Anja Smith, Jodi Wishnia and Shivani Ranchod | December 2019
In this brief…
The 2019 revised NHI Bill uses the term accreditation to refer to the Fund’s own process of determining the eligibility of healthcare facilities and providers to contract with the Fund. Compliance with the process is mandatory for those wanting to contract with the Fund. This process encompasses certification by the Office of Health Standards Compliance (OHSC) that their standards and norms are met. This certification is only a subset of the accreditation requirement: there are other requirements that will also have to be met as part of the accreditation process such as (but not limited to): providing the minimum list of services specified; having an appropriate number and composition of staff given services that are being provided; adhering to treatment protocols and guidelines; and submission of information to the national health information system.
Given the focus on certification and accreditation in the revised NHI Bill (2019 version), we take time to explain these two concepts. We describe current approaches to the measurement and management of healthcare quality of care in South Africa and comment on the steps required to move from the current to the ideal.
In this brief, we explore how certification can be married with other quality indicators and health outcome data, public reporting and contracting to drive a holistic approach to quality that is rigorous enough to change healthcare provider behaviour. In our view, the ultimate aim should be to build a culture of continuous improvement and a health system that is focussed on outcomes that matter to patients in and of themselves.