PORTFOLIO COMMITTEE on HEALTH North West Province of Health Readiness to Implement the National Core Standards (NCS) MEC for Health Dr Magome Masike 28 August 2012

Presentation Outline Overview of National Core Standards Assessment Domains / Criteria Report facility assessments Measures to address the NCS Infrastructure Complaince plans

Overview of National Core standards Improve life expentancy Reduce impact of HIV and TB Improve mother and child health Improve health system effectiveness Re-engineering of PHC Quality HR Finance and Financing Infrastructure and Technology

Assessment Domains Patient rights Safety, Clinical risk Clinical Support Public Health Leadership & Corporate Governance Operational Management Facility and Infrastrucure Six Ministerial Priorities

Summary of the latest Assessment Dormain JST Mafike Klerks Potch Tshepon Vryburg Witrand Bophelo Patient Rights A (NC) B(NC) B (NC) C (NC) - (-) (NC) Safety (C) Clinical Support B (C) Public Health C (C) D (C) Leadership A (C) Operational Man. Facility & Infra

NCS The department has had a long standing standards program known as COHSASA. Hospital facilities are therefore familiar with quality standards processes and requirements This existing quality assurance program has been replaced by the NCS

Measure to address NCS Workshop on National Core standards Development of Operational Plans and National Core Standards Appointment of staff i.e. : - Quality Assurance Managers, Infection Prevention and Control (IPC) etc.

Measure to address NCS cont. Feedback on assessments conducted by HST Developed NCS document to address identified gaps Regular formal monitoring of progress: weekly, monthly and quarterly Continuous support of developmental partners i.e. PHC - clinics .

Measure to address NCS The Quality Assurance Directorate is working closely in partnership with District Coordinating NGO’s (as directed by the National Department) to ensure six-monthly self-assessments by all PHC clinics.

Measure to address NCS The QA Directorate continues to support hospitals regular facility visits monitoring the implementation completion of quality improvement plans designed to address the gaps in compliance.

Infrastructure Compliance The following steps have been taken to achieve compliance: Provincial hospitals Klerksdorp Short term: Funding from private companies to renovate various wards Long term: Revitilisation plan to build a separate tertiary facility replacing the existing structure. Tshepong Short Term: The hospital is currently undergoing reconstruction Long term: Retained as a level one with TB and MDDR/XDR-TB wards. Job Shimankana Tabane Short term – Infrastructure grant renovations to increase operating theatres, ward areas and maternity Long term revitilisation of L2 facility and retain current facility as L1 Mafikeng Hon. Premier revamping and equipping paediatric wards

Infrastructure Compliance Cont. Specialised Hospitals Bophelong Hospital Currently on the revitalization programme for replacement. The first phase of bulk services is complete. Construction of forensic and state patients wards has just started and expected to be completed in December 2013. Witrand Hospital Currently our best performing hospital despite some infrastructural challenges. Infrastructure grant renovations for additional wards to ensure compliance.

Infrastructure Compliance Cont. District Hospitals Gelukspan Hospital One of our oldest hospitals in the province Short term: Finalising the upgrade designs of this hospital Long term: Re-configure this hospital to a CHC due to the population it serves. General de la Rey / Thusong Hospital Revitilisation planned replacement by a single hospital facility in Lichtenburg. Zeerust / Lehurutshe Planned reconfiguration in 2015/16 financial year of Lehurutshe to CHC and upgrade of Zeerust to a required standard.

Infrastructure Compliance Cont.. District Hospitals Taung and Ganyesa Hospitals These hospital were renovated not so long ago Finalising the term contracts for all our hospitals to ensure that all statutory compliance. Vryburg and Moses Kotane New revitilised structures only require routine maintenance to ensure compliance. Brits hospital The new facility will be completed by 30 November 2012 with installation of equipment and commissioning to follow. The hospital is expected to be operational by 01 March 2013 or earlier. Other hospitals will also be included in the maintenance prograamme.

REVITALISATION EXPENDITURE FOR 2011/12 & 2012/13 Conditional Grant Budget (R’000) Expend % Exp Hospital Revitalization Grant (2011/12) 370,074 362,963 98.02% Hospital Revitalisation Grant (2012/13) 423,127 187,117 44.22% NB: The under expenditure on this financial year was due to invoices which were returned by accounts indicating over-expenditure of the Department, as such we started financial year 2012/13 with accrual of about R50,0 million.

HEALTH INFRASTRUCTURE BACKLOG The Department to date have backlog of R2 billion rands on renovations, upgrades and maintenance of our facilities. (Conditional Assessment of all facilities is done) The Department also have backlog of about R2,8 billion towards health facility gaps relating to service delivery, and to implement NHI to raise most of our facilities to the required standards. (Based on Conditional Assessment as well as the current Service Transformation Plan (STP) The Department only have about R654 million for 2013/14, R681 million for 2014/15 and possible R710 million for 2015/16.

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