Updated Establishment and Transition Plan

Updated Establishment and Transition Plan The following information is provided to the Department as required by the Primary Networks Core funding Schedule (Item E2) which is due on 9 July 2015 (Item F.3). The format for this report is based upon the template and minimum content guide provided by the Department on 15 June 2015. ESTABLISHMENT AND TRANSITION PLAN MINIMUM CONTENT GUIDE The PHN Establishment and Transition Plan formed a part of applicant s response to Selection Criteria 4 of the PHN ITA. The Schedule requires an update to this Establishment Transition Plan (ETP) and this guide provides details from the schedule that need to be reflected when updating it. PART 1 - ESTABLISHMENT AND TRANSITION ACTIVITY (Item B.3 of Schedule) 1. Priority Establishment Activity (Item B.3.1) Establishment of PHN Board and governance arrangements The Board of Loddon Mallee Murray Medicare Local Limited has been proactive in making appropriate changes to its constitution and its membership to ensure the smooth transition to the Murray Primary Network. From January 2015, the company made changes to its constitution to provide for an additional 3 co-opted directors to assist with governance through a 2-year transition phase. Eight (8) of the current Directors are continuing on to ensure continuity and knowledge retention at a governance level. Since the announcement that the company was successful in its application to establish the Murray PHN (April 2015), the Board has sought out people from across the PHN region with the appropriate skills and experience to come onto the Board as Directors. It is anticipated that appointments to these three seconded positions as company Directors will be confirmed in July 2015. As part of its preparation for the announcement of the PHN tender process, the Board also updated its Skills Matrix to better reflect the requirements of the Primary Network in line with the programme guidelines and to reflect the much broader geographic region. This work was completed in March 2015 The CEO and executive team has remain unchanged throughout the application, planning, establishment and transition to the Primary Network and this has resulted in seamless transfer of knowledge and a rapid adaptation to the Primary Network context. Clinical Council(s) Additional information: The business model for the Murray PHN had assumed at least 4 regional clinical councils and one catchment wide clinical council 1 of 10

Recognising the size and complexity of the Murray PHN catchment area, our engagement across the region and collaboration with hospitals and State Government has resulted in a in considering a higher number of councils to ensure a more locally focussed input. A further 2 clinical council s is under consideration and is subject to further engagement across the sector The scope and draft terms of reference for Clinical Councils have been directly contributed to and informed by outgoing Clinical Advisory structures of Lower Murray Mallee Medicare Local and will be subject to further engagement Advisory Committee(s) Additional information: The business model for the Murray PHN had assumed at least 4 regional community advisory committees and one catchment wide community advisory committees Recognising the size and complexity of the Murray PHN catchment area, our engagement across the region and collaboration with hospitals and State Government has resulted in a in considering a higher number of committees to ensure a more locally focussed input. A further 2 community advisory committees is under consideration and is subject to further engagement across the sector The Murray PHN will draw upon the networks and affiliations with 12 primary care partnerships and 24 Local Governments to support the development and recruitment of community leaders and advocates to the community advisory committees Stakeholder management/engagement activity A Stakeholder Engagement Strategy has been prepared and endorsed by the Board. It follows IAP2 engagement principles and has applied a whole of organisation approach. and Clinical engagement are cornerstone features of a number of roles within the organisation that have been filled by appropriately qualified and experienced staff. The Murray PHN CEO actively leading this strategy and is therefore positioning the purpose, influence and function of the organisation at an appropriately high and strategic level. Office establishment (eg. acquisition of premises, equipment, staffing, sub-regional structure if applicable, IT and communications systems) As indicated in the application, the Murray PHN is initially establishing four regional offices throughout the region in the North-West (Mildura), Central Victoria (Bendigo), Valley (Shepparton) and North-East (Albury/Wodonga) while it s corporate office will remain in Bendigo. Progress on these four sites follows: North-East (Albury/Wodonga) The Hume Medicare Local has been most helpful in facilitating a smooth transition to Murray PHN operations in the North-East area. The early notification that the company was intending to wind-up their operations has assisted greatly, and agreement was quickly reached that the North-East regional office would be temporarily based in the Hume ML offices in Hovell Street Albury. Over coming months, more permanent accommodation will be sought and made suitable to house the regional office operations. Assets such as office furniture and equipment is also being transferred to the Murray PHN as provided for in the DoTR. Valley (Shepparton) Similarly, the GVML was able to give an early indication of their intention to wind-up operations and this has facilitated a smooth transition in the Valley. Agreement was quickly reached for GVML to host the Murray PHN s regional office operations in Wyndham Street Shepparton for a period of 3 months until longer-term and more suitable accommodation is sourced. The mental health services which were directly provided by GVML (Navigating Life) are in separately leased accommodation to the ML offices, but 2 of 10

agreement has been reached for the continuation of these services out of that location until such time that they are sub-contracted to other providers later in 2015. Assets such as office furniture and equipment is also being transferred to the Murray PHN as provided for in the DoTR. Central Victoria (Bendigo) Company headquarters for the Loddon Mallee Murray Medicare Local are already established in Rowan Street Bendigo. The existing site is presently accommodating the Corporate office, as well as the newly formed Regional Office for the Central Victorian region. While adequate for now, office space is growing tighter and it is possible that separation of the regional office from the corporate office may need to be arranged at a future time (depending on growth). LMMML s office in Echuca is no longer required and arrangements are presently underway to terminate this lease and close this office down. North-West (Mildura) Unlike the Hume and Valley Medicare Locals, the Lower Murray Medicare Local had signalled its intention to continue to operate as a service provider, so negotiation for transfer of assets and possible hosting for the Murray PHN regional office has been delayed somewhat. which were directly delivered by LMML were opened to a competitive tender process in May/June 2015 and service continuity was achieved for these services through contracting a range of local providers. It has only been since the results of this tender process have become known that the Lower Murray ML (Mallee Division of General Practice) has also commenced action to wind-up. A lease has recently been signed for temporary office accommodation in Fifteenth Street Mildura with occupancy occurring from 6 July 2015. Similar to Albury and Shepparton, work is underway to source accommodation which is suitable for the longer term. Identification and transfer of appropriate assets has commenced and will be concluded by end-july. Staffing The recruitment to the organisational structure for the Murray PHN has progressed well but is not yet completed. A 3-step process was adopted to ensure that the company s legal obligations (as set out in its enterprise agreement) were met, while also providing the opportunity to capture the knowledge, skills and relationships which were held by Medicare Local staff across the Murray PHN region. Briefly, this 3-step process to recruitment was: Step 1 Positions in the Murray PHN structure were mapped against the LMMML structure, and incumbents were redeployed where possible after ensuring that their skills and knowledge matched the requirements of the new positions. This method ensured that redundancies were minimised and key skills and competencies retained. 28 Medicare Local staff were successfully redeployed through this step. Step 2 Remaining vacant positions (including the positions in the regional office locations) were made available for existing Medicare Local staff to apply for in a closed recruitment process. Seven former Medicare Local staff were successfully recruited through this step. In addition to this, a further 12 clinical staff from Medicare Locals transferred their employment to Murray PHN under transfer of business arrangements. Step 3 Is presently underway and involves advertising widely and opening up the remaining vacant positions for recruitment in the open market. IT and communication systems Implementation of basic ICT services across the four regional offices is progressing very smoothly and would not have been possible if it was not for the early decision to migrate ICT infrastructure away from traditional architecture into the cloud. A new domain (murrayphn.org.au) was registered and Office365 has been successfully rolled-out across the enterprise, providing document sharing and email communication. Telecommunications are presently being provided through our temporary accommodation arrangements at 3 of 10

Shepparton and Albury, but new numbers and telephone system is awaiting delivery for Mildura. A connected-up IP telephony system and a broadband Wide-Area-Network (WAN) will be implemented once more permanent accommodation is sourced. A new website landing page has been launched www.murrayphn.org.au but further development of our website is being hampered by the non-receipt of branding guidelines. A new finance system (Microsoft Dynamics NAV) has been implemented for the PHN and went live on July 1. Most of our enterprise applications (such as patient information, contract management, and client relationship management systems) are already hosted applications, so are unaffected provided that internet connectivity is maintained. 2. Priority Transition Activity (Item B.3.2) Transition from Medicare Locals, including: transfer of records from Medicare Locals has been undertaken for active clients where services were directly provided and records maintained by the Medicare Local. This has been a seamless process with Valley and Hume Medicare Locals. Due to a lack of preparation on the part of Lower Murray the transfer of records has become a protracted process however we continue to work closely with Lower Murray and the new service providers to ensure necessary information is made available as efficiently as possible to minimise disruption to continuity of care for patients. transfer of assets, IP or third party services As indicated in Part 1, the transfer of these items from Hume and Valley Medicare Locals is well progressed but is also well underway with Lower Murray Medicare Local. Once a final list of assets and liabilities has been agreed upon, arrangements will be made for auditors to conduct relevant due-diligence processes. Arrangements with each Medicare Local are being documented into a formal Transfer Agreement which (after due diligence) will be signed off by both parties. transfer of data, information systems and operational information commenced is an ongoing process and is governed by the scope and rate of IT development for the PHN. The recruitment of staff formerly employed by outgoing Medicare Locals is providing an immediate resource to support transfer for IP. More broadly, the development of the organisation wide CRM model is currently under development. planned training and recruitment. See earlier description in Part 1. In addition to this recruitment activity, plans are progressing well for a comprehensive change management process to ensure all Murray PHN employees understand the objectives and context of the PHN programme, are truly engaged in the work of the Murray PHN and make a meaningful contribution to the organisation s operations and culture. This induction and change management process will commence in late July and continue through to December 2015. 3. Continuity (Item B.3.3) The following services were previously directly provided by Medicare Locals in the Murray PHN region: Hume Diabetes Educator- this service has been contracted through a competitive tender process and will continue to be available. The new service provider will ensure clients previously receiving the service continue to have access. Mental - a component of ATAPS T1 and T2 Chile Mental were directly delivered by Hume ML employed clinicians, theses services will continue to be provided through employment by Murray PHN while we organise to subcontract service delivery through a competitive approach to the market. Valley 4 of 10

Mental - a component of ATAPS T1 and T2 Chile Mental were directly delivered by Hume ML employed clinicians, theses services will continue to be provided through employment by Murray PHN while we organise to subcontract service delivery through a competitive approach to the market. Lower Murray Autism- this service has been contracted through a competitive tender process and will continue to be available. The new service provider will ensure clients previously receiving the service will have access. We continue to work with Lower Murray to access client information to support continuity of care. Geriatrician -this service has been contracted through a competitive tender process and will continue to be available. The new service provider will ensure clients previously receiving the service will have access. We continue to work with Lower Murray to access client information to support continuity of care. Movement Disorders- this service has been contracted through a competitive tender process and will continue to be available. The new service provider will ensure clients previously receiving the service will have access. We continue to work with Lower Murray to access client information to support continuity of care. Pain Management- this service has been contracted through a competitive tender process and will continue to be available. The new service provider will ensure clients previously receiving the service will have access. We continue to work with Lower Murray to access client information to support continuity of care. Care Coordination and Supplementary - the CCSS service was previously directly delivered by Lower Murray, this has been subcontracted through competitive tender process. We continue to work with Lower Murray to access client information to support continuity of care. The new service provider arrangements for Mildura area have been referenced in recent media to support consumer awareness. PART 2 OPERATIONAL AND FLEXIBLE FUNDING (Item B.4 of Schedule) 1. GP and Stakeholder Engagement (Item B.4.1) A stakeholder engagement strategy has been developed by the organisation and endorsed by the Board. Implicit to the strategy is that it is a whole-of-organisation activity that involves staff, executive and Board Directors. The Strategy seeks to support the following outcomes: To provide clear and consistent information relative to the intended audience. To engage proactively not reactively, so that Murray PHN drives engagement with the stakeholders. That stakeholders have a good understanding of what will happen after the 1 st of July, and how the change will impact them (if at all). To build better relationships and confidence between the stakeholders and the Murray PHN, leading to a better Murray PHN and better health outcomes for the community. The Strategy is being implemented with achievements to date being: Contact will all General Practices across the Murray PHN to communicate the role purpose and function of the organisation as it relates to General Practice Person to person contact with Practice personnel is in progress and will accelerate as the organisational structure is filled Media profile across the regional area of the establishment of each regional office and introduction of Regional presence and roles 5 of 10

Presentation to State hospital CEO forums outlining purpose, structure and performance framework as it relates to acute services across the region Development of website and social media profile Planned activities over July and August is to conduct a series of targeted audience and community-based forums to launch the introduction of the Murray PHN, generate shared focus upon improving primary health effectiveness, efficiency and coordination, and from this base, generate interest and momentum to establish Clinical Council s and Advisory Committees appropriate to the needs of the region as well as provide an transparent mechanism to initiate planned activities including the introduction of health pathways (or an equivalent) and to inform the strategic development of the Murray PHN organisation. Practice support activities have included: Establishment of roles explicitly focussed to support improved health outcomes through the coordinated support of General Practice. These are significant roles that are based at each regional office with the primary purpose being to to improve front line health service delivery through the agency of General Practice by: Improving front line health service delivery and the capacity of General Practice through quality improvement initiatives; Reinforcing the importance of coordinated primary health care; Facilitating change through a population health evidence-based approach and Effective engagement with primary health providers, particularly General Practitioners at a local level to support improvements in frontline health services and better coordination of care across primary, community and secondary health care systems. Ongoing coordination and implementation of a professional development has been an important area to support continuity and engagement of General Practice, especially General Practice. Professional development events are being videoed and made available across the region to support access while the regional offices are under establishment. 2. Population Planning (Item B.4.2) Development of Baseline Needs Assessment has across a number of fronts: Epidemiological support from LaTrobe University to support the development of Regional profile of health evidence that aligns with National and Local health needs; This provides the first practical example of the joint partnership agreement between the Murray PHN and LaTrobe University to support the population health planning requirements of the Murray PHN Broader engagement with State Government, Universities and Local Government has confirmed participation with a Population Planning Advisory Committee and this is under development. Licence agreements with a clinical audit tool to extract deidentified patient data to report upon patterns of health presentations within General Practice and other health services is in its closing stages. This is a key evidence to support population health planning functions. Development of a health services commissioning plan 3. Delivery (Item B.4.3) The following health services activities will be delivered in 2015-16 6 of 10

REGION CONTRACTED PROVIDER Bendigo Care Group Castlemaine District Ltd SERVICE ACTIVITY(S) Dietetics; Podiatry Counselling Castlemaine Physiotherapy East Wimmera Eloquent Speech Pathology nursing; Dietetics; Occupational therapy Speech Pathology Heathcote Diabetes education; Physiotherapy Inglewood District Mallee District Aboriginal Njernda Aboriginal Corporation Northern District Swan Hill District Wimmera Hearing Society Inc. Alexandra Medical Centre Cobram District Eildon Medical Centre Euroa Medical Family Practice Diabetes education; District nursing; Mental health nursing; Physiotherapy; Social work (alcohol and other drugs) Youth Counselling Aboriginal health Diabetic education; Dietetics; Occupation therapy; Podiatry/foot care Dietetics; Podiatry; Speech pathology Hearing screen Diabetes Education Dietetics; Diabetes Education; Podiatry Diabetes education Diabetes education; Dietetics 7 of 10

Honeysuckle Regional Janette Tregenza Diabetes education Kilmore Medical Centre Kilmore Medical Practice Murchison Medical Clinic Care Coordination and Promotion Diabetes education; Dietetics; Exercise physiology Diabetes Myrtle Street Clinic Diabetes education Macedon Princess Park Clinic Shepparton Medical Centre Yea Medical Centre Cobaw Podiatry; Exercise physiology; Physiotherapy; Dietetics Dietetics Dietetics; Exercise physiology Diabetes education Physiotherapy; Speech Pathology Alpine Dietetics; Diabetes education Balance Up Nutrition Beechworth Dietetics Dietetics Benalla Diabetes educator; Dietetics Border Dietitians Dietetics Gateway Diabetes Educator Indigo North Inc. Kelly Creamer Podiatry Kiewa Valley Physiotherapy Ovens Valley Physiotherapy Occupational therapist; Physiotherapy; General podiatrist; Allied health assistant Podiatry Physiotherapy Physiotherapy 8 of 10

Ovens Valley Podiatry Tallangatta Podiatry Physiotherapy The Foot Centre Podiatry Upper Murray & Vision Australia Irymple Foot Clinic Podiatry Karen Bulman Dietetics Lynette Flavel Diabetes education Mallee Track and Mildura Base Hospital Mildura Base Hospital coordination; Exercise physiotherapy; Occupational therapy; Physiotherapy; Allied health assistant (Physiotherapy); Allied health assistant (Podiatry); Physiotherapy; Allied health assistant; Chronic disease management; After hours nursing Occupational therapy; Orientation and mobility; Optometry; Orthoptics; Adaptive technology; Social work Podiatry; Social work; Speech pathology; nurse; health education/promotion; Allied health assistant Autism Assessment and Diagnosis Geriatrician MyChemist Mildura Opioid Replacement Therapy 4. Performance Management (Item B.4.4) Robinvale District Sunraysia Sunraysia Sunraysia LTD Aboriginal allied health assistant; health nurse; Dietetics; Occupational therapy; Physiotherapy; Podiatry; Social worker; Speech pathology; Allied health assistant Movement Disorders Nurse Pain Management Opioid Replacement Therapy 9 of 10

Development of Local Performance Indicators will follow the confirmation of the scope and development of the Needs Assessment and Strategic Plan for the organisation. The significance of a strong performance management orientation has been reflected within the position descriptions and establishment of organisational systems that are in the closing stages of finalisation. PART 3 OTHER ACTIVITY (If applicable) Not applicable PART 4 CHALLENGES AND OPPORTUNITIES Barriers or risks that may hinder achievement of the E&T Plan (in addition to any listed separately for activities) including strategies being undertaken to mitigate or address these risks. Generally, the establishment phase leading up to the commencement of the Murray PHN has gone very smoothly. This is testament to the hard work of many staff and the cooperation of Medicare Locals in sharing relevant information when required. There is a huge workload associated with the service continuity aspects of establishment gathering information and understanding all of the services and arrangements which were in place and then arranging for the contracting of 86 different companies with over 110 separate service agreements servicing over 50 communities. All of this was achieved in a very tight timeframe. Emerging issues that may require amendment of the E&T Plan (if applicable) including strategies being undertaken to mitigate or address these risks. As already indicated, the establishment of the Murray PHN has been characterised by a good deal of engagement and goodwill, from Medicare Locals, other stakeholders and contractors. The only significant issue which remains unresolved at this time is the naming and branding of Primary Networks. The lack of branding is hampering activities such as website development, recruitment and other communications. PART 5 OPERATIONAL AND FLEXIBLE BUDGETS Projected budgets for 2015-16 itemised as per templates provided. Current versions of the Operational and Flexible Funds budgets are provided in the templates provided and sent with the email along with this report. There have been some variations since the original submission due to the changes to boundaries and the inclusion of Albury into the Murray PHN catchment area. Other changes to the composition of both the operational funds and flexible funds have been made to reflect the increasing knowledge of financial commitments required to ensure service continuity through the flexible funds, as well as a growing understanding of the costs associated with maintaining operations through four regional offices in a large geographic area. Even with this increased understanding, many of the estimates remain provisional only and are subject to further change during the financial year. 10 of 10