Presentation to the Health Portfolio CommitteeNHLS 2013/2014 Annual Performance Plan

Sagie Pillay (CEO)

Prof. Perez (Chair)

Supporting a long and healthy life for all South Africans

Supporting a long and healthy life for all South Africans

Mission and Vision

Vision• To be the leader in pathology; service, surveillance and academic health sciences 

Mission• To provide quality, affordable and sustainable health laboratory services, train for

health science education and undertake innovative and relevant research. 

Values • Service Excellence: To meet and exceed client expectation in diagnostics service

delivery• Responsive: Striving for accurate and quality response to client requests• Ethical : Shared beliefs about what is important and how things are done• Accountable : Committed to diagnostics services, teaching and training• Customer service: Meeting the needs of our customers timely and proactively• Respect: Showing respect for our clients and partners by being open, truthful and honest

in all of our service renderings

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Supporting Documents

The following documents were used to inform the strategic discussion that yielded the 2013-2014 APP:•The Maputo Declaration on the Strengthening of Laboratory Systems, WHO, 2008•Moscow declaration on Non Communicable Diseases(NCD)•Government’s Programme of Action 2009 – Human Development Cluster: Health •NHLS Strategy 2010-2015(2011 Review)•NHLS Annual Report 2012/2013•National Service Level Agreement for NDOH•NHI Green Paper and related Planning Documents

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Planning Process

• This plan is aligned to the 5 year strategy plan of the NHLS and the of the NDOH.

• Based on an evaluation of the last two financial years.• Taken in to account reviews of the 2012-2013 Annual Performance

Plan.• Two day planning workshop of executives and Board.• Presented to the Board and approved• Presented to honourable Minister for Health and approved.

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NHLS 10 point plan

1. Developing a new service delivery model that is more affordable for the public sector;

2. Determine a best fit service delivery model;3. Deliver a quality, customer focused service;4. Align resources, support services and infrastructural

development for service delivery;5. Become laboratory services “Employer of Choice”;6. Prioritise innovation, teaching and research to be relevant,

appropriate and leading edge;7. Become the health information powerhouse; 8. Drive stakeholder collaboration;9. Position NHLS as the “Provider of Choice” for NHI; and10. Protect our community and environment.

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The 4 pandemics• Most severe and very expensive burden or pandemic is

that of HIV and AIDS and TB• Unacceptably high maternal and child mortality• Alarming and ever increasing incidence of non-

communicable disease i.e. high blood pressure and other cardiovascular diseases; Diabetes mellitus; chronic respiratory disease; the various cancers and mental health.

• The pandemic of violence and injury.

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National Service Level Agreements

Alignment with the National Service Delivery Agreement

• Output 1: Increasing Life Expectancy • Output 2: Decreasing Maternal and Child Mortality• Output 3: Combating HIV and AIDS and decreasing the burden of

diseases from Tuberculosis • Output 4: Strengthening the Health System Effectiveness

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National Service Level Agreements

• NHI -11 pilots Districts • Reengineering PHC and the DHS

• specialist teams• School health programme• Ward based PHC

• Increased through-put and New medical schools • New teaching hospitals

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Upscaling the Gene Xpert program

• Support the NDOH in its quest to urgently strengthen programs against TB, MDR-TB and XDR-TB

• Support the implementation of new HIV and AIDS strategies announced on World AIDS Day.

99

Support for NHI Initiatives

NHLS to support the NDOH (pilot studies and strengthening the health system) in the following areas:

•Quality improvement (Proficiency Testing)•Medical devices including equipment (Assessments)•Information management and systems support (Interfaces)

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Strategic Outcomes• Develop a new service delivery model that is more affordable for the

public sector• Determine a best fit service delivery model

• Deliver a quality, customer focused service• Align resources, support services and infrastructural development for

service delivery

• Become laboratory services “Employer of Choice”• Prioritise innovation and research to be relevant, appropriate and leading

edge

• Become the health information powerhouse• Drive stakeholder collaboration• Position NHLS as the “Provider of Choice” for NHI

• Protect our community and environment

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Develop a new service delivery model that is more affordable for the public sector

• Proposal for Alternative Funding Models for Teaching, Research and Surveillance

• Maintain annual price increase below inflation until 2013• Improved Electronic Gatekeeping• Continued Support (for NDOH) in rollout of GeneXpert

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Determine a best fit service delivery model

• Point of Care Testing - Policy/ Implementation Plan/ Rollout by NHLS

• Develop and Implement Total TAT methodology • Implement Standardised Laboratory Technology

Framework - automation, centralisation, decentralisation

1313

Deliver a quality, customer focused service

• Encourage customers to utilise Electronic Access to Laboratory Results

• Develop and Maintain internal accreditation system for peripheral labs. (ISO15189)

• Expand EQA programmes

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Align resources, support services and infrastructural development for service delivery

• Rollout Trakcare Lab to remaining laboratories • Create and Implement Health Technology Assessment

Unit • Continuous Productivity Improvements• Optimise National logistics tracking system

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Become laboratory services “Employer of Choice”

• Establish NHLS Academy ,Implement Management and Leadership Development Programmes

• Develop Succession Plan• One Performance Management System for ALL employees• Drive Organisational Culture

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Prioritise innovation and research to be relevant, appropriate and leading edge

• Innovate in systems and processes to improve laboratory and health service delivery

• Research output aligned to National Priorities• International benchmark against diagnostics best practices• Increased focus on Non-Communicable Diseases

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Become the health information powerhouse

• Develop IMU to provide appropriate information to stakeholders

• Provide single source of information• Deliver Enhanced Business Intelligence• Enhance Data Quality and Consistency• Provide Historical Intelligence• Provide quality Reports• Support stakeholder decision making.

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Drive stakeholder collaboration;

• Safeguard national assets by establishing a Biorepository - specimens for Teaching and Research

• Safeguard national assets by establishing Institutional Archives - recording pioneering ventures + historical "firsts”

• Develop and Implement Structure for Intersectoral Collaboration, including framework for alignment of priorities

• Create Stakeholder Management Strategy + Implement

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Position NHLS as the “Provider of Choice” for NHI;

• Prepare for NHI• Continued support for NHI pilot sites• Investigate Joint Ventures with other service

providers/Suppliers

2020

Protect our community and environment.

• Environmentally-sustainable disposal of Biomedical, Electronic and Laboratory Equipment waste

• Implement recycling of materials, including paper, plastic and glass at every NHLS site

• Implement Energy/Utility Savings in the operations

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Balanced Score Card

• Outlines the strategic objectives and KPI• Each objective has specific activities with SMART targets

quarter by quarter• Reviewed by Exco & monitored by CEO monthly.• Monitored and approved by Board quarterly• Review by Internal auditors quarterly • Report quarterly to NDOH and Treasury.

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Customer Perspective

VISION

VISION MISSION

To be a leader in Pathology; services,

surveillance and academic health

sciences

To provide Quality, Affordable and Sustainable health laboratory services, train for health science education and undertake health research

To be a leader in Pathology; services, surveillance and academic health sciences

100%

STRATEGIC OBJECTIVE

KEY PERFORMANCE INDICATOR

2008 Actual

2009 Actual

2010 Actual

2011 Actual

2012 Forecast

2013 Target

2014 Target

2015 Targ

et2016

Target2013

Weight

STRATEGIC OBJECTIVE

CUSTOMER PERSPECTIVE40%

CUSTOMER PERSPECTIVE

C1. Improve Customer Satisfaction CSI - Service n/a 54.4% 59.7%

66.6% 69.6% 69.6% +3% +3% 0.0%5%

C1. Improve Customer Satisfaction

C2. Improve Total Turnaround Times

TAT - TB Microscopy n/a n/a 57.0% 95.0% 90.0% 90.0% 90.0%90.0

% 0.0% 5%

C2. Improve Total Turnaround Times

TAT - CD4 n/a n/a 86.0% 86.0% 80.0% 85.0% 90.0%90.0

% 0.0% 5%

TAT - Viral Load n/a n/a 41.0% 52.0% 80.0% 85.0% 90.0%90.0

% 0.0% 5%

TAT - HIV PCR n/a n/a 55.0% 67.0% 80.0% 85.0% 90.0%90.0

% 0.0% 5%

TAT - Cervical Smear n/a n/a n/a 47.0% 60.0% 65.0% 70.0%75.0

% 0.0% 5%

C3. Improve Quality of Tests

Proficiency Testing - Excl Paracytology + Morphology n/a n/a n/a n/a 90.0% 95.0% 95.0%

95.0% 0.0% 5%

C3. Improve Quality of Tests

Proficiency Testing - Paracytology + Morphology n/a n/a n/a 70.0% 70.0% 75.0% 75.0%

75.0% 0.0% 5%

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Financial Perspective

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STRATEGIC OBJECTIVE

KEY PERFORMANCE INDICATOR

2008 Actual

2009 Actual

2010 Actual

2011 Actual

2012 Forecas

t2013

Target2014

Target2015

Target2016

Target2013

Weight

FINANCIAL PERSPECTIVE10%

F1. Achieve Budgeted Turnover Turnover 2 237 2 667 3 033 3 456 3 460 3 650 3 851 4 082 0 0%

F2. Spend overheads as per budget Overheads 1499 1801 2042 2353 2519 2 554 2 663 2 840 0 2.5%

F3. Spend materials as per budget Material % of Sales 27.5% 30.2% 29.8% 25.1% 26.6% 27.3% 26.7% 26.2% 0.0% 2.5%

F4. Minimum Cash Collection Cash Received Rm n/a n/a n/a n/a

4 536 4 786 5 049 5 352 0 0%

F5. Improve payment to creditors Creditor Days n/a

59

45

62

40 40 40 40 0 0%

F6. Improve collections from debtors Debtor Days 114 147 130 154 45 45 45 45 0 5%

Employee Perspective

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STRATEGIC OBJECTIVE

KEY PERFORMANCE INDICATOR

2008 Actual

2009 Actual

2010 Actual

2011 Actual

2012 Forecas

t2013

Target2014

Target2015

Target2016

Target2013

Weight

EMPLOYEE PERSPECTIVE30%

P1. Improve Employee Satisfaction ESI n/a n/a

2.66

2.66

2.80 2.80

2.90

2.90

- 5%

P2. Maintain low staff turnover rate Staff Turnover Rate n/a n/a 7.8% 10.0% 10.0% 10.0% 10.0% 10.0% 0.0% 5%

P3. Maintain a low vacancy rate Vacancy Rate n/a n/a n/a 20.0% 10.0% 5.0% 5.0% 5.0% 0.0% 5%

P4. Improve EE profile EE n/a n/a 88.0% 60.0% 60.0% 60.0% 60.0% 60.0% 0.0% 5%P5. Improve BBBEE procurement BBBEE Procurement n/a n/a n/a 45.0% 52.5% 55.0% 55.0% 55.0% 0.0% 2.5%

P6. Improve BBBEE status BBBEE Level n/a n/a n/a

8

6 5 4 3 0 2.5%

P7. Maintain high Registrar pass rate Registrar Pass rate n/a n/a n/a 60.0% 60.0% 60.0% 60.0% 60.0% 0.0% 5%

Internal Perspective

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STRATEGIC OBJECTIVE

KEY PERFORMANCE INDICATOR

2008 Actual

2009 Actual

2010 Actual

2011 Actual

2012 Forecas

t2013

Target2014

Target2015

Target2016

Target2013

Weight

INTERNAL PERSPECTIVE20%

I1. Achieve Lab. accreditation

SANAS Accreditation - Academic Labs n/a n/a n/a 64.0% 70.0% 75.0% 85.0% 100.0% 0.0% 5%

 SANAS Accreditation - Regional Labs n/a n/a n/a 6.0% 30.0% 50.0% 75.0% 100.0% 0.0% 5%

I2. Improve translation of research

Research Reports submitted to influence policy n/a n/a n/a n/a

2 3 4 5 0 5%

into serviceResearch Reports translated into service n/a n/a n/a n/a

2 3 4 5 0 5%

NHLS 2013-2014: Activities

• For detailed deliverables for 2013-2014, Refer to Table B2 , Page 12 of 26 of APP

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2013-2014 BudgetAssumptions

• Inflation 5.9%• Salary Increase 6.6% • Volume Increase 0.0%• Test Price Increase 4.0%• Debtor Days 45 days• Creditor Days 40 days• Budget Cash Cover 1.2 months• Targeted Cash Cover 2-3 months

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Budget Summary(in Millions)

2929

Debtors and Creditors Days

3030

Debtors Days by Province

3131

Capital Expenditure

RMillions• Land and Buildings 212• Laboratory Equipment 66• Computer Equipment and Software 83• Furniture + Fittings 8• Office Equipment 30• TOTAL 399

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Conclusion

On behalf of the Board, our thanks to the honourable chair and members for your support and guidance .

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Questions

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