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Reports

Published

Actions for Attracting, retaining and managing Nurses in hospitals

Attracting, retaining and managing Nurses in hospitals

Health
Internal controls and governance
Management and administration
Service delivery
Workforce and capability

The department has done well to attract and retain nurses. Between 2001-02 and 2005-06 the average number of nurses employed increased to 39,804 with the annual resignation rate falling from 16 to 14 per cent. Overall, the public health sector gained 5,588 nurses, representing an average annual increase of four per cent. Despite the gains, there are indicators that there may still not be enough nurses.

 

Parliamentary reference - Report number #162 - released 12 December 2006

Published

Actions for Helping older people access a residential aged care facility

Helping older people access a residential aged care facility

Health
Community Services
Compliance
Internal controls and governance
Management and administration
Risk
Service delivery
Shared services and collaboration
Workforce and capability

Assessment processes for older people needing to go to an Residential Aged Care Facility (RACF) vary depending on the processes of the Aged Care Assessement Teams (ACAT) they see and whether or not they are in hospital. The data collected on ACAT performance was significantly revised during 2004 making comparisons with subsequent years problematic. ACATs have more responsibilities than assessing older people for residential care. It is not clear whether they have sufficient resources for this additional workload.

 

Parliamentary reference - Report number #160 - released 5 December 2006

Published

Actions for Major infectious disease outbreaks: Readiness to response

Major infectious disease outbreaks: Readiness to response

Health
Internal controls and governance
Management and administration
Risk
Service delivery
Shared services and collaboration
Workforce and capability

NSW Health is working to increase its preparedness to respond to a major infectious disease outbreak. It is also contributing to the development of national policies, strategies and capabilities, which affect its level of preparedness. We found however little evidence that other jurisdictions were significantly further advanced than NSW in preparation and testing of plans for a pandemic. In our view NSW Health needs to balance the costs of over-preparedness and additional capacity that may never be used, against the very significant consequences of under-preparation. It needs to identify the desired level of preparedness for its Area Health Services, set measurable goals and identify key gaps between those goals and current capabilities. It needs to set clear plans for closing those gaps and then sustaining desired levels of preparedness.

 

Parliamentary reference - Report number #159 - released 22 November 2006

Published

Actions for Condition of State Roads

Condition of State Roads

Transport
Infrastructure
Internal controls and governance
Management and administration
Procurement
Project management
Service delivery

The Roads and Traffic Authority (RTA) has improved the overall surface condition of State Roads in the last decade. Country road surfaces are now generally much better. Ride quality has improved and cracking has been reduced. The RTA has also achieved a substantial reduction in the number of structurally deficient bridges over the same period. 

Despite a significant increase in the State’s contribution to maintenance since 1999-2000, the RTA has deferred road rebuilding projects. The RTA is rebuilding at less than half its long term target, and has not met this target at any time this decade. The RTA has not identified how it will address deferred rebuilding, although it advises it is developing a new road network management plan which will address this.

 

Parliamentary reference - Report number #157 - released 16 August 2006

Published

Actions for The Cross City Tunnel Project

The Cross City Tunnel Project

Transport
Treasury
Premier and Cabinet
Planning
Environment
Infrastructure
Management and administration
Procurement
Project management
Risk

In our opinion the Government’s ‘no net cost to government’ requirement was a legitimate (but not the only possible) basis for the tunnel bid process. The Government was entitled to decide that tunnel users meet the tunnel costs. Structuring the bid process on the basis of an upfront reimbursement of costs incurred (or to be incurred) by the Roads and Traffic Authority (RTA) was therefore appropriate.

In our opinion, however, the Government, Treasury and the RTA did not sufficiently consider the implications of an upfront payment involving more than simple project cost reimbursement (i.e. the ‘Business Consideration Fee’ component). In addition, the RTA was wrong to change the toll escalation factor late in 2002 to compensate the tunnel operator, Cross City Motorway Pty Ltd, for additional costs.

 

Parliamentary reference - Report number #152 - released 31 May 2006

Published

Actions for Fare evasion on public transport: Follow-up audit

Fare evasion on public transport: Follow-up audit

Transport
Finance
Management and administration

The overall level of fare evasion is now lower, and the revenue forgone much less, than in 2000. The estimation of fare evasion, detection of fare evasion and management of fare compliance by RailCorp, State Transit and Sydney Ferries has improved, although Sydney Ferries needs to improve further.

However, only one in four fines for fare evasion are paid within 12 months. This is worse than in 2000. And the number of frequent fare evaders has almost trebled. State Debt Recovery Office and the transport agencies need to develop new and improved strategies to reduce the level of fine default and to better manage frequent fare evaders.

 

Parliamentary reference - Report number #150 - released 26 April 2006

Published

Actions for Managing Hospital Waste

Managing Hospital Waste

Health
Management and administration

In 1998 NSW Health developed Waste Management Guidelines to promote continuous improvement in waste management across the public health sector. Systematic implementation of the Guidelines was impeded in 1999- 2000 by resistance from the waste industry and transport workers. Since then, NSW Health has not actively promoted waste management in public hospitals. As a consequence Area Health Services (AHSs) and hospitals have developed separate and individual responses to waste management. This has resulted in inconsistent management of waste by public hospitals, inappropriate segregation of waste and additional costs of waste disposal.

 

Parliamentary reference - Report number #105 - released 10 December 2002

Published

Actions for Managing Grants

Managing Grants

Community Services
Industry
Planning
Management and administration
Service delivery

In our view, the agencies we studied cannot be sure that the grants they allocate align with their corporate objectives, and that program outcomes are achieved. This is mainly due to problems with grant selection and the evaluation of results. It was good to see that most of the grants programs had funding objectives which were fairly clear. But we found problems across most programs which could affect the fair and equitable selection of grants, such as, often no procedures for assessing applications, no assessment guidelines for advisory committees, often no clear rationale for assessments and poor documentation of the reasons for decisions.

 

Parliamentary reference - Report number #104 - released 4 December 2002

Published

Actions for Electronic Procurement of Hospital Supplies

Electronic Procurement of Hospital Supplies

Health
Information technology
Management and administration
Procurement

Reform of procurement in the NSW public health system is a huge, complex and difficult task. Much thought has been given to this reform. An immense amount of planning and preparatory work is required, and is apparent. In our opinion, at this time, the NSW public health system is making only limited progress towards achieving the economies in purchasing that its size and market dominance could deliver. While millions of dollars in savings are potentially available, much needs to be done to realise this. It is critical that all those involved, at all levels, ensure that reform is given priority, and driven through to fruition.

 

Parliamentary reference - Report number #102 - released 25 September 2002

Published

Actions for Managing Risk in the NSW Public Sector

Managing Risk in the NSW Public Sector

Transport
Management and administration
Risk

The Audit Office is of the opinion that, while agencies are aware of the need to manage risk, their risk management falls short of better practice. Many agencies do not consider their risk management to be adequate. The survey suggests that some agencies, mainly those in the Public Trading Enterprise Sector have approached risk management in a systematic way and in accordance with the principles of better practice standards. Others, mainly departments not subject to commercial imperatives, have yet to progress the management of risk beyond the traditional response of insuring against the more common types of risk. Thus there is a danger that with a number of agencies, risk may not be managed adequately, especially in the General Government Sector.

 

Parliamentary reference - Report number #98 - released 19 June 2002