We Asked, You Said, We Did

Below are some of the issues we have recently consulted on and their outcomes.

We asked

We asked you for your experiences, views and perspectives of health practitioners working to full scope of practice in primary care.  

You said

We received 686 online submissions from people representing a wide range of professions and roles in primary care.

We did

The review analysts will now highlight the trends and key issues form the submissions. Together with the literature review, this will paint a comprehensive picture of the current state of scope of practice in primary care, to inform the next stages of the review.

We asked

The Department of Health and Aged Care (Department) asked for your views and input on the draft aim, outcomes and actions in the consultation draft Nurse Practitioner Workforce Plan (the Plan). The draft Plan was released for stakeholder feedback from 19 December 2022 to 10 February 2023.

Targeted meetings were also held during this time to seek feedback from stakeholder organisations. Yarning circles and a consumer focus group were also held to test the actions within the draft Plan to ensure they are realistic, implementable and well received by both First Nations peoples and consumers.

Feedback received during the consultation process is being used to refine and inform the final Plan.

You said

In total, 215 submissions were received, comprising of 172 online survey responses, 25 written submissions via email, 15 targeted stakeholder meetings, 1 consumer focus group and 2 yarning circles.

The mix of responses from consumers, nurse practitioners, health professionals and organisations provided a comprehensive understanding of how the aim, outcomes and actions of the Plan were received. Feedback on improving the draft Plan was constructive with suggestions to refine language and review the action’s timeline. Whilst many responses were focused on the barriers to nurse practitioners providing care, the Department received useful suggestions for refining the draft Plan.

We did

The Department undertook analysis of the online submissions (including survey and written responses) using the Citizen Space application in February 2023. The data from online and written submissions was further analysed simultaneously with stakeholder feedback from meetings, yarning circles and focus groups. This involved coding the qualitative responses for feedback on key themes and creation of analysis notes to further refine the consultation draft. 

Stakeholder feedback captured is being used to refine the Plan and ensure the actions address key nurse practitioner workforce challenges. Suggestions proposed during this round of consultation will be considered by the Nurse Practitioner Steering Committee and used to develop a final version of the Plan for approval by Government. 

We asked

The department asked for feedback about the core capabilities to support the Intellectual Disability Health Capability Framework (framework) in an open consultation from 22 November 2022 – 27 January 2023.  The proposed framework for consultation included the following capabilities:

  • Intellectual Disability Awareness
  • Communication
  • Quality Evidence- Based Clinical Care
  • Coordination and Collaboration
  • Decision-Making and Consent
  • Responsible, Safe and Ethical Practice.

We asked whether people thought the framework and the core capabilities address the key areas for health students’ knowledge and practice. We also asked people to comment on the content and detail covered by each of the six capabilities.

You said

Ninety-three submissions to the open consultation were received from a range of stakeholders including individuals, health services, peak bodies, education providers, and groups representing and serving those with intellectual disabilities. A breakdown of responses is as follows:

  • 22 responses from individuals/consumers
  • 37 responses from organisations
  • 34 responses from section/teams within an organisation

The results showed that overall, 77% of respondents agreed that the capability areas capture the key capabilities. The level of agreement by specific capability area ranged from 63% (Intellectual Disability Awareness) to 74% (Responsible, Safe and Ethical Practice). Submissions also proposed changes to terminology, and identified gaps in capabilities, areas where more emphasis was required, and clarification was needed. Feedback also identified potential learning outcomes and implementation ideas for the framework.

We did

Feedback has been recorded and will be used to futher develop the framework. All submissions have been reviewed and amendments have been made to capabilities as appropriate. The following significant changes were made: 

The addition of two new capabilities 

  • Appropriate assessment (Quality Evidence-Informed Health Care). Employ appropriate assessment procedures and tools to inform diagnosis of health conditions, with an awareness that modified diagnostic criteria and reasonable adjustments may be required for assessment of people with intellectual disability. 
  • Safe and quality practices (Responsible, Safe and Ethical Practice). Provide a safe health care environment for people with intellectual disability and apply knowledge of the risks that may be associated with accessing health care to inform safe service provision.  

Key wording changes 

  • ‘Adapt communication’ will replace ‘person’s preferred language and communication style and adapted communication’ to clarify the description and emphasise adaptation of communication. 
  • ‘Communicate to reassure’ will replace ‘communicate about safety’ to clarify the intent of the description, which is focused on communicating to provide a sense of control and comfort. 
  • ‘Evidence-informed practice’ will replace ‘evidence-based practice’ to recognise other types of evidence, including lived experience.  
  • ‘Partnership’ rather than ‘inclusion’ in care will be used to describe respectful involvement where both parties are equal participants in care with a minimised power differential. 
  • ‘Where at all possible, non-restrictive techniques’ will replace ‘least restrictive’ to highlight that any restrictive practice is a last resort.​ 
  • ‘Responsible prescribing’ will replace ‘over prescribing’ to include inappropriate prescribing, lack of prescribing, or prescribing older drugs when newer ones should be used.​ 
  • ‘Collaborate with other professionals’ will replace ‘intra- and interdisciplinary collaboration’ to simplify the capability and be inclusive of community and other service networks and providers. 
  • ‘Continuity in care during transitions’ will replace ‘transitions in care’ to include continuity in care and emphasise the importance of effective handovers and collaboration between health professionals. 

Following the open consultation process, a modified Delphi method will be conducted with key stakeholders to reach consensus on the core capabilities. A futher public consultation will be undertaken in September 2023 to seek feedback on the draft framework document.

We appreciate all the interest and expertise shared throughout the consultation phase and thank all stakeholders who prepared a submission.

We asked

The department asked for your views and input on the Review of the National Bowel Cancer Screening Program (the Review). The Review was released for written stakeholder feedback from 6 April 2022 to 17 June 2022.

You said

18 submissions were received from a range of stakeholders including peak health bodies, advocacy organisations, First Nations health care services and state government organisations. The submissions were broadly supportive of the Review findings.

We did

Where appropriate, feedback provided on the Review has been considered to inform Program activities and enhancements.

A summary of the Review’s Findings and Program Reform Actions is provided in the below table.

Review Finding

Program Reform Actions

1

Consider feasibility of lowering screening entry age to 40 or 45 for Aboriginal and Torres Strait Islander people, coupled with scale up of the Alternative Pathway pilot for this group.
  • A review of the Clinical Practice Guidelines for the prevention, early detection and management of colorectal cancer (Colorectal Clinical Practice Guidelines) is considering the clinical evidence for lowering the screening age for colorectal cancer. Implications for the Program will be considered by Government.
  • The Alternative Access to Kits Model commenced in October 2022 allowing all participating health care providers to issue screening kits directly to First Nations Peoples, consistent with the original pilot.

2

Review timing intervals for reminders with clinical input.
  • Currently under consideration by the Program

3

Consideration should be given to alternate forms of communication which do not require simultaneous availability of the participant follow-up function (PFUF) officer and recipient (e.g., email/SMS).
  • Currently under consideration by the Program

4

Support the Australian Commission on Safety and Quality in Health Care (ACSQHC) with its implementation of the Colonoscopy Clinical Care Standard (CCCS) and monitor colonoscopy performance against colonoscopy quality standards.
  • Currently under consideration by the Program

5

Work with states and territories to pilot projects that reshape the PFUF role in line with innovative colonoscopy access models.
  • As part of a broader program of continuous improvement, the potential for enhancements to the Participant Follow Up Function role is under consideration by the Program.

6

Engage with Primary Health Networks (PHNs) and professional bodies (e.g., The Royal Australian College of General Practitioners and the Royal Australasian College of Physicians) to promote a comprehensive set of educational materials, which describe the NHMRC-approved clinical practice guidelines, the Program’s full alignment with biennial screening recommendations, and recent changes to the Medicare Benefits Schedule item codes for colonoscopy.
  • Education material and delivery for healthcare providers is regularly reviewed, including following completion of the review of the Colorectal Clinical Practice Guidelines.

7

Re-configure Program Delivery Advisory Group (PDAG) to include jurisdictional representatives that are able to provide operational advice on contextual issues related to colonoscopy access.
  • Considered as part of a broader review of governance across all cancer screening programs. No substantive changes to PDAG planned at this point.

8

Promote the Program’s research priorities to external researchers.
  • The Program continues to work in partnership with researchers.
  • Relevant research findings are incorporated into campaigns and used to support updates to public facing program materials.

9

Reset the working relationship with all stakeholders to ensure needs are being met in regard to the purpose of each group and expectations on information sharing.
  • Targeted consultation with peak bodies and consumer advocates continues to focus on proposed programmatic changes, education and campaign materials.

10

Reconvene a working group with the goal of prioritising initiatives to address data gaps and agree on any required changes to the endorsed set of KPIs. This group should be set-up over the medium to long term to manage the stakeholder engagement, effort and time required to implement and oversee initiatives to address data gaps.
  • An approach to continued improvement and capability improvement is shared across all key stakeholders involved in data holding, analysis and reporting.

11

Improve visibility of the target population’s participation in other forms of bowel cancer screening, including via over-the-counter iFOBT kits or kits provided by clinicians. Identifying invitees in the target population deemed to be at higher risk for bowel cancer (who may be undergoing surveillance colonoscopies) would also allow a more accurate measure of the true Program participation rate.
  • The Alternative Access to Kits Model commenced in October 2022 allowing all participating health care providers to issue screening kits directly to patients, including under screeners.
  • Methods for identifying screening occurring outside the Program is currently under consideration.

12

Implement sustained and coordinated media and communications campaigns. Campaigns should be national in nature (across jurisdictional and cancer charities, where possible) to promote a coordinated message that minimises fragmentation and duplication of effort.
  • A national campaign raising awareness across multiple media platforms continues to be delivered. Campaign details are shared with states and territories to enable coordination of efforts.

13

Use the primary care sector as a resource to promote participation through education and opportunistic provision of kits. GPs, practice nurses and pharmacists are well placed to promote and provide counselling regarding Program participation.
  • The Alternative Access to Kits Model commenced in October 2022 allowing all participating health care providers to issue screening kits directly to patients, including under screeners.
  • GP education and awareness content for screening programs were distributed mid-2022.

14

Consider piloting sample drop-off points. Trials of this nature should initially be targeted at people in regional areas due to their unique challenges in complying with the strict return postage requirements.
  • This is being considered in partnership with other Government and non-government heath outreach programs.

15

Scale up the Alternative Pathway pilot, as appropriate in other population groups. This includes other locations targeted at Aboriginal and Torres Strait Islander people, as well as exploration of how the pilot could be tailored to address access barriers faced by invitees from CALD backgrounds.
  • The Alternative Access to Kits Model commenced in October 2022 allowing all participating health care providers to issue screening kits directly to First Nations Peoples, consistent with the original pilot.

16

Explore utilisation of the NCSR to improve participation. This could include electronic reminders, streamlined processes for completion of personal details, access to in-language communications, as well as personalised invitations based on Program screening history and/or demographic factors. However, given phone/email contact information is unavailable for first-time screeners, mechanisms to collect this information from other government databases, such as MyGov, may be required.
  • Currently under consideration by the Program.

17

Modify kit contents and accessories to mitigate common reasons for non-completion. This may include an action plan for completion contained in the kit instructions (to overcome the procrastination barrier), and/or provision of accessories such as an opaque bag for fridge storage (to overcome perceived hygiene concerns).

  • Refresh of program resources is underway.

We asked

For your feedback on the goals, principles, and priority areas of the draft National Tobacco Strategy 2022-2030 (the Strategy). We appreciate the diverse perspectives, experiences and knowledge of all stakeholders and interested members of the community and their contribution to the final Strategy.

You said

We received 515 submissions, from peak health bodies, businesses, academics, clinicians and members of the public. You said that reducing the rates of tobacco use in Australia is important, and the Strategy is key to informing how this is achieved. The Strategy must set the direction for future tobacco control activities in Australia.

All submissions are now available on the consultation page.

We did

Reviewed and analysed the feedback to strengthen the Strategy. The new National Tobacco Strategy is expected to be finalised in 2023 pending endorsement from Commonwealth, state and territory governments.

We asked

For your views and input on the draft domains and capabilities in the draft National Rural and Remote Nurse Generalist Framework (the Framework), that describe the unique context of practice and core capabilities for remote area nursing practice, and rural nursing practice.

You said

In 157 submissions, from peak health bodies, organisations, businesses and clinicians, that this Framework is significant for rural and remote area nursing, health services and the health of communities.  There were a number of expert recommendations across various submissions, together with various commendations on the draft presented. 

We did

Review and analyse the feedback, which has strengthened the Framework.  A report on the public consultation feedback is available on the consultation page.  We appreciate the great insight and expertise shared with the Framework Steering Committee during this public consultation phase and anticipate the final Framework will be released in late 2022.

We asked

Between November 2021 and March 2022, the Department of Health and Aged Care conducted initial targeted consultations with the medicines sector about the potential to introduce a National Medicines Traceability Framework in Australia.

This initial round of consultation sought to:

  • help shape the framework policy
  • determine feasible framework designs and implementation approaches
  • gauge industry’s appetite and readiness to operation within a framework
  • identify the expected impacts and benefits a framework may have on businesses.

You said

We received 42 submissions from a cross section of stakeholders, including medicines sponsors, wholesalers, peak bodies (including consumer and clinical representatives), pharmacies, and state and territory organisations.

We did

We have reviewed all submissions and the results are now available in the NMTF - Analysis of Consultation Survey Responses. Note, the questions that relate to each section of analysis are summarised in the report at the end of each page.

The results show:

  • the type of NMTF will determine the benefits that can be realised, for example, while 79 per cent of respondents proposed that an NMTF could provide faster and more accurate product recalls, this is likely to refer to a full track and trace model, rather than ‘point of dispense’ model
  • organisations expect additional investment in data systems and services, with some planning and implementation assistance likely to be needed
  • organisations expect a high regulatory burden, noting this is dependent on the type of NMTF to be implemented i.e. full track and trace, point of dispense verification, or a dispersed data model
  • organisations are confident they could participate in an NMTF, however, there is a clear need for further detailed stakeholder engagement on the function and scope of an NMTF.

In addition to these results, there are a range of other issues that require further detailed consultation, for example, impacts on patient privacy, data security, and the appropriate role of governments.

We will continue to consult with stakeholders as the NMTF policy recommendations are further developed. More opportunities for wider consultation on key elements of the framework will be available at a later date.

We asked

The Minister for Health has committed to development of a Nurse Practitioner 10 Year Plan (Plan). The purpose of the Plan is to describe a set of actions that can be taken to address nurse practitioner workforce issues, and enhance the delivery of nursing care to the Australian community.

As part of the development of the Plan the Department of Health sought the views of stakeholders from 19 November to 20 December 2021. The purpose of the consultation was to collect ideas from a wide range of stakeholders on their perspectives, experiences and knowledge of nurse practitioners (NP) and to identify benefits, barriers and workforce solutions to inform development of the Plan.

You said

The total submissions received was 496 with 458 online survey responses and 38 written submissions via email. Of the online survey responses, 64% (295) of respondents completed the long-form and 36% (163) the short-form survey. Of the total submissions, 430 (87%) responded as an individual and 63 (13%) responded on behalf of an organisation or institution.

The high response rate received to this open consultation was welcomed and has highlighted the interest in this work. The mix of responses from consumers, nurse practitioners, health professionals and organisations provided a comprehensive picture of current NP workforce issues.

We did

The Department reviewed and analysed all the responses received and prepared a consultation analysis report which will be used to inform development of the Plan.

We asked

For your feedback on the draft Healthy Food Partnership Serving Size Recommendations and example pages of the Industry Best Practice Guide (the Guide). The Guide aims to provide practical solutions to support the food industry to reduce the serving sizes. The Guide covers 11 discretionary foods and beverages for the retail and out of home sectors.

You said

We received 27 submissions from food industry, public health organisations, academia, government and consumers. There was strong support for portion and serving size guidance as a public health measure. Practical and detailed feedback was provided on the individual categories and the design of the Guide. Useful feedback was also provided on the look and feel of the layout of the example pages and the usefulness of the included information.

We did

We reviewed and considered the feedback provided and developed a Consultation Summary. The working group refined the serving sizes and tailored the content of the Guide. Among other changes, the title of the Guide was amended to the ‘Industry Guide to Voluntary Serving Size Reduction’.

The final Guide is now available on the Healthy Food Partnership website.

The Consultation Summary is available on the Consultation Hub and the Healthy Food Partnership website. Complete submissions will be published on the website (if consent to publish was granted by the respondent).

We asked

Between November 2020 and January 2021, the Department of Health sought feedback on the The Framework for the Collection, Release, Use and Publication of Voluntary Indigenous Identifier Data (VII Data Framework). Specifically, the Department asked:

  1. Does the VII Data Framework clearly set out the legal and ethical obligations for data users?
  2. What suggestions do you have on how the Department should communicate the legal and ethical obligations to data users?
  3. Does the VII Data Framework sufficiently protect Medicare estimations and enrolment data?
  4. What suggestions do you have on how VII data should be used?
  5. Is the Five Safes Framework an appropriate way to assess data requests?
  6. What else should be considered when assessing a request for VII data?
  7. How would you assess the types of statistical data tables that can be released to data users?
  8. Please include any other comments about the VII Data Framework below

You said

Seven organisations and four individuals responded to the consultation including, Aboriginal and Torres Strait Islander health authorities, doctor peak organisations, a nurses’ and mid-wives’ group and government agencies. Most respondents were satisfied with the VII Data Framework’s  legal and ethical obligations, protections for Medicare and enrolment data, and access and release arrangements.

Specific feedback on the VII Data Framework include:

  1. Aboriginal and Torres Strait Islander Data Sovereignty Principles need to be strengthened.
  2. It should include a supplement that further clarifies a user’s legal and ethical obligations.
  3. It should include a metadata document detailing technical information about the VII variables.
  4. It should provide further details on what the VII can and can’t be used for.
  5. Endorsement of the use of VII data in linkage or integration projects, provided an Accredited Integrating Authority conducted the linkage and all other restrictions on VII data are met (i.e. data can only be used for statistical purposes, and not to identify individuals, and must be used for health-related research and policy development).
  6. Requests for VII unit record data should have approval from a Human Research Ethics Committee with expertise in evaluating Aboriginal and Torres Strait Islander research projects.
  7. Action should be taken to improve VII coverage including via data linkage and communication with Aboriginal and Torres Strait Islander communities.
  8. Priority access should be available for planning and policy development.
  9. VII data should be released at lower levels of geographic aggregation.

The Department appreciates all the feedback and thanks all respondents.

We did

The Department has considered all responses, and these will be used to inform updates to the VII Data Framework.

  1. While some information on this will be added to the VII Data Framework, Indigenous Data Sovereignty is a broader issue that the Department will address in the context of the National Agreement on Closing the Gap and in collaboration with the National Indigenous Australians Agency.
  2. Additional information on legal and ethical obligations will be added to the VII Data Framework.
  3. A metadata document will be included in the appendix of the VII Data Framework .
  4. The VII Data Framework will include more detail on appropriate use of VII data, as well as specifying prohibited uses (e.g. to identify or target individuals).
  5. Information on the circumstances guiding linkage of VII data will be included in the Framework.
  6. The VII Data Framework will specify that requests for unit record data for a research project must be accompanied by approval from a Human Research Ethics Committee with expertise in evaluating research including Aboriginal and Torres Strait Islander people.
  7. There are currently no plans for a broad-based communications strategy, but the Department notes the work of ACCHS in this space which has supported growth in VII enrolment of 3,000 new enrolments per month on average over the last ten years.
  8. While prioritising access by particular users is not currently planned, the Department continuously reviews and refines the data release process to better meet the needs of users and stakeholders.
  9. Currently, MBS estimates that use the VII are available at the State/Territory, Remoteness Area and PHN levels. Lower levels of aggregation will become available as coverage increases.

We asked

For views and input across all sectors of the Australian community about a Lung Cancer Screening enquiry to investigate the feasibility of a national lung cancer screening program for people at high risk of lung cancer.

 

You said

That many factors should be considered across many sectors of the Australian community and the health system.  Public consultation submissions and input from stakeholders were detailed. Thank you for this feedback.

 

We did

We considered all feedback and engaged a consultant to analyse and summarise consultation outcomes for consideration by the Minister for Health. The Lung Cancer Screening enquiry report will be submitted to the Minister for Health in October 2020.

We asked

Between November 2019 and February 2020, the national obesity strategy Working Group asked for feedback on a proposed framework and ideas to be included in a national obesity strategy.

On 31 August 2021, the Health Chief Executive Forum agreed to support public consultation on the draft national obesity strategy.

During September and October 2021, the national obesity strategy Working Group will be seeking feedback on the draft national obesity strategy from all stakeholders. We look forward to receiving your comments. Details of how you can provide feedback will be posted on this webpage in the coming weeks.

You said

November 2019 - February 2020

Across the country, 604 Australians engaged in community events. In addition, 1,038 short-form and 342 long-form surveys were completed, and 35 stand-alone submissions were received. Some further targeted consultation was also progressed with three priority groups (people with disability, young people, older people).

Respondents proposed a range of ideas and suggestions for what could be included in a national obesity strategy, with most highly supportive of a comprehensive strategy. The feedback received is appreciated.

We did

Consultants reviewed and analysed all the feedback received in the 2019/20 national public consultation and prepared consultation reports.

Despite the challenges arising from the COVID-19 pandemic response, the national obesity strategy Working Group has considered all feedback and progressed the development of the national obesity strategy.

We asked

For written feedback, based on the Terms of Reference, for the independent review of nursing education - Educating the Nurse of the Future - by 30 June 2019.

You said

We received 83 written submissions and these have now been published (scroll down to view).

We did

Professor Steven Schwartz AM has now submitted the final report to Minister Hunt following completion of the Review. The report will be considered by government and a plan for public release will be developed. There is no fixed date for the release of the report available at this time.

We asked

For feedback on our tobacco control legislation to make sure that it is effective and fit for purpose.

You said

Improvements could be made. Public consultation submissions and input from stakeholder workshops were detailed. Thank you for this feedback.

We did

We considered all feedback and engaged a consultant to analyse and summarise consultation outcomes for Australian Government consideration (scroll down for the consultation summary). This feedback is being used to progress this legislative review.

We asked

In December 2018, we asked for feedback based on the Terms of Reference for the Review of the Quality Use of Medicines Program’s delivery by the National Prescribing Service (NPS MedicineWise).

You said

54 external submissions were received and 26 external interviews were conducted. Submissions were detailed and highlighted the requirement for greater transparency, accountability and efficiency in the delivery of quality use of medicines programs. Thank you for this feedback.

We did

Emeritus Professor Lloyd Sansom AO conducted the Review and a final report has been accepted by Minister Hunt. The public report and the Government’s response to the Review recommendations can be found at

https://www1.health.gov.au/internet/main/publishing.nsf/Content/qum-nps-review

 We are working with NPS MedicineWise to implement the Review’s recommendations.