Compared to the mental health workforce in most other Australian states and territories, the NSW workforce is more concentrated in acute hospitals for adult patients and is marginally smaller for its population. NSW Health increased its mental health workforce between 2006 and 2009. It has improved the geographical distribution of clinicians across the state to more closely match need. It has also increased the number of staff working with younger and older mental health patients. These are positive achievements in a time of financial stringency.

Parliamentary reference - Report number #210 - released 16 December 2010

We found that the contract process was satisfactory. Ambulance data show that the performance of CHC is meeting contract requirements with the exception of the availability of the Wollongong helicopter. Ambulance’s ability to transport patients to the right hospital at the right time has improved. However the cost of the new Greater Sydney helicopter contract is three times higher than before.

Parliamentary reference - Report number #206 - released 22 September 2010

The report includes comments on his annual audit of entitlements paid to Members of NSW Parliament and financial audits of WorkCover, Justice Health, Waste Recycling Processing Corporation and some other NSW Government agencies.
 
In his audit the Auditor-General had called for a system to be developed to ensure accrued loyalty/reward benefits are used to reduce Members’ parliamentary business travel expenditure, rather than be forfeited when a Member leaves Parliament. He also called for better controls over the Logistic Support Allocation used for transport, communications, printing, stationery, office supplies and equipment.

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

Periodically we review the extent to which agencies have changed their practices as a result of our 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 September 2002 report, to assess whether NSW Health has improved its buying of hospital supplies using electronic systems.

NSW Health spends over $1.3 billion on hospital supplies. It is the largest expenditure area after employee costs. Reform of this area has the potential to make significant savings that could be redirected to frontline services.

As part of our series of audits in the area of e-government, our previous audit looked closely at the extent to which technology was being used to deliver potentially major savings in purchasing hospital supplies. This is a key area of so-called “process re-engineering” in the “e” field, and NSW Health provided an ideal case study.

Whilst implementing large-scale e-procurement has many technical aspects, it is not chiefly a technical issue. The key requirements for success reside in effective change management, in particular being clear as to who has the authority to make change decisions and be held accountable.

This audit looks at NSW Health’s successes to date, and its frustrations and challenges in making further progress in this field. Many of the issues raised in this report may provide lessons for any agency that is seeking to drive a significant change program.

Parliamentary reference - Report number #145 - released 23 November 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

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