C.6 - Statement of performance

Health 15 Report of Factual Findings Pg1

Audit Office Health Pg2

Health 15 - Report of factual findings - accessible version

Health 15 - Report of factual findings - accessible version

Health  Statement of RES

Output Class 1: Health and Community Care

Output 1.1 Acute Services

Description

The Canberra Hospital provides a comprehensive range of acute care, including inpatient, outpatient, and emergency department services. The key strategic priority for acute services is to deliver timely access to effective and safe hospital care services.  

This means focussing on:

  • strategies to meet performance targets for the emergency department, elective and emergency surgery; and
  • continuing to increase the capacity of acute care services.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

751,424

759,283

1%

Total Cost was higher than anticipated in the budget.  This relates to depreciation for new information technology systems not included in the budget and the derecognition of motor vehicle assets when a change was made at the Whole‑of‑Government level to the lease type from finance to operating leases.  These higher costs were offset by deferral of expenditure into 2015-16 for the Health Infrastructure Program.

 

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

100,469

96,284

-4%

GPO was lower than anticipated in the budget.  The lower revenue relates mainly to the return of ‘Public Hospital System – Additional Funding’ as a saving to the ACT Government.

 

 

 

 

 

 

 

Accountability Indicators

a. Admitted - National Weighted Activity Units {14}

72,058

70,031

-3%

Admitted activity was lower than anticipated in the budget.  The original target included 3,100 National Weighted Activity  Units that relate to 1.1.d.

1

b. Non-Admitted - National Weighted Activity  Units {14}

        26,966

27,103

1%

 

2

c. Emergency Services – National Weighted Activity Units {14}

9,720

9,697

-

 

3

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

Explanation of Measures

1.   Admitted services delivered at Canberra Hospital and Health Services, including those provided to cancer patients or rehabilitation patients, but excluding admitted mental health and subacute services.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014-15.

2.   Services provided to clients who were not admitted into hospital.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014-15.

3.   Services provided to clients in the emergency department of Canberra Hospital and Health Services.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014-15.

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

d. Acute Admitted Mental Health Services – National Weighted Activity Units {14}

841

3,905

364%

Acute Admitted Mental Health Services was higher than anticipated in the budget.  The calculation used in setting the original target excluded approximately  3,100 NWAUs.  They were included in the 1.1.a target.

4

e. Sub Acute Services – National Weighted Activity Units {14}

3,942

4,632

18%

Sub Acute Services activity was higher than anticipated in the budget.  The higher activity is due to longer patient length of stay.

5

f. Calvary Services – National Weighted Activity Units (out of scope)

1,567

1,383

-12%

Calvary Services activity was lower than anticipated in the budget.  The lower activity is due to a decline in Department of Veterans' Affairs activity.

6

g. Mean waiting time for clients on the dental services waiting list

6 Months

4 Months

-33%

Mean waiting time for dental services was lower than anticipated in the budget.  This was due to increased funding from the Commonwealth for the ‘Treating More Public Dental Patients’ National Partnership Agreement.  The Dental Health Program has been able to maintain shorter waiting times by referring extra clients to private dental services and employing additional clinical staff.

7

h. Percentage of the Women’s Health Service Intake Officer’s clients who receive an intake and assessment service within 14 working days of their initial referral

100%

100%

-

 

 

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

Explanation of Measures

4.   Acute Admitted Mental Health Services delivered at Canberra Hospital and Health Services.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014-15.

5.   Sub Acute Services delivered at Canberra Hospital and Health Services.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014-15.

6.   All patient activity for Calvary Public Hospital that does not meet the Independent Hospital Pricing Authority's criteria for inclusion on the ‘General List of In-Scope Public Hospital Services’.  Activity is measured in National Weighted Activity Units {14} as defined by the Independent Hospital Pricing Authority's National Efficient Price Determination 2014-15.

7.   Client mean waiting time is defined as the mean waiting period between when a client is placed on the adult dental central waiting list and the receipt of treatment.

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.

Output 1.2 Mental Health, Justice Health and Alcohol and Drug Services

Description

The Health Directorate provides a range of Mental Health, Justice Health and Alcohol and Drug Services through the public and community sectors in hospitals, community health centres and other community settings, adult and youth correctional facilities and peoples’ homes across the Territory.  These services work to provide integrated and responsive care to a range of services, including hospital based specialist services, and therapeutic rehabilitation, counselling, supported accommodation services and other community based services.

The key strategic priorities for Mental Health, Justice Health and Alcohol and Drug Services are ensuring that people’s needs are met in a timely fashion and that care is integrated across hospital, community, and residential support services. 

This means focussing on:

  • ensuring timely access to emergency mental health care;
  • ensuring that public and community mental health services in the ACT provide people with appropriate assessment, treatment and care that results in improved mental health outcomes;
  • providing community and hospital based alcohol and drug services; and
  • providing health assessments and care for people detained in corrective facilities.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

126,378

129,675

3%

Total Cost was higher than anticipated in the budget.  The higher expenses relate to higher levels of depreciation and the derecognition of motor vehicle assets when a change was made at the Whole‑of‑Government level to the lease type from finance to operating leases.

 

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

47,102

47,637

1%

 

 

 

 

 

 

 

 

Accountability Indicators

 

a. Adult mental health program community service contacts

109,000

113,610

4%

 

8

b. Children and youth mental health program community service contacts

65,000

64,933

-

 

9

c. ACT wide mental health program community service contacts

100,000

106,251

6%

ACT wide mental health community service contacts was higher than anticipated in the budget.  This is mostly attributable to higher activity by the Crisis Assessment and Treatment Team.

10

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

Explanation of Measures

8.   Mental Health ACT Adult community occasions of services (Age group 18-64).

9.   Mental Health ACT Children and Adolescents community occasions of service (Age group 0-17).

10.        ACT wide mental health program community services contacts includes Aboriginal and Torres Strait Islander Services, Mobile Intensive Treatment Team (MITT) North, Mental Health Service Intellectual Disability, Neuropsychology, Mental Health Dual Diagnosis, Crisis Assessment and Treatment Team (CATT) and Older Persons Mental Health Community team.

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

d. Proportion of detainees at the Alexander Maconochie Centre with a completed health assessment within 24 hours of detention

100%

100%

-

 

11

e. Proportion of detainees in the Bimberi Youth Detention Centre with a completed health assessment within 24 hours of detention

100%

94%

-6%

During 2014-15, four health assessments were not undertaken within the 24 hour period. One was due to a potential security risk for staff as advised by Bimberi management.  The assessment was completed approximately 48 hours after admission. The other three did not occur within 24 hours as health staff were not advised of their admission.  The health assessments were completed at 24.5, 27  and 27.5 hours after admission.

11

f. Justice Health Services community contacts

105,000

114,860

9%

Justice Health Services community contacts was higher than anticipated in the budget.  The higher activity reflects the increased number of detainees at the Alexander Maconochie Centre.

12

g. Percentage of current clients on opioid treatment with management plans

98%

99%

1%

 

13

h. Alcohol and Drug Services Community contacts

70,000

68,051

-3%

 

14

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

Explanation of Measures

11.        Percentage of detainees at Alexander Maconochie Centre and Bimberi who are assessed within 24 hours of arrival at the facility.  In respect of Bimberi, young detainees who are detained for a period of less than 24 hours are excluded from this indicator.

12. Community contacts are occasions of service with or about the client resulting in a dated entry in the clinical file.  Contacts include both direct and indirect clinical contact, reported for all community mental health service units in the Justice Health program.

13.        On presentation for opioid replacement treatment, a management plan is developed. This indicator represents the percentage of clients with management plans.

14. Direct occasions of service with a client (appointment, contact or dose).

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.

Output 1.3 Public Health Services

Description

Improving the health status of the ACT population through interventions which promote behaviour changes to reduce susceptibility to illness, alter the ACT environment to promote the health of the population and promote interventions that remove or mitigate population health hazards. This includes programs that evaluate and report on the health status of the ACT Population, assist in identifying particular health hazards and measure to reduce the risk to the health of the public from communicable diseases, environmental hazards and the supply of medicines and poisons.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

32,387

31,748

-2%

 

 

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

26,148

25,215

-4%

GPO was lower than anticipated in the budget.  The lower revenue relates to the deferral of Health Program Grant funding to 2015‑16 and the transfer of functions to Access Canberra.

 

 

 

 

 

 

 

Accountability Indicators

a. Samples analysed

8,500

11,918

40%

Samples analysed was higher than anticipated in the budget.  The higher number of samples was due to increased food, water and oral fluid samples and a significant increase in illicit drug samples submitted for analysis.

15

b. Compliance of licensable, registrable and non licensable activities at the time of inspection

85%

77%

-9%

The compliance rates recorded primarily related to regulated food business. The non-compliance is a continuation of previous downward trends in food safety compliance.  ACT Health is examining further industry engagement and education along with appropriate regulation to improve compliance rates.

16

c. Response time to environmental health hazards, communicable disease hazards relating to measles and meningococcal infections and food poisoning outbreaks is less than 24 hours

100%

100%

-

 

17

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

Explanation of Measures

15. Number of samples analysed during the period by the ACT Government Analytical Laboratory.

16.        Percentage of inspected premises found to be in compliance with relevant legislation, licence or registration. The data is drawn from records of inspection carried out under provisions of all ACT Health administered legislation. The relevant Acts are: Food Act 2001, Public Health Act 1997, Radiation Protection Act 2006 and Medicines, Poisons and Therapeutic Goods Act 2008.

17.        Response time is defined as the elapsed time between notification and commencement of investigation. The reported percentage is derived from the combined data sets across the three classes of quick response categories: environmental health hazards, communicable disease control hazards and food poisoning outbreaks.

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

d. Legalisation amendments to allow for deregulation of temporary non-profit community organisations (TNPCOs) that sell food

1

1

-

 

18

e. Percentage of Health Protection Service’s regulated businesses/activities who have access to Multi-year licenses/registrations

20%

100%

400%

All Health Protection Service’s regulated business/activities have access to multi-year licenses/registrations.

19

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

Explanation of Measures

18.        Relates to legislative amendments to the Food Act 2001.

19.        Relates to activities regulated under the: Public Health Act 1997; Food Act 2001; Medicines, Poisons and Therapeutic Goods Act 2008; and Radiation Protection Act 2008.

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.

Output 1.4 Cancer Services

Description

Capital Region Cancer Services provides a comprehensive range of screening, assessment, diagnostic, treatment, and palliative care services.  Services are provided in inpatient, outpatient, and community settings.

The key strategic priorities for cancer care services are early detection and timely access to diagnostic and treatment services.  These include ensuring that population screening rates for breast and cervical cancer meet targets, waiting time for access to essential services such as radiotherapy are consistent with agreed benchmarks, and increasing the proportion of women screened through the BreastScreen Australia program for the target population (aged 50 to 69 years) to 70 per cent over time.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

73,599

73,816

-

 

 

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

8,097

8,089

-

 

 

 

 

 

 

 

 

Accountability Indicators

a. Total breast screens

15,500

15,559

-

 

20

b. Number of breast screens for women aged 50 to 69

12,950

11,687

-10%

Overall screening numbers were impacted by the introduction of the new BreastScreen Information System (BIS) in December 2014. The service commenced sending reminder letters to lapsed attendees and invitation letters to women on the electoral roll to improve participation rates.

21

c. Percentage of women who receive results of screen within 28 days

100%

100%

-

 

22

d. Percentage of screened patients who are assessed within 28 days

90%

90%

-

 

23

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

Explanation of Measures

20.        Total number of women screened in the period.

21.        Number of women aged between 50 to 69 years screened in the period.

22.        The percentage of women with a ‘normal’ result who receive notice of this outcome within 28 days of their screening appointment.  Consistent with national methods, the end date is the date the results are produced, as it is not possible to ascertain the date a client receives a mailed document.

23.        The percentage of women requiring assessment who wait 28 days or less from their breast screen appointment to their assessment appointment.

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.

Output 1.5 Rehabilitation, Aged and Community Care

Description

The provision of an integrated, effective and timely response to rehabilitation, aged care and community care services in inpatient, outpatient, emergency department, sub-acute and community-based settings.

The key strategic priorities for Rehabilitation, Aged and Community Care are:

ensuring that older persons in hospital wait an appropriate time for access to comprehensive assessment by the Aged Care Assessment Team.This will assist in their safe return home with appropriate support, or access to appropriately supported residential accommodation;

improving discharge planning to minimise the likelihood of readmission or inadequate support for independent living, following completion of hospital care; and

ensuring that access is consistent with clinical need, is timely for community based nursing and allied health services and that community based services are in place to better provide for the acute and post acute healthcare needs of the community.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

128,319

122,979

-4%

Total Cost was lower than anticipated in the budget.  The lower expenses relates to identification of more services as early intervention and prevention (output 1.6) and underspends related to delayed opening of beds and difficulties in recruitment of staff.

 

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

44,490

44,995

1%

 

 

 

 

 

 

 

 

Accountability Indicators

a. Number of nursing (domiciliary and clinic based) occasions of service

82,000

85,220

4%

 

24

b. Number of allied health regional services (occasions of service)

22,600

26,628

18%

Allied Health Services was higher than anticipated in the budget. 

25

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

Explanation of Measures

24.        All occasions of service provided to community patients by Continuing Care Nurses in the following settings: home visits; ambulatory care clinics; foot care clinics; continence clinics; wound clinics; and stoma clinics.

25.        All occasions of service provided to community patients by Continuing Care Allied Health Professionals and Technical Officers for Physiotherapy, Occupational Therapy, Social Work, Podiatry and Nutrition.

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.

Output 1.6 Early Intervention and Prevention

Description

Improving the health and wellbeing of the ACT population through a range of programs, services and initiatives, focused on early intervention, prevention and health promotion. The key strategic priorities for early intervention and prevention include encouraging and promoting healthy lifestyle choices to decrease the rates of conditions like obesity and diabetes and reducing risky health behaviours such as smoking and alcohol consumption and maintaining high levels of immunisation.

 

Original Target

2014-15

Actual

Result

2014-15

% Variance

from Original Target

Explanation of

Material Variances

Notes

Total Cost ($000’s)

76,642

77,832

2%

Total Cost was higher than anticipated in the budget.  The higher expenses relates to identification of more services as early intervention and prevention (output 1.6).  These were offset by deferral of Commonwealth funding to 2015-16.

 

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

31,309

30,397

-3%

GPO was lower than anticipated in the budget.  The lower revenue relates to the deferral of Commonwealth funding to 2015‑16.

 

 

 

 

 

 

 

Accountability Indicators

a. Immunisation coverage for the primary immunisation schedule measured at 1 year of age, in accordance with the Australian Childhood Immunisation Register

92%

93%

1%

 

26

b. Proportion of clients attending ‘Well Women’s Check’ within the Women’s Health Service that are from culturally and linguistically diverse communities

40%

41%

3%

 

27

c. Proportion of children aged 0–14 who are entering substitute and kinship care within the ACT who attend to the Child at Risk Health Unit for a health and wellbeing screen

90%

93%

3%

 

28

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

Explanation of Measures

26.        Percentage of 12 month old children who have been fully immunised in accordance with the Australian Childhood Immunisation Register.

27. This indicator measures the percentage of women who are from culturally and linguistically diverse communities accessing a ’Well Women's Check’.

28.        This indicator measures the percentage of children aged 0-14 placed in out of home care (substitute or kinship care) who have received a health and wellbeing screen. The Health Directorate is reliant on referrals from the Community Services Directorate in order to provide these services.

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.