Service Delivery Framework for hearing services in Australia

The Service Delivery Framework aims to provide a range of benefits for hearing service providers and clients, in that it sets a clear and consistent outline for the delivery of hearing services in accordance with best practice, and focuses on client outcomes, confidence and trust, as well as encouraging continuous quality improvement. 

The journey toward a safety and quality regulation model

The Australian Government Hearing Services Program (the program) was established in 1997 and provides assessment and hearing devices through a voucher scheme for eligible clients, as well as specialised services for specific groups through a Community Service Obligations arrangement delivered by Australian Hearing.  These services are currently provided by approximately 270 private providers, offering services out of approximately 3000 sites, accredited with the program.

The program places quality obligations on accredited service providers, and requires practitioners to be members of a professional association. These obligations do not extend beyond services delivered to program clients. There is currently no nationally consistent safety and quality regulation or accreditation system in place for the entire hearing services sector. With the full roll out of the National Disability Insurance Scheme (NDIS) in mid-2019, there will be a requirement for service providers to be certified under the NDIS Quality and Safeguarding Framework, should they wish to deliver services to NDIS clients. Or alternatively the NDIS may mutually recognise established regulatory models already in place.

In late 2015 and early 2016, in partnership with the hearing sector through the Hearing Care Expert Reference Group (HCERG), a potential Service Delivery Framework (Framework) for hearing services was developed in an effort to introduce a nationally consistent approach that the NDIS could recognise.  Initially, work was focused on developing a new set of standards for practices and clinicians (draft Quality Principles and National Practice Standards for Hearing Care Practitioners). This was to compliment the established hearing sector codes of conduct, clinical guidelines and scope of practice documents, governed by the professional associations that guide the delivery of hearing care services by clinicians.  In May 2016, the draft Quality Principles and National Practice Standards were released for public consultation.

Implementation Planning Steering Group

In July 2016, an Implementation Planning Steering Group (Steering Group), made up of hear sector industry, professional and consumers representatives, was established to develop the most appropriate hearing sector self-regulation model for the draft Quality Principles and the National Practice Standards, including the governance and implementation arrangements.  A discussion paper which included independent research and analysis of potential regulatory model options was developed for the Steering Group.  The discussion paper considered a number of assessment processes, certification methods, regulatory and governance models in detail. Additionally, the Steering Group approached the Australian Commission on Safety and Quality in Health Care (the Commission) regarding its Australian Health Services Safety and Quality Accreditation (AHSSQA) Scheme. Further information was sought on the National Safety and Quality Health Services (NSQHS) Standards (second edition) for acute settings, and the development of similar standards for primary care settings within which hearing services could be included.

A mapping exercise was conducted by the Commission and provided to the Steering Group members for review in January 2017. The mapping of both sets of standards demonstrated that the NSQHS Standards (second edition) for acute settings cover all of the requirements of the draft Quality Principles.

Outcome of the Steering Group

Following consideration of the various regulatory model options, the Steering Group unanimously agreed that the most appropriate option would be to include hearing services in the development of the NSQHS Standards for primary care settings, governed by the Commission under the AHSSQA Scheme.

The following key factors lead to this outcome

• The Code of Conduct  and Scope of Practice (governed collectively by the professional associations), were not in place at the time of the Framework development, and these have now been in place since July 2016;
• The implementation, governance, and self-regulation of the draft Quality Principles requires significant investment by the hearing industry, which may not be sustainable;
• The Commission has the established AHSSQA Scheme being adapted for primary care;
• The AHSSQA Scheme uses a risked-based approach to protect the quality of services to the most vulnerable consumers, so that they receive a high quality of care; and
• The NDIA has indicated support for the approach to developing the NSQHS Standards for primary care, given that it would provide efficient and streamlined regulation of Government funded services.

Components of the Framework

The purpose of the Framework remains the same – to ensure that clients receiving hearing care services achieve the best possible outcomes. Beneath this are a number of distinct but interrelated components that will contribute to a safety and quality assured system that supports the delivery of hearing services and the outcomes of individuals.
 

Pyramid Diagram - Components of the Framework

Next steps

The Commission has established a project steering committee to provide expert advice and oversight on the development of the NSQHS Standards for primary care settings. The project steering committee includes representatives from 15 different primary care stakeholder organisations and consumers, including the hearing sector.

The Commission will work with the project steering committee as well as primary care stakeholders more broadly on developing an implementation plan for the NSQHS Standards for primary care settings over the course of this project.

Public consultation

The Commission has released a public consultation paper -  Patient safety and quality improvement in primary care – October 2017,  and is seeking feedback from primary care stakeholders.

Further Information

For enquiries or to make comments on the outcomes of the Steering Group please contact the program

Phone 1800 500 726

E-mail hearing@health.gov.au

For further information in relation to the development of the NSQHS Standards for primary care settings and public consultation please refer to the information provided on the Commission website www.safetyandquality.gov.au.