Cairns and Hinterland Hospital and Health Service

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Acknowledgment to traditional ownersThe Cairns and Hinterland Hospital and Health Service respectfully acknowledges the traditional owners and custodians both past and present of the land and sea which we service; and declare the Cairns and Hinterland Hospital and Health Service’s commitment to reducing inequalities between Indigenous and non-Indigenous health outcomes in line with the Australian Government’s Close the Gap initiative.

Public Availability StatementOur Annual Report is available on our website at: http://www.health.qld.gov.au/cairns_hinterland/

We invite your feedback on our report. Please contact our Communications team on (07) 4226 3243.

CopyrightCairns and Hinterland Hospital and Health Service 2014-15 Annual Report

© Cairns and Hinterland Hospital and Health Service 2015

LicenceThis annual report is licensed by the State of Queensland (Cairns and Hinterland Hospital and Health Service) under a Creative Commons Attribution (CC BY) 3.0 Australia licence.

AttributionContent from this annual report should be attributed as: The State of Queensland (Cairns and Hinterland Hospital and Health Service) Annual Report 2014–15.

ISSN NUMBER: 2201-9863

Interpreter Service StatementThe Queensland Government is committed to providing accessible services to Queenslanders from all culturally and linguistically diverse backgrounds. If you have difficulty in understanding the annual report, you can contact us on (07) 4226 9768 and we will arrange an interpreter to effectively communicate the report to you.

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The Honourable Cameron Dick MPMinister for Health and Minister for Ambulance ServicesMember for WoodridgeLevel 19, 147-163 Charlotte StreetBrisbane Qld 4000

Dear Minister,

I am proud to present the Annual Report and financial statements 2014-15 for the Cairns and Hinterland Hospital and Health Service.

I certify that this annual report complies with:

• the prescribed requirements of the Financial Accountability Act 2009 and the Financial and PerformanceManagement Standard 2009, and

• the requirements set out in the Annual report requirements for Queensland Government agencies for the2014-15 reporting period.

A checklist outlining the annual reporting requirements can be found at page 120 of this Annual Report or accessed at http://www.health.qld.gov.au/cairns_hinterland/

Yours sincerely

Robert NormanChairCairns and Hinterland Hospital and Health Board

4 September 2015

LETTER OF COMPLIANCE

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Contents

Letter of compliance 3

Contents 5

Our Chair and Chief Executive 8

About us 11

Our purpose and values 11Our facilities 12Our clinical services provided 13

Our corporate performance 14

Our capital works, building and facilities 18

Our operational performance 20

Building on health and service delivery initatives 22Divisional highlights 24

Our financial performance 30

Our strategic priorities 35

Our governance 43

The Cairns and Hinterland Hospital and Health Board 44Our executive 48Our organisational structure 52

Our people 54

Our partners 61

Financial statements 2014 - 2015 64

Independent auditor’s report 114

Glossary 116

Compliance checklist 120

Contact us 122

CONSOLIDATION AND COLLABORATION ANNUAL REPORT 2014-2015

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81.2%Proportion of people admitted

or treated and discharged within 4 hours of presentation to an

emergency department

4.27Average number of days

that patients stayed in our hospitals

(acute overnight patients only)

150,440 Number of emergency presentations

225,541 Number of outpatient clinic attendances

41,154 Number of overnight admissions

50,453 Number of same day admissions

91,607 Total number of admissions

3,264Number of babies born

764 Number of

Hospital in the Home admissions

6,609

98%

Number of elective surgery patients treated

Percentage of elective surgery treated in time

ELECTIVE SURGERY

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Cairns and Hinterland Hospital and Health Service by numbers

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The Cairns and Hinterland Hospital and Health Service is committed to understanding our community’s culturally diverse needs and providing holistic, innovative and responsive models of patient care.

Manner of establishmentOn 1 July 2012 the Cairns and Hinterland Hospital and Health Service was established as a statutory body under the provisions of the Hospital and Health Boards Act 2011 (Qld). The Cairns and Hinterland Hospital and Health Service through the Board, reports to the Queensland Minister for Health and Minister for Ambulance Services, the Honourable Cameron Dick, MP.

The functions of a Hospital and Health Service are outlined in the Hospital and Health Board Act 2011 (Qld), with the main function being to deliver the hospital services, other health services, teaching, research and other services stated in our Service Agreement.

Our roleThe Cairns and Hinterland Hospital and Health Service performs a key role in the provision of public health services in Far North Queensland. We are committed to collaborating and consolidating our strong relationships with community healthcare providers, such as general practitioners, community health services and affiliated healthcare agencies.

Geographically, we cover the municipalities of Cairns Regional Council, Cassowary Coast Regional Council, Croydon Shire Council, Mareeba Shire Council, Douglas Shire Council, Etheridge Shire Council, Tablelands Regional Council and Hinchinbrook Shire Council.

THE CAIRNS AND HINTERLAND HOSPITAL AND HEALTH SERVICE

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In our 2014-2015 Annual Report, we reflect on a year of consolidation and collaboration for the Cairns and Hinterland Hospital and Health Service (Health Service). We highlight how we are working to respond to the increasing demand for our services, acknowledge our challenges and provide an outlook for the year ahead.

Robert Norman Chair

Julie Hartley-Jones Chief Executive

In the face of challenging performance targets, ever-increasing demand for services and fierce competition for a limited funding pool, our organisation continued to build on its capacity to provide top quality health care to the people of the Cairns, Hinterland and north east Australian regions.

This year saw the return of urology services to Cairns for the first time in more than a decade. Until February 2015, the Health Service had an agreement with the Mater Hospital in Brisbane to deliver urology services for our community. Those services are now delivered locally at Cairns Hospital. Demand has far exceeded our expectations.

In April 2015, we introduced a 24-7 on-call cardiac catheter service for patients experiencing a heart attack in the Far North. Cardiac services have come a long way in the past decade, with no cardiologist cover in Cairns in 2004.

The final piece of the diagnostic puzzle for oncology services in the Far North will be delivered soon. Major construction works to prepare the site for the $2.4 million PET-CT scanner are now complete, with the scanner installed at the site adjacent to the Liz Plummer Centre in June 2015. Final calibration and commissioning works are now underway, with the service expected to commence in September 2015.

We have responded to the growing demand for mental health services, particularly those aimed at supporting people to reintegrate into the community. A 20-bed Mental Health Community Care Unit has been constructed and is expected to commence operation by the end of 2015. We also secured funding and identified a preferred site for a Youth Prevention and Recovery Centre (Y-PARC). First of its kind in Queensland, the facility will be for 16 to 21 year olds who have recently experienced, or who are at risk of experiencing, an acute episode of mental illness.

This year, Australia’s principal health governing body, the Australian Council of Healthcare Standards, granted the Health Service a further four years accreditation. For the first time the accreditation survey involved all facilities except one, with visits to 39 different sites to assess services against more than 200 clinical and organisational criteria. This is

OUR CHAIR AND CHIEF EXECUTIVE

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a fantastic testament to our efforts to consolidate our services, given the growth of the organisation and the wider range of specialist services delivered since the previous accreditation cycle.

Cairns Hospital continued to operate as a major acute facility while a $446.3 million redevelopment took shape around us – a credit to our staff and our community.

The redevelopment is now entering its final stages with the refurbishment of blocks A and B, and some areas of Block C, well underway and due for completion next year. There are still highlights to come from the final stages of the redevelopment including the establishment of an eight-bed adolescent unit and a birthing centre for women with low risk pregnancies.

Growing demand has posed some challenges for the Health Service in meeting its targets. In 2014-15, the number of patients moving through Cairns Hospital’s Emergency Department (ED) within four hours reduced to 69.3 per cent, down from 71.7 per cent last financial year. This is compounded by Cairns Hospital regularly operating at 100 per cent or higher occupancy and a 2.5 percent increase in ED presentations across the Health Service. We continue to work to improve the patient flow through EDs and in August 2014 introduced a new, 32-bed Medical Assessment Unit (MAU) to improve patient assessment and ease pressure on the ED at Cairns Hospital.

The Health Service is now treating 98 per cent of patients requiring elective surgery within the clinically recommended time, an increase against last year’s 91 per cent. For much of 2014-15, the Health Service treated all patients within the clinically recommended time.

The demand for outpatient services has increased significantly in recent years with more than 21,440 people waiting for a Specialist Outpatient Clinic appointment across the Health Service as at 30 June 2015, including 14,383 waiting for surgical specialties. Sixty-four per cent of these surgical patients were waiting longer than the clinically recommended wait time.

In May 2015, the State Government allocated $2.4 million to the Health Service to tackle the outpatient wait list, and this will be a continued focus into 2015-2016.

Five organisations involved in health care across the region formed a consortium to create a new company, the North Queensland Primary Health Care Collaborative, set up to run the North Queensland Primary Health Network, which commenced operation on 1 July 2015. This will allow us to better collaborate and integrate our services with primary health service providers, and provide patients with the right care, in the right place and at the right time.

An historic agreement between the Health Service and Gurriny Yealamucka Health Services Aboriginal Corporation saw primary health care services in Yarrabah transitioned to community control on 1 July 2014 – a first for Queensland. Since that time Gurriny Yealamucka Health Services has provided a broader range of services to the local community as part of a holistic service model.

Fundamental to our success is the dedication and commitment of our Health Service team. We would like to thank everyone – from our clinical staff, to our operational and administrative staff, from the volunteers and consumers, to the leadership of Board members, the Executive Management Team and Divisional Directors. All have risen to the challenge in collaboration to consolidate the services we provide and work with the community, stakeholders and partners.

Now that 2015-16 is underway, we must continue to respond to the health needs of our community. A key challenge is the growing and ageing population. An extra 67,000 people are expected to live in our catchment area by 2026, and close to one in five will be aged over 65. We are ready for the challenge. Key to this will be pursuing innovation and working with partners to better integrate our services.

In the meantime, it is with great pleasure that we present to you the Cairns and Hinterland Hospital and Health Service’s 2014-2015 Annual Report.

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The vision of the Cairns and Hinterland Hospital and Health Service is to provide world-class health services to improve the social, emotional and physical wellbeing of people in the Cairns, Hinterland and north east Australian regions.

The Cairns and Hinterland Hospital and Health Service is responsible for providing health services to the people of the Far North. With a geographical area of 141,000 square kilometres spanning from Cairns to Tully in the south, Cow Bay in the north and Croydon in the west, our staff commit every day to improving the social, emotional and physical wellbeing of people in the Cairns, Hinterland and north east Australian regions. The outer western region of our Health Service encompasses extremely remote communities.

The Cairns and Hinterland Hospital and Health Service supports a population of 283,197 which is forecast to grow by nine per cent by 2026. The highest level of growth will occur within the 65 and over age group. Tourism is a key industry and contributes to a relatively high transient population. It is estimated that nine per cent of the population are Indigenous Australians, compared to 3.5 per cent for Queensland as a whole.

Cairns Hospital is the specialist referral hospital for Far North Queensland, as we deliver health services across the continuum of care and provide health services to the people of Torres and Cape Hospital and Health Service.

Our purpose The purpose of the Cairns and Hinterland Hospital and Health Service is to:

• provide holistic, innovative and responsive modelsof patient care;

• enable caring, highly skilled and dedicated staff;

• facilitate partnerships providing internationallyrecognised education and research;

• provide equitable, integrated and sustainableservices; and

• engage and understand our communities’culturally diverse needs.

Our values• Customers first

• Ideas into action

• Unleash potential

• Be courageous

• Empower people

ABOUT US

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Our hospital facilities Atherton Hospital – 56 beds

Babinda Multi-Purpose Health Centre – 22 beds

Cairns Hospital – 571 beds

Gurriny Yealamucka Health Service (Yarrabah)

Gordonvale Hospital – 24 beds

Herberton Hospital – 38 beds

Innisfail Hospital – 49 beds

Mareeba Hospital – 53 beds

Mossman Multi-Purpose Health Service – 32 beds

Tully Hospital – 20 beds

Primary Health CentresChillagoe Primary Health Centre

Croydon Primary Health Centre

Dimbulah Primary Health Centre

Forsayth Primary Health Centre

Georgetown Primary Health Centre

Malanda Primary Health Centre

Millaa Millaa Primary Health Centre

Mount Garnet Primary Health Centre

Ravenshoe Primary Health Care Centre

Community Health CentresCommunity health services include: before and after hospital care; cardiac rehabilitation; community nursing; counselling services; hearing health screening; health education; home care services; immunisation services; oral health (dental clinics); Positive Parenting Program; school health; and baby clinics.

Location of Community Health Centres

Atherton Primary Health Care Centre

Cairns Community Health• Cairns North Community Health• Edmonton Community Health Centre• Smithfield Community Health Centre

Innisfail Community Health Centre

Jumbun Community Health Care Centre

Mission Beach Community Health Centre

Tully Community Health Centre

Other ServicesThere is an Integrated Mental Health Program and a Sexual Health Service in Cairns. In addition, there are Alcohol, Tobacco and Other Drug Service (ATODS) centres in Cairns, Mossman, Innisfail and Mareeba.

Lotus Glen Health Service

Etheridgeshire Remote Healthcare Clinics• Einasleigh• Mt Surprise• The Lynd

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Clinical Services provided We provided the following services through our facilities (Note: not all facilities provide all services):

Inpatient Services

Anaesthetic services Breast surgery Burns (low acuity burns) Cardiology Chemotherapy and radiotherapy Children’s services Colorectal surgery Critical care Dental surgery Diagnostic endoscopy Drug and alcohol servicesEar, nose and throat Endocrinology Gastroenterology General medicine General surgery Gynaecology Haematology Immunology and infections Interventional cardiology Maternity Medical oncology Neurology Ophthalmology Orthopaedics Pain management Palliative care Plastic and reconstructive surgery Psychiatry Renal Respiratory medicine Rheumatology Sub-acute Thoracic surgery Urology Vascular surgery

Outpatient and Ambulatory services

Allied Health (psychology, nutrition, podiatry, prosthetics, physiotherapy, occupational therapy, social work and speech pathology)

Cardiac surgery Cardiology Children’s services Dementia Diabetes Drug and alcohol Ear nose and throat Emergency department Endocrinology Gastroenterology General surgery Gynaecology Haematology Infectious diseases Internal medicine Maternity Mental health Neonatal Neurology Older persons Oncology Ophthalmology Paediatric medicine Paediatric surgery Pain management Palliative care Plastic and reconstructive surgery Rehabilitation Renal Rheumatology Thoracic medicine Urology

Interventions and Procedures

Chemotherapy Dialysis Endoscopy Interventional cardiology Interventional radiologyRadiation oncology