A coordinated 'network response' and approach to paediatric services in Victoria was identified in 2002 as a key strategy to meet expected increases in future service demand and better coordinate existing services. This strategy is still being considered by DHS.
The delay in introducing a coordinated network response and statewide approach to paediatric services may have impacted on the service planning for the new RCH. Clarity around the role played by a particular hospital in the wider health care network and system is important when planning a redevelopment of that hospital facility. While the service planning documents for the new RCH were clear in articulating the RCH role in the wider system, this was not underpinned by a clear statewide paediatric service strategy promulgated by DHS.
The Review of Paediatric Services was commissioned by DHS in 2002 as a component of the Metropolitan Health Strategy and the Victorian Rural Human Services Strategy. Its purpose was to identify existing health services for Victorian children and adolescents, potential gaps in service level and usage, and provide advice on future directions for paediatric health service provision on a state wide basis. The final report on the review was published in December 2002 and included a range of recommendations that focused on a coordinated approach for planning, developing and enhancing paediatric services in Victoria.
Although several of the recommendations have been implemented, other key recommendations relating to a network response and statewide paediatric services strategy have not been addressed. In September 2007, DHS commenced a project to progress a coordinated approach to planning and developing statewide paediatric services. This project is planned for completion in June 2009.
The first phase in the current DHS project involves developing a strategic framework for paediatric services in Victoria. A discussion paper on the framework has been developed but not released for public consultation, despite the original intention to finalise the framework by November 2008. DHS advised that the discussion paper has been the subject of 'targeted consultation' and was expected to be finalised in early 2009.
The discussion paper provides a suggested framework for the future development of paediatric health services in Victoria, outlining the role of a proposed new body, the Paediatric Clinical Network, to promote and ensure the delivery of paediatric models of care in Victoria. The discussion paper also recommends that health services work together to formalise and build upon existing partnerships and to ensure a statewide system of integrated and coordinated care. Following the development of the strategic framework for statewide paediatric health services, updated demand projections and capacity analysis and planning will need to be undertaken.
Phase two of the project involves defining the roles and responsibilities between RCH and the Monash Medical Centre in the provision of high complexity low volume paediatric services. This phase has commenced and was planned for completion in April 2009.
The final phase in the project is to establish a Paediatric Clinical Network to progress any priorities arising from the development of the Strategic Framework for Paediatric Services in Victoria.
In summary, DHS has yet to develop a statewide approach to the delivery of paediatric health care despite a recommendation on this matter in 2002. A better approach would have been to develop a statewide strategy on paediatric health services concurrently with the service plan for the RCH redevelopment.
The RCH is currently engaged in a review of the RCH service plan which involves consultation with key stakeholders, including clinicians. This process is planned for completion in mid-2009. Clearly it will be important for the RCH service plan review process to be informed by, and provide input into, the DHS whole of system framework for the future development of paediatric health services in Victoria.