On commission by the Government, Statskontoret (the Swedish Agency for Public Management) has carried out an agency analysis of the National Board of Forensic Medicine. We have analysed in overall terms the conditions, operations and results of the agency. In addition, we have given a number of proposals to the National Board of Forensic Medicine.
The National Board of Forensic Medicine carries out analyses and investigations within the areas of forensic medicine, forensic psychiatry, forensic genetics and forensic chemistry, chiefly for criminal investigation authorities. The agency carries out operations at nine departments in six locations around Sweden.
Stable conditions to perform its commission
Statskontoret considers that the government has provided the National Board of Forensic Medicine with stable conditions in which to carry out its commission. Its operations are highly regulated by statutes and its commission has remained largely unchanged since the agency was established in 1991. During the last five years, the agency has generally obtained the amount of grant it has requested. Compared with other authorities within the judicial system, the National Board of Forensic Medicine has received relatively large increases in its grants.
The National Board of Forensic Medicine has generally achieved good results
The overall picture obtained by Statskontoret is that the National Board of Forensic Medicine fulfils its commission in all essential aspects. Its operations are mainly controlled by its commission task and its target groups are generally satisfied with the duties and the service delivered by the agency. However, the agency needs to follow up its clients' needs and requirements more systematically.
The National Board of Forensic Medicine has a relatively constant number of incoming cases from year to year. Statskontoret considers that the areas of forensic chemistry, forensic genetics and forensic psychiatry have relatively good processing times. On the other hand, processing times for post-mortem examinations in forensic medicine operations have increased in recent years. This depends to some extent on a decision made by the agency to issue more forensic certificates itself rather than through contracted doctors. There are considerable differences in the processing times for post-mortem examinations between the different forensic medicine departments.
Scope for synergies in operations
Statskontoret considers that the National Board of Forensic Medicine needs to be better at profiting from synergies by using shared resources regarding personnel and skills.
In particular, Statskontoret believes that there is a potential for efficiency in forensic operations through changed working methods, shared case management and reviewing what service levels are reasonable to meet the needs of clients. The current decentralised and geographically spread organisation makes it more difficult to coordinate operations. Statskontoret considers that lack of operations managers with decision mandates for the forensic medicine and forensic psychiatric departments has been a major obstacle to efficient coordination.
Coordination must have priority in development work
The new management at the National Board of Forensic Medicine is currently putting more effort into developing internal control, which has been neglected in the past. Statskontoret considers that the management needs to make clearer priorities in their initiatives and to strengthen coordination in forensic medicine and forensic psychiatry operations. In addition to making operations more efficient, we believe that increased coordination could also improve quality assurance of the assessments in statements issued by the agency.
Statskontoret would like to underline the importance of involving employees in continued development work to ensure its impact on operations, particularly in an expert organisation such as the National Board of Forensic Medicine. The National Board of Forensic Medicine needs to organise and reduce the large number of steering documents at the agency.
Need for overall policy on the supply of qualified staff
The picture obtained by Statskontoret is that the National Board of Forensic Medicine has rectified the previous shortage of specialist doctors at the agency. It is important that the National Board of Forensic Medicine continues to work strategically to secure its supply of doctors. In 2014 the workload of forensic doctors also increased as a result of the decision by the agency to issue more forensic certificates by internal doctors. Statskontoret considers that the agency needs to make an overall review of its supply of qualified staff in all categories of operations. Having competent staff is a crucial factor for the National Board of Forensic Medicine to continue achieving good results.
Different functions of research need to be clearer
The National Board of Forensic Medicine needs to clarify the different functions of its own research. This has two aspects: how research should be a support for core operations and how research can be used to recruit and retain staff. The agency can then clarify the role and scope of research in relation to its core operations.
Statskontoret proposes that the National Board of Forensic Medicine:
- reviews the organisational structure, processes and working methods in order to improve coordination between the departments
- considers the option of setting up joint operations managers for forensic psychiatry and forensic medicine
- looks at the possibility of establishing a joint case management process within forensic medicine and forensic psychiatry
- systematically follows up clients' perceptions of its operations
- clears up and updates the agency's steering documents
- actively involves employees in ongoing development work
- reviews future needs of all professional groups at the agency and analyses how staff composition and skills can be developed
- reviews how the processing of forensic certificates can be developed in relation to the supply of doctors and other assignments at the agency
- clarifies the different functions of research at the agency and then clarifies the role and scope of research in relation to core operations.