NEW ENGLAND
Annual Report 2012-13
New England Medicare Local Limited
2012-13 Annual Report ABN 75 152 868 669 www.neml.org.au Suite 3, 180 Peel Street PO Box 1916 TAMWORTH NSW 2340
t 02 6766 1394 f 02 6766 1372
Medicare Locals gratefully acknowledge the financial and other support from the Australian Government Department of Health.
Annual Report 2012 - 2013 Our Vision and Purpose.........................................................Page 4
Everyday in our region............................................................Page 5
Community Snapshot..............................................................Page 6
Our Values................................................................................Page 7
Our Board.................................................................................Page 8
Our Executives.........................................................................Page 9
Report from the Chair.............................................................Page 10
Report from the CEO...............................................................Page 11
Our Streams.............................................................................Page 12
Financial Statements..............................................................Page 14
New England Medicare Local Annual Report 2012-13
Our Vision
Partnerships, programs and practices that make a difference
Our Purpose
Improving health in local communities
Page | 4
New England Medicare Local Annual Report 2012-13
Everyday in the NEML region...
Boggabilla Mungindi Tenterfield Ashford Moree
Deepwater Emmaville
Warialda Inverell Bingara
Glen Innes
Tingha Guyra
Wee Waa Narrabri
Barraba Armidale
Boggabri
Uralla
Manilla Kootingal
Walcha
Gunnedah Tamworth Werris Creek Caroona Quirindi
2035
People attended a GP service under the Medical Benefits Scheme
326
People will attend an Emergency Department
52
People are admitted to hospital for same day surgery
Nundle
6
Babies are born
Page | 5
New England Medicare Local Annual Report 2012-13
community snap shot Population 176,194
Aboriginal & Torres Strait Islander
Average Age 40 years
9.0% of total population
The total fertility rate for the NEML area is
2.08 births
Median total family income per week $1123
per woman
(NSW:1.8, Aust: 1.83)
18.3%
Services in our Region
Hospitalisations due to diabetes are higher than NSW averages
General Practices
60
Aboriginal Medical Services
4
General Practitioners
182
Specialists
70 - Residential 12 - Visiting
Dental practices
36
Pharmacies
40
Hospitals/Emergency Departments
19
Residential Aged Care Facilities
36
Condition/Health Risk Factor
NEML NSW 3.5%
Potentially preventable hospitalisations are significantly higher than NSW averages
of people aged 18 years & over reported a self assessed health status of fair / poor
91.79%
Aust
Type 2 Diabetes
3.7%
Asthma
10.7%
9.2%
9.7%
Arthritis
16.3%
14.9%
14.9%
High or very high psychological distress levels
11.5%
12.1%
11.7%
Smokers, 18 years and over (2007/8)
23.8%
19.9%
20.3%
People, 18 years + with at least one of four of the following health risk factors – Smoking, harmful use of alcohol, physical inactivity, obesity.
61.8%
56.6%
55.9%
of children aged 12 - 15 months were immunised between July and September 2013.
3.4%
32.2%
of males targeted participated in the National Bowel Cancer Screening Program 2010.
• 27.5% of families are single parent families with children under the age of 15 years (NSW: 21.2%, Aust: 21.3%) • 18.7% of families are jobless families with children under the age of 15 years (NSW: 14.1%, Aust: 13.3%) • 29.3% of the NEML area population are concession card holders (NSW:22.8%, Aust: 22.6%) • 44.1% of the NEML area population participate in volunteer work for an organisation (NSW: 37.8%, Aust: 37.6%) • 4.9% of people report having have difficulty accessing services due to transport issues. NSW: 4.4%, Aust: 4.1%)
New England Medicare Local Annual Report 2012-13
OUR VALUES
New England Medicare Local Annual Report 2012-13
Board of Directors Dr. David Briggs (Chair) -
BHA (NSW), MHM(1st class Hons) PhD (UNE) FCHSM, FHKCHSE
Mr. Roger Munday -
Dr. David Briggs is a health academic and consultant based in Tamworth. He was appointed as a Director in 2011 and elected inaugural Chair. He also chairs the Innovation and Research Advisory Committee.
Dr. Grahame Deane -
MBBS, DACOG, FRACGP, FACRRM, DRANZCOG (Advanced)
B Bis, LLB; Grad Dip L Prac (Coll Law)
Mr Munday is a lawyer based in Armidale. He was appointed as a Director in 2011 and accepted the role of Deputy Chair in 2012. He chairs the Finance, Audit and Risk Committee.
Ms. Debbie McCowen - BSocSc (Applied);Â
AvdDip Community Services Management
Ms McCowen is currently the Executive Officer, Armajun Aboriginal Health Service Inverell. She was appointed as a Director in 2012.
Dr. Deane is a GP Obstetrician based in Gunnedah. He was appointed as a Director in 2011 and chairs the After Hours Committee.
Dr.. Cheryl McIntyre - MBBS,BSc(Med),FACRRM,FRACGP,
Ms. Jackie Kruger - B.Sc Forestry;
DRANZCOG (Advanced),DipPaed,DipDerm
Dr. McIntyre is a GP Obstetrician based in Inverell. She was appointed as a Director in 2011 and represents the Board on the Service Development and Clinical Governance Committee.
Dr.. Stephen Howle - M.B.B.S. FRACGP Dip.Phys.Med. Dr.. Howle is a GP based in Tamworth. He was appointed as a Director in 2011 and chairs the Service Development and Clinical Governance Committee.
Ms. Gae Swain Ms Swain comes from a Local Government background. She brought to NEML her expertise in consumer understanding and knowledge of Local Government and Corporate Governance. She chairs the Community and Partnerships Committee.
M.Ed in Environmental Education
Jackie Kruger joined NEML in September 2013, She is the Director of Planning and Community Services for Tamworth Regional Council.
Ms. Lyn Rickard - B.Sc; Grad Dip Ed Lyn joined NEML in September 2013. She is the Faculty Director for Human and Personal Services at TAFE New England,responsible for the education and training of significant health workforce personnel.
New England Medicare Local Annual Report 2012-13
EXECUTIVE STAFF
Mr. Graeme Kershaw - Chief Executive Officer Graeme was previously the CEO of the North West Slopes Division of General Practice and has been involved in healthcare for over 30 years. He is responsible for the overall operation of the organisation and implementing the strategic directions of the Board
Ms. Sally Armitage - Director Clinical Services Sally was the former CEO of the New England Division of General Practice. She oversees clinical services across our region. Allied Health Practitioners and visiting Medical Specialists employed or contracted by New England Medicare Local are an important part of the region’s health workforce.
Ms. Natalie Green - Director of Aboriginal Health
Ms. Fiona Strang - Director of Primary Health Care & Partnerships Fiona was the former CEO of the Barwon Division of General Practice. Her teams provide support services for local health practitioners, work on health workforce recruitment and engage with local communities to assist them to meet their health needs.
Ms. Melissa Hayes - Director Finance & Operations Melissa joined New England Medicare Local in 2012. She manages the NEML budget on behalf of the Board with the primary objective to improve out of hospital healthcare for people in the region. Melissa also oversees the day to day operation and logistics of each office within the New England Medicare Local region.
Natalie previously guided the development of the New England Division’s Aboriginal Health services and is now bringing that expertise to a range of Aboriginal Health programs and services across the region. Over 30% of the Medicare Local’s staff work in Aboriginal Health and this is a vitally important role for the new organisation to continue.
Page | 9
New England Medicare Local Annual Report 2012-13
A message from the chair
Dr. David Briggs CHAIR
This is our second annual report operating as a Medicare Local and is prepared at a time when there has been a change in Federal Government. As a relatively young organisation we have made good progress in the second year of our existence given our pre-occupation in our first year of transferring three General Practice Divisions into a new organisation. Considerable effort was made by our staff and the Board to focus on our purpose: ‘Improving health in our local communities’ and our vision: ‘partnerships, programs and practices that make a difference’. A set of values and behaviours around how our staff and Board would like to be perceived by those with whom we engage was also developed. Importantly, in terms of strategic direction priority was to be given to prevention in service and program development as was engagement with our communities, health professionals and partner organisations. This strategic approach has been further enhanced by the internal collation of demographic, epidemiological, and socio-economic data from a range of government sources to more clearly define the health needs of both our regional and local government defined communities. While there are some clearly identified regional priorities there are clear differences in priorities for each of the LGAs. This underpins the importance of the word ‘Local’ in our title. We cover a land mass larger than the State of Tasmania with a relatively small population but with many diverse communities geographically distant from each other. There is clear indication of groups
Page | 10
across the region who are socioeconomically disadvantaged and a range of health needs around chronic disease and lifestyle risk factors and general shortages of health workforce. There are also positives in the data and in our community that is actively engaged and resilient. These characteristics are important particularly in trying to ensure equity of access to health services and, in delivering the range of services provided across the region. Equity in access is one of NEML’s objectives, in attempting to improve the patient journey. It is our role to support clinicians who often work in isolation from others or with insufficient workforce to meet demand for services. These objectives suggest that they must be coupled with a funding, advocacy and service delivery role. As can be seen elsewhere in this report we are active service providers particularly in areas where other effective providers do not exist. Secondly we actively collaborate with other providers to meet identified health and service needs. However, our funding is mostly specific to relatively narrowly defined programs where there is little ‘local’ discretion in the use of those funds and very detailed reporting for each program. Therefore, for Medicare Locals to be effective, in the future, they should be relieved of some of the current detailed program reporting and be given greater discretion in how program funds are utilised. Government might also need to consider a funding source to allow Medicare Locals to address the priority needs determined through undertaking their needs identification role. At the least Medicare Locals might need to become advocates for their communities and also become more innovative in sourcing new funding, be given the opportunity to contract for funding of new and existing services or by suggesting better ways for existing funding to be used. Better access to data and sharing that data with other organisations to inform collaborative planning will also be essential.
The Board has made a significant contribution to the organisations governance through a range of defined sub committees in concert with staff and stakeholders throughout the year. The initial Board of six was expanded by three skills based appointments following public advertising and selection on merit and against identified criteria. The Board was pleased to appoint Debbie McCowen, Patricia Kearton and Paul Callaghan as Directors during the year and their details are also provided in the Report. Unfortunately due to personal commitments and work relocation Directors Kearton and Callaghan subsequently resigned and two new appointments in Jackie Kruger and Lyn Rickard have subsequently occurred. Membership of NEML has been defined as ‘organisations’ albeit that in many cases PHC professionals and their practice entity could operate as a single individual and entity. Applications for membership have been opened and we are progressively increasing our membership. With this decision having been implemented we have also resolved that our foundation members, the Divisions of General Practice, however named, will in future nominate a director each to the NEML Board. Member organisations will nominate and jointly elect three further directors. The NEML Board will then make further appointments, approximately three based on skills and criteria required at the time. Implementation of this approach and Board member succession planning will become a priority for consideration in 2014. I would like to take this opportunity to thank our Board, the Chief Executive, senior staff and all of those who work for or with NEML for their efforts and positive contributions throughout the year.
Dr.. David Briggs CHAIR
New England Medicare Local Annual Report 2012-13
A message from the CEO
Mr. Graeme Kershaw CEO
There’s a Leunig cartoon pinned to the Notice Board in my office. It’s entitled “How to get there”. The character sets out with a bundle over his shoulder and the caption reads – “Go to the end of the path until you get to the gate, go through the gate and head straight out towards the horizon”. It then goes through more frames with similar captions until the last, that says “ Keep on going as far as you can. That’s how you get there.” And so it is with New England Medicare Local or NEML. We have embarked on a journey to become one of the regional primary health care organisations that are needed all over the country to strengthen general practice and primary health care and reduce Australia’s reliance on expensive and unsustainable hospital based health care. We are only two years into our journey to ‘get there’ and it’s only by looking back over your shoulder at the year gone by that you realise just how far you’ve come. During the past twelve months 112 people who worked for the Divisions of General Practice transferred across into the Medicare Local. With comings and goings during that time 37 people have come to work in NEML. We’ve taken three financial management systems and merged them into one. Similarly, what served the three Divisions for IT systems had to be merged into a solution that would cover the 93,000 square kilometres we cover with 12 office locations. More importantly during that time we have also delivered 22,500 episodes of care to 3837 Aboriginal clients of our Aboriginal health team (often in collaboration with other organisations, most importantly the region’s Aboriginal Medical Services). We also provided 10,000 mental
health services to people from 21 communities across the region and 10,000 allied health services (physiotherapy, podiatry, speech pathology, dietetics, etc.) to the same range of communities. Over 200 clinics were able to be conducted by visiting specialists as a result of funds that we manage from the Federal Government, so that people in the region didn’t have to travel so far to receive the assessment and treatment that they need. We’ve provided these services through a combination of employed and contracted health professionals. Where it is possible and effective we contract with local health care providers who are part of their local communities, because it enriches the local community by having their own local physio or podiatrist and we can make the providers’ services more sustainable through the contracts that we have with them. We’ve done a whole lot more too supporting the recruitment of health professionals into the region and supporting those that are already here with information and services. We were involved in the recruitment of 11 additional GPs and 14 extra medical specialists during the year. As much as I like to see the number of services that we provide to communities, it’s the personal stories that touch both me and the people that I work with. One that I heard recently was about an Aboriginal woman who was struggling with cancer. Uncertain where to turn for assistance with her unaffordable health costs she was referred by her GP to the NEML Aboriginal Health Worker. Our staff members were able to assist her with appropriate social security benefits. Through the Closing the Gap scheme, she was able to access the medications that she needed as she underwent treatment for her cancer. She also received transport assistance to her outpatient cancer treatments when she had no other way to get there. She is aware
she has a long road to travel, but says she feels more confident now that she is supported. There are lots of stories like this one and it makes me proud to be part of an organisation that can positively affect people’s lives in such a way. Reflecting on the past is important but if we are going to “get there” we need to focus on the horizon. Australia, like the rest of the world, can’t continue to provide healthcare the way they have in the past. We need a robust and effective primary health care sector, with general practice at its core, to prevent the need for expensive hospital treatment. We need communities, families and individuals who want control of their health and wellbeing and, where there are social factors like poverty and lack of education that prevent them having that control, we need a health system that works with others to overcome those barriers. We need to re-design the health system. We need to re-make it in a way that keeps people well and out of hospital. In the journey to “get there”, to that new system, I have the great privilege of working with a very committed Board and a whole lot of excellent staff. To each and every one of them my sincere thanks for this past year and I look forward to the journey ahead.
Mr. Graeme Kershaw CEO
Page | 11
New England Medicare Local Annual Report 2012-13
Aboriginal Health
Clinical Services
“Supporting and improving access to health services and building capacity”
‘”Providing quality and equitable clinical services to contribute to the wellbeing of our communities”
Our Aboriginal Health Team is committed to improving the health and wellbeing of Aboriginal people and their communities. We recognise that to reduce the burden of chronic disease, a much greater effort needs to be put into delivering prevention programs and comprehensive and well-coordinated primary health care for Aboriginal and Torres Strait Islander people.
Our Clinical Services team provides allied health, mental health and specialist outreach services to our local communities across the region. They aim to provide quality and equitable services and to improve access to health services for all clients in an effort to contribute to the wellbeing of our communities.
Our Aboriginal Health programs and support are delivered by both Aboriginal and non-Aboriginal people.
Services are planned based on population needs and identification of gaps in existing services.
We work with a range of people, including other health service providers, and local Aboriginal Communities, to deliver services, programs, health information and access to health care which will improve the health outcomes of Aboriginal people.
Services provided by the NEML Clinical Services team include, but are not limited to: dietetics, diabetes education , dementia education and carers’ support, exercise physiology, memory assessment, medical specialist outreach, physiotherapy , podiatry, primary health care nurses, psychology and speech therapy.
Our programs and services are tailor-made to the individual needs of the many and varied communities we service, but all are designed with the intention of educating and empowering Aboriginal people about health and well being in a culturally appropriate and safe way.
Snapshot of the NEML Aboriginal Health team, during the period of 1 July 2012 – 30 June 2013: 3837 clients accessed the Aboriginal Health service for individual support or intervention 22,527 episodes of care were provided by the Aboriginal Health Stream 32,202 client contacts were made, including 9,115 transports that were provided to access NEML services, as well as services not provided directly by NEML 719 group activities and population health promotional activities were run by the Aboriginal Health Stream
Page | 12
NEML aims to intervene early in mental health problems and provided almost 10,000 consultations to residents from 21 communities across the region.
New England Medicare Local Annual Report 2012-13
Primary Health Care and Partnerships “Building partnerships, engaging with community and supporting providers to enable high quality, accessible primary health care” Our Primary Health Care and Partnerships team is integral to keeping people healthy and out of hospital, and assisting patients to navigate their local health system. The team delivers support to primary health care providers to assist them in the uptake of health care initiatives, ensures they have the knowledge required to deliver high quality services, and links them to other health care providers and key stakeholders. Our workforce support program focuses on the recruitment and retention of primary health care providers and works closely with key stakeholders to plan for the future health workforce needs of our local communities. Community and stakeholder engagement is a key role of our PHCP team, as well as knowing the community through comprehensive needs analysis, and working with them and key partners to identify service gaps and opportunities. Providing up to date information on services and service providers within the community forms a large part of our work. The Primary Health Care and Partnerships team is also responsible for integrating and connecting people with the appropriate care for their health needs. It facilitates preventative health activities across NEML communities, in partnership with our Clinical and Aboriginal teams, as well as with external organisations.
Finance and Operations “Building the foundations to help our organisation improve health in local communities” Finance and Operations provide a number of corporate functions to support the staff and Board of the New England Medicare Local to improve health in our local communities. Our finance team is responsible for all finance functions of the NEML, from the processing of day-to-day transactions, to the development and management of the budgeting and financial reporting processes. The human resources area is responsible for developing and overseeing processes that attract, select, develop and retain competent and skilled staff. The remit of the information management and technology team is to oversee the NEML’s IT network and enable best practice in the use and management of NEML’s data. In addition to the provision of administrative support, the administration team is responsible for the effective management of the organisation’s resources, including facilities and vehicles. Quality management is an important function of the NEML and supports the delivery of quality programs and services through the delivery and oversight of effective corporate governance systems and benchmarking activities.
Innovations in Primary Health Care and Partnerships: Recognising overweight and obesity are major health problems in the region, NEML piloted a social media program “Shape Up” to provide diet, physical activity and general health coaching. With encouraging results and an overwhelming response from participants, the program will be expanded in 2014.
Page | 13
Medicare Locals gratefully acknowledge the financial and other support from the Australian Government Department of Health.
www.neml.org.au PO Box 1916 Tamworth NSW 2340 t 02 6766 1394 f 02 6766 1372 facebook.com/NewEnglandMedicareLocal twitter.com/NEMedicareLocal NEW ENGLAND
ABN 75 152 868 669