September 1-28, 2024: Issue 634

 

Northern Beaches Hospital Audit: now Open For Submissions

Photo of NB Hospital by Cabrils.

In 2014, the State entered into a Public Private Partnership (PPP) with a private operator to deliver the Northern Beaches Hospital. The Northern Beaches Hospital opened in late 2018 and provides free public patient services as well as a range of services for private patients. 

This audit, being undertaken by the Audit Office of NSW, will examine whether the Northern Beaches Hospital PPP is efficiently and effectively delivering public hospital services.

You can share information relating to this scope with the audit team. Submissions can be made anonymously. Please note that submissions will close on COB Friday 15 November 2024. 

You can contribute to this audit either through the contribute to this audit button in left hand menu (comment icon on top right for mobile) via this link: https://www.audit.nsw.gov.au/our-work/reports/northern-beaches-hospital

Mid 2024 Federal Member for Mackellar, Dr Sophie Scamps and NSW State Member for Wakehurst, Michael Regan, stated they welcomed the announcement that the performance audit has commenced.

“We are proud that following our advocacy, this audit is now taking place,” the two MPs said.

“The Northern Beaches Hospital is staffed by skilled and committed doctors, nurses and allied health professionals, and this audit will assess whether these professionals are being  supported structurally by Healthscope to be able to deliver the quality of care the Northern Beaches community deserves.”

“I would also like to thank the NSW Auditor General, Bola Oyetunjil, for his engagement with my office and other local stakeholders regarding the scope of the audit,” Dr Scamps said.

“I have been pushing for this audit since the Northern Beaches Hospital declined the $7.5million offered by the NSW government to provide a four-bed youth mental health unit.

That rang alarm bells for me. There needs to be far greater transparency regarding the hospital’s performance” the Mackellar MP said.

“Securing an independent performance audit of Northern Beaches Hospital has been a key priority for me since being elected to state parliament last year. At every opportunity, I have  made it clear – we need it, and we need it now. Our community needs more scrutiny and accountability around the quality of care being delivered at Northern Beaches Hospital. That is what this audit will deliver,” Mr Regan said.

The audit will provide a real opportunity to test whether this unique public private arrangement is delivering for the 350,000 people who rely on Northern Beaches Hospital as well as assessing whether it is delivering value for money for taxpayers.

One in ten patients spent more than 11 hours waiting in emergency departments (ED) across NSW between June and April 2024, the most recent Bureau of Health Information's Quarterly health report has found.  

Independent candidate for the 2024 Pittwater by-election Jacqui Scruby has stated the September 18 released data on ambulance response times is alarming. Patients across the peninsula are waiting longer for ambulances, with people in Pittwater having to deal with increased response times across all priority categories.

The data shows the median time it took an ambulance to reach emergency cases is 18 minutes, up 1.8 minutes from the same quarter the previous year.

Just 35.5% of emergency cases (P1) waited less than 15 minutes for an ambulance to arrive, which is down 5.5 percentage points from last year.

Those which are Life Threatening Cases (P1A) shows a 9.8 minutes median time for it took an ambulance to reach the highest priority emergency cases, up 1.7 minutes.

Urgent Cases (P2) show 30.1 minutes as the median time it took an ambulance to reach urgent cases, up 4.4 minutes from the same quarter the previous year.

There were 385,345 ambulance responses in the April to June 2024 quarter, up 7.8% from the same period last year.

''This is a direct result of years of poor decisions and neglect from the NSW Liberal Party, including the privatisation of our public hospitals.'' Jacqui Scruby said

'' The Northern Beaches Hospital was meant to deliver improved health outcomes for our community, but instead, we have a system under immense pressure. The staff at Northern Beaches Hospital are amazing and working tirelessly, and while many have a great experience, too many haven’t. Two public hospitals were merged into one private facility, and the people of Pittwater have been left to deal with the consequences.

It took Michael Regan MP, a strong Independent next door in Wakehurst, to fight for our community and secure a performance audit of the Northern Beaches Hospital. This audit is now accepting submissions and now is the time to have your voice heard.'' 

''The Liberals didn’t want this audit – they are responsible for the decisions that led to these problems. It’s only with strong, independent voices that we can hold the government to account and demand better for our community and our local health services.''

See June 2024 report: Northern Beaches Hospital Audit Welcomed

''Pittwater deserves better. We need leaders who will stand up for our community and fight for the services we deserve – from reducing ambulance wait times to ensuring our hospital can deliver. I’m committed to being that voice for Pittwater, working alongside strong independents like Michael Regan, Dr Sophie Scamps, and Zali Steggall, who are delivering for the peninsula.'' 

''This by-election is a chance for us to push for better healthcare and improved services. The people of Pittwater have waited long enough – it's time for action.'' Ms Scruby stated

The Northern Beaches Hospital had 16,147 ED attendances, down 1.5% compared with same quarter previous year.

Arrivals to the ED by ambulance was 4,597, up 4.9% compared with same quarter the previous year.

Patients were transferred from paramedics to Northern Beaches Hospital ED staff within 30 minutes was 87.2%, down 8.1 percentage points compared with same quarter previous year.

Patients starting ED treatment on time is listed at 71.0%, down 5.9 percentage points compared with same quarter previous year.

Patients leaving ED within four hours was 46.9%, down 5.4 percentage points compared with same quarter previous year.

See September 2024 report: Increase in Pittwater Ambulance Wait Times - transfer to NBH ED: Scruby Calls for Action

Northern Beaches Hospital Audit: Scope

The audit will answer the following questions: 

  1. Do NSW Health agencies ensure the effective and efficient delivery of public funded hospital services from the Northern Beaches Hospital? 

a) Do NSW Health agencies effectively identify and monitor risks to the success of the Northern Beaches Hospital?

b) Do NSW Health agencies collect the information required to ensure effective delivery of public hospital services at the Northern Beaches Hospital?

c) Do NSW Health agencies effectively manage the Northern Beaches Hospital contract to ensure effective delivery of public hospital services at the Northern Beaches Hospital? 

d) Is the Northern Sydney Local Health District using the Northern Beaches Hospital Public Private Partnership to achieve efficient service delivery? 

2. Is the operator of the Northern Beaches Hospital effectively delivering public hospital services in selected clinical areas? 

a) Does the Northern Beaches Hospital meet contract requirements for performance, planning and reporting? 

b) Does the Northern Beaches Hospital provide quality care consistent with equivalent public health facilities in NSW?

Included within the scope: 

  • The parties to the Northern Beaches Hospital contract deed: Northern Sydney Local Health District, the Ministry of Health (as the delegate for the Health Administration Corporation) and the private sector operator, NBH Operator Co (a subsidiary of Healthscope Ltd.). 
  • Comparison against benchmarks for peer or near-peer NSW Health hospitals. 
  • The audit will focus on two areas of clinical activity: Emergency Department activity and General Surgery. 
  • The main period of focus for this audit is from July 2022 to June 2024.

Excluded from the scope: 

  • The decision to deliver the Northern Beaches Hospital via a Public Private Partnership. 
  • The design and construction phases of the Northern Beaches Hospital Public Private Partnership. 
  • Quality as it relates to an assessment of the specific effectiveness of clinical activities or scopes of practice. However, the audit may comment on whether the agencies have themselves adequately considered and assessed clinical evidence as part of performance monitoring and oversight of clinical services. 
  • Merits of government policy objectives.

The Audit Office of New South Wales advises it may use your submission to identify key themes, risks or issues which may then be further investigated during the audit.

''In some instances, we may use extracts of submissions in our audit report as examples of feedback provided where appropriate. If we use extracts of a submission, we will not identify the source of the submission in the report.''

However, please note: 

  • We will not examine individual matters, nor can we investigate all issues or concerns raised. In general, the audit team will look for confirmatory evidence from other sources (such as documentation, data and audit interviews). 
  • We will not share submissions with any party, including NSW Health or the private operator of the Northern Beaches Hospital, nor do we publish submissions on our website.  
  • While we will consider all submissions, we may not contact you to discuss your submission. 
  • We are not able to answer questions or provide information collected during the course of the audit. 
  • Performance audits focus on assessing whether public money is spent efficiently, effectively, economically and in compliance with the law. The Auditor-General is not permitted to question the merits of government policy objectives. Click here for more information on how we undertake performance audits. 

Confidentiality requirements and disclosure

The Audit Office is required by section 38 of the Government Sector Audit Act to keep information obtained during an audit confidential and the Audit Office takes its responsibilities under these sections very seriously.  

All information that the Audit Office receives, and working papers that the Audit Office creates during an audit, are classed as excluded information in Schedule 2 of the Government Information (Public Sector) Act 2009 (GIPA Act). An access application under the GIPA Act cannot be made for excluded information.

Other resources

If you have questions or comments about individual matters, you can: 

  • make a complaint about the provision of healthcare to the Health Care Complaints Commission online or by calling 1800 451 524 
  • make a complaint about a NSW government agency to the NSW Ombudsman online or by calling 1800 043 159 
  • make a complaint about corruption to the Independent Commission Against Corruption online or by calling 02 8281 5999. 

Please note that submissions will close on COB Friday 15 November 2024. 

You can contribute to this audit either through the contribute to this audit button in left hand menu (comment icon on top right for mobile) via this link: https://www.audit.nsw.gov.au/our-work/reports/northern-beaches-hospital

previously (a Selection - several years more in past features)