- lay down requirements about the services that shall be offered to the population
- lay down requirements about the quality of services
- regulate the work of health care personnel who have authorization
- give users of health and social services rights, for example, according to the Patients’ Rights Act.
Supervision applies to all statutory services, irrespective of whether they are provided by publically owned hospitals, municipalities, private businesses or health care personnel who run their own practice.
The Norwegian Board of Health Supervision is a national public institution organized under the Ministry of Health and Care Services. The politically adopted acts and regulations provide the framework for the services that shall be supervised.
However, the supervision authorities work independently of political management. To a large extent, they decide themselves which services to give priority to with regard to supervision, and which areas supervision shall include. Among other things, priorities are determined on the basis of information about risk and vulnerability.
The supervision authorities shall help to ensure that:
- the needs of the population for health and social services are met
- services are provided in accordance with sound professional standards
- deficiencies in provision of services are prevented
- resources are used in an appropriate and effective way.
Supervision reports, results and experience from supervision, information about supervision methods, and other types of information, are available to the public on this website, in Norwegian. We have a lot of contact with the mass media and professional organizations. Our policy of transparency is necessary, so that the findings of supervision can be used by the services as a basis for learning and quality improvement. In order for people to have confidence in supervision, it is necessary for the professions, consumer organizations and the public to be able to criticise our knowledge base, our methods and our results.
Area surveillance
Area surveillance is supervision with an overall perspective. It involves collecting, organizing and interpreting information about health and social services. Such information provides the basis for evaluating whether needs are met (are people offered the services they require?) and whether the quality of services is adequate (do the services that are provided meet the requirements laid down in the legislation?). Reports from area surveillance are distributed to the services and to the public.
Planned supervision of services
System audits is the method that is used to supervise services (municipalities, nursing homes, hospitals etc.). This method is internationally recognized. The organization is investigated by examining documents, carrying out interviews, reviewing the organization and carrying out sample tests. The report of the supervision includes a description of conditions or factors that are not in accordance with acts and regulations. These deficiencies are called nonconformities. The supervision authority follows up nonconformities until the requirements laid down in acts and regulations are met. Follow-up involves the management of the organization, and if necessary the owner (the municipality, the board of directors etc.).
Between 400 and 500 system audits of health and social services are carried out each year. Supervision reports are available to the public, and are looked at about one million times each year on www.helsetilsynet.no.
About half of all the supervision activities are carried out as countrywide supervision each year. The Norwegian Board of Health Supervision chooses the areas for countrywide supervision. This supervision is reported in separate reports. See reports for 2006:
1,
2 and
3.
The areas for countrywide supervision in 2007 were:
- municipal health and social services for adults with mental disorders
- dental services for people in priority groups
- respite care and support person services according to the social services act
the quality of services in emergency units in somatic hospitals.
The areas chosen for countrywide supervision in 2008 are:
- municipal services for vulnerable children
- specialized health services for adults with mental disorders.
The supervision authorites work actively to ensure that organizations that provide health and social services use supervision reports in their work with developing management systems and with improving the quality of services.
Individual cases of deficiencies in services
The Norwegian Board of Health Supervision in the Counties receive information about possible deficiences in services from many sources (patients, relatives, employers, the police, the mass media). About 2000 cases per year are investigated to see whether there has been a breach of acts or regulations. This is called incident-related supervision.
If deficiencies are identified, the Norwegian Board of Health Supervision can give an administrative reaction against the organization in the form of instructions to correct the situation, or an administrative reaction against health care personnel who have authorization. This can be a warning, withdrawal of the right to prescribe addictive drugs, or withdrawal of authorization. Each year about 50 health care personnel loose their authorization. Most of these are nurses. About 300 000 health care personnel have authorization in Norway. The most common reasons for loss of authorization are alcohol or drug addiction, or sexual abuse of a patient.
Reports of events that have led to, or could have led to, serious injury to a patient
The Norwegian Board of Health Supervision has responsibility for MedEvent – the reporting system for adverse events in specialized health services. This system collects reports of incidents that have occurred in specialized health services that have led to, or could have led to, serious injury to patients. Hospitals have a statutory duty to report such events.
These events shall be a source of information for the organizations to learn from, both information from incidents that have happened in their own organization, and information published in the annual reports from MedEvent. See summaries
2001-2002,
2003,
2004,
2005.
Complaints about services and failure to meet patients’ rights
The Patients’ Rights Act gives the population many rights relating to health services.
The Act contains provisions about:
- essential health care
- assessment by a specialist within 30 days
- choice of hospital
- the right of access to and the right to correct patient records
- client participation
- information.
There are also provisions about:
- the special rights of children
- consent to health care
- individual plans for people who require several different types of services.
Complaints about failure to meet patient’s rights are dealt with by the Norwegian Board of Health Supervision in the the Counties. There are between 500 and 1000 such complaints each year.
The Social Services Act contains provisions about the duty of the municipalities to provide services to the population, such as providing:
- information, advice and guidance that can contribute to solving or preventing social problems
- practical assistance and training for people with special needs for care because of illness, physical disability, age or other reasons
- respite care and salaries for people and families who care for clients who need a high level of care
- support persons for individuals and families
- places in institutions, sheltered housing and
- accommodation for people with special problems.
Complaints about these services are dealt with by the Offices of the County Governors. There are between 5 000 and 7 000 such complaints each year.
The Norwegian Board of Health Supervision is the superior authority for dealing with complaints, and isues guidelines, provides training, and carries out other measures to ensure that complaints are dealt with correctly and in a similar way in all the counties. Individual decisions about complaints cannot be appealed against to the Norwegian Board of Health Supervision.
The organizationThe supervision authorities are the Norwegian Board of Health Supervision (the central office), the Norwegian Board of Health Supervision in the Counties, and the Offices of the County Governors.
The Norwegian Board of Health Supervision (the central office) is the superior, national supervision authority. The office has about 85 employees, of which about 25 are lawyers, about 20 are doctors, 10-15 are other health care personnel, 5-10 are professionals within the field of social work and about 10 are social scientists.
At the level of the counties, supervision is carried out by the Norwegian Board of Health Supervision in the Counties (supervision of health services and health care personnel) and the Offices of the County Governors (supervision of social services).
The leader of the supervision services is the director general of the Norwegian Board of Health Supervision,
Professor Lars E. Hanssen (Ph.D).
- legislation
- a description of Norwegian health and social services
- a description of public administration of health and social services
- the annual supervision report with articles and statistics in full text
- summaries of all the publications of the Norwegian Board of Health Supervision
- links to other useful websites
Links to other web resources in English and other languages
The Ministry of Health and Care Services has responsibility for all health and social policy, apart from social security benefits. The Norwegian Board of Health Supervision is organized under this ministry.
Norwegian Directorate of Health is the competent authority within those two areas responsible for technical and certain administrative functions. It is subordinate to the Ministry of Health and Care Services and the Ministry of Labour and Social Inclusion.
The Norwegian Institute of Public Health is a national centre of excellence in the areas of epidemiology, mental health, control of infectious diseases, environmental medicine, forensic toxicology and drug abuse.
The Norwegian Knowledge Centre for the Health Services gathers and disseminates evidence about the effect and quality of methods and interventions within all parts of the health services. The uptake of this evidence by the health services is also an important goal for the Centre’s activities. The Centre measures and analyses the quality of selected health services in the light of the experiences of patients and clients.
The Norwegian Labour and Welfare Organisation (NAV) was established in 2006. NAV is a merger of three former organizations: the National Insurance Administration (state), the National Employment Service (state) and the Social Welfare System (municipal). Among other things, it has responsibility for pensions, social security benefits and employment measures.
Statistics Norway publishes statistics about health and social conditions, and health and social services.
WHO has a website with pages for each country. See “Countries” in the menu on the left-hand side.
OECD has well-organized statistics and other information about its member countries. See “Browse / By country” in the menu on the left-hand side.
Postal address:
Norwegian Board of Health Supervision, P.O. Box 8128 Dep, NO-0032 Oslo, Norway
Street address:
Calmeyers gate 1, Oslo, Norway
Office hours:
From 15 May to 14 September: 0800-1500 CET
From 15 September to 14 May: 0800-1545 CET
Updated 15 july 2008