ACT Local Hospital Network Directorate

Management Discussion and Analysis for the ACT Local Hospital Network Directorate for the Year Ended 30 June 2015

General Overview

Purpose

The ACT Local Hospital Network Directorate (ACT LHN) was established under the Health Act 1953 (the Act), and is administered by the Director-General of the Health Directorate and supported by staff from the Health Directorate.

The ACT Local Hospital Council (Council), constituted under the Act, provides advice to the Director‑General of the Health Directorate on the clinical and corporate governance framework needed to support the improvement in standards of patient care and services provided through the ACT LHN. The Council also advises on ways to support, encourage and facilitate community and clinician involvement in the planning of services that form part of the ACT LHN. The Council reports to the Minister for Health on the state of the ACT LHN and any recommendations relating to improvement of the ACT LHN that the Council considers necessary.

The ACT LHN receives Activity Based Funding (ABF) from both the Commonwealth and the ACT Governments, and block funding for teaching, training and research. It purchases public hospital services from four ACT public hospital providers:

  • Canberra Hospital and Health Services;

  • Calvary Public Hospital;

  • Clare Holland House; and

  • Queen Elizabeth II Family Centre.

Risk Management

The Directorate’s management has identified the following potential risk that may influence the future financial position of the Directorate.

Actual public hospital activity (inpatient and outpatient services) delivered by entities in the ACT Local Hospital Network is lower than the budgeted activity resulting in a reduction of funding from the Commonwealth Government.

The Commonwealth Government will fund 45 per cent of the growth in public hospital activity from 2015-16 and the ACT Government and the Directorate will agree on the process for managing fluctuation in activity and costs from 2015-16.

The above risk is monitored regularly throughout the year.

Financial Performance

The following financial information is based on audited financial statements for 2013‑14 and 2014-15, and the forward estimates contained in the 2015-16 Health Directorate and ACT LHN Budget Statements.

Total Net Cost of Services

 

Actual

Budget

Actual

Budget

Forward

Forward

Forward

 

 

 

 

 

Estimate

Estimate

Estimate

 

2013-14

2014-15

2014-15

2015-16

2016-17

2017-18

2018-19

 

$m

$m

$m

$m

$m

$m

$m

Total Expenses

915.4

957.1

966.0

1,019.6

1,070.3

1,109.4

1,142.7

Total Own Source Revenue

377.2

355.3

402.9

414.5

438.8

459.8

473.2

Total Net Cost of Services

538.2

601.8

563.1

605.1

631.5

649.6

669.5

 

Comparison to Budget

The Directorate’s net cost of services for 2014-15 of $563.1 million was $38.7 million or 6.4 per cent lower than the 2014-15 budget (refer to Attachment A). This was mainly due to higher activity based funding and cross border revenue due to increased patient numbers compared to the estimate used in the budget.

Comparison to 2013-14 Actual Expenses

There was an increase of $24.9 million or 4.6% compared to the 2013‑14 net cost of service of $538.2 million. This is due to higher expenses of $50.4 million from growth in public hospital activity, including acute services, mental health services and cancer services and an increase in the price paid for these services. Higher expenses are partially offset by an increase in own source revenue of $25.7 million from Commonwealth grant funding for growth in services and an increase in the price paid for these services.

Future Trends

 

 

Figure 1: Net Cost of Services

Pg 253 net cost.jpg
As shown above in Figure 1, net cost of services is expected to increase across the forward years.

Total Expenditure

Components of Expenditure

Figure 2 below shows that for the financial year ended 30 June 2015, 99.4 per cent of total expenditure ($966.0 million) relates to grants and purchased services.

Pg 254 fig2.jpg

Figure 2 – Components of Expenditure

Comparison to Budget

Total expenses of $966.0 million was $8.9 million, or 0.9 per cent higher than the original 2014-15 budget of $957.1 million.

Comparison to 2013-14 Actual Expenses

Total expenses were $50.6 million or 5.5 per cent higher than the 2013-14 actual result.  This was due to growth in public hospital activity, including acute services, mental health services and cancer services, and inflation.

Future Trends

Expenses are budgeted to steadily increase across the forward estimate years.

Total Revenue

Components of Revenue

Figure 3 below indicates that for the financial year ended 30 June 2015, the Directorate received 58.4 per cent of its total revenue of $970.1 million from Government Payment for Outputs ($567.3 million), 9.5 per cent from Cross Border User Charges ($91.9 million), with the remaining 32.1 per cent made up of Grants from the Commonwealth ($311.0 million).

Pg 254 fig3.jpg

Figure 3 – Components of Own Source Revenue

Comparison to Budget

Own source revenue for the year ending 30 June 2015 was $402.9 million, which was $47.6 million or 13.4 per cent higher than the 2014-15 budget of $355.3 million. The higher own source revenue is due to higher activity based funding and cross border revenue from higher patient numbers than estimated in the budget.

Comparison to 2013-14 Actual Income

Own source revenue was $25.7 million or 6.8 per cent higher than the 2013-14 result of  $377.2 million. The increase is mainly due to an increase in the price paid for services and growth in public hospital activity including acute services, mental health services and cancer services funded through the National Health Reform Agreement.

Future Trends

Total own source revenue is expected to increase steadily.

Financial Position

Total Assets

Components of Total Assets

Figure 4 below indicates that, as at 30 June 2015, the Directorate held total assets of $17.6 million with 72.1 per cent of its assets in receivables and 27.9 per cent in cash and cash equivalents.

Pg 255 fig4.jpg

Comparison to Budget

The total asset position as at 30 June 2015 is $17.6 million, which exceeds the 2014-15 budget of $16.7 million by $0.9 million.

The variance reflects an increase in:

  • Receivables ($11.5 million) – which relates to the cross border receivables from other jurisdictions for the treatment of their residents in ACT hospitals and a refund of GST from the Australian Taxation Office; offset by a decrease in

  • Cash and Cash Equivalents ($10.6 million) – relates to the return of surplus cash to the ACT Government ($20.0 million) offset by the receipt of prior year cross border receivables from the New South Wales Ministry of Health.

Comparison to 2013-14 Actual

The Directorate’s total asset position is $18.6 million lower than the 2013-14 actual result of $36.2 million.  This is mainly due to the return of surplus cash to the ACT Government ($20.0 million) offset by the receipt of prior year cross border receivables from the New South Wales Ministry of Health.

Total Liabilities

Components of Total Liabilities

100.0 per cent of the Directorate’s liabilities relates to payables.

Comparison to Budget

The Directorate’s liabilities as at 30 June 2015 was $6.6 million, which relates to cross border payables owed to other jurisdictions for admitted and non‑admitted patient services provided to residents of the ACT in hospitals outside of the ACT that were not anticipated in the budget.

Comparison to 2013-14 Actual

Total liabilities were $2.7 million lower than the actual results as at 30 June 2014 of $9.3 million.

The lower level of payables in 2014-15 is due to higher level of provisional payments made by the Directorate to the New South Wales Ministry of Health for cross border health services, which has resulted in a lesser amount owed at year end.

Net Assets

The Directorate’s net assets as at 30 June 2015 were $5.7 million lower than the $16.7 million budgeted. This is mainly due to payables owed for cross border services not included in the budget.

Attachment A – Comparison of net cost of services to budget 2014-15

Description

Original

Budget

$'000

Plus AAO

Transfers

$'000

Total

Funding

$'000

Less

Actual

$'000

Variance to be Explained

$'000

%

Expenses

 

 

 

 

 

 

Purchased Services

936,600

 -

936,600

960,497

(23,897)

-2.6%

Other Expenses

14,853

 -

14,853

 -

14,853

100.0%

Transfer Expenses

5,601

 -

5,601

5,542

59

1.1%

Total Expenses

957,054

 -

957,054

966,039

(8,985)

-0.9%

Own Source Revenue

 

 

 

 

 

 

User Charges

84,249

 -

84,249

91,906

(7,657)

-9.1%

Grants from Commonwealth

271,080

 -

271,080

310,958

(39,878)

-14.7%

Total Own Source Revenue

355,329

 -

355,329

402,864

(47,535)

-13.4%

Total Net Cost of Services

601,725

 -

601,725

563,175

38,550

6.4%

LHN audit pg1.jpg

LHN audit pg2.jpgLHN Statement of RES.jpgLHN CHO.jpg

 

ACT Local Hospital Network Directorate Controlled Financial Statements for the Year Ended 30 June 2015

ACT Local Hospital Network Directorate Operating Statement for the Year Ended 30 June 2015

 

Note No.

Actual 2015

$’000

Original Budget

2015 

$’000

Actual 2014

$’000

Income

 

 

 

 

Revenue

 

 

 

 

Government Payment for Outputs

3

567,279

601,725

550,054

User Charges - Non-ACT Government

4

91,906

84,249

101,992

Grants from the Commonwealth

5

310,958

271,080

275,181

Total Revenue

 

970,143

957,054

927,227

Total Income

 

970,143

957,054

927,227

Expenses

 

 

 

 

Grants and Purchased Services

6

960,497

936,600

910,084

Other Expenses a

 

-

14,853

-

Transfer Expenses

7

5,542

5,601

5,316

Total Expenses

 

966,039

957,054

915,400

Operating Surplus

 

4,104

-

11,827

Total Comprehensive Income

 

4,104

-

11,827

The above Operating Statement should be read in conjunction with the accompanying notes.  The Directorate only has one output class and as such the above Operating Statement is also the Directorate's Operating Statement for the ACT Local Hospital Network Output Class. A separate disaggregated disclosure note has therefore not been included in these Financial Statements.

ACT Local Hospital Network Directorate Balance Sheet as at 30 June 2015

 

Note

No.

Actual

2015

$’000

Original Budget

2015

$’000

Actual

2014

$’000

Current Assets

 

 

 

 

Cash and Cash Equivalents

11

4,902

15,502

12,277

Receivables

12

12,650

1,177

23,827

Other Assets

13

-

-

79

Total Current Assets

 

17,552

16,679

36,183

Total Assets

 

17,552

16,679

36,183

Current Liabilities

 

 

 

 

Payables

14

6,605

-

9,340

Total Current Liabilities

 

6,605

-

9,340

Total Liabilities

 

6,605

-

9,340

Net Assets

 

10,947

16,679

26,843

Equity

 

 

 

 

Accumulated Funds

 

10,947

16,679

26,843

Total Equity

 

10,947

16,679

26,843

The above Balance Sheet should be read in conjunction with the accompanying notes.  The Directorate only has one output class and as such the above Balance Sheet is also the Directorate's Balance Sheet for the ACT Local Hospital Network Output Class. A separate disaggregated disclosure note has therefore not been included in these Financial Statements.

ACT Local Hospital Network Directorate Statement of Changes in Equity for the Year Ended 30 June 2015

 

Accumulated

Funds

Actual

2015

$’000

Total

Equity

Actual

2015

$’000

Original

Budget

2015

$’000

Balance at 1 July 2014

26,843

26,843

16,679

Comprehensive Income

 

 

 

Operating Surplus

4,104

4,104

-

Total Comprehensive Income

4,104

4,104

-

Transactions Involving Owners Affecting  Accumulated Funds

 

 

 

Capital (Distributions)

(20,000)

(20,000)

-

Total Transactions Involving Owners

   Affecting Accumulated Funds

(20,000)

(20,000)

-

Balance at 30 June 2015

10,947

10,947

16,679

 

 

Accumulated

Funds Actual

2014

$’000

Total Equity

Actual 2014

$’000

Original

Budget

2014

$’000

Balance at 1 July 2013

15,016

15,016

-

Comprehensive Income

 

 

 

Operating Surplus

11,827

11,827

-

Total Comprehensive Income

11,827

11,827

-

Transactions Involving Owners Affecting Accumulate Funds

 

 

 

Capital Injections

-

-

-

Total Transactions Involving Owners

   Affecting Accumulated Funds

11,827

11,827

-

Balance at 30 June 2014

26,843

26,843

-

The above Statement of Changes in Equity should be read in conjunction with the accompanying notes.

The above Statement of Changes in Equity should be read in conjunction with the accompanying notes.

ACT Local Hospital Network Directorate Cash Flow Statement for the Year Ended 30 June 2015

 

Note

No.

Actual

2015

$’000

Original

Budget

2015

$’000

Actual

2014

$’000

Cash Flows from Operating Activities

 

 

 

 

Receipts

 

 

 

 

Government Payment for Outputs

 

567,279

601,725

550,054

User Charges

 

103,152

84,249

162,730

Grants Received from Commonwealth

 

310,958

271,080

275,181

Goods and Services Tax Input Tax Credits

   from the Australian Taxation Office

 

18,681

18,623

18,634

Total Receipts from Operating Activities

 

1,000,070

975,677

1,006,599

Payments

 

 

 

 

Grants and Purchased Services

 

968,697

942,201

972,608

Goods and Services Tax Paid to Suppliers

 

18,748

-

18,721

Other

 

-

33,476

-

Payments to the Health Directorate

 

-

-

5,316

Total Payments from Operating Activities

 

987,445

975,677

996,645

Net Cash Inflows from Operating Activities

19

12,625

-

9,954

 

Cash Flows from Investing Activities

 

 

 

 

Receipts

 

 

 

 

Capital (Distributions)

 

(20,000)

-

-

Total Receipts from Investing Activities

 

(20,000)

-

-

Net Cash (Outflows) from Investing Activities

 

(20,000)

-

-

Net (Decrease)/Increase in Cash and Cash Equivalents

 

(7,375)

-

9,954

Cash and Cash Equivalents at the Beginning of the

 

 

 

 

  Reporting Period

 

12,277

15,502

2,323

Cash and Cash Equivalents at the End of the

  Reporting Period

 

4,902

15,502

12,277

The above Cash Flow Statement should be read in conjunction with the accompanying notes.

The above Cash Flow Statement should be read in conjunction with the accompanying notes.

ACT Local Hospital Network Directorate Controlled Statement of Appropriation for the Year Ended 30 June 2015

 

 

Original

Budget

2015

$’000

Total

Appropriated

2015

$’000

Appropriation

Drawn

2015

$’000

Appropriation

Drawn

2014

$’000

Controlled

 

 

 

 

 

Government Payment for Outputs

 

601,725

606,098

567,279

550,054

Total Controlled Appropriation

 

601,725

606,098

567,279

550,054

The above Controlled Statement of Appropriation should be read in conjunction with the accompanying notes.

Column Heading Explanations

The Original Budget column shows the amounts that appear in the Cash Flow Statement in the Budget Papers. This amount also appears in the Cash Flow Statement.

The  Total  Appropriated  column is inclusive of all appropriation  variations occurring after the Original Budget.

The Appropriation Drawn is the total amount of appropriation received by the Directorate during the year. This amount appears in the Cash Flow Statement.

Variances between ‘Original Budget’ and ‘Total Appropriated’

Government Payment for Outputs

The difference between the Original Budget and Total Appropriated to the Directorate relates to funding from the Commonwealth for the ‘Public Hospital System – Additional Funding National Partnership Agreement’ ($4.4 million).

Variances between ‘Total Appropriated’ and ‘Appropriation Drawn’

Government Payment for Outputs

The difference between the Total Appropriated and the Appropriation Drawn relates to appropriation not required following increases in Commonwealth funding for inpatient and outpatient activity above original estimates and higher than budgeted cross border revenue from the New South Wales Ministry of Health and final acquittal of the 2012-13 cross border activity.

ACT Local Hospital Network Directorate Controlled Note Index

Note

1

Objectives of the ACT Local Hospital Network Directorate

Note

2

Summary of Significant Accounting Policies

Income Notes

Note

3

Government Payment for Outputs

Note

4

User Charges - Non-ACT Government

Note

5

Grants from the Commonwealth

Expense Notes

Note

6

Grants and Purchased Services

Note

7

Transfer Expenses

Note

8

Auditor's Remuneration

Note

9

Waivers, Impairment Losses and Write-Offs

Note

10

Act of Grace Payments

Asset Notes

Note

11

Cash and Cash Equivalents

Note

12

Receivables

Note

13

Other Assets

Liability Note

Note

14

Payables

Other Notes

Note

15

Financial Instruments

Note

16

Commitments

Note

17

Contingent Liabilities and Contingent Assets

Note

18

Events Occurring After Balance Date

Note

19

Cash Flow Reconciliation

Note

20

Service Concession Asset

Note

21

Budgetary Reporting

ACT Local Hospital Network Directorate Notes to and Forming Part of the Financial Statements for the Year Ended 30 June 2015

Note 1.     Objectives of The ACT Local Hospital Network Directorate

Operations and Principal Activities

The ACT Local Hospital Network Directorate (ACT LHN) was established under the Health Act 1953 (the Act), and is administered by the Director-General of the Health Directorate and supported by staff from the Health Directorate.

The ACT Local Hospital Council (Council), constituted under the Act, provides advice to the Director-General of the Health Directorate on the clinical and corporate governance framework needed to support the improvement in standards of patient care and services provided through the ACT LHN. The Council also advises on ways to support, encourage and facilitate community and clinician involvement in the planning of services that form part of the ACT LHN. The Council reports to the Minister for Health on the state of the ACT LHN and any recommendations relating to improvement of the ACT LHN that the council considers necessary.

The ACT LHN receives Activity Based Funding from the Commonwealth and ACT Governments, and block funding for teaching, training and research. It purchases public hospital services from four ACT public hospital providers:

  • Canberra Hospital and Health Services;
  • Calvary Public Hospital;
  • Clare Holland House; and
  • Queen Elizabeth II Family Centre.

Note 2.         Summary of Significant Accounting Policies

(a)           Basis of Preparation

The Financial Management Act 1996 (FMA) requires the preparation of annual financial statements for ACT Government agencies.

The FMA and the Financial Management Guidelines issued under the Act, requires the Directorate’s financial statements to include:

  1. an Operating Statement for the year;
  2. a Balance Sheet at the end of the year;
  3. a Statement of Changes in Equity for the year;
  4. a Cash Flow Statement for the year;
  5. a Statement of Appropriation for the year;
  6. an Operating Statement for each class of output for the year;
  7. a summary of the significant accounting policies adopted for the year; and
  8. such other statements as are necessary to fairly reflect the financial operations of the Directorate during the year and its financial position at the end of the year.

These general-purpose financial statements have been prepared to comply with ‘Generally Accepted Accounting Principles’ (GAAP) as required by the FMA.  The financial statements have been prepared in accordance with:

  1. Australian Accounting Standards; and
  2. ACT Accounting and Disclosure Policies.

The financial statements have been prepared using the accrual basis of accounting, which recognises the effects of transactions and events when they occur.  The financial statements have also been prepared according to the historical cost convention.

These financial statements are presented in Australian dollars, which is the Directorate’s functional currency.

The Directorate is an individual reporting entity.

(b)           Controlled and Territorial Items

The Directorate produces Controlled financial statements.  The Controlled financial statements include income, expenses, assets and liabilities over which the Directorate has control. 

The Directorate does not produce Territorial financial statements because it does not administer any resources on behalf of the Territory.

(c)           The Reporting Period

These financial statements state the financial performance, changes in equity and cash flows of the Directorate for the year ending 30 June 2015 together with the financial position of the Directorate as at 30 June 2015.

(d)           Comparative Figures

Budget Figures

To facilitate a comparison with Budget Papers, as required by the Financial Management Act 1996, budget information for 2014-2015 has been presented in the financial statements. Budget numbers in the financial statements are the original budget numbers that appear in the Budget Papers.

Prior Year Comparatives

Comparative information has been disclosed in respect of the previous period for amounts reported in the financial statements, except where an Australian Accounting Standard does not require comparative information to be disclosed.

Where the presentation or classification of items in the financial statements is amended, the comparative amounts have been reclassified where practical.  Where a reclassification has occurred, the nature, amount and reason for the reclassification is provided.

(e)           Rounding

All amounts in the financial statements have been rounded to the nearest thousand dollars ($’000).  Use of the “‑” symbol represents zero amounts or amounts rounded up or down to zero.

(f)            Revenue Recognition

Revenue is recognised at the fair value of the consideration received or receivable in the Operating Statement. All revenue is recognised to the extent that it is probable that the economic benefits will flow to the Directorate and the revenue can be reliably measured. In addition, the following specific recognition criteria must also be met before revenue is recognised:

Government Payment for Outputs

Government Payment for Outputs are recognised as revenues when the Directorate gains control over the funding.  Control over appropriated funds is normally obtained upon the receipt of cash.

Cross Border (Interstate) Health Revenue

Revenue for cross border (interstate) health services is recognised when the number of patients and complexities of treatments provided can be measured reliably using the price payable for the service. The price payable for services is determined by the Independent Hospital Pricing Authority. Actual patient numbers and services are settled following an acquittal process undertaken in subsequent years and variations to the revenue recognised are accounted for in the year of settlement.

The National Health Reform Agreement specifies that each jurisdiction will make funding contributions through the National Health Funding Pool for services provided by other jurisdictions to its residents either on an ad hoc basis reflecting actual activity, or on a regular basis as scheduled through a Cross Border agreement.  For 2014-15 the ACT has a Cross Border Agreement in place with the New South Wales Ministry of Health.

Commonwealth Grants

Commonwealth Grants relate to Activity Based Funding and Block Funding under the National Health Reforms.  They also include the Commonwealth funding component of cross border health costs for interstate residents treated in ACT public hospitals.

Activity based funding (ABF) refers to a national system for funding public hospital services using national classifications, national price weights and a national efficient price (NEP). It is predicated on the Independent Hospital Pricing Authority (IHPA) pricing model which has set weights and pricing adjustments based on patient characteristics, that together give rise to a total payment amount for a hospital patient service. ABF covers all admitted, non‑admitted and emergency department services that meet the IHPA criteria for inclusion on the ‘General List of In‑Scope Public Hospital Services’.

For 2014-15, ABF was paid at a rate of 45% of the NEP for activity above last year’s baseline, with base activity payment paid at last year’s rate plus price indexation.

Block funding is provided to support public hospital functions that are recognised by the Independent Hospital Pricing Authority as services acceptable to be funded on this basis and that conform to the Independent Hospital Pricing Authority’s national pricing model.

Commonwealth Grants is calculated and paid using estimates. The estimate is based on expected number of patients treated during the year. Further information on the basis of the estimate is provided in Note 2(O): Significant Accounting Judgements and Estimates.

Commonwealth Grants are recognised as revenues upon the receipt of cash.

Revenue Received in Advance

Revenue Received in Advance is recognised as a liability if there is a present obligation to return the funds received, otherwise all funds received are recorded as revenue.

(g)           Waivers of Debt

Debts that are waived during the year under Section 131 of the Financial Management Act 1996 are expenses during the year in which the right to payment was waived.  Further details of waivers are disclosed at Note 9: Waivers, Impairment Losses and Write‑offs.

 (h)          Current and Non-Current Items

Assets and liabilities are classified as current or non-current in the Balance Sheet and in the relevant notes.  Assets are classified as current where they are expected to be realised within 12 months after the reporting date. Liabilities are classified as current when they are due to be settled within 12 months after the reporting date or when the Directorate does not have an unconditional right to defer settlement of the liability for at least 12 months after the reporting date. 

Assets or liabilities which do not fall within the current classification are classified as non-current.

(i)            Cash and Cash Equivalents

For the purposes of the Cash Flow Statement and the Balance Sheet, cash includes cash at bank and cash on hand.

Cash equivalents are short-term, highly liquid investments that are readily convertible to known amounts of cash and which are subject to an insignificant risk of changes in value.

(j)            Receivables

Accounts receivable are initially recognised at fair value and are subsequently measured at amortised cost, with any adjustments to the carrying amount being recorded in the Operating Statement.

Accrued Cross Border revenue relates to the estimated number of interstate patients treated in an ACT public hospital for 2014-15.  Under the National Health Reform Agreement, States and Territories are required to pay for Cross Border activity using the price payable for services. The price payable for services is determined by the Independent Hospital Pricing Authority.  The actual level of revenue will be subject to an acquittal process to be completed in subsequent years.

The allowance for impairment losses represents the amount of receivables the Directorate estimates will not be repaid. The allowance for impairment losses is based on objective evidence and a review of overdue balances. The Directorate considers the following is objective evidence of impairment:

  • becoming aware of financial difficulties of debtors;
  • default payments; or
  • debts more than 90 days overdue.

The amount of the allowance is the difference between the assets’ carrying amount and the present value of the estimated future cash flows, discounted at the original effective interest rate. Cash flows relating to short‑term receivables are not discounted if the effect of discounting is immaterial. The amount of the allowance is recognised in the Operating Statement. The allowance for impairment loss is written off against the allowance account when the Directorate ceases action to collect the debt as it considers that it will cost more to recover the debt than the debt is worth.

Receivables that have been renegotiated because they are past due or impaired are accounted for based on the renegotiated terms.

 (k)          Payables

Payables are a financial liability and are initially recognised at fair value based on the transition costs and subsequent to initial recognition at amortised cost, with any adjustments to the carrying amount being recorded in the Operating Statement. All amounts are normally settled within 30 days after the invoice date.

(l)            Employee Costs and Employee Benefits Liabilities

The Directorate does not employ any staff. All staff providing administrative support are employed by the Health Directorate. Therefore, the Directorate does not incur any employee costs and does not have any employee benefit liabilities.

(m)         Equity Contributed by the ACT Government

Contributions made by the ACT Government, through its role as owner of the Directorate, are treated as contributions of equity.

Increases or decreases in net assets as a result of Administrative Restructures are also recognised in equity.

(n)           Budgetary Reporting

Explanations of major variances between the 2014-15 original budget and the 30 June 2015 actual results are discussed in Note 21: Budgetary Reporting.  

The definition of ‘major variances’ is provided in Note 2(o): Significant Accounting Judgements and Estimates – Budgetary Reporting.  

Original budget refers to the original budgeted financial statements presented to the Legislative Assembly in a form that is consistent with the Directorate’s annual financial statements.  The 2014-15 budget numbers have not been audited.

Budgetary reporting is disclosed for controlled financial statements with the exception of Statement of Changes in Equity as relevant line items are included in other financial statements.

(o)           Significant Accounting Judgements and Estimates

In the process of applying the accounting policies listed in this note, the Directorate has made the following judgements and estimates that have the most significant impact on the amounts recorded in the financial statements:

Cross Border (Interstate) Health Receivables: is an estimation based on the number of interstate patients converted into a National Weighted Activity Unit and paid at the price determined by the Independent Hospital Pricing Authority. Interstate patient numbers for the current year is an estimation based on actual patient numbers for the nine months to 30 April 2015. Actual patient numbers and services are settled following an acquittal process undertaken in subsequent years and variations to the revenue recognised are accounted for in the year of settlement.

Commonwealth Grants: is an estimation based on the expected number of patients converted into a National Weighted Activity Unit and paid at the price determined by the Independent Hospital Pricing Authority. Actual National Weighted Activity Units is settled following an acquittal process undertaken in the following financial year and variations to the revenue recognised are accounted for in the year of settlement.

Budgetary Reporting: Significant judgements have been applied in determining what variances are considered as ‘major variances’ requiring explanations in Note 21: Budgetary Reporting.   Variances are considered to be major variances if both of the following criteria are met:

  • The line item is a significant line item:  the line item actual amount accounts for more than 10% of the relevant associated category (Income, Expenses and Equity totals) or sub-element (e.g. Current Liabilities and Receipts from Operating Activities totals) of the financial statements; and
  • The variances (original budget to actual) are greater than plus (+) or minus (-) 10% of the budget for the financial statement line item.

Further information on this is provided in Note 2(n): Budgetary Reporting.

(p)           Impact of Accounting Standards Issued but yet to be Applied

The following new and revised accounting standards and interpretations have been issued by the Australian Accounting Standards Board but do not apply to the current reporting period. These standards and interpretations are applicable to future reporting periods. The Directorate does not intend to adopt these standards and interpretations early. Where applicable, these Australian Accounting Standards will be adopted from their application date.

(p)           Impact of Accounting Standards Issued but yet to be Applied (Continued)

  • AASB 9 Financial Instruments (December 2014) (application date 1 January 2018);

This standard supersedes AASB 139 Financial Instruments: Recognition and Measurement. The main impact of AASB 9 is that it will change the classification, measurement and disclosure of the financial assets.  No material financial impact on the Directorate is expected.

  • AASB 15 Revenue from Contracts with Customers (application date 1 January 2017);

AASB 15 is the new standard for revenue recognition. It establishes a comprehensive framework for determining whether, how much and when revenue is recognised. It replaces AASB 111 Construction Contracts and AASB 118 Revenue.  No material financial impact on the Directorate is expected as the Directorate’s current revenue recognition is already in line with the requirement of this standard.

Note 3.     Government Payment for Outputs

Government Payment for Outputs (GPO) is revenue received from the ACT Government for the purchase of hospital services from ACT public hospitals. The ACT Government pays GPO appropriation on a fortnightly basis.

 

 

2015

$’000

2014

$’000

 

Revenue from the ACT Government

 

 

 

Government Payment for Outputs a

 567,279

550,054

 

Total Government Payment for Outputs

 567,279

550,054

 

 

  1. The increase is due to growth in services in acute services, mental health, community health centres, the Centenary Hospital for Women and Children, the Canberra Region Cancer Centre, community nursing, the emergency department, and outpatient and imaging services.

Note 4.     User Charges – Non-ACT Government

User charge revenue is derived by providing public hospital services to interstate residents.  User charge revenue is not part of ACT Government appropriation and is paid by other state or territory governments.  This revenue is driven by demand for health services from interstate patients and is not for profit in nature.

 

2015

$’000

2014

$’000

User Charges - Non-ACT Government

 

 

Cross Border (Interstate) Health Revenue a

91,906

101,992

Total User Charges - Non-ACT Government

91,906

101,992

 

  1. 2013-14 included additional one-off revenue relating to prior year acquittals for cross border activity from several jurisdictions.

Note 5.     Grants from the Commonwealth

Grants from the Commonwealth reflect contributions from the Commonwealth for Activity Based Funding and Block Funding, as well as a contribution for public health services.

 

2015

$’000

2014

$’000

Grants from the Commonwealth

 

 

Grants a

310,958

275,181

Total Grants from the Commonwealth

310,958

275,181

  1. The increase is mainly due to an increase in the price paid for services and growth in activity for public hospital services funded through the National Health Reform Agreement.

Note 6.     Grants and Purchased Services

Grants and Purchased Services reflect public hospital payments to the Canberra Hospital and Health Services, Calvary Public Hospital, Clare Holland House, Queen Elizabeth II Hospital, and States and the Northern Territory for cross border patient services.

 

2015

$’000

2014

$’000

Purchased Services

 

 

Payments to Service Providers

 

 

 - Canberra Hospital and Health Services a

754,745

711,956

 - Calvary Public Hospital a

178,557

167,133

 - Clare Holland House

5,114

4,870

 - Queen Elizabeth II Hospital

2,534

2,482

Cross Border (Interstate) Health Costs b

19,547

23,643

Total Grants and Purchased Services

960,497

910,084

  1. The increase is mainly due to an increase in the price paid for services and growth in public hospital services.
  2. The decrease is mainly due to the finalisation of prior year acquittals for several jurisdictions during 2013‑14 which resulted in recognising additional expense in 2013-14.

Note 7.     Transfer Expenses

Transfer Expenses relate to the on-passing of the Commonwealth’s contribution to public health funding to the Health Directorate.

 

2015

$’000

2014

$’000

 

 

 

Transfer Expenses

5,542

5,316

Total Transfer Expenses

5,542

5,316

Note 8.     Auditor’s Remuneration

Auditor’s remuneration represents fees charged by the ACT Audit Office for financial audit services provided to the Directorate.

 

2015

$’000

2014

$’000

Audit Services

 

 

Audit Fees Paid or Payable to the ACT Audit Office

45

44

Total Audit Services

45

44

No other services were provided by the ACT Audit Office.

Note 9.     Waivers, Impairment Losses and Write- Offs

Under Section 131 of the Financial Management Act 1996 the Treasurer may, in writing, waive the right to payment of an amount payable to the Territory.

A waiver is the relinquishment of a legal claim to a debt over which the Directorate has control.  The write-off of a debt is the accounting action taken to remove a debt from the books but does not relinquish the legal right of the Directorate to recover the amount.  The write-off of debts may occur for reasons other than waivers.

The Directorate had no waivers, impairment losses or write-offs in 2014-15 (nil, 2013-14).

Note 10.     Act of Grace Payments

Under Section 130 of the Financial Management Act 1996 the Treasurer may, in writing, authorise Act of Grace Payments to be made by a Directorate.  Act of Grace payments are a method of providing equitable remedies to entities or individuals that may have been unfairly disadvantaged by the ACT Government but have no legal claim to the payment.

The Directorate made no Act of Grace Payments during 2014-15 (nil, 2013-14).

Note 11.     Cash and Cash Equivalents

The Directorate holds a number of bank accounts on which it does not earn interest. These funds are able to be withdrawn upon request.

 

2015

$’000

2014

$’000

Cash at Bank a

4,902

12,277

Total Cash and Cash Equivalents

4,902

12,277

 

  1. The decrease is due to the return of surplus cash to the ACT Government ($20.0 million) offset by the receipt of prior year cross border receivables from the New South Wales Ministry of Health.

Note 12.     Receivables

 

2015

$’000

2014

$’000

Current Receivables

 

 

Accrued Revenue a

11,318

22,563

Net GST Receivable

1,332

1,264

Total Current Receivables

12,650

23,827

Total Receivables

12,650

23,827

  1. The reduction is mainly due to increased provisional payments from the New South Wales Ministry of Health for cross border health services in 2014-15 resulting in lower level outstanding debt.

Ageing of Receivables

Not Overdue

Over Due

Total

 

 

Less than

30 to

Greater

 

 

 

30 Days

 60 Days

than 60 Days

 

 

$'000

$'000

$'000

$'000

$'000

2015

 

 

 

 

 

Not Impaired Receivables a

12,650

-

-

-

12,650

Impaired Receivables

-

-

-

-

-

2014

 

 

 

 

 

Not Impaired Receivables

23,827

-

-

-

23,827

Impaired Receivables

-

-

-

-

-

  1. This mainly relates to cross border receivables for admitted and non-admitted patient services provided to residents of the States and the Northern Territory. This is categorised as ‘not overdue’ as the funding agreement does not mandate a timeframe for payment prior to final acquittal of activity numbers for each period and the final acquittals are yet to occur.

 

2015

$’000

2014

$’000

Classification of ACT Government/Non-ACT Government Receivables

 

 

Receivables from Non-ACT Government Entities

 

 

Other Receivables

11,318

22,563

Net Goods and Services Tax Receivables

1,332

1,264

Total Receivables from Non-ACT Government Entities

12,650

23,827

Total Receivables

12,650

23,827

Note 13.     Other Assets

 

2015

$’000

2014

$’000

Current Other Assets

 

 

Prepayments

-

79

Total Current Other Assets

-

79

Total Other Assets

-

79

 

Note 14.     Payables

 

2015

$’000

2014

$’000

Current Payables

 

 

Accrued Expenses a

6,605

9,340

Total Current Payables

6,605

9,340

Total Payables

6,605

9,340

 

 

2015

$’000

2014

$’000

Payables are aged as followed

 

 

Not Overdue

6,605

9,340

Overdue for Less than 30 Days

-

-

Overdue for 30 to 60 Days

-

-

Overdue for More than 60 Days

-

-

Total Payables

6,605

9,340

Classification of ACT Government/Non-ACT Government Payables

 

 

Payables with ACT Government Entities

 

 

Accrued Expenses

-

-

Total Payables with ACT Government Entities

-

-

Payables with Non-ACT Government Entities

 

 

Accrued Expenses a

6,605

9,340

Total Payables with Non-ACT Government Entities

6,605

9,340

Total Payables

6,605

9,340

 

  1. This is accrued cross border expenses owed to the States and the Northern Territory for health services provided to residents of the ACT in the States and the Northern Territory. The reduction reflects higher level provisional payments made by the Directorate to the New South Wales Ministry of Health during 2014-15 which has resulted in a lesser amount owed at year end.

Note 15.     Financial Instruments

Details of the significant policies and methods adopted, including the criteria for recognition, the basis of measurement, and the basis on which income and expenses are recognised, with respect to each class of financial asset and financial liability are disclosed in Note 2:  Summary of Significant Accounting Policies.

Interest Rate Risk

Interest rate risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate because of changes in market interest rates. The Directorate is considered to have no exposure to interest rate risk, as it holds only cash and cash equivalents with Westpac Banking Corporation and Reserve Bank of Australia that generate no interest, and receivables are non-interest bearing.

A sensitivity analysis has not been undertaken for the interest rate risk of the Directorate as it is not exposed to movements in interest rates.

Credit Risk

Credit risk is the risk that one party to a financial instrument will fail to discharge an obligation and cause the other party to incur a financial loss. The Directorate’s credit risk is limited to the amount of the financial assets held less any allowance for impairment.

The Directorate's financial assets consist of Cash and Cash Equivalents and Receivables.

Cash and cash equivalents are held with the Westpac Banking Corporation, a high credit, quality financial institution, in accordance with whole of ACT Government banking arrangements and at year end  the Directorate holds no investments.

The Directorate’s receivables mainly consist of amounts owed from the New South Wales Ministry of Health and the Department of Health and Human Services in Victoria.  As the New South Wales and Victorian Governments both have a AAA credit rating it is considered that there is a very low risk of default for these receivables. Any credit risk for receivables with New South Wales Ministry of Health and Department of Health and Human Services in Victoria is managed by having an agreement in place providing required activity data in a timely manner.

Liquidity Risk

Liquidity risk is the risk that the Directorate will encounter difficulties in meeting obligations associated with financial liabilities that are settled by delivering cash or another financial asset.

The main source of cash to pay these obligations is appropriation from the ACT Government and Grants from the Commonwealth. Appropriation is paid on a fortnightly basis and the Commonwealth Grants on a monthly basis during the year. The Directorate manages its liquidity risk through forecasting appropriation drawdown requirements to enable payment of anticipated obligations.

Price Risk

Price risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate because of changes in market prices, whether these changes are caused by factors specific to the individual financial instrument or its issuer, or by factors affecting all similar financial instruments traded in the market.

The Directorate holds no financial instruments that are subject to price risk and as a result, is not considered to have any price risk. Accordingly, a sensitivity analysis has not been undertaken.

Fair Value of Financial Assets and Liabilities

The carrying amounts and fair values of financial assets and liabilities at the end of the reporting period are:

 

Carrying

Amount

2015

$’000

Fair

Value

2015

$’000

Carrying

Amount

2014

$’000

Fair

Value

2014

$’000

Financial Assets

 

 

 

 

Cash and Cash Equivalents

4,902

4,902

12,277

12,277

Receivables

11,318

11,318

22,563

22,563

Total Financial Assets

16,220

16,220

34,840

34,840

Financial Liabilities

 

 

 

 

Payables

6,605

6,605

9,340

9,340

Total Financial Liabilities

6,605

6,605

9,340

9,340

The following table sets out the Directorate’s maturity analysis for financial assets and liabilities as well as the exposure to interest rates, including average weighted interest rates by maturity period as at 30 June 2015.  Financial assets and liabilities which have a floating interest rate or are non-interest bearing will mature in 1 year or less.  All amounts appearing in the following maturity analysis are shown on an undiscounted cash flow basis.

 

Fixed Interest Maturing In:

 

 

 

Note

No.

Weighted

Average

Interest

Rate

Floating

Interest

Rate

$’000

1 Year

or Less

$’000

Over 1

to 5 Years

$’000

 

Over

5 Years

$’000

Non-interest

Bearing

$’000

Total

$’000

Financial Instruments

 

 

 

 

 

 

 

 

Financial Assets

 

 

 

 

 

 

 

 

Cash and Cash Equivalents

11

 

-

-

-

-

4,902

4,902

Receivables

12

 

-

-

-

-

11,318

11,318

Total Financial Assets

 

 

-

-

-

-

16,220

16,220

Financial Liabilities

 

 

 

 

 

 

 

 

Payables

14

 

-

-

-

-

6,605

6,605

Total Financial Liabilities

 

 

-

-

-

-

6,605

6,605

Net Financial Assets

 

 

-

-

-

-

9,615

9,615

The following table sets out the Directorate’s maturity analysis for financial assets and liabilities as well as the exposure to interest rates, including average weighted interest rates by maturity period as at 30 June 2014.  Financial assets and liabilities which have a floating interest rate or are non-interest bearing will mature in 1 year or less.  All amounts appearing in the following maturity analysis are shown on an undiscounted cash flow basis.

 

 

 

 

Fixed Interest Maturing In:

 

 

 

Note

No.

Weighted

Average

Interest

Rate

Floating

Interest

Rate

$’000

1 Year

or Less

$’000

Over 1

to 5 Years

$’000

Over

5 Years

$’000

Non-Interest

Bearing

$’000

Total

$’000

Financial Instruments

 

 

 

 

 

 

 

 

Financial Assets

 

 

 

 

 

 

 

 

Cash and Cash Equivalents

11

 

-

-

-

-

12,277

12,277

Receivables

12

 

-

-

-

-

22,563

22,563

Total Financial Assets

 

 

-

-

-

-

34,840

34,840

Financial Liabilities

 

 

 

 

 

 

 

 

Payables

14

 

-

-

-

-

9,340

9,340

Total Financial Liabilities

 

 

-

-

-

-

9,340

9,340

Net Financial Assets

 

 

-

-

-

-

25,500

25,500

 

Carrying Amount of Each Category of Financial Asset and Financial Liability

2015

$’000

2014

$’000

Financial Assets

 

 

Loans and Receivables Measured at Amortised Cost

11,318

22,563

Financial Liabilities

 

 

Financial Liabilities Measured at Amortised Cost

6,605

9,340

Fair Value Hierarchy

The Directorate does not have any financial assets or financial liabilities at fair value. As such no Fair Value Hierarchy disclosures have been made. 

Note 16.     Commitments

The Directorate has no commitments as at 30 June 2015 (nil, 30 June 2014)

Note 17.     Contingent Liabilities and Contingent Assets

There were no contingent liabilities or contingent assets as at 30 June 2015 (nil, 30 June 2014).

There were no indemnities as at 30 June 2015 (nil, 30 June 2014).

Note 18.     Events Occurring After Balance Date

There were no events occurring after the balance date, which would affect the financial statements as at
30 June 2015, or in future reporting periods.

Note 19.     Cash Flow Reconciliation

 

(a) Reconciliation of Cash and Cash Equivalents at the end of the reporting period in the

Cash Flow Statement to the equivalent items in the Balance Sheet

2015

$’000

2014

$’000

The Cash and Cash Equivalents Recorded in the Balance Sheet

4,902

12,277

Cash and Cash Equivalents at the End of the Reporting Period as Recorded in the Cash Flow Statement

4,902

12,277

(b) Reconciliation of Net Cash Outflows from Operating Activities to the Operating Surplus/ (Deficit)

 

 

2015

$’000

2014

$’000

Operating Surplus

4,104

11,827

Cash Before Changes in Operating Assets and Liabilities

4,104

11,827

Changes in Operating Assets and Liabilities

 

 

Decrease in Receivables

11,177

60,650

Decrease/(Increase) in Other Assets

79

(79)

(Decrease) in Payables

(2,735)

(62,444)

Net Changes in Operating Assets and Liabilities

8,521

(1,873)

Net Cash Inflows from Operating Activities

12,625

9,954

Note 20.     Service Concession Asset

The Directorate has entered into an agreement with Calvary Health Care ACT Ltd for the provision of hospital and associated services. The original agreement was entered into by the Commonwealth on 22 October 1971 and does not stipulate any expiry date. This was subsequently amended in 1979 to include the Directorate (named at the time as Capital Territory Health Commission) with any duties or functions of the Commonwealth being transferred to the Directorate. The Agreement was for the facility to be used for a public hospital. This was varied, in 1988, by the Calvary Private Agreement to allow Calvary Health Care Ltd to use two floors of the facility for treating private patients. The Calvary Private Agreement sets the process and mechanism for Calvary Private to reimburse Calvary Public for any costs incurred in using public hospital facilities for treating private patients. These agreements were replaced on 7 December 2011 with the Calvary Network Agreement.

Under the agreement, Calvary Health Care ACT Ltd is required to provide hospital services and make these services available to all persons irrespective of their circumstances and is to charge patients fees only in accordance with the scale of fees applicable at Health Directorate hospitals for comparable services. In the event that the agreement ceases, all land is to be returned to the Territory. The level of services that is required to be provided in a financial year, for the amount of funding provided, is stipulated in a Performance Plan agreed between the Directorate and Calvary Health Care ACT Ltd for each year.

The land, hospital buildings and other assets comprising the Calvary Public Hospital are not recognised in the Directorate's Balance Sheet.

Note 21.       Budgetary Reporting – Explanations of Major Variances Between Actual Amounts and Original Budget Amounts

The following are brief explanations of major line item variances between budget estimates and actual outcomes.  Variances are considered to be major variances if both of the following criteria are met:

  1. The line item is a significant line item:the line item actual amount accounts for more than 10% of the relevant associated category (Income, Expenses and Equity totals) or sub-element (e.g. Current Liabilities and Receipts from Operating Activities totals) of the financial statements; and

  2. The variances (original budget to actual) are greater than plus (+) or minus (-) 10% of the budget for the financial statement line item.

Operating Statement Line Items

Actual

2014-15

$’000

Original

Budget1

2014-15

$’000

Variance

$’000

Varience

%

Variance Explanation

Grants from the Commonwealth

310,958

271,080

39,878

14.7

Higher than budgeted Grants from the Commonwealth is due to higher levels of activity for public hospital services funded through the National Health Reform Agreement than estimated in the budget.

1 Original Budget refers to the amounts presented to the Legislative Assembly in the original budgeted financial statements in respect of the reporting period (2014-15 Budget Statements).  These amounts have not been adjusted to reflect supplementary appropriation or appropriation instruments.

Balance Sheet Line Items

Actual

2014-15

$’000

Original

Budget1

2014-15

$’000

Variance

$’000

Variance

%

Variance Explanation

Cash and Cash Equivalents

4,902

15,502

(10,600)

(68.4)

Lower than budgeted Cash and Cash Equivalents is largely due to the return of $20 million surplus cash to the ACT Government and lower opening balance of $3 million which are partially offset by higher cashflow from operating activities due to timing of payable and receivables $13 million.

Receivables

12,650

1,177

11,473

974.8

Higher than budgeted Receivables is due to timing of acquittal of cross border health services provided to the residents of other jurisdictions.

Payables

6,605

-

6,605

100.0

Higher than budgeted Payables is due to timing of acquittals of cross border health services provided to residents of other jurisdictions.

Accumulated Funds

10,947

16,679

(5,732)

(34.4)

Lower than budgeted Accumulated Funds is largely due to the return of $20 million surplus cash to the ACT Government offset by $4 million in operating surplus, the receipt of prior year cross border payments and the recognition of current year cross border receivables and payables.

Statement of Changes in Equity

 

 

 

 

These line items are covered in other financial statements

 

1 Original Budget refers to the amounts presented to the Legislative Assembly in the original budgeted financial statements in respect of the reporting period (2014-15 Budget Statements).  These amounts have not been adjusted to reflect supplementary appropriation or appropriation instruments.

Cash Flow Statement Line Items

Actual

2014-15

$’000

Original

Budget1

2014-15

$’000

Variance

$’000

Variance

%

Variance Explanation

User Charges

103,152

84,249

18,903

22.4

Higher than budgeted User Charges is mainly due to higher cross border revenue due to higher number of interstate patients treated at the ACT Hospitals than estimated in the budget.

Grants Received from Commonwealth

310,958

271,080

39,878

14.7

Higher than budgeted Grants Received from Commonwealth is mainly due to higher public hospital activity than estimated in the budget.

Capital (Distributions)

(20,000)

-

(20,000)

(100.0)

This relates to the return of surplus cash to the ACT Government resulting from prior year operating surpluses.

1 Original Budget refers to the amounts presented to the Legislative Assembly in the original budgeted financial statements in respect of the reporting period (2014-15 Budget Statements).  These amounts have not been adjusted to reflect supplementary appropriation or appropriation instruments.

LHN 2015 - Report of factual findings Audit Pg1.jpgLHN 2015 - Report of factual findings Audit Pg2.jpgLHN 2015 - Report of factual findings RESP2.jpg

Output Class 1: ACT Local Hospital Network

Description

The ACT Local Hospital Network receives funding under National Health Reform Agreement and purchases public hospital services from the Canberra Hospital and Health Services, Calvary Public Hospital, Clare Holland House and Queen Elizabeth II Family Centre.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

957,054

966,039

1%

 

 

Government Payment for Outputs (GPO) ($000’s)

601,725

567,279

-6%

GPO revenue was lower than anticipated in the budget.  This was due to increased Commonwealth and Cross Border revenue due to revised forecasts for revenue from the Commonwealth for activity based funding and from other jurisdictions for Cross Border activity.  As such less GPO was drawndown.

 

Accountability Indicators

 

 

 

 

 

a. Admitted Services - NWAU {14}

86,324

87,169

1%

 

1,2

b. Non-Admitted Services - NWAU {14}

10,272

17,711

72%

Activity was higher than anticipated in the budget.  The target published in the ACT Budget was based on an estimate provided to the National Health Funding Body in March 2014 that was revised in May 2014 to around 17,000 based on more up to date information.

1,3

c. Emergency Services – NWAU {14}

15,929

15,727

-1%

 

1

d. Acute Mental Health Services – NWAU {14}

4,778

6,248

31%

Activity was higher than target due to greater demand than anticipated in the budget.

1,4

e. Sub Acute Services – NWAU {14}

6,360

6,940

9%

Activity was higher than anticipated in the budget.  This was due to longer patient length of stay.

1

The above Statement of Performance should be read in conjunction with the accompanying notes.

Explanation of Measures

1.   Activity purchased by the Local Hospital Network is consistent with the criteria in the National Health Reform Agreement.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014‑15.  These measures combine the results for Canberra Hospital and Calvary Public Hospital for services that meet the Independent Hospital Pricing Authority's criteria for inclusion on the ‘General List of In-Scope Public Hospital Services’.

2.   Excludes mental health and sub-acute services.

3.   Excludes community mental health services.

4.   Acute admitted mental health services only.

The above Accountability Indicators were examined by the ACT Audit Office in accordance with the Financial Management Act 1996.  The Total Cost and Government Payment for Outputs measures were not examined by the ACT Audit Office in accordance with the Financial Management (Statement of Performance Scrutiny) Guidelines 2011.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

f. Total in scope – NWAU {14}

123,663

133,795

8%

Activity was higher than anticipated in the budget.  This is largely explained by the variance arising for non-admitted patient services (Indicator 1b).

1

g. Percentage of mental health clients with outcome measures completed

>65%

<65%

-100%

64% of mental health clients had outcome measures completed.

5

h. Proportion of mental health clients contacted by a Health Directorate community facility within 7 days post discharge from inpatient services

85%

72%

-15%

The proportion of mental health clients contacted by Health Directorate was lower than anticipated in the budget.  In setting the target, the number of mental health inpatient episodes was thought to be smaller.  Changes in data collection methodology and system integration have resulted in better capturing of clients with an inpatient episode.

6

The above Statement of Performance should be read in conjunction with the accompanying notes.

Explanation of Measures

5.   Proportion of eligible mental health registered clients receiving ongoing mental health care having clinical outcome measures completed appropriate to each episode of care and service setting and the outcome measure collection protocol. Service settings included are inpatient, community and residential care. All age groups included. Eligible clients are people receiving mental health services on an ongoing basis, have a case manager assigned and are in contact with mental health services in the reference period.

6.   The proportion of clients admitted to a public mental health acute inpatient facility within the Local Hospital Network and having direct contact with mental health services within seven days post discharge. Day of discharge is not included as part of the seven days. Same day admissions are excluded.

The above Accountability Indicators were examined by the ACT Audit Office in accordance with the Financial Management Act 1996.  The Total Cost and Government Payment for Outputs measures were not examined by the ACT Audit Office in accordance with the Financial Management (Statement of Performance Scrutiny) Guidelines 2011.