In South Australia, private hospitals and private day procedure centres are licensed under the Health Care Act (2008) and associated Health Care Regulations
Private hospitals are defined in that Act as “being an entity (whether corporate or unincorporated and including a partnership or other structure) by which health services are provided, being health services that include services provided to persons on a live-in basis”. Institutions conducted by or on behalf of the State, including public hospitals and nursing homes, and premises licensed under the Supported Residential Facilities Act 1992 are not included in the definition of private hospital under the Act.
Private day procedure centres provide prescribed health services to patients who are admitted and discharged on the same day. Under the Health Care Act (2008), a person must not provide a ‘prescribed health service’ at unlicensed premises (maximum penalty: $60,000). A ‘prescribed health service’ is defined as involving the administration of:
General, spinal, epidural or major regional block anaesthetic; or
Intravenous sedation (only if greater than ‘conscious sedation’); or
Local anaesthetic (except provided by a general practitioner, or in general dentistry practice, or exclude by the Regulations*); or
Health services prescribed by the Regulations**.
*The Regulations exclude health practitioners registered with a national board and authorised under law to administer local anaesthetic from the requirement to perform local anaesthetic procedures in a licensed facility only. Topical local anaesthetic is also excluded.
** There are currently 5 prescribed classes of health services listed in the Regulations:
To obtain a licence, applicants must submit a completed application form together with any required documents to Health.Licensing@sa.gov.au. Please see the forms page for a listing of all relevant forms applicable to private health facility licensing. Details of the current fees applicable can be found on the private health facilities fees and charges page.
Before any building work is commenced an applicant for a licence for a new facility, or the licensee of an existing licensed facility, must apply to and receive written approval from the Deputy Chief Executive, SA Health, for the plans and specifications for the new or altered/extended facility. Submissions and architectural plans will be assessed against the Australasian Health Facilities Guidelines, as published by the Australasian Health Infrastructure Alliance, and Infection Control Standards and other relevant standards or guidelines, as applicable (depending on the nature of the services provided).
Before a licence is issued a physical site inspection will be carried out to ensure that the facility has been built in accordance with the approved plans and that it complies with the conditions of all relevant legislation. This inspection will only take place after the site has been completely finished and handed over to the applicant (commissioned), but prior to becoming operational.
More information on what the inspectors will be looking at is contained in the Private Health Facility Inspection and Evaluation Checklist for South Australia. Questions may also be asked to clarify work processes and procedures. Key areas of focus include:
The flow of clients through the service
The flow of equipment (dirty/clean) and how it is sterilised and stored
Reprocessing of equipment
Infection control processes
Emergency procedures for deteriorating clients, including oxygen, suction, emergency trollies, ability of barouches to fit through doors and extract clients unable to move, access for the ambulance service
Evidence of test results (eg air sampling, water quality) and commissioning documentation
Around 14 days following a successful site inspection, a licence will be issued, which may have certain conditions imposed. Only once this licence has been received can the site become operational.
Timeframe for processing of licences
The approximate timeframe to allow for the licensing process, assuming that a complete application has been submitted, comprises:
14 days to allow applications to be checked for completeness and a response to be sent
A minimum of two months for the application to be properly assessed against the relevant guidelines and standards (including time for liaison with the applicant and any other parties, as required)
A minimum of 14 days to allow for a physical site inspection to be arranged (once the the facility is ready for use)
A minimum of 14 days after the site inspection for a licence to be issued, after which time the site can become operational.
Upon the issue of a licence, SA Health will also inform the Australian Government Department of Health to advise that that it has no objection to a provider number being issued to the facility under the CommonwealthPrivate Health
Insurance Act 2007. If a facility wishes to be declared for private health insurance purposes, the Australian Government’s ‘Private Hospital Information Form’ must be completed and forwarded to the Australian Government Department of Health. This form, and further information about declaration for private health insurance can be found on the Australian Government’s Department for Health website.
Inspections and audits
Inspections are an important part of the initial process to grant and/or vary a licence. However, inspections can and will also occur at other times to ensure that all facilities are compliant with the SA licensing standards. In addition to onsite visits, compliance monitoring activities may also include paper audits, telephone contact and written correspondence. The type of visit or audit may be routine or may focus on a particular area. Facilities are provided with a report after each visit or audit, which may detail improvements to be made. These are tracked over time by the Health Licensing Unit in Quality Systems.
Ongoing compliance requirements
The Health Care Regulations 2008 specify the reports that must be submitted to SA Health on an annual basis. These reports are due by 30 April each year and are to be submitted to Health.Licensing@sa.gov.au, along with payment of the prescribed fee.
Under s87 of the Health Care Act 2008, an applicant or licensee has a right of appeal against a decision or order of the Minister in relation to private hospital licensing. The right of appeal is to the Supreme Court and must be instituted within 1 month of the making of the decision or order appealed against. The Supreme Court has the power to extend that 1 month period, if it is satisfied that it is just and reasonable in the circumstances to do so.
For more information please contact the Health Licensing Unit via email at Health.Licensing@sa.gov.au or via telephone on (08) 8226 6416.
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