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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 celebration and recognition of outstanding performance is an opportunity for the community to focus on the opportunities for improvement across the health system. The Authority will provide annual advice to the Commonwealth Minister for Health and Ageing and state and territory health ministers and governing bodies of private hospitals on the organisations it has identified as performing well above Authority expectations. Hospital Performance Reports and Healthy Communities Reports will also identify those organisations that are performing well.

Judgments of performance of Medicare Locals will be contextualised with regard to varying and unique socio economic circumstances.

In addition to identifying high performing organisations, the Authority will have an important role in the identification of poor performance as an important safety mechanism.

11.1 - States and territories remain the system manager for public hospitals and other state and territory funded services

The establishment of the Authority reinforces the ongoing role of states and territories as public hospital system managers. The establishment of the Authority enhances the information available to state and territory governments and the community for the assessment of the performance of LHNs within each state and territory.

The Authority will provide regular public assessments of the performance of LHNs to state and territory governments through Hospital Performance Reports. The role fulfilled by state and territory governments as public hospital system managers means that state and territory governments decide what response is required to each of the assessments provided by the Authority in the case of LHNs.

11.2 - Accountability framework for Local Hospital Networks and private hospitals

States and territories are responsible for the safe, high quality delivery of accessible public hospital services within their jurisdiction.

As system managers, states and territories are responsible for responding to Authority assessments of public hospital and LHN performance. Likewise, the governing bodies of private hospitals are responsible for responding to the Authority’s findings regarding the private hospitals they manage.

Whenever the Authority’s report indicates poor performance on the part of an LHN or public hospital, the relevant state or territory health minister must be consulted on the draft report prior to its finalisation and publication. In circumstances where there has been persistent poor performance, or where unsafe performance has been identified, the Authority must consult the relevant state or territory health minister prior to finalising and publishing its report. Specific arrangements for this consultation are set out in the legislation governing the Authority. Only after these provisions have been complied with may the Authority issue its public report. States and territories will consult the relevant LHN governing body before finalising its response to the Authority. Decisions on the nature and timing of remediation actions are matters solely for state and territory health ministers.

The governing bodies of private hospitals are responsible for the quality of care provided by these hospitals. The Authority will monitor and assess the performance of private hospitals using a set of indicators that will be similar to that used to monitor LHNs. This indicator set will be developed in consultation with the private hospital sector prior to implementation in 2012.

The Authority will publish regular Hospital Performance Reports on the performance of private hospitals. The Authority will also provide these Hospital Performance Reports to the governing bodies of private hospitals and the relevant state or territory licensing body on a regular basis. Where a private hospital demonstrates performance at a level above that expected by the Authority, then that outstanding performance will be acknowledged by the Authority. Where a private hospital exhibits poor or unsafe performance, the Authority will formally notify the relevant governing body as well as the state or territory licensing body. The Authority may provide both confidential - and in the case of persistent and/or unsafe poor performance and where there is a public interest in doing so - public warnings to the governing body of the private hospital and the Minister for Health and Ageing as well as to the relevant state or territory licensing body.

Prior to any publication of assessments of poor performance the Authority must comply with the natural justice provisions in its founding legislation so as to ensure that the relevant state or territory, or relevant governing body for private hospitals, is afforded the opportunity to contextualise data and if necessary, remediate poor performance.