Western NSW Local Health District

2. Population • 261,734 people • 24,800 Aboriginal – 9.5% • 1.3% population growth to 2031 • Services • 37 Hospitals • 60+ service locations • Budget • $700M+ Expenditure • Staff • 7,200 Employees • 4,900 Full Time Equivalent • 38% >50 years • Activity • 188,724 ED presentations – 72% • 82,449 Admissions - 31% • 785 Patients in beds daily • 1,058,823 non admitted occasions of service Western NSW Local Health District

3. Strategic Health Services Planning Process • Health Needs Assessment Jan – March • Board Workshop 6 March - strategic priorities were agreed • Meetings with Clinician Groups 7 March - over 120 attendees • 3 leaders workshops held in March, April and June – 30+ participants • Many consultations with: • Aboriginal Community Controlled Health Services • Western & Far West Medicare Local’s • 37 Local Health Councils • Clinical Councils • Groups of GP’s • Other Government Agencies • Open opportunity for emails with staff giving suggestions and ideas

4. Remote Western NSW Health Analysis Areas North West Dubbo Orange Bathurst

5. Life expectancy at birth 2005-07

6. Socio Economic Status lower is more disadvantaged

7. Premature mortality (ages 0-74) 2003-07

8. High numbers of patients presenting to Emergency Departments

9. High rates of Hospitalisation

10. Informed by the Health Needs Assessment • Interventions likely to provide the greatest population health outcome gains: • Smoking prevention and cessation • Nutrition and physical activity interventions • Diabetes prevention and management • Well child care during the first 1,000 days of life • Mental health - strengthening community care and support

11. The case for change Pressures on organisation and services are intensifying as a result of: • Difficulties in sustainingservices in rural and remote communities • Persisting poor healthoutcomes of our Aboriginal population • Issues in the configuration and ways of working of our hospital and community services • The need to strengthenperformance against key clinical and financial measures This is also a time of opportunity • Commonwealth and State reforms - higher levels of local decision making, new funding and, policy intent to development integrated services that improve access and outcomes

12. Scope of the Plan • Considers the strengths and weaknesses of current service configuration and performance • Presents broad options for future configuration • Has a 10-year planning horizon, with a focus on 5 years, a ‘roadmap’ for the first 3 years • Includes financial projections and impacts • 100+ actions to be implemented • 13 performance indicators for monitoring achievement

13. PrioritiesWestern NSW Local Health District Board • Develop a coherent Western NSW system of care • Support high performing primary care • Close the Aboriginal health gap • Improve the patient experience • Live within our means

14. Developing a coherent Western NSW system of care • Focus on providing care as close to home as possible with a well organised system of accessing specialised care when needed • Strengthen the role of the Patient Flow Unit to improve support for patients needing transfer to other services • Develop district-wide clinical streams, with membership from primary care • Provide increased and well coordinated specialist outpatient services, outreach clinics and support for primary care with Medicare Locals • Implement a world class telehealth network to decrease travel for rural patients and improve support for rural clinicians • Decrease the number of patients needing to go to Sydney for care through improving the capability of services

15. Support high performing primary care Develop strong partnerships with Medicare Locals and Aboriginal Community Controlled Health Services Lead an increased focus on equity of access throughout the region Deliver increased specialist support for primary care Shift to planned and structured preventive care Expand HealthOne and Connecting Care initiatives Transform service and business models in rural and remote communities

16. Close The Gap in Aboriginal Health Outcomes • Strengthen strategic partnerships with Aboriginal community controlled health services, and agree an agenda for change • Strengthen existing action to boost Aboriginal employment • Strengthen existing action to develop LHD staff cultural awareness, and build towards responsiveness and competence • Implement the Aboriginal Health Service Plan when finalised in coming months

17. Improving Patient’s Experience • Implement a patient centred care framework to improve • Communication • Patient safety • Quality • Cultural responsiveness • Engage patients, families and carers in planning and review of services • Design, implement and monitor patient-centred care pathways, with a focus on improving care quality, efficiency and equity of access • Improve transport and accommodation support for patients and families accessing services a significant distance from their home community

18. Living within our means • Balance all future decisions with considerations on quality of care, health of the population and affordability – the Tripple Aim framework • Ensure clinical decision making is supported with best practice evidence and takes consideration of affordability • Deliver transparent, timely and accurate reporting of performance information to accountable clinical and managerial leaders • Establish a ‘whole of system’ district-wide Efficiency Improvement Program within a clinical governance framework • Undertake value for money reviews of outsourced services • Develop a Strategic Investment Fund to shift resources to prioritised services and models of care, with an emphasis on supporting cost-effective ambulatory, and primary and community based delivery

19. ’Future-proofing’ of the Western NSW health system requires adoption of new ways of working that make access and outcomes more equitable, and make better use of the available workforce and funding.

20. Thank you

21. Questions ?