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Reports

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 Volume Seven 2013 focusing on Superannuation and Insurance

Volume Seven 2013 focusing on Superannuation and Insurance

Finance
Treasury
Compliance
Cyber security
Information technology
Management and administration
Procurement
Project management
Shared services and collaboration

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. 

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 Purchasing Hospital Supplies: Follow-up of 2002 Performance Audit

Purchasing Hospital Supplies: Follow-up of 2002 Performance Audit

Health
Asset valuation
Financial reporting
Management and administration
Procurement
Service delivery

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

Published

Actions for Implementing Asset Management Reforms

Implementing Asset Management Reforms

Justice
Planning
Finance
Treasury
Asset valuation
Financial reporting
Infrastructure
Internal controls and governance
Management and administration
Project management

Hospitals, schools, public housing, roads, bridges, buses and trains are just some of the assets used by government in providing services to citizens.

The NSW Government’s asset base is impressive in size - with a value of around $167 billion and with government plans to spend around $8 billion acquiring or replacing assets in the current year. Another $2 billion is spent each year on maintenance.

Good asset management is very important to government; even a small efficiency gain in this area can provide significant returns. Good practice by those responsible for managing assets can improve reliability, extend asset life, save on maintenance costs and aid in identifying and disposing of unnecessary or non-performing assets.

Improving the NSW public sector’s approach to asset management has been on the reform agenda for at least a decade. Changes in practice have been accelerated more recently by integrating asset management policy with the budget process.

In this audit we examined NSW Treasury’s efforts to improve asset management practices in the public sector and the progress made by 3 agencies - the Department of Corrective Services, NSW Fire Brigades and the Powerhouse Museum - towards better managing their asset portfolios.

This report informs Parliament and the community on progress to date and what more needs to be done to ensure that agencies manage assets effectively and achieve best value.

 

Parliamentary reference - Report number #143 - released 12 October 2005

Published

Actions for Emergency Mental Health Services

Emergency Mental Health Services

Health
Management and administration
Service delivery
Shared services and collaboration
Workforce and capability

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

Published

Actions for Follow-up of Performance Audit: Collecting Outstanding Fines and Penalties

Follow-up of Performance Audit: Collecting Outstanding Fines and Penalties

Finance
Internal controls and governance
Management and administration
Service delivery

Periodically we review the extent to which agencies have implemented the recommendations they accept 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 April 2002 report on how well the State Debt Recovery Office (under the Office of State Revenue) was collecting outstanding fines and penalties.

 

Parliamentary reference - Report number #132 - released 17 March 2005

Published

Actions for Review of Walsh Bay

Review of Walsh Bay

Finance
Infrastructure
Management and administration
Procurement
Project management

The decision to seek development of Walsh Bay without a Master Plan and/or detailed study as to the state of the precinct presented significant problems throughout the life of the project. Now, four years later, negotiations still continue on the details of the final scheme. Based on the latest estimates, it will not provide a financial return as was originally expected. The audit found no evidence to indicate why the former Government wished to expedite Walsh Bay, but it is aware that there was an election due. Many of the problems which have been encountered could have been avoided with more careful and more extensive consideration at the start, particularly in the light of Property Services Group's recommendations.

 

Parliamentary reference - Report number #58 - released 17 December 1998

Published

Actions for Management of research - NSW Health: Infrastructure Grants Program

Management of research - NSW Health: Infrastructure Grants Program

Health
Internal controls and governance
Management and administration
Shared services and collaboration

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