Likewise, the Commission has built on its previous work in supporting healthcare professionals, and also consumers, with a range of new products, documents and other resources. These include a suite of documents designed to help clinicians identify and prevent hospital-acquired complications, as well as many other valuable tools in the areas of antimicrobial resistance, medication safety and e-health, cognitive impairment and mental health care. The Commission is also seeking to engage consumers more than ever before: this year the Commission has released decision-support aids for consumers, a revised list of healthcare ‘top tips’, and an innovative online ‘question builder’ designed to help members of the public navigate their healthcare journey more confidently. Each of these examples shows the Commission becoming more sophisticated in delivering on its mission to lead national improvements in the safety and quality of health care. The huge improvements already seen in health care mean that the nature of the improvement challenge is changing: new and more complex approaches must be developed to ensure further improvements can be made. The Commission is ready for this challenge, and I look forward to its progress and its success in the coming year. My thanks go to the members of the Commission’s Board for their advice throughout 2016–17. On behalf of Board members, I would also like to thank Minister Hunt, the Commission’s executive team and employees for their continued commitment to delivering our work priorities. Their significant achievements are described in detail throughout this report.
Under the Heads of Agreement, states, territories and the Australian Government Department of Health agreed to work with the Independent Hospital Pricing Authority (IHPA) and the Commission to develop a comprehensive, risk-adjusted model that integrates quality and safety into hospital pricing and funding, and reduces avoidable hospital readmissions. This work has focused on pricing and funding for sentinel events, hospital-acquired complications and avoidable hospital readmissions. The Commission’s involvement in this work has included: Reviewing the sentinel events list Curating the hospital-acquired complications list Providing clinical advice on risk adjustment for the hospital-acquired complications list Developing advice, in consultation with the states and territories, on a list of clinical conditions that can be considered avoidable hospital readmissions Continuing to collaborate with IHPA. For details on the Commission’s review of the sentinel events list and curation of the hospitalacquired complications list, see ‘Minimising healthcare-related harm’ on page 45. Highlights Provided advice to the Australian Health Ministers’ Advisory Council on a list of clinical conditions that can be considered avoidable hospital readmissions Provided clinical advice on risk adjustment for the hospital-acquired complications list.
Commission The Commission’s Board governs the organisation and is responsible for the proper and efficient performance of its functions. The Board establishes the Commission’s strategic direction, including directing and approving its strategic plan and monitoring management’s implementation of the plan. It also oversees the Commission’s operations and ensures that appropriate systems and processes are in place so that the Commission operates in a safe, responsible and ethical manner, consistent with its regulatory obligations. The Board is established and governed by the National Health Reform Act and the Public Governance, Performance and Accountability Act. Board membership 2016–17 The Minister for Health appoints the Commission’s in consultation with all state and territory health ministers. The Board includes members who have extensive knowledge and experience in healthcare administration, the provision of health services, law, management, primary health care, corporate governance, and improving safety and quality. Professor Villis Marshall AC (Chair) Professor Villis Marshall brings to the Board experience in providing healthcare services, managing public hospitals, and improving safety and quality. Professor Marshall has had significant clinical experience as a urologist, as Clinical Director (Surgical Specialties Service) for the Royal Adelaide Hospital and as Clinical Professor of Surgery at the University of Adelaide. Professor Marshall was awarded a Companion of the Order of Australia (AC) in 2006 for services to medicine, particularly urology and research into kidney disease; to the development of improved healthcare services in the Defence forces; and to the community through distinguished contributions to the development of pre-hospital first aid care provided by St John Ambulance Australia. His previous appointments include General Manager at Royal Adelaide Hospital, Senior Specialist in Urology and Director of Surgery at Repatriation General Hospital, and Professor and Chair of Surgical and Specialty Services at Flinders Medical Centre. Qualifications: MD, MBBS, FRACS Board membership: First appointed on 1 April 2012; appointed as Chair on 1 April 2013 Mr Martin Bowles psm Mr Martin Bowles was appointed Secretary of the Australian Government Department of Health on 13 October 2014. Mr Bowles was previously the Secretary of the Department of Immigration and Border Protection. He has also been Deputy Secretary of the Department of Climate Change and Energy Efficiency, and Deputy Secretary of the Department of Defence. In 2012, Mr Bowles was awarded a Public Service Medal (PSM) for delivering highly successful energy efficiency policies and remediation programs for the Home Insulation and Green Loans programs. Before joining the Australian Government, Mr Bowles held senior executive positions in the education and health portfolios in the Queensland
Dr Williams’s previous directorships include Cancer Council SA, Noarlunga Health Services, the South Australian Divisions of General Practice, the Australian General Practice Network and the Southern Adelaide Health Service. Qualifications: MBBS, FRACGP Board membership: First appointed as a Commission member in April 2008; appointed to the Board, as established under the National Health Reform Act, on 1 July 2011 meetings and attendance Table 3: Board meetings and attendance Name Board meeting 28 July 2016 14 September 2016 27 October 2016 24 February 2017 27 2017 Professor Villis Marshall ac (Chair)1 Mr Martin Bowles psm Adjunct Professor John am2 Dr David Filby psm Professor Phillip Della3 Ms Christine Gee2 Ms Wendy Harris qc4 Dr Shaun Larkin2 Mrs Cheryle Royle2 Dr Helena Williams2
Board development and review New Board members undertake a formal induction to their role, including a meeting with the Chair and CEO. They receive an induction manual that includes the Board Operating Guidelines, which inform the conduct of Board members and describe their responsibilities and duties under legislation. members are briefed on relevant topics at meetings as appropriate, and are required to undertake ongoing professional development relevant to, and in line with, the Commission’s needs. The Commission supports Board members to pursue these activities. Ethical standards The Commission’s Board Operating Guidelines provide a Board Charter that outlines the function, duties and responsibilities of the Board, and a code of conduct that defines the standard of conduct required of Board members and the ethics and values they are bound to uphold. The Duty to Disclose Interests Policy for Board Members requires Board members to recognise, declare and take reasonable steps to avoid or appropriately manage any conflict of interest. This includes the duty to disclose material personal interests, as required under section 29 of the Public Governance, Performance and Accountability Act. Related-entity transactions In accordance with the requirements prescribed by section 17BE of the Public Governance, Performance and Accountability Rule and the Department of Finance’s Resource Management Guide No. 136 – Annual reports for corporate Commonwealth entities, relatedentity transactions during 2016–17 are disclosed in Appendix C. Indemnity and insurance The Commission holds directors’ and officers’ liability insurance cover through Comcover, the Australian Government’s self-managed fund. As part of its annual insurance renewal process, the Commission reviewed its insurance coverage in 2016–17 to ensure the coverage was still appropriate for its operations. During the year, no indemnity-related claims were made, and the Commission knows of no circumstances likely to lead to such claims being made. Many liability limits under the Commission’s Schedule of Cover are standard Australian Government limits, such as $100 million in cover for general liability and professional indemnity, as well as directors’ and officers’ liability. The Commission’s business interruption indemnity cover is for a period of up to 24 months. Motor vehicle, third-party property damage and expatriate cover have not been taken out, as they don’t apply to the Commission.
Inter-Jurisdictional Committee The Inter-Jurisdictional Committee is made up of senior safety and quality managers from the Australian Government and state and territory governments. It is responsible for advising the Commission on policy development and facilitating jurisdictional engagement. The role of committee members is to: Advise the Commission on the adequacy of the policy development process, particularly policy implementation Ensure health departments and ministries are aware of new policy directions and able to review local systems accordingly Monitor national actions to improve patient safety, as approved by health ministers Help collect national data on safety and quality effective mechanisms within jurisdictions to enable national public reporting. The committee met five times during the 2016–17 financial year. committees and consultations The Board has established two sub-committees that provide specific advice and support across all relevant areas of its work. These are the: Private Hospital Sector Committee Primary Care Committee. The Private Hospital Sector Committee is chaired by Ms Christine Gee and the Primary Care Committee is chaired by Dr Helena Williams. The Commission also works closely with a number of time-limited expert committees, working parties and reference groups to inform and support its work. These groups allow the Commission to draw on expert knowledge, consult with relevant key stakeholders and develop appropriate implementation strategies. The Commission consults widely with subject-matter experts, peak bodies, states and territories, consumers and other relevant individuals and organisations. This includes ongoing discussions with key national and other organisations, and with an extensive network of formal reference and advisory groups. These networks provide links with healthcare providers, consumers, subject-matter experts and state and territory representatives. The Commission also undertakes formal consultation on specific issues.
Statement of Financial Position as at 30 June 2017 2017 2016 Original Budget 2017 Notes $’000 $’000 $’000 ASSETS Financial Assets Cash and cash equivalents 6,333 10,851 9,089 A, B Trade and other receivables 1,858 2,182 2,838 A Total financial assets 8,191 13,033 11,927 Non-Financial Assets Property, and equipment 138 398 44 Other non-financial assets 2.2B 530 391 207 A Total non-financial assets 668 789 251 assets 8,859 13,822 12,178 LIABILITIES Payables Suppliers 1,796 3,031 738 A Other payables 2.3B 1,773 5,827 7,565 A, B Total payables 3,569 8,858 8,303 Provisions Employee provisions 3.1 2,576 2,538 1,731 A Other provisions - - 250 Total provisions 2,576 2,538 1,981 liabilities 6,145 11,396 10,284 Net assets 2,714 2,426 1,894 EQUITY Contributed equity 1,836 1,836 1,836 Reserves 5 5 5 Retained surplus 873 585 53 C Total equity 2,714 2,426 1,894 The statement should be read in conjunction with the accompanying notes. Original Budget Compared to 2017 Actual Variance Commentary Statement of Financial Position A The budget reflects projects contracted at the time of preparing the PBS. The variance is due to the increase in actual activity compared to when the PBS was prepared. B The variance arises due to the completion in 2016-17 of project work for which funding was received in advance. The completion of projects in 2016-17 has reduced the balance of cash and unearned income. C The 2016-17 budget was derived on a break even assumption and an estimated carried forward surplus at the time of budget preparation.
Assessment of the impact of the performance of each of the Commission’s functions National Health Reform Act, subsection 53(a) 16–57 Assessment of the quality of healthcare services provided National Health Reform Act, paragraph 53(b)(ii) 47 Board committees Public Governance, Performance and Accountability Amendment (Corporate Commonwealth Entity Annual Reporting) Rule, subsection 17BE(j) 67–68 Ecologically sustainable development and environmental performance Environmental Protection and Biodiversity Conservation Act 1999, section 516A 71 Enabling legislation, functions and objectives Public Governance, Performance and Accountability Amendment (Corporate Commonwealth Entity Annual Reporting) Rule, subsection 17BE(a) 6, 60 Financial statements Public Governance, Performance and Accountability Act, subsection 43(4) 81–105 Financial statements certification: Auditor-General’s Report Public Governance, Performance and Accountability Act, subsection 43(4) 82–83 Financial statements certification: a statement signed by the accountable authority Public Governance, Performance and Accountability Act, subsection 43(4) 84 Government policy orders Public Governance, Performance and Accountability Amendment (Corporate Commonwealth Entity Annual Reporting) Rule, subsection 17BE(e) 71 Indemnities and insurance premiums for officers Public Governance, Performance and Accountability Amendment (Corporate Commonwealth Entity Annual Reporting) Rule, subsection 17BE(t) 65 Judicial decisions and decisions by administrative tribunals Public Governance, Performance and Accountability Amendment (Corporate Commonwealth Entity Annual Reporting) Rule, subsection 17BE(q) 70 Key activities and changes that have affected the Commission Public Governance, Performance and Accountability Amendment (Corporate Commonwealth Entity Annual Reporting) Rule, subsection 17BE(p) 70