Breadcrumbs

Frequently Asked Questions

What are the main changes proposed?

The State Government is establishing 10 Local Health Networks (LHNs), each with its own Governing Board, which will be operational from 1 July 2019. From this date, six new regional LHNs will replace Country Health SA LHN.

In addition, the Department for Health and Wellbeing (the Department) will take on a revised role, complementing and supporting the LHNs through high-level system direction and performance management, as well as its government departmental roles to support the Minister and Chief Executive in exercising their responsibilities. 

In addition, two other key Government initiatives are being progressed, to establish
Wellbeing SA and a Commission on Excellence and Innovation in Health.

Why are Governing Boards being established?

The South Australian public health system is a large and complex network of hospitals, health services and community based care. It has an annual budget of around $6 billion, over 38,000 staff, and delivers health services located across a large geographic area.

SA Health faces many challenges, including increasing demand on our Emergency Departments and health services, the prevalence of chronic diseases and people with complex health needs, and an ageing population.

Currently, SA Health is centrally managed, with all authority and accountability resting with the Chief Executive of SA Health.

There is an opportunity for us to be more responsive and innovative in meeting the needs of local communities, including how we support vulnerable people in our community.

Establishing LHN Governing Boards provides an exciting opportunity to establish local accountability, responsibility and decision making for local health services closer to where they are delivered. 

This will achieve better health service decisions tailored to local needs and deliver a safe, high quality and financially sustainable health system into the future.

What are the roles and responsibilities of the Governing Boards?

From 1 July 2019, each Governing Board will be accountable to the Minister for Health and Wellbeing for the delivery of health services within its LHN and will have responsibility for:

  • safe, high-quality and accessible services;
  • being reflective of local values, needs and priorities; and
  • being sustainable within the resources available.

Each Governing Board will:

  • appoint its LHN’s Chief Executive Officer (as vacancies occur) after consultation with the SA Health Chief Executive;
  • have responsibility for delivering safety and quality in their LHN;
  • oversee the efficient, effective and economic operation of its LHN’s health services and budget to achieve the LHN’s performance targets; and
  • establish strong relationships with local communities and frontline health professionals, particularly through the development of clinical and community engagement strategies.

What are the expected benefits of the reforms?

The expected benefits of the governance reforms are:

  • Improved value in terms of quality and safety of services, costs and service accessibility
  • Increased clinician and community engagement in service delivery
  • Greater service responsiveness and innovation in the way services are provided
  • Increased community confidence in our state’s public health system.

How will the benefits be achieved?

The expected benefits can be achieved by:

  • A clear understanding of roles and functions, enabling better decisions and working relationships and partnerships across the system, including the Department for Health and Wellbeing as a system manager and LHNs as service providers
  • A system that provides for greater decision making and accountability at the local level, to drive best practice and innovation in the delivery of safe and quality public health services across a range of settings
  • A strong financial management and accountability framework that prioritises investment in high value, evidence-informed service responses and system sustainability at a local level
  • A leadership culture that supports accountability, transparency, collaboration, and encourages innovation.

How and when will governance changes occur?

Establishing decision making and responsibility at the local level involves significant planning and consideration of how the public health system will work as a whole. This requires detailed consideration of functions, roles, responsibilities and accountabilities across SA Health.

In the lead up to 1 July 2019, the program of work will include finalising the future state design for the public health system, as well as capability development and transition planning and implementation. Board member recruitment will be completed, and inductions undertaken. As they are appointed, Governing Boards will initially act in an advisory capacity and will have a pivotal role in supporting their LHN with the smooth transition to a new governance model.

The first phase will be implemented on 1 July 2019 when the LHN Governing Boards become operational. From this date, the Department for Health and Wellbeing will also take on a revised role, complementing and supporting the LHNs through high-level system direction and performance management. The Department will also continue its departmental functions by providing support to the Minister for Health and Wellbeing and the Chief Executive, SA Health, in exercising their functions.

The second phase will commence from 1 July 2019. This phase will involve transition planning and implementation for Wellbeing SA and the Commission on Excellence and Innovation in Health.

A high-level timeline for the planning and implementation of the reforms is available on the Governance Reform Timeline page.

How are Local Health Networks changing?

SA Health currently has six LHNs. Under the governance reforms, there will be 10 LHNs, each with its own Governing Board. Country Health SA LHN will remain until 30 June 2019.

Six new regional LHNs have been established using the same boundaries as the current Country Health SA LHN regions and will be operational from 1 July 2019.

Statewide

  • Women’s and Children’s Health Network

Metropolitan

  • Central Adelaide Local Health Network
  • Southern Adelaide Local Health Network
  • Northern Adelaide Local Health Network

Regional

  • Barossa Hills Fleurieu Local Health Network
  • Yorke and Northern Local Health Network
  • Flinders and Upper North Local Health Network
  • Riverland Mallee Coorong Local Health Network
  • Eyre and Far North Local Health Network
  • South East Local Health Network

Will there be changes to the Department for Health and Wellbeing?

Yes. The Department is being realigned to ensure we can build our analytical and commissioning capability and develop into a world-leading Department for Health and Wellbeing.

The Department will continue to have an important role in setting the strategic directions for the health system, and in supporting the Minister and the Chief Executive in exercising their functions and powers and meeting their obligations.

Proposed changes to the structure of the Department will:

  • Be more consistent in grouping of divisions around key system leader functions.
  • Build capacity and capability in new areas and functions.
  • Be reflective of leading health department roles and functions.

The future role of the Department and its functions are being worked through with Department staff and their representatives .

It is anticipated that a new organisational structure for the Department will be in place by 6 May 2019.

Will there be changes for Country Health SA before 1 July 2019?

Country Health SA LHN will continue in its current form until 30 June 2019. From 1 July 2019, Country Health SA LHN will be replaced by six new regional LHNs, each with its own Governing Board.

Planning for the transition process is underway and staff and their representatives are involved in this process.

Chief Executive Officers (CEOs) have been appointed for each of the regional LHNs. Initially they will be Deputy CEOs, reporting to the CEO of Country Health SA until 30 June 2019. View more information about the CEOs and interim arrangements on the Changes to Country Health SA page.

Will there be changes for to Statewide Clinical Support Services and SA Ambulance Service?

Statewide Clinical Support Services will remain in CALHN and will be reviewed at a later stage.

The governance arrangements for the SA Ambulance Service will remain unchanged.

What legislative changes are required?

Amendments to establish the Governing Boards under the Health Care Act 2008 were passed by Parliament on 26 July 2018 in the Health Care (Governance) Amendment Bill 2018. These amendments will be proclaimed to come into operation on 1 July 2019.

Further amendments to the Health Care Act 2008 will be introduced to Parliament in the first half of 2019 to further clarify roles and responsibilities including those relevant to the performance framework for the health system.

Will Health Advisory Councils be affected?

Health Advisory Councils ( HACs) currently exist in legislation under the Health Care Act 2008. The future roles and functions of the 39 country HACs, and how they can best operate within the new governance framework, will be discussed with HAC members over the course of these reforms.

There are also a number of other bodies established under the Health Care Act 2008 as HACs including the Local Health Network Governing Councils and other bodies providing advice to the Minister on population groups or specific matters. The future role of these bodies will be considered as part of a broader review of the governance arrangements for the public health system that will occur over the next 12 months.

What is Wellbeing SA?

Wellbeing SA will be a prevention, health promotion and primary health care agency, located within SA Health.

Responsibilities include, but are not limited to, advocating for and purchasing services for health promotion and hospital avoidance, focussing on minimising hospital admissions and brokering collaborations to jointly deliver better prevention, sub-acute and chronic disease management services.

As more information becomes available, it will be included on the SA Health intranet website

What is the Commission on Excellence and Innovation in Health?

The Commission on Excellence and Innovation in Health will provide leadership and advice within SA Health and the Government on clinical excellence and innovation.

The Commission will focus on maximising health outcomes for patients, improving care and safety, monitoring performance, championing evidence-based practice and clinical innovation, and supporting clinical collaboration.

The Commission will bring together expertise from clinicians, consumers, health partners and other relevant stakeholders to maximise health outcomes for patients.

As more information becomes available, it will be included on the SA Health intranet website

What is Digital Health SA?

Digital Health SA will be established, incorporating what is currently eHealth Systems, and will report directly into the Office of the Chief Executive, Department for Health and Wellbeing. Digital Health SA will provide state-wide system support services, centralising our digital focus to allow the Department to make best use of available technology across our public health system.

How can I provide feedback or ask further questions?

Please email comments, questions and suggestions about the Governance Reforms and Governing Boards to HealthGovernanceReform@sa.gov.au.

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