EnableNSW Strategy 2020-2024...disability and aged care supports are provided, with funding and...

EnableNSW Strategy | 2020-2024

HealthShare NSW 1

2020 - 2024

EnableNSW Strategy

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2 EnableNSW | Patient Support Services

Foreword I am pleased to introduce EnableNSW’s strategic plan for the four-year period of 2020 to 2024.

Since it was established in 2007, EnableNSW has developed into a mature business unit of HealthShare NSW, supporting more than 26,000 people, their family and carers each year through a variety of programs and services. Throughout its development, EnableNSW has remained committed to excellent customer service and to improving its programs and services in order to support the health needs of NSW residents to live safely at home.

Australia has recently undergone significant changes to the way that disability and aged care supports are provided, with funding and service responsibilities transferred from state to commonwealth governments. This has provided an opportunity to review the programs and services provided by EnableNSW and set our future directions.

As we look to the future– both as a service provider and steward of the sector – we are as committed as ever to placing the people that access our services at the centre of our service design and to supporting a stable and sustainable market. Our strategic plan looks at how we can sharpen our focus to provide quality outcomes for people, families and carers; health professionals and the health system.

Central to the plan is a digital transformation aimed at improving the ease of access and timeliness of the services for customers and health professionals, with the ability to capture feedback on people’s experiences and outcomes of the services we provide.

Over the next four years, we are committing to: increasing our focus on the changing and unmet needs of people with short-term or ongoing health needs;

ensuring quality assistive technology is readily available to people through loan services; and

improving the ease with which users can access and navigate services.I also recognise that there are other business activities that are not

specifically listed in this document but are equally important and reflect the need to continue to develop the capacity of our staff and the need for good business-as-usual systems and processes.

If we are to achieve what is laid out in this plan, we must work collaboratively with each other, our partners and with industry. Many of our service partners have brought their valuable insights and experience to the development of this document, and I sincerely thank them for their contributions and support.

Lastly, I want to thank the EnableNSW team for their involvement and enthusiasm in developing this plan. Your shared commitment to continual improvement is inspiring, and I look forward to us working together on the next phase of the design and improved delivery of our services.

James Munro FordDirector of Patient

Support Services HealthShare NSW


HealthShare NSW 3

Contents About us 4

Our achievements 5

Vision and outcomes 6

Alignment with NSW Government objectives 8

Our partners 9

Our operating environment 10

Key strategic priorities 11

Monitoring and measuring progress 19

Roadmap 21


About usEnableNSW provides assistive technology and services to people in NSW to support health needs.

What we doEnable NSW is a business unit of HealthShare NSW, the statewide organisation established to provide high-quality shared services within the NSW Health system. We provide the following programs and services to support people to live and participate at home and in the community:

Assistive technology programs Aids and Equipment Program: provides mobility, self-care and communication assistive technology; compression garments; home enteral nutrition; and continence products.

Home Respiratory Program: provides respiratory equipment including oxygen concentrators, continuous positive airway pressure machines, ventilators and respiratory consumables.

Prosthetic Limb Service: provides interim and definitive prostheses.

Clinical services Specialist Prosthetics and Orthotics Services: provides assessment, fabrication and fitting of prosthetics and orthotics in Albury, Newcastle and rural outreach centres.

Support services Isolated Patients Travel and Accommodation Assistance Scheme: provides financial assistance for people who travel significant distances to access specialist medical treatment which is not available locally.

Away from Home Haemodialysis Program: provides access to private renal units while travelling.

Safe and Supported at Home Initiative: provides temporary or permanent home modifications in order to live safely at home.

Home Ventilation Programs: provides attendant care services to eligible adults and children on life support.


HealthShare NSW 5

Our achievementsIn FY2018-19, EnableNSW supported more than 50,000 people across our services.

97%The product or equipment

met their expectations

Assistive technology (AT)

We provided assistive technology, consumables or home oxygen to people to support the safe management of their health need in their home and community. Many people were assisted multiple times, by more than one program. Not all people require assistance every year.

Financial assistance to help access to specialised health services

We worked with local health district offices to provide more than $25 million in financial assistance to people in predominantly regional and rural areas across NSW to access specialised health services.

This service has grown by close to 12% from the previous year, with approximately 70,000 applications processed.

Bridging the funding gaps

In consideration of exceptional circumstances, we provided assistive technology to people with immediate health needs who were experiencing lengthy delays in accessing their relevant long term funding. This meant people were able to leave hospital and return to their homes faster.

Refurbished items provided through the Equipment Centre

We supplied approximately 9,000 stock items, including around 4,000 refurbished items. This saves an estimated $4.5 million annually through cost avoidance and is a key reason that we have been able to eliminate waiting lists.

Prosthetic and orthotic services

We provided assessment, manufacture and repair services to people requiring prosthetic and orthotic services in regional and rural NSW as well as providing 190 clinic visits to support local health practitioners.

In a 2019 survey, our service users said that:

95%They used the product or

equipment provided

89%They were satisfied with their

overall experience

17,521 people

31,000 people

786people

4,000 items

4,188 occasions of services


Vision and outcomesVision: To support people in NSW to live safely and manage their health needs in their home and community.

Outcomes

People in NSW have access to assistive technology to facilitate faster discharge

We reduce the time people spend in hospital by providing access to the right assistive technology at the right place and the right time, allowing a faster discharge from hospital to home.

This leads to better outcomes for patients and benefits the whole NSW health system, by freeing up hospital beds for other patients and reducing time spent on administrative tasks by clinical staff.

People in NSW have equitable access to services

NSW is a diverse state, and we are committed to ensuring people can fairly and equitably access our services and specialised health services, regardless of where they live, their economic status or their cultural background.

People, families and carers in NSW have improved experiences with the NSW health care system

We put the person at the centre of the services that we provide by supporting people, their families and carers, and health professionals to navigate the system, and easily find the services they need.

By better integrating our services with other parts of the health system, we support a more connected journey and an improved experience.

To provide assistive technology and services to help people in NSW safely manage their health needs at home.

We support people to live safely at home and in their community by providing timely access to high quality assistive technology that can: sustain a person’s life; treat and manage disease, health conditions or injuries;

promote recovery and rehabilitation following an illness or injury;

prevent development of secondary health problems or complications following an illness or injury;

care for a person at the end of life; and reduce preventable contact with the health system, including hospital admissions.


HealthShare NSW 7

NSW Government The Premier’s Priorities set the policy priorities for the government to make a significant difference to enhance the quality of life of the people of NSW. Improving outpatient and community care by reducing preventable visits to hospital by five per cent through to 2023 by caring for people in the community.

Government made easy by increasing the number of government services where citizens of NSW only need to “Tell Us Once” by 2023.

Alignment with NSW Government objectivesOur vision and outcomes link closely with the direction and vision of NSW Government and NSW Health, as well as the broader HealthShare NSW direction.

NSW Health The NSW Health Plan: Towards 2021 articulates a vision for a sustainable and value based health care system. Keeping people healthy and out of hospital, with a focus on preventative and early intervention programs and services.

Providing world-class clinical care, with a priority on providing high-quality, patient-centred clinical care in hospitals.

Delivering truly integrated care, where patients and carers can easily navigate the health system, and have improved healthcare experiences and outcomes.

HealthShare NSW HealthShare NSW has set the vision of being the partner of choice, who delivers value for money services to NSW Health to achieve better outcomes for the NSW community. The new strategic plan for 2020 onwards is being developed, with a focus on three pillars, namely: customer centricity in service delivery; sustainable services; and leveraging intelligent automation and data analytics.

Easy to engage

Make it easy to access what I

need

Make it simple for me to understand

Act with empathyShow you

understand my situation

Treat me fairly an with respect

Provide service in my time of need

Respect my time

Tell me what I need to know beforehand

Minimise the need for me to repeat

myself

Make what I need to do

straightforward

Explain what to expect

Be clear about what steps are

involved

Conact me when I need to know

something

Let me know what the outcomes could be

Resolve the situation

Be accountable for your actions

Be clear in decision-making

Reach an outcome

Engage the communityListen to the

community to understand our

needs

Ask us how we want services

delivered

World class public service by implementing best-practice productivity and digital capability in the NSW public sector and drive public sector diversity by 2025.

The NSW Customer Service Commissioner’s vision for what of what customers expect when receiving government services is outlined in the NSW Customer Commitments.


Broader health system Primary health networks Private and non-government health providers General practitioners and medical specialists

Our partnersWe recognise the integral role our key partners have in achieving our vision and outcomes, and delivering person-centred services across the NSW health system.

Working with our partners supports an integrated health system which can deliver better outcomes for people, families and carers.

Non-Government Organisations Aged care providers Suppliers of assistive technology, equipment and consumables Repair and maintenance providers Advocacy organisations

NSW and Commonwealth Government National Disability Insurance Agency National Disability Insurance Agency Quality and Safeguards Commission

Australian Government Department of Health Australian Government Department of Veterans’ Affairs Department of Premier and Cabinet NSW Treasury NSW Department of Customer Service NSW Health Care Complaints Commission

NSW Health system Health professionals and clinicians Local Health Districts, Specialty Networks and affiliated health organisations

Ministry of Health


HealthShare NSW 9

Our operating environmentThere are complex external drivers which shape and inform the actions we will take to achieve our vision and outcomes.

The impact of population growth and ageing on health care servicesPopulation growth and ageing will place increased demand on NSW health services which may impact the way services are provided.

In response to increased demand due to increasing health needs, current health care service delivery may prove unsustainable.

Health care providers and their partners will be required to support the move to contemporary and technology-enabled models of care with more services delivered in the home and community rather than the traditional hospital environment.

Changing role of government as a market stewardThere has been a shift in the role of government from being the service provider or the system purchaser to fulfilling the role of a market steward. Market stewards develop, facilitate and monitor the service system to support the achievement of outcomes in the community.

This involves a stronger role in setting the long term vision and working with agencies and organisations in the system to support better outcomes for people who need to use and access these services.

Changing nature of models of service delivery to person-centred servicesThe NSW Health Plan: Towards 2021 emphasises the focus on delivering person-centred services, where care is designed around the needs of the person, rather than the needs of providers or the system itself.

NSW Health’s Integrated Care Framework sets a direction for improving the ease of accessing and navigating services for people, families and carers, as well as service providers and health professionals.

Changing policy environmentEnableNSW operates under two NSW Health policy directives.

The policy directive for the Isolated Patients Travel and Accommodation Assistance Scheme was updated in 2019.

The policy directive for assistive technology that established EnableNSW is currently under revision. The updated Policy Directives will be operationalised during the period of this Strategic Plan.

Intersection with Commonwealth Government programsSignificant reforms in disability and aged care have, and will continue to, impact EnableNSW’s services National Disability Insurance Scheme – More than 19,000 EnableNSW

consumers, and their budget, have been transitioned. This has resulted in a changing customer profile for the people who we provide services to.

My Aged Care – Nationwide funding limits and wait times has meant that there have been challenges in providing timely support. As such, EnableNSW has taken some of the demand to alleviate pressures on the NSW health system.

Our partnersWe recognise the integral role our key partners have in achieving our vision and outcomes, and delivering person-centred services across the NSW health system.

Working with our partners supports an integrated health system which can deliver better outcomes for people, families and carers.


Key strategic prioritiesWe have identified three key strategic priorities to support the achievement of the Strategy outcomes over the next four years.

Increasing our focus on health needsWe effectively respond to the changing and unmet health needs of people in NSW by providing assistive technology, clinical services and support services.

Ensuring quality assistive technology is readily availableWe provide and support a responsive and quality loan service so people in NSW can access the assistive technology they require.

Improving the ease of accessing and navigating services Our services are simple and seamless, and are supported by digital transformation that is person-centric.


HealthShare NSW 11

Increasing our focus on health needsWe effectively respond to the changing and unmet health needs of people in NSW by providing assistive technology, clinical services and support services.

Why is this a priority? EnableNSW was established in 2007 as a NSW Health disability support program. For the past five years, we have supported eligible people transition smoothly to the National Disability Insurance Scheme (NDIS). We are currently finalising our exit from our role as an NDIS provider, with the exception of specialist prosthetics and orthotics services. This provides the opportunity for us to focus on health-related assistive technology needs.

An adaptive and responsive service delivery model is required to meet the evolving health needs of people who use our services within a rapidly changing environment. As such, it is critical that we monitor and assess the services we deliver and whether they are meeting needs across the system.

What will we do?We will reallocate resources to design, manage and deliver services which support people to live safely and manage their health needs in their home and community. This includes providing assistive technology to sustain life; for prevention and management of health conditions; for recovery and rehabilitation; and for end-of-life care in coordination with other funding schemes.

This shift redefines our role and scope, and requires us to work with the Ministry of Health to implement an updated assistive technology policy directive.

Currently our tracked data tells us what we have delivered, rather than the impact of our services on people or the health system. It is important that we establish a performance monitoring framework to ensure we are effectively using our resources to meet these health needs. As such, we will commit to identifying and tracking patient reported outcomes and experience measures that will be used to assess our performance and the impact of assistive technology on individuals and the health system.

ObjectivesTransition out of NDIS servicesWe will cease services as an active registered provider of assistive technology and repairs and maintenance by 1 January 2020, with the exception of specialist prosthetics and orthotics services. Following the adjustment of the budgetary impact, we will identify the most efficient reallocation of resources across existing services or create new services that can best achieve improved outcomes.

Operationalisation of revised policy directive for EnableNSWWe will continue to work closely with the Ministry of Health to implement the updated NSW Health Assistive Technology Directive. Operationalising the policy directive will involve partnering with NSW Health agencies through transition phases, providing information to the people who use our service, and monitoring that the directive has the intended impact.

Develop, implement and monitor outcome measures We will develop, implement and monitor an outcome measurement framework including patient reported outcome measures (PROMS) and patient reported experience measures (PREMS). The monitoring of these measures will be critical to ensure we are doing what we said we will do. Reporting of patient outcomes will also assist people, their families and carers, and health professionals to make informed decisions about the role of assistive technology and services in the management of health needs and effective models of care.


SHELDON’S STORYSheldon lives with his wife Ruth and his dog, Busta. In 2016, Sheldon was diagnosed with bowel cancer which resulted in extensive cancer therapy and the removal of more than 70% of his bowels. This left Sheldon with peripheral neuropathy in his legs and hands and a significant falls risk.

Sheldon relied on Ruth for all his self-care needs as his bathroom was not equipped to safely manage his condition at home. “I would sometimes have to wait hours in my own mess to wait for Ruth to get home from work to help me clean up,” Sheldon explains.

In 2018, Sheldon applied to EnableNSW and received funding through the Safe and Supported at Home (SASH) home modifications program. The funding allowed Sheldon to completely renovate his

bathroom including hand rails, bidet, removal of the bath tub, installation of an entry level shower and the installation of a separate toilet for other members of the family. The funding also covered modification to his front and back stairs. Sheldon also received a mobility scooter from the EnableNSW Equipment Centre (EEC) to help him participate in the community.

The modifications to Sheldon’s home were ‘life changing’ and meant that Sheldon could self-care without the need for anyone to be present. Ruth, who had been on extended leave from her employer, returned to work and was comforted with the knowledge that Sheldon was at a much lower risk of falls and could safely manage at home.



HealthShare NSW 13

Ensuring quality assistive technology is readily availableWe provide and support a responsive and quality loan service so people in NSW can access the assistive technology they require.

Why is this a priority?EnableNSW has shown that refurbishing and reissuing equipment, as well as establishing a responsive and quality loan service, is an environmentally and financially sustainable way of providing quality assistive technology to more people now and in the future. EnableNSW and Local Health Districts (LHDs) have identified the need to work together to increase access to equipment loan pools, set service standards and increase reissuing of equipment to better use NSW Health resources and reduce waiting times for people requiring equipment.

What will we do?We will co-design a loan service model with our partners including LHDs, NSW Health agencies, health professionals, suppliers and people, families and carers to ensure streamlined access to assistive technology at the local level.

The new ICT system (see Priority below) will be a critical success factor in the future state as it will provide greater capability to manage and track loaned items.

ObjectivesStreamline access to assistive technology at a local levelWe will continue to work with LHDs and other partners to develop operational standards, a centralised evidence base, and register of loan assistive technology across NSW. With increased visibility and data to support and inform decision making, we will work with LHDs to identify how EnableNSW can best interface with local Equipment Loan Pool (ELP) operations.

Sustainable use of assistive technologyThe implementation of our new ICT system will allow us to track loan items so that they can be returned when no longer required; refurbished and reissued; or disposed of in a sustainable way. We will develop and pilot service models to determine the most effective way of providing operational support to ELPs.


SAMSON’S STORYSamson has spinal muscular atrophy which is characterised by progressive muscle wasting. As a result, Samson cannot walk more than 10 metres without tiring and has a history of falls.

Samson leads a very active community life and was previously reliant on a scooter for outdoor and community access and a self-propelled manual wheelchair for indoor access. However, he was unable to take his scooter on buses which restricted his independence.

For Samson to meet his goals, he required an all-in-one mobility device that would help him at home, in the community and on public transport. Most importantly, Samson

needed a mobility device that would help him to manage his deteriorating condition.

Samson’s occupational therapist prescribed a power wheelchair with specialised seating to meet his long term needs and replace the need for two mobility devices. A power wheelchair base available through EnableNSW Equipment Centre was requested, refurbished with custom made seating and delivered two months from prescription. The benefits of requesting a readily-available wheelchair meant that Samson received his chair sooner than if it had been purchased and the environmental footprint was lessened due to recycling the base.



HealthShare NSW 15

Improving the ease of accessing and navigating servicesOur services are simple and seamless, and are supported by digital transformation that is person-centric.

ObjectivesImplementation of a new fit-for-purpose ICT systemWe will implement a new user-centric ICT system, by leveraging existing systems from HealthShare NSW’s Patient Transport Services. The system will be developed to provide: easier and faster application process

greater transparency of the services and progress of requests

ability to manage equipment loan pools and to maximise equipment utilisation

roll out of a modern system, accessible through mobile devices and computers.

Through the implementation of the new system, we will be able to deliver a greater customer experience.

Encourage stakeholders to interact with us through the use of digital servicesWe will work with our stakeholders to co-design digital solutions that simplify the way they work with us. Through education and promotion, we will encourage the uptake of our online services in order to realise the full benefit of our ICT system.

Why is this a priority? Although our customers tell us that they are highly satisfied with our customer service they would like processes to be less complex, quicker and more transparent.

In order to improve our current service we need to work with people, their families and carers; health professionals and our suppliers. For example, the assistive technology journey involves a three step process - a prescription or recommendation by a health professional; funding application; and delivery. This requires navigating the various administrative systems associated with clinical services, funding bodies, assistive technology suppliers and delivery services. There is an opportunity to further develop and unify these elements to improve the end-to-end customer experience through digitisation.

At present, we have an ICT system that doesn’t meet our complex needs, resulting in a high administrative burden on our staff and health professionals.

An improved ICT system is an important tool but is only part of great customer experience. Together with our commitment to operational excellence we will continue to invest in our people to deliver outstanding customer service and empower them to take a stewardship role across the NSW health system.

What will we do?We have already successfully developed and implemented a purpose built ICT system for the Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS). This experience and lessons learnt makes us well placed to develop a new ICT system for our assistive technology programs. The ICT system will support improved services and an enhanced user experience. It will facilitate a shift to value add activities by reducing the administrative burden on our staff and freeing them up to focus on supporting more complex requests. Through the system we will collect and use data to monitor a person’s journey through our services and inform continuous service improvements.

We will continue to develop our staff with the skills to be digitally competent and confident using the new ICT system and to take on new roles and activities in the digital future.


A radical approach to service improvement


HealthShare NSW 17

The Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS) reimburses isolated rural patients for some of their costs of attending specialist health services when no services are available locally. Each year approximately 70,000 applications are submitted by more than 31,000 people to five offices across the state.In 2016, 96% of patients used the six-page application form rather than the existing online form which could take up to 45 minutes to submit. Despite a raft of process improvements, claim times barely improved and staffing and ICT costs continued to climb.

Being in the unique position of having both internal subject matter experts and ICT capabilities, EnableNSW took a radical approach to build a new ICT solution in-house. Such a project involved extensive consultations with the Ministry of Health, eHealth NSW, Local Health Districts and other

HealthShare NSW business lines during the development and implementation stages to ensure that the new system would interface with existing business systems and meet privacy and security requirements.

In April 2018, the Travel and Accommodation System (TRACs) was released, providing online access to patients to lodge and track their applications. The system provides a more efficient way to lodge applications through a user friendly interface and intuitive prompts which has resulted in online applications increasing from 4% to 16% of total applications received in the first 12 months. The increased transparency of the new system has also reduced the volume of calls received to track payments-in-progress. Overall, these improvements have reduced the administration cost per application by 29% for standard applications and 40% for bulk billing applications. More importantly patient and provider payments are processed faster.


RoadmapEnableNSW has developed a roadmap to guide the achievement of our key strategic priorities over the next four years.

PRIORITY OBJECTIVE 2020 2021 2022 2023

Increasing our focus on health needs

Transition out of NDIS services

Operationalisation of revised policy directives for EnableNSW

Develop, implement and monitor outcome measures

Ensuring quality assistive technology is readily available

Streamline access to assistive technology at a local level

Sustainable use of assistive technology

Improving the ease of accessing and navigating services

Implementation of a new fit-for-purpose ICT system

Finalisation Budget reconciliation

Implement interim policy

Review of interim

policy

Implement review

outcomes

Develop measures

Implement measures

Monitor measures

Agreement on model Pilot Staged

rollout

Service design Pilot Consolidation

Implement ICT system


HealthShare NSW 19

Monitoring and measuring progress

Strategic Priority Measure

1. Increasing our focus on health needs

Achieve implementation of NSW Health Assistive Technology Directive

Increase ability to provide information to people and health professionals on the effectiveness of specific types of assistive technology

Reduce discharge delays due to lack of assistive technology

Finalise exit as NDIS provider

2. Ensuring quality assistive technology is readily available

Increase uptake of contract and reissued equipment

Increase percentage of equipment that is returned and able to be reissued

Achieve uptake of ICT system by Equipment Loan Pools

Increase number of ELPs that adopt standard operational processes

3. Improving the ease of accessing and navigating services

Increase proportion of health professionals submitting applications online

Increase proportion of people accessing services online

Increase proportion of suppliers and repairers using mobile app for delivery and service calls

Maintain/increase customer service satisfaction levels/targets

Prime responsibility of EnableNSW Responsibility of EnableNSW and partners Influencing role for EnableNSW

Monitoring and measuring the success of this Strategy is key to continuous improvement. Given the time period for the Strategy and the reliance on the new ICT system to provide data that is presently unavailable, baseline levels for indicators of success will be set and monitored routinely as new data becomes available; and additional key indicators will be added where appropriate.

These targets will be set and monitored through the annual Business Plan together with other fundamental business activities that are not specifically listed in this document.


Contact details

James Munro Ford – Director, Patient Support Services, HealthShare NSW: [email protected]

Jackie Hiller – Associate Director, Patient Support Services, Manager EnableNSW, HealthShare NSW: [email protected]

Enable NSW | Strategic Plan 2020-2024

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