Annual Report 2014-2015 - Darling Downs Hospital …...2 Darling Downs Hospital and Health Service Annual Report 2014-15 Board Chair While I acknowledge there is always more to do,

Darling Downs Hospital and Health Service

Darling Downs Hospital and Health Service Annual Report 2014-15

Open dataWe are committed to the Queensland Government’s open data strategy and have published additional information to form part of our 2014-15 annual report. This information is published at: www.qld.gov.au/data

DDHHS has published the following data on the government’s Open Data website:

• consultancy expenditure

• overseas travel expenditure

• results against the Queensland Language Services Policy

• board fees and meetings

Version controlFirst published September 2015ISSN 2202-445X (Print)ISSN 2202-736X (Online)

Public Availability StatementCopies of this publication can be obtained at http://www.health.qld.gov.au/darlingdowns/pdf/ddhhs-annualreport-2015.pdf or by contacting:TheOfficeofChiefExecutiveDarling Downs Hospital and Health Service Jofre Level 1 Baillie Henderson HospitalPO Box 405 Toowoomba Qld [email protected] (07) 4699 8412

Copyright © Darling Downs Hospital and Health Service 2015

This work is licensed under a Creative Commons Attribution Non-Commercial 3.0 Australia licence. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/3.0/au/deed.en/ In essence, you are free to copy, communicate and adapt the work for non-commercial purposes, as long as you attribute Darling Downs Hospital and Health Service and abide by the licence terms.

Interpreter Service StatementDarling Downs Hospital and Health Service is committed to providing accessible services to Queenslanders from all culturally and linguistically diversebackgrounds.Ifyouhavedifficultyinunderstandingtheannualreport,youcancontactuson(07)46998412andwewillarrangeaninterpreter to effectively communicate the report to you.

Darling Downs Hospital and Health Service Annual Report 2014-15 i

Letter of compliance

The Honourable Cameron Dick MP Minister for Health Minister for Ambulance Services Member for Woodridge Level 19, 147-163 Charlotte Street Brisbane Qld 4000

Dear Minister

I am pleased to present the Annual Report 2014-2015 and financial statements for the Darling Downs Hospital and Health Service.

I certify that this Annual Report complies with:• the prescribed requirements of the Financial Accountability Act 2009 and the Financial and Performance

Management Standard 2009, and• the detailed requirements set out in the Annual Report Requirements for Queensland Government agencies.

A checklist outlining the annual reporting requirements can be found at page 81 of this annual report or accessed at http://www.health.qld.gov.au/darlingdowns/pdf/ddhhs-annualreport-2015.pdf.

Yours sincerely

Mr Mike Horan AM Chair Darling Downs Hospital and Health Board

4/9/2015

Darling Downs Hospital and Health Service Annual Report 2014-15ii

Our visionTo be trusted to deliver excellence in rural and regional healthcare.

Our purposeDelivering quality healthcare in partnership with our communities.

Our strategic directionsWe have four key strategic directions, which will help us to achieve our purpose and vision:

• Deliver quality healthcare• Ensure resources are sustainable• Ensure processes are clear• Ensure dedicated trained staff

Our valuesOur values guide how we work and support us to achieve our goals. They are:

• Caring – We deliver care, we care for each other and we care about the service we provide.• Doing the right thing – We respect the people we serve and try our best. We treat each other respectfully and we

respect the law and standards.• Openness to learning and change – We continually review practice and the services we provide.• Being safe, effective and efficient – We will measure and own our performance and use this information to inform

ways to improve our services. We will manage public resources effectively, efficiently and economically.• Being open and transparent – We work for the public and we will inform and consult with our patients, clients, staff,

stakeholders and community.

Acknowledgement of Traditional OwnersDarling Downs Hospital and Health Service respectfully acknowledges the traditional owners of the land on which its sites stand.

Mission Statement

Darling Downs Hospital and Health Service Annual Report 2014-15 1

Contents

Letter of compliance i

Mission Statement iiOur vision iiOur purpose iiOur strategic directions iiOur values iiAcknowledgement of Traditional Owners ii

Board Chair 2

Chief Executive 3

This year’s milestones 4

About us 9Our role 9Our region 9Our services 9

Our year at a glance 10

Strategic directions 11Our performance 12Delivering quality healthcare 13Improving our local facilities 18Ensuringresourcesaresustainable 19Ensuringprocessesareclear 23Ensuringdedicatedtrainedstaff 27

Our organisation 31

Divisional reports 33Toowoomba Hospital 33Rural Division 37Mental Health 41Nursing and Midwifery 44Medical Services 46Allied Health 51Workforce Division 55Finance Division 57

Service standards 59

Governing the organisation 61

Our Board 62Board meetings 67Board committees 67Board engagement 70

Our executive team 73

Glossary of terms 76

Compliance checklist 81

Annual financial statements 83

Independent auditor’s report 126


Board Chair

While I acknowledge there is always more to do, I believe this year has seen some major achievements that have built on the successes of the first two years of the local Board and management structure being in place.

For the second year in a row, DDHHS has provided five per cent more services than funded to do under our contract with the Department of Health. This is good news for our patients, their families, and the communities we serve.

A surplus of $20.1 million was achieved for the year. This is the third year in a row that a surplus has been achieved. These surplus funds will be allocated to increased clinical services, new equipment, and infrastructure.

Some key highlights from the year included:

• Achievement of National Elective Surgery Target (NEST) where no patients waited longer than clinically recommended for surgery (achieved December 2014).

• Reduction of specialist outpatient waiting lists with 5,028 fewer patients waiting on Toowoomba Hospital’s specialist outpatients’ waiting list.

• Exceeding the Queensland Emergency Access Target (QEAT) for 90 per cent of patients admitted to a ward, transferred or discharged within four hours across all our facilities.

• Introduction of a new online training platform, called Darling Downs Learning On-Line, to support staff professional development.

• Significant infrastructure improvements which have helped deliver more care locally.

• Being the first and only Queensland hospital and health service to be accredited against the National Safety and Quality Health Service (NSQHS) Standards and National Standards for Mental Health Services (NSMHS) under two certification bodies. The external rigorous reviews to achieve accreditation under AS/NZS ISO 9001:2008 (Quality Management System) Standard and Australian Council on Healthcare Standards (ACHS - EQuIP National) prove our commitment to providing safe and quality care.

• Being a successful bid partner, with GP Connections, to operate the new primary health network for the Darling Downs and West Moreton.

I thank all Board members for their commitment to engaging with their communities to understand current and emerging healthcare needs. I believe this strong local networking has informed our decision making to ensure we meet or exceed expectations in the care DDHHS delivers.

On behalf of the Board, I thank Chief Executive Dr Peter Bristow for his outstanding leadership, and others on the executive team who have been instrumental in achieving excellent patient-centred care and support services while maintaining a solid financial position.

I am confident DDHHS will continue to meet the challenges of delivering health services to our communities over the coming year.

Mr Mike Horan AMChairDarling Downs Hospital and Health Board

It is a privilege to present the third annual report of the Darling Downs Hospital and Health Service (DDHHS) which shows how we have realised our vision: to be trusted to deliver excellence in rural and regional healthcare. Our Board is very proud of the high quality of clinical care that has been provided to communities from our 26 facilities. We appreciate the professionalism of all our staff – clinical and non-clinical - who have worked hard to achieve the many milestones and examples of great outcomes included in this report.


ChiefExecutive

These results were achieved by our people: doctors, nurses, allied health staff, and all the support staff needed to make a modern healthcare service work.

These services were provided while maintaining a focus of quality and safety. During the year we completed accreditation against the National Standard for Safety and Quality in Healthcare, National Mental Health Standards, and Aged Care accreditation standards. Our quality management system was accredited against the ISO:9001 standard. There is always more to do. However, we have a strong process to follow-up on areas that need attention, and a commitment to doing just that.

During the year we held consumer forums, increased the number of consumers on groups to provide us with advice, and made it easier for patients and others to give us feedback. The partnership with our communities extended to our new collaboration with a local GP organisation to operate the primary health network. Our engagement with unions and the workforce improved.

The above is a summary of how we have achieved our purpose of “delivering quality healthcare in partnership with our communities”. We were able to achieve these goals because of our values. Caring about our patients and their needs drove a large improvement in the numbers and timeliness of our services.

For this I want firstly to thank all our staff who delivered this care. Managers, by listening to staff and empowering them to deliver, kept the service on track. The Board, by trusting and endorsing the policy settings to deliver more care, authorised the service to get these results. Finally, the activity-based funding system which is managed by the State and sees extra dollars f low from the Commonwealth Government for extra work, made this financially possible.

The achievement of these results and our approach to doing so has resulted in a more cohesive team throughout DDHHS. It is easy to work in silos in large organisations. This was probably very true before the formation of hospital and health services. However, DDHHS now operates on a belief of achievement and a shared view that all components should realise their goals. This is a significant cultural change.

It is my hope and belief that this culture of empowerment, fairness, and achievement will enable DDHHS to continue to improve and face the challenges of the future in our journey to achieve the service’s vision of being trusted to deliver excellence in rural and regional healthcare.

Dr Peter Bristow FRACP FCICM FRACMA GCM GAICDChief Executive Darling Downs Hospital and Health Service

I am proud of the work of the Darling Downs Hospital and Health service (DDHHS) detailed inthisannualreportfor2014-15.DDHHSachievedsignificantimprovementsinthetimelinessofcareprovided.Endoscopy,electivesurgery,andspecialistoutpatientactivitynumbers increased, so at the end of the year, more than 99 per cent of the people needing these services were receiving them within the clinically recommended time. This shows the DDHHS commitment to delivering care for the people of our communities.


2014Goondiwindi palliative

care room opensRefurbished palliative care and

quiet rooms opened at Goondiwindi Hospital. The $360,000 project was

funded by the Board through an operating surplus.

More care for mums and bubsToowoomba Hospital’s Maternity Home Care

Service expanded to become a seven-day-a-week service.

Our Values in Action guides staff

behavioursWe launched a framework

document that sets out DDHHS’s values and

expected behaviours from our staff.



Our Values in Action

Caring We deliver care, we care for each other and we

care about the service we provide.

• Displaying compassion• Being empathetic with clients• Being supportive to colleagues

A service that is valued

Doing the right thingWe respect the people we serve and try our

best. We treat each other respectfully and we respect the law and standards.

• Providing good leadership• Embracingdiversity• Acting responsibly• Acting with integrity

Professional service that is respected by the community

Openness to learning and changeWe continually review practice and

the services we provide.

• Reviewing our performance and outcomes• Trying new ways of doing things• Questioning and inquiring about better ways• Welcoming innovation, improvements and

learning

Contemporary practices

Being safe, effective and effi cient We will measure and own our performance and use this information to inform ways to improve our services. We will manage public resources effectively,efficientlyandeconomically.

• Reviewing outcomes and our performance• Reviewing our services against expected

standards• Understanding our responsibility in serving the

public and using taxpayer funds• Considering patient, staff and workplace safety

A safe and effective service

Being open and transparent We work for the public and we will keep

our patients, staff, stakeholders and community informed.

• Being honest• Answering questions and providing information• Being accessible and communicating openly• Discussing options with patients, clients and

the community

A service the community trust with staff and patients understanding

decisions made

Values Behaviours Outcomes

Examples

Our Vision To be trusted to deliver excellence in

rural and regional healthcare

Our PurposeDelivering quality healthcare in

partnership with our communities

For more information visit: http://qheps.health.qld.gov.au/darlingdowns/html/staff-support/hr-management.htm

Should you have any suggestions on how to better put values into action, discuss with your supervisor or contact Human Resources Services on 4699 8067.

1972.v1 | 01/2015

This year’s milestones

JULY AUGUST SEPTEMBER OCTOBER

Consumers involved in improved service planning

Toowoomba Hospital’s consumer advisory groupmetforthefirsttime.Overtheyear,

members have provided valuable feedback and ideas to improve patient care.

SAFE system launchedA new system designed to streamline

the clinical auditing process was established. The Systematic Approach FacilitatesExcellence(SAFE)programhelps measure clinical performance to

improve safety and quality.

NAIDOC Week celebratedSeveral sites hosted events for National Aborigines and Islanders Day Observance Committee (NAIDOC)

Week. It was a time to celebrate Australian and Torres Strait Islander history, culture and achievements.

New staff training platform rolled outThe launch of a new staff online learning platform

has helped improve staff access to training. Darling Downs Learning On-Line (DD-LOL) covers bothmandatoryandrole-specifictraining.


Wandoan Primary Health Care Centre opened

The Wandoan Primary Health Care Centre offers a new model of

healthcare not previously available in this rural community.

DDHHS showcases telehealth success

We hosted a national telehealth conference which showed how patients in rural and remote areas receive specialist clinical care thanks to state-of-the-art videoconferencing technology.2014

This year’s milestones

SEPTEMBER OCTOBER NOVEMBER DECEMBER

New Stanthorpe facility welcomed

Weofficiallyopenedthe$1.1millionrefurbished Stanthorpe birthing suites that offer much-improved facilities for local mothers and their families. The

project was funded by the Board through an operating surplus.

ENT wait list slashedToowoomba Hospital’s ear, nose and throat specialist team powered through the waiting list for treatment, seeing more than 1,250

patients over two months.

Emergency preparedness exercises upskill staff

Intensive infection control training was undertaken at all our hospitals to prepare for a possible butveryunlikelyEbolacase.

Toowoomba Hospital “makeover” finishes

A major external revamp of Toowoomba Hospital was completed. It included

repainting, roadworks, and other maintenance works.


2015This year’s milestones

Staff achievements recognised

WehostedthefirstDDHHSemployee awards which was

a chance to celebrate the significantcontributionsof our staff. More than 50

nominations were received.

JANUARY FEBRUARY MARCH APRIL

Double accreditation confirms quality care

We became the only Queensland hospital

and health service to be accredited against the

national standards under twocertificationbodies:AS/NZS ISO 9001:2008 (Quality Management

System) Standard and ACHS (EQuIPNational).

New doctors startWe welcomed 35 new medical

interns to Toowoomba Hospital and several of our

rural hospitals.

Aboriginal and Torres Strait Islander youth

health workshopThe Cunningham Centre hosted the firstAboriginalandTorresStraitIslander Youth Health workshop.

Cherbourg’s new women’s and children’s centre opens

We opened a refurbished building that brings women’s and children’s services

under the one roof.

First allied health assistants’ forum

hostedThe Cunningham Centre held the

inaugural allied health assistants’ forum. All participants gave

positive feedback, saying they intended to implement changes

on their return to their workplace.

Aboriginal and Torrres Strait Islander youth health workshop

attendees


2015This year’s milestones

Primary health partnership announcedThe Commonwealth Government announced DDHHS and GP Connections were successful in their bid to

deliver the new primary health network (PHN) for the Darling Downs and West Moreton regions.

MARCH APRIL MAY JUNE

Long-serving staff applauded

Eighty-oneemployeeswerehonoured at a special ceremony

for reaching 30, 35, 40 or 45 years within Health. They

represented more than 2,600 combined years of service.

Aboriginal and Torres Strait Islander flu campaign success

The “Tackle Flu Before it Tackles You” campaign delivered a

recordnumberoffluvaccinationswith 1,414 eligible Aboriginal

and Torres Strait Islander people receiving the injection.

Chinchilla baby boomSix babies were born in three days at Chinchilla Hospital – including two on International Midwives’ Day on 5 May.

Outpatient waiting list slashed

A multi-faceted, clinician-led initiativetosignificantlyreduce

the number of patients waiting for specialist outpatient appointments, resulted in less than one per cent of

patients waiting longer than clinically recommended as at 30 June, 2015.

More staff have their sayMore staff than ever before – 44 per

cent – took part in this year’s Working for Queensland survey to provide feedback.

Value of volunteers recognisedWe are lucky to have more than 260

volunteers across DDHHS who give their time to help others. Oakey Hospital’s

George Lipman was acknowledged for his valuable help during Volunteers Week.

Baillie Henderson Hospital (BHH) milestone celebrated We acknowledged 125 years of mental

health care at BHH including a tree-planting ceremony and afternoon tea attended by

Health Minister Cameron Dick MP.

Record number of endoscopiesWe undertook a major campaign to

increase the number of endoscopies performed. By May 2015 no patients

were waiting longer than clinically recommended for these procedures.

Minister officially opens two Toowoomba facilities

Health Minister Cameron Dick MP performed the honours at the officialopeningsofToowoombaHospital’s expanded endoscopy suite and the new mental health

community care unit.

Aboriginal and Torrres Strait Islander youth health workshop

attendees

Taroom

Wandoan

Miles

Chinchilla

Tara

Goondiwindi

Millmerran

Inglewood

Texas

Stanthorpe

Warwick

Baillie Henderson Hospital

Toowoomba

Mt Lofty

Oakey

Dalby

Murgon

Wondai Cherbourg

Nanango

Kingaroy

Jandowae

Legend

Hospital

Outpatient Clinic

Multipurpose Health Service

Aged Care Facility

Proston

Glenmorgan

Meandarra

Moonie

Our facilities


About us

The Darling Downs Hospital and Health Service (DDHHS) is an independent statutory body governed by the Darling Downs Hospital and Health Board (the Board), which reports to the Minister for Health. DDHHS was established as a statutory body on 1 July 2012. Our responsibilities are set out in legislation through the Hospital and Health Boards Act 2011 (the Act) and the Financial Accountability Act 2009 and subordinate legislation.

The DDHHS has four strategic approaches to deliver on its purpose; delivering quality healthcare services in partnership with our communities:

• Delivering quality healthcare• Ensuring resources are sustainable• Ensuring processes are clear• Ensuring dedicated trained staff.Our Strategic Plan articulates how the DDHHS delivers on the Queensland Government’s priority of strengthening the public health system, in line with the objectives for the community to create jobs and a diverse economy, deliver quality frontline services, protect the environment and build safe, caring and connected communities.

Our role DDHHS operates according to a service agreement with the Department of Health which identifies the services to be provided, the funding arrangements for our services, the performance indicators and targets to ensure outcomes are achieved.

The service is responsible for the direct management of facilities and services including hospitals, multipurpose health services (MPHS), residential aged care services and outpatients clinics (OPC) and we deliver clinical services from 26 locations.

We are one of the largest employers in the Darling Downs, employing more than 4,900 people, and in 2014-15 had revenues of more than $643 million.

The majority of the residents in our region receive public hospital inpatient care at our facilities, either at their local hospital or at Toowoomba Hospital. Patients are at times required to travel to Brisbane to access some types of specialist services only offered at tertiary facilities.

Our regionGeographically, DDHHS provides services across an area of approximately 90,000 square kilometres, covering the local government areas of the Toowoomba Regional Council, Western Downs Regional Council, Southern Downs Regional Council, South Burnett Regional Council, Goondiwindi Regional Council, Cherbourg Aboriginal Shire Council and part of the Banana Shire Council (community of Taroom).

In 2014 the estimated resident population of the DDHHS area was just under 280,000 people. The population is projected to increase by approximately 1.2 per cent annually to just under 300,000 people by 2021. Aboriginal and Torres Strait Islander Australians made up 4.2 per cent of the DDHHS population which is higher than the State’s Aboriginal and Torres Strait Islander population of 3.6 per cent.

Our services DDHHS provides a comprehensive range of hospital services including inpatient and outpatient services, surgical sub-specialties, medical sub-specialties, and diagnostic services.

Our integrated mental health service provides specialist services across a number of clinical programs through Toowoomba Hospital, Baillie Henderson Hospital and rural communities. DDHHS also operates six residential aged care services.

We offer community and primary health services including: aged care assessment, Aboriginal and Torres Strait Islander health programs, child and maternal health services, alcohol and other drug services, home care services, community health, sexual health service, allied health services, oral health, and public health programs.


Our year at a glance

Same day admissions

33,901

All outpatient attendances

221,420

Emergency department

presentations149,180

Separations (discharges)

71,860

Elective surgeries performed

8,733

Pharmacy attendances

47,916

Breast screens18,928

Adult dental treatments

34,344

Telehealth consultations (non-admitted patients,

excluding mental health)4,453

768from

2013-14

241

from 2013-14

6,232from

2013-14

1,252from

2013-14

2,110from

2013-14

829 from

2013-14

30,057from

2013-14

1,040from

2013-14

6,990from

2013-14

1,235from

2013-14

Mums and bubs visits

4,451


The Darling Downs Hospital and Health Board’s vision is to be trusted to deliver excellence in ruralandregionalhealthcare.TheDDHHSStrategicPlan2014-18identifiesthekeyinitiativestoachieve this goal, and is supported by the organisational values that underpin its success. It is a living document which guides planning, implementation and review of all aspects of our operations. It focuses on our need to have dedicated trained staff who are supported with clear processes and sustainable resources so they are best placed to deliver quality healthcare.

The Darling Downs Hospital and Health Service Strategic Plan has four key strategic directions:

• Deliver quality healthcare (delivering core health services; improving access to services; reducing the impact of chronic disease; ensuring safe and quality health outcomes; and increasing confidence in the health system)

• Ensure resources are sustainable (balanced operating position; ensuring appropriate costs; maximising revenue; leveraging other providers; and optimising asset usage)

• Ensure processes are clear (collaboration with primary health care and other service providers; deliver more care locally; effective operational planning; review and improve care; increase use of clinical evidence-based decision making; and engage the community and health care consumers)

• Ensure dedicated trained staff (embed a values-based culture; develop, educate and train our workforce; plan, recruit and retain an appropriately skilled workforce; engage clinicians to improve the service; and promote and support the health and wellbeing of our staff).

Our priorities in 2014-15 included:• Reduction of the specialist outpatient waiting list

and ensuring patients were seen within clinically recommended timeframes

• Reduction in the endoscopy waiting list• Ensuring elective surgeries were performed within

clinically recommended timeframes• Achieving the National Emergency Access Target for

patients who present to emergency departments being admitted, discharged or transferred within four hours

• Continued oral health wait list reduction, including dentures and other prosthetics

• Supporting staff through education and training » Launch of Our values in action framework to support

staff to demonstrate values-based behaviour » Inaugural employee awards to recognise and

celebrate staff achievements in demonstrating our values, vision, and purpose

» Online training platform Darling Downs Learning Online (DD-LOL) to facilitate greater access to training

• Safety and Quality – Accreditation maintained for all services

• Delivering improved local facilities including: » Expansion of the endoscopy suite at the

Toowoomba Hospital » Completion of the refurbishment of the

Stanthorpe Hospital maternity unit » Completion of the refurbishment to create a

dedicated palliative care suite and quiet room at the Goondiwindi Hospital

» Ongoing works on the Backlog Maintenance Remediation Program

» Co-location of women’s health clinics, antenatal and postnatal services, family planning and gynaecology in a refurbished facility at Cherbourg Health Service

» Officially opening the Wandoan Primary Health Care Centre

» Completion of the Commonwealth Government capital funded mental health community care unit

• Collaborating with Primary Health Care providers.

Strategic directions


Our performance

Key performance indicators show higher volume of care at DDHHS services

DDHHSEMERGENCYDEPARTMENTATTENDANCES

ELECTIVESURGERIESPERFORMEDDDHHS

NEWPATIENTSSEENATSPECIALISTOUTPATIENTS

CLINICS

ADULTDENTALTREATMENTS (EXPRESSEDASOCCASIONSOF

SERVICE)

OCCUPIEDBEDDAYS ENDOSCOPYPROCEDURESTOOWOOMBA HOSPITAL

4,107342 more patients a month

treated than in 2012-13

1,693

7,296

10,725

23,510 64 more a day

than in 2012-13

2,253188 more a month

than in 2012-13

24% increase since 2012-13608 more a month

than in 2012-13

2012

-13

2013

-14

2014

-15

145,

073

147,

070

149,

180

2012

-13

2013

-14

2014

-15

7,04

0

7,96

5

8,73

3

2012

-13

2013

-14

2014

-15

23,6

19

33,5

15

34,3

44

2012

-13

2013

-14

2014

-15

263,

527

275,

673

287,

037

45% increase since 2012-13

150000

140000

130000

120000

2013

-14

4,06

9

2012

-13

2014

-15

1,81

6

2,93

2

10000

8000

6000

4000

2000

0

35000

30000

25000

20000

15000

10000

5000

0

300000

250000

200000

150000

100000

50000

0

5000

4000

3000

2000

1000

0

250000

200000

150000

100000

50000

0

2012

-13

2013

-14

2014

-15

15,3

62

17,4

35

22,6

58


Growing demand for health services has been managed well in the three years DDHHS has operated as an independent statutory authority. We have worked consistently to reduce waiting lists for our services, and improve timeframes for patients to receive the care they need.

Less time to wait for Emergency Department treatment Not only did DDHHS treat more emergency presentations than ever before, we continued to achieve the Queensland Emergency Access Target (QEAT) from January to June 2015 with 90 per cent of patients who presented to emergency departments admitted, discharged or transferred within four hours.

Improved access to elective surgeryDDHHS has been working hard to improve access to elective surgery and to meet the National Elective Surgery Target (NEST).

In 2014-15, a total of 8,733 elective surgery procedures were undertaken across the DDHHS, with 5,740 of these at Toowoomba Hospital. The table shows the percentage of patients receiving their surgery within the clinically recommended timeframes.

National Elective Surgery Target (NEST)

Urgent Semi-urgent RoutineTarget 100% 97% 98%

DDHHS Actual 99.9% 99.8% 99.9%

Urgent = within 30 daysSemi-urgent = within 90 daysRoutine = within 365 days

DDHHS has continued to deliver more healthcare than contracted under the service agreement with the Department of Health. This is measured in weighted activity units (WAUs)whichprovideacommonunitofcomparison.In2014-15weprovidedfivepercent more services than contracted to our patients and communities.

197PATIENTSADAYARE

DISCHARGEDFROMOURFACILITIESAFTERRECEIVINGTREATMENTASANINPATIENT

409PATIENTSADAYARETREATEDINOUREMERGENCYDEPARTMENTS

728ELECTIVEOPERATIONSA

MONTHAREPERFORMEDAT OUR HOSPITALS

254BABIESAMONTHARE

BORN AT OUR HOSPITALS

Delivering quality healthcare



No dental patients wait longer than recommended for routine treatment

In May 2014, no patients within DDHHS were waiting longer than the clinically recommended timeframe for routine dental treatment (less than two years). This has been maintained during 2014-15 with approximately 78 per cent of people currently waiting less than one year for routine dental treatment.

Record number of endoscopy patients treatedDuring the year, a major campaign was undertaken to increase the number of endoscopies performed and reduce the number of patients waiting in excess of clinically recommended timeframes for endoscopic procedures. In July 2014, in Toowoomba there were a total of 1,751 patients waiting for an endoscopic procedure, and of these 84 per cent were waiting longer than the clinically recommended timeframe. By May 2015 the waiting list had reduced to 244 patients with no one waiting in excess of the clinically recommended timeframe.

Endoscopy outpatients Toowoomba Hospital

0

500

1000

1500

2000

Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15

Total patients Total LW

EMERGENCY DEPARTMENT TRAINING SUPPORTS RURAL STAFF

Dr Sheree Conroy talks to a group of training participants

EmergencySeniorStaffSpecialist and Director of Clinical Training Dr Sheree Conroy undertook a 12-month project to provide support and training for emergency services across rural facilities throughout DDHHS.

TheaimoftheEmergencyMedicineandEducationTraining(EMET)projectwastosupport rural staff and provide opportunities to access training using funding from the Australasian College of EmergencyMedicine(ACEM).

Training was delivered by Toowoomba Hospital-based EmergencyDepartmentconsultants who travelled to almost all DDHHS rural hospitals. Participants included doctors, nurses, medical and nursing students, and paramedics.

The training was as practical as possible, with hands-on simulation training, refreshers on use of vital equipment suchasdefibrillators,case studies, and group discussions on topics such as retrievals and transfers.

Dr Conroy said one of the greatestbenefitsoftheEMETproject was the improved two-way communication between medical staff, which helped contribute to improved patient outcomes.



Outpatients’ waiting list slashedStaff, including especially our ear, nose and throat (ENT) surgeons, orthopaedic surgeons, the Specialist Outpatient Referral Centre, and the General Practice Liaison Officer, coordinated and continued to build on the success of the previous year in reducing the specialist outpatient waiting list. Over 2014-15, the outpatient waiting list reduced by 56 per cent (5,028 patients), including a reduction in long-wait patients from a total of 62 per cent in July 2014 to less than one per cent in June 2015. This meant by the end of June 2015 only 17 patients were waiting in excess of the clinically recommended time. This was the lowest number of any HHS throughout the state. All told, 22,658 new specialist outpatient attendances were provided, 5,223 more than the previous year.

Outpatients Toowoomba hospital (excluding endoscopy)

Total patients Total LW

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

Jul-1

4

Aug-

14

Sep-

14

Oct

-14

Nov

-14

Dec

-14

Jan-

15

Feb-

15

Mar

-15

Apr-

15

May

-15

Jun-

15

More women screened for cancerOur Breastscreen service scanned a record number of women, performing 18,928 screens including 543 (2.9 per cent) to people who identified as Aboriginal and Torres Strait Islander. This was a 25 per cent increase in Aboriginal and Torres Strait Islander participation rates on the previous year.

The Mobile Women’s Health team provided 359 community visits and delivered 2,100 cervical screens.

Birthing services have a busy yearDDHHS operates seven designated birthing facilities. In 2014-15 the distribution of births at these facilities was:

Location BirthsToowoomba 1,941

Kingaroy 398

Dalby 242

Warwick 192

Stanthorpe 110

Goondiwindi 114

Chinchilla 44

Four babies were delivered at other DDHHS facilities.

Chinchilla experienced a baby boom in May when five babies were born in 48 hours at the hospital - two of them on International Midwives’ Day.

Accreditation affirms quality care DDHHS has maintained accreditation across all components of the service. In addition the DDHHS successfully undertook its first International Standards Organisation (ISO) audit in March 2015.

ISO certification is recognised internationally and signifies an organisation has good management practices in place which are directed at realising consumers’ quality expectations and outcomes.

The audit was undertaken by an experienced team of 17 auditors. The ISO auditors examined all operational parts of the DDHHS and visited 24 sites over a 10-day period.

The audit comprehensively examined the health service against the AS/NZS ISO 9001:2008 Quality Management System Standard, the National Safety and Quality Health Service (NSQHS) Standards, as well as National Standards for Mental Health Services.

After a successful Australian Council on Healthcare Standards (ACHS) and International Organization for Standardization (ISO) accreditation. DDHHS is one of the few services with accreditation under two certification bodies.



Mums and Bubs program supports more families During the year, a record number of in-home visits under the “Mums and Bubs” program were provided with 4,451 visits conducted by midwives and child health nurses, an increase of 241 on the previous year. The program gave information on immunisation, breastfeeding and nutrition, providing a safe environment, and the importance of reading to children.

More staff complete Cultural Practice Program The DDHHS Aboriginal and Torres Strait Islander Cultural Capability Plan has been a key focus in 2014-15. As a result there has been a 43 per cent improvement in the number of staff who have accessed and completed the Cultural Practice Program. In 2014-15, 3,337 staff completed the program which supports staff to provide care in culturally appropriate and sensitive ways.

Consumer compliments up by 55 per centAn important way to improve our service is to make it easy for patients, families and other stakeholders to provide feedback. The DDHHS consumer feedback brochure was redesigned this year to encompass compliments, suggestions and complaints. Additional feedback boxes were installed throughout all facilities and the option to provide feedback via an online form was also implemented.

Implementation of the feedback brochure and staff education to encourage consumers to provide feedback lead to a significant increase across all areas.

Compliments increased by 55 per cent while complaints only increased by 16 per cent between the 2013-14 and 2014-15 financial years.

2013-14 2014-15 % +/-Total Complaints 1,214 1,415 16% +

Total Compliments 1,454 2,256 55% +

A number of improvements were made following suggestions received, these included:

• a central lost property process at Toowoomba Hospital• menu changes • improved lighting on path from Pechey Street to

Toowoomba Hospital entrance.

Focus on safety further strengthenedDDHHS is committed to providing safe and quality healthcare. The delivery of a record amount of activity and services has been undertaken with strong clinical governance and a focus on safety and quality.

A new system designed to streamline the clinical auditing process, while improving safety and quality, was launched in July 2014. The Systematic Approach Facilitates Excellence (SAFE) audit program provided a modular approach for teams and units to assess their compliance against the National Safety and Quality Health Service (NSQHS), EQuIP National, and National Mental Health Standards. Data from the SAFE audits provided meaningful information which has been used to continually improve our service.

Maintaining a robust process of examining and reviewing outcomes of care and clinical incidents also provided the service with the opportunity to learn and implement change to prevent re-occurrence of adverse outcomes. All Severity Assessment Code (SAC) 1 clinical incidents (SAC 1 includes all clinical incidents and near misses where serious harm or death is or could be specifically caused by health care rather than the patient’s underlying condition or illness) were systematically analysed, and recommendations made for improvements. As at 30 June 2015, all corrective actions (improvements) from SAC 1 analyses had been implemented within the recommended timeframes.

Staff training and awareness programs support patient-centred careDarling Downs Learning On-Line (DD-LOL) was implemented in July 2014 and staff embraced the ease of accessibility to a range of training programs via the on-line portal available at the workplace or at home.

New training modules included:

• patient-centred care (introduced in late 2014) - 79 per cent of staff completing the training by the end of June

• sepsis awareness (launched in May 2015) - 78 per cent completion rate for eligible staff by 30 June 2015

• Adult Deterioration Detection System (ADDS) module (launched June 2015) - 51.4 per cent of eligible staff completing the program by the end of June 2015

• infection control training was up 15 per cent on the previous year with 90 per cent of staff completing this module.

17Darling Downs Hospital and Health Service Annual Report 2014-15


Tackle Flu campaign successThe “Tackle Flu Before It Tackles You” program was a partnership between our Public Health Unit, the South West Hospital and Health Service, Darling Downs South West Queensland Medicare Local and the Toowoomba Hospital Foundation.

In 2015, 1,414 Aboriginal and Torres Strait Islander people were vaccinated against the f lu, a 25 per cent increase on the previous year.

Number of ‘Tackle Flu’ vaccinations by year

NUMBEROFVACCINATIONS

325

1,06

4

1,41

4

2012-13 2013-14 2014-15

1500

1200

900

600

300

0

Legendary North Queensland Cowboys football player Johnathan Thurston was the face of this year’s Tackle Flu Before It Tackles You campaign

The Dalby Tackle Flu Before it Tackles You clinic was held at the Aboriginal Medical Service, Goondir. Providing vaccinations was Darling Downs Public Health Unit (DDPHU) nurse Josie Crowe, Goondir Dalby manager Ann-Marie Thomas and Goondir nurse Sylvia Hartman.

Roberta Weribone keeps very still as Karen Brown delivers the fluvaccination.


Improving our local facilities

GOONDIWINDI HOSPITAL PALLIATIVECAREROOM

WANDOAN PRIMARY HEALTHCARECENTRE

STANTHORPEHOSPITAL MATERNITYSUITE

CHERBOURGHEALTHSERVICEWOMEN’SANDCHILDREN’SBUILDING

TOOWOOMBA HOSPITAL ENDOSCOPYSUITE

DARLING DOWNS COMMUNITYCAREUNIT

refurbishment funded by budget surplus delivered more comfortable birthing facilities.

$360,000refurbishment funded by

budget surplus also included a new “quiet room”

$950,000 $1.1M

Commonwealth Government funding delivered new community

mental health facility.

$860,000project brought services conveniently together in

one facility.

$2.2M $11.6Mproject funded by budget

surplus doubled operating capacity.

new, improved facility supported by a $750,000 donation from resource company Glencore.


Financial summaryDDHHS achieved a financial surplus of $20.1 million for the year ending 30 June 2015. This represents a three per cent surplus against a revenue base of $643.4 million. This is the third financial year as a statutory body that an operating surplus has been achieved, while still delivering on agreed major services and meeting and improving key safety and quality performance indicators.

Revenue and expenses – financial year ending 30 June 2015 - $(000)’sRevenue 643,401

Expenses

Labour and employment expenses 433,429

Supplies and Services 164,538

OtherExpenses 4,530

Depreciation and revaluation expense 20,770

Total 623,627

Net surplus from operations 20,134

Where the money comes fromDDHHS total income from continuing operations for 2014-15 was $643.4 million. Of this the State contribution was $397 million and the Commonwealth contribution was $167.1 million. Specific Purpose Grants worth $35.6 million were received and own source and other revenue was $43.7 million.

$433.4MILLIONAYEARSPENTON

STAFF COSTS, MOST FLOWING ONTOTHELOCALECONOMY

$20.1MILLIONSURPLUSTOBEREINVESTEDINCLINICAL

SERVICES,NEWEQUIPMENT,ANDINFRASTRUCTURE

$1.7MILLIONADAYSPENT

ONPROVIDINGSERVICES FOROURCOMMUNITIES

$24.5MILLIONSPENTSOFARINTHREE-YEARBACKLOGMAINTENANCEPROGRAM

Aswespendtaxpayers’moneyandprovideadiverseandextensiveserviceprofile,acrossa wide geographical area, our costs and revenues must be carefully managed. A robust accountingandreportingsystemiskeytoensuringsatisfactoryfinancialoutcomesandcontinuing sustainability.

Commonwealth funding $167.1 million (26%)

Specific Purpose Grants $35.6 million (5%)

Own-source and other revenue $43.7 million (7%)

State funding $397 million (62%)

26%

5%

7%62%

Ensuringresourcesaresustainable


Where the money goesDDHHS operates a complex group of services. The table below shows the proportion of the budget spent on services within DDHHS. Total expenses for 2014-15 were $623.26 million averaging $1.7 million per day spent on servicing the communities of the Darling Downs and South Burnett.

Toowoomba Hospital 37%

Rural Health 34%

Mental Health 12%

Other Professional and Support Services 13%

Depreciation 3%

The largest percentage of spend was against labour costs including clinicians and support staff (73 per cent). Non-labour expenses such as clinical supplies, drugs, prosthetics, pathology, catering, repairs and maintenance, communication and energy accounted for 24 per cent of expenditure. Three per cent of expenditure was related to depreciation of our fixed asset base.

Financial outlookThe surplus generated for the DDHHS in the current financial year will be reinvested for better health outcomes for the community.

Generation of a surplus allows reinvestment into capital building and equipment, but also allows for investment in strategic initiatives and retention of a modest contingency reserve to ensure the DDHHS is well placed to meet the ongoing needs of our growing communities into the future.

Capital infrastructure planning studiesPlanning for new or improved facilities is important to inform long-term infrastructure planning.

During the year, we completed a capital infrastructure planning study (CIPS) for the Toowoomba and Baillie Henderson hospitals. The study explored possible infrastructure options to assist in meeting the DDHHS’s projected health service requirements.

CIPS were also done at several rural sites including Kingaroy, Cherbourg, Chinchilla, Dalby, Miles, Murgon, Stanthorpe and Warwick. The Board has agreed to undertake similar studies at the remaining rural sites in 2015-16.

These studies will be used to prioritise local investments, but also to negotiate with the Department of Health about major capital works projects.

Backlog maintenance programWe reached the halfway mark (48 per cent) in the $50.6 million program of maintenance and rehabilitation works to rejuvenate buildings and other facilities across DDHHS over three years.

The State Government provided the funding to fix the backlog of maintenance work, which is in addition to the service’s regular repairs and maintenance expenditure of around $13 million each year.

Some of the common works have included internal and external painting, plumbing, air conditioning upgrades, fencing repairs, improved security and electrical switchboard upgrades or replacements across the DDHHS.

Toowoomba Hospital’s endoscopy suite expanded

EndoscopyNurseUnitManagerDeniseIseppishowsMinisterforHealth and Ambulance Services the Hon Cameron Dick MP three newly installedendoscopeairingcabinetsatthesuite’sofficialopening.

A $2.2 million project to double the capacity of Toowoomba Hospital’s endoscopy suite was officially opened in May.

The project was funded by the previous DDHHS budget surplus and a $1 million donation from the Toowoomba Hospital Foundation, its largest ever.

The refurbishment provides a new operating procedure room, new wait room and three additional Stage 1 recovery spaces, doubling the previous capacity.


MILES HOSPITAL AUXILIARY HONOURED

The Miles Hospital Auxiliary was recognised for their hard work in making their local facility a better place for families and visitors.

The auxiliary’s longest serving member and current president Ailsa Gilmour (pictured) was presented with the 2014 Prime Super Community of the Year Award at the annual Queensland Regional Achievement and Community Awards Gala Dinner. Ailsa accepted the award on behalf of the auxiliary’s 28 members.

The award recognised the group’s 55 years of service to the rural hospital, including raising almost $400,000 in that time.

For their efforts, the hospital auxiliary received $2,500 and a handcrafted glass trophy.


Ensuringresourcesare sustainable

State-of-the-art spinal bed installedToowoomba Hospital is the fourth hospital in Australia to have taken delivery of one of the purpose built beds. The Legacy Turning Bed has been specifically designed for patients with spinal cord damage or other serious trauma. It’s designed to physically turn a patient without requiring any manual handling of the patient, so there’s no pushing or pulling of the patient.

The bed increases the ability to keep the patient in spinal alignment, while decreasing the risk of further injury, so will be of great benefit to both patients and staff, allowing the Orthopaedic Unit to expand its range of services when caring for patients with severe trauma.

It is also ideal for use when caring for patients with a range of serious injuries including fractured pelvis or multiple limb trauma, and the level of patient comfort it provides also makes it ideal for palliative care.

Additional bariatric equipment available

Senior Occupational Health and Safety Practitioner Leann Mischke (left) and Auxiliary Services Coordinator Steve Taylor show some of the specialist equipment used at Toowoomba Hospital for bariatric patients.

In late 2014, the Board approved the purchase of around 100 pieces of bariatric equipment valued at $400,000 for use across the 20 hospitals in DDHHS. Equipment such as specially made hoists and slings will help staff safely care for patients and not risk injuries to themselves in lifting and turning patients.

Some of the specialist bariatric equipment is rated for patients weighing up to 455kg, with the most common load limits between 250kg and 350kg.

DDHHS records indicate that during 2014-15 there were 848 hospital admissions of patients classified as obese.


Our generous supportersThe Toowoomba Hospital Foundation, rural facility auxiliaries and other groups are very generous in raising funds to buy equipment and provide other support. The following are just some of the many examples.

The Toowoomba Rehabilitation Unit Support Team (TRUST) improved stroke patient access to treatment through functional electrical stimulation (FES). The FES uses a mild electrical current to stimulate muscle movement in limbs or body parts that have been adversely affected by stroke. The machines have proven their worth, with patients already achieving results. Patient Jan Mackay used an FES machine throughout her eight weeks in the unit and said the results were clearly evident. After eight weeks of rehabilitation therapy, including daily sessions with the FES machine, Jan was using her arm to feed herself, brush her teeth and write.

The Taroom Hospital has received a donation of an Accuvein 400 from the Taroom Meals on Wheels Association. The Accuvein 400, valued at $7,000, displays on the surface of the skin in real time, a map of the blood vessels underneath, allowing clinicians to check that veins are not blocked and to avoid valves or bifurcations.

The Tara Hospital Auxiliary also donated an Accuvein 400 and a Rapid No Touch Thermometer to Tara Hospital. The Rapid No Touch Thermometer enables the temperature of a patient to be taken three to five centimetres away from the skin.

The Inglewood Multipurpose Health Service was brightened thanks to a donation of a fish tank. The auxiliary provided $750 to purchase the tank and fish to create some visual simulation for residents and added to the homely feel of the residential aged care area. Residents were given the privilege of naming each of the nine fish.

Proceeds from the annual Toowoomba Children’s Hospital Appeal, run by the Toowoomba Hospital Foundation, were used to fund three Panda Warmers valued at $84,691 designed to keep newborn babies comfortably warm. They will be used in Toowoomba Hospital’s birthing suite.

A band of local knitters presented their first delivery of “comfy cups” to Toowoomba Hospital’s Breast Care Nurse in May. The handmade knitted breasts are designed to be used by women who have undergone a mastectomy.

Members of the East Creek Community Centre knitting and crocheting group supported Toowoomba Hospital’s paediatrics unit by donating handmade pillow teddies, along with beanies for premature babies and knitted caps for palliative care patients.

Inglewood Multipurpose Health Service residential care facility residentsDavidMcLeanandJackElsleywithMelissaMcDowall,DenelleMorrison,WendyWestandafishtankdonatedbyauxiliary members.



Ensuringprocessesareclear

DDHHS leads State in the most number of telehealth consultationsUsing video conferencing to access specialist clinical advice provided more care locally for the highest number of patients ever during the year.

Compared to 2013-14, there was an increase of 78 per cent in telehealth events for admitted patients, while non-admitted patients using telehealth increased by 10 per cent compared to the previous year.

The top services using telehealth were midwifery/obstetrics/antenatal services; pre-admission/anaesthetics; and the orthopaedic clinic.

In addition, telehealth events for mental health services led the State with DDHHS contributing 49 per cent of the telehealth service provision for mental health (7,428 of the total state’s 15,499).

Telehealth saved patients approximately 826 nights away from home and more than 440,000 kilometres in travel.

The first national Rural and Remote Telehealth Conference was held in Toowoomba in October 2014. Hosted by DDHHS, the two-day conference was an opportunity to not only showcase local telehealth achievements, but also a chance for staff members to learn from some of the industry’s leaders.

Telehealth occasions of service - non admitted (excluding mental health)

1,90

4

4,08

1

4,49

8

2012-13 2013-14 2014-15

5000

4000

3000

2000

1000

0

1,137MOREENDOSCOPIES

PERFORMED THAN IN 2013-14

20PATIENTSADAYARE

TREATEDATOURREGIONAL CANCERCENTRE

371TELEHEALTHCONSULTATIONS

EACHMONTH,REDUCING THENEEDTOTRAVEL(EXCLUDING

MENTALHEALTH)

7,428TIMESAMENTALHEALTH CONSULTATIONWASDONE VIAVIDEOCONFERENCE

Darling Downs Hospital and Health Service had a strong focus on seeking opportunities to ensure our care is high quality and in line with consumer and community expectations. This was achieved through a host of collaborative initiatives during the year.

CONSUMERS HELP MAKE PUBLICATIONS

EASY TO UNDERSTAND

Consumer Advisory Group members

A consumer advisory group was established during the year to review DDHHS publications used by patients, consumers or other health service stakeholders.

The group meets monthly and members read each brochure, flyerorothermaterialasit’s produced or revised to make sure it is clear, and easy to understand in terms of language, graphics and design.

The process is important to ensure each publication isfitforpurposeandhelpsachieve Standard 2 – Partnering with Consumers – under the National Safety and Quality Health Service (NSQHS) Standards.

The group has also identified some areas to improve our services or make things easier for patients or consumers.

Some examples have included better car parking, signage, purchase of an electric wheelchair at Toowoomba Hospital for volunteers to transport frail or immobile patients, and the introduction of mobile eftpos processing for the pharmacy.


Cancer treatment partnerships deliver enhanced care In July 2014 the Regional Cancer Care Centre at Toowoomba Hospital celebrated its second anniversary. In that time the centre has developed to provide a range of cancer care services. It has fostered an excellent shared-care relationship with Toowoomba’s St Andrew’s Hospital to provide radiation oncology.

Toowoomba Hospital’s Day Oncology Unit is the region’s only chemotherapy unit that also treats paediatrics, so a good shared-care relationship has also developed with the Children’s Hospital and Health Service in Brisbane.

The 24-bed ward consistently runs at capacity, ref lecting the high demand for its services and the dedication of its team.

In 2014-15 the unit recorded almost 7,207 occasions of service, that is times when a doctor saw a patient.

New primary health network to coordinate careDDHHS, as the region’s major public health care provider, and GP Connections the largest local GP network, were successful in their joint bid to operate the new Primary Health Network (PHN) for the Darling Downs and West Moreton regions.

The partnership between DDHHS and GP Connections brings together the primary and secondary health sectors across the region to deliver on the PHNs main objective to improve coordination of care. The aim is to ensure patients receive the right care in the right place at the right time, avoiding duplication of services and improving integration of health care systems.

The PHN commenced formal operations from 1 July 2015, as an independent non-government entity overseen by a board of directors.

Clinical staff supported with dedicated blood products informationThe creation of a transfusion nurse position assisted DDHHS with managing effective and efficient use of blood and blood products, especially as we transition to a DDHHS-managed blood service.

A new online resource described as a ‘one-stop-shop for all things blood’ was launched in October 2014 to assist clinical staff source information about blood products. The intranet page complements the dedicated role of the blood transfusion nurse who works across DDHHS to promote best-practice management and use of blood products.




Community engagement continues to improve service deliveryCommunity engagement is front and centre of our approach to developing and delivering quality services for people in our region. The Darling Downs Hospital and Health Service has many established engagement processes through hospital auxiliaries, support groups, community meetings, volunteer involvement, community advisory networks and partnerships with non-government organisations.

The Board has a comprehensive program of engagement activities that is detailed in the Board section of this annual report.

In October 2014, DDHHS hosted its first organisation-wide community engagement workshop which involved senior clinical and management staff as well as representatives of consumer organisations.

The workshop participants proposed a number of initiatives to improve patient-focused care. One of the recommendations that has been implemented so far was the rollout of a training module which links patient-focused care to DDHHS values.

Some other community engagement examples during the year included:

• More than 50 head and neck cancer survivors, family members, and medical staff got together for the inaugural Toowoomba Hospital Head and Neck Cancer Support Group meeting in April 2015.

• Toowoomba Hospital’s Mums and Bubs program held a second birthday celebration in March 2015. It followed a special care nursery fun day that was hosted in November 2014.

• More than 60 displays offering the latest health and wellbeing information was on show at the biannual Health and Wellness Expo at Pittsworth in April 2015.

Toowoomba Hospital Special Care Nursery Associate Unit Manager Wendy Carlish (left) with Kim Dixon and Tyson Schmidt enjoy Toowoomba Hospital’s second special care nursery family fun day in November.


Employee awardsThe inaugural Annual DDHHS Employee Awards program was held in January 2015. This recognition program acknowledged employees for excellence in demonstrating our values, delivering our purpose, and striving towards our vision. The ceremony was held to coincide with Australia Day awards to recognise and celebrate the significant contributions our staff make to their local communities either in special projects or through core duties.

Most pleasing for those nominated for awards was that the nominations were received from their peers. This indicates the workforce values their colleagues’ efforts and looks to recognise them.

More than 50 nominations were received across all categories of the awards and from all divisions within DDHHS. Thirty individuals and 24 teams were nominated. A number were nominated in multiple categories. The winners of each category were:

DDHHS Values• Caring – Silvia Snuderl (Assistant Business Manager)• Doing the right thing – Leigh Cantwell (Clinical Nurse)

and Sandra Hilder (Quality Improvement Coordinator)• Openness to learning and change – Darling Downs

Learning On-line (DD-LOL) team comprising Dr Sheree Conroy, Hayley Farry, Kate Jurd, Katrina Henry and Vicki Stenhouse

• Being safe, effective and efficient – Geriatric Adult Rehabilitation and Stroke Service (GARSS) represented by Dr Nisal Gange, Samantha Gollan, Ben Stuart and Michelle Crawford

• Being open and transparent – Daniel McDonald (Librarian)

DDHHS purposeSpecialist Outpatient Referral Centre comprising Linda Maunder, Brenda Schwenke, Dr Debbie Carroll, Tess Wootton, Marianne Leonard, Kylie Peterson, Elizabeth Burton, Rayleen Smith, Melissa Curran and Karen Hoskin.

DDHHS visionEar, Nose and Throat (ENT) team comprising Dr Roger Grigg, Dr Ranit De, Dr Suresh Mahendran, Dr Ross Harrington, Dr Garrett Fitzgerald, Dr Martin Hanson, Dr Andrew Pastuszek, Dr Danielle Witshire, Megan Green and Lyndell Jones.

Inaugural employee awards

Darling Downs Learning On-Line team members won the Openness to Learning and Change category at the inaugural DDHHS EmployeeAwards.Theteamincluded(fromleft)KatrinaHenry,HayleyFarrey,ExecutiveDirectorAlliedHealthAnnetteScott,DrSheree Conroy, Kate Jurd, and Vicki Stenhouse.


In 2014-15, DDHHS employed 4,996 staff and we welcomed 492 new employees to our workplaces. In becoming a valued member of the DDHHS team the first step of any new employee is to have access to the relevant details about their role and that of the organisation. In 2014 DDHHS’s orientation and induction package was redesigned and is now provided via an interactive online platform which delivers a comprehensive information source about the health service. A welcome to new staff by both the Chair of the Board and the Chief Executive with personalised messages in relation to the values, expectations and behaviours within the DDHHS is also included.

The orientation and induction package is hosted on Darling Downs Learning On Line (DD-LOL). This web-based platform is available to all staff to access training requirements from work or home.

Our workforceThe workforce is our most important resource in the delivery of health services. Our clinical workforce includes doctors, nurses, and a wide range of allied health and other professional and technical staff. Effective and efficient service delivery also requires support roles in non-clinical staff, including administrative officers, operational officers and trade staff.

DDHHS’s workforce is aging with 41 per cent of our workforce aged 55 years and over. It is probable that a significant proportion of the current workforce will exit within the next five to 10 years, with nursing being the highest area of risk. In addition, the availability of flexible work options mean more people are working part time. We have an Occupied Full-Time Equivalent (FTE) of 3,916 staffed but a headcount of 4,996 employees with just over 2,000 staff accessing part-time employment status.

We value our workforce and believe that the contribution of skilled and committed professionals across all roles within our organisation ensures that the service is able to deliver quality healthcare to our communities. This requires ensuring that there are sufficientnumbersoftherightstaff,withtherightskillmix,intherightplaceattherighttime to deliver patient-focussed care.

492NEWSTAFFJOINED THEHOSPITALAND HEALTHSERVICE

1 in 56PEOPLEINTHEDARLING

DOWNS AND SOUTH BURNETTWORKFORUS

2,600COMBINEDYEARSOFSERVICECELEBRATEDATLENGTH-OF-

SERVICEAWARDSACKNOWLEDGING30YEARSPLUS

1,159COMBINEDYEARSOFSERVICE

FROMVOLUNTEERSATTOOWOOMBAANDBAILLIE

HENDERSONHOSPITALSANDMTLOFTYHEIGHTSNURSINGHOME

Ensuringdedicatedtrainedstaff


Analysis of the current workforce and key trends provides important information for projecting workforce requirements. The following is a breakdown of the workforce profile within the clinical, professional and support divisions of the DDHHS:

Employees by divisions30 June 2015

MOHRI* Occupied

FTE

MOHRI* Occupied

Headcount Clinical divisions

Toowoomba Hospital 1,426 1,789

Rural and Aged Care 1,535 2,129

Mental Health 550 637

Professional divisions (including Clinical Governance)

Medical, Allied Health, Nursing and Midwifery

231 264

Support divisions

Finance (including Infrastructure) 120 122

Workforce 34 35

Other 20 20

DDHHS Total 3,916 4,996

* Minimum obligatory human resource information

DDHHS in 2014-15 had a retention rate for permanent staff of 93.2 per cent, with a separation rate of 6.8 per cent almost identical to 2013-14 statistics of 93.4 per cent and 6.6 per cent rate respectively which infers a stable workforce ratio. No redundancy, early retirement or retrenchment packages were paid during this period.

Training and educationOur value of “Openness to learning and change” means we recognise the need to be a learning organisation. With a staffing profile of almost 5000 employees, DDHHS recognises that ongoing support mechanisms are needed to build and maintain the skill sets to support this outcome.

DDHHS identified a set of training requirements for all employees in order to meet legislative obligations including orientation; work health and safety programs; cultural practice; ethics, integrity and accountability; and patient-centred care. These are delivered through the Darling Downs Learning On-Line (DD-LOL) system. Role-required training programs designed to meet specific work group requirements such as clinical deterioration, child protection, sepsis and basic life support are also available through the DD-LOL online training platform.

DDHHS staff occupation by percentage

48%

20%

13%

10%

8%

1%

Nursing 48%

MedicalincludingVisitingMedicalOfficers(VMOs) 8%

Professional and technical 10%

Managerial and clerical 13%

Operational 20%

Trade and artisans 1%


DDHHS staff full time/part time/casual

Full-time 49%

Part-time 41%

Casual 10%

41%

49%

10%


DD-LOL has the ability to record and supply training records to both staff and managers which offers DDHHS a single point of truth for training compliance reporting. This improved visibility has resulted in a marked improvement of our compliance rates across all training modules.

Cultu

ral p

ract

ice

DD

HH

S O

rient

atio

n

Ethics,Integrity

and

Acco

unta

bilit

y

Firs

t Res

pons

e Evacuation

Inst

ruct

ions

GeneralEvacuation

Inst

ruct

ions

Infe

ctio

n Co

ntro

l

Wor

kpla

ce H

ealth

an

d Sa

fety

Occ

upat

iona

l Vi

olen

ce

Perf

orm

ance

and

Ap

prai

sal

Mus

culo

skel

etal

D

isor

ders

Patie

nt C

entr

ed

Care

2013-14financialyear 2014-15financialyear

100

80

60

40

20

0

Work health and safetyWe are committed to ensuring the health and safety of all within our workplace by having a robust governance framework and continually working towards improving our safety management system.

We are able to demonstrate our capacity to be the Queensland Health leader for statutory Workcover claims. DDHHS has been below the industry average over the past 14 consecutive quarters, an achievement that no other hospital and health service in Queensland has been able to attain.

Workcover absenteeismHours lost (Workcover hours) versus occupied FTE (staff currently working in a position)

0.40

0.35

0.30

0.25

0.20

0.15

0.10

0.05

0.002013-14 2014-15

Target 0.40

Target 0.35

0.33

0.18

Average paid days per accepted Workcover claimAverage days lost (full and partial) 25

20

15

10

5

0

Target 23.41Target 21.8

18.7

13.44

2013-14 2014-15


Average days to first return to workAverage days taken to secure any form of return to work (time lost claims only)

2013-14 2014-15

Target 21.44

Target 17.1

13.94

11.66

25

20

15

10

5

0

Average monthly payments per accepted Workcover claim

2013-14 2014-15

Target $2,360Target $2,150

$2,150$1,955

2500

2000

1500

1000

500

0



Working for Queensland Employee Opinion Survey (WfQ 2015)DDHHS participated in the annual 2015 Working for Queensland employee survey held in April/May 2015 and 2,235 staff took the opportunity to respond to the survey which was a significant increase in participation from past years.

DDHHS Working for Queensland participation rates

27%

30%

45%

2013 2014 2015

50

40

30

20

10

0

The survey results provide measures of the workplace climate across DDHHS and the wider Queensland public service agencies. It explores insights to employee engagement, job satisfaction and leadership within our organisation benchmarking to like agencies.

The 2015 WfQ results for DDHHS showed positive improvement in areas of employee engagement, job security, performance assessment, organisational leadership and organisational trust.

It is recognised that employee engagement plays a vital role in organisational performance. Through surveys such as these, value is placed on the responses and consultative action planning occurs with staff to continue to work on identified areas that require improvement.

Staff length of service awards A ceremony was held for those employees who have reached 30, 35, 40 and 45 years of service in the past 12 months to formally recognise the dedication of these long-serving employees.

Eighty-one employees including nurses, administration officers, wards persons, a psychologist, plaster technician and dental technician were honoured for more than 2,600 combined years of service.

DDHHS staff length of service awards are held each year to coincide with Queensland Week in June. In 2014-15 the DDHHS acknowledged 724 employees for 5, 10, 15, 20, 25, 30, 35, 40 and 45 years of service.

Years of Service Number Awarded5 229

10 165

15 82

20 92

25 75

30 53

35 20

40 6

45 2

TOTAL 724

VolunteersOver many years an extraordinary number of volunteers have freely contributed their time and energy to assist our patients and relatives. Volunteers enhance the core services provided by our staff. Their generosity of spirit and willing approach adds to the welcoming atmosphere of our health services and assists in contributing to a positive experience for patients, their families and visitors.

We are lucky to have 192 volunteers who give their own time to help others at Toowoomba Hospital, Baillie Henderson Hospital, and Mt Lofty Heights Nursing Home. Between them, these volunteers have provided 1,159 years of service. There are also many more volunteers who contribute greatly to our rural and aged care facilities.

We have more than 260 volunteers across our health service, each of whom give their own time to help others.

Each year we hold a ceremony during Volunteers Week to thank our volunteers and present certificates of appreciation. This year Oakey Hospital’s long-term volunteer George Lipman was acknowledged for his ongoing support of the rural facility.


Our organisation

TheHealthServiceChiefExecutive(HSCE)isaccountabletotheBoardforallaspects of DDHHS performance, including the overall management of human, materialandfinancialresourcesandthe maintenance of health service and professional performance standards.

To ensure the efficient and effective operation of the service, the DDHHS organisational structure functions through a Divisional model. Each Division has specific responsibilities and accountabilities, but function in partnership to deliver health services to our communities.

Clinical divisionsThere are three clinical divisions. These divisions lead in the delivery of high quality, evidence-based, safe patient care. The divisions work in a collaborative manner to provide integrated patient care across the continuum and geography of DDHHS.

• Toowoomba Hospital operates with four clinical services groups - Surgical, Medical, Ambulatory Care Support Services and Women’s and Children’s Services. In addition Facility Services for Toowoomba Hospital and Baillie Henderson Hospital are operationally aligned to this division.

• Rural Health operates 18 hospitals (three of which are multi-purpose health services), five outpatient clinics and six residential aged care facilities. The division is managed via a cluster model with three geographic clusters (Southern, Western and South Burnett) and a cluster for residential aged care services. In addition Oral Health Services for DDHHS are operationally aligned to this division.

• Mental Health includes child and youth, adult and older persons, acute inpatient services at Toowoomba Hospital, and community services in Toowoomba and a range of rural centres. Mental Health services for consumers who require extended treatment and rehabilitation, are provided at Baillie Henderson Hospital, Toowoomba. In addition the Alcohol and Other Drugs Service for DDHHS is operationally aligned to this division.

Professional divisionsThe clinical divisions are supported by three professional divisions. The professional divisions lead DDHHS in promoting clinical service improvement, consumer satisfaction, clinician engagement, clinical governance, professional and clinical standards and clinical workforce planning and education:

• Medical Services includes Medical Workforce, Medical Education, Clinical Governance, Rural and Remote Medical Support, Health Information Services, Pastoral Care, and Public Health.

• Allied Health provides professional leadership for Allied Health Services (including workforce planning, education and standards). This division also includes the Cunningham Centre (Registered Training Organisation), BreastScreen, Mobile Women’s Health services, and the Aged Care and Home and Community Care (HACC) Assessment Team

• Nursing and Midwifery provides professional leadership for Nursing and Midwifery Services (including workforce planning, education and standards).

Support divisionsThe support divisions work in collaboration with the clinical and professional divisions in supporting the provision of high quality, evidence-based, safe patient care.

• The Finance Division provides DDHHS-wide support functions comprising Financial Control, Management Accounting, Commercial Management, and Infrastructure and Planning to optimise quality health care and business outcomes.

• The Workforce Division supports the organisation to deliver on the key priority of ensuring a dedicated trained workforce. The division is responsible for supporting managers in » Embedding a values-based culture » Planning for, recruiting and retaining an

appropriately skilled workforce » Development, education and training of the

workforce » Employee engagement for improvements of the

service » Promotion of employee health and wellbeing.


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SomeofToowoombaHospital’semergencydepartmentteam(fromleft)ErinFrost,DrPaulFerguson, Yaana Watts and Andrea Hewett, who helped achieve more than eight in 10 patients being admitted, discharged or transferred within four hours.


Divisional reports

Toowoomba HospitalToowoomba Hospital operates with four clinical services groups - Surgical, Medical, Ambulatory Care Support Services, and Women’s and Children’s Services. Facility Services for Toowoomba and Baillie Henderson hospital are also operationally aligned to this division.

Highlights for the year included:

• outpatients wait list reduced by 56 per cent, including long wait patients reduced from 4,788 to 17

• endoscopy long wait patients reduced from 1,478 patients waiting to zero• second endoscopy suite commissioned• record number of elective surgery patients treated with a 19.7 per cent

increase on prior year.

Toowoomba Hospital emergency department continued to improve against the National Emergency Access Target (NEAT). On average during 2014-15, 82.5 per cent of patients presenting to the emergency department were admitted, discharged or transferred within four hours, with a record high of 85.2 per cent achieved in April.

This ongoing improvement was achieved despite a three per cent increase in people (1,412 increase for the year) presenting in 2014-15 compared to the previous year. Importantly, this was achieved while maintaining safety and quality. Patient re-admission rates have not increased during the year, indicating they had not been discharged too quickly.

49,406PATIENTSTREATEDINEMERGENCY

DEPARTMENTTHISYEAR

101,603ADMITTEDPATIENTBEDDAYS

133,059OUTPATIENTOCCASIONSOF SERVICE(INCLUDING25,514 ALLIEDHEALTHSERVICES)

1,941BABIESDELIVEREDTHISYEAR.


Toowoomba Hospital National Emergency Access Target (NEAT) per cent

2012-13 2013-14 2014-15

73.1

%

80.3

%

82.

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80

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Toowoomba Hospital emergency presentations

2012-13 2013-14 2014-15

45,4

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47,9

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49,4

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50000

40000

30000

20000

10000

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The NEAT success was due to a number of factors including increased medical and nursing staff, support from other parts of the hospital in admitting patients in a timely way, and the trial of a new ‘nurse pilot’ role.

Toowoomba Hospital elective surgery procedures

6000

5000

4000

3000

2000

1000

02012-13 2013-14 2014-15

3,86

2

4,79

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Maintaining National Elective Surgery Targets (NEST) remained a key focus for the Toowoomba Hospital. In 2014-15 5,740 elective surgery procedures were performed which was 944 more than in 2013-14. Of these, 99.8 per cent were provided within the clinically recommended timeframe.

A number of strategies helped achieve this success, including the introduction of weekend surgery sessions for some specialities.

Two other major challenges were overcome during the year – increasing the number of endoscopies performed, and reducing the outpatients’ waiting list.

There was an 86 per cent reduction in the endoscopic waiting list (1,751 patients to 244), with no one waiting later than clinically recommended.

Over 2014-15, the outpatient waiting list reduced by 56 per cent (5,028 patients), including a reduction in long-wait patients from a total of 62 per cent in July 2014 to less than one per cent in June 2015.

Patients in need of corrective facial surgery were able to access a range of services following the appointment of oral-maxillofacial surgeon Dr Duncan Campbell (pictured below) who started at Toowoomba Hospital in early 2015.

The new local services include corrective surgery for trauma to the face, orthognathic ( jaw corrective surgery), and surgery to deal with sleep apnoea. Previously, patients would have travelled to PA Hospital in Brisbane to receive care.

Toowoomba Hospital’s Geriatric, Adult Rehabilitation and Stroke Service (GARSS) led the State across a range of performance indicators. Toowoomba Hospital is the only facility on the Darling Downs to offer an acute stroke unit and lysis (clot-busting thrombolysis) service seven days a week.

Lysis treatment isn’t applicable to all strokes, but if eligible patients are provided with lysis treatment within four-and-a-half hours of having a stroke their chances of recovery are significantly increased. Our average ‘door-to-needle time’ (time between the patient presenting

Divisional reports


ROBOTIC ENT SURGERY IMPROVES PATIENT OUTCOMES

Toowoomba Hospital patient Mervyn Pennell received state-of-the-art surgery at St Andrew’s HospitalbyENTsurgeonDrSuresh Mahendran.

A new partnership between Toowoomba Hospital and the city’s St Andrew’s Hospital using robotic-assisted surgerywasthefirstofitskind in Queensland.

It enabled state-of-the-art ear,noseandthroat(ENT)surgery to be performed on public patients, rather than conventional open and laparoscopic procedures.

By using the technology, patients can expect a shorter hospital stay, faster return to normal daily activities, reduced risk of infection and disfigurement,andalesspainful recovery.

This arrangement not only enables patients to access modern surgical practices but it also increases the skills of our clinicians working at the Toowoomba Hospital.

at emergency and receiving the lysis injection) is 57 minutes. The national average is 87 minutes.

Ben Stuart, A/Senior Physiotherapist, helps members of the GARSS balance through their rehab and recovery.

The stroke service’s expected in-hospital mortality rate is considerably lower than that recorded across 45 similarly benchmarked hospitals throughout Australia and New Zealand. The expected mortality rate is 10.14 per cent while Toowoomba Hospital sits at 3.8 per cent.

A second geriatrician, Dr Kurugamage Wijayaratne, started at Toowoomba Hospital in February 2015.

Dr Kurugamage Wijayaratne works alongside fellow geriatrician Dr Nisal Gange to support the orthogeriatic services offered at the hospital including stroke recovery, the Geriatric Evaluation and Management Service (GEMS) program, and the service’s memory clinics. Before his arrival, memory clinics were held twice a month. This increased to twice a week.

Facility upgrades helped provide better care to patients and improved working environments for our staff.

The $2.2 million Toowoomba Hospital endoscopy suite refurbishment project included a new operating procedure room, a new waiting room and three extra Stage 1 recovery spaces, giving the unit six in total.

The expansion also included renovations to existing utility rooms; refurbishment of Stage 2 recovery and waiting area bathrooms; new storage facilities, new staff facilities and bathrooms; and installation of state-of-the-art endoscope drying cabinets.

Toowoomba Hospital Foundation donated its highest amount ever, $1 million, towards fitout of the suite.

Divisional reports


A major project to rejuvenate 24 buildings on the Toowoomba Hospital campus was undertaken. The $2.2 million extensive external revamp included painting and other repairs.

Separate works included air-conditioning upgrades, repair and resurfacing of the roadway at the main campus entrance off Pechey Street, fencing repairs, removal of redundant steam pipes, a replaced main switchboard to enable an increase in capacity, and replacement of three elevators.

More than $440,000 worth of funding for equipment purchases for Toowoomba Hospital was made available by the Board in February to help in the delivery of better health care for patients.

Purchases included:

• orthopaedic saws and drill sets (including attachments) for increased orthopaedic surgery

• an ultrasound machine for Transrectal Ultrasound (TRUS) guided biopsy for best-practice prostate surgery diagnosis and surgical management.

The Toowoomba Hospital Consumer Advisory Group (CAG) was established and met monthly. The membership includes representatives from the community, Toowoomba Hospital and the clinical governance team.

During the year the group focused on car parking, signage, consumer documents, and volunteer services. Two of the outcomes included:

• advocating for the Guiding Stars volunteers to have an electric wheelchair to transport patients within the hospital as the traditional wheelchair was difficult for some volunteers to use.

• providing feedback to the pharmacy, which now offers mobile eftpos processing, to make paying accounts convenient for patients.

CAG members and volunteers conduct a discharge survey that is collected on an iPad for a number of patients each weekday. This feedback is available daily and allows for any follow-up by Toowoomba Hospital staff quickly. It also shows any trends that are occurring in clinical services or clinical environments.

Facility Services recorded a major milestone with the Baillie Henderson Laundry processing almost 1.2 million kilograms of laundry during the year.

The 1,194,000kg was up 177,000kg on 2013-14 and included a weekly average of:

10,500 towels

8,200 sheets

6,500 pillow cases

2,600 blankets

2,150 sets of scrubs

725 pyjamas.

Operations Manager Linen Services Terry Harris shows the new chemical injection system installed at the Baillie Henderson Hospital laundry in early 2015.

The service has a weekly throughput of around 230 tonnes, handling linen from Baillie Henderson, Toowoomba and Oakey hospitals, Mt Lofty Heights Nursing Home, and flat linen from our South Burnett facilities, plus a small amount for Queensland Police Service and Queensland Ambulance Service.

Divisional reports

EnrollednurseRhondaBallinpreparesthetheatreaheadofscheduledsurgeriesatKingaroy Hospital.


Divisional reports

Rural DivisionRural Division operates 18 hospitals (three of which are multi-purpose health services), five outpatient clinics, and six residential aged care facilities. Oral health services are also delivered through this division. Highlights for the year included:

• successful re-accreditation for three years of all our residential aged care facilities (RACFs)

• re-invigoration of permanent full-time birthing services at Chinchilla• improved infrastructure at several facilities including refurbished

maternity suite at Stanthorpe Hospital, improved palliative care and quiet room at Goondiwindi Hospital, a new single building for women’s and children’s services at Cherbourg, and the official opening of Wandoan’s Primary Health Care Centre.

More care locally was achieved through:

• Kingaroy Hospital provided more public general surgical services than the previous five years. The activity for general surgery increased by 15 per cent from 2013-14. The number of endoscopy procedures was an all-time high with 636 performed, an increase of 118 from the previous year. All “long wait” patients for not only the surgical service but outpatient specialist appointments were also cleared at Kingaroy Hospital. The facility is well positioned to provide services for general surgery within the clinically recommended timeframes.

99,774PATIENTSTREATED

INRURALEMERGENCYDEPARTMENTSTHISYEAR

1,926MUMS AND BUBS VISITS,

ARECORDNUMBER

$840,000FROMBUDGETSURPLUS

FOR RURAL FACILITY EQUIPMENT

53,429DENTALPROCEDURESDELIVERED.


• Nanango and Kingaroy hospitals started a post-discharge phone call service to inpatients within 72 hours of discharge. This service was implemented in response to patient feedback provided in patient experience surveys. The service has been well received by patients and provides patients/carers with an opportunity to ask any questions that they may have thought of since they returned home. It also provides an opportunity for staff to remind patients on what follow-up care they may need.

• Increased medical and nursing staff were allocated to Warwick Hospital to improve services.

• The establishment of a Palliative Care Coordinator position in the South Burnett provided much-needed support to the local community. Within a couple of weeks of operation, referrals had more than tripled into the service.

Improved facilities and equipment enabled better care for patients. Highlights included:

• Stanthorpe Hospital underwent a $1.1 million upgrade funded from DDHHS surplus to improve its maternity unit. The maternity suite is now equipped with soundproofing, telehealth capabilities, showers and a birthing pool.

• $360,000 was spent on the redesign of the palliative care room and new quiet room at Goondiwindi Hospital funded from a DDHHS budget surplus. The work was undertaken by a local company and was the result of extensive community engagement. The room enables terminally ill patients to stay closer to their friends and family during their end-of-life care. Kind donations from the hospital auxiliary and the community helped purchase a specially designed palliative care bed and other equipment and furnishings for the rooms.

• A formerly empty building at Cherbourg Health Service came full circle with the re-establishment of services for women and children in the one space. The large refurbished building, located on the campus, now has three ‘fit-for-purpose’ clinical areas, as well as modern meeting rooms, waiting room and a reception area. The $860,000 project was funded by DDHHS and the Department of Health and was was officially opened by DDHH Board Chair Mike Horan AM in February 2015.

Community elder Kathryn Hopkins (left), Cherbourg Aboriginal Council Shire Mayor Cr Ken Bone and DDHH Board Chair Mike HoranAMtheofficialopeningofCherbourg’sWomen’sandChildren’s Service facility.

• The pride of the Wandoan community was on show during the opening of the Primary Health Care Centre in October 2014. The $950,000 centre was officially opened by DDHH Board Chair Mike Horan AM. The building offers videoconferencing and state-of-the-art telehealth capabilities. It replaced an ageing outpatients’ clinic, offering a new model of health care not previously available to residents of Wandoan and surrounds. Resource company Glencore contributed $750,000 towards the construction of the clinic, with additional funds coming from DDHHS and the Western Downs Regional Council through a community grant.

• Other infrastructure works included: » asbestos removal in a variety of rural hospitals » refurbishment of the kitchen at Texas

Multipurpose Health Service » replacement of nurse call systems at Tara,

Goondiwindi, Millmerran, Taroom, and Chinchilla » hydraulic works at Goondiwindi and stormwater

drainage and road works at Stanthorpe » roof replacement on buildings at Stanthorpe and

Tara hospitals » resurfaccing of roads, external painting,

replacement of floor coverings at Tara and Jandowae hospitals

» replacement of electrical infrastructure at Murgon, Jandowae, and Tara hospitals.

• More than $840,000 worth of funding for equipment purchases for rural hospitals was made available by the Board in February to help deliver better healthcare for patients.

Divisional reports

Purchases included: Pressure redistribution mattresses, vital signs monitors, telehealth equipment, vaccine fridges, steriliser, electrocardiographs, scanners, mobility aids, defibrillator, armchairs, ultrasounds and range of other clinical equipment items.

The Patient Travel Subsidy Scheme (PTSS) provides assistance to patients, and in some cases their carers, to enable them to access specialist medical services that are not available locally. The PTSS supported more patients than ever before.

Last year (2013-14)

This year (2014-15)

Number of patients 9,792 9,896

Number of claims 29,671 31,263

Number of nights 48,415 47,907

Total reimbursement $6,006,678 $6,395,615

Oral healthDDHHS maintained the achievement of no dental patients waiting longer than clinically recommended for routine treatment during the year. Around eight in 10 patients waited less than a year (up to two years is the recommended timeframe).

Oral health services achieved many outcomes during the year including:

Reduction of school recall times • School dental revisit times reduced from over four

years to under two years in Southern Downs• Recalls for school dental services reduced from five

years in South Burnett to just over three years. • Recalls for school dental services reduced from 31

months in Western Downs to 19 months.

Reduction in waiting lists • Oral health assessment waiting lists for adults reduced

to under 12 months for whole of Southern Downs• Patients needing dental treatment under a general

anaesthetic reduced to 24 on the waiting list• Only one in 10 of general waitlist patients on the

Western Downs waited more than one year, while in the South Burnett one in five waited more than a year

• Waitlists for prosthetics are under a year in the South Burnett

Other achievements• The Tara Oral Health Committee was formed,

bringing together all stakeholders to improve provision of oral health services to the area.

• Cherbourg offered appointments to 76 per cent of children and worked successfully with community health to ensure attendance.

• Greatest exposure for many years of oral health promotion activities to Cherbourg and other areas in South Burnett and Western Downs, including health expo events and oral health promotion events in playgroups, day care facilities, and schools.

• Warwick Hospital’s dental clinic also received a new shipment of chairs. The chairs are specially designed to support dentists and dental assistants as they work on patients. The chairs can be adjusted for each person, and are designed to support the backs of staff as they work.

• The “Healthy Mouth, Healthy Me” travelling expo visited several Southern Downs locations in August, spreading the message of good oral hygiene and its importance for overall wellbeing. The expo featured a variety of fun activities for children such as storytelling with the tooth fairy, face painting, germ busting, craft activities, balloon art and science experiments to show the effect of acid on teeth.

Tooth fairy and Warwick Oral Health Therapist Jo Gratton shares the message of good oral hygiene to prep school student Rhiannon Gaal at a health expo in Millmerran.

• General anaesthetic dental procedures were reintroduced at Warwick Hospital. This move benefits patients, mostly children, who are ordinarily too anxious or nervous to be treated in the dental chair. Previously, patients had to travel to either Stanthorpe or Toowoomba to have their treatment carried out in an operating theatre.


Divisional reports

Aged careWe cared for more than 300 people a day in our residential aged care facilities (RACFs) or multipurpose health services. This equated to a total of 100,951 bed days in our aged care facilities, including 1,253 respite bed days, and 11,233 bed days at multipurpose health services.

One of the main highlights for 2015 was the successful re-accreditation of four of our RACFs. These were Dr EAF McDonald Nursing Home at Oakey and Mt Lofty Heights in Toowoomba who underwent the process in March, Milton House at Miles in April, and The Oaks at Warwick in May. These facilities are now fully accredited until 2018. Karingal RACF at Dalby and Forest View RACF at Wondai were accredited for three years in 2013 and 2014 respectively.

The past financial year saw many changes within the aged care sector including the introduction of legislative changes to accommodation payments from 1 July 2014. A new residential and accommodation agreement was compiled and standardised to meet these changes and was put in place in all six RACFs. This also included publishing our maximum accommodation prices on the My Aged Care website.

The Home and Community Care (HACC) program provided funding for services which support frail older people, younger people with disabilities, and their carers. These services provide basic support and maintenance to people living at home and whose capacity for independent living is at risk, or who are at risk of premature or inappropriate admission to long-term residential care.

During the year, 148,621 HACC client hours were delivered, of which 4,382 (2.9 per cent) were identified as Aboriginal or Torres Strait Islander.

DDHHS TELEDENTISTRY PROGRAM A

QUEENSLAND FIRST

DentaltechnicianEilleenShepherdwith resident Daphne Hintz.

A new teledental program was rolled out to help aged care residents access oral health treatment.

Using a specially designed camera probe and video conferencing equipment, the program enables an oral review of aged-care residents wherever they are located, without the need for travel or too much disruption of the daily routine.

Real-time video images of the resident’s mouth, teeth and gums are transmitted to Toowoomba Hospital’s Oral Health clinic where dentists conduct the reviews.

Millmerran Multipurpose Health Service (MPHS) resident Daphne Hintz was the firstpatienttostepintotheteledental chair at Millmerran.

“Daphne didn’t quite know what to expect, but we talked her through the process,” Millmerran MPHS Director of Nursing Cath Frame said.

“In the end she was amazed at the technology and was glad she didn’t have to travel to Toowoomba for the appointment.”

The teledental program, the firstofitskindinQueensland,started in the DDHHS at at Toowoomba’s Mt Lofty Heights Nursing Home earlier in 2015.

Milton House resident Gwen Williams and Clinical Nurse Di Tong at the residential aged care facility.


Divisional reports

Psychiatrist Dr Ashar Imam gets ready to conduct a telehealth consultation.


Mental HealthMental Health includes child and youth, adult and older persons, acute inpatient services at Toowoomba Hospital, extended treatment and rehabilitation services and Baillie Henderson Hospital and community services in Toowoomba and a range of rural centres.

The Alcohol and Other Drugs Service (AODS) for DDHHS is operationally aligned to this division.

The Mental Health Service received 6,976 new referrals within the year with 59,681 clinical interventions provided for these clients. There were 226,927 episodes of community care provided across the service.

The adult acute inpatient unit at Toowoomba Hospital had 1,196 admissions compared with 1,151 last year. This represented 16,195 occupied bed days. The average length of stay was 8.9 days for the year – below the target of 9.1.

The Yannanda Adolescent Unit had 184 admissions throughout the year (207 last year) with 1,991 occupied bed days at 68 per cent occupancy.

Baillie Henderson Hospital discharged 31 people who returned to successful community living during the year. The facility recorded 44,620 occupied bed days at 87.5 per cent bed occupancy.

74 per cent of patients were followed up within one and seven days following discharge from inpatient care. The is well above the State target of 60 per cent. Four in five discharge summaries to GPs were completed within 48 hours.

Divisional reports

RECOGNISING DDHHS STAFF CONTRIBUTIONS

(From left) Alex Blonski, Merelyn Dowdle, and Sarah-Jane Auchter with their awards.

A number of staff from the Toowoomba Acute Mental Health Unit (AMHU) were recognised at the inaugural Toowoomba Clubhouse Mental Health Week awards in October.

The AMHU Group Program (Activities) nurses were recipients of a Recovery Ambassador Award, which recognised the tireless efforts of individuals who actively support the recovery of consumers who access Clubhouse. The group received a stone award made by Clubhouse members.

Three Group Program (Activities) staff were also individually recognised. Merelyn Dowdle (Registered Nurse), Sarah-Jane Auchter (Clinical Nurse) and Alexandra Blonski (Clinical Nurse) received Recovery Ambassador Award certificatesin‘recognitionof valuable contributions to mental health recovery in the Toowoomba community’.

The recipients were nominated and voted for by Clubhouse members.


Specialist mental health care was also provided through videoconferencing technology during the year. There were 7,428 episodes of telehealth assessments and treatment, which was a 33 per cent increase on 2013-14 and constituted 49 per cent of mental health telehealth consultations across the State.

Mental health telehealth consultations

8000

7000

6000

5000

4000

3000

2000

1000

0

4,57

9

5,84

3

7,42

8

2012-13 2013-14 2014-15

The Mental Health Division implemented a centralised phone system for access to its services. From 1 December 2014, new referrals needing to contact mental health services in DDHHS used the phone number 1300 MH CALL (1300 64 22 55). The 1300 number is part of a state-wide initiative which provides a triage response that is managed by the Acute Care Teams located in Toowoomba and Warwick.

The Division of Mental Health has well established consumer engagement mechanisms via community groups and committees, consumer and carer consultants and peer support programs. In 2014-15 a Carer Advisory Group was established to provide feedback on service delivery from a carer perspective.

The Mental Health Service also delivered five Mental Health First Aid courses to improve the mental health literacy of the community. The course provides practical information on different ways of helping people in mental health crisis situations, as well as those in early stages of mental health problems.

Divisional reports

Baillie Henderson Hospital provides mental health services for consumers who require extended treatment and rehabilitation. Baillie Henderson Hospital celebrated 125 years of providing mental health care in May.

The Minister Health and Minister for Ambulance Services the Honourable Cameron Dick MP and two of special guests – the granddaughters of the hospital’s first medical superintendent Dr James Hogg – planted a bottle tree to mark the occasion. Staff and consumers also enjoyed an afternoon tea with the Minister.

Guests also celebrated at a 125th anniversary dinner dance which included a keynote address by Board Chair Mr Mike Horan AM.

The Minister for Health and Minister for Ambulance Services the Honourable Cameron Dick MP officially opened the newly constructed Community Care Unit (CCU) in Toowoomba in May 2015.

The opening of the CCU is part of a worldwide shift towards community-based models of mental health care which offers contemporary, recovery-focused programs.

The CCU will be staffed 24 hours a day by trained mental health professionals. Consumers will be supported to regain skills but also have the freedom to start making some of their own decisions as they progress towards independent living as they recover from mental illness.

The architecturally designed facility comprises 24 one-bedroom villas with some common rooms and parking areas. Construction was funded by the Commonwealth Government at a project cost of $11.6 million.

Baillie Henderson Hospital Director of Nursing Kaye Carncross andClinicalDirectorDrKarenBrownattheofficialopeningofthe new community care unit.


Divisional reports

Nursing and MidwiferyThe Nursing and Midwifery division provides professional leadership for Nursing and Midwifery Services (including workforce planning, education and standards).

DDHHS employs around 1,750 Full Time Equivalent (FTE) nurses and midwives. As many nurses work part time this number equates to more than 2,400 nurses who care for patients and consumers across the service.

Nurses and midwives make up the majority of our workforce and are integral to making decisions on the ground – or on the ward or community nursing setting – that help us get the best value from our funding to provide care to as many people as possible.

While individual facilities celebrated International Day of the Midwife on 5 May 2015, most DDHHS events to acknowledge and applaud the work of nurses and midwives were held on International Nurses’ Day (IND) on 12 May 2015.

The International Council of Nurses’ IND theme for 2015 was: Nurses: A Force for Change: Care Effective, Cost Effective. DDHHS took this opportunity reflect on nurses’ and midwives’ roles in providing safe and quality care while also effectively managing resources.

2014-15 saw a change in leadership of the nursing and midwifery profession for DDHHS.

Ms Judy March retired as the Executive Director of Nursing and Midwifery after 48 years in the profession, the last 14 of those in our health service. Ms Robyn Henderson took over the role in December 2014.

Graduate nurses attended an orientation day in late 2014 ahead of starting their new careers with DDHHS.


Divisional reports

Rural and Isolated Practice Registered Nurse (RIPRN) is a scheduled medicines endorsement for registered nurses (RNs) who work in rural and remote locations. In 2014-15, DDHHS’s training organisation, the Cunningham Centre, had the highest number of RIPRN students enrolled in the one year.

More than 80 nurses from Queensland, Torres Strait and New South Wales got together for the RIPRN Forum in late October. In addition to presenters from DDHHS, the forum also featured presentations by representatives from a broad cross-section of the nursing profession including the Deadly Ears program (hearing issues in Aboriginal and Torres Strait Islander children); Mayo Health Care; Pathology Queensland; Laerdal (medical equipment manufacturer); Queensland Nurses’ Union; and Mandy Dederer from DDHHS Public Medicine.

The Defence Force piloted the centre’s RIPRN program for RNs. The pilot was extremely successful with a proposal made for all RNs working in Defence to complete the program.

Johnson’s Baby Midwife of the Year for Queensland was awarded to a midwife from Toowoomba Hospital for third year in a row. This year’s winner was Donna Cooper.

Twenty-five graduate nurses began in their new roles in February working across the health service in a variety of locations including Toowoomba, the South Burnett, Warwick, Texas, Oakey and Dalby.

In the South Burnett, eight first-year registered nurses (RNs) rotated through the Kingaroy, Murgon, Cherbourg and Wondai hospitals. The year-long graduate nurse program provides them with an overview of the diversity of public health care in the local area.

The Business Planning Framework (BPF): A Tool for Nursing Workload Management is the industrially mandated methodology to ensure safe and sustainable nursing and midwifery workloads. It provides nurses and midwives with a business planning process to help determine appropriate nursing staff levels to meet service requirements, and evaluate the performance of the nursing service.

It is a move away from historical staffing establishment ratios, to a method based on a demand and supply approach that is responsive to the changing healthcare delivery environment and the subsequent nursing resource requirements.

A recent review using the BPF at Warwick Hospital identified a number of new opportunities to increase nursing staff and responsibilities. The appointment of extra nurses came after the Board approved the recruitment of four additional doctors for the hospital’s emergency unit late last year.

Nursing leadership was strengthened with the addition of three nursing directors. Ms Susanne Pearce was appointed to an education directorship role, while Ms Ali Broadbent and Ms Lynn Boundy took up senior clinical governance positions.

DALBY HOSPITAL MIDWIVES BECOME INTERNATIONALLY

QUALIFIED LACTATION CONSULTANTS

Dalby midwives (from left) Anne Lane, Alison Fels, Danita Driscoll, Kerry Noller, and Melinda Daniels were recognised for their efforts to become accredited lactation consultants at the DDHHS EmployeeAwards.

Five midwives at Dalby Hospital underwent a 12-month course in preparation for the International Lactation ConsultantExamwhichisheld annually on the same day across the world.

The high interest from local midwives meant a facilitator was able to provide the course in Dalby, negating the need for them all to travel.

Allfivesuccessfullypassedthe exam to become internationallyqualifiedlactation consultants and have the most up-to-date knowledge about breast feeding.

Previously, local women had to travel to Toowoomba or Brisbane for the services our Dalby-based lactation consultants can now provide.

The Dalby midwives were recognised for their efforts at theDDHHSEmployeeAwardsasfinalistsinthe‘opennesstolearning and change’ category.


Divisional reports

Medical ServicesThe Medical Services division includes Medical Workforce, Medical Education, Clinical Governance, Rural and Remote Medical Support, Health Information Services, Public Health, and Pastoral Care.

The division faced some challenges in the past year with the formation of an ebola management group to develop preventative measures and processes to ensure that any suspected cases of ebola could be managed appropriately and safely. In collaboration with the Alcohol and Other Drugs Service, the division also led the implementation of a smoke-free environment across all DDHHS facilities, in compliance with changes to state legislation.

The division has also assisted in hosting two Clinical Leaders’ Engagement Forums in February and June 2015, with the themes of “Aged Care” and “Obesity”. These forums were designed to reinforce discussions that occur in the Queensland Clinical Senate and stimulate thoughts and ideas about how clinicians can lead changes for better healthcare services for patients in DDHHS and the community.

A major achievement for the ongoing development of medical professionalism and leadership for all senior medical officers was the commencement of the medical leadership program that included a 360° feedback component. Sixty-six senior medical officers across the Toowoomba and Baillie Henderson facilities completed the program.

Clinical governanceThe Clinical Governance Unit grew with patient safety officer positions successfully recruited to in Toowoomba Hospital and three of our rural clusters. This assisted the unit to meet its key performance indicators and deliver an unprecedented zero overdue Severity Assessment Code (SAC) 1 and 2 reports, for DDHHS.

Clinical incident management remains a priority for DDHHS. Information on the Queensland Adult Deterioration Detection System (QADDS) and sepsis detection tools and modules were rolled out across the health service through DD-LOL in an effort to prevent clinical incidents and better support our clinical and nursing staff with practical resources.

The Clinical Governance Unit oversaw the successful Australian Council on Healthcare Standards (ACHS) and International Organization for Standardization (ISO) accreditation, against all 10 National Safety and Quality Standards and the National Standards for Mental Health Services.

KingaroySeniorMedicalOfficerDrBrendanCarrigan(right)was presented with his completion of Rural Generalist Training award at the Rural Doctors Association Queensland (RDAQ) Conference in June. He received his award from Dr Denis Lennox, Director Rural and Remote Medical Support and Associate Professor Lucie Walters, President of Australian College of Rural and Remore Medicine (ACRRM).


Divisional reports

The ‘End-of-Life’ working party developed strategies and facilitated discussions across DDHHS with GPs about the importance of patients and their families to consider what extent of care they want towards the end of their life, especially by capturing these views in advance care plans.

To facilitate these messages Toowoomba Hospital, in conjunction with Medicare Local, hosted two ‘End of Life’ twilight evenings, stimulating the initiative behind these new reforms to manage the advanced care plans for our ageing population.

As a culmination of the work and dedication of the involvement of the DDHHS staff and the wider community of GPs, the ‘Advanced Care Planning’ charter was devised.

There was increased infection control surveillance and support with the creation of a Clinical Nurse Consultant (CNC) rural infection control position.

Antibiotic stewardship across DDHHS was implemented by Dr Kathryn Wilks, infectious disease physician, to ensure that clinicians use antibiotics appropriately so that the development of antibiotic resistance is minimised.

Rural and Remote Medical Support (RRMS)The RRMS Unit has a state-wide remit but is hosted and managed by DDHHS.

This past year we focussed on consolidating our Rural and Remote Medical Support (RRMS) team and programs. We have worked with many hospital and health services (HHSs) across the State to provide relieving services for medical and allied health colleagues as well as working to support and deliver workforce initiatives in many communities. It has been an exciting year that brought strong partnerships with our HHS clients and realised many of our program goals.

RRMS, which incorporates the business unit of Queensland Country Practice (QCP), continued to focus on improving access and service continuity for rural and remote communities across the State. Our team is energised to continue into the next year with more outcomes from long-term projects.

Our relieving services and programs have continued to perform strongly, delivering the combined equivalent of 49 FTE in relieving services across rural Queensland:

• 276 weeks of relief by our 30 senior vocational relieving doctors

• 1430 weeks of relief by the 290 junior doctors who rotated through our program

• 649 weeks of relief by our 25 health practitioners which include radiographers, pharmacists, physiotherapists and social workers

• 10 x-ray operator training courses, training 44 new x-ray operators to enable x-rays to be taken in small towns throughout rural Queensland

• Management of the Queensland Health Bonded Medical Scholarship Scheme which will provide 229 doctors into communities in areas of need across Queensland.

Our rural generalist workforce program is working in partnership with many HHSs to improve the sustainability and reliability of medical services through capitalising on the available rural generalist workforce being delivered through the now-maturing rural generalist pathway. These projects aim to optimise the role of the rural generalist in meeting the needs of rural and remote communities, working with service managers to design roles that are suitable and interesting for rural generalists and safe and reliable for service delivery.

Taking part in a trainee x-ray operator course in Inglewood were (from left) Sally Hunter, course co-ordinator Kirsty McMurtrie, Mark Ihle, Wendy West and Melissa McDowall.

We have entered into a research partnership with University of Queensland and South West Hospital and Health Service to better understand the outcomes of the rural generalist workforce redesign work, which will be undertaken over the next two years. This will deliver an evidence based process that QCP and our client HHSs can use to measure efficiency and effectiveness of service delivery through a rural generalist service and workforce design.


Divisional reports

Darling Downs Public Health Unit (DDPHU)DDPHU ran another successful Aboriginal and Torres Strait Islander inf luenza vaccination campaign with nearly 1,500 people vaccinated. This year Johnathan Thurston, first-grade rugby league player and captain of the North Queensland Cowboys, was engaged to help promote the program.

The “Tackle Flu before it Tackles You” program was run in partnership with the Darling Downs and South West Queensland Medicare Local and the Toowoomba Hospital Foundation.

The Darling Downs Public Health Unit also launched its “Guide to Immunisation” for local vaccine service providers. The guide was designed to provide easy access to advice on areas of immunisation such as catch up and eligibility criteria.

DDPHU officers continued to work with councils across the Darling Downs and South West Queensland to conduct mosquito surveillance targeting mosquito breeding around homes. This year Gravid Aedes Traps (GATs) were introduced into the surveillance activities. These traps were a new, low-cost, low-maintenance technology that allowed surveillance to be conducted with fewer human resources. GATs were deployed in 17 towns across eight local government areas. A house-to-house survey was also conducted at Cherbourg. These activities enabled the unit to update data on the spread of Aedes aegypti, a vector of dengue fever, across the region. This data was used to assess the risk of local disease transmission from imported cases of dengue fever.

DDPHU staff continued to work with the Health Protection Unit within the Department of Health and other government departments to investigate potential health issues related to environmental incidents such as coal seam gas, underground coal gasification, and ground water contamination with perfluorochemicals.

Medical recruitmentThe Medical Recruitment team appointed 28 senior medical officers/staff specialists in 2014-15 as well as recruiting 185 junior medical officers for 12-month placements throughout DDHHS. The unit developed a new credentialing and scope of clinical practice policy for doctors and dentists as well as implementing the CGOV electronic database to record the status of almost 500 senior doctors’ credentials. The system provides an

on-line application process as well as providing on-line access for managers which is of great benefit given the health service’s large geographical spread.

Medical educationMedical Education recorded several achievements. Highlights included:

• Successful orientation of 35 interns in 2015• Establishment of Deputy Director Clinical Training

(DCT) temporary position as Advanced Emergency Department registrar. This position was extremely helpful in facilitating extra assistance to the DCT and junior doctor support

• Teaching On the Run (TOTR) training modules delivered to senior medical staff in May. Excellent feedback was received for these sessions

• Mandatory Cultural Practice Training was delivered face-to-face at a junior doctor education session for the first time. The district facilitator delivered the session. Attendance was exceptional and feedback was positive.

Darling Downs Learning On-Line (DD-LOL)DDHHS uses an eLearning program to provide training and education for all staff. The online portal is made up of a series of educational modules to enhance healthcare workers’ knowledge and provide them with resources to assist them in safe practice, quality healthcare delivery, and risk management strategies.

The implementation of DD-LOL during the year meant:

• records of mandatory training were stored centrally • individual staff members were able to easily access

their own training records • organisational unit managers were able to report on

training completions by staff within their unit • training courses could be delivered online, with staff

training records automatically updated when online training was completed.

In 2014-15 achievements included:

• 150 courses and workshops were added to DD-LOL• 279 managers had access to reports• 68,875 courses were completed.


Divisional reports

LibraryThe library has been active in the previous 12 months consolidating its core services while also establishing new programs and investing in new products. The library has played a central coordinating role in ensuring Grand Rounds are now a consistent monthly event available to all staff across DDHHS. The library has also initiated a series of “Twilight Talks” where the public are invited to attend lectures on health topics of broad interest delivered by DDHHS specialists.

Dr Sheila Cook presented a Twilight Talk on “Healthy Living Tips To Avoid Diabetes” in September.

After much support from medical staff and the Private Practice Trust Fund, the library implemented ‘UpToDate’, an important online evidence-based, point-of-care information resource that will assist in providing better quality to patients across DDHHS.

The library has also recently made available additional computers to facilitate improved access to UpToDate and DD-LOL and the like. As well as this new and expanded work, the library continues to support the core information needs of clinical care and research output and professional development, supplying staff with some 50 books and 300 articles and 40 literature searches a month.

Librarian Daniel McDonald presented at two national conferences on various aspects of health librarianship and also received a DDHHS employee award in the category “Being Open and Transparent”.

Human Research Ethics Committee (HREC) Within DDHHS’s facilities, 30 new research projects were approved to be undertaken in a variety of topics and across the professional streams of medical, nursing, mental health, and allied health. The researchers in nine of the studies are taking the lead role in most of these projects but are working in collaboration with universities and privately sponsored studies. In 2015 there were eight published papers and five conference presentations as a result of the work of DDHHS researchers.

The DDHHS HREC committee continues to assess projects and provide advice on whether there is a research component in service evaluation and improvements. The work of this committee is invaluable in providing advice to our novice researchers.

Health Information Services (HIS)HIS has focussed attention on several keys areas with very positive outcomes. DDHHS clinicians have embraced their ability to endorse pathology results online, streamlining this aspect of their role and reducing both turnaround time and the unnecessary production of paper.

Equally useful to clinicians was their access to The Viewer, an online application that provided visibility of clinical information, results and summaries for patients regardless of which facility they attended in the State. The most recent addition to this suite of information was mental health data which had been much anticipated. This Viewer ensures that treatment can be administered without delay, as patient history is readily available.

Clinical forms management was also an area of notable achievement, with DDHHS advised that our process was so professional and of such high standard that no further benefit could be gained by adopting State-wide processes. One significant aspect was that as much production as possible is maintained locally, supporting local companies.


Divisional reports

The coding Clinician Liaison Program at Toowoomba was hugely successful, attracting interest from around the State and added to undergraduate modules. The program fostered ongoing liaison between clinicians and clinical coding staff, such that both documentation in the health record and assignment of codes to describe the treatment provided to inpatients was improved. There was also a direct impact on revenue attracted under activity-based funding.

Records managementThe Right to Information Act (2009) and Information Privacy Act (2009) grants the public a legally enforceable right to access documents in the possession of government agencies, including clinical and non-clinical records. DDHHS processes all requests for access to documents in accordance with the provisions of the Acts and Administrative Access protocols using staff with advanced health information management skills.

DDHHS ensures records are maintained through application of the State Archives-approved retention schedule.

The service has assigned formal responsibility for administrative records and clinical records to senior staff. This includes training for staff in records management.

Information system security is considered in collaboration with the Health Services Information Agency of the Department of Health.

Pastoral carePastoral care provided 200 hours of service weekly to Toowoomba and Baillie Henderson hospitals, including 24/7 service to Toowoomba Hospital.

Trained pastoral carers also worked in rural areas including Miles, Chinchilla, Dalby, Stanthorpe, Goondiwindi, Oakey, and Warwick hospitals.

Ten people graduated from the annual pastoral care 12-month training course in 2014, with 12 people studying in 2015.

Pastoral care participated in the new staff orientation program by holding a monthly session in Toowoomba Hospital’s Place of Prayer.

Support to patients and families included a new initiative of a monthly support service for home dialysis patients and their carers, and facilitating the Pink Ribbon Day- Walk of Hope for patients living with cancer.

The team was also involved in funerals for patients at Baillie Henderson Hospital; naming and claiming ceremonies for early pregnancy loss; an organ donation service of remembrance; and an annual memorial service for renal patients’ families and staff.

Celebrations were also held for International Nurses’ Day and the annual carols in wards in the lead-up to Christmas.

The pastoral care team helped organise the memorial service for Toowoomba Hospital Head of Pathology Dr Roger Guard who was tragically killed on 17 July 2014 in the MH17 plane crash, along with his wife Dr Jill Guard. The service was attended by 200 staff.


Divisional reports

Toowoomba Hospital speech therapist Prue Smeaton provides support to Archer Hazeldene and his mum, Maree. 18,927

BREASTSCREENSPERFORMED

2,100CERVICALCANCERSCREENS

7,203STUDENTPLACEMENTDAYS

169QUALIFICATIONS

AWARDEDTHROUGH CUNNINGHAMCENTRE

Allied HealthThe Division of Allied Health provides professional leadership for allied health services (including workforce planning, education and standards) across DDHHS. Allied health professions represented in the division include: occupational therapy, physiotherapy, nutrition and dietetics, speech pathology, audiology, podiatry, social work and psychology. The division also provides professional oversight of the additional health practitioner professional groups including radiography, sonography, pharmacy, oral and dental therapists, anaesthetic technicians and clinical measurement professions.

This division provides operational management of the Cunningham Centre (Registered Training Organisation), BreastScreen, Mobile Women’s Health Services, and the Aged Care and Home and Community Care (HACC) assessment team.

Highlights from the year included:

• 18,927 breast screens have been delivered to women of which 543 (2.9 per cent) were provided to women who identified as coming from an Aboriginal or Torres Strait Islander background. This was the highest number of breast screens the service has delivered, and a 25 per cent increase in Aboriginal and Torres Strait Islander participation rates on the previous year

• 359 community visits were provided by the Mobile Women’s Health Service, including 2,100 cervical screens

• 200 allied health students completed a total of 7,203 clinical placement days


Divisional reports


• Eight allied health research papers were published in high-impact, professional journals

• 14 allied health conference papers were presented at national and state conferences

• Five new models of care including two Allied Health Rural Generalist positions commenced

• 169 qualifications were awarded through the Cunningham Centre.

Clinical education Two hundred allied health students completed a total of 7,203 clinical placement days. The number of innovative models of clinical education increased with a greater number of interprofessional opportunities for students and use of telehealth technology to support students in rural placements. Evaluations of the clinical placements consistently demonstrated high levels of satisfaction and quality.

Models of careA number of new models of care were introduced:

• Weekend allied health service for acute stroke patients started in April 2015. It was designed to facilitate timely initial assessment and management for acute stroke patients admitted on or just before the weekend. Preliminary feedback has indicated that this model improves patient outcomes and a formal evaluation will commence in October 2015.

• Weekend allied health assistant service for rehabilitation and geriatric emergency medicine (GEMS) patients was implemented in April 2015 and was designed to increase task delegation and improve intensity of practice for rehabilitation and GEMS patients. Clinical activity increased with an average of greater than 20 patients receiving additional support each day of the weekend.

• Two allied health rural generalist positions, one in South Burnett and one in Western Cluster, and an advanced allied health rural generalist position were created.

• A vestibular outpatient clinic was established with an advanced allied health practitioner providing a limited vestibular screening service for patients and education for medical officers in the emergency department at Toowoomba Hospital.

• The Orthopaedic Physiotherapy Outpatient Clinic was expanded in September 2014 to allow rural patients to be treated locally.

200

150

100

50

02013-14 2014-15

171

200

Total number of students all disciplines

2013-14 2014-15

5,525

7,203

Total number of placement days all disciplines

8000

7000

6000

5000

4000

3000

2000

1000

0

Psyc

holo

gy

Soci

al W

ork

Occ

upat

iona

l Th

erap

y

Nut

ritio

n an

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iete

tics

Phys

ioth

erap

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Spee

ch

Path

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y

2013-14financialyear 2014-15financialyear

80

70

60

50

40

30

20

10

0

Number of clinical placements - DDHHS

22

138 11

33

69

1316

7064

25 27

Divisional reports


Education and research Dr Anna Tynan (pictured) was appointed to the Research Fellow position in February 2015. A research advisory committee was established to provide strategic oversight for fostering and building capacity for research across DDHHS. Two research grants were received, eight research papers published, and 14 conference papers were presented. A number of research collaborations with other facilities and tertiary institutions also commenced.

Research grant projects underway included:

• Toowoomba Hospital Foundation/Pure Land Learning College

• Geriatric Adult Rehabilitation and Stroke Service research project: A retrospective cohort study to examine the clinical efficiency and effectiveness of the Toowoomba hospital Geriatric, Adult Rehabilitation and Stroke Service Model of Care.

Several other grants were received and research work will commence in the 2015-16 financial year.

Research collaborations included DDHHS participating in the Queensland gestational diabetes mellitus (GDM) collaborative for the ‘Full scope of dietetic practice in GDM’ project. This work is a component of Dr Shelley Wilkinson’s Queensland Health - Health Research Fellowship (2014-2016) and also includes Cairns and Hinterland Hospital and Health Service.

Divisional reports

FORUM A FIRST

Allied Health Assistants LuisEscalanteandMarinaSmith demonstrate a manual handling technique on fellow AH Assistant Greg Leonard during a special forum held in Toowoomba in March

The inaugural Allied Health Assistants’ Forum was held in Toowoomba in March 2015, attracting 49 participants (35 per cent from DDHHS).

Allied health assistants work under the supervision and delegation of allied health professionals and are key members of patient care teams.

The forum included workshops about professional boundaries, patient communication and effective delivery of information to patients.

Sessions on grief and loss and manual handling were presented by the Toowoomba Hospital social work and physiotherapy departments respectively.

Evaluationoftheforumwasextremely positive, with 100 per cent of participants reporting that they intended to make changes to their workplace and clinical practice as a result of attending the forum.


Expanded scope of practice• Podiatrist-led nail surgery started at Toowoomba Hospital in January

2015 and involved triaging patients on the surgical waitlist to the Orthopaedic Podiatry Triage Clinic for nail surgery. The wait list for nail surgery is now zero.

• Speech pathologist requesting of videofluoroscopic swallow studies started in June 2015, enabling patients to be assessed in a more timely manner.

• Tracheal suctioning was endorsed as an extended scope of practice for speech pathologists which will improve the efficiency and effectiveness of patient care.

UniversityofSunshineCoastoccupationaltherapystudentsAliceCurtis(left),NoraEnglish,are pictured with DDHHS Community Care Allied Health team leader Michelle Forrest. Their student placement in June 2015 took a different approach to the norm, being project-focused, rather than purely clinical.

Cunningham Centre The Cunningham Centre, a Registered Training Organisation, maintains the delivery of education and training programs across the State with employees of all 16 Hospital and Health Services accessing training products.

Highlights for the year include:

• Certificate III in Sterilisation HLT31112 - 91 qualifications issued and 51 Statement of Attainments resulted in the highest number of completion ever with a 160 per cent increase from last financial year.

• Certificate II in Health Support Services HLT21212 - 78 qualifications issued, an increase of 52.9 per cent since the previous year.

• The management of the Allied Health Rural Generalist Pathway Scoping Project started with 11 clinicians appointed (two in DDHHS including a physiotherapist in Kingaroy and an occupational therapist in Dalby/Chinchilla).

Divisional reports

Workforce DivisionThe Workforce division supports the organisation to deliver on the key priority of ensuring a dedicated trained workforce.

In 2014-15, our organisational structure was modified to include a standalone Workforce Division incorporating Human Resources, People and Culture, Work Health and Safety, Recruitment Services, and Emergency Preparedness.

To lead this division, Mr Michael Metcalfe was appointed and started in the new role of Executive Director Workforce in January 2015.

In 2015 the DDHHS Workforce Committee was reconfigured to provide a focus on the progression of workforce issues and initiatives.

Reporting to the workforce committee are sub-committees focussing on work health and safety, performance and culture, training and education, and workforce planning and design.

ChiefExecutiveDrPeterBristowcongratulatesColleenStoweronhernomination for a staff award. The awards are part of the Our Values in Action program.


Divisional reports


The Workforce Committee and its sub-committees led in the delivery of the key priorities of the Board under the DDHHS strategic plan:

• embedding a values-based culture• planning for, recruiting and retaining an appropriately skilled workforce• development, education and training of the workforce• employee engagement for improvements of the service• promotion of employee health and wellbeing.

We maintained a strong consultative relationship with unions through scheduled consultative forums, with a key focus of these meetings being any proposed organisational change. The DDHHS developed a succinct template to map the proposed change process.

Our strategic objective was to “embed a values-based culture” which included the Queensland Public Sector Code of Conduct framework. It provides principles and expected behaviours that are mandatory practice for employees in line with our values. Every DDHHS employee plays a part in creating a quality workplace culture by expressing a positive and respectful attitude and remaining resilient in challenging work situations.

DDHHS’s Our Values in Action which was launched in 2014-15, highlighted the importance of values-based behaviour in order to be trusted to deliver excellence in rural and regional healthcare. Our Values in Action provides a framework to promote understanding of what values-based behaviour looks like in the workplace. The values were also the basis of the employee performance appraisal and development discussions with staff and line managers.

In 2014, we undertook a review of the employee performance procedure including the performance appraisal and development process. Effectiveness of the current process and tools were evaluated and this feedback was incorporated in a redesign of the electronic performance appraisal and development form (E-PAD) including the development of a suite of support tools.

The E-PAD supports two-way discussions in the following areas: clarifying performance objectives and expectations; providing feedback and guidance on performance; and identifying learning and development needs and activities.

To ensure the ongoing E-PAD experience is considered a “value add” activity in our workplaces we are committed to continually reviewing and evaluating this process, ensuring that there is understanding and active participation in performance, appraisal and development.

In terms of business continuity, DDHHS proactively implemented emergency preparedness through training programs and by providing emergency drill situations to ensure facilities were prepared for potential disasters. This included major exercises to test capacity in these situations. Processes and templates have been developed to guide employees and managers and support in the ongoing review of facility-based contingency and business continuity plans.

68,875ONLINETRAININGCOURSES

COMPLETEDBYSTAFFTHISYEAR

2,235STAFFPROVIDEDFEEDBACK

THROUGH WORKING FOR QUEENSLANDSURVEY

4,345STAFFCOMPLETE PATIENT-CENTRED CARETRAINING

3,485STAFFPERFORMANCE

PLANSINPLACE,ALMOST DOUBLETHENUMBER SINCEELECTRONIC VERSIONLAUNCHED

Divisional reports

Finance DivisionThe Finance Division provides DDHHS-wide support functions comprising Financial Control, Management Accounting, Commercial Management, and Infrastructure and Planning to optimise quality healthcare and business outcomes.

Financial controlThe Financial Control area assisted the operating divisions to maximise revenue, an ongoing focus during 2014-15.

There were significant changes in the aged care sector with the introduction of refundable accommodation deposits and daily accommodation payments. Financial Control was able to assist with the development in internal processes to ensure DDHHS was compliant with the revised requirements and continued to maximise this revenue stream.

Management accountingManagement Accounting continued to support the clinical divisions to meet their objectives. One of the key support functions was providing meaningful finance and activity information which strengthened decision making. This was achieved through ensuring costing and reporting structures were appropriate to capture the true cost of clinical service provision within the clinical divisions, development of budgets to align to clinical needs, and ensuring performance reporting was effective and accurate.

A new dashboard reporting technology called Qlikview was piloted. The introduction of Qlikview will improve the health service’s ability to respond rapidly to emerging trends by enabling better drill-down on issues by frontline managers.

Commercial managementThe Commercial Management Unit explored opportunities for business improvement with operations managers and assisted with procurement and contract management activity.

The unit assisted DDHHS to:

• reduce surgery waiting lists through the establishment of surgical services contracts (general surgery, dental, endoscopy and ophthalmology)

• improve access to local providers in the procurement of consultants’ services through the establishment of local architecture and engineering standing offer arrangements

• improve processes through the development of DDHHS policies and procedures for contract management and procurement.


Divisional reports

25,268WORKORDERSCOMPLETED

TO MAINTAIN OUR BUILDINGS

475BUILDINGS ACROSS 90,000

SQUAREKILOMETRES

6,000PIECESOFMEDICAL

EQUIPMENTMANAGED

$1.3MILLION IN FUNDING

FOREQUIPMENT ALLOCATEDFROM BUDGETSURPLUS


Infrastructure and PlanningThe Infrastructure and Planning Unit oversaw DDHHS physical infrastructure planning and buildings management requirements including capital works projects.

The unit undertook a major project to prepare for the transfer of legal ownership of land and building assets from the Department of Health to DDHHS which happened in December 2014.

Building, Engineering and Maintenance Services completed approximately 25,268 work orders during the year to help maintain buildings and other infrastructure.

DDHHS has a large asset base of land and buildings with a replacement value of $1 billion comprising 475 buildings spread across 90,000 square kilometres. We also manage over 6,000 individual pieces of medical equipment.

Capital infrastructure planning studies were undertaken at several sites to plan for future needs.

Information Communication TechnologyDDHHS completed an information communication and technology plan to guide the development and implementation of future hardware and software ensuring that all services were supported with contemporary technology.

A number of local software applications were rolled out to improve service delivery. After a successful pilot in the South Burnett, an automated accounts payable system was implemented across DDHHS, reducing paperwork and handling and improving timeliness and reducing errors.

Pyxis (a pharmacy dispensing technology system) was implemented at Toowoomba Hospital. As at June 30, eight rural facilities with emergency treatment areas had an emergency department information system (EDIS) in place.

Significant Technology Infrastructure Renewal (TIR) projects at Stanthorpe, Goondiwindi and Chinchilla hospitals were completed. These involved cabling and servers as well as telecommunications infrastructure.

Michelle Miller, with her son Samuel Miller-Atkins, Dr Dan Halliday and Tracey Gunnlaugsson. On 21 September, 2014 Samuel was thefirstbabyborninStanthorpeHospital’snewbirthingsuites,aproject overseen by DDHHS’s Infrastructure and Planning Unit. Dr Halliday and midwife Tracey performed the delivery.

Divisional reports


Service standards

DDHHS actual results in comparison to its performance, standards and targets/estimated as published in the Service Delivery Statements 2014-15 are presented below.

Performance Measure Notes2014-15Target/

Estimate

Estimated Actual

2014-15

Actual 2014-15

Effectiveness MeasuresEmergency DepartmentPercentage of patients attending emergency departments seen within recommended timeframes

Category 1 (within 2 minutes)

1

100% 100% 100%

Category 2 (within 10 minutes) 80% 94% 94%




All categories -- --

Percentage of emergency department attendances who depart within fourhours of their arrival in the department

2 86% 83% 83%

Elective SurgeryPercentage of elective surgery patientstreated within clinically recommendedtimes:

Category 1 (30 days) 3 100% 100% 99.9%

Category 2 (90 days) 97% 98% 99.8%

Category 3 (365 days) 98% 98% 99.9%

Specialist OutpatientsPercentage of specialist outpatientswaiting within clinically recommendedtimes:

Category 1 (30 days) 7 64% 90% 98.2%

Category 2 (90 days) 20% 61% 99%

Category 3 (365 days) 90% 80% 99.9%

Healthcare Associated InfectionsRate of healthcare associated Staphylococcus aureus (including MRSA) bloodstream (SAB) infections/10,000 acute public hospital patient days

4 <2.0 0.4 0.33

Mental HealthRate of community follow-up within 1-7 days following discharge from an acute mental health inpatient unit

5 >60% 72.1% 74.0%

Proportions of readmissions to an acute mental health inpatient unit within 28 days of discharge

6 <12% 11.1% 11.1%

Efficiency measureAverage cost per weighted activity unit for Activity Based Funding facilities 8,10 $4,449 $4,036 $4,347

Other measuresTotal weighted activity units 8,9,11

Acute Inpatient 42,856 45,276 45,779

Outpatients 8,748 8,932 10,818

Sub-acute 5,278 4,742 5,153

EmergencyDepartment 15,968 16,457 16,825

Mental Health 24,843 24,593 24,761

Interventions and Procedures 6,005 7,042 5,065

Ambulatory mental health service contact duration (hours) >56,680 60,567 72,252


Service standards

Notes:1. 2014-15 estimated actual figures are provided from 10 months of actual performance from 1 July 2014 to 30 April 2015. A target for

percentage of emergency department patients seen within recommended timeframes is not included for the ‘All categories’ as there is no national benchmark. The included triage category targets for 2014-15 are based on the Australasian Triage Scale (ATS). The 2014-15 Target/est. aligned with the National Emergency Access Target. In recent years, Queensland has seen an increase in emergency department presentations which has impacted the achievement of this target. Despite the increase seen in admissions, this measure has and continues to improve.

2. 2014-15 estimated actual figures are provided from 10 months of actual performance from 1 July 2014 to 30 April 2015. The 2014-15 Target/est. is set as the midway point between the calendar years. The 2014-15 Target/est. aligned with the National Emergency Access Target. In recent years, Queensland has seen an increase in emergency department presentations which has impacted the achievement of this target. Despite the increase seen in admissions, this measure has and continues to improve.

3. 2014-15 estimated actual figures are provided from 10 months of actual performance from 1 July 2014 to 30 April 2015. The 2014-15 Target/est. is set as the midway point between the calendar years

4. Staphylococcus aureus are bacteria commonly found on around 30% of people’s skin and noses and often cause no adverse effects. Infections with this organism can be serious, particularly so when they infect the bloodstream. The data reported for this service standard are for bloodstream infections with Staphylococcus aureus (including MRSA) and are reported as a rate of infection per 10,000 patient days. The Target/Est. for this measure aligns with the national benchmark of 2.0 cases per 10,000 acute public hospital patient days.

5. This represents incremental progress towards the nationally recommended target

6. Queensland has made significant progress in reducing readmission rates over the past 5 years, with continued incremental improvements towards the nationally recommended target.

7. A 2015-16 Target/est. has not yet been set as work in relation to the setting of a more suitable target/measure is currently being investigated. This work will ensure an appropriate measure and target is set in line with the Government’s priorities and the Service Agreements with the HHSs. The Government convened a Wait Times Summit, and is currently undertaking further constultation with the health sector, which will inform work around the target/measure for future reporting. The 2014-15 Est. actual figures are provided using actual performance as at 1 April 2015.

8. The 2014-15 Target/est. published in the 2014-15 Service Delivery Statements have been recalculated based on the ABF model Q18.

9. The weighted Activity Units are as per the original Final Offers (V13) finance and activity schedules of the 2015-16 Service Agreements.

10. The determination of the cost (funding) per WAU has been based on the revised Final Offers (V14) finance and activity schedules of the 2015-16 Service Agreements.

11. Actual 2014-15 is reported based on ABF model Q17. To enable clear comparison between contracted and delivered activity, the following table contains Window 1 contracted activity and Window 3 contracted activity, against the 2014-15 actual use based on ABF model Q17.

Total weighted activity units Window 1 Window 3 ActualAcute Inpatient 43,517 43,417 45,779

Outpatients 10,059 10,064 10,818

Sub-acute 5,179 5,178 5,153

Emergency Department 16,010 16,010 16,825

Mental Health 23,878 23,360 24,761

Interventions and Procedures 4,873 4,894 5,065


The Darling Downs Hospital and Health Board is comprised of nine non-executive members appointed by the Governor in Council on the recommendation of the Minister for Health, and in accordance with the Act. The Board reports to the Minister for Health.The Board sets the organisation’s strategic agenda and monitors its performance against the delivery of quality health outcomes to ensure objectives and goals meet the needs of the community and are in line with government health policies and directives.

The members of the DDHHS Board have experience in governance, management, healthcare delivery and most importantly, strong local knowledge.

There are two Board directors representing each of the four different regions of the hospital and health service area - Southern Downs, Western Downs, South Burnett and Toowoomba in addition to the Chair.

Back (left to right): Mr Terry Fleischfresser, Ms Megan O’Shannessy, Dr Ross Hetherington. Middle: Ms Marie Pietsch, Dr Jeffrey Prebble OAM , Dr Dennis Campbell, Ms Patricia (Trish) Leddington-Hill, Ms Cheryl Dalton. Front: Mr Mike Horan AM Board Chair, Dr Peter Bristow Health ServiceChiefExecutive.

Governing the organisation


Toowoomba

Mr Mike Horan AMBoard Chair

Mike was the Member for Toowoomba South in the Queensland Parliament from 1991 to 2012.

During his political career Mike served as the leader of the National Party, the leader of the Opposition, Shadow Attorney-General and Shadow Minister for Police, Health and Primary Industries respectively. Mike regards his time as Minister for Health (1996-1998) as a highlight of his political career.

Mike has considerable experience in the development and construction of small and large health facilities. More than 100 health construction projects varying from rural hospitals to major metropolitan hospitals occurred under his Health Ministry.

During his time as Health Minister the Surgery on Time System was established, a ten-year Mental Health Plan introduced and targets for breast screening and children’s immunisation were set and achieved. Thirty-eight District Health Councils were put in place and the Rural Health Council was established at Roma.

Mike held the position of General Manager of The Royal Agricultural Society of Queensland (Toowoomba Showgrounds) from 1978 to 1991 and was a driving force in the sale of the old inner city Toowoomba Showgrounds and the development of the new Toowoomba Showgrounds on a 98 hectare site. Mike also served as secretary of the Darling Downs sub-chamber of Agricultural Societies, a number of Breed Societies, the Darling Downs Harness Racing Club and the Toowoomba Greyhound Racing Club.

Mike is currently a board member of Downs Rugby Ltd, covering rugby union from Gatton to St George and a board member of the Toowoomba Police Citizens Youth Club.

In June 2013 Mike was awarded a Member (AM) in the General Division of the Order of Australia for significant service to the Parliament of Queensland and to the community of the Darling Downs.

He is a great believer in working with the community to achieve results.

Dr Dennis CampbellPhD, MBA, FCHSM, CHE, FAIM, GAICD Deputy Chair

Dr Dennis Campbell is a former Chief Executive Officer in the public and private sectors and served on numerous boards and advisory committees. He has legal and health qualifications and in 2007 was awarded an Australia Day Medallion for services to the Australian College of Health Service Executives.

Dennis has held the positions of Assistant and Acting Regional Director, in the public sector, as well as Chief Executive Officer at St Vincent’s Hospital, Toowoomba.

Dennis served as Corporate Director with Legal Aid, Queensland for ten years as well as in other executive positions within the Department of Education and Department of Aboriginal and Islander Advancement.

Dennis joined the Board of the Heritage Bank in 2000. He is currently the Deputy Chairman of this Board and Chair of the Finance Committee. He also served as a trustee of the Queensland Museum Foundation and as Chairperson on the Management Advisory Committee of the Cobb & Co Museum, Toowoomba.

In 2008, Dennis was awarded the Gold Medal for Leadership and Achievement in Health Services Management, in recognition of his contribution and professional achievements in shaping healthcare policy at institutional, state and national levels.

From left: Mr Mike Horan AM, Dr Dennis Campbell

Our Board


Dr Jeffrey Prebble OAMMB,BS(Hons), FRACP, GAICD Board Member

Dr Jeff Prebble is a respected Paediatrician with extensive medical experience in public and private hospitals across Toowoomba and Brisbane. Jeff is a member of several health-related committees and professional organisations, and has published numerous papers.

Jeff currently holds a number of key positions in the medical community. He is a consultant Paediatrician in private practice in Toowoomba and Visiting Paediatrician at Toowoomba Hospital. Previously Jeff has held positions as Senior Visiting Consultant in Department of Paediatrics, Head of Department of Paediatrics and Chairman of Division of Infants, Children and Youth at Toowoomba Hospital.

Jeff has held various committee membership positions at:

• Queensland Health• Toowoomba Hospital• St. Vincent’s Hospital, Toowoomba• Royal Australasian College of Physicians• Queensland State Committee of Australian College of

Paediatrics• The Sovereign Order of St. John of Jerusalem Knights

Hospitaller.Jeff is a member of the committee for preparation of examinations conducted by the Australian Medical Council for overseas doctors, Examiner for the Australian Medical Council and Associate Professor (Paediatrics), University of Queensland, Rural Clinical School at Toowoomba. Jeff is also a Member of the Ethics Committee, Toowoomba and District Local Medical Association and Patron of the Down Syndrome Association, Darling Downs. Jeff’s professional memberships include Member of Faculty of Community Child Heath, Member of the Australian Perinatology Society and Member of the Australian Medical Association.

Jeff has received a number of awards including the Order of Australia Medal in 2002 for services to paediatric medicine as a practitioner, educator and advocate for clinical care and practice standards for paediatrics, and the Australian Centenary Medal in 2003 for distinguished service to the medical profession.

South Burnett

Ms Cheryl DaltonBoard Member

Ms Cheryl Dalton is currently the Chief Executive Officer of SBcare, a South Burnett provider of aged and disability care services. Prior to this she was a Councillor for the South Burnett Regional Council and former Kingaroy Shire Council with 17 years local government experience. She has also been a long-standing member of the Queensland Resource Operating Plan and Moratorium Panels, a Department of Natural Resources and Mines water management and planning entity.

Community involvement includes secretary of Links Community Services Board (JobMatch Kingaroy and Gympie), a Disability Employment Service, Chairman of the South Burnett Mayors Community Benefit Fund.

Her business experience includes agribusiness, being a Managing Director of a stockfeed manufacturing business, Goldmix Stockfeeds, from 1993 to 2005 and subsequently working in a consultative role in quality assurance. She is a Managing Director of Dalton Agribusiness, which has interests in agriculture (cattle and pigs), a tractor and dozer parts wholesaling business, and property development.

From left: Dr Jeffrey Prebble OAM, Ms Cheryl Dalton

Our Board


Mr Terry Fleischfresser Board Member

Mr Terry Fleischfresser has been a member of a number of local and state government committees since 2000 in the Kingaroy Shire Council and South Burnett Regional Council. Terry is the past Chairman for South Burnett Jobmatch.

Terry is a local business owner and operator in the Kingaroy and South Burnett Region. He has a strong background in the public sector and in community engagement in the Darling Downs region over the past 37 years.

In 2000, Terry was elected to Local Government in the Kingaroy Shire Council in the portfolio of Environment and Health. He went on to a ministerial appointment for the South Burnett Regional Health Council and was re-elected in 2004 to the Kingaroy Shire Council Environment and Health Portfolio.

He currently holds the appointment of Local Government Association of Queensland (LGAQ) Representative to Health Workforce Ltd. Queensland.

Terry has long been committed to community service and has received the:

• Melvin Jones Fellow Award (International Association of Lions Clubs)—for dedication to community, and the International Association of Lions Clubs

• James D Richardson Fellow Award (International Association of Lions Clubs)—for dedication to Lions International District Convention.

• Lions International Presidents Award—for humanitarian services performed in solidarity with the civic ideals exemplified by the International Association of Lions Clubs.

Terry is a Member of the Australian Institute of Company Directors and holds a Diploma of Business and Painter and Decorator Apprenticeship.

Southern Downs

Ms Marie Pietsch MAICD Board Member

Ms Marie Pietsch has extensive healthcare experience throughout Queensland and has held positions on numerous councils and committees, including Chair of the Minister’s Rural Health Advisory Council and Chair of the Southern Downs Health Community Council. Marie has a professional background working in the Darling Downs region and her work on agricultural and health-related committees has given her strong exposure to local community issues.

Marie is a member of various health committees and panels including:

• Member of Inglewood Multipurpose Health Service Management Committee

• Chair of Inglewood Community Advisory Network.For her work in representing health consumers in her region and her distinguished service to the community as Chair of the Southern Downs District Health Council, Marie was awarded a 2003 Centenary Medal. Marie also received an Australia Day Achievement Medallion for outstanding service to Queensland Health in 2005. In 2014, Marie was awarded the Australia Day Citizen of the Year by the Goondiwindi Regional Council for her tireless efforts volunteering for many organisations, including health, in the community.

Since 1969 Marie has been an owner/operator of a successful agricultural grazing company in the Inglewood district on the Southern Downs.

From left: Mr Terry Fleischfresser, Ms Marie Pietsch

Our Board


Dr Ross HetheringtonMBBS, DRANZOG, FACCRM, PG Dip Pall Med, FAICD Board Member

Dr Ross Hetherington is a medical practitioner and a Designated Aviation Medical Examiner (DAME). Ross co-founded the Central Queensland Rural Division of General Practitioners and holds a number of aviation and medical memberships.

Ross has been in private practice as a GP in Warwick since 1996 and has extensive experience in rural medicine. He is Board Chair of Health Workforce Queensland which supports the regional, rural and remote health workforce in Queensland. Ross is Board Chair of RHealth and was a Foundation Member of the Regional Health Board, Longreach. He has held previous Directorships with the Australian General Practice Network (AGPN) and the Australian Rural and Remote Workforce Agency Group.

Ross is a Member of the Aviation Medicine Society of Australia and New Zealand and a Foundation Member of the Menopause Society of Australasia.

Ross has an MBBS from the University of Queensland and has a Post Graduate Diploma in Palliative Care.

Western Downs

Ms Trish Leddington-HillBSc, LLB, MAICD Board Member

Ms Patricia (Trish) Leddington-Hill worked for more than 10 years with RHealth, a primary healthcare organisation servicing the Darling Downs and South West Queensland. Trish grew up on a rural property near Millmerran, Queensland, and was educated in Millmerran, Toowoomba and Brisbane. She completed a Bachelor of Science and Bachelor of Laws at the University of Queensland in 2000.

Trish worked in the rural sector in a number of roles, before joining RHealth (then known as Southern Queensland Rural Division of General Practice) in 2002 where she coordinated and managed projects across the areas of allied health, mental health, aged care, quality use of medicines, health promotion and integration.

More recently, Trish’s work has focused on promoting improvements to the health and community services sectors through partnerships, workforce planning and development. She has completed studies in the internationally recognised Partnership Brokering Accreditation Scheme (PBAS) and is an internationally accredited Partnership Broker.

A keen supporter of her local community, Trish’s committee memberships have included:

• Member, Chinchilla State School Parents and Citizens’ Association

• Secretary, Chinchilla Family Support Centre• Member, Chinchilla Melon Festival• Member, Chinchilla Community Unity Committee• Member, Smoked Fish Junior Fishing Competition

Committee.

From left: Dr Ross Hetherington, Ms Trish Leddington-Hill

Our Board


Dr Ian KeysBoard Member

Dr Ian Keys is a retired medical practitioner with experience at the Princess Alexandra Hospital, Barcaldine Hospital and Private Rural Medical Practice in Dalby.

Ian is a well known identity in Dalby and operated a private rural medical practice in the area for close to 40 years, before retiring in 2008. Ian now breeds thoroughbred horses.

Ian was Medical Superintendent with Right of Private Practice at Barcaldine in 1969 and returned to Dalby in 1970 to commence Rural General Practice. During his time in Dalby he has been associated with many community and sporting bodies including a term as an Alderman on the Dalby Town Council and was also a member of the Committee which constructed the Dalby Great Hall at Dalby High School.

After his early years in Dalby, Ian attended Anglican Church Grammar School Brisbane and graduated with an M.B.B.S in 1966 from the University of Queensland.

While at University Ian was the inaugural President of the Students Club at International House and was the first student to be on the controlling body of that College’s Board of Governors.

Ian retired from the Board of the Darling Downs Hospital and Health Service on 17 May 2015.

Ms Megan O’Shannessy Board Member

Ms Megan O’Shannessy is a Registered Nurse and Midwife. Over a 25 year rural nursing career she has been the Director of Nursing at Thargomindah, Cunnamulla, Dirranbandi, St George and Warwick hospitals.

Megan completed a Bachelor of Nursing at the University of Southern Queensland in 1996 and was a member of the Queensland Nursing Council from 1998 to 2000. Megan is currently completing her Masters in Public Health at the James Cook University.

She is now the Director of Prevocational General Practice Program at Queensland Rural Medical Education (QRME), Deputy Chief Executive Officer QRME, and a Senior Lecturer at Griffith University.

From left: Dr Ian Keys, Ms Megan O’Shannessy

Our Board


Board meetings The full Board meets monthly, with every second meeting being held in a rural area. The Health Service Chief Executive and Director Executive Services attend as standing invitees at each Board meeting.

During 2014-15 Board meetings were held in Dalby, Warwick, Cherbourg, Chinchilla and Stanthorpe, as well as in Toowoomba. While meeting in the rural areas the Board routinely took the opportunity to visit all of the local hospitals and community health centres, as well as meet with staff and key stakeholders including GPs within the local communities.

In 2014-15 collectively the Board travelled in excess of 26,000 km throughout the 90,000 km² of the DDHHS to attend Board meetings and undertake site visits.

A summary of Board activities for 2014-15 is provided on page 70.

Board committees To support the Board in its functions the following committees have been established:

• Executive Committee • Finance Committee • Safety and Quality Committee • Audit and Risk Committee. Executive Committee: The Board Executive Committee focussed on supporting the Board in its role, working with the Health Service Chief Executive (HSCE) to progress strategic issues, set the Board agenda and ensure accountability in the delivery of health services by the service.

During the 2014-15 financial year 10 Executive Committee meetings were held. The membership of the committee comprised Mr Mike Horan AM (Chair), Dr Dennis Campbell and Dr Jeff Prebble. The HSCE attends all Executive Committee meetings.

Finance Committee: The Board Finance Committee provides assurance and assistance to the Board, through oversight of the financial position, performance and resource management strategies of the DDHHS in accordance with relevant legislation and regulations.

During the 2014-15 financial year, 10 Finance Committee meetings were held. The membership of the committee comprised Dr Dennis Campbell (Chair), Dr Ross Hetherington, Ms Cheryl Dalton and Mr Terry Fleischfresser. Also attending meetings in advisory capacities were the HSCE and Chief Finance Officer.

Safety and Quality Committee: The Board Safety and Quality Committee provided leadership for and scrutiny of patient safety systems and structures to ensure the delivery of safe and effective care. The committee provides assurance and assistance to the Board on safety, quality and clinical governance frameworks and strategies of the service. The committee routinely reviews a range of reports and data in relation to planning, outcomes, feedback and external review of the safety and quality of care provided by DDHHS.

During the 2014-15 financial year, safety and quality committee meetings were held bi-monthly. The membership of the committee comprised Dr Jeff Prebble (Chair), Dr Ian Keys, Ms Marie Pietsch, Ms Trish Leddington-Hill and Ms Megan O’Shannessey. Also attending in an advisory capacity are the HSCE, Executive Director Medical Services, Executive Director Nursing and Midwifery Services, and Director Clinical Governance.

Audit and Risk Committee: The Board Audit and Risk Committee operates with due regard for the Treasury’s Audit Committee Guidelines, and provides assurance and assistance to the Board on:

• the service’s risk, control and compliance frameworks, and

• the service’s external accountability responsibilities as prescribed in the Financial Accountability Act 2009, the Auditor-General Act 2009, the Financial Accountability Regulation 2009 and the Financial and Performance Management Standard 2009.

This committee has an oversight role and does not replace management’s primary responsibilities for the management of risks including fraud risk, the operations of the internal audit and risk management functions, the follow up of internal and external audit findings or governance of DDHHS generally.

Board meetings


Board meetings

During the 2014-15 financial year, Audit and Risk Committee meetings were held quarterly. The membership of the committee comprised Dr Dennis Campbell (Chair), Dr Ross Hetherington, Ms Cheryl Dalton and Mr Terry Fleischfresser. Also attending meetings in advisory capacities were the HSCE, Chief Finance Officer, Head Internal Audit and representatives of Queensland Audit Office.

The committee oversaw:

• endorsement of the annual risk-based audit plan • completion of fieldwork in line with the audit

plan, and • the preparation of the Annual Financial Statements.

Internal audit DDHHS has an Internal Audit function that operates under a Board-approved charter in accordance with the requirements of Financial and Performance Management Standard 2009, and consistent with relevant audit and ethical standards. The Internal Audit Charter gives due regard to the Queensland Government Treasury Audit Committee Guidelines.

The role of Internal Audit is to conduct independent assessment and evaluation of the effectiveness and efficiency of organisational systems, processes and control environment, thereby providing assurance and value to the Board and Management. Internal Audit works in accordance with audit plans which are approved annually by the Board. The plans are developed using a risk-based approach that considers both strategic and operational risks. Internal Audit is independent of management, and its work is carried out by both in-house resources and co-sourced providers of internal audit services. Internal audit works independently of, but collaboratively with the external auditors.

The Head of Internal Audit reports functionally to the Audit and Risk Committee of the Board, and administratively to the HSCE. The Head of Internal Audit directs the unit’s activities, provides a framework for it to operate effectively, and is required to attend all meetings of both the Executive and the Board Audit and Risk Committees to report on Internal Audit activities.

Risk management The DDHHS is committed to effectively managing risk in alignment with best practice and through a practical approach that carefully plans for and prioritises risks, and balances the costs and benefits of action.

The DDHHS Risk Management framework uses an integrated risk management approach to describe how risks are identified, managed and monitored within the DDHHS. During 2014-15 financial year a comprehensive review and update of the Risk Management Policy, Procedure, and Guide to Risk Management was completed.

The progression towards a fully integrated Compliance Program also commenced in 2014-15. Stage 1 work included the development of a Compliance Strategy and Framework, as well as the establishment of a Compliance Manager role for the DDHHS. In 2015-16 the Compliance Manager will undertake the ongoing rollout of the compliance program.

Chief Finance Officer statement Section 77(2)(b) of the Financial Accountability Act 2009 requires the Chief Finance Officer (CFO) of departments to provide the accountable officer with a statement as to whether the financial internal controls are operating efficiently, effectively and economically.

The DDHHS is not specifically required to comply with this provision as a statutory authority, however, as per best practice, for the year ending 30 June 2015, a statement assessing DDHHS’s financial internal controls has been provided by the Acting CFO to the Chair of the Board and the Board Audit and Risk Committee. This included reliance on representations from the Department of Health in relation to shared systems such as general ledger, accounts payable and payroll.


Board committees

Board and Board Committee meetings 2014-15 The table shows the number of meetings of the Board and Board Committees attended by Board members during 2014-15.

Board Meeting

Executive Committee

Finance Committee

Audit and Risk

Safety and Quality

Name Term of Office Hel

d

Atte

nded

Hel

d

Atte

nded

Hel

d

Atte

nded

Hel

d

Atte

nded

Hel

d

Atte

nded

Mr Mike Horan AMChair

18 May 2012 – 17 May 2016 11 11 10 8 - - - - - -

Dr Dennis CampbellDeputy Chair

29 June 2012 – 17 May 2016 11 11 10 9 10 10 4 4 - -

Dr Jeff Prebble 29 June 2012 – 17 May 2016 11 10 10 9 - - - - 6 6

Ms Cheryl Dalton 29 June 2012 – 17 May 2018 11 10 - - 10 9 4 3 - -

Mr Terry Fleischfresser 29 June 2012 – 17 May 2016 11 9 - - 10 6 4 1 - -

Dr Ross Hetherington 29 June 2012 – 17 May 2018 11 10 - - 10 9 4 3 - -

Ms Marie Pietsch 29 June 2012 – 17 May 2016 11 10 - - - - - - 6 5

Dr Ian Keys * 29 June 2012 – 17 May 2015 11 9 - - - - - - 6 5

Ms Trish Leddington – Hill 9 Nov 2013 – 17 May 2018 11 11 - - - - - - 6 6

Ms Megan O’Shannessy 18 May 2013 – 17 May 2016 11 11 - - - - - - 6 4

*NOTE: Ian Keys retired from the Board on 17 May 2015, so was not eligible to attend some meetings.


Board committees

Board engagement with consumers and the community The Board holds regular monthly meeting throughout the region as part of its program to visit DDHHS facilities and services and to meet with local staff and community representatives.

In 2014-15, Board Members attended over 185 meetings and events and travelled over 26,000 kms. The table below shows a summary of the events, meetings and consultations undertaken by the Board.

Forums and Events

10thAnniversary-GHDToowoombaOffice

25th celebration - Down Syndrome Support Association

Baillie Henderson Hospital 125th Anniversary

Clinical Leaders Forums

DDHHSAustraliaDayEmployeeAwards

DDHHS Patient Focused Care and Consumer Participation Workshop

DDHHS Staff Length of Service Awards

Give Me 5 for Kids Launch

Goondir Health Services 20 year anniversary

Healthy Teeth Competition Awards - Joint DDHHS and Toowoomba Regional Council Initiative

Hospital and Health Board Chairs Forums

National Rural and Remote Telehealth Conference

OfficialLaunchoftheInstituteforResilientRegions-USQ

OfficialOpening-BaillieSplashandLifestyleCentre

OfficialOpening-CommunityCareUnitToowoomba

OfficialOpening-EndoscopySuiteToowoombaHospital

OfficialOpening-GoondiwindiPalliativeCareandQuietRoom

OfficialOpening-StanthorpeMaternityandBirthingSuites

OfficialOpening-WandoanPrimaryHealthCareCentre

Queensland Clinical Senate

QueenslandHealthAwardsforExcellence

Queensland Ministerial Roundtable on Rural and Remote Mental Health

RegionsQ Framework Forum

SocialandEconomicCoalSeamGasResearchForum

Toowoomba Hospital Volunteer's Function

General Meetings and ConsultationsAbshot Physiotherapy

Active Physiotherapy

Akooramak Aged Care

Allora Medical Centre

Amcal - Dalby

Amcal - Warwick

Anglicare - Chinchilla Community Connexions

Anglicare - Toowoomba

ArrowEnergy

ASSERTServicesIncorporated

Auditor General and Deputy Auditor-General

Australian Institute of Company Directors

Australian Medical Council

Back to Health Chiro

Barambah Regional Medical Service

Big W Distribution Centre Warwick

Blue Care Chinchilla-Miles Community Care

Blue Care Dalby

Blue Care South West

Blue Care Stanthorpe

Blue Care Toowoomba Aged Care Facility- Residential and Community Crows Nest, Pittsworth/Millmerran

BoardofTAFEQueensland

BodyTune Health

Bunya Pines Family Practice

Carers Queensland

CarramarConsulting-EducationServices

Centacare - Chinchilla

Centacare - Toowoomba

Chinchilla Christian School

Chinchilla Community, Commerce and Industry Inc. (CCCI)

Chinchilla Dental Practice

Chinchilla Family Support Centre Inc.


General Meetings and ConsultationsChinchilla Inter-agency Meeting

Chinchilla Medical Practice

Chinchilla Physiotherapy

Chinchilla Speech Pathology

Chinchilla State High School

Chinchilla State Primary School

Commonwealth Respite and Care Link

Community Consultative Committee

Community Consultative Committee - Stanthorpe

Community Development Services

Condamine Medical Centre

D&RCommunityServicesNy-Ku-ByunAgedHostel

Dalby and District Friendly Society Dispensary

Dalby Chamber of Commerce and Industry

Dalby Chiropractic Clinic

Dalby Christian College

Dalby Diagnostic Imaging

Dalby Meals on Wheels, Inc.

Dalby Medical Centre

Dalby South State School

Dalby State High School

Darling Downs and South West Queensland Medicare Local

Darling Downs Local Medical Association

Department of Communities, Child Safety and Disability Services

Depression Support Network Toowoomba Inc

DISCO

Discount Drug Store - Warwick

EdwardStreetMedicalCentre-Kingaroy

Frasers Transport

Friends of McDonald Nursing Home - Oakey

General Practitioners - Dalby

General Practitioners and Specialists - Toowoomba

GHD State Manager and Representatives

Glen David Constructions

Glendon Street Medical - Kingaroy

Goondir Health Service

GP Connections

Granite Belt Dental

General Meetings and ConsultationsGranite Belt Medical Services

Guy Street Dental

Haly Health and Skin Medical Centre

Headspace

Health Pathways Alliance Initiative - The Smith Family

Hodal Chiropractic Clinic

Hooke Chiropractic

Ian Rock Chiropractor

Lions Club - Dalby

Markwell Medical

Mental Health Family and Carer Advisory Group (MHFCAG)

Mental Illness Fellowship Qld

Mothers United for Maternity Services Stanthorpe (MUMSS)

Murgon Family Medical Practice

Myall Medical Practice

Ningana Retirement Village

OfficeofthePublicAdvocate

Our Lady of the Southern Cross College - Dalby

Ozcare Warwick

Ozcare Toowoomba

Partners in Recovery, Darling Downs and South West Qld

Peppertree Medical

Police Citizens Youth Club - Dalby

Pulse Health

Queensland Ambulance Service - Chinchilla

Queensland Ambulance Service - Dalby

Queensland Ambulance Service - Warwick

QueenslandAuditOffice(QAO)

QueenslandFireandEmergencyServices-Chinchilla

QueenslandFireandEmergencyServices-Stanthorpe

Queensland Police Service - Warwick

Queensland Police Service -Dalby

Returned Services League (RSL) - Warwick

Returned Services League (RSL) Care - Toowoomba

Sims White Architects Pty Ltd

South Burnett Medical Centre

South Burnett Private Hospital

South West Regional Disability Council

Board committees


General Meetings and ConsultationsSouthern Cross Care Chinchilla - Illoura Village For Aged

SouthernQueenslandInstituteofTAFE-Dalby

St Joseph's Catholic Primary School - Chinchilla

St Vincents Private Hospital

Stanthorpe Chamber of Commerce

Stanthorpe Nursing Home

Stanthorpe Regional Art Gallery

Stanthorpe State High School

Stanthorpe State School

StateEmergencyService-Chinchilla

StateEmergencyService-Warwick

Sullivan and Nicolaides Pathology - Dalby

Sunrise Way

Surat Basin Health and Community Services Workforce Planning Meeting

SW Orthodontics

The Cognitive Institute

The Physiotherapy Centre - Stanthorpe

Toowoomba Advocacy and Support Centre

ToowoombaandSuratBasinEnterprise(TSBE)

Toowoomba Clubhouse

Toowoomba Community Advisory Committee

Toowoomba Hospice

Toowoomba Hospital Foundation

University of Queensland

University of Southern Queensland

Vital Health - Dalby

Waminda Disability Support

Warrina Disability Services

WarwickDentalClinic(Griffith)

Warwick Friendly Society

Warwick Physioworks

Western Downs Youth Hub

Wickham Freight Lines

Wondai Medical Centre

Zonta -Dalby

Hospital VisitsBaillie Henderson Hospital

Cherbourg

Cherbourg Community Health

Chinchilla

Dalby

Dalby Community Health

DrEAFMacdonaldNursingHome-Oakey

Goondiwindi

Jandowae

Mt Lofty Heights Nursing Home

Oakey

Stanthorpe

Tara

Toowoomba

Warwick

Members of ParliamentMember for Southern Downs

Member for Toowoomba North

Member for Toowoomba South

Minister for Health and Minister for Ambulance Services

Senator for Queensland

Local GovernmentCherbourg Aboriginal Shire Council

South Burnett Regional Council

Southern Downs Regional Council

Western Downs Regional Council

Board committees


Reporting to the Health ServiceChiefExecutive(HSCE)areexecutiveswhoare responsible for their respective Divisions within the organisation. Together they form the DDHHS executive team.

Dr Peter Bristow FRACP, FCICM, FRACMA, GCM, GAICD Health Service Chief Executive Dr Peter Bristow was appointed as Chief Executive of the Darling Downs Hospital and Health Service in August 2012. Dr Bristow has previously worked in the role of Chief Executive Officer for the Darling Downs Health Service District, Executive Director Toowoomba Hospital and Executive Director of Medical Services (EDMS).

Peter has a strong background in hospital medicine and is an Intensive Care specialist, previously working as the Intensive Care Unit (ICU) Director in Toowoomba. He has been a doctor for 30 years and worked in New South Wales and Victoria before coming to Queensland in 2000.

He has presented and published in medical literature with his main research interests being predictors of patient deterioration in ICU, severity of illness scoring systems and predictive algorithms.

Dr Peter Gillies MBChB, MBA, FRACMA, GAICD General Manager, Toowoomba Hospital Dr Peter Gillies came to Toowoomba in 2009 to take up the role of Director Medical Services following his employment as the Director of Medical Services for Hunter New England Health in Armidale, New South Wales.

He previously worked as the general manager of a health software company and as the regional manager for a not-for-profit private hospital group in Auckland, New Zealand.

He has been a doctor for 19 years and worked in South Africa and the UK in both hospital and general practice roles prior to emigrating to New Zealand in 1995.

Ms Shirley WiganExecutive Director Mental Health Ms Shirley Wigan has extensive experience in the delivery of mental healthcare services, having commenced her career as a Social Worker. Shirley has worked at Mackay Hospital, West Moreton, Princess Alexander Hospital, Royal Brisbane Women’s Hospital and as the Executive Director of Mental Health Services at Brisbane’s Bayside for seven years.

Shirley was appointed Executive Director Mental Health for the Darling Downs in 2008. She has a strong background in community development, consumer and community engagement and innovative service delivery models in line with national and international imperatives and trends.

She is a member of the International Mental Health Leadership Network and is committed to a safe and quality consumer-focused service within a recovery framework.

Our executive team


Mr Michael BishopMHA General Manager RuralMr Michael Bishop is a founding member of the Mental Health Council of Australia, the National Rural Health Alliance, the Australian National Art Therapy Association, Mackay Centre for Research On Children and Community Services, The Australian College for Child and Family Protection Practitioners and Services for Australian Rural and Remote Allied Health (SARRAH).

Michael commenced his career as an Occupational Therapist and has worked nationally and internationally. As a result of this development and review work, he is acknowledged as an allied health professional leader by peers (the Queensland SARRAH Network Coordinator, and Australian Chair, AHLANZ).

He has a Human Rights Commendation for work in de-stigmatising mental illness. Michael was chair of the Editorial Boards of the Australian Journal of Rural Health, Communities, and Families and Children Australia.

Ms Robyn HendersonExecutive Director of Nursing and Midwifery Services Ms Robyn Henderson carries on a proud family tradition, being a third generation nurse.

Having worked as a practice nurse, charge nurse and in staff development, Robyn brings extensive experience to the DDHHS.

Her appointment as EDNMS marks the fifth time she has held an executive director’s role, having worked in similar positions on three occasions in New Zealand and once in Ireland.

Robyn is currently completing a PhD with her research focused on aged care. She anticipates the completion of her PhD during 2015. Robyn has a keen interest in the integration of primary health and hospital healthcare for the benefit of patients.

Dr Hwee Sin Chong FRACMA, MHM, MIPH, MBChB, GAICD Executive Director Medical ServicesDr Hwee Sin Chong first commenced in Toowoomba as the Deputy Director of Medical Services in 2011, bringing with her several years of experience in medical management across a range of roles across Queensland. These settings included metropolitan, regional, public and private hospitals, as well as the Department of Health and Patient Safety Centre.

Before a career in medical administration, Hwee Sin trained and worked in the New Zealand public healthcare sector.

Ms Judy March RN, MHA Executive Director Nursing and Midwifery (until 22 August 2014)Ms Judy March retired in 2014, having worked for the Queensland public hospital system for over 40 years.

Prior to moving to Toowoomba Judy was employed at the Gold Coast Health Service for 19 years, in positions from Midwifery Student, Registered Nurse, Nurse Manager and Nursing Director (ND) for Surgical Services.

Judy worked in a variety of senior clinical positions within DDHHS from 2000, including Director of Nursing Toowoomba Hospital, Clinical Operations Manager Rural and Executive Director of Nursing and Midwifery Services.

Our executive team


Ms Annette Scott Bach Phty, GCert Mngt, GAICD Executive Director of Allied HealthMs Annette Scott commenced her career in health as a physiotherapist. After spending her earlier career as a private practitioner in solo practice in Central Queensland, she joined the public health system in Queensland in 1993. She has subsequently fulfilled a number of clinical, quality improvement and management roles, and has worked across a range of service settings including acute inpatient, outpatient, community and rural outreach.

Prior to taking on the role of Executive Director Allied Health, Annette occupied the role of Allied Health Workforce Development officer in the Darling Downs. In this role she was responsible for implementing a range of innovative redesign initiatives across the Health Practitioner workforce. These initiatives have attracted national and state-wide attention for their ability to impact positively on patient f low and health service delivery.

Mr Michael Metcalfe ASM Executive Director of WorkforceMr Michael Metcalfe commenced his career in the health field as a paramedic, commencing with Queensland Ambulance Service (QAS) in 1991.

Prior to commencing in his role as Executive Director Workforce, Michael fulfilled the role of Assistant Commissioner, Darling Downs Local Ambulance Service Network. In this role, he was responsible for the oversight and performance of all aspects of the Darling Downs QAS operational, clinical and budgetary performance. In addition to this and other roles, Michael has had a long association with workforce matters within the ambulance environment. He has been involved in enterprise bargaining/certified agreement processes over many years, taking on significant lead roles particularly since 2010. Additionally in this time frame, Michael has been heavily involved in the development and implementation of state-wide policy focussed on work health and safety and a broad range of HR matters.

Ms Tracie Faulkner BCom(Acc), GradDipMgt, CPA Acting Chief Finance OfficerMs Tracie Faulkner has been acting in the capacity of Chief Finance Officer from March 2015 whilst recruitment has been progressed for the Chief Finance Officer.

Ms Faulkner is a qualified accountant with extensive finance and accounting management experience across both the profit and not-for-profit sectors. Tracie has been working in the accounting field for over 20 years across a variety of industries including manufacturing, financial services, infrastructure, technology and healthcare. Tracie gained her experience in Tasmania, Victoria, London and more recently Queensland.

Mr Scott McConnelBComm (Hons), CPA Chief Finance Officer (until 6 April 2015)Mr Scott McConnel is an accountant with extensive management and finance experience and perspective from a diverse range of industries including mining, information technology, education and banking and finance, including seven years in financial services in London.

With experience across both the public and private sectors he has a track record of leading continuous improvement and in engendering a more commercial focus in not-for- profit settings.

Our executive team

Term Meaning

Accessible Accessible healthcare is characterised by the ability of people to obtain appropriate healthcare at the right place and right time, irrespective of income, cultural background or geography.

AccreditationAccreditation is independent recognition that an organisation, service, program or activity meets the requirements of definedcriteriaorstandards.

Activity Based Funding (ABF)

Amanagementtoolwiththepotentialtoenhancepublicaccountabilityanddrivetechnicalefficiencyinthedeliveryofhealth services by: • capturing consistent and detailed information on hospital sector activity and accurately measuring the costs of delivery • creating an explicit relationship between funds allocated and services provided • strengthening management’s focus on outputs, outcomes and quality • encouraging clinicians and managers to identify variations in costs and practices so they can be managed at a local level inthecontextofimprovingefficiencyandeffectiveness

• providing mechanisms to reward good practice and support quality initiatives.

Acute Having a short and relatively severe course.

Acute care

Care in which the clinical intent or treatment goal is to: • manage labour (obstetric) • cureillnessorprovidedefinitivetreatmentofinjury• perform surgery • relieve symptoms of illness or injury (excluding palliative care) • reduce severity of an illness or injury • protect against exacerbation and/or complication of an illness and/or injury that could threaten life or normal function • perform diagnostic or therapeutic procedures.

Acute Hospital Is generally a recognised hospital that provides acute care and excludes dental and psychiatric hospitals.

Adult Deterioration Detection System (ADDS)

Formal system to support staff to promptly and reliably recognise patients who are clinically deteriorating, and to respond appropriately to stabilise the patient.

Admission The process whereby a hospital accepts responsibility for a patient’s care and/or treatment. It follows a clinical decision, basedonspecifiedcriteria,thatapatientrequiressame-dayorovernightcareortreatment,whichcanoccurinhospitaland/or in the patient’s home (for hospital-in-the-home patients).

Advanced Allied Health Assistant

An advanced level of clinical practice which requires a high-level of clinical skill, knowledge and practice, closely integrated with clinical leadership skills, applied research and evidence-based practice capacities, and competence in facilitating education and learning of others.

Aged Care and HACC Assessment Team (ACHAT)

ACHAT provides comprehensive assessments for the needs of frail older people and facilitates access to available care services appropriate to their needs.

Allied Health staff (Health Practitioners)

Professionalstaffwhomeetmandatoryqualificationsandregulatoryrequirementsinthefollowingareas:audiology;clinicalmeasurementsciences;dieteticsandnutrition;exercisephysiology;medicalimaging;nuclearmedicinetechnology;occupationaltherapy;orthoptics;pharmacy;physiotherapy;podiatry;prostheticsandorthotics;psychology;radiationtherapy;sonography;speechpathologyandsocialwork.

Ambulatory Care provided to patients who are not admitted to the hospital, such as patients of emergency departments, outpatient clinics and community based (non-hospital) healthcare services.

Antenatal

Antenatal care constitutes screening for health, psychosocial and socioeconomic conditions likely to increase the possibilityofspecificadversepregnancyoutcomes,providingtherapeuticinterventionsknowntobeeffective;andeducating pregnant women about planning for safe birth, emergencies during pregnancy and how to deal with them (WHO, 2011).

Bariatric equipment Equipmentandsuppliesthataredesignedforlargerorobesepatients.

Backlog Maintenance Remediation Program

A State Government program providing capital expenditure and maintenance funding to address high priority and critical operational maintenance, life cycle replacements and upgrades.

Block Funded Block funding is typically applied for small public hospitals where there is an absence of economies of scale that mean some hospitalswouldnotbefinanciallyviableunderActivityBasedFunding(ABF),andforcommunitybasedservicesnotwithinthe scope of Activity Based Funding.

Breast screenA breast screen is an x-ray of the breast that can detect small changes in breast tissue before they can be felt by a woman or her doctor. A breast screen is for women who do not have any signs or symptoms of breast cancer. It is usually done every two years for women in the targeted age range.

Cardiology Management, assessment and treatment of cardiac (heart related) conditions. Includes monitoring of long-term patients with cardiac conditions, maintenance of pacemakers and investigative treatments.


Glossary of terms

Term Meaning

Chronic disease Chronic disease: Diseases which have one or more of the following characteristics: (1) is permanent, leaves residual disability;(2)iscausedbynon-reversiblepathologicalalteration;(3)requiresspecialtrainingoftheindividualforrehabilitation, and/or may be expected to require a long period of supervision, observation or care.

Clinical governance A framework by which health organisations are accountable for continuously improving the quality of their services and safeguardinghighstandardsofcarebycreatinganenvironmentinwhichexcellenceinclinicalcarewillflourish.

Clinical practice Professional activity undertaken by health professionals to investigate patient symptoms and prevent and/or manage illness, together with associated professional activities for patient care.

Clinical redesign Clinical process redesign is concerned with improving patient journeys by making them simpler and better coordinated. The redesign process is patient focused, led by clinical staff, systematic and methodical and quick with tight timeframes.

Community Care Unit A Community Care Unit (CCU) is a residential facility for adult mental health consumers who are in recovery but require additional support and life skills rehabilitation to successfully transition to independent community living.

Community health Community health provides a range of services to people closer to their home. Some of these services include children's therapy services, pregnancy and postnatal care, rehabilitation and intervention services, and programs that focus on the long-term management of chronic disease.

Computerised Tomography (CT)

CT is diagnostic imaging technique which uses Xrays that are rotated around a patient to demonstrate the anatomy and structure of the organs and tissues.

Consumer Advisory Networks

Groups that represents people who use health services. Consumer Advisory Networks act as a bridge between health consumers and the health service.

Department of Health The Department of Health is responsible for the overall management of the public sector health system, and works in partnership with Hospital and Health Services to ensure the public health system delivers high quality hospital and other health services.

EbolaEbolavirusdisease(EVD)isasevere,oftenfatalillnessinhumans.Thevirusistransmittedtopeoplefromwildanimalsandspreads in the human population through human-to-human transmission.

Emergencydepartmentwaiting time

Time elapsed for each patient from presentation to the emergency department to start of services by the treating clinician. It is calculated by deducting the date and time the patient presents from the date and time of the service event.

Endoscopy Internal examination of either the upper or lower gastro intestinal tract.

EnrollednurseEnrollednurse(EN)isanassociatetotheregisterednurse(RN)whodemonstratescompetenceintheprovisionofpatient-centredcare.ENpracticerequirestheENtoworkunderthedirectionandsupervisionofaregisterednurse.

EnvironmentalHealthEnvironmentalHealthprogramsarerelatedtohumanhealthissuesthatareaffectedbythephysical,chemical,biologicaland social factors that are present in the environment.

Full-timeequivalent(FTE) Refers to full-time equivalent staff currently working in a position.

Gastroenterology Consultation, diagnosis, treatment and follow-up of patients suffering diseases and disorders of the digestive system.

Gestational diabetes mellitus (GDM)

Gestational diabetes mellitus (GDM) is a condition that develops during pregnancy when the body is not able to make enough insulin. The lack of insulin causes the blood glucose (also called blood sugar) level to become higher than normal. Gestational diabetes affects between 2 and 10 per cent of women during pregnancy.

Governance Governance is aimed at achieving organisational goals and objectives, and can be described as the set of responsibilities and practices, policies and procedures used to provide strategic direction, ensure objectives are achieved, manage risks, and use resources responsibly and with accountability.

GP (General Practitioner) AgeneralpractitionerisaregisteredmedicalpractitionerwhoisqualifiedandcompetentforgeneralpracticeinAustralia.General practitioners operate predominantly through private medical practices.

General Practice Liaison Officer

TheGeneralPracticeLiaisonOfficerprogramstrengthensthepartnershipbetweenprimary,communityandsecondarycareby understanding the working health care environment/concerns between primary, community and tertiary care sectors andensuringtheyacttogethertoimprovehealthoutcomesforthecommunity.Thisincludesimprovingaccesstoservices;providinginformationregardingalternativeservices;continuityofcare(dischargeandongoingcarepathways);resources,technology and shared care models.

Gynaecology The branch of medical science that studies the diseases of women, especially of the reproductive organs.

Home and Community Care (HACC)

The Commonwealth funded HACC Program provides services which support frail older people and their carers, who live in the community and whose capacity for independent living are at risk of premature or inappropriate admission to long term residential care.

Hospital Healthcare facility established under Commonwealth, state or territory legislation as a hospital or a free-standing day-procedure unit and authorised to provide treatment and/or care to patients.


Glossary of terms

Term Meaning

Hospital and Health Board The Hospital and Health Boards are made up of a mix of members with expert skills and knowledge relevant to managing a complex health care organisation.

Hospital and Health Service Hospital and Health Service (HHS) is a separate legal entity established by Queensland Government to deliver public hospital services.

Aboriginal and Torres Strait Islander health worker

An Aboriginal and/or Torres Strait Islander person who works to improve health outcomes for Aboriginal and Torres Strait Islander Australians.

Inpatient A patient who is admitted to a hospital or health service for treatment that requires at least one overnight stay.

Internal Audit Internal auditing is an independent, objective assurance and consulting activity designed to add value and improve an organisation's operations. It helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control, and governance processes.

Interns Amedicalpractitionerinthefirstpostgraduateyear,learningfurthermedicalpracticeundersupervision.

Key Performance Indicators Keyperformanceindicatorsaremetricsusedtohelpabusinessdefineandmeasureprogresstowardsachievingitsobjectives or critical success factors.

Long wait A‘longwait’electivesurgerypatientisonewhohaswaitedlongerthantheclinicallyrecommendedtimefortheirsurgery,according to the clinical urgency category assigned. That is, more than 30 days for an urgent (category 1) operation, more than 90 days for a semi-urgent (category 2) operation and more than 365 days for a routine (category 3) operation.

Medical practitioner A person who is registered with the Medical Board of Australia to practice medicine in Australia, including general and specialist practitioners.

Medicare Local EstablishedbytheCommonwealthtocoordinateprimaryhealthcareservicesacrossallprovidersinageographicarea.Works closely with HHSs to identify and address local health needs.

Memory Clinic Provides a multi-disciplinary, specialist service for assessment, diagnosis and treatment of clients who are experiencing difficultieswithmemoryandcognition.

Minimum Obligatory Human Resource Information (MOHRI)

MOHRIisawholeofGovernment(WoG)methodologyforproducinganOccupiedFullTimeEquivalent(FTE)andheadcountvalue sourced from the Queensland Health payroll system data for reporting and monitoring.

Mobile Womens Health The Mobile Womens Health service, aims to improve the health and well-being of women in rural and remote areas of Queensland. Mobile Women’s Health Nurses work as sole practitioners and provide a range of preventative health services for women, including pap smears, education, information, counselling and support on a range of women’s health issues.

Models of Care ModelofCareandModelsofServiceDeliverybroadlydefinesthewaythatclinicalandnon-clinicalserviceswillbedelivered.

Multidisciplinary team Health professionals employed by a public health service who work together to provide treatment and care for patients. They include nurses, doctors, allied health and other health professionals.

Multipurpose Health Service (MPHS)

Provideaflexibleandintegratedapproachtohealthandagedcareservicedeliveryforsmallruralcommunities.Theyarefunded through pooling of funds from Hospital and Health Services (HHS) and the Australian Government Department of Health and Ageing.

Mums and Bubs PostnatalIn-HomeVisitingprogramprovidesfamilieswithnewbornswithhomevisitsfromqualifiedandexperiencedCommunity Family Health midwives and/or child health nurses.

NationalEmergencyAccessTarget(NEAT)

NEATisaNationalPerformanceBenchmarkforpublichospitals.NEATcommencedinJanuary2012,withannualincrementtargetsoverthenextfouryearsforallpatientspresentingtoapublichospitalEmergencyDepartment(ED)toeitherphysicallyleavetheEDforadmissiontohospital,betransferredtoanotherhospitalfortreatment,orbedischarged,withinfour hours.

NationalElectiveSurgeryTarget(NEST)

NESTisaNationalPerformanceBenchmarkforpublichospitals.TheobjectivesofNESTaretoimprovepatientcareby:Increasing the percentage of elective surgery patients seen within the clinically recommended time, and reducing the number of patients who have waited longer than the clinically recommended time.

National Safety and Quality Healthcare Standards (NSQHS)

The National Safety and Quality Health Service (NSQHS) Standards were developed by the Australian Commission on Safety and Quality in Health Care (the Commission) in consultation and collaboration with jurisdictions, technical experts and a wide range of other organisations and individuals, including health professionals and patients. The primary aims of the NSQHS Standards are to protect the public from harm and to improve the quality of care provided by health service organisations.

National Standards for Mental Health Services (NSMHS)

TheNationalStandardsforMentalHealthServices(NSMHS)werefirstintroducedin1996toassistinthedevelopmentand implementation of appropriate practices and guide continuous quality improvement in mental health services. Demonstration of the delivery of services against these standards ensures that consumers, carers and the community can be confidentofwhattoexpectfrommentalhealthservices.


Glossary of terms

Term Meaning

Nurse Sensitive Indicators The statewide Nurse Sensitive Indicator (NSI) reporting tool delivers a series of useful and relevant reports to help adult health facilities to analyse, trend, monitor, compare and/or benchmark the care delivered by nurses. These reports can be used to develop quality improvement initiatives which support the delivery of patient safety and care.

Occupied Bed Days Is the occupancy of a bed or bed alternative by an admitted patient as measured at midnight of each day, for any period of up to 24 hours prior to that midnight.

Oncology The study and treatment of cancer and malignant tumors.

Opthalmology Consultation, assessment, review, treatment and management of conditions relating to eye disorders and vision, and services associated with surgery to the eye.

Oral-maxillofacial surgery Specialises in treating diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the Oral (mouth) and Maxillofacial (jaws and face) region.

Orthopaedics Consultation, diagnosis, treatment and follow-up of patients suffering diseases and disorders of the musculoskeletal system and connective tissue.

Outpatient Non-admitted health service provided or accessed by an individual at a hospital or health service facility.

Outpatient Clinic Provides examination, consultation, treatment or other service to non-admitted non-emergency patients in a speciality unit or under an organisational arrangement administered by a hospital.

Outreach Services delivered to sites outside of the service’s base to meet or complement local service needs.

Own Source Revenue OwnSourceRevenue(OSR)isrevenuegeneratedbytheagency,generallythroughthesaleofgoodsandservices.Examplesof OSR include revenue generated through privately insured inpatients, private outpatients, and Medicare ineligible patients (overseas visitors).

Palliative Care Palliative care is an approach that improves quality of life of patients and their families facing the problems associated with lifethreateningillness,throughthepreventionofsufferingbymeansofearlyidentificationandassessmentandtreatmentofpain and other problems, physical, psychological and spiritual.

Pastoral Care Pastoral Care Services exist within a holistic approach to health, to enable patients, families and staff to respond to spiritual and emotional needs, and to the experiences of life and death, illness and injury, in the context of a faith or belief system.

Patient Travel Subsidy Scheme (PTSS)

The Patient Travel Subsidy Scheme (PTSS) provides assistance to patients, and in some cases their carers, to enable them to access specialist medical services that are not available locally.

Performance indicator Ameasurethatprovidesan‘indication’ofprogresstowardsachievingtheorganisation’sobjectives.Usuallyhastargetsthatdefinethelevelofperformanceexpectedagainsttheperformanceindicator.

Postnatal Postnatal care is the attention given to the general mental and physical welfare of the mother and infant up to six weeks after birth. Care is directed toward prevention, and early detection and treatment, of complications and diseases. In addition, postnatal care includes counselling, advice, and services on breastfeeding, family planning, immunization, and maternal nutrition.

Primary Health Care Primary health care services include health promotion and disease prevention, acute episodic care not requiring hospitalisation, continuing care of chronic diseases, education and advocacy.

Primary Health Network Primary Health Networks (PHNs) replaced Medicare Locals from July 1 2015. PHNs are established with the key objectives of:• increasingtheefficiencyandeffectivenessofmedicalservicesforpatients,particularlythoseatriskofpoorhealthoutcomes;and

• improving coordination of care to ensure patients receive the right care in the right place at the right time.PHNs work directly with general practitioners, other primary health care providers, secondary care providers and hospitals to ensure improved outcomes for patients.

Public hospital Public hospitals offer free diagnostic services, treatment, care and inpatient accommodation to Medicare eligible patients. Patients who elect to be treated as a private patient in a public hospital, and patients who are not Medicare eligible are charged for the cost of treatment.

Public patient A public patient is one who elects to be treated as a public patient, so cannot choose the doctor who treats them, or is receiving treatment in a private hospital under a contract arrangement with a public hospital or health authority.

QueenslandEmergencyAccessTarget(QEAT)

QueenslandEmergencyAccessTarget(QEAT)hasbeenintroducedtoincludeadditionalEmergencyDepartment(ED)sitesacrosstheStateforallpatientspresentingtoanEDtoeitherphysicallyleavetheEDforadmissiontohospital,betransferredtoanotherhospitalfortreatment,orbedischargedwithinfourhours.ForDDHHSQEATreportingfacilitiesareToowoomba,Warwick, Kingaroy, Chinchilla, Dalby, Goondiwindi, Stanthorpe and Oakey.

Queensland Weighted Activity Unit (QWAU)

QWAU is a standardised unit to measure healthcare services (activities) within the Queensland Activity Based Funding (ABF) model.

Registered nurse (RN) An individual registered under national law to practice without supervision in the nursing profession as a nurse, other than as a student.


Glossary of terms

Term Meaning

Registered Training Organisation (RTO)

A Registered Training Organisation, is a vocational education organisation that provides students with training that results in qualificationsandstatementsofattainmentthatarerecognisedandacceptedbyindustryandothereducationalinstitutionsthroughout Australia.

Renal Dialysis Renaldialysisisamedicalprocessoffilteringthebloodwithamachineoutsideofthebody.

Risk The effect of uncertainty on the achievement of an organisation’s objectives.

Risk management A process of systematically identifying hazards, assessing and controlling risks, and monitoring and reviewing activities to make sure that risks are effectively managed.

Rural Generalist ARuralGeneralistisdefinedasaruralmedicalpractitionerwhoiscredentialedtoservein:• Hospital-basedandcommunity-basedprimarymedicalpractice;and• Hospital-based secondary medical practice inatleastonespecialistmedicaldiscipline(commonlybutnotlimitedtoobstetrics,anaestheticsandsurgery);andwithoutsupervision by a specialist medical practitioner in the relevant disciplines.

SAFE(SystematicApproachFacilitatesExcellence)

A DDHHS program to measure performance against the clinical standards to improve safety and quality.

Secondary healthcare Medical care provided by a specialist or facility upon referral by a primary care physician. It includes services provided by hospitals and specialist medical practices

SeniorMedicalOfficer AmedicalofficerregisteredwiththeMedicalBoardofAustraliaundertheprovisionsoftheHealthPractitionersNationalLawAct 2009, who is not in training or supervised.

Sepsis Sepsis is a potentially life-threatening complication of an infection.

Statutory bodies / authorities

A non-departmental government body, established under an Act of Parliament.

Stroke Lysis Treatmenttodissolvebloodclotsinbloodvessels,improvebloodflow,andpreventdamagetotissuesandorgans.

Sub-acute Sub-acute care focuses on continuation of care and optimisation of health and functionality.

Sustainable health system A health system that provides infrastructure, such as workforce, facilities and equipment, and is innovative and responsive to emerging needs, for example, research and monitoring within available resources.

Telehealth Delivery of health-related services and information via telecommunication technologies, including: • live, audio and/or video inter-active links for clinical consultations and educational purposes • store-and-forward Telehealth, including digital images, video, audio and clinical (stored) on a client computer, then

transmitted securely (forwarded) to a clinic at another location where they are studied by relevant specialists • Telehealth services and equipment to monitor people’s health in their home.

Tertiary Hospitals Tertiary Hospitals provide care which requires highly specialized equipment and expertise.

Thrombolysis The pharmacological process of breaking up and dissolving blood clots.

Triage category Urgency of a patient’s need for medical and nursing care.

Urology Consultation, diagnosis, treatment and follow-up of patients suffering from surgical diseases and disorders of the kidney and urinary tract.

Ultrasound Ultrasound imaging allows an inside view of soft tissues and body cavities without the use of invasive techniques. Ultra-sound waves can be bounced off tissues by using special devices. The echoes are then converted into a picture called a sonogram.

Vestibular The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. If the system is damaged by disease, aging, or injury, vestibular disorders can result, and are often associated with one or more of these symptoms, among others: Vertigo and dizziness.

Videofluoroscopy Avideofluoroscopyisamovingx-rayofthemouthandthroatusedtoassesstheswallow.

VisitingMedicalOfficer A medical practitioner who is employed as an independent contractor or an employee to provide services on a part time, sessional basis.

Weighted activity unit A single standard unit used to measure all activity consistently.

Weighted Occasions Of Service (WOOS)

A WOOS is a unit of measure of oral health services activity based on the oral health care delivered to a client as indicated by treatment items.


Glossary of terms


Compliance checklist

Summary of Requirement Basis for requirementAnnual report reference

Letter of compliance

• Aletterofcompliancefromtheaccountableofficeror statutory body to the relevant Minister/s

ARRs – section 8 i

Accessibility

• Table of contents ARRs – section 10.1 1

• Glossary ARRs – section 10.1 76

• Public availability ARRs – section 10.2 Inside front cover

• Interpreter service statementQueensland Government Language Services PolicyARRs – section 10.3

Inside front cover

• Copyright noticeCopyright Act 1968ARRs – section 10.4

Inside front cover

• Information LicensingQGEA–InformationLicensingARRs – section 10.5

Inside front cover

General information

• Introductory Information ARRs – section 11.1 ii, 2, 3, 11

• Agency role and main functions ARRs – section 11.2Inside front cover,

9, 84

• Operating environment ARRs – section 11.3 10-60

• Machinery of government changes ARRs – section 11.4 58, 70-72

Non-financialperformance

• Government’s objectives for the community ARRs – section 12.1 9

• Otherwhole-of-governmentplans/specificinitiatives

ARRs – section 12.2 N/A

• Agency objectives and performance indicators ARRs – section 12.3 10-30

• Agency service areas and rvice standards ARRs – section 12.4 59-60

Financial performance

• Summaryoffinancialperformance ARRs – section 13.1 19-22

Governance – management and structure

• Organisational structure ARRs – section 14.1 31-32

• Executivemanagement ARRs – section 14.2 61-69, 73-75

• Government bodies (statutory bodies and other entities)

ARRs – section 14.3 24

• PublicSectorEthicsAct1994 ARRs – section 14.4 56


Summary of Requirement Basis for requirementAnnual report reference

Governance – risk management and accountability

• Risk management ARRs – section 15.1 68

• Externalscrutiny ARRs – section 15.2 15, 126-127

• Audit committee ARRs – section 15.3 67-68

• Internal audit ARRs – section 15.4 68

• Information systems and recordkeeping ARRs – section 15.5 49-50

Governance – human resources

• Workforce planning and performance ARRs – section 16.1 26-30

• Earlyretirement,redundancyandretrenchmentDirectiveNo.11/12EarlyRetirement,RedundancyandRetrenchmentARRs – section 16.2

28

Open Data

• Consultancies ARRs – section 17ARRs – section 34.1

Inside front cover

• Overseas travelARRs – section 17ARRs – section 34.2

Inside front cover

• Queensland Language Services PolicyARRs – section 17ARRs – section 34.3

Inside front cover

• Government bodiesARRs – section 17ARRs – section 34.4

Inside front cover

Financial statements

• CertificationoffinancialstatementsFAA – section 62FPMS – sections 42, 43 and 50ARRs – section 18.1

125

• Independent Auditors ReportFAA – section 62FPMS – section 50ARRs – section 18.2

126-127

• Remuneration disclosuresFinancial Reporting Requirements for Queensland Government AgenciesARRs – section 18.3

118-123

Compliance checklist

Darling Downs Hospital and Health Service | Annual Report 2014 83

Darling Downs Hospital and Health ServiceABN 64 109 516 141

Consolidated Financial Statements - 30 June 2015


Darling Downs Hospital and Health Service | Annual Report 201484

DARLING DOWNS HOSPITAL AND HEALTH SERVICE

Consolidated Financial Statements 2014-15

Contents

Statement of Comprehensive Income

Statement of Financial Position

Statement of Changes in Equity

Statement of Cash Flows

Notes To and Forming Part of the Financial Statements

Management Certificate

Independent Audit Report

General Information

Darling Downs Hospital and Health Service is a Queensland Government statutory body established

under the Hospital and Health Boards Act 2011 and its registered trading name is Darling Downs

Hospital and Health Service.

Darling Downs Hospital and Health Service is controlled by the State of Queensland which is the ultimate

parent entity.

The principal address of the Hospital and Health Service is:

Jofre

Baillie Henderson Hospital

Cnr Hogg & Tor Streets

Toowoomba QLD 4350

A description of the nature of the operations of the Darling Downs Hospital and Health Service and its

principal activities is included in the annual report.

For information in relation to the financial statements of the Darling Downs Hospital and Health Service,

email [email protected] or visit the Darling Downs Hospital and Health Service website at:

http://www.health.qld.gov.au/darlingdowns/default.asp

Amounts shown in these financial statements may not add to the correct sub-totals or totals due to rounding.





for the year ended 30 June 2015

2015 2014

Notes $'000 $'000

Income from Continuing OperationsUser charges and fees 3 604,947 569,261

Grants and other contributions 4 35,571 34,003

Other revenue 5 2,805 4,105

Total Revenue 643,323 607,369

Gains on disposal/remeasurement of assets 0. 78 18

Total Income from Continuing Operations 643,401 607,387

Expenses from Continuing Operations

Employee expenses 6 (47,031) (1,938)

Supplies and services 7 (550,936) (562,812)

Grants and subsidies 0 (1,265) (1,582)

Depreciation 13 (20,770) (21,516)

Impairment losses 8 (1,047) (1,133)

Other expenses 9 (2,218) (717)

Total Expenses from Continuing Operations (623,267) (589,698)

Operating Result from Continuing Operations 20,134 17,689

Other Comprehensive Income

Items that will not be reclassified subsequently to Operating Result

Increase in Asset Revaluation Surplus 15 - 2,393

Total items that will not be reclassified subsequently to Operating Result - 2,393

Total Other Comprehensive Income - 2,393

Total Comprehensive Income 20,134 20,082

The accompanying notes form part of these statements





as at 30 June 2015

2015 2014Notes $'000 $'000

Current Assets

Cash and cash equivalents 10 74,085 60,937

Receivables 11 14,113 9,385

Inventories 12 5,454 5,535

Other current assets 0 560 234

94,212 76,091

Total Current Assets 94,212 76,091

Non-Current Assets

Property, plant and equipment 13 301,532 305,469

Other non current assets 0 28

Total Non-Current Assets 301,560 305,469

Total Assets 395,772 381,560

Current Liabilities

Payables 14 34,560 41,551

Accrued employee benefits 0 1,190 25

Unearned revenue 0 155 30

Total Current Liabilities 35,905 41,606

Total Liabilities 35,905 41,606

Net Assets 359,867 339,954

Equity

Contributed equity 287,999 288,219

Accumulated surplus/(deficit) 52,071 31,938

Asset revaluation surplus/(deficit) 15 19,797 19,797

Total Equity 359,867 339,954




Statement of Changes in Equity

(Note 15)

Notes $'000 $'000 $'000 $'000

Balance as at 1 July 2013 14,249 17,404 296,426 328,079

Operating result from continuing operations 17,689 17,689


15

Increase in asset revaluation surplus 2(n) 2,393 2,393

Total Comprehensive Income for the year 17,689 2,393 20,082

Transactions with Owners as Owners:Net assets received (transferred under Administrative

Arrangement - -

Net assets received during year 2(f) 7,752 7,752

Non appropriated equity injections (Minor Capital

works) 2(x) 5,488 5,488

Non appropriated equity withdrawals (Depreciation

funding) 2(x) (21,447) (21,447)

Net Transactions with Owners as Owners (8,207) (8,207)

Balance as at 30 June 2014 31,938 19,797 288,219 339,954

Notes $'000 $'000 $'000 $'000

Balance as at 1 July 2014 31,938 19,797 288,219 339,954

Operating result from continuing operations 20,134 20,134

Transactions with Owners as Owners:

Net assets received during year 2(f) 2,893 2,893

Non appropriated equity injections (Minor Capital

works) 2(x) 17,656 17,656

Non appropriated equity withdrawals (Depreciation

funding) 2(x) (20,770) (20,770)

Net Transactions with Owners as Owners (221) (221)

Balance as at 30 June 2015 52,072 19,797 287,998 359,867




TOTAL

Accumulated

Surplus/

Deficit

Asset

revaluation

surplus

Contributed

Equity





2015 2014Notes $'000 $'000

Cash flows from operating activities

Inflows:

User charges and fees 578,619 543,353

Grants and other contributions 35,596 40,557

Interest receipts 193 159

GST input tax credits from ATO 10,143 7,634

GST collected from customers 593 557

Other 2,612 3,947

627,756 596,207

Outflows:

Employee expenses (45,865) (1,987)

Supplies and services (558,465) (560,636)

Grants and subsidies (1,063) (1,587)

GST paid to suppliers (10,249) (7,693)

GST remitted to ATO (541) (616)

Other (1,984) (557)

(618,167) (573,076)

Net cash provided by operating activities 16 9,589 23,131

Cash flows from investing activities

Inflows:

Sales of property, plant and equipment 91 31

Outflows:

Payments for property, plant and equipment (14,188) (6,565)

Net cash used in investing activities (14,097) (6,534)

Cash flows from financing activities

Inflows:

Proceeds from equity injections 17,656 5,488

Movements in equity - other - -

Net cash provided by financing activities 17,656 5,488

Net increase in cash and cash equivalents 13,148 22,085

Cash and cash equivalents at beginning of financial year 60,937 38,852

Cash and cash equivalents at end of financial year 10 74,085 60,937





Notes to and Forming Part of the Consolidated Financial Statements 2014-15

Index of Notes

Note Title

1. Objectives and Principal Activities of the Darling Downs Hospital and Health Service

2. Summary of Significant Accounting Policies

3. User charges and fees

4. Grants and other contributions

5. Other revenue

6. Employee expenses

7. Supplies and services

8. Impairment losses

9. Other expenses

10. Cash and cash equivalents

11. Receivables

12. Inventories

13. Property, plant and equipment

14. Payables

15. Asset revaluation surplus by Class

16. Reconciliation of Operating Surplus to Net Cash From Operating Activities

17. Non-cash financing and investing activities

18. Commitments for Expenditure

19. Contingencies

20. Restricted assets

21. Fiduciary Trust Transactions and Balances

22. Financial Instruments

23. Controlled Entities

24. Budget v Actual Comparison

25. Key Management Personnel and Remuneration

26. Events occurring after balance date

Certificate of Darling Downs Hospital and Health Service

INDEPENDENT AUDITOR'S REPORT





1. Objectives and Principal Activities of the Darling Downs Hospital and Health Service

Darling Downs Hospital and Health Service (DDHHS) is an independent statutory body, overseen by a local Hospital and

Health Board. DDHHS provides public hospital and healthcare services as defined in the service agreement with the

Department of Health.

Details of the services undertaken by DDHHS are included in the Annual Report.

2. Summary of Significant Accounting Policies

(a) Statement of Compliance

DDHHS has prepared these financial statements in compliance with Australian Accounting Standards and Interpretations

issued by the Australian Accounting Standards Board ('AASB') and in compliance with section 62(1) of the Financial

Accountability Act 2009 and section 43 of the Financial and Performance Management Standard 2009.

These financial statements are general purpose financial statements, and have been prepared on an accrual basis in

accordance with Australian Accounting Standards and Interpretations. In addition, the financial statements comply with

Queensland Treasury's Minimum Reporting Requirements for the year ending 30 June 2015, and other authoritative

pronouncements.

With respect to compliance with Australian Accounting Standards and Interpretations, as DDHHS is a not-for-profit statutory

body it has applied those requirements applicable to not-for-profit entities. Except where stated, the historical cost convention

is used.

(b) The Reporting Entity

DDHHS was established as a separate reporting entity on 1 July 2012. The services undertaken by DDHHS are disclosed in

the Annual Report. The financial statements include the value of all revenues, expenses, assets, liabilities and equity of

DDHHS.

(c) Fiduciary Trust Transactions and Balances

DDHHS acts in a fiduciary trust capacity in relation to patient fiduciary funds (formerly known as patient trust accounts) and

Right of Private Practice trust accounts. Consequently, these transactions and balances are not recognised in the financial

statements. Although patient funds are not controlled by DDHHS, trust activities are included in the audit performed annually

by the Auditor-General of Queensland. Note 21 provides additional information on the balances held in patient fiduciary funds

and Right of Private Practice trust accounts.

Following the introduction of new aged care agreements from 1 July 2014 by the Commonwealth Department of Health and

Ageing, DDHHS is required to manage payments from residents for refundable accommodation deposits and daily

accommodation payments. These funds are treated in a similar manner to patient fiduciary funds however interest earned is

offset against operating and capital costs of the facilities concerned.

(d) User Charges and Fees, Taxes, Penalties and Fines

User charges and fees primarily comprises Department of Health funding, patient and client fees, reimbursement of

pharmaceutical benefits and sales of goods and services.

The funding from Department of Health is provided predominantly for specific public health services purchased by the

Department from DDHHS in accordance with a service agreement between the Department and DDHHS. The service

agreement is reviewed periodically and updated for changes in activities and prices of services delivered by DDHHS.

The funding from Department of Health is received fortnightly in advance. At the end of the financial year, a financial

adjustment may be required where the level of services provided is above or below the agreed level.

Revenue recognition for other user charges and fees is based on either invoicing for related goods, services and/or the

recognition of accrued revenue.





2. Summary of Significant Accounting Policies continued

(e) Grants and Other Contributions

Grants, contributions, donations and gifts that are non-reciprocal in nature are recognised as revenue in the year in which

DDHHS obtains control over them. Where grants are received that are reciprocal in nature, revenue is progressively recognised

as it is earned, according to the terms of the funding arrangements.

Contributed assets are recognised at their fair value. Contributions of services are recognised only if the services would have

been purchased if they had not been donated and their fair value can be measured reliably. Where this is the case, an equal

amount is recognised as revenue and an expense.

(f) Administrative Arrangements

Transfer of assets on practical completion

Construction of major health infrastructure continues to be managed and funded by the Department of Health. Upon practical

completion of a project, assets are transferred from the Department to DDHHS by the Minister for Health as a contribution by

the State through equity. In 2014-15 the value of assets transferred in by the Department of Health to DDHHS was $11.262M

(2014: $7.752M). This was offset by one-off transfers outwards of residential properties to the Department of Public Works

and Housing of $8.369M. The net assets received during the year were $2.893M.

(g) Special Payments

Special payments include ex gratia expenditure and other expenditure that DDHHS is not contractually or legally obligated

to make to other parties. In compliance with the Financial and Performance Management Standard 2009, DDHHS maintains a

register setting out details of all special payments approved by DDHHS delegates in accordance with approved financial

delegations. The total of all special payments (including those of $5,000 or less) is disclosed separately within Other

expenses (note 9). However, descriptions of the nature of special payments are only provided for special payments greater

than $5,000.

(h) Cash and Cash Equivalents

For the purposes of the Statement of Financial Position and the Statement of Cash Flows, cash assets include all cash and

cheques receipted but not banked at 30 June 2015 as well as deposits at call with financial institutions.

(i) Receivables

Trade receivables are recognised at the amounts due at the time of sale or service delivery i.e. the agreed purchase/contract

price. Settlement of these amounts is generally required within 30 days from invoice date. The collectability of receivables is

assessed periodically with provision being made for impairment. All known bad debts were written-off as at 30 June 2015.

Impairment of receivables

Throughout the year, DDHHS assesses whether there is objective evidence that a financial asset or group of financial assets is

impaired. Objective evidence includes financial difficulties of the debtor, changes in debtor credit ratings and current

outstanding accounts over 120 days. The allowance for impairment reflects DDHHS's assessment of the credit risk associated

with receivables balances and is determined based on historical rates of bad debts (by category) and management judgement.

Increases in the allowance for impairment are based on loss events as disclosed in note 2 (t).

(j) Inventories

Unless material, inventories do not include supplies held ready for use in the wards throughout the hospital facilities. These are

expensed on issue from DDHHS’s central store. Items held on consignment are not treated as inventory, but are expensed

when utilised in the normal course of business.

Stock on hand is stated at the lower of cost and net realisable value. Cost comprises purchase and delivery costs, net of

rebates and discounts received or receivable. Inventories are measured at weighted average cost, adjusted for obsolescence.

Inventories consist mainly of medical supplies and drugs held for distribution to hospitals or residential aged care facilities

within DDHHS and other Hospital and Health Services. These inventories are provided to the facilities at cost. DDHHS

provides a central store enabling the distribution of supplies to other Hospital and Health Services, and utilises store facilities

managed by Department of Health.






(k) Other Non-Financial Assets

Other non-financial assets primarily represent prepayments by DDHHS. These include payments for rental and maintenance

agreements, deposits and other payments of a general nature made in advance.

(l) Acquisitions of Assets

Actual cost is used for the initial recording of all non-current physical and intangible asset acquisitions. Cost is determined as

the value given as consideration plus costs incidental to the acquisition, including all other costs incurred in getting the assets

ready for use, including architects' fees and engineering design fees. However, any training costs are expensed as incurred.

Where assets are received free of charge from another Queensland Government entity (whether as a result of a

machinery-of-Government change or other involuntary transfer), the acquisition cost is recognised as the gross carrying amount

in the books of the transferor immediately prior to the transfer together with any accumulated depreciation.

(m) Property, Plant and Equipment

DDHHS holds property, plant and equipment in order to meet its core objective of providing quality healthcare.

Items of property, plant and equipment with a cost or other value equal to or in excess of the following thresholds and with a

useful life of more than one year are recognised at acquisition. Items below these values are expensed in the year of

acquisition.

Class Threshold

Buildings and Land Improvements $10,000

Land $1

Plant and Equipment $5,000

Land improvements undertaken by DDHHS are included with buildings.

From December 2014, the legal title of land and buildings transferred from the Department of Health to DDHHS. As DDHHS

already controlled these assets there is no material impact to the financial statements of DDHHS as a result of this

transfer.

DDHHS has a comprehensive annual maintenance program for its major plant and equipment and built assets. Expenditure is

only capitalised if it increases the service potential or useful life of the existing asset. Maintenance expenditure that merely

restores original service potential (arising from ordinary wear and tear etc.) is expensed.

(n) Revaluations of Non-Current Physical Assets

Land and buildings are measured at fair value in accordance with AASB 116 Property, Plant and Equipment , AASB 13 Fair

Value Measurement and Queensland Treasury's Non-Current Asset Policies for the Queensland Public Sector. These assets

are reported at their revalued amounts, being the fair value at the date of valuation, less any subsequent accumulated

depreciation and impairment losses where applicable.

In respect of the abovementioned asset classes, the cost of items acquired during the financial year has been judged by

management to materially represent their fair value at the end of the reporting period.

Plant and equipment is measured at cost in accordance with the Non-Current Asset Policies . The carrying amounts for plant

and equipment at cost should not materially differ from the fair value.

Land and building classes measured at fair value, are revalued on an annual basis either by comprehensive valuations or by the

use of appropriate and relevant indices undertaken by independent experts. Comprehensive revaluations are undertaken at

least once every five years. However if a particular asset class experiences significant and volatile changes in fair value, that

class is subject to specific appraisal in the reporting period, where practicable, regardless of the timing of the last specific

appraisal. Assets under construction are not revalued until they are ready for use.

For financial reporting purposes, the revaluation process is managed by a team in DDHHS, who determine the specific

revaluation practices and procedures. The DDHHS Board Audit & Risk Committee oversees the revaluation processes

managed by the Finance team.






(n) Revaluations of Non-Current Physical Assets continued

Materiality concepts (according to the Framework for the Preparation and Presentation of Financial Statements) are considered

in determining whether the difference between the carrying amount and the fair value of an asset is material (in which case

revaluation is warranted).

The fair values reported by DDHHS are based on appropriate valuation techniques that maximise the use of available and

relevant observable inputs and minimise the use of unobservable inputs (refer to note 2 (p)).

Where assets have not been specifically appraised in the reporting period, their previous valuations are materially kept

up-to-date via the application of relevant indices. DDHHS ensures that the application of such indices results in a valid

estimation of the assets' fair values at reporting date.

The State Valuation Service (SVS) supplies the indices used for the land assets. Such indices are either publicly available, or

are derived from market information available to SVS. SVS provides assurance of their robustness, validity and

appropriateness for application to the relevant assets.

Land indices are based on actual market movements for each local government area issued by the Valuer-General. An

individual factor change per property has been developed from review of market transactions, having regard to the review of land

values undertaken for each local government area.

Reflecting the specialised nature of health service buildings and on hospital-site residential facilities, fair value is determined

using depreciated replacement cost methodology. Depreciated replacement cost is determined as the replacement cost less

the cost to bring an asset to current standards.

Buildings are measured at fair value by applying either, a revised estimate of individual asset's depreciated replacement cost,

or interim indices which approximate movement in market prices for labour and other key resource inputs, as well as changes

in design standards as at the reporting date. These estimates are developed by independent quantity surveyors.

The independent experts provide assurance of their robustness, validity and appropriateness for application to the relevant

assets. Indices used are also tested for reasonableness by applying the indices to a sample of assets, comparing the results

to similar assets that have been valued by an independent professional valuer or quantity surveyor, and analysing the trend of

changes in values over time. Through this process, which is undertaken annually, management assesses and confirms the

relevance and suitability of indices provided based on DDHHS's own particular circumstances.

Any revaluation increment arising on the revaluation of an asset is credited to the asset revaluation surplus of the appropriate

class, except to the extent it reverses a revaluation decrement for the class previously recognised as an expense. A decrease

in the carrying amount on revaluation is charged as an expense, to the extent it exceeds the balance, if any, in the revaluation

surplus relating to that asset class.

(o) Depreciation

Land is not depreciated as it has an unlimited useful life.

Property, plant and equipment is depreciated on a straight-line basis so as to allocate the net cost or revalued amount of each

asset, less its estimated residual value, progressively over its estimated useful life to DDHHS. All asset useful lives were

reviewed to ensure that the remaining service potential of the assets was reflected in the accounts.

Assets under construction (work-in-progress) are not depreciated until they reach service delivery capacity. Service delivery

capacity relates to when construction is complete and the asset is first put to use or is installed ready for use in accordance

with its intended application. These assets are then reclassified to the relevant classes within property, plant and equipment.

Any expenditure that increases the originally assessed capacity or service potential of an asset is capitalised and depreciated

over the remaining useful life of the asset. Major components purchased specifically for particular assets are capitalised and

depreciated on the same basis as the asset to which they relate. A review of major components is undertaken annually and

whilst components are not separately accounted for, there is no material effect on depreciation expense reported. The

depreciable amount of improvements to or on leasehold land is allocated progressively over the shorter of the estimated useful

lives of the improvements or the unexpired period of the lease.






(o) Depreciation continued

For each class of depreciable assets, the following depreciation rates are used:

Class Depreciation rates

Buildings and Improvements 0.76% - 7.69%

Plant and equipment 2.0% - 20.0%

(p) Fair Value Measurement

Fair value is the price that would be received upon sale of an asset or paid to transfer a liability in an orderly transaction between

market participants at the measurement date under current market conditions (i.e. an exit price) regardless of whether that

price is directly derived from observable inputs or estimated using another valuation technique.

Observable inputs are publicly available data that are relevant to the characteristics of the assets/liabilities being valued, and

include, but are not limited to, published sales data for land, and general office buildings.

Unobservable inputs are data, assumptions and judgements that are not available publicly, but are relevant to the

characteristics of the assets/liabilities being valued. Significant unobservable inputs used by DDHHS include, but are not

limited to, subjective adjustments made to observable data to take account of the specialised nature of health service buildings

and on hospital-site residential facilities, including historical and current construction contracts (and/or estimates of such

costs), and assessments of physical condition and remaining useful life. Unobservable inputs are used to the extent that

sufficient relevant and reliable observable inputs are not available for similar assets/liabilities.

A fair value measurement of a non-financial asset takes into account a market participant's ability to generate economic

benefits by using the asset in its highest and best use.

All assets and liabilities of DDHHS for which fair value is measured or disclosed in the financial statements are categorised

within the following fair value hierarchy, based on the data and assumptions used in the most recent specific appraisals:

level 1 - represents fair value measurements that reflect unadjusted quoted market prices in active markets for

identical assets and liabilities;

level 2 - represents fair value measurements that are substantially derived from inputs (other than quoted prices

included in level 1) that are observable, either directly or indirectly; and

level 3 - represents fair value measurements that are substantially derived from unobservable inputs.

None of DDHHS's valuations of assets or liabilities are eligible for categorisation into level 1 of the fair value hierarchy. There

was one transfer of an asset between Level 2 and Level 3 of the fair value hierarchy during the period. Transfers between

levels are deemed to have occurred at the beginning of the reporting period.

More specific fair value information about property, plant and equipment is outlined in note 13.

(q) Leases

Operating lease payments, being representative of benefits derived from the leased assets, are recognised as an expense of

the period in which they are incurred. DDHHS has no finance lease assets as at the reporting date.

(r) Impairment of Non-Current Assets

All non-current assets are assessed for indicators of impairment on an annual basis in accordance with AASB 136 Impairment

of Assets.

If an indicator of possible impairment exists, DDHHS determines the asset’s recoverable amount. Any amount by which the

asset’s carrying amount exceeds the recoverable amount is considered an impairment loss.






(r) Impairment of Non-Current Assets continued

The asset's recoverable amount is determined as the higher of the asset's fair value less costs to sell and depreciated

replacement cost.

An impairment loss is recognised immediately in the Statement of Comprehensive Income, unless the asset is carried at a

revalued amount, in which case the impairment loss is offset against the asset revaluation surplus of the relevant class to the

extent available.

Where an impairment loss subsequently reverses, the carrying amount of the asset is increased to the revised estimate of its

recoverable amount, but so that the increased carrying amount does not exceed the carrying amount that would have been

determined had no impairment loss been recognised for the asset in prior years. A reversal of an impairment loss is recognised

as income, unless the asset is carried at a revalued amount, in which case the reversal of the impairment loss is treated as a

revaluation increase. Refer also note 2 (n).

When an asset is revalued using either a market or income valuation approach, any accumulated impairment losses at that

date are eliminated against the gross amount of the asset prior to restating for the revaluation.

(s) Payables

Trade payables are recognised upon receipt of the goods or services ordered and are measured at the nominal amount i.e.

agreed purchase/contract price, net of applicable trade and other discounts. Amounts owing are unsecured and generally

settled in accordance with the vendors’ terms and conditions but within 60 days.

(t) Financial Instruments

Recognition

Financial assets and financial liabilities are recognised in the Statement of Financial Position when DDHHS becomes party to

the contractual provisions of the financial instrument.

Classification

Financial instruments are classified and measured as follows:

Cash and cash equivalents - held at fair value through profit or loss

Receivables - held at amortised cost

Payables - held at amortised cost

The allowance for impairment of receivables reflects the occurrence of loss events. If no loss events have arisen in respect of a

particular debtor, or group of debtors, no allowance for impairment is made in respect of that debt/group of debtors. Impairment

loss expense on trade receivables is disclosed at note 8.

DDHHS does not enter into transactions for speculative purposes, nor for hedging. Apart from cash and cash equivalents,

DDHHS holds no financial assets classified at fair value through profit and loss. All other disclosures relating to the

measurement and financial risk management of financial instruments held by DDHHS are included in note 22.

When a trade receivable is considered uncollectible, it is written off against the allowance account. Subsequent recoveries of

amounts previously written off are credited against the allowance account. Changes in the carrying amount of the allowance

account are recognised in Statement of Comprehensive Income.

(u) Employee Benefits and Health Service Employee Costs

Under section 20 of the Hospital and Health Boards Act 2011 - a Hospital and Health Service can employ health executives,

contracted senior health service employees including Senior Medical Officers (SMO's), Visiting Medical Officers (VMO's) and

where regulation has been passed for the Hospital and Health Service to become a prescribed service, a person employed

previously in the Department, as a health service employee.

Where a Hospital and Health Service has not received the status of a "prescribed service", non-executive staff working in a

Hospital and Health Service with the exception of SMO's and VMO's engaged under contract legally remain employees of the

Department of Health (Health Service Employees).






(u) Employee Benefits and Health Service Employee Costs continued

(i) Health Service Employees

In 2014-15, DDHHS was not a prescribed service and accordingly all non-executive staff, with the exception of SMO's and

VMO's employed under contract, were employed by the Department of Health. Provisions in the Hospital and Health Boards

Act 2011 enable DDHHS to perform functions and exercise powers to ensure the delivery of its operational plan.

Under this arrangement:

The Department provides employees to perform work for the Hospital and Health Service, and acknowledges and

accepts its obligations as the employer of these employees;

DDHHS is responsible for the day to day management of these employees; and

DDHHS reimburses the Department for the salaries and on-costs of these employees.

As a result of this arrangement, DDHHS treats the reimbursements to the Department of Health for departmental employees in

these financial statements as health service employee costs and are detailed in note 7.

(ii) Darling Downs Hospital and Health Service's Executives and contracted employees

In addition to the Health Service employees from the Department of Health, DDHHS has engaged employees directly. The

information detailed below relates specifically to the directly engaged employees.

DDHHS classifies salaries and wages, rostered days-off, sick leave, annual leave and long service leave levies and employer

superannuation contributions as employee benefits in accordance with AASB 119 Employee Benefits (note 6). Wages and

salaries due but unpaid at reporting date are recognised in the Statement of Financial Position at current salary rates. As

DDHHS expects such liabilities to be wholly settled within 12 months of reporting date, the liabilities are recognised at

undiscounted amounts.

Prior history indicates that on average, sick leave taken each reporting period is less than the entitlement accrued. This is

expected to continue in future periods. Accordingly, it is unlikely that existing accumulated entitlements will be used by

employees and no liability for unused sick leave entitlements is recognised. As sick leave is non-vesting, an expense is

recognised for this leave as it is taken.

Payroll tax and workers' compensation insurance are a consequence of employing employees, but are not counted in an

employee's total remuneration package. They are not employee benefits and are recognised separately as employee related

expenses. An exemption from the payment of payroll tax was announced as part of the 2014-15 state budget.

The payroll tax exemption took effect from 1 July 2014 and applied in the following cases:

state government departments as defined in section 8 of the Financial Accountability Act 2009 ;

Hospital and health services established for Queensland under section 17 of the Hospital and Health Boards Act 2011 .

As a consequence, DDHHS ceased being liable for payroll tax effective 1 July 2014.

Annual Leave

Under the Queensland Government's Annual Leave Central Scheme, a levy is made on DDHHS to cover the cost of employees'

annual leave. The levies are expensed in the period in which they are payable. Amounts paid to employees for annual leave

are claimed from the scheme quarterly in arrears. The Department of Health centrally manages the levy and reimbursement

process on behalf of DDHHS. No provision for annual leave is recognised in DDHHS's financial statements as the liability is

held on a whole-of-government basis and reported in those financial statements pursuant to AASB 1049 Whole of Government

and General Government Sector Financial Reporting.

Long Service Leave

Under the Queensland Government's Long Service Leave Scheme, a levy is made on DDHHS to cover the cost of employees'

long service leave. The levies are expensed in the period in which they are payable. Amounts paid to employees for long

service leave are claimed from the scheme quarterly in arrears. The Department of Health centrally manages the levy and

reimbursement process on behalf of DDHHS. No provision for long service leave is recognised in DDHHS's financial

statements as the liability is held on a whole-of-government basis and reported in those financial statements pursuant to AASB

1049 Whole of Government and General Government Sector Financial Reporting.






(u) Employee Benefits and Health Service Employee Costs continued

Superannuation

Employer superannuation contributions are paid to QSuper, the superannuation scheme for Queensland Government

employees, at rates determined by the Treasurer on the advice of the State Actuary. Contributions are expensed in the period

in which they are paid or payable and DDHHS’s obligation is limited to its contribution to QSuper. The QSuper scheme has

defined benefit and defined contribution categories. The liability for defined benefits is held on a whole-of-government basis and

reported in those financial statements pursuant to AASB 1049 Whole of Government and General Government Sector Financial

Reporting.

Board members and Visiting Medical Officers are offered a choice of superannuation funds and DDHHS pays superannuation

contributions into a complying superannuation fund.

Key Management Personnel and Remuneration

Key management personnel and remuneration disclosures are made in accordance with section 5 of the Financial Reporting

Requirements for Queensland Government Agencies issued by Queensland Treasury (see note 25). These may include

Health Board members, Executives, contracted senior health service employees and health service employees.

(v) Unearned Revenue

Monies received in advance primarily for preadmission deposits and fees for services yet to be provided are represented as

unearned revenue.

(w) Insurance

Queensland Government Insurance Fund (QGIF)

DDHHS is insured under a Department of Health insurance policy with the Queensland Government Insurance Fund (QGIF) and

pays a fee to the Department of Health as a fee for service arrangement. This is included in supplies and services (refer note 7).

QGIF covers property and general losses above a $10,000 threshold and health litigation payments above a $20,000 threshold

and associated legal fees. QGIF collects from insured agencies an annual premium intended to cover the cost of claims

occurring in the premium year, calculated on a risk assessment basis.

WorkCover Queensland

DDHHS is insured via a direct policy with WorkCover Queensland. The policy covers Health Service Executives, senior health

service employees engaged under contract and health service employees. Premiums paid are reported under Employee

Expenses (refer note 6) and Supplies and Services - Health Service Employee Costs (refer note 7), reflecting the underlying

employment relationships.

(x) Contributed Equity

Non-reciprocal transfers of assets and liabilities between wholly-owned Queensland Government entities as a result of

machinery-of-Government changes are adjusted to Contributed Equity in accordance with Interpretation 1038 Contributions by

Owners Made to Wholly-Owned Public Sector Entities. Appropriations for equity adjustments are similarly designated.

Transactions with owners as owners include equity injections for non-current asset acquisitions and non-cash equity

withdrawals to offset non-cash depreciation funding received under the Service Agreement with the Department of Health.

(y) Taxation

The only federal taxes that DDHHS is assessed for are Fringe Benefit Tax (FBT) and Goods and Services Tax (GST).

All FBT and GST reporting to the Commonwealth is managed centrally by the Department, with payments/receipts made on

behalf of DDHHS reimbursed to/from the Department on a monthly basis. GST credits receivable from, and GST payable to the

Australian Tax Office (ATO), are recognised on this basis.

Both DDHHS and the Department satisfy section 149-25(e) of the A New Tax System (Goods and Services) Act 1999 (Cth)

(the GST Act). Consequently they were able, with other Hospital and Health Services, to form a “group” for GST purposes

under Division 149 of the GST Act. Any transactions between the members of the "group" do not attract GST.






(z) Issuance of Financial Statements

The financial statements are authorised for issue by the Chair of the Board and the Chief Finance Officer at the date of signing

the Management Certificate.

(aa) Accounting Estimates and Judgements

The preparation of financial statements necessarily requires the determination and use of certain critical accounting estimates,

assumptions, and management judgements that have the potential to cause a material adjustment to the carrying amounts of

assets and liabilities within the next financial year. Such estimates, judgements and underlying assumptions are reviewed on

an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised and in future

periods as relevant.

Estimates and assumptions with the most significant effect on the financial statements are outlined in the following notes:

Provision for impairment of receivables

The provision for impairment of receivables requires a degree of estimation and judgement. The level of provision is assessed by

taking into account the recent revenue transaction experience, the ageing of receivables, historical collection rates and specific

knowledge of the individual debtor’s financial position. Refer note 11.

Fair value and hierarchy of financial instruments

Fair value measurement can be sensitive to various valuation inputs selected. Considerable judgement is required to determine

what is significant to fair value and therefore which category the asset is placed in can be subjective. Refer to note 2(p).

Considerable judgement is required when determining fair value and the relevant reportable category.

Estimation of useful lives of assets

DDHHS determines the estimated useful lives and related depreciation charges for its property, plant and equipment. The

useful lives could change significantly as a result of technical innovations or some other event. The depreciation charge will

increase where the useful lives are less than previously estimated, or technically obsolete or non-strategic assets that

have been abandoned or sold are written off or written down.

Further, the matters covered in each of those notes (except for Depreciation and Amortisation) necessarily involve estimation

uncertainty with the potential to materially impact on the carrying amount of DDHHS's assets and liabilities in the next

reporting period. Reference should be made to the respective notes for more information.

(ab) Other Presentation Matters

Currency and Rounding

Amounts included in the financial statements are in Australian dollars and have been rounded to the nearest $1,000 or, where

that amount is $500 or less, to zero, unless disclosure of the full amount is specifically required.

Comparatives

Comparative information has been restated where necessary to be consistent with disclosures in the current reporting period.

(ac) New and Revised Accounting Standards

DDHHS did not voluntarily change any of its accounting policies during 2014-15. The only Australian Accounting Standard

changes applicable for the first time as from 2014-15 that have had a significant impact on DDHHS's financial statements is

AASB 1055 Budgetary Reporting.

AASB 1055 became effective from reporting periods beginning on or after 1 July 2014. In response to this new standard,

DDHHS has included in these financial statements a comprehensive new note 'Budget vs Actual Comparison' (note 24). This

note discloses DDHHS's original published budgeted figures for 2014-15 compared to actual results, with explanations of major

variances, in respect of DDHHS's Statement of Comprehensive Income, Statement of Financial Position and Statement of

Cash Flows.






(ac) New and Revised Accounting Standards continued

The following new and revised standards also became applicable to DDHHS as from reporting periods beginning on or after

1 January 2014:

AASB 10 Consolidated Financial Statements ;

AASB 11 Joint Arrangements ;

AASB 12 Disclosure of Interests in Other Entities ;

AASB 127 (revised) Separate Financial Statements ;

AASB 128 (revised) Investments in Associates and Joint Ventures ; and

AASB 2011-7 Amendments to Australian Accounting Standards arising from the Consolidation and Joint

Arrangements Standards [AASB 1, 2, 3, 5, 7, 101, 107, 112, 118, 121, 124, 132, 133, 136, 138, 139, 1023 & 1038

and Interpretations 5, 9, 16 & 17].

Of these new/revised standards, the most significant potential impact would arise from AASB 10. Other new and revised

standards do not have a significant impact on financial reporting for 2014-15.

AASB 10 redefines and clarifies the concept of control of another entity, and is the basis for determining which entities should

be consolidated into an entity's financial statements. DDHHS has reviewed the nature of its relationship with Toowoomba and

District Division of General Practice Limited trading as GP Connections and other entities that DDHHS is connected with, to

determine the impact of AASB 10. It has concluded that DDHHS will have control over Darling Downs and West Moreton

Primary Health Network Limited based on existing circumstances and will not have any control over any additional entities.

On that basis, AASB 10 itself has no substantive impact on DDHHS's financial statements. However, the new AASB 12

requires a range of particular details to be disclosed in respect of controlled entities, so note 23 Controlled Entities now

contains further information that is relevant to Darling Downs and West Moreton Primary Health Network Limited and

DDHHS's relationship with that company. DDHHS will continue to review its relationships with other entities from year to year

to identify any further application of AASB 10's principles.

AASB 2015-7 Amendments to Australian Accounting Standards - Fair Value Disclosures of Not-for-Profit Public Sector Entities

amends AASB 13 Fair Value Measurement effective from annual reporting periods beginning on or after 1 July 2016. The

amendments provide relief from certain disclosures about fair values cateorised as level 3 under the fair value heirarchy (refer to

note 2(p)). Accordingly, the following disclosures for level 3 fair values in note 13 will no longer be required:

quantitative information about the significant unobservable inputs used in the fair value measurement; and

a description of the sensitivity of the fair value measurement to changes in the unobservable inputs.

As the amending standard was released in early July 2015, DDHHS has not early adopted this relief in these financial

statements, as per instructions from Queensland Treasury. However, DDHHS will be early adopting this disclosure

relief as from the 2015-16 reporting period (also on instructions from Queensland Treasury).

From reporting periods beginning on or after 1 July 2016, DDHHS will need to comply with the requirements of AASB 124

Related Party Disclosures . That accounting standard requires a range of disclosures about the remuneration of key

management personnel, transactions with related parties/entities, and relationships between parent and controlled entities.

DDHHS already discloses information about the remuneration expenses for key management personnel (refer to note 25) in

compliance with requirements from Queensland Treasury. Therefore, the most significant implications of AASB 124 for

DDHHS's financial statements will be the disclosures to be made about transactions with related parties, including

transactions with key management personnel or close members of their families.

AASB 15 Revenue from Contracts with Customers will become effective from reporting periods beginning on or after 1 January

2017. This standard contains much more detailed requirements for the accounting for certain types of revenue from customers.

Depending on the specific contractual terms, the new requirements may potentially result in a change to the timing of revenue

from sales of DDHHS's goods and services, such that some revenue may need to be deferred to a later reporting period to the

extent that DDHHS has received cash but has not met its associated obligations (such amounts would be reported as a

liability (unearned revenue) in the meantime). DDHHS is yet to complete its analysis of current arrangements for sale of its

goods and services, but at this stage does not expect a significant impact on its present accounting practices.

AASB 9 Financial Instruments and AASB 2014-7 Amendments to Australian Accounting Standards arising from AASB 9

(December 2014) will become effective from reporting periods beginning on or after 1 January 2018. At this stage and assuming

no change in the types of transaction DDHHS enters into, all of DDHHS's financial assets are expected to be measured at fair

value, which is consistent with the measurement classification currently used.






(ac) New and Revised Accounting Standards continued

All other Australian accounting standards and interpretations with new or future commencement dates are either not applicable

to DDHHS's activities, or have no material impact on DDHHS.

(ad) Other

Payroll system

Whilst employees are currently paid under a service arrangement using the Department of Health's payroll system, the

responsibility for the efficiency and effectiveness of this system remains with the Department.

Corporate Services Received for No Cost

DDHHS receives corporate services support from the Department of Health for no cost. Corporate services received include

payroll services, accounts payable services, some taxation services, some supply services and some information technology

services. As the fair value of these services is unable to be estimated reliably, no associated revenue and expense is

recognised in the Statement of Profit or Loss and Other Comprehensive Income.




Notes to and Forming Part of the Consolidated Financial Statements 2014-152015 2014

3. User charges and fees $'000 $'000

Government Funding

Activity Based Funding

State Share 191,573 161,308

Commonwealth share 107,171 104,233

298,744 265,541

Block Funding

State share 111,821 98,844

Commonwealth share 58,877 57,791

170,698 156,635

Training, teaching and research

State share 8,024 2,166

Commonwealth share 991 1,289

9,015 3,455

Other government funding 85,568 103,812

Total Government Funding 564,025 529,443

Sales of goods and services 2,732 2,475

Hospital fees 25,964 24,366

Pharmaceutical benefits scheme reimbursement 12,191 12,954

Other user charges - rental income 35 23

604,947 569,261

4. Grants and other contributions

Commonwealth and State Government grants

Nursing home grants 16,243 16,380

Home and community care grants 8,023 7,678

Other specific purpose grants 8,365 7,905

Total Government grants 32,631 31,963

Other

Donations non-current physical assets - 8

Donations other 1,214 1,359

Other grants 1,726 673

35,571 34,003

5. Other revenue

Other revenue primarily reflects Health Service employee cost recoveries $1,686K (2014: $2,699K), non-labour recoveries

$387K (2014: $913K), interest $193K (2014: $159K) and other revenue $539K (2014:$335K).





Notes to and Forming Part of the Consolidated Financial Statements 2014-152015 2014

$'000 $'000

6. Employee expenses

Employee benefitsWages and Salaries 39,914 1,465

Annual leave levy * 3,409 96

Employer superannuation contributions * 3,074 152

Long service leave levy * 57 23

Employee related expensesRedundancies and termination payments 155 159

Workers compensation premium * 400 20

Payroll tax - 21

Other employee related expenses 22 2

47,031 1,938

The number of employees including both full-time employees and part-time employees measured on a full-time equivalent basis is:

Number of Employees (Full Time Equivalents) as at 30 June 132.8 4.0

The increase in full-time equivalent employees reflects SMOs and VMOs becoming direct employees of DDHHS.

* Refer to note 2 (u).

Key management personnel and remuneration is reported in note 25.

7. Supplies and services

Health service employee costs 386,398 418,197

Consultants and contractors 17,378 12,901

Water and utility costs 7,260 7,090

Patient travel 8,549 8,148

Other travel 1,706 1,786

Building services 1,331 1,052

Insurance premiums (paid to Department of Health) 6,764 6,619

Motor vehicles 630 655

Inter-entity supplies (paid to Department of Health) 7,264 9,045

Computer services and communications 9,375 7,182

Repairs and maintenance 19,578 16,262

Minor works, including plant and equipment 1,901 2,102

Operating lease rentals 2,467 2,338

Drugs 18,297 19,180

Clinical supplies and services 23,465 20,450

Outsourced service delivery contracts (clinical services) 15,029 7,846

Catering and domestic supplies 9,904 8,769

Pathology and laboratory supplies 11,348 10,940

Other 2,292 2,250

550,936 562,812

Health Service Employee Costs

The Hospital and Health Service, through service arrangements with the Department of Health, has engaged a further 3,783

full-time equivalent persons (2014: 3,801 FTE's), as calculated by reference to the minimum obligatory human resources

information (MOHRI). Refer to note 2 (u) (i) for further details on the arrangements.

8. Impairment losses

Inventory written off 64 45

Impairment losses on trade receivables 115 579

Bad debts written off 868 509

1,047 1,133

For further information on impairment of receivables, refer note 11.





9. Other expenses

Total audit fees recognised as payable to the Queensland Audit Office relating to the 2014-15 financial year are estimated to be

$194,000 (2014: $200,000). There are no non-audit services included in this amount.

Special payments (ex-gratia payments) totaling $92K (2014: $41K) were made during the period. Special payments greater

than $5,000 include: a compensation payment of $8,676 to a member of the public; a payment of $20,028 for a matter relating

to an employment contract; a compensation payment of $6,500 to a member of the public; and a capital compensation

payment of $50,000 in relation to a contractual matter.

10. Cash and cash equivalents 2015 2014

$'000 $'000

General trust cash at bank * 366 1,239

Operating cash on hand and at bank 69,354 56,697

General trust at call deposits * 4,365 3,001

74,085 60,937

* Refer note 20 Restricted Assets

DDHHS's operating bank accounts are grouped as part of a whole-of-Government (WoG) banking arrangement with Queensland

Treasury Corporation, and does not earn interest on surplus funds nor is it charged interest or fees for accessing its approved

cash debit facility. Any interest earned on the WoG fund accrues to the Consolidated Fund.

General trust bank and term deposits do not form part of the WoG banking arrangement and incur fees as well as earn

interest. Interest earned from general trust accounts is used in accordance with the terms of the trust.

Cash deposited with Queensland Treasury Corporation earns interest, calculated on a daily basis reflecting market movements

in cash funds. Annual effective interest rates (payable monthly) achieved throughout the year range between 2.81% and 3.94%

(2014: 3.22% and 4.17%).

11. Receivables

Trade receivables 6,703 5,477

Payroll receivables 1 6

Less: Provision for impairment of receivables (1,257) (1,142)

5,447 4,341

GST input tax credits receivable 932 826

GST (payable)/receivable (41) 12

891 838

Accrued revenue from Department of Health 6,188 2,732

Other accrued revenue 1,587 1,474

Other - -

Total 14,113 9,385

Payroll receivables represent interim cash payments and salary overpayments for executive staff and contracted senior health

service employees including SMO's and VMO's.

Impairment of receivables

DDHHS has recognised a loss of $0.98M (2014: $1.09M) in respect of impairment of receivables. Refer note 22(c) for details of

the ageing of impaired receivables.

Movements in the allowance for impairment loss

Balance at beginning of the year 1,142 563

Amounts written off during the year (868) (509)

Amount recovered during the year - -

Increase/(decrease) in allowance recognised in operating result 983 1,088

Balance at the end of the year 1,257 1,142

12. Inventories

Catering and domestic 103 129

Drugs 2,240 2,275

Medical supplies and equipment 2,841 2,866

Other 270 265

5,454 5,535





2015 2014

13. Property, plant and equipment $'000 $'000

Land

At fair value 41,350 44,563

Buildings

At fair value 638,148 628,668

Less: Accumulated depreciation * (407,815) (395,505)

230,333 233,163

Plant and equipment

At cost 66,772 63,778

Less: Accumulated depreciation * (38,164) (36,634)

28,608 27,144

Capital works in progress

At cost 1,241 599

Total property, plant and equipment 301,532 305,469

* Refer note 2 (o).

Land

Land is measured at fair value using independent revaluations, desktop market revaluations or indexation by the State

Valuation Service (SVS) within the Department of Natural Resources and Mines. Independent revaluations are performed with

sufficient regularity to ensure assets are carried at fair value.

In 2015, DDHHS engaged the State Valuation Service (SVS) to undertake land revaluation in accordance with a rolling

revaluation program scheduled to occur over the next four years for all land holdings, excluding properties which do not have a

liquid market, for example properties under Deed of Grant (recorded at a nominal value of $1).

Indices are based on actual market movements for the relevant location and asset category and were applied to the fair value of

land for assets not comprehensively revalued in 2014-15.

The fair value of land was based on publicly available data on sales of similar land in nearby localities prior to the date of the

revaluation. In determining the values, adjustments were made to the sales data to take into account the location of the land,

its size, street/road frontage and access, and any significant restrictions. The extent of the adjustments made varies in

significance for each parcel of land - refer to the reconciliation table later in this note for information about the fair value

classification of DDHHS's land.

Revaluations did not result in a material movement in fair value in 2014-15.

Buildings

In determining the replacement cost of each building, the estimated replacement cost of the asset, or the likely cost of

construction including fees and on costs if tendered on the valuation date, is assessed. This is based on internal records of

the original cost, adjusted for more contemporary design/construction approaches and current construction contracts. Assets

are priced using Brisbane rates with published industry benchmark location indices applied. Revaluations are then compared

and assessed against current construction contracts for reasonableness. The valuation assumes a replacement building will

provide the same service function and form (shape and size) as the original building but built consistent with current building

standards. Area estimates were compiled by measuring floor areas of Project Services e-plan room or drawings obtained from

DDHHS. Refurbishment costs were derived from specific projects and are therefore indicative of actual costs.

In determining the asset to be revalued the measurement of key quantities includes:

Gross floor area

Number of floors

Girth of the building

Height of the building

Number of lifts and staircases.

Significant judgement is also used to assess the remaining service potential of the facility, given local climatic and

environmental conditions and records of the current condition of the facility.

The 'cost to bring to current standards' is the estimated cost of refurbishing the asset to bring it to current design standards

and in an "as new" condition. This estimated cost is linked to the condition factor of the building assessed by the quantity

surveyor. It is also representative of the deemed remaining useful life of the building. The condition of the building is based on

visual inspection, asset condition data, guidance from asset managers and previous reports.





13. Property, plant and equipment continued

In assessing the condition of a building the following ratings (International Infrastructure Management Manual) were applied:

Category Condition

1

2

3

4

5

Valuations assume a nil residual value. Significant capital works, such as a refurbishment across multiple floors of a building,

may result in an improved condition assessment and higher depreciated replacement values. This increase is typically less

than the original capitalised cost of the refurbishment, resulting in a small write down. Presently all major refurbishments are

funded by the Department of Health.

In 2015, DDHHS engaged independent experts, Davis Langdon Australia Pty Ltd (Davis Langdon) to undertake building

revaluations in accordance with a rolling revaluation program scheduled to occur over the next four years (with indices applied

in the intervening periods). Refer note 2 (n) for further details on the revaluation methodology applied.

Revaluations did not result in material movement in fair value in 2014-15.

DDHHS has plant and equipment with an original cost of $1.869 million (2014: $1.656 million), or 3% of total plant and

equipment gross value, with a written down value of zero still being used in the provision of services.

Reconciliations of the carrying amount for each class of property, plant and equipment are set out below:

Land Buildings Plant &

equipment

Work in

progress

Total

$’000 $’000 $’000 $’000 $’000

Carrying amount at 1 July 2013 42,169 239,575 27,486 1,237 310,467

Acquisitions - 5,462 5,411 3,444 14,317

Donations received - - 8 - 8

Disposals - - (200) - (200)

Transfers between asset classes - 3,963 118 (4,081) -

Net revaluation increments/(decrements) 2,393 - - - 2,393

Depreciation - (15,837) (5,679) - (21,516)

Carrying amount at 30 June 2014 44,562 233,163 27,144 600 305,469

- 12,341 6,959 6,150 25,450

(3,213) (5,181) (223) - (8,617)

- 5,509 - (5,509) -

- (15,500) (5,270) - (20,770)

Carrying amount at 30 June 2015 41,349 230,332 28,610 1,241 301,532

Categorisation of fair values recognised at 30 June 2015 (refer to note 2. (p))

2015 2014 2015 2014 2015 2014

$’000 $’000 $’000 $’000 $’000 $’000

Land 41,349 44,562 - - 41,349 44,562

Buildings * 765 5,955 229,567 227,208 230,332 233,163

Total 42,114 50,517 229,567 227,208 271,681 277,725

* Depreciation For Level 2 buildings was incorrectly disclosed against Level 3 in 2014. For comparative purposes this has been correctly restated.

TotalLevel 3

Transfers between asset classes

Depreciation

Level 2

Acquisitions

Requires renewal - complete renewal of internal fit out and engineering services required (up to 70% of capital

replacement cost).

Asset unserviceable - complete asset replacement required. Asset's value is nil.

Disposals

Largely still in good operational state however maintenance required to return to acceptable level of service.

Significant maintenance required up to 50% of capital replacement cost.

Very good condition - only normal maintenance required. Generally newly constructed assets that have no

backlog maintenance issues.

Minor defects only - minor maintenance required or the asset is not built to the same standard as equivalent new

assets (such as IT cabling, complying with new regulation's such as the Disability Discrimination Act 1992 ).

Refurbishment is approximately 5% of replacement cost.






Reconciliations (including fair value levels refer note 2 (p)) of the carrying amount for each class of property, plant

and equipment are set out below:

Total

Level 2 Level 2 Level 3

$’000 $’000 $’000 $’000

As at 1 July 2013 42,169 6,204 233,371 281,744

Acquisitions - - 5,462 5,462

Transfer between classes - - 3,963 3,963

Revaluation Increments/ (decrements) 2,393 - - 2,393

Depreciation - (249) (15,588) (15,837)As at 30 June 2014 44,562 5,955 227,208 277,725

- - 12,340 12,340

(3,213) (4,644) (536) (8,393)

Transfer between classes - - 5,509 5,509

Reclassification between fair value levels - (494) 494 -

- (52) (15,448) (15,500)

41,349 765 229,567 271,681

(a) Land level 2 assets represents land in an active market whereas level 3 assets are land parcels with no active market and/or significant

restrictions.

(b) Buildings level 2 assets represent offsite residential dwellings in an active market whereas level 3 are special purpose built buildings with no active

market.

Level 3 significant valuation inputs and relationship to fair value

As the measurement of quantities is finite for buildings, the major variables in determining the valuation are the rates applied to

each quantity, locality index and on-costs.

Increase or

decrease

An increase in the estimated costs

to bring to current standards would

reduce the fair value of the assets.

A decrease in the estimated costs

to bring to current standards would

increase the fair value of the

assets.

Condition rating Improvement

or decline

An improvement in the condition

rating would increase the fair value

of the assets. A decline in the

condition rating would reduce the

fair value of the assets.

Buildings - health service hospital

facilities

$230M Replacement cost estimates Increase or

decrease

An increase in the estimated

replacement costs would increase

the fair value of the assets. A

decrease in the estimated

replacement costs would reduce

the fair value of the assets.

Remaining useful lives

estimates

Increase or

decrease

An increase in the estimated

remaining useful lives would

increase the fair value of the

assets. A decrease in the estimated

remaining useful lives would reduce

the fair value of the assets.

Cost to bring to current

standards

Types of Level 3 input Possible

alternative

outcomes for

level 3 inputs

Disposals

Depreciation

As at 30 June 2015

Acquisitions

Buildings (b)

Land (a)

Impact of alternative outcomes

for level 3 inputs

Description Fair value at

30 June 2015






Level 3 significant valuation inputs and relationship to fair value continued

In regard to the sensitivity of valuations to variances in rates, locality index and pricing of preliminaries and builder's margin the

following factors may affect the valuation:

local industry construction volumes/market conditions;

material supply prices (steel, raw metals, etc.);

exchange rate fluctuations; and

enterprise bargaining agreements.

Davis Langdon do not reasonably foresee any substantial movements in price as construction volumes remain relatively low

with no indication of a significantly increased pipeline of new projects.

The current cost escalation estimate utilising the cost modelling method, the Davis Langdon Tender Price Index, was in the

range of 0.5% to 1% over the 2014-15 financial year.

There are no significant inter-relationships between unobservable inputs that materially impact fair value.

2015 2014

$'000 $'000

14. Payables

Trade creditors 5,178 4,265

Payable to Department of Health 16,789 26,889

Accrued expenses 12,391 10,397

Other 202 -

34,560 41,551

15. Asset revaluation surplus by Class

Land Buildings Total

$'000 $'000 $'000

Balance at 1 July 2013 - 17,404 17,404

Revaluation increment/(decrement) 2,393 - 2,393

Balance at 30 June 2014 2,393 17,404 19,797

Balance at 1 July 2014 2,393 17,404 19,797

Revaluation increment/(decrement) - - -

Balance at 30 June 2015 2,393 17,404 19,797

The asset revaluation surplus represents the net effect of revaluation movements in assets.

16. Reconciliation of Operating Surplus to Net Cash From Operating Activities2015 2014

$'000 $'000

Operating surplus 20,134 17,689

Non-cash movements :

Depreciation and amortisation 20,770 21,516

Depreciation grant funding (non-cash) (20,770) (21,447)

Net (gain)/loss on disposal/revaluation of non-current assets 156 170

Assets donated revenue - non-cash - (8)

Change in assets and liabilities:

(Increase)/decrease in receivables (1,105) 5,875

(Increase)/decrease in GST receivables (107) (59)

(Increase)/decrease in inventories 81 (772)

(Increase)/decrease in prepayments (354) (66)

(Increase)/decrease in accrued revenue (3,570) (2,713)

Increase/(decrease) in trade and other payables (8,931) 1,093

Increase/(decrease) in accrued employee benefits 1,166 (49)

Increase/(decrease) in unearned funding revenue 125 25

Increase in other operating liabilities 1,994 1,877

Net cash from operating activities 9,589 23,131





17. Non-cash financing and investing activities

Assets and liabilities received or transferred by DDHHS are set out in the Statement of Changes in Equity and note 2 (f).

18. Commitments for Expenditure 2015 2014

$'000 $'000

(a) Non-Cancellable Operating Leases

Committed at the reporting date but not recognised as liabilities, payable:

Within one year 92 74

One to five years 225 220

More than five years 638 679

Total 955 973

Commitments under operating leases at reporting date are inclusive of anticipated GST. DDHHS has non-cancellable operating

leases relating predominantly to commercial accommodation. Lease payments are generally fixed, but with escalation

clauses on which contingent rentals are determined. No lease arrangements contain restrictions on financing or other leasing

activities.

(b) Capital Expenditure Commitments

Material classes of capital expenditure commitments inclusive of anticipated GST, contracted for at reporting date but not

recognised in the accounts are included. Capital projects are included as commitments for the remaining project amounts.

Each of these projects is currently at a different stage of the contractual cycle.

Committed at the reporting date but not recognised as liabilities:

Repairs & maintenance 6,474 11,775

Supplies & services 366 357

Capital works 1,879 7,906

Other - 350

8,719 20,388

Committed at the reporting date but not recognised as liabilities, payable:

Within one year 8,703 20,388

One to five years 15 -

8,719 20,388

19. Contingencies

(a) Litigation in Progress

Health litigation is underwritten by the Queensland Government Insurance Fund (QGIF). DDHHS liability in this area is limited

to an excess per insurance event (Refer note 2 (w) Insurance). DDHHS’s legal advisers and management believe it would be

misleading to estimate the final amounts payable (if any) in respect of the litigation before the courts at this time.

The introduction of the Personal Injuries Proceedings Act 2002 (PIPA) has resulted in fewer cases appearing before the courts.

These matters are usually resolved at the pre-proceedings stage.

As at 30 June 2015 there were 29 claims managed by QGIF (2014: 14 claims), some of which may never be litigated or result

in payments to claims (note that this figure excludes Initial Notices under PIPA). The maximum exposure to DDHHS under

this policy is up to $20,000 for each insurable event.

There is currently one matter before the Industrial Relations Commission. DDHHS’s legal advisers and management believe it

would be misleading to estimate the final amounts payable (if any) in respect of the litigation before the courts at this time.

As at 30 June 2015, the following number of cases were filed in the courts naming the State of Queensland acting through

DDHHS as defendant:

2015 2014

Number of

cases

Number of

casesSupreme Court 5 4

Tribunals, commissions and boards 2 1

7 5

(b) Guarantees and undertakings

As at 30 June 2015, DDHHS held bank guarantees from third parties for capital works projects totalling $38K. These amounts

have not been recognised as assets in the financial statements.

DDHHS participated in the formation of a company limited by guarantee. The value of the guarantee is $10. This arrangement is

detailed in note 23.





20. Restricted assets

DDHHS receives cash contributions primarily from private practice clinicians and from external entities to provide for education,

study and research in clinical areas. Contributions are also received from benefactors in the form of gifts, donations and

bequests for stipulated purposes.

As at 30 June 2015, amounts are set aside for clinical trials $190,697 (2014: $203,098); clinical research $43,299 (2014:

$14,301); health research $33,940 (2014: $30,861) and other purposes $4,768 (2014: $53,208) for the specific purposes

underlying the contribution.

21. Fiduciary Trust Transactions and Balances

(a) Patient Fiduciary Funds

DDHHS acts in a custodial role in respect of patient fiduciary funds (formerly known as patient trust accounts) transactions and

balances (refer note 2(c)). As such, they are not recognised in the financial statements, but are disclosed below for

information purposes.

2015 2014

Patient Trust receipts and payments $'000 $'000

Receipts

Patient fiduciary fund receipts 10,062 7,796

Total receipts 10,062 7,796

Payments

Patient fiduciary fund payments 7,693 7,670

Total payments 7,693 7,670

Increase/(decrease) in net patient fiduciary fund assets 2,369 126

Patient fiduciary fund assets opening balance 1 July 710 584

Patient fiduciary fund assets closing balance 30 June 3,079 710

Fiduciary Fund assets

Current assets

Cash at bank and on hand 661 710

Refundable Patient fiduciary fund deposits * 2,418 -

Total current assets 3,079 710

* Following the introduction of new aged care agreements from 1 July 2014 by the Commonwealth Department of Health and

Ageing, DDHHS is required to manage payments from residents for refundable accommodation deposits and daily

accommodation payments. These funds are treated in a similar manner to patient fiduciary funds, however interest earned is

offset against operating and capital costs of the facilities concerned.

(b) Right of Private Practice (RoPP) scheme

In response to the Queensland Audit Office report to Parliament into the operation of Right of Private Practice arrangements in

Queensland Public Hospitals, on 4 August 2014 new private practice arrangements were made available at the Hospital and

Health (HHS) discretion. The HHS’s now holds the prerogative to grant a clinician limited rights to conduct private practice on

the terms and conditions of the private practice schedule within the employment contract (granted private practice).

Private Practice is used to optimise:

Patient service choice and access;

Patient health outcomes and models of care;

Clinical workforce employment, engagement and capacity to provide public and private services;

Use of resources, increase work satisfaction and professional skills of the clinical workforce;

Public health system revenue sources; and

Public health system service access and throughput and use of resources.

These new arrangements introduced two new contract options replacing Options A/B/P and R. These contract options are:

Assignment arrangement

In cases where a HHS requires a clinician to engage in private practice (in response to clinical need, business

requirements or patient choice), private practice can be granted under this model.

Performance measures in the employment contract can/may include a requirement to treat private patients.

All revenue generated is assigned to the employing HHS.





21. Fiduciary Trust Transactions and Balances continued

(b) Right of Private Practice (RoPP) scheme continued

Retention arrangement

A HHS may grant a clinician permission to engage in private practice during employed time and retain private practice

revenue after paying service fees and GST.

Performance measures in the employment contract can/may include a requirement to treat private patients

An earnings ceiling (threshold) is applicable.

Disbursement of service fee revenue and earnings ceiling (threshold) revenue to trust or operating accounts is at the

discretion of the employing HHS.

DDHHS acts in an agency role in respect of the transactions and balances of the accounts. Transactions relating to the

retention arrangement are managed in an agency capacity in relation to the portion SMOs retain of the private fees they earn.

The overhead cost incurred by DDHHS in its agency capacity is recovered as incurred and recognised as controlled revenue in

DDHHS’s accounts. The balance remaining of the earnings after distribution and overhead recoveries are paid to General Trust

Study, Education and Research Trust Account (SERTA) funds. At balance date any monies remaining in the RoPP bank

accounts that represent DDHHS’s revenue is accrued as revenue in DDHHS accounts. As such, the right of private practice

funds are not controlled by DDHHS but the activities are included in the annual audit performed by the Auditor-General of

Queensland.

2015 2014

Right of Private Practice (ROPP) receipts and payments $'000 $'000

Receipts

Medical practice receipts 6,793 6,569

Bank interest 11 8

Total receipts 6,804 6,577

Payments

Payments to medical officers 774 922

Payments to Hospital and Health Service 5,377 4,779

Payments to Hospital and Health Service general trust 653 876

Total payments 6,804 6,577

Increase in net private practice assets - -

Current Assets

Cash - RoPP 649 652Total Current Assets 649 652

Current Liabilities

Payments to medical officers 30 49

Payments to Hospital and Health Service 514 504

Payments to Hospital and Health Service general trust 105 99

Total Current Liabilities 649 652

22. Financial Instruments

(a) Categorisation of Financial Instruments

DDHHS categorises financial assets as cash and cash equivalents (note 10) and receivables (note 11). Financial liabilities

consist entirely of payables (note 14).

(b) Financial Risk Management Objectives

DDHHS's activities expose it to a variety of financial risks: credit risk, liquidity risk, and market risk (including foreign currency

risk, price risk and interest rate risk).

DDHHS measures risk exposure using a variety of methods as follows:

Risk Exposure Measurement method

Credit risk Ageing analysis, earnings at risk

Liquidity risk Monitoring of cash flows by management of accrual accounts, sensitivity analysis

Market risk Interest rate sensitivity analysis

Financial risk is managed in accordance with Queensland Government and DDHHS policy. These policies provide written

principles for overall risk management, as well as policies covering specific areas, and aim to minimise potential adverse

effects of risk events on the financial performance of DDHHS.





22. Financial Instruments continued

(c) Credit Risk Exposure

Credit risk exposure refers to the situation where DDHHS may incur financial loss as a result of another party to a financial

instrument failing to discharge their obligation.

Credit risk on receivables is considered minimal given that $8.0M (57%) (2014: $3.4M or 37%) of total receivables is receivable

from the Department of Health. Refer note 11 for further information.

Credit risk on cash and cash equivalents is considered minimal given all DDHHS deposits are held through the Commonwealth

Bank of Australia and by the State through Queensland Treasury Corporation. No financial assets have had their terms

renegotiated as to prevent them from being past due or impaired and are stated at the carrying amounts as indicated. The

maximum exposure to credit risk is limited to the balance of cash and cash equivalents shown in note 10.

No collateral is held as security and no credit enhancements relate to financial assets held by DDHHS.

Ageing of past due, but not impaired, as well as impaired financial assets are disclosed in the following tables:

Financial assets past due but not impaired 2015

Not

overdue

$'000

Less than

30 days

30-60 days 61-90 days More than 90

days

Total

Receivables 12,366 809 383 144 410 14,112

Payroll Receivables 1 1

0 809 383 144 411 14,113

Financial assets past due but not impaired 2014

Not

overdue

$'000

Less than

30 days


days

Total

7,668 944 265 70 432 9,379

(2) 8 6

7,668 944 263 70 440 9,385

Unimpaired debts are represented by amounts for hospital admissions that have been referred to health insurers for settlement.

These unimpaired debts are expected to be fully recoverable upon completion of health insurer’s processing requirements, in

line with industry experience.

Less than

30 days


days

Total

Receivables (gross) 109 49 80 409 647

Allowance for impairment (109) (49) (80) (409) (647)

Carrying amount

Less than

30 days


days

Total

Receivables (gross) 58 29 74 207 368

Allowance for impairment (58) (29) (74) (207) (368)

Carrying amount

This represents individual debts impaired. In addition, patient debtors and other debtors are impaired on a historical percentage

basis. These general impairments of $610K (2014: $774K) are not included in the individual impairment amounts above. The

sum of individually impaired assets and general impairment balance to total impairments of $1,257K (2014: $1,142K) disclosed

in note 11.

(d) Liquidity Risk

DDHHS has an approved debt facility of $6 million under whole-of-Government banking arrangements to manage any short term

cash shortfalls. This facility has not been drawn down as at 30 June 2015. The liquidity risk of financial liabilities held by

DDHHS is limited to the payables balance as shown in note 14.

Total

Overdue $’000

Individually impaired financial assets 2015

Overdue $’000

Individually impaired financial assets 2014

Overdue $’000

Receivables

Payroll ReceivablesTotal

Overdue $’000





22. Financial Instruments continued

(e) Market Risk

DDHHS does not trade in foreign currency and is not materially exposed to commodity price changes. DDHHS is exposed to

interest rate changes on the 24 hour at call deposits and there is no interest rate exposure on its cash and fixed rate deposits.

DDHHS does not undertake any hedging in relation to interest rate risk and manages its risk as per the DDHHS liquidity risk

management strategy articulated in DDHHS’s Financial Management Practice Manual. Changes in interest rates have a

minimal effect on the operating result of DDHHS.

(f) Interest Rate Sensitivity Analysis

A 1% movement in interest rates would result in a $44K impact (2014: $30K impact) on net income.

(g) Fair Value

DDHHS does not recognise any financial assets or liabilities at fair value. The fair value of trade receivables and payables is

assumed to approximate the value of the original transaction, less any allowance for impairment.

23. Controlled Entities

In February 2015, DDHHS participated, with the approval of the Treasurer, in the formation of Darling Downs and West Moreton

Primary Health Network Limited, and invested a 50% ownership interest in the company. Darling Downs and West Moreton

Primary Health Network's registered office is in Toowoomba, Queensland, with its activities being conducted in a range of

regions across the state. The company is not-for-profit in nature, being formed solely to:

(i) increase the efficiency and effectiveness of primary healthcare services for patients in Darling Downs and West Moreton,

particularly those at risk of poor health outcomes; and

(ii) improve co-ordination of care to ensure people receive the right care in the right place at the right time.

DDHHS controls the Darling Downs and West Moreton Primary Health Network Limited through the appointment of 5 out of the

9 positions on the company's Board of Directors (as per the company's constitution). The company's directors are charged

with the responsibility for ensuring the functions conducted by the company's staff and contractors are in accordance with the

broad requirements of DDHHS.

The remaining (non-controlling) ownership interest (50%) in the company is held by Toowoomba and District Division of General

Practice Limited trading as GP Connections. GP Connections occupies the 4 remaining positions on the Board of Directors of

Darling Downs and West Moreton Primary Health Network Limited.

The Company is incorporated under the Corporations Act 2001 and is a company limited by Guarantee. If the Company is

wound up, the constitution states that each member is required to contribute a maximum of $10.00 each towards meeting any

outstanding obligations of the company. Given the activities of the company, no dividends or other financial returns are

received by DDHHS or GP Connections. All funding received by the company is principally used to fulfil its objectives.

The auditor of the company is the Queensland Audit Office. Total external audit fees payable relating to the 2014-15

financial statements are quoted to be $3,000. There are no non-audit services in this amount.

As the amount of the investment and the transactions of Darling Downs and West Moreton Primary Health Network are not

considered material, the entity is not consolidated with DDHHS's financial statements.

Summary financial information about Darling Downs and West Moreton Primary Health Network Limited is as follows:

2015

$'000

Total income 110

Total expenses (110)

Operating Result -

Other comprehensive income -

Total Comprehensive Income -

Total current assets 1,090

Total non-current assets -

Total Assets 1,090

Total current liabilities 1,090

Total non-current liabilities -

Total Liabilities 1,090

Net Assets -

Net Cash increase over the reporting period 1,068





24. Budget v Actual Comparison

NB. A budget vs actual comparison, and explanations of major variances, has not been included for the Statement of

Changes in Equity, as major variances relating to that statement have been addressed in explanations of major

variances for other statements.

* The Original Budget has been reclassified to be consistent with the presentation and classification adopted

in the Financial Statements

Statement of Comprehensive IncomeOriginal

Budget * Actual

Variance 2015 2015 Variance Variance

Notes $'000 $'000 $'000 % of Budget

Income from Continuing Operations

User charges and fees 1 581,841 604,947 23,106 4%

Grants and other contributions 2 30,936 35,571 4,635 15%

Other revenue 3,679 2,805 (874) 24%

Total Revenue 616,456 643,323 26,867 4%

Gains on disposal/remeasurement of assets - 78 78 100%

100%

Total Income from Continuing Operations 616,456 643,401 26,945 4%

Expenses from Continuing Operations

Employee expenses 3 (1,693) (47,031) (45,338) 2,678%

Supplies and services 4 (589,075) (550,936) 38,139 6%

Grants and subsidies (1,655) (1,265) 390 24%

Depreciation (21,584) (20,770) 814 4%

Impairment losses (1,165) (1,047) 118 10%

Other expenses (1,284) (2,218) (934) 73%

Total Expenses from Continuing Operations (616,456) (623,267) (6,811) 1%

Operating Result from Continuing Operations - 20,134 20,134 100%


Items that will not be reclassified subsequently to Operating Result

Increase in Asset Revaluation Surplus - - - 100%

- - -

100%

Total Other Comprehensive Income - - - 100%

Total Comprehensive Income - 20,134 20,134 100%

Total items that will not be reclassified subsequently to Operating

Result





24. Budget v Actual Comparison continued

Statement of Financial PositionOriginal

Budget * Actual


Notes $'000 $'000 $'000 % of Budget

Current Assets

Cash and cash equivalents 5 50,457 74,085 23,628 47%

Receivables 6 7,981 14,113 6,132 77%

Inventories 7 4,874 5,454 580 12%

Other current assets 206 560 354 172%

63,518 94,212 30,694 48%

Non-current assets classified as held for sale - - - 100%

Total Current Assets 63,518 94,212 30,694 48%

Non-Current Assets

Property, plant and equipment 8 294,266 301,532 7,266 2%

Other non current assets - 28 28 100%

Total Non-Current Assets 294,266 301,560 7,294 2%

Total Assets 357,784 395,772 37,988 11%

Current Liabilities

Payables 9 29,752 34,560 (4,808) 16%

Accrued employee benefits 97 1,190 (1,093) 1,127%

Unearned revenue 29 155 (126) 434%

Total Current Liabilities 29,878 35,905 (6,027) 20%

Total Liabilities 29,878 35,905 (6,027) 20%

Net Assets 327,906 359,867 31,961 10%

Equity

Contributed equity 10 264,481 287,999 23,518 9%

Accumulated surplus/(deficit) 11 31,751 52,071 20,320 64%

Asset revaluation surplus/(deficit) 12 31,674 19,797 (11,877) 37%

Total Equity 327,906 359,867 31,961 10%






Statement of Cash FlowsOriginal

Budget * Actual


Notes $'000 $'000 $'000 % of Budget

Cash flows from operating activities

Inflows:

User charges and fees 13 558,944 578,619 19,675 4%

Grants and other contributions 14 30,936 35,596 4,660 15%

Interest receipts 111 193 82 74%

GST input tax credits from ATO 12,417 10,143 (2,274) 18%

GST collected from customers - 593 593 100%

Other 3,568 2,612 (956) 27%

605,976 627,756 21,780 4%

Outflows:

Employee expenses 15 (1,683) (45,865) (44,182) 2,625%

Supplies and services 16 (585,190) (558,465) 26,725 5%

Grants and subsidies (1,655) (1,063) 592 36%

GST paid to suppliers (12,425) (10,249) 2,176 18%

GST remitted to ATO - (541) (541) 100%

Other (1,104) (1,984) (880) 80%

(602,057) (618,167) (16,110) 3%

-

Net cash provided by operating activities 3,919 9,589 5,670 145%

Cash flows from investing activities

Inflows:

Sales of property, plant and equipment (196) 91 287 146%

100%

Outflows: 100%

Payments for property, plant and equipment 17 (5,449) (14,188) (8,739) 160%

100%

Net cash used in investing activities (5,645) (14,097) (8,452) 150%

Cash flows from financing activities

Inflows:

Proceeds from equity injections 18 5,449 17,656 12,207 224%

Movements in equity - other 18 - - - 100%

Outflows:

Equity withdrawals - - - 100%

Net cash provided by financing activities 5,449 17,656 12,207 224%

Net increase in cash and cash equivalents 3,723 13,148 9,425 253%

Cash and cash equivalents at beginning of financial year 46,734 60,937 14,203 30%

Cash and cash equivalents at end of financial year 50,457 74,085 23,628 47%






Variance Notes


1 User charges revenue increased $23.1M over the original budget. The significant increase was mainly due to

amendments to the service agreement between DDHHS and the Department of Health. These amendments included

$11M for the delivery of public patient activity above baseline levels, $4.7M for enterprise bargaining agreements and

other service agreement amendments totalling $4.1M. DDHHS also had growth in Hospital fees revenue as a result of

treating private and Medicare ineligible patients ($3.5M).

2 Grants and other contributions revenue increased $4.6m above budgeted levels. This increased revenue was the

result of a $1M donation from the Toowoomba Hospital Foundation for the purchase of endoscopy equipment, $1M

increased revenue for residential aged care, $0.5M escalation on grants programs including home and community

care and transition care, $0.5M for additional multipurpose health service places and $1.3M for additional specialist

and student training programs.

3 Employee expenses increased $45.3M over the original budget. $44.9M of this variance was due to the

implementation of Senior Medical Officers Contracts, which came into effect in August 2014 and established a direct

employer-employee relationship with the HHS. These expenses were included in Supplies and services in the original

budget.

4 Supplies and Services expenses decreased $38.1M below the original budget. $44.9M of this variance was due to the

implementation of Senior Medical Officers Contracts, which came into effect in August 2014 and established a direct

employer-employee relationship with the HHS. Repairs and maintenance expenditure was $3.4M below budgeted

levels due to capitalisation of some expenditure associated with the Backlog Maintenance Remediation Program.

These decreases were offset by increased expenditure on reducing the elective surgery and endoscopy waiting lists

($4.7M) and managing renal patient activity ($1.8M). Expenditure on contractors increased $3.5M above budgeted

levels due to staff turnover.


5 Cash & cash equivalents increased $23.6M over the original budget. The significant increase is largely represented by

the HHS operating surplus ($20.7M), and by equity injections for capital expenditure ($3.3M).

6 Receivables have increased $6.1M above budgeted levels. This is primarily due to end of year accruals with the

Department of Health ($6.2M). These accruals represent outstanding amounts due to the HHS for amendments to the

service agreement and include amounts for additional public patient activity above baseline levels and enterprise

bargaining agreements.

7 Inventories have increased $0.6m over the original budget. This is predominately due to increases in medical

supplies and equipment inventory in preparation for the movement of stores functions managed by the Health

Services Support Agency from Toowoomba to the Richlands distribution centre.

8 Property plant and equipment has increased $7.3M over budgeted levels. Of this variance $12.5M is the result of

capital works projects delivered by the Department of Health including the Mental Health Community Care Unit,

upgrading fire safety systems in nursing homes and significant roof restorations at Baillie Henderson Hospital.

Additionally the HHS has invested in capital assets through the Backlog Maintenance Remediation Program ($4.1M),

reinvesting retained surpluses ($2.4M) and endoscopy equipment ($1.1M). Offsetting this is asset revaluation

increments that were budgeted for ($11.9M), however there were no material movements in the fair value of land and

buildings.

9 Payables have increased $4.8m over budgeted levels. This is primarily due to the timing of payments to the

Department of Health for reimbursements for Health service employee costs ($5.5m).

10 Contributed equity has increased $23.5M above budgeted levels. Of this variance $12.5M is the result of capital

works projects delivered by the Department of Health including the Mental Health Community Care Unit, upgrading fire

safety systems in nursing homes and significant roof restorations at Baillie Henderson Hospital. The HHS also

received $8.8M for the Backlog Maintenance Remediation Program.






Variance Notes continued

Statement of Financial Position continued

11 The Accumulated surplus has increased $20.3M representing the current year's operating surplus.

12 The Asset revaluation surplus is $11.9M below budgeted levels. The HHS budgeted for increases in the fair value of

assets, however there was no material movement to the fair value of non-current assets.


13 User charges receipts increased $19.7M over the original budget. The significant increase was mainly due to

amendments to the service agreement between DDHHS and the Department of Health ($18.7M). These amendments

included $4.7M for the delivery of additional public patient activity above baseline levels, $3.2M for enterprise

bargaining agreements and other service agreement amendments totalling $7.4M.

14 The movement in receipts for Grants and other contributions is consistent with the Operating Statement (variance

note 2)

15 The movement in payments for Employee expenses is consistent with the Operating Statement (variance note 3).

16 Payments for Supplies and services were $26.7M lower than budget. In addition to the operating statement variances

described in variance note 4 above, payments for Supplies and services were $10.5M higher than budget due to

reimbursements to the Department of Health for Health service employee costs.

17 The movement in Payments for Property, plant and equipment is consistent with the non-current asset acquisitions

detailed in variance note 8.

18 The movement in Proceeds from equity injections and Movements in equity other are consistent with the movements

in Contributed equity detailed in variance note 10.



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plo

yee

Exp

en

ses



DARLING DOWNS HOSPITAL AND HEALTH SERVICENotes to and Forming Part of the Consolidated Financial Statements 2014-15

26. Events occurring after balance date

Hospital and Health Services to be prescribed as employers

Currently, all staff, except Board members, Health Service Chief Executives, and senior health service employees currently

engaged on contract (working in an Hospital and Health Service), are employed by the Director-General, Department of

Health.

In June 2012, amendments were made to the Hospital and Health Boards Act 2011 , giving Hospital and Health Boards

more autonomy by allowing them to become the employer of staff working for their Hospital and Health Service. Hospital

and Health Services will become prescribed employers by regulation.

Once a Hospital and Health Service becomes prescribed to be the employer, all existing and future staff working for the

Hospital and Health Service become its employees. The Hospital and Health Service, not the Department of Health, will

recognise employee expenses in respect of these staff. The Director-General, Department of Health, will continue to be

responsible for setting terms and conditions of employment, including remuneration and classification structures, and for

negotiating enterprise agreements.

Government policy concerning prescribed employer arrangements is currently being reviewed. Pending the outcome of the

review, DDHHS is not expected to become a prescribed employer before 2016-17.

Industrial relation reforms for public servants and restoring collective employment arrangements for senior doctors

Recent industrial relations reforms have been passed by Parliament. These reforms start the process of reversing changes

which established individual statutory contract arrangements for contracted senior health service employees. Discussions to

restore awards and certified agreements for contracted senior health service employees have reached in principle

agreement between the Department of Health and medical industrial organisations. It is anticipated that these

employees will cease to be engaged under contract in 2015-16, however they will remain employees of DDHHS.

Appointment of Chief Finance Officer

After an extensive public, merit-based recruitment process Ms Melanie Reimann was appointed to the position of DDHHS

Chief Finance Officer. Ms Reimann commenced employment with DDHHS on 24 August 2015.

Other Matters

No other matter or circumstance has arisen since 30 June 2015 that has significantly affected, or may significantly affect

DDHHS’s operations, the results of those operations, or DDHHS's state of affairs in future financial years.


Darling Downs Hospital and Health Service | Annual Report 2014 125Darling Downs Hospital and Health Service Annual Report 2014-15 125

Darling Downs Hospital and Health Service | Annual Report 2014126 Darling Downs Hospital and Health Service Annual Report 2014-15126

127Darling Downs Hospital and Health Service Annual Report 2014-15


https://www.health.qld.gov.au/darlingdowns/

Documents

Annual Report 2014-2015 - Darling Downs Hospital …...2 Darling Downs Hospital and Health Service Annual Report 2014-15 Board Chair While I acknowledge there is always more to do,