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

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.

Unqualified audit opinions were issued on the NSW Government controlled insurance and compensation entities’ 30 June 2013 financial statements, except the NSW Self Insurance Corporation (SICorp). SICorp’s audit opinion was qualified due to non-compliance with Australian Accounting Standards applicable to general insurance contracts. The auditor’s reports drew attention to the significant uncertainty in estimating outstanding claims liabilities of $14.0 billion in the Workers’ Compensation Nominal Insurer and $2.1 billion in the Lifetime Care and Support Authority. The audit of the Building Insurers’ Guarantee Corporation was not complete at the time of this report and is excluded from this commentary. 

The NSW Government does not estimate or report the total cost of alcohol abuse. The Audit Office of New South Wales’ sponsored research estimates it costs the government over $1 billion a year, or around $416 from each NSW household.

Parliamentary reference - Report number #235 - released 6 August 2013

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

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

The NSW Government’s defined benefit superannuation funds have had positive returns for the last three years. However, the returns fell significantly in 2011-12. Global economic conditions led to substantial volatility and uncertainty in markets creating challenges for superannuation funds’ trustees.

The following overview of audits from 2011 found agency restructures significantly impacted agency financial reporting processes, agencies are having difficulty establishing and enforcing compliance with their own policies and procedures, agencies experienced problems complying with regulations and providing adequate documentation to support their financial statements, the poor quality of some financial statements with 1,256 misstatements identified, 540 so significant they had to be corrected, deficiencies in information security exist across many agencies, computer system disaster recovery plans for financial systems not existing or outdated, do not align with agencies’ business recovery requirements, do not properly identify and assess critical systems and processes and testing is incomplete.

We found that hospitals are generally able to deploy their VMOs and staff specialists to be at the place and time required. However, a hospital’s ability to manage supply and demand at a local level is limited. This limitation will become more critical with the current national health reforms when public hospital funding will depend on their ability to set and meet activity targets and priorities. NSW Health cannot be sure that all payments made to VMOs are for agreed and delivered services. Across the hospitals visited we found limited checking of VMO claims for payment, limited quality information on staff specialist activities and limited hospital-level analysis of trends or inconsistencies in activities and treatments.

Parliamentary reference - Report number #219 - released 14 December 2011

The audits of the New South Wales Government controlled superannuation entities financial statements for the year ended 30 June 2011 resulted in unmodified audit opinions within the Independent Auditor’s Reports. Findings show that Treasury should review the structure and number of public sector superannuation funds and consider whether efficiencies and cost savings could be achieved through consolidation.