National Health Reform

Building a 21st Century - Primary Health Care System - Australia’s First National Primary Health Care Strategy

Key Priority Area 4: Improving quality, safety, performance and accountability

The Australian Government will use its position as the majority funder of health and hospital services in Australia to impose strong national standards for primary health care performance. These national standards will clearly reflect the high expectations that all Australians have of their health and hospital services. As part of its national leadership role, the Australian Government will insist on higher national performance standards, more consistently applied across the country, with new targets backed up by explicit financial rewards and penalties.

Underpinning quality and safety, and primary health care policy more broadly, the Australian Government will maintain its commitment to primary health care research, both through funding for research capacity, and through the use of research-based evidence to inform policy and practice.

Actions – how the Government will implement this reform

The Australian Government, in conjunction with states and territories, will establish a strong framework for safety and quality in health care, including:

Developing a new performance and accountability framework for the National Health and Hospitals Network

The Network will have a new performance and accountability framework, which will include:

• national performance indicators already agreed through COAG in the 2008 National Healthcare Agreement (NHA) to report on national trends and the performance of all jurisdictions; and
• national clinical quality and safety standards developed by the Australian Commission on Safety and Quality in Health Care.

Creating new national governance functions for the health care system, including the establishment of a new National Performance Authority (NPA)

The NPA will be established from 1 July 2011 as an independent Commonwealth statutory authority, covered by a legislative charter which sets out the functions for the NPA and arrangements to secure its continued independence.

The NPA will monitor the performance of primary health care organisations (Medicare Locals) against agreed performance measures and standards to identify high performing organisations and to facilitate sharing of innovative and effective practices. The NPA's reports will allow comparative analysis across jurisdictions to identify best practice.

Reporting to the public through Healthy Communities Reports

The Government will develop a Healthy catchment area. This report will include, on a nationally consistent basis, local and regional area information covering:

• preventive health risk factors and other measures of community health and wellbeing;
• access to GP services and out of hours GP care; and
• the extent to which the health system is working in a coordinated way, for example, through the number of avoidable hospital admissions, and trends in this information over time.

The Government will work with GP and other primary health care stakeholder groups and the National Preventive Health Agency to develop the Report structure.

At the local level these changes will involve a move to a more performance based focus, with a greater emphasis on improved patient outcomes. Continuing investment in quality improvement through peer-based learning and support will assist general practices to better utilise their data to improve their patients’ outcomes.

Overall, nationally consistent and independent performance monitoring at the local level will:

• identify high performing general practice and other primary health care services;
• facilitate sharing of effective and innovative practices; and
• incorporate strong national service standards and financial performance standards to increase accountability and drive improved patient outcomes.

Continuing the role of the COAG Reform Council (CRC)

The role of the independent CRC will be continued, with the following functions:

• providing clear, transparent and regular public reporting on all jurisdictions’ performance;
• providing an independent assessment of whether predetermined performance benchmarks have been achieved prior to reward payments being made; and
• advising COAG on changes that might be made to improve performance reporting against the NHA performance indicators.

Expanding the role of the Australian Commission on Safety and Quality in Health Care (ACSQHC)

The existing governance and funding arrangements of the ACSQHC will continue. It is intended that the role of the ACSQHC will expand, subject to detailed agreement on the scope and financial implications by Health Ministers.

The ACSQHC will develop new national clinical standards and strengthened clinical governance that will support clinicians to lead the drive towards continuous improvement in quality and safeguarding high standards of care.

What this means for patients

Based on national standards for primary health care performance and Healthy Communities Reports at the Medicare Local level, Australians will be able to access transparent and nationally comparable performance data and information on health services.


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