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Electronic Health Records - VA Needs to Identify and Report Existing System Costs
Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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US Government Accountability Office
, issued in 2019
Risk cases: 3
Staff scheduling in government institutions
Scheduling irregular hours work Danish Rigsrevisionen shows in their study problems with staff scheduling in government institutions where employees are required to work irregular hours. Optimized staff scheduling contributed to reducing payroll costs. On the other hand, problems with rearrangement of work, recording working hours, optimisation of staffing levels and analysis of overtime triggers - add up to high costs of workforce. IT is not always used as ally either.
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Scheduling irregular hours work Danish Rigsrevisionen shows in their study problems with staff scheduling in government institutions where employees are required to work irregular hours. Optimized staff scheduling contributed to reducing payroll costs. On the other hand, problems with rearrangement of work, recording working hours, optimisation of staffing levels and analysis of overtime triggers - add up to high costs of workforce. IT is not always used as ally either.
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National Audit Office of Denmark
, issued in 2015
Risk cases: 5
Identifying and meeting central government's skills requirements
Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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National Audit Office
, issued in 2011
Risk cases: 6
Centralisation of support services of state authorities
Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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National Audit Office of Estonia
, issued in 2018
Risk cases: 2
State funds spent on development, operation and using of data centres services
The aim of the audit was to scrutinise the management of funds spent on building and operating the national data centre (hereinafter “STC1 data centre”), including the expenditure of selected ... organisational units of the state on buying hosting, server-housing and other related services. The audited period was between 2010 and 2014; where relevant, the preceding period was also scrutinised. Audited ... entities: Ministry of the Interior (“MoI”); Ministry of Finance (“MoF”); STÁTNÍ TISKÁRNA CENIN, state firm (state banknote printing firm, hereinafter “STC” or “the state firm”). The audit was conducted ... ... Risks steming from uncoordinated strategy ... SAI of Czech Republic analysed consequences of failures in strategic IT management at the state level. Lack of coordination and implementation rules reduced practical role of the ministry whose task ... was to guard high quality standards for all crucial IT systems in the state administration. Next consecquences were (among others) risk of uneconomical results of large IT investment and risk of inefficient ... supply of services, as well as opposite results of workforce reduction.
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The aim of the audit was to scrutinise the management of funds spent on building and operating the national data centre (hereinafter “STC1 data centre”), including the expenditure of selected ... organisational units of the state on buying hosting, server-housing and other related services. The audited period was between 2010 and 2014; where relevant, the preceding period was also scrutinised. Audited ... entities: Ministry of the Interior (“MoI”); Ministry of Finance (“MoF”); STÁTNÍ TISKÁRNA CENIN, state firm (state banknote printing firm, hereinafter “STC” or “the state firm”). The audit was conducted ... ... Risks steming from uncoordinated strategy ... SAI of Czech Republic analysed consequences of failures in strategic IT management at the state level. Lack of coordination and implementation rules reduced practical role of the ministry whose task ... was to guard high quality standards for all crucial IT systems in the state administration. Next consecquences were (among others) risk of uneconomical results of large IT investment and risk of inefficient ... supply of services, as well as opposite results of workforce reduction.
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Supreme Audit Office of Czech Republic
, issued in 2015
Risk cases: 7
Use of consultants and temporary staff
New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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National Audit Office
, issued in 2016
Risk cases: 7
Conflicts of interest
First, recognise the conflicts of interest are a real risk the British NAO gathered a significant amount of intelligence on conflicts, particularly in the health and education sectors. These are areas of government where services are increasingly commissioned and delivered by parties at arm’s-length to departments. Conflicts of interest can occur naturally as a product of the way a system is designed and most often arise from operational situations.
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First, recognise the conflicts of interest are a real risk the British NAO gathered a significant amount of intelligence on conflicts, particularly in the health and education sectors. These are areas of government where services are increasingly commissioned and delivered by parties at arm’s-length to departments. Conflicts of interest can occur naturally as a product of the way a system is designed and most often arise from operational situations.
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National Audit Office
, issued in 2015
Risk cases: 8
Homelessness
Homelessness grows despite increased spendings to reduce it British NAO analyses the root-causes of unsuccessful effort to reduce homelessness in England. They point at a side effect of the Goverment reform of welfare reform and at lack of full impact assessment.
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Homelessness grows despite increased spendings to reduce it British NAO analyses the root-causes of unsuccessful effort to reduce homelessness in England. They point at a side effect of the Goverment reform of welfare reform and at lack of full impact assessment.
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National Audit Office
, issued in 2016
Risk cases: 3
The effectiveness of Official Development Assistance expenditure
Need of more coordination and transparency The audit of the UK's Official Development Assistance revealed among others: fragmented responsibilities and difficulties in review and reporting. These led to difficulties in assessment of effectiveness of the assistance and of progress in implementing the UK Aid Strategy.
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Need of more coordination and transparency The audit of the UK's Official Development Assistance revealed among others: fragmented responsibilities and difficulties in review and reporting. These led to difficulties in assessment of effectiveness of the assistance and of progress in implementing the UK Aid Strategy.
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National Audit Office
, issued in 2019
Risk cases: 4
Performance measurement by regulators
Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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National Audit Office
, issued in 2016
Risk cases: 2