ACT Budget 2019-20. Budget Statement C: ACT Health ...



Contents TOC \h \z \t "Heading 1,1,Heading 2,2" HYPERLINK \l "_Toc10030966" ACT HEALTH DIRECTORATE PAGEREF _Toc10030966 \h 1Purpose PAGEREF _Toc10030967 \h 12019-20 Priorities PAGEREF _Toc10030968 \h 1Estimated Employment Level PAGEREF _Toc10030969 \h 2Strategic Objectives and Indicators PAGEREF _Toc10030970 \h 3Output Classes PAGEREF _Toc10030971 \h 10Accountability Indicators PAGEREF _Toc10030972 \h 13Changes to Appropriation PAGEREF _Toc10030973 \h 16Summary of 2019-20 Infrastructure Program PAGEREF _Toc10030974 \h 20Financial Statements PAGEREF _Toc10030975 \h 21CANBERRA HEALTH SERVICES PAGEREF _Toc10030976 \h 33Purpose PAGEREF _Toc10030977 \h 332019-20 Priorities PAGEREF _Toc10030978 \h 33Estimated Employment Level PAGEREF _Toc10030979 \h 34Strategic Objectives and Indicators PAGEREF _Toc10030980 \h 35Output Classes PAGEREF _Toc10030981 \h 39Accountability Indicators PAGEREF _Toc10030982 \h 43Changes to Appropriation PAGEREF _Toc10030983 \h 47Summary of 2019-20 Infrastructure Program PAGEREF _Toc10030984 \h 51Financial Statements PAGEREF _Toc10030985 \h 53ACT LOCAL HOSPITAL NETWORK PAGEREF _Toc10030986 \h 64Purpose PAGEREF _Toc10030987 \h 642019-20 Priorities PAGEREF _Toc10030988 \h 64Estimated Employment Level PAGEREF _Toc10030989 \h 64Strategic Objectives and Indicators PAGEREF _Toc10030990 \h 65Output Classes PAGEREF _Toc10030991 \h 68Accountability Indicators PAGEREF _Toc10030992 \h 69Changes to Appropriation PAGEREF _Toc10030993 \h 70Financial Statements PAGEREF _Toc10030994 \h 72ACT HEALTH DIRECTORATEPurposeThe ACT Health Directorate is the steward of the health system in the ACT and partners with the community, government and other jurisdictions to provide better health outcomes for all in the ACT and surrounding regions. We provide a policy and population health capability based on a foundation of world-leading health and medical research. We develop strategies and set directions to ensure services meet community needs and expectations, delivering improved health outcomes. We are working to ensure our public health system is innovative, effective and sustainable now and into the future. The ACT Health Directorate will deliver on these objectives by:promoting good health and well-being;supporting and applying preventative health measures;improving access to appropriate healthcare;ensuring quality health outcomes and stewardship of the health system;delivering whole of government health strategy and policy, including infrastructure assets and system performance; andsupporting community sector organisations to provide various health services.The ACT Health Directorate aims to support our people and strengthen teams by helping staff to reach their potential, promoting a learning culture and providing high-level leadership.2019-20 PrioritiesIn 2019-20 there will be a continued focus on building and improving health infrastructure in the ACT, including through the progression of major projects for the Centenary Hospital for Women and Children, the Surgical Procedures Interventional Radiology and Emergency Centre (SPIRE) and the Inner North Walk in Centre. There will also be a focus on modernising core information technology systems and progressing work to expand Clare Holland House. More resources will be directed towards essential medical and health research. There will also be additional funding for vaccinations for young people, Aboriginal and Torres Strait Islander health services and palliative care.The ACT Health Directorate will continue to provide an integrated approach to mental health services through an expansion of services for people with mental illness as well as further support for mental health carers.Improving the health and wellbeing of the community and preventing chronic disease will be an ongoing focus. We will work with community and academic and non-government partners to support all Canberrans to live healthier, more active lives.The ACT Health Directorate along with Canberra Health Services and Calvary Public Hospital will work together in 2019-20 to implement all recommendations of the final report of the Independent Review into the Workplace Culture within ACT Public Health Services. Estimated Employment LevelTable SEQ Table \* ARABIC 1: Estimated Employment Level2017-18ActualOutcome12018-19Budget12018-19Estimated Outcome2019-20BudgetStaffing (FTE)-557557603Note:This Directorate was created during 2018-19, on 1 October 2018 through an Administrative Arrangement Order. The 2018-19 Budget has been notionally adjusted for comparative purposes. Strategic Objectives and Indicators Strategic Objective 1Reducing the Waiting List for Elective SurgeryReducing the number of people waiting longer than clinically recommended timeframes for elective surgery.Table SEQ Table \* ARABIC 2: The number of patients waiting longer than clinically recommended timeframes for elective surgery1Strategic Indicator2018-192018-192019-20TargetEst.?OutcomeTargetThe number of patients waiting longer than clinically recommended timeframes for elective surgeryn/an/a430Note:This Strategic Objective was previously reported in the former Health Directorate in 2018-19. The 2018-19 Target and estimated outcome is reported on page 35.Strategic Objective 2Performing more Elective SurgeryIncreasing the number of elective surgery procedures performed.Table SEQ Table \* ARABIC 3: Number of elective surgeries performed1Strategic Indicator2018-192018-192019-20TargetEst.?OutcomeTargetNumber of elective surgeries performedn/an/a14,250Note:This is a new Strategic Objective for 2019-20.Strategic Objective 3Improving Timeliness of Emergency Department TreatmentPercentage of Emergency Department presentations whose length of stay in the Emergency Department is four hours or less. This provides an indication of the effectiveness of the public hospital system in meeting the need for Emergency Department services.Table SEQ Table \* ARABIC 4: The Percentage of Emergency Department presentations whose length of stay in the Emergency Department is four hours or less1Strategic Indicator2018–192018–192019–20TargetEst.?OutcomeTargetPercentage of Emergency Department presentations whose length of stay in the Emergency Department is four hours or less2n/an/a90%Notes:This Strategic Objective was reported in the ACT Local Hospital Network in 2018-19. The 2018-19 Target and estimated outcome is reported on page 66.Includes those admitted, transferred, referred for treatment elsewhere or sent home.Strategic Objective 4 Improving the Mental Wellbeing of CanberransPercentage of ACT adults who self-report their mental health status as good, very good or excellent. This indicator reflects people’s feelings and views about their mental health. Mental health is impacted by a range of factors, including access to appropriate preventive, early intervention, primary care, community and acute services. Table SEQ Table \* ARABIC 5: Percentage of ACT adults who self-report their mental health status as good, very good or excellent1Strategic Indicator2018–192018–192019–20TargetEst.?OutcomeTargetPercentage of ACT adults who self-report their mental health as good, very good or excellent n/an/a>90%Sources: ACT General Health SurveyNote:This is a new Strategic Objective in 2019-20. This Strategic Objective is measured biennially.Strategic Objective 5 Improving the Health Status of CanberransPercentage of ACT adults who self-report their health status as good, very good or excellent.This indicator reflects people’s feelings and views about their physical health status. Physical health status at a population level is impacted by a range of factors, including access to appropriate preventive health, health protection, primary care and hospital services. Table SEQ Table \* ARABIC 6: Percentage of ACT adults who self-report their health status as good, very good or excellent1Strategic Indicator2018-19 2018-192019-20TargetEst. OutcomeTargetPercentage of ACT adults who self-report their health status as good, very good or excellentn/an/a>90%Sources: ACT General Health SurveyNote:This is a new Strategic Objective in 2019-20. This Strategic Objective is measured biennially.Strategic Objective 6Reducing the Risk of Fractured Femurs in ACT Residents Aged over 75?yearsThis indicator provides an indication of the success of public and community health initiatives to prevent hip fractures. In 2017-18, the ACT rate of admissions in persons aged 75 years and over with a fractured neck of femur was 6.0 per 1,000 persons in the ACT?population. This is not significantly different to the long term target and follows a generally decreasing trend over a 10 year period.Table SEQ Table \* ARABIC 7: Reduction in the rate of broken hips (fractured neck of femur)Strategic Indicator2017–18 ACT RateLong TermTargetRate per 1,000 people6.05.3Source: ACT Admitted Patient Care data (Public Hospital data only)Strategic Objective 7 Management of Chronic Disease: Maintenance of the Highest Life Expectancy at BirthLife expectancy at birth provides an indication of the general health of the population and reflects on a range of issues other than the provision of health services such as economic and environmental factors. The ACT continues to enjoy the highest life expectancy of any jurisdiction in Australia and the Government aims to maintain this result.Table SEQ Table \* ARABIC 8: Life expectancy at birth in the ACT and Australia, by sex, 2014-20161Strategic IndicatorACT(Years)National (Years)2019-20TargetFemales85.284.6n/aMales81.380.4n/aSource: Australian Bureau of Statistics (ABS) 2017. Cat. no.33302.0.55.001, ABS, Canberra.Note:This Strategic Objective is being discontinued in 2019-20 as the data reported is publicly available and reported through the Australian Bureau of Statistics (ABS) National Health Survey.Strategic Objective 8Lower Prevalence of Circulatory Disease than the National Average The prevalence of cardiovascular disease is an important indicator of general population health as it is a major cause of mortality and morbidity.While people of all ages can present with a chronic disease, the ageing of the population and longer life spans mean that chronic diseases will place major demands on the health system for workforce and financial resources. Table SEQ Table \* ARABIC 9: Proportion of the ACT population with heart or vascular disease, including stroke1Strategic IndicatorACT RateNational Rate2019-20TargetProportion of the population diagnosed with heart, or vascular disease, including stroke3.9%4.7%n/aSource: Australian Bureau of Statistics 2015 National Health Survey: First Results, 2014–15. Cat no. 4364.0.55.001. ABS, Canberra.Note: This Strategic Objective is being discontinued in 2019-20 as the data reported is publicly available and reported through the Australian Bureau of Statistics (ABS) National Health Survey.Strategic Objective 9 Lower Prevalence of Overweight and Obese People This indicator provides a marker of the success of healthy weight initiatives. Being overweight or obese is the most significant risk factor leading to Type 2 diabetes. Table SEQ Table \* ARABIC 10: Proportion of the ACT population that are overweight and obese1Strategic IndicatorRate2019–20 TargetACT National 63.5%62.8%n/an/aSource: Australian Bureau of Statistics 2015 National Health Survey: First Results, 2014–15. Cat no. 4364.0.55.001. ABS, Canberra.Note: This Strategic Objective is being discontinued in 2019-20 as the data reported is publicly available and reported through the Australian Bureau of Statistics (ABS) National Health Survey and in the ACT Chief Health Officer’s Report.Strategic Objective 10 Addressing Gaps in Aboriginal and Torres Strait Islander Immunisation StatusThe immunisation rate provides an indication of the success of programs and services to minimise the incidence of vaccine preventable diseases. The Aboriginal and Torres Strait Islander population is at higher risk of vaccine preventable diseases and associated complications. Although immunisation coverage rates for Aboriginal and Torres Strait Islander people fluctuate quarterly, annualised data indicates numbers are similar to the non-indigenous population.Table SEQ Table \* ARABIC 11: Immunisation rates—ACT Aboriginal and Torres Strait Islander population1Strategic Indicator2018–192018–192019–20TargetEst.?OutcomeTargetImmunisation rates for vaccines in the national schedule for the ACT Indigenous population:12 to 15 months≥95%95%n/a24 to 27 months≥95%89%n/a60 to 63 months≥95%95%n/aAll≥95%93%n/aNote: This Strategic Objective has been moved to Accountability Indicators (see 1.2.d). The 2019-20 Targets are reported on page 14. Strategic Objective 11 Higher Participation Rate in the Cervical Screening Program than the National AverageThe two year participation rate provides an indication of the effectiveness of early intervention health messages. The ACT aims to exceed the national average for this indicator.Table SEQ Table \* ARABIC 12: Two year participation rate in the Cervical Screening Program1Strategic IndicatorACT RateNational Rate2019-20TargetTwo year participation rate56.2%56.9%n/aSource: Cervical Screening in Australia 2014-15 (Published: Australian Institute of Health and Welfare, 2017).Note: This Strategic Objective is being discontinued in 2019-20 as the data reported is publicly available and reported through the Australian Institute of Health and Welfare. Strategic Objective 12 Achieve Lower than the Australian Average in the Decayed, Missing or Filled Teeth (DMFT) IndexThis gives an indication of the effectiveness of dental prevention, early intervention and treatment services in the ACT. The aim for the ACT is to better the national average on the DMFT.Table SEQ Table \* ARABIC 13: The mean number of teeth with dental decay, missing or filled teeth at ages 6 and 121Strategic IndicatorACT RateNational Rate2019-20TargetDMFT Index at 6 years0.901.30n/aDMFT Index at 12 years0.300.90n/aSource: Oral Health of Australian Children – The National Child Oral Health Study 2012-14, (Published: University of Adelaide Press, 2016).Note: This Strategic Objective is being discontinued in 2019-20 as the data reported is publicly available and reported through the Australian Institute of Health and Welfare.Strategic Objective 13 Reduction in the Youth Smoking RateResults from the 2014 Australian Secondary School Alcohol and Drug (ASSAD) Survey show that 5.2?per?cent of students in the ACT were current smokers in that year. This demonstrates a continued decline in current smoking from 15.3?per?cent in 2002, 6.7?per?cent in 2008 and 5.8?per?cent in 2011. The national rate for current smoking in youths in 2014 was 5.1?per?cent.Table SEQ Table \* ARABIC 14: Percentage of persons aged 12 to 17 years who smoke regularly1Strategic Indicator2014 ACT2014 National2019-20RateRateTargetPercentage of persons aged 12 to 17 who are current smokers5.2%5.1%n/aSources: Australian Secondary Students’ Alcohol and Drug (ASSAD) Survey deidentified unit record files 2014, ACT Health: Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2014 report, Centre for Behavioural Research in Cancer, Cancer Council Victoria, October 2016.Note: This Strategic Objective is being discontinued in 2019-20 as this data is publicly available and reported through the National Drug Strategy and in the ACT Chief Health Officer’s Report. Output ClassesThe ACT Health Directorate will undertake Territory wide planning of public health services, promote physically and mentally healthy communities and support continuous improvement of the public health system. On 1 October 2018, the ACT Health Directorate was created following the Administrative Arrangement Order transferring from the former Health Directorate.Output Class 1: Public Health ServicesTable SEQ Table \* ARABIC 15: Output Class 1: Public Health Services2018-192019-20 Estimated OutcomeBudget2$'000$'000Total Cost1241,017274,930Controlled Recurrent Payments218,632229,341Notes:Total cost includes depreciation and amortisation of $15.714?million in 2018-19 and $24.503?million in 2019-20.The increase in the 2019-20 budget from the 2018-19 estimated outcome is mainly due to the timing of the Administrative Arrangement Order. The 2018-19 estimated outcome only includes nine months of operation for the new ACT Health Directorate. In addition, the 2019-20 Budget includes new initiatives.Output 1.1: Improved Hospital ServicesThe ACT Health Directorate will focus on:planning and delivering an ACT wide health service model;managing, developing, implementing and providing advice on health services planning processes across the system;developing strategic policy and stewardship of the health system, including working with the Commonwealth on key health improvement initiatives;managing demand for and supply of health services across the territory;improving the health and wellbeing of the ACT population by promoting healthy behaviours and lifestyles and through ongoing monitoring and evaluation of health programs and policy;preventing, and providing a timely response to, potential public health incidents;leading the health workforce and clinical training strategy including building strong partnerships with key academic institutions and training providers; andcommissioning and managing contracts for the provision of health services, including partnerships with community sector organisations, peak bodies and advocacy groups.Table SEQ Table \* ARABIC 16: Output 1.1: Improved Hospital Services12018-192019-20Estimated OutcomeBudget$'000$'000Total Cost51,93359,240Controlled Recurrent Payments45,91348,162Note:This is a new output following the Administrative Arrangements Order, creating the ACT Health Directorate from the former Health Directorate (now Canberra Health Services) on 1 October 2018.Output 1.2: Healthy CommunitiesCanberrans enjoy one of the highest standards of health and wellbeing and have the highest life expectancy in Australia. However, our ageing population and increased prevalence of chronic conditions make it ever more challenging to keep our community healthy.The ACT Health Directorate seeks to improve the health of the ACT population through evidence-based promotion of healthy lifestyles and interventions to address the range of risk and protective factors that determine the health of our community. This includes the delivery of activities that influence the social and environmental conditions that impact on population and individual health, comprising monitoring of recreational and drinking water quality, food safety, communicable diseases control and general environmental health. Table SEQ Table \* ARABIC 17: Output 1.2: Healthy Communities12018-192019-20Estimated OutcomeBudget$'000$'000Total Cost66,30575,635Controlled Recurrent Payments61,21764,216Note:This is a new output following the Administrative Arrangements Order, creating the ACT Health Directorate from the former Health Directorate (now Canberra Health Services) on 1 October 2018. This output replaces Output 1.3 from the former Health Directorate in 2018-19.Output 1.3: Mentally Healthy CommunitiesThe ACT Health Directorate delivers an integrated cross-sector system that supports people with mental health concerns or illness, to access appropriate treatment and care in a timely and least restrictive manner. The Directorate collaborates with stakeholders on service system planning and policy, to ensure funding is targeted to provide safe, quality programs and services that offer seamless transition through stepped care and interventions as needed. A comprehensive response includes: leadership through The Office for Mental Health and Wellbeing to the whole of government approach to sustainable, effective and coordinated sector innovation;promotion of mental health and social wellbeing for all Canberrans;raising awareness of mental health, suicide and mental illness across the community to reduce stigma and discrimination as well as on a personal level, encouraging people to seek help as needed;prevention of suicide and suicide attempts wherever possible;early intervention to increase resilience and reduce the impact of mental health issues;accessible and responsive primary, secondary and tertiary mental health services to meet the needs of people with mental health issues including severe mental illness; andevaluation and research to support ongoing development and improvement of the programs and services available.Table SEQ Table \* ARABIC 18: Output 1.3: Mentally Healthy Communities12018-192019-20Estimated OutcomeBudget$'000$'000Total Cost48,30955,107Controlled Recurrent Payments43,72645,868Note:This is a new output following the Administrative Arrangements Order, creating the ACT Health Directorate from the former Health Directorate (now Canberra Health Services) on 1 October 2018.Output 1.4: Continuous Improvement of the ACT Public Health SystemThe ACT Health Directorate provides strategic leadership and direction for the health system through development and administration of policies and legislation. This includes:collaborating with stakeholders to develop territory-wide plans for health services, workforce and major capital investment;driving service improvement and innovation through a collaborative policy cycle;providing responsive policy advice to government reflecting the changing nature of the health sector;support delivery of high quality health services by building and maintaining intergovernmental partnerships; andconducting research programs that translate research evidence into improved healthcare.Table SEQ Table \* ARABIC 19: Output 1.4: Continuous Improvement of the ACT Public Health System12018-192019-20Estimated OutcomeBudget$'000$'000Total Cost74,47084,948Controlled Recurrent Payments67,77671,095Note:This is a new output following the Administrative Arrangements Order, creating the ACT Health Directorate from the former Health Directorate (now Canberra Health Services) on 1 October 2018. Accountability IndicatorsOutput Class 1: ACT Health DirectorateOutput 1.1: Improved Hospital ServicesTable SEQ Table \* ARABIC 20: Accountability Indicators Output 1.12018–19Targets2018–19Estimated Outcome2019–20TargetsPercentage of all Emergency Department presentations treated within clinically appropriate timeframes1n/an/a70%Percentage of Category 1 elective surgery patients admitted for surgery within clinically recommended timeframes2,3n/an/a100%Percentage of Category 2 elective surgery patients admitted for surgery within clinically recommended timeframes2,4 n/an/a80%Percentage of Category 3 elective surgery patients admitted for surgery within clinically recommended timeframes2,5n/an/a93%Calvary service (out of scope)61,4341,228n/aProportion of people who undergo a surgical operation requiring an unplanned return to the operating theatre within a single episode of care due to complications of their primary condition7 Canberra Hospitaln/an/a<1.0%Calvary Public Hospitaln/an/a<0.5%Proportion of people separated from ACT public hospitals who are re-admitted to hospital within 28 days of their separation due to complications of their condition (where re-admission was unforeseen at the time of separation)8Canberra Hospitaln/an/a<2.0%Calvary Public Hospitaln/an/a<1.0%Notes:This is a new Accountability Indicator in 2019-20 and was previously reported in the Local Hospital Network as Strategic Objective number 2.1 in the 2018-19 Budget Statements.These are new Accountability Indicators in 2019-20, they were previously reported in the Local Hospital Network Strategic Objective number 1 in the 2018-19 Budget Statements. The 2018-19 Targets and estimated outcomes are reported on page 65.Admission within 30 days is desirable for Category 1 (urgent) elective surgery patients.Admission within 90 days is desirable for Category 2 (semi-urgent) elective surgery patients.Admission within 365 days is desirable for Category 3 (non-urgent) elective surgery patients. This indicator was formerly reported in the old Health Directorate in output 1.1.f and is being discontinued in 2019-20. This Accountability Indicator is measured in NWAU (National Weighted Activity Units).This is a new Accountability Indicator in 2019-20, formerly Local Hospital Network Strategic Objective number 3.1 in the 2018-19 Budget Statements. The 2018-19 Targets and estimated outcomes are reported on page 67.This is a new Accountability Indicator in 2019-20, formerly Local Hospital Network Strategic Objective number 3.2 in the 2018-19 Budget Statements. Hospital targets are based on similar rates for peer hospitals – based on the Australian Council of Healthcare Standards (ACHS). The 2018-19 Targets and estimated outcomes are reported on page 67.Output 1.2: Healthy CommunitiesTable SEQ Table \* ARABIC 21: Accountability Indicators Output 1.22018–19Targets2018–19Estimated Outcome2019–20TargetsSamples analysed1,211,50013,30012,500Total number of inspections and proactive site visits of food business12,5002,4362,500Immunisation coverage for the primary immunisation schedule measured at 1 year of age, in accordance with the Australian Immunisation Register95%95%95%Immunisation rates for vaccines in the national schedule for the ACT Aboriginal and Torres Strait Islander population:3 i. 12 to 15 monthsn/an/a≥95% ii. 24 to 27 monthsn/an/a≥95% iii. 60 to 63 monthsn/an/a≥95% iv. Alln/an/a≥95%Number of businesses signed up to provide and promote healthier food choices as part of the Healthier Choices Canberra initiative4n/an/a60Number of educators that complete health promotion professional learning courses and activities5n/an/a250Number of teachers who complete Food&Me training1,6300275n/aNumber of It’s Your Move schools recruited to the Program1,7,81222n/aNotes:These Accountability Indicators have transferred from the former Health Directorate 2018-19 Output 1.3 Population Health.The increase in the 2018-19 estimated outcome from the 2018-19 target is due to an increase in requests for analysis by ACT Policing in relation to controlled substance seizures and road traffic samples.These Accountability Indicators have moved from Strategic Objective 11 in the 2018-19 Budget Statements. The 2018-19 Targets and estimated outcomes are reported on page 7.Cumulative total of new and existing businesses who have participated in Healthier Choices Canberra since its commencement.Total number of educators from early childhood to college (including student educators) who complete either face-to-face or online versions of Health Promotion professional learning/activities relating to the Fresh Tastes, Kids at Play Active Play, Ride or Walk to School and/or It’s Your Move programs.This Accountability Indicator will be discontinued and replaced from 2019-20 with indicator 1.2.f.This Accountability Indicator will be discontinued and replaced from 2019-20 with indicator 1.2.e.The increase in the 2018-19 estimated outcome from the 2018-19 target is due to the continued and increasing popularity of the program. This has resulted in a significant increase in the number of schools participating.Output 1.3: Mentally Healthy CommunitiesTable SEQ Table \* ARABIC 22: Accountability Indicators Output 1.32018–19Targets2018–19Estimated Outcome2019–20TargetsPercentage of mental health clients with outcome measures completed1n/an/a65%Annual progress report on the implementation of the Office for Mental Health and Wellbeing Workplan 2019-2021 published2n/an/a1Notes:This Accountability Indicator was previously reported in the 2018-19 Budget Statements under the ACT Local Hospital Network 1.1.g. The 2018-19 Target and estimated outcome is reported on page 69.This is a new Accountability Indicator in 2019-20.Output 1.4: Continuous Improvement of the ACT Public Health SystemTable SEQ Table \* ARABIC 23: Accountability Indicators Output 1.42018–19Targets2018–19Estimated Outcome2019–20TargetsBiannual Report of progress in implementing the recommendations arising from the Independent Review into the Workplace Culture of ACT Public Health Services tabled in the Legislative Assembly1n/an/a2ACT Public Health Services Quarterly Performance Report1n/an/a4Note:These are new Accountability Indicators in 2019-20.Changes to AppropriationTable SEQ Table \* ARABIC 24: Changes to appropriation – Controlled Recurrent Payments2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'0002018-19 Budget-----FMA Section 16B Rollovers from 2017-18Breastscreen 70-74 Year Extension NPA70----Delivering the SPIRE Centre at Canberra Hospital939----Elective Surgery616----Encouraging More Clinical Trials NPA50----Essential Vaccines Program NPA2,088----Health Manager Upgrade123----Health Protection Service Capital Procurement Program250----Healthy Canberra Grants635----Northside Hospital Scoping Study604----PP&E Contractual Commitments4,950----Safer Families298----University of Canberra Operational Readiness1,434----Workforce Strategy944----2018-19 Budget Review Commencing operations of the Drug and Alcohol Court-7901,361--Flu vaccinations for children513524538551565Independent Review into the workplace culture within ACT Public Health Services2,565----Supporting government transparency96195---2019-20 Budget Policy DecisionsACT Health Core IT Systems to align with the Digital Health Strategy-2,8604,6257,97510,825Delivering better mental health care for people in crisis-147---Co-design and planning: Aboriginal and Torres Strait Islander Alcohol and Drug Residential Rehabilitation Facility-300---Implementing the Independent Review into the Workplace Culture within ACT Public Health Services-1,5004,0004,0004,000-Delivering better care for Canberrans with complex needs through general practice-5001,0001,000-Delivering the ACT Drug Strategy Action Plan-500308315323Delivering the ACT Strategic Priorities for Aboriginal and Torres Strait Islander Health 2019-2028-180310310315Delivering the SPIRE Centre at Canberra Hospital--200400500Expanding Clare Holland House to strengthen palliative care---60120Expanding public healthcare services for eating disorders-179442683913Table 24: Changes to appropriation – Controlled Recurrent Payments (continued)2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'000Implementing real time prescription monitoring---30-30-30Implementing the Nurses and Midwives: Towards a Safer Culture - The First Step strategy-560588144-Implementing the recommendations of the Royal Commission into Institutional Responses to Child Sexual Abuse-321377285289Investing in medical and health research-1,0001,0001,000-Microsoft User Licensing Expansion-1,8941,9421,9902,040Protecting teens with meningococcal ACWY vaccinations-170174179182Strengthening capacity for mental health carers-226231--Supporting better healthcare for lesbian, gay, bisexual, transgender, intersex and queer Canberrans-87---Training ACT Government frontline workers to respond to family violence-69--Transfer - New Initiative ICT expenses-5726797177382019-20 Budget Technical AdjustmentsEfficiency Target-513-524-538-551-565Revised Superannuation Parameters-1,1211,1211,1211,121Rollover - ACT Pathology Laboratory Information System Replacement-1,0171,017---Rollover - Digital Solutions Capital ICT Program-1,0661,066---Rollover - Early Planning to expand Alcohol and Drug Services-154154---Rollover - Essential Vaccines-1,0001,000---Rollover - Healthy Canberra Grants-423212211--Rollover - Safer Families: Support and referral through specialist drug and alcohol treatment services-598598---Saving - Comcare Premium--3,664-3,664-3,664-3,664Transfer - Healthy and Active Living from Chief Minister, Treasury and Economic Development Directorate-920238244251Transfer - National Disability Insurance Scheme to Community Services Directorate--18,272-18,728-19,197-19,677Transfer - Separation of Canberra Health Services and ACT Health Directorate208,728240,840249,453250,591255,721Transfer - Shared Services to Chief Minister, Treasury and Economic Development Directorate--10,138-10,391-10,652-10,9182019-20 Budget218,632229,341235,456237,471239,049Table SEQ Table \* ARABIC 25: Changes to appropriation – Expenses on Behalf of the Territory2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'000FMA Section 16B Rollovers from 2017-18Calvary Public Hospital – Operating theatre upgrade386----Calvary Public Hospital – Upgrade of medical imaging equipment146----2019-20 Budget Review Replacement of aluminium composite panels at Calvary Public Hospital1,159350---2019-20 Budget Policy DecisionsCentenary Hospital for Women and Children-3,000---More surgical theatres at Calvary Public Hospital-64014--More urology services at Calvary Public Hospital-2,500---2019-20 Budget Technical AdjustmentsTransfer - Better Infrastructure Fund to ACT Health Directorate553887909932957Transfer - Upgrade and Maintain ACT Health Assets Stage 25902,370---Transfer - Winnunga Nimmityjah Aboriginal Health Service1,1652,4357,700--2019-20 Budget3,99912,1828,623932957Table SEQ Table \* ARABIC 26: Changes to appropriation – Capital Injections, Controlled2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'000FMA Section 16B Rollovers from 2017-18An E-Healthy Future933----Improved the Drugs and Poisons Information System (DAPIS)185----2018-19 Budget ReviewCentenary Hospital for Women and Children4,000----2019-20 Budget Policy DecisionsACT Health Core IT Systems to align with the Digital Health Strategy-3,92024,57425,50416,380Expanding the Centenary Hospital for Women and Children--30,00010,550-Expanding Clare Holland House to strengthen palliative care--2,0002,000-Delivering the SPIRE Centre at Canberra Hospital-53,700---Implementing real time prescription monitoring-7881,326--2019-20 Budget Technical AdjustmentsEnterprise Bargaining Agreement (EBA) pay increase721----Revised Funding Profile:- ACT Health ICT Upgrades-2,4142,414---- An E-Healthy Future2,139-2,139---- Delivering the SPIRE Centre at Canberra Hospital-6,5006,500---- Expanding the Centenary Hospital for Women and Children-5,5005,500---Transfer - Separation of Canberra Health Services and Health Directorate29,43112,685887--2019-20 Budget22,99583,36858,78738,05416,380Summary of 2019-20 Infrastructure ProgramTable SEQ Table \* ARABIC 27: 2019-20 ACT Health Directorate Infrastructure ProgramProject2019-20$'0002020-21$'0002021-22$'0002022-23$'000Four YearInvestment$'000PhysicalCompletionDateWork In ProgressACT Health ICT upgrades5,305---5,305Jun-20ACT Pathology Laboratory information system replacement5,829887--6,716Jun-21An E-Healthy Future1,071---1,071Jun-20Delivering the SPIRE Centre at Canberra Hospital6,500---6,500Jun-24Expanding the Centenary Hospital for Women and Children5,500---5,500Jun-22Protecting Canberrans from infectious diseases398---398Jun-21Total Work In Progress24,603887--25,490Capital Upgrade ProgramsBetter Infrastructure Fund - Health357---357Sep-20Better Infrastructure Fund – Calvary Public Hospital8879099329573,685Sep-20Total Capital Upgrade Programs1,2449099329574,042New WorksACT Health Core IT Systems to align with the Digital Health Strategy13,92024,57425,50416,38070,378Jun-27Delivering the SPIRE Centre at Canberra Hospital53,700---53,700Jun-24Expanding Clare Holland House to strengthen palliative care2,0002,0002,000-6,000Dec-20Expanding the Centenary Hospital for Women and Children-30,00010,550-40,550Jun-22Implementing real time prescription monitoring7881,326--2,114Jun-22Total New Capital60,40857,90038,05416,380172,742Capital GrantsACT Health critical assets upgrades2,370---2,370Jun-20Expanding the Centenary Hospital for Women and Children 3,000---3,000Jun-22More surgical theatres at Calvary Public Hospital64014--654Sep-20More urology services at Calvary Public Hospital2,500---2,500Jun-20New facility for Winnunga Nimmityjah Aboriginal Health Service2,4357,700--10,135Jun-21Replacement of aluminium composite panels at Calvary Public Hospital350---350Oct-19Total Capital Grants11,2957,714--19,009Total Infrastructure Program97,55067,41038,98617,337221,283Note:This program is funded over 8 years at a total of $106.384 million.Financial StatementsTable SEQ Table \* ARABIC 28: ACT Health Directorate: Operating Statement 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var%2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000IncomeRevenue-Controlled Recurrent Payments218,632229,3415 235,456237,471239,049-User Charges5,5979,00161 9,4329,88710,134-Resources Received Free of Charge-10,176# 10,43010,69110,958-Other Revenue4,4505,36421 3,9604,0594,161-Total Revenue228,679253,88211 259,278262,108264,302Gains-Total Gains--- ----Total Income228,679253,88211 259,278262,108264,302Expenses -Employee Expenses58,11774,71929 72,88974,10474,095-Superannuation Expenses6,70312,42085 14,70314,84014,912-Supplies and Services75,13697,37730 104,330104,465106,994-Depreciation and Amortisation15,71424,50356 25,78731,12536,346-Grants and Purchased Services83,89763,975-24 64,55565,90265,501-Interest Expenses-2# 222-Other Expenses1,4501,93433 1,9822,0312,082-Total Expenses241,017274,93014 284,248292,469299,932-Operating Result-12,338-21,048-71-24,970-30,361-35,630-Total Comprehensive Income-12,338-21,048-71 -24,970-30,361-35,630Table SEQ Table \* ARABIC 29: ACT Health Directorate: Balance Sheet Budgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Current Assets-Cash and Cash Equivalents4,4293,736-16 3,5383,3323,122-Receivables3,1913,2702 3,3523,4363,522-Other Assets9199544 9891,0241,059-Total Current Assets8,5397,960-7 7,8797,7927,703Non Current Assets-Property, Plant and Equipment83,89080,086-5 77,92982,27277,495-Intangible Assets117,082140,61420 156,548158,311145,849-Capital Works in Progress37,82082,750119 104,70061,20061,200-Other Assets9,2419,241- 9,2419,2419,241-Total Non Current Assets248,033312,69126 348,418311,024293,785-TOTAL ASSETS256,572320,65125 356,297318,816301,488Current Liabilities-Payables4,6914,8093 4,9285,0515,179-Finance Leases-55# 110165220-Employee Benefits20,82522,89010 25,03327,23329,489-Total Current Liabilities25,51627,7549 30,07132,44934,888Non Current Liabilities-Finance Leases-19# 385776-Employee Benefits1,2461,2762 1,3071,3391,372-Other Provisions102102- 102102102-Other Liabilities13,92513,397-4 12,85912,30611,737-Total Non Current Liabilities15,27314,794-3 14,30613,80413,287-TOTAL LIABILITIES40,78942,5484 44,37746,25348,175-NET ASSETS215,783278,10329 311,920272,563253,313-Accumulated Funds215,783278,10329 311,920272,563253,313-TOTAL FUNDS EMPLOYED215,783278,10329311,920272,563253,313Table SEQ Table \* ARABIC 30: ACT Health Directorate: Statement of Changes in Equity Budgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Opening Equity-Opening Accumulated Funds-215,783# 278,103264,870272,563-Balance at the Start of the Reporting Period-215,783# 278,103264,870272,563Comprehensive Income-Operating Result - Including Economic Flows-12,338-21,048-71 -24,970-30,361-35,630-Total Comprehensive Income-12,338-21,048-71 -24,970-30,361-35,630-Total Movement in Reserves--- ---Transactions Involving Owners Affecting Accumulated Funds-Capital Injections22,99583,368263 58,78738,05416,380-Inc/Dec in Net Assets due to Admin Restructure205,126--100 ----Total Transactions Involving Owners Affecting Accumulated Funds228,12183,368-63 58,78738,05416,380Closing Equity-Closing Accumulated Funds215,783278,10329 311,920272,563253,313-Balance at the end of the Reporting Period215,783278,10329311,920272,563253,313Table SEQ Table \* ARABIC 31: ACT Health Directorate: Cash Flow Statement 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var %2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000CASH FLOWS FROM OPERATING ACTIVITIESReceipts-Controlled Recurrent Payments218,632229,3415 235,456237,471239,049-User Charges5,5979,00161 9,4329,88710,134-Other4,4505,36721 3,9644,0624,165-Operating Receipts228,679243,7097 248,852251,420253,348Payments-Employee57,06973,05428 71,25572,42472,372-Superannuation6,70312,42085 14,70314,84014,912-Supplies and Services75,13687,29816 93,90093,77496,036-Grants and Purchased Services83,89763,975-24 64,55565,90265,501-Interest Expenses-2# 222-Other1,4501,93433 1,9822,0312,082-Operating Payments224,255238,6836 246,397248,973250,905-NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES4,4245,02614 2,4552,4472,443CASH FLOWS FROM INVESTING ACTIVITIESReceipts-Proceeds from Sale/Maturity of Investments143--100 ----Investing Receipts143--100 ---Payments-Purchase of Property, Plant and Equipment24,55289,032263 61,38540,65218,978-Investing Payments24,55289,032263 61,38540,65218,978-NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES-24,409-89,032-265 -61,385-40,652-18,978Table 31: ACT Health Directorate: Cash Flow Statement (continued)2018-19 Estimated Outcome $'0002019-20 Budget $'000Var %2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000CASH FLOWS FROM FINANCING ACTIVITIESReceiptsCapital Injections22,99583,368263 58,78738,05416,380Receipts of Transferred Cash Balances1,419--100 ---Financing Receipts24,41483,368241 58,78738,05416,380PaymentsRepayment of Finance Lease Liabilities-55# 555555Financing Payments-55# 555555NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES24,41483,313241 58,73237,99916,325NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS4,429-693-116 -198-206-210CASH AT THE BEGINNING OF REPORTING PERIOD-4,429# 3,7363,5383,332CASH AT THE END OF REPORTING PERIOD4,4293,736-16 3,5383,3323,122Notes to the Controlled Budget StatementsOn 1 October 2018 the former Health Directorate was separated into two Directorates, the ACT Health Directorate and Canberra Health Services. For the purposes of these statements, the 2018-19 estimated outcome reflects nine months of operation of the new ACT Health Directorate. Therefore, in most instances, the variances between the 2018-19 estimated outcome and the 2019-20 Budget relate to the part year operation in 2018-19 and the full year 2019-20 Budget.Significant variations that do not relate to the separation of the former Health Directorate are as follows:Operating Statementuser charges: the increase of $3.404 million in the 2019-20 Budget from the 2018-19 estimated outcome is mainly due to third party funding attached to the Clare Holland House expansion. resources received free of charge: the increase of $10.176 million in the 2019-20 Budget from the 2018-19 estimated outcome is due to the recognition of services provided free of charge by Shared Services for the provision of human resources, finance and procurement services.superannuation expenses: the increase of $5.717 million in the 2019-20 Budget from the 2018-19 estimated outcome is due to wage rises, an increase in the superannuation contribution rates and new initiatives.depreciation and amortisation: the increase of $8.789 million in the 2019-20 Budget from the 2018-19 estimated outcome is due to the centralisation of information technology and communication functions within the ACT Health Directorate and the ‘ACT Health ICT Upgrades program’.grants and purchased services: the decrease of $19.922 million in the 2019-20 Budget from the 2018-19 estimated outcome is mainly due to the transfer of National Disability Insurance Scheme payments to the Community Services Directorate and the removal of one-off payments to Canberra Health Services in 2018-19.Balance Sheetproperty, plant and equipment: the decrease of $3.804?million in the 2019-20 Budget from the 2018-19 estimated outcome mainly relates to the depreciation of assets.intangible assets: the increase of $23.532 million in the 2019-20 Budget from the 201819 estimated outcome is mainly due to the completion of information technology projects including ‘An E-Healthy Future’, ‘ACT Health ICT Upgrades’ and ‘ACT Core IT Systems’.capital works in progress: the increase of $44.930?million in the 2019-20 Budget from the 2018-19 estimated outcome is mainly due to the ‘SPIRE Centre at Canberra Hospital’.current employee benefits: the increase of $2.065 million?in the 201920 Budget from the 2018-19 estimated outcome is mainly due to wage rises and new initiatives.Statement of Changes in Equity capital injections: the increase of $60.373 million in the 2019-20 Budget from the 201819 estimated outcome is mainly due a larger capital works program including the ‘SPIRE Centre at Canberra Hospital’, ‘Expansion of the Centenary Hospital for Women and Children’ and ‘ACT Health Core IT Systems’.Cash Flow StatementVariations in the Statement are explained in the notes above.Financial Statements - TerritorialTable SEQ Table \* ARABIC 32: ACT Health Directorate: Statement of Income and Expenses on behalf of the Territory 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var%2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000Revenue-Payment for Expenses on Behalf of the Territory3,99912,182205 8,623932957-Taxes, Fees and Fines1,0211,47444 1,5321,5781,617-Total Revenue5,02013,656172 10,1552,5102,574-Total Income5,02013,656172 10,1552,5102,574Expenses -Grants and Purchased Services3,86612,182215 8,623932957-Transfer Expenses1,0211,47444 1,5321,5781,617-Total Expenses4,88713,656179 10,1552,5102,574-Operating Result133--100----Total Comprehensive Income133--100 ---Table SEQ Table \* ARABIC 33: ACT Health Directorate: Statement of Assets and Liabilities on behalf of the TerritoryBudgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Current Assets-Cash and Cash Equivalents1,0891,089- 1,0891,0891,089-Receivables1,5781,578- 1,5781,5781,578-Total Current Assets2,6672,667- 2,6672,6672,667Non Current Assets-Total Non Current Assets--- ----TOTAL ASSETS2,6672,667- 2,6672,6672,667Current Liabilities-Payables300300- 300300300-Total Current Liabilities300300- 300300300Non Current Liabilities-Total Non Current Liabilities--- ----TOTAL LIABILITIES300300- 300300300-NET ASSETS2,3672,367- 2,3672,3672,367REPRESENTED BY FUNDS EMPLOYED-Accumulated Funds2,3672,367- 2,3672,3672,367-TOTAL FUNDS EMPLOYED2,3672,367 - 2,3672,3672,367Table SEQ Table \* ARABIC 34: ACT Health Directorate: Statement of Changes in Equity on behalf of the TerritoryBudgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Opening Equity-Opening Accumulated Funds-2 367# 2 3672 3672 367-Balance at the Start of the Reporting Period-2 367# 2 3672 3672 367-Operating Result - Including Economic Flows133--100 ----Total Movement in Reserves--- ---Closing Equity-Closing Accumulated Funds2 3672 367- 2 3672 3672 367-Balance at the end of the Reporting Period2 3672 367 - 2 3672 3672 367Table SEQ Table \* ARABIC 35: ACT Health Directorate: Cash Flow Statement on behalf of the Territory2018-192018-192019-20Var2020-212021-222022-23BudgetEstimated OutcomeBudget%EstimateEstimateEstimate$'000$'000$'000$'000$'000$'000CASH FLOWS FROM OPERATING ACTIVITIESReceipts-Payment for Expenses on Behalf of the Territory3,99912,182205 8,623932957-Taxes, Fees and Fines1,0211,47444 1,5321,5781,617-Other4011,218204 8629395-Operating Receipts5,42114,874174 11,0172,6032,669Payments-Grants and Purchased Services3,86612,182215 8,623932957-Transfer of Territory Receipts to the ACT Government1,0211,47444 1,5321,5781,617-Other4011,218204 8629395-Operating Payments5,28814,874181 11,0172,6032,669-NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS1,089--100 ----CASH AT THE BEGINNING OF REPORTING PERIOD-1,089# 1,0891,0891,089-CASH AT THE END OF REPORTING PERIOD1,0891,089- 1,0891,0891,089Notes to the Territorial Budget StatementsOn 1 October 2018, the former Health Directorate was separated into two Directorates, the ACT Health Directorate and Canberra Health Services. The Territorial Financial Statement figures shown here represent 9 months activity in 201819 only. The 2018-19 original budget is shown against the Canberra Health Services Territorial Financial Statements.Significant variations are as follows:Statement of Income and Expenses on behalf of the Territorypayment for expenses on behalf of the territory and grants and purchased services: the increase of $8.183 million in the 2019-20 Budget from the 201819 estimated outcome is due to a larger capital grants program including expansion of Calvary Public Hospital Urology, Winnunga Nimmityjah Aboriginal Health Service and the Centenary Hospital for Women and Children.taxes, fees and fines and transfer expenses: the increase of $0.453 million in the 2019-20 Budget from the 2018-19 estimated outcome is due to a full twelve months of operating in 2019-20 and indexation.Cash Flow StatementVariations in the Statement are explained in the notes above.CANBERRA HEALTH SERVICESPurposeCanberra Health Services partners with the community and consumers for better health outcomes by: delivering timely, patient and family centred care;strengthening partnerships;promoting good health and well-being; improving access to appropriate healthcare; and having robust safety and quality systems. We aim for sustainability and improved efficiency in the use of resources by designing sustainable services to deliver outcomes efficiently and embedding a culture of research and innovation. Canberra Health Services continues to strengthen clinical governance of its processes and strives to be accountable to both the government and the community. Canberra Health Services aims to support our people and strengthen teams by helping staff to reach their potential, promoting a learning culture and providing high-level leadership.2019-20 PrioritiesIn line with the ACT Government announcement in March 2018, the former Health Directorate separated into two distinct organisations as of 1 October 2018, with Canberra Health Services now responsible for the delivery of clinical services and the ACT Health Directorate responsible for strategic policy and planning. Both Canberra Health Services and the ACT Health Directorate will continue with reform activities to achieve the commitment of the health of our growing community, a commitment to quality, innovation, engagement, accountability and a focus on strategic policy and planning stewardship of the health system. In 2019-20, there will be a continued focus on core services within the ACT health system enhancing the efficiency in Emergency Surgery, Emergency Department services and Elective Surgery to meet the growing demand for critical care services.Both Canberra Health Services and the ACT Health Directorate will continue to work to improve efficiencies across the system and focus on providing care in the right place at the right time through initiatives such as Hospital in the Home, which will be expanded in 201920.Canberra Health Services will continue to focus on improving the efficiency and effectiveness of ACT mental health services, in particular relating to accommodation to support people with mental health issues to recover and live in our community.Estimated Employment LevelTable SEQ Table \r 1 \* ARABIC 1: Estimated Employment Level2017-18ActualOutcome2018-19Budget12018-19Estimated Outcome2019-20BudgetStaffing (FTE)6,6606,1396,3906,529Note: The 2018-19 Budget has been notionally adjusted for comparative purposes to reflect the Administrative Arrangements Order to establish the ACT Health Directorate on 1 October 2018. Strategic Objectives and Indicators Strategic Objective 1Reducing the Waiting List for Elective SurgeryReducing the number of people waiting longer than clinically recommended timeframes for elective surgery.Table SEQ Table \* ARABIC 2: The number of patients waiting longer than clinically recommended timeframes for elective surgery1Strategic Indicator2018-192018-192019-20TargetEst.?OutcomeTargetThe number of patients waiting longer than clinically recommended timeframes for elective surgery430571n/aNote:This Strategic Objective has been discontinued as a 2019-20 Canberra Health Service indicator. The 2019-20 target for the whole Territory, including Calvary Public Hospital, will be reported in 2019-20 in the ACT Health Directorate, Strategic Objective 1 as shown on page 3. The 2018-19 target and estimated outcome as reported also include Calvary Public Hospital patients.Strategic Objective 2Reducing the Usage of Seclusion in Mental Health EpisodesThis measures the effectiveness of public mental health services in the ACT over time in providing services that minimise the need for seclusion.Table SEQ Table \* ARABIC 3: Strategic Indicator 2.1: The proportion of mental health clients who are subject to a seclusion episode while being an admitted patient in an ACT public mental health inpatient unitStrategic Indicator2018–192018–192019–20TargetEst.?Outcome1Target2The proportion of mental health clients who are subject to a seclusion episode while being an admitted patient in an ACT public mental health inpatient unit<5%16%n/aNotes:The estimated outcome for this measure in 2018-19 is exceeding the target of less than 5 per cent due to sustained periods of high demand with an increase in volatile patients requiring seclusion. Due to the opening of Dhulwa, which is specifically used to treat complex patients, increases in seclusion can be expected.This Strategic Objective is being discontinued in 2019-20 and replaced with the ‘rate’ of seclusion events per 1,000 bed days, which is the national standard and counting methodology for this indicator (refer 2.2 below).Table SEQ Table \* ARABIC 4: Strategic Indicator 2.2: The rate of mental health clients who are subject to a seclusion event while being an admitted patient in an ACT public mental health inpatient unit per 1,000 bed daysStrategic Indicator2018–192018–192019–20TargetEst.?OutcomeTarget1The rate of mental health clients who are subject to a seclusion event while being an admitted patient in an ACT public mental health inpatient unit per 1,000 bed daysn/an/a<7 per 1,000 bed daysNote:For 2019-20, Canberra Health Services have adopted the national standard and counting methodology for this indicator which is reported as a rate per 1,000 bed days.Strategic Objective 3Maintaining Reduced Rates of Patient Return to an ACT Public Acute Psychiatric Inpatient Unit This indicator reflects the quality of care provided to acute mental health patients. Table SEQ Table \* ARABIC 5: The proportion of clients who return to hospital within 28 days of discharge from an ACT public acute psychiatric unit following an acute episode of careStrategic Indicator2018–192018–192019–20TargetEst.?Outcome1Target2Proportion of clients who return to hospital within 28?days of discharge from an ACT acute psychiatric mental health inpatient unit<10%n/a<17%Notes:Due to considerations of recommendations made under the ACT Auditor General’s Report: Mental Health Services – Transition from Acute Care 2016, the estimated outcome was not available at the time of publishing. However, a methodology will be adopted for reporting in 2019-20.The methodology for this measure in 2019-20 has changed to reflect the national counting methodology which now incorporates all Mental Health inpatient readmissions as opposed to the previous measure of unplanned readmissions only and therefore the target for 2019-20 has been adjusted to reflect this. The Strategic Objective measures Canberra Health Services performance only.Strategic Objective 4Maximising the Quality of Hospital ServicesThis indicator highlights the effectiveness and quality of care provided to patients within Canberra Health Services from a patient’s perspective.Table SEQ Table \* ARABIC 6: Overall how would you rate the care you received in hospital1Strategic Indicator2018–192018–192019–20TargetEst.?OutcomeTargetPatient Experience Survey – score of positive patient experience responsesn/an/a>80Note:This is a new Strategic Objective in 2019-20.Strategic Objective 5The number of people admitted to hospitals per 10,000 occupied bed days who acquire a Staphylococcus Aureus Bacteraemia infection (SAB infection) during their stay. This provides an indication of the safety of hospital based services.Table SEQ Table \* ARABIC 7: The number of people admitted to hospitals per 10,000 occupied bed days who acquire a Staphylococcus Aureus Bacteraemia infection (SAB infection) during their stay1,2Strategic Indicator2018–192018–192019–20Target3Est.?Outcome3TargetNumber of admitted patients who acquire a SAB infection per 10,000 bed daysn/an/a<2.0 per 10,000Notes:Hospital targets are based on similar rates for peer hospitals – based on the Australian Council of Healthcare Standards (ACHS).This is a new Strategic Objective for Canberra Health Services and was previously reported in the Local Hospital Network in 201819, Strategic Objective 3.3 as a Territory wide measure. The 2019-20 target is for Canberra Health Services performance only.The 2018-19 Target and estimated outcome is reported on page 67.Strategic Objective 6The estimated hand hygiene rate for a hospital is a measure of how often (as a percentage) hand hygiene is correctly performed.It is calculated by dividing the number of observed hand hygiene 'moments' where proper hand hygiene was practiced in a specified audit period, by the total number of observed hand hygiene 'moments' in the same audit period.Table SEQ Table \* ARABIC 8: Estimated Hand Hygiene Rate1,2Strategic Indicator2018–192018–192019–20Target3Est.?Outcome3TargetCanberra Hospitaln/an/a80%Notes:Hospital targets are based on similar rates for peer hospitals – based on the Australian Council of Healthcare Standards (ACHS).This is a new Strategic Objective for Canberra Health Services and was previously reported in the Local Hospital Network in 2018-19, Strategic Objective 3.4. The 2019-20 target is for Canberra Health Services performance only.The 2018-19 Target and estimated outcome is reported on page 67.Strategic Objective 7 Reaching the Optimum Occupancy Rate for all Overnight Hospital BedsThis provides an indication of the efficient use of resources available for hospital services.Table SEQ Table \* ARABIC 9: The mean percentage of overnight hospital beds in useStrategic Indicator2018–192018–192019–20TargetEst.?OutcomeTargetMean percentage of overnight hospital beds in use90%86%90%Strategic Objective 8No Waiting for Access to Emergency Dental Health ServicesTable SEQ Table \* ARABIC 10: The percentage of assessed emergency clients seen within 24 hours1Strategic Indicator2018-192018-192019-20TargetEst.?OutcomeTargetPercentage of assessed emergency clients seen within 24 hours100%100%n/aNote:This Strategic Objective is being discontinued in 2019-20.Strategic Objective 9Improving Timeliness of Access to Radiotherapy ServicesTable SEQ Table \* ARABIC 11: The percentage of cancer patients who commence radiotherapy treatment within standard timeframes1Strategic Indicator2018–192018–192019–20TargetEst.?Outcome2TargetCategory:Emergency — treatment starts within 48?hours100%100%n/aPalliative — treatment starts within 2 weeks90%70%n/aRadical — treatment starts within 4 weeks90%50%n/aNotes:In 2019-20 this Strategic Objective is being discontinued and will be reported as Accountability Indicators at 1.3.f to h. The 2019-20 Targets are reported on page 45.The performance in radiotherapy wait times is impacted by the increasingly complex treatment techniques and related treatment delivery times. This consequently decreases access to radiotherapy services. An increase in palliative cases and long course treatments requiring additional fractions has had an impact on the waiting times for radical patients. The Directorate is currently replacing a linear accelerator as one machine has been unavailable for the past 6 months. There have been more cases seen in clinics this year compared with last year which also impacting the ability to meet demand for this service.Strategic Objective 10 Improving the Breast Screen Participation Rate for Women aged 50 to 74 yearsTable SEQ Table \* ARABIC 12: The proportion of women in the target age group (50?to?74?years) who had a breast screen in the 24?months prior to each counting period1Strategic Indicator2018–192018–192019–20TargetEst.?OutcomeTargetProportion of women aged 50 to 74 who had a breast screen60%56%n/aNote:In 2019-20 this Strategic Objective is being discontinued and will be reported as an Accountability Indicator at 1.3.a. The 2019-20 Target is reported on page 45.Output ClassesCanberra Health Services aims to deliver the best possible healthcare and health related services in Australia. It will do this through its public hospitals and related health services through: Acute Services; Mental Health, Justice Health and Alcohol and Drug Services; Women, Youth and Children; Cancer Services; and Rehabilitation, Aged and Community Care.Output Class 1: Health and Community CareTable SEQ Table \* ARABIC 13: Output Class 1: Health and Community Care2018-192019-20Estimated OutcomeBudget$'000$'000Total Cost1,21,263,1061,224,706Controlled Recurrent Payments3101,926-Notes:Total cost includes depreciation and amortisation of $36.511?million in 2018-19 and $32.375?million in 2019-20.The decrease in Total Cost for 2019-20 Budget from the 2018-19 estimated outcome is due mainly to the Administrative Arrangements Order, reflecting that the 2018-19 estimated outcome includes three months operation of the former Health Directorate.Canberra Health Services receives funding through the Local Hospital Network and not from Controlled Recurrent Payments.Output 1.1: Acute ServicesCanberra Health Services provides a comprehensive range of acute care, including:tertiary inpatient, outpatient and ambulatory services to the ACT and surrounding NSW;emergency department, intensive care unit and retrieval services;a range of medical speciality services including cardiology, respiratory, gastroenterology, neurology, endocrinology, rheumatology and renal services;elective and emergency surgery services in general surgery; andservices for women, youth and children in obstetrics, gynaecology, gynaecology surgery, paediatrics and paediatric surgery.The key strategic priority for acute services is to deliver timely access to effective and safe hospital care services while responding to the growing demand of services.This means focusing on:strategies to improve access to services, including for the emergency department and elective surgery; and continuing to increase the efficiency of acute care services.Table SEQ Table \* ARABIC 14: Output 1.1: Acute Services2018-192019-20Estimated OutcomeBudget$'000$'000Total Cost788,464801,193Controlled Recurrent Payments138,216-Note:Canberra Health Services receives funding through the Local Hospital Network and not from Controlled Recurrent Payments.Output 1.2: Mental Health, Justice Health and Alcohol and Drug ServicesCanberra Health Services provides a range of Mental?Health, Justice?Health and Alcohol and Drug Services through the public and community sectors in hospitals, community health centres and other community settings, adult and youth correctional facilities and people’s homes across the Territory. These services work to provide integrated and responsive care to a range of services including hospital-based specialist services, therapeutic rehabilitation, counselling, supported accommodation services and other community-based services.The key priorities for Mental?Health, Justice?Health and Alcohol and Drug Services are ensuring that people’s health needs are met in a timely fashion and that care is integrated across hospital, community and residential support services.This means focusing on:ensuring timely access to emergency mental health care;ensuring that public and community mental health services in the ACT provide people with appropriate assessment, treatment and care that result in improved mental health outcomes;providing community and hospital-based alcohol and drug services;providing health assessments and care for people detained in corrective facilities; andengagement and liaison with community sector services, primary care and other government agencies providing support and shared care arrangements.Table SEQ Table \* ARABIC 15: Output 1.2: Mental Health, Justice Health and Alcohol and Drug Services2018-192019-20Estimated OutcomeBudget$'000$'000Total Cost1194,108165,685Controlled Recurrent Payments220,763-Notes:The decrease in Total Cost for 2019-20 Budget from the 2018-19 estimated outcome is due mainly to the Administrative Arrangements Order, reflecting that the 2018-19 estimated outcome includes three months operation of the former Health Directorate.Canberra Health Services receives funding through the Local Hospital Network and not from Controlled Recurrent Payments.Output 1.3: Cancer ServicesCanberra Health Services provides a comprehensive range of screening, assessment, diagnostic, treatment and palliative care services. Services are provided in inpatient, outpatient and community settings.The key priorities for cancer care services are early detection and timely access to diagnostic and treatment services. These include ensuring that population screening rates for breast cancer meet targets, waiting time for access to essential services such as radiotherapy are consistent with agreed benchmarks and there is timely access to chemotherapy and haematological treatments.Table SEQ Table \* ARABIC 16: Output 1.3: Cancer Services12018-192019-20Estimated OutcomeBudget$'000$'000Total Cost285,39477,970Controlled Recurrent Payments33,570-Notes:This Output Class was previously Output 1.4 in the 2018-19 Budget Statements. Due to the Administrative Arrangements Order, this output has been renumbered.The decrease in Total Cost for 2019-20 Budget from the 2018-19 estimated outcome is due mainly to the Administrative Arrangements Order, reflecting that the 2018-19 estimated outcome includes three months operation of the former Health Directorate. Canberra Health Services receives funding through the Local Hospital Network and not from Controlled Recurrent Payments.Output 1.4: Subacute and Community ServicesThe provision of timely and effective, coordinated and comprehensive services?which optimise the functionality and quality of life of adult patients. Following illness, injury or surgery, subacute services enable individuals to safely transition to community living. Community based services sees care delivered safely and closely to where people live.The key priorities for Subacute and Community Services are:ensuring consistent and timely access to appropriate care and services, based on clinical need. This includes the efficient and appropriate transfer of people from acute to subacute settings, and ensuring community-based services are in place to support healthcare needs;ensuring effective planning for discharge and care planning occurs, including comprehensive aged care assessment where necessary, in order to provide appropriate support for independent living and minimise unplanned readmissions to hospital;for services that receive Commonwealth aged Care funding, complying with the Commonwealth’s quality and safety requirements; andreduced waiting times for access to emergency Dental Health Services.Table SEQ Table \* ARABIC 17: Output 1.4: Subacute and Community Services12018-192019-20Estimated OutcomeBudget$'000$'000Total Cost2181,711179,858Controlled Recurrent Payments326,268-Notes:This Output Class was previously Output Class 1.5 Rehabilitation, Aged and Community Care in the 2018-19 Budget Statements. Due to the organisational Administrative Arrangements Order, this output class has been renamed and renumbered. The decrease in Total Cost for 2019-20 Budget from the 2018-19 estimated outcome is due mainly to the Administrative Arrangements Order, reflecting that the 2018-19 estimated outcome includes three months operation of the former Health Directorate.Canberra Health Services receives funding through the Local Hospital Network and not from Controlled Recurrent Payments.Transferred OutputsPopulation Health (formerly Output 1.3)This output has been transferred to the ACT Health Directorate following the Administrative Arrangements Order on 1 October 2018. The related Accountability Indicators have been transferred to the ACT Health Directorate (refer to Output 1.2: Healthy Communities).Table SEQ Table \* ARABIC 18: Population Health (formerly Output 1.3)2018-192019-20Estimated OutcomeBudget$'000$'000Total Cost13,429-Controlled Recurrent Payments13,109-Accountability IndicatorsOutput Class 1: Health and Community CareOutput 1.1: Acute ServicesTable SEQ Table \* ARABIC 19: Accountability Indicators Output 1.12018–19Targets2018–19Estimated Outcome2019–20TargetsPercentage of Elective Surgery Cases Admitted on Time by Clinical UrgencyUrgent – admission within 30 days is desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency1n/an/a100%Semi-urgent – admission within 90 days is desirable for a condition causing some pain, dysfunction or disability which is not likely to deteriorate quickly or become an emergency1n/an/a80%Non-urgent – admission within 365 days is desirable for a condition causing minimal or no pain, dysfunction or disability, which is not likely to deteriorate quickly, and which does not have the potential to become an emergency1n/an/a93%The Proportion of Emergency Department Presentations that are Treated within Clinically Appropriate TimeframesOne (resuscitation seen immediately)2n/an/a100%Two (emergency seen within 10 mins)2n/an/a80%Three (urgent seen within 30 mins)2n/an/a75%Four (semi urgent seen within 60 mins)2n/an/a70%Five (non-urgent seen within 120 mins)2n/an/a70%All presentations2n/an/a70%National Weighted Activity UnitsNWAU{18}NWAU{18}NWAU{19}Admitted services383,54381,816n/aNon-admitted services3,425,94428,874n/aEmergency services312,41511,803n/aAcute admitted mental health services3,55,7666,580n/aSub-acute services3,68,02410,052n/aCalvary services (out of scope)3,71,4341,228n/aNotes:These Accountability Indicators were Strategic Objectives from the Local Hospital Network in 2018-19 that reported Territory wide outcomes. The 2018-19 Targets and estimated outcomes are reported on page 65. The 2019-20 targets are for Canberra Health Services performance only.These Accountability Indicators were Strategic Objectives from the Local Hospital Network in 2018-19 that reported Territory wide outcomes. The 2018-19 Targets and estimated outcomes are reported on page 66. The 2019-20 targets are for Canberra Health Services performance only.These Indicators have been discontinued and will only be reported at the Territory wide level through the Local Hospital Network.Non-admitted activity is estimated to be 11% above the target in 2018-19, which was largely driven by increased patient volume in services such as urology, general medicine and midwifery and maternity.Admitted mental health activity is 14% above the target in 2018-19 due to an increase in average complexity per separation for services such as schizophrenia disorders, major affective disorders and drug intoxication and withdrawal.Sub/Non-acute admitted activity is 25% above the target in 2018-19 due to an increase in the number of patients receiving rehabilitation care and maintenance care, reflecting the commissioning of the University of Canberra Hospital earlier this financial year.Calvary out-of-scope activity is 14% below the target in 2018-19, which was largely driven by a shift in patient casemix in non-admitted services. This however does not affect Commonwealth funding to the ACT.Output 1.2: Mental Health, Justice Health and Alcohol and Drug ServicesTable SEQ Table \* ARABIC 20: Accountability Indicators Output 1.22018–19Targets2018–19Estimated Outcome2019–20TargetsAdult mental health program community service contacts1198,000185,000198,000Children and youth mental health program community service contacts272,00082,00072,000Mental health rehabilitation and specialty services326,25030,70026,250Alcohol and drug services community contacts70,00066,00070,000Proportion of detainees at the Alexander Maconochie Centre with a completed health assessment within 24 hours of detention100%100%100%Proportion of detainees in the Bimberi Youth Detention Centre with a completed health assessment within 24 hours of detention100%100%100%Justice health services community contacts155,000135,200150,000Percentage of current clients on opioid treatment with management plans498%95%98%Proportion of mental health clients contacted by a Canberra Health Services community facility within 7 days post discharge from inpatient services5n/an/a75%Notes:The 2018-19 estimated outcome variance is largely due to staff vacancies and modifications to service functions. These changes have meant more community based visiting rather than phone contact resulting in less overall occasions of services.The 2018-19 estimated outcome variance is due to increases in demand and staff levels particularly in the acute areas. The program has been expanded through the Youth Mental Health Assertive Outreach and Expansion of the Perinatal Mental Health Service budget initiatives.The 2018-19 estimated outcome variance is due mainly to demand for rehabilitation and speciality mental health services.The 2018-19 estimated outcome variance is due to adjustments in clinical and operational practices resulting in less occasions of services.This Accountability Indicator was reported in the Local Hospital Network (1.1.h) in 2018-19 and will only report on contacts by Canberra Health Services for 2019-20. The 2018-19 Target and estimated outcome are reported on page 69.Output 1.3: Cancer ServicesTable SEQ Table \* ARABIC 21: Accountability Indicators Output 1.32018–19Targets2018–19Estimated Outcome2019–20TargetsParticipation rate, proportion of women aged 50 to 74 who had a breast screen1n/an/a60%Total breast screens18,50018,70019,500Number of breast screens for women aged 50 to 74 213,00015,440n/aPercentage of women who receive results of screen within 28 days2100%100%n/aPercentage of screened patients who are assessed within 28?days390%84%90%Radiotherapy Treatment Within Standard TimeframesEmergency – treatment starts within 48 hours4n/an/a100%Palliative – treatment starts within 2 weeks4n/an/a90%Radical – treatment starts within 4 weeks4n/an/a90%Notes:This is a new Accountability Indicator and was previously reported as Strategic Indicator 4 in the 2018-19 Budget Statements in the former Health Directorate. The 2018-19 Target and estimated outcome are reported on page 38.These Accountability Indicators have been discontinued.The 2018-19 timely recall to assessment has been impacted by program capacity as well as client choice. Screening capacity increased significantly with the engagement of locum radiographers. This resulted in an increase in the number of women recalled for assessment. This in turn exceeded available assessment appointments and resulted in some women exceeding the 28 day timeframe.These Accountability Indicators are new and were previously reported as Strategic Objective 3 in the former Health Directorate. The 2018-19 Targets and estimated outcomes are reported on page 38.Output 1.4: Subacute and Community ServicesTable SEQ Table \* ARABIC 22: Accountability Indicators Output 1.42018-19Targets2018-19Estimated Outcome2019-20TargetsNumber of nursing (domiciliary and clinic based) occasions of service191,89089,000n/aNumber of allied health regional services (occasions of service) 1,230,63025,000n/aMean waiting time for clients on the dental services waiting list36 months8 months12 monthsPercentage of the Women’s Health Service Intake Officer’s clients who receive an intake and assessment service within 14 working days of their initial referral1100%97%n/aProportion of clients attending ‘Well Women's Check’ within the Women's Health Service that are from culturally and linguistically diverse communities140%41%n/aProportion of children aged 0-14 who are entering substitute and kinship care within the ACT who attend the Child at Risk Health Unit for a health and wellbeing screen190%93%n/aSub-acute bed days of care at University of Canberra Hospital4n/an/a27,600Walk in Centre presentations to Gungahlin4n/an/a20,000Walk in Centre presentations to Belconnen4n/an/a24,000Walk in Centre presentations to Tuggeranong4n/an/a24,000Median wait time to be seen, in minutes (all Walk in Centre’s combined)4n/an/a<30 minutesNotes:These Accountability Indicators have been discontinued. The 2018-19 estimated outcome variance reflects reductions in activity due in part to staff vacancies and unplanned personal leave. Physiotherapy occasions of service are also down due to an increase in group sessions.The lower estimated outcome and 2019-20 target relates to reductions in Commonwealth National Partnership Agreement funding.These Accountability Indicators are new in 2019-20.Changes to AppropriationTable SEQ Table \* ARABIC 23: Changes to appropriation – Controlled Recurrent Payments2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'0002018-19 Budget310,654313,625294,875266,943266,9432019-20 Budget Technical AdjustmentsRevised Indexation Parameters----3,111Transfer - Separation of Canberra Health Services and ACT Health Directorate-208,728-313,625-294,875-266,943-270,0542019-20 Budget101,926----Table SEQ Table \* ARABIC 24: Changes to appropriation – Expenses on Behalf of the Territory2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'0002018-19 Budget2,6205,6928,6099329322019-20 Budget Technical AdjustmentsRevised Indexation Parameters----25Transfer - Separation of Canberra Health Services and ACT Health Directorate-2,620-5,692-8,609-932-9572019-20 Budget-----Table SEQ Table \* ARABIC 25: Changes to appropriation – Capital Injections, Controlled2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'0002018-19 Budget123,012105,46511,0174,9814,661FMA Section 16B Rollovers from 2017-18Better Infrastructure Fund1,540----Bowes St Fit Out6----Clinical Infrastructure Improvement Project – Acute Aged Care and Cancer Inpatients168----Critical Hospital Infrastructure Systems – Enhancing patient and staff safety821----Major Building Plant Replacement and Upgrade4----More mobile dental clinics539----More nurse-led Walk in Centres558----Replacement of CT Scanner at the Canberra Hospital78----Training our future health workforce200----Enterprise Bargaining Agreement (EBA) pay increase back pay6,079----2019-20 Budget Policy DecisionsDelivering the Weston Creek Walk in Centre2,0002,120---Delivering the Inner North Walk in Centre-1,100614--Expanding pharmacy services at The Canberra Hospital-2,2123,318--More mental health services at The Canberra Hospital-1,764756--More public medical imaging services for Canberra Hospital--2,8006,1002,300Opioid treatment services on Canberra’s northside-611---2019-20 Budget Technical AdjustmentsNgunnawal Bush Healing Farm-66----Aluminium Composite Panels - Centenary Hospital -153----Clinical Services and Inpatient Unit Design and Infrastructure Expansion (CSIUDIE)-14----Clinical Services Redevelopment - Phase 3-26----Continuity of Health Services Plan - Essential Infrastructure-74----Revised Funding Profile:- Accommodation to support people with Mental Health7821,611-2,159-234-- ACT Health critical assets upgrades -9,743-6,45616,199--- Aluminium Composite Panels Centenary Hospital-526526---- Clinical Services & Inpatient Unit Design & Infrastructure Expansion-4893486--- Clinical Services Redevelopment Phase 2-217217---- Clinical Services Redevelopment Phase 3311-311---- Delivering the Weston Creek Walk-in Centre-325325---- Health Infrastructure Program - Project Management Continuation--490490--- Improved infrastructure for acute aged care and cancer patient - Ward 14A/B-3,744-2564,000--Table 25: Changes to appropriation – Capital Injections, Controlled (continued)2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'000- More nurse-led Walk in Centres Gungahlin815-815---- More nurse-led Walk in Centres Weston-8282---- New Medical Imaging Equipment-500500---- Secure Mental Health-754754---- Sterilising Services Relocation & Upgrade-2,8942,894---- The Canberra Hospital Essential Works - Infrastructure Engineering-874874---- Training our future health workforce-1,4001,100300--- Upgrading & Maintaining ACT Health Assets (UMAHA)6,511-22,78916,278--- University of Canberra Car Park-1,5941,594---- University of Canberra Hospital4,443-9,4835,040--- Weston Creek Region Community Health Infrastructure-2,0002,000---Revised Indexation Parameters----117Secure Mental Health Facility-1----Sterilising Services - Relocation and Upgrade-110----Transfer - Better Infrastructure Fund between EBT & Capital injection312----Transfer – Separation of Canberra Health Services and ACT Health Directorate-29,829-12,287-887--Transfer - Supported Mental Health Dwellings to Housing ACT--2,900---University of Canberra Car Park (Grant Component)-2,160----University of Canberra Public Hospital (Construction)-3,334----Upgrading & Maintaining ACT Health Assets (UMAHA)-3,417----2019-20 Budget83,85369,96558,25210,8477,078Summary of 2019-20 Infrastructure ProgramTable SEQ Table \* ARABIC 26: 2019-20 Canberra Health Services Infrastructure ProgramProject2019-20$'0002020-21$'0002021-22$'0002022-23$'000Four YearInvestment$'000PhysicalCompletionDateWork In ProgressACT Health critical assets upgrades6,32416,199--22,523Sep-21Clinical Services and Inpatient Unit Design and Infrastructure Expansion926486--1,412Jul-19Clinical Services Redevelopment Phase 2217---217Jun-19Clinical Services Redevelopment Phase 3700---700Jun-19Health Infrastructure Program – Project management continuation-490--490Jun-18Improved infrastructure for acute aged care and cancer inpatients9,3804,000--13,380May-20More mental health accommodation4,9443,40186-8,431Nov-20More nurse-led Walk in Centres505---505Nov-19New medical imaging equipment500---500Jun-20Aluminium composite panels – Centenary Hospital 526---526Jun-18Secure Mental Health Unit754---754Nov-16Sterilising Services – Relocation and upgrade2,894---2,894Sep-19The Canberra Hospital – Essential infrastructure and engineering works1,748---1,748Aug-19Training our future health workforce1,400300--1,700Jun-20University of Canberra Public Hospital3,8855,040--8,925Feb-18University of Canberra Public Hospital Car Park (Grant)1,594---1,594Jul-18Upgrading and maintaining ACT Health assets19,43216,278--35,710Dec-20Total Work In Progress55,72946,19486-102,009Capital Upgrade ProgramsBetter Infrastructure Fund4,1044,5704,6614,77818,113Sep-20Total Capital Upgrade Programs4,1044,5704,6614,77818,113Table 26: 2019-20 Canberra Health Services Infrastructure Program (continued)Project2019-20$'0002020-21$'0002021-22$'0002022-23$'000Four YearInvestment$'000PhysicalCompletionDateNew WorksDelivering the Inner North Walk in Centre1,100614--1,714Aug-20Delivering the Weston Creek Walk in Centre4,445---4,445Nov-19Expanding pharmacy services at The Canberra Hospital2,2123,318--5,530Sep-20More mental health services at The Canberra Hospital1,764756--2,520Sep-20More public medical imaging services for Canberra Hospital-2,8006,1002,30011,200Mar-21Opioid treatment services on Canberra’s northside611---611Jun-20Total New Capital10,1327,4886,1002,30026,020Total Infrastructure Program69,96558,25210,8477,078146,142Financial StatementsTable SEQ Table \* ARABIC 27: Canberra Health Services: Operating Statement 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var%2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000IncomeRevenue310,654Controlled Recurrent Payments101,926--100 ---1,051,282User Charges1,079,5241,158,5677 1,193,2871,233,6981,253,1034,546Grants4,5464,6592 4,7754,8945,016191Interest1911952 1992042072,062Resources Received Free of Charge2,0622,0972 2,1562,1512,19914,218Other Revenue12,25914,52819 15,76016,08316,4361,382,953Total Revenue1,200,5081,180,046-2 1,216,1771,257,0301,276,961Gains1,017Other Gains1,0171,0422 1,0681,0951,1221,017Total Gains1,0171,0422 1,0681,0951,1221,383,970Total Income1,201,5251,181,088-2 1,217,2451,258,1251,278,083Expenses 780,388Employee Expenses758,213742,095-2 771,776796,420806,09199,666Superannuation Expenses92,054101,83211 103,562105,260106,335396,291Supplies and Services327,288315,579-4 325,515332,044341,00150,817Depreciation and Amortisation36,51132,375-11 33,24735,79537,56899,066Grants and Purchased Services33,61016,766-50 17,18517,61418,0559,636Cost of Goods Sold9,3679,8775 10,12510,37710,636436Interest Expenses43647910 4794904907,674Other Expenses5,6275,7031 5,8505,9996,0451,443,974Total Expenses1,263,1061,224,706-3 1,267,7391,303,9991,326,221-60,004Operating Result-61,581-43,61829-50,494-45,874-48,138-60,004Total Comprehensive Income-61,581-43,61829 -50,494-45,874-48,138Table SEQ Table \* ARABIC 28: Canberra Health Services: Balance Sheet Budgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Current Assets81,745Cash and Cash Equivalents48,90847,878-2 41,58843,00644,4283,029Investments--- ---35,464Receivables28,43029,4434 30,45331,46132,4679,418Inventories7,0847,2843 7,4847,6847,8847,339Other Assets4,8524,9171 4,9825,0475,112136,995Total Current Assets89,27489,522.. 84,50787,19889,891Non Current Assets1,336,571Property, Plant and Equipment1,120,4821,164,9904 1,208,1661,233,0461,221,08657,511Intangible Assets--- ---21,259Capital Works in Progress11,21614,37528 6,28213,5825,13014,765Other Assets1,6691,669- 1,6691,6691,6691,430,106Total Non Current Assets1,133,3671,181,0344 1,216,1171,248,2971,227,8851,567,101TOTAL ASSETS1,222,6411,270,5564 1,300,6241,335,4951,317,776Current Liabilities92,204Payables45,12146,3913 47,67149,50151,3420Interest-Bearing Liabilities425425- 4254254250Finance Leases-686# 1,3722,0582,744261,126Employee Benefits239,789256,4137 273,720291,521309,8057,363Other Liabilities8,1888,9279 9,6669,86610,066360,693Total Current Liabilities293,523312,8427 332,854353,371374,382Non Current Liabilities0Interest-Bearing Liabilities2,0692,069- 2,0692,0692,0690Finance Leases-365# 7301,0951,46019,372Employee Benefits16,23918,12312 20,05622,02223,9871,462Other Provisions9191- 91919122,272Other Liabilities--- ---43,106Total Non Current Liabilities18,39920,64812 22,94625,27727,607403,799TOTAL LIABILITIES311,922333,4907 355,800378,648401,9891,163,302NET ASSETS910,719937,0663 944,824956,847915,7871,030,677Accumulated Funds780,555806,9023 814,660826,683785,623132,625Asset Revaluation Surplus130,164130,164- 130,164130,164130,1641,163,302TOTAL FUNDS EMPLOYED910,719937,0663944,824956,847915,787Table SEQ Table \* ARABIC 29: Canberra Health Services: Statement of Changes in Equity Budgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Opening Equity967,669Opening Accumulated Funds963,807780,555-19 806,902861,710826,683132,625Opening Asset Revaluation Reserve130,164130,164- 130,164130,164130,1641,100,294Balance at the Start of the Reporting Period1,093,971910,719-17 937,066991,874956,847Comprehensive Income-60,004Operating Result - Including Economic Flows-61,581-43,61829 -50,494-45,874-48,138-60,004Total Comprehensive Income-61,581-43,61829 -50,494-45,874-48,138-Total Movement in Reserves--- ---Transactions Involving Owners Affecting Accumulated Funds123,012Capital Injections83,85369,965-17 58,25210,8477,078-Inc/Dec in Net Assets due to Admin Restructure-205,524-100 ---123,012Total Transactions Involving Owners Affecting Accumulated Funds-121,67169,965158 58,25210,8477,078Closing Equity1,030,677Closing Accumulated Funds780,555806,9023 814,660826,683785,623132,625Closing Asset Revaluation Reserve130,164130,164- 130,164130,164130,1641,163,302Balance at the end of the Reporting Period910,719937,0663944,824956,847915,787Table SEQ Table \* ARABIC 30: Canberra Health Services: Cash Flow Statement 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var %2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000CASH FLOWS FROM OPERATING ACTIVITIESReceipts310,654Controlled Recurrent Payments101,926--100 ---1,047,059User Charges1,075,3011,154,2597 1,188,9281,229,2961,248,7014,546Grants4,5464,6592 4,7754,8945,016191Interest Received1911952 19920420771,846Other69,86873,6075 76,24477,99878,3771,434,296Operating Receipts1,251,8321,232,720-2 1,270,1461,312,3921,332,301Payments764,710Employee743,752727,446-2 756,382780,487789,66295,358Superannuation87,74697,41711 99,147100,845101,920396,106Supplies and Services327,103316,524-3 326,351332,945341,85499,066Grants and Purchased Services33,61016,766-50 17,28517,71418,155452Interest Expenses45250412 5045155159,636Related to Cost of Goods Sold9,3679,8775 10,12510,37710,63657,990Other55,92456,188.. 57,61459,06359,1091,423,318Operating Payments1,257,9541,224,722-3 1,267,4081,301,9461,321,85110,978NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES-6,1227,998231 2,73810,44610,450CASH FLOWS FROM INVESTING ACTIVITIESReceipts-Proceeds from Sale/Maturity of Investments2,879--100 ----Investing Receipts2,879--100 ---Payments133,943Purchase of Property, Plant and Equipment90,68478,298-14 66,58519,18015,411133,943Investing Payments90,68478,298-14 66,58519,18015,411-133,943NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES-87,805-78,29811 -66,585-19,180-15,411Table 30: Canberra Health Services: Cash Flow Statement (continued)2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var %2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000CASH FLOWS FROM FINANCING ACTIVITIESReceipts123,012Capital Injections83,85369,965-17 58,25210,8477,078123,012Financing Receipts83,85369,965-17 58,25210,8477,078Payments-Repayment of Finance Lease Liabilities-695# 695695695-Payment of Transferred Cash Balances1,419--100 ----Financing Payments1,419695-51 695695695123,012NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES82,43469,270-16 57,55710,1526,38347NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS-11,493-1,03091 -6,2901,4181,42281,698CASH AT THE BEGINNING OF REPORTING PERIOD60,40148,908-19 47,87841,58843,00681,745CASH AT THE END OF REPORTING PERIOD48,90847,878-2 41,58843,00644,428Notes to the Controlled Budget StatementsOn 1 October 2018, the former Health Directorate was separated into two Directorates, the ACT Health Directorate and Canberra Health Services. For the purposes of these statements, the 2018-19 Budgets reflect the former combined Health Directorate and the 201819 estimated outcome includes three months operation of the former combined Health Directorate, plus nine months of Canberra Health Services.Therefore, in most instances the variances between the original 2018-19 Budget and the 2018-19 estimated outcome and the variances between the 2018-19 estimated outcome and the 2019-20 Budget relate to the separation of the former Health Directorate.Significant variations that do not relate to the separation of the former Health Directorate are as follows:Operating Statementcontrolled recurrent payments: from 2019-20 all controlled recurrent payments will be received via the ACT Local Hospital Network and therefore appear as user charges.user charges: the increase of $79.043 million in the 2019-20 Budget from the 2018-19 estimated outcome is mainly due a change in the way Canberra Health Services receives controlled recurrent payments via the ACT Local Hospital Network. other revenue: the increase of $2.269 million in the 2019-20 Budget from the 2018-19 estimated outcome is mainly due to services provided under the National Disability Insurance Scheme (NDIS), previously provided as in-kind.superannuation expenses: the increase of $9.778 million in the 2019-20 Budget from the 2018-19 estimated outcome is due mainly to changes in superannuation contribution rates.Balance Sheetcapital works in progress: the increase of $3.159?million in the 2019-20 Budget from the 2018-19 estimated outcome is mainly due to new capital works projects including pharmacy works, electro convulsive therapy and the inner north Walk in Centre.current and non current employee benefits: the increase of $18.508 million?in the 201920 Budget from the 2018-19 estimated outcome is mainly due to wage rises and growth in staff.Statement of Changes in Equity capital injections: the decrease of $13.888 million in the 2019-20 Budget from the 201819 estimated outcome is due to a smaller Capital Works program which is summarised on the Infrastructure table.Cash Flow StatementVariations in the Statement are explained in the notes above.Financial Statements - TerritorialTable SEQ Table \* ARABIC 31: Canberra Health Services: Statement of Income and Expenses on behalf of the Territory 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var%2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000Revenue2,620Payment for Expenses on Behalf of the Territory--- ---1,410Taxes, Fees and Fines389--100 ---4,030Total Revenue389--100 ---4,030Total Income389--100 ---Expenses 2,620Grants and Purchased Services133--100 ---1,410Transfer Expenses389--100 ---4,030Total Expenses522--100 ----Operating Result-133-100----Total Comprehensive Income-133-100 ---Table SEQ Table \* ARABIC 32: Canberra Health Services: Statement of Assets and Liabilities on behalf of the TerritoryBudgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Current Assets674Cash and Cash Equivalents--- ---51Receivables--- ---725Total Current Assets--- ---Non Current Assets-Total Non Current Assets--- ---725TOTAL ASSETS--- ---Current Liabilities300Payables--- ---261Other Liabilities--- ---561Total Current Liabilities--- ---Non Current Liabilities-Total Non Current Liabilities--- ---561TOTAL LIABILITIES--- ---164NET ASSETS--- ---REPRESENTED BY FUNDS EMPLOYED164Accumulated Funds--- ---164TOTAL FUNDS EMPLOYED-- - ---Table SEQ Table \* ARABIC 33: Canberra Health Services: Statement of Changes in Equity on behalf of the TerritoryBudgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Opening Equity164Opening Accumulated Funds2,366--100 ---164Balance at the Start of the Reporting Period2,366--100 ----Operating Result - Including Economic Flows-133-100 ----Total Movement in Reserves--- ---Closing Equity164Closing Accumulated Funds--- ---164Balance at the end of the Reporting Period-- - ---Table SEQ Table \* ARABIC 34: Canberra Health Services: Cash Flow Statement on behalf of the Territory2018-192018-192019-20Var2020-212021-222022-23BudgetEstimated OutcomeBudget%EstimateEstimateEstimate$'000$'000$'000$'000$'000$'000CASH FLOWS FROM OPERATING ACTIVITIESReceipts2,620Payment for Expenses on Behalf of the Territory--- ---1,410Taxes, Fees and Fines389--100 ---261Other13--100 ---4,291Operating Receipts402--100 ---Payments2,620Grants and Purchased Services133--100 ---1,410Transfer of Territory Receipts to the ACT Government389--100 ---261Other13--100 ---4,291Operating Payments535--100 ----NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS-1,089-100 ---674CASH AT THE BEGINNING OF REPORTING PERIOD1,089--100 ---674CASH AT THE END OF REPORTING PERIOD--- ---Notes to the Territorial Budget StatementsFunctions undertaken through the Territorial account were transferred to the ACT Health Directorate Territorial account on 1 October 2018. The 2018-19 estimated outcome therefore reflects 3 months of operation only.Taxes, fees and fines and transfer expenses relate to regulatory fees collected by the former Health Directorate prior to 1 October 2018.In 2018-19, grants and purchased services relate to capital grants paid to Calvary Public Hospital prior to 1?October 2018.ACT LOCAL HOSPITAL NETWORKPurposeThe ACT Local Hospital Network was established under the Health?Act?1953, and is administered by the Director-General of the ACT Health?Directorate and supported by staff from the ACT Health?Directorate.The ACT?Local Hospital Network receives Activity?Based?Funding (ABF) from both the Commonwealth and the ACT?Governments, and block funding for teaching, training and research. It purchases public hospital services from five ACT public hospital providers:Canberra Hospital;University of Canberra Hospital;Calvary Public Hospital;Clare Holland House; andQueen Elizabeth II Family Centre.2019-20 PrioritiesOperational initiatives to be pursued in 2019-20 include:receiving and distributing funding for public hospital services under the National Health Reform Agreement (NHRA);purchasing public hospital services from five ACT public hospital providers; andfunding the expansion of Calvary services including urology, the emergency department and two additional operating theatres. Estimated Employment LevelThe ACT?Local Hospital Network does not employ any staff. All staff providing administrative support for the ACT?Local Hospital Network are employed by the ACT Health?Directorate. Strategic Objectives and Indicators Strategic Objective 1 Establishment of an integrated planning, funding and performance monitoring framework that drives coordinated, high-quality health care service delivery Table SEQ Table \r 1\* ARABIC 1: Number of Public Hospital Performance AgreementsStrategic Indicator2018–19 2018–192019–20TargetEstimatedOutcomeTargetPerformance Agreements with Public Hospital Service Providers in place1 n/an/a2Note:This is a new Strategic Indicator for 2019-20. The Canberra Hospital and the University of Canberra Hospital are contracted under the same agreement, as is Calvary Public Hospital Bruce and Clare Holland House.Strategic Objective 2 Percentage of Elective Surgery Cases Admitted on Time by Clinical UrgencyTable SEQ Table \* ARABIC 2: Percentage of Elective Surgery Cases Admitted on Time by Clinical UrgencyStrategic Indicator Clinically recommended time by urgency category2018–19 2018–192019-20TargetsEstimatedOutcomeTargets1Urgent—admission within 30 days is desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency100%96%n/aSemi urgent—admission within 90 days is desirable for a condition causing some pain, dysfunction or disability which is not likely to deteriorate quickly or become an emergency78%78%n/aNon urgent—admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability, which is not likely to deteriorate quickly and which does not have the potential to become an emergency91%79%n/aNote:This Strategic Objective has been moved to the ACT Health Directorate Accountability Indicators 1.1.b to d and will be reported as a Territory wide indicator as shown on page 13. This measure is also included in Canberra Health Services as Accountability Indicators 1.1a to c, measuring timeliness only for Canberra Health Services.Strategic Objective 3 Improved Emergency Department TimelinessTable SEQ Table \* ARABIC 3: Strategic Indicator 3.1: The Proportion of Emergency Department Presentations that are Treated within Clinically Appropriate Timeframes Strategic Indicator2018–192018–192019-20TargetsEstimatedOutcomeTargets1One (resuscitation seen immediately)100%100%n/aTwo (emergency seen within 10 mins)80%75%n/aThree (urgent seen within 30 mins)75%33%n/aFour (semi urgent seen within 60 mins)70%48%n/aFive (non urgent seen within 120 mins)70%84%n/aAll presentations70%48%n/aNote:This Strategic Objective has been moved to Canberra Health Services Accountability Indicators 1.1.d to i for 2019-20 and will measure timeliness performance for Canberra Health Services only as shown on page 43. ‘All Presentations’ for Territory wide is reported in the ACT Health Directorate under Accountability Indicator 1.1a.Table SEQ Table \* ARABIC 4: Strategic Indicator 3.2: The proportion of Emergency Department presentations whose length of stay in the Emergency Department is four hours or lessStrategic Indicator2018–192018-192019-20TargetsEstimatedOutcomeTargets1The proportion of Emergency Department presentations who either physically leave the Emergency Department for admission to hospital, are referred for treatment or are discharged, whose total time in the Emergency Department is within four hours90%60%n/aNote:This Strategic Objective has been discontinued in the Local Hospital Network and will be reported by the ACT Health Directorate under Strategic Objective 3 as shown on page 4.Strategic Objective 4Maximising the Quality of Hospital ServicesTable SEQ Table \* ARABIC 5: Strategic Indicator 4.1: The proportion of people who undergo a surgical operation requiring an unplanned return to the operating theatre within a single episode of care due to complications of their primary conditionStrategic Indicator2018–192018–192019-20TargetsEstimatedOutcomeTargets1Canberra Hospital<1.0%0.8%n/aCalvary Public Hospital<0.5%0.4%n/aNote:This Strategic Objective has been discontinued in the Local Hospital Network and will be reported by the Health Directorate under Accountability Indicator 1.1.f as shown on page 13.Table SEQ Table \* ARABIC 6: Strategic Indicator 4.2: The proportion of people separated from ACT public hospitals wo are readmitted to hospital within 28?days of their separation due to complications of their condition (where the re-admission was unforeseen at the time of separation) Strategic Indicator2018–192018–192019-20TargetsEstimated OutcomeTargets1Canberra Hospital<2.0%1.2%n/aCalvary Public Hospital<1.0%0.8%n/aNote:This Strategic Objective has been discontinued in the Local Hospital Network and will be reported by the Health Directorate under Accountability Indicator 1.1.g as shown on page 13.Table SEQ Table \* ARABIC 7: Strategic Indicator 4.3: The number of people admitted to hospitals per 10,000 occupied bed days who acquire a Staphylococcus Aureus Bacteraemia infection (SAB infection) during their stayStrategic Indicator2018–192018–192019-20Targets Estimated OutcomeTargets1Canberra Hospital<2.0 per 10,0001.2 per 10,000n/aCalvary Public Hospital<2.0 per 10,0000.0 per 10,000n/aNote:This Strategic Objective has been discontinued in the Local Hospital Network and will be reported by Canberra Health Services at Strategic Objective 5 as shown on page 37. Canberra Health Services will report on their performance only in 2019-20.Table SEQ Table \* ARABIC 8: Strategic Indicator 4.4: The estimated hand hygiene rateStrategic Indicator2018–192018–192019-20TargetsEstimated OutcomeTargets1Canberra Hospital75%83%n/aCalvary Public Hospital75%78%n/aNote:This Strategic Objective has been discontinued in the Local Hospital Network and will be reported by Canberra Health Services at Strategic Objective 6 as shown on page 37. Canberra Health Services will report on their performance only in 2019-20. Output ClassesThe ACT Local Hospital Network will receive funding under the NHRA and purchase public hospital services from the Canberra Hospital, University of Canberra Hospital, Calvary Public Hospital, Clare Holland House and Queen Elizabeth II Family Centre. The NHRA commits to funding public hospitals using Activity Based Funding where practicable using the National Efficient Price (NEP) determined by the Independent Hospital Pricing Authority (IHPA). The national efficient price is based on the projected average cost of a National Weighted Activity Unit (NWAU).An NWAU is a measure of health service activity expressed as a common unit, against which the national efficient price (NEP) is paid. It provides a way of comparing and valuing each public hospital service (whether it is an admission, emergency department presentations or outpatient episode), by weighing it for its clinical complexity. The average hospital service is worth one NWAU – the most intensive and expensive activities are worth multiple NWAU’s, the simplest and least expensive are worth fractions of an NWAU. NWAU’s are updated annually.The 2019-20 National Efficient Price is $5,134 per NWAU.Output Class 1: ACT Local Hospital NetworkTable SEQ Table \* ARABIC 9: Output Class 1: ACT Local Hospital Network2018-192019-20Estimated OutcomeBudget$'000$'000Total Cost1,175,9461,305,623Controlled Recurrent Payments654,588771,178 Accountability IndicatorsOutput Class 1: ACT Local Hospital NetworkTable SEQ Table \* ARABIC 10: Accountability Indicators Output 1.12018-19Targets2018-19Estimated Outcome2019-20TargetsNWAU{18}NWAU{18}NWAU{19}Admitted Services – National Weighted Activity Units1101,853100,031101,917Non-admitted Services – National Weighted Activity Units1,218,89721,52420,758Emergency Services – National Weighted Activity Units119,38918,63219,590Acute Admitted Mental Health Services – National Weighted Activity Units1,38,4339,2099,824Sub-Acute Services – National Weighted Activity Units1,410,12511,65612,340Total in Scope – National Weighted Activity Units1158,697161,052164,429Percentage of mental health clients with outcome measures completed565%71%n/aProportion of mental health clients contacted by a Health Directorate community facility within 7 days post discharge from inpatient services675%74%n/aNotes:National Weighted Activity Unit (NWAU) is the ‘currency’ that is used to express the price weights for all services that are funded on an activity basis. NWAU {18} is the currency as defined by the Independent Hospital Pricing Authority in the National Price Determination 2018-19, while NWAU {19} is the currency for 2019-20. NWAU{19} and NWAU{18} are not directly comparable. These measures combine the results for Canberra Hospital, University of Canberra Hospital and Calvary Public Hospital.Non-admitted estimated outcome is 14% above the 2018-19 target, which was largely driven by increased in patient volume in services such as midwifery and maternity, urology and general medicine.Admitted mental health activity is 9% above the 2018-19 target, which was largely driven by an increase in average complexity per separation in services such as schizophrenia disorders, major affective disorders and drug intoxication and withdrawal.Sub/Non-acute admitted activity is 15% above the 2018-19 target, which was largely driven by an increase in the number of patients receiving rehabilitation care and maintenance care, reflecting the commissioning of the University of Canberra Hospital earlier in the financial year. This measure has been discontinued as a Local Hospital Network Accountability Indicator for 2019-20 and will be reported by ACT Health Directorate as a Territory wide indicator under Accountability Indicator 1.3.a as shown on page 15.This measure has been discontinued as a Local Hospital Network Accountability Indicator for 2019-20 and will be reported by Canberra Health Services 1.2.i as shown on page 44. Canberra Health Services will report on their performance only.Changes to AppropriationTable SEQ Table \* ARABIC 11: Changes to appropriation – Controlled Recurrent Payments2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'0002018-19 Budget669,990674,088695,188725,173725,1732018-19 Budget ReviewCaring for older Canberrans at home8692,5583,0653,1423,220Commencing operations of the Drug and Alcohol Court2767751,742--Delivering the Weston Creek Walk-in Centre--438585Flu vaccinations for children4925015135265392019-20 Budget Policy Decisions7-day-a-week Mental Health Consultation Liaison service-8001,2341,2661,292ACT Health Core IT Systems to align with the Digital Health Strategy-----6,338Alternative justice pathways for people with mental illness-731749768787Boosting police for a growing city-82277285-Delivering the Inner North Walk in Centre--2,6482,6872,744Delivering the Weston Creek Walk in Centre-1,9462,7052,8872,933Expanding early intervention and diversion programs for people experiencing alcohol and drug dependence-949644660677Expanding frontline services at The Canberra Hospital-11,44811,61411,93412,106Expanding health services at the Alexander Maconochie Centre-259266273277Expanding palliative care for older Canberrans-408363373519Expanding pharmacy services at The Canberra Hospital-302545749813Expanding public dermatology services-175180185188Expanding public Fracture Clinic services-5561,1391,1671,197Expanding public inpatient mental health care-1,6801,7221,7651,809Expanding public ophthalmology services-250---Expanding the Centenary Hospital for Women and Children--3,99014,99020,510Expanding the emergency department at Calvary Public Hospital-3,0216,1436,3526,475Improving access to maternity services across Canberra-513515529537Maintaining support for disability services in the transition to the full scheme National Disability Insurance Scheme-1,1791,2081,2391,270More mental health services at The Canberra Hospital--4889991,078More public medical imaging services for Canberra Hospital-1006771,2171,458Table 11: Changes to appropriation – Controlled Recurrent Payments (continued)2018-19 Estimated Outcome$'0002019-20 Budget$'0002020-21 Estimate$'0002021-22 Estimate$'0002022-23 Estimate$'000More specialised women’s health care-114214220223More support for families travelling for healthcare-250512525538More surgical theatres at Calvary Public Hospital-1,5393,3023,4613,625More urology services at Calvary Public Hospital-4329629911,021Opioid treatment services on Canberra’s northside--750770790Protecting teens with meningococcal ACWY vaccinations-150153158160Strengthening care for childhood and gestational diabetes-567765784796Strengthening care for chronic disease-240462474481Strengthening care for older Canberrans-470482494506Training ACT Government frontline workers to respond to family violence-210288296300Transfer – New Initiative ICT Expenses to ACT Health Directorate--572-679-717-7382019-20 Budget Technical AdjustmentsCommonwealth National Health Reform Agreement-15,402----19,222Efficiency Target-1,637-4,272-4,703-4,808-4,907Improving Safety of Older Drivers-300---Revised Indexation Parameters----8,889Revised Superannuation Parameters-9,2309,2309,2309,230Saving - Comcare Premium --5,531-5,531-5,531-5,531Saving - Insurance Premium--3,800---Saving - SMS Procurement - Health Labour Hire Project--401-401-401-401Transfer - National Disability Insurance Scheme to Community Services Directorate--2,854-2,925-2,998-3,073Transfer - Separation of Canberra Health Services and ACT Health Directorate-72,78545,42216,35214,3332019-20 Budget654,588771,178785,961798,551786,369Financial StatementsTable SEQ Table \* ARABIC 12: ACT Local Hospital Network: Operating Statement 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var%2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000IncomeRevenue669,990Controlled Recurrent Payments654,588771,17818 785,961798,551786,369107,921User Charges107,921110,6192 113,385116,219119,124398,035Grants413,437423,8263 451,293480,544511,7791,175,946Total Revenue1,175,9461,305,62311 1,350,6391,395,3141,417,272-Total Gains--- ---1,175,946Total Income1,175,9461,305,62311 1,350,6391,395,3141,417,272Expenses 1,169,126Grants and Purchased Services1,169,1261,298,44111 1,343,0721,387,3381,409,0976,820Payments to ACT Government Agencies6,8207,1825 7,5677,9768,1751,175,946Total Expenses1,175,9461,305,62311 1,350,6391,395,3141,417,272-Operating Result-- - ----Total Comprehensive Income--- ---Table SEQ Table \* ARABIC 13: ACT Local Hospital Network: Balance Sheet Budgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Current Assets3,771Cash and Cash Equivalents500500- 50050050024,218Receivables34,88734,887- 34,88734,88734,88727,989Total Current Assets35,38735,387- 35,38735,38735,387Non Current Assets-Total Non Current Assets--- ---27,989TOTAL ASSETS35,38735,387- 35,38735,38735,387Current Liabilities14,780Payables15,60615,606- 15,60615,60615,60614,780Total Current Liabilities15,60615,606- 15,60615,60615,606Non Current Liabilities-Total Non Current Liabilities--- ---14,780TOTAL LIABILITIES15,60615,606- 15,60615,60615,60613,209NET ASSETS19,78119,781- 19,78119,78119,781REPRESENTED BY FUNDS EMPLOYED13,209Accumulated Funds19,78119,781- 19,78119,78119,78113,209TOTAL FUNDS EMPLOYED19,78119,781 - 19,78119,78119,781Table SEQ Table \* ARABIC 14: ACT Local Hospital Network: Statement of Changes in Equity Budgetat30/6/19 $'0002018-19 Estimated Outcome$'000Budgetat30/6/20 $'000Var%Estimateat30/6/21 $'000Estimateat30/6/22 $'000Estimateat30/6/23 $'000Opening Equity13,209Opening Accumulated Funds19,78119,781- 19,78119,78119,78113,209Balance at the Start of the Reporting Period19,78119,781- 19,78119,78119,781-Total Movement in Reserves--- ---Closing Equity13,209Closing Accumulated Funds19,78119,781- 19,78119,78119,78113,209Balance at the end of the Reporting Period19,78119,781 - 19,78119,78119,781Table SEQ Table \* ARABIC 15: ACT Local Hospital Network: Cash Flow Statement 2018-19 Budget $'0002018-19 Estimated Outcome $'0002019-20 Budget $'000Var %2020-21 Estimate $'0002021-22 Estimate $'0002022-23 Estimate $'000CASH FLOWS FROM OPERATING ACTIVITIESReceipts669,990Controlled Recurrent Payments654,588771,17818 785,961798,551786,369107,921User Charges107,921110,6192 113,385116,219119,124398,035Grants413,437423,8263 451,293480,544511,77921,089Other21,08921,9944 21,99422,54422,5441,197,035Operating Receipts1 ,197,0351,327,61711 1,372,6331,417,8581,439,816Payments1,175,946Grants and Purchased Services1,175,9461,305,62311 1,350,6391,395,3141,417,27221,089Other21,08921,9944 21,99422,54422,5441,197,035Operating Payments1,197,0351,327,61711 1,372,6331,417,8581,439,816-NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES--- ---3,771CASH AT THE BEGINNING OF REPORTING PERIOD500500- 5005005003,771CASH AT THE END OF REPORTING PERIOD500500- 500500500Notes to the Controlled Budget StatementsSignificant variations are as follows:Operating Statementcontrolled recurrent payments: the decrease of $15.402 million (2?per?cent) in the 2018-19 estimated outcome from the original budget is due to increased commonwealth revenue; andthe increase of $116.590 million (18?per?cent) in the 2019-20 Budget from the 2018-19 estimated outcome is due to indexation, new initiatives and a change in methodology in the way Canberra Health Services receive funding from ACT Government.grants revenue: this funding relates to Activity Based Funding under the National Health Reform Agreement. The increase of $15.402 million in the estimated outcome from the original budget is mainly due to back adjustments related to the 2016-17 and 201718 financial years.grants and purchased services: the increase of $129.315 million in the 2019-20 Budget from the 2018-19 estimated outcome is due to indexation, new initiatives and a change in methodology in the way Canberra Health Services will receive its funding from ACT Government. Balance Sheetreceivables: the increase of $10.669?million in the 2018-19 estimated outcome from the original budget is due to outstanding cross border health receipts.Cash Flow StatementVariations in the Statement are explained in the notes above. ................
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