Reports
Actions for Mental health post-discharge care
Mental health post-discharge care
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
Actions for Large construction projects
Large construction projects
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
Actions for Managing length of stay and unplanned readmissions in NSW public hospitals
Managing length of stay and unplanned readmissions in NSW public hospitals
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
Actions for Areas of focus from 2014
Areas of focus from 2014
Actions for Volume Ten 2011 Focusing on Health
Volume Ten 2011 Focusing on Health
This report includes comments on financial audits of government agencies in the Health sector. In 2010-11, Ambulance Officers spent an extra 77,200 hours waiting at emergency departments for patients to transfer to hospital care. In 2010-11, only 66 per cent of patients were moved from the emergency department to an inpatient bed within eight hours of their arrival. This is significantly down on last year’s 73 per cent and well below the 80 per cent target.
Actions for Visiting medical officers and staff specialists
Visiting medical officers and staff specialists
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
Actions for Responding to Domestic and Family Violence
Responding to Domestic and Family Violence
Organisations generally work together to improve the safety of victims when there is an overt and serious crisis, particularly where children are involved. There are no standard ways for victims and perpetrators to access help that might prevent ongoing violence and address underlying issues. This is particularly problematic where there are repeat victims and perpetrators, many of whom have complex mental health, drug and alcohol problems and are difficult to work with. New South Wales has trialled a number of projects to improve the way that organisations work together to support vulnerable people in particular communities.
Parliamentary reference - Report number #218 - released 8 November 2011
Actions for The effectiveness of cautioning for minor Cannabis offences
The effectiveness of cautioning for minor Cannabis offences
Over the last ten years the NSW Police Force (Police) has used cautioning to divert over 39,000 minor cannabis offenders from the courts, saving at least $20 million in court costs. People cautioned for minor cannabis offences are also less likely to reoffend than those dealt with by the courts. Adults are more likely to be cautioned for minor cannabis offences today than when cautioning was introduced ten years ago. However this is not the case for young offenders who are more likely to be charged today. Cautioning may help people think about the consequences of their cannabis use. However few people seek help to reduce it with only 1.6 per cent of offenders contacting the drug helpline under the adult cautioning scheme. And there have been no evaluations yet on whether cautioning reduces drug use in NSW.
Parliamentary reference - Report number #211 - released 7 April 2011
Actions for Immunisation in NSW
Immunisation in NSW
Improving immunisation levels has been a policy priority for NSW and Commonwealth governments since the early 1990s. Along with other States they are pursuing a range of initiatives aimed at reaching immunisation target levels above 95% by the year 2000. At such levels, the occurrence of vaccine preventable diseases is minimised and their spread prevented.
There is considerable support for this policy from the public, the medical profession and all levels of government. However, like much in public health, it depends for its success on effective cooperation between many participants, both nationally and locally, with competing demands on their time and resources.
Parliamentary reference - Report number #38 - released 12 June 1997