Area Health Services and hospitals have developed programs which can provide clinical outcomes as good for patients as in-hospital care and can reduce the time they spend in hospital. They have operated for several years and show considerable potential. Ageing of the population, increasing costs and higher expectations of health care will continue to challenge health systems. Sometimes, unfortunately, the system struggles to cope. 

Parliamentary reference - Report number #182 - released 24 September 2008

The Better Practice Guide (BPG) aims to provide guidance for those implementing an amalgamation. It provides a series of questions identifying what needs to be done to achieve a successful amalgamation following the formal announcement of the amalgamation and the Administrative Orders for the new arrangements being finalised. The BPG’s aim is to alert those managing an amalgamation to actions that should be considered. How the Guide is applied will depend on circumstances. A lot will depend on how clear the expectations of the amalgamation are and on how complex it is.

Parliamentary reference - Report number #176 - released 5 March 2008

Both Commerce and DPI substantially achieved their stated amalgamation savings objectives as set by government. The departments are expected to achieve savings targets of about $150 million and $190 million respectively over their first four years. Our analysis indicates that there are two key factors in successful amalgamations. The first is effective early planning by departments based on clear objectives, supported by quick action. Second, significant synergies in service delivery can be achieved when departments with similar services and customers are amalgamated. The Department of Primary Industries is an example.

Parliamentary reference - Report number #175 - released 5 March 2008

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

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

The Audit Office is of the opinion that there are several features of the current Senior Executive Service (SES) model, or its application, which hinder the capacity of the SES to operate effectively in line with the Government’s stated objectives. The ultimate effect of these features is to reduce the capacity or perceived capacity of the SES to meet the Government’s objectives for the operation of the SES.

Taken overall, difficulties in the SES identified by the audit included: uncertainty caused by the way some contracts have been applied in practice, removal for reasons other than poor performance, informal strategies such as using restructuring to “terminate contracts and to move people in and out of positions regardless of their formal reported performance” (Section 5.4), inconsistently applied rules about selection/recruitment, appointment and removal of the SES, an imbalance between CES responsibility to the Minister as the employer/reviewer with their responsibility not to act in a political or partial manner, apparent lack of rigour in, value of and Ministerial accountability for CES performance review processes and failure to implement an adequate system of rewards and sanctions related to performance.

Parliamentary reference - Report number #59.1 - released 17 December 1998

This Performance Audit Report, prepared by the University of Technology, Sydney (UTS) on behalf of The Audit Office of New South Wales (NSW), is a study of the NSW Senior Executive Service (SES).

It found the dissonance between where optimal executive performance might take place on a performance spectrum, encompassing the formal SES and less formal political arenas, is canvassed. The critical point here is that this arena, between the informal political actions and the application of formal SES structures, where much of the important decision making takes place, will always be difficult to manage. Transparency in decision making processes where non partisan and partisan actions are clearly defined seems a primary essential element of performance if the integrity of the NSW SES is to be maintained.

Parliamentary reference - Report number #59.2 - released 17 December 1998

NSW Health has progressed in identifying and addressing key R&D issues in a complex and difficult environment. The Infrastructure Grants Program (IGP) is an innovative program and reflects a commitment by Government to support research infrastructure. The IGP has as its aims the provision of significant funding accompanied by clear research objectives and criteria for accountability and introduces a rational basis for the allocation of infrastructure grants.

While NSW Health has progressed, there is an opportunity to make the IGP more efficient and effective. These opportunities are in the areas of addressing longer term planning issues in health, streamlining and clarifying eligibility and selection criteria, improving decision-making structures and processes and improving accountability.

Parliamentary reference - Report number #56 - released 25 November 1998

The Audit Office is of the view that:

• there is no system wide plan for the location of emergency departments. This function is undertaken by each Area Health Service

• 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

• there is no policy framework that recognises the increasing role and impact of private providers

• 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.

• 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