1. Overview of the Office of Health Standards Compliance
Dr Siphiwe Mndaweni
07 November 2018

2. Purpose To communicate the work of the Office as a Regulatory Body
To communicate the various functions of the Office as relevant to the regulatory process

3. Mandate of the OHSC
“Promote” implies the state plays an ‘active’ role in quality and safety of health services
National Health Amendment Act # 12 of 2013 established the OHSC as an independent public entity:
Section 78. Objects of the Office
The objects of the Office are to protect and promote the health and safety of users of health services by:
Monitoring and enforcing compliance by health establishments (HEs) with prescribed norms and standards
Ensuring consideration, investigation and disposal of complaints relating to breaches of norms and standards
“Protect” implies the State’s responsibility is to protect citizens from harm
All audiences

4. Vision and Mission of the OHSC
Safe and Quality Healthcare for all South Africans
Mission
We act independently, impartially, fairly and fearlessly on behalf of the people of South Africa in guiding, monitoring and enforcing health care safety and quality standards in health establishments

5. National Health, Act No 12 of 2013
Section 79 of the National Health, Act No 12 of Functions of the Office
MUST
1. Advise the Minister of Health on determining norms and standards that are to be prescribed for the national health system and on the review of such norms and standards
2. Inspect and certify health establishments as compliant or non-compliant with prescribed norms and standards or, where appropriate, withdraw such certification
3. Make recommendations for intervention by national, provincial or municipal health departments or by individual health establishments to ensure compliance with prescribed norms and standards
4. Publish information relating to prescribed norms and standards through the media, website and gazette etc, where appropriate, to specific communities
5. Recommend to the Minister quality assurance and management systems for the national health system
National Health, Act No 12 of 2013

6. National Health, Act No 12 of 2013
Section 79 of the National Health, Act No 12 of Functions of the Office
MAY
1. Issue guidelines to help health establishments implement the prescribed norms and standards
2. Request or collect any information on prescribed norms and standards from health establishments and health service users
3. Liaise with and exchange information with other regulatory authorities on matters of common interest and specific complaints or investigations
4. Negotiate co-operative agreements with any regulatory authority in order to co-ordinate and harmonise their work where their jurisdictions are closely related

7. Powers of the OHSC .. and implications
Regulations promulgated Feb 2018
Powers of the OHSC
.. and implications
Guidance outlining best practice
Monitor compliance; early warning indicators of breach of norms & standards
Investigate complaints relating to breaches of norms & standards
Inspect to assess compliance with norms & standards
Assess; “diagnose”
Recommend interventions and systems
Issue guidance relating to norms & standards
Recommend
Annual returns, EWS, Complaints
Advise on …
Prescribed norms and standards for the health system
Advise
Publications / guidance outlining requirements
Issue recommendations and publish response & outcomes
Complaints call centre assesses calls, allocated for management or referred for investigation
Certify compliance with norms & standards (link to NHI)
Issue notice of non-compliance with norms & standards; monitor
Implement sanctions for persistent non-compliance with norms & standards
Enforce
Performance improving slowly
Routine and risk based inspections
Health establishments must implement corrective action
May receive written warning, be subject to a hearing

8. The OHSC, and the link to funding (Policy - June 2017: National Health Insurance for Universal Health Coverage) xx
Monitoring of risk
Services to be provided
OHSC
NHI fund
Service provision
Certification
Contracting
Compliance with norms & standards
Cost / price
Certification of compliance with norms and standards
as a pre-requisite for funding
Appeal to social solidarity underpinning UHC must also address:
Acceptability and responsiveness of services - a key factor in public acceptance or opposition, patient choice
Effectiveness and efficiency - will be critical in accounting for (increased) public funds
Public audience and Provincial government

9. What behaviour do we seek to change?
Promote and recognise
Discourage and penalise
Systems to assess and control risks to safety and quality
“User focus” - compassionate, respectful, available
“Provider focus” - effective, efficient
Proactive, problem-solving
Accountable
Ad-hoc and arbitrary actions / activities
Impunity - for abuse of power, negligence, non-delivery
Acceptance of mediocrity
“Its not my fault”
“Compliance” and benchmarking
Making it more comfortable to do your job than not to

10. Desired regulatory outcomes / impact
The mandate of the OHSC contributes to two distinct but interdependent regulatory outcomes.
Reductions in avoidable mortality, morbidity and harm within health establishments through reliable and safe health services
Improvements in the availability, responsiveness and acceptability of health services for users
In addition, it will contribute to enhancing universal access to quality services

11. Thank You