NDOH Perspectives on Regulated Norms and Standards Ramphelane Morewane NDoH

Presentation Outline Legislative Framework Institutional Arrangements DOH measures NDOH views of OHSC Roles and Responsibilities Suggested Approach Way Forward

Legislative Framework Constitution and Bill of Rights National Health Act Regulations Norms and Standards Other related legislation e.g. Medicines Control Act, PFMA, OHSA etc Related Professional Acts and regulations Policies and guidelines Frameworks

Legislative Imperatives for quality of health care

Institutional Arrangements NATIONAL –Governance & leadership /M& E / Regulatory/ policy setting (Central Hospitals) PROVINCES –Co-ordination /governance/ monitoring (Regional and Tertiary Hospitals, DHS) DISTRICTS-Implementation of services (PHC facilities, CHC, CDC, Hospitals)

NDOH Measures Mechanisms for quality assurance: Internal Audit Ideal Clinic Framework Ideal Hospital Framework- Aligned to the OHSC Provincial Consultations and Orientation completed Ready for implementation

OHSC Roles and Responsibilities (NDOH Perspectives ) External Audit function “AG” Inspection Compliance Certification Enforcement Purpose : To assure the public that the specific HE is safe and delivers minimum standard of care as measured against the norms and standards set by the NDOH

IHRM-F Link to OHSC measures OHSC has 586 measures IHF elements and checklist match to 562 measures 24 OHSC measures relating to case management, billing, outsourcing of labour and other specific services are not applicable at the current stage

Ageing infrastructure Inadequate revenue collection Challenges affecting health system in South Africa- impact on the hospitals Funding constraints Inadequate human resource distribution and allocation (correct skills and numbers) Ageing infrastructure Inadequate revenue collection Inefficient supply chain management Poor quality of care Poor Health Technology Management

Developmental Approach Contextual to SA Evidence- based Guiding Principles / Approach Collaborative, less confrontational and less competitive but synergistic Developmental Approach Contextual to SA Evidence- based Robust measures that have the same intent (expected outcome) to ensure same standard measured Trust relationship between OHSC & DOH /HE

Way Forward OHSC measures to incorporate / take cognizance of existing Health System developments that are aligned to current regulations, Norms and Standard-must measure with same intent Suggest a small Technical Working Group from OHSC and NDOH to meet to reach common ground

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