An audit of the governance of local health districts has found that the Department of Health, Local Health Districts and their boards have a clear understanding of their main roles, responsibilities and relationships.
In her report Governance of Local Health Districts, Auditor-General Margaret Crawford (pictured) said however, there was scope for improvement.
Ms Crawford said Local Health Districts (LHDs) were established to deliver greater local decision-making, including better engagement with clinicians, consumers and local communities, as well as other stakeholders in the primary care and non-government sectors.
She said clinician engagement had not met expectations and required attention as a priority.
“A statement of principles to guide decision-making in a devolved system was also needed,” Ms Crawford said.
She said accountability and oversight mechanisms, including the Health Performance Framework and Service Agreements, had been effective in supporting a cultural shift that supported LHDs being held to account for meeting their obligations.
The audit assessed the efficiency and effectiveness of the governance arrangements for LHDs and answered two questions:
- Are there clear roles, responsibilities and relationships between the Ministry of Health and LHDs and within LHDs?
- Does the NSW Health Performance Framework establish and maintain accountability, oversight and strategic guidance for LHDs?
Ms Crawford determined there was some ambiguity for more complex and nuanced functions.
She said a statement of principles to support decision-making in a devolved system would help to ensure that neither LHDs nor the Ministry ‘over-reach’ into areas that were more appropriately the other’s responsibility.
She said better clinician engagement in LHD decision-making was a key driver for devolution but had not met the expectations and required attention as a priority.
The Auditor-General’s 48-page report and recommendations can be accessed at this PS News link.
