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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 & 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 & 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 & 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 & 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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