Statement on HSE National Service Plan, 2010
The Minister for Health and Children Mary Harney, T.D. today (Monday 8 February) announced her approval of the HSE National Service Plan 2010.
The Plan outlines how the HSE plans to deliver health and personal social services within its 2010 current budget of €14.069bn. It projects service activity levels for 2010 which are broadly in line with 2009 levels.
The Minister said “I welcome the fact that the Plan commits to treating people in a more effective way with no reduction in access to appropriate services. By reducing costs, and reforming the way services are provided, I am confident the HSE will deliver the services people expect and continue to improve health outcomes for the population.”
A target of €106m in non-pay savings has been set for the HSE in 2010. This is in addition to the continuation of measures that achieved savings of €280m in 2008 and €115m in 2009. The Minister said, “I believe that the savings target is certainly achievable without affecting client care in any way.”
“In relation to acute hospital services, the focus for 2010 will be on managing inpatient care activity levels, delivering a shift to care on a day case basis, where appropriate, and on performance improvements such as same day of surgery admission and minimising length of stay. There will be a particular focus on reducing the current variance across different hospitals for similar procedures”.
The Plan targets a reduction of 33,313 in emergency admissions targeted at those who are admitted for very short periods of time. The Minister said “This will be achieved through increasing access to the specialist skills and senior clinical decision making available in Medical Assessment Units, diagnostics and other ambulatory care services and by increasing access to diagnostics for at least 10,000 of those who, on an annual basis, are admitted only for that purpose”.
In line with the development of more detailed measures of activity, performance and patient experience by the HSE over recent years, there are further new, important measures being introduced this year, for example, in the areas of antibiotic use; primary care teams; waiting times for cancer treatment and for referrals for assessments upon reports of child abuse or neglect.
The Minister said, “I strongly believe that you can only manage what you measure. I have asked the HSE to focus on developing and reporting on these measures of patient experience, to enable us to see better the responsiveness of the health system, and to take actions to achieve the results we want.”
Under the provisions of the Health Act 2004, the Minister will now make arrangements for the approved Plan to be laid before both Houses of the Oireachtas and the HSE will also publish the Plan on its website.
Because of the savings that are being made in both pay and non-pay costs, the Government has been able to make available additional resources to assist the HSE in responding to priority demographic and other needs and to support ongoing reform of the public health services.
These measures will allow for:
- €97m to support the growth in the number of people qualifying for Fair Deal;
- €10m to bring Home Care Packages up to 5,100, benefiting 9,613 people;
- €230m to bring the numbers covered by a medical card to over 1.6m and to provide 114,436 GP visit cards;
- €20m for further development of cancer services nationally, including improvements in lung, prostate, rectal and pancreatic cancer treatment and radiotherapy treatment, as well as initiation of a colorectal cancer screening programme and implementation of a cervical vaccination programme;
- €15m for implementation of the Ryan Report recommendations (€14m for the HSE and €1m for HIQA);
- €55m for the H1N1 vaccination costs;
- €70m to support new service needs arising from demographic changes in the areas of haemodialysis; transplants; paediatric transport; adult critical care; paediatric neurosurgery/critical care; neonatal hearing; childcare and fostering; immunology; out of hours childcare and disability, mental health and addiction services;
- a minimum of €17m in innovation funding to support innovation in service delivery.
Further service levels outlined in the Plan include:
- 10,000 urgent referrals and 22,000 non urgent referrals for breast cancer;
- 100% of patients requiring urgent colonoscopy receiving access within 4 weeks.
- 540,993 inpatient discharges;
- 689,310 day cases;
- 3,394,882 outpatient attendances.
- 100% of patients admitted or discharged within 6 hours of emergency department registration;
- 1,190,435 emergency presentations;
- 330,298 emergency admissions.
- 394 primary care teams;
- 22,130 patients receiving orthodontic treatment;
- 1,195,945 dental treatments;
- 880,000 GP out of hours contacts.
Children and Families
- 5,700 children supported in care;
- 477 referrals to family welfare conferences.
- 11.98m home help hours benefiting over 54,500 people;
- 9,613 persons in receipt of home care packages.
- 7,705 residential places for persons with an intellectual disability and autism;
- 834 residential places for persons with a physical and/or sensory disability.
- Supporting 15,702 admissions to acute inpatient units for mental health (adults and children);
- 61 community child & adolescent mental health teams, including day hospital teams and paediatric liaison teams.
- 3,614 persons receiving palliative care;
- 8,775 clients receiving methadone treatment.
New performance measures
The Plan also commits to the development and reporting of additional performance measures in 2010 including:
- a range of measures in the quality and clinical care area, including antibiotic consumption rates;
- the percentage of primary care teams that are implementing structured diabetes care and structured asthma prevention and care;
- waiting times for assessment following a referral of child abuse or neglect
- elder abuse measures;
- waiting times from GP referral to attendance at outpatient departments and from outpatient departments to admission;
- waiting times for lung, prostate and rectal cancer treatment.