The Bulletin Volume 9

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OHSC Engages in Collaborative Skills Development Session with HWSETA

Dr Mathabo Mathebula, Chief Operations Officer of the Office of Health Standards Compliance (OHSC), has been invited to participate in a significant dialogue hosted by the Health and Welfare Sector Education and Training Authority (HWSETA). This discussion will enable the OHSC to share its expertise on the National Health Care Norms and Standards, aiming to enhance the quality of healthcare delivery across the sector.

Established under the National Health Act of 2013, the OHSC serves as an independent health regulator responsible for overseeing a wide range of health establishments in South Africa, from large hospitals and clinics to independent healthcare practices.

Key areas of discussion will include:

– Identifying Skills Needs: Assess the current skills landscape within the health sector to equip professionals to meet healthcare norms and standards better.
Support Mechanisms: Determining the necessary support to address existing skills gaps and needs and ensuring compliance with healthcare norms.
– Partnership Opportunities: Exploring potential collaborations to research and develop essential skills required for the health sector to meet the healthcare standards successfully.

For further details, please contact:
Ricardo Mahlakanya – Director: Communication and Stakeholder Relations
066 473 8666 / rmahlakanya@ohsc.org.za

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Highlights: Office of Health Standards Compliance 2023/24 Annual Performance Report

For Immediate Release
24 October 2024

Highlights: Office of Health Standards Compliance 2023/24 Annual Performance Report Pretoria – The Office of Health Standards Compliance (OHSC) presented its Annual Performance Report for the 2023/24 financial year to the Health Portfolio Committee. This report highlights the progress in implementing the entity’s Annual Performance Plan for 2023/24, based on the OHSC’s Strategic Plan for 2020-2025. The report allows the OHSC to evaluate its successes and areas for improvement. The OHSC is an independent health regulator established under the National Health Act of 2013. Its purpose is to oversee health establishments in South Africa, ranging from major hospitals and clinics to independent practices of doctors and other health professionals providing safe and quality healthcare services.

Compliance Inspection Analysis

As the regulatory body for health services, the OHSC protects and promotes health service users’ health and safety by conducting routine and additional inspections to assess whether various healthcare establishments comply with norms and, standards regulations. In this reporting period, the OHSC conducted 734 routine inspections at public health establishments and 60 at private acute establishments. Health establishments that achieved compliance status post-inspection were issued certificates of compliance, while those that were non-compliant received compliance notices outlining the necessary steps and timeframes for improvements. The OHSC’s role in ensuring safe and quality health services provisioning by health establishments contributes significantly to implementing the National Health Insurance (NHI). Obtaining an OHSC certificate of compliance is a prerequisite for health establishments to receive accreditation and contract with the NHI Fund.

Certification and Enforcement Analysis

The OHSC implemented several enforcement interventions in response to non-compliant health establishments. The OHSC registered a significant increase in the certification rate during the reporting period compared to the previous financial years. During this review period, 618 certificates of compliance were issued to health establishments that met the norms and standards regulations: 501 from routine inspections and 117 from re-inspections. The Certificate of Compliance is valid forfour years and must be renewed. According to Regulation 19, health establishments must apply to the OHSC to renew their compliance certificates no more than six months before the certificate expires.

Enforcement actions were taken against establishments that remained consistently non-compliant after re-inspection. As a result, 45 establishments received written warnings. A written warning is an enforcement action issued by the OHSC under Regulation 23 to individuals in charge for failing to address breaches of the norms and standards specified in the Compliance Notice issued by an OHSC inspector.

To strengthen the enforcement of the OHSC’s policy, the Office has introduced a pre-enforcement consultation process. This includes meetings with district health authorities and CEOs of public and private hospitals scheduled for re-inspections after non-compliance. Health establishments must present their remedial measures, discuss challenges to compliance, and share their readiness for re-inspection

Monitoring of Prescribed Norms and Standards

The OHSC’s core function as a healthcare regulator is rooted in the norms and standards for the national health system established by the Minister of Health. The OHSC continuously develops inspection tools for various levels of care based on these regulations through a consultative process involving relevant stakeholders. During this reporting period, the OHSC finalised inspection tools for central and provincial tertiary hospitals, piloted with inputs from health establishments before finalisation. Additionally, annual updates for inspection tools for clinics, community health centers, district hospitals, regional hospitals, and private acute hospitals have been completed. To further enhance quality and safety in the healthcare sector, the OHSC issued three recommendation reports during this period. The reports issued include the National Early Warning System, National Annual Returns recommendations, and others addressing identified gaps in the Eastern Cape province with suggestions for improvement.

Overall Annual Performance Analysis

The OHSC achieved an overall performance rating of 69.6% and received an unqualified audit outcome from the Auditor-General of South Africa. This positive audit opinion was made possible by ongoing improvements in internal controls, the institutionalization of good governance, policy reviews, and continuous monitoring of implementation. Total revenue increased by 2%, from R160,847,649 in 2022/23 to R164,449,593 in 2023/24. Meanwhile, total expenditure decreased from R187,212,951 in 2022/23 to R183,892,113 in 2023/24—a 2% reduction. Of the total expenditure, 58% was allocated to core functions, while support functions accounted for 42%. The entity maintained a vacancy rate of 4.55%, equating to six vacancies out of 132 funded positions. Ends.

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The OHSC and Health Ombud presents their 2023/24 Annual Performance Reports to the Parliament Portfolio Committee on Health

 

The OHSC Executive Management Team and the Health Ombud, Prof Taole Mokoena, led by the Board Chairperson, Dr Ernest Kenoshi, will brief the Health Portfolio Committee this afternoon on the 2023/24 Annual Performance Report.

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Highlights of the OHSC 2023/24 Annual Report

OHSC Tables its 2023/24 Annual Report the Health Portfolio Committee

The Office of Health Standards Compliance (OHSC) has finalised its 2023/24 Annual Report, which details the progress in implementing its Annual Performance Plan (APP). The OHSC is an independent health regulator created under the National Health Act of 2013 to ensure health establishments in South Africa – from major hospitals to clinics, the independent practices of doctors and other health professionals who provide healthcare services.

The 2023–2024 fiscal year heralds a new era for the OHSC as the entity reflects on its achievements and challenges from previous years. The entity continued to enhance its strategic objectives as outlined in the 2020 – 2025 Strategic Plan – our journey over the past four years. Despite facing challenges, the health regulator has achieved 69.6% (16) of the 23 planned APP output indicator targets, while 30.4% (7) have not been achieved. Of the achieved indicators, 62.5% (10 out of 16) were attributed to core programmes, while 37.5% (6 out of 16) were attributed to support programmes.

As a healthcare quality assurance regulator, the functioning of the OHSC is mainly influenced by the norms and standards prescribed by the Minister of Health. The OHSC continuously develops inspection tools for various levels of care through a consultative process involving relevant stakeholders. During the reporting period, the OHSC has finalised inspection tools for central and provincial tertiary hospitals. The inspection tools for central and provincial tertiary hospitals were piloted, and inputs from health establishments were considered before finalisation. In addition, annual updates for the clinic, community health centre, district, regional, and private acute hospital inspection tools have been finalised.

As part of monitoring compliance with the prescribed regulations, the OHSC is responsible for conducted routine and additional inspections in different categories of health establishments, both in the public and private health sectors. During the reporting period, the OHSC conducted 734 routine inspections in public health establishments against a target of 689 and 60 routine inspections at private sector health establishments.

In numerous instances, Health establishments that attained compliant status with the norms and standards regulations were issued certificates of compliance, and those that gained a non-compliant status were issued compliance notices. Compliance notices were sent to all non-compliant health establishments, indicating the steps to achieve the required service standards and setting timeframes for such improvements. During the period under review, 618 health establishments were certified. Of the 618 certified health establishments, 501 were from routine inspections, while 117 were from re-inspections.

Enforcement actions were taken against health establishments that were found to be persistently non-compliant with the regulated norms and standards after a re-inspection. As part of the enforcement action, a total of 45 health establishments were issued with written warnings.

The OHSC follows legal prescripts and regulations when collecting, processing, storing, and sharing its information with other parties. Our Information, Communication, and Technology (ICT) systems have been streamlined to protect information collected from electronic inspection tools, annual returns, early warning systems, and by developing self-assessment and dashboards.

In terms of complaints management, the office works with the Health Ombud, located within the OHSC, to consider, investigate, and dispose of complaints that lead to breaches of the prescribed norms and standards in a fair, economical, and expeditious manner. The complaints are risk-rated into low, medium, high, and extreme. All complaints that receive a high and extremely high-risk rating are referred for investigation.

In the financial year 2023/24, the OHO resolved 96.6% (2308/2389) of low-risk complaints within 25 working days of lodgment in the call centre and 54% (34/63) of medium-risk complaints within 30 working days through assessment and investigated a total of 44 complaints. The resolution rate of low-risk complaints was above 95% in all provinces.

During the period under review, a total of 132 posts were funded with 126 posts filled as of 31 March 2024. This equates to 95.45% of funded posts being filled. Out of the 126 posts filled, 47% (8/17) are women in Senior Management Services. Out of the the total positions, the youth is comprised of 13.5% (17/126), people living with disability is 0.8% (1/126).

The OHSC continues to raise awareness among key stakeholders on its role and powers. The organisation embarked on community campaigns in all provinces. Twenty-five (25) community stakeholder engagements were conducted to raise public awareness of the OHSC and Health Ombud’s role and powers.

General financial review

The total revenue increased by 2% from R 160,847,649 in 2022/23 to R 164,449,593 in 2023/24. The OHSC’s expenditure decreased from R 187,212,951 in 2022/23 to R 183,892,113 in 2023/24, which represented a decrease of 2%. Due to the nature of its current operations, the total expenditure for the OHSC’s core functions was 58%, and the support functions accounted for 42% of the total expenditure .

In terms of the NHI Act, all health establishments must obtain certification to participate in the NHI fund. Taking this into account, the OHSC’s scope of work is enormous and requires sufficient funding to be able to be executed efficiently. Currently, the OHSC faces human resource capacity constraints as a result of the limited funding, and this will impact the OHSC’s ability to deliver on its mandate.

Discontinued key activities/activities to be discontinued

There were no discontinued key activities in the OHSC during the year under review.

Requests for rollover of funds

During the year under review, the OHSC requested the National Treasury to retain the surplus of R29 million for the 2022/23 financial year and this was approved. The surplus was largely used to fund the employment of staff on short-term contracts to supplement the existing capacity and other operational activities.

Supply chain management

The OHSC has supply chain management policies and procedures for procurement activities in place and applies the National Treasury prescripts to ensure compliance with legislative requirements.

All concluded unsolicited bid proposals for the year under review

No unsolicited bid proposals were concluded for the year under review. Measures to prevent and detect irregular expenditures included revised and optimised procurement delegations and continuous review of SCM circulars and policies to align with new directives issued by the National Treasury. There is continuous engagement with Internal Audit, Internal Control, and risk management to identify emerging risks.

Audit report matters in the previous year and how they would be addressed

The OHSC has implemented a tracking register of all internal and external audit findings to monitor the implementation of recommendations made by the auditors. Progress on implementing action plans is reported to the Audit, Risk, and Finance (ARF) Committee and Board quarterly.

Challenges experienced and how they will be resolved

Despite limited financial and human resources, the OHSC continues to strive to fulfill its legal mandate. The limited number of permanent funded posts in the structure continues to humper the operations. These limitations compromised the OHSC’s ability to expand inspections and development of more inspection tools. As a result, the OHSC had to appoint contract workers to assist with the workload.

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The Office of Health Standards Compliance joins the healthcare community globally in observing World Patient Safety Day 2024

Pretoria. The Office of Health Standards Compliance (OHSC) unites with the healthcare community globally in observing World Patient Safety Day 2024 under the theme “improving diagnosis for patient safety” with the slogan “Get it right, make it safe!” highlighting the critical importance of correct and timely diagnosis in ensuring patient safety and improving health outcomes. The World Health Organization’s (WHO) established this global public campaign to raise global awareness about patient safety and call for solidarity and united action by all countries and international partners to reduce patient harm.

The OHSC is an independent regulatory body for health services established by the government to ensure quality and safety in healthcare by promoting and protecting the health and safety of users of health services. Patient safety is at the heart of the OHSC, and the entity perseveres in its endeavours and contributions to building a quality and safe healthcare system. As the regulator, the OHSC continues advocating for quality and safe healthcare for users by exercising its oversight role in health establishments – from major hospitals to clinics, the independent practices of doctors, and other health professionals to monitor compliance requirements with the prescribed norms and standards regulations. In this regard, the OHSC enhanced support to the public and private health sectors to improve the performance of health establishments against the norms and standards. With the entity operating in a highly regulated environment, the OHSC has undertaken a diagnostic assessment study to determine the state and performance of its monitoring and evaluation system – this will, in turn, strengthen our compliance inspection function. Furthermore, with the entity’s functioning essentially governed by the norms and standards prescribed by the Minister of Health, the entity continues to develop inspection tools for various health establishment categories.

To ensure compliance by health establishments, the OHSC continues its enforcement efforts, taking action against those persistently non-compliant with the regulated norms and standards after re-inspection. In this regard, the OHSC established an Enforcement Committee to oversee the OHSC’s compliance enforcement function and ensure that it is executed according to the organisation’s relevant legislation and prescripts. The OHSC continues to closely monitor risk indicators through the Early Warning System (EWS) to identify serious breaches of norms and standards. The information collected through EWS guides the authorities in addressing challenges that may result in serious harm to users. The EWS recommendations report outlines the trends in breaches of norms and standards related to patient safety and overall health system weaknesses and provides explicit recommendations to address these weaknesses. The OHSC persists in working closely with the Office of the Health Ombud (OHO), which is mandated to protect and promote the health and safety of healthcare users by considering, investigating, and disposing of complaints in the national health system. These complaints relate to non-compliance with prescribed norms and standards. The OHSC and OHO urge healthcare users and the public to report any poor quality of healthcare received from both public and private facilities to the Office of the Health Ombud through our Toll-Free Call Centre number at 080 911 6472 or email
complaints@ohsc.org.za.

Media Statement_OHSC Commemorates World Patient Safety Day 2024 (1)

Ends.
Issued by the Office of Health Standards Compliance.
For Media Enquiries Contact:
Ricardo Mahlakanya – Director: Communication and Stakeholder Relations
066 473 8666 / rmahlakanya@ohsc.org.za

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The Office of Health Standards Compliance pays tribute to nurses on International Nurses’ Day 2024

Pretoria. As the global health community and the world at large commemorate International Nurses Day, the Office of the Health Standard Compliance (OHSC), the regulator of healthcare services, joins in recognising and acknowledging the commitment and dedication of all nurses. This year’s International Nurses’ Day is celebrated under the theme “Our Nurses, Our Future. The Economic Power of Care”, as set by the International Council of Nurses (ICN). The Council set out the economic power of care, which creates healthy people and societies and drives healthy economies. Nurses are critical stakeholders of the OHSC; the entity shares the fraternity’s belief that investing in people leads to a healthy workplace, communities, and economies, all promoting economic and health security.

Nurses play a crucial role in creating a safe and healthy healthcare environment. With this considered, the OHSC will continue to work with nurses and other health professionals to ensure quality and safety in healthcare across all health sectors.
“Today, we celebrate our nurses for the invaluable role they play in improving the lives of our communities and their incredible power of care that heals our families; our nurses remain at the forefront when it comes to diagnosing and treating the numerous ailments that our communities encounter,” stated Dr Siphiwe Mndaweni, OHSC Chief Executive Officer, in observance of this day. As the regulator of the healthcare sector, the OHSC appreciates and thanks all the nurses for their resilience and compassion in health sectors.

ENDS.

Issued by the Office of Health Standards Compliance.

For media inquiries, please contact Mr. Ricardo Mahlakanya on 066 473 8666.

Media Statement International Nurses Day 2024

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Quarterly Bulletin

The Office of Health Standards Compliance (OHSC) is the regulator mandated to protect and promote the health and safety of users of health services and healthcare personnel. As part of ensuring the delivery of its mandate, the OHSC is actively working on finalising the outstanding inspection tools for various categories of health establishments. The OHSC conducts regular guidance and support workshops for healthcare personnel on the implementation of norms and standards regulations applicable to different categories of health establishments.

The guidance and support workshops are facilitated by the sub-programme: Health Standards Development and Training which is within Programme 4: Health Standards Design, Analysis and Support (HSDAS) of the OHSC. The workshops are conducted with the relevant authorities to ensure that those responsible for the implementation of the norms and standards regulations have a common
understanding and interpretation of the requirements, the intended benefits of compliance and common application to improve the quality of the health system and its outcomes. The norms and standards regulations applicable to different categories of health establishments were promulgated in 2018 and came into operation in 2019. The prescribed norms and standards contains seven (7) chapters which has twenty-two (22) regulations.

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