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Mid-Term Evaluation of the NSW ABORIGINAL HEALTH PLAN 2013-2023

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Mid-Term Evaluation of the NSW ABORIGINAL HEALTH PLAN 2013-2023 Mid-Term Evaluation of the NSW ABORIGINAL HEALTH PLAN 2013-2023 MAIN REPORT May 2019 NSW MINISTRY OF HEALTH 73 Miller Street Locked Mail Bag 961 NORTH SYDNEY NSW 2060 Copyright © NSW Ministry of Health 2019 This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the NSW Ministry of Health. SHPN (CEE) 190064 ISBN 978-1-76081-091-7 Produced by: Centre for Epidemiology and Evidence and Centre for Aboriginal Health Population and Public Health Division Suggested citation: Centre for Epidemiology and Evidence and Centre for Aboriginal Health. Mid-Term Evaluation of the NSW Aboriginal Health Plan 2013-2023. Sydney: NSW Ministry of Health, 2019. Further copies of this document can be downloaded from the NSW Health website at www.health.nsw.gov.au May 2019 Artwork: Inspired by the original artwork of Aboriginal artist Tanya Taylor and designed by the National Aboriginal Design Agency, this artwork symbolises the Centre for Aboriginal Health working in partnership with Aboriginal people to support wholistic health and wellbeing and its role in the health system to build culturally safe and responsive health services. NSW ABORIGINAL HEALTH PLAN 2013-2023: MID-TERM EVALUATION ACKNOWLEDGEMENT OF COUNTRY The NSW Ministry of Health acknowledges Aboriginal people as the traditional custodians of the lands and waters of NSW and pays respect to elders past, present and future. In this report, Aboriginal and Torres Strait Islander people are referred to as Aboriginal people in recognition that Aboriginal people are the original inhabitants of NSW. DEFINITION OF ABORIGINAL HEALTH “Aboriginal health means not just the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their community…”1 ACKNOWLEDGEMENTS The NSW Ministry of Health gratefully acknowledges staff of the following organisations for their participation in surveys and interviews: the Aboriginal Health & Medical Research Council of NSW; Awabakal Medical Service; Bulgarr Ngaru Medical Aboriginal Corporation; Waminda South Coast Women’s Health and Welfare Aboriginal Corporation; Bourke Aboriginal Health Service; Galambila Aboriginal Health Service; Walgett Aboriginal Medical Service; Tharawal Aboriginal Corporation; The Glen Centre Central Coast Drug Alcohol Rehabilitation; Griffith Aboriginal Medical Service; Katungul Aboriginal Corporation; and various NSW Health organisations. Thanks to the members of the NSW Aboriginal Health Plan Mid-term Evaluation Working Group for their input and guidance during all phases of the evaluation: • Stephen Blunden, Aboriginal Health & Medical Research Council of NSW • Robyn Martin, Mid North Coast Local Health District • Catherine White, Centre for Aboriginal Health, NSW Ministry of Health (Chair) • Helen Gardiner, Centre for Aboriginal Health, NSW Ministry of Health • Andrew Milat, Centre for Epidemiology and Evidence, NSW Ministry of Health • Aaron Cashmore, Centre for Epidemiology and Evidence, NSW Ministry of Health • Leigh McIndoe, Centre for Epidemiology and Evidence, NSW Ministry of Health Thanks to the following people for their contribution to data collection, analysis and/or reporting processes: Dr Aaron Cashmore; Dr Andrew Milat; Ms Leigh McIndoe; Ms Amanda Jayakody; Ms Shelley Thompson; Ms Wedyan Meshreky; Ms Kit Leung; Ms Sarah Neill; Dr Michael Nelson; Ms Jackie Robertson; Ms Kristy Goldsworthy; Ms Catherine White; Ms Helen Gardiner; Dr Megan Campbell; Ms Lisa Yu; and Ms Brenda Currie. Thanks to the System Information and Analytics Branch in the NSW Ministry of Health for supporting the preparation and analysis of administrative health data. Executive sponsors of the evaluation are Dr Kerry Chant, Ms Geraldine Wilson-Matenga and Associate Professor Sarah Thackway. NSW ABORIGINAL HEALTH PLAN 2013-2023: MID-TERM EVALUATION ii ABBREVIATIONS ACI Agency for Clinical Innovation AHIS Aboriginal Health Impact Statement AHW Aboriginal Health Worker ACCHS Aboriginal community-controlled health service AH&MRC Aboriginal Health & Medical Research Council of NSW BBV blood borne virus BRISE BBV & STI Research, Intervention and Strategic Evaluation CAH Centre for Aboriginal Health CEE Centre for Epidemiology and Evidence CHeReL Centre for Health Record Linkage CPH Centre for Population Health ECAV Education Centre Against Violence ED emergency department EHO Environmental Health Officer ERA Enhanced Reporting of Aboriginality HETI Health Education and Training Institute JH&FMHN Justice Health & Forensic Mental Health Network KHC Knockout Health Challenge KPI key performance indicator LHD local health district MoH NSW Ministry of Health NGO non-government organisation NH&MRC National Health & Medical Research Council SHN specialty health network STI sexually transmissible infection UNSW University of New South Wales NSW ABORIGINAL HEALTH PLAN 2013-2023: MID-TERM EVALUATION iii CONTENTS ACKNOWLEDGEMENTS ii ABBREVIATIONS iii EXECUTIVE SUMMARY 1 1. BACKGROUND 13 1.1 The NSW Aboriginal Health Plan 2013–2023 13 1.2 Evaluation objectives 13 1.3 Evaluation methods 14 1.4 Evaluation governance 14 2. CONTEXT 15 2.1 Aboriginal people in NSW 15 2.2 The policy environment 15 2.3 The service delivery context 16 2.4 Governance of Aboriginal health in NSW Health 16 3. RESULTS 18 3.1 STRATEGIC DIRECTION 1: BUILDING TRUST THROUGH PARTNERSHIPS 18 3.1.1 NSW Health activities 18 3.1.2 Stakeholder feedback 23 3.1.3 Summary and implications 25 3.2 STRATEGIC DIRECTION 2: IMPLEMENTING WHAT WORKS AND BUILDING THE EVIDENCE 27 3.2.1 NSW Health activities 27 3.2.2 Progress indicators 34 3.2.3 Stakeholder feedback 37 3.2.4 Summary and implications 38 3.3 STRATEGIC DIRECTION 3: ENSURING INTEGRATED PLANNING AND SERVICE DELIVERY 39 3.3.1 NSW Health activities 39 3.3.2 Progress indicators 47 3.3.3 Stakeholder feedback 50 3.3.4 Summary and implications 51 3.4 STRATEGIC DIRECTION 4: STRENGTHENING THE ABORIGINAL WORKFORCE 53 3.4.1 NSW Health activities 53 3.4.2 Progress indicators 58 3.4.3 Stakeholder feedback 59 3.4.4 Summary and implications 60 3.5 STRATEGIC DIRECTION 5: PROVIDING CULTURALLY SAFE WORK ENVIRONMENTS AND 63 HEALTH SERVICES 3.5.1 NSW Health activities 63 3.5.2 Progress indicators 70 3.5.3 Stakeholder feedback 72 3.5.4 Summary and implications 75 3.6 STRATEGIC DIRECTION 6: STRENGTHENING PERFORMANCE MONITORING, MANAGEMENT 76 AND ACCOUNTABILITY 3.6.1 NSW Health activities 76 3.6.2 Stakeholder feedback 83 3.6.3 Summary and implications 83 4. CONCLUSIONS 86 4.1 Overview of key findings 86 4.2 Evaluation strengths and limitations 87 4.3 Recommendations 87 REFERENCES 95 TECHNICAL APPENDIX AND ADDITIONAL FINDINGS 96 NSW ABORIGINAL HEALTH PLAN 2013-2023: MID-TERM EVALUATION iv LIST OF TABLES AND FIGURES Tables 1. Formal partnership agreements between LHDs and ACCHSs 20 2. Examples of key initiatives aligning with Strategic Direction 2: Implementing what works 30 and building the evidence 3. Examples of key initiatives aligning with Strategic Direction 3: Ensuring integrated planning 43 and service delivery 4. Examples of key initiatives aligning with Strategic Direction 4: Strengthening the Aboriginal 55 workforce 5. Examples of key initiatives aligning with Strategic Direction 5: Providing culturally safe work 66 environments and health services 6. Examples of key initiatives aligning with Strategic Direction 6: Strengthening performance 79 monitoring, management and accountability Figures 1. Population by age and Aboriginality, NSW 2016 15 2. Estimated level of reporting of Aboriginal people in Admitted Patient Data, NSW 2010–11 to 2016–17 34 3. Estimated level of reporting of Aboriginal people in Admitted Patient Data by local health district/ 35 specialty health network, NSW 2010–11 and 2016–17 4. Estimated level of reporting of Aboriginal people in the Emergency Department Data Collection, 35 NSW 2010 to 2017 5. Estimated level of reporting of Aboriginal people in the Emergency Department Data Collection by 35 local health district/specialty health network, NSW 2010 and 2017 6. Estimated level of reporting of Aboriginal people (mothers) in the Perinatal Data Collection, 36 NSW 2010 to 2016 7. Estimated level of reporting of Aboriginal people in the Perinatal Data Collection (mothers) by 36 local health district, NSW 2010 and 2016 8. Unplanned emergency department re-presentations by Aboriginal status of the patient, 47 NSW 2010–11 to 2016–17 9. Unplanned emergency department re-presentations in Aboriginal patients by local health 48 district/specialty health network, NSW 2010–11 and 2016–17 10. Unplanned hospital readmissions by Aboriginal status of the patient, NSW 2010–11 to 2016–17 48 11. Unplanned hospital readmissions in Aboriginal patients by local health district/specialty health 48 network, NSW 2010–11 and 2016–17 12. Elective surgery patients treated on time by Aboriginal status of the patient, NSW 2010–11 to 2016–17 49 13. Aboriginal elective surgery patients treated on time by local health district/specialty health 49 network, NSW 2010–11 and 2016–17 14. Unplanned mental health readmissions by Aboriginal status of the patient, NSW 2010–11 to 2016–17 49 15. Proportion of NSW Health staff who identify as Aboriginal, 2011–12 to 2016–17 58 16. Proportion of NSW Health staff who identify as Aboriginal by local health district/specialty health 58 network, 2011–12 and 2016–17 17. Proportion of NSW Health staff who identify as Aboriginal by salary band, 2012–13 to 2016–17 59 18. Proportion of NSW Health staff who identify as Aboriginal by salary band, 2016–17 59 19. Proportion of NSW Health staff who identify as Aboriginal by Treasury Group, 2016–17 59 NSW ABORIGINAL HEALTH PLAN 2013-2023: MID-TERM EVALUATION v 20. Self-reported overall experience of hospital care by Aboriginal status of the patient, NSW 2014 70 21.
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