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.