Central West Hospital and Health Service · Centre, RSL Care and the Department of Health Clinical...

Central West Hospital and Health Service

YOUR DEPARTMENT – OUTSIDE FRONT COVER – COLOUR

The Central West Hospital and Health Service was established as a statutory body on

1 July 2012 under the Hospital and Health Boards Act 2011 (Qld).

The Central West Hospital and Health Service 2016 – 2017 Annual report has been prepared in

accordance with the annual report guidelines for Queensland Government agencies and provides

our communities, stakeholders and government with a report of financial and

non-financial performance for the 12 month period to 30 June 2017.

Public availability statement

Printed copies of this annual report can be obtained from:

Central West Health Hospital and Health Service

Corporate Office

139 Eagle Street

Longreach Q 4720

An electronic copy of this annual report is able to be viewed online at www.centralwest.health.qld.

gov.au OR www.health.qld.gov.au/centralwest/default.asp

Requests for copies to be posted can be made via:

Mail – Central West Hospital and Health Service, P O Box 510 Longreach Q 4730

Email – [email protected]

Phone - +61 746528000

ISSN 2202-7130

Interpreter service statement

The Queensland Government is committed to providing accessible services to Queenslanders

from all culturally and linguistically diverse backgrounds. If you have difficulty in understanding the

annual report, you can contact us on telephone (07) 4652 8000 and we will arrange an interpreter

to effectively communicate the report to you.

Copyright

You are free to copy, communicate band adapt this annual report provided you attribute the work

to the State of Queensland Department of Health. Content from the report can be attributed as

follows: The State of Queensland Department of Health annual report 2016 – 2017.

To view a copy of the licence which confirms this copyright statement please visit

http://creativecommons.org/licenses/by/4.0/

© Central West Hospital and Health Service 2017

Artworks attributed to Lionel Dempsey, Amy Blucher, Joyce Crombie, Jean Barr-Crombie, Jennifer Punch, Kiona Weldon, Madonna

Dwyer, Pearl Eatts, Lyndal Monaghan and Zane Douglas

We would like to pay our respect to the First Peoples, traditional custodians of the land and waterways and thank the custodians who act on behalf of their peoples for their continued hospitality across the expanse of the health service.

We acknowledge and celebrate the continuation of a living culture that has a unique role in the Central West Hospital and Health Service area.

We also acknowledge our elders past and present as well as our emerging leaders of tomorrow and thank them for their wisdom and guidance as we seek to improve healthcare outcomes for all our population.

8 per cent of the population of Central West identifies as Aboriginal or Torres Strait Islander and 5.08 per cent of our workforce. We aim to increase workforce representation to 8 per cent over the next three years.

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ContentsLETTER OF COMPLIANCE 7

CHAIR’S INTRODUCTION 8

CHIEF EXECUTIVE’S REPORT 9

OUR PLACE 10

OUR HUBS 12Central Hub 12Eastern Hub 12Southern Hub 13Western Hub 13

VALUES, PRIORITIES, ACTIONS 15

OUR PERFORMANCE 20

OUR STORIES 22

HIGHLIGHTS 24

ACTIVITY 26

FINANCIAL SUMMARY 28

OUR PEOPLE 29

ETHICS 34

OUR BOARD 35

OUR CORPORATE GOVERNANCE 37

OUR EXECUTIVE LEADERSHIP 38

ORGANISATIONAL STRUCTURE 39

OUR FUTURE 40

RISK MANAGEMENT, INTERNAL AUDIT AND EXTERNAL SCRUTINY 41

PUBLIC INTEREST DISCLOSURE 41

INFORMATION SYSTEMS AND RECORD KEEPING 42

OPEN DATA 42

ABBREVIATIONS 43

GLOSSARY 44

ATTACHMENT A: COMPLIANCE CHECKLIST 45

FINANCIAL STATEMENTS FOR YEAR ENDED 30 JUNE 2017 46

Contents 5

Letter of compliance 7

6 September 2017

The Honourable Cameron Dick MP Minister for Health and Minister for Ambulance Services GPO Box 48 BRISBANE QLD 4001

Dear Minister

I am pleased to submit for presentation to the Parliament the Annual Report 2016 – 2017 and financial statements for Central West Hospital and Health Service.

I certify that this Annual Report complies with:• the prescribed requirements of the Financial Accountability Act 2009 and the Financial and Performance

Management Standard 2009, and• the detailed requirements set out in the Annual report requirements for Queensland Government agencies.

A checklist outlining the annual reporting requirements can be found on page 46 of this Annual Report.

Yours sincerely

Jane Williams

Board Chair Central West Hospital and Health Service

8 Central West Hospital and Health Service Annual Report 2016–2017

In 2016–2017 we have continued to work with our communities to improve health infrastructure and health outcomes for the Central West. The Board and Executive Leadership Team have fully committed themselves with me on this journey and I value their insight, expertise and passion in working towards achieving our vision of delivering excellence in healthcare for remote Queenslanders.

In August 2016, the Board welcomed Health Service Chief Executive, Ms Jane Hancock. We acknowledge the enthusiasm, experience and knowledge that Ms Hancock has brought to the role and her leadership of the Executive Team. The Board looks forward to working with Jane to drive the strategic direction of the health service, which is enabled and shaped by the infrastructure investment by the State of Queensland and focussed on improving healthcare access and equity for our residents. During the year we farewelled two members of the Board, Dr Nikola Stepanov and Mr Peter Skewes OAM and I thank them both for their valued contribution to the delivery of improved health service delivery across the Central West.

A collaborative approach to the delivery of improved healthcare will continue to ensure the efficient and effective use of resources to enhance the health of our communities. The drought continues across the State and the resilience of our communities continues to be challenged. This in turn challenges our organisation to work even harder to support their mental and physical health. As is the way in the bush, Central West Health is not meeting this challenge alone. We appreciate the ongoing productive partnerships provided by local community leaders, local Council representatives, leaders and staff of the Queensland Ambulance Service, Queensland Police Service, Royal Flying Doctor Service and the Western Queensland Primary Healthcare Network.

Continued and new partnerships with James Cook University, the Cunningham Centre, RSL Care and the Department of Health Clinical Excellence Division provide educational opportunity and innovative health service delivery improvements. These partnerships will provide long lasting benefits for our communities. A fine example of these improvements is the Central West Rehabilitation Service, operational since March 2017. This service enables early rehabilitation and recovery from treatment undertaken in hospitals from outside the Central West. Now more of our residents can complete their recovery within our community, bringing them closer to their family and friends sooner to improve the pace of recovery and reduce the personal and financial cost of being away from home.

We welcomed the Minister for Health and Minister for Ambulance Services, the Honourable Cameron Dick MP to Alpha on 16 November 2016 to open the brand new Alpha Community Hospital. In 2017–2018 the new Aramac Primary Healthcare Centre will be commissioned, and the works underway to improve services facilities at Longreach Hospital, including installation of a CT Scanner, will mean enhanced services closer to home for our residents.

Identification and management of mental health conditions within rural and remote communities is a strategic challenge for Central West Health to ensure that all members of the community can be heard, are engaged with their health needs and have the opportunity to be productive. At a Regional Health Forum facilitated by the University of Southern Queensland, I spoke of the challenges faced by remote health services to build a system of care to promote positive mental health outcomes and resilience in rural settings. There are so many stories within our communities to draw from, and we are taking steps to ensure that what we do and advocate for today is carefully planned to ensure that our children and our children’s children have access to healthcare and community services which will enable vibrant and resilient communities to flourish in the Central West.

A society grows great when old people plant trees whose shade they know they shall never sit in.

(Greek proverb)

Chair’s introductionJane Williams

Chief Executive’s report 9

During 2017 Central West Health delivered demonstrable excellence in care to its diverse and widely spread communities. The Service delivered ongoing focussed commitment to safety and quality and strengthened those elements of the system that contribute to safe, compassionate and quality outcomes. Emphasis was placed on ensuring that the Service has a qualified and capable staff, effective risk management, clinical effectiveness, a commitment to professional development, an effective use of resources and most importantly, active participation with consumers. To enable these goals to provide safe and equitable care were delivered additional funding was invested in the staff, their processes and support systems. This focus on the safety and quality of services resulted in Central West Health achieving Accreditation with the Australian Council of Health Standards for four (4) years.

Another focus was on our partnerships. The ever-increasing involvement of consumers and communities through their representatives on committees, together with the feedback that they provide, is greatly appreciated. There are now twelve (12) Consumer Advisory Networks across Central West. With the assistance of the Primary Healthcare Network a very dynamic group at Tambo was recently founded. Partnering with Consumers is a new and exciting framework developed over the last six months. This framework sets a future

direction for the Service to build on the work that has already been done and will assist it to extend the ways in which our communities are involved as partners in the planning, design, delivery and improvement of services in this region.

A $1.5 million Integrated Care Innovation Fund Project is an excellent example of effective engagement and partnering between staff and consumers. Its focus is on connecting care and improving health outcomes for the communities in our western corridor, which includes Boulia, Bedourie, Birdsville, Windorah, Jundah, Stonehenge and Yaraka. The Project will be implemented during 2017–2018. The great start that was made during this financial year can only help to ensure future success for the Service.

There are always challenges for a health service organisation that is dispersed over a wide remote area and Central West Health is no exception. To deliver benefit from the investment of revenue in Central West Health the Service has continued to improve the delivery of services locally. Connection to the National Broadband Network brings doctors and other clinical specialists right into those areas where previously patients would have had to travel major distances for such access and at great expense and inconvenience.

The focus on Telehealth resulted in over 2000 Telehealth Services being delivered this year. The infrastructure upgrade at Longreach, with an investment of $8.5 million has commenced and once completed will further assist with improved Day Surgery access and upgraded Medical Imaging services. The innovative Rehabilitation Model, in partnership with RSL Care, commenced at Pioneers Retirement Village in Longreach. Patients are now provided with the opportunity to receive care that previously they would have needed to access from a larger centre.

Our people are our major asset and most valuable resource. The development and implementation of the Staff Reward and Recognition Program is therefore a significant milestone. The Program recognises staff for outstanding service and those who demonstrate, through their service, the values of the organisation. These awards are a way of celebrating specific contributions of individuals and teams. An organisation that knows not just what it does but why it does it and celebrates its achievements is one that is focussed and capable of achieving a great deal.

Additional milestones and achievements by Central West Health during 2017 include:• A modest surplus of $0.950 million• Opening of the new facility at Alpha • Completion of the Dental Hub at

Barcaldine • Securing funding for the new Blackall

Hospital • Commencement of the new Primary

Healthcare Centre at Aramac.

As I have travelled to every part of the Health Service over the last twelve months I feel both privileged and proud to work with the staff of Central West Health. I commend them for the contributions they each make, together with that of visiting specialists, consumer advisors and partners, and for their passion, commitment and contributions to the communities of the Central West.

Chief Executive’s reportJane Hancock


Central West Hospital and Health Service (CWHHS) provides care to people who live, work, play, reside or visit the vast 396,650 km which is 23 percent of the State of Queensland. The Central West region of Queensland is hot and dry with highly variable rainfall. Rainfall is most likely to occur between December and March. Temperatures range annually from –2°C to 49°C. While the region’s flora and fauna are adaptable to irregular rainfall and flooding events, the highly variable climate is one of the major challenges for both town and pastoral communities – currently the majority of Central West has been in declared drought for the last six years.

The region is unique in regard to the biodiversity and demographics due to the extreme population change in the tourist season. During the seven cooler months of the year, as many as 12,000 to 15,000 tourists traverse the region in caravans and motorhomes for prolonged periods of time. Typically this group of the population are retired and many have a chronic disease. This places a high demand on the limited health resources.

Central West Hospital and Health Service shares not only boundaries but strong cooperative relationships with the local government areas of Diamantina Shire Council, Barcoo Shire Council, Boulia Shire Council, Winton Shire Council, Longreach Regional Council, Barcaldine Regional Council and Blackall Tambo Regional Council.

Further to this, the Central West Health’s boundaries are the same as the Central West Local Ambulance Support Network (LASN). Law and order is supported by three Queensland Police Service (QPS) Commands. Other emergency services are provided principally through a volunteer workforce, including Queensland Fire and Emergency Services.

In essence, there are two distinct population cohorts to which the health service must respond to. These are the small permanent resident populations and the large transient older population.

The resident population will be characterised by an increasing median age from 39 years in 2015 to 46.3 years in 2036. It enjoys a lower than average unemployment rate of 4 percent against the State rate of 6.2 percent as at March 2017. The main industry driving the economy of the Central West is agriculture, specifically sheep and cattle grazing. Tourism is also a major industry, which significantly contributes to the region’s economy annually. Outback Queensland Tourism reports 513,000 domestic overnight visitors contributing an annual spend of $465 million to December 2016 across an area of rural Queensland which includes the Central West. There is also a slightly higher than State average annual personal income.

Our place

Our place 11

North West HHS

Central West HHS

Mackay HHS

Central Queensland HHSWide

Bay HHS

South West HHSDarlingDowns

HHS

SunshineCoast HHS

Metro North HHS

Metro South HHS

West Moreton HHS

Gold CoastHHS

The Torres and Cape HHS

Cairns & Hinterland HHS

Townsville HHS

District hospital – generally serve a population of more than 4000 and provides a comprehensive mix of clinical services capability framework level 3 acute health services including medical, surgical, medical and maternity. The Central Hub is home to the Service’s only District hospital in Longreach.

Multipurpose health service (MPHS) – acute health services may be similar in mix and services to Rural hospitals or Community hospitals. MPHS also provide dedicated aged care and community care services. Barcaldine is classified as a Rural MPHS and the centres of Alpha and Winton have facilities which are classified as Community MPHSs.

Community hospital – generally serve populations with less than 2000 people and provide clinical services capability framework level 2 acute services including medical and emergency. Community hospitals may also provide a range of other primary, ambulatory, aged care, surgical, maternity and community services. Blackall is home to Central West’s only Community hospital.

Community clinic – generally serve small populations in rural and remote and very remote locations within Queensland. Services provided at community clinics include treatment and triage for lower acuity medical conditions and minor procedures plus life support and stabilisation prior to transfer to a higher level health service. They may also provide a range of other primary, ambulatory, aged care, prenatal, postnatal care and community services. In the East the centres of Muttaburra, Aramac and Jericho service their communities via Community clinics. In the South the communities of Tambo and Isisford and in the West Boulia, Bedourie, Birdsville, Windorah and Jundah provide Central West service delivery via the Community clinic format.

The reference to clinical services capability framework in definition of health service facilities informs management of the service and workforce requirements in the planning and delivery of safe and sustainable rural and remote healthcare.

The Queensland rural and remote health service framework (2014) in support of consistent planning for health services defined facilities in rural and remote areas as follows:

Map symbols

District hospital

Community hospital

Community clinic

Community MPHS

Rural MPHS

Central West Health delivers services using a hub and spoke model. The hubs are Longreach (Central), Barcaldine (Eastern), Blackall (Southern) and Winton (Western). These centres support the smaller facilities located in Alpha, Bedourie, Birdsville, Boulia, Isisford, Jericho, Jundah, Muttaburra, Tambo and Windorah where 24 hour access to care is available.

Jundah

Stonehenge Isisford

Longreach Barcaldine

Aramac

Alpha

Jericho

WintonMuttaburra

Boulia

Bedourie

Birdsville

Tambo

BlackallYaraka

Windorah


Central HubCentral West Health’s only district hospital forms the focal point of the health service’s obstetric and surgical service delivery for residents of the Central West area. An operating budget of $12 million and staffing equivalent of 71 FTE services a facility which offers 31 inpatient beds, 24 hour emergency department, pharmacy, pathology and medical imaging and allied health services.

The community accesses general practice service through a contract with Outback Medical Services staffed by medical practitioners employed by Central West Health.

Eastern HubBarcaldine Multi-Purpose Health Service (MPHS) centres the Eastern Hub supported by a Rural MPHS in Alpha and Community Clinics in the townships of Muttaburra, Aramac and Jericho.

Outback Medical Services provide contracted access to GP services to the communities of the Eastern Hub from its location at the Barcaldine Medical Centre and through outreach services to the towns of Alpha, Muttaburra and Aramac.

A staff of 83 with a budget of $13 million provides the residents of Central West Health’s five eastern locations with a combination of 24 hour emergency care, aged care services, chronic disease management and access to allied health services.

The Hub provides 75 of its eligible residents with access to transport and in home care and support services through the federally funded and agreed Community Care Service Agreement 2015–2017.

Highlights:• 21,011 patients accessed the services of a General

Practitioner.• 562 paediatric outpatients’ occasions of service• 98 per cent of emergency department patients seen within

the recommended timeframe• 62 births• 429 surgeries.

Highlights: • 9927 patients accessed the services of a GP• 6845 meals on wheels deliveries • 136 more allied health occasions of service delivered in

2016–2017 than in the previous year.

Jundah

Stonehenge

Winton

Boulia

Bedourie

BirdsvilleWindorah

Isisford


Aramac

Alpha

Jericho

Muttaburra

Tambo

BlackallYaraka

Jundah

Stonehenge

Winton

Boulia

Bedourie

BirdsvilleWindorah

Isisford


Aramac

Alpha

Jericho

Muttaburra

Tambo

BlackallYaraka

Our hubsService across Central West Health Allied health activity has increased 179 per cent during 2016–2017 with Social Work and Physiotherapy occasions of service leading the way reflecting a 362 per cent and 54.4 per cent increase in occasions of service respectively. Maternity saw the delivery of 62 babies during the year and recorded a total of 1189 outpatient occasions of service. Central West Health provided 826 service episodes of mental health support to its residents with 401 patients being seen during the 2016–2017 year.

Our hubs 13

Western HubThe Western Hub covers a geographical area of 210,772.7 square kilometres which describes a unique healthcare service delivery challenge second to none. The rural multipurpose health service facility located in Winton is supported by community clinics in Bedourie, Boulia, Birdsville, Jundah and Windorah.

61 staff supported by a budget of $9.471 million provided aged care, general practice, chronic disease management and access to 24 hour emergency and acute care. Central West Health staff the Winton Medical Practice with three medical officers providing GP services.

Highlights:• 5170 occasions of GP services• 5621 meals on wheels deliveries• 3016 emergency presentations with 97 per cent seen within

the recommended time.

Southern HubThe Southern Hub of the health service area is populated by the residents of the Blackall, Tambo, Yaraka and Isisford communities. The town of Blackall is home to an 18 bed community hospital and its health care service delivery to Eastern Hub residents is supported by two community clinics in Tambo and Isisford. The Central West Health owned and operated Black Stump Medical Centre provides general practice services to Blackall community residents with outreach visits by doctors regularly provided to Tambo.

46 full time equivalent staff delivered service on an operational budget of $7.2 million during the year to provide 24 hour emergency care, acute care and allied health services to the hub residents.

Highlights:• 8560 patients accessed the services of a GP• 3059 emergency presentations in 2016–2017 year

– increase of 6 per cent on previous year• 6532 outpatient services.

Jundah

Stonehenge

Winton

Boulia

Bedourie

BirdsvilleWindorah

Isisford


Aramac

Alpha

Jericho

Muttaburra

Tambo

BlackallYaraka

Investing in our communitiesCommunity Advisory Network (CAN) groups across Central West hold regular meetings to identify community health needs, allow information to be shared regarding health service delivery, and allow consumers and community to have input into the planning, development and delivery of public health services in their areas.

The Tambo CAN held its inaugural meeting on 23 March 2017. Discussing such topics as setting up My Health record and nominations for attendance at a statewide forum for consumers in Townsville provided the attendees with a sense of the purpose of the group.

Caption

Isisford


Aramac

Alpha

Jericho

Muttaburra

Tambo

BlackallYarakaJundah

Stonehenge

Winton

Boulia

Bedourie

BirdsvilleWindorah


Jundah

Boulia

Bedourie

Birdsville

Stonehenge

Jericho

Isisford


Aramac

Alpha

WintonMuttaburra

Tambo

BlackallYaraka

Windorah

Initial $1.46 million investment in health improvement boost for our western most residentsCentral West Health is delivering an exciting project with assistance from the State Government’s $35 million Integrated Care Innovation Fund (ICIF). The funds will be used to help improve the delivery of comprehensive health services to the remotest communities in the western sector of Central West Health, including Birdsville, Bedourie, Boulia, Junda, Windorah, Yaraka and Stonehenge.

In the planning and development of this program, Central West Health is partnering with other key service providers, such as the Western Queensland Primary Healthcare Network, the Royal Flying Doctor Service, North West Remote Health, CheckUp, the Queensland Aboriginal and Islander Health Council and local government authorities. By working closely with other groups and coordinating efforts, the project expects to extract from the various available services the maximum possible health benefits for these remote communities.

The vision for the Central West HealthIntegrated Care Innovation Fund (ICIF) project is ‘Connected care through Connecting with Communities’.

The primary objectives of the project are to:• Design and implement a connected and sustainable

model for chronic disease management in the Western Corridor of Central West

• Improve the overall wellness of people in the Western Corridor.

The project is split into four key phases summarised below:

1. Understand the current state

• Understand current services provided and funding arrangement

• Understand current patient experience• Identify priority areas for focus

2. Co-design the future state

• Co-design the future patient experience• Develop innovative models of care and sustainable

funding model• Recommended model of care approved

3. Implement the future state

• Build a roadmap for implementation• Implement future state• Manage and embed change

4. Monitor and sustain the change

• Complete post implementation outcome measurement • Conduct continuous improvement

Initially the plan is to pilot an innovative model of care on a subset of chronic diseases in late 2017.

Following the embedding of this model, the project will move to the next set of chronic diseases and commence activities from phase 2 (co-designing the future state) through to phase 4 (monitoring and sustaining the change). This process will continue until all identified chronic diseases have an appropriate model of care.

Values, Priorities, Actions 15

Values, Priorities, Actions

Excellence in healthcare for remote Queenslanders The values of Central West Health:

• Patient-centred care – we support our patients through their care journey, involve patients/consumers in decisions about their care and learn from their experience(s) when in our care

• Quality and safety – we put safety first in the care of our patients/consumers and build quality into what we do each day

• Integrity – we have a culture of mutual respect, fair dealing, ethical behaviour and transparency

• Investing in staff – we support ongoing learning, planned development and career advancement to attract and retain a happy, secure and competent workforce

• Innovation and change – we encourage ideas, evaluate opportunities, consult with those affected, weigh up the risks, implement with purpose and celebrate improvements.

Tambo Primary Helathcare Centre wins overall Point of Care Testing Excellence Award for remote sites demonstrating their commitment to safety and quality.

Executive Director Nursing and Midwifery Services Lorraine Matthison joins staff to celebrate International Nurses Day 2017 which recognises and celebrates the unique and valued roles of nurse and midwives.


The Central West Hospital and Health Service Strategic Plan 2015–2019 identifies the key risks and challenges and puts objectives into action to enable us to prioritise a value driven approach to achievement of outcomes.

1. Ensure patients have access to safe and high quality healthcare

• Continuous improvement against national health safety and quality standards and extend national accreditation to mental health services

• Enhance remote area nursing leadership to improve professional support for isolated primary healthcare centres

• Enhance coordination with the Patient Safety Board to ensure clinical investigations are rigorous, timely and findings are disseminated and implemented

• Ensure safe staffing levels and nursing skills mix are maintained in all hospitals and multi-purpose health centres, in accordance with the business planning framework

• Patient experiences are captured, reviewed and reflected in service delivery

How we will measure success?

• National accreditation standards are met or exceeded• Clinical investigations are completed within recommended

timeframes• High level of patient/consumer satisfaction with healthcare

from patient experience surveys• All health professionals are credentialed for their scope of

practice

In 2016 Central West Health achieved national accreditation against the National Safety and Quality Healthcare Standards for a period of four years. Self-assessment against these same standards is now overseen by newly formed Standards Workgroups which support a continuous improvement approach to the delivery of across the region healthcare.

Credentialing of our medical and nursing workforce has been enhanced and supported by the Rural and Remote Clinical Support Unit and North West Hospital and Health Service. Ensuring that staff are appropriately qualified and registered to undertake their roles is a key foundation of effective clinical governance. 100 per cent of professional staff are appropriately cedentialed.


2. Integrate primary and acute care services to promote patient wellbeing

• Co-sponsor establishment and operation of the Western Queensland Primary Health Network

• Restore and revitalise general practice in our region through partnerships with private providers

• Combine, coordinate and integrate community health, community health centres and general practices to foster a continuous patient care journey

• Integrate patient data and health records across all primary health centres and general practices

• Establish care coordinators to identify and assist patients with chronic disease to manage care and avoid preventable hospitalisation

• Implement the patient journey board to provide regional visibility and coordination of all inpatient care


• Increase in public health engagement and health promotion

activities• 70 per cent of chronic disease patients are managed through

a healthcare plan with their healthcare professional• 20 per cent reduction in preventable hospitalisations

over three years• 10 per cent increase in elective surgery services over

three years

Despite a lengthy period of closure of the theatres at the surgical unit in Longreach Hospital as redevelopment works are underway the total number of 429 surgical procedures during the period 1 July 2016 to 30 June 2017 reflected a continuation of the growth experienced in the previous year.

The health service is committed to improving its capability to deliver elective surgery locally for its residents thus reducing the need to travel. The current redevelopment works at Longreach Hospital, although restrictive in the immediate short term, will greatly enhance Longreach Hospital’s capability to deliver more day surgery in future years – delivering services closer to home.

3. Deliver more services locally where it is safe and sustainable to do so

• Increase visiting specialists and surgical services, particularly in specialties with high patient travel usage and cost

• Establish a CT scanning service at Longreach Hospital and transition medical imaging services under a public-private partnership

• Expand telehealth services and implement health-in-the-home options at all sites

• Invest in health infrastructure renewal and maintenance of the region’s healthcare facilities


• Double surgical and procedural activity over four years• 20 per cent annual increase in the use of telehealth services• 5 per cent annual reduction in patient travel assistance

applications• CT scanner operating in Longreach• Upgraded health infrastructure in Aramac, Boulia, Blackall

and Windorah over the next four years

Unprecedented infrastructure spending and commitment for the future has and will see the communities of Alpha, Barcaldine, Aramac, Boulia, Blackall and Windorah receive new or upgraded facilities to support the delivery of more services locally. The construction of the new medical imaging department at Longreach Hospital is well under way including the installation of a multi-slice CT Scanner. This initiative alone is expected to service approximately 50 patients per month and deliver improved health outcomes for residents through reduced travel and more immediate response to their health needs within the region.

In the 2016–2017 year patient travel remained an area of significant cost for Central West Health and inconvenience for our residents. Recent improvements in telehealth service capability to deliver healthcare in the remote communities of the Western Hub will drive improvement in this area in future years.


4. Attract, retain and develop a motivated healthcare workforce to meet our communities future needs

• Establish a culture that promotes and encourages innovation, leadership and collaboration

• Involve our staff in the planning, design and delivery of services

• Implement safe work practices across all sites – safety for all• Continue to recruit graduate nurses and junior doctors and

support students to experience the potential of a future career in rural health

• Employ clinical educators to plan and deliver more training locally and support our junior doctors, nurses and health professionals

• Provide appropriate incentives to encourage staff attraction and retention


• Staff turnover reduced by 10 per cent• High level of staff satisfaction from annual Working for

Queensland employee opinion survey• Reduced workplace injury and absenteeism• Staff recognition and award scheme established

The Executive Committee of the Board welcomed the recently endorsed Staff Recognition and Reward Strategy for the health service and look forward to its implementation across the facilities. In 2016–2017 71 per cent of nursing graduates have chosen to remain with Central West Health at the conclusion of their participation in the award winning graduate nurse program. Adoption of a pro-active approach to occupational health and safety incident prevention has recorded a 6 per cent reduction in workplace incidents in the twelve months ending 30 June 2017.

5. Involve our communities and stakeholders in the planning, design and delivery of services in our unique region

• Regularly review community and clinician engagement strategies

• Inform our communities about healthy lifestyles and available health services

• Give a voice to our communities through consultation and feedback and engage with Councils, local health action groups and community advisory networks

• Be open and transparent with communities on health service activities and performance

• Maintain partnerships with the Primary Health Network, Royal Flying Doctor Service, Queensland Ambulance and other local health and aged care providers


• Establish a health service website• Health service plans and engagement strategies are

published on the internet• Communities and stakeholders are satisfied with health

service engagement

Central West Health has developed a publicly accessible website which provides regular health related information and updates from around the state and the region. The user friendly site provides residents with service information including visiting specialist timetables and who to contact for more information if required.

The Service is continuing to invest in improving our community and clinician engagement activities with the Board approving revised strategies in these key areas during 2016–2017.


6. Provide responsible governance and effective leadership of the healthcare system in the Central West

• Build organisational governance to strengthen performance, compliance, clinical oversight, financial capability and public accountability

• Contribute to the development of state wide industrial relations policies

• Transition responsibility for the employment of health service staff and asset ownership from the Department of Health

• Develop processes to improve the accuracy of recording of clinical information and coding

• Establish processes to ensure service development and business improvement proposals align with health board priorities, demonstrate value for money, reflect consultation feedback and have acceptable risk profiles


• Implementation of assurance activities, including internal audits and reviews of compliance with legislation and policy

• Community and stakeholder feedback on effectiveness of our corporate governance

• Improved reliability of clinical data and key performance indicator reporting

• Balanced operating budget

The Safety and Quality Committee of the Board receives a report on key performance designed to provide assurance to the Board on the effectiveness, efficiency and quality of service delivery. Expansion in data collection and reporting tools across our facilities will further enhance the integrity of the data and reports over time to enable informed decision making. For the first time in the health service’s history whole of organisation clinical activity is now captured electronically .

Reinvigoration of the Consumer Advisory Networks (CAN) is occurring and functioning CAN groups are now operating across the health service. Thematic analysis of community feedback and issues is considered by the Management Team and Board periodically.

Central West Health has delivered a $0.950 million surplus in the 2016–2017 year.


Our performance

What a day for Alpha “What a day for Alpha” – opening statement by Central West Hospital and Health Service Board Chair Ms Jane Williams framed just what this type of investment in rural and remote health means to the people on the ground in the Central West communities. Local dignitaries from across the Central West as far west as Winton and south to Blackall and everywhere in between joined with the Honourable Minister for Health and Ambulance Services Cameron Dick to officially open the facility in the presence of the local staff of Queensland Health, Queensland Ambulance Services, Queensland Police and Queensland Fire and Emergency Services and the residents of the Alpha and Jericho townships and surrounding properties. Co-located headquarters accommodating the spectrum of Health and Emergency Services in Alpha is a giant leap forward in bringing these essentially linked services together for the first time under the one roof.

The new Alpha Community Multipurpose Health precinct celebrated by staff, patients, the Health Minister and Board Chair

My Health, Queensland’s future: Advancing Health 2026 was developed to respond to the challenges and opportunities we face in Queensland. In 2015–2016 a total budget of $14.18 billion saw Queensland Health receive the largest share of departmental funding in the state.

Central West Health recorded a 2016–2017 budget which reflected government funded revenue of 84 per cent and accountability expectations from that commitment are delivered to support our vision of providing excellence in healthcare for remote Queenslanders.

The methodology for service delivery and outcomes measurement were informed by our values and objectives.

The strategy and directions outlined in Advancing Health 2026 are consistent with

our strategic plan and key objectives which complement the broader Queensland Public Sector Values of customers first; ideas into action; unleash potential; be courageous and empower people.

Delivery of infrastructure and technology improvements in line with the Queensland governments objectives create the opportunities for Central West Health to invest in its staff and community’s ability to deliver improved health outcomes for its residents like never before.

• In November 2016 the Minister for Health and Minister for Ambulance Services, the Hon. Cameron Dick MP opened the new $17.5 million Alpha Multipurpose Health Service (MPHS) facility in the Eastern Hub.

• Barcaldine MPHS received a $4.7 million upgrade of dental and air conditioning infrastructure and both projects were delivered on time and within budget.

• Works commenced in 2017 on the new Aramac Primary Healthcare Centre at a cost of approximately $3.1 million.

• The Central Hub will receive an $8.5 million investment in upgrading maternity facilities and installation of the new CT Scanner as part of a new state of the art medical imaging department at Longreach Hospital.

• In the Western Hub, proposed refurbishment of the Community Clinic at Boulia at an estimated cost of $2 million is in the planning stages.

Our performance 21

Our current and target performance is summarised as follows:

Notes*2016–17

Target/Est.2016–17 Est.

Actual2017–18

Target/Est.

Percentage of patients attending emergency departments seen within recommended timeframes:

1

Category 1 (within 2 minutes) 100% 95% 100%Category 2 (within 10 minutes) 80% 97% 80%Category 3 (within 30 minutes) 75% 98% 75%Category 4 (within 60 minutes) 70% 98% 70%Category 5 (within 120 minutes) 70% 100% 70%

All categories .. 99% ..

Percentage of emergency department attendances who depart within 4 hours of their arrival in the department

2 >80% 98% >80%

Percentage of elective surgery patients treated within clinically recommended times

3

Category 1 (30 days) >98% 100% >98%Category 2 (90 days) >95% 91% >95%Category 3 (365 days) >95% 98% >95%

Median wait time for treatment in emergency departments (minutes) 4 20 3 20

Number of Telehealth outpatient occasions of service events 5 New measure 2270 2914Notes:1. The2016–2017EstimatedActualfiguresarebasedonactualperformancefrom1July2016to30April2017.ATarget/Estimateforpercentageofemergencydepartmentpatientsseen

withinrecommendedtimeframesisnotincludedinthe‘AllCategories’asthereisnonationalbenchmark.Queenslandpublichospitalemergencydepartmentsfaceongoingincreasesindemand,withanaverage1.3percentannualincreaseinemergencydepartmentattendances,whichhasaneffectonemergencydepartmentperformance.

2. Thisisameasureofaccessandtimelinessofemergencydepartmentservices.The2016–2017EstimatedActualfiguresarebasedonactualperformancefrom1July2016to30April2017.3. Thisisameasureofeffectivenessthatshowshowhospitalsperforminprovidingelectivesurgeryserviceswithintherecommendedtimeframeforeachurgencycategory.The2016–2017

EstimatedActualfiguresarebasedonactualperformancefrom1July2016to30April2017.4. Thismeasureindicatestheamountoftimeforwhichhalfofallpeoplewaitedintheemergencydepartment(forallcategories),fromthetimeofpresentationtobeingseenbyanurseor

doctor(whicheverwasfirst).The2016–2017EstimatedActualfigureisbasedonactualperformancefrom1July2016to30April2017.5. ThismeasuretracksthegrowthinoccasionsofserviceforTelehealthenabledoutpatientservices.Theseservicessupporttimelyaccesstocontemporaryspecialistservicesforpatients

fromregional,ruralandremotecommunities,supportingthereductioninwaittimesandcostsassociatedwithpatienttravel.The2016–2017EstimatedActualfigureisbasedonactualperformancefrom1July2016to30April2017forecastoutover12months.

Agency service areas and service standards

In 2017–2018 Central West Health will continue to focus on the integration of primary health and hospital care, targeting avoidable presentations and preventable conditions. General practices, together with the community health and outlaying primary care nursing staff, will collaborate on a single healthcare plan to help residents manage their own care. This will be supported by the Integrated Care Innovation Fund project to improve services in the remote Western Corridor. This will improve both non-Indigenous and Indigenous health outcomes.

Together with its regional partners Central West Health will continue to implement priorities identified in the 10-year regional health plan Health of the West that centres

around health services focused on patients and people, empowering the community and our health workforce; providing Queenslanders with the value in health services; and investing, innovating and planning for the future. These priorities are consistent with the Queensland Government’s objectives for the community.

In 2017–2018 Central West Health will lead the redevelopment of Longreach Hospital which will include a purpose built day surgery, modernisation of all patient wards, as well as the upgrading of radiology with the addition of a CT scanner. Construction of a new Primary Health Care Facility is underway in the Aramac community.

During 2016–2017 median wait times for elective surgery increased by 252 per cent due to the Longreach Hospital redevelopment works. Effective project

planning communicated this expected consequence to the community and alternate referral pathways were provided to those who sought this resolution. The number of elective surgery patients treated within clinically recommended times were a new measure in 2016–2017. Actual numbers – Category 1 (30 days) –40, Category 2 (20 days) – 48 and Category 3 (365 days) – 160 days are the 2017–2018 targets. The total weighted activity units of measure for acute inpatient, outpatients, sub-acute, emergency department, mental health and prevention and primary care delivered totalled 4517 for the twelve months which is a 94.97 per cent achievement against the target. Ambulatory mental health service contact duration delivered against target of over 1966 hours.


An innovative rehabilitation service to help Central West residents return home sooner after a hospital stay or avoid premature entry into residential care has commenced.

In partnership with RSL Care, Central West Health staff provide the allied health services, medical care and rehabilitation nursing support for the bed-based care located in the facility. RSL Care provides inpatient care for patients.

Rehabilitation can assist patients experiencing a loss of function from injury or illness to become as independent as possible in their activities of daily living.

Our stories

Winton nursing staff with the donor of the smart TV and sound bar

A generous bequest on behalf of a local family has been bringing joy and comfort to patients and their families at Winton Multipurpose Health Service.

Following the death of a local Winton resident following a long battle with breast cancer the family requested donations be made to cancer services instead of flowers at her funeral. The family rounded the donations received up to the amount of $2000 and offered the funds to Winton MPHS in memory of their wife and mother.

The staff and the family agreed that a the purchase of a smart TV and sound bar would be a fitting tribute to facilitate the playing of palliative care patients favourite music and sharing of their favourite photos.

The TV has also enabled family or friends who do not live in Winton to video call their loved ones in hospital.

“We now have the best technology in place for patient viewing and listening pleasure as well as high-tech options for connecting families during their time of need.” Acting Director of Nursing Bill Hackett

Our story 23

Central West Rehabilitation ServiceFollowing the securing of $1.066 million in recurrent funding through the Revitalisation of Regional, Rural and Remote Health Services Program, Central West Health established a slow stream rehabilitation service in partnership with RSL Care. Located at the Pioneer Nursing Home in Longreach the refurbishments, fittings, equipment and health professional staffing is provided by Central West Health with RSL Care providing the physical location as well as inpatient nursing care.

Operational since March 2017 the rehabilitation service, whilst in its infancy, provides opportunity for Central West residents to discharge from hospital care closer to home to receive rehabilitation care. Planned expansion of referral pathways and improved communication will continue to grow the capability of the Central West Rehabilitation Service ensuring better health outcomes for our residents.

The opportunity to partner with the Cunningham Centre to develop, trial and evaluate an inter-professional student clinical placement model commencing in 2018 will also see the Central West Rehabilitation Service be home to a unique allied health student experience in Queensland.

Building infrastructure improvements create consumer and staff environments which are physically able to contribute to improved health outcomes and the Service is supporting this investment through increased nursing numbers. This investment is in the form of nurse practitioners, nurse navigators and senior nursing positions. Improved facilities – including staff accommodation will speak to the Service’s improved ability to attract and retain clinical staff.

The announcement of the funding of $17.9 million for a new hospital in the Southern Hub’s centre of Blackall in June 2017 continues to reflect the State’s commitment to, and confidence in, Central West Health’s residents and staff and the opportunities for delivering on our vision, values and objectives are exponentially enabled.

The recent installation of fibre optic infrastructure in remote communities in

the Western Hub has meant opportunity to enable patient and clinical connectedness through Telehealth health care delivery have delivered real change for our residents. This infrastructure improvement delivery, hard fought by local government representatives in the area, brings a level of connectedness to residents of these communities that the majority of Queenslanders take for granted and with it comes health improvement opportunities.

Acting Director of Nursing – Bedourie Primary Health Care Centre records her experience in delivering care via telehealth and what it means for her and the community.

“Just to let you know that another Video conference was held today with Dr John North at PAH and it was just fantastic, clear screen, no audio issues and the family were sooooo happy to do it instead of traveling an insane distance, accommodation issues, time off work and crazy costs for the travel etc for a quick review. I completed the requested medical tasks by Dr North and he was also happy with that side of things and including awesome visual ability for Dr North while I followed his instructions.

So far Bedourie clinic, the patients and their family members are so happy with the service that word is racing around the community and a lot of locals are dropping in to the clinic to ask more about it. This service was also discussed at a community forum with an absolute need voiced very clearly that it is a “must” for such a remote community

The outcome is already FANTASTIC!”

Director of Pharmacy delivers telepharmacy service to Bedourie.


Highlights

Infrastructure spending

$8.5 million upgrade to Longreach Hospital – improvements to maternity, surgery and installation of a CT scanner have commenced

•

$3.1 million new primary health care facility at Aramac is underway

•

$4.72 million upgrade to air-conditioning and dental facilities at Barcaldine has been completed

•

Alpha co-located Hospital has opened

•

$4 million in facility upgrades planned for Boulia and Windorah community clinics

2270 Telehealth non-admitted patient occasions of service

Telehealth services continue to provide support to residents of our communities as we invest in reducing travel and delivering excellence in healthcare closer to home

Rehabilitation service up and running

A partnership with RSL care which enables Central West Health to provide rehabilitation closer to home. Investing to enable a faster and safer return from hospital either in the Central West or from further afield.

Investing in our children

The service delivered a total of 1370 outpatient occassions of service to paediatric patients. This reflects a 124% increase on the previous year

Investing in our communities

18,390 health service prepared meals on wheels provided to residents across the health service

Responsible stewardship

$0.950 million surplus at the end of 2016–2017 fiscal year

Investing in safe and quality healthcare

National Safety and Quality Healthcare Standards accreditation secured for four years from 2016

Investing in staff education

17 of 21 graduate nurses are remaining with Central West Health for 2017–2018

Investing in staff

As at 30 June 2017, and for the first time in more than 20 years, Central West Health’s medical establishment is staffed by permanent doctors.

We have implemented highly successful recruitment strategies for permanent doctors, nurses, allied health professionals and other clinical staff which has dramatically reduced the reliance on rotating locums from outside Central West area.

Highlights 25


Activity

Investing in emergency care

15,155 emergency presentations

•

Increased by 3425 occasions on the previous year

•

97% of emergency presentations seen within clinically recommended

timeframes

Investing in scheduled care

Scheduled returns up by 34%

representing improved patient access and confidence in our service

Investing in GP services

More patients accessing GP services – 44,668 patients

seen in 2016–2017

Investing in mental health

20% increase on 2015–2016 in number

of patients seen

Investing in staff development

90 new staff attend orientation 2016–2017

•

85 staff engage in ethics, integrity, code of conduct and workplace behaviour

updates

•

22 supervisors undertook recruitment and

selection training

Investment in allied health service

provision

2896 physiotherapy occasions of service

Investing in information systems

55 staff in Decision Support System (DSS) training

Investing in improved health literacy

– Alcohol, Tobacco and Other Drugs

83 new referrals

•

84 client cessations

•

566 service contacts

Activity 27


Our Financial Performance Central West Health reported a profit for the year of $2.152 million. This included a $0.950 million surplus, an increase in building revaluations of $1.267 million and a decrease in land revaluations of $0.065 million.

Queensland Department of Health commissions services from Central West Health on behalf of the State and the Commonwealth. The relationship is monitored using a service agreement underpinned by a performance management framework.

The total income for Central West Health for 2016–2017 was $72.806 million compared with $66.940 million in 2015–2016. The main source of funds is the Queensland Department of Health.

At the end of the financial year a surplus of $0.950 million was posted, this together with previous year’s surpluses means that there is an accumulated surplus of $2.258 million which will be available for reinvestment into services in the future.

How were funds used

The demands of providing services to a large geographic area are a significant driver behind key expenses including employee expenses which increased by 8 per cent from 2015–2016, patient travel and drugs. With the challenges associated with developing a sustainable, robust mental health service there was some additional money for consultants to assist with review and the development of plans for these services. Employee expenses also reflect the increased number of medical staff including the cost of agency staff where vacancies could not be filled with Queensland Health staff.

Future financial outlook

Central West Health is committed to providing better health outcomes for consumers and patients for the amount of money that is invested and therefore we are looking at effective ways of increasing the value we provide to the communities of the central west. Partnerships with other service providers are critical. This includes ensuring that we are making the most of infrastructure including technology, specifically telehealth, in our new buildings.

Assurance statement

For the financial year ending June 2017, the Acting Executive Director of Finance, Infrastructure and Support Services provided an assurance statement to the Central West Health Board and Chief Executive about the preparation of the financial statements and notes thereto of the financial controls framework and compliance with the prescribed requirements for establishing and keeping the financial records in accordance with the applicable standards. The Queensland Audit Office has delivered an unqualified audit of our financial statements for the financial year.

Revenue sources

77%State funding

6% User charges

1%Commonwealth grants

13%Commonwealth

funding

3%Other revenue

Key expenses

67%Labour andconsultancy

6%Aeromedical and

patient travel

6%Clinical supplies

13%Other supplies

8%Depreciation, repairs

and maintenance

Assets

7%Plant andequipment

86%Land andbuildings

6%Cash andreceivables

1%Inventoriesand other

Our peopleIn the last twelve months, Central West Hospital and Health Service has continued to focus on growing its capacity and capability to manage our people. We have strengthened the health service to meet both current and future health needs of our communities.Central West Queensland is one of the most sparsely populated and remote regions in the state. Residents should enjoy the same healthy lifestyle as other Queenslanders and have the same access to quality healthcare services when they are needed. Due to the size of the service area and the dispersed locations of facilities and communities we serve, recruitment and retention of highly skilled and motivated workforce remains an ongoing priority. Central West Health staff represent the organisation’s largest investment in enabling its vision, purpose and values to be delivered upon.

Central West Health workforce profiles for 2016–2017 are in Table 1.

Table 1 Workforce Stream

MOHRI 2016Occupied Full

Time Equivalent

% MOHRI 2017Occupied Full

Time Equivalent

%

Medical 22 6.6 23 6.5Nursing 149 45 150 42.5Health professional 19 5.7 24 6.8Managerial & clerical 61 18.2 75 21.2Operational 81 24.2 80 22.7Trades & artisan 1 0.3 1 0.3Total 333 100 353 100

*MOHRI is predominantly based on employed workforce and is a snapshot of the previous fortnight. Excludes external staff and overtime.

Workforce planning, performance, attraction and retentionCentral West Health is a major employer in the region and an integral part in each of our communities. Central West Health employs approximately 400 staff across the region and 75 per cent of these are performing frontline roles delivering health services and supporting patient care to our residents.

During 2016–2017 there has been an increase of full time equivalent staffing as follows:• three nurse navigators • eight graduate nurses• five Central West Rehabilitation Service team members• one Integrated Care Innovation Fund Project Manager.

Central West Health made no redundancy, early retirement or retrenchment packages to staff during the 2016–2017 fiscal year.

The Central West Hospital and Health Service Strategic Workforce Plan identifies strategic priorities that guide the attraction, recruitment and retention of an inclusive, diverse and capable workforce. Individual strategies covered in the document are:• Workforce Capability, Planning and Practice• Workforce Equity and Diversity• Workforce Sustainability• Developing Valued Partnerships• Succession Planning initiatives• Workplace Culture, Values and Practices

Our people 29


Reward and recognition strategy 2017–2020The Central West Hospital and Health Service Staff Reward and Recognition Program supports attraction and retention by contributing to a culture of recognition throughout the organisation and embedding appropriate recognition and reward initiatives as normal business practice. The program outlines both tangible and intangible options and tools that are endorsed and encouraged by Central West Health leadership, many of which can be adopted for local use.

Endorsed by the Executive Committee of the Board the Central West Hospital and Health Service Staff Reward and Recognition has set the milestones of achievements and contributions of teams and individuals, showcasing their high quality performance and innovative improvements in pursuing excellence and will be rolled out across the health service commencing August 2017.

Community (People’s Choice) Award

The community, patients or visitors will be invited to nominate a staff member or team who they believe have displayed the health service values and delivered an outstanding service to patients, visitors or the community. This encourages community engagement and involvement in the health service.

Compassion Award

An individual or team that shows a genuine concern and compassion for others is interested in others and in helping to meet their needs and providing the best possible quality of care. They treat people as valued individuals and strive to put the needs of others before their own.

Clinical Excellence Award

An individual or team who have demonstrated or contributed towards the delivery of safe and high quality care to patients and to the continuous improvement of health services to Central West Queensland communities.

Central West Health Values Award

An individual or team who demonstrates care and commitment to patients and integrity and respect to each other while keeping patients at the heart of everything they do. An award may be given for each of the Central West Health values:• Patient-Centred Care• Quality and Safety• Integrity• Investing in Staff• Innovation and Change

Employee of the Year

An individual who inspires others. They influence without authority, often putting the interests of others ahead of their own, and serve as “a champion for staff”.

Inclusion and Diversity Award

An individual or team dedicated to ensuring inclusion and diversity lie at the heart of their day-to-day work and in their belief and commitment to the health service – its values, processes and behaviours. Celebrating difference and the importance of diversity, they will act as a role model to those around them, striving towards continuous improvements in equality or involvement.

Team of the Year

A clinical or non-clinical team that has improved the quality of experience for service users, carers, families or colleagues by embracing teamwork and the health service values.

The Southern Hub team rewarding, recognising, sharing and caring at regular staff morning tea gathering.

Our people 31

Training and staff developmentCentral West Health was named Training Organisation of the Year for 2016 by Healthcare Training Service, a nationally recognised provider of clinical training services. This training organisation was founded in 1994 and provides clinical training programs for health professionals across Australia, as well as England, Sweden, Dubai and Mongolia.

The award recognised the work the health service had done during 2016 to ensure health professionals in the region had access to high-quality training programs and were able to maintain and build specialised skills. The award citation noted that: “Central West Health has once again shown extraordinary organisational wide commitment to training. Central West Health’s collaboration and support to ensure the delivery of quality training for their staff and the wider health care community is outstanding.”

Central West Health has made access to appropriate training opportunities for all staff a priority since its establishment as a statutory authority in July 2012. Some of the training delivered during the course of the year, include advanced life support and Paediatric advanced life support programs. “These programs are part of Central West Health’s commitment to provide all staff with access to appropriate training opportunities during the course of the year so as to allow them to build and maintain vital clinical skills.” (Danielle Causer – Nurse Educator).

Central West Health recognised early that one of the major obstacles to successful recruitment and retention of health professionals in rural and remote areas was a perceived lack of access to training and continuing education opportunities when compared with metropolitan areas. As a result it invests substantial time and effort into ensuring health professionals in our region are not disadvantaged in terms of access to training opportunities due to their remote location.

Approximately ninety new staff attended orientation for in the twelve months commencing 1 July 2016 and as part of this process they were exposed to information across a range of topics including workplace health and safety. All staff across the health service was also encouraged to attend training and development days that were held in Longreach, Barcaldine, Blackall, Alpha and Winton facilities. These days are designed to provide an educational update with respect to ethics, integrity, code of conduct and workplace behaviours. Eighty five staff attended these sessions throughout the year and early in 2017, the code of conduct presentation was reviewed and rewritten to become more inclusive of learners. This revised program enables staff to identify what the code of conduct means in their day to day working lives and enables greater self-awareness and responsibility for their own actions.

Recruitment and Selection Training was once again rolled out through the district with twenty two staff attending. All staff who will chair a selection panel are expected to attend this training and this education is aimed at informing staff of the correct process to be undertaken when recruiting.

Supervisor lunchbox video conference sessions were held to enable managers and supervisors to attend bite sized sessions once a month. Topics included:• New employee paperwork• Human resource delegations• Industrial Relations Act 2016

These sessions were attended by twenty supervisors during the year.

Decision Support Systems (DSS) training sessions were facilitated by the Queensland Health DSS team who travelled from Brisbane to Longreach. Fifty-five staff had the opportunity to receive either one on one coaching sessions or group sessions which included workboard design and human resource and payroll reporting.

DISC (Dominance, Influence, Steadiness, Conscientiousness) refers to a neutral universal language about how people prefer to act and communicate. Each individual is a mix of all four factors. DISC can help us understand our own behaviour, identify other people’s style and help us adapt our communication for better relationships and increased effectiveness with flow-on benefits including reducing conflict, building trust and cooperation and improving communication. DISC sessions were conducted in 2017 at the request of staff and these small interactive sessions proved to be a success in providing visibility to individuals as to how their own personality and that of their colleagues can merge successfully together to meet mutual objectives.


Medical practitionersRecord number of permanent doctors

A record number of permanent senior doctors will deliver services throughout the Central West, with twenty two permanent senior doctors on the books supporting a further five junior training positions. This will mean for the first time in five years Central West Health will have no locum filled medical officer positions. In addition to this Central West Health has included a Medical Director of the State-wide Rural Generalist Program and a consultant psychiatrist to its team.

This growth in Central West Health’s permanent medical establishment is a reflection of the service’s strategy over the past several years to reduce reliance on locums by attracting more permanent doctors, aiming specifically at young Australian graduates. Having such a pool of senior and highly skilled doctors has given Central West Health the capacity to host, teach and supervise the next generation of young doctors. Central West Health is now regarded as an attractive place for doctors to work, train, and obtain valuable experience in rural and remote medicine.

Medical, allied health and nursing students enjoy a social gathering in Longreach over the Easter 2017 weekend.

Rural health students took the opportunity to share experiences of living and working in rural and remote locations across the state as they come together in Longreach. In partnership with James Cook University, Central West Health hosts gatherings like this to encourage young health professionals to take placements in rural locations to encourage and support each other to return to work in these communities once qualified. Taking stories of their time in rural locations back to university will also provide opportunity for even more students to consider a rural placement as part of their education.

Health and safety Central West Health is committed to ensuring a safe and productive workplace for all.

Central West Health operates a targeted training and audit system which involves awareness raising, regular workplace assessment and audits, incident reporting and analysis, risk assessment and pro-active mitigations, and statutory compliance reviews.

Reporting and investigating workplace incidents forms an integral part of risk mitigation and continuous improvement. In 2016–2017 there were 118 workplace incidents reported compared to 126 in 2015–2016 reflecting a six per cent decrease.

Of the reportable incidents notified during the 12 months ending 30 June 2017 the following categories totalled 44 per cent:• Occupational Violence Patient/Staff (19 per cent)• Occupational Violence Staff/Staff (13 per cent)• Patient handling (12 per cent)

There were no serious injuries or deaths. Work Cover claims and costs continue to decrease through continued incident prevention and rehabilitation and return to work planning. Central West Health has maintained a 100 per cent return to work conversion rate and did not have any new common law claims or regulatory infringement notices. The improvements have translated into a significantly reduced insurance premium rate of 0.656, which is well below the gazetted industry average.

Our people 33

Eight new graduate nurses join the ranks in February 2017

In July 2016 Central West Health was pleased to expand the nurse graduate program to include the Post Graduate Year 2 (PGY2) pilot program. PGY2 provides post graduate second year support to individuals in the form of specialised training in an area of identified need.

Louise came to us from Cairns as part of the 2016 intake of nurse graduates and is now part of the PGY2 specialising in immunisation and child health. Louise and her family have been welcomed into the community of Barcaldine and following her husband securing employment at a local engineering firm will continue to contribute to the improved health outcomes of our residents well into the future.

Nursing Central West Health welcomes graduate nurses to the region

The Central West Health welcomed twenty one new nurse graduates to the region during 2016–2017. Graduates worked across a variety of different clinical areas throughout the region including medical, surgical, emergency, community and primary health. The graduates also provided support to the hospital based ambulance services and came from various institutes including James Cook, Southern Queensland, Curtin and Flinders Universities.

Central West Health remains committed to providing training opportunities for graduate nurses into the future. In welcoming the graduate nurses Central West Health acknowledges them as an important part of the team and value the contribution they have made and continue to make during their 12 month graduate transition program. Graduate nurses are provided support and mentorship by experienced staff to help make the transition from studying at university to life in the workforce.

Nursing is a rewarding and fulfilling vocation that provides many pathways for career development, and is a fabulous way of serving the community in which we live. Central West Health opened their eyes to the opportunities and diverse range of professional experiences available in our vast region and opt to continue their career with us in the future. From the 2016–2017 intake seventeen nursing and midwifery graduates are choosing to continue working with Central West Health upon completion of their transition program.


EthicsLeaders need to consciously model strong ethical decision making which informs and supports a positive and strong organisational culture.

Members of the Board and executive team members undertake, as a minimum, annual declarations of pecuniary and non-pecuniary interests which inform the effective management of perceived and real conflicts of interests. Each meeting forum of the Board and Executive Leadership Team refers attendees to the need for reference to declared interests.

Code of conduct training is mandatory for employees of Central West Health.

The Queensland Public Service Ethics Act 1994 (the Act) governs all public sector officials and those individuals contracted to the public service agency. The Act’s principles of integrity and impartiality, promoting the public good, commitment to the system of government and accountability and transparency inform its content which is further guided by the values.

The Central West Hospital and Health Service has built its own vision, strategic intentions, values and objectives on these principles and the statement of purpose encompasses this:

Central West Health’s purpose is to lead the healthcare service system to keep residents healthy and act swiftly to treat ill-health.

We will talk with people in our communities and engage with our clinicians to plan, design and deliver effective healthcare services.

We will build partnerships with other healthcare providers to deliver a full range of preventative, primary and acute care services.

We will encourage and foster the principle that each person is ultimately responsible for their own health and must actively participate in their own healthcare.

Our Board 35

Our BoardThe members of the Board as at 30 June 2017 are:

Ms Jane Williams (Chair)

Jane is an experienced registered nurse and has been a member of the Board from its inception in 2012. Jane was appointed to the position of Chair in May 2016 and brings to the role a passion and commitment to improving health outcomes for the people of the Central West. Jane is a member of the Board’s Executive and Safety and Quality Committees and works to achieve a strong and supportive partnership with the Health Service Chief Executive and deliver strategic support in the oversight of clinical safety and quality assurance.

Mr David Arnold (Deputy Chair)

David is the Chief Executive Officer of the Central Western Queensland Remote Area Planning and Development Board (RAPAD) who partners with local Councils and key stakeholders to understand and respond to communities needs across central western Queensland. David knows the importance of working together to improve the sustainability of communities in rural and remote areas and leads his professional team to achieve the best development outcomes possible. David was first appointed to the Board in 2012 and is Chair of the Board’s Executive Committee as well as a member of its Finance and Audit and Risk Committees.

The Central West Health Board controls the health service. The members are appointed by the Governor in Council by gazette notice on the recommendation of the Minister for Health and Ambulance Services. The Minister’s recommendation considers the skills, knowledge and experience required for a Service to perform its functions effectively and efficiently. Control of the health service is provided to the board under the authority of the Hospital and Health Boards Act 2011 and the Hospital and Health Boards Regulations 2012.

The terms of office of four members were renewed for a period of four years in vol. 375 of the Queensland Government Gazette published on Friday 12 May 2017. Two members resigned from office during the period. Outgoing members were, Mr Peter Skewes OAM and Dr Nikola Stepanov. Mr Skewes was appointed to the Board in 2012 and was the Chair of the Finance Committee and resigned his position in January 2017. During her time on the Board Dr Stepanov was Chair of the Safety and Quality Committee and member of the Executive Committee of the Board. Dr Stepanov resigned from office effective 30 June 2017.

Dr Nikola Stepanov

Nikola is a nationally recognised expert in all aspects of health and research ethics, law and governance. She is a knowledgeable advocate for human and community rights.

Ms Elizabeth (Liz) Fraser

Previous experiences across all levels of government in the provision of human and educational services has provided Liz with a wealth of experience in developing government policy and leading large scale organisational change with a view to achieving strategic reforms. Liz’s time as the Queensland Commissioner for Children and Young People advocating actively for the rights, safety and wellbeing of young people together with her career in the area of social work leaves her well placed to objectively inform strategic oversight of the health service. Liz is a member of the Safety and Quality, Finance and Executive Committees of the Board and draws on her past experiences in cabinet level policy development to inform her work. Liz was first appointed to the Board in May 2016.

Mr William (Bill) Ringrose

Appointed to the Board in 2012 Bill has been able to provide support to the Board through his extensive experience as a chartered accountant. Being a partner of a Longreach based accounting firm which also has offices outside of the Central West has enabled Bill to build strong relationships with people across a large geographical section of Queensland. Bill has previously had extensive experience as auditor of local governments under contract with the Queensland Audit Office and draws on this knowledge and experience to inform his role as Chair of the Audit and Risk Committee and Chair of the Finance Committee.

The Board on tour at the Blackall Community Hospital in February 2017


Attendance of Board members at meetings 2016–2017

Boar

d

Exec

utiv

e Co

mm

ittee

Fina

nce

Com

mitt

ee

Safe

ty a

nd Q

ualit

y Co

mm

ittee

Audi

t and

Ris

k Co

mm

ittee

No of meetings 11 10 6 8 4

Name Position Term

Jane Williams Member Chair

Appointed 1/7/2012 Re-appointed 18/5/2013 Re-appointed 18/5/2016 (Chair from 18/5/2016)

9 7 1 3 1

David Arnold Deputy Chair Appointed 1/7/2012 Re-appointed 18/5/2013 Re-appointed 18/5/2016

9 9 2 2

Elizabeth Fraser Member Appointed 18/5/2016 Re-appointed 18/5/2017

11 8 5 8

William Ringrose Member Appointed 1/7/2012 Re-appointed 18/5/2013 Re-appointed 18/5/2016

9 5 4

Leisa Fraser Member Appointed 18/5/2016 Re-appointed 18/5/2017

11 6 2

Dr Clare Walker Member Appointed 18/5/2016 Re-appointed 18/5/2017

10 8

Dr Nikola Stepanov Member Appointed 18/5/2016 Re-appointed 18/5/2017 (resigned as at 30/6/2017)

11 10 7

A total of $0.314 million was paid in the 2016 – 2017 fiscal year for remuneration of the Board with a collective additional amount of $26,833 post salary expenses recorded during the same period.

Ms Leisa Fraser

Her recent appointment as the Human Resources Manager for Winton Shire Council has meant that Leisa is now living and working in the Central West area. Leisa has in more than 20 years’ professional experience in financial and human resource management roles as well as in workplace health and safety and quality improvement aspects of business management. Her role as Social Services Manager for Nhulundu Wooribah Indigenous Health Organisation Inc. complements her membership of the Board through her established understanding of health, aged and community services sector. Leisa is a member of the Board’s Audit and Risk and Finance Committees and was appointed to the Board in May 2016.

Dr Clare Walker

As a member of the Rural Doctors Association and in her role as a general practice training supervisor Clare is well placed to bring her clinical expertise, knowledge and understanding to the work of the Board through its Safety and Quality Committee. Clare’s work as a general practitioner with the Longreach Family Medical Practice and Senior Medical Officer with Central West Health provide a valuable connection to frontline operations which can valuably inform strategic direction. Clare has been a member of the Board since May 2016 and, in addition to her work on its Safety and Quality Committee is also a member of the Audit and Risk Committee of the Board.

Our Corporate Governance 37

Other committees

The Regulation Part 7 section 31 prescribes the need for the establishment of a (a) safety and quality committee (b) finance committee and (c) an audit committee under the Financial Performance Management Standard 2009 Section 35.

Functions of these committees are defined in sections 32, 33 and 34 of the Regulation as follows:

Safety and Quality Committee

The Safety and Quality Committee of the Board advises the board on matters of safety and quality including the Service’s strategies for:• Minimising preventable patient harm• Reducing unjustified variation in

clinical care• Improving patient and carer

experiences in the receipt of health services

• Monitoring and promoting improvements in safety and quality of health services being provided by the Service through the development of appropriate indicators

The work of the Safety and Quality Committee also provides assurance on compliance with the National and State policies, agreements and standards relevant to promoting consultation with health consumers and members of the health community about the provisions of health services by the Service.

Dr Nikola Stepanov (Chair) (resigned effective 30/6/2017)Elizabeth FraserJane WilliamsDr Clare Walker

Executive Committee

The Hospital and Health Boards Act 2011 (the Act) and Hospital and Health Boards Regulation 2012 (the Regulation) require health service boards to establish committees to carry out their responsibilities. Section 32A of the Act describes the requirement for establishment of an Executive Committee to:• Oversee the performance of the

Service in line with the service agreement

• Support the board in the development of engagement strategies and protocols with primary healthcare organisations

• Support the board in the development of service plans and other plans

• Work the health service chief executive in the response to critical emergent issues

David Arnold (Chair)Jane WilliamsElizabeth FraserDr Nikola Stepanov (resigned effective 30/6/2017)

Finance Committee

The Finance Committee provides advice to the board in the promotion of effective and efficient resource management which is consistent with its objectives and relative to its funding structure.

Peter Skewes (Chair) 1/7/2016 to 12/1/2017Bill Ringrose (Member 1/7/2016 to 12/1/2017 and Chair from 13/1/2017)Leisa FraserElizabeth FraserDavid Arnold (from 13/1/2017)

Audit and Risk Committee

The Audit and Risk Committee assumes the responsibility of assessing the financial statements through seeking assurance of legislative compliance with the Financial Accountability Act 2009 and the Financial Management Performance Standard 2009. This Committee provides oversight on behalf of the Board the liaison with the Queensland Audit Office as its external auditors and monitoring the internal controls of the Service in response to the requirement for its internal audit function.

Bill Ringrose (Chair)David ArnoldLeisa FraserDr Clare Walker (from 25/5/2017)

Our Corporate Governance


Chief Executive Officer

Mr Michel Lok, Chief Executive of Central West Health from 2012 commenced in the role of Chief Executive of Torres and Cape Hospital and Health Service in August 2016.

Ms Jane Hancock was appointed initially in an acting capacity and then for a contracted period up to September 2017. Jane came to Central West from the position of Executive Director Operations at Gold Coast Hospital and Health Service and brought with her a wealth of knowledge and experience built on her professional work history with Gold Coast, Mater Hospital and the Queensland Department of Health. Jane has assumed overall accountability for the implementation of policy and strategic direction, performance reporting, legislative compliance and management of risk under the direction of the Board.

Executive Director Medical Services

Dr David Rimmer provides the Service with strategic leadership and responsibility for:• clinical governance• medical workforce direction and

education• general practice management• allied health service management

David has extensive experience in a range of clinical areas including obstetrics, palliative care and inpatient management and has been in this role since its inception in 2013.

Central West Hospital and Health Service is led by an executive management team committed and passionate about meeting the recognised challenges of health service delivery in the rural and remote setting to provide sustainable services to a relatively small population. The State of Queensland published its Rural and Remote Health Service Framework (RRHSF) in June 2014 in direct consultation with rural clinicians and building on the identified need for a change of approach. The common theme of ageing infrastructure and higher costs associated with healthcare delivery in a rural environment identified in the RRHSF spoke to the need for rural health services to be better at planning and be able respond to community need with flexibility. The Service’s executive management team, whilst small in number, is flexible in its approach to leading the health service evidenced through the willingness and capability of its members to assume roles and responsibilities across the breadth of health service delivery and management as and when required.

Executive Director of Nursing and Midwifery Services

Ms Lorraine Mathison is a registered nurse with over 30 years working in the healthcare industry brings a wealth of knowledge and expertise to the role.

Lorraine has management oversight of:• nursing recruitment and retention• patient care and safety• identification and response to

changing community health needs

Chief Financial Officer

This office was filled by Mr Stephen Harbort from 2014 to April 2017 and then by Ms Amy Lamb, in an acting capacity, from April to June 2017.

This role leads the finance team of Central West Health in ensuring the efficient and effective use of resources is strategically led and operationally enabled to best position our staff to deliver excellence in healthcare for our residents.

Executive Director People and Culture

Ms Lorelle Coombe leads Central West Health’s strategic human resources and operational organisational design, education and development. Lorelle has undertaken this role since 2015 and draws on her extensive professional experience in the government sector areas of human resource management, workplace health and safety and finance to meet the responsibilities of the office.

Our Executive Leadership

Organisational structure 39

Maternity Medical services Finance People and culture

Mental health 2 x Medical practices Building, engineering and maintenance

Occupational health and safety

Manager Board Operations

Community health Allied health Administration services

5 x Hospitals Clinical governance

10 x Primary health clinics

Central West Hospital and Health Board

Minister for Health and Minister for Ambulance Services

Executive Director Nursing and Midwifery

Services

Executive Director Medical Services

Chief Finance OfficerExecutive Director People and Culture

Health Service Chief Executive

Organisational structure


The board and executive team are excited to implement the recently endorsed Framework for Partnering with Consumers. Recognising the critical need to know and understand and listen to our communities Central West Health improving its ability to proactively engage with its consumers and staff to deliver excellence in healthcare for remote Queenslanders.

Following on from our recorded $0.950 million surplus this year the 2017–2018 budget prediction of $1.1 million in retained earnings will stand Central West Health in good stead to deliver on priorities as mutually identified and agreed with communities. The flexibility to embrace new technologies or innovation in support of improving health outcomes supports the state government’s vision as described in My health, Queensland’s future: Advancing health 2026.

According to the Australian Bureau of Statistics (ABS) the region which is serviced by Central West Health has recorded a negative growth rate of 0.8 per cent over the five year period ending June 2016 and can expect this to slowly continue with a 0.2 per cent predicted population decline by the year 2036. The aging population within the service area is in line with the State of Queensland’s 14.4 per cent of the population aged 65 years plus and is currently 14.7 per cent. ABS Census of Population and Housing 2016 reveal the area has an Indigenous population of 7.3 per cent which reflects a comparatively higher percentage than the recorded State percentage of 4 per cent. In line with the Queensland Government’s objectives for the community it is essential that Central West Health works with integrity and accountability and in consultation with our people to build safe, caring and connected communities and deliver quality frontline services.

Quality data informs quality service improvement capability. To further enhance our work in this space the formation of National Safety and Quality Healthcare Standard Workgroups will provide opportunity for identification and management of procedural change in the way we do what we do. Sharing this information across our healthcare facilities will then embed the identified best practice outcomes the workgroups identify and develop to again provide that continual improvement process.

The Board endorsement of the key performance indicator suite for clinical governance reporting purposes combined with the recent improvements in electronic data capture across the health service will enable the continual improvement in delivery of safe and quality healthcare for our residents.

Our future

Risk management 41

External Audit conducted by Queensland Audit Office (QAO) was completed in August 2017. No significant internal control deficiencies were identified.

Crowe Horwath were contracted as internal auditors for Central West Health during the 2016–2017 year. Crowe Horwath noted in their final update for the period that, although some findings remain outstanding, good progress has been made in the half year period ending 30 June 2017.

The Department of Health and hospital and health services have adopted a new platform for management of incidents and risk – RiskMan. Central West Health rolled this platform out across its facilities in April 2017. RiskMan provides all personnel with the opportunity to be involved in the identification of risk and management. Internal and external audit scrutiny also informs the assurance of risk management process within Central West Health.

Central West Health recognises that risk is present in all organisations and that effective risk management provides staff with the capability to effectively, efficiently and accountably work to deliver safe and quality healthcare. Central West Health’s Board Audit and Risk Committee has oversight of risk management and draws on the clinical expertise of its Safety and Quality Committee of the Board to support its strategic assessment and review of risk, risk mitigation and risk appetite.

In accordance with section 160 of the Hospital and Health Boards Act 2011, the Central West HHS is required to include a statement in its Annual Report detailing the disclosures of confidential information in the public interest. There were no disclosures under this provision during 2016–2017.

Public Interest Disclosure

Risk management,internal audit and external scrutiny


Queensland Health’s recently acquired RiskMan software replaced PRIME and is a database that allows easier sharing of incidents across line managers and facilities. It maintains privacy by only allowing access via an alert distribution system and has the capability to allocate tasks and set reminders for all recommendations. With the change to RiskMan has come an increase to four severity assessment codes. The principles of incident management remain the same and analysis tools such as root cause analysis and human error and patient safety review processes remain available. Central West Health continues to use recommendations and lessons learned to drive system improvements which lead to an increase in patient safety.

Hospital Based Corporate Information System (HBCIS) is a State-wide system which enables data collection for the purposes of reporting and management. Following the purchase of an additional module to increase the HBCIS software Central West Health will, for the first time from 1 July 2017, electronically capture the non-admitted patient data. This will dramatically increase our ability to produce quality data at the touch of a button.

On the 8 May 2017 a major change to the way Central West Health reports and electronically manages incidents occurred.

Additional annual report disclosures – relating to expenditure on consultancy, overseas travel and implementation of the Queensland Language Services Policy are published on the Queensland government’s open data website. Access to this information is available via the website link www.data.qld.gov.au

Medical Director software systems have now been installed and are operational in general practice locations across the Central West Health area. Extensive training with staff following installation has embedded the resource in the practice management functions in all four hubs with the exception of the Western Hub locations of Boulia, Bedourie, Birdsville, Jundah and Windorah. This investment in system improvement will inform the service’s ability to better identify and manage its resources and target primary care improvement capability through the delivery of better care of our residents with diabetes, asthma and heart disease. The Medical Director recording system will provide opportunity for Central West Health to manage its investment in the One Practice model of Central West Health employed doctors delivering primary care supported by nurse navigators and nurse practitioners.

Information systems and record keeping

Open data

Abbreviations 43

Abbreviations used throughout this report

ABS Australian Bureau of Statistics

ACHS Australian Council on Healthcare Standards

AHPRA Australian Heath Practitioner Regulation Agency

CAN Consumer advisory network

CFO Chief Finance Officer

COAG Council of Australian Governments

CheckUp CheckUp

DISC Dominance, Influence, Steadiness, Conscientiousness

DoH Department of Health

DON Director of Nursing

DSS Decision Support Systems

EDIS Emergency Department Information System

EDMS Executive director medical services

EDNMS Executive director of nursing and midwifery services

FTE Full time equivalent

QGIF Queensland Government Insurance Fund

GST Goods and Services Tax

HACC Home and Community Care

HHS Hospital and Health Service

HR Human resources

HSCE Health service chief executive

ICIF Integrated Care Innovation Fund

IHPA Independent Hospital Pricing Authority

ISO International Organisation for Standardisation

KPI Key performance indicators

MOHRI Minimum Obligatory Human Resource Information

MPHS Multipurpose health service

NEAT National emergency access target

NEST National elective surgery target

NHFB National health funding body

PHC Primary healthcare centre

PTSS Patient travel subsidy scheme

QAO Queensland Audit Office

QBA Queensland bedside audit

QTC Queensland Treasury Corporation

QCoal QCoal

RAPAD Remote Area Planning and Development Board

RFDS Royal Flying Doctor Service

RoPP Right of private practice

SMO Senior medical officer

TAMP Total Asset Management Plan

VMO Visiting medical officers

WAU Weighted activity unit

YES The Your Experience of Service

Abbreviations


National Partnership Agreement on Closing the Gap in Indigenous Health OutcomesThis agreement was established to address targets set by the Council of Australian Governments and sets out specific action to be taken by the Australian Government and complementary action by State/Territory governments to address the gap in health outcomes experienced by Aboriginal and Torres Strait Islander people

National Emergency Access TargetThe National Emergency Access Target (NEAT) is based on the proportion of patients who present to a public emergency department to be admitted, referred for treatment to another hospital or discharged within four hours

National Elective Surgery TargetThe National Elective Surgery Target (NEST) requires an increase in the percentage of elective surgery patients seen within the clinically recommended time

Primary careFirst level healthcare provided by a range of healthcare professionals in socially appropriate and accessible ways and supported by integrated referral systems including health promotion, illness prevention, care of the sick, advocacy and community development

Service Delivery StatementsThe Service Delivery Statements form part of the suite of state budget papers and provide budgeted financial and non-financial information for the budget year

TelehealthTelehealth involves the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across distance

Queensland Aboriginal Islander Health CouncilEstablished in 1990, QAIHC is the peak organisation for Queensland’s Aboriginal and Islander Community controlled Health Services. QAIHC’s role is to support its members through sector development, policy and research activities.

Royal Flying Doctor ServiceThe Royal Flying Doctor Service of Australia is a not-for-profit organisation delivering extensive primary healthcare and 24-hour emergency service to those who live, work and travel throughout Australia

Western Queensland Primary Health NetworkWestern Queensland PHN was formed as an independent not for profit company by the three Western Queensland Hospital and Health Services to create an entity to foster real partnerships with all funders and providers with an aim to improve primary healthcare service delivery to the people of Western Queensland.

Terms used throughout this report

Australian Commission on Safety and Quality in Health CareThe Australian Commission on Safety and Quality in Health Care was created by Health Ministers in 2006, and funded by all governments on a cost sharing basis, to lead and coordinate healthcare safety and quality improvements in Australia

Australian Council on Healthcare StandardsThe Australian Council on Healthcare Standards (ACHS) is an authorised accreditation agency with the Australian Commission on Safety and Quality in Health Care. The ACHS is authorised to accredit healthcare organisations to the National Safety and Quality Health Services Standards (NSQHSS). These standards form the basis of many of the accreditation programs provided by the ACHS

CheckUPCheckUP Australia is a not-for-profit industry body dedicated to advancing primary healthcare by fostering innovation and integration and working collaboratively to deliver practical solutions focused on best practice outcomes for a better primary healthcare sector and better health for all

EQuIP5EQuIP5 is the 5th edition of the ACHS Evaluation and Quality Improvement Program and is a four-year continuous quality assessment and improvement accreditation program for healthcare organisations that supports excellence in consumer/patient care and services

EQuIP NationalEquip National is the four year evaluation and quality improvement accreditation program for health services to ensure a continued focus on quality across the healthcare organisation

Hospital and Health ServiceA Hospital and Health Service is a separate legal entity established by the Queensland government to deliver public hospital services and replaced the former health service districts

Indigenous Cardiac Outreach ProgramThe Indigenous Cardiac Outreach Program aims to improve early diagnosis, management and clinical care of patients who have or are at risk of cardiovascular disease in remote Aboriginal and Torres Strait Islander communities

International Association for Public Participation The International Association for Public Participation is the preeminent international organisation advancing the practice of public participation which seeks to promote and improve the practice of public participation or community engagement, incorporating individuals, governments, institutions and other entities that affect the public interest throughout the world

National Safety and Quality Health Service StandardsThe National Safety and Quality Health Services Standards (NSQHSS) form the basis of many of the accreditation programs provided by the Australian Council on Healthcare Standards

Glossary

Compliance checklist 45

ATTACHMENT A: Compliance checklistSummary of requirement

Basis for requirement Annual report reference

Letter of compliance A letter of compliance from the accountable officer or statutory body to the relevant Minister/s

ARRs – section 7 Page 7

Accessibility Table of contentsGlossary

ARRs – section 9.1 Page 5 Page 44

Public availability ARRs – section 9.2 Inside front coverInterpreter service statement Queensland Government Language Services Policy

ARRs – section 9.3Inside front cover

Copyright notice Copyright Act 1968ARRs – section 9.4

Inside front cover

Information Licensing QGEA – Information LicensingARRs – section 9.4

Inside front cover

General information Introductory Information ARRs – section 10.1 Page 10Agency role and main functions ARRs – section 10.2 Page 11Operating environment ARRs – section 10.3 Pages 12–14

Non-financial performance Government’s objectives for the community ARRs – section 11.1 Page 21Other whole-of-government plans / specific initiatives ARRs – section 11.2 Pages 14, 20–28Agency objectives and performance indicators ARRs – section 11.3 Pages 16–19Agency service areas and service standards ARRs – section 11.4 Page 21

Financial performance Summary of financial performance ARRs – section 12.1 Page 28

Governance – management and structure

Organisational structure ARRs – section 13.1 Page 39Executive management ARRs – section 13.2 Page 38Government bodies (statutory bodies and other entities)

ARRs – section 13.3 N/A

Public Sector Ethics Act 1994 Public Sector Ethics Act 1994ARRs – section 13.4

Page 34

Queensland public service values ARRs – section 13.5 Page 34Governance – risk management and accountability

Risk management ARRs – section 14.1 Pages 37, 41Audit committee ARRs – section 14.2 Page 37Internal audit ARRs – section 14.3 Page 41

External scrutiny ARRs – section 14.4 Page 41

Information systems and recordkeeping ARRs – section 14.5 Page 42

Governance – human resources

Workforce planning and performance ARRs – section 15.1 Page 29, 31–33Early retirement, redundancy and retrenchment Directive No.11/12 Early Retirement,

Redundancy and RetrenchmentDirective No. 16/16 Early Retirement, Redundancy and Retrenchment (from 20 May 2016)ARRs – section 15.2

Page 29

Open Data Statement advising publication of information ARRs – section 16 Page 42Consultancies ARRS – section 33.1 Page 42Overseas travel ARRs – section 33.2 Page 42Queensland Language Services Policy ARRs – section 33.3 Page 42

Financial statements Certification of financial statements FAA – section 62FPMS – sections 42, 43 and 50ARRs – section 17.1

Page 31 of financial statements

Independent Auditors Report FAA – section 62FPMS – section 50ARRs – section 18.2

Page 32 of financial statements

FAA Financial Accountability Act 2009 FPMS Financial and Performance Management Standard 2009ARRs Annual report requirements for Queensland Government agencies

YOUR DEPARTMENT – OUTSIDE FRONT COVER –MONO


30 June 2017

ABN 22 692 119 544

FINANCIALSTATEMENTS

2016–2017

Central West Hospital and Health ServiceTable of Contents

for the year ended 30 June 2017

STATEMENT OF COMPREHENSIVE INCOME...................................................................................................................................................2

STATEMENT OF FINANCIAL POSITION............................................................................................................................................................3

STATEMENT OF CHANGES IN EQUITY……………………………………………………………………………………………………………………...4

STATEMENT OF CASH FLOWS.........................................................................................................................................................................5

..........................................................................................................................................................................................................7 SECTION A

......................................................................................................................8 SECTION B NOTES ABOUT OUR FINANCIAL PERFORMANCE

REVENUE..................................................................................................................................................................................................8 B1EXPENSES................................................................................................................................................................................................9 B2

...............................................................................................................................11 SECTION C NOTES ABOUT OUR FINANCIAL POSITION

CASH AND CASH EQUIVALENTS ..........................................................................................................................................................11 C1RECEIVABLES ........................................................................................................................................................................................11 C2INVENTORIES.........................................................................................................................................................................................11 C3PROPERTY, PLANT AND EQUIPMENT AND RELATED DEPRECIATION.............................................................................................12 C4LIABILITIES .............................................................................................................................................................................................16 C5EQUITY ...................................................................................................................................................................................................16 C6

........................................................................................17 SECTION D NOTES ABOUT RISK AND OTHER ACCOUNTING UNCERTAINTIES

FINANCIAL RISK DISCLOSURES...........................................................................................................................................................17 D1CONTINGENCIES ...................................................................................................................................................................................18 D2COMMITMENTS......................................................................................................................................................................................19 D3

.................................................................................................................................................................20 SECTION E OTHER INFORMATION

FIDUCIARY TRUST TRANSACTIONS AND BALANCES.........................................................................................................................20 E1KEY MANAGEMENT PERSONNEL AND REMUNERATION ..................................................................................................................21 E2RELATED PARTY TRANSACTIONS .......................................................................................................................................................24 E3ASSOCIATES ..........................................................................................................................................................................................25 E4TAXATION ...............................................................................................................................................................................................25 E5FIRST YEAR APPLICATION OF NEW STANDARDS OR CHANGE IN POLICY......................................................................................25 E6FUTURE IMPACT OF ACCOUNTING STANDARDS NOT YET EFFECTIVE...........................................................................................25 E7EVENTS AFTER THE REPORTING PERIOD..........................................................................................................................................26 E8

..........................................................................................................................27 SECTION F NOTES ON OUR PERFORMANCE TO BUDGET

BUDGET TO ACTUAL COMPARISON – STATEMENT OF COMPREHENSIVE INCOME.......................................................................27 F1BUDGET TO ACTUAL COMPARISON – STATEMENT OF FINANCIAL POSITION.................................................................................28 F2BUDGET TO ACTUAL COMPARISON – STATEMENT OF CASH FLOWS..............................................................................................29 F3

MANAGEMENT CERTIFICATE .........................................................................................................................................................................31

INDEPENDENT AUDITORS REPORT ..........................................................................................................................................................32

1


STATEMENT OF COMPREHENSIVE INCOME


2017 2016

Notes $'000 $'000 Income

User charges and fees B1-1 70,674 64,688 Grants and contributions B1-2 1,457 1,806 Other revenue B1-3 675 446

Total Income 72,806 66,940 Expenses

Employee expenses B2-1 6,392 6,191 Health service employee expenses B2-2 35,799 32,841 Supplies and services B2-3 24,374 23,363 Depreciation C4-2 4,268 3,948 Other expenses B2-4 815 714 Revaluation decrement - land C4-2 208 -

Total Expenses 71,856 67,057 Operating result 950 (117) Other comprehensive income Items that will not be reclassified subsequently to profit or loss Increase in asset revaluation surplus 1,202 - Other comprehensive income for the year 1,202 - Total comprehensive income 2,152 (117)

The accompanying notes form part of these statements. 2


STATEMENT OF FINANCIAL POSITION

as at 30 June 2017

2017 2016 Notes $'000 $'000 Current assets

Cash and cash equivalents C1-1 2,889 2,026 Receivables C2-1 1,580 1,828 Inventories C3-1 590 560 Prepayments 213 55

Total current assets 5,272 4,469 Non-current assets

Property, plant and equipment C4-2 63,529 61,651 Total non-current assets 63,529 61,651 Total assets 68,801 66,120 Current liabilities

Payables C5-1 3,920 3,920 Accrued employee benefits 199 156

Total current liabilities 4,119 4,076 Total liabilities 4,119 4,076 Net assets 64,682 62,044 Equity

Contributed equity 59,359 58,873 Accumulated surplus/(deficit) 2,259 1,309 Asset revaluation surplus C6-1 3,064 1,862

Total equity 64,682 62,044



STATEMENT OF CHANGES IN EQUITY


Notes Accumulated

surplus

Asset revaluation

surplus Contributed

equity Total

equity $’000 $’000 $’000 $’000

Balance as at 1 July 2015 1,426 1,862 44,724 48,012 Profit and Loss Operating result (117) - - (117) Other Comprehensive Income Total Comprehensive Income for the Year (117) - - (117) Transactions with Owners as Owners: Net assets received - - 16,381 16,381 Equity injections - cash - - 1,716 1,716 Non-cash equity withdrawal-depreciation - - (3,948) (3,948) Net Transactions with Owners as Owners - - 14,149 14,149 Balance at 30 June 2016 1,309 1,862 58,873 62,044 Balance as at 1 July 2016 1,309 1,862 58,873 62,044 Profit and Loss Operating result 950 - - 950 Other Comprehensive Income -

Increase/(decrease) in asset revaluation surplus - buildings - 1,267 - 1,267 Increase/(decrease) in asset revaluation surplus - land - (65) - (65)

Total Comprehensive Income for the Year 950 1,202 - 2,152 Transactions with Owners as Owners: Net assets received - - 3,144 3,144 Equity injections - cash - - 1,610 1,610 Non-cash equity withdrawal - depreciation - - (4,268) (4,268) Net Transactions with Owners as Owners - - 486 486 Balance at 30 June 2017 2,259 3,064 59,359 64,682



STATEMENT OF CASH FLOWS


2017 2016 Notes $'000 $'000 Cash flows from operating activities

Inflows User charges and fees 66,692 60,195 Grants and contributions 1,457 1,806 GST collected from customers 74 116 GST input tax credits from ATO 1,486 1,449 Other 671 444 Outflows Employee expenses (6,285) (6,127) Health service employee expenses (35,600) (32,841) Supplies and services (24,872) (23,804) GST paid to suppliers (1,489) (1,416) GST remitted to ATO (109) (102) Other (744) (330)

Net cash from/(used by) operating activities CF-1 1,281 (610) Cash flows from investing activities

Inflows Sales of property, plant and equipment 38 - Outflows Payments for property, plant and equipment (2,066) (743)

Net cash from/(used by) investing activities (2,028) (743) Cash flows from financing activities

Inflows Equity injections 1,610 1,716

Net cash from/(used by) financing activities 1,610 1,716 Net increase/(decrease) in cash and cash equivalents 863 363 Cash and cash equivalents at the beginning of the financial year 2,026 1,662 Cash and cash equivalents at the end of the financial year 2,889 2,026



NOTES TO THE STATEMENT OF CASH FLOWS

CF-1 Reconciliation of surplus to net cash from operating activities 2017 2016 $'000 $'000 Operating result 950 (117) Non-cash items:

Depreciation expense 4,268 3,948 Non-cash equity withdrawal - Depreciation (4,268) (3,948) Net losses on disposal of property, plant and equipment 22 9 Impairment losses - 12 Revaluation decrement 208 - Donated assets received (2) (6)

Changes in assets and liabilities:

(Increase)/decrease in receivables 248 (488) (Increase)/decrease in inventories (30) 25 (Increase)/decrease in prepayments (158) (7) Increase/(decrease) in payables - (101) Increase/(decrease) in accrued employee benefits 43 64

Net cash from operating activities 1,281 (610)


Central West Hospital and Health Service Notes to the financial statements


SECTION A

GENERAL INFORMATION Central West Hospital and Health Service is a Queensland Government statutory body established under the Hospital and Health Board Act 2011. The Central West Hospital and Health Service operates under its registered trading name of Central West Health. Central West Health is controlled by the State of Queensland which is the ultimate parent entity The principle address of Central West Health is: Glasson House Eagle Street Longreach QLD 4730 For information in relation to financial statements of Central West Health, email [email protected].

STATEMENT OF COMPLIANCE These financial statements have been prepared in compliance with section 62(1) of the Financial Accountability Act 2009 and section 43 of the Financial and Performance Management Standard 2009. Central West Health is a not-for-profit entity and these general purpose financial statements have been prepared on an accrual basis in accordance with Australian Accounting Standards and Interpretations applicable to not-for-profit entities. In addition, the financial statements comply with Queensland Treasury's Reporting Requirements for the year ending 30 June 2017 and authoritative pronouncements.

THE REPORTING ENTITY The financial statements include the value of all revenues, expenses, assets, liabilities and equity of Central West Health. Central West Health does not have any controlled entities.

AUTHORISATION OF FINANCIAL STATEMENTS FOR ISSUE The financial statements are authorised for issue by the Chairperson of the Board, the Health Service Chief Executive, and the Executive Director – Finance, Infrastructure and Support Services, at the date of signing the Management Certificate.

MEASUREMENT Historical Cost Historical cost is used as the measurement basis in this financial report, except for land and buildings, which are measured at fair value. Accounting estimates and judgements The preparation of financial statements necessarily requires the determination and use of certain critical accounting estimates, assumptions and management judgements that have the potential to cause a material adjustment to the carrying amounts of assets and liabilities within the next financial year. Such estimates, judgements and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised and in future periods as relevant. Key judgements and estimates are disclosed in the relevant note to which they apply.

PRESENTATION MATTERS Rounding and comparatives Amounts included in the financial statements are in Australian dollars and have been rounded to the nearest $1,000 or, where the amount is less, to zero unless the disclosure of the full amount is specifically required. Comparative information has been restated where necessary to be consistent with disclosures in the current reporting period and to improve transparency across the years.

7

mailto:[email protected]



SECTION B

NOTES ABOUT OUR FINANCIAL PERFORMANCE

REVENUE B1

B1-1: User charges and fees 2017 2016

$'000 $'000 Government funding Block funding 61,165 55,687 Depreciation funding 4,268 3,948 Total Government funding 65,433 59,635 Medical practice receipts 3,512 3,301 Hospital fees 530 573 Sales of goods and services 1,150 1,125 Rental income 49 54 70,674 64,688

Accounting Policy – User charges Government funding revenue is received in accordance with Central West Health's Service Agreement with the Department of Health. Block funding from the Commonwealth and State governments is received for services and other State funding is provided for depreciation and minor capital works. Both Commonwealth and State funding is managed and paid by the Department of Health to Central West Health. Funding is recognised as revenue when received. At the end of the financial year, a financial adjustment may be required where the level of services provided is above or below the agreed level. The ability for Central West Health to remain viable is dependent upon continued funding from the State Government in accordance with the Service agreements with the Department of Health. The service agreement between the Department of Health and Central West Health specifies that the Department funds Central West Health’s depreciation and amortisation charges via non-cash revenue, with an offsetting equity withdrawal shown in the Statement of Changes in Equity.

Revenue from sale of goods or rendering of a service is recognised when the service is rendered and can be measured reliably with a sufficient degree of certainty. This involves either invoicing for related goods/services and/or the recognition of accrued revenue. Sale of goods and services primarily consists of reimbursements from the pharmaceutical benefit scheme and revenue from nursing homes.

B1-2: Grants and contributions 2017 2016

$'000 $'000 Australian Government grants Home and community care 515 524 Other specific purpose grants 417 328 Total Australian Government grants 932 852 Other Grants - 798 Other specific purpose grants 519 150 Total Other Grants 519 948 Donations other 6 6 1,457 1,806

Accounting Policy – Grants and contributions Grants, donations and gifts that are non-reciprocal in nature are recognised as revenue in the year in which Central West Health obtains control over them (control is generally obtained at the time of receipt). Where grants are received that are reciprocal in nature, revenue is progressively recognised as it is earned, according to the terms of the funding agreements. Where the Central West Health receives contribution of assets from the government, these assets are recognised at fair value on the date of acquisition in the Statement of Financial Position. A corresponding amount is recognised as an equity contribution. Where the Central West Health receives contributions of assets from other parties, these assets are recognised at fair value on the date of acquisition in the Statement of Financial Position and a corresponding amount of revenue is recognised as a donation. Contributions of services are recognised only if the services would have been purchased if they had not been donated and their fair value can be measured reliably. When this is the case, an equal amount is recognised as revenue and expense. Central West Health receives corporate services support from the Department for no cost. Corporate services received include payroll services, accounts payable services and taxation services. As the fair value of these services is unable to be estimated reliably, no associated revenue or expenditure is recognised in the Statement of Comprehensive Income.

8



B1-3: Other revenue 2017 2016

$'000 $'000

Other reimbursements 574 360 Other revenue 101 86 675 446

Other revenue is recognised when the right to receive the revenue has been established. Revenue is measured at the fair value of the consideration received, or receivable.

EXPENSES B2 B2-1: Employee expenses 2017 2016

$'000 $'000 Employee benefits Wages and salaries 5,420 5,272 Employer superannuation contributions 407 356 Annual leave levy 328 366 Long service leave levy 110 95 6,265 6,089 Employee related expenses Other employee related expenses 127 102 6,392 6,191

The number of employees as at 30 June includes full-time and part-time employees measured on a full-time equivalent (FTE) basis (reflecting Minimum Obligatory Human Resource Information (MOHRI). The number of employees does not include the chair, deputy chair and board members unless employed concurrently by Central West Health. Number of Central West Health employees 19 16

Accounting Policy – Employee benefits The Hospital and Health Boards Act 2011 (the Act) outlines the employment arrangements for Central West Health. Board members, the Health Service Chief Executive and Senior Medical Officers are directly engaged by Central West Health while Health Service employees remain employed by the Department of Health. Central West Health's directly engaged employees Wages, Salaries and Sick Leave Wages and salaries due but unpaid at reporting date are recognised as liabilities in the Statement of Financial Position at the salary rates applicable at the time the service was delivered. As Central West Health expects such liabilities to be wholly settled within 12 months of reporting date, the liabilities are recognised at undiscounted amounts. As sick leave is non-vesting, an expense is recognised for this leave as it is taken. Annual Leave, Long Service Leave and Superannuation Central West Health participates in the Queensland Government's Annual Leave Central Scheme and the Long Service Leave Scheme. Under these schemes, levies are payable by Central West Health to cover the cost of employees' annual leave (including leave loading and on-costs) and long service leave. These levies are expensed in the period in which they are payable. Amounts paid to employees for annual leave and long service leave are claimed from the schemes quarterly in arrears which is currently facilitated by the Department of Health. Employer superannuation contributions are paid to QSuper, the superannuation scheme for Queensland Government employees, at rates determined by the Treasurer on the advice of the State Actuary. The QSuper scheme has defined benefit and defined contribution categories. Contributions are expensed in the period in which they are payable and the obligation of Central West Health is limited to its contribution to QSuper. Liabilities for annual leave, long service leave and the QSuper defined benefit scheme are held on a whole-of-government basis and reported in the Whole-of-Government financial statements pursuant to AASB 1049 Whole of Government and General Government Sector Financial Reporting. Central West Health’s obligations for employee compensation are covered through the Department of Health's cover with Workcover Queensland. Central West Health pays fees for these insurances to the Department of Health as part of a fee for service arrangement. Key management personnel and remuneration expense disclosures are detailed in Note E2.

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B2-2: Health service employee expenses 2017 2016

$'000 $'000 Health service employee expenses 35,799 32,841 35,799 32,841

The number of employees below includes full-time, part-time and casual employees measured on a full-time equivalent (FTE) basis (reflecting Minimum Obligatory Human Resource Information (MOHRI). Health service employees In accordance with the Act section 67, the employees of the Department of Health are referred to as Health Service Employees. Under this arrangement:

• The department provides employees to perform work for Central West Health, and acknowledges and accepts its obligations as the employer of these employees.

• Central West Health is responsible for the day to day management of these departmental employees.

• Central West Health reimburses the department for the salaries and on-costs of these employees. As a result of this arrangement, Central West Health classifies the reimbursements to the Department of Health for departmental employees in these financial statements as health service employee expenses.

Number of Department of Health - Health service employees 334 318 B2-3: Supplies and services 2017 2016

$'000 $'000

Consultants and contractors 6,117 5,528 Electricity and other energy 1,191 1,095 Staff transport and vehicles 1,320 1,181 Patient transport 4,505 4,139 Repairs and maintenance 1,840 2,367 Building expenses 1,462 1,172 Computer and communication services 1,183 1,099 Catering and domestic supplies 517 543 Clinical supplies 2,533 2,530 Medical practice facility fees 1,120 1,059 Department of Health and HHS supplies and services 1,610 1,764 Supplies and services 976 886 24,374 23,363 B2-4: Other expenses 2017 2016

$'000 $'000

Audit expenses* 248 178 Impairment losses - 12 Inventory written off 56 58 Net losses from disposal of property, plant and equipment 22 14 Legal expenses 64 72 QGIF Insurance 274 300 Other expenses 151 80 815 714

*Total audit fees payable to the Queensland Audit Office relating to the 2016-17 financial year are estimated to be $140,000 (2016: $130,000). There are no non audit services included in this amount. Accounting Policy – Insurance Property and general losses above a $10,000 threshold are insured through the Queensland Government Insurance Fund (QGIF) under the Department of Health's insurance policy. Health litigation payments above a $20,000 threshold and associated legal fees are also insured through QGIF. Premiums are calculated by QGIF on a risk assessed basis.

10



SECTION C

NOTES ABOUT OUR FINANCIAL POSITION

CASH AND CASH EQUIVALENTS C1

C1-1: Cash and cash equivalents 2017 2016

$'000 $'000

Cash on hand 4 4 Cash at bank 2,860 1,995 Restricted cash 25 27 2,889 2,026

Accounting Policy – Cash and cash equivalents For the purposes of the Statement of Financial Position and the Statement of Cash Flows, cash assets include all cash and cheques receipted but not banked at 30 June as well as deposits at call with financial institutions. Central West Health's operational bank accounts form part of the Whole-of-Government banking arrangement with the Commonwealth Bank of Australia and no interest is earned on these accounts by Central West Health. Central West Health’s General Trust Funds operate from Commonwealth Bank of Australia accounts and Queensland Treasury Corporation at call accounts. Cash held in these in this accounts earn Interest at a rate of 2.02% (2016: 2.46%). Refer to Notes D1 and E1.

RECEIVABLES C2

C2-1: Receivables 2017 2016

$'000 $'000

Trade debtors 1,440 1,728 Less: Allowance for impairment (11) (13) GST input tax credits receivable 154 151 GST payable (3) (38) 1,580 1,828

Accounting Policy – Receivables Trade debtors are recognised at the amounts due at the time of sale or service delivery, and are generally settled within 60 days. The recoverability of trade debtors is reviewed at the end of each month at an operating unit level, with allowance being made for impairment. Any allowance for impairment is based on loss events disclosed in section D1. All known bad debts are written off when identified. Key estimate and judgement: The allowance for the impairment reflects the credit risk associated with receivables balances and is assessed by taking into account the ageing of receivables, historical collection rates and review of specific debtor’s to assess debt collectability.

INVENTORIES C3

C3-1: Inventories 2017 2016 $'000 $'000 Inventories Pharmacy 270 193 Clinical supplies 316 364 Other 4 3 590 560

Accounting Policy – Inventories Inventories consist mainly of pharmaceutical and medical supplies held for distribution in hospitals and are provided to patients free of charge except for pharmaceuticals which are provided at a subsidised rate. Inventories are measured on a weighted average cost adjusted, for obsolescence.

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PROPERTY, PLANT AND EQUIPMENT AND RELATED DEPRECIATION C4

C4-1: Property, Plant and Equipment 2017 2016

$'000 $'000 Land At fair value 1,091 1,376 1,091 1,376 Buildings At fair value 153,157 128,146 Less: accumulated depreciation (95,556) (72,361) 57,601 55,785 Plant and equipment At cost 10,924 10,290 Less: accumulated depreciation (6,318) (6,041) 4,606 4,249 Capital works in progress At cost 231 241 Total property, plant and equipment 63,529 61,651

Accounting Policy – Property, Plant and Equipment Acquisition and recognition of assets Actual cost is used for the initial recording of all non-current asset acquisitions. Cost is determined as the value given as consideration plus costs incidental to the acquisition, including all other costs incurred in getting the assets ready for use, including architects' fees and engineering design fees. However, any training costs are expensed as incurred. Assets under construction are at cost until they are ready for use. The construction of major health infrastructure assets is managed by the Department of Health on behalf of Central West Health. These assets are assessed at fair value upon practical completion by an independent valuer. They are then transferred from the Department of Health to Central West Health via an equity adjustment. Where assets are received free of charge from another Queensland Government entity (whether as a result of a machinery-of-Government change or other involuntary transfer), the acquisition cost is recognised as the gross carrying amount in the books of the transferor immediately prior to the transfer together with any accumulated depreciation. Items of property, plant and equipment with a cost or other value equal to more than the following thresholds and with a useful life of more than one year are recognised at acquisition. Items below these values are expensed on acquisition. Class Threshold Buildings $10,000 Land $1 Plant and Equipment $5,000 Measurement of assets Plant and equipment is measured at historical cost in accordance with Queensland Treasury’s Non-Current Asset Policies for the Queensland Public Sector. The carrying amount for such plant and equipment at cost is not materially different from their fair value. Land and buildings are measured at fair value as required by Queensland Treasury’s Non-Current Asset Policies for the Queensland Public Sector. These assets are reported by their revalued amount, being the fair value at the date of valuation, less any subsequent accumulated depreciation and impairment losses where applicable. Depreciation Key estimate and judgement: The depreciation rate is determined by application of appropriate useful life to relevant non-current asset classes. The useful lives could change significantly as a result of change in use of the asset, technical obsolescence or some other economic event. The impact on depreciation can be significant and could also result in a write-off of the asset.

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for the year ended 30 June 2017 Property, plant and equipment are depreciated on a straight-line basis so as to allocate the net cost or revalued amount of each asset, progressively over its estimated useful life to Central West Health. Annual depreciation is based on net book values and Central West Health's assessment of the remaining useful life of individual assets. Land is not depreciated as it has an unlimited useful life. Assets under construction (work-in-progress) are not depreciated until they reach service delivery capacity. Any expenditure that increases the originally assessed service potential of an asset is capitalised and depreciated over the remaining useful life of the asset. Service delivery capacity relates to when construction is complete and the asset is first put to use or installed ready for use in accordance with its intended application. These assets are then reclassified to the relevant classes within property plant and equipment. The estimated useful lives of the assets are reviewed annually and where necessary, are adjusted to better reflect the pattern of consumption of the asset. In reviewing the useful life of each asset, factors such as asset usage and the rate of technical obsolescence are considered. For each class of depreciable assets, the following spans of useful life were used:

Class Span of Useful Life Buildings 27 to 81 Years Plant and Equipment 4 to 20 Years Impairment of non – current assets All non-current assets are assessed for indicators of impairment on an annual basis. If an indicator of possible impairment exists, Central West Health determines the asset's recoverable amount (higher of value in use and fair value less costs of disposal). Any amount by which the asset's carrying amount exceeds the recoverable amount is considered an impairment loss. Leased property, plant and equipment Operating lease payments, being representative of benefits derived from the leased assets, are recognised as an expense of the period in which they are incurred. Central West Health has no finance leased assets.

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for the year ended 30 June 2017 C4-2: Property, Plant and Equipment - Balances and Reconciliations of Carrying Amount

Land Buildings Plant and

equipment

Capital works in progress

Total

Level 2 Level 3 Level 3 $’000 $’000 $’000 $’000 $’000 $’000

Carrying amount at 1 July 2015 1,301 75 42,494 4,072 219 48,161 Acquisitions - - 14,954 732 22 15,708 Disposals - - (2) (12) - (14) Transfers out to other Queensland Government entities - - 1,390 354 - 1,744 Depreciation - - (3,051) (897) - (3,948) Carrying amount at 30 June 2016 1,301 75 55,785 4,249 241 61,651 Acquisitions - - 438 1,355 265 2,058 Disposals - - - (38) - (38) Transfers in from other Queensland Government entities - - 3,421 (2) (275) 3,144 Revaluation increment to asset revaluation surplus (65) - 1,267 - - 1,202 Revaluation decrement (208) - - - - (208) Depreciation - - (3,310) (958) - (4,268) Write off - land (12) - - - - (12) Carrying amount at 30 June 2017 1,016 75 57,601 4,606 231 63,529

Fair value measurement

Key estimate and judgement: Property, plant and equipment valuation in respect of fair value measurement can be sensitive to the various valuation inputs selected. Considerable judgement is required to determine what input is significant to fair value and therefore which category within the fair value hierarchy the asset is placed. Valuation standards are used to guide any required judgements. Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date under current market conditions (i.e. an exit price) regardless of whether that price is directly derived from observable inputs or estimated using another valuation technique. Observable inputs are publicly available data that are relevant to the characteristics of the assets/liabilities being valued, and include, but are not limited to, published sales data for land and operational housing. Unobservable inputs are data, assumptions and judgements that are not available publicly, but are relevant to the characteristics of the assets being valued. Significant unobservable inputs used by Central West Health include, but are not limited to, subjective adjustments made to observable data to take account of the characteristics of Central West's assets, internal records of recent construction costs (and/or estimates of such costs) for assets' characteristics/functionality, and assessments of physical condition and remaining useful life. Unobservable inputs are used to the extent that sufficient relevant and reliable observable inputs are not available for similar assets. A fair value measurement of a non-financial asset takes into account a market participant's ability to generate economic benefits by using the asset in its highest and best use. All assets of Central West Health for which fair value is measured or disclosed in the financial statements are categorised within the following fair value hierarchy, based on the data and assumptions used in the most recent specific appraisals: • level 1 - represents fair value measurements that reflect unadjusted quoted market prices in active markets for identical assets; • level 2 - represents fair value measurements that are substantially derived from inputs (other than quoted prices included within level 1) that are observable, either directly or indirectly; and • level 3 - represents fair value measurements that are substantially derived from unobservable inputs. None of Central West Health's valuations of assets are eligible for categorisation into level 1 of the fair value hierarchy. Revaluation of non-current assets Land and buildings are measured at fair value in accordance with AASB 116 Property, Plant and Equipment, AASB 13 Fair Value Measurement and Queensland Treasury's Non-Current Asset Policies for the Queensland Public Sector. These assets are reported at their revalued amounts, being the fair value at the date of valuation, less any subsequent accumulated depreciation and impairment losses where applicable.

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for the year ended 30 June 2017 Land and buildings measured at fair value are revalued on an annual basis either by appraisals undertaken by an independent professional valuer, or by the use of appropriate and relevant indices. Comprehensive revaluations are undertaken at least every five years. However if a particular asset class experiences significant and volatile changes in fair value (i.e. where indicators suggest that the value of the class has changed 20% or more since the previous reporting period), that class is subject to specific appraisal using independent experts in the reporting period, where practical, regardless of the timing of the last specific appraisal. Where assets have not been specifically appraised in the reporting period, their previous valuations are materially kept up-to-date via the application of an interim index which approximates fair values at reporting date. Central West Health ensures that the application of such indices results in a valid estimation of the assets' fair values at reporting date. Independent experts supply the indices used for these assets. Such indices are either publicly available, or are derived from market information available to the experts. Materiality is considered in determining whether the difference between the carrying amount and the fair value of an asset warrants a revaluation. Any revaluation increment arising on the revaluation of an asset is credited to the asset revaluation surplus of the appropriate class, except to the extent it reverses a revaluation decrement for the class previously recognised as an expense. A decrease in the carrying amount on revaluation is charged as an expense, to the extent it exceeds the balance, if any, in the revaluation surplus relating to that asset class. Central West Health has adopted the gross method of reporting revalued assets. Land Land is measured at fair value using independent revaluations, desktop market valuations or indexation by the State Valuation Service (SVS) within the Department of Natural Resources and Mines. In 2016-17, Central West Health’s land was valued by SVS using market indices. The last external valuation of land was conducted in 2012-13. The fair value of land is based on individual factor changes per property derived from the review of market transactions. These market movements are determined having regard to review of land values undertaken for each local government area issued by the Valuer-General. All local government property market movements are reviewed annually by market surveys to determine any material change in values. These ongoing market investigations assist in providing an accurate assessment of the prevailing market conditions and detail the specific market movements applicable to each property. The revaluation of land in 2016-17 resulted in a decrement of $0.27 million to the carrying amount of land (2016: nil). Buildings In 2016-17 Central West Health engaged independent experts, AECOM quantity surveyors to undertake building revaluation in accordance with the fair value methodology. The revaluation methodology adopted by AECOM has been refined as outlined below. AECOM performed a desktop valuation for 13% of Central West Health’s building portfolio (14 buildings) previously valued in 2012-13 financial year to align the fair value assessment to the 2016-17 methodology. Central West Health performed a desktop valuation for 43% of their building portfolio (48 buildings). The remaining building portfolio was revalued by indexation. The effective date of the valuation was 30 June 2017. The valuation methodology for the independent valuation uses historical and current construction contracts. The replacement cost of each building at date of valuation is determined by taking into account Longreach location factors and comparing against current construction contracts. The valuation is provided for a replacement building of the same size, shape and functionality that meets current design standards, and is based on estimates of gross floor area, number of floors, building girth and height and existing lifts and staircases. This method makes an adjustment to the replacement cost of the modern day equivalent building for any utility embodied in the modern substitute that is not present in the existing asset (e.g. mobility support) to give a gross replacement cost that is of comparable utility (the modern equivalent asset). The methodology makes further adjustment to total estimated life taking into consideration physical obsolescence impacting on the remaining useful life to arrive to the current replacement cost via straight line depreciation. This method addresses each form of obsolescence referred to by AASB 13 as follows: Physical deterioration – Where the condition of a building has declined significantly over the course of a year, the impact is on the estimate of total useful life and future maintenance costs rather than the benefits provided by the building during the year. If a component’s current condition is better (or worse) than previously anticipated, its estimated total useful life is extended (reduced), resulting in a higher (lower) fair value. Functional (technological) obsolescence – This form of obsolescence is captured either via the gross replacement cost (because the modern equivalent asset of comparable utility by definition excludes functional obsolescence) or through a decrease in the component’s total useful life (if the component will be replaced early because it is functionally obsolete). Economic (external) obsolescence – This method measures any permanent surplus capacity by basing the modern equivalent asset of comparable utility on the required service capacity rather than the service capacity of the existing asset. If an entity will replace a component earlier than anticipated because of economic obsolescence, it captures the resulting reduction in fair value by decreasing the component’s estimated total useful life. Central West Health has adopted a refined methodology for building valuation as outlined above. This has impacted on key estimates and judgement in regards to buildings valued via desktop valuation. The desktop valuation and assessment of useful life for 2016-17 resulted in a net increment of $1.3 million to the carrying amount of buildings. No adjustment to fair value was recognised for buildings by indexation as the cumulative movement was less than 1%.

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LIABILITIES C5 C5-1: Payables 2017 2016

$'000 $'000 Department of Health payables* 1,194 1,605 Trade and other creditors 335 146 Accrued expenses 2,391 2,169 3,920 3,920

• Department of Health payables are due to outstanding payments for payroll and other fee for service charges. Accounting Policy – Payables Payables are recognised for amounts to be paid in the future for goods and services received. Trade creditors are measured at the agreed purchase/contract price, gross of applicable trade and other discounts. The amounts are unsecured and are generally settled in accordance with the vendors’ terms and conditions, typical within 30 days.

EQUITY C6C6-1: Asset revaluation surplus by class 2017 2016 $'000 $'000 Land Balance at the beginning of the financial year 66 66 Revaluation decrement (66) - Balance at the end of the financial year - 66 Building Balance at the beginning of the financial year 1,796 1,796 Revaluation increment 1,267 - Balance at the end of the financial year 3,063 1,796

Accounting Policy - Asset revaluation surplus The asset revaluation surplus represents the net effect of revaluation movements in assets.

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SECTION D

NOTES ABOUT RISK AND OTHER ACCOUNTING UNCERTAINTIES

FINANCIAL RISK DISCLOSURES D1

D1-1: Financial instrument categories Central West Health has the following categories of financial assets and financial liabilities: 2017 2016 Notes $'000 $'000

Financial assets Cash and cash equivalents C1-1 2,889 2,026 Receivables C2-1 1,580 1,828 4,469 3,854

Financial liabilities Payables C5-1 3,920 3,920 3,920 3,920

. Accounting Policy - Financial instruments Recognition Financial assets and financial liabilities are recognised in the Statement of Financial Position when Central West Health becomes party to the contractual provisions of the financial instrument. Classification Financial instruments are classified and measured as follows: a. Cash and cash equivalents - held at fair value through profit and loss b. Receivables - held at amortised cost c. Payables - held at amortised cost Central West Health does not enter into transactions for speculative purposes, nor for hedging. Financial assets are assessed for indicators of impairment at the end of each reporting period. Financial Risk Management Central West Health is exposed to a variety of financial risks - credit risk and liquidity risk. Changes in interest rates and other market risks have a minimal impact on the operating result of Central West Health. Financial risk is managed in accordance with Queensland Government and agency policies. Central West Health's policies provide written principles for overall risk management and aim to minimise potential adverse effects of risk events on the financial performance of Central West Health. Risk Exposure Measurement method Credit risk Ageing analysis, cash inflows at risk Liquidity risk Monitoring of cash flows by active management of creditors

Credit Risk Exposure Credit risk is the potential for financial loss arising from a counterparty defaulting on its obligations. The maximum exposure to credit risk at balance date is equal to the gross carrying amount of the financial asset, inclusive of any allowance for impairment. The carrying amount of cash at bank, cash held with Queensland Treasury Corporation (QTC) and receivables represents the maximum exposure to credit risk. Refer to Note C1-1 and C2-1 for further information. No collateral is held as security and no credit enhancements relate to financial assets held by Central West Health. No financial assets and financial liabilities have been offset and presented in the Statement of Financial Position. No financial assets have had their terms renegotiated as to prevent them from being past due or impaired and are stated at the carrying amounts as indicated.

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for the year ended 30 June 2017 Ageing of past due but not impaired as well as impaired financial assets are disclosed in the following table: 2017 Financial assets past due

Receivables Less than 30

days 30-60 days 61-90 days More than

90 days Total

Past due but not impaired 33 11 5 27 76 Individually impaired - - - 11 11

Total 33 11 5 38 87 2016 Financial assets past due

Receivables Less than 30

days 30-60 days 61-90 days More than

90 days Total

Past due but not impaired 59 52 15 6 132 Individually impaired - - - 13 13

Total 59 52 15 19 145 Liquidity Risk Liquidity risk is the risk that Central West Health will not have the resources required at a particular time to meet its obligations to settle its financial liabilities. Central West Health is exposed to liquidity risk through its trading in the normal course of business and aims to reduce the exposure to liquidity risk by ensuring that sufficient funds are available to meet employee and supplier obligations as they fall due. Central West Health bank accounts form part of the whole-of-government banking arrangement with the Commonwealth Bank of Australia. Under this arrangement, Central West Health has access to the whole-of government debt facility with a $500,000 limit approved by Queensland Treasury to manage any short term cash shortfalls. This was undrawn at 30 June 2017 (2016: undrawn). All Central West Health financial liabilities in Note C5-1, are based on undiscounted cash flows at reporting date, and are due within one year or less.

CONTINGENCIES D2(a) Litigation in Progress

2017 2016 Cases Cases Cases have been filed with the courts as follows: Tribunals, commissions and boards - 2 - 2

Central West Health's liability is limited to an excess per insurance event of $20,000. Refer Note B2-4. Central West Health is responsible for claims from 1 July 2012 with pre 1 July 2012 claims remaining the responsibility of the Department of Health. Central West Health legal advisers and management believe it would be misleading to estimate the final amounts payable (if any) in respect of the litigation before the courts at this time.

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COMMITMENTS D3(a) Non-cancellable operating lease commitments

Central West Health's non-cancellable operating lease commitments inclusive of non-recoverable GST, contracted for at reporting date but not recognised in the accounts are payable as follows:

(b) Capital expenditure commitments

Capital expenditure commitments inclusive of non-recoverable GST, contracted for at reporting date but not recognised in the accounts are payable as follows:

No later than 1 year - 34 Total - 34

2017 2016 $'000 $'000 No later than one year 237 266 Later than one year but no later than five years 394 666 Total 631 932

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SECTION E

OTHER INFORMATION

FIDUCIARY TRUST TRANSACTIONS AND BALANCES E1Central West Health acts in a fiduciary trust capacity in relation to patient trust accounts. All patient trust monies are held by Central West Health on behalf of the patient while admitted to Hospital or Multi-Purpose Health Service facility. These transactions and balances are not recognised in the financial statements, but are disclosed below.

2017 2016 $'000 $'000

Patient trust receipts Winton Patient Trust 72 102 Longreach Patient Trust 2 3 Barcaldine Patient Trust 26 30 Total receipts 100 135

Patient trust related payments Winton Patient Trust 72 101 Longreach Patient Trust 2 4 Barcaldine Patient Trust 26 30 Total receipts 100 135

Increase/decrease in net patient trust assets - -

Trust assets Current assets – cash 39 40

Represented by Patient trust deposits Winton Patient Trust 32 32 Longreach Patient Trust 1 1 Barcaldine Patient Trust 6 7 Total 39 40

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KEY MANAGEMENT PERSONNEL AND REMUNERATION E2

As from 2016-17, Central West Health’s responsible Minister is identified as part of Central West Health’s key management personnel, consistent with additional guidance included in AASB 124 Related Party Disclosures. The responsible Minister is Hon Cameron Dick, Minister for Health and Minister for Ambulance Services.

The ministerial remuneration entitlements are outlined in the Legislative Assembly of Queensland’s Members’ Remuneration Handbook. Central West Health does not bear any costs of remuneration of the Minister for Health. The majority of Ministerial entitlements are paid by the Legislative Assembly, with remaining entitlements being provided by Ministerial Services Branch within the Department of Premier and Cabinet. As all Ministers are reported as key management personnel of the Queensland Government, aggregate remuneration expenses for all Ministers is disclosed in the Queensland Government and Whole of Government Consolidated Financial Statements as from 2016-17, which are published as part of Queensland Treasury’s Report on State Finances.

The following details for non-Ministerial key management personal include those positions that had authority and responsibility for planning, directing and controlling the activities of Central West Health during 2016-17. Further information on key management personal positions can be found in the body of the Annual Report under the section relating to Executive Management

All executives are appointed under the authority of Hospital and Health Boards Act 2011 Position Responsibilities

Health Service Chief Executive (HSCE)

Responsible for the efficient and effective management of Central West Health and to support and implement the Board’s strategic plans for the improved health care of Central West residents and visitors.

Executive Director Medical Services (EDMS)

Responsible for safe and effective delivery of medical and allied health services, including recruitment, retention and development of workforce, and leads clinical governance within the Health Services.

Executive Director Nursing and Midwifery Services (EDoNMS)

Oversees the safe and efficient operations of all hospitals and health centres, maternity and community health services and provides leadership to the nursing streams.

Executive Director People and Culture (EDPAC)

Oversees the Human Resource and Organisational Development functions of the Central West Health Services.

Chief Finance Officer (CFO)/Executive Director Infrastructure and Support Services (EDFISS)

Responsible for budget planning and forecasting, financial control and performance, statutory compliance and supporting effective business decision making within Central West Health. The Chief Finance Officer (CFO) has been reclassified and re-named Executive Director Infrastructure and Support Services in 2017.

Section 74 of the Hospital and Health Boards Act 2011 (the Act) provides that the contract of employment for health service executive staff must state the term of employment, the person's functions and any performance criteria as well as the person's classification level and remuneration package. The remuneration policy for the Central West Health Service Chief Executive is set by a direct engagement common law employment contract setting out the remuneration and other terms of employment including non-salary benefits such as motor vehicles and remote area housing. Remuneration of other key executive management personnel are determined by their awards and industrial agreements determined by the Department of Health. For the 2016-17 year, remuneration packages of key management personnel except HSCE and EDoMS increased by 2.5 per cent in accordance with government policy. Remuneration expenses for key executive management personnel comprise the following components: • Short-term employee expenses which include:

• Salaries, allowances and leave entitlements paid and provided for the entire year or for that part of the year during which the employee occupied the specified position.

• Non-monetary expenses - consisting of provision of remote area housing, motor vehicles and applicable fringe benefits tax benefits. • Long term employee expenses include amounts expensed in respect of long service leave entitlements earned. Post-employment

expenses include amounts expensed in respect of employer superannuation contributions. Termination benefits are not provided for within individual contracts of employment. Contracts of employment provide only for notice periods or payment in lieu on termination, regardless of the reason for termination.

• There were no performance bonuses paid in the 2016-17 financial year (2016: nil).

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E2 KEY MANAGEMENT PERSONNEL DISCLOSURES (continued) 1 July 2016 - 30 June 2017

Position

Short Term Employee Expenses

Long term expenses

Post employee expenses

Termination benefits

Total expenses

Monetary expenses

Non-monetary expenses

$'000 $'000 $'000 $'000 $'000 $'000 HSCE (End Date 11/09/2016) 49 7 1 4 - 61 HSCE (Start Date 16/08/2016) 214 32 4 20 - 270 EDMS 439 26 9 31 - 505 A/EDMS (04/05/17 - 25/06/17) 47 - 1 4 - 52 EDoNMS 119 17 2 12 - 150 A/EDoNMS (30/01/17 - 02/05/17) 45 - 1 4 - 50 EDP&C 131 18 2 15 - 166 CFO (End Date 12/04/2017) 114 17 2 13 - 146 A/EDFISS (Start Date 20/04/2017) 37 - 1 3 - 41

1 July 2015 - 30 June 2016

Position


Long term expenses

Post employee expenses

Termination benefits

Total expenses

Monetary expenses


$'000 $'000 $'000 $'000 $'000 $'000 HSCE 259 24 5 24 - 312 EDMS 419 26 8 28 - 481 EDoNMS 153 18 3 16 - 190 EDP&C 123 16 2 14 - 155 CFO 133 19 2 15 - 169

Board remuneration

Central West Health is independently and locally controlled by the Hospital and Health Board (the Board). Board appointments are for one or three year terms. Remuneration arrangements for the Central West Health Board are approved by the Governor in Council and the chair, deputy chair and members are paid in annual fee consistent with the government procedures titled ‘Remuneration procedures for part-time chairs and members of Queensland Government bodies’. Responsibility

The Board decides the objectives, strategies and policies to be followed by Central West Health and ensure it performs its functions in a proper, effective and efficient way. The Board appoints the Health Service Chief Executive and exercises significant responsibilities at a local level, including controlling the financial management of the Service and the management of the Service's land and buildings (Section 7 Hospital and Health Boards Act 2011). Appointment Authority

Appointments are under the provisions of the Hospital and Health Boards Act 2011 by Governor in Council. Notice published in the Queensland Government Gazette.

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E2 KEY MANAGEMENT PERSONNEL DISCLOSURES (continued)

Position and Name Date of Appointment Date of Cessation

Board Chair Jane Williams

Appointed 01/07/2012 Reappointed 18/05/2013 Reappointed 18/05/2016

Deputy Chairperson David Arnold


Board member William Ringrose


Board member Peter Skewes


Resigned 25/01/2017

Board member Dr. Nikola Stepanov

Appointed 18/05/2016

Board member Elizabeth Fraser


Board member Leisa Fraser


Board member Dr Clare Walker*


*Board members who are employed by either Central West Health or the Department of Health are not paid board fees. Remuneration paid or owing to Board members during 2016-17 was as follows:

Board Member

Short Term Employee Expenses Post employee

expenses Total Expenses Monetary Non-monetary

expenses $'000 $'000 $'000 $'000

Jane Williams 75 - 6 81 David Arnold 40 - 4 44 William Ringrose 41 - 4 45 Peter Skewes 25 - 2 27 Dr Nikola Stepanov 42 - 4 46 Elizabeth Fraser 45 - 4 49 Leisa Fraser 46 - 4 50 Clare Walker - - - -

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for the year ended 30 June 2017 Remuneration paid or owing to Board members during 2015-16 was as follows:

Board Member


Post employee expenses Total Expenses Monetary


$'000 $'000 $'000 $'000 Edward Warren 63 - 5 68 David Arnold 39 - 4 43 Jane Williams 44 - 5 49 William Ringrose 38 - 3 41 Peter Skewes 41 - 3 44 Bruce Scott 40 - 3 43 Dr Nikola Stepanov 4 - - 4 Elizabeth Fraser 4 - - 4 Leisa Fraser 4 - - 4

*Board members who are employed by either Central West Health or the Department of Health are not paid Board fees.

RELATED PARTY TRANSACTIONS E3Transactions with Queensland Government Controlled Entities

Central West Health is controlled by its ultimate parent entity, the State of Queensland. All State of Queensland controlled entities meet the definition of a related party in AASB 124 Related party Disclosures.

Department of Health

Central West Health receives funding from the Department of Health. The Department of Health receives its revenue from the Queensland Government (majority of funding) and the Commonwealth.

The funding provided predominantly for specific public health services purchased by the Department from Central West Health in accordance with a service agreement between the Department of Health and Central West Health. The service agreement is reviewed periodically and updated for changes in activities and prices of services delivered by Central West Health. Refer to note B1-1.

The signed service agreements are published on the Queensland Government website and publicly available. The 2016-17 service agreement was for $72 million.

In addition, the Department of Health provides a number of services as outlined in note B1-2. Any other expenses paid by Department of Health third parties on behalf of Central West Health are recouped by the Department of Health.

Refer to note C2 for more information on receivables from the Department of Health.

Other Government-controlled Entities

All other transactions in the year ended 30 June 2017 between Central West Health and other Queensland Government-controlled entities were on commercial terms and conditions and were immaterial in nature. The entities Central West Health engaged with include:

• Other Hospital and Health Services – payments to and receipts from other Hospital and Health Services occur to facilitate the transfer of patients, drugs, staff and other incidentals.

• Queensland Treasury Corporation – Central West Health have an investment account with Queensland Treasury Corporation for general trust monies. Refer to note C-1.

• Department of Housing and Public Works – Central West Health pays rent to the Department of Housing and Public Works for a number of properties. In addition, Central West Health pays the Department of Housing and Public Works for vehicle fleet management services.

• Central West Health provides accommodation at Alpha to the Queensland Police Service and Queensland Fire and Emergency Services free of charge.

Transactions with People/Entities Related to KMP

All transactions in the year ended 30 June 2017 between Central West Health and Health Service key management personal, including their related parties were on normal commercial terms and conditions and were immaterial in nature.

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ASSOCIATES E4Western Queensland Primary Care Collaborative Limited (WQPCC) was registered in Australia as a public company limited by guarantee on 22 May 2015. Central West Health is one of three founding members with North West HHS and South West HHS, each holding one voting right in the company. The principal place of business of WQPCC is Mount Isa, Queensland. Each founding member is entitled to appoint one Director to the Board of the company. WQPCC's principal purposes as a not for profit organisation are to increase the efficiency and effectiveness of health services for patients in Western Queensland, particularly those at risk of poor health outcomes; and improve co-ordination to facilitate improvement in the planning and allocation of resources enabling the providers to provide appropriate patient care in the right place at the right time. These purposes align with the strategic objective of Central West Health to integrate primary and acute care services to support patient wellbeing. Each member's liability to WQPCC is limited to $10. WQPCC's constitution legally prevents it from paying dividends to the members and also prevents the income or property of the company being transferred directly or indirectly to the members. This does not prevent WQPCC from making loan repayments to Central West Health or reimbursing Central West Health for goods or services delivered to WQPCC. Central West Health's interest in WQPCC is immaterial in terms of the impact on Central West Health's financial performance because it is not entitled to any share of profit or loss or other income of WQPCC. Accordingly, the carrying amount of Central West Health's investment and subsequent changes in its value due to annual movements in the profit and loss of WQPCC are not recognised in the financial statements. Central West Health does not have any contingent liabilities or other exposures associated with its interests in WQPCC. Accounting Policy - Associates Associates are all entities over which Central West Health has significant influence (the power to participate in the financial and operating policy decisions of the investee). This is generally the case where Central West Health holds between 20% and 50% of the voting rights. Material investments in associates are accounted for using the equity method of accounting, after initially being recognised at cost. Under the equity method of accounting, the investments are initially recognised at cost and adjusted thereafter to recognise Central West Health's share of the post-acquisition profits or losses of the investee in Central West Health's operating result, and Central West Health's share of movements in other comprehensive income of the investee in other comprehensive income.

TAXATION E5

Both Central West Health and the Department of Health satisfy section 149-25E of the A New Tax System (Goods and Services Act) 1999 (Cth) (the GST Act) and were able, with other hospital and health services, to form a “group” for GST purposes under Division 149 of the GST Act. This means that any transactions between the members of the “group” do not attract GST.

FIRST YEAR APPLICATION OF NEW STANDARDS OR CHANGE IN POLICY E6Accounting Standards early adopted in 2016-2017

No Australian Accounting Standards have been early adopted for 2016-17.

New and revised accounting standards AASB 124 Related Party Disclosures AASB 124 is effective from reporting periods beginning on or after 1 July 2016 and requires disclosures about the remuneration of key management personal (KMP), transactions with related parties, and relationships between parent and controlled entities. AASB 124 has no impact on financial statement line items. Related party transaction information for 2016-17 is disclosed in Note E3. As this is the first year of application, comparative information is not required. Central West health previously disclosed detailed information about remuneration of its KMP, based on Queensland Treasury’s Financial Reporting Requirements for Queensland Government Agencies (refer to Note E2 and E3). Due to additional guidance about the KMP definition in the revised AASB 124, Central West Health has assessed that the Minister for Health is a part of its KMP for 2016-17, and is included in the KMP disclosures. Comparative information will continue to be disclosed in respect of KMP remuneration.

FUTURE IMPACT OF ACCOUNTING STANDARDS NOT YET EFFECTIVE E7At the date of authorisation of the financial report, the expected impacts of new or amended Australian Accounting Standards issued but with future commencement dates are set out below. AASB 15 Revenue from Contracts with Customers This Standard will become effective from reporting periods beginning on or after 1 January 2018 and contains much more detailed requirements for the accounting for certain types of revenues from customers. Depending on the specific contractual terms, the new requirements may potentially result in a change to the timing of revenue for Central West Health services, such that some revenue may need to be deferred to a later reporting period to the extent that the HHS has received cash but has not met its associated obligations (such amounts would be reported as a liability (unearned revenue) in the meantime). The HHS considers that the most likely financial impact will be the deferred recognition of certain revenue to the extent that there are performance obligations under an enforceable contract that meet the “sufficiently specific” criteria of AASB15.

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for the year ended 30 June 2017 AASB 1058 Income of Not-For-Profit Entities This standard will become effective for reporting periods commencing on, or after, 1 January 2019. AASB1058 clarifies and simplifies the income recognition requirements that apply to not-for-profit (NFP) entities, and the majority of income recognition requirements relating to private sector NFP entities and the majority of income recognition requirements relating to public sector NFP entities, previously in AASB1004 Contributions. AASB 1058 applies to transactions where the consideration given to acquire an asset (including cash) is significantly less than fair value of the asset principally to enable a not-for profit entity to further its objectives or to volunteer services. Where consideration provided under a transaction solely involves performance obligations under an enforceable contract and is sufficiently specific it is accounted for under AASB15 Revenue from Contracts with Customer. Central West Health is yet to complete its analysis of current arrangements in relation to transactions that fall within the ambit of AASB1058, but does not expect a significant impact on its present accounting practices. AASB9 Financial Instruments and AASB 2014-7 Amendments to Australian Accounting Standards arising from AASB9 (December 2014) These standards will become effective from reporting periods beginning on, or after, 1 January 2018. The main impacts of these standards on Central West Health are that they will change the requirements for classification, measurement, impairment and disclosures associated with financial assets. AASB9 will introduce criteria for whether financial assets can be measured at amortised cost or fair value. At this stage, and assuming no change in the types of transactions that Central West Health enters into, all financial assets are expected to be measured at fair value. In the case of Central West Health’s current receivables, as they are short term in nature, the carrying amount is expected to be a reasonable approximation of fair value. Changes in the fair value of those assets will be reflected in Central West Health’s operating result. Another impact of AASB 9 relates to calculating impairment losses for receivables. Assuming no substantial change in the nature of Central West Health’s receivables, as they do not include a significant financing component, impairment losses will be determined according to the amount of lifetime expected credit losses. On initial adoption of AASB9, Central West Health will need to determine the expected credit losses for its receivables by comparing the credit risk at the time to the credit risk that existed when those receivables were initially recognised. Assuming no change in the types of financial instruments that Central West Health enters into, the most likely ongoing disclosure impacts are expected to relate to the credit risk of financial assets subject to impairment through other comprehensive income.

EVENTS AFTER THE REPORTING PERIOD E8

Other matters No other matter or circumstance has arisen since 30 June 2017 that has significantly affected, or may significantly affect Central West Health's operations, the results of those operations, or Central West Health's state of affairs in future financial years.

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SECTION F

NOTES ON OUR PERFORMANCE TO BUDGET

This section discloses CWHHS’s original published budgeted figures for 2016-17 compared to actual results, with explanations of major variances, in respect of CWHHS’s Statement of Comprehensive Income, Statement of Financial Position and Statement of Cash Flows.

BUDGET TO ACTUAL COMPARISON – STATEMENT OF COMPREHENSIVE INCOME F1

F1-1: Budget to actual comparison - Statement of Comprehensive Income 2017 Variance $'000 $'000 $'000 %

Notes Budget Actual Variance Variance OPERATING RESULT Income

User charges and fees A1 66,651 70,674 4,023 6% Grants and other contributions A2 690 1,457 767 111% Other revenue A3 1,250 675 (575) (46%)

Total Income 68,591 72,806 4,215 Expenses

Employee expenses A4 10,464 6,392 (4,072) (39%) Health service employee expenses 35,053 35,799 746 2% Supplies and services A5 18,749 24,374 5,625 30% Depreciation expense 4,179 4,268 89 2% Other expenses A6 70 815 745 1064% Losses on sale/revaluation of assets A7 76 208 132 174%

Total Expenses 68,591 71,856 3,265 Operating results - 950 950 Other comprehensive income Items that will not be reclassified subsequently to profit or loss

Increase/(decrease) in asset revaluation surplus - 1,202 1,202 100% Total items that will not be re-classified to operating results - 1,202 1,202 Total comprehensive income for the year - 2,152 2,152

Materiality for Notes commentary is based on the calculation of the line item’s actual value percentage of the group total. If the percentage is greater than 5%, the line item variance from budget to actual is reviewed. A note is provided for where this percentage is 5% or greater for Employee expenses, Supplies and services, and Property, plant and equipment and 10% or greater for others.

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BUDGET TO ACTUAL COMPARISON – STATEMENT OF FINANCIAL POSITION F2

F2-1: Budget to actual comparison - Statement of Financial Position 2017 Variance $'000 $'000 $'000 % Notes Budget Actual Variance Variance Current Assets

Cash and cash equivalents A8 1,288 2,889 1,601 124% Receivables A9 1,379 1,580 201 15% Inventories 594 590 (4) (1%) Prepayments A10 64 213 149 233%

Total Current Assets 3,325 5,272 1,947 Non-Current Assets

Property, plant and equipment A11 69,537 63,529 (6,008) (9%) Total Non-Current Assets 69,537 63,529 (6,008) Total Assets 72,862 68,801 (4,061) Current Liabilities

Payables A12 1,851 3,920 2,069 112% Accrued employee benefits 108 199 91 84%

Total Current Liabilities 1,959 4,119 2,160 Total Liabilities 1,959 4,119 2,160 Net Assets 70,903 64,682 (6,221) Total Equity 70,903 64,682 (6,221)

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BUDGET TO ACTUAL COMPARISON – STATEMENT OF CASH FLOWS F3

F3-1: Budget to actual comparison - Statement of Cash Flows 2017 Variance $'000 $'000 $'000 %

Notes Budget Actual Variance Variance Cash flows from operating activities

Inflows User charges and fees A1 66,641 66,692 51 0% Grants and other contributions A2 690 1,457 767 111% GST collected from customers - 1,486 1,486 -% GST input tax credits from ATO - 74 74 -% Other receipts A3 3,060 671 (2,389) (78%)

Outflows Employee expenses A4 (10,464) (6,285) 4,179 (40%) Health service employee expenses (35,321) (35,600) (279) 1% Supplies and services A5 (20,873) (24,872) (3,999) 19% GST paid to suppliers - (1,489) (1,489) -% GST remitted to ATO - (109) (109) -% Other (70) (744) (674) 963%

Net cash provided by (used in) operating activities 3,663 1,281 (2,382) Cash flows from investing activities

Inflows Sales of property, plant and equipment

- 38 38 -%

Outflows Payments for non-financial assets A13 (1,075) (2,066) (991) 92%

Net cash provided by (used in) investing activities (1,075) (2,028) (953) Cash flows from financing activities

Inflows Equity injections A13 1,075 1,610 535 50% - - - -% Outflows - - - -% Equity withdrawals A14 (4,179) - 4,179 (100)%

Net cash provided by (used in) financing activities (3,104) 1,610 4,714 Net increase/(decrease) in cash held (516) 863 1,379 (267%) Cash at the beginning of the financial year 1,804 2,026 222 12% Cash at the end of the financial year 1,288 2,889 1,601

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BUDGET VS ACTUAL COMPARISON

A1 The variance in user charges relates to additional funding provided through amendments to the Service Agreement between Central West Health and the Department of Health ($2.8m). The remaining variance is due to increases in the pharmaceutical benefits scheme, additional program funding, enterprise bargaining, depreciation and private practice revenue ($0.8m).

A2 The original budget did not presume funding for Diamantina, Checkup and Allied Health Rural Generalist Training Positions would be received as grants and contributions ($0.8m).

A3 The original budget presumed funding for Diamantina, Checkup and Allied Health Rural Generalist Training Positions would be received as other revenue instead of grants and contributions ($0.8m) with the remaining variance due to reimbursement of project costs (-$0.3m).

A4 The budget included health service employees in error ($3.2m). The remaining variance is due to the use of locums in vacant medical officer positions ($0.8m).

A5 The variance is due to an increase in nursing costs due to the use of agency nurses in vacant nursing positions ($2.8m) and locums in vacant medical positions ($0.8m). The remaining variance is due to increases in patient travel ($0.6m), building rental due to increase in project staff ($0.2m), drugs ($0.53m), consultancy ($0.5m), building expenses ($0.1m) and communications ($0.1m).

A6 The variance is due to unbudgeted prepayments ($0.45m). The remaining variance is due to increases in costs relating to audit fees and recruitment advertising totalling ($0.1m).

A7 The variance is due to a larger than anticipated decrease in land valuation from the downturn in the pastoral industry.

A8 The variance is due to the timing of receipts and payment and the difficulty in estimating these for budgeting purposes ($1.6m).

A9 The variance is due to an unanticipated reimbursement of capital project expenses from the Department of Health ($0.2m).

A10 The variance is due to an unanticipated increase in prepayments for advisory board membership fees, cardiharb software support, medical director licence fee and RSL Care licence fee ($0.1m).

A11 The budget presumed completion of major projects including Aramac New Primary Health Care Centre ($2.7m) and the Longreach Hospital Mechanical Services Upgrade and Medical Imaging ($4m) in 2016-17.

A12 The variance is due to changes in the timing of Department of Health payroll and invoicing payments and the difficulty in estimating these for budgeting purposes.

A13 The variance is due to unbudgeted payment for capital projects.

A14 Actual equity withdrawal funding has been excluded from the cash flow as it is a non-cash item; however it was included in the original budget for whole-of-government reporting requirements in error.

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2016–2017 Annual Report

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