The agency's performance (DHW Annual Report 2019 - 20)

Department for Health and Wellbeing Annual Report 2019-20

In this section


Performance at a glance

As at the end of June 2020, 60 percent of the department’s election commitments* were reported as completed. Only three percent of commitments were identified as ‘Critical’ (Hospital and Health workforce planning commitment) or ‘At Risk’ (Elective Surgery Backlog commitment).

Table 1: Election commitment progress ratings at end June 2020

Table 2: CE KPI comparison between 2019-20 and 2018-19

CE KPI comparison between 2019-20 and 2018-19
No KPI Descriptor Target YTD 2019-20 YTD 2018-19
1 Transfer of care <= 30 minutes (ambulance ramping) >=90% 63.8% 68.9%
2 (a) ED seen on time - Resuscitation
(b) ED seen on time - Emergency
>=100%
>=80%
100%
67.5%
100%
61.1%
3 Elective surgery overdues <=300
2131
410
4 Consumer experience: overall quality >=85%
89.3% 89.8%
5 Potentially preventable admissions <=8%
8.3% 8.8%
6 Hospital acquired complication rate <=2.0%
2.8% 3.1%
7 SAB infection rate <= 1
0.8 0.7
8 Hospital standardised mortality ratio Inlier Inlier Inlier
9 Average cost per NWAU* <=NEP
114% Not applicable
10 Executive tenure within SA >= 3 years
3.1 years Not applicable

Notes: SAB infection = Staphylococcus aureus bloodstream infections
*Average Cost per National Weighted Activity Unit (NWAU) represents the 2019-20 December YTD costing for all LHNs, except Regional LHNs whose costing was not able to be completed and signed off prior to publication.
**Executive tenure refers to LHN and SAAS CEOs and DHW Deputy Chief Executives (within own LHN/SAAS/DHW). Includes tenure of positions where CEOs were in executive positions prior.

In addition to election commitment progress, the Chief Executive has identified 10 specific key performance indicators (KPIs) to monitor operational performance of the system. These are reported on a monthly basis, provided to the Department of the Premier and Cabinet.

Four KPIs have shown a deterioration in performance against the same time last year, however performance has been adversely impacted by COVID-19 for Transfer of care <= 30 minutes and Elective surgery overdues. Consumer experience and SAB infection rate KPIs have consistently achieved targets since 2018-19, however a small deterioration was evident in 2019-20 against 2018-19.

Bushfire assistance

South Australia experienced three major bushfires between November 2019 and January 2020 in Yorketown, Cudlee Creek and Kangaroo Island. As part of recovery activity, SA Health was heavily involved in the coordination and delivery of mental health and wellbeing support services at all levels to the communities across the three bushfire-affected areas. This support included high acute services, as well as lower-level psychological first aid.

COVID-19 pandemic response

As South Australia experienced the Novel Coronavirus (COVID-19) during 2019-20, SA Health fulfilled its role as Hazard Leader for human epidemics as outlined in the South Australian Emergency Management Act 2004.

As at 30 June 2020, there were to date in South Australia:

  • 443 confirmed cases of COVID-19 in total
  • 436 people who had recovered from COVID-19
  • 4 COVID-19 related deaths.

A multi-agency Command Centre was launched within SA Health headquarters as part of a whole-of-government response to the COVID-19 pandemic. The Command Centre included representatives from key State Government agencies, working together to enable a comprehensive statewide response.

SA Health’s measures implemented during the COVID-19 response to date have been compiled, primarily assessing technology and initiatives including: telehealth and digital health; models of care; service delivery processes and approaches; workforce flexibility; governance parameters, and; partnership approaches.

Royal Commission response

The department is responsible for triage, coordination and response to notices, summons, requests and correspondence from three Royal Commissions on behalf of SA Health and its legal entities. Table 3 demonstrates SA Health’s active engagement with the Royal Commission into Aged Care Quality and Safety. An active watching brief is kept on hearings, issues papers and information from the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability and the Royal Commission into National Natural Disaster Arrangements.

Table 3: Royal Commission into Aged Care Quality and Safety — Agency contribution to whole of Government objectives

Royal Commission into Aged Care Quality and Safety
Active engagement Total
Notice to Give 9
Notice to Produce 2
Summons to Appear 3
Voluntary Submissions 6

Agency contribution to whole of Government objectives

Agency contribution to whole of Government objectives
Key objective Agency’s contribution
More jobs
Rural Health Workforce Strategy
$20 million has been committed to the development and implementation of a Rural Health Workforce Strategy. This has resulted in delivery of the SA Rural Medical Workforce Plan and development of a Rural SA Ambulance Service Workforce Plan. Work is commencing on the Nursing and Midwifery and Allied Health Workforce plans. These plans will also include the Aboriginal health workforce.
Lower costs
Financial Monitoring
As part of its revised role as system leader, the department provided high-level system direction and ongoing performance management during 2019-20 to LHNs and SAAS. Regular monitoring of financial management and performance was conducted. This maintained focus on accurate budgeting, budget forecasting methodologies and savings targets.
Assessment of the activity volumes and case mix was undertaken regularly to review the cost to deliver services, such that a reduction in cost per National Weighted Activity Unit was closer to alignment with the National Efficient Price.
Better Services
Reactivating the Repatriation
General Hospital (the Repat)
as a health precinct
The final Repat Master Plan project has moved into the implementation phase, through a staged delivery process. This includes:
• The refurbishment of C-Block for Older Person’s Mental Health
• Construction of the 18-bed Neurobehavioural Unit and 12-bed Older Person’s Medical Unit
• A 78-bed specialised aged care facility
• Development to deliver the Town Square, Specialist Rehabilitation and Veteran’s Wellbeing Centre.
Reducing the elective
surgery backlog
On 31 August 2018, the Government announced a $45 million investment to significantly reduce the number of patients who were overdue for elective surgery or a colonoscopy procedure.
Providing better health
services in our regions
Six regional local health networks were established with independent boards, putting regional communities back in charge of their health care. Maintenance and upgrades are being addressed in regional hospitals, and investments made in improved services and skills in regional areas.
Improving mental health
services
Additional resources for mental health services have been provided, including:
• Virtual Mental Health Support Network to provide support to those in distress as a result of COVID-19
• Suicide prevention funding
• New specialist Borderline Personality Disorder Service
• A dedicated Paediatric Eating Disorder Service.

Agency specific objectives and performance

The department is committed to delivering services that produce positive outcomes to the health and wellbeing of all South Australians by:

  1. Providing leadership in reforming our health system, public health services, health and medical research, policy development and planning
  2. Managing growth and increasing demand on our health system, and providing our patients with the best possible care
  3. Improving the quality and safety of health care through the provision of technology and information solutions that deliver better patient outcomes
  4. Improving mental health care
  5. Reducing and better managing health conditions and promoting Aboriginal community health and wellbeing
  6. Focussing on health promotion, illness prevention and early intervention to sustain good community health and wellbeing.

These areas of strategic focus strongly support the government’s objectives to deliver real change in SA that creates better government services.

1. Providing leadership in reforming our health system, public health services, health and medical research, policy development and planning

Agency contribution to whole of Government objectives
Indicators Performance
Reform SA Health Governance The State Government established 10 LHNs, each with its own Governing Board, which commenced operation on 1 July 2019. LHN Governing Boards are responsible for the overall governance and oversight of local service delivery by the LHNs, including performance and budget achievement, clinical governance, safety and quality, risk management and fulfilment of the Governing Board functions and responsibilities. Governing Boards are responsible and accountable to the Minister for Health and Wellbeing.

Under the revised governance arrangements, six new regional LHNs were established, replacing Country Health SA LHN. 

The department took on a revised role; complementing and supporting the LHNs by providing high-level system direction and performance management. 
Establish Wellbeing SA and the Commission on Excellence and Innovation in Health Wellbeing SA and the Commission on Excellence and Innovation in Health (the Commission) have been proclaimed as attached offices to the Department for Health and Wellbeing (the department), effective 6 January 2020.

This proclamation delivers on the election commitments of the State Government to set up both Wellbeing SA and the Commission to rebalance the health system. While independent, both Wellbeing SA and the Commission will continue to work closely with the department.
SA Pathology Sustainability Project SA Pathology is on track to deliver a cost reduction target of $7.3 million and is on track to delivering a year two cost reduction target of $18 million. On-time delivery for time critical diagnostics has increased from 66 percent to 90 percent. It remains in public ownership, given the organisation’s vastly improved performance and clear commitment to quality care, innovation and sustainability.
Upgrade hospital infrastructure Women’s and Children’s Hospital (WCH)
Sustainment works to the Operating Theatres and Paediatric Emergency Department commenced in November 2019 and works on the Child and Adolescent Mental Health Service Unit (Boylan Ward) commenced in February 2020.

Modbury Hospital
The Emergency Extended Care Unit was completed and commenced providing clinical services in August 2019.

Construction is underway on the new outpatients building and the Palliative Care Unit. Refurbishment of the Surgical Unit and administration area was completed in May 2020.

A High Dependency Unit (HDU) Steering Committee has been established to develop a detailed plan to establish a 4-bed HDU at Modbury Hospital.

Lyell McEwin Hospital 
The construction phase has commenced, involving enabling works for the Emergency Department. This follows a temporary delay due to COVID-19, with completion anticipated in late 2020.

The Queen Elizabeth Hospital
Works to upgrade the existing cardiology catheter lab were completed, with the unit fully operational from July 2019. The construction of a new five-storey 500 space car park for patients and visitors is complete and opened on 1 December 2019.

Barossa Hospital Business Case 
The business case to consider a single health hub in the Barossa has been completed and submitted for consideration.

Murray Bridge Soldiers' Memorial Hospital
Construction work is proceeding well to deliver a $7 million upgrade of the Emergency Department at the Murray Bridge Soldiers Memorial Hospital, anticipated to be completed by December 2020. 

Country Hospital Capital Works 
A program of works is being implemented to address the backlog of asset sustainment works associated with country hospital and aged care facilities. SA Health is working with the now titled Department for Infrastructure and Transport to promote the engagement of regional construction and trade enterprises to deliver these critical sustainment works.

Lighthouse Lodge
Work on this project continues in order to deliver the upgraded facility. The site at Kingston was mobilised in May 2020 to support the commencement of work.

Strathalbyn and District Health Service
Consultation continues with staff and residents on-site regarding design elements for the 36-bed extension build. Construction is expected to commence in August 2020.

Yorketown Hospital and Health Service
Building works commenced in June 2020, on track for an August 2020 completion date. A communication plan regarding service impacts during the upgrade has been developed and implemented.
Response to the Independent Commissioner Against Corruption (ICAC) Commissioner's Report Following the release of the ICAC Commissioner’s Report Troubling Ambiguity: Governance in SA Health, a taskforce was established which agreed Terms of Reference in the coordination of a response.

The Taskforce operates independently and critically reviews the adequacy and implementation of the planned program of work that SA Health is developing to address the concerns raised by ICAC.


2. Managing growth and increasing demand on our health system, and providing our patients with the best possible care

Managing growth and increasing demand on our health system, and providing our patients with the best possible care
Indicators Performance
COVID-19 response: Testing of wastewater SA Health has worked with SA Water to locate any possible COVID-19 clusters in the community by analysing wastewater samples.
COVID-19 response: Workforce measures
Nursing and midwifery
The recruitment of nurses and midwives has been fast-tracked. SA Health is also working with education partners in the rapid upskilling of nurses in areas of need, including Intensive Care Unit (ICU) level care.

Extra front line responders
An additional 97 paramedics have been recruited into the South Australian Ambulance Service to support the frontline response to COVID-19.

Contact tracing team
The Communicable Disease Control Branch’s contact tracing team is being boosted by up to 300 additional staff. The new recruits join an existing team of 140 experts, as well as medical students who are already assisting with contact tracing.

Personal Protective Equipment Matrix
The COVID-19 Personal Protective Equipment (PPE) Assessment Matrix has been developed for use in the care of hospital patients with a suspected and confirmed COVID-19 case and is mandatory for all SA Health hospital-based staff.
It provides a consistent assessment protocol for testing, identifying what PPE is required and what type of room is appropriate for the patient.
COVID-19 response: PPE stock boost SA Health has partnered with Adelaide-based company Detmold to source 10 machines to manufacture 45 million N95/P2 medical respirator and Level 3 barrier protection surgical masks for use in South Australia.
COVID-19 response:
Increased hospital capacity
Dedicated COVID-19 facilities
Dedicated facilities at the Wakefield Hospital, ECH College Grove and the Repat have been established, creating 278 additional beds throughout the health system.

Additionally, the Royal Adelaide Hospital is the dedicated COVID-19 treatment facility for adults, Flinders Medical Centre for high risk pregnant women and the Women’s and Children’s Hospital for treating paediatric patients.

Private hospitals
South Australian private hospitals are included as part of the State’s response plan to COVID-19. The agreement between the State and Commonwealth will provide the local health system with up to 1,700 beds and significant ICU capacity.

Flinders Medical Centre expansion
The $45.7 million expansion of the Flinders Medical Centre Emergency Department is being brought forward to provide extra capacity during the COVID-19 pandemic.

Women’s and Children’s Hospital boost
The Women’s and Children’s Hospital has opened more high dependency beds and is training around 80 nurses to work at an ICU level.
Integrated Inpatient Strategy The SA Health Integrated Inpatient Strategy outlines how public, private and community health sectors would work together to manage a ‘worst case scenario’ outbreak.
COVID-19 response:
Mental Health
On 30 April 2020, the Premier and the Minister for Health and Wellbeing made a joint announcement for the establishment of a South Australian Mental Health Virtual Support Network in direct response to COVID-19.

The Office of the Chief Psychiatrist has developed and implemented the Mental Health Virtual Support Network which consists of non-government organisations (NGOs), providing support to those experiencing distress as a result of the COVID-19 pandemic. This includes both phone and video support lines, call back services and an online chat service as well as individual and group counselling. The support line is staffed by trained Lifeline counsellors. Individual NGOs have been identified to deliver services to specific groups such as Culturally and Linguistically Diverse communities and Aboriginal communities.
Ramping and surge capacity Service Agreements between the department and LHNs and SAAS include agreed performance indicators to measure activity and demand management specific to Emergency Departments (EDs) and ambulance services. These indicators are supported by a range of statewide and local strategies which aim to improve system-wide flow, capacity and demand management.

Statewide Patient flow and Capacity Initiatives include:

Priority Care Centres (PCCs)
These continue to provide an alternative to presenting to an ED. As at the week ending 30 June 2020, a total of 2,386 patients had been seen at a PCC. The PCC initiative is a DHW commissioned service being administered by Wellbeing SA.

National Disability Insurance Agency (NDIA) partnership
DHW and Wellbeing SA are partnering with NDIA to improve the timeliness of National Disability Insurance Scheme (NDIS) approvals, so that inpatients can transition to the community with NDIS supports once they have completed their acute care, to free up acute beds for acute patients.

The SA Hospital Discharge project and the Long Stay Transition to Discharge project
These projects continue to facilitate discharges and link people with the NDIS, releasing over 35,000 bed days across the system in 2019-20. These pieces of work have been commissioned by DHW to be administered by Wellbeing SA.

Transition 2 Home
This was implemented by partnering with the Department of Human Services, LHNs and Wellbeing SA to establish a ‘step down’ service for NDIS patients who no longer need acute care but do not have their longer term support arrangements in place. This service commenced on 26 March 2020 and currently has one site with a capacity of 20 beds.

My Home Hospital
My Home Hospital will deliver safe, high quality care in the patient’s own home or residential care facility as a substitute to going to hospital. The tender process, seeking responses from the market for the delivery of My Home Hospital services, closed on 28 May 2020. Evaluation of responses is complete and services are expected to commence in mid- to late-2020. This piece of work has been commissioned by DHW to be administered by Wellbeing SA, with services expected to commence in 2020.

The Southern Health Expansion Plan
The plan accelerates access to health services across the southern region by increasing the clinical capability of Noarlunga Hospital, increasing the size of the Flinders Medical Centre Emergency Department, and co-locating dementia specialist services at the Repat Health Precinct.
Reduce elective surgery waiting times Due to COVID-19, on 25 March 2020 the Australian Government National Cabinet restricted non-urgent elective surgery procedures. Since 14 May 2020, all surgical procedures across South Australia have resumed, subject to ongoing PPE review and availability. Prior to the impact of stricter elective surgery limitations, the majority of LHNs had been on track to achieve zero overdues prior to the end of the 2019-20 financial year.
Statewide, overdue procedures resulting from COVID-19 reached a peak of 2,781 in May 2020. SA Health has continued to pursue initiatives to reduce overdue procedures that includes:

Direction under Health Care Act 2008
A Direction issued by the Chief Executive on 14 May 2020, under the Health Care Act 2008, mandates that elective surgery activity in all specialties be comprised from each hospital’s overdue elective surgery waiting list, until the list is extinguished. Once achieved, each speciality will maintain an ongoing “Treat in Turn” rate of at least 60 percent.

LHN initiatives
Initiatives to reduce elective surgery waiting times have included continuing to work with private partners to deliver appropriate surgery. This has improved theatre efficiency and facilitated additional evening and weekend public hospital sessions and roll out of new systems to better support demand planning.

SA Health’s Patient Services Panel (the Panel)
This provides a framework for LHNs to partner with approved private providers to access a range of health services. Since its commencement on 23 July 2019, the Panel continues to facilitate access to private bed capacity and the delivery of elective surgery procedures. These established partnerships have continued strongly during the COVID-19 pandemic.
Provide funding to palliative care outreach services, extending the operating hours to 24/7 This is a $16 million commitment over four years that became fully operational by the end of 2019-20 financial year.
Funding was fully allocated by the Minister for Health and Wellbeing for 2019-20 and initiatives funded include LHN 24/7 innovation projects and NGO Grants. The Project Agreement on Comprehensive Palliative Care in Aged Care is underway.
SA Health has established a Statewide Palliative Care Clinical Network and a Statewide Palliative Care Clinical Network Steering Committee that continues to be engaged in improving palliative care across South Australia.
Raise the participation rate of South Australians in Advanced Care Directives (ACDs) The uptake of ACDs continues to steadily increase as reflected in the sale of kits and forms by Service SA and the use of the ACD website. A range of targeted activities and projects are underway, including education for substitute decision-makers, workshops to provide practical support for older people, and trials of innovative ways to increase the advance care planning in residential aged care facilities.

3. Improving the quality and safety of health care, through the provision of technology and information solutions that deliver better patient outcomes

Agency contribution to whole of Government objectives
Indicators Performance
Reduce the abuse of prescription drugs through real-time prescription monitoring  In the 2018-19 State Budget, $7.5 million was committed over three years (from 2019-20) to support a real-time prescription monitoring (RTPM) solution for Schedule 8 medicines in SA. Work is well-progressed towards procuring and implementing the RTPM software, legislative amendments and establishing support and training for prescribers and pharmacists. The commitment to deliver a RTPM system for SA is on track for March 2021.
Activation of the Sunrise Electronic Medical Records System (Sunrise EMR) Following the cancellation of the EPAS Program, activation of the Sunrise EMR and Patient Administration System (PAS) was successfully completed in March 2020 at the two exemplar sites; Mount Gambier and Districts Health Service and Royal Adelaide Hospital (RAH). Sunrise EMR and PAS were also activated at the Central Adelaide Local Health Network (CALHN) Intermediate Care, Hospital Avoidance and Supported Discharge Service on 18 May 2020.

In response to COVID-19, the Sunrise EMR Project developed and deployed a number of new EMR COVID-19 functional changes, as requested by sites.

No new paper patient medical records are being created at the RAH following activation of the Sunrise EMR and PAS application to enable a gradual reduction in recalls of paper patient medical records over the next 12-18 months.
Quality Information and Performance Hub (QIP Hub) The QIP Hub supports our workforce with increased access to transparent data regarding clinical outcomes and system performance. This enables greater opportunities for data utilisation to propel innovation into our practice and delivery.

Achievements include the release of a real time dashboard with operational data; an ED Activity Analysis dashboard and a Cancer dashboard. 
Expand existing technology platforms to enhance service delivery Vulnerable groups have been protected by removing the requirement to enter a healthcare environment, though improvements in the management of hospital demand and supporting access to care. Examples of achievements in the response to COVID-19 included:
• Outpatient services delivered with support from MBS billing items and HealthDirect
• Delivering health services by telehealth.
• Digital prescriptions and electronic pathology requests
• Expansion of the Virtual Mental Health Support Network.

4. Improving mental health care

Agency contribution to whole of Government objectives
Indicators Performance
Develop a Statewide Mental Health Services Plan 2019-2024
The Mental Health Services Plan was publicly released on 2 November 2019.
Expand support for the prevention of suicide
$2.5 million of funding for suicide prevention has been provided to 2021-22. This will fund SA Suicide Prevention Networks (SPNs) and associated voluntary groups to increase compassion and break down stigma associated with mental illness and suicide.

The Council areas of Port Pirie and Barossa are in the final stages of SPN Development, increasing the total number of networks to 40. This includes seven SPNs established by Wesley Life Force but supported with both advice and funding by SA Health.

The statewide training approach to suicide mitigation, Connecting with People has been delivered to over 3,700 front line staff, community members and NGOs. To meet demand, an additional 18 clinicians have been trained to deliver this training.
Establish a paediatric eating disorder service The department continues to work with the Chief Psychiatrist, Southern Adelaide Local Health Network and Women’s and Children’s Health Network to establish dedicated statewide paediatric eating disorder services, with a focus on outpatient services for children and young people under 15 years of age with an eating disorder.
Expand support for people living with Borderline Personality Disorder (BPD) The Borderline Personality Disorder Collaborative (BPD Co) is operational and currently rolling out the Model of Care in a staged implementation process. Shared care is being provided in partnership with LHNs for people with the most complex and severe BPD.

A short-term group program based on common factors of evidence-based therapy for people with BPD has been developed and piloted. This has been run by BPD Co and will roll out in partnership with LHNs and other relevant service providers in late 2020.

Training in foundational skills has continued to support frontline clinicians, including crisis response services in providing compassionate, evidence-based care for people with BPD.
Assessment and Brief Intervention Clinics have commenced in piloting LHNs.

5. Reducing and better managing health conditions and promoting Aboriginal community health and wellbeing

Agency contribution to whole of Government objectives
Indicators Performance
Establish a permanent renal dialysis unit in the APY Lands A permanent dialysis unit in Pukatja opened on 16 August 2019.
Development of SA Health’s Aboriginal Health Care Framework (Framework) A new five-year Framework is being developed through comprehensive consultation with Aboriginal communities, partners and our staff to guide local service responses across the life course. The Framework will replace the previous Aboriginal Health Care Plan.
The Framework seeks to provide an effective benchmark to measure contributions towards closing the gap on health disparity between Aboriginal and non-Aboriginal people in South Australia across the life course.

6. Focusing on health promotion, illness prevention and early intervention to sustain good community health and wellbeing

Agency contribution to whole of Government objectives
Indicators Performance
Better Prevention and Targeted Preventative Health Following the establishment of Wellbeing SA, actions relating to priority population groups are to be included in the Wellbeing SA Strategic Plan 2020-2025, in line with the commitments outlined in the Targeted Prevention policy platform. 

The Wellbeing SA Strategic Plan 2020-2025 is to be released by the Minister for Health and Wellbeing for implementation by Wellbeing SA in 2020

Further information is available in the Wellbeing SA Annual Report 2019-20 at https://openyourworld.sa.gov.au/about-wellbeing-sa.  
Vaccinations for Influenza SA Health distributed 665,430 doses of influenza vaccine by week 14 of the 2020 influenza program (26 June 2020). Vaccines were distributed to children aged between six months to less than five years, SA Health healthcare workers, people aged 65 years and over, pregnant women, Aboriginal people, homeless people and those considered medically at risk.
Vaccinations for meningococcal disease The SA population is protected against meningococcal disease through the state funded Meningococcal B Immunisation Program, the first in Australia, and the National Immunisation Program meningococcal ACWY* program.
Vaccination programs are implemented in age groups most at risk of disease, namely young children and adolescents.
*Meningococcal ACWY vaccine protects against four types of meningococcal infection; the A, C, W and Y types. .
Bowel cancer prevention – cut waiting times for patients to receive procedures quickly and prevent progression A $45 million investment has been made to significantly reduce the number of patients who are overdue for a colonoscopy or elective surgery procedure.

Until the Australian Government National Cabinet announcement on 25 March 2020, restricting non-urgent elective procedures, LHNs were making significant progress reducing the number of overdue new patients waiting for a colonoscopy with only 35 percent overdue across the state.

SA Health established a panel of approved suppliers for the provision of colonoscopy services to public patients, extensively used by the LHNs. LHNs also continued to undertake additional internal lists.

As at 30 June 2020, the number of overdue new colonoscopies for the state was 574, a decrease of 2,315 (80 percent) since 30 June 2019.
Clinical Cancer Registry The Government is committed to working with the relevant stakeholders in developing a model that enables an effective and efficient collation of clinical data that ensures the optimal impact and sustainability of this vital resource.
A business case has been developed and approved by the Minister for Health and Wellbeing and the plan is progressing.
Introduce a system of Youth Treatment Orders for children under the age of 18, confirmed as suffering from dependence on or at risk of harm from alcohol related or other drug use The Controlled Substances (Youth Treatment Orders) Amendment Act 2019 was assented to on 21 November 2019, and will commence operation on a date to be fixed by proclamation. The new legislation will provide the option of Court ordered treatment for children and young people experiencing drug dependency.

An Interagency Working Group has been established to provide advice on the most appropriate model of care to address youth substance dependence and to guide the development of the legislation. Community consultation on the Draft Model of Care underpinning the initiative will commence in 2020.

Corporate performance summary

Corporate initiatives for the department in 2019-20 include:

  • Health and Wellbeing Strategy

Released in March 2020, the Health and Wellbeing Strategy 2020-2025 informs the work, priorities and direction for the public health system for the next five years, with a view to realising an aspirational long-term (twenty-year) vision. 

  • Information classification and records management

Revisions were made to two key policy directives in response to the ICAC Report and to align with the State and Commonwealth Information Classification System. Implementation in DHW is on track for August 2020.

  • Risk management system

RiskConsole, a repository for risk records was implemented in 2019-20. This supports the department’s risk management activities, including the recording and reporting of risks, risk ratings, controls, and treatment plans.

  • SA Health website

A new SA Health website was launched in April 2020 with many enhancements, including improved search ability, a modern look and feel, and mobile responsiveness.

Employment opportunity programs

Employment opportunity programs
Program name Performance
Aboriginal Employment Register Four positions were recruited from the Aboriginal Employment Register which included an ASO5, ASO6 and two ASO7 positions.
2019-20 SA Study Assistance Program for Nurses and Midwives With 203 successful recipients in 2019-20, this program supports SA Health nurses and midwives to ensure quality care delivery to patients/clients and to complete post-graduate study.
SA Health Leading Clinicians Program This program assists health professionals in clinical leadership roles to develop their leadership capability and improve patient-centred care. In 2019, 81 clinicians (69 participants and 12 facilitators) completed the program. A further 84 clinicians (72 participants and 12 facilitators) commenced the program in February 2020. Program evaluations consistently demonstrate high levels of satisfaction and valuable contributions to SA Health’s strategies and plans.
Partner with the Universities, VET sector and health sites regarding clinical placements across all health professions, teaching, education standards, training and research Expansion of the Clinical Placement Management System continued in 2018-19. Bookings for 2.7 million clinical placement hours (covering the majority of health professions) continue to be online for more than 243 organisations. Data from January to June 2020 was impacted by COVID-19, resulting in some students being moved from their locations and some cancellations.
System logins and Sunrise accounts, where applicable, have been provided for around 7,000 student placements.
Leadership and Development of the Allied Health and Scientific Professions within SA Health The Allied Health Professional Reimbursement Program continued, with funding support provided to 1,556 Allied and Scientific Health professionals in 2019-20.

Agency performance management and development systems

Agency performance management and development systems
Performance management and development system Performance
Department for Health and Wellbeing Performance Review and Development (PRD) process Two designated PRD cycles were established for managers to undertake a PRD conversation with direct reports: the first cycle from September to October, and the second cycle from March to April.
After the launch of the first cycle in September 2019, the department recorded an increase in PRD participation rates of about 20 percent.
Due to COVID-19 and the degree of essential work being carried out by employees, the department did not enforce the second cycle from March to April 2020.

Work health, safety and return to work programs

Work health, safety and return to work programs
Program name Performance
Response to COVID-19 An SA Health Workforce COVID-19 Wellbeing Proposal and Action Plan was developed with contribution from Workforce Services (DHW), Wellbeing SA, Office of the Chief Psychiatrist, Commission on Excellence and Innovation in Health, and the Office of the Commissioner for Public Sector Employment.
The COVID-19 Action Plan involves review and monitoring of existing data sources to identify high-risk groups and inform intervention strategies. The Action Plan contains a range of strategies and initiatives to support the SA Health Workforce and relevant to the specific stages of the pandemic.
An online e-Learning module was developed during COVID-19 to encourage SA Health staff to look after themselves and their colleagues. The short 20-minute module aims to increase mental health literacy and contains links to a range of COVID-19 specific mental health resources.
COVID-19 – Personal Protective Equipment (PPE) response As the world faced the COVID-19 pandemic in the latter half of 2019-20, the department took a lead role in coordinating the response for the state of South Australia and for SA Health. One of the major concerns related to the pandemic centred on ensuring PPE supply in the context of world-wide demand and critical shortages. The department has ensured continued supply and worked to acquire newly developed state supplies of products and equipment.
Development of the PPE Matrix has ensured that all LHNs have knowledge of the PPE to use in particular circumstances.
Challenging Behaviours The department established the Challenging Behaviour Project Steering Group and Project Working Group to oversee the review and development of a revised Challenging Behaviour Strategy. The project aims to further improve staff safety across SA Health by addressing gaps, adopting best practice and identifying opportunities and innovative approaches to ensure ongoing improvements and safe work environments for all.
A Challenging Behaviour Strategic Framework has been developed. The policy directive, policy guideline and toolkit have been reviewed, following extensive consultation with topic experts, staff, unions and consumers.
‘Gayle’s Law’ The revised Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Act 2017 became operational on 7 November 2019. This is more commonly referred to as ‘Gayle’s Law’, in response to the tragic death of dedicated nurse, Mrs Gayle Woodford in 2016.
The SA Health Remote or Isolated Work Safety (WHS) Policy Directive and associated documents were released on 11 May 2020, ensuring the department’s compliance with the Gayle’s Law provisions of the Health Practitioner Regulation National Law (South Australia) Act 2010 and Regulations.
The department is required to undertake a regulated review of the operation of Gayle’s Law, commencing in November 2020.
Seasonal Influenza Program The 2020 annual Influenza Program was conducted from March to April 2020 across SA Health. As at 12 June 2020, 67 percent of staff had received an influenza vaccination. The program will continue to operate into the latter half of 2020.
Fatigue Management To support meeting legislative requirements under the Work Health and Safety Act 2012 (SA), SA Health utilises resources including: SA Health’s Fatigue Management Strategy, Worker Health Wellbeing and Fitness for Work Policy Directive, and the publication Prevention of Fatigue – An educational risk management guide for South Australian Health Services. This work also aligns with the SA Health Work Health Safety and Injury Management System Program 4 – Fitness for Work.
The guide and its resources are designed with a preventative risk management focus, emphasising the shared responsibilities of SA Health leaders and workers providing health care and services. It provides information and the steps which should be taken by SA Health leaders to identify people and occupational groups that may be at potential risk of fatigue due to specific roles, tasks and/or work patterns. The department continues to work with the LHNs and SAAS to ensure clear guidelines and advice around fatigue management and work planning are provided to staff relevant to COVID-19.
Manual Task Risk Management System - Training The department coordinates the Manual Tasks Local Facilitator (MTLF) Training System across SA Health.
There are over 1,000 MTLFs throughout SA Health who provide training, induction and support to their colleagues to reinforce safe work practices. In 2019-20, 121 new facilitators completed the two-day practical training and 263 current facilitators attended refresher sessions.
Training was put on hold for new and existing MTLFs on 16 March 2020 due to COVID-19 social distancing requirements and has not yet recommenced.
Risk assessments and control measures continue to be provided for hazardous manual tasks, plant and equipment.
Contractor Safety The department recognises its duty of care to all persons in the workplace including labour hire, contractors, volunteers and visitors. The SA Health Contractor Safety Management (WHS) Policy Directive was developed and released on 11 May 2020. This ensures effective arrangements are in place to safeguard the health and safety of contractors at SA Health sites.
SA Health Psychological Health Strategy The department facilitated a Psychological Health Strategy Implementation Workshop in September 2019 to address the findings of the SA Health internal audit report of the Psychological Health Strategy. A follow up workshop is planned for the end of 2020.
The SA Public Sector Mentally Healthy Workplaces (MHW) Framework and MHW Toolkit were published by the Office of the Commissioner for Public Sector Employment at the end of 2019. The MHW checklist was compared with current SA Health systems and practice. A gap analysis of the SA Health Psychological Health Strategy has been completed against the MHW Framework and the existing strategy will be revised to address any identified gaps.
Bullying and Harassment Policy Recognising the impact on our staff, a specific Prevention and Management of Workplace Bullying and Harassment policy is being drafted to supplement guidance on respectful behaviours in the workplace.

Workplace injury claims - Department for Health and Wellbeing

Workplace injury claims - Department for Health and Wellbeing
Workplace injury claims 2019 - 20 2018 - 19 % change (+ / -
Total new workplace injury claims 21 28 -25.0%
Fatalities
0 0 0.0%
Seriously injured workers*
0 0 0.0%
Significant injuries (where lost time exceeds a working week, expressed as frequency rate per 1000 FTE)
5.08 5.07 +0.2%

*Note: number of claimants assessed during the reporting period as having a whole person impairment of 30% or more under the Return to Work Act 2014 (Part 2 Division 5)

Work health and safety regulations - Department for Health and Wellbeing

Workplace injury claims
Work health and safety regulations 2019 - 20 2018 - 19 % change (+ / -)
Number of notifiable incidents (Work Health and Safety Act 2012, Part 3) 4 2 +100.0%
Number of provisional improvement, improvement and prohibition notices (Work Health and Safety Act 2012 Sections 90, 191 and 195) 1 0 0.0%

Return to work costs - Department for Health and Wellbeing

Return to work costs
Return to work costs** 2019 - 20 2018 - 19 % change (+ / -)
Total gross workers compensation expenditure ($) $508,524 $377,984 +34.5%
Income support payments – gross ($) $126,341 $114,799 +10.1%

Note: **before third party recovery

Data for previous years is available at: https://data.sa.gov.au/data/dataset/department-for-health-and-wellbeing.

Executive employment in the agency

Executive employment
Executive classification Number of executives
Executive Level F 1
SAES 1 Level 36
SAES 2 Level 8

Data for previous years is available at: https://data.sa.gov.au/data/dataset/department-for-health-and-wellbeing.

The Office of the Commissioner for Public Sector Employment has a workforce information page that provides further information on the breakdown of executive gender, salary and tenure by agency: https://www.publicsector.sa.gov.au/about/Our-Work/Reporting/Workforce-Information.