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Tasmanian Health Assistance Package

Tasmanian Health Assistance Package - Key Facts and Figures

On 15 June 2012, Minister Plibersek announced a $325¹ million package for Tasmania’s health system, outlining a number of significant investments to ease pressures and equip Tasmania’s health system to meet future challenges.

PDF printable version of Key Facts and Figures - December 2012 (PDF 469 KB)

The Package focuses on the following key areas:

• addressing social determinants of health and health risk factors;
• improving care coordination for people with chronic disease and aged care clients;
• trialling streamlined care pathways – enabling Medicare Locals to use flexible funds to better meet the post hospital care needs of patients;
• clinical redesign of Tasmania’s health and hospital system;
• establishment of walk-in centres in Hobart and Launceston;
• funding an elective surgery blitz to benefit overdue patients on Tasmania’s waiting lists;
• providing innovative flexible funding for mental health;
• investments in eHealth initiatives;
• strengthening palliative care services; and
• strategies to build workforce capacity.

The Commonwealth recognises the importance of ensuring that experts and key stakeholders have an opportunity for input into the design and implementation of these initiatives. It is also recognised that many of these initiatives are interlinking and must be developed and implemented with this in mind, in order to get the best outcomes and benefits for Tasmanians.

Addressing social determinants of health and health risk factors

$13.3m over 4 years

This element aims to address the social determinants of health (such as social status, health literacy, housing and education) and target health risk factors (such as providing strength development and fitness programs for frail, older Tasmanians, and addressing excessive alcohol consumption, smoking, physical inactivity and poor diet).

• Initiatives under this element will focus on:

-reducing inequalities in health and improving health outcomes across Tasmania;
- improving health system efficiency; and
- reducing health system pressure.

• The Tasmania Medicare Local (the primary care organisation established to coordinate primary care delivery and tackle local health care needs and service gaps) will use local expertise to develop and implement innovative initiatives for at-risk groups.
• Commences in 2012-13

Improving care coordination for people with chronic disease and aged care clients

Top of Page

$35.4m over 4 years

This element of the Package addresses the need to develop better coordination for patients who have regular and frequent contact with the health system. In order for this element to be successful it must link with other initiatives under this Package such the eHealth elements, walk-in centres and those involving the Medicare Locals and other providers. This element will:

• focus on improving care coordination for people with chronic and complex disease and for aged care clients (living in a residential aged care facility or in the community) with the aim of better integrating patient transitions through primary, secondary, and aged care services;
• involve the Tasmania Medicare Local (TML) in managing a pilot program to improve care coordination - the pilot may include implementing hospital avoidance strategies for people with complex health needs;
• involve an Expert Advisory Group to assist in the development of this element, recognising the importance of engagement and drawing on local expertise to ensure Tasmanians receive the most appropriate services for their particular circumstances and context; and
• commence in 2012-13.

Trialling of streamlined care pathways – Medicare Locals using flexible funds to better meet the post hospital care needs of patients

$11.2m over 4 years

This element aims to better meet the health care needs of patients after leaving hospital, and its successful implementation will rely on close linkages with other components of this Package to ensure joined-up and integrated approaches for patients moving through the Tasmanian health system, such as clinical redesign within hospitals and eHealth. This element will:

• aim to improve patient transitions between the acute and primary or aged care sectors, this element will seek to:

- reduce hospital length of stay and re-admissions;
- reduce adverse patient events and associated health care utilisation;
- improve the ability of GPs to lead and provide ongoing care to patients; and
- improve post hospitalisation health outcomes for patients.

• be delivered through the TML in consultation with its local stakeholders; and
• commence in 2012-13.

Clinical redesign of Tasmania’s health and hospital system

$40.9m over 4 years

This element is an investment pool to be utilised to improve health system capacity. In particular this element will address:

• the way clinical services are currently delivered in Tasmania’s public hospitals and across the wider health system to ensure that demand and resources can be effectively managed into the future;
• improvements in patient safety and quality of clinical care, by removing obstacles to patient flow that contribute to emergency department overcrowding and patients waiting too long for surgery;
• opportunities for redesigning patient care services with local and regional needs in mind and the unnecessary use of acute hospital services by improving links with primary and community care, particularly with regard to the effective management of patients with chronic disease;
• finding good ideas that have been raised in Tasmania and on the mainland, with the view to adapt and make use of those good ideas to ensure they are fit-for-purpose in the Tasmanian health system; and
• will commence in 2012-13.

Establishment of walk-in centres in Hobart and Launceston

Up to $22.8m over 4 years

This element of the Package seeks to alleviate pressures on the Tasmanian health system, and will have close links to other Package elements to ensure the best outcome for patients. In particular this element will:

• establish walk-in centres in Hobart and Launceston which provide free-of-charge primary healthcare services for people with a range of minor illnesses and injuries;
• assist in managing after-hours and non-urgent patients who might otherwise have presented to an emergency department;
• be developed and implemented based on local need (may be different in each of the two locations), and will be determined in consultation with local stakeholders; and
• commence in 2012-13.

Funding for elective surgery blitz to benefit overdue patients on Tasmania’s waiting lists

$31.2m over 4 years

One of the key priorities of the Package is the reduction of elective surgery waiting lists in Tasmania. Under this element surgeries commenced in September 2012:

• at least 2,600 additional elective surgery procedures will be provided to treat patients on public hospital waiting lists who have been waiting longer than the clinically recommended period for their elective surgery; and
• an annual Action Plan will be agreed between the Commonwealth and Tasmanian governments under the National Partnership Agreement, that will detail the projected volume and mix of elective surgery categories to be targeted for that year.

Providing innovative flexible funding for mental health Top of Page

$15.4m over 4 years

This element will provide funding to deliver additional mental health and support services in Tasmania, and will:

• target gaps in mental health service delivery and populations not traditionally well served, by encouraging innovation in the mental health system;
• effectively identify and target existing and emerging service gaps through consultation with local stakeholders; and
• commence in 2012-13.

Investment in eHealth initiatives

$36.8m over 3 years

There are three strategies under the Commonwealth Package that provide important investments in eHealth for Tasmania, these include:

Enabling public hospital connection to the Personally Controlled Electronic Health Record System

• This element will enable public hospitals in Tasmania to connect to the personally controlled electronic health record (PCEHR) system.
• This will enable staff to view the record of participating patients and to create electronic discharge summaries that can then be viewed by other authorised providers involved in the patient’s care, such as their general practitioner.
• Upgrade of the clinical systems will also provide capability for hospitals to create other clinical documents such as specialist letters and event summaries.
• Expected commencement: from June 2014.

Support allied health connection to the Personally Controlled Electronic Health Record System

• This element aims to support allied health professionals to connect to the PCEHR system and will fund the modelling of eHealth solutions designed specifically for allied health practitioners.
• Funding will also include software vendor support for investment in desktop system solutions.
• Expected commencement: from June 2014.

Supporting the adoption of e-pathology and diagnostic imaging

• This element aims to support adoption of key components of electronic pathology and diagnostic imaging in Tasmania, including electronic requesting of pathology tests and images, and sending reports back to the requester.
• Funding will also include support for upgrades to GP desktop software.
• The PCEHR will also be upgraded to make available electronic pathology and diagnostic imaging reports from participating providers and consumers.
• Expected commencement: from June 2014.

Strengthening Palliative Care services

$63.2m over 4 years

There is recognition under this Package of the need to build on and strengthen palliative care services in Tasmania, which focus on coordination and communication through eHealth technology, addressing training and development and strengthening care options for patients through community based palliative care. There are three strategies under the Commonwealth Package, these include:

Expanding the Cradle Coast eHealth site to support improved palliative care service delivery

• This element aims to expand deployment of electronic Advance Care Plans (ACPs) across residential aged care facilities in Tasmania.
• 2012-13 funding for this element will support the continuation of the Cradle Coast Connected Care (4C) clinical repository.
• In following years, this element will support the continued rollout of ACPs in residential aged care facilities in Tasmania.
• Funding will also support local health areas to engage clinical resources to provide training to residential aged care facilities across Tasmania in how to use the advanced care planning tool set developed by the Cradle Coast eHealth site.
• Commences: 2012-13.

Pilot project in Tasmania: palliative care training

• This element aims to build capacity in Tasmania by improving the palliative care services delivered to people living at home. The funding will be provided to enhance the palliative care support skills of GPs, nurses, pharmacists, aged and community care workers, respite carers, carers and volunteers through piloting training, workshops and seminars of the existing Guidelines for a Palliative Approach for Aged Care in the Community Setting.
• The project will complement an existing National Palliative Care Program project to develop an online approach to education and training for the Guidelines. The pilot project will be evaluated to help determine whether online or face-to-face training education is more effective and efficient.
• Commences: 2012-13.

Enhancing subacute care – Better access to community based palliative care services

• This element will support delivery of multi-disciplinary; community based palliative care services for people in Tasmania, by expanding the palliative care service capacity of the private, non-government and public health sectors.
• It is envisaged that services will link with existing acute in-patient services to ensure continuity of care across treatment settings within a palliative care services network.
• Commences: 2012-13.

Strategies to build workforce capacity

$54.9m over 4 years

In order for the elements of this Package to be successful there must be the appropriate workforce response and planning, with particular emphasis on strategies involving a range of clinicians, that is, doctors, nurses and allied health professionals. It will also require working with the education sector to ensure that clinicians in Tasmania can be locally trained. There are four strategies under the Commonwealth Package to build this capacity in Tasmania:

Workforce – Medical Specialist Outreach Assistance Program Tasmania expansion Top of Page

• This element aims to increase access to medical specialists in Tasmania, and expands Tasmania’s fly in fly out services by expanding the Medical Specialist Outreach Assistance Program (MSOAP).
• Funding under this element will be additional to the core funding already provided through MSOAP, which removes disincentives for specialists to provide services in these locations.
• Expansion of MSOAP in Tasmania aligns with the Government’s priority to make medical services more accessible to people living in regional, rural and remote locations, by increasing service levels and reducing the comparatively high burden of disease for people in rural Tasmanian communities.
• Commences: 2012-13.

Workforce – Training more doctors in Tasmania

• The element involves targeted funding to support the training and retention of hospital-based doctors and specialist doctors training in other settings in Tasmania.
• Funding will be delivered through enhancing existing training arrangements to enable investments in new training places, new salaried supervisor positions, new training coordinator positions and enhanced professional development initiatives to improve retention and recruitment.
• Commences: 2013-14.

Workforce – Academic health sciences precinct pilot project

• This element will promote teaching, training and research excellence within Tasmanian hospitals by establishing a Virtual Academic Health Sciences Precinct that integrates Royal Hobart Hospital, the University of Tasmania Faculty of Health Science, the Menzies Research Centre and appropriate primary care providers.
• Commences: 2013-14.

Nursing and Allied Health Scholarship Support Scheme (NAHSSS) Tasmanian scholarships

• This element will build the nursing and allied health workforce in Tasmania, by providing scholarships to support undergraduate clinical placements, post graduate training for nurses and allied health workers and continuing professional development (CPD) activities.
• Funding will be provided by the two administrators of the Nursing and Allied Health Scholarship Support Scheme: the Australian College of Nursing (ACN), and Services for Australian Rural and Remote Allied Health (SARRAH).
• Commences: Students commence supported study at the beginning of the 2013 academic year.

Commission on Delivery of Health Services in Tasmania

A key underpinning of the Commonwealth’s investment is the establishment of the Commission on Delivery of Health Services in Tasmania. The Commission will have an important advisory and oversight role on the implementation of the Package. It will also advise on system-wide improvements to ensure that real and sustained reform to Tasmania’s health system is achieved. For more information please refer to the Terms of Reference published on the Commission website.

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1 There will be variation in the flow of funding under each element of this Package depending on the administrative requirements required for implementation.