Development of the ACT Clinical Services Plan

What is the Clinical Services Plan?

The Clinical Services Plan (CSP) will provide a strategic framework for the delivery of Health Directorate clinical services between 2012 and 2017.  It is a strategic level plan which will build on the Clinical Services Plan 2005-2011. 

The CSP will:

·        outline the clinical service framework and service needs to 2017, and a longer term strategic vision to 2022 for ACT public hospitals and community based services;

·        identify broad strategic directions for health service delivery, and guide more detailed planning, models of care and work to be undertaken in the future; and

·        guide the provision of services to meet projected demand during a period of significant infrastructure development across the Health Directorate.

A discussion paper is available online.

How is the CSP being developed?

A Steering Committee (SC) will oversee the development of the CSP.  Darlene Cox is a member of the Committee, representing HCCA.

A communication and consultation plan has been developed to ensure stakeholders and the broader community have the opportunity to contribute to the strategic directions that will be considered during the planning process.

Initially, senior staff at Canberra Hospital & Health Services, Calvary Hospital and other Health Directorate stakeholders are reviewing the information upon which the plan will be based and provide advice to the Steering Committee.

Health Care Consumers Association has provided informal feedback and will continue to be part of the development process.  We are particularly interested in how this plan will ensure that quality and safety is a driver in the development of health services. 

Once the plan is drafted there will be an opportunity for all staff, the broader community, non-government organisations, regional health services, other government departments, private hospitals, peak bodies and unions to provide feedback.

Progress

So far Health Directorate staff have held consultation fora at Calvary Hospital and are planning for meetings with senior staff in Canberra Hospital and Health Services. These consultative meetings will continue through to the end of March.

Clinical technology planning is being undertaken through a Technology Mapping project. A set of Horizon Scanning Clinical Technology Roadmaps have been developed. Customised maps for the Health Directorate will be developed in consultation with clinicians.

A draft Clinical Services Plan will be finalised in April 2012 to enable broader consultation to mid 2012.

 How do you get involved?

·        Email a comment to: healthplanning@act.gov.au;

·        Reading and commenting on the draft Clincal Service Plan when it is released in a couple of months.

HCCA will be preparing a response to the draft Cliniacl Services Plan and we welcome your comments.

ACT Falls Prevention Forum

ACT Health Directorate hosted its first Falls Prevention Forum at the University of Canberra on 9 February 2012.

The forum was opened by ACT Chief Health Officer, Dr Paul Kelly, who said the response from participants had been overwhelming, which indicated the clear need to hold such a forum.  The audience comprised about 75 people, which included clinicians, government and non-government organisations, the community and aged care sectors and consumers. 

The ACT has the fastest growing number of people aged over 65 in Australia and falls are a leading cause of injury among the elderly and are the leading cause of injury-related deaths in Australia.  There are, for instance, far more deaths resulting from falls than from car accidents.  Injuries to limbs are the most common, followed by head and neck injuries.   ACT Health Directorate is committed to working with other government departments to significantly reduce the rate of falls and is particularly concentrating on hospitals, aged care facilities and the home, which is where the majority of falls occur.

I attended this forum as a HCCA consumer representative.  The speakers were well prepared and presented a range of information about a number of ACT falls reduction initiatives.  They also talked about research and data collection in the ACT and how this was being used to reduce the incidence of falls-related injuries.

Cathy Baker, Acting Director, Epidemiology Branch, stated that 10.4% of ACT residents in are in the age group (65 years plus) with the greatest falls risk, that 20% of all injury deaths in 2007 were falls-related; in 2009-10 over 1000 people were hospitalised because of a fall, and the good news for ACT residents that the rate of falls resulting in injury has decreased over the past three years.

Irene Lake, Executive Officer, Research Centre for Nursing and Midwifery Practice, reported that the number of falls in ACT hospitals is declining and attributed this decrease to The Canberra Hospital  Falls Prevention Program.  The ACT Health Falls Clinic is also playing an important role in assessing people who are at risk of falling or who have had falls.  The Clinic performs detailed assessments and advises consumers on strategies to reduce their falls risk. 

Other presentations including information about helping people with musculoskeletal conditions to stay on their feet,  an update on the Stepping On Program and Falls Clinic, and the Commonwealth Government’s “Liveable Housing design guidelines”. 

Further details about the ACT Falls Prevention Forum presentations are available here

Jo Bothroyd

HCCA Consumer Representative

Consumers need to opt in to ehealth records

Adam Cresswell wrote a piece in last week’s Weekend Australian highlighting concerns raised by doctors and consumer groups about likely low take-up rates for the electronic health records and calling for basic changes to keep the scheme on track.  The article focuses on comments from CHF in its submission to the Senate inquiry on the legislation to the program, in which it argues in favour of an opt-out, rather than an opt-in system. 

HCCA also presented a submission to this inquiry, strongly supporting the opt-in model.  This view is based on discussion of consumer members of the ACT ehealth Consumer Reference Group.

In an ideal world, opt-out has many strong arguments in its favour.  However, the reality of getting the PCEHR successfully implemented requires giving up some health data principles.  The introduction of the PCEHR represents a major shift in public perception and if the system to realise its potential, both health care providers and health care consumers need to be supportive and to be supported.  We are not there yet!

If everyone has a PCEHR, but few access it, what use is that?  Let those that know about it and want it be the trail seekers.  We have to start slowly otherwise it will fail.

There is also an issue around the incentives that are required to entice practitioners to become nominated providers in the system.  There is considerable discussion around the need for the Government to provide payment.  Why should the medical profession take on more tasks without being paid?  No amount of saying in the long run it will be beneficial to clinicians and their patients will bring about the change needed.  The demand for the time of our clinicians is strong and in some areas we do not have enough clinician to meet the needs of our communities. Some feel strongly that to expect them to add to their workload is a big ask and would mean other 'services' can't be provided.  A mechanism to engage clinicians to become nominated providers and to upload documents to the PCEHR has to be agreed soon so that consumers are not disadvantaged.

HCCA understands why the Government has adopted an “opt in” policy for consumer participation in the system and continues to support it, although we remain concerned that allowing clinicians to withhold records from the system may disadvantage consumers who choose to opt in and that some form of mechanism to limit this possibility needs to be incorporated in the EHR implementation. This, we believe, will enable it to better cater to consumer needs.

Darlene Cox

Executive Director

New Northside Hospital for Canberra

The ACT Government has released a report identifying the University of Canberra as their preferred site for the construction of the new Northside Hospital.
The ACT Government has indicated that there is a need to enhance public hospital facilities on the north side of Canberra to accommodate the growing health needs of our population over the next 20 years. The ACT Health Capital Asset Development Plan was developed as a blueprint for the redevelopment of the ACT health system.  A discussion paper on options for northside hospital services was issued in February 2011. As a result of that that process, the Government decided to building a stand-alone sub-acute facility in North Canberra. HCCA has been advocating for the establishment of a specialised sub-acute care facility for some time; this is reflected in our submission of November 2010 to the Government Standing Committee on Health, Community and Social Services Inquiry into Public Hospital Options as well as our response to the Government consultation on this matter in 2011.  The HCCA Submission is available online (160kb Pdf)
The HCCA has been very supportive of the decision to build  a sub acute hospital and has not seen a need to replicate The Canberra Hospital in North Canberra.  We have advocated that a sub-acute facility or community hospital, supported by primary health care centres around Canberra, would better meet the needs of the Canberra community. A community hospital with sub-acute and non-acute services will supplement the new enhanced primary health care centres. Planning for these centres is well developed with the new centres in Belconnen and Gunghalin expected to be opened in this year.  
The new Northside Hospital could be designed, built and staffed to provide rehabilitation services for people recovering after an operation (e.g. a hip replacement), an illness (e.g. a heart attack) or an injury (e.g. a fall or car accident). This would improve the potential for recovery as less time would be spent in an acute hospital (ie, Calvary or TCH). It could also include geriatric evaluation and management services, transition care and other step-up or step-down programs.
We have also suggested the facility could house a second secular hospice for the ACT and will participate in consultations with the Government for the review of the Palliative Care Strategy this year. 
The community recognises that people with serious mental illness need access to a range of treatment and support services, connected across the spectrum of care. We believe there is scope to include this in the development of the Hospital at the University of Canberra.  This would complement the successful step up step down facilities currently in place in the community.
A sub-acute facility on the University of Canberra grounds is vital to meet the needs of our community.   
The selection of the site is very important; it needs to be accessible, which means close to major transport routes. One of the failings of the Village Creek Rehabilitation Centre was the site selection.  The services, once you are inside the building, are excellent but being tucked away in a suburban setting has caused difficulty for some consumers and carers when accessing the Centre.  the University of Canberra is located to arterial roads and public transport, has sufficient area for dedicated parking, is close to the Belconnen Town Centre and is within easy travelling distance for people living in Gungahlin and the future Molonglo Valley development
In addition it would create valuable connections with the Faculty of Health Science and provide clinical placements for students in areas including, but not limited to, nursing and midwifery, pharmacy, physiotherapy and psychology.  We agree with the Government that the relationship should assist with staff recruiting and training, and should assist the university in undertaking health research.
The community wants assurance that decisions regarding the planning and design of our health system are taken on sound advice, based on identified clinical need and community needs and sound economic judgement.  We are satisfied with the range of issues the Government has considered in identifying the most appropriate site for the new hospital.
We look forward to being involved in the community discussion on the matter.

Darlene Cox
Executive Director

Consumer Representative Training Course

Are you, or a member of your family, a patient, carer or user of health care services? Then you are a health care consumer

Do you want a better understanding of the Health System in the ACT?

Are you interested in learning new skills to help yourself and others?

Have you thought about getting involved in a Health Directorate Committee?

Do you have questions or feedback about the health system?

This course will answer your questions and provide you with the necessary skills to help you to make a really valuable contribution to the health system.

We invite you to come along, learn some new skills and meet other health care consumers in a friendly atmosphere over the two day course.

After completing the course (you must attend both days), you will receive a certificate of participation, which enables you to nominate as a consumer representative on a Health Directorate Committee.

Course Date:  Friday 23 & 30 March 2012: 10am-2pm

HCCA Meeting Room, Sports House, 100 Maitland Street, 

Hackett ACT 2602

This course is free and morning tea and lunch will be provided. Please tell us of any dietary requirements.  Transport assistance may be available. Please ask for details.

To find out more and to register for course (you must attend both sessions) please contact us: Tel: 6230 7800: email adminofficer@hcca.org.au

Consumer Representative Training Courses are held 3 times a year.

If you miss this one, please ask about the June and September courses.