Hospital Groups

In May 2013, the Minister for Health published two reports on our hospitals – The Establishment of Hospital Groups as a Transition to Independent Hospital Trusts and The Framework for Development – Securing the Future of Smaller Hospitals.

The establishment of Hospital Groups is a key building block in delivering on the Programme for Government commitment to fundamentally reform our health services.

Each with their own governance and management, they will provide an optimum configuration for hospital services to deliver high quality, safe patient care in a cost effective manner. Groups It will allow integration and improve patient flow across the continuum of care.  Each group includes a primary academic partner, which will stimulate a culture of learning and openness to change within the hospital group. Smaller hospitals will be supported within the Hospital Group in terms of education and training, continuous professional development, the sustainable recruitment of high quality clinical staff and the safe management of deteriorating and complex patients

As Hospital Groups are implemented, of key importance is the early demonstration of progress towards a more a co-ordinated approach to the planning and delivery of services within and across the hospital groups. The establishment of Hospital Groups is potentially a key enabler for reorganisation of services across hospitals, with associated benefits in terms of providing care in the most appropriate setting, and delivering a safe quality service.

As part of the overarching policy framework for the implementation of Hospital Groups, the  Department of Health will develop national policy direction in relation to a number of key national and supra regional services.

Trauma services have been identified as a priority service requiring national policy direction on the basis of the international evidence of the benefits of major trauma networks. The Department of Health, in consultation with the HSE, will now develop a Policy on a Trauma Network for Ireland.  The Minister has established a Steering Group (chaired by Prof Eilis McGovern) to deliver on this objective and it is expected that the work of the Group will be completed in Q4 2016.

Background

Seven hospital groups have been established on a non-statutory administrative basis as follows: (i) RCSI Hospitals (Dublin North East); (ii) Dublin Midlands; (iii) Ireland East; (iv) South/South West; (v) Saolta University Healthcare Group (West/Northwest); (vi) UL Hospital Group (Midwest) and (vii) Children’s Hospital Group.

No. Composition of Hospital Groups
i Dublin North East: Beaumont Hospital; Our Lady of Lourdes Hospital, Drogheda; Connolly Hospital; Cavan General Hospital; Rotunda Hospital; Louth County Hospital; Monaghan Hospital. (Academic Partner: RCSI).
ii Dublin Midlands: St James’s Hospital; Tallaght Hospital; Midlands Regional Hospital, Tullamore; Naas General Hospital; Midlands Regional Hospital Portlaoise; the Coombe Women and Infant University Hospital. (Academic Partner: TCD).
iii Dublin East: Mater Misericordiae University Hospital; St Vincent’s University Hospital; Midland Regional Hospital Mullingar; St Luke’s General Hospital, Kilkenny; Wexford General Hospital; National Maternity Hospital; Our Lady’s Hospital, Navan; St Columcille’s Hospital; St Michael’s Hospital, Dun Laoghaire; Cappagh National Orthopaedic Hospital; Royal Victoria Eye and Ear Hospital. (Academic Partner: UCD).
iv South/South West: Cork University Hospital/CUMH; Waterford Regional Hospital; Kerry General Hospital; Mercy University Hospital; South Tipperary General Hospital; South Infirmary Victoria University Hospital; Bantry General Hospital; Mallow General Hospital, Lourdes Orthopaedic Hospital, Kilcreene. (Academic Partner: UCC).
v West/North West: University Hospital Galway and Merlin Park University Hospital; Sligo Regional Hospital; Letterkenny General Hospital; Mayo General Hospital; Portiuncula Hospital; Roscommon County Hospital. (Academic Partner: NUIG).
vi Midwest: Mid-Western Regional Hospital, Limerick; Ennis General Hospital; Nenagh General Hospital; St John’s Hospital Limerick; Mid-Western Regional Maternity Hospital; Mid- Western Regional Orthopaedic. (Academic Partner: UL)..
vii Children’s: Our Lady’s Children’s Hospital Crumlin; Children’s University Hospital Temple Street; paediatric service at Tallaght Hospital. (Academic partners: all)

A network of care with a new children’s hospital at the epicentre will reach out through satellites and regional centres to deliver comprehensive paediatric care for Ireland’s children and young people. The development of the new children’s hospital provided a key impetus for the establishment of the Children’s Hospital Group. Work is underway to integrate  the three children’s hospitals in advance of the move to the new hospital.

Group Board Chairs

Dublin North East – Ms. Anne Maher

Dublin Midlands – Dr. Frank Dolphin

Dublin East – Dr. Tom Lynch

South/South West – Prof. Geraldine McCarthy

West/North West (Interim) – Dr. John Killeen

Mid West – Prof. Niall O’Higgins

Children’s Hospital Group- Dr. Jim Browne

Group Management Teams also in place.

Development of Group Strategic Plans

The priority is to get all the Hospital Groups up and running as single cohesive entities. Each hospital group will be required to develop a strategic plan to describe how they will provide more efficient and effective patient services; reorganise these services to provide optimal care to the populations they serve; and how they will achieve maximum integration and synergy with other groups and all other health services, particularly primary care and community care services.

It is acknowledged that each group is at a different stage of implementation and the strategic planning process of each group may progress at a different pace so that issues including resource allocation and service configuration can be addressed appropriately.

Broadly, Hospital Groups must be able to demonstrate that they are using resources available to them in the most beneficial, effective and efficient manner in order to improve, promote and protect health and welfare by:

  • providing services to the population they serve within the financial envelope to which  they have been allocated;
  • delivering on quality and activity targets outlined in the HSE National Service Plan;
  • using all the services that are available in the Group in an integrated way;
  • complying with legislative and regulatory requirements, and
  • operating in manner that is consistent with national policy

The implementation of Hospital Groups will progress in a phased manner, during which time the implementation of Strategic Plans and delivery of key access, budgetary, patient safety and quality and human resources requirements will be subject to regular appraisal and review. Of key importance is the early demonstration of progress towards a more co-ordinated approach to the planning and delivery of services within and across the groups. This implementation approach provides for devolved decision making, fostering flexibility, innovation and local responsiveness, while also adhering to prescribed national service objectives and standards.

An Oireachtas All-Party Committee has been established to develop a single long-term vision for healthcare over a 10 year period. It is intended to progress discussions in this regard before giving further consideration to the issue of establishing Hospital Groups on a legislative basis.