Our Collective Vision

Our Visions

Together, caring for the West Our patients, staff, community and environment

Our Purpose

Leading the delivery of a connected and consistent patient experience and providing the best care to save and improve the lives of those in our community most in need.

Foreword

Western Health is a powerhouse of health care, education and research serving Melbourne’s western suburbs. We are the largest health provider in the fastest growing region of Australia.

The development of this strategic plan comes at a critical time in the organisation’s growth and maturity.

The vitality, diversity and challenges of our multicultural community inspire us to be innovative and they anchor our proud identity and tradition as a health service created by and for the people of the west. Reflecting on this tradition reminds me of the importance of grounding our contemporary provision of care in our connections with social justice.

We hold a very significant responsibility to respond to the deep need within our communities for a health service which is as efficient and innovative as it can be.

In developing the Strategic Plan, we listened to our community and we heard that, while we have improved significantly over the last five years, there are a number of ways in which we can do even better, particularly in reducing the wait for services; matching services to the diverse needs of our community; providing better facilities; and delivering more consistent care.

Bringing this Strategic Plan to life will translate to the provision of even better care to hundreds of thousands of patients over the five year life of the Plan.

The Hon. Bronwyn Pike
Western Health Board Chair

Western Health services a region with high levels of industry, communities with diverse economic circumstances and high numbers of families from a refugee or migrant background. These factors combine to have a significant impact on the health and wellbeing of our population. We must respond to higher than average rates of chronic and complex disease, cancer and mental illness.

The West is a region with strong community linkages and a well-developed history of partnership to address the substantial challenges it faces. Our health service is embedded in and committed to our community and this is a key strength and one we will build on over the five years. This Strategic Plan takes the social characteristics of our region into account and includes many initiatives designed to respond to the complex healthcare issues they generate.

Our five strategic aims focus on improving the quality of care provided to our patients, better connecting care as patients move in and out of our service, improving how we listen and engage with patients, our partners and with each other and having a broader level of responsibility to influence the health outcomes and sustainability of our community. These priorities will be realised through supporting our people to do the best job they can do.

I look forward to leading these changes with the support of the communities of the West and making a genuine difference for the sake of our patients in the years to come.

Associate Professor Alex Cockram
Western Health Chief Executive

UNDERSTANDING OUR COMMUNITY

OUR CATCHMENT PROFILE

1. Moorabool (S) – Bacchus Marsh
2. Wyndham (C) – West
3. Wyndham (C) – South
4. Wyndham (C) – North
5. Melton (S) – Bal
6. Hume (C) – Sunbury
7. Melton (S) – East
8. Brimbank (C) – Keilor
9. Brimbank (C) – Sunshine
10. Moonee Valley (C) – West
11. Moonee Valley (C) – Essendon
12. Maribyrnong (C)
13. Hobsons Bay (C) – Williamstown
14. Hobsons Bay (C) – Altona
15. Sunbury Hospital
16. Sunshine Hospital
17. Footscray Hospital
18. Williamstown Hospital

Our community is characterised by its rapid growth and diversity.

Growth in our catchment is significantly above the national average, consistently outstripping forecasts. The rate of growth is unlikely to slow, with our total population expected to grow from a current population of approximately 800,000 to well over 1.2 million people by 2026 .

More than 30% of our community is born outside of Australia . Within our catchment at least 110 different languages are spoken, with around 8% of the total population having poor or no English proficiency, significantly higher than the national average of 2.6%.

We also have a high number of refugee and asylum seekers within the region.

Our region has the highest rates of births in Australia, while other areas within our catchment house a much higher proportion of older residents than the national average.

Many of those in the community experience entrenched disadvantage, with higher than average unemployment, lower than average labor force participation and a large proportion of our population living below the poverty line .

OUR COMMUNITY’S HEALTH AND WELLBEING

The social determinants summarised above are core factors in the poor self-reported status of the health and wellbeing of our community. Our community has much higher rates of chronic disease, with many having multiple chronic diseases, including: Type 2 Diabetes; vascular disease; kidney disease; and heart disease. The prevalence of certain types of cancer is much higher compared with the rest of Victoria.

We are also seeing an increase on the already high rates of mental illness throughout the region, with high reported levels of psychological stress for the communities of Brimbank, Hume and Melton. Frailty is becoming an increasing inhibitor to independent healthy living, and while only 8% of our total population is aged over 70, more than 90% of all of our non-same day hospital stays (excluding maternity and paediatric services) are by patients in this age group

At Western Health, the birth rate is forecast to increase from around 5,500 births per annum to over 7,200 births per annum by 2026. This increase in demand, coupled with the large proportion of children in our catchment, means there will be a continuing and increased need for appropriate women’s and children’s health services.

MEETING OUR COMMUNITY’S HEALTH NEEDS

It is anticipated that without intervention, Western Health will continue to be able to provide about 40% of the health service demand in our community. Other services within our community such as Werribee Mercy Health and Djerriwarrh Health Services provide some further services, however, our region is heavily reliant on other tertiary and quaternary services, such as Melbourne Health, St Vincent’s and the Royal Women’s and Royal Children’s hospitals. As demand continues to rise, these services will also become capacity constrained. Therefore, to successfully address these health issues requires a system-wide response to health service delivery. This strategy clearly articulates the need for a partnership approach to address the risks as well as harness the opportunities within our community.

POLICY CONTEXT

As a public health service, Western Health is committed to continuing to respond to key statewide priorities, these include:

• Improving health services by responding to growing patient demand through increasing capacity, focusing on the wait for emergency care and elective surgery and improving coordination across the care continuum
• Developing key infrastructure, such as the Western Women’s and Children’s Hospital at Sunshine
• Strengthing the health workforce with a particular focus on workplace violence, mental health and appropriate training and education
• Improving access to culturally appropriate services for Aboriginal and Torres Strait Islander communities as well as culturally and linguistically diverse communities.

OUR STORY SO FAR

WHO WE ARE

Western Health provides comprehensive health services to those living in western Melbourne. Covering a population of more than 800,000 our services are a combination of hospital and community-based services to newborn babies, children, adults and the elderly.

With an annual operating budget of more than 650 million dollars, we provide acute tertiary services in areas of emergency medicine, intensive care, medical and surgical services, as well as sub-acute care and specialist ambulatory clinics.

We are responsible for managing three acute public hospitals – Footscray, Sunshine and Williamstown, a day hospital at Sunbury, a transition care facility at Williamstown and a drug health service in Footscray.

 

Facility	Description
Footscray Hospital	Acute and sub-acute teaching hospital with approximately 300 beds. It provides the majority of acute elective and acute emergency services for Western Health. Patients are provided with a range of inpatient and outpatient services including acute general medical and surgical, intensive and coronary care, sub-specialty medicine, surgical services, and related clinical support.
Sunshine Hospital	Acute and sub-acute teaching hospital with approximately 600 beds (including Mental Health beds managed by North West Mental Health). Sunshine Hospital has a range of services including a new intensive care unit, cardiac care services, women’s and children’s services, surgical, medical, mental health, aged care and rehabilitation services. Sunshine Hospital’s emergency department, including a paediatric service, is one of the busiest general emergency departments in Victoria.
Williamstown Hospital	A 90 bed facility providing emergency services, surgical services, rehabilitation and geriatric evaluation and management services, renal dialysis services and community rehabilitation and transition care services.
Hazeldean Transition Centre	Provides a goal-oriented, time limited and therapy focused care to assist older people at the conclusion of their hospital stay.
Sunbury Day Hospital	Provides day medical, day surgical, day chemotherapy, haemodialysis treatment and a number of specialist clinic.
Drug Health and Addiction Medicine Services	A community based program of Western Health offering innovative recovery programs. Addiction Medicine provides inpatient treatment for complex drug and alcohol patients and toxicology services.
Western Centre for Health Research and Education (WCHRE)	Located as Sunshine Hospital, the WCHRE provides a range of purpose built, state-of-the-art teaching and research facilities. The WCHRE is the result of the partnership with the University of Melbourne and Victoria University.

 

Despite operational funding pressures and facility constraints, we continue to grow in many areas in order to meet the increasing needs of our community. In particular over the last five years, since 2010/11, we have seen approximately 7% growth in emergency department presentations, a 30% increase in outpatient appointments as well as a greater level of acuity and complexity of patients within the acute care setting.

To effectively deliver these services we employ over 6,200 staff plus over 600 volunteers and have a strong philosophy of working with our local community in a range of partnerships to deliver excellence in patient care.

Those who work at Western Health have an energy and agility to consistently respond to transforming our health service. Our staff and volunteers have a strong connection to our local communities, which brings a sense of identity and pride that is unique to Western Health.

 

OUR PARTNERS

We have long term partnerships with many providers across the region, including local government, primary and community care providers. This has culminated in the development and ongoing implementation of the Better Health Plan for the West. We are also partners in Strengthening Hospitals in Melbourne’s West – a coalition with our neighbouring health services Djerriwarrh Health and Mercy Health, which aims to build a cohesive view of how health services in the region can best meet the needs of our community now and into the future.

Western Health also has long term partnerships with:

• Peter MacCallum Cancer Centre, in the Sunshine Hospital Radiation Therapy Centre
• North Western Mental Health and Mercy Health in the delivery of mental health services across western Melbourne
• University of Melbourne, Victoria University and Deakin University, in addition to a number of other university providers in the delivery of research and education.

WHAT WE HAVE ACHIEVED TO DATE

We are committed to consistently delivering better outcomes for our community. Our new strategic plan sets ambitious goals for our future, building on our hard work over the last five years. Our previous strategic plan focused on building a strong foundation for quality health service delivery at Western Health.

Our previous strategic goals were safe and effective care; people and culture; community and partnerships; research and learning; and self-sufficiency and sustainability. Over the last five years we have:

• Adopted the National Standards for safe, quality care supported by Western Health’s leading Best Care Framework
• Seen significant advances in eHealth in the use of the digital medical record and the use of electronic devices
• Supported more than 20% of our staff in acquiring a nationally recognised qualification via our Registered Training Organisation
• Implemented the “Clinicians at the Helm” leadership and alumni program for more than 150 senior leaders and clinicians
• Increased research funding and activity, with a substantial increase in the international recognition of research studies involving Western Health
• Opened the Western Centre for Health Research and Education and established the Western Health Simulation Centre
• Implemented the Western Health occupational health and safety strategy, achieving an above average Work Cover performance rating
• Attracted high calibre candidates to key staff vacancies through a successful workforce strategy and focus on reputational issues
• Supported the implementation of the Better Health Plan for the West, with 22 partner organisations and collaborated to provide partnership models of service delivery
• Improved capacity to provide acute specialist services following the construction of the $90m Acute Services Building at Sunshine and introduced intensive care and cardiac services at Sunshine Hospital
• Managed patient activity at 3-6% above funding levels, while consistently delivering a budget surplus.

FACTORS AFFECTING THE FUTURE SUCCESS OF WESTERN HEALTH

At present we face a number of key strategic risks and opportunities that should be addressed for the future success of Western Health. Our plan for responding is set out below.

 

Key challenges and opportunities	How we have addressed these within the plan
The impact of population growth and the burden of disease on the capacity of our services to effectively meet community health needs	Within Aim 1, we articulate the need for a review of our existing service profile and pursue expansion or alternative service delivery opportunities that better meet the needs of our community. Aim 2 focusses on the importance, particularly for those with chronic and complex conditions that require ongoing support from a variety of health and wellbeing providers to have a connected care experience.
The growing external focus on clinical practice requirements for providing quality safe care	A core element of Aim 1 is for Western Health to provide a consistent care experience, underpinned by our leading Best Care framework.
The growing complexity of the health system and the need to often partner with multiple providers to successfully deliver high quality health care across the care continuum	Aim 2 identifies Western Health’s commitment to partner with a variety of health and wellbeing providers to better support the people most in need, enabling access to a continuous level of services in an efficient way.
The growing use of technology to effectively transfer information in a comprehensive and timely way	Aim 3 identifies two key communication platforms to support patients in their ongoing care by boosting internal communication through the implementation of the Electronic Medical Record and enhancing the continuity of information flow to other health service providers.
The increasing appetite for those consumers with appropriate levels of health literacy and capacity, to have a coordinated experience so that they can actively and safely participate in their own care, but ensuring that the socially disadvantaged patients are not left behind.	Aim 3 places emphasis on person-centred care, firstly through improving the way we listen and respond to patients and their support network and secondly by empowering patients through knowledge so that they can be a genuine partner in their care planning and ongoing management.
The growing importance of establishing economically sustainable, collaborative community partnerships to bridge the gap in addressing health service needs	Community partnerships are a fundamental cornerstone within our plan. Aim 4 identifies key strategies that ground the health service in a variety of service delivery and research partnerships within the region.
Despite the substantial investment in the expansion of Sunshine Hospital, including the development of the Western Women’s and Children’s Hospital by 2018, the age and fit for purpose design of our existing infrastructure at Footscray Hospital brings operational risk, particularly given the growth within inner western Melbourne.	Aim 4 identifies the need to develop fit for purpose infrastructure that supports the needs of our community.
The increasing competition for limited capital and operational funding in the public sector	Aim 4 identifies the need for Western Health to seek and leverage alternative capital and operational funding models, driving service efficiency as well as evaluating service decisions based on financial sustainability.
Anticipated future state-wide workforce shortages coupled with the need to attract, retain and support staff to meet specialist and general clinical workforce gaps	By valuing and empowering our people (Aim 5), we are continuing to place an emphasis on the ongoing building and attraction of talent in the face of workforce shortages.

Transforming Health in the West

Western Health aspires to transform the health and wellbeing outcomes of our community – a dynamic community with great cultural diversity, significant growth, entrenched disadvantage and high health needs. This presents a unique opportunity to be transformative in the way Western Health provides care over the next five years. We must harness the vitality and diversity of our community, by being innovative in the delivery of care and by working in partnership with our patients and their support networks.

We cannot do this without our staff and volunteers, who have a strong sense of commitment to improving the health and wellbeing in our community and understand the need for change. As the major health service in Melbourne’s West, we acknowledge that we cannot achieve our goals alone, and we need to continue to build strong partnerships with others in the community.

Being accountable and measuring our success

In developing the strategic plan we have set some clear parameters to hold ourselves accountable.

To achieve excellence, we are committed to continually comparing our performance and learning from others. With this in mind, many of our measures within the strategic plan look to benchmark against our peers on a local, national and even international basis.

Further, in developing the strategic plan we have drawn on several health services across jurisdictions to determine appropriate strategies and measures to respond in the best possible way to the key challenges and opportunities we face.

Appendices

Appendix 1. SUMMARY OF THE STRATEGIC PLANNING PROCESS

DEVELOPMENT PROCESS

Western Health undertook a highly consultative process in the development of the organisational wide strategic plan. The following activities were undertaken across the four stage process between December 2014 and July 2015:

	Stage 1: Looking forward Developed underst-anding of the key strengths, weaknesses, opportunities and threats facing Western Health based on a review of the current and potential future environmental factors likely to influence Western Health’s operations over the next three to five years. Activities included an assessment of previous organisational strategies and reviews as well as consultation with staff.
	Stage 2: Firming up ideas Key organisational-wide strategic themes were identified based on the outcomes from Stage 1 and an all-day working session with Western Health senior leaders, which were subsequently tested and iterated with community partners. At this stage, a working session with the Board and the Department of Health and Human Services was held to test and iterate these themes.
	Stage 3: Refining ideas An extensive staff and consumer engagement process was undertaken to identify potential activities that could be undertaken by Western Health to effectively address the strategic themes raised in Stage 2. The ideas from these consultations were then synthesised, with clear strategic aims resulting and objectives and initiatives developed.
	Stage 4: Pulling it Together A draft strategic plan was developed and tested with Western Health senior leaders, Executive and the Board. Externally, the strategic plan was tested with the Department and a selection of community partners. Based on feedback, the strategic plan was incorporated with the final obtaining Board and Ministerial approval.

 

ENGAGEMENT PROCESS

As highlighted previously, extensive stakeholder engagement was undertaken, using a variety of mediums including:

• A short film detailing the strategic planning process
• Intranet and internet webpages
• Online survey for consumers and community providers
• Face-to-face interviews
• Focus groups
• Staff forums

Overall Western Health engaged with over 1,000 people in the development of the strategic plan.

Throughout the four stage process, input from well over 700 staff and volunteers was gathered, through a combination of focus groups and one-on-one interviews, at Footscray Hospital, Sunshine Hospital, Williamstown Hospital, Hazeldean Transition Care Unit and Sunbury Day Hospital. Staff were provided the opportunity to comment on the strategic focus areas as well as identify potential opportunities for Western Health to pursue.

During Stage 2 Western Health commenced its engagement with consumer partners with more than 80 providers engaged through one-on-one interviews or focus groups, including neighbouring health services, private health providers, primary and community care providers (including GPs, aged care facilities and large primary care providers), local government and universities. The engagement process enabled community providers to identify what was important to each partner and potential opportunities for the future, influencing the development of objectives and initiatives for the strategic plan.

During Stage 3, around 180 consumers were consulted, mostly on a one-on-one and group basis. The consultations included both direct patients (attending either ED, outpatient clinics or as an inpatient on a ward) and previous consumers (engaged primarily via focus groups). Further, consumers had the opportunity to provide feedback through an online survey that was available via the strategic planning website. Outcomes were captured via the online survey, which enabled analysis of key demographic and thematic information. Those consulted were from all over the Western Health catchment, including suburbs like Altona, Bacchus Marsh, St Albans, Sunshine, Tarneit and Footscray. Many of those engaged were between 25-54 years

OUTCOMES FROM ENGAGEMENT

Key outputs from consultations were fed directly into the development of the plan.

 

What we heard	How we have responded
Patients want to feel safe and properly cared for, and to be treated consistently no matter where they come from or where they are going	Within Strategic Aim 1, Objectives 2-3 identifies the need to deliver consistent care and where possible are evidence-based
Patients, carers and community providers would like Western Health to do a better job at ‘connecting the dots’ within and outside hospital walls	Strategic Aim 2, Objectives 2-4 focus on connecting the patient journey, particularly for those who use our services the most
Patients would like to be heard, to have their needs respected and to be kept informed about what’s happening at each stage of their journey	Within Strategic Aim 3, Objective 1 is focused on improving the way Western Health listen and responds to patients throughout their journey
Our community partners and staff need timely and accurate access to information about patients whose care includes Western Health services	Within Strategic Aim 3, Objective 2-3 clearly establishes the prioritization for tools and technology to improve information flow.
Our partners want to work with us to deliver services that match the diverse needs of a rapidly growing community	Within Strategic Aim 1, Objective 1 and Aim 4 Objectives 1-4, there is a clear focus on improving partnerships and growing the health system across Western Melbourne to meet the needs of the catchment
Our staff and community would like to see us reduce the wait for services and improve efficiency without sacrificing quality of care	Within Strategic Aim 2, Objective 1 focusses on improving the timeliness and responsiveness of the health service
Our staff want clear role expectations, consistent accountability standards and to be supported to do what is expected of them	Strategic Aim 4 focusses on valuing and empowering the workforce

Appendix 2. REFERENCES

1. Department of Transport, Planning and Local Infrastructure (2014); Victoria in Future 2014;
   available at: www.dtpli.vic.gov.au/victoria-in-future-2014 and Melbourne’s population – a story of growth, April 2012; available at: http://blog.id.com.au/2012/population/australian-population/melbournes-population-
   a-story-of-growth/9 

2. LeadWest, Birthplace of population in Melbourne’s West, 2011; available at: http://www.communityprofile.com.au/melbourneswest/population/birthplace

3. Australian Bureau of Statistics (2010) Cited in Better Health Plan for the West (page 18); available at: http://www.westernhealth.org.au/AboutUs/BHPW/Pages/default.aspx

4. Department of Immigration and Citizenship (2011) Cited in Better Health Plan for the West (page 19); available at: http://www.westernhealth.org.au/AboutUs/BHPW/Pages/default.aspx

5. Department of Transport, Planning and Local Infrastructure (2014); Victoria in Future 2014;
   available at: www.dtpli.vic.gov.au/victoria-in-future-2014

6. Better Health Plan for the West (page 14); available at: http://www.westernhealth.org.au/AboutUs/BHPW/Pages/default.aspx

7. Department of Health and Human Services, 2015-16 Statement of Priorities