​​​​​​​​​​At the Local Health District/Specialty Health Network level of decision making and governance, decisions impact how organisations are managed.

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

    • LHD/SHNs have commissioning processes in place that include Aboriginal people, including Community members, ACCOs and Aboriginal NSW Health staff, for funding programs that have a significant impact on Aboriginal health. This includes reviewing whether programs are being delivered by the most culturally appropriate and skilled service.
    • There is a minimum of two Aboriginal people on each LHD/SHN board to ensure cultural safety and representation from across Aboriginal Communities.
    • Each LHD/SHN has an Aboriginal Health board sub-committee, or an Aboriginal Health Advisory Committee that includes Aboriginal Community members and representatives from local Aboriginal organisations. The Committee has clear lines of accountability for clinical and other health services delivered to Aboriginal people in each LHD/SHN. The Committee has clear lines of reporting to the board and LHD/SHN Chief Executive to hold the LHD/SHN to account for Aboriginal health outcomes.
    • LHD/SHN stakeholder and community engagement and governance strategies, policies and committees have representation and active participation from ACCHOs, LDM Accords and other key Aboriginal stakeholders.
    • Aboriginal people are included in health advisory committees, including community and consumer committees. Multiple Aboriginal people are included on these committees to ensure multiple Aboriginal voices are heard and there is increased cultural safety. Aboriginal people are selected through an expression of interest process and are compensated for their time and expertise, as per the NSW Health consumer, carer and community member renumeration policy.

  • 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

    • Each LHD/SHN has an:
      • Executive Director or Director of Aboriginal Health that reports to the Chief Executive, participates in Executive Leadership Committees and is graded at an executive level.
      • Aboriginal Health Directorates, Services or Units that is appropriately resourced to provide strategic advice, accountability and cultural governance for Aboriginal health in their LHD/SHN.
    • The governance role of Aboriginal NSW Health staff in Clinical Governance Units and Committees is embedded into each health service, to ensure health services are culturally safe for Aboriginal patients.

  • 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

    • ACCO representatives, including ACCHOs, are included in the LHD/SHN Board Sub-committees for Aboriginal health. This enables shared decision making, partnerships and governance for Aboriginal health across the LHD/SHN management.
    • Each LHD/SHN has a formal partnership agreement in place with their local ACCHO that embeds strong partnership mechanisms to provide integrated and coordinated care. 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.
    • ACCHO CEOs and LHD Chief Executives have communication pathways to facilitate collaboration and problem solving that are based on respect and facilitate truth-telling.
    • NSW Health LHD Executives, on behalf of the NSW Government and in partnership with AANSW, work with their LDM Assemblies to negotiate and enter into Accords, and to progress and deliver on agreed actions and investment.

  • The NSW Health system is held accountable for improving outcomes for Aboriginal people at each level of decision making and governance

    • Each LHD/SHN is held accountable for Aboriginal health through the NSW Health Performance Framework. The Performance Framework sets out clear expectations and accountability mechanisms for Aboriginal health, including KPIs that are for Aboriginal people, guidelines for how LHDs/SHNs should provide culturally safe and holistic care for Aboriginal people and escalation processes for when LHD/SHNs aren’t meeting the healthcare needs of Aboriginal people.
    • Each LHD/SHN outlines in their annual Safety and Quality Account what improvements have been made to their services to improve the health outcomes of Aboriginal people.
    • Chief Executives of LHDs/SHNs have a formal responsibility for Aboriginal health included in their role descriptions and performance assessments, and are held accountable by the NSW Health Secretary, NSW Health Ministers and their Board for their District’s Aboriginal health processes and performance.
    • The NSW Health Corporate Governance and Accountability Compendium outlines the governance requirements for LHDs/SHNs for Aboriginal health. This includes the roles and responsibilities of LHDs/SHNS for Aboriginal health, and how LHDs/ SHNs can demonstrate their accountability for the principles of the framework in their organisations.
    • Each LHD/SHN has a Senior Executive Committee for Aboriginal health, that is co-chaired by the Chief Executive and Executive Director of Aboriginal Health and has equal representation of senior Aboriginal and non-Aboriginal staff, to drive change and hold accountability for Aboriginal health within their LHD/SHN.

Examples of how the framework principles look in practice

For examples of how the framework principles look in practice at this level, visit:

View all case studies

 

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Current as at: Friday 27 September 2024
Contact page owner: Centre for Aboriginal Health