1 Auditing the Netherlands Health Care Inspectorate Winnie Sorgdrager, chairman of the auditing committee

Winnie Sorgdrager | | EPSO conference 2 Mandate Inspectorate Promotion of public health through effective enforcement of the quality of health services, prevention measures and medical products.  552 employees at the inspectorate  health care institutes (locations and companies) and thousands of independently working professionals  Over 3000 inspection visits and over 3000 reports are issues each year  Budget inspectorate: >60 MLN.  Supervision is also performed in the Dutch Caribbean islands

Winnie Sorgdrager | | EPSO conference 3 Governance of healthcare  Health care institutes  Inspectorate  Politics (Minister and parliament)  Insurance companies

Winnie Sorgdrager | | EPSO conference 4 Supervision procedures  Risk-based (indicators) supervision  Incident-based supervision (notifications by citizens/patients)  Thematic supervision

Winine Sorgdrager | | EPSO conference 5 Inspectorate in troubled water  Signals from the Ombudsman  Media attention about disfunctioning of inspectorate  Debate in the parliament  From the year 2000 different inquiries from the Ombudsman about the inspectorate with many recommandations.  2 Inquiry reports from ‘Sorgdrager’ and ‘van der Steenhoven’.

Winnie Sorgdrager | | EPSO conference 6 Audit committee  Appointed by the Minister  For three years  Starting in 2014  Independent audit (on the progress of improvement)  Members of the committee

Winnie Sorgdrager | | EPSO conference 7 Plan for improvement of performance of inspectorate for the years , with a view on following years. What was being audited at the inspectorate?

Winnie Sorgdrager | | EPSO conference 8 Principal themes for the coming three years to audit:  Internal governance  Professionalism  Notification process  Internal and external communication  Effectiveness of supervision by the inspectorate How took the audit place?

Winnie Sorgdrager | | EPSO conference 9 The auditing process  Background: documents on internal procedures  Attending meetings  Interviews with +/- 40 employees of the inspectorate  Presentations about workprocesses by the inspectorate  Attending inspections by the inspectorate

Winnie Sorgdrager | | EPSO conference 10 The first results

Winnie Sorgdrager | | EPSO conference 11 Internal governance Necessary improvement is a major task  Possitive attitude of employees of the inspectorate  Many projects, prioritising is necessary  Role of the managers

Winnie Sorgdrager | | EPSO conference 12 Professionalism  Sense of urgency is clear, but difficult to materialize  Dedicated employees  Change is difficult  Inspectorate wants to be a learning institute  Autonomy versus need for leadership

Winnie Sorgdrager | | EPSO conference 13 Incident-based supervision  IT needs improvement  Improvement notification process  Lead times substantially shortened  Centralised handling of notifications

Winnie Sorgdrager | | EPSO conference 14 Communication  Need for corporate story  Improvement of internal communication  More proactive communication with stakeholders in case of serious crisis.

Winnie Sorgdrager | | EPSO conference 15 Effectiveness of supervision  Basic processes and procedures  Development of risk-based supervision  Start with dashboards of the health care institutes  Debate about supervision strategy

Winnie Sorgdrager | | EPSO conference 16  11 recommendations for the year 2014  Monitoring implementation by the committee