Activity and infrastructure projections 2019–2032

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Wide Bay Hospital and Health Service Activity and infrastructure projections 2019–2032

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This version was formally approved by the Wide Bay Hospital and Health Board on 5 November 2019

For further information please contact:Office of Chief Executive Wide Bay Hospital and Health Service Bourbong Street, Bundaberg QLD 4670 PO Box 34, Bundaberg, QLD 4670 [email protected]

www.health.qld.gov.au/widebay | ABN 67 558 031 153

This work is licensed by the State of Queensland (Wide Bay Hospital and Health Service) under a Creative Commons Attribution (CC BY) 4.0 International license.

You are free to copy, communicate and adapt this annual report, as long as you attribute the work to the State of Queensland (Wide Bay Hospital and Health Service). To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

© Wide Bay Hospital and Health Service 2019.

An electronic version of this document is available at www.health.qld.gov.au/widebay/publications

Wide Bay Hospital and Health Service respectfully acknowledges the Traditional Custodians of the land and water on which we work and live. We pay our respects to Elders and leaders past, present and emerging.W

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ContentsIntroduction 3

Methodology 5

Future facilities 7Bundaberg Hospital 7

Hervey Bay Hospital 9

Maryborough Hospital 11

Childers Multipurpose Health Service 14

Monto Hospital 15

Gin Gin Hospital 16

Gayndah Hospital 17

Mundubbera Multipurpose Health Service 18

Eidsvold Multipurpose Health Service 19

Appendix A — Infrastructure assumptions 20

3Activity and infrastructure projections 2019–2032

IntroductionThe following document describes the Wide Bay Hospital and Health Service’s (WBHHS) future service profile within the context of the strategies outlined in the WBHHS Health Service Plan (HSP) 2019–2032.

This addendum is a supporting document to the Wide Bay Hospital and Health Service Health Service Plan 2019–2032, aligning to five key strategic priorities for now and into the future:

Right care, right place, right time — Our first priority will be to grow our services through a consistent service model that provides more care closer to home for our communities.

Transform and optimise — We will continue to transform and optimise our services through new models of care and better integration across the health continuum; as well as partnering with other local providers to ensure we are supporting our communities to access the right care, in the right place, at the right time.

Infrastructure for the future — We will continue to plan for the future of our infrastructure, focusing on the sustainable growth, transformation and optimisation of our existing capacity.

Develop our future workforce — We are committed to developing and maintaining a skilled and sustainable local workforce, that understands and is working to their full scope of practice.

Modernise through research, education and technology — Our organisation is committed to creating a sustainable, future-focused health service by embedding research, education and technology in everything that we do.

The addendum describes the WBHHS’s future service profile within the context of these strategic priorities in terms of projected activity, infrastructure requirements and service capability. The following document provides two projection scenarios for WBHHS future activity and infrastructure projections — the baseline and an alternative projection scenario.

Demand pressureWBHHS is experiencing significant service and infrastructure pressure. This pressure is being driven by a growing population that, when compared to Queensland, is significantly older, more socioeconomically disadvantaged, and with higher rates of complex chronic disease. The WBHHS response to the service pressure to date has included a number of initiatives, including:

• service optimisation initiatives across WBHHS where the equivalent of approximately 100 beds have been avoided across the WBHHS since 2012 (key initiatives are identified in Figure 14 on page 17 of the HSP).

• leveraging rural facilities.

• outsourcing arrangements for select clinical services to local private providers.

Despite these strategies, WBHHS is expected to continue to experience significant service and infrastructure pressure over the next 13 years.

• Under the baseline, demand for WBHHS inpatient services is projected to grow by 4.0 per cent per annum between now and 2031–32 equating to an additional 46,737 separations.

• This growth is projected to require the construction of an additional 371 beds (including existing cold shell beds for Bundaberg Hospital). Note: the baseline projections account for ongoing and planned Transform and Optimise initiatives for Bundaberg Hospital.

• The implementation of planned Transform and Optimise initiatives (modelled as the scenario) will see this growth decrease to 3.7 per cent per annum, amounting to 4,278 separations less than projected baseline activity in 2031–32.

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Over the next 20 years, demand for services is projected to increase significantly in line with population growth and demographics, as well as planned CSCF Level 5 services growth. This will impact activity levels and required infrastructure under both baseline and scenario assumptions.

Demand pressure cont.• This is expected to have the impact of 45 beds

avoided by 2031–32, reducing the total projected bed requirement to 326 beds (including existing cold shell beds) by 2031–32.

• The scenario methodology does not impact the emergency department (ED), outpatient or mental health activity, however all facilities are expected to experience growth in the number of presentations to the ED and occasions of service for outpatients.

• Bundaberg Hospital and Maryborough Hospital are projected to experience growth in mental health activity, noting that activity and infrastructure projections outlined in this document do not reflect plans to develop an acute mental health facility and capacity at Hervey Bay Hospital.

Both activity profiles require significant investment in new and fit-for-purpose infrastructure to safely manage increased demand for services over the next 13 years. In either case, WBHHS will require an interim demand and bed management strategy for each facility to ensure the needs of the community are met with current infrastructure, either due to the commissioning of new infrastructure or because WBHHS facilities will be at capacity. The following facility profiles provide detailed activity and infrastructure projections for each WBHHS facility to support future planning for infrastructure and service delivery.

Figure 1: WBHHS projected future infrastructure – baseline and scenario

2019 2022 2027 2032

Existing Baseline gap Scenario gap

100

300

500

700

900

0

200

400

600

800

1000

371beds

326beds

Includes: acute, subacute, maternity and cardiac care beds. Excludes: renal dialysis, chemotherapy, theatres, intervention suites (and recovery beds), and emergency department infrastructure.

#FY22 values are interpolated.

NOTE: AIM infrastructure projections have been developed in accordance with the Department of Health endorsed Estimated Future Activity (EFA), service and infrastructure benchmarking methodologies, and are based on service access and population trends over the last five years.


MethodologyThe following document provides two projection scenarios for WBHHS future activity and infrastructure projections — the baseline and an alternative projection scenario.

Baseline methodologyThe WBHHS future activity and infrastructure projections have been developed in accordance with the Department of Health endorsed Estimated Future Activity (EFA), service and infrastructure benchmarking methodologies (refer to Appendix A). Under the baseline, all facility activity profiles, with the exception of Bundaberg Hospital, assume a continuation of the current patient flow and service utilisation patterns to estimate future demand for services. This activity profile is then converted into an estimated infrastructure requirement based on the Department of Health methodology — where current state assumptions differ from the planning benchmark, leading to differences between actual (existing) physical infrastructure and projected infrastructure.

Bundaberg Hospital baseline activity profile has been modified to account for the impact of ongoing and planned Transform and Optimise initiatives in line with the Bundaberg Hospital 2019 Preliminary Business Case. This baseline activity profile has been agreed with the Department of Health as part of the Bundaberg Hospital 2019 Preliminary Business Case process. This means that under both the baseline and scenario projections, Bundaberg Hospital’s activity and infrastructure profile accounts for ongoing and planned “transform and optimise” initiatives, and aligns with the Bundaberg Hospital 2019 Preliminary Business Case.

Alternative scenario methodologyThe alternative scenario applies two adjustments to the baseline activity profile to take into account planned Transform and Optimise initiatives in line with the HSP and strategic direction of WBHHS. The adjustments to the baseline are consistent with the methodology applied to Bundaberg Hospital in the Bundaberg Hospital 2019 Preliminary Business Case applied across all facilities. The scenario adjustments include:

• Optimise: for the purpose of quantifying the impact of Optimise initiatives, the target utilisation rate on acute beds for Hervey Bay and Maryborough Hospital has been increased above the Department of Health’s endorsed guidelines which have been used for the Baseline projections— to 90 per cent for acute overnight beds (from 85 per cent under the guidelines) and 200 per cent for acute same day beds (from 170 per cent under the guidelines). Note: this does not mean that the HHS intends to operate at a higher utilisation rate but that this assumption has been used to quantify the potential impact of Optimise initiatives. This reduces the number of beds required.

• Transform: the potential bed impact of additional Transformation initiatives has been modelled by targeting a reduction in the crude Potentially Preventable Hospitalisation rate in the Hervey Bay and Maryborough regions to the current state-wide average (noting that on an age standardised rate, WBHHS performs well). It is estimated that by 2021–22 achieving the current state-wide average crude rate would result in 4,278 fewer separations and 8,804 fewer bed days (assuming PPH separations currently have an average length of stay of 2.5 days for Hervey Bay Hospital and 1.5 days for Maryborough Hospital). WBHHS is currently developing or implementing a range of initiatives that will transform their models of service delivery and achieve this target. The impact of meeting this target by 2021–22 has then been modelled through to 2031–32. This results in a reduction in bed requirements.

The following facility profiles outline both baseline and scenario infrastructure profiles for each WBHHS facility, noting that only Hervey Bay and Maryborough facilities have been impacted by the scenario assumptions.

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MethodologyThe activity and infrastructure projections presented in this report are based on the following data sources and assumptions, and should be read in consideration of a number of limitations.

Data sources• WBHHS’s future activity and infrastructure

projections have been developed for the period to 2036–37, in accordance with Queensland Health endorsed EFA, service and infrastructure benchmarking methodologies.

• Mental Health activity and infrastructure projections have been developed in accordance with the National Mental Health Service Planning Framework. These projections do not extend out to 2031–32.

• The baseline for the inpatient activity and infrastructure projections is the 2015-16 Activity Inpatient Modelling (AIM) outputs provided by the Department of Health.

• The AIM tool provides projections based on the historical trend of activity, current utilisation of services and current referral patterns. The tool generates a base case model of projected activity, which is distributed across hospitals in accordance with current referral patterns to extrapolate a projection based on historical trends.

• The base case projection sensitivity (confidence level) is affected by population projections, past hospital admission practices, the assumption that private sector will continue to provide services at the current rate and changes to service delivery.

• The projections are provided to assist in the health service planning process and are not a guarantee or commitment by the Department of Health.

• The baseline for all other activity (procedures and interventions, emergency department and outpatient) and infrastructure projections is the 2015–16 Non AIM output provided by the Department of Health.

• All current infrastructure information was provided by WBHHS Senior and Executive stakeholders based on a standardised infrastructure data request, and other reporting mechanisms.

Key assumptions and limitations of the baseline and scenario methodology

• The activity and infrastructure projections presented in this addendum are based on the Department of Health’s endorsed activity projection and infrastructure requirement methodology, including endorsed occupancy/utilisation benchmarks.

• Current built capacity (referred to as existing beds) of WBHHS facilities does not align to projected capacity requirements (referred to as projected beds) under both baseline and scenario projections. This reflects the difference between calculated bed requirements (based on actual activity) and existing built capacity.

• Current built capacity was provided by WBHHS Senior and Executive stakeholders. Where current built capacity was unable to be determined, a “–” has been used — this symbol does not necessarily mean that no infrastructure exists.

• While some facilities are not projected to reach capacity in terms of number of beds, this does not mean that these facilities will not require investment in infrastructure to provide appropriate spaces for the delivery of services and to support staff safety.

• Limitations of the projection methodology need to be considered when using projections to inform future planning. Key limitations include:

• The projections are based on a set of assumptions and changes to the assumptions may result in different projections.

• It is important to note that projections are not intended to function as exact forecasts, but to give an indication of what might be expected if the stated assumptions were to apply over the projected time frame.

• The projections do not account for future changes to policy or models of care beyond those which are known when undertaking the projections.


Future facilitiesBundaberg HospitalUnder the baseline, Bundaberg Hospital inpatient activity is projected to grow by 4.0 per cent per annum to 2031–32. This aligns to activity projections that underpin the 2019 Bundaberg Hospital Business Case which outlines infrastructure options for a new or significantly refurbished Bundaberg Hospital. Activity projections under the scenario are consistent with baseline projections (i.e. no change).

Table 1: Bundaberg Hospital projected future baseline and scenario activity accounting for public activity currently provided in private hospitals on a contract basis)

Service

Current Baseline Scenario

Base

line t

o Sc

enar

io ch

ange

Base** FY22 FY27 FY32

Change in

volume CAGR* FY22 FY27 FY32

Change in

volume CAGR*

Inpatient 22,612 30,897 36,793 42,131 19,519 4.0% 30,897 36,793 42,131 19,519 4.0% –Procedures & Interventions

– 28,823 35,295 39,817 10,994 3.3% 28,823 35,295 39,817 10,994 3.3% –

Interventional Cardiology***

– – 1,117 1,117 – – – 1,117 1,117 – – –

Radiotherapy – Treatment

– 6,458 7,350 8,214 1,756 2.4% 6,458 7,350 8,214 1,756 2.4% –

Chemotherapy – 3,119 3,551 3,969 850 2.4% 3,119 3,551 3,969 850 2.4% –Endoscopy – 4,534 6,054 6,692 2,158 4.0% 4,534 6,054 6,692 2,158 4.0% –Renal Dialysis – 14,712 17,223 19,825 5,113 3.0% 14,712 17,223 19,825 5,113 3.0% –

Emergency Department

50,100 59,018 68,694 78,374 28,274 3.2% 59,018 68,694 78,374 28,274 3.2% –

Outpatients 135,037 160,344 191,725 219,060 84,023 3.3% 160,344 191,725 219,060 84,023 3.3% –Mental Health (beddays)***

– 15,938 16,649 – 710 0.9% 15,938 16,649 – 710 0.9% –

Source: Department of Health endorsed AIM and Non-AIM activity projections for FY19 planning

*CAGR is calculated for the longest possible period based on available data e.g. for Inpatients, this is FY16–FY32; for Mental Health this is FY22–FY27; for Outpatients this is FY17–FY32.

**Base year data reflects Department of Health endorsed AIM and Non-AIM activity projections therefore there is a differential between base projection data and WBHHS historical activity data. Divided by 365, divided by 95 per cent .

*** Interventional cardiology activity in 2026–27 reflects current public activity provided in the private sector, as well as increases in activity as part of the reverse flow of Level 5 CSCF services planned. It is consistent with the Bundaberg Hospital Preliminary Business Case and will ultimately depend on the development option pursued.

****National Mental Health Service Planning Framework projections provided for Mental Health do not extend out to 2031/32..

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Bundaberg HospitalTo accommodate the projected growth in activity, Bundaberg Hospital will require an additional 167 beds* by 2031–32. This growth will exceed Bundaberg Hospital’s existing infrastructure and is in line with the Bundaberg Hospital 2019 Preliminary Business Case. The scenario will see no change to baseline infrastructure projections.

Table 2: Bundaberg Hospital projected future baseline and scenario infrastructure requirements accounting for public activity currently provided in private hospitals on a contract basis

Services

Current Baseline Scenario Baseline to Scenario change 2019 FY22 FY27 FY32 CAGR** FY22 FY27 FY32 CAGR**

Beds and alternativesAcute Inpatient 150 193 247 267 3.3% 193 247 267 3.3% –

Acute – same day*** 23 26 29 33 2.4% 26 29 33 2.4% –Acute – overnight*** 107 150 204^ 221^ 4.0% 150 204^ 221^ 4.0% –Maternity – same day – – 1 1 – – 1 1 - –Maternity – overnight 20 17 13 12 -3.4% 17 13 12 -3.4% –

Subacute InpatientSubacute – same day – – – – – – – – – –Subacute – overnight 27 29 31 36 2.2% 29 31 36 2.2% –

Support ServicesIntensive care unit 8 10 12 13 2.7% 10 12 13 2.7%Cardiac care beds 0 6 7 8 2.9% 6 7 8 2.9% –

Mental Health 12 34 36 36 34 36 36Acute 12 18 19 19 0.5% 18 19 19 0.5% –Non-acute (hospital based) – 12 13 13 0.8% 12 13 13 0.8% –Sub-acute (hospital based) – 4 4 4 – 4 4 4 – –

AlternativesRenal Dialysis Chairs 23 25 28 32 2.5% 25 28 32 2.5% –Chemotherapy Chairs 12 – 8 8 – – 8 8 – –

Suites and roomsOperating theatre

Theatres 4 5 7 7 3.4% 5 7 7 3.4% –Theatre recovery 7 9 11 11 2.0% 9 11 11 2.0% –

Endoscopy suiteEndoscopy Suite 1 2 3 3 4.1% 2 3 3 4.1% –Endoscopy Suite Stage 1 and 2 Recovery

– – 18 18 – – 18 18 – –

Cardiac catheterisation labCatheterisation Lab 0 0 1 2 – 0 1 2 – –Catheterisation Lab Stage 1 and 2 recovery

– – 3 6 – – 3 6 – –

Suites and TheatresBirthing Suite 4 4 4 4 – 4 4 4 – –Special Care Nursery 8 7 7 7 - 7 7 7 – –

Outpatient Outpatient Clinic Rooms – 36 42 49 3.1% 36 42 49 3.1% –

Emergency Department Treatment Spaces 21 29 39 45 4.5% 29 39 45 4.5% –Resuscitation Bays 3 4 6 7 5.8% 4 6 7 5.8% –Isolation Rooms 1 3 5 5 5.2% 3 5 5 5.2% –ED Short Stay 13 13 13 15 1.4% 13 13 15 1.4% –

Source: Department of Health endorsed AIM and Non-AIM activity projections for FY19 planning.

*Projected growth in bed requirements (including Acute and Subacute Inpatient, Support Services and Recovery Beds, and excluding Mental Health, Alternatives, Suites and Theatres, Outpatient and Emergency Department) is 167 by FY32 (includes 30 beds of shell space and assumes that 8 of the existing (current) overnight maternity beds would be repurposed) — following the modelled implementation of additional transform and optimise strategies.

**CAGR is calculated between FY22 and FY32.

***Acute same day and overnight beds include Paediatric same day and overnight beds.

^Acute overnight bed projections for FY27 and FY32 account for 30 bed cold shell space.

Note: Accommodation Plan for the Bundaberg Hospital (included in the Bundaberg Hospital 2019 Preliminary Business Case) differs as a result of the ward and faculty configuration. .


Hervey Bay HospitalUnder the baseline, Hervey Bay Hospital inpatient activity is projected to grow by 4.0 per cent per annum to 2031–32. Under the scenario, Hervey Bay inpatient activity is projected to grow by 3.5 per cent per annum and be 2,385 separations less than baseline activity projections in 2031–32 — this reflects a reduction in the crude PPH rate in the Hervey Bay region.

Table 3: Hervey Bay Hospital projected future baseline and scenario activity accounting for public activity currently provided in private hospitals on a contract basis

Service


Base

line t

o Sc

enar

io ch

ange

Base** FY22 FY27 FY32

Change in


Change in

volume CAGR*

Inpatient 18,220 23,400 28,810 34,069 15,849 4.0% 21,762 26,793 31,684 13,464 3.5% -2,385Procedures & Interventions

– 21,124 24,449 27,553 6,429 2.7% 21,124 24,449 27,553 6,429 2.7% –

Radiotherapy - Treatment

– 6,458 7,350 8,214 1,756 2.4% 6,458 7,350 8,214 1,756 2.4% –

Chemotherapy – 5,461 6,217 6,948 1,487 2.4% 5,461 6,217 6,948 1,487 2.4% –Endoscopy – 1,180 1,487 1,577 397 2.9% 1,180 1,487 1,577 397 2.9% –Renal Dialysis – 8,025 9,395 10,814 2,789 3.0% 8,025 9,395 10,814 2,789 3.0% –


35,789 39,341 43,781 48,212 12,423 2.2% 39,341 43,781 48,212 12,423 2.2% –

Outpatients 97,737 116,425 140,925 163,357 65,620 3.5% 116,425 140,925 163,357 65,620 3.5% –



**Base year data reflects Department of Health endorsed AIM and Non-AIM activity projections therefore there is a differential between base projection data and WBHHS historical activity data.

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Hervey Bay HospitalTo accommodate the projected growth in baseline activity, Hervey Bay Hospital will require an additional 110 beds* by 2031–32. This growth will exceed Hervey Bay Hospitals existing infrastructure. Under the scenario, Hervey Bay will require 31 less beds in 2031–32 (79 beds in total) when compared to the baseline projection of 110 beds by 2031–32. This reflects increased utilisation of acute overnight and same-day beds, and a reduction in PPH.

Table 4: Hervey Bay Hospital projected future baseline and scenario infrastructure requirements accounting for public activity currently provided in private hospitals on a contract basis

ServicesCurrent Baseline Scenario

Baseline to Scenario change 2019 FY22 FY27 FY32 CAGR** FY22 FY27 FY32 CAGR**

Beds and alternativesAcute Inpatient 153 182 213 243 2.9% 160 187 212 2.9% -31

Acute – same day*** 8 19 25 31 5.0% 14 19 23 5.1% -8Acute – overnight*** 131 151 176 200 2.9% 134 156 177 2.8% -23Maternity – same day 1 1 1 – 1 1 1 – –Maternity – overnight 14 11 11 11 – 11 11 11 – –

Subacute Inpatient Subacute – same day 1 2 2 7.2% 1 2 2 7.2% –Subacute – overnight**** – – – – – – – – –

Support Services – – – – – – – – –Intensive care unit 5 7 8 9 2.5% 7 8 9 2.5% –Cardiac care beds 3 4 5 5 2.3% 4 5 5 2.3% –

Mental Health***** Acute 16 17 17 0.6% 16 17 17 0.6% –

Alternatives Renal Dialysis Chairs 14 13 16 18 3.3% 13 16 18 3.3% –Chemotherapy Chairs****** 14 13 14 16 2.1% 13 14 16 2.1% –

Suites and rooms Operating theatre – –

Theatre (including endoscopy)

4 4 5 6 4.1% 4 5 6 4.1% –

Theatre Recovery 6 7 8 2.9% 6 7 8 2.9% –Endoscopy suite – –

Endoscopy Suite 1 1 1 – 1 1 1 – –Endoscopy Suite Stage 1 and 2 Recovery

2 4 4 7.2% 2 4 4 7.2% –

Suites and Theatres Birthing Suite 3 3 5 5 2.9% 3 5 5 2.9% –Special Care Nursery 8 5 6 6 1.8% 5 6 6 1.8% –

Outpatient Outpatient Clinic Rooms 21 25 29 3.3% 21 25 29 3.3% –

Emergency Department – – Treatment Spaces 32 23 26 28 2.0% 23 26 28 2.0% –Resuscitation Bays 4 4 5 6 4.1% 4 5 6 4.1% –Isolation Rooms 4 3 3 4 2.9% 3 3 4 2.9% –ED Short Stay 10 8 9 10 2.3% 8 9 10 2.3% –Safe Assessment Room 1 – – Procedure Room 5 – –

Source: Department of Health endorsed AIM and Non-AIM activity projections for FY19 planning.*Projected growth in bed requirements (including Acute and Subacute Inpatient, Support Services and Recovery Beds, and excluding Mental Health, Alternatives, Suites and Theatres, Outpatient and Emergency Department) is 96 beds by FY32 (assumes that 3 of the existing (current) overnight maternity beds would be repurposed) - following the modelled implementation of additional transform and optimise strategies. **CAGR is calculated between FY22 and FY32.***Acute same day and overnight beds include Paediatric same day and overnight beds. ****Subacute overnight beds have been added to Acute overnight bed projections based on feedback from WBHHS Executive Stakeholders.*****Mental Health beds calculated and apportioned by applying ratio of Bundaberg Hospital beddays to beds to Maryborough Hospital beddays in FY22 and FY27. Acute infrastructure has been allocated to Hervey Bay as part of future service direction to develop acute mental health capacity. Infrastructure for FY32 has been calculated based on FY27 beddays. ******1 chemotherapy chair that was projected for Maryborough has been added to Hervey Bay infrastructure requirements in line with the directions and future service model outlined in the WBHHS Health Service Plan. Note: Infrastructure projections do not account for any cold shell space at Hervey Bay.


Maryborough HospitalUnder the baseline, Maryborough Hospital inpatient activity is projected to grow by 4.3 per cent per annum to 2031–32. Under the scenario, Maryborough Hospital inpatient activity is projected to grow by 3.4 per cent per annum and be 1,894 separations less than projected baseline activity in 2031–32 — this reflects a reduction in the crude PPH rate across the Maryborough region.

Table 5: Maryborough Hospital projected future baseline and scenario activity accounting for public activity currently provided in private hospitals on a contract basis

Services

Current Baseline ScenarioBaseline

to Scenario changeFY18 FY22 FY27 FY32

Change in


Change in

volume CAGR*

Inpatient 7,426 9,854 12,221 14,566 7,140 4.3% 8,573 10,632 12,672 5,246 3.4% -1,894Procedures & Interventions

– 6,705 8,070 9,023 2,318 3.0% 6,705 8,070 9,023 2,318 3.0% –

Chemotherapy – 292 333 372 80 2.5% 292 333 372 80 2.5% –Endoscopy – 2,401 3,040 3,244 843 3.1% 2,401 3,040 3,244 843 3.1% –Renal Dialysis – 4,012 4,697 5,407 1,395 3.0% 4,012 4,697 5,407 1,395 3.0% –


19,783 21,748 23,657 25,455 5,672 1.8% 21,748 23,657 25,455 5,672 1.8% –

Outpatients 37,369 46,724 58,018 68,574 31,205 4.1% 46,724 58,018 68,574 31,205 4.1% –Mental Health (beddays)

– 13,796 14,333 – 536 0.8% 13,796 14,333 – 536 0.8% –




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Maryborough HospitalTo accommodate the projected growth in activity, Maryborough Hospital will require an additional 84 beds* by 2031–32. This growth will exceed Maryborough Hospitals existing infrastructure. Under the scenario, Maryborough Hospital will require 15 less inpatient beds in 2031–32 (69 beds in total) when compared to baseline projection of 84 beds by 2031–32. This reflects increased utilisation of acute overnight and sameday beds, and a reduction in PPH.

Table 6: Maryborough Hospital projected future baseline and scenario infrastructure requirements accounting for public activity currently provided in private hospitals on a contract basis

Services

Current Baseline Scenario Baseline to Scenario change

2019 FY22 FY27 FY32 CAGR** FY22 FY27 FY32 CAGR**

Beds and alternativesAcute Inpatient 42 39 49 58 4.0% 30 38 44 3.9% -14

Acute – same day*** 6 15 19 22 3.9% 10 13 15 4.1% -7Acute – overnight*** (inc multipurpose beds)

36 24 30 36 4.1% 20 25 29 3.8% -7

Maternity – same day –Maternity – overnight – – – – – – – – –

Subacute InpatientSubacute – same day – – –Subacute – overnight 42 72 82 95 2.8% 72 82 95 2.8% –

Support ServicesIntensive care unit – – –Cardiac care beds 4 4 4 – 4 4 4 – –

Mental Health****Non-acute (hospital based) 14 11 11 11 – 11 11 11 – –Sub-acute (hospital based) 3 3 3 – 3 3 3 – –

AlternativesRenal Dialysis Chairs 6 7 8 9 2.5% 7 8 9 2.5% –Supportive Therapies***** 6 1 1 1 – 1 1 1 – –

Suites and rooms Operating theatre – – –

Theatre (including endoscopy) 1 1 1 – 1 1 1 – –Theatre Recovery 2 2 2 – 2 2 2 – –

Endoscopy suite – – –Endoscopy Suite 1 2 2 7.2% 1 2 2 7.2% –Endoscopy Suite Stage 1 and 2 Recovery

6 8 8 2.9% 6 8 8 2.9% –

Suites and Theatres Birthing Suite – – – – –Special Care Nursery – – –


Emergency Department Treatment Spaces 18 12 13 15 2.3% 12 13 15 2.3% –Resuscitation Bays 2 3 3 4.1% 2 3 3 4.1% –Isolation Rooms 1 2 2 2 – 2 2 2 – –ED Short Stay 4 4 5 5 2.3% 4 5 5 2.3% –

Source: Department of Health endorsed AIM and Non-AIM activity projections for FY19 planning.*Projected growth in bed requirements (including Acute and Subacute Inpatient, Support Services and recovery beds, and excluding Mental Health, Alternatives, Suites and Theatres, Outpatient and Emergency Department) is 96 beds by 2032 (assuming that 3 of the existing (current) overnight maternity beds would be repurposed) — following the modelled implementation of additional transform and optimise strategies. **CAGR is calculated between FY22 and FY32.***Acute same day and overnight beds include Paediatric same day and overnight beds.****Mental Health beds calculated and apportioned by applying ratio of Bundaberg Hospital beddays to beds to Maryborough Hospital beddays in FY22 and FY27. Infrastructure for FY32 has been calculated based on FY27 beddays. *****1 chemotherapy chair that was projected for Maryborough has been added to Hervey Bay infrastructure requirements in line with the directions and future service model outlined in the WBHHS Health Service Plan. Note: Infrastructure projections do not account for any cold shell space at Hervey Bay.


Biggenden Multipurpose Health ServiceBiggenden Multipurpose Health Service inpatient activity is projected to grow by 3.4 per cent per annum out to 2031–32 under both baseline and scenario projections. It is projected that the health facility will require no additional beds to accommodate this growth.

Table 7: Biggenden Multipurpose Health Service projected future baseline and scenario activity requirements

Services

Current Baseline Scenario Baseline to

Scenario change

Base FY22 FY27 FY32 Change in

volume

CAGR* FY22 FY27 FY32 Change in

volume

CAGR*

Inpatient 345 421 505 587 242 3.4% 421 505 587 242 3.4% –

Emergency Department 972 1,038 1,095 1,152 180 1.2% 1,038 1,095 1,152 180 1.2% –

Outpatients 2,292 2,753 3,331 3,875 1,583 3.6% 2,753 3,331 3,875 1,583 3.6% –


*CAGR is calculated for the longest possible period based on available data e.g. for Inpatients, this is FY16–FY32; for Mental Health this is FY22–FY27; for outpatients this is FY17–FY32.


Table 8: Biggenden Multipurpose Health Service projected future baseline and scenario infrastructure requirements

Services

Current Baseline Scenario Baseline to Scenario change 2019 FY22 FY27 FY32 CAGR* FY22 FY27 FY32 CAGR*

Acute Inpatient 7 4 5 5 4.10% 4 5 5 4.10% –Acute – same day 1 1 1 1 1 1 Acute – overnight 7 3 4 4 3.40% 3 4 4 3.40% –

Subacute Inpatient Subacute – overnight 2 2 2 0.90% 2 2 2 0.90% –


Emergency Department Treatment Spaces 1 1 1 1.80% 1 1 1 1.80% –


*Note CAGR is calculated between FY22 and FY32

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Childers Multipurpose Health ServiceChilders Multipurpose Health Service inpatient activity is projected to grow by 2.9 per cent per annum out to 2031–32 under both baseline and scenario projections. It is projected the health facility will require no additional beds to accommodate this growth.

Table 9: Childers Multipurpose Health Service projected future baseline and scenario activity requirements

Services


Baseline to Scenario change Base FY22 FY27 FY32

Change in


Change in

volume CAGR*

Inpatient 531 698 874 1,046 515 4.3% 698 874 1,046 515 4.3% –Emergency Department 2,078 2,297 2,315 2,333 255 0.8% 2,297 2,315 2,333 255 0.8% –

Outpatients 1,819 2,185 2,644 3,075 1,256 3.6% 2,185 2,644 3,075 1,256 3.6% –




Table 10: Childers Multipurpose Health Service projected future baseline and scenario infrastructure requirements

Services


Acute Inpatient 16 7 9 11 4.6% 12 14 16 2.9% –Acute – same day 1 1 1 0.0% 1 1 1 0.0% –Acute – overnight 16 6 8 10 5.2% 6 8 10 5.2% –




Treatment Spaces 2 2 2 0.0% 2 2 2 0.0% –ED Short Stay 1 1 1 0.0% 1 1 1 0.0% –




Monto HospitalMonto Hospital inpatient activity is projected to grow by 2.7 per cent per annum out to 2031–32 under both baseline and scenario projections. It is projected that the health facility will require no additional infrastructure to accommodate this growth.

Table 11: Monto Hospital projected future baseline and scenario activity requirements

Services



Change in


Change in

volume CAGR*

Inpatient 600 703 813 922 322 2.7% 703 813 922 322 2.7% –


1,094 1,206 1,307 1,409 315 1.8% 1,206 1,307 1,409 315 1.8% –

Outpatients 2,242 2,694 3,260 3,791 1,549 3.6% 2,694 3,260 3,791 1,549 3.6% –

Source: Department of Health endorsed AIM and Non-AIM activity projections for FY19 planning*CAGR is calculated for the longest possible period based on available data e.g. for Inpatients, this is FY16–FY32; for Mental Health this is FY22–FY27; for outpatients this is FY17–FY32.


Table 12: Monto Hospital projected future baseline and scenario infrastructure requirements

Services



Subacute Inpatient Subacute – overnight

4 4 4 0.0% 4 4 4 0.0% –

Outpatient Outpatient Clinic Rooms

1 1 2 7.2% 1 1 2 7.2% –


Treatment Spaces 1 1 1 0.0% 1 1 1 0.0% –



16

Gin Gin HospitalGin Gin Hospital inpatient activity is projected to grow by 3.8 per cent per annum between now and 2031–32 under both baseline and scenario projections. To accommodate this growth, it is projected that the health facility will require an additional 7 beds by 2031–32.

Table 13: Gin Gin Hospital projected future baseline and scenario activity requirements

Services



Change in


Change in

volume CAGR*

Inpatient 692 895 1,091 1,253 561 3.8% 895 1,091 1,253 561 3.8% –Emergency Department 3,043 3,229 3,408 3,587 544 1.2% 3,229 3,408 3,587 544 1.2% –

Outpatients 2,630 3,159 3,823 4,446 1,817 3.6% 3,159 3,823 4,446 1,817 3.6% –




Table 14: Gin Gin Hospital projected future baseline and scenario infrastructure requirements

Services


Acute Inpatient 6 7 8 9 2.5% 7 8 9 2.5% –

Acute – same day 1 1 1 0.0% 1 1 1 0.0% –

Acute – overnight 6 6 7 8 2.9% 6 7 8 2.9% –Subacute Inpatient

Subacute – overnight 4 4 4 0.0% 4 4 4 0.0% –







Gayndah HospitalGayndah Hospital inpatient activity is projected to grow by 2.6 per cent per annum out to 2031–32 under both baseline and scenario projections. It is projected that the health facility will require no additional infrastructure to accommodate this growth.

Table 15: Gayndah Hospital projected future baseline and scenario activity requirements

Services



Change in


Change in

volume CAGR*

Inpatient 491 564 652 735 244 2.6% 564 652 735 244 2.6% –Emergency Department 1,186 1,338 1,480 1,622 436 2.3% 1,338 1,480 1,622 436 2.3% –

Outpatients 2,954 3,549 4,295 4,995 2,041 3.6% 3,549 4,295 4,995 2,041 3.6% –




Table 16: Gayndah Hospital projected future baseline and scenario infrastructure requirements

Services









18

Mundubbera Multipurpose Health ServiceMundubbera Multipurpose Health Service inpatient activity is projected to grow by 2.9 per cent per annum between now and 2031–32 under both baseline and scenario projections. The health facility is projected to require no additional beds between now and 2031–32 to accommodate this growth.

Table 17: Mundubbera Multipurpose Health Service projected future baseline and scenario activity requirements

Services



Change in


Change in

volume CAGR*

Inpatient 349 413 486 551 202 2.9% 413 486 551 202 2.9% –Emergency Department 836 906 971 1,036 200 1.5% 906 971 1,036 200 1.5% –

Outpatients 1,584 1,903 2,302 2,678 1,094 3.8% 1,903 2,302 2,678 1,094 3.8% –




Table 18: Mundubbera Multipurpose Health Service projected future baseline and scenario infrastructure requirements

Services


Acute Inpatient 4 3 3 4 2.90% 3 3 4 2.90% –Acute – overnight 4 3 3 4 2.80% 3 3 4 2.80% –







Eidsvold Multipurpose Health ServiceEidsvold Multipurpose Health Service inpatient activity is projected to grow by 2.7 per cent per annum under both the baseline and scenario projections. The health facility will require no additional inpatient beds between now and 2031–32. This growth does not change under the scenario.

Table 19: Eidsvold Multipurpose Health Service projected future baseline and scenario activity requirements

Services



Change in


Change in

volume CAGR*

Inpatient 255 299 347 391 136 2.7% 299 347 391 136 2.7% –Emergency Department 521 551 576 601 80 1.0% 551 576 601 80 1.0% –

Outpatients 880 1,057 1,279 1,488 608 3.8% 1,057 1,279 1,488 608 3.8% –




Table 20: Eidsvold Multipurpose Health Service projected future baseline and scenario infrastructure requirements

Services


Acute Inpatient 4 2 2 3 2.30% 2 2 3 2.30% –

Acute – overnight 4 2 2 3 2.60% 2 2 3 2.60% –

Subacute – overnight 1 1 1 1.10% 1 1 1 1.10% –



20

Appendix A — Infrastructure assumptionsThe following appendix details the assumptions used as part of the baseline and scenarios infrastructure projections.

Infrastructure type

Title Description Baseline assumption

Inpatient bed infrastructure assumptions

Beds Acute – Sameday – utilisation Target bed utilisation rate 170%

Beds Acute – Sameday – days operated Days of year are assumed to operate 250

Beds Acute – Overnight – utilisation Target bed utilisation rate 85%

Beds Acute – Overnight – days operated Days of year are assumed to operate 365

Beds Maternity – Sameday – utilisation Target bed utilisation rate 170%

Beds Maternity – Sameday – days operated Days of year are assumed to operate 250

Beds Maternity – Overnight – utilisation Target bed utilisation rate 75%

Beds Maternity – Overnight – days operated Days of year are assumed to operate 365

Beds Subacute – Sameday – utilisation Target bed utilisation rate 170%

Beds Subacute – Sameday – days operated Days of year are assumed to operate 250

Beds Subacute – Overnight – utilisation Target bed utilisation rate 90%

Beds Subacute – Overnight – days operated Days of year are assumed to operate 365

Beds Intensive Care – utilisation Target bed utilisation rate 75%

Beds Intensive Care – hours per day Hours per day assumed to operate 24

Beds Intensive Care – days per year Days of year are assumed to operate 365

Beds Cardiac Care – share of beds 2.5%

Beds Cardiac Care – utilisation rate 75%

Beds Cardiac Care – minimum beds 4

Bed Alternatives Renal Dialysis – sessions per day Renal dialysis sessions per chair per day 2

Bed Alternatives Renal Dialysis – days per week Days of operation of dialysis unit per week 6

Bed Alternatives Renal Dialysis – weeks per year Weeks of operation of dialysis unit per year 52

Bed Alternatives Chemotherapy – sessions per day Chemotherapy sessions per chair per day 2

Bed Alternatives Chemotherapy – days per week Days of operation of chemotherapy unit per week 5

Bed Alternatives Chemotherapy – weeks per year Weeks of operation of chemotherapy unit per year

48

Bed Alternatives Non-Chemo corrective factor 143%

Surgical theatre infrastructure assumptions

Operating Theatre Overnight separations per theatre Rate of conversion from number of overnight surgical separations to required number of theatres

1,100

Operating Theatre Sameday separations per theatre Rate of conversion from number of sameday surgical separations to required number of theatres

1,900

Recovery Beds Recovery beds per theatre Number of recovery beds per theatre 1.5


Infrastructure type


Birthing suite infrastructure assumptions

Activity weighting Ante-natal admission Weighting for Ante-natal activity 20%

Activity weighting Caesarean delivery Weighting for Caesarean activity 50%

Activity weighting Post-natal admission Weighting for Post-natal activity 20%

Activity weighting Vaginal delivery Weighting for Ante-natal activity 100%

Activity weighting Maternity activity threshold Maternity activity threshold determining birthing suite requirements

1,000

Activity weighting Maternity activity per suite (>1000) Rate of conversion from weighted maternity activity to required number of birthing suites (>1,000 activity)

300

Activity weighting Maternity activity per suite (<1000) Rate of conversion from weighted maternity activity to required number of birthing suites (<1,000 activity)

250

Special Care Nursery

Cots per 1,000 live birth 5.60


Weighted activity to cot ratio Number of weighted separations per SCN cot 1,000


Cot occupancy Expected occupancy rate of SCN Cots 90%

Emergency Department infrastructure assumptions

Emergency department

Resus Bays – Cat 1 Cat 1 presentations per resuscitation bay 500


Resus Bays – Cat 2 Cat 2 presentations per resuscitation bay 1,500


Treatment Spaces – Cat 2 Cat 2 presentations per treatment space 1,879


Treatment Spaces – Cat 3 Cat 3 presentations per treatment space 1,315


Treatment Spaces – Cat 4 + 5 Cat 4+5 presentations per treatment space 2,628


Isolation Rooms Total presentations per isolation room 15,000


Short Stay Beds Short stay bed requirement as a share of total treatment spaces

33.33%


Sameday Bed Reduction % of estimated short stay bed requirement to be deducted from total facility same day medical bed requirement. Remaining % to be deducted from facility overnight medical bed requirement

80%

22

Infrastructure type


Imaging infrastructure assumptions

X-ray Avg time (mins) Average time per procedure (treatment, prep, interpretation) – mins

14.60

X-ray Hours per day Hours of operation per day – hours 13

X-ray Days per year Days of operation per year – days 365

CT Avg time (mins) Average time per procedure (treatment, prep, interpretation) – mins

23.60

CT Hours per day Hours of operation per day – hours 13

CT Days per year Days of operation per year – days 365

US Avg time (mins) Average time per procedure (treatment, prep, interpretation) – mins

27.40

US Hours per day Hours of operation per day – hours 9

US Days per year Days of operation per year – days 365

Angiography Avg time (mins) Average time per procedure (treatment, prep, interpretation) – mins

67.40

Angiography Hours per day Hours of operation per day – hours 9

Angiography Days per year Days of operation per year – days 250

MRI Avg time (mins) Average time per procedure (treatment, prep, interpretation) – mins

41.80

MRI Hours per day Hours of operation per day – hours 9

MRI Days per year Days of operation per year – days 250

Fluoroscopy Avg time (mins) Average time per procedure (treatment, prep, interpretation) – mins

44.00

Fluoroscopy Hours per day Hours of operation per day – hours 9

Fluoroscopy Days per year Days of operation per year – days 250

Outpatient

Baseline New to review Ratio of review appointments to new 2.00

Baseline Review proportion Proportion of review appointments 0.67

Baseline New appointment time Minutes length of new appointment 30

Baseline Review appointment time Minutes length of review appointment 15

Baseline Days per week Days per week of operation 5

Baseline Hours per day Hours per day of operation 8

Baseline Utilisation Room utilisation rate 95%

Baseline Minutes operation per day Effective Minutes per day of operation 455

Baseline Days operation per year Number of days per year the clinics operate 240

Endoscopy

Activity Annual endoscopy growth Minimum annual endoscopy growth rate (%) 25%

Infrastructure Endoscopies per suite per year Minimum annual endoscopy growth rate (%) 2,550

Infrastructure Recovery beds per suite Minimum annual endoscopy growth rate (%) 6

Infrastructure Proportion of Stage 1 Recovery beds Minimum annual endoscopy growth rate (%) 50%

Activity and infrastructure projections 2019–2032

Activity and infrastructure projections 2019–2032 - Queensland Health€¦ · Bay Hospital and...

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