The CMO and rural health issues

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The CMO and rural health issues
Professor Paddy Phillips SA Chief Medical
Officer Celebrating rural practice RDWA
Conference, October 2008
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Who am I?

• Born 1956 in Johannesburg, South Africa to
  English academic nomad parents
• Moved to SA when 1yo
• 1969-73 Adelaide Boys High School
• 1974-79 University of Adelaide Medical School
• 1980 Internship at RAH
• 1981-83 University of Oxford, PhD
• 1984-87 PHH and Austin Hospital, Melbourne,
  FRACP (General Medicine)
• 1987-96 Department of Medicine, University of
  Melbourne, Austin Hospital
• 1996-97 University of Oxford, May Reader in
  Medicine
• 1997-2008 Flinders University Chair of Medicine
  Division of Medicine Director, FMC and RGH
• 2002-03 Member, Generational Health Review
• 2007 Chair, Cardiology Clinical Network
• Chair, Clinical Senate
• Acting CMO
• 2008 CMO

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What do I do?

• The Chief Medical Officer
• is the primary source of medical advice to
• the SA Health Portfolio Executive
• the Chief Executive
• and
• the Minister for Health.
• will oversee the
• public presentation of medical advice,
• resolution of technical medical issues, and
• the development of the medical profession within
  South Australia.

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What do I do?

• Also
• General Medicine ward service at FMC and RGH
• General Medicine Clinic at RAH
• Chair, Cardiology Clinical Network
• Chair, Clinical Senate
• Health services research into
• Improving evidence into practice
• Improving chronic disease management
• Care of older people

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My key issues

• All in this together one system
• Improving system integration
• Clarifying roles and responsibilities
• Increasing investment in prevention, early
  intervention and effective chronic disease
  management
• Medical workforce development
• Clinician engagement

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How can we work together?

• My thoughts
• Recognise status quo not an option
• Dialogue with jurisdiction is fundamental
• Engagement on key issues
• No better time for clinicians to be involved

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Clinical Senate?

• A forum where clinical leaders within the SA
  health system share their collective knowledge,
  provide advice, leadership and guidance on
  clinical issues and participate in the
  decision-making process in relation to clinical
  service planning.
• Operates outside of the formal departmental
  structure of SA Health and is a major source of
  clinical advice to the Minister for Health and
  the Chief Executive of SA Health.

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Membership

• Includes
• Chairs of the Statewide Clinical Networks
• GPs (rural and metro)
• Allied Health Practitioners (rural and metro)
• Nursing/Midwifery (rural and metro)
• Medical Specialists (rural and metro)
• Public Health Practitioners
• Mental Health Practitioners

• Ex-Officio members
• SA Health CEO
• Regional CEs
• Chief Medical Officer
• ED, PHCC
• ED, SSS
• ED, Operations
• Chief Nurse
• Principal AH Advisor

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Senators

• Elaine Ashworth
• Dr Phil Aylward
• Prof Peter Bardy
• Heather Baron
• Prof Justin Beilby
• Dr Taryn Bessen
• Elizabeth Birchmore
• Dr John Bonifant
• Dr Phil Brock
• Dr Chris Cain
• A/Prof Simon Carney
• Cate Curry
• A/Prof Chris Doecke
• A/Prof Karen Grimmer-Somers
• Christine Holliday
• A/Prof Geoff Hughes
• Prof Norman James
• Dr Sue Johanson
• Dr Sharon Liberali

• Prof Guy Maddern
• Dr Ruth Marshall
• Michele McKinnon
• David Morris
• Di Norris
• Dr Rob Padbury
• Prof Paddy Phillips
• A/Prof John Pierides
• Dr Michael Rice
• Dianne Rogowski
• Prof Jeffrey Robinson
• A/Prof Graeme Russ
• Dr Cathy Sanders
• Judy Smith
• Dr Michael Taylor
• Dr Jo Thomas
• Deborah Walker
• Dr Lucie Walters
• Dr David Watson

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New Modus Operandi 2008

• Based on a Charrette Model
• Key features
• Executive Sponsor
• Specific questions put to Senate
• SA Health provides a response to Senate
  recommendations

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2008 Program

• January What it means to be a Senator
• February Elective surgery
• March 24/7/365 Cover
• April Clinical simulation facilities
• May Health and Medical Research
• June Clinical Network Service Plans
• July Model of Care
• October Hospital/health reform
• November Review of 2008

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For more information

• Please visit our website
• www.health.sa.gov.au/clinicalsenate
• Or email
• clinicalsenate_at_health.sa.gov.au

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How can we work together?

• Your thoughts..?

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Clinical Networks

• Responsibilities
• Planning Priority Setting
• Clinical Practice Improvements
• Considering Workforce Development Needs
• Advising on Teaching Research
• Creating Partnerships
• Monitoring and Reviewing Performance

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Cardiology Network

• Cardiology Network Steering Committee
• Chair Professor Paddy Phillips
• Deputy Chair Dr Peter Joyner, GP
• Dr Margaret Arstall, LMHS
• Professor Phil Aylward, FMC
• Dr Leo Mahar, RAH
• Professor John Horowitz, TQEH
• Ms Rachel Bishop, Consumer
• Mr Colin Purvis, Consumer
• Mr Alwin Chong, Aboriginal Health Council
• Dr Marion Eckert, nurse
• Professor Janet Hiller, Public Health Ms Deb
  Rowett, Pharmacist

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Cardiology network work groups
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Cardiology network achievements

• Cardiology service delineation and plan across
  all health services in SA.
• Ambulance diagnosis of STEMI and opening of
  nearest emergency PCI lab (if within 60 minutes
  drive time)
• Geographical boundary for transfer of STEMI
  patients for emergency PCI or transfer to local
  hospital for stabilisation and thrombolysis.
• Agreed protocols for low risk chest pain,
  unstable angina, NSTEMI, and STEMI.

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Achievements contd

• Formal statewide rotational training program for
  advanced trainees.
• Collaboration with South Australian universities
  to develop a statewide cardiac nursing training
  curriculum.
• Consistency of cardiology technician
  classification across the state.
• Report on the current cardiovascular research in
  SA.
• Stock-take of existing cardiac databases in SA.
• Engagement of gt120 clinicians.

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Key Messages

• One system
• Improving system integration
• Clarifying roles and responsibilities
• Increasing investment in prevention, early
  intervention and effective chronic disease
  management
• Workforce development
• Clinician engagement.