Health and Wellness

(a) The Western Cape Department of Health and Wellness is implementing a range of measures to improve service delivery at provincial hospitals, within the context of rising service demand, constrained resources, and changing population health needs.

These measures include:

1. Stabilising the core service platform
   The Western Cape Department of Health and Wellness is focused on stabilising hospital services after a prolonged period of austerity, while progressively implementing service reforms that improve health and wellbeing across the life course.
2. Strengthening patient flow and referral pathways
   Hospitals are managed as part of an interconnected health ecosystem, where patients are referred to the appropriate level of care. This includes strengthening coordination between primary healthcare, district hospitals, regional hospitals, central hospitals, emergency services, and specialised services to ensure that patients are treated at the most appropriate level.
3. Improving clinical prioritisation and bed management
   Hospitals continue to use triage, clinical prioritisation, discharge planning, and bed management processes to ensure that urgent and high-risk patients are attended to timeously, while also managing elective and planned care as far as available resources allow.
4. Supporting surgical recovery and service efficiency
   Where feasible, hospitals are using measures such as additional theatre lists, prioritisation of urgent cases, in-reach and outreach support, and improved scheduling to address surgical backlogs and reduce delays.
5. Investing in infrastructure and maintenance

The Western Cape Department of Health and Wellness continues to prioritise infrastructure development, maintenance, and facility improvements, guided by service need, population growth, safety, and available budget. This includes both major infrastructure projects and smaller projects that improve patient flow, safety, and the care environment.

6. Using digital systems and data for better management
   The Western Cape Department of Health and Wellness is prioritising digital systems and health information to support planning, monitoring, patient administration, service coordination, and decision-making. These systems help identify pressure points and support more responsive management across the platform.
7. Improving quality of care and patient experience
   Patient experience, complaints, compliments, suggestions, patient safety incidents, clinical governance, and quality improvement processes are monitored to identify areas requiring intervention. Facilities are expected to use this information to improve responsiveness, communication, and service quality.
8. Supporting staff and strengthening capacity where possible
   The Western Cape Department of Health and Wellness continues to manage staffing within available resources, including prioritising critical posts, supporting skills development, using task-sharing where appropriate, and strengthening clinical governance and supervision.
9. Reducing avoidable pressure on hospitals
   The Western Cape Department of Health and Wellness is strengthening primary healthcare, prevention, chronic disease management, community-based services, medicine collection systems, and differentiated models of care. This helps reduce avoidable hospital visits and supports earlier intervention before conditions become more severe.

(b) The Western Cape Department of Health and Wellness will ensure that patients receive timely and quality care across all regions of the province through a combination of province-wide planning, local operational management, and ongoing monitoring.

This includes:

1. Equitable planning across regions
   Services are planned according to population need, disease burden, geography, available infrastructure, and referral patterns. Rural and remote areas require particular consideration because distance, transport, and limited alternative services can affect timely access to care.
2. A whole-system approach to service delivery
   The Western Cape Department of Health and Wellness does not view hospitals in isolation. District, regional, tertiary, central, emergency, specialised, and primary healthcare services are managed as part of one provincial health ecosystem to support access to the right care, at the right time, in the right place.
3. Routine monitoring of service pressure
   Hospital performance is monitored through indicators such as bed utilisation, emergency centre activity, theatre activity, outpatient activity, inpatient separations, average length of stay, patient safety indicators, complaints resolution, and patient experience feedback.
4. Clinical prioritisation of urgent patients
   Patients are prioritised according to clinical urgency. This ensures that emergency, life-threatening, and high-risk conditions are attended to first, while planned and elective care is managed according to clinical need and available capacity.
5. Quality and safety governance
   Facilities are expected to use clinical governance structures, patient safety reviews, complaints management, and quality improvement plans to identify risks and improve the standard of care.
6. Infrastructure and digital enablers
   The Western Cape Department of Health and Wellness will continue to prioritise infrastructure, maintenance, digital systems, and data-driven planning as key enablers of improved access and quality care.
7. Partnerships and integrated care
   The Western Cape Department of Health and Wellness will continue working with partners across government, civil society, academia, NGOs, and the private sector where appropriate, recognising that health outcomes are shaped not only in hospitals, but also in homes, schools, workplaces, and communities.

The Western Cape Department of Health and Wellness remains committed to improving access to person-centred quality care across the province. While demand remains high and resources remain constrained, the focus is on stabilising the service platform, improving efficiency, strengthening quality and safety, and ensuring that available resources are used where they can have the greatest impact for patients.