The proposed recommendations for implementation

Please scroll down to view the preliminary recommendations and findings for this section of the review.

* The public consultation for the review of Australia’s health system performance information and reporting frameworks closed on 17 February 2017.

Have your say

To have your say on this section of the review, please click here to answer the following questions:

  1. What are your views on the recommendations for implementation? Is there anything else that should be considered? (Please limit response to 400 words or less)
Recommendation 7
National leadership through the COAG Health Council should drive improvements in health system performance information and reporting.

Rationale for Recommendation 7

Strong national leadership is an essential component of implementation. The National Health Reform Agreement (NHRA) stipulates that responsibility for health performance information and reporting ultimately lies with COAG, with support from the Standing Council on Health (now known as the COAG Health Council) and Treasurers. As such, current arrangements imply leadership from First Ministers rather than Health Ministers.

Health Ministers, through the COAG Health Council, should hold ultimate responsibility for leadership of health system performance information and reporting. This is because their portfolios and responsibilities align and they have the necessary technical understanding and exposure to the health system.


Recommendation 8
Governance of health system performance information and reporting through the relevant Committees should take a more strategic focus by reviewing membership of the Committees, the terms of reference and implementing procedural changes consistent with the broader review of the Australian Health Ministers’ Advisory Council (AHMAC) Principal Committee structures.

Rationale for Recommendation 8

Robust strategic direction is essential to coordinate the diverse range of players across the health system performance information and reporting system. Governance of health system performance should reflect the principle that policy objectives drive decisions around data usage, rather than data availability. Therefore strategic objectives need to be considered in technical deliberations. The membership of governance committees involved in health system performance information and reporting should consist of both policy and technical experts to ensure the focus and skillsets of these committees are balanced.


Recommendation 9
Roles and responsibilities for key national bodies and the jurisdictions should be reviewed to ensure they are aligned to the key functions required under the combined framework.

Rationale for Recommendation 9

A number of organisations are involved in Australia’s health system performance information and reporting system. This includes the AIHW, Australian Bureau of Statistics, Australian Commission of Safety and Quality in Health Care (ACSQHC), Independent Hospital Pricing Authority, State and Territory Governments and the Productivity Commission. Further work is required to determine the roles and responsibilities of these organisations in implementing a new health system performance information and reporting framework, including the required additional roles.


Recommendation 10
Legislation (the National Health Reform Act 2011) and Agreements (the National Healthcare Agreement 2012, the National Health Reform Agreement 2011, and the National Health Information Agreement 2012) should be amended to enact recommendations from this review.

Rationale for Recommendation 10

Relevant legislation and Agreements will need to be updated to enact recommendations made in this review. Consideration should be given to incorporating elements of the COAG-agreed PAF document into existing agreements or legislation. Any new agreements should learn from and build on the principles outlined in the more recent agreements. Further work is required to create an exhaustive list of the amendments required to action the recommendations in this review and create a new health system performance information and reporting framework.


Recommendation 11
Principles for indicator management and review should be agreed by the Australian Health Ministers’ Advisory Council (AHMAC) through the National Health Information Standards and Statistics Committee (NHISSC) and the National Health Information and Performance Principal Committee (NHIPPC), which AIHW should then use to biennially review the indicators in consultation with relevant organisations.

Rationale for Recommendation 11

Once the future health system performance information and reporting framework is agreed, it will be necessary to review the indicators underpinning the framework. This process should firstly assess the common NHPF and PAF indicators to ensure their relevance to the combined framework. NHPA’s review of the PAF indicators consolidates the views of the sector on performance indicators and the recommendations should be considered in the combined framework’s indicator selection and review.

The review and selection of indicators should be based on a set of agreed principles. Further work is required to establish these principles. The figure below outlines some principles identified in the review. This includes indicator selection principles from the PAF and additional suggested principles from the AIHW review of NHPA and PAF Indicators. Principles for indicator management and review should be agreed by AHMAC through NHISSC and NHIPPC, which AIHW should then use to biennially review the indicators in consultation with relevant organisations. Indicators may also need to be reviewed at other times when, for example, relevant changes to intergovernmental agreements are made.

Suggested principles for the selection of indicators

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Recommendation 12
Infrastructure and digital systems, including METeOR and relevant data collection systems, should be upgraded to support the health system’s increased capabilities in performance information and reporting.

Rationale for Recommendation 12

The review has identified effective infrastructure and digital technologies as a critical enabler of the single provision multiple use model for data collection, supply and use. Specifically:

  • Data collection systems need to reduce barriers at the point of data collection so that data can be effectively stored, linked, analysed and reported on.
  • Data linkage and analysis should ideally rely on a central system that can accept data from a number of data sources across Australia. Data systems, such as the AIHW’s METeOR,need to be upgraded to support the health system’s increased capability in data linkage and longitudinal analysis.
  • Digital reporting through apps and other online platforms should be expanded. Good progress is already being made through websites such as MyHospitals, MyHealthyCommunities and My Health Record.

Recommendation 13
Key stakeholders (consumers, providers, jurisdictions and other bodies) should be engaged to refine implementation and obtain the support and cooperation of stakeholders across the system.

Rationale for Recommendation 13

Stakeholder engagement will play a crucial role in refining and enabling implementation of a new framework, a new data model, and all supporting recommendations. A number of stakeholders should be engaged as part of the implementation process, including those outlined in the figure below.

Key stakeholders to engage as part of the implementation process

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Recommendation 14
Regular monitoring of the framework’s performance and periodic evaluation of the framework’s achievements of its purpose, along with implementation recommendations, should be conducted.

Rationale for Recommendation 14

The proposed framework for health system performance information and reporting will need to be regularly monitored and periodically evaluated to ensure it remains relevant and effective. Specifically:

  • Regular monitoring should assess the framework against the agreed principles which the framework is intending to achieve.
  • Periodic evaluation should commence with a formal evaluation after no more than four years, or if regular monitoring identifies issues which require larger scale evaluation sooner.

* The public consultation for the review of Australia’s health system performance information and reporting frameworks closed on 17 February 2017.

Have your say

To have your say on this section of the review, please click here to answer the following questions:

  1. What are your views on the recommendations for implementation? Is there anything else that should be considered? (Please limit response to 400 words or less)