National Health Reform

National Health Reform Agreement

Schedule C – Transparency and Performance

Performance and Accountability Framework

C1. The Commonwealth and the States will introduce clear and transparent performance reporting against the new Performance and Accountability Framework to provide Australians with information about the performance of their health and hospital services in a way that is nationally consistent and locally relevant.

C2. The Performance and Accountability Framework will include:

1. a subset of the national performance indicators already agreed by COAG through the NHA to report on national trends and the performance of all jurisdictions;


2. reference to national clinical quality and safety standards developed by the ACSQHC as approved by the Standing Council on Health; and


3. design principles for the new Hospital Performance Reports and Healthy Communities Reports which will provide clear and transparent reporting on the performance of every Local Hospital Network, the hospitals within it, every private hospital and every Medicare Local. These reports will reflect:
   1. new service and financial performance standards developed by the NHPA;
   
   
   2. new national standards which will be agreed by COAG from time to time, to reflect selected short to medium term goals and priorities of national significance; and
   
   
   3. selected clinical quality and safety measures drawn from the quality and safety standards developed by the ACSQHC and agreed by the Standing Council on Health.

C3. The Performance and Accountability Framework may be amended from time to time, as agreed by the Standing Council on Health.

C4. The COAG Reform Council will continue its role of reviewing the national performance indicators at a State level and of publicly reporting on the performance of the Commonwealth and the States in achieving the jurisdictional level outcomes and performance benchmarks included in the NHA.

C5. New national standards will be used over time to drive improved performance across the health system. New national standards have already been developed by COAG (in the National Partnership Agreement on Improving Public Hospital Services) in relation to:

1. emergency departments; and


2. elective surgery.

C6. The new national standards, Hospital Performance Reports, Healthy Communities Reports and national clinical and quality standards will report on access to services, quality of service delivery, financial responsibility, patient outcomes and patient experience. Performance measures will be few in number and supported by data which is timely, comparable, administratively simple, cost effective and accurate.

C7. The NHPA will make regular assessments on the performance of Medicare Locals against the measures in the Performance and Accountability Framework and provide advice to the Commonwealth on both high and low performing Medicare Locals. The Commonwealth will be responsible for appropriate action to address any ongoing poor performance of Medicare Locals.

C8. Through the Healthy Communities Reports, the NHPA will transparently and publicly report on GP and primary health care services and outcomes in the local community and region of each Medicare Local, including on local demography and health status, local services and health outcomes.

C9. Through the Hospital Performance Reports the NHPA will transparently and publicly report on public hospital service staffing, financial resources and performance outcomes and standards.

C10. The NHPA will make regular assessments of Local Hospital Network performance against the measures in the Performance and Accountability Framework and provide advice to the Commonwealth and State governments on poor performing Local Hospital Networks. States, as system managers of the public hospital system, will act in line with Health Ministers’ agreed roles and responsibilities to remediate ongoing poor performance.

C11. The MyHospitals website will become the online vehicle for the NHPA to report on the performance of individual hospitals and Local Hospital Networks, enabling patients to compare the services available at, and the performance of, different hospitals in their local area.

C12. To support monitoring and reporting on Medicare Local and Local Hospital Network activity against the Performance and Accountability Framework, the Commonwealth (in regard to Medicare Locals) and the States (in regard to Local Hospital Networks) will provide the NHPA with patient-level and hospital-level service data, staffing information, financial payment and other financial information relating to the provision of public hospital, GP and primary health care services, according to a timetable determined by the NHPA and agreed by the Standing Council on Health.

C13. In order to streamline the data reporting obligations of the States, private hospitals and Medicare Locals under the Performance and Accountability Framework, existing data sources and existing data supply pathways will be utilised as much as possible. The Standing Council on Health will continue to rationalise reporting required from the States, private hospitals and Medicare Locals.

C14. The NHPA will determine appropriate performance reporting data to be provided by private hospitals, taking into account commercial confidentiality.