Media Briefing
by the Chairman of the Hospital Authority, Mr Peter Woo,
and the Chief Executive, Dr E K Yeoh, after the Plenary Meeting
on Tuesday, September 1, 1998

 IINFORMATION   NOTES:

Hospital Authority Planning for 1999/2002

At the Hospital Authority (HA) Board meeting today (Tuesday, September 1), HA members discussed and endorsed the objectives, structure, process and approach of the HA Planning for 1999 and beyond.

Terms of Reference of the Committee

(1)

To monitor progress of the implementation of the recommendations for managing clinical risks in the HA hospitals/institutions; and

(2)

It will sustain quality improvement and monitor service delivery.

(3)

With an output/outcome-based resource allocation, it ensures HA's accountability to the stakeholders.

The Board also noted that the Committee could follow up on the investigations into the recent clinical incidents, including site visits and meeting with staff concerned, if necessary. The Committee would also seek expert advice from Professor Cyril Chantler of Guy's and St Thomas's Hospitals of University of London, and also agreed to invite input from an external nursing expert.

Planning Framework

A Task Force on HA Planning has been established to coordinate the planning process. To strengthen hospital and clinicians’ input in the planning process, the Task Force also includes a Hospital Chief Executive, a Chief of Service and an experienced clinician.

The scope of HA Planning for 1999/2002 covers Corporate Planning, Head Office Planning, Cluster Planning and Hospital Planning, each being looked after by a sub-group convened by a Deputy Director.

Current Progress

The planning framework has been described, defined and communicated. The Corporate Planning Sub-group involving frontline staff has reviewed and reconfirmed the corporate vision. An Initial Issue List is being formulated.

Key Features

1)

The Corporate vision was reviewed by frontline clinicians and professional groups.

2)

An Initial Issue List will be drawn up and addressed by the four sub-groups in their respective planning processes.

3)

The organisation issues and priority goals identified for 1999/2000 under Corporate Planning will be addressed through Head Office Planning while Cluster and Hospital Planning will tackle the development of priority services.

4)

A more bottom-up approach will be adopted to engage frontline staff and professional groups in the planning process.

Focus of the 1999/2002 Planning Cycle

The emphasis of the 1999/2002 Planning Cycle will be to further strengthen the core basic services using the tools developed in recent years, such as clinical audit, risk management, quality improvement with process indicators in the delivery of care and evidenced-based clinical practice.

Close liaison with the Government policy bureaus on health care reforms and systems will be maintained to ensure that appropriate corporate strategies are formulated.

The cluster concept will be reviewed to clarify and confirm the application value and limitations of the cluster concept.

The expert input of Specialty Coordinating Committees will be incorporated in the development of hospital services. During the planning process, there will be greater involvement from the clinical management teams and clinical accountability will be explicitly defined.

Redistribution of funds due to quality/productivity gain initiatives will continue to be kept by hospitals for improvement of services as in the planning process for 1998/1999. Specialty costing and patient related group costing will only be used for reference but not mathematically applied to the resource allocation.

Despite current economic downturn and anticipated financial constraint, the HA planning process would ensure that service quality could be sustained and well documented in the hospital annual plans.

The HA Planning 1999/2002 will again be communicated externally and internally as in the 1998/1999 planning process. External as well as internal stakeholders such as District Boards, Patient Focus Groups, HA staff and Hospital Governing Committees would be well informed and consulted throughout the planning process.

Progress Update on Business Support Services

At the Hospital Authority (HA) Board meeting today (Tuesday, 1 September), Members were updated on the progress of HA's business support initiatives and discussed the way forward in facilitating hospitals to implement changes in supporting services to enhance quality of patient care.

Business support services include an extensive range of activities and operational systems. They include the provision of direct patient support; vocational service management and logistic support; and engineering and technical support.

Progress Update

To improve the overall access, efficiency and standards of hospital services, the HA has identified the need to transform the various facets of the organisation's business supporting services. The reforms effectively complement and support the provision of quality health care in HA hospitals and clinics.

Significant achievements and progress have been made in a number of areas. Highlights of various initiatives are as follows:

Green Initiatives – A total of 17 public hospitals have completed their phasing-out programme of ozone depleting substances. The current schedule is for all HA hospitals to be free of identified sources of ozone depleting substances by 1999.

On energy conservation, there are basically three levels of approach. At Level 1, the approach by reduction and regulation such as take down of unnecessary lightings and shut down of lifts in non-peak hours; Level 2 is by investment on simple energy saving measures such as install timer for lighting and air-conditioning control. Both Level 1 and 2 approaches have been promulgated to all hospitals.

In Level 3, a pilot scheme in "Performance Contracting" was introduced in 1997 in Pamela Youde Nethersole Eastern Hospital. This is a comprehensive energy management scheme working in partnership with an external firm which guarantees overall energy performance of 12% energy savings at around $6 million a year in the coming six years. The pilot will be evaluated for the potential of introducing the approach to other hospitals.

Security & Facility Safety Management – Work has been undertaken in the past several years to improve overall security management. Each hospital has now designated a security officer or established a Security Steering Committee to address security issues. Modern security devices and systems such as closed circuit television with central monitoring system and electronic tags to new born babies etc. were introduced in hospitals in line with their assessed risk profiles.

With Government funding of $47 million in 1996, a 3-year programme was being implemented to upgrade the piped medical gas installation in 29 public hospitals. The works included adding safety control valves and alarm control panels and replacing outdated gas terminal units.

Direct Patient Support - The Health Care Assistant (HCA) scheme has been rolled out to 41 public hospitals with a cumulative total of over 3,000 HCAs trained and appointed. It has been shown that HCAs could relieve nurses 20% of their low complexity duties like provision of personal care such as feeding, thus releasing precious nursing time for other more complex duties. It is planned to increase the number of HCAs to 3,500 by end of 1998/99.

Non-Emergency Ambulance Transfer Service (NEATS) - Currently the NEATS service provides on average 1,600 patient-trip on a weekday. This workload represents an increase of approximately 40% as compared to that of 1994, prior to the takeover of the service by HA from the Fire Services Department. To improve service efficiency and productivity and also to ensure genuine needy patients are served, a number of improvement and control measures have been introduced.

The Way Forward

To address the implementation issues as well as facilitating hospitals to plan and implement reforms in their business supporting services, a number of measures have been formulated:

Different Liaison Groups on various services have been formed to share experience, identify problem and resolve issues.

Hospital clustering arrangements for selected business supporting functions are proposed for effective utilisation of professional expertise and to ensure more consistent quality standards.

To grant seeding resources to those hospitals that require them to kick-start the implementation process, hospitals are given one-off support from the Central Development Fund.