Reports

 

How South Australian health system performance compares nationally

Every year the Productivity Commission releases its Report on Government Services (RoGS), providing information on the equity, effectiveness and efficiency of government services in Australia. RoGS includes a Health volume that covers primary and community health, ambulance, public hospitals and mental health.

Our annual short summary reports highlights a selection of indicators across health-related topics reported in the RoGS report, comparing South Australia’s performance with the other states and territories and previous reporting periods:

 

Monitoring access and outcomes in mental health

Mental health in South Australia, monitoring access and outcomes, July 2020 (PDF, 734KB) summarises indicators from the mental health management data tables of the Report on Government Services 2020—supplemented with data from other sources—and compares South Australia to the other states and territories and national averages across the domains of: risk and resilience factors; services activity; patient outcomes; workforce and carers; capacity and utilisation; safety, quality and consumer experience; and costs.

We find that monitoring and reporting of mental health access and outcomes in South Australia could be improved, with priority attention required in three important areas:

  1. There is an inability to report multilayered, timely data for: (i) high-needs geographic areas; (ii) specific and vulnerable population groups; and (iii) distribution of workforce in a cohesive way. Data gaps in these areas need urgent attention before monitoring and reporting can claim to be representative of the population.
  2. Consumer experience of mental health treatment and rehabilitation services is a critical gap in the state’s monitoring and reporting of mental health outcomes. The Council could make no assessment of South Australia’s performance in relation to consumer experience of mental health care in this state due to no data made available by the public health system.
  3. Mental health outcomes would be improved with better collaboration and data sharing between government agencies and departments, the private sector and non-government organisations. This is hampered, in part, by data systems that are outdated and not compatible with other technological infrastructure.

 

Monitoring the effects of implementing the South Australian Health and Wellbeing Strategy

We produced this indicator report to monitor implementation of the South Australian Health and Wellbeing Strategy 2020–2025. More broadly, this indicator report presents baseline indicators for SA Health to consider in its own regular and publicly available performance monitoring. 

Indicators in this report are presented over time, by local health network, and specific population group for monitoring implementation of the strategy's four goals of: Trusted, Targeted, Tailored, and Timely.

 

Post-implementation review of Country Health SA’s Aboriginal Community & Consumer Engagement Strategy

We have published our final report from our post-implementation review of Country Health SA’s Aboriginal Community & Consumer Engagement Strategy. Download the report or find out more.

 

Improving end-of-life care for South Australians

Quality end-of-life care is an important measure of a humane society and an essential element of heath care systems. South Australia faces growing demand for end-of-life services arising from an ageing population and a growth in chronic and life-limiting diseases. Consumers expect that the care provided to them will not add to their confusion and stress, or that of their families and carers. They seek care that will be seamless, coordinated, available when they need it and where they want it, and will support their physical, psychosocial and spiritual needs.

2019 statistical addendum

This report forms a statistical addendum to complement the 2018 revisit review (see below). The primary purpose of this 2019 update is to look at long-term trends and outcomes in public hospital utilisation in the months before a person's death in South Australia. It supplements and expands on the quantitative analysis in the 2018 report, with attention to additional detail by geographies and by specific and vulnerable population groups. It is intended as a short ‘bite-sized’ statistical report, presenting a range of summary measures in relation to end-of-life care in South Australia, across the following seven themes:

  1. Demographics of an ageing population
  2. A profile of death—causes, geography and place
  3. Palliative care access and equity
  4. Palliative care outcomes
  5. Growth in hospital-based palliative care
  6. Estimates of unmet need for palliative care
  7. Quality of palliative care.

2018 revisit review

We reviewed SA Health's Palliative Care Services Plan 2009-2016 and found that achievement of its aim to expand and reshape end‐of‐life care services in South Australia has been uneven. Despite the early impetus to establish a sustainable, consumer-centred and centrally coordinated model of end-of-life care, progress in achieving its goals has stalled. Four objectives identified in the plan—improved health and wellbeing outcomes, person-centred care, more care in the community, and consistent service delivery—have been achieved only in part.

Our 2018 review offers evidence and analysis that ensures that new end-of-life care strategies lead to initiatives with measurable, evidence-based health and wellbeing outcomes. We make ten key recommendations to the Minister for Health and Wellbeing to improve end-of-life care more generally across South Australia.

2013 review

Our 2018 review is a five‐year revisit and update of our 2013 midpoint examination, Improving End of Life Care for South Australians (PDF, 1.0MB).

 

Our response to the SA Health Equity and Access in Health Care Policy Directive

The Health Performance Council was asked to comment on SA Health's Equity and Access in Health Care Policy Directive Version No. 1. We agree there is a good set of evidence of what works to improve equity and access in the health system and commend SA Health on acknowledging the challenges by preparing this draft policy. We encourage SA Health to produce the definitive policy directive on equity of access to public health services. We also encourage SA Health to continue to work with government and stakeholders in developing an all-of-state strategic direction on the broader aspects of equity and access in health care. Download our full response (PDF, 1080Kb)

 

Our response to the ABS consultation on 2021 Census topics

The Australian Bureau of Statistics consulted with data users, organisations and the wider community about the topics to be included in the 2021 Census of Population and Housing. Download our response to the consultation (PDF, 418Kb)

 

Monitoring the implementation of Transforming Health

Transforming Health was a major South Australian state government initiative that ran between 2015 and 2017. Its stated aims were to improve the metropolitan Adelaide public acute hospital system and align better models of health care delivery with new and upgraded hospital facilities.

Indicator reports

HPC produced six monitoring reports in total. The focus of these reports is to look at whether Transforming Health may have resulted in a widening of health outcome gaps between specific population groups: Aboriginal people, culturally and linguistically diverse communities, lower socio-economic areas, aged persons and country residents.

The first five monitoring reports monitor changes in indicators of access and equity before and during the period of Transforming Health. These reports chart hospitalisations (inpatient separations), average length of overnight stay, in-hospital deaths and hospital transfers. Results are also presented by local health network.

The sixth edition is the final release of our Transforming Health indicator reports. It is an update of our previous five reports, and also features the inclusion of patient/consumer experience and staff engagement measures.

 

Our comment on SA Health's consultation draft Consumer, Carer, and Community Feedback and Complaints Strategic Framework 2020-23 (2020)

SA Health's Consumer, Carer, and Community Feedback and Complaints Strategic Framework 2020-23 (PDF)—released on 28 April 2020 as a consultaton draft—provides direction for SA Health to effectively seek and manage feedback and complaints to identify and address gaps and improve health care services.

We welcome SA Health’s commitment to engaging and partnering with consumers, carers and the community, valuing the positive contributions they make, through feedback and complaints to improve health care service quality, equity and management.

We have reviewed the consultation draft framework and provides feedback and information on three aspects: (1) the document’s five goals; (2) document structure; and (3) future audit intentions of the Council.

Our full submission (PDF) expands on these points.

 

Our reponse to the South Australian Productivity Commission's inquiry into health and medical research (2020)

It is our view that access to comprehensive, timely data that can be linked and shared is an important factor affecting South Australia’s capacity to secure funding; and identify opportunities to improve South Australia’s capability to attract investment in health and medical research. South Australia cannot compete for health and medical research funding without integrated all-of-population data infrastructure that is shared widely and used widely to see the whole.

Our submission to the South Australian Productivity Commission's Inquiry into Health and Medical Research in South Australia responds to their request for information related to access to data. In summary:

  • In our experience, the current regulatory environment is not conducive to data generation and sharing.
  • In our experience, any overlap between national and state legislation does not interfere with health and medical research.
  • We believe that all types of data are important to share. In our experience, more can be done to improve data sharing, while still meeting legitimate privacy concerns.
  • In our experience, one of the biggest barriers to sharing data lies in the comprehensiveness of the data itself, specifically in relation to vulnerable and specific population groups. When it comes to missing data, you cannot share what you do not have.
  • In our experience, the main bottleneck that constrains health and medical research concerns timeliness of access to data.

Our full submission (PDF) expands on these points.

 

Our response to the Productivity Commission Reforms to Human Services inquiry (2016)

We responded to a Productivity Commission report from December 2016 that suggests key human services are in need of reform to offer more choice and competition. The Productivity Commission identify services such as public hospitals, public dental services and end of life care. While mentioning international examples of choice and competition policy, the report offers no explanation about how this might drive improvements in individual or population health outcomes or service delivery outcomes. HPC is concerned that if this inquiry recommends trialling any competition based reforms to human services, and particularly in public hospitals, that these preconditions should be met:

  • transparency of performance monitoring and reporting outcomes
  • service providers accountable for fostering consumer and community information literacy
  • government stewardship including sufficient funding and regulatory systems that take in consumer feedback and complaints management
  • recognition that a balanced and consumer-centred health system fosters better health outcomes and is most efficient when it integrates preventive and primary care with hospital services.

Our submission to the Productivity Commission – Reforms to Human Services: Issues Paper December 2016 expands on these points.

 

Health care for people from Culturally and Linguistically Diverse (CALD) backgrounds

In 2015, we commissioned a study to explore key issues in health care for Culturally and Linguistically Diverse (CALD) populations in South Australia. The scope of CALD populations for this study included new and emerging communities (new migrants and refugees) and established CALD communities, with a focus on older people from CALD backgrounds.

The study's report by Dr Iolanda Principe of IP Strategic Solutions, Issues in Health Care in South Australia for People from Culturally and Linguistically Diverse Backgrounds - A Scoping Study for the Heath Performance Council identifies current priority issues regarding appropriate care and quality of experience for people from CALD backgrounds through consultation with CALD peak bodies, advocacy groups and service providers, as well as a review of relevant information and research outcomes.

 

Aboriginal health in South Australia

At the seventh Aboriginal Leaders' Forum on 31 May 2017, we launched our 2017 Aboriginal Health Case Study report as a consultation draft for feedback. We invited stakeholders and interested parties in Aboriginal health to comment on consultation questions developed in conjunction with the case study.

Valued feedback to the consultation draft was provided by Aboriginal leaders, SA Health, expert independent bodies and other interested parties during the project's consultation phase and incorporated into our final report, Aboriginal health in South Australia: 2017 case study.

The 2017 case study formulates advice for health system reform to address disparities in health outcomes of Aboriginal people. Aboriginal leaders are clear. If better health outcomes are to be realised across the board, there must be an integrated, cross-discipline, cross-portfolio, and Aboriginal-led approach. This approach must take account of social, cultural, spiritual, economic and environmental determinants such as education, employment, safe housing, and culturally appropriate health practices and health promotion.

Four key areas for action emerged through consultation and research:

  1. Increase the numbers of Aboriginal people trained for and placed in the health workforce, particularly in senior and health professional roles.
  2. Expand culturally appropriate treatment to the entire health system, respecting Aboriginal people and drawing on their strength and endurance to support both individuals and communities to improve wellbeing.
  3. Remove barriers to the reporting and recording of Aboriginal identification in the health system, both as staff and consumers.
  4. Reduce and remove perceived and real institutional racism towards Aboriginal people within the health system through workplace audits, consumer feedback, safety and quality standards and personalised healthcare plans and by ensuring Aboriginal health consumers know their rights.

This 2017 case study is our second evaluation of Aboriginal health. It follows the HPC's 2014 report, Aboriginal Health in South Australia 2011-2014: A Case Study, our inaugural assessment of how the health system is performing for Aboriginal people.

 

Mental Health in Rural and Remote South Australian Communities

We heard from country Health Advisory Councils that mental health was a very important issue for regional South Australia, so we looked at mental health outcomes and mental health services in country South Australia. Mental Health in Rural and Remote South Australian Communities details our findings.

 

Review of Country Health Advisory Councils' (HACs) Governance Arrangements

In 2016, five years after the first review of governance arrangements between Country Health SA and the Health Advisory Councils, we set out to revisit the 2011 review to comment on changes over time and highlight where improvement was possible.

Importantly, we acknowledge the great volume and variety of work that is done by Country HACs across South Australia. HPC commends all Country HAC members for their service, commitment and amazing achievements in contributing to stronger regional health services for all country South Australians, now and in the future. As part of this review, we invited Country HACs to submit case examples describing achievements, and these are all published in the report. HPC acknowledges all observations in the review and future expectations for HAC activities should be proportionate with the unpaid part-time role of HAC members.

Our report comments on promoting the interests of specific population groups; building health and health governance literacy; receiving relevant health system performance information from Country Health; supporting Governing Council and Country Health achieving key strategic directions for patient safety and quality health services; and building on the shared future vision for collaboration through the full implementation of the June 2017 Country Health Partnership Framework. 

In 2011, the first HPC review of the governance arrangements between Country Health SA and the Health Advisory Councils was undertaken in accordance with its mandate under the Health Care Act 2008. We submitted our report to the Minister for Health on 31 December 2011 and it was tabled in Parliament on 4 April 2012.