First Nations health equity strategies

Directive number: QH-HSD-053:2021

Effective date: 1 January 2024

Review date: at least by 31 December 2026

Supersedes: Version 1

On this page:

Purpose

The purpose of this Health Service Directive (HSD) is to achieve:

  • A consistent and transparent process to the development, implementation, and resourcing of First Nations Health Equity Strategies with development stakeholdersin accordance with the requirements outlined in the Hospital and Health Boards Regulation 2012.
  • Comprehensive consultation and transparent decision-making processes with development stakeholders during the development, implementation, and resourcing of a Hospital and Health Service’s (HHSs) First Nations Health Equity Strategy; and
  • A consistent mediation and conflict resolution standard if disagreement arises about the development and/or implementation and/or resourcing of the First Nations Health Equity Strategy.

Scope

This HSD applies to all Hospital and Health Service (HHSs).

Principles

  • Collaboration: HHSs will work effectively and constructively with the prescribed development stakeholders under the Hospital and Health Boards Regulation 2012.
  • Transparency: to enhance accountability through openness and increased participation leading to better-informed decision making.
  • Quality: to enable and support safe, high quality delivery of health services to Aboriginal peoples and Torres Strait Islander peoples.
  • Consistency: to ensure consistent approaches to the development and delivery of the First Nations Health Equity Strategies with development stakeholders.
  • Alignment: to be consistent with principles outlined in the Hospital and Health Boards Regulation 2012, National Agreement on Closing the Gap 2020, Queensland Government Statement of Commitment to Reframe the Relationship between Aboriginal and Torres Strait Islander people and the Queensland Government 2019, and National Aboriginal and Torres Strait Islander Health Plan.

Outcomes

HHSs included in the scope of this Directive shall achieve the following outcomes:

  • Consistent and transparent process to the development of First Nations Health Equity Strategies with development stakeholders in accordance with the requirements outlined in the Hospital and Health Boards Regulation 2012;
  • Comprehensive consultation and transparent decision-making with development stakeholders in developing, implementing and resourcing of a First Nations Health Equity Strategy; and
  • A consistent mediation and conflict resolution standard if disagreement arises about the development, implementation and resourcing of the Health Equity Strategy.

Mandatory requirements

HHSs must comply with the:

  • Hospital and Health Boards Act 2011; and
  • Hospital and Health Boards Regulation 2012

Consultation Practice Standards

  • A First Nations Health Equity Strategy must be developed in accordance with the principles of continuous quality improvement, shared decision-making, collaboration and partnership. With each development stakeholder in particular, the Aboriginal and Torres Strait Islander community-controlled health sector.
  • HHSs must provide a draft First Nations Health Equity Strategy to each development stakeholder and allow at least 30 business days for the stakeholder to provide feedback to the HHS.
  • Once feedback is received from the development stakeholder, the HHS must consider the feedback and provide a report back to the development stakeholder with respect to how their feedback has been incorporated, or not incorporated, into the First Nations Health Equity Strategy. Any feedback must be provided to the development stakeholder in written form within 90 calendar days from the date the feedback was received.

Mediation and determinations

Health Equity Strategies will significantly increase the ability of development stakeholders – particularly, the Aboriginal and Torres Strait Islander community-controlled health sector, Aboriginal and Torres Strait Islander peoples, consumers and organisations – to co-design and negotiate with HHSs with confidence knowing that their participation is legislated.

The Chief First Nations Health Officer will provide mediation, when and if required in relation to disputed issues which arise regarding the development, implementation, and resourcing of Health Equity Strategies, as per steps outlined below. Therefore , where disagreement arises, the parties are bound by the determination of the mediation process outlined:

  • Step 1:The parties attempt to resolve the disagreement through natural justice processes.
  • Step 2: If parties are unable to resolve the dispute, the dispute is then elevated in the first instance to the Health Service Chief Executive. Should the Health Service Chief Executive be unable to resolve the dispute then the dispute is elevated to the Health Service Board Chair.
  • Step 3: If parties are unable to resolve the dispute locally, the dispute is escalated to the Chief First Nations Health Officer for joint non-binding mediation; and
  • Step 4: If parties remain unable to resolve the dispute, both parties are bound by the determination of the Chief First Nations Health Officer to achieve a resolution.
  • Hospital and Health Boards Act 2011
  • Hospital and Health Boards Regulation 2012

Supporting documents

  • Health Equity Framework
  • Health Equity Toolkit

Business area contacts

  • Strategy and Policy Branch, First Nations Health Office, Queensland Health

Review

This Health Service Directive will be reviewed at least every three (3) years.

Date of next review: at least by 31 December 2026

Approval and implementation

Directive Custodian

Haylene Grogan, Chief First Nations Health Officer, First Nations Health Office, Queensland Health

Approval by Chief Executive

Director-General, Queensland Health

Approval date: 18 January 2024

Issued under section 47 of the Hospital and Health Boards Act 2011.

Definitions of terms used in this directive

Term

Definition/Explanation/Details

Source

Development Stakeholder

Means the persons prescribed by regulation in sections 11C [Service-Delivery Stakeholders], 11D [Prescribed Persons] and 13B [Implementation Stakeholders] the Hospital and Health Boards Regulation 2012

Hospital and Health Boards Regulation 2012

Chief First Nations Health Officer

Means the public service officer employed in the Department of Health who is appointed as the Chief First Nations Health Officer formerly known as the Chief Aboriginal and Torres Strait Islander Health Officer and Deputy Director-General

Resource

Means any factor necessary to accomplish the development and implementation of a Hospital and Health Services: Health Equity Strategy

 

Continuous Quality Improvement

Means a deliberate and defined quality management process that is responsive to community needs and concerned with improving population health via incremental improvements in the practices and processes of health care for measurable improvements in: outcomes, efficiency, effectiveness, performance, accountability, and/or other quality indicators.

N/A

Shared decision-making

Means to work with the prescribed Development Stakeholders in each aspect of the decision including the development of alternatives and the identification of the preferred solution.

N/A

Collaboration

Means the act of working together with other people and/or organisations to create or achieve something.

N/A

Partnership

Means a formal arrangement and/or collaborative relationship between two or more parties who have agreed to work together, that is based on trust, equality, and mutual understanding, and focuses on the pursuit of common goals and/or interests.

N/A

Version control

VersionDate Prepared byComments
1.0 1 August 2021 Aboriginal and Torres Strait Islander Health Division New Health Service Directive
2.018 January 2024

Strategy and Policy Branch, First Nations Health Office, Queensland Health

Updated as a result of scheduled review

Last updated: 12 February 2024