The National Health Act is being updated to provide for the setting up of the Office of Health Standards Compliance (OHSC). The aim is to make sure you get good quality care from the healthcare providers the public uses. The OHSC will advise the Minister of Health and report to the Minister. It will guide and inspect health facilities and will only certify those that meet the required standards. An OHSC certificate at healthcare facility will be public guarantee that standards of hygiene, safety, and respect for patients are being met.
What is a contracting unit for primary health care?
The district health system in South Africa divides the country into 44 contiguous health districts and eight metropolitan areas. Contracting units for primary health care (CUP) will be established around the 260 district hospitals and their primary healthcare platforms. The CUP will be responsible for accrediting the primary health care services, such as clinics, health centres, general practitioner practices and ward-based outreach teams. The CUP will not be responsible for accrediting the district hospital.
The CUP will identify local service needs in terms of demographics and epidemiological profiles. The CUP will also identify and accredit local primary care facilities to meet these needs. These facilities are referred to as health establishments in the Bill. The CUP will contract with primary care establishments, in either the public or private sectors, to provide services and disperse NHI funds according to the contract. The contract will specify the required access to, range and volume of services, as well as the expected performance, quality requirements and data to be collected on the NHI digital health information system.
In addition, the CUP will be responsible for accessing information on the health needs of the community, improving access to health services for the local population, and ensuring that the referral and transport system is functional. They will also be responsible for resolving complaints about the health services.
What standards will be used to accredit practices?
Practices will have to meet a number of criteria, as specified in the Bill, in order to be accredited by the Fund:
Certification by the Office of Health Standards Compliance
Registration of health professionals with the appropriate Council
Provide the minimum package of primary care
Have the necessary mix and number of health professionals to deliver the package
Adhere to the relevant clinical protocols and guidelines
Adhere to the referral pathways
Submit the necessary data to the health information system
Adhere to the national pricing regimen for services
The Office of Health Standards Compliance must certify the practice as meeting the required standards. The National Department of Health has developed criteria for the ideal primary care clinic and these will form the basis of certification by the Office of Health Standards Compliance. There are currently 10 components and 32 sub-components that need to be measured.
What happens if you don’t meet the standards?
According to the bill the CUP will only contract with providers that are certified by the Office of Health Standards Compliance as meeting the required standards and with accredited establishments. Accreditation will be reviewed every 5 years and, if the primary care facility is not able to meet the criteria, then a loss of accreditation will lead to a loss of the ability to contract with the CUP.
What must I do to get ready for the NHI accreditation process?
Take a deep breath and calm down. The accreditation process development will take indefinite time to be completed. Some aspects of the CUPs are not finalised. For example, it is not yet decided who the juristic entity will be that CUPs should contract with. It could be the providers themselves or the establishment as an organisation. It is also not yet clear if the CUPs will take responsibility for the supply chain (e.g. medication, laboratory services, consumables) to the primary care establishments.
iZandla has your back!
iZandla Consulting is a private company with the objective of engaging with Healthcare Stakeholders by representing the interests of its shareholders and members.
The company is managed by and consists of physiotherapists in private practice who can engage by negotiating and contracting with relevant parties for the benefit of its shareholders.
If and when the accreditation process has been finalised and made public, iZandla with the help of its strategic partners will assist its shareholders and members to prepare their private practices for the NHI accreditation for primary care units.
Contact iZandla today at info@izandla.org.za should you wish to become a shareholder or a member.
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