NSW Health system management

At the NSW Health system management level of decision making and governance, decisions impact how the NSW Health system is managed, including Ministry of Health, pillar organisations, shared and statewide services.

What does success look like at this level?

Aboriginal people are embedded into decision-making processes and governance structures that impact Aboriginal people in NSW Health
- The NSW Health system has flexible and agile processes in place to work with Aboriginal people to respond to emerging needs and challenges.
- The Ministry of Health has several NSW Aboriginal health community councils to ensure that Aboriginal Community voices are embedded into statewide policy and program governance.
- For example, a NSW Aboriginal Women’s Health Council to provide governance over NSW Health programs and policies for women’s health from an Aboriginal Community perspective and advise the MoH on where gaps exists across the state for Aboriginal Women’s health.
- These members include Aboriginal people who are members on local hospital and LHD/SHN advisory and community councils.
- Council members are compensated for their time and expertise, as per the NSW Health consumer, carer and community member renumeration policy.
- All NSW Health Pillars, Statewide Services and Shared Health Services have an Aboriginal Community member on their governance board.
- NSW Health has a Cultural Governance Council to provide governance to NSW Health Patient Safety and Clinical Quality processes for Aboriginal people and embed multiple Aboriginal voices including Community voices, Aboriginal NSW Health staff, and ACCHSs.
Aboriginal NSW Health staff are recognised in the NSW Health system and are supported and empowered to participate in shared decision making, governance and accountability structures
- NSW Health has an NSW Aboriginal Health System Committee and Management Framework that outlines where senior and executive Aboriginal NSW Health staff are embedded into governance structures, for both Aboriginal health and population wide programs.
  - The framework ensures that Aboriginal voices are included in all decisions and governance structures that impact Aboriginal people.
  - The framework ensures that Committees with a specific focus on Aboriginal health should have at least 50% Aboriginal membership, and Committees with a significant impact on Aboriginal health have at least 2 Aboriginal members.
- NSW Health has a Chief Aboriginal Health Officer role that embeds a senior Aboriginal health clinical voice into clinical and policy governance structures. This role has a focus on advocating, supporting and elevating the roles of AHPs and AHWs in NSW Health.
- The MoH has an:
- NSW Health Pillars, Shared Services and Statewide Services have:
  - an identified Senior Executive role for Aboriginal health in their organisation in Executive Leadership Committees and is graded at an executive level
  - Aboriginal Health Directorates, Services or Units that are appropriately resourced to provide strategic advice, accountability and cultural governance for the organisation’s services, policies, and programs that impact Aboriginal people.
NSW Health and the Aboriginal Community Controlled Sector have strong partnership mechanisms to provide integrated and coordinated care and services to Aboriginal people in NSW
- The MoH and the AH&MRC have a formal Partnership Agreement that embeds the principles of shared decision making, co-creation and strong partnership mechanisms. The roles of each partner are defined and agreed on in the Partnership Agreement to ensure clarity about responsibilities, functions, deliverables and opportunities for collaboration in the agreement.
- The MoH and the NSW Council of Aboriginal Peak Organisations (CAPO) have a formal partnership and governance committee in place that embeds collaborative mechanisms and shared decision making for state wide policies, strategies and reforms for Aboriginal health, including the implementation of CTG.
- NSW Health Statewide Services have formal partnership mechanisms in place with ACCOs where applicable to identify and enable opportunities for integrated and coordinated care across their services, and to provide input on policies, programs and policies that will affect their patients and staff.
- The MoH has a formal mechanism to monitor LHD/SHN relationships with ACCHOs and hold partners to account on their partnership agreements.
The NSW Health system is held accountable for improving outcomes for Aboriginal people at each level of decision making and governance
- The MoH has processes to co-create KPIs for Aboriginal health for NSW Health in place-based and local approach. This includes partnering with local Aboriginal people to develop KPIs for NSW Health that are critical for Aboriginal health in their area.
- The MoH has KPIs for the NSW Health system for ongoing and on-country culturally safety, decolonising and anti-racism training.
- The NSW Health system has a senior executive committee for Aboriginal health, that is co-chaired by the NSW Health Secretary and Executive Director of the CAH and has equal representation of senior Aboriginal and non-Aboriginal staff across the NSW Health system to drive change and hold accountability for Aboriginal health.
- The MoH shares KPI data that monitors performance in NSW Health and is disaggregated for Aboriginal people across the health system and with the public to ensure transparency of information and drive continuous service improvements
- NSW Health patient and consumer data is disaggregated for Aboriginal people to understand the patient experience of Aboriginal people in NSW Health facilities, hold the system accountable for Aboriginal patients and consumers’ experience, and drive continuous service improvements. For example, Mental Health consumer experience measures, including the Your Experience of Service and the Carer Experience Survey are disaggregated for Aboriginal people, the data is analysed from an Aboriginal perspective with cultural governance procedures in place and holds all NSW public mental health services in inpatient and community services to account for providing culturally responsive and safe care for Aboriginal people.
- Responsibility for Aboriginal health is embedded in role descriptions and performance assessments for NSW Health Senior Executives
- NSW Health is held accountable to an independent statewide Aboriginal Accountability Mechanism for the implementation of CTG and for achieving Aboriginal health outcomes.
- The MoH, Pillars and Statewide Services ensure Aboriginal people are included from the commencement of program and service design, to ensure that Aboriginal Community voices are considered throughout program development, implementation and evaluation.
- All NSW Health business plans that impact Aboriginal people include action items that define the specific goals to be achieved in relation to healthcare for Aboriginal people and are held accountable for realising these deliverables.