1. DEPARTMENT OF HEALTH SEPTEMBER 2012 Briefing of the Portfolio Committee on Health by MEC For Health and Social Development the state of readiness for implementing the norms and standards 12 September 2012 1

2. Presentation outline Purpose Approach Number of facilities assessed Sample graph of the facilities Overview of the sampled facilities by domain. Challenges and strategic intervention 2

3. Purpose The purpose of the Presentation is to highlight the level of readiness by the Department of Health Limpopo in complying with the prescribed norms and standard. The presentation will further indicate the facilities assessed in preparation for the norms and standards and challenges and measures taken in ensuring that the province is fully ready. 3

4. Approach 4 Self assessment are conducted External training on baseline assessment and Quality improvements projects and by COHSASA. Follow-up of Health facility audits by facility improvement teams in Vhembe (NHI Pilot site)

5. FACILITIES ASSESSED ON NATIONAL CORE STANDARDS (NCS) The Following Number of Facilities Have Been Assessed from 2010-2012: 5 HOSPITALSCHC’SCLINICS 201012544 201121679 20127267 TOTAL4013190 TOTAL FACILITES ASSESSED = 243

6. FACILITIES INSPECTED JOINTLY BY OFFICE OF HEALTH STANDARDS COMPLIANCE (OHSC) AND PROVINCIAL M&E 6 DATEFACILITYSTATUS CAPRICORN DISTRICT 16- 18 July 2012Mankweng HospitalCompleted 19-20 July 2012Seshego HospitalCompleted WATERBERG DISTRICT 13-15 August 2012Warm Bath HospitalCompleted 16 August 2012Bela-Bela ClinicCompleted 17 August 2012District OfficeCompleted

7. READINESS INSPECTION ACTION PLAN BY NATIONAL WITH PROVINCIAL M & E 7 DATE SCHEDULEDFACILITY VHEMBE DISTRICT 22- 24 October 2012Elim Hospital Tshilidzini Hospital William Edie CHC Musina Clinic Thengwe Clinic Tshikundamamela Clinic Guyuni Clinic Vhembe District Office 25 October 2012Folovhodwe Clinic William Eddie Clinic

8. Assessment's were conducted using the following national core standard domains. 8 Annexure A shows sub-domain s

9. SAMPLED 4 FACILITIES THAT WERE PILOTED ON THE NEW REVISED TOOL BY THE OHSC IN AUGUST 2012 FACILITIES STILL NON-COMPLIANT 9

10. 10 BASELINE ASSESSMENTS OF FACILITY PER DOMAIN

11. 11

12. 12

13. Scoring and summary Cut-off levels for compliance required across all units – Vital 90% – Essential 80% – Developmental 60% 3 options in listing failed measures (domains & standards, 6 priorities, functional areas) 13

14. Challenges and intervention Priority AreasChallengesIntervention Positive and caring attitude Shortage of staff resulting in burnout Continuous recruitment and retention of staff Reduction on waiting time Shortage of Health Professionals Retention Strategy being implemented. Introduction of fast lanes established in some facilities. Few consultation rooms Continue with revitalisation of facilities Drug AvailabilityInability to deliver required stock by suppliers Shortage of Pharmacy personnel Turn around strategy for the pharmaceutical depot developed Train,recruit and retain pharmacy personnel 14

15. Priority AreaChallengesInterventions. Improvement In Cleanliness Shortage of CleanersMotivate to appoint more cleaners at facilities. Patients SafetyInadequate security at facilities Terms of references for the security contracts were reviewed and Service level Agreements have been implemented. Infection control Shortage of infection control personnel Dilapidated infrastructure Motivate to appoint infection control personnel Maintain and upgrade infrastructure. 15

16. DOMAINSUB - DOMAIN 1. Patients Rights1.1 Respect and dignity 1.2 Information to patients 1.3 Physical access 1.4 Continuity of care 1.5 Complaints management 1.6 Reducing delays in care 1.7 Emergency care 1.8 Delivery of package of services 2. Patient Safety2.1 Clinical Risk 2.2 Adverse events 2.3 Infection prevention and control 3. Clinical Governance & Clinical Care 3.1 Clinical leadership 3.2 Patient care 3.3 Clinical management of priority health programmes 3.4 Pharmaceutical services 3.5 Clinical support services 3.6 Clinical equipment and supplies 3.7 Medical records 4. Public Health4.1 Population based service planning and delivery NATIONAL CORE SYTANDARDS DOMAINS AND SUB-DOMAINS ANNEXURE A

17. 4.2 Health promotion and disease prevention 4.3 Disaster preparedness 5. Leadership & Corporate Governance 5.1 Strategic Leadership 5.2 Stakeholder representation 5.3 Oversight 6.1 Planning 6. Operational Management6.2 Risk management 6.3 Human resource management & development 6.4 Employee Wellness 6.5 Financial Resource Management 6.6 Supply chain Management 6.7 Contract management 6.8 Transport management 6.9 Information management 6.10 Communication and public relations 6.11 Quality improvement 7.1 Buildings and grounds 7. Facilities & Infrastructure7.2 Machinery and utilities 7.3 Safety and Security 7.4 Hygiene and cleanliness 7.5 Waste management 7.6 Linen and laundry 7.7 Food services 7.8 Health care technology maintenance