From July to September, the Deniliquin community was involved in the consultation process around the Clinical Services Plan (CSP) for Deniliquin Health Services.
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More than 300 surveys were returned, and multiple community and stakeholder sessions took place.
The Deniliquin Local Health Advisory Committee and Edward River Council were involved extensively in reference and planning groups.
We would like to encourage feedback on this plan.
The CSP draft document and a snapshot of this is now available https://www.mlhd.health.nsw.gov.au/get-involved/your-opinion. It is open for feedback until November 18.
We must reiterate that the focus and purpose of this plan is about services, rather than infrastructure.
Having said that, the Clinical Services Plan forms a critical part of the first stage of potential infrastructure upgrades/ redevelopment, and a starting point for making a case for this if indicated.
Thus the CSP dictates what clinical services the community needs 10 years into the future using current health data projections of future needs, such as population growth and changing age profile.
Other factors that come into play in future services recommended in the CSP includes workforce, models of care, infrastructure, technology and importantly, role delineation (seen in many tables used in CSP).
Role delineation is a NSW Health framework that describes the minimum support services, workforce, and other requirements for clinical services to be delivered safely.
It ensures service delivery and care do not lead to adverse health outcomes and are delivered safely and sustainably with good clinical outcomes.
The CSP is a hefty 81-page document with a massive amount of information to process.
For this reason, we thought we would try and outline some of the key points for the community.
There is an executive summary on pages 3-6 of the plan, which is well worth looking at to get a snapshot of what is expanded on in the rest of the plan.
In its entity, there are essentially four things the CSP captures:
1.What have we currently got?
Current services that exist across all of Deniliquin Health Service. A summary is found on page 9 and 10, and expanded on extensively from pages 30-55. This is an important piece of work as it is the starting point. We need to fully understand our scope of services - what have we got, how much is being done in this space (data) and how is it delivered?
2.What did the community say?
As we have said before, most of what has been documented in the plan is consistent with what we have been hearing in the community. Consultation outcomes are documented in the snapshot and in the plan from pages 17-25.
Some of the key themes from survey and consultations included the following:
- Lack of access to primary care; thus GP’s, specialists, dental care, and allied health is noted;
- Transport Systems and Services; and lack thereof;
- Virtual/ Telehealth – the importance of support / facilitation to be able to access more of this;
- Improved Care planning and co-ordination including discharge - involving all service providers, particularly aged care;
- Workforce issues, recognised by community, and the importance of workforce strategy to match any future enhancement of services;
- Services - the community wants access to increased specialist services as well a more allied health – referring to both public and private sector; and a better understanding of services delivered; and
- Infrastructure – improvement to maintain current services and attract new workforce, noting upgrades to the operating theatre, inpatient unit, and community health.
3.What does the CSP say about what can be delivered safely and sustainably in response to what the community says they want?
We suggest that the snapshot provided on the website captures some of this, and we suggest pages 58-62 of CSP be read in conjunction with this.
There are essentially two parts to this:
- Core services the community says it wants which are already being delivered on, and can be expanded on and/or be introduced and enhanced. For example more outpatient clinics and enhanced GP type service models
- Opportunities for future service delivery. E.g. Hospital in the home services, strengthened safe surgical procedures and more diagnostic support ( increased ultrasound and MRI feasibility study).
4.What does the plan say about infrastructure?
Having said that the focus is on service delivery, the plan does point out infrastructure upgrades/redevelopments that would reasonably be needed to enable the delivery of clinical services into the future. These are well summarised on pages 68 and 69 of the CSP.
It includes:
- Upgraded inpatient facilities (Middleton Gorman Wing) to support new models of care and flexible spaces, to include a safe paediatric room in the ward for admission of children up to 48 hours where clinically safe.
- Operating theatre - an additional anaesthetic enabled procedure room to be considered.
- Radiology/ultrasound - noting the need for additional ultrasound, as well as a feasibility study for an MRI.
- Ambulatory/community health – notes aged infrastructure and it’s proximity to other ambulatory care. Suggests increase of seven more consultation/interview rooms into the future.
- Mental health - need for increase in consultation space and to consolidate infrastructure in one space in CBD to meet demands of growing service.
- Accommodation - notes proposed staff accommodation and the exploration of carer accommodation, as well as office space to accommodate expanding workforce.
What happens next?
Once feedback is received, relevant changes are incorporated.
Once it has gone through a series of final consultations, it is presented to the Ministry.
MLHD starts the process of several associated plans to lead to implementation of this plan.
As we have said before, this is but a starting point for more services and improved infrastructure.
Ongoing collaboration and advocacy will need to be sustained to see all of this come to fruition.
For those interested in the process of where the CSP sits within infrastructure developments, there is a very handy document about “how to build a hospital”. I encourage you to look at page eight in particular. Get it at https://www.hinfra.health.nsw.gov.au/WWW_Hinfra/media/SiteImages/PDF/180312_HTBAH-Booklet_LR.pdf.
~ Lourene Liebenberg (pictured) is chair of the Deniliquin Local Health Advisory Committee.