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1 

Kangaroo Island 
10 Year Local Health Service Plan 

 

 

2011   2020 

Kangaroo Island Health Advisory Council
Kangaroo Island Health Services

Country Health SA Local Health Network



 
2 

10 Year Local Health Service Plan  
 

Kangaroo Island Health Services 
 

2011 - 2020 
 

 

Table of Contents 
 

 

1. Executive Summary .......................................................................................................3 
2. Catchment summary......................................................................................................5 
3. Needs Analysis summary..............................................................................................7 
4. Local implications of Statewide plans..........................................................................9 
5. Planning Principles...................................................................................................... 10 
6. Service Delivery Plan................................................................................................... 11 

6.1 Core Services to be Sustained ............................................................................... 11 
6.2 Strategies for the Future......................................................................................... 15 

7. Key Enablers for Supporting Services ....................................................................... 20 
7.1 Safety &amp; Quality...................................................................................................... 20 
7.2 Patient Journey ...................................................................................................... 21 
7.3 Cultural Respect..................................................................................................... 22 
7.4 Engaging with our community................................................................................. 22 
7.5 Local Clinical Networks .......................................................................................... 23 

8. Resources Strategy ..................................................................................................... 24 
8.1 Workforce............................................................................................................... 24 
8.2 Infrastructure .......................................................................................................... 25 
8.3 Finance .................................................................................................................. 25 
8.4 Information Technology .......................................................................................... 26 
8.5 Risk Analysis .......................................................................................................... 26 

9. Appendix ...................................................................................................................... 27 
9.1 Leadership Structure .............................................................................................. 27 
9.2 Methodology........................................................................................................... 27 
9.3 Review Process...................................................................................................... 28 
9.4 Glossary................................................................................................................. 28 

 

Date: 07 July 2011 
 

 



 
3 

1. Executive Summary 
 

Kangaroo Island Health Services (KIHS) are delivered in the Multipurpose (MPS) Model.  
Multipurpose Services are integrated health and aged care services.  They receive Australian 
Government funding for flexible aged care places and State funding for a range of health services.   
A strength of the MPS model is its capacity to adapt to the circumstances of diverse rural 
communities and to flexibly accommodate organisational arrangements that may change and develop 
over time.   
 

The resident population for Kangaroo Island has grown from 4,261 in 2006 (ABS 2006 Census) to 
4,622 in 2011 (DPLG, Population Projections 2011). People from Aboriginal and Torres Strait Islander 
backgrounds comprise 0.7% of the Kangaroo Island population compared with 3.1% of the total 
country South Australian population. There is also a significant Maori and Phillipino population. When 
compared with the overall population structure of country South Australia, Kangaroo Island has a 
lower proportion of the population in the 15-24 age group, and a higher proportion of the population in 
the 45-64 year age group.  The projected population for Kangaroo Island is estimated to increase to 
approximately 5,400 by the year 2021. 
 

It is important to acknowledge that during peak holiday times such as Christmas and Easter the local 
population of Kangaroo Island doubles.  The latest Tourism Optimisation Management Model 
(TOMM) statistics evidence that 180,000 people visit the Island annually.  Kangaroo Island is a major 
tourist destination which can mean that the actual number of people on Kangaroo Island is at least 
6,000 with up to 25,000 at peak times. 
 

Kangaroo Island lies to the South of Adelaide, 24 kms from the South Australian Coastline and just 
124 kms from Adelaide CBD and is economically and socially disadvantaged by its 16 km  watergap  
separation from the mainland.  Travel to all other service centres requires either road/ferry or air 
transport with associated costs. There is a negative Impact on the social determinants of health; and 
recruitment &amp; retention of a skilled health service work force due to the 24 km  watergap  separation 
from the mainland.  There is general agreement that prevention is about dealing with risk factors, that 
is the causes of disease; but, equally importantly, it is about dealing with the causes of the causes, 
that is the determinants of health and illness   be they economic, social or environmental in origin .i 
 

The Kangaroo Island 10 Year Local Health Service Plan was developed by the Hills, Southern 
Fleurieu, Kangaroo Island Cluster Executive Team in collaboration with the Kangaroo Island Health 
Advisory Council.  This plan has been based on consultation undertaken by the Health Advisory 
Council with the local community, including key stakeholders, statewide health initiatives, trends in the 
local Health Services Profile, health improvement plans and the directions identified to improve 
population health by the SA Inner Country Health Network Alliance.   
 

Priority needs identified through the needs analysis process include: 
  Recruitment and retention of a skilled health care workforce. 
  Creating effective partnerships to maximise expertise and funding streams. 
  Redesigning aged care infrastructure. 
  Increasing/redesigning disability support. 
  Increase access to timely mental health specialist care. 
  Continue the Early Intervention service for young children 
  Address domestic violence issues 
  Increase the awareness of Better Care in the Community (incorporating self managed care for 

chronic disease). 
  Reduce transport cost to the community and health care staff due to the water gap between 

Kangaroo Island and the mainland. 
  Utilise e-health technology. 
  Identify clear links to tertiary support. 
  Clarify clinical governance for medical support. 
  Provision of opportunity to exercise eg. sporting fields / clubs and healthy lifestyle support. 
  Prioritise the concept of health promotion to men, including the moderation of alcohol intake. 
  Ensure that emergency response keeps pace with tourism demand. 



 
4 

 

This 10 year Plan sets out to sustain and strengthen its existing core services including 24 hour, 7 
day/week emergency and acute care, medical services, maternal services, community and allied 
health, aged care and other core services.  This works closely with Kangaroo Island s role as a MPS 
and its 2009-2012 MPS Service Delivery Plan. Key recommendations to be incorporated into the 
future proposed model include: 

  Contribute solutions to the transport barrier and the impact of the water gap between 
Kangaroo Island and the mainland. 

  Ensure equity of access to services to enable the elderly to stay in their own homes regardless 
of where they reside on the Island or appropriate residential aged care. 

  Ensure equity in health outcomes for people who live on Kangaroo Island. 
  Work towards integration of care (eg. a co-morbidity approach) so that every door is the right 

door (improve the patient journey). 
  Provision of respite services across the age spectrum. 
  Build early intervention capacity for children and youth   especially in regard to mental health. 
  Introduce a simple communicated and understood referral system. 
  Build consumer, carer and community participation. 
  Transition from crisis management to early intervention for Aboriginal and culturally and 

linguistically diverse populations. 
  Utilisation of the outreach centre for health promotion and early intervention at Penneshaw, 

American River and Parndana. 
  Utilise information and communications technology (ICT) capabilities and e-health. 
  Increase accessibility of emergency services 

 

The Kangaroo Island Health Advisory Council acknowledges the importance of reviewing the 
plans and progress annually as needs change in the future.  The Plan provides a framework to 
move forward in a planned and forward thinking way. It sets out strategic directions over the next 
10 years and implementation steps will need to be established annually to describe how they will 
be achieved   addressing the highest priorities first. 

 

 



 
5 

2. Catchment summary 
 

Introduction 
 

The Kangaroo Island Health Service is located within the Kangaroo Island Statistical Local Area 
(SLA). The Health Service has been a recognised Multipurpose Service (MPS) since 1997. Kangaroo 
Island is Australia s third largest island situated 110 kilometres south-west of Adelaide and covers an 
area of approximately 4,400 square kilometres.  Kangaroo Island has approximately 1,600 kilometres 
of sealed and unsealed roads; 509 kilometres of coastline; and is 155 kilometres from east to west. 
Townships on Kangaroo Island include Kingscote, Penneshaw, American River, Vivonne Bay and 
Parndana (see map below). The distance from Kingscote to Adelaide is approximately 180 kilometres 
with road and ferry travel time of up to 6 hours.  
 

 

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

Population 
 

The resident population for Kangaroo Island has grown from 4,261 (ABS 2006 Census) to 4,622 in 
2011 (DPLG, Population Projections 2011). People from Aboriginal and Torres Strait Islander 
backgrounds comprise 0.7% of the Kangaroo Island population compared with 3.1% of the total 
country South Australian population.  Approximately 2.2% of the population speak a language other 
than English at home, compared with 3.9% across country South Australia. 
 

The total population of Kangaroo Island has remained relatively consistent in the five year period 
between 2001 and 2006 Census counts. When compared with the overall population structure of 
country South Australia, Kangaroo Island has a lower proportion of the population in the 15-24 age 
group, and a higher proportion of the population in the 45-64 year age group.  The projected 
population for Kangaroo Island is estimated to increase to approximately 5,400 by the year 2021. The 
fertility rate for the Island is 2.44 which is higher than both the replacement level and the South 
Australian average rate (1.82).  The indirect standardised death rate is 5.4, with a total of 30 deaths in 
2008. 
 

Kangaroo Island is an international tourist destination which attracts an average of 180,000 visitors 
per annum. At peak periods between September to April, the tourist population quadruples the 
resident population and in January is reported to rise to six times the resident population.  This can 
mean that the actual number of people on Kangaroo Island is at least 6,000 with up to 25,000 at peak 
times. 



 
6 

 

    Table 1: Kangaroo Island population 
 

 

No. % Cluster* No. 
Cluster* 

% 
Country 

SA 
% 

SA total 
% 

Total Population 4,622 
 

98,235 
   

       

Males 2,387 51.6% 48,662 49.5% 50.2% 49.2% 
Females 2,235 48.4% 49,573 50.5% 49.8% 50.8% 
  

 

 

   

0-14 years of age 867 18.8% 18,403 18.7% 20.4% 18.5% 
15-24 years 439 9.5% 10,908 11.1% 11.4% 13.3% 
25-44 years 1,041 22.5% 22,183 22.6% 25.1% 26.7% 
45-64 years 1,523 33.0% 27,997 28.5% 27.3% 26.1% 
65-84 years  648 14.0% 16,236 16.5% 13.9% 13.4% 
85 years and over 104 2.3% 2,507 2.6% 1.8% 2.0% 
  

 

 

   

ATSI** 30 0.7% 681 0.9% 3.1% 1.7% 
CALD (Speaks a language 
other than English at 
home)** 

95 2.2% 2,360 2.8% 3.9% 12.2% 

*Adelaide Hills, Southern Fleurieu and Kangaroo Island Cluster total 
Source: Projected population by age and sex   SLAs in South Australia, 30 June 2011, Department of Planning and Local Government 

**Source: 2006 ABS Census 
 

Socioeconomic factors 
 

On the basis of Australian Bureau of Statistics  measures of remoteness, Kangaroo Island has been 
identified as  remote  which indicates a relatively high level of geographical isolation and distance to 
service centres including Adelaide and other health services in the cluster area. Travel to all other 
service centres requires either road/ferry or air transport with associated costs. No public transport 
exists either on the Island or to other areas of the State. The Kangaroo Island catchment reflects a 
relatively high level of socioeconomic disadvantage when assessed across a range of measures 
including income, education and employment.  
 

Based on population data, which monitors the trends of diseases, health related problems, risk 
factors and other issues across major regional areas, the Hills Mallee Southern region demonstrates 
similar levels of risk factors for alcohol consumption, obesity, blood pressure, cholesterol, physical 
inactivity and smoking when compared with country South Australia overall.  The prevalence of 
chronic disease for persons aged 16 years and over in the overall Hills Mallee Southern region 
demonstrates a slightly lower prevalence of diabetes and a slightly higher prevalence of existing 
mental illness when compared to country and total South Australia. 
 

The economy of Kangaroo Island is primarily derived from wool, prime lamb, mutton and beef, 
horticulture, viticulture, tourism, aquaculture, fishing, forestry, plantation, eggs and poultry and mining 
industries. The raising of sheep has traditionally provided about 60% of the Island s economic base. 
However intensive animal keeping activities are limited. Honey is produced and Ligurian bees 
exported. Agriculture accounts for 23% of employment in the Kangaroo Island catchment, followed by 
accommodation and food services (12%); and retail trade (11%).  
 



 
7 

3. Needs Analysis summary  
 

From mid January 2010 the dedicated Planning Officer along with senior staff from the Kangaroo 
Island Health Service and key stakeholders undertook a SWOT (strengths, weaknesses, opportunities 
and threats) analysis.  This process considered the results of the community survey undertaken by 
the Kangaroo Island Health Advisory Council (HAC) and other existing consultation information, 
analysis of data regarding services accessed in Adelaide and diverse others sources of  information. 
This approach contributed to identifying priority service needs for the local community over the next 
10 years. 
 

Summary of findings 
 

Aboriginal Health Services 
  Upfront gap payments can be a barrier to accessing timely health care. 
  There is a transport barrier for those who do not reside near Kingscote. 

Culturally and Linguistically Diverse Background 
  Upfront gap payments can be a barrier to accessing timely health care. 

Disability Services 
  There is a need for enhanced disability services. There is a 13% level of disability within the 

school population reported by participants in consultations.   
Aged Care Services 

  Community care may not meet future demand. 
  Consideration should be given to a replacement or an upgrade of the existing aged care hostel 

 Carnarvon  to support higher resident care needs.  
  Need for access to geriatric and psycho geriatric consults and dental care for residents who 

are bed or chair bound is limited.  
  Recent aged care forums identified a strong desire to stay home, rather than enter residential 

aged care.  There is a community need for independent living unit type accommodation such 
as a retirement village.  A desire for aging in place and available choice of accommodation for 
older people on the Island is also evidenced.  Many community members discussed the 
possibility of a more flexible approach to in home care including the ability to have more 
control over the services offered.  There were several comments in regard to having access to 
general cleaning, gardening and window cleaning1. 

  Access to low and high level aged care beds is anticipated to rise in the future. 
Mental Health 

  Need for promotion, prevention and early intervention approaches adopted on Kangaroo 
Island. There is an understanding of the importance of community engagement to improve 
health outcomes for people who have a mental health issue, particularly within the confines of 
an Island. 

Better Care in the Community 
  Strong demand for early intervention, prevention and self management programs integrated 

between health service providers, which aligns well with the Statewide direction for the GP 
Plus strategy services and packages of care. 

  Chronic disease management to maximise health is needed and is outlined in the Chronic 
Disease Action Plan for South Australia 2009-2018. 

  Provision for e-learning and audio-visual learning - very important for isolated workers on 
Kangaroo Island.  

Acute Services 
  Local clinicians from the health services identified an opportunity in the stakeholders 

workshops that an alternative medical model of care for on-call, obstetrics and Emergency 
Department services could be explored through meaningful engagement with all local 
clinicians. 

  The Health Advisory Council acknowledged the impact of tourists on the needs for emergency 
acute triage and care. 

                                                      
1
 Lisa Sparrow. Southern Fleurieu and Kangaroo Island Positive Aging Taskforce. Care-Full Ageing Forums, Kingscote, 

Parndana, Pennshaw (July   October 2009). 



 
8 

  Gap payments for non-admitted emergency department attendances can be a barrier to 
accessing services. 

Maternity Services 
  Consideration of current and future demand along with the isolation from accessible transport 

options due to the water gap between Kangaroo Island and the mainland. The maternity 
service provision may need to be analysed to determine sustainable service requirements.  In 
2008 there were 65 births registered to residents of Kangaroo Island.  Between thirty to fifty 
percent of women electively choose to birth off the Island (non-medical reasons) for a variety 
of reasons such as being closer to family and access to private services and also for valid 
medical reasons such as twins or complications.   

  The community and local GP s value and support access to safe birthing services on 
Kangaroo Island. 

Transport 
  There is a transport barrier for those who do not reside near Kingscote, particularly the 

Western end of the Island. 
  There is a negative Impact on the social determinants of health; and recruitment &amp; retention of 

a skilled health service work force due to the 24 km  watergap  separation from the mainland. 
Youth Services 

  The YWCA of Adelaide Southern Services gathered information regarding youth needs 
through their services, activities and community consultations. The information supports the 
perception amongst young people, that they are excluded from their local communities, and a 
need for access to youth services, facilities and transport. Substance abuse and mental 
wellbeing were identified as key issues. 

 



 
9 

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 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. 
  Connect local patients with pathways to higher level care needs. 
  Reduce 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 Health Service Plans.  The Health Advisory Council 
acknowledges the important principle of integrating with Statewide directions but also reiterates the 
importance of applying this to local needs such as: 

  Ageing population 
  Increasing prevalence of chronic disease 
  Disability and injury 
  Poorer health of Aboriginal people and people of lower socio-economic status 
  Increasing risks to society from communicable diseases 
  Biological threats 
  Natural disasters and climate change 



 
10 

5. Planning Principles 
 

The Strategy for Planning Country Health Services in South Australia 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.  
 

 

In addition, the Health Advisory Council acknowledges important local planning principles that have 
been set out in past planning, including those identified in the  Shared Vision for Kangaroo Island 
Health Service   
 

 

 



 
11 

6. Service Delivery Plan 
 

6.1 Core Services to be Sustained 
 

Service Category Service Description Target Group Directions over the next 10 Years 
Community Health Promotion, 
Prevention and Early Intervention 
Programs 
 

  Local area access to Aboriginal health, 
community nursing and midwifery 
services, children and youth health 
services, drug and alcohol services, 
mental health (adult and child) 
counselling and allied health services 

  Older adults - over 
65 years 

  Children 
  Men, Women and 

Youth 

  Implement programs for older adults: 
o Falls prevention 
o Weights training 
o Walking groups 
o Orthotics / podiatry 
o Dental care 
o Increase Extended Aged Care in Home (EACH) 

packages 
o Pharmacy review (home medication review) 
o Provide alternative accommodation to residential care 

(also see aged care directions) 
  Implement programs for children: 

o Affordable access to specialist review 
o Timely access to speech pathology 
o Early intervention services 

  See section 6.2 for expanded services 
Community Health and GP Plus 
Strategy Services 

  Local area access to community care, 
Aboriginal health, community nursing and 
midwifery services, children and youth 
health services, drug and alcohol 
services, mental health (adult and child) 
counselling and allied health services 

  Low risk chemotherapy 

Kangaroo Island 
community and 
visitors 

  Chronic disease self management2 
  Build collaborative working systems with acute care, 

community care and local GPs 
  Increase access to specialist counselling 
  Provision of IT connectivity to outreach centres on the 

Island and regular clinics in the outreach centres at 
Penneshaw, American River and Parndana 

  Explore opportunities to support enhanced access to 
government agencies that are not on the Island eg. 
Anglicare, Eldercare, Salvation Army, Second Story 
Youth Health Service, SHINE-SA, Housing SA, Centrelink 

  Explore other opportunities to access transport on the 
Island such as school bus, local council cars  

  Implement programs to support womens health, 
particularly with regard to the remoteness of living on the 
island. 

                                                      
2

 Chronic Disease Action Plan for South Australia 2009-2018 



 
12 

 

Allied Health   Large range of allied health services 
provided 
 

Kangaroo Island 
community 

  Ensure timely response to referrals 
  Increased access to speech pathology, dietician, podiatry 
  Review service delivery models and work collaboratively 

with other community health facilities to provide services 
  Work with Country Health SA Local Health Network 

(CHSALHN) to review recruitment and retention 
strategies for remote areas 

  Support multi-skilling of allied health staff 
Emergency Service   24 hour service 7 days a week,  

  Videoconferencing link with SA Retrieval 
Service in place 

Kangaroo Island 
community and 
visitors 

  Ongoing emergency response capacity review  
  Review the quality and safety impact of utilising the ED 

treatment area to recover theatre patients 
  Support nurses to continue to expand emergency skills 

such as wound assessment and suturing, removal of 
foreign bodies and plasters of fractures 

Acute Inpatient Care   Acute services including step down 
services from tertiary hospitals for local 
community 

Kangaroo Island 
community and 
visitors 

  Maintain current services 
  Implement the planned Stage III upgrade of facilities 

Elective Surgical   Low complexity elective surgery 
undertaken in areas such as general 
surgery, orthopaedics, urology, 
gynaecology, obstetrics and other 
appropriate emergency procedures 

Kangaroo Island 
community 

  Review potential to provide elective surgery strategy 
initiative to Island community and decrease need for 
transport to other facilities, including attracting and 
retaining an appropriate medical and clinical workforce to 
support this service 

Maternal and Birthing Services   Local Area Services. Midwifery Led Care: 
o Antenatal and postnatal care 
o Shared Care Programs 
o Access to community midwifery 

services and parenting programs 
  District Services: 

o Low risk, single birth, theatre and 
staffing for caesarean sections 24 
hours a day, 7 days a week 

Pregnant women, 
foetus and infants 

  Review the maternity service model in line with available 
resources and contemporary standards3 

  Provide access to safe birthing and maternal services 
  Explore opportunities for antenatal and postnatal 

extended care on the Island 

Medical Specialist Services   Local area visiting specialists for scope 
services  

  Visiting specialists including: 
o General surgery 
o Orthopaedic surgery 
o Urology 
o Paediatric 
o Gastroenterology 

Kangaroo Island 
community and 
visitors 

  Improve access to specialist services, including exploring 
potential for ophthalmology, rheumatology, palliative care 
and sports medicine 

  Consider establishing consulting space at time of Stage 
III redevelopment to enable visiting specialists to consult 
from KIHS  

 

                                                      
3

 Standards for Maternal and Neonatal Services in South Australia 2009 



 
13 

o ENT 
o Cardiology 
o Endocrinology 
o Dermatology 
o General Physician (includes cardiac, 

geriatric conditions) 
o Psychiatry 

Mental Health   Local and district services available 
  Partnerships with the community, GPs, 

health service, SA Police 
  Community health 24/7 primary care  
  Early intervention, shared care with local 

GPs  
  Individual psychosocial rehabilitation 

support  
  Counselling 
  Local voluntary acute and respite 

admissions to local hospital 
  Specialist mental health services 

Kangaroo Island 
community and 
visitors 

  Work closely with GP s as the primary carer for patients 
with a mental health condition 

  Explore opportunities for research and new programs 
  Implement a geriatric psychotherapy service 
  See section 6.2 for expanded services 

Disability Support  Kangaroo Island 
community 

  Increase services for intellectual disability especially for 
children/youth 

Rehabilitation   Local area service for recuperative and 
maintenance care, community home 
based rehabilitation support, centre 
based day therapy, outpatient 
rehabilitation 

Kangaroo Island 
community and 
visitors 

  Explore access to geriatric rehabilitation service (Geriatric 
Evaluation and Management (GEM))4 

  Increase rehabilitation capacity, recognising Kangaroo 
Islands unique needs and aligning with the Statewide 
Rehabilitation Plan 

  Increase capacity to provide Rapid Intensive Brokerage 
Support (RIBS), Transitional Care Packages (TCPs) 

Respite Services   Local area access to residential and 
hospital care 

Kangaroo Island 
community 

  Ensure the sustainability for the Kangaroo Island carers 
program  

  See section 6.2 for expanded services 
Aged Care   Domiciliary care in home and the 

community 
  Inpatient admissions for elderly, including 

respite care 
  Low high care and respite residential 

aged care  
  Access to aged care assessment 

Kangaroo Island 
community 

  Increase community care   in particular EACH and 
Dementia EACH packages5 

  Consideration should be given to a replacement or an 
upgrade of the existing aged care hostel  Carnarvon    

  Explore access to psycho-geriatric consults and dental 
care for residents who are bed or chair bound  

  Increase access to home care help 
  Explore independent living unit type accommodation such 

                                                      
4

 Statewide Rehabilitation Service Plan 2009-2017 
5

 Health Services Framework for Older People 2009-2016 



 
14 

as a retirement village   
  Advocate with the Commonwealth to grow residential low 

and high care beds to meet local needs 
  See section 6.2 for expanded services 

Palliative Care   Patients admitted for palliative care and 
some in home support 

Kangaroo Island 
community 

  See section 6.2 for expanded services 

Clinical Support Services   Point of care testing 
  Access to pharmacy services including 

starter packs of medication availability 
after hours  

  Access to general x-ray capabilities 
  Access to visiting Audiology, 

ultrasonography and radiology 

Kangaroo Island 
community and 
visitors 

  Extended point of care testing 
  Access to e-health 
  Specialist support for GPs interpreting x-ray 
  Maintain access to existing services 

Oral Health   There is no public oral health system 
provided through KIHS  

  KIHS supports a local dentist through the 
provision of consulting space (and recent 
redevelopment) to the rear of Carnarvon.  

  The hospital provides rooms for a private 
practice 

Kangaroo Island 
community and 
visitors 

  See section 6.2 for expanded services 
 

 

 



 
15 

6.2 Strategies for the Future 
 

Service objective: Mental Health:  
Target group: All age groups 
Critical milestones: Identify clear links to tertiary visiting services; Inclusive leadership and governance 

   

Outcomes Strategies Time Frames  
  Equity of access to specialist care 
  Equity of outcomes with metropolitan / state services 
  Contribute to reduction in suicide rate 
  Promotion of optimum quality of life for people with mental 

disorders and / or mental health problems 
 

 

  Identify opportunities for and implement e-health: 
o Facilities to support Telehealth consultations / assessment 
o Good e-clinical records management 
o Integration of services via shared medical records 
o Electronic Decision Support (eg. high level electronics tool for decision 

making for risk assessment and early intervention) 
o Electronic referral tools that embed the assessment tools  
o Shared / integrated separation summaries 

TBD 
 

 

 

 

 

 

 

 

 

 

Service objective: Disability Services: Explore opportunities for research and development of new programs   
Target group: Initially children with intellectual / learning disability; progress to youth, young adults as priorities 

Critical milestones: Scope the extent of the need in the population; Identify clear links with Disability SA to meet service demand 
   

Outcomes Strategies Time Frames  
  Equity of access to disability services for children, youth and 

young adults in the community 
  Equity in health outcomes for children, youth and young 

adults with an intellectual disability when compared to state 
averages 

  Continual engagement with the community 
  Maintain/strengthen essential partnerships 
  Implement the new Mental Health Service Delivery Model of Care 
  Introduce a mental health nurse practitioner role 

TBD 

 

 

 



 
16 

 

Service objective: Mental Health Emergency Response 
Target group: All people who are having an acute mental health episode and present to the Emergency Department or their local GP 

Critical milestones: Emergency care   provided in conjunction with the Rural and Remote 24/7 Mental Health Emergency Triage and Liaison Service 
and over time to implement a local 24/7 on call service response capability within the local service networks 

   

Outcomes Strategies Time Frames  
  Enhance the mental health emergency response in line with 

the strengthened cardiac networks 
 

  Work with Inner Country Mental Health Team to implement a streamlined 
response to acute mental health need 

  Introduce a mental health nurse practitioner role  
 

TBD 
 

 

 

 

 

 

 

 

 

Service objective: Aged Care - Health Promotion Programs 
Target group: Older adults over 65 years 
Critical milestones: Program definition; Retirement Village / Independent Living Units / Respite options  

   

Outcomes Strategies Time Frames  
  People who reside on Kangaroo Island who are older have 

optimum bone density, strength, agility, medication 
management and oral health 

  People who reside on Kangaroo Island who are older have 
the opportunity to remain in their own home for longer 

periods of time, and the option of aging in place 

  Implement programs: 
o Falls prevention 
o Weights training 
o Walking groups 
o Orthotics / podiatry 
o Dental care 
o Increase EACH packages 
o Pharmacy review (home medication review) 
o Provide alternative accommodation to residential care, including advocating 

with the Commonwealth to grow residential low and high care beds to meet 
local needs 

TBD 
 

 

 

 

 

 

 

 



 
17 

 

Service objective: Disability Services 
Target group: Children with a disability  
Critical milestones: Access to respite on the Island; Effective link to specialist support 

   

Outcomes Strategies Time Frames  
  Equity of access to specialist review and treatment 
  Equity of access to respite for carers 

  Increase access to: 
o Community day respite centres 
o Residential / hospital beds 
o Transitional Care Packages 
o Volunteer programs 
o Organised in home respite 
o Respite for higher level acuity / disability care 

TBD 
 

 

 

Service objective: Men s Health 
Target group: Men and Youth  
Critical milestones: Resources to implement a men s health program 

   

Outcomes Strategies Time Frames  
  Reduction in chronic medical conditions such as heart 

disease, diabetes and stroke due to risk factors such as 
obesity, diet, exercise, smoking and alcohol intake 

  Reduction in violence 
  Reduction in motor traffic accidents 
  Increased health and wellbeing for youth and men 
  Increased health and wellbeing for women and children 
  Increased screening 

  Implement Programs: 
o Alcohol awareness, impact on health and social structure 

o Domestic violence awareness, link to alcohol and impact on social structure 
o Men s health promotion programs 

TBD 
 

 

 

 



 
18 

 

Service objective: GP Plus Service Strategies  
Target group: All people, particularly adults over 45 years 
Critical milestones: Introduce a multi-disciplinary, multi-agency Better Care in the Community Committee 

   

Outcomes Strategies Time Frames  
  People with chronic illness will be better managed in the 

community, reducing the need for hospital admission and 
improving the patient journey 

  Implement Programs: 
o Chronic disease self management 
o Build collaborative working systems with acute care, community care and 

local GPs 
o Increased access to specialist counselling 
o Provision of IT connectivity to outreach centres on the Island and regular 

clinics in the outreach centres 
  Explore opportunities to support access to government agencies on the Island 

eg. Anglicare, Eldercare, Salvation Army, Second Story Youth Health Services, 
SHINE-SA, Housing SA, Centrelink 

  Engage local GPs 
  Explore other opportunities to access transport on the Island 

TBD 
 

 

 

 

 

 

Service objective: Palliative Care 
Target group: All people in need of palliation 
Critical milestones: Formal links with level 6 palliative care at RGH / other cluster resources6 

 

Outcomes Strategies Time Frames  
  Equity of access to effective palliative care for people who 

reside on Kangaroo Island 
  Implement programs for: 

o Multi-disciplinary teams 
o Specialist nurse input 
o Specialist GP input 
o Formal links with level 6 palliative care at RGH 
o Support existing clinicians providing ongoing care such as GP s and 

community health nurses 

Work within the 
timeframes as 
set out in the 
Palliative Care 
Services Plan 
2009-16 

 

                                                      
6

 Palliative Care Services Plan 2009-2016 



 
19 

 

Service objective: Oral Health 
Target group: People in residential care 
Critical milestones: Public dental service 

 

Outcomes Strategies Time Frames  
  Improved oral health for older people, leading to improved 

general health 
  Implement programs for: 

o Dental early intervention and preventative care for residents 
o Emergency dental extractions in the hospital 

TBD 
 

 

 

 

 



 
20 

7. Key Enablers for Supporting Services 
 

7.1 Safety &amp; Quality 
 

Objective: Continue to improve the quality and safety of care in a sustainable manner 
Critical milestones: NA                                              

 

Outcomes  Existing Strategies Sustained  Strategies for the Future 
Sustainable skilled employment models in place to 
deliver the local service profile 

  Continue to support and credential qualified 
medical staff   able to provide a 24hr on call 
service 

  Continue staff up skilling and development, such as 
the Advanced Life Support, triage skills, 
assessment and minor procedure training for all 
registered nurses 

  Develop staffing models to meet times of increased 
activity 

  Enhance clinician involvement in clinical 
governance leadership 

Integrated access across the health system   Access the iCC network for clinical support and 
guidance 

  24 hr access to consultant/specialist medical staff 
  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 
SA clinical networks 

  Expand relationships and combine resources within 
the cluster 

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

Continual improvement and patient-centred 
approach underpinning service delivery 

  Maintain ACHS Accreditation 
  Adherence to the Aged Care Act 
  Audit the full range of programs in place to ensure 

client satisfaction 
  Implement the Australian Charter of Health Care 

Rights 
  Implement strategies to improve the State and 

National Patient Safety priority areas 

  Contribute to a country-wide accreditation 
framework 

  Integrate acute, community health and aged care in 
accreditation 

 



 
21 

7.2 Patient Journey 
 

Objective: Increase the accessibility of the health system to reduce the impact on the patient journey 
Critical milestones: NA                                              

 

Outcomes  Existing Strategies Sustained  Strategies for the Future 
Local access to specialists and clinical 
consultations through telehealth services 

 

  Enhance access to Rural and Remote Mental 
Health Services through existing telehealth facility 

 

  Increase access to telehealth facilities 
  Integrate with statewide planning to coordinate 

access to specialists and clinicians across South 
Australia 

Accessible public transport service between 
Kangaroo Island and health services on the 
mainland for increased access to health services 

  Seek to enhance current patient transfer scheme   In partnership with other key stakeholders facilitate 
the development of a transportation system for 
patients needing to travel to access specialist 
services, allied health consultations outside of 
regular visit schedule and any other health services 

  In partnership with other stakeholders contribute to 
address the challenges of distance, leading to low 
economic status, lack of affordable housing and 
transport 

  Partnerships between Australian and State 
Government departments to bring about a State 
Government Passenger Vehicle Equalisation 
Scheme 

  Kangaroo Island HAC to lobby for the 
implementation of the Regional Development 
Board Water gap Project 

  Kangaroo Island HAC to lobby for a daily flight 
schedule that permits patients to travel and return 

in the same day 
Fast and efficient patient transport and retrieval   Work with SA Ambulance Service (SAAS) and the 

Royal Flying Doctor Service (RFDS) to explore 
opportunities to reduce delays in patient transport  

 

 



 
22 

7.3 Cultural Respect 
 

Objective:  Increase capacity to contribute to the priority of closing the gap in Aboriginal health life expectancy 
Critical milestones: NA                                              

 

Outcomes  Existing Strategies Sustained  Strategies for the Future 
Kangaroo Island Health Service is culturally safe 
and accessible 

  All staff have attended Aboriginal cultural 
awareness training 

  Aboriginal nursing placements  
  Aboriginal employees who are encouraged to 

complete further education 

  Expand opportunities for Aboriginal people to be 
employed at all areas of the health service 

  Implement recommendations identified in the 
Aboriginal Health Impact Statement for the 10 year 
Health Service Plan 

Targeted Aboriginal health improvement strategies   Close working relationship with cluster Aboriginal 
health workers 

  Aboriginal specific chronic disease management 
program 

  Build connections with the Aboriginal health 
workers within cluster 

  Increase working towards wellness group 
opportunities 

 

7.4 Engaging with our community 
 

Objective: Increase the capacity for the community to contribute to the planning, implementation and evaluation of services 
Critical milestones: NA 

 

Outcomes  Existing Strategies Sustained  Strategies for the Future 
Health service needs of the community are 
understood 

 

  Support the Kangaroo Island Health Advisory 
Council to implement their ongoing role of engaging 

with the community and local stakeholders 
  Regular community information through local 

channels in partnership with the Health Advisory 
Council 

  Explore opportunities for ongoing and meaningful 
discussion with the community and targeted 
population groups 

 



 
23 

7.5 Local Clinical Networks 
 

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

 

Outcomes  Existing Strategies Sustained  Strategies for the Future 
Formal ties with health service organisations in the 

region 
  Build on linkages within the cluster for mental 

health and other health service programs 
  Continue to expand relationships, access to 

specialised staff and combine resources within 
 

  Explore formal pathways with Repatriation General 
Hospital for palliative care and specialist geriatric 
management 

  Explore how state networks can link to services on 
the Island 

  Engage with other agencies and service providers 
on the Island to improve patient journey and health 
outcomes eg. Kangaroo Island Local Council, 
Finding Workable Solutions, DASSA, CAMHS, 
Disability SA, Regional Development Board  

Formal ties with statewide and Country Health SA 
clinical networks 

  Strengthen networks with metropolitan and 
statewide services to sustain outpatient 
chemotherapy services, access to Rural and 
Remote Mental Health Service, mental health 
services for older people and other clinical services 

  Expand collaborative relationships with visiting 
specialists throughout the region 

  Further expansion of statewide and Country Health 
SA clinical networks 

 



 
24 

8. Resources Strategy 
 

8.1 Workforce 
 

Objective: Improve ability to recruit, develop and retain a skilled health workforce 
Critical milestones: NA 

 

Outcomes  Existing Strategies Sustained Strategies for the Future  
Highly skilled and qualified workforce   Continue to develop the skills of clinical staff  

  Rotate staff from other outlying units to assist in 
staff development throughout the cluster 

  Staff skilled in providing both high and low level 
residential care services 

  Expand training opportunities for nursing staff, 
particularly in palliative care, x-ray capabilities, 
midwifery, personal care and aged care nursing  

  Up skilling / support of local persons to obtain allied 
health qualifications given difficultly faced in 
recruiting allied health staff to rural and remote 
locations 

Recruitment and retention of the workforce to 
support the service profile 

  Support to retain qualified medical staff 
  Recruitment of qualified nursing staff via graduate 

nurse and cadetship programs 

  Explore options to strengthen the retention of all 
personnel in the health service 

  Support the training of new registered midwifes and 
ongoing professional development of current 
midwives, building on strong staff interest in gaining 
and/or maintaining midwifery qualifications  

  Plan for implications of an ageing workforce 
  Explore a sustainable model to recruit and retain 

specialist medical staff within the region 

Increased accessibility for Aboriginal people to be 
employed in the Health Service 

  Continue to encourage Aboriginal employees to 
complete further education 

  Maintain Aboriginal nursing placements 
  Continue to seek all staff to undertake Aboriginal 

cultural awareness training 

  Encourage and recruit Aboriginal employees 
across all levels of the health service  

 



 
25 

8.2 Infrastructure 
 

Objective: Increase the capability of the infrastructure to support the planned service levels are provided and maintained within local communities 
Critical milestones: NA 

 

Outcomes  Existing Strategies Sustained Strategies for the Future  
  Physical building meets the needs of the 

service delivery for acute, aged, respite care 
and community health programs 

  Improved patient journey  
  Better Care in the Community 
  Improved health outcomes for people who live 

on the Island 
  Improved staff satisfaction leading to improved 

retention of skilled staff 
  Potential to attract more visiting specialists 

  Plan for Health Service redevelopment including 
consideration of: 
  Emergency waiting room 
  Consulting rooms for visiting medical 

specialists, counselling 
  Clinicians work space 
  Recovery 
  Community health program space 

 

  Seek capital works upgrade funding 
  Advocate with the Commonwealth to grow 

residential low and high care beds to meet local 
needs 

 

8.3 Finance  
 

Objective: Increase the efficiency and effectiveness of resources, and balanced with the provision of services as close to home as possible 
Critical milestones: NA 

 

Outcomes  Existing Strategies Sustained Strategies for the Future  
Sustainable funding to achieve the planned service 
profile 

  Maintain funding to support the existing services to 
be sustained 

  Develop business cases to seek funding to 
implement new services or ease demand pressures 
on existing services 

 



 
26 

8.4 Information Technology 
 

Objective: Increase access to communication and information technology systems to strengthen health care 
Critical milestones: NA 

 

Outcomes  Existing Strategies Sustained Strategies for the Future  
Reduced need for patients to travel away for 
specialised services 

  Establish effective and efficient clinical networks to 
support emergency advice and support including 
access to retrieval teams / consultant advice 

  Explore options to increase use of digital x-ray 
capacity to reduce the need for patients to travel to 
the mainland 

  Explore options for enhanced telehealth equipment 
  Advocate for flexible funding to enable clinicians in 

other areas to effectively utilise telehealth services 
  Support enhanced IT access between service 

providers 

 

8.5 Risk Analysis  
 

Objective: Increase ability to plan for and manage risks 
Critical milestones: NA 

 

Outcomes  Existing Strategies Sustained Strategies for the Future  
Key risks are understood and have plans in place 
to mitigate 

  Recruitment and retention of qualified clinicians for 
specialised areas such as resident GP 
practitioners, visiting medical specialist, allied 
health and other clinicians 

 

  Explore options for enhanced telehealth equipment 
  Explore Australian Government funding options to 

ensure aged care bed / service availability meets 
local needs 

  Work collaboratively with local clinicians to explore 
models for periods of remote call by medical officer 

within safe standards 
  Enhancing diagnostic pathology services, overnight 

and weekends 



 
27 

9. Appendix 
 

9.1 Leadership Structure 
 

The Kangaroo Island 10 Year Local Health Service Plan was developed by the Hills, Southern 
Fleurieu, Kangaroo Island Cluster Executive Team in collaboration with the Kangaroo Island Health 
Advisory Council.  The Plan considered the statewide health initiatives, trends in the Local Services 
Profile, health improvement plans and the directions identified to improve population health by the SA 
Inner Country Health Network Alliance. 

 

9.2 Methodology 
 

The Kangaroo Island 10 Year Local Health Service Plan has been developed following consultation 
with the local community, including key stakeholders.  The Plan addresses community health needs 
considering services already in place, existing infrastructure, capacity to attract workforce to provide 
services, the demographic, geography, burden of disease, health service utilisation, statewide SA 
Health initiatives, expected population growth and expected tourism development in the next 10 
years.     
 

Community consultation was fostered through a number of formal and informal stand alone and 
ongoing forums. 
 

Methodology used to identify community needs: 
  1998-2000 - comprehensive consultation with community to develop the MPS model. 
  2005-2006 - major community consultation to develop the Vision for Kangaroo Island Health 

Service. 
  2007 - Mental Health Action Plan consultation. 
  2009 - Continuous Improvement Plan included key strategies to engage with the local 

community.  
  2009   during the development of the MPS Service Delivery Plan a discussion group and 

planning forum was conducted with the Kangaroo Island HAC to review previous needs 
assessments from community consultations, to consider emerging needs of the community 
and to provide feedback in relation to the priority areas for the 10 year service plans. 

  2009 - HACC program consultation on the needs of carers living on Kangaroo Island. 
  Advertisements in local newspaper seeking community feedback. 
  Regular meetings with service clubs. 
  Collaborative relationship with Southern Fleurieu and Kangaroo Island Positive Aging 

Taskforce. 
  Collaborative relationship with Community Living and Support Services (CLASS) and Disability 

SA. 
 

Specific methodology for the development of the 10 Year Local Health Service Plan included: 
  Provision of questionnaires to the local community (20 respondents, 16 of which were from 

residents under 21 years of age).  
  Questionnaires provided to all KIHS staff and health service providers (23 respondents across 

all disciplines). 
  HAC members canvassed the community and received feedback from 27 members of the 

community ranging in age from 25 to 65.   
  Presentation to Kangaroo Island Local Council and Kangaroo Island Development Board. 
  Consideration of key local planning and development documents. 
  From mid January 2010 the dedicated Planning Officer along with senior staff from the 

Kangaroo Island Health Service and key stakeholders undertook a SWOT analysis.  This 
process considered the results of the community survey undertaken by the HAC and other 
existing consultation information, analysis of data regarding services accessed in Adelaide 
and diverse others sources of  information. 

  Consultation interviews undertaken with key stakeholders. 



 
28 

  Release of a draft plan for all community and stakeholder to contribute feedback 
 

The Kangaroo Island Health Advisory Council undertook a genuine consultation strategy and 
acknowledge that it has an ongoing role to represent the views of the community to the Minister for 
Health and local health services.  The Kangaroo Island Health Advisory Council acknowledges the 
importance of reviewing the plans and progress annually as needs change in the future and further 
community engagement occurs.   

 

9.3 Review Process 
 

A monitoring and evaluation strategy will be developed to support the implementation of this Plan in 
collaboration between the Kangaroo Island Health Advisory Council and the local health service. 

 

9.4 Glossary 
 

24/7 24 hours / 7 days a week 
ABS Australian Bureau of Statistics 
ACHS Australian Council on Healthcare Standards 
CALD Culturally and linguistically diverse 
CAMHS Child and Adolescent Mental Health Service (Statewide Service) 
CHSALHN Country Health SA Local Health Network 
DASSA Drug and Alcohol Services SA (Statewide Service) 
EACH Extended Aged Care at Home packages 
ED Emergency Department 
GEM Geriatric Evaluation and Management 
GP General Practitioner 
GP Plus 
Services 

GP Plus Services provide early intervention, prevention and self 
management programs provided by building partnerships and 
relationships with key health service providers to improve health 
outcomes for the population through service integration and 
coordination 

HAC Health Advisory Council 
IT Information Technology 
KIHS Kangaroo Island Health Service 
MPS Multipurpose Service 
RFDS Royal Flying Doctor Service 
RGH Repatriation General Hospital 
SA South Australia 
SAAS SA Ambulance Service 
SHINE-SA Sexual Health Information Networking Education - SA 
SLA Statistical Local Area 

SWOT analysis Strategy development tool which identifies strengths, 
weaknesses, opportunities, threats 

 

                                                      
i SA Health, Public Health Bulletin SA - Prevention, Vol 6, No 1, March 2009 


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