Audits of Providers
Auditing Providers
The Planning & Funding division of CDHB is responsible for monitoring the service performance of providers. An essential part of this monitoring programme is the auditing of the service agreements (contracts) with providers. This enables the CDHB:
To ascertain if the provider is delivering the service for which it is funded & that claims for payment are appropriate
To ensure patient safety is not at risk
To gain assurance on the quality of service provided
To identify problems in a timely manner
A comprehensive audit programme is developed annually, covering personal health, mental health, and aged-care services. The audits are prioritised, based on a risk management approach and on service priorities. In addition, ad-hoc issues-based audits and service delivery reviews are undertaken as necessary. Note: The MoH is responsible for certifying providers who are required to comply with the Health and Disability Sector Safety Act. Under this Act these providers are required to employ a Designated Audit Agency to ensure they meet the appropriate Sector Standards. These audits are separate to the service agreement (contractual) audits undertaken by CDHB. (Refer to part 3 also)
Objectives for Auditing Providers
The objectives for the auditing and monitoring of health service Providers are:
To improve the quality of the services and ensure better outcomes for service users by evaluating providers against contractual and regulatory requirements, acceptable benchmarks, and quality standards.
To identify poor performers and instigate support to improve the quality of services. This may include negotiating a pathway through which the provider can work to meet the standards.
To identify actual or potential risks with providers that would have an adverse impact on the quality or the level of services provided, and to take action to reduce the risk where it exists.
To assess the capability of providers requesting a service agreement for new or additional services.
The Canterbury DHB endeavours to use auditing, monitoring, and risk management tools in the most cost-effective way, to enhance the health sector’s performance.
For CDHB, the goal is to achieve an environment where the health providers it funds have a culture of continuous improvement for the provision of health services. The concept of continuous improvement in service performance and in the quality of the health outcomes is an integral step in the strategy to improve the health status and wellbeing for the people within the Canterbury DHB.
Statutory and Contractual Requirements for CDHB to Audit
The Crown Funding Agreement (CFA) with the Ministry of Health requires the Canterbury DHB:
To monitor providers in accordance with the NZ Public Health and Disability Act, & the Operating Policy Framework
To ensure it carries out, as necessary, the monitoring of services and the management of risk.
Under the NZ Public Health and Disability Act, the Canterbury DHB must:
Uphold the ethical and quality standards commonly expected of providers of services
Monitor the delivery and performance of services provided
Monitor the performance of the other parties to the service agreement
The Operational Policy Framework (which is part of the Crown Funding Agreement) requires the CDHB to be accountable for:
Ensuring that third party providers demonstrate a commitment to the DHB’s quality standards.
Undertaking corrective action when quality issues are identified, in particular consumer complaints and peer review processes.
CDHB Audit Responsibilities
The CDHB is responsible for ensuring that its audit activities encompass the following principles:
Audits are conducted in a professional and confidential manner
Audits are carried out by suitable personnel in a professional and competent manner
Audits are carried out with as little disruption to the service as possible
All communication and interactions have consideration and respect for the customs and culture of service staff, tangata whaiora/consumers, whanau/family/carers, referrers and others
Full information and prompt responses are provided to all relevant queries/concerns
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| Planning & Funding |
