Third Quarterly Report: 2001-2002 DHB Crown Funding Agreement
Date of publication: October 2002
This report is the Ministry’s assessment of the District Health Boards’ (DHBs) performance for the third quarter of the 2001-2002 financial year as agreed between the Minister and DHBs, and detailed in respective Crown Funding Agreements (CFAs). The performance expectations for the third quarter continued with the process established during the first two quarters concentrating on performance indicator confirmation and progress of respective process development.
The majority of DHBs provided appropriate and accurate information by the required date to the Ministry in accordance with the timelines stipulated in the CFAs.
DHB responses reflected continuing good progress towards greater capability, and bore out the Ministry’s optimistic expectations for the continued improvement as expressed in the second quarterly report.
As a result of further advice from three DHBs concerning the achievement rating of a number of accountability indicators from the second quarter period, the Ministry has reviewed the original ratings. Amendments, where appropriate, to these ratings are advised in this report.
The following are a number of significant issues arising from the third quarter period:
- For the nine months ended 31 March 2002, DHBs reported a combined net deficit in the Governance and Administration arm of $19.5 million, which was favourable, by $0.6 million, to the planned deficit of $20.2 million. In the Funder arm, the sector deficit of $22.6 million represented net over-spending of $7.1 million, or 0.25% of planned revenue for the period resulting from contract values devolved to some DHBs for contracts with First Health, Prime Health and Pegasus Health.
- It was advised in the second quarter report that those DHBs who had reported that they had not yet achieved 100% certainty of people waiting for surgical services, including a wait of no longer than six months for first surgical assessment in the first quarter, were expected to continue improvement initiatives. A number of DHBs are now reporting success in achieving compliance. Where under delivery is still being reported, remedial action plans are in place.
- Clinical audit processes have improved over the DHB sector. While the requirement for clinical assessment remains, some confusion is evident within the sector over what constitutes clinical audit and what is clinical governance. The Ministry is engaging with relevant DHBs and will continue to reassess this area.
- As for the previous reporting periods, the six relevant DHBs are continuing to have difficulties meeting the recommended waiting times for radiation oncology treatment. However, there has been steady improvement in the reduction of waiting times and this trend is expected to continue. Referrals from New Zealand to Australia have declined with the current programme due to terminate in July. A final decision regarding continuation of the programme will be made shortly.
- There has been improvement by all DHBs in their compliance with audit and quality improvement activities for mental health reporting and provision of information over previous periods. There is a good level of audit activity being undertaken in provider arms and NGOs.
- Reporting on nursing matters has improved to the extent that reports from all DHBs were comprehensive and all seven components of this deliverable have been met. The Ministry is satisfied that full compliance has been achieved across the sector.
- Reporting on diabetes continues to be inconsistent across the sector. Not all DHBs provided sufficient detail in accordance with the accountability requirements, and it appears that the diabetes reporting system is not universally effective. The Ministry is continuing to engage with the sector to improve the DHB ability to comply with ongoing reporting requirements.
- Colposcopy services continued to be provided in accordance with Funder requirements. However, there is discrepancy with what some DHBs have said they have provided and the data held by the Ministry. This gap is being investigated.
- The trend, reported in the second quarterly report of rural GPs leaving and not being replaced within three months has worsened. However, the Ministry has been working on a rural support package with the DHBs to try and reverse this trend. Initial feedback indicates that the package has been generally well received in the sector.
Assessments of DHBs responses are provided in matrix form at Appendix A. Each deliverable for the third quarter is allocated an achievement, partial or non-achievement. Where a deliverable is not applicable to a DHB this is noted in the matrix, or if the requirement does not fit precisely with the assessment rating this is footnoted.
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