Rural Patients Initiative

2001 - 2002 Rural Patients Initiative Application Form (Word File 29KB) (PDF File 107KB)

Rural Patients Initiative Guidelines

Growth funds for rural Victoria in 2001-2002 are focussed on improving access to targeted specialties for rural patients. These funds will be aimed at reducing waiting times for long waiting rural elective surgery patients and medical patients experiencing delays in receiving services.

Metropolitan hospitals able to deliver services for rural patients are eligible to apply for funding. Metropolitan hospital submissions should be discussed with rural regions also prior to approval to allow consideration of local alternatives whenever possible.

Funding will be available through a funding round to be completed by the end of August 2001 (see Timelines). Regional staff will be the key contact point for hospitals wishing to discuss and submit proposals. Final decisions will be made by the Director, Acute Health on advice from Regional Directors and Divisional staff on priority needs.

It is expected that hospitals accessing these additional funds will maintain usual activity levels for the financial year 2001-2002. The Rural Patients Initiative will purchase additional activity.

In some instances, metropolitan hospitals will be able to provide services to rural patients which will mean patients receive their service in a more timely way. Contract arrangements between rural and metropolitan hospitals to achieve this outcome are eligible for funding. These arrangements may also be effective in achieving outcomes in relation to base WIES.

Criteria for Targeting

Need

Hospitals must be able to demonstrate a need for services in the targeted areas. This will take the form of waiting lists and waiting times for services. Hospitals which do not keep such data, and are able to demonstrate a need through other means may discuss their concerns with regional contact staff and make a case for inclusion. This may include the situation where a change in service mix or role is planned.

Organisational Capacity and Sustainability

Whilst proposals should target specialties in which there are a high proportion of long waiting patients, the approach should be sustainable in terms of the hospital's capacity to offer such levels of activity in the medium to long term. If long waiting patients are a function of mismatched supply and demand, the need for a sustainable increase in activity should be demonstrated, which may lead to recurrent funding (see Ongoing Funding below).

The capacity of the organisation to deliver the additional work, including whether recruitment of staff will be needed and timelines, will also need to be demonstrated.

Specialties and Patient Categories

Hospitals should decide which specialties to target, based on the following criteria for inclusion.

• Specialties to be included can be those where, as at March 2001, more than 30% of Category 2 patients are waiting more that 90 days and 20% of Category 3 patients are waiting over one year. However, it is possible to only target Category 2 patients if this is the major group affected by long waits.
• Medical patients where excessive waits can be demonstrated

Based on March 2001 data, the following specialties should be considered for inclusion:

• ophthalmology
• orthopaedics
• general surgery
• ENT

Funding will be considered for treatment of Category 2 and 3 elective surgery patients waiting over 90 days and one year respectively, and medical patients where excessive waits can be demonstrated.

The type of activity should be appropriate to the level and role of the hospital within the local area and region.

Funding

In accordance with long standing policy on rural specialty grants, the preferred models for service provision are non fee for service models. Modified arrangements may be considered, but non fee for service models will be given higher priority in assessments.

Funding models which are based on costs which vary from the usual WIES price will be considered if rural access is facilitated.

Models which involve the transport of rural patients to receive more timely service may include additional costs for travel, medi-hotel arrangements or other additional costs if these are necessary for more timely treatment.

Funding Options

The type of payment may be determined by the model of funding. For example, if additional activity is approved at the normal WIES rate, funding will flow as WIES. If other models are approved which involve additional or modified costs, funding will be in the from of a cashflowed specified grant. However, it is anticipated that most funding will be via WIES payments.

Ongoing Funding

Where an ongoing need for service is demonstrated and the initiative is used to successfully treat long waiting patients and reduce waiting lists and times, initiatives funded in 2001-2002 will be considered for ongoing funding if this is available.

Monitoring of Activity and Budget Adjustments

Activity undertaken under this initiative will be flagged in VAED. Hospitals which receive additional funding through this initiative will be required to submit information monthly on elective surgery throughput and throughput under this initiative and DHS will check this against VAED reporting. The previous year's elective activity will be considered as a baseline, unless special circumstances are demonstrated. Budgets may be adjusted if baseline elective activity is not demonstrated in addition to the extra activity generated by this initiative. A quarterly report on throughput funded by this initiative and other elective throughput will be compiled. Variances with the previous year's activity will be monitored and discussed with hospitals before decisions about budget adjustments are made.

Timelines for Submission and Funding Decisions

Contact:
Tim Williamson, Inpatient Services Unit, Quality Branch, Acute Health Division
Tel (03) 9616 9878

Updated 1 December 2001

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