​​The Ideal Clinic Framework was introduced in 2013 as a way of systematically improving the quality of care provided at primary healthcare facilities, by introducing set criteria that facilities have to adhere to.

In the last 18 months, the number of Ideal Clinics in Cape Town has increased from three to 57, with a target of 83 compliant facilities by 2019/20. Across the province, Ideal Clinic status has been awarded to 54% of primary healthcare facilities.

‘The Ideal Clinic framework is an important tool because it sets out norms and standards that have to be attained, but also sustained in order to retain the status. Not only does it clarify expectations for staff, but it is also a clear service level agreement for clients.

‘The City of Cape Town fully supports this initiative and, while we recognize that there are many challenges in the provision of primary healthcare, we are also very proud of the advances made by City Health in the last decade, in partnership with a number of non-governmental organisations and the Western Cape government. Not only have there been notable achievements in the provision of basic services, but there have also been a number of additional offerings tailored to meet the needs of different groups,’ said the City’s Mayoral Committee Member for Safety and Security; and Social Services, Alderman JP Smith.

The gains include, but are not limited to:

• A drop in the total number of tuberculosis (TB) cases from a recorded high of nearly 30 000 cases in 2010 to just over 23 942 cases in 2016. The drop coincides with increasing anti-retroviral coverage. The cure rate for new smear-positive TB has been maintained at over 80%. In addition, the decentralized management of drug-resistant TB at primary care level has increased access to treatment for these patients, reducing the number of days before they are started on medication.
• By the end of this financial year, the number of City clinics offering anti-retroviral treatment (ART) will have grown to 57. This means easier access to ART and we have already submitted plans to further increase the number of sites.
• The introduction of the anti-retroviral club system whereby stable clients responding well to therapy are placed in clubs at their local facility and receive repeat medication, by appointment, without having to see a clinician. This system has allowed the rollout of ARTs with reduced crowding at facilities and has improved the retention in care rate.
• To address health issues specific to men, and to increase the number of men accessing health services, the first male clinic was opened in Site C, Khayelitsha in 2007. Since then, similar sites have been opened in Gugulethu and Bellville, with two more facilities opening in Khayelitsha. The clinics offer primary healthcare services; education on safe sex; sexually transmitted infection diagnosis and treatment; and HIV testing and counselling. The City works in conjunction with a non-governmental organisation, TB/HIV Care Association, and the Western Cape Health Department to promote safe adult male circumcision as a way to prevent the spread of HIV. We provide pre-circumcision checks, counselling and referrals to circumcision facilities.
• The introduction of youth services. The first youth clinic was opened in Site B, Khayelitsha in 2015. Since then, another youth clinic was opened at Site C. All other clinics now offer youth-friendly services with dedicated service times to cater for youth services. Some of these clinics are offering after hours services to the youth.
• As part of the Draft Operational Alcohol and Drug Strategy, the City opened the doors to its first Matrix® substance abuse treatment site in Tafelsig in 2008 and this year we celebrated the 10th anniversary of the programme. Currently we have six treatment sites in Khayelitsha, Mitchells Plain, Delft South, Parkwood, Milnerton and Manenberg, with plans to open two more.
• The City’s roll-out of health screening services in 2017 for older residents coincided with the International Day of Older Persons, celebrated annually on 1 October and aimed at improving access to health services for those aged 65 and older.
• In our attempt to further increase our basket of services and improve access to antenatal services, we announced the expansion of Basic Antenatal Care (BANC) to all City facilities in October 2017. This was a very significant launch, as antenatal care is crucial to reducing both mother and infant mortality. The service had only been available at Provincial Health facilities and at a limited number of City clinics before.
• The launch of a pilot project for electronic appointment bookings at eight facilities is in various phases, and is supported by a manual appointment system at all other facilities. The system includes features such as automated SMS appointment reminders and will be an invaluable tool in supporting staff to better organize their services, for the benefit of the community. 
• The Health Department is building a number of new clinics around the metropole as part of its capital expenditure plans. A prime example is Pelican Park Clinic which is anticipated to open its doors towards the end of February 2019. We are also awaiting final approval of the design of the new Fisantekraal Clinic. A total of R14 million has been set aside for this project in the current financial year.