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Northern Sydney Local Health District Strategic Plan 2022 - 2027
Exceptional Care, Leaders in Research, Partners in Wellbeing
Acknowledgement of Country
Northern Sydney Local Health District acknowledges the traditional custodians of the lands on which our health services are located, the Guringai and Dharug peoples, and we honour and pay our respects to their ancestors. We acknowledge and pay our respects to all Aboriginal and Torres Strait Islander peoples and to Elders past and present. We acknowledge that past, current and future Aboriginal and Torres Strait Islander peoples are the continuing custodians of this country upon which we live, work and meet and that it is from their blood, courage, pride and dignity that we are able to continue to live, work and meet on this ancient and sacred country.
Waraba Wandabaa (Turtle Spirit) The Waraba (turtle) was painted by Adjunct Associate Professor Peter Shine, Director Aboriginal and Torres Strait Islander Health, Northern Sydney Local Health District.
Muru Dali Gili Gili (path to shine) The Muru Dali Gili Gili background artwork was created by the Northern Sydney Local Health District Aboriginal and Torres Strait Islander Employee Network, Muru Dali Gili (meaning path to shine). Through painting, employees have come together to tell their story of connectedness to the community, the District and to each other.
All artwork has been used with permission.
Contents
4
Statement of Commitment to Aboriginal and Torres Strait Islander Families and Communities
25 Strategic Outcomes
56 Implementation of the Strategic Plan
27 Patients and carers are our partners in their healthcare
58 Planning Framework
59 Strategic Planning Process
6
Foreword
60 CORE Values
8
Introduction
31 Safe, high quality connected care
62 NSLHD in Numbers
10 Strategic Outcomes
11
About Northern Sydney Local Health District
37 Keeping people healthy and well
12 Our District
13 Our Health Ecosystem
43 Our staff are engaged and well supported
14 Our Population
19 NSLHD in 2027
47 Research, innovation and digital advances inform and improve the delivery of patient care 51 Our services are sustainable, efficient and committed to planetary health
22 Challenges and Opportunities
24 Strategy Map
3
NSLHD Strategic Plan 2022-2027
Statement of Commitment to
Aboriginal and Torres Strait Islander Families and Communities
4 NSLHD Strategic Plan 2022-2027
Our commitment will be demonstrated through: » Working with our hospitals, services and external partners to ensure Aboriginal and Torres Strait Islander people have equitable access to health services » Measuring, monitoring and reporting on our progress against agreed commitments » Recognising that specific measures are needed to improve Aboriginal and Torres Strait Islander people’s access to health services » Recognising that equity of access to health services is dependent upon Aboriginal and Torres Strait Islander people being actively involved in the design and delivery of those services » Recognising that the social determinants of Aboriginal and Torres Strait Islander health include education, employment, housing, environmental factors, social and cultural issues, and racism » Working together to close the health gap between Aboriginal and Torres Strait Islander people and non-Aboriginal and Torres Strait Islander people.
Northern Sydney Local Health District acknowledges the traditional custodians of the Northern Sydney region, the Guringai and Dharug peoples. Their spirit can be found across the region and we honour the memory of their ancestors and Elders past and present. Aboriginal and Torres Strait Islander people are a resilient community who have a deep connection to family, culture and country. Intergenerational trauma caused by colonisation, stolen generations, racism and unconscious bias have impacted the community and significant health disparities exist between Aboriginal and non-Aboriginal people. The NSLHD Strategic Plan 2022-2027 builds on our commitment to improve the health, social and emotional wellbeing of Aboriginal and Torres Strait Islander people living in and accessing health services in NSLHD.
NSLHD strives to provide a holistic approach to services offered to the Aboriginal and Torres Strait Islander people. Partnering with Aboriginal and Torres Strait Islander people in the design and delivery of health services will remain our priority.
5
NSLHD Strategic Plan 2022-2027
Foreword
Every day, staff in NSLHD aim to deliver the very best, safe, effective, and person-centred care for our community.
6 NSLHD Strategic Plan 2022-2027
F O R EWO R D (continued)
The NSLHD Strategic Plan 2022-2027 provides a framework for how we will deliver care over the next five years. Our Strategic Plan builds on our existing strengths, outlines our key priorities and defines our future goals and ambitions. Our Strategic Plan aligns closely with the NSW Health Future Health: Strategic Framework 2022- 2032. The key priority for both the Future Health Strategic Framework and NSLHD Strategic Plan is to deliver personalised healthcare and outcomes that matter most to our patients, carers, consumers and community. Over 800 staff, patients, carers, members of the local community, clinical leaders, and key partners have been consulted in the development of the NSLHD Strategic Plan. Their insights, experiences, individual perspectives and feedback have been incredibly important. We thank them for their contribution in helping to ensure we are well placed to continue to deliver high quality, person-centred care now and in the years ahead. Our Strategic Plan focuses on six key Strategic Outcomes: 1. Patients and carers are our partners in their healthcare 2. Safe, high quality connected care 3. Keeping people healthy and well 4. Our staff are engaged and well supported 5. Research, innovation and digital advances inform and improve the delivery of patient care 6. Our services are sustainable, efficient and committed to planetary health Our progress against these Strategic Outcomes will be supported by strong governance, transparent reporting frameworks and our enabling plans. NSLHD will continue to promote the NSW Health CORE Values of Collaboration, Openness, Respect and Empowerment and ensure these values are embedded in everything that we do. As part of our new Strategic Plan, we are pleased to launch our new vision: Exceptional Care, Leaders in Research, Partners in Wellbeing . Our vision, together with our Strategic Plan 2022-2027, will guide the future of care in NSLHD. We look forward to working alongside each of you as we continue to care for our patients, our community and each other.
Trevor Danos AM FTSE Board Chair, NSLHD
Deb Willcox Chief Executive, NSLHD
7
NSLHD Strategic Plan 2022-2027
Introduction NSLHD is one of the leading health services in Australia providing high quality healthcare to a population of almost one million people. The NSLHD Strategic Plan 2022-2027 describes our objectives to ensure that as a renowned healthcare organisation, we continue to provide high quality person-centred care, in the right place, at the right time.
Note: The NSLHD Strategic Plan 2022-2027 has been developed in close alignment with the NSW Health Future Health: Strategic Framework 2022-2032. The Strategic Outcomes identified in the NSLHD Strategic Plan reflect the Strategic Objectives of the NSW Health Future Health Strategic Framework. NSLHD looks forward to working with the Ministry of Health to achieve the priorities of the whole NSW Health system over the coming years.
8 NSLHD Strategic Plan 2022-2027
The NORTH Foundation, our philanthropic and fundraising partner, provides valuable support for our hospitals and services as well as providing grants for innovative health research to inform the delivery of exceptional patient care and improve community wellbeing. Planetary health and climate change are of major concern to our staff and our community. We must identify ways we can continue to provide high quality care in line with the principles of planetary health. NSLHD has an ambitious target of Net Zero carbon emissions by 2035. We will continue to develop a culture that engages and empowers our people, prioritises diversity, inclusion and belonging, and ensures all staff members are physically and psychologically safe, and importantly can be themselves wherever they work in NSLHD. Over the next five years, we will continue to build on our learnings and achievements by encouraging innovation, supporting the wellbeing and development of our staff, and designing models of care with our community that will improve patient and carer experience.
NSLHD is a proud partner of Sydney Health Partners (SHP), an Advanced Health Research and Translation Centre recognised by the National Health and Medical Research Council. NSLHD and the University of Sydney have a long history of collaboration in teaching, education and research. In addition, we are joint venture partners in the governance of the Kolling Institute and together we work to translate scientific breakthroughs into clinical practice, directly improving patient care and the health of our community. The University of Sydney Northern Clinical School educates the next generation of clinicians within clinical teaching facilities at Royal North Shore, Hornsby Ku-ring-gai, Ryde and Macquarie Hospitals. NSLHD also partners with Macquarie University providing clinical placements for students at Royal North Shore Hospital. NSLHD is proud to partner with a number of other tertiary education providers including the University of Technology Sydney, the University of Tasmania, the University of Notre Dame, Australian Catholic University and TAFE NSW.
The Strategic Plan has been developed to build on our accomplishments over the last five years. A comprehensive analysis of our current state was undertaken to understand and capture the strategic issues, challenges and priorities across our hospitals, services and clinical directorates. The COVID-19 pandemic has shown us how in the face of significant pressures, NSLHD is able to remain an incredibly flexible and resilient organisation. Our highest priority will continue to be the delivery of safe, high quality healthcare. Alongside our service delivery partners, we will continue to improve the way in which we deliver this care. Advancing our technological and digital health capabilities will have a renewed focus to enable the delivery of person-centred care, support our staff and improve the patient and carer experience. Delivering our Digital Strategy 2021-2026 will be dependent on our digital infrastructure and management of privacy and cybersecurity capabilities. Health research will remain at the core of everything we do and we will maintain our reputation as a research-focused organisation.
9
NSLHD Strategic Plan 2022-2027
Strategic Outcomes
Patients and carers are our partners in their healthcare
Safe, high quality connected care Safe, high quality, reliable healthcare is delivered in a personalised way across all settings.
Keeping people healthy and well Investment is made in keeping people healthy to promote wellness and address health inequity in our community.
Patients and carers are empowered to make informed decisions about their care, goals and health outcomes.
Our staff are engaged and well supported
Research, innovation and digital advances inform and improve
Our services are sustainable, efficient and committed to planetary health
Staff are engaged and well supported to deliver safe, reliable person-centred healthcare and equipped to respond to a changing healthcare environment.
the delivery of patient care The care we deliver is digitally enabled and informed by research and data.
We use a value-based approach to optimise use of resources with a focus on embedding both planetary health and financially sustainable principles in everything we do.
10 NSLHD Strategic Plan 2022-2027
About Northern Sydney Local Health District
NSLHD is one of 15 Local Health Districts in New South Wales. Covering an area of 900km 2 it encompasses nine local government areas including Hornsby, Ku-ring-gai, Northern Beaches, Lane Cove, Mosman, North Sydney, Willoughby, Ryde and Hunters Hill.
Within our hospitals and services, clinical networks play an important role in establishing and overseeing standards of care, providing leadership with respect to research and innovation, and providing advice on service development, resource allocation, workforce requirements, and configuration of services. Our clinical networks include: » Maternal, Neonatal and Women’s Health » Children and Young People » Acute and Critical Care Medicine » Chronic and Complex Medicine » Surgery and Anaesthesia (including Cardiothoracic and Vascular Health) » Musculoskeletal Health, Integumentary and Trauma » Neurosciences » Cancer
There are four geographic health sectors within NSLHD: Hornsby Ku-ring-gai, Northern Beaches, Lower North Shore and Ryde Hunters Hill. Each sector has an acute hospital with an emergency department, along with a broad range of other acute, sub-acute and community health services. Clinical services in NSLHD are organised across four acute hospitals Royal North Shore Hospital, Hornsby Ku-ring-gai Hospital, Ryde Hospital and Northern Beaches Hospital, one sub-acute hospital at Mona Vale and an Adolescent and Young Adult Hospice currently under development at Manly. There are two clinical directorates in NSLHD; Mental Health Drug and Alcohol, which includes Macquarie Hospital; and Primary and Community Health. Clinical and other support services include Medical Imaging, Pharmacy and Allied Health, Aboriginal and Torres Strait Islander Health, and Carer Support.
Under the leadership of the Ministry of Health, healthcare in NSLHD is well supported by a network of specialist health organisations including NSW Ambulance, Health Infrastructure NSW, HealthShare NSW, NSW Health Pathology and eHealth NSW, and pillar agencies including the Agency for Clinical Innovation, the Clinical Excellence Commission, the Bureau of Health Information, the Health Education and Training Institute and the Cancer Institute NSW. Additional services in NSLHD are provided through arrangements with Affiliated Health Organisations including HammondCare (sub- acute palliative care, ambulatory and home-based rehabilitation and older persons mental health services) and Royal Rehab (specialist brain and spinal injury rehabilitation).
» Supportive and Palliative Care » Rehabilitation and Aged Care.
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NSLHD Strategic Plan 2022-2027
Our District
NSLHD
Greater Sydney
Mona Vale Hospital
Hornsby Ku-ring-gai Hospital
Neringah Hospital
Northern Beaches Hospital
Northern Sydney Local Health District NSLHD Hospitals and Hospice Affiliated Health Organisations Public-private Partnership
Macquarie Hospital
Royal North Shore Hospital
Adolescent and Young Adult Hospice
Ryde Hospital
Royal Rehab
Greenwich Hospital
12 NSLHD Strategic Plan 2022-2027
Our Health Ecosystem
Our staff, community, and partners are critical to our success. We are well placed to maximise and leverage these partnerships to enhance the delivery of clinical services, foster high quality research, enable the development of new technologies and further embed research and teaching in all of our clinical services.
The NSLHD ‘health ecosystem’ includes a diverse range of private sector groups, primary and community services, research and education entities, and public organisations, which together, create a vibrant and innovative system of healthcare, education and research.
There is widespread collaboration between individual NSLHD departments and staff, and university health and non-health faculties, their staff and students. There is a deep commitment to continue these collaborations.
Private Hospitals (x41) and Day Procedure Centres (x20) including: • - Macquarie University • - Mater Sydney Hospital • - North Shore Private Hospital • - Sydney Adventist Hospital • - Ramsay Clinic Northside • Northern Beaches Hospital (public-private partnership) • Private Medical Specialists • • •
Public Hospitals and Service Directorates Hornsby Ku-ring-gai Hospital
• •
Mona Vale Hospital
• •
Northern Beaches Hospital (public private partnership)
Private Sector
• • • • • •
Royal North Shore Hospital
Ryde Hospital
Macquarie Hospital
Manly Adolescent and Young Adult Hospice
Mental Health Drug and Alcohol Primary and Community Health Affiliated Health Organisations Royal Rehab
• • •
Sydney North Health Network
• • • • • • • •
General Practice (298+ practices, 1,602 GPs)
Community Pharmacy Private Allied Health
• • • •
Home and residential aged care (9,083 places in 110 facilities) Non-Government Organisations (16 agreements with NSLHD) NSW and Federal Human Service Agencies including: - Australian Department of Health and Aged Care - NSW Department of Communities and Justice - NSW Department of Education - National Disability Insurance Agency Local Government (9 councils)
HammondCare
NSLHD Patients, Carers, Consumers and Community
• • •
- Greenwich Hospital - Neringah Hospital
Primary and Community Sector
•
Public Sector
NSW Health Pillars:
•
- Clinical Excellence Commission - Agency for Clinical Information - Bureau of Health Information - Health Education and Training Institute Cancer Institute NSW
•
• • • • • •
• • •
NORTH Foundation
• • • •
HealthShare NSW
Kolling Institute
eHealth NSW
Sydney Health Partners
•
NSW Ambulance
Universities and Colleges including: - The University of Sydney - Macquarie University - University of Tasmania - University of Technology Sydney - The University of Notre Dame - Australian Catholic University - Royal Colleges (medical) - NSW TAFE Industry Partners
NSW Health Infrastructure NSW Health Pathology
Research, Education and Industry Sectors
Neighbouring LHDs and Speciality Networks Central Coast, Sydney, Western Sydney, South Eastern Sydney • Sydney Children’s Hospitals Network • Justice Health and Forensic Mental Health Network •
•
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NSLHD Strategic Plan 2022-2027
Our Population
In 2022 there were an estimated 956,486 residents in NSLHD, representing 11.7 per cent of the NSW population: » 203,381 (21.3 per cent) were children under 18 years » 343,888 (36.0 per cent) were younger working aged (18-44 years) » 242,071 (25.3 per cent) were older working aged (45-64 years) » 117,251 (12.3 per cent) were retirement aged (65-79 years) » 49,895 (5.2 per cent) were elderly (80 years and older). Compared with NSW, NSLHD has a similar proportion of children (21.3 per cent compared with 21.7 per cent) and a higher proportion of elderly residents (5.2 per cent compared with 4.6 per cent). Across all of NSLHD sectors Hornsby Ku-ring-gai has both the highest proportion of children (24.0 per cent) and elderly residents (5.2 per cent).
14 NSLHD Strategic Plan 2022-2027
Health Status NSLHD residents compare favourably with the rest of NSW on most socioeconomic and health status indicators. There are however identifiable geographical areas and population sub-groups within NSLHD with higher health and social care needs and lower economic means. » Vulnerable population sub-groups include Aboriginal and Torres Strait Islander people; people from culturally and linguistically diverse (CALD) backgrounds; people who identify as lesbian, gay, bisexual, transgender and intersex population (LGBTQI+); people with mental illness; people who are homeless; and frail older people » Pockets of disadvantage within NSLHD are concentrated in Ryde, Hornsby, and Northern Beaches LGAs
By 2032 the population of NSLHD is expected to reach 1,023,462 residents (passing 1 million residents in 2029), representing an increase of 66,976 (7.0 per cent) residents at an annual growth rate of 0.7 per cent. The annual growth rate for NSW is expected to be approximately the same as NSLHD. The growth in NSLHD residents aged 80 years and older is expected to exceed 4 per cent per annum for the next 10 years. Between 2022 and 2032, Ryde-Hunters Hill is expected to be the fastest growing sector. Growth in this area (25.4 per cent) will be more than twice the rate for the rest of NSLHD (6.3 per cent) and faster than the NSW average (6.8 per cent). Ryde-Hunters Hill population growth is expected to be greater for all age groups but is strongest in children (0-17 years) where it will be the only NSLHD sector that will grow (5.9 per cent). NSLHD is a diverse population: » 4,266 Aboriginal people live in NSLHD, representing 0.5 per cent of the population » 30 per cent of residents speak a language
NSLHD residents have a longer life expectancy (men: 85 years, women: 88 years) compared to Greater Sydney (men: 83 years, women: 86 years) and NSW (men: 81 years, women: 85 years)
NSLHD residents have significantly lower standardised mortality ratios compared to the NSW average, for cancer, accidents, heart disease and respiratory conditions
43.1 per cent of NSLHD adults are overweight or obese (compared to 56.8 per cent in NSW)
Risky alcohol drinking: NSLHD 28.0 per cent and NSW 32.5 per cent (both NSLHD and NSW have trended upwards over last five years)
other than English at home of which 15 per cent report having limited or no proficiency in English. Top 5 languages other than English spoken by NSLHD residents are: – Mandarin – Cantonese
Tobacco smoking: NSLHD 6.4 per cent (down from 9 per cent in 2016) and NSW 12.0 per cent (downward trend)
NSLHD residents have, on average, greater access to both public and private health services with 132 FTE General Practitioners per 100,000 population (similar to NSW with 123 FTE per 100,000) and higher utilisation of private health insurance (compared to the rest of NSW)
– Korean – Spanish – Hindi.
1 in 8 people (equivalent to 120,000 NSLHD residents) are estimated to provide care to a family member, partner or friend, of which, 30,000 are providing intensive support.
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NSLHD Strategic Plan 2022-2027
Activity in 2020/21
226,205 Emergency Department presentations across 4 acute hospitals
47,522 adults over 70 years (21 per cent)
52,272 children under 16 years (23 per cent)
53,467 ambulance arrivals (24 per cent)
2,177 triage category 1 presentations (1 per cent); just over half of these patients are cared for at RNSH
105,688 semi-urgent or non-urgent (triage categories 4 and 5) presentations (47 per cent)
EMERGENCY DEPARTMENT ACTIVITY
59,991 admissions from ED (27 per cent)
25,289 adults aged over 70 years admitted from ED (53 per cent)
6,108 paediatric admissions from Emergency Department (12 per cent)
44,700 acute adult medical admissions 26,912 surgical admissions (adult and paediatric)
6,788 acute paediatric admissions (medical/surgical/other)
2,740 acute mental health admissions (adult and paediatric)
5,513 babies delivered
ADMITTED HOSPITAL ACTIVITY
72,954 mental health community contacts 332,523 adult allied health or specialist nurse interventions
410,007 medical outpatient consultations 24,772 dialysis treatments
56,365 registered nurse visits for babies in first year of life 34,755 oral health visits
52,849 breast screens
179,173 home nursing visits
NON-ADMITTED AND COMMUNITY HEALTH ACTIVITY
16 NSLHD Strategic Plan 2022-2027
ACTIVITY IN 2020/21 (continued)
TELEHEALTH
PRIVATE HEALTHCARE ACTIVITY
38,841 telehealth occasions of service (OOS) (up from 14,057 in 2019/20)
7,199 eMeds orders placed daily
5,467 peak concurrent eMR users
203,214 private hospital admissions (overnight and day only) including 4,257 births to NSLHD resident mothers (2019/20)
1,317,479 Private Medical Specialist attendances 5,784,062 GP attendances
COVID-19 ACTIVITY (SINCE START OF PANDEMIC 2020 TO JULY 2022)
COVID-19 testing 19 testing clinics established in NSLHD 3.6 million COVID-19 tests on NSLHD residents 507,298 PCR tests and 128,770 RATs completed in NSLHD testing clinics
Vaccination 703,413
COVID-19 Care 310,712 NSLHD residents have had COVID-19 3,145 patients with COVID-19 admitted to NSLHD hospitals
12,782 patients cared for in virtual COVID-19 Hospital 349 patients with COVID-19 admitted to NSLHD ICUs
NSLHD residents are fully vaccinated (95 per cent of eligible population) 145,550 vaccinations provided in NSLHD clinics
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NSLHD Strategic Plan 2022-2027
In 2027, the principles of safe, person- centred, high quality care continue to be part of our culture.
18 NSLHD Strategic Plan 2022-2027
NSLHD in 2027
During the consultation process for the NSLHD Strategic Plan 2022-2027, our staff were asked to describe what NSLHD would look like in 2027. Clear themes emerged with NSLHD envisioned as a healthcare organisation that provided truly person-centred care, enabled by advancements in technology, with a strong and resilient workforce, and a sustainable health system.
In 2027, the principles of safe, person-centred, high quality care continue to be part of our culture. Patients and carers are our partners in their healthcare and are supported to make informed decisions about their care. The healthcare they receive is flexible and responsive to their preferences and needs. Safety, quality and continuous improvement are part of business as usual and integral to everything we do. Patient Reported Measures and patient, carer and consumer feedback are used to inform changes and improvements to models of care, services and processes. Programs targeting priority and vulnerable populations are in place and have demonstrated success including the First 2000 Days, Closing the Gap, healthy ageing and frailty, refugee health and improving mental health and wellbeing. We continue to focus on the health and wellbeing of our population and are seeing improvements across the population with declines in smoking and alcohol intake and increases in physical activity. Our hospitals and services recognise diversity and deliver culturally safe and sensitive services that respond to the needs of our community.
Our workplace culture is positive and focused on the physical and psychological wellbeing of our staff to create a safe and supportive workplace. Flexible work practices are in place to achieve a positive work-life balance. Strong and supportive leadership is in practice across all levels of the workforce. We have high levels of staff satisfaction, good staff retention and NSLHD is considered an attractive place to work. Our people are capable and confident with new technologies, adaptable and responsive to change, supported through training and professional development, and are equipped with the knowledge and skills needed. Learning and development are key components of developing and maintaining a skilled workforce. We continue to have strong links with our tertiary education providers and other training bodies. Service planning and infrastructure align with community needs making optimal use of available built capacity. Patients, carers and staff participate in co-design for new and redesigned services, technologies and facilities.
Our services and the way we deliver care have been transformed through the availability and use of digital technology. Our data systems are streamlined and connected, staff are digitally literate, have access to training in the use of technology and ongoing support to maximise functionality of the information, communications and technology systems available. Clinicians have ready access to real-time relevant data that inform clinical decision making, improve models of care and operational processes. Digital technologies support patient care, facilitating the shift toward increased healthcare provision in non-hospital environments. This is supported by the use of virtual technologies for patient and carer consultation, care provision and remote monitoring, as well as the use of applications to support increased self-care at home, hospital avoidance and reduced inpatient length of stay. Patients and carers can easily access support in the use of these technologies.
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NSLHD Strategic Plan 2022-2027
NSLHD IN 2027 (continued)
Provision of integrated and seamless care is facilitated through a single digital patient record and virtual care enhancements including telehealth. This shift supports interaction of the whole care team from across settings including the patient’s general practitioner at a single appointment with the patient and their carer where collaborative decisions around care planning can be made. The patient and carer experience is enhanced through easy access to relevant health and service information, electronic booking systems, and the ability to interact with members of their care team to seek advice about their care and treatment. Support is easily accessible to assist patients and carers to use available technologies. Systems are in place to identify carers and alert staff to any potential carer support needs. The development of new partnerships and the strengthening of existing partnerships with patients, carers, consumers, primary care, Sydney North Health Network and other care providers play an important and ongoing role in
providing integrated care for patients. Developed in conjunction with Sydney
North Health Network, HealthPathways and collaborative commissioning are in place across NSLHD and have been successful in reducing avoidable Emergency Department presentations and hospital admissions for patients who can be safely cared for at home.
20 NSLHD Strategic Plan 2022-2027
NSLHD IN 2027 (continued)
Research and innovation underpin the delivery of safe, high quality healthcare and improved experiences for patients, carers and staff. Research in all its forms is recognised as a core part of everyone’s role with outcomes used to inform patient care, models of care and innovative practice. Research is undertaken in partnership with patients, carers, consumers, industry, research organisations and key pillar organisations with an emphasis on translation into best practice healthcare. Ongoing partnerships with Sydney Health Partners and the Kolling Institute as well as the development of the St Leonards Health, Research and Education Precinct are key components of this approach. The philanthropic fundraising by the NORTH Foundation provides valuable support for these initiatives. The completion of the redevelopment of Ryde Hospital in 2026 has transformed the delivery of healthcare for the Ryde local community, ensuring that people access the care they need close to home. The redevelopment sees the preservation of the historic Denistone House, alongside new and enhanced health facilities and services including emergency, critical care, inpatient, community and ambulatory care services, with expertise in rehabilitation services through the Graythwaite Rehabilitation Centre.
The redevelopment strengthens the networking of services across our hospitals and provides increased service capability and capacity for inpatient and ambulatory care enabling patients to access a greater range of services closer to home. The new hospital is NSW’s first 100 per cent electric hospital including all building services and systems, hot water, heating, ventilation, air conditioning and cooking facilities. The hospital design incorporates comprehensive waste management facilities, enhanced open space, and renewable onsite energy. Planetary health remains a priority and has strong staff engagement across NSLHD. There has been significant progress toward achieving our commitment to Net Zero carbon emissions by 2035. There is green space across all our hospitals and services, solar panels are in place and utility usage and waste generation have been reduced. Initiatives have extended to clinical and non-clinical processes to reduce waste through low-value care and inefficient systems and processes. All new capital works developments are environmentally sustainable and contribute to our goal of Net Zero carbon emissions by 2035.
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NSLHD Strategic Plan 2022-2027
Challenges and Opportunities
The health system and environment continues to change at a rapid pace. Advances in technology are impacting how we deliver healthcare, what services we provide, and where and how these services are accessed.
22 NSLHD Strategic Plan 2022-2027
Our achievements over the last five years in delivering healthcare have ensured that we are well prepared to respond to the challenges ahead and to meet the complex healthcare needs of the NSLHD community.
CHALLENGES » Population growth and an ageing population » Increasing patient demand, acuity and complexity » Ongoing impact of the COVID-19 pandemic on our workforce, patients, carers, the community and services as it becomes part of business as usual: – Maintaining a state of readiness for ongoing challenges of the pandemic – Caring for patients with planned and non-urgent healthcare needs – Workforce impacts including fatigue, early retirement, training and education of students and clinicians, gaps in the new graduate pipeline, and staff wellbeing » Balancing increasing demand and costs of service delivery with finite resources including capacity constraints » Rapid increase in digital technologies and shift to digital healthcare and adaptation by both patients and staff including those unable to easily use technology » Operating in an increasingly complex healthcare environment with policy and funding from both the Federal and State governments, and with multiple partners including private providers and primary care.
OPPORTUNITIES » Increasing importance placed on patient and carer engagement, diversity inclusion, value-based care, partnerships, and integration of services to improve patient and carer experience and outcomes
» Building on our achievements arising from the COVID-19 pandemic: – Structures to support rapid decision making and effect change
– Development of virtual care expertise and technology – Improved relationships with our care delivery partners
» The use and translation of research to inform clinical practice and service delivery » The role and impact of technological change, data availability and data analytics to inform value-based care and improve patient care and outcomes » Transforming and developing digital health and virtual care capabilities that integrate across services and providers » Targeted and sustainable investment in, and development of, non-admitted patient services across NSLHD » The use of virtual care and other technologies to improve patient and carer access to services and the provision of increased out of hospital care options » Strengthening the network of hospitals and services across NSLHD to provide increased service capability and capacity for inpatient and ambulatory care » Enhancing existing partnerships and collaborations with the Sydney North Health Network, general practice and primary care, our affiliated health organisations, residential aged care facilities, private hospitals, tertiary education partners, and the NORTH Foundation » Increasing philanthropic and fundraising opportunities through the NORTH Foundation to support research and innovation to deliver exceptional healthcare » Precinct planning and building on the vision for the St Leonards Health, Research and Education Precinct Plan » Working towards and achieving our target of Net Zero carbon emissions by 2035 » Partner with Northern Beaches Hospital to enhance collaboration across the clinical streams by establishing integrated networks including outreach from hospital to community based services.
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NSLHD Strategic Plan 2022-2027
NSLHD Strategy Map
VISION Exceptional Care, Leaders in Research, Partners in Wellbeing
PURPOSE Transforming healthcare through innovation, research and partnerships, for our patients, community and staff
Patients and carers are our partners in their healthcare
Safe, high quality connected care
Keeping people healthy and well
Our staff are engaged and well supported
Research, innovation and digital advances inform and improve the delivery of patient care The care we deliver is digitally enabled and informed by research and data
Our services are sustainable, efficient and committed to planetary health We use a value-based approach to optimise use of resources with a focus on embedding both planetary health and financially sustainable principles in everything we do 6.1 Optimise the use of resources by using an outcomes-focused approach to support efficient and effective care 6.2 Deliver services that maximise value from existing resources and reduce waste 6.3 Develop collaborative partnerships with external
Patients and carers are empowered to make informed decisions about their care, goals and health outcomes
Safe, high quality, reliable healthcare is delivered in a personalised way across all settings
Investment is made in keeping people healthy to promote wellness and address health inequity in our community
4.1 Cultivate a safe, flexible and positive workplace culture where staff feel valued, heard, empowered and are supported to perform at their best 4.2 Ensure our workforce reflects the diversity in our community and our culture leverages diversity of thinking 4.3 Develop our talent and leadership capability across our workforce 4.4 Develop a skilled and capable workforce equipped to provide high-value and person-centred care 4.5 Support and foster innovative thinking and practices related to future care 4.6 Develop our workforce to have the capabilities and culture to address future demands on the health system Staff are engaged and well supported to deliver safe, reliable person-centred healthcare and equipped to respond to a changing healthcare environment
1.1 Involve patients and carers as active partners in their healthcare 1.2 Ensure positive experiences of care 1.3 Increase health literacy to support informed decisions about healthcare 1.4 Promote co-design in the development and evaluation of our services and facilities
2.1 Make safety and quality
3.1 Improve population health through the development,
5.1 Advance and translate
fundamental to everything we do
research and innovation with institutions, industry partners, clinicians, patients and carers
implementation and evaluation of policies, programs and services to improve health and reduce the burden of chronic disease
2.2 Provide high quality care that delivers good clinical outcomes 2.3 Increase the range of services provided in non-inpatient and out of hospital settings 2.4 Patient care is seamless across providers, services and settings 2.5 Implement systems that support navigation of care, improved patient and carer experience and easy access to out of hospital services
5.2 Improve care delivery and operations by harnessing the power of digital technology and data 5.3 Design and develop the required infrastructure to
3.2 Decrease the burden of disease by reducing risk factors and promoting health and wellness 3.3 Improve health outcomes for vulnerable and priority populations 3.4 Enhance collaborative partnerships to address the social and environmental determinants of health
service providers to support our strategic objectives and deliver high quality health outcomes
enable and embed innovations in digital technology and data
5.4 Engage and support
our workforce, patients, carers and partners in an increasingly digital healthcare environment
6.4 Prioritise initiatives that positively impact planetary health and environmental sustainability 6.5 Ensure robust corporate and clinical governance standards are embedded in all decision making processes
C
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OUR VALUES
Collaboration
Openness
Respect
Empowerment
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Strategic Outcomes
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NSLHD Strategic Plan 2022-2027
When we improve the voice and equity of all consumers, we drive innovation and the integration of services to deliver the very best patient and carer experience.
26 NSLHD Strategic Plan 2022-2027
Patients and carers are our partners in their healthcare Patients and carers are empowered to make informed decisions about their care, goals and health outcomes
Why this is important NSLHD has a proud history of partnering with consumers who include patients and carers. Our patients and their carers have a fundamental right to participate in the delivery of the healthcare they receive. When we empower, engage and co-design with consumers, we recognise the value lived experience contributes to moving towards a shared vision of delivering person-centred care. When we improve the voice and equity of all consumers, we drive innovation and the integration of services to deliver the very best patient and carer experience. We promote partnering with consumers and the community to: » Improve our patient, carer and staff experiences and outcomes » Improve collaborative decision making about treatment and care » Enhance our health service development » Improve the quality of our services » Reduce the rate of hospital readmissions by working with patients and carers, ensuring support needs are assessed and addressed. The NSLHD Partnering with Consumers Framework 2021-2026 is a re-affirmation of our commitment to consumer engagement, further embedding a culture of inclusive, integrated and valued consumer partnerships. The Framework outlines key priorities for action, co- designed with consumer advisors and guides the future of consumer engagement and the patient, carer and staff experience in NSLHD. The Framework aligns closely to the NSW Health Elevating the Human Experience – Guide to Action which provides a roadmap for Local Health Districts to coordinate a strategic approach for the patient experience.
We will support our workforce to recognise diversity and deliver culturally safe and sensitive services that respectfully respond to the diversity of our patients, carers, staff and community. This diversity includes the Aboriginal and Torres Strait Islander community, Culturally and Linguistically Diverse (CALD) communities, people who experience mental health issues, people living with a disability, and people who identify as Lesbian, Gay, Bi-Sexual, Transgender, Queer and Intersex (LGBTQI+) and other consumers.
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NSLHD Strategic Plan 2022-2027
STRATEGIC OUTCOME 1 (continued)
Objectives
1.2 Ensure positive experiences of care Treating patients, carers and families with respect and dignity to ensure they receive care that is personalised and considerate of their cultural, educational, social and economic status. » Work in partnership with patients, carers and families to better understand their experience of care. » Ensure service provision is flexible and responsive to the diverse preferences, values and needs of our patients, carers and community. » Provide holistic and trauma-informed healthcare, linking together physical and psychological health. » Partner with Aboriginal and Torres Strait Islander Health to fully engage staff in the Aboriginal Workforce and the NSW Health Respecting the Difference initiative to improve cultural awareness and ensure the provision of respectful, responsive and culturally sensitive health services to Aboriginal and Torres Strait Islander people. » Reduce health disparities for diverse community groups including Aboriginal and Torres Strait Islander people, people from a CALD background, people who identify as LGBTQI+, people with a disability and people living with mental illness.
1.3 Increase health literacy to support informed decisions about healthcare
1.1 Involve patients and carers as active partners in their healthcare Working in partnership with patients and carers to co-design their care and significantly improve the healthcare experiences and outcomes. » Ensure all patients and carers, including people living with a disability, people with cognitive impairment and communication difficulties including limited English language skills or those experiencing vulnerability, are able to access information regarding their treatment options and are encouraged to be involved with their own care and self-management. » Partner with the Health Care Interpreting Service and the Multicultural Health Service to improve access to interpreting services. » Develop care plans with patients and carers incorporating their individual goals, preferences, values and needs. » Ensure open and transparent communication between patients, carers, their families and treating teams regarding their care.
Ensuring access to health-related information empowers patients and carers to make decisions about their health and healthcare. » Embed health literacy including digital health literacy into our education and communication. » Work with our Consumer and CALD Advisory Groups to ensure that education material and health related information is readily available, up to date, easy to understand, and is written in accessible languages and formats. » Use clear and easily understood language and communication tools when communicating with patients, carers and their families.
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STRATEGIC OUTCOME 1 (continued)
1.4 Promote co-design in the development and evaluation of our services and facilities Engaging with patients, carers, consumers and the community in the design, implementation and evaluation of our healthcare services improves patient and carer experiences and outcomes. » Ensure that patient and carer experience and feedback is used to improve services and models of care. » Involve patients, carers, consumers and the community in the planning, design, implementation and evaluation of services, processes and models of care. » Extend patient, carer and community engagement to areas including patient safety, quality improvement, education, ethics and research. » Seek genuine engagement to co-design
culturally safe services and care that reflects and addresses the needs of a diverse community.
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NSLHD Strategic Plan 2022-2027
Essential metrics MEASURE
STRATEGIC OUTCOME 1 (continued)
TARGET
Overall Patient Experience Index (Number) Adult admitted patients
What does success look like? » Patients and carers are active partners in their care, and have the knowledge to make informed decisions. » Hospitals and services are culturally welcoming, safe and responsive to the diverse cultural needs of our community. » Aboriginal and Torres Strait Islander people are identified when they attend our hospitals and services and receive culturally safe and clinically appropriate high quality care. » Preferred language and interpreter need is recorded in all clinical records and interpreters are provided to patients in a timely manner. » Care is individualised and responsive to patient and carer values, needs and preferences. » Patients, carers and families feel comfortable to ask questions and receive answers in their preferred language or communication method. » Patients and carers have positive experiences of care with high Patient Reported Measures survey response rates.
≥ 8.7 ≥ 8.6
» Patient and carer feedback is incorporated into safety and quality improvements. » Consumers and the community are represented and actively involved in all aspects of hospital and service planning, development, implementation and evaluation. » Service design and models of care reflect patient, carer and consumer input and feedback including through Patient Reported Measures. » People with a disability have their disability accurately documented, with additional support needs clearly identified in their clinical records and care is provided in a way that considers specific adjustments that may be required. » Carers are identified in the patient’s clinical record to facilitate decision making about treatment and care. » Patient Reported Measures are used to improve healthcare and support person-centred and value-based care. » Full accreditation against the National Safety and Quality Health Service Standards.
Emergency department
Patient Engagement Index (Number) Adult admitted patients
≥ 8.5 ≥ 8.5
Emergency department
Mental Health Consumer Experience: Mental Health consumers with a score of Very Good or Excellent (%) Patient-reported Experience Measure surveys with a score of Very Good (%) Aboriginal and Torres Strait Islander identification in Emergency Department reporting (%) Aboriginal Culture: Respecting the Difference all-staff training completion (%)
≥ 80
≥ 70
≥ 90
≥ 60
Enabling plans NSW Health » Elevating the Human Experience – Our Guide to Action (2020) NSLHD » Partnering with Consumers Framework (2021-2026) » Carer Strategy (2018-2023) » Disability Inclusion Action Plan (2018-2022)
» Aboriginal Health Plan (2017-2022) » Multicultural Health Plan (2020-2024) » Core Values and Behaviours Charter (2017) » Clinical Governance Framework (2022-2025)
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