Department of health and ageing annual report 2002-03


PART 2: PERFORMANCE INFORMATION



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PART 2: PERFORMANCE INFORMATION

Performance Information for Administered Items


  1. Primary care strategies, including:

Strategies to increase the number of doctors practising in designated outer metropolitan areas;

Measure

Result

Quality:

An increase in the number of Other Medical Practitioners and GP specialists practising in a designated outer metropolitan area of workforce shortage.



Since the More Doctors for Outer Metropolitan Areas Measure was implemented in January 2003, a total of 58 doctors have agreed to relocate to designated outer metropolitan areas as part of this program.

An increase in the number of other medical practitioners enrolling in a training pathway for vocational recognition.

Since the implementation of the Other Medical Practitioners Program in January 2003, a total of 39 other medical practitioners have undertaken to complete a pathway to vocational recognition as part of this program.

Strategies to increase the number of registrars practising in the designated outer metropolitan areas;

Measure

Result

Quality:

An increase in the number of Registrars undertaking a term of training in a designated outer metropolitan area.



Since the More Doctors for Outer Metropolitan Areas Measure was implemented in January 2003, 22 registrars have undertaken placement in an outer metropolitan area.

An increase in the number of accredited training practices in the designated outer metropolitan areas.

As this is a new measure, baseline data is currently unavailable and will be collected in 2003-04.

Divisions of General Practice;

Measure

Result

Quantity:

123 Divisions of General Practice meeting funding agreement requirements.



121 Divisions of General Practice met the requirements of their funding agreements with the Department.

(Note: during the year the number of Divisions was reduced by 2 as a result of amalgamation).



Strategies to increase the number of GP Registrars in rural and remote communities;

Measure

Result

Quantity:

All eligible Registrars paid under General Practice Registrars Rural Incentive Payment Scheme.



Target met. 372 registrars received payments during 2002-03.

Quality:

An increase in the number of GP Registrars undertaking the bulk of their general practice training in Rural, Remote and Metropolitan Areas (RRMA) 4-7 locations.



The maximum number of new first-year places for general practice registrars training in RRMA 4-7 locations in the rural training pathway is 200. All of these places were fully taken up in 2002-03.

Strategies to support recruitment and retention of GPs in rural and remote areas;

Measure

Result

Quantity:

All eligible rural GPs paid under the Rural Retention Program.



Target met. In its fourth year of operation the program has made payments to over 2,400 eligible doctors. An independent review conducted in January 2003 indicated that the program captures all eligible doctors.

Quality:

Medical Schools increase the range and availability of undergraduate education and training in rural general practice.



Measure met. All Australian medical schools continue to participate in the Rural Undergraduate Support and Coordination Program which requires an increase in the rural component of the curriculum and the provision of enhanced support for rural teachers and academics.

Quantity:

All Rural Australia Medical Undergraduate Scholarship and John Flynn Scholarship Scheme places taken up.



Target met. 88 RAMUS scholarships awarded, maintaining the total at 500 active scholarships. 150 John Flynn scholarships awarded, maintaining the total at 600 active scholarships.

All eligible graduates paid under the HECS Reimbursement Scheme.

An increase in the percentage of eligible other medical practitioners in RRMA 4-7.



Target met. All eligible applicants (52), have been paid under the scheme.

The intention of the measure is to track progress in the number of eligible Other Medical Practitioners in RRMA 4-7 participating in alternative pathways to vocational recognition. The baseline data is still being established for this measure.



Rural Women’s GP Service increases the provision of regular female GP services in rural areas;

Measure

Result

Quantity:

Eligible localities are receiving services under the Rural Women’s GP Service initiative.



Of the 181 approved locations, 104 (57%) are currently receiving the service.

Gain consensus on the role of GPs in population health and develop strategies to create greater collaboration between the general practitioner and population health sectors;

Measure

Result

Quality:

Progress Smoking, Nutrition, Alcohol and Physical Activity (SNAP) information systems and other infrastructure to support population health approaches in general practice.



In 2002-03 a practice guide on smoking cessation, and guidelines and physical activity scripts for GPs to deliver to their patients was developed in collaboration with the Royal Australian College of General Practice.

After Hours Primary Medical Care Services; and

Measure

Result

Quality:

Improved access to after hours primary medical services.



86 projects have been established to improve access to after hours primary medical care services and an evaluation process is in place to identify key learnings from these projects.

The evidence to support system reform for after hours primary medical care continues to be gathered through research grants and trials.



Quality:

Up to 32 sites being established over four years.



2002-03 is the second year of this measure. Funding agreements have been negotiated for the establishment of 26 new services. A fourth funding round was undertaken in August 2003.

Number of medical deputising services participating in the Quality Incentive Funding Program.

Negotiation of contracts with all eligible medical deputising services (MDS) to participate in the funding program is under way, with strong stakeholder support for the program. To date the Department has negotiated seven contracts for quality innovation funding with accredited medical deputising services.

Incentives for the employment of practice nurses in General Practice.

Measure

Result

Quality:

Greater access to quality primary health care in areas of doctor shortages.



Measure met. An additional 147 practices have employed a practice nurse over the twelve month period to 30 June 2003, bringing the total number of practices participating in the Additional Practice Nurses for Rural Australia and Other Areas of Need 2001-02 Budget initiative to over 940.

Increased employment and training opportunities in rural and remote Australia.

Measure met. HIC data indicates that the number of practices employing a practice nurse has increased by 61% since the introduction of the Additional Practice Nurses for Rural Australia and Other Areas of Need initiative.

Quantity:

70% of targeted practices eligible for incentive payment.



Target partially met. HIC data indicates that 66% of eligible PIP practices participated in the Additional Practice Nurses for Rural Australia and Other Areas of Need initiative as at June 2003.

Integrated and Coordinated Care Strategies, including:

Palliative care in the community;



Measure

Result

Quality:

An increase in the provision of palliative care education, training and support programs for primary care workforce in different settings.



Measure met. Two university-based post-graduate programs initiated. Undergraduate curriculum resource for all health disciplines initiated. Guidelines, education and training program in Residential Aged Care initiated. 10 community-based education programs commenced.

Dissemination of information bulletins on palliative care research into funding and service delivery models as results become available.

Measure met. This is an ongoing process with all major programs incorporating a communication element which includes website and periodic bulletins. A total of 6 bulletins were disseminated during this year.

Quantity:

At least 6 community capacity building projects funded by 2003-04.



Target met. 34 projects were funded by 30 June 2003.

Community information packs to raise knowledge about palliative care in the community are developed in 4 different languages.

Target met. Fact sheets for carers developed in Greek, Italian, Vietnamese and Chinese. Brochures are available at .

GPs to implement Medicare Benefits Schedule (MBS) items for Enhanced Primary Care; and

Measure

Result

Quality:

All GPs receive education information on MBS items.



All GPs have had the opportunity to receive education through the Divisions of General Practice or the availability of the Royal Australian College of General Practice Standards and Guidelines document available on their website.

Quantity:

Over half of GPs achieve target for Practice Incentive Program payment.



Over 1,440 practices (or 32% of all PIP practices) provided care plans or case conferences to at least 20% of their estimated number of patients with chronic disease. The PIP incentive for multi- disciplinary care-planning and case conferencing services was withdrawn in November 2002, having achieved its objective of increasing usage of the Enhanced Primary Care MBS items.

Second round of coordinated care trials.

Measure

Result

Quantity:

Up to 6 second round coordinated care trials covering up to 15,000 people with complex and chronic health care needs are operating.



5 second round coordinated care trials have been established. 3 of the 5 trials have gone live and commenced recruiting clients. The remaining 2 trials have not begun to recruit clients due to the need to develop their capacity further prior to going live.

Hospital Care Strategies, including:

National Demonstration Hospitals Program (NDHP);



Measure

Result

Quality:

Lessons from NDHP are promoted and widely disseminated as good practice innovations.



The Department facilitated dissemination of lessons from NDHP by organising the February 2003 conference ‘The 21st Century Hospital: Innovative Care for Older People’.

Quantity:

All Australian hospitals receive periodic information about NDHP projects.



The Department’s periodic newsletter about NDHP projects, Innovative Hospitals, was distributed to all 707 public hospitals in Australia.

hospital innovation;

Measure

Result

Quality:

A range of hospital based approaches to improve services for older people are identified, tested and promoted throughout the health care sector.



The National Demonstration Hospitals Program Steering Committee selected 30 public hospitals to participate in NDHP 4. The hospitals are developing, trialing and implementing a range of measures to improve services, including streamlined assessment procedures, electronic health records development, falls prevention, medication safety and consumer engagement.

NDHP consortia are established which include hospitals from a number of States and Territories to facilitate the transfer of effective models.

Hospitals from all States and Territories except Tasmania are participating in NDHP 4. Each of the 5 consortia of hospitals comprises a mix of hospitals from various jurisdictions.

Quantity:

Hospital based innovation projects are established in up to 30 participating sites.



30 hospitals are participating in NDHP 4.

Australian Refined Diagnosis Related Groups (AR-DRG) classification and national hospital cost and benchmarking data;

Measure

Result

Quality:

Updated and refined the casemix classification, cost weights and supporting reports for hospitals and funders.



Version 5.0 of the AR-DRG classification was released in September 2002. Classification work on emergency departments, outpatients, allied health and sub and non acute care was a major focus during 2002-03.

Quantity:

AR-DRG version 5.0 classification is available to hospitals and funders by November 2002.



AR-DRG version 5.0 delivered in September 2002.

National hospital cost data collection round 5 is reported by August 2002.

Target met. National hospital cost data collection round 5 was released in August 2002.

Comparison and benchmark statistics on privately insured patients up to June 2001 available December 2002.

Target met. Statistics released in December 2002.

plasma products;

Measure

Result

Quality:

Maintain adequate supply of plasma products for Australia’s population.



Product levels were maintained to meet clinical demand and stock the national reserve.

Quantity:

Achieve agreed annual plasma collection target.



The annual plasma collection target for 2002-03 was 267,600 kg. Australian Red Cross Blood Service records indicate they collected 273,875 kg of plasma in 2002-03.

Achieve agreed annual plasma product manufacturing targets in accordance with individual product target levels.

In 2002-03 the level of all products detailed in the Plasma Fractionation Agreement were at or within agreed annual plasma product manufacturing targets.

Bone Marrow Transplantation; and

Measure

Result

Quality:

Facilitate timely access to lifesaving bone marrow treatment.



Assessment of claims for funding under the Bone Marrow Transplant Program are considered a high priority for the Department, and as such internal mechanisms are in place to ensure that claims are treated as urgent and are processed accordingly.

Quantity:

Number of people assisted under the bone marrow program.



137 people were assisted under the Bone Marrow Transplant Program in 2002-03.

National Cord Blood Collection Network.

Measure

Result

Quality:

Facilitate national access to cord blood units, which meet national standards for transplantation as an alternative to bone marrow transplantation.



Continued planning, implementation and management of the development phase of the National Cord Blood Collection Network.

Quantity:

Number of cord units banked against agreed annual targets.



As of 31 March 2003, 2,099 cord units had been banked against the agreed national target for that time of 2,895.

The Australian Bone Marrow Donor Registry has advised that targets have not been met due to the combination of a number of factors, including:

the establishment of fewer collection sites than were anticipated for the period;

transition of collection sites from pilot to operational phase; and

a decrease in the number of births—targets are determined based on previous birth rates.


Mental Health Strategies

National Mental Health Strategy;



Measure

Result

Quality:

Implement the second phase of Auseinet including the engagement of key stakeholders and the development of an agreed workplan.



Measure met. The second phase of Auseinet commenced in January 2001 and implementation continued during 2002-03.

National database available for use by Lifeline, Kids Helpline and ReachOut by December 2002.

As at June 2003 beta version of the database is being trialed. Due to technical difficulties the finalisation of the database was delayed and is due for release by October 2003.

The national database for mental health information, referral and tele-counselling including the engagement of pilot partners is fully operational.

Partners engaged, pilot to take place in second half of 2003. Delays occurred as a result of the technical difficulties experienced in the finalisation of the database.

All specialised public mental health services to collect adult consumer outcomes measures and casemix measures by June 2003.

All states except South Australia are collecting adult consumer outcome and casemix measures. South Australia is currently piloting the measures in 2 services.

All specialised public mental health services to have begun the process of quality improvement (as set out in the National Standards for Mental Health Services) through a suitable review process by June 2003.

All jurisdictions have reaffirmed their commitment to external review of all specialised public mental health services against the national standards for Mental Health Services. Approximately 88% of specialised public mental health services have commenced external review processes, with remaining services to commence review in the near future.

Quantity:

All mental health integrated projects evaluated by June 2003.



All mental health integrated projects have undergone evaluation.

National Suicide Prevention Strategy; and

Measure

Result

Quality:

National and local level National Suicide Prevention Strategy initiatives implemented across population settings and targeting at- risk groups, under the direction of the National Advisory Council on Suicide Prevention.



Measure met. Currently 140 community based suicide prevention initiatives are being funded across Australia to support target groups such as adult males, people with mental illness and Indigenous Australians.

Around half of these projects are targeted toward the priority areas of youth, males and Indigenous Australians.



Mental Health: More Options Better Outcomes.

Measure

Result

Quality:

All components of the initiative implemented by November 2002.



All components were implemented by November 2002, except for part of the access to psychiatrist component (see outcome summary for more information).

Quantity:

Number of GPs registered for service incentive payments.



As at June 2003, 2,680 GPs had registered for the initiative.

Minimum of 4 allied health service pilots in operation.

28 pilots were commenced during 2002-03.

Performance Information for Departmental Outputs


  1. Policy advice in relation to:

new funding arrangements and progress on structural reform in Primary Care;

national issues of concern relating to the integration and coordination of health services;

continuous quality improvement;

delivery of health services to maximise health reforms; and

the development of health policy

Measure

Result

Quality:

A high level of satisfaction of the Ministers, Parliamentary Secretary and Ministers’ Offices with the relevance, quality and timeliness of policy advice, Question Time Briefs, Parliamentary Questions on Notice and briefings.



The Minister and Minister's Office were satisfied with the relevance, quality and timeliness of policy advice, Question Time Briefs, Parliamentary Questions on Notice and briefings.

Agreed time frames are met for responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing.

Agreed time frames were met for:

93% of ministerial correspondence;

97% of Question Time Briefs;

83% of Parliamentary Questions on Notice; and

77% of ministerial requests for briefing.


A high level of stakeholder satisfaction with the quality and timeliness of departmental/portfolio inputs to national policy, planning and strategy development and implementation.

The Third National Mental Health Plan 2003-08 was endorsed by the Australian Health Ministers Advisory Council in May 2003 for submission to the Australian Health Ministers Conference in July 2003.

A high level of stakeholder satisfaction with the relevance, quality and timeliness of information and education services.

The Triage Education Resource Book was well received by emergency department educators and staff in all States and Territories.

Timely production of evidence-based policy research to inform and engage stakeholders in meaningful policy and program discussions.

The General Practice Partnership Advisory Council convened two standing committees covering quality, research, evaluation and development in general practice; and issues impacting on rural and remote general practice.

Quantity:

800-850 responses to ministerial correspondence, 95-115 Question Time Briefs, 5-10 Parliamentary Questions on Notice and 85-100 ministerial requests for substantial briefings.



There were approximately:

911 items of ministerial correspondence items processed;

134 Question Time Briefs prepared;

6 responses to Parliamentary Questions on Notice; and

135 ministerial briefings prepared.


Program management, including:

suitable project approvals in line with agreed strategic plans and service development;

payments under funding agreements;

types of areas:

grant programs;

mental health issues;

acute and coordinated care issues;

information technology issues; and

GP issues;

financial management and reporting for Outcome 4;



Measure

Result

Quality:

A high level of stakeholder satisfaction with the timely development and implementation of national strategies.



Delays have occurred in the implementation of some elements of the Primary Health Care Research Evaluation and Development Strategy. Action is now underway to implement the remaining components in 2003-04.

Budget predictions are met and actual cash flows vary by less than 5% from predicted cash flows.

Measure met through regular monitoring and revision of cash flows. Actual expenses for Outcome 4 were $860.2 million or 95.4% of the Budget estimate of $901.6 million.

100% of payments are made accurately and in accordance with contractual requirements.

Measure met where deliverables were received and accepted in accordance with requirements.

Quantity:

250 contracts; 400 funding agreements; and 85 consultancies.



Actual numbers exceeded estimates in two out of three areas: 355 contracts, 569 funding agreements and 48 consultancies.

distribution of information among consumers, carers and mental health professionals; and

education and training relating to consumer participation in health care.



Measure

Result

Quality:

A high level of stakeholder satisfaction with relevance, quality and timeliness of information and education services.



The release of the Hospital Casemix Protocol and Private Hospitals Data Bureau benchmarking and comparison statistical CDs have been well received by industry groups

Information campaigns conducted during the year are evaluated as being effective.

Australian Organ Donor Awareness Week (AODAW) was conducted in February 2003. The evaluation report supports its effectiveness, and documents that in the month following the 2001-02 AODAW campaign, 4,657 people registered their intention to donate, while in 2002-03 this figure increased to 5,962.

Quantity:

A total of 43 publications published including 7 Casemix; 1 National Demonstration Hospital Programs; 13 general practice strategic development; and 22 mental health and special access programs.



Target met. Publications listed are available or were drafted ready for publishing by the end of 2002-03.

A total of 13,100 calls to telephone information lines (10,600 to the mental health publications line and 2,500 to the general practice help line).

8,150 calls were received to the Mental Health line and over 2,290 calls were made to the general practice help line.

A total of 30 reports, newsletters, bulletins etc. including 4 acute care; 10 general practice and strategic development; and 16 mental health and special access programs.

Target met. Items listed are available for distribution or have been drafted ready for publishing by the end of 2002-03.

Maintenance of 11 websites: 1 departmental site; 1 for general practice; 2 sites for general practice strategic development, 1 site for mental health and special access programs, and 6 sites for acute and coordinated care and the National Demonstration Hospitals Program.

All websites maintained during 2002-03. Development commenced on new website structure to mirror organisational realignment.

6 general practice strategic development audio tapes/CDs produced.

6 audio programs produced and distributed to 18,000 GPs.


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