Health criticised for failing to show PHNs are delivering

The Department of Health and Ageing has failed to show the Primary Health Network (PHN) model is delivering its objectives, an audit has found.

Blair Comley: need to improve PHN performance management recognised

It also found the IT system used to monitor the performance of Australia’s (PHNs) isn’t up to scratch, and calls on Health to implement something that’s fit for purpose.

PHNs are non government organisations but are funded via government grants and have received $11.6 billion over the last nine years.

They were established by the health department in 2015 to improve efficiency, quality of service, and access to care.

There are currently 29 PHN providers responsible for 31 regions across Australia working across Aboriginal health, population health, workforce, digital health, aged care, and drugs and alcohol.

However when it comes to performance management Health needs to lift its game, according to a new audit report.

“Health has not demonstrated that the PHN delivery model is achieving its objectives,” the report by Auditor General Grant Hehir says.

No evaluation plans

The audit looked at whether Health is appropriately monitoring compliance and performance of individual PHNs, as well as the overall performance of the PHN delivery model.

Auditor-General Grant Hehir

It concluded the department has only been partly effective in its performance management of PHNs.

Health had no evaluation plans for the PHN delivery model after 2018, and hasn’t conducted a comprehensive delivery model evaluation of the program, Mr Hehir said.

“A 2018 early implementation evaluation was inconclusive about the achievement of objectives at that early stage in the delivery model’s implementation,” he says.

“A lack of baseline and relevant performance data impedes understanding of whether the delivery model has met its objectives.”

Mr Hehir found compliance and assurance arrangements were largely fit for purpose, but assurance was weakened by record keeping practices and a lack of public transparency.

He found performance measurement and reporting only partly fit for purpose, with public performance reporting neither timely nor informative.

IT system ‘limited’

The report was most critical about IT systems for PHN performance, describing them as not fully fit for purpose.

The report says the PHN Program Electronic Reporting System (PPERS), developed in 2019, has has limited capability to validate and analyse data, and limited capability to generate compliance and performance reporting.

The report makes eight recommendations, including that Health put in place a “fit-for-purpose IT system for administering Primary Health Networks that supports the accurate capture and reporting of compliance and performance information”.

The health department has welcomed the findings and accepted most recommendations.

In his response to Mr Hehir, Health Secretary Blair Comley said the department recognised the need for improvement, including “stronger governance to ensure compliance with requirements, improved performance measures… further data assurance and risk oversight, enhanced performance reporting that is timelier and more transparent.”

Mr Hehir said the report underscored the need for proper evaluation frameworks when developing new government programs, and transparency over grant expenditure.

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