A HEALTHY STATE (4) To establish a process leading to a five-year plan, including an implementation strategy for health in SA, to be completed within 12 months of the 2018 election. Such a plan will address all aspects of public policy relating to the achievement of health and not be confined to the Health portfolio. A Marshall Liberal Government will develop a strategy for health within the first year, with a number of plans linking to it. We appreciate that any health strategy needs to link to health-related policies in other portfolios. Unlike the Weatherill Government s Transforming Health reforms which focused on metropolitan public hospitals, our strategy will be broad taking in areas such as preventive health, chronic disease management, and mental health, as well as clinical governance and workforce planning. To recognise the impacts of education, employment and housing in particular as social determinants of health that must be acted on as matters of urgency. The Liberal Party recognises the significant impact of the social determinants of health. To adopt environmental policies consistent with world sustainability, including action on climate change, rejection of greater involvement in the nuclear fuel cycle and improvement to quality of water, air and other elements of the environment in the interests of health. The Liberal Party recognises that a clean and healthy environment is key to South Australia s future. A sustained focus on public health will ensure that the environment in which we live is free of contamination and the foods that we eat nourish us rather than harm us. The Liberal Party does not support the building of a high level nuclear waste repository in South Australia and has ruled out expanding South Australia s involvement in the nuclear fuel cycle. To act in specific ways to address the needs of communities and individuals affected by factors that promote social isolation, disengagement and discrimination. In particular, this will require action to address the needs of our first peoples, refugees and displaced persons, and that such plans be developed and implemented in consultation and with the agreement of these groups. PUBLIC HOSPITALS (6) The Liberal Party understands that not everybody s needs are the same. In particular, Aboriginal South Australians and people from other culturally diverse groups need to have their health needs met in culturally appropriate ways. Our longstanding support for the establishment of a permanent renal dialysis facility on the APY Lands is a tangible example of this commitment. 1 P a g e
That all nursing and midwifery executives be employed under the terms of the SA Public Sector enterprise agreement (modified for their classification) and provided tenure to ensure their capacity to safely advocate for nursing/midwifery and for patients. A Marshall Liberal Government will ensure that nursing and midwifery executives are supported and enabled to raise issues in relation to the care of their patients and professional issue. That SA Health and LHNs be required to implement policies that give effect to nurse/midwife-led discharge processes within 12 months of the 2018 election. The Liberal Party supports the use of nurse/midwife-led discharge processes in accord with best practice models of care. A Marshall Liberal Government will encourage SA Health and LHNs to develop and implement policies on such discharge processes. LHN s will be required to report on progress within 12 months of the 2018 election. That all LHNs be required to implement standardised clinical pathways for all highly utilised clinical interventions to improve care quality and consistency, and help to manage patient stay. The SA Liberals supports the development and implementation of standardised clinical pathways for all highly utilised clinical interventions. That SA Health, in negotiating performance agreements with LHNs, be required to separately allocate activity and funds for elective and emergency/urgent care, with emergency/urgent care funded to the actual levels encountered at the hospital level. The SA Liberals support Board-level governance of LHNs. Boards will have significant autonomy in the allocation of resources, across the spectrum of elective and emergency/urgent care. At this stage, we would not expect to need to prescribe the split between elective and emergency/urgent care. Provide ongoing funding to continue to expand the highly successful RNAO BPSO Program and the implementation of RNAO BPG s across all health care sectors in South Australia. A Liberal Government will be keen to support innovative, evidence-based programs, such as RNAO BPSO. Support and resource executive Nursing/Midwifery leadership roles across all SA Health services and the adoption of the Nursing Now Campaign. SA Liberals support the development of the nursing/midwifery leadership, including executive positions within leadership. We will work with the ANMF to assess the value of the Nursing Now campaign being launched early this year in the context of other professional development 2 P a g e
opportunities for nursing staff. EMERGENCY CARE (2) That services offering emergency care will be retitled to clearly reflect their capacity to meet the needs of people attending for care. These titles should include Trauma Centre (for the most complex care), Emergency Care (for more complex but not tertiary level care), Casualty Services (for minor accidents but requiring 24-hour medical coverage) and Minor Injury services (nurse-led support and care for minor injuries and illnesses). The SA Liberals recognise that current SA Health s emergency care service information is not currently effective in conveying what level of care is available at each site. That is unsafe and needs to be clarified. We believe that Transforming Health has further muddied the waters in terms of where emergency care is available. If elected to Government, we will work with clinicians and their representative bodies, professional and industrial, to provide clarity and improve communication. Apply financial penalties to LHNs breaching the four-hour targets for stay in emergency care when there are meaningful alternatives available to them for care of patients requiring admission, such as opening flex bed capacity, opening closed wards, or making use of appropriate alternative areas for ongoing care. While we support incentives towards best practice, we need to make sure that they are well-constructed and that they do not act as an incentive to diminish service at other stages of the patient journey. We note the public concerns of the Principal Community Visitor that such penalty schemes may currently harm patient outcomes in the mental health area. NURSE LED PRIMARY CARE & URGENT CARE SERVICES; DAY ONLY SERVICES; SUBACUTE SERVICES AND CARE COORDINATION AND ACCESS (4) Implement nurse-led primary care clinics, such as those operated in Ontario, Canberra and Western Australia, with a firm commitment to open pilot units at Modbury, Noarlunga and Central Adelaide within 12 months of the 2018 election. Establish day only hospitals within the campuses of The Queen Elizabeth Hospital The State Liberals are committed to strengthening public health, preventive health and primary health. Nurses are wellplaced to make strong contributions in all three domains. However, we would not want to mandate particular models without prior consultation with relevant professionals and the LHN boards. The State Liberals support the development of day surgery and the infrastructure to 3 P a g e
and the Noarlunga and Modbury Hospitals in order to improve the delivery of elective surgery and procedures. Implement nurse-led convalescent services, both inpatient and community based, in all metropolitan LHNs. Implement Nurse/Midwife Consultant/ Navigator roles in SA with an initial target of 50 such new positions within two years of the 2018 election. support it. Commitments to projects beyond those already funded will be made at the appropriate time. We support LHNs deploying nurse-led convalescent services. The rate of development will be determined in conjunction with the boards. We support Nurse/Midwife Consultant/ Navigator roles in SA, in particular, in managing care beyond hospitals. Planning to meet the future demand for these roles would be a key part of workforce planning. WORKFORCE (9) Introduce a deliberate policy of reaggregating work to full-time roles to levels that meet workforce demand. This process should require agreement at the local hospital level over advertising any roles as part-time or casual until greater balance has been restored. Provide at least 100 advanced practice scholarships each year for the life of the next government. Require each LHN to develop workforce strategies and plans that can be aggregated at the state level to ensure the future capacity of the workforce. Require SA Health to undertake workforce planning in collaboration with ANMF (SA Branch) to address current and future supply issues, particularly in relation to areas of specialist practice such as mental health, critical care, perioperative, aged and, although separately licensed, midwifery. Task workforce planning to address advanced practice roles and, in particular, the sustainability of Nurse Practitioner roles. Require SA Health to collaborate with ANMF (SA Branch) to review staffing standards necessary to support decision-making in Our overarching goal is to recruit and retain a quality workforce. A Marshall Liberal Government will insist that SA Health and Local Health Networks optimise the mix of full-time and part-time roles to meet that goal. We recognise the value of advance practice in nursing and midwifery. We will fund expanded opportunities for training, in conjunction with the implementation of workforce plans. Under a Marshall Liberal Government, SA Health will engage LHN s in the development and implementation of statewide workforce strategies and plans. LHN s will manage regional planning and implementation. The State Liberals consider that health workforce planning, which engages professional and industrial organisations, is vital to ensure we maintain sufficient quality health care professionals to meet current and future needs. Workforce planning will include planning to meet the need for advance practice roles, including nurse practitioners. A Marshall Liberal Government would require SA Health to work with the ANMF to undertake ongoing reviews of staffing 4 P a g e
areas of ambulatory, outpatient and community-based services and any others not afforded protection under current arrangements. Undertake a skills mix study over the coming two years to review the evidence of skills mix impact on patient outcomes, nurse satisfaction and retention, and costs. Support the regulation (licensure) of personal care workers (however titled) under the authority of the Nursing and Midwifery Board of Australia (NMBA) in the interests of the public. Advocate for Commonwealth funding and the implementation of mandated minimum staffing levels and skills mix in the aged care sector. standards across a range of domains. We would expect workforce planning to consider skills mix and are open to the proposal put forward. We support the regulation of unregistered aged care workers who provide direct care under the National Code of Conduct for Health Care Workers. We support the current practice of staffing South Australian Government-run residential aged care facilities at higher levels than most other aged care facilities and will advocate for increased Commonwealth funding to support these enhanced levels of nursing care. PROFESSIONAL PRACTICE MATTERS (9) Support the development of a mental health nursing model of care that is underpinned by professional standards recognising the unique specialised role within health care. Support the development of principles that underpin the concept of advanced nursing/ midwifery practice, including prescribing, in addition to the development of relevant prescribing models. Establish additional community/primary health care services to allow for greater access to timely care in an appropriate environment. Investment in community, preventative and lifestyle programs. The SA Liberals support this position. The SA Liberals support this position. The SA Liberals recognise the importance and value of providing South Australians with greater and more timely access to community and primary health services. A Marshall Liberal Government will support community-wide health and prevention services with the aim of reaching all South Australians. We will invest in preventive health and work to rebalance health service funding. Our commitment to spend $5 million on a Bowel Cancer Prevention Initiative is a tangible example of our determination to ensure South Australians have access to key procedures and treatment when and where they need them. 5 P a g e
Genuinely consult with ANMF (SA Branch) in developing a sustainable model to support the expansion of the Nurse Practitioner and Nurse/Midwife Consultant roles in aged care and primary health care. Provide adequate resourcing and funding for Midwifery Services in regional and rural and remote settings, including funding for Registered Nurse/Midwife collaborative graduate programs. Incentivise rural and remote Registered Midwives to undertake training for dual registration, giving them a broader scope of practice in their health setting. Promote the regulation and licensing of Personal Care Workers (however titled) by the NMBA. Draft voluntary euthanasia legislation in collaboration with an expert committee including palliative care physicians, nurses and consumer advocates, based on the Victorian and recent SA Bills, to allow for its introduction as a Government Bill within 12 months of the election. Effective prevention requires dedicated longterm action in many areas of our community. Yes, in conjunction with workforce and service planning. Yes, in conjunction with workforce and service planning. Yes, in conjunction with workforce and service planning. We support the regulation of unregistered aged care workers who provide direct care under the National Code of Conduct for Health Care Workers. Each Parliament in recent years has considered a euthanasia bill. We expect that the same will happen in the next Parliament. A euthanasia bill will be subject to a conscience vote for Liberal Party members. INDUSTRIAL RELATIONS (8) Provide a clear and unambiguous commitment to supporting the maintenance of penalty rates, at least at current levels, through all available means including the use of legislation if necessary. We will support maintenance of penalty rates at current levels. Intervene in any case before the Fair Work Commission to support the penalty rates of nursing and midwifery staff in private/nongovernment services in SA should there be any attempt to attack their application in those sectors. We would consult with the ANMF and all other stakeholders before making any decision on whether to intervene or not. Not to impose public sector wide wages or Any public sector wide wages or conditions 6 P a g e
conditions policies that do not properly consider and respond to the nursing and midwifery workforce. policies will properly consider and respond to the nursing and midwifery workforce. Approach enterprise bargaining under the principle of gainsharing. We are prepared to discuss and consider any sensible approach to enterprise bargaining, including gainsharing. Not to attack the capacity of enterprise agreements to deal with matters presently contained within them. We will not attack the capacity of enterprise agreements to deal properly with matters presently contained within them. Recognise ANMF (SA Branch) as the bargaining agent, principal union and professional organisation for nursing and midwifery employees, and afford our representatives with the appropriate rights and supports to undertake their work. We recognise the ANMF as the key bargaining agent and principal union and a key professional organization for nursing and midwifery employees. Promote an environment to support sustained change and healthy work environment for all health care practitioners. Agreed. Implement the measures sought to address the Workplace Health & Safety of nursing and midwifery staff as a matter of urgency. We will work with the ANMF to enhance workplace health and safety of nursing and midwifery staff. We are open to implementing the measures proposed. OWNERSHIP AND CONTROL OF PUBLIC HEALTH SERVICES (1) Oppose any further privatisation or outsourcing of public health services, whether for delivery or management or for the development of physical infrastructure. A Marshall Liberal Government will not sell any public hospitals, nor will we move to have any public hospital privately managed. The Labor Party has sourced a wide range of services from beyond the public sector. In assessing such options, the Liberal Party will be focussed on health outcomes. SINGLE ROOM ACCOMMODATION (1) 7 P a g e
Provide support to the research program already established by ANMF (SA Branch) in securing external and internal grants for funding, as well as providing support via a direct funding contribution from Government. The SA Liberals will honour any formal commitments that the current Government has made to fund research into the effects of single room accommodation at the nrah on both patient care and staff workloads. As each phase is completed, we will look favourably at funding further research and completing the research plan. INFRASTRUCTURE - IT SUPPORT (2) Work in collaboration with ANMF (SA Branch) to improve measures required to address hardware and content issues that are not robust within the existing EPAS system. The SA Liberals recognise the need for our hospital network to have access to a reliable, intuitive, clinically-safe and clinicallyappropriate electronic patient record system. We also recognise the importance of involving the ANMF (SA Branch) and other health professional and industrial organisations in steps taken to address EPAS problems and shortcomings. If elected in March, a Liberal Government will immediately suspend the roll-out of EPAS to other hospital sites and commission an independent review of EPAS functionality, performance and long-term prospects. The Independent Review will be tasked with working out if SA Health should push on with the implementation of EPAS and, if so, the likely cost of addressing its known problems and drawbacks. A recommendation that EPAS cannot or should not be salvaged, would need to provide a clear, cost-effective pathway to a more suitable, robust patient administration system. Work with ANMF (SA Branch) to incorporate nursing order sets that reflect evidence-based nursing practice within EPAS. The Independent Review of EPAS (see previous answer) will examine the projected cost and benefit of expanding EPAS to include the type of nursing order sets the ANMF (SA Branch) would like to see included. INFRASTRUCTURE - PERSONNEL (3) 8 P a g e
Provide support for appropriate levels of senior management and clinical nursing/midwifery leaders on a 24/7 basis in all health services. Implement the proven NHS Hospital At Night Model across all LHNs. Improve and resource administrative supports for nurses and midwives at ward/unit level (ward clerks) to respond to changes in patient throughput and admission practices. A Marshall Liberal Government will support appropriate levels of senior management and clinical nursing/midwifery leaders at all times. The State Liberals appreciate the value of improving handovers between hospital shifts. We will work with the ANMF and regional boards to seek a base for a trial of this model. The State Liberals will redirect administrative resources within SA Health to better support clinical care, in particular, at ward/unit level. 9 P a g e