National standards and performance

In partnership with states and territories, the Australian Government is driving improved performance across the health system through higher national performance standards and unprecedented transparency.

New transparency measures – in both hospital financing and health system reporting – will mean that communities can have greater confidence in knowing how resources are being used in their health system, and what results are being achieved.

As part of National Health Reform Australians are - for the first time - able to access information on the performance of their hospitals and health system. The MyHospitals website provides a central place where Australians can go to find clear, capable and user friendly information about the services and performance of local hospitals.

Australians will be able to access information about improvements in standards of clinical care and performance reporting, including on emergency departments, elective surgery waiting times and reporting of safety and quality measures such as hospital infection rates. This will be achieved through the:

• National Health Performance Authority (NHPA);
• Independent Hospital Pricing Authority (IHPA); and
• Australian Commission on Safety and Quality in Health Care (ACSQHC).

A national approach to activity based funding, to commence from 1 July 2012, will make public hospital funding more transparent, and help drive efficiency in the delivery of hospital services. Activity based funding links funding of public hospital services to performance, which will drive continuous improvement.

The reforms mean all Australians will be able to access information about the performance of the health system and how hospitals are funded. This increased transparency will drive performance improvement throughout the health system.

The establishment of Lead Clinicians Groups will enhance the engagement of clinicians in the reform of the Australian health system, to improve patient care across health sectors and promote evidence based clinical practices.

Performance and Accountability Framework

A new national Performance and Accountability Framework will underpin the safety, quality and transparency elements of the National Health Reform Agreement. The framework will be used to improve performance across hospital and primary care services over time.

Increased transparency measures will allow the identification of high-performing hospitals and enable sharing of innovative practices across Local Hospital Networks and Medicare Locals and help to create continuous improvement within the hospital and broader health system.

Agencies being established under the National Health Reform Agreement

National Health Performance Authority (NHPA)

NHPA will operate independently of the Australian Government and state and territory governments. It will develop and produce quarterly reports on the performance of every Local Hospital Network and the hospitals within it, every private hospital and all Medicare Locals through their Hospital Performance Reports and Healthy Communities Reports.

The performance measures and standards contained in the Performance and Accountability Framework will allow the NHPA to identify high-performing Local Hospital Networks and Medicare Locals and hospitals to enable the sharing of innovative and effective practices, while also identifying those that are under-performing to enable effective performance management.

Independent Hospital Pricing Authority (IHPA)

IHPA will be a new independent statutory authority that determines the national efficient price of public hospital services under a new model of hospital funding—activity based funding. It is expected to begin in early 2012. However, whilst parliamentary consideration of the legislation to establish the IHPA is awaited, COAG has agreed to establish an Interim IHPA which commenced work on 1 September 2011. The Interim IHPA is currently progressing the activity based funding work plan.

The new national system of activity based funding will make public hospital funding more transparent, and help to drive efficiency in the delivery of public hospital services. Public hospitals will be funded according to the number and kind of services they provide. This new approach will provide incentives for hospitals to treat patients more efficiently and for hospitals and governments to ensure patients are treated in the most appropriate setting. For services where activity based funding would not be appropriate, including small country hospitals, funding will continue to be provided through block grants.

The Commonwealth Government will increase its contribution to efficient growth funding for public hospital services to 45 per cent in 1 July 2014 and then to 50 per cent from 1 July 2017.

Australian Commission on Safety and Quality in Health Care (ACSQHC)

In addition to the establishment of these new agencies, the Australian Commission on Safety and Quality in Health Care (ACSQHC) was established as a permanent independent statutory authority on 1 July 2011. The ACSQHC will play an important role in developing, implementing and monitoring national clinical safety and quality standards that will cover safety, quality and the appropriateness of clinical care.