WA Health Clinical Services Framework 2010-2020 · The WA Health Clinical Services Framework...

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WA Health Clinical Services Framework 2010–2020


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W A H e a l t h C l i n i c a l S e r v i c e s F r a m e w o r k 2 0 1 0 – 2 0 2 0

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CONTENTS 1

FOREWORD 2

1. BACKGROUND 3

2. DELIVERING WA HEALTH SERVICES 5

a. Safety and Quality 5

b. Models of Care 5

c. Area Health Services 6

3. ADDRESSING DEMAND 7

4. HEALTH SERVICE PROVIDERS 9

a. Metropolitan Area Health Service 9

b. WA Country Health Service 9

c. Partnerships 10

5. INFLUENCING CHANGE 13

a. Activity 13

b. Workforce 14

c. Infrastructure 14

d. Information and Communication Technology 15

e. Costing 15

f. Medical Technology 16

6. CLINICAL SERVICES FRAMEWORK MATRIX 17

7. THE WAY FORWARD 27

APPENDICES: 34

Clinical Services Role Delineation 34

Definitions 35

F o r e w o r d

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FOREWORDThe WA Health Clinical Services Framework 2010–2020 (CSF 2010) sets out the planned structure of public health service provision in Western Australia over the next 10 years. It is an important tool for strategic statewide planning and will assist Area Health Services in developing localised clinical service plans.

The CSF 2010 is a revised, updated and expanded version of the WA Health Clinical Services Framework 2005–2015 (CSF 2005). It provides new levels of detail and a more comprehensive picture of clinical services across the state. It is based on the most up-to-date demographic data and projections of future service needs, helping us to prepare and plan for emerging clinical challenges.

The scope of the framework has been significantly expanded since the publication of the CSF 2005. For the first time, the framework includes information on services and service levels at Western Australia’s country hospitals and health facilities, making this the first comprehensive statewide picture of clinical service provision in the public sector.

The framework has also been expanded to include a range of non-hospital services provided across WA, in areas including:

Aboriginal health

ambulatory care

child health

dental care

mental health

primary care

public health.

Considerable work has gone into preparing this document. The CSF 2010 takes into account policy decisions made since the publication of the previous clinical services framework. The development of new Models of Care by Health Networks, and targeted consultations held with clinical and community stakeholders have also informed this framework.

The publication of the CSF 2010 reinforces WA Health’s efforts to ensure openness and transparency in the Western Australian public health system. It is all part of our commitment to providing sustainable, equitable, efficient and accountable health services to meet the needs of the WA community.

Dr Peter Flett DIRECTOR GENERAL OF HEALTH


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1. BACKGROUNDA WA Health Clinical Services Framework was first released in 2005 as a government endorsed framework for planning health care services throughout Western Australia. The WA Health Clinical Services Framework 2005–2015 (CSF 2005) was a blueprint for providing safe, high quality care to the community of Western Australia in the most efficient and effective manner possible.

The CSF is reviewed and updated periodically to ensure it remains responsive to the principles of health reform and reflects changes in the health care environment. The review process accommodates significant changes in direction that can impact on the planning and delivery of health services. For example, the decision to retain Royal Perth Hospital has necessitated a major adjustment in the clinical planning process.

The CSF 2005 was developed through an extensive consultation process. The CSF 2010 employs the same focus on planning, research and consultation, drawing from the following:

a review of planning assumptions including the impact of reform measures, the impact of new technology, service demand modelling and population projections

Area Health Service (AHS) plans for clinical services

Foundations for Country Health Services 2007–2010

Models of Care.

Development of CSF 2010 was overseen by a Clinical Services Steering Committee chaired by the Director General. The Committee ensured that service definitions, role delineation and significant parameters of demand and capacity projections were reviewed and signed-off as appropriate for use in the framework document.

Consultation on CSF 2010 involved extensive collaboration with AHSs, Health Networks and a large number of clinicians. In addition, the Health Consumers’ Council WA was briefed on the progress of CSF 2010.

The CSF 2010 goes beyond the scope of the previous CSF to include:

detailed modelling and role delineation of services provided by the WA Country Health Service (WACHS)

modelling not only for inpatient services, but also non-admitted and emergency department services

demographic information based on the results of the 2006 Population Census

progress on the development and implementation of Models of Care

updated demand and capacity projections

contributions from Health Networks

developments in infrastructure, workforce and information communication technology (ICT).

In recent years, a number of service improvement programs have been established to refocus the health system. The common objective of these programs is to assist consumers to stay healthy; access safe, quality services; and make a simple and effective journey through the health system. The programs include the development and implementation of Models of Care, strategies for community supported services, initiatives for outpatient service reform and the Four Hour Rule Program.

The CSF 2010 is the first document published in WA that encompasses clinical planning across the entire State public sector and across all facets of hospital care. While it is an over-arching medium to long-term planning document, it also provides a foundation for more extensive and detailed planning to be undertaken by AHSs. It sets the high-level policy framework to assist local AHS planning and informs infrastructure, ICT and workforce planning across the health system.

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Since the release of CSF 2005, all AHSs have developed their own localised clinical services plans. Following the publication of CSF 2010 the AHSs will update their individual clinical services plans to reflect the updated information.

The CSF 2010 outlines strategies for delivering the Government’s vision for providing public sector clinical services over the next 10 years and informs our external stakeholders and partners of health service development intentions throughout the State. This high-level planning tool will provide an indication of the magnitude of demand for and supply of services into the future.

In reading CSF 2010, it is important to note first that much of the planning is based on projections, and projections become less exact the further they reach into the future. Secondly, the successful delivery of services specified within CSF 2010 is contingent on the correct alignment of circumstances (political, economic, etc.) and resources (workforce, funding, etc.). Many of these factors are beyond the control of this CSF.

The CSF is scheduled for updates at regular intervals to respond to emerging trends in demand, clinical practice, technology and policy. However where significant change to the CSF is needed at times that do not fit the schedule of regular updates, there will be a process in place to allow for such change to be endorsed.

Clinical Services Framework Process

CURRENT PROCESS DRIVERSModels of Care Operational PlanAHS CSP Strategic IntentSafety & Quality BudgetDemand Modelling Infrastructure PlanWorkforce Plan ICT Plan Medical Technology WHCM / RAM

ORIGINAL PROCESS DRIVERSReid Report Strategic IntentSafety & QualityBudgetDemand ModellingInfrastructure Plan

WA HealthCSF 2005 – 2015

(1)

FUTURE PROCESS DRIVERS

WA Health CSF (3)

FUTURE PROCESS DRIVERS

WA Health CSF2010 – 2020

(2)


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2. DELIVERING WA HEALTH SERVICESThe delivery of public sector health services is influenced by policy, planning, strategy and resource parameters that reflect the changing context of health care in the State. These parameters describe the kind of services we strive to deliver and provide direction to service planning.

a. Safety and Quality

Significant challenges must be met to ensure that health care in WA remains both safe and of high quality. These challenges include increasing demand for health services, constraints on resources, demographic change, workforce shortages and increasing patient expectations.

The WA Strategic Plan for Safety and Quality in Health Care 2008–2013 (the Strategic Plan) provides direction and guidance for WA Health in delivering safe, high quality health care. The Strategic Plan was developed by the WA Council for Safety and Quality in Health Care in conjunction with the Office of Safety and Quality in Healthcare and is the third five year plan of its kind.

Building on achievements since the first five-year plan was published in 1998, the Strategic Plan is built around The Four Pillars of the WA Clinical Governance Framework. It outlines the objectives, strategies and governance requirements that will provide the foundation for programs, initiatives and activity aimed at ensuring the delivery of safe, high quality health care in WA. It clearly articulates that safety and quality is an integral part of Statewide clinical service planning, incorporating all facets of hospital care. Importantly, it also emphasises the need for safety and quality to play equally important roles at all levels of health service delivery.

The Strategic Plan aligns with the priority work programs and proposed National Safety and Quality Framework currently being developed by the Australian Commission on Safety and Quality in Health Care. The Western Australian Strategic Plan for Safety and Quality in Health Care 2008–2013 is available at:

www.safetyandquality.health.wa.gov.au/docs/WA_strategic_plan_for_safety_and_quality_in_health_care_ 2008-2013.pdf

b. Models of Care

Models of Care are strategic policies related to a disease grouping, population sub-group or service need. They set out an evidence-based framework describing the right care, at the right time, by the right person/team in the right location across the continuum of care.

The Models of Care are focused on improving patient care throughout the health system and have been developed across a range of specialties. Their coverage extends from prevention and promotion, early detection and intervention, to integration and continuity of care and self management.

The Health Networks, which were first established in July 2006, have engaged clinicians and consumers in the development of statewide clinical policy across Western Australia. To date, 18 Health Networks have been formed for specific population groups, disease groupings and service needs and have had the lead role in the development of Models of Care.

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These Networks include:

Acute Care Infections and Immunology

Aged Care Injuries and Trauma

Cancer and Palliative Care Mental Health Community

Cardiovascular Health Musculoskeletal

Child and Youth Health Neurosciences and the Senses

Digestive Primary Care

Diabetes and Endocrine Health Renal

Falls Prevention Respiratory Health

Genetics Women’s and Newborns’

More information about Health Networks is available at www.healthnetworks.health.wa.gov.au

The Models of Care can be viewed at www.healthnetworks.health.wa.gov.au/modelsofcare/

c. Area Health Services

Since the release of CSF 2005, there has been an integrated approach to the provision of health care underpinned by the area health service model. The Area Health Services (AHSs) are comprised of the North Metropolitan Area Health Service (NMAHS), the South Metropolitan Area Health Service (SMAHS), Child and Adolescent Health Service (CAHS) and the WA Country Health Service (WACHS). The AHSs have actively planned and managed health service delivery around the broad health needs of their respective catchment populations.

Each AHS has developed a Clinical Services Plan that focuses on delivering a more balanced and holistic health service that meets not only the tertiary health care needs of the population, but also their primary and secondary health care needs. The perspective and input of the AHSs has been crucial to the delineation of roles for hospitals and other health service facilities outlined in CSF 2010.


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3. ADDRESSING DEMANDWA Health has introduced a number of strategies to manage demand in areas of greatest need. Some of the achievements from these strategies are detailed below.

1. Inpatient Demand

From the early days of health reform, WA Health has recognised the importance of ensuring that the demand for inpatient services is managed appropriately. The public health system remains the community’s provider of choice for admitted patient care. For this reason, WA Health places great emphasis on strategies to achieve safe, quality hospital inpatient care substitution and to reduce hospital lengths of stay (beddays).

Initiatives implemented to date have resulted in lower average lengths of stay, higher proportions of sameday admissions and a decrease in the use of hospital beds for ambulatory sensitive conditions. Some examples of these initiatives are the Ambulatory Surgery Initiative (ASI), the SurgiCentres at Osborne Park Hospital and Kaleeya and community supported services such as Hospital in the Home (HITH) and Rehabilitation in the Home (RITH).

2. Emergency Department Demand

Hospital emergency departments (EDs) have continued to be viewed as convenient ‘one-stop-shops’ for patients to receive all inclusive health care (diagnosis and treatment) that does not entail out-of–pocket expenses. This has resulted in rapidly increasing demand for ED services that could not continue to be safely accommodated in existing facilities.

A number of initiatives have been introduced to manage ED demand. ED process redesign for mental health patients, after hours GP clinics, Hospital in the Nursing Home and policy changes regarding the operation of ambulance services have all targeted the improvement of the processes and responsiveness of emergency departments.

3. Outpatient Services

An Outpatient Reform Project was initiated in 2007 to standardise and streamline administrative processes in metropolitan outpatient services. The project scope included all doctor attended outpatient clinics in five metropolitan tertiary hospital sites, a total of approximately 750,000 visits per annum.

The five initiatives targeted:

central receipting /caseload allocation

Clinical Priority Access Nurse (GP Liaison)

audit of referrals

standardised performance reporting

electronic referrals.

To date, the project has:

reduced wait times for first appointments at adult tertiary sites (to <90 days)

eliminated cases of waiting beyond recommended times in three of the five sites

reduced the ratio of new to follow-up appointments from 1:5 to 1:3, increasing the number of new patients seen by 21 per cent or 20,000 individuals

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increased throughput by between one and 16 per cent, depending on the site

implemented electronic secure messaging and standardised periodic performance measures (KPI) reporting.

4. Service Redesign

The AHSs have introduced a number of strategies that aim to improve the efficiency of service provision, particularly in hospitals. Principal among these initiatives is a program of service redesign.

The Service Redesign Program aims to improve the management of demand for health care. It does this through measures including delivery of better services outside hospitals and freeing up hospital capacity through improved patient flow and increased availability of beds. Previous redesign projects focusing on unplanned admission, elective surgery, the surgical patient journey and mental health have been implemented primarily at tertiary hospitals.


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4. HEALTH SERVICE PROVIDERSThe provision of State public health services is principally the responsibility of the AHSs. The CSF 2005 described in some detail the roles of the metropolitan Area Health Services, NMAHS, SMAHS, and CAHS.

For the first time, CSF 2010 details the WA public health system’s response to rural area health needs as coordinated by the WA Country Health Service (WACHS). This framework also outlines the range of partners with whom WA Health collaborates to deliver a comprehensive health service.

a. Metropolitan AHS

Since CSF 2005, there have been significant government policy changes in regard to the planned delivery of health services in WA. When CSF 2005 was developed; government policy included the closure of Royal Perth Hospital (RPH) and the relocation of services to other facilities, primarily to Fiona Stanley Hospital (FSH) and Sir Charles Gairdner Hospital (SCGH). In CSF 2010, RPH will remain open and will sit within SMAHS in terms of policy, planning and operations. The CSF 2010 reflects the updated delineation of responsibilities for these metropolitan area services.

b. WA Country Health Service

The CSF 2010 now includes services provided by WACHS and recognises the challenges of delivering high-quality health care in rural and remote WA. While Australians generally enjoy very good health, country residents experience poorer health than those living in metropolitan areas. There is also an unacceptable gap between Aboriginal and non-Aboriginal health outcomes and life expectancy.

To address the challenges impacting on the health of country residents WACHS works closely with its communities and partners to:

deliver contemporary care and service models

address health inequities and seek to close the gap in health outcomes for Aboriginal residents

build workforce excellence by striving to make WACHS a great place to work

invest responsibly in health services that support our strategic directions.

The WACHS is the largest Area Health Service in Australia in geographical terms, covering 2.55 million square kilometres. This vast area presents significant challenges for health service delivery. It is made up of seven distinct and diverse regions which provide health services through:

70 country hospitals (six larger centres, 15 medium sized hospitals and 49 small hospitals)

47 nursing posts in regional and remote locations

numerous community based health centres.

Ensuring integrated and coordinated emergency and trauma services for all communities is a priority for WACHS in collaboration with metropolitan services. All 70 WACHS hospitals provide a level of emergency and disaster response in partnership with the Royal Flying Doctor Service and St John Ambulance emergency retrieval services. The smaller sites provide resuscitation and medical stabilisation with support and access to specialist advice prior to transfer to larger sites.

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In considering the role delineation for country health services a number of unique issues need to be considered. These include:

the need for country patients to travel long distances to other country centres or to the Perth metropolitan area for investigations, diagnosis, treatment and outpatient follow-up care

recruitment and retention of staff, including in some specialty areas

availability of appropriate professional support

greater reliance on generalist medical workforce, and the broader range of skills required to provide family medicine, emergency medical and procedure practice

lack of private general practitioner and certain specialty services in some country areas, meaning that services must be supplied and funded by the public health system.

All regions have developed clinical service plans which will form a guide for investment and reform over the next five to ten years and integrate with workforce, medical technology; communication and information management; capital and resource allocation plans.

c. Partnerships

WA Health works within the constraints of policy and available resources to provide a range of health services. In order to ensure that the community has access to as comprehensive a range of services as practicable, WA Health may enter into partnership arrangements with external agencies. These partnerships are contingent on evidence that good patient outcomes and efficiency gains can be achieved.

WA Health consults with key agency partners, including the private sector, non-government organisations (NGOs) and the Australian Government in order to inform State health planning and to keep abreast of new trends in service delivery, infrastructure and policy.

1. General Practitioners

General Practitioners (GPs) are often the first point of contact for people seeking health care. They provide the first points of diagnosis and treatment and linkages to specialist care where appropriate. In addition, GPs are important in helping to disseminate healthy lifestyle messages and implement health screening campaigns. For these reasons, GPs are integral to the delivery of health care.

GPs in the community are funded by the Commonwealth, rather than the State Government, and therefore the role delineation matrix does not capture their services. However, WA Health works closely with the Divisions of General Practice to continually improve integration of services between State funded services and the Commonwealth funded primary care spectrum.

2. Australian Government Department of Health and Ageing (Commonwealth)

The Australian and Western Australian Governments share responsibilities in the delivery of health services to the WA community. Recent changes and reforms to the roles and responsibilities in resourcing the delivery of health care have seen new and exciting opportunities develop that are aimed at improving the health outcomes of all Australians.

In July 2009, the National Health and Hospitals Reform Commission released its final report outlining a number of strategies to improve health outcomes for all Australians. The full report can be viewed at:

www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhhrc-report


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In September 2009, the Commonwealth also released the report of the Preventative Health Taskforce. The National Preventative Health Strategy Taskforce report is available at:

www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/national-preventative-health-strategy-1lp

In line with the Commonwealth Government’s strategies, future financial investment will focus on these areas.

3. Private Hospital Care

The public health system provides an extensive range of services that are also available in the private sector. For this reason, planning for the future delivery of health care services includes consideration of private sector plans.

For many years, WA Health has collaborated with the private sector to ensure effective and efficient health care planning. For example, in planning for the new Fiona Stanley Hospital, WA Health aimed to achieve synergies with the private sector by selecting a site that is co-located with a private facility. WA Health linkage with the private sector includes the purchase of beds from private hospitals during times of high demand and the ongoing agreements with private sector hospital care providers such as Ramsay Health Care at Joondalup and Health Solutions (WA) Pty Ltd at Peel.

4. Non-Government Organisations

NGOs play an important role in delivering care to patients. These organisations offer expertise and support primarily (though not exclusively) in the public health, disease control, health promotion and research arenas.

In 2008/09 WA Health funded approximately 560 NGO contracts to a value of over $650 million to deliver services ranging from patient advocacy to Hospital in the Home services. Typically, NGOs deliver specialised care and may receive part funding from the State Government (and/or the Commonwealth) to deliver services. Examples of NGOs that receive funding from the State Government include the Royal Flying Doctor Service, St John Ambulance Australia, Silver Chain and the WA Red Cross.

5. Aboriginal Health

Achieving improvement in Aboriginal health status remains one of the most complex and challenging tasks faced by the Western Australian Government. Contributing to the complexity of achieving significant improvement in health outcomes is the fact that provision of better health services must happen alongside improvements in other key areas such as housing, education, employment and economic development.

WA Health works with a number of organisations including the Aboriginal Medical Service, the Department of Indigenous Affairs and other agencies of government in an effort to improve the health status of WA’s Indigenous population.

6. WACHS Industry Partnerships

The WACHS faces health service challenges which differ from those present in the metropolitan area, and which require different strategies to meet community needs. One such challenge is the increased demand for health services created as a direct result of resource sector expansion in country areas.

Modelling for population in the Pilbara was undertaken by Heuris Partners Ltd. and used in the WA Health modelling, has projected that by 2021 the population will increase to 63,000 from its present level of around 44,000. This will lead to a corresponding increase in demand for health services and health workforce.

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The result for the WACHS is that its ability and capacity to continue to provide and maintain health services to a standard acceptable to the Pilbara community presents logistical challenges on a scale not seen previously. Fortunately, the private sector is increasingly aware of the considerable benefits of working with government and local communities to enhance the ‘liveability’ of the regional towns which house its workforce.

Recent examples of industry partnerships include:

A joint funding agreement between WACHS and BHP Billiton Iron Ore Pty Ltd over six years (beginning in 2006) to the value of approximately $5.4 million. Funding initiatives include:

– the appointment of an emergency medicine specialist at Port Hedland Regional Resource Centre and a child and adolescent mental health practitioner for Newman

– fortnightly charter flights to Newman to increase clinical and community services

– telehealth, and child and maternal health programs.

A $38.2 million partnership between WACHS and the Pilbara Industry’s Community Council to undertake multiple initiatives in the areas of emergency response, workforce, Indigenous employment, population health, and health infrastructure and planning. The Liberal – National Government’s Royalties for Regions Program has underwritten the State’s ongoing investment over the period of the forward estimates.


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5. INFLUENCING CHANGEHealth service planning, development and implementation are enabled by a handful of factors that underpin health care delivery:

activity demand

workforce

infrastructure

information and communication technology

costing

medical technology.

The way in which these factors interact has an impact on where and how we deliver services.

a. Activity

WA Health’s CSFs are underpinned by modelling of activity demand and capacity. In CSF 2005, the modelling focused solely on metropolitan inpatient activity. In CSF 2010, the modelling has been expanded to incorporate inpatient activity for both metropolitan and country areas, emergency department projections and future estimates of outpatient activity.

The demand modelling process utilised the population projections of the Australian Bureau of Statistics (ABS) Series C released in 2008. These figures were the low-growth projections of the Estimated Resident Population (ERP) from the 2006 Australian Census.

Projections of inpatient activity (Hardes data) were based on estimates produced by consultants Hardes and Associates, similar to activity projections used in CSF 2005.

Demand modelling is comprised of three major steps as outlined below.

1. Projection of base year demand into the future (status quo model). This model is based on the current utilisation and population projections. It assumes that demand is not restricted by workforce, bed capacity or funding; that the level of service in the base year is continued and adequate; and that policies in place in the base year are maintained.

2. Development of a ‘scenario’ model by modification of future demand projections generated by the status quo model (scenario model). This, and the status quo projections, are developed by applying the impact of a range of strategies to achieve quantified efficiencies and known changes that will impact upon utilisation rates in the status quo model. This model is developed in consultation with Health Networks and AHS planners regarding anticipated changes in health care practices and service delivery changes.

3. Redistribution of demand across facilities in the scenario model to reflect changing patterns of service (capacity model). Following endorsement of the latest Hardes data, the capacity model has been produced redistributing demand to hospitals based on the closest, most appropriate (as defined by role delineation in the CSF) and available hospital. Production of the capacity model has been completed in consultation with AHS planners and WA Health Infrastructure team.

More detailed information on the scenario development is available from the Clinical Modelling and Infrastructure Unit at WA Health.

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b. Workforce

An adequate supply of suitably skilled workers is essential for the delivery of the clinical services outlined in CSF 2010. Successful planning for the delivery of these services requires the integration of workforce planning with infrastructure and financial resources and with activity objectives. The addition of WACHS into CSF 2010 provides, for the first time, an opportunity to develop an integrated workforce plan for all services provided by WA Health.

Workforce and clinical planners have commenced collaborative work on modelling the workforce required to deliver the clinical services specified in the CSF 2010 and to identify areas of risk due to workforce shortages. More generally, workforce plans will enable the planning for clinical services to consider emerging workforce issues. The modelling is scheduled to be completed in late 2009.

A number of reforms are being developed over 2009–10 which improve the capacity of the workforce. These reforms will also allow for closer monitoring of workforce issues that can impact on service delivery, and provide for better coordination of WA Health’s response to those issues. The reforms include:

a new clinical training placement system to improve coordination, consistency and funding for professional entry clinical training

nationally consistent registration and accreditation for 10 occupations which account for 80 per cent of the clinical workforce

projections of supply and demand at detailed occupational/specialty levels by site and service

improved FTE budgeting projections linked to activity

streamlined and consistent system-wide HR policies

the use of simulated learning environments to expand clinical training capacity

expanding education and training at major regional hospitals as part of the Rural Clinical Schools Program.

WA Health is committed to developing a sustainable supply of skills in the health workforce. This commitment underpins the development and implementation of our workforce policies. Over the course of 2010, the current strategic workforce framework will be revised to reflect emerging workforce developments at a State and national level, the revised clinical services framework, and related financial and infrastructure planning.

c. Infrastructure

WA Health’s State Health Infrastructure Plan (SHIP) is currently in development and will provide a detailed 10 year plan for the management and development of capital assets. To ensure that projected service needs can be met, SHIP will be based on the role delineation and service requirements outlined in CSF 2010 and identified capital development requirements.

The SHIP will cover all areas of asset development requirements, from minor upgrades required to ensure buildings remain fit-for-purpose through to the provision of new or replacement health facilities.

The SHIP builds on the previous Metropolitan Infrastructure Development Plan (MIDP) developed in 2005 as a follow on from CSF 2005. Whilst the focus of the MIDP was predominantly on the metropolitan area, SHIP will be expanded to become a statewide plan – encompassing both metropolitan and rural infrastructure developments. The process will include a review of WA Health’s current asset investment program in light of the updated service needs outlined in CSF 2010. Additionally, SHIP will have a broader focus, including non-inpatient infrastructure such as that related to the delivery of community supported services, consistent with CSF 2010.


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Further information on the SHIP development process and linkages within the broader Government asset management framework will be available in SHIP, due for release in 2010.

d. Information and Communication Technology

Supporting the CSF and a number of health reform projects is an Information and Communication Technology (ICT) Strategic Framework.

The ICT Strategic Framework will ensure that ICT investment and effort focuses on and aligns with WA Health’s key strategies and priorities. This framework will be linked to a strategic plan.

There are six key elements of the framework:

Clinical Systems – covering patient administration, clinical and specialty departmental applications

Corporate Systems – encompassing administrative, business support and corporate applications

Information – standardising, monitoring, analysing and disseminating information

Infrastructure – procuring and maintaining servers, storage, desktop, communication and network infrastructure

Facilities – aligning ICT products and services to the commissioning of health service facilities

Medical Equipment – integrating medical equipment with the ICT network.

Stakeholders will be appropriately engaged in the development of any business cases, procurement activities, implementation and/or ongoing operational activities.

e. Costing – Recurrent Costing

Following earlier investment in the development of cost-modelling methodologies, WA Health now uses two powerful tools for projecting costs associated with CSF 2010 and monitoring the financial and activity aspects of its implementation.

The two models are the Whole of Health Cost Model (WHCM) and the Resource Allocation Model (RAM). The WHCM is used to project WA Health’s total recurrent (i.e. non-capital) expenditure, based upon current costs as well as expected changes in prices and wages. The RAM is a tool for allocating funding between health services. Whilst both models are subject to ongoing development and improvement, they have been in operation for several years and have been used to cost earlier iterations of clinical services planning work, including CSF 2005.

Both WHCM and RAM use demand projections associated with CSF 2010 as a major input into their forecasting processes. This is the same set of demand projections used to estimate workforce and infrastructure requirements. These projections include the Hardes inpatient activity projections, and ED and outpatient activity targets.

When completed, cost projections from both models will be used to assess the potential impact of CSF 2010 on the State health budget over the medium and long term. The estimates will be an important indicator of the further work that is required to put our public health system on a more sustainable footing, in line with Government policy and priorities.

The cost projections will be fed into the next stages of system-wide demand, workforce and financial planning. It will be used to engage partners and stakeholders in productive discussions about health system financing and achieving better integration between service provision and budget management.

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f. Medical Technology

A high-level medical technology map is being developed for WA Health. This map will be used to ensure that clinical and facility planning are flexible and forward thinking in their approach to medical technology. It will capture the emergence of future technology and inform the current Medical Equipment Replacement Program. In addition, the extensive review that informs the medical technology map, contributes to more detailed area-wide clinical plans and informs individual site clinical plans and facility designs.

There is considerable input and collaboration with clinical stakeholders in identifying and prioritising technology requirements. To date, the clinical streams that have been involved are:

Cancer

Neurosciences

Cardiovascular

Musculo-skeletal

Pain.

Further analysis will be undertaken following the completion of these maps to ensure that the introduction of new technology will assist in:

improving patient outcomes and quality of care

providing faster and more accurate diagnosis and treatment

reducing length of stay.


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6. CLINICAL SERVICES FRAMEWORK MATRIXThe CSF 2010 includes three separate matrices. The first outlines metropolitan hospital services, the second details WACHS hospital services and the third captures non-hospital services across the entire State.

METROPOLITAN HOSPITAL SERVICES

Tertiary Hospitals

Tertiary hospitals provide services requiring highly specialised skills, technology and support to all of Western Australia. Typically a tertiary hospital may include centres of excellence, research and development; and will provide a leadership role for integrated clinical services.

As a rule, a tertiary hospital provides services at a level 6 according to the clinical services role delineation definitions.

In 2010, the tertiary hospital sites in Western Australia are:

Royal Perth Hospital (RPH) Wellington St Campus

RPH Shenton Park Campus

Sir Charles Gairdner Hospital (SCGH)

Fremantle Hospital

Princess Margaret Hospital

King Edward Memorial Hospital

Graylands Selby-Lemnos and Special Care Health Service.

The major adult tertiary developments that will occur in the Perth metropolitan area within the next 10 years include the following:

By 2014, Fiona Stanley Hospital (FSH) will be functioning as a tertiary hospital.

Services will be reconfigured across RPH, SCGH and FSH. Fremantle Hospital will no longer provide tertiary services.

SCGH will provide cardiothoracic surgery, liver and kidney transplants, a comprehensive cancer centre, State centre for neurosciences, tertiary medical and surgical centres, mental health services, and a major research centre.

FSH will deliver major trauma services, cardiothoracic surgery, kidney transplant, State burns service, a comprehensive cancer centre, tertiary surgical and medical services, tertiary mental health, obstetric and neonatal services, paediatrics and a major research centre.

RPH will provide major trauma services, cardiothoracic surgery, heart and lung transplants, an advanced heart failure unit, tertiary mental health, major research centre and tertiary surgical and medical services.

RPH Shenton Park Campus will close and the tertiary rehabilitation services will be relocated to FSH.

It is also planned that within the next six years, a new children’s hospital will be built on the Queen Elizabeth II Medical Centre site, adjacent to the SCGH. This development will bring together a broad range of specialist services and assist in improving the transition between adolescent and adult health services.

The CSF 2010 provides a view of planned services out to 2020. Joondalup Health Campus will remain a general hospital within the scope of this iteration of the CSF.

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General Hospitals

A general hospital is a facility that provides hospital services with a focus on the broader health needs of the community it serves, rather than a concentration on the purely clinical aspects of health care. A general hospital should provide for most of the health needs of its population. It would usually have the following clinical services and facilities:

emergency departments

24 hour anaesthetic cover

critical care units

general surgery capacity (including day surgery)

obstetric and neonate services

general medical and geriatric services

general paediatrics

some mental health services

some rehabilitation and sub-acute care

diagnostics, treatment and ambulatory care.

A general hospital will have resident general specialists, some visiting subspecialists and junior medical staff. In the main, a general hospital provides services at a level 4 or possibly level 5 according to the clinical service role delineation definitions.

The CSF 2010 includes the following general hospitals:

Joondalup Health Campus

Swan District Hospital

Armadale Kelmscott Memorial Hospital

Rockingham General Hospital (including Murray Districts Hospital)

Peel Health Campus.

Specialist Hospitals

By 2014, the specialist hospitals will be:

Osborne Park Hospital

Bentley Hospital

Fremantle Hospital.

Although they may provide some general hospital services, these hospitals will largely be reconfigured to focus on mental health, aged care, rehabilitation services and elective surgery. None of these hospitals will have an emergency department.

These facilities may undertake high volume, low complexity surgery which may be done on an ambulatory or overnight basis, depending on the role delineation of the facility.

Generally, specialist hospitals will provide services at level 4/5 in their specialty according to the clinical services role delineation definition.


19


19

Other Hospitals

Kalamunda District Community Hospital

Kalamunda hospital will focus on primary care, general procedures, aged care, subacute care, and low acuity maternity according to the CSF Role Delineation.

WA Country Health Service Hospital Services

The WACHS services and infrastructure are dispersed across the State and include:

6 Regional Resource Centres

15 Integrated District Health Services

49 small hospitals, including 32 multipurpose services and centres

26 community mental health services

47 nursing posts in regional and remote locations

2 State Government funded nursing homes

community health services (53 locations)

child health services (168 locations).

The Regional Resource Centres form the hub of regional services that span out to the smaller sites and services (the spokes) across the region. They incorporate the regional WACHS administration centres, are the base for region-wide services and are locations for the six regional hospitals at Albany, Broome, Bunbury, Geraldton, Kalgoorlie and Port Hedland. The Integrated District Health Services incorporate 15 medium sized hospitals and district-wide health services.

In addition to existing facilities, WACHS has a range of infrastructure developments underway or planned across the regions.

NON-HOSPITAL SERVICESThis iteration of the CSF has separated out non-hospital services in order to demonstrate the broad range of services delivered by WA Health. It should be noted that this matrix uses a region/district based structure rather than the facility focus used in the hospital matrices.

Separating out non-hospital services in CSF 2010 has meant using some non-standard definitions of clinical and physical scope. This means that there are services provided in the hospital setting that may also be provided in a non-hospital setting. This overlap of hospital and non-hospital services highlights the blending that exists between these services. This blending is essentially a benefit for patients as WA Health strives to deliver seamless patient care.

21

METROPOLITAN HOSPITAL CLINICAL SERVICES FRAMEWORKSouth Metropolitan North Metropolitan Statewide

Fiona Stanley Hospital

RPHRPH Shenton Park Campus

Fremantle Rockingham Bentley Armadale Peel SCGH Swan Osborne Park Kalamunda Joondalup KEMH PMHGraylands (inc Selby)

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

Medical ServicesGeneral – 6 6 6 6 6 – – – 6 5 5 4 5 5 3 3 3 4 5 5 4 4 4 6 6 6 4 5 5 3 3 3 3 3 3 4 5 5 – – – 6 6 6 – – –Cardiology – 6 6 6 6 6 – – – 6 – – 3 5 5 – – – 3 5 5 3 3 3 6 6 6 3 5 5 – – – – – – 3 5 5 – – – 6 6 6 – – –Endocrinology – 6 6 6 6 6 – – – 6 4 4 3 4 4 – – – 3 4 4 3 3 3 6 6 6 3 4 4 4 3 3 3 – – 4 5 5 5 5 5 6 6 6 – – –Endocrinology at KEMH offers a specialist service for gestational diabetesGeriatric – 6 6 6 6 6 – – – 6 5 5 4 5 5 5 5 5 5 5 5 3 4 4 6 6 6 5 5 5 5 5 5 3 3 3 5 5 5 – – – – – – – – –

Neurology – 6 6 6 5 5 – – – 4 – – 3 4 4 – – – 3 4 4 3 3 3 6 6 6 4 4 4 – – – – – – 4 5 5 – – – 6 6 6 – – –Renal Medicine – 6 6 6 5 5 – – – 6 3 3 – 4 4 – – – 3 4 4 3 3 3 6 6 6 3 4 4 – – – – – – 3 5 5 – – – 6 6 6 – – –Renal Dialysis 4 6 6 6 6 6 4 – – 6 – – – 4 4 3 3 3 4 5 5 4 4 4 6 6 6 3 3 3 3 3 3 – – – 4 5 5 – – – 6 6 6 – – –Oncology – 6 6 6 – – – – – 6 – – – 4 4 – – – – 4 4 3 4 4 6 6 6 – 4 4 – – – – – – 3 4 5 6 6 6 6 6 6 – – –

chemo only *gynae-oncology only

Radiation oncology – 6 6 6 – – – – – – – – – – – – – – – – – – – – 6 6 6 – – – – – – – – – – – 5 – – – – – – – – –Respiratory – 6 6 6 6 6 – – – 6 – – 3 4 4 3 – – 4 4 4 3 3 3 6 6 6 4 4 4 – – – – – – 4 5 5 – – – 6 6 6 – – –Palliative care 5 6 6 6 4 4 – – – 6 – – – 4 4 – – – – 4 4 2 2 2 6 6 6 – 3 3 – – – 4 4 4 3 5 5 – – – 6 6 6 – – –Gastroenterology – 6 6 6 6 6 – – – 6 4 4 3 4 4 3 3 3 3 4 4 3 3 3 6 6 6 4 4 4 4 4 4 – 3 3 4 5 5 – – – 6 6 6 – – –Haematology – 6 6 6 5 5 – – – 6 – – – 4 4 – – – – 4 4 3 4 4 6 6 6 4 4 4 – – – – – – 3 5 5 4 4 4 6 6 6 – – –Immunology – 6 6 6 5 5 – – – 6 – – 4 4 4 – – – 4 4 4 3 3 3 6 6 6 4 4 4 – – – – – – 4 4 5 4 4 4 6 6 6 – – –Infectious Diseases – 6 6 6 4 4 – – – 6 – – – 4 4 – – – – 4 4 – – – 6 6 6 4 4 4 – – – – – – 4 4 5 4 4 4 6 6 6 – – –

Surgical Services

General – 6 6 6 6 6 – – – 6 4 4 4 5 5 3 – – 4 5 5 4 4 4 6 6 6 4 5 5 4 4 4 – 3 3 5 5 5 – – – 6 6 6 – – –

kidney Tx Heart lung Tx kidney, liver Tx kidney Tx

ENT – 6 6 6 5 5 – – – 6 4 4 4 4 4 4 – – 4 4 4 4 4 4 6 6 6 4 4 4 4 4 4 – – – 4 5 5 – – – 6 6 6 – – –Gynaecology – 5 5 – – – – – – 4 – – 4 4 4 3 – – 4 4 4 3 3 3 – – – 4 4 4 4 4 4 – – – 4 5 5 6 6 6 4 4 4 – – –Ophthalmology – 6 6 6 5 5 – – – 6 5 5 4 4 4 3 – – 4 4 4 3 3 3 6 6 6 4 4 4 4 4 4 – – – 4 5 5 – – – 6 6 6 – – –Orthopaedics – 6 6 6 6 6 5 – – 6 4 4 4 4 4 3 – – 4 4 4 3 3 3 6 6 6 4 4 4 4 4 4 – – – 4 5 5 – – – 6 6 6 – – –Urology – 6 6 6 5 5 4 – – 6 4 4 4 4 4 3 – – 4 4 4 3 3 3 6 6 6 4 4 4 4 4 4 – – – 4 5 5 6* 6* 6* 6 6 6 – – –

*uro/gynae only

Cardiothoracic – 6 6 6 6 6 – – – 6 – – – – – – – – – – – – – – 6 6 6 – – – – – – – – – – – – – – – 6 6 6 – – –heart, lung Tx

Vascular surgery – 6 6 6 6 6 – – – 5 4 4 3 4 4 – – – 3 4 4 3 3 3 6 6 6 4 4 4 4 4 4 – – – 4 5 5 – – – 6 6 6 – – –Neurosurgery – 6 6 6 6 6 – – – 4 – – – – – – – – – – – – – – 6 6 6 – – – – – – – – – 4 4 4 – – – 6 6 6 – – –

Plastics – 6 6 6 6 6 4 – – 4 4 3 4 4 3 – – 3 4 4 3 3 3 6 6 6 3 4 4 4 4 4 – – – 4 4 4 – – – 6 6 6 – – –

Burns – 6 6 6 4 4 – – – 4 – – 2 2 2 – – – 2 2 2 2 2 2 4 4 4 2 2 2 – – – – – – 3 3 3 – – – 6 6 6 – – –Trauma – 6 6 6 6 6 – – – 5 – – 4 4 4 – – – 4 4 4 3 3 3 5 5 5 4 4 4 – – – – – – 4 4 4 – – – 6 6 6 – – –Emergency Services ED – 6 6 6 6 6 – – – 6 – – 4 5 5 – – – 4 5 5 4 4 4 6 6 6 4 5 5 – – – – – – 5 5 5 6 6 6 6 6 6 – – –

*obstetrics only

Obstetrics and Neonatal ServicesObstetrics – 5 5 – – – – – – 3 – – 3 4 4 3 – – 3 4 4 3 3 3 – – – 4 4 4 3 4 4 – – – 4 5 5 6 6 6 – – – – – –

Neonatology – 5 5 – – – – – – 3 – – 3 4 4 3 – – 3 4 4 3 3 3 – – – 4 4 4 3 3 3 – – – 4 5 5 6 6 6 6 6 6 – – –

Paediatrics Services

Paediatrics – 5 5 – – – – – – 4 – – 3 4 4 2 – – 3 4 4 3 3 3 – – – 3 4 4 3 3 3 – – – 4 5 5 – – – 6 6 6 – – –Rehabilitation ServicesRehabilitation – 6 6 5 – – 6 – – 6 5 5 3 5 5 5 5 5 5 5 5 3 3 3 5 5 5 5 5 5 5 5 5 3 3 3 5 5 5 – – – 6 6 6 2 5 6

State Rehab Centre

Child and Adolescents Mental Health Services Emergency Services (hospital based)

– 4 4 – – – – – – – – – – 4 4 5 5 5 4 4 4 – 4 4 – 4 4 3 4 5 – – – – – – – 4 5 – – – 5 6 6 – – –

Mental Health inpatient services

– – – – – – – – – – – – – – – 5 5 5 – – – – – – – – – – – – – – – – – – – – 5 – – – 5 6 6 – – –

–

22

METROPOLITAN HOSPITAL CLINICAL SERVICES FRAMEWORK (cont.)South Metropolitan North Metropolitan Statewide

Fiona Stanley Hospital

RPHRPH Shenton Park Campus

Fremantle Rockingham Bentley Armadale Peel SCGH Swan Osborne Park Kalamunda Joondalup KEMH PMHGraylands (inc Selby)

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

2007

/08

2014

/15

2020

/21

Adult Mental Health ServicesEmergency services (hospital based)

– 6 6 6 6 6 – – – 6 – – 4 5 5 5 5 5 5 5 5 4 4 4 5 6 6 4 5 5 – 5 5 – – – 4 5 5 4 5 5 – – – – – –

Mental Health inpatient services

– 6 6 5 6 6 – – – 6 5 5 – 5 5 5 5 5 5 5 5 – – – 5 6 6 5 5 5 – 5 5 – – – 5 5 5 5 6 6 – – – 6 6 6

Older Persons Mental Health ServicesEmergency services (hospital based)

– 6 6 4 4 4 – – – 6 5 5 4 5 5 5 5 5 5 5 5 4 4 4 – 6 6 3 5 5 3 5 5 – – – 4 4 4 – – – – – – – – –

Mental health inpatient services

– 6 6 – – – – – – 5 5 5 – 5 5 5 5 5 5 5 5 – – – – – – 5 5 5 5 5 5 – – – – – – – – – – – – 5 5 5

Disaster Preparedness & Response ServicesDisaster Preparedness – 6 6 6 6 6 6 6 6 6 4 4 5 5 5 4 4 4 5 5 5 5 5 5 6 6 6 5 5 5 4 4 4 3 3 3 4 6 6 4 4 4 6 6 6 4 4 4Clinical Support ServicesPathology 6 6 6 6 6 6 4 – – 6 4 4 3 4 4 3 3 3 3 4 4 3 4 4 6 6 6 4 4 4 3 3 3 3 2 2 4 4 5 6 6 6 6 6 6 2 2 2Radiology – 6 6 6 6 6 5 – – 6 5 5 4 5 5 4 3 3 5 5 5 4 4 4 6 6 6 4/5 5 5 3 4 4 3 3 3 5 5 5 5 5 5 6 6 6 – – –Pharmacy – 6 6 6 6 6 4 – – 6 4 4 4 4 4 4 4 4 4 4 4 4 4 4 6 6 6 4 4 4 4 4 4 2 2 2 4 5 5 5 5 5 6 6 6 6 6 6ICU/HDU – 6 6 6 6 6 4 – – 6 4 4 – 4 4 – – – – 4 4 3 3 3 6 6 6 – 4 4 – – – – – – 4 4 5 3 3 3 – – – – – –Paediatric ICU – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – 6 6 6 – – –CCU – 6 6 6 6 6 – – – 6 – – – 4 4 – – – – 4 4 – – – 6 6 6 – 4 4 – – – – – – 4 4 5 – – – 6 6 6 – – –Anaesthetics – 6 6 6 6 6 4 – – 6 4 4 3 4 4 4 – – 3 4 4 4 4 4 6 6 6 3 4 4 4 4 4 3 3 3 4 4 5 6 6 6 6 6 6 – – –Operating theatres – 6 6 6 6 6 5 – – 6 5 5 3 5 5 4 – – 4 5 5 4 4 4 6 6 6 4 4 4/5 4 4 4 3 3 3 4 4 5 5 5 5 6 6 6 – – –Training and research – 6 6 6 6 6 5 – – 6 5 5 3 4 4 4 4 4 4 4 4 3 3 3 6 6 6 4 4 4 4 4 4 3 3 3 4 4 5 5 5 5 6 6 6 4 4 4

BED NUMBERS

Medical/Surgical 0 473 473 534 325 325 58 0 0 326 148 138 42 85 158 47 0 0 101 101 189 75 90 111 452 452 452 70 130 243 36 36 36 23 21 27 99 243 301 37 37 37 32 32 39 0 0 0Obstetrics & Neonates 0 48 48 0 0 0 0 0 0 25 0 0 14 26 27 23 0 0 30 36 36 17 11 11 0 0 0 17 28 28 35 25 25 0 0 0 35 53 53 201 206 221 25 25 25 0 0 0Paediatrics 0 24 24 0 0 0 0 0 0 21 0 0 8 8 8 0 0 0 10 10 10 0 0 0 0 0 0 8 12 12 0 0 0 0 0 0 24 24 24 0 0 0 171 171 127 0 0 0Sameday 0 68 68 91 48 48 0 0 0 70 65 65 10 50 70 7 0 0 59 59 87 56 39 48 91 91 91 20 35 61 24 24 36 0 0 0 40 68 104 20 20 20 33 43 44 0 0 0Rehabilitation 0 140 180 17 17 17 150 0 0 44 60 90 0 30 40 36 84 84 24 24 70 0 0 40 30 30 30 24 46 60 88 88 88 7 14 14 51 41 70 0 0 0 0 0 0 0 0 0Mental Health 0 30 30 20 20 20 0 0 0 66 66 66 0 30 45 115 115 115 40 40 45 0 0 0 36 30 30 41 56 60 24 74 74 0 0 0 31 42 42 8 8 8 8 8 12 254 195 195Other 0 0 0 0 0 0 0 0 0 0 0 0 20 13 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 8 2 0 0 0 0 0 0 0 0 0 0 0 0Total beds on site 0 783 823 662 410 410 208 0 0 552 339 359 94 242 356 228 199 199 264 270 437 148 140 210 609 603 603 180 307 464 207 247 259 43 43 43 280 471 594 266 271 286 269 279 247 254 195 195Contracted Beds 15 15 15 36 60 84 0 0 0 23 23 23 0 0 0 20 20 20 0 0 0 0 0 0 13 13 13 12 20 32 20 20 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Total 15 798 838 698 470 494 208 0 0 575 362 382 94 242 356 248 219 219 264 270 437 148 140 210 622 616 616 192 327 496 227 267 279 43 43 43 280 471 594 266 271 286 269 279 247 254 195 195NB: Medical/Surgical includes HDU/CCU/ICU & ESSU & Palliative Care Total bed numbers refer to physical capacity and include contracted public beds off site. FSH Includes State Rehabiliation Centre beds Rockingham includes Murray District Hospital beds Graylands includes beds located at Selby (40 in 2007/08, 40 in 2014/15 & 40 in 2020/21) Statewide subacute (maintenance) contract of 42 beds in 2014/15 and 64 beds in 2021/22 – these beds are not allocated to any particular site Sameday includes Dialysis and Chemotherapy 2020/2021 bed numbers assume additional built capacity by 2020/2021. The exact timing of these developments will be outlined in Health’s updated 10 year capital plan to be released in 2010.

23

WAC

HS

HO

SPIT

AL S

ERVI

CES

FRAM

EWO

RK

– R

EGIO

NAL

RES

OU

RCE

CEN

TRES

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uthw

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2007/08

2014/15

2020/21

2007/08

2014/15

2020/21

2007/08

2014/15

2020/21

2007/08

2014/15

2020/21

2007/08

2014/15

2020/21

2007/08

2014/15

2020/21

Med

ical

Ser

vice

s

Gen

eral

44

54

45

44

54

55

45

54

55

Card

iolo

gy4

44

44

44

44

44

44

44

44

5En

docr

inol

ogy

44

43

44

34

44

44

44

44

44

Ger

iatr

ic4

44

34

44

44

44

44

44

44

5N

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logy

44

44

44

44

44

44

44

44

44

Rena

l Med

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44

44

54

44

44

44

44

44

4Re

nal D

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sis

44

44

45

44

44

44

44

44

44

Med

ical

Onc

olog

y4

44

44

44

44

44

44

44

44

5Ra

diat

ion

onco

logy

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

55

Resp

irato

ry4

44

44

44

44

44

44

44

44

4Pa

lliat

ive

care

44

44

44

44

44

44

44

44

44

Gas

troen

tero

logy

44

43

44

34

44

44

44

44

44

Hae

mat

olog

y3

44

34

43

44

44

44

44

44

4Im

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olog

y3

44

34

43

44

44

44

44

44

4In

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Dis

ease

s4

44

44

44

44

44

44

44

44

4Su

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ervi

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Gen

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4

44/

54

44/

54

44/

54

4/5

4/5

44/

54/

54

55

ENT

44

44

44

44

44

44

44

44

44

Gyn

aeco

logy

44

44

44

44

44

44

44

45

55

Oph

thal

mol

ogy

44

43

33

33

34

44

44

45

55

Ort

hopa

edic

s4

44

44

44

44

44

44

44

45

5U

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44

4 4

44

44

44

44

44

44

44

Vasc

ular

sur

gery

44

44

44

44

44

44

44

44

45

Neu

rosu

rger

y4

44

44

44

44

44

44

44

44

4Pl

astic

s4

44

44

44

44

44

44

44

44

4Bu

rns

44

44

44

44

44

44

44

44

44

Trau

ma

44

44

44

44

44

44

44

44

44

Emer

genc

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4/5

4/5

4/5

44/

54/

54

4/5

4/5

44/

54/

54

4/5

4/5

4/5

4/5

4/5

Afte

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sni

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lni

lni

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Obs

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44

44

44

44

44

44

44

44

4/5

4/5

Neo

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logy

44

44

44

44

43

44

44

44

44

Paed

iatr

ics

Serv

ices

Paed

iatr

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44

44

44

44

44

44

44

44

44

Reh

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litat

ion

44

54

44

44

44

55

45

54

55

Child

and

Ado

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Men

tal H

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Ser

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Serv

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(ho

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44

44

44

44

44

44

44

44

44

Men

tal h

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lni

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Emer

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55

45

54

44

55

54

45

55

5M

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patie

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55

54

55

44

45

55

44

55

55

Old

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Emer

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55

45

54

44

55

54

45

55

5M

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patie

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55

54

55

44

45

55

44

55

55

Dis

aste

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epar

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Res

pons

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45

54

55

4/5

55

45

54

55

45

5Cl

inic

al S

uppo

rt S

ervi

ces

Path

olog

y4

44

44

44

44

44

44

44

44

5Ra

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55

54/

54/

54/

54/

54/

54/

55

55

55

55

55

Phar

mac

y 4

44

44

44

44

44

44

44

44

4IC

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44

44

44

44

44

44

44

44

55

Paed

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Uni

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lni

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lAn

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s4

44

44

44

44

44

44

44

4/5

4/5

4/5

Ope

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g th

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s4

44

44

44

44

44

44

44

4/5

4/5

4/5

Trai

ning

and

rese

arch

55

55

55

55

55

55

55

55

55

BED

NU

MBE

RS

Mul

tiday

8910

410

429

4949

4247

5685

8083

6669

8110

511

515

2Sa

med

ay18

1825

66

716

1616

3030

3527

2727

88

27M

enta

l Hea

lth9

911

014

170

00

916

160

09

3333

33Re

side

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d Ca

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00

00

00

00

00

00

00

00

0To

tal b

eds

on s

ite11

613

114

035

6973

5863

7212

412

613

493

9611

714

615

621

2Co

ntra

cted

bed

s0

00

1010

140

00

00

00

00

1414

33To

tal

116

131

140

4579

8758

6372

124

126

134

9396

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24

WACHS HOSPITAL SERVICES FRAMEWORK – INTEGRATED DISTRICT HEALTH SERVICES

Goldfieds Kimberley PilbaraGreat

SouthernMidwest South West Wheatbelt

Esperance Derby Kununurra Newman Nickol Bay Katanning Carnarvon Busselton Margaret River Collie Warren Northam Merredin Narrogin* Moora

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Medical ServicesGeneral 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Cardiology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Endocrinology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Geriatric 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 2 3 3 3 3 3 3 3 3 2 3 3 2 3 3 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3Neurology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Renal Medicine 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Renal Dialysis 2 2 2 3 3 3 3 3 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 nil nil nil nil nil nil nil 4 4 nil nil nilMedical Oncology 3 3 3 2 2 2 2 2 2 2 2 2 3 3 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 3 2 2 2 2 4 4 2 2 2Radiation oncology nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilRespiratory 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Palliative care 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Gastroenterology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Haematology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Immunology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Infectious Diseases nil nil nil nil nil nil nil nil nil nil nil nil 3 3 3 nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilSurgical ServicesGeneral 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3ENT 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Gynaecology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 3 3 3 nil nil nil nil nil nil 3 3 3 nil nil nil 3 3 3 nil nil nil

Ophthalmology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 nil nil nil 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 nil nil nilOrthopaedics 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Urology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Vascular surgery nil nil nil nil nil nil nil nil nil nil nil nil 3 3 3 nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilNeurosurgery nil nil nil nil nil nil nil nil nil nil nil nil 3 4 4 nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilPlastics 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Burns 2 2 2 2 2 2 2 2 2 2 2 2 4 4 4 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 4 4 2 2 2Trauma 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Emergency Services ED 3 3 3 3 3 3 3 3 3 3 3 3 4 4 4 3 3 3 3 3 3 3 3 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3After Hours GP Clinics nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilObstetrics and Neonatal ServicesObstetrics 3 3 3 3 3 3 3 3 3 1 1 1 3/4 3/4 3/4 3 3 3 3 3 3 3 3 3/4 2 2 2 3 3 3 3 3 3 3 3 3 1 1 1 3 3 3 1 1 1Neonatology 3 3 3 3 3 3 3 3 3 2 2 2 3/4 3/4 3/4 3 3 3 2 2 2 3 3 3 2 2 2 2 2 2 2 2 2 3 3 3 2 2 2 3 3 3 2 2 2Paediatrics Services Paediatrics 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Rehabilitation ServicesRehabilitation 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4Child and Adolescents Mental Health ServicesEmergency Services (hospital based)

3 4 4 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 4 4 4 3 4 4 3 4 4 3 4 4 4 4 4 3 3 3 4 4 4 3 3 3


nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil

Adult Mental Health ServicesEmergency Services (hospital based)

4 4 4 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 4 4 4 4 4 3 4 4 3 4 4 3 4 4 4 4 4 3 3 3 4 4 4 3 3 3


4 4 4 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 4 4 4 4 4 3 4 4 3 4 4 3 4 4 4 4 4 3 3 3 4 4 4 3 3 3

Older Persons Mental Health ServicesEmergency Services (hospital based)

4 4 4 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 4 4 4 3 4 4 3 4 4 3 4 4 4 4 4 3 3 3 4 4 4 3 3 3


4 4 4 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 4 4 4 3 4 4 3 4 4 3 4 4 4 4 4 3 3 3 4 4 4 3 3 3

*From an organisational structure and reporting perspective, Narrogin mental health sits within the Great Southern, not Wheatbelt+A35

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WACHS HOSPITAL SERVICES FRAMEWORK – INTEGRATED DISTRICT HEALTH SERVICES (cont.)

Goldfieds Kimberley PilbaraGreat

SouthernMidwest South West Wheatbelt

Esperance Derby Kununurra Newman Nickol Bay Katanning Carnarvon Busselton Margaret River Collie Warren Northam Merredin Narrogin* Moora

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Disaster Preparedness & Response ServicesDisaster Preparedness 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4 3 4 4Clinical Support ServicesPathology 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3Radiology 3/4 3 3 4 4 4 4 4 4 3 3 3 4 4 4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 4 4 4 3 3 3 4 4 4 3 3 3Pharmacy 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2ICU/HDU nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilPaediatric ICU nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilCCU nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilAnaesthetics 3 3 3 3/4 3/4 3/4 3/4 3/4 3/4 3 3 3 3/4 3/4 3/4 3 3 3 3/4 3/4 3/4 3/4 3/4 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3/4 3/4 3/4 3 3 3Operating theatres 3 3 3 3 3 3 3 3 3 3 3 3 3/4 3/4 3/4 3 3 3 3 3 3 3 3 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3/4 3/4 3/4 3 3 3Training and research 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 3 4 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3BED NUMBERSMultiday 39 39 39 43 43 48 32 32 36 12 12 12 32 32 32 29 29 29 16 16 17 45 58 64 20 20 21 36 36 36 30 30 30 35 35 35 30 30 30 37 37 37 12 12 12Sameday 0 0 0 0 0 0 0 0 0 0 0 0 8 8 8 0 0 0 10 10 10 14 18 18 4 4 4 0 0 0 0 0 0 13 13 13 0 0 0 14 14 14 3 3 3Mental Health 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Residential Aged Care 0 0 0 0 0 0 10 10 10 0 0 0 0 0 0 19 19 19 15 15 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 8 8Total beds on site 39 39 39 43 43 48 42 42 46 12 12 12 40 40 40 48 48 48 41 41 42 59 76 82 24 24 25 36 36 36 30 30 30 48 48 48 30 30 30 51 51 51 23 23 23Contracted beds 0 0 0 4 10 10 0 4 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Total 39 39 39 47 53 58 42 46 50 12 12 12 40 40 40 48 48 48 41 41 42 59 76 82 24 24 25 36 36 36 30 30 30 48 48 48 30 30 30 51 51 51 23 23 23

NB: Multiday includes medical/surgical, palliative, obstetrics, neonates, paediatrics, rehabilitation and non-APU mental health Sameday includes medical/surgical, renal dialysis and chemotherapy Mental Health includes only APU beds

26

WA NON HOSPITAL SERVICES FRAMEWORKSouth Metropolitan North Metropolitan WACHS Statewide

Armadale Bentley Fremantle Peel Rockingham –Kwinana Inner City Joondalup –

WannerooCity and

Lower WestStirling –

Osborne ParkSwan and

Hills Inner City Goldfields Kimberley Pilbara Great Southern Midwest Southwest Wheatbelt

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Sexual Health Medicine – 4 4 – – 2 6 6 6 2 3 3 2 4 4 6 6 6 – 4 4 5* 5* 5* – – – – 3 3 n/a n/a n/a 2 4 4 2 3 3 2 4 4 1 3 3 2 3 3 1 3 3 1 3 3

*NB: These services are provided from KEMH

After Hours GP 3 3 3 3 3 3 3 3 3 nil nil nil 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 n/a n/a n/a nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nil nilPublic Health ServicesEnvironmental Health 1 1 1 1 1 1 5 5 5 1 1 1 1 1 1 n/a n/a n/a 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 4 4 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 6 6 6Communicable Disease Control 1 3 3 1 1 1 4 4 4 1 1 1 1 3 3 n/a n/a n/a 1 1 1 5 5 5 1 1 1 1 1 1 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 6 6 6

Child and Community Health 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 n/a n/a n/a 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 6 6 6

Aboriginal Health 2 3 3 2 3 3 2 3 3 2 2 2 2 3 3 n/a n/a n/a 2 3 3 2 2 2 2 2 2 2 2 2 5 5 5 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 6 6 6Health Promotion 5 5 5 4 4 4 5 5 5 4 4 4 4 4 4 n/a n/a n/a 5 5 5 4 4 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 4 4 4 5 5 5 5 5 5 5 5 5 4 4 4 6 6 6Breastscreen 2 2 2 3 3 3 3 3 3 2 2 2 3 3 3 5 5 5 3 3 3 5 5 5 3 3 3 3 3 v n/a n/a n/a 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 5 2 2 2 6 6 6Cervical 3 3 3 3 3 3 5 5 5 3 3 3 3 3 3 n/a n/a n/a 3 3 3 5 5 5 3 3 3 3 3 3 6 6 6 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 6 6 6Genomics 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 n/a n/a n/a 3 3 3 6 6 6 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 6 6 6Migrant Health 5 5 5Drug & Alcohol Services – Prevention Services 4/5 4/5 4/5 4 4 4 4/5 4/5 4/5 4 4 4 4 4 4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 3/4 5 5 5 3/4 3/4 3/4 3/4 3/4 3/4 3 3 3 3 3 3 3/4 3/4 3/4 3 3 3 3 3 3 6 6 6

Drug & Alcohol Services – Treatment Services 4 4 4 4 4 4 5 5 5 4 4 4 4 4 4 4 4 4 5 5 5 4 4 4 4 4 4 5 5 5 3 3 3 3 3 3 3 3 3 3 3 3 3/4 3/4 3/4 3 3 3 3 3 3 6 6 6

Primary Care Services

GP based community nursing 4 4 5 4 4 5 4 6 6 3 3 3 4 5 5 n/a n/a n/a 4 5 5 5 5 6 4 5 5 4 5 5 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4

Community Midwifery 5 5 5 – 5 5 nil 5 5 – 5 5 – 5 5 6 6 6Ambulatory Care Services

Acute Substitution 4 4 3 3 5 4 4 4 4 3 4 4/5 4 5 6 3 4 4 3 4 4 n/a n/a n/a 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 4 4 5 2 2 2

Hospital Avoidance 3 4 4 4 4 5 4 4 3 4 4 3 4/5 4/5 4 5 6 3 4 4 3 4/5 4/5 n/a n/a n/a 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 5 3 3 3Aged Care 3 4 4 4 4 4 5 4 4 3 3 3 4 4 4 4 4/5 6 6 6 4 5 5 4 5 5 n/a n/a n/a 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 5 4 4 4Outpatients 3 4 4 4 4 4 5 5 5 3 4 4 4 4 4 4 5 6 6 6 3 4 4 3 4 5 n/a n/a n/a 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 5 4 4 4School Dental Services 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 n/a* n/a* n/a*

Adult Dental Services 3 2/3 2/3 3 3 3 3 3 3 2 2 2 3 3 3 2/3 2/3 2/3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2/3 2/3 2 2 2 n/a* n/a* n/a*

Specialty Dental Services 6 6 6 5/6 5/6 5/6 4/6 4/6 4/6 n/a* n/a* n/a*

* State wide services are managed from the Como offices of Dental Health Services

Child and Adolescents Mental Health ServicesCommunity mental health services 4 4 4 5 5 5 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 5 n/a n/a n/a 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 5 5 4 4 4

Adult Mental Health ServicesCommunity mental health services 4 4 4 5 5 5 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 5 5 n/a n/a n/a 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 5 5 4 4 4

Older Persons Mental Health ServicesCommunity mental health services 4 4 4 5 5 5 4 4 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 n/a n/a n/a 2 3 4 2 3 4 2 3 4 4 4 4 4 4 4 2 4 5 2 3 4

NB: For completeness Child & Adolescent Health Services community services are captured as delivered under NMAHS, SMAHS & WACHS


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7. THE WAY FORWARDWA Health is committed to strong planning, focusing on integrated health services, delivering new models of care, a greater focus on community supported services and on safe and quality care closer to home. With finite resources, WA Health is working to manage demand and to reduce inefficiencies.

Many strategies have been successfully put in place to better manage the ever increasing demands on the health system. Ongoing service improvement programs and national reform initiatives will be rolled out in WA over the coming years to deliver better patient outcomes.

A number of significant health care plans and strategies are currently in development or in the early stages of implementation. Initiatives such as the WA Mental Health Strategic Plan 2010–2020 have been recognised in the preparation of CSF 2010 through consultation and dialogue related to assumptions, objectives and strategies.

NATIONAL INITIATIVES

Reform of Commonwealth/State Financial Arrangements

Western Australia and the other States and Territories have entered into a National Healthcare Agreement (NHCA) and National Partnership Agreements (NPAs) with the Commonwealth.

The NHCA succeeds the former Australian Health Care Agreement through which the Commonwealth contributed funding for public hospitals. In addition to funding for public hospitals, funding for population health and certain other programs has been integrated into NHCA.

The NHCA is expected to provide WA with an additional $506 million over the period 2008/09 – 2012/13, compared to a continuation of the previous Australian Health Care Agreement. The NHCA came into effect on 1 July 2009.

The NPAs provide time-limited funding for agreed Commonwealth/state priorities to improve health services. The NPAs relate to the areas of Hospital and Health Workforce Reform, Preventive Health, and Indigenous Health. They involve significant financial commitments by both the Commonwealth and Western Australian Governments. Work is now progressing on implementing the NPAs. Western Australia has fulfilled all implementation commitments to date.

National Health and Hospitals Reform Commission

In July 2009, the National Health and Hospitals Reform Commission (NHHRC) released its final report ‘A Healthier Future for all Australians’, which focuses on developing a long term plan for reforming the health system. Without reform, the management of chronic diseases, costly new health technologies and the ageing of the population are highlighted as areas that are likely to impact greatly on health services.

The report recommends significant changes to Commonwealth/State health arrangements, including:

the Commonwealth to assume full responsibility for primary, aged care and Indigenous health services

the Commonwealth to pursue an activity-based funding approach in funding 100 per cent of the “efficient cost” of outpatient services and 40 per cent of the “efficient cost” of public inpatient services.

Following consultation by the Prime Minister and the Commonwealth Minister for Health and Ageing, a reform plan is to be developed and presented to COAG early in 2010.

7 . T h e w a y f o r w a r d

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National Primary Health Care Strategy

The Commonwealth Government worked to develop a National Primary Health Care Strategy, and released a draft strategy in August 2009. The strategy endeavours to provide a long term plan for the delivery of primary care services. Improving access, better management of chronic disease, a core systematic focus on prevention, and a strong framework for quality and safety are identified as key directions in the draft strategy.

National Preventative Health Taskforce and Strategy

A National Preventative Health Taskforce established by the Commonwealth Government delivered a National Preventative Health Strategy to the Commonwealth Minister for Health and Ageing on 30 June 2009. Following delivery of the Strategy, the Taskforce began developing a workplan, and has indicated an interest in undertaking work in three new areas: mental health, sexual and reproductive health; and injury prevention. Implementation of the Strategy and the future work of the Taskforce is the subject of further consultation by the Commonwealth and State Health Ministers.

STATE INITIATIVES

Mental Health

In September 2008 the State Government made a commitment to enhance the mental health and wellbeing of all Western Australians through the:

appointment of WA’s first Minister for Mental Health

establishment of an independent Commissioner for Mental Health and Wellbeing

development of a State Mental Health Policy and WA Mental Health Strategic Plan 2010-2020 to reform the mental health sector.

The Strategic Plan, which is due for release in early 2010, will provide a framework and blueprint for the service elements required to deliver a contemporary mental health system. The current orientation of the system on treating mental illness will broaden to emphasise promoting mental wellbeing and preventing illness.

The Plan will apply best practice benchmarks to identify the required level and mix of inpatient and community services within a defined geographical catchment (known as a ‘district’ in the metropolitan area and a ‘region’ in the rural areas). These include:

increasing hospital substitution interventions designed to provide better health care for people with a mental illness, mainly by improving their access to community-based services over the next 10 years

improving the range of community services available at the district and regional level to enable individuals to remain in their local community and maintain their social, vocational, and family connections thus strengthening the capacity of community services to support people to live in their own home

enhancing and expanding the role and number of community intervention teams that will provide prompt crisis/emergency assessment and treatment wherever an individual is living thus alleviating the demand on hospital emergency departments and inpatient beds for those individuals who can be treated at home.

The Strategic Plan will outline the range of emergency services required for an optimum system of mental health care and will assist in decreasing unnecessary emergency department presentations and inpatient admissions. Models considered best practice include short stay mental health emergency units co-located with emergency departments, and assertive community intervention teams operating out of emergency departments.


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Following the delivery of the WA Mental Health Strategic Plan 2010-2020 the blueprint for investment and reform in mental health will be built into WA Health’s asset investment and resource allocation plans for clinical services over the next decade.

The delivery of improved community based, non-inpatient acute and community care is essential in any strategy aimed at controlling the increasing demand pressures on emergency departments and hospitals.

Four Hour Rule Program

The WA Four Hour Rule Program commenced in April 2009 to fundamentally change the way WA Health manages patients presenting for unplanned or emergency care. The aim of the Program is to improve the patient experience and quality of care provided to the patient by redesigning and streamlining processes for admission and discharge across the hospital. The overall target for the Program is to improve the quality of care provided to patients by ensuring that 98 per cent of patients arriving at EDs are seen and admitted, discharged or transferred within a four-hour timeframe.

Each hospital will have two years to identify issues, redesign processes and implement improvements in order to reach the 98 percent target by mid-2012.

The rollout of the Program throughout WA Health hospitals is occurring in a series of stages, with Stage 1 for tertiary sites commencing in April 2009. Stage 2, for general hospitals with emergency departments, commences in October 2009 and Stage 3, for country Regional Resource Centre hospitals and King Edward Memorial Hospital, commences in April 2010. Graylands Selby-Lemnos and Special Care Health Service will also investigate service provision and commence redesign efforts during the life of the Program.

Friend in Need – Emergency (FINE) Scheme

The State Government has committed $84 million to the FINE scheme, which will support WA Health’s program of developing and enhancing the capacity of non-in-patient acute and complex care in the community. The FINE scheme will align with and complement the work of existing hospital outreach programs including Hospital in the Home (HITH), Rehabilitation in the Home (RITH) and the Residential Care Line (RCL).

The aim of the FINE scheme is to deliver care and support to people in need enabling them to remain in their own home, hostel or nursing home, rather than present to an emergency department or be admitted into hospital. The target group is not limited by an age criteria.

The FINE scheme will also support:

informal carers and family who are recognised as partners in care

GPs, whose engagement and involvement will be pivotal to the success of the scheme.

WA Health’s work to increase the capacity of non-inpatient and community care aligns with and augments the major changes occurring as a result of the Four Hour Rule Program.


30

Demand Management

Inpatient Demand

Work on managing demand for hospital inpatient services remains a priority for WA Health. Analysis of admitted patient information indicates that there are around 20 Extended Service Related Groups (ESRG) – disease or condition groupings – that have the potential to produce 80 per cent of achievable total bedday savings.

Focusing particularly on the 20 ESRGs, admission rates and beddays can be reduced by initiatives such as:

refining and expanding early discharge initiatives and day hospital programs

increasing the use of community supported services such as post acute care programs, Hospital in the Home (HITH) and Rehabilitation in the Home (RITH)

moving the care of patients from inpatient beds to outpatient clinics as clinically appropriate.

The extension of the general hospital model and increasing the use of hospital bed substitution and length of stay reduction initiatives will further enhance the efficiency and cost effectiveness of hospital inpatient service delivery.

The achievement of these savings will be monitored on a quarterly basis through the WA Health Operational Plan.

Emergency Department Demand

Demand for ED services continues to trend upwards, fuelled by ambient economic conditions and the shortage of alternative services. To manage ED demand a number of strategies have been designed within the two broad categories of patient flow and the provision of alternate places for care.

Patient Flow initiatives will have the following objectives:

Reduced demand on the ED for mental health consumers will be achieved by redefining patient flows and pathways with a particular emphasis on:

ED attendances by clients with chronic mental health conditions

inter-hospital transfers (including mental health rural patients)

high prevalence mental health conditions.

Demand for EDs to provide general health services will be reduced by:

direct admissions for chronic disease type patients and known surgical patients from the community through liaison with GPs

better management of nursing home patients in place of residence

streamlining admission process for inter-hospital transfers

redefining pathways for admission direct from outpatient departments to bypass ED where appropriate

diverting and directing less and non urgent patients to the Alternate Places for Care programs.

The Alternate Places for Care program will establish alternate services and facilities, enabling lower acuity patients to access urgent primary care either co-located at a hospital or with other community based care.


37


31

JOINT NATIONAL AND STATE INITIATIVES

WA Subacute Care Plan 2009–2013

As part of a $48.6million National Health Partnership Agreement signed in December 2008, WA has committed to a 20 per cent increase in subacute care services from 2009–2013. While the overall aim of the agreement is to improve delivery of subacute care services, a key strategic direction of the plan is to encourage a shift in these services from the inpatient setting to the community. Specifically, the plan will provide increased services in the community setting, move services to general hospital sites closer to where people live and assist hospitals to be more efficient and sustainable.

Growth in subacute care services will occur across the State, with a focus on geographical areas where services are minimal or undeveloped. The subacute services, as determined by the Commonwealth Government within the plan, are:

rehabilitation

geriatric evaluation and management

psychogeriatric care

palliative care.

GP Super Clinics

The GP Super Clinic Program in WA is a collaborative project of the Commonwealth and Western Australian Governments. The clinics will be privately run and the program aims to improve coordination between GPs, public hospital and community services including allied health services and Commonwealth health services.

The range of services available at these super clinics will be based on local community needs and priorities – ensuring existing health services are complemented and enhanced. The NMAHS: GP Super Clinics: Service Delivery Strategy identifies the priorities and provides a framework for managing community expectations. The priorities include the Commonwealth program objectives:

early identification of risk factors affecting the immediate and long-term health of an individual

linking acute and primary health care providers in order to ensure greater balance in the health system and the services provided to individuals

providing health promotion and illness prevention strategies in the local community.

The Super Clinics provide an opportunity for service development and care delivery. A collaborative approach between NMAHS and the providers will focus on avoiding duplication and providing integrated services.

The GP Super Clinics will:

provide the infrastructure to allow GPs and other health professionals to work together in the one space

provide a greater focus on prevention and management of chronic disease, easing the pressure off hospitals

provide modern training facilities for medical students and trainees

make healthcare more convenient, by providing local health services together in the one location, with extended hours of operation.


32

Commonwealth/State Elective Surgery Programs

The Commonwealth/State Elective Surgery Programs comprise several initiatives funded independently by the Commonwealth and the WA Governments.

The WA Government’s $30 million Elective Surgery Election Commitment will fund approximately 5,850 additional elective surgery cases (above the 2007 base year) to be completed in the period from 1 January 2009 to 30 June 2010. This program is currently above target on a year-to-date basis.

The Commonwealth Elective Surgery Program Stage 1 (Blitz) was completed on 31 December 2008. WA received $15.4 million to conduct an additional 2,720 cases above the 2007 base year. WA Health actually completed 3,727 cases, being 1,007 cases or 37 per cent above target.

The Commonwealth Elective Surgery Program Stage 2 (Capital) has provided WA Health with $13.3 million in capital funds to undertake systemic improvement projects to improve elective surgery capacity in WA public hospitals. Five projects will receive funding.

The Commonwealth Elective Surgery Program Stage 3 (incentive payments) will provide WA with a maximum of $29 million spread over the 2009/10 and 2010/11 financial years. This program requires WA to meet elective surgery throughput targets as well as waiting time reduction targets in order to receive incentive payments. The minimum funding WA can receive is $4 million in 2009/10 and $2 million in 2010/11 upon signing of the agreement. At the time of publication of the CSF 2010, WA has been informed of the proposed model but has not been presented with a formal agreement.

Indigenous Health Partnership Agreement

The Commonwealth and Western Australian Governments have signed two National Partnership Agreements that directly impact on Indigenous Health Outcomes. These are Closing the Gap in Indigenous Health Outcomes and Indigenous Early Childhood Development. These involve significantly increased expenditure over the four years to 2013/14. Improvements will be pursued in the following priority areas:

reduction in the prevalence of smoking

access to primary health care services that can deliver

fixing the gaps and improving the patient journey

healthy transition to adulthood

making Indigenous health everyone’s business

improving antenatal, pre-pregnancy and sexual/reproductive health for Aboriginal women, specifically targeting teenagers

increasing access to parent/child health services.

WA Health has an implementation plan for the Agreement. This plan will guide the development of detailed project plans and strategies and will set out costs, performance measures, evaluation methodologies and risk assessments. The detailed project plans will be prepared in close consultation and collaboration with Aboriginal communities and agencies to ensure that they satisfactorily address identified community need.


39


33

PUBLIC PRIVATE PARTNERSHIPS (PPP)There is an emerging requirement for WA Health to explore further partnership opportunities with the private sector in resourcing its program of reform and development. The State has substantial experience of delivery in this space and is recognised locally and elsewhere for successful public private joint ventures.

The PPP initiatives could relate to a single aspect or combination of aspects in the areas of asset investment or service operation. Any strategies considered under this umbrella will be articulated in the context of State Government policy and WA Health’s overall governance and management approach.

A p p e n d i c e s

34

APPENDICES

Appendix 1. Role Delineation

In CSF 2005, the planning process for hospitals and non-hospital services was based on the NSW Health Guide to Role Delineation of Health Services. The intent of the role delineation matrix within CSF 2010 is to guide service planning across the health service continuum. It is a high-level planning tool that ultimately outlines what WA Health aims to achieve over the short, medium and long term.

The role delineation process starts with the identification of specialty groups which are classified as hospital or non-hospital services. Each specialty group is defined in terms of the actual clinical treatment or service provided, the complement of staff required to provide the treatment or service and often, the type of facilities, tools and/or equipment that are needed.

The definitions describe the range of service complexity covered for each specialty group, classifying these as levels 1 through 6. Level 1 services are the least complex and level 6 services are the most complex. However many specialty groups do not include all of the six levels. This standardised set of definitions allows for the categorisation of specialty groups across different sites.

After definitions were completed, the Role Delineation Matrix was constructed. This Matrix shows the most complex level of a specialty that is available at each facility or region in WA. Not all facilities have all specialty groups and certain specialty groups are only available in some facilities. For example, our high level tertiary hospitals will be the only sites to deliver level 6 cardiothoracic surgery, reflecting the highly specialised nature of this type of care.

The CSF 2010 does not attempt to describe all the specialty groups which are provided by health care facilities, but confines itself to those which are widely considered to be the core services.

It must be noted that the definitions matrix includes only brief descriptions of the capabilities and requirements of the specialty groups. Therefore, role delineation definitions should be interpreted with some degree of flexibility, combined with consideration for the functional level of service delivery. Alternatively, at some sites, a service may not satisfy all the stated criteria to achieve a particular level, but may exceed the criteria required for the lower level. These sites are assigned a combination of levels as indicated in the role delineation matrix.

Role delineation does not document the patient journey and the many different pathways that a patient may take to receive the best possible care. Instead the role delineation process defines various services and the level at which these are to be provided at different sites.

In summary, role delineation provides a consistent language to describe health services and acts as a tool for planning service developments.


41


35

Hos

pita

l Ser

vice

s D

efini

tions

MED

ICAL

SUR

GIC

AL

Gen

eral

ist

Type

I Su

bspe

cial

ties

Type

II S

ubsp

ecia

lties

Gen

eral

ist

Type

I Su

bspe

cial

ties

Type

II S

ubsp

ecia

lties

Phys

icia

n•

Card

iolo

gy•

Der

mat

olog

y•

Endo

crin

olog

y•

Gas

troen

tero

logy

•G

eria

tric

med

icin

e•

Neu

rolo

gy•

Rena

l Med

icin

e•

Rhe

umat

olog

y•

Vene

reol

ogy

•Pa

edia

tric

s•

Resp

irato

ry M

edic

ine

•

Clin

ical

Hae

mat

olog

y•

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ical

Mic

robi

olog

y•

Imm

unol

ogy

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edic

al O

ncol

ogy

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lliat

ive

Care

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diot

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peut

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ncol

ogy

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enet

ics

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inic

al In

fect

ious

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ease

s•

Gen

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Sur

geon

•Ea

r, N

ose

and

Thro

at•

Obs

tetr

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and

•

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aeco

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thal

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tic s

urge

ry•

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spla

nt S

urge

ry•

Vasc

ular

Sur

gery

•Bu

rns

•

Appendix 2. Service Definitions

A p p e n d i c e s

36

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Med

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Ser

vice

s

Gen

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are

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VMP

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r cov

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N

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ting

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spec

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may

be

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e Ty

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spec

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incl

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e-h

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43


37

Leve

l 1Le

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A p p e n d i c e s

38

Leve

l 1Le

vel 2

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l 3Le

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ogy

depa

rtm

ent

and

emer

genc

y ca

re

Stat

ewid

e re

ferr

al ro

le•

Und

ergr

adua

te a

nd

•po

stgr

adua

te te

achi

ng

role

Acce

ss to

CT

and

MR

I •

and

poss

ibly

PET

Rese

arch

role

•


45


39

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Rena

l – g

ener

alG

P in

patie

nt c

are

•Ac

cess

to g

ener

al

•ph

ysic

ian

or re

nal

spec

ialis

t vis

iting

or b

y te

lehe

alth

24 h

our c

over

by

RN

•O

utpa

tient

car

e by

•

visi

ting

gene

ral

phys

icia

n an

d po

ssib

ly

rena

l spe

cial

ist

May

acc

omm

odat

e se

lf •

care

dia

lysi

s in

patie

nts

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:In

patie

nt c

are

by

•re

side

nt g

ener

al

phys

icia

n O

utpa

tient

con

sulta

tion

•by

vis

iting

rena

l sp

ecia

list

Self

care

dia

lysi

s un

it •

with

link

s to

larg

er re

nal

unit

Spec

ialis

t RN

•Ac

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:In

patie

nt c

are

by re

side

nt

•re

nal s

peci

alis

tsRe

gist

rar/

RM

O•

Emer

genc

y se

rvic

es

•pr

ovid

ed b

y on

-cal

l sp

ecia

list

Regi

onal

refe

rral

role

•Ac

cess

to s

peci

alis

t SR

N•

Som

e un

derg

radu

ate

•te

achi

ng a

nd p

ossi

bly

som

e re

sear

ch ro

leAl

l typ

es o

f dia

lysi

s •

avai

labl

e an

d re

nal

biop

sies

per

form

edPr

ovid

es a

full

rang

e of

•

dial

ysis

acc

ess

surg

ery

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of re

nal

•se

rvic

es, w

ith re

nal

depa

rtm

ent a

nd

emer

genc

y ca

re

serv

ices

Rena

l tra

nspl

anta

tion

•av

aila

ble

Coor

dina

ted

by fu

ll tim

e •

rena

l uni

t man

ager

St

atew

ide

refe

rral

•

role

and

sta

tew

ide

geog

raph

ical

are

a ba

sed

serv

ice

deliv

ery

role

Und

ergr

adua

te a

nd

•po

stgr

adua

te te

achi

ng

role

Rese

arch

role

•

Rena

l – d

ialy

sis

Com

mun

ity m

ay

•su

ppor

t sel

f car

e di

alys

is in

patie

nts

(if

adeq

uate

wat

er s

uppl

y)

As fo

r lev

el 1

plu

s:Se

rvic

es o

ffere

d by

a

•ge

nera

l hea

lth s

ervi

ce/

clin

icCa

re u

nder

sup

ervi

sion

•

of G

P w

ith o

r with

out

RN

Self-

carin

g st

able

•

patie

nts

Out

reac

h su

ppor

t for

•

hom

e di

alys

is, p

ossi

bly

unde

r rem

ote

dire

ctio

n fro

m a

Lev

el 5

or L

evel

6

dial

ysis

faci

lity

May

acc

omm

odat

e se

lf •

care

dia

lysi

s in

patie

nts

with

in th

e fa

cilit

y.

As fo

r lev

el 2

plu

s:Co

mm

unity

-bas

ed

•sa

telli

te s

ervi

cePr

edom

inat

ely

self-

•ca

ring

stab

le p

atie

nts

Spec

ialis

t RN

•Vi

sitin

g sp

ecia

list f

or

•m

ore

com

plic

ated

ca

ses

Som

e as

sess

men

t •

serv

ices

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:G

ener

al h

ospi

tal-b

ased

•

sate

llite

ser

vice

Visi

ting

spec

ialis

t or

•ge

nera

l phy

sici

an w

ith

neph

rolo

gy s

kills

Mor

e co

mpl

icat

ed

•ca

ses

Asse

ssm

ent s

ervi

ces

•Sp

ecia

list R

N•

Acc

ess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:Re

side

nt s

peci

alis

t•

Acce

ss to

spe

cial

ist S

RN

•M

ore

com

plic

ated

cas

es•

Asse

ssm

ent s

ervi

ces

•Re

gion

al re

ferr

al ro

le•

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:M

ore

com

plic

ated

•

case

sPr

ovid

es a

cute

dia

lysi

s •

whe

n ne

cess

ary

Und

ergr

adua

te a

nd

•po

stgr

adua

te te

achi

ng

role

Stat

ewid

e ce

ntre

of

•ex

celle

nce

and

refe

rral

ro

leAc

cess

to o

n-si

te a

llied

•

heal

th s

uppo

rt (e

.g.

Die

titia

ns a

nd S

ocia

l W

orke

rs)

Com

plic

ated

•

asse

ssm

ent a

nd

treat

men

t of u

nsta

ble

co-m

orbi

ditie

s

A p p e n d i c e s

40

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Med

ical

Onc

olog

ySp

ecia

list R

N in

•

regi

on (C

ance

r Nur

se

Coor

dina

tor/

Brea

st C

are

Nur

se) w

ho li

nks

with

re

leva

nt tu

mou

r spe

cific

CN

C an

d tre

atin

g fa

cilit

y fo

r car

e co

ordi

natio

nN

o tre

atm

ent f

acili

ties.

•

As fo

r lev

el 2

plu

s:G

P in

patie

nt c

are

•24

hou

r cov

er b

y R

N•

Low

risk

che

mot

hera

py

•fo

r the

4 m

ost c

omm

on

canc

ers

and

palli

ativ

e pa

tient

sO

utpa

tient

car

e by

•

resi

dent

gen

eral

ph

ysic

ian

and

visi

ting

med

ical

onc

olog

ist w

ith

supp

ort v

ia te

lehe

alth

Mul

tidis

cipl

inar

y •

case

con

fere

ncin

g w

ith tu

mou

r spe

cific

sp

ecia

list f

or a

ll pa

tient

sAc

cess

to s

ome

allie

d •

heal

th s

ervi

ces

As fo

r lev

el 3

plu

s:In

patie

nt c

are

by

•re

side

nt g

ener

al

phys

icia

n Ch

emot

hera

py s

hare

d •

care

with

the

tert

iary

fa

cilit

ies

for c

omm

on

canc

ers

with

mor

e co

mpl

ex n

eeds

Out

patie

nt c

onsu

ltatio

n •

by v

isiti

ng m

edic

al

onco

logi

st o

n re

gula

r ba

sis

with

tert

iary

fa

cilit

y su

ppor

t for

co

mpl

icat

ions

Link

s w

ith ra

diot

hera

py,

•pa

lliat

ive

care

and

pai

n m

anag

emen

t ser

vice

sSp

ecia

list R

N•

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:In

patie

nt c

are

by re

side

nt

•on

colo

gist

Regi

stra

r/R

MO

•Re

gion

al re

ferr

al ro

le•

Acce

ss to

spe

cial

ist S

RN

•So

me

unde

rgra

duat

e •

teac

hing

and

pos

sibl

y so

me

rese

arch

role

Mul

tidis

cipl

inar

y •

man

agem

ent o

f pa

tient

s in

clud

ing

case

co

nfer

ence

s.Li

nks

with

pal

liativ

e ca

re

•se

rvic

es a

nd m

ay h

ave

pain

man

agem

ent c

linic

Em

erge

ncy

care

ava

ilabl

e•

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of o

ncol

ogy

•se

rvic

es, w

ith o

ncol

ogy

depa

rtm

ent a

nd

emer

genc

y se

rvic

es

(NB:

radi

atio

n on

colo

gy

defin

ed s

epar

atel

y)M

edic

al re

gist

rar o

n •

site

24

hrs

Stat

ewid

e re

ferr

al ro

le•

Stat

ewid

e m

ento

ring

•an

d sp

ecia

list

lead

ersh

ip ro

leU

nder

grad

uate

and

•

post

grad

uate

teac

hing

ro

leRe

sear

ch ro

le•


47


41

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Radi

atio

n O

ncol

ogy

Visi

ting

radi

atio

n •

onco

logi

st w

orki

ng

in c

onju

nctio

n w

ith

com

preh

ensi

ve c

ance

r se

rvic

e N

o tre

atm

ent f

acili

ties

•

As fo

r lev

el 4

plu

s:Ba

sic

radi

atio

n on

colo

gy

•se

rvic

e w

ith m

inim

um

equi

pmen

t - p

ossi

bly

only

on

e m

achi

neH

as a

cces

s to

radi

atio

n •

onco

logi

sts,

phy

sici

sts

and

radi

atio

n th

erap

ists

Acce

ss to

spe

cial

ist S

RN

•Li

nks

to le

vel 5

pal

liativ

e •

care

ser

vice

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of ra

diat

ion

•on

colo

gy s

ervi

ces,

lo

cate

d in

prin

cipl

e re

ferr

al c

entre

w

ith a

cces

s to

all

subs

peci

altie

sSt

atew

ide

refe

rral

role

•St

atew

ide

men

torin

g •

and

spec

ialis

t le

ader

ship

role

Und

ergr

adua

te a

nd

•po

stgr

adua

te te

achi

ng

role

Rese

arch

role

•Fu

lly in

tegr

ated

•

com

pute

rised

pla

nnin

g,

treat

men

t and

ve

rifica

tion

syst

ems

Mec

hani

cal a

nd

•bi

omed

ical

sup

port

fa

cilit

ies

A p p e n d i c e s

42

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Resp

irato

ryG

P in

patie

nt c

are

•24

hou

r cov

er b

y R

N•

Out

patie

nt c

are

by

•vi

sitin

g ge

nera

l ph

ysic

ian

and

poss

ibly

re

spira

tory

spe

cial

ist o

r by

tele

heal

thAc

cess

to s

piro

met

ry.

•If

visi

ting

Resp

irato

ry

Spec

ialis

t, ne

ed v

isiti

ng

Basi

c Lu

ng F

unct

ion

Labo

rato

ryEl

ectro

nic

acce

ss to

•

Spec

ialis

t SR

N N

etw

ork

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:In

patie

nt c

are

by

•re

side

nt g

ener

al

phys

icia

n O

utpa

tient

con

sulta

tion

•by

vis

iting

resp

irato

ry

spec

ialis

tSp

ecia

list S

RN

•Ac

cess

to B

asic

Lun

g •

Func

tion

Labo

rato

ry

(Spi

rom

etry

, vol

umes

an

d ga

s tr

ansf

er)

Acce

ss to

Res

pira

tory

•

Spec

ialis

t for

in-p

atie

nt

cons

ulta

tion

Link

with

Sle

ep S

ervi

ce•

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:In

patie

nt c

are

by re

side

nt

•re

spira

tory

spe

cial

ist

Regi

stra

r/R

MO

•Re

gion

al re

ferr

al ro

le•

On

site

spe

cial

ist S

RN

•Si

gnifi

cant

und

ergr

adua

te

•te

achi

ngPr

ovis

ion

of L

ung

•Fu

nctio

n La

bora

tory

Prov

isio

n of

Non

Inva

sive

•

Vent

ilatio

nPr

ovis

ion

of

•Br

onch

osco

py s

uite

Resp

irato

ry W

ard,

with

•

Non

-inva

sive

Ven

tilat

ory

(NIV

) cap

abili

tyAc

cess

to le

vel 5

•

card

iolo

gy a

nd

card

ioth

orac

ic s

urge

ryEm

erge

ncy

care

pro

vide

d •

by o

n-ca

ll sp

ecia

list

Stro

ngly

link

ed w

ith S

leep

•

Serv

ice

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of re

spira

tory

•

serv

ices

, with

re

spira

tory

dep

artm

ent

and

emer

genc

y ca

reSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

•

post

grad

uate

teac

hing

ro

le

Rese

arch

role

•H

as a

resp

irato

ry

•fu

nctio

n la

bora

tory

Prov

isio

n of

com

plet

e •

diag

nost

ic s

ervi

ces

incl

udin

g Br

onch

osco

py

suite

Spec

ialis

ed R

espi

rato

ry

•W

ard,

with

NIV

ca

pabi

lity

Intim

atel

y lin

ked

to

•Sl

eep

Serv

ice


49


43

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Palli

ativ

e Ca

reIn

patie

nt c

are

by

•ac

cred

ited

GP

24 h

our c

over

clin

ical

•

nurs

e w

ith e

xper

ienc

e in

pal

liativ

e ca

re

serv

ices

Out

patie

nt c

are

by

•vi

sitin

g ge

nera

l ph

ysic

ian

and

poss

ibly

pa

lliat

ive

care

spe

cial

ist

or b

y te

lehe

alth

Acce

ss to

som

e al

lied

•he

alth

ser

vice

sCo

nsul

t lia

ison

ser

vice

s •

for i

npat

ient

s

As fo

r lev

el 3

plu

s:Pa

lliat

ive

care

pat

ient

s •

man

aged

by

GP

and

med

ical

pra

ctiti

oner

sp

ecia

lisin

g in

pal

liativ

e ca

reAc

cess

to s

peci

alis

t •

SRN

Link

age

to c

omm

unity

•

base

d pa

lliat

ive

care

Ac

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:In

patie

nt c

are

by re

side

nt

•pa

lliat

ive

care

phy

sici

anRe

gist

rar/

RM

O•

Regi

onal

refe

rral

role

•U

nder

grad

uate

teac

hing

•

and

som

e re

sear

ch ro

leIn

tegr

ated

com

mun

ity

•co

nsul

tativ

e se

rvic

e un

der

dire

ctio

n of

pal

liativ

e ca

re

phys

icia

nLi

nks

with

onc

olog

y,

•ra

diot

hera

py,

anae

sthe

tics,

psy

chia

try,

pa

in c

linic

and

re

habi

litat

ion

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of p

allia

tive

•ca

re s

ervi

ces

with

pa

lliat

ive

care

spe

cial

ist

prov

idin

g co

nsul

tanc

y to

oth

er u

nits

refe

rral

ho

spita

lsEm

erge

ncy

serv

ices

•

avai

labl

e St

atew

ide

refe

rral

role

•U

nder

grad

uate

and

•

post

grad

uate

teac

hing

ro

le

Has

sta

ff w

ith c

onjo

int

•ap

poin

tmen

ts

Gas

troen

tero

logy

GP

inpa

tient

car

e•

24 h

our c

over

by

RN

•O

utpa

tient

car

e by

•

visi

ting

gene

ral

phys

icia

n an

d po

ssib

ly

gast

roen

tero

logi

st o

r by

tele

heal

thPo

ssib

ly h

ave

fibre

•

optic

end

osco

py b

y ac

cred

ited

med

ical

pr

actit

ione

rAc

cess

to s

ome

allie

d •

heal

th s

ervi

ces

As fo

r lev

el 3

plu

s:In

patie

nt c

are

by

•re

side

nt g

ener

al

phys

icia

n O

utpa

tient

•

cons

ulta

tion

by v

isiti

ng

gast

roen

tero

logi

stRe

gula

r end

osco

py

•se

rvic

e in

clud

ing

colo

nosc

opy

Spec

ialis

t RN

•G

astro

ente

rolo

gy

•se

rvic

es p

rovi

ded

by

inte

grat

ed p

hysi

cian

an

d su

rgic

al s

ervi

ces

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:In

patie

nt c

are

by re

side

nt

•ga

stro

ente

rolo

gist

Re

gist

rar/

RM

O•

Regi

onal

refe

rral

role

•Ac

cess

to s

peci

alis

t SR

N•

Som

e un

derg

radu

ate

•te

achi

ng a

nd p

ossi

bly

som

e re

sear

ch ro

leFu

ll en

dosc

opy

serv

ice

•Em

erge

ncy

care

ava

ilabl

e •

by o

n-ca

ll sp

ecia

list

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of

•ga

stro

ente

rolo

gy

serv

ices

, with

ga

stro

ente

rolo

gy

depa

rtm

ent a

nd

emer

genc

y ca

reSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

•

post

grad

uate

teac

hing

ro

le

Rese

arch

role

•

A p p e n d i c e s

44

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Hae

mat

olog

yM

ay in

clud

e:•

GP

inpa

tient

car

e•

24 h

our c

over

by

RN

•vi

sitin

g ha

emat

olog

ist

•or

by

tele

heal

thAc

cess

to s

ome

allie

d •

heal

th s

ervi

ces

As fo

r lev

el 3

plu

s:O

n ca

ll H

aem

atol

ogis

t•

Som

e in

patie

nt s

ervi

ces

•Vi

sitin

g ou

tpat

ient

•

cons

ulta

tive,

day

tre

atm

ent s

ervi

ces

Inte

grat

ion

of h

ome

•ba

sed

serv

ices

with

ar

ea b

ased

pro

gram

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:G

ener

al M

edic

al R

egis

trar

•

on c

all 2

4 hr

s.Ap

poin

ted

Hae

mat

olog

ist

•M

ay h

ave

teac

hing

and

•

rese

arch

role

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

sM

ay h

ave

canc

er u

nit

•

As fo

r lev

el 5

plu

s:M

edic

al R

egis

trar

on

•si

te 2

4 hr

sH

as H

aem

atol

ogy

Dep

t•

Hae

mat

olog

ist o

n ca

ll •

24 h

rsH

aem

atol

ogy

Regi

stra

r •

on c

all 2

4 hr

sH

as te

achi

ng a

nd

•re

sear

ch ro

le.

May

pro

vide

•

cell

sepa

ratio

n/pl

asm

aphe

resi

sM

ay p

erfo

rm b

one

•m

arro

w tr

ansp

lant

atio

nFu

ll ra

nge

of s

ervi

ces

•an

d in

patie

nt, o

utpa

tient

an

d am

bula

tory

m

anag

emen

tCo

mpr

ehen

sive

can

cer

•ce

ntre

Inpa

tient

car

e de

liver

ed

•by

a m

ulti

disc

iplin

ary

team

Mos

t acu

te c

are

•se

rvic

es m

ust b

e av

aila

ble

24/7

Link

s w

ith a

num

ber

•of

oth

er c

onsu

ltatio

n se

rvic

es in

clud

ing

imm

unol

ogy,

infe

ctio

us

dise

ases

, pai

n se

rvic

es, p

allia

tive

care

, ps

ychi

atry

ser

vice

s,

radi

othe

rapy

, rad

iolo

gy,

rena

l phy

sici

ans,

re

spira

tory

phy

sici

ans,

su

rgic

al s

ervi

ces.


51


45

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Imm

unol

ogy

GP

inpa

tient

car

e•

24 h

our c

over

by

RN

•O

utpa

tient

car

e of

•

patie

nts

with

HIV

in

fect

ion

by v

isiti

ng

Clin

ical

Imm

unol

ogis

t in

a s

mal

l num

ber o

f Ce

ntre

s or

by

tele

heal

thAc

cess

to s

ome

allie

d •

heal

th s

ervi

ces

As fo

r lev

el 3

plu

s:In

patie

nt c

are

by

•re

side

nt g

ener

al

phys

icia

nO

utpa

tient

con

sulta

tion

•by

vis

iting

Clin

ical

Im

mun

olog

ist

Spec

ialis

t RN

•Ac

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

Phon

e ad

vice

and

•

cons

ulta

tion

prov

ided

to

smal

ler s

ites

incl

udin

g vi

a te

lehe

alth

/e-h

ealth

.

As fo

r lev

el 4

plu

s:In

patie

nt c

are

by a

•

Med

ical

Spe

cial

ties

RM

ORe

gist

rar/

RM

O•

Regi

onal

refe

rral

role

•Ac

cess

to s

peci

alis

t SR

N•

Som

e un

derg

radu

ate

•te

achi

ng a

nd re

sear

chFu

ll se

rvic

e fo

r the

•

asse

ssm

ent a

nd

treat

men

t of p

atie

nts

with

al

lerg

y di

sord

ers

(eg.

ski

n te

stin

g, d

rug

chal

leng

es,

imm

unot

hera

py),

acqu

ired

and

prim

ary

imm

unod

efici

ency

di

sord

ers

(eg.

an

tiret

rovi

ral a

nd

IVIg

ther

apie

s) a

nd

auto

imm

une

dise

ase

(eg.

imm

unos

uppr

essa

nt

and

imm

unom

odul

ator

y th

erap

ies)

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

sSp

ecia

list c

onsu

ltatio

n •

or d

iagn

osis

pro

vide

d by

te

lehe

alth

/e-h

ealth

to

rura

l and

oth

er s

mal

ler

site

s an

d se

rvic

es.

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of C

linic

al

•Im

mun

olog

y se

rvic

es

with

Imm

unol

ogy

Dep

artm

ent a

nd 2

4 ho

ur c

linic

al a

nd

labo

rato

ry o

n-ca

llSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

•

post

grad

uate

teac

hing

an

d tr

aini

ng ro

leRe

sear

ch ro

le•

A p p e n d i c e s

46

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Infe

ctio

us

Dis

ease

sAm

bula

tory

and

•

inpa

tient

con

sulti

ng

serv

ices

may

be

prov

ided

by

gene

ralis

t w

ith tr

aini

ng in

in

fect

ious

dis

ease

sFa

cilit

ies

incl

ude

•is

olat

ion

room

s w

ith

inte

rnal

was

h ba

sins

an

d to

ilets

, as

wel

l as

sta

ff w

ash

basi

ns

imm

edia

tely

out

side

the

room

.An

are

a w

ith s

epar

ate

•ai

r con

ditio

ning

av

aila

ble

Del

iver

y an

d •

adm

inis

trat

ion

of H

ITH

to

pat

ient

s re

quiri

ng

intr

aven

ous

antib

iotic

th

erap

yIn

fect

ion

Cont

rol

•le

ader

ship

re

spon

sibi

litie

s –

supe

rvis

es o

n-si

te C

NM

Phon

e ad

vice

and

•

cons

ulta

tion

prov

ided

to

smal

ler s

ites

incl

udin

g vi

a te

lehe

alth

/e-h

ealth

.

As fo

r lev

el 4

plu

s:M

edic

al R

egis

trar

on

call

•24

hrs

Ded

icat

ed ID

& H

ITH

•

regi

stra

r +/-

RM

O (b

asic

or

adv

ance

d tr

aine

e(s)

)Ap

poin

ted

spec

ialis

t •

with

dire

ct li

nks

to

tert

iary

/qua

tern

ary

leve

l In

fect

ious

dis

ease

s se

rvic

eM

ay h

ave

teac

hing

and

•

rese

arch

role

Link

with

sex

ual h

ealth

•

serv

ices

, vira

l hep

atiti

s an

d H

IV s

ervi

ces

and

mic

robi

olog

y de

ptSp

ecia

list c

onsu

ltatio

n •

or d

iagn

osis

pro

vide

d by

te

lehe

alth

/e-h

ealth

to

rura

l and

oth

er s

mal

ler

site

s an

d se

rvic

es.

As fo

r lev

el 5

plu

s:M

edic

al R

egis

trar

on

•si

te 2

4 hr

sH

as s

peci

alis

t •

Infe

ctio

us D

isea

ses

Phys

icia

ns a

nd

adva

nced

trai

nee

Infe

ctio

us D

isea

ses

Regi

stra

r(s)

and

fe

llow

(s).

Infe

ctio

us D

isea

ses

•CN

Cs w

ith

resp

onsi

bilit

ies

in

Sexu

al H

ealth

, vira

l he

patit

is, H

IV, c

linic

al

tria

ls a

nd In

fect

ion

Cont

rol

Des

igna

ted

inpa

tient

•

area

for m

anag

emen

t of

infe

ctio

us a

nd

com

mun

icab

le

dise

ases

.Fa

cilit

ies

to tr

eat a

ll •

quar

antin

able

dis

ease

s (s

ingl

e si

te o

nly

– SC

GH

)M

ajor

teac

hing

and

•

rese

arch

role

Has

sta

tew

ide

role

.•


53


47

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Surg

ical

Ser

vice

s

Gen

eral

Min

or o

utpa

tient

and

•

sam

e da

y pr

oced

ures

on

ly b

y G

P or

vis

iting

ge

nera

l sur

geon

Inpa

tient

car

e fo

llow

ing

•su

rger

y el

sew

here

Resi

dent

ser

vice

with

•

a nu

rsin

g po

st o

r clin

ic

(pub

lic o

r NG

O)

Out

patie

nt c

are

•Vi

sitin

g G

P•

24 h

our c

over

by

RN

•

As fo

r lev

el 2

plu

s:D

ay s

urge

ry ty

pe c

ases

, •

unco

mpl

icat

ed e

lect

ive

surg

ery

and

emer

genc

y su

rger

yG

P an

d vi

sitin

g ge

nera

l •

surg

ical

spe

cial

ist

Visi

ting

anae

sthe

tist

•w

ith v

isiti

ng s

urge

onTh

eatre

trai

ned

RN

•

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:Su

rger

y by

GPs

, gen

eral

•

surg

eons

and

vis

iting

Ty

pe I

sub-

spec

ialis

tsBr

oad

rang

e of

day

and

•

gene

ral s

urge

ry a

nd

som

e sp

ecia

lty s

urge

ryTh

eatre

trai

ned

nurs

es•

Mor

e th

an 1

thea

tre•

May

incl

ude

high

-•

depe

nden

cy n

ursi

ng

unit

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:G

ener

al s

urge

ons

•So

me/

all T

ype

I sub

-•

spec

ialis

tsM

ay h

ave

visi

ting

Type

II

•su

b-sp

ecia

lists

Regi

stra

r/R

MO

•IC

U•

May

hav

e so

me

teac

hing

•

and

rese

arch

role

Und

erta

kes

mos

t •

emer

genc

y su

rger

yAc

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of s

urgi

cal

•su

b-sp

ecia

lists

Typ

e I

and

IISt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

pos

t •

grad

uate

teac

hing

role

Rese

arch

role

•U

nder

take

s em

erge

ncy

•su

rger

yM

ay in

clud

e ki

dney

and

•

liver

tran

spla

ntat

ion

in

sele

cted

site

s

ENT

Day

sur

gery

type

cas

es,

•fo

r unc

ompl

icat

ed

elec

tive

surg

ery

Som

e si

tes

have

vis

iting

•

ENT

surg

eon

and

anae

sthe

tist

Acce

ss to

EN

T •

spec

ialis

t out

patie

nts.

May

offe

r pae

diat

ric

•EN

T if

spec

ialis

t pa

edia

tric

ana

esth

etis

t.

As fo

r lev

el 3

plu

s:Co

mm

on a

nd

•in

term

edia

te s

urge

ry

done

on

low

or

mod

erat

e ris

k pa

tient

s by

vis

iting

EN

T su

rgeo

nN

o ne

uro-

optic

or

•in

trac

rani

al s

urge

ryAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:D

iagn

ostic

ser

vice

s an

d •

surg

ery

on lo

w, m

oder

ate

and

high

risk

pat

ents

by

on-c

all E

NT

surg

eon

Acce

ss to

spe

cial

ist S

RN

•Re

gion

al re

ferr

al ro

le•

May

hav

e so

me

teac

hing

•

and

rese

arch

role

Link

s w

ith o

ncol

ogy,

•

radi

othe

rapy

and

pal

liativ

e ca

re s

ervi

ces

Lim

ited

neur

o-op

tic

•su

rger

y Ac

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:Ab

ility

to d

eal w

ith

•al

l cas

es in

clud

ing

full

rang

e of

com

plex

ca

ses

in a

ssoc

iatio

n w

ith o

ther

spe

cial

ists

in

clud

ing

neur

o-op

tic a

nd in

trac

rani

al

proc

edur

es, a

s lo

ng a

s le

vel 6

neu

rosu

rger

y av

aila

ble

on s

iteEm

erge

ncy

serv

ices

•

avai

labl

eSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

pos

t •

grad

uate

teac

hing

role

Rese

arch

role

•EN

T re

gist

rar/

RM

O•

A p p e n d i c e s

48

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Gyn

aeco

logy

Com

mon

and

•

inte

rmed

iate

pr

oced

ures

on

low

or

mod

erat

e ris

k pa

tient

s by

cre

dent

iale

d G

P or

vi

sitin

g su

rgeo

nAc

cess

to g

ynae

colo

gist

•

visi

ting

or b

y te

lehe

alth

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:Co

mm

on, i

nter

med

iate

•

and

som

e m

ajor

pr

oced

ures

on

low

and

m

oder

ate

risk

patie

nts

perf

orm

ed b

y vi

sitin

g gy

naec

olog

ists

Link

s w

ith o

ncol

ogy,

•

radi

othe

rapy

and

pa

lliat

ive

care

ser

vice

sAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:D

iagn

ostic

ser

vice

s an

d •

surg

ery

on lo

w, m

oder

ate

and

high

risk

pat

ient

s by

on

-cal

l gyn

aeco

logi

sts

Acce

ss to

spe

cial

ist S

RN

•M

ay h

ave

gyna

ecol

ogy

•re

gist

rar/

RM

ORe

gion

al re

ferr

al ro

le•

May

hav

e so

me

teac

hing

•

and

rese

arch

role

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Ab

ility

to d

eal w

ith

•al

l cas

es in

clud

ing

full

rang

e of

com

plex

ca

ses

in a

ssoc

iatio

n w

ith o

ther

spe

cial

ists

in

clud

ing

repr

oduc

tive

endo

crin

olog

y,

infe

rtili

ty,

gyna

ecol

ogic

al

mal

igna

ncy

Full

emer

genc

y se

rvic

es•

Stat

ewid

e re

ferr

al ro

le•

Und

ergr

adua

te a

nd p

ost

•gr

adua

te te

achi

ng ro

leRe

sear

ch ro

le•

Gyn

aeco

logy

•

regi

stra

r/R

MO

and

po

ssib

ly re

gist

rars

in

subs

peci

altie

s


55


49

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Oph

thal

mol

ogy

Min

or p

roce

dure

s an

d •

diag

nosi

s on

low

-ris

k pa

tient

s by

vis

iting

op

htha

lmic

sur

geon

As fo

r lev

el 3

plu

s:Pr

oced

ures

on

low

or

•m

oder

ate

risk

patie

nts

perf

orm

ed b

y vi

sitin

g op

htha

lmic

sur

geon

Acce

ss to

ort

hopt

ists

•

As fo

r lev

el 4

plu

s:D

iagn

ostic

ser

vice

s an

d •

surg

ery

on lo

w, m

oder

ate

and

high

risk

pat

ient

s by

on-

call

opht

halm

ic

surg

eon

Ort

hopt

ists

on

staf

f•

May

hav

e te

achi

ng a

nd

•re

sear

ch ro

le

As fo

r lev

el 5

plu

s:Ab

ility

to d

eal w

ith a

ll •

case

s in

clud

ing

full

rang

e of

com

plex

cas

es

in a

ssoc

iatio

n w

ith

othe

r spe

cial

ists

Full

emer

genc

y se

rvic

es•

Oph

thal

mol

ogy

•re

gist

rar/

RM

OAc

cess

to s

peci

alis

t •

SRN

Able

to u

nder

take

•

neur

o-op

htha

lmol

ogy

whe

re le

vel 6

ne

uros

urge

ry a

vaila

ble

on s

iteAc

cess

to le

vel 5

•

radi

othe

rapy

Stat

ewid

e re

ferr

al ro

le•

Und

ergr

adua

te a

nd p

ost

•gr

adua

te te

achi

ng ro

leRe

sear

ch ro

le•

Ort

hopa

edic

sM

inor

redu

ctio

n of

•

frac

ture

s pe

rfor

med

on

low

-ris

k pa

tient

s by

GP

or v

isiti

ng

gene

ral s

urge

on

with

exp

erie

nce

in

orth

oped

ics

Ort

hopa

edic

•

cons

ulta

tion

avai

labl

e

As fo

r lev

el 2

plu

s:Co

mm

on a

nd

•in

term

edia

te

proc

edur

es o

n lo

w o

r m

oder

ate

risk

patie

nts

perf

orm

ed b

y vi

sitin

g or

thop

aedi

c or

gen

eral

su

rgeo

n cr

eden

tiale

d in

or

thop

aedi

csG

ener

al o

rtho

paed

ic

•eq

uipm

ent a

nd th

eatre

x-

ray

avai

labl

ePr

efer

ably

acc

ess

to

•sp

ecia

list S

RN

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:Co

mm

on a

nd

•in

term

edia

te

proc

edur

es o

n lo

w o

r m

oder

ate

risk

patie

nts

perf

orm

ed b

y on

-cal

l or

thop

aedi

c su

rgeo

nAc

cess

to le

vel 4

•

reha

bilit

atio

n se

rvic

eAc

cess

to s

peci

alis

t •

SRN

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:Fu

ll ra

nge

of m

ajor

•

diag

nost

ic a

nd

proc

edur

es o

n lo

w,

mod

erat

e an

d hi

gh ri

sk

patie

nts

perf

orm

ed b

y on

-ca

ll or

thop

aedi

c su

rgeo

nsM

ay p

rovi

de re

gion

al

•se

rvic

esM

ay h

ave

teac

hing

and

•

rese

arch

role

Ort

hopa

edic

regi

stra

r •

on-c

all

Acce

ss to

sub

spec

ialti

es•

Link

to le

vel 5

•

reha

bilit

atio

n se

rvic

eAc

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:Ab

ility

to d

eal w

ith a

ll •

case

s in

clud

ing

full

rang

e of

com

plex

cas

es

(and

all

emer

genc

y) in

as

soci

atio

n w

ith o

ther

sp

ecia

lists

Stat

ewid

e re

ferr

al ro

le•

Und

ergr

adua

te a

nd p

ost

•gr

adua

te te

achi

ng ro

leRe

sear

ch ro

le•

Link

to le

vel 6

•

reha

bilit

atio

n ro

le

A p p e n d i c e s

50

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Uro

logy

Com

mon

and

•

inte

rmed

iate

pr

oced

ures

on

low

or

mod

erat

e ris

k pa

tient

s pe

rfor

med

by

visi

ting

urol

ogis

t or g

ener

al

surg

eon

cred

entia

led

in

urol

ogy

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:So

me

maj

or p

roce

dure

s •

on lo

w o

r mod

erat

e ris

k pa

tient

s pe

rfor

med

by

visi

ting

urol

ogis

tH

as li

nks

with

•

onco

logy

, rad

ioth

erap

y an

d pa

lliat

ive

care

se

rvic

esAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:Fu

ll ra

nge

of m

ajor

•

diag

nost

ic a

nd

proc

edur

es o

n lo

w,

mod

erat

e an

d hi

gh ri

sk

patie

nts

perf

orm

ed b

y on

-cal

l uro

logi

stAc

cess

to s

peci

alis

t SR

N•

May

pro

vide

regi

onal

•

serv

ices

and

teac

hing

an

d re

sear

ch ro

leAc

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:Ab

ility

to d

eal w

ith a

ll •

case

s in

clud

ing

full

rang

e of

com

plex

cas

es

(and

all

emer

genc

y) in

as

soci

atio

n w

ith o

ther

sp

ecia

lists

Uro

logy

Reg

istr

ar/R

MO

•St

atew

ide

refe

rral

role

•U

nder

grad

uate

and

pos

t •

grad

uate

teac

hing

role

Rese

arch

role

•

Card

ioth

orac

icEl

ectiv

e an

d em

erge

ncy

•th

orac

ic p

roce

dure

s by

vi

sitin

g/on

-cal

l tho

raci

c su

rgeo

ns

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:El

ectiv

e an

d em

erge

ncy

•th

orac

ic a

nd e

lect

ive

card

ioth

orac

ic

proc

edur

es b

y vi

sitin

g/on

-cal

l car

diot

hora

cic

surg

eons

Le

vel 5

reha

bilit

atio

n •

serv

ices

ava

ilabl

e on

site

Link

with

pal

liativ

e ca

re

•an

d pa

in m

anag

emen

t se

rvic

esAc

cess

to s

peci

alis

t SR

N•

Som

e re

gion

al re

ferr

al

•ro

leIC

U/C

CU•

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:El

ectiv

e an

d •

emer

genc

y th

orac

ic

and

card

ioth

orac

ic

proc

edur

es b

y ca

rdio

thor

acic

sur

geon

sAb

le to

dea

l with

hig

hly

•co

mpl

ex d

iagn

osis

and

tre

atm

ent i

n as

soci

atio

n w

ith o

ther

spe

cial

ties

Card

ioth

orac

ic

•re

gist

rar/

RM

OSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

pos

t •

grad

uate

teac

hing

role

Rese

arch

role

•Le

vel 6

ICU

•To

incl

ude

hear

t and

•

lung

tran

spla

ntat

ion

at

sele

cted

site

s


57


51

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Vasc

ular

sur

gery

Com

mon

, int

erm

edia

te

•an

d so

me

maj

or

proc

edur

es o

n lo

w a

nd

mod

erat

e ris

k pa

tient

s pe

rfor

med

by

visi

ting

vasc

ular

sur

geon

s or

ge

nera

l sur

geon

s Pr

e-op

erat

ive

•re

habi

litat

ion

spec

ialis

t co

nsul

tant

ava

ilabl

eAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:D

iagn

ostic

ser

vice

s an

d •

surg

ery

on lo

w, m

oder

ate

and

high

risk

pat

ient

s by

on-

call

vasc

ular

or

gene

ral s

urge

onM

ay h

ave

regi

onal

refe

rral

•M

ay h

ave

som

e te

achi

ng

•an

d tr

aini

ng a

nd re

sear

ch

role

Link

with

leve

l 5

•re

habi

litat

ion

serv

ices

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Ab

ility

to d

eal w

ith a

ll •

case

s in

clud

ing

full

rang

e of

com

plex

cas

es

in a

ssoc

iatio

n w

ith

othe

r spe

cial

ists

Prov

ides

all

emer

genc

y •

serv

ices

On-

call

vasc

ular

•

surg

eon

Acce

ss to

spe

cial

ist

•SR

NSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

pos

t •

grad

uate

teac

hing

role

Rese

arch

role

•

Neu

rosu

rger

yM

inor

hea

d in

jurie

s •

deal

t with

by

gene

ral

surg

eon

Neu

rosu

rgic

al

•co

nsul

tatio

n av

aila

ble

Ope

ratin

g eq

uipm

ent

•ad

equa

te fo

r em

erge

ncy

neur

osur

gery

Link

with

leve

l 4

•re

habi

litat

ion

serv

ices

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:D

iagn

ostic

ser

vice

s an

d •

surg

ery

on lo

w, m

oder

ate

and

high

risk

pat

ents

by

on-c

all n

euro

surg

eon

Des

igna

ted

neur

osur

gica

l •

beds

Acce

ss to

spe

cial

ist S

RN

•24

hou

r acc

ess

to C

T•

Link

with

bra

in a

nd s

pina

l •

inju

ry re

habi

litat

ion

May

hav

e so

me

teac

hing

•

and

rese

arch

role

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Ab

le to

dea

l with

all

•ca

ses

incl

udin

g al

l em

erge

ncy

case

sN

euro

surg

ical

war

d •

and

neur

osur

gica

l hig

h de

pend

ency

/ICU

Neu

rosu

rger

y re

gist

rar/

•R

MO

Link

with

leve

l 5

•re

habi

litat

ion

serv

ice

Stat

ewid

e re

ferr

al ro

le•

Und

ergr

adua

te a

nd p

ost

•gr

adua

te te

achi

ng ro

leRe

sear

ch ro

le•

A p p e n d i c e s

52

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Plas

tics

Min

or o

utpa

tient

s an

d •

sam

e da

y pr

oced

ures

by

GP

As fo

r lev

el 2

plu

s:As

for l

evel

2 b

ut

•pr

oced

ures

may

re

quire

vis

iting

pla

stic

s su

rgeo

n Ac

cess

to s

ome

allie

d •

heal

th s

ervi

ces

As fo

r lev

el 3

plu

s:Se

lect

ed m

inor

•

proc

edur

es o

n lo

w a

nd

mod

erat

e ris

k pa

tient

s by

vis

iting

pla

stic

su

rgeo

ns

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

n

As fo

r lev

el 4

plu

s:D

iagn

ostic

ser

vice

s an

d •

surg

ery

on lo

w, m

oder

ate

and

high

risk

pat

ents

by

on-c

all p

last

ic s

urge

ons

Link

with

leve

l 5

•re

habi

litat

ion

serv

ices

May

hav

e so

me

teac

hing

•

and

trai

ning

role

Visi

ting

burn

s L6

•

spec

ialis

tAc

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:Ab

le to

dea

l with

all

•ca

ses

incl

udin

g al

l em

erge

ncy

case

sPl

astic

s re

gist

rar/

RM

O•

Acce

ss to

spe

cial

ist

•SR

NSt

atew

ide

refe

rral

role

•U

nder

grad

uate

and

pos

t •

grad

uate

teac

hing

role

May

hav

e re

sear

ch ro

le•

Burn

sM

inor

out

patie

nt a

nd

•sa

me

day

proc

edur

es

only

by

GP

Able

to p

rovi

de

•em

erge

ncy

stab

ilisa

tion

serv

ice

for b

urns

As fo

r lev

el 2

plu

s:G

ener

al s

urge

on a

ble

•to

pro

vide

ser

vice

s fo

r m

inor

/mod

erat

e bu

rns

to s

mal

l are

as o

f bod

yAc

cess

to s

ome

allie

d •

heal

th s

ervi

ces

As fo

r lev

el 3

plu

s:G

ener

al s

urge

on

•pr

ovid

ing

serv

ices

for

min

or/m

oder

ate

burn

s to

sm

all p

arts

of b

ody

Acce

ss to

spe

cial

ist

•SR

NLi

nks

to le

vel 4

•

reha

bilit

atio

n se

rvic

esAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:G

ener

al s

urge

on

•pr

ovid

ing

serv

ices

for

min

or/m

oder

ate

burn

s to

sm

all p

arts

of b

ody

24 h

our o

n-ca

ll re

gist

rar

•Li

nks

to le

vel 5

•

reha

bilit

atio

n se

rvic

esAc

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:Fu

ll ra

nge

of b

urns

•

serv

ices

, with

a s

peci

al

burn

s un

it, in

clud

ing

all

emer

genc

y ca

ses

24 h

our o

n-ca

ll co

ver

•St

atew

ide

refe

rral

role

•Em

erge

ncy

care

•

serv

ices

pro

vide

d by

on

-cal

l spe

cial

ist

Und

ergr

adua

te a

nd p

ost

•gr

adua

te te

achi

ng ro

leRe

sear

ch ro

le•


59


53

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Trau

ma

Acce

ss to

Med

ical

•

Doc

tor a

dvic

e w

ithin

30

min

utes

or

Med

ical

do

ctor

in a

ttend

ance

w

ithin

30

min

utes

Part

icip

ates

in th

e ca

re

•of

min

or tr

aum

aRu

ral:

may

be

the

•oc

casi

onal

nee

d fo

r re

susc

itatio

n of

a m

ajor

tr

aum

a pa

tient

, with

ra

pid

tran

sfer

on

Prim

ary

retr

ieva

l fro

m

•in

cide

nt s

ite a

s th

e ne

ares

t em

erge

ncy

serv

ice

Seco

ndar

y re

trie

val

•by

fixe

d w

ing,

rota

ry

win

g to

Maj

or T

raum

a Ce

ntre

s Se

cond

ary

retr

ieva

l of

•m

inor

trau

ma

by fi

xed

win

g or

road

tran

spor

t to

Reg

iona

l Tra

uma

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res

In

itial

dis

aste

r res

pons

e •

in a

mul

ti ca

sual

ty

even

t whe

re c

entre

is

the

near

est e

mer

genc

y he

alth

ser

vice

Rura

l Tra

uma

Cent

res

•Le

vel I

V N

RTAC

•

Prom

pt a

sses

smen

t, •

resu

scita

tion,

em

erge

ncy

surg

ery

&

stab

ilisa

tion

of a

sm

all

num

ber o

f ser

ious

ly

inju

red

patie

nts

and

tran

sfer

on

Gen

eral

sur

gica

l ser

vice

•

and

part

icip

ates

in th

e ca

re o

f min

or tr

aum

a24

ava

ilabi

lity

of a

n •

ondu

ty s

peci

alis

t su

rgeo

n &

ana

esth

etis

t an

d/or

gen

eral

ist

anae

sthe

tist

nurs

e ex

perie

nced

in

•tr

aum

ara

diol

ogy

faci

litie

s•

Hel

icop

ters

sho

uld

•be

abl

e to

land

saf

ely

near

byRo

le in

man

agem

ent,

•as

sess

men

t and

tre

atm

ent

of m

inor

tr

aum

a in

mul

ti-ca

sual

ty d

isas

ter

resp

onse

Regi

onal

Tra

uma

•Ce

ntre

s. U

rban

Tra

uma

Cent

res.

Leve

l III

NRT

AC•

A su

rgeo

n av

aila

ble

in a

ll •

spec

ialti

es c

omm

ensu

rate

w

ith L

evel

624

hr a

vaila

bilit

y of

•

neur

osur

gica

l &

card

ioth

orac

ic s

ervi

ces

Hig

h le

vel I

CU tr

aum

a •

team

resp

onse

&

oper

atin

g su

ites

with

24

hr a

vaila

bilit

yO

nsite

hel

icop

ter l

andi

ng

•si

teRo

le in

man

agem

ent

•of

maj

or tr

aum

a ca

ses

>48h

rs d

urin

g m

ulti-

casu

alty

dis

aste

r re

spon

seM

etro

polit

an T

raum

a •

Cent

res

Leve

l II N

RTAC

•

Full

spec

trum

of c

are

•24

hr tr

aum

a re

cept

ion

•te

am24

hr a

vaila

bilit

y of

•

seni

or c

onsu

ltant

leve

l ge

nera

l sur

geon

Appo

inte

d tr

aum

a •

dire

ctor

Elec

tive

&

•em

erge

ncy

surg

ery

in n

euro

surg

ery,

ca

rdio

thor

acic

, or

thop

aedi

cs &

pla

stic

sLe

ad ro

le in

the

•co

ordi

natio

n &

m

anag

emen

t of m

ass

casu

alty

& d

isas

ter

prep

ared

ness

sce

nario

sPr

inci

pal h

ospi

tal

•fo

r rec

eptio

n of

inte

r ho

spita

l tra

nsfe

r of

maj

or tr

aum

a pa

tient

sRe

sear

ch•

Educ

atio

n &

fello

wsh

ip

•tr

aini

ngTr

aum

a sy

stem

s •

over

view

Qua

lity

impr

ovem

ent

•pr

ogra

mD

ata

colle

ctio

n•

Prev

entio

n &

out

reac

h •

prog

ram

sTr

aum

a au

dit

•Le

ader

ship

•

resp

onsi

bilit

ies

Maj

or T

raum

a Se

rvic

e•

Leve

l I N

RTAC

•

A p p e n d i c e s

54

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Emer

genc

y Se

rvic

es

Emer

genc

y D

epar

tmen

tLo

cal G

Ps ro

ster

ed to

•

prov

ide

24 h

our c

over

w

ith s

ervi

ce b

y R

NRe

susc

itatio

n an

d •

stab

ilisa

tion

Acce

ss to

spe

cial

ist

•se

rvic

es v

isiti

ng o

r by

tele

heal

th

As fo

r lev

el 3

plu

s:Lo

cal G

Ps ro

ster

ed to

•

prov

ide

24 h

our c

over

w

ith s

ervi

ce b

y R

NEm

erge

ncy

oper

atin

g •

thea

tre fa

cilit

ies

Resu

scita

tion

and

•st

abili

satio

nO

n-ca

ll ge

nera

list

•sp

ecia

lists

Acce

ss to

spe

cial

ist

•SR

NAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

As fo

r lev

el 4

plu

s:M

edic

ally

sta

ffed

24

•ho

urs

per d

ayM

edic

al a

nd s

urgi

cal

•su

b-sp

ecia

lists

ava

ilabl

e on

-cal

lAc

cept

s tr

ansf

ers

from

•

othe

r hos

pita

ls in

regi

onAc

cess

to IC

U a

nd C

CU

•fa

cilit

ies

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

As fo

r lev

el 5

plu

s:Em

erge

ncy

med

icin

e •

cons

ulta

nt o

n du

ty 2

4 ho

urs

per d

ay*

Stat

ewid

e re

ferr

al ro

le•

Back

up fr

om fu

ll •

rang

e of

med

ical

and

su

rgic

al s

peci

alis

ts a

nd

diag

nost

ic s

ervi

ces

ICU

and

CCU

faci

litie

s• *

Not

cur

rent

ly o

pera

ting

in W

A


61


55

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Obs

tetr

ics

and

Neo

nata

l Ser

vice

s

Obs

tetr

ics

No

plan

ned

birt

hs•

If re

quire

d, in

patie

nt

•ca

re fo

llow

ing

birt

h el

sew

here

Ante

nata

l, po

stna

tal

•ca

re is

car

ried

out b

y vi

sitin

g pu

blic

, ACH

HO

or

RFD

S G

Ps w

ith o

r w

ithou

t the

ass

ista

nce

of A

HW

s or

RN

s/R

Ms

depe

ndin

g on

the

type

of

pat

ient

car

e ne

eded

.

As fo

r lev

el 1

plu

s:N

orm

al lo

w-r

isk

•pr

egna

ncie

s an

d bi

rths

an

d m

anag

emen

t of

new

born

s >

37+0

w

eeks

ges

tatio

n w

ith

min

imal

com

plic

atio

nsSe

rvic

e by

GPs

/GP

•ob

stet

ricia

ns/D

MO

s an

d m

idw

ives

Caes

area

n se

ctio

n •

tran

sfer

red

else

whe

re

but m

ust b

e w

ithin

saf

e tim

efra

me

Acce

ss to

24

hr

•te

leph

one

supp

ort f

rom

ob

stet

ricia

nsAc

cess

to a

llied

hea

lth

•Ac

cess

to e

-hea

lth o

r •

tele

heal

thO

nsite

Lev

el 1

neo

nata

l •

faci

litie

s

As fo

r lev

el 2

plu

s:El

ectiv

e an

d em

erge

ncy

•ca

esar

ean

capa

bilit

y24

hr a

naes

thet

ic

•se

rvic

e pr

ovid

edVi

sitin

g ob

stet

ricia

n•

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:Pl

anne

d bi

rths

of l

ow

•an

d m

oder

ate

risk

mot

hers

/bab

ies

Acce

ss to

spe

cial

ist

•ob

stet

ricia

ns,

paed

iatr

icia

ns a

nd

anae

sthe

tists

O

n-ca

ll ro

ster

for

•ob

stet

ricia

ns a

nd

anae

sthe

tists

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e al

lied

heal

th

•un

derg

radu

ate

educ

atio

nO

nsite

Lev

el 2

A •

neon

atal

faci

litie

s

As fo

r lev

el 4

plu

s:Bi

rths

of l

ow, m

oder

ate

•an

d hi

gh ri

sk m

othe

rs/

babi

esSe

rvic

e pr

ovid

ed to

hig

h •

risk

mot

hers

/bab

ies

by

spec

ialis

t obs

tetr

icia

ns,

neon

atal

pae

diat

ricia

ns

and

anae

sthe

tists

O

nsite

24

hr m

edic

al

•of

ficer

obs

tetr

ic c

over

by

regi

stra

r or a

bove

24 h

r cov

er b

y •

spec

ialis

t obs

tetr

icia

ns,

paed

iatr

icia

ns a

nd

anae

sthe

tists

Acce

ss to

HD

U/IC

U

•fa

cilit

yRe

gion

al re

ferr

al ro

le

•Ac

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

Ons

ite L

evel

2B

neon

atal

•

faci

litie

s

As fo

r lev

el 5

plu

s:Te

rtia

ry o

bste

tric

•

serv

ices

Spec

ialis

t obs

tetr

ic

•se

rvic

es in

clud

ing

subs

peci

alty

mat

erna

l fe

tal m

edic

ine,

obs

tetr

ic

med

icin

e, g

enet

ic

serv

ices

D

edic

ated

HD

U fa

cilit

ies

•O

nsite

acc

ess

to IC

U•

Has

faci

litie

s to

•

unde

rtak

e ob

stet

ric a

nd

feta

l res

earc

hCo

ordi

nate

s tr

aini

ng o

f •

spec

ialis

t obs

tetr

icia

ns

and

spec

ialis

t mid

wiv

esO

nsite

Lev

el 3

NIC

U•

A p p e n d i c e s

56

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Neo

nato

logy

A ne

onat

al s

ervi

ce

•is

not

app

licab

le, b

ut

for p

ostn

atal

car

e of

new

born

infa

nts,

th

e st

anda

rds

with

in

Leve

l 2 (o

nsite

Lev

el

1 ne

onat

al fa

cilit

ies)

sh

ould

be

appl

ied

Ons

ite L

evel

1 n

eona

tal

•fa

cilit

ies

Nor

mal

low

-ris

k •

preg

nanc

ies

and

birt

hs

and

man

agem

ent o

f ne

wbo

rns

> 37

+0

wee

ks g

esta

tion

with

m

inim

al c

ompl

icat

ions

24 h

r ons

ite a

cces

s to

•

a he

alth

pro

fess

iona

l sk

illed

in in

itiat

ing

(acc

redi

ted)

neo

nata

l re

susc

itatio

nph

otot

hera

py fo

r •

phys

iolo

gica

l jau

ndic

eTe

leph

one

acce

ss to

•

emer

genc

y ca

re a

nd

tran

spor

tAc

cess

to s

ome

allie

d •

heal

th s

ervi

ces

Leve

l 1 n

eona

tal

faci

litie

s

As fo

r lev

el 2

Leve

l 1 n

eona

tal

faci

litie

s

As fo

r lev

el 3

plu

s:O

nsite

Lev

el 2

A •

neon

atal

faci

litie

s w

ith lo

w d

epen

denc

y pa

tient

s an

d ap

noea

m

onito

ring,

low

-le

vel O

xyge

n th

erap

y (in

clud

ing

mon

itorin

g)

and

nasa

l/ora

l-gas

tric

fe

edin

gPa

edia

tric

ians

on-

call

•24

hou

rsLo

w to

mod

erat

e ris

k •

preg

nanc

ies

and

birt

hs

and

man

agem

ent o

f ne

wbo

rns

> 34

+0

wee

ks g

esta

tion

with

m

inim

al c

ompl

icat

ions

Shor

t ter

m in

trav

enou

s •

ther

apy

avai

labl

eAl

l pat

ient

s ar

e re

ferr

ed

•fo

r man

agem

ent b

y at

tend

ing

paed

iatr

icia

nAc

cess

to d

esig

nate

d •

allie

d he

alth

ser

vice

sSo

me

allie

d he

alth

•

unde

rgra

duat

e ed

ucat

ion

Leve

l 2A

neon

atal

fa

cilit

ies

As fo

r lev

el 4

plu

s:O

nsite

Lev

el 2

B ne

onat

al

•fa

cilit

ies

with

hig

h de

pend

ency

pat

ient

s an

d pr

ovis

ion

of s

hort

-ter

m

mec

hani

cal v

entil

atio

n (<

6 h

ours

) pen

ding

tr

ansf

er, n

asal

CPA

P w

ith

faci

litie

s fo

r art

eria

l blo

od

gas

mon

itorin

gN

on in

vasi

ve B

P •

mon

itorin

gH

as a

cces

s to

clin

ical

•

and

diag

nost

ic p

aedi

atric

su

bspe

cial

ties

Serv

ice

led

by n

eona

tal

•pa

edia

tric

ians

Paed

iatr

icia

ns o

n-ca

ll 24

•

hour

sPa

edia

tric

regi

stra

r or

•ab

ove

on s

ite 2

4 ho

urs

Mod

erat

e to

hig

h-ris

k •

preg

nanc

ies

and

birt

hs

and

man

agem

ent o

f ne

wbo

rns

> 32

+0 w

eeks

ge

stat

ion

with

min

imal

co

mpl

icat

ions

Acce

ss to

spe

cial

ist S

RN

•Ro

le in

pos

t gra

duat

e •

med

ical

and

nur

sing

ed

ucat

ion

Care

ful c

onsi

dera

tion

to

•re

ceiv

ing

tran

sfer

s fro

m

L1 n

eona

tal f

acili

ties

(Lev

el 2

or L

evel

3

hosp

ital)

Acce

ss to

spe

cial

ised

•

allie

d he

alth

ser

vice

s

Leve

l 2B

neon

atal

faci

litie

s

As fo

r lev

el 5

plu

s:O

nsite

Lev

el 3

NIC

U

•w

ith h

igh

depe

nden

cy

patie

nts

and

prov

isio

n of

med

ium

-long

term

m

echa

nica

l ven

tilat

ion

and

full

life-

supp

ort

Neo

nata

l pae

diat

ricia

ns

•on

-cal

l 24

hour

sH

igh-

risk,

hig

h •

depe

nden

cy

preg

nanc

ies

and

birt

hsM

anag

emen

t of

•ne

wbo

rns

< 32

+0

wee

ks g

esta

tion

Und

erta

kes

neon

atal

•

surg

ery

and

care

for

com

plex

con

geni

tal a

nd

met

abol

ic d

isea

ses

of

the

new

born

Co

ordi

nate

s st

atew

ide

•re

trie

val s

ervi

ceCo

ordi

nate

s po

st

•gr

adua

te m

edic

al

and

nurs

ing

neon

atal

ed

ucat

ion

Has

neo

nato

logy

•

rese

arch

Leve

l 3 N

ICU


63


57

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Paed

iatr

ics

Serv

ices

Paed

iatr

ics

Care

is c

arrie

d ou

t •

by G

Ps (p

oten

tially

vi

sitin

g) w

ith o

r with

out

the

assi

stan

ce o

f RN

s de

pend

ing

on th

e ty

pe

of p

atie

nt c

are

need

edSt

abili

satio

n an

d fir

st

•ai

d

As fo

r lev

el 1

plu

s:Pa

edia

tric

med

ical

•

beds

– c

are

by g

ener

al

prac

titio

ner

On-

call

paed

iatr

ic

•ad

vice

No

surg

ery

•

As fo

r lev

el 2

plu

s:O

utpa

tient

car

e by

•

visi

ting

paed

iatr

icia

nLi

mite

d su

rger

y by

•

visi

ting

paed

iatr

ic

surg

eon

or s

urge

on

with

pae

diat

ric s

kills

Day

sur

gery

, •

unco

mpl

icat

ed e

lect

ive

surg

ery

and

emer

genc

y su

rger

yD

esig

nate

d pa

edia

tric

•

war

d, in

clud

ing

shor

t st

ayIn

patie

nt m

edic

al c

are

•by

GP

or p

aedi

atric

ian

Acce

ss to

som

e al

lied

•he

alth

ser

vice

s

As fo

r lev

el 3

plu

s:O

utpa

tient

car

e by

•

resi

dent

or v

isiti

ng

paed

iatr

icia

nLi

mite

d su

rger

y by

•

visi

ting

paed

iatr

ic

surg

eon

Day

sur

gery

, •

unco

mpl

icat

ed e

lect

ive

surg

ery

and

emer

genc

y su

rger

yD

esig

nate

d pa

edia

tric

•

war

d, in

clud

ing

shor

t st

ayIn

patie

nt m

edic

al c

are

•by

resi

dent

or v

isiti

ng

paed

iatr

icia

nAc

cess

to s

peci

alis

t •

SRN

Poss

ibly

Res

iden

t/RM

O

•ro

tatio

ns fr

om L

evel

5

or 6

faci

lity

Acce

ss to

des

igna

ted

•al

lied

heal

th s

ervi

ces

Som

e un

derg

radu

ate

•ed

ucat

ion

As fo

r lev

el 4

plu

s:In

patie

nt a

nd o

utpa

tient

•

care

by

resi

dent

pa

edia

tric

ian

Regi

stra

r/R

MO

•Re

gion

al re

ferr

al ro

le•

Som

e un

derg

radu

ate

•te

achi

ngRa

nge

of p

aedi

atric

•

surg

ery

Resi

dent

pae

diat

ric

•su

rgeo

n24

hou

r on-

call

paed

iatr

ic

•an

aest

hetis

tAc

cess

to s

peci

alis

ed

•al

lied

heal

th s

ervi

ces

As fo

r lev

el 5

plu

s:St

atew

ide

refe

rral

role

•U

nder

grad

uate

and

•

post

grad

uate

teac

hing

ro

leFu

ll ra

nge

of p

aedi

atric

•

surg

ery

Paed

iatr

ic IC

U•

Neo

nata

l ICU

•O

nsite

or 2

4 hr

•

paed

iatr

ic a

naes

thet

ic

serv

ices

Ope

rate

s in

spe

cial

ist

•fa

cilit

ysp

ecia

list S

RN

•

Reh

abili

tatio

n Se

rvic

es

Reha

bilit

atio

n Li

mite

d le

vel a

llied

•

heal

th a

vaila

bilit

yAs

for l

evel

2 p

lus:

Regu

lar v

isiti

ng

•se

rvic

es p

rovi

ded

by

dist

rict/r

egio

nal a

llied

he

alth

sta

ff

As fo

r lev

el 3

plu

s:Fu

ll tim

e sa

larie

d •

phys

ioth

erap

y,

occu

patio

nal t

hera

pySp

eech

and

soc

ial w

ork

•se

rvic

esRe

gion

refe

rral

role

•Li

mite

d da

y ho

spita

l •

prog

ram

As fo

r lev

el 4

plu

s:Re

hab

prog

ram

for b

oth

•in

patie

nt a

nd o

utpa

tient

Link

s be

twee

n re

gion

s •

and

desi

gnat

ed

met

ropo

litan

hos

pita

lsRe

hab

Spec

ialis

t ser

vice

•

with

exp

erie

nced

RN

/PT/

OT

/SP/

Die

titia

n

As fo

r lev

el 5

plu

s:H

ave

acce

ss to

acu

te

•ca

reFu

ll-tim

e re

hab

•sp

ecia

list

A p p e n d i c e s

58

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Child

and

Ado

lesc

ents

Men

tal H

ealth

, Ad

ult M

enta

l Hea

lth,

Old

er P

erso

ns M

enta

l Hea

lth S

ervi

ces

Emer

genc

y se

rvic

es (h

ospi

tal

base

d)

No

spec

ialis

t men

tal

•he

alth

pro

fess

iona

ls

avai

labl

e on

site

Emer

genc

y as

sess

men

t •

capa

city

As fo

r Lev

el 3

plu

s:M

enta

l Hea

lth

•pr

ofes

sion

als

on c

all

As fo

r Lev

el 4

plu

s:

Men

tal h

ealth

•

prof

essi

onal

s on

dut

y 24

/7

As fo

r Lev

el 5

plu

s:D

esig

nate

d m

enta

l •

heal

th e

mer

genc

y be

ds

Men

tal h

ealth

in

patie

nt s

ervi

ces

Capa

city

for n

on

•au

thor

ized

men

tal

heal

th tr

eatm

ent o

nly

Adm

issi

on a

nd

•m

anag

emen

t by

gene

ral

prac

titio

ners

or o

ther

m

edic

al o

ffice

rsCa

paci

ty to

cop

e w

ith

•ac

utel

y un

wel

l pen

ding

tr

ansf

erLi

mite

d as

sess

men

t •

and

treat

men

t for

se

vere

and

per

sist

ent

men

tal h

ealth

co

nditi

ons

Lim

ited

acce

ss

•to

men

tal h

ealth

m

ultid

isci

plin

ary

team

As fo

r Lev

el 3

plu

s:•

Capa

city

for d

edic

ated

•

but n

on a

utho

rized

m

enta

l hea

lth tr

eatm

ent

only

Asse

ssm

ent a

nd

•tre

atm

ent f

or s

ever

e an

d pe

rsis

tent

men

tal

heal

th c

ondi

tions

Capa

city

to c

ope

with

•

acut

ely

unw

ell

Mul

tidis

cipl

inar

y st

aff

•av

aila

ble

24/7

on

call

Capa

city

for

•un

derg

radu

ate

and

post

grad

uate

teac

hing

ro

le

As fo

r Lev

el 4

plu

s:•

Capa

city

for a

utho

rized

•

men

tal h

ealth

trea

tmen

tCo

mpr

ehen

sive

•

mul

tidis

cipl

inar

y te

am

rout

inel

y av

aila

ble

on s

iteLi

mite

d co

nsul

tatio

n •

liais

on s

ervi

ces

to g

ener

al

heal

th w

ards

Capa

city

to p

artic

ipat

e in

•

rese

arch

As fp

r Lev

el 5

plu

s:•

Asse

ssm

ent a

nd

•tre

atm

ent f

or c

ompl

ex

men

tal h

ealth

co

nditi

ons

Com

preh

ensi

ve

•m

ultid

isci

plin

ary

team

av

aila

ble

24/7

on

site

Psyc

hiat

ric c

onsu

ltatio

n •

liais

on s

ervi

ces

avai

labl

e to

gen

eral

he

alth

war

ds

A st

rong

aca

dem

ic a

nd

•re

sear

ch fo

cus

NB:

Fut

ure

plan

ning

for m

enta

l hea

lth in

patie

nt s

ervi

ces

will

not

incl

ude

non

auth

oriz

ed fa

cilit

ies.

Tha

t is,

in th

e fu

ture

all

units

will

be

auth

oriz

ed. G

iven

the

CSF

is a

n ev

olvi

ng b

ody

of w

ork,

no

n au

thor

ized

faci

litie

s ha

ve b

een

incl

uded

in th

is re

visi

on a

s th

ey s

till e

xist

For L

evel

6: T

he d

efini

tion

of c

ompl

ex m

enta

l hea

lth p

rese

ntat

ions

:

Clie

nts

with

com

plex

men

tal h

ealth

pre

sent

atio

ns a

re c

hara

cter

ized

by

havi

ng m

ore

than

one

sig

nific

ant c

ondi

tion.

Indi

vidu

als

expe

rienc

e se

vere

and

per

sist

ent m

enta

l illn

ess

and

one

or

mor

e of

the

follo

win

g co

nditi

ons:

age

rela

ted

phys

ical

or m

edic

al c

ondi

tions

, sub

stan

ce u

se d

isor

ders

, dev

elop

men

tal d

isor

ders

and

neu

rops

ychi

atric

dis

orde

rs. C

lient

s re

quiri

ng fo

rens

ic

care

are

als

o in

clud

ed.


65


59

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Dis

aste

r Pr

epar

edne

ss

Dis

aste

r Pr

epar

edne

ssH

ospi

tal P

ABX

line

with

•

back

-up

non

PABX

lin

e an

d m

ust b

e ab

le

to c

omm

unic

ate

with

Re

gion

al E

OC

(REO

C)Si

ngle

fax

line

for

•ho

spita

l

All o

ther

dis

aste

r pr

epar

edne

ss

requ

irem

ents

to b

e ba

sed

on lo

cal r

isk

asse

ssm

ent

As p

er le

vel 1

plu

s •

Nee

d Em

erge

ncy

•O

pera

tions

Cen

tre

(EO

C)EO

C to

be

conn

ecte

d to

•

esse

ntia

l pow

er s

uppl

yEO

C to

hav

e a

min

imum

•

of 2

net

wor

ked

com

pute

rs

All o

ther

dis

aste

r pr

epar

edne

ss

requ

irem

ents

to b

e ba

sed

on lo

cal r

isk

asse

ssm

ent

Hos

pita

l •

com

mun

icat

ion

and

EOC

set u

p as

per

le

vel 2

Spec

ific

stor

age

area

•

for d

isas

ter e

quip

men

t

All o

ther

dis

aste

r pr

epar

edne

ss

requ

irem

ents

to b

e ba

sed

on lo

cal r

isk

asse

ssm

ent

As p

er le

vel 3

plu

s:

Nee

d fo

r •

deco

ntam

inat

ion

show

ers

to b

e ba

sed

on ri

sk a

sses

smen

t in

rela

tion

to lo

cal

indu

stry

.Ab

ility

to m

anua

lly

•se

cure

the

perim

eter

of

the

hosp

ital

CCTV

mon

itorin

g •

at d

esig

nate

d en

try,

ex

its, a

nd p

harm

acy

and

foot

age

from

ea

ch c

amer

a sh

all b

e re

cord

ed.

Alte

rnat

ive

entr

y/•

exit

that

is c

apab

le

of m

anag

ing

larg

e nu

mbe

rs o

f peo

ple

and

vehi

cles

.

Met

ro E

OC’

s •

Two

pre-

desi

gnat

ed

•Em

erge

ncy

Ope

ratio

ns

Cent

re (E

OC)

lo

catio

ns in

diff

eren

t ge

ogra

phic

al a

reas

w

ith re

dund

ancy

in

pow

er s

uppl

y.

EOC

to h

ave

a •

min

imum

of 1

0 ne

twor

ked

com

pute

rs,

2-w

ay ra

dio

com

mun

icat

ion

with

H

EOC,

dire

ct p

hone

lin

e to

FES

A, d

edic

ated

sa

telli

te p

hone

line

s an

d ab

ility

to d

igita

lly

reco

rd E

OC

tele

phon

es.

WAC

HS

– Re

gion

al

•Em

erge

ncy

Ope

ratio

ns

Cent

res

(REO

C) fo

r the

pu

rpos

e of

coo

rdin

atin

g a

regi

onal

resp

onse

. R

EOC

mus

t be

able

to

com

mun

icat

e w

ith

SHEO

C, h

ave

inco

min

g an

d ou

t-go

ing

fax

lines

, be

con

nect

ed to

UPS

and

ha

ve a

min

imum

of 4

ne

twor

ked

com

pute

rs

As fo

r lev

el 5

plu

s6

– 8

deco

ntam

inat

ion

•sh

ower

sSe

cure

ED

sto

rage

•

room

for d

isas

ter

equi

pmen

t.2

x ne

gativ

e pr

essu

re

•ro

oms

1 x

20 b

ed w

ard

•ca

pabl

e of

isol

atio

n.Se

para

te ro

ads

for e

ntry

•

and

exit

to h

ospi

tal

A p p e n d i c e s

60

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Dis

aste

r Pr

epar

edne

ss

(con

t.)

For d

etai

led

requ

irem

ents

, re

fer t

o G

roup

5 in

the

“Red

unda

ncy

& D

isas

ter

Plan

ning

in H

ealth

’s

Capi

tal W

orks

Pro

gram

”

docu

men

t ava

ilabl

e at

w

ww

.hea

lth.w

a.go

v.au

/di

sast

er

For d

etai

led

requ

irem

ents

, re

fer t

o G

roup

5 in

the

Redu

ndan

cy &

Dis

aste

r Pl

anni

ng in

Hea

lth’s

Ca

pita

l Wor

ks P

rogr

am”

do

cum

ent

For d

etai

led

requ

irem

ents

, re

fer t

o G

roup

4 in

the

Redu

ndan

cy &

Dis

aste

r Pl

anni

ng in

Hea

lth’s

Ca

pita

l Wor

ks P

rogr

am”

do

cum

ent

For d

etai

led

requ

irem

ents

, re

fer t

o G

roup

3 in

the

Redu

ndan

cy &

Dis

aste

r Pl

anni

ng in

Hea

lth’s

Ca

pita

l Wor

ks P

rogr

am”

do

cum

ent

All o

ther

crit

eria

as

for l

evel

4

plus

: H

ospi

tal P

ABX

line

and

•no

n-PA

BX li

ne c

onne

cted

to

uni

nter

rupt

ed p

ower

su

pply

(UPS

)4

x de

cont

amin

atio

n •

show

ers

1 x

nega

tive

pres

sure

•

room

1 x

4-be

dded

room

•

capa

ble

of is

olat

ion

Elec

troni

c pe

rimet

er

•se

curit

yCC

TV m

onito

ring

and

•ab

le to

sto

re fo

otag

e fo

r 10

-14

days

. In

tern

al H

ospi

tal 2

-way

•

Radi

o N

etw

ork

Radi

olog

ical

mon

itorin

g •

devi

ces

at E

D e

ntra

nces

.Si

ngle

che

mic

al

•co

ntam

inat

ion

isol

atio

n ro

om in

ED.

ED D

isas

ter t

eam

pre

p •

area

.

For d

etai

led

requ

irem

ents

, re

fer t

o G

roup

2 in

the

Redu

ndan

cy &

Dis

aste

r Pl

anni

ng in

Hea

lth’s

Ca

pita

l Wor

ks P

rogr

am”

For d

etai

led

requ

irem

ents

, re

fer t

o G

roup

1 in

the

Redu

ndan

cy &

Dis

aste

r Pl

anni

ng in

Hea

lth’s

Ca

pita

l Wor

ks P

rogr

am”

do

cum

ent


67


61

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Clin

ical

Sup

port

Ser

vice

s

Path

olog

ySp

ecim

en c

olle

ctio

n by

•

RN

or G

PSp

ecim

ens

tran

smitt

al

•to

refe

rral

labo

rato

ry

As fo

r lev

el 2

plu

s:Sp

ecim

en c

olle

ctio

n by

•

path

olog

y st

aff

Able

to p

erfo

rm a

•

defin

ed ra

nge

urge

nt

test

s

As fo

r lev

el 3

plu

s:Pe

rfor

ms

rang

e of

bas

ic

•te

sts

May

hav

e bl

ood

gas

•

anal

yser

Bloo

d ba

nk•

Serv

ices

sur

roun

ding

•

area

sFu

ll tim

e la

bora

tory

•

scie

ntis

ts

As fo

r lev

el 4

plu

s:24

hou

r on

site

ser

vice

•Pa

thol

ogy

depa

rtm

ent

•Fu

ll tim

e pa

thol

ogis

t•

Mic

robi

olog

y an

d •

hist

opat

holo

gy

avai

labl

eRe

gion

al re

ferr

al ro

le•

As fo

r lev

el 5

plu

s:St

atew

ide

refe

rral

role

•Te

achi

ng a

nd re

sear

ch

•ro

leSp

ecia

list r

egis

trar

in

•tr

aini

ng

Radi

olog

yM

obile

ser

vice

and

•

limite

d to

x-r

ay o

f ex

trem

ities

, che

st,

abdo

men

Inte

rpre

ted

by

•on

site

doc

tor/

heal

th

prof

essi

onal

or b

y el

ectro

nic

mea

ns

As fo

r lev

el 2

plu

s:O

n si

te d

esig

nate

d •

room

Ra

diog

raph

er in

•

atte

ndan

ce w

ho

has

regu

lar a

cces

s to

radi

olog

ical

co

nsul

tatio

nSi

mpl

e ul

tras

ound

•

capa

city

for f

oeta

l m

onito

ring

Tele

radi

olog

y fa

cilit

y •

avai

labl

e

As fo

r lev

el 3

plu

s:Fa

cilit

ies

for g

ener

al a

nd

•flu

oros

copy

, in

addi

tion

to m

obile

CD

for w

ards

, O

R a

nd E

DAu

to fi

lm p

roce

ssin

g •

capa

city

Mob

ile im

age

inte

nsifi

er

•in

OR

and

/or I

CU/C

CUSt

aff r

adio

grap

her o

n-•

call

24 h

ours

Visi

ting

spec

ialis

t •

radi

olog

ical

ap

poin

tmen

tAl

way

s ha

s ul

tras

ound

•

May

hav

e CT

sca

nner

•Re

gist

ered

nur

se a

s •

requ

ired

Tele

radi

olog

y fa

cilit

y •

avai

labl

e

As fo

r lev

el 4

plu

s:Es

tabl

ishe

d D

epar

tmen

t•

Full

ultr

asou

nd•

Has

radi

olog

ist i

n ch

arge

•M

ay h

ave

radi

olog

y •

regi

stra

rH

as re

gist

ered

nur

se 2

4 •

hour

on

site

ser

vice

for

urge

nt x

-ray

sCT

sca

nner

on

site

or

•lo

cally

ava

ilabl

ePA

Cs a

vaila

ble

•Po

ssib

le M

RI

•

As fo

r lev

el 5

plu

s:Sp

ecia

l roo

ms

for

•di

gita

l ang

iogr

aphy

, ne

uror

adio

logy

etc

CT s

can

and

full

•ul

tras

ound

ser

vice

av

aila

ble

24 h

ours

Alw

ays

has

MR

I and

•

digi

tal a

ngio

grap

hyH

as ra

diol

ogy

regi

stra

r •

and

post

gra

duat

e fe

llow

sPe

rfor

ms

inva

sive

•

proc

edur

esPA

Cs a

vaila

ble

•

A p p e n d i c e s

62

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Phar

mac

ySe

rvic

e ov

ersi

ght b

y •

phar

mac

ist l

ocat

ed

else

whe

reD

rugs

sup

plie

d on

•

indi

vidu

al p

resc

riptio

n fro

m c

omm

unity

ph

arm

acy

As fo

r lev

el 1

plu

s:Vi

sitin

g ph

arm

acis

t •

from

regi

onal

hos

pita

lM

inim

al c

linic

al s

ervi

ce•

Staf

f edu

catio

n•

Dru

gs p

rovi

ded

by

•re

gion

al h

ospi

tal

As fo

r lev

el 2

plu

s:At

leas

t one

pha

rmac

ist

•em

ploy

ed fu

ll tim

ePh

arm

acy

drug

•

purc

hasi

ng a

nd

dist

ribut

ion

to

inpa

tient

s in

ac

cord

ance

with

sta

te

drug

pol

icie

s an

d fo

rmul

ary

May

pro

vide

pha

rmac

y •

unde

rgra

duat

e an

d po

stgr

adua

te te

achi

ng

role

May

hav

e re

gion

al ro

le•

As fo

r lev

el 3

plu

s:M

ore

than

one

•

phar

mac

ist e

mpl

oyed

Em

erge

ncy

afte

r hou

rs

•on

-cal

l ser

vice

Lim

ited

clin

ical

•

phar

mac

y se

rvic

e to

in

patie

nts

Lim

ited

outp

atie

nts

•di

spen

sing

Dev

elop

s lo

cal d

rug

•po

licie

sPa

rtic

ipat

es in

hos

pita

l •

com

mitt

ees

May

pro

vide

pha

rmac

y •

unde

rgra

duat

e an

d po

stgr

adua

te te

achi

ng

role

May

hav

e re

gion

al ro

le•

As fo

r lev

el 4

plu

s:6

day

serv

ice

and

on-c

all

•se

rvic

eIn

patie

nt a

nd o

utpa

tient

•

serv

ices

Dru

g in

form

atio

n•

Exte

nsiv

e cl

inic

al

•ph

arm

acy

serv

ice

to

inpa

tient

sIn

trav

enou

s ad

ditiv

e •

and/

or c

ytot

oxic

dru

g pr

epar

atio

n

Exte

mpo

rane

ous

•di

spen

sing

Supp

ort f

or c

linic

al tr

ials

•U

nder

grad

uate

and

•

post

grad

uate

pha

rmac

y te

achi

ng ro

le

As fo

r lev

el 5

plu

s:7

day

serv

ice

with

•

exte

nded

hou

rs24

hou

r on-

call

serv

ice

•Sp

ecia

list p

harm

acis

t •

posi

tions

eg

onco

logy

, ca

rdio

logy

, pae

diat

rics,

ge

riatr

ics,

psy

chia

try,

dr

ug in

form

atio

n In

volv

ed in

rese

arch

, •

clin

ical

tria

ls, c

linic

al

revi

ew, D

UE’

s,

Prov

ide

unde

rgra

duat

e •

and

post

grad

uate

te

achi

ng ro

lePr

oduc

t eva

luat

ion

•w

ith d

rug

use/

polic

y de

velo

pmen

t


69


63

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

ICU

/HD

URe

cove

ry a

rea

for p

ost-

•op

erat

ive

patie

nts

Diff

eren

t hig

h •

depe

nden

cy a

rea

for

gene

ral w

ard

patie

nts

requ

iring

obs

erva

tion

over

and

abo

ve th

at

avai

labl

e in

gen

eral

w

ard

area

RN

equ

ival

ent t

o 4

•hr

s/pa

tient

/day

(1:6

) de

sira

ble

As fo

r lev

el 2

plu

s24

hr a

cces

s to

Med

ical

•

Offi

cer o

n si

te o

r av

aila

ble

with

in 1

0 m

inut

esR

N e

quiv

alen

t to

6 •

hrs/

patie

nt/d

ay (1

:4)

desi

rabl

e fo

r hig

h de

pend

ency

bed

s.H

as N

UM

•Se

para

te re

cove

ry a

rea

•pr

efer

able

Liai

son

psyc

hiat

ry

•av

aila

ble

Acce

ss to

med

ical

•

and

nurs

ing

educ

atio

n pr

ogra

ms

As fo

r lev

el 3

plu

s:M

echa

nica

l ven

tilat

ion

•an

d si

mpl

e in

vasi

ve

card

iova

scul

ar

mon

itorin

g fo

r sev

eral

ho

urs

Sepa

rate

and

sel

f-•

cont

aine

d fa

cilit

y in

th

e ho

spita

l cap

able

of

prov

idin

g ba

sic,

mul

ti-sy

stem

life

sup

port

us

ually

for l

ess

than

24

hour

sM

edic

al D

irect

or w

ith

•tr

aini

ng a

nd e

xper

ienc

e in

inte

nsiv

e ca

reAt

leas

t one

RM

O o

n •

site

or a

vaila

ble

to th

e un

it at

all

times

Equi

vale

nt to

leve

l I

•FI

CAN

ZCA

Gui

delin

es

As fo

r lev

el 4

plu

s:M

echa

nica

l ven

tilat

ion,

•

extr

a-co

rpor

eal r

enal

su

ppor

t ser

vice

s an

d in

vasi

ve c

ardi

ovas

cula

r m

onito

ring

for a

per

iod

of s

ever

al d

ays

Sepa

rate

and

sel

f-•

cont

aine

d fa

cilit

y in

ho

spita

l cap

able

of

prov

idin

g co

mpl

ex m

ulti-

syst

em li

fe s

uppo

rt

Med

ical

Dire

ctor

ac

cred

ited

Inte

nsiv

e Ca

re

Spec

ialis

t or c

onsu

ltant

ph

ysic

ian

in in

tens

ive

care

At le

ast o

ne s

peci

alis

t •

accr

edite

d w

ith

appr

opria

te e

xper

ienc

e in

in

tens

ive

care

Plus

one

RM

O(s

) who

is

•on

site

, pre

dom

inan

tly

pres

ent i

n th

e un

it an

d ex

clus

ivel

y ro

ster

ed to

th

e un

it at

all

times

NU

M w

ith p

ost-

•re

gist

ratio

n qu

alifi

catio

ns

in in

tens

ive

care

or t

he

clin

ical

spe

cial

ty o

f the

un

itN

urse

in c

harg

e of

the

•sh

ift is

a p

erm

anen

t sta

ff m

embe

r and

app

ropr

iate

qu

alifi

edAl

l nur

sing

sta

ff of

uni

t •

resp

onsi

ble

for d

irect

pa

tient

car

e ar

e R

Ns

As fo

r lev

el 5

plu

s:M

echa

nica

l ven

tilat

ion,

•

extr

a co

rpor

eal r

enal

su

ppor

t ser

vice

s an

d in

vasi

ve c

ardi

ovas

cula

r m

onito

ring

for

an in

defin

ite

perio

dSep

arat

e an

d se

lf-co

ntai

ned

unit

in

hosp

ital c

apab

le o

f pr

ovid

ing

com

plex

, m

ulti

syst

em li

fe

supp

ort f

or a

n in

defin

ite

perio

dRe

ferr

al c

entre

for

•in

tens

ive

care

pat

ient

sM

edic

al D

irect

or

•ac

cred

ited

Inte

nsiv

e Ca

re S

peci

alis

t or

cons

ulta

nt p

hysi

cian

in

inte

nsiv

e ca

rePl

us o

ne R

MO

who

•

is in

the

hosp

ital,

pred

omin

antly

pre

sent

in

the

unit

and

excl

usiv

ely

rost

ered

to

the

unit

at a

ll tim

esN

UM

with

pos

t-•

regi

stra

tion

qual

ifica

tions

in

inte

nsiv

e ca

re o

r uni

ts

clin

ical

spe

cial

tyN

urse

in c

harg

e of

•

shift

is p

erm

anen

t st

aff m

embe

r and

ap

prop

riate

ly q

ualifi

ed

A p p e n d i c e s

64

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

ICU

/HD

U

(con

t.)M

ajor

ity o

f nur

sing

sta

ff •

have

pos

t-re

gist

ratio

n qu

alifi

catio

ns in

inte

nsiv

e ca

re o

r clin

ical

spe

cial

ty

of th

e un

it1:

1 ca

re fo

r ven

tilat

ions

•

or e

quiv

alen

tly c

ritic

ally

ill Ca

paci

ty to

pro

vide

•

grea

ter t

han

1:1

care

if

requ

ired

At le

ast t

wo

RN

s in

uni

t •

if th

ere

is a

pat

ient

in th

e un

itAc

tive

med

ical

and

•

nurs

ing

educ

atio

n pr

ogra

ms

Acce

ss to

the

CNE

•24

hr a

cces

s to

•

phar

mac

y, p

atho

logy

, op

erat

ing

suite

and

im

agin

gAp

prop

riate

acc

ess

to

•ph

ysio

ther

apis

t, so

cial

w

orke

r, di

etiti

ans,

pa

stor

al c

are

and

othe

r al

lied

heal

th s

ervi

ces

Equi

vale

nt to

leve

l II o

f •

FICA

NZC

A G

uide

lines

Mus

t be

RN

s if

•pr

ovid

ing

dire

ct

patie

nt c

are.

Maj

ority

of

nur

sing

sta

ff ha

ve

post

-reg

istr

atio

n qu

alifi

catio

ns in

in

tens

ive

care

or u

nit

clin

ical

spe

cial

ty1:

1 ca

re fo

r ven

tilat

ions

•

or e

quiv

alen

t crit

ical

ly

ill, g

reat

er th

an 1

:1 fo

r se

lect

ed p

atie

nts

Mor

e th

an tw

o R

Ns

•pr

esen

t in

the

unit

if pa

tient

in th

e un

itCN

E an

d fo

rmal

nur

sing

•

educ

atio

nal p

rogr

amPh

ysio

ther

apy

serv

ices

•

are

acce

ssib

leAp

prop

riate

acc

ess

•to

oth

er a

llied

hea

lth

serv

ices

Activ

e re

sear

ch•

Des

igna

ted

soci

al

•w

orke

rBi

omed

ical

eng

inee

ring

•se

rvic

es o

n si

teEq

uiva

lent

to le

vel I

II •

FICA

NZC

A G

uide

lines


71


65

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Paed

iatr

ic IC

UAs

for l

evel

5 fo

r adu

lts

plus

:Pr

ovid

es c

ompl

ex,

•m

ulti-

syst

em li

fe

supp

ort f

or a

n in

defin

ite

perio

dTe

rtia

ry re

ferr

al c

entre

•

for c

hild

ren

need

ing

inte

nsiv

e ca

reH

ave

exte

nsiv

e ba

ckup

•

labo

rato

ry a

nd c

linic

al

serv

ice

faci

litie

s to

su

ppor

t thi

s te

rtia

ry

role

Able

to p

rovi

de

•m

echa

nica

l ven

tilat

ion,

ex

trac

orpo

real

rena

l su

ppor

t ser

vice

s an

d in

vasi

ve c

ardi

ovas

cula

r m

onito

ring

for a

n in

defin

ite p

erio

d to

in

fant

s an

d ch

ildre

n le

ss th

an 1

6 ye

ars

of

age,

or c

are

of a

sim

ilar

natu

reSp

ecia

list R

N•

Acce

ss to

spe

cial

ist

•SR

NO

n du

ty m

edic

al o

ffice

r•

On

call

cons

ulta

nt•

A p p e n d i c e s

66

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

CCU

Able

to s

uppl

y cr

itica

l •

care

exp

ertis

e fo

r co

rona

ry p

atie

nts

Prov

ides

a le

vel o

f car

e •

mor

e in

tens

ive

than

w

ard

base

d ca

reD

iscr

ete

area

with

in th

e •

heal

th fa

cilit

y (m

ay b

e co

mbi

ned

with

in a

n IC

U

or H

DU

)N

on in

vasi

ve

•m

onito

ring

Can

prov

ide

•re

susc

itatio

n an

d st

abili

satio

n of

em

erge

ncie

s un

til

tran

sfer

or r

etrie

val t

o a

back

up

faci

lity

Spec

ialis

t RN

•Ac

cess

to s

peci

alis

t •

SRN

Form

al li

nk w

ith p

ublic

•

or p

rivat

e he

alth

fa

cilit

y(s)

for p

atie

nt

refe

rral

and

tran

sfer

to/

from

a h

ighe

r lev

el o

f se

rvic

e, to

ens

ure

safe

se

rvic

e pr

ovis

ion

As fo

r lev

el 4

plu

s:Ab

le to

pro

vide

add

ition

al

•m

onito

ring

capa

city

(c

entr

al m

onito

ring

at

staf

f sta

tion)

for c

ardi

ac

patie

nts

and

incr

ease

d m

edic

al a

nd n

ursi

ng

supp

ort

As fo

r CCU

ser

vice

leve

l •

4 pl

us:

Beds

ide

and

cent

ral

•m

onito

ring

capa

city

(a

ble

to m

onito

r pa

tient

s at

the

staf

f st

atio

n)

As fo

r lev

el 5

plu

s:Pr

ovid

es fu

ll ra

nge

of

•ca

rdia

c m

onito

ring

(incl

udin

g in

vasi

ve

mon

itorin

g) fo

r car

diac

pa

tient

sFu

ll ca

rdio

logy

sup

port

•

incl

udin

g 24

hou

r on-

call

echo

card

iogr

aphy

, an

giog

raph

y,

angi

opla

sty

and

perm

anen

t pac

emak

er

serv

ices

As fo

r CCU

ser

vice

leve

l •

5 pl

us:

Inva

sive

car

diov

ascu

lar

•m

onito

ring

(inde

finite

ly)

Hig

hest

leve

l ref

erra

l •

cent

re fo

r CCU

pat

ient

s w

ith a

ctiv

e lia

ison

with

lo

wer

leve

l crit

ical

car

e se

rvic

es fo

r ref

erra

ls

and

tran

sfer

of p

atie

nts

to e

nsur

e sa

fe s

ervi

ce

prov

isio

n

Anae

sthe

tics

Anal

gesi

a/m

inim

al

•se

datio

n av

aila

ble

by

visi

ting

med

ical

offi

cer

As fo

r lev

el 2

plu

s:G

ener

al A

naes

thet

ics

•on

low

-ris

k pa

tient

s gi

ven

GP

anae

sthe

tists

or

gen

eral

ana

esth

etis

tM

ay h

ave

visi

ting

•sp

ecia

list a

naes

thet

ist

As fo

r lev

el 3

plu

s:G

ener

al a

naes

thet

ics

on

•lo

w-r

isk

patie

nts

give

n by

acc

redi

ted

med

ical

pr

actit

ione

rSp

ecia

list a

naes

thet

ist

•ap

poin

ted

for

cons

ulta

tion

and

to

prov

ide

serv

ice

for

mod

erat

e ris

k pa

tient

sSp

ecifi

c op

erat

ing

•ro

om a

naes

thet

ic s

taff

supp

ort a

vaila

ble

As fo

r lev

el 4

plu

s:Sp

ecia

list a

naes

thet

ist o

n •

24 h

our r

oste

r for

low

, m

oder

ate

and

high

risk

pa

tient

sN

omin

ated

spe

cial

ist

•di

rect

or o

f ana

esth

etic

st

aff

Anae

sthe

tic re

gist

rar o

n •

site

24

hour

s

As fo

r lev

el 5

plu

s:Su

b sp

ecia

lists

, •

rese

arch

and

teac

hing

of

gra

duat

es a

nd

unde

rgra

duat

esTe

achi

ng a

nd re

sear

ch

•ro

le


73


67

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Ope

ratin

g Th

eatre

sM

inor

pro

cedu

re

•ca

pabi

lity

no e

mer

genc

y op

erat

ing

thea

tre

As fo

r lev

el 2

plu

s:Si

ngle

ope

ratin

g th

eatre

•

for m

inor

/ sa

me

day

proc

edur

es24

hou

r cov

er fo

r •

caes

aria

n se

ctio

n if

perf

orm

ing

obst

etric

s

As fo

r lev

el 3

plu

s:M

ore

than

one

•

oper

atin

g th

eatre

/ pr

oced

ure

room

Sepa

rate

reco

very

•Ac

cred

ited

med

ical

•

prac

titio

ner p

rovi

ding

an

aest

hetic

ser

vice

sSp

ecia

list R

N•

Acce

ss to

spe

cial

ist

•SR

N

As fo

r lev

el 4

plu

s:Sp

ecia

list a

naes

thet

ist o

n •

24 h

our r

oste

r for

low

, m

oder

ate

and

high

risk

pa

tient

sM

edic

al o

ffice

r on

site

24

•ho

urs

Acce

ss to

ICU

•

As fo

r lev

el 5

plu

s:M

ultip

le o

pera

ting

•th

eatre

s an

d pr

oced

ure

room

sM

ajor

and

com

plex

•

proc

edur

es

(car

diot

hora

cic

and

tran

spla

nt)

Teac

hing

and

rese

arch

•

role

Teac

hing

, Tra

inin

g an

d Re

sear

ch

Acce

ss to

clin

ical

•

e-le

arni

ngAs

for l

evel

2 p

lus:

Som

e m

edic

al n

ursi

ng

•an

d al

lied

heal

th

teac

hing

pro

gram

sRo

tatio

nal s

tude

nt

•pl

acem

ents

As fo

r lev

el 3

plu

s:So

me

inte

rn, r

egis

trar

•

and

resi

dent

teac

hing

Som

e sp

ecia

list n

ursi

ng

•an

d al

lied

heal

th

teac

hing

Poss

ibly

col

labo

rativ

e •

rese

arch

As fo

r lev

el 4

plu

s:Sm

all r

esea

rch

unit

•Sp

ecia

list t

each

ingf

or

•nu

rsin

g an

d al

lied

heal

thSo

me

inte

rn, r

esid

ent

•an

d re

gist

rar t

each

ing

As fo

r lev

el 5

plu

s:La

rge

Rese

arch

Uni

t/•

Inst

itute

with

link

s to

un

iver

sitie

sFu

ll te

achi

ng p

rogr

am

•at

all

leve

lsFo

rmal

teac

hing

link

s •

with

the

univ

ersi

ties

A p p e n d i c e s

68

Non

Hos

pita

l Ser

vice

s D

efini

tions

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Med

ical

Ser

vice

s

Sexu

al H

ealth

M

edic

ine

Emer

genc

y se

rvic

es

•w

ith a

sses

smen

t, tre

atm

ent a

nd

appr

opria

te re

ferr

al

by R

N o

r med

ical

pr

actit

ione

r with

lim

ited

trai

ning

in S

TIs

Link

s w

ith id

entifi

ed

•se

xual

hea

lth s

ervi

ces

As fo

r lev

el 1

plu

s:D

esig

nate

d cl

inic

•

sess

ions

run

by

Nur

se p

ract

ition

er o

r M

O w

ith re

cogn

ised

qu

alifi

catio

ns.

Lim

ited

outre

ach

and

•ed

ucat

ion.

On

site

mic

rosc

opy

•av

aila

ble

Cont

act

trac

ing

resp

onsi

bilit

y

As fo

r lev

el 2

plu

sN

P or

MO

and

•

mul

tidis

cipl

inar

y te

am

incl

udin

g co

unse

llors

. H

ealth

pro

mot

ion

and

•ed

ucat

ion.

Ac

cess

to s

peci

alis

t •

med

ical

ser

vice

s.

Link

to s

exua

l ass

ault.

.•

As fo

r Lev

el 3

plu

s: S

exua

l hea

lth p

hysi

cian

•

sess

ions

. Pr

ovid

es G

P an

d ju

nior

•

staf

f tr

aini

ng a

nd

supp

ort.

Form

al li

nk to

spe

cial

ist

•se

rvic

es in

clud

ing

HIV

. Re

sear

ch a

nd

•m

utid

isci

plin

ary

hea

lth

prom

otio

n co

nduc

ted

As fo

r Lev

el 4

plu

s:Se

xual

hea

lth p

hysi

cian

•

on s

taff

and

team

of

med

ical

and

nur

sing

st

aff w

ith re

cogn

ised

qu

alifi

catio

ns a

nd

spec

ialis

t clin

ics

in a

reas

su

ch a

s de

rmat

olog

y an

d co

lpos

copy

. Cl

inic

al re

sear

ch

•an

d pr

ofes

sion

al

deve

lopm

ent.

On

site

labo

rato

ry.

•U

nder

grad

uate

and

•

post

grad

uate

teac

hing

In

tegr

ated

with

leve

l 6

serv

ices

As fo

r Lev

el 5

plu

s:

Acce

ss to

inpa

tient

•

beds

and

ser

vice

s in

clud

ing

thea

tres

and

HIT

H

Emer

genc

y Se

rvic

es

Urg

ent P

rimar

y Ca

reCa

re is

car

ried

out

•by

GPs

(pot

entia

lly

visi

ting)

with

or w

ithou

t th

e as

sist

ance

of R

Ns

depe

ndin

g on

the

type

of

pat

ient

car

e ne

eded

Basi

c re

susc

itatio

n •

equi

pmen

t and

dru

gs

As fo

r lev

el 1

plu

s:Li

mite

d G

P co

ver

•Se

rvic

es b

y R

N•

Resu

scita

tion

and

•st

abili

satio

n ca

pabi

lity

As fo

r lev

el 2

plu

s:Lo

cal G

Ps ro

ster

ed to

•

prov

ide

24 h

our c

over

w

ith s

ervi

ce b

y R

NM

inor

pro

cedu

re

•ca

pabi

lity

Resu

scita

tion

and

•st

abili

satio

n ca

pabi

lity


75


69

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Publ

ic H

ealth

Ser

vice

s

Envi

ronm

enta

l H

ealth Hea

lth

•Pr

otec

tion

incl

udin

g fo

od,

air,

wat

er,

radi

atio

n,

phar

mac

eutic

al,

pest

icid

es,

mos

quito

bor

ne

dise

ases

Com

mun

ity b

ased

•

orga

nisa

tions

re

spon

sibi

lity

with

su

ppor

t fro

m lo

cal

gove

rnm

ent

As fo

r lev

el 1

plu

s:•

Loca

l Gov

ernm

ent

•re

spon

sibi

lity

with

ac

cess

to D

OH

st

atew

ide

unit

whe

n re

quire

d

As fo

r Lev

el 2

plu

s:•

Loca

l lin

ks b

etw

een

•Lo

cal G

over

nmen

t and

Po

pula

tion

Hea

lth U

nit

As fo

r lev

el 3

plu

s:•

Coor

dina

te

•in

vest

igat

ions

of l

ocal

in

cide

nts

As fo

r lev

el 4

plu

s:•

Com

preh

ensi

ve

•m

ultid

isci

plin

ary

Popu

latio

n H

ealth

Uni

t

As fo

r lev

el 5

plu

s:•

Stat

ewid

e pr

ogra

m,

•pl

anni

ng, a

nd

coor

dina

tion

role

sD

edic

ated

offi

cers

•

with

sta

tew

ide

resp

onsi

bilit

ies

and

legi

slat

ed s

ervi

ce

func

tions

Com

mun

icab

le

Dis

ease

Con

trol

Incl

udes

food

•

and

wat

er

born

e di

seas

es,

vacc

inat

ion

prog

ram

s,

STI’s

, BBV

’s an

d ar

bovi

ral

dise

ases

Visi

ting

prim

ary

heal

th

•se

rvic

es n

ot in

clud

ing

GP’

s

As fo

r lev

el 1

plu

s:•

Visi

ting

prim

ary

care

•

prov

ider

s, in

clud

ing

GPs

and

Com

mun

ity

Hea

lth N

urse

s

As fo

r lev

el 2

plu

s:•

Resi

dent

prim

ary

care

•

prov

ider

sup

port

ing

stat

e pr

ogra

ms

incl

udin

g G

Ps a

nd

Com

mun

ity H

ealth

N

urse

s

As fo

r lev

el 3

plu

s:•

CDC

Nur

se in

•

Popu

latio

n H

ealth

Uni

t

As fo

r lev

el 4

plu

s:•

Com

preh

ensi

ve

•m

ultid

isci

plin

ary

Popu

latio

n H

ealth

Uni

t w

ith d

isea

se c

ontro

l do

ctor

and

cap

acity

to:

Inve

stig

ate

case

s/

•ou

tbre

aks

Perf

orm

con

tact

trac

ing

•Co

ordi

nate

regi

onal

•

vacc

inat

ion

prog

ram

s et

c

As fo

r lev

el 5

plu

s:•

Stat

ewid

e pr

ogra

m,

•pl

anni

ng, a

nd

coor

dina

tion

role

sD

edic

ated

offi

cers

•

with

sta

tew

ide

resp

onsi

bilit

ies

and

legi

slat

ed s

ervi

ce

func

tions

Child

and

Co

mm

unity

H

ealth Co

mm

unity

•

Hea

lth S

ervi

ces,

Sc

hool

Hea

lth

Serv

ices

, Ch

ild H

ealth

Se

rvic

es, C

hild

D

evel

opm

ent

Serv

ices

Visi

ting

prim

ary

care

•

prov

ider

s As

for l

evel

1 p

lus:

•Re

side

nt p

rimar

y ca

re

•pr

ovid

ers

with

acc

ess

to s

tate

wid

e pr

ogra

m

initi

ativ

es

As fo

r lev

el 2

plu

s:•

Child

and

Ado

lesc

ent

•Co

mm

unity

Hea

lth

Serv

ice

or C

hild

D

evel

opm

ent C

entre

As fo

r lev

el 4

plu

s:•

Mul

tidis

cipl

inar

y •

popu

latio

n he

alth

se

rvic

es w

ith C

omm

unity

H

ealth

sta

ff

As fo

r lev

el 5

plu

s:•

Stat

ewid

e Po

licy,

•

prog

ram

, pla

nnin

g,

trai

ning

and

rese

arch

ro

les

A p p e n d i c e s

70

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Abor

igin

al H

ealth

Visi

ting

prim

ary

care

•

prov

ider

s As

for l

evel

1 p

lus:

Visi

ting

mai

nstre

am

•he

alth

ser

vice

pro

vide

rs

(incl

udin

g G

Ps)

As fo

r lev

el 2

plu

s:M

ains

tream

hea

lth

•se

rvic

e pr

ovid

ers

As fo

r lev

el 3

plu

s:Co

mm

unity

con

trolle

d •

Abor

igin

al h

ealth

se

rvic

e

As fo

r lev

el 4

plu

s:In

tegr

ated

ser

vice

•

deliv

ery

As fo

r lev

el 5

plu

s:St

atew

ide

prog

ram

, •

plan

ning

, and

co

ordi

natio

n ro

les

Ded

icat

ed o

ffice

rs

•w

ith s

tate

wid

e re

spon

sibi

litie

s

Hea

lth P

rom

otio

nIn

form

atio

n se

rvic

es

•su

ch a

s vi

sitin

g pr

imar

y ca

re p

rovi

ders

int

erne

t, pu

blic

atio

n di

strib

utio

n,

phon

e in

fo li

ne

As fo

r lev

el 1

plu

sBe

havi

our/

risk

•as

sess

men

tBr

ief i

nter

vent

ions

eg

•sm

okin

g, d

iet,

wei

ght

Prim

ary

care

refe

rral

•

path

way

s

As fo

r lev

els

2 pl

us:

Spec

ialis

t adv

ice

•th

roug

h al

lied

heal

th

prac

titio

ners

, life

styl

e se

rvic

es (e

g sm

okin

g ce

ssat

ion,

nut

ritio

n,

phys

ical

act

ivity

, wei

ght

man

agem

ent,

men

tal

heal

th)

Impl

emen

t com

mun

ity

•ba

sed

skill

s de

velo

pmen

t pro

gram

s

As fo

r lev

el 1

plu

s / m

ay

incl

ude

leve

ls 2

and

/or 3

Hea

lth p

rom

otio

n •

offic

ers

Loca

l are

a /c

omm

unity

•

heal

th p

rom

otio

n pr

ogra

ms/

initi

ativ

es

Com

mun

ity

•de

velo

pmen

t - e

ngag

emen

t, co

mm

unity

act

ion,

ca

paci

ty d

evel

opm

ent

and

advo

cacy

Inte

rven

tion

rela

ted

•pa

rtne

rshi

ps w

ith

loca

l gov

t, co

mm

unity

or

gani

satio

ns,

wor

kpla

ces,

sch

ools

on

polic

y/pr

ogra

ms

Spon

sors

hip

of lo

cal

•co

mm

unity

act

iviti

es

Envi

ronm

enta

l •

initi

ativ

es (s

afe,

su

ppor

tive

setti

ngs)

As fo

r lev

el 1

and

4 p

lus

/ m

ay in

clud

e le

vels

2 a

nd/

or 3

:Co

mpr

ehen

sive

•

mul

tidis

cipl

inar

y Pu

blic

H

ealth

Uni

t inc

ludi

ng

heal

th p

rom

otio

n of

ficer

sRe

gion

al re

sear

ch,

•pl

anni

ng, p

olic

y an

d co

ordi

natio

nD

evel

opin

g an

d pi

lotin

g •

new

pro

gram

sEv

iden

ce b

ased

regi

on

•w

ide

prog

ram

s/in

itiat

ives

Targ

eted

initi

ativ

es fo

r •

spec

ial n

eeds

gro

ups

(eg

men

tal h

ealth

)Pa

rtne

rshi

ps w

ith

•lo

cal g

ovt,

othe

r gov

t ag

enci

es a

nd c

omm

unity

or

gani

satio

ns

Wor

kfor

ce c

apac

ity

•bu

ildin

g

Ded

icat

ed o

ffice

rs

•w

ith s

tate

wid

e re

spon

sibi

litie

s St

atew

ide

rese

arch

, •

plan

ning

, pol

icy,

re

sour

ce a

lloca

tion

and

coor

dina

tion

role

Dev

elop

men

t, •

impl

emen

tatio

n an

d ev

alua

tion

of s

tate

wid

e pr

ogra

ms

and

cam

paig

nsTa

rget

ed s

tate

wid

e or

•

syst

em w

ide

heal

th

prom

otio

n pr

ogra

ms

(ATS

I)W

orkf

orce

cap

acity

•

build

ing

(tra

inin

g)Re

gula

tion

and

•le

gisl

atio

nPa

rtne

rshi

ps w

ith o

ther

•

govt

age

ncie

s, in

dust

ry,

NG

Os

Stat

ewid

e •

inte

rsec

tora

l wor

k to

de

velo

p su

ppor

tive

envi

ronm

ents

and

re

late

d po

licy

Fede

ral l

iais

on,

•co

mm

unic

atio

n an

d de

liver

y of

agr

eed

prog

ram

s an

d po

licie

s


77


71

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Brea

stsc

reen

Scre

enin

g an

d •

asse

ssm

ent

Visi

ting

serv

ice

by

•m

obile

scr

eeni

ng u

nit

All i

mag

es re

ad b

y •

spec

ialis

t rad

iolo

gist

As fo

r lev

el 2

plu

s:Fi

xed

site

scr

eeni

ng

•cl

inic

As fo

r lev

el 3

plu

s:As

sess

men

t by

•an

exp

erie

nced

m

ultid

isci

plin

ary

team

of

scr

een

dete

cted

ab

norm

aliti

es

As fo

r lev

el 5

plu

s:St

atew

ide

prog

ram

, •

plan

ning

, and

co

ordi

natio

n ro

les

Ded

icat

ed o

ffice

rs

•w

ith s

tate

wid

e re

spon

sibi

litie

s

Cerv

ical

Hea

lth

•pr

omot

ion,

sc

reen

ing

awar

enes

s,

mai

ntai

n ce

rvic

al

cyto

logy

re

gist

er

Visi

ting

prim

ary

care

•

prov

ider

sAs

for l

evel

1 p

lus:

Resi

dent

prim

ary

care

•

prov

ider

s, in

clud

ing

GPs

As fo

r lev

el 3

plu

s:Pa

thol

ogy

labo

rato

ries

•tr

aine

d in

the

colla

tion

and

repo

rtin

g of

Cer

vica

l Cy

tolo

gy R

egis

try

data

As fo

r lev

el 5

plu

s:St

atew

ide

Prog

ram

, •

plan

ning

, and

co

ordi

natio

n ro

les

Ded

icat

ed o

ffice

rs

•w

ith s

tate

wid

e re

spon

sibi

litie

s

Gen

omic

sEd

ucat

ion,

•

rese

arch

Visi

ting

prim

ary

care

•

prov

ider

s w

ith n

o sp

ecifi

c pr

ogra

m

As fo

r lev

el 1

plu

s:Vi

sitin

g pr

imar

y ca

re

•pr

ovid

ers

with

acc

ess

to s

tate

wid

e ed

ucat

ion

and

info

rmat

ion

As fo

r lev

el 2

plu

s:Re

side

nt p

rimar

y ca

re

•pr

ovid

ers

with

acc

ess

to s

tate

wid

e ed

ucat

ion

and

info

rmat

ion

As fo

r lev

el 5

plu

s:St

atew

ide

Prog

ram

, •

plan

ning

, and

co

ordi

natio

n ro

les

Ded

icat

ed o

ffice

rs

•w

ith s

tate

wid

e re

spon

sibi

litie

s

Mig

rant

Hea

lthCo

mpr

ehen

sive

, •

mul

tidis

cipl

inar

y fre

e sc

reen

ing

prog

ram

pr

ovid

ed to

new

ly

arriv

ing

refu

gees

(a

ttend

ance

is v

olun

tary

), in

clud

ing:

Prov

isio

n of

man

agem

ent

•pl

an &

refe

rral

to

com

mun

ity n

ursi

ng fo

r fo

llow

upRe

ferr

al to

spe

cial

ty

•cl

inic

s as

requ

ired

A p p e n d i c e s

72

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Dru

g an

d Al

coho

l Se

rvic

es -

Prev

entio

n

Info

rmat

ion

serv

ices

; •

the

Alco

hol a

nd D

rug

Info

rmat

ion

Serv

ice

(AD

IS) a

nd th

e Pa

rent

D

rug

Info

rmat

ion

Serv

ice

(PD

IS).

Loca

l Dru

g Ac

tion

•G

roup

s

As fo

r lev

el 1

plu

sLo

cal p

opul

atio

n he

alth

•

and

com

mun

ity d

rug

serv

ices

pro

vide

alc

ohol

an

d dr

ug p

reve

ntio

n in

itiat

ives

Ta

rget

ed s

ocia

l •

mar

ketin

g ca

mpa

ign

web

site

sSc

hool

dru

g ed

ucat

ion

•

As fo

r lev

el 2

plu

s:Co

mm

unity

•

deve

lopm

ent

- eng

agem

ent,

com

mun

ity a

ctio

n,

capa

city

dev

elop

men

t an

d ad

voca

cy In

terv

entio

n re

late

d •

part

ners

hips

with

lo

cal g

over

nmen

t, co

mm

unity

or

gani

satio

ns,

wor

kpla

ces,

sch

ools

on

polic

y/pr

ogra

ms

As fo

r Lev

el 3

plu

s:Pr

even

tion

Offi

cers

•Lo

cal a

rea

/com

mun

ity

•he

alth

pro

mot

ion

prog

ram

s/in

itiat

ives

En

viro

nmen

tal

•in

itiat

ives

(saf

e,

supp

ortiv

e se

tting

s)

As fo

r lev

el 4

plu

s:Co

mpr

ehen

sive

•

Prev

entio

n se

rvic

es

incl

udin

g re

gion

al a

lcoh

ol

man

agem

ent s

trat

egie

s.Ev

iden

ce b

ased

regi

on

•w

ide

prog

ram

s/in

itiat

ives

Targ

eted

initi

ativ

es fo

r •

spec

ial n

eeds

gro

ups

(eg

men

tal h

ealth

)Pa

rtne

rshi

ps w

ith lo

cal

•go

vern

men

t ot

her

gove

rnm

ent a

genc

ies

and

com

mun

ity o

rgan

isat

ions

W

orkf

orce

cap

acity

•

build

ing

Spon

sors

hip

prog

ram

s •

rela

ted

to c

ampa

ign

mes

sage

s

As fo

r lev

el 5

plu

s:D

edic

ated

offi

cers

•

with

sta

tew

ide

resp

onsi

bilit

ies

Stat

ewid

e re

sear

ch,

•pl

anni

ng, p

olic

y,

reso

urce

allo

catio

n an

d co

ordi

natio

n ro

leD

evel

opm

ent,

•im

plem

enta

tion

and

eval

uatio

n of

soc

ial

mar

ketin

g pr

even

tion

cam

paig

ns a

nd

prog

ram

s Li

quor

lice

nsin

g •

mon

itorin

g an

d to

re

duce

the

avai

labi

lity

of a

lcoh

ol in

hig

h ris

k co

mm

uniti

es.

Part

ners

hips

with

oth

er

•go

vt a

genc

ies,

indu

stry

, N

GO

sSt

atew

ide

•in

ters

ecto

ral w

ork

to

deve

lop

supp

ortiv

e en

viro

nmen

ts a

nd

rela

ted

polic

y


79


73

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Dru

g an

d Al

coho

l Se

rvic

es –

Trea

tmen

t and

su

ppor

t

No

spec

ialis

t alc

ohol

•

and

drug

pro

fess

iona

ls

avai

labl

e on

site

.In

form

atio

n, ri

sk

•as

sess

men

t and

re

ferr

al is

pro

vide

d by

co

mm

unity

hea

lth s

taff

and

GPs

.In

form

atio

n,

•co

unse

lling

and

refe

rral

ar

e pr

ovid

ed th

roug

h th

e Al

coho

l and

Dru

g In

form

atio

n Se

rvic

e (A

DIS

), a

stat

e-w

ide

24

hour

tele

phon

e lin

e.

Supp

ort f

or h

ealth

•

via

the

Dru

g an

d Al

coho

l Offi

ce’s

Clin

ical

Ad

viso

ry S

ervi

ce.

Sob

erin

g up

Cen

tres

•m

ay b

e av

aila

ble

for t

he

safe

car

e of

per

sons

fo

und

into

xica

ted

in

publ

ic.

Lim

ited

alco

hol

•an

d dr

ug li

aiso

n in

em

erge

ncy

depa

rtm

ents

w

ith li

nks

to a

lcoh

ol

and

drug

spe

cial

ist

serv

ices

As fo

r Lev

el 1

plu

s:As

sess

men

t, br

ief

•in

terv

entio

ns fo

r al

coho

l, ca

nnab

is a

nd

othe

r dru

gsPh

arm

acot

hera

py fo

r •

opio

id d

epen

denc

e /

treat

men

t pro

vide

d by

tr

aine

d an

d ac

cred

ited

GPs

and

med

ical

of

ficer

s.Li

mite

d on

site

•

outp

atie

nt a

lcoh

ol a

nd

drug

ser

vice

s in

som

e re

mot

e ar

eas,

vis

iting

al

coho

l and

dru

g pr

ofes

sion

als

avai

labl

e.

Cons

ulta

tion

liais

on

•se

rvic

es a

re p

rovi

ded

via

tele

phon

e an

d m

ay

also

be

avai

labl

e by

vi

deo

conf

eren

cing

. Ca

ll ba

ck s

ervi

ce

•fo

r peo

ple

quitt

ing

smok

ing

and

refe

rral

fro

m G

Ps fo

r the

Q

uitli

ne a

nd fo

r oth

er

drug

s.

Asse

ssm

ent a

nd

•re

ferr

al fo

r the

div

ersi

on

of o

ffend

ers

into

ed

ucat

ion

and

treat

men

tLi

mite

d ou

treac

h •

coun

selli

ng fo

r you

ng

peop

le a

nd a

dults

en

gage

d w

ith o

ther

se

rvic

es p

rovi

ded

by

dedi

cate

d al

coho

l and

dr

ug s

ervi

ces

As fo

r Lev

el 2

plu

s:Lo

cal a

lcoh

ol a

nd

•dr

ug p

rofe

ssio

nals

are

av

aila

ble

on s

ite d

urin

g bu

sine

ss h

ours

. Sp

ecia

list a

sses

smen

t •

and

treat

men

tCo

unse

lling

and

•

supp

ort f

or fa

mili

es

and

sign

ifica

nt o

ther

s af

fect

ed b

y dr

ug u

se.

Alco

hol a

nd d

rug

•re

side

ntia

l reh

abili

tatio

n se

rvic

es m

ay b

e av

aila

ble

Lim

ited

alco

hol a

nd

•dr

ug s

ervi

ces

in

Abor

igin

al c

omm

unity

co

ntro

lled

serv

ices

.So

me

hosp

ital b

ased

•

deto

xific

atio

n se

rvic

es

are

avai

labl

e.Fo

rmal

link

ages

at

•w

ith c

hild

pro

tect

ion

and

men

tal h

ealth

for

coor

dina

ted

serv

ices

, re

ferr

al a

nd c

ase

man

agem

ent.

As fo

r Lev

el 3

plu

s:Li

mite

d co

mpr

ehen

sive

•

mul

tidis

cipl

inar

y al

coho

l and

dru

g te

ams

avai

labl

e on

site

. O

utpa

tient

/hom

e ba

sed

•w

ithdr

awal

sup

port

se

rvic

es.

Acce

ss to

ser

vice

s fo

r •

co-o

ccur

ring

men

tal

heal

th a

nd a

lcoh

ol a

nd

drug

pro

blem

sLi

mite

d ac

cess

to

•in

patie

nt b

eds

and

reha

bilit

atio

n se

rvic

es.

As fo

r Lev

el 4

plu

s:Sp

ecia

list a

ddic

tion

•m

edic

ine

pro

fess

iona

ls

on s

ite a

nd c

linic

al

psyc

holo

gist

and

ps

ychi

atric

ser

vice

s Cl

inic

al re

sear

ch

•an

d pr

ofes

sion

al

deve

lopm

ent.

Acce

ss to

inpa

tient

bed

s •

and

serv

ices

Acce

ss to

inpa

tient

bed

s •

and

serv

ices

(ATS

I).

Inpa

tient

with

draw

al

•su

ppor

t ser

vice

s (n

on-

med

ical

)Vo

lunt

eer a

ddic

tion

•co

unse

llor t

rain

ing

prog

ram

.

As fo

r Lev

el 5

plu

s:Sp

ecia

list s

tate

wid

e •

serv

ices

pro

vide

d fo

r co

mpl

ex c

ondi

tions

. St

atew

ide

rese

arch

, •

plan

ning

, pol

icy,

re

sour

ce a

lloca

tion

and

coor

dina

tion

role

Wor

kfor

ce c

apac

ity

•bu

ildin

g (t

rain

ing,

co

nfer

ence

s, re

gist

ered

tr

aini

ng o

rgan

isat

ion)

Prev

alen

ce s

urve

ys a

nd

•ep

idem

iolo

gy

Clin

ical

Sup

port

and

•

trai

ning

pro

vide

d fo

r com

mun

ity

phar

mac

othe

rapy

pr

ogra

ms

Spec

ialis

t alc

ohol

and

•

drug

mat

erni

ty s

ervi

ceIn

patie

nt d

etox

ifica

tion

•se

rvic

es w

ith m

edic

al/

nurs

ing

supp

ort

Spec

ialis

t and

•

inte

grat

ed s

ervi

ces

avai

labl

e fo

r you

ng

peop

le.

A p p e n d i c e s

74

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Prim

ary

Care

Ser

vice

s

GP

base

d

Com

mun

ity

•nu

rsin

g

Visi

ting

GP

or G

P by

•

phon

eSo

me

visi

ting

allie

d •

heal

thO

ther

ser

vice

s su

ch a

s •

child

hea

lth a

nd p

ost

nata

l car

e by

RN

As fo

r lev

el 1

plu

s:Re

side

nt G

Ps•

Som

e vi

sitin

g Ty

pe I

•sp

ecia

lists

(out

patie

nts)

Resi

dent

or v

isiti

ng

•ph

ysio

ther

apy

Oth

er v

isiti

ng a

llied

•

heal

thO

ther

ser

vice

s by

RN

/•

CHN

(res

iden

t)

As fo

r lev

el 3

plu

s:Re

side

nt G

Ps•

Mos

t vis

iting

Typ

e I

•su

b-sp

ecia

lists

Maj

ority

alli

ed h

ealth

•

avai

labl

eRe

side

nt c

omm

unity

•

nurs

ing

spec

ialis

t

As fo

r lev

el 4

plu

s:Re

side

nt G

Ps•

Resi

dent

som

e/al

l Typ

e I

•su

b-sp

ecia

lists

Visi

ting

Type

II s

ub-

•sp

ecia

lists

Full

rang

e of

alli

ed h

ealth

•Ex

tens

ive

com

mun

ity

•nu

rsin

g se

rvic

e

As fo

r lev

el 5

plu

s:Re

side

nt G

Ps•

Full

rang

e of

Typ

e I a

nd

•II

sub-

spec

ialis

tsFu

ll ra

nge

of a

llied

•

heal

thEx

tens

ive

com

mun

ity

•nu

rsin

g se

rvic

eRe

sear

ch a

nd te

achi

ng

•ro

le

Com

mun

ity

Mid

wife

ryCa

selo

adin

g m

idw

ifery

•

with

in m

ater

nity

gro

up

prac

tice

Ded

icat

ed o

ffice

rs

•w

ith s

tate

wid

e re

spon

sibi

litie

sD

evel

opm

ent,

•im

plem

enta

tion

and

eval

uatio

n of

clin

ical

go

vern

ance

, pol

icy,

pr

oced

ures

and

gu

idel

ines

for t

he

prog

ram

Targ

eted

mar

ketin

g of

•

prog

ram

Ambu

lato

ry C

are

Serv

ices

Acut

e Su

bstit

utio

nG

P/or

prim

ary

care

•

prov

ider

As

for l

evel

1 p

lus:

GP

and

spec

ialis

t •

outp

atie

nt c

linic

Li

mite

d ac

cess

to

•ge

nera

list d

omic

iliar

y nu

rsin

g

As fo

r lev

el 2

plu

s:Vi

sitin

g sp

ecia

list

•Sp

ecifi

c pr

ogra

ms

for

•am

bula

tory

sur

gery

, H

ITH

, RIT

HSo

me

early

dis

char

ge

•se

rvic

esAc

cess

to g

ener

alis

t •

dom

icili

ary

nurs

ing

and

som

e al

lied

heal

th

As fo

r lev

el 3

plu

s:In

crea

sing

rang

e an

d •

com

plex

ity o

f acu

te

subs

titut

ion

prog

ram

sG

ood

acce

ss to

•

gene

ralis

t alli

ed h

ealth

/nu

rsin

g st

aff

Acce

ss to

hos

pita

l •

med

ical

/sur

gica

l tea

mVi

sitin

g m

edic

al

•sp

ecia

list/g

ener

al

surg

eon

As fo

r lev

el 4

plu

s:Sp

ecia

list m

edic

al/

•nu

rsin

g/ a

llied

hea

lth

staf

fIn

crea

sed

rang

e an

d •

com

plex

ityEn

hanc

ed d

iagn

ostic

s•

Teac

hing

and

trai

ning

•

role

As fo

r lev

el 5

plu

s:Re

sear

ch ro

le•

Fully

inte

grat

ed

•am

bula

tory

car

e se

rvic

esFu

lly in

tegr

ated

•

diag

nost

ics

Incl

udes

regi

onal

•

suba

cute

cen

tre/s

ervi

ceRa

nge

of s

ub-

•sp

ecia

lties


81


75

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Hos

pita

l Av

oida

nce

GP/

or p

rimar

y ca

re

•pr

ovid

erAs

for l

evel

1 p

lus:

GP

and

spec

ialis

t •

outp

atie

nt c

linic

Li

mite

d ac

cess

to

•ge

nera

list d

omic

iliar

y nu

rsin

g

As fo

r lev

el 2

plu

s:Vi

sitin

g sp

ecia

list

•So

me

chro

nic

dise

ase

•pr

ogra

ms

Acce

ss to

gen

eral

ist

•do

mic

iliar

y nu

rsin

g an

d so

me

allie

d he

alth

As fo

r lev

el 3

plu

s:In

crea

sing

rang

e an

d •

com

plex

ity o

f hos

pita

l av

oida

nce/

chro

nic

dise

ase

prog

ram

sVi

sitin

g m

edic

al

•sp

ecia

list

Goo

d ac

cess

to

•ge

nera

list a

llied

hea

lth/

nurs

ing

staf

f

As fo

r lev

el 4

plu

s:Sp

ecia

list m

edic

al/

•nu

rsin

g/ a

llied

hea

lth

staf

fIn

crea

sed

rang

e an

d •

com

plex

ityEn

hanc

ed d

iagn

ostic

s•

Teac

hing

and

trai

ning

•

role

Av

oida

nce

serv

ices

eg:

•

Resi

dent

ial C

are

Line

As fo

r lev

el 5

plu

s:Re

sear

ch ro

le•

Fully

inte

grat

ed

•am

bula

tory

car

e se

rvic

esFu

lly in

tegr

ated

•

diag

nost

ics

Incl

udes

regi

onal

•

suba

cute

cen

tre/s

ervi

ce

Aged

Car

eG

P/or

prim

ary

care

•

prov

ider

As fo

r lev

el 1

plu

s:G

P an

d sp

ecia

list

•ou

tpat

ient

clin

ic a

t di

scha

rge

hosp

ital

Acce

ss to

gen

eral

ist

•al

lied

heal

th a

nd s

ome

dom

icili

ary

nurs

ing

As fo

r lev

el 2

plu

s:Vi

sitin

g sp

ecia

list

•So

me

hosp

ital

•av

oida

nce/

hosp

ital

subs

titut

ion

Som

e ea

rly d

isch

arge

•

serv

ices

As fo

r lev

el 3

plu

s:Li

nks

with

HAC

C•

Incr

easi

ng ra

nge

and

•co

mpl

exity

of h

ospi

tal

avoi

danc

e/su

bstit

utio

n/ea

rly d

isch

arge

Chro

nic

dise

ase

•pr

ogra

ms

Visi

ting

med

ical

•

spec

ialis

tG

ood

acce

ss to

•

gene

ralis

t alli

ed h

ealth

/nu

rsin

g st

aff

As fo

r lev

el 4

plu

s:Sp

ecia

list m

edic

al/

•nu

rsin

g/ a

llied

hea

lth

staf

fIn

crea

sed

rang

e an

d •

com

plex

ityH

ACC

inte

grat

ion

•En

hanc

ed d

iagn

ostic

s•

Teac

hing

and

trai

ning

•

role

As fo

r lev

el 5

plu

s:Re

sear

ch ro

le•

Fully

inte

grat

ed

•am

bula

tory

car

e se

rvic

esFu

lly in

tegr

ated

•

diag

nost

ics

Incl

udes

regi

onal

•

suba

cute

cen

tre/s

ervi

ce

Out

patie

nts

GP/

or p

rimar

y ca

re

•pr

ovid

erAs

for l

evel

1 p

lus:

GP

and

spec

ialis

t •

outp

atie

nt c

linic

at

disc

harg

e ho

spita

lLi

mite

d ac

cess

to

•ge

nera

list d

omic

iliar

y nu

rsin

g

As fo

r lev

el 2

plu

s:Vi

sitin

g sp

ecia

list

•Ac

cess

to g

ener

alis

t •

dom

icili

ary

nurs

ing

and

som

e al

lied

heal

thPo

st a

cute

car

e –

may

•

be p

rovi

ded

thro

ugh

hosp

ital o

r com

mun

ity

serv

ices

Som

e ch

roni

c di

seas

e •

prog

ram

sSo

me

reha

bilit

atio

n •

prog

ram

s

As fo

r lev

el 3

plu

s:In

crea

sing

rang

e an

d •

com

plex

ity p

rogr

ams

Visi

ting

med

ical

•

spec

ialis

tG

ood

acce

ss to

•

gene

ralis

t alli

ed h

ealth

/nu

rsin

g st

aff

As fo

r lev

el 4

plu

s:Sp

ecia

list m

edic

al/

•nu

rsin

g/ a

llied

hea

lth

staf

fIn

crea

sed

rang

e an

d •

com

plex

ityEn

hanc

ed d

iagn

ostic

s•

Teac

hing

and

trai

ning

•

role

As fo

r lev

el 5

plu

s:Re

sear

ch ro

le•

Fully

inte

grat

ed

•am

bula

tory

car

e se

rvic

esFu

lly in

tegr

ated

•

diag

nost

ics

Incl

udes

regi

onal

•

suba

cute

cen

tre/s

ervi

ce

A p p e n d i c e s

76

Leve

l 1Le

vel 2

Leve

l 3Le

vel 4

Leve

l 5Le

vel 6

Den

tal S

ervi

ces

Scho

ol d

enta

l •

serv

ices

Adul

t den

tal

•se

rvic

esSp

ecia

lty d

enta

l •

serv

ices

Emer

genc

y an

d ge

nera

l •

oral

car

e to

enr

olle

d sc

hool

chi

ldre

nM

obile

or fi

xed

site

s•

Prov

ided

by

scho

ol

•de

ntal

ther

apis

ts a

nd

dent

ists

Prov

ides

und

ergr

adua

te

•cl

inic

al tr

aini

ng in

Ora

l H

ealth

dis

cipl

ines

Min

or re

sear

ch ro

le•

Emer

genc

y an

d ge

nera

l •

oral

hea

lth c

are

to

elig

ible

pat

ient

sM

obile

or fi

xed

site

•Ca

re p

rovi

ded

by

•de

ntis

ts, d

enta

l th

erap

ists

, den

tal

hygi

enis

ts o

r den

tal

pros

thet

ists

Prov

ides

und

ergr

adua

te

•cl

inic

al tr

aini

ng in

Ora

l H

ealth

dis

cipl

ines

Min

or re

sear

ch ro

le•

Prov

ides

gen

eral

and

•

som

e sp

ecia

list d

enta

l se

rvic

es to

elig

ible

pa

tient

sFi

xed

site

•Pr

ovid

es u

nder

grad

uate

•

clin

ical

trai

ning

in O

ral

Hea

lth d

isci

plin

esRe

sear

ch ro

le•

Prov

ides

gen

eral

and

•

som

e sp

ecia

list d

enta

l se

rvic

es to

elig

ible

pa

tient

sFi

xed

site

•Ca

re p

rovi

ded

by

•re

gist

ered

den

tists

Prov

ides

a w

ide

scop

e •

of u

nder

grad

uate

and

po

stgr

adua

te tr

aini

ng in

O

ral H

ealth

dis

cipl

ines

Subs

tant

ial r

esea

rch

•ro

le (o

r res

earc

h tr

aini

ng ro

le)

Spec

ialis

t tre

atm

ent

•in

spe

cific

ora

l hea

lth

disc

iplin

es a

vaila

ble

to

sele

cted

pat

ient

sFi

xed

site

•Ca

re p

rovi

ded

by

•po

stgr

adua

te s

tude

nts

or

regi

ster

ed s

peci

alis

tsSu

bsta

ntia

l res

earc

h ro

le

•(o

r res

earc

h tr

aini

ng ro

le)

Gen

eral

ana

esth

etic

for

•da

y su

rger

y or

long

er

adm

issi

on if

ava

ilabl

eFi

xed

site

•Ca

re p

rovi

ded

by

•po

stgr

adua

te s

tude

nts

or re

gist

ered

spe

cial

ists

Subs

tant

ial r

esea

rch

•ro

le (o

r res

earc

h tr

aini

ng ro

le)

Child

and

Ado

lesc

ents

Men

tal H

ealth

, Ad

ult M

enta

l Hea

lth,

Old

er P

erso

ns M

enta

l Hea

lth S

ervi

ces

Com

mun

ity

men

tal h

ealth

se

rvic

es

No

spec

ialis

t men

tal

•he

alth

pro

fess

iona

ls

avai

labl

e on

site

.As

sess

men

t/tre

atm

ent

•fo

r com

mon

con

ditio

ns

is p

rovi

ded

by

com

mun

ity h

ealth

sta

ff an

d G

Ps

Emer

genc

y se

rvic

es

•ar

e av

aila

ble

from

loca

l ho

spita

ls/ n

ursi

ng

post

s an

d m

enta

l hea

lth

emer

genc

y re

spon

se

line

(24

hour

tele

phon

e lin

e)

As fo

r Lev

el 1

plu

s:Li

mite

d on

site

men

tal

•he

alth

pro

fess

iona

ls,

and

visi

ting

men

tal

heal

th p

rofe

ssio

nals

av

aila

ble.

Sp

ecia

list a

sses

smen

t •

and

treat

men

t is

prov

ided

, plu

s pr

ovis

ion

of a

dvic

e to

fam

ilies

, co

mm

unity

and

hea

lth

prac

titio

ners

. Co

nsul

tatio

n lia

ison

•

serv

ices

are

pro

vide

d

As fo

r Lev

el 2

plu

s:Lo

cal m

enta

l hea

lth

•pr

ofes

sion

als

are

avai

labl

e on

site

dur

ing

busi

ness

hou

rs.

Visi

ting

spec

ialis

ts a

re

•av

aila

ble,

and

may

als

o be

ava

ilabl

e by

vid

eo

conf

eren

cing

.

As fo

r Lev

el 3

plu

s:Co

mpr

ehen

sive

•

mul

tidis

cipl

inar

y m

enta

l he

alth

team

ava

ilabl

e on

site

. Li

mite

d sp

ecia

lists

•

avai

labl

e on

site

in

clud

ing

child

/ad

oles

cent

and

/or

psyc

hoge

riatr

ic c

are

spec

ialis

ts.

Lim

ited

afte

r hou

rs

•se

rvic

es m

ay b

e av

aila

ble.

Se

rvic

es m

ay p

rovi

de

•ed

ucat

ion

and

trai

ning

pr

ogra

ms

and

othe

r se

rvic

es, v

ia v

ideo

co

nfer

enci

ng a

nd

phon

e, fo

r low

er-le

vel

serv

ices

.

As fo

r Lev

el 4

plu

s:Sp

ecia

list m

enta

l •

heal

th p

rofe

ssio

nals

on

site

incl

udin

g ch

ild/

adol

esce

nt a

nd/o

r ps

ycho

geria

tric

car

e sp

ecia

lists

. Se

rvic

es a

re a

vaila

ble

•24

/7 w

hen

requ

ired.

U

nder

take

s a

limite

d •

rang

e of

teac

hing

and

re

sear

ch fu

nctio

ns.

As fo

r Lev

el 5

plu

s:Sp

ecia

list s

tate

wid

e •

serv

ices

pro

vide

d fo

r co

mpl

ex c

ondi

tions

.U

nder

take

s a

rang

e of

•

teac

hing

and

rese

arch

fu

nctio

ns.

Prov

ides

ser

vice

s vi

a •

vide

o co

nfer

enci

ng fo

r lo

wer

-leve

l ser

vice

s.


83


WA Health Clinical Services Framework 2010-2020 · The WA Health Clinical Services Framework...

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