Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012

Technical Appendix—Data development—New South Wales (NSW)

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and will be an important tool for developing the new National Aboriginal and Torres Strait Islander Health Plan (NATSIHP).

Page last updated: 15 November 2012

In NSW, Indigenous status is collected in a range of health datasets, including the NSW Midwives Data Collection (MDC), the NSW Admitted Patient Data Collection (APDC), the NSW Emergency Department Data Collection (EDDC), the Non-admitted Patient Data Collection, the NSW Notifiable Conditions Information Management System (NCIMS), the NSW Health Survey Program, and the NSW Central Cancer Registry (CCR).

Standard ABS Indigenous status question and recording categories

NSW Health has adopted the standard ABS Indigenous status question and recording categories. NSW Health has recently released the revised Policy PD2012_042 Aboriginal and Torres Strait Islander Origin—Recording of Information of Patients and Clients. The revised Policy incorporates all elements of the AIHW's Best Practice Guidelines.

"Respecting the difference: an Aboriginal and Cultural Training Framework for NSW Health" outlines a mandatory cultural training framework for all staff working in health, and includes information on collecting Indigenous status information.

Improving Procedures for collecting Indigenous status information

NSW has undertaken a review of evidence concerning best practice for determining and recoding the Indigenous status of NSW Government Service agency clients. The review has been largely informed by the Best Practice Guidelines released by the AIHW. The scope of the review considered the literature beyond health to consider data collection informing all measures in the NIRA.

Aboriginal Affairs NSW has sought to review current practice within relevant agencies with reference to the available evidence for best practice. The agencies that were involved included the NSW Ministry of Health, the Department of Education and Communities and Births, Deaths and Marriages.

This work includes:
  • a review of information resources and training packages used to train staff in key data collection positions;
  • a list of recommendations to support staff competencies; and
  • the development of a checklist detailing 17 components of best practice against which Government agencies can review their work.
Following consultation with NSW Government agencies a final report will be produced towards the end of 2012.

NSW Health will commence the NSW Hospitals Identification Project in 2012, which aims to improve the cultural competency of services provided to Aboriginal and Torres Strait Islander peoples in NSW hospitals, by developing a framework based on continuing quality improvement processes, implementing the framework in improving cultural competency as assessed by improved Aboriginal and Torres Strait Islander identification in routinely collected data sets.

NSW Health is conducting a project entitled "Improved reporting of Aboriginal and Torres Strait Islander people on population datasets using record linkages". The aims of this project are to:
  1. develop methods for improving reporting of Aboriginal and Torres Strait Islander peoples on population datasets using record linkage;
  2. describe the improvements in reporting achieved by record linkage; and
  3. explore the impact of any changes in reporting due to record linkage on a selection of indicators of health status and health services utilisations.
NSW Health has participated in the 2011–12 AIHW Admitted Patients Data Quality Survey to assess the completeness of identification in the Admitted Patients Data Collection. The AIHW will compile the results of this survey for publishing.

Attorney General and Justice: The Registry of Births, Deaths and Marriages has instituted staff training to improve accuracy in the verification of registrations, including the recoding of Indigenous status data. In 2011, the Registry amended some 1500 records when inaccurate data entry was identified, regarding the Indigenous question for parent on birth registrations. Continued monitoring of these data and greater diligence in verifying data are in place.

As part of the Registry's Get Your Rego Right campaign, Registry staff have held meetings with funeral director industry groups, as well as individuals, to address reproving issues, including the completion of the Indigenous question on death registrations. The Registry has encouraged funeral directors to ensure that the information concerning a deceased person's Indigenous status is obtained directly from the family of the deceased.

The Registry has also seen a marked improvement in the compliance of doctors regarding completion of the Indigenous question on medicinal certificates of cause of death. Completion of this question by doctors is now at 100%.

The Registry is in the process of developing a new IT system called Lifelink, which will include improvements in the recording and reporting of Indigenous data. This includes automatically detecting discrepancies between Indigenous status data supplied by the funeral director on a death registration, and by the doctor on a medical certificate of cause of death.

The Department of Education and Communities has included a section on strategies to be more culturally sensitive and inclusive with enrolment and procedures in the Connecting to Country professional development component (Principals). This will align with the evaluation of the Aboriginal and Torres Strait Islander Education Action Plan 2010–14, where schools will be expected to answer a question relating to enrolment procedures.

Raising Indigenous community's awareness about importance of identifying

Aboriginal Affairs NSW has employed two Senior Project Officers for three years to work with Aboriginal and Torres Strait Islander communities to raise community awareness of the importance of identifying as Aboriginal and Torres Strait Islander when accessing and using services. The project has two broad phases.Top of page

Phase 1

Seeks to understand why Aboriginal and Torres Strait Islander peoples choose not to self-identify. This first phase involves two components:
  • a literature review; and
  • research with Aboriginal and Torres Strait Islander peoples in NSW to understand the issues as they pertain to NSW. This will involve conducting interviews and surveys.
It is anticipated that the second component will provide information that is specific to NSW Government agencies about their processes in working with Aboriginal and Torres Strait Islander peoples. NSW Aboriginal Affairs will seek to work collaboratively with other NSW Government agencies regarding the feedback obtained. This may involve brokering solutions with agencies where communities indicate a concern regarding the use of Indigenous status information.

Phase 2

Information from phase one will inform the development of a program that will seek to increase the propensity of Aboriginal and Torres Strait Islander peoples to identify when accessing and using NSW Government services.

The work, to date, has been carried out in consultation with state Government agencies, the ABS; Aboriginal and Torres Strait Islander and non-Indigenous community organisations and individual members of Aboriginal and Torres Strait Islander communities. The project will be completed in two years.

NSW Health: Local Health Districts are implementing initiatives to raise awareness about the importance of identifying. The programs are designed and implemented locally. The Office of Aboriginal Affairs contacted Local Health Districts directly and examples have been provided.

Attorney General and Justice: Since 2008, the Registry of Births, Deaths and Marriages has conducted visits to over 50 Aboriginal and Torres Strait Islander communities across NSW to foster a stronger relationship between the Registry and Aboriginal and Torres Strait Islander peoples, and encouraged accurate reporting on birth and death registrations. Another eight community visits are planned for this year, these visits are also used to ensure the Aboriginal and Torres Strait Islander children born in NSW have their births registered. As a result of this initiative, over 5000 children have now been registered who were previously not registered.

The health of the people of New South Wales—Report of the Chief Health Officer has been produced regularly since 1996 and has become a flagship publication of the NSW Ministry of Health. The 2012 edition of the Report of the Chief Health Officer is a special report on the health of Aboriginal people in NSW. Increased reporting will facilitate improved monitoring of progress towards closing the gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians across key population health and health system indicators. The indicators presented in the report were selected to represent those health issues that contribute most to the burden of disease and injury experienced by Aboriginal and Torres Strait Islander peoples in NSW, or where there is a large disparity in terms of both health care and health outcomes for Aboriginal and Torres Strait Islander peoples compared with non-Indigenous Australians. Many of the indicators presented contribute to national targets and benchmarks set by all Australian governments to close the gap in life expectancy and improve the health of Aboriginal and Torres Strait Islander peoples across Australia.Top of page