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Project Brief – Case Study B
Western Sydney Wellness Trust
The Western Sydney Wellness Trust provides community health care and social care services to a population
of 2,000,000 people living in the Western Sydney Area of Australia. The Trust was formed five years ago
from the merger of the then separate Community Health Care Trust and Social Services Department.
The Community Health Care Trust employed staff with medical training from a variety of disciplines such as
District Nurses and Physiotherapists. They visited patients in their home and provided care to them.
The Social Services Department employed staff with non-medical care skills, from a wide variety of
disciplines, such as Adult Carers and Child Protection Officers, which visited clients in their own home also,
yet provided social care.
The objective of both organisations was to enable people to go on living in their own home for as long as
possible, thus delaying their move to Trust-funded Nursing homes.
The merger of these two organisations was the result of a new central government policy being piloted in
the region in which Western Sydney falls. There are nine other Community Trusts within the region, none of
which are as progressive in their thinking as the Western Sydney Health and Social Care Trust. The
objectives of the government policy are to improve the care provided and reduce the overall cost of
providing that care. The new combined Trust was given a large degree of organisational and financial
autonomy within the framework of overall management by the local region, and an energetic, forward
thinking Chief Executive, Jim James, previously the Director of Social Services, was appointed to lead the
new combined Trust. Jim James immediately appointed the hardworking Operations Director of the
Community Health Care Trust, Dr Robert Northy to the position of Business Development Director –
effectively his deputy.
The Trust is headquartered in an old Victorian-style Mental Health Hospital facility in Parramatta with 50
other offices, clinics and care homes scattered over the geographical area served by the Trust. Very few of
these offices have been purpose-built.
The Trust now employs 3000 staff split into a relatively small Head Office team including Finance, Personnel
and Business Development and the professional care staff who are divided into 3 Directorates as follows:
• Adult Care
• Mental Health Care
• Child Care
The main IT software systems used in the Trust are not integrated with each other and comprise:
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• The legacy Social Care system, which is primarily concerned with providing a basis for analysing the
type and source of referrals received by the individual social care teams and recording the type of
care and cost of care delivered in response to the referral. No attempt is made to record the
outcome of the care delivered and all notes made by the social workers are handwritten and filed
• The legacy Health Care system which is primarily concerned with collecting details of the activities
carried out by the health care workers so that mandatory statistical analyses can be forwarded to
the Ministry of Health in federal government
• An effective email system linking all of the offices together
• A financial management and payroll system
The legacy systems are old and not user friendly, and staff activity data is entered by clerks located in the
scattered offices and then used for statistical report generation by the central IT Department. None of the
health and social care professionals ever make use of the information in these systems.
The network linking all of the offices together is the responsibility of the IT Team in the Regional Office. They
have wider and deeper IT infrastructure skills than the Trust.
Company’s Creation and Use of Information
The Trust is one of only a few separate organisations which deliver care to the geographic area of Western
Sydney. The other organisations are:
• Separate NSW Government-managed Hospitals who provide Accident & Emergency services,
maternity services and a full range of clinical services to perform operations on patients as required
• Doctor Practices (Clinics) that are all contracted independently to the National Health Service and
run effectively as individual small businesses, paid by Medicare depending on how many patients are
served by them
People in need of care are referred to the Trust from a range of sources, for example Centrelink, Medical
Doctors, Hospitals, Police, Schools, neighbours or next of kin.
Referrals contain wide disparities in the quality and quantity of their information. They are normally directed
to a local Trust office which may or may not house the professional care team capable of dealing with the
particular problem, so the referral is then forwarded on within the Trust, finally reaching the correct team
who take action. Referrals are received on a 24-hour basis 7 days a week and are actioned immediately if
they are deemed to be urgent.
The key actions following receipt of the referral are typically:
• A visit to the referred person in need of care by a senior care professional from the most relevant
care team, who carries out an assessment of the patient and may generate referrals to other teams
within the Trust for their follow-up
• Creation of a handwritten care plan. Some care plans are very complicated and some very simple.
For example, the Child Protection teams draw up very complex plans to solve the domestic problems
leading to abuse of the child whereas the Podiatry teams are only concerned with scheduling visits
to cut elderly patients’ toenails
• Signoff of the costs of delivering the care by the Team Manager, or adjustment if too expensive
• Delivery of the care services, which vary in duration from one hour to several years depending on
the discipline and type of care
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• Review of progress and revision of the care plan as necessary
Each professional care discipline has developed its own style of assessment form and care plan to record
information about the patient, and each uses its own medical and care jargon to describe the same
condition. Although a patient may receive care services from several teams in parallel, each of which is
delivering its own speciality – for example district nurses dressing leg ulcers or occupational therapists
modifying the home environment – no attempt is made to coordinate the care delivery or exchange care
plans between the teams so they may well turn up at the same patient’s house on the same day and at the
same time and one will then have to reschedule their visit.
The teams are traditionally suspicious of sharing patient related information in case they make patient
diagnosis mistakes, and the mental health and child protection teams are particularly concerned about
security of information for their patients and clients.
Company Contact: Dr Robert Northy, Business Development Director. Dr Northy will be the company
contact and the medium to the Chief Executive Jim James.
Such a cheap price for your free time and healthy sleep
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