COMMUNICATION

MAJOR PUBLICATIONS

Each year the NHFB publishes a suite of documents that guide and support the work of the organisation, and report publicly on the NHFB’s performance. The main focus of the NHFB’s publications are financial and data specification documents which support the work of the Administrator. These are listed in Table 2.

TABLE 2: STRATEGIC, OPERATIONAL AND COMPLIANCE DOCUMENTS DEVELOPED ON BEHALF OF THE ADMINISTRATOR

TABLE 2: STRATEGIC, OPERATIONAL AND COMPLIANCE DOCUMENTS DEVELOPED ON BEHALF OF THE ADMINISTRATOR
DATE
PUBLICATION

10 JUL 2015

2014–15 Reconciliation Framework

4 SEPT 2015

June 2015 Quarter Compliance Report

20 JAN 2016

September 2015 Quarter Compliance Report

23 MAR 2016

December 2015 Quarter Compliance Report

1 JUN 2016

March 2016 Quarter Compliance Report

27 JUN 2016

Administrator’s Three Year Data Plan 2016–17 to 2018–19 and File Specifications

In addition to the publications developed for the Administrator, the NHFB also developed the following:

NHFB’S ANNUAL REPORT 2014–15

The NHFB’s Annual Report 2014–15 was tabled in the Commonwealth Parliament on 28 October 2015 and provided to all Health Ministers. This publication reported against the 2014–15 Portfolio Budget Statements on the work undertaken by the NHFB.

ADMINISTRATOR’S ANNUAL REPORT 2014–15

The Administrator’s Annual Report 2014–15 was provided to all Health Ministers for tabling in their respective Parliaments. This publication reported on the third year of operation of the National Health Funding Pool from 1 July 2014 to 30 June 2015.

MONTHLY REPORTS

For the 2015–16 financial year, the NHFB produced a total of 1,780 monthly reports for the Administrator.

Each month a national report, a state and territory report, and a report for each local hospital network are produced.

Section 240 of the Act requires that the Administrator provide monthly reports to the Commonwealth and each state and territory, and to make them publicly available. The reports must contain:

  • amounts paid into each State Pool Account and State Managed Fund by the relevant state, and the basis on which the payments were made
  • amounts paid into each State Pool Account by the Commonwealth, and the basis on which the payments were made
  • amounts paid from each State Pool Account to local hospital networks, a State Managed Fund or other organisations or funds, and the basis on which the payments were made
  • amounts paid from each State Managed Fund to local hospital networks or other organisations or funds, and the basis on which the payments were made
  • number of public hospital services funded for each local hospital network (including as a running financial year total) in accordance with the system of activity based funding
  • number of other public hospital services and functions funded from each State Pool Account or State Managed Fund (including a running financial year total).

The Administrator’s monthly reports are available from publichospitalfunding.gov.au/reports.

Table 3 shows the release dates for the Administrator’s monthly reports published for 2014–15 and 2015–16, satisfying the Administrator’s legislated requirement. The timeliness of the public release of the monthly reports varied throughout the year. The release of the monthly reports is subject to the supply of accurate information by all states and territories.

TABLE 3: MONTHLY REPORTS FOR 2014–15 AND 2015–16

TABLE 3: MONTHLY REPORTS FOR 2014–15 AND 2015–16
2015–16
2014–15

July 2015

(released on 18.12.2015)

July 2014

(released on 18.9.2014)

August 2015

(released on 18.12.2015)

August 2014

(released on 10.10.2014)

September 2015

(released on 18.12.2015)

September 2014

(released on 29.10.2014)

October 2015

(released on 20.1.2015)

October 2014

(released on 5.12.2014)

November 2015

(released on 20.1.2015)

November 2014

(released on 21.1.2015)

December 2015

(released on 3.2.2016)

December 2014

(released on 13.2.2015)

January 2016

(released on 9.2.2016)

January 2015

(released on 20.3.2015)

February 2016

(released on 1.4.2016)

February 2015
(released on 15.4.2015)

March 2016

(released on 10.5.2016)

March 2015

(released on 8.7.2015)

April 2016

(released on 10.6.2016)

April 2015

(released on 4.9.2015)

May 2016

(released on 10.8.2016)

May 2015

(released on 4.9.2015)

June 2016

(released on 16.9.2016)

June 2015

(released on 16.10.2015)

WEBSITES

The NHFB website provided a communications channel for our stakeholders and the general public. The website contains information on the operations on the NHFB, including our role and functions. The website enables us to meet our obligations with regard to Senate Order reporting and Freedom of Information requests. The NHFB website is at nhfb.gov.au.

In 2015–16, the NHFB website had 20,783 page views and 6,171 unique visitors.

The NHFB maintains the Administrator’s Public Hospital Funding website, found at publichospitalfunding.gov.au. The website provides information and financial reports on the funding of the Australian public hospital system by the Commonwealth, states and territories, and payments made to local hospital networks for public hospital services.

In 2015–16 the Public Hospital Funding website had 24,597 page views and 17,416 unique visitors. Users in Australia made up 85.01 per cent of visits to the site. The majority of visits to the site (69.4 per cent) were from new visitors.

PRESENTATIONS

The NHFB made a number of presentations to the Commonwealth, states and territories in 2015–16, including on emerging tasks and opportunities.

The NHFB was invited to present at the Independent Hospital Pricing Authority 2016 Activity Based Funding Conference held at the Brisbane Convention and Exhibition Centre, 9–11 May 2016.

The Chief Executive Officer, Lynton Norris, presented ‘New frontiers in health system insights using data analytics’. See page 34 for the presentation abstract.

NEW FRONTIERS IN HEALTH SYSTEM INSIGHTS USING DATA ANALYTICS

THE REFORM OF FEDERATION DISCUSSION PAPER HAS IDENTIFIED THE IMPORTANCE OF BETTER USE OF EXISTING DATA SETS TO IMPROVE UNDERSTANDING OF HEALTHCARE AND INFORM EFFORTS TO IMPROVE THE EFFICIENCY AND EFFECTIVENESS OF THE AUSTRALIAN HEALTH SYSTEM.

The Administrator of the National Health Funding Pool (the Administrator) has a unique set of deterministically integrated data holdings used to perform his legislated functions which include identifying where a national health reform funded hospital service also received funding through other Commonwealth programs.

Through the ‘data–matching’ of hospital activity with Medicare Benefits Schedule (MBS) data and hospital activity with Pharmaceutical Benefits Scheme (PBS) data, the National Health Funding Body (NHFB) has demonstrated the successful integration of large national health data sets and the enormous potential for the Administrator’s integrated data holdings. Exploring the ‘data–matches’ (potential double–dips of Commonwealth funding for the same hospital service), the NHFB sought to identify and review the specific circumstances of the ‘matches’. This work involved reviewing the patient pathway through the hospital and out of hospital setting (the patient ‘continuum of care’), and relationship of primary and specialist care to the hospital service.

This project successfully demonstrated the capability of the deterministically integrated health data sets using hospital activity and MBS/PBS data. This work produced new insights into healthcare service utilisation patterns, costs of care, and patients’ interactions across the health system (primary, secondary and tertiary setting). Very effective in identifying true ‘data–matches’, these new insights could also inform evidence based policy development and healthcare funding into the future. It is evident that the benefits gained would be of great value to all jurisdictions (Commonwealth, states and territories), and stakeholders across the health system, particularly purchasers, providers, and citizens.

It is recognised that a key factor impacting efforts to improve the efficient delivery of health services is a lack of integrated information about how the whole system comes together. While ABF has allowed a better understanding of hospital use and costs across Australia, the NHFB project has expanded this understanding through analyses of patients and their hospital and community health journey, and their patterns of use and costs of care of both in hospital and out of hospital services.

Although a very positive first step, there is more work to be done to further understand the capability and usefulness of the existing hospital, MBS and PBS deterministically integrated dataset. This work will inform how the insights could be shared and used more effectively in health policy development in Australia, and contribute to the current National conversations on healthcare costs and sustainability.

This session demonstrated how the deterministically integrated data sets are used for ‘data–matching’, and how they can be applied to bring new insights into the health system use and costs (such as costs of avoidable admissions).

FUNDING INTEGRITY

Under clauses A6 and A7 of the Agreement, the Commonwealth will not fund patient services through the Agreement if the same service or any part of that service is funded through MBS, PBS, or any other Commonwealth program. To assist the Administrator in meeting this obligation, the NHFB undertakes funding integrity analysis through deterministic data matching in the Administrator’s Dataset.

ADMINISTRATOR’S LINKED DATASET

To facilitate the identification of services that may have been funded by more than one Commonwealth program, the Administrator has a unique dataset that allows deterministic merging via Medicare PIN of patient level hospital activity data and MBS, or the hospital activity data and PBS. The data linkage of the Medicare Number to a Medicare PIN is undertaken by the Australian Government Department of Human Services (DHS), an accredited integrating authority.

The resulting dataset contains anonymised patient level information while maintaining the unique identifier that enables the NHFB to undertake data matching for funding integrity.

BUSINESS RULES FOR DATA MATCHING

Since the commencement of the national health reform funding arrangements, the NHFB, in collaboration with the Commonwealth, states and territories, has worked on business rules to progress matching of hospital activity and MBS claims data, and hospital activity and PBS claims data, to ensure funding compliance with legislative requirements.

These business rules are published on publichospitalfunding.gov.au.

The data matching process enables the Administrator, as part of their statutory role and function, to be assured of the funding integrity by enabling the identification of services that have been funded by the Commonwealth more than once.

This work commenced as a ‘proof–of–concept’ project in collaboration with the Commonwealth, states and territories. The NHFB remains the sole entity that has been permitted to undertake deterministic analysis with these datasets. In this privileged position, the NHFB continues to work thoroughly and carefully through the process to ensure its veracity and reliability, whilst maintaining patient confidentiality.

The funding integrity analysis initially undertaken in 2014–15 has progressed in 2015–16 through the intergovernmental health committees, AHMAC and NHIPPC, which has facilitated jurisdictional discussion on the use of the outcomes to ensure compliance with the Agreement.

INTERNAL GOVERNANCE

The NHFB operates in a complex and challenging environment, involving a wide range of internal and external stakeholders. We are subject to legislation, regulations, standards and guidelines applicable to the NHFB and its activities.

The NHFB’s values and governance is based on the principles of public sector governance including:

  • accountability — to comply with the legislative requirements according to the parameters set
  • collaboration — to maintain effective working relationships with all stakeholders, to instil continued confidence
  • integrity — to conduct business and make decisions in a manner which demonstrates the principles of honesty, consistency, accuracy, and ethics
  • leadership — to ensure leadership, effective policy advice, and best practice in the management of national health funding
  • privacy — to comply with secrecy and disclosure requirements
  • transparency — to be transparent in the reporting and transactions of funding activities within the National Health Funding Pool.

The NHFB is committed to managing its business operations so it strives to meet its strategic objectives, statutory obligations and ethical standards. This commitment is an integral part of the NHFB’s management practices and is the foundation of the NHFB’s Corporate Governance Framework.

To facilitate the work of the Administrator and that of the NHFB, the NHFB has various internal and external governance arrangements in place. Further details of the external governance arrangements can be found on page 13.

The internal committees of the NHFB that support the governance framework include:

  • NHFB Executive Committee
    The NHFB Executive Committee is the primary decision making body in the NHFB. The Committee provides advice and makes recommendations to the CEO on policies, direction, initiatives, and immediate and emerging issues. The Committee also acts as a forum for discussion, prioritisation, and forward planning.
  • Risk, Compliance and Business Continuity Committee
    The Risk, Compliance and Business Continuity Committee provides assurance to the CEO and the Audit Committee on the adequacy and effectiveness of the NHFB’s risk, control and compliance frameworks, internal audit activities and assurance reviews. It also oversees management of business continuity.
  • Workplace Consultative Committee
    The NHFB Workplace Consultative Committee brings together employees and management to cooperatively and collaboratively consult and discuss employment conditions and health and safety matters affecting employees.
  • Digital 2020 Committee
    The Digital 2020 Committee provides governance to the implementation of Commonwealth digital initiatives. These include Digital Continuity 2020 (National Archives), Whole of Government Digital Records Transformation (Department of Finance), and initiatives promoted by the Digital Transformation Office.

ACCOUNTABILITY

AUDITS AND ASSURANCE REVIEWS

Internal audit provides assurance to the CEO and the Audit Committee (via the Risk, Compliance and Business Continuity Committee) that the NHFB’s financial and operational controls, designed to manage the NHFB’s risks and achieve the NHFB’s objectives, are operating in an efficient, effective, economical and ethical manner. Internal audit also assists management in improving the NHFB’s business performance.

The NHFB adopts a co–sourced service delivery model, where the internal audit and assurance function is provided by a combination of in–house and contract resources.

An integral part of the internal audit and assurance reviews is the review conducted over the Administrator’s Payments System, in accordance with the Framework for Assurance Engagements issued by the Auditing and Assurance Standards Board. This review concluded that Payment System controls are effective in all material aspects.

EXTERNAL SCRUTINY

Audit Committee members, including the Chair, are independent and external to the NHFB. See page 24 for further information on the Audit Committee.

No judicial, tribunal or Australian Information Commissioner decisions have been made or are pending with regard to the NHFB.

No reports on the operations of the NHFB have been released by the Auditor–General, a Parliamentary Committee, or the Commonwealth Ombudsman.

There have been no capability reviews on the NHFB.

RISK MANAGEMENT

In accordance with Section 16 of the PGPA Act, the NHFB maintains an appropriate system of risk oversight, management and internal control.

The NHFB’s risk management policy, framework and processes including registers and plans are consistent with the Commonwealth Risk Management Policy, Comcover’s Better Practice Guide: Risk Management and ASNZ ISO 31000:2009 Risk Management — Principles and Guidelines.

FRAUD CONTROL

In accordance with the PGPA Act, Section 10 of the Public Governance, Performance and Accountability Rule 2014 and the Commonwealth Fraud Control Policy the NHFB maintains an appropriate system of risk management and internal control including measures relating to compliance with finance law.

During 2015–16 the NHFB undertook an agency–wide fraud risk assessment taking into consideration its internal and external fraud risks, updated its Fraud Control Plan to manage the identified risks, and incorporated the identified risk into its internal annual audit program. The NHFB also conducted an internal audit over the adequacy of current fraud policies and procedures.

The NHFB has appropriate fraud prevention, detection, investigation, and reporting mechanisms in place and has taken all reasonable measures to appropriately deal with fraud, including the provision of fraud awareness training to all staff
in 2015–16.

PUBLIC SERVICE CODE OF CONDUCT

The NHFB promotes adherence to the Australian Public Service (APS) Values and Code of Conduct.

ASSETS MANAGEMENT

In 2015–16 the NHFB leased assets from the Commonwealth Department of Health.

PURCHASING

The NHFB’s purchasing activities were conducted in line with the Commonwealth Procurement Guidelines and the NHFB Accountable Authority Instructions.

The NHFB supports small business participation in the Commonwealth Government procurement market. Small and Medium Enterprises and Small Enterprise participation statistics are available on the Department of Finance’s website: finance.gov.au/procurement/statistics-on-commonwealthpurchasing-contracts.

CONSULTANTS

No consultants were engaged by the NHFB in 2015–16.

AUSTRALIAN NATIONAL AUDIT OFFICE ACCESS CLAUSES

The NHFB did not enter into any contracts precluding access by the Commonwealth Auditor–General.

EXEMPT CONTRACTS

The NHFB did not enter into any contracts that were exempt from publication on the AusTender website.

HEALTH AND SAFETY OUTCOMES

In 2015–16 the NHFB had no reportable incidents or serious personal injury incidents, and no notices or directions under the Work Health and Safety Act 2011.

ADVERTISING AND MARKET RESEARCH

The NHFB did not undertake any advertising campaigns or market research during 2015–16.

ECOLOGICAL AND ENVIRONMENTAL REPORTING

The NHFB is committed to the principles of ecologically sustainable development.

In 2015–16 the NHFB has continued to minimise its environmental impact by:

  • encouraging all staff members to reduce the volume of printing
  • turning off lights and computers when the office is not in use
  • utilising waste recycling stations
  • reducing our office space
  • limiting travel by using technological solutions whenever possible.

DISABILITY REPORTING

Commonwealth agencies have previously reported in annual reports on their performances as policy advisers, purchasers, employers, regulators, and providers under the Commonwealth Disability Strategy.

This has been replaced by reporting under the National Disability Strategy 2010–2020. This strategy sets out a ten–year national policy framework to improve the lives of people with disability, promote participation, and create a more inclusive society.

Information and reporting on the National Disability Strategy is available at https://www.dss.gov.au/our-responsibilities/disability-and-carers/program-services/government-international/national-disability-strategy

In 2015–16 the NHFB did not have any employees who identified themselves as having a disability.

INFORMATION PUBLICATION SCHEME

The Freedom of Information Act 1982 (the FOI Act) gives members of the public a right to access copies of documents, other than exempt documents, held by the NHFB.

Agencies subject to the FOI Act are required to publish information to the public as part of the Information Publication Scheme.

In accordance with the FOI Act requirements, the NHFB publishes FOI information on its website at: nhfb.gov.au/contact-us/freedom-of-information.

No FOI requests were received by the NHFB in 2015–16.

GRANT PROGRAMS

There were no grant programs undertaken by the NHFB in 2015–16.