Aboriginal infant mortality

 Implement the following plans and strategies:
   – NSW Healthy Eating and Active Living Strategy 2013-2018
   – NSW Tobacco Strategy 2012-2017
   – NSW HIV Strategy 2012-2015 with a focus on increasing HIV testing
   – Implement NSW Hepatitis C and B Strategy Strategies 2014-2020 focusing on
     reducing the sharing of injecting equipment among people who inject drugs

                                                                                     29

Other priority plans and initiatives

– NSW Aboriginal Health Plan 2013-2023 with a focus on
  enhancing formal partnerships with local Aboriginal community
  controlled health services, and ensure appropriate consultation
  in the development of local healthcare plans.
– Oral Health 2020: A Strategic Framework for Dental Health in
  NSW
– Healthy, Safe and Well: A Strategic Health Plan for Children,
  Young People and Families
– Strategies to support advance planning for quality care at end of
  life

                                                                      30

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Transition grant
Nil

                         34

Capital program

                  35

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Grossed up private patient service adjustment

                                           37

2016 -17 National Health Funding Body Service
                                      Agreement

Period: 1 July 2016 – 30 June 2017

                                                   38

Budget principles
   As with previous years, the District is holding a contingency of $35M (to meet
    additional patient demands, unforeseen equipment replacement or other
    unexpected District costs)

   The District has also allocated $10M for enhancements, to be finalised with the
    executive and clinical directors this week. $500K has already been allocated for
    obesity and $1M for sustained home visiting

   To derive the contingency:
    – NWAU price adjusted for contribution to contingency
    – Block funding adjusted for contribution to contingency             LHD NWAUs X
                                                                          SLHD PRICE

   Facility budgets built using available ABF and block funding principles:
    – ABF funding pool developed using discounted 2016 financial year prices
    – Block funding allocated (e.g. dental, AIDS, NGO grants)
    – Alignment of entity budgets to 2016 financial year
      actual and budget

                                                                                       39

Budget principles
  180
                                   2015/16 SLHD Flow of Expenses Budget and Actual MTD (GF & SPF)

  170
  160
  150
  140
  130
  120
  110
              Jul         Aug          Sep      Oct      Nov      Dec                  Jan         Feb      Mar      Apr      May                   Jun
                                   2015/16 Combined expenses budget                              2015/16 Combined expenses actual

                                     Jul       Aug       Sep       Oct       Nov       Dec        Jan       Feb       Mar       Apr       May        Jun       YTD Jun
2015/16 Combined expenses budget     130,967   127,883   124,271   125,287   122,376   134,668    123,038   133,410   136,659   126,598   136,431    176,384    1,597,971
2015/16 Combined expenses actual     132,916   127,468   122,557   123,955   121,713   132,864    120,711   129,910   136,181   130,054   140,405    174,771    1,593,505
Variance (+ Fav, - Unfav)             -1,949       415     1,714     1,332       663     1,804      2,327     3,500       478    -3,456    -3,974      1,613        4,466

% of Budget                           8.20%     8.00%     7.78%     7.84%     7.66%      8.43%      7.70%    8.35%     8.55%     7.92%     8.54%      11.03%
YTD Budget expended                   8.20%    16.20%    23.98%    31.82%    39.48%     47.91%     55.61%   63.96%    72.51%    80.43%    88.97%     100.00%

                                                                                                                                                                            40

2016/17 Budget from MoH
   SLHD total expenditure budget for 2016-17 is:

                           $1.631BILLION
             GENERAL FUND                  SP&T
                 $1.605B               $25.102M

   MoH presents budget escalation on prior year annualised
    budget – this is a 4.9 per cent increase for SLHD

                                                              41

2016/17 Budget from MoH
   SLHD total revenue budget for 2016-17 is:

                         $1.570BILLION
     Govt contribution       SP&T        Own source
         $1.291B            $37.789M     $241.369M

   Own source revenue target of $241.369M represents a 3.44
    per cent increase on the 2015/16 actual result

                                                               42

Activity NWAU prices 2016/17

 National weighted activity unit (NWAU) prices:
   – State price = $4,605
   – MoH determined SLHD price acute = $4,545
   – MoH determined SLHD price non-admitted = $3,477

                                                       43

Facility NWAU prices 2016/17
 2016-17 price reflects the 2015-16 price discounted by 0.5 per cent.
  Discount reflects the impact of the change from NWAU 15 to NWAU 16

                                         2016-17 price /
    Facility / Service
                                              NWAU16
    RPA                                          $4,172
    Concord Hospital                             $4,003
    Canterbury                                   $3,358
    Balmain                                      $3,200
    IRO                                          $3,593
    Mental Health                                $3,348

                                                                     44

2016/17 NWAU activity
 SLHD NWAU activity targets

                                 2016-17
   Facility / Service
                                NWAU16
   RPA                           117,988
   Concord Hospital               64,544
   Canterbury                     27,282
   Balmain                         7,586
   IRO                             5,429
   Mental Health                  31,860

                                            45

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Next steps
 19 – 26 July 2016 – Chief Executive issues budget letters to
  facility general managers including budget, activity and FTE
  targets. Summaries posted on internet
  www.slhd.nsw.gov.au/budget.html

 31 July 2016 - Revenue and efficiency roadmap strategies
  finalised

 District budget roadshows/presentations
   – 15 August 2016 – CEWD – 5.30pm
   – 16 August 2016 – Concord Hospital – 5.30pm
   – 17 August 2016 – Balmain Hospital – 2.30pm
   – 23 August 2016 – Royal Prince Alfred Hospital – 7.30am
   – 25 August 2016 – Canterbury Hospital – 12 noon

                                                                 58

Next steps
 Continue strong governance over financial performance:
   – Monthly distribution of modified monthly finance reports
   – Chief Executive and Department of Finance performance
     meetings with general managers
   – Continued monthly performance reporting to FRAP
   – Monitoring of revenue and efficiency improvement roadmaps

                                                                59

End

 Questions?

                     60