Annual Report 2020-21 Riverland Mallee Coorong Local Health Network


Hon Stephen Wade MLC

Minister for Health and Wellbeing

This annual report will be presented to Parliament to meet the statutory reporting requirements of the Public Sector Act 2009, the Public Finance and Audit Act 1987 and the Health Care Act 2008, and the requirements of Premier and Cabinet Circular PC013 Annual Reporting.

This report is verified to be accurate for the purposes of annual reporting to the Parliament of South Australia.

Submitted on behalf of the Riverland Mallee Coorong Local Health Network Inc by:

Wayne Champion
Chief Executive Officer
Riverland Mallee Coorong Local Health Network Inc
Signed: 30/09/2021

From the Governing Board Chair

It is with great pleasure that I report on the second year of operation of the Riverland Mallee Coorong Local Health Network Inc (RMCLHN) that was established on 1 July 2019 following the devolution of the former Country Health SA Local Health Network Inc, and the formation of six regional Local Health Networks (LHN).

The 2020-21 financial year has been an extremely challenging one for everyone, including RMCLHN, but there have also been may achievements and highlights.

I have been privileged to continue to Chair the Governing Board that, under the Health Care (Governance) Amendment Act 2018, is required to be skills based with experience and expertise in fields including health management, clinical governance, commercial management, finance, legal, provision of health services, and knowledge or experience in relation to Aboriginal health. We are fortunate to have maintained stable Board membership with six highly skilled, experienced and knowledgeable Board members and I thank all Board members for their diligence and commitment to our LHN.

The Governing Board maintained the Board committees for Finance, Clinical Governance and Audit and Risk, and these committees have continued to evolve as the organisation has matured. Terms of Reference of the committees have been reviewed and updated, and self-evaluations undertaken of the Governing Board and committees in order to continuously improve Board governance.

The Governing Board continued to work with Chief Executive Officer (CEO), Wayne Champion and the Executive Team of RMCLHN. There have been some changes to the team during 2020-21 and the current diverse and experienced team are an asset to the organisation.

The biggest challenge for the Governing Board, our health system and our communities has of course been the ongoing impacts related to the COVID-19 pandemic. The RMCLHN Incident Management Team continued throughout 2020-21 to lead the Network through this extremely difficult time. The ongoing requirements, including those associated with the provision of testing facilities and vaccination clinics, in addition to maintaining all of our services has placed an enormous strain on our workforce. The Board acknowledges the significant stressors for staff during 2020-21 and is appreciative of the efforts of all staff who have continued to achieve positive outcomes for our communities.

Aged care continued to be a major focus for the Governing Board during 2020-21, with members diligently monitoring any identified deficiencies in residential aged care and supporting changes to ensure achievement of the required standards.

The Governing Board followed the progress of the Royal Commission into Aged Care Quality and Safety during 2020-21. The Royal Commission released a special report on COVID-19 and aged care 1 October 2020 and the final report was released 26 February 2021 with the Australian Government providing a comprehensive response to the 148 recommendations on 11 May 2021. The Governing Board has considered these in the context of RMCLHN and will continue to  monitor the implementation of the recommendations.

Under the Health Care (Governance) Amendment Act 2018, the Governing Board is required to develop and publish both a Consumer and Community Engagement Strategy and a Clinician Engagement Strategy. The Governing Board was pleased to formally launch both its Consumer and Community Engagement Strategy and Clinician and Workforce Engagement Strategy on 30 July 2020.

Despite the restrictions imposed by COVID-19, work continued on the development of the Governing Board’s inaugural Strategic Plan with a comprehensive workshop held on 28 August 2020 involving a broad range of staff, partner organisations and Health Advisory Council (HAC) Presiding Members who provided valuable input to shape the plan. HACs provided further feedback through the regional HAC conference held on 25 September 2020, and Aboriginal communities voiced their issues at the annual Aboriginal community forums held in October 2020.

The high utilisation of our social media platforms enabled further broad public consultation that resulted in the Governing Board endorsing its five-year Strategic Plan (2021-2026) in January 2021. The Governing Board was delighted to then formally launch the Plan on 25 March 2021 at a combined meeting of the Governing Board and HACs that took place in person and via videoconference. It has been pleasing to see the operationalisation of the Plan through the RMCLHN Operational Plan and the Governing Board will receive regular reports on implementation progress in 2021-22.

To celebrate the achievements of our staff, contractor, partners, volunteers and HACs, the Governing Board was again delighted to be part of the RMCLHN Awards. COVID-19 restrictions in 2019-20 meant that the celebratory event for the 2020 finalists and winners was deferred to 27 August 2020. The 2021 Award process culminated in an event held on 24 June 2021 where the winners of the ten categories were announced.

The year saw the completion of significant redevelopments within the region. On 21 October 2020, the Minister for Health and Wellbeing, the Honourable Stephen Wade MLC, officially opened the Murray Bridge Soldiers’ Memorial Hospital Emergency Department (ED), a state-of-the-art facility that will assist people in our region having access to safe, high quality health services as close to home as possible. Also, a Medical Resonance Imaging (MRI) machine is now housed in a new purpose-built Unit at Riverland General Hospital (RGH) in Berri, with this service opening to patients on 1 December 2020.

The provision of emergency services for our communities has been a significant issue for the Governing Board during the year. RMCLHN took over responsibility for medical service delivery at the RGH ED on 1 December 2020, following a 10-year period of private management by RiverDocs ED. The transition has allowed the Network to simplify governance of the ED and to improve coordination of the service.

Additionally, a new model for weekend and public holiday emergency care has been implemented at the Murray Bridge Soldiers’ Memorial Hospital ED in conjunction with Bridge Clinic.

Maintaining a skilled workforce is always a challenge for rural communities and this has been exacerbated by the COVID-19 pandemic. The RMCLHN Governing Board is committed to the vision of ‘growing our own workforce’ and a vehicle for this will be the Riverland Academy of Clinical Excellence (RACE) that commenced operation during 2020-21. The initial focus will be medical education in line with the National Rural Generalist Pathway and we look forward to significant achievement in future years.

The 2020-21 year has been a challenging year for the RMCLHN Governing Board as we continued to evolve as a new organisation while grappling with the impact of COVID-19. We look forward to continuing to work with the CEO, Executive Team, staff and clinicians, along with our consumers and communities, as we continue to develop safe, high quality services that meet the needs of those living and working in our region..

Dr Peter Joyner
Chair Governing Board
Riverland Mallee Coorong Local Health Network Inc

From the Chief Executive Officer

It is a great pleasure to present the second Annual Report for RMCLHN following the devolution of the former Country Health SA Local Health Network Inc and the formation of six regional LHNs.

The 2020-21 financial year has been another exciting year as we continue to grow and evolve as an organisation. However, it has also been very challenging due to the impact of the COVID-19 pandemic that has strained health systems throughout the world.

I am immensely proud of all our staff who have continued to provide the best possible care and support to our patients, consumers and communities during this very trying time. RMCLHN established a number of COVID-19 testing clinics in conjunction with SA Pathology across the region to assist with the identification and treatment of any outbreak within our communities. RMCLHN led Australia as the first health service to provide the AstraZeneca vaccine, and we were also one of the first health services in Australia to make the Pfizer vaccine available to all people aged 16 to 50.

I thank all our staff, medical officers and the community for their continued support, cooperation and commitment as we strive to reach community vaccination levels that will decrease the requirement for restrictions associated with community outbreaks.

The continued growth of our social media platforms through our Facebook and Instagram pages, YouTube channel and LinkedIn account have played a significant role in helping to keep our communities informed in relation to COVID-19 but also in relation to other activities and issues. Our social media platforms have proven to be an excellent medium for promoting our organisation in the community and they have also enabled engagement with the community, both generally and on specific topics.

The Governing Board formally launched both a Consumer and Community Engagement Strategy and a Clinician and Workforce Engagement Strategy in June 2020 following their endorsement by the Governing Board in accordance with the legislative requirement.

Despite the restrictions imposed by COVID-19, I am pleased to report that the Network was able to engage with staff, consumers and the community in the development of the inaugural RMCLHN Strategic Plan (2021-2026) that was formally launched on 25 March 2021. The Executive Team has worked with the Governing Board to develop an Operational Plan to support us to achieve the goals outlined under the four strategic themes in the Strategic Plan: Caring for our communities; Excellence in clinical care; Local accountability, and; Investing in our people. This is a practical framework of strategies and activities that defines what needs to be done, how and by whom, to meet the vision and goals of the Strategic Plan. The activities are charted across a three-year time horizon, with a detailed plan of work for year one, an outline of our priorities for year two and a glimpse of year three.

The Governing Board will monitor progress towards achieving its strategic objectives through regular reporting of the Operational Plan, noting that it is iterative and will be regularly updated to meet the changing needs of our communities. A number of sub-plans will sit under the Strategic Plan.

The timing of the Strategic Plan launch enabled us to showcase the new branding for RMCLHN. The branding project was undertaken in conjunction with other regional LHNs, with each Network having its own unique colour palette and icons. Our icons, - the Pelican, Murray Cod and Mallee Tree - aptly depict our region.

It has been wonderful to see the completion of the $12.5 million Murray Bridge Soldiers’ Memorial Hospital Emergency Department (ED) and Central Sterile Supplies Department redevelopment that was officially opened on 21 October 2020. I am proud of the design of the ED, that aims to provide a meaningful community meeting place, with elements that acknowledge the 18 nations of the Ngarrindjeri traditional custodians, whilst preserving the integrity of the hospital memorial monument. The redevelopment not only provides a state-of-the-art emergency facility for the community but one that is welcoming and respectful of the Aboriginal community and features symbolic and colourful public art. Sam Gollan’s large-scale Aboriginal artwork, displayed across the façade pillars of the ED, was unveiled in March 2021. The colourful artwork depicts the Aboriginal community and health system working together in collaboration.

This year also saw the completion of the $2 million MRI Unit that now accommodates the $1.5 million MRI machine within the Riverland General Hospital (RGH) at Berri. Since opening in December 2020, we have provided an MRI service to more than 1000 consumers. Additionally, with the support of the Waikerie and Districts Health Advisory Council, redevelopment works were completed at the Waikerie Health Service this financial year. The $2.14 million project included work on the carpark, aged care rooms and the hospital entrance.

Our Health Advisory Councils (HACs) continue to play an important role in the Network and they have provided valuable input during the year along with their ongoing advocacy role for their communities. Despite the limitations imposed by COVID-19, they have continued to raise funds for the benefit of our health services. We also held our first ever annual RMCLHN HAC conference on 25 September 2020 with the Minister for Health and Wellbeing linking in via videoconference.

The LHN underwent various accreditation processes during the year. Our accreditation granted by the Australian Council on Healthcare Standards (ACHS) for the National Safety and Quality Health Service Standards (NSQHSS) was extended by one year due to COVID-19 and the next accreditation date is February 2024. We achieved successful National Disability Insurance Scheme (NDIS) Practice Standards Accreditation in 2020-21 and successful full facility accreditation with South Australian Medical Education and Training (SAMET) for intern and Postgraduate Year Two (PGY2) medical trainees.

The quality and safety of our aged care services remains an area of focus, and we are constantly seeking to improve in this area. The Aged Care Quality and Safety Commission (ACQSC) have continued their scrutiny of our facilities with the Barmera facility being re-assessed during the year with ‘Improvements Needed’, and a Plan for Continuous Improvement developed. All other residential aged care facilities currently meet requirements. The recommendations from the Royal Commission into Aged Care Quality and Safety were released in February 2021 with the Government’s response released in May 2021. Implementation of the agreed recommendations within the specified timeframes will be a focus for the Network over the coming years.

I reported last year on the inaugural RMCLHN Awards with COVID-19 restrictions limiting the celebrations. We were delighted to hold a deferred celebratory event on 27 August 2020 where the finalists and winners were showcased. For 2021, the COVID-19 situation at the time enabled us to hold an RMCLHN Awards celebration on 24 June 2021.

The award categories for 2021 were: Person Centred; Values Superstar – RMC CARES (Respectful, Motivated, Compassionate, Consumer Focussed, Accountable, Resourceful, Excellence and Service); Inspired Innovation; Excellence in Aboriginal Health; Excellence in Clinical Care; Excellence in Non-Clinical Services; Young Achiever; Area of Focus 2021 – COVID-19; Outstanding Contribution to RMCLHN by general practitioners, contractors and partners, and; Outstanding Contribution to RMCLHN by Health Advisory Council members and volunteers. The Awards provided a great opportunity to highlight some of the many achievements of our staff, volunteers and partners in the delivery of health services across the region, during what has been a very difficult year. The finalists and winners have also been highlighted through RMCLHN’s social media channels.

The inaugural RMCLHN NAIDOC Week Awards were also implemented in November 2020 during NAIDOC Week, which celebrates the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. The winners of the inaugural awards were announced in December 2020.

Aboriginal health and collaboration with the Aboriginal community is another area of focus for the Network. The Governing Board, with members of Executive, listened to the voices of our Aboriginal communities during the annual Aboriginal Community Forums held across the region. Increasing employment opportunities for Aboriginal people has been a specific focus during the year and we have been able to establish new Aboriginal Liaison Officer positions in the Riverland, and also establish four Aboriginal Administration Trainee positions. We have also developed our draft inaugural Reconciliation Action Plan which will be formally launched in the 2021-22 financial year.

Another significant area of focus and development during 2020-21 has been the provision of medical services in RMCLHN. Work continued to transition the inpatient medical model at RGH in Berri, including recruiting and attracting salaried rural generalists and general physicians to the region to now be able to provide 24-hour inpatient medical cover for the hospital wards.

A salaried emergency medical model was implemented at RGH, in place of the former RiverDocs ED model. RMCLHN successfully recruited rural generalists and specialist emergency physicians to the model, including the Clinical Director roles.

An anaesthetic medical model at RGH was also implemented in 2020-21 with the recruitment of two salaried anaesthetists to support the GP-led rural generalist anaesthetic services. The changes have necessitated the development of coordination functions and administrative support for the expanding Medical Services team.

The ED medical model at Murray Bridge also underwent significant change coinciding with the redevelopment of the ED. A new model for weekend and public holiday emergency care has been implemented in conjunction with Bridge Clinic. The LHN has implemented these changes and successfully attracted a number of doctors into our clinical workforce despite the uncertainty posed by the COVID-19 pandemic.

I would like to acknowledge the Executive Team with some new additions during 2020-21. We successfully recruited to vacancies in the positions of Executive Director Medical Services, Executive Director Community and Allied Health and Director People and Culture. In addition, we created a new position for an Executive Director of Clinical Innovation with significant achievements in this area during the year. In creating this position, RMCLHN has become the first regional LHN to have someone dedicated to the roles of Director of Medical Education, Chief Medical Information Officer and Director of Clinical Research.

A major innovation that commenced during 2020-21 was the creation of the Riverland Academy of Clinical Excellence (RACE) which aims, over time, to train our own clinical workforce and also bring benefits through integrated teaching, research and clinical care. Whilst longer term the education arm will address all areas of RMCLHN’s clinical workforce, the initial focus is on building the medical workforce in line with the South Australian Rural Health Workforce Strategy, SA Rural Medical Workforce Plan and the National Rural Generalist Pathway. Accreditation has been granted for intern and trainee medical officer training posts which will assist the Network to work towards an evolving pathway to Rural Generalist qualifications.

After a very challenging 12 months, RMCLHN finished the financial year in a less than favourable financial position. This is primarily as a result of the costs associated with changing models for the provision of emergency medical services, continuing the commitment of additional resources for aged care, and the costs involved in responding to COVID-19. Staff are to be commended for the efforts to achieve savings in other areas.

Looking ahead, 2021-22 will no doubt also be another interesting and challenging year. The situation in relation to COVID-19 will continue to evolve as outbreaks occur in various communities while the population works towards achieving targeted vaccination levels.

Sustaining our medical workforce models will also continue to be a challenge but we are excited by what 2021-22 will bring through the further development of RACE. The significant focus on aged care will also continue as the implementation of recommendations from the Royal Commission come into effect.

I wish to thank the RMCLHN Governing Board for their enthusiasm, and the knowledge and skills they bring to our organisation. I also want to thank the Executive Team for their expertise and support throughout the year. Most importantly, I acknowledge and thank all staff, volunteers, contractors and partner organisations for their commitment to ensuring RMCLHN continues to provide safe, high quality services for our communities.

Wayne Champion
Chief Executive Officer
Riverland Mallee Coorong Local Health Network Inc