BETTER HEALTH FOR OUR COMMUNITIES
Sunshine Coast Health Network Limited t/a Sunshine Coast Medicare Local
2014-2015 Highlights 3 Report from the Board Chair 4 Report from the CEO 5 Board of Directors 6 Board Subcommittees and Working Groups 9 Board Meetings and Attendance 10
Commissioning Preventative Health - Women’s Health and Sexual Health Mental Health Services Access to Allied Psychologocal Services and Rural Mental Health Service Mental Health Clinical Council
11 12 13 13 13
Health Outcomes Team Enhancing Quality Care: Falls and Fracture Prevention Immunisation Reducing Conscientious Objection Establishment of the Immunisation Advocacy and Working Group Vaccination Outreach Program Immunisation Practice Support Education GP Liaison Officer Team GP Council Establishment GP Network Establishment Aged Care and Palliative Care After Hours After Hours Assist Payment gpExtend Maleny Gympie Nurse Practitioner Clinic Cooroy Catchment After Hours Service eHealth
14 14 15 15 15 16 16 18 19 19 19 20 20 20 20 21 21 21
Community and Stakeholder Engagement The Gympie Project Gympie Collaborative Network Inspiring Health Leaders Dinner Health Consumers Queensland ‘The Health System Explained’ The Primary Health Care Steering Committee Gympie Multipurpose Outreach Clinic Other Health Promotion Activities Yah‘Ning Place - Gympie Office
22 22 22 22 23 24 24 24 24
Aboriginal and Torres Strait Islander Health 25 Closing the Gap 25 Care Coordination and Supplementary Services 26 Partners in Recovery 27 Media and Communications 29 Membership 29 Sunshine Coast Medicare Local acknowledges the Traditional Custodians of the land on which we work and live, and recognises their continuing connection to land, waters and community. We pay our respect to them and their cultures; and to Elders past and present and to emerging community leaders.
HIGHLIGHTS Development of local Clinical Care Pathways for GPs
Delivered Cultural Awareness training to 150+ participants
Launch of a region-wide immunisation billboard campaign
Gympie Multipurpose Outreach Clinic for people at risk of poor health outcomes
Development of eReferral template for GPs to enable better integration between tertiary and primary care
Engagement with over 200 Aboriginal and Torres Strait Islander students at USC
Funding to provide transport to medical appointments for Goomeri and Kilkivan residents
Establishment of a GP Council
Implemented a Closing the Gap Acknowledgement poster for general practice
Immunisation outreach service for targeted communities
Inspiring Health Leadersâ€™ Dinners
Establishment of the Mental Health Clinical Council
Formation of the Gympie Collaborative Network, focusing on mental health, youth and aged services
Establishment of a new website
Establishment of Yahâ€˜Ning Place in Gympie
REPORT FROM THE
rass roots primary care revolves around general practice.
Sunshine Coast Health Network Ltd (SCHN) has worked diligently to improve the connectedness of the primary social care network and building capability in general practices. We currently have strong relationships with more than half of the general practices in the Sunshine Coast and Gympie region, resulting in practices becoming better informed about their own community of patients to more accurately assess areas of need and thus assisting in prioritising patient care. The challenge ahead is substantial. With our work leading into the Governmentâ€™s newly-formed Primary Health Networks (PHN), our area of responsibility will triple, the population double and the health needs more than proportionately increase. However the values of respect, truth and determination continue to be embedded in all activities. I'm still amazed by the energy and effort displayed by the team. This was an organisation that was threatened with closure, yet the staff continued to work tirelessly to achieve their goals. The team were determined to submit an excellent bid for the PHN whilst continuing to progress the services provided to our Sunshine Coast and Gympie communities. The successful outcome of the tender process is a testament to the dedication and commitment of our staff and leadership. The Board composition went through a change at the close of the 2014-15 year to adapt to meet the change in geography, demographics and regional challenges. To this end we have taken steps to expand the Board, finding the expertise needed for this expanded responsibility. The Board plans to hold Board meetings throughout the region, taking the opportunity to meet local stakeholders and community leaders. The corporate membership structure will also need to change. We will be looking to move to an effective membership model that is an enabler of deeper community ties across our new region as we transition to a commissioning organisation. I am truly humbled to be the Chair of such a wonderful organisation. I would like to thank Pattie Hudson, our CEO, and her team. Their ability to rise to the challenge of an uncertain future and keep delivering to such a high standard was just wonderful to witness. To my fellow Board members, thank you for your confidence and wisdom. It is wonderful to be part of the success that has been achieved and I look forward to what will be an exciting future ahead.
Board Chair Peter Dobson
REPORT FROM THE
It is with great pleasure that I present you with the final annual report for Sunshine Coast Health Network Ltd while trading as Sunshine Coast Medicare Local. In the 2014 Federal Budget, the government made a decision to defund the national network of 61 Medicare Locals at the end of June 2015 and replace them with 31 Primary Health Networks. Despite this announcement, the team remained focused on our mission to improve the health and wellbeing of our communities. We continued to work in collaboration with stakeholders to fulfil the commitments in our Deed of Funding. Most of all, we reassured our community that we would carry out our responsibilities across the region to the contract end. Health is everyoneâ€™s business and we all have an important role to play. Through our partnerships, over the past year we have improved integration of primary and tertiary care with a focus on system change to improve the patient journey; expanded equity and access to primary healthcare; continued to support general practice and allied health, particularly with education and training, and in the prevention and management of chronic disease; we explored technological opportunities and innovation; and ensured monitoring and evaluation was outcome-focused. However, alongside this work, another substantial task was being undertaken with the tender submission for the new Primary Health Network. Due to delayed and limited information about the boundaries of the new PHNs, staff, service providers, and our communities experienced an enormous amount of uncertainty and distress. This demonstrates the impact that our three year political cycles have on the delivery of quality primary health care to our communities.
On 28 October, the boundaries were announced, creating a new region that would stretch from the Glasshouse Mountains on the Sunshine Coast to north of Rockhampton; taking the current footprint from 6,000km2 to 161,000km2 and increasing our population from 372,000 to 759,000. With an enormous effort from our team and the support of our consortium partner Abt JTA and alliance partners Westfund Health and Philips Health Care, we submitted our tender to the Department of Health. On 11 April 2015, we were ecstatic and proud to receive the call that our bid for Central Queensland, Wide Bay, Sunshine Coast PHN was successful. For our Board and staff this meant we could continue to build on the momentum, successes and achievements of the last three years. As the Medicare Local chapter closes, and a new chapter as a PHN opens, we are in a very fortunate position of being able to build on the strengths and learnings of these experiences, along with a new and skilled leadership team, commitment from Hospital and Health Services, universities, public and private health service providers, all levels of government and most of all, the community. It is a great honour and privilege to lead this amazing organisation, I would like to acknowledge our team, the Board, Partners and our community for doing their part in building healthier communities. I look forward to sharing our progress and successes with you next year.
Dr Peter Dobson (Chair) MBBS
Peter is a GP and general practice owner with over 20 years’ experience. He has over 10 years’ experience in key executive roles within the Sunshine Coast Division of General Practice, the Sunshine Coast Gympie Partnership Council and the District Division Alliance. Peter is highly involved and networked within the SCHN stakeholder groups and has enjoyed a long involvement with and made contributions to State and National initiatives. As an experienced Chair, Peter has strong governance skills with his areas of key competency and experience including stakeholder engagement, conflict resolution, performance evaluations and member engagement.
Ms Rebecca Bell
B Occ Thy, Exec MBA, GAICD, AFAIM, Grad. Cert. App. Fin. Rebecca is presently General Manager of Member Health with Medibank Private. Rebecca has worked in a range of health settings in both clinical and corporate functions. Originally an Occupational Therapist, Rebecca understands the coalface of health service delivery and the importance of local nuances across geographies and demographics, critical success factors for the SCHN. Rebecca has completed an Executive MBA, is a Graduate of the Australian Institute of Company Directors, an Associate Fellow with the Australian Institute of Management and Adjunct Associate Professor at University of NSW (School of Public Health and Community Medicine).
Mr David Conroy ADipBus, QAY, FAIM
David is Managing Director of Damarcon and holds several non-executive roles including Chair of the Brisbane Powerhouse Arts, The Queensland Museum Network, Charlton Brown Pty Ltd, The Australian Institute of Health and Welfare and TCI Pty Ltd. Among several awards and commendations, David has been recognised with the honour of Queensland’s Australian of the Year 2007 and EY Social Entrepreneur of the Year for his work in founding the national disability organisation Youngcare. David is a Fellow of the Australian Institute of Management and graduate member of the AICD.
Mr Grant Dearlove
LLB, LLM, MBA, FAIM, ACIS
Grant is a company director and
lawyer. He holds a Bachelor of Laws, Master of Laws, Master of Business Administration, Graduate Diploma in Applied Corporate Governance and has studied leadership of professional service organisations at Harvard. Grant has held executive roles and directorships in several state and national organisations spanning law, property, risk, franchising, finance, tourism, economic development and training.
Dr Fiona McGrath
MBBS, Dip RANZCOG
Fiona worked as a GP on the Sunshine Coast from 1997 until 2015. She is a passionate advocate for primary health care and has been closely involved in improving healthcare delivery through her involvement at local and state governance levels. Fiona held the position of Chair of the Sunshine Coast Division of General Practice from 1998 to 2008 and sits on the Board of CheckUP. She has had extensive governance training through a number of programs including the AICD.
Dr Peter McGregor
BHA, MBA, PG Dip Health. & Med. Law, FAICD, FCHSM, CAHRI Peterâ€™s career has been devoted to health administration, mostly as a regional CEO in the public health system in Victoria. His current role is in executive health recruitment. Peter holds an MBA, a Bachelor of Health Administration and a Post Graduate Diploma in Health Law. He is a Fellow of both the Australian Institute of Company Directors and the Australasian College of Health Service Executives. As a former health executive Peter understands the important role primary care plays in keeping people well and out of hospital.
Mr John Woodward
BPharm (Hons), GAICD, AACPA
John is a pharmacist who has practiced in the Sunshine Coast and Gympie area since 2004. He provides pharmacy consultancy services within a number of general practices in the region and also works in community pharmacy. He has previous experience in hospital pharmacy. John is also a Director on the Board of a local not-for-profit provider of residential aged care, in-home care and rehabilitation services on the Sunshine Coast.
Ms Amanda Boland (Company Secretary)
BBus, GDACG, FGIA, FCIS, MAICD Amanda is an independent governance professional with clients throughout Queensland. She is company secretary for a number of companies and charities in healthcare, creative industries, and communications. She is also a non-executive director serving on a number of boards, and President of the Sporting Wheelies and Disabled Association. Amanda has significant senior executive experience, and demonstrates leadership, engagement and mentoring to ensure teams and individuals can deliver strong results in line with business strategy.
Ms Pauline Gargan (Board Secretariat)
Pauline is Principal and owner of an organisational development consultancy, People and Teams Pty Ltd. Based on the Sunshine Coast, Pauline, through her consultancy, supports organisations and businesses to maximise effectiveness and results through their people and teams. Prior to commencing People and Teams Pty Ltd in 2002, Pauline worked in a variety of senior roles in the corporate sector in Australia, in operational, general and state management. Pauline specialises in the areas of Talent Management, Team Dynamics, Leadership and Organisational Coaching. Pauline has qualifications in Business (Banking & Finance), Workplace Training and Assessment, Neuro Linguistic Programming (Master Practitioner), Executive Coaching (IECL- Level One), Certificate in Governance Practices (CGIA) and is a Fellow of Australian Institute of Learning Professionals (FAILP).
BOARD SUBCOMMITTEES AND
FINANCE, AUDIT & RISK SUBCOMMITTEE • • • • • •
Grant Dearlove (Chair) Peter Dobson John Woodward Pattie Hudson Terry Plant Secretariat: Pauline Gargan
The Finance, Audit and Risk Subcommittee was charged with assisting SCHN Board to discharge its duties in relation to the internal controls, risk management, reported financial information and corporate standards of behaviour. The Finance, Audit and Risk Subcommittee had a critical role in the maintenance of best practice standards.
MEMBERSHIP & COMMUNICATIONS SUBCOMMITTEE • • • • •
David Conry (Chair) Peter Dobson Jessica Barr Jo Pennell Secretariat: Pauline Gargan
The purpose of the Membership and Communications Subcommittee was to develop and support a broad-based organisational Membership for SCHN and to provide a governance framework to support organisational activity around media, publicity and communications.
INFORMATION MANAGEMENT & PLANNING SUBCOMMITTEE • Rebecca Bell (Chair) • Fiona McGrath • Peter McGregor • Secretariat: Pauline Gargan
SCHN was committed to ensuring the programs and activities undertaken (both solely and in partnership) and commissioned by the organisation were developed and executed with both a continuous quality improvement framework and a consumer safety focus. SCHN recognised that quality and safety in healthcare had three essential characteristics: • A consumer-centred focus • Driven by information • Organised for safety The committee supported the adoption of and accreditation to the National Safety and Quality in Health Care Standards.
NOMINATIONS WORKING GROUP • Fiona McGrath (Chair) • Additional delegates as appropriate • Secretariat: Pauline Gargan
The Nominations Working Group was to make recommendations to SCHN Board to optimise the composition of the SCHN Board. The Working Group was accountable to the SCHN Board and comprised part of a formal, rigorous and transparent procedure for the appointment of the SCHN Board. The Working Group's guiding principle was to choose the best candidate to fill SCHN Board vacancies and, in so doing; it endeavoured to seek a balance between the personal and professional qualifications of a candidate and the other matters, including age, gender and geographical balance of the SCHN Board.
CLINICAL QUALITY ASSURANCE WORKING GROUP • • • • • •
Fiona McGrath (Chair) John Woodward Jonathan Harper Donna Waterford Additional delegates as appropriate Secretariat: Pauline Gargan
This Working Group was established to provide direction in the coordination of improved clinical care delivery whilst monitoring quality improvement standards to enhance consumer participation, with an assurance that services provided directly or contracted, were subject to quality standards within a Clinical Governance Framework implemented by the Service Supplier.
REMUNERATION WORKING GROUP • Peter McGregor (Chair) • Additional delegates as appropriate • Secretariat: Pauline Gargan
The Board Remuneration Workgroup assisted and advised the Board of Directors to fulfil its responsibilities to members of the SCHN on matters relating to the compensation, bonuses, incentives and remuneration issues of the Directors, seconded Membership Committee members, and CEO. I9
BOARD MEETINGS AND
Nine of which were ordinary board meetings and seven of which were flying minutes.
COMMISSIONING SCHN, with assistance of the Commissioning Team, evaluated the services within the region and determined the need to continue much-needed programs into the 2014-15 year. SCHN partnered with existing stakeholders and service providers in identifying and evaluating the need to uphold a balance of services for the region. SCHN further committed its obligation to the Department by ensuring Federal programs were executed in accordance with the plan for the year. These programs included: • Access to Allied Psychological Services (ATAPS) and Rural Mental Health Service (RMHS) contracted to Artius Health • Women’s Health – Preventative Health program provided by the Gympie and District Women’s Health Centre • Care Coordination and Supplementary Services brokerage model in partnership with North Coast Aboriginal Corporation for Community Health (NCACCH) • gpExtend After Hours weekend General Practice service for Maleny • Partners in Recovery and its partner organisations • PIR System Gap Initiative ‘Daliya House’ project • Gympie Nurse Practitioner Clinic program to alleviate the strain on the Emergency Department of the Gympie Hospital and Health Service • Health Intervention Project for Seniors (HIPS) in conjunction with Sundale • Lungs in Action (Gympie & Kawana) • Lung Max program in conjunction with the Lung Foundation • Smoking Cessation program run out of the Goldfields Fullife pharmacy in Gympie The Commissioning team contracted new service providers to meet needs in the region, through various collaborative efforts within community, stakeholders and other team members. Many projects were either supported or were newly formed, developed and executed to meet identified service needs, including: • The Cooroy Catchment After Hours Service commissioned to National Home Doctor Service (via a limited tender process) • Carer’s Queensland Carer’s Week was supported by SCHN • Carer’s Queensland Mental Health Foundation for Carers Workshop
• PIR ‘Bright Ideas’ Grants: o Peer workforce development project through Community Focus Association o Strengthening Communities Education Project through Cooloola Human Services Network (CHSN) o Wellness Recovery Action Planning (WRAP) training for facilitators through St Vincent de Paul Society o Suncare Gympie Referral Pathway Project • Supporting housing crisis for Gympie Youth in conjunction with Family Planning Queensland • GP Network Coordinators engaged for peer support bringing together GPs to identify educational and other needs • Graham House Transport providing a service to Kilkivan residents to surrounding areas and Brisbane for medical, social and community transportation requirements • Community Action Youth Service providing support for youth in Gympie • Home Doctor to You to improve the after hours GP care for the Gympie community • Immunisation Outreach Project • Kilkivan Medical Centre administrative support • Mungalla Forum quarterly events • Purser’s Coaches Goomeri transport service Other relationships were formalised to continue partnerships with multiple organisations including Cooloola Human Service Network, Sunshine Coast Regional Council, Sunshine Coast Hospital and Health Service, University of the Sunshine Coast, Pen CAT computer systems, RACGP and the Queensland University of Technology (QUT). The end of the 2014-15 year saw a very busy time for the Commissioning Team in the move from the Medicare Local into the new Government initiative of the Primary Health Networks. To ensure continuity of service for all existing services across the extended region, the Commissioning Team was responsible for negotiating and issuing approximately 40 contracts and several MOUs. Due to delays with the announcement and contracting of the PHNs, much of this work was undertaken during the last few weeks of the year. I 11
PREVENTATIVE HEALTH - WOMEN’S HEALTH AND SEXUAL HEALTH GYMPIE AND DISTRICT WOMEN’S HEALTH CENTRE PAP SMEAR CLINICS SCHN provided funding to the Gympie and District Women’s Health Group Inc. (referred to as the Gympie District Women’s Health Centre – GWHC), to improve access to health screening services, particularly to those with limited access to health care services in the Gympie and outer Gympie regions. GWHC was contracted to provide Pap smear clinics to reduce the pressure on GPs in Gympie. Of the 275 women who attended the 45 clinics held during 2014-15, 36% recorded that it had been more than the recommended 2 years since their last screening. This would indicate that the service has been successful in engaging the hard to reach cohort. SEXUAL HEALTH CLINICS Clinics were provided through the GWHC as an outreach service via a partnership with Clinic 87, part of the Sunshine Coast Hospital and Health Service. Clinic 87 staff travelled from Nambour to provide appointments at the GWHC for men and women. During this period, 39 clinics were hosted; 172 appointments booked; 142 appointments attended (83%). WORKSHOPS The GWHC also provided opportunities for improved health for women through two workshops: • Mindfulness Based Stress Reduction Therapy, and • Art as Therapy. Information for the Mindfulness Based Stress Reduction Therapy was conveyed within the format of focused psychological strategies and included principals of the following: • Cognitive behaviour therapy (CBT) • Behavioural therapy • Psychoeducation • Structured relaxation and breathing • Skills training and demonstration of social skills and emotion regulation Comments indicated the participants benefitted specifically from being involved in the group, having a variety of mindfulness techniques to draw from, improved insight and personal growth with being able to be fully present, have more control, increased compassion, be more focused, cope with life better and have increased energy. The program added to the resilience of two participants who experienced major, ongoing issues; both acknowledged that without their attendance at the program their symptoms may have been more severe. Outcomes from the Art as Therapy program showed significant improvement in participants’ ability to recognise and maintain their improved mood states. The program culminated in a display of the completed art work at the Yah’Ning Place in Gympie, attended by participants, their support people and staff at SCHN. Press and television media coverage, organised by SCHN, increased awareness of mental illness in the community.
MENTAL HEALTH SERVICES
ACCESS TO ALLIED PSYCHOLOGICAL SERVICES AND RURAL MENTAL HEALTH SERVICE Artius Health continued their contractual arrangement from the previous year to provide Access to Allied Psychological Services (ATAPS) and Rural Mental Health Services (RMHS) in 2014-15. Partnership-based compliance and close management of the contract has resulted in the target numbers for session delivery being exceeded through out the contract. Continued referral and demand management, particularly in the Suicide Prevention tier, along with criteria-based referral onto the Better Access program, allowed for those hard to reach groups to be seen under the ATAPSâ€™ no-cost mental health program. The table below shows the distribution of Referrals and Session Delivery across the Tiers per month: The Tiers were tracked monthly and any that were under-demand by mid-contract, were successfully improved through timely marketing and engagement activities, particularly within the areas of child mental health and Indigenous Tiers (see table below): Total Number of Sessions and Session Variance:
MENTAL HEALTH CLINICAL COUNCIL During 2014-45 SCHN established a Mental Health Clinical Council (MHCC). Membership comprised of the decision makers in mental health in the SCHN region and the group meets quarterly. The purpose of the MHCC was to prioritise the mental health needs of the Sunshine Coast and Gympie region and to take action to meet the needs.
ENHANCING QUALITY CARE: FALLS AND FRACTURE PREVENTION
SCHN expanded upon the original Enhancing Quality Care (EQC) program, by developing the EQC2 program. The EQC2 program aimed to enhance primary health care in general practice, by developing better practice processes and patient management through a series of innovative clinical audits for asthma, osteoporosis and Chronic Obstructive Pulmonary Disease (COPD).
general practices enrolled in the pilot program
clinical audits were conducted among the participating practices
The clinical audits enabled general practices to:
Program activities included:
• Use correct clinical coding in practice software to ensure clean patient data and creation of accurate registers; • Understand and apply best practice guidelines in the diagnostic assessment of patients in high risk groups; • Review and/or establish policies and procedures for recalls and reminders; • Apply best practice guidelines (pharmacological and non-pharmacological) in the treatment of patients; • Review and/or establish policies and procedures for the ongoing management of patients.
• Development of three clinical audit practice manuals that were approved for 40 category one RACGP QI & CPD points for general practitioners; • Policy, procedure and protocol review that assisted with general practice activities; • Enhanced business development and generation of potential new income streams through – identification of at risks patients to screen; diagnose; treat; manage and monitor; • Whole of practice team professional development opportunity.
EQC2 Program evaluation: The University of the Sunshine Coast partnered with SCHN in the pilot project and provided ethics approval and research assistance. The program then underwent evaluation and review. Qualitative and quantitative methods of evaluation were undertaken to measure changes in practice data and changes in GP systems for managing asthma, COPD and osteoporosis.
REDUCING CONSCIENTIOUS OBJECTION
OUTCOMES BILLBOARD CAMPAIGN: • A six month billboard campaign was launched. Located , at Palmview, it had approximately 70,000 – 90,000 cars passing the site each way every day, with each car with averaging 1.5 people per vehicle. • Media campaigns targeted six areas within the Sunshine Coast region including: Palmview, North Arm, Nambour, Glasshouse Mountains, Coolum Beach and Gympie. • Supplied Queensland Health VacciDate App flyers at all community events, in general practice visits and childcare centres. POSTCARD CAMPAIGN: • Developed a postcard campaign targeting ‘back to school’ immunisations. The same image from the billboard campaign was used to ensure culturally appropriate and consistent messaging to the community who had seen the billboards. Promotion was made through media release, contacting councils to include in rates notices, visits to childcare/vocational care prior to schools commencing. • Results showed that 20 childcare centres out of 24 where postcards were delivered were very supportive of the campaign. One centre (in priority area one) out of the 24 stated that all children were vaccinated. An additional two centres (priority area one) stated that the majority of their children were vaccinated. Four centres stated that most if not all of their prep-age students, had left the centre and would not be seen again before they started school. One centre (in priority area two) spoke quietly and their non-verbals suggested that they had some conscious objectors who may have been in the room at the time. One centre (in priority area two) said they have recently sent reminder text messages to those who are overdue for their immunisations.
ESTABLISHMENT OF THE IMMUNISATION ADVOCACY AND WORKING GROUPS Members represented from the Public Health Unit, North Coast Aboriginal Corporation (NCACCH), Maleny Hospital, a GP, Sunshine Coast Council, University of the Sunshine Coast and a community immunisation champion. Terms of Reference were developed and outcomes included the funding of the Vaccination Outreach Program.
VACCINATION OUTREACH PROGRAM In partnership with Sunshine Coast Public Health Unit (PHU) and Child, Youth and Family Health Services within the Sunshine Coast Hospital and Health Service (SCHHS), SCHN funded a six month Vaccination Outreach Service to increase immunisation rates within the identified high-risk population groups among the non-Indigenous community and to provide protection from vaccine-preventable diseases to children living in the SCHHS district.
OUTCOMES • The project became a data cleaning exercise however, the projected minimum number of four to five children to be “vaccinated” per day continued to be reached and often exceeded; • The project members worked for two days per week on collecting and correcting immunisation data; • Data was collated and sent from the Sunshine Coast Public Health Unit to the Project team on a fortnightly basis; • A total of
578 individual children’s immunisation histories have been checked
and collated from the following databases: ACIR, VIVAS, and the Qld Health
96 children’s immunisation histories reflect that they are now age-appropriately vaccinated, 22 individual histories are currently being analysed and are pending the outcome of same, 31 children BHCIS database. Of those 578:
are on an immunisation catch-up schedule with their known vaccine service
24 children were unregistered conscientious objectors, 240 children are deemed unable to be contacted, 29 children moved outside the SCHSS’s geographical area, 125 children were not a priority for the purposes of the project (they did not have a VIVAS record), 11 provider i.e. general practitioner,
children and families had moved overseas – this information has now been reflected on the ACIR data and the 11 children will be removed from any further overdue notices.
IMMUNISATION PRACTICE SUPPORT • Multiple education sessions provided to practice nurses, included sessions on data management and the promotion of the Vacci Date campaign; • Assisted PHU with Immunisation resource mail out to 120 practices; • Up to date resources uploaded to the health resources page and immunisation pathway on the SCHN website; • Health Outcomes team received educational training with the PHU Immunisation Nurse and the PHU Data Officer to ensure that their knowledge was up to date, so that they could support practices with immunisation enquiries; • Accreditation support plan included responding to practices’ requests to assist them with accreditation preparation. This included discussing administrative requirements and assisting with documents, policies and procedures, as well as ensuring vaccine management, infection control and sterilisation standards were met. I 16
EDUCATION SCHN partnered with key stakeholders to deliver evidence based Quality Improvement and Continuous Professional Development (QI & CPD) activities for general practitioners, practice managers, practice nurses, allied health and general practice staff. Key priority areas targeted were the clinical priorities determined by SCHN’s Comprehensive Needs Assessment, Annual Plan and the Sunshine Coast Hospital and Health Service (SCHHS) clinical priority areas. We also responded to education needs identified by our practice support staff. The clinical priorities included; immunisation, mental health, asthma, COPD, osteoporosis, chronic disease management.
OUTCOMES Immunisation: (run in collaboration with Public Health Unit Sunshine Coast) • Orientation to Immunisation for nurses new to general practice • Immunisation: Catch up scheduling • Vaccine management • Data management • Travel vaccination evening event (GPs) in collaboration with BioCSL Mental Health: • Co-funded a mental health conference for GPs in collaboration with Sunshine Coast Private Hospital • Mental Health First Aid (Aboriginal and Torres Strait Islander-specific) 2-day course • Don’t sweat the small stuff (GP education – depression and anxiety) • Mind the Risk: GP event on suicide prevention • Beyond Blue bus visit to five areas of Sunshine Coast for community education events.
Facts and Figures: a snapshot of 2014-15
Asthma – Respiratory: Courses run in conjunction with National Asthma Council • Respiratory management for practice nurses • Spirometry (GPs and practice nurses) • Asthma/ respiratory update (all primary health professionals) Courses run in conjunction with Asthma Foundation Queensland • Active Learning Module: Enhancing Asthma Management in General Practice (GPs only) COPD - Collaboration with Cancer Australia • Cough workshop- new COPDX guidelines and investigating symptoms in lung cancer • Clinical Audit Activity for GPs: Asthma and COPD Osteoporosis: • Clinical Audit Activity: Osteoporosis • Provision of links to online training and face to face events for GPs and practice staff around osteoporosis
GP LIAISON OFFICER TEAM In the final quarter of the SCHN program, the General Practice Liaison Officer Team continued to undertake cross-sectoral activities such as establishment of a GP Council which included ten GPs from the Sunshine Coast and Gympie regions.
OUTCOMES • Progressed work on localised Clinical Care Pathways in mapping and improving patient pre-referral care and investigation, through to post-discharge. Shared follow-up for 40 separate conditions across the medical and surgical specialities and outpatient services within our Hospital and Health Service boundary; • Assisted in the design and improvement of the SCHHS eReferral template for GP referrals to the SCHHS outpatient departments; • Provided clinical/GP opinion and input into the design of the proposed smart ‘SeNT’ eReferral pilot software solution; • Provided clinical and primary care/GP opinion from the commencement of the multi-agency SPOT-ON Hospital Avoidance Pilot; • Provided clinical/GP review of the Benchmark Practice Reports. Continued strengthening of the engagement between SCHN and SCHHS, at this level, provided ongoing opportunities for collaboration on system redesign activities and data sharing initiatives.
GP COUNCIL ESTABLISHMENT In November 2014, the SCHN established the GP Council with the following objectives: a) Improve communication and coordination of services between: general practice; SCHHS; private hospitals; and primary care providers, and b) Review and develop clinical programs that improve health outcomes for issues SCHN has identified through its Comprehensive Needs Assessment, and other initiatives. Its membership comprised: eight General Practitioners, SCHN and SCHHS GP Liaison Officers and representatives from local private hospitals. The GP Council met every eight to ten weeks and achieved the following outcomes: • Provided feedback on a new electronic referral template for GPs to refer to the SCHHS; • Assisted SCHN in rolling out a chronic disease management pilot project (EQC2); • Provided valuable feedback to Queensland Health representatives to assist the development of the state-wide Clinical Prioritisation Criteria program; • Met with local Queensland Ambulance Service representatives and provided the initial discussions that led to planning a regional hospital-avoidance strategy; • Provided feedback on a web-based clinical investigation report portal to improve its usability in general practice; • Created the framework for establishing a Sunshine Coast Clinical Council under the incoming PHN.
GP NETWORK ESTABLISHMENT There were four General Practitioner Networks and the activities were as follows: • The total of seven face-to-face meetings were completed by the GP Network since March 2015, including two in March, one in April, three in May and one in August; • A total of 50 participants have attended these meetings. The topics under discussion included: hip replacements, inhalers, osteoporosis, mental health, vitamin D and urology. I 19
AGED CARE AND PALLIATIVE CARE
AGED CARE CARE-COORDINATION THROUGH EMERGENCY DEPARTMENT, RESIDENTIAL AGED CARE AND PRIMARY HEALTH COLLABORATION OUTCOMES An ongoing collaborative project between multiple organisations, the CEDRiC program that commenced in 2013 (Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration) was an innovative model of service delivery. It aimed to reduce RACF resident trauma and distress by reducing inappropriate transfer to the hospital emergency department (ED) and to maximise the care and efficiency of care where transfer to ED was appropriate. CEDRiC had two components: 1. The Health Intervention Program for Senior (HIPS) the provision of proactive care in the RACF via a Nurse Practitioner Candidate working closely with GPs and RACF staff
2. Geriatric Emergency Department Intervention (GEDI) program advanced practice nurses in the ED who case-manage older adults in the ED
The aims of the evaluative research project were to: 1. Describe ED clients included in GEDI program and describe the structures and processes involved in the delivery of these services; 2. Describe the RACF residents managed by the HIPS program and describe the structures and processes involved in the delivery of these services; and 3. Compare the outcomes, in terms of rates of ED re-presentations within 28 days, ED length of stay (LoS) and hospital LoS, hospital admission rates and healthcare costs, between patients who presented to Nambour General Hospital (NGH) ED from Sundale following the implementation of the CEDRiC program and matched cases that presented to NGH ED in the 12 months prior to the implementation of the program.
AFTER HOURS One of the priority areas funded by the Department is the provision of After Hours services. SCHN continued managing the Practice Incentive Payments (PIP) for After Hours services within General Practice through the distribution of the After Hours Assist Payments. SCHN also supported a number of needs areas that lacked in the provision of After Hours Services through the Gympie Nurse Practitioner Clinic, gp Extend and the Cooroy Catchment After Hoursâ€™ Service.
AFTER HOURS ASSIST PAYMENT SCHN delivered the After Hours Assist Payment (AHAP) to 89 accredited practices in the SCHN region. These funds supported the practices in the SCHN region to provide after hours care for their patients at three different tier levels. These funds also supported the continued provision of an after hours Medical Deputising Service (MDS), via general practice subscriptions. There was a significant increase in the use of the MDS for after hours home visits, which is well subscribed to by practices in the SCHN region. There was a 180% increase in the use of the MDSâ€™ in the SCHN region when comparing the 2013-14 financial year (9,112 patients seen) to the 2014-15 financial year (16,506 patients seen).
gpEXTEND MALENY gpExtend has continued to provide an after hours, weekend GP service to the Sunshine Coast Hinterland since
1 July 2013. gpExtend is a walk in, weekend general practice which has seen 949 patients in the 2014-15 financial year. The service is highly regarded by both the stakeholders in the local area (Stakeholder Reference Group) as well as the community in the region (Community Advisory Group). I 20
GYMPIE NURSE PRACTITIONER CLINIC
The Gympie NP Clinic commenced in September 2014, operating out of the Gympie Hospital’s Emergency Department. In the period between 1 September, 2014 and 31 May, 2015, the Clinic saw a total of 1,400 patients. During this period, the Gympie NP Clinic achieved 95% NEAT* score compared to the set KPI of 83% which demonstrates that the patients are being seen and treated in a timely manner. The number of patients presenting to Gympie Hospital ED has decreased when comparing June 2014 and 2015 (SCHHS Gympie Hospital Website, July 2015); the Gympie NP Clinic could be a significant contributor to this reduction.
There is a stakeholder group in Gympie called the ‘Gympie Primary Health Care Reference Group’ that meet quarterly to discuss various health system topics, including topics such as the Gympie NP Clinic, Queensland Country Practice’s review in Gympie, Hospital in the Home and Telehealth. This group has provided positive and favourable feedback of the clinic and the service it provides along with the patient discharge information received. *NEAT is the percent of patients assessed / managed by a NP who departed from the ED within 4 hours of their arrival time at the ED.
COOROY CATCHMENT AFTER HOURS SERVICE National Home Doctor Service (NHDS) was successful in their bid for the tender to provide after hours services to the Cooroy region. NHDS expanded their region to the Cooroy Catchment area which provided an additional 16,000 residents in the SCHN region with after hours services. Between September 2014 and June 2015, NHDS saw 461 patients in the Cooroy Catchment area. This service is now self-sustaining and continuing in this area without SCHN’s financial support into thw 2015-16 financial year.
eHEALTH A team of SCHN eHealth Registration Officers commenced a consumer awareness campaign to improve the eHealth literacy across the Sunshine Coast and Gympie regions and to assist with understanding and registration of the Personally Controlled Electronic Health Record. This initiative saw strategic engagement across childcare facilities, schools, residential aged care facilities, community groups, sporting groups and council libraries. The methodology focussed on organisations and events where the metrics reflected the greatest opportunity to use scale as a means of increasing the number of people improving their literacy and ultimately registering themselves. In excess of 760 individual conversations occurred which assisted 1824 registrations, with a further 105 conversations revealing 231 people has already registered. Further conversations indicated that 126 people or dependants would register themselves online. The number of people who chose not to register was not counted (estimated to be in excess of 350). Additionally, a team of SCHN Practice Support Officers engaged with General Practice to assist with the practice management function of eHealth Practice Incentive Program (PIP) compliance. This included healthcare identifier compliance, the establishment of secure messaging and electronic prescriptions, data cleansing and clinical coding along with connection to and use of the eHealth record system. Other work that occurred under the guise of eHealth activity included the embedding of an electronic referral solution outbound from General Practice to the SCHHS Specialist Outpatient Department which enabled an efficient referral process and an improved referral criteria.
COMMUNITY AND STAKEHOLDER
ENGAGEMENT THE GYMPIE PROJECT SCHN has been aware of the challenging health needs of the Gympie region since our first Health Needs Assessment in 2012. In our first year we began to prioritise health issues in Gympie by funding Gympie Women's Health Centre, Family Planning Queensland and a range of other local organisations to enhance the existing organisations and address the region's health issues. In 2014 we expanded this support by providing additional services: • Addressing the workforce shortage in the Gympie region by providing GPs and allied health providers for Kilkivan and Gympie; funding a GP to provide free appointments at a local service for youth in crisis; and working with Gympie Hospital to develop a Nurse Practitioner role within the hospital to reduce pressure on the Emergency Department;
• With around 25% of the Gympie population smoking, we realised the importance of funding a quit smoking program in Gympie through Goldfields Fullife Pharmacy; • A shopfront venue in the heart of Gympie, so SCHN staff and partner organisations had a base from which to provide health services and information to the people of Gympie; • The launch of a region-wide immunisation billboard campaign to improve immunisation rates; • Funding Purser’s Coaches to provide a Volunteer Bus Service to the people of Goomeri to get into town for an additional day every week for appointments and social interaction; • Supporting Graham House to continue to provide volunteer transport for the people of Kilkivan to access medical appointments in Gympie, Nambour and Brisbane; • Providing administrative services to the Kilkivan Health Centre.
GYMPIE COLLABORATIVE NETWORK The attendees at ‘Think Health’ event held in February 2014 had identified a lack of collaborative approaches to health services in the Gympie region. SCHN was able to establish and maintain the Gympie Collaborative Network (GCN) which was established to focus on local health needs and initiatives and to provide a collaborative approach to health service planning in the Gympie region. The GCN further provided opportunities to partner with the SCHHS to explore innovative solutions to the health needs of the Gympie region. The GCN prioritised mental health, youth, transport and aged services. Sunshine Coast Hospital and Health Service commissioned Queensland Country Practice to undertake a primary care needs analysis to inform decisions to better manage primary care demand. SCHHS also specifically used the GCN to connect with Gympie GPs, service providers and consumers.
INSPIRING HEALTH LEADERS DINNER SCHN held two Inspiring Health Leaders Dinners in 2014-15, to bring together local health leaders to explore innovation and best practice, to challenge the status quo in health care delivery and contribute to healthier, happier communities. Special guest speakers included Professor Martin Connor, Executive Director of the Centre for Health Innovation, who outlined several strategic performance improvement programs within the HHS; former Royal Marine Commando and Founder of Leadership Horsepower, Stuart Harrison who focused on performance through leadership, teamwork, wellbeing and productive behaviour; and Michael Moore, CEO of the Public Health Association of Australia, who spoke about advocacy in challenging environments. I 22
HEALTH CONSUMERS QUEENSLAND ‘THE HEALTH SYSTEM EXPLAINED’
SCHN worked in partnership with Health Consumers Queensland (HCQ) to deliver a series of three locally tailored ‘Health System Explained’ workshops to demystify the health system for consumers at risk of poor health outcomes. The workshops provided guest speakers from the Director of a local Hospital, SCHN senior management, eHealth specialist, telehealth specialist, patient safety and quality officer within the Hospital, Patient Liaison Officer at the Hospital, experienced health consumer and carer representatives and Health Consumers Queensland. Video interviews of consumer experiences of the workshop were documented and provided as a training resource with patient care. This was particularly useful for gaining insight into Aboriginal and Torres Strait Islander perspectives. Outcomes: • Increased eHealth adoption by general practices and consumers in the community; • Consumer recruited to the Patient Safety and Quality meeting at the Hospital and Health Service; • Ongoing consumer referencing through the establishment of a consumer advisory group in the region. The workshops gathered consumer perspectives about existing barriers to accessing healthcare. The first order issue for the group was identified as transport (this was a need identified in the health needs assessment). This provided a call to action to work with the transport providers in the community to identify what resources were underutilised and over capacity (see transport working group).
THE PRIMARY HEALTH CARE STEERING COMMITTEE The Primary Health Care (PHC) steering committee was formed in June 2014 to provide a framework for the establishment of collaborative approaches between SCHN and SCHHS where key linkages may have occurred. The steering committee was chaired by the SCHHS Director of Community Services and included SCHHS managers from aged care, ACAT, Transitional services, Public Health Unit and Aboriginal and Torres Strait Islander team. SCHHS agreed to a Primary Health Care Strategic Alignment Workshop to support strategic initiatives and to reduce any duplication of services.
GYMPIE MULTIPURPOSE OUTREACH CLINIC
arly in 2014, through the ‘Taking the Pulse’ survey and community engagement, we identified a need to increase GP and allied health care in the Gympie region, particularly in relation to access for Aboriginal and Torres Strait Islander communities and people from other vulnerable groups. The Gympie Multipurpose Outreach Clinic operated out of the Blue Care Respite Centre and, with funding from CheckUP and Queensland Aboriginal and Islander Health Council (QAIHC) provided a visiting GP, podiatrist and physiotherapist, delivering a free rural health service for Aboriginal and Torres Strait Islander people and people with a concession card. The clinic commenced in September 2014 after SCHN was successful in its application. The clinic has seen a gradual increase in patients since it commenced.
OTHER HEALTH PROMOTION ACTIVITIES The Community and Stakeholder Engagement team were able to support, attend and organise a number of events including: • • • • • •
Biggest Blood Pressure Check Gympie Carers Wellbeing Day Men’s Health Week World COPD Day Mental Health Week Skin Cancer Awareness Week
• Buderim Men’s Pit Stop • Healthy Weight Week • NCACCH Wellperson’s Health Check Day - USC Mobile Health Van and Gympie Women’s Health conducted Pap smears
YAH‘NING PLACE - GYMPIE OFFICE SCHN identified the pressing need to have a presence in Gympie. The opportunity arose to take over the lease of a Mary Street property after the departure of a non-government organisation from the premises in August 2014. The office, named “Yah‘Ning Place”, is located at 2/107 Mary Street which is close to public transport in the centre of Gympie. The Yah‘Ning place offers a range of services to organisations involved in primary health in the Gympie and outlying areas, such as, a well-appointed training room, a smaller office and interview room and “hot” desks that allow service providers a space to work when they are in Gympie. The Yah‘Ning Place is a collaborative project between SCHN, service providers and community stakeholders, hosting the Gympie Collaborative Network (GCN) meetings which address a range of primary health and social determinants of health in Gympie and its surrounds, amongst others. SCHN chairs a Yah‘Ning Place Steering Committee of partners in Gympie including the Cooloola Human Services Network (CHSN), Cooloola Aboriginal Services Inc (CASI) and the Cancer Council of Queensland. This Steering Committee oversees the governance of the Yah‘Ning Place and the stakeholders involved, making joint decisions on activities, tenancies and the contribution of primary health to the region.
ABORIGINAL AND TORRES STRAIT ISLANDER
SCHN acknowledges the traditional owners of the land upon which we work and live. We remember the Gubbi Gubbi/ Kabi Kabi people in all that we do, as we deliver the Closing the Gap (CTG) and Care Coordination and Supplementary Services (CCSS) programs. We look to the teachings and wisdom that we receive from Elders both past and present as we go about our business in community. During the year, SCML delivered a number of initiatives under the Federal Government’s “Closing the Gap” program, including: • Improving Indigenous Access to Mainstream Primary Care;
• Care Coordination & Supplementary Services Program. Both programs aim to contribute to improving the life expectancy and the overall health status for Aboriginal and Torres Strait Islander people. The team has community engagement as the core method in identifying and ameliorating the challenges that Aboriginal and Torres Strait Islander people face when accessing health services, along with the challenges that Primary Health Care providers encounter when delivering services.
CLOSING THE GAP The CTG Team are members of a number of service provider committees as well as Aboriginal and Torres Strait Islander support groups and committees in the Gympie and Sunshine Coast Region. The CTG Team achieved the five goals linked to the objectives of the Funding Agreement when considering activity under Improving Indigenous Access to Mainstream Primary Care.
Goal 1 - Improve the capacity of mainstream primary care services to deliver culturally sensitive services: • General practices and Community were offered the opportunity to undertake cultural awareness training and how to improve their mainstream activity in favour of culturally safe and considerate practice. The total number of facilitated sessions delivered was 5 with 122 participants. Goal 2 - Increase the uptake of Aboriginal and Torres Strait Islander health assessments and increase the uptake of specific MBS items: • As a CTG team and in conjunction with the Health Outcomes Team, general practice staff were regularly engaged, this included educational activities surrounding the use of the MBS Item number 715 – Indigenous health check. Attention was also drawn to the use of recall and reminder systems to enable an improvement in the completion rate of Enhanced Primary Care. • This component was reinforced with segments of the Cultural Awareness Training concentrating on MBS Items specifically for Aboriginal and Torres Strait Islander consumers. Goal 3 - Support mainstream primary care services to encourage Aboriginal and Torres Strait Islander people to self-identify: • Throughout the year the CTG team encouraged general practice staff to enquire with clients as to whether they identify as Aboriginal or Torres Strait Islander or both. Additionally the Health Outcomes Team followed this through as an accreditation matter. This component was reinforced with segments of the Cultural Awareness Training concentrating on non-MBS Items. Goal 4 - Increase awareness and understanding of CTG measures relevant to mainstream primary care:
• A series of visits (quarterly in frequency) were made to general practices on the Sunshine Coast and in Gympie to clarify the purpose of CTG and Individual Healthcare Identifier (IHI) Item numbers. Practices were identified through a shared data arrangement, which allowed the CTG Team to make use of data that reveals which practices record which clients have been registered for CTG/IHI.
Goal 5 - Foster collaboration and support between
mainstream primary care and the Aboriginal and Torres
Strait Islander health sector: • During the year, the CTG Team worked closely with North Coast Aboriginal Corporation for Community Health (NCACCH) who have approximately 50 practices contracted to deliver services through a brokerage model. • The CTG Team worked closely with the SCHHS Aboriginal and Torres Strait Islander Team on a number of occasions that included consumer support and attendance at significant events.
CARE COORDINATION AND SUPPLEMENTARY SERVICES (CCSS) As a recipient of funding to deliver Care Coordination and purchase Supplementary Services from a pool of flexible funding, SCHN consistently met the aim of the activity; to improve health outcomes for Aboriginal and Torres Strait Islander people with chronic health conditions. The Care Coordinator achieved this through improving the access to coordinated and multidisciplinary care and specifically: • Provided care coordination for approximately 60 clients; • Coordinated transport services for identified patients; • Worked closely with the SCHN Indigenous Outreach Worker as a point of contact during home visits; • Mentored practice staff in the use of the Clinical Audit Tool (CAT) to identify eligible patients; I 26
• Delivered nurse education on the correct use of item numbers 715,721 and recall processes for disease management; and • Co-developed and delivered practice resources (such as information sheets and flyers). Further to the above, Aboriginal and Torres Strait Islander Cultural Awareness Training was delivered to a variety of service providers that support the Aboriginal and Torres Strait Islander Community within the Sunshine Coast and Gympie regions. The key participants included: • University of Sunshine Coast; • Central Queensland University; • East Coast TAFE; and • a number of primary and secondary schools in the region
RECOVERY The Partners in Recovery (PIR) service team, governing bodies and various reference groups have continued to operate successfully over the past twelve months allowing for many quality organisational and participant outcomes. Of particular significance, during the transition to the PHN, SCHN was approached to become the lead agency for Wide Bay’s and Central Queensland’s PIR consortia. Other outcomes included: • PIR’s ongoing recognition and inclusion of consumers and carers as partners, has allowed for the successfully implementation of many carer and consumer-driven initiatives and process improvements.
• The System Gap Initiative, supported by PIR, continued to produce many positive outcomes for participants and the Sunshine Coast and Gympie community as a whole. This had been evidenced in the way the primary stakeholders have worked together, to secure funds and to develop approved protocols, to establish and begin operating the accommodation facility. Further to this, positive client outcomes were reported at regular review meetings and interim reports. • PIR continued to maintain a transparent financial and collaborative decision-making model which has underpinned the effectiveness of the consortium model.
• PIR has successfully maintained a quality focus on service provision, by prioritising those most disadvantaged or at risk, by ensuring that they received appropriate and timely coordinated responses. • The development and retention of a cohesive and professional Service Delivery Team was a major achievement for PIR Sunshine Coast and Gympie. This has increased PIR’s capacity to provide better coordination and improve the overall cohesion of the service system.
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PIR DASHBOARD - FROM STARTUP TO 30 JUNE 2015
COMMUNICATIONS SCHN launched its new website in July 2014. Consultation with stakeholders indicated that they were in favour of information more targeted to their specific needs, so the new website was established as two mini-sites – one focused on community stakeholders and health consumers, and the other focused on the needs of general practitioners and health professionals. The development and implementation of the website was a planned and strategic process, coming in on time and on budget. The finished product has been very well received by health professionals. Their feedback has been very helpful in continuing to refine the layout, content and functionality of the site. SCHN spent the 2014-15 year consolidating its media presence in the region. The organisation established its position as the “go-to” source for media comment on primary health matters, particularly immunisation, chronic disease and mental health issues. The team ran community activities for key events such as Men’s Health Week, Skin Cancer Awareness Week, Carers’ Week and Mental Health Week; engaging closely with the community and clinicians across the Sunshine Coast and Gympie. The highlight of the year’s media activities was an awareness-raising piece about HPV vaccination rates. Professor Ian Frazer kindly provided his time to be interviewed on the importance of the vaccine, and students from a local college were interviewed and filmed, as they received their vaccinations. This story received coverage on Nine News Queensland, in the Courier Mail as well as in local and regional news outlets.
MEMBERSHIP 2014-15 was a challenging year for SCHN’s Organisational Membership, with considerable upheaval around the dissolution of Medicare Locals and the delays in announcement of the successful PHN bid. With the announcement that SCHN had been selected to operate the PHN, Membership structure was able to remain unchanged over the transition period.
Ground Level, Mayfield House 29 The Esplanade, Cotton Tree QLD 4558 PO Box 3067 Maroochydore QLD 4558 t: 07 5456 8100 f: 07 5443 9100 ABN 21 156 526 706
SUNSHINE COAST HEALTH NETWORK LTD TRADING AS SUNSHINE COAST MEDICARE LOCAL GRATEFULLY ACKNOWLEDGES THE FINANCIAL AND OTHER SUPPORT FROM THE AUSTRALIAN GOVERNMENT DEPARTMENT OF HEALTH