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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

Fare evasion on public transport

Transport
Management and administration
Regulation

The Audit Office is of the opinion that whilst agencies have taken steps to combat fare evasion, the current arrangements are not adequate and improvement is required. A significant number of passengers travel without paying the due fare, resulting in many millions of dollars in revenue foregone. Even when infringed, the majority does not pay the fine. To some extent it would appear to be due to the lack of a provision requiring evaders to produce valid identification.

There is a need for the State Rail Authority and the State Transit Authority to estimate more reliably the extent of fare evasion. Only with more accurate estimates can the most appropriate response to fare evasion be developed.

 

Parliamentary reference - Report number #78 - released 5 December 2000

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