About the toolkit

This Toolkit is a resource to assist board directors of public health services and public hospitals (including multi purpose services) and other interested parties to better understand their role and the operating environment of the public sector health service entities they govern.

The department developed the Toolkit to enhance the support tools available to directors of health services, recognising the need for a stronger emphasis on public sector health governance. The 2016 report ‘Targeting Zero’, a review of quality and safety in the Victorian public health service, highlighted the need for greater oversight of clinical care systems across the state in the delivery of high quality, safe, person-centred care.

This accountability starts with the board.

The board of directors is held to be ultimately responsible for virtually every aspect of the health service’s activities. However, it is impractical and undesirable for a board to attempt to supervise minutia associated with the health service’s operation.

Good corporate governance requires a balance between compliance (with codes, regulations and standards) and oversight of operational and financial performance. The core purpose of good governance in health services is ensuring the delivery of high quality, safe and effective person-centred care.

Boards of high performing health services:

  • understand the board’s role in governance
  • discharge their legal duties
  • ensure accountability to stakeholders
  • understand stakeholder and management expectations
  • effectively use board committees to enhance governance
  • build a talented management team
  • champion a productive and ethical culture
  • make informed decisions
  • actively contribute to strategy, and closely monitor strategic effectiveness
  • ensure a disciplined approach to risk governance
  • receive independent assurance
  • actively engage externally on current and emerging issues relevant to their organisation and the political, social, and economic environment in which it operates.

By understanding the environment and the pressures the health service and its management face, the board can assure itself that the material risks are being identified and, most importantly, managed. Such an approach enables the board to exercise its responsibilities in an active rather than a reactive manner and minimises ‘surprises’. The board should be alert to the red flags or risk indicators that may impact the organisation’s performance.

In preparing this Toolkit, the department, in its stewardship role, has not attempted to establish a model or pattern for the optimum composition and conduct of a health service board. Instead it has provided insight and guidance as a practical resource for health service directors.

For guidance, on the initial pages of chapters 1–14, there are a number of red flags, plus a list of pertinent questions that directors of health services may ask.

In addition, the Toolkit documents and summarises information on roles and responsibilities and consolidates statutory and policy-based elements, including those in the Health Services Act 1988 (Vic), the Ambulance Services Act 1986 (Vic), the Mental Health Act 2014 (Vic), other acts, and policy and administrative documents.

Initially published in 2017 the Toolkit is being progressively updated to reflect current governance practice.

Although this Toolkit sets out material of key importance to health service boards, the boards of other entities, such as, ambulance services, mental health services, aged care services, community health centres, and other private and not-for-profit entities delivering Victorian Government health services, may also find the material useful.