Communique from the Co-Chairs of the Governance Advisory Panel - 1 November 2022
The Child Safe Governance Review Governance Advisory Panel (the Panel) met for the sixth time on Tuesday, 1 November 2022 via Microsoft Teams.
The meeting agenda focussed on:
- a report from the Chair of the Lived Experience: Expert Reference Group
- a further presentation and discussion on governance and organisational structures at the Launceston General Hospital (LGH)
- a presentation and discussion on the establishment of the independent central complaints management unit
Report from the Chair of the Lived Experience: Expert Reference Group
Dr Maria Harries spoke about her continued work with the members of the Lived Experience: Expert Reference Group, many of whom are experiencing significant trauma following the Commission of Inquiry.
Victim-survivors have shared their lived experiences with Dr Harries as well as their thoughts on what needs to change to ensure the safety of children when accessing health services.
Victim-survivors have indicated that they are very keen to see the Recommendations from the Governance Advisory Panel.
Dr Harries reported that there continues to be a need to reassure the victim-survivors about the authenticity of the commitment to hearing and paying attention to their voice. Having faith that things will change is a big challenge for them at this time.
The Panel continues to stress the importance of the ongoing advice from those who have been and continue to be traumatised by historic and ongoing sufferings.
Launceston General Hospital Governance and Organisational Structures
Mike Wallace, Principal Adviser at the Australian Commission on Safety and Quality in Health Care presented to the panel on the governance and organisation structures of the LGH, including the tier two executive structure, as well as executive committee and accountability structures.
A number of recommendations were proposed to the Panel. Based on the discussion in the meeting these recommendations will be further refined out-of-session for inclusion in the final report from the Panel.
The final structure will ensure, that everyone – from frontline clinicians to managers, and members of the executive team – is accountable to patients and the community for assuring the delivery of health services that are safe, effective, integrated, high quality and continuously improving. The Chief Executive Hospitals North will be responsible for driving accountability in the new structure and leading the implementation of good governance arrangements including culture change at the LGH and more broadly across Hospitals North.
Further to this, the entire executive must work as a team and take collective responsibility and accountability for effective service delivery, performance and culture both at the LGH and across Hospitals North.
The final structure, in conjunction with Statements of Duties, will provide clarity for individual executive responsibilities.
The matter of where responsibility for child safeguarding sits and the position of a child safety unit in the structure will be discussed at the 15 November 2022 meeting of the Panel when the Deputy Secretary responsible for implementing the Child Safe Organisation Framework presents to the Panel.
Independent Central Complaints Management Unit
Representatives from the Project Team, including KPMG presented to the Panel, providing further detail to the Panel on the review of complaints management that is currently being undertaken across Department of Health (DoH) and the Tasmanian Health Service (THS).
The presentation spoke to actions already undertaken and resources already in place, including the development of an online complaints form which is now available on the DoH website.
An overview was provided of the current models for management of complaints, as well as the scope of the complaints review project, which included the approach being taken to review current models, the issues that have been identified and consultation and key considerations for developing a future model.
The Panel considered a number of recommendations presented to the GAP, including:
- review the DoH and THS policy framework for complaints to establish a consistent statewide approach. The policy and procedure should include a one-page flow chart for simple communication of the process for staff
- establish delegations of authority and escalation requirements for managing complaints
- develop a strong and committed culture around complaints management and strengthen support for staff involved in complaints
- map training requirements and ensure relevant staff are provided appropriate training to uplift capability
- explore and deliver technology upgrades where required and
- establish key executive reporting requirements and ensure regular reporting is undertaken both internally and externally.
A timeline for the implementation of the complaints management review has been developed and broken down to immediate and longer-term initiatives.
It was clarified by the project team that the existence of the statewide Complaints Management Oversight Unit (CMOU) does not remove the need for complaints to be managed at the point where the problem arises.
The Panel recommended that the following operational principles are included in the state-wide policy:
- In all cases, the aim will be to resolve the matter quickly, efficiently and to preserve the relationship between the person making the complaint and the health organisation.
- Most complaints will be dealt with directly and quickly at the point where the problem arises and to resolve the concern in the same interaction where possible
- Complaints will be acknowledged within 5 days of receipt of the complaint with an aim to resolve the complaint within 35 days from the date the complaint is received.
The model proposed will still see the majority of complaints management being undertaken at the local level, with the CMOU providing independent oversight to ensure complaints have been appropriately triaged and assessed, and that key insights are shared across the DoH and THS.
It was noted by members of the Panel that the LGH needs to rebuild the trust of the community and demonstrate to them that if they make a complaint, it will be managed appropriately. Establishing a consistent statewide approach to managing complaints is the first step to doing this, but it will take time to embed the approach and demonstrate to the community that it is working.
The Panel agreed that consideration should be given to whether there is a need to recommend a role for a patient advocate at the hospital. Dr Maria Harries will discuss this suggestion with victim-survivors through the Lived Experience: Expert Reference Group.
The design and implementation of the new approach to complaints management including the communication strategy should be co-designed with patients/consumers and families.
The next meeting of the Governance Advisory Panel is an extraordinary meeting scheduled for 8 November 2022 and will be held online via Microsoft Teams.
This meeting will be focussed on the incident management system and open disclosure including the use of the Safety Reporting and Learning System (SRLS).
The meeting will include an overview of the National Safety and Quality Health Service (NSQHS) standards, the experience of frontline staff members who use the SRLS regularly, as well as a demonstration of the system using case studies and analysis of feedback on incidents.