Department for Health and Wellbeing Annual Report 2019-20
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Department for Health and Wellbeing Annual Report 2019-20
The agency's performance (DHW Annual Report 2020 - 21)
Performance at a glance
As at the end of June 2021, 77 percent of the department’s election commitments* were reported as completed.
Table 1: Election commitment progress ratings at end June 2021
| Progress rating | June 2021 |
|---|---|
| Critical | 0 |
| At Risk | 0 |
| Delayed | 4 |
| On track | 12 |
| Completed | 53 |
Note: *Excludes commitments where DHW is not the lead agency
Table 2: CE KPI Comparison 2020-21 to 2019-20
| No | KPI Descriptor | Target | YTD 2020-21 | YTD 2019-20 |
|---|---|---|---|---|
| 1 | Transfer of care <= 30 minutes (ambulance ramping) | >=90% | 54.1% | 63.8% |
| 2 | (a) ED seen on time - Resuscitation (b) ED seen on time - Emergency |
>=100%
>=80% |
100%
63.2% |
100%
67.5% |
| 3 | Elective surgery overdues | <=300
|
1194 |
2131 |
| 4 | Consumer experience: overall quality*** | >=85%
|
88.8% | 89.3% |
| 5 | Potentially preventable admissions | <=8%
|
7.6% | 8.2% |
| 6 | Hospital acquired complication rate | <=2.0%
|
2.9% | 3.0% |
| 7 | SAB^ infection rate | <= 1
|
0.9 | 1.3 |
| 8 | Hospital standardised mortality ratio*** | Inlier | Outlier | Inlier |
| 9 | Average cost per NWAU* | <=NEP
|
113.7% | 114.2% |
| 10 | Executive tenure within SA** | >= 3 years
|
3.6 years | 3.1 years |
Notes:
^SAB infection = Staphylococcus aureus bloodstream infections
*Average Cost per National Weighted Activity Unit (NWAU) represents the 2019-20 December YTD costing for all LHNs, except Regional LHNs whose costing was not able to be completed and signed off prior to publication. Funding Models team unable to provide more up to date data at time of publication.
**Executive tenure refers to LHN and SAAS CEOs and DHW Deputy Chief Executives (within own LHN/SAAS/DHW). Includes tenure of positions where CEOs were in executive positions prior.
***Metrics reported quarterly
Four KPIs have shown a deterioration in performance against the same time last year. Increased demand for service and the impact of COVID-19 have adversely influenced performance of the Transfer of care <= 30 minutes and Emergency Department seen on time metrics. Elective surgery overdues show a substantially improved position against same time last year. Consumer experience and SAB infection rate KPIs have consistently achieved targets since 2018-19.
Productivity Commission
Health and Medical Research (HMR) is an integral component of South Australia’s healthcare system. It is also one of the largest components in the broader Research and Development sector. The South Australian Productivity Commission (SAPC) was asked to identify where improvements could be made to the structure, governance and operation of publicly funded HMR to better support sustained growth in the sector. The SAPC Inquiry reported in November 2020 setting out its recommendations across five key themes:
- Regulatory reform
- Workforce
- Access to data
- Commercialisation and translation
- Enabling system architecture.
The recommendations were broadly supported by Government as a starting point for reform and capacity building in the sector and SA Health will be the lead agency in a number of these areas. Whilst SA Health provides important enablers, the HMR sector is complex and to be successful will require a whole of government approach together with purposeful relationships between partners such as universities, research institutes and individual innovators.
There is a focus in the report on systems and processes within SA Health to streamline research ethics and governance approvals. Together with reform of the regulatory environment and support for better access to patient data the recommendations strongly align and build upon existing activity within the department. The report also makes recommendations that call for greater transparency of outcomes and performance, which will form the basis for more deliberate actions and investment to build the sector. There is a significant focus on the use of data within research and the department has supported the Commission on Excellence and Innovation in Health to develop a Data and Analytics Plan 2020–2023.
The Government response to the Inquiry also called for the development of a South Australian Health and Medical Research Strategy to be developed by July 2022 which will provide an opportunity to provide a system level perspective and define a vision for the sector in South Australia.
Agency response to COVID-19
SA Health continued to fulfil its role as Control Agency for human epidemics as outlined in the South Australian Emergency Management Act 2004.
Between 1 July 2020 and 30 June 2021 there were 696 confirmed cases of COVID-19 with zero COVID-19 related deaths in South Australia.
The State Control Centre Health (SCCH) remained operational throughout 2020-21 seven days a week 7am – 10pm. SCCH includes representatives from key State Government agencies, particularly emergency services, to support a statewide response. SCCH also attended airports and medi-hotels to manage the repatriation of international arrivals into the medi-hotel system across seven regular in-bound flights a week, and numerous ad hoc commercial flights.
In addition to this, the SCCH has supported many key major events to ensure they are COVID safe.
Quarantine
With support from key internal and external partners, Medi-Hotel Operations managed the State’s nationally commended supervised hotel quarantine program. The Program includes six medi-hotels located in Adelaide’s Central Business District, including Australia’s first dedicated COVID-positive facility, Toms Court.
Supplementary alternative quarantine arrangements support seasonal workers (Riverland region); special interest groups (such as international tennis stars for ‘A Day at the Drive’ tennis tournament, and USA and Japanese astronauts and space technicians for their joint exercise and rocket launch); with planning underway to accommodate international students next financial year (metropolitan Adelaide).
The Medi-Hotel Program is underpinned by a model of care operationalised by
SA Health’s Rapid Response Nursing and Midwifery Service. The Program operates with a collaborative ‘one-team’ continuous improvement approach, to quickly and effectively implement change as the COVID pandemic evolves – to identify and ensure containment of COVID-19 within the quarantine environment. External partners include but are not limited to the participating hotels, SA Police, the Australian Defence Force, MSS Security, the Department for Trade and Investment and the Department of Primary Industries and Regions.
The Program is subject to expansive assurance processes, and strict surveillance testing is undertaken and mandated by the Emergency Management (Supervised Quarantine) (COVID-19) Direction 2021.
Between 1 July 2020 and 30 June 2021, the Program supported:
- 23,323 International Travellers
- 1,560 Domestic Travellers
- 406 Local Travellers
- 807 Seasonal Workers.
Infection Control Service
A dedicated infection prevention and control service was established to support and guide the statewide multi-disciplinary infection control response. Initially assembled from a small number of highly experienced infection control nurses, this unit is currently in the process of rapid expansion, onboarding and upskilling additional staff. Further statewide capacity is being built by developing a new rapid training program for COVID-19 surge infection control link nurses.
Contact tracing
Contact tracing capability is supported by approximately 100 trained staff with the capacity to scale up during outbreak situations. This workforce is broken down into four key units, including COVID Surveillance and Investigation Services, Infection Control Service, Medical Unit and Operations Support. In addition, over 160 public sector staff have undertaken contact tracing training, with around 100 of these mobilised staff returning on a monthly basis for continuity training.
IT systems
A customised Salesforce platform was procured in 2020 to support and enhance contact tracing capability, with further specialised development to provide comprehensive back up and audit functionality and integrate with the COVID Operations Contact Management Application.
High-Risk Outbreak Response Planning
Extensive work was undertaken to support the development of outbreak response plans for high-risk environments, including Aboriginal populations, commercial maritime vessels, hospitals, prisons and aged care facilities. Further work is underway for homeless persons, meatworks, schools and international students.
COVID-19 vaccinations
The COVID-19 vaccination program commenced in February 2021 with the establishment of vaccination clinics in the State’s major metropolitan hospitals and most regional State hospitals. Since this time, the vaccination program has extended to include four large scale vaccination sites in metropolitan Adelaide (Elizabeth, Women’s and Children’s, Noarlunga and Wayville) as well as more than 30 clinics across regional South Australia.
The program has worked closely with a range of stakeholders including identified vulnerable groups, other government agencies, emergency services and LHNs who have delivered the program. Consistent with the Commonwealth implementation framework, the vaccination program supports the delivery of COVID-19 vaccine to eligible South Australians who request it and will be delivered in a safe and timely manner.
Agency contribution to whole of Government objectives
| Key objective | Agency’s contribution |
|---|---|
| More jobs Rural Health Workforce |
The State Government provided an investment of $20 million over four years, from 2018-19 to 2021-22, to develop and implement a Rural Health Workforce Strategy. The election commitment to ‘recruit, train and develop health professionals and skilled volunteers needed to deliver services in rural areas’ has seen more than $16 million spent on initiatives to support doctors, nurses, midwives, paramedics, Aboriginal health workers and allied and scientific health professionals working in rural South Australia, including the delivery of the:
|
| Lower costs Financial Monitoring |
As system leader, the department provided high-level system direction and ongoing performance monitoring and management during 2020-21 to LHNs and SAAS. Regular monitoring of financial management and performance was conducted. Assessment of activity volumes and complexity was undertaken to review the cost to deliver services against the National Efficient Price (NEP), to determine system efficiency. A key commissioning principle is to allocate activity and funding in line with the NEP which is determined on an annual basis by the Independent Hospital Pricing Authority. The department introduced a budget management workstream plan to ensure a continued focus on the development and implementation of solutions for cost effective delivery across South Australian public hospitals. |
| Better Services
Reactivating the Repatriation General Hospital (the Repat) as a health precinct |
The Repat Master Plan project continued through the implementation phase and a staged delivery process in 2020-21. This included:
|
| Reducing the elective surgery backlog | On 11 June 2021, the Minister announced a further investment of $20 million for elective surgery and colonoscopy procedures in the 2021-22 State Budget. Funding is specifically targeted towards those surgeries and procedures where the greatest impact on wait times will be achieved. |
| Providing better health services in our regions | The department developed a regional services workstream plan to develop and implement a clear roadmap to support the ongoing delivery of sustainable health services in regional South Australia. |
| Support to those in distress as a result of bushfires and COVID-19 | The South Australian Government responded to the mental health impact of COVID-19 with a $15 million plan, which has been allocated across a range of mental health initiatives and drug and alcohol services in response to the pandemic. An additional $5 million was invested over two years in response to the bushfire crisis through the increase of mental health clinical services to impacted areas, in particular, Kangaroo Island and the Adelaide Hills. |
Agency specific objectives and performance
The department is committed to delivering services that produce positive outcomes to the health and wellbeing of all South Australians by:
- Providing leadership in reforming our health system, public health services, health and medical research, policy development and planning that collaborates with other government agencies whenever possible.
- Managing growth and aligning services to population demand and addressing inequities in patient outcomes.
- Improving the quality and safety of health care through evidence and research.
- Utilise technology and information solutions that provide alternate options for patients to deliver better patient outcomes.
- Improving mental health care.
- Reducing and better managing health conditions and promoting Aboriginal community health and wellbeing.
- Focussing on health promotion, illness prevention and early intervention to sustain good community health and wellbeing.
These areas of strategic focus strongly support the government’s objectives to deliver real change in South Australia that creates better government services.
1. Providing leadership in reforming our health system, public health services, health and medical research, policy development and planning that collaborates with other government agencies whenever possible.
| Indicators | Performance |
|---|---|
| Reform SA Health Governance | The Health Care (Governance) Amendment Act 2021 was passed by the South Australian Parliament on 8 June 2021. Page 12 of this Annual Report provides further information about the Act. |
| SA Pathology Sustainability Project | SA Pathology delivered on its second-year cost reduction target of $11 million, resulting in a total of $18.3 million across 2019-20 and 2020-21 through re-modelling business delivery models and establishing sound commercial practices. Service level improvements for time critical diagnostics continued to meet and exceed national targets with statewide performance increasing to 92 percent. SA Pathology continued to lead the pathology COVID response for South Australia and demonstrated a vastly improved performance with a clear commitment to quality care, innovation and sustainability. |
| Independent Commissioner Against Corruption (ICAC) Commissioner’s Report Troubling Ambiguity: Governance in SA Health | The government response to the ICAC Commissioner’s Report Troubling Ambiguity: Governance in SA Health was overseen by a multi-agency Taskforce, chaired by the Chief Executive of the Department of the Premier and Cabinet. The SA Health Integrity Program was comprised of three related workstreams supporting the development of integrity improvement initiatives. Although impacted by the COVID-19 pandemic in early 2020, work recommenced from mid-2020 with activities under the cultural and practice reform workstreams completed in late 2020. Activities under the industrial reform workstream were completed in early 2021 with program closure activities underway in July 2021. The deliverables under the SA Health Integrity Program have been significant, although there is strong recognition that the work delivered through the Program will require embedding into business as usual. Specific deliverables, such as the development of the Cultural Evolution Pathway and the implementation of new policy and compliance frameworks across the system will be key to ensuring a continued focus on integrity in SA Health. |
| Upgrade Hospital Infrastructure | New Women’s and Children’s Hospital (nWCH) Work on preparing a full business case and completing early design work for the nWCH continued through 2020-21 enabling further consideration by Government and approval of the project scope and budget in June 2021. Project delivery is targeting completion in 2026. Women’s and Children’s Hospital (WCH) The new Special Care Baby Unit became operational in August 2020 with the Neonatal Intensive Care Unit upgrade commencing clinical services in August 2021. A new 12-bed Child and Adolescent Mental Health Service became operational in March 2021 and the Paediatric Emergency Department (ED) was upgraded with full operation commencing in May 2021. Six of the eight existing operating theatres have now been upgraded with the remaining zones to be progressively completed by March 2022. The Queen Elizabeth Hospital (TQEH) Sustainment works to upgrade the existing engineering infrastructure and readiness of the site for future construction works is scheduled for completion in early September 2021. Site preparation works commenced in June 2021 to prepare for the construction of a new clinical services building in late 2021 delivering a new ED, medical imaging, operating theatres, central sterile services, general rehabilitation wards and associated functions. Concept, design development and documentation of the new clinical services building continued with full design documents to be completed late 2021. The construction tender process (Registration of Interest) also commenced. Modbury Hospital Works to Level 1 West and North Surgical Units were completed on 30 March 2021 and commenced providing clinical services on 28 April 2021. The four-bed High Dependency Unit commenced providing clinical services on 31 March 2021. Works to the new outpatient department building were completed on 30 March 2021. The main entry, kiosk and accessible car park opened to the public on 31 March 2021 and outpatient clinical services commenced 19 April 2021. Palliative Care Unit and Short Stay General Medical Unit works are forecast for completion in January 2022. Flinders Medical Centre Design works and construction commenced on the expansion of the ED with delivery of the enabling phases and the paediatric ED stage completed. Remaining stages are scheduled for completion in August 2021. Repat Health Precinct Works to reactivate the Repat as a health precinct continued with the delivery of the Neuro-Behavioural Unit and Specialist Advanced Dementia Unit in July / August 2020 and completion of the transition care wards in March 2021. The new Veteran’s Wellbeing Centre became operational in June 2021. Construction works on the new town square, brain and spinal rehabilitation buildings will continue to late 2021. Murray Bridge Soldiers' Memorial Hospital All stages of a $7 million upgrade of the ED were completed and became operational in January 2021. Mt Barker Soldier’s Memorial Hospital Design works continued on the expansion of the ED with construction works planned to commence in October 2021. Lyell McEwin Hospital Enabling works to support the new building construction were completed in December 2020. Part of these works included a shared temporary corridor to allow emergency services and community access into the existing ED during construction of the new ED. New building construction is ongoing with the concrete floor slabs and columns being completed. Completion of the new building is anticipated to occur in March 2022. Internal refurbishment of parts of the existing ED will then follow on with full project completion anticipated for the end of 2022. Country Hospital Capital Works / Regional Asset Sustainment Program A program of works (with a total budget of $150 million) is being implemented to address the backlog of asset sustainment works associated with country hospital and aged care facilities across all regional LHNs with 2020-21 being the third year of a 10-year program. SA Health is working with the Department for Infrastructure and Transport to promote the engagement of regional construction and trade enterprises to deliver these critical sustainment works where possible. Strathalbyn and District Health Service Construction works commenced on the 36-bed residential aged care extension including new kitchen and laundry facilities. Construction of the new 12-bed Memory Support Unit was completed in June 2021 with the remaining components scheduled for completion December 2021. SA Health Distribution Centre Development of a new distribution centre continued with the core building structure completed and the internal equipment fit-out underway. Full project completion and transition of warehousing functions to the new facilities will occur by late 2021. Development of a new SA Pathology Laboratory Price Waterhouse Cooper has been engaged to develop the full business case to consider dual options for consolidating:
Sites for co-location have been explored and a preferred site identified. Further work is underway to detail the costs associated with co-location on the preferred site compared to alternate site options. The outcome will enable government to make an informed decision on the financial viability of:
|
2. Managing growth and aligning services to population demand and addressing inequities in patient outcomes.
| Indicators | Performance |
|---|---|
| Ramping and Surge Capacity | Service Agreements between the department and LHNs and SAAS continue to include agreed performance indicators to measure activity and demand management specific to EDs and ambulance services. The indicators are supported by a range of statewide and local strategies which are activated across the department, LHNs and SAAS to tackle ambulance ramping and access block. These strategies aim to create system capacity, support access to timely and safe health care, and reduce length of stay. This includes, but is not limited to, the Southern Health Expansion Plan, Priority Care Centres, Urgent Mental Health Care Centre and criteria led discharge. The hospital demand portal is regularly updated with new strategies and initiatives. Further information can be found on the Hospital Demand Management Plan page. The department in collaboration with Statewide Demand, Escalation and Policy Working Group nominated representatives, continues to progress development of a suite of documents to support escalation and patient flow. This includes the draft Statewide Demand and Escalation Policy, which aims to enable a more consistent approach to demand management in public hospitals, maximise available capacity, and ensure the continuity of critical business services while maintaining patient and staff safety. |
| Demand Management | From February 2021, the department has led an executive priority workstream focussed on demand management. The aim is to develop and implement solutions for improved management of demand and patient flow in public hospitals with a view to addressing the causal factors of ambulance ramping. The workstream has worked collaboratively to devise a range of targeted projects to achieve the following:
The projects include a planned uplift in public hospital capacity across the broader system in 2021 and patient-centred initiatives such as the Complex and Restorative Evaluation Program delivered by Southern Adelaide LHN and the Virtual Triage and Assessment Service delivered by the Women’s and Children’s Health Network (WCHN). |
| Reducing the elective surgery backlog | Restrictions on elective procedures across public and private hospitals early in the COVID-19 pandemic, whilst necessary to preserve stocks of Personal Protective Equipment and prepare the health sector for the impact of COVID-19, created pressure on the provision of timely access to care. As at 30 June 2021, there were 19,249 patients ready for care on an elective surgery waiting list, including 1,194 patients (six percent) who were overdue for their procedure. This is a 44 percent improvement from the 30 June 2020 position of 2,131 overdue patients, and a reduction of 57 percent from the COVID high of 2,781 on 30 May 2020. The department continues to pursue initiatives to reduce overdue procedures including: Direction under Health Care Act 2008 A Direction issued by the Chief Executive on 14 May 2020, under the Health Care Act 2008, mandates that increased elective surgery activity in the public system must be comprised of each hospital’s overdue elective surgery waiting list. Once the overdue waiting list is extinguished (within a given specialty) a ‘Treat in Turn’ rate of at least 60 percent must be maintained in the relevant specialty thereafter. LHN initiatives In March 2021, the department established a new elective surgery workstream to ensure people receive surgery within clinically defined time frames. The department worked with LHNs to progress work on a number of initiatives to address overdue elective surgery patients, focusing on a combination of internal efficiencies as well as utilising private providers. SA Health Patient Services Panel (PSP) The PSP provides a framework for LHNs to partner with approved private providers to access a range of health services. The PSP continued to facilitate access to private bed capacity and the delivery of elective surgery procedures. As at 30 June 2021, 2,851 referred elective surgery patients had been treated in 2020-21. |
| Palliative care outreach services | From 2018-19 to 2021-22, $16 million has been invested to expand palliative care in the community. In 2020-21 this was delivered through:
|
| Raise the participation rate of South Australians in Advance Care Directives (ACDs) | The State Government is committed to increasing the uptake of ACDs by increasing resources, raising awareness, and delivering education programs. Following a review of the Advance Care Directives Act 2013, an Oversight Group is now guiding the implementation of the Government’s response to simplify the process of ACDs for the community. In 2020-21, the department led the development of draft legislation to amend the ACD Act, commenced the redesign of the ACD Form and Kit, and continued to promote new ways of completing ACDs in partnership with local councils and residential aged care facilities. |
3. Improving the quality and safety of health care through evidence and research.
| Indicators | Performance |
|---|---|
| Reduce the abuse of prescription drugs through real-time prescription monitoring (RTPM) | In the 2018-19 State Budget, $7.5 million was committed over three years to support a RTPM solution for Schedule 8 medicines in South Australia. ScriptCheckSA was released in March 2021 to meet the Government’s election commitment and is supported by training and resources for prescribers and pharmacists and community / patient education. Following a formal evaluation of the implementation process, it is intended to transition to mandatory use of ScriptCheckSA within the next 12 months. South Australia is the second jurisdiction, following the release of Victoria’s SafeScript, to deliver a RTPM system to prescribers and pharmacists. |
4. Utilise technology and information solutions that provide alternate options for patients to deliver better patient outcomes.
| Indicators | Performance |
|---|---|
| Sunrise Electronic Medical Records System | Work to implement the Sunrise electronic medical record (EMR) continued at Southern Adelaide LHN (SALHN) and commenced at WCHN. Flinders Medical Centre implemented the first two stages of the EMR including the Patient Administration System (Sunrise PAS) across outpatient and inpatient areas. Work continues to finalise the clinical implementation of Sunrise EMR across inpatient areas in July 2021, completing SALHN’s implementation. The WCHN commenced site preparation activities and staff training for Stage 1 implementation of Sunrise PAS across outpatient areas, due to be completed in September 2021. Additional key projects completed include:
Additional system improvements were deployed into the EMR in response to improvement requests made by clinical and administrative staff. |
| Expand technology platforms to enhance service delivery | Improvements in the management of hospital demand and supporting access to care by removing the requirement to enter a healthcare environment has protected vulnerable groups. Examples of achievements in response to COVID-19 included:
|
| Quality Information and Performance Hub (QIP Hub) | The QIP Hub supports our workforce with increased access to transparent data regarding clinical outcomes and system performance. This enables greater opportunities for data utilisation to propel innovation into our practice and delivery. Achievements include the release of real time dashboards with operational data - an Inpatient Activity Analysis dashboard, a Challenging Behaviours dashboard and an entire suite of COVID dashboards. |
5. Improving mental health care.
| Indicators | Performance |
|---|---|
| Suicide prevention | The community and population component of suicide prevention responsibility was transferred into Wellbeing SA during 2020-21, with commensurate staffing resources. The Office of the Chief Psychiatrist within the department maintains approaches to suicide prevention in clinical care. This includes Towards Zero Suicide in care initiated under the Mental Health Services Plan 2020 – 2025. Towards Zero is an internationally recognised approach to improving care and outcomes for people presenting with self-harm and suicidal thoughts. The approach has broad outcomes for services, staff and the people receiving care. |
| Mental Health Services Plan (the Plan) 2020 – 2025 | The Plan supports more efficient access to personalised care, earlier intervention and crisis prevention and has a strong human rights approach. It includes the Toward Zero program, alternative models for people experiencing mental distress, and is based on a nationally agreed planning framework. The Urgent Mental Health Care Centre is an integral part of the reformed crisis response outlined in the Plan. The Centre supports a better experience for people in psychological distress and aims to improve outcomes. The Centre was opened in the Adelaide CBD on 1 March 2021. The crisis response part of the Plan includes Crisis Stabilisation Units with the first being planned for the northern suburbs. Crisis Stabilisation Units support early intervention in a more welcoming and home-like environment with a high ratio of staff with a lived experience of mental health issues. The Non-Government Organisation (NGO) Redesign project aims to deliver redesign for SA Health contracted NGO services, align accessible and equitable services with the needs of people with mental health issues, and maximise public value, particularly in the context of the National Disability Insurance Scheme (NDIS). New NGO service models will be identified, developed using a co-design partnership approach. |
| Establish a paediatric eating disorder service | SA Health continues to progress with the establishment of a dedicated statewide paediatric eating disorder service, focusing on outpatient services for people under 18. A model of care and associated governance structure has been approved, with SALHN and WCHN collaborating to deliver an integrated service with statewide reach. More detailed planning of services and implementation is well underway, with appointments to clinical positions expected in the coming months. |
| Expand support for people living with Borderline Personality Disorder | SA Health is facilitating three groups, two common factors short groups (adult and youth), one Brief Schema Therapy group and one Dialectical Behaviour Therapy group. The latter two are conducted by videoconference for regional consumers. Training and research activities are continuing and demonstrating positive results for therapeutic and capacity building services |
6. Reducing and better managing health conditions and promoting Aboriginal community health and wellbeing.
| Indicators | Performance |
|---|---|
| Development of SA Health’s Aboriginal Health Care Framework (Framework) | A five-year Framework is being finalised. It synthesises the most recent available data with the results of previous comprehensive consultation with Aboriginal communities, partners and our staff to guide local service responses across the life course. The Framework seeks to provide an effective benchmark to measure contributions towards closing the gap on health disparity between Aboriginal and non-Aboriginal people in South Australia across the life course. |
| Development of the South Australian Aboriginal Sexually Transmissible Infections (STI) and Blood Borne Virus (BBV) Action Plan 2020-2024 | The Action Plan was finalised and endorsed by the Minister in 2020-21. The purpose of the Action Plan, developed by an Aboriginal-led steering committee is to outline strategies and actions to reduce disparities between Aboriginal and non-Indigenous South Australians with respect to the transmission of, and morbidity and mortality caused by STI and BBV and to reduce the clinical and social impact of these infections. |
| Development of the SA Syphilis Outbreak Response Plan | The aims of this Plan, which was finalised and endorsed by the Minister in 2020-21, are to control the outbreak of infectious syphilis among Aboriginal and Torres Strait Islander populations in South Australia, focusing on eradicating congenital syphilis. |
7. Focussing on health promotion, illness prevention and early intervention to sustain good community health and wellbeing.
| Indicators | Performance |
|---|---|
| Vaccinations for meningococcal disease | Eligible South Australians are protected against meningococcal ACWY* disease through the National Immunisation Program (NIP) and against meningococcal B disease through the State funded Meningococcal B Immunisation Program and the NIP meningococcal B program for Aboriginal and Torres Strait Islander infants and persons at high risk of meningococcal disease. In 2020-21, 90,153 doses of meningococcal B vaccine were distributed with 79,554 doses through the State funded Program and 10,599 through the NIP. As part of the 2021-22 State Budget, it was announced on 22 June 2021 that the Meningococcal B Immunisation Program (the first in Australia) will continue indefinitely after proving its effectiveness at preventing the disease in high-risk age groups. A total of 42,293 doses of meningococcal ACWY* vaccines were distributed through the NIP. *Meningococcal ACWY vaccine protects against four types of meningococcal disease; the A, C, W and Y types. |
| Vaccinations for Influenza | The eligible SA population is protected against influenza disease through the national and State funded immunisation programs. Funded vaccines are available to children aged from six months to less than five years, SA Health healthcare workers, people aged 65 years and over, pregnant women, Aboriginal people, homeless people and those considered medically at risk. SA Health distributed 528,171 doses of funded influenza vaccine by week 13 of the 2021 Influenza Program (25 June 2021). Influenza vaccines are available on the private market for those not eligible for the funded vaccines. |
| Clinical Cancer Registry | Responsibility for the development of the Clinical Cancer Registry transferred to Wellbeing SA and the Commission on Excellence and Innovation in Health in 2020-21. |
| Elective Surgery and Colonoscopy Collaborative | In 2020-21, the department developed an elective surgery and colonoscopy workstream plan to develop and implement solutions for improved management and performance of elective surgery and colonoscopy procedures across South Australian public hospitals. The workstream is driven by an Elective Surgery and Colonoscopy Collaborative comprising key stakeholders from across the department and LHNs. As at 30 June 2021, there were 19,249 patients ready for care on an elective surgery waiting list, including 1,194 patients (six percent) who were overdue for their procedure. This is a 44 percent improvement from the 30 June 2020 position of 2,131 overdue patients, and a reduction of 57 percent from the COVID high of 2,781 on 30 May 2020. As at 30 June 2021 statewide, a total of 1,407 new patients were ready for care on a public hospital colonoscopy waiting list including 409 (29 percent) overdue new colonoscopy patients. This is a decrease of 748 (35 percent) overdue patients since 30 June 2020. |
| Reduce statewide smoking prevalence | The State Government’s commitment to high levels of quit smoking advertising has contributed to a general downtrend in South Australian smoking rates (20.7 percent in 2010 compared to 10.6 percent in 2020). The two campaigns delivered in South Australia in 2020-21 focussed on encouraging smokers to quit their own way. The ‘Quit your way in May’ initiative in May 2021 further added to the campaign’s ability to drive large numbers of smokers to engage in quitting attempts. This resulted in almost 1,200 registrants and more than 9,000 people visiting the event’s website. The Aboriginal-focused campaign had over 3,500 website users on average each month and over 17,000 visits to the campaign website. |
| Introduce a system of Youth Treatment Orders for children under the age of 18, confirmed as suffering from dependence on or at risk of harm from alcohol related or other drug use | The department works across Government to respond to drug dependency in young people. This Program provides the option of Court ordered treatment for children and young people experiencing drug dependency. An Interagency Working Group provided advice to the Government on a draft Model of Care to guide the implementation of the legislation. Community consultation on the draft Model of Care underpinning the program was completed in early 2021. The Government is considering findings from the consultation. |
| Accessible advice and self-assessment tool for individuals concerned about their alcohol and other drug use | The Know Your Options website directs the public and health professionals to alcohol and other drug assessment, treatment and support services across South Australia. The site also provides advice on minimising the risk of harm associated with alcohol and other drug use. In 2020-21, there were 23,073 website sessions across 16,122 users, an increase of 22 percent and 23 percent respectively compared to the previous reporting period. Know Your Options has been expanded to include eASSIST, the World Health Organisation endorsed assessment tool enabling the public to assess their own risk relating to the use of alcohol and other drugs, or clinicians to work through the questionnaire with a client. |
| Pharmaceutical Benefits Scheme (PBS) - Subsidised Take Home Naloxone Pilot (the Pilot) | The Pilot commenced 1 December 2019 with an initial completion date of 28 February 2021. The completion date has been extended while independent evaluation is completed and submitted to the Commonwealth for consideration in September 2021. Through the Pilot, vouchers for free naloxone are provided to people at risk of experiencing or witnessing adverse effects of opioids. The vouchers are offered via hospital and community pharmacies, primary care settings, alcohol and other drug services and Clean Needle Programs. People may also present to participating pharmacies for no cost naloxone without a voucher and receive brief advice alongside naloxone client handouts. In 2020-21, 2,109 individuals accessed naloxone through one of 250 Pilot registered community pharmacies in South Australia. |
Corporate performance summary
Corporate initiatives for the department in 2020-21 include:
Legislative compliance
On 14 May 2021 the department finalised an across-Health master agreement for law firm Health Legal Pty Ltd to provide certain enhanced Legislative Compliance Services.
Health portfolio entities (including LHNs and SAAS) may enter individual supply contracts for a range of services to assist compliance activities and accreditation activities for National Safety and Quality Health Service Standards. The services include legislative obligations registers, aged care quality standards registers, register updates, legislative alerts, and case law updates.
The master agreement operates for up to six years (comprising of an initial three-year term, with three further one-year extension options).
SA Health Policy Governance Framework
The department released a new SA Health Policy Governance Framework (the Framework) in February 2021 providing a contemporary approach to developing and implementing policies across SA Health. The new Framework makes it easier for staff to understand and fulfil their obligations and supports the more effective operation of our public health system.
The new Framework is a key component of the SA Health Integrity Program, established to guide our governance and culture improvements.
Windows 10 and office 365 upgrade
To enable the department to operate in a modern, agile and secure ICT environment, a Windows 10 and office 365 upgrade program commenced in June 2021 with completion scheduled for 30 July 2021.
Employment opportunity programs
| Program name | Performance |
|---|---|
| Aboriginal Employment Register | Twelve positions were recruited from the Aboriginal Employment Register, which included four trainees in addition to one ASO3, two ASO5, two ASO6, two ASO7 and one ASO8 position. |
| SA Study Assistance Program for Nurses and Midwives | With 212 successful recipients in 2020-21, this program supports SA Health nurses and midwives to ensure quality care delivery to patients/clients and to complete post-graduate studies. |
| SA Health Leading Clinicians Program | This program assists health professionals in clinical leadership roles to develop their leadership capability and improve patient-centred care. In 2020, the program was interrupted due to COVID-19 with 80 clinicians (69 participants and 11 facilitators) completing the program in a virtual environment. A further 83 clinicians (71 participants and 12 facilitators) commenced the program in 2021. Program evaluations continue to demonstrate high levels of satisfaction and valuable contributions to SA Health’s strategies and plans. |
| Partner with the Universities, VET sector and health sites regarding clinical placements across all health professions, teaching, education standards, training and research | Expansion of the Clinical Placement Management System continued in 2020-21 mainly in the areas of Cert III and IV courses. Bookings were ~ 2.7 million clinical placement hours (covering the majority of health professions) made online in ~ 1000 health care facilities. Data was impacted by COVID-19 lockdowns in 2020-21, resulting in booking cancellations and rescheduling and students being moved to other locations. System logins and Sunrise accounts were provided to around 7,750 students (10 percent increase) noting the recent go-live of Flinders Medical Centre in SALHN. |
| Leadership and Development of the Allied Health and Scientific Professions within SA Health | The Allied Health Professional Reimbursement Program continued, with funding support provided to 769 Allied and Scientific Health professionals in 2020-21. |
Agency performance management and development systems
| Performance management and development system | Performance |
|---|---|
| Department for Health and Wellbeing Performance Review and Development (PRD) process | Two designated PRD cycles are established for managers to undertake a PRD conversation with direct reports; the first cycle from September to October and the second cycle from March to April. COVID-19 impacted participation rates in 2020-21 as workforce resources were redirected to COVID specific activities. As at 30 June 2021, 11 percent of PRDs were completed. Business units in the second cycle were provided the opportunity to finalise and update PRD discussions until 30 June 2021 to encourage increased participation rates. |
Work health, safety and return to work programs
| Program name | Performance |
|---|---|
| COVID-19 Medi-hotel Worker Respirator Fit-testing Program | In July 2020 a fit-testing program commenced for health care workers, staff and contractors working in Medi-hotels, the Adelaide Airport, the Rapid Response Teams, Communicable Disease Control Branch, Infection Control Service and SA Police to ensure correctly fitted respirators are worn and to facilitate the safe transition of the Detmold D95 respirators for when they are received for clinical use. From 6 April 2021, respirator fit-testing was provided by the department to bus drivers, bus marshals and security guards transporting international arrivals from Adelaide Airport to Medi-hotels. A total of 640 Medi-hotel staff and contractors have been fit-tested to a respirator, with some fit-tested to more than one respirator. |
| Bullying and Harassment Policy | In response to the ICAC report ‘Troubling Ambiguity: Governance in SA Health’ the Cultural Evolution Pathway was released on 9 September 2020. Recognising the impact on our staff, a specific Prevention and Management of Workplace Bullying and Harassment Policy is under development to supplement guidance on respectful behaviour in the workplace. An online Bullying and Harassment eLearning module has been developed to support the release of the policy. |
| Challenging Behaviours | The SA Health Challenging Behaviour Strategic Framework, Incident Dashboard, revised policy and guideline and associated resource tools were released via a CE Update on 17 November 2020. The launch included a two-part communications strategy. Part one was the launch of the Strategic Framework, incident dashboard and revised resources. Part two involved internal communications raising staff awareness about specific themes and spotlighting topics to be rolled out over five quarters throughout 2021-22 across SA Health. |
| Seasonal Influenza Program | A free Seasonal Influenza (flu) vaccination is available to all SA Health workers. The vaccine for the 2021 Influenza Immunisation Program is FluQuadriTM provided by contractor Sanofi Pasteur. The 2021 SA Health Flu Vaccination Program commenced from 1 April 2021 at various sites and hospitals. Flu Vaccination clinics for Medi-hotel staff commenced on 3 May 2021. The timing of the 2021 flu vaccination program was aligned to meet the COVID-19 vaccination rollout requirements. As at 30 June 2021, 55.22 percent of staff had received a flu vaccination. The program will continue to operate into the latter half of 2021. |
| SA Health Employee Assistance Program (EAP) | An EAP tender was released to market on 26 October 2020 in preparation for the existing contract expiry on 30 June 2021. On 19 June 2021, the Minister approved Financial Authorisation (TI8) to establish a panel of five providers to supply EAP services to SA Health for a contract term of three years with the option for two additional 12-month extensions commencing 1 July 2021. The EAP continues to be made available by telehealth or phone counselling during the COVID-19 pandemic. EAP utilisation data indicates the SA Health utilisation rate ranging from 0.2 to 3.65 percent. |
| ‘Gayle’s Law’ | The revised Health Practitioner Regulation National Law (South Australia) (Remote Area Attendance) Amendment Act 2017 was passed by Parliament on 7 November 2019 to provide better protection for health practitioners working in remote areas of South Australia. When the law (more commonly referred to as ‘Gayle’s Law’) was written, it included a requirement that the implementation be reviewed within 12 months. An independent review was undertaken by Flinders University. An online staff survey opened on 19 March 2021 encouraging SA Health staff participation in the review. The review report was received in May 2021 and made a total of 18 recommendations and identified a number of issues including the financial cost to health service providers of implementing Gayle’s Law and opportunities to extend the scope of Gayle’s Law beyond out of hours and unscheduled callouts in remote areas of South Australia. The review report also proposes a number of legislative amendments. SA Health will undertake comprehensive consultation with key stakeholders regarding the proposed amendments during 2021-22. |
| Fatigue Management | In response to recommendations from the Workplace Fatigue and Bullying in South Australian Hospital and Health Services Parliamentary Committee, the Safety Learning System (SLS) Wakefulness and Fatigue question set within the SLS worker module was made mandatory effective 9 June 2021. This change is to assist in identifying whether fatigue is a contributory factor in work related incidents. SafeWork SA completed an audit campaign derived from the Parliamentary Committee on Occupational Safety, Rehabilitation and Compensation, Parliamentary Inquiry into Workplace Fatigue and Bullying in 12 South Australian Hospitals and Health Services. The department is working with LHNs and SAAS to identify key actions, particularly from a whole of system perspective. |
| Manual Tasks Risk Management System - Training | The department coordinates the Manual Tasks Local Facilitator (MTLF) Training System across SA Health. There are 1158 MTLFs throughout SA Health providing training, induction and support to their colleagues to reinforce safe work practices. Despite disruptions to the 2020-21 training program due to COVID-19 social distancing requirements and the repurposing of the training facilities at the RAH, 129 new facilitators completed the two-day practical training and 323 current facilitators attended refresher sessions. The SAAS Manual Tasks program commenced during May 2021 for 16 regional trainers responsible for volunteer training. Ergonomic consultancy and risk assessment continue to be provided for hazardous manual tasks, plant and equipment. |
| Psychological Health | The department launched a revised version of SA Health’s Psychological Health Strategy via CE Update on 13 January 2021. The Strategy aligns with the Office of the Commissioner for Public Sector Employment’s Mentally Healthy Workplaces Framework which is based on an integrated approach to ensuring a strong, confident, resilient and agile workforce. On 2 February 2021, the Chief Executive and Deputy Chief Executives signed a Statement of Commitment to become a mentally healthy workplace. The department’s Statement of Commitment highlights seven action statements to assist in building a culture of care within the department. On 11 March 2021, the department launched the Peers Offering Peer Support (POPS) program to further support improved mental health and wellbeing of staff. The POPS program is an evidence-based strategy to support staff experiencing stress at work and help create a psychologically healthy workplace. While not trained clinicians, peer support officers are trained to offer support and accurate information about additional support options to their colleagues and peers. The department continues to work with LHNs and SAAS to coordinate a network of POPS coordinators across SA Health. |
Workplace injury claims - Department for Health and Wellbeing
| Workplace injury claims | 2020 - 21 | 2019 - 20 | % change (+ / - |
|---|---|---|---|
| Total new workplace injury claims | 10 | 21 | -52.4% |
| 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)
|
5.93 | 7.58 | -21.8% |
*Note: 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 - Department for Health and Wellbeing
| Work health and safety regulations | 2020 - 21 | 2019 - 20 | % change (+ / -) |
|---|---|---|---|
| Number of notifiable incidents (Work Health and Safety Act 2012, Part 3) | 2 | 4 | -50.0% |
| Number of provisional improvement, improvement and prohibition notices (Work Health and Safety Act 2012 Sections 90, 191 and 195) | 0 | 1 | -100.0% |
Return to work costs - Department for Health and Wellbeing
| Return to work costs** | 2020 - 21 | 2019 - 20 | % change (+ / -) |
|---|---|---|---|
| Total gross workers compensation expenditure ($) | $582,682 | $508,524 | +14.6% |
| Income support payments – gross ($) | $271,722 | $126,341 | +115.1% |
Note: **before third party recovery
Data for previous years is available at: https://data.sa.gov.au/data/dataset/department-for-health-and-wellbeing.
Executive employment in the agency
| Executive classification | Number of executives |
|---|---|
| Executive Level F | 1 |
| SAES 1 Level | 37 |
| SAES 2 Level | 13 |
Data for previous years is available at: https://data.sa.gov.au/data/dataset/department-for-health-and-wellbeing.
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.