Engaged by Sir Edward Dunlop Hospitals (1) Ltd to source and field the necessary senior management, nursing and education technical experts to undertake the feasibility study and prepare the report.

The Indian Nursing Council in conjunction with the Department of Health and Family Welfare, WHO and INC constituents seek to establish a strategy for achieving excellence in Indian Nursing Education. The strategy will enable it to prepare Indian Nursing to take on new and emerging roles in health care and successfully undertake the implementation of the National Health Plan of India. As part of this strategy it was resolved to undertake a Feasibility Study into the development of a proposed National Institute for Advancement of Standards in Nursing and Allied Health.

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United Medical Group was engaged to undertake a service plan review – the previous Service Plan had been completed in 2002 – in order to guide the redevelopment process. Extensive and intensive internal & external stakeholder consultation was undertaken over the eight week project life. These consultations largely took the form of User Groups, i.e. health professionals were grouped according to discipline and the sessions conducted as a two-way exchange of information.

The consultation process was informed by a data analysis phase, which indicated that demand was only going to continue to increase over the next ten years.

The report is now in the process of being finalized and is being used as the starting point for the business case and functional briefing phases of the redevelopment project.

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Central Bayside Community Health Service and Bentleigh Bayside Community Health Service provide a broad range of community health services to a large part of Melbourne’s south eastern suburbs, serving a total community of approximately 270,000 persons. Over the past decade in particular services have grown in a somewhat ad hoc manner, due in part to the diverse streams of funding that government, at all levels, has made available in order to target particular problem areas. For instance, the hospital in the home scheme, HITH and the hospital admissions Risk Program, HARP both aim to reduce the usage of acute hospital beds by trying to prevent sub-acute cases progressing to the acute stage, but the funding for each is restricted to activities specified under the relevant regulations pertaining to that program and cannot be diverted to other activities no matter how pertinent they may be from an overall community health perspective. In this climate both CHSs have grown significantly as measured by equivalent full time (EFT) employees. In the past decade Bentleigh grew from 17.8 EFT to 53.0 EFT and Central grew from 60.0 to 122.5 EFT. The time had come for a strategic review of services and UMG was engaged to undertake that review.

The original intention was to undertake a thorough data analysis and services projection exercise which was to inform the intensive but directed consultation process. This approach founded due firstly, to a lack of good quality data; and secondly and most importantly, to the realization that even with good throughput data, there is an irresolvable dilemma in that utilization or usage (e.g. no. of cases, or clients treated for instance) does not necessarily equate to demand or even need in the community health setting. Indeed it is the common experience in this setting that if a new program is commenced it will quickly fill up with clients. In the acute setting however, the assumption that utilization is an adequate proxy measure for demand and need is valid.

A fresh approach was required. UMG turned to a “top-down” approach by examining community wide data and studies such as the Burden of Disease study of Victoria. The approach then taken was to examine underlying causes of particularly prevalent diseases or conditions and project how much “burden” will befall communities (as defined geographically such as the South eastern section of Melbourne) in the future if the pattern proceeds unchecked. Measures such as DALY (Disability Adjusted Life Years) and YLD (Years Lost to Disability) and YLL (Years Life lost) have been devised to quantify “burden”, and these were applied to each CHS’s projected catchment population. Armed with this information the client was able to determine priorities for the usage of future increases in EFT and to put the results in round table forums with their senior management, their boards, their key strategic partners (i.e. the relevant acute hospital network and relevant local government authority) and their community.

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The main objectives of the Project were to:

• Evaluate the acute hospital services of Lebanon.
• Produce an hospital accreditation assessment tool based on a review of international literature survey and broadly-based consultation
• Enhance quality assurance and quality improvement practices.
• Recommend a structure for institutionalizing quality into the management practices of acute hospitals throughout Lebanon.

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This project's objectives were to apply the hospital accreditation standards developed under the previous project to the 134 private hospitals that treat patients with Government funding assistance.

This project had a strong change management imperative to it. Hospital management teams from Lebanese hospitals regularly sought advice from the team on how to go about implementing improved management practices.

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Develop a 4,200 m2 accommodation facility for 155 students / residents on a Public Private Partnership model in Bendigo, Northern Victoria. Under the Public Private Partnership model the land is provided by the public sector while the private sector plans, funds, builds and commissions the facility then wins the concession to operate and manage it on a long term - typically 30 years - contract. At the end of the concession period ownership of the facility reverts to the public sector.

UMGA will join a funding partner in the creation of a Joint Venture Company to develop the Project and under the terms of the concession the Joint Venture Company will levy and collect all revenues and be responsible for all costs.

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UMGA was commissioned to develop an evaluation strategy and to conduct the evaluation of the first stage of the project. In order to describe the Medicare Access Model scheme in the context of Aboriginal Health Services and assess the efficiency, effectiveness and appropriateness of the Medicare Access Model, information was collected from a wide range of sources including from individual service providers, including the Royal Flying Doctor Service and members of remote communities who are recipients of health services provided through the Medicare Access Model.

The evaluation provided an assessment of the impact of the Medicare Access Model initiative, contributed to a better understanding of primary health care needs of Aboriginal people in remote areas, identified opportunities for improvements to the current approach, and suggested practical strategies in response to views widely expressed by stakeholders.

Although the Medicare Access Model scheme was found to meet some of its objectives, it was not meeting them in an efficient manner. It was recommended that the scheme be wound down and several alternative, and more efficient, schemes were suggested in its stead.

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Undertake a preliminary study into the feasibility of developing a comprehensive Statewide Integrated Health Services Plan.

For various reasons, although the feasibility study was positive, the development of the Statewide Plan has proceeded very slowly. However, one component of it - the “Naga Hospital Upgradation Project” – has proceeded and United Medical Group Australia undertook the detailed health service plan, which encompassed the preparation of a Services Plan, a Functional Brief and a Business Plan. The activities required a close working relationship with the US architectural company Ariane Zand and Associates.

This project marks the beginning of the transformation process, which ultimately aims to achieve access to significantly improved quality-oriented primary, secondary and tertiary health services throughout the State of Nagaland. The key underpinning for restructuring and reform of Nagaland’s health care system is to develop an integrated health financing and delivery system. By bringing preventive, curative, family planning and hospital care under one organized system operated in a cost-effective manner, the objective is that integrated care will help conserve resources and result in their maximum and efficient utilisation, and to improve morbidity and mortality indices.

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This detailed costing project involved the systematic valuation of private sector costs associated with the provision of health services to entitled armed services veterans. The project progressively covered all of Australia on a State-by-State basis.

At the end of the Project the most comprehensive database of this type of hospital costing data had been assembled and the Project itself lead to the definition and application of relevant new key performance indicators enabling the Department of Veteran’s Affairs to manage the entire tendering process efficiently, effectively and appropriately. These complex key performance indicators related activities, case mix and costs for the first time in this field.

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Working with Mohamed Salahuddin, Consulting Engineering Bureau, Bahrain, we conducted a study into the health service requirements of the Bahrain National Aluminium Company's employees, family members, nearby community members and other industrial organisations located within the industrial area of Bahrain. Space plans and indicative capital requirements for a facility to service these requirements were then developed.

UMGA was able to draw upon its vast data base of international health planning stats and apply WBP principles adjusted for local conditions in order to provide practical and robust advice which had been verified through an effective program of local consultation.

This complex project involved visits to every hospital in Bahrain plus a selection of other health care facilities (a total of circa 15 in all).