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1 

Mount Gambier Health Advisory Council
Mount Gambier and Districts Health Service

Country Health SA Hospital Inc

Mount Gambier
10 Year Local Health Service Plan

 

2010   2019



2 

10 Year Local Health Service Plan  
 

Mount Gambier and Districts Health Service 
 

2010 - 2019 
 
 
 

Table of Contents 
 
 

1. Executive Summary ............................................................................................ 3 
2. Catchment summary ........................................................................................... 5 
3. Needs Analysis summary ................................................................................... 8 
4. Local implications of Statewide plans............................................................. 13 
5. Planning Principles ........................................................................................... 14 
6. Service Delivery Plan ........................................................................................ 15 

6.1   Core Services to be Enhanced and Sustained ................................................ 15 
6.2   Strategies for new / expanded services........................................................... 21 

7. Key Requirements for Supporting Services.................................................... 30 
7.1   Safety &amp; Quality............................................................................................... 30 
7.2   Patient Journey ............................................................................................... 31 
7.3   Cultural Respect .............................................................................................. 32 
7.4   Engaging with our community ......................................................................... 33 
7.5   Local Clinical Networks ................................................................................... 34 

8. Resources Strategy........................................................................................... 36 
8.1   Workforce ........................................................................................................ 36 
8.2 Infrastructure ................................................................................................ 38 
8.3 Finance ........................................................................................................ 39 
8.4 Information Technology................................................................................ 40 
8.5 Risk Analysis ................................................................................................ 41 

9. Appendix ............................................................................................................ 42 
9.1   Leadership Structure ....................................................................................... 42 
9.2   Methodology.................................................................................................... 42 
9.3   Review Process............................................................................................... 43 
9.4   Glossary .......................................................................................................... 43 

 
Date: 22 July 2010 

 
 



1. Executive Summary 
 
The Mount Gambier and Districts Health Service (including the Mount Gambier Country 
General Hospital) is located within the City of Mount Gambier Council area. Mount Gambier 
is the Regional Centre for the South East region of South Australia and much of the Western 
Districts of Victoria. The Mount Gambier and Districts Health Service is a teaching hospital 
and the Regional Hospital for the South East of South Australia and the majority of the 
Western District of Victoria. Mount Gambier and Districts Health Service provides a range of 
accident and emergency, acute inpatient, elective and emergency surgery, birthing, 
paediatric, mental health and various associated and clinical support. Resident and visiting 
medical specialists, resident salaried medical officers and interns provide the medical 
services. Allied health services are provided by the South East Regional Community Health 
Service (SERCHS).  
 
The catchment area for the Mount Gambier and Districts Health Service is the Mount 
Gambier Statistical Local Area (SLA) and the Grant SLA. The catchment also extends into 
Victoria, with residents from Nelson, Winnap, Dartmoor and Strathdownie accessing regular 
health services from the Mount Gambier and Districts Health Service and throughout the 
South East including the SLAs: 

? Wattle Range - West 
? Wattle Range   East 
? Kingston 
? Robe 
? Naracoorte and Lucindale 
? Tatiara 

 
The resident population for the Mount Gambier catchment is 32,061 (ABS 2006 Census). 
People from Aboriginal and Torres Strait Islander backgrounds comprise 1.4% of the Mount 
Gambier catchment compared with 3.1% of the total country South Australian population. 
Approximately 3.5% of the population in the catchment speak a language other than English 
at home, compared with 3.9% of the total country South Australian population. 
 
When compared with the population structure for country South Australia, the Mount 
Gambier population has a higher proportion under the age of 45, and a lower proportion 
aged 45 years and over. Approximately one-third of the population is under the age of 24. 
 
The projected population for the broader South East Statistical Division (encompassing 
Mount Gambier) is estimated to increase by approximately 9% by the year 2021. The 
broader Limestone Coast region attracts an average of 589,000 overnight visitors and 
1,758,000 domestic same day visitors per annum. The catchment reflects a moderate/low 
level of socioeconomic disadvantage. 
 
The Mount Gambier Health Advisory Council and the Mount Gambier Districts Health 
Service, with the support of the Country Health SA Planning Projects Team, have worked 
closely in the development of the 10 Year Health Service Plan including implementation of 
the community consultation and oversight of the planning process. 

       
Between July to December 2009 the Mount Gambier Health Advisory Council undertook a 
community consultation process seeking feedback on the health service needs of the local 
population. In February 2010, the Mount Gambier Districts Health Service Executive team, in 
partnership with Health Advisory Council members, undertook a needs analysis process to 
capture the strengths, weaknesses, opportunities and threats (SWOT) of existing services 
and future directions. The needs analysis has drawn on information obtained through the 
consultation process, analysis of the Health Service Profile, consideration of statewide 
directions and other relevant data.  

  3 



 
      Themes which emerged through the community and key stakeholder consultations include 

the need for local hospital and health services to be maintained and improved; more general 
practitioners and easy access to appointments; improved accident and emergency services; 
more specialists appointments; mental health services are expanded including access by 
children and youth; ability to provide rehabilitation and cancer care in the South East; more 
transport and travel options across the region; better information and prevention 
approaches; improved discharge planning and continuity of care; improved coordination of 
care and improved access to public dental and clinical support services. 
 
Key evidence which supports future priorities identified in the  Plan includes an ageing 
population; rates of chronic disease/risk factors; statewide planning directions for people to 
access safe services as close to home as possible within the available resources; lack of 
accessible community transport options locally; and identification of priority health needs by 
the community and clinicians. 
 
The primary focus of the Plan is to build on existing core services towards an expanded 
range of care associated with becoming a teaching and Country General Hospital. Key 
directions for future enhancement and development include: 
 
New and enhanced services: 

? Enhanced range of acute care in Mount Gambier Health Service including elective 
surgery, maternal and birthing services. 

? Improved access to emergency services. 
? Explore visiting or clinic medical specialist services including: 

o Allergy 
o Autism specialists 
o Dermatologist 
o Endocrinology 
o Urologists 
o Neurologist 
o Respiratory clinics and cystic fibrosis specialists 
o Sleep clinic in the South East 

? Expanded mental health services including: 
o Mental health intermediate care (step up and step down care) 
o Limited Treatment Centre to provide acute inpatient services for more serious 

mental illness. 
o Expanded resident psychiatric service. 
o Mental health services for children, youth and aged. 
o Mental health services for older people including better access to psycho-

geriatricians and other clinical staff. 
? Mount Gambier and Districts Health Service Staff Education Centre to support the 

role of the Country General Hospital as a teaching hospital. 
? Allied health services in the South East (especially for children and youth). 
? Public orthotics and prosthesis services in the South East. 
? Increased local access to specialist rehabilitation services in the South East. 
? Level 4 palliative care services established in Mount Gambier and Districts Health 

Service. 
? Child and youth health services in the South East, including youth workers. 
? Increased x-ray capacity such as exploring magnetic resonance imaging (MRI) 

technology in the South East. 
 
 

 
 

4 



 
2. Catchment summary 
 
Introduction 
 
The Mount Gambier and Districts Health Service (including the Mount Gambier Country 
General Hospital) is located within the City of Mount Gambier Council area. Mount Gambier 
is the Regional Centre for the South East region of South Australia and much of the Western 
Districts of Victoria. The catchment area for the Mount Gambier and Districts Health Service 
is the Mount Gambier Statistical Local Area (SLA) and the Grant SLA. It includes the Mount 
Gambier City at the centre of the catchment area, and extends to Port MacDonnell to the 
south; Kongorong and Carpenter Rocks to the west, Tarpeena to the north and Donovans to 
the south east (refer Map 1 below). The Mount Gambier and Districts Health Service 
catchment also extends into Victoria, with residents from Nelson, Winnap, Dartmoor and 
Strathdownie, accessing regular health services from the Mount Gambier and Districts 
Health Service (refer Map 2 below). The Mount Gambier Country General Hospital also 
supports an extended catchment throughout the South East including the townships and 
surrounding areas of Robe, Kingston, Naracoorte, Bordertown, Penola and Millicent. The 
township of Mount Gambier is located approximately 450 kilometres south-east of Adelaide, 
130 kilometres south-east of Robe and 180 kilometres south of Bordertown.  
 
Map 1: Mount Gambier and Districts Health Service   core catchment area 
 

 
Reference: http://www.atlas.sa.gov.au 

 

5 




Map 2: Mount Gambier and Districts Health Service   Victorian catchment extension (Collection 
Districts) 
 

 
 
Population 
 
The resident population for the Mount Gambier catchment is 32,061 (ABS 2006 Census). The 
population for the Lower South East cluster is approximately 44,000 residents. People from Aboriginal 
and Torres Strait Islander backgrounds comprise 1.4% of the Mount Gambier catchment compared 
with 3.1% of the total country South Australian population. Approximately 3.5% of the population in 
the catchment speak a language other than English at home, compared with 3.9% of the total country 
South Australian population. 
 
When compared with the population structure for country South Australia, the Mount Gambier 
population has a higher proportion under the age of 45, and a lower proportion aged 45 years and 
over. Approximately one-third of the population is under the age of 24. 
 
The projected population for the broader South East Statistical Division (encompassing Mount 
Gambier) is estimated to increase by approximately 9% by the year 2021. The average fertility rate for 
the core Mount Gambier catchment area is approximately 2.3. This is above replacement level and 
higher than the South Australian rate (1.82). The indirect standardised death rate for the core 
catchment area is 5.7, lower than the average South Australian rate (6.1).  
 
The broader Limestone Coast region (which includes Mount Gambier, Millicent, Penola, Bordertown, 
Kingston and Naracoorte) had an estimated 589,000 overnight visitors and 1,758,000 day visitors in 
2007. Mount Gambier attracted approximately 420,000 visitors in 2007.  
 

  
 
 

6 



7 

Table 1: Mount Gambier catchment population 
 

 No. % Cluster* No. 
Cluster* 

% 
Country 

SA 
% 

SA total 
% 

Total Population 32,061  43,947    
       
Males 15,843 49.4% 21,856 49.7% 50.2% 49.2% 
Females 16,218 50.6% 22,091 50.3% 49.8% 50.8% 
       
0-14 years  6,801 21.2% 9,368 21.3% 20.4% 18.5% 
15-24 years 4,079 12.7% 5,309 12.1% 11.4% 13.3% 
25-44 years 8,680 27.1% 11,860 27.0% 25.1% 26.7% 
45-64 years 8,208 25.6% 11,357 25.8% 27.3% 26.1% 
65-84 years  3,793 11.8% 5,344 12.2% 13.9% 13.4% 
85 years and over 499 1.6% 708 1.6% 1.8% 2.0% 
       
ATSI 447 1.4% 592 1.3% 3.1% 1.7% 
CALD (Speaks a language 
other than English at home) 1,129 3.5% 1,422 3.2% 3.9% 12.2% 

*Lower South East Cluster total 
Source: 2006 ABS Census 

 
 
Socioeconomic factors 
 
The majority of the catchment region has been identified as outer regional indicating a moderate level 
of remoteness when compared with other South Australian locations. The catchment reflects a 
moderate degree of socioeconomic disadvantage.  
 
Based on data which monitors the trends of diseases, health related problems, risk factors and other 
issues across major regional areas, the South East region demonstrates higher levels of risk factors 
for overweight, obesity, physical inactivity, and smoking when compared with total South Australia. 
The prevalence of chronic disease for persons aged 16 years and over in the South East region 
demonstrates a higher prevalence of diabetes when compared with total South Australia. 
 
The Limestone Coast is one of South Australia's highly productive and diverse agricultural regions 
with a range of products including vegetables, wine grapes, cereal grain, softwood timber, pastures 
and livestock. Fishing is also a major contributor to the regional economy and aquaculture an 
emerging industry. Unique natural attractions such as the Blue Lake at Mount Gambier and the World 
Heritage listed Naracoorte Caves contribute to an active tourism industry. Manufacturing makes up 
17% of total employment across the Mount Gambier catchment, followed by retail trade (13%), 
agriculture, forestry and fishing (11%) and health care and social assistance (9%). The Lower South 
East region has not been identified for exceptional circumstances due to the prevailing drought. 
However the Upper South East has been identified for exceptional circumstances.  
 
 
 



8 

3. Needs Analysis summary  
 

A needs analysis was conducted as a part of the strategy for planning process. The needs analysis 
sought to combine data from the community, key stakeholders, health professionals, statistics and 
statewide plans. This information was used to undertake a SWOT analysis (identification of strengths, 
weaknesses, opportunities and threats) for relevant service categories. Local priorities and key 
enablers were also identified. 
 
Needs Analysis   Significant findings 
 
Mount Gambier and Districts Health Services infrastructure 
It is anticipated that to meet the growing needs of the community, The Mount Gambier and Districts 
Health Service infrastructure capacity will need to grow in alignment with the expected increase in 
activity over the next ten years. The Mount Gambier and Districts Health Service was built 12 years 
ago as a general practitioner (GP) led model of service delivery. Clinicians have identified the value of 
adequate space to support the doctors and specialists now resident in the workforce.  

 
The solution may be to build on the spatial audit that has already been undertaken and develop it to 
ensure it meets the principles of SA Health s Model of Care document. Key infrastructure needs are 
aligned with the expanded service needs described in this plan. 

 
Mount Gambier and Districts Health Service workforce  
The ageing workforce reinforce the need to ensure an appropriate succession plan for sustaining the 
workforce.  The provision of skilled staff continues to be an important focus for the Mount Gambier 
and Districts Health Service across the maternity and paediatric wards, emergency and pharmacy 
departments and operating theatre. Consultation feedback from staff supported the opportunity for a 
Staff Education Centre to support the role as a teaching hospital and the increasing teaching aspects 
within SERCHS. 

 
Priority Service Areas 
Findings from the needs analysis process which contributed to the priority service areas identified in 
the  Plan include: 

 
Emergency Department 

? Local community, stakeholders and clinical feedback identified the value of continuing to 
improve the efficiency and effectiveness at the Mount Gambier Emergency Department 
(MGED) to cope with the growing demand, provision of appropriate areas for patients requiring 
mental health and/or drug and alcohol services. 

? Local community, stakeholder and clinical feedback identified the need for timely access.  
? Clinicians identified the opportunity for additional nurse practitioner resources and a greater 

need for more information in the community about health care and related services including 
Kid s Helpline. 

? Local stakeholders considered the opportunity to explore the possibility for the SA Ambulance 
Service (SAAS) in partnership with Mt Gambier Hospital to further enhance the emergency 
response by initiating an extended care paramedic response, as currently being utilised in 
Adelaide.  

 
Acute Care  

? Statewide directions for Country General Hospitals and local clinical and community feedback 
have demonstrated the need for the expansion of a range of services, along with associated 
infrastructure, to allow patients to have services provided closer to home. 

? Local clinicians and stakeholders identified the need to improve capacity for allied health 
clinical staff.  

? State and SA country strategic directions, supported community and clinician feedback to 
increase the focus on wellbeing, restorative approaches and population health initiatives such 
as improved primary health care approaches and care coordination with GPs, expanded GP 
Plus Strategy programs, increased and improved discharge planning. 



9 

 
Rehabilitation Unit 

? Statewide directions in the Statewide Rehabilitation Service Plan 2008   2017 for Country 
General Hospitals and local clinical and community feedback have supported the development 
of inpatient rehabilitation, home and centre based day therapy and outpatient rehabilitation. 

? State and countrywide strategic directions and local community and clinical feedback 
recognise that increased rehabilitation services locally will require additional infrastructure,  
facilities, allied health staff, increase in coordination and collaboration to work across the 
continuum of care. 

? State and countrywide strategic directions and local community and clinical feedback 
recognise that the there is a need to provide a respite/convalescence facility where people are 
supported while they recover and gain strength. This is important for older people with 
complex conditions, especially diabetes, requiring constant care after hospitalisation. 

 
Child and Youth Health Services 

? Statewide directions for Country General Hospitals and local clinical and community feedback 
have identified that child and youth health services continues to be an important focus. Timely 
access for children s services such as CAMHS is also important.  

? Local community, clinicians and stakeholders identified the value of expanding early 
intervention services for children and youth; impact of national shortage of all allied health staff 
in meeting the demand; need for more services for disabled children and youth. The needs 
analysis process identified priorities including services for children with autism and cystic 
fibrosis and access to medical specialist services.  

? Local community, clinicians and stakeholders identified the need for new or increased services 
in paediatric mental health specialist services, mental health early intervention service, youth 
support/counselling, special education and support for parents of children with mental illness 
and disabilities. 

   
Maternal and Birthing Services  

? Local community, clinicians and stakeholder feedback, supported by the trend in birthing 
statistics, identified the increasing demand for maternity care, with consumers and clinicians 
identifying the need for infrastructure to meet growth in demand and the high value placed on 
access to private beds.  

? The needs analysis in Millicent has identified the opportunity for obstetric services in Mount 
Gambier to support maternity care in the South East. 

 
Elective Surgery  

? Statewide directions for Country General Hospitals and local clinical and community feedback 
have demonstrated a need for expansion in the range of specialist surgical services available 
locally to reduce the need to travel to metropolitan hospitals and assist in providing services 
closer to home. 

? Increasing the range of resident and visiting specialists, including maximising day surgery 
opportunities, have been identified by community and clinicians in the areas of general 
surgery, especially for gastroenterology, obstetricians and gynaecologists, orthopaedic 
surgery (including paediatric orthopaedic) and visiting plastic reconstructive surgery.  
Clinicians noted that this would need to be supported by an expansion in anaesthetics and 
registrars.   

? Statewide directions for Country General Hospitals and local clinical and community feedback 
have contribute to the opportunity to examine capacity for connections to be built between 
surgical services from the Country General Hospital in Mount Gambier with services at 
appropriate sites across the South East . 

? State and country SA directions and community and clinician feedback supports the need to 
expand the range of pre and post surgical services to increase the focus on wellbeing and 
restorative approaches. 

 
 
 



10 

 
Medical Specialists  

? Statewide directions for Country General Hospitals and local clinical, stakeholder and 
community feedback have demonstrated a need for an expansion in the range of medical 
specialists required locally to assist in providing services closer to home. 

? Local communities and clinicians have identified that an increase in visiting specialists will be 
required to reduce travelling for health services in the areas of urology, endocrinology, 
oncology, sleep clinics, allergy specialists, dermatology, respiratory specialist clinics, and 
neurology. Clinicians identified the value in strengthening support for interns and the capacity 
to have more trainees in the Mount Gambier and Districts Health Service system. 

? The need to increase the focus on wellbeing and restorative approaches identified by state 
and SA country directions as well as community and clinical feedback support the opportunity 
to increase the complexity of services provided locally, increase community care service 
support and increased allied health support available locally. 

 
Mental Health Services  

? Statewide directions for Country General Hospitals, the new Mental Health Act (2009), mental 
health reforms and increasing prevalence of mental illness have emphasised the need for: 
o Establishment of Limited Treatment Centre beds to provide acute inpatient treatment for 

people with serious mental illness. This will be a new service staffed 24/7 by multi-
disciplinary mental health clinicians and will support both inpatient and emergency 
presentations to meet the needs of supporting a seven day a week and after hours 
service in the South East. This will reduce the necessity for many consumers to travel to 
Adelaide for specialist mental health care. 

o Provision of  step up  and  step down  care options by establishing an Intermediate Care 
service for the South East. This service will be nurse led and will be staffed by a multi-
disciplinary clinical team. The objective of intermediate care will be to intervene earlier to 
prevent a hospital admission or to allow earlier transfer following an acute admission 
where a prolonged inpatient admission or higher level of care is not required.  

o Strengthen the partnerships and range of services provided by non-government 
organisations to promote and support recovery from illness by working in conjunction 
with the consumer, their carers and mental health services. 

o Provision of additional housing options for mental health consumers   two new houses 
ready for occupation. 

o Improve ICT infrastructure to deploy high quality audio-visual conferencing to allow for 
improved access to specialist services and support to local clinicians. 

? Improved capacity for early identification, referral to and collaboration with appropriate 
services both within the health sector and the community have been identified by state, SA 
country strategic directions and local community and clinicians. 

? Rates of diagnosed mental health conditions, and clinician and community feedback have 
reiterated the need for psychiatrists. psycho-geriatricians and psychologists particularly for 
youth, children and older people. 

? Local community, stakeholders and clinicians identified the need for increased access to 
services for patients with postnatal depression and bi-polar disorder. 

? Local community, stakeholders and clinicians identified the need for enhanced drug and 
alcohol services including detoxification and methadone programs especially for youth. 

  
South East Regional Community Health Service (SERCHS) 

? Local clinicians and stakeholders recognise that SERCHS currently has some high quality 
facilities. However increased investment in Council of Australian Governments (COAG) 
initiatives including rehabilitation and palliative care programs will lead to the need for 
appropriate accommodation and staffing.  

? Local clinicians and stakeholders noted the importance of building community and allied health 
capacity to support the increased acute care and medical services in Mount Gambier and to 
provide a seven day a week service to support increased early discharge. 

? Local community identified the opportunity to improve timely access to access allied health 
services especially for children. 



11 

? Local clinicians identified the importance of aligning capacity with the growth in demand in the 
areas of community nursing; best practice infection control; continence nurse to cover 
increased urology activity; and additional podiatrist to cover growing demand, especially with 
the ageing population. 

? Local communities, stakeholders and clinicians identified the need for orthotics and prosthesis 
services; designated men s health service and Hospital in the Home. 

? State and SA country strategic directions and local communities, stakeholders and clinicians 
have identified the need for an increased focus on wellbeing and population health initiatives 
such as early intervention and targeting vulnerable and at risk groups, in particular children 
and youth and the economically and socially disadvantaged. 

? Statewide directions in chronic disease and local clinician feedback support the expansion of 
self management programs, and GP Plus strategies in all South East towns. 

 
Palliative Care  

? Statewide directions for Country General Hospitals and the Palliative Care Plan 2009-2016 
emphasise the need for a level 4 palliative care service in country regional hospitals in future 
planning. 

? Local community, stakeholders and clinicians from across the South East have identified the 
need for expanded palliative care services and oncology service consultation, assessment and 
treatment. 

? Local community, stakeholders and clinicians identified that patients would like access to GPs 
and chemotherapy to be streamlined.  

? Local community, stakeholders and clinicians have recommended exploring the opportunity for 
a hospice care facility in the South East. 

 
Aged Care Services  

? Population projections which highlight increasing demand for aged care services into the 
future, supports feedback from the local community, stakeholders and clinicians to form 
partnerships with the local aged care facilities in the South East to have designated respite 
care and dementia beds, enhanced care in the hospital for patients with dementia and greater 
support in the community for older people.  

 
Oral Health  

? Local communities, stakeholders and clinicians identified the need for timely access for public 
dental services for adults and children.  

? Continue to work in partnership with SA Dental Service to improve a range of oral health in the 
South East. 

 
Radiology Services  

? Local communities, stakeholders and clinicians identified to the need for improved local 
access to radiology services, such as exploring MRI technology in the South East and 
enhancing the accessibility of non-emergency x-rays in Mount Gambier.  

 
Partnerships 

? Working in partnerships with other service providers will be an important aspect for delivery of 
efficient and effective health services across the South East. 

 



12 

Transport 
? Local community, stakeholders and clinicians feedback have emphasised the opportunity to: 

o Work collaboratively in the region to develop increased transport and travel options. 
o Improve education and information dissemination concerning transport and travel.  
o Advocate for affordable accommodation for family members to stay in Mount Gambier 

and Adelaide. 
o Contribute to a review of the Patient Assistance Transport Scheme (PATS) 

reimbursement to cover accommodation and travelling costs for people coming from 50 
kilometres or more away to Mount Gambier for health care. 

o Establish a liaison position to provide advice about travel and to support doctors and 
other health professionals in referring to patients needing to travel for services. 

 
Information Technology 

? Adequately resourced tele-medicine units will need to be available. 
? Common electronic client files. 
? Point of care technology. 
? Consider using electronic files for sharing of records and information between South East and 

other GP, hospital and medical specialists to improve continuity of care.  
 
Security and access 

? Adhere to standards and procedures. 
 
Safety and quality 

? Adhere to standards and procedures. 
 
Infection Control 

? Adhere to standards and procedures. 
 

Culturally Appropriate Services 
? Meet the needs of Aboriginal and culturally and linguistically diverse communities. 
? Extensive education and training for mainstream services. 
? Adequate use and access to interpreter services. 

 
Collaboration   intra and inter agency 

? Increase focus on working collaboratively. 
? Processes to support inter and intra agency collaboration. 

 
Linkages with Flinders University Rural Clinical School (FURCS) and other universities 

? Further rural based training and education programs. 
? Support for collaborative research and evaluation. 



13 

 
4. Local implications of Statewide plans 
 
The Strategy for Planning Country Health Services in South Australia, endorsed in December 2008, 
builds on the vision in South Australia s Health Care Plan 2007-2016, South Australia s Strategic 
Plan, and the SA Health Aboriginal Cultural Respect Framework and sets out how to achieve an 
integrated country health care system so that a greater range of services are available in the country, 
meaning fewer country residents will need to travel to Adelaide for health care. 
 
The Strategy identifies the need for significant changes to achieve a sustainable health system that 
addresses the contemporary challenges facing the health system.  The main factors contributing to an 
increasingly unsustainable health system include the ageing population, increasing prevalence of 
chronic diseases, disability and injury, poorer health of Aboriginal people and people of lower 
socioeconomic status, and increasing risks to society from communicable diseases, biological threats, 
natural disasters and climate change. 
 
A key focus of both the Strategy and the SA Health Care Plan was the development of Country 
General Hospitals, one of which is Mount Gambier.  The aim for Country General Hospitals is to be 
developed to manage the majority of health care needs so that only patients requiring highly 
specialised or complex care will need to access this in Adelaide. Country General Hospitals will have 
an increased capacity, a high complexity of services and a range of enhanced and new health 
services. 
 
A number of Statewide Clinical Service Plans have been developed, or are currently under 
development, providing specific clinical direction in the planning of services.  Interpreting these plans 
for country South Australia and specific health units is an important element of the planning process 
for Country Health SA. The enabling factors which are demonstrated across the statewide clinical 
plans include: 
 

? Multi-disciplinary teams across and external to the public health system. 
? Patient focused care. 
? Care as close to home as possible. 
? Teaching and research integrated in service models. 
? Integrated service model across the continuum of care. 
? Streamlining access to specialist consultations. 
? Increasing use of tele-medicine. 
? Improving Aboriginal health services. 
? Focus on safety and quality. 
? Recruiting and developing a workforce to meet future service models. 
? Engaging closely with consumers and community. 
? Developing the infrastructure to meet future service models. 
? Clinical networking and leadership. 
? Connecting local patients with pathways to higher level care needs. 
? Reducing progression to chronic disease for at risk populations. 

 
Strategies within the Statewide Clinical Service Plans which support the achievement of local needs 
have been integrated through the 10 year local health service plans. 
 



14 

5. Planning Principles 
 
The Strategy for Planning Country Health Services in SA set out important principles which have been 
used to guide the local planning which include: 
 

1. Focusing on the needs of patients, carers and their families utilising a holistic care 
approach.  
 
2. Ensuring sustainability of country health service provision.  
 
3. Ensuring effective engagement with local communities and service providers.  
 
4. Improving Aboriginal health status.  
 
5. Contributing to equity in health outcomes.  
 
6. Strengthening the IT infrastructure.  
 
7. Providing a focus on safety and quality.  
 
8. Recognising that each health service is part of a total health care system.  
 
9. Maximising the best use of resources.  
 
10. Adapting to changing needs.  

 
 



6. Service Delivery Plan 
 

6.1   Core Services to be Enhanced and Sustained 
 

Note: The  10 Year Mount Gambier Districts Health Service Plan acknowledges that it will continue to maintain a Regional level of services as defined in the Country 
Health Care Plan Taskforce Service Delineation Framework for Country Health Services. 
Service Category Service Description Target Group Directions over next 10 years 

Community Health 
Promotion and 
Prevention Programs 

? Community health 
promotion is provided by 
SERCHS across the South 
East  

 
 

All age groups 
covering the 
South East of SA 
and some parts 
of Western 
Victoria 

? Maintain and extend current services  
? Build a strong partnership between SERCHS and the community. 
? Expand health promotion and early intervention programs for adults, youth and 

children1 
? Introduce men s health programs 
? Increase South East youth workers  
? Explore opportunities for services similar to SHINE-SA in Mount Gambier 
? Expand drug and alcohol counselling for youth and young adults 
? Expand community mental health services for children and youth 

Community Health and 
GP Plus strategies 

? Community Health Services 
in the South East are 
delivered through SERCHS 

All age groups 
covering the 
South East of SA 
and some parts 
of western 
Victoria 

? Maintain, enhance and extend current services  
? Extend Hospital in the Home2 
? See section 6.2 for expanded services 

Allied Health ? Allied Health staff are a part 
of the SERCHS structure  

All age groups 
covering the 
South East of SA 

? Maintain and extend current services  
? Build a strong partnership between SERCHS and the community 
? Strong interaction between SERCHS allied health staff across Mount Gambier 

Hospital services 
? Expand podiatry services  
? Increased use of videoconferencing 
? Maintain and extend partnerships with outside agencies 
? See section 6.2 for expanded services 

Emergency Service ? Mount Gambier Emergency 
Department (24/7) is a 
Regional Emergency 
Department Centre  

? Emergency surgical 
procedures of higher 
complexity with access to 
clinical networks, eg. 

All age groups 
covering the 
South East of SA 
and Western 
Victoria, tourists 
and seasonal 
workers 

? Maintain, enhance and extend current services 
? Reduce impact of the number of low acuity triage 4-5 patients using MGED 
? Improve timely access to MGED 
? Employ and maintain skilled staff 
? Employ nurse practitioner(s) 
? Improve technology and IT infrastructure to support consultations and 

procedures 
? Introduction of volunteer services 

                                                      
1 Strategy for Planning Country Health Services in South Australia 
2 Chronic Disease Action Plan for South Australia 2009-2018 

15 



ICCnet 

 

? Access to statewide clinical networks (eg. stroke and cardiac guidelines,  Royal 
Flying Doctor Service and SA Retrieval Services) 

? Maintain safe transportation for people requiring mental health services 
? Development of culturally respectful practice 
? See section 6.2 for expanded services 

Acute Inpatient Care ? Teaching hospital with 
resident specialists, doctors 
and interns providing 
medical services 24 hours / 
7 days week  

? Capacity to admit patients 
for more complex and 
higher risk treatment and 
procedures for medical, 
surgical, birthing, mental 
health beds, renal dialysis, 
and paediatrics  

? High Dependency Unit  
? Clinically appropriate work 

force, equipment and 
infrastructure to support the 
level of service 

All age groups 
covering the 
South East of SA 
and Western Part 
of Victoria, 
tourists and 
seasonal workers 

? Maintain, enhance and extend current services  
? Upgrade and modify the existing infrastructure to accommodate the needs of a 

teaching hospital  
? Increased use of information technology and video-conferencing to support 

consultations and procedures 
? Maintain and strengthen partnerships with South East health units, metropolitan 

health units, clinical networks and statewide services 
? Development of culturally respectful practice. 
? See section 6.2 for expanded services 

Elective Surgical ? Surgery provided at Mount 
Gambier Hospital is more 
complex and is delivered by 
resident and visiting 
specialists 

? Resident surgeons in 2010 
include: 

o General surgeons 
(anaesthetists (3), 
gynaecologists (2), 
obstetricians (2) 
ophthalmologists (3),  
orthopaedic surgeon (2)) 

? Visiting surgeons in 2010 
include: 

o ENT (1), 
gastroenterologist (1), 
oral surgeon (1), plastic 
(non-cosmetic) surgeon 
(1) 

All age groups 
covering the 
South East of SA 
and Western 
Victoria, tourists 
and seasonal 
workers 

? Maintain, enhance and extend current services to support sustainable elective 
surgery  

? Continue to maintain operating theatres available 24 hours / 7 days a week in 
Mount Gambier and Districts Health Service 

? Improve timely access to a range of elective surgery services 
? Improve information technology to support consultations and procedures 
? Integrated system and easy access to statewide services and clinical networks 
? Examine capacity for connections to be built between surgical services from the 

Country General Hospital in Mount Gambier with services at appropriate sites 
across the South East  

? Maintain and strengthen partnerships with South East health units to  improve 
continuity of care and discharge planning 

? See section 6.2 for expanded services 

16 



Maternal &amp; Birthing 
Services 

? Mount Gambier maternity 
ward provides a regional 
service 

? All birthing including 
pregnancy-related illnesses 
that remain stable except 
for high risk pregnancies 
transferred to tertiary 
centres  

? 20 beds (12 obstetrics beds 
and 6-10 paediatric beds) 
Three delivery rooms and 
Level 2 Nursery 

? Antenatal and postnatal 
care 

? Community Midwifery 
Program 

? Two resident obstetricians  
? Two  resident 

paediatricians, 1 registrar 
and 1 intern 

Women  
Children aged 0-
18 years covering 
the South East of 
SA and Western 
Victoria, tourists 
and seasonal 
workers 

? Maintain, enhance and extend current services3  
? Improve information technology and increase use of video-conferencing 
? Maintain and strengthen partnerships with South East health units, Child and 

Family Health Service and other statewide services to improve  health services, 
continuity of care and discharge planning for babies, children and parents 

? Form a partnership between Mount Gambier based specialists obstetricians with 
Millicent general practitioners, and hospital staff to provide midwifery shared 
care in Millicent 

? Strengthen access to maternity network(s) 
? Sustainable and skilled workforce working in maternity and paediatric wards 
? Extend the infrastructure and enhance services to accommodate birthing and 

paediatric needs   
? Provide more child friendly ward environments 
? Meet the requirements set out in Standards for Maternal and Neonatal services 

in SA   
? Introduce Hand Held Records and Shared Care 

 

Medical Specialist 
Services 

? 17 resident specialists and 
12 visiting specialists 
covering: 

o Physicians (1) 
o Cardiologists (1) 
o Anaesthetists (3) 
o Paediatricians (3) 
o Orthopaedics (2) 
o General Surgeons (3) 
o Gynaecology and 

Obstetrics (2)    
o Ophthalmology (3)   

? Visiting Surgeons in 2010 
are: 

o ENT (1)  
o Gastroenterology (1)  
o Oral Surgeon (1)  
o Plastic (non cosmetic 

surgery) (1) 

All age groups 
covering the 
South East of SA 
and Western 
Victoria 

? Maintain, enhance and extend current services to provide a sustainable medical 
specialist service for the South East  

? Provision of a the regional services covering sleep apnoea clinic, respiratory 
clinics, cystic fibrosis consultants, dermatologist, urologist and endocrinology 
specialists 

? Improve information technology and increase use of video conferencing 
? Maintain and extend partnerships with outside providers and statewide clinical 

networks that support country practitioners, Flinders University Rural Clinical 
School, Limestone Division of General Practice 

? Maintain and extend partnerships with South East Health units to improve 
continuity of care and discharge planning for all patients 

? Extend Mount Gambier paediatric clinics and consulting to support areas in the 
South East, where appropriate 

? See section 6.2 for expanded services 

                                                      
3 Standards for Maternal and Neonatal Services in South Australia 2009 

17 



? Resident specialists are 
providing an outreach 
services to lower  South 
East health Units 

? 26 Salaried Medical 
Officers and Interns also 
providing a service 

Mental Health ? Mental Health services are 
based at the Mount 
Gambier with mental health 
staff located in Mount 
Gambier, Millicent, 
Naracoorte and Bordertown 

? Provides acute care and 
community based care 

? Limited Treatment Centre 
(under the new Mental 
Health Act) providing acute 
inpatient care with ability to 
detain, admit and provide 
short-term treatment for 
serious mental illness 

? Multi-disciplinary 
community based specialist 
mental health team with 
more than 16 staff -  
includes social work, 
psychology, occupational  
therapy and nursing 

? Visiting public and private 
specialist psychiatrists (3) 

? 1 resident (private) 
psychologist in South East 
Regional Health Service 
and 3 visiting (private) 
psychologists 

 

Adults aged 18 
years and over 
covering the 
South East of SA, 
Western Victoria, 
seasonal workers 
and tourists 

? Maintain, enhance and extend current services through implementation of Local 
Mental Health Service Networks   promote strong relationship between mental 
health team and other South East health workers 

? Strengthen role of the South East as part of an integrated mental health system 
within a strong primary care base 

? Implement provisions of the new Mental Health Act from 1st July 2010. 
? Provide access at the local level to expanded and upgraded telehealth network 

across Country Health SA. 
? Implement comprehensive Mental Health Workforce Development Plan to meet 

the future workforce needs 
? Strengthen GP mental health partnership and collaboration  
? Adequate staffing, capacity and resources to improve, increase or provide the 

following services in the South East: 
o Establish Limited Treatment Centre for mental health inpatient care    

staffed 24 hour/7 day a week service by specialist mental staff 
o Psychiatrists for adults and children 
o Psycho-geriatrician and services for older people 
o Encourage increased access to private resident psychologists 
o Increased services for children and adolescents  
o Increased counsellors for youth 
o Rehabilitation programs for children and adults 
o Increased early intervention programs for children and adults 
o Establish Intermediate Care  (step up and step down care) in Mount 

Gambier 
o Supported accommodation and access to social housing 
o Access to mental health rehabilitation services 

? Maintain and strengthen partnerships to improve safe transportation, continuity 
of care and transfer planning when being admitted to and discharged from 
metropolitan services and local services 

? Maintain and strengthen partnerships and consultations with patients/clients and 
community to ensure their involvement in designing and implementing the 
network and culturally sensitive environment 

? See section 6.2 for expanded services 

18 



Rehabilitation ? Admissions for recuperative 
and maintenance care 

? Access to community/home 
based rehabilitation support 

? Centre based day therapy 
? Single and multi-discipline 

outpatient rehabilitation 

All age groups 
covering the 
South East of SA 
and Western 
Victoria, tourists 
and seasonal 
workers 

? Maintain and extend current rehabilitation services4 
? See section 6.2 for expanded services 

Respite Services ? Respite care in external 
Mount Gambier aged care 
facilities  

55 years and 
onwards covering 
the Lower South 
East 

? Advocate for additional respite care beds in the South East 
? Availability of respite for higher level acuity/disability care 
? Expand access to Transitional Care Packages 
? Increase Domiciliary Care services 

Aged Care ? Home and community 
Domiciliary Care services 

? Aged care assessment 
? Access to aged care 

packages 
? Aged care services in 

external Mount Gambier 
aged care facilities  

60 years onwards 
covering the 
Lower South East

? Advocate for additional aged care beds and facilities in the South East 
? Build strong partnerships with aged care providers, Commonwealth Government  

and country-wide ILEP equipment program to meet aged care requirements 
? Establish Geriatric Evaluation and Management or  GEM  Team to promote a 

strong focus on minimising loss of function, independence and confidence 
through multi-disciplinary input, timely access to neuropsychological 
assessment, diagnostic and imaging services and co-ordinated care 

? Increased gerontology, psycho-geriatric support and mental health services for 
older people5 

Palliative Care ? Access to Palliative care 
beds 

? Visiting oncologist six 
weekly 

 

 

All age groups 
covering the in 
South East 

? Commitment to maintain, enhance and extend current services6 
? Ensure adequate infrastructure, staffing, capacity and resources to support  the 

service profile 
? Increase staff knowledge and skills 
? Development of a culturally respectful practice  
? Maintain and extend oncology clinics in Mount Gambier 
? Improve information technology and increase use of video conferencing 

? See section 6.2 for expanded services 
Clinical Support Services ? Radiology services in Mount 

Gambier are provided by a 
private company (Benson 
Radiology) located in Mount 
Gambier Hospital 

? Mount Gambier pharmacy 
supplies the Lower South 
East health units (including 
local aged care facilities)  

? 24 hour/7 day/week 

All age groups 
covering the 
Lower South East

? Mount Gambier Hospital pharmacy capacity and infrastructure to be increased 
and to explore to provide an expanded the provision of a regional  clinical 
pharmacy service 

? Recruit more pharmacists 
? Maintain access to 24 hour/7 day/week pathology laboratory  
? In partnership with Bensons Radiology enhance access to radiology services  
? Maintain access to a wide range of diagnostic services to support medical, 

surgical and emergency services, such as access to CT scanning in light of best 
practice advancements in treatment of stroke 

? Increase radiology capacity and explore access to MRI technology in the South 
                                                      
4 Statewide Rehabilitation Service Plan 2009-2017 
5 Health Services Framework for Older People 2009-2016 
6 Palliative Care Services Plan 2009-2016 

19 



pathology laboratory  
Oral Health ? SA Dental Service is co-

located in the Mount 
Gambier Hospital 

 
 

All age groups 
covering the 
South East 

? In partnership with SA Dental Service to improve timely access to public dental 
services, including emergency and after hours care, throughout the South East  

? Advocate for the Patient Assistance Transport Scheme (PATS) coverage for oral 
health 

? Improve timely access for public dental services for local adults and children 
? Advocate for the recruitment of more public dentists 
? Advocate for increased Medicare rebates for accident work 

20 



6.2   Strategies for new / expanded services 
 
Service objective: To improve and extend Emergency Services in Mount Gambier and Districts Health Service  

Target group: All age groups 
Critical milestones: Teaching and Country General Hospital 

 
Outcomes Future Strategies Time Frames  
Rapid access to emergency care integrated with statewide 
remote advice and retrieval services 
 
 

? Employ trained nurse practitioners to work in the Mount Gambier Emergency 
Department 

? Increase capacity to manage the growing demand by redeveloping the 
Emergency Department to strengthen the effectiveness and efficiency  

? Establish a safe area for patients requiring mental health and/or drug and 
alcohol services 

? Form partnerships with SA Ambulance,  Royal Flying Doctor Service, and 
SA Retrieval Team to initiate an extended care response and more 
streamlined patient transfer to urban health units 

2011 
 
 
 

 

21 



 
Service objective: To improve and extend acute care in Mount Gambier and Districts Health Service 

Target group: All age groups living in the South East and some parts of Western Victoria  
Critical milestones: Teaching and Country General Hospital  

 
Outcomes Future Strategies Time Frames  
Expanded range of acute inpatient care services  ? Redevelop acute care inpatient facilities to increase flexibility, efficiency and 

occupancy levels in line with the Country SA Model of Care 
? Increase capacity to support allied health staff to work in the Mount Gambier 

and Districts Health Service 
? Ensure development of alternative support services to reduce avoidable 

admissions 
? Incorporate requirements for paediatric security and pandemic management  
? Form stronger partnerships with South East health units to improve discharge 

planning and continuity of care for all patients 
? Maintain and strengthen partnerships with the Limestone Coast Division of 

General Practice and general practitioners to encourage the recruitment and 
retention of more general practitioners to work in Mount Gambier 

2014 

 

 

 

 

 

 

22 



 
Service objective: Increase local access to specialist rehabilitation services 
Target group: Patients requiring stroke, amputee, orthopaedic and neurological rehabilitation services: Older people, Aboriginal community and children 

Critical milestones: Specialist inpatient rehabilitation established 
 
Outcomes Future Strategies Time Frames  
Access to a rehabilitation facility in Mount Gambier and Districts 
Health Service 
 

? Work in partnership with metropolitan rehabilitation hospitals (including 
Hampstead Rehabilitation Centre and St Margaret s) to enhance specialist 

rehabilitation skills across the cluster 
? Over the 10 years establish the staff, infrastructure and capacity to provide: 

o Specialist in-patient services 
o Access to a consultant specialist in rehabilitation medicine  
o Outpatient and day services 
o Home based services  
o Mental health rehabilitation 
o Hub and spoke and satellite services and teams to reach rural locations 
o A senior lead clinician (allied health or nursing)  
o Where gaps exist in local service provision, defined systems for referral 

and funding will be put in place to ensure that patients can gain timely 
access to services which are not available in their locality  

o Adequately resourced tele-medicine units. 
? Develop a restorative program providing rehabilitation, stroke management 

and post surgery support, linked to metropolitan and Country Health SA based 
medical specialists, with a multidisciplinary team led by rehabilitation 
specialists 

2010 

 

23 



 
Service objective: To improve child and youth health services in the South East  

Target group: Residents 0-18 years living in the South East and some parts of Victoria  
Critical milestones: Teaching and Country General Hospital  

 
Outcomes Future Strategies Time Frames  
Expanded range of services for children and youth in the South 
East 
 
 

? Increase the range of services and specialists for children and youth in the 
South East to reduce the need for parents and children travelling to access 
services in Adelaide or elsewhere 

? Increase the focus on early intervention and prevention and allied health 
services  

? Increase access to allergy services and services for people with autism and 
cystic fibrosis  

? Strengthen partnerships with Child, Adolescent Mental Health Services, Child 
and Family Health, Department of Education and Children Services and 
SHINE-SA to enhance services 

? Integrate with future statewide paediatric and early childhood development 
planning into the future 

? Extend Mount Gambier paediatric clinics and consulting to cover the South 
East, where appropriate 

2012 

 

24 



 
Service objective: To improve access to elective surgery in the South East   

Target Group: All age groups living in the South East and some parts of Victoria 
Critical milestones: Teaching and Country General Hospital  

 
Outcomes Future Strategies Time Frames  
Access to elective surgical services which meets the needs of 
the Mount Gambier and South East catchment as per the 
Statewide directions for Country General Hospitals 
 

? In partnership with local stakeholders, examine capacity for connections to be 
built between surgical services from the Country General Hospital in Mount 
Gambier with appropriate services across the South East  

? Increased number of specialists including general surgeons, obstetricians and 
gynaecologists,  orthopaedic surgeons, resident urologists and registrars and 
interns to reduce the number of people travelling for elective surgery and 
medical specialists 

? Introduce hand held records 
? Strengthen  partnerships between South East and Adelaide specialists and 

health units to improve discharge planning and continuity of care 

2011 

 

25 



 
Service objective: To improve access to medical specialists in the South East 

Target group: All age groups living in the South East and some parts of Victoria 
Critical milestones: Teaching and Country General Hospital  

 
Outcomes Future Strategies Time Frames  
There is a South East Medical Specialists Network across the 
South East meeting the local needs of health units  
 

? In partnership with stakeholders across the South East, introduce new medical 
specialist services to reduce the number of people travelling for medical 
specialist services in the following areas: 

o Physicians 
o Paediatricians, registrar and intern 
o Cardiologist 
o Oncologists 
o Respiratory specialist and clinics 
o South East Regional Sleep Clinic 
o Allergy specialists 
o Visiting dermatologist 
o Visiting neurologist  

? Introduce hand held and/or electronic records 
? Build a strong partnership between South East and Adelaide specialists to 

improve continuity of care and discharge planning 
? Build a strong partnership with Flinders University Rural Clinical School to 

encourage more medical specialists to work in the South East  
? Continue to enhance  supervision and support for the interns and increase 

capacity to have more trainees working in Mount Gambier and Districts Health 
Service  

? Improve timely access to see specialists in the South East 

2012 

 

26 



 
 
Service objective: To improve and extend mental health services in the South East  
Target group: All age groups living in the South East 

Critical milestones:  
? Implementation of the new Mental Health Act from 1st July 2010 
? Implementation of new models of care for country mental health 
? Implementation of comprehensive telehealth network across Country Health SA by December 2010 
? Establishment of new mental health facilities (Limited Treatment Centre) and workforce 
 
Outcomes Future Strategies Time Frames  
Sustainable mental health workforce and infrastructure  
covering  the South East residents needs 
 

? Implement robust South East  Mental Health Service Network as identified in  
Country Mental Health Model of Care 

? Mental health services are available 24/7 in the South East 
? Develop a skilled multidisciplinary care management  team with resident 

psychiatrists, psycho-geriatrician, additional psychologists and health workers 
? Establish intermediate care services as a part of a  stepped  system of care 
? Recruit additional mental health clinicians across the South East to meet 

demand and staff both Limited Treatment Centre and Intermediate Care services 
? Establish new service partnerships with non-government organisations to 

support intermediate care 
? Under the new Mental Health Act (2009); establish a 3 bed Limited Treatment 

Centre (LTC) and the capacity to admit involuntary patients to a secure 
environment for a period of up to 7 days, without impacting on the existing 
inpatient services. 

? Recruit and employ additional mental health clinicians to operate the Limited 
Treatment Centre beds on a 24/7 basis 

? More emphasis on mental health services for children, youth, aged, and for 
postnatal depression and bi-polar disorder 

? Contribute strategies to support reduction in the youth suicide rate across the 
South East 

? Maintain and strengthen partnerships with DASSA, CAMHS and Rural and 
Remote Mental Health services to develop an appropriate mental health service 
for all age groups, reduce the amount of time travelling and living away from 
home for care 

? 2012 

 
 
 

27 



Service objective: To improve and extend South East Regional Community Health Service (SERCHS)  
Target Group: All age groups living in the South East and some parts of western Victoria 

Critical milestones: Teaching and Country General Hospital  
 
Outcomes Future Strategies Time Frames  
SERCHS has sustainable infrastructure and capacity to provide 
services across the  South East 

? Extending appropriate accommodation and staffing to meet the needs of 
increased investment in COAG initiatives such as programs in rehabilitation and 
palliative care  

? SERCHS services to provide a 7 day a week service 
? Expand allied health services for children and youth to improve timely access for 

public appointments in speech pathology, physiotherapy, occupational therapy 
and dietetics 

? Build community and allied health capacity to support the increased acute care 
and medical services in Mount Gambier, including: 

o Range and timing of pre and post surgery care  
o Increased specialised services 
o Increased allied health services especially for children, youth and aged 
o Increased community nursing programs including infection control nurses 

and incontinence nurse 
? Introduce a public orthotics and prosthesis services 
? Introduce men s health services  
? Maintain and strengthen  partnerships with all South East health units to improve 

discharge planning and continuity of care 

2011 

 

28 



 
Service objective: To improve and extend palliative care in the South East7  

Target Group: All age groups living in the South East 
Critical milestones: Level 4 palliative care services in place as part of the Country General Hospital 

 
Outcomes Future Strategies Time Frames  
Level 4 palliative care services established in Mount Gambier 
and Districts Health Service 
 

? Establish a partnership with Southern Adelaide Palliative Services to meet 
palliative care needs of patients, caregivers and families with complex 
needs. This will be achieved by enhancing: 

o Inpatient care; with a small cluster of (four-dedicated) palliative care 
beds and specialised inpatient medical and nurse-led care options 

o Links to primary care providers 
o Expand the regional palliative care services outreach team, supporting 

local staff with complex care management across settings 
? Explore the extension of current oncology services consultation, assessment 

and treatment across the South East  
? Explore opportunities with Limestone Coast Division of General Practice to 

recruit an additional GP with chemotherapy skills in Mount Gambier 
? Explore the feasibility of a South East chemotherapy mobile unit  
? Review the need and provide a hospice care facility in the South East 
? Support Level 2 palliative care units in the Lower South East 

2016 

 
 
 
 

                                                      
7 Palliative Care Services Plan 2009-2016 

29 



7. Key Requirements for Supporting Services 
 
7.1   Safety &amp; Quality 

 
Objective: To provide a safe environment for staff and patients in Mount Gambier and Districts Health Service 

Critical milestones: N/A 
 
Outcomes  Existing Strategies Sustained  Strategies for the Future 
Continual improvement and patient-centres 
approach underpinning service delivery 
 

? Flexible adaptable and committed to clients and 
care provided 

? Contribution to country-wide accreditation 
framework 

? Continue to audit triage times 
? Implement the Australian Charter of Health Care 

Rights 
? Implement strategies to improve the State and 

National Patient Safety priority areas 
? Audit program in place to ensure client satisfaction 
? Update and build consistency in policies and 

procedures 
? Patient consumer feedback surveys 
? Patient advocate position 

? Improve access for disadvantaged groups including 
people with mental illness, lower socioeconomic, 
elderly, children, youth  

? Increase flexibility of service delivery and allocation 
of time to provide quality of services 

? Reorientation of services to achieve a greater focus 
on primary health care, early intervention and health 
promotion 

? Enhance clinical involvement in clinical governance 
leadership and clinical governance framework 

? Work towards the implementation of national open 
disclosure for people from culturally and 
linguistically diverse backgrounds such as support 
for interpreter services 

? Increase opportunities for clinical debriefing 
? Increase client/family consultation and participation 

in care 
? Develop escalation plans to cope with increased 

activity 
? Expand the capability  to safely manage aggressive 

clients 
Integrated access across the health system ? Access iCCnet for clinical support and guidance 

? 24 hour access to consultant/specialist medical 
staff, salaried medical staff and interns 

? Access to perinatal practice guidelines which ensure 
the provision of evidence based care 

? Access to statewide obstetric/neonatal retrieval 
service 

? Further expansion of statewide and country health 
clinical networks 

? Improve the use of knowledge and information 
management and technology to increase quality and 
safety 

? Contribute to a regional focus for disaster planning 
and management 

? Review and implement new consumer feedback 
monitoring tools as part of SA Health program 

 

30 



 
7.2   Patient Journey 

 
Objective: To improve South East transport and travel options to Mount Gambier and Districts Health Service  

Critical milestones: 2010 
 
Outcomes  Existing Strategies Sustained  Strategies for the Future 
Access a safe and quality care near home 

 

? Patient journey project 
? Red Cross transport 

 

? Advocate for the improvement of accessible 
community transport options locally, to outlying 
towns in the catchment, and across the South East 

? Explore the range of activity that could be 
repatriated back to the South East so that only 
patients requiring highly specialised or complex care 
will need to access services in Adelaide 

Provide a smooth and supported journey when 
people do need to travel to access services 

? Strengthen access to discharge planning  
? The South Australian Patient Assistance Transport 

Scheme (PATS) 

? Work closely with other services in the South East 
to ensure equity of access to regional health 
services 

? Support the new designated patient journey liaison 
office position 

? Contribute feedback/solutions to improve PATS for 
residents of the catchment 

? Improve coordination of care for local patients being 
transferred within the South East and to 
metropolitan health units 

? Investigate an inter South East patient transport 
system 

? Facilitate appointments with specialists or 
metropolitan hospitals during the middle of the day 
so that patients can travel to Adelaide and back on 
the same day 

? Maintain and strengthen partnerships with SA 
Ambulance Service, Royal Flying Doctor Service, 
and SA Retrieval Team to provide streamlined 
patient transfer to urban health units 

? Explore electronic client record management to 
assist in care coordination 

? Support SAPOL and SAAS to reduce delays in 
transport to an approved treatment centre under the 
Mental Health Act  

 

31 



7.3   Cultural Respect 
 

Objective: To recognise and understand the needs of people from culturally and linguistically diverse backgrounds using Mount Gambier and Districts 
Health Service 
Critical milestones: 2010 

 
Outcomes  Existing Strategies Sustained  Strategies for the Future 
? Health services provided in a culturally 

sensitive and respectful way 
? Increased cultural awareness and sensitivity by 

Mount Gambier and Districts Health Service 
staff   

 
 
 

? Aboriginal health promotion and prevention project 
officer 

? Continue to strengthen working relationships with 
Pangula Mannarmurna staff and sharing of 
programs 

? Establish cultural respect awareness education and 
training programs for all Hospital staff 

? Strengthen relationships between the Hospital and 
Aboriginal communities 

? Establish stronger representation of cultural groups 
on Hospital Advisory Committees 

? Provide culturally appropriate programs and 
counselling for culturally diverse groups 

? Establish culturally appropriate women s health 
clinics 

? Facilitate improved coordination of services  
? Provide improved consultation mechanisms for 

Aboriginal and Torres Strait Islander people 
? Satisfaction with Hospital services, by patients 

from culturally diverse backgrounds 

 

? Use of interpreter services 
? Partnership with Limestone Coast Migrant Centre 
? Partnership with Skilled Migrant Centre  
? Accessible health promotion and prevention 

programs for all population groups 
? Facilitate workshops on the needs and culture of 

Burmese residents 
 

? Conduct cultural respect education and training 
programs for all Hospital staff 

? Advocate for the review of visa holders  access to 
medical care  

? Advocate on behalf of skilled migrants for access to 
health care services 

? Culturally sensitive programs for women and 
children have been developed including mental 
health programs 

? Establish stronger partnerships with the SE Migrant 
Resource Centre and Skilled Migrant Programs 

? Strengthen relationships between Hospital and 
patients from a range of cultural backgrounds 

 

32 



 
7.4   Engaging with our community 

 
Objective: Increase the capacity of the community to contribute to the planning, implementation and evaluation of services 

Critical milestones: N/A 
 
Outcomes  Existing Strategies Sustained  Strategies for the Future 
Strong awareness of the availability of services in 
the community  
 
 

? Maintain and support diverse community groups 
 

? Build awareness in the community of what services 
and processes can be expected locally 

? Stronger partnerships and liaison links have been 
developed and maintained with community 

? Improved discharge planning and patient continuity 
of care  

? Develop improved communication and marketing of 
the health system throughout the South East 
community 

Health service needs of the community are 
understood 
 

? Support the Mount Gambier Health Advisory 
Council to implement their ongoing role to engage 
with their community and local stakeholders  

? Improve processes to listen and act on community 
views 

? Improve the management and coordination of 
volunteers 

? Strengthen partnership between Health Advisory 
Council, health services and Limestone Coast 
Division of General Practice 

? Acknowledge that local community support will be 
vital to the success of the new and changed 
programs 

 

33 



 
7.5   Local Clinical Networks 

 
Objective: Enhance relationships with other services locally, regionally and statewide 

Critical milestones: N/A 
 
Outcomes  Existing Strategies Sustained  Strategies for the Future 
Formal ties with statewide and country health 
networks 
 
 

? Maintain access to statewide clinical services such 
as:  

o Cancer 
o Cardiology 
o Child health 
o Maternal neonatal 
o Mental health 
o Older people 
o Orthopaedics 
o Palliative care 
o Rehabilitation 
o Renal 
o Stroke 

? Continue to improve links and communication with 
statewide retrieval teams 

? Increase links and provision of child and family 
health services 

? Build partnerships with special clinical services in 
Adelaide to support a shared model of care and 
provide support for workforce, training and 
professional development and quality management 

 
 

Mount Gambier Country General Hospital extends 
formal ties with health service organisations in the 
region 

? Lower South East Health cluster meetings 
? Contribute to regional approach to delivery of 

services to increase diversity of services offered in 
the South East 

? Continue to work closely with Limestone Division of 
General Practice to enable effective engagement of 
GPs 

? Contribute to strengthening links and networks 
across the region and programs 

? Improve coordination and linkages between intra 
and inter agency services, including time and 
process for engagement and rapport 

? Improve communication and learning opportunities 
with SA Ambulance service, visiting specialists, non-
government organisations 

? Strengthen working partnerships with CAMHS, Child 
and Family Health, Department of Education and 
Children Services to improve health services for 
children and youth and to provide support and 
advice to school youth counsellors 

? Explore the extension of the clinical networks across 
the South East 

Reciprocal relationships between local partners ? Maintain good processes for sharing information 
and case managing clients holistically 

? Continue coordination and collaboration with 

? Increased partnerships with South East 
communities, Limestone Coast Division of General 
Practice, GPs, SERCHS, aged care facilities and 

34 



 
35 



 
8. Resources Strategy 
 

8.1   Workforce 
 

Service objective: Improve ability to recruit, develop and retain a skilled health workforce 
Critical milestones: 2011 

 
 

Outcomes  Existing Strategies Sustained Strategies for the Future  
Highly skilled and qualified workforce ? Recruitment strategies reviewed and new ones 

implemented, suitable for the South East working 
environment 

? Monitor staff workloads, expectations and demands 
? Improve access to Continual Professional 

Development 
? Continue to increase skills of triage staff working in 

Emergency Department 
 

? Increased funding for staff training and 
education is required 

? Mount Gambier Hospital has an ageing 
workforce and there is a need to 
commence succession planning, 
maintaining up to date skills and 
practice, balanced workforce of 
experienced nurses and new carer 
nurses 

? Increased education and training for 
primary health care models of care 

? Develop processes and conduct training 
and education to manage the increasing 
complexity of activity. 

? Expand pool of nursing skills and 
experience 

? Build a culture that advocates ongoing 
training and learning 

? Explore the implications for parity of 
reimbursement rates in SA and Victoria, 
especially for allied health staff 

? Recognise and acknowledge the Green 
Triangle Model for future work between 
the two states. The current work needs 
to be acknowledged such as a Mental 
Health Service partnership considered 
between Victoria and SA 

36 



Integrated workforce recruitment and retention ? Recruit to key vacancies including the Medical Director, Physician,  
? Strengthen support for medical interns and trainees 

? Explore opportunity for Nurse 
practitioner(s) to work in the ED 

? Meet the expanded workforce needs of 
the service profile outlined in sections 
6.1 and 6.2 of this plan including: 

? Medical specialists 
? Nursing 
? Pharmacy 
? Radiology 
? Allied health  
? Support services 

 

 

37 



 
8.2 Infrastructure 

 
Service objective: Increase the capability of the infrastructure to support planned service levels are provided and maintained within local communities 

Critical milestones: Expansion of infrastructure 
 

Infrastructure and capacity meets standards and 
supports existing and future service delivery 
 

? Consider how Mount Gambier and Districts Health 
Service locates all current and new resident 
specialists  

? Seek accommodation for corporate and external 
services to support increased access to on-site 
space for clinical services 

 

? Undertake a business case for the expansion in 
capacity for the Mount Gambier Hospital by: 
o delivering appropriate space for mental 

health and palliative care  
o Achieving the principles set out in the SA 

Health Model of Care  
o Redeveloping the emergency department, 

high dependency unit and clinical support 
services to support the future service profile 

? Development of a staff education centre to 
strengthen teaching hospital role 

? Explore, with other key stakeholders, the 
development of a separate private hospital on 
the same site as Mount Gambier Hospital  

? Extend SERCHS facilities on the current site to 
match the expected growth and capacity in service 
delivery now and within the next ten years 

 
 

38 



8.3 Finance  
 
Objective: Increase the efficiency and effectiveness in the allocation of resources, balanced with the provision of services as close to home as possible 

Critical milestones NA 
 
Outcomes  Existing Strategies Sustained Strategies for the Future  
? Mount Gambier District Health Service is 

resourced to deliver a Regional Health Service 
and to cover the needs of a teaching hospital 

 

? State Government funding 
? Commonwealth funding 
? Specific purpose funds  
? Donations and funds stay locally  

? Explore opportunities for increasing resources to 
support existing and expanded services 

? Provide access to flexible recurrent funding 
arrangements 

? Develop processes and supports to maximise 
potential to access new funding opportunities to 
meet priorities of the region 

? Plan resource needs to meet changing demand for 
services in the future 

? Reduce the duplication of services locally 
 

39 



 
 

8.4 Information Technology 
 
Objective: To improve information technology and video conferencing throughout the South East  

Critical milestones: NA 
 
Outcomes  Existing Strategies Sustained Strategies for the Future  
Up-to-date information technology is in place and 
being used to improve service delivery 

 ? Build adequate IT infrastructure to interface with 
variety of programs and shared care and 
information encompassing: 
o Discharge planning information between the 

Hospital staff and other health providers 
o Open Architecture Clinical Information 

System (OACIS) 
o Nursing Clinical System 
o Electronic Files 
o Establish telehealth facilities integrated with 

statewide retrieval services and consultative 
advice 

Patient journeys reduced  ? Increased use of and adequately resourced IT and 
video conferencing for specialist services to 
increase local access to services 

 

40 



41 

 
8.5 Risk Analysis  

 
Objective: Identify and manage risks associated with implementation of planned strategies 

Critical milestones: N/A 
 
Outcomes  Existing Strategies Sustained Strategies for the Future  
? Successful implementation of the service 

directions identified in the 10 Year Local Health 
Service Plan 

? All staff are aware of the need for risk analysis 
and the ramifications of not doing this and the 
need to continually monitor and review services 

 
 
 

? Australian Council of Healthcare Standards (ACHS) 
Accreditation 

? Maintain local quality and safety personnel 
? Maintain risk register, policies, procedures and 

adherence to standards, instructions, acts and 
regulations 

? Maintain patient advocate role and patient 
comments and complaints surveys 

? Staff education and performance evaluations 
? Continue to engage locally, in partnership with the 

HAC, in future planning 
? Monitor infrastructure accessibility 
? Maintain control meetings currently in place 

including clinical, corporate and consumer groups 

? Develop an implementation, monitoring and review 
strategy for the 10 Year Health Service Plan, 
including early identification of risks 

? Ongoing contribution and participation in Country 
Health SA Risk Management policy framework 

? Ongoing participation and contribution to other 
Country Health SA nominated risk management 
activities 

 
 
 

 



42 

9. Appendix 
 
9.1   Leadership Structure 

 
Mount Gambier and Districts Health Service is a part of the Lower South East Health Cluster. The 
health cluster encompasses three health units (Mount Gambier, Millicent and Penola) managed by 
the Director of Lower South East Health Services and supported locally by a Director of Nursing. The 
planning process towards the development of the 10 Year Local Health Service Plan has been led by 
the Director of the Lower South East Health Cluster, with the Mount Gambier Health Advisory 
Committee overseeing this process. The Mount Gambier Executive undertook the role of reviewing 
the draft Plan and a Planning Officer was employed to assist this process. 

 
9.2   Methodology 

 

The Mount Gambier 10 Year Local Health Service Plan has been developed in alignment with the 
planning principles and processes set out in the Strategy for Planning Country Health Services in 
South Australia, released by the Minister of Health, 17th December 2008. The process of developing 
the 10 Year Plan brought together data and evidence from local communities, health professionals, 
key stakeholders, statistics and statewide plans which was used to undertake a needs analysis 
process which identified strengths, weaknesses, opportunities and threats for each service categories 
identified in the Plan. 
 
A range of people were engaged to accomplish this strategy. The members of the Mount Gambier 
Health Advisory Council conducted 45 community consultations and public meetings; three Local 
Government meetings, assisted by the Planning Officer. The Mount Gambier Health Advisory 
Committee also played a major role in conducting 100 face-to-face interviews within the Health Unit 
and local shopping complex. This resulted in 607 members of the community being consulted.  

 
In addition nine key stakeholder groups were consulted including the Mount Gambier and Districts 
Health Service Providers Forum (which includes dentists, doctors, medical specialist and allied health 
workers), South East Regional Community Health staff forums, Mount Gambier Nursing and 
Midwifery Practice Nursing Group, Mount Gambier Nursing Management Group, and other service 
providers in the region. 
 
There were four executive groups consulted including the Mount Gambier and Districts Health Service 
Executive, Lower south East Cluster Executives, South East Regional Community Health Executive 
and Mount Gambier Senior Doctors Group. 
 
The data from the consultations was comprehensively analysed for frequency of issues and key 
themes. Priorities were identified within the following key areas as follows: 

1. Funding. 
2. Communication. 
3. Workforce. 
4. Infrastructure and capacity. 
5. Mount Gambier Accident and Emergency. 
6. Mount Gambier general practitioners. 
7. Mount Gambier Hospital acute care. 
8. Mental health services for adults, youth and children. 
9. Services for youth and children. 
10. Dental services. 
11. Support Services: x-rays and Mount Gambier Pharmacy. 
12. Patient journey. 
 

 
 



43 

9.3   Review Process 
 

To be developed during the consultation for the final Plan. 
 

9.4   Glossary 
 

24/7              24 hours seven days per week 

A&amp;E Accident and Emergency 

ABS Australian Bureau of Statistics 

ACHS Australian Council of Healthcare Standards 

CAMHS Child Adolescent Mental Health Services 

COAG Council of Australian Governments 

CT Scan Computerised Tomography Scan 

DASSA Drug and Alcohol Services SA 

ENT Ear, Nose, Throat 

GPs General Practitioners 

iCCnet Integrated Cardiac Assessment Regional Network 

ICT Information and Communications Technologies 

ILEP Country Wide Equipment Program 

IT Information Technology 

LTC Limited Treatment Centre 

MGED Mount Gambier Emergency Department 

MPS Multipurpose Service 

MRI Magnetic Resonance Imaging 

PATS Patient Assistance Transport Service 

PHC Primary Health Care 

SA South Australia 

SAAS SA Ambulance Service 

SAPOL SA Police 

SE South East 

SERCHS South East Regional Community Health Service 

SHINE-SA Sexual Health Information, Networking and Education SA 

SLA Statistical Local Area 
 
 


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