A massive overhaul of the ACT's health system is in the works, after the health directorate awarded more than $700,000 worth of contracts to consultancy firm Ernst and Young to review the territory's clinical services and examine community health programs.
Signed in the weeks before the ACT government went into caretaker mode, the two contracts were for a $565,810 "Review of Clinical Service Needs of the ACT Community" and $225,500 to examine "Opportunities to better manage community health service provision".
Work began on both contracts in late August, as part of a wider "System Innovation Program" being run under director-general Nicole Feely's leadership.
Fairfax Media understands that program aims to update ACT Health's Clinical Services Framework, find "efficiencies" across the health system and turn around the territory's reputation for having the most expensive hospitals in the country.
It is understood the program also aims to reduce waiting times in both Canberra and Calvary Hospitals and the directorate has previously said any savings found will be redirected within the ACT health budget, and are not be used to line the territory's budget coffers.
Fairfax Media has spoken to numerous health sector sources about the directorate's intentions.
While most agreed there was a need to find savings for the longer term, several sources were concerned about the lack of communication from the highest levels of the department and the potential effects it could have on frontline staff, with some fearing job losses.
The clinical services review contract outlines a 12-week plan to review the current service delivery model, financial analysis of all parts of the ACT's health system and develop "core ratings" for each service assessed, including "in-patient, emergency department, outpatient and mental health services including cross-border flows from New South Wales".
A final report to ACT Health will include a "cost-benefit analysis of the opportunities identified that compares the costs of continuing with the current model and the potential impact of changing the service delivery model" with the focus on creating a new "baseline projection for future service provision" over the next 10 to 15 years.
It also includes a further contract to develop "implementation plans to establish an intensive care unit network" which could include a level 4 ICU facility at Bega as part of efforts to "reverse cross-border patient flows with NSW" and "reversal of elective surgery flows".
The second review, of community health service provision, was meant to be completed over six weeks, likely by the end of October.
Contract documents show that work included defining and reviewing the existing performance indicators for community health services and aligning them to the "broader ACT Health strategy", as well as setting new benchmarks to analyse ACT's community health services against comparable services interstate.
It would also identify areas for improvement, find "key deficiencies" and make recommendations to ACT Health on "performance improvement options".
An ACT Health spokeswoman said the contracts were a "desktop data-gathering exercise to update our services profile".
"It has been a matter of discussion for several months and the terms were agreed to in early August 2016," she said.
The spokeswoman said Ms Feely had spoken about the framework in ACT health "staff forums" and "in her discussions with external stakeholders", including unions and other bodies including the Capital Health Network.
"In these discussions with external stakeholders, ACT Health has had positive feedback, with peak bodies eager to have their input into future health service delivery plans," she said.
Daniel Burdon is a reporter for The Canberra Times