Key components of system stewardship in Australia: A scoping review, Stage 1 and 2

In March 2021, the Final Report of the Australian Royal Commission into Aged Care Quality and Safety recommended that the Department of Health and Aged Care focus on stewardship of the aged care system and all its components. Funds were allocated in the 2021-22 Budget to strengthen the governance of aged care by creating a local network of department staff. The initial rollout, from 1 July 2021, involved establishing a regional presence in eight Primary Health Network (PHN) regions across Australia. Further funding was provided in the 2022-23 Budget to continue the regional stewardship approach.

The Department of Health and Aged Care has recognised that implementing stewardship requires a continuous improvement approach and that a developmental evaluation would assist to achieve this goal. Clear Horizon was commissioned to undertake this evaluation, which included a literature review in its early stages. The focus of the literature review was on system stewardship:

Stage 1: What is systems stewardship?

Stage 2: Is a systems stewardship approach effective?

▪ How is effectiveness defined?

▪ What is the impact of systems stewardship on systems, staff, and clients?

▪ What conditions are associated with successful implementation of systems stewardship?

This first report (Stage 1) addressed the first of these questions. This report (Stage 2) incorporates evidence on questions relevant to the effectiveness of systems stewardship in more detail.