Prepared by Teresa Anderson

Chief Executive

Steven Carr Director of Finance July / August 2014

Dr Teresa Anderson, Chief Executive Opening and Welcome Dr Teresa Anderson and Mr Steven Carr, Chief Financial Officer Budget Presentation Mr Charlie Farah, Director Performance Monitoring, System Improvement and Innovation STARS Ms Jodi McLeod on behalf of Ms Miranda Shaw, Acting General Manager Community Health Services Sydney District Nursing Dr Teresa Anderson, Chief Executive Questions

Wrap up of 2013/14 GENERAL FUND FOR YEAR TO 30 JUNE 2014

$M VARIANCE TOTAL EXPENSES $1,409.720M $11.187M or 0.79% F (Performing)

TOTAL REVENUE $1,360.055M $10.610M or 0.77% UF (Not Performing)

TOTAL NCoS $49.665M $0.577M F (Performing)

Wrap up of 2013/14 SPECIAL PURPOSE & TRUST FUND FOR YEAR TO 30 JUNE 2014

$M VARIANCE TOTAL EXPENSES $31.3070M $3.242M or 11.55% UF

TOTAL REVENUE $58.999M $7.233M or 13.97% F

TOTAL NCoS ($27.692M) $3.991M F

Wrap up of 2013/14

Facility level financial performance 30 June 14:

SLHD HOSPITAL / SERVICE

2012/13 NCoS ($M)

% 2013/14 NCoS ($M)

%

RPAH $15.072M UF -3.46% $12.000M UF 2.44%

CANTERBURY $3.449M UF -4.44% $3.000M UF 3.44%

BALMAIN $1.429M UF -5.57% $0.698M F 2.62%

IRO $0.488M UF -3.04% $1.256M F 7.53%

SYDNEY DENTAL $0.00M F 0.02% $1.994M F 3.53%

CONCORD $0.483M F 0.21% $5.500M UF 2.18%

MENTAL HEALTH $0.846M F 1.05% $1.249M F 11.49%

THOMAS WALKER $0.065M F 1.42% $0.313M F 6.72%

COMMUNITY HEALTH $2.383M F 9.58% $0.542M F 2.26%

Note: Colour coded to NSW Health & SLHD Performance Framework

2013/14 ACHIEVEMENTS PROJECT EXPENDITURE

SLHD COAG ED SHORT STAY $2.532M

SLHD COAG HVSS Peri-OP/EV-CAP $1.815M

ENDOSCOPY EQUIPMENT RPA AND CONCORD

$2.6 M

LIFEHOUSE MEDICAL IMAGING EQUIPMENT $2.732M

RPAH 3.0T MRI $2.531M

CONCORD ED & ICU MONITORS $0.741M

SLHD WIRELESS NETWORK $1.708M

WORK IN PROGRESS PROJECTS

POWERCHART CARDIOVASCULAR PROJECT $2.613M

MISSENDEN MENTAL HEALTH UNIT $54.505M

CONCORD SUB ACUTE BEDS $7.718M

2013/14 ACHIEVEMENTS More effective & SLHD focused service provision

– Population Health

– Oral Health

– Mental Health

– Drug Health

– Breast Screen

– Payroll

– HRIS

– Child Protection Services

– Community Paediatrics

– CRGH haematology services

– Sydney Health Interpreter Service

– CEWD

2013/14 ACHIEVEMENTS

150,400 people attended emergency departments across SLHD

24,000 operations were performed in our hospitals

145,000 admissions and discharges across our hospitals

6,900 babies were born at RPA and Canterbury

2013/14 ACHIEVEMENTS

Maintained Performance at level 0 for the full year

Came in on budget

Maintained surgical performance at 0,0,0

Significantly improved performance on most KPIs including NEAT

Met the NPA target for Oral Health

Successful Accreditation of Sydney Dental Hospital and Oral Health services, Community Health, Balmain and RPA against National Standards

2013/14 ACHIEVEMENTS Transition of selected non-admitted cancer

services to Lifehouse on 18 November 2013

Establishment of the Health Equity Unit

Establishment of the Population Health Observatory

Enhancement of RPA toxicology services

Development of STARS

Establishment of the Innovations group and Innovation Symposium

Commencement of Concord ERAS project

2013/14 ACHIEVEMENTS

Establishment of Sydney Research

Establishment of the Clinical Research Centre

Establishment of the RPA Institute of Academic Surgery

Planning for the Clinical Research Facility at Charles Perkins

Enhancement of Hospital in the Home

Enhancement of Sydney District Nursing and mobile devices

2013/14 ACHIEVEMENTS

Completed the renovations of Yaralla House and relocated the HIV/AIDs Dementia Services

Establishment the program for the Physical Wellbeing of people living with a mental illness (ccChip) (Living Well, Living Longer)

Development of the implementation plan for and enhancement of Organ Donation for Transplantation

Commencement of the Patient and Family Centred Care Program

Refresh of CEWD

Refresh of our websites

2013/14 ACHIEVEMENTS

Significant progress with the launch of Health Pathways and development of approximately 150 HealthPathways in partnership with the IWSML

Completion and Launch of “Hello Baby” Parenting with Confidence a Tresillian Guide by Catherine Fowler

Installation of NSPs at Redfern and RPA

Introduction of Pets as Therapy at Balmain Hospital

Establishment of the first outpatient detox service for Aboriginal people

2013/14 ACHIEVEMENTS

Completion of the Survivorship Centre at Concord Hospital

Completion of construction of the new Palliative Care Centre at Concord Hospital

Upgrade of the Skin Laboratory in the Burns Unit at Concord

HAI Collaboration for Excellence Redesign project at Concord Hospital

Ongoing development of the relationship with the AMS Redfern

Overview of the Service Agreement

Goals NSW 2021: a Plan to make NSW Number one

– Keeping people healthy and out of hospital

– Providing world class clinical services with timely access and effective infrastructure

CORE Values

active engagement of LHD and other Health Services with the NSW Health Performance Framework.

Priorities:

– Building healthy communities

– Integrated care

– High quality, sustainable services

Strategic Context

The Service Agreement is a key component of the NSW Health Performance Framework for LHDs and other health services. The Framework:

– has the over-arching objectives of improving service delivery, patient safety and quality

– provides a single, integrated process for performance review, escalation and management

– provides a clear and transparent outline of how the performance of LHD is assessed

– outlines how responses to performance concerns are structured to improve performance

– operates in conjunction with the Purchasing Framework and the Activity Based Funding Guidelines.

Performance Framework

Strategic Themes for 2014/15

Key strategies

Specific Focus Areas for 2014/15

Local Accountability and Clinician Engagement

Integrated Care Strategy

Whole of Hospital Program

Public Specialist Outpatient Services

Reducing Smoking Rates among Aboriginal Populations

Workplace Culture

Transition Grant

Capital Program

Grossed up Private patient service adjustment

2014-15 National Health Funding Body Service Agreement

Budget principles The District is holding a contingency of $30M (to meet

additional patient demands, unforeseen equipment replacement or other unexpected District costs)

To derive the Contingency:

– NWAU paid to facilities at SLHD price rather than State Price for Non-Admitted activity

– NWAU growth paid at 50% of SLHD price - recognising service extension is often at marginal costs

– Partial use of Transition Grant

Budget principles Facility budgets built using ABF & Costing data pillars:

1. Activity funding pool developed

2. Activity funding separated by facility & program using Program Costing Fractions

3. Block funding allocated (eg Dental, AIDS, NGO grants)

4. Minor true up / entity alignment to account for ABF knowledge and data imperfections

LHD NWAUs X SLHD PRICE

Budget principles MoH efficient escalation rate is 1.9% for 2014/15. Escalation rates

for SLHD entities varies, but in general are around the 1-2% range

Facility base budgets include: $4.224M of Chief Executive identified strategic priorities:

NAME FY2014/15 Enhancement

Expenditure Budget

Centre for Nursing Research $0.120M

Institute of Academic Surgery $0.525M

Palliative Care Establishment $0.215M

Missenden Eating Disorders $0.923M

Missenden Short Stay Unit $1.436M

Missenden Assessment Unit $0.717M

Population & Public Health Unit Enhancements $0.200M

Budget principles $6.723M of CE approved GM requested enhancements including:

Facility/Services Short Description Cost ($) 2014/2015

Community Health Services Child & Family Health Nurses (3.0fte) $287,403

Canterbury Recurrent funding for Emergency Medical Unit (EMU) (14.84FTE)

$1,494,464

Recurrent Funding Drug Health Staff $780,000

Concord Haematology Staff Specialist Concord $165,350

Senior Assessment Service $408,000

RPAH Upper GI VMO $400,730

Palliative Care JMO $72,000

SLHD/Salary Packaging Salary Packaging Officer $62,557

SLHD/Human Resources Aboriginal Admin Trainee $29,638

Performance Unit STARS Application Developer $92,397

Population Health HARP Manager $200,000

Public Health Observatory $180,000

Mental Health Acute “Crisis” Community $74,000

Dietician $45,000

Exercise Physiologist $65,000

Other Enhancements Planned

Clinical Academic Organ Donation for transplantation (Trust fund 2014/1- $200K)

Respiratory Enhancement (CNS)

Endocrinologist for the ccChip (0.3 FTE)

Imaging Equipment (Trust funds – capital cap relaxed)

Relocation of renal services to NW precinct

Additional Public Dental Services - $5.8M

Budget principles Internal Predictive Tool again used to guide cash flow of

expenditure & revenue budgets.

– Hospital ERE costs forecast by facility using linear regression with OBD and Days in Month as variables.

– G&S & RMR flowed evenly 1/12th

– Individual predictive models available for most facilities

Budget principles SLHD ERE Expenditure Predictor 2014/15

2014/15 Budget from MoH SLHD Total Expenditure Budget is:

– MoH presents budget escalation on prior year annualised budget – this is a 4.01% increase for SLHD

– $1.309M enhancement for 10.22 FTE Clinical Nurse Educators & Clinical Nurse Specialists

$1.468 BILLION GENERAL FUND SP&T

$1.440B $28.664M

2014/15 Budget from MoH SLHD Total Revenue budget is:

– Own Source requirement is a $10.649M or 4.481% increase on 2013/14

$1.430 BILLION Govt Contribution SP&T Own Source

$1.182B $33.0594M $215.039M

Activity NWAU Prices 2014/15

NWAU prices:

– State Price = $4,583

– MoH determined SLHD Price = $4,477

Lifehouse NWAU midpoint of RPA & Concord

Facility NWAU Prices 2014/15

Includes price adjustment to reflect complexity

SLHD Weighted Average Price Hospital/Service

NWAU 2014/15 ($)

RPA 4,289

Lifehouse Australia 4,193

Concord 4,096

Mental Health 3,523

IRO 3,776

Balmain 3,339

Canterbury 3,652

2014/15 NWAU Activity SLHD NWAU activity targets

Note: 6,679 NWAU Transition Funding not included above

2014/15 MOH Revenue Budget Build for SLHD

Next steps 22 - 31 July 2014 – CE issues budget letters to facility GMs including

budget, activity and FTE targets. Summaries posted on internet (link is www.slhd.nsw.gov.au/budget.html)

31 July 2014 - Revenue & Efficiency Roadmap strategies finalised

District Budget Roadshows/Presentations

– 28 July 2014 – RPA – 7.30am

– 31 July 2014 – CEWD– 5.00pm

– 1 August 2014 - Concord – 12.00pm

Continue strong governance over financial performance:

– Monthly distribution of modified monthly finance reports.

– CE & DoF performance meetings with GMs.

– Continued monthly performance reporting to FRAP.

– Monitoring of Revenue & Efficiency Improvement Roadmaps.

End

Questions?