ACT Health Proposal: Formation of two Health Organisations

Transcription

1 Newsletter: 534/2018 Date: 14 September 2018 Distribution: ACT Health members Contact: Your HSU Organiser ACT Health Proposal: Formation of two Health Organisations Dear Member, Attached is a proposal in relation to the formation of two Health Organisations that has been sent to the HSU for the purposes of consultation. Member feedback requested The HSU industrial team is currently reviewing the draft proposal and its impact on members and is seeking feedback, views and comments from members. Please review the attached document and provide comment and feedback by close of business Wednesday 19 September 2018 to HSU Industrial Officer Julie Gordon via julie.gordon@hsu.asn.au with subject line ACT Health proposal Forming two Health Organisations. Please distribute this newsletter to your work colleagues for their information and comments. Not a member of the HSU? Now is time to join and have your say! You can join online at or call 1300 HSU NSW and join over the phone. A union s effectiveness and negotiation power depends upon the strength and density of its membership base. Join your work colleagues today by becoming a member of the Health Services Union and help us continue to protect and improve your working life. In unity, Gerard Hayes Secretary, HSU NSW/ACT/QLD

2 Office of the Director-General Gerard Hayes Secretary Health Services Union NSW/ACT/QLD Branch CC: Dear Mr Hayes Consultation on Organisational Change ACT Health Transition I write in accordance with clause G.1 of the ACT Public Sector Support Services Enterprise Agreement ( the Agreement ), and other equivalent provisions of the relevant industrial instruments, in relation to organisational change. As advised in my correspondence dated 16 August 2018, the changes are largely administrative in nature, with one organisation focusing on the delivery of clinical services, and the other on strategic policy, territory-wide planning and population health. Since the Minister for Health and Wellbeing s transition announcement of 23 March 2018, ACT Health has provided information in order to engage employees, unions and other key stakeholders, in arriving at the proposed structure attached to this correspondence, including: The engagement of the Nous Group, in which Mr Robert Griew (Principal Consultant) conducted a series of consultation sessions in July with staff and stakeholders, with the aim of designing the governance relationships between the organisations; The establishment of a Transition Office, with a focus on providing multiple channels for meaningful feedback and engagement; and Staff information sessions, all staff fora, intranet updates, team meeting discussions, a Joint Consultative Committee meeting, and all staff communications. For the majority of your members, there will be no impact on their day-to-day work, with the changes largely being a change to reporting lines. You will note that there are some shared functions across the two organisitions, with the aim of enabling efficient and effective delivery of corporate services. These changes may result in more than just reporting line changes. GPO Box 825 Canberra ACT 2601 Ph: DGACTHealth@act.gov.au I

3 It is intended at this time for consultation on the attached proposal to close on 19 September 2018, close of business. I invite you to meet with the Transition Team and People & Culture to discuss the proposal. Please feel free to contact Jim Tosh, Senior Manager, Employee Services, on jim.tosh@act.gov.au to organise. Yours sincerely Michael De Ath Director-General 6 September 2018

4 Forming two Health organisations Information Pack for Staff 6 September 2018

5 In this pack: Contents Introduction... 1 The case for change... 2 Our journey... 5 The development process... 6 Proposed structures Health Services proposed structure ACT Health Directorate proposed structure Proposed changes People and Culture Quality and Safety Finance and Organisational Performance Commissioning and Performance Communications and Government Relations Governance and Risk Digital Solutions Division Strategic Procurement Health System Policy and Research Health and Medical Research Infrastructure Clinical Support Services Providing your feedback Supporting you through change Staff Information Pack Draft for consultation i

6 Introduction Background On 1 October 2018, ACT Health will become two organisations. One organisation will be focused on the delivery of clinical services, and the other on strategic policy for the health system, Territorywide planning, research and population health. This will bring: clarity of purpose, and stability of functions and responsibilities. It will position us to deliver excellence in the provision of health services to the people of the ACT. We are developing a more strategic, forward looking health service. One where we will aim to reduce the future burden on clinical services through: promoting improved community health and wellbeing improving ongoing clinical services through strategic improvement of our health system. By creating two organisations, we will be better positioned to respond to future community and population needs. We aim to shape our organisations for sustainability, and enable growth and opportunity for our staff and the community. This document provides the detail of proposed organisational structures for the two new organisations and forms a key part of the formal consultation process. The structures are subject to change after all feedback received is reviewed and considered. Two structures have been created as the result of a co-design process with a large number of staff across the organisation: the Health Services organisation structure and a structure for the Health Directorate. It is important to note that the focus of the structure design has been on the allocation of support and corporate functions across the organisations. Most of the structure of the Health Services organisation remains the same. Staff Information Pack Draft for consultation 1

7 The case for change As the Canberra community continues to grow, it is important that our health service grows alongside it, to keep up with increasing demand and changing needs. Forming two health organisations will ensure that we are in the best position to provide Canberrans with quality health care, now and into the future. This change will provide a strong focus on operational effectiveness, efficiency and accountability, with both organisations committed to person-centred care, quality, innovation and engagement. We will have two organisations that are appropriately resourced and focused on what they need to do. This will ensure clearer roles and responsibilities for staff, allowing us to focus on our core service. Why change? Because of our growing size, increase in population catchment, and the need to align to the national reform agenda, we need to organise ourselves differently. The Ministers need to be able to seek advice on policy matters from one source; this will be the role of the Directorate and it will be set up to focus on its stewardship role. The Health Services need to be able to focus on service provision and be able to make decisions on the way the services are delivered. We need to have a system that provides clarity, accountability and progress. We are moving FROM: Disconnect between information and service delivery Lack of clarity in roles, functions and process Unclear governance processes Health service not in control of the levers to manage their operation Inconsistent, sometimes conflicting, advice and policy development Poor communication with stakeholders and funded organisations, leading to poor relationships and failure to capitalise on strategic partnership opportunities Silos preventing collaboration Services unable to be delivered efficiently TO: Clear vision and purpose that all staff and stakeholders understand Aligning ourselves with better practices Alignment of functions to core purpose Targeted deployment of resources Clarity of our business and plan for the future Clearer accountability Clear governance with minimal layers, ensuring effective delivery of safe, quality, accessible and consistent health services Fit for purpose organisations More efficient and quicker decision making Decisions able to be made by people closer to the ground Consistency of healthcare, service delivery across the Territory Cooperation and collaboration Staff Information Pack Draft for consultation 2

8 Clear separation of functions to enable greater focus on the objectives of the function/organisation Greater autonomy and control to manage the health service Strengthened capability to support strategic partnerships, including research partnerships, and clear relationship management goals and outcomes Building a sustainable system with proactive and broad health prevention and health promotion to decrease demand for acute services The opportunities We are developing a more strategic, forward looking health service. One where we will aim to reduce the future burden on clinical services through: promoting improved community health and wellbeing improving ongoing clinical services through strategic improvement of our health system. For our staff, this means: renewed focus on our culture and values improved patient outcomes through more efficient service delivery fit for purpose organisations: one to deliver services, and the other to focus strategically and across the health system clearer accountabilities and a focus on improving our performance quicker and more efficient decision making two organisations able to focus on what they need to do greater flexibility to adapt to growing population and changing healthcare needs. For our patients and consumers: the transition will be a seamless one. people visiting one of the three public hospitals, our popular Walk-in Centres or in any way accessing the many community based health services that we offer will not experience any disruption as a result of the transition. over time, our patients and consumers will benefit from the change as we take advantage of the opportunities outlined above. Culture and values ACT Health has four core values: Care Excellence Collaboration and Integrity. These were developed by staff and consumer representatives and highlight the values considered most important in our work, as well as community expectations. Values represent what we believe is important and worthwhile. Organisational values support our approach to work and how we treat each other. Building a strong values-based culture is an essential part of our transition. To be successful, both our organisations need the right culture. Staff Information Pack Draft for consultation 3

9 The Director-General has been leading a substantial piece of work around improving workplace culture and values. This has been running alongside the transition process and is an important part of the foundations of the organisations we are designing. Feedback from staff indicates that there has been a significant shift in the positivity of the workplace over recent months. This was particularly evident through the accreditation process, during which staff made many great improvements in a short period of time to ensure ACT Health was re-accredited for another three years, the maximum allowable period. This work on building a positive workplace culture centred around our values will continue as we transition and beyond. Staff Information Pack Draft for consultation 4

10 Our journey On 23 March 2018, the Minister for Health and Wellbeing and the Minister for Mental Health announced a decision to create two distinct organisations from ACT Health. This is all about making sure Canberrans get the best possible care and continue to be the healthiest people in the country. With our health system expanding and increasing demand on our health services, now is the perfect time to move towards a more contemporary health system. This separation will enable a clearer focus on operational effectiveness and efficiency, and improve accountability for health service delivery. Minister for Health and Wellbeing Meegan Fitzharris, 23 March This separation will facilitate improved mental health services delivery, while also allowing mental health policy to improve its focus within Health and across Government. Minister for Mental Health Shane Rattenbury, 23 March Key activities and events Since this announcement in March, the following has occurred: 9 April Michael De Ath commenced as Interim Director-General ACT Health 23 April Mr De Ath announced the Form and Function review of ACT Health to improve alignment and clarity of functions May June May Form and Function engagement and design Head of Service engages Nous Group to make recommendations on the high level governance for the two new organisations 7 June Proposed Interim Structure for ACT Health resulting from the Form and Function Review is released for formal consultation 16 July Interim ACT Health Structure is implemented July June August August Engagement with staff, executives and external stakeholders to seek views on the Nous Group s Draft Governance Report Workshops, forums, group and individual meetings held to develop design principles, review functions, and help shape the new organisations. Collaborative leadership event with over 140 leaders to discuss functional allocations and core processes Nous Group report finalised. This report informs the development of the Administrative Arrangements to establish the organisations 31 August Proposed organisation structures completed We are now seeking your feedback on the proposed structures. This consultation period commences on 6 September and will end on 19 September Staff Information Pack Draft for consultation 5

11 The development process The transition to two organisations is occurring through a phased approach as shown in the diagram below. A detailed overview of the approach can be found at Appendix A. A Transition Office was established to lead this work. The work of the Transition Office is governed by a steering committee chaired by the Director-General. Information about the governance of the project can be found on the intranet at: Design process The process of designing an organisation follows a four step methodology and considers the topics shown below. Staff Information Pack Draft for consultation 6

12 Designing the structure A co-design process has been undertaken to ensure the functions and structures of the two organisations are developed in collaboration with staff and stakeholders. Over the past seven weeks a series of workshops have been held with the executives, leaders and subject matter experts from across ACT Health to undertake this co-design process. The workshops covered: Developing a shared vision and guiding principles for the change How we will ensure the two organisations will provide better health outcomes for our community Defining the purpose and functions of the organisation Developing guidelines for how functions would be allocated across the organisations The development of a Target Operating Model The allocation of functions. In designing the structure, the Transition Office has engaged with staff and stakeholders through: Design Principles Just like drafting plans to build a house, we needed a list of specifications for the two new organisations. The design principles for both organisations are: Focus on person-centred service outcomes Transparency in accountability, being clear who does what Clearer relationships with service users and partners Focus on quality outcomes Prioritise data and information management capability Leadership capability as well as technical expertise Staff Information Pack Draft for consultation 7

13 For the Health Service: Focus on service delivery, quality and standards management Full responsibility to provide health care service delivery to national benchmarks Transparency of end-to-end financial and service performance. For the Directorate: A focus on whole of government health strategy and policy, assets and system performance. Governance frameworks and regulations to ensure quality health outcomes. Stewardship of the health system. Underlying principles In addition to the design principles, the following principles were applied to the development of the structure: There will be two distinct organisations separated by responsibilities for the delivery of health services and the strategic policy and planning functions for the ACT. The transition will be enabled through Administrative Arrangements and Delegations, not through legislative change. There will not be a Board structure governing the two organisations. The two organisations will be established as individual directorates. The CEO of the Health Services and the Director-General of ACT Health will have distinct roles in the system. They will both report to the Head of Service and both will have relationships with Ministers. They will function as interdependent, closely connected, components of the health system working toward a shared vision and strategy. The Health Service will receive its own funding appropriation. This will be made through the ACT Health Directorate and then pass through to the Health Service. This enables both transparency and appropriate financial management of the appropriations. Likewise, budget bids from the Health Service will pass through the Directorate to facilitate cohesion, coordination and progression to ACT Treasury. Any changes to the structure of clinical operations within CHHS will occur after 1 October 2018 through another program of work under the direction of the CEO. There will be no additional funding to manage the individual organisations. The transition and establishment must be managed within the existing budget envelope. All existing functions and services are required as part of the new organisation, as a result, it is not anticipated that there will be any voluntary redundancy program. Service Level Agreements will be developed between the organisations to ensure core responsibilities, delegations and performance expectations are clarified. No functions will be outsourced as a result of this restructure. Staff Information Pack Draft for consultation 8

14 Defining the functions Once the design principles were established, the next phase of the process commenced, which was establishing which functions are needed where, to best support the core business of each organisation. Core Functions The core functions of each organisation are listed in the table below. Please note this is not an exhaustive list of every activity in Health, but shows the main activities to be performed by each organisation. These functions have been verified through the collaborative leadership workshop, executive workshops and corporate services workshop. Health Services ACT Health Directorate Purpose To deliver quality, safe and consistent health services To enable quality, safe and consistent health services across the ACT through research, strategies, policies, commissioning and regulation. Core Functions Provide acute, subacute and community-based health services Maintain quality and standards clinical care Achieve key performance indicators with respect to clinical care Manage and monitor levels of operational and clinical risk Improve patient outcomes through clinical quality reporting and analysis Build culture of high performance and multidisciplinary care and improvement Meet legislative, regulatory and compliance obligations as they relate to clinical care Manage financial performance and have visibility and control over direct health costs including workforce, supplies and equipment and planned/reactive maintenance Manage integration of health services with primary health Participate in preventive and community health campaigns Plan and direct schedule of infrastructure works to maintain safety and operational needs of staff and facilities Influence long-term health planning Advise the DG and Minister/s of any issues of public concern or risk Develop Territory-wide planning for integrated, holistic, health services from population and preventive health, community and primary health and sub-acute and acute care Provide support functions for strategy and planning including workforce, technology and infrastructure Appropriately advise Minister/s and government of key strategic and operational outcomes/plans and risks Promote, protect, maintain and monitor the health of the population Represent the Territory and contribute to national forums Develop, communicate and maintain strategic policy and frameworks for multiple health facilities Define and maintain clear governance and accountability frameworks Promote excellence and improvement in research and Territory-wide professional leadership Allocate and distribute funding across the ACT health system and manage responsibilities according to the Commonwealth funding agreement Define requirements and purchase additional health services/high-value products and equipment Monitor compliance, report and regulate performance of health facilities and related to public health Staff Information Pack Draft for consultation 9

15 Target Operating Model The Target Operating Model shows, at a high level, the basic functions that need to be performed across both the Directorate and Health Services organisations to deliver integrated, end-to-end health services in the ACT. It shows the pattern of activities from strategic planning and policy on the left, through compliance, regulation and reporting, population health, community and primary health to sub-acute and acute health services. The primary responsibilities at a Directorate level are for strategic planning, population health and compliance, regulation and reporting across the health system. The Directorate plays a system stewardship role and is the primary source of advice to Ministers on health policy. The primary responsibility and accountability for the delivery of health services and operations rests with the Health Services organisation. Support Functions To ensure each organisation is able to function effectively, corporate functions are needed to support both organisations. Due to our goal of minimising duplication and staying within our budget, these functions were reviewed in depth to identify the best way these services can be provided. The services included Human Resources, Finance, ICT, Ministerial and Government Services, Communications, Infrastructure and Procurement. Staff Information Pack Draft for consultation 10

16 Proposed structures This section outlines the proposed structures for the Health Services and ACT Health Directorate. Important things to note when reviewing these structures are: The Health Services structure focuses on the functions that are being added. The majority of the existing structure, in particular the clinical services of CHHS remain the same. The structure diagrams highlight the executive and director level units. Some teams are not highlighted in the structure as their reporting lines within their branch remains the same. This does not mean they are forgotten. However, if you are concerned about a function or team not being represented, please speak to your manager, or contact the Transition Office. A more detailed explanation of the changes to corporate and support functions is provided on the pages following the structures. Governance Both organisations and their leaders are responsible to the Minister for Health and Wellbeing and the Minister for Mental Health. The diagram below from the Nous Group report shows the nature of this governance relationship. The diagram shows that while the Director-General and the CEO will both have relationships with the Ministers and will provide advice to the Ministers in their area of responsibility, the Directorate as the steward of the Territory s health system will be responsible for reporting on system-wide issues and policy advice. This diagram shows the flow of information to the Ministers, it does not mean that the CEO has a reporting relationship to the Director General. Source: Nous Group Report Developing new Governance Arrangements for ACT Health Staff Information Pack Draft for consultation 11

17 Health Services proposed structure Coordinator Staff Information Pack Draft for consultation 12

18 ACT Health Directorate proposed structure Staff Information Pack Draft for consultation 13

19 Proposed changes The next few pages provide details on the proposed allocation of support functions and how the functions will be delivered in each organisation. Important things to note when reviewing these structures are: It is expected that Service Level Agreements (SLA) will be developed between each organisation specifying the performance and service delivery expectations of shared functions. An SLA is a formal document that defines a working relationship between a service provider (for example Digital Solutions Division) and a client (for example the Health Service). Some of the functions will be transferred as complete teams to the Health Services organisation. Some functions will be replicated in each organisation to maintain a high level of support where required. Some functions will be delivered across both organisations and use a mix of embedded (or in-business) teams, business partners, or account managers. Where there are solid lines between areas this means it is a direct reporting relationship. If the line is dotted, then that means an informal reporting relationship is required. The structures follow the hierarchy: Group (usually at DDG level ) Division (Executive Director or Senior Director level) Branch (Business unit led by a Director or Senior Manager). After all feedback has been reviewed and considered, each team impacted by the changes will have more information about what this means for the team and its members. The following pages describe the changes proposed to: People and Culture Quality and Safety Finance and Organisational Performance Communications and Government Relations Governance and Risk Digital Solutions Division Strategic Procurement Health Systems, Policy and Research Health and Medical Research Infrastructure Clinical Support Services Staff Information Pack Draft for consultation 14

20 People and Culture Staff Information Pack Draft for consultation 15

21 Quality and Safety Staff Information Pack Draft for consultation 16

22 Finance and Organisational Performance Staff Information Pack Draft for consultation 17

23 Commissioning and Performance Staff Information Pack Draft for consultation 18

24 Communications and Government Relations Staff Information Pack Draft for consultation 19

25 Governance and Risk Staff Information Pack Draft for consultation 20

26 Digital Solutions Division Staff Information Pack Draft for consultation 21

27 Strategic Procurement Staff Information Pack Draft for consultation 22

28 Health System Policy and Research Staff Information Pack Draft for consultation 23

29 Health and Medical Research Staff Information Pack Draft for consultation 24

30 Infrastructure Staff Information Pack Draft for consultation 25

31 Clinical Support Services Staff Information Pack Draft for consultation 26

32 Providing your feedback Consultation on the proposed structures for the two new organisations has now commenced and will close on 19 September 2018 This is your chance to provide feedback and tell us: where we may have missed an opportunity to improve the way we work if there is something that does not make sense your concerns about the structure, or what you think will be of benefit to your work. There are a number of ways for you to have your say - you can choose any method that suits you. You can: Provide feedback to the Transition Office through your manager Fill out an online survey form about your views on the proposed changes (this feedback will be anonymous unless you provide your name in the feedback) Send feedback directly to the Transition Office by: o ing healthtransition@act.gov.au o calling o filling in the online feedback form on the transition intranet page. Place your comments or questions in feedback boxes, which will be rotated around various locations at CHHS and Bowes Street. All feedback will be considered. Any changes made as a result of feedback, along with a consolidated response summarising the feedback, will be provided to all staff at the conclusion of the consultation process. While giving feedback through the intranet feedback form or the online survey form anonymously is an available option, in line with the positive culture being promoted, we would encourage you to express your opinion openly. What will happen next? It is important to recognise that 1 October 2018 represents the beginning of our next phase. From 1 October, we will have two Health organisations established and core functions allocated to each organisation. After 1 October, we will need to focus on stabilising and refining our organisations to make sure that we continue to evolve and improve. This will allow us to further refine processes and internal structures once the organisations are fully established. Your feedback will continue to be a key element of this phase. Staff Information Pack Draft for consultation 27

33 You can expect that after 1 October, we will: Continue to refine the structures this includes identifying any areas where there may be gaps, or unintended consequences resulting from the change. Update and refine relevant committees and governance arrangements to ensure opportunities for collaboration are built in to the system. Review and update Service Level Agreements to ensure the organisations are delivering to the correct standard and expectations. Work with the CEO to refine the structure of the Health Services organisation to ensure it has the right people in the right places to deliver its objectives within existing resources. Review, build capability and improve the functions of procurement, commissioning, data management and reporting. Update all relevant policies, procedures, delegations manuals and business processes to reflect the new methods of operating. Supporting you through change People deal with change in different ways, often depending on their personal experiences with change in the past. During changes such as these, it is important that you feel supported, and know how to access support. Workshops Organisational Development delivers workshops to support staff and managers through the transition process: For managers: Leading People Through Change workshop For staff: Understanding Change workshop. Details of available workshops will be provided on the Intranet. If you have any questions, you can contact the Organisational Development Unit at healthorgdev@act.gov.au or on Support options The document Dealing with Change is also available on the intranet for you to read. If you need any help or support during this transition period, the following options are available: discuss your concerns with your manager contact the Transition Office at healthtransition@act.gov.au or contact Organisational Development at healthorgdev@act.gov.au or on access the Employee Assistance Program. Staff Information Pack Draft for consultation 28

34 APPENDIX A Staff Information Pack Draft for consultation 29

35 Accessibility If you have difficulty reading a standard printed document and would like an alternative format, please phone If English is not your first language and you need the Translating and Interpreting Service (TIS), please call For further accessibility information, visit: Phone: Australian Capital Territory, Canberra July 2018