National Aboriginal Community Controlled Health Organisation

Strategic Plan 2011 2014

Contents
MESSAGE FROM THE CHAIRPERSON_________________________________ 1 OUR PRINCIPLES AND ASPIRATIONS _________________________________ 3 Our constitutional objectives ____________________________________________ 3 Our guiding principles ___________________________________________________________ 3 Our vision ______________________________________________________________________ 4 Our values _____________________________________________________________________ 4 MEMBERSHIP AND GOVERNANCE ___________________________________ 5 Membership ____________________________________________________________________ 5 Governance ____________________________________________________________________ 5 STRATEGIC DIRECTIONS ___________________________________________ 7 Overview _______________________________________________________________________ 7 1: Shape the national reform of Aboriginal health __________________________ 7 2: Promote and support high performance and best practice models of culturally appropriate and comprehensive primary health care ________________________ 7 3: Promote research that will build evidence-informed best practice in Aboriginal health policy and service delivery _______________________________________ 7 CONTACTS ______________________________________________________ 15

NACCHO Strategic Plan: 2011-2014

Message from the Chairperson

I am pleased to present this new strategic plan which will take NACCHO forward in a focused, achievable and effective way. In the struggle to Close the Gap, a struggle in which NACCHO has many willing partners, it is time to take a leap forward and leave behind the incremental change we have seen up to now. Our plan has three main strategic directions that are as vital as each other in taking us forward. The first, to Shape the national reform of Aboriginal health, makes it clear that we need to embark on a new process of reform at the national level. The last major national reform was the transfer of responsibility for Aboriginal health to the Department of Health and Ageing back in 1995. Our sector led the advocacy for this change and it was the springboard we needed to greatly increase the amount of funding now available for Aboriginal health service delivery. This included much better access to the MBS and PBS as well as grant funding. Unfortunately, these funds have not systematically flowed into the creation of new and enhancing existing Aboriginal community controlled health services even though this is the best practice model agreed in the national strategic plan. There are systemic barriers within government to transforming of the health system in favour of Aboriginal community controlled comprehensive primary health care. Once again, national reform is needed to address these barriers so that our people can access the highest quality, culturally safe community controlled health care in a way that builds our responsibility for our own health. This requires existing health funds to be better invested. This leads into our second strategic direction which is to promote the quality and effectiveness of our services and for greater recognition that Aboriginal community controlled health services are the best practice model for Aboriginal people. This was recognised in the recent report from the National Health and Hospital Reform Commission. It is time for a more effective pathway to community controlled primary health care to enhance the quality and effectiveness of the health system for our people. Finally, this plan is clear that the Gap cannot be closed by the health system alone even if we achieve our goal of reforming the health system so that there is a greater focus on Aboriginal community controlled health services. This is necessary but not sufficient by itself. We must also address the social determinants of health, beyond access to health services. This is possibly our biggest challenge and it is taken head on in this plan. This includes the need to ensure that we have strong research to build an evidence base to guide our policy development. Strategic direction three is to Promote research that will build evidence-informed best practice in Aboriginal health policy and service delivery. We must get better educational outcomes for our people. This needs to be seen as central to our struggle for health improvement, but how best do we achieve this? One key part of this is to focus on the early childhood environment of our kids so that they grow up well nurtured and stimulated and free from adverse events such as violence in the home. But how can this be best achieved? We know that better education 1

NACCHO Strategic Plan: 2011-2014 leads to better jobs, higher income, more control and better health but we need to do more to achieve these outcomes. NACCHO has always understood this holistic concept of health and we all have a responsibility to work together to address the social determinants of health. This means at the local community level our community controlled health services need to lead action to address these social determinants. At the state and territory level our Affiliates need to lead action to address these determinants. At the national level; this plan commits NACCHO to providing stronger leadership than even before we must move forward more quickly and not accept the very slow pace of change. Australia can do better than this. Finally, at the level of each and every Aboriginal person there is also a responsibility to join the struggle. Together we can make a difference. I am proud to lead NACCHO in these directions and to continue the tradition of a struggle that has so characterised the Aboriginal community controlled health movement.

Yours in the struggle,

Justin Mohamed Chairperson

NACCHO Strategic Plan: 2011-2014

Our principles and aspirations

NACCHO is the national peak body for Aboriginal health. It is entrusted to represent the needs and interests of Aboriginal health on behalf of its Members in the national arena. It supports State and Territory peak Aboriginal Community Controlled Health bodies - its Affiliates - to do this at a jurisdictional level, and works collectively with them to address shared concerns on a national basis. NACCHO has and continues to be a living embodiment of the aspirations of Aboriginal communities and their struggle for self-determination. NACCHO and the community controlled comprehensive primary health care services who are its Members are enduring examples of community initiated and controlled solutions to the deep-rooted social, political and economic conditions that prevail in many Aboriginal communities and need to be addressed along with the delivery of essential health care. In the contemporary context they represent the only truly effective and culturally valid mode of delivering effective and sustainable primary health care services to Aboriginal Peoples.

Our constitutional objectives

NACCHOs long-term objectives as an organisation are defined within its Constitution. To ameliorate poverty within the Aboriginal community. The advancement of Aboriginal religion. To provide constructive educational programs for Members of the Aboriginal community. To deliver holistic and culturally appropriate health and health related services to the Aboriginal community.

Our guiding principles

NACCHOs guiding principles are based on the Ways Forward Report (Swan & Raphael 1995). They are: The National Aboriginal Health Strategy (1989) definition of health. The Aboriginal concept of health as holistic. The right to self-determination. The impact of history in trauma and loss. The need for cultural understanding. The recognition of human rights. The impact of racism and stigma on Aboriginal Peoples lives.

NACCHO Strategic Plan: 2011-2014 The recognition of the centrality of kinship. The recognition of diverse communities and different needs. The strengths of Aboriginal Peoples. The right to have universal access to basic health care. The need for high quality health care services. The need for equitable funding for health care. NACCHO is only as strong as the participation of its Members and Affiliates. Thus two-way feedback, advice and support from our Members and Affiliates are implicit in all we do. Aboriginal Peoples and Torres Strait Islanders have different cultures and histories and in many instances different needs. Nevertheless, both groups are affected by the problems that face them as unique Australians. The differences must be acknowledged and may need to be addressed by locally developed, specific strategies.

Our vision
NACCHOs vision is for Aboriginal Peoples to be: Sovereign Aboriginal Peoples with a state of well-being, consistent with our holistic concept of health, at least equal to that which existed prior to invasion and colonisation, enjoying all the rights and responsibilities inherent in our unceded sovereignty.

Our values
Our core values are embedded in the following: Aboriginal Community Control An holistic, comprehensive Primary Health Care approach A ground-up approach to planning, policy development and implementation Aboriginal cultural integrity Co-ordinated and integrated activity Strategic partnerships and alliances Proactive and responsible action Respect and loyalty Equity Quality

NACCHO Strategic Plan: 2011-2014

Membership and governance

Membership
Membership of NACCHO is open to Member organisations of our State or Territory peak Aboriginal Community Controlled Health Organisations (ACCHSs) affiliated with NACCHO that have been deemed by the respective peak body to have met the following criteria for Membership: an incorporated Aboriginal organisation initiated by a local Aboriginal community based in a local Aboriginal community governed by an Aboriginal body that is elected by the local Aboriginal community delivering a holistic and culturally appropriate health service to the Community that controls it. Under the Articles of Association NACCHO Membership does not permit: organisations controlled by Government to any extent organisations that do not provide holistic comprehensive primary health care services. The NACCHO Constitution also provides for Associate Membership status this means Aboriginal Community Controlled Health Committees, which are elected by a local Aboriginal community with the objective of establishing a Local Aboriginal Community Controlled Health Service, yet deemed by a State or Territory peak Aboriginal community controlled health body affiliated with NACCHO and the NACCHO Board not to have yet met the NACCHO criteria for membership but who are recognised by NACCHO to exercise an essential part in the enhancement of Community Controlled Aboriginal Health Services.

Governance
The NACCHO Board
The 150 ACCHSs that are NACCHO members directly elect the 16-person NACCHO Board. It is made up of one delegate each from the ACT and Tasmania, two delegates each from the remaining six jurisdictions, and a Chairperson and Deputy Chairperson. Elections for delegates to the NACCHO Board are held annually to coincide with each Affiliates Annual General Meetings. However, the full NACCHO Membership elects NACCHOs Chairperson and Deputy Chairperson for three-year terms at triennial Annual General Meetings of NACCHO Members.

NACCHO Strategic Plan: 2011-2014 The NACCHO Boards role is to meet at least two and up to four times each year to: make decisions regarding the strategic policy directions of the organisation develop, monitor and review the NACCHO Strategic Plan, approve the annual business plan, and monitor its implementation through six monthly reports against agreed KPIs maintain and strengthen connections between the Affiliates, Membership and the NACCHO Board.

Effective governance
The keys to the effective governance of NACCHO are the performance of its Board and the quality of three sets of working relationships: namely, between the Chief Executive Officer and the Board Chairperson, between the NACCHO Board and Members, and NACCHOs relationship with its Affiliates.

The Chief Executive Officer - Board Chairperson relationship

The basis for healthy working relationships with the Secretariat is a strong, cooperative and respectful relationship between the CEO and the Board Chairperson based on their different but complementary roles. The NACCHO Board sets organisational priorities and develops the Strategic Plan under the leadership of the Chairperson and with active support from the CEO. The Chairperson liaises with the CEO to ensure these priorities are understood and translated into agreed activities that the Secretariat undertakes through an annual Business Plan. This is monitored by the CEO and progress reviewed with the Chairperson and Board.

The NACCHO Board - Membership relationship

Maintaining and strengthening the connections between the Membership and the NACCHO Board is a responsibility for all 16 NACCHO Board Members, especially through their positions on Boards of our Affiliates. It also involves special attention from the Chairperson and Deputy Chairperson of NACCHO.

The NACCHO - State and Territory NACCHO Affiliates relationship

NACCHO Board Members are aware of NACCHO Member expectations and priorities through their direct contact and direction at meetings of their jurisdictional Affiliate. This is a significant advantage that NACCHO possesses over many other national peak bodies. NACCHO and its Affiliates have a strong working relationship. To ensure the most effective way of channeling the high volume of two-way communication required to coordinate feedback on policy development, advocacy, and priorities at a national level, ongoing improvement strategies are fostered. NACCHO has coordinated many national projects involving its Affiliates, so there is a long-standing history of collaboration to achieve shared goals that result in benefits at a jurisdictional and national level. The NACCHO Board has also endorsed a process to out-source national projects, within the parameters of expertise within our Affiliates, to ensure an effective and stronger working relationship between all our peak organisations. 6

NACCHO Strategic Plan: 2011-2014

Strategic directions
Overview
NACCHOs Strategic Directions over the next three years will focus on three central areas that are consistent with its constitutional objectives. Strategic Direction 1: Shape the national reform of Aboriginal health. Strategic Direction 2: Promote and support high performance and best practice models of culturally appropriate and comprehensive primary health care Strategic Direction 3: Promote research that will build evidence-informed best practice in Aboriginal health policy and service delivery. The work to address the Strategic Directions is outlined below. Each Strategic Direction has objectives and several key strategies that will be implemented to achieve the objective over the next three years. The listed indicators will determine how well NACCHO is progressing under each Strategic Direction. They are divided into process and impact indicators. Process indicators are used to judge the effectiveness and appropriateness of strategies, and focus on issues of satisfaction, quality, audience and reach. Impact indicators are used to judge progress toward or achievement of objectives and focus on difference or change.

NACCHO Strategic Plan: 2011-2014

1: Shape the national reform of Aboriginal health

Objective 1: To increase the ACCH Sectors involvement and authority in
determining how Aboriginal health is funded, managed and monitored in the national health reform process.

Impact indicators
Impact 1.1: The ACCH Sector is regularly involved in decision-making on how Aboriginal health is funded, managed and monitored through the national health reform process. Impact 1.2: The authority of the ACCH Sector in how Aboriginal health is funded, managed and monitored is consistently recognised and respected by Government and other health stakeholders.

Rationale: As a NACCHO guiding principle, the right to self-determination means

having the authority to determine how health services and related-activities are designed, managed and monitored for Aboriginal Peoples. NACCHO is the only remaining legitimate and truly representative national organisation for Aboriginal communities serviced by ACCHSs covering remote, rural and urban areas. This enables NACCHO to clearly articulate the health concerns of Aboriginal Australia, propose culturally appropriate and relevant models of service delivery, and determine whether reported health outcomes represent real and substantial change for Aboriginal communities. NACCHO offers a vital resource to the national health reform process that has yet to be fully realised. It can be involved more effectively in a consistent and ongoing manner to set the public health agenda and determine how to fund, monitor and report on health activities and outcomes. The authority vested in NACCHOs voice will be a critical factor in achieving Australias shared aspirations to close the gap in health outcomes for Aboriginal Peoples.

Strategies
1.1 Advocate for the establishment of a National Aboriginal and Torres Strait Islander Health Authority.

Process indicators
Process 1.1: There is high-level and sustained support for a National Aboriginal and Torres Strait Islander Health Authority.

1.2 Initiate and contribute to whole of Process 1.2: NACCHO has a strong track Government initiatives, particularly those record in initiating and contributing to whole addressing the social determinants of health of Government initiatives focused on the for Aboriginal Peoples. social determinants of health. 1.3 Liaise and work with key Federal Ministers and Government agencies on a regular basis. Process 1.3: NACCHO works with Federal Ministers and Government agencies that help address the social determinants of health on a consistent basis.

NACCHO Strategic Plan: 2011-2014

Strategies

Process indicators

1.4 Advocate for a streamlined approach to Process 1.4: NACCHO is satisfied with Government funding and reporting in the how Government agencies adopt the ACCH Sector, including a shift to function- following as standard approaches: based rather than position-based funding. logical and streamlined planning and reporting systems that reduce duplication function-based funding. 1.5 Support Affiliates and Members to advocate and enable Aboriginal health services to transition into ACCH Services. 1.6 Strengthen and maintain cooperative relationships and partnerships with a broad range of stakeholders across the health sector. 1.7 Advocate for NACCHO to have observer status at the Australian Health Ministers Advisory Council (AHMAC). 1.8 Advocate for the 2003 National Strategic Framework for Aboriginal Torres Strait Islander Health and associated biannual report against key indicators to be updated. Process 1.5: NACCHO Affiliates and Members are satisfied with the nature and level of NACCHO support for transitioning to ACCH Services. Process 1.6: NACCHO has extended the number, range and quality of relationships and partnerships it has with stakeholders across the health sector. Process 1.7: Observer status is granted for NACCHO at AHMAC meetings on an ongoing basis. Process 1.8: NACCHO plays a prominent role in updating the National Strategic Framework for Aboriginal Torres Strait Islander Health and associated key indicators that align with other relevant indicators (i.e. Closing the Gap and COAG initiatives), which is completed by 2013.

NACCHO Strategic Plan: 2011-2014

2: Promote and support high performance and best practice models of culturally appropriate and comprehensive primary health care
Objective 2a: To increase the profile of the ACCH Sectors comprehensive
primary health care model and achievements.

Objective 2b: To improve the capacity of the ACCH Sector to provide best
practice comprehensive primary health care, and monitor and report the outcomes of care.

Impact indicators
Impact 2.1: The ACCH Sector comprehensive primary health care model is consistently recognised and supported by Government and other health stakeholders as the best practice model for providing culturally appropriate services for Aboriginal Peoples. Impact 2.2: Australian Government funding decisions and allocations in Aboriginal health reflect the achievements and capacity-strengthening needs of the ACCH Sector. Impact 2.3: The ACCH Sector has ready access to data and information on the impact and value of comprehensive primary health care for Aboriginal Peoples.

Rationale: Our commitment to Aboriginal concepts of health as holistic, recognition

of diverse communities and different needs and the right to have universal access to basic health care has resulted in NACCHO Members developing a culturally appropriate comprehensive primary health care model that is adaptable to a variety of locations. In fact, NACCHO Members ability to service areas in which few or any access to health care is available has increasingly been used as the recommended model for the delivery of services in difficult to access and often forgotten or hidden areas of Australia. It is a critical part of achieving health equity for all Aboriginal people throughout Australia. While there is increasing evidence for the effectiveness of the ACCH Sectors culturally appropriate comprehensive primary health care model, the model and its achievements needs to be profiled on a broader basis so it is recognised and supported more effectively. Opportunities to enhance the model and ensure the ACCH Sector has the capacity to deliver, monitor and report on best practice health services are also required. This aligns with NACCHOs guiding principle of ensuring Aboriginal people have access to high quality health care services.

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NACCHO Strategic Plan: 2011-2014

Strategies

Process indicators

2.1 Document and distribute information on Process 2.1: A broad range of stakeholders the ACCH Sectors comprehensive primary in the health sector have access to health care model and achievements in a information on the ACCH Sectors variety of formats to a broad range of comprehensive primary health care model in stakeholders in the health sector. one or more formats. 2.2 Coordinate and hold an annual NACCHO Advocacy Day and NACCHO National Symposium on best practice in Aboriginal health. 2.3 Advocate for active involvement of the ACCH Sector in making equitable and needs-based funding decisions in ACCH Sector identified priority areas. Process 2.2: The NACCHO Advocacy Day and NACCHO National Symposium are standard annual events that effectively profile NACCHOs top priority issues. Process 2.3: The ACCH Sector is regularly and actively involved in making funding decisions that reflect demonstrated needs across all priority areas.

2.4 Develop and coordinate national Process 2.4: NACCHO Affiliates: capacity-strengthening and information actively participate in agreed sectorsharing initiatives in collaboration with wide initiatives focused on high priority Affiliates, such as: needs governance and member support are satisfied with the nature and level of IT workforce development NACCHO coordination and support. data and information monitoring, pooling and reporting the quantity and quality of ACCH service infrastructure. 2.5 Advocate for recognition of and action Process 2.5: The ACCH Sector is regularly on the key social determinants of health involved in profiling the importance of beyond the health system. addressing the social determinants of health beyond the health system. 2.6 Foster workforce supply for the ACCH Process 2.6: NACCHO Affiliates: Sector and build a national framework that actively participate in developing supports recruitment and retention of the strategies that address workforce workforce. supply, recruitment and retention are satisfied with the nature and level of NACCHO coordination and support.

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NACCHO Strategic Plan: 2011-2014

Strategies

Process indicators

2.7 Work collaboratively with Aboriginal Process 2.7: Aboriginal health health professional organisations to professional organisations: strengthen the status and aspirations of agree to work collaboratively with the Aboriginal health workforce, including NACCHO on initiatives that benefit the to: Aboriginal health workforce promote understanding of the full are satisfied with the nature and level scope of the Aboriginal Health of NACCHO participation and support. Worker (AHW) role gain wage parity with Government workers ensure there are realistic training, education and career pathways into the broad range of health disciplines needed within Aboriginal health services. 2.8 Develop an approach to engaging Process 2.8: Within NACCHO and across young people more actively in NACCHO the ACCH Sector young people: and across the ACCH Sector more broadly. undertake active roles in greater numbers are satisfied with the nature of these roles and the opportunities they provide. 2.9 Strengthen the culture of pride in our work across the ACCH Sector, including through an annual NACCHO Awards program. Process 2.9: NACCHO Affiliates and Members report: satisfaction with the focus and organisation of the annual NACCHO Awards program an elevated sense of pride in the ACCH Sectors work and how it is recognised.

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NACCHO Strategic Plan: 2011-2014

3: Promote research that will build evidenceinformed best practice in Aboriginal health policy and service delivery
Objective 3: To increase the quantity and application of relevant research and
evaluation in Aboriginal health.

Impact indicators
Impact 3.1: The quantity of available research and evaluation that reflects ACCH Sector priorities increases over the next three years. Impact 3.2: There is increasing evidence that ACCH Sector conducted, commissioned or initiated research and evaluation is used to shape decisions about the funding, management and monitoring of Aboriginal health.

Rationale: Research and evaluation in Aboriginal health that is conducted,

commissioned or initiated by the ACCH Sector will fulfill important functions defined in the NACCHO Constitution. Specifically, these are to: increase NACCHOs influence over the collection and analysis of Aboriginal health information and research, and undertake both collaborative and stand-alone research. Research and evaluation projects must have a clear purpose that respond to ACCH Sector priorities and help identify improvements in health experiences and outcomes for Aboriginal Peoples. The learning gained must have the capacity to shape decisions about service delivery needs and models, funding, management and monitoring in Aboriginal health. NACCHO would work with relevant organisations to source funds to undertake collaborative, independent and commissioned research and evaluation; as well as recommend how research institutes allocate existing funds or source funds to address ACCH Sector priorities.

Strategies
3.1 Work with Affiliates and Members to develop ACCH Sector research and evaluation priorities for the next triennium.

Process indicators
Process 3.1: NACCHO has a clearly defined and well promoted set of research evaluation priorities for 2011-2014.

3.2 Identify funding sources for conducting Process 3.2: NACCHO has a well or commissioning research and evaluation maintained list of research and evaluation that addresses ACCH Sector priorities. funding options that outlines conditions, focus and levels of available funding. 3.3 Strengthen and maintain cooperative relationships and partnerships with relevant research bodies that support ACCH Sector research priorities. Process 3.3: NACCHO has extended the number, range and quality of relationships and partnerships it has with relevant research bodies.

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NACCHO Strategic Plan: 2011-2014

Strategies
3.4 Share and promote research and evaluation outcomes to a broad range of stakeholders across and beyond the health sector. 3.5 Utilise research and evaluation outcomes to advocate for and protect the cultural integrity and security of the ACCH Sector, and the range of services and programs it delivers to Aboriginal Peoples.

Process indicators
Process 3.4: A broad range of stakeholders across and beyond the health sector have access to ACCH Sector conducted, commissioned or initiated research and evaluation in one or more formats. Process 3.5: NACCHO has a strong track record in using research and evaluation outcomes for protecting the ACCH Sectors: cultural integrity and security range of services and programs. Process 3.6: NACCHO has a strong track record in using research and evaluation outcomes in advocating for evidenceinformed policies that directly address the social determinants of health for Aboriginal Peoples.

3.6 Utilise research and evaluation outcomes to advocate for evidenceinformed policies to address the social determinants of health for Aboriginal Peoples.

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NACCHO Strategic Plan: 2011-2014

Contacts
If you would like to know more about NACCHOs activities please contact: The Chief Executive Officer on 02 6248 0644 or admin@naccho.org.au

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