Strategic Plan 2016-2020 - Gippsland Primary …...Strategic Plan 2016-2020 Annual Business Plan Gippsland Health Network Limited Trading as Gippsland PHN ACN: 155 514 702 Document

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Strategic Plan 2016-2020

Annual Business Plan

Gippsland Health Network Limited

Trading as Gippsland PHN

ACN: 155 514 702 www.gphn.org.au

Document No. DOC/17/4991

Business Unit/Owner Chief Executive Officer

Approvals Body/Date Exec Manager

CEO

Board 19 April 2017

Published HPRM Other

Document Control Review Annual Due 2018



Table of Contents Gippsland Health Network ................................................................................................................................ 3

Strategic Directions ....................................................................................................................................... 3

Our Vision .................................................................................................................................................. 3

Our Core Functions/Mission ...................................................................................................................... 3

Our Objectives ........................................................................................................................................... 3

Our Principles ............................................................................................................................................ 3

Our Values and Behaviours ....................................................................................................................... 3

Our Enablers .............................................................................................................................................. 3

Mission outcomes: What does success look like? ........................................................................................ 4

Governance and Advisory Structures ............................................................................................................ 5

Organisational Structure ............................................................................................................................... 6

Strategic Priorities ............................................................................................................................................. 7

Local Priorities ............................................................................................................................................... 7

Monitoring and Evaluation ............................................................................................................................ 7

Research, Ethics and Data Governance ......................................................................................................... 8

Quality and Safety ......................................................................................................................................... 8

Strengths, Weaknesses, Opportunities, Threats ........................................................................................... 9

Risk Management ........................................................................................................................................ 10

Program Management and Governance ..................................................................................................... 11

Commissioning Principles ............................................................................................................................ 12

Organisational Business Growth ................................................................................................................. 12

Information Management Systems ............................................................................................................. 13

Organisational Documentation ................................................................................................................... 13

Primary Health Networks ................................................................................................................................ 15

Primary Health Network Program Objectives ............................................................................................. 15

National Priorities ........................................................................................................................................ 15

Funding Agreements ................................................................................................................................... 16

Primary Health Network Program Evaluation ............................................................................................. 16

Tier 1: National Headline Indicators / KPIs ............................................................................................. 16

Tier 2: Local Indicators ............................................................................................................................ 16

Tier 3: Organisational Indicators ............................................................................................................. 16

Annual Business Plan 2016-2017 ..................................................................................................................... 17

Background .................................................................................................................................................. 17

Structure ...................................................................................................................................................... 18

Monitoring and Reporting ........................................................................................................................... 18



Gippsland Health Network

Gippsland Health Network Limited is trading as Gippsland Primary Health Network (Gippsland PHN).

Strategic Directions

Gippsland PHN Board expressed the strategic direction of the organisation by defining vision, core functions (mission), objectives, principles, enablers, values and behaviours. Together this is called our ‘Strategic Directions’.

Our Vision

Our Core Functions/Mission

Our Objectives

Improved health outcomes for people with chronic disease and those patients at risk of poor health

outcomes.

Improved coordination of care that ensures patients receive the right care in the right place at the right time.

Lower prevalence of national and locally prioritised conditions

Increased efficiency and effectiveness of medical services and other primary health services.

Our Principles

A long-term, whole system perspective

Performance, efficiency and value

Leading innovation and evidence-based practice

Collaborative local leadership

Equitable access

Consumer self-determination and empowerment

Our Enablers

Our Values and Behaviours

Community Centred

Ethical and Respectful

Innovative

Accountable

Quality



Mission outcomes: What does success look like?

At the 2017 annual Strategy Day, the board considered key outcomes and measures of success for the four mission areas. These were endorsed by the Board 15 March 2017.

Health Planning Systems Integration

1. Vulnerable communities and the population have a better consumer/carer experience

Access to services close to home

Information I need to navigate the health system is easily accessible and up to date

My health providers has all the information needed to meet my health needs.

2. The Gippsland community is healthier:

Decreased smoking rates

Decreased suicide attempts/rates

Decreased preventable hospital admissions for chronic disease, aged care and medication related concerns.

1. Health services are using information systems that connect and communicate quickly and accurately:

More services using interoperable systems that comply with national referral standards

Primary care can connect to each other, diagnostic services, and health/hospital services.

2. Referrals to specialist clinics and health

services are appropriate and high quality:

Service information is visible to practitioners and up to date

Referral acceptance is right first time, providing faster community access

Commissioning Practice Support

1. Markets are stimulated to improve access and quality of care for consumers.

Increased service availability in remote communities

2. Alcohol and Drug and mental health

community and carers can access the service system when they are ready to act:

Consumers and carers have a no wrong door experience and are given a list of suitable options

The service system is responsive and flexible using a stepped care model.

3. Service system design is informed by

clinicians and community:

Highly engaged clinical councils and community committee

High engagement of clinicians across Gippsland.

1. Patient outcomes are improved through localised, evidence based care:

HealthPathways is used to drive benchmarking and quality in health care

General Practices use POLAR GP to undertake clinical improvement activities

2. Clinicians experience greater collegiality and

support:

Access to quality education and training

Access to other professionals and expertise.

3. Health workforce is suited to local

communities and accessible:

Attractive training pipeline

Technology is an enabler to access services and reduces barriers of isolation

Business capacity developed

Business Services

1. Strong financial reserves with long term financial plan and increased funding diversity. 2. Comprehensive, integrated performance reporting and monitoring systems with risk and contract

management 3. High quality accredited organisation with strong data governance. 4. Gippsland PHN is reported as a great place to work, with a culture of success.

* Gold items are seen as leading measures for each mission area



Governance and Advisory Structures

Gippsland PHN has a Board of Directors with the Audit, Risk and Finance Committee, Clinical Governance Committee and Nomination and Remuneration Committee reporting to the Board. This ensures a dynamic coverage of topics and authorities are in place to govern process and approvals that enable the organisational performance. The Board employs a Chief Executive Officer to operationalise and implement the Board’s direction, and achieve the organisation’s goals and objectives. The Chief Executive Officer is guided by a comprehensive Instrument of Delegations and board level governance frameworks and policies. A challenge for the organisation is continuous meaningful engagement with local stakeholders including general practice, health and hospital organisations, to influence adoption of best practice, and advance coordinated and integrated care. Meso level organisations such as PHNs have a role and capacity to support practitioners to synthesise complexity, and crystallise solutions that enhance beyond current capacity. Through a culture of change management, PHNs create the link between local health services and the big picture of the whole health system and reduce the isolation particularly for general practice. They distribute information (evidence-based learning and resources) and provide individualised support, responding to health service need and capacity.1 Key features of Gippsland PHN are the Clinical Councils and Community Advisory Committee, ensuring health professionals and community are major contributors to the organisation. It is integral to Gippsland PHN that general practice, other health professionals as well as the consumer voice and experience of care in centrally involved in planning and advisory decision making about health solutions.

1 Australian Journal of Primary Health, 201 2.18, 101 104

GP Networks as enablers of quality of care: implementing a practice engagement framework in a General Practice Network. C Pearce, M Shearer, K Gardner, J Kelly and TB Xu



Our promise as stated in our Stakeholder Engagement and Communication Framework:

Gippsland PHN will involve its stakeholders in key decisions of the organisation to ensure transparency and accountability, recognising that this can be achieved moving fluidly across the spectrum of informing and consulting as required.

Organisational Structure

Gippsland PHN operates with an organisational structure incorporating the following business units

Office of Chief Executive Officer

Primary Health and System Integration

Health Planning and Commissioning

Corporate Services

Chief Executive Officer

Executive Manager Primary Health

and System Integration

Executive Manager Health Planning

and Commissioning

Executive Manager Corporate Services

https://www.google.com.au/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiO1aHb173MAhUDF6YKHZYKDuQQjRwIBw&url=https://www.flickr.com/photos/planspark/12249559465&psig=AFQjCNFFJxAPEPps5wdwQTtH_MRLQXX01w&ust=1462356905731886



Strategic Priorities

Local Priorities

Gippsland PHN works with organisations, health professionals, community groups and available data to analyse Gippsland’s population health profile to then determine local priorities. In 2015/16 a comprehensive needs assessment was undertaken which identified the following areas as local priorities to focus on through planned initiatives and programs to improve the health of Gippslanders in these areas. A snapshot and the full Needs Assessment report are available on our public website.

Monitoring and Evaluation

Within Gippsland PHN a number of indicators have been selected and are structured in the form of a Balanced Scorecard (BSC) provided to the Board on a quarterly basis. Working within an approach of ‘information and data being collected once and used multiple times’ many of the BSC indicators are also Organisational Indicators and/or Local Indicators gaining efficiencies in reporting resource required. The Balanced Scorecard includes governance level metrics relating to

Financial Performance

Stakeholders

Internal Operations

Learning and Development

Supporting People

•Children (0-14 years)

•People with disabilities

•Indigenous people

•People with social and financial worries

•People 60 years and over

•Young people (12-25)

Main Health Issues

•Alcohol and other drugs

•Cancer

•Heart related issues

•Ongoing lung related issues

•Diabetes

•Immunisation

•Mental health

•Reproductive/sexual health

Better Health Services

•Access to Services

•Better use of technology

•Services working together

•High quality care

•Enough trained health professionals



Program Level Metrics are streamed and linked into the governance level metrics so that performance can be monitored throughout the organisation. Linkage is defined in the Annual Business Plan.

Research, Ethics and Data Governance

Gippsland PHN is committed to continuous quality improvement, internally in all that we do, and externally in the services we commission and support we provide. A Research, Ethics and Data Governance Frameworks were adopted by the Board in March 2017 which provide strategic guidance to the organisation in how we integrate research and quality improvement in our work.

Quality and Safety

Endorsed by Health Ministers in 2010, the Australian Safety and Quality Framework for Health Care describes a vision for safe and high-quality care for all Australians, and sets out the actions needed to achieve this vision. The Framework specifies three core principles for safe and high-quality care. These are that care is consumer centred, driven by information, and organised for safety. The Framework provides 21 areas for action that all people in the health system can take to improve the safety and quality of care provided in all healthcare settings over the next decade. The Gippsland PHN Clinical Governance Framework describes the safety and quality standards for the organisation including understanding of systems and safeguards that govern clinical practice in commissioned services. The framework includes four pillars of clinical governance including:

Consumer Directed Care;

Clinical Risk Management;

Clinical Effectiveness and Appropriateness;

Effective Workforce and Staff Education.

As a commissioning organisation Gippsland PHN contracts supplier health services/stakeholders and requires them to provide evidence of adequate clinical governance against the four pillars of clinical governance.

At regular Program Management meetings, supplier health services are required to participate in clinical governance process audits or provide details of existing organisational audits and, if identified, undertake improvement activities to ensure internal Clinical Governance processes reach a minimum agreed standard.

The Supplier is also required to participate in ongoing discussions in relation to health system development and integration with a focus on the following areas:

Regular updating of the National Health Services Directory;

Exploration and utilisation of e-referral systems;

Exploration and utilisation of MyHealth Record;

Contribution to the development and use of Health Pathways.

Gippsland PHN benchmarks service performance and quality across the region, across the State using the Victorian PHN Alliance, and nationally against the national KPIs and other benchmarking opportunities still under development. Gippsland will transparently demonstrate accountability to quality and safety through pursuing organisational accreditation, internal and external auditing using external review.



Strengths, Weaknesses, Opportunities, Threats

The Board discussed the organisation’s strengths, weaknesses, opportunities and threats (SWOT) at its annual workshop in January 2016, and finalised the assessment at its October 2016 meeting as follows.

HELPFUL

To achieving the objective HARMFUL

To achieving the objective

INTE

RN

AL

OR

IGIN

(A

ttri

bu

tes

of

the

org

anis

atio

n)

STRENGTHS

Improving stakeholder and consumer engagement and awareness increased

Awareness and declarations of Interests

Current suite of skills, and cumulative experience

Evidenced based approach

Use of data, health planning

Professionalism

Defined purpose

Early wins, Clinical Councils, Community Committee

Evolving maturing commissioning

Financial reporting

Gippsland wide catchment

WEAKNESSES

Financial reporting – still progressing

Insufficient (unencumbered) cash reserves

Diversity of funds

Conflicts of Interest

National PHN KPIs

Size of Gippsland PHN

EXTE

RN

AL

OR

IGIN

(A

ttri

bu

tes

of

the

en

viro

nm

en

t)

OPPORTUNITIES

Conflicts of Interest constantly monitored

Evidenced based approach

Use of data (GP data and health mapping) – consolidate and use for knowledge and growth, turning data into knowledge/wisdom particularly in terms of commissioning

Goodwill – people willing to work with us

Grow diversity of funding

Benchmarking across PHNs.

Financial reporting

Innovation

State funding and mechanism to be used

Collaboration with external parties

THREATS

Conflicts of Interest – need to constantly monitor and manage

Demonstrate performance and success or be at risk

Potential federal political instability

Closing the commissioning cycle to learn and evaluate – closing growth loop and demonstrate achievement

Insufficient reserves / cash – need to diversify funds

Benchmarking across PHNs, turn Data into knowledge/wisdom particularly in terms of commissioning

Size of Gippsland PHN



Risk Management

Risks are monitored through a Risk Management Governance Framework which includes Board level strategic risks, and articulates the Board’s strategic risk appetite. Executive and Program Level risks are detailed and an on-line risk documentation and monitoring system is being developed to enable regular review.

The following Strategic Level Risks have been identified

1. Performance of the commissioning cycle is not adequate to guide appropriately identified priorities, services purchased, safely delivered, monitored for continuous improvement.

2. Funding sources and limitations do not allow agile responsiveness to identified health priorities. 3. General Practice engagement is not adequate to meet their support needs or to influence

improved practice. 4. Stakeholder needs and expectations (internal and external) are not adequately understood and

addressed which reduces our ability to engage and achieve objectives. 5. Lack of infrastructure, capability and resources (internal and external) does not enable

outcomes to be measured and achieved. 6. Health services and systems are not adequately integrated to enable improved efficiency,

effectiveness and patient experience.

Strategic Risk Profile

Enterprise Risk Profile

Business Unit Risk Profiles

Strategy Board

Executive

Operational Management

Material Risks

Operational

TYPES OF RISK



Program Management and Governance

Programs will be governed in line with the Gippsland PHN Project Management Framework which is based on Prince2 best practice project management methodologies. The Framework ensures that projects are aligned with organisational strategic direction, appropriately resourced in terms of time, money and competency and that accountability through appropriate approvals processes, risk management, stakeholder engagement, communication, budgetary control and reporting mechanisms are built in to project governance. This structure provides for transparent accountability to both Board and funders. Example Gippsland PHN project governance structure using Prince2

Prince2 Methodology



Commissioning Principles

Gippsland PHN is committed to a process of strategic planning and investment in quality primary health care services with the aim of maximising health gain for the population and efficiency for the health system.

It can be defined as

• A whole of organisation approach targeted specifically at addressing the health needs of the local community

• Clearly focussed on developing quality primary health care services and associated interventions that deliver better health outcomes

• Promote joint working and coordination across the whole health care system for the benefits of the patients

This approach is underpinned by two governance frameworks:

Commissioning Governance Framework

Procurement Governance Framework

Organisational Business Growth

Gippsland PHN’s approach to ongoing business continuity and business growth is to ensure that the organisation has planned for securing diversified income streams either through existing business operations or via new and strategic business opportunities that are consistent with our mission. The organisation will take a long term view with regard to fiscal planning to underpin the mitigation of short term deficits and towards achieving long term liquidity. This will be achieved via development of a long term financial plan that will be monitored and reviewed annually. The long term financial plan will serve as a blue print for business continuity beyond the Gippsland PHN’s contracted tenure of 2018 and provide a basis for growth that has been conservatively ascertained through acquirement of planned and deliberate diversified income.

Plan

DeliverReview

Analyse

Stage Components

1. Analyse Analysis of resources/service provision Population Needs Assessment Legislation/Policy/Guidance Market drivers

2. Plan Service Gap Analysis Commissioning Strategy Co-design services – shape supply

3. Deliver Service capacity building Sector development Procurement Provider relationship management

4. Review Evaluate outcomes Review strategy and performance



Information Management Systems

Organisational IT systems are well developed and near completion to optimise the integration of financial, governance and program related applications to link our sites at Moe, Wonthaggi and Bairnsdale in real time. This will facilitate improved systems support for external stakeholders and flexible, customised reporting capability for Board, Management and external funder purposes. Establishment of an electronic document management system (HPRM) has enhanced the organisation’s ability to store all documentation on a centralised basis with consistent classification and archival conventions. Remote and easy access to global organisational information are the hallmarks of the system, with access determined on the responsibility profile of employees. Together with the organisation’s intranet (Sharepoint currently under development), transition from paper based records is well advanced and in time single source electronic documentation will overcome issues of version control and create a high degree of information integrity. The payroll (Meridian) and financial (NAV Dynamics) systems are implemented and well advanced and will be supported by the reporting function (BI360) currently under implementation. Together these systems will enable fast reporting and link performance to strategic directions and monitoring such as the Board’s balanced scorecard. A customer relationship management (CRM) system is being established to manage the member and stakeholder engagement, tracking and reporting. This will enable transparent accountability and help to demonstrate links between PHN influence and performance outcomes.

Organisational Documentation

Gippsland PHN is supported by an Organisational Documentation Governance Framework which operationally supports activities undertaken by the organisation. The Organisational Documentation Governance Framework details

The responsibilities of Gippsland PHN’s Board and staff in relation to Organisational Documentation development and review activities.

Structure to define the level and type of information that needs to be included.

Appropriate approvals and ownership.



The diagram below demonstrates all identified Governance Level Frameworks.

Organisational Governance

Clinical Governance

Commissioning

Health Planning

Practice Support

System Integration

Finance

Stakeholder Engagement and Communication

Procurement

Human Resources

Risk

Monitoring and Evaluation

Information and Communications Technology

Project Management

Organisational Documentation

Research and Ethics

Data Governance

Quality Improvement

PURPOSE & CULTURE GOVERNING ENABLING MISSION



Primary Health Networks

Gippsland PHN is primarily funded by the Federal Department of Health through the Primary Health Network Program. This program is the government’s main mechanism for addressing and implementing health reforms, including a focus on consumer outcomes through improved quality care and great outcomes in an increasingly challenging environment.

Primary Health Network Program Objectives

The key objectives of PHN’s are to:

Increase the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes; and

Improve coordination of care to ensure patients receive the right care in the right place at the right time.

PHN’s are expected to achieve these objectives by

Understanding the health care needs to their PHN communities through analysis and planning. They will need to know what services are available and help to identify and address service gaps where needed, including in rural and remote areas, while getting value for money;

Providing practice support services so that GPs are better placed to provide care to patients subsidised through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), and help patient to avoid having to go to emergency departments or being admitted to hospital for conditions that can be effectively managed outside of hospitals;

Supporting general practices in attaining the highest standards in safety and quality through showcasing and disseminating research and evidence of best practice. This includes collecting and reporting data to support continuous improvement;

Assisting general practices in understanding and making meaningful use of eHealth systems, in order to streamline the flow of relevant patient information across the local health provider community; and

Working with other funders of services and purchasing or commissioning health and medical/clinic services for local group most in need, including, for example, patients with complex chronic conditions or mental illness.

National Priorities

Activities of PHN’s are guided by a number of national priority areas

Mental health;

Aboriginal and Torres Strait Islander health;

Population health;

Health workforce;

Digital health; and;

Aged Care



Funding Agreements

Department of Health provide funding to Primary Health Networks through Standard Funding Agreement Schedules across a variety of areas of health reform and provide specific objectives for the area in focus. Funding agreements currently in place include

Primary Health Networks Core Funding - Operational and Flexible Funding, After Hours Primary Care, Innovation

Indigenous Australian’s Health Program – Integrated Team Care

Primary Mental Health Care

Drug and Alcohol Treatment Activities

Partners in Recovery

Primary Health Network Program Evaluation

The federal Department of Health evaluate the ongoing success of the PHN program through a number of indicators structured across 3 tiers.

Tier 1: National Headline Indicators / KPIs

A set of prescribed indicators that reflect the Australian Government priorities (get full descriptors

Potentially preventable hospitalisations

Childhood immunisation rates

Cancer screening rates (cervical, breast and bowel)

Mental health treatment rates (including for children and adolescents) The Department of Health acknowledges that there are a number of drivers which potentially influence a PHNs ability to effect improvement in the national headline indicators. Reporting: PHNs are not required to collect or report on data for national headline indicators. Data for these will be independently sourced for each indicator by DOH.

Tier 2: Local Indicators

Local indicators acknowledge the unique context and primary health care needs of each PHN and the need to pursue locally relevant activities. Developed through the strategic planning phase of commissioning and annual work plan process, PHNs are required to identify at least one local indicator to measure the successful attainment of intended outcomes. Reporting: PHNs are required to report against Local Indicators in six and twelve month reports to the Department of Health.

Tier 3: Organisational Indicators

Prescribed indicators on the characteristics and activities of PHNs relating to

Governance

Financial management

Stakeholder engagement

Commissioning Organisational indicators measure the organisations capability to deliver on activities measured through the national headline and local indicators. The purpose of organisational indicators is to measure organisational growth and maturity to support continuous improvement. Reporting: PHNs are required to report against Organisational Indicators in six and twelve month reports to the Department of Health.



Annual Business Plan 2016-2017

Background

Development on an Annual Business Plan supports achievement of the organisational vision of ‘a measurably healthier Gippsland’ through clear definition of objectives and measurables at multiple levels of the organisation as well as assigning accountability and responsibility for delivery.



Structure

This document will demonstrate the Mission and Enablers in the structure of What, How, Why and Measures and provide a more detailed explanation for each area.

Mission Enablers 1. Commissioning 2. System Integration 3. Practice Support 4. Health Planning

5. Governance 6. People 7. Quality (inc. Data) 8. Culture (inc. Values and Behaviours) 9. Business Services (inc. Technology and Financial)

What Outcomes do we want to achieve for the people of Gippsland

Outcomes do we want our people and systems to achieve

Why We choose to focus our attention and resources in these areas

How Do we intend to achieve the desired outcomes

Measures How will we measure our success

Monitoring and Reporting

The Annual Business Plan is a live document saved within the Gippsland PHN document management system and is used to track progress towards activities. A quarterly high level report is provided to the board. Continuing development will create interconnectivity between reporting against the business plan and Board’s Balanced Scorecard. It is essential to monitor and report outcomes relating to both Mission and Enablers. This recognises that successful delivery of mission is dependent upon and the appropriate performance of enablers.

Documents

Strategic Plan 2016-2020 - Gippsland Primary …...Strategic Plan 2016-2020 Annual Business Plan Gippsland Health Network Limited Trading as Gippsland PHN ACN: 155 514 702 Document