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NSP ‘discussed’ with Department

17 Nov 2016

As the HSE was due to submit its National Service Plan for 2017 to the Department of Health following an earlier process of engagement, its Director General presented the current state of the health service to Oireachtas members, writes Gary Culliton

The HSE was due to submit its 2017 National Service Plan (NSP) to the Department of Health on November 15. The Executive is currently in discussions with the Department on the Plan, the Executive’s Director General Tony O’Brien told the Oireachtas Joint Committee on Health last week.

At the end of August, the HSE recorded expenditure of €8.925 billion against a budget of €8.902 billion — leading to a deficit of €22.7 million or 0.26 per cent, he said. Pensions and demand-led areas represented two-thirds or €15 million of the overall deficit with the remaining one-third, or €7.7 million, arising within operational service areas.

There were 909,468 emergency presentations in the year to August, an increase of 6.1 per cent on expected activity. ED patient experience time (PET) registrations in August were 4.8 per cent higher than the corresponding period in 2015. The INMO 30-day moving average for trolleys in the same month was lower than the corresponding month last year, by up to 5.6 per cent.

This year’s NSP has set a target that there will be no inpatient/day-case patient waiting longer than 36 months by year end. Hospitals are also required to reduce by half inpatient and day-case waiting lists for patients waiting 18 months or longer. At the end of August, 89 per cent of the inpatient/day cases were waiting shorter than 15 months.

In addition, 83 per cent of patients on the outpatient’s waiting list were waiting shorter than 12 months and 90 per cent were waiting shorter than 15 months.

Winter Plan

The HSE has an extra €40 million this year for the Winter Plan, to provide a comprehensive range of actions and measures, across community and hospital services, to increase the availability of community care, facilitate timely discharge from hospital and increase hospital capacity.

Specifically, the €40 million provides for an additional 950 new home-care packages, and 58 weekly approvals for transitional care to support discharges from acute hospitals. An additional 55 acute hospital beds are being provided across a range of hospitals as well as 18 step-down beds provided by the Mercy University Hospital in Cork.

The funding will support the expansion of minor injury services in Dublin for an additional 100 patients each week.

Community Intervention Team (CIT) services will be expanded, and there is an increase in funding for aids and appliances specifically to support targeted discharge of patients from hospitals. A targeted waiting list programme for orthopaedics, spinal and scoliosis is being implemented in designated sites by year end.

The outcomes to be achieved through the implementation of this plan, and through integrated work across community healthcare organisations (CHOs) and hospital groups, include a reduction of delayed discharge levels, and reduced numbers of patients on trolleys in emergency departments, as well as improved PETs.

CITs are now operating in 13 areas, and are expanding further for the coming winter period. Structured chronic illness programmes are under way for type 2 diabetes patients and asthma care for children. Improved access to diagnostic tests such as ultrasound is in place for GPs, while minor surgery is also under way at 20 GP practices around the country.

This programme of work is ongoing and scheduled to increase further in 2017 — enabled by developments such as the review of the GP contract and ICT enhancements such as Healthlink, eReferral, the individual health identifier (IHI) and the development of a shared electronic health record.

The 2016/17 Flu campaign, which was launched as part of this year’s winter planning, is also under way. This year’s campaign is targeting the challenges encountered in increasing uptake levels last year, with each CHO and hospital group required to develop a flu plan. Staff are a particular focus this year, with staff vaccination clinics being held in CHOs, supported by ‘peer-to-peer’ vaccination training. Additionally, poster campaigns, text messaging, screen-saver reminders and other innovative ideas are being used to encourage staff in particular to get the vaccine.

Mental Health
Within Mental Health the allocation of an additional €15 million to initiate new developments in 2017, with a recurring full year value of up to €35 million, will allow for the ongoing development of services in line with A Vision for Change.

Approval has been received for the awarding of the contract for the construction of the new National Forensic Mental Health facility at Portrane. This facility, estimated for completion in early 2020, will replace the existing Central Mental Hospital in Dundrum, with a modern facility providing 120 adult forensic beds, a 10-bedded Forensic Child and Adolescent Mental Health Unit and a 10-bedded Mental Health Intellectual Disability Unit.

There is an ongoing need to improve access to psychological therapies for children. Funding is in place to develop this service and approval is now awaited from the Department of Public Expenditure to recruit in excess of 100 assistant psychologists.

The post NSP ‘discussed’ with Department appeared first on Irish Medical Times.

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