SAQA All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.
SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED UNIT STANDARD THAT HAS PASSED THE END DATE: 

Investigate industry initiatives to quality control medical providers 
SAQA US ID UNIT STANDARD TITLE
242570  Investigate industry initiatives to quality control medical providers 
ORIGINATOR
SGB Insurance and Investment 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY
-  
FIELD SUBFIELD
Field 03 - Business, Commerce and Management Studies Finance, Economics and Accounting 
ABET BAND UNIT STANDARD TYPE PRE-2009 NQF LEVEL NQF LEVEL CREDITS
Undefined  Regular  Level 5  Level TBA: Pre-2009 was L5  6 
REGISTRATION STATUS REGISTRATION START DATE REGISTRATION END DATE SAQA DECISION NUMBER
Passed the End Date -
Status was "Reregistered" 		 2018-07-01  2023-06-30  SAQA 06120/18 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2026-06-30   2029-06-30  

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.  

This unit standard does not replace any other unit standard and is not replaced by any other unit standard. 

PURPOSE OF THE UNIT STANDARD 
This unit standard is intended for learners who work at a senior or strategic level in healthcare benefits administration and/or advise on medical schemes and products. It would be useful for intermediaries, risk managers in medical schemes, people in managed care, professionals who consult to medical schemes, Medical Advisors, Medical Scheme Fund Managers, Trustees and people who give advice to Trustees and other stakeholders.

The qualifying learner is capable of:
  • Researching international models for quality assurance of medical providers.
  • Analysing current South African quality assurance initiatives.
  • Suggesting ways of providing the most effective outcome for the patient at the least possible cost.
  • Analysing the impact of legislation on the rights of providers and patients. 
    		•

    LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    It is assumed that learners are competent in Communication and Mathematical Literacy at NQF Level 4. 

    UNIT STANDARD RANGE 
    The typical scope of this unit standard is:
  • Providers include, but are not limited to, doctors, pharmacists, hospitals, public and private institutions, clinical training institutions, auxiliary services and emergency response. 
    		•

    Specific Outcomes and Assessment Criteria: 

    SPECIFIC OUTCOME 1 
    Research international models for quality assurance of medical providers. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    International models are researched and compared for effectiveness. 

    ASSESSMENT CRITERION 2 
    Aspects of the various models that are appropriate for the South African situation are identified and suggestions are made as to how these could be implemented in South Africa. 

    SPECIFIC OUTCOME 2 
    Analyse current South African quality assurance initiatives. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    Aspects of medical provision that require quality assurance are identified with reference to different levels and consequences if there is no quality assurance in place. 

    ASSESSMENT CRITERION 2 
    Initiatives to quality assure different aspects of medical provision in South Africa are investigated and evaluated in terms of effectiveness. 

    ASSESSMENT CRITERION 3 
    Best practice in international and the South African situation is identified for benchmarking purposes. 

    ASSESSMENT CRITERION 4 
    The importance of accurate and accessible data in a quality assurance system is explained with examples. 

    ASSESSMENT CRITERION 5 
    Data needed to support a quality assurance system is identified and used to substantiate a decision. 

    SPECIFIC OUTCOME 3 
    Suggest innovative ways of providing the most effective outcome for the patient at the least possible cost. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    Solutions to ensure a minimum quality of care by medical providers are proposed with reference to the practical implementation. 

    ASSESSMENT CRITERION 2 
    A solution is presented, motivated and substantiated to relevant stakeholders to obtain buy-in. 

    SPECIFIC OUTCOME 4 
    Analyse the impact of legislation an the rights of providers and patients. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    Legislation and codes that address the rights of providers and patients are analysed in terms of how they work together to ensure quality. 

    ASSESSMENT CRITERION 2 
    The impact of legislation on actual service delivery is assessed for a specific provider. 


    UNIT STANDARD ACCREDITATION AND MODERATION OPTIONS 
  • Anyone assessing a candidate against this unit standard must be registered as an assessor with the relevant ETQA or ETQA where a Memorandum of Understanding (MOU) exists with the relevant ETQA.
  • Any institution offering learning that will enable achievement of this unit standard must be accredited as a provider through the relevant ETQA or ETQA where a Memorandum of Understanding (MOU) exists with the relevant ETQA.
  • Moderation of assessment will be overseen by the relevant ETQA according to the moderation guidelines and the agreed ETQA procedures. 
    		•

    UNIT STANDARD ESSENTIAL EMBEDDED KNOWLEDGE 
    N/A 

    UNIT STANDARD DEVELOPMENTAL OUTCOME 
    N/A 

    UNIT STANDARD LINKAGES 
    N/A 


    Critical Cross-field Outcomes (CCFO): 

    UNIT STANDARD CCFO IDENTIFYING 
    The learner is able to solve problems in proposing innovative ways to provide cost effective medical care. 

    UNIT STANDARD CCFO COLLECTING 
    The learner is able to collect, organise and critically evaluate information in researching international models and South African initiatives for quality assurance of medical providers. 

    UNIT STANDARD CCFO COMMUNICATING 
    The learner is able to communicate effectively in presenting, motivating and substantiating a possible solution. 

    UNIT STANDARD CCFO DEMONSTRATING 
    The learner is able to see the world as a set of related systems in analysing the impact of legislation on quality assurance. 

    UNIT STANDARD ASSESSOR CRITERIA 
    N/A 

    REREGISTRATION HISTORY 
    As per the SAQA Board decision/s at that time, this unit standard was Reregistered in 2012; 2015. 

    UNIT STANDARD NOTES 
    Search words: Healthcare Benefits Administration; healthcare delivery system; trustees; quality assurance, medical scheme providers. 

    QUALIFICATIONS UTILISING THIS UNIT STANDARD: 
      ID QUALIFICATION TITLE PRE-2009 NQF LEVEL NQF LEVEL STATUS END DATE PRIMARY OR DELEGATED QA FUNCTIONARY
    Elective  66611   National Certificate: Wealth Management  Level 5  NQF Level 05  Passed the End Date -
    Status was "Reregistered"     		 2023-06-30  As per Learning Programmes recorded against this Qual 


    PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS UNIT STANDARD: 
    This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.
     
    NONE 


    All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.