If you run a general practice in South Africa, OHSC (Office of Health Standards Compliance) inspections are part of the landscape. But between seeing patients and managing your practice day-to-day, it can be difficult to know exactly where you stand – or where to start.
This summary breaks down the key compliance requirements from the Regulatory General Practice Inspection Tool v1.1, covering both the Administration & Practice Management and Clinical Care & Support domains. No overwhelming paperwork – just clear, practical guidance to help your practice meet the standard.
1. Administration & Practice Management
1.1 User Rights
Your practice must provide clear information about available services and how patients can access them. You also need a documented Complaints, Compliments, and Suggestions SOP that covers:
- How patients can submit a complaint
- What information is collected
- The investigation and redress process
- How resolutions are logged and communicated (within 12 months)
Maintain a complaints register with full details (name, reference number, date, and summary), and inform patients of the outcome in writing – by email or letter.
1.2 Access to Care
A triage or prioritisation system must be in place to identify and manage urgent cases – including life-threatening emergencies, frail patients, infants, and the acutely unwell. Your SOP should document the prioritisation procedure and how it is communicated to patients (for example, via a waiting-room notice).
1.3 Clinical Governance & Health Records
Your Health Records SOP must address filing, confidentiality, retention, access, release, archiving, and disposal – aligned with HPCSA Booklet 9, the National Health Act, and POPIA. Key requirements include:
- Annual training or orientation for all staff who handle records
- Archiving and disposal registers and certificates in line with HPCSA retention guidelines
- An Informed Consent SOP covering required information, legal standing, and emergency consent (HPCSA Booklet 4)
- Safe Injection and Surgical SOPs detailing aseptic technique, sterilisation, sharps management, and documentation
- Research SOPs (if applicable) including ethical approval, consent forms, and insurance disclosure
1.4 Infection Prevention & Control
- Maintain sufficient linen with clear clean/dirty segregation
- Train staff on standard precautions and transmission-based precautions
- Maintain SOPs for decontamination, sterilisation equipment testing, and pest control
- Hold valid SLAs for any outsourced decontamination or pest control services
1.5 Waste Management
Your Waste Management SOP must cover segregation, handling, storage, collection, and disposal. Keep a valid SLA for waste removal, monitor compliance, and document any corrective actions taken.
1.6 Adverse Events
A documented system must be in place for reporting adverse drug reactions and other adverse events. Reports must be submitted to the appropriate authorities and recorded internally.
2. Clinical Care & Support
2.1 Patient Information & Access
The following must be visibly displayed in your practice:
- Services provided and operating hours
- Complaints procedure and indicative pricing
- Results of patient experience surveys
- Emergency contact details (GP, after-hours, and EMS)
Keep copies of all referral letters on file, including the reason for referral, clinical summary, and receiving provider details.
2.2 Health Record Management
Every patient record must include name, ID or date of birth, contact details, next of kin, and a unique patient number. Each visit must be documented with date and time, allergies, assessments, management plan, prescribed medications, investigations ordered, referrals made, and follow-up plan. Records must be signed in permanent ink – no correction fluid.
A POPIA notice must be displayed, and all records – paper and digital – must be securely stored. Diagnostic results must be available, reviewed, communicated to the patient, and acted upon.
2.3 Informed Consent
Every surgical or invasive procedure requires a correctly completed, signed consent form on file – including patient details, the nature of the procedure, the date, and signatures from both the patient and provider.
2.4 Clinical Management & Emergency Preparedness
- Current national clinical guidelines (HIV, TB, NCDs, Maternity, Child Health) must be available in consulting rooms
- Emergency trolley or bag must be stocked with required equipment, medications, and consumables – all functional and within expiry date
- Emergency equipment checks must be documented monthly
- Resuscitation protocols must be displayed, and infection control standards maintained throughout
2.5 Infection Prevention & Control
Each service area must have:
- Working handwash basins with soap dispensers and paper towels
- Alcohol-based hand rub and laminated hand-hygiene posters
- Designated clean and dirty linen storage areas
Staff must be familiar with prophylactic immunisation protocols for high-risk exposure and know the decontamination procedures.
3. Self-Assessment Checklist
Use this checklist to evaluate your practice’s readiness before an OHSC inspection.
| Domain | Requirement |
|---|---|
| User Rights | SOP for complaints management (reporting, investigation, and redress) |
| Complaints register maintained and up-to-date | |
| Patients informed of complaint resolutions | |
| Services, hours, pricing, and complaints info visibly displayed | |
| Access to Care | Triage procedure in place and displayed |
| Emergency contacts displayed | |
| Health Records | Records SOP covers filing, retention, and confidentiality |
| Staff trained on records management | |
| POPIA notice displayed | |
| Secure storage for physical and electronic records | |
| Informed Consent | Consent SOP covers information, legal standing, and review |
| Signed consent forms on file for all surgical procedures | |
| Clinical Management | Current national clinical guidelines accessible in consulting rooms |
| Emergency trolley/bag checked monthly | |
| Emergency drugs and equipment stocked and unexpired | |
| Infection Control | Handwashing stations functional in all areas |
| Hand hygiene posters displayed | |
| Clean and dirty linen storage areas identified | |
| Infection prevention training records available | |
| Decontamination SOP and staff training records on file | |
| Pest control and waste management SLAs valid | |
| Waste Management | Waste segregation and disposal SOP implemented |
| Compliance monitoring and remedial actions documented | |
| Adverse Events | SOP for adverse drug reaction reporting in place |
| Evidence of reporting and review on file |
Elle Health & OHSC Compliance
Elle Health complies with all applicable clauses of the Regulatory General Practice Inspection Tools v1.1 that relate to data confidentiality, record management, and administrative integrity.
Our platform adheres to the Protection of Personal Information Act (POPIA), HPCSA ethical standards for record confidentiality, and maintains documented SOPs for complaints management, data retention, and information security.
Clinical, environmental, and infection control standards under the regulatory tools are not applicable to our operations as a non-clinical, digital service provider.
