Evaluation of the Medical Specialist Outreach Assistance Program and the Visiting Optometrists Scheme

9.3 Roles and operation of advisory structures

Page last updated: 28 February 2012

Stakeholder views

Many stakeholders outside of those directly involved were unaware of the role of VOS National Advisory Committee or the state/territory reference groups. In some jurisdictions the reference groups had not met for some years, with business being transacted by email or telephone.

In terms of appointments to national and state/territory advisory committees, one issue raised was the general lack of rural representation. The Optometrists Association of Australia suggested the role of the reference groups be enhanced through:
    • Expanding the membership to include representatives from the peak AMS in each state/territory, relevant regional eye health coordinators, state based eye health coordinators (if appointed) and representatives from Medicare Locals.
    • Establishing formal communication links with the state based MSOAP fundholders particularly in relation to ophthalmology services and other programs funded to deliver eye health programs.
    • Review the outcome of visiting services and provide recommendations to National Advisory Committee on system improvements and how to address gaps in services.
Most MSOAP fundholders were unaware of the operation of VOS and the reference groups. There also appears to have been no specific attempt to engage in joint planning between VOS and MSOAP. In its submission, the Australian Society of Ophthalmologists argued for a central role for Indigenous and Remote Eye Health Service (IRIS) in planning, funding, coordination, implementation for MSOAP for ophthalmological services, but did not comment specifically on how planning for outreach optometry could be coordinated within this process.

Evaluation findings

We consider that with the recommendation for the continuation of VOS as a discrete program, it is appropriate to maintain the current VOS National Advisory Committee. However, we believe its membership should be changed. The membership currently includes five DoHA officers (the Minister’s delegate, two from state/Northern Territory offices, one from OATSIH and one from the Office for an Ageing Australia) and three members from outside of the Department. We suggest three other members be included representing:
    • primary care service providers based in rural and remote Australia
    • Aboriginal and Torres Strait Islander health services
    • Ophthalmologists engaged in outreach services, specifically from IRIS.
The current terms of reference for the VOS National Advisory Committee appear appropriate and do not need fundamental change. However, the Committee could periodically review administrative processes for the program and recommend improvements.

The arrangements for state/Northern Territory reference groups are more problematic with stakeholders reporting mixed views about their effectiveness. One issue raised is the lack of understanding of the program by state/Northern Territory DoHA officers who support the scheme and a high level of turn-over in staff with these roles. There are three main options for addressing these issues:
    • Disband the reference groups. Under this option the Optometrists Association of Australia could be asked to obtain input from its state/territory branches on the issue of priority locations.
    • Create a broader planning committee at the state/territory level to provide advice on all relevant eye health outreach services. This is the essence of recommendation 18 above.
    • Enhance the reference groups, including expanding membership to reflect a broader range of perspectives, creating clearer expectations on the regularity of meetings, and ensuring secretarial support for the reference groups is improved.
Mechanisms to address eye health issues (e.g. coordination with MSOAP) also need to be considered. We suggests that the proposed joint eye health planning committee take on the role of advising on priority locations and assessment if specific outreach proposals. Should state/Northern Territory eye health coordinators be important, they may play a key role as a member and in supporting the work of this group. Meetings of all advisory groups should be scheduled to ensure expressions of interest are issued well before and that funding agreements can be in place before the commencement of each funding period.

Recommendations - Roles and operation of advisory structures

44. The membership of the VOS National Advisory Committee be revised to include:
    a. The Minister’s delegate
    b. Three officers from DoHA, including from: a state/Northern Territory office, OATSIH and the Office for an Ageing Australia
    c. Two representative from the Optometrists Association of Australia
    d. A representative from Vision Australia
    e. A representative of primary care service providers based in rural and remote Australia
    f. A representative of Aboriginal and Torres Strait Islander health services nominated by NACCHO
    g. A representative from IRIS.
45. The role of providing advice from state/territory level on priority locations and assessment of service proposals allocated to the state/Northern Territory joint eye health planning committee proposed in recommendation 18 above.