C.6 Statement of performance

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
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
Total Cost ($000’s) 788,298 819,445 4%    
Government Payment for Outputs (GPO) ($000’s) 97,404 99,985 3%    
Accountability Indicators
a. Admitted - National
Weighted Activity Units {15}
71,644 73,441 3%   1,2
b. Non-Admitted -
National Weighted
Activity Units {15}
27,275 28,942 6% The annual performance result is higher than target due to higher than expected demand for services across all patient types. This service stream has been a growth area in recent years as patients with less urgent conditions are encouraged to seek medical attention in non-admitted settings. 1,3
c. Emergency Services
- National Weighted
Activity Units {15}
9,927 10,335 4%   1,4
The above Statement of Performance should be read in conjunction with the accompanying notes.

Notes

Explanation of Accountability Indicators

  1. Activity is measured in National Weighted Activity Units (NWAU) {15} as defined by the Independent Hospital Pricing Authority’s National Efficient Price Determination 2015-16. National Weighted Activity Unit (NWAU) is the ‘currency’ that is used to express the price weights for all services that are funded on an activity basis.
  2. 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.
  3. Services provided to clients who were not admitted into hospital.
  4. Services provided to clients in the emergency department of Canberra Hospital and Health 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

 

  Original
Target
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
d. Acute Admitted Mental Health Services – National Weighted Activity Units {15} 4,060 4,350 7% Mental health services experienced higher patient volumes than expected for 2015–16, leading to a higher NWAU result compared to the target. There were 1,974 mental health episodes recorded in 2015–16 compared to 1,646 episodes the year before. 5
e. Sub Acute Services – National Weighted Activity Units {15} 4,603 7,431 61% The higher than budgeted result is due to a change in methodology in accounting for sub acute activity which includes some activity not previously counted. This approach was agreed in February 2016 in consultation with the relevant national bodies. 6
f. Calvary Services – National Weighted Activity Units (out of scope) 1,391 1,345 -3%   7
g. Mean waiting time for clients on the dental services waiting list 6 months 6 months -   8
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% 99% -1%    
The above Statement of Performance should be read in conjunction with the accompanying notes.

Notes

Explanation of Accountability Indicators

  1. Acute Admitted Mental Health Services delivered at Canberra Hospital and Health Services. Activity is measured in National Weighted Activity Units {15} as defined by the Independent Hospital Pricing Authority’s National Efficient Price Determination 2015–16. National Weighted Activity Unit (NWAU) is the ‘currency’ that is used to express the price weights for all services that are funded on an activity basis.
  2. Sub Acute Services delivered at Canberra Hospital and Health Services. Activity is measured in National Weighted Activity Units {15} as defined by the Independent Hospital Pricing Authority’s National Efficient Price Determination 2015–16.
  3. 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 {15} as defined by the Independent Hospital Pricing Authority’s National Efficient Price Determination 2015–16.
  4. 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

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;
  • providing health assessments and care for people detained in corrective facilities; and
  • engagement and liaison with community sector services, primary care and other government agencies providing support and shared care arrangements.

 

  Original
Target
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
Total Cost ($000’s) 135,532 139,094 3%    
Government Payment for Outputs (GPO) ($000’s) 48,299 49,698 3%    
Accountability Indicators
a. Adult mental health program community service contacts 120,000 120,466 -   9
b. Children and youth mental health program community service contacts 65,000 71,295 10% During 2015–16 the service introduced a new intake process referred to as the Choice and Partnership Approach (CAPA) model. The new intake model resulted in a higher than expected result. 10
c. ACT wide mental health program community service contacts 106,000 106,791 1%   11

 

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

Notes

Explanation of Accountability Indicators

  1. Mental Health ACT Adult community occasions of services (Age group 18-64).
  2. Mental Health ACT Children and Adolescents community occasions of service (Age group 0-17).
  3. 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

 

  Original
Target
2015-16
Actual
Result
2015-16
% 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% -   12
e. Proportion of detainees in the Bimberi Youth Detention Centre with a completed health assessment within 24 hours of detention 100% 100% -   12
f. Justice Health Services Community contacts 108,000 151,210 40% The higher than target result is a reflection of the higher numbers of detainees in the Alexander Maconochie Centre as well as improved data capture within the service. 13
g. Percentage of current clients on opioid treatment with management plans 98% 97% -1%   14
h. Alcohol and Drug Services community contacts 70,000 67,183 -4%   15
The above Statement of Performance should be read in conjunction with the accompanying notes.

Notes

Explanation of Accountability Indicators

  1. Percentage of detainees at Alexander Maconochie Centre and Bimberi who are assessed within 24 hours of arrival at the facility. For Bimberi, young detainees who are detained for a period of less than 24 hours are excluded from this indicator.
  2. 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.
  3. On presentation for opioid replacement treatment, a management plan is developed. This indicator represents the percentage of clients with management plans.
  4. 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

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 measures to reduce the risk to the health of the public from communicable diseases, environmental hazards and the supply of medicines and poisons.

 

  Original
Target
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
Total Cost ($000’s) 33,937 34,894 3%    
Government Payment for Outputs (GPO) ($000’s) 26,077 26,765 3%    
Accountability Indicators
a. Samples analysed 8,500 12,693 49% The variance relates to a higher than anticipated demand for analysis of controlled substances (illicit drug samples) and microbiological testing of food and water. 16
b. Compliance of licensable, registrable and non licensable activities at the time of inspection 85% 69% -19% The lower than targeted result relates to food safety compliance. There was also a greater focus in the last quarter of the financial year to undertake outstanding routine inspections. 17
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% -   18
d. Percentage of Health Protection Service’s regulated businesses/activities who have access to Multi-year licenses/registrations 75% 100% 33% Only one of the 6,203 registrable businesses (Drinking Water Utility) does not have access to Multi-Year Licences. 19
The above Statement of Performance should be read in conjunction with the accompanying notes.

Notes

Explanation of Accountability Indicators

  1. Number of samples analysed during the period by the ACT Government Analytical Laboratory.
  2. Percentage of inspected premises found to be compliant 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 the Medicines, Poisons and Therapeutic Goods Act 2008.
  3. 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.
  4. Relates to activities regulated under the: Public Health Act 1997; Food Act 2001; Medicines, Poisons and Therapeutic Goods Act 2008; and the 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

Output 1.4 Cancer Services

Description

Canberra Hospital and Health 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 to 70 per cent over time.

 

  Original
Target
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
Total Cost ($000’s) 75,627 77,124 2%    
Government Payment for Outputs (GPO) ($000’s) 8,212 8,975 9% The increase in GPO relates largely to the deferral of Commonwealth funding from 2014–15 due to the late receipt of funds by the Territory.  
Accountability Indicators
a. Total breast screens 16,500 17,869 8% The higher than target result is primarily due to an increase in promotional activity and the opening of a new screening site in Belconnen in December 2015. 20
b. Number of breast screens for women aged 50 to 69 12,800 13,376 5% The higher than target result is primarily due to an increase in promotional activity and the opening of a new screening site in Belconnen in December 2015. 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% 82% -9% Timeframes for attendance at assessment were adversely impacted by the installation of a new mammography/biopsy machine in January 2016 and the need to train clinicians in its use. In addition, a significant number of women elect to delay their attendance at assessment clinics due to personal circumstances. 23
The above Statement of Performance should be read in conjunction with the accompanying notes.

Notes

Explanation of Accountability Indicators

  1. Total number of women screened in the period.
  2. Number of women aged between 50 to 69 years screened in the period.
  3. 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.
  4. 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

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
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
Total Cost ($000’s) 133,835 133,369 -    
Government Payment for Outputs (GPO) ($000’s) 45,113 46,441 3%    
Accountability Indicators
a. Number of nursing (domiciliary and clinic based) occasions of service 84,000 91,779 9% The higher than target result in occasions of service relates to the expansions of Belconnen, Gungahlin and Tuggeranong health centres in recent years. Improved capacity for wound care and stoma management in particular has improved access to these clinical presentations. 24
b. Number of allied health regional services (occasions of service) 25,000 31,829 27% The higher than target result in occasions of service relates to the expansions of Belconnen, Gungahlin and Tuggeranong health centres in recent years. Changes in service models and improvements in efficiencies have also been implemented resulting in improved capacity and the number of occasions of service. 25

 

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

Notes

Explanation of Accountability Indicators

  1. All occasions of service provided to community patients by Community Care Nurses in the following settings: home visits; ambulatory care clinics; foot care clinics; continence clinics; wound clinics; and stoma clinics.
  2. All occasions of service provided to community patients by Community Care Allied Health Professionals and Allied Health Assistants 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.

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
2015-16
Actual
Result
2015-16
% Variance
from
Original
Target
Explanation of
Material Variances
Notes
Total Cost ($000’s) 86,489 90,011 4%    
Government Payment for Outputs (GPO) ($000’s) 39,752 40,502 2%    
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% 94% 2%   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% 46% 15% The higher than target result in the proportion of clients from culturally and linguistically diverse (CALD) communities is due to increased marketing of the service. Furthermore, the Women’s 27 Health Services’ relationship with CALD communities has been strengthened through a targeted community development project, which has led to an increase in referrals for Well Women’s Checks. 27
c. Proportion of children aged 0–14 who are entering substitute and kinship care within the ACT who attend the Child at Risk Health Unit for a health and wellbeing screen 90% 97% 8% The higher than target result is due to the Child at Risk Health Unit (CARHU) conducing rigorous follow-up action, collaboration with staff in the Community Services Directorate as well as liaison with the carer/guardians of children. 28
The above Statement of Performance should be read in conjunction with the accompanying notes.

Notes

Explanation of Accountability Indicators

  1. Percentage of 12 month old children who have been fully immunised in accordance with the Australian Childhood Immunisation Register.
  2. This indicator measures the percentage of women who are from culturally and linguistically diverse communities accessing a ’Well Women’s Check’.
  3. 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 as this is not required by the Financial Management (Statement of Performance Scrutiny) Guidelines 2016.