Communique from the Co-Chairs of the Governance Advisory Panel - 20 September 2022
The Child Safe Governance Review Governance Advisory Panel (the Panel) met for the third time on Tuesday, 20 September 2022 in Launceston.
The meeting agenda focussed on:
- a report back from the Chair of the Lived Experience: Expert Reference Group
- a report from the Co-Chairs regarding their meeting with the Chair of the Consumer and Community Engagement Council
- the North / North West and Launceston General Hospital senior executive leadership roles and structure and
- child safety reforms, including at the LGH.
Report from the Chair of the Lived Experience: Expert Reference Group
Dr Maria Harries, spoke about her continued work with those who expressed interest in the Lived Experience: Expert Reference Group to enable input from the lived experience of victim-survivors to the Panel.
Dr Harries informed the Panel that she has now met with victim-survivors who have expressed an interest in participating in this group.
Dr Harries noted that victim-survivors have been understandably focussed on the continuation of the Commission of Inquiry hearings in Hobart in early September 2022.
Dr Harries’ initial focus is in building a trustful relationship with participants. It is critical that it is clear to participants what the Panel is trying to achieve, what their role will be, why the timelines have been set, and that the Panel is committed to hearing what participants have to say.
Report from the Co-Chair on the Meeting with the Chair of the Consumer and Community Engagement Council
The Co-Chair of the Panel, Debora Picone, provided a report on a meeting between the Co-Chairs and Peter O’Sullivan, Chair of the THS Northern Consumer and Community Engagement Council (CCEC).
The Co-Chair noted that from the discussion, the group appears to be working well and is well embedded in hospital governance through their involvement on a number of executive committees, involvement in the Root Cause Analysis process and through their contribution to ongoing accreditation processes.
At the suggestion of the Chair of the CCEC, the Co-Chairs have committed to a further meeting with the full membership of the CCEC.
Senior Executive Leadership Roles and Structure
Michael Wallace, Principal Adviser at the Australian Commission on Safety and Quality in Health Care, who is highly experienced in health service administration and management, presented to the Panel on the current executive structure of Hospitals North / North West and the Launceston General Hospital and recommendations for changes for the Panel’s consideration.
The Chief Executive Hospitals North / North West and the Director LGH Operations were in attendance during the presentation to answer questions from Panel members.
There was a general consensus of the Panel that dedicated senior executive leadership focus on the LGH was urgent and essential to commence the necessary organisational renewal and achieve implementation of critical reforms. These reforms include a clearer and stronger accountability framework, a more pro-active and responsive child patient safety system through effective implementation of the Child Safe Organisation Framework, and improvement in culture, staff morale and engagement.
The Panel also considered that senior leadership renewal to achieve a consistent and sustained focus on these reforms over both the immediate and longer term would be a critical contributor to their success.
The Panel also noted that allied health should be represented at the second tier of hospital leadership, as is presently the case for medical services, and nursing and midwifery services, in the interests of an integrated multi-professional approach to leadership and management of the LGH.
In light of the above, the Panel determined to make a number of interim recommendations regarding the Executive structure at the LGH:
- that the position of Chief Executive Hospitals North / North West be replaced by two distinct senior executive roles being a Chief Executive for the North, encompassing the LGH and primary and community services and smaller facilities in the northern region, and a similar position of Chief Executive for the North West region.
- that the position of Chief Executive Hospitals North be created, advertised and filled on merit, with a key focus of the recruitment being organisational renewal and the ability to lead organisation wide cultural change.
- that the Director of Allied Health should sit at the second tier of the LGH executive structure and
- that the Executive Director of Nursing position should be retitled Executive Director Nursing and Midwifery to properly reflect its professional accountabilities.
The Panel will further consider the more detailed organisational structure of the LGH below the senior executive leadership tiers, as well as critical governance committee structures, at a future meeting.
Reporting Child Safety Concerns
Frances Hall, Project Manager for the Child Safe Organisation Project attended for a Panel discussion on reporting of child safety concerns.
Frances also provided an update from the Panel working group that was tasked with providing practical insights and input to the Child Safe Organisation Project based on their experience working at LGH. Frances advised that the feedback from the working group is being factored into the work of the Child Safe Organisation Project.
The Panel agreed that the child safety training which is now being rolled out by the Child Safe Organisation Project Team using a targeted approach, should be mandatory across the Tasmanian Health Service, with consideration also given to refresher training at appropriate intervals as part of that implementation. The Panel asked for further information on the program of mandatory training as it related to Launceston General Hospital.
The Panel also discussed the availability of appropriate resources on the ground at the LGH to assist and support staff in assessing and reporting concerns around child safety. The Panel was advised that there is currently a part-time Child Safety Liaison Officer position on site at the LGH, provided by the Department of Communities Tasmania.
The Panel noted that for those staff who were not routinely involved with the child safeguarding systems, and for which the need to report child safety concerns was rare, simplicity and ease of access to a reporting protocol was essential.
Considering the above, the Panel determined to make a number of interim recommendations in relation to safeguarding children at the LGH:
- That a simple, concise protocol and flow chart, preferably one page, communicating relevant contact points and details for the reporting of child safety concerns be immediately developed by the Child Safe Organisation Project to give all staff at the LGH clarity around how to report child safety concerns under current arrangements. The Panel has requested that this work be prioritised and tested with those frontline LGH staff on the Panel over the next few weeks.
- That the size and complexity of the LGH warrants full-time resources for child safety liaison and the establishment of a dedicated Child Safe unit to support the reporting and training in child safety at the LGH under the Child Safe Organisation Framework and to provide expert advice to staff where needed.
- That the key executive management responsibility for ensuring oversighting child safeguarding at the LGH be clarified as a matter of urgency and the Child Safe unit report to this executive position.
The next meeting of the Panel is scheduled for 4 October 2022 and will be held via Microsoft Teams.
The meeting will be focused on the management of complaints, including:
- a presentation and discussion on the current LGH complaints management system, including from the consumer perspective
- a presentation on complaints management from external experts in complaints management and
- a presentation and discussion from the project team managing the implementation of a central complaints management unit in the Office of the Secretary.
Chief Medical Officer, Professor Tony Lawler, will also lead a discussion on the current requirements for mandatory reporting to Ahpra.
The Panel has also agreed to include an additional special meeting in its forward agenda to look further into the operation and governance of the Safety Reporting and Learning System at LGH.