Structures for health care organisations to engage with consumers vary across Australia, but most states have some form of ‘consumer advisory committee’ required under legislation or as part of expected practice. Health Performance Council (HPC) revisited a previous review (2011) to assess what had changed in the effectiveness of a South Australian community and consumer voice variant, the Country Health Advisory Councils (HACs) to provide a mechanism for a community and consumer voice in health services serving rural South Australia.
HPC surveyed members of the Country HACs, staff of the relevant health service, Country Health South Australia, and consumers to assess perceptions of the HACs. The report has a number of case examples describing where the HACs had a positive impact on local services.
An overwhelming finding from the surveys was the very different views of HACs and Country Health South Australia staff of the level of skills of the HACs. While HAC members are appointed based on their skill and position, the differences in perception between staff and Council members suggest that the skills Country Health South Australia staff think are required to fulfil the functions are different to the skill-mix that Council members bring.
The report used the International Association for Public Participation IAP2 framework and asked a series of questions to identify the level of engagement Country HACs have with both members of the community and Country Health staff. At an overall level, both Country HACs and Country Health staff believed that there should be greater participation at the ‘collaboration’ level with most community and consumer groups. This highlights an opportunity to work together towards a higher level of participation.
Using the same participation scale to assess HACs process to engage with particular constituencies, Country HACs were asked to what extent each engaged with specific population groups. Health Advisory Councils self-reported engagement was highest with local community members, health service consumers/patients and stakeholder organisations. With these groups engagement was reported to be primarily at the higher levels of the IAP2 spectrum (inform, consult and involve). However, HACs reported that they largely had ‘no engagement’ with Aboriginal Experts by Experience (73%), local Aboriginal and Torres Strait Islander People (67%) and local culturally and linguistically diverse people (54%). Council engagement was reported to be at the inform level with Aboriginal people (6%), culturally and linguistically diverse populations (21%), low income families (23%), people with a disability (17%) and young people (29%).
The advice of HPC included that Country Health South Australia needs to develop the skills of HACs, including by providing better information to the Councils, to help them do their job better. The IAP2 spectrum proved to be a useful one to evaluate consumer engagement in health care in South Australia.