Eyre and Far North Local Health Network Annual Report 2019-2020

Eyre and Far North Local Health Network
Oxford Terrace, Port Lincoln, South Australia 5606
Contact phone number: (08) 8683 2777
Contact email: Health.EFNOCEOCorrespondence@sa.gov.au
ISSN: 2652-6646 (Online)

Date presented to Minister: 30 September 2020

To:

Hon Stephen Wade MLC, Minister for Health and Wellbeing

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

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

Submitted on behalf of the Eyre and Far North Local Health Network by:

Verity Paterson
Chief Executive Officer
Eyre and Far North Local Health Network

Date: 30 September 2020

Michele Smith
Chair Governing Board
Eyre and Far North Local Health Network

Date: 30 September 2020

From the Board Chair

I am proud to be the inaugural Chair of the Eyre and Far North Local Health Network (EFNLHN), which has done an exceptional job in its first year in the face of COVID-19, natural disasters and the challenges of delivering services to remote and rural communities across a third of South Australia.

The EFNLHN Governing Board took over responsibility and accountability for this Local Health Network on 1 July 2019 as part of reforms to the governance of the SA Health system.

I would like to thank each Member of the new Governing Board for the skill, wisdom, and subject expertise they have brought to Board deliberations and to recognise the contribution of Tina Miller, the Aboriginal Health Member, who resigned from the Board at the end of 2019.

The Board focused this year on identifying and setting the LHN’s strategic priorities, commissioning the development of a five-year Strategic Plan, which has been informed by extensive consultation with communities, clinicians, staff and partners, and will be released in early 2020-21. We have also developed and approved a Consumer and Community Engagement Strategy and are well progressed with the development of a Clinician Engagement Strategy. Both these strategies will ensure that our decision making is shaped by our communities and clinicians.

From a performance perspective, EFNLHN has had a successful first year, balancing its budget and meeting the key performance targets we are measured against, except when COVID-19 restrictions prevented that. We have also retained the highest performance management rating (Level One) from the Department for Health and Wellbeing. But these measures tell only half the story.

Leadership of public health services is challenging at the best of times; health is a complex and high-risk business. In a vast geographical area like the Eyre and Far North, those challenges are compounded multiple times, particularly when an unprecedented challenge like COVID-19 emerges.

We have grappled through the year with funding models that have not kept pace with the needs of remote communities nor the costs and additional requirements of delivering health services to very remote and isolated communities. The Board will continue to seek recognition of these costs.

The Board recognised this year that the biggest risk facing the LHN is the ongoing doctor recruitment and retention crisis so prioritised a program of work to lay the foundations for fundamental reform in this area, supported by the Rural Health Workforce Strategy and Rural Medical Workforce Plan, released during the year.

The Board is particularly proud of work to redesign and re-establish the Ceduna Birthing Service, which provides a key service not just to local communities but to Aboriginal communities further inland.

The willingness of the LHN to think creatively, involve partners, and explore a new and ground-breaking midwifery model of care, along with success at recruiting medical services, made it possible.

We acknowledge the injustices and racism that continues to impact on the health and wellbeing of Aboriginal people, children, families and communities. We see the inequity in access to good health care and have set a strategic priority going forward that Aboriginal health is everyone’s business. We will not tolerate racism. We also acknowledge that more effort needs to be made to build the capacity and capability of our workforce who identify as Aboriginal. It is deeply regrettable that we did not achieve the four per cent target set this year for Aboriginal participation in our workforce and we will work hard to rectify that.

In terms of strategic priorities, the Board also focused on aged care governance. We have more aged care beds than hospital beds and recognised early the need to protect our elderly and vulnerable patients in our COVID-19 preparations. The Board has monitored the progress of the Royal Commission into Aged Care Safety and Quality so we are prepared for the recommendations, when they are released.

On behalf of the Board, I would like to thank the Chief Executive, Executive Team, clinicians, contractors and staff for their achievements this year; it is hard to convey concisely how complex and challenging this first year has been but the new LHN team has shown itself more than up to the task. We look forward to building on these achievements as we move into our second year.

Michele Smith
Board Chair
Eyre and Far North Local Health Network

From the Chief Executive Officer

I am pleased to present the 2019-20 Annual Report from the Eyre and Far North Local Health Network (EFNLHN).

At the start of this reporting period, the Eyre and Far North LHN became operational, following the devolution of Country Health SA Local Health Network to six regional Local Health Networks (LHNs).

Our new LHN has benefitted from being able to build on the strong foundations provided by the previous organisation whilst developing as an independent statutory authority with our own culture and ways of working.

Eyre and Far North LHN is one of the largest Local Health Networks, by geography, in Australia yet has one of the smallest populations. Planning and delivering services to remote and rural parts of South Australia can pose enormous challenges but also drives us to find new ways of working and to innovate.

There is no better example than the outbreak of COVID-19 in early 2020, which tested our staff, facilities, systems and processes. With hospital and aged care beds at 10 or our 11 hospital sites, we chose to prioritise the protection of vulnerable and elderly patients. We developed a strong coalition of partners, including District Councils, Aboriginal Community Controlled Health Organisations, emergency services organisations, the SA Ambulance Service, the Royal Flying Doctors Service, SA Pathology and others. We embraced the use of technology and new ways of working, and an enduring legacy will be expansion of the use of telehealth consultations to ensure our residents have access to the medical consultations that they need.

Despite the threat of COVID-19, we maintained acute and aged care services at all our sites without interruption and met our main key performance targets except in relation to elective surgery, which was postponed as part of the COVID-19 response state-wide. We balanced our budget despite a small reduction in activity at Port Lincoln Hospital, which was offset by a significant increase in the uptake of home and community care packages and disability services at home. This was achieved without increasing staffing and while our community nurses also visited people at home to provide COVID-19 swabbing and testing.

I would like to thank the LHN Governing Board for its support and our new Executive Team, who in their first year showed courage and determination in adapting to their new roles while planning and preparing for COVID-19. I pay tribute to our staff and contractors, including the General Practitioners we partner with to provide services in our hospitals, for their collaboration and resilience in what has been a challenging year. COVID-19 has perhaps overshadowed other crises, like the bushfire that threatened Port Lincoln and damage to Port Lincoln Hospital as the result of a storm at the start of 2020.

Over 2019-20 we conducted an extensive consultation to inform a new five-year Strategic Plan for the EFNLHN which will be released early in 2020-21. I would particularly like to thank local communities who participated in the consultation and provided us with feedback and insights about what they value most about health services, which has formed the basis of our new Strategic Plan.

In our first year, we have deliberately sought to change perceptions about the services we provide – in the past there has been a tendency to view the work of a Local Health Network as focused on hospitals, when in reality we have more aged care beds than hospital beds, and provide more care to people in the community than we have aged care beds.

We also manage the majority of Aboriginal health contracts in the SA Health system, as well as the Aboriginal Family Birthing Service and the Trachoma Program, which has made significant improvements to the health and wellbeing of communities it has worked with. Continuing to improve access to health services and outcomes for Aboriginal communities was a key focus this year and will continue to be a cornerstone of our work going forwards.

Redesigning and re-establishing the Ceduna Birthing Service was a key achievement in 2019-20 which will support that objective.

By the measures we report against, we have had a successful first year. There is always room for improvement, we have made a good start and look forward to working with our communities, staff, contractors and partners as we move into our second year.

Verity Paterson
Chief Executive Officer
Eyre and Far North Local Health Network

Overview: about the agency

Our strategic focus

Our Purpose

EFNLHN adopted the strategic purpose of Country Health SA LHN in its first year – to deliver a safe, reliable and consumer focused-health service, meeting changing needs and strengthening health outcomes for all.

Our Vision

EFNLHN adopted the Vision of the Country Health SA LHN in its first year – to be the best rural health service.

Our Values

EFNLHN adopted the Values of the Country Health SA LHN in its first year - Customer Focus; Collaboration; Caring; Creativity; Courage.

Our functions, objectives and deliverables

The Eyre and Far North Local Health Network provides hospital and community-based services including aged care, community health, disability and mental health to residents of the Eyre and Far North. The LHN’s objectives were to:

  • Build innovative and high performing health service models that deliver outstanding consumer experience and health outcomes.
  • Pursue excellence in all that we do.
  • Create vibrant, values-based place to work and learn.
  • Harness the power of partnerships to improve the effectiveness of services.
  • Elevate and enhance the level of health in Eyre and Far North communities.
The LHN’s key deliverables were to:
  • Provide safe, high quality health and aged care services.
  • Engage with the local community and local clinicians.
  • Ensure patient care respects the ethnic, cultural and religious rights, views, values and expectations of all people.
  • Ensure the health needs of Aboriginal people are considered in all health plans, programs and models of care.
  • Meet legislation, regulations, Department for Health and Wellbeing policies and agreements.


Our organisational structure

The Eyre and Far North Local Health Network (EFNLHN) is led by a Governing Board which is accountable to the Minister for Health and Wellbeing. The Chief Executive Officer is accountable to the Governing Board and leads an Executive Team as described in the organisation chart below.

Changes to the agency

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

  • Governance of the SA Health system was reformed to introduce Governing Boards to lead the Local Health Networks from 1 July 2019.
  • Country Health SA LHN was dissolved on 30 June 2019 and six new Local Health Networks established on 1 July 2016, including the Eyre and Far North Local Health Network, with a Governing Board and Chief Executive Officer.

Our Minister

The Hon Stephen Wade MLC is the Minister for Health and Wellbeing in South Australia. The Minister oversees health, wellbeing, mental health, ageing well, substance abuse and suicide prevention.

Our Governing Board

The Governing Board is responsible and accountable to the Minister for Health and Wellbeing for setting strategic priorities, performance, compliance and local decision- making.

Michele Smith, Chair of the Governing Board

Michele is the Chief Executive Officer of the North Eastern Community Hospital and previously spent 11 years as the Regional Director of the Eyre and Far North Region for Country Health SA Local Health Network. Michele maintains registration as a Registered Nurse and is a Fellow of the Australasian College of Health Service Management. She has close family connections to the Eyre and Far North.   

Leanne Dunchue, Governing Board Member

Leanne is the finance expert on the Board. She is a self- employed Public Accountant living in Streaky Bay, with previous experience in the banking sector. She holds a Bachelor of Commerce and is a Fellow of the Institute of Public Accountants. 

Bruce Green, Governing Board Member

Bruce is the governance and business expert on the Board. He is a former Mayor of the City of Port Lincoln Council and served two terms as Mayor of Port Lincoln Council. Previously he has served as Chairman of Darling Downs Bacon, which returned to a position of financial viability under his leadership, as well as a Board Director on the Port Lincoln Health Advisory Council, West Coast Youth and Community Support and the Local Government Association of SA. 

Tina Miller, Governing Board Member (resigned 28/12/2019)

Tina is the Aboriginal Health expert on the Board. She is a Wirangu women from Ceduna, holding a Bachelor of Nursing, a Diploma in Aboriginal Primary Health and Certificate IV in Indigenous Leadership. Tina resigned from the Board at the end of 2019.

The Aboriginal Health member position on the Board had not been filled as at 30 June 2020.

Dr David Mills, Governing Board Member

David is the medical expert on the Board. He has worked as a GP on the Eyre Peninsula since 1988 and is a committed undergraduate and postgraduate teacher. He has worked in the Port Lincoln Aboriginal Health Service, served on the Eyre Regional Health Board and at the time of his appointment, was Associate Professor and Director of the Adelaide Rural Clinical School at the University of Adelaide.  

Jamie Siviour, Governing Board Member

James is the consumer expert on the Board. He is a self- employed cropping and livestock farmer from Lock on the Centre Eyre Peninsula. He was awarded a Medal of the Order of Australia in 2018 for services to the local community with an emphasis on rural health. Previously he has been involved with the Port Lincoln Hospital Inc Board, the Port Lincoln Health Advisory Council and the Lock Health Centre Advisory Committee. He is a Justice of the Peace and a Graduate of the Australian Institute of Company Directors.

Chris Sweet, Governing Board Member

Chris is the legal expert on the Board. He is a partner with Finlaysons law firm, with extensive experience in health professional disciplinary matters, claims management, clinical risk management and coronial inquests. He served as an independent member of the Clinical Risk and Audit Committee of the Women’s and Children’s Health Network between 2010 and 2018. 

Our Executive

Chief Executive Officer

Verity Paterson is accountable to the Governing Board for the provision, management and administration of health services and achieving the overall performance of the Eyre and Far North Local Health Network.

Executive Director, Nursing and Midwifery

Julie Marron is responsible for the delivery of Nursing and Midwifery professional services and is Executive lead for residential aged care services and quality, risk and safety.

Executive Director, Medical Services

Dr Susan Merrett is responsible for the professional leadership of and practice standards for medical services.

Executive Director, Allied and Community Health

Lisa Campbell is responsible for Allied and Community Health Services which provide a wide range of community, home and hospital-based services covering community health, aged and disability care.

Chief Finance Officer

Hudson Vieira is responsible for the delivery of comprehensive financial services and reporting, as well as the provision of strategic financial advice and leadership.

Director, Aboriginal Health

Sharon Bilney is responsible for the management of Commonwealth and State Aboriginal health contracts as well as Aboriginal Health programs and providing strategic advice and leadership.

Director, Corporate Services

Malinda Watson is responsible for corporate and business services that support the effective and safe operation of health units across the LHN.

Director, Governance and Strategy

Jane Robinson is responsible for governance, including the operations of the Board and Office of the CEO, and is the Executive lead for strategy, performance, communications, and project management.

Director, Mental Health Services

Martin Brueker is responsible for the delivery of mental health services within the LHN.

Director People and Culture

Joanne (Jo) Eaton is responsible for Human Resources, workforce services and strategies, strengthening culture and leading organisational development within the LHN.

Manager, Quality Risk and Safety (QRS)

Rebecca Kavanagh is responsible for the quality, risk and safety function, supporting sites and services to provide safe and quality consumer-focused care that is also compliant with national and state standards and requirements.

Legislation administered by the agency

Nil

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

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

The agency’s performance

Performance at a glance

In 2019-20 Eyre and Far North LHN achieved key performance areas including:

  • Meeting targets for all emergency department ‘seen on time’ triage categories.
  • Meeting targets for emergency department patients who left at their own risk.
  • Meeting all elective surgery timely admissions and overdue patient categories prior to the introduction of COVID-19 elective surgery restrictions.
  • Meeting targets for Mental Health services including post discharge community follow up rate.
  • Achieving targets for positive responses to key consumer experience questions.
  • Achieving targets in safety and quality performance indicators including potentially preventable admissions, hand hygiene compliance rates and hospital acquired complications rates.
  • Delivering services tailored specifically to the needs of local Aboriginal populations such as the Aboriginal Family Birthing Program, Trachoma Program and Aboriginal Community and Consumer Engagement Strategy.
  • Significantly expanding the delivery of community, in-home and disability services under the Country Health Connect brand within existing staffing.
  • All sites accredited under the Australian Council Healthcare Standards.
  • Effective transition to new governance arrangements from 1 July 2019.

Agency contribution to whole of Government objectives

More jobs

  • Establishment of a stand-alone Local Health Network, one of the biggest employers in the
  • Eyre and Far North.
  • Addition of an LHN
  • Chief Executive Officer, as well as Executive Team and Risk and Compliance Manager positions.

Lower costs

Costs for consumers were reduced through delivering programs such as:

  • COVID-19 testing at home.
  • Timely elective surgery.
  • Increasing access to Telehealth services, including for specialist consultations.
  • Home-based chronic disease monitoring.

Better Services

EFNLHN has delivered:

  • COVID-19 testing – with drive through clinics at Port LincoIn, Ceduna and Coober Pedy, and home testing by community-based nurses.
  • Re-opening of Ceduna Birthing Services with a new midwifery-focused model of care to strengthen quality and safety.
  • Expansion of renal services at Ceduna Hospital.
  • Introduction of medium level chemotherapy at Port Lincoln Hospital.
  • Funding secured for a GP/Obstetrician and GP/Anaesthetist to be based in GP practices in Port Lincoln.
  • 22 per cent increase in Home Care Packages, including 48 per cent increase in number of Aboriginal clients accessing those services.
  • A 45% increase in the value of packages for clients accessing National Disability Insurance Scheme (NDIS) services - growth from $1.3 million to $2 million.


Agency specific objectives and performance

Agency objectives Indicators Performance
Improving access to health services in our community
  • Specialist nursing and allied health activity service activity
  • Avoidable hospital activity
  • Potentially preventable admissions
  • National Disability Insurance Scheme (NDIS) program activity
  • 4,851 clients and 23,453 occasions of service in 2019-20
  • 478 clients and 8,560 occasion of service in 2019-20
  • 9.2% potentially preventable admissions, an increase from 8.4% in 2018-19
  • 165 clients and 6,230 occasions of service in 2019-20
Hospital services
  • Emergency departments seen on time
  • Elective surgery timely admissions
  • Acute inpatient activity
  • Targets met across all triage levels
  • Targets met prior to COVID-19 elective surgery restrictions were implemented
  • 4,776 same day patients, 5,048 overnight patients, 315 babies delivered (for whole of Eyre and Far North LHN in 2019-20)
Continuous improvement of quality and safety
Safety assessment code (SAC) 1 and 2 incidents
  • 29 SAC 1 and 2 incidents, compared to 19 the previous year (a 53% increase)
  • Overall, an increase of 66 patient incidents reported, with SAC 1 and 2 incidents accounting for 1.53% of all incidents reported
  • Continuous improvement of quality and safety
    Hospital acquired complications (HAC)
    1.2% of total overnight episodes where one or more HAC’s were present; an increase from 0.8% on the previous year
    Aboriginal Health
    • Aboriginal Health – Left ED at own risk
    • Aboriginal Health – left against medical advice (inpatient)
    • Aboriginal percentage of workforce
    • Trachoma
    • Trichiasis
    • 1.7% (target less than 3%); a reduction from 2.4% the previous year
    • 6.7% (target less than 4.5%); an increase from 6.3% the previous year
    • Target of 4% not met, 3.17% in June
    • 919 Aboriginal children aged 1 to 14 years old were screened for trachoma. Four cases of trachoma were detected in the 10-14 age group. The overall prevalence of active trachoma in Aboriginal children aged 1-14 years screened was 0.4%
    • 1,371 Aboriginal adults aged 15 years and over were screened for trichiasis. 4 cases of trichiasis detected and referred to the ophthalmologist. The prevalence of trichiasis in adults aged 15 years and over was 0.3%
    Improving Mental Health Outcomes
    • Restraint incidents per 1,000 bed days
    • Seclusion incidents per 1,000 bed days
    • Percentage of Mental Health clients seen by a community health service within 7 days of discharge
    • Not applicable
    • Not applicable
    • Not applicable
    Aged Care
    • Residential aged care occupancy
    • Aged Care Assessment Program (ACAP) assessments
    • Home Care Package occupancy rates
    • Commonwealth Home Support Program (CHSP) client numbers
    • Not applicable
    • 387 assessments completed
    • Occupancy rates increased from 107 to 136 between July 2019 and June 2020
    • 1,573 CHSP clients providing 27,510 occasions of service, enabling older people to remain independent in their own home for longer

    Corporate performance summary

    The Eyre and Far North Local Health Network achieved key performance outcomes including:

    • Introduction of effective governance framework to support the work of the new Governing Board.
    • Highest (Level 1) performance against Department for Health and Wellbeing annual contract achieved and maintained.
    • Completion of a security review at the two largest sites – Port Lincoln and Ceduna.
    • National Disability Insurance Scheme accreditation achieved.
    • Aged care staffing review undertaken to improve the safety of care.
    • Target for employees having an annual performance review and development discussion met.
    • Large number of staff supported to pursue professional development opportunities.
    • Country Health SA Reconciliation Action Plan for 2018-2020 adopted and development of the Eyre and Far North Local Health Network’s Reconciliation Action Plan commenced.

    Employment opportunity programs

    Table name
    Program name Performance
    Skilling SA EFNLHN supported 6 employees to undertake training relevant to their discipline including 1 staff member undertaking Cert IV in Work Health and Safety and 5 staff undertaking Diploma of Practice Management.
    Growing Leaders EFNLHN supported 9 employees to undertake the Growing Leaders Program.
    Manager Essentials Via the SA Leadership Academy, EFNLHN supported 4 staff to undertake this program.
    Enrolled Nurse (EN) Cadets 3 x EN Cadets commenced employment with the EFNLHN. Cadets commenced at Streaky Bay, Cleve and Coober Pedy, although 1 resigned before completing the cadetship.
    Transition to Professional Practice Program (TPPP) 9 Registered Nurses and 3 Registered Midwives commenced employment as TPPP’s within EFNLHN.
    4 RNs and 3 RMs commenced at Port Lincoln 2 RNs commenced at Wudinna 1 RN commenced at Kimba 1 RN commenced at Cowell 1 RN commenced at Ceduna

    Agency performance management and development systems

    Table name
    Performance management and development system Performance
    Performance review and development supports continuous improvement of the work performance of employees to assist them to meet the organisation’s values and objectives.
    • 90.33% of staff had an annual performance review and development discussion.
    • 63.78% of staff had a 6 monthly performance review and development discussion.
    EFNLHN has a strong commitment to the recruitment and retention of Aboriginal employees, striving to continue to build workforce capacity and capability to achieve a positive impact on the care provided to Aboriginal patients and families within a culturally safe environment. As at 30/06/20, 3.21% of employees within the Eyre and Far North Local Health Network identified as Aboriginal & Torres Strait Islander. 8 – Nursing 12 – Salaried 14 – Weekly Paid 2 – Other
    Mandatory Training Compliance As at 30/06/20, EFNLHN identified 66% compliance.
    Criminal History & Relevant Screening As at 30/06/20, EFNLHN identified 99.56% compliance.
    Flu Vax As at 30/06/20, EFNLHN identified 63% compliance.
    Immunisation Compliance As at 30/06/20, Immunisation Compliance was: Cat A – 100% Cat B – 100% Cat C – 100%

    Work health, safety and return to work programs

    Prevention and management of musculoskeletal injury (MSI)

    EFNLHN recorded 13 new MSI claims in 2019-20. This was 1 less than 14 in 2018-19, a decrease of 7%. New MSI claims accounted for 42% of new claims submitted.

    Prevention and management of psychological injury

    4 new PSY claim were received in 2019-20. This was 1 more than the previous year of 3 claims, an increase of 33%. PSY claims accounted for 13% of new claims.

    Prevention and management of slips, trips and falls (STFs)

    5 new STF claim received in 2019-20. This was 1 more than the previous year of 4. New STF claims accounted for 16% of new claims.

    Workplace injury claims


    Table name
    Workplace injury claims Current year 2019-20 Past year 2018-19 % Change (+ / -)
    Total new workplace injury claims 31 25 +24.0%
    Fatalities 0 0 0.0%
    Seriously injured workers* 0 0 0.0%
    Significant injuries (where lost time exceeds a working week, expressed as frequency rate per 1000 FTE) 24.14 16.79 +43.8%

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

    Work health and safety regulations

    Table name
    Work health and safety regulations Current year 2019-20 Past year 2018-19 % Change (+ / -)
    Number of notifiable incidents (Work Health and Safety Act 2012, Part 3) 1 4 -75.0%
    Number of provisional improvement, improvement and prohibition notices (Work Health and Safety Act 2012 Sections 90, 191 and 195) 1 8 -87.5%

    Return to work costs**

    Table name
    Return to work costs** Current year 2019-20 Past year 2018-19 % Change (+ / -)
    Total gross workers compensation expenditure ($) $426,666 $417,937 +2.1%
    Income support payments – gross ($) $259,698 $93,789 +176.9%

    **before third party recovery

    Data for previous years is available at Data.SA website

    Executive employment in the agency

    Table name
    Executive classification Number of executives
    SAES1 1
    RN6A06 1
    MD029G 1

    Data for previous years is available on the Data.SA website

    The Office of the Commissioner for Public Sector Employment has a workforce information page that provides further information on the breakdown of executive gender, salary and tenure by agency.


    Financial performance

    Financial performance at a glance

    The following is a brief summary of the overall financial position of the agency. The information is unaudited. Full audited financial statements for 2019-20 are attached to this report.

    Table name
    Statement of Comprehensive Income 2019-20 Budget $000s 2019-20 Actual $000s Variation $000s 2018-19 Actual $000s
    Total Income 111,501 121,415 9,914 n/a
    Total Expenses 115,970 123,900 7,930 n/a
    Net result (4,469) (2,485) 1,984 n/a
    Total Comprehensive Result (4,469) (2,485) 1,984 n/a


    Table name
    Statement of Financial Position 2019-20 Budget $000s 2019-20 Actual $000s Variation $000s 2019-19 Actual $000s
    Current assets n/a 30,602 n/a n/a
    Non-current assets n/a 146,330 n/a n/a
    Total assets n/a 176,932 n/a n/a
    Current liabilities n/a 29,626 n/a n/a
    Non-current liabilities n/a 12,584 n/a n/a
    Total liabilities n/a 42,210 n/a n/a
    Net assets n/a 134,722 n/a n/a
    Equity n/a 134,722 n/a n/a

    Consultants disclosure

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

    Consultancies with a contract value below $10,000 each

    All consultancies below $10,000 each - combined  Nil

    Consultancies with a contract value above $10,000 each

    Table name
    Consultancies Purpose $ Actual payment
    System Solution Engineering Storm rectification Engineering Services $10,000
    Leadership Pty Ltd Delivery of Stakeholder Consultation $15,700
    Total

    $25,700

    Data for previous years is available on the Data.SA website

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

    Contractors disclosure

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

    Contractors with a contract value below $10,000

    All contractors below $10,000 each - combined   $42,798

    Contractors with a contract value above $10,000 each

    Table name
    Contractors Purpose $ Actual payment
    HCA – Health Care Australia Agency $851,192
    Rural Locum Scheme Pty Ltd Agency $89,452
    Your Nursing agency Pty Ltd Agency $85,386
    Allied Employment group Pty Ltd Agency $35,077
    Workpac Group Agency $19,153
    Port Lincoln Aboriginal Health Service Inc Aged Care Services $64,530
    BDO Advisory (SA) Pty Ltd Financial Advice/Support Secondment $46,798
    Alan Morris Celebrancies & Business Services Professional Services provided in the role of Manager, Risk & Compliance $25,980
    Daniel Ross Services provided for Mid West - Country Health Connect Clients $24,465
    Susanne Rendell Services Provided for Clients $22,356
    David Wolf Services Provided for Clients $15,289
    Barry Nash Services Provided for Clients $12,687
    Total

    $1,292,365

    Data for previous years is available on the Data.SA website.

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

    The website also provides details of across government contracts.


    Risk management

    Risk and audit at a glance

    EFNLHN established an Audit and Risk Committee (A&RC) with an external independent Chair to advise and support the Board in fulfilling its responsibilities regarding risk management, audit and assurance.

    The A&RC meets quarterly and receives risk reports from EFNLHN as well as audit reports conducted by the Auditor-General’s Department, Department for Health and Wellbeing (DHW), and Internal Audits by the Rural Support Service (RSS).

    EFNLHN has implemented a local Ward to Board Risk Management Procedure which is consistent with the SA Health System-Wide Risk Management Policy Directive, providing staff with specific guidance on context, identification, analysis, evaluation, treatment, monitoring and communication of risk.

    The EFNLHN Governing Board developed and agreed a Risk Appetite Statement (RAS) during the year; the Risk Register adopted from the previous entity, Country Health SA LHN, was reviewed and aligned with the RAS, resulting in the consolidation and redrafting of risks, treatment and controls, to ensure the EFNLHN Risk Register is fit for purpose.

    An Internal Audit Charter was developed by the Rural Support Service and approved by the EFNLHN Audit and Risk Committee and Governing Board, enabling an Internal Audit Function in the Rural Support Service to support the six regional LHNs, including EFNLHN. The Charter provides guidance and authority for audit activities.

    Fraud detected in the agency

    Misconduct  0

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

    Strategies implemented to control and prevent fraud

    EFNLHN processes implemented to help control and prevent fraud include the following:

    • Establishment of an Audit and Risk Committee to provide advice directly to the Governing Board about any instances of fraud reported to the Independent Commission Against Corruption and to the Department for Health and Wellbeing’s Risk and Audits Branch.
    • Monthly reviews of organisational finances, financial management and performance by an operational Finance and Performance Committee, chaired by the Chief Finance Officer, and reporting monthly to the Board’s Finance and Performance Committee.
    • Annual review of Financial Controls Self-Assessment by the Audit and Risk Committee to ensure controls are in place to avoid fraud.
    • Annual Declaration of Interests procedure and registers to monitor and report on Conflicts of Interest.
    • Regular reporting by Shared Services SA to the EFNLHN Chief Finance Officer detailing any expenditure outside of procurement and approved delegations, reported to the Audit and Risk Committee and to the Board.

    Data for previous years is available at Data.SA website

    Public interest disclosure

    Number of occasions on which public interest information has been disclosed to a responsible officer of the agency under the Public Interest Disclosure Act 2018: 0

    Data for previous years is available at: Data.SA website

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

    Reporting required under any other act or regulation

    Nil

    Reporting required under the Carers’ Recognition Act 2005

    The EFNLHN Governing Board approved a Consumer and Community Engagement Strategy during the year, after extensive consultation with consumers, carers, and local communities, involving the six Health Advisory Councils in the Eyre and Far North.

    The Strategy is underpinned by the EFNLHN Consumer and Community Engagement Framework 2020-2023 (CCEF), the South Australian Health and Community Services Complaints Commission (HCSCC) Charter for Health and Community Services Rights (2011) and the SA Carer Recognition Act (2005).

    The Strategy supports the seven principles in the SA Carers Charter:

    • Carers have choices within their carer role.
    • Carers’ health and well-being is critical to the community.
    • Carers play a critical role in maintaining the fabric of society.
    • Services providers work in partnership with carers.
    • Carers in Aboriginal and Torres Strait Islander communities need specific consideration.
    • All children and young people have the right to enjoy lie and reach their potential.
    • Resources are available to provide timely, appropriate and adequate assistance to Carers.

    It also is consistent with the SA Health Consumer and Community Engagement Strategic Framework (CCESF) 2020-23 Principles of Engagement which include that “consumers, carers and the community must be active in service design and decision making”.

    EFNLHN’s approach is guided by five core enablers:

    1: Inclusive of diversity

    Strengthening health system participation and partnership with diverse communities and engaging effectively with these diverse groups.

    2: Accessible and informed opportunities to participate

    Promoting engagement opportunities that are accessible to the broadest range of consumers, carers and community groups to meaningfully participate.

    3: Partnering in co-design, planning and evaluation

    Partnering with consumers, carers and the community in planning, implementation and evaluation of its service.

    4: Systems, strategies and mechanisms for active engagement

    Ensuring systems, strategies and mechanisms to actively engage with consumers, carers and the community.

    5: Consumer centred best practice

    Ensuring consumer, carer and community engagement practices meet national standards and are informed by best practice.

    For people with or supporting someone with a mental illness, the Rural and Remote Mental Health Consumer and Carer Participation Program has been created to assist teams to achieve co-design with consumers; this is delivered to teams in a range of ways including through direct contact by the Experts by Experience team.

    EFNLHN maintains an Aboriginal Health Experts by Experience Register to assist services to engage with Aboriginal people living in country South Australia. The Register acknowledges the lived experience of Aboriginal people and the wealth of knowledge that comes with their life experience.

    EFNLHN also encourages the use of tools like the SA Health Guide for Engaging with Aboriginal People to support staff to engage Aboriginal people and their carers in a culturally respectful and effective way.

    Public complaints

    Number of public complaints reported (as required by the Ombudsman)

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

    Table name
    Complaint categories Sub-categories Example Number of Complaints 2019-20
    Professional behaviour Staff attitude Failure to demonstrate values such as empathy, respect, fairness, courtesy, extra mile; cultural competency Not applicable
    Professional behaviour Staff competency Failure to action service request; poorly informed decisions; incorrect or incomplete service provided Not applicable
    Professional behaviour Staff knowledge Lack of service specific knowledge; incomplete or out-of-date knowledge Not applicable
    Communication Communication quality Inadequate, delayed or absent communication with customer Not applicable
    Communication Confidentiality Customer’s confidentiality or privacy not respected; information shared incorrectly Not applicable
    Service delivery Systems/technology System offline; inaccessible to customer; incorrect result/information provided; poor system design Not applicable
    Service delivery Access to services Service difficult to find; location poor; facilities/ environment poor standard; not accessible to customers with disabilities Not applicable
    Service delivery Process Processing error; incorrect process used; delay in processing application; process not customer responsive Not applicable
    Policy Policy application Incorrect policy interpretation; incorrect policy applied; conflicting policy advice given Not applicable
    Policy Policy content Policy content difficult to understand; policy unreasonable or disadvantages customer Not applicable
    Service quality Information Incorrect, incomplete, out dated or inadequate information; not fit for purpose Not applicable
    Service quality Access to information Information difficult to understand, hard to find or difficult to use; not plain English Not applicable
    Service quality Timeliness Lack of staff punctuality; excessive waiting times (outside of service standard); timelines not met Not applicable
    Service quality Safety Maintenance; personal or family safety; duty of care not shown; poor security service/ premises; poor cleanliness Not applicable
    Service quality Service responsiveness Service design doesn’t meet customer needs; poor service fit with customer expectations Not applicable
    No case to answer No case to answer Third party; customer misunderstanding; redirected to another agency; insufficient information to investigate Not applicable
    Total

    0

    Number of positive feedback comments — 112

    Number of negative feedback comments  76

    Total number of feedback comments  188

    % complaints resolved within policy timeframes   22% (17) complaints not acknowledged within 2 working days, 19% (15) complaints not responded to within 35 working days

    Data for previous years is available on the Data.SA website