statutory annual report - slhd.nsw.gov.au

central sydney area health service

statutory annual report

1999/2000statutory

report

http://www-test.cs.nsw.gov.au/corporate/annual/default.htm

1999/2000 CSAHS Statutory Annual Report 1

CONTENTS Introduction . . . . . . . . . 2

Mission & Service Commitment . . . . . . . 3

Chairman’s Message . . . . . . . . 4

Operational Structure . . . . . . . . 5

Corporate Governance . . . . . . . . 6

Objectives & Performance Review . . . . . . 9

Clinical Groups . . . . . . . . . 14

Other Services . . . . . . . . . 29

Facilities . . . . . . . . . 31

Quality, Research & Teaching . . . . . . . 41

Corporate Services . . . . . . . . 43

Operational Efficiency . . . . . . . . 51

SES Officers Report . . . . . . . . 52

Non-Government Organisations . . . . . . . 54

Audited Financial Statements . . . . . . . 55

Appendix A (1999/2000 – 2000/2001 Performance Agreement)



INTRODUCTION Central Sydney Area Health Service manages all public healthcare within its geographic boundaries, incorporating 71 suburbs. It is one of 17 area health services in NSW. Our cutting edge services are organised into 14 clinical groups that provide referral specialties to the State, as well as healthcare that is needs specific to a local population of 480,000. The clinical groups operate out of more than 90 sites including 10 hospitals, a family care centre, an institute of forensic medicine and an extensive network of community health centres. During 1999/2000, our dedicated staff of some 8,700 were responsible for more than 135,000 inpatient and 1.8 million outpatient treatments, and delivered 5,522 babies. CSAHS is now more than halfway through the largest rebuilding venture in the State’s health system. The $375 million Resource Transition Program promises a healthy outlook with healthcare that is even more efficient and patient-focused. The 1999/2000 CSAHS Statutory Annual Report addresses annual report criteria established by NSW Health and NSW Treasury. A summary document titled A Healthy Outlook: Central Sydney Area Health Service 1999/2000 is available for the wider community.



MISSION & SERVICE COMMITMENT MissionMissionMissionMission Central Sydney Area Health Service is committed to: • Γ working with the people of central

Sydney to promote, protect and maintain their level of wellbeing

• Γ fulfilling Statewide and national responsibilities to provide a high level of quality specialist services

• Γ providing, in conjunction with the tertiary education sector, professional health education and training, and

• Γ encouraging and fostering research. CSAHS is primarily funded by NSW Health. It was formed on August 1 1988 and charged with full responsibility for the effective management of the health service. CSAHS operates under the Health Services Act, 1997. Commitment of ServiceCommitment of ServiceCommitment of ServiceCommitment of Service

Guarantee of Service CSAHS aims to offer the best quality services to all patients by providing: • Γ information about their health

condition and services • Γ world-class standards in healthcare and

technology • Γ a friendly and cooperative approach to

service delivery • Γ access to the range of hospital and

community-based health services • Γ staff who care • Γ training for the future generations of

healthcare professionals, and • Γ a sound research base to extend our

knowledge of illness, its treatment and prevention.

CSAHS offers a wide range of health services in different care settings and which require different skills, resources and management.

These cover: • Γ community services and domiciliary

care • Γ ambulatory care • Γ inpatient care • Γ convalescent support care • Γ long-term care • Γ health promotion and illness prevention

activities, and • Γ public health activities. Each setting has staff especially selected for their expertise to assist in every way. CSAHS ensures that staff are competent, confident and well trained to provide care and services in a secure and safe environment. CSAHS’s commitment is to: • Γ recognise individuals and include where

appropriate family, friends and carers in programs

• Γ respect cultures, beliefs and conscientious convictions

• Γ provide services in a non-discriminatory manner regardless of race, age, gender, sexual preference, marital status, intellectual or physical impairment

• Γ discuss with patients options for treatment, indicating benefits and risks, enabling informed decisions

• Γ include patients in all aspects of their care by ensuring ongoing communication

• Γ respect patients’ privacy and maintain all information as confidential, and

• Γ arrange interpreter services to assist if needed.

Staff at CSAHS welcome comments and suggestions that would help improve the care and services provided.



CHAIRMAN’S MESSAGE The purpose in running a health system is to make real improvements in personal and community wellbeing for all the people of the State. The past year in Central Sydney Area Health Service has seen both our commitment to and our delivery of those outcomes for all our patients and clients clearly manifest. During the year more people were treated in most of our departments, with a significant increase in the rates of admission on the day of surgery, freeing up more beds with patients spending less time in hospital. Our survival rates for many of the most complex procedures such as those involving multiple myeloma, upper gastrointestinal and renal tumours are better than the State average, and thanks to an aggressive campaign on our part we have brought down the rate of smoking in the Vietnamese community from 42 per cent to 36 per cent. During this year the progress of our Resource Transition Program has been notable. Major works at Royal Prince Alfred Hospital took shape, while rebuilding at the United Dental Hospital and the Institute of Rheumatology & Orthopaedics neared completion. The success of the television series RPA reflects the strong community support we receive. It brings into people’s homes real stories about real people and demonstrates the quality of our work and the skills and dedication of our staff. Little wonder then that it won this year’s Logie Award as the most popular reality program – a tribute to everyone concerned on both sides of the camera. Close attention to quality control issues is imperative and this year a Clinical Quality Control Council was established for that very purpose. Both Y2K and GST concerns were successfully addressed and dealt with in a most skilful fashion by our IT and finance officers. At the end of the year we find ourselves well prepared to meet the challenges of the next, from our readiness to respond to Olympic demands through to our commitment to our patients. I encourage you to read this report in conjunction with A Healthy Outlook: Central Sydney Area Health Service 1999/2000, which focuses on benefits to the community.

Chris Puplick



OPERATIONAL STRUCTURE

NSW Minister for Health

NSW Health Director-General Chief Executive Officer Board of Directors

Internal Audit Manager Director of Health

Services Deputy Chief

Executive Officer Director of

Corporate Services Director of

Finance Director of Health

Services Development &

Planning

Director of Nursing Services

Hospitals that offer key servicesHospitals that offer key servicesHospitals that offer key servicesHospitals that offer key services Key service areasKey service areasKey service areasKey service areas

Balmain Balmain Balmain Balmain HospitalHospitalHospitalHospital

RPARPARPARPA Concord Concord Concord Concord HospitalHospitalHospitalHospital

Canterbury Canterbury Canterbury Canterbury HospitalHospitalHospitalHospital

United United United United Dental Dental Dental Dental

HospitalHospitalHospitalHospital

Rozelle Rozelle Rozelle Rozelle HospitalHospitalHospitalHospital

Bone, Joint and Connective Tissue Service

� � �

Cancer Services

� � �

Cardiovascular Services

� �

Central Sydney Laboratory Service

� � � �

Dental Services

� � � �

Gastroenterology and Liver Services

� � �

General, Geriatric and Rehabilitation Medicine

� � � �

General Practice

� �

Medical Imaging Services

� � � �

Mental Health Services

� � �

Neurosciences

� � �

Population Health and Drug & Alcohol Services

� � � �

Respiratory and Critical Care Service

� �

Women’s and Children’s Health

� � �

Allied Health

� � � � �



CORPORATE GOVERNANCE Board MembersBoard MembersBoard MembersBoard Members CSAHS board members serve up to a four-year term, with board meetings held on the first Wednesday of each month. Chris PuplickChris PuplickChris PuplickChris Puplick Chairman BA (Hons) (Syd), MA (Syd) A member of the board since 1993 and chairman since 1996, Chris is president of the Anti-Discrimination Board of NSW and the State’s Privacy Commissioner. He chairs the Australian National Council on AIDS, Hepatitis C and Related Diseases (ANCHARD), the AIDS Trust of Australia and the National Task Force on Whaling. He is a board member of the Griffin Theatre Company. John Young John Young John Young John Young AOAOAOAO Deputy Chairman DSc, MD, FAA, FRACP Professor Young joined the board in 1989. He is the pro-vice chancellor of the University of Sydney’s College of Health Sciences. Maria Pethard Maria Pethard Maria Pethard Maria Pethard Treasurer BSc (Hons), DipCompSc, FASCT, AIBF (Aff), ASIA A member of the board since 1997, Maria is Banca Commerciale Italiana’s chief representative for Australia, New Zealand and the South Pacific, as well as a member of the Executive Committee of the Australian Society of Corporate Treasurers. Diana Horvath Diana Horvath Diana Horvath Diana Horvath AOAOAOAO MB, BS (Hons), MHP, FRACMA, FAFPHM, FCHSE Dr Horvath was appointed chief executive officer in 1992. She has chaired the National Health and Medical Research Council and served as president of the Australian Hospital Association as well as five years as a commissioner with the Health Insurance Commission, and was a member of the Trade Policy Advisory Council. Charles Linsell Charles Linsell Charles Linsell Charles Linsell BA, DipEd, GradDipBusStudies IR, RN The staff-elected representative since 1992, Charles is staff education manager for CSAHS Mental Health Services.

Peter FernandoPeter FernandoPeter FernandoPeter Fernando Appointed to the board in 1998, Peter is the deputy chief executive officer of the Aboriginal Medical Service. Nea Goodman Nea Goodman Nea Goodman Nea Goodman LLB (Hons Class 1) Nea joined the board in 1998. She is a lawyer with GIO Australia. Frances CarolanFrances CarolanFrances CarolanFrances Carolan A board member since 1996, Frances is an operations nurse manager at Canterbury Hospital. Olwyn Mackenzie Olwyn Mackenzie Olwyn Mackenzie Olwyn Mackenzie BA (Hons) (Syd) A member of the board since 1996, Olwyn is a member of the Consumer’s Health Forum, the Kings Cross Community Drug Advisory Team, Council on the Ageing, Older Women’s Network, University of the Third Age and the Kings Cross Community Consultative Committee. John Meadth John Meadth John Meadth John Meadth MB, BS Dr Meadth was appointed to the board in 1997. He is a general practitioner in Concord, chairs the Medical Panel for Cricket NSW and the Department of General Practice at Strathfield Private Hospital, and is a board member of the Leukaemia Foundation of NSW. Nada RNada RNada RNada Roude oude oude oude BA (Hons) (Syd) A member of the board since 1996, Nada is a senior liaison officer with the Ethnic Affairs Commission of NSW. Gwynn BoydGwynn BoydGwynn BoydGwynn Boyd Appointed to the board in 1997, Gwynn is an associate director with the Corporate Finance Group of the Macquarie Bank.



The board met 12 times during the year: MemberMemberMemberMember AttendanceAttendanceAttendanceAttendance Chris Puplick 12 Gwynn Boyd 10 Frances Carolan 10 Peter Fernando 7 Nea Goodman 11 Diana Horvath AO 11 Charles Linsell 12 Olwyn Mackenzie 8 Dr John Meadth 9 Maria Pethard 9 Nada Roude 8 Prof John Young AO 8 Board and staff members comprise committees relevant to CSAHS activities. These are: • Γ Finance and Budget CommitteeFinance and Budget CommitteeFinance and Budget CommitteeFinance and Budget Committee, chaired

by Maria Pethard. It makes recommendations about budget allocation and financial performance. It meets on the third Wednesday of each month. Members (attendance): M Pethard (10), Dr D Horvath (10), F Carolan (10), N Goodman (9), C Linsell (10), Prof J Young (4).

• Γ Medical and Dental Appointments Medical and Dental Appointments Medical and Dental Appointments Medical and Dental Appointments

Advisory CommitteeAdvisory CommitteeAdvisory CommitteeAdvisory Committee, chaired by Prof John Young. It recommends all CSAHS medical and dental appointments, and meets quarterly. Members (attendance): Prof J Young (5), Dr D Horvath (5), C Linsell (4), A/Prof K Rickard (2), Prof B Freedman (2), Dr M Stewart (1), Dr P Hoyle (3), Dr M Sanger (3), Dr S Liew (2), Dr P Kennedy (5), A/Prof B McCaughan (1), A/Prof P Torzillo (2), Prof R Houghton (4), A/Prof G Duggin (2), Dr G Stewart (3), J Neville (3), G Berg (2), Prof M Bashir (1), Dr V Storm (1), Prof J Bishop (2), Dr J Cullen (2), Prof M Besser (3), Dr P Holman (1), Dr S Buchanan (3), Dr H Jagger (2).

• Γ CSAHS Audit CommitteeCSAHS Audit CommitteeCSAHS Audit CommitteeCSAHS Audit Committee, chaired by

Gwynn Boyd. It oversees matters arising from internal and external audit reviews, and met three times in 1999/2000. Members (attendance): G Boyd (3), Dr J Meadth (1), Dr D Horvath (1), Prof J Young (1).

• Γ Clinical Quality CouncilClinical Quality CouncilClinical Quality CouncilClinical Quality Council, chaired by

Prof John Young. It was established in September 2000 and meets every two months to make recommendation on issues regarding quality of service. Members (attendance): Professor J Young (5), Prof M Bashir (4), Prof M Besser (4), Prof J Bishop (4), Prof L Bokey (2), Dr S Buchanan (5), Dr A Child (2), Dr A Chalasani (2), Dr J Cullen (4), M Dickinson (2), A/Prof G Duggin (1), K Eu/K Moore (5), A/Prof J Englert (3), A/Prof M Fulham (3), R Gilbert (5), Prof P Harris (4), A Hay (5), Dr P Holman (5), Dr D Horvath (4), Prof J Horvath (2), Dr P Hoyle (4), W Jamieson (3), Dr P Kennedy (3), A/Prof B McCaughan (5), Prof M Mira (4), G Rowley (3), K Russell (3), Dr P Sainsbury (3), Dr M Sanger (3), Dr G Stewart (2), Dr G Szonyi (1), A/Prof L Thompson (4), Dr P Torzillo (3), A/Prof J Ward (3), T Wilson (5).

• Γ Ethics Review committeesEthics Review committeesEthics Review committeesEthics Review committees meet

monthly at Royal Prince Alfred and Concord hospitals. The RPA committee is chaired by Dr Robert Loblay, Concord Hospital’s by Dr Sue Liew, and the UDH committee by Dr Susan Buchanan to December 1999 and Dr Barbara Taylor from January 2000.

• Γ RPA members (attendance): Dr R Loblay

(11), D Andrews (commenced 2000) (1), A Bolton (8), D Brine (4),

Dr R Brown (8), Dr P Butow (1), T Clarke (7), Prof D Cook (12), Dr A Eyers (8), N Goodman (11),

Dr V Levy (12), S Linden (3), J Lutman (12), Rev Dr R McFarlane (1), H Milne (10), Rev Dr M Nixon (10), Dr I Rieger (10), D Scarlett (2), K Vesk (8),

A/Prof I Young (9), L Townsend (12). • Γ Concord Hospital members

(attendance): Dr S Liew (9), • Γ Dr D Brieger (7), Dr J Donnelly (3), • Γ C George (4), E Lane (7), J Lutman

(10), C Marsh (3), Dr M Millward (8), L Nigro/Ms K Whitelock (11),

• Γ Dr G Pearce (5), Dr E Spence (7), C Stewart (8), K England (until August 1999) (2), Rev D Hayes (until



December 1999) (5), Dr J Moulton (until December 1999) (5), Dr S Whyte (until December 1999) (5). From February 2000 J Bell (5), Dr G Aggarwal (4), Dr G Molland (4), Rev P Watkins (4), M Richardson (3), Dr F Li (from Feb 2000) (4), Dr S Lim (4).

• Γ UDH members (attendance):

Dr S Buchanan (2), Dr B Taylor (2), Dr R Loblay (2), J Lutman (1), P Power (2), A Roth (2). Until the end of 1999 Fr L Cashen (1), Dr N Hunter (1), A Low (1), A/Prof S Yeung) (1). From May 2000 C Diep (1), Fr M Milani (1), Dr W Sherson (1), Prof M Swain (1).

Executive ManagementExecutive ManagementExecutive ManagementExecutive Management A team of seven is responsible for the management of Central Sydney Area Health Service, and works closely with the senior staff of each facility and clinical group. Chief Executive OfficerChief Executive OfficerChief Executive OfficerChief Executive Officer Dr Diana Horvath AO MB, BS, MHP, FRACMA, FCHSE, FFPHM The CEO is accountable to NSW Health for the facilities and services of CSAHS. The 10 hospitals, health programs, extensive teaching and research units provide healthcare to central Sydney’s population, some 480,000 people. CSAHS has an annual turnover of more than $776 million and employs 8,700 staff, responsible for 135,000 inpatients and 1.8 million outpatient treatments each year. DepuDepuDepuDeputy Chief Executive Officerty Chief Executive Officerty Chief Executive Officerty Chief Executive Officer Mike Wallace MSc (Soc) BSc The deputy CEO is responsible for the operational management of CSAHS and the use of resources and facilities. Director of Health ServicesDirector of Health ServicesDirector of Health ServicesDirector of Health Services Dr Greg Stewart MB, BS, MPH, FRACMA, FAFPHM The director of Health Services plans for and assists the development and integration of health provision across the 14 clinical

groups at CSAHS, with a focus on outcomes and quality. Director of FinanceDirector of FinanceDirector of FinanceDirector of Finance Candy Cheng BComm (UNSW) FCPA The director of Finance ensures that CSAHS’s available financial resources and assets are managed equitably, efficiently, and effectively through the planning, direction, coordination and monitoring of their use. Director of Health Services Development & Director of Health Services Development & Director of Health Services Development & Director of Health Services Development & Planning Planning Planning Planning Richard Gilbert BSc (Hons) The director of Health Services Development & Planning advises on and manages all aspects of health development and planning including policy and funding implications. Director of Corporate ServicesDirector of Corporate ServicesDirector of Corporate ServicesDirector of Corporate Services Jan Whalan BPharm, MPH, MBA, AFAIM The director of Corporate Services’ responsibilities include human resources management; risk management, occupational health safety and rehabilitation; procurement and tendering; management and performance contracts; policy development; administrative and legal services; and non-government organisations. Director of Nursing ServicesDirector of Nursing ServicesDirector of Nursing ServicesDirector of Nursing Services Prof Joan Englert AM RN, CM, MSc (Soc), BHA, DNA, COTM, CIC, FCN (NSW), FRCNA, FAIM The director of Nursing Services manages strategic planning and coordination of nursing provision across facilities within CSAHS. The position looks after the Staff Development and Training Network to meet the on-going needs of all employees, and the quality management of services.



OBJECTIVES & PERFORMANCE REVIEW

Extracts from the Extracts from the Extracts from the Extracts from the 1999/2000 1999/2000 1999/2000 1999/2000 –––– 2000/2001 2000/2001 2000/2001 2000/2001 Performance Performance Performance Performance Agreement*Agreement*Agreement*Agreement* Central Sydney Area Health Service is proud of its achievements in the last year. With the cooperation of senior managers and clinicians all budget targets were achieved. The integrated approach to problem solving has been key in CSAHS’s success, not only in financial performance but in reviewing and improving clinical care and developing new facilities designed for both clinician and patient. The transition to 2000 passed uneventfully and preparations commenced for the Olympics.

Major AchievementsMajor AchievementsMajor AchievementsMajor Achievements

a.a.a.a. Financial ManagementFinancial ManagementFinancial ManagementFinancial Management

CSAHS delivered a favourable Net Cost of Service and Net Cash result for both the General Fund and the Special Purpose Trust Fund for 1999/2000.

All creditors were paid within 45 days.

b.b.b.b. Asset Management Asset Management Asset Management Asset Management

Projects proceeded in accordance with NSW Health approval. Expenditure allocation target of $57.1 million was met for 1999/2000. Progress at June 2000 is summarised below:

Royal Prince Alfred Hospital Royal Prince Alfred Hospital Royal Prince Alfred Hospital Royal Prince Alfred Hospital •

Gloucester House was reconfigured and Levels 2 to 6 (inclusive) were refurbished and occupied.

• The design and documentation for RPA is approximately 98 per cent complete.

• Construction documentation commenced for the laboratory complex at the southern end of the eastern campus.

• Pouring of slabs up to Level 6 of the new clinical services building is almost completed.

Institute of Rheumatology & Institute of Rheumatology & Institute of Rheumatology & Institute of Rheumatology & OrthopaedicsOrthopaedicsOrthopaedicsOrthopaedics • The Level 4 refurbishment

has been completed with Level 5 occupation programmed for July. The fit-out to Levels 6 west and Level 7 is well advanced.

• The project is on target for relocation of Rachel Forster Hospital in September 2000.

Concord HospitalConcord HospitalConcord HospitalConcord Hospital • The Conservation

Management Plan was approved by Heritage Office and infill structure accepted.

• Concord Council approved the development application in May 2000.

• The Fire Engineering Design Brief report was finalised with documentation on all major works packages.

United Dental HospitalUnited Dental HospitalUnited Dental HospitalUnited Dental Hospital • The new assessment and

emergency department was completed, as was the administration area.

• The infrastructure services project is progressing well with on-site fire services 90 per cent complete.

• The new main switchboard, cooling tower and stair



pressurisation arrangements were approved and the bulk of new service equipment delivered.

c.c.c.c. Clinical ManagementClinical ManagementClinical ManagementClinical Management

A Clinical Quality Council was established to oversee and further improve high standards of care. The council meets bi-monthly and is chaired by a member of the CSAHS board.

Clinical risk management reporting mechanisms have been reviewed and are in place with each of the clinical service groupings and cover: • Sentinel events • Facilitated incident

monitoring • Ad hoc audits

1.31.31.31.3 Initiatives for 2000/2001Initiatives for 2000/2001Initiatives for 2000/2001Initiatives for 2000/2001

Key initiatives for the coming year include: • The continuing introduction of

the State government’s Action Plan for Health.

• The progressive implementation of the Resource Transition Program.

• An ongoing focus on clinical governance.

SECTION 2: SUMMARY OSECTION 2: SUMMARY OSECTION 2: SUMMARY OSECTION 2: SUMMARY OF PROGRESS F PROGRESS F PROGRESS F PROGRESS ON GOALS IN ON GOALS IN ON GOALS IN ON GOALS IN STRATEGIC DIRECTIONSSTRATEGIC DIRECTIONSSTRATEGIC DIRECTIONSSTRATEGIC DIRECTIONS FOR HEALTHFOR HEALTHFOR HEALTHFOR HEALTH 2.12.12.12.1 Healthier PeopleHealthier PeopleHealthier PeopleHealthier People

a.a.a.a. Mental HealthMental HealthMental HealthMental Health

During 1999/2000 the Area Mental Health Service (AMHS) focused on quality activities and improving IT infrastructure, with the decision taken to move to the HNA Millennium system. Triage assessment documentation is currently being reviewed to ensure that mandatory data fields are

captured and that consistent practices apply across the AMHS.

Increasing emphasis has been given

to prevention, promotion and early intervention with recruitment of a specific project officer and placement of mental health consultation liaison officers in the emergency departments at RPA, Canterbury and Concord hospitals.

b. b. b. b. Health Priority Areas and Health Health Priority Areas and Health Health Priority Areas and Health Health Priority Areas and Health

PromotionPromotionPromotionPromotion

The progressive implementation of the Second Tobacco Control Plan was particularly successful. Programs were made available for staff, inpatients and, on request, local residents. CSAHS’s Smoke-free Environment Policy came into effect on 1 May 2000. The policy includes limiting exposure to tobacco smoke to areas exempted from the policy with a total of 71 areas identified for this purpose. Processes to manage visitors, patients and staff in the use of these exempted areas were developed.

The Health Promotion Unit has

continued to work with local councils and schools on projects related to physical activity, sun protection and food and nutrition. The Drink Driving, It’s a Crime. Choose Don’t Lose campaign was implemented in hotels and clubs throughout Leichhardt, South Sydney, City of Sydney and Marrickville Council areas over Christmas 1999. Partners in the project included publicans, councils, RTA and the police service. A Portuguese version of the campaign is being developed to be conducted toward the end of 2000.



Health ProtectionHealth ProtectionHealth ProtectionHealth Protection

Extensive work was undertaken by the Public Health Unit in preparation for the Olympics, in conjunction with local councils.

Strategies to improve the return

rate of immunisation certificates included sending reminder letters to stakeholders, surveying schools, preparing facts sheets, and assisting providers with developing processing systems and eliminating certificate backlogs. A review of documentation at school entry was completed.

2.22.22.22.2 Fairer AccessFairer AccessFairer AccessFairer Access a.a.a.a. Aboriginal HealthAboriginal HealthAboriginal HealthAboriginal Health

Aboriginal & Torres Strait Islander Employment Strategy for CSAHS has been developed and the Aboriginal Employment Committee continues to work in conjunction with HR to recruit staff to mainstream positions. Cultural Awareness Programs continue to be conducted by the Aboriginal Employment Coordinator with over 300 staff having attended. Sessions have been targeted to identified priority units. Negotiations with the Aboriginal Medical Service regarding the partnership agreement are to recommence.

b.b.b.b. Service Access and Service ModelsService Access and Service ModelsService Access and Service ModelsService Access and Service Models

The CSAHS Integrated Bed Management Committee focused on improving performance in three main areas: maximising day surgery and admission on the day of surgery where an overnight stay was required; more efficient discharge processes; and supporting the emergency departments in

accessing beds where patients required admission.

There was an improvement in the percentage of elective surgery undertaken on a day basis from 43.6 per cent to 44.3 per cent and particularly for admission on the day of surgery where for patients requiring an overnight stay the percentage rose from 40.1 per cent at June 1999 to 65.0 per cent at June 2000.

A working party was formed to develop consistent protocols across the area in relation to child protection. Child Protection Policies and Procedures in Drug and Alcohol Services have been developed and education has been provided for each drug and alcohol service in relation to these. Child protection training continues to be provided across CSAHS. A memorandum of understanding is being developed between CSAHS and the Inner West Department of Community Services.

The Outreach Home Dialysis Service clinics established at Coffs Harbour, Wagga Wagga, Dubbo and Brewarrina continue to function successfully.

2.32.32.32.3 Quality Health CareQuality Health CareQuality Health CareQuality Health Care

a.a.a.a. Initiatives in Quality ManagementInitiatives in Quality ManagementInitiatives in Quality ManagementInitiatives in Quality Management

The Clinical Quality Council, which meets bi-monthly, is chaired by a member of the board. Examples of initiatives in Liver and Gastroenterology Services include: the review of complications of liver biopsies, resulting in the utilisation of ultrasound guided liver biopsies resulting in a greater degree of accuracy and control during the procedure; and the introduction of the Colorectal Cancer Family Project by the Colorectal Unit at Concord Hospital.



All CSAHS facilities met their three-year EQuIP cycle targets to maintain their accreditation status.

b. Community Eb. Community Eb. Community Eb. Community Engagement and ngagement and ngagement and ngagement and Working in Partnerships Working in Partnerships Working in Partnerships Working in Partnerships

Some examples of projects in which

CSAHS has been involved are summarised here: Projects involving inter-agency collaboration have included the Inner West Child Protection CEOs and Senior Officers’ Group, the Inner West Families First Program, the Redfern/Waterloo Co-ordination Project, Boarding House Project and the Health Promoting Schools Project.

Women’s and Children’s Services participation in the Cervical Screening Advisory Group to formulate a Framework for Service Action, where GPs were targeted through their association with the Antenatal GP Shared Care Program to promote cervical screening of marginalised women.

A collaborative project was undertaken between King George V Hospital and the Division of General Practice to evaluate the degree of patient satisfaction with the health education and health promotion they received during their antenatal period.

Consultation was undertaken on the birthing needs of Aboriginal and Torres Strait Islander women and a working party was established to implement the agreed recommendations within KGV, AMHS and the CSAHS Community Health Services.

The GP Shared Care Program is expanding to include approximately 350 accredited GPs and is setting benchmarks for the antenatal services of other area health services. Currently 44 per cent of the antenatal patients at KGV and 30 per cent at Canterbury have

elected the GP Shared Care program as their management plan.

The pilot service for the General Practice after hours clinic at Canterbury began.

CSAHS again supported the production of the RPA television series which is viewed widely by the community. The program enhances community understanding of diseases and their treatment, as well as the operation of a large public hospital.

c.c.c.c. Teaching and ResearchTeaching and ResearchTeaching and ResearchTeaching and Research

The ANZAC Health and Medical Research Foundation facilities were redeveloped on the Concord Hospital site to better enable the foundation to focus on medical research of relevance to the war veteran community including veterans and their families. This focuses on lifestyle and ageing disorders, and indicates an interest in the origins and progression of degenerative diseases. The foundation’s activities are intended to advantage the veteran community by providing better access to medical research expertise. As the embodiment of the foundation’s efforts, the ANZAC Research Institute’s overall mandate is congruent with high quality scientific work in a wide range of specific medical research areas.

CSAHS continued to support research and attract a significant level of funding for research, as well as continuing its commitment to teaching.

d.d.d.d. Skilled, Valued WorkforceSkilled, Valued WorkforceSkilled, Valued WorkforceSkilled, Valued Workforce

CSAHS supports its workforce through a training and development program which is developed and implemented in conjunction with general managers.



The following initiatives were progressed:

The trial of innovative work practices continued at Concord Hospital with the introduction of unit-based staffing by the nursing division.

The CEO continued to hold regular staff forums at each facility, in addition to attending facility management meetings on a routine basis.

The Staff Consultative Committee and the Joint Consultative Committee continue to meet to facilitate unions and management negotiations.

2.42.42.42.4 Better ValueBetter ValueBetter ValueBetter Value

a.a.a.a. Activity, Financial and Activity, Financial and Activity, Financial and Activity, Financial and Management and Efficiency Management and Efficiency Management and Efficiency Management and Efficiency StrategiesStrategiesStrategiesStrategies

b.b.b.b. Service Strategic and Development Service Strategic and Development Service Strategic and Development Service Strategic and Development

and Asset Strategiesand Asset Strategiesand Asset Strategiesand Asset Strategies

CSAHS assets are well managed through the Resource Transition Program, the capital funding strategy which underpins service delivery.

c.c.c.c. Information ManagementInformation ManagementInformation ManagementInformation Management

CSAHS has adopted a proactive approach to implementing clinical and information technology management, such as integrated clinical records and the telemedicine initiative.

CSAHS continued the implementation of several key information management and technology initiatives including: the CCIS project which links patient demographics and clinical results on a CSAHS-wide basis; the YIPI project, the integrated patient information project which replaced the facility based non-Y2K PAS systems. This enables enterprise-

wide scheduling and CSAHS-wide electronic orders; and the PathNet Millennium project which was implemented at Concord Hospital to facilitate standardisation across CSAHS and Y2K compliance.

* see Appendix for the full Performance Agreement, which documents our objectives, targets, outcomes and future goals for the past financial year



CLINICAL GROUPS

Bone, Joint and Connective Tissue Bone, Joint and Connective Tissue Bone, Joint and Connective Tissue Bone, Joint and Connective Tissue ServiceServiceServiceService Clinical DirectClinical DirectClinical DirectClinical Director: Dr Peter Holman or: Dr Peter Holman or: Dr Peter Holman or: Dr Peter Holman MB, BS (Syd), FRACS, FAOrthA The Bone, Joint and Connective Tissue Service specialises in trauma, sports medicine, plastic and reconstructive surgery including burns, immunology and AIDS as well as orthopaedics, rheumatology, faciomaxillary and dental surgery. In addition to providing services at the CSAHS facilities, the Department of Immunology conducts ambulatory clinics at Orange Base Hospital in the State’s central west. Highlights in 1999/2000: •

Committing to increased bed numbers in the Burns Unit at Concord Hospital following a specialty review and rising admissions from 98 in 1998/99 to 120 in 1999/2000. It is being considered as the designated NSW burn injury centre.

• Nearing completion of the building work on the $17.4 million RPA Institute of Rheumatology & Orthopaedics, with commissioning expected early in the 2000/01 financial year. Unique in Australia, the institute is a stand-alone facility offering inpatient and outpatient services. A specialist team of orthopaedic surgeons and physicians, occupational therapists and nursing staff diagnose and manage patients with a variety of arthritic and bone diseases under the one roof.

• Establishing specialised combined orthopaedic and rheumatology clinics for hands, feet and osteoporosis.

• Reducing the number of inpatient HIV admissions as a result of improved therapy.

• Relocating the HIV clinic and introducing individual patient booking arrangements that have increased patient comfort and enhanced the facilities for confidential medical assessment.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 338.91 360.17 359.43 Admissions 10,264 10,166 9,799 Same-day admissions 3,225 3,225 3,456 Occasions of service 65,290 64,706 60,776 Bone, Joint and Connective Tissue ServiceBone, Joint and Connective Tissue ServiceBone, Joint and Connective Tissue ServiceBone, Joint and Connective Tissue Service RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury Orthopaedics � � �

Rheumatology � � �

Plastic & Reconstructive Surgery � �

Burns �

Faciomaxillary Surgery � �

Trauma � �

Dentistry � �

Endocrine �

Immunology � �

NSW Institute of Sports Medicine �



Cancer ServiceCancer ServiceCancer ServiceCancer Servicessss

Clinical Director: Professor James Bishop Clinical Director: Professor James Bishop Clinical Director: Professor James Bishop Clinical Director: Professor James Bishop MD, MMed, MB, BS, FRACP, FRCPA Cancer services in CSAHS are united under the banner of the Sydney Cancer Centre which is Australia’s largest cancer treatment facility, running programs at Royal Prince Alfred, Concord and Canterbury hospitals. A review of cancer outcomes in CSAHS revealed better than State average survival rates for multiple myeloma, upper gastrointestinal and renal cancers. Highlights for 1999/2000 included: • Developing a specialist clinic for

prostate cancer at Concord Hospital supported by the Department of Veterans’ Affairs.

• Completing building works in Gloucester House at RPA as part of the Resource Transition Program (RTP), providing a sophisticated, integrated cancer ambulatory care centre. It houses part of the ambulatory clinical activity of breast screen, the Sydney Melanoma Unit, palliative care, medical oncology, radiation oncology, dermatology, gynae-oncology, urology, breast surgery, head and neck surgery and clinical haematology. Similar concepts are planned at Concord Hospital under the RTP.

• Relocating the Rachel Forster Breast Clinic to Gloucester House.

• Expanding a coordinated clinical research program to cover 30 cancer clinical trials of new anti-cancer therapies to improve outcomes for patients.

• Increasing activity, lowering length of stay and providing more outpatient treatments....

• Collaborating on international research with the National University of Singapore, Chinese University of Hong Kong and Johns Hopkins Oncology Centre and the US National Cancer Institute.

• Providing training for oncology fellows from Thailand as well as overseas teaching workshops.

• Attracting more than $4.5 million over the past three years in grants for the cancer research program.

• Developing laboratory-based research programs in gene therapy and cancer pharmacology, drug radiation interactions, DNA methylation in collaboration with the Kanematsu Laboratories, Centenary Institute of Cancer Medicine and Cell Biology and the University of Sydney.

• Initiating the Clinical Cancer Registry.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 361.7 363.0 370.0 Admissions 22,195 18,890 18,111 Same Day Admissions 13,029 10,592 5,737 Outpatient Occasions of Service 67,800 95,000 114,775 Cancer ServicesCancer ServicesCancer ServicesCancer Services RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury Medical Oncology � � �

Surgical Oncology � �

Radiation Oncology � �

Urology � �

Sydney Breast Cancer Institute � �

BreastScreen NSW Central & Eastern Sydney �

Gynaecological Oncology � �

Clinical Haematology � �

Head and Neck Surgery � �

Sydney Melanoma Unit �

Palliative Care � � �

Dermatology � �

Bone and Soft Tissue Sarcoma Service �



Cardiovascular ServicesCardiovascular ServicesCardiovascular ServicesCardiovascular Services

Clinical Director: Associate Professor Brian Clinical Director: Associate Professor Brian Clinical Director: Associate Professor Brian Clinical Director: Associate Professor Brian McCaughan McCaughan McCaughan McCaughan MB, BS (Hon 1), FRACS Cardiovascular Services specialises in cardiology, renal, endocrinology, vascular, clinical pharmacology, cardiothoracic surgery, and toxicology (National Poisons Register). These services are primarily based at Royal Prince Alfred and Concord hospitals, with links to Canterbury Hospital. Residents of Central Sydney Area Health Service, other parts of NSW and overseas access the quality innovation provided by Cardiovascular Services. As new technology and techniques are applied the care and treatment provided is continually upgraded. Highlights for 1999/2000 included: •

Introducing new treatment protocols, including the use of photopheresis in the management of complex renal transplants.

• Developing the use of endoluminal aortic surgery. A prospective study was finalised comparing the results of open versus endoluminal aneurysm repair and confirmed the many advantages of the endoluminal approach.

•

Introducing brachytherapy to treat narrowed coronary arteries in a joint project between RPA’s cardiology and radiation oncology departments.

• NSW Health selecting the internationally known RPA high-risk foot clinic as a telemedicine project,

continuing the work done by the Diabetes Centre with health professionals in rural and remote NSW to improve care to residents.

• Closing holes in the heart by using cardiac catheters, avoiding open-heart surgery and a prolonged hospital stay.

• Vascular Surgery and Renal Medicine at Concord Hospital meeting to discuss areas of common interest, including renal access surgery, to improve patient care.

• Development of an innovative web-based patient information system for patients with renal disease that will interface with information stored in current hospital and national systems.

• The Endocrinology and Metabolism Centre at RPA moving into larger premises and acquiring a lunar bone densitometer. This allowed an expansion of services including a menopause clinic and research into the therapy of osteoporosis associated with thyroid cancers.

• Staff contributing to global research including cardiologist Dr David Brieger being appointed the Australian and New Zealand coordinator of the Global Registry of Acute Coronary Syndromes.

• Vascular Surgery at Concord Hospital continuing its emphasis on pre-admission and post discharge services. Elective patients routinely attended the Pre-Admission Clinic and 80 per cent were admitted on the day of surgery.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 528.61 509.72 517.79 Admissions 25,488 27,227 27,745 Same day admissions 16,773 17,514 18,591 Outpatient occasions of service 27,929 29,942 32,285 Cardiovascular ServicesCardiovascular ServicesCardiovascular ServicesCardiovascular Services RPARPARPARPA ConcordConcordConcordConcord Renal � �

Cardiology � �

Cardiothoracic Surgery � �

Endocrinology �

National Poisons Register �

Vascular Surgery � �

Clinical Pharmacology �



Central Sydney Laboratory ServiceCentral Sydney Laboratory ServiceCentral Sydney Laboratory ServiceCentral Sydney Laboratory Service Clinical Director: AssociateClinical Director: AssociateClinical Director: AssociateClinical Director: Associate Professor Geoff Professor Geoff Professor Geoff Professor Geoff DugginDugginDugginDuggin MB, BS (Hons), PhC, FRACP, FAFPHM The Central Sydney Laboratory Service provides the widest range of specialist tests in NSW, including molecular and clinical genetics, endocrinology, bone and mineral metabolism as well as the complete range of hepatitis testing. The CSLS aims to return quality test results for patients in minimum time. As one of five pathology hubs in NSW it services public and private healthcare facilities. Incorporating labs at Royal Prince Alfred, Concord, Canterbury and Balmain hospitals, research and teaching are an important component of the CSLS activities.

Highlights in 1999/2000 included: • Approving the final plans for the new

laboratory facility under the Resource Transition Program. The laboratory service will be centralised, ensuring better use of staff and resources and a faster turnaround on results.

• Integrating Diagnostic Endocrinology into the General Diagnostic Unit, maximising use of state-of-the-art equipment.

• Signing memoranda of understanding with ACT Pathology, Pacific Laboratory Medicine Service, and Hampson Sugerman Pathology for certain specialised tests to be carried out by the CSLS.

• Developing key performance indicators for pathology centres across NSW. Comparative data will be available early in the new financial year.

Key indicatorsKey indicatorsKey indicatorsKey indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 CSLS staff (EFTs) 463 444 427 Occasions of service 736,422* 818,179* 826,231

* a review of occasions of service for 1997/98 and 1998/99 indicated that there were anomalies in counting Central Sydney Laboratory ServiceCentral Sydney Laboratory ServiceCentral Sydney Laboratory ServiceCentral Sydney Laboratory Service BalmainBalmainBalmainBalmain Concord**Concord**Concord**Concord** RPA**+RPA**+RPA**+RPA**+ CanterburyCanterburyCanterburyCanterbury Anatomical Pathology � �

Biochemistry � � � �

Blood Bank � � � �

Electron Microscopy �

Endocrinology � �

Clinical Andrology Laboratory �

Gastroenterology �

Haematology � � � �

Immunology �

Kanematsu Research �

Laboratory Information Services �

Microbiology � �

Molecular Genetics/Medicine � �

Renal �

� not a full range of specialised services ** RPA and Concord Hospital laboratories provide a wide range of tests for health facilities outside CSAHS + includes the laboratory at Rachel Forster Hospital, which does not offer a full range of specialised services



Dental ServicesDental ServicesDental ServicesDental Services Clinical Director: Dr Susan BuchananClinical Director: Dr Susan BuchananClinical Director: Dr Susan BuchananClinical Director: Dr Susan Buchanan BDSc, MDS, MBA, FRACDS, FICD Based at the United Dental Hospital, Dental Services provides oral treatment to people in NSW and particularly CSAHS who hold current pensioner and healthcare concession cards. Specialist and general services are offered to adults and children from UDH, with outreach programs, 10 off-site clinics and three mobile units also available. Highlights in 1999/2000 included: •

Reducing average waiting times for dental emergency patients to less than two hours, following the introduction of

a streamlined booking and patient flow system. • Providing training opportunities for

dental students at the University of Sydney as well as TAFE colleges.

• Developing clinical indicators and formal guidelines for dental services under the Australian Council on Healthcare Standards.

• Linking oral health treatment and a priority access program Statewide to provide more equitable access, with funding announced during the year for information technology initiatives.

• Researching the link between gum disease and general health with Royal North Shore Hospital and the University of Oslo in Norway.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 373.6 360 325 Occasions of service Adults Children

176,103 32,593

164,166 31,261

157,221 31,876

Dental ServicesDental ServicesDental ServicesDental Services SpecialisSpecialisSpecialisSpecialistttt General AdultGeneral AdultGeneral AdultGeneral Adult ChildrenChildrenChildrenChildren UDH � � �

RPA � �

St George Hospital �

Peakhurst Community Centre �

Sutherland Hospital �

Canterbury Hospital � � �

Concord Hospital � �

Rozelle Hospital �

Clemton Park School �

Marrickville School �

Newtown School �

Rozelle School �

Homebush West School �

Kirkton Road Centre �

Cellblock Youth Centre �

3 x mobile vans �

� not a full range of specialist services � patient assessment with referral to UDH for treatment



Gastroenterology and LiGastroenterology and LiGastroenterology and LiGastroenterology and Liver Servicesver Servicesver Servicesver Services Clinical Director: Professor Les BokeyClinical Director: Professor Les BokeyClinical Director: Professor Les BokeyClinical Director: Professor Les Bokey MB, BS, MS, FRACS Gastroenterology and Liver Services encompasses the Australian National Liver Transplantation Unit and the Total Parenteral Nutrition Service as well as gastroenterology, colorectal, general and upper gastrointestinal (GIT) surgery. It uses a multi-disciplinary approach for patient care and is equipped with sophisticated state-of-the-art technology for diagnosis and treatment. During the year agreement was achieved on RTP design and configuration supporting service provision, as well as developing appropriate protocols and requirements for patient care during construction at RPA and Concord hospitals. Highlights for 1999/2000 included: • Developing best practice procedures

with the Toxicology Unit for the management of acute paracetamol overdose. They provided guides for

medical therapy, renal dialysis and liver transplantation.

• Collaborating with the Geriatrics Department on best practice for the insertion of percutaneous entero-gastrostomy tubes to help elderly patients maintain nutritional status.

•

Cloning a new peptidase molecule (DPP-8) that may be important with regulating and controlling gastrointestinal inflammation. It is under provisional patent.

•

Achieving international benchmarking in the treatment of patients with colorectal and renal cancer.

• Continuing a close involvement with the development of complex endosurgical procedures in upper gastrointestinal and colorectal surgery.

• Concord Hospital was recognised in the United Kingdom and Ireland as well as in Australia as a training centre for colorectal surgeons.

• Admitting almost 70 per cent of patients undergoing major colorectal surgery on the day of their operation.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 279.2 290.4* 261.5** Total admissions 15,575 16,625 16,398 Day-only admissions 7,101 6,600 6,420 Occasions of service 13,400 11,200 10,730 * EFT increase due to Canterbury Hospital opening to full operational capacity ** Restructuring of bed configurations towards the RTP levels Gastroenterology and Liver ServicesGastroenterology and Liver ServicesGastroenterology and Liver ServicesGastroenterology and Liver Services RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury Liver Transplant �

Gastroenterology � �

Colorectal Surgery � �

Upper GIT Surgery � �

General Surgery � � �



General, Geriatric & Rehabilitation General, Geriatric & Rehabilitation General, Geriatric & Rehabilitation General, Geriatric & Rehabilitation MedicineMedicineMedicineMedicine CliniCliniCliniClinical Director: Dr John Cullencal Director: Dr John Cullencal Director: Dr John Cullencal Director: Dr John Cullen MB, BS, FRACP Frail and elderly people, individuals with disability and those with general medical problems are the focus of General, Geriatric and Rehabilitation Medicine (GGRM). Acute care, inpatient rehabilitation, carer support, community health, day hospital and ambulatory services are provided. Specialist clinics are available for people with Parkinson’s disease, cognitive disorders, continence and chronic pain management, amputee and burns rehabilitation. GGRM works with the other clinical streams to provide care to people whose needs extend beyond a single clinical group, for example sufferers of stroke, orthogeriatrics, burns and boarding house residents. Highlights in 1999/2000 included: • Expanding funding of the Carer Respite

Centre based at Concord Hospital.

• Extending a program supporting carers of people with challenging behaviours to residents of Canterbury and the eastern sectors of CSAHS after more funding was received.

• Receiving a three-year NSW Health research and development infrastructure grant to the Centre for Research and Education on Ageing (CERA) at Concord Hospital.

• Achieving Australian Council on Healthcare Standards for all GGRM community services. All GGRM services now have current ACHS accreditation.

• Reviewing Emergency Department protocols at Canterbury Hospital to facilitate direct triage to subspecialty services according to clinical needs.

• Receiving ongoing funds to continue the Strength, Training Rehabilitation and Outreach Needs in Geriatric Medicine (STRONG) program at Balmain Hospital. STRONG provides supervised strength training for older people with a variety of health problems.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 478.59 473.29 472.71 Admissions 14,606 13,454 12,123 Same-day admissions 6,337 3,268 3,249 Occasions of service 113,061 107,021 103,353 General, Geriatric and Rehabilitation General, Geriatric and Rehabilitation General, Geriatric and Rehabilitation General, Geriatric and Rehabilitation MedicineMedicineMedicineMedicine BalmainBalmainBalmainBalmain RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury CommunityCommunityCommunityCommunity Acute Inpatient Services � � � �

Rehabilitation Inpatient Services � � �

Day Hospital Services � �

Outpatient Services � � � �

Community Assessment �

Psychogeriatric Services � �

Home Therapy Service � �

Respite and Carer Support � �

Community Options � �

PADP* �

Community Podiatry � � � �

Residential Information Service �

Transcultural Aged Care Services �

Day Centres � � �

* Provision of Appliances for Disabled People



General PracticeGeneral PracticeGeneral PracticeGeneral Practice Clinical Director: Professor Michael MiraClinical Director: Professor Michael MiraClinical Director: Professor Michael MiraClinical Director: Professor Michael Mira BSc (Med), MS, BS, PhD (to June 2000) Acting Clinical Director: Associate Professor Acting Clinical Director: Associate Professor Acting Clinical Director: Associate Professor Acting Clinical Director: Associate Professor Lindsay ThompsonLindsay ThompsonLindsay ThompsonLindsay Thompson AM, MB, BS, FRACGP, FAMA (from June 2000) The General Practice clinical group is made up of GPs in the Central Sydney Division of General Practice, Canterbury Division of General Practice, General Practice Casualty at Balmain Hospital and the Canterbury Hospital General Practice After Hours Service. It works to establish partnerships between GPs, hospitals and local facilities, with an emphasis on community care in the entire health system. Highlights during 1999/2000 included: • Establishing a General Practice after-

hours service at Canterbury Hospital as part of a trial funded by the Federal Government involving the Central

Sydney and Far West area health services. It includes an after-hours telephone service called Health Connect for residents in these areas.

• Continuing the NSW Health-funded phone line trial where GPs and health service staff can obtain information about community and hospital-based care.

• Introducing technology and information management programs for general practitioners with support and education provided.

•

Providing general practitioners with advice on immunisation, quality use of medicines, accreditation and amalgamating practices.

• Collaborating with other clinical groups in the preparation of plans for integrated care of chronic disease in the areas of respiratory and cardiovascular illness, diabetes and cancer.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 GPs 590 520 649 Active major projects 10 17 19 General PracticeGeneral PracticeGeneral PracticeGeneral Practice BalmainBalmainBalmainBalmain CanterburyCanterburyCanterburyCanterbury CommunityCommunityCommunityCommunity Central Sydney Division of GP � �

Canterbury Division of GP � �

General Practice Casualty � �



Medical Imaging ServicesMedical Imaging ServicesMedical Imaging ServicesMedical Imaging Services Clinical Director: Dr Max SchiebClinical Director: Dr Max SchiebClinical Director: Dr Max SchiebClinical Director: Dr Max Schieb MB, BS, DDR, FRACP, FRACR (to December 1999) Associate Professor Michael FulhamAssociate Professor Michael FulhamAssociate Professor Michael FulhamAssociate Professor Michael Fulham MB, BS, FRACP (from January 2000) Medical Imaging Services combine the departments of Radiology and Nuclear Medicine, with Royal Prince Alfred Hospital housing the only positron emission tomography (PET) scanner in NSW. While medical imaging has an essential role in the assessment and management of patients, often it provides therapeutic options for individuals. Interventional techniques such as stenting and coil placement avoid major surgery and can be carried out on an outpatient basis. Highlights in 1999/2000 included: • Transferring images from patient scans

directly to referring doctors and wards rather than being produced as X-ray

films, enabling the introduction of filmless medical imaging. While departments use filmless imaging for some procedures, the completion of the Resource Transition Program will see it introduced across the board.

• Installing a new mobile image intensifier for operating theatres and commissioning a new general room in the main Radiology Department at Concord Hospital.

• Introducing fluoroscopy under direct computed tomography (CT) control to improve biopsies and drainage procedures.

• Beginning a study in collaboration with the Department of Cardiothoracic Surgery and the Centre for Health Economic Research and Evaluation (CHERE) on the role of PET in selecting lung cancer patients for surgery. The research is a first for Australia and one of only two other studies in the world.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 139 242.83* 228 Occasions of service 215,800 205,000 215,772 * includes Canterbury Hospital Medical Imaging ServicesMedical Imaging ServicesMedical Imaging ServicesMedical Imaging Services BalmainBalmainBalmainBalmain CanterburyCanterburyCanterburyCanterbury ConcordConcordConcordConcord RPARPARPARPA General Radiology � � � �

Interventional Radiology � �

MRI �

CT � � �

Ultrasound � � �

Cerebrovascular Embolisation �

Mammography � �

Nuclear Medicine � �

PET �



Mental Health ServicesMental Health ServicesMental Health ServicesMental Health Services Clinical Director: Professor Marie Bashir Clinical Director: Professor Marie Bashir Clinical Director: Professor Marie Bashir Clinical Director: Professor Marie Bashir AOAOAOAO MB, BS, FRANZP Mental Health Services provides comprehensive and integrated care to a diverse and changing population. Services are provided for all stages of life and include acute care, consultation and liaison, community crisis intervention, assertive community follow-up and rehabilitation. Community teams are located at Glebe, Canterbury, Marrickville and Ashfield and link with inpatient units at Concord, Royal Prince Alfred and Rozelle hospitals to provide care before and after admission. Rozelle Hospital offers acute and rehabilitation inpatient services including an intensive psychiatric care unit for the severely ill. The CSAHS Mental Health Education Centre provides continuing education programs for staff of all disciplines. The Aboriginal Mental Health Unit works with the indigenous populations of central Sydney and regional areas. Continuing mental health education to health workers in partnership with the Aboriginal Medical Service in Redfern is an important component of the program. Children, adolescents and families are catered for by the Rivendell Unit located at

Thomas Walker Hospital, Concord through inpatient, day and assertive community follow-up programs. Highlights in 1999/2000 included: • Working with other healthcare

providers, particularly general practitioners. This allows people with mental health disorders to be better managed by their local doctor. Shared care for young people with eating disorders between Mental Health Services and GPs across NSW had regular, demonstrated success with the clients receiving treatment without being away from familiar surroundings.

• Supporting patients in Royal Prince Alfred, Concord, Canterbury and Balmain hospitals with psychiatric consultation and liaison. This was extended to new mothers to provide early intervention for those at risk of depression.

•

Achieving improved outcomes for patients, with the Mental Health Service Plan 2000 – 2003 developed to guide future care.

• Developing and trialling guidelines for the care of patients arriving at RPA’s emergency department showing signs of attempted suicide, self harm or overdose. A partnership between Mental Health and nurses at RPA and Canterbury hospitals improved service delivery.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 782.3 820 790.4 Admissions 5,181* 10,134 9,767 Same-day admissions 1,687* 6,033 6,157 *does not include mental health activity statistics from Concord Hospital



Mental Health ServicesMental Health ServicesMental Health ServicesMental Health Services RPARPARPARPA ConcordConcordConcordConcord RozelleRozelleRozelleRozelle RivendellRivendellRivendellRivendell MarrickvilleMarrickvilleMarrickvilleMarrickville Glebe/Glebe/Glebe/Glebe/

RedfernRedfernRedfernRedfern CanterburyCanterburyCanterburyCanterbury AshfieldAshfieldAshfieldAshfield NGO NGO NGO NGO

linkslinkslinkslinks Other Other Other Other GovtGovtGovtGovt

24-Hour Acute Care � � � ��

Consultation/Liaison � � �

Intake/Assessment � � � �� +

Acute Inpatients � � � ��

Rehabilitation Accommodation � �� +

Aged Care Assessment � � � � � �

Aged Care Beds � �

Aboriginal MH Service � � � � � � � + �

Telepsychiatry � � +

Forensic Services � � � � �

Child and Family Services � ��

HIV/AIDS Mental Health � � � � � �

Boarding House Teams

Hearing Impaired Services � �

Dietary Disorders Service � �

Bilingual Counsellors � � �

� not on weekends + respite � supervised group homes � psychogeriatric assessment teams � located in separate premises � special service for boarding house residents but have access to all adult facilities as required � includes Aboriginal medical services at Redfern, Kempsey and Richmond fellowship includes Corrective Services Juvenile Justice



NeurosciencesNeurosciencesNeurosciencesNeurosciences Clinical Director: Associate Professor Clinical Director: Associate Professor Clinical Director: Associate Professor Clinical Director: Associate Professor Michael BesserMichael BesserMichael BesserMichael Besser MB, BS (Syd), FRACS, FRCSC (Canada), FACS Neurosciences brings together the disciplines of neurology, neurosurgery, ophthalmology, otolaryngology (ENT), head and neck cancer, and pain management. The Institute of Clinical Neurosciences brings together neurology and neurosurgery at the University of Sydney and Royal Prince Alfred Hospital within a single administrative structure. With services offered across CSAHS, different facilities provide specialisations. Otolaryngology at RPA has an emphasis on complex skull-based surgery and managing acoustic tumours and facial nerve disorders. It includes the pioneering Cochlear Implant Unit. Concord Hospital focuses on establishing a centre of excellence in rhinology. The Parkinson's disease ambulatory clinic also operates out of Concord Hospital.

Neurosciences has a high international profile with renowned research facilities at Concord and RPA hospitals. Highlights in 1999/2000 included: • Relocating and amalgamating wards at

RPA as part of the Resource Transition Program.

• Increasing day of surgery admissions, resulting in a shorter length of stay in hospital and freeing up more beds.

• Establishing pre-admission clinics at Concord and RPA hospitals to streamline day-of-surgery admissions.

• Initiating a stroke patient and carer education project after surveys indicated that stroke patients were less satisfied with the information received and the ability to talk to staff than those who underwent neurosurgery. The surveys showed more than 95 per cent of patients were happy with the quality of service and personal and professional care, with 85 per cent satisfied with their level of recovery.

• Clinical director Prof Michael Besser being elected President of the Neurosurgical Society of Australasia for a two-year term.

Key IndicatorKey IndicatorKey IndicatorKey Indicatorssss 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 179.63 203 190.63 Admissions 8,430 8,216 8,202 Same-day admissions 1,849 2,242 2,643 Occasions of service 31,742 30,624 31,847 NeurosciencesNeurosciencesNeurosciencesNeurosciences RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury Neurology � �

Neurosurgery � �

Ophthalmology � � �

Otolaryngology, Head and Neck Surgery � � �

Pain Management Unit � �



Population Health and Population Health and Population Health and Population Health and Drug & Alcohol ServicesDrug & Alcohol ServicesDrug & Alcohol ServicesDrug & Alcohol Services Clinical Director: Dr Peter SainsburyClinical Director: Dr Peter SainsburyClinical Director: Dr Peter SainsburyClinical Director: Dr Peter Sainsbury MB, BS, DObstRCOG, MHP, FRACMA, FAFPHM, PhD The Population Health and Drug & Alcohol Services clinical group looks at the CSAHS community and develops programs to maximise their general well being. This clinical group encompasses drug and alcohol services, community and public health, health promotion and a Needs Assessment and Health Outcomes Unit. It conducts social health research and also provides services in Aboriginal, multicultural and women’s health. Highlights in 1999/2000 included: • Focusing on improving health outcomes

with the Health Promoting Schools program trialled in 12 schools and the Population Health Nutrition Strategy launched.

• Developing a model for a home-visiting program for families with new babies. This will be the basis for the State Government’s Families First project in CSAHS.

• Reducing smoking in the local Vietnamese community from 42 per cent to 36 per cent, and a shift in intention to quit from 16 per cent to 24 per cent, through the Health Promotion Unit’s Vietnamese tobacco control project Health is Gold.

• Working with those GPs not offering

Pap smears by providing on-site clinics and referral services through the Cervical Screening Project. A forum provided input on strategies for next year’s plan.

• Investigating several outbreaks of disease, with the Public Health Unit receiving more than 2,670 notifications of diseases.

• The Resource and Education Program for Injecting Drug Users based in Redfern receiving the inaugural Baxter Healthcare Award for Organisational Development and the Ted Noffs Community Development Award.

• CSAHS becoming the administrative centre for the creation of the Statewide Drug and Alcohol Clinical Information System (DACIS). The DACIS will significantly improve information about drug and alcohol services, those who receive assistance and the results of treatment.

• Receiving additional resources following the NSW Drug Summit to increase the provision of methadone treatment, outpatient services, ambulatory detoxification and aftercare, and shared care with GPs and pharmacists.

• Increasing drug and alcohol services in the Canterbury area to better reflect the size of the population and the opportunities to improve drug-related healthcare.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff FTE 349.2 429.7* 439 * includes part of the Sydney Home Nursing Service transferred in 1998 Population Health and Drug & Alcohol ServicesPopulation Health and Drug & Alcohol ServicesPopulation Health and Drug & Alcohol ServicesPopulation Health and Drug & Alcohol Services RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury RozelleRozelleRozelleRozelle CommunityCommunityCommunityCommunity Community Health Services � � �

Public Health Unit �

Health Promotion Unit � � �

Aboriginal Health � �

Needs Assessment & Health Outcomes Unit

�

Multicultural Health � �

Social Health Research Unit �

Women’s Health � �

Drug & Alcohol Services � � � � �



Respiratory and Critical Care ServiceRespiratory and Critical Care ServiceRespiratory and Critical Care ServiceRespiratory and Critical Care Service Director: Associate Professor Paul TorzilloDirector: Associate Professor Paul TorzilloDirector: Associate Professor Paul TorzilloDirector: Associate Professor Paul Torzillo MB, BS, FRACP

The Respiratory and Critical Care Service encompasses intensive care, anaesthetics, emergency treatment, respiratory medicine and infectious diseases. The service has a high national and international research profile. Respiratory medicine departments at Royal Prince Alfred and Concord hospitals are internationally recognised for work in asthma, non-invasive ventilatory management of complex respiratory failure and cystic fibrosis.

Highlights in 1999/2000 included: • Participating in forums in CSAHS and

Statewide to review intensive care and emergency medicine practices to improve efficiency, quality of care and access problems.

• Forming a multi-disciplinary group to address the needs of patients with chronic lung disease and develop

innovative strategies to improve their quality of life and illness management.

• Planning for services to move to new facilities as part of the Resource Transition Program process.

• Head of the Institute of Respiratory Medicine Professor Ann Woolcock being awarded the President’s Prize by the European Respiratory Society in recognition of her research in lung disease.

• Receiving $750,000 over three years from the United States Cystic Fibrosis (CF) Foundation for research building on previous work undertaken at RPA which indicated that a single dose of inhaled hypertonic saline significantly improved lung function in patients with CF. It was the largest grant outside the United States from the peak funding body.

•

Concord Hospital’s Dr Christine Jenkins being appointed to the Global Initiative on Chronic Lung Disease working group.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 643.3 626.2 644.4 Admissions 15,046 14,996 15,024 Same-day admissions 3,791 3,799 4,802 Occasions of service 96,042 89,440 99,848 Admissions via emergency 25,242 25,542 26,004 Respiratory and Critical Care ServiceRespiratory and Critical Care ServiceRespiratory and Critical Care ServiceRespiratory and Critical Care Service RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury Respiratory Medicine � �

Sleep Disorders � �

Tuberculosis Clinic � � �

Thoracic Surgery �

Emergency Department � � �

Intensive Care � � �

Anaesthetics � � �

Infectious Diseases � �

Sexually Transmitted Diseases � � �



Women’s and Children’s HealthWomen’s and Children’s HealthWomen’s and Children’s HealthWomen’s and Children’s Health Clinical Director: Professor Roger HoughtonClinical Director: Professor Roger HoughtonClinical Director: Professor Roger HoughtonClinical Director: Professor Roger Houghton DPhil (Oxon), MB, BS, BSc(Med), FRACOG, FRCOG Women’s and Children’s Health comprises five departments located at three hospitals. Standard patterns of care were developed which will see the move from King George V to Royal Prince Alfred Hospital under the Resource Transition Program in 2001 proceed smoothly. Highlights in 1999/2000 included: •

Establishing a Perioperative Unit that resulted in more than 70 per cent of elective patients arriving at hospital on the day of surgery. Patients for elective caesarean section were admitted on the same basis.

• Being selected as a special education centre by the World Bank. The international reputation of the Neonatal Unit at King George V and department head Associate Professor Heather Jeffery saw the hospital selected to train neonatal specialists from Macedonia, which has one of the highest perinatal death rates in Europe.

• Delivering more than 1,480 babies at Canterbury Hospital, indicating a high level of community support for its birthing unit. There were 5,522 babies born at Canterbury and KGV hospitals.

• Recognising staff members for their work, with awards from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Royal Prince Alfred Graduate Nurses Association.

KeyKeyKeyKey Indicators Indicators Indicators Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 314.75 320.38 326.7 Admissions 15,402 18,762 18,274 Same-day admissions 6,286 6,262 7,254 Occasions of service 47,316 46,298 51,196 Women’s and Children’s HealthWomen’s and Children’s HealthWomen’s and Children’s HealthWomen’s and Children’s Health RPA/KGVRPA/KGVRPA/KGVRPA/KGV ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury Obstetrics � �

Gynaecology � � �

Paediatrics � �

Urogynaecology �

Reproductive Endocrinology and Infertility �

Neonatal Medicine � �

Diagnostic Ultrasound and Foetal Medicine � �

Gynaecological Oncology �

Pelvic Floor Unit �



OTHER SERVICES Allied Health ServicesAllied Health ServicesAllied Health ServicesAllied Health Services Director: Kit EuDirector: Kit EuDirector: Kit EuDirector: Kit Eu BEc, BSoc Admin Allied Health Services work closely with other healthcare professionals to help patients reach their maximum physical and psychosocial potential. Staff offer specific assessments and therapeutic interventions at hospitals as well as in community settings. The services include hydrotherapy, home visits to review safety and function, making orthotic devices, grief counselling, stuttering programs, nutritional advice, mobility retraining and psychological treatments. Highlights in 1999/2000 included: •

Gaining outstanding results in preliminary research into stuttering, with the potential to overturn conventional treatment programs that have been standard for 20 years. Studies indicated that patients had fewer relapses and were treated in a shorter time than with previous stuttering programs. The breakthrough followed an agreement to enhance clinical development and research between Royal Prince Alfred Hospital’s

Speech Pathology Department and the Australian Stuttering Research Centre.

• Allied Health Services becoming a partner in the Research Centre for Adaptation into Health and Illness (RACHI) at the University of Sydney.

•

Standardising a bereavement package for use in all CSAHS hospitals to assist grieving family and friends.

• The departments of Physiotherapy, Occupational Therapy, Speech Pathology, Orthotics and Podiatry at RPA moving into refurbished spaces as part of the Resource Transition Program.

• Establishing a new multidisciplinary Pulmonary Rehabilitation Program at Concord Hospital, coordinated by a respiratory physiotherapist and supported by psychologists and dietitians.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 227 235 218 Inpatient occasions of service 231,631 225,508 204,858 Outpatient occasions of service 126,791 142,026 111,726 This table only applies to RPA, Concord and Canterbury hospitals Allied Health ServicesAllied Health ServicesAllied Health ServicesAllied Health Services RPARPARPARPA ConcordConcordConcordConcord CanterburyCanterburyCanterburyCanterbury RozelleRozelleRozelleRozelle BalmainBalmainBalmainBalmain CommunityCommunityCommunityCommunity Physiotherapy � � � � � �

Social Work � � � � � �

Nutrition & Dietetics � � � � �

Occupational Therapy � � � � � �

Speech Pathology � � � � � �

Psychology � � � �

Orthotics � �

Podiatry � � � � � �



Multicultural ServicesMulticultural ServicesMulticultural ServicesMulticultural Services Ethnic Affairs Priority StateEthnic Affairs Priority StateEthnic Affairs Priority StateEthnic Affairs Priority Statementmentmentment According to the Australian Bureau of Statistics ERP numbers* there were 483,000 residents within CSAHS boundaries. Of those, nearly 5,000 identified themselves as Aborigines or Torres Strait Islanders. CSAHS is culturally diverse with 41.1 per cent of residents born overseas, compared to 23 per cent of the population of NSW. Of the overseas-born residents, 83.4 per cent are from non-English speaking backgrounds, most commonly China, Italy, Greece, Lebanon and Vietnam. Of people older than 5 in the CSAHS population, 46 per cent speak a language other than English at home, compared to 21.4 per cent in the rest of the State. In recognition of the multicultural population within its boundaries, CSAHS implements the NSW Government Principles of Cultural Diversity through multicultural health programs and access committees. The following programs operate in CSAHS: • the Health Care Interpreter Service

(HCIS), a 24-hour, seven-day-a-week service of professional interpreters trained in healthcare

•

an ethnic aged access program offering culturally sensitive aged care services

• a migrant health team providing information and referral, health education and promotion for Arabic, Greek, Vietnamese, Chinese, Portuguese and Turkish communities. The team has been working on promoting cancer-screening services such as BreastScreen NSW and healthy lifestyle opportunities.

• mental health counsellors providing case management in community languages

• a cross-cultural training program to equip staff with the necessary skills to

work with a diverse clientele and workforce

• a multicultural health promotion officer to design, implement and evaluate health promotion programs for non-English speaking background communities

• the Canterbury Multicultural Youth Health Service, which offers counselling, activities and a medical referral service for homeless youth in the Canterbury local government area.

CSAHS manages two Statewide services: the Multicultural HIV/AIDS Service and the Transcultural Aged Care Service. In 1999/2000 the HCIS increased its productivity by instituting improved procedures for providing interpreters to day-stay admissions and emergencies. Offering services to Central and South Eastern Sydney area health services, the HCIS is available free of charge to public health clients for face-to-face interpreting on a 24-hour seven-day-a-week basis in 71 languages including Auslan (Australian Sign Language). The Multicultural Health Unit helps clinical groups assess the health needs of immigrants and implement changes to improve service quality for these people. Three quality improvement surveys were conducted in 1999/2000 in Concord, Canterbury and RPA hospitals to assess access to professional interpreters and cultural/spiritual needs of patients. The results will be used to improve aspects of care of our diverse hospital customers. During the first Multicultural Health Week in 1999 staff were informed about multicultural health programs and how to access them. * Estimated Resident Population



FACILITIES Balmain HosBalmain HosBalmain HosBalmain Hospital pital pital pital Booth Street Balmain NSW 2041 Phone: (02) 9395 2111 Fax: (02) 9395 2020 E-mail: [email protected] General Manager: Ken Cahill Balmain Hospital has offered care to its local community since 1885 and now specialises in general medicine, rehabilitation and treating older people. It is the home of a unique General Practice Casualty department in partnership with local doctors and the Division of General Practice, and the administration point for all CSAHS community-based services for the aged.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 253.82 251.4 270.3 Average available beds 96 93 87 Inpatient bed days 30,036 29,826 27,544 Total admissions 2,558 2,526 2,365 Bed occupancy rate (%) 86.4 87.2 86.9 Average length of stay (days) 11.8 12.3 11.5 ENIOOS 80,927 82,133 79,897



Canterbury Hospital Canterbury Hospital Canterbury Hospital Canterbury Hospital Canterbury Road Campsie NSW 2194 Phone: (02) 9787 0000 Fax: (02) 9787 0031 E-mail: [email protected] General Manager: Peter Clout Canterbury Hospital offers general medicine, surgery, obstetrics and gynaecology, paediatrics, aged care and rehabilitation as well as palliative care. The hospital is located in Campsie in the Canterbury local government area. Of its 135,000 population, 51 per cent come from non-English speaking backgrounds providing special challenges and opportunities for staff. New procedures were introduced to maximise patient safety, particularly in the administration of substances. These practices, some of which have Statewide implications, were a result of recommendations made after the hospital became aware in June 1999 that up to 24 patients were injected with an incorrect contrast medium in the operating theatres.

Key indicatorsKey indicatorsKey indicatorsKey indicators 1997/981997/981997/981997/98 1998/99*1998/99*1998/99*1998/99* 1999/001999/001999/001999/00 Staff EFT 379.7 400.82 579 Average available beds 117 173 156 Inpatient bed days 39,580 53,628 56,329 Total admissions 7643 13,029 14,361 Bed occupancy rate 90.2 95.5 91.3 Average length of stay (days) 5.2 5.0 3.9 Births 306 1,276 1,485 ENIOOS 152,474 142,940 165,505 * significant increases reflect the opening of the fully functional new hospital



CEIDA CEIDA CEIDA CEIDA (Centre for Education and Information on (Centre for Education and Information on (Centre for Education and Information on (Centre for Education and Information on Drugs and Alcohol)Drugs and Alcohol)Drugs and Alcohol)Drugs and Alcohol) Rozelle Hospital grounds Balmain Road Rozelle NSW 2039 Phone: (02) 9818 0444 Fax: (02) 9818 0441 E-mail: [email protected] Director: Lyn Stoker CEIDA offers programs Statewide. It aims to increase the use of strategies throughout NSW that reduce drug and alcohol-related harm. They include projects with a range of government and non-government agencies. Education programs comprise seminars, publications and the website www.ceida.net.au

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 42.3 33.4 25.2



Concord Repatriation General HospitalConcord Repatriation General HospitalConcord Repatriation General HospitalConcord Repatriation General Hospital Hospital Rd Concord NSW 2139 Phone: (02) 9767 5000 Fax: (02) 9767 6991 E-mail: [email protected] Group General Manager: Dr Peter Kennedy Executive Director: Matthew Daly Concord Hospital is a major referral centre with strong links with the war veteran community. It continues to be a leader in the management of burn-injured patients and those with colorectal cancer.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 2,289 2,140.75 2075.6 Average available beds 616 550 498 Inpatient bed days 184,634 176,140 170,603 Total admissions 50,787 47,093 48,042 Bed occupancy rate (%) 83.52 88.18 93.7 Average length of stay (days) 3.6 3.7 3.5 ENIOOS 337,013 329,362 273,440



HealthQuestHealthQuestHealthQuestHealthQuest Workforce Health Management Level 2 187 Thomas Street Haymarket NSW 2000 Phone: (02) 9281 0811 Fax: (02) 9211 1060 E-mail: [email protected] Director: Dr Helia Gapper HealthQuest provides occupational health services throughout NSW to the public and private sectors. A self-funded body, its main activities are work-site assessments of ergonomic, chemical, physical and biological hazards, vaccinations, occupational health and safety training as well as fitness for duty and pre-employment appraisals. HealthQuest is the office of the NSW Government Medical Officer (GMO), with assessments carried out at the Haymarket facility and throughout NSW by GMO nominees.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 17.13 19.96 15.7 ENIOOS 19,489 18,901 19,311



NSW Institute of Forensic MedicineNSW Institute of Forensic MedicineNSW Institute of Forensic MedicineNSW Institute of Forensic Medicine 42-50 Parramatta Road Glebe NSW 2037 Phone: (02) 8584 7800 Fax: (02) 9552 1613 E-mail: [email protected] Director: Associate Professor John Hilton The NSW Institute of Forensic Medicine has as its principal client the State Coroner on whose behalf it conducts a variety of pathology investigations. It offers medico-legal support to the legal profession and the courts. A high-risk autopsy service is also offered to NSW Health and other area health services. This year staff were involved in United Nations activities in East Timor and the former Yugoslavia. The institute provides grief counselling as well as support to international organisations such as the United Nations. In the past year, staff have worked in East Timor and testified at The Hague to a war crimes tribunal about killings in Bosnia.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 46.4 45.56 48.4 Admissions 2,832 2,698 2,724 Post-mortems 2,362 2,288 2,201 High-risk autopsies (HIV, CJD, hep C) 173 182 158



Royal Prince Alfred HospitalRoyal Prince Alfred HospitalRoyal Prince Alfred HospitalRoyal Prince Alfred Hospital Missenden Road Camperdown NSW 2050 Phone: (02) 9515 6111 Facsimile: (02) 9515 6133 E-mail: [email protected] Group General Manager: Dr Peter Kennedy Executive Director: Dr Philip Hoyle Royal Prince Alfred Hospital, the principal teaching hospital of the University of Sydney, is one of Australia’s leading referral centres. It offers advanced inpatient, non-inpatient, critical care and diagnostic facilities as well as teaching and research to the people of central Sydney and NSW. Highly specialised services include cardiology; cardiothoracic, renal and neonatal medicine; liver and kidney transplantation; cancer care; obstetrics; neurology; diagnostic imaging; interventional radiology; intensive care; emergency and respiratory medicine as well as gastrointestinal, head and neck, plastic, vascular and neurosurgery. In addition to the main campus, services are provided at King George V Memorial Hospital for Mothers and Babies in Camperdown, Rachel Forster Hospital in Redfern, Dame Eadith Walker Hospital in Concord West as well as community settings.

RPARPARPARPA Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 3,425.2 3,428 3,445.2 Average available beds 672 737 712 Inpatient bed days 217,852 254,539 239,007 Total admissions 63,296 60,335 60,420 Bed occupancy rate (%) 90.91 89.6 87 Average length of stay (days) 3.7 4.2 4 ENIOOS 540,748 481,208 469,591 Births 4,599 4,117 4,037 Rachel Forster (part of RPA)Rachel Forster (part of RPA)Rachel Forster (part of RPA)Rachel Forster (part of RPA) Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 138.3 133.9 125.8 Average available beds 68 56 52 Inpatient bed days 15,330 14,239 13,010 Total admissions 2,448 2,462 2,131 Bed occupancy rate (%) 63.32 70 69 Average length of stay (days) 6.3 5.8 6.1 ENIOOS 26,093 26,231 21,378



Rozelle HospitalRozelle HospitalRozelle HospitalRozelle Hospital Church and Glover streets Leichhardt NSW 2040 Phone: (02) 9556 9100 Fax: (02) 9818 5712 E-mail: [email protected] General Manager: Glenda Cleaver Rozelle Hospital was the first public psychiatric hospital to be accredited by the Australian Council on Healthcare Standards and is the leading such facility in NSW. It specialises in acute adult psychiatric and psychogeriatric services, rehabilitation and help for war veterans, as well as drug and alcohol problems.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 682.1 655.4 746.1 Average available beds 277 250 244 Inpatient bed days 80,320 72,725 67,614 Total admissions 2,695 2,648 2,187 Bed occupancy rate (%) 79.5 82.4 75.8 Average length of stay (days) 29.5 29.5 30.9 ENIOOS 254,508 211,805 169,902 All figures include 10 beds at Burwood Respite Care Centre



Tresillian Family Care Centres Tresillian Family Care Centres Tresillian Family Care Centres Tresillian Family Care Centres McKenzie Street Belmore NSW 2192 Phone: (02) 9787 0800 Fax: (02) 9787 0880 E-mail: [email protected] President of Council: Bob Elmslie OAM General Manager: David Hannaford Tresillian Family Care Centres help parents who are experiencing difficulties with their baby or toddler. Nurses, social workers, psychologists, paediatricians and psychiatrists are available to provide assistance or advice at any of the four facilities. While the Tresillian network is administered from CSAHS, there are centres in Belmore, Willoughby, Wollstonecraft and Penrith. More than 60,000 families used Tresillian’s services this year. Parents can be referred by their general practitioner or an early childhood nurse.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Staff EFT 86.8 85.1 83.5 Average available beds 34.5 33.9 34.1 Inpatient bed days 10,897 10,683 11,093 Admissions 2,307 2,277 2,262 Bed occupancy rate (%) 86.1 86.3 89.0 Average length of stay (days) 4.7 4.7 4.9



United Dental Hospital of Sydney United Dental Hospital of Sydney United Dental Hospital of Sydney United Dental Hospital of Sydney 2 Chalmers Street Surry Hills NSW 2010 Phone: (02) 9293 3200 Fax: (02) 9293 3488 E-mail: [email protected] General Manager: Geoff Neems The United Dental Hospital provides oral healthcare to people in NSW and particularly CSAHS who hold current pensioner and healthcare concession cards. UDH has mobile dental units for homebound patients as well as clinics at schools, Canterbury and Concord hospitals. It is a teaching hospital for the University of Sydney’s dentistry faculty and TAFE students.

Key IndicatorsKey IndicatorsKey IndicatorsKey Indicators 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/001999/001999/001999/00 Staff EFT 340.3 360 310.8 ENIOOS 168,569 195,580 189,806



QUALITY, RESEARCH & TEACHING Quality Quality Quality Quality The quality of care and service provided to patients is of great importance to all staff. Quality is fundamental to the every day work practices of employees and CSAHS continually strives to build on and improve its methods. CSAHS has worked closely with NSW Health to develop key indicators for the quality issues of safety, effectiveness, appropriateness, consumer participation, efficiency and access. Each clinical group collects statistics with the intention of plotting trends over time, benchmarking with similar institutions or service providers, and improving the quality of care as necessary. New indicators being developed will offer a consistent method of measuring quality in all clinical streams as well as at various facilities. Four risk-monitoring systems were developed by CSAHS and they will be further refined in the next financial year. A working group was established to improve the reporting and use of Accident and Incident data throughout our services. Sentinel events, which are unexpected occurrences resulting in death or serious injury, will be monitored. All clinical directors identified the events relevant to their specialty and made a commitment to reviewing and reporting these to the Clinical Quality Council. Ad hoc quality audits are conducted when a problem is highlighted from a complaint or any of the risk monitoring systems. All CSAHS facilities received full EQuIP (evaluation and quality improvement program) accreditation from the Australian Council on Healthcare Standards.

Research and TeachingResearch and TeachingResearch and TeachingResearch and Teaching The hospitals and facilities in CSAHS are renowned throughout Australia and the world for commitment to developing improved forms of treatment, diagnosis and patient care. The National Health and Medical Research Council funds more projects at CSAHS than at any other area health service in Australia. Advances made through research are transferred to clinical settings at the earliest opportunity, bringing tangible benefits to patients and clients. Each year researchers undertake hundreds of projects. A selection can be found in this report’s companion document, A Healthy Outlook. As with research, teaching is critical to maintaining our leading edge, and opportunities for staff and students to undertake training and continuing professional education are paramount. Students from the University of Sydney undertake practical experience at Royal Prince Alfred, United Dental and Concord hospitals. Formal teaching agreements were finalised during the year between the psychology department and the universities of New England and Western Sydney. Back to RPA Week and Concord Clinical Week featured educational conferences for senior clinicians and staff. More than 200 people participated in RPA’s undergraduate and graduate medical programs, and the intern teaching program ensured junior staff were given practical experience in clinical management and professional development. During the year, Concord Hospital’s intake included 44 undergraduate and 154 graduate medical program students from the University of Sydney. The hospital was



the choice of 95 overseas students for elective components of their courses. Within CSAHS, 296 new graduate and 96 trainee enrolled nurses began their careers. More than 300 nurses attended specialty programs to strengthen their skills in orthopaedics and rheumatology, burns, ophthalmology, gastroenterology and neurosciences. The latest edition of Research for Better Health: Royal Prince Alfred Hospital Research Report is available by phoning the hospital on (02) 9515 6111.



CORPORATE SERVICES Employee ReEmployee ReEmployee ReEmployee Relationslationslationslations The Staff Consultative Committee meets monthly and provides a valuable communication channel for issues resolution. Members represent all relevant associations or unions and management. The first CSAHS-wide Human Resources Strategic Plan was developed to provide a framework for HR management over the next five years. A review of the human resources departments and structures paved the way for its implementation. EEO statistics 1999/2000EEO statistics 1999/2000EEO statistics 1999/2000EEO statistics 1999/2000 Equality and equal opportunity is a fundamental right of every employee and must be applied to every aspect of work life as good management practice and as a legislative requirement. CSAHS promotes the principles and practices of EEO which apply to conditions of employment, relationships within the workplace, evaluation of performance and opportunities for training and career development. CSAHS’s EEO Management Plan was recently reviewed based on the Office of the Director of Equal Opportunity in Public Employment’s (ODEOPE’s) EEO Outcomes Framework. The framework focuses on

outcomes with measurable indicators identified to monitor EEO practices and progress towards population benchmarks and Government targets. CSAHS aims to promote equity initiatives, pursuing programs which assist people traditionally disadvantaged in the workplace: people from non-English speaking backgrounds, Aboriginal and Torres Strait Islanders and those with disabilities. Statistics 1999/2000Statistics 1999/2000Statistics 1999/2000Statistics 1999/2000 The statistical information for the tables shown below was obtained from the 1998/99 and 1999/2000 Annual EEO Reports to ODEOPE. The information is collated from data maintained in CSAHS’s Human Resource Information System, Workforce. The salary levels for the 1999/2000 period have been adjusted by ODEOPE to reflect industry-wide wage increases. Increases were granted to various groups of employees, with the first increment of 2 per cent paid retrospectively from the first pay period on or after January 1 2000. The figures indicate there has been an overall decrease of approximately 3 per cent in the total number of staff employed by CSAHS, not including casual staff.

Salary level Salary level Salary level Salary level 1999/20001999/20001999/20001999/2000

MenMenMenMen Per cent of Per cent of Per cent of Per cent of menmenmenmen

Per cent of Per cent of Per cent of Per cent of salary rangesalary rangesalary rangesalary range

WomenWomenWomenWomen Per cent of Per cent of Per cent of Per cent of womenwomenwomenwomen


Total Total Total Total number of number of number of number of staffstaffstaffstaff

<$26,276 63 2.2 30.3 145 2.3 69.7 208 $26,277 - $34,512

1077 37.7 33.4 2148 33.8 66.6 3225

$34,513 - $38,582

227 8.0 31.0 505 8.0 69.0 732

$38,583 - $48,823

569 19.9 19.7 2326 36.6 80.3 2895

$48,824 - $63,137

393 13.8 30.3 906 14.3 69.7 1299

$63,138 - $78,921

283 9.9 57.9 206 3.2 42.1 489

>$78,921 242 8.5 67.8 115 1.8 32.2 357 Total No. Total No. Total No. Total No. staffstaffstaffstaff

2854285428542854 100100100100 6351635163516351 100100100100 9205920592059205

Total per Total per Total per Total per cent staffcent staffcent staffcent staff

MaleMaleMaleMale 31.031.031.031.0 FemaleFemaleFemaleFemale 69.069.069.069.0



Salary level Salary level Salary level Salary level 1998/991998/991998/991998/99

MenMenMenMen Per cent of Per cent of Per cent of Per cent of menmenmenmen


WomenWomenWomenWomen Per cent of Per cent of Per cent of Per cent of womenwomenwomenwomen


Total Total Total Total number onumber onumber onumber of f f f staffstaffstaffstaff

<$25,760 100 3.4 34.5 190 2.8 65.5 290 $25,761 - $33,835

1142 38.7 33.4 2280 33.7 66.6 3422

$34,836 - $37,825

221 7.5 27.3 590 8.7 72.7 811

$37,826 - $47,866

545 18.5 18.4 2423 35.9 81.6 2968

$47,867 - $61,899

396 13.4 29.3 954 14.1 70.6 1350

$61,900 - $77,374

291 9.9 58.0 211 3.1 42.0 502

>$77,374 254 8.6 69.4 112 1.7 30.6 366 Total No. Total No. Total No. Total No. staffstaffstaffstaff

2949294929492949 100100100100 6760676067606760 100100100100 9709970997099709

Total per Total per Total per Total per cent staffcent staffcent staffcent staff

MaleMaleMaleMale 30.430.430.430.4 FemaleFemaleFemaleFemale 69.669.669.669.6

Code Of Conduct and EthicsCode Of Conduct and EthicsCode Of Conduct and EthicsCode Of Conduct and Ethics The updated Code of Conduct and Ethics was endorsed by the CSAHS board and redistributed to staff. It determines acceptable standards of behaviour, and employees must observe the code as part of their conditions of employment. Corruption preventionCorruption preventionCorruption preventionCorruption prevention Progress of CSAHS programs included: • Internal Audit conducting six interactive

sessions for all levels of staff focusing on corruption prevention and detection, as well as protected disclosures

• ongoing quarterly review meetings to monitor incidents and corruption prevention activities at each facility, attended by 170 staff

• conducting internal audits, with reports submitted to the chief executive officer and CSAHS board

• Internal Audit promoting its role as a corruption prevention help-desk

• reporting appropriate matters to the State’s police force, the Independent Commission Against Corruption and NSW Health.

During 1999/2000 there were 29 instances of possible corrupt conduct reported to ICAC. The matters were raised by either senior management or staff, with 21 initially reported by staff. Of the 29 instances, 14 were reported to the NSW police force.

Recognition ProgramRecognition ProgramRecognition ProgramRecognition Program The Employee Recognition Program acknowledges the valuable work of CSAHS staff and honours individuals for excellence in the workplace. The program is sponsored by the Millennium Hotel in Sydney and Christchurch, Air New Zealand and Student Flights. Details of the 1999/2000 winners can be found in A Healthy Outlook: Central Sydney Area Health Service 1999/2000. Risk ManagementRisk ManagementRisk ManagementRisk Management CSAHS is committed to the ongoing development and implementation of effective risk management strategies in order to protect the safety and security of employees and to contain insurance costs for the organisation. Occupational Health and SafetyOccupational Health and SafetyOccupational Health and SafetyOccupational Health and Safety CSAHS facilities have occupational health and safety policies and programs to identify, assess and manage work-related injuries and illnesses. Specific strategies have been developed and implemented to control the risks associated with manual handling, hazardous substances, security and critical incidents. Occupational health and safety was incorporated into planning for the Resource Transition Program.



The NSW Health Occupational Health, Safety and Rehabilitation Numerical Profile provides comparison with best practice. Results for 1999/2000 showed improvement from 1998/99 for all CSAHS facilities.

Occupational Health Safety & Rehabilitation Occupational Health Safety & Rehabilitation Occupational Health Safety & Rehabilitation Occupational Health Safety & Rehabilitation Numerical Profile scores (%)Numerical Profile scores (%)Numerical Profile scores (%)Numerical Profile scores (%) FacilityFacilityFacilityFacility 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Balmain 64.1 78.0 Canterbury 54.8 71.5 Concord 60.4 66.3 Population Health* 58.3 Rozelle 58.1 61.3 RPA 52.2 60.4 Rachel Forster* 77.3 UDH 52.5 56.8 Average scoreAverage scoreAverage scoreAverage score 59.959.959.959.9 64.764.764.764.7 * not surveyed in both years Workers compensationWorkers compensationWorkers compensationWorkers compensation CSAHS has a commitment to effective workers compensation claim management and workplace-based rehabilitation. Employees with job-related injuries or illnesses are offered specific programs of suitable duties to assist their return to work. There is constant discussion with managers at the GIO Treasury Managed Fund and legal advisers to monitor the estimated expense of claims and implement any actions to reduce outstanding costs. Workers compensation performance is measured by comparison of claim rates and costs with average NSW Health figures.

Workers compensation claims as at June 30 1999Workers compensation claims as at June 30 1999Workers compensation claims as at June 30 1999Workers compensation claims as at June 30 1999 1997/981997/981997/981997/98 1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000 Claims 743 674 588 CSAHS claim rate/100 EFT 8.1 7.3 6.4 NSW Health claim rate/100 EFT* 9.3 8.9 7.6 CSAHS claim cost/EFT ($) 1,280 610 369 NSW Health claim cost/EFT ($)* 1,156 730 427 * refers to entire NSW Health system



Motor fleet risk managementMotor fleet risk managementMotor fleet risk managementMotor fleet risk management The CSAHS Transport Department continued to develop strategies to improve fleet management. There has been a review of policies and procedures, improved accident investigation and analysis of data to identify trends, costs and specific control strategies, resulting in overall better risk management. The hailstorm of April 1999 had a significant impact on costs1. Audits completed for the Treasury Managed Fund and the Audit Office of NSW, as well as those conducted by the CSAHS internal audit department are used to assess and manage risks in property, public liability, environment, fraud and corruption, information systems management and year 2000 compliance.

Motor fleet claims as at June 30 2000Motor fleet claims as at June 30 2000Motor fleet claims as at June 30 2000Motor fleet claims as at June 30 2000

1998/991998/991998/991998/99 1999/20001999/20001999/20001999/2000

Claims 246 173 CSAHS claim rate/100 vehicles 35 25 *NSW Health claim rate/100 vehicles 29 23 CSAHS claim cost/vehicles ($) 1,3151 752 *NSW Health claim cost/vehicle ($) 818 562

* refers to entire NSW Health system



Freedom of Information (FOI)Freedom of Information (FOI)Freedom of Information (FOI)Freedom of Information (FOI) The Freedom of Information Act (1989) was introduced to ensure that records held by government agencies concerning personal affairs of members of the public are not incomplete, incorrect, out of date or misleading, by allowing the public the right to view, obtain copies and/or amend documents held by government agencies. Section 14(1)(a) of the FOI Act requires an agency to ensure that up-to-date information is available to the public through a Statement of Affairs, published on an annual basis. The current Statement of Affairs for CSAHS is incorporated here. The CSAHS mission statement, operational structure and a comprehensive report detailing the objectives and performance review are outlined in the 1999/2000 CSAHS Statutory Report. CSAHS has established liaison with consumer groups including patients/clients/families, GPs and health professionals both within CSAHS and other area health services, non-government organisations, community groups, councils, and local businesses. Consumer involvement can range from informal to structured and ongoing committee representation, as well as consultation in an advisory capacity. The involvement gives consumers the opportunity to have input to the services that are provided for them, and helps health providers identify to what extent services are meeting the community’s needs. Access to personal and/or non-personal documents held by CSAHS can be obtained by lodging an FOI application (either by completing an FOI application form or by writing a letter of request), with the appropriate facility as listed in the Summary of Affairs. The processing fee for an FOI application is $30.00 (GST free) however a 50 per cent reduction is given should the applicant be able to show hardship. For access to medical records, the applicant should write or telephone the Medical Records Department of the appropriate CSAHS facility. A processing fee of

$32.00 (including GST) is required, however a 50 per cent reduction is given should the applicant be able to show hardship. If the applicant requires copies of their medical records a fee of $0.27 (GST included) per page is charged after the first 80 pages. Summary of AffairsSummary of AffairsSummary of AffairsSummary of Affairs Freedom of Information Act 1989, Section 14(1)(b) and (3) of CSAHS (FOI Agency No. 2322) The CSAHS Summary of Affairs covers the area health service office, Central Sydney Supply Services, CEIDA, HealthQuest, the Institute of Forensic Medicine and Tresillian Family Care Centres. It also covers Royal Prince Alfred, Concord, Canterbury, Balmain, Rozelle and United Dental hospitals, as well as the Division of Population Health. SECTION 1: POLICY DOCUMENTSSECTION 1: POLICY DOCUMENTSSECTION 1: POLICY DOCUMENTSSECTION 1: POLICY DOCUMENTS The following policies and documents are produced by CSAHS, individual hospitals and units and may be accessed for information: CSAHS CSAHS CSAHS CSAHS • CSAHS/NSW Health Performance

Agreement • Governing Body of Management

Manual - Board of CSAHS • CSAHS By-Laws • Management policies and procedures:

organisation and administration, staffing and direction, patient’s rights and special needs, corruption prevention, recruitment and employment of staff and other persons, vetting and management of allegations and improper conduct

• No Smoking • Staff Development and Training • Facilities and Equipment • Quality Activities • Equal Employment Opportunity

Management Plan • Annual Report • CSAHS newsletter newsworks •

RTP News - Resource Transition Program

• Building Today, Caring for Tomorrow: RPA redevelopment



• Corporate Plan • CSAHS health plans: Health Gain for

Children & Youth of Central Sydney Disability Plan, Women’s Health Strategic Plan, Domestic Violence Protocols, Managing Emergency & Elective Workloads in CSAHS, RTP Service Delivery Plans, Hep C Plan, Strategic Directions HIV Health Promotion in CSAHS, 1999/01 CSAHS Health Improvement Performance System (CHiPS), Strategic Business Plan, Sexual Health Services 1999/02, Tobacco Control Plan, Critical Incident Management Plan, Mental Health Service Plans 2000/03

• Delegations Manual • Human Resources Manual •

Guidelines for Service Planning •

CSAHS Demographic Profile • CSAHS Staff Handbook • COSOPS - Critical Operations Standing

Operating Procedures • Infection Control Manuals • Displan Hospitals, community services and unitsHospitals, community services and unitsHospitals, community services and unitsHospitals, community services and units • Hospital and departmental policy and

procedure manuals • Quality management plans • Admission and discharge policy • Patient information booklets/brochures • Hospital newsletters from Concord and

United Dental hospitals • Occupational Health and Safety

manuals • Management structures • Disaster plans • Staff handbooks and brochures •

Complaints policy and procedures SECTION 2: STATEMENT OF AFFAIRSSECTION 2: STATEMENT OF AFFAIRSSECTION 2: STATEMENT OF AFFAIRSSECTION 2: STATEMENT OF AFFAIRS The current CSAHS Statement of Affairs is incorporated into the 1999/2000 CSAHS Statutory Annual Report, which provides information on the objectives, functions and structure of CSAHS. The cost of purchase is $27.50 (including GST) and inquiries can be made by contacting any of the FOI officers listed in Section 3. A processing charge of $0.27 (including GST) per page will be charged for photocopies.

SECTION 3: CONTACT SECTION 3: CONTACT SECTION 3: CONTACT SECTION 3: CONTACT ARRANGEMENTSARRANGEMENTSARRANGEMENTSARRANGEMENTS Inquiries in relation to the inspection or purchase of CSAHS’s policy documents, statutory report or the Summary of Affairs can be made with any of the officers listed below between the hours of 8.30am and 5pm or through CSAHS on (02) 9515 9600. CSAHSCSAHSCSAHSCSAHS Gayle Berg Central Sydney Area Health Service Building 11, RPA campus Missenden Rd Camperdown NSW 2050 Phone: (02) 9515 9600 Balmain HospitalBalmain HospitalBalmain HospitalBalmain Hospital Kirsten Hinze Balmain Hospital Booth St Balmain NSW 2041 Phone: (02) 9395 2111 Canterbury HospitalCanterbury HospitalCanterbury HospitalCanterbury Hospital Eva Fares Canterbury Hospital Canterbury Rd Campsie NSW 2194 Phone: (02) 9787 0000

CEIDACEIDACEIDACEIDA Fred D’Cruz CEIDA C/- Rozelle Hospital Church St Leichhardt NSW 2040 Phone: (02) 9818 0444 Concord HospitalConcord HospitalConcord HospitalConcord Hospital Jenny Niemeyer Concord Hospital Hospital Rd Concord NSW 2139 Phone: (02) 9767 5000 Division of Population HealthDivision of Population HealthDivision of Population HealthDivision of Population Health Samantha Adel Level 4 Queen Mary building Grose St Camperdown NSW 2050 Phone: (02) 9515 3270

HealthQuestHealthQuestHealthQuestHealthQuest Dr Armand Casolin 187 Thomas St Haymarket NSW 2000 Phone: (02) 9281 0811



NSW Institute of Forensic MedicineNSW Institute of Forensic MedicineNSW Institute of Forensic MedicineNSW Institute of Forensic Medicine Kevin Best NSW Institute of Forensic Medicine 50 Parramatta Rd Glebe NSW 2037 Phone: (02) 8584 7800

RoRoRoRoyal Prince Alfred Hospitalyal Prince Alfred Hospitalyal Prince Alfred Hospitalyal Prince Alfred Hospital David Baty RPA Missenden Rd Camperdown NSW 2050 Phone: (02) 9515 6111

Rozelle HospitalRozelle HospitalRozelle HospitalRozelle Hospital Kathleen Lee Rozelle Hospital PO Box 1 Rozelle NSW 2039 Phone: (02) 9556 9100 Tresillian Family Care CentresTresillian Family Care CentresTresillian Family Care CentresTresillian Family Care Centres Jane Kookarkin Tresillian Family Care Centres Canterbury Hospital Canterbury Rd Campsie NSW 2194 Phone: (02) 9787 0800 United Dental HospitalUnited Dental HospitalUnited Dental HospitalUnited Dental Hospital Suzanne Maxwell United Dental Hospital 2 Chalmers St Surry Hills NSW 2010 Phone: (02) 9293 3200 The CSAHS Summary of Affairs is updated and forwarded to the Government Printing Office for inclusion in the Government Gazette every six months. FOI officers listed in the Summary of Affairs are available for inquiries regarding FOI applications, access to medical records and/or amendment of records. Freedom of Information StatisticsFreedom of Information StatisticsFreedom of Information StatisticsFreedom of Information Statistics The number of FOI applications received by CSAHS for the 1999/2000 period was slightly less than the previous year. HealthQuest, Royal Prince Alfred and Canterbury hospitals received the largest proportion of new applications, with the remaining applications being divided

between Balmain and United Dental hospitals, the Division of Population Health and CSAHS. A number of applications were received via CSAHS and forwarded to the appropriate facility for processing. CSAHS received one personal application which was processed within the required time frame and partially released under Schedule 1 Clause 6 (1) of the FOI Act, Documents Affecting Personal Affairs. One applicant who submitted an application for Internal Review for Amendment of Records under Schedule 47 of the FOI Act, and for which a determination was made and reported in the 1998/99 CSAHS Annual Report, lodged an appeal of that decision to the Administrative Decisions Tribunal. The matter was heard over two separate days and as at 30 June 2000, the mediator’s decision has not been released. A third application received was of a non-personal nature and following a search for the requested documents, it was realised that they were held by another agency. The application and fee were transferred to that agency to be processed.



FREEDOM OF INFORMATION STATISTICAL RETURNSFREEDOM OF INFORMATION STATISTICAL RETURNSFREEDOM OF INFORMATION STATISTICAL RETURNSFREEDOM OF INFORMATION STATISTICAL RETURNS

NUMBER OF APPLICATIONSNUMBER OF APPLICATIONSNUMBER OF APPLICATIONSNUMBER OF APPLICATIONS

1998/991998/991998/991998/99 PersonalPersonalPersonalPersonal

1998/19991998/19991998/19991998/1999 NonNonNonNon----PersonalPersonalPersonalPersonal

1999/20001999/20001999/20001999/2000PersonalPersonalPersonalPersonal

1999/20001999/20001999/20001999/2000 NonNonNonNon----PersonalPersonalPersonalPersonal

Applications carried forward from 30 June (applications not completed in the previous period)

0

1

1

1

New applications

214

39

184

13

Applications completed

175

21

146

11

Number of amendments and/or notations

1

0

1

0

OUTCOME OF APPLICATIONS

Outcome of completed applications

Granted in full 163 15 140 10

Granted in part 6 2 6 1

Refused 38 17 35 0

Deferred 1 0 0 0

Applications granted in part or refused

Exempt (Schedule 1) 6 2 7 0

Unreasonable diversion of resources 0 0 0 0

Otherwise available 36 0 35 0

Other 2 2 2 1

No record held 4 2 1 1

No fees submitted 2 17 0 0

FEES

Fees received ($) 4,245 720 3,699 510

Number of discounts allowed 67 0 25 0

Financial Hardship 16 0 11 0

Public Interest 0 0 0 0

PROCESSING TIME

0-14 days 155 12 123 8

15-21 days 17 4 13 0

Over 21 days 3 5 10 3

Reviews and appeals 2 0 2 0



OPERATIONAL EFFICIENCY Energy ManagementEnergy ManagementEnergy ManagementEnergy Management • To facilitate compliance with the

Government Energy Management Policy, CSAHS appointed an energy manager and established a working party to develop and implement strategies. Achievements to date include: - Developing an energy plan - Conducting energy audits - Developing a staff awareness

program - Establishing baseline data from

which to monitor future savings. • Energy Management Strategies are

incorporated into plans for the Resource Transition Program.

Waste ManagementWaste ManagementWaste ManagementWaste Management • Waste management initiatives continue

to be implemented in all facilities across CSAHS in line with Government policy. Waste audits are conducted regularly and recycling is undertaken at all facilities.

Other servicesOther servicesOther servicesOther services • Information about CSAHS’s linen

service, cleaning, catering and other operational costs is available in the audited financial statements in Note 4: Goods and Services and Note 9: Sale of Goods and Services.



SES OFFICERS REPORT Name:Name:Name:Name: Dr Diana Horvath AO Position:Position:Position:Position: Chief Executive Officer,

Central Sydney Area Health Service,

SES Level 7 Period in Period in Period in Period in Position:Position:Position:Position: First appointed in

December 1992; re-appointed in December 1997

RESULTS:RESULTS:RESULTS:RESULTS: Strategic Initiatives:Strategic Initiatives:Strategic Initiatives:Strategic Initiatives: • Significant progress made with planning

and implementing CSAHS’s $375 million capital asset program with the expenditure allocation target of $57.1 million for 1999/2000 being met. Projects include the progressive redevelopment of Royal Prince Alfred Hospital, the renovation of the Institute of Rheumatology & Orthopaedics, the planning and redevelopment of Concord Hospital and the ANZAC Foundation, the relocation of Central Sydney Supply Service’s store to the Concord Hospital site and continued refurbishment at United Dental Hospital.

• Developed clinical quality initiatives through the Clinical Quality Council

• Upgraded and continued implementation of clinical information systems

• Completed a review of research development in CSAHS

• Implemented the Tobacco Control Strategy

• Finished the Mental Health Plan

• Completed the Aboriginal and Torres Strait Islander Employment Strategy

• Supported health outcomes and promotion initiatives

• Developed initiatives in Cancer Services • Implemented initiatives in youth health • Met day-surgery targets • Achieved goals set in the Bed

Management Plan • Finished year 2000 project planning

and rectification • Initiated staff training in child

protection, and prevention and early intervention for mental health services and suicide

• Commenced a review of CSAHS’s quality framework

• Chair, Australian Medical Disaster Coordination Group (reports to AHMAC)

• Chair, Clinical Systems Steering Committee for NSW Health

• Member, Macquarie University Council.

Management Accountabilities:Management Accountabilities:Management Accountabilities:Management Accountabilities: • Achieved a favourable net cost of

services and accrual budget result • Repaid loan in full to NSW Health • No trade creditors over 45 days • Met audit requirements • Debt recovery performance achieved to

the satisfaction of NSW Health • Improved revenue collection •

Maintained Australian Council on Healthcare Standards accreditation status for all hospitals

• All capital works milestones achieved • Continued implementation of energy

and waste management initiatives in accordance with Government policy.



Name:Name:Name:Name: Michael P Wallace

Position:Position:Position:Position: Deputy Chief Executive Officer, Central Sydney Area Health Service,

SES Level 5 Period in Period in Period in Period in

Position:Position:Position:Position: First appointed in February 1993; re-appointed in August 1998

Results:Results:Results:Results: Strategic InitiatStrategic InitiatStrategic InitiatStrategic Initiatives:ives:ives:ives: • Continued to progress the

implementation of the CSAHS capital asset plan (the Resource Transition Program), including:

- The decommissioning of RPA and the redevelopment of the new clinical services block

- The refurbishment of the Queen Elizabeth II building, RPA and the commissioning of the Institute of Rheumatology & Orthopaedics

- Progression of the Concord Hospital redevelopment with approval of the development application by Concord Council and approval of the conservation management plan by the Heritage Council

- Continued upgrades to United Dental Hospital with the completion of the new assessment and emergency department and progression of infrastructure services

- Ongoing planning for Croydon site and community health services - The realisation of assets, as approved by the CSAHS board

• Consultation and liaison with Macquarie Health Services to further progress the Prince Alfred Private Hospital

• Achieved savings through CSAHS’s tendering and procurement practices

• Continued upgrades to CSAHS’s IT infrastructure and systems including the HNA Millennium system and PathNet.

Management accountabilities:Management accountabilities:Management accountabilities:Management accountabilities: • Met financial management targets • Implemented cost-saving initiatives

and controls to achieve favourable net cost of services

• Capital works milestones attained • Improved revenue collection

performance • Debt recovery achieved to the

satisfaction of NSW Health • Implemented CSAHS’s performance

management system • Continued risk management initiatives •

Maintained implementation of EEO strategies, particularly with respect to Aboriginal and Torres Strait Islanders

• Completed CSAHS’s Y2K initiatives in accordance with Office of Information Technology requirements.



NON-GOVERNMENT ORGANISATIONS CSAHS is responsible for administering the following non-government organisations (NGOs) funded through the NSW Health NGO grant program. Subsidy NGO Grant 1999/2000 Recipients/GranteesRecipients/GranteesRecipients/GranteesRecipients/Grantees ProgramProgramProgramProgram 1999/2000 Grant1999/2000 Grant1999/2000 Grant1999/2000 Grant 1 Australian Nutrition Foundation Health Promotion 46,900 46,90046,90046,90046,900 2 Barnardo’s – Marrickville Drug & Alcohol 83,100 3 Barnardo’s – Youth at Risk Drug & Alcohol 74,400 4 Building Trades Union Drug & Alcohol 115,700 5 CO AS IT Drug & Alcohol 51,900 6 Cyrenian House – ADF NSW Drug & Alcohol 253,366 7 Fact Tree Youth Services – Making It Drug & Alcohol 91,100 8 Guthrie House Drug & Alcohol 116,300 9 Leichhardt Women’s Health Centre Drug & Alcohol 59,900 10 South Sydney Women’s Therapy Centre Drug & Alcohol 108,700 11 We Help Ourselves Drug & Alcohol 323,037 12 Youth Unlimited Drug & Alcohol 45,600 1,323,1031,323,1031,323,1031,323,103 13 Family Planning NSW AIDS 386,000 14 Haemophilia Society of NSW AIDS 63,200 15 Stanford House Inc AIDS 89,000 16 The Gender Centre AIDS 164,100 17 We Help Ourselves AIDS 94,700 797,000797,000797,000797,000 18 Dental Health Foundation Dental 50,300 50,30050,30050,30050,300 19 Centacare Services – Sydney Community Services 25,300 20 Dympna House Community Services 289.500 21 Family Planning NSW Community Services 504,900 22 Leichhardt Women’s Health Centre Community Services 435,600 23 Lifeline Sydney Community Services 44,100 24 NSW Council Child’s Film & TV Community Services 1,100 25 Sydney Rape Crisis Centre Community Services 436,700 26 South Sydney Women’s Therapy Centre Community Services 185,300 27 Sydney Indo-Chinese Youth Support Community Services 49,000 28 Thalassaemia Society of NSW Community Services 44,400 2,015,9002,015,9002,015,9002,015,900 29 After Care - Administration Mental Health 74,400 30 After Care – Ashfield/Parramatta Mental Health 70,300 31 After Care – Psycho Support Services Mental Health 61,800 32 CO AS IT Mental Health 76,200 33 GROW (Community Services) Mental Health 360,100 34 Homicide Victims Support Group Mental Health 356,500 35 Richmond Fellowship Mental Health 579,000 1,578,3001,578,3001,578,3001,578,300 36 Diabetes Australia Aged & Disabled 17,400 37 Ella Community Centre Aged & Disabled 43,600 38 Motor Neurone Disease Association Aged & Disabled 111,649 39 Royal Blind Society of NSW Aged & Disabled 165,000 40 Stroke Recovery Association Aged & Disabled 82,000 419,649419,649419,649419,649 Total 6,231,1526,231,1526,231,1526,231,152



TREASURER’S REPORT Again, the year was a busy one - the year 2000 compliance project was completed successfully and much effort was required in preparing for the introduction of the Federal Government’s new tax system (the Goods & Services Tax, Fringe Benefits Tax and Pay As You Go). The rebuilding of CSAHS’s facilities was advanced significantly with much of the effort centred at Royal Prince Alfred and Concord hospitals. The projects absorbed $61 million. Expenses for the year totalled $776.049 million, a sum $7.935 million favourable to budget and $6.977 million less than the 1999 expenditure. The outgoing on goods and services was higher than anticipated by $3.495 million, the other seven lines of expenses were favourable to budget. Revenues for the year of $229.519 million were $3.752 million ahead of budget and $6.338 in excess of last year’s revenue. Net Cost of Services of $543.204 million were $11.269 million favourable to budget. The provision of services to residents of other area health services was costed at $117.784 million; that sum was $2.156 million more than a year earlier. The cost of services provided to the residents of CSAHS by other area health services was $53.183 million in 2000 and $46.846 million a year earlier. Equity at June 2000 was $559.999 million or $7.053 million more than that of a year earlier. Once again I would like to congratulate the staff of CSAHS on this excellent result.

Maria PethardMaria PethardMaria PethardMaria Pethard


Beginning of Audited Financial Statements

CENTRAL SYDNEY AREA HEALTH SERVICEStatement of Financial Position as at 30 June 2000

Parent Consolidated

Actual2000$000

Budget2000$000

Actual1999$000

Notes Actual2000$000

Budget2000$000

Actual1999$000

1,61253,35315,159

5,325

3,73051,07714,188

5,443

7,17751,44917,2635,660

ASSETSCurrent Assets

Cash InvestmentsReceivablesInventories

2(q)(I),16,302(q)(iii),2(o),17,30

2(q)(ii),182(p),19

1,87755,86915,163

5,325

3,73051,07714,188

5,443

7,28258,19217,2885,660

75,449 74,438 81,549 Total Current Assets 78,234 74,438 88,422

588,53154,595

1,000

585,15751,182

1,000

551,89966,0741,500

Non-Current AssetsLand and BuildingsPlant and EquipmentReceivables

2(f), 2(j), 202(h), 20

2(q)(ii), 18

593,58254,651

1,000

585,15751,182

1,000

552,32366,0811,500

644,126 637,339 619,473 Total Non-Current Assets 649,233 637,339 619,904

719,575 711,777 701,022 Total Assets 727,467 711,777 708,326

30,988-

50,142

28,318-

47,394

20,395750

56,405

LIABILITIESCurrent Liabilities

Accounts PayableBorrowingsEmployee Entitlements

2(q)(iv),222(q)(v), 23

2(b),24

30,998-

50,142

28,318-

47,394

20,406750

56,405

81,130 75,712 77,550 Total Current Liabilities 81,140 75,712 77,561

-86,328

-86,898

-77,819

Non-Current LiabilitiesBorrowingsEmployee Entitlements

2(q)(v)232(b),24

-86,328

-86,898

-77,819

86,328 86,898 77,819 Total Non-Current Liabilities 86,328 86,898 77,819

167,458 162,610 155,369 Total Liabilities 167,468 162,610 155,380

552,117 549,167 545,653 Net Assets 559,999 549,167 552,946

151,961400,156

151,961397,206

151,961393,692

EquityReservesAccumulated Funds

2525

151,961408,038

151,961397,206

151,961400,985

552,117 549,167 545,653 Total Equity 559,999 549,167 552,946

The accompanying notes form part of these financial statements


CENTRAL SYDNEY AREA HEALTH SERVICEOperating Statement for the Year Ended 30 June 2000

Parent Consolidated

Actual2000$000

Budget2000$000

Actual1999$000


Budget2000$000

Actual1999$000

487,83724,587

199,20621,99129,825

7,851

4,395

490,04324,816

197,49827,67233,101

6,267

4,587

494,45924,696

195,80027,59027,7597,404

4,798

ExpensesOperating Expenses Employee Related Visiting Medical Officers Goods and ServicesMaintenanceDepreciationGrants and SubsidiesPayments to Affiliated HealthOrganisations- Recurrent

3

2(t), 42(g),52(I),6

7

8

488,01724,587

199,37321,99629,830

7,851

4,395

490,04324,816

195,87827,67233,101

7,887

4,587

494,83424,696

195,94027,59427,7607,404

4,798

775,692 783,984 782,506 Total Expenses 776,049 783,984 783,026

194,1393,258

25,8845,292

193,5302,706

24,9044,627

193,5942,461

20,3415,808

RevenuesSale of Goods and ServicesInvestment IncomeGrants and ContributionsOther Revenue

2(l),910

11,1412,14

194,2123,536

26,3295,442

193,5302,706

24,9044,627

193,7872,789

20,7255,880

228,573 225,767 222,204 Total Revenues 229,519 225,767 223,181

(3,326) (3,744) 2,242 (Gain)/Loss on Sale of Non Current Assets 13 (3,326) (3,744) 2,242

543,793 554,473 562,544 Net Cost of Services 31 543,204 554,473 562,087

490,824

28,170

-

31,263

490,824

28,170

-

31,699

479,968

29,188

(8,911)

32,137

Government ContributionsNSW Health Department RecurrentAllocationsNSW Health Department CapitalAllocationsAsset Sale Proceeds transferred to theCrown EntityAcceptance by the Crown Entityof Superannuation Liability

2(a)

2(a)

2(s)

2(c)

490,824

28,170

-

31,263

490,824

28,170

-

31,699

479,968

29,188

(8,911)

32,137

6,464 (3,780) (30,162) Movement in Accumulated Funds 25 7,053 (3,780) (29,705)



CENTRAL SYDNEY AREA HEALTH SERVICEStatement of Cash Flows for the Year Ended 30 June 2000

Parent Consolidated

Actual2000$000

Budget2000$000

Actual1999$000


Budget2000$000

Actual1999$000

(453,704)(7,851)

(237,875)

(454,283)(7,887)

(235,762)

(447,377)(7,404)

(235,287)

Cash Flows From Operating ActivitiesPayments

Employee RelatedGrants and SubsidiesOther

(453,885)(7,851)

(238,051)

(454,283)(7,887)

(235,762)

(447,757)(7,404)

(235,426)

(699,430) (697,932) (690,068) Total Payments (699,787) (697,932) (690,587)

195,9563,117

28,637

192,7192,705

23,225

193,4512,163

23,103

ReceiptsSale of Goods and ServicesInterest ReceivedOther

196,0293,416

29,198

192,7192,705

23,225

193,6442,472

23,560

227,710 218,649 218,717 Total Receipts 228,643 218,649 219,676

490,82428,170

-

490,82428,170

-

479,96829,188

(8,911)

Cash Flows From GovernmentNSW Health Department RecurrentAllocationsNSW Health Department CapitalAllocationsAsset Sale Proceeds transferred to the

Crown Entity

490,82428,170

-

490,82428,170

-

479,96829,188

(8,911)

518,994 518,994 500,245 NET CASH FLOWS FROM GOVERNMENT 518,994 518,994 500,245

47,274 39,711 28,894NET CASH FLOWS FROM OPERATINGACTIVITIES 47,850 39,711 29,334

15,280

(68,158)2,693

14,538

(69,831)-

26,353

(54,346)2,742

Cash Flows From Investing ActivitiesProceeds from the Sale of Land and Buildings, Plant and EquipmentPurchases of Land and Buildings, Plant andEquipmentOther

15,280

(72,804)2,696

14,538

(69,831)-

26,353

(54,729)2,773

(50,185) (55,293) (25,251)NET CASH FLOWS FROM INVESTINGACTIVITIES (54,828) (55,293) (25,603)

(750) (750) (3,084)Cash Flows From Financing Activities

Repayment of Borrowings (750) (750) (3,084)

(750) (750) (3,084)NET CASH FLOWS FROM FINANCINGACTIVITIES (750) (750) (3,084)

(3,661)58,626

(16,332)71,139

55958,067

NET INCREASE/(DECREASE) IN CASH Opening Cash and Cash Equivalents

(7,728)65,474

(16,332)71,139

64764,827

54,965 54,807 58,626 CLOSING CASH AND CASHEQUIVALENTS

30 57,746 54,807 65,474



Central Sydney Area Health ServiceNotes to and forming part of the Financial Statements

for the Year Ended 30 June 2000

CSAHS EXPENSES AND REVENUES Program1.1

Program1.2

Program1.3

Program2.1

Program2.2

Program2.3

Program3.1

Program4.1

Program5.1

Program6.1

Grand Total

2000 1999 2000 1999 2000 1999 2000 1999 2000 1999 2000 1999 2000 1999 2000 1999 2000 1999 2000 1999 2000 1999

$000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000

ExpensesOperating Expenses Employee Related Other Operating ExpensesMaintenanceDepreciationGrants and SubsidiesOther Expenses

23.9277,608

653335

4.103458

24,9996,7021,062

4643,905

416

27570

21--

29841

1---

75,14335,337

4,4135,232

-382

73,83233,886

4,2494,244

-735

21,7916,317

9471,558

--

17,3108,069

9551,086

--

210,971125.880

9,52916,289

-3,555

233,510

120,911

14,00715,166

-3,240

28,60617,950

1,8102,390

--

26,54214,600

1,7051,994

--

48,88711,984

1,2161,3911,590

-

49,33611,712

1,5961,8381,507

-

29,2658,4361,1371,160

489-

29,78311,927

1,7321,424

426407

6,6513,749

437296

49-

6,6323,438

318146

46-

42,5016,6291,8521,1781,620

-

32,5929,3501,9691,3981,520

-

488,017223,960

21,99629,830

7,8514,395

494,834220,636

27,59427,760

7,4044,798

Total Expenses 37,084 37,548 348 340 120,507 116,946 30,613 27,420 366,224 386,834

50,756 44,841 65,068 65,989 40,487 45,699 11,182 10,580 53,780 46,829 776,049 783,026

Retained RevenueSale of Goods and ServicesInvestment IncomeGrants and ContributionsOther Revenue

2,147353

2,630544

1,881109

2,805771

----

----

26,674228

1,696350

26,050270

1,542440

7,63931

23249

7,26419

15945

114,654868

6,4601,329

114,824

5106,5131,858

12,46866

495102

13,64512

464132

17,14439

29260

17,392204513

12,634208

1,546319

12,149391

2,157615

219

7221

16114714

8311,733

12,9072,668

5661,4476,9931,992

194,2123,535

26,3305,442

193,7872,789

20,7255,880

Total Retained Revenue 5,674 5,566 - - 28,948 28,302 7,951 7,487 123,311 123,705

13,131 14,253 17,535 17,470 14,707 15,312 123 88 18,139 10,998 229,519 223,181

Gain/(Loss) on Sale of Non Current Assets (33) (29) - - (35) 10 - - 3,735 1,958 - - (20) (4,213) (321) 32 - - - - 3,326 (2,242)

NET COST OF SERVICES 31,443 32,011 348 340 91,594 88,634 22,662 19,933 239,178 261,171

37,625 30,588 47,553 52,732 26,101 30,355 11,059 10,492 35,641 35,831 543,204 562,087

The name and purpose of each program is summarised in Note 15.





1. CSAHS Reporting Entity

Central Sydney Area Health Service (CSAHS) was established on 1st August 1988. CSAHS incorporates and manages allthe operating activities of the following hospitals, community health services and other facilities under its control:

C Royal Prince Alfred HospitalC Concord Repatriation General HospitalC Balmain HospitalC Canterbury HospitalC Centre for Education and Information on Drugs and AlcoholC HealthQuestC NSW Institute of Forensic MedicineC Population HealthC Rachel Forster HospitalC Rozelle HospitalC Thomas Walker HospitalC United Dental Hospital• ANZAC Health and Medical Research Foundation

In addition, the following Affiliated Health Organisations are associated by special arrangements with CSAHS.

C Central Sydney Scarba ServiceC Tresillian Family Care Centres

The Financial Statements encompass the activities of the General Fund and the controlled segment of the Special Purposes andTrust Fund. As CSAHS cannot use the uncontrolled segment of the latter fund to achieve its objectives, the cash balances andactivity of that segment are disclosed by way of a note to the financial statements. Within the controlled segment of the SpecialPurposes and Trust Fund there are assets restricted to specific uses by donors but nonetheless controlled by CSAHS.

The primary objectives of CSAHS are to protect, promote and maintain the health of Central Sydney residents and to providestate and nationwide health services, research and training.

Principles of Consolidation

The consolidated accounts are those of the consolidated entity, comprising CSAHS (the chief entity), and its controlled entity,ANZAC Health and Medical Research Foundation.

In the process of preparing the consolidated financial statements for the economic entity consisting of the controlling andcontrolled entity, all inter-entity transactions and balances have been eliminated.




2. Summary of Significant Accounting Policies

CSAHS’s Financial Statements are a general purpose financial report which has been prepared on an accrual basis inaccordance with applicable Australian Accounting Standards, other mandatory professional reporting requirements and therequirements of the Health Services Act 1997 and its regulations including observation of the Accounts and AuditDetermination for Area Health Services and Public Hospitals.

Where there are inconsistencies between the above requirements, the legislative provisions have prevailed.

Statements of Accounting Concepts are used as guidance in the absence of applicable Accounting Standards, other mandatoryprofessional requirements and legislative requirements.

Except for certain property, plant and equipment, which are recorded at valuation, the financial statements are prepared inaccordance with the historical cost convention. All amounts are rounded to the nearest one thousand dollars and are expressedin Australian currency.

Other significant accounting policies used in the preparation of these financial statements are as follows:

(a) NSW Health Department Cash Payments

Cash Payments are made by the NSW Health Department on the basis of the net allocation for the Health Service asadjusted for approved supplementations, mostly for salary agreements, patient flows between Health Services and otherStates and approved enhancement projects. This allocation is included in the Operating Statement before arriving at theoperating result on the basis that the allocation is earned in return for the health services provided on behalf of the NSWHealth Department.

General operating expenses/revenues of Affiliated Health Organisations ie Tresillian Family Care Centres and CentralSydney Scarba Service have only been included in the Operating Statements to the extent of the net cash payments madeto the facilities concerned. CSAHS is not deemed to own or control the various assets/liabilities of the aforementionedAffiliated Health Organisations and such amounts have been excluded from the Statement of Financial Position. Anyexceptions are specifically listed in the notes that follow.

The NSW Health Department has implemented a policy of net appropriation with all revenues earned being retained atCSAHS level and, with NSW Health Department Cash Payments, applied to offset net expenditure.

Capital Allocations have been treated as revenue in these financial statements and have been brought to account afterNet Cost of Services.




(b) Employee Entitlements

The elements of the entitlements are: salaries and wages, annual leave, long service leave, sick leave and on-costs.

Liabilities for salaries and wages, annual leave and vesting sick leave are recognised and measured as the amountunpaid at the reporting date at current pay rates in respect of employees’ services up to that date.

Long Service Leave measurement is based on the remuneration rates at year end for all employees with five or moreyears of service. It is considered that this measurement technique produces results not materially different from theestimate determined by using the present value basis of measurement.

Employee leave entitlements are dissected between the “Current” and “Non Current” components on the basis ofanticipated payments for the next 12 months. This in turn is based on past trends and known resignations andretirements.

Neither unused non-vesting sick leave nor the Staff Specialists’ training, education and study leave give rise to aliability, as it is not considered probable that those forms of leave taken in the future will be greater than theentitlements accrued.

The outstanding amounts of workers’ compensation insurance premiums and fringe benefits tax, which areconsequential to employment, are recognised as liabilities and expenses where the employee entitlements to which theyrelate have been recognised.

Under the Leave Mobility provisions applicable in the Government Sector from May 1993, CSAHS paid and receivedmonies in respect of employee leave transferred.

(c) Superannuation

CSAHS’s liability for superannuation is assumed by the Crown Entity. CSAHS accounts for the liability as having beenextinguished resulting in the amount assumed being shown as part of the non-monetary revenue item described as“Acceptance by the Crown Entity of Superannuation Liability”.

The superannuation expense for the financial year is determined by using the formulae specified by the NSW HealthDepartment. The expense for certain superannuation schemes (ie. Basic Benefit and First State Superannuation) iscalculated as a percentage of the employee’s salary. For other superannuation schemes (ie. State SuperannuationScheme and State Authorities Superannuation Scheme), the expense is calculated as a multiple of the employee’ssuperannuation contributions.

In the seven years ending 30 June 2000, since Concord Repatriation General Hospital was absorbed into CSAHS, thesuperannuation expenditure associated with those staff who have remained in the Federal Superannuation Fund waspaid by NSW Health Department. That expenditure totalled $6.877 million in 1999/00 and $6.997 million in 1998/99.

(d) Insurance

CSAHS’s insurance activities are conducted through the NSW Treasury Managed Fund Scheme of self insurance forGovernment agencies. The expense (premium) is determined by the Fund Manager based on past experience.

(e) Use of Outside Facilities

CSAHS uses a number of facilities owned and maintained by the local authorities in the area to deliver communityhealth services, for which no charges are raised by the authorities. The cost method of accounting is used for the initialrecording of all such services with cost being determined as the fair value of the services given which is then dulyrecognised as both revenue and matching expense.




(f) Acquisition of Assets

The cost method of accounting is used for the initial recording of all acquisitions of assets. Cost is determined as thefair value of assets given up at the date of acquisition plus costs incidental to the acquisition.

Assets acquired at no cost, or for nominal consideration, are initially recognised as assets and revenues at their fair valueat the date of acquisition.

Fair value means the amount for which an asset could be exchanged between a knowledgeable, willing buyer and aknowledgeable, willing seller in an arm’s length transaction.

Land and Buildings which are owned by the Health Administration Corporation or the State and used by CSAHS aredeemed to be controlled by CSAHS and are reflected as such in the financial statements.

Construction in Progress is carried at cost and relates to Capital Work on the redevelopment of the Resource TransitionProgram and miscellaneous projects.

(g) Repairs, Maintenance and Replacements

Repairs and maintenance costs and minor replacements or renewals (items less than $5,000) are expensed as incurred.Maintenance costs include expenses on periodic overhaul of major items of plant, machinery and equipment.

(h) Plant and Equipment

Individual items of plant and equipment costing $5,000 or more are capitalised.




(i) Depreciation

Depreciation is provided on a straight line basis against all depreciable assets so as to write off the depreciable amountof each depreciable asset as it is consumed over its useful life to CSAHS. Land is not considered a depreciable asset.

Property, Plant and Equipment have been depreciated from not later than the month following acquisition or operation.Depreciation rates on individual assets are reviewed annually.

Details of depreciation rates for major asset categories are as follows:Buildings 0.2% - 2.8% Electro Medical Equipment- Costing less than $200,000 10.0%- Costing more than or equal to $200,000 12.5%Computer Equipment 20.0%Computer Software 20.0%Office Equipment 10.0% -12.5%Plant and Machinery 10.0%Furniture, Fittings and Furnishings 10.0%Linen 20.0% - 33.3%Motor Vehicles - Trucks, Buses and Vans 20.0%

(j) Revaluation of Physical Non Current Assets

Buildings and improvements and infrastructure assets (excluding land) are valued on the basis of the estimated writtendown replacement cost of the most appropriate modern equivalent replacement facility having a similar service potentialto the existing asset. Land is valued on an existing use basis.

Plant and equipment are carried at net book value, which management has assessed to approximate written downreplacement cost. Construction in progress is shown at cost.

Land and buildings surplus to CSAHS’s requirements are stated at market value.

Land and buildings are revalued every 5 years. The last such valuation was completed as at 1 July 1997.

Where assets are revalued upward or downward using the replacement cost basis, CSAHS restates separately the grossamount and the related accumulated depreciation of that class of assets.

The recoverable amount test has not been applied as CSAHS is a not-for-profit entity whose service potential is notrelated to the ability to generate net cash inflows.




(k) Leased Assets

A distinction is made between finance leases which effectively transfer from the lessor to the lessee substantially all therisks and benefits incidental to ownership of the leased assets, and operating leases under which the lessor effectivelyretains all such risks and benefits. CSAHS has no finance leases. It does however, have a number of operating leasesfor buildings and office equipment and motor vehicles.

Operating lease payments are charged to expense in the periods in which they are incurred.

(l) Patient Fees

Patient Fees are derived from chargeable inpatients and non-inpatients on the basis of rates specified by the NSWHealth Department from time to time.

(m) Use of Hospital Facilities

Specialist doctors with rights of private practice are charged for the use of hospital facilities at rates determined by theNSW Health Department or the Salary Agreement with the doctors. That charge is based on fees collected.

(n) Research and Development Costs

Research and development costs are charged to expense in the year in which they are incurred.

(o) Investments

The vast majority of investments are held as cash deposits which would suffer no capital loss if they were redeemedbefore maturity. The need to restate them at net market selling values does not arise. They are carried at cost.

Interest revenues are recognised as they accrue.

(p) Inventories

All inventories have been valued at the lower of cost and net realisable value, and have been classified as current assetsbased on expected use. Costs are assigned to individual items of stock mainly on a weighted average cost basis.

Obsolete items are disposed of in accordance with instructions issued by the NSW Health Department.




(q) Financial Instruments

Financial instruments give rise to positions that are either a financial asset or a liability of CSAHS. For CSAHS theseinclude cash at bank, receivables, investments, accounts payable and borrowings.

In accordance with Australian Accounting Standard AAS33, “Presentation and Disclosure of Financial Instruments” information is disclosed in Note 35 in respect of the credit risk and interest rate risk of financial instruments. All suchamounts are carried in the accounts at net fair value. The specific accounting policy in respect of each class of suchfinancial instrument is stated hereunder.

Classes of instruments recorded at cost and their terms and conditions at balance date are as follows:

(I) Cash

Accounting Policies - Cash is carried at nominal values reconcilable to moneys on hand and independentbank statements.

Terms and Conditions - Monies on deposit attract an interest rate ranging from 4.05% to 5.3% (4.05% to4.3% in 1998/99).

(ii) Receivables

Accounting Policies - Receivables are carried at nominal amounts due less any provision for doubtfuldebts. A provision for doubtful debts is recognised when collection of the full nominal amount is nolonger probable.

Terms and Conditions - Accounts are issued on 30 day terms.

(iii) Investments

Accounting Policies - Investments reported at cost include both short term and fixed term deposits. Interest is recognised in the Operating Statement when earned.

Terms and Conditions - Short term deposits had an average maturity of 24 hours and interest rate rangingfrom 4.55% to 5.80% (4.55% to 4.8% in 1998/99). Fixed term deposits had an average maturity of 45days and an interest rate ranging from 4.77% to 6.14% (4.73% to 5.1% in 1998/99).

(iv) Accounts Payable

Accounting Policies - Accounts Payable are recognised for amounts to be paid in the future for goods andservices received, whether or not billed to CSAHS.

Terms and Conditions - Trade liabilities are settled within any terms specified. If no terms are specified,payment is made by the end of the month following the month in which the invoice is received.

(v) Borrowings

Accounting Policies - Bank Overdrafts and Loans are carried at the principal amount. Interest is chargedas an expense as it accrues.

Terms and Conditions - Bank Overdraft interest is charged at the Bank’s benchmark rate.

A non-interest bearing loan was obtained from the NSW Health Department and was repayable in annualinstalments. The final instalment was repaid during the year.

There are no classes of instruments which are recorded at other than cost or market valuation.

All financial instruments including revenue, expenses and other cash flows arising from instruments are recognised onan accruals basis.




(r) Trust Funds

CSAHS receives monies in a trustee capacity for various trusts as set out in Note 27. As CSAHS performs only acustodial role in respect of these monies, and because the monies cannot be used for the achievement of the Area’s ownobjectives, they are not brought to account in the financial statements.

(s) Proceeds on Sale of Motor Vehicles

The 1998/99 proceeds from the sale of motor vehicles associated with NSW Treasury negotiated leases of motorvehicles have been lodged to the credit of NSW Treasury. Such remittances have been deducted from GovernmentContributions in the Operating Statement.

(t) Motor Vehicles

During the 1998/99 financial year an operating lease facility was established for the motor vehicle fleet of all HealthServices. The new facility was established through an open tender process arranged through the NSW Treasury.

Under the arrangement all existing vehicles suitable for acquisition under an operating lease facility were sold andleased back to CSAHS.

The capital funds released through the sale of motor vehicles were paid to the Consolidated Fund to support the budget.

(u) Inter Area Patient Flows

Area Health Services recognise the flow of acute inpatients from the area in which they are resident to other areas withinthe State. The expense and revenue values reported within the financial statements have been based on the previousyear’s activity data using standard cost weighted separation values to reflect estimated costs for acute weighted inpatientseparations. Where treatment is obtained outside the home Area Health Service the Area providing the service isreimbursed by the benefiting Area.

The reporting adopted also aims to provide a greater accuracy of the cost of service provision to the Area’s residentpopulation and discloses the extent to which service is provided to non-residents.

The adjustments have no effect on equity values as the movement in Net Cost of Services is matched by a correspondingadjustment to the value of the NSW Health Recurrent Allocation.

In 1999/2000 calculation of the patient flows has been amended to include the flows to specialist paediatric hospitals. Ifthis change had been applied previously the 1998/99 net cost of services would have increased by $60.711 million.

The composition of patient flow revenue/expense is disclosed in Notes 4 and 9.

v) Goods and Services Tax (GST)

Commitments existing at 30 June 2000 are reported inclusive of the GST of 10% which has effect from 1 July 2000.

Additionally, contingent assets have been disclosed for amounts equivalent to any available input tax credits, whichrepresents the GST that is expected to be recoverable from the Australian Taxation Office.




3. Employee Related Expenses

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

377,2964,751

12,37938,743

5,360978

17,00731,323

353,49625,86013,61742,5835,197

86120,62732,218

Salaries and WagesEnterprise Agreements/AwardsLong Service Leave [see note 2(b)]Annual Leave [see note 2(b)]Nursing Agency PaymentsOther Agency PaymentsWorkers Compensation InsuranceSuperannuation [see note 2(c)]

377,4734,751

12,37938,746

5,360978

17,00731,323

353,84825,86013,61742,5975,199

86120,62732,225

487,837 494,459 488,017 494,834

4. Goods and Services2,572

10,66836,297

6,0487,830

11,207331856

53,18345,226

3,9103,3322,334

12,0661,059

3261,961

4,36812,03533,714

7,3937,4229,263 655 875

46,84644,1804,1213,3922,626

11,748892

4,6021,668

Computer Related ExpensesDomestic ChargesDrug Supplies Food SuppliesFuel, Light and PowerGeneral ExpensesHospital Ambulance Transport Costs InsuranceInter Area Patient Outflows, NSW * Medical and Surgical SuppliesPostal and Telephone CostsPrinting and Stationery Rental, Rates and Charges Special Service DepartmentsStaff Related CostsSundry Operating Expenses Travel Related Costs

2,57210,66836,297

6,0487,830

11,276331856

53,18345,227

3,9103,3602,334

12,0661,061

3901,964

4,36812,03533,7147,3937,4229,287

655875

46,84644,1804,1213,4112,626

11,748894

4,6951,670

199,206 195,800 199,373 195,940

3260

8623,740

Sundry Operating Expenses comprise:Aircraft Expenses (Ambulance)Other (including Y2K expenses in 1999)

32664

8623,833

326 4,602 390 4,695




Parent Consolidated

2000$000

1999$000

2000$000

1999$000

6851,000

3,294186

150416380

3,1738

1,915

712963

1,901161

217224195

3,040144

1,706

General Expenses comprise:AdvertisingBooks and MagazinesConsultancies- Operating ActivitiesCourier and FreightExternal Audit Fees- Audit WorkLegal ExpensesMembership/Professional FeesOperating Lease ExpensePayroll ServicesProvision for Bad and Doubtful Debts

6851,001

3,357188

152416381

3,1738

1,915

720964

1,907162

223226195

3,040144

1,706

11,207 9,263 11,276 9,287

* Payments for Inter Area Patient Flows from other NSW Area Health Services were as follows ($000):

South Eastern Sydney AHS: $28,676 ($25,039). South Western Sydney AHS: $11,227 ($12,873). Northern SydneyAHS: $3,862 (4,464). Western Sydney AHS: $3,571 (3,512). New Children’s Hospital $4,732 (N/A) Other AreaHealth Services (12 in all): $1,115 ($958).

5. Maintenance10,710

5,824

5,457

9,684

7,440

10,466

Repairs and Routine MaintenanceOther Renovations and Additional Works Replacements and Additional Equipment less than $5,000

10,711

5,824

5,461

9,684

7,440

10,470

21,991 27,590 21,996 27,594

6. Depreciation14,55615,269

11,75716,002

Depreciation - BuildingsDepreciation - Plant and Equipment

14,55615,274

11,75816,002

29,825 27,759 29,830 27,760

7. Grants and Subsidies6,231

272720348200

7010

5,8842727203489090

-

Payments to Non Government OrganisationsInstitute of Respiratory Medicine Heart Research Institute Centre for Health Economics and Research EvaluationCentre for Education and Research on Ageing Perinatal Health Other

6,231272720348200

7010

5,8842727203489090

-

7,851 7,404 7,851 7,404




8. Payments to Affiliated Health OrganisationsParent Consolidated

2000$000

1999$000

2000$000

1999$000

-4,049

346

4074,004

387

Recurrent Our Lady of Loreto Nursing Home for the Aged Tresillian Family Care Centres Central Sydney Scarba Service

-4,049

346

4074,004

387

4,395 4,798 4,395 4,798

9. Sale of Goods and Services

49,906763

11,1121,107

390344746

2,253128

4,386117,784

1,9273,293

51,234760

9,7761,202

412296864

2,247232

3,620115,628

1,8585,465

Patient Fees [see note 2(l)]Staff Meals and AccommodationUse of Hospital Facilities [see note 2(m)]Car ParkingChild Care FeesFees for Medical RecordsLease and Rental IncomeNon Staff MealsLinen Service Revenues - Other Health ServicesSale of ProsthesesInter Area Patient Inflows *HealthQuest RevenueOthers

49,906763

11,1121,107

390344746

2,253128

4,386117,784

1,9273,366

51,234760

9,7761,202

412296864

2,247232

3,620115,628

1,8585,658

194,139 193,594 194,212 193,787

* Revenues from Inter Area Patient Flows provided to other NSW Area Health Services were as follows ($000):

South Western Sydney AHS: $23,147 ($23,860). Northern Sydney AHS: $18,941 ($18,634). WesternSydney AHS: $18,889 ($17,669). South Eastern Sydney AHS: $16,359 ($15,731). Illawarra AHS: $8,667($8,622). Mid-Western AHS: $4,826 ($5,307). Central Coast AHS: $4,585 ($5,131). Macquarie AHS:$5,318 ($4,979). Wentworth AHS: $3,996 ($3,581). Mid-North Coast AHS: $3,692 ($3,194). New EnglandAHS: $1,627 ($2,244). Southern AHS: $2,178 ($1,847). Greater Murray AHS: $1,848 ($1,785). HunterAHS: $1,971 ($1,526). Far Western AHS: $1,067 ($786). Northern Rivers AHS: $673 ($732).

10. Investment Income

3,258 2,461 Interest 3,536 2,789

3,258 2,461 3,536 2,789




11. Grants and Contributions

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

4374,5013,343

3,5932,649

655

681652

9,2131942

2056,8772,279

2,4642,518

-3414

-90

5,480380

University Commission GrantsCommonwealth Government GrantsResearch Grant Non GovernmentsOther- Mammography- Centre for Education and Information on Drugs and Alcohol- Manufacturing- Wholesale and Retail Trade - Finance, Property and Business Services- Public Administration and Defence- Community Services- Recreation, Personal and Other Services- Sundry

4374,5013,555

3,5932,649

665

1421672

9,3061,987

2056,8772,291

2,4642,518

233478

-99

5,737399

25,884 20,341 26,329 20,725

12. Other Revenue5,292 5,808 Other 5,442 5,880

5,292 5,808 5,442 5,880

13. (Gain)/Loss on Sale of Non Current Assets

21,951(9,997)

73,537(44,942)

Property, Plant and EquipmentLess Accumulated Depreciation

21,955(10,001)

73,537(44,942)

11,954(15,280)

28,595(26,353)

Written Down ValueLess Proceeds from Sale

11,954(15,280)

28,595(26,353)

(3,326) 2,242 (Gain)/Loss on Sale of Non Current Assets (3,326) 2,242




14. Conditions on Contributions

Contributions recognised as revenues during current year for which expenditure in manner specified has notoccurred as at balance date.

Parent Consolidated

Total2000$000

Total1999$000

Major Category Total2000$000

Total1999$000

7,3514,2683,624

6,236763

2,635

Health Promotion, Education and ResearchPurchase of AssetsGeneral

8,2964,2683,624

6,687763

2,635

15,243 9,634 Total 16,188 10,085

Aggregate of Contributions recognised as revenues during the financial year which were specifically providedfor expenditure over a future period.

Major Category <1 Year$000

1-2 Years$000

2-3 Years$000

3-4 Years$000

Parent2000 Total

$000

Health Promotion, Educationand ResearchPurchase of AssetsGeneral

1,8381,067

906

1,8381,067

906

1,8371,067

906

1,8381,067

906

7,3514,2683,624

Parent Total 3,811 3,811 3,810 3,811 15,243

Major Category <1 Year$000

1-2 Years$000

2-3 Years$000

3-4 Years$000

Consolidated

2000 Total$000

Health Promotion, Educationand ResearchPurchase of AssetsGeneral

2,0741,067

906

2,0741,067

906

2,0741,067

906

2,0741,067

906

8,2964,2683,624

Consolidated Total 4,047 4,047 4,047 4,047 16,188




Revenues recognised in previous years which were obtained for expenditure in the current financial year.

Parent Consolidated

2000$000

1999$000

Major Category 2000$000

1999$000

5,031839

2,341

3,6661,0592,041


5,388839

2,341

4,2521,0592,041

8,211 6,766 Total 8,568 7,352

Total Amount of unexpended Contributions as at Balance Date.Parent Consolidated

2000$000

1999$000

Major Category 2000$000

1999$000

16,9558,3849,053

15,6353,5269,871


22,83710,384

9,053

20,9255,5269,871

34,392 29,032 Total 42,274 36,322

Comment on restricted assets appears in Note 21

15. Programs/Activities of CSAHS

Program 1.1 Primary and Community Based ServicesObjective: To improve, maintain or restore health through health promotion, early intervention, assessment, therapy and

treatment services for clients in a home or community setting.

Program 1.2 Aboriginal Health ServicesObjective: To raise the health status of Aborigines and to promote a healthy lifestyle.

Program 1.3 Outpatient ServicesObjective: To improve, maintain or restore health through diagnosis, therapy, education and treatment services for

ambulant patients in a hospital setting.

Program 2.1 Emergency ServicesObjective: To reduce the risk of premature death and disability for people suffering injury or acute illness by providing

timely emergency diagnostic, treatment and transport services.

Program 2.2 Overnight Acute Inpatient ServicesObjective: To restore or improve health and manage risks of illness, injury and childbirth through diagnosis and

treatment for people intended to be admitted to hospital on an overnight basis.

Program 2.3 Same Day Acute Inpatient ServicesObjective: To restore or improve health and manage risks of illness, injury and childbirth through diagnosis and

treatment for people intended to be admitted to hospital and discharged on the same day.

Program 3.1 Mental Health ServicesObjective: To improve the health, wellbeing and social functioning of people with disabling mental disorders and to

reduce the incidence of suicide, mental health problems and mental disorders in the community.




Program 4.1 Rehabilitation and Extended Care ServicesObjective: To improve or maintain the wellbeing and independent functioning of people with disabilities or chronic

conditions, the frail aged and the terminally ill.

Program 5.1 Population Health ServicesObjective: To promote health and reduce the incidence of preventable disease and disability by improving access to

opportunities and prerequisites for good health.

Program 6.1 Teaching and ResearchObjective: To develop the skills and knowledge of the health workforce to support patient care and population health.

To extend knowledge through scientific enquiry and applied research aimed at improving the health andwellbeing of the people of New South Wales.

16. Cash

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

341,578

347,143

Current Cash on HandCash at Bank

351,842

347,248

1,612 7,177 1,877 7,282




17. Investments

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

17,77735,576

15,00336,446

CurrentDeposits at callShort term deposits

18,07537,794

15,03343,159

53,353 51,449 55,869 58,192

The ANZAC Health and Medical Research Foundation (refer Note 1) is a controlled entity of CSAHS by virtue of CSAHS’s capacityto control the casting of the majority of the votes at meetings of the governing body of the Foundation. The Foundation is incorporatedin Australia and it is an economic entity whose principal activity is research. The beneficial interest held by CSAHS is 100%.

The revenue of the Foundation for the year was $945,823 (1999 $1,043,692), expenditure was $357,199 (1999 $586,249) and the surpluswas $588,624 (1999 $457,444).

No Director received income from the ANZAC Health and Medical Research Foundation during the financial year (1999 - Directorship -$Nil).




18. Receivables

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

10,24612

1,3381,180

725343

2,391902

1,443

11,18437

8871,5532,365

6111,715

4991,051

CurrentSale of Goods and Services Prepayments Prostheses Intra Area charges Debtors - NSW Health Department Workers Compensation Sundry Debtors Leave Mobility Debtors Other Debtors

10,24612

1,3381,180

725343

2,391902

1,447

11,18437

8871,5532,365

6111,715

4991,076

18,580 19,902 Sub Total 18,584 19,927

(3,153)(268)

(2,498)(141)

less Provision for Doubtful DebtsOthers

(3,153)(268)

(2,498)(141)

15,159 17,263 15,163 17,288

213644229

47

23581118969

Bad Debts written off during the year

Patients’ Fees- Private - Overseas visitors - Compensable Other Debtors

213644229

47

23581118969

1,133 1,304 1,133 1,304

2,1965,0992,951

2,2476,2292,708

Note: Sale of Goods and Services includes:Patient Fees - CompensablePatient Fees - IneligiblePatient Fees - Other

2,1965,0992,951

2,2476,2292,708

10,246 11,184 10,246 11,184

1,0001,500

Non CurrentOther Debtors- Leave Mobility Receivable 1,000 1,500

1,000 1,500 1,000 1,500




19. InventoriesParent Consolidated

2000$000

1999$000

2000$000

1999$000

3,5581,203

33560

169

3,5581,416

397106183

Current - at cost

DrugsMedical and Surgical SuppliesFood and Hotel SuppliesPrinting and StationeryOther including goods in transit

3,5581,203

33560

169

3,5581,416

397106183

5,325 5,660 5,325 5,660




20. Property, Plant and Equipment

2000 1999

Land

$000

Buildings

$000

Work InProgress

$000

Plant andEquipment

$000

Total

$000

Total

$000

Balance 1 July At Valuation At CostCapital Expenditure/Donations [see note 2(f)]Reclassification/TransfersDisposalsBalance at 30 June 2000

At ValuationAt Cost

230,785--

(8,130)(5,870)

216,785-

694,69675,534

6,5898,529

(2,225)

702,87180,252

-42,14652,230

--

-94,376

76,234134,965

8,113(399)

(13,856)

75,529129,528

1,001,715252,645

66,932-

(21,951)

995,185304,156

1,065,152227,033

35,712-

(73,537)

1,001,715252,645

Total 216,785 783,123 94,376 205,057 1,299,341 1,254,360

DepreciationBalance 1 July

At ValuationAt Cost

Charge for the year [see note 2(i)]Adjustment for disposalsRevaluation AdjustmentBalance at 30 June

At ValuationAt Cost

----

--

488,1073,155

14,556(65)

501,8913,862

----

--

78,12467,00115,269(9,932)

73,89376,569

566,23170,15629,825(9,997)

575,78480,431

592,96560,60527,759

(44,942)-

566,23170,156

Total - 505,753 - 150,462 656,215 636,387

Carrying Amount at 30 JuneAt Valuation date 1 July 1997At Cost

216,785-

200,98076,390

-94,376

1,63652,959

419,401223,725

435,484182,489

Total 216,785 277,370 94,376 54,595 643,126 617,973

ParentCarrying amount at 30 June 216,785 277,370 94,376 54,595 643,126 617,973

ConsolidatedCarrying amount at 30 June 216,785 281,819 94,978 54,651 648,233 618,404

(I) Land and Buildings include land owned by the NSW Health Department and administered by CSAHS [see note 2(f)].(ii) Land and Buildings were valued by Preston Rowe Paterson NSW Pty Ltd, property valuers at 1 July 1997. The firm also provides property

management services to CSAHS.(iii) Plant and Equipment (excluding Concord Hospital’s), other than motor vehicles were valued by CSAHS on 1 July 1992 on the basis of depreciated

replacement cost. Plant and Equipment of Concord Hospital have been valued at cost of acquisitions.(iv) As of 30 June 2000, fully depreciated assets comprised 532 pieces of Medical Equipment, 179 pieces of Non Medical Equipment, 35 items of

Furniture and Equipment, 431 units of Plant and Machinery, and 483 units of Computer Equipment.




21. Restricted Assets

CSAHS’s financial statements include the following assets which are restricted by externally imposed conditions, eg.donor requirements. The assets are only available for application in accordance with the terms of the donor restrictions.

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

16,9558,3849,053

15,6353,5269,871

Major Categories of Contributions


22,83710,384

9,053

20,9255,5269,871

34,392 29,032 42,274 36,322

22. Accounts Payable

24,641

2,6031,1272,617

14,918

2,519419

2,539

Current

CreditorsOther Creditors- Sundry Creditors- Leave Mobility Creditors- Accrual VMOs

24,641

2,6131,1272,617

14,918

2,530419

2,539

30,988 20,395 30,998 20,406




23. Borrowings Parent Consolidated

2000$000

1999$000

2000$000

1999$000

- 750

Current

NSW Health Department Loan Against Recurrent Allocation - 750

- 750 Sub Total - 750

- 750

Repayment of Borrowings

Not later than one year - 750

- 750 Total Borrowings at Face Value - 750

24. Current / Non Current Liabilities - Employee Entitlements

36,8506,3452,9174,030

38,3176,8938,7062,489

Current

Employee Annual LeaveEmployee Long Service LeaveAccrued Salaries and WagesTaxation and other Payroll Deductions

36,8506,3452,9174,030

38,3176,8938,7062,489

50,142 56,405 Aggregate Employee Entitlements 50,142 56,405

14,71171,617

11,26366,556

Non Current

Employee Annual LeaveEmployee Long Service Leave

14,71171,617

11,26366,556

86,328 77,819 Aggregate Employee Entitlements 86,328 77,819




25. Equity

Accumulated Funds Asset Revaluation Total Equity

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

Parent

Balance at the beginning of the financial year 393,692 423,858 151,961 151,961 545,653 575,819

Movement in Accumulated Funds for the Year 6,464 (30,162) - - 6,464 (30,162)

Correction to previously recognised asset* - (4) - - - (4)

Balance at the end of the financial year 400,156 393,692 151,961 151,961 552,117 545,653

Consolidated

Balance at the beginning of the financial year 400,985 430,690 151,961 151,961 552,946 582,651

Movement in Accumulated Funds for the Year 7,053 (29,705) - - 7,053 (29,705)

Balance at the end of the financial year 408,038 400,985 151,961 151,961 559,999 552,946

* This represents assets not recognised when CSAHS adopted accrual accounting on 1 July 1992.




26. Commitments for Expenditure

Parent

Consolidated

2000$000

1999$000

2000$000

1999$000

104,32999,00049,916

-

73,08690,504

141,669-

a) Capital Commitments

Aggregate Capital Expenditure contracted for atBalance Date but not provided for in the accounts:- Not later than one year- Between one and two years- Between two and five years

- Later than five years

104,32999,00049,916

-

73,08690,504

141,669-

253,245 305,259 Total Capital Expenditure Commitments (including GST) 253,245 305,259

4,3534,0629,502

12,231

4,1943,9509,250

12,000

b) Operating Lease Commitments

Commitments in relation to non cancellable operating leasesare payable as follows:- Not later than one year- Between one and two years- Between two and five years- Later than five years

4,3534,0629,502

12,231

4,1943,9509,250

12,000

30,148 29,394 Total Operating Lease Commitments (including GST) 30,148 29,394

c) Contingent Asset related to Commitments for Expenditure

The total “Expenditure Commitments” above includes input tax credits of $25.763 million thatare expected to be recoverable from the Australia Taxation Office.




27. Trust Funds

CSAHS holds Trust Fund moneys of $38.720 million (1999 $34.080 million) which are used for the safe keeping of patients’ moneys,deposits on hired items of equipment and Private Practice Trusts. These moneys are excluded from the financial statements as CSAHScannot use them for the achievement of its objectives. The following is a summary of the transactions in the trust accounts.

Patients’ Trusts Refundable Deposits

Private Practice TrustFunds

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

Cash Balance at the beginning of the financialyear

Receipts

Expenditure

160

9

(9)

150

14

(4)

9,613

7,604

(7,940)

9,167

4,916

(4,470)

24,307

41,904

(36,928)

18,935

37,609

(32,237)

Cash Balance at the end of the financial year160 160 9,277 9,613 29,283 24,307

28. Contingent Liabilities

(a) Claims on Managed Fund

Since 1 July 1989, CSAHS has been a member of the NSW Treasury Managed Fund. The Fund will pay to or on behalf of CSAHS allsums which it shall become legally liable to pay by way of compensation or legal liability if sued except for employment related,discrimination and harassment claims that do not have State wide implications. The costs relating to such exceptions are to be absorbedby CSAHS. Since 1 July 1989, no contingent liabilities exist in respect of liability claims against CSAHS. A Solvency Fund (now calledPre-Managed Fund Reserve) was established to deal with the insurance matters incurred before 1 July 1989 that were above the limit ofinsurance held or for matters incurred before 1 July 1989 that would have become verdicts against the State. The Solvency Fund willlikewise respond to all claims against CSAHS. There is an unquantified liability in respect of the claims for Workers Compensation asthe payments in respect of some claims are not finalised until eighteen months after the financial year in which the claims are made. (Seethe following note).

(b) 1996/97 Workers Compensation Hindsight Adjustment

When the New Start (to the) Treasury Managed Fund was introduced in 1995/96, hindsight adjustments in respect of WorkersCompensation (three years from commencement of Fund Year) and Motor Vehicle (eighteen months from commencement of Fund Year)became operative.

The hindsight adjustment has now been effected for the 1996/97 year and resulted in an increase in revenue of $248,309.

A contingent liability or asset may now exist in respect of the 1997/98 and 1998/99 Workers Compensation Fund years.

This estimate however is subject to further actuarial calculation and a better indication of quantum will not be available until the lastquarter of 2000.




(c) Affiliated Health Organisations

Based on the definition of control in Australian Accounting Standard AAS24, Affiliated Health Organisations listed in Schedule 3 of theHealth Services Act, 1997 are only recognised in CSAHS’s consolidated Financial Statements to the extent of cash payments made.

However, it is accepted that a contingent liability exists which may be realised in the event of cessation of health service activities by anyAffiliated Health Organisation. In this event the determination of assets and liabilities would be dependent on any contractual relationshipwhich may exist or be formulated between the administering bodies of the organisation and the NSW Health Department.

(d) Claim by Lessee of Certain Property

The lessee of certain property controlled by CSAHS has made a claim against CSAHS. The claim related to Supreme Court proceedingsin respect of recision of an agreement and lease relating to a proposed private hospital on the Royal Prince Alfred Hospital campus whichwas to be constructed and operated by the lessee. Litigation is ensuing with a claim by the lessee for compensation in respect of rentalspaid to date amounting to approximately $5,000,000 together with damages which have not been quantified.

It is the opinion of the Board that the likelihood of success of the claim is minimal and accordingly no provision in relation to this matterhas been reflected in the financial statements.

As part of the original agreement for construction of the private hospital, the lessee constructed a private car park on the land leased fromCSAHS. The lease was cancelled in March 2000 and, after an interlocutory hearing, CSAHS was granted the right to operate the car park.The car park has now been in operation since 26 June 2000 and has not been recognised as an asset in the financial statements asownership has not been transferred.

(e) Claim by the Supplier of Certain Goods

There is a debt recovery claim being brought by the supplier of certain goods in the sum of approximately $1.3 million.

It is the opinion of the Board that the likelihood of success of the claim is minimal and accordingly no provision in relation to this matterhas been reflected in the financial statements.




29. Charitable Fundraising Activities

Fundraising Activities

CSAHS conducts direct fundraising in all units under its control.

Income received and the cost of raising income for specific fundraising have been recognised in the financial statement of CSAHS. Fundraising activities are dissected as follows:

2000 1999

IncomeRaised$000

DirectExpenditure

$000

IndirectExpenditure

$000

NetProceeds$000

Net Proceeds$000

Appeals (Consultants)Appeals (In House)RafflesFunctions

-866

-664

-92

-111

-4-4

-770

-549

-1,081

-12

Parent 1,530 203 8 1,319 1,093

Percentage of Income - 13.3 0.5 86.2 96.0

Consolidated* 1,901 255 9 1,637 1,331

Percentage of Income - 13.4 0.5 86.1 91.0

Note: Direct Expenditure includes printing, postage, raffle prizes, consulting fees, etc.Indirect Expenditure includes overheads such as office staff administrative costs, cost apportionment of light, power and other

overheads. 2000 1999

Consolidated:The net proceeds were used for the following purposes:

$000 $000

Purchase of EquipmentResearchHeld in Special Purpose and Trust Fund Pending Expenditure

567110960

86553692

1,637 1,331

The provision of the Charitable Fundraising Act 1991 and the regulations under the Act have been complied with and internal controlsexercised by CSAHS are considered appropriate and effective in accounting for all the income received in all material respects.

* The consolidated figures are:

Income Raised$000

DirectExpenditure

$000

IndirectExpenditur

e$000

2000 Net

Proceeds$000

1999 Net

Proceeds$000

Appeals (Consultants)Appeals (In House)RafflesFunctions

-1,100

-801

-96

-159

-5-4

-999

-638

1361,148

542

Consolidated 1,901 255 9 1,637 1,331




30. Cash and Cash Equivalents

Parent Consolidated

2000$000

1999$000

2000$000

1999$000

1,612-

53,353

7,177-

51,449

For the purposes of the Cash Flow Statement, cash includes cash,current investments and bank overdraft.Cash at the end of the financial year as shown in the Cash FlowStatement is reconciled to the related items in the Statement ofFinancial Position as follows:- Cash- Bank Overdraft- Current Investments

1,877-

55,869

7,282-

58,192

54,965 58,626Closing Cash and Cash Equivalents(per Cash Flow Statement) 57,746 65,474

31. Reconciliation of Net Cost of Services to Net Cash Flows from Operating Activities

47,274(29,825)

(782)

(31,263)(705)(605)

(12,219)3,326

(490,824)(28,170)

-

28,894(27,760)

(401)

(32,137)(15,278)(12,409)

(966)(2,242)

(479,968)(29,188)

8,911

Net Cash Used on Operating ActivitiesDepreciationProvision for Doubtful DebtsAcceptance by the Crown Entity of Superannuation Liability(Increase)/Decrease in ProvisionsIncrease/(Decrease) in Prepayments and Other Assets(Increase)/Decrease in CreditorsNet (Loss)/Gain on Sale of Property, Plant and EquipmentNSW Health Department Recurrent AllocationsNSW Health Department Capital AllocationsAsset Sale Proceeds transferred to the Crown Entity

47,850(29,830)

(782)

(31,263)(704)(591)

(12,216)3,326

(490,824)(28,170)

-

29,334(27,760)

(401)

(32,137)(15,274)(12,390)

(972)(2,242)

(479,968)(29,188)

8,911

(543,793) (562,544) Net Cost of Services (543,204) (562,087)

32. 1999/2000 Voluntary Services

It is considered impractical to quantify the monetary value of voluntary services provided to CSAHS. Services provided include:

• Chaplaincies and Pastoral Care • Patient and Family Support• Pink Ladies/Hospital Auxiliaries • Patient Services, Fundraising• Patient Support Groups • Practical Support to Patients and Relatives• Community Organisations • Counselling, Health Education, Transport, Home Help and Patient Activities




33. Unclaimed Moneys

Unclaimed salaries and wages are paid to the credit of the Department of Industrial Relations and Employment in accordance with theprovisions of the Industrial Arbitration Act, 1940, as amended.

All money and personal effects of patients which are left in the custody of CSAHS by any patient who is discharged or dies in the hospitaland which are not claimed by the person lawfully entitled thereto within a period of twelve months are recognised as the property ofCSAHS.

All such money and the proceeds of the realisation of any personal effects are lodged to the credit of the Samaritan Fund which is usedspecifically for the benefit of necessitous patients or necessitous outgoing patients.

34. Budget Review

Net Cost of Services

The Net Cost of Services for the year of $543.204 million was lower than the budget of $554.473 million by $11.269 million (2.03%).

The variation reflects favourabilities in revenues ($3.752 million), expenses ($7.935 million), and unfavourably in sale of Non CurrentAssets ($418,000).

Movement in Accumulated Funds

The movement in accumulated funds is principally attributed to the Net Cost of Services variation.

Assets and Liabilities

Assets totalled $727.467 million and were $15.690 million favourable to budget. This represented $3.796 million improvement inCurrent Assets and $11.894 million increase in Non-Current Assets.

Cash Flows

The net decrease in Cash for the year was $7.727 million or $8.605 million less than the budgeted sum; the major improvement was in theflows from other receipts ($5.973 million).




35. Financial Instruments - Consolidationa) Interest rate risk, is the risk that the value of the financial instrument will fluctuate due to changes in market interest rates. Central Sydney Area Health Service’s

exposure to interest rate risks and the effective interest rates of financial assets and liabilities both recognised and unrecognised, at the (consolidated) Statementof Financial Position date are as follows:

Fixed Interest rate maturing in

Financial InstrumentsFloating interest

rate1 year or less Over 1 to 5

yearsMore than 5 years Non-interest

bearing

Total carrying amountas per the Statement ofFinancial Position

Weighted averageeffective interest rate*

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

2000%

1999%

Financial Assets

CashReceivablesOther Loans andDeposits

1,842-

18,075

7,248-

15,033

--

37,794

--

43,159

--

-

--

-

--

-

--

-

3515,163

-

3417,288

-

1,87715,163

55,869

7,28217,288

58,192

4.52N/A

5.29

4.17N/A

4.82

Total Financial Assets 19,917 22,281 37,794 43,159 - - - - 15,198 17,322 72,909 82,762 - -

Financial LiabilitiesBorrowings - BankO/draftBorrowings - OtherAccounts Payable

----

----

----

----

----

----

----

----

---

30,998

--

75020,406

---

30,998

--

75020,406

N/AN/AN/AN/A

N/AN/AN/AN/A

Total FinancialLiabilities - - - - - - - - 30,998 21,156 30,998 21,156 - -

* Weighted average effective interest rate was computed on a semi-annual basis. It is not applicable for non-interest bearing financial instruments. (This may be varied if the Health Service is aware of furtherfluctuations)




b) Credit risk is the risk of financial loss arising from another party to a contract or financial position failing to discharge a financial obligation thereunder.The Central Sydney Area Heal Service’s maximum exposure to credit risk is represented by the carrying amounts of the financial assets included in the consolidated Statement ofFinancial Position.

Credit Risk by classification of counter party.

Government Banks Patients Other Total

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

2000$000

1999$000

Financial Assets

CashReceivablesInvestment - 11am

---

---

1,842--

7,248--

-7,093

-

-8,686

-

358,070

-

348,602

-

1,87715,163

-

7,28217,288

-

Total Financial Assets - - 1,842 7,248 7,093 8,686 8,105 8,636 17,040 24,570

The only significant concentration of credit risk arises in respect of patients ineligible for free treatment under the Medicare provisions.

Receivables from these entities totalled $5.99 million at balance date.

c) As stated in Note 2(q) all financial instruments are carried at Net Fair Value, the values of which are reported in the Statement of Financial Position.

d) CSAHS holds no Derivative Financial Instruments.

End of Audited Financial Statements




Additional Financial Information

SCHEDULE OF PROPERTIES

The following properties are owned by CSAHS.

DESCRIPTION Land and Buildings werevalued at 01/07/97 (referto Note 20 for the detailsof carrying value)

CURRENT USE POTENTIALFORALTERNATIVEUSE

1. Royal Prince Alfred Hospital

Royal Prince Alfred HospitalMissenden RoadCamperdown NSW 2050

$62.800m Land$113.980m Buildings Hospital NIL

2. Rhodes House

Rhodes HouseUnit 525Unit 506Missenden RoadCamperdown NSW 2050

$0.214m Strata Title$0.182m Strata Title

GuestAccommodation NIL

3. Dame Eadith Walker Estate

Nullawarra RoadConcord West NSW 2138

$37.000m Land$0.674m Buildings Health Facility NIL

4. Luddenham

Land Only $3.250m Land Farm NIL

5. Rachel Forster Hospital Complex

149-155 Pitt Street38 Douglas StreetRedfern NSW 2016


6. Concord Repatriation General Hospital

Concord HospitalHospital RoadConcord NSW 2139







7. Rozelle Hospital

Rozelle HospitalCnr Church and Glover StreetLeichhardt NSW 2040


8. NSW Institute of Forensic Medicine

42-50 Parramatta RoadGlebe NSW 2037

$1.600m Land$5.795m Buildings Forensic Science NIL

9. Sydney Dental Hospital

United Dental Hospital2 Chalmers StreetSurry Hills NSW 2010

20-28 Chalmers StreetSurry Hills NSW 2010

$3.800m Land$2.875m Buildings

$1.890m Land

Hospital NIL

10. Balmain Hospital

Balmain HospitalBooth StreetBalmain NSW 2041


11. Former Western Suburbs Hospital Site

25 Croydon AvenueCroydon NSW 2132

$5.700m Land Only$0.025m Buildings

12. Canterbury Hospital

Cnr Canterbury Road and Tudor StreetCampsie NSW 2194







13. Community and Mental Health ServicesHouses

4 Ewell StreetBalmain NSW 2041

117 James StreetLeichhardt NSW 2040

34 Malvern AvenueCroydon NSW 2132

114 Ewart StreetDulwich Hill NSW 2203

11 Berna StreetCanterbury NSW 2193

46 Charlotte StreetAshfield NSW 2131

11 Euralla StreetBurwood NSW 2134

155, 157-159, 182, 184 and 186 Livingston RoadMarrickville NSW 2204

15 Tranmere StreetDrummoyne NSW 2047

9A Wrights RoadDrummoyne NSW 2047

17 Atkins AvenueFive Dock NSW 2046

229 Bridge StreetGlebe NSW 2037

491 Parramatta RoadLeichhardt NSW 2040

184 Glebe Point RoadGlebe NSW 2037

$6.865m Land$3.479m Buildings Health Facility

ResidentialHouse




2000$000

1999$000

Percentage of accounts paid on time (based on dollar amount)Total dollar amount of accounts paid on timeTotal dollar amount of accounts paid

66.82%53.75580,451

60.6%43,23571,317

GENERAL FUND CONSULTANCY FEES OVER $30,000Name General Consultancy

Clinical Support 94,400.00Hunter Valley Research Foundation 35,891.00Millennium Marketing & Management 61,310.61Potent Technology 46,500.00Real Time Australia 67,202.00Sequent Computer 132,977.79University of Newcastle 75,415.09

Capital WorksAndersen Contracting 122,130.00Computemp Australia P/L 57,588.75Gutteridge Haskins & Davey 60,849.75NSW Public Works 84,200.00Pacific Rim Technology 94,929.30Paramedical Software 167,108.00Progressive People (Aust) 37,576.00Real Time Australia 133,587.00Sequent Computer 240,661.41Wentworth Area (Oracle 10.7) 351,520.98

Total Consultants Fees over $30,000 1,684,128.84

PATIENTS FEES AGEING ANALYSIS

Consolidated30 June 2000

< 30 days$000

30-60 Days$000

60-90 Days$000

>90 Days$000

2000$000

1999$000

Compensable 195 112 126 1,763 2,196 2,247

Ineligible 517 472 248 3,862 5,099 6,229

Other 1,829 113 80 929 2,951 2,708

Total 2,541 697 454 6,554 10,246 11,184

TRADE CREDITORS AGEING ANALYSIS

2000$000

1999$000

<30 days30-59 days60 days and over

24,439245(43)

14,927-

(9)

Total 24,641 14,918

PAYMENT PERFORMANCE INDICATORSPayment Performance Indicators for the Three Month Period Ending 30 June 2000




STATISTICAL STATEMENTSAs at 30 June 2000

2000 1999

Bed CapacityTotal Beds as at 30 June 2000Average Available Beds

1,7811,791

1,9551,973

Patient Details

InpatientsNumber in Hospitals at 1 July 1999Admissions during the yearTotal Patients treated

Number in Hospital at 30 June 2000Bed Days of Inpatients TreatedNumber of Operations

1,661133,648135,309

1,491588,78435,680

1,827132,181134,008

1,661633,34038,511

BabiesNumber of Live BirthsBed Days of Newborn Babies

5,61016,952

5,39017,154

OutpatientsTotal Occasions of Service 1,848,412 1,989,314

AveragesDaily Average of InpatientsAdjustment for Outpatients and BabiesAdjusted Daily Average (ADA)

Average Stay of Inpatients (days)Bed Occupancy Rate (%)

1,565529

2,094

4.487.4

1,688568

2,256

4.885.6%

Staff Details

Staff employed at 30 June 2000 (EFT)NursingMedicalOther

3,264.1975.4

4,397.3

3,294.5956.9

4,679.7

TOTAL 8,636.8 8,931.1


1999/2000 – 2000/2001

Performance Agreement

Central Sydney Area Health Service

And

Director-General, NSW Health

Prepared by Corporate Services, CSAHS


Table of Contents

HEALTHIER PEOPLE Mental Health ............................................................................................................7 Health Priority Areas And Health Promotion ...........................................................12 Health Protection.....................................................................................................19

FAIRER ACCESS

Aboriginal Health.....................................................................................................21 Service Access and Service Models .......................................................................23

QUALITY HEALTH CARE

Initiatives in Quality Management ...........................................................................28 Community Engagement and Working In Partnerships...........................................30 Teaching and Research ..........................................................................................34 Skilled, Valued Workforce .......................................................................................36

BETTER VALUE

Activity, Financial Management and Efficiency Strategies ......................................38 Health Service Strategic Development and Asset Strategies..................................40 Information Management ........................................................................................43 Addendum: Nurses Study Leave ..........................................................................46

Preamble .............................................................................................................................2 Health Service Context ........................................................................................................3 Summary: Board Accountabilities ........................................................................................5 Summary: Department Accountabilities ...............................................................................6


Central Sydney Area Health Service 1999-2001 Performance Agreement 2

PreambleUnder section 126 of the Health Services Act 1997, the Director-General of NSW Health may enter into Performance Agreements with public health organisations on behalf of the Minister. This 1999/2000 – 2000/2001 Agreement builds on progress made in previous Agreements, but with an increased emphasis on key issues and flexibility to reflect local needs and focus on targets over which Health Services have control or significant influence. It is agreed by both parties that that the purposes of the Agreement are to: � state agreed objectives and goals � specify accountabilities � measure performance A classification of 12 Performance Areas is used in this Agreement to encompass the various core businesses of Health Services and the corporate functions supporting core businesses. For each Performance Area, the corresponding accountabilities are listed for the Health Service Board and Management, and the Department. This Agreement is a two way undertaking between the Department and the Health Service, within a spirit of mutual partnership and fair dealing. It includes significant NSW Health priorities but does not attempt to cover every responsibility of the Health Service - nothing in the Agreement diminishes the obligations, duties or accountabilities of the Director-General or the Health Service, or the effects of existing or new Ministerial directives, Departmental circulars, policies, inter-agency agreements or other instruments.

Both parties acknowledge that the foundations of this Agreement are existing policy and planning frameworks, particularly: � Strategic Directions for Health 1998 – 2003 - This Agreement is

structured to correspond to the Goals of NSW articulated in Strategic Directions and includes selected strategies requiring statewide coordination.

� Corporate Governance in Health - This Agreement provides a means of monitoring and reviewing corporate accountabilities, at both Board and management levels, a major emphasis of Corporate Governance better practice.

� Area Health Plans - The Area Health Plans address local circumstances and health needs, and give rise to the local targets and accountability items included in this Agreement.

It is also agreed that the Performance Measures and Targets in this Agreement will build on and extend current levels of achievement. Reporting and review of performance is central to the purpose of this Agreement. There will be quarterly reporting and performance will be reviewed annually by the Director-General and the Minister, as required by the Health Services Act. This Agreement may be reviewed after 12 months and, if necessary, varied through mutual agreement between the Department and the Health Service. A new Agreement will be developed for the 2001/2002 – 2002/2003 period.



Health Service Context Central Sydney Area Health Service (CSAHS) has responsibility for the provision of public healthcare to 480,000 residents of 10 Local Government Area (LGA), a diverse population in terms of socioeconomic status, ethnicity, housing and income. Compared to the State average the age structure in CSAHS is characterised by a smaller percentage of residents aged 0-19 and a larger percentage aged 20-39. CSAHS is the most multiculturally diverse Area in NSW, with 41.1% (NSW 23%) born overseas and 46% (NSW 21.4%) speaking a language other than English at home, including substantial Chinese, Italian, Greek, Arabic and Vietnamese communities. There is also significant Aboriginal and Torres Strait Islander communities centred around Redfern/Waterloo and Marrickville. CSAHS communities experience significant problems of homelessness, increased use of drugs and alcohol and mental illness. There are also high rates of unemployment, with many low income families and associated socioeconomic related health risks. The socioeconomic conditions faced by some CSAHS residents impacts on their health status and risk behaviour resulting in worse health outcomes in areas such as the incidence of lung cancer and cervical cancer, stroke mortality rates, hospital separation rates for asthma and falls in elderly men, rates of Pap smears, sexually transmitted disease notification rates, opiate overdose rates, the proportion of people with high blood pressure, tobacco smoking and the use of sunscreens. Healthcare services in CSAHS are provided from 90 different sites, including 10 hospitals and an extensive range of community health and primary care facilities. CSAHS is undertaking a major facilities redevelopment project, the resource Transition Program (RTP), to provide the infrastructure which will enable high quality health care to be provided to residents of CSAHS and the inflows to clinical services to expertise, within the Area’s projected RDF target.

1. Population profile of Central Sydney Area Health Service Figure 1: Percentage of selected population groups Notes: 1. Age data based on ABS population projections for 30 June 1997 derived from ABS Census 1996. 2. ATSI data based on 30 June 98 estimates derived from ABS Census 1996. 3. NESB population based on language other than English spoken at home in ABS Census 1996. 4. Population growth from June 1998 to June 2006.

5. The index of EDOCC (Education and Occupation), ABS Census 1996, is a good indicator of socio-economic status. The quartile of EDOCC is in relation to other Health Services – ie a Health Service with a ranking of 1 is in the bottom quartile of Health Services for this index.

12.3

16.314.1

1

42

4

21

14

1.8

17

76

12.7

0

5

10

15

20

25

30

35

40

45

65+ years Below 15years

15-24 years Aboriginaland Torres

StraitIslander

NESB PopulationGrowth(1998 to

2006)

Quartile ofEDOCC

% o

f Pop

ulat

ion

CSAHSNSW



2. Selected Indicators for NSW Health Priority Areas

Figure 2: Note the NSW Average is 100 for each rate ratio.

Separation Rate Ratio

Falls in Older People ($65 yrs)

Road Traffic Accidents (15-24 yrs)

Unintentional Poisoning (0-4 yrs)

Sports Injuries Asthma

Male 122.4 (+) 64.6 (-) 80.0 68.2 (-) 112.2 (+) Female 104.1 67.6 (-) 71.7 67.3 (-) 96.5 Rate Ratio Coronary

heart disease Deaths (25-74yrs)

Stroke deaths

Lung Cancer Incidence

Melanoma Incidence

Breast Cancer Incidence

Prostate Cancer Incidence

Cervical Cancer Incidence

Colorectal Cancer Incidence

Male 103.0 115.2 (+) 122.1 (+) 63.6 (-) 88.1 (-) 93.3 Female 102.6 108.3 (+) 101.3 73.2 (-) 100.2 109.8 88.2 (-) Prevalence Rate Ratio

(NSW) Most Common Mental Disorders (18-64yrs)

Diabetes ($16 yrs)

Current Smoking ($16 yrs)

Harmful/ Hazardous Alcohol Use($16 yrs)

Adequate Physical Activity ($16 yrs)

Overweight/ Obesity ($16 yrs)

Often or Always use Sunscreen ($16 yrs)

Male 24.4% 121.8 107.4 66.0 (-) 91.4 (+) 85.3 (-) 85.0 (+) Female 20.3% 108.2 101.2 118.2 86.7 (+) 98.2 90.0 (+)

Notes: All rate ratios are directly age standardised. The NSW Average is 100 for each rate ratio. Ratios statistically significant from NSW are indicated by (+) significantly above or (-) significantly below NSW. For more details on the definitions of the indicators and how they are calculated see the Health Status Profile in the Reference Guide.

Source: ABS Mortality Data, NSW Inpatient Statistics Collection (HOIST) NSW Central Cancer Registry (HOIST) and NSW Health Survey 1997 (HOIST), Epidemiology and Surveillance Branch, NSW Health

3. Service and Facility Profile

Figure 3: Selected Indicators on Service Profile

Standardised Separation Ratio (1) Indicator CSAHS Metropolitan Average All Service Related Groups 98 98

Percentage in 1997/98 % Variation over 1996/97 CSAHS Metro Average CSAHS Metro Average

Chargeable bed days (2) 32.6% 31.3% -11.0% -5.0% % Sufficiency (3) % of Residents Treated Locally 1995/96 1996/97 1997/98 1995/96 1996/97 1997/98 CSAHS – HCC 169 189 190 65 66 69 Metro Average – HCC 116 115 116 99 99 99 CSAHS – Non-tertiary 101 105 108 65 66 68 Metro Average Non-tertiary 102 102 102 99 99 99 CSAHS – All 105 110 113 65 66 68 Metro Average – All 103 103 102 99 99 99 Notes: 1. HSRG Standardised Separation Ratios. NSW Average is 100 for each ratio. 2. Department of Health Reporting System as at 18/3/99.

3. Sufficiency is defined as the total volume of acute inpatient care delivered by an AHS compared with the total volume of inpatient care received by AHS residents anywhere. This measures an AHS’s capacity to meet demand for all of its residents.

Figure 4: Facility Profile Principal

Referral Major

MetropolitanPsychiatric Mothercraft Ungrouped

Non-acute No in Central Sydney AHS 2 1 2 1 2

No with Relative Stay Index > Peer Group value

1 1

No of casemix weighted separations

125,300 8,252

No above state benchmark By 5% (1)

1 1

Notes: 1. Benchmark for High Cost Complex Adjusted Cost per Casemix Weighted Inpatient. Sources: 1996/97 NSW Public Hospitals Comparison Data Book and NSW Health Department. 4. Funding Profile Figure 5: Progress towards RDF targets (%)

12.82

11.99 12

11.55

10.5

11

11.5

12

12.5

13

1994/95 1997/98 1998/99 2001/2002 RDFTARGET SHARE

Share of Resources by Financial Year

Perc

enta

ge



Summary: Board Accountabilities The Board will ensure that Strategic Directions for Health 1998-2003 is implemented throughout the period of this Agreement and Health Service progress demonstrated and reported through the annual Health Service report on the Performance Agreement, consistent with the Reporting, Evaluation and Accountability Framework for Health Service Performance Agreements 1999. HEALTHIER PEOPLE • Mental Health: To ensure the improvement and maintenance of mental

health and well being in the population. In particular the implementation of the 5 directions in Caring for Mental Health – A Framework for Mental Health Care in NSW: developing partnerships; emergency mental health response; prevention, promotion and early intervention; providing better mental health care; and quality and effectiveness.

• Health Priority Areas and Health Promotion: To ensure the improvement of health at both population and clinical levels through initiatives in health promotion and the 5 Health Priority Areas: cardiovascular disease, diabetes, cancer, asthma and injury.

• Health Protection: To ensure the protection of health through the

management of health risks associated with the environment, infectious diseases and food safety. In particular focus on the 3 areas of skin penetration guidelines, immunisation and local participation in statewide food safety surveys.

FAIRER ACCESS • Aboriginal Health: To ensure the improvement of health of Aboriginal

people in collaboration with Aboriginal communities and to provide better access and more effective services in accordance with the directions in the local Aboriginal Health Plan. In particular the 4 areas of Aboriginal health partnerships; NSW Aboriginal Health Strategic Plan; Aboriginal health workforce and staff cultural awareness.

•

Service Access and Service Models: To provide the direction for ensuring equity of access to services and the provision of appropriate models of care. In particular within the 4 areas of waiting times; continuity of care; targeted population groups and the provision of outreach specialist support services.

QUALITY HEALTH CARE • Initiatives in Quality Management: To ensure improvement in the quality of

health services and provide direction for the management of quality. In particular the implementation of the Framework for Managing the Quality of Health Services in NSW.

• Community Engagement & Working In Partnerships: To involve local

communities in the planning of health services in their area and oversee inter-agency collaboration for the planning and provision of services.

• Teaching and Research: To ensure an environment in which scientific enquiry

and rigorous evaluation are integral parts of local health service policy, management and practice; in which National and State standards for research practice and ethics are applied; and in which the training and education of health professionals is supported.

• Skilled, Valued Workforce: To provide direction for effective human resource

systems, appropriate training and support for staff, and the improvement of occupational health and safety. In particular focus on initiatives in the 3 areas of: HR 2003 – A Framework for Human Resource Management; Skills and Tools for the Job; Consultation, Communication and Collaboration.

BETTER VALUE •

Activity, Financial Management and Efficiency Strategies: To ensure that the health services available are provided in an effective and efficient manner, within the funds available to the service. In particular focus on the 5 areas of activity, financial management, day surgery, utilisation rates and efficiency.

•

Health Service Strategic Development and Asset Strategies: To provide strategic direction for major initiatives; guide the implementation of the Area Health Plan and ensure efficient and effective use and management of Health Service physical resources.

•

Information Management: To ensure the effective management of information systems and technologies needed to support quality health care service delivery and management. In particular focus on the 7 areas of Unaudited Annual Return and Hospital Cost Data Collection, Health Information Exchange, Information Management and Technology Strategy, Year 2000 compliance and a common health record.



Summary: Department Accountabilities The scope of Department Accountabilities identified in this Performance Agreement relate to Department of Health functions in relevant areas of engagement with Health Services. Under this approach, other Department functions such as legislative support to the Minister, are deemed to be beyond the scope of this Agreement. Key areas of Department Accountability include being responsive to the health concerns of the community, provision of advice and leadership on health issues and the overall results and performance of NSW Health. Department Accountabilities in this Agreement are consistent with the functions of the Director-General under the Health Services Act 1997, Strategic Directions for Health 1998 - 2003 and the NSW Department of Health Corporate Plan 1998 - 2003. Licensing, regulatory and enforcement functions directed at ensuring compliance with Acts administered by the Department are also applicable to this Agreement. Specific Department Accountabilities are included throughout this Agreement under each Performance Area. Progress against the specific Department Accountabilities listed in this Agreement will be reported to Health Services at the annual performance review with the Director-General. •

Development of Policy Provide leadership for the health system by developing policies for improving and maintaining health and identifying broad health priorities that require a policy response to achieve the Strategic Directions of NSW Health. Specific Department Accountabilities include the development of policies, strategies and initiatives to assist Health Services fulfil their functions under each Performance Area in this Agreement.

• Management of Public Health Issues

Investigate and report on the health needs of the NSW population, manage emerging health risks, encourage research, and promote public health through regulation, health promotion, health protection and clinical policy. Specific Department Accountabilities include the development of statewide initiatives across the Health Priority and Health Protection Performance Areas specified in this Agreement.

• System - Wide Planning

Develop statewide planning frameworks, guidelines, information and tools to support local planning initiatives. Specific Department Accountabilities relate to the development of statewide strategies for the effective delivery of speciality health services and technologies, asset management and workforce planning initiatives.

•

Workforce Relations The Director-General in his capacity as the Health Administration Corporation is the employer of all health system staff and responsible for the negotiation and determination of wages and other conditions of employment. Specific Department Accountabilities include collaborative initiatives with Health Services to improve system level staff communication and consultation and the resolution of industrial issues of statewide significance.

•

Health System Performance Monitoring Build on and coordinate current indicator development, monitoring and evaluation activities to improve NSW health system performance in accordance with relevant benchmarks and standards and facilitate access to statewide information systems and better practice models. Specific Department Accountabilities include the implementation of performance monitoring and reporting mechanisms, statewide information management and technology initiatives and the development of statewide comparative classification systems and quality monitoring indicators.

• Operational Management

Facilitate the efficient and economic operation of the health system, coordinate and direct the fair allocation of financial resources and enhancements, and negotiate activity levels consistent with government policy. Specific Department Accountabilities include initiatives in respect of cross-Area patient flows, efficiency and operational issues management.


Central Sydney Area Health Service 1999-2001 Performance Agreement: 7

PERFORMANCE AREA: MENTAL HEALTH BOARD ACCOUNTABILITY: To ensure the improvement and maintenance of mental health and wellbeing in the population. In particular the implementation of the 5 directions in Caring for Mental Health – A Framework for Mental Health Care in NSW: developing partnerships; emergency mental health response; prevention, promotion and early intervention; providing better mental health care; and quality and effectiveness. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Mental Health Service Model framework for mental health services across the lifespan, provided to Health Services (September 1999) for consultation and guide to

service planning • Forensic Mental Health Strategy circulated to Health Services for consultation from September 1999

HEALTH SERVICE MANAGEMENT

ACCOUNTABILITIES PERFORMANCE MEASURES

LINK TO

SDFH TARGETS

PROGRESS

Baseline: Recording system being established Year 1: Establish the number of clients who have a GP actively involved in their care

Database established on CRISP. Six monthly audits (July and December) were undertaken to establish issues of concern with data collection within CRISP and with current practices/procedures. Data is to be transferred to HNAM system. Triage assessment documentation is under review to ensure that mandatory data fields are captured and that consistent practices apply across the AMHS.

1.1 Mental health clients have a designated General Practitioner involved in their mental health treatment

4.4

Year 2: To be determined 1.2 Demonstrated progress on

implementation of School Link Program

3.5 4.1

Year 1: School link officer appointed, oriented and program commenced Year 2: Program expanded and coordinated with other adolescent community outreach and healthy Schools initiatives

School link officer appointed, oriented and program commenced in April 2000.

1. Partnerships in Mental Health

1.3 Enhance community awareness about mental health

3.5

Year 2: Develop an Area action plan for the local implementation of the 1999 Mental Health Promotional Prevention National Action Plan Development

Mental Health Promotion Project Officer appointed. Development of Action Plan has commenced. Project Officer and Steering Committee have developed a framework to commence implementation in July 2000.



HEALTH SERVICE

MANAGEMENT ACCOUNTABILITIES

PERFORMANCE MEASURES LINK TO

SDFH TARGETS

PROGRESS

Year 1: 1800 Access Line operational Area-wide by January 2000 with ongoing monitoring

1800 Working Party reconvened May 2000. Implementation plan developed with implementation now scheduled for December 2000. Note: Progress with this project was less than anticipated because of priorities related to the implementation of the HNAM system – which is necessary for optimal use of the 1800 Access Line

2.1 24 hour telephone access to mental health services available across the Health Service

B8

Year 2: Evaluate service within 18 months after operation Baseline: ED protocols in place at RPAH and CRGH Year 1: a. Extend ED protocols and staff development

program to Canterbury/Balmain Hospitals b. Develop and implement measures to evaluate

the effectiveness of ED protocols

a. Mental Health Consultation Liaison positions

established at both RPA/Canterbury Hospitals b. Working party established. Protocol developed for

continuity of care and follow-up of mental health patients/suicidal patients presenting at emergency departments.

2. Emergency Mental Health Response

2.2 Demonstrated progress on the implementation of the recommendations of Working Group for Mental Health Care in Emergency Departments Final Report and Recommendations that are the responsibility of Health Services

A1

C10

Year 2: Evaluate the Mental Health CNC program at CRGH

Year 1: a. Develop an Area plan for implementation of the

1999 National Mental Health Promotional Prevention Plan

b. Development and implementation of maternal/

perinatal mental health program with inbuilt evaluation strategies

a. Working party established. Development of Plan

commenced b. Recruitment to position of Project Officer finalised.

Appointee to commence in August 2000. Earlier recruitment efforts were unsuccessful.

3. Prevention, Promotion and early Intervention in Mental Health

Demonstrated progress on the implementation of: - Prevention programs for people 0 –

15 years - Early intervention programs for

people 15 – 25 years

A1

Year 2: Evaluation of Prevention Early Intervention in Psychosis program





LINK TO

SDFH TARGETS

PROGRESS

4. Better Mental Health Care

4.1 Each mental health client has a Health Service-wide unique identifier

A8 5.6

Year 1: Appoint Senior Project Officer to develop implementation strategies in accordance with NSW Health and CSAHS IT strategic directions Year 2: Implement an Area-wide unique patient identifier subject to Information Systems compatibility

External review of the Medical Records Department completed. Restructure of Department completed. Health Information Manager appointed. Data Collections Manager under recruitment. Business Plan and Program Statement submitted for OPT rollout section of MHIDP.

4.2 Demonstrated progress on the implementation of the NSW Aboriginal Mental Health Policy

A2

Year 1: Recruitment of additional staff for Aboriginal Mental Health Unit

Additional positions advertised in both mainstream and Koori press failed to attract any applicants. To be re-advertised later in 2000.

Year 2: Evaluate Aboriginal Mental Health Program Protocols for evaluation are formulated.



HEALTH SERVICE



SDFH

TARGETS

PROGRESS

Year 1: Recruitment of additional staff for Aboriginal Mental Health Unit

Additional positions advertised in both mainstream and Koori press failed to attract any applicants. To be re-advertised later in 2000.

4.3 Demonstrated progress on the implementation of the NSW Aboriginal Mental Health Policy

A2

Year 2: Evaluate Aboriginal Mental Health Program Protocols for evaluation are formulated.

4. Better Mental Health Care (continued)

4.3 Demonstrated progress on: a. Service programs for adolescents

and young people b. Early intervention in Psychosis

programs c. Suicide Prevention for adolescents

and young people d. Consolidating partnership

arrangements with Population Health in Services for Children and Adolescents

4.3

Baseline: Year 1: a. Establish current provision of Occasions of

Service to adolescents and young people b. Numbers registered and occasions of service in

Early Intervention in Psychosis to be increased by 10%

c. Establish rate of self harm and suicide in

CSAHS d. Increase referrals to and counselling by

CSAMHS to Population Child and Adolescent Services by 10%

Year 2: a. Monitor and evaluate service provision b. Evaluate efficacy of EIP (readmission rates and

other morbidity measures) c. Monitor efficacy of Suicide Prevention

Programs d. Monitor and Evaluate Partnership of Service

a. Data collection commenced manually. HNAM

system implemented at Rivendell from 1 July 2000 b. Evidence of increased activity through numbers

registered, in the order of 10% c. Every episode of attempted suicide and every

known suicide by an AMHS client is reviewed individually, for clinical and system issues, by the Serious Incidents and Suicide Prevention Committee.

d. Program for Child and Adolescent staff in

Population Health is being developed and the level of referrals are being monitored.

Year 2 Database established and analysis commencing



HEALTH SERVICE



SDFH TARGETS

PROGRESS

5. Quality and Effectiveness in Mental Health

5.1 Compliance with monthly activity reporting requirements

D11

Annual: 100% compliance

Achieved

Baseline:: All AMHS participate in ACHS EQuIP program Year 1: Continue implementation of the EQuIP program through the: a. Established working groups b. Completion of the EQuIP cycle c. Participation in quality improvement processes d. Focus on Continuum of Care

EQuIP accreditation achieved. Periodic Review scheduled for 7-8 November 2000. Mental Health Community Services will participate in periodic review in Nov 2000. a. Working Groups established as per EQuIP

functions. b. Organisation wide survey scheduled 6-9 August

2002. c. All service components participating in QI

processes. d. Continuum of Care function submitted to ACHS as

part of supported self-assessment in May 2000.

5.2 Implement a quality framework based on the ACHS EQuIP program which reflects the National Standards for Mental Health Services

C1 C7

Year 2: Maintain accreditation status for hospital services and attain accreditation status for community services



PERFORMANCE AREA: HEALTH PRIORITY AREAS AND HEALTH PROMOTION

BOARD ACCOUNTABILITY: To ensure the improvement of health at both population and clinical levels through initiatives in health promotion and the 5 Health Priority Areas: cardiovascular disease, diabetes, cancer, asthma and injury. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • 1999 Report of the Chief Health Officer by March 2000 (on-line information disaggregated to AHS by June 2000) • Framework for Health Promotion Beyond 2000 by December 2000 • AHS Health Promotion Demonstration Grants Scheme and Capacity Building Indicators Framework Document developed by December 1999 • Skin Cancer Prevention Campaign phase III by January 2000 and Strategic Plan for Skin Cancer Control by June 2000 • Fruit and Vegetable AHS promotional kits by October 1999 and Strategic Plan for Nutrition 2000 – 2005 by June 2000 • Active Australia Campaign phase IV by December 1999 • Launch NSW Guide to Effective Stroke Care September 1999 and Develop Consumer Information on Stroke by June 2000 • Launch Consumer Guide to Policy Standards for Cardiac Rehabilitation September 1999 • Develop Best Practice Model for Early Detection and Clinical Management of Diabetes in ATSI people by June 2000 • Staged implementation of Clinical Cancer Registries from 2000, Develop Minimum Data Set for the Central Cancer Registry and Data Standards by December 1999 • Develop clinical care indicators for colorectal cancer by June 2000 • Develop strategies to improve ED – GP asthma clinical information exchange 2000 • NSW Falls Prevention Program commenced by December 1999



LINK TO

SDFH TARGETS

PROGRESS

6. Health Promotion 6.1 Health Service initiatives implemented consistent with Statewide campaigns and programs for Tobacco Control

A6 A10

Baseline: Phase 2 of the CSAHS Tobacco Control Plan Year 1: a. Increased marketing of tobacco related harm in

targeted ethnic groups

First Year of the Second Tobacco Control Plan (1999 – 2004) has been implemented. a. World “No Tobacco Day” and “Smoke Free Homes“

and “Smoke Free Environment Policy” have been marketed through local media this year. Print media included articles in: The Torch, Cooks River Valley Times, The Express, The Courier, The Glebe and Inner Western Weekly, The Express, Koori Mail and E1 Telegraph. Development of “Smoke Free Homes” brochures, bus posters, pamphlets, production and distribution of ‘you can quit’ booklets. Radio media included: ABC Radio National, SBS and 2AC.





LINK TO

SDFH TARGETS

PROGRESS

6. Health Promotion (continued)

6.1 Health Service initiatives implemented consistent with Statewide campaigns and programs for Tobacco Control (continued)

b. Maintain and extend cessation services in public and private sectors

b. Smoking cessation services for staff: Smoking cessation services are offered at Drug and Alcohol Departments at Canterbury Community Health Centre, RPAH and Concord Hospital. Brief intervention, counselling and nicotine replacement therapy are offered to CSAHS staff wishing to quit. Smoking cessation services for inpatients: Training of staff in tobacco brief interventions has been undertaken since December 1999, The aim is to have all staff equipped to provide inpatients (of more than 24 hours) with brief intervention (and nicotine replacement therapy as required). There have been 14 training sessions across sites, with 66 staff trained to date. RPA, Canterbury and Concord hospitals provide inpatient assessments and secondary referrals for counselling. Residents are provided with brief interventions, counselling and quit groups on request.

Two training sessions have been conducted with Aboriginal Medical Service workers, who have subsequently run quit groups in their community.

c. Maintain and extend strategies to prevent supply of tobacco products to youth

c. Compliance monitoring and enforcement related to Section 59 of the Public Health Act 1991 has been maintained.

A joint surveillance working group has been developed with Marrickville Police and Strathfield Council to increase their awareness of compliance monitoring processes.

d. Extend strategies to reduce exposure to Environmental Tobacco Smoke in private, public and work settings

d. Strategies within this target are noted in a. and b. above. Also, CSAHS’s Smokefree Environment Policy came into effect on 1 May 2000. The policy includes limiting exposure to tobacco smoke to areas ‘exempted’ from the policy. 23 sites within CSAHS have identified in total 71 areas for this purpose, and have established processes to manage visitors, patients and staff in the use of these exempted areas.





LINK TO

SDFH TARGETS

PROGRESS


6.1 Health Service initiatives implemented consistent with Statewide campaigns and programs for Tobacco Control (continued)

e. First phase introduction of Smoke-free Workplace Policy for CSAHS

Year 2: Continued implementation of Phase 2 strategies

e. The first phase of the Smokefree Environment Policy was implemented as planned.

Exemption areas are in operation across all sites. CSAHS is preparing to offer all inpatients (of more than 24 hours) brief intervention and nicotine replacement therapy as required. Balmain Hospital, Tresillian and Canterbury Hospital are progressing well, with at least one staff member on each ward/ unit attending training in ‘tobacco brief interventions’. Negotiations with Nursing and Staff Development continue in an effort to encourage RPA and Concord Hospitals. Protocols for brief interventions and NRT have been developed for medical, nursing and community/ allied health staff.





LINK TO

SDFH TARGETS

PROGRESS

Baseline: “Let’s Get Physical” strategic plan Year 1: Continuing implementation of identified priority strategies: a. Working with local councils b. Active Australia promotion and targets – Phase

III young people c. Continuing and extending work of SHARE and

WAVES classes d. Completion of “Concord – a great place to be

active” project

a. The “Bike It – You’ll Like It” report was completed

The “Walkwise” report was written and distributed. In phase II of this program walking routes including signage have been completed and a map was enclosed in Marrickville Matters (distributed to 40,000 residents in the Marrickville municipality)

b. CSAHS has continued to promote the “Active

Australia Message”. c. New brochures promoting SHARE are near

completion. SHARE is marketing classes in CSAHS more widely and is offering Tai Chi classes.

Approximately 720 CSAHS residents attended a

total of 60 WAVES classes (ie 180 participants and 15 classes per term)

d. The final “Concord” project reports are in progress.

They are due at NSW Health by 4 August 2000.

6.2 Health Service initiatives implemented consistent with Statewide campaigns and programs for Physical Activity

A6

Year 2: Review of strategy 6.3 Health Service initiatives

implemented consistent with Statewide campaigns and programs for Sun Protection

A6

Baseline: CSAHS Sun Protection Strategy – 1998 Year 1: Develop Sun Protection policies with: a. Local primary and secondary schools b. Local sporting organisations and venues

a. Evaluation of policy implementation resulting from

two schools workshops is to be completed. In March 2000 a school sun protection workshop was conducted - 50 participants attended.

b. As part of the “Sun Smart Sport Program”, five local

sports clubs are working in partnership with the Health Promotion Unit, the Cancer Council and other organisations to implement sun protection policies in the sports clubs.


Year 2: Phase 2 priority strategies identified and implemented





LINK TO

SDFH TARGETS

PROGRESS


6.4 Health Service initiatives implemented consistent with Statewide campaigns and programs for Food and Nutrition

A6

Baseline: Food in Sydney – CSAHS Nutrition Strategic Plan 2 Year Target: a. Canterbury Parent Nutrition Project b. Home care workers nutrition training c. Fruit and Vegetable promotion d. Arabic Nutrition campaign e. Long day care centre (LDCC) nutrition training

a. Two nutrition education sessions for Arabic

speaking parents were conducted and evaluated in October 1999. A report has been completed.

b. Training is scheduled to commence in November

2000. c. A local media and fruit and vegetable advertising

campaign was conducted with 281 people requesting more information. This resulted in two newspaper articles and one radio interview.

The formative evaluation is near completion. A media campaign in scheduled for November 2000.

d. The post intervention evaluation has been completed.

e. Seven workshops were held in August to October

1999 (four Caring for Children workshops for 1 - 5 years and three Caring for Infants workshops for 0 -1 year.) Over 100 LDCC staff attended. Impact evaluation of the Caring for Infants workshops was completed in November and a report completed.

Baseline: 80% December 1998 Year 1: 85% December 1999

97% for the period June to December 1999.

7. Cardiovascular Proportion of people with a discharge diagnosis of AMI who were eligible for thrombolysis and received it within one hour of arrival in the ED

C8

Year 2: 90% June 2001 Year 1: Collect baseline data for patients seen by diabetes educator

January to June 2000: 1640 patients attended the Diabetes Centre for a total of 3801 visits. A diabetes educator saw 100% of these patients.

Year 2: Target to be established following baseline data collection in Year 1

8. Diabetes Proportion of patients with diabetes in CSAHS who have been seen by a diabetes educator

A10





LINK TO

SDFH TARGETS

PROGRESS

Baseline: Multiple nursing service delivery systems and separate allied health service delivery and medical consultancy service Year 1: Establish a working party to consider options for integrating multidisciplinary palliative care service delivery in the community

An Area Community Palliative Care Director has been appointed. A proposal has been submitted for additional nursing staff for the project. A working party has been established. A Strategic Plan is being developed for the service.

9. Cancer Develop coordinated palliative care service for the community linked to the inpatient facilities

B3 C5 4.7

Year 2: Implement coordinated palliative care services in the community based on the recommendations of the working party

Baseline: No formal arrangements between providers Year 1: Establish an Area-wide Asthma working group to review current practices in ED management, chronic asthma management and treatment for children and adults, any GP shared care arrangements in CSAHS and health worker education

An Asthma Working Group has been established and is reviewing current practices.

10. Asthma Implement the recommendations of the NSW Health Asthma Health Improvement Project and interventions recommended in the Strategic Plan Health Gain for children and youth of Central Sydney

A10 4.4

Year 2: Develop performance indicators for inclusion in the CSAHS Health Improvement Performance System (CHIPS)



HEALTH SERVICE



SDFH TARGETS

PROGRESS

Baseline: Completion of Falls Prevention Strategic Plan – Aged Care Year 1: Implementation of strategies in the Plan

The Falls Risk Assessment Tool was implemented in all GGRM wards in May 2000. The Falls Prevention Strategy Implementation Committee continues to meet. Strategies continue to be developed and implemented in collaboration with partners. Two progress reports have been completed since Dec 1999.

11. Injury 11.1 Fall Prevention programs A6 A10

Year 2: Continued implementation of Strategic Plan and Evaluation of Year activity

Baseline: Prevention program established in 3 large communities

Year 1: Target small NESB groups One scalds program has been conducted with the Korean Community.

11.2 Prevention of burns and scalds in Children

A6

Year 2: Evaluate Year 1 program and continue implementation adapted for small NESB groups

Baseline: Co-ordination of interventions with licensees, Police and RTA Year 1: Continue to provide education for licensees, servers and patrons of licensed premises – monitoring intake, prevention of drink driving, also at community events

“Drink Driving, it’s a crime. Choose don’t lose” campaign was implemented in hotels and clubs throughout Leichhardt, South Sydney, City of Sydney and Marrickville Council areas over Christmas 1999. Partners in the project included publicans, Councils, RTA and the Police Service. A Portuguese version of the campaign is being developed to be conducted toward the end of 2000. Local implementation of the Northern Rivers “Drink Check” campaign was undertaken in June at the Canterbury Hurlstone Park RSL Club. Local Police Region keen to provide ongoing support the project. CSAHS received funding from Men’s Health Unit (NSW Health) June 2000 to develop a Substance Use Therapeutic Program for implementation by bilingual mental health workers. The Program will be trialed in December with Portuguese men who have identified they have problematic alcohol use.

`

11.3 Implementation of Adult Alcohol Action Plan

A4 4.1

Year 2: To be determined


Central Sydney Area Health Service 1999-2001 Performance Agreement: Healthier People – HEALTH PROTECTION 19

PERFORMANCE AREA: HEALTH PROTECTION

BOARD ACCOUNTABILITY: To ensure the protection of health through the management of health risks associated with the environment, infectious diseases and food safety. In particular focus on the 3 areas of skin penetration guidelines, immunisation and local participation in statewide food safety surveys. DEPARTMENT ACCOUNTABILITIES: • Revise Regulatory Framework for Legionella notifications (through revision of the Public Health Act 1991) by June 2000 • Develop 12 Housing for Health proposals for implementation throughout NSW by June 2001 • Establish a water quality database by June 2001 • Implementation of National Food Safety Standards from 2000 • Develop Statewide Strategic Plan for Immunisation and Oasis system to monitor school entry immunisation rates by December 1999 • Develop skin penetration audit tool by January 2000 • Develop Sexual Health Statement of Strategic Directions by December 1999



LINK TO

SDFH TARGETS

PROGRESS

Baseline Year 1: a. Collaboration with Local Councils by June 2000 b. Pilot test by June 2000

a. Collaboration with local Councils has occurred and

is now well established. Presentations to local Council EHOs has been conducted.

b. Pilot testing of the standardised audit tool has

occurred as requested by DOH.

12. Environmental Health

Skin penetration guidelines disseminated and: - collaboration with Local Councils

on implementation strategies undertaken;

- pilot test of standardised audit tool on a random sample completed; and

- 1 year compliance measurement

A5

Year 2: One year compliance measurement by June 2001 Baseline: Year 1: One survey - Public Health Unit to participate in Olympics foodwatch program, coordinated by NSW Health

Public Health Unit has participated actively in Foodwatch Program.

13. Food Safety Participation in at least one statewide food safety survey agreed by the Network

A5 5.7

Year 2: One survey – to be specified


Central Sydney Area Health Service 1999-2001 Performance Agreement: Healthier People – HEALTH PROTECTION 20



LINK TO

SDFH TARGETS

PROGRESS

Baseline: Year 1: Immunisation Uptake Strategies a. ACIR • Support GPs in providing data as requested • Undertake a follow-up pilot survey in

Canterbury Area of unimmunised children, using ACIR

b. School immunisation – develop and implement local strategies to improve immunisation certificate documentation at school entry

c. Vaccine Cold Chain – develop and disseminate

a vaccine cold chain pamphlet c. Pre-adolescent hepatitis B – project to increase

health Professional awareness about adolescent hepatitis B Vaccination in CSAHS

a. GPs are provided with ACIR data when requested.

Follow-up pilot survey of unimmunised children in Canterbury Area data collection completed.

b. Strategies to improve the return rate of

immunisation certificates included: reminder letters to stakeholders, a schools survey, preparation of facts sheets, assisting providers with developing processing systems and eliminating certificate backlogs. Review of documentation at school entry has been completed.

c. Cold chain pamphlet has been developed and

disseminated to relevant local stakeholders. d. Educational interventions to increase professional

awareness about adolescents hepatitis B vaccination in CSAHS have been completed . Facts sheets and GP bulletins have been distributed.

14. AIDS and Infectious diseases

Activities consistent with the Statewide Strategic Plan, undertaken to improve immunisation uptake

A11

Year 2: Activities to be specified


Central Sydney Area Health Service 1999-2001 Performance Agreement: Fairer Access – ABORIGINAL HEALTH 21

PERFORMANCE AREA: ABORIGINAL HEALTH BOARD ACCOUNTABILITY: To ensure the improvement of health of Aboriginal people in collaboration with Aboriginal communities and to provide better access and more effective services in accordance with the directions in the local Aboriginal Health Plan. In particular the 4 areas of Aboriginal health partnerships; NSW Aboriginal Health Strategic Plan; Aboriginal health workforce and staff cultural awareness. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • NSW Aboriginal Health Strategic Plan by November 1999 • Education Training Package – Aboriginal Family Health Strategy by June 2001 • Review Aboriginal Cultural Awareness Training by October 1999



LINK TO

SDFH TARGETS

PROGRESS

15. Aboriginal Health Partnerships

Aboriginal Health Partnerships at the local/Area level between Health Services and the Aboriginal Community Controlled Health Services are established and achieve agreed objectives

B1 3.4

Baseline: Negotiations commenced re: Partnerships Agreement Year 1: Sign regional Partnership Agreement with AMS Redfern and SESAHS and NSAHS Year 2: Report progress on agreed targets identified in the Partnership Agreement

Partnership negotiations have continued.

Baseline: Year 1: Release ‘Bunga Buruk’ Resource Document profiling Aboriginal Health within Central Sydney

“Binya Guring” pamphlet published and released for Aboriginal Families and young children.

16. NSW Aboriginal Health Strategic Plan

Initiatives consistent with the 5 priorities of the NSW Aboriginal Health Strategic Plan are implemented:

- Improving access to health services

- Addressing identified health issues

- Improving social and emotional wellbeing

- Increasing the effectiveness of health promotion

- Creating an environment supportive of good health

A2 B1 C5

Year 2: a. Develop Aboriginal Strategic Health Plan b. Participate in community consultation in

Redfern regarding D & A services c. Conduct education programs for sexual health

workers in conjunction with AMS Consistent with Partnership Arrangement, review service needs in Marrickville and commence implementation of recommendations


Central Sydney Area Health Service 1999-2001 Performance Agreement: Fairer Access – ABORIGINAL HEALTH 22

HEALTH SERVICE



SDFH TARGETS

PROGRESS

Baseline: Employment Strategy Year 1: Continue implementation of Strategy with emphasis on the Mentoring Program, Skills audits and Career development initiatives

Mentoring program being trialed. Traineeships offered. Positions identified in the TEN program. Eight trainees have completed the course and been provided with full-time employment.

17.1 Implementation of the Aboriginal and Torres Strait Islander Employment Strategy

2.1

Year 2: Review of strategy Baseline: Initiatives identified in Employment Strategy Year 1: Implementation of initiatives

CSAHS Network Committee meets monthly. Aboriginal Employment Coordinator supported in Public Sector Management Course. Secondments supported.

17. Aboriginal Health Workforce

17.2 Initiatives to support the development of the Aboriginal Health workforce are implemented by the Health Service

2.4

Year 2: Review to assess progress Baseline: Senior executive staff have attended Cultural Awareness Program Year 1: a. Continue training front line staff and Nurse Unit

Managers

b. Review Orientation Program to ensure appropriate information presented to new employees

a. Three hour Cultural Awareness Programs are

conducted by Aboriginal Employment Co-ordinator. Over 300 key staff have attended. Sessions have been targeted to areas/units recognised as being a priority; Program documented currently under review by Network Committee.

b. Orientation Program has been reviewed and

adapted to meet current needs. Information is also included in all relevant courses.

18. Staff Cultural Awareness

Staff cultural awareness guidelines are implemented

B11 2.10

Year 2: Review cultural awareness program and continue training of managers and frontline staff


Central Sydney Area Health Service 1999-2001 Performance Agreement: Fairer Access – SERVICE ACCESS AND SERVICE MODELS 23

PERFORMANCE AREA: SERVICE ACCESS AND SERVICE MODELS BOARD ACCOUNTABILITY: To provide the direction for ensuring equity of access to services and the provision of appropriate models of care. In particular within the 4 areas of waiting times; continuity of care; targeted population groups and the provision of outreach specialist support services. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Emergency Department Services Planning Model by December 1999 • General Practice Policy by November 1999 • Carers Framework by March 2000 • Womens Health Strategic Framework Update November 1999 • Child Protection Service Model by July 2000 • Intensive Care Service Planning Model by January 2000 • Map service needs and requirements for Drug and Alcohol statewide and identify key priorities by December 1999; and develop service standards from July 2000



LINK TO

SDFH TARGETS

PROGRESS

19.1 PAS targets for the management of elective admissions achieved

C2

D11

Categories • BK1 (U1 & U2) > 30 days • BK3 (U8) > 12 months • BK5 Delayed - 3 times or

more

Year 1 • 80 • 60 • 0%

Year 2 • TBA

Jul Aug Sep Oct Nov Dec BK1: 228 97 98 159 224 261 BK3 126 134 162 172 207 233 BK5 4 3 3 4 2 4 Jan Feb Mar April May June BK1: 358 260 318 422 326 344 BK3: 247 264 308 313 336 360 BK5 4 2 0 0 0 2

19. Waiting Times

19.2 Meet Emergency Department targets for: - Triage category benchmarks - Reduction in access block

C2

Categories % • T1 • T2 • T3 Access Block

Year 1 • 99% • 85.4% • 61.5% • 80%

Year 2 •

TBA

Jul Aug Sep Oct Nov Dec T1: 100 100 100 100 96 100 T2: 81 81 84 85 81 83 T3: 51 48 47 51 57 57 AB: 77 71 Jan Feb Mar April May June T1: 100 100 100 100 100 100 T2: 86 86 84 86 84 80 T3: 54 59 58 57 51 44 AB: 76 82 80 79 74 70



HEALTH SERVICE



SDFH

TARGETS

PROGRESS

Baseline: Establish Home Based Health Care Steering Committee Year 1: Finalise model for home based health care in CSAHS and appropriate protocols/guidelines for implementation

Home based Health Care Committee has met four times and is in the process of developing protocols for implementation in CSAHS. Snapshot of services, relevant issues, possible structure, identification of stakeholders, review of other Area’s structures all completed. Awaiting meeting with Hospital in the Home officers and a discussion paper prepared by Allied Health. Funding issues to be assessed before model can be completed.

20. Continuity of Care Community Health Services work in partnership with other parts of the health and community services sector to improve continuity of care

B3

Year 2: Implement model throughout CSAHS Baseline: Successful community development campaign was undertaken for 4 NESB groups over the last two years to raise awareness of domestic violence in the community Year 1: Develop a community based program and train community leaders within the Samoan community

The consultant’s report has been received by the Steering Committee and the final report has been circulated. CSAHS Womens Health Team: - has developed and delivered two day training programs covering issues related to domestic violence and the importance of changing attitudes about the acceptance of domestic violence in community life. Participated on the reference group, supporting the development of culturally appropriate strategies to address community attitudes to reduce the acceptance of domestic violence.

21. Targeted Population Groups Women’s Health

2I.1 In participation with the Regional Violence Prevention Committee, develop initiatives with new NESB communities with high incidence of domestic violence

4.7

Year 2: Evaluate outcomes and follow-up with support services for women, also linked with PANOC services

21.2 Respond to the needs of Aboriginal women using CSAHS birthing services

B2

Baseline: A research project has commenced to review issues around access to current birthing services for Aboriginal women Year 1: Report on the outcome of the review to NSW Health and consider options for improving access to birthing services Year 2: Implement recommendations of the review

CSAHS Women’s Health Team has worked with the Aboriginal Health Project Officer, the Redfern Aboriginal Health Service and CSAHS Planning to prepare a full report. In consultation with other key players an implementation plan has been developed to ensure improved access to birthing services. Three priority areas for action have been identified.



HEALTH SERVICE


PERFORMANCE MEASURES

LINK TO

SDFH

TARGETS

PROGRESS

Baseline: Maintain Area Child Protection Committee Year 1: Continue the activities of the child protection training officer for targeted staff

The Area Child Protection Committee continues to meet bi-monthly. A working party has been formed to develop consistent protocols across the area in relation to child protection. Child Protection Policies and Procedures in Drug and Alcohol Services have been developed and education has been provided for each drug and alcohol service in relation to these. “Playing your Part” Child protection training continues to be provided across the area. A memorandum of Understanding is being developed between CSAHS and Inner West Department of Community Services.

22. Targeted Population Groups: Victims of Abuse

Maintain child protection policy for ongoing training of staff and development of Area-wide protocols for prevention and treatment of PANOC

C8

Year 2: Implement consistent child protection policies across all Area facilities



HEALTH SERVICE



SDFH TARGETS

PROGRESS

Baseline: Preliminary development has been undertaken for home visiting, health promoting schools and schools as communities programs (Connect Redfern) Year 1: a. Develop implementation plan for Early

Childhood home visiting model of CSAHS

b. Collaborate with DCS, DET on expanding

schools as communities in CSAHS

c. Undertake audit of existing child and youth

mental health services in CSAHS and develop implementation plan for mental health issues and related strategies in Strategic Plan

a. Implementation Plan developed (Innerwest Plan)

and approved by Senior officers. Project Officer for CS Family First strategy recruited. Orientation conducted in CSAHS, Implementation of early childhood home visiting service model is being undertaken by a training officer for 6 months prior to Inner West Families First funds rollout in 2000/2001.

b. Expansion of “schools as communities” projects has

been discussed by the Inner West Interdepartmental Senior Officers Group and will be addressed in the Families First Program.

c. A Steering Group has met to oversee the audit of

adolescent mental health service activity in CSAHS and a survey from has been developed.

23. Targeted Population Groups: Children,

Adolescents and their families

Implement the strategies identified in the Strategic Plan Health Gain for Children and Youth of Central Sydney

4.3

Year 2: a. Implement a home visiting service in

conjunction with the Families First program b. Establish additional schools as communities

programs in conjunction with Families First program

c. Develop a paper on the child and youth mental health service strategies and implementation plan for CSAHS

24. Drug and Alcohol Development of Long Term Drug and Alcohol Plan consistent with the NSW Drug Summit – Government Plan of Action 1999

A4 A10

Year 2: From July 2000

Detailed work plans for each of the projects supported by the Drug Summit have been prepared. Project Committees have been established to steer the implementation of each Drug Summit Project A Five-year plan for Drug Health Services in CSAHS will be prepared by December 2000.





LINK TO

SDFH TARGETS

PROGRESS

25. Outreach Specialist Support Services

Home Dialysis Services

Meet agreed targets for home dialysis including: • access to home training unit • waiting times for home dialysis • proportion of patients managed on

home dialysis

Baseline: Outreach clinics established at Coffs Harbour, Wagga Wagga, Dubbo, Brewarrina Year 1: a. Maintain rural clinics and access to home

training unit. b. Maintain current proportion of patients on home

dialysis to centre based dialysis at 75:25, according to age profile

As at June 2000 rural clinics have been maintained and the breakdown of patients is: Home Haemodialysis 158 Home CAPD 112 Training/Waiting for Training 19 Satellite/Waiting for Satellite 82 SUB TOTAL 371 Non In-Centre Pat. “Permanent” in Centre 10 TOTAL 381 Dialysis Pat. Target of 75:25 is exceeded.

B9



Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – INITIATIVES IN QUALITY MANAGEMENT 28

PERFORMANCE AREA: INITIATIVES IN QUALITY MANAGEMENT BOARD ACCOUNTABILITY: To ensure improvement in the quality of health services and provide direction for the management of quality. In particular the implementation of the Framework for Managing the Quality of Health Services in NSW. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Establish Quality in Health Care Unit by June 2000 • Develop NSW Strategic Directions document for Quality in Health Care by June 2001 • Work towards establishing suitable quality of care indicators for NSW Health Services by June 2001



LINK TO

SDFH

TARGETS

PROGRESS

Year 1: Quality Framework as mandated in NSW Health Framework document introduced

NSW Quality Framework has been introduced to CSAHS and the Quality Clinical Council established. It meets bi-monthly and is chaired by a member of the Board A formal review of the quality framework will be undertaken in August /September 2000. Reporting mechanisms in regard to clinical risk management is in place with each of the clinical service groupings covering: • Sentinel events • Facilitated incident monitoring • Ad hoc audits These are reported at the Area Clinical Quality Council meetings and the action and outcomes discussed by the Clinical Directors

26. Quality Framework 26.1 Mechanism to monitor and manage the quality of health care is established consistent with the Framework for Managing the Quality of Health Services in NSW

C4 C9

Year 2: Formal independent review of effect on quality and outcomes of introduction of Quality Framework


Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – INITIATIVES IN QUALITY MANAGEMENT 29



LINK TO

SDFH

TARGETS

PROGRESS

Year 1: a. ACHS Accreditation b. Continue to develop indicators under Phase 2 of

CSAHS Health Improvement Performance System (CHIPS) ie priority areas – diabetes, stroke, cardiovascular disease, tobacco, breast cancer and mental health

a. RPAH – Accreditation achieved 1998. Periodic

review conducted successfully during May 2000.

CRGH – accredited until 2002. Periodic review due 2001.

Canterbury Hospital - ACHS accreditation achieved 1999. Periodic Review scheduled for August 2000. United Dental Hospital – completed its Periodic Review in January 1999 and will have a facility wide survey in August 2000. Balmain Hospital - Periodic Review was successful in June 2000. GGRM Eastern Sector Community was accredited in April 2000.

Division Population Health (Community Health) organisational wide survey scheduled for August 2000..

a. Work has proceeded to refine the Health

Improvement Performance System (CHIPS) indicators for diabetes, stroke cardiovascular a tobacco, breast cancer and mental health. All clinical service groups are currently collecting and acting on the results of the ACHS clinical indicators to improve outcomes.

26. Quality Framework (continued)

26.2 The set of quality of care indicators is collected and reported

C7

Year 2: a. ACHS Accreditation b. Assess capacity to report agreed quality of care

indicators following statewide implementation


Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – COMMUNITY ENGAGEMENT AND WORKING IN PARTNERSHIPS 30

PERFORMANCE AREA: COMMUNITY ENGAGEMENT AND WORKING IN PARTNERSHIPS BOARD ACCOUNTABILITY: To involve local communities in the planning of health services in their area and oversee inter-agency collaboration for the planning and provision of services. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Strategy for Community Involvement in the Health System developed by March 2000 • Develop recommendations on health advisory lines by November 1999 • Report on the evaluation of the establishment and initial operation of rural Health Councils by October 1999



LINK TO

SDFH TARGETS

PROGRESS

Baseline: Consultation undertaken on routine basis by some clinical services Year 1: Establish % of CSAHS needs assessments and plans conducted during 1999/00 that incorporate community consultation

Chair, Division of General Practice is a member of the Clinical Council and the Quality Clinical Council. Membership of the Quality Clinical Council includes two consumer representatives. CSAHS has an active GP Shared Care program. Consumer participation/ consultation continues within all mental health services Note: No needs assessment or plans conducted during 1999/2000.

27. Community Engagement

27.1 Incorporate community consultation in setting priorities and identifying community needs

3.1

Year 2: To be determined Baseline: Need for review identified. Year 1 Review of CSAHS community information dissemination needs and strategies

Community awareness programs continued via multi-media


3.1

Year 2: Implementation of selected strategies

Baseline: Community consultation guidelines drafted Year 1: CSAHS community consultation guidelines developed

Community consultation undertaken through RTP planning process. Formal guidelines yet to be developed


3.1

Year 2: Implementation of community consultation strategy by all Clinical Services



HEALTH SERVICE



LINK TO

SDFH

TARGETS

PROGRESS

Baseline: Need for collaborative projects identified Year 1: Three collaborative projects with NSW Health Human Service Partners are established or maintained

Projects involving inter-agency collaboration included the Inner West Child Protection CEOs and Senior Officers’ Group, the Inner West Families First Program, the Redfern/Waterloo Co-ordination Project, Boarding House Project, the Health Promoting Schools Project.

28. Inter-Agency Collaboration

Health Service links with NSW Health Human Services Partners are established and utilised in the coordination of planning and the provision of comprehensive services

4.1 4.5

Year 2: Three collaborative projects with NSW Health Human Service Partners are established or maintained



HEALTH SERVICE



LINK TO

SDFH

TARGETS

PROGRESS

29. Working in Partnership

Clinical streams to report collaboration initiatives undertaken with GPs

4.1 4.5

Baseline: No systematic reporting of links with GPs Year 1: Each Clinical Service to provide an annual report in June of collaborative initiatives with GPs and community organisations

• Participation in the Cervical Screening Advisory Group to formulate a Framework for Service Action from March 2000 – June 2000, where GPs were targeted through their association with the Antenatal GP Shared Care Program to promote cervical screening of marginalised women.

• A collaborative project between KGV Hospital and the Division of General Practice from June 1999 to July 2000 to evaluate the degree of patient satisfaction with the health education and health promotion they received during their antenatal period.

• Participation in the co-ordination Group to oversee the implementation of the Strategic Plan. This included the recent establishment of the Asthma Working Group to consider the current services provided for people with asthma in CSAHS, any shared care GP program arrangements, the need for service development and ongoing monitoring of this health issue.

• Consultation on the birthing needs of Aboriginal and Torres Strait Island women and the established of a working party to implement that agreed recommendations within KGV, AMH and the CSAHS Community Health Services.

• The GP Shared Care Program is expanding to include approximately 350 accredited GPs and is setting benchmarks for the antenatal services of other Area Health Services. Currently 44% of the antenatal patients at KGV and 30% at Canterbury have elected the GP Shared Care program as their management plan.



HEALTH SERVICE



LINK TO

SDFH

TARGETS

PROGRESS

29. Working in Partnership

Baseline: No systematic reporting of links with GPs Year 1: Each Clinical Service to provide an annual report in June of collaborative initiatives with GPs and community organisations

• The establishment of the Sexual Health Clinic in the last two years has introduced a positive collaboration between Livingstone Road and Community Clinic, GPs and KGV with increasing attendance at the KGV clinics and the introduction of a life style screening tool in May 2000.

. • In collaboration with the GPs and social work

department, criteria has been established to identify antenatal patients at medium and high and high risk of negative health outcomes during the course of their pregnancy and also during the postnatal period.

• The research proposal to assess the incidence of

Hepatitis C in pregnant patients in association with KGV, Community Organisations and GPs is currently before the CSAHS Ethics Committee.

• The Pilot Service for the General Practice after

hours clinic at Canterbury is underway.

Clinical streams to report collaboration initiatives undertaken with GPs

4.1 4.5

Year 2: Each Clinical Service to provide an annual report in June of collaborative initiatives with GPs and community organisations


Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – TEACHING AND RESEARCH 34

PERFORMANCE AREA: TEACHING AND RESEARCH BOARD ACCOUNTABILITY: To ensure an environment in which scientific enquiry and rigorous evaluation are integral parts of local health service policy, management and practice; in which National and State standards for research practice and ethics are applied; and in which the training and education of health professionals is supported. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Implementation of research infrastructure grant program from July 2000 • Establishment of Intellectual Property Unit from July 2000 • Development and implementation of NSW Health Strategy for Research and Development from July 2000



LINK TO

SDFH TARGETS

PROGRESS

Year 1: Commence implementation consistent with the outcomes of the review undertaken by the Teaching Advisory Committee (TAC) of the Health Department

Awaiting Teaching Advisory Committee Report. CSAHS has numerous persons actively participating in this ongoing process

30. Teaching Ability to report on current teaching activity and investment in teaching at Health Service level

2.1 6.10

Year 2: To be advised Committee established. Research Director, RPAH recruited. Research Forum established.

Baseline: CSAHS Research and Development Framework Strategy completed. Research Director for the ANZAC Foundation, Concord Hospital recruited Year 1: a. Establish Area R&D Advisory Council b. Recruit appropriate Research Director for

RPAH

31. Research 31.1 Research and development strategy developed which: - seeks to identify priority research areas - builds research capacity - encourages research

collaborations - promotes the dissemination

and application of research results

6.3

Year 2: Hold first annual CSAHS Research Forum


Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – TEACHING AND RESEARCH 35



LINK TO

SDFH TARGETS

PROGRESS

Baseline: Research report included in Area’s Annual Report

Recommendation made that facilities create joint research report as this level of detail is outside the scope of the CSAHS annual report. Infrastructure support for research units provided by NSW Health. a. International benchmarks have been adopted, with

some modifications being developed in relation to "dry lab" research activities.

Year 1: a. Establish measures of research performance b. Review of research investment at CSAHS

b. Completed building of ANZAC Medical and

Research Institute. Review of research investment underway, involving Research Director.

31.2 Ability to report on research investment and research outcomes

6.4

Year 2: Number of peer reviewed publications produced in Central Sydney to be reported

New directions are emerging and these will flow into next years plan eg the research corridor with Sydney University


Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – SKILLED, VALUED WORKFORCE 36

PERFORMANCE AREA: SKILLED, VALUED WORKFORCE BOARD ACCOUNTABILITY: To provide direction for effective human resource systems, appropriate training and support for staff, and the improvement of occupational health and safety. In particular focus on initiatives in the 3 areas of: HR 2003 – A Framework for Human Resource Management; Skills and Tools for the Job; Consultation, Communication and Collaboration. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Develop a Recruitment and Selection Policy for NSW Health by December 1999 • Review HR 2000, NSW Health Workforce Learning and Development Strategy and NSW Health Management Development Strategy by November 1999 • Develop Flexible Work Practices Guidelines for NSW Health by December 1999 • Negotiate new award structures for NSW Health that balance the service objectives of Health Services and State Government Wage Policy by December 1999 • Develop proposals for a NSW Health Senior Executive Service that meet the specific needs of the NSW Health System by June 2000 • Review and implement the NSW Area of Need program by December 1999 • Facilitate the development of standard reports for the NSW Public Sector Profile on all workforce groups in the NSW public health system by November 1999



LINK TO

SDFH TARGETS

PROGRESS

Baseline: JCC & SCC Consultation committees established Year 1: Continue consultation

Consultation continues through the monthly SCC meetings and quarterly JCC meetings

32. Consultation, Communication, Collaboration

Process to enable staff and unions to actively participate in the development of new work practices and conditions, established across the Health Service

2.4 2.9

Year 2: Continue consultation and review to identify initiatives to improve consultation processes

Baseline: Staff Development & Training Network established and conducting an Area-wide program Year 1: Identify key competencies and review performance management progress

The Staff Development and Training Network Strategic Plan has been reviewed and the Business Plan for 2000/2001 amended to reflect current needs/ priorities. Consultation was undertaken with facility general managers. Management training programs have been ongoing to reflect learning and development needs of staff. Change management, teamwork and leadership workshops have been held with 187 NUMS attending. Extensive training has been held in the Minimisation of Aggression and Critical Incident Management.

33. Skills and Tools for the Job

Health Service learning and development strategies and management programs established which address change management skills, leadership and people skills and collaborative practice

1.3 2.1

Year 2: Review strategies and update programs Baseline: Develop Strategic Plan by Dec 1999 Year 1: Implement Strategic Plan from December 1999

Strategic Plan drafted and circulated for comment. Area-wide review of Human Resources commenced as part of strategy.

34. HR 2003 – A Framework for Human Resource Management

Develop a framework for the management within CSAHS

2.13

Year 2: Review Strategic Plan by Dec 2000


Central Sydney Area Health Service 1999-2001 Performance Agreement: Quality Health Care – SKILLED, VALUED WORKFORCE 37

HEALTH SERVICE



SDFH TARGETS

PROGRESS

Baseline: Develop Best Practice Guidelines by Dec 1999 Year 1: Implement Guidelines in Dec 1999

Awaiting release of policy from NSW Health. The Staff Development and Training Network continue to conduct a program on recruitment and selection.

35. Retention and Recruitment

35.1 Best Practice Recruitment and Selection Guidelines implemented

2.1

Year 2: Review outcome of implementation by Dec 2000

Year 1: Local issues identified and strategies developed

Report prepared and presented to CSAHS Board. An Area Nurses Career Advisory group has been set up to: • Explore, implement and evaluate marketing

strategies with schools, universities including attendance at Open Days

• Develop marketing tools eg brochures • Participate in the successful launch of recruitment

program for nursing by the Minister for Health (June 2000) at Glebe High School

• Take part in the Nursing Expo 2000 to market nurse recruitment

• Identify work experience opportunities in liaison with the Careers Advisors at local schools

35.2 Nursing Recruitment and Retention Taskforce recommendations implemented particularly:

- work experience programs - quality strategies - safe and secure work

environment - grievance policies and

complaints - support of nurses with childcare

needs

2.6

Year 2: Full implementation of strategies

36. Working Environment

Continued implementation of EEO initiatives

2.1

Baseline: EEO Management Plan Year 1: Review EEO Management Plan Year 2: Ongoing implementation of strategies identified in planning process

EEO Management Plan reviewed and circulated to general managers for comments.


Central Sydney Area Health Service 1999-2001 Performance Agreement: Better Value – ACTIVITY, FINANCIAL MANAGEMENT AND EFFICIENCY STRATEGIES 38

PERFORMANCE AREA: ACTIVITY, FINANCIAL MANAGEMENT AND EFFICIENCY STRATEGIES BOARD ACCOUNTABILITY: To ensure that available health services are provided in an effective and efficient manner, within the funds available to the service. In particular focus on the 5 areas of activity, financial management, day surgery, utilisation rates and efficiency. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Tax Reform (GST and FBT) coordination from 1999/2000 • Implementation of Forward Financial Planning Model from 1999/2000 • Implementation of the Central Cancer Registry IM&T Strategy from 1999/2000 • Revenue Policy submitted to the Minister’s Office by December 1999 • Benchmarking costs for Peer Hospitals by April 2000 • Provision of data on NSW Hospital Cost Data Collection by May 2000



LINK TO

SDFH TARGETS

PROGRESS

37.1 Meet agreed targets for: - Admissions - NAPS

D1 D5

Baselines 98/99 • 132,353 • 1,989,058

Year 1 126,700 1,930,500

Year 2 • TBA

99/00 (DOHRS Actual 133,818 1,848,412

37. Activity

37.2 Timely and accurate submission of Health Service data:

- ISC - DOHRS, WLCOS, EDIS - Cancer Notifications

A8

Categories • % ISC received • % ISC quality • % received Timeliness

Year 1 • Circ 99/52 • Circ 99/52 • TBA • TBA

Year 2 • TBA

99/00 (ISC Compliance Report May YTD) 65.7% Deadlines for submission met

38. Financial Management

Achieve targets for: • Net Cost of Service/General Fund

(annual budget) • Net Cash Result (General Fund) • Timely payment of trade creditors • YTD Budget Performance Index

/NCOS/General Fund

D2 D11

Baselines 98/99 • Favourable • Favourable • 40 days (average) • 0

Year 1 • Meet budget • Meet budget • # 45 days • # 0.5

Year 2 • TBA

Achieved Achieved Achieved – no creditors over 45 days Achieved

Baseline: 44% YTD April 99 Year 1: 46%

Jul Aug Sept Oct Nov Dec 44% 44% 46% 44% 45% 46% Jan Feb Mar April May Jun 32% 42% 44 % 43% 47% 48%

39. Day Surgery Increased % of all elective surgery performed is on a same day basis, consistent with the rates and procedures identified in the Same Day Surgical and Endoscopic Procedures Policy

D3 D11

Year 2: Work during the redevelopment of facilities and reduced theatre capacity to provide same day surgery where possible


Central Sydney Area Health Service 1999-2001 Performance Agreement: Better Value – ACTIVITY, FINANCIAL MANAGEMENT AND EFFICIENCY STRATEGIES 39



LINK TO

SDFH TARGETS

PROGRESS

Baseline: Year 1: Data on admissions analysed, areas for further action identified and strategies developed by June 2000

A Quality Working Group (a sub committee of the Area Quality Council) has been established to look at analysis of variation and to develop an implementation strategy.

40. Utilisation Rates Health care provided is clinically required and appropriate

D12

Year 2: Strategies to address inappropriate admissions implemented from July 2000

41.1 Achieve/maintain benchmark cost per casemix weighted separation, with HCCC adjustment, for acute hospitals (excluding community hospitals)

D2

Baseline: 97/98 RPAH: $2519 CRGH $2462 Canterbury $2593

Year 1: Within 5% of benchmark for all acute hospitals

Year 2: Meet benchmark for all acute hospitals

Data not available from NSW Health at time of reporting

Baseline: ARDRGS collected annually Year 1: Consistent with agreed details and strategies from State-wide working group

Not achieved - as new patient system was being implemented the data was not available

41.2 Expand coverage and frequency of costing for major product groups defined by the Department

D11 5.7


Baseline: Year 1: As advised by DOH

41. Efficiency

41.3 Submission of annual cost data (NSW Hospital Costing Study)

A8

Year 2:

Agreements established with affected Health Services on flows resulting from major service and capital developments where there are significant changes required to flow patterns Year 1: a. Formal contracting process consistent with HERC

and Ministerial endorsement b. Flow Management Plan to be included in the Area

Health Plan

a. Agreement reached at NSW Clinical Council

and HERC not to implement formal contracting for inter–area patient flows.

b. Draft Flow Management Plan completed

41.4 Management of Cross Area patient flows

4.2



Central Sydney Area Health Service 1999-2001 Performance Agreement: Better Value – HEALTH SERVICE STRATEGIC DEVELOPMENT AND ASSET STRATEGIES 40

PERFORMANCE AREA: HEALTH SERVICE STRATEGIC DEVELOPMENT AND ASSET STRATEGIES BOARD ACCOUNTABILITY: To provide strategic direction for major initiatives; guide the implementation of the Area Health Plan and ensure efficient and effective use and management of Health Service physical resources. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Review and provide feedback on Area Health Plans (ongoing) • Provide training in Asset Strategic Planning by June 2000



LINK TO

SDFH TARGETS

PROGRESS

Baseline: Area Health Plan drafted for consultation Year 1: Release Area Health Plan

Drafted for comment. Document now being revised to address Health Council Strategies.

42. Strategic Development

Progress strategies and implement milestones consistent with the Area Health Plan

D1

Year 2: Review progress with implementation of Plans





LINK TO

SDFH TARGETS

PROGRESS

43. Asset Strategies Progress further development of the Health Service Asset Strategic Plan and Memorandum of Understanding (MOU) for the Resource Transition Program subject to existing funding arrangements and existing government policy

D4

Baseline: Targets achieved in accordance with MOU and Program Year 1: a. Continue to meet Program targets for RPAH

and CRGH

a. Projects proceeding in accordance with NSW Health approval. Expenditure allocation target of $57.1M met for 1999/2000. RPAH • Gloucester House reconfigured and refurbished

Levels 2 to 6 inclusive and occupied. •

Repairs to entry foyer terrazzo finalised. •

Design and documentation approximately 98% complete.

• Construction documentation commenced for laboratory complex at southern end of eastern campus.

• Pouring of slabs up to Level 6 completed. • Twenty-one packages contracted. • Staging and decanting strategies being addressed by

Commissioning Steering Committee. CRGH • Conservation Management Plan approved by

Heritage Office and infill structure accepted. •

Development Application approved by Concord Council on 9 May 2000 and consent issued with conditions.

•

Documentation progressing on all major works packages.

• Fire Engineering Design Brief report finalised. • Expression of Interests called for trade contractors

wishing to tender for works packages. • Tenders called for piling package. Dame Eadith Walker •

Tender accepted for stables restoration project and work commenced in mid April with estimated completion date September 2000.

United Dental Hospital •

New assessment and emergency department completed in April and administration area in May.

• Orthodontia Department has reached 100% sign-off. • Commissioning program has been initiated. •

IDR/Tutorial rooms schematic design sign-off completed.

• Infrastructure services project progressing well, on-site fire services now 90% complete.

• New main switchboard, cooling tower and stair pressurisation arrangements approved and bulk of new service equipment delivered.





LINK TO

SDFH TARGETS

PROGRESS

43. Asset Strategies (continued)

Progress further development of the Health Service Asset Strategic Plan and Memorandum of Understanding (MOU) for the Resource Transition Program subject to existing funding arrangements and existing government policy

D4

Baseline: Targets achieved in accordance with MOU and Program Year 1: a. Continue to meet Program targets for RPAH

and CRGH (continued)

b. Maintain progress on the QEII project to

enable transfer of Rachel Forster Hospital by September 2000

Year 2: Continue to meet agreed Program targets

Other • Sale of Dunblane Street carpark site finalised and

funds received. • Sale of Prince Alfred Farm site at Luddenham

progressing. Inner West Health Centre • Exclusive dealings with the preferred proponent are

no longer proceeding. • Proposals are to be recalled with some

modifications to requirements. • A submission has been made to Treasury to

proceed with the recall with anticipated construction commencement August 2001.

RPAH – JRRU • Level 4 refurbishment completed with Level 5

occupation programmed for July. • Roof to the new extension has been completed. • Fit-out to Levels 6 west and Level 7 well advanced. • Project on target for relocation of Rachel Forster

Hospital in September 2000.



PERFORMANCE AREA: INFORMATION MANAGEMENT BOARD ACCOUNTABILITY: To ensure the effective management of information systems and technologies needed to support quality health care service delivery and management. In particular focus on the 6 areas of Unaudited Annual Return and Hospital Cost Data Collection, Health Information Exchange, Community Health Information System, Information Management and Technology Strategy, Year 2000 compliance and a common health record. DEPARTMENT ACCOUNTABILITIES AND TARGETS: • Implementation of NSW Health Information Management and Technology Strategy from 2000 • Progress the completion of Statewide Patient Administration Systems (ongoing till 2002) • Statewide completion of Health Information Exchange data warehouses by June 2000 • Review resource issues relevant to the implementation of Drug and Alcohol service access data capabilities (including MDS) from July 2000 • Statewide completion of Y2000 compliance program by December 1999 • Statewide Community Health Information System developed by December 2000



LINK TO

SDFH TARGETS

PROGRESS

44. Information Management

44.1 Meet targets for Unaudited Annual Return (UAR) reports

5.7

Annual: Targets as per annual circular met

Achieved

Year 1: Interface engine implemented by June 2000 Interface engine implemented. PAS for CRGH and RFH implemented. RPAH etc done prior to this. PAS extended to Mental Health Community Patients. Canterbury Hospital yet to be undertaken.

44.2 Expand the use of a common health record in consultation with consumers, through implementation of an Enterprise-Wide Patient Master Index

5.6

Year 2: Infrastructure requirements met consistent with Department advice and subject to compatibility with CSAHS architecture

Year 1: Determine, with assistance of NSW Health the cost/benefits of implementation of HIE

First phase of HIE implemented with mandatory feeds. (EDCOS, Wilcso 99/2000). Testing of Diseased Index 99/2000 underway. Work to commence on ATS extract from PAS.

44.3 Health Information Exchange implemented and incorporated into business processes

5.11

Year 2: Commence implementation in accordance with agreed schedule





LINK TO

SDFH TARGETS

PROGRESS

44. Information Management (continued)

44.4 Health Service IM&T Strategy developed and reviewed

D7 5.1

Year 1: Implementation of Plan from July 1999

IM & T strategy has been reflected in CSAHS IMC agenda, elements of plan have been implemented, review of strategy and impact of recommendations / goals being evaluated. Planning Workshops underway to revise CSAHS IM&T Strategy and priorities.

Baseline: CSAHS is one of the pilot sites trialing the National MDS Year 1: Report on trial of MDS

Drug and Alcohol staff were trained in the use of the NMDS. Components of the NMDS were incorporated into the existing Drug and Alcohol Service data system. The pilot occurred in April 2000. June Deadline to report on National and State Minimum Data Sets achieved. Local Drug and Alcohol Non Government Organisations funded under the NSW Health Grants Program have since been trained in the use of the NMDS. Full implementation of the NMDS will occur on 1 July 2000.

44.5 Data to be provided on Drug and Alcohol treatment services to meet the requirements of the national minimum data set

A8 5.4

Year 2: Implement and report MDS from the effective date as advised by the Department

44.6 Maintain and further develop Drug & Alcohol clinical management systems

A8

Year 1: Determine feasibility of proceeding with a consortium business case to develop a clinical management system Year 2: If funding approved, consortium to commence development of clinical management system for State-wide use

A submission to scope and specify the Drug and Alcohol Clinical Information System (DACIS) Project was presented to NSW Health in August 1999. A grant of $26K was received from NSW Health Local IT Initiatives Committee (LITI). A second business case for project development was presented to NSW Health in Dec 1999. A further grant of $50K was received from LITI. In January 2000 the Drug Programs Bureau funded the development of the core application of the DACIS. It is proposed that system development will commence in July 2000. Currently a Consortium proposal is being prepared to be sent to all Area Health Services inviting their membership to the DACIS consortium. The eight-month trial of the DACIS core application is scheduled to occur in October 2000.





LINK TO

SDFH TARGETS

PROGRESS

45. Information Technology (continued)

45.1 Ensure health information systems, plant, equipment and technology are Year 2000 compliant

6.13

Baseline: Testing and rectification commenced 1998/99. OIT external Audit requirements achieved Year 1: Achieve deliverables as required by Office of Information Technology

Achieved

NSW Health has provided a brief technical architecture presentation. Further detailed discussions on functionality and interfacing are pending availability of CHIME and NSW Health stuff.

45.2 Ensure that the relevant modules of the Community Health Information System (CHIS) are implemented to support an Area-wide integrated patient-centred health record across the continuum of care

5.10

Year 1: Determine with assistance from NSW Health the most effective PAS/CHIS/SCHEDULING/RESULTS architecture for CSAHS Year 2: Implementation in accordance with agreed schedule



PERFORMANCE AREA: NURSES STUDY LEAVE Achievement of organisational goals under Strategic Directions for Health 1998 – 2003 includes the development of a skilled and valued workforce. System initiatives to support the professional learning and development competencies of nurses is critical in the provision of safe quality health advice. Health Services are accountable for the effective implementation of NSW Health Policy and Strategic Directions. To facilitate system wide performance, monitoring ad reporting, the following statewide approach to nurses study leave will be applicable throughout the term of this Agreement. BOARD ACCOUNTABILITY: To ensure Health Service Strategies are established to support equity and access to study leave for all nurses within the Health Service. DEPARTMENT ACCOUNTABILITIES: Data guidelines for the collection and reporting of nurse study leave data, circulated to Health Services by the end of September 1999. Annual analysis and report on nurses study leave produced from June 2000. Management of Leave for Study and Career Development Circular (97/634) re-issued January 2000.



LINK TO

SDFH TARGETS

PROGRESS

Study leave has been collected and reported for the period July – December 1999 and January – June 2000 and submitted to the NSW Health Nursing Branch CSAHS offers a high percentage of study leave and leads the State (results from July-December 1999).

46.1 Collection mechanism established and fully Implemented across the

Health Service by December 1999.

Baseline for all data items for the period for July - December 1999 established and reported to the Department by January 2000. Demonstrated % improvement change in applications approved (by category of staff) by June 2000, and on an annual basis thereafter.

46 Nurses Study Leave

46.2 Annual reporting to the NSW Health Department established and meeting quality and time submissions standards from May 2000.

Strategy to publish indicator data to all nurses across the Health Service on a 6 monthly basis developed and implemented from December 1999

Report received from NSW Health Nursing Branch was appropriately distributed.

F:\SHARE\WP\JWNB\CSPAREP2.DOC


dedication,

skills and

a caring outlook


statutory annual report - slhd.nsw.gov.au

Documents

Transcript of statutory annual report - slhd.nsw.gov.au