1. Health Networks in Western Australia
Dr James Flexman
Clinical Co-Lead Infections and Immunology Health Network

2. Why Health Networks?
The major weakness evident in the Western Australian health system is a lack of integration across its component agencies
Planning has been isolated from clinical expertise and consequently implementation of plans and recommendations has been difficult
Metropolitan Health Services Review, Final report to the Government of Western Australia, Deloitte Ross Tohmatsu (1991)

3. Health Networks are…
A group of interested people and organisations including health professionals, patients, careers, consumers and others, coming together to help plan and develop health policy and services across the state.
A means of providing a new collaborative focus across all clinical disciplines toward prevention of illness and injury and maintenance of health for all Western Australians.

4. Health Network Outcomes
POLICY
Leading and facilitating the development of evidence based policy.
PRIORITIES
Aligning Health Network activities with the WA Health Strategic Intent, focusing on the promotion of health and wellbeing.
PERFORMANCE
Driving performance indicators across the system
adding value by providing
opportunities for informed
collaborative action
PROTOCOL
Providing opportunities to develop systems and work practices that improve clinical expertise and encourage best use of both physical and intellectual resources
PEOPLE
Providing opportunities for leadership.
Identifying and advising on opportunities to improve clinical workforce support, teaching and training
PLANNING
Strategic and operational planning for health and health service delivery is informed by Health Network advice.

5. WA Health Operational Plan 2006-08 – Health Networks
Participate in the development of resource allocation priorities
Participate in the deployment of approved Commonwealth health initiatives
Develop & inform the health and medical research agenda
Provide leadership on key issues regarding the implementation of the WA Health strategies related to the Australian Better Health Initiative
Incorporate National Service Improvement Frameworks into Network terms of references & plans

6. Health Networks in other jurisdictions
NSW Health - Greater Metropolitan Clinical Taskforce
Established interventional cardiological procedures at several hospitals, improving standard of care
Set up acute stroke units in outer Sydney
Reduced waiting times for living related donor renal transplantation
Provided uniform clinical protocols
Implemented data management programs they designed

7. Health Networks in other jurisdictions
SA Health - Statewide Cardiac Network
Improved outcomes for patients with acute coronary syndrome
More efficient systems for maintaining stocks of high cost drugs
Point of care blood tests and wireless broadband for ECGs enabling almost instant cardiologist review regardless of where the patient presents
Better support for rural GPs and practice nurses

8. Health Networks in WA The challenges ahead..
Building partnerships that enable a system wide view over institutional view
Delivering horizontal networks as opposed to vertical hierarchies
Becoming comfortable with fuzzy boundaries

9. Benefits of being involved
Influence the future shape of WA Health
Receive recognition as a leader
Make a real contribution
Embed a focus on prevention and maintenance of health
Build effective integration across service providers
Strengthen links and information exchange across WA Health
Provide input to health plans which are based on needs of patients and services rather than buildings and organisations

10. Current Health Networks
Acute Care
Aged Care
Cancer and Palliative Care
Cardiovascular Health
Child and Youth Health
Digestive
Endocrine
Falls Prevention
Genetics

11. Current Health Networks
Infections and Immunology
Injury and trauma
Mental Health
Musculoskeletal Health
Neurosciences and Senses
Renal
Respiratory health
Women and newborns’

12. Models of Care that have been developed
Chronic kidney disease
Coeliac disease
Diabetes
Cystic fibrosis
Sexually transmitted infections
HIV
Palliative care
Stroke
Falls

13. Infections and Immunology Health Network

14. Current Structure CO-LEADS
Dr Jim Flexman Clinical Microbiologist, RPH and Pathwest Laboratory Medicine WA
Dr Lewis Marshall Sexual Health Physician, Fremantle Hospital
Julia Fallon-Ferguson Senior development officer

15. Network Executive 2007 Dr Wendy Cheng Hepatology (Digestive Network)
Ms Crystal Connelly Nursing
Dr Charles Douglas WACHS
Mr Michael Doyle Aboriginal Health
Prof Martyn French Immunology
Ms Michele Kosky Consumers
Ms Trish Langdon NGOs
Dr Richard Loh Paediatrics
Ms Gae Sawyer GP Divisions
Dr David Speers ID Physicians
Dr Paul Van Buynder CDC DOH
Dr Rhyon Johnson General Practice

16. Network Executive 2008 Dr Wendy Cheng Hepatology (Digestive Network)
Ms Crystal Connelly Nursing
Dr Charles Douglas WACHS
Dr Sandra Thompson Aboriginal Health
Prof Martyn French Immunology
Ms Michele Kosky Consumers
Ms Trish Langdon NGOs
Dr Tony Keil Paediatrics
Ms Gae Sawyer GP Divisions
Dr John Dyer ID Physicians
Dr Paul Van Buynder CDC DOH

17. Subgroups WA Infectious Diseases Physicians Group 14 ID physicians
NGOs
FPWA, Hepatitis Council, SECCA, Silver Chain, WAAC and WASUA
Nurses
40 nurses from a wide range of disciplines
Clinical Immunology Interhospital Liaison Group ( 2008 )

18. Protocols and guidelines
To be patient centred:
Staphylococcus aureus bacteraemia
Post splenectomy immunisation
Post exposure Prophylaxis for HIV
Statewide anaphylaxis Service
Working with Health Networks branch on guideline distribution strategy

19. Advocacy Education and prevention
Prevention and education included in Models of Care
WA Health Promotion Strategic Framework
Partnership with Office of Safety and Quality in Health Care
Hand Hygiene
Public Health Act
Influenza strategy
Immunisation policy
Anaphylaxis service

20. Service delivery inc Policy
To be Patient centred and including:
Sexual health services
Aboriginal sexual health
Migrant health
Hepatitis and HIV
Allergic Disease

21. Service delivery inc Policy
Model of Care STI
Model of Care Hep C
Model of Care HIV
Staff Immunisation register
Telehealth
TB control-advocacy role

22. Workforce Training for HCW’s e.g. e-learning in infection control
On call support for GPs
Training and education included in Models of Care
Advanced practice roles for nurses included in MOC
Research and education forum March 2008

23. Research and Education
Support Research centres
Data management and collection e.g. State-wide clinical database for HCV
Encouraged applications to SHRAC for research grants
Chlamydia research proposal developed with wide network support for SHRAC process
Letters of support for Raine Foundation applications
Support for the development of e-Learning projects
Questionnaire on how to promote research agenda
Research Forum held 18th March 2008 included social research and the community perspective

24. Partnerships Partnerships established through EAG members e.g. NGO’s
Collaboration with Digestive Network re Hep C MOC
Immunologists review of Coeliac disease MOC for the Gastroenterology Network
SHRAC application for research
HICWA
Other Health Networks
Communication links between CDCD and Microbiologists and Infectious Diseases Physicians
General Practice e.g. WAGP Network and GP’s
PathWest Laboratory Medicine WA

25. Priorities for 2008
Implementation strategies for models of care and guidelines that have been developed
Continue ongoing projects
Model of care for allergic disease
Statewide support for infection control
Guideline on the management of central nervous system infections
Antibiotic stewardship
Consumer information on models of care
Review of refugee health in collaboration with other networks