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What you need to know about the inspection and certification of hospitals, clinics and doctors’ practices

5 November 2021

The Office of Health Standards Compliance (OHSC) was created by Parliament to protect and promote the health and safety of users of health establishments across the country.

Among the core functions of the OHSC is the conduct of routine inspections of health establishments to measure them against norms and standards determined by the Minister of Health. The assessment process results in the certification of those health establishments that meet the required norms and standards, or the issuing of compliance notice to health establishments that fail to meet the norms and standards.

Once the Minister of Health has promulgated norms and standards for various categories of health establishments, the OHSC develops inspection tools that are used to ascertain whether norms and standards have been met.

Scope of norms and standards

The regulated norms and standards for health establishments apply equally to public and private hospitals, public sector clinics and community health centres, private health clinics and General Practitioners (GPs) practices. Since the scale and range of services offered differ among these different healthcare sectors, different inspection tools are developed and used to measure compliance. The main categories of standards are:

User rights – User information; access to care; and waiting times

Clinical governance and clinical care – User health records and management; clinical management; infection prevention and control; waste management; and responses to adverse events

Clinical support services – Medicines and medical supplies; diagnostic services; blood services; medical equipment

Facilities and infrastructure – Management of buildings and grounds; engineering services; transport management; security services

Governance and human resources – Governance; human resources management; occupational health and safety

Routine inspections for different categories of health establishments can only commence once norms and standards for that category have been prescribed and related inspection tools have been finalised in consultation with stakeholders. This is a phased process:

  • By 2019, the OHSC had finalised regulatory processes and began to inspect public sector clinics and community health centres.
  • From 2022, public and private hospitals will form part of the OHSC’s compliance inspection schedule.
  • The development of Inspection tools for district and regional hospitals in the public sector have been completed.
  • Inspection tools for private hospitals are at an advanced stage of development and approval.
  • The OHSC has been engaging stakeholders on the development of inspection tools for general medical practitioners (GPs).
  • Emergency medical services tools have been developed and will be the next major category to receive attention.

Although the OHSC conducts hundreds of routine inspections, unannounced and risk-based inspections each year, it will have to significantly increase its capacity to inspect and consider certification of health establishments in all categories.

The OHSC publishes an annual inspection plan on its website in April of every year, and any establishment that is selected for inspection is notified in advance.

Quality – our starting point and destination

As a regulatory body, the OHSC stands on solid ground in terms of enforcing standards for the improvement of quality of healthcare. We believe that healthcare professionals also want the best for our healthcare users.

The OHSC is concerned with achieving minimum standards in relation to the systems and procedures of health establishments. Upholding these standards benefits both users and healthcare providers by creating an environment in which risks are minimised and positive results enhanced. The promulgated norms and standards are essential to effective and quality healthcare and should be achievable by all.

In a country such as ours, with significant historical inequalities in the provision of health services, it is critical that we approach the challenge of quality by addressing inequities through raising the overall quality of healthcare services. This approach is also essential to the introduction of National Health Insurance (NHI), that will finance essential health services from a single national health insurance fund.

It is widely acknowledged that a lot of work still needs to be done to improve the quality public health services. Furthermore, the Competition Commission’s Health Market Enquiry underscored the existence of substantial quality issues even in the better-resources private health sector.

The draft National Health Insurance (NHI) Bill provides that certification by the OHSC will be a precondition for health service providers seeking to obtain accreditation and ultimately be able to contract with the National Health Insurance Fund. Perhaps stakeholders are anxious about fulfilling this requirement timeously in light of the current pace of inspections. We are very conscious of this issue and seeking both to increase the resourcing of the OHSC and improve efficiencies.

Telephone: 012 942 7700 • Physical Address: Office of Health Standards Compliance, 79 Steve Biko Road, Prinshof, Pretoria • Postal Address: OHSC Private Bag X21 Arcadia, 0007 • Email: admin@ohsc.org.za • Website: www.ohsc.org.za