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Stakeholder engagement

Our work is driven by the needs of our stakeholders and understanding these needs was a focus throughout 2019–20. To successfully perform our functions, we rely on forging and maintaining positive, productive relationships with many agencies and organisations across the Australian, state and territory governments, and non-government sectors. The multisectoral nature of our work is reflected in the statutory composition of the AIHW Board and Ethics Committee and the diverse range of entities with which we have entered into an agreement or a memorandum of understanding (MoU).

We completed 3 major stakeholder engagement activities during 2019–20:

  • a broad stakeholder survey
  • focus groups to gauge community trust
  • a survey of Specialist Homelessness Information Platform (SHIP) users.

We also commissioned an independent review to look at the development processes of our products and how to better engage with our major stakeholders.

In addition, we seek and act on feedback from our stakeholders through our various committees and working groups for specific products. This engagement ensures that the requirements of major stakeholders are considered in preparing our products. It enables us to draw on the expertise of data providers and subject matter specialists to deliver high-quality and timely products that meet stakeholders' needs.

Stakeholder survey

Our stakeholders have the potential to directly influence health and welfare outcomes via their decisions and their work. They can also influence how the AIHW is perceived at all levels of the sector. Building and reinforcing preferred methods of engaging strategically and collaboratively with these stakeholders is a priority. In March 2020, we conducted a survey of our stakeholders. Its primary aims were to gain a clear view of: stakeholder perceptions; which AIHW products and services they use; their preferred ways to engage with the AIHW; and the AIHW’s reputation.

Survey approach

The survey was sent to 4,559 email addresses sourced from our news subscription list and our authorised list of embargo users. It comprised 10 questions and took approximately 4 minutes to complete.

Results

The AIHW was favoured as the most common source for health and welfare data, followed by the ABS, then other Australian and state and territory government agencies. This result affirmed the AIHW’s prominence and reliability in the health and welfare space.

Survey respondents were highly likely to speak positively about the AIHW to colleagues or friends and a vast majority (97%) had used one or more of our product types Figure 3.1: AIHW products used by survey respondents Respondents were also asked about their preferred method of engagement with the AIHW (Figure 3.2: Preferred method of engagement by survey respondents).

The survey data reinforced the AIHW’s momentum towards a more visual digital engagement and marketing approach, with more opportunities for collaboration and news updates.

Figure 3.1: AIHW products used by survey respondents Bar graph showing the products used by survey respondents which are Reports downloaded in PDF 305, Fact sheets 230, Website 206, Infographics 177, Media releases 168, Data tables in Excel 154, Online Reports in HTML 115, Education resources 107, Interactive data visualisations 105, Data cubes 93, Hard copy publications 51, Data requests 45

Figure 3.2: Preferred method of engagement by survey respondents Bar chart showing the preferred method of engagement by survey respondents which are E-newsletters/email subscription 299, Website content 256, Email correspondence 242, Webinars 96, Academic journal articles 83,Social media posts 66, Conferences and event displays 47 Face-to-face meetings 36, Phone calls 21, Other 8, SMS 6.

Case study 8: Community trust in AIHW’s use and management of data

Our challenge

Developing an AIHW approach

The AIHW’s Strategic Directions have historically been oriented towards gaining the trust of our core audiences—data users, data suppliers and funders. There is decreased trust in government, high- profile data breaches and heightened sensitivity towards use and management of data related to people. In this context, the Executive Committee endorsed ‘Developing an approach to community trust in the AIHW’s use and management of data’ as one of our Priority Actions for 2019–20. Our Ethics Committee also had a particular focus on this issue, aiming to meet community expectations of how data are used and managed at the AIHW. Similarly, in recent times, broader directives have emerged from PM&C about building trust in government data use.

Our response

Better understanding community attitudes towards the AIHW

To take forward this action, we ran a series of focus groups with the public to gain an up-to- date understanding of attitudes towards the AIHW’s use and management of data.

Ten focus groups were held in several cities and regional centres across Australia. A total of 77 people attended, with participants recruited to ensure a mix of social circumstances and attitudes to privacy. Sessions were arranged to gather perspectives from Aboriginal and Torres Strait Islander people.

Discussion covered our uses of data, safeguards and case studies describing different data sets and collection methods, including a household survey, linked data, enduring linked data, and data from the private sector.

Our results

A new policy statement

This invaluable work has provided some useful perspectives. Results suggest that different types of work require different communication approaches, and that there are additional steps we can take to demonstrate trustworthiness to Indigenous communities.

The Executive Committee, AIHW Board and the Ethics Committee have recommended a new policy statement and related actions to be undertaken as part of implementing our approach to building and retaining community trust. The findings have been well received by our Strategic Committee for National Health Information (SCNHI), the Department of Health, the ABS, PM&C and the Canadian Institute for Health Information (CIHI).

Specialist Homelessness Information Platform

SHIP is a client management system provided to Specialist Homelessness Services agencies through state and territory governments funding. The AIHW negotiated the contract for provision of SHIP with Infoxchange on behalf of state and territory housing departments.

SHIP satisfaction survey

We conducted a SHIP satisfaction survey from 11 April to 30 May 2019. The survey was distributed to all 4,645 SHIP users from approximately 900 agencies in Victoria, Queensland, Western Australia, Tasmania, the Northern Territory and the Australian Capital Territory. New South Wales and South Australia do not use SHIP. Responses were received from 1,516 users, yielding a response rate of 33%.

The survey was designed to gauge the overall level of satisfaction of users with SHIP as well as its usability and adequacy of available functions. It also contained questions about characteristics of the users to enable analysis of what factors may affect satisfaction with SHIP.

The number of questions was kept small to limit the burden on respondents. On average, respondents completed the survey in 3–4 minutes. No identifiable information about the respondent or their agency was collected.

Results

Overall, 84% of respondents were satisfied with SHIP. Detailed national results were outlined in a paper and provided to state and territory governments. A specific state/ territory-level report was also produced for each jurisdiction.

Independent review of product development

In October 2019, we commissioned Mr Peter Harper, a former deputy statistician at the ABS, to undertake a systemic review of the approaches used in the development of reports and products. This review was established to examine differences between statistical approaches used by the AIHW and other organisations in the Health portfolio and the Productivity Commission, and the small number of errors in reports released in September 2019.

The differences in statistical approaches are generally justifiable but there is the potential for confusion by users of the reports. There is also a risk that our statistics could be considered of poor quality or potentially unreliable if the discrepancies are not adequately explained or accepted by users. In particular, where differences in statistical approaches are likely to be contentious with stakeholders, we need to be aware of it and manage stakeholder expectations.

The report included suggestions for reducing the risk of errors and enhancing the AIHW’s reputation with stakeholders. These suggestions related to:

  • statistical and methodological differences
  • limiting use of ‘1-year snapshots’
  • stakeholder engagement for major reports
  • quality of data received
  • internal approval processes.

The report was considered by the Risk, Audit and Finance Committee and the AIHW Board at its meeting in March 2020. Implementation of the recommendations has commenced.

Engagement through committees

We actively engage in more than 60 national committees across health and welfare.

We collaborated with all state and territory governments, the Department of Health, and other key agencies and stakeholders through our committees, the Strategic Committee for National Health Information (SCNHI) and the National Health Data and Information Standards Committee (NHDISC). Through these committees we maintained relationships with the AHMAC, primarily through its Health Services Principal Committee (HSPC). An MoU has been established to formalise our relationship with the AHMAC.

The Housing and Homelessness Data Working Group (HHDWG) is an advisory body established by the National Housing and Homelessness Agreement. Working group members have provided input into AIHW publications, data products, and AIHW managed data collections. Participation in the HHDWG in 2019–20 primarily focused on finalisation of the Data Improvement Plan.

Strategic Committee for National Health Information

The SCNHI is an advisory committee to the AIHW. It provides strategic advice in relation to the AIHW’s national health information work, including overall priorities, and the Institute’s health sector performance reporting work in the context of the National Health Information Agreement. The SCNHI also provides advice on engagement with the AHMAC and the HSPC. The Chair of the committee and the AIHW CEO jointly report to the AHMAC annually and provide advice to the AHMAC on national health information matters.

The SCNHI met 4 times in 2019–20 and discussed the following topics:

  • Royal Commission into Aged Care Quality and Safety
  • AIHW’s community trust work
  • AIHW Data Governance Framework AIHW Data Plan
  • AHPF
  • COVID-19 response and lessons learned
  • National Health Information Strategy (NHIS) NIHSI AA
  • Primary Health Care Data Asset and other primary health-care activities.

The SCNHI’s advice on these projects and issues will inform the next steps taken by the AIHW. Members also discussed a number of jurisdictional initiatives of broader relevance to the group, including updates on development of the National Health Reform Agreement, approaches to consultation and engagement, general practitioner (GP) data linkage, low value/values-based care, patient safety reporting, and tools to map geographical variation in health-care delivery.

National Health Data and Information Standards Committee

The NHDISC was established to provide advice to the AIHW on its work in developing and maintaining national health data and information standards and related national health information infrastructure, in the context of the National Health Information Agreement. The NHDISC undertakes the work set out in our agreement with the AHMAC, to manage national processes for development, agreement and maintenance of national health data and information standards.

We perform the role of the National Health Registration Authority (for national health data standards published in METeOR) on behalf of the AHMAC. The NHDISC approves any new or changes to National Minimum Data Sets, National Best Endeavours Data Sets and National Best Practice Data Sets. It also oversees the development and endorsement of specifications for performance indicators, such as those reported in the AHPF.

The NHDISC met 5 times in 2019–20. In addition to its ongoing functions, its key outcomes were:

  • a review of data elements in the Admitted Patient Care National Minimum Data Set (NMDS)
  • updates to the Non-admitted patient care aggregate National Best Endeavours Data Set (NBEDS), Non-admitted patient NBEDS, Perinatal NMDS and NBEDS
  • a review of both the AHPF indicators and the National Healthcare Agreement performance indicators for 2020
  • revision of the specification for National Healthcare Agreement Performance Indicator 30—Elapsed times for Home Care Packages.

Supporting the AHMAC

Our CEO attended the AHMAC’s meeting on 6 December 2019 to present and discuss the work of the AIHW; seek advice from the AHMAC on our work priorities; provide advice on health information matters; and other matters of mutual interest.

The AIHW undertook a number of projects funded by the AHMAC. We also provided regular updates on these projects to the AHMAC’s HSPC. In addition to regular progress and project updates, the AIHW submitted papers to the HSPC on the review of the International Classification of Diseases, 11th Revision (ICD-11), palliative care and end-of-life data development, and received approval for the AIHW Data Plan.

WHO Family of International Classifications

The AIHW is the Australian Collaborating Centre (ACC) for the WHO’s Family of International Classifications (WHO-FIC). In this role, the AIHW assists the WHO in its work to develop, maintain and implement the classifications, which include the International Classification of Diseases. We also worked to coordinate the efforts of other Australian stakeholders in collaboration with the WHO and disseminated information about the WHO’s classifications work within Australia.

The AIHW, as the ACC, provided information to Australia’s Member State representative to the World Health Assembly—the Department of Health—as and when required.

Over the past year, the ACC contributed to the WHO’s work to finalise ICD-11. Also, the ACC coordinated field testing of the International Classification of Health Interventions in Australia on behalf of the WHO.

Spotlight on developing the National Health Information Strategy

Australia’s health information system achieves some of the best outcomes in the world through strong foundations in clinical practice, education, training and research, supported by an evolving national health information infrastructure. However, the absence of a national strategy or framework for the management of national health data and information in Australia has been a barrier to collaboration (including with the clinical and research communities and the private sector) and has resulted in missed opportunities and limited strategic investment.

The AIHW, SCNHI and HSPC have been working to remedy this barrier by developing the NHIS. The objectives of the NHIS are to provide a 10–15-year vision, outline the challenges and priorities, and develop an enduring and overarching framework to achieve coordinated, integrated, efficient, effective and timely health information and data that will meet the needs of health consumers and all who work in, and manage, Australia’s health system. It will cover intersecting aspects of health and wellbeing, including the social determinants of health, over the lifecourse of individuals. It will bring together data from other sectors, such as aged care, disability, education, welfare, justice, housing and employment, and integrate comprehensive data and information from private and public sources. It will provide a framework for a series of action plans to shape strategic investment in health information both in the short and longer term. In July 2019, the AIHW established an independent expert panel to take the overall lead on the development of the NHIS. We commenced engagement and consultation with stakeholders in governments and the health sector.

Panel members as at 30 June 2020 are:

  • Emeritus Professor Mike Daube AO (Chair), previously professor of health policy, Curtin University and director general of health for Western Australia
  • Professor Louisa Jorm, Director, Centre for Big Data Research in Health, University of New South Wales
  • Ms Leanne Wells, CEO, Consumers Health Forum
  • Dr Kalinda Griffiths, Scientia Fellow, Centre for Big Data Research, University of New South Wales
  • Dr Michael Wright, Chair of the Central and Eastern Sydney PHN and Chair of the Royal Australian College of General Practitioners’ national Reference Expert Committee on Funding and Health System Reform.

Professors Michael Kidd and Sandra Eades were original members of the panel but stepped down in early 2020. More information on the NHIS can be found at www.aihw.gov.au/our-services/committees/ national-health-information-strategy- independent-e.

A series of face-to-face consultation sessions, facilitated by Dr Norman Swan, were held in late 2019 and early 2020 in each capital city to engage with stakeholders. Similar sessions were held with the National Health Leadership Forum and the Consumers Health Forum. An online submission process was made available during March 2020 on the AIHW website. Feedback received from these sessions will be used by the panel to inform the development of the NHIS.

The NHIS was planned to be provided to the AHMAC and the COAG Health Council by early 2021, before its release. However, on 29 May 2020, the National Cabinet agreed on a revised architecture for federal relations and a review of the COAG Ministerial Councils. These changes may impact the release of the NHIS.