​​​​​​​​​At the hospital and health facility level of decision making and governance, decisions impact how facilities 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​​​​

    • Aboriginal Community members are embedded in NSW Health service and program governance structures, for example identified Aboriginal positions in hospital working parties and on hospital Boards.
    • Governance structures have processes and procedures in place to ensure Aboriginal Community members are empowered to participate in shared decision making and have a clear role and responsibility. This includes implementing a standardised section in the terms of reference for committees and working groups about the role and scope of Aboriginal identified roles to ensure they are culturally safe and facilitate shared decision making.

  • 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

    • Aboriginal Community members are embedded in NSW Health services and programs.
    • NSW Health facilities and hospitals have governance structures to embed the voices of Aboriginal staff within each facility to advise hospital management. This can include:
      • Aboriginal Hospital Staff Advisory Committees, for all Aboriginal staff within a hospital to meet and provide advice to the Hospital or Health Facility General Manager.
      • Identified roles within hospital management and governance structures for Aboriginal staff, including embedding identified roles in middle and upper management structures, that are appropriately supported and recognised for their capability.

  • 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​

    • ACCHOs and hospitals have mechanisms in place to facilitate coordinated health care, which is embedded into ACCHO and LHD/SHN Partnership Agreements. NSW Health hospital staff are aware of and implement these partnership mechanisms.
    • ACCHOs and hospital executive teams have communication pathways in place to escalate urgent health care needs or address challenges when they arise. These communication pathways are based on respect and facilitate truth-telling at a local level.

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

    • NSW Health facilities and hospitals are held accountable through performance mechanisms for Aboriginal health. This includes specific KPIs for Aboriginal health which are co-created with Aboriginal people and the disaggregation of data for Aboriginal people, to ensure that NSW Health services are culturally safe and improve health outcomes for Aboriginal people.
    • Accountability mechanisms for NSW Health facilities and hospitals for Aboriginal health are transparent so stakeholders are aware what these facilities are being asked to do.
    • Aboriginal NSW Health staff and Aboriginal Community Members are embedded into hospital and health service governance committees to hold services to account for Aboriginal health.
    • NSW Health facilities and hospitals are audited for cultural safety and to identify institutional and systemic racism. These audits are conducted by or in partnership with Aboriginal people. For example, Directors of Clinical Governance in partnership with local Aboriginal stakeholders use the Aboriginal Cultural Engagement Self-Assessment Audit Tool as a part of the routine Quality Audit Reporting System to monitor and strengthen the cultural safety for NSW Health services.’

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