STATUS OF PRIMARY HEALTH CARE CLINICS PORTSHEPSTONE HOSPITAL

STATUS OF PRIMARY HEALTH CARE CLINICS PORTSHEPSTONE HOSPITAL

Agenda • Key message • Situation and complications • Organisation structure proposal

KEY MESSAGE The current structure is cumbersome and duplicative, constraining service delivery A decentralized management of the Primary health care system will improve service delivery to accelerate and improve fully integrated services, accessible to all and a higher level of accountability at all levels.

Staff morale appears good except for quality of facilities and career progression

Patients are happy with service except for time taken (turnaround time)

HUMAN RESOURCES SITUATION COMPLICATIONS RESOLUTION 1. Staff shortage Lack of accommodation Unattractive accommodation Comfortable beds with base and a mattress

HUMAN RESOURCES cont. SITUATION COMPLICATION RESOLUTION Staff Shortage Failure to retain staff at clinics Clinic professional nurse entry grade post be upgraded to level 7

PHYSICAL SPACE SITUATION COMPLICATION RESOLUTION Lack of privacy Spatial Overcrowding problem/physical space. Build more structures / add temporary office space

PHYSICAL SPACE cont. SITUATION COMPLICATIONS RESOLUTION Lack of privacy Addition of new Overcrowding programs Use temporary park homes/ porter camps

CLINIC MAINTENANCE SITUATION COMPLICATIONS RESOLUTION Poor maintenance Communication lines undefined /absence of responsible contact person Structured visits to clinics by identifiable maintenance person

REPORTING PROCEDURE SITUATION COMPLICATIONS RESOLUTION Duplication of reporting procedures Organizational structure problems/ Parallel reporting structures / procedures Simplified organizational structure with direct reporting lines

Current structure HOD CHO (DDG) COO (DDG) CFO (DDG) CD CD D D Province DD DD Area 1 Manager (CD) Finance District Manager DHS HR … … … District Manager Hospital Manager Area District Hospital 2 Hospital. . … … … … PHC Service support Ugu District Manager … Clinical Programmes e. Thekwini District Manager … Ilembe District Manager Area Manager (CD) Area 3 Manager (CD) … District Manager Area 2 Manager (CD) Lack of integration between hospital and clinics, lack of clarity of roles and responsibilities Duplication HR Finance/ Systems Medical Nursing PRO 12 Institution …

…causes delays HOD CHO (DDG) COO (DDG) CD CD D D CFO (DDG) IT Committee D Procurement Province DD DD Area 1 Manager (CD) District Manager Ilembe Clinical Programmes District Manager e. Thekwini Area 2 Manager (CD) District Manager Ugu District IT Service Finance support Committee Area Manager (CD) Area 3 Manager (CD) District Manager DHS HR District Manager Hospital Manager Area District Hospital 2 Hospital. . … … … … PHC HR Finance/ Systems Medical Nursing Need new printer – big delay in outpatients!! PRO 8 months!! 13 Institution …

Proposed structure Province HOD DDG (Planning) DDG Service Delivery (COO) DDG (HR) DDG Finance District Managers use support structures of Province but sit at the “coal face” District Manager NHLS separate structure District Manager Hospital Manager 1 HR Finance/ Systems District Manager Hospital 2 Medical District Manager Hospital 3 Nursing Clinic 1 District Manager Hospital 4 PRO District Manager Hospital 5 Hospital 6 Clinical Manager Clinic 2 Clinic 3 District Manager Public Health Local Clinic… 14

SIYABONGA THANK YOU DANKIE ENKOSI RE A LEBOGA