Agency Overview July 2012

Agency Overview July 2012 High quality, safe services for the people of Tasmania when they need them, so they can live well and live longer. Department of Health and Human Services

Published by the Department of Health and Human Services, Tasmania. Copyright State of Tasmania, Department of Health and Human Services, 2012. This publication is copyright. No part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968. Published on www.dhhs.tas.gov.au July 2012

Table of Contents Introduction 2 Our Strategic Directions 3 Our Vision 3 Our Mission 3 Our Strategic Objectives 3 Our Ministers 4 Our Departmental Executive 4 Our Structure 4 Strategic Control, Workforce and Regulation 6 Education and Training 6 Government Relations and Strategic Policy 6 Legislative Review and Legal Support 6 Mental Health and Alcohol & Drugs Services 7 Nursing and Midwifery 8 Office of the Chief Information Officer 8 Strategic Financial Control 8 Workplace Health and Wellbeing 9 Workplace Relations and Safety 9 System Purchasing and Performance 10 Service Planning and Design 10 Service Purchasing and Performance 10 Service Quality and Improvement 11 Strategic Planning 11 Population Health 12 Adviser for Oral Health 12 Chief Medical Officer 12 Population Health Operations 12 Children and Youth Services 13 Operations 13 Program Support Unit 13 Quality Improvement and Workforce Development 14 Disability, Housing and Community Services 14 Community Sector Relations 14 Disability and Community Services 14 Housing Tasmania 14 Ambulance Tasmania 15 Aero-medical and Medical Retrieval 15 Clinical Services 15 Emergency and Medical Services 15 Health Transport Services 15 Operational Support Services 15 Office of the Secretary 16 Shared Services 16 Implementing Health Reform in Tasmania 17 How Health Services are Provided 17 The Role of the Department System Manager 18 Tasmanian Health Organisations 19 Accountability and Performance of the THOs 19 Clinical Engagement 20 Community Advisory Council 20 Contact Us 21 Agency Overview July 2012 1 of 21

Introduction The Department of Health and Human Services is one of the largest Tasmanian Government agencies, employing more than 11 000 Tasmanians. At the Department of Health and Human Services our focus is on providing the very best care and services possible for Tasmanians to improve health and wellbeing. Each year, we provide more than 1.5 million occasions of service to our patients and clients. In addition to hospital, ambulance and other health services, we provide human services including housing, disability, community, children and youth services. Between August 2009 and October 2011, for example, we provided over 8 000 cases of service to families through Gateway Services, while in 2010-2011 nearly 1 500 families received our help and extended services at crucial times in their lives. The Agency also contracts or provides funding to around 250 private and non-government sector organisations to deliver a wide range of health and human services to the community. Health and human services have changed significantly in recent times particularly with the implementation of many national reforms in housing, homelessness and disability services as well as the national health reforms agreed in August 2011 by the Australian Government and all states and territories. Improved care pathways, national standards and workforce planning have helped improve services for clients and their carers. The key elements of the Council of Australian Governments reforms, including the introduction of activity-based funding, are incorporated in how Tasmania s health system and services are now governed. The national reform agenda has included changes in how we support people who are experiencing or are at risk of homelessness, as well as transitioning some public housing stock to the community sector. On the horizon are plans to develop a National Disability Insurance Scheme. In addition, the Agency is improving how it delivers children and youth services in reference to the Our Children, Young People and Their Families strategy. In recent times, the Agency has also responded to budget imperatives to reduce expenditure. While this process is ongoing, recently the Federal Government announced a range of health funding initiatives that will provide opportunities for the Agency to further collaborate across the sector to provide a truly integrated health system. We have reshaped our Agency to facilitate these important reforms so we can deliver better and more efficient health and human services for all Tasmanians into the future. Matthew Daly Secretary Agency Overview July 2012 2 of 21

Our Strategic Directions Our Vision High quality, safe services for the people of Tasmania when they need them, so they can live well and live longer. Tasmanians deserve the best possible levels of health and wellbeing. They have the right to expect that when they need care, the health and human services provided will effectively and efficiently meet their needs. To achieve this, the Department of Health and Human Services will provide a comprehensive, high quality, safe and sustainable health and human services system within the resources available. Our Mission To design and implement a sustainable, people-focused health and human services system which supports individuals and communities to be active partners in the management of their own health and wellbeing. People have the right to expect to be able to access care and support when they need it, to make informed choices about what is best for them so that their quality of life is improved, to be engaged in the major decisions that affect them and be given a full and honest explanation of what happened if things go wrong. Our Strategic Objectives Tasmania already has excellent services being provided by skilled and dedicated staff. However, the profile of the population including its age and health status is changing, and it is important that the Department of Health and Human Services constantly reviews its objectives to ensure it continues to focus on the changing needs of the population. The Agency has the following strategic objectives: 1 Supporting individuals, families and communities to have more control over what matters to them. 2 Promoting health and wellbeing and intervening early when needed. 3 Developing responsive, accessible and sustainable services. 4 Creating collaborative partnerships to support the development of healthier communities. 5 Shaping our workforce to be capable of meeting changing needs and future requirements. Agency Overview July 2012 3 of 21

Our Ministers The following Ministers are responsible for the Health, Children and Human Services portfolios in Tasmania: Michelle O Byrne MP, Minister for Children Michelle O Byrne MP, Minister for Health Cassy O Connor MP, Minister for Human Services Our Departmental Executive The role of an Agency Secretary is central to the effective and efficient operation of Government. The Secretary is accountable to the Premier through the Minister for Health, the Minister for Children and the Minister for Human Services for the performance of the Agency. The Secretary s role is undertaken in an environment of intense public scrutiny including from the Auditor-General, the Ombudsman, portfolio-specific regulators and integrity bodies. Committees of Parliament, the Opposition, the media and the general public also provide scrutiny. The Secretary has established the Departmental Executive to consider strategic management issues and deliver objectives and directions set by Government through its Ministers. The Departmental Executive supports the Secretary in effectively discharging responsibilities and ensuring compliance with legislation. Chaired by the Secretary, the Departmental Executive is the key management meeting for the Agency. It takes collective decision-making responsibility for establishing objectives, frameworks, policies and procedures to support the delivery of Agency objectives and directions. It also considers and makes decisions on issues including the Agency s budget and monitoring of system performance. Our Structure The Agency has undergone major organisational change in recent times. This is in response to state budget savings strategies and a number of national and state reforms in housing, homelessness, disability services, children and youth services, and health (including establishment of three Tasmanian Health Organisations under national health reforms). The Department s structure now more closely reflects the traditional Westminster model providing functions supporting the Ministers and the Government, regulatory functions, and system manager functions in statewide planning, purchasing and performance monitoring of health and human services. Section 8 of the National Health Reform Agreement sets out the roles of states and territories as system managers. In addition, the Agency provides population health, ambulance, disability, housing, community, children and youth services. The organisational structure includes a shared services entity that provides services to its customers: Agency business units and the Tasmanian Health Organisations. This Shared Service function will be predominantly owned by the Tasmanian Health Organisations. The Agency is structured to best deliver services for patients and clients, and to fulfil Tasmanian and Australian Government policy goals. Agency Overview July 2012 4 of 21

Department of Health and Human Services June 2012 Minister for Children Minister for Human Services Minister for Health Secretary Lead Clinicians Group Tasmanian Health Organisations Chair Community Advisory Council Strategic Control, Workforce and Regulation System Purchasing and Performance Population Health Children and Youth Services Disability, Housing and Community Services Ambulance Tasmania Governing Council North Governing Council North West Governing Council South Education and Training Service Planning and Design Adviser for Oral Health Operations Community Sector Relations Aero-medical and Medical Retrieval Government Relations and Strategic Policy Service Purchasing and Performance Office of the Chief Medical Officer Program Support Unit Disability and Community Services Clinical Services Legislative Review and Legal Support Service Quality and Improvement Population Health Operations Corporate Services Housing Tasmania Emergency and Medical Services Mental Health and Alcohol & Drugs Services Strategic Planning Population Health and Wellbeing Strategy, Program Development and Evaluation Health Transport Services Nursing and Midwifery Public and Environmental Health Services Quality Improvement and Workforce Development Operational Support Services Tasmanian Health Organisation North Tasmanian Health Organisation North West Tasmanian Health Organisation South Office of the Chief Information Officer Strategic Financial Control Workplace Health and Wellbeing Workplace Relations and Safety Shared Services (Asset Management / Business Systems / Finance / Internal Audit / Payroll / Procurement / Risk Management) Agency Overview July 2012 5 of 21

Strategic Control, Workforce and Regulation Strategic Control, Workforce and Regulation ensures effective strategic processes are established and maintained across the health and human services system to provide efficient statewide service delivery. Education and Training This Unit provides strategic leadership for education and training across the Agency. Specific responsibilities include: providing strategic responses to the National Health Workforce Reform Agenda, including representation on the Health Workforce Principal Committee, Australian Health Ministerial Advisory Council and Standing Council on Health and the translation of statewide reforms providing strategic responses to Health Workforce Australia (HWA) and leading implementation of HWA s Tasmanian projects developing and implementing the strategic work plan for the Tasmanian Clinical Education Network, which focuses on building capacity, innovation, sustainability, quality and support in health workforce education and training multi-profession education and training and the development of a whole-of-workforce strategic agenda for clinical education and training and leadership and management development, including continued implementation of the Leadership and Management Framework (comprising the Foundation Program, the Academic Program and the Graduate Health Management Trainee Program). Government Relations and Strategic Policy This Unit manages intergovernmental relations and the strategic policy agenda to strengthen relationships with key stakeholders. This includes: managing Australian Government/State relations, Ministerial Councils and Senior Officials meeting commitments leading negotiations and managing intergovernmental agreements, National Partnership Agreements and associated implementation plans providing support to units to develop submissions, applications and business cases associated with intergovernmental agreements and supporting units by providing strategic policy analysis and advice. Legislative Review and Legal Support This Unit provides a specialist high-level legislative review and legal support advisory service to the Ministers, the Secretary, the Tasmanian Health Organisations CEOs and senior management. The service is the central point of contact for legal matters and the management of complex legal projects. The Unit s functions include: legal policy advice and research specialist and general legal support services in relevant areas Agency Overview July 2012 6 of 21

leading the Agency s legislative program; coordinating development of new legislation and amendments to primary and subordinate legislation; and researching, preparing and reporting on legislative proposals, including coordinating preparation of documents for Cabinet and Parliamentary processes providing high-level advice to the Government, Ministers, Secretary and senior executives and officers on legal matters affecting the Agency and liaison with other agencies on related issues being the central point of review and advice in relation to contracting issues including initial tendering advice, contract negotiations, types of contract, developing agreements and Memorandums of Understanding, matters relating to insurance and indemnities, Government Information Technology Contracts (GITC) and Australian Standard contracts (used for architecture and building works) coordinating liaison with Crown Law, and managing the legal opinion database for the Agency and The Unit works with the Office of the Secretary in the management and maintenance of the delegations framework for legislation administered by the Agency. Mental Health and Alcohol & Drugs Services This Unit undertakes a range of statewide functions including strategic planning, policy development and purchasing advice for Mental Health and Alcohol and Drugs Services. It includes the statutory role of Chief Psychiatrist, and is the Agency lead for the prevention and management of alcohol and drug-related harm. The Unit works mainly through the mental health and alcohol and drugs programs in partnership with the Tasmanian Health Organisations, non-government organisations and other organisations. The Unit plays a lead role in relevant inter-jurisdiction and cross-government forums. It also includes Forensic Health Services, which comprises two service components: Correctional Primary Health Services and Forensic Mental Health Services. These services have strong links and help clients within, the correctional and justice systems. Forensic Mental Health Services provides specialist mental healthcare. Correctional Primary Health Services provides primary healthcare and treatment and specialist referral for men and women held within the Tasmanian Prison Services and across a range of correctional facilities. Health services are also delivered to Ashley Youth Detention Centre. Services are delivered throughout Tasmania in the following streams: Community Forensic Mental Health Services Inpatient Forensic Mental Health Services and Court Liaison Services. A mental health/alcohol and drugs services working group is supporting the transition of clinical services to the Tasmanian Health Organisations during 2012-2013. Agency Overview July 2012 7 of 21

Nursing and Midwifery This Unit provides high-level specialist advice on nursing policy and clinical workforce planning. This includes advice on aspects of legislation that affect professional practice and regulate health professionals and strategic health workforce planning across the private and public health sectors and aged care sector. This links to the tertiary and vocational education and training sectors through the leadership of the Tasmanian Clinical Education Network and Partners in Health. Office of the Chief Information Officer This Unit works with business units to design and deliver information technology solutions and support. In health, this includes statewide ehealth solutions focused on affordable and better outcomes for patients and clients. This includes realising the potential of existing core clinical systems as the foundation for statewide health and human services. The Unit delivers infrastructure services, stabilises existing services and aligns information technology to support the work of business units and Tasmanian Health Organisations. It strengthens Agency-wide architecture and security, redefines the IT service delivery model, refreshes IT policies and procedures, and improves vendor contract performance management and financial controls. Strategic Financial Control This Unit ensures the proper allocation of financial resources in accordance with Government and Agency decisions. This includes ensuring financial controls are in place, monitoring overall financial performance and reporting the extent to which they have been met to the Secretary and (via the Secretary) to Ministers, the Department of Treasury and Finance and the Budget Sub-Committee of Cabinet. The Unit also prepares the annual statutory accounts in line with Tasmanian Audit Office requirements. Functions and services include: reviewing, analysing and reporting on financial outcomes across the Agency developing and managing the Agency s budget in liaison with operational areas and the Department of Treasury and Finance, including compiling and managing the information flow into the Treasury budget management system conducting cost accounting and business analysis taxation compliance and advice, including GST, FBT, payroll tax and superannuation reporting on financial management of the Agency financial risk management, including fraud prevention and the Procurement Review Committee, which ensures compliance with Treasurer s Instructions when purchasing goods and services. The Unit works with the Office of the Secretary in the maintenance of the delegations framework. Agency Overview July 2012 8 of 21

Workplace Health and Wellbeing The Unit provides a comprehensive occupational health service for all staff within the Agency which will ensure that the Agency meets its legal obligations reduces costs and appropriately cares for its staff. The service provides: the active promotion of and support for health and wellbeing throughout the Agency preventative occupational health and safety related services, such as employee health assessments, immunisations and management of occupational exposures to blood and body fluids support for managers and staff with dealing with complex workers compensation cases, performance issues and staff with excessive sick leave support for managers on developing a healthy and positive organisational culture an emphasis on psychological wellbeing and the tools to support this and the development of Agency Policies in relation to workplace health and wellbeing. The service works closely with the Workplace Relations and Safety Unit to achieve the above activities. Workplace Relations and Safety This Unit is responsible for providing strategic leadership in the recruitment and management of staffing within the Department to enable the delivery of safe, effective and high quality integrated patient and client care. Areas of responsibility include: strategic human resource management policy maintaining an effective framework for the negotiation and regulation of remuneration, employment conditions and industrial relations human resource management for DHHS departmental and DHHS operational units. The Unit works with the Office of the Secretary in the coordination of the Senior Executive Service, the maintenance of the delegations framework and the development of management information systems which support the efficient and effective use of human resources thoughout the Agency. The Unit works closely with the Workplace Health and Wellbeing business unit. Areas of cooperative effort include: occupational health and safety, injury prevention and management (including workers compensation) and the Employee Assistance Program with greater emphasis on in-house rehabilitation and early return to work programs. Agency Overview July 2012 9 of 21

System Purchasing and Performance The System Purchasing and Performance Group consolidates a number of complementary functions across policy, planning, funding, monitoring and service improvement. This Group is also the principal support for the Secretary in establishing Agency system-level priorities. System Purchasing and Performance functions include service improvement (focusing on developing statewide services and new patient pathways), and supporting the Tasmanian Health Organisations to develop consistent, collaborative models of care particularly for chronic and complex conditions. The Group also integrates the Agency s safety and quality and medication strategy and reform functions to ensure funding improves patient outcomes and system sustainability. The Group s functions support planning, funding and improvement through monitoring, analysing and reporting on service-provider performance. This role ensures service-provider accountability and enables improvement efforts to be targeted and relevant. The Group also includes an information team to implement a new information framework directed at producing shared, high-quality activity and performance reports between the Department and the Tasmanian Health Organisations based on common and nationally agreed standards and methods. Service Planning and Design Functions and services of this Unit include: developing detailed plans for the purpose of purchasing services from the Tasmanian Health Organisations that integrate policy, legislative requirements, administrative decisions, clinical services planning, funding, resource allocation and use, service delivery and quality management helping identify opportunities for service collaboration, including developing and implementing statewide clinical and clinical support services designing health service plans with a particular focus on primary, community and rural health services and their links with acute health services collaborating with private providers and the Australian Government to develop plans, policies and processes for the delivery of integrated health services and developing strategic alliances with Tasmania Medicare Local and the aged care sector. Service Purchasing and Performance Functions and services of this Unit include: collecting, processing, analysing and disseminating statistics on the health of Tasmanians and their use of health services assessing service capacity in the State to deliver the broad range of health and human services, and strategically developing services where gaps exist Agency Overview July 2012 10 of 21

managing and facilitating the implementation of the classification, counting and costing of hospital products necessary to fund hospitals based on activity within national health reform agenda timelines establishing activity-based funding models for Tasmanian public hospitals developing an evidence-based, sustainable performance monitoring framework for health and human services and negotiating and developing service agreements with Tasmanian Health Organisations. Service Quality and Improvement This Unit is responsible for planning, developing and promoting clinical governance policies, programs and safety and quality strategies to achieve system level consistency focusing on: the patient/consumer experience, including reflecting their journey through many levels of the health system clinical leadership and engagement a systems approach to improving patient safety, including to understanding risks and improving quality of care system learning and improvement through data collection and analysis and communication and creating links, partnerships and supporting collaborative responses across the health system. The Unit also includes the medication strategy and reform function. It is responsible for developing strategies and supporting programs to improve the safe, effective and sustainable use of medicines in line with national standards and reforms such as: managing cost-effective access to high cost and specialised medicines leading statewide medication safety projects and policy in line with national standards, agreed performance indicators and priorities and optimising buying efficiencies through statewide medicine contracting and medicine use analysis. Strategic Planning Functions and services of this Unit include: developing and setting strategic direction and priorities supporting future updates of Tasmania s Health Plan and developing a system-wide performance management and measurement framework for the reformed health and human services system. Agency Overview July 2012 11 of 21

Population Health The Population Health Group focuses on improving and promoting health and wellbeing for all Tasmanians. It works to reduce inequalities in health and to protect Tasmanians from public and environmental health hazards. Population Health operates within a framework of primary, secondary and tertiary prevention to deliver policies and programs based on evidence and provide tangible and equitable health benefits for all Tasmanians. It works with many stakeholders across a wide range of sectors and all levels of government. All areas working within Population Health contribute to national and State policy. The Chief Health Officer oversees this Group and holds the statutory position of Director of Public Health. Adviser for Oral Health The Adviser provides advice and links to national and State policy to optimise oral health and dental care with reference to the impact of avoidable risk factors, relevance of health protection and promotion, and the potential for lifetime health benefits. Chief Medical Officer This Unit oversees clinical and related matters. They include emergency preparedness, research, pharmaceutical services (including the administration of the Poisons Act 1971), medical workforce, cancer services system development, blood and blood products, organ and tissue transplantation and the Tasmanian Infection Prevention and Control team. The Unit also incorporates cancer screening and control services such as BreastScreen Tasmania, the Cervical Cancer Prevention Program, Policy and Education team and the National Bowel Cancer Screening Program. These cancer screening and control services report to the Chief Medical Officer. Population Health Operations This Unit comprises two sub-units: Population Health and Wellbeing which includes the Health Minister s Healthy Tasmania initiative, physical activity, community nutrition, healthy settings, population health equity (including Aboriginal health, multicultural health, men s and women s health) and tobacco, alcohol and public health nutrition policy. Public and Environmental Health Services which includes assessing and managing public health risks such as environmental health, radiation protection and communicable diseases prevention, epidemiology, and monitoring and supporting the health status of Tasmanians to inform decision-making and health priorities. Agency Overview July 2012 12 of 21

Children and Youth Services Children and Youth Services comprises integrated programs that support all children and young people and their families in Tasmania. Operations Functions and services of this Unit include: Child Health and Parenting Service (CHAPS) a community-based health promotion service providing child-centred and family-focused services Child Protection Services protecting children and young people at risk of abuse or neglect Youth Justice Services delivering restorative justice services to the victims and perpetrators of youth (aged 10 to 17 years) crime. It includes community youth justice (supervision in the community) and the Ashley Youth Detention Centre (custodial service) Family Violence Counselling and Support Services offering professional and specialised services to help children, young people and adults affected by family violence and Adoption Services and Out-of-Home Care providing care for children and young people unable to live with their birth families. Program Support Unit The Program Support Unit provides support to Operational Areas so that they can deliver their services efficiently and effectively and achieve high quality and enduring outcomes for children, young people and their families. This Unit comprises two sub-units: Corporate Services functions and services of this Unit include: Financial Management Human Resource Management Asset Management Strategy, Program Development and Evaluation functions and services of this team include: Program development the ongoing review and development of Children and Youth Services programs so they collectively contribute to an effective service system for children and young people Legislation reform in collaboration with the Legislative Review and Legal Support Unit, this team monitors the ongoing review of legislation as it applies to Children and Youth Services and Disability Services (shared with Community and Disability Services) Program evaluation the collection, analysis and reporting of data to support performance management and the effective application of service level agreements that specify resources for, and planned outcomes from, Children and Youth Services operations (shared with Community and Disability Services) Information system management the ongoing support for information technology system development and review for all Children and Youth Services Programs. Agency Overview July 2012 13 of 21

Quality Improvement and Workforce Development This Unit works closely with Operational Units and most team members are embedded in work teams. Its functions and services include: the Quality and Safety Framework a point of reference for the quality and safety of services and methodology to continually improve services delivered to clients complaints in care a process for investigating and resolving serious complaints made by children and young people in Out-of-Home Care and workforce development a structured and integrated approach to the recruitment, skilling and retention of the Children and Youth Services workforce. Disability, Housing and Community Services Disability, Housing and Community Services provides a range of vital human services to Tasmanians including policy, planning, reporting and contract management for disability and community services; community sector relations, and policy, planning, reporting and contract management for a range of social housing and homelessness programs. Community Sector Relations This Unit is accountable for the Agency s strategic relationship with the community sector including the Partnership Agreement, the Peaks Network and Government Strategic Forum and the priorities arising from these initiatives. It is also responsible for administering all Grants to the community sector and auditing the quality and safety of services that are delivered by the community sector. Disability and Community Services Following a previous reform process, most services provided by this Unit were outsourced to the community sector. Disability and Community Services is responsible for policy, planning, reporting and contract management for these outsourced services. The Unit also has a small specialist disability assessment and advisory service and oversees gambling support programs, the Neighbourhood House programs and a number of other family support programs. Housing Tasmania Housing Tasmania is responsible for policy, planning, reporting and contract management across a range of social housing and homelessness programs. Housing Tasmania manages the direct delivery of public and Aboriginal housing, which involves tenancy management, property maintenance and capital projects. It also provides accommodation to a range of specialist programs such as Disability Services, Mental Health Services, Out-of-Home Care and Neighbourhood Houses. Agency Overview July 2012 14 of 21

Ambulance Tasmania Ambulance Tasmania provides integrated pre-hospital emergency and medical services, health transport, aero-medical and medical retrieval services to the Tasmanian community. It provides these services through a system of paramedics, doctors, patient transport officers, volunteer officers and the support and partnership of independent services. Ambulance Tasmania establishes new paramedic services, such as air and land-based services; managing ambulance workforce; and asset planning, including fleet, information technology, communications and facilities to respond to the community s medical and transport needs. Many volunteers work alongside salaried staff; together they provide Tasmania with more ambulance response points per capita than any other service in the country. Four Community Emergency Response Teams provide first response. Aero-medical and Medical Retrieval This Unit provides inter-facility transport and mobile critical care for patients travelling within and outside Tasmania. Ambulance Tasmania uses a range of transport options for aero-medical and medical retrieval including road ambulances, a fixed-wing air ambulance, special operations vehicles and occasionally the Tasmania Police rescue helicopter. Clinical Services This Unit provides a credentialed and competent workforce delivering safe, evidence-based clinical practice to improve patient outcomes. Ambulance Tasmania activities are supported by a Clinical Governance Framework, which promotes, reviews, measures and monitors the quality of patient care in four key areas: clinical performance and effectiveness, clinical risk management, consumer value, and professional learning and development. Emergency and Medical Services This Unit provides emergency and urgent pre-hospital medical care by responding to emergency calls from the community on the triple zero telephone service. Health Transport Services This Unit provides safe, high quality, non-emergency patient transport services statewide. Operational Support Services Operational Support Services is a statewide unit that underpins the four operational streams of Ambulance Tasmania through: fleet management, including acquisition of ambulance fleet and support vehicles; technical services, including information technology and support for the State Communications Centre and the electronic patient care reporting system; human resource management, including payroll, industrial relations and recruitment; financial and budget management; equipment acquisition and management; asset management, including procurement and capital asset planning; and policy development and support. Agency Overview July 2012 15 of 21

Office of the Secretary Reporting to the Secretary, this Unit has unique responsibilities in an environment of intense scrutiny. It provides advice to the Secretary which is independent and reliable. The Unit manages all areas of the Office of the Secretary to support the effective management of the Department. The area ensures the flow of briefings and critical information to, from and within the Department, the Secretary and the Ministers Offices with adherence to deadlines, quality standards and policy congruence and provides an early warning and tracking system. The work of the group is influenced by a wide range of legislative and administrative compliance obligations met through a number of integrated systems and processes. Shared Services Shared Services comprises a range of services used by the Tasmanian Health Organisations and all DHHS departmental, operational and business units. It remains in the Department at 1 July 2012. However, while the structure is still under development, the functions are expected to be devolved in a Shared Service form to the Tasmanian Health Organisations and broadly include at least parts of the following services: finance operations, such as debtor and creditor administration to deliver Shared Services once the structure, processes and systems are ready payroll services finance systems including Payroll systems asset management procurement services risk management and internal audit. The primary aim of Shared Services is to support Tasmanian Health Organisations and Agency business units (its customers) to deliver effective health and human services that best meet the needs of Tasmanians. The move towards this new entity will give its customers confidence the shared statewide services they receive are appropriate and responsive to their needs. Over time it is expected the services will become more integrated with a strong focus on reforming business processes to deliver the most efficient services to its customers. Shared Services will have a strong customer focus and clear key performance indicators to drive performance improvement. Service level agreements will be negotiated between the entity and individual customers. The transition to the new Shared Services will take place between July 2012 and June 2013. Agency Overview July 2012 16 of 21

Implementing Health Reform in Tasmania National health reforms are being implemented in Tasmania with the aim of improving the health of Tasmanians and ensuring the sustainability of our health system. This is part of a national change, with all states and territories and the Australian Government agreeing to implement reforms. From 2007, before the national health reforms were in place, the Department of Health and Human Services began to transform the delivery of healthcare across the State through Tasmania s Health Plan. Some of the key milestones for reform in recent years have included the following actions. Tasmania created three Area Health Services in 2009 to integrate hospital and community care services and develop stronger collaborative relationships with primary care at the local level. This involved the devolution of a number of services and staffing from the central Department to enable improved decision-making at the local level. Aware of the need to improve local responsiveness, the Agency devolved a number of functions to the Area Health Services to strengthen their decision-making processes. For example, human resource management staff, clinical coders and information resources. Similarly, the creation of finance director roles within the Area Health Services further prepared the system for financial accountability at the local level. The Area Health Services have had greater community engagement functions that helped them stay connected and concerned with their local communities. The reform process has been ever-present and a continual part of how the health system has been managed. The focus has been on health and wellbeing, not just illness. This has included increased health promotion, disease prevention and management of chronic conditions in community health centres and integrated care services. The Agency has striven to foster individuals control over their own health and participation in health decision-making. The role of clinical advice has been elevated ensuring highly skilled clinicians are involved centrally with decision-making. Professional education has been prioritised, knowing the value of a properly educated and skilled clinical workforce. Cooperative relationships have been pursued federally something which has proved invaluable throughout the Council of Australian Governments reform process. Throughout this, the Agency has committed to rigorous financial management, better communications including genuine two-way consultation with the community, but more fundamentally, much improved services that are safe and sustainable into the future. How Health Services are Provided From 1 July 2012, three Tasmanian Health Organisations (THOs) will provide hospital and primary and community health services in Tasmania. The THO boundaries are the same as those of the area health services they supersede. Agency Overview July 2012 17 of 21

THOs are far more autonomous than the former area health services, and manage the funding they receive to provide maximum services for their communities. At the same time, the role of the Department has changed it is now the funder of services and the system manager making sure the THOs deliver what they are funded to do. The Role of the Department System Manager The National Health Reform Agreement sets out the roles of the states and territories as health system managers: establishing legislation and governance arrangements of public hospital services system-wide public hospital service planning, purchasing and performance planning, funding and delivering capital planning, funding (with the Commonwealth) and delivering teaching, training and research and statewide public hospital industrial relations, including negotiation of enterprise bargaining agreements, and remuneration and employment terms and conditions. In Tasmania, the Tasmanian Health Organisations Act 2011 (the Act) has put this system manager role into effect by: specifying the functions and powers of the THOs and the limitations on these powers the functions and powers of the responsible Ministers under the Act the ministerial guidance and direction provided under the Act the reporting requirements under the Act and the performance management requirements under the Act. As the Departments for the respective Ministers, Treasury and the Department of Health and Human Services will perform the roles and functions of the responsible Ministers under the Act. Treasury s role will cover high-level powers and functions, the Ministerial Charter as well as financial management and reporting. The role of the Department of Health and Human Services on behalf of the Minister will include: negotiating service agreements coordinating, with Treasury, the Ministerial Charter preparing Ministerial policies and determinations performance management, including the correction of poor performance negotiating intergovernmental agreements whole of system planning system-wide industrial relations and workforce development and statewide capital planning. Agency Overview July 2012 18 of 21

Tasmanian Health Organisations Three Tasmanian Health Organisations (THOs) have been established under the national health reforms to provide hospital, primary and community health services to Tasmanians. The THO boundaries are the same as the previous area health services they supersede. They are the THO North, THO North West and THO South. The THOs are governed by the Tasmanian Health Organisations Act 2011, each responsible for delivering integrated services that maintain and improve the health and wellbeing of Tasmanians. The THOs have a clear responsibility and accountability for governing and delivering high quality, efficient and integrated healthcare services in their area, through the public hospital system and primary and community health services (including mental health and oral health services). This purpose is consistent with the direction established under the existing Area Health Services. Primary and secondary health care operate under a single management team, bringing operational management closer to the patient. There is also an emphasis on linking information systems between the primary and secondary sectors, and between all health professionals whether they are employed by the State, the Australian Government or the private sector. The new structure is also supported by a new funding model based on a national efficient price for health services determined by the Commonwealth Independent Hospital Pricing Authority. The more efficiently services can be supplied to patients and clients, the more services can be provided under current funding. Accountability and Performance of the THOs Each of the three THOs has a Governing Council whose functions are outlined under section 22 the Tasmanian Health Organisations Act 2011. Through their Governing Councils, THOs deliver all aspects of hospital and health services for their local communities under a service agreement with the Agency. The service agreement supports the devolution of decision-making, responsibility and accountability for providing safe, high quality, patient-centred care to THOs by setting out the performance expectations and funding for the THO. While the Agency and the Minister for Health have a system manager role, including performance monitoring and management of the Governing Councils and their THOs, the Governing Council and THOs are expected to manage themselves and resolve problems to meet the service agreement requirements and fulfil their statutory obligations and powers. A single chairperson has been appointed across the three Governing Councils. Other accountability and performance controls include: Ministerial Charter a statement outlining the broad policy expectations and strategic priorities of the Treasurer and the Minister for Health. Ministerial policies the Tasmanian Health Organisations Act 2011 provides that the Minister for Health may require THOs to implement specified policies. This will allow for some statewide policies, plans and services to be implemented across the healthcare system, when required. Agency Overview July 2012 19 of 21

Ministerial Directions the Treasurer and the Minister for Health may give directions to THOs or a Governing Council that relate to the exercise of their functions and powers. This power generally will be used to provide clarification to THOs on their functions and powers and the Minister s expectations. Treasurer s Instructions under section 35 of the Tasmanian Health Organisations Act 2011, the Treasurer may apply, or modify the application of, a Treasurer s Instruction issued under the Financial Management and Audit Act 1990 to THOs. Under section 35(3) the Treasurer may also issue Treasurer s Instructions specifically to THOs regarding guidelines, principles, practices and procedures to be observed by THOs, Governing Councils or audit and risk sub-committees about corporate plans, annual reports, financial management and other prescribed matters. Corporate plan the corporate plan for a THO, which is approved by the Treasurer and the Minister for Health, is a rolling four-year strategic plan that outlines a THO s objectives, policies and programs in accordance with the Ministerial Charter and service agreement. The corporate plan is tabled in Parliament. Annual business plan an annual business plan (operating plan) is required for each THO. It includes a budget and a description of how the THO intends to meet the requirements of its service agreement. The plan is provided to the Treasurer and the Minister for Health. Progress report the Treasurer and the Minister for Health have the power to request regular progress reports on how a THO is performing against its annual business plan. They also have the power to ask for reports on other matters relating to plans, financial statements and information on the operations of a THO or request a review or audit of the operations of a THO. Annual report the annual report will report on the operations of the THOs in the immediately preceding financial year. Clinical Engagement A group of highly skilled clinical leaders, drawn from across Tasmania, will be established by the Department of Health and Human Services (DHHS) as the peak clinical engagement body for the Tasmanian health system. It will provide advice on significant planning and policy matters and guide the provision of high quality and safe care. It will have links with the Community Advisory Council. Community Advisory Council The Agency encourages and values feedback from people who use its services. The Community Advisory Council will ensure community representatives are involved in how services are provided. The Council is a strategic link between the community and the Agency. Its role includes monitoring the Agency s commitment to consumers, carers and community participation, and to ensure the community is included in service planning. The Council also acts as a conduit of information and discussion between the Agency and community organisations. The Council will be established during the 2012-2013 transition year. Agency Overview July 2012 20 of 21

Contact Us For more information about our organisation, please: Go to our website: www.dhhs.tas.gov.au Write to us: Office of the Secretary GPO Box 125 HOBART TAS 7001 Email us: ots.mailbox@dhhs.tas.gov.au Phone us on the Service Tasmania One Number for Government: 1300 13 55 13 Agency Overview July 2012 21 of 21

Department of Health and Human Services GPO Box 125, Hobart 7001 Tasmanina www.dhhs.tas.gov.au