Schedule 21.1
REGIONALLY TAILORED PRIMARY HEALTH CARE INITIATIVES
THROUGH MEDICARE LOCALS FUND
2014-15 Annual Plan
Medicare Local Name
FAR WEST NSW MEDICARE LOCAL
CEO
STUART GORDON
Phone:
0429 152156
e-mail:
sgordon@fwml.com.au
Contact Person
Stuart Gordon
Phone:
A/B
e-mail:
A/B
Date Submitted
In submitting this Annual Plan to the Department of Health, the Medicare Local has ensured
that all internal clearances have been obtained and the Annual Plan has been endorsed by
the CEO and any other appropriate personnel and/or Board members.
FWNSWML Medicare Local 2014-15 Annual Plan
Notes
This document is one component of the material your Medicare Local is required to submit
to the Department by 16 May 2014. It includes:



Directions against the Medicare Local Strategic Objectives;
Annual Plan activities; and
Risk Management Plan.
The other components due by 16 May 2014 are:



the Comprehensive Needs Assessment Reporting Template;
the Budget (FPRT, staffing profile and assets register); and
ensuring that all information on the ‘My Medicare Local’ tab in MELVIN is current
and correct (accreditation status, board membership, certificates of insurance,
company membership, contact details, corporate details, organisational chart and
strategic plan).
It is expected that the 2014-15 Annual Plan is informed by and directly related to the
Comprehensive Needs Assessment Report Template.
Glossary
Activity
Identified Need
Strategy
Resourcing
Region
Strategic Objective (SO)
Key Reporting Area (KRA)
Fund Priorities (FP)
The action(s) undertaken to implement the strategy
The issue(s)/need(s) that have been established as priorities to address in
Table 6 of the Comprehensive Needs Assessment Reporting Template
The approach/intervention/initiative chosen to address the identified
need in Table 6 of the Comprehensive Needs Assessment Reporting
Template
The indicative proportion of funding allocated to the activity from the
overall funding provided under Schedule 21.1 for 2014-15. This must be
GST exclusive
The region in which the activity is being delivered. This could be the
whole Medicare Local region or a sub-region
The Five Medicare Local Strategic Objectives outlined in Schedule 1.1 of
the Medicare Local Deed for Funding and Medicare Local Operational
Guidelines
The Six Key Reporting Areas outlined in the Medicare Local Operational
Guidelines
The Six Flexible Fund Priorities outlined in the Flexible Fund Guidelines
for the Regionally Tailored Primary Health Care Initiatives through
Medicare Locals Fund
Page 2 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Strategic Directions
Provide a brief description of your Medicare Local’s strategic directions for the 2014-15
financial year with reference to the Medicare Local Strategic Objectives listed in
Schedule 1.1 of the Medicare Local Deed for Funding.
Page 3 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Strategic Objective 1 – Improving
the patient journey through
developing integrated and
coordinated services
Initiatives undertaken under the SO1 will continue to focus on
better utilisation of technology and eHealth methodologies to
better connect clinicians with patients, augment greater
connectivity across service provider networks, increasing
access and efficiency of interventions and better knowledge of
services available in remote communities. Knowledge of
services available, better integration of services, patient
directory development The NHSD, Health Direct and local
service directories will better support consumers to access the
right services in the right place at the right time. The critical
role of the PCEHR in supporting better access to health
information, particularly for priority populations will also be
actively supported and promoted across provider networks
Interdependencies with SO3 will also create the framework for
greater integrated approaches to determining health priorities
and models of care. Access to general practice services after
hours will also be promoted throughout the catchment,
including additional transport services in Broken Hill.
Strategic Objective 2 – Provide
support to clinicians and service
providers to improve patient care
Supporting the development and retention of a skilled health
workforce to respond to the critical health needs of the
catchment population with all the necessary innovation,
intersectoral collaboration and strategy remains a key focus
under this strategy. Assisting all elements of the primary health
care GP and allied health workforce are targeted along with
deliberate CPD frameworks, support for clinical & professional
networks, interdisciplinary innovation and learning and
development frameworks.
The critical role of quality lead initiatives across a range of
individual, group and whole of organisational settings are being
addressed, increasingly underpinned by the FWNSWML
clinical Governance subcommittee of the Board and emerging
clinical leadership through collaboration within the LHD and ML
sectors.
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FWNSWML Medicare Local 2014-15 Annual Plan
Strategic Objective 3 –
Identification of the health needs of
local areas and development of
locally focussed and responsive
services
The Population Health Needs Assessment and associated
consultative frameworks have established momentum toward a
greater congruence of health priority across service provider
networks and is driving greater stakeholder collaboration and
networking. The HNA continues to provide a vehicle for
engagement with health partners and consumers alike and the
ML is continuing to work toward more formally integrated
planning frameworks inclusive of LHDs and other service
provider networks. Improved identification and collation of
population health data sets within the catchment has been
highlighted.
Leveraging an orientation across networks to develop a
coherent response to critical social determinants of health is
being targeted with a continuing commitment to urban
infrastructure, food security and increasing advocacy to local
government authorities and other government sectors.
The ability to determine health priorities will be enhanced
through ongoing engagement and additional strategies to
ensure meaningful consumer participation and engagement in
health planning activities.
Strategic Objective 4 – Facilitation
of the implementation and successful
performance of primary health care
initiatives and programs
There will continue to be significant investment into efforts to
improve the early intervention and prevention of chronic
conditions and lifestyle illnesses through direct employment,
subcontracting and commissioning. Active support for GP lead
multidisciplinary models of care continue to be a feature of
efforts under the SO4 with an emphasis on supporting more
innovation in Aboriginal health beyond other dedicated CTG
programs being implemented by the ML.
LRFM, Child and maternal health, men’s and women’s health
are targeted along with school health promotion, greater
collaborative group and event strategies to improve prevention
awareness and behaviour change at a population level. The
CDM focuses on ensuring appropriate support for GPMP and
TCA activities of general practice and adoption of systems and
procedures to support coordinated care across service
provider networks.
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FWNSWML Medicare Local 2014-15 Annual Plan
Strategic Objective 5 – Be efficient
and accountable with strong
governance and effective
management
The critical elements of performance within a high performing
construct of good corporate, program and clinical governance
systems and practices have been enabled through awarding of
accreditation against the ML standards by the QiP certifying
agency. The governance activities led by the Board and its
numerous subcommittee’s and supported by the Executive
Management team and the operational elements of the
organisation. The skills based Board includes cross
representation from both LHDs and the ACCHO sector and
General Practice. Priorities in the coming year will be to
continue to build a robust internal framework for performance,
clinical leadership and service innovation. It is a politically
dynamic time in the national primary healthcare landscape.
The legitimacy and value proposition of a regional primary
health care organisation in the FWNSW catchment is
reinforced by the emerging relationships and innovation with
LHDs, a clear roadmap of health needs through the HNA, and
a skilled and increasingly integrated workforce and
commissioning capability.
Page 6 of 35
Activities Table
NUMBER 1
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
Consumer Engagement and participation
SO
1, 3
KRA
3
FP
2
Comprehensive Needs Assessment Findings: Limited capacity for population to take responsibility for their own
health. Poor understanding of available services and referral pathways.
Strategic Objectives: 3 – Identifying the health needs of their local areas and development of locally focused
and responsive services.
Ongoing
Ongoing
 Staffing costs (clinical input into planning and evaluation, program support to local advisory groups, admin
support for evaluation and, resource development
 Service directories, brochures, and consumer portal
 Other admin and meeting costs linked to community / consumer engagement activities
$75,000
Improving health requires a conversation with the whole community and support for individuals and families to
take responsibility for their own health. Ensuring people are properly informed in ways they can understand is
paramount in the expectation that the population is empowered and have the knowledge required to actively
participate in management of their own health. The FWNSWML is remote with high numbers of Aboriginal and
marginalized people with low socioeconomic status and a high burden of disease. The historical paucity of
services, fly in fly out (FIFO) nature of services, high turnover of GPs, continued threatened viability of Primary
Health Care (PHC) providers, mental health, acute and aged care health providers, has done little to empower
communities and individuals to participate in health care planning and delivery of services, access to services
and self management of lifestyle behaviors, illness and disease.
The FWNSWML continues to create frameworks for meaningful engagement with consumers to support
increased participation, capacity and knowledge of the system, the importance of accessing health services in
a timely manner, proactive health management and lifestyle modification. Local communities respond to local
health providers who live and work within their local communities, share common issues and who demonstrate
commitment to community. Under new open disclosure requirements, having a conversation with the patient
and their carer(s) is a requirement for all clinicians and also helps to inform opportunities to improve the quality
of services and get feedback on the wider community priorities. Facilitating community input and seeking
meaningful feedback across a broad spectrum of key community stakeholders has supported FWNSWML to
tailor and craft programs to meet community and individual needs in culturally appropriate manner. Effective
engagement, early recognition of gaps and the delivery of responsive PHC services is attributable to the efforts
of FWNSWML to engage the consumers of our services.
Type of activity

Cultural competency of provider networks
FWNSWML Medicare Local 2014-15 Annual Plan




Region
Sector
Service Provision
Performance information
Expected outcome
Supporting the currency of referral pathways
Ongoing development of service brochures aligned to health service provider networks
Further roll out of a comprehensive service directories for individual communities
Continue to support community and clinician information sharing through newsletter and website
media.
 Provision of independent secure portal for anonymous feedback of service
 Continue to facilitate and support community advisory groups (Health Councils, Aboriginal Community
Working Parties, LGA forums)
 Consumer engagement and participation in health service development, evaluation and planning
activities..
Whole of Far West NSW Medicare Local (FWNSWML) region.
All residents and consumer advocacy groups of the catchment.
FWNSWML will undertake all the activities under this strategy in partnership with consumer advocate groups.
Quantitative:
 Responses through anonymous patient and carer portal
 Responses / number of consumer surveys received
 Increased patient referrals (esp targeted population groups)
 Completion and distribution of service directories
 Number of Health Council and other consumer forums attended
Qualitative:
 Evidence of consumer engagement and participation
 Better clinician / patient interface and information exchange
 Improved input from consumers and greater responsiveness of health service planning and evaluation
 Better recognition of role of consumers and evidence of their participation in forums and discussions
relating to health service delivery and planning & evaluation
1. Informed, empowered and engaged consumers who have knowledge of services, ability to access
services and improved health outcomes.
2. Established frameworks to enable consumer input into service planning, delivery and evaluation,
particularly in priority population groups such as youth, Aboriginal and Torres Strait Islander and aged.
Page 8 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 2
ACTIVITY NAME
Supporting Clinicians and building a better health workforce
SO
2
KRA
3
FP
2
IDENTIFIED NEED
Comprehensive Needs Assessment Findings: Difficulties recruiting and retaining a skilled workforce. Impacts of
remoteness in access to appropriate clinical supervision and CPD.
STRATEGY
Strategic Objectives: 2 - Providing support to clinicians and service providers to improve patient care.
DURATION
Ongoing
Ongoing
 Staffing costs associated with clinical supervision, workforce planning and coordination
 Program resources to support travel, accommodation, meeting costs and other administrative costs.
 CPD related expenses (including events per CPD calendar)
 Nursing bursaries and scholarships (co payments/support to private general practice)
 Funding to assist extended scope of practice (ie AHW diabetic education, foot care, nutrition, motivational
interviewing and health coaching for primary health care workers)
$220,000
Having access to an appropriately skilled, resourced and integrated workforce available in the right place at the right
time is a fundamental challenge for consumers and service providers alike. The remoteness of the FWNSWML
catchment and the significant burden of disease within its populations require a strategic approach to meeting and
sustaining a stable work force that lives and works in our outback communities. The FWNSWML has undertaken a
wide range of activities, internally and externally to ensure clinicians are supported, opportunities for extended
scope of practice are reinforced, innovative recruitment and retention of a regional workforce, support for career
pathways, informative medical and nursing student placements, and continuing professional development
opportunities.
RESOURCING
FUND ESTIMATE
Description
FWNSWML is at the forefront of recruitment of a stable and skilled workforce across the PHC spectrum. Allied
Health providers that visited infrequently via outreach from Dubbo that were not part of the GP led multidisciplinary
team have been replaced by providers recruited to hubs located in Lightning Ridge and Bourke who service all
communities within the LGAs of Walgett, Brewarrina, Bourke and Cobar.
FWNSWML are the key providers of clinical supervision to allied health staff from ACCHOs and neighboring MLs
and has supported quality improvement strategies through support to GP to participate in the APCC activities, GP
and ML accreditation processes. Much of the CPD delivered to the PHC workforce are delivered through the
FWNSWML.
FWNSWML have supported Practice and PHC nurses from LHD, AHWs and Allied health providers with attendance
at workshops and conferences, access to elearning modules and onsite training by purchasing training to be
delivered locally. This has allowed greater opportunities and participation in training and support of the PHC
Page 9 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Type of activity
Region
Sector
Service Provision
Performance information
Expected outcome
workforce which has in turn led to improved retention, greater satisfaction and improved knowledge of evidence
based best practice.
 Supporting Clinicians (GPs and practice nurses) working in General Practice
 Providing support for Aboriginal health Workers working in (private) General Practice
 Assisting the development of GP led Multidisciplinary Team Based Care through clinical supervision and
interdisciplinary networks
 Continue to support Secondary school Career Expos
 Continue to support Medical, Nursing, Pharmacy and Allied Health students placements across the
catchment, especially in the NW were FWNSWML is the broker for all placement activities)
 Supporting Aboriginal Health Worker students and Trainee Aboriginal Allied Health Assistants
 Responding to appropriate clinical supervision requirements
 Facilitate and continue to support established professional clinical networks (allied health team, podiatry
network, nurses in general practice, Aboriginal health worker networks)
 Participate and inform the Local Health District workforce planning for Integrated Care Pilot (FWNSWML
CEO and Executive Team are part of the WNSW ICP consortia leading this program).
 Participate and inform the Centre for Remote Health medical workforce planning (FWNSWML is the Chair
of the CRH)
 Participate and inform Beyond Medical Registrar support (FWNSWML has a member)
 NSW Rural Doctors Network workforce planning, recruitment (OTD, RVTS) and incentives for Allied Health
 Individual support for overseas trained Doctors to meet the requirements for independent medical practice
Whole of FWNSWML region
Primary Health Care organisations, ACCHOs, LHDs and Practice entities, individual clinicians and universities.
FWNSWML direct and Inter-sectoral participation
Quantitative:
 Number of training and CPD events either convened or supported
 Sustained GP and registrar workforce in catchment
 Number of student placements
 Percentage of wider PHC workforce retained
 Number of ATSI PHC trainees
 Number of workforce network meetings (NSW RDN NiGP, PHC Clinicians, Team etc.)
 Number of inter-sectoral workforce support planning activities
Qualitative:
 Evidence of workforce collaboration
 Improved interdisciplinary networks
 Improved clinical supervision networks
 Effective clinical professional networks including professional disciplines and interdisciplinary
1. Increase in workforce competencies
2. Extended scope of practice with excellent clinical supervision
3. Robust succession planning across PHC workforce (ML catchment)
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FWNSWML Medicare Local 2014-15 Annual Plan
4. More strategic planning for workforce needs (filling gaps, supporting new models of care, improving
competencies)
5. Adequate professional development for remote clinicians
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FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 3
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
Better sharing of clinical information and use of technology
SO
1
KRA
3
FP
4
Comprehensive Needs Assessment Findings: Demand for technology to support innovation in management of
clinical information and patient data and better utilization on eHealth technology for remote consultations
Strategic Objectives: 1 - Improving the patient journey through developing integrated and coordinated services
Ongoing
Ongoing
 Staffing Costs (to support uptake of secure messaging, data extraction support for local disease registers,
clinical staff training and mentoring, Consumer assisted registration to myGov.au PCEHR.
 Data Extraction licensing costs (all practices currently supported by FWNSWML for argus secure)
 IM and IT software and licensing costs (internal and external)
 Program resource development and other admin costs linked to practice and clinician support activities
 PCEHR promotion and assisted registration.
$200,000
The FWNSWML has successfully raised the profile of the critical role of eHealth in improving the systems,
management, and uptake of technologies to improve the efficiency and access of individual episodic care (such
as recalls and data extraction activity, televideoconferencing and specialist networks, secure messaging etc)
and system-wide strategies linked to PCEHR, specialist networks and practice accreditation.
There is a paucity of qualified personnel in the catchment and the FWNSWML leadership and support for
remote clinicians and organisations is evident in current partnerships and collaborations.
FWNSWML staff are the major local eHealth support provider in the catchment. Currently the team are directly
involved in supporting practices, ACCHO and LHD facilities in their capability and uptake to new technologies
including sharing clinical information, establishing patient register’s and supporting clinical front-line staff in
data extraction activities. This work is directly linked to quality activities associated with better management of
chronic conditions in their practice population and alignment with PiP and GPMP team care arrangements.
During the next twelve months collaborations across the LHD networks will increase linked to the launch of the
NSW HealtheNet and Integrated Care Project in both LHDs. The adoption of an eHealth plan, Health
Intelligence Unit and better referral mechanisms have been identified in the LHD Integrated Care Project
supported though the Ministry of Health and the FWNSWML are providing that critical interface with the
practice networks on the ground. Internally the eHealth capability includes ongoing development of the
Mypractice clinical database for clinicians engaged in activities of the FWNSWML and leadership in the uptake
and adoption of technologies, as well as nurturing best practice and ‘champions’.
The FWNSWML is registered as an ART provider and is currently providing assistance to practice staff and
consumers in general practice and communities settings to enroll to get a PCEHR. This work is critical in
Page 12 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Type of activity
Region
Sector
Service Provision
Performance information
Expected outcome
enabling better management of chronic conditions, aged and ATSI population cohorts have been targeted
within the catchment.
 Assistance in ensuring connectivity and interoperability across networks and systems for Secure
Messaging
 Ongoing assistance to General Practices (GPs and practice staff) in PENCAT data management and
extraction activities
 PCEHR assisted registrations, practice support for uploads and bringing wider networks online
(Pharmacy, EDs and hospitals, ACCHOs.)
 Data base support for clinical activities of the FWML through My Practice software, and related
interoperability and data extraction
 Ongoing support for the NHSD, HealthDirect and other national initiatives
 Bureau of Health Information and NSW health Statistics
 Participation in the LHD led WNSW Integrated Care Project
Catchment-wide
LHDs, General Practice, Pharmacy, Specialist networks, allied health, visiting services, and consumers.
Medicare Local eHealth team in collaboration with WML eHealth, NSWRDN and other IT provider networks
Quantitative
 No of practice visits linked to eHealth support (data management, televideo /conferencing, PCEHR etc)
 No consumers with PCHER
 No of televideo consultations undertaken across catchment
 % of FWML clinical interventions recorded within MyPractice
 % of Practices contributing de-identified patient information via extraction through PAT CAT population
data extraction tool
 % of referrals made via secure messaging across clinical networks
 No emergency departments, pharmacies and specialist services with access to PCEHR data portal
Qualitative
 Increased consumer interest in PCEHR, particularly for priority population groups (aged care, people
with complex chronic conditions, including mental health, Aboriginal and Torres Strait Islander and
child and maternal).
 Better uptake and utilization of technology by clinicians within the catchment
1. Greater collaboration to remove barriers and attitudes to sharing clinical information
2. Better access to Specialists for remote consultations
3. Improved data extraction, management and critique of episodic and group data for services provided
through the Flexible fund
4. Improved procedures for general practice clinicians and team in targeting populations within practice
data-base
5. Better sharing of data across practice networks throughout the catchment
6. Greater capability and movement toward models of shared care using e-technologies (ie care planning,
secure messaging etc) including with the social care sector.
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FWNSWML Medicare Local 2014-15 Annual Plan
7. Increased capability and competency of PHC workforce in the uptake and meaningful utilisation of
technology in primary health care systems and services.
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FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 4
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
Integrated Planning and Stakeholder Engagement
SO
3
KRA
3
FP
2
Comprehensive Needs Assessment Findings: Overall lack of alignment of planning activities across
stakeholder agencies to address service planning, implementation and evaluation.
Strategic Objectives: 3 - Identifying the health needs of their local areas and development of locally focused
and responsive services.
Ongoing
Ongoing
 Staffing costs (health planning / integration activities)
 Project resources including population health data management, health stakeholder planning (including
ACCHO forums, WNSW ICP project, CRH etc) and meeting expenses
 Consumer and stakeholder engagement forum costs and other administrative expenses
$100,000
One of the greatest barriers to achieving better coordinated, efficient and integrated primary health care
services is the lack of planning, in particular joint planning to enable the design and delivery of services
appropriate to the needs of patients within a timely and accessible context. The FWNSWML acknowledges the
diversity of the health demographic which is influenced by a wide range of factors including socioeconomic
status, past experiences with the health system, lifestyle choices, cultural backgrounds and the relative impacts
of remoteness, access to the broader social system and shrinking populations.
The process of planning is complex and the FWNSWML is determined to work toward a more integrative
planning framework with LHDs, ACCHOs and other NGOs. It is critical that primary health organisations
working in the catchment have a common understanding of health needs and are sharing information across
the primary, acute and aged care sectors. The health service needs assessment has provided an opportunity
to develop an accurate critique of issues affecting the health of our communities and ensure a conversation
with consumers and other stakeholders at a local level.
Priorities identified in the HNA are providing opportunities for strategic engagement with health provider
networks. Through this engagement, the Bureau of Health Information is working in partnership with
FWNSWML, WNSWML, WNSWLHD and FWLHD to develop joint planning protocols, common data collection
and more effective and unified approaches to planning and development of health services. Innovation through
the Integrated Care Program in Western NSW is strengthening the strategic partnerships in preparation for
establishment of demonstration sites within the catchment.
FWNSWML is working collaboratively to inform the development of a Health Intelligence Unit as a deliberate
framework to promote collaboration and integration in planning activities, targeted population based data
management and priority setting across provider networks.
Type of activity

Support for implementation frameworks linked to monitoring and evaluation of HNA and its effectiveness.
Page 15 of 35
FWNSWML Medicare Local 2014-15 Annual Plan

Region
Sector
Service Provision
Performance information
Expected outcome
Development of FWNSWML population health and planning subcommittee including intersectoral
collaboration and engagement within the construct of the WNSW ICP project initiative.
 Consumer engagement strategies including surveys, focus groups, consumer and stakeholder forums,
website activity and Patient Opinion.
 Continued leadership in the implementation of the Lightning Ridge HealthOne development and
identification of other sites within catchment.
 Ongoing collaboration with the NSW Bureau of Health Information to inform better capability and
intelligence
 Ongoing collaboration and support for the Aboriginal Health Partnership
 Collaboration with NGO sector - Poche Centre for Indigenous Health (Sydney University), Royal Far West
and Family and Community Services, and others.
Whole of FWNSWML region
Primary Health Care organisations, ACCHOs, LHDs and Practice entities, individual clinicians and universities.
FWNSWML direct and Intersectoral participation
Quantitative:
 Development and adoption of the Comprehensive Needs Assessment priorities
 Number of partnership and service agreements in place
 Number of planning and consultation forums conducted
Qualitative:
 Evidence of congruence across provider networks for key strategic health priorities
 Successful implementation of the Integrated Care Pilot sites in Lightning Ridge and Cobar
 Development of a regional population health and PHC data collection through joint collaboration with
the Bureau of Health Information
 Evidence of compliance with contractual and performance indicators
 Engagement with ACCHO network on data issues
1. Improved coordination and integration of service planning, delivery and evaluation.
2. Improved identification and collation of population health data sets within the catchment (census,
HealtheNet, NSW Health statistics, practice data, social atlas, Boscar and other data sources).
3. Better evidence base to support health service interventions and health planning priorities.
4. Better alignment and timing across provider networks of planning activities.
5. Movement towards integrated planning practices across provider networks.
6. Progress towards the identification and adoption of a single population health data set for the
FWNSWML, including social data.
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FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 5
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
Improving the Social Determinants of Health
SO
3
KRA
4
FP
5
Comprehensive Needs Assessment Findings: High level of disadvantage, limited access to services and
increased vulnerability due to remoteness of our communities.
Strategic Objectives: 3 - Identifying the health needs of their local areas and development of locally focused
and responsive services.
Ongoing
Ongoing
Staffing costs (Project Coordination, Allied Health leadership, co-payments for community staff working in
remote discrete communities)
Project resources including health promotion equipment and materials
$0
“The social determinants of health are the conditions in which people are born, grow, live, work and age,
including the health system. These circumstances are shaped by the distribution of money, power and
resources at global, national and local levels. The social determinants of health are mostly responsible for
health inequities – the unfair and avoidable differences in health status seen within and between countries”
World Health Organisation.
Our region has some of the most severely disadvantaged communities in NSW and nationally with many
people on low incomes, living alone or in overcrowded housing, with little to no education and limited
employment opportunities. They are more vulnerable to ill health, less able to manage their own health needs,
more likely to develop chronic diseases, be hospitalized and die prematurely. Addressing the social
determinants of health is a key focus of the FWNSWML to balance the inequities experienced in our
catchment. Many of these inequities are a result of historical social policy impacting on our Aboriginal
population with intergenerational issues relating to removal from home and country, loss of cultural identity,
lack of education and employment opportunities, insufficient housing and social isolation. The FWNSWML
have worked with communities to recognise and create employment and educational opportunities, improve
urban infrastructure and food security, and address the loss and grief associated with dispossession and loss
of cultural identity.
The critical determinants being addressed under this activity related to improved food security, improved urban
infrastructure in remote communities, access to fuel and transport services, and activity promoting healthier
urban environments, particularly in discrete Aboriginal communities. Many Local Councils in the region have
limited engagement and capability in relation to responding to critical pressures associated with drought,
maintaining healthy urban environments, food security and a raft of other important determinants affecting the
health status of remote populations.
Page 17 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Type of activity

Region
Sector
Service Provision
Performance information
Ongoing support for the maintenance and utlisation of the Enngonia and Weilmoringle community
outdoor kitchen and community garden infrastructure.
 Ongoing maintenance of the Mercy Park (Bourke) and Enngonia Oval to enable sporting activities in
support of increased physical activity (these projects were developed through earlier RPHS and PHI
activities)
 Work in collaboration with other Local Council and Aboriginal Community organisations to improve the
Urban environments through beatification, permanent plantings, dust mitigation, food security, water
quality, and social inclusion through communal areas for catering eg; Bush BBQ, washing up facilities
and seating, improved recreational infrastructure and maintenance of existing infrastructure (developed
by FWNSWML)
 Improved and supported community based education opportunities such as training in horticulture and
irrigation, first aid, food preparation storage and hygiene
 Support and collaborate in Aboriginal employment and training strategies such as Murdi Paaki
Regional Enterprise job service network
 Development of networks with LGAs to support better planning and investment in health infrastructure
ie; dust mitigation, improved water quality, managing drought, fluoridation of town water supplies,
permanent plantings of native tress and food sources
 Housing and Healthy Lifestyles initiatives to support improved access to housing, maintenance of
houses and education relevant to budgeting, food security, healthy food options, cooking
demonstrations etc.
 Health promotion activities to reinforce healthy choices as the easier choices through programs such
as the Healthy Outback Kids project aimed at providing school gardens and infrastructure, healthy
canteens and quarterly health promotion activities delivered by dietitians and AHWs to every primary
school in the eastern area of the catchment
 Community advocacy for Health Related Transport, Aboriginal housing, youth truancy, justice.
Whole of FWNSWML region
PHC organisations, whole of community, Government and non-Government agencies, and Local Government
sector.
FWNSWML in collaboration and partnership with key stakeholders as outlined above.
Quantitative:
 Increased access and utlisation of health infrastructure (ovals, green areas outdoor kitchens
 Increase in the number of young people learning or earning
 Increased health education and promotion activities using community infrastructure
 Better access to ‘hard to reach populations’ linked to disease management and prevention strategies
 Increase in community events and healthly lifestyles activities (football knockouts etc)
Qualitative:
 Evidence of improved lifestyle behaviours and better participation (uptake) in GP led programs
Page 18 of 35
FWNSWML Medicare Local 2014-15 Annual Plan




Expected outcome
Evidence of improved housing, employment, education and access to services
Improved environmental health infrastructure in remote and discrete communities
Better informed support for social inclusion strategies
Increased capability and resilience of remote communities
1. Healthier and more resilient communities with increased opportunities.
2. Better informed local authorities in priority health infrastructure.
3. Better access to appropriate recreational infrastructure for maintaining healthy lifestyles in remote
areas.
4. Greater acknowledgement and evidence of interventions targeting the social determinants of health.
5. Less suicide and mental illness
6. Better access to transport service for health related transport, particularly for discrete population with
no fuel access
7. Less lawlessness and imprisonment
Page 19 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 6
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
Fund Estimate
Description
Early Intervention and Prevention Services
SO
4
KRA
2
FP
3
Comprehensive Needs Assessment Findings: High rates of major lifestyle risk factors and high burden of
illness.
Strategic Objectives: 4 - Facilitating the implementation of Primary Health Care initiatives and programs.
Ongoing
Ongoing
 Staffing costs (Directly employed Allied Health service providers, contractors and volunteers)
 Commissioned services; Maari Ma Health early childhood and Child and maternal health Broken Hill,
Wilcannia, Menindee Ivanhoe; Outback Eye Service visiting ophthalmology and eye screening service
Bourke, Brewarrina, Cobar and Walgett.
 Direct service delivery costs, resourcing, commissioning, contract management and travel &
accommodation across catchment.
$1,072,000
The FWNSWML programs linked to early intervention and prevention cover the complete spectrum of health,
from the cradle to the grave. Upstream they seek to empower individuals and communities to maintain healthy
lifestyles and prevent the onset of chronic conditions later in life. Downstream they provide much needed
health education to support individuals self manage their disease. Programs implemented by FWNSWML have
been primarily in response to gaps created by the inability of other agencies to recruit to vacancies and the
withdrawal of services due to changes or loss of funding.
The FWNSWML has been proactive in recognising gaps and activation of recruitment strategies that have
been supported by organisations such as the NSWRDN, Poche and RFW. In the previous 2 years
FWNSWML have initiated the following services:
 Women’s Health Nurse focusing on raising cervical and breast screening rates servicing Walgett,
Brewarrina and Bourke LGAs. In addition FWNSWML are supporting the training of practice nurses
in Well Women’s screening and Sexual and Reproductive Health.
 Early Childhood Nursing services focusing on raising immunisation rates for <4year olds in Walgett,
Wilcannia, Ivanhoe, and Menindee.
 Community Midwife focusing on antenatal and postnatal care of women in Walgett LGA, and Cobar
LGA
 Allied Health hubs developed in Walgett and Bourke LGAs including Dietitians, Physiotherapists,
Speech Pathologists, Aboriginal Health Workers and Occupational Therapists to support GP led
Lifestyle risk factor management, health coaching, health promotion (including schools and social
care sector) and event coordination (health education, targeted screening events etc)
Page 20 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
FWNSWML is the most significant provider of allied health services in the Bourke, Brewarrina, Walgett and
Cobar including targeted services in the Broken Hill, Central Darling and unincorporated areas
Type of activity
Region
Sector
Service Provision
Performance information

Lifestyle Risk Factor Management to address smoking cessation, physical activity, weight
management, nutrition, AOD
 Health Promotion activities such as the Market Basket Survey, Healthy Bodies Happy Homes, Healthy
Outback Kids (school health promotion), Get Healthy, Pharmacy Support under the 5th Pharmacy
Agreement.
 Health education and screening at targeted community and school sporting events (eg. Rugby League
and Union, Netball, Cricket and Swimming events).
 Allied Health hubs for Dietetics, Speech Pathology, Occupational Therapy, Physiotherapy
 Partnerships – RFW and Poche to increase access to paediatric Speech Pathology and Occupational
Therapy.
 Immunisation services to address lower than state average rates of immunization especially the 0-4
year old age group and aged.
 Commissioned services – Maari Ma, Outback Eye Service,.
 Maternity and Early Childhood Nursing services.
 Healthy Kids Checks within preschool and primary school aged children in partnership with
WNSWLHD, ACCHOs and RFW.
 Pitstop Men’s health screening and referral program .
 Women’s Health services.
 Direct and indirect support for community events.
Whole of FWNSWML region.
FWNSWML catchment.
Directly employed, commissioned, contracted and subcontracted and employment models through joint
collaboration.
Quantitative:
 Occasions of service (OOS) per location (episodic, GP led, directed referrals, self referrals, fee for
service) at clinician level.
 Group OOS at disease and/or clinician level linked to referred LRFM.
 Number of HP events including education, opportunistic screening.
 Social marketing activities for “at risk” population target groups.
 Reduction in preventable hospitalisation due to lifestyle risk factors.
 Increase rates of population based screening and interventions (immunisation, cervical screening,
men’s health screening and other local indicators.
Qualitative:
 Improved attitudes and participation in LRFM and early intervention activities.
 Improved self management of lifestyle risk factors.
Page 21 of 35
FWNSWML Medicare Local 2014-15 Annual Plan

Expected outcome


1.
2.
3.
4.
5.
6.
7.
Greater intersectoral collaboration on Lifestyle risk priorities (smoking, AOD, obesity, physical inactivity,
mental health).
Improved herd immunity of the population.
Improved antenatal and early childhood screening and interventions.
Increased screening rates of the population.
Reduction in smoking prevalence.
Reduction in obesity rates.
Increased participation in physical activity.
Increase in participation and uptake in GP led LRFM activities.
Greater interdisciplinary collaboration in the prevention key chronic conditions.
Better informed communities and capacity for self management.
Page 22 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 7
ACTIVITY NAME
Chronic Disease Management Services
IDENTIFIED NEED
Comprehensive Needs Assessment Findings: High incidence and prevalence of chronic disease.
STRATEGY
Strategic Objective: 4 - Facilitating the implementation of Primary Health Care initiatives and programs.
DURATION
Ongoing
Ongoing
 Staffing costs (Directly employed and contracted Allied Health service providers)
 Direct service delivery costs, resourcing, commissioning, contract management and travel &
accommodation across catchment.
RESOURCING
FUND ESTIMATE
Description
SO
4
KRA
4
FP
5
$1,500,000
The FWNSWML have the highest incidence of lifestyle risk factors and chronic disease nationally. This is
attributable to numerous factors such as social determinants of health,
Populations within the FWNSWML experiences a significantly greater burden of illness from chronic conditions
than most other communities in Australia and substantial resources are dedicated to the management of these
conditions in the acute and secondary care sectors.
FWNSWML is the main provider of allied health and Aboriginal health worker services to private general
practice organisations throughout the catchment. There is an extreme paucity of any private or public allied
health services in the catchment with the exception of limited services in Broken Hill and some services
through the ACCHO’s.
FWNSWML is responding directly to this need and builds on a continuing strategic response under the former
Regional Primary Health service Program. FWNSWML clinicians employed and subcontracted through the
Schedule 21.1 have both generalists and specialized roles and are working as part of the practice support team
of the ML to assist better identification and management of people with chronic conditions. ML is also working
to improve the responsiveness, coordination, and capacity of services in collaboration with general practice and
other health partners. Improving health outcomes for Aboriginal people either at risk or with a chronic condition
is a critical priority for the FWNSWML.
Services provided for under this program are responding to direct market failure and the urgent need to move
away from the episodic fly in fly out services which do not enable other critical elements of the PHC team
based care and innovation.
Type of activity

General Practice referred interventions for management of chronic conditions and risk factor
management.
Page 23 of 35
FWNSWML Medicare Local 2014-15 Annual Plan


Region
Sector
Service Provision
Performance information
Expected outcome
Supporting better access to Aboriginal Health Workers in General Practice
eHealth innovation including stratification of practice population, recall activities, GPMP/TCA,
Collaboration and other models of care.
 Continued support Allied Health interventions in RACF facilities throughout the catchment (only ones
being provided)
 Allied Health to support GP led Multidisciplinary Team Based Care.
 Diabetes support groups.
 Integrated models of chronic disease management programs – Brewarrina and Walgett.
 Program design and delivery to compliment CTG programs
Whole of FWNSWML region.
PHC Organisations, General Practice, LHDs, ACCHOs.
FWNSWML
Quantitative:
 Occasions of service (OOS) per location (episodic, GP led, directed referrals, self referrals, fee for
service) at clinician level.
 Group OOS at disease and/or clinician level linked to referred chronic condition.
 Increased uptake and participation in quality GPMP and TCA Activities
 Support for APCC collaborative activities and participation in Wave 4
 Number of CDM groups including education, motivational interviewing, CD self management.
 Social marketing activities to promote CDM awareness and better access.
 Completed cycles of care.
 Reduction in preventable hospitalisation due to better management of chronic conditions.
 Increase rates of participation in GP led CDM.
Qualitative:
 Improved attitudes and participation in CDM activities.
 Improved self management of CDM.
 Greater intersectoral collaboration on CDM priorities (Diabetes, CVD, Respiratory, musculoskeletal,
mental illness).
1. Better identification and management of priority chronic conditions in the catchment area.
2. Improved workforce alignment to support GP led Multidisciplinary Team Based Care.
3. Evidence of interdisciplinary models of care to support better management of chronic conditions.
4. Evidence of registers for nominated diseases in General Practices.
5. Evidence of patient centered care planning with more extensive referral networks including to the social
sector.
6. Improved compliance with diagnostics and medication regimes.
Page 24 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 8
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
Improving Aboriginal and Torres Strait Islander Health
SO
4
KRA
5
FP
5
Comprehensive Needs Assessment Findings: Poor health status of the Aboriginal and Torres Strait Islander
population.
Strategic Objectives: 4 - Facilitating the implementation of Primary Health Care initiatives and programs.
Ongoing
Ongoing
Staffing support for dedicate Aboriginal health Workers as part of the ATSI in GP strategy support for private
general practice (Tier 1, II and III activities under the strategy)
Funding allocation to support activities of the Aboriginal Health Subcommittee of the Board of Directors.
$125,000
Developing responses to improve Aboriginal and Torres Strait Islander health is complex. It requires
partnerships across provider organisations together with advocacy, leadership and innovation in team based
multidisciplinary care. Improving Aboriginal and Torres Strait Islander health is every bodies business. It is
important that ACCHO expertise is effectively integrated into health service development activities within our
catchment and opportunities for Aboriginal and Torres Strait Islander employment and training are maximised.
The FWNSWML is responding to a paucity of Aboriginal Health Workers available for private general practices
in the NW part of the catchment. Under this strategy Aboriginal Health Workers are employed to provide
practice support to private practices in Cobar, Bourke, Walgett, Lightning Ridge, Brewarrina and Collarenebri.
AHWs employed in these roles are working to a scope of practice that enables the effective identification and
stratification of private practice population data, assistance in recall and GPMP activity, providing of LRFM and
health coaching services and support to assist referrals for ongoing support and treatments. The % of ATSI
clients in some practice populations are as high as 80% however there is a lack of AHW workers skilled to work
in practice settings.
The roles of AHWs also include working with the practice support team, health promotion activities and
interdisciplinary mentoring for cultural competency and patient assistance / advocacy. The ATSI in GP has
been a feature of the former RPHS program and continues to be a significant program within the FWNSWML
strategy to improve services for ATSI people of the catchment.
Type of activity




Aboriginal and Torres Strait Islander in GP Strategy.
Aboriginal Health Partnership – Western NSW Local Health District, Western and Far Western NSW
Medicare Locals, Bila Muuji Aboriginal Community Controlled Health Organisations consortia.
Strategies under Social Determinants of Health.
Engagement with key Aboriginal Stakeholder groups – Murdi Paaki Regional Assembly, Community
Working Parties, ACCHOs (Maari Ma, Bourke, Brewarrina and Walgett).
Page 25 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Region
Sector
Service Provision
Performance information
Expected outcome
 Care Coordination and Supplementary Services and Connecting Care.
 Aboriginal student workforce.
 National Centre for Cultural Competence.
 Connected communities.
Whole of FWNSWML region
PHC organisations, General Practice, ACCHOs, LHDs
FWNSWML in partnership with ACCHOs and LHD
Quantitative:
 Aboriginal and Torres Strait Islander participation in health service evaluation activities.
 Evidence of the Aboriginal Health partnership with ACCHOs.
 Number of Aboriginal and Torres Strait Islander consumer forums conducted during the reporting
period.
Qualitative:
 Increased number of Aboriginal Health professionals across health disciplines.
 Strategic engagement of Aboriginal Health Worker workforce within the FWNSWML catchment.
 Strategic agreement with the National Centre for Cultural Competency.
1. Increased participation by Aboriginal and Torres Strait Islander people in the design and evaluation of
health services within the catchment.
2. Increased engagement of Aboriginal Health professionals in health planning evaluation.
3. Progress towards a strategic Aboriginal Health Plan.
4. Structures to support catchment wide Aboriginal Health professional’s network.
5. Improved cultural competency in the planning, delivery and evaluation of health services.
6. Practical linkages between health services and other social care agencies.
Page 26 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 9
ACTIVITY NAME
IDENTIFIED NEED
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
Type of activity
Supporting better access to After Hours GP services
SO
1
KRA
6
FP
1
Comprehensive Needs Assessment Findings: Access to afterhours services for “at risk” populations, support
for preventable hospitalisations.
Strategic Objectives: 1 - Improving the patient journey through developing integrated and coordinated services.
Ongoing
Ongoing
 After hours service incentive contracts with all participating Practices of the catchment (100%)
 Transport support
 Funding for staff resourcing and program support in emergency departments of small remote hospitals
 Program resources including staffing, project management, and direct and indirect expenses.
$300,000
Other than taxis there is no public transport in Broken Hill in the after hours period. Many patients are therefore
unable to access health care when required, or are inappropriately using ambulance services. Fare Assist
provides fully funded taxi transfers for patients who become ill in the afterhours period and need to see a doctor
straight away.
The GP After Hours Incentive Program has ensured that no practice is disadvantaged in the transition from
Medicare funding and therefore that no after hours services were compromised. In the Health Needs
Assessment (HNA) it became clear that neither consumers nor health service providers knew what health
services were available in Broken Hill, when they were available or who could access them. This includes after
hours services. FWNSWML has undertaken to develop and distribute a hard copy Health Service Directory
throughout Broken Hill.
Patients in residential aged care facilities often have limited mobility and can therefore have difficulty accessing
medical care in the after hours period. Equally nursing staff in RACFs do not necessarily have skills or
confidence in emergency or acute care. By providing targeted training to after hours nursing staff, we will
increase their capacity and confidence to manage patients in situ, and to identify patients requiring urgent
medical care.
The FWNSWML is currentl working with the WLHD to innovate the models of care for GP presentations in the
emergency departments of small remote communities with GP/VMNO arrangements. GP type presentation will
be differentiated and managed under a different program including nursing lead protocols, and new referral
systems back to general practice priority waiting lists.




After hours health transport program in Broken Hill - FARE Assist.
After hours incentive payments to practices.
Marketing and educational campaign for after hours services.
Training and support for nurses on call after hours including in residential aged care facilities.
Page 27 of 35
FWNSWML Medicare Local 2014-15 Annual Plan

Region
Sector
Service Provision
Performance information
Expected outcome
Provision of support for nurse-led interventions in emergency departments linked to GP after hours
arrangements for non-urgent presentations
Whole of FWNSWML region
General Practice, Hospitals, RACFs, ACCHOs.
FWNSWML, transport providers.
Quantitative:
 Number of Practices participating in after hours activities.
 Number of supported transport OOS.
 Number of education events with nursing staff.
Qualitative:
 More efficient use of Emergency Departments after hours.
 Better management of unstable chronic conditions.
 Improved referral and management of afterhours patients within provider networks.
 Evidence of strategic approaches and joint planning for after hours services between FWNSWML and
LHDs.
1. Better access to GP afterhours services.
2. Better referral networks across service providers for afterhours presentations.
3. More efficient utilisation of ED in small country towns.
4. Appropriate after hours support for people living in very remote communities.
5. Workforce innovation including nurse led interventions and extended scope of practice after hours.
Page 28 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 10
SO
FP
ACTIVITY NAME
Quality Improvement to support evidence based best practice
IDENTIFIED NEED
Comprehensive Needs Assessment Findings: Lack of coordinated, comprehensive and integrated
services, Poor understanding of available services and referral pathways.
Strategic Objectives: 2 - Providing support to clinicians and service providers to improve patient care.
STRATEGY
DURATION
RESOURCING
FUND ESTIMATE
Description
2
KR
A
5
2
Ongoing
Ongoing
 Staffing allocation (Clinical Governance Committee, Quality Improvement and Accreditation)
 Project support funds for Clinical Governance activities, practice quality initiatives, intersectoral
collaboration, targeted clinical competency development, software support for monitoring and
evaluation of clinical activities and compliance, resourcing for new models of care and health
pathways, and other administrative support.
$200,000
The provision of quality PHC services requires the careful alignment of clinical competencies with a
skilled workforce, evidence based practice, consumer participation and collaboration across
providers and settings. FWNSWML understands quality comes through establishing a framework for
best practice organisational management and service delivery systems and a culture of quality
improvement. In remote areas it is impossible to independently meet all the needs of our
communities. Clinical networks, joint consumer engagement protocols, sharing of information and
developing integrated pathways of care are essential to maintain effective, quality services.
FWNSWML achieved accreditation through QiP in May 2014 and has supported General Practices in
the catchment through the AGPAL & GPA accreditation process and APCC waves to improve GP
systems and management of their practice populations. These activities have become embedded in
the values and objectives of the organisation.
The Clinical Governance subcommittee of the Board of Directors guides the clinical Governance
framework in relation to our clinicians, service delivery models and activities. FWNSWML recognises
the importance of supporting clinicians by provision of good Governance through policy and
procedure, clinical supervision, cultural mentoring and, compliance with registration and legislative
requirements. Clinicians are committed to providing quality care through working within their scope of
Page 29 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
practice, recognising opportunities and training for extended scope of practice and practicing
according to evidence based best practice principals.
FWNSWML being in such a remote area, developing clinical supervision networks has been a
challenge. However, FWNSWML have led the development of networks that ACCHOs, GP and other
MLs utilise.
Type of activity
Region
Sector
Service Provision
Performance information

Clinical Governance subcommittee guidance on clinical structures, pathways, models of care,
strategic direction, monitoring of Continuous Quality Improvement (CQI) issues, activities and
outcomes.
 Accreditation maintenance and review of policies and procedures.
 Australian Primary Care Collaboratives (APCC) supporting CQI in GP and ML.
 RACGP Accreditation for Continuous Professional Development for GPs and the wider PHC
workforce.
 Internal Auditors training to ensure compliance.
 Links to academic institutions for clinical partnerships – University Department of Rural
Health, Centre for Remote Health, Centre for Remote Mental Health, University of Sydney
Centre for Indigenous Health (Cultural Competency)
 West and Far West Local Health Districts Ethics Committee for approval of research projects.
 Credentialing and re credentialing of staff, contractors and sub-contractors.
 Intersectoral collaboration and alignment around national safety and quality standards.
Whole of FWNSWML region
PHC Organisation, General Practice, ACCHO and LHD.
FWNSWML, General Practice and GP entities, ACCHOs and academic institutions.
Quantitative:
 Evidence of effective compliance with FWBSWML quality management system.
 Number of Clinical Governance meetings.
 Number of Primary Care organisations represented in Clinical Governance framework.
 Number of CPD events supported or delivered and attendance.
 Number of APCC waves supported and outcomes.
 Number of partnerships developed and maintained.
Qualitative:
 Evidence of periodic review of policies and procedures.
 Maintenance of accreditation status.
 Better alignment of clinical networks across PHC organisations (credentialing, models of care,
scope of practice, data sharing, competency development).
Page 30 of 35
FWNSWML Medicare Local 2014-15 Annual Plan

Expected outcome

1.
2.
3.
4.
5.
Adoption of improved systems in consideration of Consumer viewpoints in health service
delivery.
Management of patient complaints.
Improved quality, safety, performance and accountability across the organisation.
Improved capability of clinicians working in the General Practice environment.
Better systems for Quality Improvement in the management of priority disease groups.
Effective uptake of Patient Opinion consumer portal.
Evidence of clinician and practice participation in quality activities (NPS, APCC etc)
Page 31 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
NUMBER 11
ACTIVITY NAME
Governance
IDENTIFIED NEED
Comprehensive Needs Assessment Findings:
STRATEGY
Strategic Objectives: 5 - Being efficient and accountable with strong Governance and effective management.
DURATION
Ongoing
Ongoing
 Funding allocation for Executive Management Team and Corporate staffing
 Board Governance support
 Professional indemnity and professional insurances
 Finance, accounting, audit and other expenses
RESOURCING
FUND ESTIMATE
Description
Type of activity
SO
5
KRA
3
FP
6
$516,597.00
The FWNSWML is skills based: our directors individually and collectively have a wealth of expertise relevant to
the development and delivery of primary health care in the diverse and complex environment in which we
operate. There is good gender balance, Aboriginal representation and the first Board will include Directors from
the FWNSWLHD and WLHD Boards. The constitution provides for up to 3 appointed Directors to ensure all
necessary skills and expertise are present on the Board and to enhance the independence. The Transition
Board and Executive has overseen the establishment of the FWNSWML financial, corporate operating and
governance frameworks. The transition of contracts, capital, staff and IP was completed including the complete
transition of business with a seamless changeover of clinical and program services.
During 2014 the FWNSWML has 31 individual contracts under management with 80% of services delivered
through staff employed through the FWNSWML.
 Board of Directors
 Sub committees – Audit and Risk, Clinical Governance, Finance, Nomination and Governance,
Aboriginal Health
 Executive Management Team Activities
 Western NSW Local Health District Strategic Leadership group
 Effective contract management
 Service Commissioning (>$1m in commissioned services)
 Risk management
 Strategic Planning
 Advocacy and leadership
 Corporate Governance subcommittee guidance in the structure and function of the organisation.
Page 32 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
Region
Sector
Service Provision
Performance information
Expected outcomes
 Work Health and Safety Committee ensuring compliance with legislation.
 Member engagement.
Whole of FWNSWML region
Corporate/clinical/program Governance, member engagement.
Board and Executive leadership team.
Quantitative:
 Grant compliance.
 Effective and efficient management of finances and resources.
 Good Corporate Governance.
 Performance accountability and transparency.
 Increased membership of the FWNSWML.
Qualitative:
 Stakeholder support and value proposition.
 Health leadership within the catchment area.
1. Excellence in Corporate, clinical and program Governance.
2. Valued partnerships within health service provider organisations within the catchment area.
3. Motivated and skilled leadership team.
Page 33 of 35
FWNSWML Medicare Local 2014-15 Annual Plan
SCHEDULE 21.1 BUDGET 2014/15
Financial Reporting Period:
Medicare Local Name:
Program:
Version:
2014-15
Far West NSW Medicare Local
2013-14 Annual
Budget
Income
Operating
Expenses
Capital
Expenditure
Balance
Program Funds
Carryover (Brought Forward)
Interest Accumulated on Program Funds
Other Contributions to Program Expenses
Other Income Derived from the Program
Total Income (A)
Administration
Board/Governance (sub-total)
Board fees, salaries and allowances
Board training and development
Board travel and accommodation
Other Board/Governance expenses
Communications/IT
Consultants and Contractors (sub-total)
Subcontractors
Other Consultants and Contractors expenses
Equipment
Finance/Insurance (sub-total)
Audit Fees
Other Finance/Insurance expenses
Occupancy
Program Delivery Expenses (sub-total)
Meetings and Events
Payments to GPs
Payments to Allied Health professionals
Planning, Reporting and Evaluation
Program Resource Development
Other Program Delivery expenses
Salaries and Wages (non Board) (sub-total)
Long Service Leave
Redundancy Provision (must be approved by the Commonwealth)
Other Salaries and Wages expenses
Sundry expenses
Travel and Accommodation (non Board) (sub-total)
Motor Vehicle expenses
Other Travel and Accommodation expenses
Total Operating Expenses (B)
Asset Purchases (C) ($5,000 or more GST exclusive)
Balance (D) = (A - (B+C))
Explanation of variance at 6
Months only required if both
columns show Y
Regionally Tailored Primary Health Care Initiatives through Medicare Locals Fund
$4,308,597.00
$0.00
$0.00
$500,000.00
$150,000.00
$4,958,597.00
Six Month
Actual
SIX MONTH REPORT
($) Variance to
(%) Variance to
Budget
Budget
Variance Thresholds
$391,872.44
$150,000.00
$241,872.44
$4,958,597.00
$0.00
$0.00
$0.00
$0.00
-$250,000.00
-$75,000.00
-$325,000.00
$0.00
-$25,000.00
-$25,000.00
$0.00
$0.00
$0.00
$0.00
-$400,000.00
-$400,000.00
$0.00
$0.00
-$150,500.00
-$13,000.00
-$137,500.00
$0.00
-$458,500.00
-$17,500.00
$0.00
-$100,000.00
$0.00
-$16,000.00
-$325,000.00
-$1,249,362.28
$0.00
$0.00
-$1,249,362.28
$0.00
-$195,936.22
-$75,000.00
-$120,936.22
-$2,479,298.50
-$0.00
$0.00
$0.00
$2,154,298.50
$0.00
$50,000.00
$50,000.00
$0.00
$0.00
$0.00
$0.00
$800,000.00
$800,000.00
$0.00
$0.00
$301,000.00
$26,000.00
$275,000.00
$0.00
$917,000.00
$35,000.00
$0.00
$200,000.00
$0.00
$32,000.00
$650,000.00
$2,498,724.56
$0.00
$0.00
$2,498,724.56
-100%
-100%
-13%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
-100%
Explanation of Variance
Required?
Over 10K
Over 10%
N
N
Y
Y
N
N
Y
Y
N
Y
Y
N
N
N
N
Y
Y
N
N
Y
Y
Y
N
Y
Y
N
Y
N
Y
Y
Y
N
N
Y
N
Y
Y
Y
N
Y
Y
N
N
N
N
Y
Y
N
N
Y
Y
Y
N
Y
Y
N
Y
N
Y
Y
Y
N
N
Y
N
Y
Y
Y
N
N
Explanation of Variances should be provided below (or on another worksheet if extra space is required):
To add a new template for another program:
Right-click the relevant worksheet tab at the bottom of the screen
Click on 'Move or Copy Sheet'
Tick the 'Create a Copy' box
Click OK
Page 34 of 35
Explanation of variance at 12
Months only required if both
columns show Y
TWELVE MONTH REPORT
Twelve Month ($) Variance to (%) Variance
Explanation of Variance
Actual
Budget
to Budget
Required?
Variance Thresholds
Over 10K
Over 10%
-$4,308,597.00
-100%
Y
N
$0.00
N
N
$0.00
N
N
-$500,000.00
-100%
Y
N
-$150,000.00
-100%
Y
N
$0.00
-$4,958,597.00
-100%
$0.00
N
N
$0.00
-$50,000.00
-100%
Y
N
-$50,000.00
-100%
Y
N
$0.00
N
N
$0.00
N
N
$0.00
N
N
$0.00
N
N
$0.00
-$800,000.00
-100%
Y
N
-$800,000.00
-100%
Y
N
$0.00
N
N
$0.00
N
N
$0.00
-$301,000.00
-100%
Y
N
-$26,000.00
-100%
Y
N
-$275,000.00
-100%
Y
N
$0.00
N
N
$0.00
-$917,000.00
-100%
Y
N
-$35,000.00
-100%
Y
N
$0.00
N
N
-$200,000.00
-100%
Y
N
$0.00
N
N
-$32,000.00
-100%
Y
N
-$650,000.00
-100%
Y
N
$0.00
-$2,498,724.56
-100%
Y
N
$0.00
N
N
$0.00
N
N
-$2,498,724.56
-100%
Y
N
$0.00
N
N
$0.00
-$391,872.44
-100%
Y
N
-$150,000.00
-100%
Y
N
-$241,872.44
-100%
Y
N
$0.00
-$4,958,597.00
-100%
$0.00
$0.00
$0.00
N
N
FWNSWML Medicare Local 2014-15 Annual Plan
Risk Assessment – See attached Risk Report from FWNSWML Risk Footprint Report – Tickit system
Page 35 of 35