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National Health Act, 2003 (Act No. 61 of 2003)

Regulations

Procedural Regulations Pertaining to the Functioning of the Office of Health Standards Compliance and Handling of Complaints by the Ombud

Annexure

Prescribed Forms

OHSC 1 : Health establishment information

 

OHSC 1

 

INFORMATION ABOUT THE HEALTH ESTABLISHMENT

 

All health establishments and users that are required by the Office to provide information relating to norms and standards, in terms of section 79(2)(b) of the National Health Act, 2003 (Act No. 61 of 2003), must do so by 31 March of each year. If the person in charge, referred to in regulation 6(1), fails to provide the Office with the required information within the specified period, the Office must refer the matter to the head of the national or relevant provincial department of health or the department of a municipality or the head of the health establishment, as the case may be, for intervention in accordance with the intervention policy and procedure of the relevant authority.

 

Name of health establishment

 


Legal status


Details of relevant authority (head of national, provincial or municipal health department, head of the health establishment or private hospital group)


Physical address of health establishment


GPS coordinates - latitude and longitude


Contact details of the Health Establishment including—

telephone no.

e-mail address

website details


Name of the person in charge


Contact details of the person in charge


Category of health establishment (according to Policy on Management of Public Hospitals published in Government Gazette No. 34522 of 12 August 2011);


Health district in which the health establishment falls


Services offered by speciality, including number of beds by service or number of consulting rooms


Operating days and times:

In patient unit

Outpatient unit


Emergency unit

Pharmacy


Human resources. Number of staff by category:

Health care professionals

Management

Administrative

Clinical support services


Results of the most recent self-assessment against norms and standards


Chief Executive Office

 

(signature)

 

 

Date