1. National Health Laboratory Service Strategic Plan
Fiscal Years 2015/16 – 2019/20
Presenter: Ms Joyce Mogale

2. National Health Laboratory Services (NHLS)
Part A
National Health Laboratory Services (NHLS)

3. The Vision, Mission and Values
Our vision is “Africa’s centre of excellence for innovative laboratory medicine”
Mission
“To provide quality, affordable and sustainable health laboratory medicine, provide training for health science education and undertake innovative and relevant research”.
Values
The NHLS has identified the following values as the principles that will govern behaviour of all the employees within the organisation, and these are:
Caring, Unity of Purpose, Service Excellence, Transformation, Innovation and Integrity.

4. Legislative and Other mandate
The Legislative Mandate of the NHLS is derived from the Constitution, the National Health Act, 61 of 2003, the NHLS Act 37 of 2000, and several pieces of legislation, regulations and policies passed by parliament.
4.1 Constitutional Mandate
In terms of the constitutional provisions, the NHLS is, amongst others, guided by the following sections and schedules;
The Constitution of the Republic of South Africa, 1996, places obligations on the state to progressively realize socio-economic rights including access to health care.
Section 27 of the Constitution refers to everyone having the right to have access to health care, food, water and social security

5. Legislative and Other Mandate
4.2 The National Health Act, 61 of 2003
Provides a framework for a structured uniform health system within the Republic, taking into account the obligations imposed by the Constitution and other laws on national, provincial and local governments with regard to health services.
4.3 The National Health Laboratory Service Act, 37 of 2000
This Act mandates the NHLS to provide cost-effective and efficient health laboratory diagnostic services to all public sector health care providers; other government institutions inside and outside of the Republic that may require such services and any private health care provider that requests such services. The Act also mandates the NHLS to support health research; and support training for health science education.

6. Legislative and Other Mandate
4.4 Other planned legislative and policy initiatives
The NHLS will also support the following policy initiatives:
Support and prepare for the implementation of National Health Insurance (NHI)
The establishment of the National Public Health Institutes of South Africa (NAPHISA), comprising the following divisions:
a) Communicable Diseases
b) Non-Communicable Diseases
c) Cancer Surveillance; and
d) Injury and Violence Prevention
e) Occupational Health

7. Situational Analysis 5.1 Performance Overview
During the 2014/15 period, the demand from provinces for the NHLS’ services showed an increase of 4.52% from to in test volumes, mainly driven by Viral Load and GeneXpert volumes.
5.2 SWOT Analysis
The NHLS identified SWOT analysis as a powerful tool to ensure that a better understanding of the current situation and environment and will provide a platform upon which planning can be performed. A clear understanding of Strengths and Weaknesses will enable the NHLS to be in a better position to plan for any possible Opportunities or make plans to prevent Threats to become realities.

8. Situational Analysis 5.2 SWOT Analysis Continued..
The following items were identified as priority risk/s during the NHLS Strategic Risk Assessment Workshop:
Outsourcing/Insourcing;
Economic sustainability (e.g. the impact of exchange rate); and
The current IT system not being able to support business, amongst others.

9. High Level Organisational Structure

10. Strategic Outcome Orientated Goals
Situational Analysis was used to develop the Strategic Outcome Orientated Goals (SOOG). These are:
Goal
Goal Statement
Accessible Pathology Service Footprint
The NHLS has an obligation to promote and improve the national health system in South Africa as mandated by the National Department of Health. The ultimate intention is to entrench and uphold that 100% of hospitals within the three spheres of government have access to onsite NHLS services.
International Best Practice Laboratory Medicine
It is within the ambit of the NHLS to ensure improved patient care in South Africa through a comprehensive, quality, cost effective and timeous pathology service which subscribes to international standards. The intended consequence would be to ensure that all tests performed are done within prescribed timeframes and compliant to international quality standards.
Academic Excellence
In order to develop a sustainable pathology health service, the NHLS needs to ensure that academic institutions produce highly competent pathology health professionals who would spearhead research outputs to advance scientific policy directives. It is the ultimate strategic intent of the NHLS to ensure that all (100%) medical scientists and pathologists are registered with the HPCSA by 2020.

11. Strategic Outcome Oriented Goals
Goal Statement
State of the Art Laboratories
The vision of the NHLS is to be the centre of excellence for innovative laboratory medicine with adequately resourced and accredited laboratories. It is the intended goal of the NHLS to improve service delivery turnaround times through the use of modern advanced technology.
Improved Stakeholder Relations
The NHLS is a State Owned Enterprise created by government to promote and support the national health system in South Africa. It is incumbent upon the NLHS to ensure a seamless harmonious operational platform by building strong and sustainable relationships with all its stakeholders. It is the intended goal of the NHLS to improve stakeholder relations and customer satisfaction. 
Performance Driven Processes and Systems
The NHLS aspires to become the centre of excellence for innovative laboratory medicine. Hence, operational processes and systems play a pivotal role to spearhead improved efficiencies and effectiveness of the organisation. It is the intended goal of the NHLS to improve Laboratory Information System (LIS) uptime from 98% to 99.5% by in order to create a performance driven organisation. 
Adequate, Competent and Motivated Human Capital
Competent and motivated staff play a vital role in ensuring organisational success. It is the intended goal of the NHLS to have the right number of staff with the right skills mix at the right level available and employed in appropriate positions within the organisation. It is strategic intent of the NHLS to source and uphold workforce mix to subscribe 100% with the HPCSA scope of practice by 2020. 
Sound Governance and Financial Practices
Sound corporate governance practices and adherence to compliance codes are the foundation for all decisions made within the NHLS. The reinforcement of this will establish and foster an environment of accountability. This would ensure that the NHLS complies with all relevant legislation, financial regulations, directives, policies and procedures and thereby achieves “clean” governance by  

12. Strategic Map

13. Part B Programmes

14. Program 1: Administration: this programme plays a crucial role in the delivery of the NHLS services through the provision of a range of support services.
Program 1: Administration is divided into 4 sub-programmes:
Financial Management: The purpose is to improve the liquidity of the NHLS.
Governance and Compliance: The purpose is to provide support services and ensure compliance with the relevant legislation.

15. Program 1: Administration (Continued)
Information Technology and Communication (ICT): The purpose is to develop and implement ICT integrated governance framework by focusing on the business continuity plan.
Human Resources: The purpose is to provide effective services through efficient processes and adequate Human Resources

16. Resource Consideration
It is crucial that the corporate function is resourced adequately financially and human capital.
The identification and filling of critical posts is therefore an important aspect of resource consideration

17. Programme 2: Surveillance of Communicable Diseases
National Institute for Communicable Diseases (NICD) is a national public health institution for South Africa providing reference microbiology, virology, epidemiology, surveillance, and public health research to support the government’s response to communicable disease threats

18. Resource Consideration
The NICD has been cross subsidised by fee for service revenue from the NHLS
Starting in 2015/16, the NICD is funded through a direct transfer payment from the National Department of Health.
This change in the funding has resulted in national functions provided by NICD not being reliant on recovery of fees.

19. Programme 3: Occupational Health and Safety NIOH provides occupational health and safety across all sectors of the economy to improve and promote worker’s health and safety
Programme 3 is divided into 5 sub-programmes
Occupational health and Safety: to provide quality and accredited laboratory services for all occupational health related matters.
Technical Support for Occupational Health and Safety: to provide occupational medical services to the NHLS and to be the occupational health practitioner for NHLS.

20. Programme 3: Occupational Health and Safety (Continued)
Occupational health and Safety Research: to promote, conduct and submit reports and publications pertaining to occupational health in South Africa
Training and Development for Occupational Health: to promote capacity building and strengthen human resources on occupational health and safety by contributing to the teaching and training of doctors, nurses, medical scientists, hygienists and occupational health practitioners.
National Biobank: to store and secure bio materials and associated data to enable research through specimen storage.

21. Resource Consideration
The National Institute for Occupational Health (NIOH) has been cross subsidised by fee for service revenue from the NHLS
Starting in 2015/16, the NIOH has been funded through a direct transfer payment from the National Department of Health.
This change in the funding has resulted in national functions provided by NIOH not being reliant on recovery of fees.

22. Program 4: Academic Affairs, Research and Quality Assurance (AARQA)
The objective is to strengthen the mandate of the NHLS of maintaining and providing quality assured and accredited laboratory medicine and supporting the academic platform.
Focus in ensuring that research is conducted inter alia to contribute to service delivery improvement and quality.
The aim is to oversee and collaborate with various training institutions that contribute to the development of qualified and skilled people operating within the scientific field of pathology services

23. Programme 4: Academic Affairs, Research and Quality Assurance (Continued)
Programme 4 is divided into 3 sub-programmes
Quality Assurance: to provide total quality management systems, processes, equipment and resources within laboratories to increase accreditation of those laboratories.
Academic Affairs: to promote capacity building of health professionals to strengthen a business case for sustained development of the NHLS through the development of Pathologists, Medical Scientists and Medical Technologists
Research: to increase the knowledge base of diseases and sharpen diagnostic decisions, treatment and management of these diseases through research outputs.

24. Resource Consideration
This is a department that needs to be adequately resourced to ensure quality service delivery
Since the establishment of NHLS, the cost related to teaching, training and research has been funded through cross subsidisation from fee for service revenue.
In 2015/16, the cost for teaching, training and research has been funded through a direct transfer payment from the Department of Health.
This change in funding has resulted in reduced reliance on NHLS fees for service.

25. Program 5: Laboratory Service:
This programme represents the core business of the NHLS as mandated by the NHLS Act (Act 37 of 2000). It is anticipated that the NHLS should provide a comprehensive, accessible, quality and timeous pathology service resulting in improved patient care
Programme 5 is divided into 5 sub-programmes:
Increase accessibility to NHLS service: to increase access to NHLS laboratory services with the main aim of servicing all health care facilities as part of government health care services.
Operational Efficiency: to increase the overall turnaround times of all the tests within every laboratory across South Africa .

26. Program 5: Laboratory Service (Continued)
Quality of Service: to improve levels of quality of tests performed in the laboratories by ensuring that laboratories comply with quality standards and attain accreditation
State of the Art Laboratories: to increase number of adequately resourced laboratories by ensuring that all laboratories are equipped with advanced technology and equipment as well as having sufficient infrastructure to perform these functions.
Productivity Efficiency: to provide highly efficient and productive laboratory services by adopting best practices and technologies.

27. Resource Consideration
Laboratory service provision is the largest component of the NHLS Budget.
The budget of this programme sees a comprehensive, accessible, quality and timeous pathology service.
The budget for human resources increased over the 5 year period in line with increasing volumes of work.