C.5 Internal accountability

Senior executive and responsibilities

The organisational chart on pages 2 and 3 shows the structure of ACT Health at 30 June 2013. This chart includes the names of the senior executives responsible for each of the organisation’s output areas.

Executives in the ACT Public Service are engaged under contract for periods not exceeding five years. Their remuneration is determined by the Australian Capital Territory Remuneration Tribunal.

Senior executive and organisational changes

ACT Health underwent an internal restructure during 2010–11. The purpose of this restructure was to improve the delivery of family- and patient-centred care, achieve good governance and accountability, and position the organisation to meet demand for services now and into the future.

Prior to implementation of the restructure, extensive consultation occurred with staff and stakeholders. One of the commitments coming out of this consultation was that a number of factors and decisions would be reviewed one year after implementation.

In 2012, ACT Health engaged the Nous Group to conduct an external review of ACT Health’s 2011 restructure. Its purpose was to determine the effectiveness of the restructure and how well it was meeting its primary objectives. Following consideration of the considerable amount of feedback received during the six-week consultation process earlier in 2013, a detailed response to each of the recommendations in the final Nous report has been developed.

The review acknowledged that the majority of staff have been supportive of many of the structural changes put in place over the last two years, but opportunities have been identified for further refinement. A total of 36 recommendations were made in the review report. These will be a focus for ACT Health in the next 12 to 18 months to ensure that the structure continues to be a strong basis for the delivery of our diverse health services. Consultation has been undertaken with relevant staff and unions to discuss the details of how changes can best be implemented.

Senior executive

ACT Health is organised into groups and operational areas which report directly to the Director-General.

The two groups—Canberra Hospital and Health Services, and Strategy and Corporate—are led by the Deputy Directors-General and are divided into direct clinical service divisions and strategic and corporate support branches. Canberra Hospital and Health Services employs the majority of staff working in ACT Health.

Senior executive positions across the organisation are as follows:

  • Dr Peggy Brown Director-General (DG)
  • Stephen Goggs Deputy Director-General (DDG), Strategy and Corporate
  • Ian Thompson Deputy Director-General (DDG), Canberra Hospital and Health Services
  • Dr Frank Van Haren Director, DonateLife ACT
  • Dr Paul Kelly Chief Health Officer, Population Health Division
  • Elizabeth Trickett Executive Director, Quality and Safety Unit
  • Ron Foster Chief Finance Officer, Financial Management Unit
  • Judy Redmond Chief Information Officer, E-health and Clinical Records Branch
  • Phil Ghirardello Executive Director, Performance and Innovation Branch
  • Rosemary Kennedy Executive Director, Business and Infrastructure Branch
  • Ross O’Donoughue Executive Director, Policy and Government Relations Branch
  • Grant Carey-Ide Executive Director, Service and Capital Planning Branch
  • Judi Childs Executive Director, People Strategy and Services
  • Veronica Croome Chief Nurse/Executive Director, Nursing and Midwifery
  • Karen Murphy Allied Health Advisor
  • Prof Frank Bowden Principal Medical Advisor/Executive Director, Medical Services
  • Dr Helen Toyne GP Advisor
  • Prof Paul Gatenby AM Director of Research
  • Barbara Reid Executive Director, Division of Surgery and Oral Health
  • Elizabeth Chatham Executive Director, Division of Women, Youth and Children
  • Jeannette MacCullagh (A/g) Executive Director, Division of Critical Care and Imaging
  • Denise Lamb Executive Director, Division of Capital Region Cancer Service
  • Linda Kohlhagen Executive Director, Division of Rehabilitation, Aged and Community Care
  • Katrina Bracher Executive Director, Division of Mental Health, Justice Health and Alcohol and Drug Services
  • Prof Julia Potter Executive Director, Division of Pathology
  • Rosemary O’Donnell Executive Director, Division of Medicine
  • June Gunning Director, Acute Support Services.

Senior management committees, roles and membership

ACT Health committees are established at the following levels:

  • Tier 1—directorate level
  • Tier 2—division/branch level and Tier 1 subcommittees
  • Tier 3—unit/team level.

Information in the organisation is cascaded down from Tier 1 committees, and similarly information and issues can be raised at the Tier 3 level and reported and managed up through the higher committee tiers.

The overarching governance committee for ACT Health is the Executive Council.

 

Name of committee Role of committee Membership
Executive Council At the centre of ACT Health’s governance model is the Executive Council. The role of the council is to:
  • support the Director-General to meet responsibilities outlined in the Health Act 1993
    and other relevant legislation
  • make recommendations on the strategic direction, priorities and objectives of the organisation and endorse plans and actions to achieve the objectives
  • oversee finance, performance and
    human resources
  • set an example for the corporate culture throughout the organisation.
The Executive Council is chaired by the Director-General and meets twice monthly; one of these meetings each month is focused on finance and performance and other matters, and the other meeting is focused on other business. A number of subcommittees report to the Executive Council, each dealing with different areas of accountability across ACT Health.
Director-General (Chair)
Deputy Director-General, Canberra Hospital and Health Services
Deputy Director-General, Strategy and Corporate
Chief Finance Officer
 Chief Health Officer
Executive Director, Quality and Safety Allied Health Advisor
Chief Nurse/Executive Director, Nursing and Midwifery
Principal Medical Advisor/Executive Director
Medical Services
Consumer Representative
Academic Representative
Executive Directors Council This council provides an opportunity
for all executive members to communicate and collaboratively work in partnership with other areas of ACT Health to deliver patient-focused, high-quality care through influencing policy and strategic direction, managing policy governance and risk, and maximising operational effectiveness. The Executive Directors Council meets monthly and reports to the Executive Council on strategic operational matters and
risk management.
Director-General (Chair)
Deputy Director-General, Strategy and Corporate
Deputy Director-General, Canberra Hospital and Health Services
Director, Executive Coordination
Manager, Communications and Marketing
Manager, Internal Audit and Risk Management
Chief Finance Officer
Chief Health Officer
Executive Director, Quality and Safety
Chief Nurse
Principal Medical Advisor
Allied Health Advisor
Chief Information Officer
Director, Donate Life
Executive Director, Performance and Innovation
Executive Director, Business and Infrastructure
Executive Director, Service and Capital Planning
Executive Director, Policy and Government  Relations
Executive Director, People Strategy and Services
Executive Director, Surgery and Oral Health
Executive Director, Critical Care
Executive Director, Women, Youth and Children
Executive Director, Medicine Executive Director, Rehabilitation, Aged and Community Care
Executive Director, Capital Region Cancer Service
Executive Director, Mental Health, Justice Health and Alcohol and Drug Services
Executive Director, Pathology
Executive Director, Medical Services
Executive Director, Nursing and Midwifery
Safety and Quality Committee This committee comprises executive and professional adviser positions and academic and consumer representatives. Its role is to:
  • set strategic directions, priorities and objectives in quality and safety
  • oversee clinical practice improvement, quality improvement, accreditation, clinical governance matters (including sentinel events), consumer engagement and clinical policy
  • monitor research activity across ACT Health.
 The committee is chaired by the Director-General, meets monthly and reports to the Executive Council. Subcommittees:
  • Accreditation Steering Group
  • Health Technology and Assessment Committee
  • Health Interagency Clinical Review Committee
  • Medical and Dental Appointments Committee
  • Clinical Privileges Committee
  • Appropriate Use of Blood Reference Group.
Director-General
Deputy Director-General, Corporate and Strategy
Deputy Director-General, Canberra Hospital and Health Services
Executive Director, Quality and Safety Unit
Chief Information Officer
Executive Director, Performance and Innovation Branch
Executive Director, Business and Infrastructure Branch
Executive Director, Service and Capital Planning Branch
Executive Director, Policy and Government Relations Branch
Executive Director, People Strategy and Services
Chief Nurse
Principal Medical Advisor
Principal Allied Health Advisor
Manager, Internal Audit and Risk Management Unit
Consumer representatives (2)

 

 

Name of committee Role of committee Membership
Work Health and Safety Committee This committee:
  • facilitates cooperation between ACT Health and staff to instigate, develop and carry out measures designed to ensure the health and safety of staff
  • assists in the development of standards, rules and procedures relating to health and safety that are to be complied with in the workplace
  • provides work health and safety advice and recommendations on strategies, allocation of resources and legislative arrangements
  • addresses whole-of-agency work health and
    safety issues unable to be resolved at division or branch level.
Director-General (Chair)
Director, Workplace Safety
To achieve a quorum, at least half of the members of the committee must be staff who are not nominated by ACT Health.
Two representatives from each division/branch Tier 2 Health and Safety Committee—one manager and one Health and Safety Representative.
Subcommittee members attend as visitors, as do others.
Information Communication and Technology Committee This committee:
  • oversees the development of ACT Health
    IM&ICT plans, policies and frameworks, as required, ensuring whole-of-government issues
    are considered
  • monitors lifecycle ICT asset management frameworks, strategies and policies consistent
    with best practice
  • monitors IM&ICT risks
  • monitors, reviews and manages ICT asset, service and delivery and financial performance and infrastructure risk across ACT Health
  • ensures whole-of-ACT Government and
    ACT Health IM&ICT policies and standards are implemented across the organisation
  • prioritises IM&ICT initiatives
  • evaluates proposed IM&ICT initiatives and recommends supported business cases for all
    major IM&ICT projects to Executive Council
  • regularly reviews and reports on the status of ICT projects under development and, if required, recommends strategies to rectify significant variances of these.
Deputy Director-General, Strategy and Corporate
Deputy Director-General, Canberra Hospital and Health Services
Chair, Clinical Working Group or representative Chief Information Officer
Executive Director, Performance and Innovation
Executive Director, Business and Infrastructure
Executive Director, Service and Capital Planning
Executive Director, Policy and Government Relations
Chief Health Officer
Chief Nurse
Principal Medical Advisor
Executive Director, Critical Care
Executive Director, Capital Region Cancer Service
Executive Director, Rehabilitation, Aged Care and Community Care
Executive Director, Surgery and Oral Health
Executive Director, Womens, Youth and Children
Executive Director, Mental Health, Justice Health and Alcohol and Drug Services
Executive Director, Pathology
Executive Director, Medicine
Executive Director, Shared Services ICT or representative
Chief Executive, Calvary Public Hospital or representative
Health Care Consumer representative
ACT Medicare Local representative
Redevelopment Committee The ACT Health Redevelopment Committee is the chief decision-making body for the ACT Health Health Infrastructure Program (HIP). It is responsible for providing advice, monitoring progress and monitoring risk of the HIP. Director-General, ACT Health (Chair)
Deputy Director-General, Strategy and Corporate
Deputy Director-General, Canberra Hospital and Health Services
Executive Director, Policy Coordination
and Development, Treasury Directorate
Executive Director, Shared Services Procurement
Executive Director, Shared Services ICT
Executive Director, Service and Capital Planning
Executive Director, Business and Infrastructure
Chief Finance Officer
Executive Director, People Strategy and Services
Director-General, Commerce and Works Directorate
Chief Information Officer, ACT Health
Deputy Director-General, Chief Minister and Cabinet Directorate
Chief Executive, Calvary Healthcare ACT
Executive Director, Health Care Consumers’ Association
Senior Manager, Health Services Planning, Service and Capital Planning
Executive Construction Director, Service and
Capital Planning
Senior Finance Manager, Service and Capital Planning
Operations Manager, Service and Capital Planning
Director, Health Infrastructure Branch, Shared Services Procurement, Commerce and Works Directorate
The committee may invite other attendees, at the Chair’s discretion.
Workforce Strategy Committee To provide high-level advice to the Executive Council on all matters about the ACT Health workforce. This committee:
  • gives strategic context and direction for the development of the workforce, including a focus on planning, recruitment and retention strategies, organisational development, workplace culture and leadership and human resource management
  • ensures alignment and integration of strategies to broader Health Directorate objectives
  • provides strategic oversight of organisation
    redesign on the workforce profile and health
    and safety.
Principal Medical Advisor
Executive Director, CRCS
Executive Director, PSSB
ACT Chief Nurse, Strategy and Corporate
Lead Commissioning Manager
Executive Director, Performance and Innovation
Deputy Director-General, Strategy and Corporate
Director, Workforce Policy and Planning Unit
Director of Operations A/g Director of Acute Support
Senior Data Officer, WPPU
Executive Director, Business and Infrastructure
Allied Health Manager
Allied Health Advisor
Executive Director, Surgery and Oral Health
Director, Staff Development Unit
Director, Community Care Program
Senior Manager, Organisational Development Unit Deputy
Director-General, Canberra Hospital Executive
Director, Quality Improvement
Workforce Initiatives Coordinator

 

 

Name of committee Role of committee Membership
Audit and Risk Management Committee   The committee consists of five members:
  • Chairperson—The chair of the audit committee is external and independent of the directorate
  • Deputy Chair—one Deputy Director-General, appointed for a fixed period
  • two senior executives
  • an external member with an appropriate business or audit background.
The Internal Audit and Risk Manager is invited to all meetings of the ARMC. The secretariat role is performed by the Internal Audit and Risk Management Branch.

 

As well as these committees, governance meetings are established at the Tier 2 level in the Strategy and Corporate group and the Canberra Hospital and Health Services group, as well as in clinical divisions and corporate branches. Senior staff from divisions and branches are involved in these meetings and key information is cascaded down from the Tier 1 level via groups, divisions and branches to unit level across the directorate.

A range of forums provide the opportunity for stakeholder input. These include:

  • ACT Health Human Research Ethics Committee—ongoing
  • ACT Local Hospital Network Council (six times a year)—ongoing
  • ACT Medicare Local/ACT Health Liaison Committee (quarterly)
  • ACT Region Integrated Regional Clinical Training Network—ongoing
  • Allied Health Forum (quarterly)—ongoing
  • Clinical Senate (quarterly)—ongoing
  • Director-General Forums (six-weekly)—ongoing
  • GP Liaison Network (quarterly)—ongoing
  • ACT Health/Community Services Directorate Liaison committee (quarterly)—ongoing
  • ACT Health/Human Rights Commission (annual)—ongoing.
  • Health Emergency Management Subcommittee (quarterly)—ongoing.
  • Healthcare Consumers Liaison Committee (quarterly)—ongoing
  • Integrated Regional Clinical Training Network—ongoing
  • Leadership Network (three times a year)—ongoing
  • Medical Staff Council (monthly)—ongoing
  • Nursing and Midwifery Leaders meeting (monthly)—ongoing
  • Private Hospitals Liaison Committee (quarterly)—ongoing
  • Southern Local Hospital Network HN Liaison Committee—ongoing
  • Tertiary Education Liaison Committee (quarterly)—ongoing

ACT Local Hospital Network Council

On 27 July 2011, the Chief Minister announced the establishment of the ACT Local Hospital Network Council. The council was established under amendments to the Health Act 1993, passed by the Legislative Assembly on 29 March 2011. It is responsible for providing strategic advice to the Director-General of ACT Health on matters critical to the ACT Local Hospital Network’s success. The council’s specific functions are set out in section 14 of the Act.

Each financial year the council is required to present to the Minister for Health a report on the state of the local hospital network and any recommendations relating to the improvement of health services by the local hospital network that the council considers necessary.

Part 3A of the Act requires that the council consist of not more than 10 members, appointed by the Minister.

The council must include members who bring the necessary skills and experience to allow the council to perform its functions under the Act and include members who have expertise or experience in several areas, including, but not limited to: health management experience; expertise in clinical matters; and academic, teaching and research experience in the field of health services and consumers.

The Act requires the council to meet at least six times a year. ACT Health provides secretariat support to the council.

Clinical Senate

The role of the Senate is to provide a forum for a multidisciplinary group of clinicians, health experts and consumers with diverse perspectives to share their collective knowledge in discussing strategic clinical issues.
The Clinical Senate makes recommendations and reports to the Director-General, ACT Health, and the Chair of

ACT Medicare Local, who consider and respond formally and transparently to all recommendations.

The membership of the Senate reflects the range of views that would be encountered across the full breadth of the community on significant clinical strategic issues. Members are appointed following due consideration of clinical skills and/or knowledge, capacity to make a contribution, clinical influence, consumer input and multidisciplinary coverage.

The Senate comprises up to 40 members, the majority of whom are clinicians with direct clinical duties. In addition to ex-officio members, membership consists of specialist medical practitioners, junior medical practitioners, specialist dental practitioners, nursing and midwifery representatives, academic staff, allied health professionals and consumer representatives.

Meetings are held three or four times a year. ACT Health provides secretariat support to the Senate.

Corporate and operational plans (and associated reporting and review)

Corporate Plan 2012–2017

The Corporate Plan 2012–2017 replaces the Corporate Plan 2010–2012. The plan articulates the key focus areas, priorities for improvement, key strategies for achieving the priorities, and achievements planned for the long term (five years).

The priorities of ACT Health are organised under four key focus areas.

Community and consumers—Partnering for better health outcomes

  • Deliver patient and family-centred care
  • Continue and strengthen partnerships
  • Promote good health and wellbeing
  • Improve access to appropriate health care
  • Have robust safety and quality systems

Our resources—Building sustainability and improving efficiency

  • Design sustainable services to deliver outcomes efficiently
  • Strengthen decision support
  • Embed a culture of research and innovation

Our processes—Strengthening governance

  • Be accountable to government and the community
  • Continue to strengthen clinical governance

Our people—Supporting and strengthening the teams

  • Support our staff to reach their potential
  • Promote a learning culture
  • Provide high-level leadership

In 2012‑13, ACT Health continued to measure performance against these areas through key performance measures identified in the ACT Public Health Service’s quarterly performance report, ACT Health’s strategic and accountability indicator sets in the ACT Budget Papers and the Public Hospitals Scorecard. The target achievements for each year are contained in ACT Health’s Business Plan.

Clinical Services Plan

There is recognition that the demand for health services is increasing every year. Expanding health technologies, greater consumer expectations and an increasing and ageing population all contribute to this demand for public health services.

Following extensive consultation with our stakeholders towards the end of 2012, the Clinical Services Plan is now being finalised. The plan will provide strategic guidance for the development of publicly funded health services in the ACT. The strategies in the plan have been developed to position ACT Health to meet future demand for health services and improve access for those most in need.

There are a number of specific health services plans which cascade and align strategic directions from the Clinical Services Plan to enable the delivery of an integrated service and offer a continuum of care to patients. The focus areas of the plan are to:

  • meet increasing demand for health services
  • improve the patient journey
  • improve the health of vulnerable people
  • build and nurture a sustainable health system
  • ensure the planning and delivery of health services is underpinned by the ACT Health Safety and Quality Framework.

ACT Primary Health Care Strategy 2011–2014

The Health Minister launched the ACT Primary Health Care Strategy 2011–2014 on 14 December 2011, building on the previous health care strategy and setting the direction for primary health care into the future. The strategy aims to improve integration between general practice and the wider primary health care sector in the provision of primary health care.

The Primary Health and Chronic Disease Strategy Committee (PH&CDS) oversees implementation of the strategy.

Six-monthly reports outlining progress against the annual implementation plan are provided to the ACT Health Executive Council and primary health care stakeholders.

Action areas where progress is being made include:

  • improving access and reducing inequity
  • improving continuity and coordination of care, especially for people with chronic conditions
  • increasing the focus on health promotion, prevention, early intervention and consumer empowerment
  • improving quality, safety, performance and accountability
  • information management
  • workforce
  • infrastructure.

Successful ongoing activities include:

  • the General Practice Aged Day Service (GPADS), which provides access to GPs for patients who are homebound or in residential aged care facilities
  • the nurse led Walk-in Centre, which successfully meets health care needs in the community while relieving pressure on the public hospital system
  • the GP Marketing and Support Officer role, which aims to increase the number of GPs living and working in the Canberra region, via an online, print and in-person campaign.
  • Implementation highlights include:
  • provision of mini-health checks and follow-up reviews for the vulnerable or disadvantaged at the Early Morning Centre in central Canberra and at Ainslie Village
  • provision of three full-time care coordinators to assist local Aboriginal and Torres Strait Islander people to manage the health system in relation to their chronic conditions
  • establishment and promotion of the Get Healthy information and coaching service, which provides targeted messaging and a free personal health coach, and the ACT-wide Healthier Work Service, which supports employers to develop health and wellbeing initiatives in their workplaces
  • provision of the Health Services Directory, which lists the majority of ACT Health’s services as well as all ACT GP and pharmacy localities
  • development and promotion of ACT Health policies and procedures to ensure better sharing of clinical information between and within the acute and primary health care sectors
  • funding for the ACT Medicare Local to undertake the GP Workforce Scoping Study to provide jurisdictional information and mapping of the GP workforce across the ACT.

ACT Chronic Disease Strategy

The new ACT Chronic Conditions Strategy—Improving Care and Support 2013–2018 will provide overarching direction for chronic condition care and support in the ACT over the next five years and outlines the requirement for a coordinated approach across the government and non-government sectors. It concentrates on improving care and support services and is based on the commitment goals that every person living with a chronic condition:

  • receives appropriate screening and early detection
  • receives the right care in the right place at the right time from the right team
  • has a plan which supports active participation in their care
  • is aware of relevant support options and how to access them
  • is provided with information and support to stay healthy and/or minimise the risk of other diseases
  • does not have to repeat their story unnecessarily.
  • The key priorities in the draft strategy are to:
  • optimise existing services through enhanced integration
  • improve access
  • better support those in the community
  • improve person-centredness
  • enhance detection and secondary prevention
  • enhance governance and system enablers.

The Primary Health and Chronic Disease Steering Committee oversees implementation of the strategy and provides oversight and central coordination of related policies and initiatives. The committee is chaired by the Policy and Government Relations Branch and includes representation from relevant operational areas of ACT Health, the ACT Medicare Local, the Pharmacy Guild of Australia (ACT), the Health Care Consumers’ Association of the ACT, Winnunga Nimmityjah Aboriginal Health Service, ANU Medical School, the Heart Foundation ACT, and Diabetes ACT, the University of Canberra, the Australian primary Health Care Research Institute and the Community Services Directorate. Six-monthly reports outlining progress against the annual implementation plan are provided to the ACT Health Executive Council and key stakeholders.

ACT Palliative Care Services Plan

The ACT Palliative Care Strategy 2007–2011 provided overarching direction for the delivery of palliative care services in the ACT in accordance with Palliative Care Australia’s National Palliative Care Standards. From 2007 to 2011, the strategy made considerable progress in promoting coordinated palliative care services. In particular, achievements were made in:

  • the availability of palliative care and bereavement information and education resources for community members
  • increased liaison between palliative care services, residential aged care facilities and primary health care
  • implementation of Australian Government-funded palliative care projects.

The development of the new draft ACT Palliative Care Services Plan 2013–2017 included extensive community consultation and an examination of likely future demand for palliative care, existing workforce needs and future needs, community education, support for non-government organisations and identification of possible future models of care.

As a result, the draft plan outlines a vision that ‘people with a life-threatening illness in the ACT and their families and carers will have timely access to quality palliative care that is consumer and carer focused, respects their choices and is appropriate to their need’. It also outlines six key goals for the future development of ACT palliative care services, along with 16 associated strategies to achieve them. The six key goals are as follows:

  • ACT Health plays a leadership role in ensuring reliable access to quality palliative care in the ACT.
  • To ensure that palliative care services provide continuity of care and smooth transitions between settings.
  • The ACT community is well informed about all aspects of death and dying and individuals and families are able to make an informed choice about their treatment options.
  • To build capacity of palliative care services to meet the current and projected population demand.
  • To ensure an appropriately qualitative and sustainable workforce to provide the projected level of palliative care services in the ACT.
  • To develop the knowledge base to inform service and workforce development and quality improvement.

The draft plan is aligned with the draft Clinical Services Plan and in particular suggests the establishment of a single ACT Palliative Care Clinical Network, a proposal which was well received during the public consultation of the plan.

As this is a services plan, the document is long and contains technical language that may be a barrier to some consumers and time-poor clinicians. As a result, a one-page summary and a shortened version of the plan, which will be known as the ACT Palliative Care Services Plan 2013–2017, have been developed. The full technical paper will also be available.

The ACT Palliative Care Services Plan Steering Committee oversaw the development of this services plan. This committee included representatives from ACT Health, the ACT Medicare Local, the Southern New South Wales Local Health District, Calvary Health Care, Palliative Care ACT and the Health Care Consumers’ Association of the ACT.

The plan is expected to be endorsed by the Minister in September 2013.

HIV/AIDS, Hepatitis C, Sexually Transmissible Infections: A Strategic Framework for the ACT 2007–2012

The HIV/AIDS, Hepatitis C, Sexually Transmissible Infections—A Strategic Framework for the ACT 2007–2012

outlines a strategic approach to the management of HIV/AIDS, hepatitis C and sexually transmissible infections and provides a framework to guide cooperation between ACT Government and non-government organisations, private practitioners, researchers, service providers, community groups, affected communities and the broader ACT community.

The ACT framework confirms ACT Health’s commitment to guiding principles such as harm minimisation and health promotion, a partnership approach, an evidence-based approach, access and equity, social determinants of health, a population health approach and human rights. Progress has been made towards the ACT framework’s goals of:

  • reducing the transmission in the ACT of HIV, hepatitis C virus (HCV) and sexually transmissible infections (STIs)
  • increasing access for ACT residents to testing and treatment for HIV, HCV and STIs
  • improving the health and wellbeing of ACT residents living with HIV/AIDS and HCV and reducing the morbidity associated with undiagnosed and untreated STIs.

The ACT Ministerial Advisory Council on Sexual Health, HIV/AIDS, Hepatitis C and Related Diseases (SHAHRD) advises on the implementation of the ACT framework. It was agreed that the ACT framework be extended beyond 2012 to correspond with the development of the National Strategies for HIV, Hepatitis B, Hepatitis C, Sexually Transmissible Infections and Aboriginal and Torres Strait Islander Blood-Borne Virus and Sexually Transmissible Infections. The national strategies will be under development in 2013 for an estimated launch in July 2014.

The new ACT framework will align with these strategies.

ACT Children’s Plan

The ACT Children’s Plan was launched in June 2010 to provide an aspirational whole-of-government and whole-of-community vision to make Canberra a great and safe place for children and to ensure their needs are a priority for the government and community. The ACT Children’s Plan is operational from 2010 to 2014.

The aim of the ACT Children’s Plan is that Canberra is a child- and youth-friendly city that supports all children and young people to reach their potential, make a contribution and share the benefits of our community. The plan proposes six building blocks to make Canberra a child-friendly city:

  • opportunities for children to influence decisions about their lives and their community and to actively participate in their communities
  • advocacy, promotion and protection of children’s rights
  • processes to assess the impact of law, policy and practice on children
  • regular monitoring of the state of children’s health, wellbeing, learning and development
  • services, programs and environments that support children’s optimal development and enhance parental, family and community capacity
  • effective governance mechanisms across government and community.

Strategies, actions and projects fully implemented at the end of June 2012

A Picture of ACT’s Children and Young People 2012 was released.

Major goals and projects commenced in 2012‑13

ACT Health contributed to the development of the 2013 A Picture of ACT Children and Young People, which will be the third report on children’s health, wellbeing, development and learning indicators.

Drafting commenced for a Standard Operating Procedure (SOP) on Neglect of Medical Needs of Children and Young People to improve ACT Health’s capacity to meet the needs of vulnerable children and their families.

The ACT Health Child Protection Policy was reviewed and a Child Protection Practice Paper and SOP were drafted.

ACT Mental Health Services Plan 2009–2014

The ACT Mental Health Services Plan 2009–2014 is a strategic-level document giving broad direction for the future development of public mental health services in the ACT. It was developed in consultation with stakeholders over a two-year period. The plan covers the years 2009 to 2014 but conveys a vision for how mental health services will be delivered in the ACT in 20 years’ time. The guiding vision for mental health services in the ACT is that by 2020 the mental health needs of the community will be met by a comprehensive network of complementary and integrated mental health services that:

  • enhance knowledge and understanding
  • intervene and provide support early and for as long as is necessary
  • as far as possible, address mental health issues in community settings, working with and developing natural systems of support.

The ACT Mental Health Services Plan 2009–2014 states that consumer and carer participation will be richly woven through all aspects of service planning, delivery, research, teaching and evaluation, while peer support and advocacy services will be available as required to support consumers in their journey of recovery.

The plan aligns services with four developmental stages that, rather than promoting service delivery along age lines alone, will focus on developmental and life milestones to determine the most appropriate point of service.

Strategic directions

The plan sets goals for change and improvements in the mental health sector. Timelines for implementation have been indicated throughout the five-year life of the plan. Oversight of the implementation process was allocated to the Strategic Oversight Group (SOG). Co-chaired by a consumer representative and an ACT Health representative, the SOG includes consumer, carer, community and primary care representatives, with participation from ACT and Australian Government agencies. The SOG reports annually on implementation of the ACT Mental Health Services Plan 2009–2014.

In 2012‑13, the ACT Government, in partnership with the community sector, consumers and carers, continued to work towards the guiding vision of the ACT Mental Health Services Plan 2009–2014 by focusing on the four priorities outlined in it:

  • reinforcing capacity in the mental health sector
  • extending the mental health service system
  • innovating in the mental health service system
  • planning implementation of change.

Building a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014

Building a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014 aims to guide the implementation and development of activities to promote mental health and wellbeing, prevent mental illness and, where this is not possible, intervene early to detect and treat mental disorders.

The framework has three priorities:

  • Promoting mental health and wellbeing is everybody’s business.
  • Preventing mental illness is a shared responsibility.
  • Early intervention requires strong inter-sectoral cooperation.

Oversight of the process is undertaken by the Mental Health Promotion, Prevention and Early Intervention Implementation and Evaluation Working Group, which includes consumer, carer, community, education, primary care and directorate representation.

The evaluation report, Building a Strong Foundation: Evaluation Findings 2010–2011, was finalised in 2013 and summarises the implementation findings from the second-year evaluation of the framework. Highlights include:

  • Twenty-four agencies reported that they had successfully embedded activities to promote mental health and wellbeing into their strategic plans and strategies.
  • A review of international and national social marketing campaigns was completed in order to better inform future ACT integrated physical and mental health and wellbeing campaigns.
  • A total of 5,500 people were successfully trained in workplace mental health literacy.
  • The Alexander Maconochie Centre introduced extended visiting hours for families and set aside two private units in the Visitors’ Centre for family visits. This is to encourage detainees to maintain and strengthen their family relationships while incarcerated.

Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009–2014

Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009–2014 provides a service development framework to guide an integrated, whole-of-community approach to suicide prevention across the lifespan. The strategy’s main strategic directions are to:

  • reduce rates of suicide and self-harm in the ACT
  • increase resilience, coping skills and connectedness
  • improve awareness of and access to suicide prevention training, education and information
  • increase collaboration and partnerships between organisations providing suicide prevention and postvention services in the ACT.

The evaluation report, Managing the Risk of Suicide: Evaluation Findings 2010–2011, was finalised in 2013. This report summarises the implementation findings from the second-year evaluation of the strategy.

ACT Health, in conjunction with the Centre for Mental Health Research at the Australian National University, is leading the way internationally in evaluating the outcomes of implementation and identifying the factors that affect implementation of both Building a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014 and Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009–2014.

Outcome and process evaluation data, collected from agencies identified as having responsibility for implementing actions, is collated and the findings from the surveys used to compile an annual report to the Legislative Assembly.

National Partnership Agreement Supporting National Mental Health Reform

The Council of Australian Governments signed a National Partnership Agreement Supporting National Mental Health Reform in 2012. This agreement provides $200 million in Commonwealth funding, alongside investments by the states and territories, to improve outcomes for people with severe and persistent mental illness. The two ACT projects being funded under the agreement are:

The Adult Mental Health Step-up, Step-down Outreach Support. Woden Community Services has been engaged to provide short-term early intervention to avoid acute hospital admission, and post-discharge follow-up support. Funding under the agreement allows for support for up to an additional 60 consumers per annum.

Supported Accommodation Outreach targeting people with serious mental illness and recent experience of involuntary institutional care. St Vincent de Paul has been engaged to provide supported accommodation and outreach for an additional 18 people annually who have serious mental illness and a history of involuntary institutional care.

Roadmap for National Mental Health Reform 2012–2022

The Council of Australian Governments endorsed the Roadmap for National Mental Health Reform 2012–2022 in December 2012. The roadmap recommits the Australian Government and states and territories to whole-of-government and whole-of-lifespan approaches to mental health reform and to maintaining mental health as an ongoing national priority. A key commitment of the roadmap is the development of the successor to the Fourth National Mental Health Plan. The ACT Government is a member of the working group charged with this responsibility.

Fourth National Mental Health Plan

The Fourth National Mental Health Plan: An Agenda for Collaborative Government Action in Mental Health

2009–2014 demonstrates a commitment to ongoing national mental health reform and identifies key actions to advance the vision of the National Mental Health Policy 2008. While led by health ministers, the plan takes a whole-of-government approach by involving sectors other than health. It provides a basis for governments to advance mental health activities in the various portfolio areas in a more integrated way, recognising that many sectors can contribute to better outcomes for people living with mental illness.

Two significant elements of the Fourth National Mental Health Plan have been progressed in 2012‑13: the development of the National Mental Health Services Planning Framework and the National Mental Health Recovery Framework. When finalised, these two frameworks will appreciably contribute to the culture and provision of mental health services into the future.

A New Way—Aboriginal and Torres Strait Islander Health and Wellbeing Plan 2006–2011

The ACT Aboriginal and Torres Strait Islander Health and Family Wellbeing Plan 2006–2011 was developed in response to the requirement of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) for each jurisdiction to develop a local implementation plan. A review of the plan was undertaken in 2012‑13 by the Aboriginal and Torres Strait Islander Health Forum, which includes membership from ACT Health, the ACT Aboriginal and Torres Strait Islander Elected Body, Winnunga Nimmityjah Aboriginal Health Service and ACT Medicare Local. In this process, many factors were identified as affecting its implementation, most significantly the Closing the Gap Indigenous reform agenda, which was introduced halfway through implementation of the plan in 2008.

Development of a new ACT Aboriginal and Torres Strait Islander Health Plan commenced in 2013. The plan will incorporate learning from the review of the previous plan and outstanding action items which have been identified as ongoing strategies requiring implementation by the Health Forum. The new plan will also be informed by the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes and will seek to form linkages with the other national health-related plans developed in 2013:

  • National Aboriginal and Torres Strait Islander Health Plan
  • National Aboriginal and Torres Strait Islander Social and Emotional Wellbeing Plan
  • National Aboriginal and Torres Strait Islander Suicide Prevention Strategy
  • National Aboriginal and Torres Strait Islander Blood-Borne Viruses and Sexually Transmissible Infections Strategy
  • National Aboriginal and Torres Strait Islander Drug Strategy.

The new health plan aims to promote a holistic approach to Aboriginal and Torres Strait Islander health planning for the ACT and surrounding community.

Health Workforce Plan 2013–18

The ACT Health Workforce Plan 2013–2018 was released in 2012‑13, aligning with national health workforce reform, including the Health Workforce Australia (HWA) National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015.

The principles that underpin the plan include workforce initiatives driven by consumer needs and cost-effectiveness, efficiency and sustainability. The plan provides a framework for actions by providing medium-term sustainable workforce planning strategies and associated actions which support the continued delivery of high-quality health services to the ACT region in an environment of increasing workforce challenges. The focus areas of the plan are strongly linked to ACT Health strategies and service plans which support more specific local needs.

The plan seeks to address health workforce issues through the use of five areas focus areas:

  • health workforce reform: improving service delivery
  • health workforce capacity: skills development
  • leadership and culture improvement for health system sustainability
  • health workforce planning
  • policy, funding and regulation.

The plan provides strategies under each focus area which provide direction, actions, accountabilities and measures of success which are able to be applied for operational workforce planning in all areas of ACT Health.

ACT Breastfeeding Strategic Framework 2010–2015

The ACT Breastfeeding Strategic Framework 2010–2015

document=2777) sets the context for the protection, promotion and support of breastfeeding in the ACT. The framework is consistent with, and supports the implementation of, the action areas in the Australian National Breastfeeding Strategy 2010–2015. While ACT Health is the lead agency to guide implementation, there is a whole-of-ACT Government commitment to this project, including the identification of strategies to support breastfeeding-friendly workplaces (BFW) across ACT Government directorates.

Significant achievements in 2012‑13 include breastfeeding-friendly workplace accreditation for three directorates, including ACT Health, with others considering accreditation. An inclusive DVD for young parents was produced in 2012 as a collaborative initiative between the Aboriginal and Torres Strait Islander Health Unit, Gugan Gulwan Aboriginal Youth Corporation, Canberra College Cares and young parents in the ACT. There has been substantial support for health professional education, including support for candidates sitting for the International Board of Lactation Consultant Examiners (IBLCE). There has also been considerable collaboration with non-government organisations, including the Australian Breastfeeding Association.

Both public hospitals in the ACT are Baby-Friendly Health Initiative (BFHI) accredited. All breastfeeding resources developed are web compatible and most resources utilise ‘apps’ to be user-friendly for a young target audience.

Enhanced breastfeeding data has been collected since July 2011, with capability to report against the nationally agreed indicators: ‘exclusive’, ‘predominant’ and ‘any’ breastfeeding.

A dedicated project officer oversaw implementation of the framework in 2012‑13, guided by a multidisciplinary Breastfeeding Initiative Steering Committee.

ACT Alcohol, Tobacco and Other Drug Strategy 2010–2014

Actions from the ACT Alcohol, Tobacco and Other Drug Strategy 2010–2014 progressed in 2012‑13 included:

  • smoking reduction and cessation programs for target populations:
  • – The Alcohol, Tobacco and Other Drugs Association ACT (ATODA) received funding in the 2012‑13

ACT Health Promotion Grants Program Community Funding Round to conduct the Under 10% project.

The project aims to support the ACT to be the first jurisdiction in Australia with a smoking prevalence under 10 per cent by providing targeted tobacco management and support to community services workers and clients with high smoking rates who experience disadvantage.

  • – ACT Health, in collaboration with a small reference group, developed a Brief Intervention Smoking Cessation E-learning Package, which has been available to ACT Health staff online since December 2012.
  • – ACT Health’s ‘Beyond Today … it’s up to you’ social marketing campaign to promote tobacco cessation and healthy lifestyle behaviours among the Aboriginal and Torres Strait Islander communities of the

ACT and surrounding regions was launched in December 2012.

  • drug treatment for people experiencing withdrawal, including those continuing on opioid maintenance treatment programs or choosing to cease opioid maintenance treatment:
  • – ATODA developed a discussion paper on expanding access to all ACT alcohol, tobacco and other drug residential treatment for people receiving opioid maintenance therapy and engaged with key people nationally working in this area, including We Help Ourselves (WHOS), an interstate provider of residential treatment for people receiving opioid maintenance therapy.
  • – Karralika Programs Inc. received three years of federal government funding to plan, implement and evaluate a pilot program admitting people on opioid maintenance therapy to its residential rehabilitation program. Implementation began in mid-2013.
  • peer-based models of service delivery, support advocacy and community development:
  • – The Canberra Alliance for Harm Minimisation and Advocacy (CAHMA), in collaboration with ATODA and ACT Health, developed and implemented Australia’s first overdose management program, which provides naloxone on prescription to potential overdose victims. The program is being evaluated by Professor Paul Dietze (Burnet Institute), Professor Simon Lenton (National Drug Research Institute), Dr Anna Olsen (Kirby Institute, UNSW) and Mr David McDonald (Social Research and Evaluation and Consultant to ATODA).

drug diversion programs:

  • – An external evaluation of ACT police and court drug diversion programs was undertaken. The evaluation was conducted by the Drug Policy Modelling Program, National Drug and Alcohol Research Centre and University of New South Wales and was completed in February 2013.

Sustainability Strategy

ACT Health continues to demonstrate its commitment to the principles of sustainability by monitoring its use of resources and integrating economic, social and environmental considerations into implementing measures to minimise the impact of agency activities on the environment. In 2012‑13, it:

  • continued to embed the ACT Health Sustainability Strategy into governance processes
  • implemented the first phase of the Sustainability Action Plan by incorporating sustainability actions into key focus areas of ACT Health business activity. All actions have been classified as short-, medium- and long-term.

Of the short-term actions (1–3 years), 93 per cent have now been completed. This equates to 59 actions.

  • developed and endorsed Sustainability—Environmental Principles and Guidelines for Building and Infrastructure Projects, a document designed to guide and inform all future development of healthcare facilities, including sustainability checklists for master planning, building design, the construction phase and the operational stage
  • implemented additional bicycle storage for visitors and staff on the Canberra Hospital campus
  • used a restricted OfficeMax stationery catalogue to ensure cost minimisation, maximising value for money and embedding the principles of purchasing sustainable products
  • conducted community consultation forums on future energy options for the Canberra Hospital campus as part of a feasibility study to best meet the sustainability goal of minimising CO2 emissions associated with future infrastructure growth
  • became a member of the Australasian Health Infrastructure Alliance Environmentally Sustainable Design Subcommittee, a forum whose mission is to share best practice between jurisdictions, pool resources to deliver infrastructure projects, leverage existing state-based projects at a national level and implement a common and unified understanding of sustainability in health care.

Quality and Safety Framework 2010–2015

The Quality and Safety Framework 2010–2015 describes a vision and direction to improve safety and quality in ACT Health and sets out the key activities that will happen throughout the organisation to improve the safety and quality of services provided to consumers.

The plan includes a set of actions divided into three themes, which align with those of the Australian Commission on Safety and Quality in Health Care in its framework for a vision for safe and high-quality health care for Australia. These themes are that care will be:

  • consumer-centred
  • driven by information
  • organised for safety.

To meet these themes, the Quality and Safety Unit has achieved the following:

  • partnered with the Health Care Consumers’ Association ACT to provide forums on ‘how to complain properly’, consumer representative training and advocacy training
  • supported ACT Health through the Australian Council on Healthcare Standards (ACHS) Organisation-Wide Survey to retain its accreditation status. ACT Health met all criteria to achieve accreditation for another four years, with 28 marked achievements, 18 extensive achievements and one outstanding achievement
  • implemented and evaluated training in bedside handover as part of the Effective Communication in Clinical Handover (ECCHO) project, a national Australian Research Council funding project in collaboration with the University of Technology Sydney and three other jurisdictions. Training is now being piloted in another ward. The project team presented at the International Council of Nurses Conference in May 2012
  • supported the establishment of the 10 National Safety and Quality in Health Services Standards Groups to provide strategic direction for the implementation of these standards and monitor progress on key activities
  • developed clear policy documents on important safety and quality issues such as:
  • – consent and treatment policy and standard operating procedures
  • – responding to the use of non-prescription alcohol and other drugs in health settings
  • – open disclosure
  • – work health and safety, and the safety management system
  • – dangerous substance management
  • held Open Disclosure Master Classes for senior clinical and executive staff. These classes provide targeted skills to support staff when open disclosure discussions with patients and families are required
  • supported and monitored the quality of policy documents through the Policy Advisory Committee and staff training sessions on policy governance and policy writing
  • provided education and training to staff on implementing the 10 National Safety and Quality Health Service Standards (NSQHSS)
  • facilitated the ACT Quality in Healthcare Awards, which showcase patient safety and quality initiatives across the territory and the ACT Health Better Practice Awards, which celebrate local quality improvement activities
  • developed an ACT Health Quality Improvement and National Safety and Quality Health Service Standards (NSQHSS) education strategy to improve understanding of change management and quality improvement methodology to support improvements in quality and safety practices
  • worked to update the Safety and Quality Framework to include the new National Safety and Quality in Health Services Standards. A consultation draft will be issued in early 2013‑14
  • appointed a Patient Experience Leader
  • completed a project on behalf of the Local Hospital Network (LHN) Council to collect patient stories relating particularly to bedside handover and discharge planning to allow the LHN Council to make recommendations for improvements
  • developed a toolkit to support chairs and secretariats of committees who have consumer representatives on the committees
  • made a successful budget bid to allow increased resourcing for the Respecting Patient Choices program to increase community awareness and uptake of advance care plans
  • held an annual Thank You celebration for consumer representatives on ACT Health committees
  • held regular liaison meetings with the Human Rights Commission to discuss processes and training opportunities for staff
  • completed the divisional progress report, providing weekly updates of consumer feedback and status
  • arranged guest presentations at Medicare Local Aged Care Forums and the Council on the Ageing ACT
  • rolled out education and training on the National Recommendations for User-Applied Labelling of Injectable Medications, Fluids and Lines
  • completed a training strategy to further support the implementation of open disclosure in ACT Health
  • ACT Health coordinated and monitored preparations for the November 2012 Australian Council on Health Standards organisation-wide survey
  • developed and implemented Canberra Hospital and Health Services-wide clinical audits that align with the National Safety and Quality Health Service Standards
  • revised ACT Health incident management policy and associated standard operating procedures (SOP), including the Incident Management SOP, Significant Incident SOP and Open Disclosure SOP
  • completed the first ACT Audit of Surgical Mortality Annual Report.

The framework is being reviewed for progress against the areas for action and alignment with the 10 National Safety and Quality Health Service Standards.

General Practice and Acute Sector Interaction Surveys

Several new services, communication strategies and process refinements have been put in place to improve the interaction between general practice and ACT Health, following two GP and acute sector interaction surveys conducted in 2009 and 2010. The combined report made 25 recommendations, which have now been implemented or are ongoing. Improvements have been wide-ranging and have included:

expansion of the ACT Health GP website to include common external resources, integration with outpatient and surgical waiting times and referral guidelines for outpatient services across ACT Health

establishment of an e-referral system, which allows clinician-to-clinician communication

improvements to the quality and timeliness of discharge summaries, including education, clinical support and discharge summary awards development, endorsement and promotion to all staff of policies and standard operating procedures (SOPs) to ensure better access and sharing of clinical information between and within the acute and primary health care sectors improved communication and referral practices facilitated by interaction between the General Practice Liaison Unit, ehealth staff and general practices.

Formal communication channels between general practice and ACT Health continue to operate through the ACT Health and ACT Medicare Local quarterly meetings, GP Liaison Network quarterly meetings and the ACT GP Workforce Working Group.