Barossa Hills Fleurieu Local Health Network Annual Report 2019-2020

Barossa Hills Fleurieu Local Health Network
Mount Barker District Soldiers Memorial Hospital
87 Wellington Road
Mount Barker, South Australia, 5251

www.sahealth.sa.gov.au/barossahillsfleurieulhn
Contact phone number: (08) 8393 1777
Contact email: Health.BHFLHN@sa.gov.au

ISSN: 2652-6611

Date presented to Minister: 30 September 2020

To:

Hon Stephen Wade MLC
Minister for Health and Wellbeing

This annual report will be presented to Parliament to meet the statutory reporting requirements of Public Sector Act 2009, the Public Finance and Audit Act 1987 and the Health Care Act 2008, and the requirements of Premier and Cabinet Circular PC013 Annual Reporting.

This report is verified to be accurate for the purposes of annual reporting to the Parliament of South Australia.

Submitted on behalf of the Barossa Hills Fleurieu Local Health Network by:

Rebecca Graham
Chief Executive Officer
Date 23 September 2020     


From the Governing Board Chair  

I think most Australian health leaders would be hard pressed to recall a more astonishing and challenging year than the one we have just experienced – especially for a new local health network. 

Looking back on the year that has been, I am particularly proud of a number of key achievements by our local health network.

While navigating the challenges presented by COVID-19, BHFLHN has continued important strategic work behind the scenes, including the recent finalisation of our Strategic Intent document, which will lay the foundation for our strategic planning for the period July 2020 – June 2021. Through this work, we are ensuring that our community members receive extraordinary health services and care. To us, this means delivering safe, effective, personal, and connected services and care for every person, every time.   

The BHFLHN Consumer and Community Engagement Strategy is continuing to be developed with the input of staff, Governing Board members, Health Advisory Council members and consumers through a series of workshops. The establishment of tier-one and tier-three committees have been ratified by the BHFLHN Governing Board. These committees will work to reinforce consumer and community engagement as everybody’s everyday business.

The Rural Health Workforce Strategy is a State Government election commitment, which sees $20 million committed between 2018-2022 to develop and implement a Rural Health Workforce Plan. For BHFLHN, early priorities for this work include developing collaborative relationships with key stakeholders, including our medical workforce, rural training schools other regional and metropolitan local health networks, to ensure we are well positioned for current and future strategic opportunities.

Collectively, this foundational strategic work serves our conviction that safe, effective, personal, and connected services and care, is a right of all community members, regardless of where they live across our local health network. Furthermore, in enacting these initiatives and priorities, we will confidently work toward retaining our level one performance rating with the Department for Health and Wellbeing, for both service delivery and financial performance.

I speak for the whole BHFLHN Governing Board when I say that we are honoured to serve the communities of the Barossa, Adelaide Hills, Fleurieu Peninsula and Kangaroo Island, and we credit BHFLHN staff and leadership team for the dedication and resilience they have demonstrated throughout the inaugural year of Barossa Hills Fleurieu Local Health Network.

Carol Gaston AM
Governing Board Chair - Barossa Hills Fleurieu Local Health Network

From the Chief Executive  

The Barossa Hills Fleurieu Local Health Network (BHFLHN) covers the Adelaide Hills, Kangaroo Island, Fleurieu Peninsula and Barossa areas. Across our eleven health sites, we offer a wide range of health care services including acute care, medical, accident and emergency, surgery, birthing and midwifery, specialist consultancy, renal dialysis, chemotherapy, transfusions, rehabilitation, respite care, Aboriginal health, mental health and allied health.

BHFLHN is unique is that it provides clinical governance oversight to country-wide mental health services and the state-wide borderline personality disorder service, BPD Co. BHFLHN also hosts the Rural Support Service (RSS), which supports the six regional local health networks, bringing together clinical and corporate advisory services focused on improving quality and safety. Under the banner of Country Health Connect we proudly deliver a wide range of community, in-home and residential aged care, early childhood and disability support services.

BHFLHN has overcome a great deal in its inaugural year. From the significant governance changes that come with reporting to a new Governing Board, through to the devastating 2019-20 bushfire season, which profoundly affected our sites, staff and communities – before being confronted with the coronavirus (COVID-19) global pandemic, which has affected every facet of how we live, work and even relate to one another.

BHFLHN implemented an emergency command structure in response to the 2019/2020 bushfire season and COVID-19 pandemic and we now find ourselves highly prepared and experienced should events like these ever occur in the future. Our response has helped shaped our values and priorities for the coming year ahead, where we exemplify excellence, courage, agility and accountability in all that we do.     

Through these events, BHFLHN has risen and surpassed even our own expectations in managing the most complex, unprecedented challenges. It is a testament to the wisdom and expertise of our leadership team – many of whom have proudly lived and worked in our network for many years, as well as those who have joined us more recently and brought fresh perspective, experience and knowledge.

Leadership development has indeed been a key focus of our first year. From Executive participating in monthly coaching, to a dedicated program for emerging and new leaders – we are committed to building a workforce that is high performing and sustainable.

BHFLHN continues to be strongly committed to anti-racism with all members of Executive completing a Cultural Safety workshop.  This workshop challenged participants to explore their values and examine all forms of racism including institutional racism.  BHFLHN have some exciting news in this space in 2020-21 to further develop our message that racism will be not be tolerated.

I am proud to be Chief Executive Officer of an organisation that is so firmly values-centred and absolute in its commitment to the health and wellbeing of the communities we are privileged to serve. Together, we have proved BHFLHN to be a formidable and highly valued asset of the South Australian public health system.

Rebecca Graham
Chief Executive
Barossa Hills Fleurieu Local Health Network


Overview: about the agency

Our strategic focus

Our Purpose

Ensuring that health services in BHFLHN are:

  • Safe, high quality, accessible and, where possible, innovative.
  • Reflect the values, needs and priorities of the communities they serve.
  • Have a focus on sustainability in terms of resources available and impact on the environment.

Our Vision   

To be the best rural health service.

Our Values  

  • Trust 
  • Respect
  • Integrity
  • Collaboration
  • Kindness 

Our functions, objectives and deliverables

BHFLHN provided a wide range of public acute, residential aged care, community health and mental health services to country-based South Australians.

BHFLHN’s key objectives were to:

  • Build innovative and high-performing health service models that deliver outstanding consumer experience and health outcomes.
  • Pursue excellence in all that we do.
  • Create a vibrant, values-based place to work and learn.
  • Harness the power of partnerships to improve the effectiveness of services.
  • Elevate and enhance the level of health in country communities.

BHFLHN’s key deliverables were to:

  • Provide safe, high-quality health and aged care services.
  • Engage with the local community and local clinicians.
  • Ensure patient care respects the ethnic, cultural and religious rights, views, values and expectations of all peoples.
  • Ensure the health needs of Aboriginal people are considered in all health plans, programs and models of care.
  • Meet all legislation, regulations, Department for Health and Wellbeing policies, and agreements.

Our organisational structure

BHFLHN Governing Board

The inaugural board was established on 1 July 2019:

  • Juliet Brown – Chair (resigned 29 January 2020)
  • Joe Ullianich (resigned 29 January 2020)
  • Carol Gaston – Chair (appointed 26 March 2020)
  • Pru Blackwell
  • Robert Zadow (resigned 20 March 2020)
  • Roger Sexton
  • Judy Curran (appointed 28 January 2020)
  • Kevin Cantley (appointed 28 January 2020)

BHFLHN was managed by the Chief Executive Officer (CEO), who reported to and was accountable to the BHFLHN Governing Board.

Rural Support Service Organisational Structure

The RSS is jointly managed by two co-directors, a Chief Clinical Advisor and an Executive Director.  The co-directors report to the CEO, BHFLHN.

Changes to the agency

During 2019-20 there were the following changes to the agency’s structure and objectives as a result of internal reviews or machinery of government changes.

  • Country Health SA Local Health Network was dissolved on 30 June 2019.
  • As a result of governance reform, BHFLHN became a legal entity on 1 July 2019, governed by a Board of Directors.
  • At 1 July 2019, the BHFLHN Governing Board assumed the host role for the RSS.  The RSS brings together clinical and corporate advisory services focused on improving quality and safety for the six regional Local Health Networks (regional LHNs) in South Australia. The RSS includes highly specialist, system wide clinical and corporate capabilities, clinical leadership and expertise.
  • At 1 July 2019, the BHFLHN Governing Board assumed governance responsibility for the Rural and Remote Mental Health Service (RRMHS) which consists of a 23 bed acute psychiatric inpatient facility and a distance consultation service.   The RRMHS holds clinical leadership and clinical governance responsibility for the six regional LHNs through the Clinical Director, Mental Health, whilst operational responsibility for local services is held by individual LHNs.

Our Minister 

Hon Stephen Wade MLC is the Minister for Health and Wellbeing in South Australia.

The Minister oversees health, wellbeing, mental health, ageing well, substance abuse and suicide prevention.

Our Executive team  

As at the 30 June 2020, the BHFLHN Executive team consisted of:

Chief Executive Officer

Rebecca Graham is accountable to the Governing Board for the provision, management and administration of health services and achieving the overall performance of the public health system for BHFLHN.

Director Aboriginal Health

Peter Taylor is responsible for initiating, planning, implementing, coordinating and delivering Aboriginal Health programs across BHFLHN. 

Clinical Director Mental Health

Dr Brian McKenny is responsible for the management of the Rural and Remote Mental Health Service within BHFLHN and Mental Health Clinical Governance for regional LHNs in country South Australia.

Executive Director Community and Allied Health (Acting)

Amy Foote is responsible for the efficient and effective management of Community Health Services resulting in the provision of a range of community and hospital based health services responsive to the identified needs of BHFLHN.

Interim Executive Director Medical Services

Sharon Morton is responsible for the delivery of professional leadership and professional practice standards of medical staff across BHFLHN and is also the medical lead for the Quality, Risk and Safety Team.  

Executive Director Nursing and Midwifery Services

Annie Price is responsible for the delivery of Nursing and Midwifery professional services across BHFLHN and also leads the Quality, Risk and Safety Team.  

Director Corporate Services

Daniel Panic is responsible for managing, developing, coordinating and monitoring significant and critical, corporate and business services that support the effective operation of health units across BHFLHN. 

Chief Finance Officer

Steve Brown is responsible for leading the provision of comprehensive financial services by contributing to the leadership, performance and financial strategic direction of BHFLHN.

Executive Director Finance Services (commenced 15 June 2020)

Lis Wilson is responsible for the provision of comprehensive financial services across BHFLHN and the Rural Support Service (RSS).

Director People and Culture

Mandy Palumbo is responsible for leading and managing the delivery of best practice human resources services within a business partnering framework, implementing proactive workforce strategies and interventions within services across BHFLHN in order to drive continuous improvement, performance and accountability of workforce goals and objectives.

Director Service Development

Alison King is responsible for leading and contributing to the design, planning, development, implementation, management, and evaluation of significant service development initiatives across BHFLHN. The position develops and manages overall service development project plans and provides project assistance. 

Director Strategy and Governance

Kylie Williams is accountable for the provision of high quality and timely support to the Chief Executive Officer and the Governing Board.  Kylie is also responsible for the Strategy and Governance team which is accountable for the delivery of secretariat support to board governance committees, project management, ministerials, performance analysis, communications and Freedom of Information (FOI).

Rural Health Workforce Strategy Implementation Manager (commenced 4 May 2020)

Kelly Borlase is responsible for undertaking Board readiness and organisational readiness responsibilities that are crucial to the successful transition to regional Local Health Networks from 1 July 2019.

Rural Support Service

As at the 30 June 2020, the RSS Executive team consisted of:

Chief Clinical Advisor

Dr Hendrika Meyer is responsible for co- directing the RSS with responsibility for delivering a comprehensive range of clinical, workforce, governance and business services that support regional LHNs.

Executive Director

Debbie Martin is responsible for co-directing the RSS with responsibility for delivering a comprehensive range of clinical, workforce, governance and business services that support regional LHNs.

Legislation administered by the agency

Nil

Other related agencies (within the Minister’s area/s of responsibility)

  • Department for Health and Wellbeing
  • Central Adelaide Local Health Network
  • Eyre and Far North Local Health Network
  • Flinders and Upper North Local Health Network
  • Limestone Coast Local Health Network
  • Northern Adelaide Local Health Network
  • Riverland Mallee Coorong Local Health Network
  • Southern Adelaide Local Health Network
  • Women’s and Children’s Health Network
  • Yorke and Northern Local Health Network
  • South Australian Ambulance Service

The agency’s performance

Performance at a glance

In 2019-20, BHFLHN achieved key performance in the following areas:

  • Meeting targets for emergency department ‘seen on time’ triage categories 2-5, achieving 98.9% for Triage Category 1.
  • Meeting targets for emergency department patients who left at their own risk.
  • Meeting all elective surgery timely admissions and overdue patient categories prior to the introduction of COVID-10 elective surgery restrictions.
  • Meeting targets for mental health services such as readmission rates and timeliness of care in the community.
  • Achieving improvements in other key performance indicators including the percentage of potentially preventable admissions, relative stay index and hand hygiene compliance.
  • Achieving above target ratings for key consumer experience indicators.
  • Delivering the Aboriginal Family Birthing Program, tailored specifically to the needs of local Aboriginal and Torres Strait populations.
  • Growing renal dialysis services through the redevelopment of the existing chemotherapy unit at Mount Barker to a multipurpose unit including three dialysis chairs.
  • Planning for the Care Pods project, whereby BHFLHN will establish Care Pods in selected sites as a service strategy to support health system demand and bed flow in metropolitan hospitals. The intent of Care Pods is to move identified long stay patients from occupying acute care beds in tertiary hospitals to identified BHFLHN hospitals where ‘pods’ of beds are grouped at sites and consumers with similar needs are co-located for care.
  • Continuing to deliver community and in-home services through Country Health Connect.
  • Continuing the Country Referral Unit (CRU) which processes Community and Allied Health referrals for all regional LHNs 7 days a week and answers the 1800 Country Health Connect line.  All performance indicators were met including processing within two hours for a Country Home Link referral (early supported discharge from a metropolitan hospital) and inpatient referrals processed within one day.
  • Developed a Consumer and Community Engagement governance framework.
  • Developed an Aged Care Governance Framework – appointed an Aged Care Lead, developed a committee structure to ensure compliance and quality standards are met. 
  • All sites are accredited with the Australian Council of Healthcare Standards.
  • Successfully completing an NDIS Audit with BHFLHN now granted NDIS Provider status.
  • Achieving Baby Friendly Hospital accreditation for all birthing sites in BHFLHN.
  • Achieving six out of six of the SA Health Work Health and Safety Injury Management (WHSIM) Performance Measures and 100% compliance for SA Health KPIs.
  • Implementing an emergency command structure for bushfires, Cudlee Creek and Kangaroo Island and for the COVID-19 pandemic.
  • Introducing technology at aged care sites to enable virtual connections between residents and their friends and families.
  • Development of a Barossa Hospital Business Case.

Rural Support Service

In 2019-20, the RSS achieved key performance in the following areas:

  • Providing training, 493 occasions, through the Rural Support Service Country Allied Health Clinical Education Program plus (CAHCEP+) for Allied Health Professionals working in regional LHNs.
  • Delivering South Australia's Rural Health Workforce Strategy, including recommending and implementing more than $6 million worth of investments in the rural health workforce.
  • Developing and launching South Australia's Rural Medical Workforce Plan in December 2019, including an extensive in person consultation process with doctors, clinicians and the community across South Australia.
  • Developing the Rural SA Ambulance Service (SAAS) Workforce Plan in collaboration with SAAS.
  • Establishing the South Australian Rural Generalist Coordination Unit to support a Rural Generalist Training Pathway for doctors.
  • Coordinating and advertising the first South Australian Rural Generalist Pathway medical training positions, to commence in 2021.
  • Completing an initial feasibility study (August 2019 – February 2020) into the potential use of Remote Piloted Aircraft (RPA) for urgent medical item deliveries between hospitals in regional SA, supported by an eHealth Innovation Grant. 
  • Continuing the South Australian Virtual Emergency Service with extended hours introduced in April 2020 - 7pm – 7am.

Agency contribution to whole of Government objectives

Key objective Agency’s contribution
More jobs
  • Rural Health Workforce Strategy - delivering the government’s $20 million, four year commitment to ensure country health services are sustainable and to address the shortage of health practitioners with advanced skills in regional areas.
  • SA Rural Medical Workforce Plan 2019-24 released by the Minister for Health and Wellbeing in December 2019. Corresponding plans for South Australian Ambulance Service, nursing and midwifery, allied health and Aboriginal health workforces under development.
  • BHFLHN have recruited an Implementation Manager Rural Health Workforce Strategy. A key activity of this project is to implement 2-3 Medical Intern rotations in 2021. These positions will be integral to ensuring a sustainable workforce into the future.
Lower costs Costs for consumers were reduced through delivering programs such as:
  • The Patient Assistance Transport Scheme.
  • Timely elective surgery.
  • Increasing access to Telehealth services.
  • Home based chronic disease monitoring.
Better services BHFLHN Significant service outcomes achieved in 2019-20 included the following:
  • COVID-19 Testing – establishment of five COVID testing clinics in March 2020. As at 30 June 2020, there were 14,777 tests undertaken at these clinics, representing 10.1% of all tests completed in South Australia.
  • Country Health Connect Services – receiving an average of 1,734 referrals per month for state funded allied health and community nursing services, with high demand for physiotherapy, occupational therapy and dietetics.
  • Care Pods - developed a model of care through engagement with clinicians and consumers to identify suitable long stay consumers who could transfer from metropolitan hospitals to BHFLHN sites. The Care Pod Model of Care offers consumers multidisciplinary restorative care to facilitate their discharge or transfer to long term care in a less acute setting. 
RSS Significant service outcomes achieved in 2019-20 included the following:
  • Expanding Palliative Care Services through the Regional LHN Palliative Care Innovation Grant.
    • Memoranda of understanding developed/expanded with three metropolitan level six Palliative Care services providing both new and additional Palliative Care consultant access across six regional LHNs.
    • Telehealth device distribution enabling over 30 palliative care allied health/nursing staff to increase at home bedside consultation to up to 90% of regional palliative care consumers.
    • Regional Chronic Condition palliative care education seminar adapted to a nine session webinar series allowing expansion from the original target of 30 clinicians to reaching a broader virtual audience of more than 100 regional LHN clinicians.
    • Supporting the expansion and review of End of Life Choice Packages enabling consumers to be supported on packages exceeding 30 days, allowing more patients to die at home consistent with their wishes.
  • Regional LHN renal Coordinators appointed at pilot sites in Ceduna and Whyalla.
  • Across all regional LHN chemotherapy units in 2019-20, there have been an additional 1,632 cancer treatment episodes and 501 medical oncology consultations. 
  • Continuation of the South Australian Virtual Emergency Service with extended hours introduced in March 2020, 7pm – 7am. 920 calls were taken in the 2019-20 financial year.

Agency specific objectives and performance

Agency objectives Indicators Performance
Improving access to health services in our community BHFLHN
  • Community nursing service activity
  • Allied health service activity
  • Potentially preventable admissions
  • National Disability Insurance Scheme (NDIS) program activity
  • Renal dialysis
RSS
  • SA Telestroke Service (formerly known as the 24/7 Stroke Neurologist Support Service)
11,572 hours to 16,640 clients.
23,449 direct hours to 28,161 clients.
There were 7.9% potentially preventable admissions (target 8.5%).
The NDIS program has provided services to 181 children and 69 adults.

There were 8,559 renal dialysis separations undertaken at Gawler, Mount Barker and South Coast Hospital dialysis units.

Conducted 225 consultations with 21 patients recommended for thrombolysis with an average door to needle time of 87 minutes.  Nine patients were recommended for an endovascular thrombectomy (surgical clot removal), 57 patients requiring expedited retrieval, 55 of these patients transferred to a metropolitan hospital. 80 transfers were avoided through timely assessment and treatment advice.
Improving access to health services in our community Continued
  • ICCnet SA – Catch – Telephone Cardiac Rehabilitation Programs
  • ICCnet SA – My Health Point of Care Innovative Technologies Trial (My Health PoCiTT)
  • ICCnet SA – Virtual Clinic Care (VCC)
  • Telerehabilitation Consultations
  • Patient Assistance Transport Scheme (PATS)
660 referrals to telephone programs with 70% uptake of programs and subsequent 89% completion rate of entire programs. 

Supporting 25 General Practice sites with Point of Care Testing and Virtual Home Monitoring, with over 75 patients commencing home monitoring.  

Increased suite of chronic disease interviews to 85 different interview combinations.

Technical Support provided to VCC by iCCnet for 102 cases with average of 12.86 minutes per case.

13,600 video enabled rehabilitation sessions.

Number of clients – 16,195.

Number of travel kilometres supported – 14,114,307.

Nights of accommodation supported – 75,702.
Hospital Services BHFLHN
  • Emergency Department Seen on Time
  • Elective Surgery Timely Admissions
  • Acute Inpatient Activity
Targets were met across triage levels 2-5. 

Triage 1 seen on time was 98.9%.

Targets were met prior to COVID-19 elective surgery restrictions.

19,634 same day patients and 11,677 overnight patients were admitted with 1,145 babies delivered.
Continuous improvement of quality and safety BHFLHN
  • Safety Assessment Code (SAC) 1 and 2 Incidents
  • Hospital Acquired Complications (HACs)
There were 20 (SAC) 1 and 2 incidents, compared to 25 last year, a decrease of 20%. 

Overall there was a 0.95% decrease in reporting of patient incidents, with SAC 1 and 2 incidents accounting for 0.55% of all incidents reported.

There were 106 HACs in 2019-20, a reduction from 157 in 2018-19.
Aboriginal Health BHFLHN
  • Aboriginal Health – Left ED at Own Risk
  • Aboriginal Family Birthing Program
  • Aboriginal Percentage of Workforce
4.2% (target <3%), an increase from previous year (3.4%).

27 Births. 2.1% (target 4%), increase from previous year (2%).
Improving mental health outcomes
  • Seclusion incidents per 1,000 bed days.
  • Percentage of mental health clients seen by a community health service within seven days of discharge.
  • 28 day readmission rate.
1.1% (target 3%), decrease from previous year (2.3%).

88% (target>80%), an increase from the previous year (79%).

14.6% (target 12%), an increase from the previous year (10.4%).
Aged Care
  • Residential Aged Care Occupancy (Commonwealth Residential Aged Care)
  • Aged Care Assessment Program Assessments.
  • Home Care Package rates.
  • Commonwealth Home Support Program (CHSP) client numbers.
84% compared to 87% in 2018-19.

1,949 ACAP assessments completed. 

359 assessments over target.

Provided 206 packages in June 2020, compared to 177 packages in June 2019, an increase of 29 packages. 4,568 CHSP clients, enabling older people to remain independent in their own home for longer.

Corporate performance summary

BHFLHN achieved key corporate performance outcomes including:

  • Completed a staff Secure Car Park expansion at Gawler increasing capacity for a further 116 car parks.
  • Completed Fire Safety Assessments at Gumeracha, Mount Pleasant, Kangaroo Island, Tanunda and Angaston.
  • Completed a Fire Safety project at Southern Fleurieu Health Service, comprising sophisticated fire tanks and pumps that allows a level of self-sufficiency and fire security for the site.
  • Completed a Distribution Board and Generator upgrade at Tanunda Hospital.
  • Completed demolition of office and accommodation buildings at Strathalbyn site and re-housed displaced staff.
  • Developed a Barossa Hospital Business Case.
  • Commenced planning and implementation of significant capital investments including:
    • $11.4 million ($7.5 million state, $3.9 million federal) funding for a new 36-bed aged care facility at Strathalbyn.
    • $8.6 million funding for the Mount Barker emergency department upgrade.
    • $8.4 million for Southern Fleurieu Health Service site development planning.
  • Undertook a collective Leadership Survey of Governing Board, Executive and Senior Managers.
  • Undertook Individual Leadership Circle 360s by all members of Executive and 35 Senior Managers.
  • Attendance of 130 staff at the new face to face Orientation program.
  • Meeting the target for the rate of new workplace injury claims and early assessment for rehabilitation.
  • BHFLHN incurred approximately $2.4 million expenditure in its response to the COVID-19 pandemic.

Rural Support Service

RSS achieved key corporate performance outcomes including:

  • 213 nurses and midwives completed the Emergency Nurse and Midwife Education Program (ENAME) program.
  • Reduction rate of 1.6% of red blood cell wastage (annual average) across regional LHNs, falling below the national target of 2%.
  • Developed the Regional Blood Supply Management Plan in response to COVID-19.
  • Established Maternity Care Virtual Clinics in six regional LHNs.
  • Launched Maternity Referral Platform, developed in partnership with iPOCCS.

Employment opportunity programs

Program name Performance
Aboriginal Employment Program Through aboriginal employment initiatives, BHFLHN employed nine people who identified as Aboriginal or Torres Strait Islander.
Enrolled Nurse Cadet program One student commenced the program in 2019-20.  This targeted recruitment strategy offers a training and employment pathway for rural people to commence their health career.
Growing Leaders 91 emerging leaders from BHFLHN and RSS have completed or are currently completing the Growing Leaders Program.
Scholarships 17 scholarships were awarded across regional LHNs as part of the 2020 scholarship intake, this included:
  • Six Rural Undergraduates with one awarded from each LHN.
  • One Margaret Tobin Mental Health Scholarship. 
  • 10  regional LHN scholarships.

Agency performance management and development systems

Performance management and development system Performance
Performance Review and Development is a process for supporting continuous improvement of employees’ work performance to assist them to meet SA Health values and objectives 1,951 BHFLHN employees (77.6%) have participated in a PRD review within the twelve months prior to 30 June 2020. 1,339 BHFLHN employees (53.2%) have participated in a PRD review within the six months prior to 30 June 2020.
  • BHFLHN data includes Rural Support Service.

Work health, safety and return to work programs

Program name Performance
Internal Audit Program 258 (100%) completed of the 258 scheduled. The Senior Work Health and Safety Consultants also completed self-assessment audits for each site against the Red Dot Mobility Program procedure to determine the level of implementation and conformance to the requirements in the procedure. There were four recommendations and three opportunities for improvement noted against the six audit criteria.
Worksite Safety Inspection Program 160 (98%) completed of the 164 scheduled.
Emergency Exercise Program 60 (100%) completed of the 60 scheduled, an additional 12 exercises were undertaken:
  • 15 Code Red
  • 15 Code Yellow
  • 15 Code Black
  • 14 Code Orange
  • 13 Code Brown
Corrective Action Plan In the fourth quarter, 122 actions were added to the Work Health and Safety Corrective Action Plan (CAP) and 95 actions were closed. 155 actions remain open, 22 (21%) more actions compared to the second quarter. Of the 155 open actions, 68 (44%) have been open for greater than 3 months.  22 (14%) have been open for greater than 1 year.
1800 Injury Reporting *See table below

1800 Injury Reporting:

 

Jul

Aug

Sept

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Total number of 1800 number calls for month 26 20 33 34 26 22 20 24 27 20 20 35
Number of calls made on the same shift 18 15 21 19 15 15 12 11 13 14 13 24
% of calls made on the same shift 69% 75% 64% 56% 58% 68% 60% 46% 48% 70% 65% 69%
Number of calls within 2 business days 23 20 31 30 24 18 19 21 23 18 18 32
% of calls made within 2 business days 89% 100% 94% 88% 92% 86% 90% 88% 85% 90% 90% 91%
  • BHFLHN data includes Rural Support Service
Workplace injury claims Current year
 2019-20
Past year 2018-19 % Change
(+ / -)
Total new workplace injury claims 59 51 +15.7%
Fatalities 0 0 0%
Seriously injured workers* 0 0 0%
Significant injuries (where lost time exceeds a working week, expressed as frequency rate per 1000 FTE) 11.92 10.83 +10.1%

*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)

  • BHFLHN data includes Rural Support Service.
Work health and safety regulations Current year 2019-20 Past year 2018-19 % Change
(+ / -)
Number of notifiable incidents (Work Health and Safety Act 2012, Part 3) 4 7 -42.9%
Number of provisional improvement, improvement and prohibition notices (Work Health and Safety Act 2012 Sections 90, 191 and 195) 0 0 0%
  • BHFLHN data includes Rural Support Service.
Return to work costs** Current year 2019-20 Past year 2018-19 % Change
(+ / -)
Total gross workers compensation expenditure ($) 990,528 1,466,217 -32.4%
Income support payments – gross ($) 404,835 421,979 -4.1%

**before third party recovery

  • BHFLHN data includes Rural Support Service.

With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: https://data.sa.gov.au/data/dataset/country-health-sa-local-health-network

Executive employment in the agency

Executive classification Number of executives
SAES1 2
SAES2 1
  • BHFLHN data includes Rural Support Service.

With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: https://data.sa.gov.au/data/dataset/country-health-sa-local-health-network

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.

Financial performance

Financial performance at a glance

During 2017-18, the Health Care Act 2008 was amended to facilitate six new regional Local Health Networks.  These regional LHNs and their governing boards become fully operational from 1 July 2019 and have assumed responsibility for health services previously provided by the Country Health SA Local Health Network.

The following table and charts provide a brief summary of the overall financial performance of BHFLHN.  Audited financial statements for 2019-20 are attached to this report.

Statement of Comprehensive Income 2019-20 Budget
$000s
2019-20 Actual
$000s
Variation
$000s
Past year 2018-19 Actual
$000s
Total Income 271,906 275,584 3,182 Not Applicable
Total Expenses 276,665 282,460 -5,602 Not Applicable
Net Result 4,759 6,876 -2,420 Not Applicable
Total Comprehensive Result 4,759 6,876 -2,420 Not Applicable


Statement of Financial Position 2019-20 Budget
$000s
2019-20 Actual
$000s
Variation
$000s
Past year 2018-19  Actual
$000s
Net cash provided by operating activities Not Applicable 6,276 Not Applicable Not Applicable
Current assets Not Applicable 34,860 Not Applicable Not Applicable
Non-current assets Not Applicable 149,213 Not Applicable Not Applicable
Total assets Not Applicable 184,073 Not Applicable Not Applicable
Current liabilities Not Applicable 57,087 Not Applicable Not Applicable
Non-current liabilities Not Applicable 37,939 Not Applicable Not Applicable
Total liabilities Not Applicable 95,026 Not Applicable Not Applicable
Net assets Not Applicable 89,047 Not Applicable Not Applicable
Equity Not Applicable 89,047 Not Applicable Not Applicable

Expenses by category 2019-20

Staff benefit expenses: $168.5m

Supplies and services: $102.6m

Depreciation and amortisation expense: $9m

Grants and subsidies: $1m

Other expenses: $1.2m

Income by category 2019-20 (excl Revenue from SA Government)

Revenues from fees and charges: $50m

Grants and contributions: $29m

Interest revenues: $0.4m

Resources received free of charge: $3m

Other revenues/income: $0.5m

Consultants disclosure

The following is a summary of external consultants that have been engaged by the agency, the nature of work undertaken, and the actual payments made for the work undertaken during the financial year.

Consultancies with a contract value below $10,000 each

  • BHFLHN data includes Rural Support Service.
Consultancies Purpose $ Actual payment
All consultancies below $10,000 each - combined Various $ 26,790

Consultancies with a contract value above $10,000 each

  • BHFLHN data includes Rural Support Service.
Consultancies Purpose $ Actual payment
GPEX Limited Medical Specialty Career Decision Making Research project $ 147,892
Centre for International Economics Review of service delivery models of the Medical Services for hospitals in the Barossa Hills Fleurieu Region $ 74,270
Babyboomers Pty Ltd Lifestyle Program Toolkit and Program for MPS (Multi-Purpose Service) Care $ 30,502
Babyboomers Pty Ltd Model of Care for Local Health Networks $18,268
  Total $ 270,932

With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: https://data.sa.gov.au/data/dataset/country-health-sa-local-health-network

See also the Consolidated Financial Report of the Department of Treasury and Finance for total value of consultancy contracts across the South Australian Public Sector.

Contractors disclosure

The following is a summary of external contractors that have been engaged by the agency, the nature of work undertaken, and the actual payments made for work undertaken during the financial year.

Contractors with a contract value below $10,000

  • BHFLHN data includes Rural Support Service.
Contractors Purpose $ Actual payment
All contractors below $10,000 each - combined Various $ 141,581

Contractors with a contract value above $10,000 each

  • BHFLHN data includes Rural Support Service.
Contractors Purpose $ Actual payment
HCA - Healthcare Australia Agency 1,011,863
Your Nursing Agency Pty Ltd Agency 279,779
Mediserve Nursing Agency Agency 115,510
Avancii Services provided for Barossa Hills Fleurieu Region 114,300
Matthew Flinders Home Inc Social Support Group and Transitional Care Packages 98,835
Medrecruit Pty Ltd Agency 89,972
Resthaven Inc Transitional Care Packages and Day Therapy Services 79,938
Victoria Road Medical Clinic Chief Obstetric Consultant 74,902
Boandik Lodge Inc Transitional Care Packages and End of Life Choices Funding 73,152
Hays Specialist Recruitment (Australia) Pty Limited Agency 72,362
NSW Business Chamber Ltd Agency 67,460
The Clare Medical Service Trust Anaesthetics expertise - Dr P Gribble 65,389
Rexco People Agency 61,053
Altaira Nursing Services Agency 59,735
Rural Locum Scheme Pty Ltd Agency 55,120
Mintoneast And Associates Pty Ltd Budget Pressures and Efficiencies Project 58,850
Hartfield Health Planning Provision of Health Planning Consultancy Services 54,004
Wavelength International Pty Limited Agency 50,760
Elizabeth Pengilly Services provided for Barossa Hills Fleurieu Region Community Health Clients 44,200
Recruitment Solutions Group Australia Pty Ltd Agency 40,760
Steve Nicholls Services provided for Barossa Hills Fleurieu Region Community Health Clients 40,133
Rosemary Decker Services provided for Barossa Hills Fleurieu Region Community Health Clients 36,213
Kemp Recruitment Pty Ltd Agency 34,973
System Solutions Engineering Pty Ltd Engineering Services - Whyalla Hospital 32,964
My Care Solution Pty Ltd Client Care Support Services 32,856
Sharon Cole Domestic Assistance, Personal Care & Social Support 24,614
Susan Cash Services provided for Barossa Hills Fleurieu Region Community Health Clients 24,564
Michael Beckoff Clinical Advisor Position 22,753
Rosey Batt & Associates Rural Support Services Governance Fees 22,000
Mcarthur Management Services (SA) Pty Ltd Agency 21,182
Aurecon Australasia Pty Ltd Country  Health Asset Sustainment Program - Project Management Support 20,480
David Wittkowsky Domestic assistance 20,280
Rachel Jane Beaumont Services provided for Hills Southern Fleurieu Kangaroo Island Clients 19,829
Debra Drake Home and Community Care personal care 15,975
Randstad Pty Limited Agency 15,614
WSP Australia Pty Ltd Fire Resilience Assessments 14,685
Kompletecare Community And Home Care Services Personal Care, Domestic Assistance, Respite 14,403
Guangli Zhu Nursing Services 14,254
Matt Linnett Administrative Services 13,963
Leeanne McLeod Services provided for Barossa Hills Fleurieu Region Clients 13,832
Energy Architecture Pty Ltd Architects - Kingston Lighthouse Lodge Drawings 12,500
Sonia Schutz Clinical Leads Meetings 12,424
Marchese Partners Architectural Services 11,820
Jennifer Rezmann Services provided for Barossa Hills Fleurieu Region Community Health Clients 11,805
Active Retirement Services Accredited Exercise Physiologist Services 11,040
  Total $3,083,100

With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: https://data.sa.gov.au/data/dataset/country-health-sa-local-health-network

The details of South Australian Government-awarded contracts for goods, services, and works are displayed on the SA Tenders and Contracts website. View the agency list of contracts.

The website also provides details of across government contracts.

Risk management

Risk and audit at a glance

BHFLHN have established an Audit and Risk Committee (ARC) with an independent Chair, reporting to the Governing Board to assist the Board in fulfilling its responsibilities regarding risk management, audit and assurance.

The ARC meets quarterly and receives regular risk reports from BHFLHN as well as reports resulting from audits conducted by the Auditor-General’s office, Department for Health and Wellbeing (DHW), and internally by the Rural Support Service (RSS).

The Board has endorsed an Interim Risk Management Framework which is consistent with the System-Wide Risk Management Policy Directive, providing specific guidance on context, identification, analysis, evaluation, treatment, monitoring and communication of risk.  The framework is provided as an interim document and will be reviewed following development of, and in consideration of, BHFLHN’s risk appetite statement.

An Audit Charter has been developed by the RSS enabling the internal audit function to be delivered by the RSS.  The Charter provides guidance and authority for audit activities.

Fraud detected in the agency

Category/nature of fraud Number of instances
Time and Attendance Records 1
Personal Use of Business Resources 1
Asset Misappropriation 1

NB: Fraud reported includes actual and reasonably suspected incidents of fraud.

Strategies implemented to control and prevent fraud  

BHFLHN Local Health Network processes implemented to help control and prevent fraud include the following:

  • Establishment of an Audit and Risk Committee providing advice directly to the Governing Board about any instances of fraud reported to the Independent Commission Against Corruption and to the Department for Health and Wellbeing’s Risk and Audits Branch.
  • Internally, organisational finances are reviewed monthly by the Performance Committee chaired by the Executive Director Finance Services.
  • The Corporate Governance Committee chaired by the Director Corporate Services reviews outstanding debts and debt write-offs on a monthly basis.
  • An annual Financial Controls Self-Assessment is undertaken to ensure that controls are in place to avoid fraud.
  • An Annual Declaration of Interests Procedure and registers exist to monitor any conflicts of interest.

With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: https://data.sa.gov.au/data/dataset/country-health-sa-local-health-network

Public interest disclosure

Number of occasions on which public interest information has been disclosed to a responsible officer of the agency under the Public Interest Disclosure Act 20180

With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: https://data.sa.gov.au/data/dataset/country-health-sa-local-health-network

Note:  Disclosure of public interest information was previously reported under the Whistleblowers Protection Act 1993 and repealed by the Public Interest Disclosure Act 2018 on 1/7/2019.

Reporting required under any other act or regulation

Act or Regulation

Requirement

Nil  

Reporting required under the Carers’ Recognition Act 2005

BHFLHN is continuing to work towards their Consumer Engagement Strategy involving all aspects of the health service, include aged care services.

While respecting consumer choices carers are provided a choice in the caring capacity in all health services. They are regularly involved in case conferences regarding a consumer to operate as an advocate, contributing to the individual’s health and well-being. Health services in BHFLHN respect the level of involvement of the next of kin or ‘carer’. Where issues are identified support is gained from various services to ensure the carer’s health and well-being is also acknowledged and catered for. An example of this are the availability of respite services within the aged care environment allowing the carer rest, while their loved one is receiving the care they require.

Information provided to carers is easy to read and understand making it possible for consultation when informed care decisions are required. All health care sites ensure support when requiring access to external providers to assist with care provision or advocacy.

At time where the carer of a consumer identifies as an Aboriginal person or Torres Strait Islander resources are allocated to ensure the consumers of the health service feel culturally safe. Resources available include the Aboriginal Health Team and community health services. Staff are provided with culturally safe health care provision which is mandatory, ensuring they are aware of issues that Aboriginal or Torres Strait Islander people may encounter when accessing health services in BHFLHN ensuring appropriate recognition and response.

BHFLHN is particularly interested in their health care environments and how consumers and their carers interact with our spaces. Dementia Support Australia resources have been gathered to audit all facilities to ensure they become ‘Dementia friendly’, while also ensuring our health services are culturally safe for all.

Ensuring all that are involved in the health service are able to reach their full potential to contribute to community and feel valued as an individual is of vital importance to BHFLHN.

BHFLHN has a staff orientation and induction program and a mandatory staff training program that ensures staff are educated about the Carers Charter.

BHFLHN has a comprehensive consumer engagement strategy and regularly consults with Health Advisory Councils and other representative groups when developing policies and programs that affect consumers or carers when undertaking strategic or operational planning.

BHFLHN actively encourages consumer and carer engagement in our health services and actively seeks feedback from consumers and carers about the services that we provide.

Public complaints

Number of public complaints reported

A whole of SA Health response will be provided in the 2019-20 Department for Health and Wellbeing Annual Report, which can be accessed on the SA Health website.

Complaint categories Sub-categories Example Number of Complaints
Professional behaviour Staff attitude Failure to demonstrate values such as empathy, respect, fairness, courtesy, extra mile; cultural competency 51
Professional behaviour Staff competency Failure to action service request; poorly informed decisions; incorrect or incomplete service provided 3
Professional behaviour Staff knowledge Lack of service specific knowledge; incomplete or out-of-date knowledge 0
Communication Communication quality Inadequate, delayed or absent communication with customer 22
Communication Confidentiality Customer’s confidentiality or privacy not respected; information shared incorrectly 11
Service delivery Systems/technology System offline; inaccessible to customer; incorrect result/information provided; poor system design 5
Service delivery Access to services Service difficult to find; location poor; facilities/ environment poor standard; not accessible to customers with disabilities 7

Complaint categories Sub-categories Example Number of Complaints
Service delivery Process Processing error; incorrect process used; delay in processing application; process not customer responsive 0
Policy Policy application Incorrect policy interpretation; incorrect policy applied; conflicting policy advice given 0
Policy Policy content Policy content difficult to understand; policy unreasonable or disadvantages customer 0
Service quality Information Incorrect, incomplete, out dated or inadequate information; not fit for purpose 0
Service quality Access to information Information difficult to understand, hard to find or difficult to use; not plain English 24
Service quality Timeliness Lack of staff punctuality; excessive waiting times (outside of service standard); timelines not met 20
Service quality Safety Maintenance; personal or family safety; duty of care not shown; poor security service/ premises; poor cleanliness 47
Service quality Service responsiveness Service design doesn’t meet customer needs; poor service fit with customer expectations 0
No case to answer No case to answer Third party; customer misunderstanding; redirected to another agency; insufficient information to investigate 0
Cost Cost Billing practices; government subsidies; information on cots 20

Complaint categories

Sub-categories

Example

Number of Complaints

Treatment Treatment Coordination of treatment; diagnosis; inadequate treatment 78
Administration Services Corporate Services Administrative services; lost property 2
No Category Recorded     10
    Total 300
  • BHFLHN data includes Rural Support Service
Additional Metrics Total
Number of positive feedback comments 739
Number of negative feedback comments 286
Total number of feedback comments 1,076
% complaints resolved within policy timeframes Not applicable
  • BHFLHN data includes Rural Support Service.


With effect from 1 July 2019, six new Regional LHNs replaced Country Health SA Local Health Network. To access data published for reporting periods prior to 2019-20, please see Data for previous years is available at: Department for Health and Wellbeing

Service Improvements resulting from complaints or consumer suggestions over 2019-20

  • Review and update of scheduled cleaning of common areas.
  • Gluten free and vegetarian options expanded and made available on menu.
  • Coffee machine installed in Accident and Emergency department for consumer access.
  • Signage reviewed and updated.