Annual report 2017/18: Governance

Governance

Our place in the wider health system

The WA health system consists of the Department of Health, five board-governed health service providers, the Quadriplegic Centre and Health Support Services. The Department of Health, led by the Director General, provides leadership and management of the health system as a whole, ensuring the delivery of high quality, safe and timely health services. Each health service provider, with the exception of Health Support Services, is governed by a Board appointed by the Minister for Health. Board members bring a wealth of experience in a range of fields such as health care, finance, law, and community and consumer engagement.

Health service providers are responsible and accountable for the delivery of safe, high quality, efficient and economical health services to their local areas and communities. They are the Child and Adolescent Health Service, East Metropolitan Health Service, North Metropolitan Health Service, South Metropolitan Health Service and the WA Country Health Service (WACHS). While WACHS is the State Government health care provider for country patients, it works together with the Department of Health and other health service providers to ensure country patients have coordinated care when needed.

System-wide support to health service providers, including some technology, supply, workforce and financial services, are provided through a shared services arrangement by Health Support Services, which is a chief executivegoverned health service provider.

[Figure 1: Governance structure(PDF only) - WACHS Executive reports to the WACHS Chief Executive. WACHS Chief Executive reports to the Director General and the WACHS Board. Also reporting to the WACHS Board is the Finance Committee; the Audit and Risk Committee; and the Safety, Quality and Performance Committee. The Director General reports to the Minister for Health].

Minister

The WA Country Health Service is responsible to the Minister for Health, the Honourable Roger Cook MLA.

Accountable Authority

The WA Country Health Service is a board governed statutory authority, where the Board is directly accountable to the public and the Minister for Health, working with the Director General of the Department of Health.

The Board Chair Professor Neale Fong is the reporting officer for the WA Country Health Service in 2017–18.

Enabling legislation

The WA Country Health Service was established as a board governed health service provider by the Health Services (Health Service Provider) Order 2016 made by the Minister under section 32 of the Health Services Act 2016. The WA Country Health Service is responsible to the Minister for Health and the Department CEO of the Department of Health (System Manager) for the efficient and effective management of the agency.

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WA Country Health Service Board

The WA Country Health Service is a State Government statutory authority under the Health Services Act 2016. The legislation, which came into effect on 1 July 2016, replaced the Hospitals and Health Services Act 1927 and established boards responsible and accountable for delivering safe, high-quality, efficient and economical health services to their local communities.

From 1 July 2016, the WA Country Health Service Board commenced as the governing body for the organisation. It comprises highly capable and committed professionals with a diverse range of experience across the fields of medicine and health care, finance, law and community and consumer engagement.

The Board works closely with the Chief Executive, who manages the day-to-day operations to deliver safe, high-quality and efficient health services to communities across regional Western Australia.

The Board is supported by three committees; the Audit and Risk Committee; Finance Committee; and Safety, Quality and Performance Committee. These bodies assist the Board to perform its functions and provide support and advice to the Board in exercising its authority. Each committee is directly responsible and accountable to the Board for the exercise of its duties and responsibilities.

Read more about the WA Country Health Service Board in Our structure.

[Photo (PDF only): Board members, Chief Executive Jeff Moffet and Regional Director Kimberley Bec Smith visit One Arm Point]

Professor Neale Fong

Professor Neale Fong is a registered medical practitioner with over 30 years’ experience in medical and health care delivery and leadership roles. His strengths lie in reform and change management, developing strategic direction for healthcare organisations and leading over the entire spectrum of health policy and service delivery.

In addition to his role as Chair of the WA Country Health Service Board, Neale is also Chairman of Bethesda Health Care and Chairman of the Ministerial Council for Suicide Prevention. A former Director General of the Department of Health (WA) and former CEO of St John of God Hospital Subiaco, Neale holds Masters degrees in Business Administration and Theological Studies, and Bachelor degrees in Medicine and Surgery. He consults to Curtin University on the establishment of WA’s third medical school, is a Professor in Healthcare Leadership and is the National and WA President of the Australasian College of Health Service Management.

Ms Wendy Newman

Wendy Newman is CEO of the Wheatbelt Development Commission. She has extensive experience in individual, organisational and regional development and in addition to her role as Deputy Chair of the WA Country Health Service Board, is on the Board of Regional Development Australia, Wheatbelt and is Deputy Chair of Directions Workforce Solutions.

Wendy has extensive experience in working at all levels of government to develop strategy and drive reform. Wendy has a Masters in Commerce (Management), a Bachelor of Education and is a graduate of the Australian Institute of Company Directors’ program.

View video: Telehealth is supported by everyone at WACHS, especially our Board (YouTube)

Mr Alan Ferris

Alan Ferris has significant experience in Government and not-for-profit sectors and is currently managing his own consultancy business. Prior to starting his own consultancy business Alan led the consulting team at the accounting firm BDO. Alan has worked in the Senior Executive Service of the State Government in positions including General Manager of the Perth Theatre Trust and Acting Director General of the Department of Culture and the Arts. He also held the position of Chief Financial Officer at the Department of Culture and the Arts for seven years.

Alan is Chair of Palmerston Association Inc. a not for profit drug and alcohol service provider and is Chair of the Finance Committee for the WA Country Health Service. Alan also has significant local government experience having been Mayor of the Town of East Fremantle for six years and a Councillor for eight years. Alan holds Bachelor of Commerce (Accounting and Information Systems), is a Certified Practising Accountant and a Fellow of Leadership WA.

Mr Michael Hardy

Michael Hardy is a lawyer who practiced for some 40 years in a large national firm, a boutique firm and as a sole practitioner. Michael’s principal areas of practice were administrative, contract, planning, environmental and property law.

In addition to his position on the Board of WA Country Health Service, he is a member of the Contaminated Sites Committee and a member of the Metro Central Joint Development Assessment Panel. Michael is a former chairman and non-executive director of Fleetwood Limited.

Dr Daniel Heredia

Dr Daniel Heredia is the Deputy CEO and Medical Director at Hollywood Private Hospital, the largest private hospital in WA. He has previously worked as a Medical Advisor to Medicare Australia and prior to this worked in clinical medicine at various hospitals in WA. Daniel sits on the WA Board of the Medical Board of Australia and is a former Director of the Australian Medical Association (WA).

Daniel has completed a Bachelor of Medicine and Bachelor of Surgery with Honours, an MBA with Distinction, and a Diploma of Public Health. He is a Graduate of the Australian Institute of Company Directors, Fellow of the Royal Australasian College of Medical Administrators and Fellow of the Australasian College of Health Service Management.

Dr Kim Isaacs

Dr Kim Isaacs is a Yawuru, Karajarri and Noongar woman and the current Deputy Medical Director of the Kimberley Aboriginal Medical Service. Kim has a strong background in rural and remote medicine and Aboriginal primary health care and is a General Practitioner in remote clinics north and south of Broome.

Kim is an Aboriginal health lecturer at the University of Notre Dame Australia, Fellow of the Royal Australian College of General Practitioners and a Fellow of the Australian Rural Leadership Foundation. Before starting a medical career, Kim completed a Bachelor of Commerce degree at UWA with a major in Accounting and Finance.

Mr Joshua Nisbet

Joshua Nisbet is most recently an Associate with Focal HR Consulting and his own consulting business. Formerly the Manager of Aboriginal Economic Participation with Rio Tinto, responsible for the employment and contracting obligations Rio Tinto Iron Ore has with the Traditional Owners of the Pilbara, arising from the commercial agreements and Indigenous Land Use Agreements.

Joshua has post graduate qualifications in Psychology and Commerce from UWA, Murdoch and the University of NSW and commenced his career working for WA’s specialist psychiatric disability employment agency, Workright (WA).

*Retiring member from July 1 2018

Ms Mary Anne Stephens

Mary Anne is a senior executive and non-executive director with more than 25 years’ experience leading teams within the financial services, IT and not-forprofit sectors in Australia and the United States. She has extensive experience in strategy, finance, risk management, audit and governance. Mary Anne is currently the Chief Financial Officer for Amana Living.

Mary Anne is a Non-Executive Director of Diabetes WA, a Board Member of VenuesWest, and an external member of the Football West Finance and Audit Sub-committee.

She holds a Master of Accounting degree, is a Fellow of CPA Australia, a Fellow of the Institute of Public Accountants, a Fellow of the Australian Institute of Management WA and a Graduate of the Australian Institute of Company Directors.

Mrs Meredith Waters

Meredith Waters arrived in the Esperance region 19 years ago from Melbourne, and quickly grew to love life in the regional community. With a background in the justice system as a Clerk of Courts in Victoria, Meredith commenced with the Esperance Court House in 2000.

Meredith has held a variety of roles in the community and volunteer sector including management roles with Bay of Isles Community Outreach and YouthCARE, project work with Esperance Community Arts and Esperance Volunteer Centre and volunteering with Esperance Care Services and Esperance Civic Centre.

Meredith is currently a member of Esperance Local Drug Action Team, Volunteer Manager for 103.9HopeFM community radio, board member with Esperance Community Arts, and the Chairperson of the South East District Health Advisory Council with the WA Country Health Service.

Board meeting and committee attendance

Table 1:

NameNumber of meetingsMeetings attended
Full Board Meeting
Professor Neale Fong 11 10
Wendy Newman 11 10
Dr Daniel Heredia 11 11
Dr Kim Isaacs 11 10
Joshua Nisbet 11 8
Michael Hardy 11 10
Mary Anne Stephens 11 10
Meredith Waters 11 11
Alan Ferris 11 11
Finance Committee
Alan Ferris (Chair) 11 11
Wendy Newman 11 11
Mary Anne Stephens 11 9
Audit and Risk Committee
Michael Hardy (Chair) 11 9
Meredith Waters 11 10
Alan Ferris 11 10
Safety, Quality and Performance Committee
Dr Daniel Heredia (Chair) 7 6
Dr Kim Isaacs 7 6
Meredith Waters 7 7
Joshua Nisbet 7 7

WA Country Health Service Executive

The WA Country Health Service Executive is the principal advisory body to the Chief Executive of the WA Country Health Service and as such assists with the management of the organisation by providing advice to the Chief Executive on strategic, service and policy issues.

The Executive provides an important unifying link between executive management across organisational divisions.

  • WACHS Board
    • WACHS Chief Executive
      • Executive Director Health Programs
      • Executive Director Medical Services
      • Executive Director Mental Health
      • Executive Director Nursing & Midwifery Services
      • Executive Director Business Services
      • Executive Director Innovation and Development
      • Chief Operating Officer
        • Regional Director Kimberley
        • Regional Director Goldfields
        • Regional Director Pilbara
        • Regional Director South West
        • Regional Director Midwest
        • Regional Director Wheatbelt
        • Regional Director Great Southern
      • Director Office of the Chief Executive
      • Executive Director Health Programs

Note: Senior Officers and their area of responsibility for the 2017-18 year are listed in Other Legal Disclosures.

Our values in action

Artwork tells local story of fusion and renewal

The two-year redevelopment of the Narrogin Health Service has reached a new stage, with installation of feature artwork at the main entry of the hospital. The artwork is a tribute to ancient and recent history of the local environment and has been created in consultation with local Aboriginal elders and using local craftsmen.

Public Art contributes to our understanding and appreciation of cultural and natural heritage, enhancing our built environment and creating meaningful public spaces. Among its many social, economic and cultural benefits, public art can help to define a place and create a sense of cultural and community identity; improve the public experience of buildings and spaces; and encourage creative collaborations between artists and other professionals such as architects, designers, landscape architects and engineers. Wherever possible WA Country Health Service seeks to use artwork to improve the experience of people visiting our facilities.

Research released in 2016 by the WA Arts and Health Consortium Reference Group showed that art in clinical settings improves clinical outcomes for patients.

“Artwork in a healthcare setting is more than just decorative. It can give people a pause from the trauma or stress of their current situation and can improve their experience.” said Sean Conlan, WA Country Health Service Wheatbelt Regional Director.

At Narrogin Health Service, artist Lorenna Grant has created a unique artwork that tells the story of the local eco system and environment in the creation of a sculptural piece featuring local granite and wandoo timber that was once the floorboards in the Narrogin Baptist Church.

Specialising in creating public artwork that has a local connection, Lorenna felt that the use of local craftsmen, and cooperation with local Aboriginal elders, were key to the creation of this piece.

To achieve the vision for the sculptural piece Lorenna joined forces with Narrogin woodworker Stan Samulkiewicz to create the wooden structure.

A passionate environmentalist, Lorenna's artwork tells a story that is particular to the Narrogin area. “The triangular timber panels are my interpretation of the triangular fissures created by the plants in the rock face,” she said. “At the top of the work, between the panels, small flower buds reach up to the light, representing the continuation of the renewal process.”

Lorenna Grant and Stan Samulkiewicz are also set to deliver a range of external feature seating options throughout the health service as part of the Percent for Art Scheme.

[Photo (PDF only): Artists Lorenna Grant and Stan Samulkiewicz]

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Performance Management Framework

Outcome based Performance Management Framework

To comply with its legislative obligation as a Western Australian government agency, the WA Country Health Service operates under the WA Health Outcome Based Management (OBM) Framework.

The framework was updated comprehensively for 2017-18 to reflect the new governance structure resulting from the introduction of the Health Services Act 2016 and to update the previous framework which had been in place for fifteen years. The resulting changes include new outcomes, services and the replacement of some Key Performance Indicators (KPIs).

The framework describes how outcomes, services and KPIs are used to measure agency performance towards achieving the relevant overarching whole-of-government goal. WA Health’s KPIs measure the effectiveness and efficiency of the WA Country Health Service in achieving the following outcomes:

  • Outcome 1: Public hospital based services that enable effective treatment and restorative healthcare for Western Australians.
  • Outcome 2: Prevention, health promotion and aged and continuing care services that help Western Australians to live healthy and safe lives.

These updated outcomes are reflective of a continuum of care approach and the split between delivering services in both a hospital and community based setting.

KPIs and services delivered by the WA Country Health Service to achieve WA Health outcomes are outlined in Table 2 (next page).

Performance against these outcomes and activities are summarised in the Summary of KPIs section on page 46 and described in detail in the KPI section starting on page 100.

KPIs and services delivered by WACHS to achieve WA Health outcomes

WA Government Goal: Strong Communities Safe communities and supported families.

WA Health Agency Goal: Delivery of safe, quality, financially sustainable and accountable healthcare for all Western Australians.

Outcome 1: Public hospital based services that enable effective treatment and restorative healthcare for Western Australians

Services delivered to achieve Outcome 1:
  1. Public hospital admitted services
  2. Public hospital emergency services
  3. Public hospital non-admitted services
  4. Mental health services
Key Performance Indicators for Outcome 1:

Effectiveness Indicators:

  • Proportion of elective wait list patients waiting over boundary for reportable procedures (Existing)
  • Hospital infection rates (Healthcare-associated Staphylococcus aureus bloodstream infections (HA-SABSI) per 10,000 occupied bed-days in public hospitals) (New)
  • Survival rates for sentinel conditions (Existing)
  • Percentage of admitted Aboriginal and Non-Aboriginal patients who discharged against medical advice (New)
  • Percentage of live-born term infants with an Apgar score of less than 7 at 5 minutes post delivery (Existing)
  • Rate of total hospital readmissions within 28 days to an acute designated mental health inpatient unit (New)
  • Percentage of contacts with community-based public mental health non-admitted services within seven days post discharge from and acute public mental health inpatient unit (Existing)
  • Average admitted cost per weighted activity unit (New)
  • Average Emergency Department cost per weighted activity unit (New)
  • Average non-admitted cost per weighted activity unit (New)
  • Average cost per bed-day in specialised mental health inpatient units (Existing)
  • Average cost per treatment day of non-admitted care provided by public clinical mental health services (New)

Efficiency Indicators:

  • Average admitted cost per weighted activity unit (New)
  • Average Emergency Department cost per weighted activity unit (New)
  • Average non-admitted cost per weighted activity unit (New)
  • Average cost per bed-day in specialised mental health inpatient units (Existing)
  • Average cost per treatment day of non-admitted care provided by public clinical mental health services (New)

Outcome 2: Prevention, health promotion and aged and continuing care services that help Western Australians to live healthy and safe lives

Services delivered to achieve Outcome 2:

  1. Aged and continuing care services
  2. Public and community health services
  3. Community dental health services
  4. Small rural hospital services
Key Performance Indicators for Outcome 2

Effectiveness Indicators:

  • Response times for emergency air-based patient transport services (Percentage of emergency air-based inter-hospital transfers meeting the statewide contract target response time for priority 1 calls) (New)
  • Percentage of patients who access emergency services at a small rural or remote Western Australian hospital and are subsequently discharged home (New)

Efficiency Indicators:

  • Average cost per bed-day for specialised residential care facilities, flexible care (hostels) and nursing home type residents (Existing)
  • Average cost per person of delivering population health programs by population health units (Existing)
  • Cost per trip of patient emergency air-based transport, based on the total accrued costs of these services per the total number of trips (New)
  • Average cost per trip of Patient Assisted Travel Scheme (PATS) (Existing)
  • Average cost per rural and remote population (selected small rural hospitals) (New)

Following a review of the Outcomes Based Management structure for WA Country Health Services, a number of Key Performance Indicators are reported for the first time in the 2017-18 Annual Report. These KPIs are identified in the table above, and will not report comparatives for the prior period.

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Our partners

Shared responsibilities

Health Service Providers across Western Australia work with a range of service providers across the patient journey to deliver high quality integrated healthcare.

In the country providing integrated care for patients is even more complex. The WA Country Health Service shares responsibility for delivering care with a range of other State agencies, including but not limited to: other Health Service Providers, the Mental Health Commission, WA Police, the Department of Corrective Services, and the Department of Communities and its Disability Services, Child Protection and Family Support sections. We also work closely with general practitioners, the WA Primary Health Alliance, Aboriginal Community Controlled Organisations, local shires and other care and service providers such as Silver Chain in regional and remote communities across the state.

In addition to the relationships we have with other agencies, WA Country Health Service also has a key partnership with the Royal Flying Doctor Service to ensure that country patients can access tertiary care when they require it. Royal Flying Doctors Service provides Inter-hospital patient transfer services across the state for transfer of patients between a WA Country Health Service site and another hospital facility such as the metropolitan tertiary hospitals.

6,542 patients accessed the Royal Flying Doctor Service in 2017 (for Inter-hospital Patient Transfer)

Similarly, we have a key partnership with St John Ambulance in ensuring that country patients can also be transferred by road either from the place of their emergency, or between hospitals or health sites and there are over 160 ambulance locations operating in country WA providing this important service. This is achieved through a combined model of volunteer ambulance officers, community paramedics and paid paramedic services. WA Country Health Service works closely with St John Ambulance so that country people have access to this vital service in their time of need.

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