Tasmanian Health Service Performance Framework

Contents

Contents2

Executive Summary3

1Overview4

1.1 Context4

1.2 Purpose of the Performance Framework5

2Performance Requirements under the Act7

2.1 Performance Requirements7

2.2 Unsatisfactory Performance7

3Performance Monitoring Mechanisms9

3.1 Service Agreement9

3.2 Corporate Plan10

3.3 THS Governing Council/THS Functions and Powers10

4Performance Interventions under the Act13

4.1 Under Review13

4.2 Level 1 - Performance Improvement Plan (PIP)13

4.3 Level 2 - Appointment of a Ministerial Representative or a PIT15

4.4 Level 3 - Dissolve the Governing Council, Appoint an Administrator and/or Appoint a New Governing Council17

5Performance Interventions Process for Implementation20

Appendix24

Executive Summary

Under the Tasmanian Health Organisations Act 2011 (the Act) the Tasmanian Health Service (THS) Governing Council is accountable to the Minister for Health and the Treasurer for the performance of its powers and functions. This includes ensuring that the THS performs its functions and exercises its powers in a satisfactory manner and also includes the monitoring of the THS performance against performance measures set out in the THS service agreement.

The Department of Health and Human Services is responsible to the Minister in relation to the Acts administration, and the Minister has delegated a number of performance related functions and powers to the Secretary, Department of Health and Human Services (DHHS) in this context.

This is consistent with the National Health Reform Agreement which recognises the states and territories as system managers of the public hospital system, which includes system-wide public hospital performance. The relationship between the Minister for Health, the Secretary (as the Ministers delegate), the Department, and the THS Governing Council is articulated in the DHHS as System Manager,[footnoteRef:1]document. [1: http://www.dhhs.tas.gov.au/intranet/system/quality/The_DHHS_as_System_Manager_final_endorsed.pdf (only accessible to DHHS/THS staff)]

This Performance Framework (the Framework) provides a single, overarching administrative process through which the THS performance may be monitored. It should be noted that, whilst applying more broadly than section 45 of the Act, this Framework has been developed to meet the requirements of s45 (1)(e). The aim of the Framework is to describe the relevant provisions of the Act as well as outlining how they will be practically implemented. As such, in addition to referencing the relevant provisions and accountabilities of the Act, the Framework details administrative processes that serve to operationalise them. This is particularly the case where the relationship between the Department and the THS CEO, in discussion and review of performance issues and performance interventions, is articulated.

For example, a new under review phase of the performance escalation process is included in the Framework. Once a performance issue has been identified, officers of the Department will commence discussions with the THS to confirm the issue and may require the THS to provide formal advice on the reasons leading to the issue and the actions to be put in place by the THS to remediate it. During this phase, if the view is formed that the THS is unable to remediate the issue, a performance escalation may be recommended.

Whilst its primary focus is on the early identification and remediation of performance issues, equally, strong performance will be highlighted and acknowledged. The Minister and the Secretary are committed to working with the THS Governing Council and the THS to drive high levels of performance whilst at the same time ensuring that performance issues are identified and acted upon in a timely manner.

The Framework expands on the previous 2015-16 Service Agreement Performance Framework. In addition to performance against the requirements of the service agreement, the Frameworks scope now includes:

Performance against the corporate plan (to ensure the requirements of the corporate plan are being met), and

Performance by the Governing Council of its functions to ensure that it performs its functions and exercises its powers in a satisfactory manner.

In addition to the under review phase, three levels of performance escalation are described and high level guidance on the implementation of the performance interventions applicable at each level of escalation, and the requirements for de-escalation, are also provided.

Appendix

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1Overview

The THS Governing Council is accountable to the Minister for Health and the Treasurer for ensuring that the THS provides effective and safe health care and performs its functions, and exercises its powers, in a satisfactory manner.

The Department assists the Governing Council in its obligations to the Minister by providing strategic leadership and direction and through the establishment of a governance framework of processes, procedures and controls. This is consistent with the Departments role as system manager.

In order for the Department to meet its obligations as system manager and Ministerial delegate, it is crucial that performance issues are identified and that the Department can take appropriate action and provide direction to ensure that the THS Governing Council can meet its performance obligations.

1.1 Context

The object of the Act is to assist in the establishment of a public sector health system that delivers safe, high quality health services and health support services so as to improve, promote, protect and maintain the health of Tasmanians (s 3(1)).

This object is achieved through the establishment of Tasmanian Health Organisations for the provision and coordination of health services and health support services (s 3(2)(a)).

In Tasmania there is one Tasmanian Health Organisation the Tasmanian Health Service (THS). As such, for the purposes of this document where the Act is referenced, THS will be used rather than THO.

The THS primary purpose is to promote and maintain the health of Tasmanians and to provide care and treatment to, and ease the suffering of, people with health problems (s 10).

The THSs functions include:

To improve, promote, protect and maintain the health of Tasmanians

To provide effective and safe care

To conduct and manage public hospitals, health institutions, health services, and health support services that are under the THS control

To provide training and education and to undertake research and development that is relevant to the provision of health services and health support services

To manage the organisations budget and its other funds to ensure the efficient and economic operation of public hospitals, health institutions, health services and health support services, and delivery of health services, and health support services that are under the THS control, and the efficient and economic use of its resources (s 11).

The Act provides that the Governing Council of the THS is responsible to the Minister for Health and the Treasurer for the performance of functions and the exercise of powers under the Act (s 14).

The Governing Councils functions include:

To ensure that the THS:

Delivers the services that it has agreed, under the THS service agreement, to provide, and

Delivers those services in accordance with the performance standards set out in the service agreement,

Delivers those services in accordance with the budget set out in the THS annual business plan, and

Delivers those services in accordance with the THS corporate plan, and

To monitor the THS performance against the performance measures set out in the service agreement, and

To ensure that the objectives specified in the THS ministerial charter and corporate plan are achieved (s 22).

The THS must act in accordance with its corporate plan (s 48) and business plan (s 51); and the THS may be considered to be performing unsatisfactorily if the Minister is of the opinion that the THS has failed to meet the requirements of its service agreement or corporate plan, or if the organisation, or the Governing Council of the organisation, has not been performing its functions, or exercising its powers, in a satisfactory manner (s 59).

The Minister, or the Secretary as delegate, may authorise a person or persons to conduct a review or audit of any aspect of the THS operations or performance (s 58) and may require a governing council to produce a performance improvement plan and appoint a performance improvement team if the THS is performing unsatisfactorily (ss 60 and 67 respectively).

1.2 Purpose of the Performance Framework

The Act establishes the accountability relationship between the responsible Ministers and the THS Governing Council. It also outlines the performance requirements of the Governing Council and identifies the interventions available to the Minister for Health and delegate when a performance issue is identified.

The Framework provides a single, overarching administrative process through which the legislative framework established by the Act is translated into a consistent and transparent approach for the identification, monitoring and management of the THS performance. It provides the THS with certainty regarding responses to identified performance issues, establishes a structure around the legislative performance interventions available and describes processes through which the escalation and de-esc