and Human Services
policy and funding
guidelines 2016
Volume 2: Health operations 2016–17
Chapter 1: Overview, key changes and new initiatives
To receive this publication in an accessible format, please phone 9096 8572 using the National Relay Service 13 36 77 if required, or email <>.
Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne.
© State of Victoria, Department of Health and Human Services July 2016.
Where the term ‘Aboriginal’ is used it refers to both Aboriginal and Torres Strait Islander people. Indigenous is retained when it is part of the title of a report, program or quotation.
Available at <https://www2.health.vic.gov.au/about/policy-and-funding-guidelines>.
Printed by Impact Digital, Brunswick (1605009)
Contents
Ministers’ foreword 11
Chapter 1: Overview, key changes and new initiatives 13
1.1 Overview 14
1.2 Highlights 16
1.2.1 Better Care Victoria 16
1.2.2 Statewide Design, Service and Infrastructure Plan 16
1.2.3 Victoria’s 10-year mental health plan 18
1.2.4 Victorian health and wellbeing plan 2015–2019 19
1.3 Budget highlights 21
1.3.1 Output initiatives 21
1.3.2 Asset initiatives 24
1.4 Quality and safety 28
1.4.1 Patient safety in Victorian public hospitals 28
1.4.2 Credentialing and scope of practice 28
1.4.3 Clinical governance 28
1.4.4 Open disclosure 29
1.4.5 Victorian Healthcare Experience Survey 29
1.4.6 Consumer participation and experience 30
1.4.7 Incident reporting 30
1.4.8 Staff safety in Victorian health services 31
1.4.9 Workplace culture 31
1.4.10 Implementation of the Health Complaints Act 2016 31
1.5 Victorian health services performance framework 33
1.5.1 Policy and funding guidelines 33
1.5.2 Statement of Priorities 34
1.5.3 Multipurpose service tripartite agreements 34
1.5.4 Notification obligations 35
1.6 Service performance 36
1.6.1 Health service performance measures 36
1.6.2 Performance monitoring for community service organisations 36
1.6.3 Transparency in Government Bill 36
1.6.4 Mental health annual report 37
1.7 System improvements and innovation 38
1.7.1 Health system innovation 38
1.7.2 Mental health and drugs 40
1.7.3 Our pathway to change: eliminating bullying and harassment in healthcare 42
1.7.4 Responding to family violence 42
1.7.5 Telehealth 42
1.7.6 Cancer service reform 43
1.7.7 Elective surgery 43
1.7.8 Victorian Patient Transport Assistance Scheme 45
1.7.9 Ageing, aged care and supported residential services 46
1.7.10 Acute and subacute services 47
1.7.11 Specialist clinics access 54
1.7.12 Nurse/Midwife to Patient Ratio Improvements Taskforce 55
1.7.13 Ambulance services 55
1.7.14 Non-Emergency Patient Transport Regulations 2016 57
1.7.15 Community health services 57
1.7.16 Health literacy 58
1.7.17 Meeting the needs of Victoria’s diverse populations 58
1.7.18 Working towards greater gender equality 59
1.7.19 Implementation of changes to the Assisted Reproductive Treatment Act 2008 59
1.7.20 Health Purchasing Victoria 60
1.7.21 Clinicians Health Channel 61
1.7.22 Public Health and Wellbeing Amendment (Safe Access Zone) Bill 2015 61
1.7.23 No Jab, No Play 61
1.8 The pricing and funding framework for Victorian health services 62
1.8.1 Pricing and funding framework 62
1.8.2 Commonwealth funding 62
1.8.3 Funding reforms 2016–17 63
1.9 Data and reporting changes 68
1.9.1 Revisions to the Victorian Hospital Admission Policy 68
1.9.2 Data collection changes 68
List of tables
Acronyms and abbreviations
iii
Ministers’ foreword
The Victorian Budget 2016–17 provides an extra $2.45 billion over four years for hospitals facilities and services, elective surgery, ambulances and mental health services.
This biggest ever increase in health funding will see more patients receive the care, treatment and surgeries they need sooner, and ensure our hardworking doctors, nurses and paramedics get the support they need to save lives and keep Victorians healthy.
It will help get patients of elective surgery waiting lists with the Australia’s largest ever one-off investment to tackle waiting lists.
This $335 million boost will see nearly 200,000 patients get their surgery this year, and includes immediate funding to build more theatres, open more beds and buy more equipment to support health services to treat more patients, more quickly.
The Budget also increases its much-needed funding for the mental health system to support Victorians with a mental illness and their families.
A $356 million boost for mental health will focus on providing better access to services and investing in prevention. With $132 million will assist in managing critical demand in the mental health system and ensuring people with a mental illness receive the specialist intensive care they need.
As part of this funding package, the Andrews Labor Government is investing in more mental health services and establishing new facilities, with $59 million to rebuild Orygen Youth Mental clinical and research facility in Parkville.
Through the 10-year Suicide Prevention Framework – which aims to halve the number of suicides over the next decade - $27 million will be provided for new suicide prevention initiatives.
Investing in hospital infrastructure to improve capacity to meet current and future demand is also a key focus, with a new dedicated $200 million fund to rebuild regional and rural hospitals across the state.
In addition to this new $200 million Regional Health Infrastructure Fund, the Budget provides $169 million to redevelop Goulburn Valley Health in Shepparton and $61.3 million for Western Health. Work will also begin on Australia’s first specialist stand-alone heart hospital at Monash University in Clayton.
Victoria’s ambulance service and paramedics will receive the support they need to make sure Victorians needing emergency care get better, faster responses.
A $144 million boost will go towards rebuilding our ambulance system and giving paramedics the support and resources they need to save lives.
Hundreds of children with severe epilepsy will have access to medicinal cannabis as early as 2017, with $28.5 million fast-tracked to support the establishment of the Office of Medicinal Cannabis and an independent Medical Advisory Committee as part of the roll-out of the Victorian Medicinal Cannabis Access scheme.
Whether it’s through building new facilities, providing extra funding and resources, or investing in new initiatives to keep Victorians safe and healthy – Victorian patients, their families and our health services can have confidence that the Andrews Labor Government is putting them first.
The Honourable Jill Hennessy MP
Minister for Health
Minister for Ambulance Services /
Martin Foley MP
Minister for Housing, Disability and Ageing
Minister for Mental Health
Volume 2: Health operations 2016–17 Page 11
Overview, key changes and new initiatives
Chapter 1: Overview, key changesand new initiatives
1.1 Overview
The Victorian Government is responsible for ensuring that a wide range of health services are delivered to the Victorian community. The Department of Health and Human Services (‘the department’) plans, develops policy, funds and regulates health service providers and activities that promote and protect the health of Victorians. Through the department, the government funds more than 500 organisations to provide various health services to Victorians including:
• acute and subacute healthcare delivered by public hospitals and in community settings
• mental health and alcohol and drugs services delivered by public hospitals and community service organisations (CSOs)
• residential care for older people, support and assistance to enable people to function independently in their own homes, positive ageing programs, and healthy and active living
• primary health services delivered by a wide community of health services
• health promotion and protection through emergency management, public health and related preventative services, education and regulation
• emergency transport and ambulance services through Ambulance Victoria.
The Department of Health and Human Services policy and funding guidelines 2016: Volume 2, Health operations 2016–17 (‘the guidelines’) represent the system-wide terms and conditions (for funding, administrative and clinical policy) of funding for government-funded healthcare organisations.
The guidelines reflect the government and department’s role as a system manager and underpin the agreements at an organisational-level (Statements of Priorities (SoPs) and Service Agreements). The agreements set out the requirements that funded organisations must comply with in addition to their contractual and statutory obligations, outline activity that is required in order to receive funding, and detail expectations of administrative and clinical conduct.
The guidelines are relevant for all funded organisations including health services, community service organisations and other funded organisations such as Ambulance Victoria.
Volume 2 is divided into five chapters:
• Chapter 1 sets out the key changes and initiatives in 2016–17
• Chapter 2 focuses on the financial framework for providing funding
• Chapter 3 outlines all the prices and associated cost weights that support the overall financial framework
• Chapter 4 outlines the conditions and expectations of that funding
• Chapter 5 includes the modelled budgets for organisations that receive more than $1million in health funding.
In addition to these guidelines, funded organisations are expected to comply with all relevant policy documents and guidelines. A list of key policies and guidelines can be found at https://www2.health.vic.gov.au/about/policy-and-funding-guidelines>.
Hospital circulars provide updates on the changes that affect health services during the year. These are available at https://www2.health.vic.gov.au/about/news-and-events/hospitalcirculars>.
Funded organisations should always refer to the guidelines website for the most recent version of the guidelines, as items may be updated throughout the year.
Where these guidelines refer to a statute, regulation or contract, the reference and information provided in these guidelines is descriptive only. In the case of any inconsistencies or ambiguities between these guidelines and any legislation, regulations and contractual obligations with the State of Victoria acting through the department or the Secretary to the department, the legislative, regulatory and contractual obligations will take precedence. Each funded organisation should refer to the relevant statute, regulation or contract in order to ascertain all the details of its legal obligations. If any funded organisation has questions in relation to its legal obligations it should seek independent legal advice.
A note on terminology
The term ‘funded organisations’ relates to all entities that receive departmental funding to deliver services. Aspects of these guidelines referring to funded organisations are applicable to all department-funded entities.
For the purposes of these guidelines, the term ‘health services’ relates to public health services, denominational hospitals, public hospitals and multipurpose services, as defined by the Health Services Act 1988, in regard to services provided within a hospital or a hospital-equivalent setting. Aspects of these guidelines that refer specifically to ‘health services’ are only applicable to these entities.
The term ‘community service organisations’ (CSOs) refers to registered community health centres, local government authorities and non-government organisations that are not health services.
These guidelines are also relevant to Ambulance Victoria, Health Purchasing Victoria, Ramsay Health Care and the Victorian Institute of Forensic Mental Health. The guidelines specify where aspects of the guidelines are relevant for these organisations.
1.2 Highlights
1.2.1 Better Care Victoria
The Victorian Government is investing in and improving Victoria’s health system to ensure that all Victorians get the right care, in the right place, at the right time, and innovation is a central component of these efforts.
In 2015 the Travis Review: Increasing the capacity of the Victorian public hospital system for better patient outcomes, highlighted that innovation is vital to the future of Victoria’s public health system, as one of the best ways to sustainably increase the capacity of our public hospitals and to deliver better access to public health services and better quality of care to Victorian patients.
In response to the Travis Review, Better Care Victoria has been established to support the sector in identifying, scaling and embedding innovation effectively.
Dedicated clinicians and service providers across the state have many great ideas about how to improve our system and are often leading improvement efforts at a local level. Better Care Victoria will look across our health system to draw on the expertise and innovation that is already happening and invest in spreading this across our system.
The Better Care Victoria Innovation Fund will provide funding for sector-led innovation projects and support the development of innovation capability across the state. In 2016–17 the Better Care Victoria Innovation Fund will have $10 million to invest across the Victoria. Funded projects will be required to demonstrate a strong ability to significantly improve timely and appropriate access to high-quality care for Victorians. Initially this investment will be across five focus areas: chronic complex medical patients; outpatients; care outside the hospital walls; variance in practice in delivering defined areas of care; and the 24-hour health system.
Better Care Victoria has an independent board, chaired by Dr Douglas Travis, to advise the Minister for Health on health sector innovation and investment of Better Care Victoria’s innovation funding.
In addition to the innovation funding, Better Care Victoria will offer a range of services to support sector-led innovation including:
• analytical and evaluation support
• delivery support for innovation projects
• knowledge sharing of best practice innovation and ‘how-to guides’
• innovation engagement and networking
• leadership and innovation capability building.
The combined efforts of Better Care Victoria are about helping to develop new, improved and more integrated models of care and service delivery across our system. Innovation that helps to ensure that we can provide appropriate and timely access to the highest quality of care for all Victorians for many years to come.
1.2.2 Statewide Design, Service and Infrastructure Plan
The Victorian public health system is entering a new era of service planning from a whole-of-health system perspective. Planning for the provision of health services will be less a question of individual projects or programs pursued in relative isolation, as one of how the department can best coordinate and integrate health services to achieve a greater overall system outcome for patients and communities.
Directions for the health service system in Victoria are driven by a set of challenges that are common across the state, at the national level and in many other countries. These challenges include:
• addressing inequalities and disparities in health outcomes, especially for Aboriginal people, people living in areas with low socio-economic status, people living in rural and remote areas, people with disabilities, and people with a mental illness
• responding to the changing needs and expectations of consumers, including providing person-centred care and ensuring consumer participation in the planning, design and delivery of healthcare services