1. Metropolitan Health Service of the Year 2010 Nurse Led Clinics Stephen Thomas Nurse Director – Systems and Workforce

2. Metropolitan Health Service of the Year 2010 What is VACS The Victorian Ambulatory Classification and Funding System (VACS) is an outpatient classification and monitoring system used in VACS funded hospitals Hospitals report patient visits as either bundled encounters, or occasions of service Encounters refer to face to face visits within one of the 35 VACS weighted medical/surgical clinic categories, whereas occasions of services refer to visits within one of the 11 VACS Allied Health unweighted categories Allied Health encounters are calculated at a common set rate Nursing is captured under VACS 609 (other) Note – Nurse Practitioner is reflected as Medical VACS

3. Metropolitan Health Service of the Year 2010 VACS Schedule Hospitals are required to maintain a VACS clinic schedule This describes and maps their clinics to the VACS categories. New and revised clinics are submitted to the department on the VACS Notification form throughout the year. The department continually monitors and updates VACS schedules and once a year provides a summary of proposed new clinics to the VACS Clinical Panel Hospitals report clinic activity through the Agency Information Management System (AIMS), an online entry system and reporting facility.

4. Metropolitan Health Service of the Year 2010

5. The VACS Panel Meets annually, usually in late April, pre the budget process Is comprised of eminent senior clinicians from a range of specialties and representatives from the field and the Department of Health Formal establishment of clinic schedules for funding purposes is undertaken by the VACS Clinical Panel Hospitals advise the Department of Health of proposed new clinics which are submitted annually to the VACS Clinical Panel for approval. It reviews new clinic requests to assess whether they appropriately meet the criteria for inclusion in VACS It also considers specified grant applications in the context of the criteria for inclusion in VACS and whether they are appropriate as grants or clinics It does not have a brief for approving funding for clinics, only their inclusion It may also consider policy changes to the VACS model

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7. To determine approx annual activity Nursing is VACS 609 All nursing encounters are public Signed by hospital delegate (often the Hospitals VACS contact) Describing what you do Determined internally by the hospital

8. Metropolitan Health Service of the Year 2010 Describing what you do It is vitally important to ensure that the description of your planned activities meet the criteria for a VACS encounter. Some examples include: –To provide review/assessment/education and coordination of care of oncology patients with skin cancer and melanoma by Clinical Nurse Specialist/Clinical Nurse Coordinator –To provide review/assessment/education and co-ordination of paediatric oncology patients. –To provide specialist review/assessment/education support and coordinate Pain and Palliative Care of oncology patients by nurse consultant only –Nurse led clinic set up to review oncology patients following discharge from hospital after undergoing autologous transplant. The clinic aims to provide post acute care through health assessments, monitoring and provision of supportive care as required. –Stoma therapy nurse led clinic for pre operative consultation and review of patients with an osotomy.

9. Metropolitan Health Service of the Year 2010 Current Nurse Led Services at Petermac Skin & Melanoma Nurse Paediatric Nurse Coordinator Palliative Care Nurse Consultant Post Transplant Nurse Led Clinic Pre-Transplant Nurse Education Quit Smoking Lung Nurse Coordinator Skin post op Stomal Nurse Trial of Void GI Nurse Follow up AYA oncology Urology flow meter Outpatient Dressing Urology Nurse review Neuro Oncology Nurse Coordinator Late Effect Nurse Coordinator Head and Neck Nurse Coordinator Haematology Skin and Lymphoma Nurse Led Clinic Haem Nurse Led Clinic GI Nurse Coordinator Gastro intestinal Stoma Nurse led clinic Chemo Day unit Nurse Education Clinic Breast Nurse Coordinator Bone and Soft Tissue Nurse Coordinator