On 17 December 2015 the NSW Acting Auditor-General, Tony Whitfield, released a report on the care that is provided to mental health patients in the first seven days after they are discharged from acute mental health units.
 
The audit examined models of care provided by five Local Health Districts: Northern NSW, Sydney, Western Sydney, Central Coast, and Murrumbidgee. The audit looked at how well these Local Health Districts implemented the Ministry of Health’s policy directive on the transfer of mental health patients from hospitals to the community.

Parliamentary reference - Report number #263 - released 17 December 2015

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

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

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

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

The Country Towns Water Supply and Sewerage Program has effectively promoted adoption of better management practices by local water utilities, but will not achieve its objective of eliminating the water supply and sewerage infrastructure backlog in urban areas of country NSW.
 
The $1.2 billion Program aims to help local water utilities provide appropriate, affordable, cost effective and well-managed water supply and sewerage services in the urban areas of country NSW. It has two broad elements:

• promoting adoption of better practices 
• providing financial assistance towards the capital cost of infrastructure backlog works.

Parliamentary reference - Report number #251 - released 4 May 2015

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

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

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

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