OHSC Fraud Hotline

History

The OHSC has its roots in the National Health Act of 2003 which recognised the need to foster good quality health services and made provision for an "Office of Standards Compliance" to be created within the Department of Health (DOH). It also provided for inspectorates of health establishments to be established in all provinces.

The Act envisaged that the office set up within the DOH would play a dual role: it would advise on how to improve quality of care as well monitoring and reporting on non-compliance with health standards.This office was established as a cluster of DOH in 2008 and played an active role in driving quality assurance systems in the public health sector.

This cluster also co-ordinated the development of a comprehensive set of National Core Standards for Health Establishments (NCS). The process involved extensive consultation and piloting of the NCS before they were finally adopted by the National Health Council as policy, applicable in all provinces. Detailed tools for measuring compliance with the NCS were subsequently developed and health establishments began to self-evaluate using these tools.

However, even as the Office within the department was taking shape and generating national standards, broader health policy evolved and it became clear that there was a need for an independent body to certify health establishments in both the public and private sectors. This was especially relevant in the light of the 2011 decision to introduce a system of national health insurance over the course of the next 14 years and create a national health insurance fund which would purchase services only from certified healthcare providers.

The internal office became the springboard for the creation of this independent regulator, the Office of Health Standards Compliance (OHSC). Drawing on international best practice and insights from various regulatory bodies in South Africa, the office assisted in the drafting of the relevant legislation and developed a business case for the envisaged OHSC.

In addition, a national inspectorate of health establishments was set up within the DOH in 2011. The intention was that members of the inspectorate would transfer to the OHSC once the legislative process had been concluded and the OHSC had been created as a public entity.

A dedicated training course was developed for inspectors, and senior members of the team had opportunity to undergo additional training at the Care Quality Commission in the United Kingdom.

From 2012 to March 2015, the inspectorate conducted over 1 000 inspections of clinics, health centres, hospitals and district health offices as part of their preparation and training. While relevant health establishments participated voluntarily in this process and the DOH lacked the authority to certify compliant establishments, the progress was extremely valuable because it:

  • Provided an indication of the overall level of performance of health establishments in the public health system in relation to NCS.
  • Produced extremely useful information on the adequacy of the NCS for measuring quality of care. This knowledge is being applied in the drafting of the first regulations on norms and standards.
  • Gave health establishments a foretaste of the inspection process and how this could be used constructively to guide quality improvement.

The above developments ensured that, when the National Health Amendment Act was promulgated in 2013, giving birth to the OHSC, there was fairly widespread understanding in the healthcare sector of the concept of certification against prescribed standards.

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