Auditor General Michael Pickup issued his 2017 health-related performance audit report today, Nov. 22. The report contains three chapters.
Chapter one: Family Doctor Resourcing: is about how government provides family doctors and primary care to Nova Scotians and communicates its approach. The report concludes that:
— the Department of Health and Wellness and the Nova Scotia Health Authority are doing a poor job of explaining to Nova Scotians their plans to meet current and future needs for primary care, including family doctors
— the health authority prepared communication plans but did not put them into action and the department’s and the health authority’s websites are not providing useful information
–the health authority has a doctor recruitment strategy, but needs to define, measure, and monitor the success of its efforts
— decisions about the province’s long-term needs for family doctors, and where they are needed, are based on factors such as population details, and health trends.
“Poor communication to Nova Scotians about its plans could lead to public confusion over what the department and the health authority are doing about the need and approach to family doctor resourcing,” said Mr. Pickup. “Nova Scotians should be able to know what to realistically expect in terms of levels and kinds of services.”
Chapter two: Mental Health Services: in looking at access to mental health services across the province, the report notes that:
— the Nova Scotia Health Authority does not have a province-wide plan for how it provides mental health services to Nova Scotians. Work on a plan started in late 2015 and the initial March 2016 completion date was not met
— the approach to mental health care across the province is not consistent and led to significant variations in wait times standards, initial reviews, eligibility criteria, and in how clients were assessed
— the health authority lacks provincewide policies in some areas, such as crisis services and the role of security. This may decrease efficiency in service delivery and raises safety concerns.
“The health authority has been working on a provincial plan to improve how and where mental health services are delivered and the plan needs to be completed and implemented without unnecessary delay,” said Mr. Pickup. “Approximately $225 million per year is spent on mental health services, and Nova Scotians expect to receive quality care in a reasonable time.”
Chapter three: Managing Home Care Support Contracts: in examining contract management processes at the Department of Health and Wellness and Nova Scotia Health Authority, the report notes that:
— the department has still not completed eight recommendations that addressed home care program weaknesses known to exist since the 2008 audit
— the department and the health authority did not do a good job checking the completeness and accuracy of service hours reported, and regularly monitoring performance of home support providers to ensure they met contract terms
— the department allocates funding to home support providers following a systematic process, based on rate per service hour delivered.
“We expected the department to act on all commitments it made in 2008 in response to recommendations it accepted. The department still does not know whether availability of home care staff will limit meeting future demand, or whether the hours reported by service providers are complete and accurate,” said Mr. Pickup.
The report contains 21 recommendations which have all been accepted by government.
The full report, a two-page highlight and a two-minute video for each of the three chapters are available at www.oag-ns.ca.