The NSW Auditor-General, Peter Achterstraat, yesterday tabled his report to the NSW Legislative Assembly on whether NSW Health’s Out of Hospitals programs provide effective alternatives to treatment in hospital.
The Auditor-General’s main finding was Out of Hospital care must be increased across NSW to take pressure off NSW’s health system. The provision of out-of-hospital care is an innovative and cost-effective way of ensuring the best health care for the people of NSW. Without Out of Hospital care, NSW Health will have to open at least 300 beds every year to keep up with patient demand.
NSW Health’s Out of Hospital programs currently provide care to 45,000 patients in NSW each year, which is approximately three per cent of patients. The Auditor-General found there is potential for 10 per cent of patients to be treated by Out of Hospital programs.
The Auditor-General recommended NSW Health play a stronger role in the provision of Out of Hospital care, as the current system is ad hoc and largely hospital based. He also recommended NSW Health establish which Out Of Hospital programs work best, where to locate them, and provide support and qualified staff to ensure the right care is provided.
The Auditor General’s specific recommendations include:
- NSW Health should establish an interim team to plan the expansion of out of hospital programs, coordinate it with existing Area Health Service responsibilities, and monitor progress of implementation
- NSW Health should prepare the community for the change that more extensive use of out of hospital services will mean for them and their carers.
- To demonstrate that increasing out of hospital care capacity is a realistic way of responding to growing demand NSW Health should:
- ensure that it has systems to monitor the number of patients being treated in out of hospital programs and the cost of providing this care;
- confirm that increased out of hospital capacity is a realistic economic alternative to treating patients in hospital;
- determine the number and location of potential patients that can be treated in out of hospital programs;
- demonstrate the impact that the change will have on emergency department attendances and inpatient beds;
- identify the resources - people, systems and funding – required to achieve the increased out of hospital care capacity;
- ensure that health professionals are informed of how out of hospital care will affect them and their patients;
- establish quality indicators to ensure that out of hospital care is safe, appropriate and reliable;
- set targets for out of hospital performance and ensure appropriate monitoring, evaluation and public reporting;
- report progress against the State Plan, ensuring that data reported on the State Plan website accurately reflect progress.
- The Healthy at Home pilots should be continued until they more clearly demonstrate that the program is achieving its objectives.
The Auditor General also found NSW Health should be able to demonstrate significant progress toward the above recommendations by the end of the current financial year.
For more information, see: http://www.audit.nsw.gov.au/publications/reports/performance/2008/health_care/health_care-contents.htm
