We see considerable potential for the Ministry of Transport to plan and manage interchanges more effectively, so as to make better use of our public transport network. We believe that the Ministry now needs to focus more on multi-modal transport planning and interchange performance. It needs to assign responsibility for the coordination and oversight of inter-modal operations to an entity resourced for the purpose. Without this it will continue to be very difficult to identify and address unmet needs, seek and secure stakeholder funding, and monitor and evaluate system performance.

Parliamentary reference - Report number #168 - released 6 June 2007

The Ambulance Service of New South Wales has substantially implemented the 28 recommendations of the 2001 audit report that it accepted. It has also introduced significant new initiatives to improve performance that were not part of the 2001 recommendations. It has made substantial changes to its organisation and operations to implement these changes. Many of the changes are still proceeding. The Service has addressed a key finding of the 2001 audit report - that it did not have adequate, relevant or credible management data for decision making. The Service now has five years of operational data from the Computer Aided Dispatch (CAD) system.

Parliamentary reference - Report number #167 - released 6 June 2007

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

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

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

Decisions to relocate government agencies to non-metropolitan areas are not made purely for cost reasons. They can also serve government policy objectives, such as promoting regional economic development.

Regardless of the policy objectives that may exist, I would expect that decisions on individual agency relocations would be based on sound business cases. Those business cases would show how the relocation achieves any relevant government objectives, what costs (or savings) would be involved, logistical considerations such as obtaining appropriate accommodation and staff, and any impacts on levels service to the public.

In my view, the existence of government policy objectives does not remove the need for individual decisions to be made in a transparent, rational and accountable manner. Responsible public servants should provide the appropriate information to government to allow it to judge how best to implement its policies.

Parliamentary reference - Report number #147 - released 14 December 2005

About one in every twelve Sydney people travels by train each weekday.

Unplanned disruptions to services are inevitable, even on the best-run railways.

Because of the complexities of Sydney’s rail network, a single event can disrupt many services.

From a passenger’s perspective, three issues are important –

• how quickly the disruption is fixed (“When will my train arrive?”)
• the accuracy of information provided about the disruption (“Should I change my travel/meeting/other arrangements?”)
• how often the disruptions occur (“Should I give up on rail travel?”).

In this audit, we looked at how well RailCorp responds when there are routine disruptions to its CityRail passenger services. We focused on how RailCorp manages passenger journeys and informs passengers.

This report informs Parliament and the community about the limitations of the current system, and what more needs to be done in order to minimise the impact of disruptions on passengers.

It should also help passengers judge the extent to which they can rely on the information they receive, and to better understand some of the obstacles faced by staff.

Parliamentary reference - Report number #139 - released 22 June 2005

Periodically we review the extent to which agencies have implemented the recommendations they accepted from our earlier audits.

This gives Parliament and the public an update on the extent of progress made.

In this follow-up audit, we examine changes following our May 2002 report on how well the:

• State Transit Authority maintained its buses
• Ministry of Transport administered contracts for the provision of regular passenger bus services.

Parliamentary reference - Report number #138 - released 14 June 2005

It is estimated that one in five people will be affected at some stage by a mental health problem or illness. The increasing prevalence of mental illness means that at some point in time most of us will either be affected or we will know of someone who is.

Although most people with mental illness can be treated in the community, at times some may require emergency treatment or admission to hospital for shortterm intensive therapy.

Not only are more mental health patients presenting to an emergency department for treatment than ever before, they are reportedly sicker and a greater number require admission to a hospital bed for further treatment. And, because of its very nature, those suffering from acute mental illness may not understand what is wrong or be able to communicate their problems clearly.

This makes access to emergency mental health services a significant issue for government that requires continuing attention.

The focus of this report is on the provision of 24-hour crisis services to adults. Emergency mental health services play a vital role in providing timely and appropriate care. Without proper treatment the severity of the illness may escalate, increasing the risk of self-harm or harm to others.

There have been many changes to mental health services over the last decade to deal with increasing demand. Much has been done to improve access to, and the quality of emergency services through significant increases in funding, the opening of new beds and the employment of more mental health staff.

Yet recent reviews have highlighted problems with accessing mental health beds and inadequate levels of psychiatric support in rural areas.

I believe that our report will provide valuable assistance to area health services on alternative models of emergency mental health care that better manage patient risk and further improve service quality.

Parliamentary reference - Report number #136 - released 26 May 2005

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