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COMPENDIUM TO Southern NSW Local Health District Health Care Services Plan 2013-2018 The Southern NSW Local Health District Health Care Services Plan is a strategic planning document that identifies the priorities and key directions for the Local Health District for the next five years. Compendium – SNSW LHD Health Care Services Plan 2013-2018 A Healthy Community Page 1 of 43 Compendium To Southern NSW Local Health District Health Care Services Plan 2013-2018 Contents Policy Environment ................................................................................................................................................. 3 Projected Population for SNSW LHD (2006 -2036) ................................................................................................. 8 Projected population change 2006-2026 for SNSW LHD by age group .................................................................. 9 SNSW LHD Bed Numbers by Bed Unit Type as at June 2012 ................................................................................ 11 SNSW LHD Staffing ............................................................................................................................................... 13 Acute Inpatient Projections for SNSW LHD facilities base case scenario - aIM 2012 ........................................... 14 Projections for SNSW LHD Hospitals top five SRG Projections- aIM 2012............................................................ 14 Projections by age groups – aIM 2012 ................................................................................................................. 16 Projections – Medical/Surgical – aIM 2012 .......................................................................................................... 16 Projections for sub-acute –SiAM 2012 ................................................................................................................. 17 Projections – SNSW LHD residents treated in non SNSW LHD facilities – aIM 2012 ............................................ 18 Flow to ACT Public Hospitals-Acute Inpatient Activity - Flowinfo v 11.2 ............................................................. 19 Supply of Hospital Inpatient Services in SNSW LHD – Flowinfo Vs 11.2 ............................................................... 19 Supply Inpatient Hospital Services SNSW LHD Hospitals- SRGs ........................................................................... 20 Demand for Inpatient services – SNSW LHD residents – Flowinfo v 11.2 ............................................................ 21 ACT Private Hospital activity for SNSW LHD residents ......................................................................................... 23 SNSW LHD Activity 2010/11 ................................................................................................................................. 25 Emergency Attendances ....................................................................................................................................... 26 Cancer Incidence and Mortality: Projections 2011 to 2021 ................................................................................. 26 Cancer Services SNSW LHD – February 2013........................................................................................................ 27 Renal Services SNSW LHD February 2013............................................................................................................. 28 Community Health Services .................................................................................................................................. 29 SNSW LHD Aboriginal Health – February 2013 ..................................................................................................... 31 SNSW LHD Population Health – February 2013 ................................................................................................... 32 Oral health services SNSW LHD - March 2013 ...................................................................................................... 33 Role Delineation - SNSW LHD .............................................................................................................................. 36 Hospital Peer Group Definitions ........................................................................................................................... 37 Southern NSW Medicare Local Services as at May 2013...................................................................................... 39 Glossary ................................................................................................................................................................ 39 Organisational Responsibilities ............................................................................................................................ 42 .......................................................................................................................................................................... 42 Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 2 of 43 Policy Environment SNSW LHD Strategic Plan Southern NSW LHD was formed in January 2011 and has adopted the following vision, mission and strategic goals. Vision: A healthy community Mission: To create a sustainable, patient-centric, efficient and effective health service Values CORE (Collaboration, Openness, Respect, Empowerment) Strategic goals: • We put patients first • We are accountable for health outcomes in Southern NSW • We insist on fairness, respect and transparency in everything we do • We will establish and promote well governed coordinated services • We encourage excellence in the acquisition and sharing of knowledge The HCSP aligns with major National and State agreements and policies, notably: National Healthcare Agreement 2011 The seven objectives of the National Healthcare Agreement are: • Prevention: Australians are born and remain healthy • Primary and Community Health: Australians receive appropriate high quality and affordable primary and community health services • Hospital and Related Care: Australians receive appropriate high quality and affordable hospital and hospital-related care • Aged Care: Older Australians receive appropriate high quality and affordable health and aged care services • Patient Experience: Australians have positive health and aged care experiences which take account of individual circumstances and care needs • Social Inclusion and Indigenous Health: Australia’s health system promotes social inclusion and reduces disadvantage, especially for Indigenous Australians • Sustainability: Australians have a sustainable health system NSW 2021: A Plan to Make NSW Number One September 2011- Goals 11 and 12 relate to the Health system: • Keep people healthy and out of Hospital o Reduce smoking rates, overweight and obesity rates and risk drinking o Close the gap in Aboriginal infant mortality • Improve outcomes in Mental health o Reduce Mental Health readmissions o Increase rate of community follow up o Increase number of people with mental illness diverted from court to treatment • Reduce potentially preventable hospitalisations by 1% and by 2.5% for Aboriginal people • Provide world class clinical services with timely access and effective infrastructure • Reduce Hospital waiting time o Planned surgical patients admitted within clinically appropriate time o Meet national benchmarks from time of Emergency Department (ED) triage to commencement of clinical treatment • Improve transfer of patient from Emergency Department to Wards • Reduce unplanned readmissions • Decrease Healthcare associated bloodstream infections • Ensure all publicly provided health services meet national patient safety and quality standards • Increase patient satisfaction. Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 3 of 43 National Rural Framework for Rural and Remote Health While primarily a tool for government, the Framework may also be useful to communities, local health service providers and community groups to help identify and develop new and innovative ways to address specific needs or unique characteristics of their local area or region. The Framework outlines strategies to help realise the goals: • Improved access to appropriate and comprehensive health care for people living in rural and remote Australia. • Effective, appropriate and sustainable health care in rural and remote settings. • Rural and remote Australia has an appropriate, skilled and well-supported health workforce • Collaborative health service planning and policy development in rural and remote Australia. • Strong leadership, governance, transparency and accountability for rural and remote health services. Draft National Primary Health Care Strategic Framework The Commonwealth and States have agreed a national vision for primary health care: • A strong, responsive and sustainable primary health care system that improves health care for all Australians, especially those who currently experience inequitable health outcomes, by keeping people healthy, preventing illness and reducing their need for hospital services. Commonwealth and state governments must work together to ensure the ongoing improvement and sustainability of the primary health care system with the goal of ensuring effective, safe services for consumers aimed at providing care in the most appropriate and efficient setting, and improving health outcomes. The following strategic outcomes are considered to have the greatest potential to make a difference: • Build a consumer-focused integrated primary health care system; • Improve access and reduce inequity; • Increase the focus on prevention, screening and early intervention; and • Improve quality, safety, performance and accountability. Health Professionals Workforce Plan 2012-2022 The Plan rests on a three-part strategic framework: • Stabilising the foundations o Multi-faceted and multi-owned solutions o Integrated and comprehensive workforce planning • Building blocks o Provide effective working arrangements o Develop a collaborative health system o Support local decision making o Develop effective health professional managers and leaders • Right people, right skills, right place o Recognise the value of generalist and specialist skills o Grow and support a skilled workforce o Effective use of our health care workforce NSW Aboriginal Health Plan 2013-2023 Acknowledges the significant health disparities between Aboriginal and non-Aboriginal people in NSW and reflects the NSW Government’s commitment to closing this gap. Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 4 of 43 NSW Health Policy and Implementation Plan for Healthy Culturally Diverse Communities 2012-2016 A strategic statewide policy for improving the health of NSW residents from backgrounds which are culturally, religiously and linguistically diverse. Policy Environment for key Streams of Care and Programs Critical Care • Integrated Governance Framework for SNSW LHD • National Safety and Quality Health Service Standards • National Health Reform Agreement and National Partnership Agreement Surgical Services • The Australian College Of Operating Room Nurse’s (ACORN) Standards • Rural Surgery Futures 2011-2021 – NSW Ministry of Health (2011) • High Volume, Short Stay Surgical Model Toolkit – NSW Ministry of Health (2011) • Emergency Surgery Guidelines – NSW Ministry of Health (GL 2009_009) • Pre-Procedure Preparation Toolkit - NSW Ministry of Health (GL 2007_018) • AS/NZS 4187:2003: Cleaning, disinfecting and sterilizing reusable medical and surgical instruments and equipment, and maintenance of associated environments in healthcare facilities • The Orthogeriatric Model of Care – NSW Agency for Clinical Innovation 2010 • Infection Control Policy – NSW Ministry of Health (2007_036) • Infection Control in Endoscopy – Gastroenterological Nurses College of Australia (2010) Medical Services • The Southern NSW LHD Medical Services Plan (2011) • The Australian Health Ministers Advisory Council ‘Delirium Care Pathways’ (2006) • The Delirium Model of Care WA (2008) • NSW Dementia Services Framework 2010-2015 Palliative Care • Standards for Providing Quality Palliative Care for all Australians • National Palliative Care Strategy 2010 • Palliative Care Strategic Framework 2010-2013 • Palliative Care Role Delineation Framework • Palliative Care Development Planning Framework Maternity • Australian Government. National Maternity Services Plan (2010) • NHMRC. National Guidance on Collaborative Care (2010) • Australian Government. Improving Maternity Services – The report of the review (2009) • AHMAC. Primary Maternity Services in Australia – A Framework for Implementation (2008) • NRHA. National Consensus Framework for Rural Maternity Services (2008) • ACSQHC. National Safety and Quality Health Service Standards 2012 • ACHS Obstetric Clinical Indicators User Manual 2011 • NSW MoH Maternity – Towards Normal Birth in NSW PD 2010_045 • NSW MoH Breastfeeding in NSW: Promotion, Protection and Support PD2011_042 • NSW MoH Maternity – Clinical Risk Management Program PD 2009_003 • NSW MoH Maternity - National Midwifery Guidelines for Consultation and Referral 2nd Edition 2010_022 • NSW MoH Midwifery Continuity of Carer Model Tool-kit October 2012 • NSW MoH Framework for Maternity Services (2000) • Birthrate Plus – retrospective staffing acuity tool Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 5 of 43 Mental Health • National Partnership Agreement on Hospital and Health Reform • NSW Mental Health Commission • Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009-2014. • Ten-Year Roadmap for National Mental Health Reform (in draft) • National Recovery-Oriented Mental Health Practice Framework (in draft) • National Standards for Mental Health Services 2010 (under revision) • National Health Workforce Innovation and Reform Strategic Framework for Action 2011-2015 • Framework for the NSW Mental Health Consumer Workforce (in draft) • NSW Service Plan for Specialist Mental Health Services for Older People (SMHSOP) 2005-2015. • NSW Child and Adolescent Mental Health Services (CAMHS) Competency Framework Drug and Alcohol • National Drug Strategy 2010-2015: A Framework for Action on Alcohol, Tobacco and other Drugs. • NSW Ministry of Health Drug and Alcohol Plan 2012-2017 • NSW Opioid Treatment Program Strategic Plan 2011-2016 • NSW Drug and Alcohol Health Promotion Plan 2012-2017 • NSW Drug and Alcohol Psychosocial Interventions Professional Practice Guidelines • Aboriginal Drug and Alcohol Prevention and Treatment Plan 2012-2017 • Consumer Engagement in NSW Drug and Alcohol Treatment • NSW Clinical Guidelines for the Care of Persons with Comorbid Mental Illness and Substance Use Disorders in Acute Care Settings. Rehabilitation • The NSW Health Rehabilitation Redesign Project 2010, reviewed existing adult rehabilitation services in NSW to inform a consistent model of care for application across metropolitan, regional and rural areas of NSW:NSW Rehabilitation Model of Care www.aci.health.nsw.gov.au • ACI Rehabilitation Network Musculoskeletal Model of Care • Ortho-geriatric Model of Care • Osteo-arthritis Model of Care • Osteoporosis Re-fracture Model of Care • National Stroke Audit / Rehabilitation Services Report 2012 Cancer Care • NSW Cancer Plan 2011-2015 • Cancer Incidence and Mortality Projections 2011-2021 (NSW Cancer Institute pub) • Reporting for Better Cancer Outcomes Funding Agreement (Cancer Institute and SNSW LHD) Renal Services • NSW Renal Dialysis Service Plan to 2011 (current plan) • Review of the implementation of the NSW Renal Dialysis Service Plan to 2011 • ACT Health Renal Health Services Plan 2010-2015 • Kidney Health Australia – A Model for Home Dialysis Australia- 2012 • Agency for Clinical Innovation Renal Network - NSW Dialysis Capacity Audit 2010 • CARI guidelines – (Caring for Australians with renal impairment) • NSW Health Kidney health check policy PD2010_023 – (currently under review) Population Health • NSW Health Population Health Priorities for NSW 2017 – 2017 • NSW 2021: A plan to make NSW number one • Aboriginal Health Plan for NSW Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 6 of 43 NSW Tobacco Strategy 2012–2017 Prevention of Falls and Harm from Falls among Older People: 2011–2015 The NSW Government Plan for Preventing Overweight and Obesity in Children, Young People and their Families 2009–2011 • The NSW HIV/AIDS Strategy: Overview and Action Plan • The NSW Hepatitis C Strategy • The NSW Sexually Transmissible Infections Strategy • Population Health Surveillance Strategy NSW 2011 to 2020 • Promoting the generation and effective use of population health research in NSW: A Strategy for NSW Health 2011–2015 • NSW Immunisation Strategy • Notification of Infectious Diseases under the NSW • NSW Health Influenza Pandemic Plan Primary and community based services • National Partnership Agreement on Hospital and Health Reform (2010) • Draft National Primary Health Care Strategic Framework (2012) • NSW Health Integrated Primary and Community Health Policy 2007-2012 Women’s Health, Child Youth and Family • NSW Women’s Health Plan (Ministry of Health) • Women in NSW (Office for Women) • National Women’s Health Policy • Future Governance Arrangements for Children and Young People’s Health Services in NSW • NSW Youth Health Policy PD 2010_073 • Safe Start Guidelines • Statewide Eyesight Preschooler Screening Policy (StEPS) PD 2012_001 • Statewide Infant Screening Hearing Policy (SWIS-H) GL2010_002 Aged Care The Commonwealth and State aged care reform agenda as outlined in: • ‘Living Longer. Living Better’- Aged Care reform Platform (Commonwealth) • Australian Government Response to the Productivity Commission's Caring for Older Australians Report and the Aged Care Reform Package • NSW Ageing Strategy Chronic Care • Ministry of Health/SNSWLHD Service Agreement 2012-2013 • Ministry of Health letter (28/2/12 TRIM H11/69645) re 2011/12-2014/15 Funding of the Connecting Care and 48Hr Follow Up Programs and Enrolment Targets • Report on NSW Chronic Disease Conference 2011 • Chronic Disease Consumer Issues Paper, Health Consumers NSW, Sept 2012 • Revised Strategic Direction for the SNSWLHD Chronic Disease Management Program- July 2012 • SNSWLHD Connecting Care Program Framework, 2010 Oral Health Services • Oral Health 2020: A Strategic Framework for Dental Health in NSW • PD 2009_074: Oral Health – Eligibility of Persons for Public oral Health Care in NSW • PD2008_065: Oral Health Fee for Service Scheme (OHFFSS) • PD2008_056: Priority Oral Health Program and List Management Protocols • PD2008_020 Early Childhood Oral Health (ECOH) Program: The Role of Public Oral Health Services • PD2001_071: Oral Health Specialist Referral Protocols • • • Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 7 of 43 Violence Prevention and Care • NSW Children and Young Persons (Care and Protection) Act 1998 • Keep Them Safe A Shared Approach to Child Wellbeing 2009-2014 • NSW Interagency Guidelines • NSW Health Frontline Policy and Procedures for the Protection and Wellbeing of Children and Young People • JIRT Policy & Procedures, • CPCS Service Standards and Policy document (to be finalised 2013), • Sexual Assault Policy and Procedures Manual, • Model Pathway for the Comprehensive Health and Developmental Assessments for all Children and Young People entering Out of Home Care” 2010-2011. • Clinical Practice guidelines for the Health Assessment for Children and Young People in Out of Home Care, • Policy and Procedures for Identifying and Responding to Domestic Violence Aboriginal Health • NSW Centre for Aboriginal Health, Maternity, Children’s and Young People’s Health Branch MOH, • Workforce Learning and Development Strategy for NSW Health, • Aboriginal Workforce Strategic Framework 2011-2015, • NSW Aboriginal Health Impact Statements and Guidelines, State-wide Infant Screening Hearing Policy (SWIS0-H) GL2010_002, • Children Young People and Family Health and Well-being Unit, • Safe Start Guidelines, • NSW Aboriginal Health Strategic Plan. Projected Population for SNSW LHD (2006 -2036) LGA Bega Valley (A) Bombala (A) 2006 2011 2016 2021 2026 2031 2036 Difference 20062036 32,477 34,875 37,292 39,628 41,840 43,888 45,707 13,230 2,625 2,521 2,425 2,328 2,226 2,119 2,005 -620 Cooma-Monaro (A) 10,174 10,276 10,374 10,463 10,540 10,602 10,635 461 Eurobodalla (A) 36,585 40,000 43,425 46,736 49,874 52,780 55,346 18,761 Goulburn Mulwaree (A) Goulburn 21,030 20,726 20,455 20,156 19,812 19,410 18,926 -2,104 Goulburn Mulwaree (A) Bal 6,208 6,785 7,377 7,965 8,537 9,088 9,608 3,400 Palerang (A) - Pt A 9,567 10,823 12,149 13,526 14,936 16,364 17,779 8,212 Palerang (A) - Pt B Queanbeyan (C) 3,357 3,512 3,676 3,844 4,013 4,178 4,335 978 38,092 42,521 47,239 52,095 56,963 61,758 66,334 28,242 3,869 Snowy River (A) 7,583 8,248 8,927 9,595 10,244 10,867 11,452 Upper Lachlan Shire (A) 7,349 7,346 7,333 7,312 7,280 7,240 7,183 -166 13,762 15,018 16,322 17,639 18,946 20,217 21,408 7,646 188,809 202,648 216,995 231,286 245,211 258,512 270,718 81,909 Yass Valley (A) Source: NSW Health Population Projections Series 1.2009.Numbers will differ to those of Dept of Planning due to an alternate fertility rate used in health Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 8 of 43 Projected population change 2006-2026 for SNSW LHD by age group Age group (years) 2006 2011 2016 2021 2026 Number Percent (%) 0-14 37,481 38,088 39,870 42,144 43,823 15-69 131,695 141,478 149,202 154,528 159,849 28,154 21 70-84 16,729 19,138 23,027 28,908 34,519 17,790 106 85+ Total 6,342 17 2,904 3,944 4,897 5,706 7,021 4,117 142 188,809 202,648 216,995 231,286 245,211 56,402 30 Key points from the 2012 Social Health Atlas data for SNSW LHD (http://www.publichealth.gov.au/) Indicator Total fertility rate (2005-2007) Education Full time participation in secondary school education at age 16 (% of 16 year olds, 2011) Participation in vocational education and training (rate per 100 population, 2009) LHD na NSW 1.80 79.2 80.1 na 7.6 *rates for 7 of the 10 LGAs are significantly higher than NSW average School leaver participation in higher education (% of 17 year olds, 2011) Early childhood development Children developmentally vulnerable on 2 or more domains (% of assessed 5 year olds in their first year of school, AEDI, 2009) *includes physical health & wellbeing Families (2011) Single parent families (% of families with children aged less than 15 years) Housing & transport (2011) Centrelink rent assistance (2009) (% of total dwellings) 14.0 11.3 23.2 14.6 Government housing (% of total dwellings) 3.1 Mortgage stress (households in the bottom 40% of income distribution, spending more than 30% of income on mortgage repayments) (% of mortgaged dwellings) 9.6 Rental stress (households in the bottom 40% of income distribution, spending more than 30% of income on 25.9 Compendium – SNSW LHD Health Care Services Plan 2013-2018 26.6 10.3 21.2 16.3 4.4 11.1 26.3 Selected LGAs Lowest: Snowy River Highest: Upper Lachlan Lowest • • Highest • • Lowest • • Highest* • • Lowest • • Highest • • Bombala Snowy River 68.9 74.2 Yass Valley Bega Valley 82.9 81.6 Palerang Queanbeyan 6.6 7.0 Bombala Eurobodalla 18.4 13.7 Goulburn Mulwaree Bega Valley Bombala Upper Lachlan More vulnerable • Bega Valley • Queanbeyan Less vulnerable • Snowy River • Upper Lachlan Higher % • • • Lower % • Higher % • • • Lower % • Higher % • • Lower % • Higher % • • • Lower % • 1.67 2.71 9.2 9.9 26.6 24.7 14.0 13.3 4.3 6.8 Eurobodalla Goulburn Mulwaree Bega Valley 31.8 28.3 26.9 Yass Valley 13.7 Eurobodalla Goulburn Mulwaree Bega Valley 21.7 17.4 17.2 Palerang 8.7 Goulburn Mulwaree Queanbeyan 5.3 4.8 Palerang 0.2 Eurobodalla Bega Valley Goulburn Mulwaree 16.2 14.2 12.7 4.4 Queanbeyan Higher % • Eurobodalla 37.6 32.6 Page 9 of 43 Indicator rent) (% of rented dwellings) Dwellings with no motor vehicle Income support (June 2009) Age pensioners (% of 65+ years old) LHD 5.8 NSW 10.4 Selected LGAs • Bega Valley • Cooma-Monaro Lower % • Bombala Higher % • Goulburn Mulwaree • Cooma-Monaro Lower % • Palerang Higher % Eurobodalla Goulburn Mulwaree Bega Valley Eurobodalla Bombala Bega Valley Eurobodalla Bega Valley Goulburn Mulwaree Eurobodalla Bega Valley Eurobodalla Bega Valley Goulburn Mulwaree Eurobodalla Snowy River Bega Valley Goulburn Mulwaree Eurobodalla Bega Valley Goulburn Mulwaree Eurobodalla Bega Valley Goulburn Mulwaree 30.5 10.2 8.6 7.5 1.6 69.2 70.1 Disability support pensioners (% of 16- 64 years old) 6.2 5.0 Female sole parent pensioners (% of 15- 54 years old) 5.9 5.3 Unemployment benefit (% of 16-64 years old) • Long term (% 16-64 years old) 4.3 4.3 2.9 2.9 6.1 5.4 9.0 10.0 19.6 21.7 22.9 20.1 Bombala Upper Lachlan Goulburn Mulwaree Eurobodalla Broadband connections (% of private dwellings) Labour force (June 2009) Unemployment (% of labour force) 66.0 69.9 Bombala Upper Lachlan 35.3 29.5 28.0 26.3 55.1 59.8 4.9 5.7 Labour force participation (% of 15+ years old) Unpaid child care Own child/ren 65.4 63.1 Eurobodalla Bega Valley Goulburn Mulwaree Eurobodalla Bega Valley 9.6 6.8 6.3 53.4 60.4 18.9 19.6 Other child/ren Community strength Volunteering (15+ years old, 2011) 7.1 7.1 Yass Valley Palerang Queanbeyan Yass Valley 23.2 22.6 21.7 8.4 22.3 16.9 Smoking during pregnancy (2006-08) Smoking during pregnancy (2006-08) Disability (2011) Providing unpaid assistance to persons with a disability (% of total population) People with a profound or severe disability (% of total population) *53% aged 65+ years MBS Services (2009/10) GP services (rate per 100 population) * All LGAs significantly less than NSW average 25.1 13.0 Bombala Upper Lachlan Queanbeyan Goulburn Mulwaree Eurobodalla Cooma-Monaro 33.4 28.9 32.7 28.1 27.0 26.3 12.1 11.4 Bombala Upper Lachlan 14.5 13.5 5.1* 4.9 Eurobodalla Bombala na 578 Lowest rate • Upper Lachlan Highest rate • Goulburn Mulwaree • Young people (% 15-24 years old) Low income, welfare dependent families with children (% of total families) Children in low income, welfare dependent families (% children under 16 years) Internet access (2011) No internet connection (% of private dwellings) 6.9 6.1 Private health insurance Compendium – SNSW LHD Health Care Services Plan 2013-2018 74.7 73.6 72.0 10.3 9.4 7.8 9.7 7.8 7.3 8.1 5.9 5.8 4.2 3.4 11.5 8.2 7.8 7.6 12.0 11.0 10.8 33.4 26.2 23.8 Page 10 of 43 386 470 Indicator % of total population with PHI (2001) LHD 40.6 Predicted rate of PHI per 100 population aged 15+ years old (2007-08) NSW 48.2 na Aged Care (June 2010) Residential aged care Selected LGAs Lower % • Snowy River • Eurobodalla Higher % • Bombala • Palerang Lower rate • Bega Valley • Eurobodalla Higher rate • Palerang • Yass Valley 48.0 93.7 87.6 Lower • • Higher • • Total places (low- and high-level care) per 1,000 population aged 70+ years 30.0 34.8 56.0 49.8 35.6 36.9 63.0 56.0 Snowy River Palerang 22.8 28.6 Bombala Yass Valley 190.1 118.7 National Bowel Cancer Screening Program (NBCSP, 2010) • LHD 39.1%, NSW 34.9% of those invited to participate Self-assessed health (synthetic predictions, 15+ years, 2007-08) • Fair or poor – LHD range from 11.9% in Snowy River to 17.4% in Eurobodalla • Very good or excellent – LHD range from 65.6% in Eurobodalla to 72.1% in Yass Valley Median age at death (2003-2007) - LHD range (years): • Males: 71.5 (Palerang) to 78.0 (Eurobodalla) • Females: 80.0 (Palerang & Queanbeyan) to 85.0 (Bombala) • Persons: 75.0 (Palerang) to 80.0 (Bombala & Eurobodalla) MBS Services (2009/10) • 45 Year Old Health Checks – high rates in Goulburn, lower in Cooma-Monaro, Yass Valley, Eurobodalla • Annual health assessments by GPs, 75+ yrs, low in Yass Valley, Upper Lachlan, Goulburn, Eurobodalla • Practice nurse services – low in Bombala, Goulburn, Upper Lachlan • Better Access Program – preparation of mental health care plan HACC (Home & community care, 2010/11) • Instances of allied health care, care counselling, case management, domestic assistance, personal care, respite care, transport etc • Clients: living alone, with carer, Indigenous, non-English speaking 21 0 26 28 41 215 26 4 6 2 215 26 4 4 2 0 20 2 0 20 2 4 0 Compendium – SNSW LHD Health Care Services Plan 2013-2018 4 Total Southern 4 T Basis unit Queanbeyan 30 Mental Hlth (Kenmore) Delegate 5 Eastern Sector Total Cooma 7 Moruya Braidwood 10 Bateman's bay Bombala 25 Pambula Yass 18 20 2 Bega Bourke St HS Bed Unit type 01 General - Mixed 04 Psych Acute 15 General ICU 16 Neonate Special Care Nursery 33 Coronary Care 34 High Dependency Crookwell Network and Facility G'burn C Hlth Goulburn SNSW LHD Bed Numbers by Bed Unit Type as at June 2012 Southern NSW LHD officially reports on 724 beds. A summary is provided below. Please note that the Goulburn Community Health (Mental Health) are no longer admitted to and Pambula Hospital no longer provides Maternity services. 4 4 Page 11 of 43 Total Southern T Basis unit 0 Mental Hlth (Kenmore) Bateman's bay 4 Eastern Sector Total Pambula 7 22 18 Moruya Bega Queanbeyan Delegate Cooma Braidwood Bombala Yass Bourke St HS Crookwell G'burn C Hlth Goulburn Network and Facility Care 43 Paediatric 46 Medical 47 Surgical 48 Medical Oncology 49 Obstetric 60 Bassinets for Newborns on Wards 62 CAMHSNET Supported Paediatric 63 CAMHSNET Supported Psychiatric 69 Stroke Total 'Overnight Acute' 02 Rehabilitation 03 Palliative Care Total 'Overnight Sub acute' 39 Same Day Renal Dialysis 75 Same Day Other 04 Psych Acute 73 Same Day Mental Health 81 Same Day Surgical Total 'Same Day' 53 Brain Injury Transitional Living 09 CADE 25 HITH 46 Medical (Designated NHTP) Total State Funded 'Other' beds 55 Community Residential Care Units (Mental Health) less than 24 hrs 05 Psychiatric Rehab (ECU) 20 Psychiatric Ext Care (PGU) Total State Funded 'Other' Institution Type C beds 14 Residential Aged Care - High (Nursing Home) 23 Residential Aged Care - Low (Hostel) 51 Respite - High Federal Govt Block Funded 52 Respite - Low Federal Govt Block Funded 10 7 7 5 7 18 46 40 0 36 10 7 7 5 7 36 36 1 1 0 0 0 0 7 24 22 0 1 102 0 18 25 10 7 5 44 4 39 69 30 32 1 59 444 1 1 0 444 1 1 0 0 0 0 0 0 1 0 2 0 2 12 3 7 30 30 0 0 2 2 1 0 0 0 0 0 1 8 0 2 10 20 0 0 0 0 0 0 4 4 0 6 18 5 8 0 4 4 5 12 34 66 6 0 16 14 16 4 4 0 0 18 16 41 0 10 0 8 0 3 0 0 4 126 18 46 40 0 36 0 5 0 48 0 4 0 57 4 81 0 30 0 37 6 77 3 16 14 0 30 542 3 3 19 19 34 66 33 545 19 0 22 0 0 32 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 19 54 0 19 126 19 18 41 10 8 5 48 4 57 81 30 37 77 561 54 3 618 10 10 8 28 28 15 0 15 15 1 1 2 2 1 1 1 Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 12 of 43 Goulburn G'burn C Hlth Crookwell Bourke St HS Yass Bombala Braidwood Cooma Delegate Queanbeyan Bega Pambula Bateman's bay Moruya Eastern Sector Total Mental Hlth (Kenmore) T Basis unit Total Southern 0 126 0 19 0 18 0 41 0 10 10 18 27 32 0 48 9 13 0 57 0 81 0 30 0 37 0 77 46 607 0 54 0 3 46 664 Network and Facility 77 Jointly AG-State Funded Intermittent Transitional Care (in Hospital) 78 Jointly AG-State Funded Intermittent Transitional Care (in Community) 0 5 5 Same Day Nonadmitted patient Oncology Total 'Same Day' 17 Emergency Dept Level 3+ 58 Emergency Dept Level 1 & 2 66 Delivery 67 Operating theatres 67 Recovery 76 Transit Lounge Total 'Other' beds 10 0 0 5 10 0 10 0 0 0 0 0 5 10 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 30 4 30 0 0 30 0 0 0 9 9 39 11 12 16 0 87 2 0 3 2 3 11 2 16 10 9 7 8 39 11 12 16 0 87 19 0 2 10 3 2 3 11 2 21 20 9 7 8 117 0 0 117 145 19 20 51 13 20 35 59 15 78 101 39 44 85 724 54 3 724 2 3 2 3 3 3 3 14 5 2 1 3 2 8 3 2 3 2 4 5 1 1 2 5 1 1 4 2 2 0 SNSW LHD Staffing FTE % of total Allied Health 203 11 Corporate and Hospital Support Workers 327 18 Hotel Services 74 4 Maintenance and Trade 29 2 Medical 62 3 Nurses 1026 56 Oral Health Practitioners and Support Workers 25 1 Other Professional and Para Professional and Support Staff 68 4 30 2 Scientific and Technical Clinical Staff Support 1844 Source: Workforce - Oct 12 SNSWLHD Pivot table analysis Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 13 of 43 Acute Inpatient Projections for SNSW LHD facilities base case scenario - aIM 2012 Acute Inpatient Projections for SNSWLHD Facilities Base Case scenario- aIM 2012 ED_only_label Other SRG_name (All) Less Chemo, renal dialysis, unqual neonates, psychiatric acute HITH_flag Other Year Data 2011 2017 2022 hosp_group_name Seps beddays beds Seps beddays beds Seps beddays Batemans Bay 4,020 8,890 32 4,862 13,682 50 5,584 15,591 Bega 4,834 14,060 48 5,639 19,544 67 6,266 21,822 Bombala 178 1,074 4 224 1,204 4 248 1,316 Braidwood 126 448 2 177 926 3 225 1,180 Cooma 2,726 7,318 27 2,934 9,283 34 3,171 10,055 Crookwell 716 3,019 11 727 3,023 11 781 3,242 Goulburn 6,411 21,067 72 6,619 21,970 75 7,079 23,389 Moruya 3,870 10,981 40 4,701 16,477 60 5,243 18,402 Pambula 1,504 5,537 20 1,685 6,828 25 1,893 7,750 Queanbeyan 2,920 9,480 35 3,481 10,354 38 4,092 12,388 Yass 455 1,335 5 549 2,161 8 645 2,560 Grand Total 27,760 83,209 296 31,599 105,451 376 35,228 beds 57 75 5 4 37 12 80 67 28 45 9 117,694 420 Projections for SNSW LHD Hospitals top five SRG Projections- aIM 2012 Projections for SNWLHD hospitals top five SRGs - aIM 2012 Less Chemo, renal dialysis, unqual neonates, psychiatric acute ED_only_label HITH_flag Other Other Data SRG_name 16 Diagnostic GI Endoscopy 15 Gastroenterology 11 Cardiology 49 Orthopaedics 24 Respiratory Medicine 27 Non Subspecialty Medicine 24 Respiratory Medicine 49 Orthopaedics 11 Cardiology 15 Gastroenterology Separations beddays Year 2011 2017 2022 3,193 2,592 2,457 2,213 2,288 3,579 3,098 2,889 2,606 2,486 3,984 3,586 3,284 2,873 2,801 9,082 11,052 8,390 8,501 5,784 27,760 13,494 13,255 12,411 10,268 7,750 31,599 15,609 14,993 13,954 11,541 8,814 35,228 83,209 105,451 117,694 Total Separations Total beddays Data Seps SRG_name 11 Cardiology 11 Cardiology Total 15 Gastroenterology ESRG_name 111 Chest Pain 112 Unstable Angina 113 Heart Failure and Shock 114 Non-Major Arrhythmia and Conduction Disorders 115 AMI W/O Invasive Cardiac Inves Proc 116 Syncope and Collapse 119 Other Cardiology 151 Oesophagitis, Gastroent and Misc Digestive System Disorders 152 Gastroscopy 153 ERCP 159 Other Gastroenterology 15 Gastroenterology Total 16 Diagnostic GI Endoscopy 161 Other Colonoscopy 162 Other Gastroscopy 16 Diagnostic GI Endoscopy Total 24 Respiratory Medicine 241 Bronchitis and Asthma Compendium – SNSW LHD Health Care Services Plan 2013-2018 2011 612 208 418 461 232 183 343 2,457 507 893 9 1,183 2,592 2017 748 152 500 580 241 275 394 2,889 550 1,030 15 1,503 3,098 2022 850 168 569 656 265 337 438 3,284 603 1,248 18 1,718 3,586 2,372 821 3,193 233 2,646 934 3,579 238 2,973 1,011 3,984 254 Page 14 of 43 242 Chronic Obstructive Airways Disease 243 Respiratory Infections/Inflammations 244 Bronchoscopy 249 Other Respiratory Medicine bedday 24 Respiratory Medicine Total 27 Non Subspecialty Medicine 271 Kidney and Urinary Tract Infections 272 Cellulitis 275 Injuries - Non-surgical 276 Dementia and Delirium 277 Septicaemia 278 Surgical Follow Up 279 Other Non Subspecialty Medicine 27 Non Subspecialty Medicine Total 49 Orthopaedics 491 Injuries to Limbs - Medical 492 Wrist and Hand Procedures incl Carpal Tunnel 494 Knee Procedures 495 Other Orthopaedics - Surgical 496 Hip Replacement/Revision 497 Knee Replacement/Revision 499 Other Orthopaedics - Non-surgical 49 Orthopaedics Total 11 Cardiology 111 Chest Pain 112 Unstable Angina 113 Heart Failure and Shock 114 Non-Major Arrhythmia and Conduction Disorders 115 AMI W/O Invasive Cardiac Inves Proc 116 Syncope and Collapse 119 Other Cardiology 11 Cardiology Total 15 Gastroenterology 151 Oesophagitis, Gastroent and Misc Digestive System Disorders 152 Gastroscopy 153 ERCP 159 Other Gastroenterology 15 Gastroenterology Total 16 Diagnostic GI Endoscopy 161 Other Colonoscopy 162 Other Gastroscopy 16 Diagnostic GI Endoscopy Total 24 Respiratory Medicine 241 Bronchitis and Asthma 242 Chronic Obstructive Airways Disease 243 Respiratory Infections/Inflammations 244 Bronchoscopy 249 Other Respiratory Medicine 24 Respiratory Medicine Total 27 Non Subspecialty Medicine 271 Kidney and Urinary Tract Infections 272 Cellulitis 275 Injuries - Non-surgical 276 Dementia and Delirium 277 Septicaemia 278 Surgical Follow Up 279 Other Non Subspecialty Medicine 27 Non Subspecialty Medicine Total 49 Orthopaedics 491 Injuries to Limbs - Medical 492 Wrist and Hand Procedures incl Carpal Tunnel 494 Knee Procedures 495 Other Orthopaedics - Surgical 496 Hip Replacement/Revision 497 Knee Replacement/Revision 499 Other Orthopaedics - Non-surgical 49 Orthopaedics Total Compendium – SNSW LHD Health Care Services Plan 2013-2018 563 779 52 661 2,288 666 819 46 717 2,486 760 915 50 823 2,801 378 300 91 155 154 185 566 1,829 517 295 163 563 187 213 275 2,213 1,103 589 2,629 1,673 795 494 1,218 8,501 1,350 1,244 64 3,126 5,784 446 426 106 188 200 231 720 2,318 641 317 208 670 207 246 318 2,606 1,308 445 3,398 1,900 976 909 1,332 10,268 1,588 1,581 125 4,456 7,750 534 474 139 225 232 264 817 2,686 701 351 223 732 232 282 352 2,873 1,442 475 3,830 2,145 1,064 1,113 1,472 11,541 1,786 1,880 149 4,998 8,814 2,610 1,078 3,688 525 3,448 3,937 131 3,011 11,052 2,958 1,247 4,205 626 4,300 4,987 113 3,228 13,255 3,311 1,342 4,653 675 4,865 5,586 124 3,742 14,993 1,564 1,344 454 974 920 1,600 2,226 9,082 1,742 341 188 2,051 1,218 1,170 1,680 8,390 2,236 2,329 831 1,724 1,414 2,023 2,937 13,494 3,330 343 232 2,536 1,639 1,499 2,832 12,411 2,684 2,640 1,102 2,001 1,657 2,248 3,277 15,609 3,778 379 250 2,859 1,803 1,673 3,212 13,954 Page 15 of 43 Projections by age groups – aIM 2012 Projections for age groups being treated. ED_only_label Other HITH_flag Other ESRG_name (All) Data Separations beddays age_group_label 00-15 years 16-44 years 45-69 years 70-84 years 85+ years 00-15 years 16-44 years 45-69 years 70-84 years 85+ years Total Separations Less Chemo, renal dialysis, unqual neonates, psychiatric acute Year 2011 2017 2022 1,597 1,671 1,715 6,749 6,646 6,744 9,819 10,924 11,509 7,276 9,172 11,500 2,319 3,185 3,759 3,186 3,175 3,240 15,085 14,296 14,299 24,876 28,280 29,097 27,784 39,411 47,748 12,278 20,288 23,309 27,760 31,599 35,228 Total beddays 83,209 105,451 117,694 Projections – Medical/Surgical – aIM 2012 Projections - Medical Surgical breakup- aIM2012 ED_only_label Other HITH_flag Other ESRG_name (All) Data Separations Medical/Surgical/Procedural 1 Surgical 1 Surgical Total 2 Medical 2 Medical Total 3 Procedural beddays 3 Procedural Total 1 Surgical 1 Surgical Total 2 Medical 2 Medical Total 3 Procedural 3 Procedural Total Total Separations Less Chemo, renal dialysis, unqual neonates, psychiatric acute Year Dayonly_label 2011 2017 2022 Dayonly 3,115 3,522 3,982 Overnight 3,152 3,527 3,817 6,267 7,048 7,799 Dayonly 2,362 2,867 3,238 Overnight 14,716 16,782 18,623 17,078 19,648 21,861 Dayonly 4,035 4,460 5,079 Overnight 380 443 489 4,415 4,902 5,568 Dayonly 3,115 3,522 3,982 Overnight 12,472 14,257 15,484 15,587 17,778 19,466 Dayonly 2,362 2,867 3,238 Overnight 59,311 78,274 87,612 61,673 81,140 90,850 Dayonly 4,035 4,460 5,079 Overnight 1,914 2,073 2,299 5,949 6,532 7,378 27,760 31,599 35,228 Total beddays Compendium – SNSW LHD Health Care Services Plan 2013-2018 83,209 105,451 117,694 Page 16 of 43 Projections for sub-acute –SiAM 2012 Sub-Acute projection - SiAM 2012 lga_group_name Southern NSW LHD 2011 SRG_name 84 Rehabilitation 84 Rehabilitation Total 85 Psychogeriatric Care 85 Psychogeriatric Care Total 86 Palliative Care 86 Palliative Care Total 87 Maintenance hosp_group_name N201 Batemans Bay N202 Bega N205 Braidwood N206 Cooma N207 Crookwell N209 Goulburn N211 Moruya N214 Pambula N215 Queanbeyan N216 Goulburn BSHS N217 Yass Z1 Other NSW Public Z2 Other NSW/ACT Private Z4 Interstate Public 2017 2022 active_episodes 274 278 3 21 17 26 144 112 31 225 2 60 beds 6 6 0 1 1 0 3 3 2 10 0 6 active_episodes 366 277 4 74 11 94 204 137 40 291 8 86 beds 10 9 0 2 1 2 9 5 2 14 0 4 active_episodes 487 364 5 101 12 123 257 183 52 332 10 110 beds 12 11 0 3 1 3 10 6 3 15 1 4 838 656 2,687 2 13 19 70 0 1,905 955 4,452 2 0 0 0 0 0 1 0 1 22 33 114 0 0 0 0 0 0 0 0 0 2,661 1,221 5,919 3 0 0 0 0 0 1 0 1 0 28 39 135 0 0 0 0 0 0 0 0 0 0 1 0 5 5 0 0 5 6 0 0 3 62 17 9 8 26 12 50 22 36 18 65 17 5 0 1 0 0 0 1 0 1 0 1 1 4 0 0 15 80 22 9 11 22 6 22 28 46 18 47 19 5 1 3 1 0 0 1 0 1 1 2 1 2 1 0 18 94 26 11 14 25 7 24 33 55 23 51 22 6 1 3 1 0 1 1 0 1 1 2 1 2 1 0 6 85 438 5 30 1 8 14 65 37 31 0 2 13 0 1 0 1 0 3 1 1 5 105 447 7 34 1 9 17 68 39 36 0 4 16 0 2 0 1 1 3 2 2 8 122 520 8 39 1 10 19 69 40 40 0 4 18 0 2 0 1 1 3 2 2 N202 Bega N203 Bombala N205 Braidwood N206 Cooma N207 Crookwell N209 Goulburn N214 Pambula N215 Queanbeyan N216 Goulburn BSHS Z1 Other NSW Public Z2 Other NSW/ACT Private Z4 Interstate Public N201 Batemans Bay N202 Bega N203 Bombala N205 Braidwood N206 Cooma N207 Crookwell N209 Goulburn N211 Moruya N214 Pambula N215 Queanbeyan N216 Goulburn BSHS N217 Yass Z1 Other NSW Public Z2 Other NSW/ACT Private Z4 Interstate Public N201 Batemans Bay N202 Bega N203 Bombala N205 Braidwood N206 Cooma N207 Crookwell N209 Goulburn N214 Pambula Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 17 of 43 N215 Queanbeyan N216 Goulburn BSHS N217 Yass Z1 Other NSW Public Z2 Other NSW/ACT Private Z4 Interstate Public 87 Maintenance Total Grand Total 57 105 33 5 1 9 1 0 62 111 36 5 4 7 2 0 69 115 40 6 4 7 2 0 48 375 814 3,942 0 11 29 111 47 359 832 5,746 3 20 48 179 50 389 896 7,352 3 20 48 203 Projections – SNSW LHD residents treated in non SNSW LHD facilities – aIM 2012 Projections - to non SNSWLHD facilities - aIM2012 SRG_name (All) ED_only_label Other HITH_flag Other lga_group_name 10550 Bega Valley (A) 10550 Bega Valley (A) Total 12059 Cooma-Monaro + Bombala + Snowy River hosp_group_name Z1 Other NSW Public Z2 Other NSW Private (excl DPCs) Z3 Other NSW Day Procedure Centres Z4 Interstate Public Z1 Other NSW Public Z2 Other NSW Private (excl DPCs) Z3 Other NSW Day Procedure Centres Z4 Interstate Public 12059 Cooma-Monaro + Bombala + Snowy River Total Z1 Other NSW 12750 Eurobodalla (A) Public Z2 Other NSW Private (excl DPCs) Z3 Other NSW Day Procedure Centres Z4 Interstate Public 12750 Eurobodalla (A) Total 13319 Goulburn Mulwaree Z1 Other NSW (A) + Upper Lachlan Public Z2 Other NSW Private (excl DPCs) Z3 Other NSW Day Procedure Centres Z4 Interstate Public 13319 Goulburn Mulwaree (A) + Upper Lachlan Total 16479 Palerang + Z1 Other NSW Queanbeyan Public Z2 Other NSW Private (excl DPCs) Z3 Other NSW Day Procedure Centres Z4 Interstate Public 16479 Palerang + Queanbeyan Total Z1 Other NSW 18710 Yass Valley (A) Public Z2 Other NSW Private (excl DPCs) Z3 Other NSW Day Procedure Centres Z4 Interstate Public 18710 Yass Valley (A) Total Grand Total less chemo, unqual neonates, renal dialysis, acute psychiatry 2011 Seps Beddays beds 2017 Seps Beddays beds 2022 Seps Beddays beds 346 1,782 6 402 1,838 6 440 2,024 7 2,165 3,506 11 2,647 4,394 14 3,060 5,030 16 95 1,219 3,825 95 5,183 10,566 0 17 34 136 1,418 4,602 136 5,880 12,248 0 19 40 180 1,584 5,264 180 6,522 13,756 1 21 44 228 1,027 3 226 990 3 243 1,042 3 825 2,002 6 984 2,293 7 1,094 2,503 8 90 1,124 90 4,079 0 13 117 1,265 117 4,539 0 15 146 1,378 146 4,872 0 16 2,267 7,198 23 2,592 7,939 26 2,861 8,562 28 670 3,018 10 819 3,479 11 922 3,855 13 1,368 3,948 13 1,783 4,658 15 2,061 5,281 17 321 1,575 3,934 321 6,590 13,877 1 21 45 320 1,916 4,838 320 7,669 16,125 1 25 52 417 2,170 5,570 417 8,572 18,125 1 28 59 890 3,311 11 828 3,194 10 860 3,286 11 1,661 4,076 13 1,703 3,942 13 1,818 4,152 13 193 1,104 193 4,025 1 13 218 1,180 218 4,062 1 13 246 1,244 246 4,211 1 14 3,848 11,605 38 3,929 11,416 37 4,168 11,896 39 376 1,503 5 397 1,601 5 461 1,835 6 2,750 6,063 20 3,242 7,139 23 3,823 8,295 27 113 4,722 7,961 113 14,286 21,965 0 46 71 138 5,719 9,496 137 17,824 26,701 0 57 86 202 6,699 11,184 202 20,768 31,100 1 67 100 189 1,012 3 198 818 3 229 931 3 977 2,012 6 1,223 2,997 10 1,418 3,419 11 46 1,508 2,720 46 4,718 7,788 0 15 25 58 1,777 3,255 58 5,780 9,653 0 19 31 82 2,005 3,734 82 6,462 10,895 0 21 35 24,555 72,999 236 28,713 84,082 272 32,782 94,334 305 Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 18 of 43 Flow to ACT Public Hospitals-Acute Inpatient Activity - Flowinfo v 11.2 Year 2009/10 Seps Beddays 10928 38008 495 Other Orthopaedics - Surgical 597 2144 121 Invasive Cardiac Inves Proc 485 772 722 Vaginal Delivery 379 945 219 Other Neurology 342 769 159 Other Gastroenterology 338 942 539 Other Vascular Surgery Procedures 278 1296 529 Other Urological Procedures 265 1093 122 Percutaneous Coronary Angioplasty 259 618 279 Other Non Subspecialty Medicine 233 645 Enhanced Service Related Groups Total 492 Wrist and Hand Procedures incl Carpal Tunnel 231 281 Source: Flowinfo V 11.2 – Please note that 2009/10 ACT data is the latest available. Excludes chemo, unqualified neonates, renal dialysis, Supply of Hospital Inpatient Services in SNSW LHD – Flowinfo Vs 11.2 Supply of Inpatient Hospital Services in SNSW LHD Hospitals 2008/09 Row Labels seps 2009/10 beddays 2010/11 seps beddays seps 2010/11 beddays beddays % seps % Goulburn 7252 27035 7576 26997 7759 29151 20.4 21.5 Bega 5896 20014 6284 18835 6409 19810 16.9 14.6 Batemans Bay 4716 12334 5176 12058 5498 12959 14.5 9.6 Moruya 5154 15906 4852 14857 5038 14211 13.3 10.5 Queanbeyan 4048 10387 4007 11085 4502 12147 11.9 9 6.3 Cooma 3027 9733 2960 9301 3151 8575 8.3 Pambula 2440 8158 2488 7348 2550 8189 6.7 6 Crookwell 701 4007 906 4171 999 4488 2.6 3.3 Yass 651 2402 739 2402 810 2340 2.1 1.7 Goulburn Bourke St Health Service 470 12650 444 11004 445 11547 1.2 8.5 Kenmore 333 10656 333 11432 333 9824 0.9 7.3 Braidwood 218 1013 278 868 236 963 0.6 0.7 Bombala Grand Total 218 1219 268 1564 229 1278 0.6 0.9 35124 135514 36311 131922 37959 135482 100 100 Source: Flowinfo vs 11.2less unqual neonates, renal dialysis & chemo Supply of Inpatient ACUTE Hospital Services in SNSW LHD Hospitals SRG Service Related Group V40 Hospital Goulburn Bega Moruya Queanbeyan Batemans Bay Cooma Pambula Crookwell Yass Bombala Braidwood (Multiple Items) 2008/09 Seps 6427 5681 4824 3883 4411 2837 2215 610 557 209 197 2009/10 beddays 19739 17890 13692 9431 9904 8298 6342 2244 1617 1142 705 Seps 6638 6016 4588 3840 4800 2826 2317 800 671 245 254 Compendium – SNSW LHD Health Care Services Plan 2013-2018 2010/11 beddays 19989 17094 13428 9776 9961 8211 6343 2843 1913 1244 740 Seps 6854 5830 4708 4267 4955 3003 2277 898 734 211 207 beddays 21820 15510 12367 10829 9825 7595 6310 3202 1622 1107 529 av seps 6640 5842 4707 3997 4722 2889 2270 769 654 222 219 % 20.2 17.7 14.3 12.1 14.3 8.8 6.9 2.3 2.0 0.7 0.7 Page 19 of 43 av beddays 20516 16831 13162 10012 9897 8035 6332 2763 1717 1164 658 % 22.5 18.5 14.4 11.0 10.9 8.8 6.9 3.0 1.9 1.3 0.7 SRG Service Related Group V40 (Multiple Items) 2008/09 2009/10 Hospital Seps beddays Seps beddays Goulburn Bourke St Health Service 3 53 2 30 Grand Total 31854 91057 32997 91572 Source: Flowinfo vs 11.2less unqual neonates, renal dialysis & chemo 2010/11 Seps 3 33947 beddays 20 90736 av seps % 3 32933 0.0 Supply Inpatient Hospital Services SNSW LHD Hospitals- SRGs LGA - ASGC 200707(used with LHD) LHD of Hospital (All) SNSWLHD 2008/09 seps 3308 2782 3016 2698 2431 2621 2299 2027 1496 1503 735 1206 680 757 657 731 635 607 567 less unqual neonates, renal dialysis & chemo 2009/10 Row Labels beddays seps 11 Cardiology 9639 3349 15 Gastroenterology 6199 3088 16 Diagnostic GI Endoscopy 3537 2965 54 Non Subspecialty Surgery 6524 2691 24 Respiratory Medicine 11752 2546 49 Orthopaedics 8327 2832 27 Non Subspecialty Medicine 10528 2336 72 Obstetrics 5684 2004 82 Psychiatry - Acute 9217 1586 21 Neurology 4988 1510 84 Rehabilitation 10212 699 71 Gynaecology 1995 1229 52 Urology 1483 658 50 Ophthalmology 835 796 44 Upper GIT Surgery 1869 810 81 Drug and Alcohol 1996 789 43 Colorectal Surgery 2324 698 46 Neurosurgery 2142 626 48 ENT & Head and Neck 964 620 51 Plastic and Reconstructive Surgery 581 912 593 18 Immunology and Infections 385 690 357 19 Oncology 349 1857 476 87 Maintenance 422 8705 371 86 Palliative Care 238 2573 273 22 Renal Medicine 278 790 300 17 Haematology 292 936 322 83 Psychiatry - Non Acute 269 8721 235 14 Endocrinology 250 1233 282 53 Vascular Surgery 199 1138 204 26 Pain Management 274 435 234 25 Rheumatology 157 669 162 41 Breast Surgery 143 281 139 13 Dermatology 102 286 109 73 Qualified Neonate 187 732 138 85 Psychogeriatric Care 107 5014 150 47 Dentistry 91 91 101 99 Unallocated 25 97 22 62 Extensive Burns 12 85 9 12 Interventional Cardiology 2 26 1 63 Tracheostomy 1 1 42 Cardiothoracic Surgery 4 27 1 Grand Total 35124 135514 36311 Source: Flowinfo vs 11.2 less chemo, unqualified neonates, renal dialysis, Compendium – SNSW LHD Health Care Services Plan 2013-2018 beddays 8773 6624 3427 6377 10731 10047 10510 5569 8918 4417 8004 2091 1460 853 2483 1932 2490 1972 1023 1153 518 2268 5937 2966 1091 921 7807 1347 1126 436 673 296 235 444 6718 101 142 26 5 11 131922 2010/11 seps 3449 3429 3194 2833 2805 2693 2293 2077 1706 1471 1201 1182 795 777 727 725 711 687 625 beddays 9561 6627 3689 6102 11816 9070 9954 5595 10175 3972 11282 1869 1593 849 2147 1809 2247 2010 1077 587 441 427 373 335 326 278 271 254 226 211 187 151 131 129 126 85 20 9 5 5 2 37959 935 721 2248 5434 3437 961 910 9361 1243 1175 346 632 359 292 627 5057 86 73 59 29 44 9 135482 Page 20 of 43 av beddays 34 91122 % 0.0 ACUTE inpatient Supply – SNSW LHD Hospitals - SRGs SNSWLHD Hospital s 2008/09 2009/10 SRG Seps beddays Seps 11 Cardiology 3308 9639 3349 15 Gastroenterology 2782 6199 3088 16 Diagnostic GI Endoscopy 3016 3537 2965 54 Non Subspecialty Surgery 2698 6524 2691 24 Respiratory Medicine 2431 11752 2546 49 Orthopaedics 2621 8327 2832 27 Non Subspecialty Medicine 2299 10528 2336 72 Obstetrics 2027 5684 2004 21 Neurology 1503 4988 1510 71 Gynaecology 1206 1995 1229 52 Urology 680 1483 658 50 Ophthalmology 757 835 796 44 Upper GIT Surgery 657 1869 810 81 Drug and Alcohol 731 1996 789 43 Colorectal Surgery 635 2324 698 46 Neurosurgery 607 2142 626 48 ENT & Head and Neck 567 964 620 51 Plastic and Reconstructive Surgery 581 912 593 18 Immunology and Infections 385 690 357 19 Oncology 349 1857 476 22 Renal Medicine 278 790 300 17 Haematology 292 936 322 14 Endocrinology 250 1233 282 53 Vascular Surgery 199 1138 204 26 Pain Management 274 435 234 25 Rheumatology 157 669 162 41 Breast Surgery 143 281 139 13 Dermatology 102 286 109 73 Qualified Neonate 187 732 138 47 Dentistry 91 91 101 99 Unallocated 22 82 22 62 Extensive Burns 12 85 9 12 Interventional Cardiology 2 26 1 63 Tracheostomy 1 1 42 Cardiothoracic Surgery 4 27 1 Grand Total 31854 91057 32997 Source: Flowinfo vs 11.2 less chemo, unqualified neonates, renal dialysis, beddays 8773 6624 3427 6377 10731 10047 10510 5569 4417 2091 1460 853 2483 1932 2490 1972 1023 1153 518 2268 1091 921 1347 1126 436 673 296 235 444 101 142 26 5 11 91572 2010/11 Seps 3449 3429 3194 2833 2805 2693 2293 2077 1471 1182 795 777 727 725 711 687 625 587 441 427 326 278 254 226 211 187 151 131 129 85 20 9 5 5 2 33947 beddays 9561 6627 3689 6102 11816 9070 9954 5595 3972 1869 1593 849 2147 1809 2247 2010 1077 935 721 2248 961 910 1243 1175 346 632 359 292 627 86 73 59 29 44 9 90736 Demand for Inpatient services – SNSW LHD residents – Flowinfo v 11.2 Demand for ACUTE Inpatient services – SNSW LHD Residents 2008/09 LHD of Hospital STH CATC A.C.T. Other Private Sydney Children' South Eastern Sy Sydney St. Vincent's Ne South Western Sy Illawarra Shoalh 2010/1 1 2009/10 Seps 28988 10764 9351 bedday s 85599 37031 20590 Seps 29985 10928 9992 bedday s 86115 38008 21245 Seps 30941 10928 9747 bedday s 85399 38008 21608 Av seps 29971 10873 9697 % 55.1 20.0 17.8 Av beddays 85704 37682 21148 % 54.3 23.9 13.4 428 1691 402 1582 439 2407 423 0.8 1893 1.2 334 378 137 1756 1984 733 338 394 134 1762 2589 1007 378 335 205 1953 1950 1052 350 369 159 0.6 0.7 0.3 1824 2174 931 1.2 1.4 0.6 364 341 990 902 436 289 1154 827 451 336 1038 921 417 322 0.8 0.6 1061 883 0.7 0.6 Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 21 of 43 2008/09 LHD of Hospital Private Day Proc Victoria Northern Sydney Western Sydney Nepean Blue Moun Murrumbidgee Queensland Hunter New Engla Western North. Territory South Australia Mid North Coast Central Coast Tasmania Northern West. Australia Network with Vic Far West bedday s Seps 2010/1 1 2009/10 bedday s Seps bedday s Seps Av seps Av beddays % % 654 189 654 497 707 211 707 788 858 211 858 788 740 204 1.4 0.4 740 691 0.5 0.4 115 398 120 562 137 716 124 0.2 559 0.4 169 670 169 797 214 709 184 0.3 725 0.5 51 217 116 207 554 485 46 180 85 186 394 251 90 178 85 576 389 251 62 192 95 0.1 0.4 0.2 323 446 329 0.2 0.3 0.2 32 56 9 23 73 92 20 62 41 60 34 26 194 152 92 71 38 63 34 26 137 128 92 71 37 60 26 25 0.1 0.1 0.0 0.0 135 124 68 68 0.1 0.1 0.0 0.0 18 17 12 24 18 57 72 26 76 52 20 23 13 22 3 46 56 56 72 30 33 20 13 21 3 70 68 56 53 30 24 20 13 22 8 0.0 0.0 0.0 0.0 0.0 58 65 46 67 37 0.0 0.0 0.0 0.0 0.0 12 3 77 10 13 4 54 12 9 1 29 8 11 3 53 10 Grand Total 52820 155358 54675 158809 55794 Source: Flowinfo vs 11.2 less chemo, unqualified neonates, renal dialysis, 159365 54430 0.0 0.0 100. 0 0.0 0.0 100. 0 157844 Demand for Inpatient Hospital services – SNSW LHD residents – Flowinfo v 11.2 SRG Service Related Group V40 (Multiple Items) less unqual neonates, renal dialysis & chemo Row Labels 2008/09 2009/10 2010/11 average % SNSWLHD 31970 32987 34580 33179 55.3 A.C.T. 11886 12112 12112 12037 20.1 Other Private 10198 10902 10972 10691 17.8 Private Day Proc 654 707 858 740 1.2 South Western Sy 381 455 470 435 0.7 Sydney Children' 436 414 453 434 0.7 South Eastern Sy 342 354 397 364 0.6 Illawarra Shoalh 359 309 356 341 0.6 Sydney 384 398 342 375 0.6 Western Sydney 183 178 225 195 0.3 Victoria 198 221 221 213 0.4 St. Vincent's Ne 152 146 220 173 0.3 Murrumbidgee 238 217 197 217 0.4 Northern Sydney 140 140 156 145 0.2 56 53 103 71 0.1 122 88 88 99 0.2 Western 60 69 67 65 0.1 Hunter New Engla 36 44 39 40 0.1 North. Territory 11 37 37 28 0.0 Mid North Coast 18 20 34 24 0.0 South Australia 24 28 28 27 0.0 Central Coast 17 26 22 22 0.0 Northern 24 26 22 24 0.0 Nepean Blue Moun Queensland Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 22 of 43 SRG Service Related Group V40 (Multiple Items) less unqual neonates, renal dialysis & chemo Row Labels 2008/09 2009/10 2010/11 average % Network with Vic 34 16 13 21 0.0 Tasmania 12 13 13 13 0.0 West. Australia 19 6 6 10 0.0 Justice Health 1 2 2 2 0.0 Far West 3 4 1 3 0.0 0 0.0 59988 100.0 Forensic Mental 1 Grand Total 57958 59973 62034 ACT Private Hospital activity for SNSW LHD residents Request Number: Prepared by: Date: Data Source: Description: Notes: 2009-10 Jul07 SLA description BEGA VALLEY (A) BOMBALA (A) COOMA-MONARO (A) EUROBODALLA (A) GOULBURN MULWAREE (A) GOULBU GOULBURN MULWAREE (A) BAL GREATER QUEANBEYAN (C) SR3525 Julie Searle April 2013 ACT Admitted Patient Care Data Collection ACT Private Hospital activity in Southern NSW LHD by SLA and SRG Combined data for all Private Hospitals in ACT is provided Data does not include private free-standing day facilities 2010-11 Jul07 SLA description BEGA VALLEY (A) BOMBALA (A) COOMA-MONARO (A) No. 440 68 % 6.7 1.0 369 5.6 645 9.8 323 4.9 45 .7 803 12.2 GREATER QUEANBEYAN (C) EUROBODALLA (A) GOULBURN MULWAREE (A) GOULBU GOULBURN MULWAREE (A) BAL PALERANG (A) PT A 808 12.3 PALERANG (A) - PT A PALERANG (A) PT B 141 2.1 PALERANG (A) - PT B 1447 219 22.0 3.3 172 2.6 QUEANBEYAN (C) SNOWY RIVER (A) UPPER LACHLAN SHIRE (A) YASS VALLEY (A) Total 1105 6585 2009-10 SRG description Orthopaedics Urology Chemotherapy and Radiotherapy ENT GIT Endodoscopy Non-acute QUEANBEYAN (C) SNOWY RIVER (A) UPPER LACHLAN SHIRE (A) No. 485 69 % 7.2 1.0 264 3.9 616 9.1 306 4.5 74 1.1 843 12.5 900 2011-12 Jul07 SLA description BEGA VALLEY (A) BOMBALA (A) COOMA-MONARO (A) No. 453 77 % 7.1 1.2 232 3.6 561 8.7 293 4.6 60 .9 GREATER QUEANBEYAN (C) 891 13.9 13.3 PALERANG (A) - PT A 820 12.8 143 2.1 PALERANG (A) - PT B 112 1.7 1507 231 22.3 3.4 1520 162 23.7 2.5 196 2.9 QUEANBEYAN (C) SNOWY RIVER (A) UPPER LACHLAN SHIRE (A) 173 2.7 1060 6414 16.5 100.0 No. 844 725 % 13.2 11.3 429 6.7 415 6.5 374 5.8 344 5.4 EUROBODALLA (A) GOULBURN MULWAREE (A) GOULBU GOULBURN MULWAREE (A) BAL 16.8 100.0 YASS VALLEY (A) Total 1116 6750 16.5 100.0 YASS VALLEY (A) Total No. 1187 475 % 18.0 7.2 No. 1162 551 % 17.2 8.2 447 6.8 2010-11 SRG description Orthopaedics Non-acute Urology 460 6.8 2011-12 SRG description Orthopaedics Non-acute Urology 441 6.7 428 6.3 335 5.1 427 6.3 335 5.1 385 5.7 GIT Endodoscopy Chemotherapy and Radiotherapy ENT Compendium – SNSW LHD Health Care Services Plan 2013-2018 ENT GIT Endodoscopy Chemotherapy and Radiotherapy Page 23 of 43 Gynaecology Interventional Cardiology 301 4.6 296 4.5 292 4.4 278 4.2 257 224 3.9 3.4 203 3.1 187 158 156 137 122 116 104 86 71 2.8 2.4 2.4 2.1 1.9 1.8 1.6 1.3 1.1 65 1.0 44 .7 44 .7 44 .7 41 .6 Obstetrics Plastic and Reconstructive Surgery Babies General Surgery Dentistry Ophthamology Breast Surgery General Medicine Haematology Upper GIT Surgery Vascular Surgery Neurosurgery Psychiatry Medical Oncology Colorectal Surgery Endocrinology Gastroenterology Head and Neck Surgery Cardiology Cardiothoracic Surgery Interventional Cardiology Gynaecology Plastic and Reconstructive Surgery 317 4.7 311 4.6 293 4.3 264 3.9 233 220 3.5 3.3 194 2.9 27 .4 Renal Medicine Respiratory Medicine 27 .4 27 .4 Dermatology Drug & Alcohol 21 .3 14 .2 Neurology Rheumatology Tracheostomy Burns Ungroupable Total 11 8 2 1 1 6585 .2 .1 .0 .0 .0 100.0 Ophthamology Vascular Surgery General Medicine Upper GIT Surgery Neurosurgery Haematology Colorectal Surgery Breast Surgery Psychiatry Medical Oncology 187 164 155 124 115 113 106 91 69 2.8 2.4 2.3 1.8 1.7 1.7 1.6 1.3 1.0 63 .9 Gastroenterology Head and Neck Surgery 61 .9 51 .8 Cardiology 39 .6 Renal Medicine 36 .5 Cardiothoracic Surgery .5 Endocrinology Neurology 29 .4 23 .3 Dermatology Respiratory Medicine 18 .3 18 .3 4 3 1 1 .1 .0 .0 .0 6750 100.0 Total Compendium – SNSW LHD Health Care Services Plan 2013-2018 5.2 323 5.0 239 3.7 237 3.7 General Surgery Babies Plastic and Reconstructive Surgery 205 204 3.2 3.2 185 2.9 Ophthamology General Medicine Vascular Surgery Psychiatry Upper GIT Surgery Haematology Neurosurgery Colorectal Surgery Breast Surgery Cardiothoracic Surgery 166 153 145 137 123 117 112 104 92 2.6 2.4 2.3 2.1 1.9 1.8 1.7 1.6 1.4 55 .9 54 .8 51 .8 46 .7 45 .7 27 .4 Renal Medicine Respiratory Medicine 27 .4 27 .4 Endocrinology Rheumatology 25 .4 23 .4 Dermatology Drug & Alcohol Ungroupable 18 9 2 .3 .1 .0 6414 100.0 Obstetrics 34 Drug & Alcohol Rheumatology Tracheostomy Ungroupable 332 Interventional Cardiology Dentistry Obstetrics Babies Dentistry General Surgery Gynaecology Cardiology Gastroenterology Medical Oncology Head and Neck Surgery Neurology Total Page 24 of 43 SNSW LHD Activity 2010/11 SNSWLHD 2010/11 Age Group Service Category 1 - Acute Care 2 - Rehabilitation Care same days seps overnight seps cost w eighted seps (Cost Weight B) bed days ALOS Planned Unplanned Planned Unplanned Planned Unplanned Planned Unplanned Planned Unplanned 2775 542 3693 308 3680 0 2 0 0 4 0 556 297 3029 0.0 5 0.0 11 0.0 3.6 3 - Palliative Care Paediatrics (<15) 4 - Maintenance Care 5 - New born Care 20 4341 6 - Other Admitted Patient Care 7 - GEM 8 - Psycho-geriatric Total 1 - Acute Care 2775 542 3699 308 3680 556 317 7386 0.0 8.7 14181 15923 28405 4630 32677 14341 11793 38123 0.3 1.9 2 - Rehabilitation Care 0 0 187 37 0 0 698 8600 3.7 232.4 3 - Palliative Care 0 1 41 8 0 0 171 446 4.2 49.6 4 - Maintenance Care 4 180 0 270 576 1.5 1095 365 0 9 0 1768 5397 Adult (15-64) 5 - New born Care 6 - Other Admitted Patient Care 7 - GEM 44 8 - Psycho-geriatric Total 1 - Acute Care 2 - Rehabilitation Care Older Adult (>65) 14185 15924 28822 4675 32677 14341 15795 53551 0.4 6396 10801 26411 3672 37316 12362 12260 42193 0.4 2.6 2.9 1 4 848 158 0 0 1731 9580 2.0 59.1 3 - Palliative Care 2 0 255 13 10 0 171 2568 0.7 197.5 4 - Maintenance Care 8 0 1142 36 12 0 136 4997 0.1 138.8 5 - New born Care 6 - Other Admitted Patient Care 0 0 16 92 0 0 9164 5112 572.8 55.6 7 - GEM 0 0 155 3 0 0 19 1271 0.1 423.7 904 3059 226.0 6407 10805 28831 3974 37339 12362 24385 68780 0.7 4.7 23352 27266 58509 8610 73673 27260 24350 83345 0.3 2.3 8 - Psycho-geriatric Total 1 - Acute Care 0 4 0 2 - Rehabilitation Care 1 4 1037 195 0 0 2429 18185 2.3 91.4 3 - Palliative Care 2 1 296 21 10 0 342 3014 1.1 137.0 12 0 1326 36 12 0 406 5584 0.3 155.1 0 0 0 0 0 0 20 4341 4 - Maintenance Care Total 0.0 5 - New born Care 6 - Other Admitted Patient Care 0 0 16 92 0 0 10259 5477 641.2 59.5 7 - GEM 0 0 164 3 0 0 19 1315 0.1 438.3 8 - Psycho-geriatric Total 0 0 4 0 0 0 2672 8456 668.0 23367 27271 61352 8957 73695 27260 40497 129717 0.5 Source: PAU October 2012 Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 25 of 43 3.6 Emergency Attendances With the majority of our hospitals reporting manually on ED presentation and only one Hospital (Goulburn Base) with more than 2 years of data collected via EDIS (Emergency Department Information system) or FirstNet it is difficult to analyse the data with any accuracy. Yellow cells: EDIS or FirstNet data All other cells: ED NAPOOS excluding Phone Triage and Diagnostics plus ED admissions 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 Bateman's Bay District Hospital 11421 13983 15071 17657 16911 16589 15702 16914 Bega District Hospital 10584 11271 12805 11465 12274 12761 13020 11621 2692 2081 1939 1904 2144 2235 2397 1909 1365 1426 1232 947 1509 1502 1460 1399 Bombala Health Service Braidwood Multi-Purpose Service Cooma Health Service 8512 9284 9766 11228 11029 11625 13026 11558 Crookwell Health Service 1645 2224 2993 3181 3150 3698 3849 3468 723 645 389 530 443 419 410 397 Delegate Multi-Purpose Service Goulburn Base Hospital 15835 20126 17490 18116 17607 18141 18261 18785 Moruya District Hospital 9786 12581 12844 11877 10975 11338 9497 10961 Pambula District Hospital 7776 7913 7538 7637 8061 8415 8318 5210 14864 16532 17100 16974 16264 17331 19311 16659 3915 4218 4767 5049 4888 5014 4864 3915 Queanbeyan Health Service Yass Health Service ED Attendances SNSW LHD 25000 20000 15000 10000 2007/08 2008/09 5000 0 2009/10 2010/11 2011/12 Cancer Incidence and Mortality: Projections 2011 to 2021 The Cancer Institute NSW predicts that the incidence of cancer will increase overall in NSW by 44% between 2007 and 2021: Southern NSW LHD is predicted to have a 70% increase in cancer diagnoses by 2021 mainly due to the increase in the number of patients aged 65 or older. Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 26 of 43 Local Government Area Bega Valley Bombala Cooma-Monaro Eurobodalla Goulburn Mulwaree Palerang Queanbeyan Snowy River Upper Lachlan Yass Valley 5 yr totals 2006 220 13 52 270 152 65 133 30 51 41 1027 2011 2016 266 18 64 331 178 70 184 35 60 75 1281 317 19 71 390 199 84 226 44 66 90 1506 2021 370 19 78 452 220 100 275 53 71 107 1745 Grand Total 953 56 213 1172 598 254 685 132 197 273 Source: Cancer incidence and mortality: projections 2011 to 2021. Cancer Institute NSW, Sydney: May 2011. Cancer Services SNSW LHD – February 2013 Cooma: • Operates Tues - Thurs • 3 chairs +1 bed, • Allocated RN FTE = 1.2; No administrative support • Chemotherapy treatments average 20 per month • Part-time support services provided by- Cancer Care Coordinator (0.2FTE), Breast Care Nurse (0.6FTE) and Oncology Social Worker (0.5FTE (also covers Queanbeyan and Cooma)) Bega: • Mon-Fri service – complex chemotherapy given Tues to Thurs; supportive care and less complex chemotherapy treatments given Fridays • 6 chairs + 1 bed • South East Regional Hospital in the Bega Valley will have a 10 chairs and 2 beds • Allocated RN FTE = 2.24 including 1 CNC (supplemented with additional 0.53 FTE from Community Health); Administrative support FTE = 1 • Chemotherapy treatments average 90 per month • Part-time support services provided by- Cancer Care Coordinator (0.5FTE), Breast Care Nurse (0.4FTE) and Oncology Social Worker (0.6FTE) Goulburn (Bourke St Oncology): • Operates Wed – Fri • 5 chairs + 1 bed • Allocated RN FTE = 1.7; Allocated administrative support FTE = 1; actual 0.75 due to special contract • Chemotherapy treatments average 70 per month • Part-time support services provided by- Cancer Care Coordinator (0.6FTE (also covers Queanbeyan and Yass)), Breast Care Nurse (0.4FTE) and Oncology Social Worker (0.5FTE (also covers Queanbeyan and Cooma)) Moruya: • Mon-Fri service – complex chemotherapy given Tues to Thurs; supportive care and less complex chemotherapy treatments given Mon and Fri • 6 chairs +1 bed • Chemotherapy treatments average 95 per month • Part-time support services provided by- Cancer Care Coordinator (0.5FTE), Breast Care Nurse (0.6FTE) and Oncology Social Worker (0.6FTE) • Currently at or close to capacity for treatments Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 27 of 43 All oncology units operate as privately referred outpatient clinics. Medical oncologists and haematologists visit Moruya, Goulburn and Bega at least monthly. Radiation Oncologists visit Bega and Goulburn monthly to 6 weekly. Gaps • Moruya has been without a visiting radiation oncologist since late 2011 with all patients having to travel to Canberra for follow up. • Cooma which has no cancer specialist visits. • Limited visits by medical oncologists and haematologists to Bega and Moruya mean that waiting lists can be long and patients are discharged earlier than indicated by best practice to the care of their GPs. • Limited capacity for further chemotherapy treatments without increased appropriately trained registered nurses. Renal Services SNSW LHD February 2013 Goulburn : 8 chair satellite haemodialysis unit managed by Goulburn Hospital • Current funding including staffing FTE is for 16 permanent patients • Open Mon – Sat one shift per day • Currently 13 permanent patients Bega: 3 chair satellite haemodialysis unit managed by Bega Hospital • Current funding including staffing FTE is for 12 permanent patients ( no room for expansion) • Open Mon – Sat two shifts per day • Currently 11 permanent patients • South East Regional Hospital in the Bega Valley will have a 6 chair satellite haemodialysis unit when the new hospital is built Moruya: 7 chair satellite haemodialysis unit managed by Moruya Hospital • Current funding including staffing FTE is for 20 permanent patients • Open Mon/Wed/Fri two shifts per day and Tues/Thurs/Sat one shift per day • Currently 20 permanent patients Queanbeyan: 12 chair satellite haemodialysis unit managed by Queanbeyan Hospital • Current funding including staffing FTE is for 24 permanent patients • Open Mon – Sat one shift per day • Currently 21 permanent patients Cooma: Currently a self-care haemodialysis unit (2 chairs) managed by Canberra Hospital Renal Services– no staffing – run on a different model of care to satellite haemodialysis units • Plans currently underway for a 4 chair satellite haemodialysis unit ( as per an election commitment) – this will be in addition to the self-care unit All peritoneal dialysis and home haemodialysis initial patient training and all vascular access creation for haemodialysis and access creation for peritoneal dialysis occurs at the Canberra tertiary hospital – if there are any issues with the access the patient is referred back to the tertiary hospital for review • Renal Clinical Nurse Educators at each unit (currently being recruited) – provide renal education in the renal units • Renal Outreach Clinical Nurse Specialist – based at Moruya – covers Bega Valley/ Eurobodalla and Goulburn responsible for the provision of high level patient centred evidence-based clinical care. Provides o Comprehensive nursing assessments and expert consultation and educational support to patients with referred chronic kidney disease and to patients requiring haemodialysis and peritoneal dialysis in the SNSW LHD community. o Consultation and educational support is provided to family members/carers Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 28 of 43 Coordination of renal clinics in Goulburn and Moruya in conjunction with visiting Canberra Nephrologists and Registrars – clinics to be increased at these sites and clinics to be established in Bega o Pre –dialysis home visits/ home assessments o Home dialysis home visits o Pre dialysis patient education forums - Moruya Allied Health support -At some of the SNSWLHD renal sites (Goulburn/Moruya/Queanbeyan), there are funded Renal Dietician and Renal Social worker positions that provide consultations/assessments to pre dialysis patients and dialysis patients (both satellite patients and home patients) The Renal CNC works in close collaboration with the DoNM SNSWLHD, and the Nurse Unit Managers of the SNSWLHD Haemodialysis Units. The Renal CNC provides education, clinical leadership and consultation to renal services across SNSWLHD and consults with the SNSWLHD facilities in relation to early detection and management of chronic kidney disease. Private Renal Physician: admitting rights to all SNSWLHD renal units – provides private clinic consultations at Bega/ Moruya/Canberra o • • • Community Health Services Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 29 of 43 Bega Bombala Delegate Braidwood Cooma Crookwell Eurobodalla Goulburn Queanbeyan Yass Aboriginal Health Education Officer Yes No No No No yes Yes No Yes Aunty Jean’s Yes No No No No yes Yes Yes No Aboriginal Health 48 Hour Follow Up Yes No No No No yes Yes Yes No Building Strong Foundations Aboriginal Maternal Infant Health Service No No No No No yes Yes Yes No No No No No No yes No No Aboriginal Health OM Clinic No No No No No No No No Priority Population: Breast Cancer and Cervical Screening Yes Yes Ye s No Yes No Yes No No No No No no No No No No No No No No no No No No Priority Populations Multicultural Health No No No No No no No Yes No Priority Population: Refugee health No No No No No no No No No Yes yes Yes Yes Service Comments Priority Population: Aboriginal Health Priority Populations: Carers Support Priority Population: Disabilty Services Yes Outreach from large to small site Yes Yes Yes No Yes Yes Yes Yes Yes Servi ce Improvement Di re ctora Servi ce te Improvement Di re ctora te Yes No Yes Yes Yes Yes Yes Yes Yes Outreach from large to small site ACAT AARC CAPAC TRAC ASET Yes Yes Yes Yes Yes Yes No No No No Yes Yes No No Yes Yes No No No No No Yes yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No No No No Dementia Services No Yes Yes Yes No Yes No Yes No Falls Yes Yes Yes No Yes Yes Yes Yes Geriatric medicine HACC (Allied Health) HACC (Day Care) HACC (Nursing) Rehabilitation Palliative Care Renal Outreach No Yes Yes Yes Yes Yes No No No No Yes No Yes No Yes Yes Yes Yes No Yes No Yes Yes No Yes Yes Yes No No No no Yes Yes No Yes Yes Yes Yes No No No Yes Yes Yes No Yes No No Yes Yes Yes No No Yes No No No Yes No Yes Yes Yes Yes No Yes Yes Yes Yes Child Infant Tertiary Service Child and Family Nurses Immunisation Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes yes Safe Start Yes Yes Yes Yes Yes Yes Yes Yes Yes Youth Health no No No No No No No No StEPS Yes Yes Yes Yes No Yes Yes Yes Yes SWISH Yes Yes Yes Yes No No Yes Yes Yes Outrea ch from l a rge to sma l l s ite Outrea ch from l a rge to sma l l s ite Child Protection Counselling Services Yes No No Yes No Yes Yes Yes Yes Outreach from large to small site Sexual Assault Service Yes No No Yes No Yes Yes Yes Yes Sexual Assautl After hours Yes No No No No Yes Yes No Yes Out of Home Care Assessment and Co-ordination Yes Yes Yes Yes Yes yes Yes Yes Yes Yes No Yes No Yes No Yes No yes no Yes No Yes No Yes No No No No No no No No No No No No No Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Priority Population: Needle Syringe Program Prioirty Population: Sexual Health Priority Population: Women's Health Yes Yes Yes Yes Yes Aged Care and Rehabilitation Health Services No No No Yes Yes No No Outreach from large to small site LHD wide CNC service and program oversight Program only no FTE Program only no FTE Chronic Care Connecting Care and other Chronic Care Services Womens Health,Child Youth and Family Service provided by speciallist team Program only no FTE Violence Prevention and Care JIRT Yes Victims of Crime no Domestic and Family Violence Services no Oral Health Oral Health promotion yes Public Dental Services yes Community Nursing General yes Diabetes yes Continence yes Allied Health Services General Compendium – SNSW LHD Audiometry yes Dietetics yes Occupational Therapy yes Podiatry yes Physiotherapy yes HealthNoCare Services Plan No No No No No No No No Yes Yes Yes Yes Yes 2013-2018 No Yes Yes Yes Yes No No No Yes Page 30 of 43No Yes Yes Yes Yes Yes Yes Yes No Yes Outreach from large to small site Other sites referred to ACT LHD wide service no FTE LHD wide service - 1 FTE SNSW LHD Aboriginal Health – February 2013 AHEO/AHLO = Aboriginal Health Education Officer/Aboriginal Hospital Liaison Officer Area positions: To date we have 1 FTE Team Leader (HSM2) based in Goulburn. 1FTE Aboriginal Health Manager (HSM4) based in Moruya. Aboriginal Health Education Officer/Aboriginal Hospital Liaison Officer positions undertake multiple duties including Health Education addressing prevention and promotion of healthy lifestyles. Undertake hospital consultations for inpatients to ensure that all their needs are being met and to give support as needed to patient and family. Post discharge follow up is also undertaken by staff as needed. Other programs that they facilitate are the Otitis Media screening and referrals for school aged children from their schools. Drug and Alcohol education, Smoking Cessation, Renal support and education, Policy and Procedures input, Sexual Health, Mental Health and Health Promotion. • Yass: 1x .4 FTE Currently on Maternity Leave as AHEO/AHLO • Queanbeyan: 2 x FTE AHEO/AHLO • Goulburn: 1 x FTE Currently vacant and in recruiting process. • Batemans Bay: 1 x FTE AHEO/AHLO • Moruya: 1 x FTE AHEO/AHLO vacant successful applicant to commence 2/4/13 • Bega: 1 x FTE AHEO/AHLO • Eden: 1 x FTE AHEO/AHLO Program Staff: AMIHS (KMAP) KMAP is an outreach program that supports Aboriginal women to receive antenatal and postnatal services to improve Aboriginal Perinatal outcomes. To improve health service delivery to Aboriginal women with complicated pregnancies, at risk pregnancy and teenage mothers. To strengthen community based initiatives to improve the maternal and infant outcomes for all Aboriginal women. • Queanbeyan: .4 FTE vacant currently recruiting • Moruya: .6 FTE AHEO .6 Midwife • Bega: Managed by Katungul AMS funded by SNSWLHD .6 FTE Building Strong Foundations (BSF) BSF staff will provide culturally appropriate child and family primary health services to Aboriginal children from birth to school age and their families including prevention, health education and promotion, community development or well-being issues affecting the child or parents/ capacity to provide a safe, nurturing and stimulating environment for the child. Batemans Bay: 1 x FTE AHEO 1 x CFHN MSOAP ICD (Aunty Jeans) This program is Medical Specialist Outreach Access Program for Indigenous Chronic Disease, the aim of this program is to support educate and provide primary health services support for clients that have a chronic disease as an outreach service. This program is facilitated from community settings with strong partnerships with Non-government service providers. The program provides exercise, dietary education and food preparation to address diabetes and heart disease, diabetic education, social work support for carers and clients and those identifying mental health issues. The program provides clinics in Mogo, Bodalla, Narooma and Batemans Bay from Moruya. 1 x .6 FTE AHEO, 1 x .6 Diabetic Educator, 1 x .6 FTE Admin support, 1 x .3 FTE Social work, 1 x .3 FTE Dietician, 1 x .2 FTE Footcare Nurse. All positions are recruited to except Footcare Nurse that is vacant. Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 31 of 43 SNSW LHD Population Health – February 2013 Health Promotion Health promotion priority programs are implemented by health promotion staff located at SNSWLD sites. There are 7.5 FTE plus 0.5 FTE Epidemiologist. Key relationships include SNSW Medicare Local; extensive involvement with preschool and school settings; communities and volunteers through the Falls Prevention Program; and acute setting working parties. Contracted services deliver the Go4Fun program. Priorities in health promotion and programs are as follows: Healthy Weight programs are focused within the early childhood and primary school settings, with the exception of Go4Fun, which is a community program which targets children aged 7 to 13 years. • Munch & Move early childhood program • Live Life Well @ School, Crunch & Sip and Fresh Tastes @ School primary school programs • Go 4 Fun Falls Prevention Programs are focused within the community, acute and subacute settings offering Low to high risk programs for people >65 years . • Population Health Programs: Physical Activity Leader Network, Tai Chi, Stepping on • Community health setting: Case finding and hospital avoidance, targeted interventions- Quickscreen, post-fall care • Subacute setting: Case finding and hospital avoidance, targeted interventions, Postfall care • Acute setting : Falls risk screen, assessment, targeted interventions, post-fall care Tobacco programs are focused within the community and acute setting. Priority strategies for aboriginal communities, groups with high smoking prevalence and reducing second hand smoke. • Population health programs: supporting brief intervention – Quit for new life program. reducing second hand smoke through early childhood and primary school settings • Acute settings: development /review of appropriate local policy documents. Performance measures or Key Performance Indicators for current priorities • Live life well @school KPI of 58% (n=55) primary schools engaged by 2013 • Munch & Move KPI of 88% (n= 78), preschools engaged by 2013 • Deliver 7 Go4Fun programs , with 56 participants during 2013 • Increase participation rates for Tai Chi classes by 10% during 2013 • Reduce to zero SAC 1 (deaths) incidents due to falls in snswlhd acute / subacute facilities for people aged 65 years+ due to falls • Reduce by 20% incidents due to falls in SNSWLHD acute /subacute facilities for people aged 65 years + • 100% of Munch & Move and Live Life Well @ School settings receive information on health risks to children of second hand smoke during 2103 • Deliver 20 Stepping On programs between 2012-13 Gaps / emerging issues • Actions to support Aboriginal Tobacco Control program – cessation services • Recruitment actions to ensure participation in the Go4Fun program Public Health The operation of the public health unit transgresses socioeconomic circumstance and reduces inequalities by providing services across the region which underpin a minimum basic service or care for the population regardless of their geographic location, ethnicity or Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 32 of 43 socioeconomic situation. In the context of this health care services plan, public health operations include; Environmental health Reduce health risks by monitoring and enforcing public health legislation, including the; • Monitoring of the drinking water program ensuring communities have access to drinking water which meets the Australian Drinking Water Guidelines, • Oversight of regulated systems including cooling tower maintenance to reduce the risk of Legionalla contamination and subsequent risk to the public, • Oversight of public swimming pools and spa’s to ensure operational maintenance meets requirements, • Ensure premises which perform skin penetration procedures, do so within required regulations, • Tobacco compliance monitoring to ensure premises comply with tobacco control regulations for both smoking areas and sales and advertising of tobacco products. Immunisation • Education of immunisation providers, • Coordination of the adolescent immunisation program at schools, • Oversight of provision of vaccine and immunoglobulin to babies at risk of contracting hepatitis B, • Oversight of the appropriate storage of vaccines to ensure maximum potency of vaccines is maintained. Infectious disease control • Provide surveillance for new and existing infectious diseases, • Responding to infectious disease occurrences, including provision of control interventions such as antibiotic, antiviral, vaccination and immunoglobulin where appropriate, • Contact tracing and screening, and the provision and observed taking of medication for patients and contacts with Mycobacterium tuberculosis. HIV and Related programs • Program coordination of free public sexual health clinics, • Provision of free injecting equipment and sharps disposal facilities for intravenous drug users. Oral health services SNSW LHD - March 2013 CLINIC/SERVICES ORAL HEALTH SERVICES MANAGEMENT & ADMINISTRATION ORAL HEALTH INTAKE SERVICES (OHIS) CLINICAL DIRECTOR ORAL HEALTH INFORMATION SYSTEMS MANAGEMENT/ADMIN Manager, Oral Health Clinical Network for SNSW & Murrumbidgee LHD STAFFING LEVELS OPERATIONAL INFO 1 FTE Manager, Oral Health Clinical Network 1FTE Administration Support Officer. Five days a week Managed by Oral Health Services Manager, Coordinated by OHIS Coordinator covering SNSW & Murrumbidgee Clinical Director covering SNSW & Murrumbidgee 5 FTE Five days a week Managed by Oral Health Services Manager. 1 FTE Five days a week Oral Health Program Coordinator : Health Information Compendium – SNSW LHD Health Care Services Plan 2013-2018 1 FTE Five days a week SERVICES Management & Administration of Oral Health Services across SNSW & Murrumbidgee LHD’s. Oral Health Fee for Service Scheme in partnership with local private practices. Intake Service for patients requesting access to dental care across Murrumbidgee and Southern NSW LHD’s. Clinical oversight of all Murrumbidgee and Southern NSW LHD’s clinical services. Coordinate and support clinical services, training and development for oral health IT systems Murrumbidgee and Southern NSW LHD’s. Provide Page 33 of 43 ORAL HEALTH PROMOTION/DEVELOPMENT COOMA GOULBURN MORUYA PAMBULA Systems, covering SNSW & Murrumbidgee Managed by Oral Health Services Manager. 1 FTE Five days a week Oral Health Program Coordinator : Health Development, covering SNSW & Murrumbidgee CLINICAL SERVICES DATA SUBMITTED VIA LOCAL SITES Managed by Community Health Five days a week Services 1 Chair Clinic 2 day Part Time Dental Officer 2 days Part Time Dental/Oral Health Therapist Managed by Community Health Five days a week Services 3 chair clinic Currently: 1 FTE Dental Officer 1 Part Time Dental Officer .8 FTE Dental Therapist 2.2 FTE Dental Assistants Managed by Community Health Five days a week Services 4 chair clinic Currently: FTE G 3 FTE G 2 Dental Officer (1) FTE: 1 Dental/Oral Health Therapist (DT/OHT) FTE: 3 Currently FTE G2 DO FTE .71 DT FTE: 1 OHT Level 1 FTE: 1 2 x .8 Receptionist 16hrs a week. Managed by Community Health Five days a week Services 2 chair clinic 1 FTE Dental Therapist 1 FTE Dental Officer (vacant) BEGA REDEVELOPMENT clinical services to Albury 2 days a week. Coordinate and support oral health promotion, development projects across Murrumbidgee and Southern NSW LHD’s. Provide clinical services 1 day week to Yass. Clinical services: Adult Oral Health Services Children Oral Health Services Clinical Services: Adult Oral Health Services Children Oral Health Services Clinical Services: Adult Oral Health Services Children Oral Health Services Clinical Services: Adult Oral Health Services Children Oral Health Services Adult services provided by locum Dentists internally or Justice Health. Plans in progress for Bega: 4 chair clinic. QUEANBEYAN Managed by Queanbeyan Hospital & Community Health Services Five days a week 4 chair clinic YASS Managed by Yass Hospital & Community Health Services Three days a week 1 chair clinic 1 day Dental Therapist 1 Vacant 2 day Dental Officer position. Clinical Services: Adult Oral Health Services Children Oral Health Services Specialist Services: Oral Surgery Paediatric (from Sydney Dental Hospital) Clinical Services: Adult Oral Health Services Children Oral Health Service Adult Services: locum service provided by dentists intermittently. Oral Health Services for SNSW: • Management and Administration Services are provided from Batemans Bay Hospital. • The Oral Health Intake Service is located in Goulburn and provides ‘Intake Services’ across Murrumbidgee and Southern NSW LHD’s. • Clinical services are provided for the above sites and managed by relevant Hospital and Primary Community Health Services. • Adult Oral Health Services majority of treatment provided by Dental Officers. • Children Oral Health Services (0 to 17 year olds) are provided mainly by Dental Therapists and Oral Health Services. • Clinical services are supported by the Oral Health Fee for Service Scheme which enables eligible patients to access timely dental care via participating private practice providers in their local areas. • Oral Surgery and Paediatric Dental Specialist Services are provided for SNSW eligible patients via Queanbeyan Hospital: Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 34 of 43 Oral Surgery: twice a month Paediatric Dental Specialist: quarterly (or when Sydney Dental Hospital are able to provide extra sessions). National Partnership Agreement Funding: to reduce waiting times to access dental care in the public oral health services. Risks: • • Any decrease in staffing levels at the dental clinics may affect the ability to reach targets. Targets will be continually monitored and any remedial action such as issuing additional denture vouchers will be taken. Any decrease in private providers under the oral health fee for service scheme will impact on the number of choices for patient. This is not expected to pose any problem as the winding up of the Medicare Chronic Disease Oral Health Program has enabled the service to sign up additional providers. Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 35 of 43 Batemans Bay Hospital Bega Hospital Bombala MPS Bourke Street Health Service Braidwood MPS Cooma Hospital Crookwell Hospital Delegate MPS Goulburn Hospital Moruya Hospital Pambula Hospital Queanbeyan Hospital Yass Hospital District Group 1 MultiPurpose Services Sub-Acute MultiPurpose Services District Group 2 Community Non-Acute MultiPurpose Services District Group 1 District Group 2 Community Acute With Surgery District Group 2 Community Acute Without Surgery Pathology Pharmacy Diagnostic Imaging Nuclear Medicine Anaesthetics ICU CCU Operating Suite Emergency General Medicine Cardiology Dermatology Endocrinology Gastroenterology Haematology Immunology Infectious Diseases Neurology Oncology - Medical Oncology Radiation Renal Respiratory Rheumatology General Surgery Burns Cardiothoracic Surgery Day Surgery Ear,Nose & Throat Gynaecology Neurosurgery Ophthalmology Orthopaedics Plastic Surgery Urology Vascular Surgery Maternity Neonatology Paediatric Medicine Paediatric Surgery Family & Child Health District Group 2 Role Delineation - SNSW LHD 3 4 3 3 2 2 1 3 2 3 3 3 3 2 2 3 3 2 3 4 4 4 3 4 4 3 5 3 3 3 3 3 3 3 3 3 3 3 1 2 1 3 1 0 1 0 2 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 3 1 0 1 0 2 2 2 2 2 2 2 2 2 2 2 3 3 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 1 2 1 3 1 0 1 0 2 2 2 2 2 2 2 2 2 2 2 1 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 4 3 4 4 4 5 4 4 4 4 3 4 3 3 3 3 3 4 4 3 3 2 2 1 4 3 3 3 3 3 2 3 3 3 3 3 3 3 3 3 2 2 1 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 2 3 4 3 3 3 3 3 2 3 3 3 3 3 1 2 2 3 1 0 1 0 2 2 2 2 2 2 2 2 2 2 2 0 2 3 3 3 2 4 3 3 3 4 3 0 2 2 2 1 0 0 0 0 0 0 0 0 2 2 2 1 0 0 3 3 3 3 2 0 2 2 2 1 0 0 0 0 0 0 0 4 4 4 3 4 3 4 3 3 3 3 2 0 2 2 2 2 2 0 3 3 3 3 2 0 2 2 2 1 0 1 3 1 2 1 1 2 1 2 1 1 1 2 1 1 4 3 4 3 1 4 3 4 3 3 3 3 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3 0 3 0 0 3 1 1 1 3 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 4 4 3 3 4 3 3 3 4 3 3 3 1 3 1 3 1 0 1 1 1 1 3 2 2 1 1 3 1 2 1 1 2 1 1 1 1 1 2 1 1 3 1 3 1 0 2 1 1 1 3 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 3 2 0 2 3 2 1 4 3 2 3 2 Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 36 of 43 Adolescents Adult Mental health IP Adult Mental Health CC ChildAdol Mental Health IP ChildAdol Mental Health CC Older Adult Mental Health IP Older Adult Mental Health CC Child Protection Services Drug & Alcohol Services Geriatrics Health Promotion HIV/AIDS Palliative Care Rehabilitation Sexual Assault Services Aboriginal Health Community Health General Community Nursing Oral Health Multicultural Health Sexual Health Services Women's Health Genetics 2 3 1 0 1 2 1 1 3 2 2 2 2 1 3 1 0 1 1 1 0 4 1 1 1 1 3 3 1 0 1 3 1 1 3 3 3 3 3 1 2 0 0 0 1 0 0 3 1 1 1 0 3 3 1 0 1 3 1 1 3 3 3 3 3 1 2 1 1 1 1 1 0 2 1 1 1 1 3 3 1 0 1 2 1 1 3 3 3 3 3 1 3 1 0 1 3 1 1 3 3 1 3 1 3 2 4 2 3 3 3 4 2 3 3 4 2 2 2 2 2 0 0 0 0 0 0 0 2 2 2 2 2 0 3 3 4 2 2 3 2 2 3 2 2 0 0 0 2 0 0 0 3 3 2 3 3 3 3 3 2 2 3 3 3 2 4 2 3 3 3 3 4 2 2 3 2 2 2 2 2 0 4 5 4 5 1 1 0 0 1 1 3 1 1 1 1 1 4 3 4 5 4 5 3 3 1 3 4 5 1 1 4 5 1 2 2 2 0 1 0 0 0 0 2 2 0 1 4 4 2 1 2 2 0 1 1 2 0 1 4 5 2 1 4 5 2 1 4 5 2 2 4 5 3 1 2 2 2 1 2 3 1 2 3 1 1 2 1 0 0 0 1 2 1 1 3 1 1 2 1 1 2 1 2 3 3 2 3 1 2 3 1 2 3 1 1 2 1 Hospital Peer Group Definitions Code Value A1a Principal Referral Group A Acute hospitals, treating 25,000 or more acute casemix weighted separations per annum, with an average cost weight greater than 1 and having more than 1 specialty service. A1b Principal Referral Group B Acute hospitals, treating 25,000 or more acute casemix weighted separations per annum, with an average cost weight greater than 1 and 1 or fewer specialty services. A2 Paediatric Specialist Establishments where the primary role is to provide specialist acute care services for children. A3 Ungrouped Acute Establishments whose primary role is the provision of acute services of a specialised nature for which there is insufficient peers to form additional peer groups. Limited comparisons can be made with other hospitals in either A1 or A2. B1 Major Metropolitan Acute hospitals, treating 10,000 or more acute casemix weighted separations per annum, but having less than 25,000 acute casemix weighted separations or an average casemix weight of less than 1. Major Non-Metropolitan Acute hospitals treating 10,000 or more acute casemix weighted separations per annum that are located in rural areas providing acute specialist and referral services for a catchment population from a large geographical area. B2 Description Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 37 of 43 Code Value C1 District Group 1 Acute hospitals, treating 5,000 or more, but less than 10,000 acute casemix weighted separations per annum. C2 District Group 2 Acute hospitals, treating 2,000 or more, but less than 5,000 acute casemix weighted separations per annum, plus acute hospitals treating less than 2,000 acute casemix weighted separations per annum but with more than 2,000 separations per annum. D1a Community Acute with Surgery Acute hospitals, treating less than 2,000 acute casemix weighted separations per annum, and less than 2,000 acute separations per annum, with less than 40% non-acute and outlier bed days of total bed days and greater than 2% of their acute weighted separations being surgical. D1b Community Acute without Surgery Acute hospitals, treating less than 2,000 acute casemix weighted separations per annum, and less than 2,000 acute separations per annum, with less than 40% non-acute and outlier bed days of total bed days, and less than 2% of their acute weighted separations being surgical. D2 Community Non-Acute Non-acute hospitals, treating less than 2,000 acute casemix weighted separations per annum, and less than 2,000 acute separations per annum, with more than 40% non-acute and outlier bed days of total bed days. Psychiatric Establishments devoted primarily to the treatment and care of inpatients with psychiatric, mental or behavioural disorders. Centres of non-acute treatment of drug dependence, developmental and intellectual disability are not included here. This group also excludes institutions mainly providing living quarters or day care. Nursing Homes Establishments which provide long-term care involving regular base nursing care to chronically ill, frail, disabled or convalescent persons or senile inpatients. They must be approved by the Commonwealth Department of Health and Family Services and / or licensed by the State, or controlled by government departments. F3 Multi-Purpose Services Multi-Purpose Services (MPSs) which provide integrated acute health, nursing home, hostel, community health and aged care services under one organisational structure, as agreed between the Commonwealth and State Governments. MPSs provide a range of services which are negotiated with the community, the service providers and the relevant Departments. F4 Sub Acute Establishments that primarily provide sub-acute services, but are not specialist palliative care or specialist rehabilitation establishments. F5 Palliative Care Establishments with a specific function of providing palliative care to terminally ill patients. F6 Rehabilitation Establishments with a primary role in providing services to persons with an impairment, disability or handicap where the primary goal is improvement in functional status. F7 Mothercraft Establishments where the primary role is to help mothers acquire mothercraft skills in an inpatient setting. F1 F2 Description Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 38 of 43 Code F8 Value Description Ungrouped Non-Acute Establishments whose primary role is the provision of non-acute services, but for which there are insufficient peers to form an addition peer group. Limited comparisons can be made within this peer group and with other non-acute facilities. http://internal4.health.nsw.gov.au/hird/view_domain_values.cfm?ItemID=1246 Southern NSW Medicare Local Services as at May 2013 Table 1. Hub/location Bega Valley Eurobodalla Queanbeyan Goulburn Yass Cooma/Monaro Regional Roles • • SNSWML CLINICAL SERVICES, CARE COORDINATION SERVICES & NETWORK SERVICES 2013-14 Service Employees(headcount) Contractors Aboriginal health team Mental health practitioner Youth health worker Regional primary care coordinator Mental health practitioner Aboriginal health team Foot care nurse Speech pathologist Dietitian Regional primary care coordinator Aboriginal health team Mental health practitioner Regional primary care coordinator Mental health practitioner Aboriginal health team Regional primary care coordinator Mental health practitioner Aboriginal health team Foot care nurse Youth health worker Mental health practitioner Health promotion Regional primary care coordinator Education Workforce After Hours eHealth / Telehealth Afterhours Aged Care Youth health Health promotion Population Health Planning 7 3 1 2 10 1 1 2 1 3 0 1 2 3 1 1 1 1 1 1 1 1 1 1 1 5 1 1 2 1 2 4 1 4 4 2 1 2 *SNSWML’s Regional Primary Care Coordinators are located in each hub to work with GPs, allied health and other primary care providers to connect and integrate primary health services. This table reflects those workers involved in direct service provision and does not include management or administrative positions. Glossary ABF Access ACHS ACI ACSQHC ACT Meaning Activity Based Funding is a method of allocating funds – based on the activity or outputs of an organisation or service. The capacity or potential to obtain a quality service. Access incorporates notions of geographical access, cultural access, service appropriateness, affordability and so on. Australian Council on Healthcare Standards Agency of Clinical Innovation Australian Commission on Safety and Quality in Health Care Australian Capital Territory Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 39 of 43 Activity Meaning Refers to work done by health services measured as hospital inpatient separations and outpatient occasions of service AHMAC AIDS aIM 2012 Australian Health Ministers' Advisory Council Acquired immunodeficiency syndrome Acute Inpatient Modelling Tool- allows health planners to analyse historical trends and projected trends for acute inpatient activity for NSW hospitals, both public and private Ambulatory Care Non-inpatient care provided in settings such as outpatients departments, community care and the home AusDiab Beddays The Australian Diabetes, Obesity and Lifestyle study The number of days from admission to discharge for a particular episode of care for a patient BIU BMI CAMHS CARI CEC Chronic Diseases Brain Injury Unit Body Mass Index Child and Adolescent Mental Health Services Caring for Australians with Renal Impairments Clinical Excellence Commission are illnesses that are prolonged in duration, do not often resolve spontaneously, and are rarely cured completely. CKD CNC COAG Connecting Care Program D&A D/O Demand ECG Chronic Kidney Disease Clinical Nurse Consultant Council of Australian Government NSW Health Severe Chronic Disease Management Program - Connecting Care Drug and Alcohol Day Only Refers to the requirement for health services from the community ED EDIS EMR ESKD ESRG FirstNet Flowinfo Emergency Department Emergency Department Information System Electronic Medical Record End Stage Kidney Disease Enhanced Service Related Groups Emergency Information System (Cerner FirstNet) Ministry of Health tool that assists planners with analyses of admitted patients' data FTE GP HCSP Full Time Equivalent is equivalent to one employee working full-time. General Practitioner Health Care Services Plan- Is the overarching document identifying the key strategic clinical service directions for a defined period. HDU HETI HITH High Dependency Unit Health Education & Training Institute Hospital in the Home is the provision of acute care to public hospital patients in the comfort of the person's own home or other suitable environment. HIV ICU Inflows Human Immunodeficiency Virus Intensive Care Unit Services delivered to inpatients that reside in a District other than the one in which the service is provided Inpatient IRSD LGA LHD A patient admitted to a hospital or health service facility Index of Relative Socio-economic Disadvantage Local Government Area Local Health District- There are 18 Local Health Districts (LHD) across NSW. The LHDs are responsible of strengthening local decision make and community involvement in health service delivery. They have their own budgets, management and accountabilities for their local areas MH MHECS MLA Mental Health Mental Health Emergency Care Service Member of Legislative Assembly An electrocardiogram (ECG) is a medical test that detects cardiac (heart) abnormalities by measuring the electrical activity generated by the heart as it contracts. Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 40 of 43 MoH MOU MPS Meaning Ministry of Health Memorandum of Understanding Multipurpose Service- A facility which provide integrated acute health, nursing home, hostel, community and aged care services under one organisation structure, as agreed between the Commonwealth and the State Governments. MS NEAT Multiple Sclerosis National Emergency Access Targets- public hospitals will ensure that patients presenting to an emergency department are within four hours either: admitted to hospital;referred for followup treatment; or treated and discharged. NEST National Elective Surgery Target (NEST) - progressively increase the number of elective surgeries performed so that 100% of patients receive their elective surgery within the clinically recommended time by 2016 NHMRC NRHA Outflows National Health and Medical Research Council National Rural Health Alliance Services delivered to residents of a District/Network in a facility that is administered by a District other than that of the patient PPH Redesigning Care potentially preventable hospitalisations Redesigning Care focuses on improving the patient journey. These journeys could include anything from hospital admission to discharge, to the experience of seeking and then receiving support from a community health site. Role Delineation Redesigning Care uses Lean Thinking principles as the basis for improving the patient journey. Lean Thinking is about designing processes that focus on value adding steps in the best sequence and removing unnecessary steps. In health care this ensures the patient journey is designed to be as smooth and safe as possible. Is a process that determines the support services, staff profile, minimum safety standards and other requirements to ensure that clinical services are provided safely and appropriately. The roles range from 1(the lowest) to 6(highest level and most comprehensive service) RMS Separations Roads and Maritime Services A formal separation is a discharge, transfer to another hospital or death of a patient SERH SiAM South East Regional Hospital Sub-acute Inpatient Modelling tool- enable health planners to review subacute inpatient projections SMHSOP SNSW LHD SRG Specialist Mental Health Services for Older People Southern NSW Local Health District Service Related Groups-classification is a method of grouping hospital inpatient records into categories corresponding to clinical divisions of hospital activity Supply T Basis Transitional Care Refers to the health services that the LHD provides Transitional Behavioural Assessment & Intervention Service Triage The Transition Care Program provides goal oriented, time limited and therapy focused care to help older people at the conclusion of a hospital stay. A method of ranking sick or injured people according to the severity of their sickness or injury VMO WHO Visiting Medical Officer World Health Organisation Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 41 of 43 Organisational Responsibilities SNSWLHD As at May 2013 Board Responsible for: Chief Executive Director Clinical Governance Director Finance Director Medical Services Director Service Improvement Director Community Health Director MHDA • Public Affairs • Corporate Record Management Director Executive Services Unit SNSWLHD Director Audit and Governance Director Nursing & Midwifery General Manager Eurobodalla General Manager Goulburn General Manager Manager People and Culture Bega Valley Responsible for: Responsible for: Responsibl e for: Responsible for: Responsible for: Responsibl e for: Responsible for: Responsible for: Responsible for: Responsible for: Responsible for: • Accreditation • Patient Safety & Quality Program • Enterprise Wide Risk Management • Policy System • Professional Practice • Research governance • Consumer Liaison & MedicoLegal • Finance • Information Management • Corporate Services • Contract management • Asset Management • Waste management • Medical Workforce • Pharmacy • Radiology • Pathology • Critical Care • • Activity reporting & analysis • Health Information Management • Patient Flow and Wait lists • Clinical Service Redesign • Clinical Service Planning • Population Health • Aboriginal Health • Violence Prevention and Care • Women’s Health, Child, Youth & Family • Aged Care Programs • Chronic Care • Oral Health • Palliative Care • Allied Health • Community Health strategy • Mental Health Services • Drug and Alcohol Services • CNC’s – various clinical streams •• Nursing Nursing Workforce • Nursing Policy Policy • Nursing Education • Nursing Projects • Smaller sites & Community Health Services – – Services Qbyn, Braidwood, Crookwell, Yass, Cooma, Bombala & Delegate • Breastscreen • Moruya Hospital and Community Health • Batemans Bay Hospital and Community Health • Narooma Community Health • Goulburn Hospital and Community Health • Bourke St Health Service • Bega Hospital and Community Health • Pambula Hospital and Community Health • Eden Community Health • Workforce Planning • HR Operations • Workforce Health, Safety & Wellbeing • Workforce relations Compendium – SNSW LHD Health Care Services Plan 2013-2018 Page 43 of 43