2004-05 Annual Report - Sydney Local Health District - NSW ...

SSWAHS StatutoryAnnual Report 04>05

ContentsSection one – profile, purpose and goalsLocations ......................................................................................................................................... 2Chief executive year in review......................................................................................................... 5Highlights......................................................................................................................................... 7Asset management.......................................................................................................................... 10Health service profile ....................................................................................................................... 12Organisation chart ........................................................................................................................... 14Purpose and goals........................................................................................................................... 15Corporate governance..................................................................................................................... 16Section two – performance summaryPerformance indicators.................................................................................................................... 18Clinical governance ......................................................................................................................... 28Selected activity levels ................................................................................................................... 30Section three – health servicesHealth service locations................................................................................................................... 35Area healthcare service planning .................................................................................................... 40Facilities........................................................................................................................................... 41Allied health and clinical support services....................................................................................... 56Population and drug health services ............................................................................................... 58Mental health services..................................................................................................................... 60Nursing and midwifery services....................................................................................................... 61Quality clinical indicators ................................................................................................................. 62Section four – health support servicesCorporate services .......................................................................................................................... 68Financial services ............................................................................................................................ 69Information management services .................................................................................................. 70Public affairs and marketing ............................................................................................................ 71Internal audit.................................................................................................................................... 72Section five – our peopleWorkforce profile ............................................................................................................................. 73Executive reports ............................................................................................................................ 74Staff profile ...................................................................................................................................... 76Equal employment opportunity........................................................................................................ 77Occupational health and safety ....................................................................................................... 82Teaching and training initiatives ...................................................................................................... 86Research ......................................................................................................................................... 87Official overseas travel .................................................................................................................... 92Section six – our communityArea health advisory council............................................................................................................ 100Community participation.................................................................................................................. 101Fundraising and sponsorship .......................................................................................................... 102Donations and bequests.................................................................................................................. 103Ethnic affairs priority program ......................................................................................................... 104Non-government organisations ....................................................................................................... 105Volunteers ....................................................................................................................................... 109Section seven – freedom of information (FOI) reportFreedom of information ................................................................................................................... 111Section eight – financial reportFinancial overview ........................................................................................................................... 122Independent audit report…………………………………………………………………………………..124Index................................................................................................................................................ 166Sydney South West Area Health Service Statutory Annual Report 04/05 1

SSWAHSSydney South West Area Health ServiceHead OfficeLiverpool Hospital (Eastern Campus)Elizabeth StreetLiverpool NSW 2170Mailing AddressLocked Bag 7017Liverpool BC 1871Telephone: 61 2 9828 5700Fax: 61 2 9828 5769Email: arearecords@swsahs.nsw.gov.auWebsite: www.sswhealth.nsw.gov.auRoyal Prince Alfred HospitalKing George V Building Level 11Missenden RoadCamperdown NSW 2050Telephone: 61 2 9515 9600Fax: 61 2 9515 9611Hours of operation: 8.30am – 5.00pmSydney South West Area Health Service Statutory Annual Report 04/05 2

SSWAHS LocationsOur major healthcare centres:1. Balmain Hospital2. Bankstown Hospital3. Bowral Hospital4. Camden Hospital5. Campbelltown Hospital6. Canterbury Hospital7. Concord Hospital8. Department of Forensic Medicine9. Fairfield Hospital10. Karitane11. Liverpool Hospital12. Royal Prince Alfred Hospital13. Rozelle Hospital14. Sydney Dental Hospital15. TresillianSydney South West Area Health Service Statutory Annual Report 04/05 3

The Hon John Hatzistergos MPNSW Minister for HealthParliament HouseMacquarie StreetSydney NSW 2000Dear MinisterI have pleasure in submitting the Sydney South West Area Health Service (SSWAHS) 2004/05 AnnualReport.The Report complies with the requirements for annual reporting under the Accounts and AuditDetermination for public health organisations and the 2004/05 Directions for Health Service AnnualReporting.Yours sincerelyProf Diana Horvath AOChief ExecutiveSydney South West Area Health Service Statutory Annual Report 04/05 4

Chief Executive Year in ReviewOn 27 July 2004, I was formally appointed theadministrator of Central Sydney Area HealthService (CSAHS) and South West Sydney AreaHealth Service (SWSAHS).This was the first step towards theamalgamation of two separate board-governedentities into one executive-governed entity.Enshrined in legislation as Sydney South WestArea Health Service, it became effective on 1January 2005.The new area is the most populous of the sevennew area health services formed throughamalgamation.It covers a land area of 6,380 km stretching frominner city Balmain to rural Bowral and serves apopulation of approximately 1.33 millionrepresenting 20 per cent of the NSW population.The amalgamation brought together anestablished area health service characterised byan older population and tradition and a youngdynamic rapidly growing health service on thecusp of change.The new area is the most ethnically diversehealth area in Australia, with 39 per cent of thepopulation speaking a language other thanEnglish at home. It also includes some of thepoorest communities in the State – Fairfield isthe fourth most disadvantaged LGA in NSW andCanterbury and Liverpool are in the bottomquartile.The culture and management structure of thetwo areas were very different.CSAHS incorporated the established services ofthe inner west of the city, closely linked to theUniversity of Sydney by 120 years of tradition,with significant medical training programsproducing many of the specialists employedacross the State and beyond.It was the first health service in Australia tomove to a clinical stream structure (in 1995). Ithad instigated a detailed clinical services-driventotal asset management program – theResource Transition Program – which hadchanged the landscape of hospitals and healthcentres across the inner west.SWSAHS covered the rapidly expandingpopulation of the south-west corridor of Sydneyand its numbers are expected to increase by afurther 300,000 by 2030.It was run on a sector management model –devolving responsibility for hospital andcommunity health services to a series of semiautonomoushealth services.At the time of the amalgamation it had only justdeveloped its clinical services plan SouthWestern Sydney Health Network – The WayForward 2004-2008 which introduced clinicalstreams and greater clinician involvement indecision making and resource allocation.It had also struggled with recruitment ofclinicians, trained and trainee, because of therapid population growth and comparativelyrecent involvement with the University of NSWMedical School.The amalgamation is already reaping manybenefits and we will see more next year.In Corporate Services gradual elimination ofduplication has allowed us to return savings tofrontline clinical services. Financial managementhas been simplified with the creation of onegeneral ledger.An area-wide approach to purchasing andtendering means more competitive prices can beachieved for the benefit of clinical services.The area-wide nursing service has focused onrecruiting nurses into permanent positions andhas centralised the staffing function in eachfacility to reduce vacancy rates, agency staff andovertime usage.The development of the clinical governance unithas allowed us to take an area-wide approach topatient safety and clinical safety issues.The Statewide Incident Information Managementsystem (IIMS) has been successfullyimplemented across the Area and more than1,400 managers have trained on the system,supporting patient safety programs.The Professional Practice Unit established at theformer SWSAHS to deal with complaints,grievances and professional issues is now anarea-wide service.The investment in The Way Forward hascontinued as intended. During the year, allmonies were kept strictly quarantined betweenthe two former Area Health Services underministerial direction, and both sets of accountsare presented for public viewing. These havealso been subjected to two audits, one for theperiod July-December 2004, and the other forJanuary-June 2005.With the great advantage that the two previousarea health services had both selected Cernerfor their clinical computing, we will continue our‘trailblazing’ development of integrated clinicalsystems. The roll-out of these as fully functionalpackages via the newly established HealthTechnology Unit will benefit the rest of the State.Sydney South West Area Health Service Statutory Annual Report 04/05 5

Chief Executive Year in ReviewIt is an exciting concept which we know willinspire our skilled staff long into the future.The amalgamation is an ongoing process. Iwould like to place on record my thanks for thepatience and continuing efforts of all staff whohave kept on with their daily workload withcommitment, despite the obvious anxiety of somany about the future, and their role in it. Wehave undertaken 32 planning exercises, many ofwhich are now being implemented in conjunctionwith our union colleagues.The amalgamation has seen a number of seniormanagers leave us and although there will befurther changes to the organisation, I do notbelieve we will have undue difficulty in placingevery staff member who wishes to stay with us.People are our most treasured resource andtheir value cannot be overestimated.As we are setting the new clinical streamstructure in place, and simultaneouslydismantling old sector management, we are alsoprogressively centralising many of theadministrative support functions. This will freemany people from dreaded paper work. It willalso change reporting and accountability lines,but it won’t change the activity at the frontline –people will still be getting sick, being treated andgoing home again after care. The fundamentalsof our services remain constant, even thoughthe governance frameworks may be altered.Prof Diana Horvath AOChief ExecutiveSydney South West Area Health Service Statutory Annual Report 04/05 6

Highlights$2.2 million for premature studyLiverpool Hospital joined 19 other neonatalintensive care units in Australia byparticipating in a $2.2 million National Healthand Medical Research Council funded trial onoxygen needs of very premature babies.The study was a major investment which couldimprove the long-term health of thousands ofvery premature babies not only in south-westernSydney but worldwide.The study, which aims to enrol 1200 babies bornmore than 12 weeks prematurely, will determinethe safest level of oxygen in the first few weeksafter birth.At two years of age, the babies will have aspecialist examination to compare health anddevelopmental skills.Professor of MidwiferyDr Pat Brodie was appointed as the inauguralUTS Professor of Midwifery, to develop andimplement models for midwife-led maternity carethroughout both the Area and the State.Canterbury Hospital celebrates 75yearsCanterbury Hospital celebrated its 75thanniversary with an official ceremony launchedby the NSW Minister for Health, Morris Iemma.The Hospital was opened in 1929 with just 28beds to serve a population of 70,000 people.Seventy-five years later it is a 184-bedmetropolitan general hospital that caters for adiverse population of more than 135,000 peopleof whom 57 per cent were born overseas.Cardiac catheter lab opensThe third cardiac catheter laboratory at LiverpoolHospital was opened by Premier Bob Carr andHealth Minister Iemma. The $2.8 million upgradeof the cardiac catheter laboratories at LiverpoolHospital will provide reduced procedure timeand improved safety for patients and staff.Chronic care collaborationA Chronic Care Collaborative in SSWAHSeastern zone was successful in improvingservices for people with Chronic ObstructivePulmonary Disease (COPD) and strengtheningcommunication between key stakeholdersacross the State.The collaborative team included respiratorynurses, general practitioners, area healthservice executives, health promotion officers,respiratory physicians, pulmonary rehabilitationphysiotherapists, an emergency physician, asmoking physiologist and a consumerrepresentative.Other interventions to increase the use of selfmanagementstrategies for patients with COPDhave followed the collaboration.Croydon Health Centre opensThe purpose-built $23 million Croydon HealthCentre opened in December 2004. The centreaccommodates nine different community healthservices, a 67-bed aged care facility and a 60-bed special care nursing home. The centreprovides early childhood health services, child,adolescent and family health services,community nursing, paediatric services includingaudiology, physiotherapy, occupational therapyand orthoptics, mental health clinical services, amental health living skills centre, communitydentistry and health interpreter services.Drug stimulates killer T-cells to fightcancerResearchers at RPA discovered how the drugthalidomide, once responsible for birth defects,works in the battle against multiple myeloma, adebilitating blood cancer.Laboratory studies conducted at the Institute ofHaematology at RPA, show that the drugstimulates the body’s own immune system toproduce killer T cells specifically directed to thecancer cells.Sydney South West Area Health Service Statutory Annual Report 04/05 7

HighlightsEchocardiology comes toCampbelltownMacarthur area heart patients in need of urgentdiagnosis now have access to a state-of-the-artechocardiology service at CampbelltownHospital.The new echocardiology service is part of the$133.7 million five-year Macarthur strategy andis part of a new cardiology network initiativewhich has provided 10 dedicated cardiologybeds at Liverpool Hospital for patients from allareas of south-western Sydney, giving cardiacpatients faster access to urgent procedures.Critically ill patients are diagnosed on the spot atCampbelltown Hospital, stabilised and thentransferred to the cardiology centre at LiverpoolHospital.South-western Sydney has the State’s highestincidence of heart disease.Linear acceleratorA second linear accelerator was commissionedat Campbelltown Hospital cancer treatmentcentre, with treatment of patients commencing inApril 2005. In addition, installation andcommissioning of a new linear accelerator in theRadiation Oncology department at RPA isunderway and the replacement of a 10-year-oldLINAC at Liverpool has commenced.Men’s health surveyedConcord Hospital launched the world’s largeststudy of older men’s health, aiming to recruit3,000 men over the age of 70 for a five-yearproject.The study will examine health issues such asfalls and fractures, osteoporosis, muscleweakness, male hormones, bladder andprostate health and mobility.Mental health unitsWork on the 50-bed acute adult inpatient MentalHealth Centre at Liverpool Hospital is almostcomplete.The centre will also house the ambulatory careservice which provides 17,000 home and walk-invisits for adults each year and a new dedicatedresearch area focusing on population mentalhealth and schizophrenia which will offer trainingprograms in psychology, occupational therapyand social work.In May, Health Minister Iemma officiated at thesod-turning ceremony at the new sub-acutemental health unit at Campbelltown. The 20-bedunit will be open for business in 2006.Mental health services located at GlebeCommunity Health Centre began the move to astate-of-the-art Community Health Centre inCamperdown as part of a $408 milliondevelopment of services and facilities in theeastern zone.New test for asthmaA team of researchers from RPA developed asimple test to help diagnose and manageasthma, one of Australia’s most commondiseases, affecting one in four children and onein 10 adults.The RPA test, developed commercially by thehospital through a licence with Australianbiotech company, Pharmaxis, uses a naturallyoccurring plant sugar. When inhaled, the sugarmimics a natural process that occurs in asthmapatients allowing clinicians to measure thebody’s reaction and medicate accurately.Nursing and Midwifery ServicesSince the amalgamation, Nursing and MidwiferyServices have worked towards developing asingle area-wide service. The delivery ofeducation and recruitment functions have beenreorganised and centralised to promoteefficiency and benefits of these strategies arealready apparent. A focus on recruitment ofnurses and midwives into permanent positionshas reduced vacancy rates, agency staff andovertime and there has been a significant andsuccessful recruitment drive of overseas nursesand midwives.SSWAHS provides an extensive range of needsbasededucational and professionaldevelopment opportunities and is a registeredhigher education institution. As well as providingformal education, SSWAHS is also committed tocontinuing professional development for nursesand midwives with over 200 area-wide clinicalenhancement and professional developmentprograms offered through the year.Sydney South West Area Health Service Statutory Annual Report 04/05 8

HighlightsPredictable Surgery PlanEfforts to cut long-term waiting lists for surgeryacross the Area are showing results, withincreases in booked surgery activity and adecline in the number of patients waiting morethan 12 months for surgery.The Area’s implementation of the statewidePredictable Surgery Plan has resulted inhospitals across the area sharply cutting thenumber of patients waiting for surgery for morethan 12 months and increasing access tosurgery for patients in all urgency categories.Canterbury Hospital achieved its target of zeropatients waiting longer than 12 months forsurgery by the end of June 2005.Measures to increase throughput and safetyincluded the opening of additional beds, theintroduction of 23-hour wards, the appointmentof additional surgeons and the addition of newsurgical lists. In the western zone, LiverpoolHospital has consolidated less urgent surgery atFairfield and Bankstown allowing it to focus onurgent and complex surgery.RPA redevelopmentThe $325 million redevelopment of RPAcontinued with the staged completion andcommissioning of the Clinical Services buildingand refurbishment of the King George Vbuilding.Staff morale improved in the new surrounds,boosting recruitment and retention rates ofnursing staff.The RMOQ courtyard was awarded first place inthe prestigious NSW Heritage awards, in theB1conservation built heritage category.A number of administrative and other servicesrelocated into the refurbished King George Vbuilding including, the George Institute, TheRPA Museum, Mental Health, Aboriginal MentalHealth, Child and Family Health Services andAboriginal Liaison Services.Smoke-free healthSSWAHS chief executive Professor DianaHorvath launched phase three of the Area’ssmoke-free environment policy at LiverpoolHospital on 30 June 2005.As part of the smoke-free policy, counselling andfour weeks’ free nicotine replacement therapy(NRT) will be provided on request to allemployees who quit smoking. Ongoing supportwith cost-price NRT will continue after the fourweekperiod.A similar NRT program will be offered tonicotine-dependent patients after assessment onadmission. Employees and patients with anexisting medical condition or pregnant womenmust first obtain a medical practitioner’sapproval to use NRT.The World Health Organisation has identifiedsmoking as the single most importantpreventable cause of avoidable illness andpremature death. Each year in Australia thereare over 19,000 tobacco-related deaths.State-of-the-art MRI aids patientsHealth Minister Iemma officially opened the new3.0 Tesla Magnetic Resonance scanner in June2005, which will significantly improve thediagnosis and treatment of stroke, one of thekey causes of death and disability forAustralians. It is also a key diagnostic tool forpsychiatric disorders.The MRI will also have important benefits forpatients when mental health facilities relocate toConcord Hospital, as well as for the diagnosisand treatment of a range of other disorders.Sydney Kid’s comes toCampbelltownThe Sydney Children’s Hospital Macarthur Unitwas opened at Campbelltown Hospital in August2004, providing services to children in the southwestof Sydney that were previously onlyavailable in Randwick or Westmead.The new unit has close links with SydneyChildren’s Hospital and offers paediatric surgery,enhanced paediatric emergency medicine andneurology, a specialist child diabetes service, anew centre for community child health and ajoint child and adolescent mental health unit forthe two hospitals.Three new paediatric specialists have beencross-appointed between Sydney Children’s andCampbelltown Hospitals to deliver the newservices.Sydney South West Area Health Service Statutory Annual Report 04/05 9

Asset ManagementResource Transition Program (eastern zone)Royal Prince Alfred HospitalStage 1 of the RPA East CampusRedevelopment was completed in late 2004 withall clinical services located in the new complex.The new design has resulted in improved staffmorale, along with increased recruitment andretention rates, particularly amongst nursingstaff.The reinstated RMOQ courtyard was awardedfirst place in the prestigious NSW Heritageawards, category B1 conservation built heritagein March 2005.Stage 2 of this program will commence in late2005. This $30 million project will complete the‘hot-floor’ (Level 3) of the clinical servicesbuilding and provide the final link to the surgicalsuite. Construction of the Perioperative unit atthe entrance to the operating theatre suite willstreamline services for patients and improvetheatre efficiencies.Completion of the new Stage 2a laboratories willenhance opportunities for teamwork and workingpartnerships between the various specialisedunits of the amalgamated Laboratory Services,facilitating faster and more reliable specimentesting and a more efficient service to clinicians.Concord Repatriation GeneralHospitalHealth Minister Iemma officially opened the new3 Tesla MRI machine in June 2005. A keydiagnostic tool for psychiatric disorders, the $2.8million state-of-the-art machine is the firstavailable to public patients in NSW.Work will begin on the new $40 million mentalhealth precinct in late 2005, providing 174mental health inpatient beds, as well asextended-care and rehabilitation services.A new ambulatory care building completedconstruction of the rehabilitation, aged careand medicine precinct and provides anentrance to refurbished aged care andrehabilitation wards accommodating 98inpatient beds. The project brings together anumber of disparate services, enhancing thelevel of care for this patient group.Croydon Health CentreThe $30 million Croydon Health Centre wasopened in December 2004. This inner-westhealth centre project has been a successfulpublic-private partnership between SSWAHS,Catholic Health Care Services and Bovis LendLease.The project included construction of the CroydonHealth Centre, a mental health rehabilitationunit, a 127-bed nursing home (including a 60-bed special care nursing home), undergroundcar parking for 200 vehicles and the futuredevelopment of over 110 independent andassisted living apartments.The new Croydon Health Centre provides anintegrated, community-based range of servicesincluding early childhood, child, adolescent andfamily, community nursing and post-acute careservices alongside dental services, podiatry,mental health and drug health teams.Interpreter services are also located within thecentre. The co-location of all these servicesallows a continuity of care across all age groupswithin the Burwood, Ashfield and Croydoncatchments.Marrickville Community HealthCentreConstruction of the Marrickville CommunityHealth Centre is underway with completionexpected in 2006. This $7 million project willprovide a purpose-built, one-stop facility forcommunity-based services including earlychildhood, child, adolescent and family,community nursing and post-acute careservices, multicultural and migrant healthalongside mental health and mental healthrehabilitation (living skills), podiatry and sexualhealth services. These will form an importantpart of the continuum of care of health servicesfor residents of the Marrickville LGA.Sydney South West Area Health Service Statutory Annual Report 04/05 10

Asset ManagementCapital Works Program (western zone)Camden and CampbelltownHospitalsThe $133.7 million Macarthur strategy continuedover the financial year. This visionary projectinvolves the demolition and sympatheticreconstruction of major sections of Camdenhospital and the redevelopment ofCampbelltown Hospital.Work at Campbelltown Hospital is entering itsfinal phase with the refurbishment of MaternityServices and North Block. From itscommencement in 2000, this project has seenCampbelltown Hospital transformed from anageing district hospital into a modern provider ofhigh-level clinical care.The construction of a $6.2 million non-acutemental health facility at Campbelltown Hospitalcommenced in March 2004 and is due forcompletion in late 2005. This unit willcomplement the service currently provided bythe acute inpatient facility and the adolescentservice and will greatly enhance SSWAHS’sability to provide mental health services to theMacarthur community and neighbouring areasincluding Liverpool.Liverpool HospitalThe $1.5 million extension of the InformationServices Building was completed in April 2005.Funded by the NSW Department of Health, thenew data centre is the support hub for anumber of key statewide informationmanagement initiatives.With a budget of over $9 million, alterationsand extensions to the Emergency Departmentwill be completed in September 2005. Thisinnovative project consists of staged works,allowing one of the busiest emergencydepartments in the State to continuefunctioning during redevelopment. Itscompletion will provide one of the largesttrauma centres in Australia and allowSSWAHS to meet anticipated increases in thedemand for emergency care in south-westSydney.A major new mental health facility on theLiverpool Hospital campus is scheduled forcompletion in early 2006. This $26 millionfacility will greatly enhance the treatment ofthe mentally ill residents of the area.STARTTS – Fairfield HospitalThe Service for the Treatment andRehabilitation of Torture and TraumaSurvivors (STARTTS) provides a holistic rangeof professional outpatient and outreachservices to refugees.A series of building works completed in February2005, at a cost of $1.5 million, allowedSTARTTS to expand its role and enhance thelevel of community based service it provides tothose in need across the metropolitan area.Sydney South West Area Health Service Statutory Annual Report 04/05 11

Health Service ProfileOn 27 July 2004, The Hon Morris Iemma,Minister for Health, announced theamalgamation of Area Health Services (AHS)across NSW, including formation of the newSydney South West Area Health Service(SSWAHS), combining the previous CentralSydney and South Western Sydney Area HealthServices. The amalgamated areas came intobeing as legal entities from 1 January 2005 withexisting areas continuing in legal force until thattime.SSWAHS is comprised of the following localgovernment areas (LGAs):• Sydney (part)• Leichhardt• Marrickville• Ashfield• Burwood• Strathfield• Canada Bay• Canterbury• Bankstown• Fairfield• Liverpool• Campbelltown• Camden• Wollondilly• WingecarribeeSSWAHS covers a land area of 6,380 squarekilometres and has a current population ofapproximately 1.33 million, representing 20 percent of the NSW population.With areas of both substantial new land releasefor residential development and medium densityurban infill, SSWAHS is one of the fastestgrowing parts of the State with its populationprojected to increase by up to 300,000 peopleby 2030, a 22 per cent increase.2,000,0001,800,0001,600,0001,400,0001,200,0001,000,000800,000600,000400,000200,0000Population Grow th to 2031EZ WZ SSWAHS2001 2006 2011 2016 2021 2026 2031Sydney South West Area Health Service Statutory Annual Report 04/05 12

Health Service ProfilePop ulation450000400000350000300000250000200000150000100000500000Sydney South West Area Health Service: Actual Population andProjections by Age Group2001 2006 2011 2016Year0-14 15-44 45-64 65-74 75+Source: Department Infrastructure Planning and Natural Resources, 2004Population characteristicsSSWAHS is the most ethnically diverse healtharea in Australia, with 39 per cent of thepopulation speaking a language other thanEnglish at home. This is most notable in Fairfieldand Canterbury, where over 60 per cent of thepopulation do not speak English at home. Ahigh proportion of new migrants to Australiachoose to settle in the south-west of Sydney,including refugees. There are considerablevariations between local government areas(LGAs) in the proportions of the populationidentifying as Aboriginal (highest in SouthSydney and Campbelltown).In addition to the influx of new migrants to theArea, the population grows by around 19,000new births per annum. In some parts of theArea, notably Canterbury, Liverpool andBankstown, birth rates are between 2.09 to 2.16,considerably above the State average of 1.79and this trend is projected to continue withyoung families expected to comprise a largeproportion of new residential developments.LGAs with the highest proportion of youngerpeople (0-14 years) are Camden, Campbelltownand Liverpool. Across the Area there are266,000 children under the age of 15representing 20 per cent of the total population.LGAs with the highest proportion of older people(85 years+) are Ashfield, Burwood andStrathfield. Across the Area there are 180,000people over the age of 65, representing 17 percent of the population. There are large numbersof elderly people in some of the SSW localgovernment areas, with more than 24,000people over the age of 65 in Bankstown andaround 18,000 in both Fairfield and Canterbury.Hospital data indicates that people over the ageof 65 years utilize 45 per cent of all acutehospital bed days. The number of people agedover 65 years is projected to increase by 45 percent by 2016 at which time they will represent 13per cent of the total population.South-western Sydney has some of the poorestcommunities in the State, characterised by alarge number of recent migrants, significantlyhigher unemployment and a high proportion offamilies dependent on welfare. Such areasinclude Fairfield, the fourth most disadvantagedLGA in NSW as ranked by the SEIFA Index, andCanterbury and Liverpool, which are both in thelowest quartile.The age standardised death rates for SSWAHSresidents are higher than the State average forboth males (721.8 per 100,000 vs 709) andfemales (457 per 100,000 vs 443).The major causes of death are circulatorydiseases, cancers, injury/poisoning andrespiratory diseases. These comprise about 80per cent of all deaths in both SSWAHS andNSW. The four major causes of death are thesame for both males and females. Deaths due tocancer, injury/poisoning and respiratorydiseases were higher among males. Theproportion of female deaths due toinjury/poisoning is about half that for males (4per cent vs. 8.5 per cent).Sydney South West Area Health Service Statutory Annual Report 04/05 13

Organisation ChartAs part of the amalgamation of area healthservices across New South Wales, the NSWDepartment of Health formalised a singleorganisational and management structure forarea health services. The aim of the structure isto improve corporate governance andmanagement of area health services.The organisational structure is separated intotiers and incorporates the clinical governancemodel as well as legislative and statutoryresponsibility for the Sydney South West AreaHealth Service (SSWAHS).The first tier within SSWAHS is the position ofChief Executive. The Chief Executive isaccountable for the overall corporategovernance, performance and strategic planningof the organisation. The position of ChiefExecutive reports directly to the Director-General of NSW Health.The seven positions within the second tier ofSSWAHS report to the Chief Executive. Thesesenior management positions are responsiblefor the delivery of clinical services, strategicplanning, workforce planning, performance,corporate support, finance and nursing for theorganisation.Internal AuditChief ExecutiveClinical Governance UnitClinical Quality UnitExecutiveSupportPublic Affairsand MarketingProfessionalPractice UnitDirector of ClinicalOperations(Deputy CE)Director ofCorporate ServicesDirector of PopulationHealth, Planning andPerformanceDirector of StrategicWorkforce Planningand DevelopmentDirector ofNursing Servicesand MidwiferyChief FinanceOfficerSydney South West Area Health Service Statutory Annual Report 04/05 14

Purpose and GoalsThe SSWAHS purpose, vision and strategicdirection has 10 inter-related Focus Areas forAction, which summarise the key priorities forthe Area Health Service. They are: -To keep people healthyPopulation healthSSWAHS will invest strategically to improvepopulation health. SSWAHS will take action toaddress social and environmental conditionsconducive to better health; reduce individualbehavioural health risk factors detrimental tohealth; and advocate for unmet needs andinequalities in population health.To provide the health care peopleneedAccessible health careNo one in SSWAHS should be disadvantagedfrom achieving and maintaining good health.Improving health requires that people haveaccess to the health services they need. Animportant priority for SSWAHS over the nextthree years is to ensure that its residents haveequal access to health services.Health care in the communityPrimary health care providers are the mostvisible and utilised part of the health care sector,and generally the first point of contact for peopleseeking help with their health. A strong and vitalprimary health care system is therefore essentialto the pursuit of better health outcomes inSSWAHS. SSWAHS will ensure that withgreater choice in the setting where care isdelivered, care is integrated, safe, of high qualityand appropriate to the needs of patients,consumers and their carers.To deliver high quality healthservicesCollaboration and community participationThe pursuit of better health outcomes is not justthe responsibility of individuals or of the widerhealth system. By strengthening ourpartnerships with our local communities and withother service providers we can work together toeffectively advance the health and wellbeing ofthe communities we serve.High quality clinical careFostering a culture that promotes high qualityhealth care through safety and compliance,clinical review, best practice and clinical riskmanagement is fundamental to the pursuit ofeffective clinical governance. SSWAHS willstrategically invest in enhancing the governanceof its clinical services to ensure that patients andconsumers receive reliable, appropriate, highquality and evidence-based clinical care.To manage health services wellWorkforce capabilityInvesting in our workforce and ensuring that theorganisation has the right volume and mix ofskills is essential to the fulfilment of our purposeand vision. Becoming an employer of choice bybuilding the kind of work environment that willattract skill and expertise to our Area, and enticepeople to stay, is an important strategic priorityfor SSWAHS.Continuous learningBuilding a successful future in SSWAHS isdependent upon a capacity to transform ourlocal knowledge, discoveries, talents andcreative energies into a sustainable benefit forour staff and communities. SSWAHS will investin building its knowledge base through research,encourage growth through innovation, andenhance the organisation’s service, academicand research capabilities.Leadership and directionStrengthening the capacity and capability of ourorganisation is critical to the successful pursuitof our vision. This requires strong and enduringcorporate governance arrangements. SSWAHSwill continue to build and strengthen corporategovernance systems and structures across theArea Health Service as a whole.Information managementA myriad of benefits may be obtained fromstrategic investment in structured informationmanagement systems. Indeed, informationsystems are critical to effective health serviceprovision and patient management, as well assystem efficiencies.Over the next three years, SSWAHS will ensurethat staff at all levels of the organisation haveaccess to technological support and timely andappropriate information to deliver high qualityhealth services.Financial sustainabilitySSWAHS is responsible for ensuring thatresources are used optimally and fairly to deliverhealth services to the people of SSWAHS.Sydney South West Area Health Service Statutory Annual Report 04/05 15

Corporate GovernanceThe Chief ExecutiveThe Chief Executive carries out all functions,responsibilities and obligations in accordance withthe Health Services Act of 1997.The Chief Executive is committed to better practicesas outlined in the Guide on Corporate Governance,issued by NSW Health.The Chief Executive has practices in place to ensurethe primary governing responsibilities of the SydneySouth West Area Health Service (SSWAHS) arefulfilled with respect to:• setting strategic direction• ensuring compliance with statutory requirements• monitoring performance of the Area HealthService• monitoring financial performance of the AreaHealth Service• monitoring the quality of health services• industrial relations/workforce development• monitoring clinical, consumer and communityparticipation• ensuring ethical practiceStrategic directionThe Chief Executive has processes in place for theeffective planning and delivery of health services tothe communities and patients serviced by SSWAHS.This process includes setting a strategic direction forboth the organisation and for the health services itprovides.Code of conductThe Chief Executive and the Area Health Service hasadopted a Code of Conduct (the Code) to guide allemployees and contractors in carrying out theirduties and responsibilities. The Code covers suchmatters as: responsibilities to the community,compliance with laws and regulations, and ethicalresponsibilities.A statement about the Code is included in the annualreport.Risk managementThe Chief Executive is responsible forsupervising and monitoring risk managementby the Area Health Service, including theSSWAHS system of internal controls. The ChiefExecutive has mechanisms for monitoring theoperations and financial performance ofSSWAHS.The Chief Executive receives and considers allreports of SSWAHS external and internalauditors and, through the Audit and CorporateRisk Management (CRM) Committee, ensuresthat audit recommendations are implemented.SSWAHS has a Risk Management Program andRisk Register that includes both clinical and nonclinicalrisks.Committee structureSSWAHS has a committee structure in place toenhance its corporate governance role. Thecommittees meet regularly, have defined termsof reference and responsibilities, and areevaluated against agreed performanceindicators.Quality committeesThe Chief Executive has systems and activitiesin place for measuring and routinely reporting onthe safety and quality of care provided to thecommunity. These systems and activities reflectthe principles, performance and reportingguidelines as detailed in the Framework forManaging the Quality of Health Services in NSWdocumentation. The key quality committees forSSWAHS are the Clinical Quality Councils(eastern and western zones).Audit and Corporate Risk Management(CRM) committeeThe Chief Executive has established an Auditand CRM Committee.The Audit and CRM Committee is chaired by anindependent external expert, with the followingmembership:• Chair: Independent external expert• Manager Internal Audit• Director Clinical Operations• Chief Financial Officer• Independent Auditor• Chief Executive (in attendance)Sydney South West Area Health Service Statutory Annual Report 04/05 16

Corporate GovernanceThe Audit and CRM Committee meets four timesper year. The objectives of the Committee areto:• maintain an effective internal controlframework• review and ensure the reliability and integrityof management and financial systems• review and ensure the effectiveness of theinternal and external audit functions• monitor the management of risks to thehealth service, including responsibility forreviewing and updating the Risk Register.For clinical risks, authority to analyse risks,implement preventative risk strategies andcontrol risks is delegated to the ClinicalQuality Councils (eastern and westernzones). For non-clinical risks, authority toanalyse non-clinical risks, implementpreventative risk strategies and control risksis delegated to officers, as outlined in theRisk Management Program.Finance and Performance committeeThe Chief Executive has established a Financeand Performance Committee. This Committee ischaired by the Chief Executive, with thefollowing membership:• Director Clinical Operations• Director Corporate Services• Chief Financial Officer• Director Population Health, Planning andPerformance• Director Nursing and MidwiferyThe Finance and Performance Committee meet12 times per year. The objectives of the Financeand Performance Committee are to:• examine budget allocations• monitor overall financial performance inaccordance with budget targets• develop and maintain efficient, costeffective finance functions and informationsystems• ensure appropriate financial controls are inplace• manage funds effectivelyThe Chief Executive complies with theprovisions of the Accounts and AuditDetermination for Health Services issued byNSW Health.Performance appraisalThe Chief Executive has ensured that there areprocesses in place to:• monitor progress of the matters andachievement of targets contained withinthe Performance Agreement between theChief Executive and the Director-Generalof NSW Health.• regularly review the performance of theSSWAHS through the Annual GovernanceReview process.This statement reflects the corporategovernance arrangement in place with theSydney South West Area Health Service(SSWAHS).Sydney South West Area Health Service Statutory Annual Report 04/05 17

Performance IndicatorsTo keep people healthyMore people adopt healthy lifestylesSSWAHS Performance Measures 2003Target04-05 2004Chronic disease risk factors• Alcohol (risk drinking behaviour %) 34 ▼ 28• Smoking (daily or occasionally %) 24 ▼ 24• Overweight or obese (%) 47 ▼ 49• Physical activity (adequate %) 46 ▲ 53• Fruit (recommended daily intake %) 50 ▲ 46• Vegetables (recommended daily intake %) 9 ▲ 6Chronic disease risk factors – overweight and obeseMajor factors impacting performanceIncreasing overweight and obesity in the population is a phenomenon faced by all developed countries.Factors that impact upon overweight and obesity are often outside of the control of health services.Prior to amalgamation, a needs assessment around obesity prevention was undertaken in the easternzone, and a number of recommendations made for area-wide activities. In the western zone, populationnutrition and physical activity plans have been prepared.Actions being taken to meet target includeThere has been considerable investment in the eastern zone in an Area Active Transport policy, designedto increase physical activity through less motor vehicle use. This program will be expanded to the westernzone.A new strategic plan for health promotion is being prepared with explicit focus on obesity prevention. Thiswill include the development of an area-wide policy, a staff development and training strategy, andstrategies with partner organisations to increase physical activity and nutrition awareness.SSWAHS Performance Measures 2002 2003Potentially avoidable mortality - persons aged75 and under (age-adjusted rate per 100,000population)185 169Sydney South West Area Health Service Statutory Annual Report 04/05 18

Performance IndicatorsTo keep people healthyPrevention and early detection of health problemsSSWAHS Performance Measures 02-03 03-04Fall injuries - for people aged 65 years +(age standardised hospital separation rate per100,000 population)• Male 1,937 1,987• Female 2,928 2,797Falls injuriesTarget achieved for females. An area-wide approach to falls injuries has commenced and a project officerto coordinate prevention and in-hospital approaches will be appointed in 2006.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05People aged 65 years + immunised against:Influenza - in the last 12 months (%) 76 85 76Pneumococcal disease – in the last 5 years (%) 46 ▲ 44People aged 65 yrs+ immunised against Influenza – in the last 12 monthsMajor factors impacting performanceThe individual practice of GPs has the largest influence on influenza immunisation rates in over 65 yearolds.Actions being taken to meet target includeRegular formal and informal liaison with Divisions of General Practice about immunisation issues isconducted and direct advice and education has been provided to general practitioners about vaccinationmatters. Liaison with nursing home staff is ongoing. A project to vaccinate Aboriginal elders in thewestern zone was undertaken in 2005.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Breast cancer screening – two yearlyparticipation rate for women 50-69 years (%) 46.1 49.8 47.3Breast cancer screeningFollowing the establishment of the NSW Cancer Institute, the Area has renegotiated the breast screeningtarget to 49.8% of the eligible age group (women aged 50-69) and has been allocated additional funds tohelp achieve this new target.Sydney South West Area Health Service Statutory Annual Report 04/05 19

Performance IndicatorsTo keep people healthyA healthy start to lifeSSWAHS Performance Measures 2003 2004First antenatal visit before 20 weeks gestation (%)• Aboriginal mothers 58 61• Non-Aboriginal mothers 80 83Low birthweight babies –births with birthweight less than 2,500g (%)• Aboriginal 11 9• Non-Aboriginal 6 7First antenatal visit and low birth weight babiesTargets were exceeded due to much better coordination and integration between maternal and childservices, community health and specialised services, for example, Aboriginal Health and Drug Health.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Infants fully immunised - at 12 to < 15 months (%) 92 94 90Infants fully immunised - at 12 to < 15 monthsMajor factors impacting performanceSSWAHS works closely with GPs to influence immunisation rates, as GPs are the providers of at least 85per cent of childhood vaccinations in NSW for this age group. While considerable efforts by the AreaHealth Service are put into immunisation coordination, education of general practitioners, and liaison withDivisions of General Practice, it is the individual clinical practice of GPs which is the largest influence onthis indicator.Other factors impacting performance includeConscientious parental objection to immunisation affects the number of children immunised. Redfern,Pyrmont and Glebe postcode areas have higher rates of conscientious objection to immunisation than theNSW State average.Actions being taken to meet target includeRegular formal and informal liaison with Divisions of General Practice about immunisation issues is beingundertaken. Council clinics are to be supported in their activities and ACIR reporting and annual updateswill be conducted for nurse immunisers.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Families First Universal Health Home Visits(UHHV):• Offered• Received within 2 weeks of the birth Data not available Data not availableSydney South West Area Health Service Statutory Annual Report 04/05 20

Performance IndicatorsTo provide the health care people needEmergency care without delaySSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Off stretcher time - transfer of care to emergencydepartment within > 30 minutes of ambulancearrival (%) 64 90 59Emergency department(cases treated within Australian College ofEmergency Medicine (ACEM) benchmark times %)• Triage 1 100 100 100• Triage 2 79 80 79• Triage 3 53 75 56• Triage 4 61 70 65• Triage 5 87 70 86Emergency department - cases treated within ACEM benchmark times (%):Triage 3 (within 30 minutes)Major factors impacting performance includeED activity in Campbelltown in Triage 2 and Triage 3 patient presentations has shown significant growth.Building works in Liverpool ED disrupted access between Waiting/Ambulance and Triage. Also, thenumber of mental health patients spending prolonged periods in ED has increased, especially atLiverpool and Campbelltown Hospitals, delaying access of arriving patients to the treatment areas.Actions being taken to meet target includeCompletion of building works at Liverpool Hospital and the Clinical Redesign project on patient flow inLiverpool and RPA EDs has enhanced access at these facilities. Work has also commenced with EDdirectors across the Area to implement recruitment and retention strategies for emergency physicians tofill vacant positions. A psychiatric emergency care centre (PECC) will open at Liverpool; a new 50-bedacute mental health centre will open at Liverpool and a 30-bed sub-acute mental health unit will open atCampbelltown.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Access block -(% of ED patients not transferred to an inpatientbed within 8 hours of commencement of activetreatment) as at 30 June 2005 42 34 36Sydney South West Area Health Service Statutory Annual Report 04/05 21

Performance IndicatorsTo provide the health care people needShorter waiting times for booked non-emergency careSSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Waiting times - booked medical and surgicalpatients as at 30 June 2005• Waiting more than 30 days(categories 1 & 2) 1,086 ▼ 1,119• Waiting more than 12 months(categories 1,2, 7 & 8) as at 30 June2005 2,007 1,100 1,282Waiting times - booked medical and surgical patients:More than 30 days - categories 1 and 2 (number)Actions being taken to meet target includeDirectors of Surgery are leading work to ensure appropriate categorising of Category 1 patients bysurgeons. A regular list review and audit by the Area coordinator is in process to ensure that Category 1and 2 patients have timely priority access to surgery.Waiting times - booked medical and surgical patients: More than 12 months -categories 1,2, 7 and 8 (number)Note: Long waits declined at the start of year from 2500 to 1282 at the end of June 2005.Actions being taken to meet target includeThe appointment of an additional ENT surgeon and a PRNIP ophthalmologist at Bankstown will decreasewaiting times. Additional beds (101 across the Area) have been opened and are available for electivesurgery. A 23-hour surgical ward model is being implemented at Liverpool, RPA and Concord, andadditional general surgical lists at Bankstown are now permanently in place. A Predictable Surgery Planhas been implemented to achieve 2005/06 performance targets. The consolidation of complex subspecialitysurgery in the western zone to increase throughput and safety, for example, plastics andurology at Bankstown and joint replacement at Fairfield. This reduces the likelihood of non-urgent surgeryhaving to be cancelled at Liverpool to accommodate emergency and trauma cases.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Average length of stay - overall, includingsame day admissions (days) 4.6 4.6Public hospital beds occupied by patients waiting forother care or accommodation Data not available Data not availableSydney South West Area Health Service Statutory Annual Report 04/05 22

Performance IndicatorsTo provide the health care people needFair access to mental health servicesSSWAHS Performance MeasuresMental health – need met for services (%)• Ambulatory care• Acute inpatient• Non-acute inpatientBaseline03-04Target04-05Achievement04-0548% 48%80% 80%34% 26%Mental healthCommissioning of a new 50-bed mental health facility at Liverpool Hospital will increase bed capacity,access to acute beds and overnight inpatient separations. This facility is scheduled for commissioningduring early 2006.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Radiotherapy utilisation rates Data not available Data not availableSydney South West Area Health Service Statutory Annual Report 04/05 23

Performance IndicatorsTo deliver high quality health servicesConsumers satisfied with all aspects of services providedSSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05% of the surveyed population rating their healthcare as “excellent, very good or good“ for:• Emergency department 74 ▲ 75• Hospital inpatient 91 ▲ 92• Community Health Centres 88 ▲ 92Consumer responseData provided through the Continuous Health survey indicates that all targets are achieved.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Complaints resolved within 35 days (%) 86 80 87Complaints resolvedThe establishment of a Professional Practice Unit in the Area has had a major impact on the quality andtimeliness of complaint management.SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Standardised measure of patient experiencefollowing treatment Data not available Data not availableSydney South West Area Health Service Statutory Annual Report 04/05 24

Performance IndicatorsTo deliver high quality health servicesHigh quality clinical treatmentSSWAHS Performance MeasuresUnplanned:Baseline03-04Target04-05Achievement04-05• Overnight re-admission to hospital(within 28 days of discharge followingbooked surgery %) 3.81 ▼ 1.70• Re-admission to ICU(within 72 hours of discharge from anICU) 2.09 ▼ 1.52• Return to an operating room(booked surgery only %) 0.95 ▼ 0.82SSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Mental Health acute adult readmission - within28 days to same facility (%) 5

Performance IndicatorsTo deliver high quality health servicesCare in the right settingSSWAHS Performance Measures 02-03 03-04Potentially avoidable hospital admissions -age adjusted rates per 100,00 population• Vaccine preventable 75 65• Acute 691 1,447• Chronic 1465 712SSWAHS Performance Measures 02-03 03-04Potentially avoidable hospital admissions - ageadjusted rates per 100,00 population• Aboriginal 3,334 3,000• Non-Aboriginal 2,185 2,186Aboriginal Health – potentially avoidable hospital admissions – (age-adjustedrates per 100,000 population):Major factors impacting performance includeVascular health is the leading health problem for the Aboriginal population. Environmental Health isanother aspect of Aboriginal Health which has broad consequences including asthma, food bornediseases, trachoma and rheumatic heart disease. Self-harm is also an area of critical importance as is theissue of drug and alcohol abuse, which can lead to hospital admissions. Admissions into the health caresystem by Aboriginal people often occur at the chronic stage of disease.Actions being taken to meet target includeAboriginal Health now has a number of social and emotional wellbeing staff who aim to address andsupport self harm through capacity building of individuals. An MOU on alcohol and drug use has beendeveloped for the greater west of Sydney, intended to direct drug health and Aboriginal health servicesto reduce harmful drug and alcohol use. From this MOU, an Aboriginal drug health action plan has beendeveloped.Vascular health is being addressed by Aboriginal health through the Aboriginal home visiting program.Also, the Aboriginal Health Promotion Plan has recently been completed and focuses on smoking,physical activity, nutrition and stress in order to combat vascular health problems. RPA has recentlyintroduced the Aboriginal Cardiovascular Health project targeting indigenous users of services at RPA.Non-Aboriginal health - potentially avoidable hospital admissions – (ageadjustedrates per 100,000 population):This indicator reflects a need for improvement in primary, secondary and tertiary prevention and improvedmodels of care for patients with chronic and complex conditions. The Area has a wide range of strategiesto improve both these areas, for example, improved immunisation rates, diabetes management programs,chronic obstructive pulmonary disease (COPD) programs. A significant improvement in avoidableadmission has occurred, for example, due to the COPD program. The Area will continue to implementthese and other strategies to prevent avoidable admissions.Sydney South West Area Health Service Statutory Annual Report 04/05 26

Performance IndicatorsTo manage health services wellSound resource and financial managementSSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Net Cost of Service General Fund (General)- variance against budget) n/a 0 -0.08Total general creditors profile monthly average(days)51 daysCreditors >45 days as at the end of year ($) n/a 0 $1.9 millionMajor and Minor Works: variance againstapproved BT4 capital allocation (%) -2.3 0 13.1Maintenance expenditure as % of total replacementvalue of assetsData not available0.85% for 6months ending30 June 2005To manage health services wellSkilled, motivated staff working in innovative conditionsSSWAHS Performance MeasuresBaseline03-04Target04-05Achievement04-05Proportion of total staff that are: medical, nursing,allied, dental or uniformed ambulance (%) 66.0 ▲ 66.9StaffSSWAHS is the largest Area health Service in NSW with a workforce of 16,411. The workforce hasgrown steadily over recent years with nurses being the largest component of our workforce.To manage health services wellStrong corporate and clinical governanceSSWAHS Performance MeasuresCorporate Governance StatementClinical Governance StatementBaseline03-04Target04-05Achievement04-05Non quantitative:no data suppliedNon quantitative:no data suppliedSydney South West Area Health Service Statutory Annual Report 04/05 27

Clinical GovernanceClinical Governance DirectionsStatementThe NSW Patient Safety and Clinical QualityProgram was implemented in 2004 to improveclinical governance by providing staff with thesupport they need to deliver safer, better qualitycare.Under the program, Sydney South West AreaHealth Service (SSWAHS) was required toimplement the clinical governance functionsfrom the Implementation Plan that commencedin June 2005.This is to be achieved through the establishmentof the Clinical Governance Unit. The Unitprovides the roles of support, performance andconformance to develop and monitor policiesand procedures for improving systems of care.This includes the designation of a SeniorComplaints Officer to receive and manageserious complaints.Program reportingSSWAHS Clinical Governance programperformance reports were lodged with NSWHealth in October 2004 and June 2005.100 per cent of the Clinical Governanceperformance measures due by June 2005 wereimplemented.In achieving this result, SSWAHS is satisfiedthat it has implemented the required clinicalgovernance functions.Clinical Governance Unit2004/05CGU formation and qualityimprovementTo ensure and improve the safety and quality ofhealth care for our patients and our community,a Clinical Governance Unit (CGU) has beenestablished with Dr Peter Kennedy as theDirector.At SSWAHS, the quality of care and serviceprovided to our consumers is of greatimportance to all staff and is fundamental to oureveryday work practices. The commitment toquality and safety is apparent when reflecting onthe implementation of our patient safetyprogram, and when reviewing the recent resultsof each facility’s Australian Council on HealthStandards, Evaluation and Quality ImprovementProgram (ACHS EQuIP) Accreditation surveys.All facilities continue to meet EQuIPAccreditation standards. This has beenchallenging as there is now mandatory criteriathat must be met before an organisation can beaccredited. Our staff are also dedicated tocontinuous improvement in all aspects of theirwork. The CGU unit provides training andassistance to departments undertaking qualityimprovement projects. These projects haveachieved success in many externally run qualityawards including:2004 NSW Multicultural CommunicationAwardMulticultural HIV/AIDS and Hepatitis C Service(MHAHS) won the 2004 NSW MulticulturalCommunication Award for a series of posters incommunity languages encouraging HIV/STIscreening among gay men from Culturally andLinguistically Diverse (CALD) backgrounds -Tadgh McMahonAustralian Healthcare Association (AHA)National Awards 2004Finalist: RPA - Improving Medical ImagingReport Turn Around Times – A/Prof MichaelFulhamNSW Premiers Award 2004Finalist: RPA - Improving Medical ImagingReport Turn Around Times - A/Prof MichaelFulham.Sydney South West Area Health Service Statutory Annual Report 04/05 28

Clinical GovernanceAsia Hospital Management 2004 AwardsRunner-up: RPA - Improving Medical ImagingReport Turn Around Times - A/Prof MichaelFulham (IT and e-commerce category)Runner-up: CRGH - Weigh Scale Transporter- Stan Scahill (customer service category)Baxter NSW Health Awards 2004Finalist: RPA - Improving Medical ImagingReport Turn Around TimesFinalist: SDH - Helping Carers CareFinalist: Area - Fortifying texture modifiedmeals with infant cereal: thick, cheap and easy!Highly commended: Area -Teaching the Toolsof Quality Using Automated ElectronicTemplatesSSWAHS Quality Improvement Postercompetition: June 20051 st PrizeEastern zone: Respiratory Medicine - ChronicCare Collaborative - Better outcomes forpersons with chronic obstructive pulmonarydiseaseEqual 2 nd prizeLiverpool: Neurosurgery Department - Fallinghead over heels. Reducing falls in neurosurgerypatientsFairfield: Joint Whitlam Program –Orthopaedics - Restrictive blood transfusionpractices following primary TKREqual 3rd prizeConcord: Ward 6 North - Preparing yourself forsurgeryLiverpool: Risk Management Working PartyMultidisciplinary Team - Rapid screeningreviews of hospital mortalityHighly commendedRPA: Department of PET and Nuclear Medicine‘Meaningful’ clinical indicators in a medicalimaging departmentProfessional Practice Unit (PPU) andpatient complaintsThe Professional Practice Unit (PPU) isresponsible for overseeing the management ofall complaints within the Area. The PPUmanager is the Area’s designated seniorcomplaints officer. As well as dealing withcomplaints, grievances and professional practiceissues, the unit also proactively promotes ethics,professional practice and the SSWAHS code ofconduct.The PPU currently consists of a manager and anArea patient complaints officer who have acombination of clinical, legal and mediationskills. They also have administrative support.The PPU meets monthly with the Area’s patientliaison officers to develop a standard bestpractice approach to complaint handling. ThePPU also works closely with the HumanResource and Development unit to facilitateeducation around professional practice, ethics,code of conduct and complaint handling.IIMSThe Incident Information Management System(IIMS) project is a statewide initiative designedto support the NSW Safety ImprovementProgram. It is a key component in the NSWPatient Safety and Clinical Quality Strategy.Designed to assist clinicians, managers andother health care workers to minimise any risksin health services by managing all health careincidents as they occur, IIMS has beensuccessfully implemented in SSWAHS and staffare now using the system to notify incidents ofall types.More than 1,400 managers have been trainedon the system and are now using it to manageincidents. Reports generated from IIMS havebeen providing information for patient safety andquality improvement programs. Ongoing supportis available and continuous improvements forIIMS software are occurring in order to meetstaff needs.Root cause analysis / patient safetyprogramRoot Cause Analysis (RCA) is used to reviewand analyse an incident to identify the factorsthat contributed to it and to recommend actionsto prevent a similar occurrence. SSWAHS hasnow undertaken 147 Root Cause Analyses intoserious incidents and many improvements topatient care have been implemented as a result.Staff must be trained in the RCA process beforethey can lead an RCA investigation. 278 staffhave been trained in the RCA process so far.Training was initially conducted by NSW Healthand the Clinical Excellence Commission. Asmall faculty of our staff have undergone theTrain the Trainer program and are now able totrain staff within SSWAHS. Two RCA trainingcourses were run by our staff in 2004/05.Sydney South West Area Health Service Statutory Annual Report 04/05 29

Selected Activity LevelsSelected data for the year ended June 2005 part 1* Data provided by NSW HealthHospital nameSeparations Planned as% of totalseparations% of samedayseparationTotal beddaysAveragelength ofstay(acute) 3Daily average ofinpatients 4Rozelle Hospital 3,074 2.0% 64,484 177Department ofForensicMedicineScarba House –Central SydneyUnitBalmain Hospital 2,096 15.3% 24,200 66Canterbury15,652 21.6% 25.9% 58,801 3.5 161HospitalRPA Hospital 56,376 47.6% 43.2% 236,050 4.2 647CommunityHealth – CentralSydney AHSTresillian Care 2,368 0.9% 11,296 31CentreThomas Walker 526 23.0% 59.1% 2,389 7Concord Hospital 39,287 68.8% 60.1% 141,092 3.4 387RPA Institute 2,129 89.7% 25.9% 9,978 4.7 27Rheumatology /OrthopaedicsSydney DentalHospitalKaritane884 52.9% 2.3% 3,481 10MothercraftSocietyScarba House –South WestSydney AHSCamden Hospital 7,938 59.9% 72.3% 26,571 2.2 73Fairfield Hospital 15,049 26.5% 25.5% 51,329 3.4 141Liverpool57,966 52.7% 53.7% 219,212 3.7 601HospitalCampbelltown 22,171 17.6% 16.7% 92,164 4.1 253HospitalBankstown27,047 38.4% 36.3% 130,069 4.6 356HospitalBraeside Hospital 3,409 0.1% 69.6% 22,970 63Queen Victoria(Thirlmere)Bowral Hospital 8,492 22.0% 44.7% 23,365 2.6 64South WestSydney AHSExpenditureSSWAHS Total 264,464 43.5% 43.0% 1,117,451 3.8 3,062Sydney South West Area Health Service Statutory Annual Report 04/05 30

Selected Activity LevelsSelected data for the year ended June 2005 part 2* Data provided by NSW HealthHospital nameOccupancyrate 5Acute beddaysAcuteovernight beddaysNonadmittedpatientservicesRozelle Hospital 12,021Department of51,284Forensic MedicineScarba House –2,128Central SydneyUnitEDattendances8Balmain Hospital 124,803 15,665Canterbury89.0% 52,277 48,237 181,036 24,157HospitalRPA Hospital 94.9% 235,916 211,588 589,403 45,575Community Health– Central SydneyAHS340,236Tresillian Care58,474CentreThomas Walker 9,791Concord Hospital 105.8% 130,329 106,825 289,535 23,605RPA InstituteRheumatology /Orthopaedics60.2% 9,978 9,426 19,139Sydney DentalHospitalKaritaneMothercraft SocietyScarba House –South West SydneyAHS186,02430,3548,044Expenses – allprogram ($000)Camden Hospital 82.5% 16,445 10,701 120,067 9,775Fairfield Hospital 76.1% 51,262 47,422 270,646 23,768Liverpool Hospital 97.6% 211,083 179,938 556,540 46,909Campbelltown 92.5% 91,108 87,385 328,780 34,758HospitalBankstown96.7% 120,814 110,996 396,942 30,673HospitalBraeside Hospital 21,985Queen Victoria4,111(Thirlmere)Bowral Hospital 85.9% 22,017 18,219 98,614 16,095South West Sydney318,225AHS ExpenditureSSWAHS Total 94.1% 941,229 830,737 4,018,182 270,980 1,981,885* See notes on page 32.Sydney South West Area Health Service Statutory Annual Report 04/05 31

Selected Activity LevelsSelected data for the year ended June 2005Notes:Inpatients activity data are not directly comparable to previous years’ published data in the followingways:- the Health Information Exchange (HIE) data were used except for The Children’s Hospital atWestmead, Sydney South West and North Coast where Department of Health Reporting System(DOHRS) data were used for bed days due to issues in the HIE;- the number of separations includes care type changes;All historical data were recalculated using the same method and source of data.2. Includes services contracted to the private sector.3. Acute average length of stay = (acute bed days) / (acute separations)4. Daily average of inpatients = total bed days / 365.5. The bed occupancy rate includes only June data and covers only major facilities. This is notcomparable with earlier reports as bed occupancy previously contained information for a full year andincluded community and non-acute facilities. The following bed types are excluded from all occupancyrate calculations: emergency departments, delivery suites, operating theatres and recovery wards. From2004/05 Residential Aged care, Confused and Disturbed Elderly, Community residential and respiteactivity was also excluded. Unqualified baby bed days were included in occupied bed days from 1 July2002.6. June 2005 Justice health inpatient data were not available and are not included.7. Acute separation is defined by service category of acute or newborn.8. Emergency Department attendances are based on DOHRS and Emergency Department InformationSystem (EDIS) and are not comparable to previous years’ data as pathology and radiology servicesperformed in Emergency Departments are excluded from 2004/05 data.9. Non-Admitted Patients Service data for the Justice Health were provided directly by Justice Healthrather than through DOHRS as for other Area Health Services.10. Inpatients data for 2000/01 are incomplete due to the introduction of the HIE in 2000.Sydney South West Area Health Service Statutory Annual Report 04/05 32

Selected Activity LevelsBed and bed equivalents and bed occupancy, June 2005Beds in emergency departments, delivery suites, operating theatres and recoveryrooms are excluded* Data provided by NSW HealthHospital nameJune bedcount – allbedsGeneralhospital unitsNursing homeunitsCommunityresidentialOther unitsRozelle Hospital 194 194BedequivalentsBalmain Hospital 78 78Canterbury184 184HospitalRPA Hospital 721 721Tresillian Family 36 36Care CentresThomas Walker 17 17HospitalConcord Hospital 411 411RPA Institute of 54 54Rheumatology /OrthopaedicsKaritane16 16MothercraftCentreCamden Hospital 82 82Fairfield Hospital 206 206Liverpool649 649HospitalCampbelltown 283 283HospitalBankstown395 395HospitalBraeside Hospital 72 72Carrington94 94CentennialNursing HomeQueen Victoria 100 100(Thirlmere)Bowral Hospital 83 83Mental Health3 3Group Homes -BankstownMental Health 14 14Group Homes -CampbelltownMental Health 43 43Group Homes -LiverpoolCompacks 19 19Transitional CareHome based30 30* See notes on page 34.Sydney South West Area Health Service Statutory Annual Report 04/05 33

Selected Activity LevelsBed and bed equivalents and bed occupancy, June 2005Notes:The numbers of available beds presented reflect the average for June 2005 and are not comparable withinformation from previous years as these were based on average available beds for a full financial year.Since March 2005, the bed information previously obtained from the Department of Health ReportingSystem (DOHRS) was replaced by a new beds collection, which provided more detailed information onbed type and availability. Owing to the limited period that the new bed collection has been in place, it isnot possible to provide an average number of beds for the year.Beds in emergency departments, delivery suites, operating theatres and recovery wards are excluded.A bed equivalent is the estimated additional bed capacity arising from services provided to reduce apatient’s period of stay in hospital or from initiatives that provide alternatives to an admission to hospital.The number of bed equivalents is not comparable with those in the 2003/04 Annual Report, as thesewere derived based on admissions reclassified to non-inpatients. Data on such activity are no longercollected.Sydney South West Area Health Service Statutory Annual Report 04/05 34

Health Service LocationsPublic HospitalsBalmain Hospital29 Booth StreetBalmain NSW 2041Tel: (02) 9395 2111Fax: (02) 9395 2020Email: lee.barlow@email.cs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auBankstown HospitalEldridge RoadBankstown NSW 2200Tel: (02) 9722 8000Fax: (02) 9722 8570Email: chris.wood@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auBowral and District HospitalCorner Mona Road and Bowral StreetBowral NSW 2576Tel: (02) 4861 0200Fax: (02) 4861 4511Email: elizabeth.brunette@sswahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auCamden HospitalMenangle RoadCamden NSW 2570Tel: (02) 4634 3000Fax: (02) 4654 6240Email: jane.ferguson@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auCampbelltown HospitalTherry RoadCampbelltown NSW 2560Tel: (02) 4634 3000Fax: (02) 4634 3880Email: jane.ferguson@sswahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auCanterbury HospitalCanterbury RoadCampsie NSW 2194Tel: (02) 9787 0000Fax: (02) 9787 0031Email: canterbury@email.cs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auConcord Repatriation General HospitalHospital RoadConcord NSW 2139Tel: (02) 9767 5000Fax: (02) 9767 6991Email: concordinfo@email.cs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auFairfield HospitalCorner Polding Street and Prairievale RoadPrairiewood NSW 2176Tel: (02) 9616 8111Fax: (02) 9616 8240Email: sandra.lombardini@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auLiverpool HospitalCorner Elizabeth and Goulburn StreetsLiverpool NSW 2170Tel: (02) 9828 3000Fax: (02) 9828 6318Email: anne.crowley@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auRoyal Prince Alfred HospitalMissenden RoadCamperdown NSW 2050Tel: (02) 9515 6111Fax: (02) 9515 5001Email: susan.cameron@cs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auRozelle HospitalCorner Church and Glover StreetsLeichhardt NSW 2040Tel: (02) 9556 9100Fax: (02) 9818 5712Email: rozelle@email.cs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auSydney Dental Hospital2 Chalmers StreetSurry Hills NSW 2010Tel: (02) 9293 3200Fax: (02) 9293 3488Email: sydneydentalhospital@email.cs.nsw.gov.auWeb: www. sswhealth.nsw.gov.auSydney South West Area Health Service Statutory Annual Report 04/05 35

Health Service LocationsThird Schedule FacilitiesTresillian Family Care CentresHead OfficeMcKenzie StreetBelmore NSW 2192Tel: (02) 9787 0800Fax: (02) 9787 0880Email: tresillian@email.cs.nsw.gov.auWeb: www.tresillian.netCarrington Centennial Care90 Werombi RoadCamden NSW 2570Tel: (02) 4659 0590Fax: (02) 4655 1984Email: carrington@carringtonrv.org.auWeb: www.sswhealth.nsw.gov.auBraeside Hospital340 Prairievale RoadPrairiewood NSW 2176Tel: (02) 9616 8600Fax: (02) 9616 8605Email: connie.chan@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auKaritaneCorner The Horsley Drive and Mitchell StreetCarramar NSW 2163Tel: (02) 9794 1800Fax: (02) 9794 1858Email: robert.mills@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auQueen Victoria Memorial Home615 Thirlmere WayPicton NSW 2571Tel: (02) 4683 6900Fax: (02) 4683 6910Email: jane.hartley@swsahs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auSydney South West Laboratory ServicesMissenden RoadCamperdown NSW 2050Tel: (02) 9515 7960Fax: (02) 9515 7931Email: maureen.harrison@cs.nsw.gov.auWeb: www.sswhealth.nsw.gov.auCommunity Facilities - easternzoneCommunity Health ServicesCamperdown Child, Adolescent and FamilyHealth ServiceCamperdown Community Health CentreLevel 5, King George V BuildingMissenden RoadCamperdown NSW 2050Tel: (02) 9515 9788Croydon Health Centre24 Liverpool RoadCroydon NSW 2132Tel: (02) 9378 1100Fax: (02) 9378 1111Croydon Child, Adolescent and Family HealthServiceCroydon Health Centre24 Liverpool RoadCroydon NSW 2132Tel: (02) 9378 1100Canterbury Child, Adolescent and Family HealthServiceCanterbury Community Health CentreCorner Thorncraft Parade and Canterbury RoadCampsie NSW 2194Tel: (02) 9787 0600Other ServicesDepartment of Forensic Medicine50 Parramatta RoadGlebe NSW 2037Tel: (02) 8584 7800Fax: (02) 9552 1613Email: pattersonm@email.cs.nsw.gov.auWeb: www.forensic.org.auCanterbury Community Nursing ServiceCanterbury Community Health CentreCanterbury HospitalCanterbury RoadCampsie NSW 2194Tel: (02) 9787 0599Canterbury Multicultural Youth Health ServiceCanterbury Community Health CentreCorner Thorncraft Parade and Canterbury RoadCampsie NSW 2194Tel: (02) 9787 0600Sydney South West Area Health Service Statutory Annual Report 04/05 36

Health Service LocationsCellblock Youth Health Service142 Carillon AvenueCamperdown NSW 2050Tel: (02) 9516 2233Community HIV/AIDS Allied HealthRedfern Community Health Service1 Albert StreetRedfern NSW 2016Tel: (02) 9395 0444Community NutritionLevel 6, King George V BuildingMissenden RoadCamperdown NSW 2050Tel: (02) 9515 9729Community Paediatric Occupational TherapyServicesCamperdown Child, Adolescent and FamilyHealth ServicesLevel 5, KGVMissenden RoadCamperdown NSW 2050Tel: (02) 9515 9788Community Paediatric Physiotherapy ServicesCroydon Health Centre24 Liverpool RoadCroydon NSW 2132Tel: (02) 9378 1100Concord Community Nursing ServiceConcord HospitalHospital RoadConcord NSW 2139Tel: (02) 9767 6199Croydon Community Nursing Service24 Liverpool RoadCroydon NSW 2132Tel: (02) 9378 1100Eastern and Central Sexual Assault ServiceL5, King George V BuildingMissenden RoadCamperdown NSW 2050Tel: (02) 9515 9040Lewisham Community Nursing ServiceC/- Ann Walsh HouseOzanam VillageWest StreetLewisham NSW 2049Tel: (02) 9560 9711Marrickville Child, Adolescent and Family HealthService184 Livingstone RoadMarrickville NSW 2204Tel: (02) 9550 0155Migrant Health TeamRedfern Community Health Centre1 Albert StreetRedfern NSW 2016Tel: (02) 9395 0444Multicultural HIV/AIDS and Hepatitis C ServiceLevel 1, Building 12Corner Grose Street and Missenden RoadCamperdown NSW 2050Tel: (02) 9515 5030Redfern Community Health Centre1 Albert StreetRedfern NSW 2016Tel: (02) 9395 0444The Sanctuary6 Mary Street,Newtown NSW 2040Tel: (02) 9519 6142Early Childhood Health ServicesEastern Sector CentresBalmain530A Darling StreetRozelle NSW 2039Tel: (02) 9810 1609CamperdownLevel 5, KGVMissenden RoadCamperdown NSW 2050Tel: (02) 9515 9944Dulwich Hill12 Seaview StreetDulwich Hill NSW 2203Tel: (02) 9560 2747Glebe/UltimoCorner Pyrmont Bridge Road and Glebe PointRoadGlebe NSW 2037Tel: (02) 9660 3451Leichhardt11 Marion StreetLeichhardt NSW 2040Tel: (02) 9560 5604Sydney South West Area Health Service Statutory Annual Report 04/05 37

Health Service LocationsMarrickville228 Illawarra RoadMarrickville NSW 2204Ph: (02) 9569 6048RedfernCorner Elizabeth and Redfern StreetsRedfern NSW 2016Tel: (02) 9698 1613Early Childhood Health ServicesWestern Sector CentresAshfield260 Liverpool RoadAshfield NSW 2131Ph: (02) 9716 1853Concord57A Wellbank StreetConcord NSW 2137Tel: (02) 9743 1654Croydon24 Liverpool RoadCroydon NSW 2132Tel: (02) 9378 1156Drummoyne64 College StreetDrummoyne NSW 2047Tel: (02) 9181 2619Five DockCorner Park Road and First AvenueFive Dock NSW 2046Tel: (02) 9713 6140HomebushA2 Fraser StreetHomebush NSW 2140Tel: (02) 9746 7763Summer HillSummer Hill Community Centre131 Smith StreetSummer Hill NSW 2130Tel: (02) 9798 3169Early Childhood Health ServicesCanterbury Sector CentresBelmoreSenior Citizens HallRedman ParadeBelmore NSW 2192Tel: (02) 9718 0157Campsie143 Beamish StreetCampsie NSW 2194Tel: (02) 9718 3177EarlwoodCorner Homer and William StreetsEarlwood NSW 2206Tel: (02) 9718 4847Lakemba35 Croydon StreetLakemba NSW 2195Tel: (02) 9759 2034RoselandsL94, Level 1Roselands Shopping CentreRoselands NSW 2196Tel: (02) 9750 7452Community Facilities - westernzoneFairfield LGAPrairiewood Community Health CentreCorner Polding Street and Prairie Vale RoadPrairiewood NSW 2176Ph: (02) 9616 8169Cabramatta Community Health Centre7 Levuka StreetCabramatta NSW 2166Ph: (02) 8717 4000Fairfield Community Health Centre53-65 Mitchell StreetCarramar NSW 2163Ph: (02) 9794 1700Sydney South West Area Health Service Statutory Annual Report 04/05 38

Health Service LocationsLiverpool LGAMoorebank Community Health Centre29 Stockton AvenueMoorebank NSW 2170Ph: (02) 9602 6419Hoxton Park Community Health Centre596 Hoxton Park RoadHoxton Park NSW 2171Ph: (02) 9827 2222The Miller HUB16 Woodward CrescentMiller NSW 2168Ph: (02) 9608 8920Health Services BuildingCorner Campbell and Goulburn StreetLiverpool NSW 2170Ph: (02) 9828 4844Bankstown LGABankstown Community Health Centre36-38 Raymond StreetBankstown NSW 2200Ph: (02) 9780 2777Macarthur LGAIngleburn Community Health Centre59A Cumberland RoadIngleburn NSW 2565Ph: (02) 9605 8900Narellan Community Health Centre14 Queen StreetNarellan NSW 2567Ph: (02) 4640 3500Rosemeadow Community Health Centre5 Thomas Rose DriveRosemeadow NSW 2560Ph: (02) 4633 4100Wollondilly Community Health Centre5-9 Harper CloseTahmoor NSW 2573Ph: (02) 4683 6000Wingecarribee LGABowral Community Health CentreBendooley PlaceBowral NSW 2576Ph: (02) 4861 8000Primary Health NursingLevel 2, 27 Greenfield ParadeBankstown NSW 2200Ph: (02) 9205 4244Sydney South West Area Health Service Statutory Annual Report 04/05 39

Area Healthcare Service PlanningIn late 2004, the Department of Infrastructure,Planning and Natural Resources released therevised population projections for NSW,including the proposed south-west growth areacentered around Bringelly and Leppington.This new growth area and accelerated landrelease will mean an additional 90,000 peoplewill reside in the western zone by 2016, and by2030 the population will increase by anestimated extra 250,000 to 300,000 people.Demand for a substantial expansion in healthservice capacity will result. In addition,population growth due to medium density urbanconsolidation in the inner and middle ringsuburbs will require a review of health servicecapacity in those areas.As a result of the formation of the new AreaHealth Service, and in recognition of the needfor early planning for new land releases, theArea has commenced development of an AreaHealth Plan to identify population health needsto 2016, and more broadly, to 2021. This planfollows on from the framework developed in TheWay Forward 2004-2008 for the former SouthWestern Sydney Area Health Service and theResource Transition Program developed byCentral Sydney Area Health Service. Planninggroups have been formed consisting ofclinicians, managers, community representativesand general practitioners.Asset Strategic Planning needs to be driven byclear and detailed service plans that outlinethe roles and future activity levels of healthservices in SSWAHS. The Area AssetStrategic Plan will be informed by the AreaHealth Plan. In addition, a Human ResourceStrategic Plan will be commenced followingthe completion of the Area Health Plan in late2005.Sydney South West Area Health Service Statutory Annual Report 04/05 40

FacilitiesBalmain HospitalA/General Manager Ann KellyCategory of hospital and majorservices providedBalmain Hospital and its community basedservices continued to provide the focus for agedcare services and rehabilitation for SSWAHSeastern sector. The General Practice Casualtyprovides treatment for the health needs ofresidents in the local area. These services willcontinue to include people from culturally andlinguistically diverse backgrounds.Summary of activityBalmain Hospital has a total of 78 beds with 90per cent occupancy rate. Total bed daysnumbered 24,200 with a daily average of 66.Major goals and outcomesDuring March the Postgraduate Medical Councilconducted a survey for accreditation of juniormedical officers at Balmain Hospital.Accreditation was achieved with positiveoutcomes.The NSW Food Authority conducted aninspection of Balmain Hospital Food Services.The report indicated Balmain complied withregulations. Minor recommendations were madeand have been implemented.Key issues and eventsThe hospital mortuary was refurbished as aresult of environmental factors that wereidentified through Environmental OccupationalHealth and Safety Audits.Future direction within the AreanetworkBalmain Hospital and community-based serviceswill continue to provide care for elderly patientsand those requiring rehabilitation servicesincluding culturally and linguistically diversepatients and clients. The hospital is also workingtoward adding to its provision of alternativemedicine with a medical acupuncture clinic to beoffered to clients in the near future.Sydney South West Area Health Service Statutory Annual Report 04/05 41

FacilitiesBankstown HospitalA/General Manager Glenda CleaverCategory of hospital and majorservices providedBankstown Hospital is a principal referralhospital which provides acute services such asemergency medicine, maternity, generalist andspecialist surgery, general and specialistmedicine, day surgery, outpatients,neonatology and adult mental health as wellas a range of specialist outpatient services.The Bankstown Health Service consists of theBankstown Community Health Centre, TheCorner Youth Health Service and YagoonaAdult Dental Health Clinic.Summary of activityThe hospital treated over 27,000 patients andprovided over 463,251 non-admitted patientservice occasions during the year. TheCommunity Health Service provided over176,329 service occasions. There were almost31,000 attendances at the ED and 1,847 babieswere born.Major goals and outcomesThe hospital won a 2004 Baxter NSW HealthAward for Education and Training and aCertificate III in Aged Care for the HSC subjectprovided at Bankstown in conjunction withBankstown Senior College.A Demand Management Plan was developedand implemented to address patient flow andaccess through the ED.The discharge process has been streamlinedand use of the patient discharge lounge hasincreased from approximately 50 patients amonth to 180 patients a month.The Bankstown Early Intervention PeerConsultation Project was launched as part of theDoCS Early Intervention program. It will provideworkers with professional support, knowledgeand skills to benefit children and families andkeep them from entering or being re-reportedinto the child protection system.Key issues and eventsRenovations to the ED have resulted inimprovements in Triage Category 4performance.With the Implementation of NSW Department ofHealth Incident Information ManagementSystem (IIMS) for recording all clinical and nonclinicalincidents, incident reporting hasincreased by approximately 20 per cent.Future direction within the AreanetworkBankstown Hospital will continue contributing toplanning for the Area structure and the ClinicalService Plan for Community Health as well asbuilding services to meet local population healthneeds.The hospital will continue the implementation ofstrategies to reduce patient numbers waiting forelective surgery as well as implementinginitiatives arising from South Western SydneyHealth Network - The Way Forward.Sydney South West Area Health Service Statutory Annual Report 04/05 42

FacilitiesBowral HospitalA/General Manager Denis ThomasCategory of hospital and majorservices providedThe Bowral and District Hospital provides arange of high quality health services includinggeneral medical, obstetrics and gynaecology,paediatric, surgical, and emergency services. Italso administers the Wingecarribee CommunityHealth Centre.Summary of business activityAdmissions to the hospital were 1.04 per centabove target, 0.01 per cent down on theprevious year. Non-admitted patient serviceswere 8.71 per cent above target, 6.09 per centabove the previous year. Additional funds wereallocated to surgical services, with an increasein theatre activity to 2480 cases for the full year,and a reduction in the long wait list to 80. Ofthese procedures, 65.4 per cent of patients wereadmitted and discharged on the same day, 0.05per cent above target. There were 696 babiesborn. Admissions via the EmergencyDepartment (ED) were down by 2.62 per cent onthe previous year. Community Health occasionsof service were up 9.4 per cent.Major goals and outcomesBowral Hospital has been granted $1.8 million toremove asbestos across the site. Plans havebeen submitted to the NSW Department ofHealth for the refurbishment of the children’sward and relocation of the short stay unit.Medical staffing was increased, with theappointment of Dr Ajay Vatsayan (staff specialistobstetrics and gynaecology). The ED benefitedfrom the temporary appointment of Dr JanetTalbot-Stern (Emergency Physician) as ActingDirector. Also in the ED, triage nurse positionshave been established, improving the quality ofcare patients receive on presentation to ED.The Clinical Advisory Council, consisting ofrepresentatives from medical, nursing,community, and allied health disciplinescontinues to provide a high level of clinicalleadership to the hospital, as well as overseeingstrategies to improve the level of patient safetyand quality of services across the organisation.Key issues and eventsThe 2004 Health Awards, an internal event, waswell represented by all departments.Bowral Hospital has benefited greatly from anumber of generous bequests and donationsfrom members of the Southern Highlandscommunity. Community participation remains ahigh priority, with nine community membersproviding valuable input into key committees,one of whom sits on the Area Clinical Council.Future direction within the AreanetworkThe amalgamation of the two area healthservices will continue to impact positively on thehospital, increasing opportunities for developingpartnerships between hospitals.Implementation of clinical services plans willincrease networking opportunities with clinicalservices across the Area. Appointments to thepositions of general manager and director ofclinical and support services will be finalised.Sydney South West Area Health Service Statutory Annual Report 04/05 43

FacilitiesCamden and Campbelltown HospitalsGeneral Manager Amanda LarkinCategory of hospital and majorservices providedCampbelltown Hospital is a level four hospitalof 273 beds. It is a centre of excellence in theprovision of cardiology and maternal care. Italso provides mental health services includinga psychogeriatric unit. Camden Hospital is alevel two hospital of 75 beds. Its specialty isrehabilitation and palliative care.Camden and Campbelltown Hospitals alsoadminister the Queen Victoria Memorial Homeand Macarthur community and mental healthservices.Summary of business activityIn the past year, 44,534 people presented tothe ED with 13,644 admissions. Non-admittedpatient services extended to 448,560 people.The occupancy rate was at 80.86 per cent andthe average length of stay 3.99 days. Therewere 2306 babies born. Total theatreprocedures were 21,856.Major goals and outcomesCamden and Campbelltown Hospitals hadthree main priorities in 2004/05: to restructurethe governance arrangements; redevelopquality systems; and review the budgetaryposition. Significant progress was made onthese three goals.The governance structure was revised toincorporate senior clinicians on the Executive.Level one committees were reviewed toensure they accurately reflect the keybusiness of the organisation.The main quality focus has been on theestablishment of the Clinical ReviewCommittee, the peak patient safety and qualitycommittee. Significant work has also beenundertaken in preparation for our ACHS EquipSurvey in November 2005.Extensive work to identify critical fundingissues and opportunities for further efficiencieswas done and will be ongoing.Key issues and eventsThe Cardiology Service commenced with theappointment of an interim director and fourstaff specialists. Refurbishment work atCamden Hospital was completed and theSpecial Care Nursery at CampbelltownHospital was opened. Both these projects arepart of the $133.7 million MacarthurRedevelopment Strategy.A special event was the relocation of theAuxiliary Baby Boutique to the foyer area ofCampbelltown Hospital.Following a review of obstetric services atCamden Hospital by an expert panel, it wasresolved to transfer births to CampbelltownHospital and commence work on thedevelopment of a midwife-led model of care.Professor Pat Brodie was appointed to leadthe development of the service and significantprogress has already been made. In themeantime, antenatal and postnatal servicesare provided at Camden Hospital.Executive appointments have been made tothe positions of general manager, director ofNursing and Midwifery Services, director ofMedical Services and the director of MentalHealth.Future direction within the Areanetwork2004/05 has seen the progressivedevelopment of clinical streams across thearea health service. These new streams willprovide important clinical support for Camdenand Campbelltown Hospitals, especially inareas such as critical care, surgery, mentalhealth and women’s health.Sydney South West Area Health Service Statutory Annual Report 04/05 44

Canterbury HospitalGeneral Manager Gary MillerFacilitiesCategory of hospital and majorservices providedCanterbury Hospital (CH) is a metropolitangeneral hospital which serves a diversepopulation of over 135,000 people with morethan 57 per cent born overseas.Services provided include general surgery andmedicine, obstetrics and gynaecology,paediatrics, aged care, rehabilitation andpalliative care.Summary of activityCanterbury Hospital had 184 beds available forthe year with an 89.1 per cent occupancy rate.Total bed days numbered 58,552 with a dailyaverage of 160.Major goals and outcomesWaiting time for patients admitted to hospitalthrough the Emergency Department (ED) hasbeen reduced through provision of anadditional 14 beds and the introduction of theAccess Block Improvement Program.There was a 20 per cent reduction in thenumber of patients waiting more than eighthours for a ward bed. Improved access tointerpreter services for non-English speakingbackground (NESB) patients in ED reducedtheir waiting time.Additional theatre sessions were scheduled aspart of a strategy to improve waiting times forpatients requiring surgery. As a consequence,the number of patients waiting more than 12months for surgery was reduced to zero inJune 2005.Key issues and eventsCH celebrated 75 years of caring for the localcommunity in October with a number offunctions including a Foundation Day service,an art competition for local schools and a 75 thAnniversary Birthday Ball held at theCanterbury Hurlstone Park RSL.The Anniversary Ball raised $100,000 foroperating theatre equipment.Future direction within the AreanetworkThe hospital will continue to implement initiativesarising from the Access Block ImprovementProgram and the Predictable Surgery Program.Sydney South West Area Health Service Statutory Annual Report 04/05 45

FacilitiesConcord Repatriation General HospitalA/Executive Director Danny O’ConnorCategory of hospital and majorservices providedConcord Repatriation General Hospital (CRGH)is a principal referral facility and a teachinghospital of the University of Sydney. It offers acomprehensive range of specialty and subspecialtyin-patient and out-patient services.CRGH leads NSW response in Adult BurnsTrauma and the unit is acknowledgedinternationally. Research at CRGH has aprimary theme of ageing, with excellence inmen’s health, bone disease and genetic aspectsof neuro-degenerative disorders. An importantfeature of the research at CRGH is themultidisciplinary nature of many of the studies.Summary of activityCRGH has an average 393 available beds with89.43 per cent occupancy rate. Total bed daysnumbered 143,289 and average length of staywas 3.6 days. Total separations numbered39,287 and same day separations were 23,625or 60 per cent of total admissions. There were23,605 ED attendances.Major goals and outcomesThe installation of the state-of-the-art licenced 3Tesla MRI technology in June 2005, the onlymachine of its kind in NSW for public hospitalpatients, provides clinicians with much higherresolution images than previously possible andallows for more accurate and earlier diagnosesin a wide range of conditions including cancerand psychiatric disorders.A Professor of Medicine was appointed and theposition of Chair of Pharmacy created.The NSW Health Sustainable Access Program(SAP) has led to the opening of a 15-bedrehabilitation ward, six monitored cardiologybeds, 14 other acute beds and four sub-acutebeds.Key issues and eventsThe opening of a purpose-built 15-bedrehabilitation ward, along with completion of theredesigned Aged Care Precinct and completedcommissioning of the multistorey building foracute services have all helped to increase thequality of service.Staff enthusiastically celebrated the culturaldiversity of the hospital at the inauguralMulticultural Week.Future direction within the AreanetworkCompleting plans and commencing constructionof the 174 bed Mental Health Service.Establishment of a 25-bed Drug Health Serviceand outpatient service.Construction of a purpose-built childcare centreto support consumer demand for increasedplaces in the 0-2 years group is plannedProgressing the amalgamation of services withinthe newly created SSWAHS.Sydney South West Area Health Service Statutory Annual Report 04/05 46

FacilitiesDepartment of Forensic MedicineGeneral Manager Mark PattersonCategory of facility and majorservices providedThe Department of Forensic Medicine (DOFM)offers high quality forensic medicine services tothe NSW State Coroner as well as statewidesupport for forensic medicine practitioners in allareas of autopsy-based and clinical forensicmedicine.DOFM is the premier forensic medicineeducational body for undergraduate andpostgraduate students in NSW.DOFM’s expertise includes disasterinvestigations, in particular, Disaster VictimIdentification (DVI) as well as aviation medicine,bereavement counselling, medical investigationof crime scenes, pre-trial and trial advice,provision of second opinions and presentation atmedico-legal seminars.Summary of activityWith a staff equivalent full-time of 45.14 DOFMhad total admissions (bodies received) of 2239.1766 post mortem examinations were carriedout, of these 96 were high risk autopsies.Major goals and outcomesThe Support After Suicide Group (SASG), aDOFM program, continues to burgeon withformer ABC radio personality, Sally Loane,recently appointed Patron. SASG provides acost-effective way of providing long-term supportfor people affected by suicide. Through theirrole with SASG, counsellors at Glebe andWestmead are able to offer appropriate supportto many more of the suicide bereaved thanwould otherwise be possible.As previously reported, a number of DOFMforensic pathologists retired or resigned during2002/03. Despite a well-documented worldwideshortage of experienced Forensic Pathologists,DOFM has successfully recruited to the last twovacant positions Dr Paul Morrow, ForensicPathologist from Vermont, USA and Dr MatthewOrde, Forensic Pathologist from Brighton UK,under an Area of Need Program.Successful negotiations have been concluded toreintroduce NSW Bone Bank donations throughDOFM.Key issues and eventsDOFM staff participated in the DVI processesinvolved with both the Boxing Day Tsunami andthe Sea King Helicopter Crash in NSW,Indonesia and Thailand.DOFM representatives continue to sit on theForensic Pathology Co-ordinating Committee ofthe NSW Department of Health, advising onforensic medicine and pathology servicesavailable to support the justice system.The General Manager DOFM was licencedunder the Anatomy Act 1997 to conduct thestudy and practice of anatomy within the termsof the Act. There are currently 130 people listedon the DOFM body donation database.Future direction within the AreanetworkDOFM’s involvement in the establishment of theNSW Forensic Medicine and PathologyAuthority will continue. If established, theproposed independent statutory authority willhave overall responsibility for the provision offorensic medicine and pathology services inNSW. Its charter will be to ensure that thoseservices are co-ordinated and provided toensure quality, equity and value for allstakeholders throughout the State.DOFM’s successful recruitment of threeoverseas forensic pathologists will ensure thatthe backlog of outstanding reports will bereduced and a benchmark of three to fourmonths for the provision of a final post mortemreport to the NSW State Coroner can beachieved and maintained.Sydney South West Area Health Service Statutory Annual Report 04/05 47

FacilitiesDivision of Population HealthDirector Associate Professor Peter SainsburyMB BS, DObstRCOG, MHP, FRACMA, FAFPHM, PhDCategory of facility and major servicesprovidedThe Division of Population Health incorporatesCommunity Health Services, Multicultural Health,Women’s Health, the Public Health Unit, theHealth Promotion Unit and the Social HealthResearch Unit. The Division focuses on thehealth needs of individuals and communities inSSWAHS (eastern zone). It aims to protect andpromote health and to treat illness, recognisingthe many personal, local and global factorsaffecting health and illness.Services are provided from 30 community healthcentres throughout the eastern zone and inschools, homes and workplaces.Summary of activityFull-time equivalent staff was 300. The serviceprovided 259,812 occasions of service.Major goals and outcomesThe Public Health Unit aims to protect thelocal community against illness proactively byquick responses to emerging situations. TheUnit developed an Area SARS plan aimed atdeveloping the Area’s capabilities to deal witha possible pandemic.The co-ordinated school based ImmunisationProgram has reached 100 per cent of targetedschools. This included 22,283 primary schoolstudents immunised for Meningococcal C,3771 high school students immunised againstDTPa (Diptheria, Tetanus and Petussis) and3124 for Hepatitis A.Central Sydney Community Nursing Service(CSCNS) have begun research into themanagement of clients with venous leg ulcers.Between 2003/05 CSCNS achieved a measureof 71-80 per cent against the 40 per centbenchmark set by Department of Veterans’Affairs for the "healing of a clean ulcer within 84days".Key issues and eventsThe HIV Allied Health Community team carriedout a pilot study on the effectiveness of lowlevel laser therapy in the management ofperipheral neuropathy in people living withHIV. Results have shown significant reductionin pain and improved quality of life for over 60per cent of clients who received treatment.The Women’s Health Unit is continuing theimplementation of its Area plan aimed atimproving the health of women. This includesthe expansion of domestic violence screeningthroughout community health services.Future direction within the Areanetwork2005/06 will see significant changes for theDivision of Population Health. The newSSWAHS Population Health will include areawidepublic health and health promotionfunctions; a unit specialising in epidemiology,surveillance and research; a new unitspecialising in urban development, health impactassessment and equity; and the HIV servicescoordination unit. Community Health Serviceswill become a separate area-wide service.Sydney South West Area Health Service Statutory Annual Report 04/05 48

FacilitiesFairfield HospitalGeneral Manager Michael Woodhouse (to 19 July 2005)Mark Shepherd (from 25 July 2005)Category of hospital and majorservices providedFairfield Hospital is a 210-bed acute generalhospital providing a wide range of hospital andcommunity based health services includingacute care services in medicine, surgery,obstetrics, paediatrics and emergency medicine.It also administers three community healthcentres located at Prairiewood, Fairfield andCabramatta.Summary of business activitiesThere were 23,768 Emergency Department(ED) presentations and 15,052 separations.Total bed days numbered 219,212 with anaverage daily average of 141. The NAPOSequivalent was 269,884. An increase inelective surgery for the last quarter of thefinancial year 2004/05 resulted in a 17 percent increase in service provision for electivesurgery.Multidisciplinary teams located at the threecommunity health centres provided 129,051occasions of service.Major goals and outcomesEmployment of visiting medical officer (VMO)specialist emergency physicians during theweekdays has been a significant factor inimproving the quality of care provided topatients. Development of a Medical EmergencyTeam (MET) call service has enhanced thefacility’s response time for potential emergenciesand improved outcomes for patients.The appointment of a full-time staff specialistcardiologist enhanced the management of acutecardiac patients.Paediatric services have been enhanced withthe employment of a full-time staff specialistpaediatrician to the ED and the secondment ofthe paediatric registrar from Children’s HospitalWestmead.Key issues and eventsA 20-bed sub-acute ward has been establishedin rehabilitation and geriatric services.A staff specialist in maternity services has beenemployed and student midwives are working inrotation between the units. Pregnant womenwho are identified at Fairfield as being high riskare now managed at Liverpool Hospital,ensuring complications are minimised.Future direction within the AreanetworkCritical care services will continue to beenhanced through ongoing networking.An ECHO cardiology service is planned forcommissioning and the purchase of newdiagnostic equipment for antenatal ultrasoundwill allow the recommencement of theseservices.The capacity for more elective surgery will bedeveloped and budgetary performanceimproved.The ward-based cardiac “Telemetry” service willbe implemented.Sydney South West Area Health Service Statutory Annual Report 04/05 49

FacilitiesKaritane Mothercraft SocietyChairman, Board of Directors Professor Bryanne BarnettExecutive Manager Robert MillsCategory of hospital and majorservices providedKaritane is an affiliated health organisationstaffed by child and family health professionals.It operates from four sites: the AdministrationCentre located at Carramar – incorporatingEducation and Research, the Residential Unitand the Volunteer Program; Jade House atFairfield Heights, which houses the perinatalmood and anxiety disorders unit; and two FamilyCare Centres located at Liverpool andRandwick.Karitane’s philosophy is to empower families byenhancing parenting knowledge, skills andconfidence both antenatally and with children upto five years of age, allowing clients to make asuccessful adjustment to parenthood. There is astrong focus on research activities.Summary of activity839 families received support through theservices of the Liverpool and Randwick FamilyCare Centres. 498 families were admitted to theResidential Family Care Unit at Carramar wherean evaluation study is exploring the outcomesfor over 150 families post-discharge.The 24-hour Karitane Careline received 20,656calls.Karitane Volunteer Programs had 98 Volunteersworking throughout the year supporting 684families with home visiting, playgroups andmaternity hospital visits.Jade House recorded 2727 client contacts and145 new referrals.Major goals and outcomesThe past year has seen Karitane successfullyprogress through goals from the 2003/06Strategic Direction, enabling the organisation toprovide timely and evidenced-based care.The Parent Child Interaction Therapy (PCIT)Clinic for toddlers commenced for children twofiveyears of age who display behaviouralproblems. The therapy places an emphasis onimproving the quality of the relationship betweenthe parent and child.Key issues and eventsA celebration was held to mark 10 years ofoperation of the parenting facility at Carramarwhere Health Minister Iemma launched a newKaritane video, Asleep at Last!, developed toassist families in settling their child, and aresource poster for parents, the Baby Map,highlighting the importance of an infant’s need tocommunicate through play. An Aboriginalartwork commissioned by the Karitane Boardentitled Creation by local artist Shareen Claytonwas unveiled by the Mayor of Fairfield, Mr NickLalich.Karitane received an Award for Excellence inPartnership, Non-Government and/orCommunity Organisation in the University ofWestern Sydney 2004 Regional PartnershipAwards.Future direction within the AreanetworkInitial plans for Karitane’s capital redevelopmentprogram are nearing completion. The total costof the capital redevelopment program isapproximately $5 million and will mainly befunded from Karitane’s trust funds. NSW Healthhas also provided a $1 million grant towards theredevelopment.New capital works on the Carramar site willinclude an expanded education and researchfacility with a conference venue and an outreachservice. Jade House will be re-located fromFairfield Heights to Carramar in a purpose-builtmental health facility consisting of a day-stayunit for women with perinatal mood disordersand postnatal depression. The building programis due for completion in early 2007.Karitane’s collaborative activities with otherorganisations will continue, includingimplementing specific services to support thecultural diversity of our clients.Sydney South West Area Health Service Statutory Annual Report 04/05 50

FacilitiesLiverpool HospitalGeneral Manager Dr Teresa AndersonCategory of hospital and majorservices providedLiverpool Hospital, with over 3,000 staff, is thetertiary referral hospital for south-westernSydney, providing leadership in clinical care,teaching and research. The Hospital provides acomprehensive range of high-level servicesincluding emergency, trauma, intensive care,oncology, medical, surgical, mental health,women’s health, newborn care and communityservices. Liverpool Health Service consists ofthe Liverpool, Hoxton Park, Miller andMoorebank Community Health Centres and theCartwright Dental Clinic.Summary of Business ActivityDuring the year there were 57,964 admissions,15,728 operations and 3,119 babies born. Therewere 543,762 Non Admitted Patient Occasionsof Services (NAPOS) and privately referredNAPOS increased by 31.79 per cent to129,460.This was due to an increasing ability to treatpatients on a ‘day only’ basis, with no overnightstay required.Major goals and outcomesAccess to clinical services has been significantlyenhanced with the opening of additional beds -one intensive-care, five newborn intensive-care,and 14 high-dependency mental health beds.As part of the Cardiac Network Strategy forInterventional Procedures, 10 cardiac beds havealso been opened. In addition, 20 medical bedsand 10 23-hour surgical beds have been openedunder the Sustainable Access Project. A newCardiac Catheter Laboratory was also opened.To further develop Liverpool’s role as a majorteaching hospital, Professors of Medicine,Ophthalmology and Rheumatology wereappointed during the year.Key issues and eventsTwo major capital works programs are nearingcompletion. The $9.1 million refurbishment ofthe ED will increase capacity to 72 beds,including four Psychiatric Emergency CareCentre (PECC) beds. The new $32.6 millionMental Health building will provide significantlyimproved mental health facilities.The Liverpool Paediatrics and AmbulatoryCare Team provides a multidisciplinaryapproach to support early discharge, preventadmissions and assist children with chronicillnesses remain in the community. The teamalso provides an integrated developmentalassessment service.Future direction within the AreanetworkImplementation of the Clinical Services PlanSouth Western Sydney Health Network - TheWay Forward 2004-2008 is providing aframework for the establishment of new areawideclinical service streams. Furtherdevelopment of services over the coming yearwill aim to improve access to health care for ourcommunity. The next stage of planning for thedevelopment of Liverpool Hospital will alsocontinue.Sydney South West Area Health Service Statutory Annual Report 04/05 51

Royal Prince Alfred HospitalExecutive Director Di GillFacilitiesCategory of hospital and majorservices providedRoyal Prince Alfred Hospital (RPA) is a principleprovider of specialist healthcare and one of theleading medical teaching hospitals in Australia.The wide range of services provided at RPAinclude the National Liver Transplant Unit, renaldialysis and transplant services, emergency,trauma, and intensive care services, medicalimaging, cardiology and cardiothoracic surgery,women’s and children’s health, the Institute ofRheumatology and Orthopaedics, respiratorymedicine and cancer services, including theMelanoma Unit, Breast Cancer Institute, and theSydney Cancer Centre.Summary of activityRPA has a total of 721 beds with 95.1 per centoccupancy rate. Total bed days numbered236,255 with a daily average of 647.Major goals and outcomesSignificant emphasis has been placed onimproving patient safety at an organisation-widelevel. Sustainable key patient safety outcomesinclude the implementation of Root CauseAnalysis protocols, increased reporting throughthe AIMS IIMS notification database and theestablishment of the Surgical OutcomesResearch Centre (SOuRCe).Recent improvements in technology havefacilitated a wider range of techniques in theTransplant Service, leading to a 100 per centincrease in the number of cases attended.Complicated breakthrough procedures such asdomino and split liver transplants can now becarried out with reduced risk.Due to an improved method of managingsurgical lists, theatre allocations and an increasein funding, a significant reduction in the long waitlists has been achieved. Notably, the Ear Noseand Throat surgery wait lists have been reducedfrom 111 in July 2004, to 32 at 30 June 2005.Stage 1 of the RPA East CampusRedevelopment was completed in late 2004 withall clinical services located in the new complex.Stage 2 of this program will commence in late2005. This $30 million project will complete thehot-floor of the clinical services building andprovide the final link to the surgical suite.Key issues and eventsA number of strategic initiatives have beenimplemented to improve patient flow and accessthrough the ED.Nursing recruitment has improved dramaticallywith the number of vacancies reducing by halfover the last 18 months with the greatestimprovement in the 2004/05 period.Implementation of an electronic medical recordand electronic discharge summary has improvedpatient information distribution and reduced timetaken for clinicians to access patient results,medical imaging and reports.Improvements in campus security haveenhanced patient, visitor and staff safety.Future direction within the AreanetworkFollowing release of the RPA Strategic Plan2005/07 in early 2005, departmental operationalplanning has since commenced with specificfocus on the five key goals of the organisation,Safe Quality Patient Care; Better Value; Sharinga Clear Direction, Skilled Valued Workforce andInformed Decision Making.A systematic review, evaluation andendorsement process for hospital policies andprocedures has been established. Additionalwork has been done to ensure compliance withlegislation and NSW Department of Healthpolicy. Further improvements in the circulation ofpolicy information and review of existingpractices will be a key focus over the comingperiod.Sydney South West Area Health Service Statutory Annual Report 04/05 52

Rozelle HospitalA/General Manager Gary RowleyFacilitiesCategory of hospital and majorservices providedRozelle Hospital is the major facility for adultmental health inpatient services for SSWAHS.Along with clinical services includingpsychogeriatric care, drug and alcohol inpatientcare, adult acute and rehabilitation, and care forwar veterans, Rozelle Hospital accommodates anumber of special projects and theadministration for the north-east cluster of Areamental health.Summary of activityRozelle Hospital has a 216 bed capacity anda bed occupancy rate of 78.4 per cent. Totalbed days numbered 65,679 with a dailyaverage of 180.Major goals and outcomesIn late 2004, the mental health clinical streamincluding Rozelle Hospital successfullyundertook a periodic review by the AustralianCouncil on Healthcare Standards, maintainingits accreditation status.As part of the Resource Transition Program, thepsychogeriatric nursing home services wererelocated from Rozelle Hospital to a modernpurpose-built facility at the new Croydon HealthCentre. Patients have been transferred to thenew unit which provides individual rooms forresidents.As Rozelle Hospital is an ageing facility,considerable effort has been put into trainingstaff to identify risk factors and implement saferpractices. This includes investigating incidentsand making repairs as necessary.Key issues and eventsIn a partnership with Catholic Health Care,psychogeriatric patients from two wards atRozelle were transferred to the new Holy Spiritfacility at Croydon. This new facility allowsresidents to live in individual rooms in purposebuiltaccommodation.Community mental health rehabilitation serviceswere moved from Leichhardt to a location on thegrounds of Rozelle Hospital. This has enabledRozelle inpatients to more easily becomeconnected into community-based activities priorto discharge.Future direction within the AreanetworkThe recent amalgamation of health servicespresents several challenges for Rozelle Hospitalincluding how best to respond to the need foracute inpatient beds from across an enlargedArea. The transfer of psychogeriatric patients toCatholic Health Care has enabled RozelleHospital to examine innovative ways to addressthe health care needs of the population.Construction of a new mental health in-patientfacility will commence in 2006 and will provide asafer environment for both patients and staff.Sydney South West Area Health Service Statutory Annual Report 04/05 53

Sydney Dental HospitalGeneral Manager Graeme AngusFacilitiesCategory of hospital and majorservices providedThe Sydney Dental Hospital (SDH) (formerly theUnited Dental Hospital) provides a generaldental service to the eligible patients within theSSWAHS and currently to eligible patientsresiding in the northern sector of South EasternSydney Area Health Service (SESAHS). As oneof two dental teaching hospitals in NSW, theSDH also provides specialist treatment to peoplereferred from across the State. Specialistservices provided include paediatrics,orthodontics, oral surgery, periodontics,prosthodontics, endodontics, and implantology.Through its Special Care Dental Unit, the SDHprovides services to people who have otherhealth conditions commonly associated withpoor oral health or reduced access to dentalservices. These patients include those withchronic mental health conditions, drugdependencies, serious medical conditions andthe frail elderly. This Special Care Unit conductsa weekly outreach service to nursing homes inthe Area.Summary of activityThe SDH provided 186,024 occasions ofservice.Major goals and outcomesFollowing a recruitment strategy aimed atattracting dental officers to the public healthservice, eight new graduates were employed.The New Graduate Dental Program involvedpartnerships with Wagga Wagga and theIllawarra regionThe Special Care Dentistry unit, headed by DrNatalie Oprea, attracted grants from the AshfieldLocal Council and the Area Health Service.These grants have allowed the expansion of aprogram of education seminars targeting carersto improve the oral hygiene of patients in theircare.The Special Care and Paediatric dentistry unitswere successful in increasing access to theatresin 2005, substantially reducing waiting time forpatients requiring general anaesthesia atConcord and Canterbury Hospitals.Key issues and eventsThe SDH celebrated its centenary in August2004 with a week of activities highlighting theadvances in dental treatment over the pastcentury. A Public Oral Health Forum attended byrepresentatives from across Australia was alsohosted by the hospital as part of its centenaryweek.SSWAHS Oral Health Service and the SDHwere successful in their bid for a $2.3 millionminor capital works allocation in June 2005. Thisfunding allowed the purchase of a NEWTOM3Gdental scanner, the only one its kind available todentists in NSW.Dr Sameer Bhole and Dr Barbara Taylor wereinducted as Fellows of the International Collegeof Dentists for their achievements in the dentalprofession.Future direction within the AreanetworkContinue to expand the availability of specialistdental services through collaborations withspecialists services based at WCOH.Improve service delivery by facilitating changesto implement a single oral health stream inSSWAHS.Provide a single level of access for patientswishing to access public dental services throughthe merger of the patient managementinformation system (ISOH) and the dentalaccess centre and the creation of a centralisedwaiting list for general treatment in the area.Continue to improve the recruitment andretention of dental staff and officers in order tomeet the increasing demand on services.Sydney South West Area Health Service Statutory Annual Report 04/05 54

FacilitiesTresillian Family Care CentresGeneral Manager David HannafordPresident of Council Bob Elmslie OAMCategory of hospital and majorservices providedThe child and family health professionals atTresillian Family Care Centres offer advice tofamilies with a baby or child up to five yearsold. Parents are generally referred toTresillian after seeking help from their localearly childhood health clinic and other healthprofessionals. Approximately two thirds ofparents utilising Tresillian’s services are firsttime parents and their queries are most oftenrelated to breastfeeding and sleep and settlingpatterns. Our health professionals also dealwith many women who have complex mentalhealth issues including post-natal depression.Summary of activityTresillian has four centres located at Belmore,Willoughby, Wollstonecraft and Penrith. Lastyear Tresillian assisted 4526 families across ourresidential units, 4628 in Day Stay and 3103 inOutreach.The Tresillian 24-hour Parents Help Line,based in Belmore, received in excess of54,000 calls per year. Tresillian’s call centre isstaffed by child and family health nurses whoprovide advice to parents on a range ofissues.Major goals and outcomesA new strategic plan for the period 2005/10was developed after a series of consultationswith staff and key stakeholders includinggovernment and non-governmentorganisations. The Tresillian Council approvedthe new strategic plan in June.Key issues and eventsNSW Health engaged Tresillian Family CareCentres to develop and implement the NSWHealth Families First Statewide EducationProject. The two-year project, which began inNovember 2004, will support the implementationof health home visiting, integrated perinatal andinfant care and the family partnerships model.Dr Cathrine Fowler, manager of the Educationand Research Unit and Julie-Anne Murphy,nurse educator, recently presented at theAustralian Association of Maternal, Child andFamily Health Nurses Conference 2005. Theirpaper, Understanding Motherhood from theInside was a collaborative project with NSWCorrective Services based on researchundertaken at the Emu Plains minimum securitycorrective services unit where children from 0-6years of age live with their mothers.The paper was based on two 10-weekmother/infant relationship programs focused onenhancing the mothers’ ability to provideresponsive, appropriate care to their youngchildren and reduce negative parentinginteractions. Made possible with a $22,000 grantfrom the NSW Department for Women, theprograms have been so successful that they willbe expanded into other correctional facilities inNSW in the near future.Future direction within the AreanetworkThe Tresillian Council and the Board of Karitaneare building a closer relationship as bothservices are now located in the Sydney SouthWest Area Health Service. Initial discussions willconcentrate on the possibility of sharingresources in research, education, qualityimprovement and Parents Help Line.Sydney South West Area Health Service Statutory Annual Report 04/05 55

Allied Health andClinical Support ServicesAllied Health will become an area-wide service in 2006. This provides a unique opportunity to review andimprove on models of care delivery, with an emphasis on ensuring clinical guidelines and care deliveryare consistent, evidence-based, effective, monitored and measured.South-western Sydney is the fastest growing area of Sydney and the increasing population, including alarge aged population, will continue to place significant demands on a range of allied health and clinicalsupport services.Western ZoneClinical Director Anthony SchembriBSW(Hons) GradDipPubAdmin MAASW(ACC)Summary of activity, including therange of services providedAllied Health and Clinical Support Servicesprovides a diverse range of clinical care andtreatment services, as well as clinicaleducation, quality improvement, research andsupport services. Services are delivered fromall hospitals and community health facilities ofthe western zone as well as statewide tertiarylevel services such as Bankstown’s Centre forExcellence in Stuttering Treatment.Established in 2005, the stream departmentsinclude nutrition and dietetics, occupationaltherapy, speech pathology, genetics,interpreters, clinical libraries, pharmacy,psychology, counselling, orthoptics, podiatry,physiotherapy and social work. Areaprofessional directors were appointed to mostdepartments of the new area service.Major goals and outcomesThe Health Care Interpreter Service (HCIS) hassuccessfully responded to the challenge ofproviding interpreting services for the newlyemerging African languages by recruiting andtraining interpreters for the Sudanese, Dinka,Somali, Kikuyu, Kineru, Kinyarwanda, Swahiliand Kirundi languages.The HCIS, in cooperation with the University ofNSW, implemented a pilot research project,Impact of Professional Interpreters in theEmergency Department to explore the influenceof language and culture on patient-doctorcommunication in the emergency department.The Area Counselling network was establishedand has consolidated information on clinical andprofessional governance across counsellingteams, resulting in improved clinical outcomes incounselling service clients.The Nutrition and Dietetics department, withfunding from the University of Wollongong,appointed a clinical educator allowing thedepartment to increase the number of dieteticstudents on clinical placement at the hospital.Allied health and clinical support staff delivereduniversity teaching and student clinicaleducation and formed a taskforce to progressthe development of an academic allied healthunit.Key issues and eventsThe Allied Health and Clinical Support GuestLecture Series was launched by Dr GregStewart and speakers in 2005 were ProfessorDavid Richmond AO and Professor RichardHugman. The SSWAHS Community and AlliedHealth Outcomes conference was held inOctober 2004. The theme was WorkingTogether in Partnership.Future direction within the AreanetworkAllied Health will become an area-wide servicein 2006. The further development of hospitalavoidance programs and the trend for earlydischarge has increased the demand on AlliedHealth’s outpatient, domiciliary and communityservices. Allied Health will continue to developand enhance the provision of a diverse range ofclinical care and treatment to patients sevendays a week.Sydney South West Area Health Service Statutory Annual Report 04/05 56

Allied Health ServicesEastern ZoneClinical Director Katherine MooreSummary of activity, including therange of services providedAllied Health professionals work in hospitalsand community health settings to facilitateimprovements to the physical andpsychosocial functioning of clients. The AlliedHealth Service grouping includes the eightprofessions of physiotherapy, podiatry,psychology, speech pathology, social work,nutrition and dietetics, occupational therapyand orthotics.Major goals and outcomesAn Allied Health Stroke Outreach Team is nowin operation to support people who havesuffered a stroke on their return home and in thefirst few years of recovery. Outcomesdemonstrate improvements in patients’ functionalong a number of parameters followingintervention from this team.Speech Pathology is now provided onweekends, and outcomes demonstrate anenhanced general rate of recovery. Weekendservice provision across other allied healthgroups is being reviewed.A full-time rather than on-call physiotherapyservice has commenced in the ED at RPA. Thebenefit of this service, possible decreases inCategory 4 and 5 waiting times throughimproved bed management, will be reviewed.Best practice guidelines for the transfer ofpatients to residential aged care facilities hasbeen implemented across SSWAHS easternzone in 2004/05 and will be implemented in thewestern zone in 2005/06.Over the past three years, occasions of serviceprovided to inpatients has remained stable,while outpatients has increased. There has beena move towards providing outpatientinterventions as groups rather than toindividuals. This is particularly beneficial forpeople with chronic and complex health careneeds, and results in more patients being seenin a timely manner.Future direction within the AreanetworkAllied Health will work closely with the AreaExecutive and other clinical streams inpreparation for the formation of a single AlliedHealth stream across both zones.Activity LevelsKey Indicators 2001/02 2002/03 2003/04 2004/05Staff EFT 211 210 212 218Inpatient occasions of service 214,796 222,123 226,297 224,901Outpatient occasions of service 119,148 113,074 110,512 139,777NB. This table only applies to Allied Health in RPA, Concord and Canterbury Hospitals.Sydney South West Area Health Service Statutory Annual Report 04/05 57

Population andDrug Health ServicesPopulation health and drug health services are currently operating under eastern and western zones.In the eastern zone, the Division of Population Health and Drug Health Services are facilities that areboth within the Population and Drug Health Services clinical group. In the western zone, Drug HealthServices is one of a number of health services that report to the Division of Population Health.SSWAHS will create a single Population Health entity across both zones in 2005/06. Drug HealthServices will also become a single area-wide service.Eastern ZoneClinical Director Associate Professor Peter SainsburyMB BS, DObstRCOG, MHP, FRACMA, FAFPHM, PhDSummary of activity, including therange of services providedPopulation and Drug Health Servicescomprises a range of services including:Community Health Services, Drug HealthServices, Multicultural and Women’s Health,as well as the Public Health and HealthPromotion Units.The Drug Health Service in the eastern zoneprovides a wide range of inpatient andoutpatient clinical services to the public. Staffare also involved in teaching and research.Major goals and outcomesAccess, treatment and health care forsubstance-using pregnant women and theirfamilies has been improved through a new teamlocated at RPA Women and Babies consisting ofservices from drug health, maternity andobstetrics, social work, neonatology services,mental health and Aboriginal services.Preliminary results indicate reduced prematurityand stillbirths and increased neonatal birthweights among participants.The Redfern Waterloo Street Team has movedfrom an outreach service to a program-basedservice, increasing the quality and effectivenessof interaction with children and young peoplefrom Redfern and Waterloo. Over 4000 contactshave been made in 2004/05 with 90 per cent ofthe clients being Aboriginal.Key issues and eventsStrategies to improve pharmacotherapytreatments for opioid dependent persons haveinvolved increased partnerships with GeneralPractitioners. As part of this initiative, GPs areregularly provided with training to maintain andimprove their ability to identify and treat drugrelated health problems. Recent topics haveincluded: cannabis, detoxification, managingchronic pain and a clinical update for GP opioidprescribers.Future direction within the AreanetworkDrug Health Services has continued to meet thepublic health challenge of preventing and caringfor HIV and Hepatitis C among intravenous drugusers. A primary area of focus has beenRedfern/Waterloo. Despite media and publicattention, the Resource and Education Programfor Injecting Drug Users (REPIDU) hascontinued to provide a daily service to people onthe Block in Redfern. Services include provisionof sterile injecting equipment; health educationand advice; brief interventions and referral toother health and welfare services.(See the facility report for the Division ofPopulation Health on page 48 for furtherinformation about Population and Drug HealthServices in the eastern zone).Keyindicators2001/02 2002/03 2003/04 2004/05Staff EFT 461+ 449.5 459 417.9Occasions 444,591 424,797 418,438 410,742of Service+ increase due to NSW Drug Summit fundingSydney South West Area Health Service Statutory Annual Report 04/05 58

Division of Population HealthWestern ZoneProfessor Jeanette Ward MB BS MHPEd Phd FAFPHM (until January 2005)A/Director Population Health Mark Thornell BSW (from January 2005)Summary of activity, including therange of services providedThe Division of Population Health designs anddelivers evidence-based health strategies aimedat improving the health status of the population,reducing inequalities between population groupsand addressing gaps in services.In 2004/05 our services included AboriginalHealth, Health Promotion, Public Health, theResource, Evidence Management andSurveillance (REMS) Centre, Women’s Health,Multicultural Health, Community Paediatrics andthe statewide Refugee Health Service. DrugHealth Services also operated within theDivision of Population Health for the first half of2004/05 before becoming a separate clinicalservice.Major goals and outcomes28 primary schools across the western zone arereceiving support from health staff as part of theHealth Promoting Schools project. The project isfocused on physical activity, nutrition or mentalhealth.The Public Health Unit assisted the Area GPUnit in the screening and vaccination of anumber of newly arrived refugees from Africa.December 2004 saw the completion of themeningococcal C vaccination of children atprimary and high schools.An epidemiological profile for SSWAHS wasdeveloped to assist in the amalgamation of theformer Central and South Western Sydney AreaHealth Services.The Aboriginal drug health advisory subcommitteeaction plan was developed andimplemented.The Families First Multicultural CommunicationProgram worked with local communities andproduced communication campaigns for Arabic,Somali and Vietnamese speaking communities.The campaigns focus on positive parenting andraising awareness of health and other services.The Community Paediatric Program ofExcellence training program and associatedChild Health Research Group wasestablished.Key issues and eventsThe Division of Population Health wassuccessful in obtaining project and researchgrants in excess of $2 million.Drug and alcohol education and trainingmodules were developed for registered nursesand new graduates as part of the NSW drugand alcohol nursing strategic plan.The development and implementation of acannabis strategy for the western zone hascommenced.The Villawood Icebreaker Project was launchedin April 2005 by Her Excellency Professor MarieBashir, Governor of NSW.The Capacity Building in Evidence BasedPopulation Health project was established.The aim of the project is to train all staff inevidence-based population health to ensurebest practice and best use of resources.Future direction within the AreanetworkThe Families First Multicultural CommunicationProgram will expand to include three newcommunities in 2005/06.Sydney South West Area Health Service Statutory Annual Report 04/05 59

Mental Health ServicesMental Health ServicesClinical Director Victor Storm MBBS MPA FRANZCP FAFPHMSummary of activity, including therange of services providedThe Mental Health Service is an area-wideservice providing community-based and clinicalinpatient services across the age spectrumincluding early intervention, acute assessmentand treatment, rehabilitation, communitysupport, consultation/liaison, dietary disorders,and old age psychiatry. It also conductsextensive education, training and researchactivities.Programs are provided in partnership withcommunity agencies and non-governmentorganisations, divisions of general practice, localschools, and other government departments.Major goals and outcomesInfant, Child and Adolescent Mental Health wasinstrumental in publishing a manual and CD forclinicians – A Practical Guide for theImplementation of Integrated Perinatal andInfant Care.A depression prevention program for primaryage children was developed and implementedacross SSWAHS and two other area healthservices.In the inner west, community services havemoved from their stand-alone buildings intopurpose-built or renovated co-located buildingsat Camperdown and Croydon. Construction hasbegun on new accommodation for services inthe Marrickville area.Key issues and eventsThe Psychiatry Research and Teaching Unit(PRTU) at Liverpool published 21 researchpapers in areas of population mental health andtraumatic stress. The PRTU was a key partner ina successful five-year National Health andMedical Research Council grant of $4.7 millionto conduct research in the area of traumaticstress studies. It was also successful as acollaborative partner in grant submissions toAusAID ($150,000), Australian Rotary HealthResearch Fund ($23,000), South West SydneyArea Health Service Health ResearchFoundation ($23,000), and the AustralianResearch Council Special Research Initiative($10,000).The Psychiatry Research Unit at Rozellepublished 36 papers and book chapters onHealth Services treatment and organization andneuro-psychiatry. The service has also been asuccessful partner with the University ofSydney’s Brain Mind and Research Institute andothers in a successful five-year National Healthand Medical Research Council grant of $7.1million to conduct research into emerging severemental illness in young people.Future direction within the AreanetworkPlanning for the amalgamation began prior toDecember 2004 with establishment of transitionworking groups. A consultant has beencontracted to bring together the reports andrecommendations of the working groups anddevelop a comprehensive strategic plan formental health across SSWAHS.Consultation is occurring with hospital managersand clinicians to look at issues of access toacute mental health inpatient beds plusestablishment of Psychiatric Emergency Careprograms for people presenting to EmergencyDepartments.Sydney South West Area Health Service Statutory Annual Report 04/05 60

Nursing and Midwifery ServicesNursing and Midwifery ServicesDirector Kerry Russell RN M.Cert Ba.Admin MCNSummary of activity, including therange of services providedNursing and Midwifery Services are responsiblefor the standard of nursing care across the areahealth service. This encompasses recruitmentand retention of staff, education, clinical practiceand research for a workforce of some 6,500nurses.Since the amalgamation, Nursing and MidwiferyServices have worked towards and madesignificant progress in developing a single areawideservice.Major goals and outcomesThere has been a focus on recruitment of nursesand midwives into permanent positions and thesubsequent reduction in the use of agency staffand overtime.The number of trainee enrolled nursesemployed has increased. SSWAHS enteredinto a new agreement with the University ofTasmania and the University of Notre Dame toprovide clinical placements for theirundergraduate nursing students.The delivery of education services has beenreorganised and an area-wide approach toeducation adopted.Recruitment of overseas nurses and midwiveshas also been centralised, resulting in a shortvisa turnaround time, and significantly moreoverseas nurses/midwives being employed. Todate, 174 full time nurses have been recruitedfrom overseas, 22 of whom we have sponsoredas permanent residents.The Nursing Reasonable Workload has beenimplemented at RPA, Campbelltown andCamden hospitals.Key issues and eventsA partnership with the University of Tasmaniahas been developed for the clinical placement of30 final year nursing undergraduate students atConcord, RPA and Area Mental Health Services.It is anticipated that this will lead to recruitmentopportunities following completion of theirprogram. Some of these students are part of anexchange program between the University ofTasmania and Swedish universities.Marketing material which promotes nursing andmidwifery as a single service across the Areahas been developed in booklet, DVD and CDformats.The appointment of Professor Pat Brodie to thenewly created clinical Chair of MidwiferyPractice Development and Research with theUniversity of Technology, Sydney was ahighlight for the area health service.Future direction within the AreanetworkNursing and Midwifery Services will continue towork to create an innovative clinical environmentwith demonstrated best practice outcomes and afocus of developing staff in leadership andmanagement.An on-line, area-wide, casual staff pool will beestablished. Employment of permanent staff willcontinue to be increased and the reduction inagency staff will continue.Networking and partnerships with internationalorganisations which may provide futurerecruitment opportunities will continue to bepursued. This may include undergraduatestudent placements and the provision ofpostgraduate programs.The midwifery models of care at CamdenHospital will continue to progress in accordancewith the strategic direction of the Area.Sydney South West Area Health Service Statutory Annual Report 04/05 61

Quality Clinical IndicatorsClinical indicators (CIs) are rate-based figures which can show where we are performing particularlywell and can serve as a model for others. When we are performing at a suboptimal rate, compared tonational or past data, they can act as an alert for further investigation or review of clinical practice toimprove the quality of care provided to our patients. The former CSAHS (eastern zone SSWAHS) haspublished in its annual report since 2002/03 a selection of CIs that have either a State or nationalcomparison. We have continued the reporting in this year’s annual report and have included somewestern zone indicators where they collect the same indicator.Adult Renal TransplantationNumerator: Number of patients/grafts surviving at one yearDenominator (n): Number of renal transplant patients/graftsSWRS: State Wide Renal Services% Survival at One YearYearSWRS (CSAHS)PatientsAustralian/NZPatientsSWRS (CSAHS)GraftsAustralian/NZGrafts1998 98% (n=59) 95% 96% (n=59) 91%1999 100% (n=51) 95% 98% (n=51) 90%2000 92% (n=52) 97% 91% (n=52) 94%2001 97% (n=62) 96% 96% (n=62) 93%2002 98% (n=61) 98% 95% (n=61) 95%2003 100% (n=66) 98% 98% (n=66) 92%2004 97% (n=70) Not available 96% (n=70) Not availableAdult Liver Transplantation survival ratesWe measure both patient survival and graft survival as a patient can have more than one liver graft.Numerator: Number of patients/grafts surviving at one yearDenominator: Number of liver transplant patients/graftsANZLTR: Australian and New Zealand Liver Transplant RegistryYear% Survival At One YearRPAANZLTR*ANZLTR*RPA GRAFTSPATIENTS PATIENTSGRAFTS1999 89% (n=28) 93% (n=117) 87% (n=31) 90% (n=124)2000 90% (n=39 92% (n=151) 83% (n=42) 90% (n=157)2001 82% (n=27) 86% (n=125) 79% (n=28) 80% (n=135)2002 100% (n=43) 96% (n=151) 96% (n=47) 94% (n=157)2003 97% (n=38) 94% (n=143) 93% (n=41) 92% (n=150)2004/05 88% (n=50) NA 87% (n=52) NASydney South West Area Health Service Statutory Annual Report 04/05 62

ObstetricsQuality Clinical IndicatorsNumerator: Number of deliveries / interventions for yearDenominator: Number of babies delivered for year2004 data not available at publication2003 NormalDeliveryForcepsVaginalVacuumExtractionVaginalBreechElectiveCaesareanEmergencyCaesareanCanterbury 71.1% 1.6% 6.3% 0.1% 10.4% 10.4%HospitalRPAH 61.9% 2.0% 7.7% 0.5% 14.2% 13.4%Fairfield 76.2% 1.3% 6.4% 0.6% 9.2% 6.4% 100%Liverpool 71.6% 0.7% 6.1% 0.8% 11.3% 9,5% 100%Campbelltown 69.5 0.2 6.6 0.2 13.1 10.3 100%Camden 85.0% 5.1% 0.4% 0.2% 1.3% 8.1% 100%NSW StatewideRate62.8% 3.4% 6.8% 0.4% 15.1% 11.5% 100%Bankstown- 73.8% 1.9% 5.8% 0.9% 10.6% 6.9% 100%LidcombeBowral 61.5% 4.7% 14.1% 0.3% 11.5% 8.0% 100%2002 Normal Forceps Vacuum Vaginal Elective Emergency TotalDelivery Vaginal Extraction Breech Caesarean CaesareanCanterbury 70.6% 2.3% 8.3% 0.1% 10.1% 8.7% 100%HospitalRPAH 62.3% 1.8% 9.2% 0.7% 13.3% 12.8% 100%Fairfield 77.8% 1.0% 7.9% 0.3% 8.0% 4.9% 100%Liverpool 74.0% 1.1% 6.7% 0.9% 9.2% 8.1% 100%Campbelltown 74.5% 0.7% 5.1% 0.5% 10.6% 8.6% 100%Bankstown- 75.9% 1.3% 7.6% 0.6% 8.6% 6.1% 100%LidcombeBowral 63.1% 3.6% 14.7% 1.0% 9.6% 8.0% 100%NSWStatewiderate64.2% 3.6% 6.9% 0.4% 13.9% 11.0% 100%Sydney South West Area Health Service Statutory Annual Report 04/05 63

Quality Clinical Indicators2001 Normal Forceps Vacuum Vaginal Elective Emergency TotalDelivery Vaginal Extraction Breech Caesarean CaesareanCanterbury 75.3% 2.1% 7.1% 0.2% 6.6% 8.7% 100%HospitalRPAH 65.8% 2.0% 6.7% 0.5% 13.9% 11.2% 100%Fairfield 77.8% 1.3% 5.2% 0.4% 9.8% 5.5% 100%Liverpool 72.3% 2.0% 6.9% 1.0% 8.7% 9.0% 100%Campbelltown 75.5% 0.9% 5.3% 0.3% 9.9% 8.1% 100%Bankstown- 74.9% 1.5% 5.2% 0.6% 9.5% 8.3% 100%LidcombeBowral 64.7% 6.8% 11.5% 0.6% 9.2% 7.2% 100%NSWStatewide rate65.4% 4.0% 6.5% 0.5% 13.0% 10.5% 100%NSW statewide rate published in the NSW Public Health Bulletin Supplement Vol 13, No S-4, Dec 2002 - NSWMothers and BabiesNeonatal Intensive Care UnitIn the RPA Neonatal Intensive Care Unit (NICU), the survival rate of babies is monitored and comparedto the rates for other NICU’s from the New South Wales Health Neonatal Intensive Care Unit Study(NICUS). In the more recent reported time periods, we have more premature babies surviving.Numerator: Number of babies born at a particular gestational age, surviving to discharge from hospitalDenominator: Number of babies born at a particular gestational age2004/05 data not available at publication2002 – 2003: Percentage survival of premature babies born at different gestational ages24/25 weeks 26/27 weeks 28/29 weeks 30/31 weeksRPA 52.0 86.2 97.5 99.5NICUS 55.0 86.0 91.5 90.52000 – 2001: Percentage survival of premature babies born at different gestational ages24/25 weeks 26/27 weeks 28/29 weeks 30/31 weeksRPA 58.8 87 97.8 99.2NICUS 55.4 86 92.4 971995 – 1999: Percentage survival of premature babies born at different gestational ages24/25 weeks 26/27 weeks 28/29 weeks 30/31 weeksRPA 62.3 79.3 91.3 98.2NICUS 60.6 81.1 92.6 97.1Sydney South West Area Health Service Statutory Annual Report 04/05 64

Quality Clinical IndicatorsRespiratory Medicine - documented evidence of an appropriate discharge planAll patients with a diagnosis of acute asthma should have maintenance therapy prescribed, appropriatetimely follow-up with a medical practitioner and a written asthma management plan on discharge.Numerator: The number of patients admitted to hospital with a diagnosis of acute asthma for whom thereis documented evidence of an appropriate discharge plan.Denominator: The total number of patients admitted to hospital with a diagnosis of acute asthma, duringthe time period under study.ACHS = Australian Council on Healthcare StandardsJantoJune2000RPAH 83.0ACHSNationalAggregateRateHospitals> 300beds%56.8%JultoDec200083.0%71.8%Jan toJune2001Jul toDec2001Jan toJune2002Jul toDec2002Jan toJune2003Julyto Dec2003Jan –June2004July –Dec2004Jan –June200591.2% 89.0% 96.7% 93.2% 98.0% 89% 89% 96% 95%71.3% 57.9% 65.7% 93.1% NotavailableNotavailableNotavailableNotavailableNotavailableOrthopaedics – post-operative infection following total hip replacementIt is important that we minimise infections after surgery. We have been able to keep the infection rateunder the national average but we still strive for no infections. To eliminate any bias in data collection,the infection control department collects the infection rate figures.Numerator: Number of total hip replacement patients with late evidence of infection within 12 monthspost discharge following primary total hip replacement.Please note that this numerator only includes patients who are managed by the facilities orthopaedicteam. It does not include patients who present to other hospitals.Denominator: Number of patients undergoing total hip replacement.ACHS = Australian Council on Healthcare StandardsJan - June 2001/02 2002/03 2003/04 2004/052001Royal Prince Alfred Hospital 0% 0.33% 2.9% 1% as atAug 040.6% (Jan-June 05)Concord RG Hospital 0% 0% 0% 0% as at 1.5%Aug 04Fairfield Hospital 4.7%(October2003-June2004) *3% (Jan2005-June2005) *ACHS National AggregateRate 20000.9% 0.9% NotavailableNotavailableNotavailable* Includes infections identified in acute period and later infections presenting to the same hospital. Does not includeSuperficial SIs diagnosed by GPs or other hospitals.Sydney South West Area Health Service Statutory Annual Report 04/05 65

Quality Clinical IndicatorsDay of Surgery Admission RateDay of surgery admission (DOSA) rate measures how many patients are admitted on the day of theirsurgery compared to all patients admitted to surgery. A high DOSA rate has advantages:• it avoids unnecessary accommodation at hospital before an operation;• it means more effective bed utilisation where hospitals can treat more patients and consequentlythere are shorter waiting times;• the use of preadmission clinics better prepares patients for surgery,• a decreased time in hospital means less risk of infection.Our DOSA rate has been steadily increasing over time and it is now above the State target of 80% andabove the State average of 87.4%.Eastern zone Western zoneNSW HealthtargetNSW Healthstatewide rate1997/98 18.1% 47.1% Not available1998/99 34.1% 77.7% Not available1999/00 50.9% 77.2% Not available2000/01 74.4% 81.0% 80% 77.7%2001/02 81.3% 85.0% 80% 83.3%2002/03 85.0% 89.7% 80% 83.9%2003/04 89.2% 90.0% 80% 87.4%2004/05 89.6% 91.1% 80%Central Sydney Laboratory Service - availability of urgent haemoglobin resultsafter hours.It is important that laboratory test results are made available to hospital staff as soon as possible sothat decisions can be made about patient care. After hours, we are able to supply urgent haemoglobinresults to staff within 60 minutes in 95.8% of cases which is more efficient than the national aggregateof 93.3%.Numerator: Number of urgent haemoglobin validated report results with a turn-around-time less than60 minutes, after hoursDenominator: Number of requests for urgent haemoglobin results received by the lab after hoursJan –June2003July -Dec2003Jan –June2004July -Dec2004Jan –June2005CSAHS 95.5% 95.8% 98.3% 97.36% 96.81%LabsSWAPS N/A 98.38% 99.13% 95.69% 98.88%ACHSNationalAggregaterate65.57% 93.37% 95.95% 57.38% NotavailableSydney South West Area Health Service Statutory Annual Report 04/05 66

Quality Clinical IndicatorsSSWAHS eastern sector physiotherapy clinical indicator - total knee jointreplacement surgeryDefinition of Numerator: Total Number of TKR patients who achieve 80° active knee flexion and -5°active knee extension by Day 7, or dischargeDefinition of denominator: Total numbers of patients receiving physiotherapy following TKR surgerySSWAHS – east and2001 / 02 2002 / 03 2003 / 04 2004 / 05benchmarksCanterburyNot collected 76% 76% 77%(100%: 2001)Concord RGHNot collected 79% 64% 21%(58%: 2001)RPAH 78% 76% 76.5% 78.5%NSW Physiotherapy rate 70%Speech Pathology – improvements in voice quality following speech pathologyNumerator: total number of voice patients who rated an actual improvement in voice quality followingSpeech Pathology interventionDenominator: total number of voice patients completing treatment and voice outcome scalesNSW Benchmark (Sydney Voice Interest Group): 80%n=25 (18 RPA, 6 Concord Hospital, 1 Canterbury Hospital)2001/02 2002/03 2003/04 2004/05Allied Health 83.3% 87.5% 88% 88%Sydney South West Area Health Service Statutory Annual Report 04/05 67

Corporate ServicesSummary of business activityNon-clinical support services across SSWAHSare managed by Corporate Services. This is adiverse portfolio including risk management,occupational health and safety andrehabilitation, procurement and tendering,contract management, overseeing complexinvestigations and administrative and legalservices.Major goals and outcomesAmalgamationTransition and amalgamation planning forcorporate services was undertaken in the latterpart of 2004, with business cases beingdeveloped for the amalgamation of supplyservices, HR, payroll, ISD, finance, pathology,engineering services, capital works, transportand fleet management and OHS services.Recommendations for future service provisionwere cognisant of the plans being developedunder the NSW Health Shared CorporateServices Program.In mid 2005, SSWAHS established workinggroups in supply, payroll and human resourcesto implement amalgamation plans. The workinggroups have representatives from management,staff and unions and underpin the consultativeprocess. SSWAHS actively participated in thecommittees and working parties to progress theNSW Health shared corporate services program.The benefits of the amalgamation are alreadyapparent across all areas of corporate serviceswith savings returned to clinical services.Financial management has been simplified withthe creation of one general ledger replacing anumber of different systems, facilitating goodcorporate governance. A risk analysis has beencompleted and a risk register is being developedfor the whole of the Area Health Service.An area-wide approach to purchasing andtendering means more competitive prices canalso be achieved for the benefit of clinicalservices.The development of area-wide policies andprocedures for grievance management,disciplinary management and management ofbullying and harassment is designed to ensureconsistent process is applied across the Area,leading to improved management of theseissues to the benefit of individual staff and theirmanagers. A code of conduct was issued to staffand placed on the intranet to facilitate ongoingaccess.Key issues and eventsWaste managementSSWAHS facilities continued to develop andimplement strategies in line with theGovernment’s Waste Reduction and PurchasingPolicy (WRAPP). Facilities monitor performancethrough the collection of indicators for clinicalwork, sharps waste, general waste, recyclingand OHS incidents related to wastemanagement.Energy managementSSWAHS electricity consumption was reducedby 897,661 KWh over the past two years.Natural gas consumption was reduced by50,864,307 MJ or 18% over the past two years.Water consumption was reduced by 95,000KI or13% over the last two years with a reduced costof $37,861 or five per cent over the last period.Future directionIn order to progress the amalgamations tocorporate services, working groups will beestablished and will include representatives fromunions and staff to assist with workplaceredesign.Existing energy and waste management planswill be reviewed and an area-wide strategydeveloped.Existing policies and procedures will continue tobe reviewed in order to develop a set of simple,area-wide guidelines for staff.Sydney South West Area Health Service Statutory Annual Report 04/05 68

Financial ServicesSummary of business activityThe Finance Department operates to ensurethat SSWAHS financial resources and assetsare managed efficiently and effectively throughappropriate planning, coordination andmonitoring. The development of area-widefinancial and accounting policies and proceduresensures the consistent process andenhancement of quality control and has been amajor focus for the division.Major goals and outcomesPlanning for the amalgamation of the financialservices function of the former CSAHS (easternzone) and SWSAHS (western zone) into a singleservice was undertaken. Upgrading of theOracle Financials system from version 10.7 toversion 11i for the eastern zone was completedin April 2005 and the implementation of 11i wasrolled out to the western zone with an expected‘go live’ date in September 2005. The OracleFinancials 11i for SSWAHS operated on thesame chart of accounts with one integratedgeneral ledger and is used as the majorbudgeting and financial reporting tool.Implementation of uniform financial and budgetperformance reporting management for both thefacilities and clinical groups across the Area wasprogressed and is close to finalisation.Key issues and eventsA uniform chart of accounts for SSWAHS wascompleted and published in the Area intranet.The cost centre structure for the western zoneclinical groupings was completed and set up inthe chart of accounts.The consolidated SSWAHS Annual FinancialReport for period ending 30 June 2005 wasprepared in accordance with the AustralianEquivalents of International Financial ReportingStandards (IFRS).Future directionThe Financial Services Department continues toplace a high priority on provision of qualitybudget and financial management informationsystem for all stakeholders. Over the next year,the main financial and associated sub-financialsystem will be fully integrated into a single areawidefinancial system with a single interface withthe general ledger.Sydney South West Area Health Service Statutory Annual Report 04/05 69

Information Management ServicesSummary of business activityThe amalgamated Information Management andTechnology Services (IM&TS) providesinformation management and technologysupport to SSWAHS clinical, corporate andsupport services.Major goals and outcomesThe two open data networks of the formerCSAHS and SWSAHS were linked into a singlearea-wide data network following theamalgamation in 2005. In order to support easiercommunication the two voice networks werealso linked, IT help desk services werecombined to provide a single area-wide serviceand a single internet and intranet service wasformed. The finance and supply system for theeastern zone was upgraded to the latest versionas the first stage in an area-wide consolidationproject.Additional Electronic Medical Record (EMR)ability continued to be provided to facilities in theeastern zone including: electronic diagnostic testand service ordering to RPA; electronicdischarge summaries to RPA, Balmain andCRGH; replacement of obstetrics and neonatalsystems at RPA; implementation of a paperlessEMR solution for Gastroenterology and LiverServices; and implementation of an integratedscheduling/billing module for Cancer Services.Planning for the introduction of electronicmedication management has commenced andprovision of a single area-wide EMR system withintegrated laboratory information is underway.Key issues and eventsThe statewide incident management system,IIMS, was implemented and secure internetaccess solutions were established in order toprovide clinicians with remote access to selectedsystems.A project to rationalise and integrate the emailsolutions of the new AHS was commenced.Future directionThe Information Management and TechnologyStrategy places a high priority on projects thatsupport the patient care process. Over the nextfive years, the EMR system will continue to growinto a single, integrated, patient-centred,enterprise-wide clinical information system.IM&TS will continue to enhance and pilotadditional EMR functionality across the areahealth service. A program to provideapproximately 5000 clinicians with access tointegrated results and orders capability is apriority in 2005/06.Other major projects include: the delivery ofEMR functionality to Drug Health Services,Cancer Services, and community-based health;building the complexity of information availablethrough the EMR by interfacing it with severalother specialist systems such as intensive care,and neurosciences; and the rollout of a singlearea-wide integrated laboratory informationmanagement system.Sydney South West Area Health Service Statutory Annual Report 04/05 70

Public Affairs and MarketingSummary of business activityThe Public Affairs and Marketing departmentpromotes the corporate identity of SSWAHS, itshospitals and healthcare facilities. It is the firstpoint of contact for the media. Our goal is tocommunicate both internally and externally, thework being carried out at our facilities for thebenefit of patients and the wider community.Our expertise includes internal and externalcommunication strategies, media advocacy,specialised promotion campaigns, corporatepublications and event management.Major goals and outcomesPublic Affairs and Marketing completed a reviewof its services with a view to becoming an areawideservice post-amalgamation.Production of a regular electronic newsletterbegan, informing staff about the amalgamationand the new management structure. A quarterlyarea-wide printed newsletter for distribution to allstaff was also produced.The community was kept informed of newclinical initiatives and services, additionalfunding, and progress on the capital works beingundertaken at our hospitals and health services.Key issues and eventsMany stories from facilities across SSWAHSwere featured in national, metropolitan and localmedia, including:• The $133.7 million five-year Macarthurstrategy at Camden and Campbelltownhospitals.• The RPA series on Channel 9 entered its11 th year and work began on a documentaryfor SBS on maternity services at Canterburyhospital.• Agreement was reached for filming to beginnext year at the ICU at Liverpool hospital fora documentary to be screened on SBS.• The $23 million Croydon Health Centreopened by Premier Bob Carr.• His Royal Highness Prince Charles visitedRPA and the Sydney Cancer Centre as partof his Australian tour.• Construction began on the $9.1 millionLiverpool Emergency and Trauma ServicesFacility.• The development of a new 50-bed subacuteMental Health unit at Liverpool.Premier Iemma officiated at a sod-turningceremony in May for the 20-bed sub-acuteCampbelltown Mental Health unit.• A second linear accelerator wascommissioned at Campbelltown Hospitalcancer treatment centre. Installation andcommissioning of a new linear accelerator inthe Radiation Oncology department at RPAbegan and the replacement of a 10 year-oldLINAC at Liverpool has commenced.• Concord Hospital installed a state-of-the-art3.0 Tesla Magnetic Resonance scanner, theonly one of its kind available to publicpatients in NSW.• A wide range of research developmentswere made, including the launch of themetabolic rehabilitation clinical at Concord,the development at RPA of a new vaccine tofight TB and the International MultipleMyeloma Conference held at RPA.• The promotion of health issues such assmoking cessation, sexual health, screeningfor babies and drink spiking.Future directionThe Public Affairs and Marketing unit willcontinue to provide a superior level of service toits clients across the area. The unit will alsopromote the ideals of the health service to thepublic and the staff. In the new financial year,Public Affairs and Marketing will promote thenew Mental Health unit at Liverpool and theopening of the Aged Care Precinct at ConcordHospital.Sydney South West Area Health Service Statutory Annual Report 04/05 71

Internal AuditSummary of business activityInternal Audit is an independent, objective,assurance and consulting activity designed toimprove SSWAHS’s operations by bringing asystematic, disciplined approach to riskmanagement, control and governanceprocesses.Major goals and outcomesInternal Audit aims to provide an independentreview of hospital systems, operations, activities,policies and procedures and where warranted,recommend cost effective controls andsolutions.Key issues and eventsSince 2000, the SSWAHS Internal AuditManager has been the convenor of the NSWHealth Audit Working Party which meetsannually to develop audit programs and provideguidance to Area Health Service AuditDepartments.The SSWAHS Internal Audit Manager is also thehealth industry representative on the NSWCorruption Prevention Network and provides aregular program of fraud awareness to areahealth service employees.Future directionThe Internal Audit Department successfullymerged its RPA and Liverpool Hospital auditunits during the year and now operates oneconsolidated audit plan for the Sydney SouthWest Area Health Service.Sydney South West Area Health Service Statutory Annual Report 04/05 72

Workforce ProfileSummary of business activityThe main workforce activity has been theongoing amalgamation of two area healthservices to form SSWAHS. This has involvedthe key service areas of human resources andworkforce development. Work has alsocommenced on bringing a more strategic focusto workforce planning, workforce developmentand people management processes. Thisstrategic work will continue into 2005/06.Major goals and outcomesThe Human Resource Development Service andNursing Education have expanded theirservices. Customised training and developmenthas been significantly increased and aimedparticularly at managers and teams.The implementation of vocational qualificationsthrough the Health Training Package has beentargeted at support services, allied healthassistants, dental assistants, pharmacyassistants and ward orderlies.Training programs are being developed by theHuman Resource Development Service incollaboration with the Professional Practice Unitto ensure our workforce is ethical andprofessional in its conduct towards patients, staffand the community.Policies and procedures on grievance,disciplinary procedures and harassment havebeen reviewed and redrafted after consultationwith staff. The new policies and procedures aimto enhance senior management involvement inthose matters which may impact on patient careand staff management.Key issues and eventsAn outline of the area workforce plan has beencompleted, with ongoing consultation with keygroups throughout the area to continue during2005/06 as part of finalising the plan.Future direction2005/06 will see the completion of the Area’sstrategic workforce plan, setting out futureworkforce requirements and a range ofinnovative actions for meeting them.The Human Resources Division will continue toreview current policies and procedures toidentify areas of improvement in our peoplemanagement services and an expandedworkforce development program focused onbuilding skills can be anticipated.Sydney South West Area Health Service Statutory Annual Report 04/05 73

Executive ReportsProfessor Diana Horvath AOChief executiveKey responsibilities: The chief executive isaccountable for the overall corporategovernance, performance and strategic planningof the organisation. The position of chiefexecutive reports directly to the Director-Generalof NSW Health. All second tier positions reportto the chief executive.Significant achievements in reporting year:see chief executive report on page 5 to 6.Mike Wallace, MSc (Soc), BScDirector of clinical operationsKey responsibilities: The director of clinicaloperations is responsible for operational serviceand strategic management of the area healthservice hospitals and facilities as well as thedirectorates of the clinical stream and clinicalbusiness units. Directors and managers of thesefacilities and clinical services report directly tothe director of clinical operations and areaccountable for their facility’s or service’sperformance.Significant achievements in reporting year:see facility reports pages 41 to 55 and assetmanagement report page 10 to 11.Jan Whalan, BPharm, MPH, MBA, AFAIMDirector of corporate servicesKey responsibilities: The director of corporateservices manages a diverse portfolio whichincludes finance and budget, informationtechnology, shared corporate services and areahealth service corporate services such asengineering, fleet, legal, risk management andprocurement.Significant achievements in reporting year:see corporate services report on page 68.Candy Cheng, B COM (UNSW), FCPAChief finance officerKey responsibilities: The chief finance officeris responsible for the management of the areahealth service’s financial resources through thedevelopment and implementation of financialmanagement systems for budget control andperformance measurement. The chief financeofficer also provides prompt and appropriateadvice to the chief executive and seniorexecutive on budget and finance matters.The position of chief finance officer has dualreporting to the chief executive and the directorof corporate services.Significant achievements in reporting year:see financial services report on page 69.Dr Greg Stewart, MB BS, MPH (Syd),FRACMA, FAFPHMDirector of population health,planning and performanceKey responsibilities: The director of populationhealth, planning and performance is responsiblefor the strategic planning and performance forthe area health service. The position alsomanages Aboriginal Health Services andPopulation Health Services which include publichealth, health promotion, health surveillance andcounter disaster management and planning.Significant achievements in reporting year:see performance indicator data on page 18 - 27.Paul Gavel, MEc.,BEcDirector of strategic workforceplanning and developmentKey responsibilities: The director of strategicworkforce planning and development isresponsible for human resources, industrialrelations and learning and development servicesacross the area health service. In addition, thedirector will manage the development andimplementation of an area health serviceworkforce plan. This will involve liaison with thethree university medical schools in the provisionof appropriate clinical placements in hospitalsand medical schools, as well as with othermedical colleges and training organisations.Significant achievements in reporting year:see workforce profile report on page 73 andteaching and training initiatives report on page86.Sydney South West Area Health Service Statutory Annual Report 04/05 74

Executive ReportsKerry Russell, RN, Cert Mgt, Bach Admin(UNE)Director of nursing services andmidwiferyKey responsibilities: The director of nursingservices and midwifery is responsible for theadministration and management of nursingservices across SSWAHS. This includes thedevelopment and implementation of nursingpolicy and practice, professional developmentand recruitment and retention issues.Significant achievements in reporting year:see nursing and midwifery services report onpage 61.Dr Peter Kennedy, MB BS FRACPDirector of clinical governanceKey responsibilities: The director of clinicalgovernance is responsible for the strategic andoperational management of the Clinical QualityUnit and the Professional Practice Unit as wellas the development and implementation ofuniform quality policies across the area healthservice.Significant achievements in reporting year:see clinical quality report on page 62.Dr Victor Storm, MB BS MPA FRANZCPFAFPHMDirector of mental health servicesKey responsibilities: The director of mentalhealth services is accountable for setting theclinical direction and coordination of clinicalservices for the Mental Health Unit across theArea. This includes making senior appointmentswithin the service group, planning for clinicalservices and the establishment of targets andperformance indicators.Significant achievements in reporting year:see mental health services report on page 60.Julie Roberts, BSC (Computer Science)Chief information officerKey responsibilities: The chief informationofficer is responsible for the coordination,management and operation of the variousinformation management and technologyfunctions of the area health service. Theseinclude strategic planning, informationtechnology policy development, securitymanagement, database management, ITinvestments, systems engineering, computerresources management, telecommunicationsand web-based activities. The chief informationofficer is also the principal advisor oninformation management and informationtechnology issues to the executive of SSWAHS.Significant achievements in reporting year:see information management report on page 70.Sydney South West Area Health Service Statutory Annual Report 04/05 75

Staff ProfileNumber of full time equivalent staff employed by SSWAHS as at 30 June 2005* Data provided by NSW HealthSydney South West Area Health Service June-02 June -03 June -04 June 05Medical 1,395 1,459 1,584 1,544Nursing 5,982 6,187 6,367 6,573Corporate Administration 671 644 755 679Allied Health Professional 2,774 2,891 2,836 2,870Hospital employees (eg wardsmen, technicalassistants and ancillary staff) 2,801 2,990 2,924 2,944Hotel Services 1,439 1,495 1,444 1,402Maintenance and Trades 204 220 211 200Other 219 221 227 199Total 15,485 16,107 16,348 16,411Medical, Nursing & Allied Health staff as aproportion of all staff (%) 65.6 65.4 66.0 66.9Third Schedule 469 472 442 329Notes:In 2004, an independent review of corporate administration FTEs resulted in more consistentapplication of the definition being applied by Health Services. As a result, corporate administrationfigures for June 02,03 and 04 have been adjusted accordingly.Sydney South West Area Health Service Statutory Annual Report 04/05 76

Equal Employment OpportunityEqual Employment Opportunity (EEO) is aboutensuring the workplace is free from all forms ofharassment and discrimination, and providingprograms of affirmative action for thoseemployees who are traditionally disadvantagedin the workplace: Aboriginal and Torres StraitIslander people, women, people whoselanguage first spoken as a child was not English,and people with a disability requiring anadjustment.Sydney South West Area Health Servicebelieves equity is a fundamental right of everyemployee, and by applying equal employmentopportunity principles to every aspect of worklife, the Area is supporting good managementpractice and observing the legislation governingthese principles, namely, the Anti-DiscriminationAct, 1977.The Area continues to promote the principlesand practices of Equal Employment Opportunity(EEO) in its application of conditions ofemployment, relationships in the workplace, theevaluation of performance and the opportunityfor training and career development.Achievement of last year’s EEOplanned outcomes for CSAHSIn July 2004, the Minister for Healthannounced changes to the NSW healthsystem, including a statewide restructure ofhealth administration. The outcome was theamalgamation of the existing 17 Area HealthServices into eight areas. As a result, CentralSydney Area Health Service (CSAHS) andSouth West Sydney Area Health Service(SWSAHS) amalgamated to form SydneySouth West Area Health Service (SSWAHS)as from 1 January 2005.The planned outcomes for CSAHS were tofacilitate a skilled and valued workforce bycontinuing to: improve occupational health andsafety (OH&S) by providing effective humanresource systems; provide appropriate trainingand support for staff; maintain the Area’sgrievance management system; meet with theworking party to look at issues surroundingbullying and harassment in the workplace; andcontinue to review the Aboriginal EmploymentStrategy, Disability Plan and HR Strategic Plans.Compulsory manual handling training is includedin the CSAHS orientation program for all newstaff. A record of staff who have attendedmanual handling training is kept in a databasemaintained by the Human Development andResource Services. When injuries do occur,CSAHS management provides rehabilitationprograms to assist and support injured workersto return to their pre-injury duties.The Area Director of Human Resourcesrepresented management on the working partyto look at issues surrounding bullying andharassment. A review of these policies wasundertaken in 2004 and the updated policieshave now been distributed throughout the AreaHealth Service.Statistical data produced by CSAHS for 2004/05indicates that the total number of staff whoidentified as Aboriginal or Torres Strait Islanderhas increased again this period from 1.6 percentto 1.8 percent. CSAHS has reported increasesin Aboriginal and Torres Strait Islanderrespondents up to 0.4 percent for the past threeyears (i.e., 2001/02 – 0.8%; 2002/03 – 1.2% and2003/04 – 1.6%).CSAHS pursued structured placement programsfor Aboriginal and Torres Strait Islander people,including traineeships. Of the four people whoenrolled in the Trainee Enrolled Nurse (TEN)Program last March, two have graduated andare working in other Area Health Services, andtwo will graduate in October this year. Oneperson commenced in the April 2005 TENProgram group.A further 10 staff were supported by the ElsaDixon Aboriginal Employment Program andhave been permanently placed in the AreaHealth Service. SSWAHS continues to supportand recognise the importance of these programsas a means of developing the Aboriginal healthworkforce within the Area.Further to the staff satisfaction survey conductedin the eastern zone in 2003, and from the workdone by three working parties formed as a resultof that survey, a number of initiatives have beencarried out. A common theme across the threeworking parties was the importance of the role ofmiddle management. An additional survey wassent out to managers regarding methods ofconsultation and participation. The analysis ofthis survey was distributed to ExecutiveDirectors, General Managers (eastern zone) andSSWAHS Learning and Development unit toassist with future planning for communicationacross facilities. An internal website has beendeveloped for the SSWAHS intranet enablingmanagers to access strategies and informationto help in their day-to-day management tasks.Sydney South West Area Health Service Statutory Annual Report 04/05 77

Equal Employment OpportunityAchievement of last year’s EEOplanned outcomes for SWSAHSThe Aboriginal Employment Coordinator positionwas reviewed and regarded. A survey wasconducted to identify Aboriginal and TorresStrait Islander positions (including Elsa Dixonpositions); a skill needs analysis was conducted;and staff mapped against Aboriginal HealthPriority areas to identify staffing gaps (to linkwith the survey and skills analysis to determinepositions to be requested for Elsa DixonAboriginal Employment Programrecruitment/funding, and with a view to preparingthe Aboriginal Workforce Development Plan).Nursing and Midwifery services have fourAboriginal and Torres Strait Islander people intraining.EEO Planned Outcomes for 2005/06SSWAHS plans to review the CSAHS Aboriginaland Torres Strait Islander Employment Strategyto reflect the needs of the amalgamated areaand develop the SSWAHS Aboriginal and TorresStrait Islander Employment Strategy. This will beachieved through consultation with staff from thewestern and eastern zones.SSWAHS will continue to review the GoverningBody of Management Manual, including theHuman Resource policies to reflect changesbrought about by the amalgamation process.This will be achieved through a consultationprocess and when policies have been completedthey will be distributed to facility managers andplaced on the SSWAHS intranet site.As a consequence of the amalgamation, theArea Health Service will continue to ensure thatany adjustment of the workforce andredeployment of existing staff will be done byconsultation, ensuring that all EEO groups aretreated fairly.Statistics 2004/05The statistical information for the following tables(salary levels and employment type) wasobtained from a report generated by thePremier’s Department from the WorkforceProfile data, for the period 1 July 2004 to 30June 2005. The salary levels are those used forthe EEO statistical data 2004/05 period. Thesefigures are adjusted annually by ODEOPE toreflect industry-wide wage increases granted tovarious groups of employees.Sydney South West Area Health Service Statutory Annual Report 04/05 78

Equal Employment OpportunitySSWAHS Percentage of Total Staff (Head Count) by Salary Level – 2004/05$94,165(nonSES)>$94,165(SES)Total Staff 351 6,154 1,753 5,181 3,605 1,476 798 19,318(Number)EEOrespondents(268)76%(4,418)72%(1,393)79%(3,671)71%(2,543)71%(993)67%(545)68%0 (13,831)72%Men (65)19%(1,692)27%(369)21%(872)17%(848)24%(704)48%(535)67%0 (5,085)26%Women (286)81%(4,462)73%(1,384)79%(4,309)83%(2,757)76%(772)52%(263)33%0 (14,233)74%AboriginalPeople &Torres Straitislanders(9)3.4%(127)2.9%(15)1.1%(45)1.2%(13)0.5%(7)0.7%0 0 (216)1.6%People fromRacial,Ethnic,Ethno-ReligiousMinorityGroupsPeoplewhoselanguage firstspoken as achild was notEnglishPeople with aDisabilityPeople with aDisabilityrequiringwork-relatedadjustment(39)15%(103)38%(1)0%(786)18%(1,646)37%(141)3%0 (36)0.8%(299)21%(504)36%(32)2%(6)0.4%(943)26%(1,199)33%(117)3%(32)0.9%(573)23%(699)27%(76)3%(15)0.6%(290)29%(278)28%(28)3%(4)0.4%(154)28%(120)22%(13)2%(2)0.4%Total0 (3,084)22%0 (4,549)33%0 (408)3%0 (95)0.7%Estimaterange(95%confidencelevel)1.4% to1.7%22.0% to22.8%32.4% to33.2%2.8% to3.1%0.6% to0.8%Sydney South West Area Health Service Statutory Annual Report 04/05 79

Equal Employment OpportunitySSWAHS – Percentage of Total Staff (Head Count) by Employment Type – 2004/05Full-timeFull-timeParttimeParttimeContractSESContract –Non SESTrainingPositionsRetainedStaffTotal Staff 11,510 4,920 2,242 416 0 16 218 0 3,800 23,122CasualTotalRespondents (8,409)73%Men (3,405)30%Women (8,105)70%Aboriginal (146)People & 1.7%Torres StraitislandersPeople fromRacial,Ethnic,Ethno-ReligiousMinorityGroupsPeople whoselanguage firstspoken as achild was notEnglishPeople with aDisabilityPeople with aDisabilityrequiringwork-relatedadjustment(1,871)22%(2,889)34%(274)3%(68)0.8%(3,483)71%(553)11%(4,367)89%(44)1.3%(671)19%(947)27%(104)3%(21)0.6%(1,524)68%(988)44%(1,254)56%(20)1.3%(464)30%(583)38%(25)2%(2)0.1%(235)56%(75)18%(341)82%(3)1.3%(52)22%(56)24%(5)2%(4)1.7%0 (3)19%(181)83%0 (9) (55)56% 25%0 (7) (163)44% 75%0 0 (7)3.9%0 (1)33%0 (1)33%(27)15%(73)40%0 (1,417)37%0 (958)25%0 (2,832)75%0 (29)2.0%0 (299)21%0 (479)33%0 0 0 0 (26)2%0 0 0 0 (3)0.2%(15,252)66%(6,053)26%(17,069)74%(249)1.7%(3,385)22%(5,028)34%(434)3%(98)0.6%Sydney South West Area Health Service Statutory Annual Report 04/05 80

Equal Employment OpportunityTrends in the Representation of EEO Groups% of total staffEEO Group Benchmark 2002 2003 2004 2005or TargetWomen 50% 74%Aboriginalpeople andTorres StraitIslandersPeople whosefirst languagewas not EnglishPeople with adisabilityPeople with adisabilityrequiring workrelatedadjustment2% 1.6%20% 33%12% 3%7% 0.7%Trends in the Distribution of EEO Groups% of total staffEEO Group Benchmark 2002 2003 2004 2005or TargetWomen 100 90Aboriginalpeople andTorres StraitIslandersPeople whosefirst languagewas not EnglishPeople with adisabilityPeople with adisabilityrequiring workrelatedadjustment100 75100 92100 100100 95Notes:1. Staff numbers are as at 30 June2. Excludes casual staff3. A Distribution Index of 100 indicates that the centre of the distribution of the EEO group across salarylevels is equivalent to that of other staff. Values less than 100 mean that the EEO group tends to bemore concentrated at lower salary levels than in is the case for other staff. The more pronounced thistendency is, the lower the index will be. In some cases the index may be more than 100, indicatingthat the EEO group is less concentrated at lower salary levels. The Distribution Index is automaticallycalculated by the software provided by ODEOPE.4. The Distribution Index is not calculated where EEO group or non-EEO group numbers are less than20.Sydney South West Area Health Service Statutory Annual Report 04/05 81

Occupational Health and SafetySSWAHS eastern zone and western zone are working towards the integration of their OccupationalHealth and Safety (OHS) policies and programs.Eastern ZoneSSWAHS eastern zone has a continuingcommitment to Occupational Health andSafety (OHS). OHS policies and programsidentify, assess and prevent work-relatedinjuries and illnesses. Specific riskmanagement strategies have beenimplemented to minimise the risks fromidentified hazards. Manual handling andsecurity issues remain a high priority.OHS Committees at each facility encourageconsultation and participation in OHS activities.Training is provided for OHS committeemembers and managers to assist them to meettheir OHS responsibilities. OHS training for allemployees includes manual handling,minimisation of aggression, infection control, firesafety and other specific training as required towork safely.Workers compensationperformanceSSWAHS continues to support effectiveworkers compensation management andworkplace-based rehabilitation. Injuredemployees are offered specific programs ofsuitable duties to assist their return to work.There is ongoing review of claims anddiscussions with legal advisors and the fundmanager to monitor costs and ensure anyissues are quickly and economically resolved.Workers compensation performance ismeasured by comparing claim rates and costswith NSW Health rates and costs. Figures areshown for the last five financial years.SSWAHS Eastern Zone 2000/01 2001/02 2002/03 2003/04 2004/05SSWAHS EZ Claims 666 677 756 745 661SSWAHS EZ Claim rate/100equivalent full-timeNSW Health claim rate/100equivalent full-timeSSWAHS EZ Claimcost/equivalent full-time ($)NSW Health claim cost/equivalent full-time ($)7.4 8.0 8.8 8.7 7.58.1 8.4 8.8 8.9 8.0$938 $836 $669 $639 $441$1,240 $1,069 $914 $717 $508Data from NSW Treasury Managed Fund as at 30 June 2005SSWAHS eastern zone has maintained claimrates and costs better than the NSW Healthaverage for the fund years 2000/01 to 2004/05.Claims are recorded in the financial year inwhich they occurred. Data for the 2004/05year is not yet complete as claims may haveoccurred during 2004/05 but had not beenreported by 30 June 2005.There was an increase in claims across NSWHealth in 2002/03 following changes to NSWWorkers Compensation legislation with theintroduction of ‘provisional liability’ commencingJanuary 2002.Claim costs increase as claims develop overtime so that claims made in 2000/01 haveaccrued more cost than claims made in morerecent years. This must be taken into accountwhen comparing claim costs over time.Comparison of claim rates and claim costsbetween SSWAHS eastern zone and NSWHealth average is used to assess ongoingperformance.There is variation in performance betweenSSWAHS eastern zone facilities.Sydney South West Area Health Service Statutory Annual Report 04/05 82

Occupational Health and SafetyClaim Rate/100 FTE 2000/01 2001/02 2002/03 2003/04 2004/05Balmain Hospital 11.6 8.6 8.6 13.9 12.1Canterbury Hospital 10.1 5.5 5.3 6.3 7.3Concord Hospital 8.3 10.3 10.1 10.3 9.0Population Health 4.6 4.7 8.3 7.7 7.4Royal Prince Alfred Hospital 6.3 7.2 9.0 7.5 6.5Rozelle Hospital 8.6 10.4 11.4 12.2 10.7Sydney Dental Hospital 12.9 12.5 11.7 9.0 7.6SSWAHS average 7.4 8.0 8.8 8.7 7.5NSW Health average 8.1 8.4 8.8 8.9 8.0Data from NSW Treasury Managed Fund as at June 30 2005Claim Cost/FTE 2000/01 2001/02 2002/03 2003/04 2004/05Balmain Hospital $704 $101 $387 $1,016 $660Canterbury Hospital $1,141 $701 $337 $689 $722Concord Hospital $1,490 $910 $609 $916 $460Population Health $297 $1,580 $416 $120 $353Royal Prince Alfred Hospital $949 $933 $527 $551 $401Rozelle Hospital $524 $588 $927 $756 $584Sydney Dental Hospital $385 $869 $1,025 $437 $551SSWAHS average $938 $836 $669 $639 $441NSW Health average $1,240 $1,069 $914 $717 $508Data from NSW Treasury Managed Fund as at 30 June 2005Variation in workers compensation performance between occupational groups reflects difference inrisks exposure as well as strategies for prevention and return to work.Claim Rate/100 FTE 2000/01 2001/02 2002/03 2003/04 2004/05Nurses 8.1 8.3 11.2 10.8 8.7Medical/Medical support 3.8 4.6 3.2 3.4 4.5General administration 5.2 5.0 5.6 5.6 4.8Hotel service 13.8 17.7 14.1 15.2 11.0SSWAHS average 7.4 8.0 8.8 8.7 7.5NSW Health average 8.1 8.4 8.8 8.9 8.0Data from NSW Treasury Managed Fund as at 30 June 2005The three most common accident types are manual handling (body stress) injuries, falls and being hitby moving objects.No of SSWAHS EZclaims2000/01 2001/02 2002/03 2003/04 2004/05Manual handling 264 279 276 294 226Falls, trips, slips 137 133 167 138 143Hit by moving objects 73 68 81 99 69Data from NSW Treasury Managed Fund as at 30 June 2005Sydney South West Area Health Service Statutory Annual Report 04/05 83

Occupational Health and Safety% of SSWAHS EZ claims 2000/01 2001/02 2002/03 2003/04 2004/05Manual handling 40% 41% 37% 39% 34%Falls, trips, slips 21% 20% 22% 18% 22%Hit by moving objects 11% 10% 11% 13% 10%SSWAHS EZclaims/100FTE2000/01 2001/02 2002/03 2003/04 2004/05Manual handling 2.9 3.3 3.2 3.4 2.5Falls, trips, slips 1.5 1.6 2.0 1.6 1.6Hit by moving objects 0.8 0.8 0.9 1.2 0.8Western ZoneSydney South West Area Health Service western zone maintains a strong commitment to supplying asafe environment for all staff, patients and visitors. Workplace safety and injuries are constantlymonitored and workers compensation claims reviewed. A summary of results within SSWAHS westernzone for the previous three years is recorded below. Key trends have been identified and strategiesdeveloped to reduce workplace incidents.Workers compensation claimsfor occupation groups 2002/03 2003/04 2004/05Total 802 827 686Nurses 44.63% 37.96% 38.62%Clerical/Management 4.63 6.52% 8.3%Allied Health/Medical 12.71% 13.54% 13.85%General Services 38.03% 41.98% 39.23%Common injury types 2002/03 2003/04 2004/05Manual Handling 36% 33.6% 33.67%Slips/Trips/Falls 17.6% 15.11% 14.43%Hit Object 17.8% 12.33% 11.37%Mental Stress 7.2% 9.19% 8.75%Other 20.14% 29.77% 31.78%Sydney South West Area Health Service Statutory Annual Report 04/05 84

Occupational Health and SafetyWorkers compensation claimsper 100FTE 2002/03 2003/04 2004/05Bankstown HS 15.4 14.6 13.2Wingecarribee HS 7.6 9.5 12.9Braeside 13.9 10.2 8.5Camden/Wollondilly HS 18.5 13.3 7.7Queen Victoria Memorial Home 6.9 6.7 7.4Campbelltown HS 13.0 13.9 10.4Carrington NA NA NAFairfield HS 11.9 9.7 8.5Karitane 3.1 5.6 5.8Liverpool HS 8.2 9.6 8.3Area 5.8 5.5 5.9SWAPS 5.2 4.5 2.8SWSAHS AVG 10.7 10.5 9.3Manual handling injuries remain the mostcommon type of injury within the health industry.Strategies to reduce these injuries include:manual handling training at initial orientation ofnew employees and task specific trainingprovided to occupational groupings; supplyinglifting equipment for patients and bulky goodstransportation; conducting risk assessments ofworkplace tasks and developing safe workpractices to standardise the safest way toperform tasks.A regular process of hazard inspections isdesigned to identify physical hazards in theworkplace environment and the annualnumerical profile safety audit program monitorsthe progress of all OHS systems and policies.Western zone facilities consistently score eitherA or B in the Hazard Inspection element of thetool, where A is best practice.Other workplace safety initiatives undertaken in2004/05 include:• Security and aggression minimisation(SAMMA) audits are conducted annually tospecifically manage staff and patients andfacility safety and security.• The Safer Place to Work program wasimplemented for all western zoneemployees.• Workplace incident forms record all actual orpotential risks and are collated to identifyemerging trends.• Numerous OHS Committees across thewestern zone actively monitor the workenvironment and communicate OHSinformation to all employees.• Training programs focus on manualhandling and ergonomics, hazardoussubstances, managing aggression, firesafety and incident investigation.• OHS practitioners meet regularly to networkand support a consistent approach to safetyacross SSWAHS.During the year, 2004/05 SSWAHS westernzone was not prosecuted for any breach of theOccupational Health and Safety legislation.The western zone remains proactive in the postincident management of injuries. Workplaceinjuries are reviewed monthly with key staff ineach facility. Quarterly Key PerformanceIndicator (KPI) reports identify the frequency ofinjuries at specific facilities and arecommunicated to all key senior staff. Incidentsinvolving patients or visitors are recorded andinvestigated through a reporting process thatensures any identified risks are eliminated orreduced.Sydney South West Area Health Service Statutory Annual Report 04/05 85

Teaching and Training InitiativesSSWAHS is one of the leading providers ofhealth education and training in Australia. Ourtraining network extends across the alliedhealth, medical and nursing professions andcovers both university placements andpostgraduate vocational training. SSWAHSoffers an extensive range of needs-basededucational and professional developmentopportunities. We are committed to producingoutstanding clinicians with the clinical andleadership skills necessary to succeed in theirchosen field and meet the needs of ourcommunity.Allied healthAllied health students are accepted fromuniversities in Sydney for fieldwork placementthroughout SSWAHS. Graduate trainingplacements are provided for several disciplines.Allied health in-service programs also operate,providing an opportunity for specialised clinicaleducation. These programs draw on theexpertise of allied health clinicians who sharetheir knowledge and experience across theirclinical network.Undergraduate medical studentOur network of undergraduate medicaleducation has links to both the University ofSydney and the University of New South Walesand will be further enhanced in 2007 with thecommencement of undergraduate medicaleducation at the University of Western Sydney.SSWAHS hospitals have a large intake ofstudents allocated to clinical placements,allowing access to a diverse range of healthservices and experiences. University of Sydneymedical students are linked to RPA and Concordhospitals. University of NSW medical studentsare linked to Liverpool, Bankstown,Campbelltown and Fairfield hospitals.Junior medical officersSSWAHS provides placements to around 130interns through the Primary Allocation Centres atRPA, Liverpool, Concord and Bankstownhospitals.The intern year vocational medical training isfocused around the Primary Allocation Centresat RPA, Liverpool, Concord and Bankstown, andoffers a wide array of training programs to suitmedical college guidelines.Training of junior medical officers willincreasingly take place across a number ofhospitals instead of only one through thedevelopment of training networks. WithinSSWAHS, medical training placements areprovided at RPA, Liverpool, Concord,Bankstown, Campbelltown, Canterbury, Fairfieldand Rozelle hospitals. 2004/05 saw theoperation of the first networks in basic physiciantraining. New training networks in basic surgeryand psychiatry will commence in 2006.Nursing education and professionaldevelopmentSSWAHS is a registered higher educationinstitution under the NSW Higher Education Act2001 and delivers the accredited GraduateCertificate in Specialty Nursing. In 2004, 43nurses graduated with the award specialising inanaesthetics/recovery, emergency, family andchild health, perioperative and renal nursing. 33of these graduates are currently employed asspecialist nurses within the Area.SSWAHS is also a recognised provider ofclinical education for trainee enrolled nursingand undergraduate bachelor of nursing andmidwifery programs. In 2004/05, 16,500 shifts ofundergraduate nursing clinical placements wereprovided and 433 new graduate nurses wereemployed. 167 trainee enrolled nurses and 48midwifery students were also providedemployment and clinical support, and wereretained as qualified nurses within the Area oncompletion of their programs.As part of the commitment to expand theenrolled nurses’ scope of practice, over 200enrolled nurses were supported to undertake theapproved EN medication administration course.171 enrolled nurses presently haveendorsement from the NSW Nurses andMidwives Board to administer medication.As well as providing formal education, SSWAHSis also committed to continuing professionaldevelopment for nurses and midwives. Over 200area-wide clinical enhancement andprofessional development programs are offeredthrough the year. In 2004/05, 2,800 nurses andmidwives were provided with salarysupplementation and another 2,500 supportedwith workplace release to attend continuingeducation programs.SSWAHS has also endorsed the NSW HealthClinical Leadership program with six clinicalleaders commencing the 12-month program.In 2004, two nurse education related entrieswere submitted to the Baxter NSW HealthAwards competition. The entry A TargetedSpecialty Education Program to Build Capacityto Promote Health was selected as a finalist, theother, The Development and Implementation ofCertificate III in Aged Care Work (BankstownHealth Service), was the winner in the educationand training category.Sydney South West Area Health Service Statutory Annual Report 04/05 86

ResearchBelow is a brief list of some of the research projects being undertaken at SSWAHS.A more detailed listing can be found at www.sswhealth.nsw.gov.auProject Title Facility /ResearchersADIPS Pilot BankstownHospitalHip Fractureintervention trial(HIPFIT)Auditorytemporalprocessing inschizophreniaStudy of theeffect of a newdrug for acutelymphoblasticleukemias usinga mouse modelMechanisms forageing changesin the hepaticCase-controlstudies ofcompleted andattemptedsuicide in youngpeople in NSWBalmainHospitalM SinghN SinghS QuineL ClemsonC RussellConcordHospitalT BuddConcordHospitalL BennellK BradstockConcordHospitalD Le ConteurR FraserDepartmentof ForensicMedicineR TaylorM DudleyA PageJ DuflouJ MowllBrief Funding Length ofProjectCommonwealthDepartment ofHealth andAgeingDesign and participation inmulti-centre NationalAustralasian Diabetes inPregnancy society pilot auditand benchmarking initiative.To improve disability post hipfracture.This project involves casecontrolstudies of suicide andattempted suicide in youngpeople in urban and ruralNSW, investigatingantecedents and risk factors.NH&MRC$800,000NH&MRC$302,250NH&MRC$497,250NH&MRC$407,750NH&MRC$802,0005 years3 years3 years3 years4 yearsSydney South West Area Health Service Statutory Annual Report 04/05 87

ResearchProject Title Facility /ResearchersA 10-year review Department ofof Sudden Death ForensicIn Young MedicineAustralians. R PuranikC ChowJ DuflouM KilbornM McGuirePericar 2KaritaneVolunteerPrograms –Outcome StudyCentre forClinicalResearchExcellence inRespiratory andSleep MedicineCentre ofClinicalResearchExcellenceProgram: Toimproveoutcomes inchronic liverdiseaseSydney DentalHospitalB TaylorJ TofflerCentre forHealthEquity,Training,ResearchandEvaluation(CHETRE)RPA HospitalR GrunsteinRPA HospitalG FarrellG McCaughanBrief Funding Length ofProjectThis research project examines N/A1 yearthe causes and circumstancesof sudden natural death in the 5to 35 year age group. In the427 cases reported to the NSWState Coroner for investigationand subject to detailedinvestigation, presumed cardiacarrhythmia in subjects with noor minimal structural heartdisease was found to be thecommonest cause of sudden,natural death in youngAustralians.A prospective, randomised 1. NH&MRC 3 yearscontrol clinical trial investigating $140,500links between Periodontal and 2. Ramaciotti 1 yearCardiovascular risks.Foundation$14,000This project describes theprocesses, impacts andoutcomes of the KaritaneVolunteer Home VisitingProgram on parents andvolunteers.The focus of this research isrespiratory and sleep disordersand the application of itsfindings to clinical practice.This project will investigatetreatments for chronic liverdiseases, eg hepatitis B and C.Department ofCommunityServices$30,000NH&MRC$400,000NH&MRC$200,0009 months5 years5 yearsSydney South West Area Health Service Statutory Annual Report 04/05 88

ResearchProject Title Facility /ResearchersExpanding the RPA Hospitalrole for noninvasiveP ByeR Grunsteinventilation in I Youngcystic fibrosis S Bell(CF)Tresillian HomeVisitingInterventionProjectEvaluation of ayouthdevelopment unitand drug andalcohol use inthree remoteAboriginalcommunitiesThe role ofpharmacotherapyin prevention ofrelapse in alcoholdependenceTresillianC Fowler(Tresillian),C McMahon(MacquarieUni)N Kowalenko(RNSH)C Rossiter(Tresillian)Drug HealthServicesK ConigraveA CloughDrug HealthServicesP HaberJ BellM TeessonR MattickC SannibaleK MorleyC ThomsonBrief Funding Length ofProjectThis project aims to treat NH&MRC 3 yearspeople with cystic fibrosis with $100,000short-term portable assistedventilation during flare-ups ofthe disease.Commonwealth Department ofFamily and CommunityServices Early InterventionParenting Grants (2001/04)Commonwealth GovernmentREACH Grant (2004/07. Thecomparison component fundedby Macquarie University(2001/04).Date: 2001 first round 2004second round.A longitudinal study ofsubstance misuse within threeremote Aboriginal communities.The project design has beendeveloped over the past 18months in collaboration withMenzies University. Datacollection commenced in 2004,and will involve evaluation ofthe effectiveness of a youthdevelopment unit.This study is a double-blindrandomised placebocontrolled treatment trialcomparing the effectivenessof Naltrexone andAcamprosate in treatingalcohol dependence. Thisproject is being conductedacross three sites: RPA,Prince of Wales and NepeanHospitals.$576,000 6 yearsAERF$181,094NH&MRC$420,0003 years3 yearsRevision of thedrink-lesspackage andstudy of itsvalue intrainingmedicalpractitioners inbriefinterventionDrug HealthServicesK ConigraveE Proude,P HaberJ SaundersThis project is funded by theRoads and Traffic Authority(RTA) to evaluate, andupdate the Drink-less kit as atool to facilitate brief medicalintervention for excessivealcohol consumption. Data isto be collected on the valueof Drink-less as a tool intraining GPs in briefintervention techniques.Roads &TrafficAuthority(RTA)$56,8181yearSydney South West Area Health Service Statutory Annual Report 04/05 89

ResearchProject Title Facility /ResearchersThe Central HealthSydney Tai Chi Promotion Unittrial: to reduce A Voukelatosthe risk of falling R Cummingfor older people S LordC RisselBrief Funding Length ofProjectThe Central Sydney Tai Chi NSW Health, 2.5 yearsTrial investigates theHealtheffectiveness of a communitybasedPromotionTai Chi program for Researchpeople aged 60 years and over, Demonstrationto improve their balance and Grant Schemereduce the risk of falling. $275 000The significanceof bloodstreaminfections withvancomycinresistantStaphylococcusAureusPlateletresponsivenessto Aspirin andClopidogrel, andTroponinincrement aftercoronaryintervention inacute coronarylesionsExamining someof the factors inthe immunesystem causingnerve damage inthe animalmodels ofmultiplesclerosis andGuillian BarrSyndromeAdjuvantTamoxifen -Longer AgainstShorter (ATLAS)MicrobiologySWAPSI GosbellFairfieldHospitalHealthResearchFoundationJ FrenchHealthResearchFoundationG TranMacarthurCancerTherapyCentreDr Della-FiorentinaDr MoylanA study to determine thesignificance of vancomycinresistant MRSA in a patient’sblood, and to identify the riskfactors for developing bloodstream infection withvancomycin resistant MRSA.Outcomes following primaryTotal Hip Replacement andTotal Knee Replacementsurgery 2003/04.Subject of resistance ofindividual antiplatelet agents(drugs that make the bloodsticky) and the mechanisms asto why this can occur.Study to understand themechanisms that lead to nerveinjury in disease such asMultiple Sclerosis MS andGuillian Barr Syndrome GBS.An international study of theefficacy and safety of prolongedtamoxifen treatment for womenwith a history of breast cancer.HealthResearchFoundationSydney SouthWest$25,000HealthResearchFoundationSydney SouthWest$24,000HealthResearchFoundationSydneySouth West$25,000ANZ BreastCancer TrialsGroupSydney South West Area Health Service Statutory Annual Report 04/05 90

ResearchProject Title Facility /ResearchersA medical oncology Macarthurstudy for patients Cancerwith advanced Non- Therapy CentreSmall Cell Lung S Della-Cancer (NSCLC). FiorentinaOAT TrialKaritane VolunteerPrograms –Outcomes StudyCardiologyLiverpoolHospitalC JuergensCardiologyLiverpoolHospitalT Marwick DLeung, D PriorD Kaye D HareCentre forHealth Equity,Training,Research andEvaluation(CHETRE)Brief Funding Length ofProjectNCIC CTG –NationalCancerInstitute ofCanadaClinicalTrials GroupA phase II multi-centre,randomised, parallel group,double-blind, placebo-controlledstudy of ZD1839 (Iressa)(250mg tablet) plus bestsupportive care (BSC) vsplacebo plus BSC inchemotherapy naïve patientswith advanced (stage IIIB or IV)Non-small cell lung cancer.Occluded Artery Trial.Efficacy and Mechanisms ofExercise Training in DiastolicHeart Failure.This project describes theprocesses, impacts andoutcomes of the KaritaneVolunteer Home VisitingProgram on parents andvolunteers.NationalInstitutes ofHealth$1750 perpatientNH&MRC$173,000$30,000fromDepartmentofCommunityServices9 monthsSydney South West Area Health Service Statutory Annual Report 04/05 91

Official Overseas TravelSouth Western Sydney Area Health ServiceJuly – December 2004Name and Unit Place visited Purpose of travel Source of FundsM SingletonRadiologyMalaysia Interventional Radiology Society of AustralasiaConferenceSpecial PurposeTrust FundB SzlingRadiologyMalaysia Interventional Radiology Society of AustralasiaConferenceSpecial PurposeTrust Fund /PersonalM WongRenal Research UnitNew Zealand First Australasian Home Haemodialysis Workshop Special PurposeTrust FundB MalkusRenal Research UnitNew Zealand First Australasian Home Haemodialysis Workshop Special PurposeTrust FundD ChongRenal Research UnitNew Zealand First Australasian Home Haemodialysis Workshop Special PurposeTrust FundA WoodcockMedical RadiationHelsinkiFinlandAnnual Congress of the European Association ofNuclear MedicineSpecial PurposeTrust FundJ MercerWisconsin International Patogenic Neisseria Conference SponsorshipSWAPSUSAS FrostThe Nederlands RC33 Sixth International Conference on Social Special PurposeSimpson CentreT BarbagiannikosMicrobiologyJ WardPopulation HealthM MalikFairfield Health ServiceB D’SouzaLiverpool Health ServiceL RealphRadiologyD CatoArea Counter DisasterJ ThomasLiverpool Health ServiceSouth CarolinaandWashington DCUSAOttawaCanadaRotoruaNew ZealandHong KongChicagoUSAPapua NewGuineaRomeItalyScience Methodology11 International Symposium on Staphylocci andStaphylococcal Infections and the 44 th InterscienceConference on Antimicrobial Agents andChemotherapyMeeting for TRANS FA (international study ofhealth research funding agencies, support andpromotion of knowledge translation) and the 12 thCochrane ColloquiumRACMA/NZIHM Conference9 th Congress of the Asian Pacific Society ofRespirologyRadiological Society of North America 90 thScientific Assembly ConferenceTo conduct training for Pogera Mine MedicalCentre Nursing, Medical and Paramedical staffThe Protocol CASM981C 2442 InvestigatorMeeting conducted by Novartis PharmaceuticalsTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSelf fundedSpecial PurposeTrust FundSponsorshipSponsorshipSydney South West Area Health Service Statutory Annual Report 04/05 92

Official Overseas TravelCentral Sydney Area Health ServiceJuly – December 2004Name and Unit Place visited Purpose of travel Source offundsA SweeNeurologyParisFranceBarany Society XXIII International Congress Special PurposeTrust FundA BishopCentenary InstituteViennaAustria20 th International Congress of theTransplantation SocietySpecial PurposeResearch FundB BlayneyHaematologyOrlandoUSA2004 Cerner Health Conference Special PurposeTrust FundA BradshawNeurologyParisFranceBarany Society XXIII International Congress Special PurposeTrust FundS BrammahAnatomicalPathologyBarcelonaSpainUltrapath XII Conference on Diagnostic EM Special PurposeTrust FundR BurkePharmacyD CumminsUrologyC CzokSocial WorkE DaviskasRespiratoryMedicineC FosterWomen’s andChildren’s HealthC GebbieMedical OncologyA Gray-WealeOperating SuiteJ HetheringtonEndocrinology &MetabolismC HillAnatomicalPathologyP KennyCHEREP KirwanAnatomicalPathologyM LangshawHaematologyG MalcolmPerinatal MedicineR MartensRespiratoryMedicineL McGarvieNeurologyKansas, Chicago,Los Angeles andBostonUSABangkokThailandBangkokThailandGlasgowUKEdinburghUKBangkokThailandRotorua NewZealandBaltimore, USALisbon, PortugalMiddlesex andBristol, UKFloridaUSACerner Head Office and site visits re: electronicprescribingXV International AIDS ConferenceXV International World AIDS ConferenceEuropean Respiratory Society Annual Congress2004Association for Medical Education in Europe2004Asia Pacific Investigator Meeting for protocolNO16966CAustralian and New Zealand Society forVascular Nurses Scientific SeminarMeeting with Endocrinology Clinical Unit at JohnHopkins University Hospital; InternationalCongress of Endocrinology for Nurses; Turner’sClinic and Endocrinology Nurses TrainingCourseCerner Health ConferenceSpecial PurposeTrust FundScholarshipSponsorshipSpecial PurposeTrust FundSpecial PurposeTrust FundSponsorshipSelf fundedSpecial PurposeTrust Fund andgrantSpecial PurposeTrust FundHong KongInternational Society for Quality of LifeConferenceSpecial PurposeTrust FundBarcelona Spain Ultrapath XII Conference on Diagnostic EM Special PurposeTrust FundOrlandoUSAEdinburghUKGlasgowScotlandParisFranceCerner Health ConferenceAssociation for Medical Education in Europe2004European Respiratory Annual SocietyConferenceBarany Society XXIII International CongressSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSydney South West Area Health Service Statutory Annual Report 04/05 93

Official Overseas TravelName and Unit Place visited Purpose of travel Source offundsS McLennanEndocrinologyMunichGermany40 th European Association for the study ofDiabetes (EASD) Annual MeetingSpecial PurposeTrust FundJ PageRadiationOncologyJ PeakeInformationSystemsZ PuthuchearyIntensive CareUnitE RoachMicrobiologyJ RobertsInformationSystems DivisionL RobertsonInformationSystems DivisionM ShawSexual HealthServicesK SommerEndocrinologyM ToddNeurologyC WangTransplantationServicesR YavorNeurologyB BajukPerinatal ServicesT BoltonDiabetes CentreJ BoserioNeurophysiologyR BrownHaematologyF BurrellTransplantSurgeryA CarvalhoDietitianM ConstantinoDiabetes CentreT EadeRadiationOncologyR FultonPET and NuclearMedicineSussexUKKansas, Chicago,Los Angeles andBostonUSAGlasgowUKOrlandoUSAKansas, Chicago,Los Angeles andBoston, USAKansas, Chicago,Los Angeles andBoston, USABangkokThailandLisbonPortugalParisFranceDebrecen, HungaryVienna, AustriaParisFranceStockholm SwedenBeijing ChinaLouisiana, NewOrleans, USASan DiegoCalifornia USAVancouverCanadaAucklandNZSingaporeAmsterdamNetherlandsRomeItaly8 th International workshop on Electronic PortalImaging; Visit Sussex Oncology Centre, RoyalSussex County HospitalCerner Head Office and other site visits re:electronic prescribingEuropean Respiratory Society meetingSpecial PurposeTrust FundSpecial PurposeTrust FundSelf Funded2004 Cerner Health conference Special PurposeTrust FundCerner Head Office and other site visits re: Special Purposeelectronic prescribingTrust FundCerner Head Office and other site visits re:electronic prescribingXV International AIDS conference2 nd International Congress of EndocrinologyNursing (ICEN)Barany Society XXIII International Congress7 th Congress of the International Society forExperimental Microsurgery and 20 th InternationalCongress of the Transplantation SocietyBarany Society XXIII International Congress45 th Annual Meeting of the European Society forPaediatric Research1 st International Congress on Diabetic VascularDiseasesAmerican Epilepsy Society Annual MeetingAmerican Society of Haematology13 th Annual International Transplant NursesSociety Symposium and General AssemblyAUSPEN ConferenceISPAD/IDF Inaugural Science School for HealthProfessionals23 rd Annual European Society for TherapeuticRadiology and Oncology (ESTRO)2004 IEEE Nuclear Science Symposium andMedical Imaging ConferenceSpecial PurposeTrust FundSponsorshipSpecial PurposeTrust Fund /Travel GrantSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSelf fundedSponsorshipSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSelf fundedSponsorshipSpecial PurposeTrust FundSpecial PurposeTrust FundSydney South West Area Health Service Statutory Annual Report 04/05 94

Official Overseas TravelName and Unit Place visited Purpose of travel Source offundsE FrigParis France International investigator meeting for Protocol SponsorshipDietitianDR15029S GehrigAuckland NZ AUSPEN Conference Self fundedDietitianA M Haque Lausanne,SwitzerlandGermanyESTRO Course on Basic Clinical Radiobiology;German ProState Brachytherapy Centre visitSpecial PurposeTrust FundW HartySydney DentalHospitalJ HeymanDietitianR Holman,LaboratoryInformationServicesK Horneman,Sydney DentalHospitalK KearinsBiochemistryR MaherRadiologyP ManiiPharmacyK MooreAllied HealthK NattressGynaecology /OncologyG OrrTransplant UnitE PalmerDiabetes CentreA PiperRespiratoryMedicineZ PuthuchearyIntensive CareUnitJ RavensNutrition andDieteticsJ ReadDieticianF RennisonHaemophiliaCentreJ SandersHaematologyD SethDrug HealthServicesSingaporeAucklandNZFlorida andCalifornia USANadiFijiPragueCzech RepublicSabah MalaysianBorneoSan-DiegoCalifornia USAWellingtonNZEdinburgh, ScotlandUKVancouverCanadaBeijingChinaHong KongGlasgowUKLisbon PortugalSingapore International Dental Exhibition andConference (SIDEC)AUSPEN Conference2004 Cerner Health Conference and preconferencecourse in Florida plus site visit44 th Annual Meeting of ANZ InternationalAssociation of Dental ResearchMonitor and Investigator meeting for MK653APN071International Australasian Radiology Society 12 thGeneral MeetingAnnual Meeting of the American Society ofHaematologyNational Council of Occupational TherapistsRegistration Board Meeting10 th Biennial International Gynaecologic CancerSociety Meeting13 th Annual International Transplant NursesSociety Symposium and General Assembly1 st International Congress on Diabetic VascularDiseasesObstructive Sleep Apnoea and Respiratory CareworkshopsEuropean Respiratory Society MeetingEuropean Society for Enteral and ParenteralNutrition (ESPEN) 26 th Annual ConferenceSydney DentalHospitalGeneral FundSelf fundedSpecial PurposeTrust FundSydney DentalHospitalGeneral FundSponsorshipSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust Fund andSponsorshipSpecial PurposeTrust FundSponsorshipSponsorshipSelf fundedSponsorshipAuckland NZ AUSPEN Conference Self fundedBangkokThailandMiami, FloridaUSAHeidelberg /MannheimGermanyXXVI International Congress of the WorldFederation of HaemophiliaDOXIL-MMY-3001 Investigators Meeting12 th World Congress on Biomedical AlcoholResearchSponsorshipSponsorshipSpecial PurposeTrust Fund andSelf FundedSydney South West Area Health Service Statutory Annual Report 04/05 95

Official Overseas TravelName and Unit Place visited Purpose of travel Source offundsD SzeInstitute ofHaematologyYuuna / Shanghai /BeijingChinaD SzeInstitute ofHaematologyN Teriana MedicalOncologyC ThorntonResearch MidwifeA TingLaboratoryInformationServicesJ TowsonPET and NuclearMedicineM TranRadiationOncologyY WeiRenal TransplantUnitFrankfurtGermanySan FranciscoUSAVienna AustriaFlorida andCalifornia, USAHelsinki FinlandCambridge UKMilpitasCaliforniaUSAViennaAustriaSymposium of Updates in Blood CancerResearch and Medical Education; visitDepartment of Haematology, Chang SzhengHospital and Cancer Hospital (Institute),Chinese Academy of Medical SciencesResearch study tour RE: Novel NK CellImmunotherapeutic Approach in MyelomaClinical Science course14 th World Congress of the International Societyfor the Study of Hypertension in Pregnancy2004 Cerner Health Conference and preconferencecourse, plus site visitEANM 2004 and 1 st International Symposium onRadionuclide Therapy and RadiopharmaceuticalDosimetry; visit Addenbrookes Hospital and PETCentreTraining course run by Varian Medical SystemsXX International Congress of theTransplantation Society 2004Special PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust Fund /SponsorshipSpecial PurposeTrust FundSydney South West Area Health Service Statutory Annual Report 04/05 96

Official Overseas TravelSydney South West Area Health Service – Western ZoneJanuary – June 2005Name and Unit Place visited Purpose of travel Source of FundsR YHong Kong 13 th World Congress of the International Special PurposeBankstownSociety of Radiographers andTrust FundS CharbelRadiology NetworkM SuenRadiology NetworkM PeregrinaPaediatricsL ByrnesPaediatricsE NewlandCardiologyA CollierPalliative CareS ShunkerIntensive Care UnitB DonkinEmergencyW LloydStuttering UnitV NelsonMacarthur HealthServiceX M KongLiverpool Health ServiceD RobinsonMicrobiologyD CatoArea Counter DisasterHong KongHong KongSan DiegoCalifornia USASan DiegoCalifornia USAFlorida USASeoulKoreaBrusselsBelgiumSingaporeOxfordUKSan FranciscoUSARadiological Technologists13 th World Congress of the InternationalSociety of Radiographers andRadiological Technologists13 th World Congress of the InternationalSociety of Radiographers andRadiological Technologists4 th Annual Forum for Improving Children’sHealth Care4 th Annual Forum for Improving Children’sHealth CareAustralian Investigators Meeting held bySanofi-Aventis and the 4 th AnnualAmerican College of Cardiology scientificsessionsAsia Pacific Hospice Conference25 th International Symposium on IntensiveCare and Emergency Medicine.Advanced Nursing Practice InternationalConferenceOxford Dysfluency conferenceLinac Service Essentials for PhysicistscourseSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust Fund/ PersonalSpecial PurposeTrust FundSpecial PurposeTrust Fund /PersonalSponsorshipSan FranciscoUSALinac Service Essentials for PhysicistscourseSponsorshipFloridaPASCV Clinical Virology Symposium and Special PurposeUSAMolecular Virology workshopTrust FundNew Guinea MIMMS course and disaster exercise. SponsorshipSydney South West Area Health Service Statutory Annual Report 04/05 97

Official Overseas TravelSydney South West Area Health Service – Eastern ZoneJanuary – June 2005Name and Unit Place visited Purpose of travel Source of fundsH CareySydney Dental HospitalBaltimoreUSAInternational American and CanadianAssociation for Dental ResearchSydney DentalHospital general fundE ChanSydney Dental HospitalThe Netherlands Complete and fulfil requirements for PhDThesis at the University of GroningenSelf funded /SponsorshipJ GalbraithHong Kong and MK653A Protocol 808 Post MI Study in SponsorshipCardiologyParis, France Hong Kong; Stradivarius Study (EFC5827) meeting in ParisL KerrAmsterdam Investigators meeting for a new clinical SponsorshipInstitute of HaematologyS LiddellMedical OncologyS AndersonRespiratory MedicineA BishopGastroenterologyJ BrannanRespiratory MedicineB BrooksEndocrinologyM ConstantinoEndocrinologyR DenticeRespiratory MedicineI DivasRadiologyS DubedatMicrobiologyS EberlPET and NuclearMedicineD FooteNutrition and DieteticsJ FranklinMetabolism and ObesityServicesR GrenengerFAST ProgramR GrenengerFAST ProgramA HaqueRadiation OncologyM KassiouPET and NuclearMedicineN LoughmanAnatomical PathologyB LoughnaneNeurosciencesThe NetherlandsBarcelonaSpainSan DiegoCalifornia USABrittanyFranceSan DiegoCalifornia USASan DiegoCalifornia USASan DiegoCalifornia USACreteGreeceSan DiegoUSAFloridaUSAToronto, OntarioCanadaSan DiegoCalifornia USAAthensGreeceBangkokThailandSingaporePoznalPolandIowaUSAParisFranceBarcelona Spaintrial 12866138 – MMY – 3002Investigators meeting for the Phase 111Randomised Study of Bay 43-9006 inpatients with Unresectable and/orMetastatic Hepatocellular CarcinomaSponsorshipAmerican Thoracic society meeting Special PurposeTrust Fund9 th Basic Sciences Symposium of the Special PurposeTransplantation SocietyTrust FundAmerican Thoracic Society Meeting Special PurposeTrust Fund65 th American Diabetes Association Special PurposeScientific MeetingTrust Fund65 th American Diabetes Association Special PurposeScientific MeetingTrust Fund28 th European Cystic Fibrosis Conference Self fundedDiagnostic Radiology review courseMolecular Urology Workshop and ClinicalUrology SymposiumSociety of Nuclear medicine 52 nd AnnualMeeting65 th American Diabetes AssociationScientific MeetingEuropean Congress of ObesityInternational investigator meeting for thetrial rFVIIa in Acute Haemorraghic StrokeTreatmentONTARGET / TRANSCEND Asia PacificRegional MeetingESTRO teaching course -“DoseDetermination Radiotherapy – BeamCharacterization, Dose Calculation, DoseVerification”16 th International Symposium onRadiopharmaceutical ChemistrySpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSponsorshipSponsorshipSpecial PurposeTrust FundSpecial PurposeTrust Fund31 st European Congress of Cytology Special PurposeTrust FundWorld Federation of Neuroscience Nurses ScholarshipConferenceSydney South West Area Health Service Statutory Annual Report 04/05 98

Official Overseas TravelName and Unit Place visited Purpose of travel Source of fundsM McGillEndocrinologySan DiegoCalifornia USA65 th American Diabetes AssociationScientific MeetingSpecial PurposeTrust FundJ MowllLondon7 th International Conference on Grief and ScholarshipDept of ForensicMedicineUKBereavement in Contemporary SocietyA PatwardhanNutrition and DieteticsMaastrichtThe NetherlandsESPEN Advanced course in ClinicalNutritionSpecial PurposeTrust FundM PearsonNuclear MedicineToronto, OntarioCanadaSociety of Nuclear Medicine AnnualMeetingSpecial PurposeTrust FundR PerkinsAnatomical PathologyParisFrance20 th European Congress of Pathology2005Special PurposeTrust FundJ ReadOrlando Florida American Society of Clinical Oncology SponsorshipNutrition and DieteticsJ RexStomal TherapyM RyanWomens and Children’sHealthN SchweitzerNeuro ICUN SuchowerskaRadiation OncologyK TastulaNeuro ICUS TwiggEndocrinologyM WilkinsonRadiologyP WilliamsEndocrinologyC WocadloNewborn CareD YueEndocrinologyUSALondonUKChristchurch NZBarcelonaSpainLisbon PortugalBarcelona SpainSan DiegoCaliforniaUSASan DiegoCaliforniaUSASan DiegoCalifornia USAViennaAustriaSan DiegoCalifornia USASt Mark’s Hospital, Northwick Park,London visit; to set up a multi-centredrandomised control trial to studytreatments of faecal incontinence betweenSt Mark’s and RPA HospitalsThrough the Looking Glass – Sharing theVision, WHA Annual ConferenceWorld Federation of Neuroscience NursesConference8 th Biennial ESTRO meeting on Physicsand Radiation Technology for ClinicalRadiotherapyWorld Federation of Neuroscience NursesConference65 th American Diabetes AssociationScientific MeetingDiagnostic Radiology Review course65 th American Diabetes AssociationScientific Meeting; American EndocrineSociety MeetingGraz Symposium on DevelopmentalNeurology; site visit to the UniversityHospital follow-up program in Vienna65 th American Diabetes AssociationScientific MeetingSpecial PurposeTrust FundSpecial PurposeTrust FundScholarshipSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSpecial PurposeTrust FundSydney South West Area Health Service Statutory Annual Report 04/05 99

Area Health Advisory CouncilAs a result of reforms to the health systemannounced by the Minister in July, 2004, eightnew Area Health Advisory Councils (AHACs) arebeing established for each of the eight new AreaHealth Services.Designed to give clinicians – including doctors,nurses and allied health professionals as well ashealth consumers and local communities – astronger voice in health decision-making, theAHACs have been established under the HealthServices Amendment Bill 2004.Members will comprise clinician andcommunity/consumer representatives and willplay an important role in advising the ChiefExecutive about health care delivery in the Areathrough interaction and cooperation betweenacute health care providers, public health,primary health, aged care and community careservices within the community.The AHAC will support and work with existingArea advisory bodies, such as Medical StaffCouncils, and local health participation groups.This structure provides an important opportunityfor clinicians and community members to work inpartnership to represent all health stakeholders,including clinical staff, consumers and carers.Professor Jeremy Wilson has been appointedChairman of the AHAC for SSWAHS. It isunderstood the Minister will be finalising the fullset of appointments in October 2005.Sydney South West Area Health Service Statutory Annual Report 04/05 100

Community ParticipationPatient feedbackCommunity participation aims to engageconsumers, carers and the community in theplanning and management of their healthservices.There are formal structures in place atSSWAHS to facilitate community participation.All facilities have a patient representative. Thisposition is highly promoted at each facility toensure patients/carers know whom toapproach with suggestions, complaints andcompliments. Complaint statistics arecollected and regularly reported to the ClinicalQuality Council and NSW Health for inclusionin the statewide database.Facilities also use surveys and suggestionboxes for patient feedback. This allowsinformation to be exchanged freely and helpsto maintain a constructive relationshipbetween staff and patients.SSWAHS holds ongoing consumer forumsfeaturing key speakers to improve dialoguebetween SSWAHS and the community weserve. Consumer representatives are included inmany committees throughout the service.Local health participation groupsThe Area Community Participation Unit isresponsible for the administration and supportof the Area’s Consumer/Community Council.The unit works with staff to increase their skillsin involving consumers, carers and thecommunity in health care, sets strategicdirections and monitors communityparticipation activities. The Area Unit will alsoprovide support to the newly created AreaHealth Advisory Council.SSWAHS western zone also operates adecentralised community participation processthrough eight local networks. These networksare supported by their facility general manager’soffice. The networks agreed to a localparticipation structure that will meet locally.The peak community participation structure inSSWAHS is the Consumer/Community Council.The Council comprises representatives from theeight local community participation networks,representatives of specific population groups,and membership that is common to the newArea Health Advisory Council. One of the keyroles of the Consumer and Community Councilis to be the strategic link between the localcommunity representative networks, the AreaExecutive team and the Area Health AdvisoryCouncil.The Chief Executive, (or her delegate in an exofficiorole), is also a member of the Council.The SSWAHS Community RepresentativeNetwork, a broader mechanism for consumerand community involvement, has a currentmembership of 260. The Network held its firstplanning day in June 2005 with 96 people inattendance.The newly formed SSWAHS Consumer andCommunity Council is working on thedevelopment of a business plan which includesthe rollout of the Community ParticipationFramework (Winner of the Baxter Award 2004)across the whole Area.Sydney South West Area Health Service Statutory Annual Report 04/05 101

Fundraising and SponsorshipBankstown HospitalIn 2004/05 Heart Support Australia BankstownBranch held two fundraising stalls allowing thepurchase of equipment for cardiac rehabilitation,the heart failure program, recliner chairs, an icemachine, an electronic blood pressure machineand an electric bed and mattress for cardiacservices inpatients.Heart Support donated money in memory offounding Bankstown Branch President DianneSpilstead.The Bankstown Cardiology Department raised$650 for the National Heart Foundation thisyear.The Child Care Centre conducted fundraisingactivities throughout 2004/05, raising $9,593 forpurchase of equipment.The 2004 Bankstown Health Service charity ballraised $83,173 for the purchase of oncologyequipment.The Aged Day Care service raised $4736 andthe Oncology Department raised $260.Bowral HospitalThrough various fundraising activities $4904was raised. The Centenary Scholarship Fundprovided scholarships to the value of $750 peryear for three students engaged in a healthrelated course of study.Concord HospitalCRGH has continued to enjoy strong supportfrom its local community. A total of $539,072was raised through various fundraising activities.2004/05 saw the City of Canada Bay Counciland the local Chamber of Commerce join forcesonce again to support the hospital’s annualOpera Night at Rivendell and the inauguralturning on of Christmas lights.CRGH’s special relationship with the veterancommunity remains a benchmark. Vietnamveterans have been involved in gardeningprojects at the hospital, with many finding theexercise therapeutic. Older veterans have alsogiven us their time by acting as tour guides forour Nurse’s Museum.Liverpool HospitalLiverpool Hospital received over $100,000 indonations, with a further commitment of $50,000for much needed equipment to assist us toimprove the care of our patients.RPA FoundationThe RPA Foundation holds an annual appeal tofund a research project at the hospital. Theaward of the RPA Foundation Medal to the mostoutstanding individual research project includesan amount of $50,000 to fund the chosenresearch.The RPA Foundation processed a total of$108,837 including general donations to RPA,as well as individual departments and wardsthroughout the hospital. Donations alsoincluded $7,900 for the Nurses Support Fund,$13,000 for cardiac research and $15,000 tourology research.TresillianThe Gidget Foundation, a group of fundraisersdedicated to raising money to promoteawareness of post-natal depression, raised$35,000 for Tresillian.Tresillian is grateful to Johnson and Johnson,who continue to provide in excess of $50,000per year in sponsorship funds.Sydney South West Area Health Service Statutory Annual Report 04/05 102

Donations and BequestsThank you to the following individuals and organisations for providing $5,000 or more in support during2004/05.Allied ExpressSir Robert and Lady Mollie AskinBankstown City CouncilBankstown District Sports Club LtdBankstown R&SL Community Club LtdBankstown Trotting Recreational Club LtdBelmore Returned Services and CommunityClub LtdBulldogs Rugby League Club LtdCabra-Vale Ex-Active Servicemen’s Club LtdCancer Council of NSWCanterbury Hospital - Pink LadiesCanterbury-Hurlstone Park RSL LtdCamden Golf Club LtdCampbelltown Catholic ClubCampbelltown CouncilCampsie RSL Sub-Branch Club LtdCampsie Rotary ClubChannel 9John Edmonson VC Memorial ClubErskine Imports Pty LtdJ H Fisher and SonsMrs Freda Jane GambleFairfield Global Pty LtdD and M R JaffeKids in Macarthur Health FoundationThe Lions NSW/ACT Save Sight and PublicHealthcare FoundationLions Club of Narellan IncLions Club of Sydney Markets IncLions Club of Yagoona IncLiverpool Indian Social ClubDaniel and Rebecca LollbackThe J S McMillan Printing GroupClub Marconi LimitedEstate of the late Gwendolin MeakerMt Pritchard and District Community ClubEstate of the late May O’BrienPharmion Pty LtdPunchbowl Ex-Services & Community Club LtdSandringham Hotel Management Pty LtdServier LaboratoriesLeo McCarthy Memorial Smithfield RSL Sub-Branch ClubStarlight Children’s Foundation AustraliaMr and Mrs P and L SullivanClayton Utz FoundationPaul WakelingSydney South West Area Health Service Statutory Annual Report 04/05 103

Ethnic Affairs Priority ProgramSSWAHS acknowledges and supports thecultural diversity of its population and adheres tothe NSW Government Principles ofMulticulturalism by providing language servicesand other services and programs targetingculturally diverse communities.In 2004/05 a number of projects wereundertaken with the aim of improving the healthof culturally diverse population groups.The Chinese Australian Tobacco and HealthNetwork (CATHN), which consists ofrepresentatives from various health services andthe Cancer Council NSW, has won the 2005Multicultural Communication Award for the Car& Home, Smoke Free Zone – Bilingual TrainingFlipchart. Staff representatives from within theSSWAHS Division of Population Health easternzone have been active members of CATHNsince its formation in 2001.The ETS and Children project in Fairfield wasdeveloped and conducted in partnership withAssyrian, Bosnian, Croatian, Khmer and SerbianWelfare organisations and community members.It aimed to reduce exposure of infants andchildren to passive smoking in homes and carsof the target group living in Fairfield LocalGovernment Area.“There is no cigarette without loss” Ma’feeshcigara men gheir khosara campaign waslaunched by Dr Horvath in April 2005 atBankstown Town Hall. Funded by the HealthPromotion Unit western zone the project aims toraise the awareness of the Arabic community ofthe ill effects of smoking.The otitis media prevention strategy amongstPacific Islander Communities (Samoan,Tongan, Fijian and Cook Island) at MacarthurHealth Service focused on preventing otitismedia amongst children using a culturallyappropriate art medium – Tapa – anddeveloping plain English resources.The Pacific Communities of Macarthur weretargeted for a healthy lifestyle program aimedat increasing physical activity andcardiovascular health.The Families First MulticulturalCommunication Program worked with Arabic,Vietnamese and Somali communities inSSWAHS western zone, developing culturallyinformed communication strategies andeducational resources around parenting.In the SWS Families First Bilingual EarlyParenting Program BCW Program, BilingualCommunity Workers worked with families fromrefugee and new and emerging CALDcommunities, providing early parentingeducation in community settings. The programalso facilitated the development of socialsupport networks with families from Somali,Arabic, Afghani, Sudanese and Bosnianspeaking backgrounds.In the eastern zone, a Families First qualitativeresearch project continued to identify theinformation needs of Chinese, Arabic andVietnamese speaking women in antenatal andpostnatal care. A total of 81 women wereinterviewed. Recommendations have beenmade based on major findings.Sydney South West Area Health Service Statutory Annual Report 04/05 104

Non-Government OrganisationsSSWAHS is responsible for administering the following non-government organisations (NGOs) fundedthrough the NSW Health NGO grant program.Recipients/Grantees Program Purpose 2004/05 GrantBankstown City Aged Care Aged and Disabled 216,615Diabetes AustraliaAged and DisabledCommunity based awareness strategiesregarding Type 2 Diabetes, to detect thedisease and delay or preventcomplications. 19,700Ella Community Centre Aged and DisabledCentre based day programs for peoplewho are frail, aged or have milddementia. 52,800Families in Partnership Aged and DisabledSupport and advocacy group for familiesand carers of children with disabilities. 19,875Motor Neurone DiseaseAssociationAged and DisabledProvides and promotes the best possiblesupport for people living with motorneurone disease, their families andcarers. 276,600Royal Blind Society ofNSWAged and DisabledStatewide specialist low vision services.187,200Scleroderma Associationof NSWAged and DisabledCommunity education re Sclerodermamanagement; dissemination of emerginginformation in treatment and research. 16,300Stroke RecoveryAssociationCabramatta CommunityCentreFamily Planning NSWGay and LesbianCounselling ServiceHaemophilia Society ofNSWLeichhardt Women'sHealth CentreStanford House IncThe Gender CentreWe Help OurselvesCentacare Services -SydneyDympna HouseFamily Planning NSWLeichhardt Women'sHealth CentreLifeline SydneyAged and DisabledAIDSAIDSAIDSAIDSAIDSAIDSAIDSAIDSCommunity ServicesCommunity ServicesCommunity ServicesCommunity ServicesCommunity ServicesTelephone counselling and information,volunteer run Stroke Recovery Clubs,advocacy and education services. 99,200Needle and Syringe program inCabramatta CBD on Friday andSaturday nights. 75,800Statewide education and preventionservices for HIV. 200,000Telephone and referral service forhomosexuals and lesbians. 4,700Harm minimisation program integratedinto generalist haemophilia services. 76,700Counselling and health education forwomen partners of gay/bisexual men. 47,200Short to medium term crisisaccommodation and respite for peoplewith HIV and AIDS. 148,100Statewide HIV and Infectious DiseasesService for people with gender issues. 217,270Harm minimisation program forresidential drug and alcohol services. 107,000Group activities and practical outreachsupport for pregnant women andmothers aged 16-25. 31,300Statewide specialist child sexual assaultcounselling, information, education andresource centre. 355,000Statewide health promotion and trainingservices focussing on sexual andreproductive health and sexuality andtargeting young people, CALDcommunities, people with disabilities andregional, rural and remote populations. 2,268,166Traditional, alternative and preventativehealth strategies for women in relation tosexual, reproductive, emotional andsocial issues. 532,30024 hour telephone counselling andsuicide crisis intervention service. 54,800Sydney South West Area Health Service Statutory Annual Report 04/05 105

Non-Government OrganisationsRecipients/Grantees Program Purpose 2004/05 GrantMelanoma and SkinCancer Research Institute Community ServicesNSW network for the treatment ofmelanoma. 524,800NSW Centre PerinatalHealth ServicesCommunity ServicesOutreach education program to countryand outer metropolitan hospitals toimprove the standard of perinatal healthcare. 23,300NSW Rape Crisis Centre Community ServicesStatewide 24 hour telephone crisisintervention, support counselling andreferral service for women who haveexperienced sexual violence. 546,400South Sydney Women'sTherapy CentreSydney Indo-ChineseYouth SupportThalassaemia Society ofNSWBenevolent Society ofNSWLifeline MacarthurLiverpool Women's HealthCentreQuest for LifeSouthern HighlandsBereavement CareWILMA Women's HealthCentreBankstown Women'sHealth CentreCommunity ServicesCommunity ServicesCommunity ServicesCommunity Servicesand Women's HealthCommunity Servicesand Women's HealthCommunity Servicesand Women's HealthCommunity Servicesand Women's HealthCommunity Servicesand Women's HealthCommunity Servicesand Women's HealthCommunity Servicesand Women's HealthCounselling and referral service forwomen who experience a variety ofmental health and social issues such asdepression, anxiety, domestic violence. 227,900Assists young refugees settle inAustralia; identifies physical or mentalhealth problems and links with healthservices; works with schools, schoolcounsellors, health services andvolunteers; residential program andfollow up camps. 61,100Specialist genetic counselling service forpeople/families affected byThalassaemia/sickle cell anaemia andother hereditary blood disorders. 50,400Services for older women, womenexperiencing domestic violence,Aboriginal women, women withdisabilities and young mothers in theMacarthur region. 1,241,70024 hour telephone counselling andsuicide crisis intervention service for theMacarthur area, Southern Highlands andSouthern Tablelands. 65,200Clinical, counselling and healtheducation services for women in theLiverpool area. 528,400Support programs for persons sufferinglife threatening illness or crisis. Fundingprovides program subsidies for lowincome participants. 157,500Counselling, prevention, education andconsultation for bereaved people in theWingecarribee Shire. 51,400Clinical, counselling and healtheducation services for women in theMacarthur area. 346,400Clinical, counselling and healtheducation services for women in theBankstown area. 313,100Health prevention and informationservices for NESB immigrant andrefugee women in the Fairfield area. 264,600Immigrant Women'sHealth CentreCommunity Servicesand Women's HealthBarnardo's - Marrickville Drug and Alcohol Street work programs. 92,700Barnardo's - Youth at Risk Drug and Alcohol Street work programs. 88,600Workplace drug and alcohol safety andBuilding Trades Union Drug and Alcohol education program. 325,700Cabramatta CommunityDrug and alcohol health promotionCentreDrug and Alcohol focussing on young people. 129,700Italian-specific drug and alcoholCO AS ITDrug and Alcohol counselling. 51,900Sydney South West Area Health Service Statutory Annual Report 04/05 106

Non-Government OrganisationsRecipients/Grantees Program Purpose 2004/05 GrantCyrenian HouseDrug and AlcoholDrug and alcohol residentialrehabilitation program for men. 261,150Fact Tree Youth Services -Making ItDrug and AlcoholYouth service with drug and alcoholcounselling, referral and group work. 103,800Family Drug Support Drug and Alcohol24 hour telephone support, informationand referral for family and friends of drugdependent persons. 291,200GROW CommunityProgramDrug and AlcoholResidential rehabilitation service forthose with a psychiatric disorder or dualdisorder. 204,300Guthrie HouseDrug and AlcoholDrug and alcohol residentialrehabilitation program for women andchildren. 135,600Kathleen York House Drug and AlcoholDrug and alcohol residentialrehabilitation program for women andchildren. 58,725Leichhardt Women'sHealth CentreDrug and AlcoholDrug and alcohol counselling, referraland group work for women. 66,400Macarthur Drug andDrug and alcohol health promotionAlcohol ServicesMaryfields RecoveryCentreOdyssey HouseSouth Sydney Women'sTherapy CentreSouth West AlternativeProgramSydney City MissionWe Help OurselvesYouth UnlimitedAfter Care - AdministrationAfter Care -Ashfield/ParramattaAfter Care - PsychoSupport ServicesCO AS ITGROW (CommunityServices)Drug and AlcoholDrug and AlcoholDrug and AlcoholDrug and AlcoholDrug and AlcoholDrug and AlcoholDrug and AlcoholDrug and AlcoholMental HealthMental HealthMental HealthMental HealthMental Healthfocussing on young people. 295,900Drug and alcohol rehabilitation service.242,000Therapeutic community for drug andalcohol and problem gamblers,residential medicated detoxification,outreach. 886,350Drug and alcohol counselling, referraland group work for women. 125,000Education, assessment and referral forNESB communities inCabramatta/Fairfield. 160,400Education and prevention to minimiseharm associated with young people anddrug use. 100,700Drug and alcohol residential therapeuticcommunities for men. 920,000Prevention of drug and alcohol abusefocussing on young people. 49,400Supported accommodation andresidential support for people with amental illness in the Ashfield andParramatta areas, support services forpeople with a mental illness. 86,400Supported accommodation andresidential support for people with amental illness in the Ashfield andParramatta areas, support services forpeople with a mental illness. 87,100Supported accommodation andresidential support for people with amental illness in the Ashfield andParramatta areas, support services forpeople with a mental illness. 75,600Linguistically and culturally appropriatemental health services the Italiancommunity. 119,500Self-help groups to assist people withmental health problems, training andsupport for people to establish and leadgroups, development of a network offieldworkers to support and monitorgroups. 408,700Sydney South West Area Health Service Statutory Annual Report 04/05 107

Non-Government OrganisationsRecipients/Grantees Program Purpose 2004/05 GrantRichmond Fellowship Mental HealthSupported accommodation servicesfor people with a mental illness inthe Central Sydney catchment area. 657,100Family Planning NSW Women's HealthStatewide health promotion andtraining services focussing on sexualand reproductive health andsexuality and targeting youngpeople, CALD communities, peoplewith disabilities and regional, ruraland remote populations. 414,100NSW Rape CrisisCentreWomen's HealthStatewide 24 hour telephone crisisintervention, support counselling andreferral service for women who haveexperienced sexual violence. 161,700Women's IncestSurvivors NetworkWomen's HealthBi-monthly newsletter for womenwho were sexually assaulted aschildren, information provision,community education andnetworking. 8,30016,016,851Sydney South West Area Health Service Statutory Annual Report 04/05 108

VolunteersBalmain HospitalBalmain Hospital encourages chaplaincyservices from all denominations and three newchaplains have been appointed. Pink ladiesprovide services to all wards of the hospital,assisting patients with personal requirements.Balmain Hospital Auxiliary holds fundraisingevents to purchase equipment for the hospital.During 2004/05 the auxiliary raised $14,964.Auxiliary office bearersCoordinator & Public Officer: Joan McLarenTreasurer:Joyce DuncanSecretary:Mary HardyBankstown HospitalBankstown has 102 volunteers who work acrossboth the hospital and community healthservices. A new service commenced in 2005which involved recruiting volunteers to act asescorts for visitors and patients throughout thehospital. The service runs seven days a weekduring visiting hours.Chaplaincy services are provided on request forall religions and are coordinated through thepatient liaison officer.Auxiliary office bearersPresident: Alf LongTreasurer: Harvey WorthBowral HospitalBowral Hospital has three Hospital Auxiliaries,Bowral, Moss Vale and Burrawang/WildesMeadow which are active in raising funds for anyspecial items of need.There are also Pastoral Care volunteers whospiritually care for our patients, the Blue Ladieswho assist by looking after the flowers on thewards, and volunteers who welcome and assistour visitors.Bowral Auxiliary office bearersPresident:Judith GreenSecretary:Wendy PedleyTreasurer:John LiebmannMoss Vale Auxiliary office bearersPresident:Sandra D’AdamSecretary:Jenny SheermanTreasurer:Rikky WinleyBurrawang/Wildes Meadow Auxiliary office bearersPresident:Jenny GairSecretary:Audrey JacksonTreasurer:Anne FordCamden and CampbelltownHospitalsIn 2004/05 volunteers have assisted with theBear and Bilby Picnic Day, staffed theinformation desks, distributed flowers to hospitalwards, and assisted Allied Health, the libraryand the Cancer Therapy Centre.The chapel at Campbelltown Hospital wasofficially opened on 9 March 2005.Camden Hospital Auxiliary office bearersPresident:Robyn JanceVice Presidents: Pat Goggins and Colleen JohnsonTreasurer:Elaine HallSecretary:Helen EvansCampbelltown Hospital Auxiliary office bearersPresident:Barry KemisterVice Presidents: Jean Mitchell and Moria FrancisSecretary:Judy KemisterTreasurer:Gail SmithBlue Ladies coordinator: Dot LechnerCanterbury HospitalForty eight volunteers work in a variety ofservices throughout the hospital including meetand greet, fundraising, pastoral care, generalpatient visiting and administration.Mrs Agatha Tamassy, one of our longer servingvolunteers was awarded a Community ServiceRecognition Certificate at the Canterbury CityCouncil Awards for 2005.Concord HospitalVolunteers are involved in fundraising, operatinga gift shop, cafe and museum as well aswelcoming and guiding patients and their visitorsaround the facility. Special events held by thevolunteer auxiliary included a golf day; jazzfestival and a sausage sizzle for the annual RTAcyclathon.Chaplains and pastoral visitors provide spiritualcomfort to those in need. Our chaplains havebeen actively involved in commemorativeservices for our veteran community, a roleunique to CRGH.Auxiliary office bearersCoordinator & Public Officer: Ruth EllisTreasurer:Christine GruntarSecretary:Annette SmithFairfield HospitalThe Auxiliary at Fairfield Hospital raised funds topurchase a mobile shower bed valued at $4450.Sydney South West Area Health Service Statutory Annual Report 04/05 109

VolunteersLiverpool HospitalLiverpool Hospital has four volunteer auxillarys –Busby, Colonial Club, Liverpool Hospital andMoorebank/Chipping Norton – engaged indedicated work including fundraising topurchase equipment.The Busby Auxillary has 11 members whoraised almost $65,000. Major purchases were alaser machine for the Eye Clinic, a dialysismachine for the Intensive Care Unit and variouspieces of equipment for the Aged Care Unit.The Colonial Club Auxillary has 26 members. Nomajor purchases were made in 2004/05.However, it is planned to purchase equipmentfor the Hospital early in 2005/06.The Liverpool Hospital Auxillary has 22members who are involved in fundraisingactivities. The major purchase made by theAuxillary was $50,000 worth of obstetricsequipmentThe Moorebank / Chipping Norton Auxillary has10 members. No major purchases were made in2004/05.Liverpool Hospital Volunteers also assist andsupport patients, visitors and staff in manyvaried ways. The Health Service is also servedby other groups of dedicated volunteers in boththe Hospital and Community. These includeMiller ‘The Hub’ Volunteers, Palliative Care andMental Health volunteers.Busby Auxiliary office bearersPresident:Nola DeanSecretary:Elaine YoungTreasurer:George DeanColonial Club Auxillary office bearersPresident: John Frame (deceased May 2005)Secretary:Margaret PeadeTreasurer:David NolanLiverpool Hospital Auxillary office bearersPresident:Elizabeth JohnsonSecretary:Robyn JanceTreasurer:Pat GogginsMoorebank / Chipping Norton Auxillary officebearersPresident:Elizabeth WinnerSecretary:Pat HughesTreasurer:Patsy ColarcoLiverpool Hospital Volunteers office bearersPresident:Elizabeth JohnsonVice-President:Kenneth WynneSecretary:Elaine GregoryTreasurer:Alester Eyre-ThompsonRoyal Prince Alfred HospitalIn 2004/05 the Royal Prince Alfred HospitalVolunteer Services attracted an extra 22volunteers, taking the number to 82. Volunteerservices have subsequently been extendedfrom Monday to Saturday, with plans to furtherextend to seven days a week.An enhanced training curriculum has beenimplemented for volunteers and a training dayhas taken place for the volunteer assistedfeeding trial. Celebrations for the NSW HealthVolunteer Appreciation Day were held at RPAwith entertainers Maria Venuti and Kamahlpresenting awards.Volunteers are developing an activities room inthe geriatric ward to allow patients to participatein craft and music during their stay.The Chaplaincy Department has providedextensive pastoral care services throughout theyear and was successful in attracting a grantfrom the Vincent Fairfax Family Foundation.Grant funds will go towards the appointment of afull time pastoral care worker in Intensive CareServices to offer additional support to patients,families and friends facing times of difficulty.The opening of a dedicated non-denominationalprayer room on Level 6 further supports theneeds of patients, families and friends visitingthe hospital.Sydney South West Area Health Service Statutory Annual Report 04/05 110

Freedom of InformationIn July 2004 the Minister for Health announcedchanges to the NSW Health system, includinga statewide restructure of healthadministration. The outcome was theamalgamation of the existing 17 Area HealthServices into eight areas. As a result CentralSydney Area Health Service (CSAHS) andSouth West Sydney Area Health Service(SWSAHS) amalgamated to form SydneySouth West Area Health Service (SSWAHS)as from 1 January 2005.Statement of affairsThe Freedom of Information (FOI) Act (1989)was introduced to members of the public toensure that records held by governmentagencies concerning personal affairs are notincomplete, incorrect, out of date or misleading,and allows the public the right to view, obtaincopies and/or amend documents held bygovernment agencies.Section 14(1)(a) of the FOI Act requires anagency to ensure that up-to-date information isavailable to the public through the Statement ofAffairs, which is published on an annual basis.The current Statement of Affairs for SSWAHS isincorporated into the 2004/05 Annual Reportand provides information on the objectives,functions and structure of the SSWAHS.The SSWAHS organisational structure and acomprehensive report detailing the Area’scorporate and future objectives are outlined inthe Annual Report.SSWAHS regularly conducts liaison with anumber of consumer groups including:patients/clients/families; general practitionersand health professionals both within SSWAHSand other Area Health Services; NonGovernment Organisations; community groups;local councils and council-run facilities; and localbusinesses.Consumer involvement can range from informalto more formal structured and ongoingcommittee representation, as well asconsultation in an advisory capacity.Consultation provides a mechanism forconsumers to have input into the services thatare provided for them. For the providers, it helpsidentify the extent to which our services aremeeting community needs.Access to personal and/or non-personaldocuments can be obtained by lodging an FOIapplication. This can be achieved by eithercompleting an FOI application form or by awritten request in the form of a letter. Thisshould then be lodged with the FOI Coordinatorof SSWAHS, or with one of the FOI Officers ofthe SSWAHS eastern zone listed in theSummary of Affairs. The processing fee for apersonal FOI application is $30.00 (GST free),or should the applicant be able to showhardship, a 50 per cent reduction is given.For all non-personal applications, there is theinitial $30.00 application fee (GST free).Agencies can, however, charge a processing feeof $30.00 per hour. The processing fee includescosts for searching/locating the information,decision-making, consultation and anyphotocopying.For access to medical records, the applicantshould write or telephone the Medical RecordDepartment of the appropriate SSWAHS facility.A processing fee of $33.00 (including GST) isrequired. However, should the applicant be ableto show hardship, a 50 per cent reduction isgiven. If the applicant requires copies of theirmedical records, a fee of $0.27 (GST included)per page is charged after the first 80 pages.Summary of affairsFREEDOM OF INFORMATION ACT 1989 -Section 14(1)(b) & (3)SYDNEY SOUTH WEST AREA HEALTHSERVICEFOI Agency No. 2322 - former CSAHS; andFOI Agency No. 2293 – former SWSAHSSydney South West Area Health Service Statutory Annual Report 04/05 111

Freedom of InformationThe Summary of Affairs of the Sydney SouthWest Area Health Service (SSWAHS) coversthe following facilities:• Area Mental Health Services includingRozelle Hospital, Rivendell Child,Adolescent and Family Unit and AreaMental Health Community Centres;• Balmain Hospital;• Bankstown–Lidcombe Hospital andCommunity Health Services;• Bowral and District Hospital and CommunityHealth Services;• Concord Repatriation General Hospital;• Department of Forensic Medicine CentralSydney Laboratory Services;• Division of Population Health Eastern andWestern Zones (Community HealthServices, Public Health Unit and HealthPromotion);• Fairfield Hospital and Community HealthServices;• Liverpool Hospital and Community HealthServices;• Macarthur Health Services (includingCamden District Hospital; CampbelltownHospital; Macarthur Community HealthServices; and Queen Victoria MemorialHome);• Royal Prince Alfred Hospital (including theInstitute of Rheumatology andOrthopaedics)• Sydney Dental Hospital;• Sydney South West Area Health ServiceAdministration Office;• Sydney South West Supply Services;• The Canterbury Hospital and CommunityHealth Services; and• Tresillian Family Care Centres.Section 1: policy documentsThe following policies and documents areproduced by SSWAHS, individual hospitals andunits, and may be accessed for information:Eastern zoneArea office• Aboriginal and Torres Strait IslanderEmployment Strategy• Annual Report• Area Newsletter• Clinical Services Directory• Critical Incident Management Plan• Delegations Manual• Equal Employment OpportunityManagement Plan• Facilities and Equipment• Governing Body of Management Manual• Guidelines for Service Planning• HealthPlan (Disaster Plan)• Health Plans:Child and Youth Health Report CardDisability PlanDomestic Violence ProtocolsDrug Health PlanGeneral Geriatric and RehabilitationMedicine (GGRM) Strategic Plan 2002 -2006Health Gain for Children and Youth ofCentral SydneyHep C PlanMental Health Strategic Plans 2000/03Palliative Care PlanRTP Service Delivery PlansStrategic Directions HIV HealthPromotion in CSAHS 1999/01Strategic Plan for Sexual HealthServices 1999/02Tobacco Control PlanWomen's Health Strategic Plan• Human Resources Manual• Human Resources Strategic Plan• Infection Control Manuals• Management Policies and Procedures:Corruption PreventionOrganisation and Administration• Patients’ Rights and Special NeedsRecruitment and Employment of Staffand Other Persons - Vetting andManagement of Allegations andImproper ConductStaffing and Direction• No Smoking• Quality Activities• Staff Development and Training• Staff Handbook• Waste Management PlanHospitals, community services and units• Admission and Discharge Policy• Complaints Policy and Procedures• Disaster Plans• Hospital and Departmental Policy andProcedure Manuals• Hospital Newsletters:Royal Prince Alfred HospitalConcord Repatriation General HospitalSydney Dental HospitalCanterbury Hospital• Management Structures• Occupational Health and SafetyManuals• Patient Information Booklets/Brochures• Quality Management Plans• Staff Handbooks and BrochuresSydney South West Area Health Service Statutory Annual Report 04/05 112

Freedom of InformationWestern zoneArea office• Advanced Resuscitation Training Policy• Annual Report• Annual Research Report• Appointment Procedures for VMOs• Area Administration BuildingsEmergency Procedures Plan (2001)• Area Newsletters• Area Profile• Area Purchasing Plan• Asset Register• Business Plan• Chest Pain Guidelines• Complaints Policy and ManagementGuidelines (1999)• Corporate Plan• Delegations Manual• Domiciliary Midwifery Policy• Engagement of Casual and AgencyStaff Policy• Equal Employment OpportunityManagement Plan and Policy• Freedom of Information Procedures• Governing Body and ManagementPolicies and Procedures:• Organisation and Administration• Staffing and Direction• Patient’s Rights and Special Needs• Policies and Procedures• Staff Development and Training• Facilities and Equipment• Quality Activities• Guidelines for Service Planning• Hazardous Substances Policy andGuidelines for Area Services (March2002)• Health Research Foundation SydneySouth West – Grant Policy andAllocation Manual (May 2001)• Human Resources Manual (2000):• Code of Conduct and Ethics• General Conditions of Employment• Equal Employment Opportunity• Recruitment and Selection• Hours of Work• Performance Management Process• Higher Grade Duties• Industrial Relations• Staff Development• Occupational Health and Safety• Sick Leave• Workforce• Personnel Records• Payroll System• Injury Management andRehabilitation Policy• Injury Plan of Action• Intellectual Property Guidelines andPolicy Statement• Latex Allergy Management• Linen Management Plan• Liverpool Eastern Campus StaffOrientation Policy (2001)• Management of Illicit SubstancesPolicy (August 2000)• Management of ProhibitedWeapons and Firearms Policy(August 2000)• Management Structure (2002)• Manual Handling Policy andGuidelines for Area Services (2002)• Motor Vehicle Fleet Policy(December 2003)• Noise Management Policy andProcedures for Area Services(March 2002)• Occupational Health and SafetyPlanning Design and Purchasing forArea Services (March 2002)• Occupational Health and SafetyPolicy for Area Services (May 2002)• Personal Health InformationManagement Policy and Guidelines• Planning Principles to GuideFunding and Networking DecisionsPolicy• Police Access to Patient InformationPolicy and Procedure• Quality Improvement Policy andGuidelines (June 1998)• Reportable Incident Notification andReporting Policy and Procedures• Safety and Security Policy for AreaServices (March 2002)• Strategic Directions Statement andImplementation Plan 1998-2003• SWSAHS Fraud and CorruptConduct Prevention and ControlPolicy• Waste Reduction and PurchasingPlan• Zero Tolerance Policy (2004)Plans• Aboriginal Health Plan 2001/06• Ambulatory Care (May 2000)• Disability Action Plan 2000/03• Oral Health Service Strategic Plan2001/04Sydney South West Area Health Service Statutory Annual Report 04/05 113

Freedom of InformationHospitals, community services and units• Admission and Discharge Policy• Business Plan• Complaints Policy and Procedures• Dangerous Goods Policy• Disaster Plans (Emergency/FireProcedures)• Fleet Policy (2004)• Guidelines and Procedures forRecruitment and Selection• Hospital and Departmental Policy andProcedure Manuals• Hospital Newsletters• Infection Control Manuals• Management Structures• Occupational Health and Safety Manuals• Orientation Packages• Patient Brochures• Patient Information Books• Performance Management Program• Quality Management Plans• Safety Plans• Security Policy and Procedures• Service Agreements with Area ServiceProviders (eg Human ResourcesDevelopment)• Service Provision Procedures (individualdepartment focus)• Staff Handbooks and Brochures• Staff Treatment Policy and Procedure• Training Plans• Waste Management PlansSection 2: Statement of affairsThe current SSWAHS Statement of Affairs isincorporated into the 2004/05 Annual Report.The Annual Report provides information on theobjectives, functions and structure of the AreaHealth Service. All enquiries can be made bycontacting the appropriate FOI Officer listed inSection 3 of this document. A processing chargeof $0.27 (including GST) per page will becharged for photocopies of documents.Section 3: contact arrangementsEnquiries in relation to the inspection orpurchase of the SSWAHS policy documents,Annual Reports or the Summary of Affairs canbe made with any of the officers listed belowbetween the hours of 8.30 am and 5.00 pm orthrough the SSWAHS Area Office on 98285700.Western zone (main area office)Mrs Silvana FlintArea Freedom of Information CoordinatorSydney South West Area Health ServiceLocked Bag 7017LIVERPOOL NSW 1871Telephone: 9828 6063Eastern zone area officeMrs Gayle BergArea Freedom of Information CoordinatorLevel 11KGV BuildingMissenden RoadCAMPERDOWN NSW 2050Telephone: 9515 9632Balmain HospitalMs Melanie AldertonMedical Records ManagerBalmain HospitalBooth StreetBALMAIN NSW 2041Telephone: 9395 2111Canterbury HospitalMs Eva FaresHealth Information ManagerThe Canterbury HospitalCanterbury RoadCAMPSIE NSW 2194Telephone: 9787 0262Concord Repatriation General HospitalMs Lise RavnA/Manager, Medical RecordsConcord Repatriation General HospitalHospital RoadCONCORD NSW 2139Telephone: 9767 5452Division of Population HealthMs Samantha AdelHealth Information ManagerQueen Mary BuildingLevel 4 Grose StreetCAMPERDOWN NSW 2050Telephone: 9515 9552Department of Forensic MedicineMs Alicia DongA/Manager of Administrative ServicesDepartment of Forensic Medicine50 Parramatta RoadGLEBE NSW 2037Telephone: 8584 7800Sydney South West Area Health Service Statutory Annual Report 04/05 114

Freedom of InformationRoyal Prince Alfred Hospital/Institute ofRheumatology and OrthopaedicsMs Charlotte RobertsManager, Medical RecordsRoyal Prince Alfred HospitalMissenden RoadCAMPERDOWN NSW 2050Telephone: 9515 8397Rozelle HospitalMr Sam LeungMedico-Legal OfficerRozelle HospitalPO Box 1ROZELLE NSW 2039Telephone: 9556 9100TresillianMrs Jane KookarkinHealth Information ManagerTresillian Family Care CentresMcKenzie StreetBELMORE NSW 2192Telephone: 9787 0875Sydney Dental HospitalMr Graeme AngusA/General ManagerUnited Dental Hospital2 Chalmer StreetSURRY HILLS NSW 2010Telephone: 9293 3326The Summary of Affairs is updated andforwarded to the Government Printing Office forinclusion in the Government Gazette every sixmonths. FOI officers listed in the Summary ofAffairs are available for inquiries regarding FOIapplications, access to medical records and/oramendment of records.Freedom of information statisticsThe tables hereunder represent the Freedom ofInformation applications received in relation to:1) CSAHS from 1 July 2004 to 31December 2004;2) SWSAHS from 1 July 2004 to 31December 2004; and3) SSWAHS from 1 January 2005 to30 June 2005CSAHS (1 July to 31 December 2004)35 FOI applications were received andprocessed by Royal Prince Alfred Hospital,Concord Repatriation General Hospital,Canterbury Hospital, Rozelle Hospital and theCSAHS Area Office. The Area Office dealt withtwo internal reviews, an appeal to theAdministrative Decisions Tribunal (ADT) and anappeal to the Ombudsman.Of the 35 applications, 26 were granted fullaccess to documents, three were grantedpartial access while five applicants wererefused access. Access was refused for suchreasons as a deposit was not paid, nodocuments were held pertaining to theapplication, and the AHS considered onerequest a diversion of its resources as theapplicant had already been supplied with alldocuments held by the organisation inprevious applications.In relation to the internal reviews, one of thedeterminations made in the original decisionwas upheld, while the second review requireda variation to the original determination, withdocuments being partially released.An appeal by an applicant to the Ombudsman inrelation to a number of exempt/partially exemptdocuments under Schedule 1 Clause 4 of theFOI Act was lodged in the previous reportingperiod. The final outcome of this appeal was thatthe area health service agreed to release anumber of exempt documents to the applicant’slegal representative with certain provisions. Inaddition, in conducting an internal review for thesame applicant, further documents wereidentified which pertained to the original FOIapplication submitted in 2003, and of the further52 documents identified as being within thescope of the original application, 22 documentswere considered exempt under Schedule 1Clause 4 of the FOI Act. The AHS again agreedto release these documents to the applicant’slegal representatives.The applicant who lodged an appeal with theAdministrative Decisions Tribunal, which wasanother matter carried over from the previousreporting period, had their application dismissedon a legal technicality.The estimated cost for processing the FOIrequests is $960 while fees totalling $1233 werereceived by the AHS. Non-personal applicationsprocessed in the Area Office were chargedprocessing fees in the amount of $480.00.There were no Ministerial Certificates issued, orformal consultations conducted during thereporting period.Sydney South West Area Health Service Statutory Annual Report 04/05 115

Freedom of InformationPrivacy and personal informationDuring the reporting period, there were no internal reviews conducted under the Privacy and PersonalInformation Protection Act 1998 and the Health Records and Information Privacy Act.CSAHS report up to 31 December 2004FOI RequestsPersonal2003/04 to Dec 04Other2003/04 to Dec 04Total2003/04 to Dec 04New (including transferred in)Brought Forward from previous year108 25113 9 121 34Total to be processed 108 26 13 9 121 35CompletedTransferred outWithdrawn103225113 9 1162341Total Processed 107 26 13 9 120 35Unfinished (carried forward) 1 1Number of amendments and/or notations 4 4Results of FOI RequestsPersonalOther2003/04 to Dec 04 2003/04 to Dec 04Granted in fullGranted in partRefusedDeferredCompleted 103 25 13 9Basis of Disallowing or Restricting AccessPersonalOther2003/04 to Dec 04 2003/04 to Dec 04Section 19 (application incomplete, wrongly directed)Section 22 (deposit not paid)Section 25 (1)(a1) (diversion of resources)Section 25 (1)(a) (exempt)Section 25 (1)(b), (b1), (c), (d) (otherwise available)Section 28 (1)(b) (documents not held)Section 24 (2) (deemed refused, over 21 days)Section 31 (4) (released to medical practitioner)Totals 11 4 5 3Days to ProcessPersonalOther2003/04 to Dec 04 2003/04 to Dec 040 - 2122 – 35 (consultation period/out of time determinations)Over 35 (extended consultation/out of time determinations)81111121311030513Totals 103 25 13 9Hours to ProcessPersonalOther2003/04 to Dec 04 2003/04 to Dec040 – 1011 – 2021 – 40Over 40832181212411011120141122032921121116211212 421 3Totals 103 25 13 9Type of Discount Allowed on Fees ChargedPersonalOther2003/04 to Dec 04 2003/04 to Dec 04Public InterestFinancial Hardship - Pensioner/Child16 6 0 3Financial Hardship - Non Profit OrganisationTotals 16 6 0 3Significant correction of personal records 0 0Sydney South West Area Health Service Statutory Annual Report 04/05 116

Freedom of InformationSSWAHS Report up to 31 December 2004FOI RequestsPersonal2003/04 to Dec 04Other2003/04 to Dec 04Total2003/04 to Dec 04New (including transferred in)brought forward from previous year25034020061450401Total to be processed 25 34 20 7 45 41CompletedTransferred outWithdrawnTotal Processed 25 29 19 1 44 30Unfinished (carried forward) 0 5 1 6 1 11Results of FOI RequestsGranted in fullGranted in partRefusedDeferred241028011900100Personal2003/04 to Dec 04914102260044102901Other2003/04 to Dec 04Completed 24 28 1 13Basis of Disallowing or Restricting AccessSection 19 (application incomplete, wrongly directed)Section 22 (deposit not paid)Section 25 (1)(a1) (diversion of resources)Section 25 (1)(a) (exempt)Section 25 (1)(b), (b1), (c), (d) (otherwise available)Section 28 (1)(b) (documents not held)Section 24 (2) (deemed refused, over 21 days)Section 31 (4) (released to medical practitioner)Personal2003/04 to Dec 040001400030006000000106070Other2003/04 to Dec 04Totals 17 6 13 1Days to ProcessPersonalOther2003/04 to Dec 04 2003/04 to Dec 040 - 2122 – 35 (consultation period/out of time determinations)Over 35 (extended consultation/out of time determinations)Totals 25 28 19 1Hours to Process0 – 1011 – 2021 – 40Over 4014742071Personal2003/04 to Dec 040405040096401000000001Other2003/04 to Dec 04Totals 25 28 19 12140027100132311000Type of Discount Allowed on Fees ChargedPersonal2003/04 to Dec 04Other2003/04 to Dec 04Public InterestFinancial Hardship - Pensioner/ChildFinancial Hardship - Non Profit OrganisationTotals 9 11 0 0Significant correction of personal records 0 0 0 00900110000000Sydney South West Area Health Service Statutory Annual Report 04/05 117

Freedom of InformationUp to 31 December 2004, the SWSAHSreceived 34 new requests for information underthe Freedom of Information Act 1989. Overall,there was an increase compared to the sameperiod last financial year and this was due topersonal records containing information that isexempt or relates to a third party and therebybeing released under FOI. Both the media andmembers of parliament are also utilising FOImore widely to obtain information held by theArea Health Service.One application was carried over from the2003/04 reporting period. Of the 41 requestsreceived, 27 were granted in full, 10 granted inpart, three refused and one withdrawn. 35 of theapplications received were requests for personalor relative’s medical records with six requestsbeing of a non-personal nature.Four applications required consultation withparties outside of the Area Health Service.Up to 31 December 2004, one case wasreferred by the applicant to the AdministrativeDecision Tribunal, with the decision being variedand the documents released to the applicant.There have been no requests for internalreviews, amendments to personal records,notations to personal records or MinisterialCertificates issued and there were noOmbudsman appeals.It took 151 hours to process the FOI requestscosting an estimated $4,530.00 with feesreceived totalling $1,660.00.Privacy and personal informationDuring the year, there were no internal reviewsconducted under the Privacy and PersonalInformation Protection Act 1998 and the HealthRecords and Information Privacy Act.Sydney South West Area Health Service Statutory Annual Report 04/05 118

Freedom of InformationSSWAHS Report from January 2005FOI RequestsPersonalFrom Jan 2005OtherFrom Jan 2005TotalFrom Jan 2005New (including transferred in)brought forward from previous yearTotal to be processed 43 18 61CompletedTransferred outWithdrawn385430012650111760000 0Total Processed 43 17 60Unfinished (carried forward) 0 1 1Results of FOI RequestsGranted in fullGranted in partRefusedDeferredPersonalFrom Jan 200539400OtherFrom Jan 2005Completed 43 17Basis of Disallowing or Restricting AccessSection 19 (application incomplete, wrongly directed)Section 22 (deposit not paid)Section 25 (1)(a1) (diversion of resources)Section 25 (1)(a) (exempt)Section 25 (1)(b), (b1), (c), (d) (otherwise available)Section 28 (1)(b) (documents not held)Section 24 (2) (deemed refused, over 21 days)Section 31 (4) (released to medical practitioner)PersonalFrom Jan 200510340OtherFrom Jan 2005000100430003000 0Totals 4 7Days to ProcessPersonalFrom Jan 2005OtherFrom Jan 20050 - 2122 – 35 (consultation period/out of time determinations)Over 35 (extended consultation/out of time determinations)Totals 43 17Hours to Process0 – 1011 – 2021 – 40Over 40PersonalFrom Jan 200538326110OtherFrom Jan 2005Totals 43 17Type of Discount Allowed on Fees ChargedPublic InterestFinancial Hardship - Pensioner/ChildFinancial Hardship - Non Profit OrganisationPersonalFrom Jan 20054210013121OtherFrom Jan 2005Totals 10 0Significant correction of personal records 0 00100000Sydney South West Area Health Service Statutory Annual Report 04/05 119

Freedom of InformationFrom 1 January to 30 June 2005, SSWAHSreceived 61 FOI applications which wereprocessed by the following facilities: HeadOffice of SSWAHS, Royal Prince AlfredHospital, Concord Repatriation GeneralHospital, Canterbury Hospital, BalmainHospital and the SSWAHS, eastern zoneoffice.Of the 61 FOI applications, 49 were releasedin full, seven were partially released while fourapplications were refused for reasons such asa deposit not being received and documentspertaining to the request not being held by theorganisation. One application was carried overto the next reporting period. There were noappeals requiring internal review.The estimated cost for processing the FOIrequests is $3,930.00, while fees totalling$3,622.00 were received by the AHS. A nonpersonalapplication processed in the AreaOffice, SSWAHS eastern zone was charged aprocessing fee of $500.00. Six non-personalapplications received at Head Office werecharged processing fees in the amount of$2,115.00.There were no Ministerial Certificates issued, orformal consultations conducted during thereporting period.Privacy and personal informationDuring the year, one internal review wasconducted under the Privacy and PersonalInformation Protection Act 1998 and theHealth Records and Information PrivacyAct.Sydney South West Area Health Service Statutory Annual Report 04/05 120

FinancialInformationSydney South West Area Health Service Statutory Annual Report 04/05 121

Financial OverviewThe audited financial statements presented for the Sydney South West Area Health Service recognisethe amalgamation of the former Central Sydney Area Health Service and the former Sydney South WestArea Health Service which had effect from 1 January 2005. For the period 1 January 2005 to 30 June2005, expenditure in accrual terms was $1.007 billion and the revenue was $205 million. The net cost ofservice for the six months ending 30 June 2005 was $793 million after taking into account the gain ondisposal of non current assets.At 30 June 2005, total equity was $1.398 billion. Major capital work expenditure for the six months was$60.2 million.In achieving the above result SSWAHS is satisfied that it has operated within the level of governmentcash payments and restricted operating costs to the budget available. At 30 June, the value of generalcreditors in excess of levels agreed with the NSW Department of Health was around $1.9 million. TheArea has effected all loan repayments within the time frames agreed.Although the audited financial statements are presented for a six month period only, consistent with theestablishment date of the Area Health Service, information is available for the twelve months ended 30June 2005, compared with 2003/04 (combined information for the former Central Sydney Area HealthServices and South Western Sydney Area Health Service). This information is detailed below:2004/05Actuals$0002004/05Budget$0002003/04Actuals$000Employee Related Expenses 1,211,396 1,213,424 1,131,372Visiting Medical Officers 67,624 64,989 62,572Goods and Services 521,403 509,124 539,080Maintenance 50,537 56,251 66,723Depreciation and Amortisation 78,607 78,161 69,056Grants and Subsidies 23,209 32,031 15,190Borrowing Costs 5,372 3,018 0Payments to Affiliated Health Organisations 23,737 22,996 23,013Other Expenses 0 0 0Total Expenses 1,981,885 1,979,994 1,907,006Sale of Goods and Services (323,209) (330,374) (349,750)Investment Income (11,437) (9,393) (10,018)Grants and Contributions (39,604) (28,662) (40,299)Other Revenue (31,315) (17,985) (19,832)Total Revenue (405,565) (386,414) (419,899)Gain/Loss on Disposal of Non Current Assets (9,852) (10,631) (86)Net Cost of Services1,566,468 1,582,949 1,487,021The favourability in the revenue result was mainly contributed from Special Purposes and Trust Fundwhich were not available for general expenditure.The Area Health Service reporting of programs is consistent with the ten programs of health care deliveryutilised across NSW Health and satisfies the methodology for apportionment advised by the NSWDepartment of Health.As a result of the establishment of the new Area Health Services on 1 January 2005, it has becomenecessary for each Area Health Service to prepare its financial statements utilising the AustralianEquivalents to International Financial Reporting Standards (AEIFRS). Each Area Health Service istherefore twelve months in advance of the majority of Government agencies.Sydney South West Area Health Service Statutory Annual Report 04/05 122

Financial OverviewIn addition to the need to adopt AEIFRS, the Area Health Service has needed to respond to several othersignificant challenges:• the amalgamation of accounting and financial systems;• the restructuring of corporate and business support services designed to generate funds to sourcefurther frontline servicesThe Sydney South West Area Health Service received its 2005/06 allocation on 22 July 2005 .Theallocation is earmarked by the provision of additional funding to address:• the provision of increased bed capacity to improve access block performance and providesustainable management of elective surgery – it is expected that the funding provided will facilitatethe establishment and opening of additional beds;• the provision of more elective surgery to tackle existing waiting lists;• the need to increase the number of intensive care beds and cots for adults, children and infants withadditional beds expected to open and operate in 2005/06;• mental health service improvements;• the continued enhancement of the delivery of cancer research and direct patient services.The Sydney South West Area Health Service will work with the NSW Department of Health in a majorreform program that will focus on ensuring that each patient has the best possible journey through thehealth system. This will ensure that patient care is better coordinated, leading to improved patientoutcomes and more efficient use of resources.The Area Health Service amalgamation, as announced by the Minister for Health on 27 July 2004, servesto better align population growth centres with existing centres of excellence and specialist medicalexpertise and also link areas of traditional clinical resource strength to areas of traditional shortage. Inaddition, the new Areas will integrate a range of administrative and clinical systems, removing duplicationand overlap, with the savings being progressively invested in clinical services.NSW Health has initiated a reform program to consolidate and share corporate and business supportservices across the NSW public health system. These reforms are aimed at redirecting resources tofrontline health care, while also improving the cost effectiveness, consistency and accessibility of supportservices across NSW.Sydney South West Area Health Service Statutory Annual Report 04/05 123

IndexActivity levels…………………………………… 30Allied health and clinical support services……56Area health advisory council………………….100Area healthcare service planning……………..40Asset management……………………………..10Balmain Hospital………………………………...41Bankstown Hospital……………………………..42Bowral Hospital………………………………….43Capital works program………………………….11Camden Hospital………………………………..44Campbelltown Hospital…………………………44Canterbury Hospital…………………………….45Chief executive year in review………………….5Clinical governance…………………………….28Concord Hospital……………………………….46Contents…………………………………………..1Community participation……………………...101Corporate governance…………………………16Corporate services……………………………..68Department of Forensic Medicine…………….47Division of Population Health (eastern zone).48Division of Population Health (western zone).59Donations and bequests……………………..103Ethnic affairs priority program……………….104Equal employment opportunity……………….77Executive reports ……………………………..74Facilities………………………………………..41Fairfield Hospital………………………………49Financial overview……………………………122Financial services…………………………….69Freedom of information……………………...111Fundraising and sponsorship……………….102Health service profile…………………………12Highlights…………………………………….…7Independent audit report……………………124Information management services………….70Internal audit…………………………………..72Karitane Mothercraft Society………………..50Liverpool Hospital…………………………….51Local health participation groups…………..101Locations……………………………………2, 35Mental health services……………………….60Non-government organizations…………….105Nursing and midwifery services……………..61Occupational health and safety……………..82Official overseas travel…… .………………..92Organisation chart……………………………14Patient feedback……………………………..101Performance indicators………………………18Population and drug health services……….58Public affairs and marketing…………………71Purpose and goals…………………………...15Quality clinical indicators…………………….62Research………………………………………87Resource transition program………………..10Royal Prince Alfred (RPA) Hospital………...52Rozelle Hospital………………………………53Staff profile……………………………………76Sydney Dental Hospital……………………..54Teaching and training initiatives……………86Tresillian Family Care Centres……………..55Volunteers…………………………………...109Workforce profile…………………………….73_____________________________________________________________________________________________Sydney South West Area Health Service Statutory Annual Report 04/05

Total number of copies printed 1,000Cost of design $1,850Cost of printing $7,125Total cost $8,975 excluding GSTThe SSWAHS 2005/05 Annual Report is available on our website www.sswhealth.nsw.gov.au or byphoning (02) 9828 5700 or (02) 9515 9600.We welcome your feedback. You can contact us by email at arearecords@swsahs.nsw.gov.au, throughour website at www.sswhealth.nsw.gov.au or by phoning us on (02) 9828 5700 or 9515 9600.A publication of SSWAHS, produced by Public Affairs and Marketing._____________________________________________________________________________________________Sydney South West Area Health Service Statutory Annual Report 04/05

Cover: Staff at Liverpool Hospital.Left to right: Marika Diamantes,Lance Holland-Keen, Marion El-Masryand Samina Munshi.