B.3 - Scrutiny

Introduction

ACT Health responds to requests from ACT Legislative Assembly Committees, including reports automatically referred from the ACT Auditor-General’s Office as required to assist with and ensure proper examination of matters.

ACT Health also responds to complaints that are referred from the ACT Ombudsman Office. In 2014–15, ACT Health received no complaints referred from the ACT Ombudsman. Some matters that are referred to the ACT Ombudsman regarding ACT Health are not within the jurisdiction of the ACT Ombudsman and are referred to the Health Services Commissioner in the Human Rights Commission or referred back to ACT Health.

Standing Committee on Health, Ageing, Community and Social Services - Annual and Financial Reports 2013–14

Reporting Entity

Standing Committee on Health, Ageing, Community and Social Services

Report Number

Report No 5. The report can be found at:

http://www.parliament.act.gov.au/in-committees/standing_committees/Health,-Ageing,-Community-and-Social-Services/annual-and-financial-reports-2013-2014/reports?inquiry=649333

Report Title

Annual and Financial Reports 2013-14

Government Response/ Submission Title

The Government Response is not due as at 30 June 2015.

Date Tabled/Released

5 May 2015

Recommendation Number and Summary of Recommendation

Recommendation 10: The Committee recommends that the ACT Government consider annual benchmarking for emergency department timeliness against peer group hospitals to provide a better indication of how the ACT is performing compared to similar hospitals.

Recommendation 12: The Committee recommends that ACT Government consider establishing targets to measure how effectively diversion to other health care and human services management programs is working to reduce frequent re-presentations at emergency departments.

Recommendation 13: The Committee recommends that ACT Government look to revise its information systems promptly in order to facilitate the recording and reporting of timeliness measures for non-elective surgery.

Recommendation 14: The Committee recommends that the ACT Government undertake additional efforts to ensure that hospital staff comply with hand washing guidelines.

Action

Recommendation 10 – Agreed.

  • ACT Health will endeavour to incorporate national peer group hospital results into our annual report for benchmarking purposes. Currently, ACT Health does not have access to national datasets for the purpose of generating our own national comparative figures. As such, ACT relies on data that is made available to jurisdictions via national publications.
  • ACT Health currently sources national peer group results and individual hospitals performance results from federal bodies such as the Australian Institute of Health & Welfare (AIHW) and the National Hospital Performance Authority (NHPA) annual hospital publications retrospectivity.
  • As these national publications can often take some time before they are made available to jurisdictions, ACT Health cannot guarantee that the inclusion of the most recent national data into our annual report.
  • Nevertheless, ACT Health will incorporate historic publicised national results into our annual report as per data availability.

Recommendation 12 - Agreed in Principle.

ACT Health is working with the ACT Primary Health Network (PHN) (formally ACT Medicare Local) to develop initiatives which are aimed at reducing pressure on Emergency Departments by providing better community based options. This initiative will initially focus on those with chronic conditions and those who present regularly at ED’s. Further extension will be determined following an evaluation of the work with the ACT PHN.

Recommendation 13 – Agreed.

This recommendation is currently a high priority for ACT Health. ACT Health currently working on ways to improve the capturing and reporting of non-elective surgery information to provide greater transparency in of this area.

Recommendation 14 – Agreed.

ACT Health strives to achieve continuous improvements in all areas including compliance with hand hygiene requirements. Since 2010 the Hand Hygiene Program at Canberra Hospital and Health Services (CHHS) has been coordinated via the Infection Prevention and Control Unit (IPCU) at Canberra Hospital, and has involved a multi-factorial approach to hand hygiene compliance ranging through education, audit and feedback, promotional activities, equipment and supplies, and focused area or unit specific intervention, with specific examples listed below. During this time the Hand Hygiene program has not only expanded significantly across the health service, but has also resulted in a steady increase in hand hygiene compliance (see graph), although further improvement is required, especially among Medical Practitioners.

Following each audit period the IPCU analyses the results according to the ward area, moment of hand hygiene and type of healthcare worker, to determine the areas to target with specific interventions prior to the next audit cycle. Whilst the IPCU has been essential in coordinating the program, the importance of individual ward areas and healthcare worker groups in leading and driving the program at a local level needs to be recognised.

Graph showing benchmark vs overall audit result

Status

In progress

Standing Committee on Health, Ageing, Community and Social Services - Inquiry into the sourcing and supply of dental prostheses and appliances to Australian dental practitioners from overseas 

Reporting Entity

Standing Committee on Health, Ageing, Community and Social Services

Report Number

Report No 4. The report can be found at:

http://www.parliament.act.gov.au/in-committees/standing_committees/Health,-Ageing,-Community-and-Social-Services/sourcing-and-supply-of-dental-appliances-and-related-products?inquiry=624642

Report Title

Inquiry into the sourcing and supply of dental prostheses and appliances to Australian dental practitioners from overseas

Government Response/ Submission Title

Letters were sent to the Chair of the Dental Board of Australia, the Director of the Therapeutic Goods Australia and the Chair of the Standing Committee on Health, Ageing, Community and Social Services 

Date Tabled/Released

17 March 2015

Recommendation Number and Summary of Recommendation

Recommendation 1: The Committee recommends that the ACT Government should request that the Therapeutic Goods Administration and the Dental Board of Australia consider amending the relevant regulations, codes and guidelines to require the details about the manufacturer of a custom-made dental device to be provided to the prescribing practitioner and the patient.

Action

Agreed. Correspondence was prepared and sent to the Chair of the Dental Board of Australia, the Director of the Therapeutic Goods Australia requesting they consider amending relevant regulations, codes and guidelines to require the details about the manufacture of a custom-made dental device to be provided to the prescribing practitioner and patient.

Status

Complete

 Standing Committee for Health, Ageing, Community and Social Services — Inquiry into the exposure draft of the Drugs of Dependence (Cannabis Use for Medical Purposes) Amendment Bill 2014

Reporting Entity

Standing Committee for Health, Ageing, Community and Social Services

Report Number

Not Applicable

Report Title

Report pending release

Government Response/Submission Title

ACT Government Submission to the ACT Legislative Assembly Standing Committee on Health, Ageing, Community and Social Services Inquiry into the Exposure Draft of the Drugs of Dependence (Cannabis Use for Medical Purposes) Amendment Bill 2014 and related discussion paper.

Date Tabled/Released

13 February 2015

Recommendation Number and Summary of Recommendation

As at 30 June 2015, the inquiry was ongoing

Action

Not Applicable

Status

In progress

 Select Committee on Estimates 2014-2015 - Inquiry into Appropriation Bill 2013-2014 and the Appropriation (Office of the Legislative Assembly) Bill 2014–2015

Reporting Entity

Select Committee on Estimates 2014-2015

Report Number

Report No 1. The report can be found at:

http://www.parliament.act.gov.au/in-committees/select_committees/estimates-2014-2015/inquiry-into-appropriation-bill-2014-2015-and-the-appropriation-office-of-the-legislative-assembly-bill-2014-2015/reports

Report Title

Inquiry into Appropriation Bill 2014–2015 and the Appropriation (Office of the Legislative Assembly) Bill 2014–2015

Government Response/Submission Title

Government Response to the Report of the Select Committee on Estimates 2014-2015 on the Inquiry into Appropriation Bill 2014–2015 and the Appropriation (Office of the Legislative Assembly) Bill 2014–2015

Date Tabled/Released

5 August 2014

Recommendation Number and Summary of Recommendation

Recommendation 91: The Committee recommends that the ACT Government collect, maintain and report annually on ACT school students’ health and fitness.

Recommendation 92: The Committee recommends that the ACT Government research and report on best practice programs to improve children’s health and fitness outcomes in the ACT by the last sitting day of March 2015.

Recommendation 94: The Committee recommends that where significant variations in the total cost or the government payment for outputs figures in the budget papers they should be accompanied by an explanatory note.

Recommendation 95: The Committee recommends that the Minister for Health update the Legislative Assembly when the detailed working figures used by the Commonwealth to derive the revised NHRA funding arrangements in its 2014‐15 Budget are made available.

Recommendation 96: The Committee recommends that the Minister for Health update the Legislative Assembly half‐yearly on the progress of updates to the Emergency Department Information System in response to Auditor‐General’s Report No.6 of 2012.

Recommendation 97: The Committee recommends that the Minister for Health detail to the Legislative Assembly improvements made to the Gastroenterology and Hepatology Unit to improve administration and governance in response to Auditor‐General’s Report No. 4 of 2014.

Recommendation 98: The Committee recommends that the Minister for Health detail to the Legislative Assembly how the issue of under reporting of incidents at the Canberra Hospital through the RiskMan system, as identified in Auditor‐General’s Report No. 4 of 2014, has been addressed.

Recommendation 99: The Committee recommends that the Minister for Health detail to the Legislative Assembly the current scope, quantum and effectiveness of government funding for Aboriginal and Torres Strait Islander health services in the ACT.

Recommendation 100: The Committee recommends that the Government take all possible steps to accurately evaluate the scope, cost and timetable of all capital works projects prior to commencement.

Recommendation 101: The Committee recommends that the ACT Government increase adult education regarding sufficient activity for those adults already engaged in some level of sport or fitness activity.

Recommendation 102: The Committee recommends that the ACT Government investigate the reintroduction of direct access to the ACT Equipment Loans Service for patients of private hospitals in the ACT.

Recommendation 103: The Committee recommends that the Government specifically address suicide among older Canberrans in its forthcoming suicide prevention initiative.

Recommendation 104: The Committee recommends that the ACT Government review the type of data collected by emergency response officers and hospital emergency room staff to better assist in dealing with alcohol-related injuries and incidents in the ACT and report to the Assembly by March 2015.

Action

Recommendation 91 – Noted.

The ACT Government has a range of mechanisms through which it collects health data of ACT school students. ACT school student’s health and fitness status is reported biennially in the Chief Health Officer’s report. Annual statistics are available. The Education and Training Directorate is working in partnership across ACT Government agencies to develop and implement programs that enhance children’s health and fitness. Action in schools is a high priority area within the Towards Zero Growth Health Weight Action Plan. Schools are already engaged with programs to improve the physical health of children such as the Walk and Ride to School Program, supporting schools canteens to provide healthy food choices and building physical activity into the school day. The Epidemiology Section of ACT Health collects and reports on the health and fitness status of primary and secondary school aged students in the ACT through several surveys including the ACT General Health Survey (GHS), the ACT Physical Activity and Nutrition Survey (ACTPANS), and the Australian Secondary Students’ Alcohol and Drug Survey (ASSAD). The GHS is conducted annually, while the ASSAD and ACTPANS are conducted every three years.

Recommendation 92 - Not agreed.

ACT Health routinely undertakes evaluation of its programs, many of which have historically been funded through the Healthy Children Initiative under the National Partnership Agreement on Preventive Health. The Commonwealth Government ceased this Agreement on 1 July 2014 and, accordingly, funding to the underlying programs has been cut. The ACT Government is currently looking at the impacts of this loss of funding.

Recommendation 94 - Agreed in principle.

The Government will examine this proposal during the 2015‐16 Budget process.

Recommendation 95 - Noted.

The ACT has not yet received a formal response to its request for detail to explain the derivation of the figures in the 2013‐14 and 2014‐15 Budgets.

Recommendation 96 - Noted.

There are only three outstanding issues in relation to the Auditor‐General’s report:

  • a single sign‐on system that reduces the time for people to log‐on to the system, as a means of eliminating the need for generic passwords;
  • adoption of new outcome measures for emergency department services; and
  • completion of relevant documentation for the system, in term of education, training, auditing and governance.

Two of these required the implementation of the new version of the emergency department information system in order to complete the actions. The new system was implemented in late June 2014, and work is now underway to complete these actions. In relation to outcome measures, the ACT is leading a national effort to consider possible outcome measures. This process will be completed in late 2014.

Recommendation 97 - Agreed.

Substantial work has been undertaken since the completion of the field work of the Auditor‐General’s office for this audit. ACT Health has introduced changes to improve processes for acceptance and registration of referrals and is focusing on increasing the Gastroenterology consultants’ utilisation of IT systems to triage, in an effort to streamline referral processing and booking of patients into clinics. Enhancements to the electronic referral system have also been identified and are being developed, which will improve the Gastroenterology and Hepatology Unit’s visibility of their demand, enabling better management of appointment requirements.

Recommendation 98 - Agreed.

This will occur as part of the ACT Government’s response to the Auditor‐General’s report.

Recommendation 99 - Noted.

The ACT Government will consider reporting to the Legislative Assembly at an appropriate time.

Recommendation 100 - Agreed in principle.

The Government notes the comments in the report in relation to the significant challenges associated with budgeting accurately for the timing of delivery of health related infrastructure. The CMTEDD has implemented The Capital Framework, designed to enhance the evaluation of the scope, cost and timing of capital works prior to any budget funding being allocated.

Recommendation 101 - Noted.

Following the cessation of the National Partnership Agreement on Preventive Health from 1 July 2014, funding for programs under the Healthy Workers Initiative has been cut. The ACT Government is currently looking at the impacts of this. Funding from the Healthy Canberra Grants Program to the Heart Foundation will deliver the Live Lighter campaign, targeting adults, to increase awareness around obesity and promotion of increasing physical activity and healthier eating.

 

Recommendation 102 - Noted.

The service is already available to patients discharged from private hospitals in the ACT.

Recommendation 103 - Agreed.

The document currently in development (the ACT Mental Health and Wellbeing (Suicide Prevention) Framework 2015‐2025) is positioned at a strategic, whole of government and whole of community level. The document identifies high level goals to promote mental health and wellbeing and reduce suicide and self‐harm across all age groups. Interventions for specific vulnerable groups, whether aged based, gender, ethnic groups, etc are not identified. Following the endorsement of the above Framework, each Directorate will develop a business plan or strategic policy to address the Framework objectives. It is within these documents that interventions targeted at specific groups will be contained. ACT Heath will develop a Mental Health Services Plan that will contain strategies targeted at various higher risk groups including older people at risk of suicide.

Recommendation 104 - Noted.

While the Government is committed to improving data collection in relation to alcohol-related harms in other areas, the collection of additional information above current requirements in emergency situations is not supported at this time. It is important that health services, and especially ambulance paramedics and clinical staff in the hospital emergency departments, manage presentations based on clinical need and record the primary condition they are treating, not the apparent cause of the condition.

Status

Complete

 ACT Auditor-General’s Office Performance Audit Report - Report No 5 of 2015 - Auditor – General’s Report - Integrity of data in Health Directorate

Reporting Entity

ACT Auditor-General’s Office Performance Audit Report

Report Number

Report No 5. The report can be found at:

http://www.audit.act.gov.au/auditreports/reports2015/Report%20No%205%20of%202015%20Integrity%20of%20Data%20in%20the%20Health%20Directorate.pdf

Report Title

Auditor – General’s Report - Integrity of data in Health Directorate

Government Response/Submission Title

Not applicable

Date Tabled/Released

Released 19 June 2015

Recommendation Number and Summary of Recommendation

As at 30 June 2015, the Committee was considering the report

Action

Not applicable

Status

In progress

 ACT Auditor-General’s Office Performance Audit Report - Report No 4 of 2014 - Auditor – General’s Report - Gastroenterology and Hepatology Unit, Canberra Hospital

Reporting Entity

ACT Auditor-General’s Office Performance Audit Report

Report Number

Report No 4. The report can be found at:

http://www.parliament.act.gov.au/__data/assets/pdf_file/0008/603773/Report-No-4-of-2014-Gastroenterology-and-Hepatology-Unit,-Canberra-Hospital.pdf

Report Title

Auditor–General’s Report - Gastroenterology and Hepatology Unit, Canberra Hospital

Government Response/Submission Title

Not applicable

Date Tabled/Released

 

Recommendation Number and Summary of Recommendation

As at 30 June 2015, the Committee was considering the report

Action

Not applicable

Status

In progress

 ACT Auditor-General’s Office Performance Audit Report - Report No 8 of 2013 - Management of funding for community services

Reporting Entity

ACT Auditor-General’s Office Performance Audit Report

Report Number

Report No 8 of 2013. The report can be found at:

http://www.audit.act.gov.au/auditreports/reports2013/Report_08-2013_-_Management_of_Funding_for_Community_Services.pdf

Report Title

Auditor-General’s Report – Management of funding for community services

Government Response/Submission Title

Government Response - Auditor-General’s Report  No 8 of 2013 - Management of funding for community services

Date Tabled/Released

Released 13 February 2015

Recommendation Number and Summary of Recommendation

As at 30 June 2015, the Committee was considering the report

Action

Not applicable

Status

In progress