<html>
<head>
<meta charset="UTF-8"/>
<meta name="tikaGenerated" content="true"/>
<meta name="date" content="2013-11-01T05:04:50Z"/>
<meta name="xmp:CreatorTool" content="Adobe InDesign CS6 (Macintosh)"/>
<meta name="trapped" content="False"/>
<meta name="meta:creation-date" content="2013-11-01T05:03:47Z"/>
<meta name="created" content="Fri Nov 01 15:33:47 ACDT 2013"/>
<meta name="xmpTPg:NPages" content="216"/>
<meta name="Creation-Date" content="2013-11-01T05:03:47Z"/>
<meta name="dcterms:created" content="2013-11-01T05:03:47Z"/>
<meta name="Last-Modified" content="2013-11-01T05:04:50Z"/>
<meta name="dcterms:modified" content="2013-11-01T05:04:50Z"/>
<meta name="Last-Save-Date" content="2013-11-01T05:04:50Z"/>
<meta name="meta:save-date" content="2013-11-01T05:04:50Z"/>
<meta name="producer" content="Adobe PDF Library 10.0.1"/>
<meta name="modified" content="2013-11-01T05:04:50Z"/>
<meta name="Content-Type" content="application/pdf"/>
</head>
<body>
<pre>
Department for  
Health and Ageing

Annual Report

2012-13



Publisher: Adelaide: SA Department for Health and Ageing, 2013
ISSN 2201-0475
ISBN 978-1-74243-519-0
Subjects: SA Health
Other Authors/Contributors: South Australia. Department for Health and Ageing



Hon. Jack Snelling M.P. 
Minister for Health and Ageing 
Minister for Mental Health and Substance Abuse

Dear Minister

In accordance with the Public Sector Act 2009 and the Finance and Audit Act 1987, I am pleased to submit the 
annual report and financial statements of the South Australian Department for Health and Ageing for presentation  
to Parliament.

This report provides an accurate account of the operations of the Department for Health and Ageing for the financial 
year ending 30 June 2013, in compliance with the Department of the Premier and Cabinet Circular on annual 
reporting requirements.

David Swan

Chief Executive 
30 September 2013

Department for Health and Ageing 
Annual Report 2012-13

  Government of South Australia, 30 September 2013 
ABN 97643356590

ISSN 2201-0475 
ISBN 978-1-74243-519-0

This annual report was prepared by  
Office of the Chief Executive 
Department for Health and Ageing

The annual report can be accessed  
at the Department for Health and Ageing  
Internet site www.sahealth.sa.gov.au

Department for Health and Ageing 
11 Hindmarsh Square 
Adelaide, South Australia 5000 
Telephone: (08) 8226 0795 
Facsimile: (08) 8226 0720



Health at a Glance 5

On Any Day, On Average  5

Each Week  5

In a Year   6

Year in Review   Highlights from the  
Chief Executive 7

Objectives, Role, Governance and Legislation  11

Objectives 11

Role 11

Department for Health and Ageing  
Organisational Structure 11

SA Health Structure as at 30 June 2013 12

Administrative and Legislative Responsibilities 12

Risk Management and Audit 13

Code of Conduct for Unregistered Health  
Practitioners 13

Advance Care Directives Act 2013 13

Premier s Strategic Priorities for  
South Australia   SA Health actions to  
support their implementation  14

Every Chance for Every Child 14

Safe Communities, Healthy Neighbourhoods 15

Creating a Vibrant City 15

Premium Food and Wine from our Clean  
Environment  16

South Australia s Strategic Plan  17

Strategic Directions 18

SA Health Lead Targets 18

All of Government Targets 30

Primary Health Care 33

Men s Health 33

Trojans Trek 33

Veterans Health Advisory Council Executive  
Officer Position 33

Aboriginal Male Health and Well Being Project  
Officer Position 34

Freemason s Foundation Centre for Men s Health 34

Transition Beds for Homeless People Program 34

Ensuring Sustainable Access to Best Practice  
Antenatal Care 34

Providing Education that Addresses Risk Factors  
for Low Birth Weight 35

eMums Program 35

Baby Friendly Health Initiative Accreditation  35

Reducing Smoking in Pregnant Women  35

Intermediate Care 36

Medicare Locals 36

Clinical Reform 37

Commissioning 37

Hospital Care 38

Statewide Clinical Support Services  38

SA Ambulance Service 38

Disability Transition Care Funding 39

Transition to Residential Aged Care  40

Health Care at Home 40

Community Nursing 40

Outpatient Reform 41

Local Health Network Analytics and  
Reporting Service 42

Improving Efficiency and Effectiveness of  
Hospital Care  42

Elective Surgery Strategy 44

Emergency Department Services 47

Day of Surgery Admission Rates 50

Relative Stay Index 50

Medicines and Technology Assessment 51

Statewide Formulary for High Cost Medicines 51

Establishment of a Statewide Medicines Formulary 51

Health Technology Assessment 51

Clinical Reform 52

Clinical Senate 52

Statewide Clinical Networks 53

Mental Health Care and Drug and  
Alcohol Services 56

Contents



Legislation, Policy and Planning 56

Policy Initiatives 57

Service Improvement 57

Education and Promotion 59

Community Care within Seven Days of Discharge 60

Average Length of Stay 61

Drug and Alcohol Services Intervention and  
Treatment 61

Policy and Monitoring 62

Primary Prevention  63

Social Marketing 64

Aboriginal Programs 64

Aboriginal Health 67

Improve the Health of Aboriginal People 67

Aboriginal Health Care Plan 2010-16  67

National Partnership Agreement on Closing the  
Gap in Indigenous Health Outcomes (2009-13)  68

National Partnership Agreement on Indigenous  
Early Childhood Development (2009-14)  68

Reduce Aboriginal Ill-Health  68

Develop a Culturally Responsive Health System  69

Promote Aboriginal Community Health and  
Wellbeing 71

Office for the Ageing 73

South Australia s Ageing Plan  73

Thinker in Residence 74

Preventing the Abuse of Older People 74

South Australia s Communities for Life:  
Our Age-friendly Future 75

Grants for Seniors and Positive Ageing  
Development Grants 76

Seniors Card 76

Retirement Villages  77

Aged Care Assessment Program 78

Public Health 79

Public Health for the 21st Century 79

Chief Public Health Officer s Report 80

South Australian Public Health Council 80

Health in All Policies 80

Asbestos 81

Toxicity and Site Contamination 81

Safe Drinking Water Act 2011 81

Port Pirie Transformation Project 82

Wastewater Management 82

Development of the Guideline and Public  
Health Policy for the Management of Severe  
Domestic Squalor (A Foot in the Door) 82

Aboriginal Environmental Health 83

Tobacco Control 83

Mosquito Control 84

Food Regulation  84

Communicable Diseases 87

Population Health 92

Safety and Quality 97

The Australian Health Service Safety and Quality 
Accreditation Scheme 97

National Standards on Safety and Quality in Health 
Service Standards 97

Health and Medical Research 105

eHealth Systems 106

Enterprise Patient Administration System 106

Enterprise System for Medical Imaging 106

Enterprise Pathology Laboratory Information  
System 106

Oracle Corporate Systems  106

South Australian Industry Participation Policy 107

Major Projects 108

Developing the new Royal Adelaide Hospital  108

Redeveloping Glenside 108

Council of Australian Governments  
Health Reforms 110

The National Health Reform Agreement    
Implementation 110



The National Health Reform Agreement   
Strengthening Primary Health Care 110

COAG Agreements 111

Nationally Funded Centres Program Secretariat 111

Public Sector Renewal 113

Criteria Led Discharge Flinders Medical Centre 113

Expanding in Criteria Led Discharge into  
Lyell McEwin Hospital  113

Providing Antenatal Services within a Childhood  
Centre  113

Emergency Management 114

Response to Critical Events 114

Training and Exercises 114

Human Health Preparedness 116

Extreme Heat 116

Aged Care 116

Health Workforce and Human Resources Activity 117

Overview: Service Demands and Workforce Trends  117

Medical, Nursing and Midwifery and Allied  
and Scientific Health Workforce Strategies 119

Allied and Scientific Health Office 121

ClinEdSA 122

Attracting, Valuing and Retaining our Workforce 122

Research and Training 123

Workforce Reform 124

Careers in Health 124

Graduate Recruitment 125

Industrial Issues 126

Employment Arrangements as at 30 June 2013 126

Executives 127

Leave Management 128

Workforce Diversity 128

Voluntary Flexible Working Arrangements 129

Performance Development 129

Young Professionals Group 130

Leadership and Management Development 130

Women in Leadership 131

Department for Health and Ageing Occupational 
Health, Safety, Welfare and Injury Management 
Committee and Health and Safety  
Representative Forum 131

Work Health and Safety and Injury Management 131

Carers Recognition Act 2005 134

Carer Participation Position Statement Guideline 135

Disability Action Plan Report  136

Greening of Government (GoGO), Sustainability 
Reporting and Energy Efficiency Action Plan 137

GoGO Priority Area One: Energy 138

Energy Efficiency Highlights  139

GoGO Priority Area Two: Water 142

Water Efficiency Highlights 142

GoGO Priority Area Three: Waste 143

GoGO Priority Area Four: Built Facilities  143

GoGO Priority Area Five: Travel and Fleet 144

GoGO Priority Area Six: Procurement 145

Investing in the Redevelopment of Metropolitan 
Hospitals 145

Investing in the Redevelopment of Regional  
Hospitals 145

Across Government Facilities Management 
Arrangement  146

Asbestos Management 146

Urban Design Charter 147

New Royal Adelaide Hospital and adjacent  
SA Health and Medical Research Institute Building 147

Redevelopment of the Glenside Health  
Care Campus 147

Repatriation General Hospital   Teaching and  
Aged Care Facility 147

Redevelopments at Major Country Hospitals 147

Regional Impact Assessments 148

Freedom of Information 149

Whistleblower Protection Act 1993 152

Use of Consultants 153



Fraud 155

Account Payment Performance 156

Contractual Arrangements 157

Employee Overseas Travel 158

Independent Auditor s Report 161

Certification of the Financial Statements 189

Appendix 1   Legislation Committed to Health 
Ministers as at 30 June 2013 190

Appendix 2   Hospitals 191

Appendix 3   Boards and Committees 192

Appendix 4   Principal Documents  194

Appendix 5   Publications 1 July 2012    
30 June 2013 196

Acronyms 199

Glossary of Terms 203

Index 205



page 5 Department for Health and Ageing Annual Report 2012-13

Health at a Glance

On Any Day, On Average 

1132 people were admitted to public hospitals. 

64 of these admissions were Aboriginal and/or Torres Strait Islanders and 25 were  
war veterans or war widows.

1498 people were treated in accident and Emergency Departments.

5130 people were seen in hospital outpatient clinics. 

SA Ambulance Service responded to 719 incidents and assessed, treated or 
transported 640 patients, of which 48 per cent were patients whose lives were 
potentially threatened. 

Each Week 

900 South Australians had an elective surgery procedure in a metropolitan  
public hospital. 

4400 patient visits were made by Royal District Nursing Service nurses. 

1446 women were screened for breast cancer.

2941 women were screened for cervical cancer. 

566 people were screened for bowel cancer. 



page 6Department for Health and Ageing Annual Report 2012-13

In a Year  

6237 South Australian patients were transferred by South Australian based  
Royal Flying Doctor Service aircraft to/from metropolitan, rural and interstate  
health services. 

1074 people received dialysis, usually three times per week. 

In the 2012 calendar year, 20 182 women gave birth to 20 505 babies with  
99.8 per cent attending antenatal care. 

The Australian Red Cross Blood Service supplied 66 311 units of blood from  
donors for use in South Australian public and private hospitals. 

896 488 doses of vaccine for all childhood, adolescent and adult vaccination 
programs throughout South Australia were distributed at a total cost of  
$23 836 317. In addition, the department responded to approximately 17 000  
calls about vaccinations from health professionals and the general public.

7 278 340 tests were performed by SA Pathology (trading as the Institute of  
Medical and Veterinary Science). 

The decrease in smoking prevalence was equivalent to 12 163 fewer persons 
smoking daily in South Australia.

7784 requests for assistance were made to the Quitline, which includes telephone 
calls, telephone messages, and text messages. 3687 referrals from health 
professionals were received and 2966 Quitpacks were distributed.

Approximately 127 500 calls were made from South Australians to healthdirect 
Australia on 1800 022 222. 

163 300 courses of dental care were commenced by the SA Dental Service. 

Schools participating in the Eat Well Be Active Primary Schools initiative increased  
to 173. 

114 early childhood staff have undertaken training in the Aboriginal Ear Health. 

36 079 consumers within South Australia had contact with a community mental 
health service. 



page 7 Department for Health and Ageing Annual Report 2012-13

Year in Review   Highlights from the  
Chief Executive
In 2012-13, the Department for Health and Ageing (the department) experienced significant reform. 

Two Deputy Chief Executives, Jenny Richter and Steve Archer, were appointed as part of a restructure 
designed to support the department s achievement of goals set out in the SA Health Care Plan 2007-16.  

Significant legislative reform was achieved during the reporting period. The Advance Care Directives Bill 
2013, which will make it easier for people to express their wishes and leave instructions about their care 
should their decision making ability be temporarily or permanently impaired, passed both houses of the 
Parliament of South Australia. The Act is expected to take effect in 2014. As a result of changes to the 
Health and Community Services Complaints Act 2004, unregistered health practitioners must now adhere 
to a new code of conduct, designed to safeguard the rights of South Australian consumers to have access 
to safe services of a consistently high standard. SA Health released a consultation paper on proposed 
legislation aimed at prohibiting unregistered practitioners from delivering midwifery services. The proposal 
stems from the recommendations of a Coronial inquest into the deaths of three newborn babies in South 
Australia. The South Australian Public Health Act 2011 became fully operational, which involved remaking 
the full suite of regulations for both infectious diseases and environmental health. New laws also came into 
effect to regulate public drinking water supplies and ensure continued access to clean, safe drinking water.

In 2012-13, the department commissioned reviews into aspects of its operations to ensure best practice, 
continuous improvement and delivery of services in a streamlined, viable and fiscally responsible way. 
These included a review of non-hospital based services, the hospital budget performance and remediation 
reviews and reviews of Emergency Department performance. A further independent review was conducted 
following lower than expected cancer detection rates from digital screening technology at BreastScreenSA. 

SA Health continued to excel in the provision of Emergency Department and elective surgery services, 
bettering the national average in a number of key areas of hospital performance including elective surgery 
waiting times and Emergency Department performance. Independent reports, including the 2013 Report 
on Government Services and the Australian Institute of Health and Welfare Australian Hospital Statistics  
2011-12 report, showed that 76 per cent of patients at our public hospital Emergency Departments 
were seen on time. By the end of 2012-13, there were no patients overdue for elective surgery in the 
South Australian public health system   an outstanding achievement given a 4.3 per cent increase in 
Emergency Department presentations during the financial year, a factor that can place additional pressure 
on scheduling of elective surgeries and associated waiting times. These results are testament to our 
hard-working hospital staff, who are to be commended for their continued commitment to our goal of 
providing South Australians with a world-class health system.

The department s participation in the Public Sector Renewal Program led to the completion of the Criteria 
led Discharge pilot program at Flinders Medical Centre. The program used a multidisciplinary approach to 
discharging patients from hospital, helping them return to their homes sooner. As a result of the program s 
success, it is expected to be rolled out across the state s metropolitan public hospitals. 

During the reporting period, the Chief Public Health Officer launched the South Australian Sexually 
Transmissible Infections Action Plan 2012-15 and a new campaign to remind parents of Aboriginal children 
to ensure they are vaccinated on time   something that is particularly important for Aboriginal children, 
who are more vulnerable to some vaccine preventable diseases. Other public health initiatives launched 
included a food safety campaign and the 2013 Influenza, Emergency Department and Pap Awareness  
Week campaigns. 

The department continued to demonstrate high standards of safety and quality in 2012-13. South 
Australia s compliance rate for hand hygiene at the five key moments was recorded at 77 per cent, 
exceeding the national average of 75 per cent. SA Health s Safety and Quality Unit worked collaboratively 
with New South Wales Health to produce Know The Plan, Share The Plan, Review The Risk, an educational 
film about clinical handover that followed a patient s journey. The annual April Falls Awareness Month 
included an engaging program of activities designed to raise community and staff awareness about 
assessment, treatment, risk management and reducing the chance of injuries through falls.



page 8Department for Health and Ageing Annual Report 2012-13

SA Health sustained its efforts throughout 2012-13 to ensure easier access to oncology services for all 
South Australians, with work progressing on the Regional Cancer Centres Initiative. The state and federally 
funded initiative includes construction of the Whyalla Regional Cancer Centre, the expanded radiotherapy 
unit and linear accelerator at Lyell McEwin Hospital and the continued expansion of chemotherapy services 
across the state. 

The department progressed work on the major capital developments during the reporting period. 
Investment in medical research and innovation continued, with the opening of the $5m Australian Cancer 
Research Foundation s Cancer Genomics Facility at the SA Pathology site. Work on the new Royal Adelaide 
Hospital site reached several significant milestones during the reporting period, including the first above-
ground concrete floor being poured and the installation of in ground and civil works, foundation works, 
eight tower cranes and 15 jump forms. The $163m Flinders Medical Centre redevelopment was opened 
and includes a new acute medical unit, expanded intensive and critical care unit, redeveloped Emergency 
Department and a redeveloped and expanded operating theatre suite. A new $12m Rehabilitation and 
Allied Health Building at The Queen Elizabeth Hospital was opened, providing services including speech 
pathology, occupational therapy, physiotherapy and rehabilitation. Construction on the final phase of the 
$17.4m Modbury Hospital Emergency Department redevelopment began and includes a four-bay secure 
paediatric area, low stimulation area for mental health consumers and 10 additional acute spaces, taking 
the total number in the Emergency Department to 24. When complete, the Emergency Department will 
include 17 extra assessment and treatment spaces, two upgraded resuscitation areas and three new rapid 
assessment bays.

Stage One of the Glenside redevelopment, including the Specialist Rehabilitation Inpatient Unit,  
Helen Mayo House and the Shared Activities Centre buildings, was opened in November. Stage Two 
was completed and included the Acute Inpatient Unit, Drug and Alcohol Services Inpatient Unit and the 
Administration and Learning Services buildings. The James Nash House redevelopment has been revised 
to include an additional 10 forensic beds. The revised total project cost is now $22m, and the new 20 bed 
facility is expected to be completed in mid 2014.

Young patients with chronic illnesses including heart disease, kidney, respiratory and digestive conditions 
are now being treated in a new ward at the Women s and Children s Hospital, following the opening of 
the $5.4m 20-bed Cassia Ward and SA Ambulance Service launched its first MedSTAR Kids neonatal and 
paediatric ambulance. 

Investment continued in major eHealth initiatives. The largest, the Enterprise Patient Administration System 
(EPAS), continued to progress during the reporting period. EPAS will provide the foundations for the 
delivery of an SA Health wide electronic health record and will help improve care by enabling clinicians  
to spend less time on paperwork and more time with patients at the bedside.  

SA Health furthered its efforts to provide high-quality mental health services, in line with the 
recommendations of the Social Inclusion Board s 2007 Stepping Up report. During the reporting period  
the Northern Community Mental Health Centre in Salisbury was opened. The centre, which provides a 
variety of services for people who need support but do not need to be admitted to hospital, is the third of 
six being built across Adelaide as part of a $34m state government initiative. Other initiatives included the 
opening of 59 new supported accommodation units for mental health consumers and the design of a new 
model of care to improve early identification and in hospital and community based care for people with 
eating disorders. The proposed model was released for public consultation during 2012-13 and is intended 
to bring our state in line with nationally and internationally recognised best practice.

Following the success of the 2012 Let s Think Positive initiative, SA Health launched a campaign to 
challenge South Australians to Rethink Mental Illness. The campaign, which incorporated television and 
radio commercials, outdoor advertisements and information on the SA Health website, encouraged South 
Australians to support, respect and accept those recovering from mental illness in the same ways as those 
with physical ailments. 



page 9 Department for Health and Ageing Annual Report 2012-13

The department implemented a range of measures for older South Australians and to encourage their 
continued participation in their local communities. In October, South Australia s Communities for All: Our 
Age-friendly Future, was launched to provide a suite of guidelines to help build better social and physical 
environments around the principles of age-friendly design. The new Seniors Card, which was delivered 
to more than 310 000 South Australian senior citizens, provides seniors with discounts on goods and 
services, and acts as a Metrocard for public transport services. A new $6m integrated teaching and research 
rehabilitation centre for older people was officially opened at the Repatriation General Hospital, catering 
to those recovering from major surgery or injury and providing them with access to a broad spectrum of 
specialist services. Also at the Repatriation General Hospital, work began on ViTA, a new $46m health, 
teaching and research facility. The centre is designed to help meet the needs of our ageing population by 
providing a seamless health, aged care and education service. It is expected to be completed in mid 2014.

Redevelopment works at Country Health SA sites, including the $39.2m Port Lincoln, and $36m Riverland 
hospitals, progressed well during the reporting period. Redevelopment and upgrade works at the 
Emergency Departments of Cummins Hospital and the South Coast District Hospital in Victor Harbor were 
completed and nine self-contained, one bedroom accommodation units were opened for patients who 
travel to Whyalla for treatment. 

SA Health s efforts to reduce the prevalence of smoking and to de-normalise it continued in 2012-13, with 
encouraging results. Evaluation conducted between July 2010 and March 2011 demonstrated that 94 per 
cent of smokers either cut back or quit smoking completely while in hospital, and 48 per cent indicated 
that they had either quit smoking or cut back after leaving hospital. The consumer survey also found that 
70 per cent of smokers were very satisfied with the assistance provided when they were offered nicotine 
withdrawal support. In the same period, South Australia s smoking rates decreased from 20.5 per cent to 
17.6 per cent. This is the largest reduction in smoking observed in the last ten years and equates to 39 545 
people over the age of 15 not smoking. Furthermore, SA Health s smoke-free policy was revised, removing 
temporary exemptions that had previously applied to short-stay voluntary mental health and country aged 
care services. 

In summary, 2012-13 proved to be a year of change and exciting challenges for the department. As we 
embark on a new financial year, we will continue to work together towards our ultimate goal   ensuring 
all South Australians can access timely, efficient and high quality health care as close to their homes  
as possible.

David Swan

Chief Executive



page 10Department for Health and Ageing Annual Report 2012-13



page 11 Department for Health and Ageing Annual Report 2012-13

Objectives, Role, Governance and Legislation 

Objectives
Our key objective is to lead and deliver a comprehensive and sustainable health system that aims to ensure healthier, 
longer and better lives for all South Australians.

The department is committed to a health system that produces positive health outcomes by focusing on health 
promotion, illness prevention and early intervention.

We will work with other government agencies and the community to address the environmental, socioeconomic, 
biological and behavioural determinants of health, and to achieve optimal health outcomes for all South Australians. 

In this context the department is guided by South Australia s Health Care Plan 2007-16 (SACHP), which provides a 
clear vision for the sustainable provision of health care services. 

Role
The department assists the Minister for Health and Ageing and the Minister for Mental Health and Substance Abuse 
to set the policy framework and strategic directions for SA Health. The department supports the delivery of public 
health services, formulates health policy, facilitates public and consumer consultation on health issues, and monitors 
the performance of South Australia s health system by providing timely advice, research and administrative support.

Department for Health and Ageing Organisational Structure
There are six divisions within the department:

 &gt; Finance and Business Services

 &gt; System Performance

 &gt; eHealth Systems

 &gt; Public Health and Clinical Systems

 &gt; Policy and Commissioning

 &gt; Mental Health and Substance Abuse

SA Health is the brand name for the health portfolio of services and agencies responsible to the Minister for  
Health and Ageing and the Minister for Mental Health and Substance Abuse, SA Health is the corporate identity  
for the portfolio only and not the legal entity.

The legal entities as at 30 June 2013 include: 

 &gt; Minister for Health and Ageing and Minister for Mental Health and Substance Abuse

 &gt; Central Adelaide Local Health Network Incorporated (CALHN)

 &gt; Northern Adelaide Local Health Network Incorporated (NALHN)

 &gt; Southern Adelaide Local Health Network Incorporated (SALHN)

 &gt; Women s and Children s Health Network Incorporated (WCHN)

 &gt; Country Health SA Local Health Network Incorporated (CHSALHN)

 &gt; SA Ambulance Service Incorporated (SAAS)



page 12Department for Health and Ageing Annual Report 2012-13

SA Health Structure as at 30 June 2013

Administrative and Legislative Responsibilities
The department has administrative responsibility for ensuring that the governance responsibilities of the Minister 
and the incorporated hospitals across the state are appropriately discharged. The Health Care Act 2008 provides for 
the administration of hospitals and other health services, and establishes the Health Performance Council (HPC) and 
Health Advisory Councils (HACs). The department supports the councils with the discharge of their governance and 
administrative responsibilities.

The department also has responsibility for the South Australian Public Health Act 2011 (which establishes the  
SA Public Health Council and other legislation relating to public health).

The department additionally ensures that those responsible for legislation committed to Ministers relevant to the 
public health system are appropriately advised about the discharge of their duties. Appendix 1 provides a full list of 
relevant legislation committed to the Minister for Health and Ageing and Minister for Mental Health and Substance 
Abuse as at 30 June 2013.

Appendix 2 lists the incorporated hospitals under the Health Care Act 2008. It should be noted that these entities 
have responsibility for preparing their own annual reports for tabling in Parliament.

Appendix 3 provides a list of boards and committees responsible to the Minister for Health and Ageing and the 
Minister for Mental Health and Substance Abuse. It also lists Health Advisory Councils (HACs) established under  
the Health Care Act 2008. These boards and committees are listed on the Boards and Committees Information 
System (BCIS). All of the members are appointed by either the Governor or the Minister and some members  
receive remuneration. 

Chief Executive  
SA Health

David Swan

Minister for Health and Ageing
Minister for Mental Health

and Substance Abuse

Hon. Jack Snelling M.P.

Health  
Performance 

Council Secretariat

Health Performance 
Council

Risk Management  
and Internal Audit

LHNs and SAAS are accountable to the Chief Executive, but will liaise on a day-
to-day basis with the Deputy Chief Executive System Performance on operational 

matters and Deputy CE Finance and Business Services on financial matters.

Policy and 
Commissioning

Executive Director

Sin ad O Brien

eHealth Systems

Executive Director

David Johnston

Public Health  
and  

Clinical Systems

Executive Director

Stephen Christley

Mental Health  
and  

Substance Abuse

Executive Director

David Davies

Southern Adelaide  
Local Health Network

Chief Executive Officer

Belinda Moyes

Northern Adelaide  
Local Health Network

Chief Executive Officer

Margot Mains

Country Health 
SA Local Health Network

A/Chief Executive Officer

Peter Chapman

Women s and Children s  
Health Network

Chief Executive Officer

Gail Mondy

SA Ambulance Service

A/Chief Executive Officer

Aaron Chia

Central Adelaide  
Local Health Network

Chief Executive Officer

David Panter

Statewide Clinical Support Services 
SA Pathology, SA Imaging 

SA Pharmacy 
Group Executive Director   Ken Barr

Deputy 
Chief Executive 

Finance and 
Business Services

Steve Archer

Deputy 
Chief Executive 

System  
Performance

Jenny Richter



page 13 Department for Health and Ageing Annual Report 2012-13

Risk Management and Audit
The department has a Risk Management and Audit Committee with both external and internal membership aimed  
at providing advice and assistance to the Chief Executive on SA Health s risk, control and compliance framework.  
The committee regularly meets and receives reports from a number of assurance providers, including the department s 
Risk Management and Internal Audit Division, which reports directly to the SA Health Chief Executive.

Code of Conduct for Unregistered Health Practitioners
Changes to the Health and Community Services Complaints Act 2004 came into effect on 14 March 2013. The 
changes include a code of conduct which all unregistered health practitioners will have to comply with, or risk  
the Health and Community Services Complaints Commissioner (the Commissioner) making an order against them.  
The changes are designed to provide better protection from the actions of unregistered health practitioners for  
the South Australian community.

Unregistered health practitioners refer to health practitioners who are not registered by the Australian Health 
Practitioner Regulation Agency (AHPRA [which registers medical practitioners, nurses, dentists and physiotherapists  
as well as other health practitioners]). This includes naturopaths, massage therapists, homeopaths, social workers  
and dieticians as well as a broad range of other practitioners. Under the new laws unregistered health practitioners 
are able to be held accountable for their practices.

If a health consumer makes a complaint, the Commissioner may investigate the matter and make an order which  
can prevent the health practitioner from practising for a period of time or permanently. This can only occur when  
the Commissioner considers that the health or safety of the public is placed at risk by the practitioner s actions.

The scheme introduced in South Australia is based on a similar scheme successfully operating in New South 
Wales for some years. While the scheme covers all unregistered health practitioners it will provide the public with 
greater protection against practitioners who seek to exploit vulnerable people with claims of being able to cure 
cancer or other illnesses when there is no evidence that this is the case. The Social Development Committee of the 
South Australian Parliament recommended the introduction of a scheme of this type in their Inquiry into Bogus, 
Unregistered and Deregistered Health Practitioners.

Advance Care Directives Act 2013
The Advance Care Directives Act 2013 (the Act) was assented to by the Governor on 18 April 2013 and is likely 
to commence mid-2014. Once it commences, the new Act will simplify existing arrangements for advance care 
directives. The three existing forms: Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory 
Direction will be replaced by a single Advance Care Directive form for health care, residential, accommodation and 
personal matters. 

The new Advance Care Directive form will make it easier for competent adults who choose to, to leave instructions 
about how they want decisions made for them in the event they cannot make such decisions for themselves. It will 
also allow competent adults to appoint and/or instruct one or more trusted Substitute Decision-Maker/s to make such 
decisions on their behalf. 



page 14Department for Health and Ageing Annual Report 2012-13

Premier s Strategic Priorities for  
South Australia   SA Health actions to  
support their implementation 
South Australia s Strategic Plan (SASP) is a comprehensive document outlining 100 targets that government, 
community and business can work towards.

The seven strategic priorities are those areas the government has chosen to focus on. The work, budgets, policy 
making and legislative agenda of the government reflect the priorities.

Advancing the priorities will directly support achievement of many of the targets outlined in the SASP. The SASP  
will continue to guide the work of the government.

Every Chance for Every Child
The SA Health Chief Executive is the deputy chair of the Senior Officer s Group, responsible to the Cabinet Task 
Force for finding ways across government to better support and strengthen South Australian families and children to 
achieve their best. A major component of this strategy is Child and Family Health Services, such as nurse home visiting 
and child health checks from the Women s and Children s Health Network (WCHN) being provided in partnership 
with the Department for Education and Child Development (DECD) to families in their local communities. This has 
extended to piloting antenatal services delivered by experienced midwives in children s centres, allowing pregnant 
women to link with parenting information and support services and have their health and pregnancy checks in their 
local community.  In addition, during 2012 dental health services extended the reach of the Lift the Lip program for 
early attention to children s oral health needs.

During 2012-13 SA Health has built upon its successful partnership since 2007 with the DECD for provision of an 
allied health program in children s centres. This unique program, supported by a partnership with the University of 
South Australia, provides prevention and early intervention by speech and occupational therapists for young children 
at risk of developmental delay on site in child care and preschool settings, currently in 16 children s centre locations.

Through the Closing the Gap in Indigenous Health Outcomes National Partnership, Health Promotion Branch 
employed 4.6 FTE Health Promotion Officers to work with children s centres and other early childhood settings in 
2012-13. The officers, based in metropolitan and regional Local Health Networks, increase health and wellbeing of 
Aboriginal children and families through staff and parent health education and support. Activities include support for 
health checks, immunisation, ear health screening, oral health programs and Nunga playgroups. A key achievement 
during 2012 was the development of a resource containing key health messages for Aboriginal families that can be 
utilised across all children s centres and other early childhood settings.  

The department continues to collaborate with Families SA to provide an innovative and culturally acceptable early 
intervention model to enhance wellbeing and functioning for high risk Aboriginal families. This very successful work 
is being conducted by highly skilled teams based at Kanggarendi, Salisbury and Nanko-walun Porlar Nomawi, Murray 
Bridge. The Murray Bridge team works closely with the Tinyeri Children s Centre and delivers a number of services 
including individual therapy, family therapy, group programs and training to local workers.  Both the above programs 
have sought to employ Aboriginal staff and this is recognised to have enhanced the ability of the programs to engage 
with local communities.

As part of the Health in all policies initiative, SA Health is leading a project to build the capacity of the current public 
sector workforce to better engage and support families with children aged under five, particularly vulnerable families. 
This and other parenting engagement and support initiatives will be progressed by SA Health during 2013-14.



page 15 Department for Health and Ageing Annual Report 2012-13

Aboriginal Ear Health Promotion Training for Early Childhood Staff

The Health Promotion Branch developed a new Aboriginal Ear Health Promotion training package designed for 
staff working in early childhood education settings. This was developed with the input of an Aboriginal Cultural 
Consultant and under the direction of a steering committee (which included a range of Aboriginal staff and a parent 
representative). Two focus groups with Aboriginal parents were also undertaken to help guide content of the training 
package. The aim of the training was to assist staff in early childhood settings build on their ear health promotion 
knowledge and skills so they can share this with families of Aboriginal children in the most useful way and be more 
aware of hearing impairment and middle ear disease in Aboriginal children. It is one step towards reducing middle  
ear disease and associated hearing loss in Aboriginal children in South Australia.

In 2012-13, training was conducted in 10 early childhood education centres. In addition, training sessions were 
provided to the Aboriginal Health Promotion officers from Country Health SA Local Health Network (CHSALHN), 
Southern Adelaide Local Health network (SALHN) and Northern Adelaide Local Health Network (NALHN) and a 
session was provided at the 2012 DECD Special Education Expo. Overall, 114 individuals were trained during 2012-13.

Safe Communities, Healthy Neighbourhoods
SA Health is actively engaged in advancing the state government s strategic priority of Safe Communities, Healthy 
Neighbourhoods, particularly through the implementation of the South Australian Public Health Act 2011. The South 
Australian Public Health Act 2011 provides the basis for developing a state Public Health Plan and local planning by 
local councils. This planning process has been identified as a driver for this priority. Its aim is to improve the health 
and wellbeing of our communities and show how to take action to make South Australia a better place to live. 
Councils have commenced planning and are aiming to complete their first plan by the end of calendar 2013.

This priority is also being supported by a range of specific initiatives including: implementation of the Eat Well Be 
Active Strategy, the Healthy Workers, Healthy Futures program, Obesity Prevention and Lifestyle program (OPAL), 
as well as contributing the further development of  people centred  planning approaches through support for the 
development and dissemination of planning guidance such as Streets for People and Healthy By Design-SA.

Creating a Vibrant City
Office for the Ageing (OFTA) business activity during 2012-13 continued to align with the SASP priority,  Creating a  
Vibrant City .

Recommendations arising from the first Thinker in Residence ageing specialist, Dr Alexandre Kalache, took account 
of the opportunity that the Baby Boomer generation presents for Adelaide to be both an age friendly and vibrant city. 
This included recognition of older people living in the central business district (CBD) and recognition of Baby Boomers 
as consumers of art, music and leisure in the CBD.

OFTA will be providing support to the Adelaide Festival of Ideas 2013 which will be held late in 2013. The Adelaide 
Festival of Ideas will attract national and international speakers to share and exchange knowledge and ideas with 
communities across the state. It will provide a timely opportunity for the community to explore and discuss  
Dr Kalache s final report, The Longevity Revolution, and to develop a deeper understanding of the ageing agenda  
in a deliberative and interactive way. 

In 2012-13, planning commenced to expand the Age Friendly Neighbourhoods (AFN) Guidelines and Toolkit for  
Local Government initiative that was launched by the Minister for Health and Ageing in October 2012. The expansion 
will fund five new local councils to implement the AFN toolkit and guidelines, providing practical ways for councils  
to develop plans for the current and emerging needs of an ageing population. The initiative contributes to the  
state s vision to strengthen the opportunities for older people to participate in social, civic, cultural and  
volunteering activities.



page 16Department for Health and Ageing Annual Report 2012-13

Premium Food and Wine from our Clean Environment 
The premium food and wine priority is led by the Department of Primary Industries and Regions SA with  
contributions from other South Australian Government agencies via a Senior Officers Group (SOG), including  
SA Tourism Commission; Department of Environment, Water and Natural Resources; Environment Protection 
Authority; Department for Health and Ageing; Department for Planning, Transport and Infrastructure and the 
Department of Manufacturing, Innovation, Trade, Resources and Energy. The department is represented on the  
SOG, through monthly meetings, by the Director of Public Health Services.

In 2012 a Concept Statement/Discussion Paper was released to introduce this strategic priority to industry and 
stakeholders. This publication presented the current thinking on how government, industry and the community can 
work together to foster growth in the South Australian food and wine sector. The paper outlined areas that required 
targeted and integrated attention to successfully deliver  Premium Food and Wine from our Clean Environment  and 
to establish South Australia as a preferred supplier of premium food and wine products. Feedback was sought to 
determine how these areas should be delivered.

An Action Plan has been developed based on extensive public and industry feedback and contributions from the SOG. 
The Action Plan will describe the intent of the strategic priority and set out a common direction for the government, 
industry and regions to shape activities to be delivered to support the growth and recognition of our food, wine and 
agriculture industries. It is expected that the Action Plan will be available in the first half of 2013-14.

The SOG also provides support and guidance on a wide range of initiatives from organising and sponsoring events 
such as Cheesefest to forging links with new and emerging economic markets in Asia. Capitalising on South 
Australia s reputation for safe food is embedded within this concept, coupled with the understanding that increasing 
local consumption of a wide range of fresh and healthy local food products may provide potential health and 
wellbeing outcomes.



page 17 Department for Health and Ageing Annual Report 2012-13

South Australia s Strategic Plan 
South Australia s Strategic Plan (SASP) was first released by the Government of South Australia in March 2004.  
SASP is the overarching document for progressing the health and wellbeing of South Australians, and the economic 
and environmental position of South Australia into the future. It sets the context for all South Australian Government 
agency activity particularly in relation to planning activities against relevant targets.

The Plan s targets reflect South Australia s aspirations for where we want to be as a state in the future. Targets are 
grouped under the following six priority areas:

 &gt; Our Community

 &gt; Our Prosperity

 &gt; Our Environment

 &gt; Our Health

 &gt; Our Education

 &gt; Our Ideas

Each priority is organised into visions and goals with the measurable targets supporting each goal that leads to the 
vision of the priority area.

The government committed to publish a report on progress against the Plan every two years, the latest report being 
published in September 2012.

The  Our Community  priority area includes the following visions:

 &gt; Our communities are vibrant places to live, work, play and visit.

 &gt; Everyone has a place to call home.

 &gt; Strong families help build our communities.

 &gt; We are safe in our homes, community, and at work.

 &gt; We are connected to our communities and give everyone a fair go.

The  Our Community  priority area includes thirty-three targets. Highlights include a substantial reduction in statewide 
crime rates of 38 per cent between 2002-03 and 2010-11 (T17) and significant progress towards the greater safety  
at work target (T21)1.

The  Our Health  priority area focuses on the vision that we are active in looking after our health. This includes by 
making healthy choices in how we live, by education young people about healthy living, by being physically active 
and assisting people to deal with all forms of illness and to live a satisfying life where they can contribute to their 
community2.

The  Our Health  priority area includes nine targets. Highlights include the proportion of Emergency Department 
patients attended to, and discharged or admitted, within four hours has improved from 59.4 per cent in 2010-11  
to 66.1 per cent in 2012-13 (T84).

1  South Australia s Strategic Plan, Progress Report September 2012

2  South Australia s Strategic Plan, Progress Report September 2012



page 18Department for Health and Ageing Annual Report 2012-13

Strategic Directions
The South Australian health agenda is underpinned by South Australia s Health Care Plan (SAHCP), which has its 
genesis in the Generational Health Review. The SAHCP sets out a coordinated system architecture that matches the 
availability of clinical services with population need and delineates the roles of major versus general hospitals. In 
implementing the SAHCP there has been a continued strong focus on ensuring services are safe, timely and located 
in the most geographically and functionally appropriate setting, with a renewed emphasis on service efficiency and 
financial sustainability.

SA Health is working to progressively identify opportunities to better align the delivery of clinical services with 
evidence-based practice. In partnership with Local Health Networks (LHNs) and clinical leaders across the system, 
work has commenced to prioritise the redesign of key clinical services across in-hospital and out-of-hospital settings. 
Emergent knowledge about clinical effectiveness and service innovation is being sought to develop improved service 
models to reform the system.

In parallel with the design and planning of best practice service models we are planning the future workforce capacity 
to ensure that a targeted, sustainable supply of skilled personnel is available into the future. We are continuing to roll 
out a transparent learning culture across all of our services with collaboration, efficiency, effectiveness, innovation and 
interdisciplinary practice at the heart of new service models across the care continuum.

Our LHNs continue to focus on accountability, reviewing performance and inspiring improvement as well as 
partnering with other health service providers to find the best ways of meeting the needs of their local populations. 
The continuous review and reshaping of our health services and structures is important to maintaining the flexibility 
and adaptability needed to meet the evolving needs of our population within available resources.

SA Health Led Targets
SA Health is the lead agency for a total of nine targets and is the lead agency for the following target contributing  
to  Our Community with the Vision: We are connected to our communities and give everyone a fair go .

Goal: We Advocate For Everyone To Reach Their Full Potential.

 &gt; Target 26 Early Childhood, Birth Weight   Reduce the proportion of low birth weight babies and halve  
the proportion of Aboriginal low birth weight babies by 2020.

SA Health is the lead agency for eight targets that contribute to  Our Health with the Vision: We are active in  
looking after our health .

Goal: We Make Healthy Choices About How We Live.

 &gt; Target 78 Healthy South Australians   Increase the life expectancy of South Australians to 82.4 years  
(6 per cent) for males and 85.5 years (4 per cent) for females by 2020.

 &gt; Target 79 Aboriginal Life Expectancy   Increase the average life expectancy of Aboriginal males to 79.3 years 
(22 per cent) and Aboriginal females to 82.5 years (19 per cent) by 2020.

 &gt; Target 80 Smoking   Reduce the smoking rate to 10 per cent of the population and halve the smoking rate  
of Aboriginal South Australians by 2018.

 &gt; Target 81 Alcohol Consumption   Reduce the proportion of South Australians who drink at risky levels by  
30 per cent by 2020.

Goal: We Educate Young People About Healthy Living.

 &gt; Target 82 Healthy Weight   Increase by five percentage points the proportion of South Australian adults  
and children at a healthy body weight by 2017.



page 19 Department for Health and Ageing Annual Report 2012-13

Goal: We Assist People to Deal With All Forms of Illness and To Live a Satisfying Life Where They Can 
Contribute to Their Community.

 &gt; Target 84 Health Service Standard   By 2015, 90 per cent of patients presenting to a public hospital Emergency 
Department will be seen, treated and either discharged or admitted to hospital within four hours.

Note: This target was revised in 2012 to reflect the Commonwealth targets of achieving 90 per cent by 2015.

 &gt; Target 85 Chronic Disease   Increase, by five percentage points, the proportion of people living with a chronic 
disease whose self-assessed health status is good or better.

 &gt; Target 86 Psychological Wellbeing   Equal or lower than the Australian average for psychological distress by 
2014 and maintain thereafter.

Target 26 Early Childhood   Birth Weight
Reduce the proportion of low birth weight babies and halve the proportion of Aboriginal low birth weight babies  
by 2020.

Figure 1   Low birth weight infants as a proportion of total live births for South Australia (2003 baseline)

Pe
r 

ce
n

t

Year

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* 

Total population 6.8 6.2 6.6 6.5 6.5 7.0 6.4 6.4 6.3 6.8 6.8 6.9 

Indigenous 17.6 16.2 18.9 17.3 17.4 17.7 13.4 16.2 16.3 12.8 16 15.2 

non-Indigenous 6.5 6.0 6.2 6.2 6.2 6.7 6.2 6.1 6.0 6.6 6.5 6.6 

Baseline 18.0 

0 

2 

4 

6 

8 

10 

12 

14 

16 

18 

20 

Data source: SA Health, Pregnancy Outcomes Unit

This target was changed as part of the SASP review to reflect SA Health s commitment to improved Aboriginal low 
birth weight outcomes. Low birth weight babies are defined as live births with a birth weight less than 2500 grams. 
The most recent data from the SA Health Pregnancy Outcomes Unit shows that the proportion of low birth weight 
babies as a proportion of total live babies for the total SA population has remained relatively stable from the baseline 
and is on track to achieve the target.

The Aboriginal birth weight rate tends to fluctuate from year to year due to the relatively small numbers. The data 
reported in 2010, based on available provisional data, listing 13.5 per cent was incorrectly reported. The final dataset 
for 2010 revealed 16 per cent of live-born Aboriginal babies to be less than 2500 grams. The 2011 provisional figure 
of 15.2 per cent continues a decreasing trend from the baseline year (2003) figure of 17.3 per cent. The target for 
Aboriginal low birth weight babies is considered within reach.  



page 20Department for Health and Ageing Annual Report 2012-13

Target 78 Healthy South Australians 
Increase the life expectancy of South Australians to 82.4 years (7 per cent) for males and 85.5 years (4 per cent) for 
females by 2020.

Figure 2   Life expectancy for South Australians (2002 baseline) 

 

70 

75 

80 

85 

90 

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 

A
g

e 
in

 y
ea

rs
 

Year 

Male 77.3 77.7 78.0 78.1 78.6 78.8 79.2 79.3 79.4 79.7 82.4

Female  82.6 82.7 83.1 83.4 83.6 83.9 83.8 83.9 83.8 84.0 85.5

Data source: Australian Bureau of Statistics (ABS) 

This target was extended to 2020 as part of the SASP review. The indicator was changed this year to reflect life 
expectancy rather than health adjusted life expectancy (HALE), as data restrictions imposed by ABS mean it is no 
longer possible to calculate HALE. The two indicators are very closely related, as the pattern of population mortality  
is by far the main determinant of both, and the two indicators have historically trended in parallel.

Health adjusted life expectancy will be calculated by the ABS from time to time, which should provide an adequate 
reflection of this indicator in South Australia. The state data is not expected to change markedly on a year-to-year 
basis. The state strategic targets are expected to be adjusted as well, to feature life expectancy per se rather than 
health adjusted life expectancy. The latter indicator requires significantly greater resources to calculate, making it 
impractical on an annual basis and nearly impossible in light of the amount of missing data due to the historical  
ABS restriction on data sharing.

The 2011-12 state data puts the most recently available life expectancy at 79.7 years for men and 84.0 years  
for women.  

 



page 21 Department for Health and Ageing Annual Report 2012-13

Target 79 Aboriginal Life Expectancy
Increase the average life expectancy of Aboriginal males to 79.3 years (22 per cent) and Aboriginal females to  
82.5 years (19 per cent) by 2020.

Figure 3   South Australian Aboriginal life expectancy at birth, rolling five year averages

 

70 

75 

80 

85 

90 

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 

Y
ea

rs
 

Period Ending

Male 

Female  

63.8 63.3 63.9 64.2 67.2 67.6 70.9 73.0 74.0 74.3 79.3

68.9 71.7 72.1 74.5 75.7 75.9 76.1 77.2 77.6 78.8 82.5

Data source: ABS Census of Population and Housing and SA Registrar of Births, Deaths and Marriages (BDM)

This target indicator has been adjusted as explained above for T78. Population numbers of Aboriginal and Torres 
Strait Islander people were estimated per year using a linear interpolation of the 2001, 2006 and 2011 Indigenous 
population profiles from the ABS census of population and housing. Deaths were retrieved from the relevant BDM 
deaths files. Based on these inputs South Australian Aboriginal life expectancy at birth was calculated for a rolling  
five year window from 1998-2002 to 2007-11. Because the ABS only releases population data in the Indigenous 
profiles for a top age bracket of 65+ years, this age group was used as the top age bracket in the life tables.

The gap between Aboriginal and non-Aboriginal life expectancy reduced by 40 per cent for males and  
38.1 per cent for females over the last 10 years. A 20 per cent improvement in the rate of reduction of the  
gap in life expectancy between Aboriginal and non-Aboriginal South Australians would require a reduction of  
48 per cent for males and 45.8 per cent for females over the next 10 years. This results in a target life expectancy  
for South Australian Aboriginal and Torres Strait Islander males of 79.3 years, and for females of 82.5 years.

The 2011-12 state data puts the most recently available Aboriginal life expectancy at 74.3 years for men and  
78.8 years for women.



page 22Department for Health and Ageing Annual Report 2012-13

Target 80 Smoking 
Reduce the smoking rate to 10 per cent of the population and halve the smoking rate of Aboriginal South Australians 
by 2018.

Progress towards SASP Target 80: The three year average of daily smoking for 2011 (i.e. 2010, 2011 and 2012) 
was 15.6 per cent (95 per cent CI=14.7-16.5), which was a statistically significant decrease since 2010 (16.7 per cent, 
95  per cent CI=15.8-17.6). Three year average daily smoking prevalence needs to decline by a further 5.6 per cent 
over the next seven years in order to reach the target of 10  per cent. This equates to a decline of 0.8 per cent per 
year in three year moving average daily smoking prevalence until 2018.

Figure 4   Smoking prevalence (per cent) in three-year moving averages, for daily smokers aged 15 years 
and over, 1999 to 2011, age standardised to 2006 population

0% 

5% 

10% 

15% 

20% 

25% 

30% 

35% 

 02  01  00 99  03  04  05  06  07  08  09  10  11  12  13  14  15  16  17  18 

Pr
ev

al
en

ce
 (

%
)

Survey Year

SASP Target 80: 

17.4%

16.7% 15.6%

10%

3-year moving average: 
15+ years, Daily smoking 
prevalence

 

Data source:  South Australian Health Omnibus Survey 2012

 



page 23 Department for Health and Ageing Annual Report 2012-13

Target 81 Alcohol Consumption 
Reduce the proportion of South Australians who drink at risky levels by 30 per cent by 2020.

Figure 6   The percentage of South Australians aged 14+ years who drank at levels that put them at risk  
of harm on a single occasion at least once a month 2007, 2010   2012 (2007 baseline)

0

5

10

15

20

25

30

35

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 

Pe
r 

ce
n

t

Year

Target

South Australia  

Baseline  

21.4 

30.5 27.3 26.4 29.7 

30.5 

 

Data sources: National Drug Strategy Household Surveys 2007 and 2010 and South Australian Health Omnibus Surveys 2011 and 2012.

Figure 7   The percentage of South Australians 14+ years who drank at levels that put them at risk of harm 
on a single occasion at least once a month by gender 2007, 2010-12

0

5

10

15

20

25

30

35

40

45

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 

Pe
r 

ce
n

t

Year

Male  

Female  

 

41.4 35.7 36.4 41.3 

19.8 19.3 16.8 18.5 

 

Data sources: National Drug Strategy Household Surveys 2007 and 2010 and South Australian Health Omnibus Surveys 2011 and 2012.
Note:  Collection of Health Omnibus Survey data for the purposes of the new SASP target only commenced in 2011, hence the absence of data 
for 2008 and 2009.

This is a new target arising from the SASP review that demonstrates SA Health s commitment to reduce the harm 
associated with excessive short term alcohol consumption, which is defined as persons consuming alcohol at  
levels (more than four standard drinks) that put them at risk of accident or injury on a single occasion at least  
once a month.

While only several data points are available from the 2007 baseline, these demonstrate a decline in overall risky 
drinking prevalence rates to 2011 then an increase in 2012 to near 2007 levels (Figure 6). Gender data (Figure 7) 
shows that a much higher proportion of males consume alcohol at risky levels than females. Age-related data shows 
risky drinking has the highest proportion among the 20-29 year old age group (47.7 per cent in 2012).

 



page 24Department for Health and Ageing Annual Report 2012-13

Target 82 Healthy Weight
Increase by five percentage points the proportion of South Australian adults and children at a healthy body weight  
by 2017.

Figure 8   Proportion of South Australian adults (18 years and over) and children (5 to 17 years*)  
at a healthy weight (baseline 2009) 

Pe
r 

ce
n

t

Year

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 

Adults 42.0 42.5 43.6 42.5 41.0 40.0 39.9 38.8 38.0 38.9 

Adult target 44.4 

Children 73.3 73.0 73.4 73.5 76.7 75.2 76.3 74.7 74.2 

Children target 80.2 

0

10

20

30

40

50

60

70

80

90

Baseline

 

Data Source: South Australian Monitoring and Surveillance System (January 2003   December 2012)
*Parent proxy used when the child is under the age of 16 years

Figure 9   Proportion of South Australian adults (18 years and over) at a healthy weight, by gender  
(2009 baseline) 

Pe
r 

ce
n

t

Year
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 

0

10

20

30

40

50

60

Males 35.2 36.6 37.4 36.0 35.6 34.6 35.3 34.0 33.2 32.0 

Females 48.7 48.3 49.7 48.7 46.5 45.5 43.6 43.4 42.7 45.7 

44.4 Adult target 

Baseline

 

 

Data Source: South Australian Monitoring and Surveillance System (January 2003   December 2012) 

The proportion of South Australian adults in the healthy weight range has been declining since 2005, however it 
appears this may now be stabilising. 

The proportion of South Australian children in the healthy weight range has remained relatively stable over time,  
but has declined since baseline (2009). 

Females continue to report higher levels of healthy weight compared to males, for whom there was a three 
percentage point increase observed in 2012. The proportion of males at a healthy weight continues to track away 
from the target. Achieving the target   to increase by five percentage points the proportion of adults and children  
at a healthy weight by 2017   is challenging.



page 25 Department for Health and Ageing Annual Report 2012-13

Increasing the proportion of people at a healthy weight is problematic across many jurisdictions nationally and also 
internationally. Overweight and obesity is a global concern and SA Health continues to work to identify, implement 
and monitor best practice strategies to arrest this trend. The Eat Well Be Active Strategy 2011-16 aims to build 
momentum for change in which large numbers of the population are supported to lead healthy and active lives.  
This strategy sets out specific commitments from 10 departments and at the same time calls for action across the 
whole community. Moving forward, the South Australian Public Health Act 2011 and associated planning process 
provides a framework for coordinated action and partnerships across local government and the community, including 
a focus on increasing opportunities for healthy eating and physical activity. 

Target 84 Health Service Standard 
By 2015, 90 per cent of patients presenting to a public hospital Emergency Department will be seen, treated and 
either discharged or admitted to hospital within four hours.

Figure 10   Emergency four hour rule (Visit time =&lt;four hours), (2010-11 baseline)

 

2007-08 2008-09 2009-10 2010-11 2011-12 
YTD May 
2012-13 

Presentations 61.3% 58.6% 57.9% 59.4% 64.6% 66.1% 

Target  71.0% 

Baseline 59.4% 

0% 

10% 

20% 

30% 

40% 

50% 

60% 

70% 

80% 

90% 

100% 

Pe
r 

ce
n

t 

Year

 

 

 

Data source: Health Information Portal

 



page 26Department for Health and Ageing Annual Report 2012-13

Figure 11   Emergency four hour rule (Visit time =&lt;four hours) Gender specific, (2010-11 baseline)

2007-08 2008-09 2009-10 2010-11 2011-12 
YTD May 
2012-13 

Male 63.5% 61.1% 60.5% 61.8% 66.5% 67.9% 

Female 58.8% 55.8% 55.1% 56.9% 62.6% 64.2% 

Baseline 60% 

0% 

10% 

20% 

30% 

40% 

50% 

60% 

70% 

80% 

90% 

100% 

Pe
r 

ce
n

t 

Year

 

Data Source: Health Information Portal

This is a new target developed in response to community feedback as part of the SASP review process regarding 
access to government services and particularly health services.

This target is based on the government s 2010 South Australian election commitment.

This target was formally changed in November 2012 to reflect the Australian Government target of 90 per cent of 
patients being seen, treated and admitted or discharged within four hours by the end of 2015 (previously 2013). The 
National targets for this indicator are based on calendar years for example 2013, 75 per cent and 2014, 82 per cent. 
SASP targets are based on financial years and the midpoint for 2012 and 2013 in setting the target for 2012-13 is  
71 per cent.

Performance against the target has shown an improvement from the baseline. A consistently higher proportion  
of males are attended within the target time frame than females.

Despite the overall performance improvement, this still remains a challenging target. SA Health is continuing to 
review strategies within hospitals and around primary and secondary care and hospital avoidance to achieve a  
positive outcome.



page 27 Department for Health and Ageing Annual Report 2012-13

Target 85 Chronic Disease 
Increase, by five  percentage points, the proportion of people living with a chronic disease whose self-assessed health 
status is good or better.

Figure 12   Proportion of South Australians (16 years and over) with a chronic disease reporting excellent, 
very good, or good health status (2003 baseline)

 

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 

Adults 72.6 69.9 72.6 69.3 69.7 71.7 69.9 69.9 71.8 72.4 

Adult target 77.6 

0

10

20

30

40

50

60

70

80

Pe
r 

ce
n

t

Year

Baseline

 

 

Data Source: South Australian Monitoring and Surveillance System (January 2003   December 2012)

Figure 13   Proportion of South Australians (16 years and over) with a chronic disease reporting excellent, 
very good, or good health status, by gender (2003 baseline)

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 

Males 71.9 68.1 73.9 66.6 68.3 70.5 68.8 68.1 70.8 69.1 

Females 73.2 71.2 71.6 71.5 70.8 72.7 70.8 71.3 72.6 74.9 

Adult target 77.6 

0

10

20

30

40

50

60

70

80

90

Pe
r 

ce
n

t 

Year

Baseline

 

 

Data Source: South Australian Monitoring and Surveillance System (January 2003   December 2012)

The chronic diseases included in Target 85 are diabetes, asthma, cardiovascular disease, arthritis and osteoporosis.  
The proportion of South Australian adults with at least one chronic condition who rated their health status as 
excellent, very good or good has remained steady over time. Females generally report better health status than males.



page 28Department for Health and Ageing Annual Report 2012-13

Target 86 Psychological Wellbeing 

Equal or lower than the Australian average for psychological distress by 2014 and maintain thereafter.

Figure 14   Proportion of South Australian adults (18 years and over) experiencing psychological distress 
(2001 baseline) 

 

2001
* 

2002
a 

2003 2004 2005 
2004-
05* 

2006 2007 2008 
2007-
08* 12* 

2009 2010 2011 2012
2011-

South Australia 14.1 10.9 10.7 10.1 9.6 12.3 9.3 8.5 8.9 13.0 8.5 8.1 9.2 11.4 8.9

Australia 12.6 13.0 12.0 10.8 

0

2

4

6

8

10

12

14

16

Pe
r 

ce
n

t

Year

 

 

Data Sources: South Australian Monitoring and Surveillance System (July 2002*   December 2012) 
*Australian Bureau of Statistics (Cat No 4364.0.55.001), data is age standardised 

Figure 15   Proportion of South Australian adults (18 years and over) experiencing psychological distress,  
by gender (2001 baseline)

 

2001
* 

2002
a 

2003 2004 2005 
2004-
05* 

2006 2007 2008 
2007-
08* 

2009 2010 2011 
2011-
12* 

2012 

Males (SA) 11.6 8.7 8.9 8.2 6.9 9.6 8.0 6.3 7.5 12.3 7.3 6.7 7.9 10.1 7.6 

Females (SA) 15.4 13.0 12.4 11.8 12.1 14.6 10.6 10.8 10.2 13.4 9.8 9.4 10.4 12.6 10.0 

Males (Aust) 9.6 10.8 9.6 8.8 

Females (Aust) 14.8 15 14.3 12.7 

0

2

4

6

8

10

12

14

16

18

Pe
r 

ce
n

t 

Year 

 

Data Source: South Australian Monitoring and Surveillance System
*Australian Bureau of Statistics (Cat No 4364.0.55.001)

Psychological distress is defined as those with high or very high psychological distress using the Kessler K10 measure 
of psychological distress. The K10 scale assesses the level of anxiety and depressive symptoms a person may have 
experienced in the most recent four week period. 



page 29 Department for Health and Ageing Annual Report 2012-13

As Target 86 compares South Australian and Australian data, results are drawn from the ABS Australian Health Survey 
(previously the National Health Survey) which is conducted every four years. Statistical limitations with the national 
data set prevent definitive comparisons between South Australian and  
national data. 

South Australian Monitoring and Surveillance System (SAMSS) data is used to assess trends in South Australia 
between national surveys and is also presented in Figures 14 and 15. The proportion of South Australian adults with 
psychological distress declined from baseline (2001) to 2010 before increasing slightly in 2011 and 2012.

Females consistently reported higher psychological distress compared to males in both state and national data sets.  



page 30Department for Health and Ageing Annual Report 2012-13

All of Government Targets

Target 30 Boards and Committees
Increase the number of women on all state government boards and committees to 50 per cent on average by 2014, 
and maintain thereafter by ensuring that 50 per cent of women are appointed, on average, each quarter

As at 30 June 2013, 51.6 per cent of board and committee members across the Health and Ageing portfolio and 
45.83 per cent of board and committee members for the Mental Health and Substance Abuse portfolio were women. 
The number of women on the department s boards and committees has increased since 1 June 2007, demonstrating 
the department has been successful in meeting and maintaining this target.

Target 31 Chairs of Boards and Committees
Increase the number of women chairing state government boards and committees to 50 per cent by 2014.

As at 30 June 2013, women chaired 43.10 per cent (25/58) of boards and committees (as recorded on BCIS) for the 
Health and Ageing portfolio. Six boards and committees did not have a chairperson appointed as at 30 June 2013.

Ongoing strategies to increase the proportion of female chairs include:

 &gt; Consulting women s networks and registers, and individual boards and committees to facilitate the participation  
of women with suitable skills and experience on boards and committees.

 &gt; Consulting SA Health networks to obtain names of potential candidates.

 &gt; Addressing the possibility and appropriateness of appointing a female chair when liaising with boards and 
committees in relation to upcoming vacancies.

Please note that figures for the Mental Health and Substance Abuse portfolio are not included above. There are two 
boards under this portfolio; one has a male chair and the other a female chair. The percentage of women chairing 
these boards as at 30 June 2013 was 50 per cent.

Target 32 Customer and Client Satisfaction with Government Services
Increase the satisfaction of South Australians with government services by 10 per cent by 2014, maintaining or 
exceeding that level of satisfaction thereafter. 

During 2012 the department continued to assess customer and client satisfaction via the SAMSS.

Questions in SAMSS are based on the Canadian Common Measurement Tool for Customer Satisfaction. Participants 
were randomly selected then all adults aged 16 years and over, who had used at least one South Australian public 
health service in the last four weeks (n= 274), were asked questions relating to customer satisfaction and the public 
health service they had used. The proportion of adults 16 years and over satisfied with the quality of service for the 
2012 calendar year was 92.1 per cent. This was a slight decrease from 93.7 per cent in 2011 but an increase from 
2010 when the satisfaction rate was 91.7 per cent.

SA Health is committed to ensuring that the experience of consumers using its services is as positive as possible. 
In order to achieve this goal it is essential that SA Health engages with consumers and the community about their 
health care experience and the type and quality of health care services they receive. Feedback about the consumer s 
experience is welcomed and community participation is actively encouraged and recognised as a positive contribution 
towards improvements in health service quality, equity and management.

The SA Consumer Experience Surveillance System (SACESS) defines the quality of health care in the context of 
consumer experience, supporting consumers to be the focus of efforts to improve health care safety and quality.

The SACESS is an epidemiological surveillance system involving a representative sample of South Australian adults, 
aged 16 years and over, designed to measure and monitor high quality data on consumers  experiences of the 
care they received in a metropolitan or country hospital. The statewide satisfaction telephone surveys of overnight 
consumers of hospital care have been conducted annually or biannually since 2001.



page 31 Department for Health and Ageing Annual Report 2012-13

In 2011-12, 2438 South Australian adults completed the 55 survey questions and met the SACESS eligibility 
requirements for analysis. The annual survey response rate was 76 per cent, which is comparable to previous South 
Australian surveys. In 2010-11, 2318 consumers met the SACESS eligibility criteria and were interviewed.

Nearly 85 per cent of patients were satisfied or very satisfied with the overall quality of service. A slightly lower 
proportion was dissatisfied or very dissatisfied with the overall quality than in 2010-11 (5.3 per cent compared to  
5.8 per cent). When asked if they would recommend the hospital to a relative or friend, nearly 90 per cent of 
respondents said yes, with the remainder either unsure, or stating that they would not make such a recommendation.

The first Measuring Consumer Experience SA Public Hospital Inpatient Annual Report was published in 2012.  
The report describes the key issues from the consumers  experiences, and is available at  
www.sahealth.sa.gov.au/safetyandquality.

Target 33 Government Planning Decisions
South Australia leads the nation in timely decisions of development applications through to 2020.

The department contributes to the establishment of a thorough and expeditious development assessment process in a 
number of ways. Until March 2013 the department funded a  Health in Planning  position in Department of Planning 
Transport and Infrastructure to ensure key planning documents support healthy living and an  upfront  consideration 
of health issues. This was a successful initiative with an example of this work being the development of the Minister s 
Specification for Noise and Air Quality along Major Arterial Roads, led by the Health in Planning position. This 
document provides clarity on the planning requirements to protect residents from the health impacts of traffic noise 
and poor air quality, avoiding protracted negotiations between development proponents and assessors.

The department continues to have a representative on the Government Planning Coordination Committee to 
assist it identify key health care service and public health considerations for urban growth in the greater Adelaide 
metropolitan area and regional centres, and supports planning reform through representation on the Planning 
Reform, Agency Reference Group.

The department also provides support to planning authorities through the expeditious assessment of development 
sites in the unincorporated areas of the state as part of health protection operations in that area and through 
assessment of wastewater treatment proposals accompanying development proposals in un-sewered areas.

Target 50 People with a Disability
Increase by 10 per cent the number of people with a disability employed in South Australia by 2020.

The department continues to implement key workforce strategies for employees with disabilities through the 
SA Health Disability Action Plan (2008-13), across the public health system. These strategies, such as training, 
recruitment, career development and disability awareness training programs aspire to address the barriers experienced 
by people with a disability employed within the South Australian public health system. 

The number of people employed in the department with disabilities that require work place adaptation represents  
1.1 per cent of the department s total workforce.

Table 1   Number of people employed in the department with disabilities that require work place 
adaptation

Disability Male Female Total per cent of Agency

Disability Requiring Workplace Adaptation 7 16 23 1.1 %

Physical 1 5 6 0.3 %

Intellectual 0 1 1 0.0 %

Sensory 2 2 4 0.2 %

Psychological/ Psychiatric 1 0 1 0.0 %



page 32Department for Health and Ageing Annual Report 2012-13

Target 52 Women
Have women comprising half of the public sector employees in the executive levels (including Chief Executives)  
by 2012 and maintain thereafter.

As at June 2013, women represent 41 per cent of the department s total executive management team.

During 2012-13 the SA Health Women in Leadership Steering Committee reinvigorated efforts towards increasing 
the proportion of women in executive roles, but is now focused on positions across the whole of SA Health. A 
strategic directions document was developed, outlining their vision and objectives for 2013-16. These were endorsed 
by Portfolio Executive and launched by the Minister for Health and Ageing, Hon. Jack Snelling M.P. and the Chief 
Executive, Mr David Swan, on 7 May 2013. The Chief Executive also announced that SA Health was aiming for a 
stretch target of 60 per cent of SA Health executives to be women by 2015.

SA Health, through the steering committee, is committed to developing a culture that fosters gender diversity at all 
levels in the workplace and to developing initiatives that support and empower women to move into leadership roles. 
The initial focus has been on revitalising the intranet site and establishing a mentor program. 

Target 53 Aboriginal Employees
Increase the participation of Aboriginal people in the South Australian public sector, spread across all classifications 
and agencies, to two per cent by 2014 and maintain or better those levels through to 2020.

As at June 2013, Aboriginal and/or Torres Strait Islander employees represented 0.8 per cent of total employees in  
the department.

The department remains steadfast in its commitment to achieving this target. By aligning the two per cent Aboriginal 
employment target with the department s efforts in developing  a culturally responsive health care system to better 
meet the needs of our Aboriginal population, SA Health is applying strategies to better attract, recruit, and develop 
Aboriginal employees across the organisation.  

The acceptance of Targeted Voluntary Separation Packages and the cessation of a number of Close the Gap  
Programs has affected our ability to retain Aboriginal staff and has impacted Aboriginal employment figures for the 
2012-13 year.

The department continues to implement the SA Health Aboriginal Workforce Reform Strategy which sets the agenda 
for Aboriginal workforce improvement.

Target 61 Energy Efficiency   Government Buildings
Improve the energy efficiency of government buildings by 30 per cent by 2020 (Milestone of 25 per cent by 2014).

SA Health is responsible for approximately 51.0 per cent of government building energy use. Since 2000-01 the 
energy efficiency of the buildings SA Health occupies has improved by 21.7 per cent as measured against GJ/m23 . 
More detailed information regarding energy efficiency performance and the steps to further energy efficiency are 
outlined on page 137 of this report.

 

3  Gigajoule (GJ) per square meter.



page 33 Department for Health and Ageing Annual Report 2012-13

Primary Health Care

Overview 
The National Health Reform Agreement (NHRA) makes provision for the Australian government, states and territories 
to work collaboratively on system-wide policy and planning for General Practice and Primary Health Care. Effective 
planning for this space is vital, given the impact it has on the efficient use of hospital and other state funded services, 
and because of the need for effective integration across Australian Government and state-funded health services.

The National Strategic Framework for Primary Health Care (the National Framework) is a requirement under Schedule 
E of the NHRA. In the NHRA, the Council of Australian Governments (COAG) agreed to the development of this 
National Framework by December 2012 and to the development of bilateral state and territory-specific plans to 
support the endorsed National Framework. 

The National Framework was approved by the Standing Council on Health (SCoH) in May 2013. State and territories 
are currently developing their bilateral Primary Health Care Plans, consistent with the National Frameworks key 
objectives. 

South Australia s Bilateral Primary Health Care Plan will be the primary vehicle for implementing national and state 
Primary Health Care objectives. It will document state-specific issues, arrangements and agreed bilateral actions to 
address shared priorities consistent with the four high level outcomes identified in the National Framework:

 &gt; Building a consumer-focused integrated primary health care system.

 &gt; Improving access and equity.

 &gt; Increasing the focus on health promotion, prevention, screening and early intervention.

 &gt; Improving quality, safety, performance and accountability.

SA Health has established the state Primary Health Care Plan Steering Committee to assure the development of an 
agreed approach to Primary Health Care planning and implementation across South Australia. Membership of this 
committee includes Medicare Locals, Local Health Networks, Aboriginal Health Council of SA, the Health Consumers 
Alliance and Department for Health and Ageing Executive leadership. 

Men s Health
The department has a range of processes for the ongoing monitoring of the health status of all South Australians, 
including the monitoring of both mortality and morbidity rates as well as self-reported health outcomes. SA Health 
also has a number of key strategic plans that address improving the health of South Australians.

Men s health issues are being addressed in various aspects of primary health and preventative care. This includes 
working collaboratively with services to improve health promotion, illness and injury prevention, screening and 
research.

The department funded the following men s health related initiatives during 2012-13:

Trojans Trek
During 2012-13 the department contributed $35 000 to the Royal Australian Regiment Association of South Australia 
for the Trojan s Trek program. Eleven younger veterans of post-Vietnam conflicts participated in this initiative.

The program aims to provide an environment to support veterans suffering from military induced stress illness and  
is a valuable and effective addition to one on one counselling and pharmacology. 

Veterans Health Advisory Council Executive Officer Position
During 2012-13, the  department contributed $35 000 funding to the Veterans Health Advisory Council (VHAC) for 
the employment of an Executive Officer.

This position manages and coordinates comprehensive support functions and project work for the VHAC and takes  
a lead role in developing and implementing the requirements of the Framework for Veterans  Health Care 2012-16. 



page 34Department for Health and Ageing Annual Report 2012-13

Aboriginal Male Health and Well Being Project Officer Position
The department funded an Aboriginal Male Health and Well Being Project Officer position within the Aboriginal 
Health Branch for the first quarter of 2012-13, contributing $21 000 funding.

The Officer worked with several Aboriginal male groups across the state and assisted these groups in improving the 
social determinants of Aboriginal male health. 

Freemason s Foundation Centre for Men s Health
The department is continuing to work with the Freemason s Foundation Centre for Men s Health regarding men s 
health research. This has involved a conversation analysis of calls from men to the healthdirect Australia call  
centre service.

The objective of this research is to gain a better understanding of how men represent themselves and their concerns 
to health services and to develop a greater understanding of men s health service needs.

Transition Beds for Homeless People Program
The department contributed $55 440 funding during 2012-13 to the Royal Adelaide Hospital (RAH) for this program. 
This program aims to reduce the amount of people who are discharged into homelessness from the RAH Emergency 
Department. 

During 2012-13, 47 people (36 men and 11 women) were transferred to transition beds with the average stay being 
14 days. The average of age of the patients was 39 years of age.

Ensuring Sustainable Access to Best Practice Antenatal Care
There are a wide range of projects and initiatives that have commenced or continued throughout 2012-13 which 
relate to ensuring sustainable access to best practice antenatal care. 

 &gt; The Early Pregnancy Unit project has commenced which provides midwifery-led care of women experiencing 
pregnancy loss in the first trimester. A study tour to the United Kingdom took place as a result of obtaining 
the Premier s Scholarship. This enables collaboration with similar units in determining best practice and 
recommendations for sustainability of the program.

 &gt; As part of the National Perinatal Depression Initiative, a mental health worker has continued to be funded. This 
role assists in providing mental health support for women who have been identified as being at risk of perinatal 
depression. In addition, the results of the Edinburgh Postnatal Depression Scale are now being recorded on OACIS4  
with the intention of being assessable postnatally.

 &gt; Midwifery Group Practice  has continued to work in partnership with the Aboriginal Maternal Infant Care workers 
to assist in the program providing Aboriginal women with cultural support during pregnancy, birthing and six 
weeks postnatally.

 &gt; Funding has been obtained to support the breastfeeding education provided to each woman at 28 weeks 
gestation, in line with the Baby Friendly Health Initiative, and women are now given a specific appointment to 
discuss feeding in the antenatal period.

 &gt; The Second Story Youth Health Service has developed links with the Pregnancy SA Referral Line in order to contact 
young pregnant women at the earliest opportunity to assist them in engaging with appropriate care and services. 
This has assisted young women to be aware and attend the Pregnancy to Parenting Group education sessions held 
specifically for under 20 year olds. This is a thriving joint initiative with The Second Story midwives. 

Preparations for the integration of midwifery-led antenatal care into early childhood development and parenting 
centres has been underway. This is one of five prototype projects under the Public Sector Renewal Program. It 
is a joint initiative between the Women s and Children s Health Network and the Department for Education and 
Child Development. This will provide midwifery-led antenatal care close to where women live and link families and 
community services with the aim of providing better outcomes for children.

4 OACIS is a clinical information system.



page 35 Department for Health and Ageing Annual Report 2012-13

Providing Education that Addresses Risk Factors for Low Birth Weight
Several programs are attempting to reduce the proportion of low birth weight babies. The Aboriginal Family Birthing 
Program is a culturally respectful and clinically safe program providing continuity of care for Aboriginal women during 
their pregnancy, birthing and for up to six weeks postnatally.  Provision of education is particularly emphasised as  
part of these programs.

Pregnant women and their families are supported by a partnership team comprising midwives and an Aboriginal 
Maternal and Infant Care Worker. A key element is addressing the social determinants of health and referring families 
into community support services. Education relating to the risk factors that impact on birth weights have been 
delivered across both metropolitan and country South Australia, the focus has been on smoking cessation; the effect 
that alcohol and other drugs may have on the unborn baby; and the importance of early and regular attendance  
for antenatal care.

eMums Program
Funding was awarded by the National Health and Medical Research Council to a partnership between the Women s 
and Children s Health Network, Research and Evaluation Unit and the Child and Family Health Service to develop  
and evaluate an  eMums  internet-based support program for new mothers. The  eMums  program provides mothers 
with information about children s development and solutions to common problems experienced by new parents.  
It also provides mothers with the opportunity to participate in nurse-mentored online mothers  groups where they  
can obtain information about child raising and benefit from support provided by other mothers. The program is 
believed to be a first internationally. 

After completion of the first phase, including development with  end users  and service providers, the web-based 
modules, the  virtual social networking and nurse mentoring  program is now being evaluated in a randomised 
controlled trial with recruitment at several metropolitan sites.

The trial is evaluating whether better outcomes are achieved in the following areas:

 &gt; The level of stress experienced by parents.

 &gt; The quality of mother-infant attachment.

 &gt; Infant social and emotional development.

 &gt; Infant communication development.

 &gt; Mothers  perceptions of the quality of nursing and program support.

 &gt; The utilisation of services available for mothers and infants.

Baby Friendly Health Initiative Accreditation 
The Child and Family Health Service (CaFHS) officially became the first community health service in Australia to receive 
Baby Friendly Health Initiative (BFHI) accreditation in 2013.

There is a global initiative to increase breastfeeding rates, and this accreditation recognises our efforts to promote 
the strong link between breastfeeding and baby health. Evidence suggests that when an organisation receives BFHI 
accreditation, both the numbers of women who elect to breastfeed and the duration for which they breastfeed 
increase.

The accreditation requires that all staff and volunteers, who have contact with women, mothers and their families 
accessing CaFHS, receive orientation and education on the benefits of breastfeeding. This will enable all mothers  
who use this service to receive the information and support they need to make the best choice for themselves and 
their baby.

This builds upon work in the hospital setting with the Women s and Children s Hospital achieving  Baby Friendly  
accreditation status in 2012. 

Reducing Smoking in Pregnant Women 
The Australian Government has created a new tool to help women who are pregnant, or wanting to become 
pregnant, to quit smoking. The campaign is called Quit for You Quit for Two and includes a smartphone app,  
which offers a fun way to quit and stay smoke-free.



page 36Department for Health and Ageing Annual Report 2012-13

Intermediate Care
Throughout 2012-13 SA Health continued to work closely with general practice and other services through the 
established GP Plus Health Care Centres and GP Plus Super Clinics at:

 &gt; Aldinga

 &gt; Woodville

 &gt; Morphett Vale

 &gt; Elizabeth

 &gt; Marion

 &gt; Ceduna

 &gt; Modbury Smart Road (GP Plus Super Clinic)

 &gt; Modbury Gilles Plains (GP Plus Super Clinic)

 &gt; Noarlunga (GP Plus Super Clinic).

Construction of a new GP Plus Centre at Port Pirie also commenced.

SA Health commenced the mapping of existing community/primary/out of hospital service provision. This was initiated 
to assess duplication and system inefficiencies and to ensure that services directly contribute to chronic disease 
management and hospital avoidance objectives. 

This process has involved the review of all such services and programs, including those delivered out of GP Plus Health 
Care Centres, to ensure safe, high-quality and affordable health care will continue to be provided into the future, 
based on contemporary, evidence based models of care and clinical practice. 

As a result, some reorientation and realignment of services/programs to the key policy objectives of SA Health has 
occurred to better address:

 &gt; Management of chronic disease.

 &gt; Hospital avoidance.

 &gt; Positive and measurable impacts on population health.

Medicare Locals
Medicare Locals (MLs) are the primary health care organisations responsible for coordinating and planning primary 
health care (out of hospital) services, including general practice and allied health care in local communities. MLs 
work to improve access to primary health care for all South Australians by coordinating primary health care delivery, 
including planning and funding services to meet local health care needs and leading improvements in primary  
health care. 

South Australia has five MLs covering metropolitan and country areas:

 &gt; Central Adelaide and Hills

 &gt; Country North SA

 &gt; Southern Adelaide, Fleurieu, Kangaroo Island

 &gt; Northern Adelaide

 &gt; Country South SA. 

SA Health is continuing to work with MLs to meet the needs of South Australian health consumers and build 
sustainable healthcare through better integrated care, focused on population needs. With health consumers, 
Aboriginal Health Organisations and the Commonwealth, MLs are partnering with SA Health in the development  
of South Australia s Primary Health Care Plan, through the state Primary Health Care Plan Steering Committee.



page 37 Department for Health and Ageing Annual Report 2012-13

Clinical Reform Agenda
The clinical reform agenda seeks to optimise system performance, manage service demand and improve the overall 
quality of health services. The values that underpin this agenda ensure that services are:

 &gt; Accessible. 

 &gt; Clinically and culturally appropriate.

 &gt; Timely, efficient and affordable.

 &gt; Patient centred.

 &gt; Based on population health needs.

 &gt; Well integrated, coordinated and provide continuity of care.

 &gt; Safe and of high quality.

Commissioning
Clinical Commissioning has been introduced to support these values and assist in delivering the objectives of South 
Australia s Health Care Plan 2007-16. Commissioning is the process of understanding the needs of the community, 
followed by designing and delivering appropriate services to meet those needs. This process ensures that investment 
is targeted at the most appropriate services and clinical interventions. Patients and the public are involved in the 
process alongside other key stakeholders.

Implementation of Clinical Commissioning has progressed well and has enabled the delivery of a number of service 
changes, including the provision of additional capacity for Northern residents to ensure they have the services needed 
to support the growing population.

Successful Clinical Commissioning requires effective clinical engagement to ensure robust clinical and professional 
input into service planning, design, delivery and monitoring of clinical outcomes and work has been ongoing to 
develop effective processes and strategies. Focus has also been on establishing and embedding monitoring processes, 
including regular meetings between the department and the Local Health Networks in order to monitor against 
agreed measures to the level of clinical specialty.

Clinicians and professionals have been involved in the process of developing priority areas of focus across the health 
system. These include strategies to reduce procedures that have been medically shown to be of limited value to the 
patient and potentially avoidable hospital admissions where alternative treatment from out of hospital or community 
programs or General Practitioner intervention may have prevented the need to attend a hospital.



page 38Department for Health and Ageing Annual Report 2012-13

Hospital Care
Enhancing hospital care through improving the coordination of hospital services, increasing the efficiency and 
effectiveness of hospital care, securing capital infrastructure improvements, and expanding out of hospital programs 
are key objectives of the SA Health Strategic Plan 2008-12 and South Australian Health Care Plan 2007-16.

Statewide Clinical Support Services 
In 2012-13, the Central Adelaide Local Health Network (CALHN) was responsible for the Statewide Clinical Support 
Service under the leadership of Mr Ken Barr, Group Executive Director. This cluster of services incorporates SA Medical 
Imaging, SA Pathology and SA Pharmacy. Information about the Statewide Clinical Support Service is published in  
the Central Adelaide Local Health Network 2012-13 Annual Report.

SA Ambulance Service
Information about SA Ambulance Service is published in the SA Ambulance Service 2012-13 Annual Report.

Key Initiatives

Every Patient   Every Service

In March 2010, the South Australian Government released its Every Patient Every Service   Hospital Services Policy 
Directive which outlined the government s commitment to introduce services and programs to reduce demand on  
our state s hospitals. The policy directive had the following objectives:

 &gt; Facilitating timely access to health services and improve the patient journey and experience.

 &gt; Ensuring that patients receive the right care, in the right place and at the right time.

 &gt; Maintaining an environment where staff are valued, supported and provided with resources to implement 
sustainable change.

SA Health released SA Health s Response to the Every Patient Every Service Policy Directive (updated in October 2011) 
which provided a number of key strategies to implement the policy including:

 &gt; Implementing models of care to support Emergency Departments.

 &gt; Improving access to diagnostic services.

 &gt; Implementing Emergency Department information technology systems.

 &gt; Increasing support for discharge planning.

 &gt; Increasing workforce capacity.

 &gt; Improving health literacy.

The following policy documents were developed or updated to support and ensure a consistent understanding of  
the strategies in SA Health s Response to the Every Patient Every Service Policy Directive:

 &gt; Improving Access to SA Health Services Policy Directive:

   Improving Access to Health Services Performance Targets Policy Guideline.

   See and Treat/Treatment Clinics Policy Guideline.

   Direct Admission to a Hospital Inpatient Unit Policy Guideline.

   Walk-in Treatment Clinics Policy Guideline.

   Acute Medical Units Policy Guideline.

 &gt; Elective Surgery Policy Framework and associated Guidelines.

 &gt; Criteria Led Discharge and Discharge Lounges Policy Directive.

 &gt; Emergency Department Referrals to Specialist Outpatient Services Policy Guideline.

 &gt; System Wide Discharge Policy Directive.

 &gt; Nurse Practitioner Policy Directive.

 &gt; Program Evaluation Framework.



page 39 Department for Health and Ageing Annual Report 2012-13

These policy documents have been communicated to patients and health care workers. Information brochures on the 
following topics have been made available on the SA Health internet site and distributed to Local Health Networks:

 &gt; Better ambulance emergency services for country South Australia.

 &gt; Elective surgery   better options for you.

 &gt; Better emergency care.

 &gt; Better general health care.

 &gt; Investing in the health of country South Australia.

In 2012-13, SA Health has continued to progress key strategies within SA Health s Response to the Every Patient  
Every Service Policy Directive.

 &gt; The following Models of Care are in place to support Emergency Departments:

   Acute Medical Units.

   See and Treat Clinics.

   Seniority of Medical Staff during the week and weekends.

   Registrars and Allied Health Professionals being more accessible.

   Patient Flow Coordinators and additional administrative support.

   Discharge Lounges and improved discharge practices.

   There are additional staff across the system to best meet patient and community need and to address existing 
and predicted demand. This includes additional doctors, nurses, allied health and appropriate administrative 
support in order to support the enhanced provision of 24/7 services.

 &gt; Seventy-one scholarships have been awarded as a part of the Nurse Practitioner Scholarship Scheme. 

 &gt; Extended Care Packages continue to reduce the number of attendances to hospital by treating patients in their 
own homes or residential aged care facilities.

 &gt; SA Health is implementing a number of initiatives to support all elective surgery patients being seen within clinically 
acceptable timeframes. This includes the investment of significant additional funding to provide up to 260 000 
elective surgery procedures statewide over the four years 2010-14. The objective of the plan is to meet national 
waiting time targets by working towards ensuring patients receive their planned surgery in line with national 
waiting times.

 &gt; Capital works projects have improved Emergency Department infrastructure in the metropolitan hospitals with 
Acute Medical Units, Short Stay Units and Discharge Lounges. The capital works program includes the planning and 
construction of the new Royal Adelaide Hospital; redevelopment of the Women s and Children s Hospital, Modbury 
Hospital, Flinders Medical Centre, the next phase of development at The Queen Elizabeth Hospital, Lyell McEwin 
Hospital and an upgrade program across country hospital sites. A further GP Plus Centre commenced construction 
work in 2012-13 at Port Pirie to enhance the network of GP Plus Centres/GP Plus Super Clinics being established 
across South Australia.

 &gt; Media awareness campaigns have proven to be beneficial in making the public aware when they should attend 
Emergency Departments.

 &gt; Information technology applications are providing clinicians and patients with real time access to Emergency 
Department performance information.

Disability Transition Care Funding
Since 2010-11, a total of $3.5m of recurrent funding has been made available to support the timely discharge of 
long stay hospital patients with a disability to the community. The System Performance Division of SA Health has 
been working closely with Local Health Networks and the Department for Communities and Social Inclusion to 
develop a service and funding model to facilitate the discharge of these patients from acute care settings into a more 
appropriate community based setting.  

In the past year SA Health has continued to work in close collaboration with the Department for Communities  
and Social Inclusion in developing the Disability Transition to Community (DTC) model of care. As at the close of  
the reporting period, a total of 93 patients have been discharged into community care under the DTC model since  
its inception.



page 40Department for Health and Ageing Annual Report 2012-13

Transition to Residential Aged Care 
The Transition to Residential Aged Care (TRAC) program targets older people assessed as eligible for residential aged 
care placement, whose care needs are no longer acute but whose discharge from hospital may or has proven to be 
avoidably delayed due to a range of complex factors. The objective of the program is to support the safe and timely 
transfer of older people in hospital to the community whose needs are consistent with this profile. The program 
provides well defined care pathways for eligible patients, which includes transfer to a  step down  or intermediate 
facility where a range of supports are provided, while arrangements for a long term placement in residential aged 
care are enacted.

In 2012-13, TRAC continued to operate in the metropolitan region across the Southern, Central and Northern 
Adelaide Local Health Networks. The TRAC program intervention resulted in a total saving of 9108 hospital bed days 
across the entire metropolitan region and supported 309 patients with highly complex care needs to safely make the 
transition from hospital to the community.

The TRAC program ceased on 30 June 2013 and the initiative will be realigned to the Australian Government s 
 Living Longer, Living Better  reform agenda announced in April 2012. The Living Longer, Living Better reform agenda 
outlines a significant growth in aged care places over the next 10 years. SA Health has focussed on working closely 
with the Australian Government, to maximise the benefits of the  Living Longer, Living Better  reform agenda for 
older patients across the health sector. 

Health Care at Home
Health Care at Home continues to work with the acute sector to develop new strategies to assist in managing the 
demand for hospital services. The program provides a flexible, short term and rapid response service that aims to:

 &gt; Avoid an Emergency Department presentation to a metropolitan public hospital.

 &gt; Avoid a hospital admission in a metropolitan public hospital.

 &gt; Short term supported discharge for clients from a metropolitan public hospital.

In 2012-13 the program has received and accepted in excess of 1400 patient referrals per month and provides the 
following service types:

 &gt; Nursing /Midwifery Care.

 &gt; Allied Health.

 &gt; Complex Medication Management.

 &gt; Wound Management.

 &gt; Paediatric Care.

 &gt; Obstetric/Neonatal Care.

 &gt; Short term overnight supported accommodation.

 &gt; Mental Health services.

Referrals to the program are made to the Metropolitan Referral Unit (MRU) which receives referrals from metropolitan 
public hospitals, primary health care services; community based mental health teams/clinicians, general practitioners, 
residential care facilities and SA Ambulance Service. The MRU provides a single point of entry for patients who may 
need this level of health care support. The MRU makes referring patients to community health care services, to either 
support discharge or avoid hospital admissions, much easier for all front-line staff.

Community Nursing
The Community Nursing Program has been operational for 12 months and provides options for specialised nursing 
services to support individuals with long term chronic health conditions and community based palliative nursing care 
to people within their own homes.

The program provides longer term care options with the aim of reducing hospital presentations and admissions. 
During 2012-13 the program has provided over 3500 episodes of care.

Referrals for the Community Nursing Program are received from metropolitan public hospitals, primary health care 
services; and general practitioners.



page 41 Department for Health and Ageing Annual Report 2012-13

Outpatient Reform
In 2010-11, the South Australian Government announced that outpatient services in public hospitals would be 
reformed in order to reduce waiting times for consultation and treatment. This reform will include determining 
outpatient services that should be provided in a hospital setting and the outpatient services that would be more 
appropriately provided in a community setting or by a General Practitioner. During 2012-13, SA Health allocated 
approximately $220m to outpatient services.  

The outpatient service improvement program aims to develop a sustainable, safe, efficient and effective outpatient 
service for the South Australian community. SA Health has commenced the development of a number of strategies 
to ensure a patient centred approach to outpatient service delivery. Through the delivery of the outpatient reform 
program SA Health has set a savings target of $5m during the 2013-14 period.

Key Initiatives

In particular the reforms aim to reduce waiting time for patients when referred to a specialist outpatient service by:

 &gt; Including all outpatient clinics in reporting systems, which will allow measurement of key performance indicators  
at clinic level, and subsequent better management of clinics.

 &gt; Developing a consistent approach for specialist clinic referral across all SA Health sites, this will assist in reducing 
inappropriate referrals where patients may be better served in a community setting.

 &gt; Providing consistent information for clinicians when making or receiving a referral through a standardised  
state-wide referral form.

 &gt; Development of consistent urgency categories for patients referred to an outpatient specialist appointment.

 &gt; Promoting the General Practitioner as the primary care provider by transferring care back using speciality designed 
care plans and pathways.

 &gt; Facilitating the introduction of best practice clinical protocols that aim to increase consistency in the treatment  
of patients across the state.

 &gt; Providing clinicians and patients with consistent information about clinics through the Outpatient section of the  
SA Health website.

This year SA Health developed the Specialist Outpatient Services Policy Directive and four associated guidelines:

 &gt; Emergency Department referrals to Specialist Outpatient Services Policy Guideline.

 &gt; Active Discharge from Specialist Outpatient Services Policy Guideline.

 &gt; Specialist Outpatient Services Patient Focussed Booking Policy Guideline.

 &gt; Referral to Specialist Outpatient Services Policy Guideline.

Strategies in 2012-13 included: 

 &gt; Reducing review appointments and improving discharge rates.

 &gt; Reducing direct referrals from Emergency Departments.

 &gt; Improving failure to attend and cancellation rates.

 &gt; Improving the quality of referrals to Outpatient Departments.

 &gt; Improving communication and engagement with key partners.

As implementation of the outpatient policy progresses during 2013-14, the changes will support SA Health to  
achieve service efficiencies across Local Health Networks. Additional strategies will be progressed during 2013-14. 
Communication between Local Health Networks and Medicare Locals (MLs) continues to strengthen as the MLs 
become more involved with clinical pathways and alternative service delivery pathways being explored to provide 
patient focused outcomes.



page 42Department for Health and Ageing Annual Report 2012-13

Strategies for 2013-14 include: 

 &gt; Improving management of patients on the waiting list.

 &gt; Developing centralised administrative processes.

 &gt; Developing clinical pathways.

 &gt; Improving outpatient reporting.

 &gt; Developing standardised outpatient triage categories.

 &gt; Developing a workforce plan for the delivery of outpatient services by specialty in South Australia.

 &gt; Develop and monitor the commissioning plan for outpatients with the associated assigned savings strategies  
across Local Health Networks.

Local Health Network Analytics and Reporting Service
In late 2012-13, the Local Health Network Analytical and Reporting System (LARS) went live across public 
metropolitan hospitals. LARS provides a single gateway to access business critical information on hospital finances, 
workforce numbers, and inpatient, Emergency Department and elective surgery services.

LARS is designed to support operational and management decision making throughout a Local Health Network. It 
comes with the capacity to produce reports for an entire Local Health Network or hospital and individual cost centres.

Some of the data in LARS is extracted nightly from hospital systems, enabling users to access business critical 
information that is far more timely than was previously possible. It is planned to make other data sources accessible 
through LARS in the short term, including additional clinical data and patient costing data once the new patient 
costing system is rolled-out fully across hospitals.

Improving Efficiency and Effectiveness of Hospital Care 

Women s and Children s Hospital   Budget Performance Review

SA Health appointed Deloitte to conduct a review of the Women s and Children s Hospital. The review commenced in 
February 2013. The purpose of the review was to identify ways to assist in delivering services more efficiently  
and effectively.

The consultant s report was released in June 2013 for a six week consultation period. A number of strategies have 
been recommended including reducing the length of stay so that healthy mothers, babies and children can return to 
their homes sooner; and improved management of consumables and supplies to reduce costs of these items to that 
of peer hospitals.

Hospital Budget Performance and Remidiation Review

The independent Hospital Budget Performance and Remediation Review undertaken in 2011-12 in respect of Central, 
Northern and Southern Local Health Networks were considered by Government, with the Government response 
approved in October 2012. This has led to a range of efficiency measures being progressively implemented across 
these Local Health Networks during 2012-13.

Hospital Inpatient Services

South Australian public hospitals treated 413 352 inpatients in 2012-13, an increase of 1.5 per cent compared with 
the previous year. Metropolitan and country hospitals accounted for 75 per cent and 25 per cent respectively of total 
activity (Figure 16). Hospital separations continue to grow, driven by population increases, population ageing and 
advances in medical technology.

Annual growth in separations from metropolitan hospitals declined steadily from 3.3 per cent in 2007-08 to 1.2 per 
cent in 2010-11 before increasing to 4.2 per cent in 2011-12 (Figure 17). Activity increased by 1 per cent only in 
2012-13, well below the national average of 4.4 per cent in 2011-12 (latest national data published).



page 43 Department for Health and Ageing Annual Report 2012-13

Figure 16   Separations from public hospitals

 

0 

50 000 

100 000 

150 000 

200 000 

250 000 

300 000 

350 000 

400 000 

450 000 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

Se
p

ar
at

io
n

s 

Financial year 

Country hospitals Metro hospitals 

 

 

Data source: Health Information Portal (Admitted activity)

Figure 17   Annual growth in hospital separations

 

 

0% 

2% 

4% 

6% 

8% 

10% 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

 P
er

 c
en

t 
g

ro
w

th
 

Financial year 

%Change   SA metro hospitals %Change   all SA hospitals %Change   national   

 

Data source: Health Information Portal (Admitted activity)

 



page 44Department for Health and Ageing Annual Report 2012-13

Elective Surgery Strategy

Overview

The government s commitment to provide additional funding through the Elective Surgery Strategy Four Year Plan 
2010-14 has continued to improve performance for SA Health in 2012-13.

The strategy aims to ensure that all patients receive elective surgical procedures within national clinical urgency 
timeframes of:

 &gt; Urgent Category 1 patients to receive their surgery within 30 days.

 &gt; Semi-Urgent Category 2 patients to receive their surgery within 90 days.

 &gt; Non-Urgent Category 3 patients to receive their surgery within 365 days.

South Australia has committed to the National Partnership Agreement (NPA) on Improving Public Hospital Services 
which includes the achievement of National Elective Surgery Targets (NEST). These targets aim to increase the 
percentage of elective surgery patients seen so that 100 per cent of all urgency category patients waiting for surgery 
are seen within their clinically recommended timeframes by 2015. 

South Australia s NEST performance continues to improve nationally and the Elective Surgery Strategy has played a 
key role in ensuring this success. The plan provides a management framework for equitable, consistent and timely 
provision of elective surgery across South Australia. 2013-14 is the final year of the Elective Surgery Strategy and 
performance will need to be maintained to ensure the achievement of both NEST and state performance in relation  
to timeliness and overdue procedures. 

Additional Funding

Investment of an additional $88.6m to:

 &gt; Support the achievement of up to 259 007 elective surgery procedures in metropolitan and country hospitals over 
the four years of the current plan.

 &gt; Improving waiting times.

 &gt; Investment of $23m in 2012-13 (the third year of the plan) to achieve up to 65 000 elective surgery procedures.

Performance Highlights

Significant performance outcomes include:

 &gt; 64 130 procedures were undertaken in metropolitan hospitals in 2012-13, an increase of 5230 procedures  
(8.9 per cent) compared with 2007-08 (Figure 18).

 &gt; 94.2 per cent of patients were admitted within clinically recommended times, compared with 80.2 per cent  
in 2007-08.

 &gt; No patients are reported overdue for surgery at 30 June 2013, compared to 1441 patients at June 2007 (Figure 21).

 &gt; No patients waited longer than 12 months for their surgery as at 30 June 2013, compared with 841 patients at  
30 June 2007.

 &gt; 90 per cent of patients were admitted for elective surgery within 182 days, 4.7 per cent better than the result from 
the previous year (Figure 19). South Australia has consistently performed better than the national average against 
this measure of performance. 

 &gt; In 2011-12, 90 per cent of patients were admitted within 191 days, 24.2 per cent lower than the national  
average of 251 days.

 &gt; Median waiting time for elective surgery in South Australia was 34 days in 2012-13, which is consistent with the 
previous year graph (Figure 20). National median waiting times have trended upwards since 2007-08. In contrast, 
the South Australian median value has fallen from a high of 42 days in 2007-08, to a low of 34 days in 2012-13. 
(NB: There is no national data for 2012-13 at time of publication).



page 45 Department for Health and Ageing Annual Report 2012-13

Key Initiatives 

A range of initiatives have been undertaken in support of the Elective Surgery Strategy and improving flexible service 
provision and adaptability. These have been achieved through centrally managed/locally implemented patient focused 
management of a statewide waiting list and include:

 &gt; Opening additional, extended and weekend theatre sessions when required.

 &gt; Transferring patients between hospitals, to those with capacity.

 &gt; Prioritising access to theatres for specialties with elevated numbers of patients on booking lists.

 &gt; Improved Information Management such as  real time  waiting lists.

 &gt; Provision of additional theatre equipment for several country and metropolitan hospitals.

Figure 18   Elective surgery procedures at metropolitan and country hospitals

 

 
 

0 

10 000 

20 000 

30 000 

40 000 

50 000 

60 000 

70 000 

80 000 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

El
ec

ti
ve

 s
u

rg
er

y 
ad

m
is

si
o

n
s 

Financial year 

Country hospitals Metro hospitals 

 

Data source: Health Information Portal (elective surgery)
Country hospital admissions estimated from the admitted activity data between 2007-08 and 2010-11

Figure 19   Days waited at 90th percentile
 

  

 

0 

50 

100 

150 

200 

250 

300 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13  

D
ay

s 

Financial year 

South Australia Australia 

 

Data source: Health Information Portal (elective surgery) and Australian Hospital Statistics, 2011-12
Note: Country hospitals included from 2011-12



page 46Department for Health and Ageing Annual Report 2012-13

Figure 20   Median waiting times in days

 

  

 

0 

10 

20 

30 

40 

50 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13  

D
ay

s 

Financial year 

South Australia Australia 

 

 
 
Data source: Health Information Portal (elective surgery) and Australian Hospital Statistics, 2011-12
Note: Country hospitals included from 2011-12.

  
Figure 21   Patients overdue for elective surgery at metropolitan hospitals as at 30 June 2013

 

 0 

200 

400 

600 

800 

1000 

1200 

1400 

1600 

Jun-07 Jun-08 Jun-09 Jun-10 Jun-11 Jun-12 Jun-13 

N
u

m
b

er
 o

ve
rd

u
e 

Financial year 

Urgent Semi-urgent Non-urgent 

 

Data source: Health Information Portal (elective surgery)

 



page 47 Department for Health and Ageing Annual Report 2012-13

Emergency Department Services
Through the Every Patient Every Service Hospital Policy, the department remains committed to improving performance 
in Emergency Departments.

A State/Australian Government agreed National Emergency Access Target for Emergency Department visit time 
requires that 90 per cent of all patients visiting Emergency Departments will be assessed, admitted, discharged or 
transferred within a four hour timeframe by December 2015.

The Council of Australian Governments (COAG) National Partnership Agreement on Hospital and Health Workforce 
Reform Initiative requires that 80 per cent of Emergency Department presentations are seen within clinically 
recommended triage times by 2012-13.

COAG committed $61.7m to South Australia over five years (2008-09 to 2012-13) with the South Australian 
Government contributing $111m over four years (2010-11 to 2013-14). 

In 2012-13, there were 375 698 Emergency Department presentations at metropolitan hospitals, an increase of  
14 536 presentations (4 per cent) from 2011-12 (Figure 22).

Figure 22   Emergency Department presentations at metropolitan hospitals
 

 

200 000 

225 000 

250 000 

275 000 

300 000 

325 000 

350 000 

375 000 

400 000 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

ED
 p

re
se

n
ta

ti
o

n
s 

Financial year 

 

Data source: Health Information Portal (Emergency Department)

In 2012-13, 67 per cent of all patients visiting public hospital Emergency Departments were assessed, admitted, 
discharged or transferred within a four hour timeframe. This is an increase of one per cent when compared to  
2011-12.

In 2012-13, 75 per cent of patients were seen within clinically recommended triage times (seen on time), a slight 
reduction compared to 2011-12.

Table 2   South Australian Emergency Department  percentage of  People Seen On Time  as at April 2013

 2007-08 2008-09 2009-10 2010-11 2011-12  2012-13

South Australia 61% 64% 67% 71% 76% 75%

National 69% 70% 70% 70% 72% N/A



page 48Department for Health and Ageing Annual Report 2012-13

Figure 23   Emergency Department patients seen on time by all triage categories (%)

 

 

0% 

10% 

20% 

30% 

40% 

50% 

60% 

70% 

80% 

90% 

100% 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

Pe
r 

ce
n

t 
Se

en
 o

n
 t

im
e 

Financial year 

South Australia Australia 

 

Data source: Health Information Portal (Emergency Department)

In 2012-13, the median waiting time to be seen in an Emergency Department was 16 minutes (down from  
29 minutes in 2007-08). South Australia was ranked first nationally for this indicator.

Figure 24   Median waiting time to service delivery in minutes

 

 

0 

5

10

15

20

25

30

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

M
in

u
te

s

Financial year 

South Australia Australia 

 

 

Data source: Health Information Portal (Emergency Department)



page 49 Department for Health and Ageing Annual Report 2012-13

Emergency Department COAG and Every Patient Every Service initiatives developed between 2010-11 and  
2012-13 include:

 &gt; Implementing models of care to support Emergency Departments such as:

   Establishing Acute Medical Units and See and Treat Clinics.

   Patient flow coordinators.

   Introducing rapid assessment capability.

   Enhanced access to community services.

   Increase in the number of Extended Care Paramedics (ECP).

 &gt; Improved access to diagnostic  services by:

   Installing equipment and systems to facilitate timely provision of diagnostic information to Emergency 
Departments.

   Increasing after-hours access to diagnostic services.

   Developing a statewide approach to centralising provision of radiography analysis services.

 &gt; Making information more readily accessible for patient flow management.

   Improved Information Systems such as a  real time  flow of information in the form of a purpose-built  
dashboard for Emergency Departments and inpatient settings.

 &gt; Increasing support for discharge planning.

 &gt; Increasing support for workforce capacity.

   Seniority of Consultants during the week and weekends.

 &gt; Improving health literacy.

   Improving community awareness through media campaigns aimed at reducing demand on Emergency 
Departments.

In July 2012, SA Health released the Monaghan Review report as an outcome of an external review of the Flinders 
Medical Centre Emergency Department performance. The focus of the review included analysis of models of care 
and patient flow throughout the Emergency Department and hospital inpatient clinical services. The report provided 
comprehensive recommendations and strategies that could improve patient care system wide, not just at Flinders 
Medical Centre specifically. The report included 52 recommendations that were placed into an action plan with an 
identified lead and proposed timeframe for implementation between 6-12 months. The action plan was endorsed by 
the Monaghan Review Implementation Steering Committee on 13 September 2012 and implementation commenced 
in October 2012. As of 30 June 2013: 

 &gt; 34 recommendations have been completed.

 &gt; 16 recommendations are well progressed and close to completion. 

 &gt; 2 recommendations, related to the Enterprise Patient Administration System and the new Royal Adelaide Hospital 
are scheduled for progression in 2014-15. 

In 2013-14 all Emergency Department COAG and Every Patient Every Service initiatives and Monaghan Review 
recommendations will continue to be monitored and evaluated.



page 50Department for Health and Ageing Annual Report 2012-13

Day of Surgery Admission Rates
The department expects hospitals to manage the use of their beds in the most efficient manner, requiring elective 
patients to be admitted to hospital on the day of their surgery.

In 2012-13 (to May), the day of surgery admission rate for metropolitan hospitals was 88.6 per cent, a rise from  
86.9 per cent in 2011-12.

Figure 25   Day of surgery admission rates, metropolitan hospitals

 

 

 

70% 

75% 

80% 

85% 

90% 

95% 

100% 

Ju
l-0

8 

Oc
t-0

8

Ja
n-

09

Ap
r-0

9
Ju

l-0
9

Oc
t-0

9

Ja
n-

10

Ap
r-1

0
Ju

l-1
0 

Oc
t-1

0 

Ja
n-

11
 

Ap
r-1

1 

Ju
l-1

1 

Oc
t-1

1 

Ja
n-

12
 

Ap
r-1

2 

Ju
l-1

2 

Oc
t-1

2 

Ja
n-

13
 

Ap
r-1

3

 D
ay

 o
f 

su
rg

er
y 

ra
te

 (
%

) 

Month 

Actual Trendline 

 

Data source: Health Information Portal (Admitted activity)

Relative Stay Index
The Relative Stay Index (RSI) compares the length of stay performance of a hospital against a standard based on  
all acute hospitals in Australia. The calculation takes account of patient age and complexity. An RSI of greater than 
one indicates that total bed days are higher than would be expected and vice versa. The RSI is calculated as a  
12 month average.

The large majority of metropolitan hospitals reported reductions in RSI in 2012-13 (to May) compared to the previous 
financial year.

Figure 26   Metropolitan hospital relative stay index: comparison of 12 month average 2010-11 to  
2012-13 (to May)

 

 

 

0.80 

0.85 

0.90 

0.95 

1.00 

1.05 

1.10 

WCH FMC TQEH RGH RAH LMH MH NPH 

R
el

at
iv

e 
St

ay
 In

d
ex

 

Hospital 

2010-11 2011-12 2012-13 

 

 

Data source: Health Information Portal (Admitted activity)



page 51 Department for Health and Ageing Annual Report 2012-13

Table 3   Metropolitan hospital relative stay index: comparison of 12 month average 2010-11 to  
2012-13 (to May)

Hospital 2010-11 2011-12 2012-13 (to May)

Women s and Children s Hospital (WCH) 1.073 1.043 1.065

Flinders Medical Centre (FMC) 1.046 1.010 0.987

The Queen Elizabeth Hospital (TQEH) 0.955 0.931 0.910

Repatriation General Hospital (RGH) 1.037 1.029 0.995

Royal Adelaide Hospital (RAH) 0.990 0.927 0.892

Lyell McEwin Hospital (LMH) 0.965 0.936 0.952

Modbury Hospital (MH) 0.893 0.866 0.856

Noarlunga Public Hospital (NPH) 0.837 0.897 0.871

Medicines and Technology Assessment
Health technologies, including medicines, medical devices, diagnostic tests and other innovations, are a critical 
component of the health system, often contributing to improved health outcomes. Increasing costs of innovative 
health technology also significantly contribute to higher overall costs of health care provision. As such, robust 
evaluation and approval processes are required to ensure safety, effectiveness and sustainability of health technologies 
within broader health service planning and budgeting considerations.

Statewide Formulary for High Cost Medicines
The South Australian Medicines Evaluation Panel (SAMEP) was established in 2011 as an expert standing committee 
of the South Australian Medicines Advisory Committee to ensure that all public hospitals provide a safe, effective and 
consistent approach to the management of high cost medicines. In 2012-13 SAMEP completed a number of robust, 
highly regarded evaluations of high cost medicines, resulting in significant cost savings and improvements in safety 
and quality through ensuring that these medicines are used where it is safe and appropriate to do so.

Establishment of a Statewide Medicines Formulary
Building on from the successful establishment of a statewide process for evaluation of high cost medicines, SA Health 
is in the process of developing a statewide formulary for all medicines routinely used within SA Health. A statewide 
medicines formulary will assist the prescribing of safe and cost-effective medicines and to promote equity of access 
to medicines for all public patients across South Australia. The process is based on robust evaluation of medicines 
currently in use across the state by a multidisciplinary group of clinical experts and strong clinical engagement to 
ensure that all needs are adequately addressed. A number of therapeutic groups of medicines have been reviewed  
to date, with significant opportunities for maximising safety, quality and cost-efficiencies already identified. 

Health Technology Assessment
SA Health commissioned a review of Health Technology Assessment within SA Health in 2012 to examine issues 
and opportunities relating to the oversight and implementation of new health technologies in SA Health. A series of 
recommendations resulting from the review for the establishment of an improved governance model for assessment 
and implementation of health technologies are now being implemented by SA Health.

The proposed new model would support priority-setting by facilitating appropriate consideration of all health 
technologies in regards to safety, effectiveness, and cost-effectiveness within the wider healthcare system, prior to  
use within SA Health. This offers the potential to maximise beneficial health outcomes within the available budget 
whilst being cognisant of the other important goals of the health system.



page 52Department for Health and Ageing Annual Report 2012-13

Clinical Reform

Clinical Senate
The Clinical Senate is an advisory group that informs strategic direction on system-wide clinical issues. Membership 
comprises of respected leaders in their clinical fields that come together to provide the South Australian community 
and health system with advice on the best possible health solutions.

The Clinical Senate provides a voice for South Australian clinicians by being a forum for discussion of system-wide 
clinical issues and has a role in integrating the outcomes of the Clinical Networks by reviewing and adding value  
to their work.

In January 2013 the Clinical Senate introduced the Clinical Senate Executive, responsible for the development of 
future Clinical Senate agenda discussion and follow up on progress relating to outcomes that the Senate have 
previously recommended. Over the last 12 months, the Clinical Senate has:

 &gt; Undertaken a review on the progress of Clinical Senate recommendations made over the last two years.

 &gt; Undertaken a review of the Senate and its operations through feedback provided by Senators.

 &gt; Undertaken an analysis of the agreed principles for the local Lead Clinician Groups linkage between the National 
Lead Clinical Group and the Clinical Senate and changes and implications to the role of the Clinical Senate.

 &gt; Progressed the implementation of the Clinical Commissioning Tool within SA Health, a process of continuously 
arranging and improving services which deliver the best possible quality and outcomes for patients, meet 
population health needs and reduce inequalities within the resources available.

 &gt; Hosted the South Australia National Clinicians Network forum which centred on aged care and the last stage of 
life, transition between services and assisted in the identification of solutions that specifically address the issues 
faced by health professionals and patients alike.

 &gt; Provided recommendations on the effective implementation of a structured and consistent approach to Advance 
Care Planning within South Australia in response to national dialogue and the recent legislative changes enacted  
in the Advanced Care Directive Bill 2013.

 &gt; Received updates on the progress of the Statewide Clinical Network Service Plans and priorities for the Networks.

 &gt; Identified safety and quality goals that would improve quality of care.



page 53 Department for Health and Ageing Annual Report 2012-13

Statewide Clinical Networks
The Statewide Clinical Networks continue to engage clinicians and consumers across the health system to assist in  
the development of Models of Care, pathways and statewide policies and guidelines which assist in the delivery of 
high quality patient care.

Some of the Statewide Clinical Networks key activities over the course of 2012-13 are outlined below.

Cardiac Clinical Network

The Cardiac Clinical Network focused on four main areas for development of high value health care:

1. Standardised criteria for decision-making

 &gt; Developed standardised general practitioner, emergency and cardiology clinician referral pathways for patients  
with low risk heart failure, chest pain and genetic cardiac conditions.

 &gt; Published the nurse-supervised guidelines for exercise stress testing.

2. Infrastructure design

 &gt; Ongoing development of ambulatory health service recommendations to accompany the referral pathways.

3. Audit/feedback

 &gt; Developed and disseminated a standard minimum dataset for cardiac rehabilitation services, which has been 
adopted in metropolitan and country public hospitals. The collection of this data will improve future performance 
and outcome evaluations.

4. Self study

 &gt; Participated in three research projects, which are expected to inform further health service development work:

   hsTroponin clinical trial.

   SNAPSHOT ACS national registry of acute coronary syndromes.

    Coronary Angiogram Database of South Australia. 

 &gt; Facilitated a workshop of all cardiac clinical networks in Australia and New Zealand at the National Clinical 
Networks Conference in November 2012 to share ideas, barriers and solutions.

Statewide Mental Health Clinical Network

The Statewide Mental Health Clinical Network has completed three major pieces of work:

 &gt; An overview of current service delivery relating to Borderline Personality Disorder services in the public sector across 
South Australia.

 &gt; A community consultation report capturing the views of clinicians, consumers and family carers in relation to the 
care, service needs and service provision for people who are intellectually disabled and also experience mental 
health issues.

 &gt; A survey of community mental health teams in regard to access to services by Aboriginal people who are 
experiencing complex grief, loss and trauma. 

Palliative Care Clinical Network

The Palliative Care Clinical Network has continued to work on the development of initiatives outlined in the Statewide 
Palliative Care Service Plan 2009-16 during the 2012-13, including:

 &gt; Establishment of a Statewide Research Collaborative.

 &gt; Establishment of a Statewide Education Subcommittee.

 &gt; Development of a statewide referral form.

 &gt; Co-hosted a Palliative Care Update Day with the Palliative Care Council SA.

 &gt; Played a strong advocacy role particularly in relation to data collection and country partnering arrangements  
within the sector.  



page 54Department for Health and Ageing Annual Report 2012-13

Rehabilitation Clinical Network

The Rehabilitation Clinical Network has developed:

 &gt; Guidelines for subacute services offering digital telehealth network consultations. These guidelines will support 
clinicians in the use of telehealth technology, enhancing access to specialist subacute services for patients in  
the country. 

 &gt; Amputee specific falls prevention protocols. These have been incorporated by Safety and Quality in the overall 
review of the Falls Policy Directive and Falls Risk Assessment Forms.

 &gt; A clinical pathway and statewide data collection form, for all uses of botulinum toxin outside of pharmaceutical 
benefits scheme-approved indications. All spasticity clinics are now required to report this data annually to the  
SA Medicines Evaluation Panel.

Renal Clinical Network

The Renal Clinical Network (the Network) commissioned a review of the Statewide Home Haemodialysis Service by an 
external provider with the aim to increase patient uptake of Home Haemodialysis (HD). The review was undertaken 
in April 2012. Their recommendations were endorsed by the Steering Committee on 11 July 2012 and have been 
implemented by the Central Adelaide Local Health Network (the Home HD service is within this Local Health 
Network). The number of patients on Home HD has increased from 18 to 29 to date.

The Network has also developed and implemented the South Australian Haemodialysis Guidelines: Routine Water 
Testing and Reverse Osmosis Monitoring in line with international standards. 

The Network produced the paper Recommendations for Appropriate Initiation of Dialysis or Supportive Care Pathways 
in End Stage Kidney Disease. This paper was a driver for a Renal Network and KHA Symposium held in April 2013 to 
discuss and debate the issues. Feedback from the Symposium indicates it was highly successful event.

Statewide Stroke Clinical Network

The Statewide Stroke Clinical Network launched the Stroke Management Procedures and Protocols in September 
2012. These protocols provide the blueprint for hospitals across the state to provide consistent, best practice care  
for all patients who present with stroke symptoms.

Child Health Clinical Network

The first statewide paediatric clinical practice guidelines have been approved, pending publication to the SA Health 
website and iPhone app for clinician access.

Older People Clinical Network

During the reporting period the Older People Clinical Network developed five key documents to guide reform in  
the provision of health services for older people. These include the overarching document Description of an Area 
Geriatric Service, for use by Local Health Networks to develop the governance, leadership and service components  
of their Area Geriatric Service. The major service components of an Area Geriatric Service are detailed in the 
Network s Acute Care of the Elderly Unit, Geriatric Evaluation and Management Unit, Geriatric Consultation Liaison 
Team and Community Geriatric Services Model of Care documents. All five documents have been referred to the 
department for endorsement.

Cancer Clinical Network

The Cancer Clinical Network (the Network) has continued to work towards the implementation of the Statewide 
Cancer Control Plan. The Network collaborated with Country Health SA Local Health Network in establishing a 
country model of cancer care, including the establishment of several rural chemotherapy centres which provide safe 
care closer to home. The Network also released a number of statewide foundation documents and cancer clinical 
pathway documents to support best practice and integration of best practice prescription processes with  
the Enterprise Patient Administration System.



page 55 Department for Health and Ageing Annual Report 2012-13

Maternal and Neonatal Clinical Network

In 2012-13, the Maternal and Neonatal Clinical Network (the Network):

 &gt; Improved access to Maternal and Neonatal clinical practice guidelines through publishing over 40 Neonatal Practice 
Guidelines to the SA Health website, and implementing the Clinical Practice Guidelines iPhone app. Specific to the 
Network, the app improves access to the perinatal and neonatal medication clinical practice guidelines by making 
them available on iPhones and iPads. 

 &gt; Facilitated the future work of all Clinical Networks through the clarification of SA Health approval and  
publication processes.

 &gt; Contributed to improved hospital retrieval directions through the development and implementation of the Neonatal 
Regional Retrieval Service Directive.

 &gt; Improved perinatal emergency education through the development of the SA Health Perinatal Emergency 
Education Framework, and supporting, in collaboration with the SA Health Safety and Quality Strategic Governance 
Committee, the development of the SA Health Perinatal Emergency Education Framework Business Plan.

 &gt; Improved termination of pregnancy health services through the development and implementation of the 
Standards for the Management of Termination of Pregnancy in South Australia, and improved access to medical 
abortion medication through the development and implementation of the Medical Abortion Therapeutic Goods 
Administration Guideline.

 &gt; Supported the statewide implementation of the National Maternity Services Plan.

 &gt; Supported the Director of Neonatal Services to implement the SA Neonatal Services Plan.



page 56Department for Health and Ageing Annual Report 2012-13

Mental Health Care and Drug and  
Alcohol Services

Legislation, Policy and Planning

Mental Health Act 2009

The purpose of the Mental Health Act 2009 (the Act) is to ensure access to services, protect the rights and liberty 
of people with serious mental illness, create more effective and appropriate engagement between consumers and 
service providers, and establish improved monitoring and accountability.

During 2012-13, the Office of the Chief Psychiatrist worked with consumers, carers, mental health services, 
emergency services, hospitals and health services, other government agencies, statutory bodies, non-government 
organisations and community groups to enhance understanding, adherence and promotion of the provisions  
of the Act.

In August 2012, amendments to the Act came into force after being proclaimed by the Governor. These amendments 
included the reduction of stigma and discrimination through changing the language of the Act, so that a  detained 
patient  is now an  involuntary patient , and a  Detention and Treatment Order  is now an  Inpatient Treatment  
Order . Clarifications were also made to provisions for Leaves of Absence, consent for Electro-Convulsive Therapy  
and correcting administrative errors in orders. Additionally, the Forms and Statements of Rights required by the  
Act were updated. 

South Australian Suicide Prevention Strategy 2012-16: Every life is worth living 

The South Australian Suicide Prevention Strategy 2012-2016: Every life is worth living (the Strategy) was released 
by Hon. John Hill M.P. in September 2012. In addition, Guidelines for Working with the Suicidal Patient have been 
developed by clinicians and the University of South Australia, to be used in Emergency Departments.  

SA Health s contributions towards the all-of-community and all-of-government Strategy have included work to 
establish community Suicide Prevention Networks linked to local councils. The networks are inclusive of community 
members, business, industry, mental health services, service clubs, emergency services, churches, sporting clubs, non-
government organisations  and government departments. The networks will develop action plans that link with the 
Strategy, identifying the services and resources available in the area and working to break down the stigma and raise 
awareness in each community. 

Community Visitor Scheme

The Act establishes the Community Visitor Scheme (CVS) to further protect the rights of people with mental illness 
in treatment centres, by conducting visits and inspections of those centres. The functions of the CVS are carried out 
by volunteer Community Visitors under the supervision of a Principal Community Visitor, all of whom are statutory 
appointments by the Governor. SA Health provides administrative support to the CVS.

In 2012-13, the government committed to an expansion of the CVS into the disability and supported residential 
facility sectors. Subsequently, the Minister for Mental Health and Substance Abuse and the Minister for Disabilities 
agreed that the expanded CVS would be administered by the Department of Communities and Social Inclusion 
(DCSI). SA Health and DCSI began planning for the expansion.

Review of the South Australian stepped system of mental health care

In March 2013 the Minister for Mental Health and Substance Abuse commissioned Ernst and Young to undertake a 
review of the South Australian stepped system of mental health care and capacity to respond to emergency demand. 
The scope of the Review included: the balance of acute and non-acute services, patient flow and bed coordination 
practices, SALHN processes during periods of peak demand, statewide capacity to respond to emergency demand 
and the effectiveness of the reforms to date in meeting the recommendations of the Stepping Up Report. SA Health 
supported Ernst and Young in carrying out the Review and staff, as well as consumers, carers and other stakeholders, 
made themselves available to the independent review team. A Report and recommendations are expected in next 
reporting period.



page 57 Department for Health and Ageing Annual Report 2012-13

Policy Initiatives
During 2012-13, a number of mental health policy and planning initiatives were underway, including:

Electro-Convulsive Therapy

SA Health established the South Australian Electro-Convulsive Therapy (ECT) Advisory Committee to collaboratively 
develop the South Australian ECT Policy, Standards and Guidelines, which are nearing completion. The suite of 
documents will provide the framework for the delivery and monitoring of ECT in South Australia and will inform the 
development of national protocols.

Gender Safety

SA Health began the review of gender safety practices and protocols in mental health inpatient settings, and 
consulted with consumers, carers, mental health services and other stakeholders to inform the development of 
Gender Safety Guidelines and Standards. The Guidelines will contain preventative strategies and practices for 
managing distress and trauma. The Standards will describe the minimum requirements for identifying and managing 
vulnerable consumers and potential consumers of concern. While being intended more broadly for women, the 
Guidelines and Standards will also be applicable for other potentially at risk inpatients, including but not limited to 
people with an intellectual disability and any personal history of trauma.

Mental Health Strategy for Culturally and Linguistically Diverse People

Work commenced on a strategy to improve the cultural responsiveness of mental health services. This work included 
the establishment of strategic collaboration with key government agencies and non-government organisations with 
expertise in this area, a review of current policies and initiatives in South Australia and across the nation, and working 
with other states as a participating member in the national Mental Health in Multicultural Australia project.

Pathways to Care

The Pathways to Care policy series will replace previous statewide mental health service policies and recognises the 
need to provide flexible joined-up mental health services that are responsive to consumer needs. The series has 
been drafted from extensive consultation with consumers, carers, mental health services, general health services, 
emergency services, non-government agencies and private health providers.

The series comprises policies for: access, care and treatment, transfer of care, working with other service providers, 
exiting mental health services, re-entry to mental health services and transport, and will be released for public 
consultation in late 2013.

Reduction of Restraint and Seclusion

SA Health continued to provide training, resources, advice and support to reduce, and where possible eliminate, 
the use of restraint and seclusion in mental health settings. Additionally, SA Health worked with consumers, carers, 
mental health services and other stakeholders to draft a Mental Health Restraint and Seclusion Reduction suite of 
documents. The suite will include a Policy Directive, Policy Guidelines, Standards, a Toolkit and an Education Package, 
which will be released for consultation in late 2013.

Service Improvement

Aboriginal Mental Health

The objectives of the Aboriginal Mental Health Action Plan have been progressed with the establishment of the 
Aboriginal Mental Health Reference Group to oversee implementation at the state level. The group is composed of 
officers from the Aboriginal Health Council of South Australia, Drug and Alcohol Services of South Australia, Local 
Health Networks , Medicare Locals, Mental Health Clinical Network, non-government organisations and Office of the 
Chief Psychiatrist. Terms of Reference and work plans have been drawn up for the Reference Group and the Working 
Groups to be established at each LHN.

The Office of the Chief Psychiatrist worked in partnership with the Adelaide Football Club and participated in 
community development activities in the Anangu Pitjantjatjara Yankunytjatjara Lands for perinatal depression and 
mental and emotional health and wellbeing.



page 58Department for Health and Ageing Annual Report 2012-13

Accommodation and Housing

The Housing SA and Mental Health and Substance Abuse Memorandum of Understanding (MOU) was redrafted and 
resigned by the Minister for Mental Health and Substance Abuse and the Minister for Social Housing for 2013-16. 
The new MOU has adopted a strategic planning focus which will engage mental health and housing staff to work for 
the coordinated delivery of mental health services, psychosocial rehabilitation and housing services to enhance the 
wellbeing and improve housing outcomes for people with a mental illness. The MOU will strengthen collaboration 
to deliver the Housing and Accommodation Support Partnership program, comprising 79 more intensely supported 
places, and the Supported Social Housing program, comprising 262 supported places. Both programs provide mental 
health, psychosocial and tenancy support to individuals so they can live in and engage with their communities.

Child, Adolescent and Youth Mental Health Services

During 2012-13, SA Health committed to the amalgamation of existing Child and Adolescent Mental Health  
Services (CAMHS) into a single statewide CAMHS for children and adolescents from zero to 15 years of age, and  
to the establishment of a Youth Mental Health Service (YMHS) for older adolescents and young adults from  
16 to 24 years of age.

The CAMHS-YMHS Implementation Steering Committee and working groups were established in October 2012 and 
continue to meet to progress models of care, implementation, transition and finance matters. The statewide CAMHS 
began operating in February 2013 under the governance of the Women s and Children s Health Network.

Collaboration with the Australian Government

SA Health continues to work in partnership with the Australian Government on a number of sub-acute mental health 
service initiatives, at various stages of planning and implementation. In 2012-13, the expansion of the Assessment 
and Crisis Intervention Service (ACIS) to be a 24-hour face-to-face service became operational across metropolitan 
Adelaide, and a community walk-in mental health service was initiated in Salisbury.

Community Mental Health Services

The implementation of the new model of care for the provision of adult community mental health services and the 
construction of Community Mental Health Centres in the metropolitan area has progressed on target during the past 
12 months. New Community Mental Health Centres have opened at Salisbury (Northern) and Woodville (Western), 
joining the Eastern (Tranmere) and Southern (Marion) centres.

Forensic Mental Health Services

SA Health commenced the planning for the redevelopment of Forensic Mental Health Services at the James Nash 
House campus at Oakden. The redevelopment will include the transfer of 10 beds from the Glenside Campus,  
the construction of 10 new acute beds and the construction of 10 new sub-acute beds in the separate Forensic  
Step-Down Facility.

In addition, SA Health has been working with the courts, the Department of Correctional Services, the Parole  
Board, SA Police and the Public Prosecutor to improve processes and communication for patients and staff across  
all agencies. SA Health planned for and established the Forensic Mental Health Court Liaison Service pilot to provide 
assessment, liaison and advice services for Courts and facilitate communication between the courts and SA Health. 

Lived Experience Participation

The Mental Health and Substance Abuse Division worked with consumers, carers, mental health services, advocates 
and statutory bodies to develop the Statewide Mental Health Lived Experience Register (the Register), the 
communication process for consumers and carers to be informed of, provide feedback to and participate in the 
planning and policy work of the division and other statewide mental health issues. The Register will supplement  
and expand existing communication mechanisms and processes, including the Consumer Reference Group and  
the Carer Advisory Group.

Non-Government Organisation Services

Funding to non-government providers has substantially increased from $3.43m in 2002-03 to $34.5m in 2012-13.  
The funding provided to the non-government organisation (NGO) sector is allocated through detailed procurement 
processes.



page 59 Department for Health and Ageing Annual Report 2012-13

During 2012-13, 1005 South Australians received individual psychosocial rehabilitation and support services from 
non-government providers in partnership with government mental health services. A further 9403 South Australians 
received some level of mental health support through a SA Health funded NGO program. 

Two new NGO delivered services commenced operation in 2012-13, a Carer Support and Respite program to provide 
assistance to carers of people with a mental illness across metropolitan and country regions; and an Intensive Home-
Based community support service, targeting people who will benefit from short term intensive psychosocial support  
in their own home. 

Education and Promotion

beyondblue

SA Health continues to collaborate with beyondblue to reduce the impact of depression and anxiety on the  
South Australian community.

Destigmatisation Campaign

The  Let s Think Positive  destigmatisation campaign continued on television, radio, outdoor, print and online.

Mental Health Week

In October 2012, Mental Health Week focussed on three key themes of  My Wellbeing, My Support, My Community  
while retaining an overall message of  Open your mind   What you do can make a difference . Mental Health Week 
was launched on World Mental Health Day (10 October 2012) at the Dr Margaret Tobin Awards for Excellence in 
Mental Health.

National Perinatal Depression Initiative

Routine and universal screening for perinatal depression has been maintained at all major public birthing hospitals 
and a large number of country sites across the state. Follow up support and care for women assessed as being at 
risk of or experiencing perinatal depression is being undertaken by perinatal mental health clinicians and National 
Perinatal Depression Initiative funded non-government organisations. Workforce training and development for  
health professionals continues to be a major focus.

To date over 3500 staff, including nurses, midwives, allied health professionals and medical practitioners have  
been trained, with 40 community awareness events this financial year. There are over 1800 registered users on  
the e-learning education tool. 

Reduction of Restraint and Seclusion

Ongoing training and education was facilitated for the prevention and management of challenging behaviour.  
A specific restraint and seclusion reduction education package was developed for trialling with mental health staff  
in the second half of 2013. The package will be trialled and fully evaluated in partnership with Flinders University  
for potential implementation across any health setting.

Statewide Training

Training was provided to personnel from agencies across South Australia regarding the Authorised Health  
Professional role and powers, Authorised Officer role and powers, Mental Health Clinicians Guide to Sharing 
Consumer Information, Mental Health Act 2009 and the Mental Health and Emergency Services Memorandum  
of Understanding.

The 1629 participants came from consumer and carer groups, mental health services, Emergency Departments,  
SA Ambulance Service, SA Police, non-government organisations and general practitioner groups.

Performance

Mental Health Readmissions within 28 Days

One benchmark for success in providing appropriate patient care to people with mental illness can be measured by 
examining the number of people who are re-admitted within 28 days of discharge. In 2007-08 rates of re-admission 
were 8.9 per cent, which has decreased to 6.4 per cent in 2012-13. South Australia is achieving consistently better 
than the national average of 12 per cent.



page 60Department for Health and Ageing Annual Report 2012-13

Figure 27   Mental health readmissions within 28 days

 

 

 
 

0% 

1% 

2% 

3% 

4% 

5% 

6% 

7% 

8% 

9% 

10% 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

 
 

Pe
rc

en
ta

g
e 

Financial year

Data source: Department central admitted patient data, Integrated South Australian Activity Collection (ISAAC)

Community Care within Seven Days of Discharge
Post-discharge follow up in the community is an important strategy for maintaining health and recovery in the 
vulnerable period following a hospital stay. This follow up may be provided by a public mental health service, a 
general practitioner or a private psychiatrist. Although public mental health services are only one of the providers  
for post-discharge community care, the percentage of people receiving public follow up has risen from 34.7 per cent  
in 2007-08 to 52.1 per cent in 2012-13.

Figure 28   Community care within seven days of discharge

 

0% 

10% 

20% 

30% 

40% 

50% 

60% 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

 P
er

 c
en

ta
g

e 

Financial year 

 

Data source: Department central admitted patient data (ISAAC) combined with community mental health systems (CBIS/CCCME/BART)



page 61 Department for Health and Ageing Annual Report 2012-13

Average Length of Stay
Average length of stay (ALOS) represents the tension between the acuity of an individual s illness, the recovery times 
for different mental illnesses and the efficacy of treatment. ALOS for inpatient mental health services has decreased 
from 17.7 days in 2006-07 to 17.1 days in 2012-13. These figures collate information from a broad range of service 
types across the age range of services for children, adults and older people. South Australian mental health ALOS 
remains within the national benchmarking range of 11 to 24 days.

Figure 29   Average length of stay

 

 

0

2

4

6

8

10

12

14

16

18

20 

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 

D
ay

s 

Financial year 

 

 

Data source: Department central admitted patient data, Integrated South Australian Activity Collection (ISAAC)

Drug and Alcohol Services Intervention and Treatment

Non-Government Alcohol and Other Drug Services

SA Health contracts non-government organisations (NGOs) to deliver services and provide essential community 
infrastructure. Contracts with NGOs to deliver alcohol and other drug treatment services commenced on 1 July  
2012 following an open competitive tender process. Services provided under the Drug and Alcohol Services  
Program includes counselling interventions, residential and non-residential beds and sobering-up services across  
South Australia. 

NGOs also deliver services under contract for the Police Drug Diversion Initiative for young people and adults detected 
by the police for minor simple possession drug offences. Individuals are diverted from the criminal justice system to 
the health system for education, assessment and treatment. These health interventions are available in metropolitan 
and regional areas. 

Community Protection Panel Case Management

In October 2011, two specialist Drug and Alcohol Services South Australia (DASSA) clinicians were appointed to 
the Community Protection Panel (CPP). This program is based within the Department for Communities and Social 
Inclusion and supports an integrated service model for high-risk repeat offenders with alcohol, tobacco and other 
drug use problems. The aim is to reduce the alcohol, tobacco and other drug use of repeat young offenders referred 
to the CPP, contributing to a reduction in one of the underlying risk factors impacting on the rate and severity of 
further offending. 

The DASSA clinicians are part of the Assertive Case Management team at the CPP, undertaking alcohol, tobacco 
and other drug assessments and therapeutic interventions for young people, complemented by family-based 
interventions. The model promotes a coordinated, multi-agency approach where clinicians support the treatment plan 
that attends to multiple needs of the young person and their family. During 2012-13, DASSA clinicians have provided 
drug assessments for five new clients and ongoing intervention for 18 clients of the CPP as well as support and 
counselling for eight family members. DASSA staff have also provided alcohol and other drug education to all CPP 
staff on a regular basis. 



page 62Department for Health and Ageing Annual Report 2012-13

Woolshed Therapeutic Community

In 2012, the Woolshed residential rehabilitation program was successful in receiving full accreditation through the 
Australasian Therapeutic Communities Association (ATCA). The Woolshed is the first South Australian residential 
rehabilitation program to complete and achieve accreditation against the ATCA Therapeutic Community standards. 
DASSA also commissioned an external quality improvement review of the program, resulting in a report reinforcing 
that it was a well-established therapeutic community. 

Following significant consultation with other South Australian and interstate therapeutic communities, staff, clients 
and stakeholders, the Woolshed program revised the admission criteria to include the integration of clients on 
medication assisted treatment for opioid dependence into the residential program. 

Approval of Sobering Up Services under the Public Intoxication Act 1984

SA Health funds non-government organisations to deliver sobering up services in Coober Pedy, Ceduna, Port 
Augusta, Adelaide and Hindmarsh. In October 2012, the Minister for Mental Health and Substance Abuse approved 
these five sobering up services under section 7(3)(b) of the Public Intoxication Act 1984 (the Act) and placed a formal 
notice in the Government Gazette. Approving the sobering up services will make it lawful for police to take a person 
apprehended under the Act to these services where they are released from custody and cared for by the service. 

Policy and Monitoring

Coordination of Services for Children in the Care of the Drug and Alcohol Services South Australia 
Treatment Client Group 

Recognising that parental substance misuse is a potential challenge to the welfare of young children, DASSA 
contracted the National Centre for Education and Training on Addiction (NCETA) to undertake a project within  
DASSA that would:

 &gt; Consider a range of prevention and early intervention strategies and resources that could be relevant to children 
aged less than eight years in the care of the DASSA treatment client group.

 &gt; Propose a number of work practice models that could integrate these strategies and resources into existing 
treatment interventions. 

 &gt; Consider the organisational resources required to implement the proposed work practice models. 

The project began in September 2012 and involved reviewing the literature, surveying and conducting in-depth 
interviews with staff on current and future practices, and examining DASSA s policy and procedure documents.  
The report was received in April 2013. The recommendations will be considered by DASSA and will augment the 
existing DASSA Family Sensitive Practice Plan.

Review of the Public Intoxication Act 1984 

In June 2012, the Minister for Mental Health and Substance Abuse commissioned a review of the Public Intoxication 
Act 1984. The Act provides for the apprehension and care of a person who is under the influence of a drug or alcohol 
in a public place and unable to take proper care of him or herself. Dr Chris Reynolds was engaged by SA Health to 
conduct the review. Dr Reynolds submitted the review report to the Minister in January 2013. The government is 
currently considering Dr Reynolds recommendations and preparing a formal response.

Drug and Alcohol Services South Australia Services   Key Performance Indicators

Preliminary data indicates that there have been 36 236 outpatient attendances at DASSA services, which include 
attendances for assessment, counselling and pharmacotherapy. This exceeds the target for 2012-13 of 34 000.

Preliminary data for inpatient separations indicates 1154 separations, which is below the target for 2012-13 of 1300. 

The proportion of treatment where the reason for cessation was  treatment completed  for inpatient separations was 
65.6 per cent. The proportion of registered client outpatient appointments with a DASSA clinician where the client 
did not attend was 16 per cent.

Staff of Drug and Alcohol Services South Australia

Staff of DASSA perform their duties in connection with the incorporated hospital Southern Adelaide Local  
Health Network.



page 63 Department for Health and Ageing Annual Report 2012-13

Primary Prevention 

Tobacco Initiatives

Prevalence of Smoking

The key target in the South Australian Tobacco Control Strategy 2011-16 is to reduce the percentage of young 
smokers (15 to 29 years) to 16 per cent by 2016. Results from the 2012 South Australian Health Omnibus Survey 
showed that achieving this target is on track. 

The survey shows that the significant reduction in overall smoking prevalence achieved in 2011 has been maintained 
in 2012. The prevalence for smoking amongst people aged between 15-29 years was 18.2 per cent in 2012, 
compared to 22.9 per cent in 2010 and 17.6 per cent in 2011.

The prevalence for people aged over 15 years was 16.7 per cent in 2012, compared to 20.5 per cent in 2010 and 
17.6 per cent in 2011. The prevalence of daily smoking for people aged over 15 years was 14.4 per cent in 2012, 
compared to 17.2 per cent in 2010 and 15.2 per cent in 2011.

Legislative Measures

Amendments to the Tobacco Products Regulation Act 1997, which came into effect on 31 May 2012, allow outdoor 
areas and events to be declared smoke-free. In 2012, the Royal Adelaide Show became the first event to be declared 
smoke-free. The City of Charles Sturt s 2012  Christmas at Our Place  event was also declared smoke-free.

Reducing Smoking during Pregnancy

SA Health funds the delivery of specific initiatives that are designed to help reduce smoking in pregnancy. These 
include a social marketing and support project targeting Aboriginal pregnant women delivered through Aboriginal 
Health Council of SA, and an education and training program for health professionals to assist pregnant women to 
quit smoking, delivered through Quit SA. 

Alcohol Initiatives

SA Health has implemented a range of strategies to address the incidence of risky drinking in South Australia. 
Strategies implemented in 2012-13 include:

 &gt; Continuation of the  Drink too much you re asking for trouble  social marketing campaign.

 &gt; Working with the Aboriginal Health Council of South Australia, which aims to identify primary prevention 
responses to address risky drinking in South Australian Aboriginal communities.

 &gt; The Early Intervention Pilot Program, which provided early intervention opportunities for young people detected by 
the police for a range of issues related to alcohol.

 &gt; Working with the Attorney-General s Department and other agencies on the Late Night Safety Strategy. 



page 64Department for Health and Ageing Annual Report 2012-13

Social Marketing

Tobacco Social Marketing 

The South Australian tobacco control social marketing campaign, run in partnership with the National Tobacco 
Campaign, aims to encourage smokers to quit smoking, ex smokers to stay quit and to discourage the uptake of 
smoking. In 2012-13, the campaign aired 10 different television commercials and online advertising was introduced.

Evaluation over the first six months of the 2012-13 campaign found it continued to inform smokers about the 
dangers of smoking and motivated them to try to quit. The addition of the online component contributed to a  
33 per cent increase in the number of Quit SA website visits. The social marketing campaign contributed to the 
decline in smoking prevalence for South Australia between 2011 and 2012, from 17.6 per cent to 16.7 per cent.

Alcohol Social Marketing

The  Drink too much, you re asking for trouble  alcohol intoxication campaign targets South Australian males 
and females aged 18-29 years, and males aged 30-39 years. The campaign aims to reduce risky drinking and the 
acceptance of public drunkenness amongst these groups.

The campaign aired during September and October 2012 through television, radio, digital, outdoor and in-venue 
advertising. The campaign also reached its target audience through a dedicated website and Facebook page, and  
by promoting its messages at community events.

A survey of the target audience in late 2012 found that 62 per cent were aware of the campaign. This increased from 
58 per cent in mid-2012. Evaluation also found that 69 per cent of the target audience surveyed agreed or strongly 
agreed that there are serious consequences related to drinking too much and 48 per cent of the target audience 
believe that public drunkenness is unacceptable. 

Aboriginal Programs

Aboriginal Blood Borne Virus Prevention Project 

DASSA is funding the Aboriginal Health Council of SA (AHCSA) to conduct the 2011-14 Aboriginal Blood Borne Virus 
Prevention Project.

The objectives of the project are to:

 &gt; Increase the understanding of the Clean Needle Program broadly and the capacity of AHCSA and the Aboriginal 
Community Controlled Health Service sector to effectively engage the target group.

 &gt; Support DASSA to expand the number of Clean Needle Program sites in specific regional and metropolitan locations.

 &gt; Support DASSA to overcome the barriers and increase the enablers of access to the Clean Needle Program by  
the target group. 

 &gt; Support DASSA to change/augment the modality of service delivery in relevant Clean Needle Program sites.

During 2012-13, all AHCSA member services received blood borne virus prevention training. Planning for culturally 
appropriate service delivery improvements via changes to Clean Needle Program training, operational procedures,  
and data collection is also in progress, for implementation in the final year of the project. DASSA and AHCSA will  
also work together to expand the number of Clean Needle Program sites in specific locations in 2013-14.

Drug and Alcohol Services South Australia Anangu Pitjantjatjara Yankunytjatjara (APY) Lands Mobile 
Outreach Substance Misuse Service

DASSA provides a mobile assertive outreach substance misuse service to Anangu referred from the APY Land 
communities. The model of care was revised and implemented in 2012, following the transfer of the DASSA 
managed facility to the Country Health SA Local Health Network for the development of the Amata Family Wellbeing 
Centre. 

An information package for agencies regarding referral processes and service operations has been distributed to 
referring agencies and is available on the SA Health website. 



page 65 Department for Health and Ageing Annual Report 2012-13

Ceduna Day Centre 

The Ceduna Day Centre commenced operations in May 2012 and was officially opened by Ms Zoe Bettison MP, 
Member for Ramsay on 26 October 2012. The Centre is operated by SA Health through Drug and Alcohol Services 
South Australia with funding from the Australian Government. 

The Centre aims to minimise substance misuse harms to Aboriginal people by providing a range of services including 
alcohol and other drug treatment interventions, diversionary activities, meals and showers. People who visit the centre 
may be referred by agencies such as health, legal and accommodation services for a range of treatment interventions. 

During 2012-13, the centre registered 43 clients for a formal treatment episode and accommodated approximately 
10 600 visits for access to showers, meals, storage, referral and support. There were 231 visits from external 
organisations.

Expansion of Ceduna Sobering Up Unit

Sobering up services provide short-term shelter and non-medical care in a therapeutic environment for people who 
are unable to take proper care of themselves due to intoxication from alcohol and other drugs. The service provides 
a safe place to sober up or recover from the immediate effects of intoxication.

A new service agreement for the operation of the Ceduna Sobering Up Unit between the Minister for Mental Health 
and Substance Abuse and Ceduna Koonibba Aboriginal Health Service Aboriginal Corporation commenced on 1 July 
2012, for three years. In accordance with the new agreement the Sobering Up Unit extended its operating hours to 
24 hours a day, seven days a week. Capacity increased from five beds to a minimum of 20 beds on 17 December 
2012, and the unit relocated into a decommissioned wing of the Ceduna Hospital, after the facility was renovated,  
to ensure closer proximity to Accident and Emergency Services as recommended by the Coroner. 

Training in the Medical Management of Alcohol Addiction for Health Professionals in Ceduna

DASSA in partnership with Ceduna Koonibba Aboriginal Health Services Aboriginal Corporation and the Ceduna 
Hospital defined the needs of staff regarding education and support for the medical management of alcohol 
dependence. A set of clinical responses were developed for in-patient and ambulatory settings to reduce relapse 
through withdrawal management, case management, psycho-social supports and the use of relapse prevention 
medications.

During 2012-13, DASSA delivered training in Ceduna for general practitioners, senior nursing staff and psychologists 
on coordinated responses to the acute and longer term management of alcohol dependence. Supplementary training 
sessions were delivered on motivational interviewing and responding to cannabis related problems.

Breaking the Cycle Taskforce

In June 2012, the Australian Government announced $4.3m over three years for a  Breaking the Cycle of Alcohol  
and Substance Misuse  initiative in Ceduna and the western region of South Australia. The initiative will facilitate  
the development of a number of localised and regional Alcohol Management Plans to support the Breaking the  
Cycle initiative.

DASSA is represented on the Breaking the Cycle Taskforce and has contributed to the development of the draft plan.



page 66Department for Health and Ageing Annual Report 2012-13

Strategic Directions
Consistent with the National Drug Strategy 2010-15, the National Tobacco Strategy 2004-09 and South Australia s 
Strategic Plan targets for reducing smoking and risky alcohol consumption, the South Australian Government has 
endorsed two high level strategic plans to direct activities to reduce the harm from alcohol, tobacco and other  
drugs activities. 

South Australian Tobacco Control Strategy 2011-16

The South Australian Tobacco Control Strategy 2011-16 aims to increase the number of people quitting smoking 
while also reducing the number of people taking up smoking over the next five years. 

Actions implemented during 2012-13 include working with stakeholders towards smoking bans in outdoor areas 
of bars, clubs and restaurants and implementing new legislation introduced in 2012 including the prohibition of 
smoking at all covered public transport stops, children s playgrounds and areas declared by regulation. SA Health  
also delivered social marketing campaigns that reach and impact Aboriginal smokers.

The South Australian Alcohol and Other Drug Strategy 2011-16

The South Australian Alcohol and Other Drug Strategy 2011-2016 is a whole-of-government commitment to 
improving the lives of South Australians by undertaking evidence-based actions to reduce the harm associated with 
the use of illicit drugs and the misuse of alcohol. The strategy was developed by SA Health and South Australia  
Police in collaboration with other government agencies and was endorsed by Cabinet in November 2011. 

The strategy has a strong focus on key indicators, data collection and progress monitoring, and identifies 60 priority 
actions with associated lead agencies.

A cross-agency steering committee has responsibility for monitoring the implementation of the priority actions and 
reporting annually to the Minister for Mental Health and Substance Abuse and the Minister for Police. The first annual 
progress report was submitted in December 2012. Of the 60 priority actions, 56 were reported as on track, four 
required additional effort and there we no priority actions behind schedule.



page 67 Department for Health and Ageing Annual Report 2012-13

Aboriginal Health

Improve the Health of Aboriginal People
SA Health is committed to improving Aboriginal health and wellbeing outcomes so they are comparable to other 
South Australians. This commitment is demonstrated in the SA Health Strategic Directions which include a focus  
on  Improving the health of Aboriginal people  through the following aims: 

 &gt; Reduce Aboriginal ill-health.

 &gt; Develop a culturally responsive health system.

 &gt; Promote Aboriginal community health and wellbeing.

SA Health is responsible for South Australia s Strategic Plan Target 79   Aboriginal Healthy Life Expectancy. Similarly, 
two of the Government of South Australia s Seven Strategic Priorities heavily influence SA Health s commitments to 
improving Aboriginal health:  Every Chance for Every Child  and  Safe Communities, Healthy Neighbourhoods .

Every Chance for Every Child includes the target of increasing the number of Aboriginal women receiving antenatal 
care by 120 (33 per cent) by December 2013. SA Health s investment in the National Partnership Agreement on 
Indigenous Early Childhood Development is aligned to this strategic priority. In addition, SA Health s investment in the 
National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes supports the Safe Communities, 
Healthy Neighbourhoods strategic priority.

SA Health s actions to improve Aboriginal health outcomes are directed by the SA Health Aboriginal Health Care Plan 
2010-16. The strategies within the Aboriginal Health Care Plan 2010-16 are governed by the SA Health Strategic 
Directions and the targets in South Australia s Strategic Plan. The strategies are also supported by South Australia s 
investment under the two aforementioned National Partnership Agreements. 

Aboriginal peoples  health and wellbeing is benefited by SA Health s efforts to create the best public health system 
for all South Australians. This section presents only a few of the many standout initiatives the department has led or 
partnered in.

Aboriginal Health Care Plan 2010-16 
The Aboriginal Health Care Plan 2010-16 is supported by sound research, data and cultural advice. It identifies 
16 priority initiatives aimed at achieving the best health gains for Aboriginal people. The 16 priority initiatives are 
supported by 46 strategies. 

The department monitors the implementation of the Aboriginal Health Care Plan 2010-16 across SA Health, which is 
heavily supported by South Australia s investments under the National Partnership Agreement on Closing the Gap in 
Indigenous Health Outcomes. In 2012-13 the following milestones were achieved: 

 &gt; Two initiatives were completed (ensure all planning for capital works programs for health facilities includes 
consideration of the need for local step down services; and implement the recommendations of the Ever felt like 
Complaining? report within the recommended time frames).

 &gt; 35 initiatives were progressed and nine have not yet commenced.

 &gt; A review of governance structures across SA Health promoted ownership and implementation of the Aboriginal 
Health Care Plan 2010-16. Following the review, high level implementation committees were established in the 
department and Local Health Networks. 



page 68Department for Health and Ageing Annual Report 2012-13

National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes 
(2009-13) 
The South Australian Implementation Plan for the National Partnership Agreement on Closing the Gap in Indigenous 
Health Outcomes has enabled the establishment of 29 SA Health funded programs aimed at addressing a variety of 
outcomes across the spectrum of the health system and the determinants of health. An independent evaluation has 
commenced to identify:

 &gt; The effectiveness of each program.

 &gt; Their cultural appropriateness.

 &gt; Their ability to engage stakeholders to achieve positive health outcomes for Aboriginal South Australians. 

SA Health has provided $53.89m over four years under this agreement. The Closing the Gap targets that underpin 
the agreement include:

 &gt; To close the life expectancy gap (between Indigenous and non-Indigenous Australians) within a generation.

 &gt; To halve the gap in mortality rates for Indigenous children under five within a decade.

National Partnership Agreement on Indigenous Early Childhood Development (2009-14) 
The National Partnership Agreement on Indigenous Early Childhood Development was established to improve 
outcomes for Aboriginal children in their early years and to contribute to the Closing the Gap targets. The National 
Partnership Agreement on Indigenous Early Childhood Development consists of three elements:

 &gt; Integration of early childhood services through the development of Children and Family Centres. This is 
administered by the Department for Education and Child Development.

 &gt; Increased access to antenatal care, pre-pregnancy and teenage sexual and reproductive health. This is administered 
by SA Health.

 &gt; Increased access to and use of maternal and child health services by Indigenous families. This is administered  
by SA Health.

Reduce Aboriginal Ill-Health 

Improving Renal Health 

The department and Country Health SA Local Health Network (CHSALHN) are partnering to provide culturally 
respectful renal care for Aboriginal patients from remote South Australia. The mobile dialysis truck has continued 
to visit the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands and other remote areas of South Australia throughout 
2012-13. CHSALHN leases the Northern Territory dialysis truck to provide the visits which generally last for one week, 
allowing people to return to their home communities while still receiving dialysis treatments. The visits have been well 
received by the local communities.

The dialysis truck made a total of eight visits to the following locations in 2012-13: Mimili (two visits), Ernabella (two 
visits), Coober Pedy (two visits), Marla and Yalata. Thirty-one patients have accessed these visits on 48 occasions.

In 2012, SA Health received capital funding from the Australian Government for a mobile dialysis truck. CHSALHN  
is now finalising the design of the truck which is expected to be ready for use in early 2014.

Reducing the Incidence of Trachoma 

CHSALHN manages the South Australia trachoma screening and treatment program. Trachoma is the world s leading 
infections cause of blindness. The department provides ongoing strategic advice on the roll out of the program. 
CHSALHN partners with local health service providers, Aboriginal Community Controlled Health Services (ACCHS),  
the Aboriginal Health Council of South Australia and Nganampa Health Service to ensure coverage of screening 
services in all at-risk rural and remote areas.

The second screening round undertaken in 2012 indicated that the prevalence of trachoma in the five to nine year 
age group has significantly reduced in comparison with the 2011 screening round, with 14 cases being identified 
during 2012 compared to 36 cases in 2011. This means that the implementation of Trachoma Control Project in all  
 at risk  communities is progressing well towards the goals and objectives.



page 69 Department for Health and Ageing Annual Report 2012-13

Coordinated Care for Those with Cancer 

The SA Health Aboriginal and Torres Strait Islander Companion Document to the Statewide Cancer Control Plan 
recommended the development of dedicated cancer care coordinator roles. The recommendations were based on 
findings that Aboriginal people have higher population-based cancer mortality rates and lower survival rates than 
non-Aboriginal Australians. They are more likely to be diagnosed at a more advanced stage and more likely to have 
high-fatality types of cancers. 

The department and Central Adelaide Local Health Network developed the Cancer Care Coordinators Aboriginal 
and Torres Strait Islander Health program in October 2011. The program works as part of an interdisciplinary team to 
support Aboriginal patients diagnosed with cancer. The program is funded under South Australia s investment in the 
National Partnership on Closing the Gap in Indigenous Health Outcomes. Its focus to improve patients  experiences, 
coordinate care in a culturally sensitive way and to provide assistance to ensure treatments are completed. 

At any one time the Cancer Care Coordinators support approximately 50 patients and their carers and/or escorts. 
Approximately three to five new patients are seen each month, totalling 53 new patients for the 2012-13 reporting 
period. On average, each client receives three to five occasions of service which include clinical nursing assessment, 
information transfer (health care providers), coordination of multiple treatment appointments/follow up, access to 
culturally appropriate care, patient/carer information/education and being a point of contact for care coordination.

Well Health Checks for Young Aboriginal People 

Nurses and Aboriginal Clinical Health Workers (ACHW) provide Aboriginal Well Health Checks to all Aboriginal and 
Torres Strait Islander young people who enter Youth Training Centres. As a result of the health checks young people 
may receive treatment and management from a clinical team of nurses, ACHWs and medical practitioners or may be 
referred to external specialist services. The Aboriginal Well Health Checks project also focuses on engaging young 
people in the management of their own health care and provides follow-up back into the community on release.  
The staff in the Training Centres also work out in community sites and the young people are encouraged to engage 
with these services on release.

Develop a Culturally Responsive Health System 

Improving Aboriginal Identifications 

The department funded the Australian Bureau of Statistics (ABS), under South Australia s investment in the National 
Partnership on Closing the Gap in Indigenous Health Outcomes, to support improvements in SA Health s Indigenous 
data collection methods. In 2010, the ABS developed a training package on the collection of the Indigenous identifier 
for frontline staff working in hospitals and other health services. The package was based on the Australian Institute of 
Health and Welfare s best practice guidelines for collecting Indigenous data in health data sets and focussed on: 

 &gt; The importance of collecting Indigenous identifier information.

 &gt; The correct way of asking the national standard Indigenous status question and recording the response.

 &gt; Strategies for dealing with special circumstances, such as seeking the Indigenous status of children and patients/
clients who are unconscious.

The first statewide training program concluded in late 2011, targeting hospital staff from Emergency Departments, 
outpatient clinics, inpatient wards and admission offices; and administrative staff from primary health-care services 
(for example community health and community mental health centres). The second statewide training program began 
in late 2012 and is due to finish in late 2013.

According to the Australian Institute of Health and Welfare s quality report Indigenous Identifications in Hospital 
Separations Data (2013), the levels of assessed completeness of Indigenous identification for South Australian public 
hospitals was 91 per cent. This is higher than the national average and 4 per cent higher than the 2007- 08 levels of 
87 per cent. 



page 70Department for Health and Ageing Annual Report 2012-13

Supporting Peak Body Functions

The department has continued to fund the Aboriginal Health Council of South Australia Inc. (AHCSA) as the peak 
body for Aboriginal health. The 2012-13 financial year is the first year under AHCSA s three year funding agreement 
with the Minister for Health and Ageing. AHCSA represents Aboriginal community controlled health services, 
Aboriginal substance misuse services and Aboriginal Health Advisory Committees. AHCSA aims to build the capacity 
of members to create a strong and enduring Aboriginal community controlled health sector and also to improve 
the capacity of mainstream health services to respond to the health needs of the Aboriginal community. The strong 
relationship between SA Health and AHCSA demonstrates the shared vision that Aboriginal control results in better 
health outcomes and the department s strong commitment to transparency and accountability in Aboriginal  
health matters.

Workforce and Career Initiatives 

Supporting a strong Aboriginal workforce is integral to improving Aboriginal health outcomes. Recruiting, retaining 
and mentoring Aboriginal staff is critical to ensure SA Health provides a culturally responsive health system.  
SA Health conducts various activities to support South Australia s Strategic Plan Target 59: increase the participation 
of Aboriginal people in the South Australian public sector to 2 per cent by 2014. 

The department s Aboriginal Health Scholarship program supports Aboriginal university students studying health-
related degrees. It is now in its fifteenth year and during the annual presentation ceremony the inaugural Joint 
Agreement for Scholarship Funding (the agreement) was signed by the Minister for Health and Ageing and the 
scholarships  co-sponsors, Australian Rotary Health. The agreement represents a strengthening of the long standing 
partnership and the ongoing funding commitment between the Minister for Health and Ageing and Australian Rotary 
Health. In 2012, there were 12 new applications and three students graduated. In 2013 there are eight new scholars.

The department is developing the Aboriginal Health Practitioner (AHP) professional career structure for SA Health. 
This is in response to the required national registration of AHPs as of 1 July 2012. SA Health is developing this 
emerging profession that recognises specialist clinical and cultural knowledge. An environmental scan was conducted 
to gain an accurate picture of the current SA Health Aboriginal Health Worker (AHW) workforce who may be  
affected by the registration process. Work is being completed to:

 &gt; Define the scope of practice and career structure for AHPs.

 &gt; Encourage registration of current AHWs.

 &gt; Identifying up-skilling requirements is currently under way.

The department, in partnership with Flinders University, delivered the Learning Set for Aboriginal Managers in 
SA Health program. The program was completed by five participants and had the aim to provide a professional 
development opportunity for Aboriginal middle managers and policy officers, and to gather information about their 
experiences of problems in the workplace. Initial results indicate that participants have experienced positive changes, 
including empowerment. 

Mr Peter Taylor is an example of the high calibre of SA Health Aboriginal employees. Mr Taylor works as an Aboriginal 
Hospital Liaison Officer, as part of the Aboriginal Mental Health Team at Rural and Remote Mental Health Service. In 
2012 he was recognised as an outstanding Aboriginal Worker within Country Health SA Local Health Network. Firstly, 
Mr Taylor was awarded the  Uncle of the Year  during National Aboriginal and Islander Day Observance Committee 
(NAIDOC) week and later was awarded the  the Black Stump  annual award for the Rural and Remote Mental Health 
Service, which recognises the work of individuals who go above and beyond the call of duty in providing services to 
country mental health clients. 



page 71 Department for Health and Ageing Annual Report 2012-13

Reconciliation 

During 2012-13, the department progressed work on initiatives to support its reconciliation commitments. 
Reconciliation is exercised daily in SA Health in practical ways, such as through programs to improve Aboriginal and 
Torres Strait Islander health. SA Health has also developed numerous activities and events to support reconciliation 
between Aboriginal and non-Aboriginal people. 

The department promoted NAIDOC Week (2012), Close the Gap Day (2013), and Reconciliation Week (2013) 
through staff communiqu s, foyer displays, posters, and promotion of events. Staff were also encouraged to attend 
the many and varied reconciliation activities at Local Health Networks, including: 

 &gt;  Join the Conversation: What it Takes to Close the Gap in Palliative Care , a panel discussion held at The Queen 
Elizabeth Hospital during the week of Close the Gap Day in March 2013. 

 &gt; Across Central and Northern Adelaide Local Health Networks a Reconciliation event was hosted at Marra Dreaming 
in partnership with other service providers. A health stall run by Watto Purunna Aboriginal health service included 
health promotion information, influenza vaccinations, child ear health checks, and booking of appointments across 
the two primary health care sites.  

 &gt; Southern Adelaide Nunga Lunches were held fortnightly with core attendees ranging from 45-50 Aboriginal 
community members. 

 &gt; The Women s and Children s Health Network hosted a stall at the NAIDOC Family Fun Day at Torrens  
Parade grounds. 

Promote Aboriginal Community Health and Wellbeing

Aboriginal Environmental Health 

The department delivers the Aboriginal Environmental Health Worker program in partnership with four Aboriginal 
Community Controlled Organisations; Ceduna Koonibba Aboriginal Health Service, Scotdesco Community, Umoona 
Tjutagku Aboriginal Health Service and Pika Wiya Aboriginal Health Service. Funded under South Australia s investment 
in the National Partnership on Closing the Gap in Indigenous Health Outcomes, the focus is to train local workers 
to deliver environmental health programs and messages to local community members to improve community health 
outcomes in the above organisations, which are predominantly set in rural and remote regions of South Australia. 

Aboriginal Environmental Health Worker Certificate II and Certificate III training was provided by the Bachelor Institute 
of Indigenous Tertiary Education. Seven workers successfully completed Certificate III and three workers completed 
Certificate II and graduated in December 2012. 

The organisations and the workers have positively and proactively supported the program and deliver positive 
environmental health messages. Key programs delivered by the workers have included:

 &gt; Dog Health: de-sexing, micro chipping and removing feral dogs from community.

 &gt; Pest Control: engaging professional services for treatment and educating community members about safe practises.

 &gt; Waste Management: recycling programs, encouraging community members to separate rubbish and improve 
disposal methods. 

 &gt; Food Safety: educating community members and schools about safe food practises.

 &gt; Water Safety: water testing for e-coli, installing first flush systems, cleaning gutters and maintaining chlorination 
standards. 



page 72Department for Health and Ageing Annual Report 2012-13

Child and Family Wellbeing 

South Australia s investment under Element Three of the National Partnership on Indigenous Early Childhood 
Development provides funding to the Family Home Visiting (FHV) program and is now offered statewide. Ongoing 
home visits and support to eligible families are provided over a two year period. Nurses are supported by a 
multidisciplinary team including social workers, psychologists, family support co-ordinators and Aboriginal  
health staff. 

The program has been developed for the APY Lands and in February 2012 fortnightly service delivery has commenced 
in Pukatja and Kenmore Park. The program s focus is on infants and children aged up to three years, and their 
families. Visiting services are now provided at Indulkana and Amata with discussions taking place to roll the service 
out in Mimili. As at 31 May 2013, there were 181 active Aboriginal clients statewide. Since commencement of FHV  
in September 2004, 528 Aboriginal clients have successfully completed the program across South Australia. 

Supporting Aboriginal Community Control 

The department and Country Health SA Local Health Network (CHSALHN) is one of a number of agencies engaged 
in a process aimed at establishing an Aboriginal Community Controlled Health Organisation to provide targeted 
Aboriginal health services in the Hills Mallee Southern area. This collaborative activity is being led by members of 
the local Aboriginal community in partnership with the Aboriginal community in the area, CHSALHN, the Aboriginal 
Health Council of South Australia and the Australian Government s Department of Health and Ageing. 

The Aboriginal community in the Hills Mallee Southern area has over many years identified a desire and need for an 
Aboriginal Community Controlled Health Service. All partners are working towards establishment in 2014. SA Health s 
ongoing commitment to this process stems from the conclusive evidence that Aboriginal community control leads to 
improved health outcomes for the community. 

Access to Traditional Healers 

Women s Health Statewide facilitated access to recognised female Traditional Healers for Aboriginal women across 
South Australia. This included access to an Aboriginal Health Worker and a Registered Nurse, and participation in the 
development of a statewide Recognised Traditional Healer Framework with SA Health. Women s Health Statewide 
continues to develop as a culturally safe service and an entry point into the health system for Aboriginal women.



page 73 Department for Health and Ageing Annual Report 2012-13

Office for the Ageing

Objective
Under the Office for the Ageing Act 1995, Office for the Ageing s (OFTA) responsibilities include:

 &gt; Consulting with, and representing the interests and needs of older people.

 &gt; Planning, developing and coordinating state government policies and strategies affecting older people.

 &gt; Monitoring the effect of policies and practices of Australian, state, and local governments on the ageing.

 &gt; Creating social structures in which the ageing are able to realise their full potential as individuals and members  
of the community and are accorded the dignity, appreciation and respect that properly belong to them.

 &gt; Ensuring that the multicultural nature of the community is reflected in the planning and implementation of 
programs and services for the ageing or affecting the ageing.

During the past year, OFTA has continued to deliver an array of programs and services including the South Australian 
Seniors Card Program, the Aged Care Assessment Program; Positive Ageing Development Grants, Grants for Seniors 
and Ethnic Aged Care Grants; and projects under Improving with Age   Our Ageing Plan for South Australia; as well 
as administering the Retirement Villages Act 1987 and Retirement Villages Regulations 2006.

South Australia s Ageing Plan 
The state s ageing plan, Improving with Age: Our Ageing Plan for South Australia (the Plan) was launched in 2006.  
In 2012-13, the Plan assisted OFTA to fulfil the aims and objectives of the Office for the Ageing Act 1995, by 
providing a framework for many diverse, innovative projects benefiting older South Australians.

In 2012-13, grant funding supporting the plan included support for the following projects:

 &gt; $41 774 to Radio for the Third Age Incorporated to deliver services within the scope of Elder Protection which 
consists of presenting a two hour radio program for five days a week to explore the wide range of relevant issues 
to older South Australians. 

 &gt; $25 000 to the University of the Third Age Association to promote low-cost leisure education, social and cultural 
activities to persons aged over 50 years of age who are no longer in full-time employment.

 &gt; A total of $272 496 to five ethno-specific non-government organisations to provide services and activities to frail 
older people and their carers from Culturally and Linguistically Diverse backgrounds.

 &gt; $70 000 to COTA SA to coordinate the annual Every Generation Festival in October which consists of hundreds of 
events and activities held across South Australia to celebrate the achievements of older people.

 &gt; $83 000 to COTA SA for peak body funding to ensure that they work closely with OFTA to advocate on behalf of 
the aged community sector and local communities.

 &gt; $25 000 to COTA SA to carry out the necessary consultation with the older South Australian population to inform 
the preparation of the new ageing plan.

 &gt; $55 000 to the Adelaide Film Festival to deliver the 2013 Adelaide Festival of Ideas that attracts national and 
international speakers to share and exchange knowledge and ideas with communities across the state.

 &gt; $25 000 to the ACH Group to conduct a year-long pilot project that will support and coach a group of people to 
live well in their seventies.

 &gt; $48 559 to the Aged Rights Advocacy Service to administer the Abuse Prevention Program, which it undertakes 
to provide counselling/support, information and advocacy to individuals, agencies and consumers in matters 
pertaining to Elder Protection.

 &gt; $25 000 to the Adelaide Festival Centre to support the program  Bring a friend to Morning Melodies  by providing 
two for one ticket price for Seniors Card holders.

 &gt; $20 000 to the Media Resource Centre to run an over 50s club for the digital age, providing a screening and 
workshop program to the growing seniors market.



page 74Department for Health and Ageing Annual Report 2012-13

In 2012-13 OFTA commenced planning for a new state ageing plan which will serve as a timely replacement for 
the Plan and enable proactive, 21st century polices to be put in place in South Australia, which has the highest 
percentage of older people on the Australian mainland. This work is being undertaken in collaboration with 
the state s peak ageing body, COTA SA. OFTA has provided COTA SA with $25 000 the Plan funds to assist in 
consultations for the new plan. Consultation commenced immediately following the May 2013 launch of  
The Longevity Revolution, the final report of Thinker in Residence, Dr Alexandre Kalache. 

Thinker in Residence
The ageing-specific residency of the internationally renowned Dr Alexandre Kalache concluded in 2012-13.  
Dr Kalache s residency supported the aims and objectives of the Office for the Ageing Act 1995; Improving with Age: 
Our Ageing Plan for South Australia 2006; a range of targets in South Australia s Strategic Plan (including Target 48; 
ageing workforce participation); and the strategic state priorities relating to the health and ageing portfolio.

In 2012-13, OFTA contributed significant in-kind support and liaised closely with key ageing sector stakeholders  
to enable Dr Kalache to achieve his goals. During 2012-13, the Ministerial Advisory Board on Ageing met with  
Dr Kalache on several occasions, providing the diverse voice of the senior South Australian community and serving  
as a confidential  sounding board  for the Thinker. 

During 2012-13 OFTA supported Dr Kalache to meet with the South Australian Minister for Health and Ageing; 
the Australian Government Minister for Mental Health and Ageing and the Commonwealth Commissioner for 
Age Discrimination. Dr Kalache also met with key academic staff from South Australia s three universities, local 
government and business leaders and key community stakeholders. 

Signifying a continuing local involvement, Dr Kalache was appointed as an Adjunct Professor at the Australian 
Population and Migration Research Centre, University of Adelaide, a research centre which liaises closely with OFTA.

Dr Kalache made his final visit to South Australia in October 2012. A senior OFTA staff member was seconded as a 
 hands-on  Kalache catalyst for the three week period, enabling strategic goals to be achieved. During this visit, the 
Minister for Health and Ageing launched a set of Age-friendly Guidelines, South Australia s Communities  for All:  
Our Age-friendly Future and, on 8 October 2012, opened Dr Kalache s well attended final lecture at the Adelaide  
Town Hall.

In the first quarter of 2013, OFTA maintained close liaison with the Thinker s Office, providing editorial assistance 
to enable Dr Kalache to finalise his work. On 30 May 2013, on behalf of the Minister for Health and Ageing, the 
Parliamentary Secretary to the Premier, Mrs Leesa Vlahos MP launched The Longevity Revolution by Dr Alexandre 
Kalache, Thinker in Residence, at COTA SA.

The Longevity Revolution s 41 recommendations are being considered in the development of the state s new  
ageing plan. 

Preventing the Abuse of Older People
On 16 November 2012, OFTA established the Review of Our Actions Steering Committee to review and update  
the existing Our Actions to Prevent the Abuse of Older People Framework 2007. 

The Our Actions Steering Committee was chaired initially by the Executive Director of OFTA and then by the Executive 
Director, Policy and Commissioning, and convened four meetings during November 2012 and May 2013. Committee 
membership included agencies such as the Alliance for the Prevention of Elder Abuse, Australian Government 
Department of Health and Ageing   South Australian State Office, Domiciliary Care, University of South Australia, 
Flinders University, SA Health Mental Health Services for Older People, SA Health Policy and Legislation Branch, 
Alzheimer s Australia (SA), and Aged and Community Services SA and NT. 

The Review of Our Actions explored recommendations from the Office of the Public Advocate s Vulnerable Adult 
Project Closing the Gaps Report 2011, launched on 14 June 2012 at the World Elder Abuse Awareness Day 
Conference. The Vulnerable Adult Project was funded $100 000 by OFTA during 2011-12.

This report recommended legislative reforms to enable provisions for an  Adult Protection Act  and, secondly, 
enhancing abuse response to vulnerable older people through a whole of government Safeguarding Vulnerable 
Adults Policy Framework, underpinned by a Charter of Rights and Freedoms of Older Persons. 



page 75 Department for Health and Ageing Annual Report 2012-13

As a result of the review, the draft South Australian Strategy for Safeguarding Older People 2014-21 was  
released at the 2013 National World Elder Abuse Awareness Day Conference for consultation early in the next 
reporting period.

This strategy, once finalised, will replace Our Actions to Prevent the Abuse of Older People 2007 as the overarching 
whole of community and government framework to ensure older people living in the community are safeguarded 
and their rights are protected.  

It has been developed with high level collaboration between key service providers and relevant state government 
agencies and builds on existing strategies in Australia and internationally. Key features of the strategy include:

 &gt; A newly developed South Australian Charter of the Rights and Freedoms of Older People   the first of its kind  
in Australia.

 &gt; Safeguarding Older People   principles for intervention from a rights based approach.

 &gt; Safeguarding Older People   a continuum model for service providers.

The strategy, once completed, will inform further development of accompanying documents to support 
implementation and evaluation of prevention, early intervention and protection practices, taking into account 
legislative, policy and service responses over a seven year time frame.

When completed, the strategy will contribute to achieve five key outcome areas:

 &gt; Safer communities through a shared responsibility for safeguarding all older people (population based approach).

 &gt; Minimised abuse risk through awareness, education, information (primary intervention).

 &gt; Implement strategies to build capacity for early interventions (secondary intervention) across national, state,  
local and non-government.

 &gt; Develop guidelines, pathways and protocols for service providers to respond and intervene with alleged cases  
of abuse (tertiary interventions).

 &gt; Establish data collection, reporting and evaluation frameworks and mechanisms to implement evidence base  
into practice. 

South Australia s Communities for Life: Our Age-friendly Future
In October 2012, OFTA released South Australia s Communities for Life: Our Age-friendly Future Guidelines and 
Toolkit. Based on the World Health Organization (WHO) Age-friendly Cities Principles, development of the three-
part guidelines culminated from extensive consultations and partnerships with state and local government key 
stakeholders and the private sector:

 &gt; Residential Development Guidelines which provide developers with an opportunity to integrate principles for  age 
friendly  design when developing plans. These guidelines were tested against Housing SA s Woodville West Renewal 
Development Project which achieved a high commendation for age-friendly environment and building design, 
demonstrating leadership in best practice for  age friendly  design principles.

 &gt; Local Government Guidelines and complementary toolkit to enable councils to undertake a self-assessment of  
their existing age-friendly policies, programs, practices, asset provision and maintenance, planning, community  
and civic engagement.

 &gt; State government Guidelines to enable developments that help achieve age-friendly statewide policies, plans, 
programs and services. 

Now broadly available, the guidelines provide practical ways for agencies across any sphere of government to 
implement  age-friendly  approaches to policy, planning and service development and delivery that enable older 
people to lead more active lives and remain connected and engaged in their communities. 

The guidelines are informed by the advice and expertise of Dr Alexandre Kalache, world renowned ageing expert and 
Adelaide Resident Thinker 2010-12 and underpinned by the World Health Organization s Active Ageing Pillars: health, 
participation, security and life-long learning. 



page 76Department for Health and Ageing Annual Report 2012-13

Grants for Seniors and Positive Ageing Development Grants
Grants for Seniors (GFS) and Positive Ageing Development Grants (PADG) support opportunities for older people 
to be involved and connected with their local communities. The GFS and PADG grants provide one-off funding for 
projects to organisations, including clubs, educational and training institutions, arts and cultural groups, museums, 
libraries, theatres, self-help groups, recreational and sporting groups and volunteer organisations.

PADG grants are one-off grants up to $25 000 each, provided to community organisations for projects which provide 
opportunities for people in line with the following:

 &gt; Enabling choice and independence.

 &gt; Participation and learning.

 &gt; Positive perceptions of older people.

During 2012-2013, PADG grants totalling $201 651 were allocated to 14 community organisations and supported  
12 900 older people. Examples of these grants included:

 &gt; Creative reminiscence for older people in residential care.

 &gt; Healthy eating, happy living.

 &gt; Community garden friendship project.

 &gt; IT workshops and strategies for overcoming isolation for grandparent carers.

GFS grants are one-off grants up to $5000 each for smaller purposes such as buying equipment or paying for a 
trainer to run activities. During 2012-13 GFS totalling $188 162 were allocated to 76 community organisations  
and supported 11 100 older people.

Seniors Card
The Seniors Card is issued by all state and territory governments to eligible senior residents, to encourage the 
contribution they have made and continue to make to the community. The Seniors Card, an initiative in partnership 
with the provider sector, entitles senior Australians to a range of benefits provided by both government and  
private enterprise.

At 30 June 2013, there were 331 000 Seniors Card holders recorded in the SA Seniors Card database, compared to 
321 000 the previous year.

The 2013 Seniors Card Discount Directory, Your Lifestyle Guide, released in December 2012, lists businesses that offer 
discounts to Seniors Card holders. Benefits for Seniors Card holders include:

 &gt; Free off-peak public transport on the Adelaide Metro network.

 &gt; Approximately 50 per cent discount on Adelaide Metro public transport at all other times outside of the free  
travel periods.

 &gt; Concession travel on interstate public transport services.

 &gt; Discounts on a broad range of products and services offered by businesses from a wide variety of industries.

 &gt; Rebates on the Emergency Services Levy and Council rates, subject to eligibility.

Launched in February 2013, WeekendPlus is a digital magazine produced by the Seniors Card Unit. Nearly 50 000 
Seniors Card holders receive information from the Government, business partners and the community each fortnight 
via this interactive, lifestyle publication accessible from any device (desktop, tablet, smart phone).

Eligibility criteria and benefits of the Seniors Card vary slightly between each state and territory. Applicants for a  
South Australian Seniors Card must:

 &gt; Be aged 60 years or over.

 &gt; Be a permanent resident of South Australia.

 &gt; Not work more than 20 hours per week in paid employment (can be averaged over a 12 month period if casual  
or ad-hoc hours are worked, with members of the clergy and primary producers exempt from the working  
hours criteria).



page 77 Department for Health and Ageing Annual Report 2012-13

New Seniors Cards featuring Metrocard technology were posted to the homes of Seniors Card holders beginning 
in October 2012. Concurrently, advertising campaigns about the new Metrocard technology and the importance of 
seniors updating their contact details (to ensure valid mailing addresses) ran from October 2012 to January 2013.  
This resulted in a spike in phone calls across this period which is shown on the following graph.

Figure 30   Seniors Card program   new applications and telephone enquiries

 

 

4 
94

7 

3 
82

9 5 
24

3 

4 
32

0 6
 0

49
 

4 
34

5 

6 
29

3 

4 
80

3 

4 
84

6 

5 
12

6 

5 
43

0 

4 
54

4 

4 
83

2 

4 
87

7 

7 
52

2 

4 
33

9 

4 
84

1 

3 
95

5 

8 
00

2 

4 
25

7 

4 
06

4 

17
 5

40
 

12
 4

08
 

6 
63

2 

0 

2 000 

4 000 

6 000 

8 000 

10 000 

12 000 

14 000 

16 000 

18 000 

20 000 

Jul   Sep 
2010 

Oct   Dec 
2010 

Jan   Mar 
2011 

Apr   Jun 
2011 

Jul   Sep 
2011 

Oct   Dec 
2011 

Jan   Mar 
2012 

Apr   Jun 
2012 

Jul   Sep 
2012 

Oct   Dec 
2012 

Jan   Mar 
2013 

Apr   Jun 
2013 

N
u

m
b

er
 o

f 
n

ew
 a

p
p

lic
at

io
n

s 
an

d
 t

el
ep

h
o

n
e 

en
q

u
ir

ie
s 

Period 

Number of new applications Number of telephone enquiries 

 

Data source: Office for the Ageing.

Retirement Villages 
A publicly available register of all South Australian retirement villages was established on 1 July 2007. OFTA holds  
a hard copy of the register which can be viewed by members of the public on request.

Registration of retirement villages allows any interested party to identify whether a particular accommodation scheme 
for retirees is covered by the Retirement Villages Act 1987. It also enables OFTA to more easily collect data for trend 
analysis and communicate with administering authorities of retirement villages.

Minister Snelling announced the establishment of a Parliamentary Select Committee to review the Retirement Villages 
Act 1987 in April 2013. The Select Committee s report is due to be presented in the next reporting period. 

Figure 31   Growth of retirement villages

459 
466 

483 

509 
517 519 

420 
430 
440 
450 
460 
470 
480 
490 
500 
510 
520 
530 

20
07

/0
8 

20
08

/0
9 

20
09

/1
0 

20
10

/1
1 

20
11

/1
2 

20
12

/1
3 

N
u

m
b

er
 o

f 
V

ill
ag

es
 

Year 

Number of villages 

 

 

Data source: Retirement Villages Register held at the Office for the Ageing.



page 78Department for Health and Ageing Annual Report 2012-13

As at 30 June 2013, a total of 519 retirement village schemes have been registered, operated by 151 companies/
groups/organisations, eight of which are managed from interstate. 

A separate annual report on activities associated with administration of the Retirement Villages Act 1987 has been 
prepared for 2012-13. The annual report must be laid before both houses of Parliament by 28 November 2013.

Aged Care Assessment Program
The Aged Care Assessment Program (ACAP) is a cooperative working arrangement between the Australian and state 
governments to fund and operate the 11 Aged Care Assessment Teams (ACAT) in the state. The core objective of the 
ACAP is to comprehensively assess the care needs of frail older people and to assist them to gain access to the most 
appropriate types of care. Assessments are carried out typically in the person s usual place of residence such as in the 
person s home; however assessments can also be conducted in hospital or in residential aged care facilities.

Assessments are undertaken by multi-disciplinary teams and are comprised of mainly social workers, registered  
nurses and occupational therapists, with small administration support. The Adelaide ACAT also has the use of  
medical officers in several of the major hospitals in the metropolitan area.

The majority of funding is invested in staff to assess and approve older people for Australian Government subsidised  
aged care services such as:

 &gt; Community based support: Community Aged Care Package or Extended Aged Care at Home package or  
EACH Dementia.

 &gt; Residential care: low or high level care.

 &gt; Residential respite care: low or high level care.

 &gt; Post-hospital support: Transition Care Program.

South Australia received $8.413m under the ACAP Funding Agreement to administer the ACAP in South Australia 
with approximately 13 816 comprehensive assessments conducted by an ACAT in South Australia during 2012-13.

Throughout 2012-13, South Australia has continued to implement reform initiatives around the timeliness, quality 
and consistency of assessments and to improve data quality. SA Health undertook an evaluation of the ACAP and 
ACATs in South Australia through August-December 2012 with the aim to develop an integrated comprehensive 
assessment system. The recommendations and findings of this evaluation will also assist with preparations for the 
anticipated changes to Australian Government funding arrangements with the states and territories, with the move 
to a purchaser provider model post June 2014.



page 79 Department for Health and Ageing Annual Report 2012-13

Public Health

Public Health for the 21st Century
South Australia has modernised its principal public health legislation by replacing the Public and Environmental 
Health Act (1987) with the South Australian Public Health Act 2011 (the Act). As a 21st century piece of legislation 
it is aimed at tackling contemporary public health challenges. This means it provides an updated range of powers for 
taking action on clearly identified and longstanding public health concerns such as the prevention, management and 
control of infectious diseases and environmental health risks. It also contains new measures that tackle what are now 
understood to be significant public health concerns, namely the growing spread of non-communicable conditions (e.g. 
cardiovascular conditions, certain forms of cancer and other obesity related conditions) as well as provisions for taking 
action on the social, environmental and economic determinants of health. The December 2012 edition of the Public 
Health Bulletin South Australia contains a comprehensive description of the powers and potential of the new Act.
(http://www.dh.sa.gov.au/pehs/publications/public-health-bulletin.htm).

The Act has been progressively implemented over two years (2012-13) in partnership with the Local Government 
Association of South Australia (LGASA). Local Councils continue to play a central role in the protection and promotion 
of public health and the Act explicitly recognises them as the local public health authority. By agreement with the 
LGASA it was decided to commence the Act in stages to allow for essential training and capacity development in local 
councils. SA Health specifically funded the LGASA over five years in the first instance to undertake capacity building 
with local councils and to support their public health functions.

Local Councils appoint environmental health officers as authorised officers under the Act to specifically undertake 
risk assessments and management of public health risks in their area. During 2012-13 SA Health in conjunction with 
LGASA provided training in the provisions of the new Act to the whole Local Government environmental health 
workforce. The aim was to ensure common understanding and approaches to the administration and consistent 
interpretation and exercise of powers contained in the Act.

The Act became fully operational in June 2013 which included the remaking of the full suite of regulations for both 
infectious diseases and environmental health. Formal policies also being developed under the Act include a policy 
dealing with the public health risks of severe domestic squalor and a policy on the remediation of clandestine  
drug laboratories.  

Provisions for Local Councils to undertake public health planning commenced on 1 January 2013 and the first State 
Public Health Plan was released for public consultation in January 2013. The State Public Health Plan articulates 
a vision for the purpose of public health; South Australia: A Better Place to Live. This vision encapsulates the 
understanding that a community s health and wellbeing cannot be secured by the actions of the health system 
working alone, it can best be secured and improved through having collaborative partnerships across sectors and 
spheres of government. The planning system described in the Act provides the basis for this collaborative planning.

In addition to articulating the vision and the purpose of public health in the 21st century the State Public Health Plan 
also identifies four key areas for priority action. These four areas are:

 &gt; Stronger and Healthier Communities and Neighbourhoods for All Generations.

 &gt; Increasing Opportunities for Healthy Living, Healthy Eating and Being Active.

 &gt; Preparing for Climate Change.

 &gt; Sustaining and Improving Public and Environmental Health Protection.

The general response to the State Public Health Plan has been positive and it is being finalised for release in the 
coming period. The State Plan also provides a framework for Local Council plans and contributes to the state 
government s strategic priority of  Safe Communities, Healthy Neighbourhoods . 



page 80Department for Health and Ageing Annual Report 2012-13

Chief Public Health Officer s Report
To meet the requirements of Section 23 of the South Australian Public Health Act 2011, the inaugural Chief Public 
Health Officer s Report has been developed and will be released early in 2013-14. The report covers the period from 
30 June 2011 to 31 December 2012. 

As required under Section 23 of the South Australian Public Health Act 2011, the report addresses:

 &gt; Public health trends, activities and indicators in South Australia.

 &gt; The implementation of the State Public Health Plan.

 &gt; The administration of the Act.

The report describes the strength, scope and diversity of public health functions, including the prevention and control 
of communicable disease and non-communicable disease, epidemiology, environmental health, health risk factors  
and the numerous agencies providing public health services.

The report incorporates health themes and indictors that draw on information from a wide range of sources and 
recognises that public health and community wellbeing are a shared concern and are impacted by many different 
social, economic and environmental factors.

For the first time, indicators for the social determinants of health, such as children s development, urban design, 
income and employment have been integrated into the public health reporting framework.

South Australian Public Health Council
The Chief Public Health Officer is assisted and advised by the South Australian Public Health Council (the Council). 
Established in February 2012, the Council is drawn from a wide range of persons with expertise in public health and 
related fields. Council members and their deputies are appointed by the Governor from nominations provided by  
the Local Government Association of South Australia, Environmental Health Australia, Environmental Protection 
Authority as well as Ministerial nominees from areas including prevention and control of communicable disease, 
health promotion, the non-government sector and other areas of recognised public health expertise. In this initial 
period the Council has provided advice specifically on the implementation of the South Australian Public Health 
Act 2011, public health planning processes, the development of indicators to use in public health planning and the 
development of a range of guidance materials to assist those charged with the administration of the Act. 

Health in All Policies
Health in All Policies (HiAP) is an approach to join up government to address complex public policy issues. 
Incorporating a focus on population health into the policy development process of various sectors and agencies has 
allowed the South Australian Government to address the social determinants of health in a more systematic manner. 
By considering health impacts across all policy domains such as agriculture, education, the environment, fiscal policies, 
housing and transport, population health can be improved. HiAP seeks to highlight the connections and interactions 
between health and policies from other sectors and identify the gains for both policy agendas.

The department and the Department of the Premier and Cabinet continue to collaborate on the implementation of 
the HiAP initiative across government. The implementation is overseen through the governance arrangements for the 
government s seven strategic priorities. The South Australian Public Health Act 2011 provides a legislative basis for 
integrating HiAP approaches, as well as other related assessment procedures, into the fabric of standard government 
development and decision-making processes.

The HiAP unit has a significant program of work with partners across government, and includes projects focusing 
on South Australia s Strategic Plan targets and the Cabinet Priorities. Work completed in 2012-13 includes the 
implementation of healthy weight commitments, the development of a health and wellbeing atlas for the Upper 
Spencer Gulf region. Current project focus includes enhancing engagement between service providers and families 
with young children; supporting vulnerable 15-24 year olds to transition from education to be earning or learning; 
and supporting the health and wellbeing of international students.



page 81 Department for Health and Ageing Annual Report 2012-13

HiAP also undertook an assessment of linkages between each of the seven Cabinet strategic priority areas and the 
health and wellbeing of the population, particularly chronic disease. This assessment identified potential health 
impacts, and highlighted opportunities for the priority area to improve population health as well as achieve the 
priority s public policy objectives.

 &gt; The Australian Government Department of Health and Ageing coordinated the development of a national book 
Action on the Social Determinants of Health: Case Studies for Australia. South Australia s HiAP initiative was 
showcased in the book, which was distributed at the 8th Global Conference on Health Promotion held in Helsinki 
10-14 June 2013.

 &gt; The department lead the South Australian Government s response to the Senate Inquiry into Australia s domestic 
response to the World Health Organization (WHO) Commission on Social Determinants of Health (SDH) report 
 Closing the gap within a generation . The submission focussed on examples of key approaches the South 
Australian Government has committed to in addressing the SDH, including HiAP, Early Childhood Development 
Reforms, Aboriginal health and wellbeing and South Australian  Public Health Act 2011.

Asbestos
To encourage householders to consider asbestos when renovating their homes or undertaking maintenance, an 
updated asbestos flier was sent to more than 600 000 home owners across South Australia with their Emergency 
Services Levy invoice. This formed part of the government s Asbestos Safety Action Plan and caused an increase in 
enquiries to the department concerning safe handling of asbestos.

The department also helped develop and review the document entitled Asbestos: A guide for householders  
and the general public published by the Australian government along with a set of frequently asked questions.  
The department also provides representation to the SA Asbestos Coalition and the SA Government Asbestos  
Advisory Committee.

Toxicity and Site Contamination
Human health risk assessments for government and other stakeholders are provided by the department s 
Public Health Toxicology Section. The purpose is to inform the management of risks arising from environmental 
contamination especially for residential sites. Where the Environment Protection Authority is the lead agency, the 
activity is coordinated through the joint department and Environment Protection Authority Site Contamination 
Working Group.

The contamination of shallow ground water and soil vapour by various pollutants has been the most pressing issue 
this year. Other health risk assessments performed included the assessment of the potential health effect from 
exposure to pesticides. Between July 2012 and June 2013 scientific evaluation were conducted on 25 sites and there 
were 12 notifications to the Minister for Health and Ageing.

Safe Drinking Water Act 2011
The Safe Drinking Water Act 2011 (the Act) was passed by Parliament in May 2011 and Draft Safe Drinking Water 
Regulations were developed in 2012. After public consultation in August-September the Regulations were gazetted 
on 6 December 2012 and came into operation with the Act on 1 March 2013.

The Act was developed to provide greater clarity and direction to drinking water providers on how to provide safe 
drinking water and how this is measured. The Act replaces regulation of drinking water other than packaged water 
under the Food Act 2001 and Food Regulations 2002. The main provisions of the Act include the registration of 
drinking water providers, implementation of Risk Management Plans, regular audits or inspections, reporting of 
results to SA Health and provision of results to customers. The regulations provide specific information required 
for effective implementation including recognition of the Australian Drinking Water Guidelines and exemptions for 
domestic dwellings and low risk premises deriving drinking water from rainwater tanks.

To support implementation of the Act and the Safe Drinking Water Regulations 2012 a range of fact sheets and risk 
management templates have been developed and further guidance is in preparation. Existing drinking water providers 
were required to register by 1 June 2013 and over 100 registrations have been received to date. Drinking water 
providers are required to develop risk management plans by 1 March 2014.



page 82Department for Health and Ageing Annual Report 2012-13

Port Pirie Transformation Project
The 2012 annual Port Pirie Technical Blood Lead report, based on screening results from the Port Pirie Environmental 
Health Centre run by Country Health SA Local Health Network, indicated that between 76.2 per cent and 79.4 per 
cent of children under five years of age living in Port Pirie had a blood lead level less than 10 micrograms per decilitre. 
In order to reduce the number of children exposed to unacceptable levels of lead the smelter, operated by Nyrstar Pty 
Ltd, identified the need to introduce new technology to transform the way the plant operates.

On 3 December 2012 the South Australian and Australian Governments along with Nyrstar announced that a 
negotiated agreement had been forged, that will see the expenditure of $350m in the construction of an advanced 
poly-metallic processing and recovery facility. In preparing for this announcement, the department provided technical 
analysis of ways children are exposed to lead and worked with the Commonwealth Scientific and Industrial Research 
Organisation (CSIRO), the smelter and the Olympic Dam Task Force which is overseeing the transformation process.

The department s Environmental Health Centre based in Port Pirie will continue to provide client focused support to 
local residents whose children are or are likely to be exposed to lead. A targeted lead abatement program, auspiced 
by the Transformation Project, is being scoped that seeks to enhance and introduce new initiatives into programs 
currently run in order to achieve the best result for children. The department will also continue to run a screening 
program and provide client and community programs aimed at helping caregivers and parents reduce their children s 
lead exposure.

Wastewater Management
During 2012-13 the department issued 155 approvals for wastewater systems across South Australia. These systems 
ranged in size from large treatment plants serving entire mine sites and towns, to small domestic wastewater 
treatment units.

A new regulatory regime to modernise the management of sewage treatment in South Australia was established 
through the commencement of the South Australian Public Health (Wastewater) Regulations 2013 (the Regulations) 
on 16 June 2013. The Regulations include two Prescribed Codes, the Onsite Wastewater Systems Code and the 
Community Wastewater Management Systems Code that contain information and technical standards relating to 
wastewater systems. 

Development of the Regulations and Codes was prompted by the continuing need to manage public health 
risks through properly regulated wastewater systems, the mandatory legislative review process and the need to 
accommodate advances in wastewater technologies (particularly in the area of wastewater treatment and reuse). 
These advances required regulatory changes to allow usage of new types of systems not contemplated by the 
previous regulations, adoption of uniform national standards and to improve administration.

It is anticipated that this major change in wastewater focussed legislation will produce significant public health  
and industry benefits into the future. 

Development of the Guideline and Public Health Policy for the Management of Severe 
Domestic Squalor (A Foot in the Door)
On 4 June 2013 SA Health released the draft severe domestic squalor guideline entitled A Foot in the Door (the Policy 
Guideline) and the South Australian Public Health Severe Domestic Squalor Policy 2013 (the Policy Directive) for  
public consultation. 

The Policy Directive has been created under Section 53 of the South Australian Public Health Act 2011 and together 
with the Policy Guideline aims to support local government environmental health officers in dealing with cases of 
severe domestic squalor. The Policy Guideline also aims to assist other agencies in the management of incidents of 
severe domestic squalor through the promotion of a collaborative framework that aims to achieve better outcomes 
for individuals and families living in severe domestic squalor.

Interested individuals and agencies have been encouraged to provide feedback on the Policy Guideline and Policy 
Directive before they are finalised in late 2013.



page 83 Department for Health and Ageing Annual Report 2012-13

Aboriginal Environmental Health
Under the Council of Australian Governments National Partnership Agreement on Closing the Gap in Indigenous 
Health Outcomes, SA Health coordinates the Aboriginal Environmental Health Worker Program (the Program) in 
partnership with Aboriginal Community Controlled Health Organisations. The Program employs 10 Aboriginal 
Environmental Health Workers in rural and remote regions of South Australia (West Coast, APY Lands, Port Augusta 
and Coober Pedy).

The Bachelor Institute of Indigenous Tertiary Education has provided the training, delivered on site in the communities, 
for Certificates II and III in Indigenous Environmental Health. All participants in the Program have successfully 
completed Certificate II, with the majority also completing Certificate III in 2012.  

Over the course of the Program, the now qualified Aboriginal Environmental Health Workers have improved and 
developed their skills, confidence and knowledge in delivering the message of  Healthy Ways  to their communities. 
This local approach has been very effective in empowering and enabling community members to keep themselves  
and their families healthy through safe environmental health practices including maintaining clean water supplies, 
pest control, injury prevention and dog management. 

The support to the program by the community organisations, government agencies and non-government 
organisations has been exciting and positive, and contributed significantly to both the development of the 
participants and the positive health outcomes for their communities.

Tobacco Control
As guided by the South Australian Tobacco Control Strategy 2011-16, SA Health undertakes activities and programs 
aimed at improving the level of compliance of the South Australian community with the Tobacco Products Regulation 
Act 1997 and the Tobacco Products Regulations 2004.

Authorised officers respond to complaints and queries from the general public and businesses through provision of 
advice, information and resources, as well as site visits and enforcement action where appropriate.

Within the last 18 months, a number of new provisions have been added to the Tobacco Products Regulation Act 
1997 (the Act) and the Tobacco Products Regulations 2004, primarily relating to smoking bans in prescribed public 
areas (children s play equipment; covered public transport stops; declared outdoor areas) and  out-of-sight  display 
requirements in general retail outlets (specialist tobacconists temporarily exempted). Officers have been working with 
the community, businesses and landowners to introduce these new laws through an educative approach aimed at 
changing behaviours and community expectations over time.

The new laws also allow for the authorisation of appropriate local government officers under sections 49-52 of the 
Act, with 38 staff from four councils authorised in their areas to-date.

To assess general compliance with the Act and the Tobacco Products Regulations 2004, with a particular focus on the 
recent  out of sight  display restrictions, authorised officers from the Health Protection Branch conducted inspections 
of 513 premises, the majority of these being retail outlets and hotels/bars (357 and 95, respectively). Compliance was 
generally good, with retailers adapting well to the new laws.



page 84Department for Health and Ageing Annual Report 2012-13

Mosquito Control
The 2012-13 summer period was characterised by below average rainfall in the Riverland where Ross River virus and 
Barmah Forest virus are endemic. Mosquito borne disease notifications were below the five year average and no cases 
of Murray Valley Encephalitis virus were reported.

The University of South Australia (under contract to seven councils) conducted mosquito surveillance and localised 
control activities along the River Murray (from Renmark through to Lake Alexandrina). Mosquito abundance varied 
along the river surveillance sites but the overall arbovirus risk was considered low.

SA Health continued to support mosquito surveillance and control programs administered by local councils through 
the mosquito control subsidy program. The subsidy has been reviewed to better support mosquito management 
initiatives in local government areas where mosquito borne diseases are endemic.

SA Health s revised sentinel surveillance program was implemented throughout the 2012-13 mosquito season. 
Five dedicated sentinel flock have been established at strategic locations from Paringa through to Meningie. No 
seroconversions for Murray Valley Encephalitis virus or Kunjin virus were recorded during the reporting period.

The  Fight the Bite  arbovirus prevention campaign underwent review which included community consultation on the 
effectiveness of the campaign and its resources. A reinvigorated campaign will be launched in time for the 2013-14 
arbovirus season.

Food Regulation 

The Social Development Committee Inquiry into Food Safety Programs

This inquiry was established by the South Australian Parliament in November 2010 to investigate and report on the 
merits or otherwise of schemes that provide information to the public on the results of food safety inspections and 
non-compliance with the Food Act 2001. 

In September 2012 the Committee reported its findings in the 33rd report of the Social Development Committee 
titled  Inquiry Report into Food Safety Programs . This report contains 20 recommendations relating to the 
development of a centralised, statewide, food safety rating scheme in South Australia, more commonly known  
as a  scores on doors  scheme.

The response of the Minister for Health and Ageing to the Report was tabled in Parliament on 19 February 2013  
and commits to working with local government, industry and consumers to develop and implement such a scheme  
in South Australia. Work is now progressing in this area.

The Report and Ministerial response are available on the South Australian Parliament website under completed 
inquiries: www.parliament.sa.gov.au/Committees/Pages/Committees.aspx?CTId=5&amp;CId=182

Department for Health and Ageing and Local Government Working Together

Food Regulation in South Australia is a partnership between state and local government. A memorandum of 
understanding (MOU) between the Minister for Health and Ageing and the Local Government Association of South 
Australia (LGASA) clarifies the responsibilities for administration of the Food Act 2001 and establishes a joint work 
plan between SA Health and the LGASA. 

During 2012-13 work progressed on the projects contained in the joint work plan. SA Health coordinated a pilot with 
four councils to assess the useability of a new risk classification framework for food businesses. Positive feedback was 
received and it is anticipated that this tool will be released later in 2013. Work on consistent implementation and 
support for councils to enable successful roll out of this new framework is currently being undertaken.

SA Health and the LGASA are currently reviewing the joint work plan established under the MOU to focus on 
emerging issues. SA Health continues to lead and support the working group overseeing this work plan as well  
as the detailed work being undertaken within each of the work plan projects.



page 85 Department for Health and Ageing Annual Report 2012-13

National Primary Production and Processing Standards 

Implementation of the Primary Production and Processing Standards of the Australia New Zealand Food Standards 
Code (the Code) that apply to businesses captured by the Food Act 2001 (the Act) continued during 2012-13. 

Following consultation with local government in 2011-12, a framework for the administration of Primary Production 
and Processing Standards under the Act was published in October 2012. This framework explains the factors 
that will be used to decide the regulatory responsibilities of SA Health and local government in relation to these 
standards and how the standards will be monitored and enforced. The framework underpins more detailed SA Health 
Implementation and Monitoring Policies that will be developed for each of the Primary Production and Processing 
Standards. 

Seafood and Ready-to-eat Meats

SA Health Implementation and Monitoring policies for seafood and for ready-to-eat meats were also published 
in the report period. To implement these policies SA Health conducted information sessions for local government 
and councils have been asked to inform SA Health of any businesses in their areas that may be captured under the 
standards. As this occurs SA Health and the local council are working together to ensure there is effective monitoring 
of these businesses.

Eggs

During 2012-13, a new Primary Production and Processing Standard for Eggs and Egg Products became enforceable. 
This occurred in conjunction with an updated commodity standard for Eggs and Egg Products. Together, these 
standards regulate the egg supply chain from paddock to plate as they cover the control of food safety risks at the 
primary production stage, the supply and sale of unacceptable eggs (cracked or dirty eggs), and traceability of eggs 
(stamping of individual eggs) for retail sale or catering purposes.

These Standards aim to reduce food borne illness associated with eggs by preventing the sale of unacceptable 
(cracked or dirty) eggs for retail sale or catering purposes. In the event of an outbreak situation, the traceability of 
eggs will be improved because of the requirement of each egg to be stamped with the producer s or processor s  
unique identifying mark. 

SA Health is working with Local Councils and Biosecurity SA to implement these new egg Standards. SA Health 
in partnership with Biosecurity SA has actively monitored the retail sector for compliance with these standards. 
Inspection of all brands and varieties of eggs in the marketplace was conducted to assess compliance with the new 
egg stamping requirement and the requirement that cracked or dirty eggs must not be sold. Compliance is high 
throughout the industry, with only one egg producer requiring additional time to acquire egg stamping equipment.

Front of Pack Food Labelling

In response to the recommendations of the Independent Review of Food Labelling Policy and Law, the Legislative 
and Governance Forum on Food Regulation (FoFR) agreed to develop an easily understood interpretive front of 
pack labelling system for Australia. SA Health has been closely involved in the work that has been undertaken in 
partnership with industry, public health, health professional and consumer groups to design a system. 

On 14 June 2013 the FoFR agreed that this label will consist of a health star rating element from   to five stars and 
a nutrient information element for saturated fat, total sugars, energy and sodium content. The label will allow direct 
comparison of products with higher star ratings representing better nutritional choices. 

Figure 32   Proposed Front of Pack Label 

 



page 86Department for Health and Ageing Annual Report 2012-13

The FoFR also agreed that the preferred implementation option is a voluntary system, subject to there being 
consistent and widespread uptake of the labelling. If, following evaluation after two years, voluntary implementation 
is found to be unsuccessful, a mandatory approach will be required.

Over the next 12 months work to finalise the system will be undertaken and marketing and education strategies  
will be developed. 

Kilojoule (KJ) Labelling Monitoring and Compliance 

On 23 February 2013 South Australian Food Regulations 2002 to require multiple site food businesses to display  
KJ information at the point of sale became enforceable.

Only businesses that sell standardised food from 20 or more outlets in South Australia or 50 or more outlets 
nationally are captured by the new requirements. The types of businesses that must comply include burger, pizza, 
coffee, ice cream, beverage, bakery and salad chains. 

Industry was provided with a 12 month implementation period from February 2012 and a User Guide explaining  
the new requirements was published in October 2012. 

SA Health is responsible for monitoring and enforcing compliance with the requirements. To date there are 564  
multi-site food businesses captured in South Australia. 

Those businesses which are currently below 20 multi-site food businesses in South Australia will be closely monitored 
to ensure they are provided will relevant information to be able to comply with the Regulations.

SA Cervix Screening Program

SA Health runs a statewide program to maximise cervical screening in line with the national guidelines. The focus is 
primarily on under screened groups of women. This includes Aboriginal and Torres Strait Islander women, younger 
women and women from rural and remote regions.

South Australia s participation rate for 2010-11 was 59.7 per cent, which was higher than the national average. 
South Australia had the second highest rate in Australia with the range for other jurisdictions being from  
53.5 per cent in Northern Territory to 60.3 per cent in Victoria.

Nationally, participation was similar across remoteness areas, with the highest participation of 58 per cent in inner 
regional and the lowest of 55 per cent in remote areas.



page 87 Department for Health and Ageing Annual Report 2012-13

Communicable Diseases

Sexually Transmissible Infection and Blood Borne Virus Section 

The Sexually Transmissible Infection and Blood Borne Virus (STI and BBV) Section (the Section) provides a central 
coordination role for developing and monitoring the implementation of state and national policy in relation to HIV, 
STIs, hepatitis B and hepatitis C in South Australia. In 2012-13 the Section administered $8.6m in state and Australian 
Government funding to non-government organisations for HIV, STI and BBV prevention, education, care, support and 
advocacy programs throughout the state.

The Section provides support to the SA Health South Australian STI and BBV Advisory Committee and its two 
sub-committees. This committee is the peak structure of the partnership between government, non-government 
organisations, researchers, clinicians and affected communities in South Australia, which underpins the public health 
response to this program area. It monitors surveillance and epidemiology and provides expert strategic advice on 
the planning, implementation, monitoring and evaluation of the strategies and activities that make up the South 
Australian health system s response to STIs and BBVs. 

A review of the 2009-12 HIV and Hepatitis C Funding and Service Plan for Non-Government Services identified new 
and emerging priorities for HIV, hepatitis B and hepatitis C in South Australia based on alignment with state action 
plans, Australian Government strategies, current research, reviews and surveillance epidemiology. The review proposes 
fewer service models than in 2009-12 whilst maintaining key program elements of community development, 
prevention, education, care and support. The review was endorsed by the department s Executive in May 2013. 

The impact of the review is the development of updated service delivery models for the non-government organisation 
sector for the grant funding period 2013-16. The updated service delivery models will prioritise:

 &gt; Increasing access to and uptake of voluntary HIV, hepatitis B and hepatitis C testing. 

 &gt; Enhancing access to and uptake of HIV, hepatitis B and hepatitis C treatment.

 &gt; Building capacity for hepatitis B prevention, treatment, care and support in the non-government sector.

 &gt; Building capacity of African communities living in South Australia to respond to HIV, hepatitis B and hepatitis C.

 &gt; Strengthening the partnership response to HIV, hepatitis B and hepatitis C.

The HIV Case Coordinator works collaboratively, and is co-located, with the Section. The HIV Case Coordinator is 
responsible for the coordination of the department s management system for people whose behaviours may place 
others at risk of HIV transmission. These functions contribute to the department s commitment to protect public 
health by minimising the spread of communicable diseases and the implementation of its functions under the South 
Australian Public Health Act 2011.

SA Health s Policy Directive titled Code for the Case Management of Behaviours that Present a Risk for HIV 
Transmission underwent an extensive review and was subsequently released as a Chief Public Health Officer Protocol, 
as provided for under the new South Australian Public Health Act 2011. A fact sheet was produced for healthcare 
workers to assist people impacted by the  Code  in understanding the process.

Specialist Services 

Specialist Services provides public health medical advice both in-hours and after-hours with respect to communicable 
disease control issues. Specialist Services also provides epidemiological and health promotion specialist advice to a 
range of internal and external customers. 

During 2012-13, Specialist Services continued to provide input into the surveillance and investigation of notifiable 
conditions in South Australia. In addition, a number of specific projects and activities were undertaken.

Notifiable Diseases and the SA Public Health Act 2011

As part of the implementation of the South Australian Public Health Act 2011 in relation to notifiable conditions, 
relevant information was widely distributed in September 2012. This included a Public Health Information and posting 
of the updated Report of Notifiable Conditions or Related Deaths forms to around 4500 notifiers.

Following this, one page forms for Report of Notifiable Conditions Sexually Transmitted Infections or Related Death 
forms for gonorrhoea, donovanosis, genital chlamydia and syphilis medical notifications were developed, printed and 
distributed to sexual health clinics across South Australia.



page 88Department for Health and Ageing Annual Report 2012-13

The Policy Directive for Control of Tuberculosis in South Australian Health Services was also revised. This was  
approved by the department s Portfolio Executive in May 2013, and the revised Policy Directive was disseminated 
across SA Health via a whole of portfolio email communication.

During May 2013, Specialist Services staff participated in national preparations in response to the newly described 
H7N9 avian influenza in China. The department s Communicable Disease Control Branch distributed information 
to relevant clinicians and laboratories. Similar communications were made in relation to the Middle East respiratory 
syndrome coronavirus infection. Specialist Services also provided technical advice to state pandemic influenza 
planning and contributed to national working groups focussed on the effective surveillance and management of 
seasonal influenza.

Individual infectious disease fact sheets for consumers and medical practitioners continue to be reviewed and 
updated. New and additional fact sheets are written and added to an already existing repertoire of electronically 
available infectious disease information.

Rheumatic Heart Disease Control Program 

The South Australian Rheumatic Heart Disease (RHD) Control Program (the Program) made significant progress during 
the year with the implementation of a statewide RHD Register (the Register) to record cases of acute rheumatic 
fever (ARF) and RHD based on national data standards. The Register assists individual health services and health 
professionals in the management of their patients as well as providing important epidemiological data.

The Register is being integrated into local systems in many health services to facilitate the sharing of data to improve 
secondary penicillin prophylaxis management. There has been strong engagement with the Register by primary health 
care services and the number of patients being enrolled on the Register has continued to grow. Strong networks and 
partnerships have been fostered with the cardiology and primary health sector to progress the RHD Program in South 
Australia. Valued relationships have been built with organisations such as the Aboriginal Health Council of SA and 
many Aboriginal Community Controlled Health Services. 

The Program provides support to health services to manage their patients with ARF/RHD. This includes facilitating 
patient appointments for specialist review and echocardiography; assisting health services to create systems to 
improve delivery of secondary penicillin prophylaxis and to identify patients who have been lost to follow up; and 
working with health services to ensure patients are placed on management plans.

Delivery and coordination of training to the clinical workforce about the RHD Register and around ARF/RHD diagnosis, 
management and prevention has occurred in various settings including conferences, statewide workshops and staff 
meetings. Particular emphasis has been given to increasing confidence and knowledge in Aboriginal health workers 
who are critical to coordinating the ongoing care of patients.

Commonwealth funding for the continuation of the South Australian RHD Control Program has been secured  
until June 2016.

Zoonotic Diseases

Zoonotic diseases are infectious diseases that can be transmitted from animals to humans. During 2012-13, there 
was a community and stakeholder evaluation of  Fight the Bite  community resources for promoting strategies to 
prevent the transmission of mosquito borne diseases. As part of the evaluation, feedback was sought from both local 
government environmental health officers and community members. Evaluation results indicate that whilst messages 
contained within the resources were relevant, there was a need to reinvigorate the  look and feel  of the resources to 
make them better able to engage the consumer with these messages. The Communicable Disease Control Branch, in 
partnership with the Health Protection Branch, continues to provide specific and tailored advice about the prevention 
of zoonotic disease to event managers or animal exhibitors where requested.

Health Care Worker Immunisation

In November 2012 a package of documents related to student health care worker immunisation was distributed to  
all education providers who have students on clinical placement in SA Health facilities. Feedback was collated and 
visits made to selected education providers in preparation for implementation of updated Guidelines for immunisation 
of health care workers in South Australia during 2013-14.



page 89 Department for Health and Ageing Annual Report 2012-13

Immunisation

A total of 896 488 doses of vaccines were distributed in 2012-13, a slight increase in distributed doses compared  
to previous years. 

According to the Australian Childhood Immunisation Register at 31 March 2013, 92.7 per cent of children in  
South Australia are fully vaccinated by two years of age. 

Vaccines are available free for adolescents under the National Immunisation Program and are delivered through a 
school based delivery program. In 2012 according to reports submitted, 81 per cent of year eight students were fully 
vaccinated against hepatitis B and 84 per cent were protected against varicella (chickenpox). Seventy-eight per cent  
of female students in year eight completed a full course of Human Papillomavirus (HPV) vaccination. In the same year,  
79 per cent of year nine students received a diphtheria, tetanus and pertussis booster vaccine.

Aboriginal Immunisation Coordinator 

The department s immunisation section was lead agency in managing the Aboriginal Immunisation Coordinator 
project, which coordinated services within the Northern Adelaide Local Health Network by undertaking a range 
of strategies including workforce development, system enhancement, improved data management and reporting 
and development of collaborative strategies aimed at improving services and vaccine immunisation coverage for 
Aboriginal children.

Help Me Stay Strong

A promotional campaign called  Help Me Stay Strong  was launched in August 2012 targeting new Aboriginal 
parents, to remind them to have their new baby vaccinated at two, four, and six months of age. The campaign  
is aimed at improving vaccine coverage rates for Aboriginal children in the first year of life.

Healthcare Associated Infection

The prevention of healthcare associated infection is covered under Standard 3 of the National Safety and Quality 
Health Service Standards which are used as the basis for accreditation of hospitals. The department has provided  
a number of tools and resources to assist hospitals in achieving the criteria specified in the Standard.

Key indicators show that South Australian hospitals continue to improve their performance in the prevention of 
healthcare associated infection. Compliance with hand hygiene practices has been equal to or slightly above the 
national average for the past year. The overall rate of bloodstream infection due to  golden staph  has remained well 
below the national benchmark of two cases per 10 000 patient-days and is currently one of the lowest in Australia. 

The control of antibiotic resistant  superbugs  in our hospitals remains a priority and most hospitals have established 
antimicrobial stewardship programs that are designed to monitor the usage and appropriate prescribing of key 
antimicrobial agents. The department conducts a national antimicrobial usage surveillance program on behalf of  
the Australian Government with over 70 contributing hospitals from all states and territories.

Disease Surveillance

The Disease Surveillance and Investigation Section conducts statewide surveillance of notifiable diseases, enabling 
analysis of health data and initiation of public health action to prevent further spread of disease. In the reporting 
period, approximately 13 400 cases of notifiable diseases were reported through the statewide surveillance system, 
similar to the approximately 13 600 notifications made in the previous financial year.

The sexually transmitted infections and blood borne virus surveillance section merged with the existing communicable 
diseases surveillance and investigation section thereby providing opportunities for efficiency gains. In the reporting 
period, there were over 7100 notifications of persons infected with sexually transmitted diseases and blood borne 
viruses.



page 90Department for Health and Ageing Annual Report 2012-13

Sexually Transmitted Infections and Blood Borne Viruses

A review of surveillance processes for persons infected with sexually transmitted diseases was completed. This 
review resulted in an update of existing medical notification forms to reflect both national and state surveillance 
requirements. Additionally, the introduction of a new medical notification form resulted in changes to existing referral 
practices for the follow-up of cases and their contacts. It is anticipated that these changes will result in improved 
follow-up and treatment of persons infected with gonorrhoea and syphilis and their close contacts.

As a result of the surveillance review, information on persons infected with sexually transmitted diseases has been 
better aligned to support policy development, planning and the evaluation of public health programs. Importantly, 
surveillance information is now available by Medicare Local areas and well-defined risk groups identified in both state 
and national public health policy. A revision of surveillance processes for persons infected with blood-borne viruses  
is underway.  

The department s Communicable Disease Control Branch introduced fortnightly reporting of the number of new 
notifications of sexually transmitted infections and blood borne viruses on the web, supporting requests for 
information from members of the public and government and non-government agencies. An annual report detailing 
surveillance of sexually transmitted infections and blood-borne viruses in South Australia, 2011 was published.

There were over 5200 new notifications of chlamydia, making this the most commonly reported sexually transmitted 
infection in South Australia. This figure reflects global trends in the incidence of genital chlamydia. Notifications 
among females exceeded males with the highest rates of infection occurring among persons aged 15 to 29 years.  

There were over 580 new notifications of gonorrhoea representing a 24 per cent increase in cases when compared to 
the previous fiscal year. Increases occurred among well-defined risk groups such as homosexual males and Indigenous 
Australians. Additionally, an increase in the number of new notifications of gonorrhoea was observed among 
heterosexual females.  

New reports of infections with blood-borne viruses including HIV, hepatitis B and hepatitis C remained relatively stable 
over this period.

Vaccine Preventable Diseases

The downward trend in the number of notified Bordetella pertussis (whooping cough) infection cases continued in 
the reporting period. There were approximately 830 cases notified, compared to over 1300 cases for the same  
period last year.

Two small measles clusters were identified in the reporting period. One of these comprised of three cases and was 
associated with transmission in a health care setting; the index case had reported travel to New South Wales where 
measles transmission was reported in the community. The second cluster involved two family members who were 
both unimmunised, and one family member acquired the infection overseas. There were a total of seven reported 
measles cases for this period, compared to six during the previous financial year. 

An increase of mumps cases was observed this financial year, with seven cases notified compared to two cases in  
the last reporting period. This increase has been observed nationally. 

Influenza numbers increased, with approximately 5700 cases notified compared to 5100 in the last reporting period. 
The predominant strain was Influenza A, accounting for nearly 80 per cent of the reported cases. Seven influenza 
outbreaks were reported in residential care facilities. 

One case each of tetanus, cutaneous diphtheria and congenital rubella syndrome were notified in the reporting 
period. All three illnesses are rarely seen in Australia due to good vaccination coverage. The congenital rubella case 
occurred in a child born overseas in a country which does not have a vaccination program for rubella.

Vector Borne Diseases

Locally acquired arbovirus infections remained low. There were approximately 180 reported cases of Ross River  
virus infection, a decrease from 220 for the same period last financial year. Barmah Forest virus numbers increased, 
with nearly 90 cases notified, compared to an approximate 50 cases notified in the last financial year.

Overseas acquired arbovirus infections notified to the department continued to trend upwards, with 50 cases of 
dengue fever, nine cases of malaria and four cases of Chikungunya virus infection notified.



page 91 Department for Health and Ageing Annual Report 2012-13

Zoonoses

Zoonoses is the transmittal of an infectious disease from animals to humans. The number of notified Q fever cases 
doubled to 18 cases in this reporting period. All cases had risk exposures identified, including living near abattoirs. 
Additionally, one case of brucellosis was identified in an abattoir worker who reported processing wild boar.

The numbers of other reported zoonoses were within expected levels and comparable to previous years.

Other Infectious Diseases

The numbers of reported infectious diseases, including meningococcal infection, were within expected levels.  
The exception was Legionella pneumophila serogroup 1, where an increase in the observed number of cases was  
seen in South Australia since December 2012. A cluster investigation was undertaken and all environmental exposures 
were referred to the department s Environmental Health Branch for investigation.

Enteric Diseases

One hundred and twenty one outbreaks of gastroenteritis occurred among residents and staff of aged care facilities. 
Of these, 81 outbreaks were caused by norovirus and three by rotavirus. No infective agent was identified in an 
additional 37 clusters. Aged-care facilities worked closely with staff from the department s Communicable Disease 
Control Branch and local environmental health officers to institute intervention strategies to contain the spread of 
infections. There was one outbreak of rotavirus at a child care centre and one outbreak of norovirus following a 
community event. Two outbreaks within hospitals were reported, one of norovirus and one of Salmonella subsp  
1 ser 4,5,12: i:-.

Notifications for Shiga toxin producing Escherichia coli were lower for this period, with 49 cases notified, compared  
to 62 in the previous reporting period. No cases of haemolytic-uraemic syndrome were reported in this financial year. 

The department s Disease Surveillance and Investigation Section undertook numerous cluster and outbreak 
investigations of suspected foodborne illness. All investigations were referred to the relevant environmental health 
officer and the Food Standards Surveillance team of the department for environmental investigation and public health 
action. Investigations for this period included:

 &gt; Eight cases of Salmonella Typhimurium phage type 9 were clustered in time and place. Four of these eight cases 
consumed items from the same local bakery.

 &gt; A retrospective cohort study was conducted amongst the 57 party guests following reports of gastrointestinal 
illness. Three guests submitted stool samples, all tested positive for Campylobacter. Analysis of the data showed  
a significant association between cases and consumption of the chicken liver p t  entr e.

 &gt; Nine cases of Salmonella Typhimurium phage type 9 had consumed fried ice cream at a common restaurant.  
The fried ice cream was rolled in egg and then breadcrumbs, and S. Typhimurium phage type 9 was subsequently 
isolated from the breadcrumb plate.

 &gt; Ten people reported illness following a community function. Two submitted samples and both were positive for 
norovirus. Person-to-person spread was the suspected mode of transmission.

 &gt; Fourteen out of 34 people reported gastrointestinal illness following a function at a restaurant. Six stool samples 
were submitted and all were positive for norovirus. 

 &gt; Nine cases of gastrointestinal illness were found to be associated with dining at a restaurant on one specific day. 
Seven of the cases submitted faecal samples; all were confirmed as Salmonella Typhimurium phage type 9 and all 
cases had consumed or tasted poached eggs and hollandaise sauce.

 &gt; Six people reported feeling ill with gastrointestinal symptoms at a boarding school. Two of the people submitted 
specimens and both were positive for Campylobacter. Five meals were common for all six people and it was 
reported that a chicken wing meal was undercooked.

 &gt; A rare phage type of Salmonella, Salmonella Typhimurium phage type 3 was identified in South Australian 
residents. An investigation identified raw almonds from a major supermarket as the link. Other cases in other  
states and territories resulted in a multi-jurisdictional outbreak investigation and a national recall of the product.



page 92Department for Health and Ageing Annual Report 2012-13

Population Health

Healthy Eating, Physical Activity and Healthy Weight

During 2012-13, SA Health has continued to implement nutrition and physical activity initiatives in the Eat Well  
Be Active strategy for South Australia 2011-16. These policy and program initiatives encourage and support South 
Australians of all ages to meet government nutrition and physical activity recommendations. Increased effort is 
required as SA Health data shows that significant numbers of South Australians remain overweight, do not eat 
enough fruit or vegetables and are insufficiently active   see figures 34 to 36.

As a result of the review of Non-Hospital Services, some primary prevention programs delivered through Local Health 
Networks ceased in June 2013. Implementation of the SA Public Health Act 2011 is providing new opportunities  
for a coordinated approach to improving nutrition and physical activity and reducing overweight and obesity across 
the state.

Mobilising the Community

The SA Health website has been expanded to include a new Healthy Living section. It provides helpful information 
and tips on a wide range of topics to encourage and assist South Australians to improve their health and reduce their 
risk of preventable lifestyle disease. A significant focus is on encouraging individuals, workplaces and community 
organisations to take steps in their own lives or sphere of influence to quit smoking, eat a healthy diet, be physically 
active, and for those who drink alcohol, to drink responsibly.

The  My Healthier Today Pledge  went live on SA Health s website on 19 April 2013. The pledge encourages 
individuals to make a public commitment to change their behaviours across smoking, nutrition, alcohol and physical 
activity to improve their general health, maintain a healthy weight and reduce their risk of developing a preventable 
chronic disease. The pledge has been promoted through current program networks and via the SA Health website, 
with 360 pledges made to date as at 30 June 2013.

 Walk Yourself Happy  was the new  be active  campaign message, with four bursts of advertising between August 
2012 and April 2013. Refined and informed through formative research,  Walk Yourself Happy  takes a positive and 
uplifting approach to encouraging people who are not achieving the physical activity recommendations to be active 
by walking.

The popular publication Your Guide to a Healthier Today was distributed across country South Australia in late 
October 2012 through all 32 regional newspapers (181 000 copies).  Adapted from the metropolitan version to 
suit a country audience, the guide provided Swap It Don t Stop It!, Go for 2&amp;5 , and Be Active practical tips and 
encouragement about healthy eating and being active, referral pathways across country South Australia, and 
direction to the new Healthy Living section of the SA Health website for further health information, resources and 
motivation. There was a significant increase in direct traffic to the Healthy Living webpage; a total of 1267 unique 
page views were achieved within the regional campaign period (a large increase of 2300 per cent). The guide  
was promoted through press and radio advertising and engaged the public via a competition through the SA Health 
Facebook page, which attracted 1168 new  likes  during the campaign promotional period, an increase of  
46 per cent.

Through 2012-13 strong demand was maintained for Go for 2&amp;5 , be active and healthy weight public education 
materials by community organisations, education and health services and many of the community programs funded 
by SA Health. These are used by organisations as part of their work with individuals and groups to promote healthy 
eating, physical activity and healthy weight.



page 93 Department for Health and Ageing Annual Report 2012-13

Community Programs

Now in its fourth year, the Obesity Prevention and Lifestyle (OPAL) program, an Australian, state and local government 
initiative, operates in 20 South Australian and one Northern Territory community. OPAL supports healthy lifestyles by 
providing physical activity and healthy eating opportunities for children and their families. In the past year the Cities of 
Alexandrina, Coorong, Campbelltown and second sites in Salisbury and Charles Sturt have been added to the existing 
OPAL sites of the Cities of Marion, Onkaparinga, Mount Gambier, Playford (two sites), Port Augusta, Salisbury, 
Whyalla, Charles Sturt, Port Adelaide Enfield, the Copper Coast, mid-Murray, Murray Bridge, Mount Remarkable and 
West Torrens. OPAL remains the largest investment in childhood obesity prevention in South Australian history with 
funding of over $1.1m over five years in each of the 20 OPAL communities.

OPAL adopts a different theme for action each year. The fifth social marketing theme being implemented in 2013   
 A healthy brekky is easy as peel, pour, pop    encourages families to eat a nutritious breakfast together. It joins the 
previous themes, which focused on reducing of soft drinks, decreasing screen time, increasing fruit and vegetables  
for snacks and increasing active travel to and from school.

The Flinders University is conducting the major component of OPAL evaluation. Baseline data has been collected 
across 20 OPAL sites and comparison sites and includes data from over 7000 respondents from 300 preschools, 
primary and high schools. An annual statewide phone survey has shown a significant increase in awareness of the 
OPAL program in intervention communities of 31 per cent, up from 25 per cent in 2011. Behaviour changes have 
included an increase in households in OPAL communities in 2012 compared with 2011 that report a reduced amount 
of screen time and increased use of fruit and vegetables at snack times. OPAL has begun changing the physical 
landscape too. From late 2012, OPAL has fostered drinking water fountains, gardens in communities, schools, 
childcare centres and back yards and infrastructure such as outdoor gyms, playground equipment, scooter and bike 
racks, bike tracks, walking paths and permanent healthy lifestyle signage.

The  Healthy Workers Healthy Futures  initiative was launched in December 2012, with the announcement of eight 
host industry agencies: Aged and Community Services; the South Australian Council of Social Services; Inner West 
Business Enterprise Centre; Cement Concrete and Aggregate; Primary Producers SA (formerly SA Farmers Federation); 
Construction, Forestry, Mining and Energy Union; Australian Services Union SA and NT Branch; and the United Trades 
and Labor Council Building Incorporated (SA Unions).

The host agencies lead the effort in their industry to promote healthy behaviours in and through workplaces. The 
focus is on the workforce to improve the modifiable chronic disease risk factors of smoking, nutrition, alcohol and 
physical activity. Advisers employed by host agencies support workplaces to assess workplace policy, practice and 
environment and develop strategies to promote the adoption of healthy behaviours and help make the healthy choice 
the easy choice. The Workplace Health and Wellbeing resource kit was also released in December 2012 at the launch 
of the program.

The Healthy Eating Local Policies and Programs (HELPP) initiative, managed by the Flinders University, works in 
partnership with local councils and community organisations and their peak bodies to develop healthy eating 
policies. Twenty seven of the total 68 South Australian Councils, supporting more than 60 per cent of the South 
Australian population, are participating, with eight councils and the Local Government Association of South Australia 
(LGASA) to date endorsing their policy. HELPP, staffed by qualified dietitians has worked closely with staff of other 
programs including Healthy Communities (Commonwealth funded), OPAL and Healthy Workers Healthy Futures to 
build capacity to promote healthy eating policy. HELPP also works in partnership with non-government community 
organisations to develop food literacy programs facilitated by community leaders or volunteers. A seven module 
food literacy program developed with culturally and linguistically diverse communities and another for the wider 
community have been disseminated statewide. Thirty additional resources complement this work. In February 2013, 
HELPP led a successful collaborative  Fruit n Veg Month  to promote the  Go for 2&amp;5   messages. More than 85 
organisations actively participated and an online  Bring a Healthy Lunchbox to Work Challenge  attracted more than 
1000 participants from 64 worksites with changes to people s food choices.

The Do It For Life program (DIFL) continued to operate out of GP Plus and selected primary health services across 
the state. Seventeen Lifestyle Advisors supported clients at high risk of developing chronic disease to set goals 
and identify actions to help increase physical activity, quit smoking, reduce alcohol consumption, manage stress or 
eat a healthy diet. Data collected from clients showed that following participation in the program the number of 
risk factors declined and self-reported general health status improved. In 2013-14 DIFL will be replaced by a new 
telephone coaching service to support people to adopt healthy lifestyle behaviours.



page 94Department for Health and Ageing Annual Report 2012-13

Through the statewide  Start Right Eat Right  award program (SRER) for South Australian childcare centres, 314 
(88.5 per cent) centres have received training, that educates staff about providing healthy, nutritious and safe food 
for children and developing a nutrition policy. Two hundred and forty two centres (68 per cent) completed the SRER 
Award requirements for a healthy menu, nutrition policy and food safety. Since 2004-05, 81 centres have achieved 
the SRER re-award process (every two years) at least three times, and 26 centres have been re-awarded four or 
more times. Nine (100 per cent) Aboriginal child care centres have attended SRER training and six have achieved the 
SRER Award. In 2012 SRER collaborated with researchers at UniSA to conduct a study to determine the impact of 
participation in SRER on the food and nutrient intake of children in care, with overall findings showing that SRER is 
effective in improving children s dietary intake. Resources and learning from the SRER program, which operated from 
2004 until June 2013, will be built into ongoing work to support the early childhood services and education sector to 
meet the new National Quality Standards.

The Eat Well Be Active Primary School program engaged 173 schools in the 2012-13 year including 26 new schools 
that commenced in 2013. These schools continue to undertake professional development and implement policies and 
programs to assist students to be more active and eat a healthy diet.

In the past year, the Community Foodies program, managed by the Southern Adelaide Local Health Network, with 
the assistance of local health services and other organisations, operated in 20 sites across metropolitan Adelaide and 
country South Australia. At each site, trained volunteer  Foodies  support healthy eating initiatives in a wide range  
of community agencies and settings. Two hundred and twenty volunteer  Foodies  were involved, including  
24  Aboriginal Foodies  and 21 from culturally and linguistically diverse backgrounds. In 2013-14 the program will  
be transferred to a non-government organisation.

The three year Community Gardens program that finished in March 2013 was managed by the Adelaide Botanic 
Gardens. The program s aim was to build capacity for existing and emerging community kitchen gardens in South 
Australia. A key legacy of the project is a website providing information for those involved in kitchen gardens and 
in March 2013 there was an average 1500 hits per page; and stronger networks between those involved in and 
supporting kitchen gardens across schools and communities. The e-newsletter assists this and has 450 subscribers  
as at 30 June 2013, with an average of 10 new subscribers every week.

Policy, Research and Data Initiatives

Environments to support health   health in planning: opportunities to promote population health and equity are 
presented by new land uses, denser urban form and infrastructure investments, such as those in public transport. 
SA Health has continued high-level collaboration, joint-agency activity and strategic projects with the Department 
of Planning, Transport and Infrastructure, Renewal SA and the Active Living Coalition which is auspiced by the 
Heart Foundation (SA) to ensure that urban planning policies and everyday practices positively influence the social 
determinants of health and wellbeing, including a focus on healthy eating and physical activity. As a result of this 
collaboration, the Streets for People compendium was launched in September 2012 and the Healthy by Design SA 
resource was launched in April 2013.

SA Health services across the state continue to support implementation of the Healthy Food and Drink Choices for 
Staff and Visitors in SA Health Facilities policy that aims to increase the availability of healthy food and drinks.  
The policy restricts unhealthy choices in all food and drink outlets on departmental premises, including cafeterias, 
kiosks, vending machines, work-related meetings, functions and events, client education programs and fundraising.  
In 2012-13 the Australian Capital Territory and the Northern Territory commenced their development of similar 
policies using the South Australian policy as a basis.

Reducing Children s Exposure to the Advertising and Marketing of Unhealthy Foods

SA Health continues to take a national lead on this issue and with other jurisdictions in exploring possible options to 
reduce children s exposure. The importance of further action in this area has been underlined by agreement by the 
World Health Organization in May 2013 to incorporate this issue as a priority internationally to reduce the worrying 
levels of childhood obesity.

Funded by SA Health from April 2010 until March 2013, the Physical Activity Nutrition Observatory: Research and 
Monitoring Alliance (PANORAMA) at the Flinders University aimed to advance the promotion of physical activity, 
public health nutrition (including breastfeeding) and obesity prevention through better understanding of their 
behavioural and environmental drivers; evidence of effective interventions; and more effective links between research, 
policy and implementation. In 2012-13 PANORAMA completed a number of deliverables to SA Health including: a 
data report, based on data collected through SA Health s SA Monitoring and Surveillance System (SAMSS) looking at 
trends in nutrition, physical activity and weight by a range of demographics; an evaluation framework for the Eat Well 
Be Active Strategy 2011-16; and a rapid review on the economic analysis of obesity prevention.



page 95 Department for Health and Ageing Annual Report 2012-13

National Partnership on Preventive Health Performance Indicators

The Australian government is providing funding for the National Partnership on Preventive Health (NPAPH), 
established to address the rising prevalence of lifestyle related chronic diseases, by laying the foundations for healthy 
behaviours in the daily lives of Australians. The aspirational performance benchmarks agreed to under the NPAPH 
relate to broad population indicators. The benchmarks measure behaviour change across the population with targets 
for children and adults for healthy weight, fruit and vegetable consumption and levels of physical activity.

Figure 33   Proportion of South Australian adults (18 years and over) and children (five to 17 years*)  
at an unhealthy weight (baseline 2009)

 

 
 

2002
-03 

2003
-04 

2004 
- 05 

2005 
- 06 

2006 
- 07 

2007 
- 08 

2008 
- 09 

2009
-10 

2010
-11 

2011
-12 

2012
-13 

2013
-14 

2014
-15 

2015
- 16 

2016
-17 

2017
-18 

Adults 54.5 54.6 55.1 55.8 56.6 55.8 58.5 58.9 59.7 60.3 

Adults target 61.4 58.8 

Children 

Baseline

29.6 26.5 26.4 26.3 23 24.2 25.5 24.3 

Childrens target 24.1 23 

0% 

10% 

20% 

30% 

40% 

50% 

60% 

70% 

80% 

Pr
o

p
o

rt
io

n
 (

%
)

Financial year

 

Data Source: South Australian Monitoring and Surveillance System (July 2002   July 2012)
*Parent proxy used when the child is under the age of 16 years

The performance benchmark for weight is to hold the increase in the proportion of adults and children at unhealthy  
weight at less than 5 per cent from baseline by 2016, and to return the proportion of adults and children at 
unhealthy weight to baseline level by 2018.

Figure 34   Mean daily serves of fruit consumed by South Australian adults (18 years and over) and children 
(five to 17 years*) (baseline 2009)

 

 

 

2002
-03 

2003
-04 

2004 
- 05 

2005 
- 06 

2006 
- 07 

2007 
- 08 

2008 
- 09 

2009
-10 

2010
-11 

2011
-12 

2012
-13 

2013
-14 

2014
-15 

2015
- 16 

2016
-17 

2017
-18 

Adults 1.53 1.47 1.47 1.53 1.5 1.52 1.57 1.54 1.51 1.49 
Adults target 1.77 2.17 
Children 

Baseline

1.68 1.65 1.64 1.73 1.71 1.75 1.82 1.74 1.76 1.74 
Childrens target 2.02 2.42 

0 

1 

2 

3 

4 

M
ea

n
 s

er
ve

s 

Financial year

 

Data Source: South Australian Monitoring and Surveillance System (July 2002   July 2012)
*Parent proxy used when the child is under the age of 16 years.



page 96Department for Health and Ageing Annual Report 2012-13

The performance benchmark is to increase the mean number of daily serves of fruit consumed by adults and children 
by at least 0.2 for fruit by 2016 and 0.6 for fruit from baseline by 2018.

Figure 35   Mean daily serves of vegetables consumed by South Australian adults (18 years and over) and 
children (five to 17 years*) (baseline 2009)

 

 

2002
-03 

2003
-04 

2004 
- 05 

2005 
- 06 

2006 
- 07 

2007 
- 08 

2008 
- 09 

2009
-10 

2010
-11 

2011
-12 

2012
-13 

2013
-14 

2014
-15 

2015
- 16 

2016
-17 

2017
-18 

Adults 

Adults target 

Children 

Baseline

Childrens target 

M
ea

n
 s

er
ve

s 

Financial year

2.42 2.51 2.65 2.77 2.62 2.66 2.77 2.86 2.74 2.62 

3.27 4.27 

1.94 2.08 2.06 2.34 2.2 2.24 2.31 2.38 2.32 2.26 

2.81 3.81 

0 

1 

2 

3 

4 

5 

 

Data Source: South Australian Monitoring and Surveillance System (July 2002   July 2012)
*Parent proxy used when the child is under the age of 16 years.

The performance benchmark is to increase the mean number of daily serves of vegetables consumed by adults  
and children by at least 0.5 for vegetables by 2016 and 1.5 for vegetables from baseline by 2018.

Figure 36   Proportion of South Australian adults (18 and over) meeting physical activity guidelines 
(baseline 2009)

 

 

2002
-03 

2003
-04 

2004 
- 05 

2005 
- 06 

2006 
- 07 

2007 
- 08 

2008 
- 09 

2009
-10 

2010
-11 

2011
-12 

2012
-13 

2013
-14 

2014
-15 

2015
- 16 

2016
-17 

2017
-18 

Adults 

Baseline

Adults target 

Pr
o

p
o

rt
io

n
 (

%
)

Financial year

38.6 37.6 40.1 41 39.8 42.3 39.6 39.8 39.9 

44.4 48.6 

 

0% 

5% 

10% 

15% 

20% 

25% 

30% 

35% 

40% 

45% 

50% 

Data Source: South Australian Monitoring and Surveillance System (July 2003   July 2012).

The performance benchmark for adults is to increase the proportion participating in at least 30 minutes of moderate 
physical activity on five or more days of the week of 5 per cent from baseline by 2016 and 15 per cent from baseline 
by 2018.



page 97 Department for Health and Ageing Annual Report 2012-13

Safety and Quality
The department has an extensive statewide program to ensure continuous improvement to the safety and quality 
of healthcare and achieve the best possible outcomes for its consumers. The program has been designed to address 
patient safety priorities that have been identified at both a national and state level and be responsive to new 
emerging issues or risks. Components of the program are briefly described below. More comprehensive information 
can be found in the annual South Australian Patient Safety Report.

Australian Health Service Safety and Quality Accreditation Scheme
From 1 January 2013, mandatory accreditation of health services under the Australian Health Service Safety and 
Quality Accreditation Scheme is required. Within this scheme services are accredited against the National Safety and 
Quality Health Service Standards.

The Australian Health Service Safety and Quality Accreditation Scheme builds on the strengths of the current 
accreditation arrangements and provides for the national coordination of accreditation processes.

SA Health recognises accreditation as an important driver for safety and quality. Through a process of regular 
assessment and review, accreditation tests that systems are in place and working effectively to promote and support 
safe patient care and continuous quality improvement.

The SA Health Accreditation Policy Directive was developed to provide an outline of the mandatory requirements for 
health services to meet in order to be assessed and accredited against the national standards and the accreditation 
scheme and any other applicable standards.

National Standards on Safety and Quality in Health Service Standards
The Australian Commission on Safety and Quality in Healthcare has developed the National Safety and Quality Health 
Service (NSQHS) Standards to protect the public from harm and to improve the quality of health service provision. 

The NSQHS Standards consist of 10 inter-related standards. Each standard describes a series of actions that are 
required to meet the Standard. The Standards describe the systems required to ensure the minimum standards of 
safety and quality are met, and a quality improvement mechanism that allows health services to realise aspirational 
and developmental goals.

The 10 national Standards are:

 &gt; Standard 1   Governance for Safety and Quality in Health Service Standards.

 &gt; Standard 2   Partnering with Consumers.

 &gt; Standard 3   Preventing and Controlling Healthcare Associated Infections.

 &gt; Standard 4   Medication Safety.

 &gt; Standard 5   Patient Identification and Procedure Matching.

 &gt; Standard 6   Clinical Handover.

 &gt; Standard 7   Blood and Blood Products.

 &gt; Standard 8   Preventing and Managing Pressure Injury.

 &gt; Standard 9   Recognising and responding to Clinical Deterioration in Acute Health Care.

 &gt; Standard 10   Preventing Falls and Harm from Falls.

An Accreditation Resource Guide for each national Standard has been developed to support health services.  
It provides examples of South Australian tools and resources that can be used to demonstrate action and standards 
have been met. Audit tools have also been developed for some standards.

Further information is available on the SA Health Safety and Quality website www.sahealth.sa.gov.au/safetyandquality.  
The website has recently been restructured to align it to the NSQHS. 



page 98Department for Health and Ageing Annual Report 2012-13

Standard 1   Governance for Safety and Quality in Health Service Standards
Standard 1 outlines the broad criteria needed to achieve the integrated governance system which is essential in order 
to maintain and improve the reliability and quality of patient care, and improve patient outcomes.

During 2012-13 extensive work has occurred in a number of areas to assist health services to meet the required 
criteria. Some of this work is highlighted below.

Performance and Skill Management 

Credentialling is the formal process used to verify the qualifications, experience, professional standing and other 
relevant professional attributes of practitioners and is designed to protect consumers by ensuring a skilled and 
competent workforce is delivering their health care. In SA Health it is a mandated process for all medical practitioners, 
dental practitioners, allied health and scientific officers and nurse practitioners.

The Credentialling and Scope of Practice System (CSCPS), which was developed to provide a centralised, secure and 
standardised method of recording health practitioner s credentials and scope of clinical practice across SA Health,  
has undergone significant modifications to help streamline processes. Extensive training has been provided across  
SA Health on the use and navigation of the database. Currently there are over 250 people using the CSCPS to upload 
practitioner s credentials and their defined scope of clinical practice. The credentials of over 10 000 practitioners have 
been recorded in the CSCPS. 

Incident Management

Everyone who provides services on behalf of SA Health is encouraged to report patient related incidents, including 
near misses, into the Safety Learning System (SLS). The most serious incidents   those categorised as Safety 
Assessment Code (SAC) 1   must be reported. SLS is a web-based integrated, single SA Health wide system which 
facilitates the management of both incidents and consumer feedback. It increases the ability of SA Health to achieve 
timely reporting, undertake review and analysis, identify trends at both a local and state level, so that specific areas 
for improvement can be targeted and the progress of recommendations monitored.

During 2012-13 the SLS underwent significant modifications and a continual process of refinement to enhance its 
ability to identify and support learnings for safety and quality across SA Health. In addition, a SLS Incident User Guide 
was developed to provide staff with a guide on how to log incidents, search for records and create reports.

Patient rights and engagement   Charter of Health and Community Services Rights Policy Directive

The SA Health Charter of Health and Community Services Rights Policy Directive was released in 2012-13. The 
purpose of the policy directive is to implement the Charter of Health and Community Services Rights (the HCSCC 
Charter), and to ensure that services are safeguarding patient rights and complying with the legislation as Part 3 of 
the Health and Community Services Complaints Act 2004. The policy directive aims to increase awareness of all staff, 
consumers and the public about the rights of consumers and the community as set out in the HCSCC Charter.

Education materials including posters, brochures and information to promote the HCSCC Charter to staff and 
consumers were provided to all health care sites. The Charter has also been translated into 11 community languages 
and a large print (English) version was also provided and all resources are available on the HCSCC website at  
www.hcscc.sa.gov.au.

Standard 2   Partnering with Consumers

Consumer Partnerships in Service Planning

SA Safety and Quality Consumer and Community Advisory Committee

The South Australian Safety and Quality Consumer and Community Advisory Committee (CACAC) is a sub-committee 
of the South Australian Council on Safety and Quality in Healthcare (SACSQHC), and was established in 2007. The 
CACAC has diverse membership and is instrumental in continuously improving patient safety and quality in providing 
the consumers  perspective in service planning, designing care and service measurement and evaluation.

The CACAC continues to work with the SACSQHC with a combined work plan which is underpinned by the 
Australian Safety and Quality Framework for Healthcare that is consumer centred, driven by information and 
organised for safety.



page 99 Department for Health and Ageing Annual Report 2012-13

The CACAC Summary of Achievements Report was provided to SACSQHC. Highlights include the CACAC s 
involvement in the SA Health A Framework for Active Partnership with Consumers and the Community and A Guide 
for Engaging with Consumers and the Community, the development of the Patient Safety Report for Consumers and 
the Community and fact sheets and provided consumer feedback on patient information sheets.

SA Health Partnering with Consumers and the Community Advisory Group

The SA Health Partnering with Consumers and the Community Advisory Group established in March 2013 includes 
representation from the Health Consumers Alliance SA, the HCSCC, the Nursing and Midwifery Office, the Mental 
Health and Substance Abuse Division, Service Development Branch, Statewide Clinical Support Services, SA 
Ambulance Service, and a representative from each Local Health Network and the SA Health Safety and Quality Unit.

The Advisory Group is the strategic committee for Partnering with Consumers. Work is underpinned by: 

 &gt; The Australian Safety and Quality Framework. 

 &gt; Australian Commission on Safety and Quality in Health Care Patient-centred Care. 

 &gt; Standard 1   Governance (National Safety and Quality in Health Services Standards) in relation to complaints 
management, patient rights and engagement and open disclosure.

 &gt; Standard 2   Partnering with Consumers (National Safety and Quality in Health Services Standards). 

 &gt; Australian Safety and Quality Goals for Health Care Goal 3   Partnering with Consumers.

The role of the Advisory Group is to oversee the coordination and monitoring of the whole of health strategy aimed 
at standardisation across SA Health in regard to partnering with consumers, described by the SA Health A Framework 
for Active Partnership with Consumers and the Community and A Guide for Engaging with Consumers and the 
Community. These were released in early 2013 and were the result of drafting by Statewide Service Strategy, Safety 
and Quality Unit and Health Promotion Branch, followed by extensive consultation.

A Framework for Active Partnership with Consumers and the Community

The SA Health A Framework for Active Partnership with Consumers and the Community (the Framework) and  
A Guide for Engaging with Consumers and the Community (the Guide) were released in early 2013.

The Framework and Guide provide an overarching structure and guide to support healthcare organisations in the 
development of effective consumer and community engagement strategies for service planning, designing care, 
service measurement and evaluation. Health literacy tools have also been developed and are included as appendices 
in the Guide on tips for communicating clearly, the teach back method, follow up with consumers, encourage 
questions, assessing readability and writing health information.

Consumer Partnership in Designing Care   Measuring Consumer Experience

SA Health is committed to ensuring that the experience of consumers using its services is as positive as possible. The 
SA Consumer Experience Surveillance System (SACESS) is a telephone survey where consumers are interviewed soon 
after an overnight stay in a metropolitan or country public hospital using a set of internationally validated questions. 
Consumers are asked about whether or not certain processes and events occurred during their episode of care, such 
as whether they felt involved in their care and treatment and in decision-making, if their care was consistent and 
coordinated, if they felt they were treated with respect and dignity, their privacy, pain control, treatment received 
from doctors and nurses, and the cleanliness of the hospital and ward they stayed in. 

In 2011-12, the response rate was 76 per cent and 2438 patients were interviewed about their experience in public 
hospitals. Local Health Networks are provided with their individual reports and asked to address the key performance 
indicators and domains of care areas that do not reach the benchmark score of 85. 

In 2012, the first Measuring Consumer Experience SA Public Hospital Inpatient Annual Report was released and is 
available on the SA Health website at www.sahealth.sa.gov.au/safetyandquality. The report details the key findings 
and further analysis of the consumers  experiences.



page 100Department for Health and Ageing Annual Report 2012-13

Consumer Partnership in Service Measurement and Evaluation   Patient Safety Report on Consumers  
and the Community and Fact Sheets

The first South Australian Patient Safety Report for Consumers and the Community was reviewed and endorsed  
by the CACAC and released in February 2013.

The Patient Safety Report Executive Summary and Consumer and Community Fact Sheets are a summarised version  
of the full SA Patient Safety Report, produced in consumer focussed and consumer friendly format. 

The Executive Summary highlights some of the main improvements across SA Health and provides information on:

 &gt; Consumer feedback and measuring consumer experience.

 &gt; Charter of healthcare rights.

 &gt; Hand hygiene.

 &gt; Preventing falls and harm from falls.

 &gt; Safety Learning System.

 &gt; Medication safety.

Topics for Consumer and Community fact sheets were:

 &gt; Partnering with consumers.

 &gt; Know your rights when receiving a Health or Community Service.

 &gt; Preventing and controlling healthcare associated infections (hand hygiene).

 &gt; Preventing falls and harm from falls.

The Executive Summary and fact sheets were distributed to all Local Health Networks and consumer organisations, 
and are available on the Safety and Quality website at www.sahealth.sa.gov.au/safetyandquality.

Standard 3   Preventing and Controlling Healthcare Associated Infections
Healthcare associated infection is an adverse outcome of hospital treatment that can have serious consequences 
for patients. Standard 3 focuses on the implementation of best practice guidelines and the employment of effective 
governance systems in hospitals to ensure that the risk of acquiring an infection is minimised. The department 
developed a Strategic Framework for the Prevention of Healthcare Associated Infection (the Framework) in  
2012, which describes the requirements for an effective infection prevention program in all hospitals and sets  
an accountability framework. 

The Framework has been supported by the development of several resources and practical tools to assist hospitals  
in achieving the requirements for accreditation against the Standard. 

Examples include: 

 &gt; Specific guidelines for dealing with infection risk due to antibiotic-resistant bacteria.

 &gt; Development and promotion of appropriate antibiotic prescribing guidelines.

 &gt; Development of cleaning standards for healthcare facilities.

 &gt; The development of a resource package promoting best practice aseptic technique during clinical care. 

The department actively monitors the rate of healthcare associated infection through its statewide surveillance 
system. One of the key indicators of good infection prevention practice is the rate of bloodstream infection due to 
 golden staph  and the overall state rate continues to be well below the national benchmark of two episodes per  
10 000 patient-days. 

The department also monitors the performance of hand hygiene at appropriate times during clinical care, which is 
one of the most important infection prevention practices. The statewide hand hygiene program continues to achieve 
good results, with the SA Health compliance rate currently sitting above the national average of 76 per cent.



page 101 Department for Health and Ageing Annual Report 2012-13

Standard 4   Medication Safety
The South Australian Health Medication Safety Program 2013-15 promotes better health outcomes for South 
Australians through improvement in the safety and quality use of medicines (QUM). Aligned with the National 
Standards on Safety and Quality in Health Service Standards Standard 4   Medication Safety, the program work plan 
is overseen by the South Australian Medication Safety Advisory Group (SAMSAG), a subcommittee of the South 
Australian Medicines Advisory Committee (SAMAC). SAMSAG is the peak SA Health advisory group promoting 
safe use of medicines in South Australia and its terms of reference and membership were reviewed and updated in 
November 2012 to reflect changes in Local Health Network structures, to enhance communication and input across 
services, and to ensure engagement with consumers.

To support organisations in meeting Standard 4   Medication Safety, the SA Health Medication Safety Forum was 
held in April 2013. Attended by representatives from the department, Local Health Networks, and Statewide Services, 
the forum provided the opportunity for discussion of current issues in meeting accreditation requirements, and 
identification of priority areas for action that can be addressed locally or coordinated from a statewide perspective. 

Facilitating development of statewide medication related policy and guidelines continued to be a key focus of the 
program. Policies for enhancing patient care through improved documentation of adverse drug reactions (ADRs) were 
developed, with the Preventing Adverse Drug Events   Documenting, monitoring and communicating adverse drug 
reactions and allergies Policy Directive and Policy Guideline.

The  High Risk Medicines  toolkits series aims to increase health professionals  awareness of high risk medicines and 
provide policies, guidelines and educational tools. The High Risk Medicines Directive and Guideline are currently under 
development and work on the generic high risk medicines toolkit, the first toolkit in the series, is progressing. Each 
toolkit includes an interactive e-learning module, with the further toolkits under development covering medicines 
universally acknowledged to be high risk including insulin, anticoagulants and opioids.

SAMSAG is the South Australian jurisdictional governance group for the oversight of implementation and review 
of the National Inpatient Medication Chart (NIMC) and ancillary medication charts. A new version of the NIMC 
incorporating a section for recording venous thromboembolism (VTE) prophylaxis will be available from July 2013.  
The new section is intended to prompt prescribers to assess all adult patients for risk of VTE on admission and 
prescribe appropriate prophylaxis. A coordinated approach to the implementation of the new version, with provision 
of educational resources and tools, will be undertaken.

Further information is available on the SA Health Medication Safety website on  
www.sahealth.sa.gov.au/medicationsafety

Strategies to reduce wrong route errors and medication omissions have been developed and initial work has been 
undertaken. These areas are a key priority for further work in 2013-14 and 2014-15. 

The department has developed an e-learning tool, titled  Labelling for Safety  to assist health services, both locally and 
nationally, with implementation of the National Recommendations for User-applied Labelling of Injectable Medicines, 
Fluids and Lines. 

Following success of the Pharmaceutical Reforms model introduced into South Australian metropolitan public 
hospitals since 2009, further roll-out to major country hospitals occurred in 2012. Patients at these country hospitals 
now have the same pharmaceutical care as patients in metropolitan hospitals resulting in improved medicines 
management services and smoother transitions between hospital and home.



page 102Department for Health and Ageing Annual Report 2012-13

Ensuring the Quality Use of Medicines along the Continuum of Care

SA Health s principal working group of the SAMAC in the area of QUM, QUMSA, has strengthened their focus on 
improving QUM along the continuum of care, in particular, hospital discharge. In 2012 SA Health commissioned 
a project to examine barriers and facilitators to QUM along the continuum of care, which provided a series of 
recommendations for achieving improvements in QUM to enhance patient safety and health outcomes. QUMSA is 
currently implementing a work plan to address the recommendations arising from the review, which focuses on the 
following key areas:

 &gt; Multi-disciplinary health professional education and training.

 &gt; Engaging with and empowering consumers and carers.

 &gt; Electronic systems.

 &gt; Promoting QUM outcomes from the Pharmaceutical Reforms.

QUMSA has already commenced work to improve consumer medicines literacy, including the dissemination of 
information and resources to support consumer understanding of their medicines, as provided on the SA Health 
website www.sahealth.sa.gov.au/medicines. 

Another initiative aimed at improving QUM when patients are admitted to and discharged from hospital was the 
implementation of a policy directive and associated resources on patients  own medications. The policy encourages 
patients to bring their medications into hospital to assist clinicians in determining comprehensive details of patients  
medications, facilitate detection of issues with current medications and ensure that medications are available if 
required in emergency situations. The policy ensures that patients  own medications are stored appropriately and  
only administered where it is safe and appropriate to do so. 

Acute Pain Management Resource Kit

Whilst being highly effective, many medicines used for the management of pain, particularly opioids have a high risk 
of side-effects and dependence when not used appropriately. SA Health is committed to ensuring the quality use of 
opioids for the treatment of acute pain to promote optimal patient outcomes and has developed a resource kit is 
currently to support healthcare professionals in the provision of effective and safe analgesia to patients with acute 
pain. These resources, which are available on the SA Health website www.sahealth.sa.gov.au/opioids, aim to guide 
best clinical practice, enhance the knowledge of both staff and patients in relation to opioids.

Standard 5   Patient Identification and Procedure Matching
Safe, high quality care can only be provided if patients are correctly identified and matched to their intended care. 
Work has been occurring across SA Health to ensure that standard patient identification and matching processes 
are consistently integrated into routine practice. An important tool used to ensure patients are correctly identified 
and matched to their intended care are identification bands. The department is currently undertaking a project to 
standardise patient identification bands across SA Health, to ensure that all identification bands used in SA Health 
comply with the national specifications.

Standard 6   Clinical Handover
Training in TeamSTEPPS , a teamwork and communication program, is offered to health services twice a year. 
TeamSTEPPS  is a patient safety and quality improvement program where health care teams determine the patient 
safety or quality issues that would benefit from improved teamwork and communication. Improvements in teamwork 
are diverse ranging from the introduction of multidisciplinary briefings and debriefs through to the development 
of context specific structured communication for clinical handover. Since the introduction of the program in 2008 
over 1000 health services and university staff have been trained in teamwork skills during the two and a half day 
TeamSTEPPS  Train the Trainer Program. These staff train their colleagues under the Train the Trainer Program.  
These teams then innovate customised approaches to improving clinical handover specific to their local context. 

An example of collaboration across health care services was the introduction of TeamSTEPPS  in the South East 
Region of Country Health SA Local Health Network. This brought together SA Ambulance Service Team Leaders in  
the South East with Clinical Leaders from Bordertown, Kingston, Naracoorte, and Mount Gambier Health Services. 
The teams trained together and a key focus of their improvement work is clinical handover within and across  
clinical teams. 



page 103 Department for Health and Ageing Annual Report 2012-13

Standard 7   Blood and Blood Products
This Standard focuses on the principles of good patient blood management that provide for clinically appropriate  
and safe management of patients while avoiding blood and blood product transfusion and its associated risks.  
The department assists in these aims through:

 &gt; The BloodSafe Program, an SA Health and Australian Red Cross Blood Service collaborative with a focus on blood 
product prescribing and appropriate use.

 &gt; The BloodMove Program, which supports close engagement between hospitals and their pathology providers to 
minimise product wastage.

 &gt; The BloodSafe eLearning Australia Program, which provides ongoing education to those involved in the transfusion 
chain (from blood specimen collection through to transfusion).

 &gt; Blood Utilisation Studies   data linkage work that provides information on blood usage trends to support local 
practice improvement efforts.

 &gt; Facilitating the collection and review of haemovigilance (blood related adverse event) data.

 &gt; Governance systems such as the Statewide Blood Management Council and clinical user advisory groups.

 &gt; The publication of transfusion and iron therapy fact sheets for patients in multiple languages, including dedicated 
paediatric kits for children receiving a transfusion.

Standard 8   Preventing and Managing Pressure Injury
The SA Health Prevention and Management of Pressure Injuries Clinical Policy Directive and Guideline was released  
in 2012.

Components of the toolkit to accompany the policy directive are grouped by the four criteria required for 
accreditation   governance; screening and assessment; clinical intervention; and engagement with consumers.  
These are collated in the Accreditation Resource Guide and housed on the SA Health Safety and Quality website. 

For governance there is guidance for reporting and analysis of incidents and other data and a template for local 
committee structure and function. Each Local Health Network has a governance structure for pressure injury 
prevention, with links to the SA Pressure Injury Prevention and Management Advisory Group. The capabilities of  
the Safety Learning System (SLS) to provide rich clinically relevant information are being realised and the requirement  
to report pressure injury through SLS is being implemented. 

For screening and assessment, the Standard requires screening combined with comprehensive skin assessment and  
to meet this need, medical record forms are under development.

It has been agreed that clinical intervention in South Australia is guided by the Pan Pacific Clinical Practice Guideline 
for the Prevention and Management of Pressure Injury, 2012 Australian Wound Management Association (AWMA); 
Standards for Wound Management, 2010, AWMA; and Evidence based practice guidelines for the dietetic 
management of adults with pressure injuries, 2011, Dietetics Association of Australia. SA Health has negotiated 
access with WA Health to the WoundsWest e-learning modules. The provision of hospital bed surfaces as a 
preventative measure is being supported through the establishment, via public tender call, of whole-of-health 
statewide contracts for purchase or rental of alternating pressure mattress replacements.

An education framework, data framework and consumer information leaflet have been drafted in preparation for 
inclusion into the toolkit accompanying the policy and guideline.

Standard 9   Recognising and Responding to Clinical Deterioration in Acute Health Care
The SA Health Recognition and Response to Clinical Deterioration Advisory Group in 2012 drafted the SA Health 
Recognising and Responding to Clinical Deterioration Policy Directive and Policy Guideline. To support the 
implementation of the policy directive and policy guideline released in December 2012, statewide, standardised 
observation charts (Rapid Detection and Response [RDR] Observation Charts) have been developed, trialled and are 
being implemented to support clinicians in recognising acute clinical deteriorating. The charts provide guidance in  
the process of established protocols for escalation of a response to concerns or changes in a patient s observations  
or clinical status. The RDR Observation Charts are available in hard-copy and are built into EPAS. 



page 104Department for Health and Ageing Annual Report 2012-13

Standard 10   Preventing Falls and Harm from Falls
The SA Health Fall and Fall Injury Prevention and Management Clinical Policy Directive, Policy Guideline and toolkit 
have all been revised. Components of the toolkit are grouped by the four criteria required for accreditation   
governance; screening and assessment; clinical intervention; and engagement with consumers. These are collated 
within the Accreditation Resource Guide.

For governance there is guidance for reporting and analysis of incidents and other data and a template for local 
committee structure and function. The capabilities of the Safety Learning System to provide rich clinically relevant 
information are being realised. Each Local Health Network has a governance structure for falls prevention, with links 
to the SA Falls and Fall Injury Prevention and Management Advisory Group. 

For screening and assessment the general risk assessment and risk review processes have been built into EPAS to 
support clinical decision-making and care planning. Tools for other settings are either developed or under trial. 

Engagement with consumers continues to be a strong element of falls prevention. The April Falls Awareness Month 
activities, consumer leaflets and Patient Safety Report continue to build the community s understanding of falls 
prevention messages and services. In April 2013 there were several articles covered by the print media and radio 
interviews. Health services held a range of activities for their consumers and workers.



page 105 Department for Health and Ageing Annual Report 2012-13

Health and Medical Research
The department has continued to actively support health and medical research during 2012-13. 

SA Health is involved in a number of National Health and Medical Research Council Partnership grants and Australian 
Research Council linkage grants spanning areas such as Aboriginal health, mental health, diabetes, overweight and 
obesity, mothers and young children and Health in All Policies.

The following research projects were funded or part-funded by the department:

 &gt; Australia s Baby Boomer Generation, Obesity and Work   Patterns, Causes and Implications.

 &gt; Improving Primary Health Care Performance and Outcomes for Indigenous Peoples.

 &gt; New Technology for New Mums   A Pragmatic Trial of Web-Based Support for Mothers of Young Children.

 &gt; Preventing diabetes in pregnancy from progressing to type 2 diabetes: macro-level system change in South 
Australia and Victoria.

 &gt; Development and implementation of an evidence-based primary health care workforce planning model to support 
best practice in community mental health.

 &gt; Discipline of Public Health (University of Adelaide).

 &gt; South Australian Community Health Research Unit (Flinders University).

 &gt; Department of Health Care Management (Flinders University).

Funding support was provided to a number of existing research activities as well as a variety of forms of in-kind 
support including provision of research facilities and equipment and provision of de-identified data from SA Health 
Client data collections.

During 2012-13, active support was provided to a number of key initiatives. A primary focus has been on supporting 
the growth of the South Australian Health and Medical Research Institute (SAHMRI) against its research themes both 
in terms of infrastructure and capacity, and research activity. This work has resulted in the transfer of the Lysosomal 
Disease Research Unit and the Melissa White Research Laboratory from SA Pathology to SAHMRI.

SA Health continues to support the  Beat Cancer Project  a joint initiative with the Cancer Council of South Australia 
to support SAHMRI s cancer theme. 

Similarly the South Australian Cardiovascular Research Development Program, a joint initiative with the National Heart 
Foundation SA, provides support for SAHMRI s Heart Disease theme.

Other key directions include continuing to support the capability of SA NT Data Link, the Health Economics 
Collaborative and the upgrade of the SA Clinical Cancer Registry.

The Ministerial Health and Medical Research Advisory Council (HMRAC) has actively provided advice to the Minister, 
particularly on future research directions for SA Health.

Policy and research work has included streamlining the ethical review process for multi-centre research across the 
South Australian public health system, providing intellectual property advice, and providing policy input and advice for 
various state and national initiatives including the streamlining of ethical review for clinical trials.



page 106Department for Health and Ageing Annual Report 2012-13

eHealth Systems
The department provides a centralised information and communication technology (ICT) services function known as 
the eHealth Systems Division. This enables an efficient and effective technology service to be delivered which is a key 
strategy to support the implementation of an electronic health record for SA Health. Work has also progressed to 
support the Australian Government s initiative of a Personally Controlled Electronic Health Record (PCEHR).

Enterprise Patient Administration System
Following the announcement in December 2011 of $408m of funding to support the introduction of an electronic 
health record across much of the state, the Enterprise Patient Administration System (EPAS) program was initiated and 
has continued to progress this important initiative. Design of the system to support the clinical functions of SA Health 
has undertaken a great deal of effort and cooperation of over 300 clinicians across the service. Initial implementation 
of EPAS is expected to take place in mid-late 2013, with all sites complete within two years.

SA Health, in partnership with Telstra, has now completed the majority of the installations of bedside computers into 
our public hospitals. Over 3400 units were installed across 12 metropolitan and country hospitals, on articulated arms 
that allow for patients and clinicians to move the unit to a convenient position. Initially these units, for a nominal 
charge, provide a modern entertainment service to each patient. Overall the service has been developed to allow for 
access to the electronic health record, provided via EPAS, for clinicians using their secure logon.

Enterprise System for Medical Imaging
SA Medical Imaging (SAMI) became a statewide service on 1 July 2012, and is responsible for the provision of all medical 
imaging services at South Australian Public Hospitals within metropolitan and country South Australia across SA Health. 

The Enterprise System for Medical Imaging (ESMI) is a key requirement to meet the objectives of SAMI to provide 
greater efficiencies and an improved level of service. Following a market approach, a preferred vendor has been 
selected. ESMI will enable the booking, reporting, distribution and storage of all medical imaging examinations to 
occur via one system. Patient reports and images will be available to be viewed across SA Health services resulting  
in improved clinical care for patients.

The implementation of the new system is expected to be conducted in a phased approach with the initial site to be 
the Women s and Children s Hospital. This system includes the components of an Enterprise Radiology Information 
System, Voice Recognition, Picture Archiving and Communication System and Billing and Revenue Collection System.

Enterprise Pathology Laboratory Information System
As part of its State Budget announcements on 31 May 2012 the South Australian Government approved funding for 
the new Enterprise Pathology Laboratory Information System (EPLIS). The new EPLIS project will allow SA Pathology  
to replace its current out-dated system and be part of a wider eHealth strategy. It is expected to have connectivity  
to EPAS and to the Australian Government initiative of the PCEHR.

EPLIS will increase SA Pathology efficiency by reducing the risk of error of current manual handling of elements of  
the Request-Test-Report process.

During 2012-13 an extensive market approach was conducted and submissions have been received. An evaluation 
committee has reviewed the submissions and will announce the successful tenderer in the next reporting period.

Oracle Corporate Systems 
In September 2009 Cabinet approved the implementation of a new finance, procurement and supply chain system 
Oracle Corporate Systems (OCS) for SA Health to provide a single, statewide solution, and to replace the disparate 
legacy systems, all beyond their useful life. Specifically, the implementation of OCS was scheduled in two phases: 
Phase 1, Oracle Financials, which was deployed to all SA Health sites in June 2010; and Phase 2, Oracle Procurement 
and Supply Chain, which saw a first release deployment to the Department for Health and Ageing, the SA Health 
Distribution Centre, Modbury Hospital and Mount Barker Hospital in December 2010.

Approval was gained from Cabinet in 2013 to progress with Phase 3 of OCS. This phase, known as Procure-to-Pay 
will enable a statewide implementation of the Oracle Procurement and Supply Chain Management function.  
It coincides with the doubling of SA Health s central Distribution Centre and will be critical in improving the efficiency 
of this key logistics function. The completion of Phase 3 will enable the decommissioning of all SA Health legacy 
finance, procurement and supply chain systems and provide a common platform for requisitioning, purchasing, 
accounts payable, inventory management and warehousing across SA Health.



page 107 Department for Health and Ageing Annual Report 2012-13

South Australian Industry Participation Policy
A new South Australian Industry Participation Policy (SAIPP) came into operation as at 1 July 2012 and is administered 
by the Department for Manufacturing, Innovation, Trade, Resources and Energy and is published by the Industry 
Capability Network. The policy aims to ensure local businesses are given full, fair and reasonable opportunity to 
tender and participate in significant public and private sector projects and obligates SA Health, tenderers and 
suppliers to comply with the policy for tenders that fall within certain amounts, depending on whether they are for 
regional or metropolitan areas.

For full details of the policy refer to: 
http://www.icn.org.au/content/south-australia/south-australian-industry-participation-policy

During the 2012-13 financial year, eight tenders* were released within the scope of the SAIPP. As at 30 June 2013, 
these tenders are under evaluation and the resultant contracts are yet to be awarded and will be reported in the 
2013-14 financial year as required under the SAIPP. 

*Tenders include Requests for Proposal, Requests for Quote and Requests for Tender.

 



page 108Department for Health and Ageing Annual Report 2012-13

Major Projects

Developing the new Royal Adelaide Hospital 
In June 2007 the South Australian Government launched the plans for developing the new Royal Adelaide Hospital 
(new RAH). The new $1.85b hospital will be located in the city s west end. The hospital will replace the existing 
Royal Adelaide Hospital and continue to provide its full range of services, including Renal Transplantation which has 
transferred from The Queen Elizabeth Hospital.

Opening in 2016, the new RAH will become the cornerstone of South Australia s Health Care Plan.

As Australia s most advanced hospital and the largest hospital in South Australia, it will provide more than 80 000 
same day and overnight admissions per year, 800 beds (including 100 same day), an ambulatory care centre, operating 
theatre suite, all clinical and non-clinical support services necessary for the provision of high quality and safe patient 
care, and an excellent facility for teaching and research.

The new RAH project is in the end stages of finalising the detailed design of the hospital under the Public Private 
Partnership contract, which commenced in June 2011. Activities during 2012-2013 have focused on site preparation, 
earthworks, construction and the completion of the Design Development consultation process.

Design and Development

The project is now in its final stage of the Design Development phase. More than 80 planning groups involving 
several hundred staff have contributed to the design and functionality of the new hospital. These groups have met  
on over 400 occasions over the past two years to ensure the design has adopted world s best practice principles  
with respect to creating efficiencies, reducing travel and minimising the risk of cross infection and other adverse 
patient outcomes. 

Construction

Currently Project Co s Builder, Hansen Yuncken Leighton Contractors is undertaking construction procurement 
activities, coordination of infrastructure enabling works and construction of the new RAH in accordance with the 
construction documents. Construction for the concrete structure is progressing across the site with suspended slabs 
progressing from west to east. Eight tower cranes are now operating on the site supported by several mobile cranes.

Site Remediation

Site remediation and bulk excavation works are largely complete with over 250 000m3 of soil having been removed 
from the site. 

Redeveloping Glenside
The state government is investing more than $300m to create modern mental health and substance abuse services 
to better support South Australian individuals and families. A significant element of this health reform is the 
redevelopment of the Glenside Campus.

The reforming, rebuilding and re-designing of mental health services and the building of a brand new state-of- 
the-art health facility is part of the vision for Glenside Campus to become a precinct for best practice care of 
vulnerable people. 

In November 2012 construction of the 40 bed Specialist Rehabilitation Inpatient Unit, the six bed infant and perinatal 
mental unit (Helen Mayo House), and the Shared Activities Centre (housing a gym, multi faith space, and music and 
art therapy) was completed. 

The opening of these buildings marked completion of stage 1 of the new Glenside Health Services. 

The remaining buildings including a 53 bed Acute Inpatient Unit, a 30 bed Drug and Alcohol Services Inpatient 
Unit and the Front of House building (accommodating reception, offices and meeting space) form stage 2 of 
the construction works and are scheduled for completion in July 2013. The large shared garden area will also be 
completed at that time. 



page 109 Department for Health and Ageing Annual Report 2012-13

The Glenside Campus Redevelopment will also include:

 &gt; Precinct 2   Adelaide Studios.

 &gt; Precinct 3   Commercial.

 &gt; Precinct 4   Retail.

 &gt; Precinct 5   Residential.

The Adelaide Studios were completed in 2011. 

Renewal SA is managing the sale and development of Precinct 3 (Commercial), Precinct 4 (Retail) and  
Precinct 5 (Residential).



page 110Department for Health and Ageing Annual Report 2012-13

Council of Australian Governments  
Health Reforms

National Health Reform Agreement    Implementation
The National Health Reform Agreement (NHRA) commenced on 1 July 2012 and included key reforms around 
governance and funding for public hospitals. Under the agreement, states and territories remain as the system 
managers for public hospital services, but the Australian Government will contribute additional funding in the 
longer term towards efficient growth in the costs of these services. For the first two years of the NHRA, transition 
arrangements exist in which funding is guaranteed in line with the previous National Healthcare Agreement. From 
2014-15 the Australian Government will make contributions towards the cost of efficient growth in public hospital 
services of up to 45 per cent from 2014-15 and up to 50 per cent from 2017-18.

Under the NHRA, Activity Based Funding (ABF) has been adopted as the primary basis for funding public hospital 
services. In 2012-13 ABF was implemented for inpatient services, Emergency Departments and non-admitted services. 
In 2013-14 ABF will be implemented across sub-acute and mental health services. Block funding will continue to 
apply for certain services such as small country hospitals and teaching, training and research, the latter of which will 
be the subject of review for activity based funding in later years.

The NHRA includes a range of implementation work, much of which is led by four new national bodies: the 
Independent Hospital Pricing Authority, the National Health Performance Authority, the National Health Funding Body 
and the Australian Commission for Safety and Quality in Healthcare.

In September 2012, South Australia passed legislation to establish the National Health Funding Body and the National 
Health Funding Body Administrator which will have responsibility for directing Commonwealth and state funding 
for public hospitals to South Australian Local Health Networks in line with SA Health s service agreements with Local 
Health Networks.

During 2012-13 SA Health, along with other jurisdictions, contributed to the ongoing refinement of the Independent 
Hospital Pricing Authority s pricing framework and national efficient price for activity based funding. SA Health 
was also involved in negotiations with the Independent Hospital Pricing Authority s scoping work on the definition 
of public hospital services that will be used as the basis for attracting Commonwealth efficient growth funding 
contributions under the NHRA. Agreement on the final scope of public hospital services is expected to be reached  
by the Standing Council on Health in late October 2013.

National Health Reform Agreement   Strengthening Primary Health Care
Under the NHRA, the Australian Government has responsibility for general practice (GP) and primary health care 
services. In line with this, five Medicare Locals (MLs) were established across South Australia with responsibility for 
addressing primary health care gaps and areas of service need within their local communities.

The NHRA makes provision for the Australian, states and territory governments to work together on system-wide 
policy and planning for GP and primary health care. In 2012-13 SA Health worked with the Australian government 
and the other states and territories to develop a National Strategic Framework for Primary Health Care. The National 
Framework has been approved by Health Ministers nationally and identifies four key areas for action by  
all jurisdictions to manage national challenges in primary health care: 

 &gt; Building a consumer focused and integrated primary health care system.

 &gt; Improving access and reducing inequity.

 &gt; Increasing the focus on health promotion and prevention, screening and early intervention (this includes a focus  
to manage patients in primary health care settings where possible, rather than in hospitals).

 &gt; Improving quality, safety, performance and accountability.

SA Health is now developing a five-year state-specific primary health care plan as a mechanism for implementation  
of the National Framework. It is expected that the state plan will be complete by July 2013. 



page 111 Department for Health and Ageing Annual Report 2012-13

COAG Agreements
SA Health is largely on track in implementing initiatives under 19 health related COAG Agreements. South Australia s 
performance is particularly notable in the National Healthcare Agreement, with data published in 2012-13 showing 
that in the reporting period 2011-12:

 &gt; 72 per cent of Emergency Department patients in South Australia were seen within the national benchmarks, 
compared to 70 per cent nationally.

 &gt; South Australia showed the strongest improvement nationally over the period 2007 08 to 2011-12, increasing from 
58 per cent to 72 per cent of patients seen within benchmark times.

 &gt; South Australia performed better than the national average in the area of elective surgery.

 &gt; Waiting time at the 50th  per centile (the median) was 34 days in South Australia, compared to 36 days nationally.

Three key new agreements were successfully negotiated with the Australian government during 2012-13 which will 
bring up to $41.498m into South Australia over the period 2012-13 to 2015-16:

 &gt; National Partnership Agreement on Treating More Public Dental Patients.

 &gt; Project Agreement for the South Coast Primary Health Care Precinct.

 &gt; Project Agreement for the Murray Bridge Community Dental Clinic.

SA Health worked closely with the Australian Government and central agencies to identify ongoing service priorities 
under key COAG agreements which expired in 2012-13:

 &gt; The National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes.

 &gt; The National Peri-natal Depression Initiative under the National Partnership Agreement on Health Services.

 &gt; The National Partnership Agreement on Hospital and Health Workforce Reform.

In April 2013, the Prime Minister announced the Australian government s intention to continue the National 
Partnership Agreement on Closing the Gap in Indigenous Health Outcomes subject to requirements on state funding 
contributions. South Australia welcomed the continuation of this commitment in Aboriginal health and confirmed 
further state funding of $32.047m announced in the 2013-14 State Budget as a contribution toward Closing the Gap 
in Indigenous Health Outcomes. South Australia will continue discussions in 2013-14 with the Australian Government 
about the new National Partnership Agreement.

The Australian Government announced as part of 2013-14 Federal Budget, the continuation of the National Perinatal 
Depression Initiative subject to continued state matched investment. Negotiations commenced on this initiative and 
as at 30 June 2013 South Australia was awaiting the Australian Government s position on state funding requirements 
for the term of the new agreement.

In 2012-13 agreement was reached with the Australian Government about continuing outcomes of Emergency 
Department and Subacute Care services previously funded under the National Partnerships Agreement on Hospital 
and Health Workforce Reform.

Nationally Funded Centres Program Secretariat
The Nationally Funded Centres (NFC) Program is a unique collaboration between the states and territories and the 
Australian Government to support the public sector provision of certain high cost, low volume and highly specialised 
clinical procedures or technologies. The objective of the program is to provide optimal access to these technologies to 
all Australians regardless of geographical location, and in the context of workforce and resource availability.

Five procedures are currently approved NFC procedures those being paediatric heart transplantation, paediatric lung 
and heart-lung transplantation, paediatric liver transplantation, pancreas transplantation and the Norwood procedure 
and staged surgical palliation for hypoplastic left heart syndrome.

The NFC Program is managed by the NFC Reference Group which comprises representation from all the states and 
territories and the Australian Government. The NFC Reference Group is supported by the NFC Secretariat, which is 
based in SA Health. This secretariat manages and coordinates the program s annual work plan and budget which 
involves liaison and consultation with all jurisdictions and relevant national bodies, as well as reporting to the 
Australian Health Minister s Advisory Council (AHMAC) and the Standing Council on Health (SCoH).



page 112Department for Health and Ageing Annual Report 2012-13

The NFC Secretariat managed and coordinated a significant work program in 2012-13 with the following  
key achievements:

 &gt; Finalised a health technology assessment resulting in AHMAC approving NFC status for islet transplantation for  
the treatment of severe hypoglycaemia unawareness and metabolic instability in Australians with Type-1 diabetes.

 &gt; Finalised a health technology assessment resulting in AHMAC approval of the recommendation not to support  
NFC status for of pelvic exenteration surgery (extended radical pelvic resection) for Australians with locally  
advanced recurrent rectal cancer.

 &gt; Coordinated an independent consultancy for the scheduled review of the NFC paediatric liver transplantation 
program to final report stage.

 &gt; Commenced a scheduled review of the NFC paediatric heart transplantation program including the tendering  
and contracting process to engage an independent consultant.

 &gt; Commenced the procurement process for consultancy services to undertake a scheduled review of the NFC 
pancreas transplantation program.

 &gt; Commenced the procurement process for consultancy services to undertake a comprehensive review of the 
Appendix 2: Costing Pro Forma from the Nationally Funded Centres Guidance for Governance, Management, 
Funding, Establishment, Review (September 2011).

 &gt; Developed the platform for electronic annual reporting by the three NFC paediatric liver transplantation sites  
in collaboration with the Australian and New Zealand Liver Transplant Registry.

 &gt; Implemented an annual reporting tool for the NFC Patient and Family Questionnaire and developed a policy  
for the provision of the questionnaire in languages other than English.



page 113 Department for Health and Ageing Annual Report 2012-13

Public Sector Renewal

Cultural Change through the Public Sector Renewal Program 
In October 2012 the state government announced a Public Sector Renewal Program (now Change@SouthAustralia) 
to ensure the delivery of better quality and more innovative community services. The first round of 90 day projects 
commenced in December 2012. 

These accelerator change projects have been catalysts for action, overcoming internal barriers and delivering results 
within 90 days. Since December 2012, SA Health has successfully completed three 90 days projects.

Criteria Led Discharge Flinders Medical Centre
This project successfully trialed an innovative approach to discharging hospital patients. Rather than having to wait 
for the doctor to discharge patients as part of their rounds, this trial saw patients being discharged by other health 
professionals based on agreed criteria approved by their doctor. This project introduced changes to the discharge 
systems in three divisions at Flinders Medical Centre   medical, surgical and midwifery   to allow other health 
professional staff to discharge patients. 

Expanding in Criteria Led Discharge into Lyell McEwin Hospital 
This project expanded on the success of the  criteria led discharge  project trialed at Flinders Medical Centre earlier  
in 2013 in tranche one. Although criteria led discharge processes were already available at the Local Health Network, 
the up take by health professionals was low. This project saw an increase application of criteria led discharge practices 
from three per cent to 15 per cent across 11 surgery specialties within 90 days. This project will continue for  
12 months to ensure the practice is sustained and being applied for all eligible patients. 

Providing Antenatal Services within a Childhood Centre 
This pilot was developed to improve parents access to antenatal services at the Cowandilla and Ocean View Children s 
Centres, along with traditional services. The program will be available for all local residents, providing particular 
support for vulnerable families. It is anticipated that through providing antenatal care in children s centres, mothers 
will find out about other services and programs on offer, and start joining in with other families for the benefit of 
themselves and their children. 

SA Health is highly supportive of the philosophy behind the 90 day project and is committed to applying the 
methodology to existing change management projects where applicable.

SA Health looks forward to continuing to work with Change@SouthAustralia through the 90 day projects and 
implementation of the agreed Public Sector values and behaviours across the health portfolio.

More information regarding Change@SouthAustralia and the 90 day projects can be located at  
http://change.sa.gov.au/.



page 114Department for Health and Ageing Annual Report 2012-13

Emergency Management

Response to Critical Events
During the reporting period, the SA Health 24-hour response team received the following incident notification calls.

Table 4   Incident notification calls

Types of Incidents/Hazard Number of each Incident

Hazardous or dangerous materials 3

Extreme Weather 2

Fire 3

Road/transport accidents 1

Bushfire 8

Human disease 3

Other 6

Total 26

SA Health also responded to a number of incidents with some requiring activation of the Health Incident Room, in the 
Citi Centre Building, Hindmarsh Square.

SA Health was involved with a number of planned major events. Such involvement included active participation in the 
planning and coordination of the event and presence in the event s control centre during the event. These included:

 &gt; Tour Down Under/Mutual Community Challenge Tour

 &gt; Clipsal 500 Race

 &gt; Schoolies Festival (Victor Harbor)

 &gt; Christmas Pageant.

Training and Exercises

Major Incident Medical Management and Support

Major Incident Medical Management and Support (MIMMS) Australia has been adapted from the United Kingdom 
MIMMS Course to suit the needs of Australian disaster management systems. It aims to teach a systematic approach 
to disaster medical management. The course applies the  all hazards approach . The emphasis of the course is on the 
scene management and the majority of the course is practical based.

The following MIMMS training was delivered during the last 12 months:

 &gt; 24 military personnel completed a three day MIMMS Commander Course at Keswick Barracks, Adelaide   
September 2012.

 &gt; 24 civilian personnel completed a three day MIMMS Commander course at MedSTAR Base, Adelaide Airport   
October 2012.

 &gt; 24 civilian personnel completed a three day MIMMS Commander Course at MedSTAR Base, Adelaide Airport   
February 2013.

 &gt; 24 military personnel completed a three day MIMMS Commander Course at Keswick Barracks, Adelaide    
March 2013.

 &gt; 44 military personnel completed the MIMMS Commander Course at RAAF Base Richmond, NSW and RAAF Base 
Amberley, Queensland as part of a SA Health/RAAF agreement   April-May 2013.



page 115 Department for Health and Ageing Annual Report 2012-13

Emergotrain

The use of the Emergotrain System as a simulation exercise tool has again continued to develop into a highly efficient 
method of exercising mass casualty scenarios with hospitals training and educating large numbers of staff without 
compromising patient care.

Over the last 12 months there have been five exercises run in South Australian country hospitals involving 124 staff.

Two Emergotrain exercises were undertaken in the aged care sector, involving 54 staff, to assess and exercise the 
capabilities around evacuation of residential aged care facilities from the threat of bushfire.

Other Exercises

SA Health has been involved in one major multi-agency exercise across the last year.

In November 2012,  Team Spirit 12  was a discussion exercise based on a significant maritime accident. The discussion 
exercise involved 95 participants from all government agencies and appropriate non-government areas.

In April 2013, Emergency Management Unit staff developed and facilitated a discussion exercise for the members of 
the Australian Health Protection Principal Committee, which is chaired by the Chief Medical Officer of Australia and 
includes the Chief Health Officers from all states and territories and also included a New Zealand representative. The 
scenario was a bird flu outbreak. 

Two further discussion exercises were developed and facilitated by the Emergency Management Unit. In July 2012 an 
exercise was held at St Andrew s, a private hospital used as an overflow facility. In May 2013 an exercise looking at a 
human disease outbreak involving the senior management of the Royal Adelaide Hospital took place involving  
25 staff.

State Trauma Activities

The Emergency Management Unit continues to provide oversight of the State Trauma Clinical Working Group 
through the provision of senior clinical leadership and coordination of this group.

The Working Group has met several times over the past year and has developed several new initiatives as well as 
compiled a gathering of experienced subject matter experts throughout the healthcare industry in South Australia. 
This has included the development and implementation of the  Trauma Team Activation Criteria .

Emergency Management Education

During this reporting period, several emergency management education sessions were delivered by the Emergency 
Management Unit across the Local Health Networks. Executive staff undertook command and control and incident 
management training as part of an initial and ongoing education program.

AusMAT Deployment

There have been no active deployments of South Australian personnel under the AusMAT arrangements in the 
reporting period. Continued funding was allocated to provide the required minimum vaccinations for the initial  
25 personnel to enable overseas deployment. SA Health continues to strengthen its AusMAT capabilities through  
an organisational commitment through access to both training and resources.

In November 2012, 25 AusMAT personnel undertook a residential based training weekend with the Emergency 
Management Unit and external training providers to simulate deployment conditions. The training involved AusMAT 
personnel sleeping in tents in the Adelaide Hills and undertaking a wide range of scenario-based exercises, including 
humanitarian training, security training and medical education.

During the reporting period, several SA AusMAT personnel undertook specialist AusMAT training at the National 
Critical Care and Trauma Response Centre in Darwin.

Business Continuity 

The Emergency Management Unit finalised and obtained executive endorsement for a revised, whole of SA Health 
Business Continuity Policy Directive and framework. The Emergency Management Unit continues to support the 
health services to build capacity and resilience through the implementation of the new framework.



page 116Department for Health and Ageing Annual Report 2012-13

Human Health Preparedness

Human Disease

SA Health is continuing to work with other Hazard Leaders in South Australia to apply the National Emergency Risk 
Assessment Guidelines (NERAG) methodology across a variety of hazards. Emergency Management Unit provided 
oversight and convened a successful NERAG workshop for Human Disease (Pandemic Influenza) on 12 June 2013 
with more than 50 attendees.

Pandemic Influenza

Pandemic Influenza planning continues to be undertaken along with the review and development of relevant 
planning, response and recovery documents to support existing state emergency management arrangements. 

Extreme Heat
The booklet Extreme Heat: Guide to coping and staying healthy in the heat has proven to be a very popular 
information resource for the general public since its release with continuing requests for the resource. A fact sheet 
translated into 10 different languages is a new addition to the current heat related fact sheets available on the  
SA Health website http://www.sahealth.sa.gov.au. 

Aged Care
The Residential Aged Care and Country Hospital Risk Assessment Review and Planning Activities Project working 
group was established to undertake the work of the Aged Care Sub-Committee of the Bushfire Task Force. The 
multi-agency group, including members from Australian and state governments, the Local Government Association of 
South Australia and aged care sector, continues to support the aged care sector in the development of an emergency 
management risk framework for aged care and country hospital facilities. Seventy nine residential aged care facilities 
and country hospitals were risk assessed during phase one and phase two. Phase three is moving to an all hazards 
approach with the intent of increasing the ability of agencies to respond to a range of potential critical incidents.

As a result of the work of the project, a significant geospatial information system has been built for use by SA Health 
to assist in a collaborative government response in an emergency incident. One of the key learnings from phase one 
is that  invacuation  is a legitimate and now the preferred option for most facilities during a bushfire (except a major 
intense fire such as Ash Wednesday) as there are greater risks and adverse health outcomes for vulnerable people as  
a result of evacuation.



page 117 Department for Health and Ageing Annual Report 2012-13

Health Workforce and Human  
Resources Activity

Overview: Service Demands and Workforce Trends 
The South Australian health system has undergone extensive change over recent years. This change is in response to 
both shifts in the demography and health status of the population, as well as innovations in technology and changing 
expectations within the workforce. The increasing demand for services in SA Health has implications for both models 
of care, workforce roles and their distribution.

The prevalence of many chronic diseases is increasing in South Australia which will impose even heavier demand for 
health services and therefore health workers. Chronic diseases include heart disease, stroke, cancer, depression and 
diabetes and are characterised by their long development period with multiple factors leading to their onset, and 
a prolonged course of illness. This has implications for the service delivery and the skill mix required for optimum 
treatment. Multi-disciplinary and team-based care is becoming increasingly important in the management of many 
chronic diseases so that the patient is at the centre of his or her care.

Advances in technology, such as enhanced diagnostic tools, better prostheses, more reliable devices and more 
effective medicines are contributing to changing patterns of health service delivery, and the skill mix required within 
the health workforce. Information technology is creating new ways for patients and health workers to communicate 
and participate effectively in decision making, and monitor the coordination of care. Similarly changing consumer 
expectations are shifting the way services are delivered and how patients and their carers engage in their care journey.

Changing expectations within the existing health workforce about their work, and in particular the hours they are 
prepared or able to work, are contributing to a workforce model that needs to be flexible and adaptable. Factors 
contributing to this trend include the increased feminisation of the workforce and an increased general cultural 
interest in a work/life balance. 

These changes impact on the current South Australian health system and its workforce, both in terms of composition, 
skill mix and location. SA Health is responding by developing workforce models that value and maximise the 
contributions made by all workers and are built on modern, evidence-based practice.

Medical Workforce

Increasing numbers of medical graduates are entering the workforce in South Australia. As part of the government s 
commitment through Every Patient Every Service, 25 new training positions for junior doctors were funded for  
2012-13. The department has continued to be able to provide domestic graduates from medical schools in South 
Australia with an intern place in the state.

Medical Education and Training

On 22 April 2013 the South Australian Institute of Medical Education and Training (SA IMET) was officially renamed 
the South Australian Medical Education and Training (SA MET) Unit. This followed a review of the SA IMET Health 
Advisory Council (the Advisory Council) to assist in the separation of the Advisory Council and the Secretariat Unit. 
The department continues to support the work of the SA MET Unit. During the 2012-13 financial year, full facility 
accreditation visits were undertaken at four hospitals and 13 units were visited to ensure appropriate education and 
training is in place for prevocational doctors. There has also been continued development of a range of training 
opportunities, with 39 prevocational general practice positions filled during 2012-13, along with other new settings 
aligned with strategic workforce need.



page 118Department for Health and Ageing Annual Report 2012-13

Recruitment, Attraction and Retention 2012-13

Recruitment activity reduced significantly in 2012-13 as a result of state government vacancy management protocols. 
Recruitment requests have been thoroughly scrutinised and major savings have been achieved in recruitment 
expenditure. This has been accompanied by a reduction in the number of international medical professionals 
appointed to SA Health positions during 2012-13.

Notwithstanding this and in line with previous trends, there have been some significant recruitment campaigns  
in 2012-13. 

Road to Rural GP: Country Health SA Local Health Network (CHSALHN) provides many opportunities for medical 
trainees to experience life working and living in rural South Australia. CHSALHN is one of the largest Local Health 
Network regions in Australia. It oversees the rural public health system in South Australia and provides high quality 
health care to 29.2 per cent of the state s population that reside in rural and remote South Australia. The CHSALHN 
incorporates 65 hospitals and 240 health services sites. Training in rural South Australia can be a great experience.

Yarrow Place: Part of the Women s and Children s Health Network, Yarrow Place is the lead public health agency 
responding to adult rape and sexual assault in South Australia. A community service with a statewide mandate, 
they provide direct services to people who have been raped or sexually assaulted and who were aged 16 years or 
more at the time of the assault. Through comprehensive training and the experiences at Yarrow Place, staff develop 
specialised forensic skills and the ability to assess and document cases in a precise and thorough way. This can be 
a real advantage in other areas of medicine such as clinical practice. The specialised forensic skills can be utilised 
nationally. 

Country Health SA Local Health Network   mental health: is leading the way in mental health reform, providing 
a number of new services in a variety of regional locations throughout South Australia. New facilities will improve 
access to acute and rehabilitation services for rural residents. Suitably qualified mental health nurses, psychiatrists, 
clinical psychologists, social workers, occupational therapists, mental health support workers, and administration and 
operational roles will commence later this year.

Return to Nursing and Midwifery: Flinders Medical Centre in collaboration with the Women s and Children s 
Hospital and the Royal Adelaide Hospital offer a free Refresher Program for Registered Nurses. The programs are 
offered on a part time and full time basis. Candidates have the ability to study from home. All participants receive a 
SA Health funded scholarship upon successful completion.

Allied Health casual recruitment: Flinders Medical Centre has been recruiting qualified Occupational Therapists, 
Physiotherapists, Podiatrists, Dieticians and Speech Pathologists interested in casual employment in an acute hospital 
setting. This presents fantastic opportunities for candidates to be involved with research, education and ongoing 
professional development. Opportunities included positions across a broad range of clinical units including: acute 
care of the elderly; stroke; neurosurgery; intensive and critical care; renal; respiratory; oncology; paediatrics and 
orthopaedic trauma.

Northern Adelaide Local Health Network nursing campaign: The Lyell McEwin Hospital is undergoing an 
exciting stage of expansion, with the opening of a new ward in July 2013. As a result it was looking to employ 
both experienced and graduate nurses in a variety of roles   Enrolled Nurses, Registered Nurses, Clinical Service 
Coordinator and Associate Clinical Service Coordinators. While it was looking for a broad range of medical nursing 
experience, skills in Neurology, Cardiology and Respiratory nursing were also highly regarded. In addition the Lyell 
McEwin Hospital was seeking experienced ICU Nurses to join its Intensive Care Unit team. 

Emergency medicine: The Central Adelaide Local Health Network was seeking Emergency Physician Registrars to 
join its emergency team working across the two recognised teaching sites: The Royal Adelaide Hospital and The 
Queen Elizabeth Hospital. 



page 119 Department for Health and Ageing Annual Report 2012-13

Medical, Nursing and Midwifery and Allied and Scientific Health Workforce Strategies

Office for Professional Leadership

The Office for Professional Leadership (OPL) is a collaboration of SA Health s Medical, Nursing and Midwifery  
and Allied and Scientific Health Offices. It is hosted by the System Performance Division of SA Health.

The OPL supports the embedding of the priorities of reform; leadership; culture and change across eight key  
focus areas within a model that acknowledges interacting programs and partnerships. The eight focus areas are:

 &gt; Best practice

 &gt; Governance

 &gt; Teaching and training

 &gt; Professional development

 &gt; eHealth

 &gt; Policy and consultation

 &gt; Workforce

 &gt; Reporting and performance.

SA Health Nursing and Midwifery Strategic Framework 2013-15 

The Chief Nurse and Midwifery Officer has been working with nurses and midwives across SA Health to develop 
the SA Health Nursing and Midwifery Strategic Framework 2013-15 (the Framework). It is designed to provide the 
vision and the direction for the transformation of practice and incorporates the change agenda priorities, actions and 
outcomes for success. The Framework is aligned to broader national and state reform agendas, and aims to ensure 
that nurses and midwives remain professionally connected to their clients and deliver high quality, safe, efficient and 
effective, evidence-based care with good outcomes and experiences for those in our care.

The purpose of the Framework is to outline a clear vision for the profession of nursing and midwifery, the strategic 
priorities for the nursing and midwifery professions, and the actions, objectives, outcomes and timelines for 
addressing the identified strategic priorities.

The vision for the SA Health nursing and midwifery professions is as follows:

   SA Health nurses and midwives practise competently, capably and professionally to meet and exceed the  
needs of clients in delivering high quality, compassionate care.

  SA Health nurses and midwives take pride in their work and aspire to continuing self-development and 
knowledge acquisition, through self-awareness and a nurturing, supportive culture of equality, honesty,  
passion and accountability. 

To achieve this vision, the Framework focuses on the following five strategic priorities:

 &gt; Caring with kindness.

 &gt; People and culture.

 &gt; Workforce capability and capacity.

 &gt; Evidence based research in clinical practice.

 &gt; Workforce organisation.

Work has commenced on the first two strategic priorities, namely  caring with kindness , and  people and culture . 
 Caring with kindness  is about connecting with our clients and putting their care and needs at the centre of our 
purpose.  People and culture  is about being explicit in relation to the culture that best supports and facilities the work 
of nurses and midwives.

The Framework belongs to and is owned by all SA Health nurses and midwives, and can only be achieved through  
the active participation and commitment of nurses and midwives at all levels, and across all service areas.



page 120Department for Health and Ageing Annual Report 2012-13

Best Practice Spotlight Organisation Project

The department, the Australian Nursing and Midwifery Federation (SA Branch) and the Registered Nurses Association 
of Ontario (RNAO) have engaged in an international collaboration to develop nursing/midwifery evidence-based 
practice cultures, enrich professional practice and improve patient outcomes by promoting and supporting 
implementation of RNAO Best Practice Guidelines .

Two SA Health sites, Hampstead Rehabilitation Centre/Primary Health Care and the Northern Adelaide Local Health 
Network have committed to the program as pilot sites. They will implement a minimum of three, internationally 
recognised RNAO Nursing Best Practice Guidelines, ensuring that practice is underpinned with evidence. These 
Guidelines are relevant to the selected health sites, and address areas identified for performance improvement, 
ensuring alignment with SA Health Reform Principles, Local Health Network and National Safety and Quality strategic 
directions.  Both sites have chosen  client centred care  as the first Guideline to implement due to the significance of 
this area to sound, consistent, day to day nursing practice. The program will run until December 2014.

Governance Framework for Advanced Scope of Practice and Extended Scope of Practice Roles

SA Health has launched a Governance Framework for Advanced Scope of Practice Roles and Extended Scope of 
Practice Roles in SA Health. The purpose of the Framework is to provide the governance framework to ensure there 
is a consistent approach to determine the need, planning, implementation and evaluation of non-medical advanced 
scope of practice or extended scope of practice roles within SA Health. With this in mind, the focus of the Framework 
is for the Nursing, Midwifery and Allied Health professions and has been developed consistent with Medicine, which 
has a clearly defined governance framework for the extension of practice.

The Framework describes the roles, responsibilities, systems and processes to optimise our workforce to provide best 
practice models of care to the full scope of the practitioner s regulatory requirements, knowledge, skills and abilities. 
This Governance Framework will contribute to the achievement of a flexible, sustainable, responsive and adaptable 
workforce that delivers quality clinical care and safe patient outcomes.

SA Nursing and Midwifery Premiers Nursing Scholarship Recipients 2012-13 

The Premier s Scholarships provide an opportunity for nurses and midwives to explore innovative practices within 
their chosen field, with the aim to advance nursing and midwifery practice within South Australia. Five Premier s 
Scholarships were awarded to nurses and midwives in 2012 to undertake overseas study tours visiting the United 
Kingdom, Ireland, Canada and America. 

The areas of study covered a broad range of clinical and professional issues across the continuum of services and 
patient need. Examples of areas of study include the establishment of a hospital based Early Pregnancy Unit and 
investigation into the development of advanced nursing roles for care of the older person. As always, recipients of the 
scholarships were from a broad range of healthcare settings and were truly representative of the diversity of clinical 
services and the contemporary nature of nursing and midwifery within South Australia.

Outcomes from the tours included the identification of numerous areas for innovation and improvement within 
existing clinical practice, and dissemination of these findings to relevant professional bodies and networks.

Graduate Nurse and Midwife Employment

The department released the SA Health Graduate Nursing and Midwifery Employment Strategy Report and Action 
Plan in June 2012. The report addressed concerns regarding a current short term oversupply of newly graduated 
nurses and to a lesser extent newly graduated midwives, within South Australia.

All recommendations outlined in the Action Plan have been implemented and in 2013 employment of graduate 
nurses and midwives increased, particularly across Country Health SA Local Health Network. The Nursing and 
Midwifery Office continues to work collaboratively with Local Health Networks, other SA Health agencies, wider 
government agencies such as Health Workforce Australia, professional bodies and universities and training institutions 
to lead and support ongoing work in regard to nursing and midwifery workforce planning and organisation.

Nursing and Midwifery Excellence Awards 2013

The South Australian Nursing and Midwifery Excellence Awards recognise and acknowledge the significant 
contribution that nurses and midwives make to the community and their professions through their practice.

On 10 May 2013 SA Health, in conjunction with industry partners, hosted the 13th annual Awards dinner at the 
Adelaide Convention Centre, where the recipients of Nursing and Midwifery Excellence Awards were announced. 
Over 100 applications were received for the 11 award categories.



page 121 Department for Health and Ageing Annual Report 2012-13

Allied and Scientific Health Office
The Allied and Scientific Health Office (ASHO) provided leadership and advocacy for Allied and Scientific Health 
Professionals (AHP) across South Australia, informed and influenced regulatory and legislative changes; models of 
care; best evidenced practice; career pathway development and clinical documentation all focused on improving care 
for clients. ASHO is currently responsible for ClinEdSA. Some of the key projects included:

 &gt; The inaugural Allied and Scientific Health Statewide Profession Advisory Groups Planning Day. Nine Statewide 
Profession Advisory Groups attended with the aim to reflect on their current agenda, plan and prioritise work 
for 2013 and 2014 and identify areas for cross-collaboration between professional groups. Presentations on key 
issues that were set to shape SA Health in 2013 were provided including: current and emerging challenges to the 
South Australian health system and the way that allied and scientific health might respond; Activity Based Funding, 
Reporting and Allied Health, and the SA Health Care Plan and Clinical Commissioning.

 &gt; Ongoing facilitation of Statewide improvements in clinical care through the continued support of the AHP Online 
Journal Club Program, AHP Master Class Series, AHP Clinical Audit Program and other research opportunities 
building access to and use of evidence based clinical practice through collaboration with the International Centre 
for Allied Health Evidence University of South Australia.

 &gt; Development of the Governance Framework for Advanced and Extended Scope of Practice in SA Health in 
collaboration with the Nursing and Midwifery Office.

 &gt; Finalising of the credentialing and access appointment policy content and database introduction to track 
registration and additional credentialing and accreditation information of AHP staff as part of safe and quality 
service delivery practices.

 &gt; Progression of the development of a Statewide Clinical Governance and Clinical Supervision Guideline to improve 
governance and support structures for AHPs across SA Health.

 &gt; Teaching and training expansion through exploratory clinical placement capacity and capabilities partnerships with 
ClinEdSA and the development of blended learning modules for multidisciplinary and inter-professional learning 
clinical supervision training.

 &gt; The AHP+ Professional Development Reimbursement Program continued to enable over 40 per cent of AHPs to 
access continuing education activities including multiple group workshops and programs to improve clinical care.

 &gt; Progression of a range of eHealth initiatives including EPAS, Activity Based Funding and compliance with Client 
Management Engine and HOMER systems from an AHP perspective.

 &gt; Statewide agreement on standardised clinical documentation through the ASHO e-Health Collaborative which will 
improve practice and standardise assessment tools and outcome measures for clients across the state.

 &gt; Development of Statewide Allied Health Data Definitions for the first time. This will enable consistent data entry 
and to ensure that Casemix, Monthly Management Summary System (MMSS) and Activity Based Funding costing 
and funding requirements are met and that future appropriate allied health care is available for South Australians.

 &gt; National and International committee engagement, representation responsibilities and provision of advice at a State 
and Australian Government level for issues relevant to Allied and Scientific Health Professions and their clients. This 
includes policy communication and consultation, leadership and support including but not limited to the National 
Allied Health Advisors Committee; International Chief Health Profession Officers Council; Health Workforce 
Australia, federal and state Ministerial committees; Statewide Allied Health Executive Business Meetings and 
Working Parties, ASHO eHealth Collaborative and the 11 Statewide Profession Advisory Groups.



page 122Department for Health and Ageing Annual Report 2012-13

ClinEdSA
ClinEdSA is the operational and secretariat support of the Integrated Regional Clinical Training Network initiative in 
South Australia, which is primarily funded by Health Workforce Australia and hosted by SA Health. ClinEdSA has 
strengthened critical relationships with key stakeholders that are focused on clinical education and training of our 
future clinician workforce. ClinEdSA s administrative hosting within the Office for Professional Leadership is ensuring  
a stronger link between the Professions  Chief Officers, SA Health and the clinical education and training sectors.

A snapshot of the work that ClinEdSA has focused on includes:

 &gt; Networking events.

   Aged and Extended Care Forum, ACCSA and NT.

   Physiotherapy Clinical Placement Working Group to promote discussions and facilitate collaborations across  
and between professional and/or geographical groupings.

   Allied and Scientific Health Clinical Education and Placement Summit which set goals for these professions  
in relation to clinical placements, including the prioritisation of key issues and recommendations for action

   Nursing Advisory and Midwifery Advisory Forum.

Clinical Placement Program:

 &gt; Development of education provider and placement provider clinical education and workforce strategies, for all 
health professions in Country Health SA Local Health Network.

 &gt; Clinical placement capacity benchmarking project to assist with the establishment of baseline criteria for nursing 
and midwifery placement provider offers to education providers requesting placements for their students.

 &gt; Process mapping work to identify and improve stakeholder clinical placement processes and systems.

 &gt; Strategic planning, management and reporting of supply and demand information, centralised coordination  
of nursing and midwifery clinical placements.

Clinical Supervision and Support Program (CSSP): 

 &gt; Provision of a series of master classes focusing on health professionals supporting education in clinical settings  
in the CSSP program. 

Simulated Learning Environments: 

 &gt; Participation in a statewide forum for planning of simulated learning initiatives. This has resulted in the 
development of a simulation learning repository containing resources and links to simulation scenarios, contacts 
and information, and building of partnerships across sectors to develop a statewide plan for simulated learning. 

Attracting, Valuing and Retaining our Workforce
The benefits of the South Australian Public Sector Wages Parity Enterprise Agreement: Salaried 2012 are now 
showing through the establishment of service structures across the state.

Women s and Children s Health Network and Country Health SA Local Health Network continue to hold Executive 
Allied Health positions. Central Adelaide Local Health Network has established and appointed an Executive Director 
of Allied Health position; Northern Adelaide Local Health Network has permanently appointed a Director of Allied 
Health; Southern Adelaide Local Health Network is currently undertaking a review of their Allied Health Executive 
structure; and Mental Health Services clinical governance has been amalgamated within each Local Health Network 
Allied Health Directorate.

This is the first time in SA Health s history that allied and scientific health has had an AHP included as an integral part 
of each of the Local Health Network (LHN) Executive teams. It has enabled a review of AHP governance structures  
and roles with LHNs and Allied and Scientific Health Office and the establishment of a Statewide Allied Health 
Executive group. This provides a single point of contact for advice on and dissemination of AHP related information 
across all relevant allied and scientific health professions as well as mechanisms for joint collaboration for allied and 
scientific health across all LHNs e.g. development of a Statewide Clinical Governance Framework and Clinical  
Support Guidelines.



page 123 Department for Health and Ageing Annual Report 2012-13

Research and Training
AHP+ Professional Development Reimbursement Program has been an outstanding success for SA Health s allied and 
scientific health staff and their clients. The allied and scientific health workforce has repeatedly reported the benefits 
of the professional development scheme which has provided funding support for clinicians to attend courses and 
conferences to increase individual clinician s knowledge and expertise in their clinical field. This program has been a 
key contributor to retaining staff and making SA Health an employer of choice for AHPs in Australia.

Allied and Scientific Health Office assisted in ensuring that SA Health funded the capability development of 19  
Allied Health Assistants to a Certificate III level, in conjunction with the Staff Development Department at the  
Royal Adelaide Hospital, which has continued in 2012-13. 

Ongoing partnership with the International Centre for Allied Health Evidence (iCAHE), University South Australia 
has offered SA Health AHPs an opportunity to undertake a workplace based clinical audit process on behalf of their 
department, clinical service or advisory group with research support.  

SA Health AHPs have also been provided with opportunities to extend their skills through access to the iCAHE website 
and Clinical Guideline Clearing House, training in evidence based practice, journal club participation, master classes 
and mentoring for staff publications. A series of two master class workshops were run by iCAHE for AHPs across the 
themes of Evidence Based Practice and Outcome Measures and use of iCAHE  Outcomes calculator  in 2012-13. This 
master class approach supports our highly skilled clinicians to move into research and publication arenas to influence 
service delivery design, along with assessment and treatment tools.  

Currently there are 43 Evidence Based Journal Clubs attended by 400 AHPs across SA Health, which is an increase of 
101 per cent from 2011-12. Evidence Based Journal Clubs provide the vehicle for critical analysis of evidence based 
practice prior to embedding into AHP service delivery.

The Chief Allied and Scientific Health Advisor (CASHA) continues to support clinical research through participation as 
industry partner, collaborator and clinical expert on a number of research projects funded through NHMRC or ARC 
Linkage Grants. The CASHA also continues her long term involvement in the Cochrane Collaboration with recent 
publications in the field of drug and alcohol use in pregnancy.

Corporate Learning and Development 2012-13 Activity Report

The purpose of the Corporate Learning and Development Team is to provide learning and development opportunities 
in non-clinical topics to SA Health staff. This is done by:

 &gt; Providing a calendar of training programs for SA Health staff in non-clinical topics.

 &gt; Responding to one-off or ad-hoc training requests.

 &gt; Undertaking or contributing to projects that support the work of SA Health.

The Corporate Learning and Development Calendar 2013 offers education and training opportunities to all SA Health 
staff. It aims to provide high quality, accessible education and training programs which will support SA Health staff  
to maximise their potential and enhance performance.

Training courses are currently offered to all staff at major metropolitan sites in the following areas:

Business and administration

 &gt; Client services

 &gt; Communication skills

 &gt; Management and leadership

 &gt; Occupational, health, safety and welfare

 &gt; Personal skills

During 2012-13 approximately 2000 staff registered for 159 programs covering 27 topics. There are waiting lists for 
several programs and the calendar is constantly adjusted to cater for demand. During the year, enrolment and data 
collection systems and operational policies have been refined.

One-off and ad-hoc training requests are considered and services provided according to set criteria, including the 
availability of training staff to deliver the programs. In 2012-13 we provided 26 programs in 12 topics to 13 sites.  
The most popular topics were, in order: Respectful Behaviours, Giving and Receiving Feedback, and Building 
Resilience and Managing Stress.



page 124Department for Health and Ageing Annual Report 2012-13

Projects undertaken included:

 &gt; The Women and Leadership Mentoring Program.

 &gt; A review of the Performance Review and Development system.

 &gt; Data collection for the Education and Training Services Review.

 &gt; Updating the Induction and Orientation Website.

 &gt; A change management pilot project for Southern Adelaide Local Health Network.

Workforce Reform
The changing South Australian healthcare landscape requires care and service responses that are built upon a capable 
and qualified health workforce. However it is apparent that the predicted demand for services and workforce are 
unsustainable and that more innovative solutions are required.

To meet the increasing demand for delivery of care, SA Health is fostering new ways of thinking and working.  
This is integral to ensuring a sustainable, future workforce that is able to provide safe, effective patient-centred care.

During 2012-13 workforce reform initiatives have been driven out of and designed to support service reforms, clinical 
practice improvements and to maximise the skills of our workforce.

SA Health s workforce is:

 &gt; Shifting to work in models that are patient-centred, providing care in the most appropriate setting and maximising 
the contribution and extent of all workers. 

 &gt; Continually exploring and creating opportunities within workforce models to enable innovation, evidence-based 
change, greater role flexibility and multidisciplinary learning. 

Careers in Health
The Workforce Directorate is very active in the area of career promotion to both secondary and tertiary students.  
Over the past few years the Directorate has developed a significant number of resources for secondary school 
students to inform them about the wide variety of careers in health.

The major event for secondary school students was the National Careers and Employment Expo which was held at the 
Wayville Showgrounds in May. Long term planning goes into this event which showcases career opportunities in the 
nursing and midwifery fields, the allied and scientific health sector, dentistry and oral health, emergency services, as 
well as the medical specialties. SA Health is one of the largest exhibitors at this event and has a number of hands-on 
exhibits to capture the interest of students. Many health professionals from across the system volunteer their own 
time to attend this event and provide valuable information for students, their parents and caregivers as well as school 
careers counsellors and those individuals looking to either re-enter the workforce or change careers.

SA Health is recognised as being very active in the area of career promotion and as such, invitations to attend 
individual school career expos have increased significantly over the past financial year. While the Workforce 
Directorate has supported a large number of these it is not possible to provide a presence at all of them. Where a 
physical presence is not possible, the Workforce Directorate will provide resources for display at the expo.

The Workforce Directorate coordinates attendance at each of the South Australian University career expos. These 
events are run for the benefit of final and penultimate year students to enable them to gain information about 
potential employers. The advantages to the students include gaining information on where to look for employment 
opportunities, and tips on how to apply for positions.

Additional, specific information sessions have been run at each of the South Australian Universities for final year 
students in nursing and midwifery. These sessions have been designed to assist nursing and midwifery graduates to 
apply for positions within the SA Health Transition to Professional Practice Program. Applications for placement in 
these programs is very competitive and the additional information sessions have been welcomed by the student body.



page 125 Department for Health and Ageing Annual Report 2012-13

Graduate Recruitment
In 2013 SA Health had 482 available positions within the Registered Nurse Transition to Professional Practice Program 
(TPPP) and 62 available positions within the Registered Midwife TPPP. The transition from graduate to registered nurse 
or registered midwife, from university to clinical workplace can be daunting, so the TPPP offers a real life hands-on 
supported program where graduates have access to education support, professional development study days and 
peer support. The TPPP assists newly registered nurses and midwives to consolidate their knowledge and expand their 
clinical skills. 

In addition to the transition programs for Registered Nurses and Registered Midwives, SA Health offers a 40 week 
program operating statewide for graduate mental health nurses employed in public sector mental health. The 
program promotes professional resilience and supports workforce service reform and development. The program has 
a strong recovery focus and runs from March to December. 

The 2013 Mental Health Allied Health Internship Program was launched in September 2012 and was open to social 
work, clinical psychology and occupational therapy graduates who completed their academic courses in 2012. It was 
aimed at employees beginning their professional careers to develop specialist knowledge and skills in mental health. 
The program provides working opportunities and an ongoing development program to enable graduates to build 
their knowledge and skills in mental health, working with different team environments and consumer groups. 

SA Pharmacy offers a number of Pharmacy Intern training positions which are available in collaboration with the 
Pharmacy Board of Australia. This is an ideal way for Pharmacy graduates to kick start their career in hospital 
pharmacy. Graduates rotate through various areas of Pharmacy practice which may include Production, Dispensing, 
Clinical and Medicines Information Services. They assist with the preparation of prescriptions for patients, the 
compounding of pharmaceutical products, counselling patients about their drug therapy, and providing and 
interpreting drug information for medical staff and patients. 

Country Health SA Local Health Network offers opportunities to motivated and enthusiastic Assistants in Nursing 
to kick-start their careers in the nursing profession. A number of positions are on offer across hospitals and health 
services in the Eyre Peninsula, Yorke Peninsula, Mid North, South East, Mallee, Adelaide Hills and Riverland Regions of 
South Australia. Successful applicants are enrolled as a student in an undergraduate program in nursing or midwifery, 
and they take part in nursing activities that enhance their understanding of the role of a nurse and the workings of a 
country hospital. Guided and supported by experienced Enrolled and Registered Nurses, they receive close supervision 
as they grow and build their nursing skills and capabilities. 

The SA Dental Service offers a number of Dental Assistant traineeships each year. This is a wonderful opportunity for 
interested applicants to commence their career in the area of oral health. Trainees work under supervision and provide 
effective and efficient support to Dental Operators at the chair-side. They not only learn the technical aspects of 
preparing dental materials and setting up equipment to perform dental procedures, they also learn to communicate 
with clients, maintain records and assist with the management of dental waiting lists. In addition, SA Dental Service 
runs a graduate program annually which targets final year dentistry students. 



page 126Department for Health and Ageing Annual Report 2012-13

Industrial Issues
Workforce Relations has continued to support workforce and work practice reform through industrial instruments, 
and negotiation with employees and their associations. The unit provides advice and assistance to management 
across SA Health in order to maintain a stable industrial relations environment and sound working relationships with 
staff and unions. 

On 23 October 2012, the Industrial Relations Commission of South Australia approved the South Australian 
Public Sector Wages Parity Enterprise Agreement: Salaried 2012. The Agreement supersedes the South Australian 
Government Wages Parity (Salaried) Enterprise Agreement 2010, which has been formally rescinded.

The South Australian Government Wages Parity (Weekly Paid) Enterprise Agreement 2010 nominally expired on 1 
October 2012. In April 2013, further to extensive negotiations in respect of a new Weekly Paid Enterprise Agreement: 
2013, an offer was made to the United Voice and other employee associations/representatives. That offer is the 
subject of an employee ballot.

Negotiations with the South Australian Salaried Medical Officers Association (SASMOA) for a new Salaried Medical 
Officers Enterprise Agreement have continued during this reporting period. On 28 June 2013, a Terms of Offer for a 
new enterprise agreement was provided to the SASMOA in settlement of its claim. 

Negotiations for a new Nursing/Midwifery (South Australian Public Sector) Enterprise Agreement commenced 
with the Australian Nursing and Midwifery Federation (the Federation) on 22 January 2013. The current enterprise 
agreement expired on 30 June 2013.

Regular meetings we scheduled between the parties to discuss SA Health s management agenda and the Federation s 
log of claims. SA Health s management agenda includes more flexibility to respond to new models of care, changes 
in patient demographics and disease trends, evidence based practice and advances in technology that will ensure a 
financially sustainable healthcare system.

The Federation s log of claims is centred on staffing levels including a new staffing model, nursing/midwifery skill  
mix issues and professional development allowances.

Also during this reporting period negotiations for a new SA Health Visiting Medical Specialists Agreement  
were finalised.

Employment Arrangements as at 30 June 2013

Table 5   Employee Numbers, Gender and Status

Total Number of Employees

Persons 2 138.0

Full-time equivalent (FTE) 2 018.4

Gender % Persons % FTEs

Male 39.9% 41.7%

Female 60.1% 58.3%

Number of Persons During the 12-13 Financial Year 

Separated from the agency 363

Recruited to the agency 476

Number of Persons at 30 June 2013

On leave without pay 84



page 127 Department for Health and Ageing Annual Report 2012-13

Table 6   Number of Employees by Salary Bracket

Salary Bracket Male Female Total

$ 0 - $ 53 199 149 221 370

$ 53 200 - $ 67 699 174 331 505

$ 67 700 - $ 86 599 290 406 696

$ 86 600 - $109 299 193 284 477

$109 300+ 48 42 90

TOTAL 854 1284 2138

Table 7   Status of Employees in Current Position

FTEs Ongoing Short-Term Contract Long-Term Contract Other (Casual) Total

Male 570.1 123.2 147.0 0.4 840.7

Female 735.8 250.9 190.9 0.1 1177.7

TOTAL 1305.9 374.1 337.9 0.5 2018.4

Persons Ongoing Short-Term Contract Long-Term Contract Other (Casual) Total

Male 576 126 150 2 854

Female 798 284 201 1 1284

TOTAL 1374 410 351 3 2138

Executives

Table 8   Executives by Gender, Classification and Status* 

Classification

Ongoing Term Untenured Total

Male Female Male Female Male % of total Execs Female
% of total 

Execs Total

Executive Officers

Level F 0 0 1 0 1 1.6% 0 0.0% 1

Level C 0 0 1 0 1 1.6% 0 0.0% 1

South Australia Executive Service (SAES)

Level 1 0 0 27 22 27 44.3% 22 36.1% 49

Level 2 0 0 7 3 7 11.5% 3 4.9% 10

Total 0 0 36 25 36 59.0% 25 41.0% 61

*The Department for Health and Ageing had no executives engaged on a Term   Tenured or Other employment contract at June 2013.



page 128Department for Health and Ageing Annual Report 2012-13

Leave Management

Table 9   Average Day Leave Per Full Time Equivalent Employee

Leave Type 2009-10 2010-11 2011-12 2012-13

Sick leave 7.4 7.5 7.4 7.6

Family carers leave 0.6 0.6 0.8 0.8

Miscellaneous special leave 1.0 0.8 0.4 0.4

Workforce Diversity

Table 10   Aboriginal and/or Torres Strait Islander Employees 

Salary Bracket Aboriginal Employees Total Employees % Aboriginal Employees Target*

$  0 - $  53 199 2 370 0.54% 2%

$ 53 200 - $  67 699 4 505 0.79% 2%

$ 67 700 - $  86 599 5 696 0.72% 2%

$ 86 600 - $109 299 3 477 0.63% 2%

$109 300+ 1 90 1.11% 2%

TOTAL 15 2138 0.70% 2%

* Target from SASP

Table 11   Number of Employees by Age Bracket by Gender 

Age Bracket Male Female Total % of Total  2013 Workforce Benchmark*

15-19   0 0 6.2%

20-24 16 46 62 2.90 9.7%

25-29 79 142 221 10.34 10.9%

30-34 95 174 269 12.58 9.8%

35-39 120 167 287 13.42 10.1%

40-44 121 166 287 13.42 11.8%

45-49 123 179 302 14.13 11.2%

50-54 128 196 324 15.15 11.3%

55-59 99 131 230 10.76 9.0%

60-64 57 72 129 6.03 6.1%

65+ 16 11 27 1.26 3.7%

TOTAL 854 1284 2138 100 100.0%

*Data source: Australian Bureau of Statistics (ABS) Australian Demographic Statistics, 6291.0.55.001 Labour Force Status (ST LM8) by sex, age, state, 
marital status   employed   total from Feb 78 Supertable, South Australia at Feb 2013.



page 129 Department for Health and Ageing Annual Report 2012-13

Table 12   Cultural and Linguistic Diversity 

Male Female Total % of Agency SA Community*

Number of employees born overseas 199 257 456 21.3% 22.1%

Number of employees who speak language(s) other 
than English at home

71 108 179 8.4% 14.4%

 
* Benchmarks from ABS Publication Basic Community Profile (SA) Cat No. 2001.0, 2011 Census.

Table 13   Total Number of Employees with Disabilities (According to the Australian Government DDA 
Definition)

Male Female Total % of Agency 

8 16 24 1.1%

Table 14   Types of Disability (Where Specified)

Disability Male Female Total % of Agency 

Disability requiring workplace adaptation 8 16 24 1.1%

Physical 1 5 6 0.3%

Intellectual 0 1 1 0.0%

Sensory 2 2 4 0.2%

Psychological/Psychiatric 1 0 1 0.0%

Voluntary Flexible Working Arrangements

Table 15   Voluntary Flexible Working Arrangements by Gender 

Male Female Total FWA*

Purchased leave 2 3 5

Flexitime 765 1195 1960

Compressed weeks 14 20 34

Part-time 57 358 415

Job share 10 90 100

Working from home 6 12 18

* Note: Employees may be undertaking more than one type of Flexible Working Arrangement at the same time. In this way, the total is unlikely to  
add to 100% 

Performance Development

Table 16   Documented Review of Individual Performance Management 

Employees with   % Total Agency

A review within the past 12 months* 18.3%

A review older than 12 months 19.0%

No review 62.7%

* Includes all recorded performance development plans established or reviewed in the last 12 months.



page 130Department for Health and Ageing Annual Report 2012-13

Young Professionals Group
The SA Health Young Professionals Group (YPG) promotes the interests of all SA Health employees, regional  
and metropolitan, aged 35 years and under. Membership is multi-disciplinary, with members from areas such  
as administration, sciences, clinical, medical, allied health, nursing, IT and finance. 

Young health employees are committed to fostering a dynamic and positive health system for the future. The aim 
is to build a culture that facilitates generations working together towards better health outcomes for the South 
Australian community. The YPG is open to all young professionals across health aged 35 years and under.

The YPG Strategic Directions 2012-15 focuses on three key areas:

 &gt; Welcoming and engaging young professionals in SA Health.

 &gt; Supporting and retaining young employees in the workplace.

 &gt; Investing in young professionals as future leaders.

Meeting on a monthly basis, the YPG Steering Committee coordinates all  behind the scenes  administration and 
logistics for events, membership recruitment and projects. 

Projects currently completed during the 2012-13 year include:

 &gt; Quarterly newsletters.

 &gt; Increasing regional involvement in the YPG, for example, through hosting the first  Meet and Greet  networking 
event in country South Australia.

 &gt; Attendance at the department s orientation days.

 &gt; Subsidising training and conference opportunities through administering the first round of grant funding.  
Ten applications were supported, all from Local Health Networks.

 &gt; Co-Hosting with SA Ambulance Service a strategic networking event where over 20 public and private sector 
executive staff were present.

 &gt; Organising informal quarterly  Meet and Greet  events for the YPG membership.

 &gt; Team building amongst steering committee members.

Leadership and Management Development
Developing LEADS (Clinical Leadership Program in Australia ) is a 12-month professional development program 
for health professionals. The primary goal of the program is to achieve safe, quality, person-centred care by helping 
participants to build leadership strategies that enable them to deal more effectively with the realities of day to day 
practice. The program regards the health professional as an agent of change in enhancing safety and quality of  
care, and facilitates development of leadership capabilities that help participants to grow from both a personal  
and professional perspective, for the purpose of implementing and sustaining improvements in practice.

The program is conducted in an inter-professional experiential learning model involving allied and scientific health 
professionals, pharmacists, doctors, nurses and midwives drawn from health sites across country and metropolitan 
South Australia. 

The program has a unique two-tiered structure that engages Local Facilitator participants in their own professional 
development program while they concurrently facilitate the program for Clinical Leader participants. Local Facilitators 
are generally people working in operational roles and Clinical Leaders are generally people working in roles involving 
implementation/delivery of services. 

Participants work together in mixed groups and engage in: 360 degree feedback; workshops; action learning; 
coaching and mentoring; and learning from patients  experiences and observations undertaken in the practice setting.



page 131 Department for Health and Ageing Annual Report 2012-13

Undertaking the program assists with:

 &gt; Building leadership and management capacity.

 &gt; Fostering a person-centred approach to service delivery.

 &gt; Facilitating active engagement in quality improvement strategies.

 &gt; Fostering development of a learning culture in the workplace.

 &gt; Developing greater appreciation of the health system as a whole.

 &gt; Contributing to recruitment and retention strategies.

During 2012-13, 71 health professionals participated in Developing LEADS.

Women in Leadership
The SA Health Women in Leadership Steering Committee was established in late 2011 and is comprised of  
15 female leaders from across SA Health, including leaders from a wide variety of professions and roles like medical, 
nursing and midwifery, allied health and project specialists. The committee provides a voice for women of all ages and 
at all levels in the health portfolio.

Using information gleaned from reviews of current literature about women and leadership and data gathered through 
the Department of the Premier and Cabinet s 2012 Executive Feeder Group Survey, the Steering Committee has 
developed a business case for improving gender diversity in the leadership ranks and released a document outlining 
SA Health s strategic directions for the next three years.  

SA Health s Portfolio Executive has endorsed this work and the objectives agreed upon. These objectives include:

 &gt; Raising awareness.

 &gt; Supporting and empowering women at all levels.

 &gt; Role modelling.

 &gt; Setting a target and tracking outcomes.

The Steering Committee knows that focusing on one strategy alone will not produce results and so has taken a multi-
facetted approach, and hopes to engage staff and leaders at all levels in their journey. 

Department for Health and Ageing Occupational Health, Safety, Welfare and Injury 
Management Committee and Health and Safety Representative Forum
The department s Work Health Safety and Injury Management Governance has been incorporated into the Portfolio 
Executive Terms of Reference. The department s Work Health Safety Consultative Committee continues to meet 
quarterly and membership is reflective of the department s changed structure, with both management and  
employee representation.

The department has continued to support a separate Health and Safety Representative Forum. The forum convened 
regularly through 2012-13 ensuring Health and Safety Representatives were kept informed of workforce health 
strategies and directions.

Work Health and Safety and Injury Management
The Safety and Wellbeing in the Public Sector 2010-15 Strategy (the Strategy) embeds the Premier s Zero Harm Vision 
and underpins the SA Strategic Plan Target 21: Greater Safety at Work.

In conjunction with WorkCover SA, SA Health has developed a Partnership Plan and has been benefiting from 
quarterly assessment and feedback sessions. The first Nominated Officer report, which replaces the Responsible 
Officer report, is due in September 2013.



page 132Department for Health and Ageing Annual Report 2012-13

Workers Compensation

Workers Compensation across SA Health is managed centrally, with Local Health Network based rehabilitation.  
An  1800  hotline was introduced to streamline reporting and ensure early intervention. This hotline is in place  
for all areas with the exception of SA Ambulance Service, where alternative early intervention systems are in place 
and effective.

Current strategies for injury management include a focus on new lost time injury claims, complex and costly claims, 
job readiness and job seeking.

The 2012-13 strategy, to include the department in the early intervention  1800  program, was achieved. Human 
Resources, Workforce Health and department managers are working together to address issues influencing 
psychological injury to minimise the number of claims and time lost. A review has been undertaken across SA 
Health in the area of manual handling services, identifying strategies, including utilising job demand information 
in recruitment and assessment of workability. Work is currently occurring to implement the strategies endorsed in 
September 2012.

Further SA Health s Health and Safety Representatives quarterly forums have continued to be provided and have been 
well received and attended.

Work Health and Safety and Injury Management System

Work Health Safety and Injury Management Peak Governance for SA Health has been incorporated into the Portfolio 
Executive Terms of Reference.

The Performance Review and Continuous Improvement framework has been established and is providing more robust 
data analysis, auditing, reporting and performance review.

The Clinical Work Health and Safety Services Review has now been completed and the recommendations are currently 
being implemented, including the development of consistent processes and practices across SA Health.

Work Health and Safety Action Plans for SA Health and LHNs continue to be monitored and maintained through 
Work Health and Safety Consultative Committees. 

SA Health Work Health and Safety and Injury Management Policy, Procedures and Guidelines have continued to be 
developed and endorsed to support the Work Health Safety and Injury Management System.

Consultation and information pathways have continued to operate across SA Health in relation to Work Health Safety 
and Injury Management, including bulletins, forums, and workshops.

Safety and Performance

In 2012-13, there were four notifiable incidents in the Department for Health and Ageing. There were two notifiable 
incidents that involved electric shock due to faulty equipment. In both cases, equipment was repaired or replaced.  
The other notifiable incidents involved two separate medical emergencies and workers were subsequently checked  
at the hospital, cleared and discharged.

Table 17   Work Health and Safety Prosecutions, Notices and Corrective Action Taken

Number of notifiable incidents pursuant to WHS Act Part 3 4

Number of notices served pursuant of WHS Act Section 90, Section 191, and Section 195 (Provisional 
Improvement, Improvement and prohibition notices)

0



page 133 Department for Health and Ageing Annual Report 2012-13

Table 18   Department s Gross Workers Compensation Expenditure5 for 2012-13 Compared with 2011-126

EXPENDITURE 2012-13 ($) 2011-12 ($)
Variation ($) 

+ (-)
% Change 

+ (-)

Income maintenance $246 279 $164 677 $ 81 602 49.6%

Lump sum settlements redemptions   Sect. 42 $190 513 $ 54 772 $135 741 247.8%

Lump sum settlements permanent disability   Sect. 43 $ 47 580 $ 18 400 $ 29 180 158.6%

Medical/hospital costs combined $215 565 $151 586 $ 63 979 42.2%

Other $178 147 $108 245 $ 69 902 64.6%

Total claims expenditure $878 083 $497 679 $380 404 76.4%

Table 19   Meeting Safety Performance Targets7 

Base: 
2009-10

Performance: 12 months to the 
end of June 2013*

Final Target

Numbers 
or %

Actual
Notional  

Quarterly  
Target**

Variation Numbers or %

1. Workplace fatalities 0 0 0 3  0 0

2. New workplace injury claims 22 30 19 7  11 17

3.  New workplace injury claims frequency 
rate

14.2 9.4 12.1 3 -2.7 10.7

4. Lost time injury frequency rate *** 6.5 4.1 5.5 3 -1.4 4.8

5. New psychological claims frequency rate 3.9 2.5 3.3 3 -0.8 3.0

6. Rehabilitation and return to work:     

6a. Early assessment within two days 68.2% 56.7% 80% 7 -23.3% 80%

6b. Early Intervention within 5 days 88.9% 100.0% 90% 3 10.0% 90%

6c. LTI have 10 business days or less lost time 33.3% 20.0% 60% 7 -40.0% 60%

7. Claim determination:     

7a.  New claims not yet determined, assessed 
for provisional liability in seven days

7.7% 81.8% 100% 7 -18.2% 100%

7b.  Claims determined within 10 business 
days

59.1% 67.6% 75% 7 -7.4% 75%

7c.  Claims still to be determined after three 
months

13.6% 16.2% 3% 7 13.2% 3%

8.  Income maintenance payments for recent 
Injuries:

    

2011-12 injuries @ 24 mths development NA $71 485 $99 849 3 -$ 28 364
Below previous 

two years average

2012-13 injuries @ 12 mths development NA $121 821 $ 27 617 7 $ 94 204
Below previous 

two years average

* Except for Target 8, which is year to date.
For Targets 5, 6c, 7b and 7c, performance in measured up to the previous quarter to allow reporting lag.
** Based on cumulative reduction from base at a constant quarterly figure.
***   Lost Time Injury Frequency Rate is the injury frequency rate for new lost-time injury/disease for each onem hours worked. This frequency rate is
calculated for benchmarking and is used by the WorkCover Corporation.
Formula for lost time injury frequency rate (new claims):
Number of new cases of lost-time injury/disease for year x 1 000 000

Number of hours worked in the year

5  Before 3rd party recovery

6  Information available from the Self Insurance Management System (SIMS)

7  Information available from the Self Insurance Management System (SIMS) (SIPS target report)



page 134Department for Health and Ageing Annual Report 2012-13

Carers Recognition Act 2005
The Carers Recognition Act 2005 requires all South Australian Government agencies to ensure that their organisation 
and its employees take action to reflect the principles of the Carers Charter in the provision of services to carers and 
the people they care for. South Australian Government portfolio Chief Executives are required to report annually on 
their progress.

The department s progress in implementing the SA Carers Policy for 2012-13 includes the following:

 &gt; The Minister for Health and Ageing met with Carers SA to discuss issues of importance for carers, transitioning 
from a quarterly basis in 2012 to a six monthly basis in 2013.

 &gt; The Chief Executive SA Health met with Carers SA on a quarterly basis.

 &gt; In 2013, the department released A Framework for Active Partnership with Consumers and the Community and 
A Guide for Engaging with Consumers and the Community. The Framework and Guide provide an overarching 
structure and guide to support health care organisations in the development of effective consumer and community 
engagement strategies for service planning, designing care, service measurement and evaluation.

 &gt; The Carers Australia s response to the Australian Commission on Safety and Quality in Health Care s Consultation 
Paper on the Australian Safety and Quality Goals for Health Care (National Goals), will be embedded as part of the 
2013 SA Safety and Quality in Health Care Consumer and Community Advisory Committee work plan, and the  
SA Health Partnering with Consumers and Community Strategic Action Plan. 

 &gt; In May 2013, The Longevity Revolution, final report of Dr Alexandre Kalache, ageing specialist Adelaide Thinker 
in Residence, was launched by Mrs Leesa Vlahos M.P., Parliamentary Secretary to the Premier, on behalf of the 
Minister for Health and Ageing. SA Health was the key partner in Dr Kalache s residency. The vital role of carers  
was recognised in Dr Kalache s residency.

 &gt; In June 2013 the Draft South Australian Strategy for Safeguarding Older People 2014-21 was released for 
consultation. The Draft Strategy includes a South Australian Charter of the Rights and Freedoms of Older People, 
the first of its kind in Australia. The Draft Strategy specifically acknowledges the unique role that carers play in our 
society and the need to ensure that appropriate supports are in place for them.

 &gt; The Statewide Mental Health Lived Experience Register (the Register), released 12 June 2013 is a mechanism by 
which mental health consumers and carers can advise the department s Mental Health and Substance Abuse 
Division about what is important to them when it comes to mental health and wellbeing, and provide feedback  
via consultations. There are four levels for participation: 

   Receive information such as newsletters and email updates.

   Provide feedback via surveys and email responses.

   Attend forums regarding different areas of mental health. 

   Provide representation on lived experience perspectives on a specific topic at meetings or forums.

 &gt; SA Health employs a Carer Consultant within the Mental Health and Substance Abuse Division. The Carer 
Consultant is responsible for engaging with, consulting and facilitating the input of mental health carers into the 
planning and delivery of mental health services in South Australia. The Carer Consultant is also responsible for the 
planning, development and implementation of projects and initiatives which ensure carer input is optimised.

 &gt; The Mental Health and Substance Abuse Division Carer Advisory Group (CAG) is one of the consultation 
mechanisms of the Register. It is convened by the Carer Consultant and meets quarterly, providing input to  
SA Health s mental health service delivery, policy development and evaluations.

 &gt; The Mental Health and Substance Abuse Division provided $10 000 for a Young Carers  Grant in 2013. Facilitated 
by a panel of staff from the department, MIND, Raw Energy and Carers SA, individual young carers could apply 
for up to a maximum of $500 to assist them to access opportunities to increase their development of skills and 
knowledge or enable them to participate in community based activities.  

 &gt; The Mental Health and Substance Abuse Division developed a Carer Support and Respite program that provides 
services to families of, and persons caring for, individuals experiencing mental illness. This service is provided across 
the metropolitan area and inner northern country, including Adelaide Hills.



page 135 Department for Health and Ageing Annual Report 2012-13

 &gt; All Local Health Networks employ Carer Consultants as integral members of mental health teams.  
Their roles include:

   Assessing the strengths, challenges, and goals of the person with a mental illness and key family members, 
recognising the importance of the family context.

   Assisting in formulating a plan that coordinates all elements of a person s treatment and support, to facilitate 
recovery and to maintain good relationships within the family.

   Providing family members/carers with information about the illness and its treatments and appropriate 
community resources.

Carer Participation Position Statement Guideline
The Position Statement applies to all of SA Health and outlines the various roles of a family carer within the health 
system. It recognises and promotes the unique role and functions of the family carer to assist greater and improved 
support for carers from the broader health system and to ensure that the exceptional health needs of family carers are 
valued and recognised. The Position Statement will be reviewed and aligned to the Carers Recognition Act 2005.

Actions Supporting Employees Who Are Carers: 

 &gt; SA Health has a range of flexible work practice policies that are consistent with whole of government standards 
and can be accessed by carers.

 &gt; Advice is provided to employees and managers on flexible working practices. 

 &gt; SA Health training programs for Human Resources personnel and managers include current requirements  
and expectations for support and assistance to be provided to staff who are carers.

 &gt; Staff orientation sessions include information about flexible work practices and support services for carers  
such as Carers SA.

 &gt; The SA Health Employee Assistance Program provides counselling and support to employees who would like 
assistance to deal with issues which may affect their health and wellbeing.

 &gt; A range of health and wellbeing initiatives are offered to all staff to improve their own wellbeing, including to  
staff who are carers. This includes smoking cessation, healthy eating programs, flu vaccinations and physical  
activity programs such as Corporate Cup sponsorship.



page 136Department for Health and Ageing Annual Report 2012-13

Disability Action Plan Report 
Promoting Independence: Disability Action Plans for South Australia (2000) provides a policy framework for all  
South Australian Government portfolios and their agencies to develop Disability Action Plans.

 &gt; The department works closely with Local Health Networks and SA Ambulance Service to develop information 
packages across all programs, to promote the rights of consumers, including people with disabilities. Local Health 
Networks have a range of consumer advisory groups/advisors that liaise and receive feedback from consumers and 
particular interest groups, including disability groups.

 &gt; A fact sheet is available to enable staff to provide information in other formats, including via audio-cassette, Braille, 
diskette, large and illustrated print, plain English, internet (utilising non-discriminatory information technology), 
radio, video (including captions), free call telephone numbers, telephone typewriter, and National Relay Service. In 
addition, people who are deaf or have hearing impairment have access to appropriate interpreters.

 &gt; An on-line Disability Awareness Training Program is available for staff. Divisions within the department, Local Health 
Networks and SA Ambulance Service also provide disability awareness training as part of mainstream training and 
staff development programs, and in some cases have used the department s on-line disability awareness program. 

 &gt; Since 2004 the department has funded the Health Consumers Alliance to ensure that the rights of consumers are 
represented, with a focus on the most vulnerable consumers, including people with disabilities.

 &gt; SA Health promotes complaints processes through its publication, Your Rights and Responsibilities and also through 
the Health and Community Services Complaints Commissioner. Consumers of public, non-government and private 
health or community services, including consumers with disabilities, can make a complaint to the Commissioner.

 &gt; In July 2012, the department released the Charter of Health and Community Services Rights Policy Directive. The 
purpose of the policy directive is to implement the Charter of Health and Community Services Rights (the Charter), 
and to ensure that services are safeguarding patient rights and complying with the legislation pursuant to Part 3 
of the Health and Community Services Complaints Act 2004. The policy directive aims to increase awareness of all 
staff, consumers and the public about the Charter. It also ensures that health care providers understand the rights 
of consumers and the community as set out in the Charter s guiding principles which states:

  Decision making capacity: Some people may have impaired capacity to make decisions due to illness, injury, 
disability or development. Impaired capacity may be temporary or permanent, partial or complete. If a person 
has impaired decision making capacity, the service provider should enable supported decision making. If a 
person has impaired decision making capacity, the service provider must involve or seek the consent of a 
substitute decision maker, including a carer. Individuals with impaired decision making capacity must not be 
disadvantaged in the provision of health or community services.

 &gt; In 2012, education materials including posters, brochures and information to promote the HCSCC Charter to staff 
and consumers were provided to all health care sites. The Charter has also been translated into 11 community 
languages and a large print (English) version was also provided and all resources are available on the HCSCC 
website at www.hcscc.sa.gov.au.

 &gt; SA Health promotes consumer feedback through publications and has developed a Patient Safety Report for 
Consumer and Community and Fact Sheets on:

   Partnering with Consumers   the consumer feedback section describes how to provide feedback including 
complaints, compliments, and suggestions. It also provides an example of the complaint process.

   Know your rights when receiving a Health or Community Service   outlines the HCSCC Charter of Rights and 
how the Charter is used by consumers, family members, carers and nominees who act on their behalf, and 
health care service providers.  

 &gt; The community mental health centres that were opened during 2012-13 in Salisbury and Woodville comply with 
the Disability Action Plan requirements regarding accessibility of buildings for people with disability.

 &gt; SA Health has worked closely with the Department for Communities and Social Inclusion (DCSI) in relation to the 
funding and service delivery responsibilities of the National Disability Insurance Scheme (NDIS) with the health 
system in South Australia to improve the lives of people with disability, in line with the National Disability Strategy.

 &gt; Mental Health and Substance Abuse Division has been working with the DCSI to prepare for the launch of the 
NDIS, now known as  DisabilityCare Australia . From 1 July 2013 the first stage will roll out for children in South 
Australia. Preparation included planning meetings about the rules and principles for the launch in South Australia, 
and also for the implementation of the full scheme. The Division has been working with DCSI and the Department 
of Treasury and Finance to identify programs and services for people with psychiatric disability that may be 
considered to be in scope for implementation of the full scheme.



page 137 Department for Health and Ageing Annual Report 2012-13

Greening of Government (GoGO), Sustainability 
Reporting and Energy Efficiency Action Plan
The following report comprises an overview of SA Health s progress in implementing the Cabinet endorsed Greening 
of Government (GoGO) Action Plan (2006) and the Energy Efficiency Action Plan (2001).

Eight key strategic milestones have been established for agencies to work towards. The table below shows progress 
against these strategic milestones.

Table 20   GoGO Eight Strategic Milestones

Strategic milestones Status as at June 30 2013

1

Establish Chief Executive 
 Statement of commitment 
to greening of agency 
operations .

 &gt; Completed.

2
Allocate resources to set up 
governance and internal 
review.

 &gt; Completed.

3

Review environmental 
impacts, determine 
priorities and allocate 
resources.

 &gt; Initial review completed. Priority setting and resource allocation is reviewed 
annually.

4
Set performance goals/
internal targets.

 &gt; Energy and water efficiency targets are developed for all major SA Health 
facilities.  

 &gt; Environmental key performance indicators are established for all major  
capital works projects.

5
Approved agency 
Implementation Plan and 
Communication Plan. 

 &gt; The SA Health Energy Efficiency Implementation Plan has been endorsed by  
the Chief Executive. This plan is reviewed and updated annually and actions  
put into place to implement the plan.

6
Reported on status/progress 
in reaching performance 
goals/targets.

 &gt; Compliance with the energy and water efficiency targets established for all 
major facilities is regularly reviewed and progress reported to relevant senior 
executives. 

 &gt; Progress against the energy, water and environmental targets established for 
each major redevelopment project are regularly reviewed and progress reported 
to relevant senior executives and project team members.

 &gt; In 2012-13 an environmental rating tool called the  In-House Green Rating 
Tool  was developed to assess the environmental performance of capital 
projects undertaken by SA Health. (See GoGo Priority Area 4: Built Facilities,  
for more detail).

7
Initiated agency 
Implementation Plan.

 &gt; Elements of the department s Energy Efficiency Implementation Plan have been 
put into effect, with further progress expected to occur over forthcoming years. 

 &gt;  A Steering Committee has been formed to oversee the procurement of a 
proposed whole-of-portfolio Waste Management Service. 

8

Undertaking ongoing 
measuring, monitoring, 
reporting and continuous 
improvement of 
performance.

 &gt; Processes are in place for measuring and reporting performance in achieving 
the energy and water efficiency targets. 

Data source: Internal SA Health information



page 138Department for Health and Ageing Annual Report 2012-13

SA Health s progress toward delivering on sustainability is aligned to the six GoGO Priority Areas as reported below:

GoGO Priority Area One: Energy
In November 2001, the Government of South Australia approved the Government Energy Efficiency Action Plan, a 
comprehensive whole of government energy management program targeted to improve energy efficiency across 
all sectors of government s operations. This initiative is an integral part of the National Greenhouse Strategy and 
incorporates the South Australian Government s State Strategic Plan target 61: Energy efficiency   government 
buildings: Improve the energy efficiency of government buildings by 30 per cent by 2020 (Milestone of 25 per cent  
by 2014).

SA Health is a very large consumer of gas and electricity, accounting for 51.8 per cent of all building energy 
consumed by the government sector in South Australia in 2010-11. As such, it is recognised as one of the key 
portfolios in determining whether this ambitious target will be achieved. The table below provides energy use 
information for all building energy consumed by SA Health in the period 2000-01 through to 2012-13.

Progress Towards 25 Per cent Energy Efficiency Target

In absolute terms the SA Health Portfolio consumed 10.1 per cent less energy in 2012-13 than it did in the 2000-
01 baseline. However, absolute energy consumption is not a measure of energy efficiency. Rather energy efficiency 
is determined by reference to energy use per some form of business output or other business measure. Energy 
efficiency by area is most commonly reported and is the measures SA Health reports against in meeting the Strategic 
Plan target. 

 &gt; Square metres: Energy use per square metres of occupied space is widely recognised as perhaps the best measure 
of the energy efficiency of hospitals and overnight stay facilities. Energy use per square metre (m2) of occupied 
healthcare space was 0.99 GJ/m2 in 2012-13 down from 1.30 GJ/m2 in 2000-01; an improvement of 23.3 per cent.

 &gt; Occupied Bed Days (OBDs): Average energy use per OBD in 2012-13 was 0.71 GJ/m2, down from a 0.85 GJ in 
2000-01; an improvement in energy efficiency of 16.8 per cent.

 &gt; Full Time Equivalents (FTEs): Across the SA Health Portfolio Energy use per FTE in 2012-13 was 39 GJ FTE down 
from 55 GJ FTE in 2000-01; an improvement in energy efficiency per FTE of 34.2 per cent.  

It is noteworthy that SA Health has arguably improved the energy efficiency of its buildings by more than indicated, as 
not only has the floor area and number of beds increased over the last decade, but so has the use of energy intensive 
medical equipment such as linear accelerators and imaging equipment. To provide a sense of scale a large MRI or 
linear accelerator can use in the order of 3-4 per cent of a large hospitals total annual electricity use.



page 139 Department for Health and Ageing Annual Report 2012-13

Table 21   Building Energy Consumption for SA Health Portfolio 2000-01   2012-13

Year

Total Energy Use Business Measures

GJ %  Change

Square metres Occupied Bed Days Full Time Equivalents

M2
GJ/
M2

%  
Change OBD

GJ/
OBD

%  
Change FTE

GJ/
FTE

%  
Change

2000-01 1 250 128 964 262 1.30 1 469 532 0.85 22 613 55

2001-02 1 231 013 -1.5% 970 021 1.27 -2.1% 1 542 349 0.80 -6.2% 23 314 53 -4.5%

2002-03 1 240 966 -0.7% 972 321 1.28 -1.6% 1 466 736 0.85 -0.5% 24 624 50 -8.8%

2003-04 1 289 072 3.1% 993 980 1.30 0.0% 1 488 522 0.87 1.8% 24 770 52 -5.9%

2004-05 1 274 676 2.0% 1 045 243 1.22 -5.9% 1 474 770 0.86 1.6% 26 190 49 -12.0%

2005-06 1 272 112 1.8% 1 079 210 1.18 -9.1% 1 540 002 0.83 -2.9% 26 017 49 -11.6%

2006-07 1 277 953 2.2% 1 084 210 1.18 -9.1% 1 566 295 0.82 -4.1% 26 258 49 -12.0%

2007-08 1 244 145 -0.5% 1 085 813 1.15 -11.6% 1 616 706 0.77 -9.5% 27 755 45 -18.9%

2008-09 1 214 878 -2.8% 1 090 635 1.11 -14.1% 1 599 044 0.76 -10.7% 28 888 42 -23.9%

2009-10 1 173 415 -6.1% 1 100 243 1.07 -17.7% 1 592 706 0.74 -13.4% 29 598 40 -28.3%

2010-11 1 190 342 -4.8% 1 101 424 1.08 -16.6% 1 616 545 0.74 -13.4% 30 023 40 -28.3%

2011-12 1 137 168 -9.0% 1 120 002 1.02 -21.7% 1 684 248 0.68 -20.6% 30 636 37 -32.9%

2012-13 1 123 258 -10.1% 1 129 164 0.99 -23.3% 1 587 014 0.71 -16.8% 30 887 36 -34.2%

Data source: SA Health s in-house energy use database

Energy Efficiency Highlights 

Redevelopments and Major Projects 

Achievement of the full 30 per cent efficiency target by 2020 will be highly contingent on the success of the capital 
projects in achieving the ambitious energy efficiency targets that are independently established for each SA Health 
redevelopment project. Progress against the energy efficiency targets established for each project is routinely 
monitored throughout the project lifecycle.

 &gt; Cumulatively the currently programmed capital projects (excluding the new Royal Adelaide Hospital project and the 
major redevelopment at the Women s and Children s Hospital) are expected to result in an improvement against  
SA Health s energy efficiency baseline of between 4 per cent and 6 per cent by 2016. 

 &gt; The new Royal Adelaide Hospital when it opens in 2016, is targeted to produce between 40 and 45 per cent less 
C02 emissions per square metre than the current Royal Adelaide Hospital. (In 2012-13 the current Royal Adelaide 
Hospital accounted for 23 per cent of SA Health s building energy use). 

 &gt; The Women s and Children s Hospital, which in 2012-13 accounted for 13 per cent of SA Health s building energy 
use, is currently in the planning phase of a major $64m redevelopment. As part of this project the future operation 
and configuration of the existing cogeneration plant is being comprehensively reviewed to determine the most 
environmentally friendly and cost effective solution for the Women s and Children s Hospital. The final path forward 
regarding the future of the central plant inclusive of cogeneration at this site will be fundamental to the future 
energy and greenhouse emissions associated with this facility. 



page 140Department for Health and Ageing Annual Report 2012-13

Solar Photovoltaics: 

In 2012-13, SA Health commenced a number of major Solar Photovoltaics (PV) Projects which cumulatively will  
reduce SA Health s energy use from 2013-14 onwards by approximately 1518 GJ per annum. These projects were: 

 &gt; Procurement of a 42Kw Solar PV system for the new Stage C Inpatient building at Lyell McEwin Hospital. 
Installation to be completed in early 2013-14.

 &gt; Procurement of 150Kw of solar panels and associated hardware for installation at a number of SA Health sites  
in 2013-14.

 &gt; Design, procurement and part installation of an innovative dual solar PV shading/awning project at SA Pathology 
Hanson Institute. The project comprises of 76 solar photovoltaic panels, with a combined rated capacity of 27Kw, 
mounted on purpose designed frames above all widows on the north and east facades of Hanson Institute.  
In essence this solution makes optimum usage of PV cells by having the PV panels provide a secondary benefit  
of shading windows in much the same way as conventional eaves or blind structures would. 

 &gt; As mandated by the Solar Panels for Government Funded Building Projects policy 5Kw PV arrays were installed  
as part of the following capital projects in 2012-13, Whyalla Hospital, Berri Hospital, Wallaroo Dental Clinic, 
Forensic Mental Health, The Queen Elizabeth Hospital Rehabilitation, The Queen Elizabeth Hospital Mental  
Health and Glenside. 

Table 22   Solar Photovoltaics

Project
System size 
(Rated Kw)

kwh generated  
p.a

GJ p.a
Kgs of C02 

avoided p.a*

LMH Stage C Inpatient building 42 58 000 209 45 820

Multisite 150 Kw of Solar PV project 150 207 000 745 163 530

Hanson institute Solar PV awning project 27 143 000 515 112 970

5 Kw Mandatory PV Policy (various sites) 25 143 000 515 112 970

TOTAL 244 551 000 1984 435 290

*A conversion factor of 0.79Kgs of C02 per kwh applied. 
Data source: Internal SA Health information

Solar Hot Water and Gas

In absolute terms SA Health has reduced its use of natural gas and LPG by 223 418GJ or 29.6 per cent. The primary 
strategy has been an ongoing program to progressively install solar hot water on all overnight stay facilities, coupled 
with installation of higher efficiency boilers for provision of space heating and domestic hot water. 

Highlights in 2012-13:

 &gt; As at July 2013 more than 80 per cent of SA Health s overnight stay facilities (primarily hospitals) have solar hot 
water services that provide a minimum 60 per cent solar contribution to the production of domestic hot water.

 &gt; A large solar hot water booster was commissioned at Modbury in 2012-13. Modbury Hospital s solar hot water 
array is the third largest in the state after those at Flinders Medical Centre and the Lyell McEwin Hospital. 

 &gt; The existing large scale solar hot water service at Lyell McEwin Hospital is being expanded to match the additional 
demand for domestic hot water resulting from the current redevelopment.

 &gt; The new Glenside mental health precinct includes solar hot water providing a minimum 60 per cent annual solar 
contribution to the production of domestic hot water.

 &gt; The Queen Elizabeth Hospital: In addition to solar hot water services being installed on both the new Rehabilitation 
and Mental Health facilities, new high efficiency gas boilers that provide space heating to much of the older parts 
of The Queen Elizabeth Hospital were commissioned in 2012-13. 



page 141 Department for Health and Ageing Annual Report 2012-13

SA Health Lighting Upgrade Program

SA Health has made significant investments in lighting upgrades across five major metropolitan sites in the past four 
years which have cumulatively reduced energy use by more than 19 000GJ per annum and reduced annual energy cost 
by approximately $1.1m per annum. Additional funding has been committed for 2013-14 to complete the lighting 
upgrade project at Flinders Medical Centre, with projected additional lighting energy savings of 1700GJ per annum. 

In 2012-13, SA Health engaged consultants to undertake a comprehensive lighting audit of those major metropolitan 
facilities where significant remaining opportunities exist for cost effective lighting upgrades. This audit is likely to 
identify in the order of 13 000 light fittings across six sites that can be cost effectively upgraded, which if upgraded 
would reduce energy use by approximately 29 000GJ or 2.1 per cent of SA Health s 2000-01 energy use baseline.  
SA Health intends to initiate this upgrade program in 2013-14. 

Energy Management Tools and Processes 

During 2012-13, SA Health developed a number of tools and processes to assist in energy management.  
These include:

 &gt; Life Cycle Assessment: During 2012-13, SA Health established processes and associated documentation to ensure 
that Life Cycle Analysis (LCA) of a minimum of four alternative air-conditioning options was rigorously undertaken 
on all capital projects. An important element of this process is the usage of a standard excel template for all Life 
Cycle Analysis reports that enables a high degree of integration sensitivity testing against future energy price 
scenarios, benchmarking against energy efficiency targets established for each project and ready comparison 
between LCA prepared for other projects. The Department for Manufacturing, Innovation, Trade, Resources and 
Energy and the Department of Planning, Transport and Infrastructure are currently evaluating the potential use  
of this process and associated documentation for across government use. 

 &gt; Energy and Water Efficiency Star Rating Tool: Whilst there are various energy and water rating tools available 
to measure the relative energy use of buildings such as office buildings, schools and retails outlets, no such tool 
currently exists to rate the relative efficiency of healthcare buildings. In recognition of this during 2012-13 SA 
Health utilised its extensive historical energy and water use database as a basis for development of its own informal 
Healthcare Specific Energy and Water Efficiency Star rating tool. This tool is currently being reviewed and evaluated 
by other state and territory Health departments and the Green Building Council of Australia with a view to possible 
refinement and broader national use. 

Looking Forward   SA Health Annual Programs

Capital Funding of $1.52m has been allocated from the 2013-14 Minor Works budget for dedicated energy efficiency 
projects across SA Health. Projects include lighting upgrades, heat recovery and various air-conditioning upgrades.

Additional capital funding of $1.67m of funding has also been allocated from the 2013-14 Minor Works budgets 
projects where energy efficiency is part of the key outcomes and drivers behind the project. Projects include upgrades 
to steam reticulation systems, lifts and various domestic hot water systems. 

Cumulatively these projects are expected to reduce energy use across SA Health by approximately 7000GJ per annum. 

Planning work has commenced for several additional projects for possible implementation in 2013-14, these include:

 &gt; Detailed evaluation and options analysis for utilising existing standby diesel generators as  peak-load-loppers   
in periods of high summertime electricity demand to reduce recurrent energy changes  and reduce the pressure  
on electrical reticulation infrastructure.

 &gt; Development of a portfolio strategy and associated business case and technical guide for future investment  
in additional energy and water sub meters. 



page 142Department for Health and Ageing Annual Report 2012-13

GoGO Priority Area Two: Water
Since 2003-04, SA Health s water use at its 62 largest hospitals has fallen in absolute terms by 230 801KL or 14 per cent. 

In water efficiency terms there has been a 24 per cent decrease in water use per square metre of occupied building 
space and a 20 per cent decrease in water use per Occupied Bed Day.

Table 23   SA Health Water Use 2003-04   2011-12

Year range Absolute water use Square Metres Per Occupied Bed Day

Kilolitres
change 

from base 
year

M2 KL/M2
change 

from 
base year

OBDs KL/OBD

change 
from base 

year

2003-04 1 607 864 972 104 1.65 1 489 255 1.08

2012-13 1 377 063 -14% 1 099 035 1.25 -24% 1 587 014 0.87 -20%

Data source: Internal SA Health information

Water Efficiency Highlights

Rainwater

Installation of rainwater tanks has progressively become standard practice for SA Health facilities over recent years.

 &gt; As at July 2013, 92 per cent of SA Health s acute care facilities capture and reuse rainwater.

 &gt; A new 100 000 litre rainwater tank was installed as part of the Glenside Redevelopment with all rainwater being 
captured available for toilet flushing. 

 &gt; Additional rainwater storage capacity was installed at several SA Health sites during 2012-13 including those  
at The Queen Elizabeth Hospital, Whyalla Hospital and Berri Hospital.

Water Efficient Capital Projects

The following are the standard water efficiency measures now applied on all SA Health Capital Projects.

 &gt; At minimum provide infrastructure suitable for capturing a minimum of 80 per cent of annual rainfall from all new 
build roof surface.

 &gt; Investigate potential capture and reuse of water from any major water using systems such as reverse osmosis plant, 
fire test water and hydrotherapy pool backwash water.

   Collected water to be treated to potable standard for general reuse or used for landscape irrigation and  
toilet flushing.

 &gt; Where available usage of non-conventional water supplies such as the Glenelg-Adelaide-Parklands scheme are  
to be actively considered. 

 &gt; Pressure reducing valves are to be installed where warranted on hydraulic appliances.

 &gt; Select hydraulic fittings and fixtures with Water Efficiency Labelling and Standard (WELS) water conservation  
ratings as follows:

   Tap ware with maximum flow rate of 4.5 litres/minute (6 Star WELS rating) in all areas unless contradicted  
for clinical reasons. 

   Showers with maximum flow rate of 6.0-7.5 litres/minute (4Sstar WELS rating).

   Unless there are site specific infrastructure constraints Duel Flush 3.0/4.5 litre toilets (4 Star WELS rating). 

   Waterless or low flow urinals for staff and visitors.

 &gt; Where feasible toilet flush water to be sourced from non-potable water sources.

 &gt; Install water meters for high water use areas, including kitchen, laundry, landscaping and Central Sterile  
Supply Department (CSSD).

 &gt; Design landscaping to be water efficient, including use of mulching, plant selection and water efficient irrigation 
system, comprising subsoil drip systems and automatic timers with rainwater or soil moisture sensor over-ride.

 &gt; Include rainwater/stormwater control in landscape and building design.

 &gt; Where cooling towers are selected the use of ultra-low water use cooling towers technology is to be evaluated on 
a life cycle analysis basis.

 &gt; Avoid cooling of equipment such as CSSD or compressors with single pass water, use chilled water loop and heat 
exchangers or non-potable water instead.



page 143 Department for Health and Ageing Annual Report 2012-13

GoGO Priority Area Three: Waste
During 2012-13, SA Health s Waste Management Steering Committee sought to initiate the approved 
recommendations made from the SA Health Waste Management Plan. The Waste Management Plan established a 
framework, and set strategic objectives, to assist healthcare facilities within South Australia to develop and implement 
sustainable waste management practices, and to ensure that all such facilities are provided with a more effective and 
efficient waste management system. In particular, SA Health s Waste Management Steering Committee provided the 
necessary governance to enable the development of a Request for Proposal tender document for the Provision of 
Waste Management and Recycling Services based on the overarching framework provided in the Waste Management 
Plan, combined with site centric information about waste and recycling requirements and quantities. 

Through the Request for Proposal tender process, SA Health is seeking to achieve the following waste management 
objectives through a single or number of Contracting Arrangements:

 &gt; Deliver efficient, cost effective, and on-time waste and recycling services to SA Health sites.

 &gt; Minimise waste management costs to SA Health.

 &gt; Simplify and reduce the costs of contract administration.

 &gt; Reduce waste generation across SA Health sites.

 &gt; Maximise resource recovery of waste and recyclables generated across SA Health sites.

 &gt; Improve the ability for SA Health site employees and patrons to participate in simple and effective recycling systems.

 &gt; Reduce risks associated with the management of waste.

 &gt; Establish accurate reporting of waste volumes and diversion outcomes for SA Health.

 &gt; Meet legislative requirements and relevant codes and standards.

GoGO Priority Area Four: Built Facilities 
SA Health recognises that whilst improving the sustainability of buildings is important consideration for all public 
buildings that it is particularly important for Healthcare buildings because:

 &gt; Hospitals are amongst the most energy and water intensive building types occupied by government.

 &gt; A high quality indoor environmental (particularly in regard to indoor air-quality and access to natural light) can  
play a significant role in reducing hospital acquired infections, length of stay and improving client well-being  
and outcomes generally.

 &gt; Public Health Departments have large capital works budgets and as such can be significant in influencing the 
directions of the design, building materials and construction industries generally. 

Highlights 2012-13:

National Healthcare Sustainability Working Group: In recognition of its commitment and leadership regarding 
sustainability SA Health was nominated by the Australasian Healthcare Infrastructure Alliance to form and Chair a 
National Sustainability Workgroup comprising of representatives from each state and territory health department.  
This workgroup has initially agreed to work towards:

 &gt; Developing a common and unified understanding of sustainability in healthcare.

 &gt; Leveraging off existing state-based projects at the national level.

 &gt; Facilitating sharing of best practice between jurisdictions.

 &gt; Pooling resources to deliver projects of common interest.

 &gt; Establishing an online information sharing platform to facilitate the above. 

 &gt; Priorities for 2013-14:

   National energy and water benchmarking.

   Integrating sustainability into capital projects.



page 144Department for Health and Ageing Annual Report 2012-13

 &gt; GreenStar: The GreenStar Healthcare tool is currently being used to help guide many of the major building projects 
across the SA Health portfolio. To date, 13 SA Health projects have been assessed either formally or informally 
against either the GreenStar Healthcare or GreenStar office tools. These include projects at the Lyell McEwin 
Hospital, Flinders Medical Centre, The Queen Elizabeth Hospital, Glenside Healthcare Precinct, Berri Hospital, Port 
Lincoln Hospital, the Whyalla Regional Cancer Centre and the GP Plus Health Care Centres at Marion and Elizabeth 
and the GP Plus Super Clinics at Modbury and Noarlunga. 

   In May 2013, the as-designed GreenStar submission for the new Inpatients building at Lyell McEwin Hospital 
was lodged for assessment with the Green Building Council of Australia. This project is targeting to achieve a 5 
Star as-built rating. 

   An as-built GreenStar submission for the Noarlunga GP Plus project is scheduled for lodgement with the Green 
Building Council of Australia in early 2013-14. This project is targeting to achieve a 5 Star as-built rating.

   During 2012-13, SA Health engaged with the Green Building Council of Australia to trial an early draft version 
of the new GreenStar Performance Tool (a new tool that rates the environmental performance and management 
practices of existing assets). SA Health will formally evaluate the merit of the GreenStar Performance Tool 
when it is finalised in early 2014 with a view to evaluating its potential as a means of assessing the relative 
environmental performance of SA Health s acute care facilities.

   In recognition of its role as a key stakeholder and its in-house technical expertise SA Health was invited by the 
Green Building Council of Australia in May 2013 to join the Technical Advisory Group that will contribute to the 
development of the next generation of GreenStar Environmental rating tools. The work of the Technical Advisory 
Group commenced in August 2013 with a new generation of tools anticipated to be piloted in mid to late 2014. 

 &gt; IGRAT: In 2012-13 an environmental rating tool called the In-House Green Rating Tool (IGRAT) was developed in-
house by SA Health in close consultation with key stakeholders to assess and rate the environmental performance 
of capital works projects undertaken by the portfolio. The IGRAT tool borrows heavily from the GreenStar 
Healthcare tool, with additional emphasis being placed on those aspects of green building identified as being a 
high priority by SA Health. The IGRAT tool and associated independent assessment process was mandated for use 
on all projects, with a budget greater than $2m that are not pursuing a formal GreenStar rating. 

   This tool is currently being utilised on the redevelopments at Port Lincoln, Mount Gambier, Modbury, South 
Coast District Hospital, Women s and Children s Hospital and the Port Pirie GP Plus project. 

GoGO Priority Area Five: Travel and Fleet

Environmental Targets

SA Health continues to reduce carbon emissions for its fleet vehicles. The carbon emission reduction target set by 
the SA Government in 2010 is  To reduce the average greenhouse gas emissions per kilometre travelled by the South 
Australian Government passenger and light commercial vehicles by 10 per cent by 2014-15 based on 2009-10 levels .

SA Health s carbon emission target reduction target is 24.6 grams per kilometre. As at 30 June 2013, SA Health has 
reduced its carbon emission by 16.9 grams per kilometre.

Motor Vehicle Governance

Procurement and Supply Chain Management is responsible for ensuring SA Health s fleet not only meets operational 
requirements but is also cost effective and continues to improve its carbon footprint.

A vehicle replacement strategy continues to be applied where large six cylinder vehicles are replaced with more cost 
effective and fuel efficient four cylinder vehicles. The vehicle replacement strategy has now been expanded to lease 
wherever possible, passenger and light commercial vehicles with the maximum ANCAP 5 Star Safety Rating. The 
number of vehicles with the maximum ANCAP 5 Star Safety Rating has increased from 1308 vehicles (70 per cent)  
at 30 June 2012 to 1552 vehicles (85 per cent) at 30 June 2013.

As part of the SA Government s cost reduction strategy, Alternative Fleet Management Arrangements were 
implemented with a transition to LeasePlan as the SA Government Fleet Manager, taking effect on 1 December 2012. 
Procurement and Supply Chain Management is working closely with LeasePlan on initiatives to further improve the 
performance of the SA Health fleet. 



page 145 Department for Health and Ageing Annual Report 2012-13

Composition of Fleet Vehicles

The above mentioned strategies have seen an increase in the number of cost effective four cylinder passenger vehicles 
and four cylinder SUV Wagons, which fall into the  other  vehicle category. This is commensurate with the decrease in 
6 cylinder passenger vehicles. As at 30 June 2013 the SA Health fleet comprised of:

Table 24   SA Health s Fleet Vehicles 2004-05   2012-13 (excluding ambulances)

2004- 
05

2005- 
06

2006- 
07

2007- 
08

2008- 
09

2009- 
10

2010- 
11

2011- 
12

2012- 
13

% of Change 
from 2004-05

6 Cylinder 1300 1244 1155 993 842 737 653 461 356 -73%

4 Cylinder 228 331 459 456 617 653 642 746 867 280%

Hybrid 2 3 14 52 100 148 175 124 59 2850%

Other 210 247 244 235 266 385 428 531 535 155%

Total 1740 1825 1872 1736 1825 1923 1898 1862 1817 4%

Data source: Fleet management database, SA Health

GoGO Priority Area Six: Procurement
SA Health considers sustainability as an assessment criteria in procurement processes wherever possible and practical. 
Procurement processes for the supply of medical consumable products consider reusability, recycling and disposability. 
Procurement processes for the provision of services consider the use of energy and water, and the environmental 
impact of the service output. SA Health has also undertaken a Sustainability Impact Assessment process, as detailed  
in the state Procurement Board s Sustainable Procurement Guideline, to identify and prioritise significant 
procurements susceptible to the consideration of sustainability in the evaluation process. One such example is the 
current procurement process for waste management with which SA Health is working collaboratively with Zero 
Waste, as a member of the Steering Committee, to ensure sustainability considerations are prominent in shaping  
the services resulting from the procurement process. This project embodies SA Health s commitment to incorporating 
sustainability into SA Health s procurement processes.

Investing in the Redevelopment of Metropolitan Hospitals
In 2012-13 capital investments for the redevelopment of South Australian metropolitan hospitals included:

 &gt; $90.23m to continue redevelopments underway at Lyell McEwin Hospital and the Modbury Hospital, and complete 
redevelopments at Flinders Medical Centre and The Queen Elizabeth Hospital.

 &gt; $4.50m to commence the construction of the Port Pirie GP Plus Health Care Centre. 

 &gt; $1.54m to complete the construction of the third floor Gilbert Building extension at the Women s and Children s 
Hospital and commence concept planning for the redevelopment of the hospital. 

 &gt; $8.66m towards the construction works to upgrade the Repatriation General Hospital, including the state-of-the-
art 20 bed sub acute bed facility.

 &gt; $4.28m towards the site preparation and preliminary works related to the new Royal Adelaide Hospital.

 &gt; $41.70m to continue the construction of the Glenside Health Care Precinct.

Investing in the Redevelopment of Regional Hospitals
In 2012-13, capital investments for the redevelopment of South Australian regional hospitals included:

 &gt; $13.86m to continue redevelopment of the Berri Hospital.

 &gt; $2.27m to progress the redevelopment of the Mount Gambier Hospital.

 &gt; $4.36m to progress the redevelopment of the Port Lincoln Hospital.

 &gt; $45.37m to continue redevelopment of the Whyalla Hospital. 



page 146Department for Health and Ageing Annual Report 2012-13

Across Government Facilities Management Arrangement 
 &gt; SA Health continued implementing the transition of all its sites to the Across Government Facilities Management 
Arrangement (AGFMA) which is on target to be completed by November 2013. 

Asbestos Management
A combined response from SA Health has been provided to the Department of Planning, Transport and Infrastructure 
for inclusion in the across government asbestos management report.



page 147 Department for Health and Ageing Annual Report 2012-13

Urban Design Charter
The South Australian Urban Design Charter is a whole-of-government urban policy which commits government 
agencies to achieve good urban design. It requires the designs for public places and their interaction with  
private buildings and spaces to reinforce the urban environment as liveable, efficient, creative, sustainable and  
socially inclusive. 

SA Health continues to integrate the principles and objectives contained in the Urban Design Charter into  
master-planning works that underpin all major redevelopment projects, and the concept development and  
design work undertaken for all new capital works projects. Examples include:

New Royal Adelaide Hospital and adjacent SA Health and Medical Research  
Institute Building
Construction works have commenced for the development of the new RAH on the North Terrace site and 
construction work is well advanced on the new SAHMRI building adjacent to the new RAH site. These buildings will 
be a significant and iconic addition to the west end precinct of Adelaide, and will complement the North Terrace/ 
River Torrens precinct by providing additional and creative public open spaces and enhancing the River Torrens Linear 
Park. The recently proposed cancer biology and medical facility sponsored by the University of Adelaide and University 
of South Australia will also enhance this precinct. These buildings will make use of the public transport network by 
linking access using bicycle paths, trams, buses and trains. 

Redevelopment of the Glenside Health Care Campus
The redevelopment of the Glenside Health Care Campus is an outstanding example of the application of the Urban 
Design Charter. The construction works related to the health care facilities are almost complete. The opportunity 
to redevelop this site has expanded the previous use of the site to integrate the health care facilities with retail and 
commercial activities, residential housing, a new cultural hub expanding opportunities for the film and acting sectors 
and provided significant public open space and wet land for community activities.

Repatriation General Hospital   Teaching and Aged Care Facility
Construction work has commenced on a joint public/private sector initiative to develop a new Teaching and Aged 
Care facility. This project will be jointly funded and operated by the ACH Group and Flinders University and the facility 
will enhance the hospital precinct by combining private sector investment and initiatives.

Redevelopments at Major Country Hospitals
The Urban Design Charter is also being applied to the developments occurring at the major public country hospitals, 
including Berri, Mount Gambier, Port Lincoln and Whyalla. These developments are at varying stages of development, 
but have all applied the Urban Design Charter principles through the concept development and design stages to 
maximise opportunities to enhance the environment through use of sustainability design principles, social inclusion 
initiatives and creation of public space for the community. 



page 148Department for Health and Ageing Annual Report 2012-13

Regional Impact Assessments
There has been no requirement to prepare a Regional Impact Statement for the capital work undertaken by SA Health 
during 2012-13. 



page 149 Department for Health and Ageing Annual Report 2012-13

Freedom of Information

Information Statement
The following information is published pursuant to Section 9 of the Freedom of Information Act 1991 (the Act).

The Act extends as far as possible the rights of the public to access documents held by the government, and to 
ensure that records held by government concerning the personal affairs of members of the public are not incomplete, 
incorrect, out of date or misleading.

The Act encourages disclosure of information to the public, subject to such restrictions within the Act as are necessary 
to protect legitimate agency, public and private interests.

Making a Freedom of Information Application
Application forms to request information under the Act or to request amendment of personal records, can be 
obtained by contacting the Principal Project Officer   FOI at the address listed below, or:  
download an application form via the State Records website.

An application for access lodged under the Freedom of Information Act 1991 costs $31.50, payable to the agency, 
and additional processing charges may also be incurred. In certain cases, a reduction of fees and charges may apply.

An application for amendment of personal records is free of charge.

Point of Contact
All Freedom of Information enquiries and requests should be addressed to:

Principal Project Officer   FOI 
Department for Health and Ageing 
PO Box 287, Rundle Mall 
ADELAIDE SA 5000

Phone: (08) 8226 0793

Agency s Functions and Structure   as at 30 June 2013
The Department for Health and Ageing assists the Minister for Health and Ageing and the Minister for Mental  
Health and Substance Abuse to set the policy framework and strategic directions for SA Health. DHA supports the 
delivery of public health services, formulates health policy, facilitates public and consumer consultation on health 
issues, and monitors the performance of South Australia s health system by providing timely advice, research and 
administrative support.

There are six divisions within the Department for Health and Ageing:

 &gt; Finance and Business Services.

 &gt; System Performance

 &gt; eHealth Systems

 &gt; Public Health and Clinical Systems

 &gt; Policy and Commissioning

 &gt; Mental Health and Substance Abuse

The department also has a Risk Management and Internal Audit Unit that reports directly to the Chief Executive.



page 150Department for Health and Ageing Annual Report 2012-13

Ways in Which the Functions of the Agency Affect Members of the Public
The department works with the key stakeholders, including the community, to address the environmental, 
socioeconomic, biological and behavioural determinants of health, and to achieve optimal health outcomes  
for all South Australians. 

The major interface of the department with the public involves setting the policy framework for health care and 
delivering services in public and environmental health, health promotion, and hospital and community services.

Arrangements that Enable the Public to Participate in the Formulation of the  
Agency s Policies
The public can contribute to policy development within the department in a number of ways. External expertise and 
policy advice is sought through statutory and non-statutory advisory committees, comprising both government and 
non-government representatives. Advice is taken from peak non-government organisations and a consultative process 
may be undertaken in the planning, development and implementation of policy.

The department consults with consumer groups, circulates discussion papers, calls for submissions on particular 
topics and convenes public meetings regarding legislative reform and impacts within metropolitan and country areas.  
Community input may be sought relating to planning, development and evaluation of services.

These processes facilitate access to services and assist informed decisions about health.

Boards and Committees Administered by the Agency
A list of the agency s boards and committees is provided as Appendix three and also in the most recent Boards  
and Committees Information System Annual Report to Parliament.

Whist the department s board and committee meetings are not open to the public, minutes of their meetings  
and documentation relating to their functions and structure can be applied for under the Act.

The Agency s Documents
The Department for Health and Ageing s policy documents can be broadly defined into the following areas:

 &gt; Data and information

 &gt; Financial management

 &gt; Governance

 &gt; Human resource management

 &gt; Procurement and asset management

The following documents are also held by the agency:

 &gt; Corporate files containing correspondence, memoranda, minutes, etc., regarding all aspects of the  
agency s operations.

 &gt; Books, discussion and background papers, reports, reviews, serial publications, pamphlets, codes of practice, 
surveys, guidelines, proposals.

 &gt; Administrative policies on general management, finance, staffing, plant and equipment, property and motor 
vehicles and industrial circulars.

 &gt; Personnel files relating to Department for Health and Ageing employees.

 &gt; Accounting and financial records relating to the administration of the department.

 &gt; Contracts.

The internet site at www.sahealth.sa.gov.au provides an overview of the department s roles and functions and 
contains media releases, service provider details, publications and news items.



page 151 Department for Health and Ageing Annual Report 2012-13

Documents Available for Inspection 
The constitutions of hospitals and health centres incorporated under the Health Care Act 2008 may be inspected 
between the hours of 9am and 5pm, Monday to Friday in the Legal and Governance Unit, 11 Hindmarsh Square, 
Adelaide (telephone (08) 8226 0793).

Documents Available for Purchase from the Agency
There are no documents currently available for purchase from the Department for Health and Ageing.  

Documents Available from the Agency Free of Charge
The following documents are made available free of charge and are available by contacting the Principal Project 
Officer   FOI, on (08) 8226 0793. Documents available free of charge include:

 &gt; Principal Documents (listed at Appendix four)

 &gt; SA Health Statewide Policies

 &gt; Information packs

 &gt; Brochures

 &gt; Pamphlets

 &gt; Posters

 &gt; Internet:

   Media releases

   Health alerts

   Health related statistics

   Submissions on reviews

   Hospital Emergency Department and elective surgery waiting times.



page 152Department for Health and Ageing Annual Report 2012-13

Whistleblower Protection Act 1993
In 2012-13 there was one occasion on which public interest was disclosed to a responsible officer of the Department 
for Health and Ageing under section 5(4)(h) of the Whistleblower Protection Act 1993.



page 153 Department for Health and Ageing Annual Report 2012-13

Use of Consultants

Summary
There were 35 consultancies undertaken in the Department of Health and Ageing during 2012-13 with total 
expenditure of $2 896 233 (as at 30 June 2013).

Table 25   Consultancies in 2012-13

Range Number of Consultancies Total Expenditure 2012-13

Below $10 000 6 $ 25 528

$10 000 - $50 000 11 $ 308 479

Above $50 000 18 $2 562 226

Total 35 $2 896 233

Table 26   Individual Consultant with Total Expenditure between $10 000 - $50 000

Consultant Names Purpose of Consultancy 
(Summary of the services for which they were engaged)

Ernst &amp; Young  &gt; Design of the management reporting templates and outputs for Southern Area 
Local Health Networks.

Ernst &amp; Young  &gt; Design of the management reporting templates and outputs for Northern Area 
Local Health Networks.

Ernst &amp; Young  &gt; Investigation services into allegations of potential employee impropriety 
concerning procurement activity.

Ernst &amp; Young  &gt; To undertake a review of existing practices of accounting for safety and 
environmental expenditure with Asset Services.

Faceworks Marketing 
Solutions

 &gt; To undertake a strategic review of the South Australian Seniors Card program.

Healthcare Management 
Advisors

 &gt; To undertake a comprehensive evaluation using regularly reported quantitative 
and qualitative Aged Care Assessment Program data.

Iolanda Principe  &gt; Identity mental health conditions experienced by South Australians living in rural 
and remote communities, describe the strategic health systems response to issues 
without and outside their responsibility.

 &gt; Identify what other agencies are doing and provide written report to the Health 
Performance Council including methodology and findings.

PKF Business Advisers Pty Ltd  &gt; Independent review of the financial model submitted by HTR Group for claiming 
lost profit as a result of the early termination of contracts.

PKF Business Advisers Pty Ltd  &gt; Review and preparation of a business case for Older Person Mental Health Oakden 
Transition to a non-government organisation.

Pricewaterhouse Coopers 
Legal

 &gt; Providing advice on the accounting treatment and appropriate business structure 
for Health Advisory Committee Gift Fund Trusts.

 &gt; Review the efficiency and effectiveness of SA Health s Taxation Services team.

Robin Michael &amp; Associates 
Pty Ltd

 &gt; Review and preparation of a Business Case assessing the delivery of Medical 
Imaging in SA Health s public hospitals.



page 154Department for Health and Ageing Annual Report 2012-13

Table 27    Individual consultant with Total Expenditure above $50 000

Consultant Names Purpose of Consultancy 
(Summary of the services for which they were engaged)

Asset Valuation Pty Ltd  &gt; For the provision of market valuation, market rental and asset register valuation 
services.

Australian Valuation Office  &gt; For the provision of market valuation, market rental and asset register valuation 
services.

Clinical Coding Services  
Pty Ltd

 &gt; Consultancy services to analyse and report findings of the Clinical Coding Audit.

Deloitte Touche Tohmatsu  &gt; Replacement Human Resources data warehouse will reside on the Oracle Business 
Intelligence application on ICT supported hardware. The new solution is to be 
architected to ensure that history is to be retained, to the Human Resources and  
finance data sets.

Deloitte Touche Tohmatsu  &gt; Consultancy services for Hospital Budget Performance and Remediation Review  
in respect of Royal Adelaide Hospital, Queen Elizabeth, Lyell McEwin and  
Modbury Hospitals.

Deloitte Touche Tohmatsu  &gt; Fraud Risk   Best Practice Gap Analysis   Audit Brief.

Ernst &amp; Young  &gt; To provide the Chief Executive with a draft response for consideration in reply to 
Ernst &amp; Young s letter of 17 October 2012 and Statement of Work in relation to 
Extended Hours of Work for Consultants employed pursuant to the Department 
of Health Salaried Medical Officers Enterprise Agreement 2008.

Ernst &amp; Young  &gt; To undertake a review of the controls currently affecting the SA Health control 
environment as reported by the Auditor-General for SA Health in its report to 
Parliament for 2010-11.

Ernst &amp; Young  &gt; Consultancy services in relation to Mental Health.

Ernst &amp; Young  &gt; To provide a review of Finance and Workforce.

Ernst &amp; Young  &gt; 2013 South Australian Prison Health Services Procurement Services Business Case.

Ernst &amp; Young  &gt; eHealth Program Review   Phase 1   Program Status and Critical Risks.

Hardes &amp; Associates  &gt; To provide SA Health with a projection model that can be used to quantify future 
demand and supply of acute hospital services and to model alternate demand / 
supply scenarios.

Health Outcomes 
International Pty Ltd

 &gt; Evaluation of the Housing and Accommodation Support Partnership Services 
Program.

KPMG  &gt; Provision of Audit Services for the Enterprise Patient Administration Systems   
eHealth Unit.

Liquid Pacific Holdings Pty 
Ltd

 &gt; For the provision of market valuation, market rental and asset register valuation 
services.

Robin Michael &amp; Associates 
Pty Ltd

 &gt; To provide professional advice and guidance in regards to the implementation of 
Health Reform-Activity Based Funding Initiative.

SynergistIQ Pty Ltd  &gt; Contribute to the design and implementation of the South Australian 
Implementation Plan Evaluation Framework based on best practice principles.

 &gt; Undertake collection, management and storage of data.

 &gt; Undertake analysis to determine effectiveness and outcomes of the South 
Australia Implementation Plan.

 &gt; Describe the progress of the South Australia Implementation Plan Evaluation and 
the effectiveness of South Australia Implementation Plan.

 &gt; Work through South Australia Implementation Plan Governance structures.



page 155 Department for Health and Ageing Annual Report 2012-13

Fraud
The Department for Health and Ageing has adopted and promoted the Code of Ethics for the South Australian Public 
Sector, which provides guidance to staff on appropriate behaviour. In addition the department has specific policies, 
procedures, and a fraud control plan for the identification and reporting of fraud and corruption. 

Two instances of fraud were reported during 2012-13, which are currently under investigation.

Table 28   Instances of Fraud Reporting During 2012-13

Nature of Fraud
Number of 
Instances 

Strategies to Control and Prevent

Printer toner cartridges 
purchased at inflated 
prices. The case 
is currently under 
investigation.

1  &gt; Whole of portfolio communication issued regarding the 
acceptance of gifts and benefits.

 &gt; Whole of portfolio communication issued regarding Probity  
in procurement. 

 &gt; Whole of portfolio communication issued regarding New 
Mandated procurement arrangements for stationery and 
related products (including toner cartridges).

 &gt; A fraud awareness training program is being developed to  
be rolled out across the portfolio CE.

 &gt; A fraud best practice internal audit project is currently in 
progress.

Reward programs from 
food providers This 
case is currently under 
investigation.

1  &gt; Whole of portfolio communication issued regarding the 
Acceptance of gifts and benefits.

 &gt; Whole of portfolio communication issued regarding Probity  
in procurement.

 &gt; Suppliers have been contacted to declare that they do not  
offer gifts to SA Health staff.

 &gt; Standard SA Health contract has been updated to preclude 
gifts to staff.

 &gt; A fraud awareness training program is being developed to  
be rolled out across the portfolio CE.

 &gt; A fraud best practice internal audit project is currently  
in progress.

  



page 156Department for Health and Ageing Annual Report 2012-13

Account Payment Performance

Table 29   Paid by Due Date

Month Year Number of accounts paid

Percentage of 
Accounts paid (by 

number)

Value in $A of 
accounts paid

Percentage of 
accounts paid  

(by value)

July 2012 3 087 54.04% $60 589 435 45.55%

August 2012 2 540 51.11% $45 948 719 67.20%

September 2012 2 768 55.73% $50 955 164 77.86%

October 2012 3 976 66.54% $80 933 912 70.30%

November 2012 3 942 75.30% $65 328 778 62.40%

December 2012 3 367 69.84% $57 669 026 77.49%

January 2013 2 952 66.68% $52 810 909 67.50%

February 2013 3 416 75.48% $36 541 195 61.37%

March 2013 4 055 78.81% $59 018 651 83.93%

April 2013 3 936 73.78% $60 337 552 72.75%

May 2013 3 693 71.85% $60 793 684 87.90%

June 2013 5 628 95.62% $79 861 409 98.79%

Total 2012-13 43 360 69.78% $710 788 434 70.93%

 
Table 30   Paid Late but Paid within 30 days of Due Date

Month Year Number of accounts paid

Percentage of 
Accounts paid (by 

number)

Value in $A of 
accounts paid

Percentage of 
accounts paid  

(by value)

July 2012 2 150 37.64% $52 306 275 39.32%

August 2012 1 990 40.04% $19 428 156 28.41%

September 2012 1 762 35.47% $8 679 470 13.26%

October 2012 1 563 26.16% $18 475 854 16.05%

November 2012 906 17.31% $28 074 377 26.82%

December 2012 1 274 26.43% $9 399 964 12.63%

January 2013 1 182 26.70% $17 281 730 22.09%

February 2013 599 13.23% $10 695 284 17.96%

March 2013 597 11.60% $7 607 478 10.82%

April 2013 851 15.95% $19 484 576 23.49%

May 2013 601 11.69% $3 773 510 5.46%

June 2013 228 3.87% $892 117 1.10%

Total 2012-13 13 703 22.05% $196 098 791 19.57%



page 157 Department for Health and Ageing Annual Report 2012-13

Contractual Arrangements
As at 30 June there were no contractual arrangements entered into where the total value of the contract exceeded 
$4m (GST inclusive) and which extended beyond a single year.



page 158Department for Health and Ageing Annual Report 2012-13

Employee Overseas Travel
Travel, including overseas travel is an important part of SA Health s business, allowing employees to participate in 
professional development opportunities including attending and presenting at leading edge conferences, seminars 
and workshops. Employees are supported through investment in training and development. SA Health is committed 
to the ongoing professional development of Medical Officers through the relevant industrial instruments.

Overseas travel allows the sharing of knowledge from one jurisdiction to another and is an opportunity for employees 
to advance SA Health s priorities and benefit the South Australian public health system by improving services.

Travel within Australasia (including visits to New Zealand, Papua New Guinea and Australian Territories) is not included 
in the tables below unless it was part of a more extensive itinerary encompassing other overseas destinations.

Table 31   Overseas Travel Summary

The table below summarises information relating to approved overseas travel by the department s employees during 
2012-13. Total cost to the department includes all travel and salary costs during the period of travel.

These figures are as at 30 June 2013 and do not include any costs associated with approved travel to be taken after 
this date.

Number of 
Employees Destination Reasons for Travel

Total cost to 
the department  

(total $)

1

Leipzig, 
Germany and 
Prague, Czech 
Republic

Undertake a two week overseas program at the HHL Graduate 
School of Management in Leipzig, Germany as part of the 
Master of Business Administration exchange program through 
the University of Adelaide Faculty of Professions.

$ 12 269

1 (a)
Kuala Lumpur, 
Malaysia

Guest speaker at the  Towards Better Health  Conference in 
Kuala Lumpur and also visit Singapore Hospital to investigate 
allied health service models. 

$  2 804

1 (b)
Jinan and 
Beijing, China

To conduct and participate in joint training workshops and 
research activities with Chinese colleagues titled  building 
resilience to health impacts due to climate change and extreme 
weather among the elderly community . 

$  3 121

1 (c)
Frankfurt, 
Germany

Attend the Frankfurt Book Fair to meet international account 
managers of information and knowledge resources subscribed to 
by SA Health Library Network in order to negotiate best possible 
licensing, pricing and access for SA Health.

$  2 257

2 (d) Paris, France
Attend EPODE training to ensure South Australia maintains the 
integrity of the EPODE program and fulfil Service Agreement 
commitments with Proteines.

$  15 249

1 (e)
London, 
United 
Kingdom

Guest speaker at the Datix International Patient Safety 
Conference and Pre-Event Workshop and the MPS International 
Conference 2012. 

$  11 974

1 (f)
Bangkok, 
Thailand

Attend and present at the Australia-Thailand bilateral meeting 
on Health Equity and to also attend the Thai National Health 
Assembly and a regional meeting on Health in All Policies 
convened by the South East Asian Regional Office of the World 
Health Organization on Health. 

$  1 315

1 (g)
London, 
United 
Kingdom

Attend the British Dental Trade Association Showcase 2012 
to assist in the recruitment of dental practitioners to South 
Australia by providing information relating to recruitment 
and appointment processes, visa requirements and salary and 
employment conditions. 

$  3 589



page 159 Department for Health and Ageing Annual Report 2012-13

Number of 
Employees Destination Reasons for Travel

Total cost to 
the department  

(total $)

1
Da Nang, 
Vietnam

Attend the Golden Jubilee and Scientific Research Conference, 
and meet with the National Technical College of Medicine to 
discuss the Competency Based Clinical Teaching - Preceptor 
Workshop for nurses and midwives.

$  14 735

1 (h)
Manila, 
Philippines

To co-facilitate a training workshop on Health in All Policies 
to share learnings and challenges relating to South Australia s 
Health in All Policies approach. 

$  1 658

1(i)
San Francisco, 
United States

Attend the American Psychiatric Association annual meeting. $  25 101

1 (j)
Manchester, 
United 
Kingdom

To attend and present two papers at the World Congress on 
Disaster and Emergency Medicine.

$  2 014

2 (k)
Quebec, 
Canada

Attend the symposium  Impact evaluation challenges in obesity 
prevention: Experiences from international leaders , and to 
present the OPAL program and evaluation learnings, and to 
attend meetings with public health counterparts to exchange 
information and ideas on obesity prevention programs. 

$  5 627

TOTAL 15   $101 713

(a) All costs for travel, accommodation and meals were fully funded by The Conference Secretariat and the Ministry for Health Malaysia. 
(b)   All costs for travel, accommodation and meals were fully funded through The University of Adelaide by the Australian-China Science and  

Research Fund.
(c) All costs for travel, accommodation and meals were fully funded by the Department for Health and Ageing employee.
(d) Proteines contributed $925.38 for one half of one return airfare.
(e) Datix contributed $5289.62 for the cost of flights and three nights  accommodation.
(f)  All costs for travel, accommodation and meals were fully funded by a grant received by the Australian National University by the Australian 

Government (the Australian   Thailand Institute of the Department of Foreign Affairs and Trade).
(g) SA Dental Service funded $6747.20 for travel costs.
(h) All costs for travel, accommodation and meals were fully funded by the World Health Organization Western Pacific Regional Office.
(i) All costs were funded by the employee s professional developemnt fund as part of the Medical Officers Enterprise Agreement.
(j) All costs for travel, accommodation and meals were fully funded by the Department for Health and Ageing employee. 
(k) All costs for travel, accommodation and meals were fully funded by the symposium organisers, Evaluation Platform on Obesity Prevention.



page 160Department for Health and Ageing Annual Report 2012-13

Table 32   SA Health Employees Overseas Travel

Note the below table summarises information relating to overseas travel by SA Health (Local Health Network) 
employees which were approved by the Chief Executive, SA Health during 2012-13.

The number of employees who travelled and any related costs are published in the relevant Local Health Network 
annual report and are therefore not included in this report.

Number of 
Employees Destination Reasons for Travel

Total cost to 
the department  

(total $)

0 (a)
Oregon, 
United States

Attend advanced technical training in the repair of dental chairs 
and associated equipment. 

-

0 (b)
Manchester, 
United 
Kingdom

To attend the Pathology Financial Management, Service 
Agreements and Quality Standards conference. 

-

0 (c) Pisa, Italy
Invited keynote speaker at the Global Addiction Conference to 
facilitate international best practice in the principles and practice 
of drug and alcohol treatments. 

-

 0 (c) Singapore

Invited keynote speaker at the Asia Pacific Behavioural and 
Addiction Medicine Conference to facilitate international best 
practice in the principles and practice of drug and alcohol 
treatments. 

-

 0 (d)
Aarhus, 
Denmark

Attend the European Summer School for Advanced Management 
as part of the Master of Business Administration exchange 
program through the University of South Australia.

-

TOTAL 0   $0

(a) All costs for travel, accommodation and meals were fully funded by SA Dental Service (CALHN).
(b) All costs for travel, accommodation and meals were fully funded by SA Pathology (CALHN). 
(c) All costs for travel, accommodation and meals were fully funded by the conference organisers for both trips for the same employee (SALHN).  
(d) All costs for travel, accommodation and meals were fully funded by the employee and SA Dental Service paid the course fees (CALHN).

Table 33   Overseas Travel funding for the new Royal Adelaide Hospital Project 

The table below summarises overseas travel costs that were approved by the Chief Executive, SA Health for 
employees who as part of the new Royal Adelaide Hospital Project, visited hospitals, health facilities and research 
facilities in order to examine any new developments in hospital services that may be applied to the new Royal 
Adelaide Hospital.  Costs for these trips have been incurred by the Department for Health and Ageing for department 
employees working on this project. 

Cabinet has approved this expenditure to be granted to Central Adelaide Local Health Network (CALHN) as the new 
Royal Adelaide Hospital asset is under the control of CALHN and not the department. Travel costs for these trips are 
published in the CALHN annual report.

Number of 
Employees Destination Reasons for Travel

Total cost to 
the department  

(total $)

2 

Rastatt, 
Germany; 
Lyon, France; 
Basel, 
Switzerland 
and Dubai, 
United Arab 
Emirates

Attend various sites to view operating room fit-outs, and 
attend the Arab Health Conference to increase product and 
technical knowledge, understand future trends and assist in the 
development of tender specifications for the new RAH to ensure 
the facility opens with the most advanced and where possible 
leading edge technology.

$0

TOTAL 2 $0



page 161 Department for Health and Ageing Annual Report 2012-13

Independent Auditor s Report
Certification of the Financial Statements



page 162Department for Health and Ageing Annual Report 2012-13



page 163 Department for Health and Ageing Annual Report 2012-13



page 164Department for Health and Ageing Annual Report 2012-13



page 165 Department for Health and Ageing Annual Report 2012-13



page 166Department for Health and Ageing Annual Report 2012-13



page 167 Department for Health and Ageing Annual Report 2012-13



page 168Department for Health and Ageing Annual Report 2012-13



page 169 Department for Health and Ageing Annual Report 2012-13



page 170Department for Health and Ageing Annual Report 2012-13



page 171 Department for Health and Ageing Annual Report 2012-13



page 172Department for Health and Ageing Annual Report 2012-13



page 173 Department for Health and Ageing Annual Report 2012-13



page 174Department for Health and Ageing Annual Report 2012-13



page 175 Department for Health and Ageing Annual Report 2012-13



page 176Department for Health and Ageing Annual Report 2012-13



page 177 Department for Health and Ageing Annual Report 2012-13



page 178Department for Health and Ageing Annual Report 2012-13



page 179 Department for Health and Ageing Annual Report 2012-13



page 180Department for Health and Ageing Annual Report 2012-13



page 181 Department for Health and Ageing Annual Report 2012-13



page 182Department for Health and Ageing Annual Report 2012-13



page 183 Department for Health and Ageing Annual Report 2012-13



page 184Department for Health and Ageing Annual Report 2012-13



page 185 Department for Health and Ageing Annual Report 2012-13



page 186Department for Health and Ageing Annual Report 2012-13



page 187 Department for Health and Ageing Annual Report 2012-13



page 188Department for Health and Ageing Annual Report 2012-13



page 189 Department for Health and Ageing Annual Report 2012-13



page 190Department for Health and Ageing Annual Report 2012-13

Appendix 1   Legislation Committed to Health 
Ministers as at 30 June 2013

Minister for Health and Ageing

Aged Citizens Clubs (Subsidies) Act 1963 

Assisted Reproductive Treatment Act 1988 

Blood Contaminants Act 1985 

Consent to Medical Treatment and Palliative Care Act 1995 

Food Act 2001 

Gene Technology Act 2001 

Health and Community Services Complaints Act 2004 

Health Care Act 2008 

Health Practitioner Regulation National Law (South Australia) Act 2010 

Health Professionals (Special Events Exemption) Act 2000 

Health Services Charitable Gifts Act 2011 

Kapunda Hospital (Variation of Trusts) Act 2009

Motor Vehicle Accidents (Lifetime Support Scheme) Act 2013 

Mount Gambier Hospital Hydrotherapy Pool Fund Act 2009 

National Health Funding Pool Administration (South Australia) Act 2012 

Office for the Ageing Act 1995 

Prohibition of Human Cloning for Reproduction Act 2003 

Research Involving Human Embryos Act 2003 

Retirement Villages Act 1987 

Safe Drinking Water Act 2011 

South Australian Public Health Act 2011 

Transplantation and Anatomy Act 1983 

Minister for Mental Health and Substance Abuse

Controlled Substances Act 1984 

Mental Health Act 2009 

Public Intoxication Act 1984 

Tobacco Products Regulation Act 1997 



page 191 Department for Health and Ageing Annual Report 2012-13

Appendix 2   Hospitals
Hospitals incorporated under the Health Care Act 2008 (as at 30 June 2013)

Name Date of incorporation

Central Adelaide Local Health Network incorporated (CALHN Inc) 1 July 2010

Northern Adelaide Local Health Network incorporated (NALHN Inc) 1 July 2011

Southern Adelaide Local Health Network incorporated (SALHN Inc) 1 July 2011

Country Health SA Local Health Network incorporated (CHSALHN Inc) 15 May 2008

Women s and Children s Health Network incorporated (WCHN Inc) 26 February 2004



page 192Department for Health and Ageing Annual Report 2012-13

Appendix 3   Boards and Committees

BCIS Boards and Committees Responsible to Minister for Health and Ageing  
(as at 30 June 2013)

Minister for Health and Ageing

BCIS Boards and Committees

Health Performance Council

Health Services Charitable Gifts Board

Health and Community Services Advisory Council

Ministerial Advisory Board on Ageing

Health Reform Advisory Committee (established 12/02/2013)

Obesity Prevention and Lifestyle (OPAL) Scientific Advisory Committee

Pharmacy Regulation Authority SA 

South Australian Board of the Medical Board of Australia

South Australian Board of the Nursing and Midwifery Board of Australia

South Australian Board of the Physiotherapy Board of Australia 

South Australian Council for Safety and Quality in Health Care

South Australian Council for Safety and Quality in Health Care   Consumer and Community Advisory Committee

South Australian Health Practitioners Tribunal

South Australian Public Health Council

**Northern Territory, South Australia and Western Australia Regional Board of the Psychology Board of Australia 

BCIS Health Advisory Councils

Incorporated

Balaklava Riverton Health Advisory Council Inc

Barossa and Districts Health Advisory Council Inc

Berri Barmera District Health Advisory Council Inc

Bordertown and District Health Advisory Council Inc

Ceduna District Health Services Health Advisory Council Inc

*Central Adelaide Local Health Network Governing Council Inc

Coorong Health Service Health Advisory Council Inc

*Country Health SA Local Health Network Governing Council Inc

Eastern Eyre Health Advisory Council Inc

Eudunda Kapunda Health Advisory Council Inc

Gawler District Health Advisory Council Inc

Hills Area Health Advisory Council Inc

Kangaroo Island Health Advisory Council Inc

Kingston/Robe Health Advisory Council Inc

Lower Eyre Health Advisory Council Inc

Lower North Health Advisory Council Inc

Loxton and Districts Health Advisory Council Inc

Mallee Health Service Health Advisory Council Inc

Mannum District Hospital Health Advisory Council Inc

Mid North Health Advisory Council Inc



page 193 Department for Health and Ageing Annual Report 2012-13

Mid-West Health Advisory Council Inc

Millicent and Districts Health Advisory Council Inc

Mount Gambier and Districts Health Advisory Council Inc

Murray Bridge Soldiers  Memorial Hospital Health Advisory Council Inc

Naracoorte Area Health Advisory Council Inc

*Northern Adelaide Local Health Network Governing Council Inc

Northern Yorke Peninsula Health Advisory Council Inc

Penola and Districts Health Advisory Council Inc

Port Broughton District Hospital and Health Services Health Advisory Council Inc

Renmark Paringa District Health Advisory Council Inc

South Coast Health Advisory Council Inc

*Southern Adelaide Local Health Network Governing Council Inc

Waikerie and Districts Health Advisory Council Inc

*Women s and Children s Health Network Governing Council Inc

Yorke Peninsula Health Advisory Council Inc

Unincorporated

Ethics Health Advisory Council 

Far North Health Advisory Council

Hawker District Memorial Health Advisory Council

Health and Medical Research Advisory Council 

Leigh Creek Health Services Health Advisory Council

Port Augusta, Roxby Downs, Woomera Health Advisory Council

Port Lincoln Health Advisory Council

Port Pirie Health Service Advisory Council

Quorn Health Services Health Advisory Council

SAAS Volunteers  Health Advisory Council

**South Australian Medical Education and Training Health Advisory Council

Southern Flinders Health Advisory Council

Veterans  Health Advisory Council

Whyalla Hospital and Health Services Health Advisory Council

Minister for Mental Health and Substance Abuse

BCIS Boards and Committees

Controlled Substances Advisory Council

Prescribers Advisory Council (sub-committee)

Notes:
*Incorporated names:

CENTRAL ADELAIDE LOCAL HEALTH NETWORK HEALTH ADVISORY COUNCIL INC

NORTHERN ADELAIDE LOCAL HEALTH NETWORK HEALTH ADVISORY COUNCIL INC

SOUTHERN ADELAIDE LOCAL HEALTH NETWORK HEALTH ADVISORY COUNCIL INC

WOMEN S AND CHILDREN S HEALTH NETWORK HEALTH ADVISORY COUNCIL INC

COUNTRY HEALTH SA LOCAL HEALTH NETWORK BOARD HEALTH ADVISORY COUNCIL INC.

**Name changed: 
22 April 2013
Note: Occupational Therapy Board of South Australia (dissolved October 2012)



page 194Department for Health and Ageing Annual Report 2012-13

Appendix 4   Principal Documents  
(Plans, Strategies, Frameworks, Reports, 
Directions Documents)
A Framework for Active Partnership with Consumers and the Community

A Framework for Comprehensive Primary Health Care Services for Aboriginal People

Aboriginal Health Care Plan 2010-16

Allied Health Business Rules: for Staff Using EPAS

An Integrated Best Practice Model for Cystic Fibrosis in SA

ATSI Companion Document to the Statewide Cancer Control Plan 2011-15 and the SA Cancer Care Pathway

Business Continuity Management Framework

Casemix Funding for Hospitals Policy Methodology 2012-13

Chief Public Health Officer s Code for the Case Management of Behaviours that Present a Risk for HIV Transmission

Chronic Disease Action Plan for South Australia: 2009-18

Code of Fair Information Practice

Data Quality Management

Disability Action Plan 2008-13

Eat Well Be Active Strategy 2011-16

Elective Surgery Policy Framework

EPAS. Get the Full Story

Fair Information Practice: Use and Disclosure April 2010

Glenside Campus Redevelopment Master Plan

GP Plus Health Care Strategy

GP Plus Health Improvement Plan

Health Service Framework for Older People 2009-16

Hepatitis C Action Plan 2009-12

HIV Action Plan 2009-12

Improving with Age   Our Ageing Plan for South Australia (2006)

Key Directions for Health and Medical Research in South Australia

Measuring Consumer Experience: SA Public Hospital Inpatient Annual Report March 2012

Nursing and Midwifery Strategic Framework 2013-15

Nursing Model of Care for Treatment of Hepatitis C in South Australia

Palliative Care Services Plan 2009-16

Primary Prevention Plan 2011-16

Risk Management: Policy and Framework

SA Health Aboriginal Cultural Respect Framework.

SA Health Aboriginal Workforce Reform Strategy: 2009-13

SA Health Clinical Care Activity Data Definitions for Allied Health

SA Health Clinical Commissioning Framework

SA Health Clinical Commissioning Intentions

SA Health Engaging Clinicians In Clinical Commissioning

SA Health Healthcare Associated Infection Prevention Strategic Framework 2012

Service Level Agreement, 2012-13  Country Health SA Local Health Network

Service Level Agreement, 2012-13 Central Adelaide Local Health Network



page 195 Department for Health and Ageing Annual Report 2012-13

Service Level Agreement, 2012-13 Northern Adelaide Local Health Network

Service Level Agreement, 2012-13 SA Ambulance Service

Service Level Agreement, 2012-13 Southern Adelaide Local Health Network

Service Level Agreement, 2012-13 Women s and Children s Health Network

Service Model: South Australian Statewide Specialist Eating Disorder Services

Setting Statewide Priorities for Clinical Practice Improvement

South Australia s Mental Health and Wellbeing Policy 2009-14

South Australia s Oral Health Plan 2010-17

South Australian Alcohol and Other Drug Strategy 2011-16

South Australian Patient Safety Report 2011-12

South Australian Stroke Service Plan 2009-16

South Australian Suicide Prevention Strategy 2012-16

South Australian Tobacco Control Strategy 2011-16

South Australia s Health Care Plan 2007-16

Statewide Cancer Control Plan 2011-15

Statewide Cardiology Clinical Service Plan

Statewide Clinical Networks: A Framework for Delivering Best Practice Health Care

Statewide Rehabilitation Service Plan 2009-17

Stepping Up: A Social Inclusion Action Plan for Mental Health Reform 2007-12

Strategy for Planning Country Health Services in SA



page 196Department for Health and Ageing Annual Report 2012-13

Appendix 5   Publications 1 July 2012    
30 June 2013

Mental Health and Substance Abuse
Framework for Recovery-Oriented Rehabilitation in Mental Health care 2012 
Adelaide: Mental Health Operations, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

South Australian Suicide Prevention Strategy 2012-16 
Adelaide: Office of the Chief Psychiatrist, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2012

Annual Report of the Chief Psychiatrist of South Australia 2011-12 
Adelaide: Office of the Chief Psychiatrist, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2012

Patient and Solicitor Access to Patient Records Standard 
Adelaide: Office of the Chief Psychiatrist, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

Community Treatment Order Statement of Rights 
Inpatient Treatment Order Statement of Rights 
Leave of Absence Statement of Rights 
Rights for Voluntary Mental Health Patients 
Available in English and 15 other languages. 
Adelaide: Office of the Chief Psychiatrist, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

Mental Health Legal Order Forms 
Adelaide: Office of the Chief Psychiatrist, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

Mental Health Walk in Service DL Brochures 
Adelaide: Mental Health Operations, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

Mental Health Destigmatisation posters 
Adelaide: Mental Health Operations, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

Intermediate Care Centre (ICC) Video 
Adelaide: Mental Health Operations, Mental Health and Substance Abuse Division,  
Department for Health and Ageing, 2013

Policy and Commissioning

Aboriginal Health Branch

South Australian Aboriginal Health Scholarship Assistance   Brochure 
Adelaide: Policy and Commissioning Division, Aboriginal Health Workforce Improvement,  
Department for Health and Ageing 2012

Planning and Commissioning Branch 

SA Health Clinical Commissioning Framework 
Adelaide: Policy and Commissioning Division,  

Department for Health and Ageing, 2013 (Feb)



page 197 Department for Health and Ageing Annual Report 2012-13

Policy and Legislation Branch

Proposal to Protect Midwifery Practice in South Australia (2012) 
Adelaide, Policy and Legislation Branch, Policy and Commissioning Division,  
Department for Health and Ageing, 2012

Explanatory Guide for the Advance Care Directives Bill 2012 and related amendments (2012);  
Adelaide, Policy and Legislation Branch, Policy and Commissioning Division 
Department for Health and Ageing, 2012

The Code of Conduct for Unregistered Health Practitioners (2013)  
(under the Health and Community Services Complaints Act 2004);  
Adelaide, Policy and Legislation Branch, Policy and Commissioning Division 
Department for Health and Ageing, 2013

An Integrated Best Practice Service Model for Cystic Fibrosis in SA 
Adelaide: Policy and Commissioning Division, Department for Health and Ageing, 2012 (Aug)

Explanatory Guide for the Advance Care Directives Bill 2012 and related amendments (2012);  
Adelaide, Policy and Legislation Branch, Policy and Commissioning Division 

Department for Health and Ageing 2012

The Code of Conduct for Unregistered Health Practitioners (2013)  
(under the Health and Community Services Complaints Act 2004);  
Adelaide, Policy and Legislation Branch, Policy and Commissioning Division 
Department for Health and Ageing, 2013

Your Rights and Responsibilities   A Charter for Consumers of the South Australian Public Health System  
(updated June 2013) 
Adelaide, Policy and Commissioning Division, 
Department for Health and Ageing 2013

Public Health and Clinical Systems

Blood, Organ and Tissue Branch

Allden R.L.W., Sinha R., Roxby D.J., Ireland S., Hakendorf P., and Robinson K.L. (2011). Red alert   a new perspective 
on patterns of blood use in the South Australian public sector. Aust. Health Review 35, 327 333.

David O., Sinha R., Robinson K., Cardone D. (2013). The prevalence of anaemia, hypochromia and mictrocytosis in 
preoperative cardiac surgical patients. Anaesthesia and Intensive Care 41, 316-321.

The BloodMove Project (poster presented at the National Rural Health Alliance conference Adelaide April 2013).  
Clarke M. and Tocchetti R., Adelaide: Blood Organ and Tissue Programs, Public Health and Clinical Systems Division, 
Department for Health and Ageing, and the Country Health South Australia Local Health Network, SA Health, 2013

Communicable Diseases Control Branch

Clarke M.F., Rasiah K., Copland J. Watson M., Koehler A.P., Dowling K., Marshall H.S. The pertussis epidemic: 
informing strategies for prevention of severe disease. Epidemiol Infect 17 2012: 1-9.

Johnson D., D Onise K., Holland R., Raupach J., Koehler A. Pneumococcal disease in South Australia: vaccine success 
but no time for complacency. Vaccine  30(12) 2012: 2206-11.

Koehler A.P., Athan E., Collins S.J. Updated Creutzfeldt-Jakob disease infection control guidelines: sifting facts from 
fiction. Med J Aust 198(5) 2013: 245-6 (editorial).

McCall B.J., Young M.K., Cameron S., Givney R., Hall R., Kaldor J., Koehler A., Krause V., Selvey C. The time has come 
for an Australian Centre for Disease Control. Australian Health Review 37(3) 2013: 300-3.

Cottrell J. et al. 2013  Rheumatic Fever and Rheumatic Heart Disease Know No Boundaries  Proceedings of the 12th 
National Rural Health Conference, editor Gordon Gregory, Adelaide, SA, 7-10 April 2013. Canberra: National Rural 
Health Alliance, 2013.

Surveillance of sexually transmitted infections and blood-borne viruses in South Australia, 2011. Epidemiological 
report 25 ISSN 2201-1994.



page 198Department for Health and Ageing Annual Report 2012-13

A study on vaccine losses through cold chain breaches published in ANZJPH, Have purpose-built vaccine refrigerators 
reduced the cost of vaccine losses in South Australia?   Katina D Onise, Sara Almond, Breda MacDonald, Maureen 
Watson, Communicable Disease Control Branch, SA Health, South Australia and Sophie Scrimgeour School of Medical 
Sciences, Flinders University, South Australia. Australia and New Zealand Journal of Public Health, Feb 2012. Aust NZ J 
Public Health. 2012; Online doi: 10.1111/j.1753-6405.2012.00932.x.

Health Promotion Branch

Healthy Workers Healthy Futures; a step by step guide to developing your workplace health and wellbeing program. 
Adelaide: Health Promotion Branch, Public Health and Clinical Systems Division,  
Department for Health and Ageing, 2012

System Performance

Office for Professional Leadership

The Nursing and Midwifery Strategic Framework 2013-15 
Adelaide: Office for Professional Leadership, System Performance Division,  
Department for Health and Ageing, 2013



page 199 Department for Health and Ageing Annual Report 2012-13

Acronyms

ABF Activity Based Funding

ABS Australian Bureau of Statistics

ACAP Aged Care Assessment Program

ACAT Aged Care Assessment Teams

ACCHS Aboriginal Community Controlled Health Service

ACHW Aboriginal Clinical Health Workers

ACIS Assessment and Crisis Intervention Service

ADR Adverse Drug Reactions 

AFN Age Friendly Neighbourhoods

AGFMA Across Government Facilities Management Arrangement

AHCSA Aboriginal Health Council of South Australia

AHMAC Australian Health Minister s Advisory Council

AHP Allied Health Practitioner

AHPRA Australian Health Practitioner Regulation  Agency

AHW Aboriginal Health Worker

AIHW Australian Institute of Health and Welfare

ALOS Average Length of Stay

ANMF Australian Nursing and Midwifery Federation

APY Anangu Pitjantjatjara Yankunytjatjara

ARC Australian Research Council

ARF Acute Rheumatic Fever

ASHO Allied and Scientific Health Office

ATCA Australasian Therapeutic Communities Association

AWMA Australian Wound Management Association

b Billion

BBV Blood Borne Virus

BCIS Boards and Committees Information System

BDM Birth Deaths and Marriages

BFHI Baby Friendly Health Initiative

BPSO Best Practice Spotlight Organisation

CACAC Consumer and Community Advisory Committee

CaFHS Child and Family Health Service

CAG Carer Advisory Group

CALHN Central Adelaide Local Health Network

CAMHS Child and Adolescent Mental Health Service

CASHA Chief Allied and Scientific Health Advisor

CBD Central Business District

CHSALHN Country Health SA Local Health Network

COAG Council of Australian Governments

CPP Community Protection Panel

CSCPS Credentialling and Scope of Practice System

CSIRO Commonwealth Scientific and Industrial Research Organisation

CSSD Central Sterile Supply Department



page 200Department for Health and Ageing Annual Report 2012-13

CSSP Clinical Supervision and Support Program

CVS Community Visitor Scheme

DASSA Drug and Alcohol Services South Australia

DCSI Department for Communities for Social Inclusion

DECD Department for Education and Child Development 

DEWNR Department of Environment, Water and Natural Resources

DIFL Do It For Life

DTC Disability Transition to Community

ECT Electro-Convulsive Therapy

EPAS Enterprise Administration System

EPLIS Enterprise Pathology Laboratory Information System

ESMI Enterprise System for Medical Imaging 

FHV Family Home Visiting

FMC Criteria Led Discharge

FMC Flinders Medical Centre

FoFR Forum on Food Regulation

FTE Full Time Equivalent

GFS Grants for Seniors

GJ Gigajoule

GoGO Greening of Government

GP General Practice

HAC Health Advisory Council

HALE Health Adjusted Life Expectancy

HCA Health Consumers Alliance

HCSCC Health and Community Services Complaints Commissioner

HD Haemodialysis

HELPP Health Eating Local Policies and Programs

HiAP Health in All Policies

HMRAC Health and Medical Research Advisory Council

HPC Health Performance Council

HPV Human Papillomavirus

ICAHE International Centre for Allied Health Evidence

ICT Information and Communication Technology

IGRAT In-House Green Rating Tool

ISAAC Integrated South Australian Activity Collection

Kw Kilowatt

LARS Local Health Network Analytical and Reporting System

LCA Life Cycle Analysis

LGASA Local Government Association of South Australia

LHN Local Health Network

m Million

m2 Meter square

MIMMS Major Incident Medical Management and Support

MLs Medicare Locals

MMSS Monthly Management Summary System



page 201 Department for Health and Ageing Annual Report 2012-13

MOU Memorandum of Understanding

MRU Metropolitan Referral Unit

NAIDOC National Aboriginal and Islander Day Observance Committee

NALHN Northern Adelaide Local Health Network

NCETA National Centre for Education and Training on Addiction

NDIS National Disability Insurance Scheme

NERAG National Emergency Risk Assessment Guidelines

NEST National Elective Surgery Targets

NFC Nationally Funded Centres

NGO Non-Government Organisation

NHRA National Health Reform Agreement

NIMC National Inpatient Medication Chart

NPA National Partnership Agreement

NPAPH National Partnerships on Preventable Health

NSQHS National Safety and Quality Health Service

NSQHSS National Safety and Quality Health Service Standards

OBD Occupied Bed Day

OCS Oracle Corporate System

OFTA  Office for the Ageing

OPAL Obesity Prevention and Lifestyle

OPL Office for Professional Leadership

PADG Positive Ageing Development Grants

PANORAMA Physical Activity Nutrition Observatory: Research and Monitoring Alliance

PCEHR Personally Controlled Electronic Health Record 

PIRSA Department of Primary Industries and Regions SA

PV Photovoltaics

QUM Quality Use of Medicines

RAH Royal Adelaide Hospital

RDR Rapid Detection and Response

RGH Repatriation General Hospital

RHD Rheumatic Heart Disease

RNAO Registered Nurses Association of Ontario

RSI Relative Stay Index

SAAS SA Ambulance Service

SA South Australia

SAC Safety Assessment Code

SACESS SA Consumer Experience Surveillance System

SACSQHC SA Council on Safety and Quality in Healthcare

SAES South Australia Executive Service

SAHCP South Australia's Health Care Plan

SAHMRI South Australian Health and Medical Research Insititute

SAIMET South Australian Institute of Medical Education and Training

SAIPP South Australian Industry Participation Policy

SALHN Southern Adelaide Local Health Network

SAMAC South Australian Medicines Advisory Committee



page 202Department for Health and Ageing Annual Report 2012-13

SAMEP South Australian Medicines Evaluation Panel

SAMET South Australian Medical Education and Training

SAMI SA Medical Imaging

SAMSAG South Australian Medication Safety Advisory Group

SAMSS South Australian Monitoring and Surveillance System

SASMOA South Australian Salaried Medical Officers Association

SASP South Australia's Strategic Plan

SCoH Standing Council on Health

SDH Social Determinants of Health

SLS Safety Learning System

SOG Senior Officers Group

SRER Start Right Eat Right

STI Sexually Transmissible Infection

TPPP Transition to Professional Practice Program

TRAC Transition to Residential Aged Care

VHAC Veterans Health Advisory Council 

VTE Venous Thromboembolism

WCHN Women's and Children's Health Network

WELS Water Efficiency Labelling and Standard

WHO World Health Organization

WiL Women in Leadership

YMHS Youth Mental Health Service

YPG Young Professionals Group



page 203 Department for Health and Ageing Annual Report 2012-13

Glossary of Terms

Aboriginal/Torres Strait Islander Health Worker

An Aboriginal/Torres Strait Islander person who provides clinical and primary health care for individuals, families  
and community groups.

Allied Health Clinician

A generic term to describe a wide range of tertiary qualified health professionals who are not doctors or nurses.

Chief Medical Officer

A public sector employee who is a qualified medical doctor who advises the government on health related matters.

Chief Nurse and Midwifery Officer

Chief Nurse and Midwifery Officer is a registered nurse who is responsible for the professional leadership of Nurses 
and Midwives and for providing advice to the government on matters relating to nursing and midwifery

Chronic Disease

A disease that persists for a long period of time.

Clinician

A generic term to describe a wide range of health professionals.

Co-morbidity

Where a person has two or more health problems at the same time.

Department for Health and Ageing

The public sector agency (administrative unit) established under the Public Sector Act 2009 with responsibility  
for the policy, administration and operation of South Australia s public health system.

General Practitioner

A medical practitioner/doctor who works in primary health care and refers patients to specialist medical care.

GP Plus Health Care Strategy

A strategy to provide a fully integrated and accessible health care system that increases prevention and early 
intervention services to promote good health.

Health System

All health services provided to the people of South Australia.

Indigenous Person

A person of Aboriginal and/or Torres Strait Islander decent who identifies, and is accepted as such by the community 
with which they are associated.

Local Health Network

An incorporated hospital under the Health Care Act 2008 with responsibility for the planning and delivery of health 
services. The Local Health Networks for South Australia are: Central Adelaide Local Health Network (CALHN), 
Northern Adelaide Local Health Network (NALHN), Southern Adelaide Local Health Network (SALHN), Country Health 
SA Local Health Network (CHSALHN) and Women s and Children s Health Network (WCHN).



page 204Department for Health and Ageing Annual Report 2012-13

Low Birth Weight Babies

Live births with a birth weight less than 2500 grams.

Medical Practitioner/Doctor

A person who is qualified (registered on the general register or on both the general and specialist registers) to 
diagnose physical and mental illness, disorders and injuries, and prescribe medications and treatment to promote 
good health.

Neonatal

Applies to an infant at any time during the first four weeks of life.

Perinatal

Relating to the period from about three months before to one month after birth.

Primary Health Care

Often the first point of contact that a person has with the health system, such as general practice, community nurses, 
pharmacists, social workers and other health providers. Primary health care is both an approach to dealing with 
health issues as well as a level of health service. It can include a range of strategies from health promotion, health 
protection, disease prevention, advocacy, social action and community development.

SA Health

South Australian public health system, services and agencies, comprising Department for Health and Ageing, Central 
Adelaide Local Health Network (CALHN), Northern Adelaide Local Health Network (NALHN), Southern Adelaide Local 
Health Network (SALHN), Country Health SA Local Health Network (CHSALHN), Women s and Children s Health 
Network (WCHN) and SA Ambulance Service (SAAS).

Separations

The formal process by which a hospital records the completion of treatment and/or care for an admitted patient.

Socioeconomic Disadvantage

A relative lack of financial or material means experienced by a group in a society which may limit their access to 
opportunities and resources that are available to the wider community.

SA Ambulance Service

SA Ambulance Service provides emergency medical assistance, treatment and transport, non-urgent patient transport 
and high-quality patient care to the people of South Australia.





page 206Department for Health and Ageing Annual Report 2012-13

Index
Aboriginal Environmental Health 83

Aboriginal Health 67

Aboriginal Health Care Plan 2010-16 67

Aboriginal Male Health and Well Being Project Officer Position 34

Aboriginal Programs 64

Account Payment Performance 156

Acronyms 199

Across Government Facilities Management Arrangement 146

Administrative and Legislative Responsibilities 12

Advance Care Directives Act 2013 13

Aged Care 116

Aged Care Assessment Program 78

Alcohol Initiatives 63

All of Government Targets 30

Allied and Scientific Health Office 121

Asbestos 81

Asbestos Management 146

Attracting, Valuing and Retaining our Workforce 122

Australian Health Service Safety and Quality Accreditation Scheme 97

Baby Friendly Health Initiative Accreditation 35

Boards and Committees (Appendix 3) 192

Careers in Health 124

Carer Participation Position Statement Guideline 135

Carers Recognition Act 2005 134

Certification of the Financial Statements 189

Chief Public Health Officer s Report 80

ClinEdSA 122

Clinical Reform Agenda 37

Clinical Reform 52

Clinical Senate 52

COAG Agreements 111

Code of Conduct for Unregistered Health Practitioners 13

Commissioning 37

Communicable Diseases 87

Community Nursing 40

Contractual Arrangements 157

Council of Australian Governments Health Reforms 110

Creating a Vibrant City 15

Criteria Led Discharge Flinders Medical Centre 113

Day of Surgery Admission Rates 50

Department for Health and Ageing Occupational Health, Safety, Welfare and Injury Management  
Committee and Health and Safety Representative Forum 131

Department for Health and Ageing Organisational Structure 11



page 207 Department for Health and Ageing Annual Report 2012-13

Develop a Culturally Responsive Health System 69

Developing the new Royal Adelaide Hospital 108

Development of the Guideline and Public Health Policy for the Management of Severe Domestic Squalor  
(A Foot in the Door) 82

Disability Action Plan Report 136

Disability Transition Care Funding 39

Drug and Alcohol Services Intervention and Treatment 61

Each Week  5

eHealth Systems 106

Elective Surgery Strategy 44

Emergency Department Services 47

Emergency Management 114

Employee Overseas Travel 158

Employment Arrangements as at 30 June 2013 126

eMums Program 35

Ensuring Sustainable Access to Best Practice Antenatal Care 34

Enterprise Pathology Laboratory Information System 106

Enterprise Patient Administration System 106

Enterprise System for Medical Imaging 106

Every Chance for Every Child 14

Expanding Criteria Led Discharge into Lyell McEwin Hospital 113

Extreme Heat 116

Food Regulation 84

Fraud 155

Freedom of Information 149

Freemason s Foundation Centre for Men s Health 34

Glossary of Terms 203

GoGO Priority Area Five: Travel and Fleet 144

GoGO Priority Area Four: Built Facilities 143

GoGO Priority Area One: Energy 138

GoGO Priority Area Six: Procurement 145

GoGO Priority Area Three: Waste 143

GoGO Priority Area Two: Water 142

Graduate Recruitment 125

Grants for Seniors and Positive Ageing Development Grants 76

Greening of Government (GoGO), Sustainability Reporting and Energy Efficiency Action Plan 137

Health and Medical Research 105

Health at a Glance 5

Health Care at Home 40

Health in All Policies 80

Health Technology Assessment 51

Health Workforce and Human Resources Activity 117

Hospital Care 38

Hospitals (Appendix 2) 191

Human Health Preparedness 116

Improve the Health of Aboriginal People 67



page 208Department for Health and Ageing Annual Report 2012-13

Improving Efficiency and Effectiveness of Hospital Care 42

In a Year  6

Independent Auditors Report 161

Industrial Issues 126

Information Statement 149

Intermediate Care 36

Investing in the Redevelopment of Metropolitan Hospitals 145

Investing in the Redevelopment of Regional Hospitals 145

Leadership and Management Development 130

Legislation Committed to Health Ministers as at 30 June 2013 (Appendix 1) 190

Local Health Network Analytics and Reporting Service 42

Major Projects 108

Making a Freedom of Information Application 149

Medical, Nursing and Midwifery and Allied and Scientific Health Workforce Strategies 119

Medicare Locals 36

Medicines and Technology Assessment 51

Men s Health 33

Mental Health Care and Drug and Alcohol Services 56

Mosquito Control 84

National Health Reform Agreement   Implementation 110

National Health Reform Agreement   Strengthening Primary Health Care 110

National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes (2009-13) 68

National Partnership Agreement on Indigenous Early Childhood Development (2009-14) 68

National Standards on Safety and Quality in Health Service Standards 97

Nationally Funded Centres Program Secretariat 111

New Royal Adelaide Hospital (new RAH) and adjacent SA Health and Medical Research  
Institute (SAHMRI) building 147

Objectives, Role, Governance and Legislation 11

Office for the Ageing 73

On Any Day, On Average  5

Oracle Corporate Systems 106

Outpatient Reform 41

Overview: Service Demands and Workforce Trends 117

Population Health 92

Port Pirie Transformation Project 82

Premier s Strategic Priorities for South Australia   SA Health actions to support their implementation 14

Premium Food and Wine from Our Clean Environment 16

Preventing Abuse of Older People 74

Primary Health Care 33

Principal Documents (Appendix 4)  194

Promote Aboriginal Community Health and Wellbeing 71

Providing Antenatal Services within a Childhood Centre 113

Providing Education that Addresses Risk Factors for Low Birth Weight 35

Public Health 79

Public Sector Renewal 113

Publications 1 July 2012   30 June 2013 (Appendix 5) 196

Redeveloping Glenside 108



Redevelopment of the Glenside Health Care Campus 147

Redevelopments at Major Country Hospitals 147

Reduce Aboriginal Ill-Health 68

Reducing Smoking in Pregnant Women 35

Regional Impact Assessments 148

Relative Stay Index 50

Repatriation General Hospital   Teaching and Aged Care Facility 147

Research and Training 123

Response to Critical Events 114

Retirement Villages 77

Risk Management and Audit 13

SA Ambulance Service 38

SA Health Led Targets 18

SA Health Structure as at 30 June 2013 12

Safe Communities Healthy Neighbourhoods 15

Safe Drinking Water Act 2011 81

Safety and Quality 97

Seniors Card 76

South Australia s Ageing Plan 73

South Australia s Communities for Life: Our Age-friendly Future 75

South Australia s Strategic Plan 17

South Australian Industry Participation Policy 107

South Australian Public Health Council 80

Statewide Clinical Networks 53

Statewide Clinical Support Services 38

Statewide Formulary for High Cost Medicines 51

Strategic Directions 18

Thinker in Residence 74

Tobacco Control 83

Tobacco Initiatives 63

Toxicity and Site Contamination 81

Training and Exercises 114

Transition Beds for Homeless People Program 34

Transition to Residential Aged Care 40

Trojans Trek 33

Urban Design Charter 147

Use of Consultants 153

Veterans Health Advisory Council Executive Officer Position 33

Wastewater Management 82

Whistleblower Protection Act 1993 152

Women in Leadership 131

Work Health and Safety and Injury Management 131

Workforce Reform 124

Year in Review   Highlights from the Chief Executive 7

Young Professionals Group 130

page 209 Department for Health and Ageing Annual Report 2012-13



Page left blank intentionally



Page left blank intentionally





For more information 

Office of the Chief Executive 
Department for Health and Ageing 
PO Box 287 Rundle Mall 
Adelaide 5000 
Telephone: +61 8 8226 0795 
www.sahealth.sa.gov.au

If you do not speak English, request an interpreter from  
SA Health and the department will make every effort to  
provide you with an interpreter in your language.

  Department for Health and Ageing, Government of South Australia. 
All rights reserved. ISSN: 2201-0475  ISBN: 978-1-74243-519-0 
FIS: 13102. Printed October 2013.

www.ausgoal.gov.au/creative-commons


</pre>
</body>
</html>