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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 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