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Reports

Published

Actions for Mental health post-discharge care

Mental health post-discharge care

Health
Internal controls and governance
Service delivery

On 17 December 2015 the NSW Acting Auditor-General, Tony Whitfield, released a report on the care that is provided to mental health patients in the first seven days after they are discharged from acute mental health units.
 
The audit examined models of care provided by five Local Health Districts: Northern NSW, Sydney, Western Sydney, Central Coast, and Murrumbidgee. The audit looked at how well these Local Health Districts implemented the Ministry of Health’s policy directive on the transfer of mental health patients from hospitals to the community.

 

Parliamentary reference - Report number #263 - released 17 December 2015

Published

Actions for Sydney metropolitan bus contracts

Sydney metropolitan bus contracts

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

On 9 September 2015, the Acting Auditor-General of New South Wales, Tony Whitfield, released a report on Sydney Metropolitan Bus Service Contracts.
 
All scheduled bus services in the Sydney metropolitan area are provided under contracts with the public and private operators. The contracts allow Transport for NSW (TfNSW) to determine what bus services are provided and to whom. This audit assessed the effectiveness of TfNSW’s design and management of these contracts.
 
Bus services provided under the Sydney Metropolitan Bus Service Contracts have largely been effective and efficient. Operators are mostly meeting their key performance indicators. Customer satisfaction is better than under the previous contracts and improving, patronage is increasing, and the unit costs of providing services are now lower than under the previous contracts. 
 
However, punctuality remains a problem. Private operators are mostly starting their trips on time, but rarely meeting their mid and end-of-trip targets. State Transit Authority’s (STA) punctuality is improving but is worse than private operators, and other areas of performance are generally below private operators.
 
The current situation is a substantial improvement over what we found in our 2010 audit on the previous contracts.

 

Parliamentary reference - Report number #258 - released 9 September 2015

Published

Actions for Managing length of stay and unplanned readmissions in NSW public hospitals

Managing length of stay and unplanned readmissions in NSW public hospitals

Health
Management and administration
Service delivery

NSW Health has achieved considerable success over recent years in reducing average length of stay despite increasing pressure on hospital admissions by older and chronically ill patients. This success has been driven by changes in the way health services are delivered, such as the increasing use of same day care for treatments that previously required overnight hospital stays. 
 
There is a good level of length of stay information available and this information is actively used to manage the time patients spend in hospital.
 
Available data suggest that the rate of unplanned readmissions has not reduced in NSW despite various statewide and local strategies. NSW Health is undertaking research to better understand unplanned readmissions, their causes and the best ways to address them.
 
There are many local and statewide initiatives that aim to reduce length of stay and unplanned readmissions. However, the impact of some local and statewide initiatives on length of stay and unplanned readmissions are not well understood and quantified due to the lack of evaluations conducted.

 

Parliamentary reference - Report number #250 - released 23 April 2015

Published

Actions for Management of road passenger transport regulation

Management of road passenger transport regulation

Transport
Management and administration
Regulation
Service delivery
Shared services and collaboration

The Audit Office is of the opinion that the Department’s levels of regulatory activity in respect of road passenger transport regulation may have exceeded optimum levels. The Department’s current focus on processing activity limits the Department in achieving all of its desired outcomes. The Audit Office considers that a change in the approach to undertaking and managing road passenger transport regulatory activities would achieve better outcomes for the community and a better use of resources within the Department.

The Audit Office believes that while there is scope to make some improvements from procedural changes, such changes would not be sufficient to generate significant improvements.

 

Parliamentary reference - Report number #75 - released 6 September 2000

Published

Actions for Hospital emergency departments: Delivery services to patients

Hospital emergency departments: Delivery services to patients

Health
Management and administration
Service delivery
Workforce and capability

There have been notable changes in the provision of emergency department services over the last decade, principally by increasing the number, seniority and training of staff and upgrading facilities. More recently, programs have focussed on achieving improvements in emergency department waiting times (the time taken to see a doctor) and access block (delay in accessing a hospital bed). However, these programs have had limited effect. Although waiting times for seriously ill patients have decreased, waiting times for around 95% of emergency department patients have increased or remain unchanged and performance against benchmarks for access block has declined each year.

Although The Audit Office identified opportunities to improve patient flow in the emergency department, benefits will be limited by access block and the congestion caused by being unable to move patients to a ward. Only a better balance of resources between inpatient access programs (that is booked and emergency department patients) will bring about improvements in access block.

 

Parliamentary reference - Report number #72 - released 15 March 2000

Published

Actions for Immunisation in NSW

Immunisation in NSW

Health
Service delivery
Shared services and collaboration

Improving immunisation levels has been a policy priority for NSW and Commonwealth governments since the early 1990s. Along with other States they are pursuing a range of initiatives aimed at reaching immunisation target levels above 95% by the year 2000. At such levels, the occurrence of vaccine preventable diseases is minimised and their spread prevented.

There is considerable support for this policy from the public, the medical profession and all levels of government. However, like much in public health, it depends for its success on effective cooperation between many participants, both nationally and locally, with competing demands on their time and resources.

 

Parliamentary reference - Report number #38 - released 12 June 1997