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From Frequently Asked Questions #1

Q1 Why are there points?
 
A1 The national performance indicators will be implemented with a point system.  This has been developed as a means to increase transparency and provide clear expectations.

In any quality and performance system there has to be a basis for positioning the participants in that system. This can be done in three different ways - either by a set of minimum standards (the floor that everyone has to meet), by having a set of fixed targets (the ceiling that organisations aim for) or by having a system that assesses participants relative to each other (a comparative system that ranks participants in some way). The Government Response refers to this latter option.

There are advantages and disadvantages for each of these options and each one can work well in different contexts.  For example, minimum standards are usually about organisational structures and processes and they are not outcomes focused. Standards setting works well in some contexts ? practice accreditation standards are a good example.   Fixed goals and targets work well in some settings too.  However, ultimately, the first two options are pass/fail systems that do not lend themselves well to the profound diversity among Divisions. Neither do such systems foster the kind of agile, responsive, forward-looking continuous quality improvement system that the Divisions network wants and needs to position itself as the main player in primary health care in the 21st century. And thirdly, neither of them allow for the measurement of relative excellence.

Within a relative performance system organisations can be assessed qualitatively or quantitatively.  Qualitative assessments are much more vulnerable to value judgements and much more difficult to keep consistent.  Quantitative approaches have the disadvantage that they put numbers on things in a somewhat arbitrary way.  However, they do have the advantage of:

• providing clear expectations for the Divisions network
• providing a mechanism to support continuous quality improvement across the Divisions network
• providing appropriate recognition for more complex activities
• introducing a platform from which the system can further develop and Divisions network members can monitor improvement
  transparency in performance management
• the facilitation of consistency in performance management across the State and Territory Offices of the Department of Health and Ageing

The point system is new and will be refined over time.
 
Q2 Will Divisions receive points for their local indicators? How will these be developed and approved by the Department?
 
A2 Points will not be allocated for local indicators this year. RIC and the Performance Working Group are currently considering how to ensure the value of local indicators is best captured, ensuring fairness and consistency across Australia. It is possible that points may be allocated for local indicators in later years.
 
Q3 The documentation provided to divisions on the National Performance Indicators and the Planning and Reporting Framework uses language such as 'It is recognised the Point System is new and the first year will be one of adjustment. As the Points System may need development, it will not be used in isolation as a basis for decision making in the first year'   What happens in Years Two and Three and beyond?
 
A3 Divisions may be expected to achieve more in Years Two and Three, depending on the outcomes of Year One.  Divisions will not be penalised in the first year if they do not achieve the minimum score.  However, the experiences in Year One will inform any adaptations required in future years when the point system will become an important element in assessing Divisions? performance.

Any changes to the Points System will be communicated to Divisions by the Department via ADGP and the SBOs prior to their implementation to ensure that Divisions are fully aware of how their performance is being assessed. 
 
Q4 How were the weighting of the points developed? Is there a methodology for this development so that Divisions can understand the thinking on this issue?
 
A4 Four general principles guided the initial assessment of points.  First, indicators at high levels reflect more complex activities than indicators at lower levels and should therefore be worth more points.  Second, there should be some consistency across the levels between different domains so that, for example, choosing to focus on one domain in chronic disease management rather than another does not mean there is an in-built disadvantage in terms of points.  Thirdly, the stepped increase in the points should provide sufficient incentive to move to the next level.  Finally, higher points make it clear what is important to the Australian Government.
 
Q5 When will the 'bonus points' system be introduced? Will bonus points be percentages or ratios? Will they be set generically for all Divisions, or per Division?
 
A5 Bonus points will be available from 2006/07.  They will be percentages or ratios as appropriate to the particular indicator and set generically for the Network, based in part on performances in 05-06.  Targets for bonus points will be set in consultation with the Divisions Network.