SA Health

375 The Hon. J.M.A. LENSINK ().27 August 2024). Can the Minister for Health and Wellbeing advise:

1. Under the Code Yellow, what number of country mental health patients on involuntary treatment orders have remained in country hospitals for greater than 24 hours requiring the level 1 treatment order to be reviewed by video rather than in person?

2. How was this directive of Code Yellow communicated to the directors of nursing and hospital staff (all health professionals including doctors, nurses, midwives, paramedics, and others)?

3. Has the Code Yellow now been lifted?

4. What is the status of the Mental Health Act 2009 review and its parliamentary progress?

5. In relation to the Drug and Alcohol Services, why was the number of outpatients' attendances listed in this year's budget almost 6,000 less than the projected figure?

6. What is meant by the allocation of $1.4 million for the extension of the 'Forensic Mental Health Stepdown Service 'in 2023-24?

7. In relation to the highlights, the first dot point: 'Continues review of the Mental Health Services Plan 2020-25, Can the minister provide update on its progress?

8. The 1.6 million mentioned in the third point regarding the additional accommodation for people living with a psychosocial disability to live independently'. My question to the minister is, can you provide a figure to the number of people who have benefitted from this amount mentioned in the budget or how many people have accessed this?

9. Is the Minister confident in meeting the timeframe for co-designing the new 24-bed Mental Health Rehabilitation Facility at the QEH which the Public Works Committee said would be the end of 2025?

10. The percentage of patients attending emergency departments who commenced treatment within clinically accepted timeframes declined from 92% to 69% this year. What are the reasons for the significant decline?

11. The decline in the percentage of patients attending ED's who commenced treatment within the clinically accepted timeframes for resuscitation (which is immediately) went from 86 per cent to 53 per cent this financial year. How many patients have died or had adverse effects due to failing to receive treatment?

12. Patients overdue for elective surgery procedures as at 30 June, has gone from 62 patients to 169 this year. What is the reason for the significant increase and is this a result of systemic issues?

13. How many private beds have been used by SA Health in the treatment of public patients over the last 12 months?

14. Which private hospitals has SA Health currently got contracts with?

15. What is the current cost as a percentage of National Efficient price to deliver care to a public patient in the private sector?

16. Did you have any conversations with private hospitals during the Code Yellow crisis to further utilise the private system?

17. If so, how much was spent on private beds during the Code Yellow crisis?

18. As part of the Wellbeing SA Strategic Plan 2020-25, have the roles of community resilience officers officially concluded and how will that funding be re-allocated to other regional mental health programs?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector, Special Minister of State): The Minister for Health and Wellbeing has advised:

1. It is usual practice for most people who are made subject to an inpatient treatment order in country South Australia to be reviewed via the telepsychiatry service. This has not changed because of the Code Yellow arrangements.

2. Each local health network and the SA Ambulance Service (SAAS) has its own internal communication processes which have been used to communicate decisions to frontline staff.

3. Yes.

4. Consultation on a discussion paper on the review of the Mental Health Act 2009 closed in January 2024. The feedback has been reviewed and a bill will be released for public consultation in the coming months.

5. The projected figure was based on data available up to 29 February 2024. The attendance figure was based on data available up to 30 June 2024.

6. $1.4 million was the cost to extend the Forensic Mental Health Stepdown Service, which was a pilot program commissioned in 2022 for an initial term of 12 months, with an option to extend for a further 12 months.

7. The Department for Health and Wellbeing's Mental Health Strategy and Planning Branch continuously considers the Mental Health Services Plan's alignment with strategies and initiatives announced subsequent to the release of the plan in November 2019.

8. Haven Foundation Limited with its consortium partner Mind Australia Ltd will build and operate housing accommodation for 16 individuals with psychosocial disability.

9. The project is progressing in line with the agreed program and is expected to be completed by the end of 2025.

10. The Barossa Hills Fleurieu Local Health Network implemented the electronic medical records system (EMR) over the course of the 2023-24 financial year, which unintentionally had a material impact on the reported data quality of their 'emergency department commenced treatment within clinically accepted timeframes'.

This is largely because of clinicians being required to actively select 'commenced treatment' in the EMR system, which was not consistently actioned and lacked a shared definition of when treatment had actually commenced.

Education has been undertaken with clinicians across the network on this function of the system to improve the input of accurate data. In addition, Digital Health SA have also introduced system changes to improve system functionality around recording when treatment has been initiated and ensure better data accuracy in future.

As the issue was one of data quality and reporting, rather than delayed care, there were no actual negative impacts on patient health and outcomes during this period because of this issue.

11. The Barossa Hills Fleurieu Local Health Network implemented the electronic medical records system (EMR) over the course of the 2023-24 financial year, which unintentionally had a material impact on the reported data quality of their 'emergency department commenced treatment within clinically accepted timeframes'.

This is largely because of clinicians being required to actively select 'commenced treatment' in the EMR system, which was not consistently actioned and lacked a shared definition of when treatment had actually commenced.

Education has been undertaken with clinicians across the network on this function of the system to improve the input of accurate data. In addition, Digital Health SA have also introduced system changes to improve system functionality around recording when treatment has been initiated and ensure better data accuracy in future.

As the issue was one of data quality and reporting, rather than delayed care, there were no actual negative impacts on patient health and outcomes during this period because of this issue.

12. The increase is a result of increasing demand and/or short notice cancellations due to workforce or patient factors. Yorke and Northern LHN are managing their theatre lists to ensure local demand is met in a timely manner.

13. Local health networks have engaged with the private sector utilising the Patient Services Panel (PSP) since July 2019, the commencement and length of any bed agreement varies depending on the service type and requirements of the LHN enacting the agreement.

On average over 100 private hospital beds each day were used across the public hospital system over the last 12 months.

14. The following private hospitals are on SA Health's Patient Services Panel:

Ashford Hospital (ACHA)

Burnside Hospital Stepney

Burnside Hospital Toorak Gardens

Calvary Adelaide Hospital

Calvary Central Districts Hospital

Calvary North Adelaide Hospital

Flinders Private Hospital (ACHA)

Glenelg Community Hospital

Griffith Rehabilitation Hospital

North Eastern Community Hospital

Ramsay Clinic Adelaide

St Andrew's Hospital

The Memorial Hospital (ACHA)

Western Hospital.

Additionally, SA Health has undertaken work with Stirling District Hospital through an exemption to the patient services panel.

15. The department funds local health networks (LHNs) at the national efficient price for all public patients, regardless of whether they receive their care in the public hospital or under local contracted care arrangements.

LHNs enter contracting arrangements with the private sector separately and the price paid is locally determined under those arrangements.

16. The Patient Services Panel Agreement, for outsourcing of public work to the private sector, has been extended to June 2027. The Department for Health and Wellbeing and local health networks continue to have regular conversations with private hospitals, which include medium term contract strategies and additional bed capacity during times of peak demand and system pressures.

17. The Patient Services Panel Agreement, for outsourcing of public work to the private sector, has been extended to June 2027. The Department for Health and Wellbeing and local health networks continue to have regular conversations with private hospitals, which include medium term contract strategies and additional bed capacity during times of peak demand and system pressures.

18. Preventive Health SA continues to provide specific mental health and suicide prevention initiatives including:

South Australian Suicide Prevention Community Grants. As a priority population identified by the State Suicide Prevention Act and plan, applications received in support of people living in regional, rural and remote South Australia receive priority consideration for approval.

Supporting South Australian Suicide Prevention Networks to carry out suicide prevention and mental health awareness activities. The majority are located in regional and rural South Australia and well placed to identify emerging local issues and needs to provide relevant and timely suicide prevention, wellbeing and capacity building initiatives.

Funding research and promoting evidence-based best practice to support the community:

In collaboration with UniSA, Preventive Health SA has funded research into the impacts of mental distress for men, women and CALD men in farming in South Australia. The associated reports continue to inform the work of Preventive Health SA in supporting South Australians in farming occupations.

Preventive Health SA is currently working in partnership by way of grant funding to Breakthrough Mental Health Research Foundation for the purposes of supporting a research fellowship for male suicide prevention.

In addition, other locally produced resources such as Dr Kate Gunn's iFarmwell are promoted to the regional, rural and remote SPNs for distribution in their communities.