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WA Health Clinical Services Framework 2005 – 2015 September 2005

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Page 1: WA Health Clinical Services/media/Files... · Healthy Workforce Recruit, develop and retain Develop knowledge, skills and participation Promote a culture of professionalism, teamwork

WA Health Clinical ServicesFramework 2005 – 2015

Delivering a Healthy WA

Healthy Workforce ● Healthy Hospitals ● Healthy Partnerships ● Healthy Communities ● Healthy Resources ● Healthy Leadership

© Department of Health, 2005

HP

2978

SE

PT

’05

2064

3

September 2005

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For further information please contact:

Health Policy and Clinical Reform

Department of Health

Phone: (08) 9222 4434

Fax: (08) 9222 2192

Email: [email protected]

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Foreword

This WA Health Clinical Services Framework 2005 – 2015 is WA Health’s strategic overview forClinical Services, developed in response to recommendations made by the Health ReformCommittee in its Final Report of 2004 (the ‘Reid report’) and the Clinical Services Consultation.

The WA Health Clinical Services Framework has now been finalised following a period of intenseconsultation. WA Health is committed to the implementation of the recommendations of the Reidreport and to utilising all available resources for best outcomes and greatest benefit for thehealth of our community.

Significant elements of the WA Health Clinical Services Framework include:

● clear role delineation for each of our health services and care facilities

● a description of the bed numbers planned for the metropolitan area

● the location of the central tertiary hospital site at the QEII Medical Centre

● significant investment in our health service infrastructure including a new tertiary hospital forthe south metropolitan region to be developed as a collaborative initiative between FremantleHospital and Royal Perth Hospital

● building up our general hospitals

● investment in education and research

● a foreshadowing of work on models of care with a greater emphasis on prevention, primarycare and care in the most appropriate setting

● advancement of country health service role delineation in alignment with metropolitan plans.

This document should be read in conjunction with the Clinical Services Consultation 2005documents (http://www.health.wa.gov.au/HRIT/csc/index.cfm) which provide the backgrounddata, rationale for change and reform options which informed the decision-making process forthis framework. The consultation process engaged a large number of expert clinical stakeholders,staff and community in deliberation about the options and implications for implementation. I amgrateful to all who participated in this process for their interest, investment of time andcontribution of knowledge and expertise.

A number of critical factors will impact on the successful implementation of the framework.These factors include the development of a strategic workforce plan, clinical frameworks andservice models, infrastructure development plans, information, communication and technologyand Area Health Service development plans. These planning processes will provide opportunitiesfor the participation of all stakeholders (clinicians, staff, community, patients, consumers) andwill build on the existing strengths and the many initiatives already in progress.

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The way forward will present many challenges for the implementation of the WA Health ClinicalServices Framework, but we are investing significant effort to ensure we are fit for the journeyahead. This includes building on the wealth of talent, skills and experience of our people,developing our leaders through our Healthy Leadership strategies and organisational realignmentto ensure our Area Health Services have the support and resources needed to deliver appropriatestandards and quality of care.

The commitment of stakeholders to work together to implement the change required is vital andalready evident throughout many parts of our system. It is this commitment that will ensure thelong-term goals of the health reform program are achieved.

DR NEALE FONG

Director General Executive Chairman Health Reform Implementation Taskforce

September 2005

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WA 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 0 5 – 2 0 1 5

Content

Foreword i

Contents iii

1. Introduction 1

2. WA Health Clinical Services Framework 4

2.1 Model of Care 4

2.2 Clinical Services Role Delineation 7

2.2.1 Metropolitan Clinical Services Role Delineation 7

Metropolitan Clinical Services Framework Matrix 11a - 11d

2.2.2 Country and South West Area Clinical Services Role Delineation 13

2.3 Metropolitan Bed Strategy 13

2.4 Vision for Area Health Services 15

2.4.1 North Metropolitan Area Health Service 16

2.4.2 South Metropolitan Area Health Service 18

2.4.3 Women’s and Children’s Health Service 20

2.4.4 WA Country Health Service 22

2.4.5 South West Area Health Service 25

2.5 Education and Research 26

2.6 Pathology Services WA 27

2.7 Mental Health 27

3. Facilitating Change 29

3.1 Governance and Organisational Structure 29

3.2 Strategic Workforce Framework 30

3.3 Infrastructure Development Framework 33

3.4 Information and Communication Technology Framework 35

3.5 Recurrent Costing of the WA Health Clinical Services Framework 35

4. Health Service Development Timeframe 37

5. The Way Forward 38

Appendix 1 Clinical Services Role Delineation 39

Appendix 2 WA Country Health Service Clinical Services Delineation Matrix 63

iii

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iv

WA 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 0 5 – 2 0 1 5

Delivering a Healthy WAWA Health Strategic Intent 2005-2010

WA Health Strategic Plan2005-2010

Healthy LeadershipImproving clinical and managerial leadership

Healthy ResourcesProviding sustainable resourcing

Managing budgetsAccountable for performance

Management of assets to deliver the best health benefit

Healthy WorkforceRecruit, develop and retain

Develop knowledge, skills and participationPromote a culture of professionalism, teamwork and accountability

Healthy PartnershipDeveloping strongerparticipation with:

Consumers NGOs

Health ProfessionalsFederal Government

Private Sector

Healthy HospitalsBuilding new

hospitalsUpgrating existing

hospital stockProviding efficient and

productive health system processes

Being innovative in delivery methodsNew generation

information technology

Healthy CommunitiesImproving lifestyle,

prevention and health promotion

Improving equitable andaccessible health services

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WA 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 0 5 – 2 0 1 5

1. Introduction

The WA Health Clinical Services Framework (CSF) is a strategic planning framework for thedevelopment and provision of health care services throughout Western Australia over the next tento fifteen years and beyond.

Informed by the final recommendations of the Health Reform Committee in 2004 (the ‘Reidreport’), the CSF provides a guide for the Department of Health and Area Health Services for thedevelopment of a health care system that will contribute to the achievement of a number of longterm reform objectives, namely to:

● improve access to services

● reduce inequality in health status

● provide safe, high quality health care

● promote a patient centred continuum of care

● ensure value for money

● optimise public and private services

● improve the balance of preventative, primary and acute care

● be financially sustainable as an integrated system

● support a highly skilled and dedicated workforce.

The CSF should be viewed as a foundation from which more extensive and detailed planning willoccur. It is to be used in conjunction with other organisational planning documents such as theDelivering a Healthy WA Strategic Intent 2005-2010 which outlines key intentions for ensuring aHealthy Workforce, Healthy Partnerships, Healthy Hospitals, Healthy Communities, HealthyResources and Healthy Leadership.

The CSF has been developed as part of an extensive planning process encompassing the followingprojects and reviews:

● Health Reform Committee Final Report as endorsed by Governmenthttp://www.health.wa.gov.au/HRIT/publications/docs/Final_Report.pdf

● Health Reform Implementation Taskforce Workplanhttp://www.health.wa.gov.au/HRIT/publications/index.cfm

● WA Health Strategic Intent 2005-2010http://www.health.wa.gov.au/hrit/publications/docs/Strategic_Intent_2005-2010.pdf

● review of planning assumptions including impact of reform measures, impact of newtechnology, service demand modelling and population projections

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● Clinical Services Consultation 2005 http://www.health.wa.gov.au/HRIT/csc/index.cfm

● WA Country Health Services Review 2003http://www.wacountry.health.wa.gov.au/publications/docs/Country_Review.pdf

The Clinical Services Consultation was an important stage in the development of the CSF and theimmense wealth of information, recommendations and suggestions gathered was reviewed andused to inform the final decision-making. All submissions received during this process have beenregistered and will be used to inform the subsequent planning for implementation of the CSF andtransition arrangements.

The consultation process also validated a number of considerations which the health carecommunity of WA felt critical to the successful implementation of the CSF:

● the need for a greater focus on workforce planning

● the role of training and research

● the importance of participation from clinicians and staff in decision making and planningprocesses

● the need for greater integration of the health care system across the state

● the need for a more defined continuum of care across levels of care within many disciplines

● the need for work on appropriate models of care for specific clinical programs

● the importance of the private and non-government sector in health care provision.

The South West Area Health Services and WA Country Health Service have also embarked uponcomprehensive health service planning processes in consultation with their communities andregions. Whilst distinct from the metropolitan process due to the nature and timing of previoussystem reviews, this plan begins to incorporate all areas and health services as they align withthe overall vision for the health system.

The CSF is situated within an ongoing organisational planning framework that will ensure planningat all levels of the system is aligned and focused on the same strategic outcomes and thatstrategies are functioning within an accountable structure.

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WA 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 0 5 – 2 0 1 5

Development of WA Health Strategic Plan 2005-2010

3

Clinical Services

Consultation

Along with● Workforce Planning● Recurrent Costing● Ambulatory Care

Projects● Infrastructure

Planning● Information and

CommunicationTechnology

WA HealthClinical Services

Framework

WACHS*Strategic

Plan

SWAHS**Services

Consultationand Planning

WA HealthStrategic

Plan

* WACHS – WA Country Health Service** SWAHS – South West Area Health Service

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2. WA Health Clinical Services Framework

2.1 Model of CareThe need for reform within the state’s public health system was well documented in the Reidreport. In particular, many recommendations were made regarding population health, primaryand community care and access to hospital services.

The report findings included:● fragmentation of the health system between primary care sector (GP, Pharmacist, Allied

Health Professional, Community Health Nurse) and the public hospital system● poor coordination and communication between primary care and acute care leading to

avoidable admissions, adverse events and poor patient outcomes● lack of focus on health promotion and early intervention● tertiary hospitals admitting 80% of patients for secondary care● concentration of hospital beds in large tertiary hospitals● barriers to patients accessing the system (cultural, geographical, socio-economic).

The Reid report recommended working towards a system that:● appears to the patient as a single unified health system, rather than comprising discrete

disconnected entities ● increasingly emphasises the importance of health promotion, early intervention and prevention

programs, and● provides care in the most appropriate setting, particularly through the development of both

general and specialist secondary care hospitals.

In essence, the vision offers a new direction forward for the model of care within the publichealth system, creating a system that invests more in keeping people well and at home andaccessing appropriate hospital services for the right reasons.

Of priority will be the implementation of appropriate strategies to reduce the inequality in healthstatus with a focus on Aboriginal health and the disadvantaged in areas of health promotion andearly intervention, fostering a patient centred approach to care services with strong consumerparticipation, the development of links with all sectors of health and broader community servicesand greater responsibility at local area health service level for service delivery.

Significant reconfiguration of health services is now required to deliver this vision. The CSF bringstogether those recommendations made in the Reid report designed to support this goal. The charton page 6 provides an example of how the principles of care as outlined in the Reid report willinform the way we organise our systems and health strategies with the goal of improving healthoutcomes and creating ‘Healthy communities’.

The model of care development will need to be supported by a range of other more specificclinical strategies and policies which complement the vision, a number of which are already well progressed. The Health Policy and Clinical Reform division within the Department of Health willtake a lead role in the development of statewide clinical networks to achieve this aim.

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WA 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 0 5 – 2 0 1 5

The following table provides examples of strategies designed to address those issues identified inthe Reid report.

Examples of Response to Identified Issues in the Model of Care Development

5

Fragmentation of the healthsystem between primary caresector (GP, Pharmacist, AlliedHealth Professional, CommunityHealth Nurse) and the publichospital system

Poor coordination andcommunication between primarycare and acute care leading toavoidable admissions, adverseevents and poor patientoutcomes

Lack of strategic policy focus onhealth promotion and earlyintervention

80% of admissions to tertiaryhospitals are for secondary care

Concentration of hospital beds inlarge tertiary hospitals

Barriers to patients accessing thesystem (culturally, geographically,socio-economic)

Components of the primary caresector have strong, clear linkswith each other and the broaderhealth sector

An easy to navigate patient carejourney incorporating tools andtechniques to support service andcare integration

An integrated and focusedapproach to health promotion,prevention and early intervention

Care in the most appropriatesetting

Increased availability of servicescloser to areas of predictedpopulation growth

Access to services closer to home

Culturally secure services

Statewide Women’s andChildren’s Health ServiceClinical Networks Cancer Network Advisory GroupHealthy Partnerships StrategicDirection

Increased use of Health CallCentreStandardised Electronic DischargeSummaries Hospital in the HomePathways HomeChronic Disease Management Expanded Residential Care LineEvidenced Based ClinicalGuidelinesElectronic Medical RecordsSystem-wide Clinical InformationSystem

Primary Care Strategy forAboriginal PeopleFalls Prevention Program.Health Promotion Campaigns

WA Health Clinical ServicesFrameworkExpanding and fully utilisingcapacity of the regional andmetropolitan general hospitalsvia Infrastructure DevelopmentProgramReconfiguration of OutpatientServicesReconfiguration of GeneralHospital ServicesExpansion of Hospital in theHome Program

Building up of General HospitalsOverhaul of Elective SurgeryBooking ProcessRegional Resource CentresMulti-purpose ServicesIntegrated District HealthServicesExpanded Telehealth ServicesPrimary Care Strategy forAboriginal PeopleIncrease number of AboriginalHealth Care Professionals

Issues (as identified by Reid) WA Health Vision New Strategies

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WA 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 0 5 – 2 0 1 5

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WA 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 0 5 – 2 0 1 5

2.2 WA Health Clinical Services Role DelineationThe WA Health Clinical Services Framework (CSF) outlines the role of each metropolitan hospitalas well as the key clinical services to be provided at each hospital site, reflecting the principlesoutlined in the Reid report, the vision for the model of care and feedback gained throughconsultation. It is based on the principles of providing services closer to people’s homes and thereduction of duplication in services provided in the metropolitan area.

The CSF provides a strategic map of health care services and acts as a foundation for furtherplanning processes. The framework will continue to be developed and refined and used moreextensively throughout the state over time.

The CSF is essential to ensure that services are integrated, service directions are clearlyarticulated and can be planned for in a strategic manner. The CSF also allows for betterworkforce planning, informs financial and capital planning and clarifies clinical governance andmodels of evaluating care to ensure safety and quality while promoting economic efficiency in ourhealth system.

The CSF, including role delineation and service level definitions, has been developed incollaboration with clinical experts and is based upon similar approaches in other health caresystems. Important factors reviewed in the development of the CSF include:

● projected future demand for clinical services

● specialty specific patterns of services delivery including where patients receive servicescompared to where they live

● population growth and ageing

● scenario modelling designed to review detailed changes at clinical, age, region of residenceand hospital level including changes in demand, average length of stay and referral patterns

● impact of reform initiatives.

2.2.1 Metropolitan Clinical Services Role DelineationThe role delineation matrix provides a clear role statement for each metropolitan public hospitaland provides an outline of the type and level of clinical services to be provided at each of thesesites into the future.

The matrix shows planned movement in clinical services from site to site as well as the upgradingof clinical services at some sites and the establishment of clinical services at new sites.

The matrix is intended as a strategic role statement, focusing on key clinical groups. Roledelineation for more specific clinical specialties will be undertaken as part of the next planningstage.

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The role and service type outlined in the matrix for each hospital is based on the application ofsome underlying principles and data including:

● providing care closer to where people live

● ensuring accessibility across the metropolitan area and country regions

● developing networked clinical services across the metropolitan area, with rural links

● supporting the Area Health Service concept

● projected future demand for services

● projected future population growth and demographic trends.

Definitions used in the Clinical Services Role Delineation

Tertiary HospitalsCurrently (2004-05) tertiary hospitals include:

● Royal Perth Hospital

● Sir Charles Gairdner Hospital

● Fremantle Hospital

● Princess Margaret Hospital (tertiary paediatric facility)

● King Edward Memorial Hospital (tertiary women’s facility)

● Graylands Hospital (tertiary mental health facility)

● Royal Perth Hospital Shenton Park Campus (tertiary rehabilitation facility).

By 2011, tertiary hospitals will be:

● Sir Charles Gairdner Hospital (central tertiary hospital)

● Fiona Stanley Hospital (southern tertiary hospital)

● Princess Margaret Hospital (tertiary paediatric facility)

● King Edward Memorial Hospital (tertiary women’s facility)

● Graylands Hospital (tertiary mental health facility)

● Royal Perth Hospital Shenton Park Campus (tertiary rehabilitation facility)

Note that by at least 2015-16, it is planned that Joondalup Health Campus will also operate as afully-fledged tertiary facility (ie northern tertiary hospital). While this was originally not planneduntil after 2020, the demand for services as population growth in the north has resulted inbuilding up of Joondalup earlier than previously anticipated.

Also, by 2015–16, it is planned that tertiary rehabilitation services will be relocated from RoyalPerth Hospital Shenton Park Campus to the Fiona Stanley Hospital, with the Shenton Park campusclosing.

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WA 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 0 5 – 2 0 1 5

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

As a general rule of thumb, a tertiary hospital provides services at a level 6 according to theclinical services definition.

General HospitalsBy 2011, general hospitals will be:

● Joondalup Health Campus (although this campus is planned to be a tertiary facility by 2015-16or sooner)

● Swan District Hospital

● Armadale Kelmscott Memorial Hospital

● Rockingham/Kwinana District Hospital.

The term general hospital highlights the community focus rather than a purely clinical focus. Ageneral hospital should provide for most of the health needs of its population. A general hospitalhas the following clinical services and facilities:

● emergency departments

● 24 hour anaesthetic cover

● high dependency units

● general surgery capacity (including day surgery)

● obstetric services

● general medical and geriatric services

● general paediatrics

● some rehabilitation and mental health services

● centre for diagnostics, treatment and ambulatory care.

In the main, a general hospital provides services at a level 4 according to the clinical servicedefinition. There are some exceptions, particularly with Joondalup Health Campus which will bebuilt up in the medium term as it positions itself to be a tertiary facility. A general hospital willhave resident general specialists, some visiting subspecialists and junior medical staff.

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Specialist HospitalsBy 2011, specialist hospitals will refer to Osborne Park, Bentley and Fremantle Hospitals whichwill be reconfigured to focus on mental health, aged care and rehabilitation services. None ofthese hospitals will have emergency departments (although Fremantle Hospital will have anurgent primary care service). All three hospitals will retain some same day/ambulatory medicaland surgical services. Some multiday elective surgical services will also be retained at Fremantlein the medium term. Osborne Park Hospital will retain some multiday elective surgery, becomingthe centre for elective surgery for the North Metropolitan Area Health Service.

Generally, specialist hospitals (Osborne Park, Bentley and Fremantle Hospitals) will provideservices at level 4/5 in their specialty according to the clinical services definition.

Other HospitalsOther hospitals by 2011 include:

● Kalamunda District Hospital

● Peel Health Campus.

Kalamunda hospital will provide varied services as per the Clinical Services Role Delineation. APeel Clinical Services Framework will be developed as part of a separate planning process.

The role delineation matrix which follows outlines the clinical services to be provided at eachmetropolitan hospital. For information regarding how to interpret the matrix, please refer toAppendix 1.

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General

Cardiology

Endocrinology

Geriatric

Neurology

Renal - general- dialysis

Oncology

Radiation oncologyRespiratory

Palliative care

Gastroenterology

Other

General

ENT

Gynaecology

Ophthalmology

Orthopaedics

Urology

Cardiothoracic

Vascular surgery

Neurosurgery

Plastics

Burns

EDUrgent primary care

METROPOLITAN CLINICAL SERVICES FRAMEWORK

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2010

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/05

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/05

2010

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/16

2004

/05

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South Metropolitan North Metropolitan Statewide

incl sleep unit incl sleep unit incl sleep unit

sameday

Fiona StanleyHospital Fremantle Rockingham Bentley Armadale SCGH RPH

RPH ShentonPark Campus Swan Osborne Park Kalamunda Joondalup KEMH PMH Graylands

Fiona Stanley Hospital includes Murdoch Hospice. SCGH includes Cottage and Hollywood Hospice publicly contracted beds

Current year: dialysis services at Fremantle Hospitalincludes Melville Satellite Centre and Swan Hospital includes Midland Satellite CentreFuture years: dialysis services at Fiona Stanley Hospital includes Melville Satellite Centre, Bentley Hospital includes Cannington Satellite Centre, Osborne Park Hospital includes Stirling Satellite Centre, and Swan Hospital includes Midland Satellite Centre

Medical Services

Surgical Services

Emergency/Trauma Services

Currently nil emergency medicine consultant on duty 24 hours per day

heart Tx

sameday

sameday

kidney Tx

thoracicheart, lung Tx

kidney Txkidney, liver Tx

sameday

samedaykidney Tx

heart, lung Tx

sameday

sameday

sameday

11a

Page 18: WA Health Clinical Services/media/Files... · Healthy Workforce Recruit, develop and retain Develop knowledge, skills and participation Promote a culture of professionalism, teamwork

METROPOLITAN CLINICAL SERVICES FRAMEWORK

Fiona StanleyHospital Fremantle Rockingham Bentley Armadale SCGH RPH

RPH ShentonPark Campus Swan Osborne Park Kalamunda Joondalup KEMH PMH Graylands

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

Obstetrics

Paediatrics

Neonatology

Rehabilitation

Community assessment

Environmental HealthCommunicable Disease Control Child and Community Health Aboriginal HealthHealthPromotionBreastscreen

Cervical

Genomics

GP based communitynursing

Surgical

Medical

Rehabilitation

Continuing care

Paediatrics

Obstetrics

5

4/5

5

6

5

55

5

5

3

5

3

3

3

6

4/5

6

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6

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3

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niln/a

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1

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3

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3

3

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3

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5

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3

3

5

Primary Care Services

Ambulatory Care Services

Prevention and Promotion Services

Rehabilitation Services

North Metropolitan StatewideSouth Metropolitan

Defined as outpatient services and community based and home care provided within the catchment area of each facility.

Current year Ambulatory Care Services are undefined. Mental Health Ambulatory Care Services are covered under Mental Health Services

State Rehab Centre

Obstetrics Services

Paediatrics Services

KEMH & PMH deliver a combined neonatal service

Level 1 SCNL1 SCNLevel 1 SCNL1 SCNLevel 2B SCN

3 Nursery

Level 3 SCNLevel 3 SCNLevel 2B SCNL1 SCNL1 SCNL1 SCN

Continuing Care Services

11b

Page 19: WA Health Clinical Services/media/Files... · Healthy Workforce Recruit, develop and retain Develop knowledge, skills and participation Promote a culture of professionalism, teamwork

METROPOLITAN CLINICAL SERVICES FRAMEWORK

Fiona StanleyHospital Fremantle Rockingham Bentley Armadale SCGH RPH

RPH ShentonPark Campus Swan Osborne Park Kalamunda Joondalup KEMH PMH Graylands

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

Mental health promotion andillness preventionEmergency services(hospital based) Inpatient servicesCommunity clinical based servicesDay therapy services(hospital based) Community non clinical support programsIntermediate care

Mental health promotion and illness preventionEmergency services (hospital based) Inpatient servicesCommunity clinical based servicesDay therapyservices(hospital based)Community non clinical support programsIntermediate care

Mental health promotion andillness preventionEmergency services(hospital based) Inpatient servicesCommunity clinical based servicesDay therapy services(hospital based) Community non clinical support programsIntermediate care

Forensic

Maternal

Neurological

Alcohol and DrugOther- Eating disorders

6

6

nil

nil

nil

3

nil

36

6

6

5

6

nil

4

6

6

5

5

6

nil

nil

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nil

nil

nil

nil

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nil

nil

3

5

5

6

nil

4

35nil

nil

nil

nil

nil

6

nil

6

6

6

3

6

3

6

5

5

5

5

6

6

6

5

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5

6

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6nil

nil

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6

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6

6

6

3

6

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6

5

5

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nil

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3

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6

nil

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nil

3

4

3

6

5

5

5

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5

nil

3

4

2

6

5

5

5

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5

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5

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2

6nil

nil

nil

nil

nil

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5

nil

5

nil

2

nil

5

5

5

5

5

5

5

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nil

3

nil

5

nil

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5

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nil

nil

nil

6

6

6

nil

nil

nil

3

nil

5

6

6

6

5

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6

4

6

6

6

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5

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5

6nil

nil

6

6

6

6

6

nil

nil

nil

3

nil

56

6

6

5

6

6

4

6

6

6

5

6

5

nil

56nil

nil

6

6

6

nil

5

nil

5

nil

2

nil

55

5

5

5

5

5

nil

nil

3

nil

5

nil

nil

nil

55nil

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

nilnil

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

nilnil

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

nilnil

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

nilnil

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

nilnil

nil

nil

nil

nil

3

3

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5

nil

2

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5

4

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5

5

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nil

3

5

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4

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nil

nil

nil

nil

6

5

nil

5

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3

nil

36

5

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5

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36nil

nil

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6

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3

6

5

5

5

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6

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6

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5

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2

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5

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4

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nil

nil

nil

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6

nil

nil

5

nil

3

nil

3

6

5

5

5

5

6

5

6

5

5

5

5

5

6

3

6nil

nil

nil

nil

nil

6

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5

nil

3

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3

6

5

5

5

5

6

5

6

5

5

5

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5

6

3

nil

nil

nil

nil

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nil

nil

nil

nil

nil

2

nil

3nil

nil

nil

2

nil

3

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nil

3

nil

2

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nil

3

3nilnil

nil

nil

nil

nil

6

nil

nil

nil

nil

3

nil

3

6

nil

nil

2

nil

4

3

6

3

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2

nil

5

3

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nil

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6

nil

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nil

3

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3

6

nil

nil

2

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4

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3

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2

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5

3

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nil

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nil

nil

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5

nil

5

nil

2

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3

5

4

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5

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3

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nil

3

nil

5

nil

nil

4

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nil

nil

nil

nil

6

6

6

6

5

3

6

3

6

6

5

5

5

6

6

6

6

5

5

5

5

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3

6nil

nil

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nil

nil

6

6

6

6

5

3

6

3

6

6

5

5

5

6

6

6

6

5

5

5

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4

3

nil

nil

nil

nil

nil

nil

3

nil

nil

nil

nil

nil

3

5

4

5

nil

5

nil

nil

nil

nil

nil

nil

nil

nil

nil

3

5nil

5

nil

nil

nil

6

3

nil

nil

nil

nil

nil

nil6

5

6

4

6

nil

4

nil

nil

nil

nil

nil

nil

nil

nil6nil

6

nil

nil

nil

6

3

nil

nil

nil

nil

nil

nil6

5

6

4

6

nil

4

nil

nil

nil

nil

nil

nil

nil

nil6nil

6

nil

nil

nil

5

4

6

4

5

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

6

6

5

6

6

6

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

6

6

5

6

6

6

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

6

nil

nil

nil

nil

nil

nil

nil

nil

6

6

nil

6

nil

nil

nil

nil

6

6

5

nil

4

nil

6

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

6

6

6

nil

6

nil

6

6

nil

6

6

6

nil

4

nil

6

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

6

6

6

nil

6

nil

6

6

nil

6

6

6

nil

4

nil

6

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

nil

5

nil

nil

nil

nil

nil

nil

nil

nil

Adult Mental Health Services

Child and Adolescents Mental Health Services

North Metropolitan StatewideSouth Metropolitan

Prevention promotion levels can not be considered as a continuum. Eg. Level 6 designation does not assume level 1- 5 are included in the level 6 coding.

Statewide Mental Health Services

Older Persons Mental Health Services

11c

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METROPOLITAN CLINICAL SERVICES FRAMEWORK

Fiona StanleyHospital Fremantle Rockingham Bentley Armadale SCGH RPH

RPH ShentonPark Campus Swan Osborne Park Kalamunda Joondalup KEMH PMH Graylands

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

2004

/05

2010

/11

2015

/16

Pathology

Radiology

Pharmacy

ICU/HDU

Paediatric ICU

CCU

Anaesthetics

Operating theatresTraining and research

Geographical Catchment Population

- Medical/Surgical

- Obstetrics

- Paediatrics

- Same Day

- HDU/CCU/ICU

- ESSU

- Rehabilitation

- Mental Health

- Other

Total

6

6

6

6

nil

6

6

6

6

3352518355012424845610

6

6

6

6

nil

6

6

6

6

ni

57427187080161475670

1058

3

3

4

nil

nil

nil

3

4

4

950020100386623

252

3

3

4

nil

nil

nil

3

4

4

60003000386623217

3

4

4

nil

nil

nil

3

3

3

85

4

5

4

4

nil

4

4

4/5

4

10020821106244010239

54

5

4

4

nil

4

4

4/5

4

11520931158405018306

3

3/4

4

nil

nil

nil

4

4

4

235

3

3

4

nil

nil

nil

1

2

4

00010006311112196

3

3

4

nil

nil

nil

1

2

4

00010006311116200

3

5

4

nil

nil

nil

3

4

4

207

4

5

4

4

nil

4

4

4/5

4

94231031108404315274

4

5

4

4

nil

4

4

4/5

4

94231033108404315276

6

6

6

6

nil

6

6

6

6

645

6

6

6

6

nil

6

6

6

6

70500877020303638986

6

6

6

6

nil

6

6

6

6

70500877020309242

1046

6

6

6

6

nil

6

6

6

6

708

nil

nil

nil

nil

nil

nil

nil

nil

nil

00000024122864

nil

nil

nil

nil

nil

nil

nil

nil

nil

00000024123672

4

5

4

4

nil

nil

4

5

5

236

nil

nil

nil

nil

nil

nil

nil

nil

nil

000050

105012122

nil

nil

nil

nil

nil

nil

nil

nil

nil

0000000000

4

4/5

4

nil

nil

nil

3

4

4

206

4

5

4

4

nil

4

4

4/5

4

120251025158485124326

4

5

4

4

nil

4

4

4/5

4

120251025158485132334

3

3/4

4

nil

nil

nil

4

4

4

209

3

3/4

4

nil

nil

nil

4

4

4

60002400892516214

3

3/4

4

nil

nil

nil

4

4

4

60003000897420273

3

3

3

nil

nil

nil

3

3

3

71

2

2/3

3

nil

nil

nil

3

3

3

3300170000050

2

2/3

3

nil

nil

nil

3

3

3

3300170000050

4

5

4

4

nil

4

4

4

4

235

4

5

5

4

nil

4

4

4

4

2403019402510405634494

5/6

5/6

5/6

5/6

nil

5/6

5/6

5/6

5/6

3003019553016646247623

6

5

5

3

nil

nil

6

5

5

276

6

5

5

3

nil

nil

6

5

5

2092212500890229

6

5

5

3

nil

nil

6

5

5

2075212500890212

6

6

6

nil

6

6

6

6

6

256

6

6

6

nil

6

6

6

6

6

00

176291070826256

6

6

6

nil

6

6

6

6

6

00

11220660826178

2

nil

6

nil

nil

nil

nil

nil

4

263

2

nil

6

nil

nil

nil

nil

nil

4

0000000

2100

210

2

nil

6

nil

nil

nil

nil

nil

4

0000000

1360

136

6

nil

nil

nil

nil

nil

nil

nil

nil

11

6

6

6

6

nil

6

6

6

6

541

Clinical Support Services

North Metropolitan StatewideSouth Metropolitan

Population

Bed Capacity

2299

07

2479

87

2698

32

5037

7

5266

5

5368

9

1157

39

1406

12

1634

09

1135

10

1191

66

1246

55

1031

06

1141

22

1341

69

2225

35

2276

47

2338

23

1811

92

2176

33

2469

73

2220

19

2288

30

2377

42

4171

8

4194

1

4522

9

2050

31

2527

92

3069

95

NOTE: Bed numbers outlined in this document are indicative numbers only and will be subject to review as the implementation of the framework progresses. Bed numbers indicate hospital capacity.SCGH/RPH includes 12 public mental health beds and 24 public restorative beds provided under contract by Mercy Hospital as well as 18 public palliative care beds provided under contract by Cottage Hospice (14) and Hollywood Hospital (4). The FSH bed numbers include 11 public palliative care beds provide under contract by Murdoch Hospice. Fremantle Hospital beds include 11 public dialysis chairs provided at the Melville Dialysis Unit.Swan District bed numbers include the 12 dialysis chairs at the Midland dialysis unit. In future years, Osborne Park and Bentley catchment areas will provide dialysis services, however, these will not be located on the hospital sites. 'Other' bed numbers refers to dialysis, neonatal and palliative care.

11d

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WA 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 0 5 – 2 0 1 5

2.2.2 Country and South West Area Clinical Services Role DelineationClinical services within the WA Country Health Service and the South West Area Health Serviceswill be guided by the CSF and configured according to the Area Health Service plans as outlined in2.4 of this framework.

As per the Reid report, more formal links will be developed between country and metropolitanArea Health Services which will ensure regional patients have timely access to tertiary healthcare and up to date professional expertise. Such links, along with other strategies such asworkforce, education/training and information management and communication technology willbenefit metropolitan and country health systems and patients.

2.3 Metropolitan Bed StrategyThe complex demand modelling information, which underpins the CSF, has provided a vital dataplatform that will be used to inform the distribution, capacity and provision of health careservices over time, including the number of inpatient and same day beds required within thehealth care system.

Demand modelling is a dynamic process used in a progressive manner in response to changeswithin the system—including the impact of health care reforms within the Reid reportrecommendations, new technology, actual population growth and service activity trends—toensure health planning and decision making is based on the most advanced information.

Using the data provided by the demand modeling exercise, a comprehensive plan was developedfor the transition from the current metropolitan hospital configuration (including number of bedsand infrastructure capacity) to the long-term requirements. This information will be used toinform the Infrastructure Development Plan (see 3.3).

The following table provides an overview of the current and projected bed capacity required tomeet future health care needs as defined through this process. The numbers provided are inreference to the provision of physical beds and hospital capacity. Please note this is a relativelydynamic model. Future detailed facility design and planning may alter the final size of thedevelopments.

13

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* Palliative care beds provided under contract by Murdoch Hospice beds

It is important to note that opportunity for revision of bed distribution within Area HealthServices will be structured into the implementation process as information is updated, refinedand the effects of the reform process are evidenced. In addition each key component of the CSFwill require detailed and comprehensive business case development and approval. This mayresult in alteration to the scale and scope of some aspects of the associated capital worksprogram.

It is not possible at this stage of planning to specify the exact numbers of beds required by sub-specialties such as cardiology or orthopaedics. This work will be undertaken in the planning forspecific sites, the ongoing work on models of care and the pragmatic approach which facilitydesign and costing will require. An overview of major groups is included in the Role DelineationMatrix.

More specific information regarding bed configuration beyond the major specialty groups will bedefined during the implementation of the CSF.

14

WA 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 0 5 – 2 0 1 5

Metropolitan HospitalsCurrent(April) 2010/2011 2015/2016

Fiona Stanley Fremantle (incl Woodside)Rockingham Bentley ArmadaleCentral Tertiary(SCGH/RPH) Shenton ParkSwan DistrictOsborne ParkKalamundaJoondalupKEMHPMHGraylands

TOTAL

11*54185

235207

135323620620971

235276256263

4,184

610252239196274

1,05012232621450

494229256210

4,522

1,058217306200276

1,1180

33427350

623212178136

4,981

Projected Hospital Capacity

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WA 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 0 5 – 2 0 1 5

2.4 Vision for Area Health Services● The health system now operates within an Area health model divided to reflect the growth in

population and expansion of services and infrastructure:

● North Metropolitan Area Health Service (NMAHS)

● South Metropolitan Area Health Service (SMAHS)

● Women’s and Children’s Health Service (WCHS)

● WA Country Health Service (WACHS)

● South West Area Health Service (SWAHS)

A continuum of care is offered within each Area Health Service from the primary care sector,where the first point of contact for many is a local general practitioner, pharmacist or communityhealth nurse, through to the secondary level care, provided by a local general or regionalhospital, and then, for some, specialty clinical services, provided by a tertiary care hospital. Thehealth system aims to provide the most appropriate and safe health care to the community in themost appropriate setting and in many cases this is not inside a hospital.

15

North

South

TERTIARY HOSPITALS

SPECIALIST HOSPITALS

GENERAL HOSPITALS

OTHER HOSPITALS

NMAHS & SMAHS Configuration

Bentley

Joondalup Health Campus

Swan DistrictsOsborne Park

Kalamunda

Armadale-Kelmscott District

Rockingham-KwinanaDistrict

Peel Health Campus

Murray District

GraylandsSCGH

Fiona Stanley HospitalFremantle

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2.4.1 North Metropolitan Area Health ServiceThe population residing north of the Swan River is now part of the North Metropolitan Area HealthService (NMAHS).

The NMAHS will consolidate its service delivery and be able to dedicate resources to thepopulation in the northern corridor following considerable development of services planned forthe south metropolitan area. Those in communities residing in the very far north of themetropolitan area have had to travel significant distances to access many health services. Thereconfiguration of the NMAHS will improve access and reduce the distance travelled for services.

Outside of the public hospital facilities across the NMAHS are a range of health care services thatsupport and complement a continuum of care for patients, such as population health preventionand promotion programs, and ambulatory care services as part of Healthy@Home. Improvementsand expansion in service delivery in order to reduce the pressures on the tertiary hospital systemand allow patients to receive the best possible care in the most appropriate setting close to theircommunity is underway. Underpinning this will be the strengthening of prevention and promotionactivities to reduce trends of chronic disease and reduce the numbers of people entering thehospital system.

The reconfiguration and planning of health services in the NMAHS is based on the projectedburden of disease for the future. Mental health, aged care and rehabilitation services will bestrengthened as specialised services in response to predicted increased need.

The roles and functions of each of the major public health care centres in the NMAHS will changeto ensure an appropriate range of clinical services is provided to the population within this Area.This is shown in the following table.

16

WA 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 0 5 – 2 0 1 5

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WA 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 0 5 – 2 0 1 5

Note: For detailed information regarding role and provision of clinical services please refer to theMetropolitan Clinical Services Role Delineation Framework at 2.2.1.

Overall, bed capacity itself will remain at a relatively constant level compared with currentfigures. In the long term there will be a slight increase in bed capacity to reflect growth inpopulation in the northern suburbs. The increase in bed capacity will not be as dramatic as thatplanned for the SMAHS. Historically, there has been a bed shortage in the south, with the northbridging the gap in services.

17

Health CareFacility

Current Role2005

Future Role2010-2015

Sir CharlesGairdnerHospital

Royal PerthHospital

JoondalupHealth Campus

KalamundaHospital

Osborne ParkHospital

Swan DistrictHospital

GraylandsHospital

RPH ShentonPark Campus

Tertiary Care

Tertiary Care

Secondary Care

Secondary Care

Secondary Care

Secondary Care

Specialist Care

RehabilitationCentre

Central tertiary hospital with significant growth and developmentplanned. Service directions to include development of the State CancerCentre, State Neurosciences Centre.

Tertiary and some secondary services to be relocated to FSH by2011. Some services will move to SCGH and northern generalhospitals. Princess Margaret Hospital to be relocated to the North Block,Wellington Street by 2015.

Significant development to become one of four metropolitangeneral hospitals. Medium term plan for Joondalup to become a second tertiaryhospital for the NMAHS and the development of a major privatehospital including mental health.

Role to change with focus on primary care, aged care and subacute care. Maternity services will be relocated whenappropriate facilities are available at general hospitals.

Role to change to a specialist hospital with focus on aged care,mental health and rehabilitation, planned overnight and samedaysurgery.

Significant development to become one of four metropolitangeneral hospitals providing increased capacity and servicecomplexity, increasing access to health care services in theeastern metropolitan region.

Continued role as specialist hospital, providing tertiary levelacute mental health services for the State.

Campus will close by 2016 with services relocated as alternativecare is available at appropriate sites. Tertiary rehabilitationservices will be relocated to a State Rehabilitation Centre atMurdoch.

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With the increased capacity in the south, the north will now be able to provide dedicatedservices to the NMAHS, thus increases will be moderate. Services outside of hospital facilities suchas hospital in the home and other ambulatory care programs will be strengthened to improveaccess and the range of health services offered to the community in the northern corridor anddecrease demand on inpatient care.

On the Joondalup Campus it is planned to have a private hospital facility guild by the privateoperator to complement the existing services (approximately 150-200 beds).

* Includes palliative care beds provided under contract by Hollywood and Cottage Hospices. Also includesrestorative and mental health beds provided under contract by Mercy Hospital.

2.4.2 South Metropolitan Area Health ServiceThe population residing south of the Swan River is now part of the South Metropolitan Area HealthService (SMAHS).

Significant development of health services will occur in the SMAHS in response to the needs of thepopulation and will include the commissioning of a new public tertiary hospital at Murdoch.

Planning for this exciting new development will commence in the short term and will beconducted as a collaborative initiative between the tertiary hospitals of Fremantle and RoyalPerth. The planning process will seek the contribution and participation of all stakeholders toensure the establishment of a new health care service of the highest quality.

As in the north, a range of health care services that support and complement a continuum of carefor patients will be enhanced outside of hospital-based services such as population healthprevention and promotion programs and ambulatory care services. Mental health, aged care andrehabilitation services will be strengthened as specialised facilities in response to the predictedincrease in demand.

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WA 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 0 5 – 2 0 1 5

2015/162010/112005Facility

Bed Provision Strategy

Central Tertiary Hospital (SCGH & RPH) Royal Perth Rehabilitation Hospital (Shenton Park) Joondalup HospitalKalamunda HospitalSwan District HospitalOsborne Park HospitalGraylands Hospital

Total

135323623571

206209263

2573

105012249450

326214210

2466

11180

62350

334273136

2534

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WA 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 0 5 – 2 0 1 5

The roles and functions of facilities located in the SMAHS will be reconfigured as follows:

Note: For detailed information regarding role and provision of clinical services please refer to theMetropolitan Clinical Services Role Delineation Framework at 2.2.1.

Overall, bed capacity will increase in the SMAHS as some services are relocated and capacity isincreased. Existing secondary hospitals in the southern corridor such as Rockingham/KwinanaDistrict Hospital and Armadale/Kelmscott Memorial Hospital will have their capacity increasedand become two of the four General Hospitals in the metropolitan area.

Expressions of interest have been called for a potential private hospital collocation on theRockingham site.

19

Health CareFacility

Current Role2005

Future Role2010-2015

Fiona StanleyHospital

FremantleHospital(includingKaleeyaHospital)

WoodsideHospital

RockinghamKwinanaHospital

Bentley Hospital

Peel HealthCampus

ArmadaleKelmscottHospital

Tertiary Care

Tertiary Care

Maternity Care

Secondary Care

Secondary Care

Secondary Care

Secondary Care

New tertiary hospital to be developed at Murdoch by 2011.Service directions will include a State Trauma and Burns Centre,State Rehabilitation Centre, Heart/Lung Transplantation Services,Comprehensive Cancer Centre.

Role to change to specialist hospital with focus on rehabilitation,aged care and mental health services. All tertiary services to berelocated to the Fiona Stanley Hospital by 2011. Someambulatory/elective surgical services will be retained.

To be closed when appropriate alternative services are availablewithin the SMAHS.

Significant development to become one of four metropolitangeneral hospitals providing comprehensive range of core clinicalservices to its catchment in the SMAHS.

Role to change to become a specialist hospital with focus onaged care, rehabilitation and mental health services. Same dayelective surgery be maintained and ambulatory care services willbe enhanced.

Whilst not included in the metropolitan clinical servicesframework, Peel Health Campus will continue its role within theSMAHS in providing health care services appropriate to the localcatchment area. A separate Peel Clinical Services Framework isbeing developed.

Significant development to become one of four metropolitanGeneral Hospitals providing comprehensive range of core clinicalservices to its catchment in the SMAHS.

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* Palliative care beds provided under contract by Murdoch Hospice beds

2.4.3 Women’s and Children’s Health ServiceThe Women’s and Children’s Health Service is a statewide service. Major services assigned toWCHS include:

● Princess Margaret Hospital (PMH)

● King Edward Memorial Hospital (KEMH)

● Child and Youth Health Clinical Network

● Women’s Health Clinical Network including maternal health.

The role and function of KEMH and PMH will continue at a tertiary level. Reconfiguration ofservices in the NMAHS and SMAHS will support and complement these existing statewide servicesby increasing the provision of women’s and children’s services in general hospitals closer to wherethe community lives.

A range of health care services support and complement the continuum of care for women andchildren, such as population health prevention and promotion programs and ambulatory careservices. Improvements and expansion in service delivery in order to reduce the pressures on thetertiary hospital system and allow patients to receive the best possible care in the mostappropriate setting close to their community is underway.

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WA 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 0 5 – 2 0 1 5

2015/162010/112005Facility

Bed Provision Strategy

Fiona Stanley HospitalFremantle HospitalWoodside Maternity Hospital Rockingham/Kwinana District HospitalBentley HospitalArmadale Kelmscott Memorial Hospital

Total

11*5043785

235207

1079

610252

0239196274

1571

1058217

0306200276

2057

2015/162010/112005(April)Facility

Bed Provision Strategy

Princess Margaret Hospital

King Edward Memorial Hospital

256

276

256

229

178

212

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Significant resources and effort have gone into re-establishing the reputation and physicalfacilities at King Edward Memorial Hospital. In the past 2 years over $25m has been spent on arange of capital works including the development of a Maternal Foetal Monitoring Centre and anupgrade of the delivery suite, emergency department and acute high dependency unit.

Long-term solutions are required for a range of issues identified at the KEMH and PMH facilitieswhich impact upon their effectiveness and efficiency.

Some of the issues identified are:

● constrained sites

● continuity of care

● isolation of some gynaecological services from other adult services

● ability to maintain high levels of clinical care, equipment, services and infrastructure onisolated sites

● difficulty in alignment of clinical quality and governance processes across distinct sites

● ability to maintain adequate maternity service provision on large number of sites given thelong-term issue of attraction and retention of suitably experienced workforce.

It is acknowledged that co-location of the hospitals within the Women’s and Children’s HealthServices at a tertiary adult site would be the preferred solution to address the issues identified.However, after extensive consultation and deliberation it has been concluded that:

● PMH should be relocated to the vacated Wellington Street Campus (North Block) when RPHservices are relocated. Many of the difficulties of the current PMH site will be addressed bythe more modern infrastructure of the north block and the proximity to public transport andparking.

● The Institute for Child Health Research should be relocated to the RPH site in close proximityto the Paediatric Hospital.

● King Edward Memorial Hospital should be relocated to a new site. Three options will bemaintained at the FSH, SCGH and a site to the west of the existing North Block at RPH, with afinal decision to be made closer to a move date. A ‘footprint’ for KEMH will be included inplanning for the development of all sites, retaining an option for the most appropriaterelocation when required.

● It is recognised that having diagnostic and adult high level support services co-located with thewomen’s tertiary service is a preferred option. If KEMH was to eventually locate at the RPHsite, it is possible that a private health provider might wish to collocate at this site, thusproviding adult tertiary support services and access to clinicians.

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Supporting the VisionThe WCHS will facilitate the enhanced coordination and support of women’s and children’s healthservice delivery to the state.

An important priority will be the articulation of a Maternal Services Framework, building uponsuccessful models of care already in place in WA, to help inform the planning of new andenhanced services within the metropolitan and country area health services. This will be donewith an aim to support and promote the practice of all members of the maternal care teamincluding obstetricians, GP obstetricians and midwives, ensuring that the community continues tohave choice in their preferred model of care.

Western Australia experiences a number of unique challenges in the provision of obstetric andmaternal care services due to our vast geography, population distribution and cultural diversity.As recommended in the Western Australian Statewide Obstetric Services Review 2002, laterendorsed by the Health Reform Committee in 2004 and as outlined in the Perinatal and InfantMortality Report 2001-02, a Statewide Obstetric Support Unit (SOSU) has been established underthe direction of the Women’s and Children’s Health Service.

The aim of the SOSU is to ensure the highest standard of maternity care is provided to thecommunity of Western Australia. To achieve this aim, the service will work collaboratively withina network of metropolitan and country maternity services to provide support and direction inareas such as development of policy and standards, clinical quality and safety activities,workforce support and professional advice.

2.4.4 WA Country Health ServiceThe WA Country Health Service has embarked upon the implementation of the recommendationsof the Country Health Services Review of 2003 (endorsed as part of the Reid report) that willguide the development of clinical services in regional areas.

The WA Country Health Service manages over 200 facilities, including 57 hospitals, 22 nursingposts and over 100 health centres, child, community and mental health facilities.

Regional Resource Centres, Integrated District Health Services and health services in smallertowns and communities form a regional network of health services across each region based on a‘hub and spoke’ concept.

The aim of building a regional network model across the WA Country Health Service is to:

● provide a guaranteed level of patient care in each hospital

● improve the patient care available within the region

● increase patient access to clinical services.

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Details on the level of service to be provided in each country hospital are included in Appendix 2.

Regional Resource CentresRegional Resource Centres will deliver as much acute care within regions as possible, limiting theneed for travel to Perth other than for services only available at major metropolitan hospitals.Regional Resource Centres will also provide patient services and other non-clinical supportservices to smaller health services within the region.

Regional Resource Centres are located in:

● Broome

● Port Hedland

● Geraldton

● Kalgoorlie

● Albany

● Bunbury

In the Wheatbelt, the dispersed population and close proximity to Perth suggest the developmentof four Integrated District Health Services rather than a single Regional Resource Centre. Adetailed plan for the unique hospital and health service system in the Wheatbelt region will beundertaken in 2005.

Integrated District Health Services Integrated District Health Services will provide a range of designated inpatient and primary careservices for the town and surrounding communities, supported by outreach services from theRegional Resource Centre. Services will include 24 hour emergency cover, the planned delivery oflow-risk births, and some low complexity surgery as well as diagnostic and primary healthservices.

Integrated District Health Servcies are located in:Esperance Katanning Moora NarroginMerredin Northam Carnarvon NewmanNickol Bay Derby Kununurra

Health Services in Small TownsHospital and health services in small towns will be flexible to accommodate changing healthneeds. The emphasis is on continued provision of 24 hour emergency treatment services, thecapacity for low level acute inpatient care, aged care and appropriate community-based services.

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Towns with such services include:Fitzroy Crossing, Halls Creek, Wyndham, Exmouth, Onslow, Paraburdoo, Wickham, Roebourne,Tom Price, Dongara, Kalbarri, Meekatharra, Morawa, Mullewa, North Midlands, Northampton,Laverton, Leonora, Norseman, Ravensthorpe, Beverley, Boddington, Bruce Rock, Corrigin,Cunderdin, Dalwallinu, Dumbleyung, Goomalling, Kellerberrin, Kondinin, Kununoppin, Lake Grace,Narembeen, Pingelly, Quairading, Southern Cross, Wagin, Wongan Hills, Wyalkatchem, York,Denmark, Gnowangerup, Kojonup, Plantagenet.

Health Services for small communities/settlementsSome small communities have difficulty in supporting resident general practitioner services.Where GPs cannot be attracted, the primary care needs of these small communities may be metthrough services staffed by resident nurse practitioners and supported by visiting generalpractitioners, community nurses and allied health staff.

Partner Metropolitan Health ServicesPartnerships between the country regions and metropolitan health services will provide supportfor country services including:

● visiting specialists/locum specialists/specialist rotations

● telehealth clinical consultations and support

● assistance with recruitment of specialists, doctors, nurses, allied health clinicians and jointappointments

● graduate medical, nursing and allied health rotations

● inservice education and training

● clinical advice and audit support.

Capital and InfrastructureA capital and infrastructure plan has been articulated to develop the capacity of our RegionalResource Centres and Integrated District Health Services, replace or upgrade small health serviceswhere necessary, improve staff and patient accommodation and medical transport services.

Priorities 2005-2010The priorities for the next five years are:

● establishing formal metro-country links

● building the clinical workforce in Regional Resource Centres

● developing the physical infrastructure and systems for regional health networks

● staff attraction and retention initiatives, especially improved staff housing

● better coordinated patient transport systems

● greater focus on aged care services.

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2.4.5 South West Area Health ServiceThe South West Area Health Services (SWAHS) has embarked on a strategic service planningprocess to ensure the systematic improvement of health care services in the region over time inalignment with the State Strategic Health Plan.

The SWAHS service planning will embody clinical services planning and includes a scope of analysisand planning which is broader than just clinical services. This approach by SWAHS seeks toachieve both the requirements of a clinical services plan with its focus on service settings and theten condition-based consumer centric programs that are the focus of service delivery in the SouthWest.

The South West Health Campus at Bunbury will be maintained as the key central hub for servicesin the south-west. This private-public collocation has been extremely successful.

25

Kimberley

Pilbara Gascoyne

Goldfields South East

MidwestMurchison

Wheatbelt

Great Southern

SouthWest

WA Country Health Service and South West Area Health Service Configuration

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2.5 Education and ResearchThe Western Australian health system has a distinguished role in undertaking cutting-edgeresearch which has benefited local, national and international patients. Similarly, there is astrong emphasis and long tradition in clinical education and training within our health caresystem.

The Department of Health is committed to the position of research within the system and tostrengthening opportunities for clinical research across all health settings, including hospital,community and ambulatory care. The newly established State Health Research Advisory Council(SHRAC) will have a pivotal role in providing leadership for the further development of health andmedical research, ensuring a coordinated approach to the planning, conduct of research andtranslation of research into policy and practice.

SHRAC will also provide advice on planning for development of facilities within current andproposed infrastructure developments, including Sir Charles Gairdner Hospital and the new FionaStanley Hospital and the expansion of research to be undertaken at the four general hospitals.Significant additional new research facilities will be established simultaneously with buildingdevelopment at FSH, SCGH and the newly located PMH.

The expanding role of health and medical research as outlined in the CSF is not confined to majorteaching hospitals – it goes beyond to general and specialist hospitals, where patients will havethe ability to participate in clinical research in hospitals that are closer to home and still benefitfrom the translation of research outcomes into policy and practice.

Teaching and training for medical, nursing and allied health students has traditionally beenthrough an apprenticeship model primarily based at our large metropolitan tertiary hospitals.After considering the medical workforce and the influx of additional medical graduates from2009, the Reid report recommended that new ways of undertaking medical training are needed.

Work has progressed to develop and implement new approaches to undergraduate andpostgraduate medical training, including:

● greater exposure to private and secondary hospitals where junior doctors have the opportunityto experience training in a variety of medical and surgical conditions

● increased training within the ambulatory care setting

● greater training in community settings.

Key stakeholders will be engaged, including clinicians, colleges and universities to discusssustainability of medical training into the future. A steering committee has been established toidentify strategies and to monitor risks, quality and timeliness of strategies for medical training.Issues already raised include the need to incorporate appropriate teaching facilities within thereconfiguration of our health system.

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There are a number of advantages to the ongoing commitment to research and training, includingthe improved quality of life and wellbeing for patients and the attraction and retention of staffinvolved in research and training.

2.6 Pathology Services WAAs recommended in the Reid report, a single pathology service has been established in WA withthe aim to providing service quality and economic benefits over time which will support theimplementation of the CSF.

Expected benefits include:

● improved demand management

● service rationalisation (adopting a system level approach to reducing costs by better matchingcapacity and demand, eliminating inappropriate duplication, and managing the developmentof specialist services)

● economies of scale in purchasing and procurement

● support for and expansion of teaching and research.

Further work will be done on the optimal facility deployment (eg centralised specialist laboratoryservices) in order to provide a comprehensive and world-class pathology service.

2.7 Mental Health The State’s mental health system has been under significant pressure for many years, andimproving mental health services for patients and health system staff is now a top priority.

$173.4 million in additional funding over the next three years has been allocated to enable theimplementation of comprehensive mental health reform initiatives.

This funding of a range of new initiatives and the expansion of existing mental health services willhave significant benefits to many individuals, carers and families in Western Australia who needsupport.

The Mental Health Strategy 2004-2007 (available at www.mental.health.wa.gov.au) outlines keyreforms needed to address the most pressing areas of need within the current mental healthsystem.

Specifically, the Mental Health Strategy 2004-2007 addresses the main areas of the health systemwhere targeted interventions have the capacity to immediately and significantly increase accessto mental health services and reduce demand on acute beds. The key areas are:

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1. Mental health emergency services

2. Adult inpatient services

3. Community mental health services (adult and young people)

4. Supported community accommodation

5. Workforce and safety initiatives

6. Promotion, prevention and early intervention

7. Specialist mental health services

8. Non-government mental health services

9. Improving mental health services

10. Primary mental health care

11. Increasing consumer and carer participation

The development of these individual strategies is the culmination of a significant amount ofconsultation involving consumers, carers, mental health professionals, governments and non-government mental health bodies and peak industry organisations.The Mental Health Advisory Group, made up of mental health specialists, is overseeing theimplementation of the Mental Health Strategy 2004-2007 and plays an integral role in thedevelopment and monitoring of activities.

In addition the Mental Health Action Plan 2005-2010 has been commenced to move improvementin mental health services including preventative strategies, forward as part of the StrategicHealth Plan (www.mental.health.wa.gov.au).

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3. Facilitating Change

A number of key support functions are critical to the successful implementation of the CSF, suchas governance and organisation structures, workforce, infrastructure, finance, informationmanagement and communication technology. Development of these support functions will takeplace over a long-term period. However, an overview of the direction for each function isincluded here.

3.1 Governance and Organisational StructureA number of key organisational changes as recommended by the HRC will serve to support theimplementation of the CSF and ensure accountability for the successful achievement of keyreform outcomes. The changes include:

● continuing the focus on reform though the Health Reform Implementation Taskforce in closeconnection with the Office of the Director General

● strengthening the Area Health Services Model

● refocussing the Department of Health’s functions towards a clearer role in supporting healthservices and reporting and evaluating health system performance for the Government

● strengthening the focus on health outcomes through the implementation of a policy frameworkfor health in Western Australia - the Health Policy and Clinical Reform Division will beresponsible for establishing statewide clinical networks within programs pertaining to long-established groups of conditions. This Division will bring together stakeholders in the public,private, non-government and academic sectors as well as consumers and carers to oversee thedevelopment of priorities that are underpinned by epidemiology, policy and protocols,planning, and performance targets for their respective clinical program areas

● establishment of the State Women’s and Children’s Health Service combining the formerWomen’s and Children’s Health and the Child and Community Health Directorate of theDepartment of Health

● Development and implementation of an improved Statewide Clinical Governance frameworkbuilt on the four pillars of clinical audit, clinical risk, consumer values and professionaldevelopment and management led by the Office of Safety and Quality in Health Care.

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WA 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 0 5 – 2 0 1 5

HEALTH POLICY &CLINICAL REFORM*

INFRASTRUCTURE*

SYSTEM EFFICIENCY*

HEALTH SYSTEMSUPPORT

STATUTORYOFFICERS

SOUTHMETROPOLITANAREA HEALTH

SERVICE

NORTHMETROPOLITANAREA HEALTH

SERVICE

WA COUNTRYHEALTH SERVICE

SOUTH WEST AREAHEALTH SERVICE

WOMEN’S ANDCHILDREN’S HEALTH

SERVICE

INTERNALAUDIT/CORPORATE

GOVERNANCE*

OFFICE OF THEDIRECTOR GENERAL*

Public Relations & MarketingFederal AffairsMinisterial & Parliamentary LiasonSystem Policy

HEALTH FINANCE

DIRECTOR GENERAL*

HEALTH OPERATIONSHEALTH SYSTEM SUPPORT

HEALTH REFORM

Health Corporate NetworkPathologyDentalClinical Technology (Biomedical Eng)Drug & Alcohol Office

WA Organisational Chart

* Includes members of the Health Reform Implementation Taskforce

3.2 Strategic Workforce FrameworkThe changes planned within the health system will have significant implications for ourworkforce. Long term strategic planning is required to ensure we have the capacity to deliver theservices that will be required to meet the health care needs of our population into the future.

A forecast of the nature and scale of future health workforce defined by the CSF across each ofthe metropolitan health sites and clinical specialties has been developed.

Projections have been made based on quantitative and qualitative knowledge of health workforcepatterns and trends along with demand elements such as projected bed capacities, servicethroughputs, and service capability level data.

Detailed information is being developed to assist in workforce planning for the followingcategories of staff:

● nursing

● medical services including interns, registrars and specialist medical practitioners

● medical support including radiology, radiotherapy, pathology, dieticians, podiatry, chaplaincy,health promotion, other medical, pharmacy, technical, speech pathology, other ancillaryservices and allied health professionals

● site services including engineering, garden and security based occupations

● hotel services including catering, cleaning, stores/supply, laundry and transport occupations

● administration and clerical.

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31

The following work in progress will impact on the CSF workforce projections:

● the increase in training posts across the health system e.g. interns, junior doctors andsupervisory positions

● the third National Mental Health Plan

● privately contracted services, such as radiology

● an assessment of ‘replacement demand’ identifying demographic changes to the healthworkforce, including participation, retirement and migration trends.

Workforce InitiativesWorkforce reform and development strategies will centre on the new health workforce requiredto meet increasing demand. In particular the current scope of practice of the various healthoccupations requires examination and change in order to optimise workforce efficiency.

Major areas of workforce development include:

● better use of available professional workforce with delegation of tasks to other groups - forexample, providing administration and clerical support to medical staff, better utilising theirtime, particularly as ‘safe hours’ pressures reduce current average working time

● expansion of scope of practice - for example, providing more Nurse Practitioners withprescribing rights in various clinical settings

● development of new, multi-skilled health workers to meet specific needs - for example,developing rural health workers able to provide services currently provided by a range ofhealth workers in rural and remote settings

● review of current education and training regimes - for example, identifying where time intraining can be reduced to address critical supply shortages.

Increasing Workforce SupplyStrategies are being developed to increase health workforce supply to meet predicted growth indemand for services.

Medical training will increase significantly in WA, with the number of medical student completingtraining doubling over the next five years.

The WA Health medical workforce is being mapped to identify specialist training priorities andoptimise training capacity. Recently the Department completed an analysis of the surgicalworkforce, identifying training needs which will provide an adequate supply of surgeons to meetthe future demand. As part of this process existing and potential training posts have beenmapped and a business case developed to implement the required changes. This process willprovide the template for future work as the other medical specialties are mapped.

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The number of nurses in training and in the Nursing Register has also increased in recent years,and WA Health has developed retraining packages and supported training in key areas ofshortages, including mental health.

WA Health is developing new models of training, such as the new podiatry training program, andthe provision of scholarships for our staff to study in other states where there are no localtraining opportunities (e.g. radiation therapy and nuclear medicine).

Improved access to overseas labour is a key initiative to meet demand pressures in the shortterm. This is being achieved through the development of labour agreements and streamlinedimmigration processes with the Department of Immigration and Multicultural and IndigenousAffairs (DIMIA).

Attraction and RetentionWA Health is developing attraction and retention initiatives that are responsive to staff needs. Inaddition to negotiations to improve pay and working conditions, the Department is exploring:

● family friendly initiatives

● flexible working arrangements

● improving the quality of working life, by putting in place strategies such as targeting violencein the workplace.

Related Systems and Reporting Development The workforce aspect of the CSF links to a number of initiatives currently being undertaken byWorkforce Planning and Supply Branch of the Department of Health to improve human resourceanalysis and reporting capacity, including:

● enhancement of reporting capacity through an improved systems-based reporting framework,which provides a single aggregated source of human resource payroll data

● changes to core source data systems to improve the completeness and quality of workforcedata through a revision of record keeping standards and identification of health-specificminimum data requirements

● developing alternative views of financial measures, including productive and non-productiveworkforce profiles

● developing baseline establishment profiles that will facilitate improved reporting of actualstaff numbers, organisational structures and identification of vacancy rates, thereby deliveringimproved workforce planning capacity

● developing alternative service-related performance reporting and workforce profiling that ismore closely aligned with the operational requirements of health service units

● forging data links with other core Department of Health systems, including finance and activitysystems.

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33

Participation In National Health Workforce InitiativesWA Health actively participates in national workforce bodies and various national initiatives as ameans of ensuring that the state is represented at the highest level of national policydevelopment, and to ensure a coordinated approach to workforce concerns across all jurisdictions

The National Health Workforce Strategic Framework, which was endorsed by Australian HealthMinisters in April 2004, is focused on continuing to expand the supply of the medical, nursing,allied health and dental workforce. Priorities identified by the Australian Health WorkforceOfficials Committee (AHWOC) in December 2004 are:

● extending health workforce participation

● health workforce education and training including a new model of clinical education,alternative approaches to specialist education, and greater interaction with the highereducation sector, and

● minimising barriers, workforce reform, redesign and new workforce models.

Work undertaken by jurisdictions in collaboration with the Australian Government includes:

● review of the Royal Australasian College of Surgeons and other Colleges arising from theAustralian Competition and Consumer Commission (ACCC) determination

● review and reworking of national workforce projections undertaken by the Australian MedicalWorkforce Officials Committee (AMWAC), and review of national workforce data collections

● minimising barriers, workforce reform, redesign and new workforce models

● National reviews of workforce including the Surgical, General Practice, Radiation Oncology,Dental and Pathology workforces

● examining the interface between the health and education sectors

● developing nationally consistent medical registration and drafting instructions for medicalregistration legislation and for an intergovernmental agreement/memorandum ofunderstanding for endorsement by State and Territory Health Ministers

● The Productivity Commission has been asked to undertake a study examining issues such as:institutional, regulatory and other factors across the health and education sectors that affectthe supply of health workforce professionals; the structure and distribution of the healthworkforce; and factors affecting the demand for services to be completed by February 2006.

3.3 Infrastructure Development FrameworkIn order to maintain and improve existing health facility infrastructure and develop the newfacilities articulated in the CSF, significant investment in health care infrastructure is required.

The Health Infrastructure Steering Group (HISG), the peak decision-making body at a whole ofhealth level, will have responsibility for developing, managing and monitoring the overall healthinfrastructure program as agreed with Government. This will involve:

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34

WA 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 0 5 – 2 0 1 5

● providing direction on infrastructure development strategies and objectives

● developing and monitoring Health’s capital expenditure program and capital investment plan

● approving new project concepts and business cases

● monitoring the progress of all approved infrastructure projects.

The HISG will meet its responsibilities with support from corporate health functions, including theHealth Reform Implementation Taskforce (HRIT), Health Finance and the Licensing Unit. Thesegroups will provide input into the infrastructure development process at various stages and:

● provide support to further clinical service planning

● develop and monitor the capital expenditure plan and investment program

● assist in the preparation, review and evaluation of business cases

● liaise with Department of Treasury and Finance

● ensure operational and facility standards are met

● explore the opportunities for public-private partnerships in line with Government policy.

The HISG will also be supported by a number of Project Control Groups (PCG) that will be thepeak decision-making bodies for Area Health Service infrastructure projects and statewideprojects such as mental health, clinical equipment replacement, minor capital works andinformation and communication technology.

The PCGs will be chaired by Area Health Service Chief Executives who will be members of theHISG and will be responsible for reporting on their infrastructure program, including reporting onworks in progress and ensuring that new projects are bought to the HISG for approval. Asmembers of the HISG, Chief Executives will also contribute to infrastructure planning at a wholeof health level.

The Infrastructure Development Framework will be prepared with reference to the roledelineation matrix and demand modeling and use a process with key steps as follows:

● development of a bed numbers framework as a guide to requirements in 2010, 2015 and 2020

● development of a ‘bed strategy’ to ensure the required numbers of beds by category bycatchments can be available on a year by year basis to 2020

● development of a facility strategy that describes how the beds and associated infrastructurecan be delivered on a campus by campus basis and in stages to 2020

● estimated area requirement (m2) (based on national benchmarks) for functional componentsfrom the facility strategies then used to estimate costs to inform the overall developmentplan.

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WA 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 0 5 – 2 0 1 5

35

Consideration will also be given to associated infrastructure development needs in partnershipwith other government agencies and non-government organisations needs, such asaccommodation for staff in country areas, accommodation for patients and families and publictransport plans to enable access to health services.

3.4 Information and Communication Technology FrameworkSupporting the CSF and a number of health reform projects is an Information and CommunicationTechnology (ICT) strategy.

The ICT program will deliver a system-wide integrated clinical information system that willincorporate the public and private hospitals, community health, primary care and mental healthsectors. This new system will be progressively implemented across the state and will includeelectronic patient records, single patient identifiers and provider identification.

The ICT program will engage stakeholders in the development of system requirements for allclinical modules. This process is now almost complete. After further discussions with stakeholdersand the completion of the regulatory processes, the Department of Health will proceed to atender process in the later part of this year.

3.5 Recurrent Costing of the WA Health Clinical Services Framework Recurrent costing of the WA Health Clinical Services Framework is progressing. As a first phase, arange of cost estimate scenarios covering metropolitan inpatient services and emergencydepartment services have been prepared.

These estimates will be used to assess the potential impact of the WA Health Clinical ServicesFramework on the State health budget over the medium and long term. The estimates will be animportant indicator of the further work that is required to place our State health system on amore sustainable footing that is in line with Government policy and priorities on the financing ofhealth services.

The costing results generated to this point will be fed into the next stages of demand, workforceand financial planning. The costing results will be used to engage partners and stakeholderswithin the system and outside, in productive discussions about health system financing andachieving better integration between service provision and budget management.

More reliable and robust costing scenarios will become available as further detailed planning isundertaken around health system infrastructure, demand and workforce, and as there is greaterclarity around the financial costs and benefits of health reforms being progressed in associationwith the WA Health Clinical Services Framework.

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36

WA 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 0 5 – 2 0 1 5

More robust costing estimates will also be derived through the progressing of developmentprojects as mentioned earlier, which will provide the necessary business intelligence, tools andcapability for enhanced medium and long term financial forecasting, including:

● Inpatient Activity Demand Modelling (next phase of demand modelling beyond the WA HealthClinical Services Framework)

● Non-Inpatient Activity Demand Modelling (including emergency care, ambulatory care, out-patients)

● Development of a uniform costing manual for the system to ensure consistent policies andpractice, and enhance intelligence around cost structures and cost behaviours

● Medium to long term cost and financial modelling of health workforce

● Medium to long term cost and financial modelling of health services

● Medium to long term price modelling of health services

● Development of a population-output based resource allocation and incentive and penaltymodel

● Development of a financial and service delivery benchmarking framework.

These projects are being undertaken in a joint manner between the Office of the DirectorGeneral, Health Reform Implementation Taskforce, Health Finance, State Health Support Services,Health Policy and Clinical Reform and the Area Health Services.

The WA Health Clinical Services Framework is a crucial first phase of system planning that willfacilitate for more detailed planning around demand, infrastructure, workforces and finances intothe future. Optimising the efficiency and effectiveness of our limited and valuable systemresources, and achieving greater financial sustainability has been a key consideration during theshaping of the WA Health Clinical Services Framework and will continue to be a considerationthrough the next phases of planning.

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WA 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 0 5 – 2 0 1 5

37

SOU

TH M

ETRO

POLI

TAN

2017201620152014201320122011201020092008200720062005

Fiona Stanley

Fremantle

Woodside

Rockingham

Bentley

Armadale

SCGH

RPH

Shenton Park

Joondalup

Kalamunda

Swan

Osborne Park

Graylands

KEMH

PMH

NO

RTH

MET

ROPO

LITA

NST

ATEW

IDE

Relocation

Hospital Operational

Development/Redevelopment

4. Health Service Development Timeframe

This chart provides an overview of the indicative Infrastructure Development timeframes whichwill guide implementation planning. Again, it is important to note that timeframes may beadjusted as the planning process unfolds and more explicit plans are detailed.

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WA 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 0 5 – 2 0 1 5

5. The Way Forward

The WA Health Clinical Services Framework provides the strategic direction for the delivery ofclinical services throughout Western Australia. However it is only one aspect of the overallplanning process that will inform WA Health’s Strategic Intent for 2005-2010 and see theimplementation of the State Health Strategic Plan 2005-2010.

Successful implementation of the plan will realise a number of health reform objectivesincluding:

● improved access to services

● reduced inequality in health status

● provision of safe, high quality health care

● promotion of a patient-centred continuum of care

● optimisation of public and private services

● improvement in the balance of preventative, primary and acute care

● financial sustainability as an integrated system

● support for a highly skilled and dedicated workforce.

Implementation PlanImplementing the CSF will be the responsibility of the entire team with WA Health.

Naturally, there will be a need for more extensive and detailed planning in many areas, buildingupon work already commenced and incorporating the new directions articulated.

This will also include a comprehensive and timely plan for the support and transition of ourworkforce as the changes are implemented. It will be important to ensure that all staff haveopportunity to participate and contribute during the implementation, are well informed about thechange process and are supported through transition arrangements.

A great deal of valuable information was submitted during the Clinical Services Consultation 2005,and this will be used to inform the implementation and transition phase which now follows.

A detailed implementation guide will be made available in due course.

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WA 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 0 5 – 2 0 1 5

39

Hospital Information

Service Information

Appendix 1 – Clinical Services Role Delineation

Reading The Clinical Services Role Delineation

Hospital InformationIf you are interested in a particular hospital scan horizontally along the row for the nominatedfacility, then scan down to view the service provided for the specialty of interest.

Service InformationIf you are interested in a particular service scan down the column for the nominated facility, thenscan across to view the service provided at the hospital of interest.

Bed NumbersIf you are interested in the number of beds for a particular specialty at a hospital, scan down thevertical column to the specialty and across to the hospital of interest.

Clinical Services Role Delineation Matrix

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Determining Level of ServiceOnce you have located the hospital and service of interest on the Clinical Services RoleDelineation Matrix, such as Cardiology Services at Rockingham/Kwinana District Hospital, you willview a number located in this box. Using this example, you will see this is shown as a Level 3 for2004/05. For an explanation of the level of service, refer to the Clinical Services Role DelineationDefinitions document.

40

WA 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 0 5 – 2 0 1 5

Determining Level of Service

E.g. This box will indicate the levelof service for Cardiology Servicesat Rockingham/Kwinana DistrictHospital

Clinical Service Role Delineation Matrix

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41

CLIN

ICAL

SER

VICE

S RO

LE D

ELIN

EATI

ON

DEF

INIT

ION

S

MED

ICA

L

Gen

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Type

I Su

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Type

II S

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spec

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SURG

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L

■Ph

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■Ca

rdio

logy

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erm

atol

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■En

docr

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■G

astr

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■G

eria

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med

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Neu

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spir

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■Cl

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mun

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42

TABL

E O

F CO

NTE

NTS

Serv

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Type

■M

edic

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■Su

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47

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ma

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Serv

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52

■Co

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53

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and

Pro

mot

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Serv

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53

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54

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bula

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■Ch

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ts M

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Men

tal

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Old

er P

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enta

l H

ealt

h Se

rvic

es

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■St

atew

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Men

tal

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lth

Serv

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■Cl

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al S

uppo

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Abb

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43

Leve

l 1

Leve

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Leve

l 3

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l 4

Leve

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Leve

l 6

Gen

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by

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gene

ral

phys

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gene

ral

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Out

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As f

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care

by

resi

dent

gene

ral

phys

icia

n ■

Out

pati

ent

cons

ulta

tion

by v

isit

ing

endo

crin

olog

ist

■D

iabe

tes

educ

atio

nse

rvic

e an

d in

tegr

ated

hosp

ital

/com

mun

ity

diab

etes

man

agem

ent

serv

ice

■Sp

ecia

list

RN

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

gene

ral

phys

icia

n an

d G

Psan

d so

me/

all

Type

I s

ub-

spec

ialis

ts■

Visi

ting

Typ

e II

sub-

spec

ialis

ts■

Regi

stra

r/RM

O/I

nter

n■

CCU

/HD

U■

Regi

onal

ref

erra

l ro

le■

Som

e un

derg

radu

ate

teac

hing

■Em

erge

ncy

serv

ices

avai

labl

e by

on

call

spec

ialis

t

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

card

iolo

gist

■Re

gist

rar/

RMO

/Int

ern

■CC

U/H

DU

■In

clud

es C

ath

Labs

■Re

gion

al r

efer

ral

role

Acce

ss s

peci

alis

t SR

N■

Som

e un

derg

radu

ate

teac

hing

and

pos

sibl

yso

me

rese

arch

rol

e■

Link

s w

ith

leve

l 5

reha

bilit

atio

n se

rvic

e■

Emer

genc

y se

rvic

esav

aila

ble

by o

n ca

llca

rdio

logi

sts

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

endo

crin

olog

ist

■Re

gist

rar/

RMO

■Re

gion

al r

efer

ral

role

■Ac

cess

to

spec

ialis

t SR

N■

Dia

bete

s ed

ucat

ion

serv

ice

and

inte

grat

edho

spit

al/c

omm

unit

ydi

abet

es m

anag

emen

tse

rvic

e■

Som

e un

derg

radu

ate

teac

hing

and

pos

sibl

yre

sear

ch r

ole

■Li

nks

to l

evel

5re

habi

litat

ion

serv

ice

■Em

erge

ncy

care

ava

ilabl

efr

om o

n ca

ll sp

ecia

list

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of m

edic

al s

ub-

spec

ialis

ts T

ype

I an

d II

and

emer

genc

y m

edic

alse

rvic

es■

Stat

ewid

e re

ferr

al r

ole

ince

rtai

n su

bspe

cial

ties

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

card

iac

serv

ices

inc

ludi

ng c

ardi

acsu

b-sp

ecia

ltie

s an

dem

erge

ncy

serv

ices

■CC

U/H

DU

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

ndpo

stgr

adua

te t

each

ing

role

■Re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

ofen

docr

inol

ogy

serv

ices

,w

ith

endo

crin

olog

yde

part

men

t an

dem

erge

ncy

care

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

ndpo

stgr

adua

te t

each

ing

role

■Re

sear

ch r

ole

Med

ical

Ser

vice

s

clinicalframeworknew spread 21/9/05 3:14 PM Page 45

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44

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Ger

iatr

ic

Neu

rolo

gy

Rena

l –

gene

ral

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g)

wit

hor

wit

hout

the

ass

ista

nce

of R

Ns

depe

ndin

g on

the

type

of

pati

ent

care

need

ed

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

As f

or l

evel

1 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Visi

ting

GP

and

poss

ibly

visi

ting

gen

eral

phy

sici

an■

24 h

our

cove

r by

RN

■Po

ssib

ly r

espi

te c

are

As f

or l

evel

1 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Visi

ting

GP

■24

hou

r co

ver

by R

N

As f

or l

evel

1 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Visi

ting

GP

■24

hou

r co

ver

by R

N

As f

or l

evel

2 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Resi

dent

GP

and

visi

ting

gene

ral

phys

icia

n■

24 h

our

cove

r by

RN

and

by G

P■

Resp

ite

care

and

lim

ited

reha

bilit

atio

n se

rvic

es

As f

or l

evel

2 p

lus:

■G

P In

pati

ent

Care

■24

hou

r co

ver

by R

N■

Out

pati

ent

care

by

visi

ting

gen

eral

phy

sici

anan

d po

ssib

ly n

euro

logi

st

As f

or l

evel

2 p

lus:

■G

ener

al p

hysi

cian

(lik

ely

to b

e vi

siti

ng)

inpa

tien

tca

re■

GP

care

■24

hou

r co

ver

by R

N■

Out

pati

ent

care

by

visi

ting

gen

eral

phy

sici

anan

d po

ssib

ly r

enal

spec

ialis

t■

May

acc

omm

odat

e se

lfca

re d

ialy

sis

in-p

atie

nts

As f

or l

evel

3 p

lus:

■Ac

cess

to

cons

ulta

ntph

ysic

ian

spec

ialis

ing

inge

riat

ric

med

icin

e■

Acti

ve a

sses

smen

t an

dre

habi

litat

ion

serv

ices

for

inpa

tien

ts a

nd o

utpa

tien

ts

As f

or l

evel

3 p

lus:

■In

pati

ent

care

by

resi

dent

gene

ral

phys

icia

n ■

Out

pati

ent

cons

ulta

tion

by v

isit

ing

neur

olog

ist

■Li

nks

wit

h at

lea

st l

evel

4ge

riat

ric

and

reha

bilit

atio

n se

rvic

es■

Spec

ialis

t RN

As f

or l

evel

3 p

lus:

■In

pati

ent

care

by

resi

dent

gene

ral

phys

icia

n ■

Out

pati

ent

cons

ulta

tion

by v

isit

ing

rena

l sp

ecia

list

■Se

lf c

are

dial

ysis

uni

t w

ith

links

to

larg

er r

enal

uni

t■

Spec

ialis

t RN

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

spec

ialis

t■

Regi

stra

r/RM

O■

Link

wit

h in

pati

ent

reha

bilit

atio

n un

it■

Inpa

tien

t as

sess

men

t un

itan

d do

mic

iliar

y co

nsul

tant

serv

ices

■Ac

cess

to

spec

ialis

t SR

N■

Som

e un

derg

radu

ate

teac

hing

Link

s w

ith

geri

atri

cps

ychi

atry

ser

vice

s

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

neur

olog

ist

■Re

gist

rar/

RMO

■Re

gion

al r

efer

ral

role

■Ac

cess

to

spec

ialis

t SR

N■

Som

e un

derg

radu

ate

teac

hing

and

pos

sibl

yso

me

rese

arch

rol

e■

Neu

rosu

rger

y su

ppor

t,EM

G,

nerv

e co

nduc

tion

,ev

oked

res

pons

es a

nd E

EGon

sit

e■

Emer

genc

y se

rvic

espr

ovid

ed b

y on

cal

lne

urol

ogis

t

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

rena

l sp

ecia

lists

■Re

gist

rar/

RMO

■Em

erge

ncy

serv

ices

prov

ided

by

on c

all

spec

ialis

t■

Regi

onal

ref

erra

l ro

le■

Acce

ss t

o sp

ecia

list

SRN

■So

me

unde

rgra

duat

ete

achi

ng a

nd p

ossi

bly

som

e re

sear

ch r

ole

■Al

l ty

pes

of d

ialy

sis

avai

labl

e an

d re

nal

biop

sies

per

form

ed■

Prov

ides

a f

ull

rang

e of

dial

ysis

acc

ess

surg

ery

As f

or l

evel

5 p

lus:

■Re

side

nt g

eria

tric

ian

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le■

Rese

arch

rol

e■

Stat

ewid

e re

ferr

al r

ole

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of n

euro

logy

serv

ices

, w

ith

neur

olog

yde

part

men

t an

dem

erge

ncy

care

Stat

ewid

e re

ferr

al r

ole

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le■

Acce

ss t

o CT

and

MRI

and

poss

ibly

PET

■Re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of r

enal

serv

ices

, w

ith

rena

lde

part

men

t an

dem

erge

ncy

care

ser

vice

s■

Rena

l tr

ansp

lant

atio

nav

aila

ble

■Co

ordi

nate

d by

ful

l ti

me

rena

l un

it m

anag

er

■St

atew

ide

refe

rral

rol

ean

d st

atew

ide

geog

raph

ical

are

a ba

sed

serv

ice

deliv

ery

role

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le■

Rese

arch

rol

e■

Prov

ides

a f

ull

rang

e of

dial

ysis

acc

ess

surg

ery

clinicalframeworknew spread 21/9/05 3:14 PM Page 46

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45

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Rena

l –

dial

ysis

Onc

olog

y

Radi

atio

n O

ncol

ogy

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

■Se

rvic

es o

ffer

ed b

y a

gene

ral

heal

thse

rvic

e/cl

inic

■Ca

re u

nder

sup

ervi

sion

of

GP

wit

h or

wit

hout

RN

■Se

lf-c

arin

g st

able

pat

ient

s■

Out

reac

h su

ppor

t fo

rho

me

dial

ysis

, po

ssib

lyun

der

rem

ote

dire

ctio

nfr

om a

Lev

el 5

or

Leve

l 6

dial

ysis

fac

ility

As f

or l

evel

1 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Visi

ting

GP

■24

hou

r co

ver

by R

N

As f

or l

evel

2 p

lus:

■Co

mm

unit

y-ba

sed

sate

llite

ser

vice

■Pr

edom

inat

ely

self

-car

ing

stab

le p

atie

nts

■Sp

ecia

list

RN■

Visi

ting

spe

cial

ist

for

mor

e co

mpl

icat

ed c

ases

■So

me

asse

ssm

ent

serv

ices

As f

or l

evel

2 p

lus:

■G

P in

pati

ent

care

■24

hou

r co

ver

by R

N■

Out

pati

ent

care

by

visi

ting

gen

eral

phy

sici

anan

d po

ssib

ly o

ncol

ogis

t

As f

or l

evel

3 p

lus:

■G

ener

al h

ospi

tal-

base

dsa

telli

te s

ervi

ce■

Visi

ting

spe

cial

ist

orge

nera

l ph

ysic

ian

wit

hne

phro

logy

ski

lls■

Mor

e co

mpl

icat

ed c

ases

■As

sess

men

t se

rvic

es■

Spec

ialis

t RN

■Ac

cess

to

on-s

ite

allie

dhe

alth

sup

port

(eg

;D

ieti

tian

s an

d So

cial

Wor

kers

)

As f

or l

evel

3 p

lus:

■In

pati

ent

care

by

resi

dent

gene

ral

phys

icia

n ■

Out

pati

ent

cons

ulta

tion

by v

isit

ing

onco

logi

st■

Link

s w

ith

radi

othe

rapy

,pa

lliat

ive

care

and

pai

nm

anag

emen

t se

rvic

es■

Spec

ialis

t RN

■Vi

siti

ng r

adia

tion

onco

logi

st w

orki

ng i

nco

njun

ctio

n w

ith

com

preh

ensi

ve c

ance

rse

rvic

e ■

No

trea

tmen

t fa

cilit

ies

As f

or l

evel

4 p

lus:

■Re

side

nt s

peci

alis

t■

Acce

ss t

o sp

ecia

list

SRN

■M

ore

com

plic

ated

cas

es■

Asse

ssm

ent

serv

ices

■Re

gion

al r

efer

ral

role

■Ac

cess

to

on-s

ite

allie

dhe

alth

sup

port

(eg

;D

ieti

tian

s an

d So

cial

Wor

kers

)

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

onco

logi

st■

Regi

stra

r/RM

O■

Regi

onal

ref

erra

l ro

le■

Acce

ss t

o sp

ecia

list

SNR

■So

me

unde

rgra

duat

ete

achi

ng a

nd p

ossi

bly

som

e re

sear

ch r

ole

■M

ulti

disc

iplin

ary

man

agem

ent

of p

atie

nts

incl

udin

g ca

seco

nfer

ence

s.■

Link

s w

ith

palli

ativ

e ca

rese

rvic

es a

nd m

ay h

ave

pain

man

agem

ent

clin

ic

■Em

erge

ncy

care

ava

ilabl

e■

Acce

ss t

o sp

ecia

list

SRN

As f

or l

evel

4 p

lus:

■Ba

sic

radi

atio

n on

colo

gyse

rvic

e w

ith

min

imum

equi

pmen

t -

poss

ibly

onl

yon

e m

achi

ne■

Has

acc

ess

to r

adia

tion

onco

logi

sts,

phy

sici

sts

and

radi

atio

n th

erap

ists

■Ac

cess

to

spec

ialis

t SR

N■

Link

s to

lev

el 5

pal

liati

veca

re s

ervi

ce

As f

or l

evel

5 p

lus:

■Re

side

nt s

peci

alis

t■

Mor

e co

mpl

icat

ed c

ases

■Pr

ovid

es a

cute

dia

lysi

sw

hen

nece

ssar

y■

Asse

ssm

ent

serv

ices

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le■

Stat

ewid

e ce

ntre

of

exce

llenc

e an

d re

ferr

alro

le■

Acce

ss t

o sp

ecia

list

SRN

■Ac

cess

to

on-s

ite

allie

dhe

alth

sup

port

(eg

;D

ieti

tian

s an

d So

cial

Wor

kers

)■

Com

plic

ated

ass

essm

ent

and

trea

tmen

t of

uns

tabl

eco

-mor

bidi

ties

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of o

ncol

ogy

serv

ices

, w

ith

onco

logy

depa

rtm

ent

and

emer

genc

y se

rvic

es■

Stat

ewid

e re

ferr

al r

ole

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le■

Rese

arch

rol

e■

Acce

ss t

o sp

ecia

list

SNR

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of r

adia

tion

onco

logy

ser

vice

s, l

ocat

edin

pri

ncip

le r

efer

ral

cent

re w

ith

acce

ss t

o al

lsu

bspe

cial

ties

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

ndpo

stgr

adua

te t

each

ing

role

■Re

sear

ch r

ole

■Fu

lly i

nteg

rate

dco

mpu

teri

sed

plan

ning

,tr

eatm

ent

and

veri

fica

tion

sys

tem

s■

Mec

hani

cal

and

biom

edic

al s

uppo

rtfa

cilit

ies

clinicalframeworknew spread 21/9/05 3:14 PM Page 47

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46

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Resp

irat

ory

Palli

ativ

e Ca

re

Gas

troe

nter

olog

y

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

As f

or l

evel

1 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Visi

ting

GP

■24

hou

r co

ver

by R

N

As f

or l

evel

1 p

lus:

■M

anag

emen

t by

GPs

and

gene

ralis

t nu

rses

■24

hou

r co

vera

ge■

Link

age

wit

h co

mm

unit

yba

sed

serv

ices

pro

vide

dby

Silv

er C

hain

Nur

sing

Asso

ciat

ion

As f

or l

evel

1 p

lus:

■In

pati

ent

and

outp

atie

ntca

re■

Visi

ting

GP

■24

hou

r co

ver

by R

N

As f

or l

evel

2 p

lus:

■G

P in

pati

ent

care

■24

hou

r co

ver

by R

N■

Out

pati

ent

care

by

visi

ting

gen

eral

phy

sici

anan

d po

ssib

ly r

espi

rato

rysp

ecia

list

As f

or l

evel

2 p

lus:

■In

pati

ent

care

by

accr

edit

ed G

P or

spec

ialis

t ph

ysic

ian

■24

hou

r co

ver

clin

ical

nurs

e w

ith

expe

rien

ce i

npa

lliat

ive

care

ser

vice

s■

Out

pati

ent

care

by

visi

ting

gen

eral

phy

sici

anan

d po

ssib

ly p

allia

tive

care

spe

cial

ist

As f

or l

evel

2 p

lus:

■G

P in

pati

ent

care

■24

hou

r co

ver

by R

N■

Out

pati

ent

care

by

visi

ting

gen

eral

phy

sici

anan

d po

ssib

lyga

stro

ente

rolo

gist

Poss

ibly

hav

e fi

bre

opti

cen

dosc

opy

by a

ccre

dite

dm

edic

al p

ract

itio

ner

As f

or l

evel

3 p

lus:

■In

pati

ent

care

by

resi

dent

gene

ral

phys

icia

n ■

Out

pati

ent

cons

ulta

tion

by v

isit

ing

resp

irat

ory

spec

ialis

t■

Spec

ialis

t RN

As f

or l

evel

3 p

lus:

■Pa

lliat

ive

care

inp

atie

ntbe

ds m

anag

ed b

y G

P or

med

ical

pra

ctit

ione

rsp

ecia

lisin

g in

pal

liati

veca

re■

Acce

ss t

o sp

ecia

list

SRN

■Se

amle

ss l

inka

ge t

o Si

lver

Chai

n N

ursi

ng A

ssoc

iati

onw

ho p

rovi

de c

omm

unit

yba

sed

palli

ativ

e ca

re

As f

or l

evel

3 p

lus:

■In

pati

ent

care

by

resi

dent

gene

ral

phys

icia

n ■

Out

pati

ent

cons

ulta

tion

by v

isit

ing

gast

roen

tero

logi

st■

Regu

lar

endo

scop

y se

rvic

ein

clud

ing

colo

nosc

opy

■Sp

ecia

list

RN■

Gas

troe

nter

olog

y se

rvic

espr

ovid

ed b

y in

tegr

ated

phys

icia

n an

d su

rgic

alse

rvic

es

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

resp

irat

ory

spec

ialis

t■

Regi

stra

r/RM

O■

Regi

onal

ref

erra

l ro

le■

Acce

ss t

o sp

ecia

list

SRN

■So

me

unde

rgra

duat

ete

achi

ng a

nd p

ossi

bly

som

e re

sear

ch r

ole

■Ac

cess

to

leve

l 5

card

iolo

gy a

ndca

rdio

thor

acic

sur

gery

■Em

erge

ncy

care

pro

vide

dby

on

call

spec

ialis

t

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

palli

ativ

e ca

re p

hysi

cian

■Re

gist

rar/

RMO

■Re

gion

al r

efer

ral

role

■Ac

cess

to

spec

ialis

t SR

N■

Und

ergr

adua

te t

each

ing

and

som

e re

sear

ch r

ole

■In

tegr

ated

com

mun

ity/

hosp

ice

cons

ulta

tive

ser

vice

und

erdi

rect

ion

of p

allia

tive

care

phy

sici

an■

Link

s w

ith

onco

logy

,ra

diot

hera

py,

anae

sthe

tics

, ps

ychi

atry

,pa

in c

linic

and

reha

bilit

atio

n

As f

or l

evel

4 p

lus:

■In

pati

ent

care

by

resi

dent

gast

roen

tero

logi

st■

Regi

stra

r/RM

O■

Regi

onal

ref

erra

l ro

le■

Acce

ss t

o sp

ecia

list

SRN

■So

me

unde

rgra

duat

ete

achi

ng a

nd p

ossi

bly

som

e re

sear

ch r

ole

■Fu

ll en

dosc

opy

serv

ice

■Em

erge

ncy

care

ava

ilabl

eby

on

call

spec

ialis

t

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of r

espi

rato

ryse

rvic

es,

wit

h re

spir

ator

yde

part

men

t an

dem

erge

ncy

care

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

ndpo

stgr

adua

te t

each

ing

role

Rese

arch

rol

e■

Has

a r

espi

rato

ry f

unct

ion

labo

rato

ry■

Acce

ss t

o sp

ecia

list

SRN

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of p

allia

tive

care

ser

vice

s w

ith

palli

ativ

e ca

re s

peci

alis

tpr

ovid

ing

cons

ulta

ncy

toot

her

unit

s re

ferr

alho

spit

als

■Em

erge

ncy

serv

ices

avai

labl

e ■

Stat

ewid

e re

ferr

al r

ole

■U

nder

grad

uate

and

post

grad

uate

tea

chin

gro

le

■H

as s

taff

wit

h co

njoi

ntap

poin

tmen

ts w

ith

hosp

ice

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

ofga

stro

ente

rolo

gy s

ervi

ces,

wit

h ga

stro

ente

rolo

gyde

part

men

t an

dem

erge

ncy

care

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

ndpo

stgr

adua

te t

each

ing

role

Rese

arch

rol

e■

Acce

ss t

o sp

ecia

list

SRN

clinicalframeworknew spread 21/9/05 3:14 PM Page 48

Page 55: WA Health Clinical Services/media/Files... · Healthy Workforce Recruit, develop and retain Develop knowledge, skills and participation Promote a culture of professionalism, teamwork

47

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Gen

eral

ENT

Gyn

aeco

logy

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

As f

or l

evel

1 p

lus:

■M

inor

out

pati

ent

and

sam

e da

y pr

oced

ures

onl

yby

GP

or v

isit

ing

gene

ral

surg

eon

■In

pati

ent

care

fol

low

ing

surg

ery

else

whe

re

■M

inor

out

pati

ent

and

sam

e da

y pr

oced

ures

onl

yby

GP

or v

isit

ing

gene

ral

surg

eon

■In

pati

ent

care

fol

low

ing

surg

ery

else

whe

re

As f

or l

evel

2 p

lus:

■D

ay s

urge

ry t

ype

case

s,un

com

plic

ated

ele

ctiv

esu

rger

y an

d em

erge

ncy

surg

ery

■G

P an

d vi

siti

ng g

ener

alsu

rgic

al s

peci

alis

t■

Visi

ting

ana

esth

etis

t w

ith

visi

ting

sur

geon

■Th

eatr

e tr

aine

d RN

As f

or l

evel

2 p

lus:

■Co

mm

on a

ndin

term

edia

te p

roce

dure

son

low

or

mod

erat

e ri

skpa

tien

ts b

y vi

siti

ngge

nera

l su

rgeo

n

As f

or l

evel

3 p

lus:

■Su

rger

y by

GPs

, ge

nera

lsu

rgeo

ns a

nd v

isit

ing

Type

I su

b-sp

ecia

lists

■Br

oad

rang

e of

day

and

gene

ral

surg

ery

and

som

esp

ecia

lty

surg

ery

■Th

eatr

e tr

aine

d nu

rses

■M

ore

than

1 t

heat

re■

May

inc

lude

hig

h-de

pend

ency

nur

sing

uni

t

■Co

mm

on a

ndin

term

edia

te s

urge

ry d

one

on l

ow o

r m

oder

ate

risk

pati

ents

by

visi

ting

EN

Tsu

rgeo

n■

No

neur

o-op

tic

orin

trac

rani

al s

urge

ry

As f

or l

evel

3 p

lus:

■Co

mm

on,

inte

rmed

iate

and

som

e m

ajor

proc

edur

es o

n lo

w a

ndm

oder

ate

risk

pat

ient

spe

rfor

med

by

visi

ting

gyna

ecol

ogis

ts■

Link

s w

ith

onco

logy

,ra

diot

hera

py a

ndpa

lliat

ive

care

ser

vice

s

As f

or l

evel

4 p

lus:

■G

ener

al s

urge

ons

■So

me/

all

Type

I s

ub-

spec

ialis

ts■

Visi

ting

Typ

e II

sub-

spec

ialis

ts■

Regi

stra

r/RM

O■

ICU

■Re

gion

al r

efer

ral

role

■M

ay h

ave

som

e te

achi

ngan

d re

sear

ch r

ole

■U

nder

take

s m

ost

emer

genc

y su

rger

y■

May

inc

lude

kid

ney

tran

spla

ntat

ion

inse

lect

ed s

ites

As f

or l

evel

4 p

lus:

■D

iagn

osti

c se

rvic

es a

ndsu

rger

y on

low

, m

oder

ate

and

high

ris

k pa

tent

s by

on c

all

ENT

surg

eon

■Ac

cess

to

spec

ialis

t SR

N■

Regi

onal

ref

erra

l ro

le■

May

hav

e so

me

teac

hing

and

rese

arch

rol

e■

Link

s w

ith

onco

logy

,ra

diot

hera

py a

ndpa

lliat

ive

care

ser

vice

s■

Lim

ited

neu

ro-o

ptic

surg

ery

As f

or l

evel

4 p

lus:

■D

iagn

osti

c se

rvic

es a

ndsu

rger

y on

low

, m

oder

ate

and

high

ris

k pa

tien

ts b

yon

cal

l gy

naec

olog

ists

■Ac

cess

to

spec

ialis

t SR

N■

May

hav

e gy

naec

olog

yre

gist

rar/

RMO

■Re

gion

al r

efer

ral

role

■M

ay h

ave

som

e te

achi

ngan

d re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of s

urgi

cal

sub-

spec

ialis

ts T

ype

I an

d II

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e■

Und

erta

kes

emer

genc

ysu

rger

y■

May

inc

lude

kid

ney

and

liver

tra

nspl

anta

tion

in

sele

cted

sit

es

As f

or l

evel

5 p

lus:

■Ab

ility

to

deal

wit

h al

lca

ses

incl

udin

g fu

ll ra

nge

of c

ompl

ex c

ases

in

asso

ciat

ion

wit

h ot

her

spec

ialis

ts i

nclu

ding

neur

o-op

tic

and

intr

acra

nial

pro

cedu

res,

as l

ong

as l

evel

6ne

uros

urge

ry a

vaila

ble

onsi

te■

Emer

genc

y se

rvic

esav

aila

ble

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e■

ENT

regi

stra

r/RM

O

As f

or l

evel

5 p

lus:

■Ab

ility

to

deal

wit

h al

lca

ses

incl

udin

g fu

ll ra

nge

of c

ompl

ex c

ases

in

asso

ciat

ion

wit

h ot

her

spec

ialis

ts i

nclu

ding

repr

oduc

tive

endo

crin

olog

y, i

nfer

tilit

y,gy

naec

olog

ical

mal

igna

ncy

■Fu

ll em

erge

ncy

serv

ices

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e■

Gyn

aeco

logy

regi

stra

r/RM

O a

ndpo

ssib

ly r

egis

trar

s in

subs

peci

alti

es

Surg

ical

Ser

vice

s

clinicalframeworknew spread 21/9/05 3:14 PM Page 49

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48

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Oph

thal

mol

ogy

Ort

hopa

edic

s

Uro

logy

■M

inor

red

ucti

on o

ffr

actu

res

perf

orm

ed o

nlo

w r

isk

pati

ents

by

GP

orvi

siti

ng g

ener

al s

urge

onw

ith

expe

rien

ce i

nor

thop

edic

s■

Ort

hopa

edic

con

sult

atio

nav

aila

ble

■M

inor

pro

cedu

res

and

diag

nosi

s on

low

ris

kpa

tien

ts b

y vi

siti

ngop

htha

lmic

sur

geon

As f

or l

evel

2 p

lus:

■Co

mm

on a

ndin

term

edia

te p

roce

dure

son

low

or

mod

erat

e ri

skpa

tien

ts p

erfo

rmed

by

visi

ting

ort

hopa

edic

or

gene

ral

surg

eon

cred

enti

aled

in

orth

opae

dics

■G

ener

al o

rtho

paed

iceq

uipm

ent

and

thea

tre

x-ra

y av

aila

ble

■Pr

efer

ably

acc

ess

tosp

ecia

list

SRN

■Co

mm

on a

ndin

term

edia

te p

roce

dure

son

low

or

mod

erat

e ri

skpa

tien

ts p

erfo

rmed

by

visi

ting

uro

logi

st o

rge

nera

l su

rgeo

ncr

eden

tial

ed i

n ur

olog

y

As f

or l

evel

3 p

lus:

■Pr

oced

ures

on

low

or

mod

erat

e ri

sk p

atie

nts

perf

orm

ed b

y vi

siti

ngop

htha

lmic

sur

geon

■Ac

cess

to

orth

opti

sts

As f

or l

evel

3 p

lus:

■Co

mm

on a

ndin

term

edia

te p

roce

dure

son

low

or

mod

erat

e ri

skpa

tien

ts p

erfo

rmed

by

onca

ll or

thop

aedi

c su

rgeo

n■

Acce

ss t

o le

vel

4re

habi

litat

ion

serv

ice

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

3 p

lus:

■So

me

maj

or p

roce

dure

son

low

or

mod

erat

e ri

skpa

tien

ts p

erfo

rmed

by

visi

ting

uro

logi

st■

Has

lin

ks w

ith

onco

logy

,ra

diot

hera

py a

ndpa

lliat

ive

care

ser

vice

s

As f

or l

evel

4 p

lus:

■D

iagn

osti

c se

rvic

es a

ndsu

rger

y on

low

, m

oder

ate

and

high

ris

k pa

tien

ts b

yon

cal

l op

htha

lmic

surg

eon

■O

rtho

ptis

ts o

n st

aff

■M

ay h

ave

teac

hing

and

rese

arch

rol

e

As f

or l

evel

4 p

lus:

■Fu

ll ra

nge

of m

ajor

diag

nost

ic a

nd p

roce

dure

son

low

, m

oder

ate

and

high

ris

k pa

tien

tspe

rfor

med

by

on c

all

orth

opae

dic

surg

eons

■M

ay p

rovi

de r

egio

nal

serv

ices

■M

ay h

ave

teac

hing

and

rese

arch

rol

e■

Ort

hopa

edic

reg

istr

ar o

nca

ll ■

Acce

ss t

o su

bspe

cial

ties

■Li

nk t

o le

vel

5re

habi

litat

ion

serv

ice

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

4 p

lus:

■Fu

ll ra

nge

of m

ajor

diag

nost

ic a

nd p

roce

dure

son

low

, m

oder

ate

and

high

ris

k pa

tien

tspe

rfor

med

by

on c

all

urol

ogis

t■

Acce

ss t

o sp

ecia

list

SRN

■M

ay p

rovi

de r

egio

nal

serv

ices

and

tea

chin

g an

dre

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Ab

ility

to

deal

wit

h al

lca

ses

incl

udin

g fu

ll ra

nge

of c

ompl

ex c

ases

in

asso

ciat

ion

wit

h ot

her

spec

ialis

ts■

Full

emer

genc

y se

rvic

es■

Oph

thal

mol

ogy

regi

stra

r/RM

O■

Acce

ss t

o sp

ecia

list

SRN

■Ab

le t

o un

dert

ake

neur

o-op

htha

lmol

ogy

whe

rele

vel

6 ne

uros

urge

ryav

aila

ble

on s

ite

■Ac

cess

to

leve

l 5

radi

othe

rapy

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e

As f

or l

evel

5 p

lus:

■Ab

ility

to

deal

wit

h al

lca

ses

incl

udin

g fu

ll ra

nge

of c

ompl

ex c

ases

(an

d al

lem

erge

ncy)

in

asso

ciat

ion

wit

h ot

her

spec

ialis

ts■

Stat

ewid

e re

ferr

al r

ole

■U

nder

grad

uate

and

pos

tgr

adua

te t

each

ing

role

■Re

sear

ch r

ole

■Li

nk t

o le

vel

6re

habi

litat

ion

role

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

5 p

lus:

■Ab

ility

to

deal

wit

h al

lca

ses

incl

udin

g fu

ll ra

nge

of c

ompl

ex c

ases

(an

d al

lem

erge

ncy)

in

asso

ciat

ion

wit

h ot

her

spec

ialis

ts■

Uro

logy

Reg

istr

ar/R

MO

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e

clinicalframeworknew spread 21/9/05 3:14 PM Page 50

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49

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Card

ioth

orac

ic

Vasc

ular

sur

gery

Neu

rosu

rger

y

■Co

mm

on m

inor

and

unco

mpl

icat

ed e

lect

ive

vasc

ular

sur

gery

■Pe

rfor

med

by

visi

ting

vasc

ular

or

gene

ral

surg

eons

■El

ecti

ve a

nd e

mer

genc

yth

orac

ic p

roce

dure

s by

visi

ting

/on

call

thor

acic

surg

eons

As f

or l

evel

3 p

lus:

■Co

mm

on,

inte

rmed

iate

and

som

e m

ajor

proc

edur

es o

n lo

w a

ndm

oder

ate

risk

pat

ient

spe

rfor

med

by

visi

ting

vasc

ular

sur

geon

s or

gene

ral

surg

eons

Pre-

oper

ativ

ere

habi

litat

ion

spec

ialis

tco

nsul

tant

ava

ilabl

e

■M

inor

hea

d in

juri

es d

ealt

wit

h by

gen

eral

sur

geon

■N

euro

surg

ical

con

sult

atio

nav

aila

ble

■O

pera

ting

equ

ipm

ent

adeq

uate

for

em

erge

ncy

neur

osur

gery

■Li

nk w

ith

leve

l 4

reha

bilit

atio

n se

rvic

es

As f

or l

evel

4 p

lus:

■El

ecti

ve a

nd e

mer

genc

yth

orac

ic a

nd e

lect

ive

card

ioth

orac

ic p

roce

dure

sby

vis

itin

g/on

cal

lca

rdio

thor

acic

sur

geon

s ■

Leve

l 5

reha

bilit

atio

nse

rvic

es a

vaila

ble

on s

ite

■Li

nk w

ith

palli

ativ

e ca

rean

d pa

in m

anag

emen

tse

rvic

es■

Acce

ss t

o sp

ecia

list

SRN

■So

me

regi

onal

ref

erra

lro

le■

ICU

/CCU

As f

or l

evel

4 p

lus:

■D

iagn

osti

c se

rvic

es a

ndsu

rger

y on

low

, m

oder

ate

and

high

ris

k pa

tien

ts b

yon

cal

l va

scul

ar o

r ge

nera

lsu

rgeo

n■

May

hav

e re

gion

al r

efer

ral

■M

ay h

ave

som

e te

achi

ngan

d tr

aini

ng a

nd r

esea

rch

role

■Li

nk w

ith

leve

l 5

reha

bilit

atio

n se

rvic

es

As f

or l

evel

4 p

lus:

■D

iagn

osti

c se

rvic

es a

ndsu

rger

y on

low

, m

oder

ate

and

high

ris

k pa

tent

s by

on c

all

neur

osur

geon

■D

esig

nate

d ne

uros

urgi

cal

beds

■Ac

cess

to

spec

ialis

t SR

N■

24 h

our

acce

ss t

o CT

■Li

nk w

ith

brai

n an

d sp

inal

inju

ry r

ehab

ilita

tion

■M

ay h

ave

som

e te

achi

ngan

d re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■El

ecti

ve a

nd e

mer

genc

yth

orac

ic a

ndca

rdio

thor

acic

pro

cedu

res

by c

ardi

otho

raci

csu

rgeo

ns■

Able

to

deal

wit

h hi

ghly

com

plex

dia

gnos

is a

ndtr

eatm

ent

in a

ssoc

iati

onw

ith

othe

r sp

ecia

ltie

s■

Card

ioth

orac

icre

gist

rar/

RMO

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e■

Leve

l 6

ICU

■To

inc

lude

hea

rt a

nd l

ung

tran

spla

ntat

ion

atse

lect

ed s

ites

As f

or l

evel

5 p

lus:

■Ab

ility

to

deal

wit

h al

lca

ses

incl

udin

g fu

ll ra

nge

of c

ompl

ex c

ases

in

asso

ciat

ion

wit

h ot

her

spec

ialis

ts■

Prov

ides

all

emer

genc

yse

rvic

es■

On

call

vasc

ular

sur

geon

■Ac

cess

to

spec

ialis

t SN

R■

Stat

ewid

e re

ferr

al r

ole

■U

nder

grad

uate

and

pos

tgr

adua

te t

each

ing

role

■Re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Ab

le t

o de

al w

ith

all

case

sin

clud

ing

all

emer

genc

yca

ses

■N

euro

surg

ical

war

d an

dne

uros

urgi

cal

high

depe

nden

cy/I

CU■

Neu

rosu

rger

yre

gist

rar/

RMO

■Li

nk w

ith

leve

l 5

reha

bilit

atio

n se

rvic

e■

Acce

ss t

o sp

ecia

list

SRN

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

Rese

arch

rol

e

clinicalframeworknew spread 21/9/05 3:14 PM Page 51

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50

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Plas

tics

Burn

s

Emer

genc

y D

epar

tmen

t

Urg

ent

Prim

ary

Care

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

■Ba

sic

resu

scit

atio

neq

uipm

ent

and

drug

s

■M

inor

out

pati

ents

and

sam

e da

y pr

oced

ures

by

GP

■M

inor

out

pati

ent

and

sam

e da

y pr

oced

ures

onl

yby

GP

■Ab

le t

o pr

ovid

eem

erge

ncy

stab

ilisa

tion

serv

ice

for

burn

s

As f

or l

evel

1 p

lus:

■Li

mit

ed G

P co

ver

■Se

rvic

es b

y RN

■Re

susc

itat

ion

and

stab

ilisa

tion

cap

abili

ty

As f

or l

evel

2 p

lus:

■As

for

lev

el 2

but

proc

edur

es m

ay r

equi

revi

siti

ng p

last

ics

surg

eon

As f

or l

evel

2 p

lus:

■G

ener

al s

urge

on a

ble

topr

ovid

e se

rvic

es f

orm

inor

/mod

erat

e bu

rns

tosm

all

area

s of

bod

y

As f

or l

evel

2 p

lus:

■Lo

cal

GPs

ros

tere

d to

prov

ide

24 h

our

cove

rw

ith

serv

ice

by R

N■

Min

or p

roce

dure

capa

bilit

y■

Resu

scit

atio

n an

dst

abili

sati

on c

apab

ility

As f

or l

evel

3 p

lus:

■Se

lect

ed m

inor

proc

edur

es o

n lo

w a

ndm

oder

ate

risk

pat

ient

s by

visi

ting

pla

stic

sur

geon

s

As f

or l

evel

3 p

lus:

■G

ener

al s

urge

on p

rovi

ding

serv

ices

for

min

or/m

oder

ate

burn

s to

smal

l pa

rts

of b

ody

■Ac

cess

to

spec

ialis

t SN

R■

Link

s to

lev

el 4

reha

bilit

atio

n se

rvic

es

■Lo

cal

GPs

ros

tere

d to

prov

ide

24 h

our

cove

rw

ith

serv

ice

by R

N■

Emer

genc

y op

erat

ing

thea

tre

faci

litie

s■

Resu

scit

atio

n an

dst

abili

sati

on■

On-

call

gene

ralis

tsp

ecia

lists

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

4 p

lus:

■D

iagn

osti

c se

rvic

es a

ndsu

rger

y on

low

, m

oder

ate

and

high

ris

k pa

tent

s by

on c

all

plas

tic

surg

eons

Link

wit

h le

vel

5re

habi

litat

ion

serv

ices

■M

ay h

ave

som

e te

achi

ngan

d tr

aini

ng r

ole

■Vi

siti

ng b

urns

L6

spec

ialis

t

As f

or l

evel

4 p

lus:

■G

ener

al s

urge

on p

rovi

ding

serv

ices

for

min

or/m

oder

ate

burn

s to

smal

l pa

rts

of b

ody

■24

hou

r on

cal

l re

gist

rar

■Ac

cess

to

spec

ialis

t SR

N■

Link

s to

lev

el 5

reha

bilit

atio

n se

rvic

es

As f

or l

evel

4 p

lus:

■M

edic

ally

sta

ffed

24

hour

spe

r da

y■

Med

ical

and

sur

gica

l su

b-sp

ecia

lists

ava

ilabl

e on

-ca

ll■

Acce

pts

tran

sfer

s fr

omot

her

hosp

ital

s in

reg

ion

■Ac

cess

to

ICU

and

CCU

faci

litie

s ■

Acce

ss t

o sp

ecia

list

SRN

As f

or l

evel

5 p

lus:

■Ab

le t

o de

al w

ith

all

case

sin

clud

ing

all

emer

genc

yca

ses

■Pl

asti

cs r

egis

trar

/RM

O■

Acce

ss t

o sp

ecia

list

SRN

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

nd p

ost

grad

uate

tea

chin

g ro

le■

May

hav

e re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Fu

ll ra

nge

of b

urns

serv

ices

, w

ith

a sp

ecia

lbu

rns

unit

, in

clud

ing

all

emer

genc

y ca

ses

■24

hou

r on

cal

l co

ver

■St

atew

ide

refe

rral

rol

e■

Emer

genc

y ca

re s

ervi

ces

prov

ided

by

on c

all

spec

ialis

t■

Acce

ss t

o sp

ecia

list

SRN

■U

nder

grad

uate

and

pos

tgr

adua

te t

each

ing

role

■Re

sear

ch r

ole

As f

or l

evel

5 p

lus:

■Em

erge

ncy

med

icin

eco

nsul

tant

on

duty

24

hour

s pe

r da

y*■

Stat

ewid

e re

ferr

al r

ole

■Ac

cess

to

spec

ialis

t SR

N■

Back

up f

rom

ful

l ra

nge

ofm

edic

al a

nd s

urgi

cal

spec

ialis

ts a

nd d

iagn

osti

cse

rvic

es■

ICU

and

CCU

fac

iliti

es

Emer

genc

y/Tr

aum

a Se

rvic

es

* N

ot c

urre

ntly

ope

rati

ng i

n W

A

clinicalframeworknew spread 21/9/05 3:14 PM Page 52

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51

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Obs

tetr

ics

Paed

iatr

ics

■N

o pl

anne

d de

liver

ies

■An

tena

tal,

pos

t na

tal

care

is c

arri

ed o

ut b

y G

Ps(p

oten

tial

ly v

isit

ing)

wit

hor

wit

hout

the

ass

ista

nce

of R

N/R

M d

epen

ding

on

the

type

of

pati

ent

care

need

ed

■Ca

re i

s ca

rrie

d ou

t by

GPs

(pot

enti

ally

vis

itin

g) w

ith

or w

itho

ut t

he a

ssis

tanc

eof

RN

s de

pend

ing

on t

hety

pe o

f pa

tien

t ca

rene

eded

■St

abili

sati

on a

nd f

irst

aid

As f

or l

evel

1 p

lus:

■N

o pl

anne

d de

liver

ies

■In

pati

ent

care

fol

low

ing

deliv

ery

else

whe

re■

Ante

nata

l, p

ost

nata

l ca

reis

car

ried

out

by

GPs

wit

hor

wit

hout

the

ass

ista

nce

of R

N/R

M d

epen

ding

on

the

type

of

pati

ent

care

need

ed

As f

or l

evel

1 p

lus:

■Pa

edia

tric

med

ical

bed

s –

care

by

gene

ral

phys

icia

n■

On

call

paed

iatr

ic a

dvic

e■

No

surg

ery

As f

or l

evel

2 p

lus:

■Pl

anne

d de

liver

ies

of l

owri

sk m

othe

rs/b

abie

s■

Serv

ice

by G

Ps a

ndtr

aine

d m

id-w

ives

■LU

CS t

rans

ferr

edel

sew

here

but

mus

t be

wit

hin

safe

tim

efra

me

■Vi

siti

ng o

bste

tric

ian

■Ac

cess

to

Leve

l 1

Spec

ial

Care

Nur

sery

As f

or l

evel

2 p

lus:

■O

utpa

tien

t ca

re b

yvi

siti

ng p

aedi

atri

cian

■Li

mit

ed s

urge

ry b

y vi

siti

ngpa

edia

tric

sur

geon

or

surg

eon

wit

h pa

edia

tric

skill

s■

Day

sur

gery

,un

com

plic

ated

ele

ctiv

esu

rger

y an

d em

erge

ncy

surg

ery

■D

esig

nate

d pa

edia

tric

med

ical

war

d■

Inpa

tien

t m

edic

al c

are

byG

P or

gen

eral

phy

sici

an o

rpa

edia

tric

ian

As f

or l

evel

3 p

lus:

■Pl

anne

d de

liver

ies

of l

owan

d m

oder

ate

risk

mot

hers

/bab

ies

■Ac

cess

to

accr

edit

edob

stet

ric

and

paed

iatr

ictr

aine

d do

ctor

s■

Able

to

cope

wit

h su

dden

unex

pect

ed r

isks

■Ca

esar

ian

sect

ion

capa

bilit

y■

Acce

ss t

o Le

vel

2A S

peci

alCa

re N

urse

ry

As f

or l

evel

3 p

lus:

■O

utpa

tien

t ca

re b

yre

side

nt p

aedi

atri

cian

■Li

mit

ed s

urge

ry b

y vi

siti

ngpa

edia

tric

sur

geon

■D

ay s

urge

ry,

unco

mpl

icat

ed e

lect

ive

surg

ery

and

emer

genc

ysu

rger

y■

Des

igna

ted

med

ical

war

d■

Inpa

tien

t m

edic

al c

are

byvi

siti

ng p

aedi

atri

cian

■Ac

cess

to

spec

ialis

t SR

N■

Poss

ibly

Res

iden

t/RM

Oro

tati

ons

from

Lev

el 5

or

6 fa

cilit

y

As f

or l

evel

4 p

lus:

■D

eliv

erie

s of

low

,m

oder

ate

and

high

ris

km

othe

rs/b

abie

s■

Able

to

cope

wit

h m

ost

com

plic

atio

ns■

Serv

ice

prov

ided

by

spec

ialis

t ob

stet

rici

ans

and

paed

iatr

icia

ns t

o hi

ghri

sk p

atie

nts

■Re

gist

rar/

RMO

■Ac

cess

to

spec

ialis

tpa

edia

tric

ians

/obs

tetr

icia

ns a

nd t

rain

ed n

urse

s an

dal

lied

heal

th■

Regi

onal

ref

erra

l ro

le■

Acce

ss t

o Le

vel

2B S

peci

alCa

re N

urse

ry

As f

or l

evel

4 p

lus:

■In

pati

ent

and

outp

atie

ntca

re b

y re

side

ntpa

edia

tric

ian

■Re

gist

rar/

RMO

■Re

gion

al r

efer

ral

role

■So

me

unde

rgra

duat

ete

achi

ng■

Rang

e of

pae

diat

ric

surg

ery

■Re

side

nt p

aedi

atri

csu

rgeo

n■

24 h

our

on c

all

paed

iatr

ican

aest

heti

st■

Neo

nata

l IC

U

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

5 p

lus:

■Sp

ecia

list

obst

etri

c un

itfo

r st

ate

■O

bste

tric

reg

istr

ar a

ndm

idw

ives

tra

inin

g■

Acce

ss t

o sp

ecia

list

SRN

■24

hou

r co

ver

byob

stet

rici

ans

and

paed

iatr

icia

ns■

Acce

ss t

o Le

vel

3 Sp

ecia

lCa

re N

urse

ry

As f

or l

evel

5 p

lus:

■In

pati

ent

and

outp

atie

ntca

re b

y re

side

ntpa

edia

tric

ian

■Re

gist

rar/

RMO

■St

atew

ide

refe

rral

rol

e■

Und

ergr

adua

te a

ndpo

stgr

adua

te t

each

ing

role

■Fu

ll ra

nge

of p

aedi

atri

csu

rger

y■

Resi

dent

pae

diat

ric

surg

eon

■N

eona

tal

ICU

■O

pera

tes

in s

peci

alis

tfa

cilit

y■

Acce

ss t

o sp

ecia

list

SRN

Obs

tetr

ics

Serv

ices

Paed

iatr

ics

Serv

ices

clinicalframeworknew spread 21/9/05 3:14 PM Page 53

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52

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Neo

nato

logy

Reha

bilit

atio

n■

Visi

ting

con

sult

ativ

ese

rvic

es p

rovi

ded

onre

ques

t■

Care

is

carr

ied

out

by G

Ps(p

oten

tial

ly v

isit

ing)

wit

hor

wit

hout

the

ass

ista

nce

of R

Ns

depe

ndin

g on

the

type

of

pati

ent

care

need

ed

■O

bste

tric

ians

,pa

edia

tric

ians

and

anae

sthe

tist

s on

cal

l 24

hour

s■

Nor

mal

low

ris

kpr

egna

ncie

s an

dde

liver

ies

and

man

agem

ent

of n

ewbo

rns

> 36

wee

ks g

esta

tion

wit

hm

inim

al c

ompl

icat

ions

■Le

vel

1 Sp

ecia

l Ca

reN

urse

ry■

Basi

c lif

e su

ppor

t fo

rne

onat

es a

vaila

ble

wit

hac

cess

to

24 h

our

anae

sthe

tic

and

neon

atal

resu

scit

atio

n se

rvic

e

As f

or l

evel

1 p

lus:

■Re

gula

r vi

siti

ng s

ervi

ces

prov

ided

by

dist

rict

/reg

iona

l al

lied

heal

th s

taff

■Li

mit

ed l

evel

alli

ed h

ealt

hav

aila

bilit

y

As f

or l

evel

3 p

lus:

■O

bste

tric

ians

and

paed

iatr

icia

ns o

n ca

ll 24

hour

s■

Low

to

mod

erat

e ri

skpr

egna

ncie

s an

dde

liver

ies

and

man

agem

ent

of n

ewbo

rns

> 34

wee

ks g

esta

tion

wit

hm

inim

al c

ompl

icat

ions

■Le

vel

2A S

peci

al C

are

Nur

sery

wit

h lo

wde

pend

ency

pat

ient

s an

dlo

w-l

evel

Oxy

gen

ther

apy

and

airw

ay m

anag

emen

t■

Basi

c lif

e su

ppor

t fo

rne

onat

es a

vaila

ble

wit

hac

cess

to

24 h

ran

aest

heti

c an

d ne

onat

alre

susc

itat

ion

serv

ice

■Pr

ovid

es s

hort

-ter

mm

echa

nica

l ve

ntila

tion

(<6

hour

s) p

endi

ngtr

ansf

er

As f

or l

evel

3 p

lus:

■Fu

ll ti

me

sala

ried

phys

ioth

erap

y,oc

cupa

tion

al t

hera

py■

Spee

ch a

nd s

ocia

l w

ork

serv

ices

■D

istr

ict

refe

rral

rol

e■

Lim

ited

day

hos

pita

lpr

ogra

m

As f

or l

evel

4 p

lus:

■H

as a

cces

s to

clin

ical

and

diag

nost

ic p

aedi

atri

csu

bspe

cial

ties

■O

bste

tric

ians

and

paed

iatr

icia

ns o

n ca

ll 24

hour

s■

Med

ical

off

icer

(s)

on s

ite

24 h

ours

■M

oder

ate

to h

igh-

risk

preg

nanc

ies

and

deliv

erie

s an

dm

anag

emen

t of

new

born

s>

32 w

eeks

ges

tati

on w

ith

min

imal

com

plic

atio

ns■

Leve

l 2B

Spe

cial

Car

eN

urse

ry w

ith

high

depe

nden

cy p

atie

nts

and

prov

isio

n of

sho

rt t

erm

mec

hani

cal

vent

ilati

on (

<6

hour

s) p

endi

ng t

rans

fer

■Ac

cess

to

spec

ialis

t SR

N■

Mul

ti-d

isci

plin

ary

follo

wup

ser

vice

pro

vide

d■

Role

in

post

gra

duat

em

edic

al a

nd n

ursi

nged

ucat

ion

As f

or l

evel

4 p

lus:

■Re

hab

prog

ram

for

bot

hin

pati

ent

and

outp

atie

nt■

Link

ages

bet

wee

n re

gion

san

d de

sign

ated

met

ropo

litan

hos

pita

ls■

Hav

e a

day

hosp

ital

wit

h:■

Mem

ory

clin

ic■

Falls

Clin

ic■

Cont

inen

ce c

linic

■A

GEM

uni

t if

ED

ser

vice

sco

lloca

ted

■Pa

rt t

ime

serv

ices

of

Ger

iatr

icia

n1

■Re

hab

Spec

ialis

t w

ith

expe

rien

ced

RN/P

T/O

T/SP

/ D

ieti

tian

■Co

lloca

ted

wit

hps

ycho

geri

atri

c se

rvic

es

As f

or l

evel

5 p

lus:

■H

as a

cces

s to

clin

ical

and

diag

nost

ic p

aedi

atri

csu

bspe

cial

ties

■M

edic

al o

ffic

er(s

) on

sit

e24

hou

rs■

Hig

h-ri

sk,

high

depe

nden

cy p

regn

anci

esan

d de

liver

ies

■M

anag

emen

t of

new

born

s<

32 w

eeks

ges

tati

on■

Leve

l 3

Spec

ial

Care

Nur

sery

wit

h hi

ghde

pend

ency

pat

ient

s an

dpr

ovis

ion

of m

ediu

m -

long

term

mec

hani

cal

vent

ilati

on a

nd f

ull

life-

supp

ort

■U

nder

take

s ne

onat

alsu

rger

y an

d ca

re f

orco

mpl

ex c

onge

nita

l an

dm

etab

olic

dis

ease

s of

the

new

born

– n

ote

curr

entl

yat

PM

H■

Acce

ss t

o sp

ecia

list

SRN

■O

n-si

te m

ulti

-dis

cipl

inar

yse

rvic

es

■Ro

le i

n po

st g

radu

ate

med

ical

and

nur

sing

educ

atio

n■

Has

neo

nato

logy

res

earc

h

As f

or l

evel

5 p

lus:

■W

ill h

ave

GEM

uni

t■

Hav

e ac

cess

to

acut

e ca

re■

Full

tim

e re

hab

spec

ialis

t■

Full

tim

e ge

riat

rici

an a

spe

r fo

otno

te o

f le

vel

5■

Tert

iary

lev

el r

ehab

serv

ices

(St

atew

ide

Reha

bCe

ntre

) on

ly i

n on

e le

vel

6 ho

spit

al w

ith

a fu

ll ti

me

clin

ical

dir

ecto

r

Reha

bilit

atio

n Se

rvic

es

1G

eria

tric

ian

shou

ld i

deal

ly b

e fu

ll ti

me,

wit

h pa

rt t

ime

spen

t in

Lev

el 6

sup

port

ing

GEM

and

acu

te c

are,

and

par

t ti

me

in l

evel

5 s

uppo

rtin

g in

reh

abili

tati

on u

nit/

day

hosp

ital

and

GEM

uni

t.

clinicalframeworknew spread 21/9/05 3:14 PM Page 54

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53

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Com

mun

ity

asse

ssm

ent

Envi

ronm

enta

l H

ealt

h

Hea

lth

Prot

ecti

on i

nclu

ding

food

, ai

r, w

ater

, ra

diat

ion,

phar

mac

euti

cal,

pes

tici

des,

mos

quit

o bo

rne

dise

ases

.

Com

mun

icab

le D

isea

seCo

ntro

l

■In

clud

es f

ood

and

wat

erbo

rne

dise

ases

,va

ccin

atio

n pr

ogra

ms,

STI’s

, BB

V’s

and

arbo

vira

ldi

seas

es

Child

and

Com

mun

ity

Hea

lth

■Co

mm

unit

y H

ealt

hSe

rvic

es,

Scho

ol H

ealt

hSe

rvic

es,

Child

Hea

lth

Serv

ices

, Ch

ildD

evel

opm

ent

Serv

ices

Abor

igin

al H

ealt

h

Hea

lth

Prom

otio

n

■Pr

imar

y pr

even

tion

incl

udin

g lif

esty

ledi

seas

es a

nd i

njur

ypr

even

tion

■Vi

siti

ng s

ervi

ces

on a

sre

quir

ed b

asis

■Lo

cal

Gov

ernm

ent

resp

onsi

bilit

y w

ith

acce

ssto

DO

H s

tate

wid

e un

itw

hen

requ

ired

■Vi

siti

ng p

rim

ary

care

prov

ider

s, i

nclu

ding

GPs

and

Com

mun

ity

Hea

lth

Nur

ses

■Vi

siti

ng p

rim

ary

care

prov

ider

s, i

nclu

ding

GPs

and

Com

mun

ity

Hea

lth

Nur

ses

■Vi

siti

ng p

rim

ary

care

prov

ider

s

■Vi

siti

ng p

rim

ary

care

prov

ider

s w

ith

acce

ss t

oD

OH

sta

tew

ide

prog

ram

reso

urce

s. E

xpos

ure

tom

ass

med

ia c

ampa

igns

As f

or l

evel

1 p

lus:

■Re

side

nt p

rim

ary

care

prov

ider

sup

port

ing

stat

epr

ogra

ms

incl

udin

g G

Psan

d Co

mm

unit

y H

ealt

hN

urse

s

As f

or l

evel

1 p

lus:

■Re

side

nt p

rim

ary

care

prov

ider

s w

ith

acce

ss t

ost

atew

ide

prog

ram

init

iati

ves

As f

or l

evel

1 p

lus:

■M

ains

trea

m h

ealt

h se

rvic

epr

ovid

ers

(inc

ludi

ng G

Ps)

As f

or l

evel

1 p

lus:

■Re

gula

r vi

siti

ng s

ervi

cesu

ppor

ted

by l

imit

ed l

ocal

allie

d he

alth

As f

or l

evel

1 p

lus:

■As

sist

sta

tew

ide

serv

ices

inve

stig

atio

n of

loc

alin

cide

nts

As f

or l

evel

2 p

lus:

■M

ains

trea

m h

ealt

h se

rvic

epr

ovid

ers

As f

or l

evel

1 p

lus:

■Re

side

nt p

rim

ary

care

prov

ider

s w

ith

awar

enes

sof

sta

tew

ide

prog

ram

init

iati

ves

As f

or l

evel

3 p

lus:

■Vi

siti

ng s

ervi

ce s

uppo

rted

by l

ocal

alli

ed h

ealt

hpr

ofes

sion

als

■M

ost

disc

iplin

es a

vaila

ble

As f

or l

evel

3 p

lus:

■Co

ordi

nate

inv

esti

gati

ons

of l

ocal

inc

iden

tsAs

for

lev

el 2

plu

s:■

CDC

Nur

se i

n Po

pula

tion

Hea

lth

Uni

t

As f

or l

evel

2 p

lus:

■Co

mm

unit

y H

ealt

hCe

ntre

/Chi

ldD

evel

opm

ent

Cent

re

As f

or l

evel

3 p

lus:

■M

ains

trea

m p

rovi

ders

■Co

mm

unit

y co

ntro

lled

Abor

igin

al h

ealt

h se

rvic

e

As f

or l

evel

4 p

lus:

■H

ome

base

for

tea

m w

ith

regi

onal

/dis

tric

tre

spon

sibi

litie

s -

part

tim

e ge

riat

rici

an

As f

or l

evel

4 p

lus:

■Co

mpr

ehen

sive

mul

tidi

scip

linar

yPo

pula

tion

Hea

lth

Uni

t

As f

or l

evel

4 p

lus:

■Co

mpr

ehen

sive

mul

tidi

scip

linar

yPo

pula

tion

Hea

lth

Uni

tw

ith

dise

ase

cont

rol

doct

or a

nd c

apac

ity

to:

■In

vest

igat

e ca

ses/

outb

reak

s■

Perf

orm

con

tact

tra

cing

■Co

ordi

nate

reg

iona

lva

ccin

atio

n pr

ogra

ms

etc

As f

or l

evel

4 p

lus:

■Co

mpr

ehen

sive

mul

tidi

scip

linar

yPo

pula

tion

Hea

lth

Uni

tw

ith

com

mun

ity

heal

thst

aff

As f

or l

evel

4 p

lus:

■M

ains

trea

m p

rovi

ders

Com

mun

ity

cont

rolle

dAb

orig

inal

hea

lth

serv

ice

■In

tegr

ated

ser

vice

deliv

ery

As f

or l

evel

3 p

lus:

■Co

mpr

ehen

sive

mul

tidi

scip

linar

yPo

pula

tion

Hea

lth

Uni

tin

clud

ing

resi

dent

off

icer

sw

ith

heal

th p

rom

otio

ntr

aini

ng

As f

or l

evel

5 p

lus:

■St

atew

ide

prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

and

legi

slat

ed s

ervi

cefu

ncti

ons

As f

or l

evel

5 p

lus:

■St

atew

ide

prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

and

legi

slat

ed s

ervi

cefu

ncti

ons

As f

or l

evel

5 p

lus:

■St

atew

ide

Prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es

As f

or l

evel

5 p

lus:

■St

atew

ide

prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

As f

or l

evel

5 p

lus:

■St

atew

ide

prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

Cont

inui

ng C

are

Serv

ices

Prev

enti

on a

nd P

rom

otio

n Se

rvic

es

clinicalframeworknew spread 21/9/05 3:14 PM Page 55

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54

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Brea

stsc

reen

■Sc

reen

ing

and

asse

ssm

ent

Cerv

ical

■H

ealt

h pr

omot

ion,

scre

enin

g aw

aren

ess,

mai

ntai

n ce

rvic

al c

ytol

ogy

regi

ster

Gen

omic

s

■Ed

ucat

ion,

res

earc

h

GP

base

d

Com

mun

ity

nurs

ing

Surg

ical

■Vi

siti

ng p

rim

ary

care

prov

ider

s

■Vi

siti

ng p

rim

ary

care

prov

ider

s w

ith

no s

peci

fic

prog

ram

■Vi

siti

ng G

P or

GP

byph

one

■So

me

visi

ting

alli

ed h

ealt

h■

Oth

er s

ervi

ces

such

as

child

hea

lth

and

post

nata

l ca

re b

y RN

■G

P on

ly

■Vi

siti

ng s

ervi

ce b

y m

obile

scre

enin

g un

it■

All

imag

es r

ead

bysp

ecia

list

radi

olog

ist

As f

or l

evel

1 p

lus:

■Vi

siti

ng p

rim

ary

care

prov

ider

s w

ith

acce

ss t

ost

atew

ide

educ

atio

n an

din

form

atio

n

As f

or l

evel

1 p

lus:

■G

P an

d sp

ecia

list

outp

atie

nt c

linic

at

disc

harg

e ho

spit

al■

Lim

ited

acc

ess

toge

nera

list

dom

icila

rynu

rsin

g

As f

or l

evel

2 p

lus:

■Fi

xed

site

scr

eeni

ng c

linic

As f

or l

evel

1 p

lus:

■Re

side

nt p

rim

ary

care

prov

ider

s, i

nclu

ding

GPs

As f

or l

evel

2 p

lus:

■Re

side

nt p

rim

ary

care

prov

ider

s w

ith

acce

ss t

ost

atew

ide

educ

atio

n an

din

form

atio

n

As f

or l

evel

1 p

lus:

■Re

side

nt G

Ps■

Som

e vi

siti

ng T

ype

Isp

ecia

lists

(ou

tpat

ient

s)■

Resi

dent

or

visi

ting

phys

ioth

erap

y■

Oth

er v

isit

ing

allie

dhe

alth

■O

ther

ser

vice

s by

RN

/CH

N(r

esid

ent)

As f

or l

evel

2 p

lus:

■Vi

siti

ng s

peci

alis

t■

Som

e ho

spit

alav

oida

nce/

hosp

ital

subs

titu

tion

■So

me

earl

y di

scha

rge

serv

ices

■Ac

cess

to

gene

ralis

tdo

mic

iliar

y nu

rsin

g an

dso

me

allie

d he

alth

As f

or l

evel

3 p

lus:

■Re

side

nt G

Ps■

Mos

t vi

siti

ng T

ype

I su

b-sp

ecia

lists

■M

ajor

ity

allie

d he

alth

avai

labl

e■

Resi

dent

com

mun

ity

nurs

ing

spec

ialis

t

As f

or l

evel

3 p

lus:

■Li

nks

wit

h H

ACC

■In

crea

sing

ran

ge a

ndco

mpl

exit

y of

hos

pita

lav

oida

nce/

subs

titu

tion

/ea

rly

disc

harg

e■

Chro

nic

dise

ase

prog

ram

s■

Visi

ting

med

ical

spe

cial

ist

■G

ood

acce

ss t

o ge

nera

list

allie

d he

alth

/nur

sing

sta

ff

As f

or l

evel

3 p

lus:

■As

sess

men

t by

an

expe

rien

ced

mul

tidi

scip

linar

y te

am o

fsc

reen

det

ecte

dab

norm

alit

ies

As f

or l

evel

3 p

lus:

■Pa

thol

ogy

labo

rato

ries

trai

ned

in t

he c

olla

tion

and

repo

rtin

g of

Cer

vica

lCy

tolo

gy R

egis

try

data

As f

or l

evel

4 p

lus:

■Re

side

nt G

Ps■

Resi

dent

som

e/al

l Ty

pe I

sub-

spec

ialis

ts■

Visi

ting

Typ

e II

sub-

spec

ialis

ts■

Full

rang

e of

alli

ed h

ealt

h■

Exte

nsiv

e co

mm

unit

y nu

rsin

g se

rvic

e

As f

or l

evel

4 p

lus:

■Sp

ecia

list

med

ical

/nur

sing

/ al

lied

heal

th s

taff

■In

crea

sed

rang

e an

dco

mpl

exit

y■

HAC

C in

tegr

atio

n■

Enha

nced

dia

gnos

tics

■Te

achi

ng a

nd t

rain

ing

role

As f

or l

evel

5 p

lus:

■St

atew

ide

prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

As f

or l

evel

5 p

lus:

■St

atew

ide

Prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

As f

or l

evel

5 p

lus:

■St

atew

ide

Prog

ram

,pl

anni

ng,

and

coor

dina

tion

rol

es■

Ded

icat

ed o

ffic

ers

wit

hst

atew

ide

resp

onsi

bilit

ies

As f

or l

evel

5 p

lus:

■Re

side

nt G

Ps■

Full

rang

e of

Typ

e I

and

IIsu

b-sp

ecia

lists

■Fu

ll ra

nge

of a

llied

hea

lth

■Ex

tens

ive

com

mun

ity

nurs

ing

serv

ice

■Re

sear

ch a

nd t

each

ing

role

As f

or l

evel

5 p

lus:

■Re

sear

ch r

ole

■Fu

lly i

nteg

rate

dam

bula

tory

car

e se

rvic

es■

Fully

int

egra

ted

diag

nost

ics

■In

clud

es r

egio

nal

suba

cute

cen

tre/

serv

ice

Prim

ary

Care

Ser

vice

s

Ambu

lato

ry C

are

Serv

ices

clinicalframeworknew spread 21/9/05 3:14 PM Page 56

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55

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Med

ical

Reha

bilit

atio

n

Cont

inui

ng C

are

Paed

iatr

ics

■G

P on

ly

■G

P on

ly

■G

P on

ly

■G

P on

ly

As f

or l

evel

1 p

lus:

■G

P an

d sp

ecia

list

outp

atie

nt c

linic

at

disc

harg

e ho

spit

al■

Lim

ited

acc

ess

toge

nera

list

dom

icila

rynu

rsin

g

As f

or l

evel

1 p

lus:

■G

P an

d sp

ecia

list

outp

atie

nt c

linic

at

disc

harg

e ho

spit

al■

Lim

ited

acc

ess

toge

nera

list

dom

icila

rynu

rsin

g

As f

or l

evel

1 p

lus:

■G

P an

d sp

ecia

list

outp

atie

nt c

linic

at

disc

harg

e ho

spit

al■

Lim

ited

acc

ess

toge

nera

list

dom

icila

rynu

rsin

g

As f

or l

evel

1 p

lus:

■G

P an

d sp

ecia

list

outp

atie

nt c

linic

at

disc

harg

e ho

spit

al■

Lim

ited

acc

ess

toge

nera

list

dom

icila

rynu

rsin

g

As f

or l

evel

2 p

lus:

■Vi

siti

ng s

peci

alis

t■

Som

e ho

spit

alav

oida

nce/

hosp

ital

subs

titu

tion

■So

me

earl

y di

scha

rge

serv

ices

■Ac

cess

to

gene

ralis

tdo

mic

iliar

y nu

rsin

g an

dso

me

allie

d he

alth

As f

or l

evel

2 p

lus:

■Vi

siti

ng s

peci

alis

t■

Som

e ho

spit

alav

oida

nce/

hosp

ital

subs

titu

tion

■So

me

earl

y di

scha

rge

serv

ices

■Ac

cess

to

gene

ralis

tdo

mic

iliar

y nu

rsin

g an

dso

me

allie

d he

alth

As f

or l

evel

2 p

lus:

■Vi

siti

ng s

peci

alis

t■

Som

e ho

spit

alav

oida

nce/

hosp

ital

subs

titu

tion

■So

me

earl

y di

scha

rge

serv

ices

■Ac

cess

to

gene

ralis

tdo

mic

iliar

y nu

rsin

g an

dso

me

allie

d he

alth

As f

or l

evel

2 p

lus:

■Vi

siti

ng s

peci

alis

t■

Som

e ho

spit

alav

oida

nce/

hosp

ital

subs

titu

tion

■So

me

earl

y di

scha

rge

serv

ices

■Ac

cess

to

gene

ralis

tdo

mic

iliar

y nu

rsin

g an

dso

me

allie

d he

alth

As f

or l

evel

3 p

lus:

■Li

nks

wit

h H

ACC

■In

crea

sing

ran

ge a

ndco

mpl

exit

y of

hos

pita

lav

oida

nce/

subs

titu

tion

/ea

rly

disc

harg

e■

Chro

nic

dise

ase

prog

ram

s■

Visi

ting

med

ical

spe

cial

ist

■G

ood

acce

ss t

o ge

nera

list

allie

d he

alth

/nur

sing

sta

ff

As f

or l

evel

3 p

lus:

■Li

nks

wit

h H

ACC

■In

crea

sing

ran

ge a

ndco

mpl

exit

y of

hos

pita

lav

oida

nce/

subs

titu

tion

/ea

rly

disc

harg

e■

Chro

nic

dise

ase

prog

ram

s■

Visi

ting

med

ical

spe

cial

ist

■G

ood

acce

ss t

o ge

nera

list

allie

d he

alth

/nur

sing

sta

ff

As f

or l

evel

3 p

lus:

■Li

nks

wit

h H

ACC

■In

crea

sing

ran

ge a

ndco

mpl

exit

y of

hos

pita

lav

oida

nce/

subs

titu

tion

/ea

rly

disc

harg

e■

Chro

nic

dise

ase

prog

ram

s■

Resi

dent

/vis

itin

g m

edic

alsp

ecia

list

■G

ood

acce

ss t

o ge

nera

list

allie

d he

alth

/nur

sing

sta

ff

As f

or l

evel

3 p

lus:

■In

crea

sing

ran

ge a

ndco

mpl

exit

y of

hos

pita

lav

oida

nce/

subs

titu

tion

/ea

rly

disc

harg

e■

Chro

nic

dise

ase

prog

ram

s■

Visi

ting

med

ical

spe

cial

ist

■G

ood

acce

ss t

o ge

nera

list

allie

d he

alth

/nur

sing

sta

ff

As f

or l

evel

4 p

lus:

■Sp

ecia

list

med

ical

/nu

rsin

g/ a

llied

hea

lth

staf

f■

Incr

ease

d ra

nge

and

com

plex

ity

■H

ACC

inte

grat

ion

■En

hanc

ed d

iagn

osti

cs■

Teac

hing

and

tra

inin

g ro

le

As f

or l

evel

4 p

lus:

■Sp

ecia

list

med

ical

/nu

rsin

g/al

lied

heal

th s

taff

■In

crea

sed

rang

e an

dco

mpl

exit

y■

HAC

C in

tegr

atio

n■

Enha

nced

dia

gnos

tics

■Te

achi

ng a

nd t

rain

ing

role

As f

or l

evel

4 p

lus:

■Sp

ecia

list

med

ical

/nur

sing

/ al

lied

heal

th s

taff

■In

crea

sed

rang

e an

dco

mpl

exit

y■

HAC

C in

tegr

atio

n■

Enha

nced

dia

gnos

tics

■Te

achi

ng a

nd t

rain

ing

role

As f

or l

evel

4 p

lus:

■Sp

ecia

list

med

ical

/nu

rsin

g/al

lied

heal

th s

taff

■In

crea

sed

rang

e an

dco

mpl

exit

y■

Enha

nced

dia

gnos

tics

■Te

achi

ng a

nd t

rain

ing

role

As f

or l

evel

5 p

lus:

■Re

sear

ch r

ole

■Fu

lly i

nteg

rate

dam

bula

tory

car

e se

rvic

es■

Fully

int

egra

ted

diag

nost

ics

■In

clud

es r

egio

nal

suba

cute

cen

tre/

serv

ice

As f

or l

evel

5 p

lus:

■Re

sear

ch r

ole

■Fu

lly i

nteg

rate

dam

bula

tory

car

e se

rvic

es■

Fully

int

egra

ted

diag

nost

ics

■In

clud

es r

egio

nal

suba

cute

cen

tre/

serv

ice

As f

or l

evel

5 p

lus:

■Re

sear

ch r

ole

■Fu

lly i

nteg

rate

dam

bula

tory

car

e se

rvic

es■

Fully

int

egra

ted

diag

nost

ics

■In

clud

es r

egio

nal

suba

cute

cen

tre/

serv

ice

As f

or l

evel

5 p

lus:

■Re

sear

ch r

ole

■Fu

lly i

nteg

rate

dam

bula

tory

car

e se

rvic

es■

Fully

int

egra

ted

diag

nost

ics

■In

clud

es r

egio

nal

suba

cute

cen

tre/

serv

ice

clinicalframeworknew spread 21/9/05 3:14 PM Page 57

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56

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Obs

tetr

ics

Men

tal

heal

th p

rom

otio

nan

d ill

ness

pre

vent

ion

Emer

genc

y se

rvic

es

(hos

pita

l ba

sed)

Inpa

tien

t se

rvic

es

■Co

mm

unit

y ba

sed

GP

wit

hor

wit

hout

com

mun

ity

nurs

ing

post

onl

y

■Pr

omot

ion

of m

enta

lhe

alth

in

the

com

mun

ity

■Eg

. Im

prov

ing

men

tal

heal

th l

iter

acy,

res

ourc

ece

ntre

s an

d st

igm

are

duct

ion

stra

tegi

es.

■Eg

. Ex

posu

re t

o m

ass

med

ia c

ampa

igns

As f

or l

evel

1 p

lus:

■N

o pl

anne

d de

liver

ies

■O

utpa

tien

t cl

inic

for

ante

nata

l an

d po

st n

atal

care

by

visi

ting

GP

obst

etri

cian

wit

h or

wit

hout

reg

iste

red

mid

wif

e ■

Lim

ited

acc

ess

toge

nera

list

dom

icili

ary

nurs

ing

care

As f

or l

evel

1 p

lus:

■U

nive

rsal

pre

vent

ion

■Id

enti

fica

tion

of

risk

fact

ors

for

men

tal

illne

ssan

d in

terv

enti

on a

t th

epo

pula

tion

lev

el b

efor

ein

itia

l on

set

of a

dis

orde

r■

Eg.

Prog

ram

s to

pre

vent

bully

ing

in s

choo

ls,

Auss

ieO

ptim

ism

. Tr

iple

P■

Eg.

Loca

l co

mm

unit

yac

tivi

ty t

hat

impr

oves

qual

ity

of l

ife

incl

udin

gM

enta

l H

ealt

h W

eek

As f

or l

evel

2 p

lus:

■G

P ob

stet

rici

an a

ndm

idw

ifer

y se

rvic

es■

Visi

ting

spe

cial

ist

obst

etri

cian

Out

pati

ent

clin

ic f

oran

tena

tal

and

post

nat

alca

re

■So

me

earl

y di

scha

rge

prog

ram

s■

Acce

ss t

o do

mic

iliar

ynu

rsin

g ca

re a

nd v

isit

ing

mid

wif

e■

Basi

c ul

tras

ound

and

path

olog

y se

rvic

es

As f

or l

evel

2 p

lus:

■Se

lect

ive

prev

enti

on■

Targ

etin

g po

pula

tion

grou

ps a

t ri

sk o

fde

velo

ping

a d

isor

der

topr

even

t it

s on

set

■Eg

. Su

ppor

t fo

r CO

PMI

■M

ains

trea

m p

rovi

ders

tele

phon

e su

ppor

t fr

omon

cal

l te

am m

embe

r/p

sych

iatr

ic e

mer

genc

yte

am

■G

ener

al h

ospi

tal

inpa

tien

tse

rvic

es w

itho

utde

sign

ated

men

tal

heal

thbe

ds,

prov

idin

g m

enta

lhe

alth

car

e fo

r vo

lunt

ary

pati

ents

adm

itte

d un

der

man

agem

ent

of G

P or

othe

r m

edic

al o

ffic

er

As f

or l

evel

3 p

lus:

■Sp

ecia

list

obst

etri

cian

■Ea

rly

disc

harg

e pr

ogra

ms

■H

ome

visi

ting

mid

wiv

es■

Dia

gnos

tic

ultr

asou

nd w

ith

spec

ialis

t ra

diol

ogis

tof

feri

ng a

nten

atal

scre

enin

g ■

Full

rang

e pa

thol

ogy

serv

ices

■Vi

siti

ng g

enet

ic s

ervi

ces

As f

or l

evel

3 p

lus:

■In

dica

ted

prev

enti

on■

Targ

etin

g hi

gh r

isk

indi

vidu

als

who

may

hav

ede

tect

able

sig

ns a

ndsy

mpt

oms

fore

shad

owin

gm

enta

l ill

ness

■Eg

. Su

icid

e pr

even

tion

stra

tegi

es

As f

or l

evel

3 p

lus:

■Li

mit

ed E

D m

enta

l he

alth

liais

on n

ursi

ng s

ervi

ce■

24 h

our

on c

all

liais

onps

ychi

atri

st m

edic

alse

rvic

e

As f

or l

evel

3 p

lus:

■Sp

ecia

l m

enta

l he

alth

care

sui

te w

ith

desi

gnat

edbe

ds■

Gen

eral

ly o

pera

ted

onde

man

d w

itho

utpe

rman

ent

staf

f (r

oom

ing

in s

ervi

ces)

■Fa

cilit

y is

una

utho

rise

d

As f

or l

evel

4 p

lus:

■Sp

ecia

list

obst

etri

cian

■Sp

ecia

lised

ant

enat

al a

ndpo

stna

tal

educ

atio

n an

dsu

ppor

t pr

ogra

ms

■Te

achi

ng a

nd t

rain

ing

role

■En

hanc

ed d

iagn

osti

cs

As f

or l

evel

4 p

lus:

■Ea

rly

inte

rven

tion

for

thos

e w

ith

earl

y si

gns

and

sym

ptom

s of

a m

enta

ldi

sord

er o

r a

firs

t ep

isod

eof

men

tal

illne

ss.

■Eg

. Ea

rly

epis

ode

psyc

hosi

s pr

ogra

ms

As f

or l

evel

4 p

lus:

■O

n du

ty E

D m

enta

l he

alth

liais

on n

ursi

ng s

ervi

ce■

On

duty

psy

chia

tris

tm

edic

al s

ervi

ce

As f

or l

evel

4 p

lus:

■D

edic

ated

acu

te m

enta

lhe

alth

hos

pita

l or

desi

gnat

ed m

enta

l he

alth

inpa

tien

t un

its

in a

cute

hosp

ital

s■

Psyc

hiat

rist

con

sult

atio

nav

aila

ble

and

on c

all

24ho

urs

■Co

mpr

ehen

sive

tea

m

As f

or l

evel

5 p

lus:

■Re

sear

ch r

ole

■St

ate

obst

etri

c su

ppor

tse

rvic

e/un

it (

SOSU

)■

Spec

ialis

t ob

stet

ric

serv

ices

inc

ludi

ngm

ater

nal

feta

l m

edic

ine

subs

peci

alty

, ob

stet

ric

med

icin

e, g

enet

icse

rvic

es■

Fully

int

egra

ted

ambu

lato

ry c

are

serv

ices

(soc

ial

wor

k,ps

ycho

logi

cal

med

icin

eet

c)■

Fully

int

egra

ted

diag

nost

ic s

ervi

ces

As f

or l

evel

5 p

lus:

■Re

laps

e pr

even

tion

for

thos

e id

enti

fied

wit

hm

enta

l ill

ness

■G

P(s)

and

loc

al m

enta

lhe

alth

tea

m m

embe

r(s)

wit

h vi

siti

ng p

sych

iatr

ist

■Eg

. Ch

ange

s (R

PH r

elap

sepr

even

tion

pro

gram

) an

dW

elln

ess

Reco

very

Act

ion

Plan

(W

RAP)

a c

onsu

mer

led

prog

ram

As f

or l

evel

5 p

lus:

■O

n du

ty E

D m

enta

l he

alth

liais

on n

ursi

ng s

ervi

ce■

On

duty

psy

chia

tris

tm

edic

al s

ervi

ce■

Acut

e ad

mis

sion

uni

tse

rvic

e

As f

or l

evel

5 p

lus:

■Sp

ecia

list

stat

ewid

ese

rvic

es p

rovi

ded

■A

stro

ng a

cade

mic

and

rese

arch

com

pone

nt i

nth

e se

rvic

e

Child

and

Ado

lesc

ents

Men

tal

Hea

lth,

Adu

lt M

enta

l H

ealt

h, O

lder

Per

sons

Men

tal

Hea

lth

Serv

ices

Men

tal

Hea

lth

Ambu

lato

ry C

are

Serv

ices

are

cov

ered

und

er M

enta

l H

ealt

h Se

rvic

es

clinicalframeworknew spread 21/9/05 3:14 PM Page 58

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57

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Com

mun

ity

clin

ical

bas

edse

rvic

es

Day

the

rapy

ser

vice

s(h

ospi

tal

base

d)

Com

mun

ity

non

clin

ical

supp

ort

prog

ram

s

Inte

rmed

iate

car

e

■Lo

cal

prim

ary

heal

thAs

for

lev

el 1

plu

s:■

Visi

ting

men

tal

heal

thpr

ofes

sion

al(s

)

■G

P an

d co

mm

unit

y he

alth

cent

re b

ased

scr

eeni

ngan

d ea

rly

dete

ctio

n of

men

tal

illne

ss■

Eg.

GPs

and

com

mun

ity

heal

th c

entr

es

As f

or l

evel

2 p

lus:

■Lo

cally

bas

ed m

enta

lhe

alth

tea

m■

Not

Mul

tidi

scip

linar

y

■So

me

limit

ed s

ervi

ces

As f

or l

evel

2 p

lus:

■N

on c

linic

al c

omm

unit

ysu

ppor

t (i

nclu

ding

psyc

hoso

cial

, di

sabi

lity,

recr

eati

onal

, an

d re

spit

eto

ind

ivid

uals

) in

the

irow

n ho

mes

and

the

com

mun

ity

up t

o 10

hou

rspe

r w

eek

■In

depe

nden

t liv

ing

prog

ram

(w

ith

supp

orti

vela

ndlo

rd)

■D

rop-

in c

entr

es a

ndfa

cilit

atin

g re

crea

tion

alac

tivi

ties

Care

r re

spit

e■

Care

r su

ppor

t an

ded

ucat

ion

■In

depe

nden

t liv

ing

skill

ssu

ppor

t■

They

do

not

all

rela

te t

ore

spit

e. T

his

is t

he r

ange

of c

omm

unit

y su

ppor

tse

rvic

es

■Cl

inic

ally

sup

ervi

sed

serv

ice

in p

erso

n’s

hom

e

As f

or l

evel

3 p

lus:

■Co

mm

unit

y m

enta

l he

alth

prog

ram

wit

hm

ulti

disc

iplin

ary

team

■Se

rvic

es g

ener

ally

prov

ided

dur

ing

core

busi

ness

hou

rs o

nly

■Li

mit

ed r

ange

ass

essm

ent

and

trea

tmen

t pr

ogra

ms

prov

ided

As f

or l

evel

3 p

lus:

■Li

mit

ed r

ange

of

day

ther

apy

serv

ices

As f

or l

evel

3 p

lus:

■N

on c

linic

al c

omm

unit

ysu

ppor

t up

to

30 h

ours

per

wee

k■

Psyc

hoso

cial

sup

port

Serv

ices

for

you

th a

t ri

skof

hom

eles

snes

s an

d lo

ngte

rm m

enta

l ill

ness

As f

or l

evel

3 p

lus:

■Cl

inic

ally

sup

ervi

sed

serv

ice

in a

fac

ility

or

pers

on’s

hom

e■

Sub

acut

e ca

re

As f

or l

evel

4 p

lus:

■Co

mm

unit

y m

enta

l he

alth

prog

ram

wit

hm

ulti

disc

iplin

ary

team

■7

day

a w

eek

cove

r ■

Exte

nsiv

e ra

nge

ofas

sess

men

t an

d tr

eatm

ent

prog

ram

s ■

Som

e lim

ited

aft

er h

ours

serv

ices

may

be

prov

ided

■Eg

. M

ulti

syst

emic

The

rapy

for

fam

ilies

Eg.

Inte

nsiv

e cl

inic

alre

habi

litat

ion

As f

or l

evel

4 p

lus:

■Ex

tens

ive

rang

e of

day

ther

apy

serv

ices

As f

or l

evel

4 p

lus:

■N

on c

linic

al c

omm

unit

ysu

ppor

t up

to

40 h

ours

per

wee

k■

Inte

nsiv

e di

sabi

lity

supp

ort

for

adul

ts a

t ri

skof

hom

eles

snes

s■

Cons

umer

res

pite

/cri

sis

care

■Su

ppor

ted

acco

mm

odat

ion

serv

ices

As f

or l

evel

4 p

lus:

■Cl

inic

ally

sta

ffed

24/

7■

Una

utho

rise

d fa

cilit

y■

Sub

acut

e ca

re

As f

or l

evel

5 p

lus:

■Co

mm

unit

y m

enta

l he

alth

prog

ram

wit

hm

ulti

disc

iplin

ary

team

prov

idin

g 24

hou

r/7

day

aw

eek

cove

r■

Spec

ialis

t st

atew

ide

derv

ices

pro

vide

d■

Eg.

Psyc

hiat

ric

emer

genc

yse

rvic

es■

Eg.

Spec

ialis

t re

side

ntia

lse

rvic

e■

Eg.

Fore

nsic

dis

char

gese

rvic

e

As f

or l

evel

5 p

lus:

■M

ulti

disc

iplin

ary

team

■St

atew

ide

or s

peci

alis

tre

ferr

al r

ole

As f

or l

evel

5 p

lus:

■N

on c

linic

al 2

4 ho

urm

enta

l he

alth

acco

mm

odat

ion

and

reha

bilit

atio

n in

resi

dent

ial

acco

mm

odat

ion

As f

or l

evel

5 p

lus:

■Cl

inic

ally

sta

ffed

24/

7■

Auth

oris

ed f

acili

ty■

Stat

ewid

e re

ferr

al r

ole

■Su

b ac

ute

care

clinicalframeworknew spread 21/9/05 3:14 PM Page 59

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58

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Fore

nsic

Mat

erna

l

Neu

rolo

gica

l

Alco

hol

and

Dru

g

Oth

er■

Eati

ng d

isor

der

■Sp

ecia

list

men

tal

heal

thpr

ogra

m w

ith

mul

tidi

scip

linar

y te

am■

Exte

nsiv

e ra

nge

ofas

sess

men

t an

d tr

eatm

ent

prog

ram

s in

clud

ing

fore

nsic

dis

char

ge a

ndac

com

mod

atio

n pr

ogra

m

■Sp

ecia

list

men

tal

heal

thpr

ogra

m w

ith

mul

tidi

scip

linar

y te

am■

Exte

nsiv

e ra

nge

ofas

sess

men

t an

d tr

eatm

ent

prog

ram

s

■Sp

ecia

list

men

tal

heal

thpr

ogra

m w

ith

mul

tidi

scip

linar

y te

am■

Exte

nsiv

e ra

nge

ofas

sess

men

t an

d tr

eatm

ent

prog

ram

s

■Sp

ecia

list

men

tal

heal

thpr

ogra

m w

ith

mul

tidi

scip

linar

y te

am■

Exte

nsiv

e ra

nge

ofas

sess

men

t an

d tr

eatm

ent

prog

ram

s

■Sp

ecia

list

men

tal

heal

thpr

ogra

m w

ith

mul

tidi

scip

linar

y te

am■

Exte

nsiv

e ra

nge

ofas

sess

men

t an

d tr

eatm

ent

prog

ram

s

As f

or l

evel

5 p

lus:

■Sp

ecia

list

stat

ewid

ein

pati

ent

serv

ices

prov

ided

■A

stro

ng a

cade

mic

and

rese

arch

com

pone

nt i

nth

e se

rvic

e

As f

or l

evel

5 p

lus:

■Sp

ecia

list

stat

ewid

ein

pati

ent

serv

ices

prov

ided

■A

stro

ng a

cade

mic

and

rese

arch

com

pone

nt i

nth

e se

rvic

e

As f

or l

evel

5 p

lus:

■Sp

ecia

list

stat

ewid

ein

pati

ent

serv

ices

prov

ided

■In

clud

es A

BI a

ndin

telle

ctua

l di

sabi

lity

■A

stro

ng a

cade

mic

and

rese

arch

com

pone

nt i

nth

e se

rvic

e

As f

or l

evel

5 p

lus:

■Sp

ecia

list

stat

ewid

ein

pati

ent

serv

ices

prov

ided

As f

or l

evel

5 p

lus:

■Sp

ecia

list

stat

ewid

ein

pati

ent

serv

ices

prov

ided

■A

stro

ng a

cade

mic

and

rese

arch

com

pone

nt i

nth

e se

rvic

e

Stat

ewid

e M

enta

l H

ealt

h Se

rvic

es

Spec

ialis

t de

sign

ed m

enta

l he

alth

ser

vice

s fo

r pe

ople

wit

h m

enta

l di

sord

ers

and

men

tal

heal

th p

robl

ems

whi

ch,

due

to a

ran

ge o

f fa

ctor

s in

clud

ing

tech

nica

l sp

ecia

lty,

hig

h co

st,

high

lev

el o

f cl

ient

nee

d an

d sm

all

clie

nt p

opul

atio

n, a

re p

rovi

ded

on a

sta

tew

ide

basi

s

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WA 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 0 5 – 2 0 1 5

59

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

Path

olog

y

Radi

olog

y

Phar

mac

y

■Sp

ecim

en c

olle

ctio

n by

RN■

Spec

imen

s tr

ansm

itta

l to

refe

rral

lab

orat

ory

■Se

rvic

e ov

ersi

ght

byph

arm

acis

t lo

cate

del

sew

here

■D

rugs

sup

plie

d on

indi

vidu

al p

resc

ript

ion

from

com

mun

ity

phar

mac

y

As f

or l

evel

1 p

lus:

■Sp

ecim

en c

olle

ctio

n by

RN

■Sp

ecim

ens

tran

smit

tal

to r

efer

ral

labo

rato

ry

■M

obile

ser

vice

and

lim

ited

to x

-ray

of

extr

emit

ies,

ches

t, a

bdom

en■

Inte

rpre

ted

by o

nsit

edo

ctor

/hea

lth

prof

essi

onal

As f

or l

evel

1 p

lus:

■Vi

siti

ng p

harm

acis

t fr

omre

gion

al h

ospi

tal

■M

inim

al c

linic

al s

ervi

ce■

Staf

f ed

ucat

ion

■D

rugs

pro

vide

d by

regi

onal

hos

pita

l

As f

or l

evel

2 p

lus:

■Sp

ecim

en c

olle

ctio

n by

RN

for

tra

nsm

itta

l to

re

ferr

al l

abor

ator

y■

Able

to

perf

orm

a d

efin

edra

nge

urge

nt t

ests

As f

or l

evel

2 p

lus:

■As

lev

el 2

, pl

us h

as o

nsi

te d

esig

nate

d ro

om

■Ra

diog

raph

er i

nat

tend

ance

who

has

regu

lar

acce

ss t

ora

diol

ogic

al c

onsu

ltat

ion

■Si

mpl

e ul

tras

ound

capa

city

for

foe

tal

mon

itor

ing

■Te

lera

diol

ogy

faci

lity

avai

labl

e

As f

or l

evel

2 p

lus:

■At

lea

st o

ne p

harm

acis

tem

ploy

ed f

ull

tim

e■

Phar

mac

y dr

ug p

urch

asin

gan

d di

stri

buti

on t

oin

pati

ents

in

acco

rdan

cew

ith

stat

e dr

ug p

olic

ies

and

form

ular

y■

May

pro

vide

pha

rmac

yun

derg

radu

ate

and

post

grad

uate

tea

chin

gro

le■

May

hav

e re

gion

al r

ole

As f

or l

evel

3 p

lus:

■Pe

rfor

ms

rang

e of

bas

ic

test

s■

May

hav

e bl

ood

gas

anal

yser

■Bl

ood

bank

■Se

rvic

es s

urro

undi

ng

■Fu

ll ti

me

labo

rato

ryte

chno

logi

sts

As f

or l

evel

3 p

lus:

■As

lev

el 3

, w

ith

faci

litie

sfo

r ge

nera

l an

dfl

uoro

scop

y, i

n ad

diti

on t

om

obile

CD

for

war

ds,

OR

and

ED■

Auto

film

pro

cess

ing

capa

city

■M

obile

im

age

inte

nsif

ier

in O

R an

d/or

ICU

/CCU

■St

aff

radi

ogra

pher

on

call

24 h

ours

■Vi

siti

ng s

peci

alis

tra

diol

ogic

al a

ppoi

ntm

ent

■Al

way

s ha

s ul

tras

ound

May

hav

e CT

sca

nner

■Re

gist

ered

nur

se a

sre

quir

ed■

Tele

radi

olog

y fa

cilit

yav

aila

ble

As f

or l

evel

3 p

lus:

■M

ore

than

one

pha

rmac

ist

empl

oyed

Emer

genc

y af

ter

hour

son

-cal

l se

rvic

e■

Lim

ited

clin

ical

pha

rmac

yse

rvic

e to

inp

atie

nts

■Li

mit

ed o

utpa

tien

tsdi

spen

sing

■D

evel

ops

loca

l dr

ugpo

licie

s■

Part

icip

ates

in

hosp

ital

com

mit

tees

■M

ay p

rovi

de p

harm

acy

unde

rgra

duat

e an

dpo

stgr

adua

te t

each

ing

role

■M

ay h

ave

regi

onal

rol

e

As f

or l

evel

4 p

lus:

■24

hou

r on

sit

e se

rvic

e■

Path

olog

y de

part

men

t■

Full

tim

e pa

thol

ogis

t■

Mic

robi

olog

y an

dhi

stop

atho

logy

ava

ilabl

e■

Regi

onal

ref

erra

l ro

le

As f

or l

evel

4 p

lus:

■As

Lev

el 4

plu

ses

tabl

ishe

d D

epar

tmen

t■

Full

ultr

asou

nd■

Has

rad

iolo

gist

in

char

ge■

May

hav

e ra

diol

ogy

regi

stra

r■

Has

reg

iste

red

nurs

e 24

hour

on

site

ser

vice

for

urge

nt x

-ray

s■

CT s

cann

er o

n si

te o

rlo

cally

ava

ilabl

e■

PACs

ava

ilabl

e■

Poss

ible

MRI

As f

or l

evel

4 p

lus:

■6

day

serv

ice

and

on c

all

serv

ice

■In

pati

ent

and

outp

atie

ntse

rvic

es■

Dru

g in

form

atio

n■

Exte

nsiv

e cl

inic

alph

arm

acy

serv

ice

toin

pati

ents

■In

trav

enou

s ad

diti

vean

d/or

cyt

otox

ic d

rug

prep

arat

ion

Exte

mpo

rane

ous

disp

ensi

ng■

Supp

ort

for

clin

ical

tri

als

■U

nder

grad

uate

and

post

grad

uate

pha

rmac

yte

achi

ng r

ole

■M

ay h

ave

regi

onal

rol

e

As f

or l

evel

5 p

lus:

■St

atew

ide

refe

rral

rol

e■

Teac

hing

and

res

earc

hro

le■

Spec

ialis

t re

gist

rar

intr

aini

ng

As f

or l

evel

5 p

lus:

■As

lev

el 5

, pl

us s

peci

alro

oms

for

digi

tal

angi

ogra

phy,

neur

orad

iolo

gy e

tc■

CT s

can

and

full

ultr

asou

nd s

ervi

ceav

aila

ble

24 h

ours

■Al

way

s ha

s M

RI a

nd d

igit

alan

giog

raph

y■

Has

rad

iolo

gy r

egis

trar

and

post

gra

duat

e fe

llow

s■

Perf

orm

s in

vasi

vepr

oced

ures

■PA

Cs a

vaila

ble

As f

or l

evel

5 p

lus:

■7

day

serv

ice

■24

hou

r on

-cal

l se

rvic

e■

Spec

ialis

t ph

arm

acis

tpo

siti

ons

eg o

ncol

ogy,

card

iolo

gy,

paed

iatr

ics,

geri

atri

cs,

psyc

hiat

ry,

drug

inf

orm

atio

n ■

Invo

lved

in

rese

arch

,cl

inic

al t

rial

s, c

linic

alre

view

, D

UE’

s,

■Pr

ovid

e un

derg

radu

ate

and

post

grad

uate

teac

hing

rol

e■

Prod

uct

eval

uati

on w

ith

drug

use

/pol

icy

deve

lopm

ent

Clin

ical

Sup

port

Ser

vice

s

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60

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

ICU

/HD

U

Paed

iatr

ic I

CU

■H

igh

depe

nden

cy a

rea

for

gene

ral

war

d pa

tien

tsre

quir

ing

obse

rvat

ion

over

and

abov

e th

at a

vaila

ble

in g

ener

al w

ard

area

As f

or l

evel

3 p

lus:

■Pr

ovid

es b

asic

,m

ulti

syst

em l

ife

supp

ort

usua

lly f

or l

ess

than

a 2

4ho

ur p

erio

d■

Able

to

prov

ide

mec

hani

cal

vent

ilati

onan

d si

mpl

e ca

rdio

vasc

ular

mon

itor

ing

for

a pe

riod

of

at l

east

sev

eral

hou

rs,

orca

re o

f a

sim

ilar

natu

re■

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

4 p

lus:

■Pr

ovid

es c

ompl

ex,

mul

tisy

stem

lif

e su

ppor

t■

Able

to

prov

ide

mec

hani

cal

vent

ilati

on,

extr

acor

pore

al r

enal

supp

ort

serv

ices

and

inva

sive

car

diov

ascu

lar

mon

itor

ing

for

a pe

riod

of

at l

east

sev

eral

day

s, o

rfo

r lo

nger

per

iods

in

rem

ote

area

s or

car

e of

asi

mila

r na

ture

■Sp

ecia

list

RN■

Acce

ss t

o sp

ecia

list

SRN

As f

or l

evel

5 p

lus:

■Pr

ovid

es c

ompl

ex,

mul

tisy

stem

lif

e su

ppor

tfo

r an

ind

efin

ite

peri

od■

Tert

iary

ref

erra

l ce

ntre

for

pati

ents

in

need

of

inte

nsiv

e ca

re s

ervi

ces

■H

ave

exte

nsiv

e ba

ckup

labo

rato

ry a

nd c

linic

alse

rvic

e fa

cilit

ies

tosu

ppor

t th

e te

rtia

ryre

ferr

al r

ole

■Ab

le t

o pr

ovid

em

echa

nica

l ve

ntila

tion

,ex

trac

orpo

real

ren

alsu

ppor

t se

rvic

es a

ndin

vasi

ve c

ardi

ovas

cula

rm

onit

orin

g fo

r an

inde

fini

te p

erio

d, o

r ca

reof

a s

imila

r na

ture

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

5 p

lus:

■Pr

ovid

es c

ompl

ex,

mul

tisy

stem

lif

e su

ppor

tfo

r an

ind

efin

ite

peri

od■

Tert

iary

ref

erra

l ce

ntre

for

child

ren

need

ing

inte

nsiv

e ca

re■

Hav

e ex

tens

ive

back

upla

bora

tory

and

clin

ical

serv

ice

faci

litie

s to

supp

ort

this

ter

tiar

y ro

le■

Able

to

prov

ide

mec

hani

cal

vent

ilati

on,

extr

acor

pore

al r

enal

supp

ort

serv

ices

and

inva

sive

car

diov

ascu

lar

mon

itor

ing

for

anin

defi

nite

per

iod

toin

fant

s an

d ch

ildre

n le

ssth

an 1

6 ye

ars

of a

ge,

orca

re o

f a

sim

ilar

natu

re■

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N

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61

Leve

l 1

Leve

l 2

Leve

l 3

Leve

l 4

Leve

l 5

Leve

l 6

CCU

Anae

sthe

tics

Ope

rati

ng T

heat

res

Trai

ning

and

Res

earc

h

■An

alge

sia/

min

imal

seda

tion

ava

ilabl

e by

visi

ting

med

ical

off

icer

As f

or l

evel

1 p

lus:

■M

inor

pro

cedu

reca

pabi

lity

no e

mer

genc

yop

erat

ing

thea

tre

As f

or l

evel

1 p

lus:

■Li

mit

ed –

pos

sibl

e m

edic

alst

uden

t w

ith

visi

ting

GP

As f

or l

evel

2 p

lus:

■G

ener

al A

naes

thet

ics

onlo

w r

isk

pati

ents

giv

en G

Pan

aest

heti

sts

or g

ener

alan

aest

heti

st■

May

hav

e vi

siti

ngsp

ecia

list

anae

sthe

tist

As f

or l

evel

2 p

lus:

■Si

ngle

ope

rati

ng t

heat

refo

r m

inor

/sam

e da

ypr

oced

ures

■24

hou

r co

ver

for

caes

aria

n se

ctio

n if

perf

orm

ing

obst

etri

cs

As f

or l

evel

2 p

lus:

■So

me

med

ical

nur

sing

and

allie

d he

alth

tra

inin

g

As f

or l

evel

3 p

lus:

■Ab

le t

o su

pply

cri

tica

lca

re e

xper

tise

for

coro

nary

pat

ient

s■

Prov

ides

a l

evel

of

care

mor

e in

tens

ive

than

war

dba

sed

care

■D

iscr

ete

area

wit

hin

the

heal

th f

acili

ty (

may

be

com

bine

d w

ithi

n an

ICU

or H

DU

)■

Non

inv

asiv

e m

onit

orin

g■

Can

prov

ide

resu

scit

atio

nan

d st

abili

sati

on o

fem

erge

ncie

s un

til

tran

sfer

or r

etri

eval

to

a ba

ck u

pfa

cilit

y■

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N■

Form

al l

ink

wit

h pu

blic

or

priv

ate

heal

th f

acili

ty(s

)fo

r pa

tien

t re

ferr

al a

ndtr

ansf

er t

o/fr

om a

hig

her

leve

l of

ser

vice

, to

ens

ure

safe

ser

vice

pro

visi

on

As f

or l

evel

3 p

lus:

■G

ener

al a

naes

thet

ics

onlo

w r

isk

pati

ents

giv

en b

yac

cred

ited

med

ical

prac

titi

oner

■Sp

ecia

list

anae

sthe

tist

appo

inte

d fo

rco

nsul

tati

on a

nd t

opr

ovid

e se

rvic

e fo

rm

oder

ate

risk

pat

ient

s■

Spec

ific

ope

rati

ng r

oom

anae

sthe

tic

staf

f su

ppor

tav

aila

ble

As f

or l

evel

3 p

lus:

■M

ore

than

one

ope

rati

ngth

eatr

e/pr

oced

ure

room

■Se

para

te r

ecov

ery

■Ac

cred

ited

med

ical

prac

titi

oner

pro

vidi

ngan

aest

heti

c se

rvic

es■

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N

As f

or l

evel

3 p

lus:

■So

me

regi

star

and

resi

dent

tra

inin

g■

Som

e sp

ecia

list

nurs

ing

and

allie

d he

alth

tra

inin

g ■

Poss

ibly

col

labo

rati

vere

sear

ch

As f

or l

evel

4 p

lus:

■Ab

le t

o pr

ovid

e ad

diti

onal

mon

itor

ing

capa

city

(cen

tral

mon

itor

ing

atst

aff

stat

ion)

for

car

diac

pati

ents

and

inc

reas

edm

edic

al a

nd n

ursi

ngsu

ppor

t■

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N■

As f

or C

CU s

ervi

ce l

evel

4pl

us:

■Be

dsid

e an

d ce

ntra

lm

onit

orin

g ca

paci

ty(a

ble

to m

onit

orpa

tien

ts a

t th

e st

aff

stat

ion)

As f

or l

evel

4 p

lus:

■Sp

ecia

list

anae

sthe

tist

on

24 h

our

rost

er f

or l

ow,

mod

erat

e an

d hi

gh r

isk

pati

ents

■N

omin

ated

spe

cial

ist

dire

ctor

of

anae

sthe

tic

staf

f■

Anae

sthe

tic

regi

stra

r on

site

24

hour

s

As f

or l

evel

4 p

lus:

■Sp

ecia

list

anae

sthe

tist

on

24 h

our

rost

er f

or l

ow,

mod

erat

e an

d hi

gh r

isk

pati

ents

■M

edic

al o

ffic

er o

n si

te 2

4ho

urs

■Ac

cess

to

ICU

■Sp

ecia

list

RN■

Acce

ss t

o sp

ecia

list

SRN

As f

or l

evel

4 p

lus:

■Sm

all

rese

arch

uni

t ■

Spec

ialis

t tr

aini

ng f

ornu

rsin

g an

d al

lied

heal

th■

Som

e in

tern

, re

side

nt a

ndre

gist

ar t

rain

ing

As f

or l

evel

5 p

lus:

■Pr

ovid

es f

ull

rang

e of

card

iac

mon

itor

ing

(inc

ludi

ng i

nvas

ive

mon

itor

ing)

for

car

diac

pati

ents

■Fu

ll ca

rdio

logy

sup

port

incl

udin

g 24

hou

r on

cal

lec

hoca

rdio

grap

hy,

angi

ogra

phy,

ang

iopl

asty

and

perm

anen

tpa

cem

aker

ser

vice

s■

Spec

ialis

t RN

■Ac

cess

to

spec

ialis

t SR

N■

As f

or C

CU s

ervi

ce l

evel

5pl

us:

■In

vasi

ve c

ardi

ovas

cula

rm

onit

orin

g(i

ndef

init

ely)

■H

ighe

st l

evel

ref

erra

lce

ntre

for

CCU

pat

ient

sw

ith

acti

ve l

iais

on w

ith

low

er l

evel

cri

tica

l ca

rese

rvic

es f

or r

efer

rals

and

tran

sfer

of

pati

ents

to e

nsur

e sa

fe s

ervi

cepr

ovis

ion

As f

or l

evel

5 p

lus:

■24

spe

cial

ist

anae

sthe

tist

rost

er■

Sub

spec

ialis

ts,

rese

arch

and

teac

hing

of

grad

uate

san

d un

derg

radu

ates

■24

hou

r on

sit

ean

aest

heti

c re

gist

rar

■Te

achi

ng a

nd r

esea

rch

role

As f

or l

evel

5 p

lus:

■M

ulti

ple

oper

atin

gth

eatr

es a

nd p

roce

dure

room

s■

Maj

or a

nd c

ompl

expr

oced

ures

(car

diot

hora

cic

and

tran

spla

nt)

■Te

achi

ng a

nd r

esea

rch

role

■Sp

ecia

list

RN■

Acce

ss t

o sp

ecia

list

SRN

As f

or l

evel

5 p

lus:

■Ac

adem

ic U

nit

Rese

arch

Inst

itut

e■

Full

trai

ning

pro

gram

at

all

leve

ls■

Form

al t

rain

ing

links

wit

hth

e un

iver

siti

es

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62

WA 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 0 5 – 2 0 1 5

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WA 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 0 5 – 2 0 1 5

63

Appendix 2 - WACHS Clinical Services Delineation Matrix

Regional Resource Centres (1)

Integrated District Health Services (2)

Hospitals in Small Towns (3)

Level* Level* Level*

Medical Services

Surgical Services

Emergency TraumaServices

Obstetric Services

Paediatric Services

Rehabilitation Services

Prevention andPromotion Services

Primary Care Services

Ambulatory CareServices

Mental Health Services

Clinical Support

4

4

4

4

3/4

4/5

5

4/5

4

3/4

3/4

2/3

2/3

2/3

2/3

2

3

3/4

3

2/3/4

2/3

2/3

1/2

1/2

1/2

1/2

1

1

1/2/3/4

1/3

1/2

1/2

1

■ This is an approximate guide to the services WACHS aims to provide at each hospital. The full range ofservices denoted by each level may not be available at all sites.

■ * the level of service is defined in the Clinical Services Consultation 2005 paper.

■ The key refers to the Centres, Services and Hospitals as per above table:

(1) Broome, Port Hedland, Geraldton, Kalgoorlie and Albany(2) Esperance, Katanning, Moora, Narrogin, Merredin, Northam, Carnarvon, Newman, Nickol Bay, Derby and

Kununurra(3) Fitzroy Crossing, Halls Creek, Wyndham, Exmouth, Onslow, Paraburdoo, Wickham, Roebourne, Tom

Price, Dongara, Kalbarri, Meekatharra, Morawa, Mullewa, North Midlands, Northampton, Laverton,Leonora, Norseman, Ravensthorpe, Beverley, Boddington, Bruce Rock, Corrigin, Cunderdin, Dalwallinu,Dumbleyung, Goomalling, Kellerberrin, Kondinin, Kununoppin, Lake Grace, Narembeen, Pingelly,Quairading, Southern Cross, Wagin, Wongan Hills, Wyalkatchem, York, Denmark, Gnowangerup, Kojonup,Plantagenet.

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62

WA 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 0 5 – 2 0 1 5

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For further information please contact:

Health Policy and Clinical Reform

Department of Health

Phone: (08) 9222 4434

Fax: (08) 9222 2192

Email: [email protected]

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WA Health Clinical ServicesFramework 2005 – 2015

Delivering a Healthy WA

Healthy Workforce ● Healthy Hospitals ● Healthy Partnerships ● Healthy Communities ● Healthy Resources ● Healthy Leadership

© Department of Health, 2005

HP

2978

SE

PT

’05

2064

3

September 2005