AOP Executive Summary

The purpose of the Area Operations Plan for South Western Sydney Area Health Service (SWSAHS) is to assist in achieving the following objectives for SWSAHS:

This has involved an analysis of the current and future operating environment for all aspects of the Area’s business. This has resulted in a strategic view of the implications for the Area in relation to roles of facilities, possible staffing requirements, bed capacity, priority services areas and how we can influence the future rather than just reacting to it.

The AOP will not detail specific service strategies. Priority areas for action are identified that will be supported by more detailed service and facilities planning. This will initially be undertaken in relation to the service priority areas identified, but will eventually be completed for all service areas.

The following objectives, strategies and targets arising from the AOP have been linked to the Area’s principles for prioritisation.

Objective	Strategies	Target
Equity	Flow Reversal	82.6% self sufficiency in acute services by 2001 84% self sufficiency in acute services by 2006
	Geographic equity	Distribution of beds consistent with outcome of Service Analysis process and agreed service networks Budgets allocated based on output based funding
	Program share equity	Development of a process to enable comparison of shares between programs
Efficiency	Networking	Implementation of networks for acute services as defined through the Service Analysis process Networks for non acute services and mental health identified
	Benchmarking	Benchmarks identified and agreed for services and Sectors to achieve
	Integrated care	Support of GP shared care 11 Priority Areas develop continuum of care processes
	Achieve reductions in inpatient length of stay where effective	Achieve LOS of 3.1 days by 2001 Achieve LOS of 2.7 by 2006 Develop an Ambulatory Care Plan
	Increase day only and ambulatory services as appropriate	Achieve or better specific day surgery targets Achieve target of 60% of all surgery and 45% of all admissions on a same day basis by 2000 Develop response to increasing demand for emergency services
	Set efficiency targets	Set efficiency targets Invest "upstream" to achieve reduced or shifts in demand
Effectiveness Defined for SWSAHS as doing the work to achieve the most health gain	Decisions on investments made with regard to evidence of effectiveness	Identify and measure health outcomes of services/interventions for the 11 Priority Areas initially Investment of Area resources in services that have evidence of most benefit Determine priorities for service investment and review current balance of investment in services Identify service networks and any gaps and complete service plans for the 11 Priority Areas
	Increase the use of underutilised effective intervention and decrease the use of over used ineffective interventions	Identify appropriate admission rates for high demand areas Agree waiting list targets with Area Health Services to prevent outflows if SWSAHS sets service limits Collect or conduct research of the evidence of the health outcome of interventions Develop outcome measures where these are not available such as in community health
	Implement evidence based practice	Develop guidelines for the management of each service type (acute and non acute) as appropriate Implement already agreed evidence based treatment guidelines and protocols
Acceptability	Inform the community of how health care be in the future	Provide information to and take opportunities to include staff, GPs, other service providers and the broader community, in considering future changes in health care
Acceptability	Involve the community in decision making regarding relative investment	Develop a community consultation policy and implement recommendations

Two main phases in the Area Operations Plan to 2006 have been identified as follows:

This phase addresses the three and a half years 1999/00, 2000/01, 2001/02 and the first 6 months of 2002/03. The significant components in phase 1 involve the following:

While phase 2 largely involves the Macarthur Strategy, Macarthur will contribute to flow reversals in phase 1 through the agreed service networks. However, its main effect will be from mid 2003 when Campbelltown Hospital opens at upgraded levels of service and with additional bed capacity. This will contribute to reversal of out-of-Area flows as well as enable further tertiary growth at Liverpool by reversal of flow of Macarthur residents from Liverpool back to Macarthur (intra-Area flow reversal). This phase will also continue flow changes commenced in phase 1.

The Area Operations Plan (AOP) for South Western Sydney Area Health Service (SWSAHS) outlines the whole of Area approach to the identifying the most effective and efficient mix, level and distribution of services required for SWS’s population health needs and to improve their health status.

The AOP is based on the following planning principles that bring together the two streams of SWSAHS’s purpose of Better Health, Good Health Care. These principles arise from the three Key Challenges in the Strategic Directions Statement concerning equity (3), efficiency (4) and effectiveness (5). The seven Key Challenges are provided at Appendix A for information.