Health

The health sector faces complex challenges. The effects of a depressed fiscal climate and rising service pressures brought on by the high burden of non-communicable diseases continue to be felt throughout the province. Coupled with this is the unnecessary burden alcohol-related injuries and conditions places on the health system.

Addressing long waiting times has been identified as a key intervention to improve the patient experience of health services, both through improving the patient experience of waiting and to reduce waiting times.

The Department developed a comprehensive set of strategies to address waiting times in a comprehensive and co-ordinated way.

Facility managers are provided with a tool box of interventions to reduce waiting times which includes mechanisms such as an appointment system, club systems for stable chronic patients, alternate site medication delivery and alternate sites to render service. Not all facilities employ the same methods, since it has to be implemented as permitted by resources (e.g. old infrastructure or high volume of patients per staff member).

The burden on our health facilities is much larger than they were designed for. There is always a tension between the escalating demand for services and the available resources. Shortage of beds is always relative to the demands on the service. In addressing the ever-increasing demand for services and reducing waiting times, the Department implemented several measures across health facilities and continues its ongoing wellness programmes amongst the public – so as to avoid requiring hospitalisation.

Despite the many challenges and significant financial constraints, the Western Cape Government: Health has persevered, focusing on service transformation strategies that enhance the effectiveness and efficiency of healthcare provision in the province, to improve the health status of its citizens. We have intensified our drive to provide person centred-care, mitigate against service pressures, and strengthen the primary healthcare platform.

The Department’s investment, over time, in key health system capabilities in terms of leadership and governance, service delivery models, infrastructure and information systems, has been central to our current successes. In an effort to reduce congestion the Primary care service is strengthened through the Community Orientated Primary Care (COPC) supported by Community Health Workers (CHWs). Through the COPC, CHWs perform household health screenings for diabetes, high blood pressure, TB and checks children’s immunisation status right in the comfort of your own home.

The 8 year waiting time to accessing arthroplasty (joint-and-hip replacement) services has been drastically reduced to 2 years with the introduction of an electronic waiting list. Uniformed clinical criteria for arthroplasty was developed and implemented across the service platform. The clinical criteria together with the time already waited is used to re-prioritise people using the electronic waiting list tool, ensuring that those who need it most, get equal access first.