Reports
Actions for Mental health post-discharge care
Mental health post-discharge care
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
Actions for Volume Five 2015 Premier and Cabinet
Volume Five 2015 Premier and Cabinet
Volume Five 2015 covered Premier and Cabinet agencies such as the Department of Premier and Cabinet, Office of Sport, Venues NSW, Barangaroo Delivery Authority and Infrastructure NSW.
Actions for Sydney metropolitan bus contracts
Sydney metropolitan bus contracts
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
Actions for Volume Two 2015 focusing on Universities
Volume Two 2015 focusing on Universities
Generally, NSW universities are in a sound financial position, but average operating margins are falling and operating expenditure is growing faster than operative revenue.
The university sector’s average operating margin fell from 6.6 per cent in 2013 to 4.8 per cent in 2014 and combined operating expenditure grew 0.9 per cent more than operating revenue. Employee expenses in 2014 increased by an average of 5.1 per cent and other expenses by 5.8 per cent.
Operating expenditure grew at a faster pace than operating revenue at six of the ten NSW universities.
Actions for Managing length of stay and unplanned readmissions in NSW public hospitals
Managing length of stay and unplanned readmissions in NSW public hospitals
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
Actions for Areas of focus from 2014
Areas of focus from 2014
Actions for Transporting and Treating Emergency Patients
Transporting and Treating Emergency Patients
This audit follows our earlier studies on ambulance response times, on waiting times for elective (i.e. non-urgent) surgery and on the ‘Code Red’ status of hospital emergency departments. Those audits indicated that matching resources to the ever-increasing numbers of people seeking emergency treatment was certainly an issue, but not the only issue. We found that problems were also occurring at the ‘interface’ between different parts of the health system – when patients arrive in ambulances at emergency departments or when they need to be admitted from emergency departments to hospital wards.
Parliamentary reference - Report number #125 - released 28 July 2004
Actions for Planning statewide services
Planning statewide services
The Audit Office is of the view that:
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there is no system wide plan for the location of emergency departments. This function is undertaken by each Area Health Service
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coordination between the Department and the NSW Ambulance Service could be improved in aspects such as the collocation of facilities and direct communications between ambulances and emergency departments
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there is no policy framework that recognises the increasing role and impact of private providers
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the Department’s guidelines do not take into account demographic factors, the number of patients treated or the acuity of presentations as criteria for determining the size of an emergency department or the level and scope of emergency services that should be available at that location.
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the Department has introduced a range of initiatives over a period of time to improve the performance of emergency departments such as the establishment of the Integrated Bed Management Committee. Some have been quite effective, whilst others have had mixed success. There has been an overall improvement in emergency department waiting times for urgent cases. However, there has been little improvement in waiting times for less urgent cases and a decline in performance for access block (the time taken to be admitted to a hospital ward from the emergency department after a decision has been made that this is required).
Parliamentary reference - Report number #54 - released 21 October 1998