Prepared by

Teresa Anderson

Chief Executive

Jacquie Ferguson

Director of Finance

August 2016

SLHD budget presentation 2015/16

SLHD budget presentation 2015/16

Excellence in Health Care

SLHD budget presentation 2015/16

Dr Teresa Anderson, Chief Executive

Opening and welcome

Dr Teresa Anderson and Ms Jacquie Ferguson

Budget presentation

Dr Teresa Anderson, Chief Executive

Questions

1

Wrap up of 2015/16

$M $ VAR % VAR STATUS

TOTAL EXPENDITURE $1,566.1M $6.10M (F) 0.38% (PERFORMING)

TOTAL REVENUE $1,476.1M -$5.97M (U) -0.40% (UNDER PERFORMING)

TOTAL NCoS $90.0M $0.13M (F) 0.14% (PERFORMING)

GENERAL FUND FOR YEAR TO 30 JUNE 2016

2

Wrap up of 2015/16

$M $ VAR % VAR STATUS

TOTAL EXPENDITURE $27.372M -$1.632M (U) -6.34%

TOTAL REVENUE $47.569M $9.494M (F) 24.9% (PERFORMING)

TOTAL NCoS $20.196M $7.862M (F) 63.7% (PERFORMING)

SPECIAL PURPOSE AND TRUST FUND FOR YEAR TO 30 JUNE 2016

3

Wrap up of 2015/16 FACILITY LEVEL FINANCIAL PERFORMANCE 30 June 2016:

HOSPITAL / SERVICE 2015/16

NCoS ($M)

% 2014/15

NCoS ($M)

%

RPA $9.210M (U) -1.74% $9.554M(U) -1.97%

CONCORD $3.133M (U) -1.10% $4.629M (U) -1.78%

CANTERBURY $1.439M (U) -1.52% $0.206M (U) -0.23%

BALMAIN $0.110M (F) 0.36% $0.012M (F) 0.04%

IRO $0.190M (F) 1.08% $0.638M (U) -3.74%

SYDNEY DENTAL $0.516M (F) 1.21% $0.009M (F) 0.02%

MENTAL HEALTH $0.129M (U) -0.13% $2.360M (U) -2.76%

THOMAS WALKER $0.147M (U) -3.07% $0.005M (F) 0.12%

COMMUNITY HEALTH $0.380M (F) 1.15% $0.748M (U) -2.61%

POPULATION HEALTH $0.254M (F) 2.89% $1.455M (F) 16.89%

4

2015/16 Achievements

PROJECT EXPENDITURE

RPA RADIOLOGY REPLACEMENT OF CT1 AND CT2

SCANNERS

$4.168M

RPA JOHN LOWENTHAL (JL) THEATRES - DA VINCI

ROBOT $3.500M

RPA RADIOLOGY REPLACEMENT OF

ANGIOGRAPHY EQUIPMENT ROOM 1 AND 2

$3.300M

RPA INSTITUTE OF ACADEMIC SURGERY $1.508M

RPA BUILDING 63 LIFT MODERNISATION $0.500M

CONCORD INTERVENTIONAL HYBRID VASCULAR

THEATRE

$4.488M

CONCORD HOSPITAL – BIOLOGICAL RESEARCH

FACILITY

$3.000M

CONCORD HOSPITAL SPECT-CT CAMERA

REPLACEMENT

$1.254M

5

2015/16 Achievements WORK IN PROGRESS PROJECTS EXPENDITURE

DENTAL HOSPITAL REFURBISHMENT $2.183M

MEDICAL RESEARCH INFRASTRUCTURE

INITIATIVES PHASE 1 (SLHD)

$2.500M

2015/16 ASSET REPLACEMENT AND

REFURBISHMENT PROGRAM

$0.494M

BED REPLACEMENT $1.000M

6

2015/16 Achievements

156,152 people attended emergency departments

across SLHD

41,612 operations were performed in our hospitals

165,524 admissions and discharges across our

hospitals

6,658 babies were born at RPA

and Canterbury

7

2015/16 Achievements

Maintained performance at level 0 for the full year – 66

months in a row

Came in on budget

Maintained surgical performance at 0,0,0

Significantly improved performance on most key

performance indicators including Emergency Treatment

Performance

Successful accreditation of Sydney Dental Hospital and

Oral Health Services against national standards

8

2015/16 Achievements

Nursing Transfer of Care (TOC)

at RPA – successfully

established an Emergency

Department nursing Transfer of

Care program in partnership

with the NSW Ambulance

Service.

Institute of Academic Surgery

at RPA – officially opened the

IAS and the RPA Transplant

Institute building and launched

the SLHD Surgical Robotic

Program.

9

2015/16 Achievements

Canterbury Hospital consistently met its emergency

department targets (including Emergency Treatment

Performance, triage and surgical targets) throughout

2015-16.

10

• The Emergency Department

Short Stay Unit was opened

at Canterbury Hospital, which

is well utilised by clinicians to

ensure best patient care and

flow throughout the

emergency department.

2015/16 Achievements The Telopea ward was refurbished, which has helped to

ensure the ward’s aged care and rehabilitation focus.

This ward now has a purpose-built bariatric room, with a

ceiling hoist.

Canterbury Hospital received the 2015 NSW Health

Harry Collins Award for reducing the incidence of

catheter associated urinary tract infections.

11

2015/16 Achievements

Rollout of the Electronic Medication

Management System ‘eMeds’.

Concord was the first public

hospital in NSW to implement

eMeds and received the Minister’s

prize for Innovation at the NSW

Health Awards 2015.

Completion of schematic design for

the Concord Hospital

redevelopment.

Construction and opening of the

hybrid theatre as well as

refurbishment of theatres 3 and 4.

12

2015/16 Achievements

Procurement of new MRI machine and new

angiography machine in the Radiology Department at

Concord.

Concord Hospital completed a hospital-wide bed

replacement program with electric beds delivered to all

wards as of June 2016.

Balmain Hospital Physiotherapy Department received

funding as part of “The Pitch” in September 2015 for the

purchase of a Litegait patient hoist.

13

2015/16 Achievements

Periodic review was conducted by ACHS surveyors in

October 2015. Balmain Hospital met all criteria in each

of the reviewed standards, successfully closed off the

two previous recommendations and did not receive any

new recommendations. Balmain Hospital was awarded

three met with merits in regards to hand hygiene.

The Falls Safety Huddle Review Tool, a clinical initiative

to address falls risk and incidents, was introduced

across all wards at Balmain Hospital in December 2015.

14

2015/16 Achievements

Sydney Dental Hospital and Oral Health Services

successfully met the accreditation requirement under

the ACQSHC National Standards and achieved 14 met

with merits.

Sydney Dental Hospital and Oral Health Services

successfully decanted prosthodontics, periodontics and

endodontics and completed half of the construction of

level 4 refurbishment for these departments.

15

2015/16 Achievements

Youth health moved into purpose-built premises in July

2015. The stand-alone building in Abercrombie Street

Redfern makes it more accessible to young people.

The implementation of the Living Well Living Longer

program continues to ensure the physical health and

wellbeing of mental health clients.

16

2015/16 Achievements

The Sexual Health Service commenced delivery of the

expanded PrEP implementation in communities (EPIC)

trial in Sydney Local Health District.

17

• Implementation and rollout of the Healthy Homes and

Neighbourhoods integrated care initiative.

• Development and implementation of the Healthy

Families Healthy Children harmonised model of

sustained health home visiting.

2015/16 Achievements

Implemented the CHOC eMR in April, with the ability for

integrated medical records to be available across the

LHD in ambulatory and inpatient settings.

Healthy Strong Communities, which evolved from the

Premier’s Service Delivery Reform initiative, has seen

the Mental Health Service, in partnership with Housing,

New Horizons and Partners in Recovery, develop maps

of rough sleepers, boarding houses and supported

accommodation.

The Harm Minimisation Program commenced a project

to increase the number of sterile injecting equipment

distributed in line with ministry targets.

18

2015/16 Achievements

Drug Health Services Strategic Plan 2016-2021 was

launched on 3 March 2016.

Drug Health Services Harm Minimisation Program won

a position on the ACI’s Clinical Redesign Program in

2016.

19

• The Professor Marie

Bashir Short Stay Unit is a

collaborative initiative

between Mental Health,

ED and Drug Health

Services at RPA and won

the People’s Choice

Award at the NSW Health

Awards 2015.

2015/16 Achievements

Continuing successful partnership with CESPHN of

Health Pathways Sydney including the development of

400 live localised pathways and completing 100

practice visits.

The continued work of the multi-agency and NGO

partnership: Healthy Strong Communities (Service

delivery reform in Sydney) includes three programs:

Housing and Mental Health, Healthy Homes and

Neighbourhoods; and RedLink officially opened on 29

July 2015.

The launch by Minister for Health of the multi-agency

Child Health and Wellbeing Plan.

20

Overview of the service

agreement

21

Strategic Priorities

NSW: Making it happen

Election commitments

Key system priorities for 2016/17

Strategic context

22

The Service Agreement is a key component of the NSW Health

Performance Framework. The Framework:

– Has the over-arching objectives of improving service delivery,

patient safety and quality;

– Provides a single, integrated process for performance review,

escalation and management;

– Provides a clear and transparent outline of how the

performance of districts and networks is assessed;

– Outlines how responses to performance concerns are

structured to improve performance;

– Operates in conjunction with the purchasing framework, the

activity based funding and small hospital operational

specifications.

Performance framework

23

2016/17 Service level

agreement,

strategic priorities and

themes

24

The NSW Ministry of Health, pillars and state wide services are

committed to co-ordinating and partnering with districts and

networks to:

– Deliver NSW: Making it happen - including the Premier’s and state priorities

– Achieve the key goals, directions and strategies articulated within the NSW State

Health Plan: Towards 2021 and the NSW Rural Health Plan: Towards 2021

– Support districts and networks to deliver optimal and efficient frontline services

– Provide leadership in NSW Health’s contribution to the Reform of the Federation

process, review of primary health care and any resulting reforms; and

identification of strategies to drive efficiency and sustainability in the health system

– Deliver on NSW Government election commitments

Strategic priorities

25

The key strategic priorities for NSW Health in 2016/17 are

articulated within the plan on the next slide.

Key system priorities for 2016/17

26

• These priorities are to be

reflected in the strategic and

operational plans of the NSW

Ministry of Health, pillars,

support organisations, districts

and networks comprising NSW

Health. Delivery of the strategic

priorities is the mutual

responsibility of all entities.

27

The roles and responsibilities for Mental Health Intensive Care

Units (MHICU) include:

– standardisation of referral

– clinical handover procedures and pathways

– the role of the primary referral centre in securing a MHICU

bed, and the

– standardisation of escalation processes

Key focus for NSW Health in

2016/17

28

Other priority plans and initiatives Implement programs and policies to achieve NSW targets, focusing

on:

– Reducing smoking rates (in both the Aboriginal and non-Aboriginal population)

– Reducing smoking in pregnant women (in both the Aboriginal and non-Aboriginal

population)

– Reducing overweight and obesity rates in children, young people and adults

– Reducing risk drinking

– Closing the gap in Aboriginal infant mortality

Implement the following plans and strategies:

– NSW Healthy Eating and Active Living Strategy 2013-2018

– NSW Tobacco Strategy 2012-2017

– NSW HIV Strategy 2012-2015 with a focus on increasing HIV testing

– Implement NSW Hepatitis C and B Strategy Strategies 2014-2020 focusing on

reducing the sharing of injecting equipment among people who inject drugs

29

Other priority plans and initiatives

– NSW Aboriginal Health Plan 2013-2023 with a focus on

enhancing formal partnerships with local Aboriginal community

controlled health services, and ensure appropriate consultation

in the development of local healthcare plans.

– Oral Health 2020: A Strategic Framework for Dental Health in

NSW

– Healthy, Safe and Well: A Strategic Health Plan for Children,

Young People and Families

– Strategies to support advance planning for quality care at end of

life

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Transition grant

34

Nil

Capital program

35

36

Grossed up private patient service adjustment

37

2016 -17 National Health Funding Body Service

Agreement

Period: 1 July 2016 – 30 June 2017

38

Budget principles As with previous years, the District is holding a contingency of $35M (to meet

additional patient demands, unforeseen equipment replacement or other

unexpected District costs)

The District has also allocated $10M for enhancements, to be finalised with the

executive and clinical directors this week. $500K has already been allocated for

obesity and $1M for sustained home visiting

To derive the contingency:

– NWAU price adjusted for contribution to contingency

– Block funding adjusted for contribution to contingency

Facility budgets built using available ABF and block funding principles:

– ABF funding pool developed using discounted 2016 financial year prices

– Block funding allocated (e.g. dental, AIDS, NGO grants)

– Alignment of entity budgets to 2016 financial year

actual and budget

LHD NWAUs X

SLHD PRICE

39

Budget principles

40

110

120

130

140

150

160

170

180

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

2015/16 SLHD Flow of Expenses Budget and Actual MTD (GF & SPF)

2015/16 Combined expenses budget 2015/16 Combined expenses actual

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun YTD Jun

2015/16 Combined expenses budget 130,967 127,883 124,271 125,287 122,376 134,668 123,038 133,410 136,659 126,598 136,431 176,384 1,597,971

2015/16 Combined expenses actual 132,916 127,468 122,557 123,955 121,713 132,864 120,711 129,910 136,181 130,054 140,405 174,771 1,593,505

Variance (+ Fav, - Unfav) -1,949 415 1,714 1,332 663 1,804 2,327 3,500 478 -3,456 -3,974 1,613 4,466

% of Budget 8.20% 8.00% 7.78% 7.84% 7.66% 8.43% 7.70% 8.35% 8.55% 7.92% 8.54% 11.03%

YTD Budget expended 8.20% 16.20% 23.98% 31.82% 39.48% 47.91% 55.61% 63.96% 72.51% 80.43% 88.97% 100.00%

2016/17 Budget from MoH

SLHD total expenditure budget for 2016-17 is:

MoH presents budget escalation on prior year annualised

budget – this is a 4.9 per cent increase for SLHD

$1.631BILLION

GENERAL FUND SP&T

$1.605B $25.102M

41

2016/17 Budget from MoH

SLHD total revenue budget for 2016-17 is:

Own source revenue target of $241.369M represents a 3.44

per cent increase on the 2015/16 actual result

$1.570BILLION

Govt contribution SP&T Own source

$1.291B $37.789M $241.369M

42

Activity NWAU prices 2016/17

National weighted activity unit (NWAU) prices:

– State price = $4,605

– MoH determined SLHD price acute = $4,545

– MoH determined SLHD price non-admitted = $3,477

43

Facility NWAU prices 2016/17

Facility / Service 2016-17 price /

NWAU16

RPA $4,172

Concord Hospital $4,003

Canterbury $3,358

Balmain $3,200

IRO $3,593

Mental Health $3,348

2016-17 price reflects the 2015-16 price discounted by 0.5 per cent.

Discount reflects the impact of the change from NWAU 15 to NWAU 16

44

2016/17 NWAU activity

SLHD NWAU activity targets

Facility / Service 2016-17

NWAU16

RPA 117,988

Concord Hospital 64,544

Canterbury 27,282

Balmain 7,586

IRO 5,429

Mental Health 31,860

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Next steps

19 – 26 July 2016 – Chief Executive issues budget letters to

facility general managers including budget, activity and FTE

targets. Summaries posted on internet

www.slhd.nsw.gov.au/budget.html

31 July 2016 - Revenue and efficiency roadmap strategies

finalised

District budget roadshows/presentations

– 15 August 2016 – CEWD – 5.30pm

– 16 August 2016 – Concord Hospital – 5.30pm

– 17 August 2016 – Balmain Hospital – 2.30pm

– 23 August 2016 – Royal Prince Alfred Hospital – 7.30am

– 25 August 2016 – Canterbury Hospital – 12 noon

58

Next steps

Continue strong governance over financial performance:

– Monthly distribution of modified monthly finance reports

– Chief Executive and Department of Finance performance

meetings with general managers

– Continued monthly performance reporting to FRAP

– Monitoring of revenue and efficiency improvement roadmaps

59

End

Questions?

60