Volume Twelve 2014 Health
Today the Auditor-General of New South Wales, Grant Hehir, released his Volume Twelve 2014 Report to Parliament focusing on agencies in the health cluster.
Improved financial reporting
The quality of financial statements in the health cluster continues to improve with significantly fewer misstatements. The financial statements of all cluster agencies received unqualified audit opinions.
Service delivery improved in 2013-14
NSW Health has maintained or bettered its emergency triage performance and the percentage of patients admitted for elective surgery within clinically appropriate timeframes has improved.
Patients are spending less time in hospital with the average length of stay down from 3.3 days in 2012-13 to 3.1 days in 2013-14.
"Given the increasing demand for health services across the State, NSW Health has improved its performance in a number of important areas," the Auditor-General said.
Local health districts and networks are admitting, transferring or discharging more emergency department patients within four hours on a State-wide basis. Despite this improvement, it will be a challenge for most local health districts to achieve the Australian Government’s 2015 target of ninety per cent in four hours.
Finances continue to be a concern
The Ministry of Health considers that three local health districts are underperforming and a further four are seriously underperforming. Finance was a common performance concern.
The Ministry can improve is cash management, with seven health entities holding excessive levels of cash at 30 June 2014 which could be better used elsewhere. On the other hand, five entities required cash assistance to manage their financial position and pay suppliers in 2013-14.
The Ministry of Health will provide $248.3 million in 2014-15 to New South Wales health entities to meet the gap between the efficient price and the expected cost of providing various hospital medical services. These payments will go to ten entities, down from 15 in the previous year.
Workforce management issues to be addressed
Health entities need to reduce sick leave, annual leave and overtime payments and ensure visiting medical officers submit their claims for payment on time.
"In particular, the Ambulance Service needs to further review its rostering practices to identify additional strategies to reduce excessive overtime and call back payments. It also needs to respond to significant challenges it faces in managing annual leave and sick leave," the Auditor-General said.
Ensuring staff take annual leave is a significant challenge for NSW Health with almost 30 per cent of staff having excessive balances. Effective monitoring is hampered by concerns that many timesheets are not reviewed and leave records are inaccurate.
Ambulance Service's patient billing system needs attention
The Ambulance Service of NSW continues to encounter problems with its patient billing system implemented in 2012-13. The Service estimated that $3.9 million in revenue was not collected in 2013-14 because some ambulance transport records were not entered in the billing system.
"The Ambulance Service and the Ministry of Health need to quickly address issues with the patient billing system to stem the leakage of revenue," said the Auditor-General.
At 30 June 2014, the Ambulance Service is owed $99.4 million by patients, of which $86.2 million is unlikely to be paid. An external review into the effectiveness of the revenue system and patient billing practices is planned for 2014-15.
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