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Reports

Published

Actions for Mental health post-discharge care

Mental health post-discharge care

Health
Internal controls and governance
Service delivery

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

Published

Actions for Large construction projects

Large construction projects

Treasury
Transport
Health
Industry
Planning
Premier and Cabinet
Whole of Government
Compliance
Infrastructure
Internal controls and governance
Management and administration
Procurement
Project management

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

Published

Actions for Managing length of stay and unplanned readmissions in NSW public hospitals

Managing length of stay and unplanned readmissions in NSW public hospitals

Health
Management and administration
Service delivery

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

Published

Actions for Areas of focus from 2014

Areas of focus from 2014

Education
Community Services
Finance
Health
Industry
Justice
Local Government
Planning
Premier and Cabinet
Transport
Treasury
Universities
Whole of Government
Environment
Compliance
Financial reporting
Fraud
Information technology
Internal controls and governance
Procurement
Project management
Risk

The 2014 audits showed that the quality and timeliness of financial reporting have continued to improve. However, many agencies do not have financial sustainability indicators that provide early warning of management issues, such as an inability to meet financial obligations. Weaknesses were identified in information security, management of leave balances, asset management and internal controls.
 
Governance issues and gaps in performance information and reporting across the sector suggest Chief Financial Officers should have a stronger role and be more involved in strategy and risk management to maximise performance and add value.
 

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 Cost of Alcohol Abuse to the NSW Government

Cost of Alcohol Abuse to the NSW Government

Treasury
Justice
Health
Premier and Cabinet
Management and administration
Regulation

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

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 Transporting and Treating Emergency Patients

Transporting and Treating Emergency Patients

Health
Service delivery
Shared services and collaboration

This audit follows our earlier studies on ambulance response times, on waiting times for elective (i.e. non-urgent) surgery and on the ‘Code Red’ status of hospital emergency departments. Those audits indicated that matching resources to the ever-increasing numbers of people seeking emergency treatment was certainly an issue, but not the only issue. We found that problems were also occurring at the ‘interface’ between different parts of the health system – when patients arrive in ambulances at emergency departments or when they need to be admitted from emergency departments to hospital wards.

 

Parliamentary reference - Report number #125 - released 28 July 2004