caring for the future - nsw health · caring for the future. welcome our vision central sydney area...

CENTRAL SYDNEY AREA HEALTH SERVICE YEAR IN REVIEW ~ 2001-2002

Caring for the future

welcome

Our vision

Central Sydney Area HealthService is dedicated toprotecting, promoting andmaintaining the health andindependence of its residentsand the wider community.

We work as a healthcareorganisation which, through our achievements, sets standards that are emulated by others.

Above: New mum Kylie (left) and Henry Smith, with Mulvey Mother Care Unit nurse unit manager Angela Smith.Cover: Intensive care staff Alessandra Schaer (left) and Anna McConnochie care for patients on the new hotfloor

in the RPA Clinical Services building.

year in review 2001-2002 1

Central Sydney Area Health Service (CSAHS) is a leader in the delivery ofpublic healthcare, with world-class standards in medical treatments,technology, teaching and research.

One of 17 area health services in NSW, it manages all public hospitalsand facilities within its geographic boundaries, across some 71 suburbs.

CSAHS is home to the largest rebuilding scheme in the State’s healthcaresystem, the $390 million Resource Transition Program (RTP). Throughthe RTP, we will continue to remain at the forefront of innovative patientcare and efficiency.

Our services are organised into 14 clinical groups that provide specialistreferral services to Statewide, national and international communities, aswell as a local population of more than 500,770 residents. We are one ofthe State’s most culturally diverse areas, with more than 41 per cent ofresidents born overseas.

Treatments are delivered from more than 90 sites comprising 10hospitals, a family care centre, a department of forensic medicine and anextensive network of community health centres.

Our dedicated staff of more than 9,250 people performed more than130,524 inpatient and 1.84 million non-admitted patient treatments aswell as delivering 4,904 babies.

Caring for the future, Central Sydney Area Health Service Year in Review2001-2002 describes our organisation and summarises our majorhighlights. It can be read in conjunction with the Central Sydney AreaHealth Service Statutory Annual Report 2001-2002.

Introduction

Contents01 Locations .................................................................................................................. 2

02 Chairman’s Message .............................................................................................. 3

03 Objectives ................................................................................................................. 4

04 Highlights ................................................................................................................. 6

05 Corporate Governance ........................................................................................... 8

06 Operational Structure ............................................................................................. 11

07 Resource Transition Program ................................................................................ 12

08 Clinical Groups ........................................................................................................ 14

09 Our Facilities ............................................................................................................ 29

10 Volunteers and Donors .......................................................................................... 38

11 Human Resources and Corporate Services ....................................................... 39

12 Quality, Research and Teaching ........................................................................... 40

13 Financial Summary ................................................................................................ 42

14 Public Affairs & Marketing .................................................................................... 44

2 central sydney area health service

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0 1km 2km 3km

CITY WEST LINK

M4 MOTORWAY

PACI

FIC

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29

6A

5A

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5B5C

Sydney Airport

Ashfield

Summer Hill

LewishamEnmore

Stanmore

AnnandaleGlebe

Chippendale

Redfern

Surry Hills

Waterloo

DarlingtonCamperdown

Petersham

Alexandria

Erskineville

Sydney Universtiy

Pyrmont

Ultimo

Rhodes Concord West

Concord

AbbotsfordChiswick

Drummoyne Birchgrove

Balmain

North Sydney

RozelleLilyfield

Leichhardt

Dobroyd Point

Five DockCanada Bay

North Strathfield

Homebush

Strathfield

South Strathfield

Marrickville South

Marrickville

Dulwich Hill

Tempe

Mascot

Rockdale

Hurstville

Rosebery

Paddington

Sydenham St PetersBelmore

Lakemba

Punchbowl

Chullora

Lidcombe

Lane Cove

Crows Nest

Riverwood

Roselands

Earlwood

Canterbury

CampsieBelfield

Enfield

BurwoodCroydon

Rodd Point Russell Lea

Gladesville

Cabarita Mortlake

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8

PARRAMATTA RIVER

SYDNEY HARBOUR

BOTANY BAY

Sydney Olympic

Park

Locations

Our major healthcare centres1 Balmain Hospital

2 Canterbury Hospital

3 Concord Hospital

4 Department of ForensicMedicine

5 Royal Prince Alfred Hospital

5A Dame Eadith Walker Hospital

5B King George V Hospital

5C Rachel Forster Hospital

6 Rozelle Hospital

6A Thomas Walker Hospital(Rivendell)

7 United Dental Hospital

8 HealthQuest

9 Tresillian Family Care Centres

Note: CEIDA is no longer part of CSAHS

CSAHS is home to the State’s most culturally diversepopulation. More than 500,770 residents live insuburbs covering the local government areas ofAshfield, Burwood, Canada Bay, Canterbury,Leichhardt, Marrickville, Strathfield and parts ofSydney and South Sydney.


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The last year has proved anotherhighly successful one for CSAHS.The problems which we have faced, inparticular issues of financial constraints,nursing shortages and the managementof our major facilities in transition, havebeen, if anything, greater than in pastyears, but we have come through withflying colours.

This report indicates the continuingprogress being made with our ResourceTransition Program. Our rebuildingschedule continues on target and onbudget. Many people, however, fail toappreciate that this whole process hasput great strains on many parts of thesystem – we simply cannot shut downanything while we rebuild. Therebuilding has to take place around thecontinued delivery of critical services,nowhere more importantly than in theprovision of emergency services. It is anenormous tribute to all of our staff, andto the planners, administrators andbuilders, that we have managed to keepeverything operating at the same timeas we replace old buildings and oldstock. I take this opportunity to expressmy public thanks and that of the Boardof CSAHS to all those who have copedso well, responded to great pressuresand never compromised on thestandards of care for which ourhospitals are renowned.

Chairman’s MessageOne of the most exciting developmentsof the past year has been our ability toproceed with the development of ournew mental health strategy. The planwhich we are implementing is to moveoff the Rozelle Hospital site to newpremises at Concord, where we willprovide mental health services in amodern, integrated facility. The newfacility will operate in accordance withthe latest best practice standards,something which cannot be done in ourcurrent complex of old and increasinglydysfunctional buildings. The principalbeneficiaries of this development will bethose people in the State who are inneed of mental health services, togetherwith their families and carers; it is withtheir interests primarily in mind that weare undertaking this work.

It is a matter of profound regret that ourplans have been attacked by peoplewho either know, or should know,better. Outrageous claims have beenmade about our plans andundertakings. These claims have neverbeen centred on an assessment of whatis in the best interests of our mentalhealth clients, nor with anunderstanding that the Rozelle facility isin fact a hospital, not a park. Many ofthe comments have displayed a selfishand self-interested desire to derail planswhich have been carefully developed inassociation with the mental healthcommunity. I can assure everyone thatthe Board of CSAHS will not allow thesepolitically motivated campaigns toprevent us moving forward and doingwhat we do best – planning for anddelivering the best health services thatcan be afforded within our budgetaryand physical constraints.

In the year ahead we will also be facingchallenges which result from thecontinued development andimplementation of the Government’sAction Plan for Health. Progress will bemade in the establishment of a systemof linked electronic health recordsthrough the State health system. Apartfrom the technical complexities of thisproject we will be particularly alert toensure that personal privacy and datasecurity issues are accorded the highestpriority.

CSAHS faces particular problems inrelation to our financial challengeswhich arise from our being an areaof relative socio-economicdisadvantage; changes in thedemography of metropolitanSydney; the range and complexityof services we provide especially topeople from outside CSAHS and thelocation of two great teachinghospitals within our Area. TheBoard will continue to makerepresentations to the Ministerabout these matters.

Recent suggestions from the GreaterMetropolitan Transition Taskforce,regarding further changes infunding allocations, have beenanother source of concern to theBoard and we are addressing allthese issues actively.

I once again have pleasure inconcluding my report by thankingthe Chief Executive Officer Dr DianaHorvath and her brilliant executiveteam, my Board colleagues, andthe Department for their continuedsupport and efforts on many fronts.

Chris Puplick AM

Healthier PeopleMental healthTo implement Caring for Mental Health– A Framework for Mental Health Carein NSW and to improve and maintaincare. The focus is on developingpartnerships; emergency mental healthresponses; prevention, promotion andearly intervention; providing bettermental health care; and quality andeffectiveness.

Chronic and complex and other careTo improve the integration of chroniccare services to patients in hospitals,community settings and the home.Priority healthcare programs will targetchronic cardiac failure, chronicobstructive pulmonary disease,diabetes and stroke patients.

Public health protection andhealth promotion To use health promotion to improvewell-being in the areas ofcardiovascular disease, diabetes,cancer, asthma and injury. To protectthe community’s vitality by managingthe health risks associated with theenvironment, infectious diseases and

food safety, using toolssuch as immunisationand surveys.


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ObjectivesCSAHS is committed to healthier people, fairer access, qualityhealthcare and better value. These philosophies build on and extendcurrent levels of achievement and orientate us towards continuing tomeet the community’s needs. Determined by NSW Health, these coregoals guide the provision of services and the setting of standardsacross the State.

The following key focus areas have been identified for each goal.

Below: Our Health Promotion Unit worked closely with local youth in Marrickvilleon a hepatitis C awareness-raising project. The result was a mural with astorybook feel. The mural contains information that is meaningful and accessiblefor young people.


Fairer AccessAboriginal healthTo improve the health of Aboriginal andTorres Strait Islander communitiesthrough closer collaboration withresidents, ensuring better access andmore effective services. The focus is oncultural awareness, developingpartnerships and employmentinitiatives.

Service access strategiesTo direct and ensure equity of access to services and the provision ofappropriate models of care whichaddress the issues of waiting times,continuity of care, targeted populationgroups and outreach specialist supportservices.

Quality HealthcareInitiatives in quality managementTo improve the quality of healthservices and provide direction for theirmanagement.

Community engagement andworking in partnershipsTo involve local residents and groups inthe development of health services andoversee inter-agency collaboration forservice planning and provision.

Skilled, valued workforceTo improve occupational health andsafety and provide direction for effectivehuman resources systems, appropriatetraining and support for staff.

Better ValueActivity, financial managementand efficiency strategiesTo ensure current health services aredelivered in an effective and efficientmanner utilising the funds available,focusing on activity, financialmanagement, day surgery, utilisationrates and efficiency.

Service development and assetstrategiesTo provide strategic direction for majorinitiatives, guide the implementation ofthe CSAHS health plan and ensure theappropriate use and management ofphysical resources.

Information managementTo manage effective informationsystems and technologies to supportquality healthcare service delivery.

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HighlightsDay of surgery admission rates exceed expectations

Day of surgery admission rates across CSAHS have increased to 85 per cent of all surgical admissions this year– up from 79 per cent last year and above the NSW Health benchmark of 80 per cent.

CSAHS clinical directors on the Clinical Council achieved this excellent result by working closely with each otherand individual department heads at each facility.

We now have a 98 to 100 per cent day of surgery admission rate in gynaecology at Royal Prince Alfred, Concordand Canterbury hospitals and regularly have a 100 per cent day of surgery admission rate at Canterbury for ear,nose and throat admissions. Rates for orthopaedics at Concord Hospital have increased from 46 per cent to 76per cent, while vascular surgery rates at RPA have increased from 69 per cent to 84 per cent.

RTP on trackThe $390 million Resource Transition Program continues to power ahead and this year entered an excitingphase at RPA, with the first department, adult intensive care, moving into the new Clinical Services building.Level three is a hotfloor which will include the Intensive Care Service, a neonatal intensive care unit, 22operating theatres, delivery suites for Women’s and Children’s Health Services and a direct, exclusive lift to theEmergency Department.

Concord Hospital is also being upgraded. Highlights this year include the near completion of the west infill abovethe Emergency Department, with related services relocating together for greater patient care.

The masterplan for the Inner West Health Centre is being finalised and planning is underway for refurbishment ofCamperdown Community Health Centre and redevelopment of Marrickville Community Health Centre, as well asrefurbishment of the King George V building.

Families First in CSAHSIn the first full year of our Families First program, early childhood nurses made more than 4,000 home visits to2,800 families with newborn babies, half within the first two weeks of birth. This was an increase of 296 percent in home visits and 318 per cent in families supported.

Families First is a coordinated strategy sponsored by the NSW Government to increase the effectiveness of earlyintervention and prevention services by supporting families to raise their children. The strategy focuses onchildren from birth to eight years.

CSAHS Picture Archival Communication System CSAHS is leading the State with the introduction of the PictureArchival Communications System. PACS uses computers, networksand software to acquire, store, transmit, display and print medicalimages electronically.

A trial of the system at Balmain Hospital last year proved sosuccessful it has now been fully installed in the Institute ofRheumatology & Orthopaedics and is 45 per cent complete at RPA.Installation at Canterbury and Concord hospitals will follow. PACSmeans quicker diagnoses for patients. Clinicians will no longer bedependent on waiting for the hard-copy of medical images such asX-rays, MRI and CT scans.

Hospital’s $10 million giftMedia proprietor Kerry Packer donated $10 million to RPA to builda multi-disciplinary education centre to be used by clinical staff and students and for the redevelopment of therenal transplant unit. Mr Packer received a kidney transplant at RPA in November 2000, using an organ fromhis long-time friend Nick Ross. The renal clinic is to be named the Nick Ross Clinic, while the education centrewill be called the Kerry Packer Education Centre.

Above: The innovative PACS technologyallows specialists like Medical Imagingclinical director Associate ProfessorMichael Fulham to view patient scanselectronically and in a matter of seconds.


Plastic surgery showcased on national televisionThousands of television viewers across Australia watched the skilled hands ofplastic surgeon Dr David Pennington and staff transform the face and body of Safari,a seven-year-old Kenyan boy with extensive burns. The boy’s battle caught theimagination of the nation and helped the Channel 9 Logie award-winning programRPA receive its third consecutive Logie nomination.

Concord Hospital plays key role in Statewide Severe Burns ServiceConcord Hospital has been allocated the largest number of burns patient beds as part of its role as the newStatewide Severe Burns Service. The hospital’s new skin laboratory allows scientists to culture skin cells fromstamp-sized patient samples and provide replacement skin for people with severe burns. In a six-week period,enough skin can be grown to cover a human body. The laboratory will be able to produce healthy middle and toplayers of skin to reconstruct the injured areas and reduce scarring.

Concord Hospital became the first public healthcare facility in Australia to hold TransCyte on site. Widely usedoverseas, TransCyte is a bio-engineered product which acts as a stimulant and accelerator for the body’s naturalhealing process when applied directly to the skin. The dressing has been used on people with second-degree burnson the face or hands, and in all cases scarring has been virtually eliminated.

NSW Health quality awardWe have developed a unique quality improvement tool to monitor andmanage sentinel events at CSAHS. A sentinel event is an unexpectedoccurrence which could result in death or serious injury. The SentinelEvent Program has been recognised as a model for other area healthservices in the State. It won the NSW Health Baxter Better Health,Good Health Care award.

The program has led to improvements in how we report these incidents and in the quality and outcomes of care for our patients. It aims to prevent sentinel events from occurring and therefore reducepotential risk.

Proton beam feasibility studyThe Sydney Cancer Centre at RPA began a feasibility study to establishAustralia’s first proton beam facility.

Proton beam treatment is the world’s latest and most effective type of cancer radiation. Protons are positivelycharged particles produced by a synchrotron or cyclotron. They can be focused into a precisely targeted beam tokill cancer deep within the body. Proton beams have fewer side effects than conventional X-ray-based radiotherapyand can be targeted more accurately on the cancer.

The facility will cost an estimated $160 million to build. The Hitachi Corporation is a key supporter and hasalready indicated its willingness to invest in the project.

Innovative smoking prevention campaigns underway This year the Central Sydney Health Promotion Unit has been working on a number of tobacco campaigns,targeting specific groups to reduce the harmful effects of smoking. The Young Women and Tobacco campaign usedTV ads in cinemas, while the Mudi Dungarra Mudang Project (Youth Dance of Life) in a joint initiative with GlebeSchool Childcare Indigenous Young Artists and Friends, took an artistic approach to getting the smoking preventionmessage across. The project developed a mural as well as a dance display to communicate the harmful effects oftobacco use for indigenous youth in CSAHS.

Other campaigns targeted indigenous women who are breastfeeding.

Above: Wendy Jamison receives the BaxterBetter Health, Good Health Care award onbehalf of the Clinical Quality Services Unitfor its Sentinel Event Program.

Above: Plastic surgeon Dr DavidPennington and Kenyan burns victimSafari during the filming of the RPA series.

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The CSAHS Board isresponsible and accountable forthe affairs of the organisation inaccordance with the HealthServices Act 1997. The 12Board members serve a four-year term, and are appointed bythe State Cabinet followingrecommendations from theNSW Health Minister. Meetingsare usually held on the firstWednesday of each month.

Chris Puplick AM ChairmanBA (Hons), MA

Chris was appointed as Chairman in1996, and has been a Board membersince 1993. He is president of the Anti-Discrimination Board of NSW andthe State’s Privacy Commissioner. Chrischairs the Australian National Councilon AIDS, Hepatitis C and RelatedDiseases (ANCHARD), the AIDS Trustof Australia and the National Task Forceon Whaling. He is a Griffin TheatreCompany Board member.

Professor John Young AO

Deputy ChairmanDSc, MD, FAA, FRACP

John joined the Board in 1989, and isthe pro-vice chancellor of the College of Health Sciences at the University ofSydney. He is a member of theNational Health and Medical ResearchCouncil and the Medical Board of NSWand is vice president and secretary(biological) of the Australian Academyof Science.

Board Members

Corporate Governance

Maria Pethard TreasurerBSc (Hons), DipCompSc, FASCT, AIBF(Aff), ASIA

A Board member since 1997, Maria isIntesaBci’s chief representative forAustralia, New Zealand and the SouthPacific and a member of the Financeand Treasury Association.

Dr Diana Horvath AOMB, BS (Hons), MPH, FRACMA,FAFPHM, FCHSE

Diana was appointed CSAHS’s ChiefExecutive Officer in 1992. She haschaired the National Health andMedical Research Council, is a formerpresident of the Australian HospitalAssociation and served a five-year termas a commissioner with the HealthInsurance Commission. Diana hasbeen an active member of the TradePolicy Advisory Council.

Above: CSAHS Board membersStanding: Nea Goodman (left), Glenn Wran, Jon Isaacs, Olwyn Mackenzie, John Meadth,Charles Linsell, Dr Roger Garsia (appointed June 30 2002).Seated: Maria Pethard (left), Chris Puplick, Diana Horvath, John Young.Not present: Frances Carolan, Peter Fernando.


Charles LinsellBA, DipEd, GradDipBusStudies IR, RN

The staff-elected representative on theBoard since 1992, Charles is the staffeducation manager for CSAHS MentalHealth Services. He has worked atRozelle Hospital for more than 25 yearsand trained as a nurse. Charles is onthe executive of the NSW Nurses’Association and a member of the NSWNurses’ Registration Board.

Peter FernandoPeter joined the Board in 1988. He isthe Redfern Aboriginal Medical Servicedeputy chief executive officer, a positionhe has held for six years. He worked asa senior health worker at the AboriginalMedical Service in Walgett.

Nea Goodman LLB (Hons I)

Appointed to the Board in 1998, Neais a lawyer with Malouf Solicitors. Neais a member of the Council of the LawSociety of NSW and a trustee of theUTS Faculty of Law AlumniAssociation. She chairs the CSAHSAudit Committee and is a member ofthe Royal Prince Alfred Hospital EthicsCommittee. Nea is a former presidentof the Women Lawyers’ Associationand the City of Sydney Law Society.

Frances Carolan A Board member since 1996, Francesis a registered nurse in the EmergencyDepartment at Canterbury Hospital.She is a Board representative on themanagement committee of theResearch Centre for Adaptation inHealth and Illness. Frances is amember of the Canterbury Branch ofthe Justices’ Association and vicepresident of the Campsie Branch ofRotary Inner Wheel.

Olwyn Mackenzie BA (Hons)

Olwyn joined the Board in 1996, andis a Board director of Warrina Women’sand Children’s Refuge. She is amember of the Consumer’s HealthForum, Kings Cross Community DrugAdvisory Team, Council on the Ageing,Older Women’s Network, University ofthe Third Age, Country Women’sAssociation and Women’s ElectoralLobby.

Attendance at meetingsEleven board meetings were held thisyear.

Member Attendance

Chris Puplick 11

Frances Carolan 10

Peter Fernando 3

Nea Goodman 11

Diana Horvath 9

Jon Isaacs 10

Charles Linsell 11

Olwyn Mackenzie 8

John Meadth 8

Maria Pethard 10

Glenn Wran 11

John Young 6

Dr John Meadth MB, BS

Concord-based general practitioner,John has been a Board member since1997. He chairs the Department ofGeneral Practice at Strathfield PrivateHospital and has a ministerialappointment as an official visitor underthe Mental Health Act.

Jon Isaacs BA (Hons), FAICD, FAIM

Jon joined the Board in 2000. He is adirector of the Sydney ForeshoreAuthority, Australian Technology ParkPrecinct Management Limited and theAmbulance Service of NSW. Jon is anexecutive coach, managementconsultant and accredited mediator. Heserves as Independent Chair of theNSW Auditor-General’s AuditCommittee.

Glenn Wran MBA (CSU)

Appointed in 2000, Glenn is generalmanager of the State Valuation Office,deputy chairman of the BusinessEnterprise Centre Northside, foundingtrustee of the Australian Cord BloodBank Foundation and director of theHaberfield Rotary Club.

CommitteesMembers of the Board and staff alsoserve on the following committees tomanage the operations of CSAHS:

> The Finance and Budgetcommittee, chaired by MariaPethard, is responsible for makingrecommendations about budgetallocation and financialperformance.

> The Medical and DentalAppointments Advisory committeerecommends all CSAHS seniormedical and dental appointments.Its chairman is Prof John Young.

> The CSAHS Audit committeemanages all matters arising frominternal and external audit reviews. It is chaired by Nea Goodman.

> The Clinical Quality Council reviewsclinical practices through sentinelevent and clinical indicatorreporting. It makesrecommendations on the quality ofclinical service delivery and ischaired by Prof John Young.

> Ethics Review committees arechaired by Dr Robert Loblay atRoyal Prince Alfred Hospital, DrGarry Pearce at Concord Hospitaland Dr Barbara Taylor at UnitedDental Hospital.


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A dedicated group of seven peopleis responsible for the managementof CSAHS. The executive enjoysclose working ties with senior staffin our facilities and clinical groups.

Chief Executive OfficerDr Diana Horvath AOMB, BS (Hons), MHP, FRACMA,FAFPHM, FCHSE

The CEO is accountable and responsibleto NSW Health for the facilities andservices which comprise CSAHS, one ofthe largest and busiest area healthservices in NSW. CSAHS has an annualexpenditure of $810 million to care forpatients from all over the State andbeyond.

Deputy Chief Executive OfficerMichael Wallace MSc (Soc), BSc

The deputy CEO is responsible for theoperations of CSAHS and oversees andmanages the use of resources andfacilities.

Executive Management

Director of Health ServicesDr Peter Kennedy MB, BS, FRACP

The director of health servicesformulates and oversees thedevelopment and integration ofhealthcare services across the 14clinical groups which make up CSAHS.

Director of FinanceCandy Cheng BComm, FCPA

The director of finance’s responsibilitiesare to oversee the efficient, professionaland equitable management of CSAHS’savailable financial resources and assetsto ensure appropriate use and value.

Director of Health ServicesPlanningRichard Gilbert BSc (Hons)

The director of health services planningmanages the development andplanning of services by assessing thehealth requirements of the populationand identifying the services required tomeet these needs. He formulatesappropriate plans and advises onappropriate funding and resources andthe use of casemix information.

Director of Corporate ServicesJan Whalan BPharm, MPH, MBA, AFAIM

The director of corporate servicesmanages a diverse portfolio includinghuman resources and riskmanagement; occupational health,safety and rehabilitation; procurementand tendering; management andperformance contracts; policydevelopment; administrative and legalservices; and non-governmentorganisations.

Director of Nursing ServicesProfessor Joan Englert AMRN, CM, MSc (Soc), BHA, DNA,COTM, CIC, FCN (NSW), FRCNA, FAIM

The director of nursing services isresponsible for nursing care at ourfacilities. She works closely with clinicalservice providers to ensure theimplementation of best practiceinitiatives as part of improved patientdelivery and outcomes. The positioncovers the Staff Development andTraining Network to meet the ongoingneeds of employees and qualitymanagement.

Above: CSAHS Executive Management Standing: Jan Whalan (left), Richard Gilbert,Candy Cheng, Dr Peter Kennedy, Professor Joan Englert AM. Seated: Dr Diana Horvath AO, Michael Wallace.


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Operational Structure

Internal Audit Manager

Director of Health Services

Director of Nursing Services

Director of Health Services

Planning

Director ofFinance

Director ofCorporateServices

Deputy Chief Executive

Officer

Hospitals that offer key servicesRoyal Prince Concord Canterbury Balmain United Dental Rozelle

Alfred Hospital Hospital Hospital Hospital Hospital Hospital

NSW Health Director-General Chief Executive Officer Board of Directors

NSW Minister for Health

Key service areas

Bone, Joint and Connective Tissue Service

Cancer Services

Cardiovascular Services

Central Sydney Laboratory Service

Dental Services

Gastroenterology and Liver Services

General, Geriatric and Rehabilitation Medicine

Medical Imaging Services

Mental Health Services

Neurosciences

Population Health and Drug and Alcohol Services

Respiratory and Critical Care Service

Women’s and Children’s Health

Allied Health Services


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Moving towards abetter futureOur massive capital worksredevelopment, the $390million Resource TransitionProgram, continues to powerahead and this year entered anexciting phase at Royal PrinceAlfred Hospital, with the firstdepartment, a combined adultintensive care unit, moving intothe new Clinical Servicesbuilding.

Concord Hospital is also beingupgraded to meet the changing trendsin healthcare. Highlights this yearinclude the near completion of the westinfill above the Emergency Department,with services moving into one building.This relocates related departmentsalongside each other for enhancedpatient care.

The RTP represents:

> the fair and equitable distribution ofhealth resources – money, peopleand facilities

> a period of transition and change inpreparation for the future

> a program of capital works whichwill provide for the best physicalenvironment in which to deliverpatient care.

Building on last year’s successes,including completion of the $10 millionupgrade at the United Dental Hospitaland the official opening of the RPAInstitute of Rheumatology andOrthopaedics, the RTP is transformingthe following facilities.

Royal Prince Alfred HospitalThe commissioning of the new ClinicalServices building has continued to takeshape since the handover of areasbegan in January 2002.

Level three is a hotfloor which willinclude the Intensive Care Service, aneonatal intensive care unit, 22operating theatres, delivery suites forWomen’s and Children’s Health, and adirect, exclusive lift to the EmergencyDepartment.

The Picture Archival CommunicationSystem has been installed into thebuilding to provide online medicalimages at the point of patienttreatment, saving time and resources.

Women’s and Children’s Health isexpected to move across from the KingGeorge V building to become RPAWomen and Babies, with its ownentrance on Johns Hopkins Drive.

Above: Let’s get packing! Therelocation team moves peoplethroughout CSAHS as part of the RTP process.


Concord HospitalWith building works progressing well,levels one to three of the multibuilding’swest infill, above the EmergencyDepartment, are almost finished. Thenew Day of Surgery Admission Centreopened in February, allowing for thesmooth transition of patients to theoperating suite and recovery room onthe same floor. In March, theambulatory care and endoscopy units,along with cardiovascular services,moved into the west infill.

The east infill, home of the newintensive care and high dependencyunits, is underway while planning forthe new Statewide Severe BurnsService is well advanced and includesa dedicated operating theatre andambulatory care.

Planning continues for the relocation ofMental Health Services from RozelleHospital to purpose-built facilities onthe Concord Hospital campus.

Inner West Health CentreA masterplan is being finalised for ajoint development with a nursing homeoperator. The $21.6 million centre atCroydon brings together communityservices currently located at severaldispersed sites and provides a specialcare nursing home and independentliving accommodation for the aged.

Other RTP projectsThere are refurbishment plans forCamperdown Community HealthCentre and redevelopment plans forMarrickville Community Health Centreunderway, as well as refurbishment ofthe King George V building to house avariety of hospital and administrativeservices next year.

For a more detailed account of thestatus of RTP projects, please refer tothe Clinical Groups section (pages 14-28) and Our Facilities section(pages 29-37).

Right: The new Clinical Services building at RPA takes shape.Below: Concord Hospital’s east infill has been carefully designed to blend the newarchitecture with the old.


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The clinical disciplines oforthopaedics, rheumatology,immunology and allergy, burns,plastic and reconstructive anddental surgery, HIV/AIDS andsexual health are united under thebanner of the Bone, Joint andConnective Tissue Service. Care is given through day surgery,inpatient admissions, ambulatory care,and elective and emergency admissions.

As part of our dedication to quality, thefollowing initiative has been highlightedin Evaluation and Quality ImprovementProgram (EQuIP) accreditation reports asan excellent program to improve patientcare.

A new assessment and treatmentprogram has been developed toidentify whether patients with lowtrauma fractures also haveosteoporosis Patients undergo bone density testingand if found to have the condition arereferred to an on-site osteoporosis clinic.The program follows a review of current treatments by theRheumatology and Orthopaedicsdepartments. In addition, rheumatologyspecialists are reviewing work areas,

Bone, Joint and Connective Tissue ServiceClinical Director Dr Peter Holman MB, BS, FRACS, FAOrthA

charts and reporting mechanisms toexamine whether there are anymeasures which can be employed toimprove care and current practices.

Rheumatology staff are continuing theirinvolvement in trialing new treatmentsto target rheumatoid arthritis, as part ofinternational and multi-centreinvestigations. Through the newtherapies, outpatients are being treated with antibodies that targetinflammation in the joints, with closemonitoring by clinical staff.

Key Indicators 99/00 00/01 01/02

Staff EFT* 359.4 319.0 296.9

Admissions 9,799 8,829 8,845

Same-day admissions 3,456 3,338 3,193

Occasions of service** 60,776 45,800 52,919

* equivalent full-time** change due to construction work and the RTP

Bone, Joint and Connective Tissue Service

RPA Concord Canterbury

Orthopaedics • • •

Rheumatology • • •

Plastic and Reconstructive Surgery • •

Burns •

Faciomaxillary Surgery • •

Trauma • •

Dentistry • •

Immunology • •

Sexual Health Services •

NSW Institute of Sports Medicine •

The Statewide Severe BurnsService at Concord Hospital willmove into a new clinical area laterthis year It will contain new treatment sites, adedicated operating theatre and a newresearch laboratory. The lab will allowscientists to culture skin cells fromstamp-sized patient samples, andprovide replacement skin for peoplewith severe burns. In a six-week period,enough skin can be grown to cover ahuman body. The introduction of newdressing materials for burns patientshas changed clinical practice, reducinginfection rates and the frequency andlength of dressings, in addition topromoting optimal healing.

The achievements of theDepartment of Plastic andReconstructive Surgery wereshowcased on the Nine Network’sRPA series in 2001Thousands of weekly television viewerswatched the skilled hands of plasticsurgeon Dr David Pennington and stafftransform the face and body of Kenyanboy Safari, who was badly burned in afire in his homeland. Safari’s battlecaught the imagination of the nationand helped the Logie award-winningprogram receive its third consecutiveLogie nomination.

Sexual Health Services started aclinic for men at The Sanctuary inNewtown and developed a sexualhealth promotion project for theVietnamese community

Above: Burns Unit medical director Dr Peter Maitz in the skin laboratory.

Left: Molecular and Clinical Genetics registrar Dr Melody Caramins.


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All CSAHS cancer services operateunder the banner of the SydneyCancer Centre. Clinical practice isbased on world’s best evidence,and care is delivered by a multi-disciplinary team with expertise inkey types of cancer. We applyresearch discoveries quickly anddisseminate information to patientsthrough various means, includingour website, publications and ofcourse, our expert staff.The Sydney Cancer Centre’s keydepartments are at Royal Prince Alfredand Concord hospitals, inpatientpalliative care at Canterbury Hospital,outreach palliative care communitynurses and a clinic at Dubbo in theState’s far west. Core units of theSydney Cancer Centre are the SydneyMelanoma Unit, radiation oncology,surgical oncology, medical oncology,palliative care, breast surgery, urology,bone and soft tissue sarcoma, headand neck surgery, gynaecologicaloncology and BreastScreen Central andEastern Sydney.

Clinical practice emphasises multi-disciplinary meetings, evidence-basedpeer-reviewed practice and clinicalresearch.

This year we undertook strategicplanning in clinical service delivery andresearch for the period 2002-2007.

We began a feasibility study toestablish a proton facility This is an initial step towardsdeveloping the first Australian protonbeam facility. Proton beam therapy isthe latest and most effective type ofcancer radiation treatment.

RPA and Dubbo were further linkedthrough grants for telemedicine and aclinical trials nurse.

The Sydney Cancer Centre Foundationwas established to assist cancerfundraising and is chaired by the LordMayor of Sydney, Frank Sartor.

Cancer ServicesClinical Director Professor James Bishop MD, MMed, MB, BS, FRACP, FRCPA

The Institute of Haematology, under theleadership of Professor Doug Joshua,has won the rights to host the 10thInternational Multiple MyelomaWorkshop.

Professor John Thompson was featuredon ABC TV’s Australian Story for hisground-breaking work in melanomatreatment at the Sydney MelanomaUnit.

Sydney Cancer Centre to becomea national centreWe are aiming to further develop theSydney Cancer Centre to meetinternational criteria as a comprehensivecancer centre, using cost-effectivemethods. This development has beenassisted by a Commonwealth cancerresearch grant held jointly with theCentenary Institute.


Staff EFT* 370.0 398.2 417.6

Admissions 18,111 14,799 12,059


Non-inpatient occasions of service** 114,775 129,022 170,663

* equivalent full-time** total public and private, including outreach clinics and BreastScreen

Cancer Services


Medical Oncology • •

Surgical Oncology •

Radiation Oncology • •

Urology •

Sydney Breast Cancer Institute • •

BreastScreen Central and Eastern Sydney •

Gynaecological Oncology •

Clinical Haematology • •

Head and Neck Surgery • •

Sydney Melanoma Unit •

Palliative Care • • •

Dermatology • •

Bone and Soft Tissue Sarcoma Service •

At the same time we expect to curemore cancers through our ownresearch, applying discoveries fromaround the world and world’s bestclinical practice.

We will provide a professional andsupportive multi-disciplinaryenvironment for all our patients, withcounselling, psychosocial support andcomplementary approaches. Depth andrelevance in basic laboratory research,translational research, clinical trials andpopulation research are integral to ourpractice innovation. To achieve this wewill continue to teach and train a newgeneration of cancer research scientists,clinical cancer specialists, oncologynurses and others, as well ascontinuing to educate the public incancer prevention and early detection.


Cardiovascular ServicesClinical Director Associate Professor Brian McCaughan MB, BS (Hons 1), FRACS

Cardiovascular Services bringstogether the specialties ofcardiology, vascular andcardiothoracic surgery, renal,endocrinology and nephrology. With a leadership role in research, newtreatments and technology, the groupmanages a variety of complex diseaseareas while continuing to focus onimproving patient outcomes.

Cardiovascular Ambulatory Care atConcord Hospital is an example of howcloser collaboration among staff fromdifferent specialties is improving patientcare. Cardiac and vascular specialistswork side-by-side in the catheterlaboratory, meaning patients are nowable to complete their diagnostic,interventional and consultativeappointments at the same on-siteservice. This has led to a 3.1 per centincrease in same-day admissions and a12 per cent rise in cardiac interventions.

Clinical advances in vascularmedicine mean some patients nolonger have to endure hours in theoperating theatre to repairdamaged or diseased arteriesNow surgeons are able to insert acatheter into an aneurysm and treat theproblem from the inside, in place ofopen abdominal surgery. The newtreatment is less invasive, with quickerrecovery and reduced complications.This technique is at world standard atRoyal Prince Alfred and Concordhospitals, with medical staff touringfacilities in the United States and Europeto teach others.

The Nephrology Department saw a 66per cent rise in non-admitted homedialysis training at the Dame EadithWalker facility. This has resulted incritically ill patients having greater accessto hospital dialysis services, with a 16.6per cent increase in services this year.

Prospects for patients who require renaltransplant surgery have dramaticallyimproved. The number of living andrelated organ donors has increased by18 per cent this year, as the focusmoves away from cadaveric donors.This has led to a 20 per cent increase inrenal transplants.

Patient outcomes continued to improvedue to the reduction of organ rejectionrates and daily monitoring through thepost-renal transplant clinic.

Two priority healthcare projects inheart failure and diabetes havemeant fewer patients withpotentially chronic illness have tospend valuable time in hospitalThe projects aim to manage patients intheir own homes, with greater access tocommunity support through hospitalstaff, general practitioners and projectliaison officers. To date more than 700people have been treated as part of theDiabetes Foot Care Program and 300patients are enrolled in the Heart Failure


Staff EFT* 517.8 534.3 540.0

Admissions 27,745 27,935 28,893


Outpatient occasions of service 32,285 34,344 40,313

* equivalent full-time

Cardiovascular Services


Renal* • •

Cardiology • •

Cardiothoracic Surgery • **

Endocrinology • • +

National Poisons Register •

Vascular Surgery • •

Clinical Pharmacology •

* includes nephrology and transplantation** a limited service specialising in the insertion of cardiac pacemakers+ specific service managed by the facility

Below: Endocrinologist Elizabeth Chua(left) and podiatrist Tazmin Clingan treatPaul Hawker in the Diabetes Centre high-risk foot clinic.

Program. The programs are improvingoutcomes for patients, with fewer re-admissions to hospital.

Six extra cardiac beds, a rise of 13 per cent, have been opened inRPA’s Emergency Department Each features state-of-the-art heartmonitoring equipment purpose-designedfor the early detection of potentially life-threatening heart rhythms. They meetan increase in demand from patientsand ensure faster medical treatmentwhile reducing waiting times.


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Central Sydney Laboratory Serviceis one of the five pathology hubs inNSW and continues to provide ahighly efficient specialised testingservice for public and privatehealthcare centres. Staff work in laboratories at RoyalPrince Alfred, Concord and Canterburyhospitals to provide the widest range ofspecialist tests in NSW, including anextensive range of molecular biologytesting.

The prime focus is to provide timelyand quality patient test results for ourmany customers, however, researchand teaching remain an importantcomponent of activities.

A successful first year partnershipwith Pathology Alliance Australiahas led to significant savings ontendersFormed last year, the superhub wasestablished to allow the sharing ofexpertise and resources, and includesHunter Area Pathology and PacificLaboratory Medicine.

As part of the Resource TransitionProgram a new laboratory facility isbeing built to co-locate similar testingareas and maximise resources and staffskills.

New clinical director AssociateProfessor Peter Stewart began his four-year term in May, succeeding AssociateProfessor Geoff Duggin, who held thepost for two terms.

Central Sydney Laboratory ServiceClinical Director Associate Professor Geoff Duggin MB, BS (Hons), PhC, FRACP, FAFPHM (to May 2002)

Associate Professor Peter Stewart MB, BS, BSc (Med), MBA, FRACP, FRCPA (from May 2002)


Staff EFT* 427 415 404

Occasions of service 826,231 858,317 945,669


Central Sydney Laboratory Service

RPA* Concord* Canterbury

Anatomical Pathology • •

Biochemistry • • •

Blood Bank • • •

Electron Microscopy •

Endocrinology • •

Clinical Andrology Laboratory •

Gastroenterology Laboratory •

Haematology ** • •

Immunology •

Laboratory Information Services • •

Microbiology • •

Molecular Genetics/Medicine • •

Renal Laboratory •

* RPA and Concord Hospital laboratories provide a range of tests for facilities outside CSAHS** includes the Kanematsu Research Laboratory

Right: The CSLS central specimenreception at RPA processes over 2,000samples each day. Farida Pambos checkseach one as they arrive.


Dental services are coordinatedfrom Australia’s largest oralhealthcare teaching facility, UnitedDental Hospital. A full range ofgeneral and specialist treatmentscater for local residents and thoseacross NSW who hold currentpensioner and healthcareconcession cards. A network of school, hospital andoutreach services also exists in additionto the on-site services. Other programscater for people with specialrequirements.

To meet society’s changing healthcareneeds, the clinical group’s strategicintent, management and structure werereviewed this year. As a result, a newOral Health Services clinical group isbeing established with the approval ofthe CSAHS Clinical Council.

The new service will enhance thespecialist areas within the group toform a new, integrated and robustclinical stream which will encouragegreater efficiency and patient care.Strategic planning for the CSAHS andNetwork Oral Health Plan will continuein 2002-03.

We opened the UDH AccessCentre, a call centre for triagingand booking appointmentsNSW Health’s Information System forOral Health computer program is theplatform on which our appointmentand patient information systemoperates. It will be accessible throughthe CSAHS network from any dentalclinic in the group when the clinics atRoyal Prince Alfred and Concordhospitals come on-line in 2002-03.

Guiding the next generation ofdental specialistsThe clinical group provides training fordentistry students from the University ofSydney and to TAFE students learningto be prosthetists and dental assistants.

Postgraduate students in a number ofclinical disciplines from the universityare spending more of their clinicalrotation at UDH. This will broaden theirskills and enhance the quality of theirfinal degrees.

Dental ServicesClinical Director Dr Susan Buchanan BDSc, MDS, MBA, FRACDS, FICD

As part of a shift from undergraduateentry to postgraduate entry courses, thesecond year of the graduate degree indentistry has been introduced in closecollaboration with the University. Thismarks a move towards problem-solvingbased learning, with practical experienceat UDH an integral part of studies.

UDH continues to research the linksbetween gum and cardiovascular diseasewith a $140,000 grant, jointly fundedby the National Health and MedicalResearch Council of Australia and theHospital Contribution Health Fund andMedical Research Foundation.

The grant was awarded to the PERICARResearch Group, led by head ofPeriodontics Dr Barbara Taylor, incollaboration with Professor GeoffreyTofler from Royal North Shore Hospital.

NSW Health has also introduced aweighted cost of services performanceindicator to measure efficiency andeffectiveness of services.


Staff EFT* 325.0 317.4 318.8

Occasions of service

Adults 157,221 148,682 177,694

Children 31,876 28,271 39,129


Dental Services

Specialist General Adult Children

UDH • • •

RPA * •

St George Hospital •

Peakhurst Community Centre •

Sutherland Hospital •

Canterbury Hospital * • •

Concord Hospital * •

Rozelle Hospital •

Clemton Park School •

Marrickville School •

Rozelle School •

Homebush West School **

Kirkton Road Centre **

Cellblock Youth Centre **

3 x mobile vans •

* not a full range of specialist services** patient assessment with referral to UDH for treatment

Above: More than 200,000 patients aretreated at UDH every year.


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The Australian NationalTransplantation Unit and the Total Parental Nutrition Service arekey components of this clinicalgroup. Other specialties includegastroenterology, colorectal, uppergastrointestinal, biliary and generalsurgery.

An integrated medical and surgicalservice is nearing completion atConcord HospitalStage one has been completed with theopening of a purpose-built AmbulatoryCare and Endoscopy Unit in the westwing, facing Hospital Road. It featuresthe endoscopy unit and stomal therapy,colorectal, liver and gastroenterologyoutpatient clinics.

The development is part of the ResourceTransition Program, which aims tomaximise the quality of patient care bylocating related medical and surgicalservices side-by-side. Inpatient services in gastroenterology, uppergastrointestinal surgery and colorectalsurgery will relocate to the same floorlater this year.

ACE remains a leader inendoscopic ultrasound, which isused to diagnose and stagegastrointestinal tract cancers priorto treatmentA $4.95 million five-yearCommonwealth project grant forresearch into screening for cancer hasbeen awarded to the colorectaldepartments at Royal Prince Alfred andConcord hospitals.

Concord Hospital’s Colorectal CancerHealth Outcomes and Values ResearchProject is now in its 32nd year. Newfindings this year included identifyingthe pathological factors which allow usto more accurately select patients foradjuvant therapy, a treatment whichhelps reduce recurrence and improvessurvival.

Other findings have included improvedsurvival in colon and rectal cancer as aresult of using standardised surgicalprotocols to remove cancers alonganatomical lines. This is a more precisetechnique than traditionally used.

Gastroenterology and Liver ServicesClinical Director Professor Les Bokey MB, BS, MS, FRACS

A quality of life study looking at howcolorectal cancer patients value theirtreatment has been completed by theCentre for Ethics, Values andPhilosophy in Medicine. Thisinformation is now being used todevelop new ways of assessing theservices we deliver.

Ongoing development inlaparoscopic surgical servicesremains an important activity forspecialist staff


Staff EFT* 261.5 242.4** 259.1

Admissions 16,398 3,253** 14,389

Day only admissions 6,402 1,048** 6,958

Occasions of service*** 10,730 9,304 5,953**

* equivalent full-time** decrease due to change in ward configurations as part of the RTP *** does not include Canterbury Hospital

Gastroenterology and Liver Services


Liver Transplant •

Gastroenterology • •

Colorectal Surgery • •

Upper GIT Surgery • •

General Surgery • • •

The Colorectal Surgical Department atRPA is continuing its research, underthe supervision of Associate ProfessorMichael Solomon, into laparoscopicsurgery for Crohn’s disease, colorectalcancer and rectal prolapse. Research isshowing improved patient outcomeswith a laparoscopic approach toCrohn’s disease and rectal prolapse.

All services at RPA and ConcordHospital continue to attract high-calibre national and internationalfellows looking to further theirtraining in their chosen fields

Above: Professor Hans Schlitt recruitedfrom Germany, has been appointeddirector of the Australian National LiverTransplantation Unit. The appointment willensure our continuing role as a leadinginternational player in transplantation.


This clinical group provides servicesfor the elderly, people withdisabilities and those with generalmedical problems. Acute andambulatory care, inpatientrehabilitation and day treatmentsare delivered by staff in hospitaland community settings.Specialist clinics include those forParkinson’s disease (in association withthe Neurosciences clinical group),cognitive disorders, continence, amputeeand chronic pain management andburns rehabilitation.

A major risk management projectbegan this year, aimed atmaximising safety for communityand hospital staff as well as clientswhen in the community New work practices were developed,piloted and introduced. These includedstandardised referral and assessmentforms, a respite outing policy includingvenue and individual client riskassessments, as well as safe outing planformats. Mobile phones have beenprovided for use in all CSAHS vehicles.

A comprehensive client system, with individual clinical assessments andindividual reviews, has been successfullyintroduced in all day centres. We arenow developing standard managementplan protocols and modifying CSAHStendering agreements to reflect riskmanagement principles.

A carers’ education project beganthis year Funded by NSW Health, this projectwill develop a model for carers’education across services in General,Geriatric and Rehabilitation Medicine. It will focus on education groups forelderly carers of adults with disabilitiesas well as investigating the special needs of this target population.

Enhanced community services Additional home and community carefunding has been received forcommunity-based physiotherapy,occupational therapy, podiatry andnutrition programs. The Inner West Carer Respite Centre and the DementiaSupport Service were re-funded.

General, Geriatric and Rehabilitation MedicineClinical Director Dr John Cullen MB, BS, FRACP

The Community Visitors Schemewon a four-year continuousfunding grant as well as fundingfor 20 additional visitors. Atpresent more than 120 visitorsfrom 30 different language groupsvisit 165 people in 86 residentialaged care homesThe Jane Evans Day Centre hasreceived funding to begin a Russiancluster group.

The culture of research andteaching remains a strong focusUnder the leadership of Professor David Le Couteur, the Centre forEducation and Research on Ageing hascontinued to expand at ConcordHospital with additional NSW Healthinfrastructure funding. The centre hasincreased its output of research papersand developed four major themes:neurodegenerative disease,biogerontology, population studies andresidential and community care.


Staff EFT* 472.2 459.0 466.8

Admissions 12,123 13,916 8,134




General, Geriatric and Rehabilitation Medicine

RPA Concord Canterbury Balmain Community

Acute Inpatient Services • • • •

Rehabilitation Inpatient Services • • •

Day Hospital Services • •

Outpatient Services • • • •

Community Assessment •

Psychogeriatric Services • •

Home Therapy Service • •

Respite and Carer Support • •

Community Options • •

Provision of Appliances for Disabled People •

Community Podiatry • • • •

Transcultural Aged Care Services •

Day Centres • • •

Above: Occupational therapist TheodoraStavrinos (right) works with Gretchen Mollat Balmain Hospital’s STRONG clinicwhich provides supervised strengthtraining for the elderly.


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Medical Imaging Services producespictures of the structure andfunction of the body that enabledoctors across CSAHS to makediagnoses and decisions abouttreatments and patient care. It includes the departments ofRadiology at Royal Prince Alfred,Concord, Canterbury and Balmainhospitals, PET and Nuclear Medicine atRPA and Nuclear Medicine at ConcordHospital.

The Positron Emission Topographyservice at RPA has secured one ofonly seven Australia-wide licencesfrom the CommonwealthGovernment to provide PET scansAll the major teaching hospitals inSydney and Newcastle joined thecompetitive tender process which wasfinalised in late 2001. The licenceallows the service to continue toprovide important diagnostic imaginginformation for people with a variety ofcancers, neurological conditions andheart disease.

The innovative Picture Archivaland Communication System hasbeen installed at RPA andBalmain hospitals PACS converts hard-copy X-ray filmsinto a digital format that can be sentelectronically and rapidly acrosscomputer networks for display oncomputer screens throughout thehospital. Doctors access the computerusing their own password to view thepatient scans when and where they areneeded – in ward, clinic, operatingtheatre and office settings. The PACS atRPA uses web-based technology whichis easy to operate and more efficientthan other systems.

The Radiology Department at RPA hasacquired a new MRI scanner as part ofthe Resource Transition Program. Thedevice is faster, lighter and moreversatile than the previous model.

Medical Imaging ServicesClinical Director Associate Professor Michael Fulham MB, BS, FRACP

RPA also successfully tendered toinstall a baby cyclotron to producenew PET compounds for the diagnosisand treatment of cancer andneurological diseases, includingepilepsy, Parkinson’s disease anddementia. The new cyclotron willbegin operations in the second half of2002.

Staff at Concord Hospital havedeveloped a unique test to detectlife-threatening fat emboli in thelungs following major orthopaedicsurgeryDeveloped by Drs Warwick Bruce andHans Van der Wall, this method fordetecting fat emboli on the lungs hasled to safer, more targeted treatments.Patients with blood clots are treatedwith anti-coagulants but those withother clots are now given oxygen aspart of their treatment and monitored.


Staff EFT* 228 231 231



Medical Imaging Services

RPA Canterbury Concord Balmain

General Radiology • • • •

Interventional Radiology • •

MRI •

CT • • •

Ultrasound • • •

Cerebrovascular Embolisation (CVE) •

Mammography • •

Nuclear Medicine • •

PET •

Two radiation safety manuals, includinga training guide, were developed as partof a quality initiative by RPA’sDepartment of PET and NuclearMedicine. The manuals can be accessedelectronically on the staff intranet,providing information for all users ofradiation and radiation devices inCSAHS. The electronic format ensuresquicker updates of new information.

Policies to limit radiation exposure towomen of childbearing age and fordealing with cardiac arrests werereviewed this year as part of an ongoingcommitment to improving quality. Thereview ensures improved awareness ofrelevant issues, revision of currentpolicies and the introduction of newmethods to record critical data.

Above: Radiographer Dr Khang Cong Vanscans an orthopaedic patient to detect forblockages in the lungs.


Mental Health Services provides acomprehensive range of care forchildren, adolescents, adults andsenior citizens in hospital,community and specialist settings.This past year we forged closer linkswith the divisions of General Practicethrough the signing of Memoranda ofUnderstanding. This will allow forimproved coordination with thedivisions and result in better continuityof care for patients in hospital and intheir homes.

To further meet changing needs in care,planning continues for new andintegrated community facilities atCamperdown, Marrickville and theInner West Health Centre at Croydon,as part of CSAHS’s Resource TransitionProgram.

In addition, the new mental healthprecinct to be built on the ConcordHospital campus is in the designphase. The project aims to co-locatemental health services on the same siteas the general hospital, in line withworld’s best practice to mainstream thedelivery of services.

Community rehabilitation services wererevamped in the Canterbury sector anda Recovery and Extended Care Servicewas established to provide morefocused and individualised care forpeople with long-term mental healthproblems.

Mental Health ServicesClinical Director Dr Victor Storm MB, BS, MPA, FRANZCP, FAFPHM

In the past 12 months we trainedthe majority of clinical staff for theStatewide Mental Health Outcomeand Assessment Tool project This initiative aims to establish acommon platform for mental healthassessment tools and outcomemeasures across NSW. It is largelybased on our established assessmentprotocol. It promotes tighter clinicalmanagement within area healthservices and between related servicesin NSW.

Services to the indigenous communitywere expanded at Redfern AboriginalMedical Service with increased clinics


Staff EFT* 790.4 745.0 751.0

Admissions 9,767 8,567 8,436



Mental Health Services

RPA Concord Canterbury Rozelle Community

Acute Care • • • •

Consultation • • • •

Assessment • • • • •

Rehabilitation Accommodation • •

Aged Care Beds • •

Aboriginal Service • • • •

Telepsychiatry • •

Forensic Services • •

Child and Family Services • •

HIV/AIDS Mental Health • • •

Boarding House Teams • • • •

Hearing Impaired Services • •

Dietary Disorders Service • •

Bilingual Counsellors •

A more detailed table on Mental Health Services is included in the CSAHS Statutory Annual Report 2001-2002

in child, adolescent and adultpsychiatry, promoting greater accessand culturally appropriate care.

In early intervention and prevention, apositive parenting program tostrengthen parental bonds and teachways to deal with young childrenbegan. We expanded our projecttargeting the children of mentally illparents to ensure they have access tosupport programs, if required. Weenhanced our connections to schoolsthrough the Schools Link project anddevoted two additional staff membersto the mobile adolescent service.


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Neurosciences is responsible fortreating patients with diseases ofthe brain, spinal cord, peripheralnerves and eye. It includes thePain Management Unit, as well asspecialist clinics for disorders ofthe ear, nose and throat. The Neuropathology Department joinedthe clinical group this year. It bringstogether services previously withinanatomical pathology, forensicmedicine and neurology to form one ofAustralia’s largest neuropathology units.The result is an enhanced clinical,research and teaching environment.

Concord Hospital’s Ear, Nose andThroat Department is a centre ofexcellence in rhinology andanterior skull base surgeryAs part of this plan the department hasinstalled a Landmarx Image GuidanceSystem. During surgery this machineallows an operating team to see on acomputer screen the location of theirinstruments in relation to the pathology.This is a more targeted approach andproduces better outcomes.

Specialists at Royal Prince AlfredHospital are treating blood vesselhaemorrhages in the brain withoutthe need for an invasive operationThe treatment is proving effective.Patients experience less trauma andrecover more quickly with asignificantly reduced hospital stay.

An area-wide policy has beendeveloped to introduce the treatmentand make full use of the specialisedendovascular and radiologicalintervention group at RPA.

A stroke chronic care project isbeing developed following a NSWHealth grantThe project involving the stroke units atRPA and Concord Hospital, will explorenew methods of caring for patients.

Neurosciences at RPA received anexcellent report from the Evaluation andQuality Improvement Program (EQuIP)accreditation surveyors in October.

NeurosciencesClinical Director Associate Professor Michael Besser AM MB, BS, FRACS, FRCSC, FACS

Favourable comment focused on theexcellent synergy within the disciplines,which involved good leadership andresulted in better patient outcomes inclinical practice and administration.Also earning praise were the group’sresearch initiatives, clinical innovationand commitment to quality outcomes.


Staff EFT* 190.6 190.0 140.5

Admissions 8,202 6,026 6,170


Occasions of service** 31,847 20,155 14,707+

* equivalent full-time** RTP realignment of services+ Concord Hospital figures not available

Neurosciences


Neuropathology • •

Neurosurgery • •

Neurology • •

Ophthalmology • • •

Otolaryngology, Head and Neck Surgery • • •

Pain Management Unit • •

Other internationally recognisedresearch facilities within CSAHScontinue to do exceptional work. These include the Department ofNeurogenetics and the specialisedParkinson’s Clinic at Concord Hospitalas well as RPA’s centre of excellence inhearing and balance.

Above: The Neuropathology Department now comes under Neurosciences, headed byAssociate Professor Michael Besser.


The Population Health and Drugand Alcohol Services comprisesthe Division of Population Health –that is, Community HealthServices, Multicultural Health,Women’s Health, the Public HealthUnit, the Health Promotion Unitand the Social Health ResearchUnit – as well as Drug HealthServices.Specialist staff provide services thatpromote good health in areas such astobacco control and physical activityprograms; protect the local communityagainst illness through, for instance,food inspection and immunisationservices; and promote the earlydetection of illnesses through suchservices as cervical and child healthscreening.

They support people experiencingdifficult periods in their lives, as well asaiming to reduce harm caused bypotentially harmful behaviours through,for example, needle and syringeexchange programs and the promotionof safe sex messages.

Staff treat illness and assist withproblems in a variety of ways including,community nursing, drug healthservices and care for children andadolescents. They monitor populationhealth in CSAHS through variousmethods, including the surveillance ofinfectious diseases and analysis ofresults from the national census andNSW Health Survey.

Following the events of September 11the Public Health Unit dealt with 78suspected cases of anthrax, followedup more than 150 people who cameinto contact with these cases and dealtwith many community inquiries andexpressions of concern.

Population Health and Drug and Alcohol ServicesClinical Director Associate Professor Peter Sainsbury MB, BS, DObstRCOG, MHP, FRACMA, FAFPHM, PhD

In the first full year of operation of theNSW Families First program, earlychildhood health nurses visited thehomes of nearly 3,000 families with anewborn baby – half within the firsttwo weeks of birth.

The introduction of second-generationwound care products to communitynursing services improved healing timeand client comfort, as well as reducingstaff hours and costs.

Our Health Promotion Unit, inpartnership with LeichhardtCouncil, piloted a Walk to Schoolproject with Forest Lodge PublicSchoolDesigned to raise awareness andpromote the benefits of walking, theprogram won two National HeartFoundation Local Government Awardsfor promoting cardiovascular healththrough physical activity.

Implementation of initiativesfollowing the NSW Drug Summithas led to significant increases indrug health servicesWe provided public methadone andbuprenorphine treatment to 600 peoplein the CSAHS area last year. Seventy-five per cent of people receivedassertive case management and a


Staff EFT* 439 430 461**

Occasions of service 467,864 467,845 444,591+

* equivalent full-time** increase due to NSW Drug Summit funding+ includes modifications to community nursing care plans

Population Health and Drug and Alcohol Services

RPA Concord Canterbury Rozelle Community Community Health Services • • • •

Public Health Unit •

Health Promotion Unit •

Multicultural Health • •

Social Health Research Unit •

Women’s Health • •

Drug Health Services • • • • •

further 25 per cent are under sharedcare arrangements with generalpractitioners and pharmacies.

Buprenorphine was introduced as atreatment for heroin and opioiddependence. Detoxification completionrates rose to 80 per cent.

The Public Health Unit investigated andtook appropriate action with allegedoutbreaks of salmonella at a localbakery and a residential college andfollowed up several contacts of cases ofmeningococcal disease on a cruiseship.

The Health Promotion Unit workedwith young people from MarrickvilleYouth Resource Centre and two graffitiartists to develop a mural atMarrickville Railway Station. Theproject aimed to raise awareness andprovide public information about thehepatitis C virus.

A drug and alcohol counselling servicewas established at RiverwoodCommunity Centre after HIV/AIDShealth promotion staff worked with theRiverwood Housing Estate, CanterburyDrug Action Team and CanterburyMulticultural Youth Health Service toidentify the health needs of youngpeople from low socio-economicgroups.


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The Respiratory and Critical CareService consists of a number oflarge and busy departments acrossCSAHS. Intensive care unitslocated at both Royal Prince Alfredand Concord hospitals, care for thesickest patients within the hospitalsystem. Anaesthetic departments at Canterbury,Concord and RPA hospitals provide acritical component in the extensivesurgical services across CSAHS. Inaddition, these departments provideexpertise in the intra-hospital transportof seriously ill patients and thetreatment and monitoring of sickpatients undergoing high-techinvestigation, and play an integral partin pain management services acrossour area health service.

Two large departments of respiratorymedicine are located at RPA andConcord Hospital. Both departmentsprovide respiratory services not onlyacross CSAHS but also specialityservices that receive referrals from allover the State. Patients with respiratorydisease account for a large proportionof patients with medical illnessrequiring hospital care, and so bothdepartments play a major role in thein-hospital care of patients with acuteand chronic respiratory conditions.

Emergency services are provided atCanterbury, RPA and Concordhospitals. These provide the front-linecare for all three institutions and arewidely recognised as being areas thatare extremely busy and where thedemands on staff are very high.

Respiratory and Critical Care ServiceClinical Director Associate Professor Paul Torzillo MB, BS, FRACP

The main activity within the Respiratoryand Critical Care Service in the lastyear has been preparation for therelocation of the intensive care servicesto new facilities provided by theResource Transition Program at bothConcord Hospital and RPA. This willallow both ICUs to further improve theirefficiency and effectiveness in care ofthe critically ill.

The new ICUs at RPA andConcord Hospital will be two ofthe most advanced multi-speciality critical care units in the worldAt RPA the new Intensive Care Service,combining a general intensive careunit, high dependency unit,neurosciences and cardiothoracicintensive care unit, will be part of alarger hotfloor. Bringing all theseelements together in intensive care willallow a flexible system of bedavailability and nursing care, thatshould significantly improve the speed


Staff EFT* 644.4 663.6 694.3

Admissions** 15,024 11,924 13,602

Same-day admissions+ 4,802 8,720 10,604

Occasions of service++ 99,408 117,475 108,121

Admissions via emergency 26,004 31,514 35,607

* equivalent full-time** includes patients admitted from the Emergency Department and admissions into respiratory medicine and

infectious diseases+ includes patients admitted and discharged from emergency medicine and patients admitted to respiratory

medicine and thoracic surgery++ includes presentations to the Emergency Department and non-inpatient services

Respiratory and Critical Care Services


Respiratory Medicine • •

Sleep Disorders • •

Tuberculosis Clinic • • •

Thoracic Surgery •

Emergency Department • • •

Intensive Care • • •

Anaesthetics • • •

at which patients from the EmergencyDepartment can be admitted tointensive care. The hotfloor will alsoaccommodate neonatal intensive careand operating theatres.

The future direction of the service willinvolve optimising the use of thesestate-of-the-art facilities to supportmodern hospital care.

A helipad to be located on top ofthe new RPA Clinical Servicesbuilding will provide rapid accessto essential facilitiesPatients transferred from elsewhere inNew South Wales via helicopter, morethan three patients per week onaverage, will be rapidly and safelytransferred to the main intensive careservice. At present helicopters land onthe football oval adjacent to thehospital, resulting in substantialtransport difficulties and delays beforepatients are finally accommodated intheir intensive care bed.


This clinical group deliversspecialised care to women andbabies from six major departmentsat three hospitals.The past year saw the continueddevelopment of the new Royal PrinceAlfred Hospital Women and Babies, apurpose-built facility across the roadfrom the existing King George Vbuilding. The move is expected to takeplace in 2002/03.

Other highlights this year includedProfessor Ian Fraser, who heads theReproductive Endrocrinology andInfertility Unit, being awarded an Orderof Australia for his services to medicine,particularly in the fields of obstetrics,gynaecology and family planning.

The Reproductive Endocrinology andInfertility Unit reported an increase inviable pregnancy rates and a decreasein miscarriage rates in the IVF and IntraCytoplasmic Sperm Injection programs,especially in younger women. Thepregnancy rates achieved by this servicecontinue to be among the best inAustralia.

Planning is underway to launch amultidisciplinary twins clinicThe Department of Obstetrics willlaunch the new clinic in 2002/03. Thenumber of twins being born isincreasing and the new service willprovide much needed education andassistance for parents and staff.

Two midwives have reviewed over a sixmonth period, the outcomes of patientshaving induced labour with Prostin. Theresults have led to a major modificationof the protocol to ensure improved safetyand patient satisfaction with the process.

The postgraduate educationalprogram for health professionals inthe Neonatal Department and theJohn Spence Nurseries,commenced January 2001We now have a strong evidence-basedpostgraduate program, which providesongoing clinical education for staff andoverseas trainees.

Women’s and Children’s HealthClinical Director Professor Roger Houghton DPhil (Oxon), MB, BS, BSc (Med), FRANZCOG, FRCOG

Record fundraising year inneonatal medicineThis year we received more donationsthan ever before, including anultrasound machine from the BurnsPhilp Foundation. Funds were alsoraised to furnish the parents’ room inthe new RPA Women and Babies Centrefor Newborn Care, the new name forthe John Spence Nurseries.

Planning for a new paediatric wardabove the Emergency Departmentat RPA is almost completeCSAHS has been involved in thedevelopment of child health networks,based on the three tertiary paediatriccentres in NSW.


Staff EFT* 326.7** 393.9 391.7

Admissions 15,274+ 14,500 11,166



* equivalent full-time** does not include Canterbury Hospital+ a review of admissions indicated anomalies in counting

Women’s and Children’s Health


Obstetrics • •

Gynaecology • • •

Gynaecologic Urology Unit •

Pelvic Floor Unit •

Gynaecological Oncology (Cancer Services) •

Reproductive Endocrinology and Infertility •

Obstetric and Gynaecological Ultrasound and Foetal Medicine •

Neonatal Medicine •

Paediatrics • •

Right: Approximately 10,000 ultrasoundscans were performed in CSAHS this year.

The Child Protection Committeehas completed the CSAHSProtection PolicyThe initial intensive phase of stafftraining in child protection has beensuccessful. The program will continueunchanged with the permanentappointment of training staff.

It is anticipated that there will be anincreasing emphasis on patient-centredcare with the development ofmultidisciplinary one-stop clinics forboth diagnosis and management ofcomplex gynaecological, obstetric andpaediatric problems.


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Allied Health staff aim to maintainand enhance physical andpsychosocial function as well asdeveloping healthy life skills forpeople in hospital, ambulatory careand community health settings. The clinical grouping comprises theeight professions of social work, speechpathology, nutrition and dietetics,physiotherapy, podiatry, psychology,occupational therapy and orthotics.

It provides a wide range of servicesincluding mobility assessment andretraining, hydrotherapy, home visits toreview safety and function, alternativeaccommodation advice, psychologicaland neuropsychological assessment andtreatment, high-risk foot care, andnutritional assessment and intervention.

CSAHS has been providingsignificant input in developing anew orthotics and prostheticscourse for the State’s tertiarystudentsOur Orthotics Department is providingon-the-job training and clinicalplacement for University of NSWstudents studying the new orthotics andprosthetics degree course which beganthis year. Students studying at certificateand diploma level through the SydneyInstitute of Technology have have begungaining practical experience at ourdepartment this year.

Research by staff in nutrition anddietetics and occupational therapyincludes diarrhoea incidence in burnspatients and the effectiveness of therapyin improving fine motor function inchildren. The projects are being fundedby seeding grants from the University ofSydney’s Research Centre for Adaptationin Health and Illness.

A series of clinical indicator scales isbeing developed to measure the processand outcome of care. In particular, thephysiotherapy departments acrossCSAHS are working together to developa system to measure and compare theeffectiveness of interventions andtreatments and investigate varianceswhen they occur.

Allied Health ServicesDirector Katherine Moore BApp Sc (OT), MAppSc (OT)

To promote cultural understanding,an Aboriginal liaison officer servicehas been established at RoyalPrince Alfred HospitalThe service aims to assist the smoothtransition of patients to hospital whilecontinuing to meet their healthcareneeds.


Staff EFT* 218 211 211

Inpatient occasions of service 204,858 208,102 214,796

Outpatient occasions of service 111,726 114,312 119,148

* equivalent full-timeThis table applies to Allied Health at RPA, Concord and Canterbury hospitals

Allied Health Services

RPA Concord Canterbury Rozelle Balmain Community

Physiotherapy • • • • • •

Social Work • • • • • •

Nutrition & Dietetics • • • • • •

Occupational Therapy • • • • • •

Speech Pathology • • • • • •

Psychology • • • •

Orthotics • • • •

Podiatry • • • • • •

Cancer Services social worker AngelaCotroneo won the United States/Australian Social Work ExchangeProgram Scholarship, which aims tofoster closer networks and the transferof information between the countries.

In line with best-evidence practice,back exercise classes for people withchronic and non-specific lower backpain began at RPA and ConcordHospital.

Additional podiatry services forhousebound clients have also started.

Below: Speech pathology services areoffered across CSAHS. Nicole Reeves (left)works with a client in RPA’s speechpathology department.

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Booth StreetBalmain NSW 2041Phone: (02) 9395 2111Fax: (02) 9395 2020Email: [email protected]/balmain

Balmain Hospital focuses on aged careand rehabilitation, as well as thegeneral health needs of residents onthe Balmain peninsula, and provides acomprehensive range of services. Weare committed to the care andtreatment of the elderly and tomanaging CSAHS’s community-basedservices for older people.

As part of a CSAHS strategy based atthe hospital, a winter beds serviceoperates from July to September eachyear to meet the annual seasonalincrease in demand from thecommunity. In the past year the servicetook patients from June 17.

The innovative Picture Archival andCommunication System is now fullyfunctional, following a successful trialat the facility. PACS has eliminated theneed for hard-copy X-ray film, withelectronic images and scans availablefor review and diagnosis at the blink ofan eye. It is now being installed atRoyal Prince Alfred Hospital as part ofa network.

Balmain’s STRONG (Strength, Training,Rehabilitation and Outreach Needs inGeneral Medicine) Program, whichprovides supervised strength training forthe elderly, continued to grow inpopularity and activity. Additionalresearch and support staffaccommodation was provided for theservice, a finalist in the State’s BaxterBetter Health, Good Health Careawards.

Balmain HospitalGeneral Manager Ken Cahill (to December 18 2001)

Ann Kelly (acting from January to February 2002) Peter Clout (appointed in March 2002)


Staff EFT* 270.3 275.5 266.1

Average available beds 87.0 78.7 80.5

Inpatient bed days 27,544 26,154 26,608

Total admissions 2,365 2,002 1,816

Bed occupancy rate (%) 86.9 91.9 90.7

Average length of stay (days) 11.5 13.1 14.7

ENIOOS** 79,897 81,045 83,491

* equivalent full-time** equivalent non-inpatient occasions of service

Above: Balmain Hospital operates a winter beds strategy each year to meet the seasonalincrease in demand.


Canterbury RoadCampsie NSW 2194Phone: (02) 9787 0000Fax: (02) 9787 0031Email: [email protected]/facilities/canterbury.htm

The hospital serves a local populationof more than 135,000 people, ofwhich 53 per cent were born overseas.Its specialties include general surgeryand medicine, obstetrics andgynaecology, paediatrics, aged care,rehabilitation and palliative care.

More than 90 per cent of peoplehaving surgery at Canterbury Hospitalare admitted on the day of theirprocedure thanks to changes in clinicalpractices, including a 20 per cent risein the use of pre-admission clinics.

The number of children withgastroenteritis being admitted tohospital fell from 34.5 per cent to 14per cent during a three-month period,from March to July this year, with theuse of best practice protocols and byemploying a staff specialist inpaediatrics. Children with asthma arealso spending less time in hospitalthanks to these measures, with theaverage length of stay falling by sixhours to 36 hours.

Four new programs for patients withchronic diseases such as cardiacfailure, stroke, diabetes and lungdisease have improved the healthoutcomes in these areas. Strategiesincluded promoting patient and carereducation, early intervention andshared care with general practitioners.

Services for people with drug andalcohol problems were expanded and amental health liaison position wasestablished in the EmergencyDepartment.

Volunteer Ron Phillips, aged 82, wasawarded for his dedication to thehospital and named CanterburyCouncil’s Outstanding Citizen of the Year.

Canterbury HospitalGeneral Manager Peter Clout (to January 2002)Acting General Manager Doug Menzies (to June 14 2002)Acting General Manager Gary Miller (from June 17 2002)


Staff EFT* 579.0 585.4 557.9

Average available beds 156 146 149





Births 1,485 1,560 1,409

ENIOOS** 165,505 197,809 204,772


Above: Cathy Lim (left), James Edwardsand Sharon McKenna all make a valuablecontribution to the busy EmergencyDepartment at Canterbury Hospital.

Right: Dancers from the Sydney KoreanSenior Performance Group captivatedvisitors to the Senior’s Week, Health andWealth Day at Canterbury Hospital.


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Concord Repatriation General Hospital Executive Director Matthew Daly

Hospital Road Concord NSW 2139Phone: (02) 9767 5000Fax: (02) 9767 6991Email: [email protected]/concord

Concord Hospital is undergoing a $112 million, six-year transformationas part of the Resource TransitionProgram. Inpatient and ambulatory careservices are being integrated into onebuilding to reflect the latest healthcaretrends while at the same timecontinuing to meet the community’sneeds and world’s best practicestandards.

Three years into the project,achievements this year includecompletion and occupation of the westwing, including a bigger Day of SurgeryAdmission Centre on level two whichenables patients to be moved easilyfrom the operating theatre suite to therecovery room on the same floor.

The Intensive Care/High Dependencycomplex in the east and north wingshas been completed, with servicesmoving across in July 2002.

High-quality, modern wards are beingbuilt on each floor of the multibuilding,with specialty ambulatory care clinicslocated adjacent to these areas.

Expansion of the Statewide SevereBurns Service will greatly enhance care for residents all over NSW. Theservice includes a designated burnsoperating theatre.

To assist patient care and the transitionto hospital, support staff roles are beingbrought together in the main foyer.These include veteran admission,liaison and RSL officers, as well aspatient representatives.

A General, Geriatric and RehabilitationMedicine precinct is being planned toprovide day hospital, ambulatory, acuteand convalescent care in one setting.Palliative care, mental health, drug andalcohol and allied healthcare precinctsare being constructed.


Staff EFT* 2,036.4 2,035.0 2,041.4

Average available beds 494 453 443



Bed occupancy rate (%) 95 97 100


ENIOOS** 270,323 329,856 361,992


With an international best practicereputation and foundation in providingservices to veterans and war widows,Concord Hospital is today a principalreferral facility and teaching centre ofthe University of Sydney. Its specialtiesinclude colorectal and laparoscopicsurgery, molecular biology, genetics andgastroenterology as well as aged andextended care.

Below: Nurse unit manager Scott McGrathwith George Phillips in the oncology/haematology ward.


Level 6, Queen Mary Building Grose StreetCamperdown NSW 2050Phone: (02) 9515 3270Fax: (02) 9515 3282Email: [email protected]/pophealth

The Division of Population Health aimsto deliver better health outcomes forevery member of society. Staff planprograms, formulate policies and workwith other agencies to improve thehealth of individuals and groups througha population-based approach.

It comprises a range of servicesincluding community health,multicultural health, women’s health,public health, health promotion andsocial health research.

For highlights of the Division’s activitiesduring 2001-2002 see PopulationHealth and Drug and Alcohol Serviceson page 25.

Division of Population Health Director Associate Professor Peter Sainsbury


Staff EFT* 322.0 322.0 328.9



HealthQuest Director Dr Armand Casolin

Level 2, 187 Thomas StreetHaymarket NSW 2000Phone: (02) 9281 0811Fax: (02) 9211 1060Email: [email protected]/facilities/healthquest.htm

HealthQuest specialises in providinghigh-quality, independent occupationalmedical advice to public and privatesector employers through an Australia-wide network of doctors.

It is a self-funding facility, with servicesincluding pre-placement health andergonomic assessments, worksite visitsand vaccinations.

HealthQuest’s income grew this yearthrough a successful marketingcampaign to increase the client baseand greater efficiency in bookingappointments.

New computer technology was installedand tested for implementation on July 1, 2002.

Planning to move to a new CBD site inGoulburn Street is underway, to allowfor continued business growth.


Staff EFT* 15.7 15.3 15.3

ENIOOS** 19,311 18,196 19,727


Left: Our Division ofPopulation Health hasembraced the digital worldwith a new interactivewebsite.

Easy-to-access information is now readily available tohealth professionals inAustralia and overseas,students and the community.

It works to improvehealthcare, reduce inequalityand deliver efficient andwell-managed services to thepeople of CSAHS.


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42-50 Parramatta RoadGlebe NSW 2037Phone: (02) 8584 7800Fax: (02) 9552 1613Email: [email protected]

Following a restructure in August2001, and changes to the practice offorensic medicine in NSW, the site isnow under the umbrella of CentralSydney Laboratory Service.

The department continues to provideforensic medicine services to the NSWCoroner and Statewide support forforensic medicine practitioners in allareas of autopsy-based and clinicalforensic medicine. It aims to provide aprompt and efficient response to allwho may require assistance, includingprivate citizens, families, members ofthe legal and insurance system,commissions of inquiry and educationalbodies.

Department of Forensic Medicine (Formerly NSW Institute of Forensic Medicine)

General Manager Mark Patterson

It is the premier forensic medicineeducational body for undergraduateand postgraduate students in NSW andoffers a comprehensive range ofmedico-legal support to the Asia-Pacificregion and beyond.

In addition to providing a wide range ofpathology and other services, itsexpertise includes disasterinvestigations and aviation medicine,forensic dentistry, bereavement


Staff EFT* 48.4 49.4 45.6

Admissions 2,724 2,479 2,372

Post-mortems 2,201 2,153** 1,942***

High-risk autopsies 158 132 102

* equivalent full-time** includes 114 cases where the Coroner has limited the examination of the case*** does not include Coronial certificates or cases where the Coroner has limited the examination of the case

counselling, medical investigation ofcrime scenes, pre-trial and trial advice,second opinions and medico-legalseminars.

Corner of Church and Glover Streets Leichhardt NSW 2040Phone: (02) 9556 9100Fax: (02) 9818 5712Email: [email protected]/facilities/rozelle.htm

Rozelle Hospital provides a wide rangeof specialised acute adult psychiatric andpsychogeriatric care, drug and alcoholservices, rehabilitation and assistance forwar veterans. A 24-hour telephone lineis available with trained staff offeringafter-hours triage advice. The hospitalalso operates a sexual health clinic forinpatients and people in the communitywho have a mental illness.

To meet the changing needs in modernmental health care, planning of newpremises is continuing. The existingbuildings at Rozelle Hospital are nolonger adequate for the provision ofmodern psychiatric care. Services willbe moved to a purpose-built facility onthe banks of the Parramatta River at theConcord Hospital campus next year.

Rozelle HospitalActing General Manager Gary Rowley

Relocation to the same site as generalhospital treatments will provide aholistic approach to care in keepingwith best practices worldwide. The newfacility will provide single-roomaccommodation for greater comfort andprivacy.

All services available at Rozelle will beretained. The purpose-built facility atConcord will include a 14-bedadolescent unit.


Staff EFT* 746.1 720.8 722.0






ENIOOS** 169,902 166,763 78,030

* equivalent full-time** equivalent non-inpatient occasions of service – these figures are reported for Area Mental Health Services.

The method of calculation of these figures changed from July 1, 2001. This affected group service counting inoccasions of service, significantly reducing the recorded occasions of service.


Royal Prince Alfred HospitalExecutive Director Diane Gill

Missenden RoadCamperdown NSW 2050Phone: (02) 9515 6111Fax: (02) 9515 6133Email: [email protected]/RPA

A major achievement for Royal PrinceAlfred Hospital was the official openingof the new Intensive Care Service, thelargest in Australia and one of theworld’s most advanced multi-specialtyintensive care units.

It was the first department to transferinto RPA’s new Clinical Servicesbuilding, which is part of the $258million Resource Transition Program.This program aims to transform one ofAustralia’s oldest teaching hospitals intothe most modern.

Unveiled in June by NSW Premier BobCarr and Health Minister CraigKnowles, the Intensive Care Servicebrings together general, cardiothoracicand neurosciences ICUs and a newHigh Dependency Unit.

Locating the specialised areas side-by-side is expected to save more lives andimprove patient outcomes in Australia,which are already among the best inthe world, up to 20 per cent betterthan in Europe and Canada.

The service is located on a hotfloor,which will include a neo-natal ICU,operating theatres and a directexclusive lift to the EmergencyDepartment.

Other RTP projects at the hospital thisyear included installing a new MRIscanner and planning for two additionalradiation oncology bunkers on the site.These works, including the completedrenovations on levels nine, 10 and 11of E Block, were achieved with minimaldisruption to patients, visitors and staff.

Established in 1882, RPA has aprestigious history of serving the health needs of local, State andinternational communities. It is one ofthe nation’s major referral centres andthe prime teaching facility of theUniversity of Sydney.

The comprehensive range of servicesincludes cardiology, cardiothoracic,emergency and intensive care, renal andliver transplantation and respiratorymedicine. Also offered aregastrointestinal, head and neck care,cancer, obstetrics and neonatal, vascularand neurology services, diagnosticimaging and interventional radiology.

Services are delivered from the mainMissenden Road campus, and facilitiesinclude the RPA Institute ofRheumatology & Orthopaedics as wellas RPA Women and Babies, which willsoon move to the Clinical Servicesbuilding from the King George Vbuilding. Treatments also operate fromThomas Walker and Dame EadithWalker hospitals at Concord West andvarious community settings.

Series seven of the Logie award-winningRPA fly-on-the-wall television programwas broadcast and secured anotherLogie nomination, while productionbegan on the eighth series, forbroadcast later in 2002.


Staff EFT* 3,445.2 3,466.9 3,451.2






Births (total babies born) 4,037 3,798 3,528

ENIOOS** 469,591 432,964+ 445,350+

* equivalent full-time** equivalent non-inpatient occasions of service+ includes Emergency Department Diagnostics and Imaging (previously reported as a separate figure)

RPA Institute of Rheumatology & Orthopaedics


Staff EFT* 125.8 105.4 96.7




Bed occupancy rate (%) 69 67 73


ENIOOS** 21,378 9,786 18,840


Above: Seen here at dawn, RPA has beenserving people’s health needs for over 110 years.


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McKenzie StreetBelmore NSW 2192Phone: (02) 9787 0800Fax: (02) 9787 0880Email: [email protected]

The health professionals at TresillianFamily Care Centres offer support andadvice to parents during the first fiveyears of their child’s life from locationsat Belmore, Willoughby, Wollstonecraftand Penrith.

Families are referred to Tresillian’sresidential, day stay and outreachprograms by their general practitioner orearly childhood health nurse. More than50,000 calls were received this year byour 24-hour Parents’ Help Line.

Tresillian Family Care CentresGeneral Manager David HannafordPresident of Council Bob Elmslie OAM

Staff assist on issues including post-natal depression and parenting skillssuch as breastfeeding, understanding ababy’s growth and development andsettling techniques.

In March an extension to Tresillian’sGuthrie Child Care Centre inWollstonecraft was officially opened.The extension is a result of apartnership agreement betweenTresillian, North Sydney Council andthe Commonwealth Department ofCommunity Services. An additional 15places at the centre for children underage two have been provided.


Staff EFT* 83.5 80.5 80.4



Admissions 2,262 2,261 2,307



ENIOOS** 61,468 60,138 57,971


Left: More than 50,000 telephone callswere received this year by the 24-hourParents’ Help Line.Below: Tresillian staff assist parents withsupport and guidance during the first fiveyears of their child’s life. This includespractical advice on how to settle a baby.

Corporate support continued this yearwith Johnson & Johnson donating$50,000 as well as baby products,while Carter Wallace contributed$10,000. Nestlé again sponsored thecentre’s rural seminar program andKimberly-Clark Australia continued tosponsor Tresillian’s newsletter, TheCrier.


2 Chalmers StreetSurry Hills NSW 2010Phone: (02) 9293 3200Fax: (02) 9293 3488Email: [email protected]/facilities/udh.htm

United Dental Hospital plays a key rolein oral healthcare in NSW and providesspecialist and tertiary services tochildren and adults across the State.Patients are treated from the mainfacility in Surry Hills as well as clinics inhospitals, schools and outreach servicesin CSAHS and neighbouring SouthEastern Sydney Area Health Service.Children from preschool to age 18,adults holding current healthcare cardsand those with disabilities and specialneeds are eligible for treatment.

UDH also provides forensic dentalexpertise to coronial and criminalinquiries. It trains undergraduate andpostgraduate dentistry students from theUniversity of Sydney and TAFE studentsstudying to be prosthetists and dentalassistants.

Our prosthetics laboratory is one of thelargest in Australia. It’s staff constructhighly specialised implants and facialprostheses as well as producing a widerange of dentures, crowns and bridges.

UDH has entered into an agreementwith South Eastern Sydney and Illawarraarea health services to create the CentralMetropolitan Network for Oral HealthServices. The aim is to share the costsand benefits of service delivery, attractand retain high-quality staff and improvethe capital infrastructure of services.

CSAHS’s Clinical Council has givenapproval for an Oral Health Servicesclinical group to be formed. This willbring together planning, developmentand administration of all oral careservices. It will improve opportunities towork closely with other clinical areas,including emergency departments andoperating theatres.

UDH’s Dental Access Centre has beenrefurbished and enhanced with newtelecommunication and informationtechnology. The call centre receives 350calls each day and makes appointmentsfor 220 people daily.

United Dental HospitalGeneral Manager Geoff Neems (to February 2002)

Danny O’Connor (from February 2002)


Staff EFT* 310.8 317.4 318.8

ENIOOS** 189,806 177,295 216,823


Above: Our prosthetics laboratory is one ofthe largest in Australia. Dental technicianIngrid List works on the construction ofhighly specialised implants and facialprostheses.

Every Friday, CanterburyHospital volunteer Ron Phillips,82, drives a van all over thesurrounding suburbs collectinghomecare equipment likewheelchairs, from people whohave recovered and no longerneed them. His cheerfulness,kindness and patience is valuedby all and has earned himCanterbury Council’s 2002Seniors’ Achievement Award.

Our dedicated volunteers are an inspiration. They donate their mostprecious gifts – their time and talents – to our hospitals andhealthcare centres. Numbering more than 500, volunteers can be found fundraising for equipmentand research, visiting patients, welcoming visitors and supporting the work ofour staff. They hail from all over the community and diverse walks of life.

This year we again paid homage to our treasured supporters on NSW HealthVolunteer Appreciation Day, with thank you events held all over CSAHS. Theoccasions demonstrated what our tireless workers mean to us year round.

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Our honour roll of donorsCSAHS receives generous donationsthroughout the year from many valuedsupporters. We are extremely grateful.

Thank you to the following individualsand organisations for providing supportto the value of $5,000 or more:

> Robert Baird> Breakfast Point Pty Ltd> Dr Warwick Bruce> Campsie Rotary Club> Campsie RSL Club> Canterbury Hospital Ball Committee> Canterbury Hospital Pink Ladies > Canterbury-Hurlstone Park RSL Club> Estate of Brian Joseph Carr (bequest)> Carter Wallace> Concord Hospital departments of

Anatomical Pathology, Biochemistry,Cardiology, Haematology, Neurology,Nuclear Medicine, Radiology andRespiratory Medicine

> Concord Hospital Volunteer ServiceAuxiliary

> Paul Daley > DMC Digital Pty Ltd> Five Dock RSL Community Club Ltd> John Foley> Fred P Archer Charitable Trust> Estate of D Gibbs > IMG Arts and Entertainment Pty Ltd> Jackal Pty Ltd> Johnson & Johnson> JS McMillan Printing Group> Kimberly-Clark Australia> Estate of Vikki Madeliene Frances

Lavasseur-Bayley > Dr Robert Loneragan> Helena Marel> Marshall Motors> Napoleon Cosmetics> Nestlé> Nine Network Australia> Operation Spider Charity Committee> Kerry Packer> Rotary Club of Burwood> Sony Foundation Australia> Star City> Suizer> Tenix Pty Ltd> Ticketek> M Virginie> Vita Medical> Kay Worrall

Come rain, hail orshine, Jean Snowruns the KGVVolunteers craft stallon the ground floor ofthe King George Vbuilding, everyWednesday. The stall is bursting withhandmade goods,including knitted teddybears, baby blankets,embroidered singletsand bunny rugs. Jeanalways has time for a friendly chat with visitors and staff who walk by. She’ll continue her work by joining RPA Women and Babies when medical

services move across the road.

Feast your eyes on the tasty goodies on sale at theKokoda Kaffe, run byConcord Hospital volunteers.The group’s coordinator, Ruth Ellis, is one of the many people who giveenormous time and energy to the hospital.



CSAHS has built its reputation onsolid teamwork, with everyone fromthe newest recruit to the longest-serving staff member a valued partof our organisation.CSAHS employs 9,254 people andtogether we are continually striving forexcellence in patient care and thedelivery of best practice in every aspectof our service, achieving the bestoutcomes for the health of thecommunity. We aim to ensure that everymember of our staff operates in asupportive, happy and safe workplace.

Employee relationsThe Staff Consultative Committeecontinues to meet monthly and hasprovided a valuable communicationchannel for resolving issues. Thecommittee consists of representativesfrom management and all relevantassociations or unions across CSAHS.

Occupational health and safety CSAHS reviewed its Occupational Healthand Safety and Rehabilitation Services tofacilitate compliance with the introductionof new legislation in the areas of OH&S,workers’ compensation and civil liability.Increased emphasis was given to themanagement of medical liability,following an announcement by the NSWHealth Minister in December 2001.NSW Health now accepts liability forclaims of negligence against visitingmedical officers for treatment,consultations and advice given to publicpatients in public hospitals. Systemswere established to facilitate compliancewith requirements and to supportmedical staff processing claims.

Freedom of informationMembers of the public have the right toview, obtain copies of and/or amenddocuments held by governmentagencies, as part of the Freedom ofInformation Act 1989.

CSAHS is required to provide up-to-dateinformation to consumers through theStatement of Affairs, which is publishedannually and incorporated into theCSAHS Statutory Annual Report 2001-2002. To obtain a copy of the reportphone (02) 9515 9600.

Employee Recognition ProgramThe Employee Recognition Programacknowledges the valuable work ofCSAHS staff and honours individualsfor excellence in the workplace.

The program is sponsored by NRMAHealth which provides a prize for eachmonthly winner and a prize for theprestigious Employee of the Year title.

Entrants are nominated by their fellowworkers. Winners are selected by theCSAHS Employee of the MonthCommittee, comprising representativesfrom each facility.

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Above: Trish Morgan (right) is ourEmployee of the Year. Trish is a welfareofficer at Canterbury Hospital and workswith many patients like Olive Dawkins.

The 2001-2002 winnersJuly 2001 > Con Constantinou, seniortheatre orderly, KGV Operating Theatre

August 2001 > Nicole Burr, leadinghand, plumber, Concord Hospital

September 2001 > Stacey Koufos,medico-legal secretary, Rozelle Hospital

October 2001 > Larraine Mortimer,nurse unit manager, Balmain Hospital

November 2001 > Thelma Deathe,switchboard, Rozelle Hospital

December 2001 > Linda Nicholson,stroke care coordinator, Concord Hospital

January 2002 > Trish Morgan, welfareofficer, Canterbury Hospital

February 2002 > Torren Carter, seniordental assistant, United Dental Hospital

March 2002 > Nicole Czinner, nurseunit manager, Concord Hospital

April 2002 > Angela Babic, socialworker, Concord Hospital

May 2002 > Bill Shum, registerednurse, Canterbury Community Health

June 2002 > Maria Constantino,computer programmer, Royal PrinceAlfred Hospital

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Near enough is never goodenough at CSAHS. We pride ourselves on striving forthe highest standards of treatment,service and care for the benefit ofour patients, staff and the entireNSW community.

All of our facilities continue to have Evaluation and QualityImprovement Program (EQuIP)accreditation and are achieving andmaintaining the strict criteria andrequirements set by the AustralianCouncil on Healthcare Standards.

State award for excellencein qualityWe have developed a uniquemonitoring and managementprogram for sentinel events. Asentinel event is an unexpectedoccurrence which could result indeath or serious injury.

The Sentinel Event Program has beenrecognised as a model for other areahealth services in the State. It won theNSW Government’s Baxter BetterHealth, Good Health Care award.

The program has led to improvementsin how we report these incidents andin the quality and outcomes of care forour patients. It aims to prevent sentinelevents from occurring by reducingpotential risk.

Dedicated to continual qualityimprovements, our staff members havedeveloped tools to assist in the analysisand investigation of sentinel events,patient complaints and other adverseincidents. These tools include rootcause analysis, which is a series ofquestions that can be used to discoverand treat the underlying cause of aproblem. Another quality improvementtool developed by our staff is theSerious Event Panel. This is an

independent panel that reviews theinvestigations and makes subsequentrecommendations to ensure all aspectsof the event have been addressed.

Our Quality Improvement Team hasbeen able to inform and educate peopleabout these services through trainingsessions and the new Quality Serviceslisting on our intranet site, which isavailable by clicking on Facilities andDepartments.

Quality WeekTo mark Quality Week in October, weconducted an open consumer forum toconsult our user groups on their level ofsatisfaction with our services, as wellas ensuring we continue to meet theirneeds. Our staff participated in aquality tools workshop and a CSAHSQuality Assurance poster competition.

Striving for the highest standardsQuality

ResearchCSAHS is a leader in medicalresearch, with a worldwidereputation for discovering newcures and developing the mostinnovative treatments toimprove diagnosis and patientcare.Our medical specialists andscientists take great pride in beingamong the best in the world. Eachyear, they attract grants from bodiessuch as the National Health andMedical Research Council.

Among our high achievers is RoyalPrince Alfred Hospital’s director ofresearch, cardiologist ProfessorDavid Celermajer, who receivedAustralia’s top medical honour, the2002 Commonwealth HealthMinisters award, for excellence inhealth and research.

Prof Celermajer’s work has included theearly detection of heart disease inchildren and identifying the linksbetween folic acid and the improvedcondition of diseased arteries.

Another leader is Department ofRespiratory Medicine principal scientist

Dr Sandra Anderson, who won the2001 RPA Foundation Medal for herresearch.

Dr Anderson was recognised for aninnovative, simple test for diagnosingasthma by having patients breathe inmannitol through an inhaler. The testcan also determine the effectiveness oftreatment.

The runner-up prize went to RPA staffspecialist Dr John Rasko for his work ingene therapy.

Awarded annually, the medal wasestablished in 2000 to highlight andcontinue the hospital’s tradition ofinnovation.

Our culture of research benefits patientsall over the globe and ensuresadvances made in the laboratory canbe transferred to the clinical setting atthe earliest opportunity.

Above: Dr Sandra Anderson was awardedthe title Miracle Worker of the Year for herresearch into asthma diagnosis.


TeachingCSAHS is dedicated to teaching thefuture generations of healthprofessionals, and currently 2,000students are training in health-related disciplines at our hospitalsand healthcare centres.

Medical studentsTrainees from the University of Sydneycontinue to undergo their clinicalinstruction at Royal Prince AlfredHospital, one of Australia’s oldestteaching facilities, and at Concord andUnited Dental hospitals.

It was the end of an era at RPA andConcord Hospital when the finalstudents completed the formerundergraduate entry degree program.They will graduate in 2002. The course shift from undergraduate topostgraduate level is moulding a newera of medical students. Now in its sixthyear, the graduate-entry medicalprogram emphasises problem-solving-based learning. At RPA, 200 medicalstudents are undergoing their clinicaltraining, with a further 140 studentsenrolled at Concord Hospital.

Rural rotations, especially to the newclinical school at Dubbo Base Hospital,have become an integral part of theCentral Clinical School’s activities. Thefirst group of students spent eight weeksof their third year in Dubbo. When thesite is fully operational 25 per cent ofstudents will spend half their time in arural setting as part of the FederalGovernment’s rural training schemes.

Interns and residentsAt RPA and Concord, almost 230 internsand resident medical officers also rotateto other facilities in the area and to ruralsettings. The directors of clinical trainingat RPA, Concord and Canterburyhospitals are responsible for coordinatingthese junior doctors and their trainingprograms.

Nursing and Allied HealthtraineesOver 1,200 nurse trainees receive workexperience and ongoing education fromCSAHS. Students from more than 15university courses undergo exceptionalclinical training that large area healthservices like CSAHS can provide. Thisyear 186 new graduate nurses wereemployed within our facilities.

We are participating in the StateGovernment’s Reconnect Program,which enables nurses to return to theworkforce. The program supportsnurses in clinical settings.

In addition, almost 100 trainees inphysiotherapy, speech therapy,occupational therapy, social work andnutrition passed through CSAHSfacilities. Trainees in psychology,orthotics and podiatry also undertooktraining here.

Above: Some 2,000 students currentlytrain in health related disciplines at ourhospital and healthcare centres.

Below is a brief list of some of the research projects being undertaken at CSAHS. A more detailed listing can be found on our website www.cs.nsw.gov.au

Early recognition of sleep disorderedbreathing in cystic fibrosis

Cystic Fibrosis Australia RPA To detect early abnormalities in sleep and theireffect on attention and vigilance

Effects of candidate genes on alcohol useand dependence

NHMRC RPA To test the influence of specific genes on alcohol useand dependence risk

Character of leukaemia-specific fusiongenes

Anthony Rothe Memorial TrustRPA To increase the understanding of the variety ofgenetic changes which occur in leukaemia

The experiences of young people withchronic illness during their firstadmission to RPA

Research Centre for Adaptationin Health and Illness

RPA To research and assess the experiences of youthduring or within one year of their first admission to anadult healthcare facility

Central Sydney Tai Chi trial NSW Health, Health Promotionbranch, Health Promotionresearch demonstration scheme

Division ofPopulationHealth

To investigate the effectiveness of Tai Chi inreducing falls in older people

Examine the factors associated withdiarrhoea in burns patients

Research Centre for Adaptationin Health and Illness, Universityof Sydney

ConcordHospital

Patients with clostridium difficile infection will be givena yoghurt containing a priobiotic or trialed with a fibresolution to test whether this will reduce diarrhoea

A potential new test for Parkinson’sdisease

Australian Brain Foundation ConcordHospital

To develop a new test for diagnosing early dopaminecell loss based on antibodies to neuromelanin, and toexamine the epidemiological risk factors forParkinson’s disease

Hip fracture intervention trial NHMRC BalmainHospital

To improve the outcomes for older people recoveringfrom hip fractures

Research project Facility Funding Brief


Despite major redevelopmentstaking place at Royal PrinceAlfred, United Dental andConcord hospitals, CSAHSwas able to continue to operatewithin the limits of our totalfunds.

This year we spent $810 millionproviding healthcare to the people ofNSW. We also spent $90 million onour building program.

Our money was mostly spent onpeople: $502 million on our staff and$25 million on visiting doctors. Goodsand services – including drugs,laboratory chemicals, X-ray film,sutures and needles cost $219 million(an increase of $14 million on theprevious year’s expenditure). We spent$22 million on the maintenance ofbuildings and the replacement ofequipment and $13 million in grantsand payments to non-governmentorganisations. Depreciation onbuildings and equipment accounted for$28 million.

Our revenue included $53 million frompatient fees, $35 million from grantsand contributions, $28 million from thesale of other goods and services, and$4 million from investments. Of the$35 million revenue from grants andcontributions, $28 million was for thespecial purpose and trust fundaccounts.

During the year, we provided healthservices worth $129 million toresidents of other NSW health areas,and health services worth $2 million toresidents of other states of Australia.Our residents received care worth $57million in other area health servicesand care worth $1 million interstate.

Funding provided by NSW Health forthe year was $601 million.

Our complete audited financialstatements are in the CSAHS StatutoryAnnual Report 2001-2002. It can be accessed on our websitewww.cs.nsw.gov.au or by phoning (02) 9515 9600.

Fina

ncia

l Sum

mar

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Financial Summary

Funding from NSW Health

$0

$100

2002

Mill

ions

2001 2000 1999 1998

$200

$300

$400

$500

$600

$700

$800

81% NSW Health Recurrent Allocations

14% NSW Health Capital Allocations

5% Acceptance of the Crown Entity of Superannuation Liability


RevenueExpenditure

62% Employee Related

3% Maintenance

3% Depreciation

1% Grants and Subsidies

1% Payments to Affiliated Health Organisations

3% Visiting Medical Officers

27% Goods and Services

85% Sale of Goods and Services

2% Other Revenue

1% Investment Income

12% Grants and Contributions

Central Sydney Area Health ServiceFive-year analysis

2002 2001 2000 1999 1998$'000 $'000 $'000 $'000 $'000

OPERATING

Expenditure (a) 809,532 777,863 776,049 783,026 678,874

Revenue (b) 250,457 239,697 232,844 220,939 78,623

Net Cost of Services 559,075 538,166 543,205 562,087 600,251

NSW Health Recurrent Allocations 514,976 501,266 490,824 479,968 546,838

NSW Health Capital Allocations 86,165 90,889 28,170 29,188 47,197

Asset Sale Proceeds Transferred to the Crown Entity 0 0 0 (8,911) 0

Acceptance by the Crown Entity of Superannuation Liability 33,587 35,444 31,263 32,136 27,037

FINANCIAL POSITION

Current Assets 85,162 78,221 78,234 88,422 92,072

Non-Current Assets 815,721 745,452 649,233 619,904 640,664

Total Assets 900,883 823,673 727,467 708,325 732,737

Current Liabilities 84,251 88,081 81,140 77,560 81,886

Non-Current Liabilities 92,757 87,370 86,328 77,819 68,200

Total Liabilities 177,008 175,451 167,468 155,379 150,086

Total Equity 723,875 648,222 559,999 552,946 582,651

(a) & (b) Include inter-area flow in both expenditures and revenue since 1999


The Public Affairs & Marketingunit plays a crucial role inpromoting the corporateidentity of CSAHS and each ofits hospitals and healthcarefacilities.The overall goal of the unit is topromote the excellent work andservices being carried out at ourfacilities for the benefit of patientsand the wider community.

We use a variety of communicationtools, including brochures, regularstaff newsletters, majormetropolitan media, local media,the internet and ethnic media.

Our wide range of expertiseincludes the formulation ofinternal and externalcommunication strategies,media advocacy, specialisedpromotional campaigns,corporate publications andevents managementWe have achieved widespreadpositive media coverage bothlocally and in major metropolitanprint, TV and radio about ourcapital works programs under the$390 million Resource TransitionProgram. This has includedextensive coverage of the openingof the new adult intensive careservice by NSW Premier Bob Carrat Royal Prince Alfred Hospital andpositive coverage in the local mediaof the new facilities at ConcordHospital.

We have continued to generatepositive media coverage for ourinternationally renowned research,including news and feature itemson our Statewide Severe BurnsService at Concord Hospital;ongoing studies into pre-eclampsia;a world-first development of aprenatal screening test for a genewhich could be implicated inAlzheimer’s and Parkinson’sdisease; and a world-first test todistinguish fat embolisms fromblood clots.

Our Logie award-winning Channel Ninereality television series RPA dominatedthe ratings in all states, with extensiveinterest in the work of our plasticsurgery department and the heart-rending coverage of African burnspatient Safari.

Our facilities and services continued toattract numerous requests for filming.These included a positive AustralianStory about our world-renownedMelanoma Unit. Negotiations began to

allow filming at the Department ofForensic Medicine for a four-partdocumentary series on the coronialprocess from the perspectives of theCoroner’s Court, the Department ofForensic Medicine and the NSW Police.

Internal communications includethe production of a monthlynewsletter and a regular updateon the RTP, which has beenamalgamated as a section in ournewsletterExtensive planning was undertakenand strategies were developed tofurther promote the opening of facilitiesunder the RTP in the next financialyear.

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& M

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Informing thecommunity

Above: Our external communicationincludes media releases, brochures,posters, newsletters and the annual report. Right: Chief Executive Officer Dr Diana Horvath, fields media questionsat the official opening of the first stage ofthe $258 million redevelopment at RPA.Below: NSW Premier Bob Carr, formerpatient Katy Williams Day (centre) with twins James and Finn, and Dr Diana Horvath at the official opening of RPA’s new adult Intensive Care Service.

Caring for the Future, CSAHS Year in Review 2001-2002provides a summary of our operations and highlights significantachievements and events for the year. The report also presentsperformance and outcome information in a candid and reader-friendly manner.

It can be read in conjunction with CSAHS Statutory AnnualReport 2001-2002, which completes our annual reporting forthe year. Both reports are available on our websitewww.cs.nsw.gov.au or by phoning (02) 9515 9600.

We welcome your feedback. You can contact us by email [email protected], through our website atwww.cs.nsw.gov.au or by phoning us on (02) 9515 9600.

Central Sydney Area Health ServiceBuilding 11RPA campusMissenden RoadCamperdown NSW 2050

Phone: (02) 9515 9600Fax: (02) 9515 9611Email: [email protected]: www.cs.nsw.gov.au

Acknowledgments

Design and production: Pro Bono Publico Pty LtdPhotography: CSAHS Audio Visual ServicesCover photo: Ray RileyPage 7: photo of Safari courtesy of Channel 9Printing: On the Pace PrintingA publication of CSAHS, produced by Public Affairs and Marketing © All rights reserved. ISSN 1447-5057

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