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1 North West Hospital and Health Service

2 Purpose of the report This annual report details the financial and non-financial performance of the North West Hospital and Health Service (North West HHS) from 1 July 2012 to 30 June It highlights the achievements, performance, outlook and financial position of the North West HHS, and satisfies the requirements of the Queensland Financial Accountability Act Public availability statement Copies of this annual report can be obtained at: or phone the Senior Communications Officer, Corporate Services Unit, Office of the Chief Executive on (07) Interpreter service statement The Queensland Government is committed to providing accessible services to Queenslanders from all culturally and linguistically diverse backgrounds. If you have difficulty in understanding the annual report, you can contact us on (07) and we will arrange an interpreter to effectively communicate the report to you. Your feedback The annual report is an important communication and accountability document. The North West Hospital and Health Service values comments and welcomes feedback from readers. To provide feedback, please contact us at: PO Box 127 MOUNT ISA QLD 4825 Phone: (07) Licence This annual report is licensed by the State of Queensland (North West Hospital and Health Service) under a Creative Commons Attribution (CC BY) 3.0 Australia Licence. CC BY Licence summary statement In essence, you are free to copy, communicate and adapt this annual report, as long as you attribute the work to the State of Queensland (North West Hospital and Health Service). To view a copy of this licence, visit: Attribution Content from this annual report should be attributed as: The State of Queensland (North West Hospital and Health Service) Annual Report ISSN: (Print) North West Hospital and Health Service 2013 Disclaimer This document has been prepared with all due diligence and care, based on the best available information at the time of publication. The North West Hospital and Health Service holds no responsibility for any errors or omissions within this document. Any decisions made by other parties based on this document are solely the responsibility of those parties. Information contained in this document is from a number of sources and, as such, does not necessarily represent the Queensland Government or North West Hospital and Health Service policy. Images contained within this document are courtesy of the North West Hospital and Health Service.

3 Letter of compliance The Honourable Lawrence Springborg MP Minister for Health Member for Southern Downs GPO Box 48 Brisbane QLD September 2013 Dear Minister I am pleased to present the Annual Report for the year ended 30 June 2013 for the North West Hospital and Health Service. I certify that this annual report complies with: the prescribed requirements of the Financial Accountability Act 2009 and the Financial and Performance Management Standard 2009 the detailed requirements set out in the Annual Report Requirements for Queensland Government Agencies. A checklist outlining the annual reporting requirements can be found on pages of this annual report. Yours sincerely Paul Woodhouse Board Chair North West Hospital and Health Service North West Hospital and Health Service Annual Report

4 2 North West Hospital and Health Service Annual Report

5 Contents Letter of compliance... 1 Message from the Chair... 4 Message from the Chief Executive... 5 Our profile... 6 In summary... 8 Our catchment area...12 Our partnerships...20 Quality, safety and risk management...21 Highlights Significant issues...28 Staff profiles...30 Health reform...32 Government s objectives for the community...33 Chief Finance Officer Statement...35 Activity summary Financial Performance Summary Our performance...40 Governance management and structure...50 North West Hospital and Health Executive...56 Governance risk management and accountability...63 Governance human resources...65 Compliance checklist...66 Glossary...68 Financial statements...71 North West Hospital and Health Service Annual Report

6 Message from the Chair In presenting the inaugural Annual Chair s Report for the North West Hospital and Health Service, I offer a mixture of professional and personal opinion and on this unique occasion seek the indulgence of all statutory scrutineers in doing so. Following the formal adoption of regional health governance by the Queensland Government under the National Health Reform Agenda, sixteen area specific and one state-wide Hospital and Health Service were established across Queensland on the 1 of July During a period of several months leading up to 1 July, as well as the twelve months since, it has been an exceptional privilege and pleasure to work with the State Government, the Health Minister, the Board and all of our staff and communities across the North West HHS region. I must report that it has also, almost without exception been an extremely challenging period for the new statutory health body as we not only seek to gain further and improved control of our finances, but as we receive and work through, very confronting and often debilitating asset and infrastructure issues. While these issues and others such as more autonomy with respect to employment and fiscal control are not unexpected in any transition from a centralised model to a more devolved approach, it is also understood that government itself must be confident in its Boards, their maturity and their processes. Between then, the local need for more ownership and control, and the design of central processes to devolve control and ownership, I am confident that following these last twelve months, the North West HHS is now worthy of trust as a key partner in health, and as a deliverer of health services and improved future health strategies for Queensland. It is also to be recognised that the faith and trust required in devolving health outcomes to autonomous Hospital and Health Services across Queensland would have been, and continues to be, a large leap of faith for any government in terms of trust and accountability. It is here that I also recognise the stalwart support of the Queensland Government and of the Health Minister in particular. Through the continuing work of the Health Renewal Executive Committee and the Progressive Autonomy Projects Board, it is acknowledged that the two main focuses for this autonomy work are prescribed employer responsibility and land and building transfer. Responsibility in these two key areas alone will not only determine much about how we set our strategy and align our workforce, but will require even more discipline with respect to how we manage and maintain our finances and our assets for the future. To meet many of these challenges the Board has elected to complement the three Committees required under the Hospital and Health Board Act 2011, with a Business Development Committee. This Committee will progressively challenge historical aspects of the way we are funded, and of the way we operate and deliver our services. It is only in this way, and by the provision of mature and objective advice to the Government can we better remodel and reshape health across the North West and meet not only the demands particular to this region as a whole, but to meet the particular needs of our communities. Over the past year, the start up work of our Committees has often been difficult but they have shown outstanding leadership. Our Committees will become increasingly focussed and demanding as they lead the change which is not only required in a statutory sense but which is also necessary in a cultural sense across the North West HHS. Local health governance brings with it many opportunities with respect to local ownership but perhaps none more so than the ability to allow every member of our staff the opportunity to share in and own the search for better practice, better cost control and improved efficiency. Over the last twelve months and extensive travels, I have never once ceased to be amazed and encouraged by the suggestions which come from staff either individually or in forums sharing their ideas about how things may or may not be done better in the future. The support and encouragement of good direction as well as the constant development of a challenge and change culture are fundamental tenets to our ability as a Board to allow all of our people and our communities to help set the future for health in the North West simply by understanding and owning both, the pitfalls and the potential. The results contained in this Annual Report I attribute to the very many people who have helped bring it about. If I am to make exception, it is to make special mention of our high performance in clinical services when benchmarked across the State, and to our improved financial discipline. In commending this Annual Report, I recognise the efforts of everyone across all of our communities and facilities who works for and partners with, the North West HHS for your very important role in providing the best of care. I also acknowledge my colleagues on the North West Hospital and Health Board. The North West is indeed fortunate to have such a mix of experience, commitment and compassion in the one room. In closing, I recognise and pay tribute to the North West HHS Chief Executive Sue Belsham, and her senior executive in bringing about this result in our first year of operations. Finally, I acknowledge the support and direction that the Minister for Health, The Hon. Lawrence Springborg MP has given to the North West HHS. His passion for improvement is evident, as is his personal commitment to making health work better in Queensland than anywhere else in Australia. Paul Woodhouse Chair, North West Hospital and Health Board 4 North West Hospital and Health Service Annual Report

7 Message from the Chief Executive The past year has seen many significant achievements for the North West Hospital and Health Service as well as a number of challenges that have had to be faced along the way. However it is with great pride that I am able to reflect on the last year and my first 12 months as the Chief Executive for the North West Hospital and Health Service. On the 1st July, 2012 the North West HHS was formally established under legislation by the Queensland Government as part of the implementation of the National Health Reform Agenda. The North West HHS is now an independent statutory body overseen by a local Hospital and Health Board with responsibility for providing public hospital and health services across the North West region. The North West HHS provides health services and achieves outcomes as defined in the Service Agreement with Queensland Health as manager of the public hospital system. The last twelve months has seen the successful transition to a Hospital and Health Service overseen by a board of eight (8) directors and Chair, Mr. Paul Woodhouse. In order to ensure that we are a responsive health service that delivers on priorities and meets the needs of the community and the individual; community and staff engagement and, consultation have been a priority throughout the last 12 months. Throughout the year, the North West HHS Board, Engagement Committee and the Executive Management Group have worked tirelessly in order to achieve this in a region where the population resides across a large geographical area. A highlight in was our exceptional performance across a number of areas. The North West HHS achieved most financial and efficiency targets and realised a budget surplus for the year. We performed exceptionally well throughout the year especially in regards to access to clinical services. This together with attaining the allocated Minimum Obligatory Human Resource Information target has now placed the North West HHS in a sound position to move into the next financial year. The recruitment of a Chief Finance Officer and Finance Manager will also ensure that we are well-placed to guarantee ongoing financial development that will maximise both internal and external opportunities. Quality, Safety and Risk have been a priority focus throughout with strategies implemented to improve governance, accountability and oversight to drive safe, high quality care. To ensure the North West HHS is best placed to meet its commitments to all consumers and staff an independent review of Quality, Safety and Risk has been completed with a final report and recommendations due by the end of July, The first Public Private Partnership for North West HHS with Laura Johnson Aged Care Facility was endorsed this year and is set to ensure that a high level of care will continue to be delivered through this partnership. Highlights during also included the opening of our new Emergency Department and regional Cancer Care Unit which are not only first class facilities but will ensure our patients receive the best care in the best facilities. The new and modern Aged Care Annexe in Cloncurry with expected completion in July 2013 will support the community of Cloncurry with an increase in available high care beds also saw the establishment of a Workforce Development Unit to support the ongoing growth of our Aboriginal and Torres Strait Islander workforce across the North West region. Of particular significance was the commencement of a partnership with Education Queensland to support four Aboriginal and Torres Strait Islander school-based apprenticeships. In October 2012 the Minister for Health, the Honourable Lawrence Springborg MP visited the North West HHS and opened the Burketown Primary Health Care Centre. During this visit he also met with staff and toured the Mount Isa Hospital as well as visiting the hospital and health services in Mornington Island and Cloncurry. November 2012 saw the North West HHS face a major challenge with the release of a report detailing structural issues that had been identified in Block C and the subsequent requirement for decanting of this block. The fundamental requirement for us at all times was ensuring the safety of both our patients and staff. The commitment of all our staff during this time, ensuring that our patients continued to receive the highest quality care during a very difficult time is a credit to all. It is with anticipation that we now move into the rectification works and subsequent recanting into Block C. Finally, I would like to thank the Executive Management Group and all staff for their ongoing support, enthusiasm and dedication over the past year, their commitment and expertise underpins the achievements made over the last 12 months. As we move into a new year, I look forward to working with our communities, the Board and all our staff to ensure we continue to deliver the best health care services, at the right time and in the right place. Sue Belsham Chief Executive, North West Hospital and Health Service North West Hospital and Health Service Annual Report

8 Our profile Our vision To be Queensland s leading Hospital and Health Service. We will lead Queensland s transformation to locally accountable Hospital and Health Service management by being innovative, creative and fiscally responsible. We will embrace change and forge close partnerships with others in the health sector, and with the private sector, in order to exceed the government s expectations and to become a proud employer of choice for our staff and throughout Queensland. Our purpose The North West Hospital and Health Service is responsible for providing high quality hospital and health care to the communities of North West Queensland. We are to secure our financial and statutory position by meeting our expenditure budgets and achieving revenue targets on a financial year basis. We are to embrace the need for change and make it work effectively and efficiently for the people of our region and our staff. The efficient delivery of our core hospital and health business services will be guided by the organisation s vision and values. Our service commitment The North West Hospital and Health Service is committed to the vision of becoming Queensland s leading Hospital and Health Service. To achieve this it is essential that the Service is responsive to the needs of our stakeholders, in particular the communities we serve and our valued workforce. This Plan will be continually informed by all stakeholders. These steps are necessary to restore accountability and confidence in the health system. 6 North West Hospital and Health Service Annual Report

9 Our values Our patients To provide better services to our patients. Our communities To work in close partnership with our communities to improve the healthcare to all people in North West Queensland and to Close the Gaps. Our staff Valuing our employees and working together to achieve healthy communities. Transparency and accountability To be accountable, provide value for money and to be open and honest in our operations. Our health service delivery To define and examine all models of care, in partnership, to achieve all opportunities for positive change and greater efficiency. Our partnerships To build productive partnerships in healthcare, and the delivery of hospital and health services. Ownership To enable and allow our staff, our communities and our people to own the vision and values of better health service delivery. Top right: Dianne Phillips (Burketown Director of Nursing), Paul Woodhouse (Board Chair, North West HHS), Sue Belsham (Chief Executive, North West HHS) and the Minister for Health, the Honourable Lawrence Springborg. North West Hospital and Health Service Annual Report

10 In summary Burketown Health Centre Mornington Island Doomadgee Karumba Health Centre Normanton North West Hospital and Health Service Camooweal Health Centre Mount Isa Cloncurry Julia Creek Hospital Health Centre Multipurpose Health Services Dajarra Health Centre Community Healthcare Centres The North West Hospital and Health Service (North West HHS) is an independent statutory body, established under the Hospital and Health Boards Act 2011 on 1 July 2012, by the Queensland Government as part of the implementation of the National Health Reform Agenda. North West HHS is overseen by a local Hospital and Health Board, with responsibility for providing public hospital and health services within north western Queensland and the Gulf of Carpentaria. The North West HHS encompasses the geographical areas of Mount Isa, Burketown, Camooweal, Cloncurry, Dajarra, Doomadgee, Julia Creek, Karumba, Mornington Island, Normanton and Urandangi. The North West HHS provide public health services and achieve health system outcomes as defined in the Service Agreement with Queensland Health as manager of the public hospital system. With an operating budget for of $ M, employing 603 FTE, the North West HHS is responsible for the direct management of the facilities within the geographical boundaries of the HHS including: Main referral centre at Mount Isa Hospital 2 x Multipurpose Health Services located at Cloncurry and Julia Creek 3 x rural/remote hospitals located at Doomadgee, Mornington Island and Normanton 4 x Primary Health Care Centres located at Burketown, Camooweal, Dajarra and Karumba 5 x Community Healthcare Centres located at Cloncurry, Doomadgee, Julia Creek, Mornington Island and Normanton. The portfolio Minister for the North West HHS, under the Administrative Arrangements order (No.3), 2012, is the Minister for Health, the Honourable Lawrence Springborg MP. Our principal place of business is located at 1 Barkly Highway, Mount Isa, Queensland. 8 North West Hospital and Health Service Annual Report

11 Our communities health Considering the whole population of the North West HHS, the major causes of death and illness include: Coronary heart disease Stroke Chronic obstructive pulmonary disease Depression Lung cancer. Health determinants of significant impact include: harmful alcohol consumption, smoking, overweight and obesity, poor nutrition, physical inactivity, and risk and protective factors for mental health. Due to the effect of geographical remoteness, the health issues and their determinants are likely to be exacerbated. In particular, in comparison to urban populations, rural and remote populations in Queensland will have greater death and illness due to injury and poisoning, particularly road transport injury. The major causes of death and illness for Aboriginal and Torres Strait Islanders in the North West HHS includes but is not limited to: Stroke, Coronary heart disease, Diabetes, Suicide, Unintentional Injury, and Mental Health Diagnosis. Health determinants of significant impact in this population include: poor diabetes management, overweight and obesity, poor nutrition, alcohol related disease, physical inactivity, high blood pressure, poor cholesterol management, smoking and family violence. Risk and protective factors for mental health have widespread effects on physical and mental health and the social determinants of health are of specific importance in this population, particularly housing, transport and social isolation. Aboriginal and Torres Strait Islanders (Queensland): Have a 10.4 year life expectancy gap to non-indigenous males Indigenous females have 8.9 year life expectancy gap to non-indigenous females Indigenous Queenslanders are admitted to hospital at a earlier age and higher rates than that of non-indigenous Queensland Aboriginal and Torres Strait Islander children experience higher rates of ear infections, hearing impairment, failure to thrive, child abuse and neglect, prematurity, rheumatic heart disease and anaemia. Above: The Minister for Health, the Honourable Lawrence Springborg, Dr Marjad Page, Francis (Aunty Fran) Page PSM Team Leader Aboriginal Workforce Development Unit and Noela Baigrie Nurse Educator during the Minister for Health s visit to Mount Isa Hospital in October Below: Mornington Island Hospital. North West Hospital and Health Service Annual Report

12 In summary The population and the geographical isolation of the North West HHS differs in many ways from the general Queensland population; therefore delivery of health care must be tailored to the unique requirements of the communities within the district. Geography North West Queensland and Lower Gulf of Carpentaria Area of 300,000 square kilometres 900 kilometres from Townsville 1,900 kilometres from Brisbane. Socio-economic factors 31.7 per cent of the North West HHS catchment population in the most socio-economically disadvantaged Aboriginal and Torres Strait Islander people in the North West HHS more likely to have higher rates of socio-economic disadvantage. 10 North West Hospital and Health Service Annual Report

13 Aboriginal and Torres Strait Islander population 25.7 per cent of North West HHS of Aboriginal and Torres Strait Islander descent Seven times higher than the 3.6 per cent of Queensland Aboriginal and Torres Strait Islander population 38.9 per cent of all 0 14 year-olds in the district 50.3 per cent of the North West HHS Aboriginal and Torres Strait Islander population reside in the City of Mount Isa 14.6 per cent reside in Doomadgee 12.6 per cent reside in Mornington Island. Visitors to the region Demand for health services in the North West HHS continues to be influenced by the mining sector and the impact of fly-in, fly-out workers, a mature pastoral industry and a developing tourism industry. Population (June 2010) 31, % of Queensland population 70% reside in Mount Isa 10.8% reside in Cloncurry. Population projections The North West HHS population is projected to increase by 14.1 per cent between 2011 and 2026 in comparison to the overall population growth projection for Queensland of 28.8 per cent The highest growth rate by percentage by age group between 2011 and 2026 is projected for people 65 years and over. North West Hospital and Health Service Annual Report

14 Our catchment area Mount Isa The city of Mount Isa is surrounded by the Selwyn Ranges on the banks of the Leichardt River. To the north lies the isolated Gulf Country and Savannah: the south is home to the Channel Country: the east is rich in pastoral grasslands and in the west the Simpson Desert stretches for hundreds of kilometres. Mount Isa is a progressive industrial, commercial and tourist centre with a thriving mining industry forming the backbone of the community. The Kalkadoon aboriginal people are the traditional owners of the land surrounding the Mount Isa region. Mount Isa City grew as a result of the rich mineral deposits in the region the first discovery is reported as being in 1923 when a seam of silver-lead was discovered by John Campbell Miles. Mining continues to be the largest industry in the area and the city has become the primary administration, commercial and industrial centre serving the north-west region of Queensland. Mount Isa is the largest city in the world, covering an area the size of Switzerland and with a main street 180 kilometres long and an area of 41,182 square kilometres and is the western gateway to Queensland. Mount Isa Hospital currently has 54 inpatient beds which was reduced in November 2012 from 76 inpatient beds due to major structural issues at the Mount Isa Hospital. The hospital also has an on-site eight-chair Renal Dialysis Unit managed as a satellite Haemodialysis Unit from the Townsville Hospital. Mount Isa provides resident services in emergency, general medicine, general surgery, obstetrics and gynecology and paediatrics. Low and medium risk birthing (from 36 weeks gestation) is carried out at the Mount Isa hospital, with the outlying rural hospitals providing for emergency/unplanned births only. North West Queensland Radiology provides medical imaging services to the district through a private outsourcing contract agreement. Co-located with Mount Isa Hospital they provide general computerised radiography, ultrasound, fluoroscopy, mammography and mobile trauma services through a digitalized Picture Archiving and Communication System. This includes transmission links from the districts outlying centers and other major hospitals across Queensland. The North West HHS also provides a comprehensive range of community and primary health services in Mount Isa with visiting services to the outlying facilities. These include: Aged care assessment Aboriginal and Torres Strait Islander health programs Child and maternal health services Mental health services Alcohol, tobacco and other drug services Home care services Community health nursing Sexual health service Allied health Oral health Health promotion programs. 12 North West Hospital and Health Service Annual Report

15 Cloncurry The township of Cloncurry was founded in 1967 by Ernest Henry. It was built upon copper mines in the surrounding district, which quickly led to it being one of the most prosperous towns in the Outback. Today, Cloncurry s core industries include grazing, copper and gold mining, transport and mining services. In June, 2011 the estimated resident population of Cloncurry Shire Local Government area was 3,410 persons. Cloncurry is accessible via sealed roads in all directions and is 124 kilometres from Mount Isa. Health and community facilities include the Cloncurry Multipurpose Health Centre, Community Health Centre, Flinder s Medical Centre, Bluecare, Centrecare, pathology service as well as the Garden Settlement retirement village. Cloncurry Hospital (25 Beds) provides a primary level of acute care services, the new Aged Care Annexe at Cloncurry will open in late 2013 and will increase the number of high care beds available. Cloncurry hospital transitioned to a Multipurpose Health Service in Services include: An emergency services component which manages resuscitation and stabilisation prior to referral to a secondary or tertiary hospital General management of medical and aged care patients General Practice Clinics Basic radiography Pathology Sample Collection Telehealth Other visiting health services including; Paediatrics, Mental Health Dietetics, Physiotherapy, Pharmacy, Podiatry, Oral Health and Child Health. Cloncurry Community Health Services include: Health assessment Liaison with hospitals, General Practitioners and other community agencies Coordination of discharge plans from admission to discharge from hospital to home to ensure continuity of care Health education Health promotion. North West Hospital and Health Service Annual Report

16 Our catchment area McKinlay Shire/Julia Creek As at 30 June 2010, the estimated resident population of McKinlay Shire Local Government Area (LGA) was 1,086 persons with approximately 634 persons living in the Julia Creek State Suburb (SS). The hospital is strategically located on the Flinders Highway which constitutes one of the most important interstate road routes in Australia. McKinlay and Kynuna are also located on the national highway network on the Landsborough Highway which forms the major inland route from Brisbane and Southern States to Darwin. Julia Creek is accessible via sealed road from Mt Isa (258 km) and is situated 664 kilometres west of Townsville. The flat downs country around Julia Creek was traditionally a cattle and sheep grazing area. Though Julia Creek still acts as cattle head for the export of live cattle, mining has taken over as the biggest source of income for the area. FREE VISITORS GUIDE & McKinlay Shire OUTBACK QUEENSLAND Julia Creek hospital transitioned to a Multipurpose Health Service in early Services include: 24-hour service for emergencies with ongoing referral and transfer dependant on patient acuity and requirements Outpatients with visiting specialist services including dental, allied health, women s health, mental health and varying specialists Inpatient capabilities of 8 beds for General medical, surgical and simple paediatric admissions (within CSCF Level 2 domains) Residential Aged Care 2 high care places with the capability of expanding to 7 and 1 palliative care bed Community Nursing Service which is jointly operated by Julia Creek MPHS and McKinlay Shire Council Telehealth/telemedicine facilities Basic radiography Physiotherapy Home Care Services. Due to the remote location situation in North West of Queensland this services collaborates with Royal Flying Doctor Service for the transfer of emergent and critical clients. No surgery is conducted within this service. Planning for will include: Transition and embed MPHS Model of Care for Julia Creek Community Develop a sustainable Mums and Bubs spoke Recruitment and Retention Strategies. The community demographics of the McKinlay Shire support the ongoing need for consideration of residential care beds as it is experiencing growth in the care of the elderly. 14 North West Hospital and Health Service Annual Report

17 Doomadgee Doomadgee is situated in Northwest Queensland, 100 kilometres inland from the Gulf of Carpentaria, 514 kilometres north of Mount Isa and 141 kilometres west of Burketown and 104 kilometres east of the Northern Territory border. At the time of the 2011 Census, there were 1,185 persons in Doomadgee Aboriginal Shire who stated they were of Aboriginal or Torres Strait Islander origin (92%) of the total population (compared with 3.6% in Queensland) The Doomadgee community was established when five family groups were relocated to Doomadgee from surrounding areas in approximately 1975, due to the availability of a fresh water supply. These included a number of different tribal groups such as the Ganggalida, Waanyi, Garrawa, Yanyula and Minginda. A mission was established on the banks of the Nicholson River. Until the early 1980s the Community was managed by the Mormon Church but is now managed by the Doomadgee Aboriginal Community Council. The number of Indigenous people aged 15 to 64 (the working-age population) is projected to increase by 25 per cent by 2026, from 643 to 804, over this period. The number of Indigenous people aged 65 years and above (the post-working age population) is projected to increase by 149 per cent over the same period. The changing size and age composition of the Indigenous population of Doomadgee will increase the need for housing and employment opportunities, as well as aged care and health services. Doomadgee provides a service point on the Savannah Way west of Burketown and is 138 kilometres from the Northern Territory border. The main road providing access to Doomadgee is the main transport link through to the Gulf of Carpentaria region and Northern Territory for road transport vehicles associated with mining, cattle transport and seasonal tourist traffic. Significant lengths of this road are unsealed and road access can be cut off to Doomadgee from both directions for weeks over the wet season. There is a commercial airstrip at Doomadgee, which is frequently used for fly-in, fly-out service providers. Doomadgee Rural Hospital provides seven acute in-patient admission beds. All health service provision aims to deliver safe, quality and effective care to the peoples of Mornington Island in a culturally appropriate environment. Key achievements during have included: Embracing Telehealth opportunities with real cost savings for the North West HHS and demonstrated patient care benefits Reviewing model of care and planning for implementation of a Primary Health Care model with a multidisciplinary focus Implementation of formal Chronic Disease recall processes Health promotion programs for year-olds. Health services include: 24 hour/7 days a week emergency service including resuscitation, stabilisation and transfer to referral hospitals Primary Health Assessment General management of medical and aged care patients Minor surgical procedures under local anaesthetic Basic radiography Pathology collection Antenatal care up to 38 weeks and postnatal care. Doomadgee Community Health services include, chronic disease management, liaison with hospitals, GPs etc. and coordination of discharge from hospital to home to ensure continuity of care. Visiting services include: Paediatrician, dentist, RFDS, Child Health and immunisation clinic, Deadly Ears Team, surgeon, vascular surgeon, gynaecologists, mental health team, chest physicians, diabetic outreach team, and cardiac team. North West Hospital and Health Service Annual Report

18 Our catchment area Mornington Island Mornington Island is a large island in the southern part of the Gulf of Carpentaria and is part of the Wellesley group of 22 islands. These islands are the traditional country of the Lardil, Yaugkaal and Kaiadilt people. There are strong family ties with people in Doomadgee, Burketown, Aurukun and Kowanyama. Mornington Island is administered by a local government authority (Mornington Shire Council) and covers the 22 islands of the Wellesley group (excluding Sweers Island, where a resort is located). There are almost 30 established out stations throughout the Shire. Most residents live in the township of Gununa. Mornington Island is an Indigenous community and permission needs to be sought from the Mornington Shire Council to visit. The estimated resident population of Mornington Shire is approximately 1246 people. Approximately 1005 people live on Mornington Island and 40 people live on Bentinck Island. As at 30 June 2031, the population for the region is projected to be 1,694 persons. The changing size and age composition of the Indigenous population of Mornington Island will increase the need for housing and employment opportunities, as well as aged care and health services. Mornington and Bentinck Islands are only accessible by boat and air. A regular barge delivers food to the community once a week while a fuel barge arrives once every two months. The barge landing is not serviceable during the full range of the tidal cycle. There is a sealed airstrip, which is frequently used for fly-in, fly-out health services. Health and community services on Mornington Island include the Hospital, Community health, Wellbeing Centre (CN and NWQML), Mission Australia and Save the Children community centre and child care centre. Mornington Island Rural Hospital is an eleven (11) bed hospital with all health service provision aiming to deliver safe, quality and effective care to the peoples of Mornington Island in a culturally appropriate environment. A key achievement during has seen the uptake and embrace of Telehealth services which has had positive benefits for the community preventing dislocation and enabling ongoing care. Mornington Island Hospital and Community Health provide: 24 hour/7 days a week emergency service including resuscitation, stabilisation and transfer to referral hospitals Primary Health Assessment General management of medical and aged care patients Minor surgical procedures under local anaesthetic Basic radiography Pathology collection Antenatal care up to 36 weeks and postnatal care Community Health Oral Health Services Family and Child Health (RFDS) Pharmacy. Visiting Services include: obstetrics and gynaecology, paediatrics, psychiatry, social work, podiatry, hearing health, physiotherapy, women s health and mental health. 16 North West Hospital and Health Service Annual Report

19 Normanton Normanton is one of the historic towns of North West Queensland, a rural and remote community serving a population of approximately 1,600 people. The population comprises a large Aboriginal community, rural workers, miners as well as a transit population of fisherman and tourists. As at 30 June 2011, the estimated resident population of Carpentaria Shire was 2,246 persons with 1468 residents in Normanton. Aboriginal and Torres Strait Islander people made up 47.5 per cent of the population. The Normanton area of the Gulf of Carpentaria holds the traditional lands of the Gkuthaarn, Kukatj, Kurtijar and Kokoberrin peoples. Normanton sits within the 68,111 square kilometres of the Carpentaria Shire and part of the only sealed access to the Gulf of Carpentaria. Normanton is located just south of the coast, 72 kilometres south of Karumba in the Gulf Country region of northwest Queensland. The shire is as large as Tasmania and only has two towns. Normanton is 700 kilometres to Cairns and 500 kilometres to Mount Isa. Normanton is accessible via a network of sealed and unsealed roads. Between December and March, some roads may be closed. There is a sealed airstrip in Normanton, which is frequently used for fly-in, fly-out health services. Normanton Hospital is an eighteen (18) bed Rural Hospital, comprising 14 acute inpatient beds and 4 respite/palliative care beds together with a 24/7 Accident and Emergency department and a Community Health Service. Medical services are provided by Medical Officers with Right to Private Practice (on call for emergency presentation). During a key achievement was the retention of staff remaining consistent with minimal external and agency support required. The hospital partners with several government and non-government organisations, including: Aboriginal Health Services, Central and North West Queensland Medicare Local, Community Health Services Townsville, Royal Flying Doctor Service (Mount Isa and Cairns), Department of Social Security, Queensland Ambulance Service, Environmental Health Officer and the Shire Council. Normanton Community Health also provide a range of health services including, assessment, liaison with hospitals, General Practitioners and other community agencies, health education and coordination of discharge plans from hospital to home to ensure continuity of care. Visiting services include: Paediatrician, Dentist, Royal Flying Doctor Service, Child Health and Immunisation Clinic, Deadly Ears Team, Diabetic Outreach team, Surgeon, Gynaecologists, Mental Health Team, Chest Physician, Eye Team and other specialty clinics. North West Hospital and Health Service Annual Report

20 Our catchment area Camooweal The Camooweal Township is situated alongside the Georgina River and is on the Barkly Highway. It is now an aboriginal settlement and is the last petrol stop for about 300 kilometres for people travelling into the Northern Territory. The township is officially part of the city of Mount Isa local government is administered from Mount Isa. In the 2011 Census, there were 187 people in Camooweal, of these 47.6 per cent were male and 52.4 per cent were female. Aboriginal and Torres Strait Islander people made up 56.5 per cent of the population. Camooweal is situated 330 kilometres south of Burketown, 188 kilometres from Mount Isa and 44 kilometres east of the Stuart Highway in the Northern Territory. All highways leading to Camooweal are sealed double lane bitumen. The Indigenous population fluctuates as people migrate from Lake Nash and Tennant Creek in the Northern Territory. Camooweal Primary Health Centre is a single nurse post, offering a range of primary health care and emergency stabilisation services prior to evacuation to a referral hospital. This facility provides short-term inpatient observation beds, management of chronic disease, domiciliary nursing services and child health services. The clinic provides the coordination of visiting services including: Mobile Women s Health Nurse Chest Physician Dietician Physiotherapist Podiatrist Mental Health Services. Dajarra Dajarra is located in the Cloncurry Shire Local Government Area and as at 30 June 2011, the estimated resident population was 429 persons living in Dajarra. Aboriginal and Torres Strait Islander people made up 36.5 per cent of the population. Dajarra is located 149 kilometres south of Mount Isa on the Diamantina Development Road, towards Boulia. The road to Boulia and Mount Isa is sealed, however the road to Cloncurry is unsealed. BHP at Phosphate Hill offers some employment and occasionally accesses the health services offered at the local Health Service. The role of the Dajarra clinic is to provide comprehensive health care services to the people of Dajarra and the surrounding area. It is a single nurse post offering a range of primary health care, 24 hour emergency stabilisation services prior to evacuation to a referral hospital, chronic disease management and community education and public health prevention provided. The clinic provides the coordination of visiting services including: Paediatrician Dietician Visiting physician from Mount Isa Fortnightly visits from the Royal Flying Doctor Service which provides general medical reviews and Child Health Clinic. 18 North West Hospital and Health Service Annual Report

21 Burketown Burketown sits on the Albert River and is in the Shire of Burke in far north Queensland, on the Gulf of Carpentaria, 400 kilometres north of Mount Isa. The Shire lies on the southern coast of the Gulf of Carpentaria and abuts the Northern Territory border. There is road access to Mount Isa and Cloncurry outside of wet season closures. There is an all-weather airport, with regular scheduled weekly services to Mount Isa and Cairns. In 2011 Burketown had a population of 202 with 85 Indigenous people living in the town. The Burketown Primary Health Care Centre is a single nurse post and the aim of the health service is to provide community focused, evidenced based primary health services for those people living in and transitioning through the Burketown region. The Health Centre is a single nurse post and provides 24 hour emergency services, primary health care, community services and an Indigenous health program. A community Indigenous health program provides outreach services to surrounding homeland communities. The clinic provides the coordination of other visiting specialist services including: Mobile Women s Health Nurse Chest Physician Dietician Physiotherapist Podiatrist Mental Health Services. Karumba Karumba (outback by the sea) is a fishing village with a population of approximately 550 people. The Aboriginal and Torres Strait Islander people make up 9.7 per cent of the population. Each year 100,000 tourists and semi-permanent residents visit Karumba during the winter months from April until October. During this time the population may be 2,000 to 3,000 people at any one time. Karumba s main industry has been based on fishing and its associated support industries such as engineering, marine motors, refrigeration and cold storage. Karumba is surrounded by cattle country and live cattle are exported from Karumba destined for international markets. In 1999, Century Zinc commenced operations in Karumba as a drying and export facility of lead and zinc. Karumba Health Clinic is a level one nurse led facility, offering a range of primary health care, emergency stabilisation, pathology collection, with a Medical Officer performing a General Practitioner clinic 12 hours per week. The clinic provides the coordination of other visiting specialist services and the center is staffed by a Director of Nursing with an additional Registered Nurse during the tourist season, from May to October each year. The public have access to a full range of services including: Provide emergency stabilisation of patients prior to evacuation Primary Health Care Management of chronic disease. Visiting services include: Mobile Women s Health Nurse Physiotherapist Chest Physician Dietician Podiatrist Mental Health Services. North West Hospital and Health Service Annual Report

22 Our partnerships National and State partnerships The Queensland Government works with the Australian Government and other states and territories through the Council of Australian Governments (COAG) to achieve agreed strategic health priorities and objectives. This includes working in partnership to prevent chronic diseases, improve access to elective surgery and emergency departments, improve health outcomes for Aboriginal and Torres Strait Islanders, support immunisation to protect the population s health, develop and implement ehealth information systems and the delivery of new or improved infrastructure. Local partnerships As part of the HHSs commitment to improving the health outcomes of our patients the North West HHS has established strong links with local government, and local organisation s. It is these partnerships that help ensure the HHS is able to respond to local needs, and to undertake the change which is necessary. This platform will also allow better integration of services with all health care providers to help ensure the seamless delivery of care throughout the region. Integral to this is a strong organisational commitment to stakeholder engagement and partnerships in health care throughout the North West region. Our stakeholders Our key stakeholders included but are not limited to: Department of Health, Queensland Commonwealth Department of Health and Ageing Central and North West Queensland Medicare Local (CNWQML) Royal Flying Doctor Service (RFDS) Gidgee Healing Mount Isa Aboriginal Community Controlled Health Service Department of Communities Mount Isa Group Apprenticeship, Traineeship and Employment (MIGATE) Centacare Mount Isa Emergency Services Queensland Ambulance Service, Police and Queensland Fire Service North Queensland Helicopter Rescue Service (RACQ NQ Rescue) James Cook University (JCU) Mount Isa Centre for Rural and Remote Health (MICRRH) Save the Children Blue Care. We worked closely with the following North West local governments: Burke Shire Council Carpentaria Shire Council Cloncurry Shire Council Doomadgee Aboriginal Shire Council McKinlay Shire Council Mornington Shire Council Mount Isa City Council The part of the local government area of Boulia Shire Council consisting of the community of Urandangi. The North West HHS has close links and works in partnership with tertiary hospitals in Cairns, Townsville and Brisbane who provide support including visiting specialists and other health services and access for our patients and health professionals for consultation and education via Telehealth and videoconferencing across the North West HHS. Queensland Bulls Masters Cricket team visit to Mount Isa Hospital North West Hospital and Health Service Annual Report

23 Quality, safety and risk management A priority for the North West HHS during has been to work towards implementing stable systems to set, monitor and improve the performance of the organisation and communicate the importance of the patient experience and quality management to all members of the workforce. A further priority is working towards systems that can be mapped with performance indicators, measured and monitored and improved to ensure that the North West HHS provides health services that are: Safe Effective Appropriate Consumer focused Accessible Efficient. The Executive Director for Medical Services chairs the Governance for Quality, Safety and Risk Committee meetings which are held monthly. This committee will undergo a review of terms of reference and membership in 2013 to ensure the committee has clear direction to provide the strategic advice and decision-making required and to also outline reporting responsibilities. Throughout the year progress has been made in developing reporting systems to the North West HHS Board Quality, Safety and Risk Committee. Monthly and Quarterly reporting requirements have been identified and further work will be undertaken to identify key performance measures and monitoring systems. The North West HHS has also focused on ensuring that there is an appropriate level of evidence against the 15 EQuIP National Standards in preparation for the next stage of the accreditation cycle which will be a Periodic Review to be undertaken in March Risk Management reporting was reviewed by the North West HHS during and a robust system that ensures all risks (both actual and potential) are identified, documented and managed appropriately has been implemented. Monthly reporting to the North West HHS Board for high and very high level risks that have been escalated to the North West HHS Executive Management Group and a Quarterly Board summary report of the status of all business area risks including actions and management strategies occurs. The North West HHS has identified core strategic risks which through our Draft Strategic Plan and ongoing consultation with consumers and our staff, combined with planning at both department and executive level will include risk mitigation and management strategies. The ongoing effective management of the following core risk areas is central to ensuring that the North West HHS continues to deliver high quality health services to the people we serve: Health Status of our Communities Financial Governance Clinical Governance Recruitment and Retention Access and Tyranny of Distance Community Expectations Sustainability of Service Delivery through Innovation. To ensure the North West HHS is best placed to meet its commitments to all consumers and staff an independent external review of Quality, Safety and Risk has been completed with the final report and recommendations are to be presented to the North West HHS Board in August North West Hospital and Health Service Annual Report

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