Reports
Actions for Activity based funding data quality
Activity based funding data quality
NSW Health has adequate arrangements to ensure that the data it uses for activity based funding is of reasonable quality. Activity Based Funding (ABF) represented 75 per cent of the funds provided to Local Health Districts (LHDs) and Speciality Health Networks in 2013-14.
For ABF to work it requires detailed information about patient activity in health services and costs of providing care.
Parliamentary reference - Report number #261 - released 4 November 2015
Actions for Identifying productivity in the public sector
Identifying productivity in the public sector
This report examines selected areas of government activity to see if sufficient information was available to identify and assess changes in productivity. The areas examined were primary and secondary school public education, acute inpatient care in NSW public hospitals, CityRail, the NSW Police Force, and the NSW Local Court.
Productivity is commonly defined as the amount of output per unit of input.
Parliamentary reference - Report number #256 - released 16 July 2015
Actions for Implementing performance audit recommendations
Implementing performance audit recommendations
NSW Government agencies have sound processes for implementing performance audit recommendations in Auditor-General’s Reports to Parliament. There are many cases of good practice. For example, some agencies formed a steering committee and developed a detailed plan to implement recommendations. Another incorporated the implementation of recommendations into both its business plan and the work plans of individual officers who were managing projects. Most agencies also used their Audit and Risk Committees to monitor recommendations.
We found some cases where agencies can improve how they coordinate actions to address recommendations. Most agencies were not revisiting these actions to determine whether they remain appropriate.
Parliamentary reference - Report number #254 - released 24 June 2015
Actions for Large construction projects
Large construction projects
The independent assurance given to the NSW Government and sponsor agencies on the viability of large capital projects throughout their lifecycle is inadequate. Government policy is regularly not followed and not properly communicated to those responsible for implementing such policy.
This audit sought to test the effectiveness of the NSW capital project assurance system - which includes gateway reviews and reporting - but significant levels of non-compliance identified in our case studies prevented this. The NSW Commission of Audit also identified this issue in 2012. Gateway reviews are conducted by independent reviewers at key stages of a project’s life cycle and provide an independent assessment on a project’s readiness to proceed to the next stage.
Parliamentary reference - Report number #252 - released 7 May 2015
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 Ambulance Service of NSW: Readiness to respond
Ambulance Service of NSW: Readiness to respond
This performance audit indicates that the Service has considerable work to do to reach its aspirations of being recognised amongst leading examples of best practice services. The commitment of the Service to serving the community and the professionalism of the Service's officers is not in question. It is, however, apparent that a number of barriers to performance will need to be overcome for the Service to perform as well as it would wish.
Parliamentary reference - Report number #80 - released 7 March 2001
Actions for Hospital emergency departments: Delivery services to patients
Hospital emergency departments: Delivery services to patients
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