Annual Report

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Annual Report

2011-2012

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Eastern Metropolitan Region Palliative Care Consortium Annual Report 2011-2012

Welcome to the 2011-2012

Eastern Metropolitan Region Palliative Care Consortium

Annual Report

This report was prepared by:

C Brusamarello, Consortium Manager

On behalf of:

Eastern Metropolitan Region Palliative Care Consortium c/- PO Box 227 Nunawading 3131 Telephone: 03 99552509 Fax: 03 99552599 Email: [email protected] Website: www.emrpcc.org.au

Copies of this report can be downloaded from the

Eastern Metropolitan Region Palliative Care Consortium website at http://www.emrpcc.org.au

or by contacting the Consortium Chair/Manager,

Eastern Metropolitan Region Palliative Care Consortium at the above address.

EMRPCC July 2012: B White, J Brown, S Fullerton, C Brusamarello J Moody, D Halliwell, M Hodgens, M Boughey, I Hatton Absent are H Pike, K Simons, K Draper & A Nugent

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The release of the Strengthening Palliative Care Policy in October 2011 has provided direction and clarity to the work of the Consortia over the past year. The work of the consortia is varied but it relies on the participation, energy and relationships that have developed over the past 7 years to ensure palliative care has high visibility within the health systems in the Eastern Region.

With the release of the Policy new funding was allocated to the EMRPCC for aged care and disability services support. This project has provided a significant increase in resources to support elderly and disabled people living in aged care and disability homes.

We are thankful to each of the agencies that participate, your expertise is essential for ensuring that we consider all aspects of care particularly including non-funded agencies. Your emphasis on how all strategies influence patient care and support for carers is commendable.

A special thank you to the Department of Health, Eastern Region for their continued and valuable input into our meetings, plans for the future and activities.

The Vision of the consortia is:

The Consortium’s aspiration is that EMR residents with a terminal condition, their families and carers have access to a high quality palliative care system that fosters innovation and provides coordinated care and support that is responsive to their needs.

Without the good will of all participants this Vision could not be realised. The results of the annual Victorian Palliative Care Satisfaction Survey prove that services are of a high quality and are working together to ensure from the patients/carers perspective service are seamless.

Thank you to all agencies who participate and in particular to the Consortia Manager, Christine Brusamarello and the Executive Committee for their sharing the workload of the management of the Consortia.

Jeanette Moody

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Consortium Manager’s Report

The release of the Victorian Strengthening Palliative Care: Policy and strategic directions 2011-2015 in August 2011, allowed the development of a four year Consortium strategic plan. Within this framework the EMRPCC has bolstered organisational partnerships through the fresh signing of a Memorandum of Understanding, restructured the Consortium Clinical Group, brought together Consortium services with areas of shared interest and developed new sector interactions.

The EMRPCC has had the opportunity to develop supports for aged and disability residential services in the region. The support and assistance to these sectors from our Palliative Support Nurses is only in an early phase. The coming twelve months will be an exciting time as the work evolves. The two part time Palliative Support Nurses are managed by the Consortium. Their appointment has tripled staff numbers and doubled staff hours.

I extend thanks to Eastern Palliative Care, not only as the employing agency and fund holder, but for actively hosting and supporting the EMRPCC with office space, information systems and administrative knowledge.

To the EMRPCC Executive, EMRPCC agencies and representatives- your combined experience, knowledge, commitment and guidance deserves more than just a thank-you. Observing the passion for quality palliative care in the region sets the Consortium for an exciting year ahead.

Christine Brusamarello Consortium Manager

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Consortium Member Agencies

Hosted the CCG and palliative carers resource group meetings, Executive, CCG reps x 2, assisted with EMRPCC recruitment, PSN advisory group. New representative commenced Sept 2011.

Fund holder, chair, employing agency, host agency, IT and administrative advice, site for EMRPCC, Executive and other meetings, Volunteer coordinators meeting, HR support, CCG reps x 3, PSN advisory Group.

100% attendance by 2 nominated representatives.

One of the first Medicare Locals in Melbourne. Supporter of the EMRPCC with nominated

representatives on the Consortium & PSN advisory groups. Key agency for Patient controlled e-health records in the region.

Deputy Chair, EMRPCC Executive, Chair of the Consortium Clinical Group (CCG), collaboration in & support for the PSN role, monthly reports, CCG reps x 3, PSN advisory group. 100% representation at EMRPCC Meetings.

Attended 6 Consortium meetings.

Participates on the Consortium Clinical group Hosted the EMRPCC meeting in Sept 2011.

Attended Palliative carers resource group & volunteer co-ordinators meetings, provided photos and items for website assisted with EMRPCC recruitment.

Have been represented at 9 EMRPCC meetings

Changing over to the Eastern Melbourne Medicare Local from 1/7/2012.

Attended the EMRPCC planning session in August 2011.

Supportive care links have been strengthened by attendance at the Palliative Carers Resource Group.

Attended 8 EMRPCC meetings.

Notification was received of the closure of Greater Eastern Primary Health from 1/7/2012.

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LGA 70+ years 2011 70 +years 2031 Increase

Boorandara 18034 25269 40% Knox 12349 31851 157% Manningham 14504 25257 74% Maroondah 11261 22674 50.3% Monash 21618 26173 21% Whitehorse 20240 26592 31.4% Yarra Ranges 11,314 28,189 149%

Demographics

The Eastern Metropolitan Region, population projections indicate small annual increases of 0.4 – 0.6%, in the population within each Local Government Area (LGA).

The region however will have a significant alteration in the number of residents aged over 70 years, in the coming 20 years.1 _{It is also to be noted that 25% of the regional CALD population aged 45+ are not}

proficient in English.2

Aboriginal Cultural Training

Aboriginal Cultural Training is an opportunity to bring the palliative care services together with a regional approach to shared education. Having not offered the training since May 2009, interest was high. The Koorie Heritage Trust worked with the Consortium to tailor training that incorporated palliative considerations within the Aboriginal community. Associate Professor Mark Boughey & Ms Kylie Draper presented both from

personal and clinical experience. In August 2011, 19 people attended

Due to the feedback the EMRPCC provided the training again in February 2012 with 25 people attending.

Confronting, satisfying and

eye opening Very educational session. Something I _{wish I had learnt many years ago}

Very informative, quite overwhelming in part

Found the training very valuable and formed a good start to learn more. Happy with pace & content. Very enjoyable and informative session. It inspires me to continue learning about Aboriginal Culture & health issues

Excellent base of how to engage & build repour with aboriginal people in the context of my social work job. Fantastic cross section of info covered. I have gained so much knowledge from today and it has been very thought provoking.

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Victoria in Future 2012 Department of Planning and Community Development http://www.dpcd.vic.gov.au/home viewed 28/6/12,

2 _{Howe, Anna L (2006) Cultural diversity, ageing and HACC: trends in Victoria in the next 15 years. Rural and Regional Health and Aged Care Services Division, Victorian}

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Consortium Clinical Group

A refreshed Consortium Clinical Group commenced meeting in 2012. The group was renamed when the role & structure was reviewed in 2011. The review affirmed that links with the EMRPCC needed to be clearer. This has been achieved by having different Consortium representatives rotating to meetings and Dr Sonia Fullerton (Eastern Health and Deputy Chair EMRPCC) as chair. Each meeting has had a theme drawn from the palliative care policy to guide the discussion amongst the multidisciplinary group.

Syringe Driver drug compatibilities - Practice Guidelines 2011 were released in July 2011. This document is an update on the 2008 document. The document is used by the 3 Department of Health funded services in the region and is available on the EMRPCC and Centre for Palliative Care websites.

In the coming year, 3 regional clinical guides will be updated. The interaction and communication with the Victorian Palliative Care Clinical Network will also become more established.

Palliative Care Service access chart for GPs

In 2010 a palliative care project being conducted by the Eastern Ranges GP Association identified an

information gap. As a result a regional service access chart was developed by the EMRPCC in March 2010 and reviewed and updated in May 2012. The chart was provided to the Divisions of GP/ Medicare Locals for distribution and included on the EMRPCC website.

Operational Plan 2011-2012

August 2011 brought the EMRPCC together for a planning session in the training room of Melbourne East GP Network (MEGPN). The morning was facilitated by Kevin Larkins and included an overview of the past 5-6 years.

Amanda Bolleter from the Department of Health provided a summary of what was to be expected in the palliative care policy that was due for release later that month.

Marianne Shearer, CEO of MEGPN, spoke of the transition activities as they became the Inner East

Melbourne Medicare Local. She emphasised that cross sector relationships are valued and that the Medicare Local model would provide further opportunities to develop these. The EMRPCC has registered as a member of the Inner East Melbourne Medicare Local.

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EMRPCC Operational Plan 2011-2012

Within the operational plan were 4 focus areas. The areas and achievements are listed.

What was achieved:

 An initial Agency scoping forum held in September 2011.

 The development of a regional Palliative Carers Resource Group as a sub group of the EMRPCC.

The Resource group met 4 times during the past 12 months. Areas reviewed have included access to information, consistency of information, carer assessment and monitoring tools.

 Eastern Palliative Care is to commence an internal background paper on additional care options to allow more people to die at home through nursing & respite support for carers.

Consortium Clinical Group

What was achieved:

 Reshaping of the Clinical group

 Development of a meeting plan for 2012 and preparation for the document reviews in 2013.

Medicare Locals

What was achieved:

 Consortium is registered for organisational membership with Inner East Melbourne Medicare Local  Medicare Locals represented on the EMRPCC.

Residential Aged Care Carers

What was achieved:

 Palliative Support Nurses  4 regional education sessions

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Strategic Plan 2012-2015

Eastern Metropolitan Region Palliative Care Consortium strategic plan 2012-2015, was approved on 6/3/2012. The following is an outline from the plan.

Strategic Direction 1 -Informing and involving clients and carers

 Provide information about palliative care that is tailored to the needs of clients and carers Strategic Direction 2 –Caring for Carers

 Increase regional support for carers, with awareness of changing needs during the palliative journey

 Continued provision of afterhours support to community clients and carers in their homes Strategic Direction 3 – Working together to ensure people die in their

place of choice

 Engagement with management of residential aged care

 Regional aged care /palliative care nurse to support residential aged care services

 Support the implementation of end of life pathways in residential aged care facilities

 Support disability accommodation services in palliative concepts

 Provide palliative education that crosses differing health sectors and levels of knowledge

 Increase understanding of the palliative support systems with general health sectors.

 Support general health and community care providers to deliver end of life care Strategic Direction 4 – Providing specialist palliative care when

and where it is needed

 Work in partnership with health providers to deliver quality palliative care for Aboriginal communities

 Interact with multicultural organisations to promote access to culturally appropriate palliative care

 Support funded palliative care services in the implementation of the palliative care Service Delivery Framework

Strategic Direction 5—Coordinating care across settings

 Renew the Memorandum of Understanding with all Consortium partner services

 Increase the EMRPCC profile in the region

 Effectively inform all stakeholders about the EMRPCC

 Strengthen the role of Palliative Care Consortia within the 2 Medicare Locals being established in the region

Strategic Direction 6 — Providing quality care supported by evidence

 Have an active Consortium Clinical Group within the region

 Consortium clinical guidelines reflect best practice

 Regional palliative care sector education

Strategic Direction 7 — Ensuring support from communities

 Strengthening community awareness, and capacity to better support people in relation to death, dying and bereavement

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Strategic Priorities—Achievements

Certificates of Recognition To celebrate the signing of the Memorandum of Understanding, a framed certificate of

recognition was presented to each agency. This special acknowledgement of the contribution and commitment to the Eastern Metropolitan Region Palliative Care Consortium was suggested at a planning day in August 2011

Memorandum of Understanding The Memorandum of

Understanding is a crucial document when working in partnership across organisations. In May 2012 the EMRPCC

approved a new Memorandum of Understanding and the process of having the document signed began. The period of the

agreement is until 31st December 2015.

At the 30th June 2012, six (6) out of seven (7) organisations had signed the Memorandum of Understanding.

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Strategic Achievements

Palliative Support Nurse

In 2011 there were over 125 Residential Aged Care (RAC) facilities with approximately 9145 beds in the 7 local government areas (LGAs) of the eastern metropolitan region. About 860 of the beds are secure unit dementia specific beds. Two-thirds of the facilities are located in the 4 LGAs of the Inner East Melbourne Medicare Local catchment. These facilities have approximately two-thirds of the regions residential beds and more than half of the dementia specific beds. The exact number of beds is unclear with new and redeveloped facilities being opened.

The region also has over 1800 beds in 49 Supported Residential Services (SRS). About 30 of these services cater for older residents.

The Department of Human Services manages 132 disability accommodation houses in the region. Non -government providers have about 90 residential & day support centres in the region.

$96,250 was provided to the EMRPCC for a ‘palliative aged care link nurse’ and $25,000 to support the disability sector in the 2011/2012 financial year. The recurrent funding is $77,750 & $25,000 ($102,750 combined). The blending of the funding created a Palliative Support Nurse role which will work across both the aged and disability sectors.

The EMRPCC chose the title Palliative Support Nurse (PSNs) rather than ‘link nurse’ to identify the role and distinguish PSNs from other services. The word ‘support’ is key within the role title and is vital to the activities being undertaken including the sustainability of the role. The intention being that the PSN will work to support the facility, not just 1 or 2 staff.

Our Model

2 part time PSNs working across sectors, providing support on palliative approach specific to sector or residential facility needs. Focus is on palliative approach, clinical continuity of care, education, communication, care trajectories, resources, information etc.

The central feature is the development of palliative support plans, with activities and goals that are jointly agreed by the PSN & facility. This approach is to gain collaborative engagement to guide improvement in palliative care. Each facility/ service has differing systems and needs. The overall strategies utilised by the PSN will be similar, but individualised plans personalise the facility support. Key result areas for future reporting

Education, consultancy & support to residential facilities Establishment and progression of the PSN role regionally Evidence of practice change occurring

Effective communication across sectors using a variety of methods

Development and sustainment of effective relationships with internal & external stakeholders Efficient & effective management of time & workload

PSN professional development

Commitment to quality, continuous improvement, occupational health & safety & risk management

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Eastern Metropolitan Region Palliative Care Consortium Annual Report 2011-2012 Nov 2011 Dec 2011 Jan 2012 Feb 2012 March 2012 April 2012 May 2012 June 2012 Advisory group Expressions of Interest sought from Residential sector. Project Coordinator appointed. Model developed & approved by EMRPCC. Documentation submitted to Department of Health Scoping of existing systems, identification of existing services, building new partnerships. Development of position descriptions & PSN tools. Advisory group’s 2nd meeting. Recruitment of the 1st PSN. EOI call to SRS sector Advisory group‘s 1st meeting. Advertising for PSN 1st PSN starts Project coordinator role concludes. Recruitment of 2nd PSN. 3rd Advisory group meeting 2nd PSN commences. PSNs working with 7 RACF s & 1 SRS plus engaging with disability sector at the regional level.

Palliative Support Nurse Achievements

November 2011 to June 2012

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4 sessions, with 159 people attending

The Program of Experience in Palliative Approach (PEPA) is arranged by the Department of Health. Regionally the EMRPCC receives a funding allocation to provide ongoing support for participants of the PEPA program. All past-PEPA participants and other health professionals are invited to activities funded by the PEPA post

placement support funds.

The target audience for the 2011-2012 program was residential aged care, as over half of the PEPA participants registered for the region work in the aged care sector

.

…would like to become more skilled in differentiating e.g somatic, visceral etc. Able to look for the right cues e.g painful contractures

perhaps more time on (the) syringe driver Adds to my knowledge & understanding

Valuable in being aware of more extensive assessment tools Will be used extensively & discussed further

Session covered topic well. Great if follow up session could be organised with analgesia newest information It was good to hear other positions/stories of pain management and cases. The case studies were interesting

and made you think of different situations All education is useful. Pace allowed interaction

Is there any changes recently about palliative care? (the) Benefit to facility of palliative care service for resident (wasn’t covered)

Very useful and helpful, got a lot out of it.

Made/helped me to look at current practices in my work place & areas for improvement. Entire session needed more time. Excellently presented. Wasn’t bored at all, thoroughly enjoyed.

Staff need more resources & training in this area. It would be better if all of the staff in our facility can participate this type of workshop

We need to look at inclusiveness differently….

Excellent presentation with lots of resources to tap into. Enough to ‘wet’ the appetite to know & understand

STRATEGIC ACHIEVEMENTS

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After Hours Service 2012 Report

Model of after hours support

In the Eastern Metropolitan Region a well- established system of out of business hours support is provided from 5 PM each evening to 8 AM each morning for clients to access specialist advice and a visit by a nurse if needed.

Over the 12 months period no significant changes were made to the system of care and no interruptions to care provision were experienced apart from a statewide pager issue which occurred for 3 hours one evening.

As Eastern Palliative Care Association Inc. is the only specialist community provider in the region all clients receive the same services outside business hours. This is composed of an on call number given to all clients on admission and reinforced by staff at subsequent visits. Client or carers use the afterhours number if they have a problem they cannot resolve. The call is answered by a Registered Nurse employed at Caritas Christi Hospice who has palliative care experience at a senior level.

The nurse, who has access to the client’s electronic health record, works through all issues described by the client resolving the issues sometimes over a number of calls. Clients call about many issues with most clients ringing about more than one issue at a time. If problems cannot be resolved the calls are referred to the EPC Nurse on call who will again attempt to resolve the issues and will then visit the client if needed regardless of the time. The EPC Nurse can contact the EPC Medical Officer on call if required including when the GP or specialist is unavailable

When clients are first assessed by EPC, the client is encouraged to use the afterhours number if they have any problems. It can allay much anxiety if people just ring and ask. The afterhours services is not one of last resort, it is part of how we support clients in the community so we encourage use as needed. Clients also regularly have actions plans that they can use if difficulties arise, particularly in relation to pain management. All members of the interdisciplinary team work to anticipate issues and develop action plans for foreseen issues that may arise.

Feedback from clients and carers highlights the value of the After Hours Service. In interviews many believe the afterhours support provides them with comfort and security they need at this very difficult time in their lives.

Program Development and Review

In June 2012, a meeting was held with Barwon Consortium, Hume Consortium, Eastern Consortium and Caritas Christi Kew, to review the services provided, raise any outstanding issues and plan for future developments.

This meeting was very successful with all services agreeing to look at the paging system and meet again following St. Vincent’s investigation and recommendations in this area.

A timetable for policy and process review was discussed with all to be reviewed by mid-2013. All participants are to meet again to finalise data collection elements in the near future.

Data analysis

Most calls come from the partner (37%) of the client or their son/daughter (30%). Most calls are made between 5 PM and midnight (75%)

The average number of calls per months was 180, but this was not consistent over the 12 month period. August and December were both 26% above the average call rate.

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Total number of calls taken 2166 Average number of calls per month 180

% of calls that ended up with call out 30%

Average number of call outs per month 55

Average length of time of call 12.7 minutes

Who called Partner = 37% Daughter/Son = 30% Client = 13% Other = 19% Time of calls 5 - 9 PM = 50% 9 – 12 midnight = 25% 12 – 3 AM = 9% 3 – 7 AM = 16%

Number of issues identified in calls Death of the client = 29% General deterioration = 6% Injection = 21%

Other symptoms = 9%

Uncontrolled symptoms = 25%

% of calls that were resolved by Triage 68%

Occupational Health and Safety

When on the road for EPC business out of hours, all nurses use a work vehicle and carry a mobile phone at all times. When they leave their home and return to their home the Triage Nurse is notified and the time noted. If no return phone call is received in the given time the Triage Nurses rings the Nurse on call and if no answer is received the Manager Nursing and Medical Services is notified. Electronic tracking devises have ben trialed but no technology has been found to date to meet the various needs of the nurses. Investigations of these issues are continuing.

Satisfaction Survey

The 2012 Victorian Palliative Care Satisfaction Survey showed that the level of satisfaction with the overall standard of services scored 4.73 out of 5 and the score for the availability for afterhours support was 4.62. Summary

The After Hours Services provided to clients and their carers is well used, understood and appreciated. Systems are in place to support clients with a nursing visit out of hours if issues cannot be resolved on the phone. All systems have functioned well in the past 12 months with streamlining of pager systems planned for the upcoming 12 months. _{Jeanette Moody—Eastern Palliative Care}

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Role statement audit and action plan

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The annual Consortium audit against the Department of Health role statements was undertaken in May 2012. There were 3 actions listed to occur as a result of the audit tabled at the June 2012 EMRPCC meeting. 1) Signing of the Memorandum of Understanding.

2) To circulate the next version of the role statement to improve awareness of performance criteria and add the role statements to the EMRPCC website.

3) To develop an orientation document for Consortium Clinical Group. The Role statement audit is attached as appendix 1.

Victorian Palliative Care Clinical Network

Associate Professor M Boughey is the Network Clinical Lead, he is also a St Vincent’s/ Caritas Christi Hospice representative on the EMRPCC. As Network Clinical Lead, Mark is also on PCCN subcommittees including the Endorsement Standing Subcommittee and Community of Practice Forum.

Ms Kylie Draper from Eastern Palliative Care has position on the PCCN. Kylie is also a member of the

Endorsement Standing Subcommittee. The role of this committee is to evaluate submitted documents prior to the final recommendations for endorsement by the PCCN.

Consortium Manager, Christine Brusamarello has been the EMRPCC representative for the past 2 years. Christine has participated in 1 community of practice forum subcommittee and is on the Endorsement Standing Subcommittee. Christine provides a link between the PCCN & the Consortium Clinical Group.

Victorian Palliative Care Satisfaction Survey 2012

The 2012 survey was conducted between mid-February and 21st May 2012. The survey captures feedback from adult patients, carers and bereaved carers from both community and in patient settings. Key findings

326 surveys were returned in 2012

35% total response rate (up from 28% in 2011 and 17% in 2010) State wide total response rate was 28%

Mean overall satisfaction was 4.68 (up from 4.63 in 2011) . The rating is out of 5 Five priority to improve areas identified in the survey are

1) opportunities to talk to other carers about their own situation as a carer

2) level of training provided to carry out specific care functions (such as massaging, moving or bathing the patient)

3) support received for Legal issues (e.g. advance care planning, medical power of attorney) 4) ongoing support to minimise financial burden

5) support received for planning ahead for funeral arrangements (if applicable)

Four of these priorities are also identified at a state level.

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Palliative Carers Resource Group

This EMRPCC working group was established in September 2011. Each EMRPCC agency involved in the 2011 palliative care satisfaction survey was identifying strategies to improve the supports for carers and a regional approach was timely. Terms of reference were developed and the group has met four times in the past 12 months. Achievements have included a regional review of information brochures handed out, discussion on regional use of a carer monitoring tool and recommendations on the EMRPCC website.

Living with Motor Neurone Disease in the EMR

Funding is received for a regional Motor Neurone Disease shared care worker from the Department of Health through MND Victoria. The shared care worker’s role is to assist palliative care services to support people living with MND and to provide information and support to service providers to understand the needs of MND clients. Within the EMR, the regional worker is based with Eastern Palliative Care who receives the EMRPCC funding. The data below is supplied to the Consortium by the MND Association and Eastern Palliative Care.

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A brief overview of regional palliative care data

For the past 3 years the EMRPCC has discussed regional trends, based on the data provided by the services. There is variation in the type of data reported across the agencies.

The following snap shot is taken from the data supplied for the 2011-2012 financial year and may not be complete.

832 people were admitted to the Wantirna Health Palliative Care Unit

Eastern Palliative Care received 1968 referrals, equating to an average of 166 referrals per month

Caritas Christi had 665 admissions, 21% of admissions came from private hospitals

40% of Caritas Christi admissions come from home with referrals mostly via community palliative care services.

These include Eastern Palliative Care, Melbourne City Mission, Banksia Palliative Care, Mercy Western Palliative Care and RDNS.

Fernlea House admitted 37 new guests to their day program

Average length of stay in Wantirna Health is 12.8 bed days Occupancy at Caritas Christi averaged 94% Discharges home from Wantirna Health increased from 21% in the first quarter of 2011/2012 to 32 % in the last quarter.

Eastern Palliative Care received 147 referrals form nursing homes or hostels

Approximately 70 RDNS clients are listed as receiving palliative care in quarterly data reports 534 people died in

Wantirna Health’s Palliative Care Unit

Inner East Melbourne Medicare Local has 188 GP practices with approximately 468 GPs

Eastern Palliative Care had 86,828 client contacts

The Eastern Health Hospital Based Consultancy team had a 13% increase in episodes of care. This is a 56% increase since 2008.

There are over 410 GPs in the Eastern Melbourne Medicare Local catchment 80% of people admitted to CCH — Kew have a malignant diagnosis There are 146 Pharmacies in the Inner East Melbourne Medicare Local catchment

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Appendix:

Each year the Eastern Metropolitan Region Palliative Care Consortium undertakes a self-audit of performance against the Department of Health, Palliative Care decision making groups—role statements.

The audit results are attached as an appendix 1

The actions arising from the audit were outlined on page 16.

Financial Reports

The financial reports will be submitted to the Department of Health when they are available and are not included as an appendix at this time

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

20 Eastern Metropolitan Region Palliative Care Consortium Annual Report 2011-2012

Background

In 2007 a revision of Victorian palliative care decision-making groups’ roles, responsibilities, structure and relationships was undertaken by the then Department of Human Services (now the Department of Health). The groups are directly linked to implementing the department’s Strengthening palliative care policy 2004–09. The decision making groups role statements are intended to support consortia activities and how they work with member services to make decisions for regional activities in a transparent way. The role statements will assist consortia in achieving effective implementation of palliative care policy into the future.

Stage two of the decision making groups project is to implement the role statements in a consistent and effective manner. To facilitate this an audit tool has been developed for use by decision making groups to assess their compliance with each of the elements contained within the role statements. Each of the decision making groups will be required to complete the audit tool and develop an action plan to address any elements where structures or processes could be improved. The action plan must include the agreed actions required by the decision making group based on the audit process, with an indication of the responsible person/agency and a completion timeline attached to each action.

Decision Making Group Role Statement

Element Established/

evident

Comment/Action required By whom/when?

PALLIATIVE CARE CONSORTIUM

Role Current regional plan Yes

Links with DH Yes

Regional governance structure Yes

Quality & risk management framework Yes

Responsibilities Organisation nominated as fundholder Yes

Consortium Chair elected Yes

Consortium Manager appointed Yes

Performance Management process for Consortium Manager

Yes Aware it occurs-not sure of process Due diligence related to fundholder

responsibilities

Yes

Consortium Executive Group Yes

Mandatory Groups – Clinical/Practitioners and/or Regional Advisory

Yes

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

evident

PALLIATIVE CARE CONSORTIUM

palliative care service

Each representative has delegated authority for their agency

Yes

One vote per DH funded organisation Yes

DH regional office representative (ex-officio) Yes

Consortium Manager (non-voting) Yes

Meets six times per annum (minimum) Yes 11 times July 2011 – June 2012 Communications Circulate DH monthly update Yes No longer a monthly update. Updates circulated

and placed on the EMRPCC website

Circulate statewide meeting updates Yes

Links with academic and statewide services Yes

Other Communication Yes

No

-Improve links to documents

- The consortium…. provides excellent

communication to members via email, the website, consortium meetings and other forums. All consortium members appear well informed as demonstrated by the ease at which decisions are reached and with general consensus. Maintaining strong relationships is probably one of the most effective ways to ensure a well functioning network, and this appears to have been be achieved through mutual respect and understanding amongst the membership….

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

Decision Making Group Role Statement Element Established/ evident Yes/No

PALLIATIVE CARE CONSORTIUM CHAIR

Role Liaises directly with DH on consortium behalf Yes

Liaises with consortium members Yes

Responsibilities Reports to DH on SPC policy implementation Yes

Represents consortium at statewide meetings Yes

Supports and performance manages Consortium Manager

Yes

Structure Elected by consortium (biennially suggested) Yes

Employed by DH funded palliative care organisation Yes

Costs associated with attendance at statewide and other meetings are met by the consortium

Yes Only if required

Communications Receives and actions DH communications Yes

Attends statewide meetings Yes

Liaises with Clinical/Practitioners and Regional Advisory/Reference groups Yes Other Decision Making Group Role Statement Element Established/ evident Yes/No Comment/Action required By whom/when? INDIVIDUAL CONSORTIUM MEMBERS (VOTING)

Role Understands consortium role Yes

Responsibilities Actively participates in regional plan development

Yes

Is authorised to make decisions on agency behalf

Yes

Reports consortium projects/issues to agency CEO (at least six monthly)

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

Decision Making Group Role Statement Element Established/ evident Yes/No Comment/Action required By whom/when? INDIVIDUAL CONSORTIUM MEMBERS (VOTING)

Champions palliative care in own agency Yes

Consults with own agency re relevant palliative care issues

Yes

Chairs consortium groups where required e.g. Clinical/Practitioners and Regional

Advisory/Reference groups

Yes

Votes at consortium meetings on agency behalf Yes Participates in funding and resource allocation

decisions at consortium

Yes Discussion at Executive meeting and general Consortia meetings

Structure Attends 75% of consortium meetings per annum

Yes No

Service not aware of this requirement  SEE attendance table

Communications Receives and actions relevant updates Yes Likes the new e bulletin

Other Decision Making Group Role Statement Element Established/ evident Yes/No

INDIVIDUAL CONSORTIUM MEMBERS (NON-VOTING)

Role Understands consortium role Yes Responsibilities Actively participates in regional plan development Yes

Reports consortium projects/issues to agency CEO (at least six monthly)

Yes

Champions palliative care in own agency Yes

Consults with own agency re relevant palliative care issues

Yes

Structure Attends 75% of consortium meetings per annum Yes No

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

INDIVIDUAL CONSORTIUM MEMBERS (NON-VOTING)

Communications Receives and actions relevant updates Yes Other Decision Making Group Role Statement Element Established/ evident Yes/No

PALLIATIVE CARE CONSORTIUM ADVISORY/REFERENCE GROUP

Role Optional – may be combined with clinical

group Yes No Decision Making Group Role Statement Element Established/ evident Yes/No

PALLIATIVE CARE CONSORTIUM CLINICAL/PRACTITIONERS GROUP

Role Mandatory – may be combined with advisory group Yes Develops resources and makes decisions based on

good clinical practice

Yes Some Current Representatives not aware of previously developed clinical resources

Responsibilities Provides advice to the consortium on clinical issues Yes Standing agenda item

Provides a forum for discussion/resolution of clinical issues

Yes -Standing agenda item

Structure Decided by consortium (chair, membership, meeting frequency and location)

Yes

The chair is a member of the consortium Yes

Communications The chair reports directly to the consortium Yes Consults with own agency re relevant palliative care

issues

Yes

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

PALLIATIVE CARE CONSORTIUM FUNDHOLDER

Role Consortium financial accountability Yes Quarterly financial reports are provided to the

consortium

Yes Monthly to Consortia and as required to DH Responsibilities Acquittal of consortium project funding and other

administrative tasks

Yes

Liaison with DH on financial accountability requirements

Yes

Structure Nominated and elected by consortium Yes Financial Accountability Statement (FAS) is

completed within 3 months of the end of financial year

Yes

FAS is lodged with relevant DH regional office Yes

The fundholder can be changed by decision of the consortium

Yes

Communications Financial reports provided to consortium/executive group/DH as required

Yes

evident

Comment/Action required By whom/when? PALLIATIVE CARE CONSORTIUM EXECUTIVE

Role Supports consortium manager to operationalise regional plan

Yes Meeting 4 times per year, general discussion and idea generation

Consortium staff recruitment and performance

management is undertaken

Yes Annual Review.

Responsibilities Reporting to consortium on all decisions for ratification

Yes Agenda item

All decisions are related to the regional plan priorities

Yes Plus governance- Risk Management, delegations, policy and processes

Support and performance management of Yes Chair meets with Consortia Manager at least 1 per

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

evident

Comment/Action required By whom/when? PALLIATIVE CARE CONSORTIUM EXECUTIVE

Consortium Manager (Chair and one other voting member)

month, regular telephone discussions. Meetings on request

Structure Consortium chair, consortium manager (non-voting) and one or two other voting consortium members. Other members optional e.g. Deputy chair

Yes

Meets face-to-face or via tele/videoconference Yes

Communications Written reports provided to consortium on any decisions made in period since last consortium meeting

No Standing agenda item

Attends all meetings Yes

evident

Comment/Action required By whom/when? PALLIATIVE CARE CONSORTIUM MANAGERS GROUP

Role Identifies common issues in implementing SPCP Yes Responsibilities A forum to provide updates and to address common

issues

Yes

Provides advice/recommendations to consortia and/or DH on common issues

Yes rarely

To meet with state wide project organisers

/managers to discuss issues and implementation of projects

Yes Guest speakers at most meetings

Structure Meets 6-8 weekly at an agreed location Yes Chair rotated annually – as agreed by members Yes T. Mander to become chair in July

DH and/or PCV representative as required Yes

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Appendix 1 Palliative Care Decision Making Groups

Role Statements Audit Tool

Eastern Metropolitan Region Palliative Care Consortium 2012

EMRPCC Meeting attendance July 2011- June 2012 attendance/number of meetings

EMRPCC Executive CCG PSN PAG Carers Resource Group

Jeanette Moody EPC 11/11 4/4 2/2 1/3 3/3

Sonia Fullerton Eastern Health 9/11 4/4 2/2 3/3

Ian Hatton St Vincent’s 8/9 4/4 2/3 2/3

Kylie Draper EPC 11/11 3/3

Ann Nugent Eastern Health 11/11

Mark Boughey St Vincent’s 6/11

Martin Hodgens RDNS 6/10

Martin Wilkinson (since Dec 2011) IEMML 2/6

Pip Bourke (until Nov 2011) IEMML 2/5

Sarah Kleinitz ERGPA 3/11 2/3

Helen Pike Fernlea 9/11 2/3

Kathy Simons NEMICS 8/11

Merissa Judkins/Sara Whitburn (Feb-May 2012) GEPH 3/4 2/3