Consultation on the Model of Service Delivery for the
University of Canberra Public Hospital (UCPH), and the
Rehabilitation, Aged and Community Care UCPH
Model of Care
Summary Paper
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Feedback and enquiries on this document should be directed to:
Consultation on RACC Model of Care, and the Model of Service Delivery for UCPH
Attention Health Infrastructure Program
PO Box 11
Woden ACT 2606
Phone: 02 6207 1141
or email your feedback to HIP@act.gov.au
All terms and acronyms used in this Consultation Summary are defined at the end of this
document.
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Contents
Purpose ................................................................................................................................................... 4
A brief overview of the University of Canberra Public Hospital ............................................................. 6
Services at UCPH ..................................................................................................................................... 7
Overview of Adult Mental Health Rehabilitation Services at UCPH ....................................................... 8
The Rehabilitation Aged and Community Care (RACC) UCPH Model of Care......................................... 9
The UCPH Model of Service Delivery .................................................................................................... 15
Next steps in planning for UCPH ........................................................................................................... 16
Acronyms .............................................................................................................................................. 17
Glossary ................................................................................................................................................. 18
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Purpose
The University of Canberra Public Hospital (UCPH) development represents a significant
change to the delivery of Mental Health and Rehabilitation, Aged and Community Care
(RACC) services in the ACT, with the relocation and expansion of some services as well as the
introduction of new services.
ACT Health is interested to find out the community views on the proposed approach to
provision of care and non-clinical services for UCPH. This Summary Paper has been
designed as an overview of the more detailed documents:

RACC UCPH Model of Care

UCPH Model of Service Delivery
A ‘model of care’ describes how clinical services are delivered.
A ‘model of service delivery’ describes the clinical and non-clinical support services to
support the model of care being delivered.
You can provide feedback by email HIP@act.gov.au
or by post to:
Consultation on RACC Model of Care, and the Model of Service Delivery for UCPH
Attention Health Infrastructure Program
PO Box 11
Woden ACT 2606
Phone: 02 6207 1141
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These questions have been developed to assist you in framing your responses.
RACC UCPH Model of Care
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Do you think the RACC UCPH Model of Care identifies the key needs of the people
for whom services will be provided?
What, if any, aspects of the RACC UCPH Model of Care would you modify?
What do you consider will work well within the RACC UCPH Model of Care?
Do you have any questions or comments relating to the RACC UCPH Model of Care?
UCPH Model of Service Delivery
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Do you think the UCPH Model of Service Delivery adequately describes the clinical
and non-clinical support services to support the models of care (for Mental Health,
and Rehabilitation, Aged Community Care) to be delivered at UCPH?
What, if any, aspects of the UCPH Model of Service Delivery would you modify?
Do you have any questions or comments relating to the UCPH Model of Service
Delivery?
Consultation on the Mental Health services that will be provided at UCPH took place in
2014. The Models of Care relating to these services have been endorsed. They are provided
in the current consultation material for information only and are not for feedback.
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A brief overview of the University of Canberra Public Hospital
Background:
In 2011, the ACT Government announced the decision to build a new sub-acute hospital, the
first in the ACT. It will form part of a planned network of ACT Health hospitals and health
facilities designed to meet the needs of our ageing and growing population. By focusing on
new and expanded sub-acute services, it will help to alleviate the pressures on acute
facilities within the ACT region.
Location and accessibility:
In 2012, the University of Canberra campus was selected as the preferred location for the
new facility, on the corner of Aikman Drive and Ginninderra Drive, following consultation
with the community. Public transport is an important factor in the ease of access to UCPH.
Details of public transport options are under development with Territory and Municipal
Services. The University of Canberra will provide parking and it will accommodate the public,
staff and government vehicles. Accessible parking and designated pick-up and drop-off bays
will be provided. Way-finding and undercover walkways will be provided to enable ease of
access to the facility entrances.
Opening Hours:
The hospital will operate 24 hours a day, 7 days a week. The majority of admissions into the
inpatient wards will occur from Monday to Friday between 9am and 5pm, however on some
occasions admissions will occur on weekends or after hours. Multidisciplinary therapy staff
will provide services Monday to Friday, however it is possible that the hours of operation
may be extended to include evening and weekend services in the long term. Visiting hours
and guidelines will be consistent with the Canberra Hospital, which are currently from 6am
to 9pm daily.
Education and Research:
UCPH will provide for research and teaching by the University of Canberra and ACT Health
and other organisations. There will be an area of the building for the University’s faculty of
Health which includes teaching rooms that will be shared by ACT Health and the University.
Future Growth:
UCPH facilities have been designed to accommodate future growth in services. The hospital
will open with unused capacity, which will be increased as demand for services occurs.
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Services at UCPH
Key services that will be provided at UCPH will include general and adult mental health
rehabilitation and identified aged care services. These services will have inpatient units, day
and ambulatory care services.
Additionally, the UCPH will be a teaching facility, allowing it to extend the scope of existing
teaching partnerships and enable joint clinical training, teaching and research opportunities
between the University of Canberra and ACT Health.
UCPH will deliver sub-acute services, aimed at improving patient mobility and functioning,
often after surgery or other acute hospital admission. The services focus on improving
quality of life. Services at UCPH will be characterised by:
 Enhanced patient-centred care
 Specific inpatient and ambulatory care provided from a single facility
 Collocation and integration of services
People who come to UCPH for care might be:
 Admitted for care that involves overnight stay (inpatients)
 Admitted to a place in a day program
 Attending as an outpatient or for sessions of therapy (for a clinic or consultation)
 Attending to use facilities on an agreed basis (e.g. the Hydrotherapy pool)
UCPH will offer a supportive environment that assists people to return home, or to remain
at home, and spend less time in hospital care. Its clinical focus will be on enabling and
facilitating independence, whether through increased physical activity in the gym or
hydrotherapy pool, learning new life skills or sharing meals with others.
Services that UCPH won’t offer:
The new hospital will not have an emergency department and will not deliver acute
services, like surgery or intensive care. Acute Geriatric Medicine care and Older Persons
Mental Health will be delivered in the existing locations at Canberra and Calvary Hospitals.
While UCPH will deliver sub-acute services (adult rehabilitation and Geriatric Evaluation and
Management) it will not provide psycho-geriatric care or specialist palliative care.
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Overview of Adult Mental Health Rehabilitation Services at
UCPH
The Models of Care for the Adult Mental Health Rehabilitation Unit (AMHRU) and the Adult
Mental Health Day Service (AMHDS) underwent development and consultation through a
separate process in 2014, and were finalised in May 2015. These documents are provided in
the current consultation material for information only and are not for feedback.
Adult Mental Health Rehabilitation Inpatient Unit:
The Adult Mental Health Rehabilitation Unit (AMHRU) will deliver effective recovery based
treatment and rehabilitation to people with mental illness aged 18-65 years, whose needs
cannot be met by less intensive community based mental health services. The primary goal
of treatment will be the enhancement of the person’s quality of life and/or improvement in
their functional status, through engagement in a variety of rehabilitation services. The
service moving from a current ACT Health site incorporates areas of Brian Hennessy
Rehabilitation Centre, currently situated on the Calvary Hospital Campus.
Adult Mental Health Day Service:
The Adult Mental Health Day Service (AMHDS) will provide services to people with mental
illness aged 18-65 years, who would benefit from a period of intensive assessment, therapy,
rehabilitation and recovery services. Care provision may be step-up (from community-based
services) or step-down (from inpatient services) and may include monitoring and
supervision for people commencing or receiving pharmacological treatments (e.g.
Clozapine, Olanzapine) and psychotherapy programs. This service has already commenced
at Belconnen Health Centre.
Referral and Eligibility for Mental Health services at UCPH:
Referral processes related to Mental Health services have already undergone consultation,
however a brief description is provided below. Referrals to the AMHRU or AMHDS may be
initiated from a number of points including, but not limited to:
 Other services within Mental Health, Justice Health and Alcohol and Drug Services
 General Practitioners
 Allied Health Practitioners
 Adult Mental Health Service Specialist Services
Referrals will be assessed and then a multidisciplinary team review will occur to enable a
planned admission to a service or make recommendations back to the referrer. A
comprehensive referral package will be made available for referring clinicians that describes
the service functions, admission criteria and processes for referral and assessment.
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The Rehabilitation Aged and Community Care (RACC) UCPH
Model of Care
The RACC UCPH Model of Care provides an overview of the current state of RACC services in
the ACT; however its main focus is on the RACC services to be provided at UCPH. It should
also be noted that patients of UCPH may access a range of services that are not provided by
RACC (e.g. other medical consultation services).
The RACC UCPH Model of Care outlines the proposed future model of care. Operational
detail to enable the provision of these services will be developed ensuring an effective and
affordable approach to service provision.
The RACC vision for the future is to provide an integrated and coordinated territory wide
range of rehabilitation, aged and community care services across the entire continuum of
care. Patients accessing RACC services may commence treatment at any point along the
care continuum and may move between different settings as required to meet their care
needs. Strong links between all RACC services with relevant external services will be
maintained to enable provision of the most appropriate clinically indicated care for all.
Services moving from current ACT Health sites:
A number of current RACC ACT Health services will be moving to UCPH, including the:
 Rehabilitation Inpatient Living Unit (RILU)
 Ward 12B (Rehabilitation Unit) at Canberra Hospital
 Ambulatory rehabilitation services based at Canberra Hospital and Community
Health Centres
 Some services will also move from Calvary Hospital to UCPH.
New services provided by ACT Health:
The RACC day program represents a predominantly new service for RACC. It will be an
alternative to inpatient care, enabling people to return home whilst still receiving
rehabilitation services.
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Rehabilitation and Aged Care Day Program:
The day service will provide an alternative to inpatient care and enable people to return
home whilst still receiving rehabilitation services.
The Rehabilitation and Aged Care Day Program will be provided as a full or half-day
program, typically over 2-5 sessions per week. Treatment will focus upon functional
improvement, delivered through a goal-directed, time-limited coordinated program.
The division of the Rehabilitation and Aged Care Day Program into clinical specialties will
ensure that multi-disciplinary teams with specialised therapeutic expertise can best meet
the care needs of patients.
Sessional services will be available for patients who require less intensive intervention than
those patients attending the day program. Patients may attend for single discipline sessional
therapy or single session service (for example, a spinal review clinic or spasticity clinic).
There will also be a number of other services based onsite or providing in-reach services to
UCPH patients. These will include a Driving Assessment Rehabilitation Service (DARS),
Vocational Assessment Rehabilitation Service (VARS) and multi-disciplinary Prosthetic
Clinics. Geriatric outpatient services will include a Memory Assessment Service (MAS) and a
Falls Injury and Falls Prevention Service.
A Hydrotherapy pool will be included on the UCPH site. The pool will be used for individual
and group therapy sessions for inpatients and ambulatory patients attending arranged
appointments. External providers will also have access to the pool through application and
agreed terms. Hydrotherapy programs will be patient focused and goal orientated and may
include the following:
 Water assisted or resisted strengthening and range of motion exercises
 General endurance training and reconditioning
 Functional retraining in a buoyancy assisted environment
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Rehabilitation and Aged Care Inpatient Units:
Neurological Rehabilitation Unit - will provide care for patients with a range of neurological
conditions including stroke, brain injury, spinal cord injury, motor neurone disease, multiple
sclerosis and Guillain-Barre syndrome.
General Rehabilitation Unit - will provide care for patients with a range of conditions
including amputations, de-conditioning and disability associated with medical illness,
surgery or trauma.
Older Person’s Rehabilitation Unit - will provide older age appropriate rehabilitation services
for patients who have a range of medical co-morbidities associated with ageing, such as
cognitive impairment, hip and other fractures, post surgery or non-operative management,
ortho-geriatric conditions, de-conditioning and Parkinson’s Disease. Services will include
Geriatric Evaluation and Management.
Slow Stream Rehabilitation Unit - will provide rehabilitation services for patients with
limited tolerance or ability to participate in rehabilitation. Patients may include those with
non- weight bearing restrictions and patients who require services to maintain their
condition whilst awaiting finalisation of arrangements for their ongoing care. Patients will
have a planned and accepted place of discharge prior to admission.
Medical emergencies:
While patients in a sub-acute hospital setting will be of a lower medical acuity, processes
and protocols will be developed to safely manage patients whose condition deteriorates.
This may be required for the following:
 Medical emergency e.g. in the event of acute coronary and cerebral events, falls,
delirium and other unanticipated events.
 Non-urgent deterioration e.g. increased pain or wound breakdown.
Minimising patient transfers is a goal underpinning the RACC UCPH Model of Care, however
sometimes patients who require investigations or a higher level of medical and nursing care
will be transferred to an acute care hospital after initial stabilisation. Patients who improve
and can be safely cared for at UCPH may continue their stay at UCPH whilst undergoing
treatment.
Pre-emptive advanced care and/ or end-of-life care planning and limitations of medical
treatment planning will be considered for all patients. Some patients may seek transfer to
Clare Holland House to receive sub-acute specialist palliative care services.
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Referral and Eligibility for RACC services at UCPH:
Referral processes relating to RACC services will be submitted through a centralised
integrated intake point consistent with a whole-of-organisation approach in order to
undertake the administrative processing of referrals.
Communication and education will occur to ensure that referrals to RACC services are
undertaken in a timely and appropriate fashion. The importance of early referral and
commencement of appropriate care in a timely manner will be emphasised.
People requiring access to RACC services at UCPH can be referred by the following sources:
 Interstate facilities
 ACT hospitals (public and private)
 Self/ family
 Medical Specialists
 GPs
 Other sources
All referrals submitted to RACC will be screened and prioritised to ensure that people will be
seen by the appropriate service.
Considerations regarding each patient’s ability to benefit from Rehabilitation and Aged Care
sub-acute services include:
 The patient has a recent impairment of functional ability due to illness or injury
 The patient has a condition that is likely to be responsive to rehabilitation
 The patient has reasonable prospects for functional gain within a reasonable
timeframe
 The patient requires the input of a multidisciplinary rehabilitation program to
achieve functional gain
 The patient cannot be managed in a more appropriate lower level of care (for
example, cannot be safely and effectively managed in a community based
rehabilitation service)
General eligibility criteria for the Rehabilitation and Aged Care inpatient units at UCPH are:
 Aged 18 years and older
 Medically stable
 Clear rehabilitation goals
 Willing and able to participate in rehabilitation process that may include multiple
therapy sessions per day as clinically indicated
Patients will be admitted to a unit under a Rehabilitation Physician or a Geriatrician.
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Specific eligibility criteria for each unit are:
Neurological Rehabilitation Unit - The target group will include but not be limited to stroke
patients, those with brain injury, and those with Motor Neurone Disease, late effects of
polio, multiple sclerosis, cerebral palsy, spina bifida, and those with early symptoms of
Parkinson’s Disease.
General Rehabilitation Unit - The target group will include but not be limited to amputees,
those with musculoskeletal disorders, and post-orthopaedic surgery patients.
Older Person’s Rehabilitation Unit - The target group will include but not be limited to those
with cognitive impairment, delirium, falls, medical fractures, orthogeriatric patients,
deconditioned patients, and those with more progressed Parkinson’s Disease. This will
include Geriatric Evaluation and Management (GEM). The criteria used to determine older
persons will include:
 Aboriginal and Torres Strait Islander peoples aged 50 years and over
 non-Aboriginal and Torres Strait Islander peoples aged 65 and over
Eligibility will be prioritised for people aged 80 and over, although admissions outside of the
age groups will be considered if the patient has progressive Parkinson’s Disease and/ or comorbidities typically associated with ageing. The target group will include people who are
reasonably likely to be discharged home or to a low level residential aged care facility and
those who require complex, interdisciplinary assessment or comprehensive geriatric
assessment.
Slow Stream Rehabilitation Unit - The target group will include but not be limited to those
with non-weight bearing restrictions, and patients who require maintenance services whilst
awaiting finalisation of arrangements for their ongoing care. Patients will have a planned
and accepted place of discharge prior to admission to the unit.
Assessment, care, and transfer of care or discharge will be undertaken in a way that it
involves community health providers and primary health care services such as GPs, where
appropriate. Processes will be tailored to ensure that referrers are involved in or aware of
treatment plans and discharge plans to enable an integrated approach to care. The patient
and, where appropriate, their family and/or carers, will be actively involved in the care
planning process.
Following completion of a period of rehabilitation, inpatients will be transferred to other
services, or discharged. For RACC services at UCPH this could mean:
 Patient achieves all of their treatment goals and further input is not required
 Patient achieves all of their treatment goals and is ready to progress to another care
setting (e.g. Rehabilitation and Aged Care day, sessional or community-based
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services or other community health services such as YMCA Exercise Group,
Alzheimer’s Australia, Parkinson’s Disease Liaison Nurse, Community Pharmacy)
Patient is no longer benefiting from treatment and may be referred on to alternative
care or discharged from the service
Patient chooses to access services in another area or through alternate means such
as private treatment
Patient may experience an acute illness or injury which results in transfer back to
acute services external to UCPH
Early discharge planning with appropriate involvement of equipment services, community
providers and other services will be key to efficient and effective care provision within the
specialised setting of UCPH. This will include provision of comprehensive and timely
discharge summary information provided to the patient’s GP. This may also include timely
facilitation of access to the National Disability Insurance Scheme or Lifetime Care and
Support for eligible patients.
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The UCPH Model of Service Delivery
The UCPH Model of Service Delivery document outlines the clinical and non-clinical support
services to support the models of care being delivered. It captures key features of clinical
services, and details the overarching operational principles for UCPH including clinical
support services (like pathology and pharmacy) and non clinical support services (like food
services and cleaning).
Non clinical support services:
The procurement of UCPH will be undertaken utilising a Design Construct and Maintain
contracting model. This will involve entering into an arrangement for the design and
construction of the facility as well as provision of certain longer-term facilities management
services (for example building maintenance, utilities management, grounds and gardens and
pest control) and soft services (for example cleaning and patient portering).
The model of service delivery for services such as linen service, equipment and property
maintenance, supply unit and other back of house services may therefore be modified from
what is described in the UCPH Model of Service Delivery document, as the model will be
based upon the requirements of the Contractor (to be appointed).
Clinical support services:
Clinical support services to be provided at UCPH include an Equipment Loan Scheme (ELS),
Pathology and Medical Imaging:
 The existing ELS service (based at the Village Creek Centre) will provide mobility and
Activities of Daily Living (ADL) equipment to eligible UCPH ambulatory inpatients
when they are discharged for short-term loan. ELS will have a satellite space at UCPH
from which they will be able to provide and receive equipment services for UCPH
patients only.
 A Pathology collection service will be provided to inpatients and ambulatory services
patients at UCPH. ACT Pathology staff (based at Canberra Hospital) will undertake
pathology collection during agreed hours Monday to Friday. If clinically indicated an
after-hours courier service will transport specimens to Canberra Hospital for
analysis. Pathology collection will be provided for UCPH patients only.
 On-site plain X-ray and video fluoroscopy will be provided for UCPH patients. After
hours X-ray services may be provided via an on-call radiographer service. The
transfer of patients off-site for medical imaging services (e.g. Magnetic Resonance
Imaging MRI and Computed Tomography/ CT or after-hours services) will be
undertaken via a coordinated process, which minimises the wait time for patients.
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Next steps in planning for UCPH
Following on from this consultation, service areas will begin developing detailed processes
for providing care in the new facility. This will enable services to move into UCPH and begin
providing services in a planned manner, once the building has been completed.
Feedback will be collated and utilised to improve the RACC UCPH Model of Care and UCPH
Model of Service Delivery documents. Collated feedback will be provided to service areas to
inform development of their detailed care processes.
A summary of feedback will be made available on the ACT Health website.
Thank you for your interest in the UCPH project.
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Acronyms
ADL
Activities of Daily Living
AMHRU
Adult Mental Health Rehabilitation Unit
AMHDS
Adult Mental Health Day Service
DARS
Driver Assessment and Rehabilitation Service
ELS
Equipment Loan Service
MAS
Memory Assessment Service
MET
Medical Emergency Team
RACC
Rehabilitation, Aged and Community Care
TAMS
Territory and Municipal Services
UCPH
University of Canberra Public Hospital
VARS
Vocational Assessment and Rehabilitation Service
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Glossary
Acute Care
Acute health care is defined where the intent is to do one or more of the following:
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Cure illness or provide definitive treatment of injury
Perform surgery
Relieve symptoms of illness or injury (excluding palliative care)
Reduce severity of illness or injury
Protect against exacerbation and/or complication of an illness and/or injury which
could threaten life or normal functions
Perform diagnostic or therapeutic procedures
Manage labour (obstetric)
Ambulatory Services
Where people come to UCPH for a day service, outpatient clinic, or for sessional therapy,
these are all referred to as ambulatory services.
Model of Care
A ‘model of care’ describes how clinical services are delivered.
Model of Service Delivery
A ‘model of service delivery’ describes the clinical and non-clinical support services to
support the model of care being delivered.
Sub Acute Care
Sub-acute care specifically for Rehabilitation Aged and Community Care (RACC) patients is
the provision of specialised multidisciplinary care in which the primary need for care is
optimisation of patient functioning and quality of life. A person’s functioning may relate to
their whole body or a body part, the whole person, or the whole person in a social context,
and to impairment of a body function or structure, activity limitation and/ or participation
restriction.
Sub-acute care specifically for Mental Health is care provided for people with moderate to
severe mental illness not requiring ongoing acute services. It has a focus on the
enhancement of a person’s quality of life and or improvement in their functional status
through the engagement in a variety of rehabilitation services. Sub-acute care will assist
people to develop their capacity to live successfully in the community and provide
foundations for continued recovery.
Note: The term ‘Geriatric’ is used through this and other documents as it is a medically
agreed and standardized term that describes an area of medicine and health care. The
medical field of Geriatrics focuses on providing care for older adults and/or comorbidities
typically associated with ageing.
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