YEAR IN REVIEW2017-2018

MURRUMBIDGEE LOCAL HEALTH DISTRICT

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MURRUMBIDGEE LOCAL HEALTH DISTRICT Level 1, 193-195 Morgan Street Locked Bag 10 Wagga Wagga 2650

mlhd-feedback@health.nsw.gov.au www.mlhd.health.nsw.gov.au

Table of Contents..................................................................3From the Board Chair ...........................................................4About Us ...............................................................................5From the Chief Executive .....................................................7Snapshot: Key Activity in 2017-2018 ....................................8Every 24 hours in health .......................................................924 hours in MLHD facilities ...................................................9Performance Dashboard ......................................................9Key Achievements ..............................................................10Focus on Wellness .............................................................12Aspire to Excellence ...........................................................16Together in Partnership ......................................................18Enhancing Aboriginal Health ..............................................20Invest in Our People ...........................................................22Reward & Recognition ........................................................28Compassion & Dignity ........................................................30Infrastructure Developments ..............................................32Executive Leadership Team ...............................................34Our Board ...........................................................................36Abbreviations and Glossary................................................38

CONTENTS

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One of the highlights from the 2017-2018 year was the 2017 NSW Health Awards.

Murrumbidgee Local Health District (MLHD) took out two State Awards: Belinda White was named NSW Volunteer of the Year and Thomas Glanville NSW Staff Member of the Year. Belinda and Thomas used their skills in a visionary manner to improve the health care of residents in MLHD.

Belinda White demonstrates the important role volunteers play in MLHD. Whenever I visit a facility I observe volunteers participating in many ways such as massaging hands and trimming finger nails, cooking barbeques, conducting church services,

joining in craft activities, or just chatting about the old times. Many of these volunteers have actively supported the Living Well in MPS program. At Narrandera, the Soroptimists Club conduct a weekly health maintenance program for patients who have chronic and complex conditions.

Some volunteers work directly with patients and residents while others raise money such as the United Hospital Auxiliaries (UHA). UHA’s are long-standing partners in providing safe quality care in our facilities. Under the leadership of State President, Linda Swales from Batlow, they raise tens of thousands of dollars. Resources purchased, such as electric beds and bariatric equipment, assist patients and nursing staff by reducing injuries and providing a more comfortable stay in hospital.

Our 33 Local Health Advisory Committees (LHAC) members are very valuable volunteers who freely give their time to act as the link between health and the community. Throughout the year there have been many examples of LHACs taking the lead for their communities such as the new Deniliquin renal service, Finley Emergency Department upgrade, a new service for Barham and the opening of the Holbrook Multipurpose Service.

Two successful LHAC forums held during the year gave members an opportunity to share their ideas and gain more understanding of the health needs of their communities. Congratulations to Tocumwal, Adelong,

Batlow and Tumbarumba for organising such informative forums for their peers.

Thomas Glanville, as NSW Health Staff Member of the Year, is one of many MLHD staff members who are willing to take on a leadership role to improve the health care we deliver. Thom is a leader who uses data and research as a foundation in all he does.

Research has been a priority for MLHD during the year supported by the Board, Executive and universities. For our Junior Medical Officers research and data is a way of life – they are excellent role models. I recognise Board Director Tom Douch for his leadership in this area.

I thank all our staff for the compassionate and safe care they give our patients and residents. I acknowledge your willingness to work at a high level by maintaining your skill level and looking for ways to improve your competencies.

I acknowledge the People and Culture team for the creative way they are working with staff to keep them safe, fit and well. As an organisation we must ensure the wellbeing of our staff. During the year the Board took a stance to stamp out aggression and bullying in our all our facilities. Our staff should be respected and not subjected to aggression and bullying from patients, carers or peers.

The MLHD Board Directors have also taken on new leadership roles this year in Quality and

Safety. Each Director has become a sponsor for one of the eight National Safety and Quality Health Service Standards. This year a Board renewal for Directors commenced with three Directors being considered for reappointment and two vacancies to be filled. This is an excellent opportunity to ensure the Board has the skills needed to function at the highest level. Director Carl Cooper resigned from the Board during the year and we thank Carl for his input into the Board and District.

Finally I would like to acknowledge the leadership of our Chief Executive Jill Ludford and her Executive. The Executive work beyond their scope of practise to maintain MLHD at a high functioning level. They have patients at the centre of everything they do. I also acknowledge the valuable and timely support we receive from NSW Health and the Health Pillars.

Gayle Murphy Board Chair

From the Board Chair

Murrumbidgee Local Health District (MLHD) spans 125,561 square kilometres across southern NSW, stretching from the Snowy Mountains in the east to the plains of Hillston in the northwest and all the way along the Victorian border.

As the largest employer in the region, with over 5,000 healthcare staff work working across 33 hospitals and 12 primary health care centres, we are supported by hundreds of volunteers who make an invaluable contribution to enriching the lives of people in our care.

Our Role The communities we support are diverse, with approximately 242,840 people in communities large and small across the region. We strive to support people to live the healthiest lives possible and to provide services as close to home as possible. Our vision is to provide excellence in all elements of health care and superior service to all of those we serve. Our values of collaboration, openness and respect, empowers us to embrace cultural diversity and to treat all people with dignity and compassion.

Our PrioritiesWe will become known as the best place to work, lead, practise, volunteer, teach, learn and grow. Our four key priorities are: • Focusing on wellness• Aspiring to excellence• Investing in our people• Working together in partnership

Our services are provided through:• 1 Rural Referral Hospital• 1 Base Hospital• 8 District Health Services• 5 Community Hospitals• 16 Multipurpose Services• 2 Mercy Health Public Hospitals• 12 Community Health Posts• 1 Brain Injury Rehabilitation Service

ABOUT US

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Murrumbidgee Local Health District (MLHD) strives to provide health care of the highest standard which is accessible to all people across our rural landscape.

On behalf of the Murrumbidgee Local Health District, we are proud of our commitment to enhancing healthcare for our people, and to our communities for their support for our health services.

Our organisation remains focused on providing affordable, effective and accessible healthcare in an environment of rapid change and complexity. Our strategies are positioning the organisation to be digitally enabled, consumer centric and have flexible operating models, all with an unwavering focus on quality and safety. We work to deliver value based clinical care that takes into consideration our regional context, with a focus on providing evidenced based practice. We are progressing important work with our clinicians to develop models of care across both community and hospital settings.

I extend my thanks and appreciation to the Board who drive our pursuit of excellence in ensuring we are a leader in healthcare. We are always aiming toward being an employer of choice and a point of pride for all our staff.

As Chief Executive, I am particularly proud of the achievements of our staff which were recognised on the statewide stage this year.

We were thrilled when MLHD won two awards at the 2017 NSW Health Awards: Staff Member of the Year, Thomas Glanville, and Volunteer of the Year, Belinda White. The awards recognise innovation and excellence in the delivery of health programs and services to the NSW community and both of our winners are extremely worthy recipients.

For an unprecedented three years in a row, a Wagga Wagga Base Hospital (WWBH) Junior Medical Officer was awarded the NSW State Junior Doctor of the Year. Dr Thomas Melhuish was recognised at the NSW Health and Australian Medical Association’s 2017 Doctor-In-Training Awards for his leadership, clinical excellence and passionate dedication to rural health.

The Stroke Unit at WWBH was ranked the best in NSW for access to care, early rehabilitation and patient education in the 2017 Stroke Foundation audit of 44 NSW hospital services.

We are also leading the way in the introduction of new services for our communities. We launched the first public hospital service in regional NSW to provide access to surgical weight loss management and also a new midwifery led maternity service in Leeton to provide coordinated care for normal risk women to birth in their local hospital. Our new Community Care Intake Service to help link people to

community health services in their local area, which has received overwhelming positive feedback, celebrated its first birthday.

Our services have been supported with significant infrastructure works, including early works for the third and final Stage of the Wagga Wagga Base Hospital redevelopment and master planning for Griffith Base Hospital redevelopment.

Our two base hospitals in Griffith and Wagga Wagga are supported by a network of district hospitals, community health services and multipurpose services. A refreshed Holbrook Health Service was opened in August to better serve aged care residents. A new renal unit at Deniliquin opened in March to provide a new local service for renal patients and minimise travel time. Sod turns were held for the start of new facilities for Barham and Tumbarumba and work on a reconfigured Emergency Department at Finley and a new multipurpose service in Culcairn. At Young Hospital, a quiet room was opened in the Emergency Department to provide a safe and welcoming space for patients who need privacy.

We continue our focus on community engagement and our Local Health Advisory Committees are actively engaged in health promotion and community education activities. Two forums helped members develop skills to actively advocate for their

communities and educate local people about how to access local services.

I value feedback and most enjoy visiting our sites to meet with staff, patients and our communities to find out about their health experiences and how we can continue to build on and improve our services.

I also wish to acknowledge the ongoing support of our dedicated volunteers for the valuable work they do every day to improve the comfort of our patients and support our staff.

Finally, I am passionate about ensuring every patient who comes in contact with us has a positive experience that contributes toward their comfort, recovery and wellbeing.

Jill Ludford Chief Executive

From the Chief Executive

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Snapshot: Key Activity in 2017-2018

148,694patients presented to our Emergency Departments

23 peoplehospitalised due to assault by a spouse or domestic partner

68,985admissions to MLHD facilities

739,187non admitted episodes of care

$582.1Mannual expenditure budget

2,091babies born

357 people admitted with stroke

108 people diagnosed with end stage kidney disease on admission

671 people admitted with heart attack (heart disease)

3,174full time equivalent staff (over 4,452 staff in total excluding agency staff)

97.6%elective surgery access performance (% of patients admitted within clinically appropriate time)

94.18%transfer of care from ambulance to Emergency Department within 30 minutes

84.09%Emergency Department patients treated within four hours

14,889 elective surgery procedures were carried out

11,689day only surgical procedures were performed

4.23% unplanned hospital readmissions within 28 (target = 5.6%)

Data at end of Financial Year June 30 2018

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Every 24 hours in health122 people are aged 16 to 74

18 are children aged less than 16

21 people have potentially preventable conditions

49 people are over 75 years old

6 people admitted to hospital for mental health conditions

Australia* MLHD facilities

Presentations made to public hospital emergency departments 21,400 407

Hospitalisations in public hospitals 17,300 189

People hospitalised due to an injury 1,300 13

Elective surgeries performed 6,000 41

Babies are born 850 6

People die 440 3

Services provided in public hospital outpatient clinics 91,500 2,025

Spent on health (total) $467 M $1.5M

TARGET ACTUAL

Get Healthy Information and Counselling Service - Referrals (number of people) 218 195

School Program Live Life Well@School (reach) 80% 83%

Early Childhood Program Munch and Move (reach) 80% 93%

Aboriginal Children Fully Immunised (under 15 months) 92% 95.8%

Non-Aboriginal Children Fully Immunised (under 15 months) 92% 94.9%

Aboriginal Children Fully Immunised (under 63 months) 93% 97.7%

Non-Aboriginal Children Fully Immunised (under 63 months) 93% 96.4%

Fall-related injuries in hospital (per 1,000 bed days) 3 1.5

Mental Health presentations staying in Emergency Department more than 24 hours 0 2

Aged Care Assessment Team (ACAT) - average time from ACAT referral to delegation for admitted patients (days) 5.0 2.9

24 hours in MLHD facilities

* Source: Australia’s health 2018: in brief; Australian Institute of Health & Welfare www.aihw.gov.au

Performance Dashboard

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Key Achievements Key achievement this year included:

Deniliquin Renal Unit Open In March the $961,000 nine-chair renal dialysis unit at Deniliquin Health Service was officially opened. The satellite service more than doubles the capacity and the new unit can accommodate up to nine clients per session. Six local nurses received specialised training.

Griffith Redevelopment The NSW Government committed $35 million for Stage 1 of the Griffith Base Hospital redevelopment. The $6 million funding allocation in the 2018-2019 financial year allows the project team to complete planning, continue early works and pending planning approvals, main works construction is expected to commence in 2019.

Stroke Unit Top Performer Wagga Wagga’s Acute Stroke Unit, one of the highest performing in NSW, celebrated its 10th birthday in February. The five-bed unit at Wagga Wagga Base Hospital (WWBH) provides acute stroke care for patients across MLHD and is a critical part of education and training for medical, nursing and allied health staff in the region. The 2017 Stroke Foundation audit of 44 NSW hospital services ranked WWBH the best in the State for access to care, early rehabilitation and patient education. The Wagga Wagga Stroke Unit outperformed the majority of NSW stroke services, including city metropolitan hospitals, in 20 of 22 key performance indicators of stroke care.

Since opening there have been more than 2,800 admissions to the acute stroke unit, with admissions increasing each year.

Weight Management Service Launched Wagga Wagga was the first public hospital in regional NSW to provide access to weight loss management with the launch of the new Metabolic Obesity Service in May.

The $657,000 service was funded by the NSW Government in the 2017-2018 financial year. The service is suitable for a select number of people with obesity-related diseases, who have tried other weight-loss programs without success, are non-smokers and are over the age of 18. The service will work with the patient’s General Practitioner to provide healthy lifestyle education and counselling as part of an extensive and essential pre-surgical program tailored to individual needs.

Real Time Patient Satisfaction Survey Tumut Health Service was the trial site for the electronic patient satisfaction survey pilot project for MLHD. The project was run in conjunction with the NSW Agency for Clinical Innovation from April to July 2018. The purpose of the project was to trial the use of electronic devices to capture patient feedback in real time and identify future values of using live data collection to capture patient feedback. At the conclusion of the trial the site provided feedback on what worked well for consumers, challenges identified and managers experiences related to how the data was captured and relayed back.

NSW Junior Medical Officer Award For an unprecedented third year in a row, a doctor from Wagga Wagga Base Hospital won the NSW Junior Medical Officer (JMO) of the Year Award. Dr Thomas Melhuish was recognised at the NSW Health and Australian Medical Association’s 2017 Doctor-In-Training Awards for his leadership, clinical excellence and passionate dedication to rural health.

New Model of Care Leeton Hospital launched a new midwifery-led model of maternity care in November. The new model supports normal risk women to have their babies in their local facility under the care of skilled midwives.

Living Well in Multipurpose Service (MPS) Program MLHD in collaboration with the Agency for Clinical Innovation implemented the Living Well in MPS concept and the use of the Agency’s Plan-Do-Study-Act Portal across 21 facilities. The portal enables teams to share ideas and learnings, to network with discussion on similar topics and access a library of resources all incorporating the eight principles of care.

Workshops and community of practice meetings have involved staff from several professional domains; nursing, activity officers, patient support services. Three working parties were established to focus on available resources, documentation and assessment and leisure and lifestyle to continue to improve lifestyle options for residents in our care.

Remote Medical Consultation Service The Patient Flow & Transport Unit celebrated the commissioning of the Remote Medical Consultation Service which delivers expert medical support for patients requiring medical treatment without the need for transfer to specialist care. The service is delivered remotely using telehealth platforms to support MLHD facilities when a Medical Officer is not available at these facilities.

The service facilitates everything around the delivery of remote medical assistance including medical case management, support for transfer to specialist care if required and opportunities to support local admissions within the cluster.

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MURRUMBIDGEE

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Primary Health Networkof

V I C T O R I A

Murrumbidgee Local Health District spans 125,561 square kilometres across southern NSW, stretching from the Snowy Mountains in the east to the plains of Hillston in the northwest and all the way along the Victorian border.

Our services are provided through:1 Rural Referral Hospital1 Base Hospital8 District Health Services5 Community Hospitals16 Multipurpose Services2 Mercy Health Public

Hospitals12 Community Health Posts1 Brain Injury Rehabilitation

Service

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Focus on Wellness

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Strong health development activities focused on healthy ageing in our communities including falls prevention strategies as well as Stepping On programs and aqua exercise sessions. The Big Vegie Crunch was held on 1 March which saw 48 schools and more than 6,900 students from the District participate in the state-wide record attempt encouraging children to eat five serves a day.

Community Care Intake Service The MLHD Community Care Intake Service (CCIS), which helps local people to link to community health services across the region, celebrated its first birthday in January. The service began with 270 referrals in its first month and now averages 1,400 referrals per month from townships across the region. The service was established to improve people’s access to community health services by tailoring and streamlining their care options in their local area. The CCIS team work closely with local clinicians, including GPs, specialists, allied Health services, hospitals and services providers to arrange care and support. The service continued its District-wide rollout in 2018, ensuring all communities and service provider have access to the benefits of this service.

Leeton Midwifery Model of Care Percy Tiffin was the first baby born under Leeton District Hospital’s new midwifery-led model of maternity care. The new model supports normal risk women to have their babies in their local facility under the care of skilled midwives. Born on 1 December 2017, Percy’s delivery was made all the more special by Midwife Robyn Fraser, who helped bring the Tiffin’s two other children into the world. The introduction of this model of care has reinvigorated the Leeton maternity service and transformed the midwives’

ability to care for local women and families. The Leeton Midwifery practice has a close working relationship with the obstetricians and the maternity service at Griffith Base Hospital where they can consult and refer any women when required. The four local midwives have assisted in the birth of 11 babies and provided close to 200 antenatal and postnatal visits service since the service commenced in November 2017.

Chronic Obstructive Pulmonary Disease A Wagga Wagga Base Hospital (WWBH) initiative to improve the care of people with Chronic Obstructive Pulmonary Disease (COPD) was launched in June. The new program will improve coordination of patient care, from acute hospital admission, transfer of care & discharge planning, to supporting people to manage COPD at home. COPD includes emphysema and chronic bronchitis which cause conditions including increasing shortness of breath and a repetitive cough. The initiative was launched as part of ‘COPD Week’. The COPD initiative is part of MLHD’s involvement in the NSW Ministry of Health’s Leading Better Value Care program which focuses on improving patient health care experiences and outcomes.

Accessline AccessLine, the MLHD mental health and drug alcohol telephone triage, information, advice and referral service, celebrated its 20th anniversary in June. AccessLine was a ground-breaking initiative when it was implemented in May 1998. Today, AccessLine handles more than 2,300 calls every month from people across MLHD, providing access to mental health services in remote and rural areas. The telephone triage service provides 24 hour / 7 days per week support, advice and referral to mental health and drug and alcohol services for people anywhere within

MLHD. The service is operated by Medibank Health Solutions, which provides the trained mental health clinicians and advanced technology to assist people seeking mental health or drug and alcohol support and advice. If you or someone you care about has a mental health or drug or alcohol problem and you would like to talk to someone, call AccessLine on 1800 800 944 (freecall).

Dramatic Minds In August, four local schools in Young took part in the inaugural Dramatic Minds Festival to promote mental health knowledge and reduce the stigma of mental illness in young people and the community. MLHD’s youth mental health team established the festival in Wagga Wagga in 2008 and it has since expanded to Albury, Tumut, Temora, Griffith, Deniliquin and now Young. Students are asked to research, write and present an original 10 minute performance on their chosen topic of youth mental health. The performances focus on the causes, occurrence, outcomes, help-seeking behaviour, hope and breaking down stigma.

Wound Prevention & Management A Wound Prevention & Management framework was released in February to improve care for people with acute or chronic wounds. The framework aims to create greater consistency in wound care and management provided by a multi-disciplinary team of health professionals. Launches were held at Wagga Wagga and Griffith and via skype for a two week period for the outlying sites. A four week education series followed to reinforce the use and implementation of the framework.

Aged Care Outreach Service MLHD’s Aged Care Service made its maiden outreach flight to Lake Cargelligo in November, expanding to become a truly

regional service. Geriatrician Professor Paul Finucane and Aged Care Nurse Practitioner Danielle Kennedy were on board the first flight to the outreach clinic, which aim to provide assessment and management of older people and referrals may be indicated for comprehensive geriatric assessments, medication reconciliation, symptom management, cognition (dementia, delirium, behavioural and psychological symptoms of dementia), falls prevention/management and incontinence.

Acute Rehabilitation Service The Acute Rehabilitation Service at Wagga Wagga Health Service (WWHS) celebrated its first birthday in December. The team is integrated with the acute medical and allied health teams to increase therapy to patients while they are still unwell. This early intervention aims to reduce the length of stay in hospital and prevent and/or reduce the need for an inpatient rehabilitation admission. The acute rehabilitation team has provided programs to more than 200 patients since January 2017, allowing many to avoid a lengthy inpatient rehabilitation admission.

Domestic Violence NSW Health and MLHD encouraged the community to speak out against domestic violence. Staff were invited to participate in events in Temora, Deniliquin, Corowa, Narrandera, Wagga Wagga, Young, Gundagai and Griffith, sending the strong message that domestic violence is a crime and that no woman, man or child should be living in the shadow of domestic violence. MLHD supports and fosters the health of those who visit our wards, outpatient clinics and consulting rooms.

Domestic Violence victims are now receiving support around the clock at Wagga Wagga Base Hospital with the implementation of

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a new pilot program which is leading the State. The program allows domestic violence and sexual assault victims access to specially trained staff within an hour of their arrival at the health service, providing contemporary patient care for those in need.

The Emergency Department plays a pivotal role in providing a response to women experiencing domestic violence. Within an hour a domestic violence victim could be sitting in one of our family rooms with a trained psychologist or social worker, who is able to identify their individual needs and provide support.

Got it! A new team of clinicians began working with schools across MLHD to support families with children with challenging and anti-social behaviour. The Got It! initiative - a partnership between the NSW Ministry of Health and the NSW Department of Education provides support and practical assistance to help children get the most out of the opportunities available to them. In 2017, the Got It! team screened more than 700 children and followed up with more than 200 families where children were experiencing difficulties managing their emotions, conduct and peer relations. More than 40 families participated in specialised child/parent programs.

Quiet Space Dedicated quiet spaces which provide a safe and private area for mental health and other patients in the Emergency Department was opened at Young District Hospital.

The project was a collaboration between NSW Police, NSW Ambulance, the Young Local Health Advisory Committee and MLHD nurses, medical practitioners and mental

health services and consumers. The furniture and décor of the room were especially chosen to create a soothing setting to improve the comfort of patients and their family or carers.

Wagga Wagga Base Hospital partnered with Ronald McDonald House to deliver an appropriate space for families with sick children. The room is located on the paediatric ward and can also be used by maternity ward patients.

Patient Wi-Fi A new Wi-Fi service at Wagga Wagga Base Hospital and Griffith Base Hospital is keeping patients and visitors connected to family and friends, giving access to entertainment and helping them manage their everyday lives, thanks to a partnership with eHealth NSW. The Wi-Fi system has a free and paid service, with the premium option being better for activities that require faster download speeds. All appropriate internet security filters are in place, and most patients use the service for video communication, streaming music and videos and social media. The Wi-Fi has already made a big difference to the care provided and the way patients and visitors stay connected while in hospital.

Tumut Wellbeing Coordinator A partnership between MLHD and Snowy Hydro saw the appointment of a Wellbeing and Health In-reach Nurse Coordinator for schools in the Tumut region. Snowy Hydro has committed $520,000 over two years to support two new nurse coordinators based at Tumut and Cooma. The nurse coordinator’s role is to improve student health and wellbeing by identifying health needs early and coordinating timely access to suitable, youth-friendly services.

Volunteers keep communities moving This year we saw the Physical Activity Leader Network continue to grow and reach more communities across the District. Thirteen new Gentle Exercise leaders joined the network. The new leaders outreachto to smaller and more remote communities of Booligal, Weethalle, Walla Walla, Mulwala and Lake Cargelligo.

An additional 11 volunteers were trained to deliver aqua classes, resulting in the delivery of the most number of classes yet. Forty two aqua classes were offered weekly across the District during summer. The growth allowed access to more communities including Barham, Moulamein and Harden.

Tai Chi volunteers refreshed their teaching skills and are leading 45 classes every week. The volunteer programs enable up to 1,500 people per week to take part in low-cost active ageing programs. For information on class locations please visit www.activeandhealthy.nsw.gov.au

Falls Prevention Forum MLHD hosted more than 185 participants at the NSW Falls Prevention Network Rural Forum in Wagga Wagga in March. The forum gave rural health care workers, clinicians, researchers, health specialists and volunteers the opportunity to connect and share ideas on how to prevent falls.

A wide range of speakers covered the latest research information on prevention strategies, as well as informative evidenced base information and discussions.

Mental Health in focus During Mental Health Month in October, MLHD promoted the importance of early intervention on positive mental health

and wellbeing as well as working to further reduce the stigma associated with mental health in the workplace and wider community. The 2017 theme was “Share the Journey”, highlighting the significance of social connectedness in everyone’s journey to better mental health and our ability to cope with life’s challenges.

Mental Health Recovery Program The Wagga Wagga Mental Health Recovery Program has been hailed a success with around 80 people graduating from the program annually. The program offers a unique service to people with a mental health problem by providing an eight-week residential course of psychoeducation and support. Graduates benefit from a holistic approach including working on sleep, diet, exercise, relationships, emotional well-being, activities and self-care. The Mental Health Recovery Program accepts program graduates who have excelled in their achievements to come back and share their experience and skills with current consumers. As a result one volunteer won the 2017 NSW Health Volunteer of the Year Award.

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Aspire to Excellence

No harm to any patient anytime.

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No harm to any patient anytime.

In 2017-2018 more than 68,000 people were treated in hospitals and multipurpose services across the District. In addition, consumers received 740,000 service events in the community or through outpatient services.

Setting an example for championing quality and safety, all Board members participate in Quality Patient Care and Safety meetings which take place in local hospitals to enable a quality walk-around with clinicians.

Accreditation MLHD achieved ongoing accreditation for the National Safety and Quality Health Service Standards in 2018. Three surveys were conducted across MLHD and included all hospital services to enable MLHD to be accredited until November 2020. Accreditation is public recognition that MLHD has achieved quality and performance standards demonstrated through an independent external peer assessment.

Antibiotic Awareness Australia is one of the highest users of antibiotics in the developed world. During Antibiotic Awareness Week in November, MLHD acknowledged the global importance of this public health issue. Patients with infections due to resistant bacteria have delayed recovery and their treatment may not be effective, meaning they are likely to have a prolonged recovery and suffer higher rates of morbidity and mortality. A number of education sessions at hospitals across the district were held during the week, focusing on national and local strategies to combat antimicrobial resistance.

Patient Flow & Transport Unit The MLHD’s Patient Flow & Transport Unit celebrated a milestone in May, with the coordination of its 20,000th inter-facility

patient transfer across the MLHD, ACT, Victoria, South Australia, Queensland and tertiary facilities. The patient being transferred was Olivia Kennedy-Manns and her daughter Ellie with Dad, Mick Murray.Olivia and Ellie were transferred to WWBH’S Special Care Nursery where Olivia says they received ‘beautiful care’.

Disaster Preparation Wagga Wagga Health Service conducted a disaster response exercise in collaboration with the NSW Ambulance Service, NSW Health Pathology and HealthShare NSW. Exercise Bravo Charlie utilised a tool called Emergo Train System (ETS) to test the hospital response in real time but in a simulated or “mock” environment. The ETS tool provided movable markers called “Gubers” on a magnetic whiteboard to represent patients being treated in hospital. Exercise Bravo Charlie highlighted areas where the hospital managed very well and identified resources and processes that can be improved. Improvements are currently being incorporated into the Wagga Wagga Health Service Disaster Response Plan.

Hand Hygiene Training Twenty five MLHD staff undertook the Gold Standard Assessor (GSA) Hand Hygiene Auditor training in Narrandera in May to improve healthcare worker hand hygiene compliance and patient safety. There are currently 107 Active Hand Hygiene Auditors across MLHD. World Hand Hygiene Day was heavily promoted across MLHD sites during the first two weeks of May through creative hand hygiene messages. This year’s campaign focused on the prevention of health care-associated sepsis through hand hygiene and infection prevention and controls action.

Cootamundra Health Service was awarded top honors for their song lyrics (and video

clip!) ‘Thinking about hands’. Boorowa MPS also helped spread the hand hygiene awareness message with a video.

Digital Medical Imaging The Radiology Information System (RIS) Patient Archiving Computer System (PACS) team developed an innovative way to enable clinicians to view medical images of critically ill patients. The RIS PACS team provides vital support services and maintains software for medical imaging across MLHD, supporting clinicians to provide care to critically ill patients and make decisions regarding patient transfer to tertiary level care.

EDISON Program MLHD employees leapt at the opportunity to develop, grow and implement their ‘bright ideas’ through the new Edison Program. The program is aimed at developing, planning, resourcing and implementing small-scale process improvement initiatives by frontline and operational staff.

Three finalists pitched their ideas to a judging panel at the March District Leaders Forum in Corowa. Ashley Schipp from Young, Beau Dupan from Wagga Wagga and Annie Nichols from Temora were all acknowledged for their exceptional, innovative ideas.

A financial contribution of up to $1,000 was provided to support each successful application.

• Ashley Schipp entered ‘Love Bites’ Program which engages young people in their own community to campaign around the issue of domestic violence and assault.

• Beau Dupan pitched the implementation of finger prick methodology for the testing of activated partial thromboplastin time results (APTT). The APTT is used to measure the effects of treatment with intravenous Herapin therapy to ensure that the blood is not too thinned or too thick.

• Annie Nichols pitched her design for a virtual fracture clinic at Young.

EDISON PROGRAMSUCCESSFUL APPLICANTS

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Together in Partnership

“Walking with a friend in the dark is better than walking alone in the light.” - Helen Keller

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Mental Health Alliance The Murrumbidgee Mental Health and Drug and Alcohol Alliance initiated an integration project to improve the experience of care and health outcomes for consumers, their carers and families with multiple agencies involved in providing services in the Murrumbidgee. The goal of the project is to design a contemporary, cross-agency model of care which supports integrated mental health drug and alcohol service delivery.

2017 NSW Rural Health & Research Congress The sixth annual NSW Rural Health and Research Congress held in Wagga Wagga in September provided an opportunity for rural health workers, service providers and researchers to share their knowledge and experience around the theme “Our Future - World Class Rural Health”.

The three-day Congress attracted over 300 Australian and international health professionals, researchers and inspiring futurist speakers.

With a focus on delivering excellent rural health services into the future through research and collaboration, delegates brainstormed how best to sustain world-class health services in rural NSW.

A number of MLHD staff and clinicians participated in the congress, presenting posters, providing oral presentations and chairing sessions. The MLHD’s Aboriginal Health team led discussion panel on working with Aboriginal people in research.

Research Workshop MLHD hosted the inaugural Research Information Workshop in Wagga Wagga in March with more than 70 people attending. The workshop provided a range of information about research planning

and governance, ethical review process and seeking site specific approvals. A group of keynote speakers with expertise in key research areas assembled to share information services, communication, statistical design, qualitative methods and, why we need ethical oversight. The new data system for ethical research (REGIS) was also discussed.

Volunteers Volunteers were celebrated across facilities on Volunteer Appreciation Day with local activities to acknowledge their work and commitment. Volunteers give their time freely and willingly and are vital to our hospitals. They provide many extra services which supplement the care and treatment of our patients.

Local Health Advisory Committee (LHAC) There are 33 LHACs across the District with around 240 community representatives who are actively engaged in health promotion and community education activities. LHACs are energetic advocates for their local communities and also play an active role in service planning and feedback.

LHAC Forums MLHD together with Murrumbidgee Primary Health Network (MPHN) co-host forums twice a year to bring LHAC members together to share experiences and ideas.

The forums are an opportunity to share information about new initiatives, programs and achievements, as well as networking for members. Forums are attended by LHAC members from every corner of the District.

The first forum was held in Tocumwal in September with the theme “Caring for Vulnerable People” with a focus on mental health, aged care and disabilities.

The second forum was held in Tumbarumba in May with the theme “It’s not just the destination, but the journey that is important”.

Celebrating Diversity MLHD’s Celebrating Cultural Diversity Steering Committee met with NSW Department of Justice Community Liaison Officer Adol Takpiny in Albury to discuss cultural diversity and opportunities for sharing information and ideas. The committee worked on creating awareness and connection with cultural diversity across MLHD through celebration.

Harmony Day Harmony Day was celebrated across the District with a number of cultural activities in March. MLHD reinforced the key message that everyone belongs with a variety of celebrations held, including tours of the Wagga Wagga Base Hospital for refugees and newly arrived communities.

Staff were encouraged to wear orange and morning and afternoon teas where held across the District, with staff sharing their favourite multicultural food.

Charity Auction The 5th annual Gallery 43 Charity Art Auction was held in Wagga Wagga in November with more than 200 artworks going under the hammer. The auction raised more than $10,000 to purchase art for Wagga Wagga Health Service. MLHD’s Senior Staff Specialist Geriatrician Professor Paul Finucane was guest speaker and spoke passionately about the importance of “The Arts” in health facilities to improve patient and carer experiences and wellbeing.

School Canteen Partnership North Wagga Wagga Public School was one of the first in the area to achieve the new food

and drink benchmark set by the NSW Health School Canteen Strategy. Canteen volunteers Amy Baulch and Trish Orban did an amazing job in meeting the benchmark in less than three months, with the support of MLHD’s health promotion team. The new snacks and lunches are going down a treat with pupils, with spaghetti bolognaise and risotto the biggest winners on the new menu.

Tresillian Partnership In a joint partnership with Tresillian, MLHD is providing support for parents struggling with the demands of a new baby or toddler. Member for Wagga Wagga Daryl Maguire opened the new Tresillian in Murrumbidgee Family Care Centre in Wagga Wagga in August. Tresillian offers specialist child and family health advice from experienced health professionals who work with parents to increase their confidence and resolve their concerns on a range of early parenting issues. Families living in the Murrumbidgee now have improved access to more intensive, specialist services closer to home, reducing the need to travel to city centres. Together with Tresillian, MLHD is committed to providing seamless, integrated care to local families in their own community, when they need it.

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Enhancing Aboriginal Health

PAGE 21

Building and strengthening partnerships with Aboriginal people remains a priority for MLHD. We acknowledge that together with local Aboriginal people we can enhance services to provide care in a culturally appropriate setting.

Narrandera Yarn Up A Yarn Up was held in Narrandera in August, providing an opportunity for Elders and Aboriginal community members to come together and share stories about the health service. These stories are collected as part of the ‘Focus on the Future’ project in partnership with Charles Sturt University students. Building on the 2016 ‘Flipping the Focus’ project, students collaborate with the community to identify what is working well with respect to their health care experiences.

Aunty Jean’s Art Narrandera Aunty Jean’s program celebrated the acquisition a piece of Aboriginal art, funded jointly by Narrandera Health Service and MLHD’s Aboriginal Health and the Arts Grants project.

Tidda Love Rebecca McGuiness, of Bec-Lee Creating Dreams, created a piece of art to help increase cancer screenings among indigenous women. Installed with BreastScreen NSW’s Wagga Wagga screening clinic, the image combines elements of traditional indigenous style and a large pink ‘B’ which will also be used in promotional material. The artwork, titled Tidda Love, is part of a new campaign to increase screening rates for breast and cervical cancer in women from Aboriginal and non-English speaking backgrounds. The artwork will be used to help promote a number of initiatives including ‘pop up’ clinics, where women can have mammogram and cervical cancer screening at the same location, on the same day, in hope it may also increase regular participation. Her work was created to represent ‘the support we share as women experiencing such trauma. It is a connection unbreakable, a passion unspeakable. It is the love we have for our mothers, aunties and sisters.’

Into the Light

A new artwork by local Aboriginal Elder Fay Clayton was unveiled in July at the Wagga Wagga Mental Health Recovery Unit. Titled “Into the Light”, the artwork uses Aboriginal symbols to tell the story of recovery in mental health. It was funded through a new Aboriginal Health and the Arts Grant, as well as donations from Wagga Wagga High School pupils who raised $1,400 as part of their enrichment studies.

Little Possum Project Throughout 2017 MLHD ran a special project for Aboriginal women and their babies at the Riverina Environmental Education Centre. The Little Possum Project collected stories from women who describe their pregnancy and family by painting it onto a possum skin. This enabled new mums to get together and yarn, sharing their stories weekly. In 2018, the project was expanded to include Narrandera, Griffith, Lake Cargelligo and Tumut.

Tobacco Free Day Together with Griffith Aboriginal Medical Services (GAMS), MLHD’s Aboriginal Health Team held a community day in Lake Cargelligo in September called “We are tobacco free for new life”. The community was invited to a day in the park to learn about the importance of not smoking during pregnancy and also educate young people about the effects of smoking and how it impacts on health.

NAIDOC Week MLHD celebrated Aboriginal and Torres Strait Islander history, culture and achievements during NAIDOC Week (27- July 2017). The theme was ‘Our Languages Matter’ which celebrated the unique and essential role indigenous languages play in cultural identity, linking people to their land and water and in the transmission of Aboriginal and Torres Strait Islander history, spirituality and rites, through story and song.

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Invest in Our People

Director Strategic Planning Marianne Warren was appointed Director Strategic Planning, responsible for leading strategy and planning for MLHD. Marianne has had a long association with MLHD and is a highly experienced senior leader and operational manager. Her most recent role was Director of Nursing & Midwifery at Wagga Wagga Rural Referral Hospital, a position she has held since February 2017.

Marianne has been working in recent years with MLHD in various strategic projects, including Key Performance Indicator improvements for the Wagga Wagga Base Hospital elective surgery waitlist. In addition, Marianne was formerly Chief Executive Officer for Mansfield District Hospital and the Regional Manager Murray River and Riverina Region for the United Protestant Association.

APPOINTMENTSMLHD promotes the district as a great place to live and work to ensure we have a skilled and sustainable workforce.

MLHD welcomed two new Directors to the MLHD Senior Executive Leadership Team at the start of 2018, Marianne Warren and Jill Reyment (refer insets).

New Graduates 20 medical graduates were welcomed to Wagga Wagga Base Hospital in January. The new graduates will undertake a year-long internship at WWBH. Competition to work at WWBH is high among graduating medical students as the hospital has a proven track record of providing the highest quality training in the State.

70 new nursing graduates began their careers in February across a number of locations in MLHD. A record 38 graduate nurses and midwives joined the teams at Tumut Hospital and Wagga Wagga Base Hospital, and will be split between the two hospitals. Wagga Wagga MP Daryl Maguire visited Wagga Wagga Base Hospital to congratulate the new graduates on their appointment.

New Aboriginal Officer A new Aboriginal Culture Development Officer, Michelle Wighton, was welcomed to the Murrumbidgee team in August. Michelle is a Noongar/Yamatji woman from Western Australia (WA). Her mother is from the Ballardong tribe in the Wheatbelt area

of WA, while her father is Badimaya from the Murchison region. Based in Albury, Michelle has more than 15 years’ experience in Aboriginal Health and Aged Care. In her role, Michelle is responsible for facilitating the face-to-face Respecting the Difference training across MLHD. Michelle is currently creating a tailored training package for Murrumbidgee, which includes working with Aboriginal elders on the local content component of the training. Respecting the Difference remains a priority for MLHD to help staff deliver great patient outcomes to Aboriginal communities and assist MLHD play our role in ‘closing the gap’ in NSW.

Wagga Hospital Director - Nursing & Midwifery MLHD welcomed Michelle Coghlan to the role of Director of Nursing and Midwifery at Wagga Wagga Base Hospital. Ms Coghlan has over 20 years’ experience in nursing and midwifery management and joins us from New Zealand where she was the Director of Nursing and Midwifery for Mid Central District Health Board.

Michelle has a strong history of nursing and health management and her studies include a Diploma of Nursing, a Bachelor of Arts (Nursing Studies) and a Master of Nursing degree. Her thesis focused on the meaning of living and nursing in rural communities, making her well-placed to understand the unique opportunities and challenges of our nursing workforce.

Professional Practice Manager Nathaniel Alexander joined MLHD’s Nursing and Midwifery Directorate as the Nurse Manager for Professional Practice and Policy. Nathaniel takes the lead for a number of portfolios including supporting Clinical Nurse Consultants /Clinical Midwife Consultants. In addition Nathaniel will provide support in relation to professional practice for nurses and midwives in the district and be the lead for policies that have nursing and midwifery implications. Nathaniel comes to MLHD from Sydney, and has worked for the Sydney Children’s Hospital Network and Sydney Local Health District. Nathaniel has worked as Clinical Nurse Consultant in Transfusion Medicine and Paediatric Bone Marrow Transplantation. Nathaniel has completed a Masters of Public Health (USYD) and a Juris Doctor (UNSW).

Director Clinical Governance Jill Reyment (pictured right) was appointed Director Clinical Governance in January 2018. Jill’s distinguished career includes work in both metropolitan and rural health services. Jill is a Registered Nurse and has held positions in clinical, management and administration areas of health.

Jill has a strong commitment to patient safety and quality. Jill is a strong advocate to improve services for patients and acknowledges it is essential clinicians, carers and consumers work together using clinical data and patient experiences and outcomes to develop services and improvements.

Jill co-chairs the MLHD Clinical Council and is a strong advocate for open disclosure and ensuring good governance processes for the management of clinical service.

In 2017, Jill completed the Institute for Healthcare Improvement’s Advisor Program which further developed and consolidated her skills for improvement and knowledge to enable analysis of clinical data. During 2017 Jill also worked with implementing the Leading Better Value Care projects.

In other achievements, Jill was the recipient of the 2012 Don Kendell Award for Leadership, MLHD’s 2013 Clinical Excellence Commission Award for Leadership for Between the Flags Program Implementation and the 2013 MLHD Employee of the Year.

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3,174 STAFFCONTRACTED FULL TIME

EQUIVALENT (FTE) INFORMATION AS AT 30 JUNE 2018

209MEDICAL

1,822NURSING

297ALLIED HEALTH

86OTHER PROFESSIONALS & PARA PROFESSIONALS

& SUPPORT STAFF

91SCIENTIFIC & TECHNICAL CLINICAL SUPPORT STAFF

36ORAL HEALTH PRACTITIONERS

& SUPPORT WORKERS

538 CORPORATE SERVICES & HOSPITAL SUPPORT

44HOTEL SERVICES

49MAINTENANCE & TRADES

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CARING FOR OUR STAFFThe MLHD BeSafe, BeWell and BeFit initiatives have continued to support staff to prioritise their health and safety and promote safety leadership – ultimately improving the quality of care delivered in our communities.

BeSafe Through a series of BeSafe focus areas, MLHD has continued to equip staff with knowledge and resources to effectively mitigate hazards and change behaviours so putting safety first is simply ‘how we do business around here’.

The BeSafe focus areas throughout the year have included occupational aggression - supporting the application of risk management strategies to decrease the likelihood of aggression arising and de-escalation strategies to reduce the severity of an incident should aggression occur; Psychological Safety – supporting staff in identifying hazards, build skills and knowledge in mental health awareness and continue to destigmatise mental health in the wider community; and Positive Safety Behaviours – addressing the motivational factors that influence the right choices being made within the workplace, in parallel with the attitudes, values and beliefs the workplace group uphold.

In addition to the BeSafe safety culture improvement strategies, the Health, Safety and Wellbeing team have worked extensively across the district to improve safety management systems and compliance.

BeWell The MLHD staff wellbeing strategy BeWell, continued to provide education and events highlighting the importance of prioritising physical, psychological and social wellbeing. BeWell aligned with community campaigns

as well recognising annual health promotion dates.

BeWell provided specific initiatives such Mental Health Month (October), Gratitude and Appreciation (December) and Mother’s Day (May), as well as education promotions around the Ministry of Health Healthy Food and Drink in NSW Health Facilities Framework changes and the 2018 Flu Vaccination program.

This year also saw 280 MLHD employees receive a face-to-face health check reinforcing the message that health staff should role model the health behaviours we would like our patients to adopt. The staff targeted were based at MLHD’s most regional and remote facilities: those who often don’t have access to other workplace wellbeing offers such as Fitness Passport.

BeFit In the 2017-2018 year MLHD achieved a 35 per cent reduction in significant workplace injuries from the 2016-2017 result. Safe for Work, the musculoskeletal pre-employment screening process continues to contribute to keeping employees safe at work, while helping to avoid unnecessarily placing new employees at foreseeable risk of injury. This preventative work, along with the MLHD commitment to supporting employees recover from injury at work, has achieved positive results in reducing the incidence of significant workplace injury.

Say ‘NO’ to Violence MLHD continues to implement Violence Prevention and Management workshops. These workshops upskill staff working in Emergency Departments and Mental Health and Drug and Alcohol Services to de-escalate potential aggressive situations and keep themselves and others safe.

Employee Survey Results Results from the 2017 People Matter NSW Public Sector Employee Survey were received in September, with MLHD receiving the second highest response rate of all the NSW Local Health Districts (60 per cent) and 2,100 employees responding to the survey. Tumbarumba Multipurpose (MPS) staff celebrated a triumph, achieving 100 per cent participation.

The survey provides an opportunity for almost 400,000 employees across NSW to have a say about their workplace and to help make the public sector a better place to work.

Key highlights:

• MLHD’s engagement scores remained steady at 65 per cent, in line with NSW Health

• Almost nine out of 10 staff feel they and their team strive to achieve the highest levels of patient/client satisfaction.

• 72 per cent of staff indicated good job satisfaction, higher within MLHD than the public sector

• There is a high level of respect for individual differences, openness to diversity, backgrounds and ideas.

The survey provides invaluable feedback to enable the MLHD leadership team develop actions and strategies together with staff. Staff advisory councils have been formed to empower staff to have input to engagement initiatives. Through the councils, staff have the opportunity to discuss the survey results and contribute to action plans.

MLHD is also continuing its culture improvement program, Our People, Our Future, which focuses on aligning staff’s passion for their work with agreed goals and behaviours. We aim to be an organisation

that provides strong leadership and direction, with openness and transparency which values the investment in staff development and innovation.

1,042 AGENCY STAFF

ACTUAL STAFF

2,112FULL TIME STAFF

1,539PART TIME STAFF

801CASUAL STAFF

PAGE 26

EDUCATION AND TRAININGLeadership Development Eighteen senior clinicians, leaders and managers from nursing and allied health backgrounds across the District have embarked on their leadership development journey through the MLHD Clinical Leadership Program (CLP). The aim of the program is to build a cohort of clinical leaders with the skills and commitment to drive and shape a sustainable culture of patient safety, work-based learning and positivity in the workplace. Participants embraced the opportunities to learn from many informative and motivating key speakers within Murrumbidgee, along with guest speakers from outside the organisation.

Our People Our Future Staff from across the District attended the Studer Group’s “What’s Right in Health Care” conference in Sydney in May to explore further ways to support Our People Our Future across MLHD. Our People Our Future embraces a principles-based approach to develop an organisational culture of excellence, which is customer focused, embeds accountability and hardwires sustainable change over the long term.

The conference focused on:• Patient engagement• Innovation• Cultural Transformation• Patient Safety• Communication Strategies• Stakeholder Engagement

Attendees heard from world-class speakers discussing the future of health care and how industry is preparing for changes in technology to meet the new and exciting times ahead. Other speakers reinforced the Our People Our Future principles in place at

MLHD, and the commitment to excellence across the work that we do and the service we provide to our communities.

Nursing & Midwifery Supporting Transition to Professional Practice (TPP) New Graduate Registered Nurses MLHD recruited 75 Registered Nurse graduates this year, four more than last year’s intake. The new nurses were welcomed and supported with a comprehensive education and mentoring program at the following hospitals: Boorowa, Cootamundra, Corowa, Culcairn, Deniliquin, Griffith, Gundagai, Harden, Hay, Henty, Holbrook, Junee, Leeton, Lockhart, Narrandera, Temora, Tumbarumba, Tumut, Wagga Wagga and Young. The majority of graduates had selected MLHD as their first preference through the state-based recruitment process.

2018 MidSTART MLHD recruited eight registered nurses to the MidSTART program, a career pathway for Registered Nurses to become Registered Midwives over a 12 month period. Six positions were offered at Wagga Wagga and two at Griffith Base Hospitals.

Transition to Specialty Rural Nursing The Transition to Specialty Rural Nursing program provides nurses, new or returning to the rural setting, support while adjusting to a rural facility, professional development opportunities to transition from novice to advanced beginner, develop skills essential to rural nursing and varied learning opportunities to access, share and validate knowledge. MLHD recruited six Registered Nurses to the program in 2018, employed at Cootamundra, Corowa, Holbrook, Temora and West Wyalong.

Aboriginal Nursing Cadets MLHD in partnership with the Nursing and

Midwifery Office at the NSW Ministry of Health is supporting five Aboriginal Nursing cadets who are undertaking university education to become a Registered Nurse. The cadets are supported with a study allowance and employment as an Assistant in Nursing (AIN) to gain clinical experience and support. MLHD welcomed a 2017 graduating cadet into the 2018 Registered Nurse Transition to Professional Practice program.

Student placements MLHD continues to be a learning organisation, hosting undergraduate students from a range of disciplines. This year MLHD hosted 12,133 placement days for nursing and midwifery students, 12,567 placement days for medical students and 3,824 placement days for Allied Health students. MLHD has 44 student placement agreements with education providers.

Fifty four per cent of graduate nurses employed by MLHD in 2018 were graduates of Charles Sturt University and 42 per cent from other NSW education providers.

HETI Mobile Simulation The Health Education Training Institute Mobile Simulation Centre toured the Murrumbidgee region in September. Stopping in Cootamundra, Tumut, Deniliquin, Corowa, Leeton and Temora, the Centre gives rural and remote staff the opportunity to access training and resources to learn how to deal with real-life medical situations. The 19-metre semi-trailer includes a replicated emergency room and hospital ward, four computerised patient mannequins and virtual reality devices with the ability to simulate many medical scenarios.

Emergency Medicine Training Emergency Medicine Education & Training (EMET) is based in the Emergency

Department of Wagga Wagga Base Hospital and sessions were held in 30 hospitals during the year. The sessions were delivered by specialist emergency medicine physicians (FACEMS) - Dr Shane Curran, Dr Hansel Addae-Bosomprah; Dr Will Davies, Dr Michael Davoren and Dr Bridget Honan. EMET seeks to improve care for patients requiring urgent and emergency services. It does this by providing education, training and supervision for the large number of doctors, nurses and paramedics working in hospitals and emergency care services - particularly those in rural and regional Australia – who are not trained in emergency medical care. EMET is funded by the federal government and is implemented by the Australasian College for Emergency Medicine (ACEM).

Nurse & Midwife Education Session MLHD Clinical Nurse and Midwife Educators spent the day together in Narrandera discussing and learning about supporting clinical staff in their workplace, electronic medical records (eMR) and supporting students (with representatives from Riverina TAFE and Charles Sturt University).

Clinician Symposium International speaker Professor Brian Dolan was guest at an inter-disciplinary clinician symposium in Wagga Wagga in September. Professor Dolan is a ‘change agent’ who puts the patient at the centre of care, while delivering quality outcomes and improved patient flow. His philosophy is that while staff time is important, the patient’s time is sacred. This forms his approach to service redesign that enables timely, safe access to services for patients, while valuing staff wellbeing and expertise.

Department of Wagga Wagga Base Hospital and sessions were held in 30 hospitals during the year. The sessions were delivered by specialist emergency medicine physicians (FACEMS) - Dr Shane Curran, Dr Hansel Addae-Bosomprah; Dr Will Davies, Dr Michael Davoren and Dr Bridget Honan. EMET seeks to improve care for patients requiring urgent and emergency services. It does this by providing education, training and supervision for the large number of doctors, nurses and paramedics working in hospitals and emergency care services - particularly those in rural and regional Australia – who are not trained in emergency medical care. EMET is funded by the federal government and is implemented by the Australasian College for Emergency Medicine (ACEM).

Nurse & Midwife Education Session MLHD Clinical Nurse and Midwife Educators spent the day together in Narrandera discussing and learning about supporting clinical staff in their workplace, electronic medical records (eMR) and supporting students (with representatives from Riverina TAFE and Charles Sturt University).

Clinician Symposium International speaker Professor Brian Dolan was guest at an inter-disciplinary clinician symposium in Wagga Wagga in September. Professor Dolan is a ‘change agent’ who puts the patient at the centre of care, while delivering quality outcomes and improved patient flow. His philosophy is that while staff time is important, the patient’s time is sacred. This forms his approach to service redesign that enables timely, safe access to services for patients, while valuing staff wellbeing and expertise.

PAGE 28

Reward & Recognition

Congratulations to our staff and volunteers who have been recognised over the past 12 months:

2017 NSW Health AwardsStaff Member of the Year Thomas Glanville, Wagga Wagga District Office

Volunteer of the Year Belinda White, Wagga Wagga

2017 MLHD Excellence AwardsChief Executive Award The Murrumbidgee & Southern Information Services Unit

Executive Director of Nursing & MIdwifery Award Craig McColm, Cluster Manager Narrandera, Lockhart & Urana

Outstanding Volunteer Award Belinda White, Mental Health Volunteer

Outstanding Staff Member Award Thomas Glanville Manager of Activity Based Management & Business Intelligence Systems

Excellence Award Liz Obersteller Wagga Wagga Health Service

Quality & Safety Award Emergency Exercise MassVax2017

Aboriginal & Torres Strait Islander Award

Joint winners: • Victoria Cuteri (Narrandera Health Service) • Whatchya Gunna Do? Youth Vaccine Hip Hop Video

Innovation Award V-DOTS Unique client care for protracted TB regimens V-DOTS - Directly Observed Treatment Supervision (DOTS) - is daily medication supervision for tuberculosis.

Collaboration & Partnership Award Deniliquin Renal Unit • Alana Tilders RN • Rachelle Austin RN • Belinda Larcombe EN

Consumer Appreciation Award Joy Gregg (AIN), Tumut Health Service

Technology Award ED NOW – A real-time dashboard to assist ED clinicians

2017 Excellence in Nursing & Midwivery AwardsExcellence in Nursing – Assistant in Nursing (AIN) Georgia Simpson Emergency Department, Wagga Wagga Base Hospital

Excellence in Nursing - Enrolled Nurse (EN) Louise Smith , Urana MPS

Excellence in Nursing – Registered Nurse (RN)Emma Evans, Tumut Health Service

Excellence in Midwifery Lisa Ferguson,Temora

Excellence in Nursing or Midwifery for a Graduate Jordon Watts (Lake Cargelligo and Griffith Health Services)

Excellence in Nursing and Midwifery – Clinical Nurse Education Nick Praestiin, Narrandera Health Service

Naomi Smith Surgical Inpatient Ward, Wagga Wagga Base Hospital

Cootamundra Business AwardsCootamundra Hospital Nurse Unit Manager Belinda Downey received the 2018 Excellence in Health, Education and Disability Award at the Cootamundra Business Awards (hosted by Cootamundra Development Corporation)

2017 MLHD Partnership AwardsThe strong partnerships MLHD has with many community groups, government and non-government agencies and private enterprises across the region were celebrated at the 2017 Partnership Awards in Wagga Wagga.

Wellness Award Joint Winners: Carpe Diem 2016 Tour and Koori Mini Olympics

Excellence Award Mathoura United Hospital Auxiliary (UHA) supporting the Community Health Centre

Our People Our Future Award Allied Health Rural Generalist Pathway

Diversity Award Refugee Oral Health Assessment Clinic

Innovation Award Sexually Transmitted Infections (STI) Screening in mental health

Board Chair’s Choice Partnership Award Aboriginal Assertive Outreach Initiative

Chief Executive’s Choice Partnership Award Temora Careers Open Day

VolunteersVolunteers were recognised in March for their tireless service. MLHD extended a warm vote of thanks to the hundreds of volunteers who generously donate their time and provide invaluable contributions supporting patients, visitors and staff of our hospitals in such a wide variety of ways. From way-finding, snack trolleys, social contact and recreation activities, our volunteers are also the driving force behind fundraising for additional items to improve the comfort of patients.

Winner of the 2017 NSW Health Staff Member of the Year Award Thomas Glanville with Heathshare Chief Executive Daniel Hunter, NSW Health Minister Brad Hazzard, Bureau of Health Information Chief Executive Kim Sutherland and NSW Health Secretary Elizabeth Koff.

NSW Junior Medical Officer (JMO) of the Year AwardDr Thomas Melhuish (pictured) was recognised at the NSW Health and Australian Medical Association’s 2017 Doctor-In-Training Awards for his leadership, clinical excellence and passionate dedication to rural health.The commitment to investing in JMO training is clearly evidenced by winning this prestigious award three years in a row.

2017 NSW Health Awards Volunteer of the YearBelinda White volunteered her time to form a creative writing group of participants of the Mental Health Recovery Program at the Wagga Wagga Mental Health Unit.

Belinda uses her lived experience of mental health and teaching background to encourage, nurture and explore the natural talents of consumers.

Winner of the 2017 NSW Health Staff Member of the Year Award Thomas Glanville with Heathshare Chief Executive Daniel Hunter, NSW Health Minister Brad Hazzard, Bureau of Health Information Chief Executive Kim Sutherland and NSW Health Secretary Elizabeth Koff.

PAGE 30

Compassion & Dignity

No act of kindness, however small, is ever wasted.

PAGE 31

5,137 followers5,091 page likes

3,036 average post reach 40,148 top post reach

918 followers64 tweets215 likes

74 subscribers14,872 views

55 likes

11 posts189 followers

1,995 followers

Social MediaCaring with a sense of humourI am writing to express my sincere heartfelt gratitude for the care I had in Junee Hospital. Junee Hospital is way out in front. The major reason for this, in my opinion is the staff. All the staff, from the receptionists and the ancillary staff, the kitchen and cleaning women, the blood collector, the physiotherapist and no doubt others I did not meet. But it is the nursing staff who are outstanding. They are highly professional and one can have total confidence in their skills and knowledge. They show empathy and caring at well balanced levels with a sense of humour when appropriate. Above all their caring and respect for each other relfects a fabulous atmopsphere of teamwork. They really are teams, sometimes just the two rostered on, other times such as handover when you can feel the strong bonds of respect and support for each other. So professional and skilled, knowledgeable, empathetic, caring, respectful team players with a sense of humour. You can put as many posters on the wall to say that these qualities are your mission statement, but they don’t always translate into reality. At Junee Hospital they really do. Whatever you are doing at management level to support them is contributing to this, so keep doing it.

My sincerest, warmest thanks, S Onorton, Junee

Strong as Dragons What a magnificient team you are: strong as dragons, skilled, caring. You built the bridge that got me over that river of pain and illness. What really impressed me is that you all support, care and respect your colleagues. It shows in everything you do.

Dragon Bridge

Junee Journey I would appreciate if you could pass on my thanks to the Doctor and staff at Junee District Hospital for the medical help I received.Their professionalism was of the highest order and they made my stay as comfortable as possible under the circumstances. I was advised of what was occurring at all times which relieved the pressure I was under. Thanks to all.

R Semour, Queanbeyan

Dedicated professionals Both my elderly parents were recently patients at Wagga Wagga Base Hospital. We were all very impressed by the dedication and professionalism shown by all the staff that looked after them. We would like to pass on our thanks and appreciation.

S Hooper, Wagga Wagga

Wonderful student experience at LockhartI have just completed two weeks placement at Lockhart Hospital. This was an amazing experience with wonderful, caring people, who went out of their way to teach or give advice. Judith Hobart is a great educator, who made sure I understood everything that was being relayed to me. I was able to see all aspects of nursing at Lockhart, ED, Acute Care, Geriatric. What a great hospital, their caring attitude to their patients has instilled the nursing passion even more within me. I absolutely lovedit !!!!!!

Yours faithfullyT Taylor

Compliment for CarramarVery happy with the care our father has received at Carramar. Couldn’t ask for any better care and nurses are lovely. John has improved 100% since being in Carramar.

(Contributed)

Caring CootamundraWould you pass on my thanks to all the staff at Cootamundra Hospital. From the time I presented by ambulance to the time I left, I received exceptional care. The nursing staff was caring and understanding from more than one nurse. The food was nourishing and attractive and I was given snacks to tide me over when I had trips to Wagga and Canberra by ambulance. You are a wonderiful, caring staff. Thank you!

R Wilson

Warm welcome at Lockhart MPSDear Dean, just wanted to give you some feedback on your team at Lockhart. It stood out to me today and other days that I have been here how lovely and refreshing your staff and team are. I have seen how they bring happiness to their clients and I see the clients are treated with utmost respect. I also wanted to say thank you for everyone being so welcoming to me when I come fortnightly, it’s very much appreciated. I just wanted to let you know how impressed I am at the staff cohesion and spirit, it’s really good to see...Warm regards,

Susannah Forrest Mental Health Nurse, Marathon Health

Wagga Wagga EMUThank you you to the nurses and doctors in Wagga Wagga Emergency Department. The nurses were so happy and friendly, and also to the amazing doctor in the EMU department, she was so thorough and did it all with a smile. Also the nurses were fantastic they took such good care of me.

(Contributed)

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Infrastructure Developments

PAGE 33

Wagga Wagga Redevelopment Wagga Wagga’s redevelopment celebrated another milestone in early December when the new front entrance to the Wagga Wagga Base Hospital was opened to the public, along with 42 more car parks in the front forecourt, where the old hospital tower once stood. The NSW Government is investing $431 million in the major redevelopment of Wagga Wagga Base Hospital.

Griffith Redevelopment NSW Deputy Premier and Leader of the NSW Nationals John Barilaro visited Griffith in June to announce the NSW Government would fully fund the complete redevelopment of Griffith Base Hospital (GBH). The NSW Government has committed $35 million for Stage 1 of the GBH redevelopment. The $6 million funding allocation in the 2018-19 financial year will allow the project to complete planning, continue early works and, pending planning approvals, main works construction is expected to commence in 2019. Construction timeframes will be confirmed once a contract for construction has been awarded. During the year, MLHD has held community information sessions, user-group and stakeholder breakfast meetings to inform community representatives about the progress of the project and to seek feedback. The community was invited to provide comments on the Master Plan which was available on the MLHD website.

Deniliquin Renal In March the $961,000 nine-chair renal dialysis unit at Deniliquin Health Service was officially opened. The satellite service more than doubles the capacity of the previous four-chair unit and will mean an additional five patients can receive vital treatment each week without having to travel. In partnership

with the Royal Melbourne Hospital, the first specialist renal outpatient’s clinic was held in Deniliquin in September. This clinic provides specialist services to support General Practitioners in the early treatment of kidney disease.

Finley Emergency Department Member for Murray Austin Evans was on site to turn the first sod to mark the start of the reconfigured emergency department works at Finley Hospital in April. Work on the $907,000 upgrade began in May. The upgrade will realign the ambulance entry and the ED to be closer to the acute ward and improvements will also provide more security to the ED including triage, treatment and the Mental Health Emergency Consultation Service.

Barham MPS Project Member for Murray Austin Evans was in Barham in February to turn the first sod marking the start of construction on the $20 million Barham Multipurpose Service (MPS).

The Barham MPS will be delivered from two connected but independent facilities. MLHD will provide acute health services, emergency department and community health services while Murray Haven Homes will provide expanded residential aged care services. Works are scheduled to be completed in early 2020, and will incorporate: • 24-hour care• Inpatient service – six beds including

palliative care• Emergency services – two resuscitation /

holding bays• Triage and Interview rooms• X-ray facilities• Community Health services• Community programs

Culcairn MPS Project NSW Premier Gladys Berejiklian visited Culcairn Multipurpose Service (MPS) in November to see the completed Stage 1 redevelopment work. The Premier was shown the newly-completed residential aged care rooms, dining rooms, lounge area and courtyard where she planted a mandarin tree for residents to enjoy in coming years. The $25 million Culcairn MPS redevelopment is part of a $300 million program of works in a number of rural and remote communities across NSW.

A Welcome and Smoking Ceremony was held in November to showcase the completion of 16 new residential aged care rooms at Culcairn. Around 200 people from the Culcairn community attended the ceremony, led by two Wiradjuri Elders, brothers Len and Pat Connolly. Culcairn MPS building works are continuing and the next stage is scheduled to be completed in early 2018.

Holbrook Redevelopment Holbrook residents celebrated the official opening of the expanded $4.6 million Holbrook Health Service Redevelopment in August. The upgrade was officially opened by Member for Albury, Greg Aplin. The updated Health Service joins a growing number of other healthcare facilities across our region that provide a range of health, community and aged care services – all under the one roof.

Tumbarumba MPS Project The first sod was turned on the new Tumbarumba Multipurpose Service (MPS) in November. Albury MP Greg Aplin joined with local residents and staff to celebrate the start of the project which will incorporate a purpose-built hospital co-located with a residential aged care facility. The first milestone will be early stage enabling works

followed by demolition works in the first quarter of 2018. Construction is expected to be completed in 2020. The project is part of the NSW Government’s $300 million MPS Program, which is improving access to health and aged care services in rural communities.

BreastScreen BreastScreen NSW refurbished their client areas at Albury and Wagga Wagga BreastScreen sites with funding from the Cancer Institute NSW. The funding was used to replace furniture and fittings and repainting of walls at both sites. This has improved comfort and aesthetics in client waiting, screening and assessment areas. Women aged 50 to 74 are encouraged to have a free screening mammogram every two years.

Temora upgrades A $390,000 upgrade to the medical ward at Temora Hospital was completed in February. The work included replacement of vinyl floor coverings, air conditioning and some painting in the medical ward. In addition a new fire alarm system was installed.

In June, Parliamentary Secretary for Health Ms Leslie Williams announced a further $67,000 of refurbishment works will occur at Temora Hospital to upgrade staff amenities. This will include a refurbished kitchenette with new furniture and fittings, new staff locker and change room facilities, new general store room and replacement of a patient shower and toilet area within the general ward.

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Kevin Lawrence Deputy Director Finance and PerformanceKevin has responsibility for budget development, clinical costing, activity and performance, clinical and performance analysis and systems development.

Dr Wendy Cox Executive Director Medical ServicesWendy is responsible for implementation of sustainable systems and processes for reviewing and improving the quality of medical services, for effective engagement of medical staff in MLHD, planning services and delivery and maintenance of a sustainable medical workforce.

Andrew ElliotChief Information OfficerAndrew is responsible for all aspects of the Information, Communication and Technology strategy including support for core clinical and corporate systems and applications, the infrastructure surrounding the clinical arena, and supporting clinical pathways from telehealth to radiography.

Jill Reyment Director Clinical GovernanceJill is responsible for managing the Clinical Governance Unit to lead, coordinate and support clinicians and managers in providing clinical excellence and best practice care.

Jill LudfordChief ExecutiveJill is accountable to the MLHD Board and responsible for thorough strategic leadership and sound governance.

Brett Thompson Director OperationsBrett is accountable for leading, directing and managing the operations of MLHD, across a broad spectrum of health service delivery settings and corporate functions.

Karen Cairney Executive Director Nursing and Midwifery and Health Services Functional Area Coordinator (HSFAC)Karen is accountable for the development, monitoring and reporting of all aspects of professional activities to optimise health outcomes provided by nurses and midwives in MLHD. Karen is HSFAC responsible for emergency management.

Maurice Ahern Director Finance and PerformanceMaurice is responsible for the leadership and management of financial services and performance reporting including clinical activity and trends. Maurice also leads procurement and revenue functions.

Colin Cowell Director Workforce ServicesColin is responsible for providing high level advice, strategy and assistance in all areas of human resources, industrial relations, recruitment and selection, performance management, operational risk management (including management and liability), work health, safety and wellbeing, workers’ compensation, and organisational development.

Fiona Renshaw Director Integrated Care and PartnershipsFiona leads, directs and manages implementation of programs relating to key State and National programs and priority areas. These include Chronic Care, Child Youth and Family Health, Violence Prevention and Response, Aboriginal Health, BreastScreen, Population Health, Oral Health, Health Promotion and Integrated Care.

Marianne WarrenDirector Strategic Planning Marianne’s key responsibilities are to guide the whole of organisation capability and capacity to lead and effectively implement change.

Robyn Manzie Director Mental Health and Drug and AlcoholRobyn leads, directs and manages mental health and drug and alcohol services across the region.

Executive Leadership Team

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Colin Cowell Director Workforce ServicesColin is responsible for providing high level advice, strategy and assistance in all areas of human resources, industrial relations, recruitment and selection, performance management, operational risk management (including management and liability), work health, safety and wellbeing, workers’ compensation, and organisational development.

Fiona Renshaw Director Integrated Care and PartnershipsFiona leads, directs and manages implementation of programs relating to key State and National programs and priority areas. These include Chronic Care, Child Youth and Family Health, Violence Prevention and Response, Aboriginal Health, BreastScreen, Population Health, Oral Health, Health Promotion and Integrated Care.

Marianne WarrenDirector Strategic Planning Marianne’s key responsibilities are to guide the whole of organisation capability and capacity to lead and effectively implement change.

Robyn Manzie Director Mental Health and Drug and AlcoholRobyn leads, directs and manages mental health and drug and alcohol services across the region.

Catherine Maloney Director Allied Health, Sub-acute and Aged CareCathy is responsible for leadership and strategic direction for the development, effectiveness, efficiency and continuous improvement of Allied Health services and Allied Health professions and for strategic and operational aspects of rehabilitation and aged care services.

Carla Bailey General Manager OperationsCarla is repsonsible for operational and strategic leadership and management, industrial relations, patient flow and workforce and delivery of safe quality

care for our communities. Diann TremainManager Aboriginal ProgramsDiann is accountable for leading Aboriginal programs and initiatives across the district, with a focus on closing the gap, cultural awareness and development and growing our Aboriginal workforce.

Helen CooperDirector Wagga Wagga Health Service Helen leads service delivery, including a comprehensive range of acute, primary health and community based services, operational matters and performance against key indicators for Wagga Wagga Health Service.

Dr Elizabeth HarfordGeneral Manager Griffith Base HospitalElizabeth leads service delivery, including a comprehensive range of acute, primary health and community based services, operational matters, and performance against key indicators for Griffith Base Hospital and the Leeton Cluster.

Rosemary Garthwaite Regional General Manager Rosemary is accountable for leading service delivery, including a comprehensive range of acute, primary health and community based services, operational matters, and performance against key indicators for the rural hospital sites.

providing safe, equitable, quality healthcare to the people of Murrumbidgee

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The MLHD Board works to ensure effective clinical and corporate governance frameworks are established to support standards of patient care and services. They set and ensure implementation of the Strategic Plan for the District.

Our Board is made up of local people who are committed to the region. Directors bring a wealth of skills, experience and local knowledge to the management of our District.

Our Board is dedicated to providing safe quality care and strives for service improvement through innovation and research.

John HardingBased in Wagga Wagga, John has extensive experience in the financial and education industries as well as being a former Councillor and Mayor. John is interested in developing education in the community to help improve health outcomes.

Adrian LindnerBased in Coolamon, Adrian is an accountant and a primary producer who serves on a number of Boards and Committees. He was the former Head of Campus at Charles Sturt University and has a background in health management.

Dr Pankaj BangaBased in Wagga Wagga, Pankaj is an experienced General Practitioner, Anaesthetist and Hospital Administrator. Pankaj is interested in supporting the community in Wagga Wagga to access a range of quality treatment options close to home.

Dr Thomas Douch (MLHD Deputy Board Chair) Based in Young, Tom is an experienced General Practitioner and Anaesthetist. Tom is interested in training and up-skilling of local health professionals to deliver quality health services in rural areas.

Gayle Murphy(MLHD Board Chair)Based in Narrandera, Gayle is a school teacher with more than 30 years’ experience in education, including 15 years as a Principal. Gayle is passionate about improving access to quality healthcare across the region.

Geoff TwomeyBased in Cootamundra, Geoff is an accountant with more than 50 years’ experience in the financial industry. Geoff is interested in the impact the new Wagga Wagga Base Hospital will have in the region.

Betty CraggBased in Wagga Wagga, Betty is a Wiradjuri Elder and has extensive experience working with Aboriginal people including youth work. Betty is interested in improving the health of Aboriginal people across the region.

Andrea JordanBased in Griffith, Andrea is an experienced Registered Nurse with specialities in areas including general, psychiatry and aged care. Andrea is interested in bringing the “coalface” perspective to the Board.

John IrelandBased in Wagga Wagga, John is a Solicitor of the Supreme Court of NSW, an Accredited Specialist Mediation and Personal Injury and Arbitrator NSW District Court. He is also a Mediator to Workers Compensation Commission.

Carl CooperBased in Wagga Wagga, Carl is a local Pharmacist and lecturer in Pharmacy at Charles Sturt University. Carl is interested in the “big picture” and delivering the right services to the right people.

Paul Braybrooks OAMBased in Cootamundra, Paul is a local Pharmacist, Councillor and former Mayor. Paul is interested in local services for local people.

Our Board

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ACI Agency for Clinical InnovationAIN Assistant in Nursing BHI Bureau of Health InformationCEC Clinical Excellence CommissionCCIS Community Care Intake ServiceCHESS Chronic/Complex Healthcare: Engaged with all Stakeholders

and ServicesCHOC Community Health and Outpatients Clinics (electronic Medical

Record)District Murrumbidgee Local Health DistrictCKD Chronic Kidney DiseaseED Emergency DepartmentEN Enrolled Nurse eMR Electronic Medical RecordFaCS Family and Community ServicesHAI Healthcare Associated InfectionsHETI Health Education Training InstituteHSFAC Health Service Functional Area Coordinator – emergency

management responseHWAN Health Wide Area NetworkGOSI Group of Special Interest (research)JMO Junior Medical OfficerLHAC Local Health Advisory CommitteeLHD Local Health DistrictMHDA Mental Health Drug and AlcoholMLHD Murrumbidgee Local Health DistrictMMHDA Murrumbidgee Mental Health and Drug and Alcohol AllianceMoU Memorandum of UnderstandingMPHN Murrumbidgee Primary Health NetworkMPS Multipurpose ServiceMRI Magnetic Resonance ImagingNSQHS National Safety and Quality Health ServiceREACH MLHD’s Patient and Family Activated Escalation

(Recognise, Engage, Act, Call, Help is on its way)RN Registered NurseRM Registered MidwifeRICH Rural Innovations Changing HealthcareUHA United Hospital AuxiliaryWAD World AIDS DayWHS Work Health and SafetyWWBH Wagga Wagga Base Hospital

ABBREVIATIONS AND GLOSSARY

MURRUMBIDGEE LOCAL HEALTH DISTRICT Level 1, 193-195 Morgan Street

Locked Bag 10 Wagga Wagga 2650

mlhd-feedback@health.nsw.gov.au www.mlhd.health.nsw.gov.au

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MURRUMBIDGEE LOCAL HEALTH DISTRICTLevel 1, 196-195 Morgan StreetLocked Bag 10Wagga Wagga NSW 2650

mlhd-feedback@health.nsw.gov.auwww.mlhd.health.nsw.gov.au