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Published

Actions for Volume Ten 2013 focusing on Health

Volume Ten 2013 focusing on Health

Health
Asset valuation
Financial reporting
Information technology
Infrastructure
Internal controls and governance
Management and administration
Project management
Risk
Shared services and collaboration

Unqualified opinions were issued for all agencies audited in the following report.

Some of the reports findings include:

  • Most cultural bodies rely heavily on government grants to fund services

  • The Sydney Opera House Trust earns most of its revenue from commercial operations

  • Less than half of the 2014-16 service agreements between HealthShare NSW and its customers have been signed. HealthShare NSW and health entities should finalise their 2014-2016 service agreements by no later than 31 January 2014

  • Five service level agreements with NSW Health Pathology for 2012-13 were never signed. NSW Health Pathology and local health districts/speciality networks should finalise their 2013-14 service agreements by no later than 31 December 2013

  • HealthShare NSW is committed to sharing internal audit findings across NSW Health

  • The Ministry has started a long-term project to review its policy directives

  • A recent review concluded the health sector has mature risk management practices

  • When changes to the Aboriginal Land Rights Act 1983 occur, the Minister should identify and assess any risks from the changes and develop strategies to mitigate against them.

Published

Actions for Reducing Ambulance Turnaround Time at Hospitals

Reducing Ambulance Turnaround Time at Hospitals

Health
Compliance
Management and administration
Service delivery

NSW Health has put in place initiatives to reduce the time ambulance crews have to wait at a hospital before they are able to leave and attend to other calls. Despite these actions, ambulance crews are waiting longer at NSW hospitals. Crews now wait on average nearly 32 minutes at a hospital before handing over a patient, up from about 24 minutes seven years ago.

 

Parliamentary reference - Report number #233 - released 24 July 2013

Published

Actions for Managing Operating Theatre Efficiency for Elective Surgery

Managing Operating Theatre Efficiency for Elective Surgery

Health
Compliance
Management and administration
Service delivery

Waiting times for elective surgery will continue to increase if NSW Health does not improve its management of operating theatres. On the positive side NSW public hospitals are performing more elective surgery than in previous years and are treating patients substantially within national clinical timeframes. However, more operations will be needed as targets are getting tighter and demand is growing.

 

Parliamentary reference - Report number #232 - released 17 July 2013

Published

Actions for Managing Forensic Analysis: Fingerprints and DNA

Managing Forensic Analysis: Fingerprints and DNA

Justice
Health
Internal controls and governance
Management and administration
Procurement
Risk
Service delivery
Shared services and collaboration
Workforce and capability

Fingerprints and DNA play a critical role in solving crime and serving justice, but DNA evidence can result in more arrests, more prosecutions and more convictions. We found that while police effectively prioritise fingerprint evidence, it could better manage the screening and analysis of both fingerprint and DNA evidence to reduce delays.

 

Parliamentary reference - Report number #195 - released 10 February 2010

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 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 Agencies working together to improve services

Agencies working together to improve services

Premier and Cabinet
Treasury
Justice
Transport
Education
Internal controls and governance
Service delivery
Shared services and collaboration

In the cases we examined, we found that agencies working together can improve services or results. However, the changes were not always as great as anticipated or had not reached maximum potential. Establishing the right governance framework and accountability requirements between partners at the start of the project is critical to success. And joint responsibility requires new funding and reporting arrangements to be developed.

 

Parliamentary reference - Report number #149 - released 22 March 2006

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