The survey revealed that 77% of sector representatives believed that government has a leading role to play in setting healthcare standards and creating an enabling environment for healthcare services integration.
Head of the Healthcare Sector at KPMG, Sandile Hlophe, says that the finding is in keeping with global trends. “KPMG conducted a global survey on integration in healthcare last year, and that survey found that almost all respondents felt that various spheres of government should be responsible for integration and setting healthcare standards. This was particularly true in developing countries. So, South Africa falls within global expectations of delivery in the healthcare sector.”
The global survey also found that the top two enablers required to achieve integration were a government plan to achieve it and government payment policies that incentivise the process.
While there are high expectations of government, there are a number of interventions the healthcare sector can introduce in terms of monitoring and evaluating service delivery before they become formalised, cautions Hlophe. “In some of the models we have examined, accreditation systems based on patient experience in facilities can form a significant basis for the evaluation of quality healthcare services,” he says. “These systems can expand beyond the evaluation of facilities from just financial performance to include the entire patient experience. This puts the patient at the centre of developing quality standards and can incorporate government standards, those of the facility and those of private payer so that an integrated quality standard is developed for the sector.”
On practical levels, quality measurement is framed within the patient’s experience, treatment outcomes and safety within a facility. In addition, doctors in each individual speciality are held to account for the outcomes they produce, as are the clinicians and nurses within it.
“The ultimate objective is to maintain patient dignity. This could become a critical approach to incorporate into the introduction of a National Health Insurance System in South Africa,” says Hlophe.
Other findings of the snap survey include:
- 66% of respondents believe that healthcare delivery comprises quality healthcare, cost-effectiveness and supply chain integration
- Quality healthcare facilities were seen by 51% of respondents to include professional and caring staff, by 20% to focus on effective prevention and control of infection in a facility, by 15% as shorter waiting times and 12% as being greater access to medicines and supplies
- Impediments to patient throughput were seen as lack of community facilities (51%), inefficient screening and admission facilities (29%), ineffective referral and transfer processes (15%) and inefficient discharge facilities (5%)
- Only 3% of respondents felt that medical aid schemes should lead the task of healthcare integration, with 8% believing it should be led by health facilities.
“Given the proposed changes to healthcare policies currently being discussed, South Africa has the opportunity to leap-frog some of the challenges facing the sector and move rapidly towards an integrated cost efficient and quality health sector model. A key enabler will be strong political will and leadership to get us there,” concludes Hlophe.