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This page refers to the Performance and Accountability Framework, an intergovernmental document that assigned various reporting responsibilities to the former National Health Performance Authority. From 1 July 2016, activities related to reporting against the indicators contained in the Framework are the responsibility of the Australian Institute of Health and Welfare.

The August 2011 Council of Australian Governments (COAG) National Health Reform Agreement (NHRA) outlined COAG’s objectives for national health reform, including:

  • improving performance reporting through the establishment of the National Health Performance Authority (the Authority); and
  • improving accountability through the Performance and Accountability Framework (the Framework).

The NHRA builds on the Heads of Agreement – National Health Reform agreed by COAG in February 2011.

The Framework is designed to support improved local level performance assessment to contribute towards the achievement of these objectives.

The key objective of the Framework is to support a safe, high quality Australian health system, through improved transparency and accountability.

A robust performance reporting framework is critical to ensuring extensive information is available for patients and clients, health providers, and health system managers.

The Framework will underpin reporting across three domains—equity, effectiveness and efficiency of service delivery in health care.

By publicly and transparently reporting on these domains of health system performance, the Framework will help to drive improvements in health system delivery and hence the achievement of broader health system objectives.

The Framework has been designed to facilitate the achievement of key national health policy objectives, such as:

  • the ongoing improvement of the safety and quality of the health system;
  • ensuring efficiency and sustainability through a rigorous data collection, monitoring and reporting system;
  • improving integration between the primary health care and hospital sectors; and
  • enabling comparisons between all sectors of the Australian health system including comparisons across the public and private sectors to assist both the public and private sectors’ improving performance.

The Authority established under Commonwealth legislation began operations on 21 October 2011. In part, the Framework establishes the conceptual basis for the Authority to fulfil its role in developing and producing reports on the performance of hospitals and health care services, including primary health care services. Specifically, the purpose of the Framework is to ensure that, through clear and transparent performance reporting:

  • members of the public have access to relevant, up to date information about health care providers (both public and private), to allow them to make informed choices;
  • Local Hospital Networks (LHNs), hospitals, clinical units, Medicare Locals and health services are provided with comparative clinical performance data to foster continuous quality improvement;
  • governments and governing bodies of private hospitals are provided with additional data to ensure robust accountability and oversight of the health system; and
  • existing reporting mechanisms are supported and coordinated, such as the COAG Reform Council processes.

In addition to underpinning the performance reporting of the Authority, the Framework incorporates the performance monitoring and assessment role of the COAG Reform Council (CRC) established under the National Healthcare Agreement (NHA). The Framework has also been designed to integrate seamlessly with the existing frameworks such as the National Health Performance Framework, the Review of Government Service Provision process and the Aboriginal and Torres Strait Islander Health Performance Framework, and are discussed later in this document.

The Framework has also been designed to integrate seamlessly with the revised National Health Information Agreement (NHIA), to be agreed by the Australian Health Ministers’ Advisory Council (AHMAC) in late 2011. The NHIA will incorporate the data management arrangements in the Framework to the extent necessary, and build on them with its underpinnings for collaborative national development, collection and use of health data.