New South Wales report, June 2016

Print friendly version (PDF, 636 kB)

In this report

This report includes the following tables:

This report is issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act 2011.

This report is prepared on a cash basis. It shows monthly and year-to-date (YTD) National Health Reform (NHR) funding and payments for New South Wales for June 2016 as part of the National Health Reform Agreement.

Local hospital networks and National Health Reform

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the Agreement. An LHN can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of an LHN.

Note: The term ‘local hospital network’ is a national term. Some states and territories use their own terminology to describe these networks, such as local health districts, health organisations, and hospital and health services.

Under the Agreement, LHNs receive funding for the following public hospital services:

  • All admitted and non-admitted services
  • All emergency department services provided by a recognised emergency department
  • Other outpatient, mental health, sub-acute services and other services that could reasonably be considered a public hospital service.

Note: LHNs also receive funding from other sources, including the Commonwealth, states and territories, and third parties for the provision of other specific functions and services outside the scope of the Agreement, for example dental services, primary care, home and community care, residential aged care and pharmaceuticals. For further information on total funding to a particular LHN, contact the NSW Ministry of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – New South Wales, June 2016

For the basis of the Commonwealth contribution to NHR funding, see Basis of Commonwealth NHR funding, 2015-16.

The basis for NHR payments to local hospital networks (LHNs) in New South Wales was advised by the NSW Ministry of Health to be as follows:

Basis used to determine NHR payments to Local Hospital Networks (LHNs) – New South Wales

The process for determining 2015/16 NHR payments to LHNs encompassed three distinct elements of preparation for the individual LHN Service Agreements, including development of annual activity estimates, discussion/negotiation of activity levels with individual LHNs, and total state-wide activity across each activity type.

Consistent with last year’s methodology and pursuant with the National Health Reform Agreement (NHRA), the Ministry of Health has adopted the National Weighted Activity Unit (NWAU) as the currency for Activity Based Funding with the applicable version being NWAU15, which is different from the previous year (NWAU14).

The Independent Hospital Pricing Authority (IHPA) has issued the second National Efficient Cost (NEC15) funding model that applies to small regional and remote hospitals. NSW has adopted the mechanics of this funding model expressed in the NEC15 matrix to determine the aggregate funding allocation to LHNs for these small hospitals.

Ensuring access to health services for local populations is a key objective of NSW health policy. The Health Services Act 1997 stipulates that in determining LHN budgets, the Minister have regard to the size and health needs of the local population and provision of services to residents outside the local area. Accordingly, targets are adjusted considering factors appropriate to each LHN and service type, rather than simple extrapolation from historical activity data. The factors considered are reviewed on an annual basis.

In 2015/16 a series of elements will be applied to each in-scope service stream to ensure that activity targets are tailored to the requirements and patterns of each LHD/SHN. Activity targets are developed by the Ministry and LHDs/SHNs based on analysis of activity level drivers. This analysis was informed for 2015/16 by the following factors:

  • Weighted population change: providing an indication of expected 'natural' growth
  • Recent trends in activity growth for each LHD/SHN
  • Rate of unplanned re-admissions within 28 days
  • Potentially preventable hospitalisations (PPH)
  • Relative Utilisation Rate adjusted for relevant demographic factors
  • Service quality and appropriateness performance in selected key area
  • Inter-district and cross-border flows (where relevant)
  • Current year activity relative to targets (for adjustment of baseline volumes, where relevant)
  • Known service changes and developments, including planned capacity increases.

Price weight adjustments which are being applied in 2015/16 include:

  • Paediatric Adjustment;
  • Specialist Psychiatric Age Adjustment;
  • Patient Remoteness Area Adjustment;
  • Indigenous Adjustment;
  • Radiotherapy Adjustment;
  • Dialysis Adjustment;
  • Intensive Care Unit (ICU) Adjustment for eligible facilities;
  • Private Patient Service Adjustment;
  • Private Patient Accommodation Adjustment;
  • Multidisciplinary Clinic Adjustment.

Provisional activity estimates are created at a LHD level to provide the basis for discussion and negotiation with individual health services to determine agreed LHD level activity targets, with the activity volumes measured using the NWAU for each Service Category. Additionally, where applicable, activity estimation is split by financial class to allow differential funding mechanisms to be applied to the respective service groups to reflect the variation in funding source.

Provisional estimates and historical activity measures provide the basis for discussions with individual LHDs and subsequent negotiations for approval or adjustment.

The negotiation process allows for relevant local LHN service issues and activity impacts to be communicated with the NSW Ministry of Health (Ministry) to assess the potential impact on future year activity volumes and the relevance of related service strategies to address these. It is important that negotiation processes recognise that funding and purchasing are undertaken in the environment of a capped State / Commonwealth funding pool for 2015/16 and recognition that NSW contributes the larger portion of these funds as well as being responsible for management of the system as a whole. When negotiations have concluded, the Ministry incorporates the final activity targets in each LHN’s annual Service Agreement. Where an LHN achieves delivery of selected services through Affiliated Health Organisations or contracted services with a private provider these arrangements are to be specified in agreements between the LHN and the respective provider. Both the funding (and subsidy) and associated activity pertaining to such providers are included in the budget and the activity estimates appearing in the LHN’s annual Service Agreement.

Cash payments processed within the National Health Funding Pool (NHFP) Payments System and included within the Administrator’s monthly reports are based on the accrued budget for both ABF and in-scope block funding derived from the LHN Service Agreements after deducting an allowance to recognise own sourced revenue earned, and retained by the LHNs and liabilities for superannuation and long service leave which are accepted by the Crown.

The resultant cash value is processed through the state pool account (ABF) or the state managed fund (in-scope block). Although a consistent methodology has been applied, variations in cash prices between LHNs reflect the differing mix of the above components (own sourced revenue and Crown accepted liabilities) of each local hospital network’s accrued cost.

In addition to receiving weekly cash payments from the state pool account and the state managed fund, LHNs also receive direct State Government funding for 2015/16 for all “out of scope” services not subject to the National Health Reform Agreement arrangements as required under their 2015/16 Service Agreements.

Monthly reports– Basis on which payments were made

For NSW, all dollar values included in the tables issued by the Administrator are cash payments from either the NSW state pool account to LHNs or cash payments from the state managed fund to LHNs, and one exception that requires a quarterly cash payment to the Victorian Department of Health for NSW contribution for the Albury-Wodonga inter-jurisdictional agreement.

The weekly cash payment to an LHN reflects the estimated cost of patient related services anticipated to be delivered during the monthly cash payment period. The estimated monthly activity and the weekly cash payments are determined based on the annual LHN Service Agreements.

Cash payments from the NSW state pool account and from the state managed fund to LHNs are processed each Tuesday. Reporting by the Administrator is based on cash payments made during a given month and is therefore dependent on the number of Tuesdays in a particular month. During 2015/16, September 2015, December 2015, March 2016 and May 2016 each have five Tuesdays. If accrual accounting principles were being applied within the NHFA Payments System, the value of the reported cash payments would recognise only the number of calendar days in a particular month, not the 35 days (five weeks paid) or 28 days (four weeks paid), as reported by the Administrator.

In 2015/16 cash payments to LHNs from the NSW state pool account are generally calculated based on equal weekly instalments to health services unless otherwise negotiated. State Managed Fund cash payments occur as cash is required and dependent on the LHD bank balance in accordance with NSW Treasury Circular TC15-01 Cash Management – expanding the Scope of the Treasury Banking System.

Other payments will occur in 2015/16 that are outside the regular weekly (Tuesday) payment cycle including quarterly payments to Victoria Health for the Albury-Wodonga inter-jurisdictional agreement and payments to other States/Territories for NSW residents treated in their public hospitals. Payments to LHNs may also vary where their cash entitlement alters during the financial year. In March the Commonwealth Contribution to the NHFP was amended to reflect the funding arrangement for treatment of Albury hospital activity for prior years and 2015/16 in the absence of an agreed proposal between NSW and Victoria.

The NSW Ministry of Health pays the NSW contribution to Albury-Wodonga Health to the Victorian Department of Health and Human Services via the NSW State Managed Fund quarterly in-advance. In March 2016, the Commonwealth NHR funding was revised to recognise the Commonwealth funding contribution for Albury hospital activity for 2015/16 and prior years. NSW is recouping the equivalent amount to the Commonwealth contribution for Albury hospital activity which had been previously paid to Victoria. The total Commonwealth and State funding to Albury-Wodonga Health has not changed.

Monthly comparison of cash payments from the NSW state pool and state managed fund can vary month to month predominately due to these planned payments.

The cash payments from the NSW state pool account or state managed fund do not reflect the full budgeted funding available to health services in NSW. Other sources of funds available to LHNs include separate payments from the Crown (for example, defined superannuation scheme and long service leave cash recovery) as well as own sourced revenues earned and retained by each LHN.

For more information on budget allocations, see the 2015/16 LHN Service Agreements which are available on each NSW LHN website as the Chief Executive and Board of the LHN's provide sign-off.

Reference information

The financial information outlined in the following report is categorised as:

  • NHR funding – when the Commonwealth or state or territory government pays NHR funding into a state pool account or state managed fund.
  • NHR payments – when NHR funding that has been deposited into a state pool account or state managed fund is paid out of the state pool account by the Administrator, or is paid out of the state managed fund by the state or territory.

State pool account transactions

Table 1a – State pool account transactions – New South Wales, June 2016

This table shows funding paid into the New South Wales state pool account by the Commonwealth, New South Wales or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the NSW Ministry of Health or the state pool accounts of other states/territories for June 2016.

NHR funding by source Paid into state pool account Paid out of state pool account
To Local hospital networks To State
Managed Fund
To state
health department
To state pool (other State) Total paid out
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
431,859,168 431,859,168 431,859,168
Commonwealth
Block funding
52,626,804 52,626,804 52,626,804
Commonwealth
Other funding
9,412,349 9,412,349 9,412,349
Total C'wealth
funding
493,898,322 431,859,168 52,626,804 9,412,349 493,898,322
NSW
funding
426,656,865 406,548,529 308,336 19,800,000 426,656,865
Other state/territory funding 10,200,000 0 10,200,000 10,200,000
Total 930,755,187 838,407,697 52,626,804 19,920,685 19,800,000 930,755,187

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – New South Wales, June 2016

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the New South Wales state pool account by the Commonwealth, New South Wales or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the NSW Ministry of Health or the state pool accounts of other states/territories as at June 2016.

NHR funding by source Paid into state
pool account
Paid out of state pool account
To Local hospital
networks
YTD
To State
Managed Fund
YTD
To state health
department
YTD
To state pool (other State)
YTD
Total paid out
YTD
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
4,771,445,473 4,771,445,473 4,771,445,473
Commonwealth
Block funding
624,999,273 624,999,273 624,999,273
Commonwealth
Other funding
113,224,322 113,224,322 113,224,322
Total C'wealth
funding
5,509,669,067 4,771,445,473 624,999,273 113,224,322 5,509,669,068
NSW
funding
5,807,455,338 5,618,242,893 3,412,445 185,800,000 5,807,455,338
Other state/territory funding 52,600,000 0 52,600,000 52,600,000
Total 11,369,724,406 10,389,688,366 624,999,273 169,236,767 185,800,000 11,369,724,406

Commonwealth ABF funding represents Acute admitted, Non-admitted, Emergency department, Sub-acute, and Admitted mental health service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to LHNs.

Commonwealth Block funding represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted categories, which are funded by the Commonwealth and paid to the state managed fund.

Commonwealth Other funding represents other amounts funded by the Commonwealth, transacted through the state pool account and subsequently paid to state or territory health departments. This currently represents the Commonwealth contribution to public health.

NSW funding represents funding contributions paid by New South Wales into its own state pool account, and subsequently paid to LHNs within the state, to the New South Wales health department and/or to other state pool accounts.

Other state/territory funding represents contributions paid to New South Wales by other states and territories for cross-border activity.

Note: The grey shaded areas in these tables reflect cells that are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and not to local hospital networks or state or territory health departments.

NHR funding and payments shown in these tables include GST where applicable.

For more information, see National Health Reform funding and payments.

State managed fund transactions

Table 2a – State managed fund transactions – New South Wales, June 2016

This table shows funding paid into the New South Wales state managed fund by the Commonwealth and New South Wales, and payments out of the state managed fund to LHNs and other provider organisations for June 2016.

NHR funding by source Paid into state managed fund Paid out of state managed fund
To local hospital networks To Other Total paid out
($) ($) ($) ($)
Commonwealth Block funding 52,626,804 52,626,804
State/territory Block funding 25,446,064 25,446,064
Total 78,072,868 78,072,868 0 78,072,868

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – New South Wales, June 2016

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the New South Wales state managed fund by the Commonwealth and New South Wales, and YTD payments out of the state managed fund to LHNs and other provider organisations as at June 2016.

NHR funding by source Paid into state
managed fund
YTD
Paid out of state managed fund YTD
To local hospital
networks
YTD
To Other
YTD
Total paid out
YTD
($) ($) ($) ($)
Commonwealth Block funding 624,999,273 624,999,273
State/territory Block funding 531,211,944 531,211,945
Total 1,156,211,218 1,156,211,218 0 1,156,211,218

Block funding represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted categories.

Commonwealth Block funding represents Commonwealth block funding contributions paid into the state managed fund from the state pool account, and block payments out of the state managed fund to LHNs and other provider organisations.

State/territory Block funding represents New South Wales block funding contributions into the state managed fund, and block payments out of the state managed fund to LHNs and other provider organisations.

Note: The grey shaded areas in these tables reflect that these block payments cannot at this stage be identified by source of funding (state, territory or Commonwealth contribution).

NHR funding and payments shown in these tables include GST where applicable.

For more, see National Health Reform funding and payments.

NHR funding and payments by service category

Table 3 – NHR funding and payments by service category – New South Wales, June 2016

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for New South Wales for June 2016. NHR funding and payments are separated into the following service categories – activity-based funding (ABF), block funding, and other funding.

Service category NHR
funding
NHR
payments
NHR
funding YTD
NHR
payments YTD
($) ($) ($) ($)
ABF
Acute admitted 484,175,742 484,175,742 6,023,260,383 6,023,260,383
Admitted mental health 52,317,521 52,317,521 663,030,506 663,030,506
Sub-acute 46,560,701 46,560,701 551,308,242 551,308,242
Emergency department 104,111,314 104,111,314 1,277,837,553 1,277,837,553
Non-admitted 151,242,419 151,242,419 1,874,251,681 1,874,251,681
Total ABF (Pool) 838,407,697 838,407,697 10,389,688,366 10,389,688,366
Block
Small rural hospitals 25,540,771 25,540,771 654,295,834 654,295,834
Teaching, training & research 25,651,123 25,651,123 234,962,031 234,962,031
Non-admitted mental health 26,880,974 26,880,974 266,953,353 266,953,353
Other non-admitted services 0 0 0 0
Total Block (SMF) 78,072,868 78,072,868 1,156,211,218 1,156,211,218
Other
Public health funding 9,412,349 9,412,349 113,224,322 113,224,322
Overdeposit 0 0 0 0
Cross-border 30,000,000 30,000,000 238,400,000 238,400,000
Interest 308,336 308,336 3,412,445 3,412,445
Total Other (Pool) 39,720,685 39,720,685 355,036,767 355,036,767
Grand Total 956,201,251 956,201,251 11,900,936,351 11,900,936,351

Total ABF (Pool) is an aggregate of both Commonwealth and state or territory NHR funding and payments for activity-based funding (ABF) which is transacted through the state pool account.

Total Block (SMF) is an aggregate of both Commonwealth and state or territory NHR funding and payments for block funding which is transacted through the state managed fund (SMF).

Total Other (Pool) represents other funding and payments transacted through the state pool account, including public health funding, overdeposits, cross-border funding and payments, and interest.

State and territory cross-border payments can either be:

  • Paid to the relevant state or territory's LHNs - included within ABF and/or block payments in the above table, or
  • Reimbursed to the relevant state or territory where the state or territory's LHNs are already being funded for the cost of treating cross-border patients - shown in the Cross-border row under Other in the above table.

NHR funding and payments shown in these tables include GST where applicable.

For more information, see National Health Reform funding and payments.

NHR contributions by local hospital network

Table 4a – NHR contributions by local hospital network – New South Wales, June 2016

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in New South Wales during June 2016.

NHR contributions to LHNs are separated into an activity-based funding (ABF) component and a block component.

Local hospital network (LHN) ABF component
(ex GST)
Block component
(ex GST)
Total NHR payment
(ex GST)
($) ($) ($)
Albury NSW Local Health District 36,989,654 -36,989,654 0
Central Coast Local Health District 37,020,360 3,658,610 40,678,970
Contracted Services 915,752 915,752
Far West Local Health District 5,078,375 1,143,680 6,222,055
Hunter New England Local Health District 97,262,201 20,886,793 118,148,994
Illawarra Shoalhaven Local Health District 34,576,908 6,605,721 41,182,629
Justice Health & Forensic Mental Health Network 0 5,409,268 5,409,268
Mid North Coast Local Health District 26,163,752 6,119,626 32,283,378
Murrumbidgee Local Health District 17,390,486 3,341,299 20,731,785
Nepean Blue Mountains Local Health District 34,579,751 3,547,428 38,127,179
Northern NSW Local Health District 33,756,330 3,552,421 37,308,751
Northern Sydney Local Health District 63,086,509 19,222,058 82,308,567
South Eastern Sydney Local Health District 83,554,731 0 83,554,731
South Western Sydney Local Health District 91,312,863 6,070,203 97,383,066
Southern NSW Local Health District 15,946,282 5,500,952 21,447,234
St Vincent's Health Network 20,303,570 2,094,276 22,397,846
Sydney Children's Hospitals Network 28,747,932 3,246,038 31,993,970
Sydney Local Health District 83,081,635 0 83,081,635
Western NSW Local Health District 41,452,575 23,394,956 64,847,531
Western Sydney Local Health District 87,188,031 1,269,193 88,457,224
Total 838,407,697 78,072,868 916,480,566

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – New South Wales, June 2016

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in New South Wales as at June 2016.

NHR contributions to LHNs are separated into an activity-based funding (ABF) component and a block component.

Local hospital network ABF component YTD
(ex GST)
Block component YTD
(ex GST)
Total NHR payment YTD
(ex GST)
($) ($) ($)
Albury NSW Local Health District 94,972,083 4,742,217 99,714,300
Central Coast Local Health District 489,615,260 29,429,594 519,044,854
Contracted Services 9,272,578 9,272,578
Far West Local Health District 59,992,458 13,811,882 73,804,340
Hunter New England Local Health District 1,199,661,507 193,977,423 1,393,638,930
Illawarra Shoalhaven Local Health District 507,284,838 83,217,151 590,501,989
Justice Health & Forensic Mental Health Network 0 48,492,255 48,492,255
Mid North Coast Local Health District 339,807,571 38,572,181 378,379,752
Murrumbidgee Local Health District 231,228,480 141,176,719 372,405,199
Nepean Blue Mountains Local Health District 503,520,968 38,087,844 541,608,812
Northern NSW Local Health District 456,652,061 41,329,305 497,981,366
Northern Sydney Local Health District 864,109,130 103,058,219 967,167,349
South Eastern Sydney Local Health District 1,043,461,884 34,262,945 1,077,724,829
South Western Sydney Local Health District 1,140,453,549 45,643,079 1,186,096,628
Southern NSW Local Health District 229,958,170 37,989,464 267,947,634
St Vincent's Health Network 255,363,717 26,164,276 281,527,993
Sydney Children's Hospitals Network 411,632,125 28,142,070 439,774,195
Sydney Local Health District 965,846,380 102,387,848 1,068,234,228
Western NSW Local Health District 461,143,167 130,678,965 591,822,132
Western Sydney Local Health District 1,125,712,440 15,047,781 1,140,760,221
Total 10,389,688,366 1,156,211,218 11,545,899,584

NHR contributions in this table are GST exclusive to enable comparability of NHR payments in each LHN report.

Note: This table excludes GST.
The majority of government funding to LHNs is not subject to GST. However in some cases hospital funding to non-government entities does attract GST, for example, denominational hospitals, privately and commercially owned health facilities, or any other non-government third party provider of health services or related supplies.

For more information, see National Health Reform funding and payments.

Estimated monthly, YTD and annual activity

States and territories provide service volume estimates at the start of each financial year, and if required, can continue to refine these estimates during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available. These estimates are expressed as National Weighted Activity Units (NWAU).

States and territories provide estimated annual NWAU to the Administrator as a basis for determining the Commonwealth activity-based funding. Current month NWAU estimates accumulate through the year-to-date (YTD) NWAU, to be equal to the annual NWAU at the end of the financial year.

States and territories may also provide activity information relating to the delivery of other public hospital functions funded.

Table 5 – Estimated monthly, YTD and annual NWAU by local hospital network – New South Wales, June 2016

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for June 2016, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each LHN in New South Wales.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2015-16
Albury NSW Local Health District 6,583 20,015 19,748
Central Coast Local Health District 9,884 116,654 118,604
Contracted Services 376 4,357 4,515
Far West Local Health District 885 10,461 10,614
Hunter New England Local Health District 24,257 287,077 291,089
Illawarra Shoalhaven Local Health District 11,143 131,505 133,715
Mid North Coast Local Health District 7,578 89,793 90,941
Murrumbidgee Local Health District 5,040 59,486 60,476
Nepean Blue Mountains Local Health District 10,234 121,038 122,804
Northern NSW Local Health District 9,425 111,725 113,104
Northern Sydney Local Health District 16,469 194,687 197,634
South Eastern Sydney Local Health District 22,816 269,010 273,796
South Western Sydney Local Health District 23,260 275,407 279,124
Southern NSW Local Health District 4,513 53,275 54,154
St Vincent's Health Network 6,449 75,904 77,390
Sydney Children's Hospitals Network 8,390 99,418 100,679
Sydney Local Health District 19,991 236,500 239,897
Western NSW Local Health District 8,251 97,614 99,010
Western Sydney Local Health District 22,493 266,043 269,916
Total 218,038 2,519,969 2,557,211

An NWAU is a measure of health service activity expressed as a common unit. It provides a way of comparing and valuing each public hospital service, whether they are admissions, emergency department presentations or outpatient episodes, by weighting them for their clinical complexity. The average hospital service is worth one NWAU - the most intensive and expensive activities are worth multiple NWAU, the simplest and least expensive are worth fractions of an NWAU.

Monthly NHR payments relate to the cash needs of public hospitals and do not necessarily reflect the volume of services to be delivered in the month.

For more information on the NWAU calculation, see Calculation of NWAU.