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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.

States and territories, some private hospital operators and some primary care providers already provide some public reporting of the performance of the health care organisations under their responsibility. The transparency of health care organisational performance will be enhanced at the national level through the establishment of the Authority which will complement the existing role fulfilled by the CRC and the ACSQHC.

7.1 - National Health Performance Authority

The main role of the Authority is to report on the performance of the health system at the local level, including trends over time.

The Authority will:

  • report on the performance of hospitals (public and private) and LHNs through Hospital Performance Reports and on Medicare Locals through Healthy Communities Reports covering:
    • service and financial performance standards and targets agreed by COAG (drawing on NHA indicators where possible);
    • the National Access Target and National Access Guarantee, and any new National Standards Agreed by COAG; and
    • National Clinical Safety and Quality Standards developed by the ACSQHC and endorsed by Health Ministers
  • identify:
    • high-performing organisations, to facilitate sharing of innovative and effective practices; and
    • poorly performing organisations to the Commonwealth, states and territories, to assist with performance management; and
  • provide a comparative analysis of the performance of hospitals, LHNs and Medicare Locals across jurisdictions and across the public and private sectors, in order to identify best practice and ensure focus on the achievement of results.

The emphasis of the Authority’s reporting will be on the longitudinal performance of LHNs and Medicare Locals, with a focus on improvement over time.

The initial set of indicators for the Authority was agreed by COAG in December 2011. However, as an independent statutory authority, the Authority, following extensive clinical and community consultation, will recommend changes to the indicator set that it deems appropriate. Indicators selected for the measurement of safety and quality in healthcare will be developed by the ACSQHC. Changes to the indicator set must be agreed by Australian health ministers. In providing recommendations to Ministers, the Authority will have regard to the following:

  • where appropriate, indicators should address access to services, quality of service delivery, financial responsibility, patient outcomes and/or patient experience; and
  • indicators should be few in number and supported by data which meets the selection criteria set out in Tables 1.1–1.3 Selection Criteria for Indicators.

The Authority will not report on the performance of individual clinicians.

7.2 - COAG Reform Council

The Intergovernmental Agreement on Federal Financial Relations tasks the CRC with reporting of national trends and comparisons of performance across jurisdictions.

Under the Framework, the CRC will report on the performance of all jurisdictions against:

  • existing performance indicators set out in the NHA and relevant National Partnership Agreements, including highlighting examples of good practice;
  • new National Standards agreed by COAG (this currently includes the National Access Target and National Access Guarantee); and
  • national clinical quality and safety standards developed by the ACSQHC and agreed by Health Ministers.

In addition, it will provide advice to COAG to improve NHA performance reporting. Further information about the CRC, including its mission and objectives, can be found at www.coagreformcouncil.gov.au. (NB: As the CRC was dissolved in 2014, this site is no longer available.)  

7.3 - Australian Commission on Safety and Quality in Health Care

The National Health and Hospitals Network (NHHN) Act 2011 establishes the ACSQHC as a permanent, independent authority from 1 July 2011. The role and functions of the ACSQHC are defined in the NHHN Act enabling the continuation of the ACSQHC’s important work.

The ACSQHC will play an important role in developing, validating, supporting implementation and monitoring the effectiveness of national clinical safety and quality standards and guidelines. It will work with clinicians, other health professionals and the National Health and Medical Research Council (NHMRC) to identify best practice clinical care to support the appropriateness of services delivered in a particular setting.

The ACSQHC will provide advice to the Commonwealth, and state and territory Health Ministers about which standards are suitable for implementation as National Clinical Safety and Quality Standards.

The ACSQHC will also collect, analyse and report on national performance against the National Clinical Safety and Quality Standards developed by the ACSQHC and endorsed by Health Ministers.

The Authority will need to work in close cooperation with the ACSQHC to ensure that assessments of safety and quality performance undertaken by the Authority are appropriate for the service being assessed.