1. Health Networks in Western Australia Dr James Flexman Clinical Co-Lead Infections and Immunology Health Network

2. Why Health Networks? • The major weakness evident in the Western Australian health system is a lack of integration across its component agencies • Planning has been isolated from clinical expertise and consequently implementation of plans and recommendations has been difficult Metropolitan Health Services Review, Final report to the Government of Western Australia, Deloitte Ross Tohmatsu (1991)

3. Health Networks are… • A group of interested people and organisations including health professionals, patients, careers, consumers and others, coming together to help plan and develop health policy and services across the state. • A means of providing a new collaborative focus across all clinical disciplines toward prevention of illness and injury and maintenance of health for all Western Australians.

4. Health Network Outcomes POLICY Leading and facilitating the development of evidence based policy. PRIORITIES Aligning Health Network activities with the WA Health Strategic Intent, focusing on the promotion of health and wellbeing. PERFORMANCE Driving performance indicators across the system adding value by providing opportunities for informed collaborative action PROTOCOL Providing opportunities to develop systems and work practices that improve clinical expertise and encourage best use of both physical and intellectual resources PEOPLE Providing opportunities for leadership. Identifying and advising on opportunities to improve clinical workforce support, teaching and training PLANNING Strategic and operational planning for health and health service delivery is informed by Health Network advice.

5. WA Health Operational Plan 2006-08 – Health Networks • Participate in the development of resource allocation priorities • Participate in the deployment of approved Commonwealth health initiatives • Develop & inform the health and medical research agenda • Provide leadership on key issues regarding the implementation of the WA Health strategies related to the Australian Better Health Initiative • Incorporate National Service Improvement Frameworks into Network terms of references & plans

6. Health Networks in other jurisdictions NSW Health - Greater Metropolitan Clinical Taskforce • Established interventional cardiological procedures at several hospitals, improving standard of care • Set up acute stroke units in outer Sydney • Reduced waiting times for living related donor renal transplantation • Provided uniform clinical protocols • Implemented data management programs they designed

7. Health Networks in other jurisdictions SA Health - Statewide Cardiac Network • Improved outcomes for patients with acute coronary syndrome • More efficient systems for maintaining stocks of high cost drugs • Point of care blood tests and wireless broadband for ECGs enabling almost instant cardiologist review regardless of where the patient presents • Better support for rural GPs and practice nurses

8. Health Networks in WAThe challenges ahead.. • Building partnerships that enable a system wide view over institutional view • Delivering horizontal networks as opposed to vertical hierarchies • Becoming comfortable with fuzzy boundaries

9. Benefits of being involved • Influence the future shape of WA Health • Receive recognition as a leader • Make a real contribution • Embed a focus on prevention and maintenance of health • Build effective integration across service providers • Strengthen links and information exchange across WA Health • Provide input to health plans which are based on needs of patients and services rather than buildings and organisations

10. Current Health Networks www.healthnetworks.health.wa.gov.au • Acute Care • Aged Care • Cancer and Palliative Care • Cardiovascular Health • Child and Youth Health • Digestive • Endocrine • Falls Prevention • Genetics

11. Current Health Networks • Infections and Immunology • Injury and trauma • Mental Health • Musculoskeletal Health • Neurosciences and Senses • Renal • Respiratory health • Women and newborns’

12. Models of Care that have been developed www.healthnetworks.health.wa.gov.au/modelsofcare/ • Chronic kidney disease • Coeliac disease • Diabetes • Cystic fibrosis • Sexually transmitted infections • HIV • Palliative care • Stroke • Falls

13. Infections and Immunology Health Network

14. Current Structure • CO-LEADS • Dr Jim Flexman Clinical Microbiologist, RPH and Pathwest Laboratory Medicine WA • Dr Lewis Marshall Sexual Health Physician, Fremantle Hospital • Julia Fallon-Ferguson Senior development officer

15. Network Executive 2007 Dr Wendy Cheng Hepatology (Digestive Network) • Ms Crystal Connelly Nursing • Dr Charles Douglas WACHS • Mr Michael Doyle Aboriginal Health • Prof Martyn French Immunology • Ms Michele Kosky Consumers • Ms Trish Langdon NGOs • Dr Richard Loh Paediatrics • Ms Gae Sawyer GP Divisions • Dr David Speers ID Physicians • Dr Paul Van Buynder CDC DOH • Dr Rhyon Johnson General Practice

16. Network Executive 2008 Dr Wendy Cheng Hepatology (Digestive Network) • Ms Crystal Connelly Nursing • Dr Charles Douglas WACHS • Dr Sandra Thompson Aboriginal Health • Prof Martyn French Immunology • Ms Michele Kosky Consumers • Ms Trish Langdon NGOs • Dr Tony Keil Paediatrics • Ms Gae Sawyer GP Divisions • Dr John Dyer ID Physicians • Dr Paul Van Buynder CDC DOH

17. Subgroups • WA Infectious Diseases Physicians Group • 14 ID physicians • NGOs • FPWA, Hepatitis Council, SECCA, Silver Chain, WAAC and WASUA • Nurses • 40 nurses from a wide range of disciplines • Clinical Immunology Interhospital Liaison Group ( 2008 )

18. Protocols and guidelines To be patient centred: • Staphylococcus aureus bacteraemia • Post splenectomy immunisation • Post exposure Prophylaxis for HIV • Statewide anaphylaxis Service • Working with Health Networks branch on guideline distribution strategy

19. Advocacy Education and prevention • Prevention and education included in Models of Care • WA Health Promotion Strategic Framework • Partnership with Office of Safety and Quality in Health Care • Hand Hygiene • Public Health Act • Influenza strategy • Immunisation policy • Anaphylaxis service

20. Service delivery inc Policy To be Patient centred and including: • Sexual health services • Aboriginal sexual health • Migrant health • Hepatitis and HIV • Allergic Disease

21. Service delivery inc Policy • Model of Care STI • Model of Care Hep C • Model of Care HIV • Staff Immunisation register • Telehealth • TB control-advocacy role

22. Workforce • Training for HCW’s e.g. e-learning in infection control • On call support for GPs • Training and education included in Models of Care • Advanced practice roles for nurses included in MOC • Research and education forum March 2008

23. Research and Education • Support Research centres • Data management and collection e.g. State-wide clinical database for HCV • Encouraged applications to SHRAC for research grants • Chlamydia research proposal developed with wide network support for SHRAC process • Letters of support for Raine Foundation applications • Support for the development of e-Learning projects • Questionnaire on how to promote research agenda • Research Forum held 18th March 2008 included social research and the community perspective

24. Partnerships • Partnerships established through EAG members e.g. NGO’s • Collaboration with Digestive Network re Hep C MOC • Immunologists review of Coeliac disease MOC for the Gastroenterology Network • SHRAC application for research • HICWA • Other Health Networks • Communication links between CDCD and Microbiologists and Infectious Diseases Physicians • General Practice e.g. WAGP Network and GP’s • PathWest Laboratory Medicine WA

25. Priorities for 2008 • Implementation strategies for models of care and guidelines that have been developed • Continue ongoing projects • Model of care for allergic disease • Statewide support for infection control • Guideline on the management of central nervous system infections • Antibiotic stewardship • Consumer information on models of care • Review of refugee health in collaboration with other networks