Statement of Intent 2007–2010

Part 5: Measuring the Ministry’s Progress

Table of Contents:

From the Minister

Part 1: Introduction and Health Context

Part 2: The Government’s Priorities

Part 3: The Ministry’s Vision and Outcomes Framework

Part 4: What the Ministry Does

Part 5: Measuring the Ministry’s Progress

Part 6: The Ministry’s Strategy: ‘Better Health for All’

Part 7: Financial Information

References

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In this section:

• Introduction
• Headline indicators
• Health targets

In 2007/08 the Ministry will use the following measures as a way of measuring progress.

1. As part of the health sector, the Ministry contributes to the overall performance of the sector,as reflected in headline indicators.
2. The Ministry is bound by health targets and has the job of assisting DHBs to make positive improvements over their current baseline efforts so that collective effort improves national performance.
3. The Ministry delivers on the performance measures in the Statement of Forecast Service Performance.

The table below shows how these measures map to the different parts of the Statement of Intent.

Table 2: Measuring progress

Part of Statement of Intent	Measures
Ministry’s outcomes framework	Headline indicators
Minister’s priorities	Health targets
Ministry’s Statement of Service Performance	Performance measures

Headline indicators

Progress towards system and societal levels of the outcomes framework is measured by using a suite of indicators, as detailed in Table 3. Progress is reported annually and includes improvements in Māori health where the data are available for the indicators listed, as shown in the following table. Where the data are not available, the Ministry is committed to improving the collection and accuracy of ethnicity data (Minister of Health and Associate Minister of Health 2006).

Table 3: Measuring progress towards system- and societal-level outcomes – the headline indicators

Outcome	Headline indicators
Better health	Life expectancy* Infant mortality* Healthy life expectancy* Mental health status*
Reduced inequalities	Life expectancy by ethnicity and deprivation* Infant mortality by ethnicity and deprivation* Healthy life expectancy by ethnicity and deprivation*
Better participation and independence	Disability requiring assistance* Unmet need for disability support services
Trust and security	Views of the health care system Confidence in obtaining high-quality and safe care when needed Access to medical care Cost of medical care
Equity and access	Primary health care utilisation+ Elective surgery discharges Radiotherapy waiting times Matching of health workforce to population characteristics* Rate of new admissions to general acute inpatient mental health services Secondary mental health services utilisation*
Quality	Patient satisfaction Emergency department triage times Hospital readmission rate* Hospital mortality rate* Cancer screening coverage* Immunisation coverage (fully vaccinated two-year-olds)* Proportion of health records with an NHI# number* Treatment injury rates
Efficiency and value for money	Day-case procedures* Age-related residential care admissions Efficiency of primary health care
Effectiveness	Ambulatory-sensitive admissions* Cardiovascular disease mortality* Cancer survival* Diabetes management* Smoking prevalence and consumption*
Intersectoral focus	Obesity* Alcohol available for consumption Destigmatisation of people with mental illness

*Data available for analysis by ethnicity
+Incorporates ethnicity in that it measures the ratio of high need (Māori, Pacific, Deprivation quintile 5) visits to non-high need visits.

Health targets

Setting and integrating national health targets into the work of the Ministry and of DHBs can lift outcomes in key priority areas (Mays 2006). As a result, in 2007/08 a range of targets aligned with strategic priorities, are being introduced and are listed in Table 4.

Table 4: Health targets

Health target	Indicator
Improving immunisation coverage	95% of two-year-olds are fully immunised + With at least 4 to 6 percent point increase on 2005 national immunisation coverage survey baselines
Improving oral health	Progress is made towards 85% adolescent oral health utilisation +
Improving elective services	Each DHB will maintain compliance in all Elective Services Patient Flow Indicators (ESPIs) Each DHB will set an agreed increase in the number of elective service discharges, and will provide the level of service agreed
Reducing cancer waiting times	All patients wait less than 8 weeks between first specialist assessment and the start of radiation oncology treatment (excluding category D)
Reducing ambulatory sensitive(avoidable) admissions	There will be a decline in admissions to hospital that are avoidable or preventable by primary health care for those aged 0–74 across all population groups *
Improving diabetes services	There will be an increase in the percentage of people in all population groups: estimated to have diabetes accessing free annual checks * on the diabetes register who have good diabetes management * on the diabetes register who have had retinal screening in the past two years * There will be improved equity for all population groups in relation to diabetes management *
Improving mental health services	At least 90% of long-term clients have up-to-date relapse prevention plans (NMHSS criteria 16.4)
Improve nutrition Increase physical activity Reduce obesity	DHB activity supports achievement of these health sector targets: proportion of infants exclusively and fully breastfed: 74% at sixweeks; 57% at three months; 27% at six months* proportion of adults (15+ years) consuming at least three servings vegetables per day, and proportion of adults (15+ years)consuming at least two servings fruit per day: 70% for vegetable consumption; 62% for fruit consumption *
Reduce the harm caused by tobacco	DHB activity supports achievement of these health sector targets: to increase the proportion of ‘never smokers’ among Year 10 students by at least 2% (absolute increase) over 2007/2008 * to increase the proportion of homes, which contain one or more smokers and one or more children, that have a smokefree policy to over 75% in 2007/2008 *
Reduce the percentage of the health budget spent on the Ministry of Health	The percentage of the health budget spent on the Ministry of Health is reduced to 1.65% of the total Vote Health budget over the three years to 2009/2010.

* Data available for analysis by ethnicity
+Data quality will be improved during the year to include ethnicity data

There are three different types of targets.

• Compliance measures for DHBs (improving elective services, reducing cancer waiting times).
• Ministry of Health-led targets (improve nutrition, increase physical activity and reduce obesity,reduce the harm caused by tobacco, and reduce the percentage of the health budget spent on the Ministry of Health)
• DHB-led targets that will be achieved by DHBs over time, with Ministry assistance (improving immunisation coverage, improving oral health, reducing ambulatory sensitive (avoidable)admissions, improving diabetes services, improving mental health services).

For those that will be achieved over time, the Ministry will negotiate local targets with DHBs. The Ministry will closely monitor the progress of DHBs towards the DHB targets and provide assistance to improve performance when appropriate.

Ethnic-specific targets are set for all of the indicators where data allows, as shown in the table.In some cases data quality is insufficient, which is why only a subset of the health targets are used to measure performance in improving Māori health and reducing inequalities. Where poor quality ethnicity data is preventing the reporting of a target, the Ministry will focus on improving the quality of ethnicity data and report on its progress.

The proposed targets will remain in place for a number of years, but each target will be reviewed annually to confirm that its inclusion in the set continues to be appropriate. The review will check that improved outcomes have included improvements in Māori health and reduced inequalities.Over time it is intended to achieve better alignment between the health sector targets and the headline indicators (Ministry of Health 2005a).