Terms of Reference

About Us

Terms of Reference

Accountability
The National Health Epidemiology and Quality Assurance Advisory Committee operating under the name ‘Quality Improvement Committee’, is established under section 11 of the New Zealand Public Health and Disability Act 2000 (the ‘Act’). It is appointed by, and accountable to, the Minister of Health.

Purpose of the Committee
The role of the Quality Improvement Committee is to provide advice to the Minister on any health epidemiology and quality assurance matters, including sponsoring, monitoring and evaluating programmes within the Improving Quality (IQ) Action Plan. It must specifically deal with perinatal, maternal, infant, child and adolescent morbidity and mortality issues.

The Quality Improvement Committee will work across the health and disability sector (with a particular focus on hospital care) as both an advisor and a facilitator. In providing its advice it must:

ensure that there is a capacity to improve health outcomes through quality improvement programmes including those directed to clinical providers
seek to develop a shared learning environment in the health sector, thereby quickening the implementation of innovation and the continual achievement of best practice
provide a national perspective of the variety of accountability mechanisms in the health and disability sector including, ethics, negotiated targets, societal demands, investigative and disciplinary systems and other formal accountability mechanisms
ensure, to the maximum extent practicable, that there is national co-ordination in the reporting of relevant health epidemiology and quality assurance matters
identify that quality in healthcare and disability support is always everyone’s business, and that improving quality is continuous and is supported by professionalism, technology, experience, a pervasive ethos of care and by the quest for better value for money
apply a broad definition of “quality” that is strongly associated with safety, value for money, people-centred care, high performance and best practice.

The advice given to the Minister is to be formulated after consultation by the Committee with District Health Boards and other persons involved in the provision of services, and any other persons that the Committee considers appropriate.

Key Tasks:

to provide independent advice to the Minister on quality improvement by analysing information and evidence on systemic quality and safety issues from a national perspective, and recommending system improvements
to develop whole system frameworks and integrative approaches to quality improvement that support and develop leadership, shared learning, trust and culture change thereby quickening the implementation of innovation and best practice
to be active in building collaboration with national organisations to facilitate an integrated approach to quality and safety and to promote the dissemination of proven innovations
to identify examples of innovation or best practice (globally and nationally) that can be adapted for implementation in New Zealand
to collect and document evidence and information to assist the spread of innovation and best practice including the findings and recommendations from mortality review committees, the Health and Disability Commissioner, Service Planning and New Health Intervention Assessment Framework (SPNIA) and other work streams of relevance
to organise and facilitate fora for the discussion and understanding of documented examples of innovation and best practice.
to recommend data sets to better inform and monitor quality improvement including the setting of targets and performance objectives for District Health Boards
to collaborate with the Office of the Health and Disability Commissioner in promoting the Code of Health and Disability Service Consumers’ Rights as a basis for continuous improvement, engaging consumers in quality improvement and ensuring complaints’ processes link with system improvement
to review the annual reports of the national mortality review committees and provide the Minister with independent commentary
to provide advice to the Tertiary Education Commission and the Health Research Council on priorities for education and research in support of improvements in the health and disability sector.

In developing its advice, the Committee must consider reports from the Perinatal and Maternal Mortality Review Committee and the Child and Youth Mortality Review Committee, and any other mortality review committee appointed under section 18 of the Act. It may also consider relevant reports, including the following:

New Zealand health sector quality improvement strategy
Health professionals competence
Audit information related to implementation of the Health and Disability Services (Safety) Act 2001
Relevant opinions of the Health and Disability Commissioner, under section 45 of the Health and Disability Commissioner Act 1994
Information relating to treatment injury provided for in section 284 of the Injury Prevention, Rehabilitation, and Compensation Act 2001.

It will also:

identify data quality and analysis issues, identify information gaps and make recommendations on how to learn from, and prevent, system failures
consider such matters as the Minister specifies by notice to the Committee
advise the Minister on clinical epidemiological matters that will improve clinical practice quality and support other quality assurance initiatives.

Composition of the Committee
The Committee will have a maximum of 13 members appointed by the Minister.

The Minister will appoint a Chairperson for the Committee, and the Minister may from among Committee membership appoint a Deputy Chair or delegate to the Committee the appointment of a Deputy Chair.

The Chair of any national mortality review committee appointed under section 11 of the New Zealand Health and Disability Act (2000) will be a member for the duration of their term of office.

Desired skills and knowledge of the collective committee membership

Members will have the ability to work strategically and co-operatively, and will have credibility in relevant communities.

Collectively the Committee will reflect the following:

expertise in quality improvement and clinical risk management in the health and disability sector
knowledge of best practice and/or implementation of innovation in the health and disability sector
knowledge of health services research and measurement
knowledge of mortality review systems
knowledge of clinical epidemiology
experience of District Health Board service provision and management at a senior level
health professionals with extensive and recent clinical experience
an understanding of diverse cultural context of the New Zealand health and disability sector
knowledge of consumer participation and representation.

The Committee may appoint sub-groups or establish working parties relevant to its agreed workplan. It may also co-opt expertise as necessary to assist both the main Committee and any sub-groups it may establish.

Nomination Process
The nomination process will comply with the requirements of the State Services Commission.

Term and Conditions of Appointment
The Minister of Health appoints members of the Quality Improvement Committee for a term of office of up to three years; members will be eligible to serve a second consecutive term to allow for continuity and the full use of increased experience and knowledge. The terms of office of members will be staggered to ensure continuity of membership. No member may hold office for more than 6 consecutive years. Unless a person sooner vacates their office, every appointed member of the Quality Improvement Committee shall continue in office until a successor comes into office.

Any member of the Quality Improvement Committee may at any time resign as a member by advising the Minister of Health in writing.

Any member of the Quality Improvement Committee may at any time be removed from office by the Minister of Health for inability to perform the functions of office, bankruptcy, neglect of duty, or misconduct, proved to the satisfaction of the Minister.

The Minister may from time to time alter or reconstitute the Quality Improvement Committee, or discharge any member of the Quality Improvement Committee or appoint new members to the Quality Improvement Committee for the purpose of decreasing or increasing the membership or filling any vacancies.

The Chair will provide advice to the Minister on Committee appointments.

Reporting Requirements

The Quality Improvement Committee is required to:

report as necessary, but at least once a year, to the Minister on its advice on the matters referred to in section 17(3) of the Act
keep a record of all Committee meetings, which outlines the matters discussed and includes a clear note of all decisions taken or recommendations made.

Frequency of Meetings
The timing and frequency of meetings will be determined by the tasks the Committee is required to fulfill and as part of its work programme to be agreed with the Minister. All meetings of the Committee will be convened by the Chair (or Deputy Chair) as appropriate.

Attendance Fees
Members of the Quality Improvement Committee are entitled to be paid fees for attendance at meetings of both the Committee and its sub-groups. The level of fees is set in accordance with the State Services Commission’s framework for fees for statutory bodies. The Chair will receive $450 (GST exclusive) per meeting day for the Committee (plus half a day’s preparation fee per meeting). In addition the Chair is entitled to claim additional fees up to two days per month Committee related activities. The Chair will preside at every meeting of the Committee at which the Chair is present.

The attendance fee for members is set at $320 (GST exclusive) per day working for the Committee (plus half a day’s preparation fee for committee meetings or teleconferences). The attendance fee for teleconferences will be calculated on a pro rata basis (the hourly rate will be calculated at one seventh of the daily rate).

Meetings of the Committee
Meetings will be held in Auckland unless the Chair decides otherwise. Actual and reasonable expenses for activities required by the Committee of its members (e.g. travel, accommodation and meals) will be met from the Committee’s budget provided prior approval is received.

At any meeting, a quorum shall consist of nine members. A quorum must include either the Chair or Deputy-Chair.

Every question before any meeting shall generally be determined by consensus decision-making. Where a consensus cannot be reached a majority vote will apply. Where a decision cannot be reached through consensus and a majority vote is made, the Chair shall have the casting vote.

Duties and Responsibilities of Members
As an independent statutory body, the Quality Improvement Committee has an obligation to conduct its activities in an open and ethical manner. The Committee has a duty to operate in an effective manner within the parameters of its functions as set out in its Terms of Reference.

Committee members are expected to:

have a commitment to work for the greater good of the Committee. They are accountable to the Minister of Health
attend meetings and undertake Committee activities as independent persons responsible to the Committee as a whole
make every effort to attend all Committee meetings and devote sufficient time to become familiar with the affairs of the Committee and the wider environment within which it operates
declare any conflict of interest (as defined in the Ministry of Health conflict of interest protocol for statutory bodies) which may prevent them from impartially and fairly carrying out their Committee duties
make every effort to attend all the Committee meetings and devote sufficient time to become familiar with the affairs of the committee and the wider environment within which it operates
act responsibly with regard to the effective and efficient administration of the Committee and the use of committee funds.

Conflicts of Interest
Members must perform their functions in good faith, honestly and impartially and avoid situations that might compromise their integrity or otherwise lead to conflicts of interest. Proper observation of these principles will help protect the Quality Improvement Committee and its members and will ensure it retains public confidence.

Members attend meetings and undertake committee activities as independent persons responsible to the committee as a whole. Members are not appointed as representatives of professional organisations and groups. The Quality Improvement Committee should not, therefore, assume that a particular group's interests have been taken into account because a member is associated with a particular group.

When members believe they have a conflict of interest on a subject that will prevent them from reaching an impartial decision or undertaking an activity consistent with the committee's functions, they must declare that conflict of interest and withdraw themselves from the discussion and/or activity.

Performance Measures
The Quality Improvement Committee will be effectively meeting its tasks when it provides relevant and timely advice to the Minister of Health based in research, analysis and consultation with appropriate groups and organisations.

The Quality Improvement Committee must:

agree in advance to a work programme with the Minister of Health
achieve its agreed work programme
stay within its allocated budget.

The Committee will agree a work programme in advance with the Minister that fulfils its functions and can be achieved within a sufficient, allocated budget.

In carrying out its functions the Committee must ensure that:

appropriate consultation has occurred when developing a methodology and subsequently disseminating findings
any recommendations are developed in the context of available evidence
any advice and recommendations comply with the laws of New Zealand
its recommendations are published and widely available.

The Secretariat
A secretariat to the Quality Improvement Committee will be based in the Ministry of Health funded out of the Committee’s allocated budget.

The Secretariat will provide advice and guidance on governmental and ministerial processes and support the Committee to meet its statutory requirements.

The Secretariat will be responsive to requests from Committee members, members of the public and other stakeholders

This document was authorised by

Hon Pete Hodgson
Minister of Health

17 April 2007