National health program administration review

The struggles of managing the invisible

Seeking to improve the performance of your program delivery but don’t know where to start? 

Learn how a rigorous administration review assisted an Australian Government department uncover the best way forward to improve program performance.

The situation – changes ahead

Following a crucial change to the delivery of a national health program (Program) and the imminent expiry of the current funding agreement, an Australian Government department engaged Grosvenor to conduct a review of the Program with a view to improve efficiency and effectiveness of the current administration and existing processes.

The Program is an Australian Government initiative which aims to enhance the capacity of people to self-manage a particular disease. The Program was established in 1987 and has been administered by the same administrator since its commencement.

When the Program was first established its purpose was to supply and deliver disease management products to registrants. Over time, the Program has expanded to include support services for registrants to promote self-management of the disease. From 1 July 2016, the core service delivered by the Program administrator is to be self-management support services. Product supply and delivery will be managed via the Community Service Obligation network.

The Department was of the view that there was a lack of visibility and transparency around the current administration and existing processes of the Program. This issue was further compounded by the imminent change that was to come into effect in conjunction with the new funding agreement on 1 July 2016. The Department needed guidance on how this change could be implemented successfully, without adversely affecting Registrants’ ability to access product and services.

The challenge – a complex, long running program

The Program initiative is a complex, long running national program. There is a very large delivery team, which includes the Program administrator, 8 state and territory agents and almost 7,000 access points spread out across Australia.

The Program administrator responded to requests for documentation in an ad hoc manner, often pulling documentation, data and information together from a wide variety of sources and consolidating information in a very short period of time prior to submission to the Department. This resulted in a lack of granularity of information provided, and often vital information was lost in the final documentation.

As such, while the Program administrator made every effort to provide transparency and visibility of the programs’ day-to-day activities to the Department, transparency and visibility became quite difficult to achieve due to these issues.

The Program administrator had previously commissioned three reviews as a part of the funding agreement. However, the Department questioned whether the outputs of these reviews were reliable given that the administrator had commissioned them.

The project – a rigorous administration review

Grosvenor discovered that the Program administrator was unable to provide data that had sufficient granularity in order to calculate cost savings and efficiencies. Upon further investigation, it was discovered that there was a lack of suitable ICT infrastructure to obtain useful data that would inform the review. This made it challenging to quantitatively identify cost savings or potential efficiencies within the Program. Furthermore, during consultation, conflicting information and views were provided by the various parties involved.

It was found that some aspects of the administration of the Program that were found not to be aligned with the funding agreement. Ultimately, the vast majority of issues relating to lack of visibility and transparency boiled down to a lack of suitable ICT infrastructure to carry out the requirements of the funding agreement.

Grosvenor developed an extensive report, with a detailed review of the current and future state of the Program, recommendations and opportunities for improvement. Significant recommendations included a strategic focus on upgrading the ICT infrastructure and for the Department and the administrator to set aside historical differences, and repair the relationship.

In doing so, this will foster more transparent dealings and improve communication between the parties.

The result – confident future planning

The final report provided the Department with the required visibility and transparency over the current processes and overall administration of the Program. When presenting the preliminary findings to the Department, it was evident that these findings had clarified, justified and provided external validation to the Department’s views and impressions.

As a result of this review, the Department is now equipped with the right information to confidently make decisions about the future administration of the Program initiative.