Tony OBrien Director General Welcome 2017 National Service Plan Population Changes Population is set to increase by 07 between 2016 and 2017 and is projected to increase by 4 by 2022 ID: 734886
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Slide1
National Service Plan
2017
Tony O’Brien, Director GeneralSlide2
Welcome
2017
National Service PlanSlide3
Population Changes
Population is set to increase by
0.7% between 2016 and 2017and is projected to increase by 4% by 2022Between 2016 and 20173.7% increase in those aged 85 years and over
2017
National Service PlanSlide4
478,500
1.7m
Hospital Discharges
No. of patients seen for therapy in primary care
3.34m
OPD attendances
1.7m
People with a
medical card
GP Visit
Cards
8,170
28,875
Home Help Hours delivered to 49,000 older people
Older people in residential settings
23,100
Ambulance Emergency
Responses
People with disabilities
provided with a residential place
Adults seen by the mental health services
309,500
17,790
Children seen by CAMHs services
1.5m
PA hours provided to adults with a physical and / or sensory disability
27,000
1.5m
No. of CIT contacts
10.57m
2017
National Service Plan
2016 – What We
H
ave DeliveredSlide5
2017 Priorities
Improving the quality and safety of our services
Improving the health and wellbeing of the populationProviding care in a more integrated wayProgramme for Health Service ImprovementDeveloping a performing and accountable health serviceDeveloping our business supports and infrastructureImplementing eHealth IrelandImplementing the Health Services People Strategy 2015-2018, Leaders in People Services
2017
National Service PlanSlide6
Health Service Reform
Integrated Care
Continue to implement integrated care programmes for chronic disease prevention and management, older people, children, and patient flowContinue to work with service users, medical colleges and nursing and therapy leads to develop and implement processes that will improve the way in which care is providedHealth Service ImprovementSupport the decisive shift of service to primary careSupport local service improvement programmes
Develop programme offices in each of the service delivery organisationsContinue the development of the new Children’s HospitalContinue to develop the way in which our corporate ‘centre’ relates to Hospital Groups, CHOs and NASSlide7
Budget 2017
Total revenue budget available in 2017
is €13,948.5mIncrease on revised budget 2016 of €458.6m (3.4%) Full year effects of 2016 developments - €72.9mPay rate funding to support existing level of staff -
€118.1mNon-pay and demographics costs - €186.3mExpanding existing & developing new services - €81.3mWithin the €13,948.5m, €36.5m is being held by the DoH to fund specific initiatives
Separately, a provision of €439m in capital funding will be made available to the HSE in 2017, comprising €384m for building, equipping and furnishing of health facilities and €55m for ICT.
2017
National Service PlanSlide8
Approach to Financial Risk
Governance
– budgetary control, enhanced Accountability FrameworkPay – integrated strategy on recruitment, agency conversion and workforce planningNon-pay – targeted cost containment programmesIncome
– sustain and improve income generationActivity – ABF model within hospitals and the progression of a community costing framework
2017
National Service PlanSlide9
Expanding and Developing
Services - €81.3m
Acute Division - €9mNAS and Emergency Management - €1mPrimary Care- €12mSocial Inclusion-
€1.5mMental Health- €15mDisability Services - €11.8mServices for Older People- €10mPCRS - €20m
National Services - €1m
2017
National Service PlanSlide10
Funding Held
Department of Health 2017 - €36.5m
Primary Care: €18.5m for service developments including reduced prescription charges for > 70sMental Health: €15m to initiate new developments in 2017 with a recurring full year value of up to €35mSocial Inclusion: €3m to invest in services relating to addiction
2017
National Service PlanSlide11
Quality and
Safety
2017
National Service PlanSlide12
Quality and Safety
We
will establish a 3 year patient safety programme to: Develop the capacity of Hospital Groups, CHOs and NAS to manage safety and risk and improve qualityPlan, oversee and ensure clinical leadership for targeted safety initiatives including Healthcare Associated InfectionsImplement the new National Standards for the Conduct of Reviews and Patient Safety IncidentsImplement the revised Integrated Risk Management PolicyStrengthen accountability for safety, risk and quality by building capacity for gathering and analysing safety information and audit, including clinical audit
€13.1mSlide13
Health and Wellbeing
2017
National Service PlanSlide14
Health and Wellbeing
Budget 2017
:€233.3m for Health and Wellbeing (increase of 4.2%)Expected activity includes:155,000 women having a complete Breastcheck
mammogram242,000 women having one or more smear tests106,875 satisfactory BowelScreen FIT tests87,000 screenings for Diabetic RetinaScreen
clients13,000 smokers receiving intensive cessation support
2,440 people having completed a structured patient education programme for diabetes
33,000 official food control planned, and planned surveillance, inspections
€233mSlide15
Health and Wellbeing
Improve research capability and continue
to assess the health needs of the population as part of designing services to promote good physical and mental healthIntegrate illness prevention, early detection and self-management into our services through initiatives such as Making Every Contact Count and Self Management SupportImplement programmes to reduce the burden of chronic disease across the policy priority areas of Tobacco, Alcohol, Healthy Eating Active Living, Healthy Childhood, Sexual Health, Positive Ageing and Mental HealthDeliver Healthy Ireland actions through the development and implementation of Hospital Group and CHO
Healthy Ireland plansPopulation health protection and capacity building for prevention, surveillance and management of HCAIsCross-sectoral partnerships to improve health outcomes and address health inequalitiesSlide16
Primary Care
2017
National Service PlanSlide17
Primary Care
Budget 2017
:€808m for Primary Care Services (increase of 4%)€2.6bn
for PCRS (increase of 0.2%)€133m for Social Inclusion (increase of 2.6%)€76.5m for Palliative Care (increase of 1.2%)€21.5m
DoH held funding for service developments including reduced prescription charges for >70s and addiction services
Expected activity includes:
32,861
CIT Patient Referrals
1.5m
t
herapy
treatments in Primary Care
9,700 opioid
substitution
treatments (outside prisons)
3,620
p
atients receiving specialist palliative care treatment in their normal place of residence
1.7m medical
card
holders
covered
€3.6bnSlide18
Primary Care
Improve quality, safety, access and responsiveness of primary care services to support the decisive shift of services to primary care
Improve health outcomes for the most vulnerable in society including those with addiction issues, the homeless, refugees, asylum seekers, Traveller and Roma communitiesImprove access, quality and efficiency of palliative care servicesReimburse contractors in line with health policy, regulations and within service level arrangements governing administration of health schemesProcess applications for eligibility (under PCRS) within agreed timelinesStrengthen accountability and compliance across all services and review contractor arrangementsSlide19
Mental Health
2017
National Service PlanSlide20
Mental Health
Budget 2017
:€853m for Mental Health (increase of 3% on 2016 closing budget)Above includes :-€15m DoH held funding for additional spending in 2017 for
enhanced services up to €35m on a full year basis;€9.4m to stabilise growing pay cost to provide existing level of service.National Forensic Service : Significant Capital Investment in 2017 with Contact to be signed in Q1
Expected Activity (Examples):18,496 children attending CAMHs
74 CAMHs inpatient beds
335 admissions to CAMHs acute inpatient beds
39,321 adult referrals seen by mental health services
13,104 admissions to adult acute inpatient units
10,013 psychiatry of old age referrals seen by mental health services
€853mSlide21
Mental Health
Promote the mental health of the population in collaboration with other services and agencies including reducing the loss of life by suicide
Design integrated, evidence-based and recovery focused mental health servicesDeliver timely, clinically effective and standardised safe mental health services in adherence to statutory requirementsEnsure that the views of service users, family members and carers are central to the design and delivery of mental health servicesEnable the provision of mental health services by highly trained and engaged staff and fit for purpose infrastructure Slide22
Social Care
2017
National Service PlanSlide23
Older People
Budget 2017
:€765m for Services for Older People (increase of 3.6%)€940m for Nursing Homes Support Scheme (NHSS)Expected activity includes:Provide additional 496 places under NHSS(Fair Deal) to over 23,603 people
Maintain 2016 outturn of 10.57m home help hoursProvide an additional 300 Home Care Packages increasing the number of recipients to 16,750 people through the Winter InitiativeMaintain 190 Intensive HCPs included 60 funded by Atlantic PhilanthropiesProvide 152 approvals per week for transitional care and 167 in January and February 2017
€1.7bnSlide24
Older People
Continue to implement a reform and improvement programme in home care and short stay residential care
Provide each CHO with an audit and quality team to support home care reformContinue to rollout SAT and share learning's of the Integrated Care Teams as part of the ICP OPContinue to implement the National Dementia Strategy and the overall investment programme of €27.5m Slide25
Disability Services
Budget 2017
:€1.69bn for Disability Services (increase of €96.3m or 6%)Expected activity includes:Emergency Cases – (€16.2m supporting 395 people)New Residential Emergency places – 185New Home support/in home respite for emergency cases – 210
Home Support – PA Hours (€5.5m to maintain ELS in mainstream services)€5.5m additional budget to maintain ELS - 250,000 hours over 2016 target.Emergency Cases funding stream will support remaining 250,000 hours over target as part of new person centred initiative.
€1.7bnSlide26
Disability Services
New Directions including School Leavers (€10m Supporting 1,500 People)
Provide day service support for approximately 1,500 people leaving school/rehab training “Time to Move on from Congregated Settings” (€100m Capital Programme)223 People will move to Community Living.... 50 additional homes purchasedService reform fund (€45m over 3 years) - supporting transition and innovation
Commitment to stakeholder consultation and engagement Neuro Rehabilitation Strategy Framework for Neuro rehabilitation Strategy completed & an innovative pilot day service aimed at supporting people with severe acquired brain injury
National Policy on Safeguarding Vulnerable Persons at Risk of Abuse Slide27
Pre-Hospital Emergency Care
2017
National Service PlanSlide28
National Ambulance Service
Budget 2017
:€155m for NAS Expected activity includes:315,000 emergency ambulance calls5,589 clinical status 1 ECHO calls activated
125,985 clinical status 1 DELTA calls activated30,503 inter-hospital transfer calls26,846 intermediate care vehicle transfer calls
€155mSlide29
National Ambulance Service
Improve operational performance and outcomes for patients
Provide a flexible, safe, responsive and effective service to meet planned alternative models of patient careEnhance clinical competencies and governance arrangements to improve quality of care and patient safetyPlay an active role in improving the health needs of the populationDeploy the most appropriate resources safely, quickly and efficientlySlide30
Acute Services
2017
National Service PlanSlide31
Acute Hospital Care
Budget 2017
:€4.367bn for Acute Services (increase of 2.8%)€78.4m for National Cancer Control Programme (increase of 9.7%)Expected activity includes:
1.7m inpatient and day cases1.2m new Emergency Department attendances3.4m new and return outpatient attendances18,000 patients triaged as urgent presenting to symptomatic breast clinics3,300 patients attending rapid access lung clinics
2,600 patients attending rapid access
prostate clinics
€4.4bnSlide32
Acute Hospital Care
Ensure Hospital Groups have clear structures to govern and deliver quality care
Monitor and control healthcare associated infections (HCAIs)Increase critical care capacityImprove inpatient flow with continued focus on delayed discharges in partnership with social care services Continue to improve patient experience times in EDsImprove access to urgent and planned care by increasing efficiencies, streamlining processes and maximising capacity in hospitalsImplement the National Maternity Strategy 2016–2026 Implement the new cancer strategySlide33
Thank you
2017
National Service Plan