7.4 Roles and operation of advisory fora

Stakeholder views

There were mixed views about how well advisory fora had operated, and the extent to which they had achieved their objectives. Fundholders, state/NT officers and advisory fora members commented about the volume of material and detail that had to be considered by advisory fora, and often felt this detracted from attention to more strategic issues.

Factors that appear to have contributed to better functions advisory processes included:

• working groups to transact more detailed issues outside the main advisory fora
• meetings appropriately scheduled throughout the year
• circulation of papers well before meetings to allow time to review
• holding meetings face to face, rather than by teleconference, at least some of the time
• a clear understanding of the advisory fora’s role and the expectation of members of the advisory fora.

Most stakeholder supported bringing forward meeting schedules so that advice for a forthcoming financial year can be considered, advised on and decided before the commencement of the financial year.

Several stakeholders believed the membership of advisory fora needed to be broadened to include a greater representation of primary care and Aboriginal and Torres Strait Islander health issues. The need for more effective regional input on priorities was also a common theme.

Evaluation findings

While there are national terms of reference set under the program guidelines, the function and organisation of advisory fora varies significantly across states/Northern Territory including: membership, frequency of meeting, communication outside meetings, communication between members and perceived roles of members and the group as a whole.

Timing of meetings is generally controlled by the state/NT DoHA office. Participation of some members (particularly specialists) is variable. Representation of Aboriginal and Torres Strait Islander groups may not be sufficient with the increasing importance of MSOAP-ICD.

Some members of advisory fora find the amount of paper work to be considered, and timeframes for consideration, very demanding and unrealistic. Some jurisdictions have established working groups involving key stakeholders that meet more regularly. The working groups appear able to address many issues prior to the advisory fora itself.

Mechanisms to address eye health issues (e.g. coordination with IRIS VOS) need to be considered.

Recommendations – Advisory fora

12. The membership of each advisory forum should be reviewed. The membership should have a stronger representation of organisations and services based in rural settings, including Aboriginal and Torres Strait Islander health services and Medicare Locals.
13. In each jurisdiction, an MSOAP working group should be established involving the state/NT DoHA office, the fundholder, the state/territory health authority and the state level Aboriginal and Torres Strait health organisation. The working group should meet regularly and consider drafts of papers and plans, identify issues prior to the full advisory forum, and deal with matters that do not require reference to the advisory forum.
14. The key functions of the MSOAP advisory fora should be to:

1. Consider and recommend broad priorities to be addressed under the MSOAP programs over a three year period, based on a comprehensive analysis of need undertaken at the commencement of that period.
2. Consider and recommend service proposals.

At the commencement of the three year period, a three year plan should be considered. This should identifying service proposals to be supported for the full three year period without further reference to the advisory forum, service proposals to be supported for a 12 month period prior to review by the advisory forum, reserve service proposals that can be supported during the year depending on funding without further reference to the advisory forum.

In years 2 and 3, the advisory forum should review new proposals or major variations in services, but should not be required to revisit service proposals approved for the three year period.

15. Advisory fora meetings should be scheduled so that the three year and annual plans are considered in April prior to the commencement of the financial year, and these are approved one month prior to the commencement of the financial year.
16. Guidelines on management of conflicts of interest should be included in the terms of reference of advisory fora.
17. Depending on circumstances and agreement, there should be an option for secretarial support for the advisory fora to be provided by fundholder rather than the state/NT office of DoHA.
18. A joint committee involving appropriate members of the MSOAP advisory forum, representatives of the optometry profession and other appropriate people should meet regularly to consider eye health issues and priorities for the state/territory. This committee should also include a member who is involved directly with the IRIS task force. The committee should be supported by the MSOAP fundholder. The committee should consider priorities for eye health services in the jurisdiction and make recommendations to the local MSOAP advisory forum on specialist eye health services being considered for support under MSOAP and to DoHA on services being considered for support under VOS.