Albury Wodonga Health - Parliament of Victoria€¦ · The Albury Emergency Department was fit for...

AlburyWodonga

Health

A N N U A L R E P O R T 2 0 1 4

ALBU

RYWO

DONG

AHE

ALTH

ALBURY WODONGA HEALTHPO Box 326

Albury NSW 2640 ABN: 31 569 743 618

ALBURY HOSPITALBorella Road

Albury NSW 2640Ph: 02 6058 4744Fax: 02 6058 4528

WODONGA HOSPITALVermont Street

Wodonga VIC 3690Ph: 02 6051 7111

Fax: 02 6051 7477

2 ALBURY WODONGA HEALTH 2014 ANNUAL REPORT

Our purpose is to deliver quality healthcare services in unique models of partnership to improve our regions health.

Albury Wodonga Health – the best of health

Both in our clinical endeavour and our business practices we will be just in all our dealings.

Esprit de corp, harmony, partnership and unity are valued.

Appreciation of the worth of others and regard for their contribution is inherent.

Confidence that all are doing their best, honestly and positively.

Understanding that all bear a personal responsibility to our community.

Consideration, empathy and humanity are given freely to our patients and staff alike.

Fairness, integrity and justice are apparent in our actions.

Our purpose is to serve our patients and clients in order to achieve the Vision and Purpose of Albury Wodonga Health.

OUR PURPOSE

OUR VISION

OUR VALUESETHICAL

TEAMWORK

RESPECT

TRUST

ACCOUNTABILITY

COMPASSION

EQUITY

PATIENT AND CLIENT FOCUSED

3ALBURY WODONGA HEALTH 2014 ANNUAL REPORT 3

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CONTENTSVision, purpose and values

About Us

Chairman and CEO Report

Board of Directors

Executive Directors Reports

Workforce Data Disclosure

Organisational Chart

Albury Wodonga Regional Cancer Centre Progress

Environmental Performance

Statutory Compliance and Mandatory Reporting

Additional Information

Attestations/Declarations

Disclosure Index

Key Financial and Service Performance Reporting Attached

Financial Statements Attached


The Albury Wodonga cities are growing at almost 2% per annum, reflected in the continuing growth of category 1 – 3 attendances in the Emergency Departments of 1.5% in 2013/14

The emergency attendances and obstetric deliveries are the second highest in regional Australia.

There has been over $15M spent in the current five (5) year period across the health service but particularly at the Albury Wodonga Regional Cancer Centre, the PET/CT scanner in Albury and a range of new developments in Wodonga including:

• The Renal Dialysis Unit• Day Procedure / Endoscopy Unit• Parents and Babies Unit• Expanded Emergency Unit• Prevention and Recovery Care (PARC) Unit• Rehabilitation Unit

ABOUT US

THE COMMUNITY WE SERVE

With more than 2,000 staff, serving a population of 250,000 across an area that is a quarter the size of Victoria, Albury Wodonga Health (AWH) is a fast developing regional health service, operating within the responsibility of the Victorian Department of Health.

AWH offers the sophistication of health services found in a city environment combined with the unique charm of North East Victoria and Southern New South Wales.

AWH, a 240 bed health service, treated almost 31,272 inpatients, triaged 55,736 emergency attendees and welcomed 1631 new born babies in the 2013/14 financial year.

These services were provided utilising 20 rehabilitation beds, 20 acute mental health beds, 6 intensive care beds, 8 operating rooms and 189 general beds together with a range of community based residential facilities and community health centres that deliver care from 12 different sites from Wangaratta and Beechworth to Albury Wodonga and Corryong.

The map below graphically represents the communities AWH serves. The catchment area population is estimated at 250,000 people.

*Includes patients status who are or whose planned procedure is a non ESIS procedure.

JERILDERIE•

WODONGA

WALWAALBURY•

HOWLONG•

WANGARATTA•

BRIGHT• MT BEAUTY

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COROWA•

CORRYONG•

TOCUMWAL

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FINLEY•

•URANA

•BEECHWORTH

•YACKANDANDAH

• TALLANGATTA

BERRIGAN

HENTY

HOLBROOK

BENALLA MYRTLEFORD

MANSFIELD

JINDERA

CULCAIRN

CHILTERN

RUTHERGLEN

NSW

VIC


In 2013/14 we were successful in sourcing new funds for elective surgery conducted in conjunction with the private sector. This resulted in 414 orthopaedics, general surgery, ENT and Urology cases being performed and 630 cataract cases being performed in the private sector to offset the delayed opening of beds at the Wodonga Hospital due to the capital works being undertaken.

As we headed into 2014 – there was good news, we had commissioned every bed, opened four new short stay beds in the Albury Emergency Department and commissioned the new Day Procedure/Endoscopy Unit at Wodonga.

The result of this is seen by the size of the waitlist at 30 June 2014 – the lowest it has been for years, at 3512, and of particular note only 2 category 1 elective surgery patients (those needing acute care and admission) remained out of time at 30 June.

Our budgeted result remains disappointingly in deficit. This has been significantly affected by the lack of revenue due to the capital works. The deficit of $1.63M is consistent with not meeting our activity targets across the organisation as a whole.

The quantity and quality of capital works has been outstanding in 2013/14 and is a result of good planning and strong government support. The projects for 2013/14 have included:

• Wodonga Emergency Department Refurbishment - $1.3M• Endoscopy/Day Procedure Unit including new endoscopes - $2.7M• Short Stay Unit – Albury Emergency Department - $0.1M• Paediatric Day Treatment and Family and Play area - $0.5M• Prevention and Recovery Care (PARC) Facility, Wodonga - $3.6M• Rehabilitation Inpatient Unit, Wodonga – $1.944M• Parents and Babies Unit (transfer of service from Mercy) purpose built facility $.960M*• Margaret Boyd Centre, Adult Community Mental Health team Wangaratta – $.476M**Denotes in progress

The People Matter Survey, conducted early in 2013, was reported to the health service in September 2013. This highlighted the pressure the health service had been under earlier in 2013, with bed closures, operating room reductions, staff reductions and a range of precipitate changes.

Major organisational change brings with it challenges, and in our special regional environment the effects were underestimated.

CHAIRMAN & CEO REPORTIt is a privilege to present the fifth Annual Report– which because it is also the transition to the new leadership, also serves as the report on the first five years of Albury Wodonga Health.

We cannot encompass all that has been achieved but the overall response we receive from the staff, the Medical Community, the Community at large and Government is that there has been a very successful transition from two small hospitals, both with challenges for the future, to a dynamic single health service that is now well positioned to go from strength to strength.

Whilst acknowledging there will always be more to do than is done and that we must be more effective on all fronts, we are all entitled to take a moment of pride before pushing onto the next level of performance or that new initiative.

Some of the hallmarks of five years have been:

• A single organisation structure at all levels, despite two separate industrial agreements• A shared clinical environment across medical, nursing and allied health services• An elective surgery program that is now seeing waiting lists falling• A strong relationship with the Private Hospital sector of Albury Wodonga• A major capital works program at Wodonga Hospital in accord with our Service Plan and Master Development Plan - $10M over the period• The transfer and now construction of the new “Parents and Babies Unit” - $1M• The consolidation of all Public Sector Mental Health Services in North East Victoria and Southern New South Wales within AWH care• The PET/CT Scanner for the investigation of Cancer - $5M• The start of construction of the Albury Wodonga Regional Cancer Centre - $70M• The commencement of the development of Albury Wodonga Cardiac Centre - $5M

And more recently the recruitment of new specialists in Anaesthesia, General and Specialty Internal Medicine, Emergency Medicine and Orthopaedics. It is expected that there will be additional surgical recruitment in the near future.

The overwhelming influence upon AWH in 2013/14 has been the capital works program of the Wodonga Hospital which, because of the delay in the recommissioning of the Emergency Department, has had a lasting impact on our ability to reach our inpatient and elective surgery targets across the whole organisation. With limited bed space capacity and with a service profile weighted towards emergency admissions and obstetrics (when compared with like organisations), elective surgery is vulnerable.


A very positive and exciting development is the $5M funding from the Commonwealth to develop a Cardiac Centre at the Albury Hospital. This centre will open in early 2016 making a real difference to over 1000 patients who travel to Melbourne for investigation and treatment for cardiac conditions.

An important issue that still awaits a solution is the development of a major Emergency Department at the Albury Hospital of a contemporary standard. Almost 60,000 people attend our emergency services each year – the second highest in Regional Australia.

The Albury Emergency Department was fit for purpose in 1990 however with its current workload and inadequate accommodation, a solution needs to be found.

Finally, we must acknowledge the contribution of Ulf Ericson, the inaugural Chair of Albury Wodonga Health for his contribution and leadership over the first five years of our endeavour.

By the time this report is published the baton will have been passed, with the retirement from the Board of Dr Peter Vine OAM, Graeme Welsh and Judy Charlton and the appointment of Dr John Moran, Timothy Farrah together with myself as Chair.

With Stuart Spring’s retirement and Susan O’Neill’s appointment as Chief Executive Officer, the Board and Executive now have the challenge to take AWH forward, as it strives to become one of Australia’s great Regional Health Services.

Lou Lieberman Dr Stuart SpringChairman CEO

This survey highlighted the need to consult and involve staff on the major issues. Additionally the survey indicated a work environment, in some quarters, that was not congenial and left a number of staff feeling harassed and unprotected.

The Board and Senior Executive are determined and deeply committed that this will be typical of AWH in the future and we are working to ensure a culture and workplace environment that reflects our espoused values.

To support this direction, the Human Resource Department has been strengthened and we welcome Desirée Harker’s appointment as Executive Director of Human Resources, to lead these changes.

The North East & Border Mental Health Services continues to develop following the merger of 2012. On 1 July 2014 the Albury Based Community and Mental Health Services and Drug and Alcohol Services of Murrumbidgee Local Health District (MLHD) also transferred to AWH. The NEBMHS – with over 400 staff is now the most significant mental health service in Regional Australia and has tremendous potential for good when the critical mass is harnessed in the future.

We welcome the former Murrumbidgee Local Health and District staff – both Mental Health and Community Health services, and look forward to their contribution.

In November 2013 AWH underwent a mid-term accreditation survey by the Australian Council on Health Care Standards. The result was affirming of the standards we seek to achieve. We have more work to do in preparation for the full survey in late 2015.

The Community Advisory Committee continues to going from strength to strength and we welcome Sue Housego, Maria Berry, Karen Purtle, Cheryle O’Loan and Mohammed Alamgir to the Committee. Their role is vital in keeping us in tune with community needs and aspirations.

The volunteers, now over 200 strong are a major source of inspiration to us, they are obviously very committed and enjoy their voluntary role and we need them. Equally the volunteer Pastoral Care Workers are providing a niche service that is greatly valued.

AWH is continuing to develop as a major Regional Health Service, from a low base. We have gaps.

The Albury Wodonga Regional Cancer Centre (AWRCC) will provide a major stimulus but it is initially only bringing together what is disseminated throughout Albury Wodonga.

CHAIRMAN & CEO REPORT (CONT.)


MR ULF ERICSON Chairman

MS NICKI MELVILLEDeputy Chair

PROF JULIA COYLEDirector

DR PETER VINE OAMDirector

MS ALLISON JENVEYDirector

BOARD COMMITTEESAUDIT AND RISK COMMITTEEThe Audit and Risk Committee meets quarterly and as requested by the AWH Board, any Committee Member, Internal Auditor and Auditor-General. The Committee liaises with the internal and external auditors, reviews and approves audit programs and evaluates the adequacy and effectiveness of the overall governance framework operating within AWH.

Members: Allison Jenvey (Chair), Nicki Melville, Ulf Ericson, Prof Julia Coyle, Phillip Williams

FINANCE COMMITTEEThe Finance Committee meets monthly to review all financial matters, management information and internal control systems and considers and makes recommendations to the Board.

Members: Nicki Melville (Chair), Ulf Ericson, Graeme Welsh, Allison Jenvey, Phillip Williams, Judy Charlton (resigned 31 March 2014)

QUALITY COMMITTEEThe Quality Committee meets bi-monthly to monitor outcomes and improved the quality and effectiveness of the health services provided by AWH.

Members: Prof Julia Coyle (Chair), Dr Peter Vine OAM, Phillip Williams, Judy Charlton (resigned 31 March 2014)

EXECUTIVE REMUNERATION COMMITTEEThe Executive Remuneration Committee meets as required to review performance and determine remuneration of executive management.

Members: Nicki Melville (Chair), Ulf Ericson, Prof Julia Coyle, Allison Jenvey

COMMUNITY ADVISORY COMMITTEEThe Community Advisory Committee meets by monthly to bring the voices of the community and consumers into the decision-making processes of AWH. Members provide information and advice on needs, demands and service developments from a community perspective.

Members: Graeme Welsh (Chairman), Liz Hare, Martin Butcher, Robyn Raine, Bev Bennie, Leanne Jenvey, from 1 January 2014: Karen Purtle, Mohammed Alamgir, Maria Berry, Cheryl O’Loan, Susan Housego

BOARD OF DIRECTORS AS AT 30 JUNE 2014MS JUDY CHARLTON – RESIGNED 31 MARCH 2014Director

MR GRAEME WELSHDirector

MR PHILLIP WILLIAMSDirector

MR MATTHEW BURKE OAM – COMMENCED 30 JULY 2013Director


• TALLANGATTA

HOLBROOK

VIC

ACUTE SERVICES• Further development of the combined bed management model that enables improvement in patient flow across both campuses.• Review of cross campus transfers and clinical handover.• Increased focus on National Safety and Quality Health Services Standards in particular those that relate to minimising patient harm including clinical handover, patient identification and consent, nutrition, falls and medication safety.• Improved management for patients at discharge and the introduction of systems to enable improved patient flow between inpatient and ambulatory services.

WOMEN’S AND CHILDREN SERVICES• Expansion of midwifery care program• Transfer of Parent and Baby Unit from Mercy Health Service

SUB ACUTE SERVICES• Planning to transfer rehabilitation services to Wodonga Hospital in 2015.• Transfer of Geriatric Evaluation Management (AGEM) service to Wodonga.• Introduction of four specialist clinics: Continence, CDAMS, Fall and Balance, and Pain Management.

PRIMARY CARE SERVICES• Planning for transition of Albury Community Health Service from MLHD to AWH.• Introduction of a Hospital in the Home (HITH) clinic at Wodonga.• Planning for a collaborative Palliative Care service.

NURSING SERVICES• Introduction of a Nurse Practitioner, Aged Care.• Introduction of Assistants in Nursing (AIN) to support clinical care in all clinical departments.• Introduction of initiatives that focus on patient experience and patient centred care.• Integrated framework and designated nursing resources for wound care and skin integrity.

REPORT BY CATHERINE O’CONNELLExecutive Director Of Clinical Operations

The Clinical Operations directorate co-ordinates and supports all services and staff directly associated with clinical care across acute, sub-acute, allied health and ambulatory care departments throughout AWH.

Another dynamic twelve months with many changes across all clinical departments as the organisation continues to respond to the challenges of providing public health services for Albury, Wodonga, Wangaratta, Beechworth and surrounding communities in north east Victoria and Southern NSW.

The directorate re-structure to a fully integrated service in January 2014 has marked a point in the life of AWH that indicates a maturing, responsive organisation. I take this opportunity to acknowledge and thank all staff who have participated in the planning and implementation of the change that now sees a structure capable of providing effective leadership across AWH reflective of a large ‘go-ahead’ regional health service.

ACHIEVEMENTS THIS YEAR INCLUDE: Clinical services have been strongly influenced by a number of capital works projects on both campuses with a reduction in beds necessary over seven months to enable the refurbishment of the emergency department at Wodonga and the new endoscopy suite. Each stream has achieved improvements in care provision through identified projects:

SURGICAL SERVICES• Enhancement of surgical operating theatre allocation and utilisation.• Commencement of the new endoscopy/procedure unit at Wodonga and associated models of care.• The competitive bidding program for surgical services, partnering with Albury Wodonga Private Hospital and Albury Day Centre.• Introduction of outreach dental services and achievement of enhanced activity requirements.

CRITICAL CARE & EMERGENCY DEPARTMENTS• Implementation of a short stay bed unit at Albury.• Commissioning of the newly re-furbished Wodonga Emergency Department.

CLINICAL OPERATIONS DIRECTORATE


WALWA

BRIGHT•

MT BEAUTY•

CORRYONG•

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As we commence our sixth year of AWH the directorate looks forward to defining priorities for improvement and continuing the work of providing high quality care for our catchment communities. While there will certainly be ongoing efforts for projects already underway additional improvement initiatives will include:

• Completion of the clinical operations business plan 2014-2016• Participation in the next iteration of the AWH strategic plan• Confirmation of the preferred bed configuration in line with the AWH service plan• Implement Code Grey response Albury Hospital• Strengthening the utilisation of Advanced Care Directives• Implementation of an integrated framework for Palliative Care • Key initiatives to progress effective processes for clinical handover and consent• Strengthened processes for patient flows to ambulatory services • Introduction of the Victorian PROMPT program - a training program for the management of maternity and neonatal emergencies.• Introduction of an additional Nurse Practitioner, aged care focussing on outreach to community and residential facilities.• Enhancement of AIN positions across inpatient services to support the high risk older patient in the acute setting.• Introduction of a model of care for medical procedures.• Improved processes for fracture clinic, outpatient orthopaedics and wound care.• Introduction of a fractured Neck of Femur (NOF) program that includes shared care between orthopaedics and geriatrics.• Planning for the transition of Albury Dental Services in January 2015.• Multiple initiatives to integrate Albury Community Health Services to AWH.• Redesign of Health Independence Programs (HIP)• Planning for the introduction of cardiology services.• Further development of the Parent and Baby Unit• Actively participate in the development and planning for the Regional Cancer Centre.• Clinical and support services workforce development.• Strengthening capacity for Risk identification and management.• Expanding paediatric tele-health services through Victorian Department of Health project aimed to improve access for Victorian regional and rural patients to sub specialist paediatric services • Implement Health Care Assistants for patient monitoring

ALLIED HEALTH SERVICES• Koolin Balit – program and updated strategic plan for Aboriginal Health Services.• Expansion of clinical educators for allied health disciplines.• Introduction of a post arthroplasty review (PAR) Clinic that enhances post-operative management for joint replacements. • Introduction of cognitive impairment assessment process in the acute setting by occupational therapy and speech pathology.

PROFESSIONAL DEVELOPMENT AND RESEARCH• Strengthened focus on staff training and education through a collaborative agreement with key local tertiary institutions, universities and other training providers.• Further development of the simulated learning environment (SLE) program across all clinical disciplines in partnership with la Trobe University.• Introduction of the Productive Ward and Productive Leader program across identified clinical departments.• Introduction of E-Learning program for clinical and mandatory training.

SUPPORT SERVICES• Introduction of an integrated security service.• Complete upgrade of CCTV system• Implementation of Code Grey at Wodonga to strengthen safety in the workplace in line with Improving Safety and Security in Victorian Health Services framework. • Participation in the E-Health project to further progress the introduction of electronic documentation/patient information systems across the organisation.• Introduction of a designated resource for fire safety and emergency/disaster management.• Enhanced Bariatric patient transfer capability• Consolidate transport booking process.• Upgraded radiology equipment at Wodonga.


• Corporate Records Management feasibility assessment completed• Deployment of new IV Pumps providing the latest technology and consistent equipment across the two main campuses• Establishment of an organisation-wide Capital Expenditure Management committee ensuring transparent decision making• Redesign and launch of a new AWH website• Implementation of Oracle Fixed Assets and Accounts Receivable enhancing financial operations and governance• Upgraded the Wodonga Hospital paging system

The year ahead will present more challenges and opportunities with further consolidation of Finance and Corporate Support service functions across AWH. A number of critical projects are already well underway including the establishment of a region-wide project team that will lead the implementation single Patient Administration System (PAS) across the health service. The directorate will also continue to make significant progress in consolidating all its services across all sites.

Key activities anticipated to be commenced or completed in 2014/15 are as follows:

• Progressive transition to new Health Purchasing Victoria (HPV) procurement policies for completion in June 2016• Implement a robust and comprehensive Financial Improvement Plan (FIP) to support the achievement of the approved 2014/15 budget• Support integration of mental health, drug and alcohol and community health services transitioning from NSW from 1 July 2014• Implement a comprehensive Waste Management Plan across all AWH sites• Transition to a common PABX and Paging Systems for Albury and Wodonga main campuses • Preparation for the implementation of Activity Based Funding (ABF) as part of the National Health Reform agenda• Implementation of a corporate records management system to improve processes and ensure relevant legislative and accreditation compliance• Development of clinical costing systems and approaches across all sites

REPORT BY MARTIN CLIFFORDExecutive Director Finance & Corporate Support

Finance and Corporate Support provides a range of services underpinning AWH operations, including food services, environmental services, supply and logistics, biomedical engineering, finance, administration services and information communication and technology (ICT). Corporately, the directorate is responsible for financial governance and reporting, fire safety, environmental management and contract and procurement oversight. Services are currently delivered through an amalgam of in-house, third party provider and contract arrangements that differ across each campus.

In the fifth year of AWH the Finance and Corporate Support directorate has continued to integrate and progressively consolidate those functions most critical to its operations. While continuing to support the delivery of safe and effective clinical services across all Campuses of AWH, the directorate has prioritised further enhancing its governance structures and projects critical to the further integration and consolidation of the corporate services supporting AWH Significant achievements include:

• Completion of the feasibility study for service provision options for corporate services ensuring in-house services continue• Sustainability Vision and action plan approved by the Board• Establishment of cross-campus administration management team• Completion of ICT Review and development of an Information Management strategic plan• Implementation of new rostering system, Roster On, for staff employed through the Wodonga Hospital.• A common menu management system, CBORD implemented across both main campuses• Establishment of an organisation-wide Capital Expenditure Management Committee ensuring transparent decision making• Completed the detailed dual campus financial review, including analysis of comparative performance with selected regional Victorian Health Services• Appointment of key leadership roles including an Environmental Services Manager, Revenue Manager, Clinical Products Manager and Financial Reporting and Analysis Manager

FINANCE AND CORPORATE SUPPORT DIRECTORATE


• We have strengthened our risk management processes. As part of a three yearly assessment cycle the Victorian Managed Insurance Authority assessed our risk management framework and as a consequence we commenced a series of risk management staff training workshops to again further improve the capability of managers to recognise and manage risks.• Our Rural Allied Health Team and District Nursing Service were assessed under the Community and Common Care Standards in November 2013 and all expected outcomes were met. We also continue to be fully accredited under the Aged Care Accreditation Standards as applied to the Blackwood Cottage Residential Aged Care Facility.

PHARMACY SERVICE• Our consolidated Pharmacy service over the year has integrated a number of activities across our two acute campuses over the year. In particular we have introduced PBS dispensing on discharge at both sites, which aims to streamline patient discharges with a smooth transition between hospital and home. There has also been this year a significant emphasis on medication safety, particularly in relation to infusions and medication prescribing.

HEALTH INFORMATIONThis year has marked the first full year of the AWH digital medical record. The project has successfully created:

• a single medical record across AWH, improving access to clinical information to support patient care;• offsite availability so consulting specialists can access their patient’s hospital records electronically;• the ability to provide electronic discharge summaries through the digital medical record to improve both the timeliness and accuracy of information provided to general practitioners.

REPORT BY DR GLENN DAVIESExecutive Director Medical Services

The Medical Services Directorate encompasses the key areas of Medical Workforce, Quality and Clinical Governance, Pharmacy Services and Health Information (including our digital medical record).

The Medical Services Directorate underwent a change of leadership during 2013/14 following the resignation of Dr Alastair Mah, Executive Director of Medical Services in May 2014 whereby Dr Glenn Davies was appointed to this position.

ACHIEVEMENTS THIS YEAR INCLUDE:

MEDICAL WORKFORCE • Medical staffing was further strengthened throughout the year. Almost all of our junior medical staff are now recruited directly by AWH. We have developed a comprehensive orientation and education program that operated throughout the year and many of our junior staff are now looking at pursuing further training within our region. • We have further strengthened and expanded medical staffing after hours on our acute campuses including the implementation of night ward cover and the 24 hour presence of on-site physician trainees.• We have established combined geriatric training positions with Mercy Health to further strengthen aged care services in Albury Wodonga.• We have actively recruited senior medical staff for our Emergency Department to meet the increasing demands for emergency services.

QUALITY AND CLINICAL GOVERNANCE• AWH is accredited by the Australian Council on Health Service Standards. In November 2013 AWH was assessed against these standards at its periodic review. The assessors confirmed our accreditation status and confirmed that all recommendations from a previous organisation wide survey were met. We have now commenced planning for our next major organisation wide survey which is scheduled for November 2015.

MEDICAL SERVICES DIRECTORATE


• The transfer of Albury based Mental Health and Drug and Alcohol services on the 1st July 2014 following an extensive piece of due diligence work involving a collaborative partnership with Murrumbidgee Local Health District during 2013-14.• Continuing work to ensure the integration of mental health services in the Northeast of Victoria with maturing systems to assist in improving clinical and corporate governance during 2013-14.• Successful preparation for the implementation of the new Victorian Mental Health Act that come into effect on the 1st July 2014• Substantial planning was undertaken to continue to align our services and reflect the clinical service planning that had been undertaken in the prior year as well as further developing models of care for our rehabilitation and recovery program. • The North East Child and Adolescent Mental Health Service (NECAMHS) introduced a new way of providing services, the Choice and Partnership Approach (CAPA) in July 2013. This substantially recast the way young people and families are being engaged and serviced in our region. • CAPA is a clinical system that is being widely implemented across the UK, New Zealand and parts of Australia. The aim is to provide user-friendly services to young people and families that are designed around their needs, accessible, safe and effective. The system uses quality parameters combined with processes to facilitate pathways through the service, attempting to avoid unnecessary waits. In doing so, it attempts to place the needs of families at the centre of care.• NECAMHS has operated without waiting lists since mid- January 2014 for the first time in many year. This change resulted in a 150% increase over the prior year in the number of clients seen after entry into the service.• Kerferd Acute Inpatient Unit Wangaratta implemented two projects aimed at improving the experience of patients. This was the Reducing Restrictive Interventions Project along with the commencement of the Safe Wards implementation, both being 12 month projects. Continuing reductions in the seclusion rates have occurred throughout the 2013-14 year with no episodes of restraint occurring.• Funding for the improvement of the physical facility that houses our adult community team in Wangaratta. This will be completed by the end of 2014.

REPORT BY PETER COLLICOATExecutive Director Mental Health

The Mental Health directorate provides public mental health services to the communities of North East of Victoria from Mansfield in the south and Yarrawonga in the West to Corryong in the East, including the cities of Wangaratta, Benalla and Wodonga. From July 2014 Albury Mental Health, including community mental health and Inpatient Services at Nolan House, along with Drug and Alcohol Services transferred to AWH extending our service boundaries into Southern NSW. North East and Border Mental Health Services (NEBMHS) operate from eleven different sites throughout North East Victoria and four in NSW.

OUR SERVICES INCLUDE• Acute Inpatient care in Wangaratta and Albury for Adults and Older People (Young people are admitted to Box Hill).• Adult Community Mental Health in three locations and providing outreach to smaller communities.• Integrated Primary Mental Health with the office in Wangaratta but covering the whole of the region.• Perinatal Mental Health and Infant Mental Health Services.• Early Psychosis Services in Wodonga and Wangaratta.• Hume Mental Health Specialist Visiting Service, Mental Health Specialist Outreach Services and the Border Private Psychiatry Service in Wodonga, Wangaratta and Beechworth.• Residential Rehabilitation and Recovery services in Wodonga and Beechworth.• Child and Adolescent Mental Health with three office locations.• Autism Assessment and Kids Early Action Programs.• Older Persons Mental Health in two sites. As well Cognitive Assessment and Behavioural Management Services for Dementia are provided to part of the region. • Residential Aged Care Specialist Service in Beechworth.• In addition we have our Mental Health Practice Development and Service Development staff.• Opening in September 2014 is Jarrah Retreat Wodonga providing sub acute residential services.

ACHIEVEMENTS THIS YEAR• Our Recovery transformation programs won two “Australia and New Zealand Mental Health Services national awards in 2013 for the work that has taken place. Our website recovery.awh.org.au won an award for innovative use of technology, while our transformative work with our clinical teams won an award in the category for assessment and treatment programs. This was positive recognition for the sustained work that many people have contributed.

MENTAL HEALTH SERVICES DIRECTORATE


LABOUR CATEGORY JUNECURRENT MONTH FTE

JUNEYTD FTE

2013 2014 2013 2014

Nursing 657.95 706.8 617.57 674.2

Administration and Clerical 191.09 205.31 194.72 199.07

Medical Support 52.53 71.78 55.69 70.2

Hotel and Allied Services 161.04 157.74 159.45 159.44

Medical Officers 12.34 12.18 22.45 13.00

Hospital Medical Officers 79.78 81.72 76.22 73.3

Sessional Clinicians 5.01 6.57 3.59 5.69

Ancillary Staff (Allied Health) 114.23 119.94 112.52 112.99

Dental Officers 3.67 4.01 3.14 3.82

Other Dental Clinicians 3.00 1.42 1.80 1.38

TOTAL 1,280.64 1,367.47 1,247.15 1,313.09

All employees of AWH are correctly classified in the above workforce data and are required to comply with the AWH Code of Conduct under their respective employment agreements. AWH is committed to applying the Public Sector employment principles and upholds the key principles of merit and equity in all aspects of the employment relationship. To this end we have policies and practices in place to ensure all employment related decisions including recruitment, training and retention are based on merit.

INJURY MANAGEMENT PERFORMANCEThroughout 2013/2014 the Health Safety and Injury Management Department, together with the work unit managers and supervisors, continued to reinforce an early intervention and supportive approach to the management of employees who are injured during the course of their employment.

Injury prevention strategies and effective return to work programs have combined to continue to reduce both the number of claims and total claims costs across the organisation.

Working within the constraints of the work environment and the individual circumstances of our injured workers, Managers and Human Resource Staff have achieved cost effective and sustainable outcomes for the organisation and our employees. Wherever practicable, AWH applies the same supportive approach to non-work related injuries.

REPORT BY DESIRÉE HARKERExecutive Director Human Resources

STRATEGIC FOCUS ON OUR PEOPLE AWH recognised the importance of strategic capital management, particularly in an environment where the integration of cross border health services has added significantly to the complexity and demand for contemporary human resource services. We place a high value on the development and sustainability of our workforce and have strengthened our focus on strategic people management at an Executive level.

Desirée Harker joined the Executive Management Team in March 2014 in the newly created role of Executive Director Human Resources. The role has responsibility for leading and implementing human capital strategies, objectives and practices that enable our workforce to deliver high quality health care services to our community and enable our people to reach their full potential. WORKFORCE PROFILEAt 30 June 2014 AWH’s Full Time Equivalent (FTE) staff was 1,367. The FTE is the total number of staff (total headcount) adjusted for casual and part-time staff to show the full-time equivalent. This compares to a FTE of 1,247 at 30 June 2013 and reflects the expansion of health services principally in the medical, nursing and allied health areas.

HUMAN RESOURCE DIRECTORATE

WORKFORCE DATA DISCLOSURE 2014

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As is apparent to every Borella Road commuter, the Albury Wodogna Regional Cancer Centre is developing at a rapid pace.

From the turning of the sod in December 2013, Hansen Yunken, its workforce and contractors are transforming the landscape.

By July 2014 we see the West Wing comprising the Wellness Centre, the clinical consulting and research wing and a pod of 10 inpatient beds arising before us. The Wellness Centre will provide individual and group programs to help people and families affected by cancer, including information sessions, support groups and complementary health programs.

The construction style of the prefabricated segments creates a weekly transformation.

On the East Side, the radiotherapy bunkers are obvious as are the fire stairs.

The vision of Albury Hospital from Borella Road is now forever changed. It is expected that the floor areas will be in place by December and once enclosed the hard yards of intricate fit out will commence, ready for occupation in late 2015.

PROGRESS ON THE ALBURY WODONGA REGIONAL CANCER CENTRE


AWH is committed to maintaining and improving the health and wellbeing of the people, communities and environment of Southern New South Wales and North East Victoria. AWH recognises that in order to do this, we must lead by example and take responsibility for our environmental footprint.

As one of the largest regional health services of Victoria, AWH has adopted appropriate environmental management planning processes to incorporate environmental sustainability in its planning, operations and policy.

ENVIRONMENTAL PERFORMANCE

ELECTRICITY Drop in consumption of 6.5% compared to previous year; due to new chiller sets and staff behaviour programs.

WATER Rise in water consumption on previous year by 3.6% due to capital works and more accurate recording.

NATURAL GAS Drop in consumption of 1.8% compared to previous year due to changeover of boilers and improved heating exchanges.

CLINICAL WASTE Drop in clinical waste generation of 14%, due to behaviour programs targeting segregation of waste by staff.

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2011-12 2012-13 2013-14

2011-12 2012-13 2013-14

2011-12 2012-13 2013-14

2011-12 2012-13 2013-14

ELECTRICITY (KWH)

WATER (KL)

NATURAL GAS (GJ)

CLINICAL WASTE (KG)

1. Data referred to in the graphs are for the Albury and Wodonga Campus only2. For more detailed breakdown please refer to the AWH Sustainability Report 2013-14


CONSULTANT PURPOSE OF CONSULTINGEXPENDITURE

2013/14$

FUTURE$

BILLARD LEECE PARTNERSHIP

Completion of feasibility assessment for the to be constructed cardiac catheterisation laboratory

10,000.00

BIRUU HEALTH PTY LTD Provision of assistance with strategic planning and service planning for mental health services and the Albury Wodonga Regional Cancer Centre

55,625.91

BYRON COLLINS Information Technology consulting services including support to major IT projects, review of IT services and assistance with preparation of an IT strategic plan

79,200.00 1,200

CLE CONSULTING AUSTRALIA PTY LTD

Workforce consulting services including support with culture change, leadership and workforce strategic planning

59,784.71

COGENT BUSINESS SOLUTIONS PTY LTD

Completion of corporate and non-clinical support services feasibility assessment

38,620.57

METIS ADVISORY Provision of advice regarding financial negotiations in support of the agreement between partner organisations regarding the Albury Wodonga Regional Cancer Centre

46,826.03

MICHAEL C RHOOK Financial and activity modelling and benchmarking services

13,500.00

MKM HEALTH PTY LIMITED

Completion of a business case for a new Patient Administration System submitted to the Department of Health for funding

84,413.65

387,970.87

STATUTORY COMPLIANCE AND MANDATORY REPORTINGMANNER OF ESTABLISHMENT AND RELEVANT MINISTERSAlbury Wodonga Health (AWH) is established under the Health Services Act 1988. The responsible Ministers for Health during the reporting period were the Honourable David Davis, MLC, Minister for Health and Ageing and the Honourable Mary Wooldridge MLA, Minister for Mental Health

OBJECTIVES, FUNCTIONS, POWERS AND DUTIESThe Objectives, Functions, Powers and Duties of AWH are described in the By-Laws of the organisation.

DETAILS OF INDIVIDUAL CONSULTANCIES > $10,000A number of consultants were contracted to work for AWH in 2013/14. As required by the Victorian Industry Participation Policy Act 2003. A summary of these consultancies is provided herewith:

DETAILS OF CONSULTANCIES < $10,000In 2013-14 Albury Wodonga Health engaged six consultancies where the total fees payable to the consultants were less than $10,000 with a total expenditure of $25,611.65 (excl GST).


FREEDOM OF INFORMATION APPLICATIONS 2013/14Under the Freedom of Information Act 1982, and the Health Records and Information Privacy Act 2002, AWH received the following requests:

CARERS RECOGNITION ACT 2012AWH meets its obligations under the Carers Recognition Act 2012. Health professionals and contracted Visiting Medical Officers understand their obligations and are trained in the care relationship principles. AWH has procedures and processes through which carers receive support, education and assistance depending on their unique situation. Nominated carers are identified in the AWH admission process, including such services as acute, community health and palliative care. Where it is not practicable for AWH to provide all facets of support and assistance required, carers are referred to external care support agencies. AWH acknowledges that carers may be in the form of family members, case workers, medical power of attorney, and / or substitute decision makers. There were no formal complaints in 2013-14 regarding failure to appropriately support and assist carers.

HEALTH AND SAFETY Workplace Health & Safety is in the forefront of the AWH armoury of staff wellbeing. Working safely is a condition of employment with AWH. All new staff are inducted to the AWH WHS programme. Consultation and engagement with all who work within, and with, AWH is fundamental to improving safety performance. AWH has an active team of Health & Safety Representatives who participate in the reporting and monitoring of Workplace Health & Safety issues for staff through their participation in the WorkplaceHealth & Safety Consultative Committee (WHSCC).

The WHCCCs report through the Workplace Health & Safety Systems Management Committee to the Executive Committee and the Board of Directors through the Audit & Risk Committee. The performance of the health service is measured against an audit tool designed by the Department of Health (VIC) and performance is improving annually.

EX-GRATIA PAYMENTSAWH made no ex-gratia payments in the 2013/2014 financial year.

PROTECTED DISCLOSURE ACT 2012The Protected Disclosures Act 2012 (Victoria) is made operational through the AWH Protected Disclosure Policy and Procedure (October 2013). These outline AWH obligations under the Act and the processes by which any staff member of AWH may make a disclosure about improper conduct without fear of retribution or discrimination. There were no reports made to the Independent Broad-based Anti-corruption Commission (IBAC) in 2013-2014.

COMPLIANCE WITH BUILDING AND MAINTENANCE PROVISION OF BUILDING ACT 1993AWH complies with the requirements of the Building and Maintenance of Building Act 1993. Routine inspections and ongoing maintenance programs were undertaken to ensure buildings on both campuses are maintained in a safe and serviceable condition. Where required, AWH implemented recommendations arising from those inspections through a program of rectification and maintenance works.

NATIONAL COMPETITION POLICYAWH supports and complies with the National Competition Policy. In addition, the Victorian Government’s competitive neutrality pricing principles for all relevant business activities have been applied.

VICTORIAN INDUSTRY PARTICIPATION POLICY ACT 2003AWH abides by the Victorian Industry Participation Policy Act 2003. In 2013/14 one contract commenced by AWH under this Act.

The contract was:• The Wodonga Hospital Inpatient Rehabilitation Ward (AWH 09) to the value of $1.8. Used 80% local content and retained 30 EFT. Skills transfer saw the retention of one (1) existing apprentice.

The contracts completed were:• The Wodonga Hospital Day Procedure Unit and Emergency Department Upgrade to the value of $3m. Used 95% local content and created for length of the project 38 additional EFT and ensured the retention of 18 EFT. Skills transfer saw the recruiting of 1 new apprenticeship and the retention of 1 existing apprentice.

• The Supply Installation & Commissioning of a PET/CT Scanner. This project was deemed not contestable by the ICN and as such there were no specific commitments in relation to local content.

AWH will continue to comply with the regulations of the VIPP and implement the policy to works and contracts as it applies.

FOI Requests received 399

Access granted 383

Requests Denied 0

Request not proceeded with 5

No documents 11


ADDITIONAL INFORMATIONIn compliance with the requirements of the Standing Directions of the Minister for Finance, details in respect of the items listed below have been retained by Albury Wodonga Health and are available to the relevant Ministers, Members of Parliament and the public on request (subject to the freedom of information requirements, if applicable):

a) A statement of pecuniary interest has been completed;

b) Details of shares held by senior officers as nominee or held beneficially;

c) Details of publications produced by the Department about the activities of the Health Service and where they can be obtained;

d) Details of changes in prices, fees, charges, rates and levies charged by the Health Service;

e) Details of any major external reviews carried out on the Health Service;

f) Details of major research and development activities undertaken by the Health Service that are not otherwise covered either in the Report of Operations or in a document that contains the financial statements and Report of Operations;

g) Details of overseas visits undertaken including a summary of the objectives and outcomes of each visit;

h) Details of major promotional, public relations and marketing activities undertaken by the Health Service to develop community awareness of the entity and its services;

i) Details of assessments and measures undertaken to improve the occupational health and safety of employees;

j) General statement on industrial relations within the Health Service and details of time lost through industrial accidents and disputes, which is not otherwise detailed in the Report of Operations; and

k) A list of major committees sponsored by the Health Service, the purposes of each committee and the extent to which the purposes have been achieved.

l) Details of all consultancies and contractors including consultants/contractors engaged, services provided, and expenditure committed for each engagement.

ATTESTATION ON DATA INTEGRITYI, Dr Stuart Spring, certify that Albury Wodonga Health Service has put in place appropriate internal controls and processes to ensure that reported data reasonably reflects actual performance. Albury Wodonga Health has critically reviewed these controls and processes during the year.

Dr Stuart SpringChief Executive Officer, Albury Wodonga Health

ATTESTATION FOR COMPLIANCE WITH THE MINISTERIAL STANDING DIRECTION 4.5.5.1 - INSURANCEI, Dr Stuart Spring certify that Albury Wodonga Health Service has complied with Ministerial Direction 4.5.5.1 - Insurance.

Dr Stuart SpringChief Executive Officer, Albury Wodonga Health__ August 2014

ATTESTATION ON COMPLIANCE WITH AUSTRALIAN/NEW ZEALAND RISK MANAGEMENT STANDARDI, Dr Stuart Spring, certify that Albury Wodonga Health Service has risk management processes in place consistent with the AS/NZS ISO j31000:2009 and an internal control system is in place that enables the executives to understand, manage and satisfactorily control risk exposures. The Audit and Risk Committee verifies this assurance and that the risk profile of Albury Wodonga Health has been critically reviewed within the last 12 months.

Dr Stuart SpringChief Executive Officer, Albury Wodonga Health__ August 2014

RESPONSIBLE BODIES DECLARATIONIn accordance with the Financial Management Act of 1994, I am pleased to present the Report of Operations for Albury Wodonga Health Service for the year ending 30 June 2014.

Hon Louis LiebermanChairman, Albury Wodonga Health__ August 2014


DISCLOSURE INDEX

LEGISLATION REQUIREMENT PAGE REFERENCEMINISTERIAL DIRECTIONS

REPORT OF OPERATIONS

CHARTER AND PURPOSE

FRD 22E Manner of establishment and the relevant Ministers 4

FRD 22E Objectives, functions, powers and duties 4

FRD 22E Nature and range of services provided 4

MANAGEMENT AND STRUCTURE

FRD 22E Organisational structure

FINANCIAL AND OTHER INFORMATION

FRD 10 Disclosure index 20

FRD 11A Disclosure of ex-gratia payments 18

FRD 12A Disclosure of major contracts 18

FRD 21B Responsible person and executive officer disclosures A2

FRD 22E Application and operation of Protected Disclosure Act 2012 18

FRD 22E Application and operation of Carers Recognition Act 2012 18

FRD 22E Application and operation of Freedom of Information Act 1982 18

FRD 22E Compliance with building and maintenance provisions of Building Act 1993

18

FRD 22E Details of consultancies over $10,000 17

FRD 22E Details of consultancies under $10,000 17

FRD 22E Major changes or factors affecting performance A2

FRD 22E Occupational health and safety 20

FRD 22E Operational and budgetary objectives and performance against objectives

A1

FRD 24C Reporting of office-based environmental impacts 16

FRD 22E Significant changes in financial position during the year A2

FRD 22E Statement of availability of other information 19

FRD 22E Statement on National Competition Policy 18

FRD 22E Subsequent events A2

FRD 22E Summary of the financial results for the year A1

FRD 22E Workforce Data Disclosures including a statement on the application of employment and conduct principles

13

FRD 25B Victorian Industry Participation Policy disclosures 18

FRD 29 Worforce Data disclosures 13

SD 4.2(g) Specific information requirements A2

SD 4.2(j) Sign-off requirements A1

SD 3.4.13 Attestation on Data Integrity A1

SD 4.5.5.1 Ministerial standing direction 4.5.5.1 compliance attestation A1

SD 4.5.5 Risk management compliance statement A1

The annual report of Albury Wodonga Health is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements.


DISCLOSURE INDEX CONT’DLEGISLATION REQUIREMENT PAGE REFERENCE

FINANCIAL STATEMENTS

Financial statements required under Part 7 of the FMA

SD 4.2(a) Statement of changes in equity A2

SD 4.2(b) Comprehensive operating statement A2

SD 4.2(b) Balance Sheet A2

SD 4.2(b) Cash flow statement A2

OTHER REQUIREMENTS UNDER STANDING DIRECTIONS 4.2

SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements

A2

SD 4.2(c) Accountable officer’s declaration A2

SD 4.2(c) Compliance with Ministerial Directions A2

SD 4.2(d) Rounding of amounts

LEGISLATION

Freedom of Information Act 1982 18

Protected Disclosure Act 2001 18

Victorian Industry Participation Policy Act 2003 18

Building Act 1993 18

Financial Management Act 1994 A2

A1 - Appendix 1, Key financial and service performance reportingA2 - Appendix 2, Financial Statements

A special thank you to the staff, patients and visitors of Albury Wodonga for their contribution to the Annual Report.Thank you also to the Border Mail for the provision of some of the photographs contained within this report.

ALBURY WODONGA HEALTHPO Box 326

Albury NSW 2640 ABN: 31 569 743 618

ALBURY HOSPITALBorella Road

Albury NSW 2640Ph: 02 6058 4744Fax: 02 6058 4528

WODONGA HOSPITALVermont Street

Wodonga VIC 3690Ph: 02 6051 7111

Fax: 02 6051 7477

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