1. ISAP: developing a sustainable health system. Integrating Strategy and Performance And our approach to strategy Presented by: Lyn Hamill A/Director, Integrating Strategy and Performance

2. ISAP: developing a sustainable health system. Integrating Strategy and Performance I will Introduce Queensland Health Introduce ISAP and our strategic framework – our achievements Describe what we plan to do from this point on

3. ISAP: developing a sustainable health system. Integrating Strategy and Performance Introducing Queensland Health Network of 38 Health Service Districts covering the state of Queensland 64,500 staff on payroll 700,000 inpatient and 340,000 day patient episodes of care using 2m bed days 8.7m non inpatient episodes of care including 800,000 emergency episodes $A4.8 billion revenue FY 2003-4

4. ISAP: developing a sustainable health system. Integrating Strategy and Performance Critical points for QH in last two years Publication of Health 2020 Change in leadership – after 8 years New strategic agenda – new mission, vision and 5 strategic intents reflected in a new strategic plan Organisation restructured to be more ”corporate” – Board, Directorates

5. ISAP: developing a sustainable health system. Integrating Strategy and Performance Health 2020 Research undertaken 2001-2 Produced a directions statement for the Department Identified challenges and implications Provide guidance to strategic direction

6. ISAP: developing a sustainable health system. Integrating Strategy and Performance Future challenges (Health 2020) ISSUES Ageing population Technological changes Slowing workforce growth Rising chronic and preventable disease IMPLICATIONS How do we ensure equitable access? How do we best use/maximise the advantages of new technologies? Can we keep up with the pace of social and technological change? What will be the impact of a shrinking revenue base?

7. ISAP: developing a sustainable health system. Integrating Strategy and Performance Video “Queensland’s health – our future” 2003

8. ISAP: developing a sustainable health system. Integrating Strategy and Performance Introducing Queensland Health’s strategy Mission –Promoting a healthier Queensland Vision –Leaders in health – partners for life Five intents –Healthier staff –Healthier partnerships –Healthier people and communities –Healthier hospitals –Healthier resources

9. ISAP: developing a sustainable health system. Integrating Strategy and Performance ISAP (Integrating Strategy and Performance) – What is it ? A two year project commenced in 2003 to introduce the Balanced Scorecard into Queensland Health Ends June 2005 – transfers to a permanent function

10. ISAP: developing a sustainable health system. Integrating Strategy and Performance Critical components of BSC in our project More than just strategic planning To drive the implementation of strategy –the technical process – development, maintenance and use of the strategy maps and scorecards To make QH a strategy focussed organisation –the change management processes –the less tangible component

11. ISAP: developing a sustainable health system. Integrating Strategy and Performance ISAP – needed to address Buy-in amongst diverse group of highly educated people –Mostly located in districts –Cautious of corporate driven models An organisation adverse to risk and resistant to change –Use of pilots –Multi-level support – statewide, zonal, district Lack of internal consulting skills – whilst using internal staff Ensuring required level of communication

12. ISAP: developing a sustainable health system. Integrating Strategy and Performance ISAP – is made up of Director General sponsorship Up to 17 dedicated people at corporate, zonal and district level providing training, guidance and assistance in the implementation of the process Allocated persons at various levels owning to administration of the scorecards Input by Balanced Scorecard Collaborative (ongoing development of model)

13. ISAP: developing a sustainable health system. Integrating Strategy and Performance ISAP - What have we achieved to date? Created and began using a corporate strategy map and scorecard Cascaded corporate scorecard to 38 Health Service Districts and a number of corporate support areas Created a 1 st version of an integrated planning calendar – to coordinate planning, budgeting and reporting Influenced the new initiative funding model to look at strategic issues – linked $ to change

14. ISAP: developing a sustainable health system. Integrating Strategy and Performance Critical components of BSC The process – development, maintenance and use of the strategy maps and scorecards – data, reporting Change management –the less tangible component required to become more strategy focussed More than just strategic planning – it drives the implementation of strategy Queensland Health Strategy Map August 2004 Healthier staff Healthier people & communitiesHealthier partnershipsHealthier hospitals Healthier resources Paying for health Consumer Promoting a healthier Queensland our vision Leaders in health — partners for life our mission Promoting a healthier Queensland C1. Achieve whole-of- government approach to quality of life C2. Increase confidence in health system C3. Increase knowledge and skills for health C4. Improve access to primary health care C5. Reduce impact of chronic disease including on Indigenous peoples C6. Smooth transition between community services, hospitals and GPs C7. Ensure safe and quality health outcomes C8. Appropriate access to specialist services across Queensland IP1. Improve community participation in the planning and delivery of health services IP2. Proactive marketing and education about QH services IP3. Progress shared priorities with government and non- government sector IP4. Inform and skill health consumers IP5. Reduce risk factors in high risk consumers IP7. Increase use of clinical evidence- based decision making IP8. Continuously improve key business processes WF4. Right information at the right time at the right place in the right medium WF1. Encourage innovation and targeted research WF2. Develop values-based organisation WF3. Recruit, develop and retain an appropriately skilled workforce P1. Balanced budget P2. Leverage other sectorsP3. Maximise revenue Internal processes Shaping our workforce IP6. Primary prevention targeting areas of high return IP9. Effective service and workforce planning

15. ISAP: developing a sustainable health system. Integrating Strategy and Performance Integrated Planning Included planning, budgeting and reporting (at multiple levels) into the one calendar Identified key activities and the require pre and post activities Version 1 mainly drove funding cycle however Health Service Directorate seeking to ensure all its activities are logically planned for

16. ISAP: developing a sustainable health system. Integrating Strategy and Performance Initiative Funding Majority of budgeting is historical – covering business as usual Identified need for a transparent process for allocating operating funds for new activities –Initiative funding model trialled 2004 –Requires initiative to be linked to strategic objective as criteria Intended to extend use into capital allocations

17. ISAP: developing a sustainable health system. Integrating Strategy and Performance Strategic Management Branch Based on BSCol SMOmodel to provide: –Support for the senior executives for leadership on strategy –Governance process to support execution of strategy –Ongoing utilisation and review of QH Scorecard –Improved alignment to the strategy of scorecards and business processes throughout Queensland Health –Establishment of a strategic management function within Queensland Health –Ongoing change management support –Ongoing evaluation and continuous improvement Additional role in some performance reporting to external bodies

18. ISAP: developing a sustainable health system. Integrating Strategy and Performance Strategic Management Branch 19 staff positions funded Strategic Management Branch – 10 staff –Board secretariat –Strategic Planning and Scorecard –Model development and promulgation Zonal and District staff – 8 staff Public Affairs – 1 staff – internal communications

19. ISAP: developing a sustainable health system. Integrating Strategy and Performance Challenges Ensuring leadership remains publicly committed to the strategy and the methodology Ensuring that strategy is something we do as part of our normal role – not an add-on Providing systems and processes to embed the methodology

20. ISAP: developing a sustainable health system. Integrating Strategy and Performance Summary Queensland Health has embarked on a journey to move away from just strategy planning to becoming a strategy focussed organisation We have completed through the “design” phase and now move to embed the processes into the organisation