WACHS Annual Report 2018-19: Significant Issues

The WA Country Health Service’s primary responsibility is to provide hospital and related services to the population it serves. The population in regional WA is diverse and expansive and as a result has widely varying health needs.

While our core focus is always on improving the quality of the care we deliver to country communities in the here and now, we must also plan for the future and respond to the challenges and barriers facing us as an organisation, but also those facing the communities we serve.

In setting our new strategic plan the organisation has undergone a comprehensive process of consultation, reflection and debate among country people and our staff from all over the State. This included a deep consideration of the environment we operate within now, and in the future. In doing this we reflected on just how much has changed in the past 15 years, and in particular, how the delivery of health care has changed in that time. 

We have also imagined a future where in the next five to fifteen years…

  • Every person can access and control their own health information, via their mobile device.
  • All country people receive the right vaccinations, live in environments that support good health, and are protected from common and preventable diseases.
  • The health and social care system is seamlessly integrated, and consumers can easily access, navigate and make choices about the care that is right for them.
  • Medical aid is delivered by drone to residents in the most remote parts of WA; without the need for them to travel.
  • Older people or people living with chronic disease can maintain independent lives in their own homes, whether that be in a regional centre or a remote community; with less need for intensive carers, and with clinicians monitoring their health and wellbeing in real-time via wearable devices and other real-time monitoring equipment.
  • Genomics enables specialist doctors in Perth to predict the potential future health issues of an unborn child in a country community and works with local doctors to deliver precision medicine to minimise those risks before the baby is born.
  • Artificial intelligence can be used to help rapidly diagnose a country patient with the most complex or rare condition, that would otherwise take months or years of tests and many visits to hospitals in Perth.
  • Remote communities, Aboriginal and Culturally and Linguistically Diverse (CALD) people have access to a range of healthcare options that meet their cultural needs.
  • Country patients have access to virtual healthcare from their home or local general practice, with greater local access to specialised and urgent care and a reduced need to travel.

"Digital disruption, and digital opportunities, have arrived in health and are accelerating and we believe that regional and remote health services will benefit the most. Our new strategic plan lays the foundation for these opportunities to become a reality in the next five to 15 years."

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Addressing disadvantage and inequity

The WA Country Health Service is the major provider of hospital, health, mental health and aged care services across country WA. We are funded to provide emergency care in hospitals and nursing posts, as well as hospital-based acute services such as general medical, general surgery, mental health, obstetrics, renal dialysis and cancer services. We are also responsible for the provision of maternal and child health, public health, health promotion, chronic conditions services, mental health, drug and alcohol services and sub and post-acute services such as palliative care and rehabilitation.

In country WA, population growth and ageing in many communities is impacting on access to appropriate aged care beds and services. The total number of people aged 70 years and above has increased 23 per cent in the past five years, to almost 50,000. This age group is projected to grow 21 per cent in the next four years. The impact of an ageing population on the demand for health and older adult mental health services is well established. An ageing population changes both the mix and volume of medical procedures and services required.

Primary and aged care services are the primary responsibility of the Australian Government, however the current fee-for-service and consumer-driven funding arrangements mean that the State is often required to fill the gaps. In country WA where service viability often leads to market failure in many communities as a result of higher costs and lower volumes, the WA Country Health Service is required to fill these primary care and aged care service gaps. This ultimately has resulted in fewer GPs, fewer pharmacies and fewer aged care providers per capita in the bush.

The vast spread of the population and the corresponding small population numbers mean that it is challenging to sustain integrated health services across the state. Significant factors driving service demand include changes in population and population demographics, increased availability in the scope of local services and a higher than average burden of disease in Aboriginal and rural populations.

Systemic demographic factors also continue to be a driver, with the ageing regional population affecting residential and community aged care places. Comprehensive health services are required by, and provided to, people living in regional WA. However, limitations to service capability and capacity leads to some consumers not being able to stay in their home towns, especially as their care needs increase or become more specialised. Where this occurs, consumers need to navigate across the healthcare system, often requiring transport, acute, inpatient and outpatient services from metropolitan health services or the non-government sector.

The health issues that cause the most harm to country communities are well known. The WA Country Health Service is working to invest in services that reduce their impact. Our efforts aim to address the social and environmental determinants of these issues with our health and community service partners. Over the past twelve months we have prepared strategies to address the highest priority issues such as Cancer, Kidney Health, Maternity and Newborn, Aboriginal Health and Mental Health and Wellbeing strategies. These strategies, along with the goals and actions outlined in our new strategic plan will help us to address these disparities.

"The total number of people aged 70 years and above has increased 23 per cent in the past five years."

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Life expectancy for Western Australia’s country people is around two years lower than for WA’s metropolitan people, but in remote and very remote communities across Australia the mortality rate is 30% higher than in our cities. Life expectancy is also much lower for Western Australia’s Aboriginal peoples and people suffering from chronic and persistent mental health conditions.

The burden of disease is higher in people living in socio-economically disadvantaged areas. In Australia, geographic areas are classed into five levels of disadvantage with level one being the most disadvantaged and level five being the least disadvantaged. Six per cent of WA Country Health Service residents live in the least disadvantaged localities (those classed as level five), whereas 57 per cent of metropolitan residents live in this type of locality. 

Approximately 39 per cent (203,210) of country residents live in the highest areas of disadvantage (those areas classified as levels one and two). In contrast, very few metropolitan residents live in localities classed as level one and only seven per cent (136,429) live in localities classed as level two.

Addressing this disparity has required the WA Country Health Service to develop new and innovative models to deliver care to country communities. The expansion of telehealth, significant investments in infrastructure and technology and the development of partnerships with other health services and providers is helping us achieve great improvements in access to care.

Life expectancy for Western Australia’s country people is around two years lower than for WA’s metropolitan people, but in remote and very remote communities across Australia the mortality rate is 30% higher than in our cities.

39% of country residents live in the highest areas of disadvantage.

Figure 3: Socio-Economic Indexes for Areas (2016) Australian Bureau of Statistics

Local Government AssociationDecile (1 = most disadvantaged, 10 = least disadvantaged)WACHS region
Ngaanyatjarraku (S) 1 Goldfields
Laverton (S) 1 Goldfields
Menzies (S) 1 Goldfields
Dundas (S) 1 Goldfields
Coolgardie (S) 1 Goldfields
Leonora (S) 2 Goldfields
Esperance (S) 5 Goldfields
Kalgoorlie/Boulder (C) 7 Goldfields
Katanning (S) 2 Great Southern
Plantagenet (S) 3 Great Southern
Broomehill-Tambellup (S) 4 Great Southern
Albany (C) 5 Great Southern
Cranbrook (S) 5 Great Southern
Ravensthorpe (S) 5 Great Southern
Denmark (S) 6 Great Southern
Gnowangerup (S) 7 Great Southern
Kojonup (S) 7 Great Southern
Woodanilling (S) 8 Great Southern
Jerramungup (S) 8 Great Southern
Kent (S) 9 Great Southern
Halls Creek (S) 1 Kimberley
Derby-West Kimberley (S) 1 Kimberley
Wyndham-East Kimberley (S) 3 Kimberley
Broome (S) 6 Kimberley
Upper Gascoyne (S) 1 Midwest
Wiluna (S) 1 Midwest
Meekatharra (S) 1 Midwest
Murchison (S) 1 Midwest
Mount Magnet (S) 1 Midwest
Cue (S) 2 Midwest
Yalgoo (S) 2 Midwest
Sandstone (S) 2 Midwest
Northampton (S) 3 Midwest
Coorow (S) 3 Midwest
Carnarvon (S) 3 Midwest
Morawa (S) 4 Midwest
Greater Geraldton (C) 4 Midwest
Irwin (S) 4 Midwest
Shark Bay (S) 4 Midwest
Carnamah (S) 5 Midwest
Three Springs (S) 5 Midwest
Mingenew (S) 7 Midwest
Perenjori (S) 7 Midwest
Exmouth (S) 8 Midwest
Chapman Valley (S) 9 Midwest
East Pilbara (S) 3 Pilbara
Ashburton (S) 8 Pilbara
Port Hedland (T) 8 Pilbara
Karratha (C) 9 Pilbara
Collie (S) 1 South West
Bunbury (C) 3 South West
Manjimup (S) 3 South West
Nannup (S) 4 South West
Bridgetown-Greenbushes (S) 4 South West
Boyup Brook (S) 5 South West
Donnybrook-Balingup (S) 6 South West
Dardanup (S) 6 South West
Harvey (S) 6 South West
Busselton (C) 7 South West
Augusta-Margaret River (S) 8 South West
Capel (S) 8 South West
Wyalkatchem (S) 2 Wheatbelt
Pingelly (S) 2 Wheatbelt
Kellerberrin (S) 2 Wheatbelt
Trayning (S) 2 Wheatbelt
Wagin (S) 2 Wheatbelt
Quairading (S) 2 Wheatbelt
Northam (S) 2 Wheatbelt
Yilgarn (S) 2 Wheatbelt
Koorda (S) 3 Wheatbelt
Brookton (S) 3 Wheatbelt
Nungarin (S) 3 Wheatbelt
Narrogin (S) 3 Wheatbelt
Tammin (S) 3 Wheatbelt
Beverley (S) 4 Wheatbelt
York (S) 4 Wheatbelt
Merredin (S) 4 Wheatbelt
Gingin (S) 4 Wheatbelt
Moora (S) 4 Wheatbelt
Wongan-Ballidu (S) 5 Wheatbelt
Bruce Rock (S) 5 Wheatbelt
Goomalling (S) 5 Wheatbelt
Corrigin (S) 5 Wheatbelt
Toodyay (S) 5 Wheatbelt
Boddington (S) 5 Wheatbelt
Kondinin (S) 6 Wheatbelt
Dowerin (S) 6 Wheatbelt
Wickepin (S) 6 Wheatbelt
Cunderdin (S) 6 Wheatbelt
Dandaragan (S) 6 Wheatbelt
Cuballing (S) 7 Wheatbelt
West Arthur (S) 7 Wheatbelt
Victoria Plains (S) 7 Wheatbelt
Dumbleyung (S) 7 Wheatbelt
Narembeen (S) 7 Wheatbelt
Mukinbudin (S) 7 Wheatbelt
Mount Marshall (S) 7 Wheatbelt
Wandering (S) 8 Wheatbelt
Westonia (S) 8 Wheatbelt
Dalwallinu (S) 8 Wheatbelt
Lake Grace (S) 8 Wheatbelt
Williams (S) 8 Wheatbelt
Kulin (S) 9 Wheatbelt
Chittering (S) 9 Wheatbelt

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Our values in action

Bringing renal services closer to home

A chronic diseases study in 2012-13 showed that nearly one in five Aboriginal people had signs of chronic kidney disease. Those in remote areas were five times more likely to have chronic kidney disease than non-Aboriginal people. For country patients treatment begins in Perth with specialist support and then patients wait for a dialysis chair to become available for them to come home.

The wait to come home can be long and many Aboriginal people report feeling sad and frustrated at being alone and away from their family, friends and community.

Commencing in 2014, WA Country Health Service has delivered the $45.8 million Bringing Renal Dialysis and Support Services Closer to Home initiative, of which $3.52 million was invested to refurbish the Kalgoorlie Dialysis Unit, increasing the number of dialysis chairs and bringing more Goldfields people home. In 2019 the Goldfields Renal Service, in partnership with the Fiona Stanley Hospital Nephrology Unit and Purple House Alice Springs was awarded the prestigious WA Health Excellence Award for Achieving better health outcomes for Aboriginal people.

The Service is part of an eight-year-long strategy by the WA Country Health Service Goldfields to expand dialysis services, incorporate new infrastructure, and introduce a renal team to address a growing need for specialist kidney services.

In just four years the service has helped to reduce the local dialysis waiting list from 30 to just two and has also supported dialysis in the home through the provision of outreach services.

"We find that health outcomes are better for people who are able to access treatment close to home as their attendance at dialysis improves, they are more involved in managing and participating in their own care and they have the support of their family and loved ones around them."

"In just four years the service has helped to reduce the local dialysis waiting list from 30 to just two."

Watch videoComing Home: Kalgoorlie Dialysis Unit

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Building healthy and thriving communities

We have a significant impact on the communities we serve – as an employer, a service provider, a service partner and a key contributor to economic and social sustainability. We will continue to create positive and reciprocal relationships with country communities; working together to achieve healthy, sustainable, thriving communities.

Responding to our communities’ current health needs is challenging and requires us to think innovatively about ways in which the WA Country Health Service can increase the sustainability of our services, and use our finite funding and resources in the most effective way. Initiatives aimed at improving access to services have been implemented and are expected to improve detection of chronic and other health conditions, particularly through the expansion of services available via telehealth.

The WA Country Health Service is building links with primary care providers, child health and development services, as well as building capacity in critical care and rehabilitation services. In addition, over the past ten years we have delivered a $1.5 billion capital works investment program, the most ambitious ever undertaken in regional WA, comprising of over 80 projects from Kununurra in the Kimberley to Albany in the Great Southern. The investment is aimed at facilitating higher levels of self-sufficiency within the regions, namely improved access and quality of emergency and primary care and improved inpatient services. 

The new Karratha Health Campus is now open. The $173 million campus is the flagship project in WA Country Health Service’s extensive capital works program. The single biggest investment in a public hospital ever delivered in regional Western Australia, the campus will provide care for around 21,000 people in Karratha and the surrounding communities.

With the redevelopment of Onslow Health Service also completed and opened in December 2018 it was a big year for health services in the Pilbara. The redeveloped campus includes an expanded three-bay emergency department plus a purpose-built procedure room, with capability for 24/7 access to emergency telehealth services.

"Across Western Australia innovative technology, along with modern new infrastructure and improved patient systems and connectivity are transforming care for country communities."

WACHS regions provided 77% of the public inpatient care required by country people.

[Image (PDF only): Onslow Health Service]

"The new Karratha Health Campus is now open. The $173 million campus is the single biggest investment in a public hospital ever undertaken in regional Western Australia."

[Image (PDF only): Karratha Health Campus]

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A $300 million capital works program is nearing completion, delivering infrastructure upgrades to 37 towns across the Wheatbelt, Great Southern, South West and Midwest regions. These infrastructure upgrades also deliver increased access to the Emergency Telehealth Service, providing patients and staff with state-of-the-art access to high quality emergency and inpatient care and increased access to outpatient and clinical services via telehealth.

Construction and refurbishments in Northam, Merredin and Narrogin are continuing with upgraded facilities also completed in Williams, Pingelly, Cunderdin, Katanning, Wyalkatchem-Koorda, Beverley, Quairading, Bruce Rock, Narembeen, Jurien Bay and Moora this year. Phase 1 upgrades to the Northam Hospital emergency department were opened in February 2019 and construction in the redevelopment of Narrogin Health Service is nearing completion.

"A $300 million capital works program is improving capital infrastructure in 37 towns across the Wheatbelt, Great Southern, Midwest and South West regions."

Watch videoMerredin Health Service redevelopment

[Image (PDF only): Minister for Health, Hon Roger Cook MLA pictured with Pingelly Primary School children at the opening of the Pingelly Health Centre]

The WA Country Health Service continues to deliver the $45.8 million Bringing Renal Dialysis and Support Services Closer to Home project. The program has expanded the number of renal chairs in the Kimberley to 30 and the total across WA to 109, with 92 dedicated renal hostel beds across regional WA. All Phase 1 facilities are now completed with completion of Phase 2 and the completion of the program expected in 2020 with completion of the Broome and Kalgoorlie renal hostels.

Further to this, the $22.2 million Remote Health Clinics program, a State Government initiative to fund the refurbishment or replacement of healthcare facilities in remote Aboriginal communities across the Kimberley and Pilbara is now in its final stages and due for completion mid 2020.

In 2018 the State Government announced an exciting commitment for the $73.3 million stage 1 redevelopment of Geraldton Health Campus and a Midwest mental health service. Planning is well underway and the investment, which begins in 2020 with a forward works package, will deliver a combination of new build and refurbished infrastructure and is expected to be fully commissioned and operational in 2023. The investment will enable an expanded emergency department and critical care unit; an acute psychiatric unit; a mental health short stay unit; and essential engineering service upgrades to the existing infrastructure.

"WA Country Health Service offers comprehensive health services to country residents and visitors."

[Image (PDF only): First patient in the new Northam Emergency Department, Mr Norman Lee with our staff member Sharon Herrick.]

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Enabling our staff

WA Country Health Service staff make an essential contribution to the health of communities across country WA. We are proud of the care, commitment, and passion that our staff bring to their work. We want to attract and retain the best and brightest from country communities, the city and from outside WA.

The Board and Executive are committed to the continued development of a positive workforce culture that embodies our values which were so strongly held by the many staff we spoke to throughout the consultation process in developing our new Strategic Plan.

The Minister for Health’s ‘Your Voice in Health’ Survey also highlighted that staff across the WA Health system are strongly committed to the goals of their organisation and that they take personal responsibility for looking for ways to continually improve the way we work.

At a high level the survey results showed that WA Country Health Service staff feel more valued and satisfied in the job they do, compared against the state benchmark, and that they are able to make good use of their considerable skills and abilities, that their health and wellbeing is valued, and that they would recommend their organisation as a great place to work.

Of the 3,727 WA Country Health Service respondents, an impressive 89% said they believe that “one of my responsibilities is to continually look for new ways to improve the way we work.” We call that curiosity, and it’s the new value we have included in our strategic plan.

There were, of course, many areas highlighted through the Minister’s survey for us to focus our efforts on improving and we will use the feedback gained through the survey to progress our staff engagement strategy going forward.

"Of the 3,727 WA Country Health Service respondents, an impressive 89% said they believe that “one of my responsibilities is to continually look for new ways to improve the way we work."

[Image (PDF only): Minister for Health, Hon Roger Cook MLA, speaking with our staff across the state by Videoconference about the survey results for WA Country Health Service.]

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Building a sustainable workforce

Attracting and retaining clinical staff can at times require innovative solutions to ensure the uninterrupted provision of healthcare services to regional areas. Ensuring that we can attract and retain a diverse and skilled workforce remains an ongoing and key area of focus for us.

During 2018-19, we implemented innovative staffing models to address regional staff requirements across nursing and midwifery, medical, allied health, mental health and Aboriginal health. This included the development of a pilot program to utilise an online recruitment platform to make the recruitment process for casual and fixed-term clinical positions easier. The WA Country Health Service ‘Talent Community’ platform is streamlining our approach to recruiting for regional nursing, midwifery and allied health roles. This is a pilot project being trialled in the Kimberley and Pilbara regions and is a step towards achieving the Sustainable Health Review recommendation to remove barriers in workforce appointments.

The WA Country Health Service medical intern program continues to be popular with all positions based at Albany and Busselton Hospital recruited from a competitive field. Most interns completing this program from the past two cohorts have chosen to work in regional or remote WA on completion of their internship. In addition, the Medical Education Unit continues to promote the benefits of working in rural WA to all junior doctors at education and recruitment information events. 

To engage and strengthen the General Practice workforce in country areas we have partnered with Rural Health West in 2018 to undertake the Better Medical Care for Rural WA initiative. This program provides local opportunities for professional development relevant to our areas of clinical service delivery, as well as implementing mentoring programs in Obstetrics, Anaesthetics, Emergency Medicine and procedural skills for General Practitioners. The initiative recognises the importance of work life balance for medical practitioners by also supporting a family assistance program and locum support. 

Our medical governance team has also been furthered strengthened in 2018-19 with the appointment of Directors of Internal Medicine and Paediatrics. By recruiting to these key positions we are now able to provide increased clinical support to clinicians working in these areas, as well as expert advice regarding regional clinical service development.

"WA Country Health Service offers comprehensive health services to country residents and visitors."

[Image (PDF only): Nine new medical interns complete their induction program with Dr David Oldham, our Director of Medical Education.]

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Central to providing effective and culturally secure healthcare for Aboriginal people is attracting and retaining Aboriginal staff.

We continue to support Aboriginal leadership development, traineeships and the Aboriginal Mentorship Program. Regional Aboriginal health consultant positions have been appointed in four of the seven regions, with recruitment to the remaining regions near completion. The consultants are members of our regional executive teams and play a significant role across all aspects of regional business.

To support attraction and retention of Aboriginal staff we also have in place an Aboriginal Entry Level Employment Framework to provide funding to support Aboriginal employees entering the WA Country Health Service workforce. The framework has supported the funding of training opportunities and the purchase of resources to support the Aboriginal mentorship program. As of March 2019, the total Aboriginal employee headcount was 445, which equates to 4.2% of the WA Country Health  Service workforce. This is above the 3.2% State Government target.

"Central to providing effective and culturally secure healthcare for Aboriginal people is attracting and retaining Aboriginal staff."

[Image (PDF only): Jo Gray and Rani Randall celebrate their graduation from the Aboriginal Leadership Excellence and Development (LEAD) Program.]

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Providing a safe and secure workforce

Healthcare providers and support workers operate in a challenging environment and attend to individuals who may be distressed, angry, confused or under the influence of alcohol or other drugs. Our staff have a right to work in safe workplaces without exposure to violence and aggression, and we are committed to achieving this.

Occupational violence in health care is a serious national issue that is increasing in prevalence. Whilst we have made improvements over the years, there is more to be done. To ensure we can provide our staff with safe workplaces, we have developed a new Preventing and Managing Occupational Violence Strategy 2019-2023 which articulates our plan to achieve high standards of safety and consistency across all of our locations.

The strategy delivers a multifaceted approach to eliminate or control, as far as reasonably practicable, the risk of occupational violence. When incidents do occur, the implementation of key elements of the strategy will ensure support is provided to staff to minimise the impact. Our work continues to implement the strategy and deliver the associated actions that will contribute to preventing and minimising incidences of occupational violence for our staff.

"Our staff have a right to work in safe workplaces without exposure to violence and aggression, and we are committed to achieving this."

"WA Country Health Service staff make an essential contribution to the health of communities across country WA."

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WA Country Health Service staff have access to a range of leadership development opportunities which include formal programs offered externally via the Public Sector Commission as well as tailored development coordinated internally. New and aspiring managers have access to an internal management development program that includes ten modules designed to assist existing and aspiring managers to understand and gain knowledge in managing services within the organisation.

In 2018-19 we have commenced a Future Leaders Program which is a tailored program designed to assist staff who aspire to senior roles within the health service to obtain targeted and essential leadership and management development. Supporting and facilitating learning programs that enable the development and maintenance of professional skills is a key focus for us in attracting and retaining a competent and skilled workforce that is aligned with our service needs across disciplines. Our Learning and Development f ramework ensures ongoing skills development and learning to support the delivery of safe, high quality and person-centred care. 

Learning and development across the organisation is facilitated through the Learning and Development Network, an organisation-wide network represented by a range of discipline areas, including the Medical Education Unit, Nursing and Midwifery Services, aged care, allied health, regional staff development educators and learning and development coordinators. Further to this, the management, publication and reporting of training and development achievements and delivery of tailored programs is enabled and supported by an organisation-wide Learning Management System.

"Our Learning and Development framework ensures ongoing skills development and learning to support the  delivery of safe, high quality and person-centred care."

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Sustainable Health Review

The Sustainable Health Review (SHR) was announced by the State Government in June 2017 to develop a more sustainable health system for Western Australia and to prioritise the delivery of patient-centred, high quality and financially sustainable healthcare across the state into the future. The Review, chaired by a panel of experts, consulted extensively with stakeholders across Western Australia and published their final report in April 2019.

Through the consultation process WA Country Health Service engaged with our consumers, clinicians, managers and staff from across our regional areas to collect their views and provide a response and recommendations for consideration of the Panel. Input to our submission included insights from our key consumer advisory groups the District Health Advisory Committees.

In our submission, we provided a summary of the significant challenges facing country communities and the critical importance of taking steps to ensure a sustainable health system into the future – one that recognises and enhances the delivery of services to country communities while ensuring the ongoing viability and sustainability of those services such that they are responsive to the needs of country communities into the future. These included strategies to make enhancements to regional aged care, patient transport and ambulance services, investment in digital capacity to ensure access to technology across the state.

Many of the issues raised by the WA Country Health Service were recognised in panel’s final report which highlights, in their enduring strategies and recommendations, a need to develop new ways to support equity in country health and better utilising resources with more care to be provided in the community. Telehealth and virtual care have been acknowledged as a key enabler of new models of care in the community and as a means of supporting country health service delivery. Other recommendations include improving coordination and access for country patients by establishing formalised links between regions and metropolitan health service providers for elective services including outpatients and telehealth, patient transfers, clinical support and education and training.

The overarching aims of the Sustainable Health Review’s final report and the valuable insights gathered from our stakeholders throughout the process of developing the WA Country Health Service submission to the review helped to inform our new Strategic Plan 2019 – 2024. The resulting significant issues are reflected in the priority areas our new Strategic Plan is focused to achieve.

"Telehealth and virtual care have been acknowledged as a key enabler of new models of care in the community and as a means of supporting country health service delivery."

View website - Read the WACHS Strategic Plan 2019–24

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